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Standing At The Back Of The Bar, Lawrance Cuellar

Open Access Theses & Dissertations

Standing at the Back of the Bar is a collection of semi-autobiographical literary pieces, a hybrid of lyrical essays, poetry, and short stories, that are based on life experiences of the author, Lawrance Cuellar. The book begins with stories of the narrator growing up as a gay Latino in the very conservative, West Texas town of Amarillo in the 1960s and 1970s. The narrator describes and expresses the normalized and internalized homophobia and racism he experienced in the city. As the title for the manuscript implies, he is expected to “stand at the back of the bar” in deference to …

Covid-19 Prevention, Testing, And Treatment Seeking Among People Who Inject Drugs (Pwid) On The Us Mexico Border, Jorge Raul Puentes

Open Access Theses & Dissertations

The outbreak of the COVID-19 pandemic exacerbated the negative social determinants of health that affect medically underserved people who inject drugs (PWID) inhibiting their access to services, promoting infectious disease acquisition such as HIV and HCV, and overdose rates. The effects of the pandemic were more pronounced among Latino PWID communities. Participants of this study are 194 PWID residing in El Paso, Texas, and Cd. Juarez, Chihuahua along the US-Mexico border. Cross-sectional surveys were administered assessing environmental risk factors that impact COVID-19 acquisition and engagement in preventive behaviors. The purpose of this secondary data analysis study was to describe the …

The Perpetuation Of Hiv Risk In Latinx Immigrations: A Cross-National Perspective, J. M. Aleman

Open Access Theses & Dissertations

Research indicates that migration is a social determinant of health that increases the risk of acquiring HIV. What is less understood, however, are the pathways through which immigration influences HIV risk. This study employed a cross-national perspective and utilized a social determinants of health framework to understand how structural factors, such as economic conditions and immigration policies and their enforcement, influence HIV risk among migrants. While mobility, migration and displacement are associated with increased HIV risk, they are not inherently the cause but rather a condition under which vulnerability is increased indicating that other distal, upstream, or structural forces are …

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

Health Care Providers' Attributions Of Blame For Unintended Pregnancy And Hiv Acquisition Among Cisgender Women, Alison J. Goldberg

Dissertations, Theses, and Capstone Projects

Unintended pregnancy and HIV are both possible but preventable outcomes of vaginal sex, and both can be prevented in similar ways (condoms, daily oral medication, etc.). Despite these similarities, providers more readily prescribe contraception to cisgender women, compared to PrEP (Guttmacher Institute, 2021; Raifman et al., 2019). Providers’ differential willingness to prescribe each medication cannot be attributed merely to differences in women’s need for pregnancy prevention vs. HIV prevention, as women account for nearly 20% of new HIV infections (CDC, 2021). Through three studies, I examined whether perceivers’ support for harm reduction (i.e., prescribing PrEP/contraception) and behavior reduction (i.e., discouraging …

The Effectiveness Of Interventions To Increase Antiretroviral Therapy (Art) Adherence Among Latinx Men Who Have Sex With Men (Msm) With Human Immunodeficiency Virus (Hiv) In The United States: A Systematic Review, Everardo Leon

Doctoral Dissertations

The human immunodeficiency virus (HIV) continues to affect Latinx men who have sex with men (MSM). Interventions have been developed to improve antiretroviral therapy (ART) adherence, but little is known about the number of available interventions and their effectiveness to assist Latinx MSM. The current systematic review investigated the effects of interventions aimed at improving ART adherence for the treatment of adult Latinx MSM with HIV in the United States. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to communicate the results. The inclusion criteria comprised Latinx MSM with HIV, any type of …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

Stigma, Social Norms, And Culture As Mediators Of Hiv And Aids Incidence In South Africa, Skyeisha Swain

