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Communicable Disease And International Security: The Case Of Africa & Hiv/Aids, Amy L Rue

Archived Theses and Dissertations

In this thesis, I will look at how communicable disease fits into the human security discourse particularly with the disease being views as the 'potential threat' and the 'referent object' within the international sphere. The case of Africa will be used to illustrate the impact of HIV/AIDS on international security at country, regional and international levels. Ultimately, I will argue that communicable disease, as a human security issue, is a clear and important international security issue due to its status as a continual "potential threat" within international relations particularly in Africa. The elements that I will use to establish my …

Distinct Functions Of Autoreactive Memory And Effector Cd4+ T Cells In Experimental Autoimmune Encephalomyelitis, Wassim Elyaman, Pia Kivisäkk, Jay Reddy, Tanuja Chitnis, Khadir Raddassi, Jaime Imitola, Elizabeth Bradshaw, Vijay K. Kuchroo, Hideo Yagita, Mohamed H. Sayegh, Samia J. Khoury

Jay Reddy Publications

The persistence of human autoimmune diseases is thought to be mediated predominantly by memory T cells. We investigated the phenotype and migration of memory versus effector T cells in vivo in experimental autoimmune encephalomyelitis (EAE). We found that memory CD4⁺ T cells up-regulated the activation marker CD44 as well as CXCR3 and ICOS, proliferated more and produced more interferon-γ and less interleukin-17 compared to effector T cells. Moreover, adoptive transfer of memory T cells into T cell receptor (TCR)αβ^-/- recipients induced more severe disease than did effector CD4⁺ T cells with marked central nervous system inflammation and …

Clinical Features And Management Of Autoimmune Hepatitis, Edward L. Krawitt

Dartmouth Scholarship

Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology which can progress to cirrhosis. Its clinical manifestations are highly variable and sometimes follow a fluctuating course. Diagnosis is based on characteristic histologic, clinical, biochemical and serological findings. Anti-inflammatory/immunosuppressive treatment frequently induces remission but long-term maintenance therapy is often required. Liver transplantation is generally successful in patients with decompensated cirrhosis unresponsive to or intolerant of medical therapy.

Hiv Risk Among Nursing Students In Rwanda : Self-Efficacy, Knowledge And Attitudes, Jacqueline Wosinski

Loma Linda University Electronic Theses, Dissertations & Projects

Acquired immune deficiency syndrome (AIDS) is the leading cause of death in sub-Saharan Africa. With a prevalence rate of 3.1% in 2006, Rwanda is one of the hardest hit countries. Nurses are often the leading health professionals in rural communities and at the forefront of the fight against the HIV pandemic. Little has been written on how nurses are prepared to intervene successfully along the continuum of HIV prevention and care. A mixed-methods sequential exploratory approach was used to explore this question.

In the first phase, cognitive, socio-psychological, and environmental factors of nursing education in Rwanda in regard to HIV …

Predictors Of Depressive And Anxiety Symptoms Among African American Hiv-Positive Women, Nina Katherine Sublette

Theses and Dissertations (ETD)

This descriptive correlation study had four purposes: describe depressive and anxiety symptom levels in pregnant and non-pregnant African American (AA) HIV-positive women, examine the association between underlying vulnerabilities and depressive symptoms in HIV-positive AA women, determine the association between underlying vulnerabilities and anxiety symptoms in AA HIV-positive women, and determine the predictors of depressive and anxiety symptoms among African American HIV-positive women. A convenience sample of 80 African American HIV-positive women was recruited from university-based obstetrics/-gynecology and infectious disease practices in a large metropolitan city in the Mid-South. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale …

Application Of The Asset Mapping Model To Church Based Hiv/Aids Prevention And Control In Aba, Abia State, Nigeria, Godwin Nwadibia Aja

