Medicine and Health Sciences Commons^™

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

Associations Of Hiv Risk Behaviors Among Older Latinas And Their Adult Daughters, Gira J. Ravelo

FIU Electronic Theses and Dissertations

This dissertation examines the associations between adult Latina daughters’ HIV risk behaviors and that of their older Latina mothers’ HIV risk behaviors. The central hypothesis of the study is that adult Latina daughters’ influence their older mothers’ behaviors and that such behaviors interact with the level of their attachment.

Older Latinas are a vulnerable population that face cultural risk factors, health care provider bias, and engage in low rates of HIV testing. The primary mode of HIV infection for Latinas is through heterosexual contact. Yet, traditional gender norms such as marianismo belief place pressure on Latina women to be submissive …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Prescribing Hiv Prep And Education Needs Among Care Providers, Martin K. Logo, Hadi Denawi, Aimee Ferraro

Journal of Social, Behavioral, and Health Sciences

Preexposure prophylaxis (PrEP) is a biomedical intervention to prevent the spread of HIV. Underprescribing PrEP could increase the probability of HIV exposure among serodivergent couples/partners and people who do not practice safer sex. Previous research on PrEP did not assess the association between awareness of PrEP, years of experience of the providers, provider types, and the frequency of PrEP among physicians. The purpose of this study is to test the hypothesis that awareness of PrEP, years of experience, and provider types might be predictors of the frequency of PrEP among physicians. Precaution adoption process model and cross-sectional design were applied …

Subjective Well-Being And Hiv Prevention: A Cross-Country Descriptive Study Using Multiple Indicator Cluster Survey Data, Janine Foggia, Anne Sebert Kuhlmann

Journal of Refugee & Global Health

Subjective well-being (SWB) is positively associated with improved health outcomes and, in particular, preventative behaviors. Yet, the relationship between SWB and HIV prevention is not well understood, especially in the context of developing countries. Furthermore, young females experience a high burden of HIV as well as sociodemographic factors which influence SWB. Therefore, this descriptive study sought to describe the global landscape of three constructs of SWB - happiness, life satisfaction, and life perception - and the following HIV prevention variables: comprehensive HIV knowledge, HIV testing, and condom use among young adult females aged 15-24 years. Descriptive statistics of Multiple Indicator …

“Do You Think I Should Be Worried?” Building A Call Structure For Hiv(-) Callers To The Nightline, Ivy Epstein

Master's Projects and Capstones

Abstract

San Francisco Suicide Prevention’s HIV Nightline provides emotional support to those living with human immunodeficiency virus (HIV) as well as support and basic medical information around relative risk and testing for who may have been exposed to HIV. Nightline counselors use a harm-reduction model, active listening, reflection of emotions, and encouragement to promote health maintenance and mental health self-care behaviors. Until now, there has been no process to assess whether callers had disproportionate anxiety about HIV given their actual risk level. Consequently, HIV(-) anxious callers could receive inconsistent information. The goal of this improvement study was to develop a …

Is Sex With Older Male Partners Associated With Higher Sexual Risk Behavior Among Young Black Msm?, Nicholas Chamberlain, Leandro A. Mena, Angelica Geter, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Participants at a sexual health clinic completed a survey with questions regarding sexual risk behavior and partner characteristics. Of 585 participants eligible for analysis, 124 reported generally having older male partners. These participants were significantly more likely to be HIV-infected (p < 0.001), have four or more sex partners as a “bottom” (p = 0.04), have concurrent partners (p = 0.01), and have partners suspected of having an sexually transmitted infection (p = 0.05) than participants without older partners. With analysis restricted to HIV− individuals, risk behaviors did not differ significantly between the groups. HIV− individuals with older partners may be at increased risk of HIV infection due …

Predictors Of Anemia Among Hiv Patients In Uganda, Catherine Nagawa

Masters Theses

HIV-related anemia is associated with increased risk of death. Prior studies suggest an inverse relationship between CD4 cell count and anemia, and a positive relationship between HIV-clinical stage and anemia. However, none have assessed the role of antiretroviral therapy (ART) treatment combinations in these relationships. Therefore, we conducted a cross-sectional study to evaluate the relationship between CD4 cell count, HIV clinical stage and anemia among 4803 Ugandan HIV-patients, and assessed the role of ART treatment combinations. We included HIV patients (> 15 years) receiving ART therapy combinations between 2010- 2015. We evaluated CD4 cell count and anemia using blood tests, …