Public Health Capstone Projects

Human Immunodeficiency Virus (HIV) is a significant global public health issue with 38.4 million individuals living with the virus in 2021. South Africa has experienced the world’s largest HIV epidemic across all regions, with 7.5 million individuals living the virus, 210,000 new infections and 51,000 related deaths, in 2021. Interventions have focused on targeting sexual behaviors and addressing mediators of HIV transmission, such as poverty, age, socioeconomic status, education, and gender. Despite a drop in HIV incidence, the virus is still having a negative impact on the continent. This paper highlights overlooked but essential mediators of HIV transmission in South …

The Effect Of Cannabinoids And Terpenes On The Activation Of Hmc3 Microglial Cells, Mohamed Marzouk

Honors Theses

Life expectancies of people living with HIV have significantly lengthened due to the availability of antiretroviral therapies. Despite their ability to increase survival, these treatments do not “cure” HIV, nor do the stop the onset of neurological symptoms associated with infection, termed neuroHIV. NeuroHIV describes a myriad of neurological impairments including mood disorders (depression and anxiety), cognitive impairment, neuropathic pain, and motor disinhibition that reduce quality of life for people living with HIV. Mechanistically, the neurological impairments may involve actions of neurotoxic proteins directly produced by the virus. One of these proteins that has been well-characterized is the HIV trans …

Noninvasive Screening Of Nonalcoholic Fatty Liver Disease Among People Living With Hiv, Essi M. Havor

Dissertations & Theses (Open Access)

Background: Nonalcoholic fatty liver disease (NAFLD) disproportionately affects up to 75% of people living with HIV (PLWH). Given the high HIV prevalence in Houston and Harris County, knowledge of the prevalence of NAFLD in PLWH is needed to inform prevention efforts. In addition, such knowledge is required to raise awareness among at-risk individuals and healthcare professionals.

Specific Aims: This cross-sectional study aimed (1) to examine the demographic, behavioral, clinical, and psychosocial characteristics of PLWH in Houston/Harris County, Texas, and to estimate the prevalence of NAFLD, (2) to determine factors associated with the severity of NAFLD, and (3) to identify specific …

The God In Hiv: How The Perceived Influence Of Christianity On Sex Education Impacts Black Men Who Have Sex With Men’S Knowledge Of Hiv, Victor Sledge

Africana Studies Theses

Black men who have sex with men (BMSM) are disproportionately affected by HIV in Atlanta, GA. The purpose of this study is to explore BMSM’s experience with how they have perceived Christianity’s influence on sex education curriculum in Atlanta, GA and how that has possibly impacted their knowledge of HIV. This study is conducted through participant interviews of BMSM between the ages of 18-30 in Atlanta, GA. This study is significant to Africana Studies because it interrogates how Anglo-Christian doctrine and its hegemony over the American South has impacted a city where sexuality, race, and religion have historically intersected. Also, …

A Scoping Review Of The Predictive Values And Use Of The Oraquick In-Home Hiv Test, Mariah Zinn

Capstone Experience

The OraQuick In-Home HIV Test was FDA-approved for over-the-counter use for people aged 17 years and older in 2012. The FDA reported on the sensitivity and specificity of the test, which looks at the accuracy of a test relative to a reference standard. However, the predictive values that account for prevalence still need to be thoroughly examined among tests distributed through community-based means. In this review, we looked at the predictive values for the OraQuick In-Home HIV Test for people aged 15 years and older when the test is distributed through community-based means. We calculated the predictive values for each …

Effects Of Cannabichromene On Pain And Neuroinflammation In Hiv-1 Tat Transgenic Mice, Sydney Wheeler

Honors Theses

HIV-1 TransActivator of Transcription (Tat) is a vital regulatory protein involved in HIV replication and implicated in development of HIV-associated pain and neurocognitive deficits. Tat is thought to contribute to these pathologies through proinflammatory pathways. Developing mechanisms to curb Tat-mediated inflammation is a key step in improving the quality of life of those living with HIV. Both recreational and medicinal cannabis use is prevalent among many people living with HIV; given this prevalence and the perceived anti-inflammatory benefits of cannabis use, it is important to investigate how chemical constituents of cannabis may impact HIV. In the present study, the effects …