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined whether HIV/AIDS activities were more frequent among churches with needs and assets for HIV/AIDS prevention and control in Aba, Nigeria and whether this connection was mediated by collective efficacy. A cross-sectional design was used to obtain data in two phases. First, a three-step forum focus group discussion (FFGD) method was used to obtain data from 32 representatives of five denominations. Second, a quantitative survey questionnaire was constructed based on the result of the FFGD and the collective efficacy model. This questionnaire was administered to 830 members aged 18 years and above from 83 churches that had operated …

Inside Unlv, Shane Bevell, Donna Mcaleer, David Ashley, Grace Russell, Michelle Mouton, Mamie Peers

Inside UNLV

No abstract provided.

Inside Unlv, Cate Weeks, Grace Russell, David Ashley, Shane Bevell, Angela Sablan

Inside UNLV

No abstract provided.

Gender Differences In Hiv And Hepatitis C Related Vulnerabilities Among Aboriginal Young People Who Use Street Drugs In Two Canadian Cities, Azar Mehrabadi, Katharina Paterson, Margo Pearce, Sheetal Patel, Kevin J. Craib, Akm Moniruzzaman, Martin T. Schechter, Patricia M. Spittal

Aboriginal Policy Research Consortium International (APRCi)

Objectives: Vulnerability to HIV and Hepatitis C virus (HCV) infection for indigenous populations worldwide must be contextualized in experiences of current and past trauma. Aboriginal women entrenched in poverty face further gender-specific harms which place them at increased risk for HIV infection.

Methods: This study was cross-sectional and based on a community-based sample of Aboriginal young people (Métis, Abo- riginal, First Nations, Inuit, and non-status Indians) between the ages of 14 and 30 years who used injection or non-injection non- cannabis illegal drugs (street drugs) in the previous month. Between October 2003 and July 2005, 543 participants living in either …

Autoimmune-Induced Preferential Depletion Of Myelin-Associated Glycoprotein (Mag) Is Genetically Regulated In Relapsing Eae (B6 × Sjl) F1 Mice, Dusanka S. Skundric, Rujuan Dai, Vaagn L. Zakarian, Weili Zhou

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Experimental autoimmune encephalomyelitis (EAE) is commonly used to investigate mechanisms of autoimmune-mediated damage to oligodendrocytes, myelin, and axons in multiple sclerosis (MS). Four distinct autoimmune mechanisms with subsequently distinct patterns of demyelination have been recognized in acute MS lesions. EAE correlates for those distinct patterns of MS lesions are unknown. An excessive loss of myelin-associated glycoprotein (MAG), as a result of distal oligodendrogliopathy, is found exclusively in the subtype III lesion. We sought to answer if types of demyelination in acute lesions during onset and relapse of EAE can replicate the specific patterns observed in MS acute lesions. …

Consentement Éclairé Dans Les Essais De Prévention Du Vih: Points Saillants D'Un Atelier International, Population Council

HIV and AIDS

Résumé adapté du rapport de l'atelier co-organisé par le Population Council et Family Health International en mai 2005. Le résumé se concentre spécifiquement sur les outils et stratégies présentés lors de l'atelier qui sont utilisés dans les essais de prévention du VIH pour faciliter le consentement éclairé, expliquer concepts difficiles et évaluer la compréhension parmi les participants à l'essai. Des exemples illustratifs d'essais achevés et en cours sont mis en évidence. Ce résumé sera utile à un public de chercheurs locaux, d'avocats et de membres du personnel des essais cliniques.

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Brief adapted from the report of the workshop co-hosted …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In Nicaragua, Freddy Solis, Ana Del Carmen Rojas, Gadea Adilia, M. Estela Rivero-Fuentes, Ricardo Vernon

Reproductive Health

Between September 2005 and April 2007, FRONTIERS and Alva, a Nicaraguan consulting firm, conducted a situation analysis of the provision and use of contraceptive services in postpartum, postabortion and prevention of mother-to-child transmission of HIV (PMTCT) programs. The project‘s objective was to assess the degree to which contraceptive services were linked to postpartum, postabortion and PMTCT services and if this allowed the programs to meet the contraceptive needs of their clients. The project proposes recommendations for improving the quality of these programs.