Various Synthetic Pathways Towards Efavirenz And Its Analogs; The Replacement Of The Side Chain, Elizabeth S. Bautista

Selected Honors Theses

Cyclopropyl acetylene (CA) is a key intermediate in the synthesis of the human immunodeficiency virus (HIV) reverse transcriptase inhibitor, Efavirenz (EFV), an antiviral drug used to treat HIV. CA is an expensive raw material, difficult to obtain, and employed in the preparation of medications to combat acquired immunodeficiency syndrome (AIDS). It was found that the structure could be synthesized by the utilization of PCl5; however, this resulted in unwanted ring opening products. To address this issue, a one pot synthesis was developed using Ph3PCl2 as a mild chlorinating agent. In addition, a new analog has been proposed substituting the cyclopropyl …

An ( R )-4-Phenyl-1,3-Oxazolidine-2-Thione Mediated Approach To 2, 3-Disubstituted Oxetanes And The Key Hydroxyethyl Isostere Of The Hiv Protease Inhibitor Darunavir. Preparation Of Non-Evans Syn Glycolate Aldol Addition Products. A New Direction For The Curtius Rearrangement In The Dehomologation Of Alpha-Alkoxycarboxylic Acids, Jordan Michael Witte

Theses and Dissertations

Since the emergence of AIDS in the early 1980s, strategies to mitigate the disease remain a high priority for medical professionals worldwide. While there is no broadly available cure or vaccine for HIV/AIDS at this time, early diagnosis and treatment can drastically reduce the severity of the infection. To this end, antiretroviral drugs are regularly employed to combat the virus and achieve HIV latency in infected patients. One such drug, Darunavir, has been used as a highly effective HIV protease inhibitor. Recently, a growing interest in derivatization of Darunavir to test for improved drug efficacy has prompted great efforts in …

Protein S In Coagulation And Inflammation, Martha Mega Silvia Sim

Theses and Dissertations--Molecular and Cellular Biochemistry

Protein S (PS) is a key regulator, which links inflammation and coagulation and performs multiple proposed functions in both processes. PS exists in the blood as a free soluble form (~40%), bound to complement component 4b-binding protein/ C4BP (~60%), and packaged in platelet α-granules (~2.5%). Subendothelial tissue factor (TF), upon exposure to blood, initiates coagulation, a proteolytic cascade which results in the activation of thrombin, the enzyme responsible for formation of a fibrin clot. PS is a critical anticoagulant that inhibits multiple steps of this process. Only the free fraction of PS has full anticoagulant properties, as C4BP blocks this …

Gender-Based Hiv Epidemic, Care Retention, And Medication Adherence In South-South Nigeria, Iniobong U. Akai

Walden Dissertations and Doctoral Studies

AbstractWomen 15-24 years of age globally have a 60% higher rate of human immunodeficiency virus (HIV) infection than men and account for over half of the population of people living with HIV worldwide. In Akwa Ibom State (AKS), Nigeria, more women than men are infected and living with HIV despite being the minority. The socioecological model and HIV treatment cascade framework formed the theoretical foundation for the study. The purpose of the study was to explore the impact of gender on the drivers of the HIV epidemic in AKS using data from the AKS AIDS Indicator Survey. I examined the …

A Unique Hiv Harm Reduction Perspective From Costa Rica: Hogar De La Esperanza An Ethnographic Case Study And Comparative Examination Of Approach To Hiv Treatment Between The United States And Costa Rica, Kim Marie Day

Theses and Graduate Projects

This case study presents a real, currently operational scenario of harm reduction in action in Costa Rica, focusing on its success and the challenges faced by healthcare professionals, the experiences of those who live at Hogar de la Esperanza, and the implications for healthcare policies and interventions in the United States. By examining this specific case of a Costa Rican community-based HIV treatment model, the aim of this ethnographic report is to shed light on the complexities and factors contributing to the success or failure of harm reduction treatment strategies within the United States and what can be learned by …

The Prepare Mobile Program For Hiv Prevention In Washington D.C., Gabrielle Cochran

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Incidence rates of HIV have decreased in the United States in the past decade, but the southern United States has higher rates of HIV than other regions, and cities in the south, like Washington D.C., have some of the highest rates of HIV incidence in the nation. Risky sexual behavior, needle sharing, and substance use increase the risk of transmitting or acquiring HIV, and these behaviors are more common among unhoused people (CDC, 2021; CPPH, 2022).