A Comprehensive Analysis Of The Naturally Occurring Polymorphisms In Hiv-1 Vpr: Potential Impact On Ctl Epitopes., Alagarsamy Srinivasan, Velpandi Ayyavoo, Sundarasamy Mahalingam, Aarthi Kannan, Anne Boyd, Debduti Datta, Vaniambadi S Kalyanaraman, Anthony Cristillo, Ronald G Collman, Nelly Morellet, Bassel E Sawaya, Ramachandran Murali

Department of Microbiology and Immunology Faculty Papers

The enormous genetic variability reported in HIV-1 has posed problems in the treatment of infected individuals. This is evident in the form of HIV-1 resistant to antiviral agents, neutralizing antibodies and cytotoxic T lymphocytes (CTLs) involving multiple viral gene products. Based on this, it has been suggested that a comprehensive analysis of the polymorphisms in HIV proteins is of value for understanding the virus transmission and pathogenesis as well as for the efforts towards developing anti-viral therapeutics and vaccines. This study, for the first time, describes an in-depth analysis of genetic variation in Vpr using information from global HIV-1 isolates …

School As A Workplace In Kenya: Evaluation Of The Teachers Matter Hiv/Aids Project, Karusa Kiragu, Caroline Mackenzie, Jennifer Weiss, Murungaru Kimani, Debbie Gachuhi

HIV and AIDS

The Horizons program of the Population Council embarked on an operations research initiative in Kenya to test the feasibility of implementing a teacher-centered workplace program based in schools. The study was conducted in partnership with the Ministry of Education, the Kenya Institute of Education, the Teachers Service Commission, and UNICEF. Called Teachers Matter, the project’s main audience was primary and secondary school teachers. The purpose of the research was to assess whether such a program would improve teachers’ HIV-related knowledge, attitudes, and behaviors; increase the proportion of teachers seeking voluntary testing and counseling; and enhance their ability to cope with …

Is It Feasible To Integrate Alcohol-Related Risk Reduction Counseling Into Vct Services? Findings From Kenya, Caroline Mackenzie, Karusa Kiragu, George Odingo, Rukia Yassin, Peter Shikuku, Patrick Angala, Nduku Kilonzo, William Sinkele, Melania Akinyi

HIV and AIDS

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the …

Improving Hospital-Based Quality Of Care In Vietnam By Reducing Hiv-Related Stigma And Discrimination, Khuat Thi Hai Oanh, Kim Ashburn, Julie Pulerwitz, Jessica Ogden, Laura Nyblade

HIV and AIDS

To address HIV-related stigma and discrimination, and improve the quality of care in the healthcare setting in Vietnam, the Institute for Social and Development Studies, the International Center for Research on Women, and the Horizons Program conducted intervention research in four hospitals. The study team conceptualized two fundamental causes of HIV-related stigma: 1) fear of casual transmission; and 2) negative values/social judgments and associations between HIV and certain behaviors and groups, such as sex workers and injecting drug users. Both intervention strategies successfully reduced stigma and discrimination toward HIV-positive patients in these healthcare settings. The findings show that addressing stigma …

Informed Consent In Hiv Prevention Trials: Highlights From An International Workshop, Population Council

HIV and AIDS

Brief adapted from the report of the workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan

HIV and AIDS

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …

Sexual Behavior And Sti/Hiv Status Among Adolescents In Rural Malawi: An Evaluation Of The Effect Of Interview Mode On Reporting, Barbara Mensch, Paul C. Hewett, Richard Gregory, Stephane Helleringer

Poverty, Gender, and Youth

This paper presents the results from an interview-mode experiment conducted by the Population Council with unmarried young women in rural southern Malawi. To collect data on sexual behavior and the dynamics of HIV transmission, respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. Clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity, yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode, whereas, when …

Has The Hiv Epidemic Peaked?, John Bongaarts, Thomas Buettner, Gerhard Heilig, Francois Pelletier

Poverty, Gender, and Youth

This working paper reviews the highly diverse regional and country patterns of HIV epidemics and discusses possible causes of the geographic variation in epidemic sizes. The main finding of this analysis is that the HIV epidemic reached a major turning point over the past decade. The peak years of HIV incidence rates are past for all regions, and the peaks of prevalence rates are mostly in the past except in Eastern Europe, where it is expected to peak in 2008. But owing in part to the life-prolonging effect of antiretroviral therapy and to sustained population growth, the absolute number of …

Assessment Of Risk Factors For Hiv Infection Among Men Who Have Sex With Men In The Metropolitan Area Of Campinas City, Brazil, Using Respondent-Driven Sampling, Maeve De Mello, Adriana De Araujo Pinho, Magda Chinaglia, Waimar Tun, Aristides Barbosa Junior, Maria Cristina, F.J. Ilario, Paulo Reis, Regina C.S. Salles, Suzanne Westman, Juan Diaz

HIV and AIDS

The Population Council, in collaboration with the Brazil Ministry of Health, the Municipal Program of STD/AIDS of Campinas, and the US Centers for Disease Control and Prevention/Global AIDS Program/Brazil, conducted a study to characterize the sociodemographic, behavioral, and environmental factors associated with subgroups of MSM who are most at risk for HIV infection. This research is the first Brazilian study to provide population-based estimates for HIV, syphilis, and HIV-related risk behaviors using an innovative sampling technique to reach members of the target population. Our data suggest the importance for HIV prevention programs to address not only sexual risk reduction, but …

If You Build It, Will They Come? Kenya Healthy Start Pediatric Hiv Study: A Diagnostic Study Investigating Barriers To Hiv Treatment And Care Among Children, Karusa Kiragu, Katie D. Schenk, Julie Murugi, Avina Sarna

HIV and AIDS

In Kenya the proportion of eligible HIV-positive children receiving ART treatment is only 11 percent. This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment, to guide the development of new interventions to encourage uptake. The study identified barriers such as cost, use of traditional healers, low knowledge of treatment options, attitudinal barriers, stigma, unique treatment issues, and dissatisfaction with available services. Additionally, healthcare workers missed opportunities to provide services and cited numerous service-side challenges. The study recommends prioritizing community awareness, mobile clinics, strengthening capacity of healthcare workers, supporting family-based HIV testing, and …

Propiciando Cambio Personal Y Social Alrededor Del Género, Sexualidad Y Vih: Evaluación De Impacto De La Estrategia De Comunicación De Puntos De Encuentro En Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Catalyzing Personal And Social Change Around Gender, Sexuality, And Hiv: Impact Evaluation Of Puntos De Encuentro´S Communication Strategy In Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Caring For Caregivers: An Hiv/Aids Workplace Intervention For Hospital Staff In Zambia—Evaluation Results, Karusa Kiragu, Mutinta Nyumbu, Thabale J. Ngulube, Panganani Njobvu, Chilufya Mwaba, Arthur Kalimbwe, Spike Bradford

HIV and AIDS

The Horizons Program collaborated on a Caring for Caregivers initiative in Zambia whose objective was to develop and test a risk-reduction workplace program for hospital staff. This was motivated by the recognition that hospital workers are often overlooked in HIV programming, and yet many are infected or affected by HIV. It was also motivated by the fact that hospital staff are heterogeneous, with both clinical and non-clinical staff having varying levels of understanding regarding HIV transmission. Caring for Caregivers was a peer education program targeted at hospital staff and implemented in two hospitals in Zambia, with a combined staff of …