Expansion of community resources in cities with high levels of HIV have allowed for many people at high risk for HIV to comply with …

Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel

All ETDs from UAB

Introduction: HIV (Human Immunodeficiency Virus) is a sexually transmitted infection (STI) that is still a major health issue in the United States and the world. Emerging adults are more likely to engage in risky sexual behaviors such as multiple sexual partners and unprotected sex. HIV testing contributes to ending the HIV epidemic by identifying at-risk individuals and promoting early diagnosis.Methods: Secondary data analyses of the City Health II dataset were conducted to 1) identify the association between HIV testing and risky sexual behaviors among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, 2) use social network …

Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao

All ETDs from UAB

The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. …

Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker

All ETDs from UAB

Sexual and reproductive health (SRH) needs for women are not being met globally. In addition to efforts towards providing widespread access to currently available contraceptives and sexually transmitted infection (STI) treatment or prevention products, another focus is the development of multipurpose prevention technologies (MPTs). These MPTs are combination methods that prevent pregnancy, and protect against HIV and/or additional STIs. The objective of this dissertation research was to assess factors related to sexual and reproductive decision-making that may influence interest in MPTs and inform MPT implementation strategies for African and African American (AA) women. The first aim of this research, I …

Investigating The Viral Nature Of Neuronal Capsid Genes, Michael Manuel Long

Master's Theses

Memory formation is an essential part of everyday life. Neuronal communication is thought to be a key driver behind memory formation. There are two heavily studied methods of neuronal communication: chemical (neurotransmitter-mediated) and electrical (physically attached). When issues arise environmentally or genetically, people can experience one of many devastating memory disorders i.e. Alzheimer’s disease and other Dementias. Due to their prevalence, the treatments for disorders that hinder memory formation are a high priority for pharmaceutical companies. Currently, many of the treatments available focus on neurotransmitters or neuronal activity, and scientists are far from a cure. However, there may be an …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

Electronic Theses and Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

A Functional Study Of Topological Dna Problem In Human T Cells During Chronic Viral Infection, Xindi Dang

Electronic Theses and Dissertations

T cells play an important role in adaptive immune system against viral infections, while premature aging and dysfunction of T cells induced by unrepaired DNA damages are always non-negligible snags during the long-term of fighting with chronic viral infections, such as Hepatitis B virus (HBV), Hepatitis C virus (HCV) or Human Immunodeficiency Virus (HIV) infection. In this dissertation, we investigated the role of topological DNA damage in reprogramming telomeric DNA damage responses (DDR), mitochondrial metabolisms, and T cell functions using CD4+ T cells derived from individuals with chronic viral infections or healthy subjects treated with topoisomerase inhibitors. The healthy human …

Investigating The Pi3k/Akt/Atm Pathway, Telomeric Dna Damage, T Cell Death, And Crispr/Cas9-Mediated Gene Editing During Acute And Chronic Hiv Infection, Sushant Khanal

Electronic Theses and Dissertations

Human Immunodeficiency Virus (HIV) infection initiates major metabolic and cell- survival complications. Anti-retroviral therapy (ART) is the current approach to suppress active HIV replication to a level of undetected viral load, but it is not a curative approach. Newer and sophisticated gene editing technologies could indeed be a potent antiviral therapy to achieve a clinical sterilization/cure of HIV infection. Chronic HIV patients, even under a successful ART regimen, exhibit a low-grade inflammation, immune senescence, premature aging, telomeric DNA attrition, T cell apoptosis, and cellular homeostasis. In this dissertation, we investigated CD4 T cell homeostasis, degree of T cell apoptosis, an …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.