Moving Forward: Tackling Stigma In A Tanzanian Community, Laura Nyblade, Kerry Macquarrie, Gideon Kwesigabo, Aparna Jain, Lusajo Kajula, Fausta Philip, William Henerico Tibesigwa, Jessie K. Mbwambo

HIV and AIDS

The International Center for Research on Women, the Muhimbili University College of the Health Sciences, the Population Council, and Family Health International conducted an evaluation of a community-based effort to reduce stigma surrounding HIV infections in a peri-urban community in Tanzania. Results presented a mixed, but hopeful, picture for a way forward in tackling stigma at the community level. Tackling stigma requires that the individuals tasked with doing this undergo personal change. Programs can start by focusing stigma-reduction efforts on a smaller, more manageable geographical area and adding specific anti-stigma components to their portfolio of activities. Engaging community opinion leaders …

Assessment Of Risk Factors For Hiv Infection In Female Sex Workers And Men Who Have Sex With Men In Ciudad Del Este, Paraguay, Magda Chinaglia, Waimar Tun, Maeve Mello, Magdalena Insfran, Juan Diaz

HIV and AIDS

Research conducted by the Population Council/Brazil, supported by the USAID-funded Horizons Project, documents findings from a study in Paraguay among men who have sex with men and female sex workers to estimate HIV and syphilis prevalence; examine knowledge, attitudes, and risk behaviors related to HIV and STIs; and describe the contextual and behavioral factors influencing HIV and STI transmission. Findings provide guidance to the development of HIV and STI prevention and care interventions and further operations research to test strategies and interventions to reduce the spread of HIV and STIs in these groups.

Consentimiento Informado En Ensayos De Prevención Del Vih: Aspectos Destacados De Un Taller Internacional, Population Council

HIV and AIDS

Resumen adaptado del informe del taller organizado conjuntamente por el Population Council y Family Health International en mayo de 2005. El resumen se centra específicamente en las herramientas y estrategias presentadas en el taller que se están usando en ensayos de prevención del VIH para facilitar el consentimiento informado, explicar conceptos difíciles, y evaluar la comprensión entre los participantes del ensayo. Se destacan ejemplos ilustrativos de ensayos concluidos y en curso. Este resumen será útil para una audiencia de investigadores locales, defensores y personal de ensayos clínicos.

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Brief adapted from the report of the workshop co-hosted by the Population …

Consentimento Informado Nos Ensaios De Prevenção Do Hiv: Pontos Altos Dum Workshop Internacional, Population Council

HIV and AIDS

Resumo adaptado do relatório do workshop organizado pelo Population Council e Family Health International em maio de 2005. O resumo se concentra especificamente nas ferramentas e estratégias apresentadas no workshop que estão sendo usadas em testes de prevenção do HIV para facilitar o consentimento informado, explicar conceitos difíceis e avaliar a compreensão entre os participantes do estudo. Exemplos ilustrativos de ensaios concluídos e em andamento são destacados. Este resumo será útil para um público de investigadores locais, advogados e equipe de ensaios clínicos.

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Brief adapted from the report of the workshop co-hosted by the Population Council and Family Health …

Childhood Sexual Abuse In Black Men Who Have Sex With Men: Results From Three Qualitative Studies, Sheldon D. Fields, David J. Malebranche, Sonja Feist-Price

David J Malebranche

This report describes the high prevalence and context of childhood sexual abuse (CSA) among Black men who have sex with men (MSM) across 3 independent qualitative studies. Semistructured one-on-one interviews were conducted with 87 Black MSM across 3 cities (Rochester, NY, n=28; Lexington, KY/Atlanta, GA, n=30; and Atlanta, GA, n =29). A combined CSA prevalence of 32% (28/87) was found among the 3 samples, despite variation in geographic location, mean age, and sexual identification. Common themes emerging across the 3 samples included prolonged and repeated abuse by a close male relative; blaming of same-sex desire on CSA; and descriptions of …