The Impact Of African American Male Incarceration Rates On The Racial Disparities In Hiv/Aids Rates, Michelle S. Aelion

DePaul Discoveries

In the United States, HIV/AIDS disproportionately impacts African Americans and African American communities. The nature of this national health disparity is complex and cannot be explained simply by one factor or an individual’s behavior within a given community. This paper suggests that the disparity in African American male incarceration rates is among the most important factors to consider in the racial disparities of HIV/AIDS rates. Existing studies on relevant subjects were examined and used to create a conceptual model of factors. This model presents an outline of factors during pre-incarceration, incarceration, and post-incarceration that contribute to the racial disparities in …

Physician Attitudes Toward The Ethics Of Pre-Exposure Prophylaxis (Prep): Cost, Safety, And Resource Allocation, Jessica Grippo, Stacy W. Smallwood, Katherine Pincura, Tamara Wright, William A. Mase

Journal of the Georgia Public Health Association

Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP.

Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for …

Predicting Death Over 8 Years In A Prospective Cohort Of Hiv-Infected Women: The Women's Interagency Hiv Study, Deborah Gustafson, Qiuhu Shi, Susan Holman, Howard Minkoff, Mardge Cohen, Michael Plankey, Donald Hoover

NYMC Faculty Publications

OBJECTIVES: Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, Veterans Aging Cohort Study (VACS); (2) a physical index, Fried Frailty Index (FFI); and (3) a mental health index, Center for Epidemiologic Studies-Depression (CES-D). Proportional hazards regression analyses were used to predict death and included relevant covariates.

DESIGN: Prospective, observational cohort.

SETTING: Multicentre, across six sites in the USA.

PARTICIPANTS: 1385 multirace/ethnic ART-experienced HIV+ women in 2005.

PRIMARY …

Retention In Health: Improving Hiv Retention Within The Sf Community Health Network, Miguel A. Ibarra

Master's Projects and Capstones

Previous work on HIV retention improvement has focused on improving access to care for communities who are either at-risk of falling out of care or who have difficulty engaging in medical care for the first time due to socio-cultural barriers. The San Francisco Department of Public Health (SFDPH), with the support of Project PRIDE, a CDC three-year demonstration project geared towards supporting health departments in implementing public health strategies to reduce new HIV infections within the men who have sex with men (MSM) and transgender communities, is seeking to improve HIV patient retention throughout the San Francisco Community Health Network …

Transitional Healthcare Coordination In New York City Jails Among People With Chronic Health Conditions: Contributions To Reduced Reincarceration And Improved Health, Janet J. Wiersema

Dissertations and Theses

People in correctional settings often have poorer health than the general US population. For example, it is estimated that 27.9% of persons in jail have hypertension, 8.1% have diabetes, and 1.6% have HIV, compared to 25.6%, 6.5%, and 0.5%, respectively, in the general population. Jail and other correctional settings are also increasingly recognized as viable places to engage poor and underserved communities into the healthcare system by offering transitional care coordination services to connect people to healthcare and other services to meet priorities after incarceration. At the same time, recidivism is an issue—over 50% of persons in New York City …

Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender

Publications and Research

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38% of self-testers did so correctly without …

Mixed Method Study Of Condom Use Among Emerging Adults With New Sex Partners Met Online Or Offline, Shana M. Green

USF Tampa Graduate Theses and Dissertations

Introduction: Emerging adults (young people age 18 to 29) are increasingly using the Internet to seek sex partners, with over 30% having tried an online or mobile dating site. As more emerging adults use dating and sex-seeking websites (DSP) for their love and sexual pursuits, it is imperative to understand how DSPs contribute to HIV/STI risk.

Objectives: The objectives of this research were accomplished by pursuing the following specific aims: Aim 1. To systematically review and quantitatively synthesize evidence from published findings to determine the association between condom use and meeting venue (online and offline). Aim 2. To determine whether …

Prenatal Care Providers’ Perspectives And Practices: Informed Consent For Hiv Screening Among Latinas With Limited English Proficiency In South Carolina, Edena G. Meetze

Journal of Health Disparities Research and Practice

Abstract

The rapid increase in Latinos in South Carolina that has occurred within the past 15 years is associated with both in-migrationand high birth rates. Limited ethnic-specific data and communication barriers betweenLatinas with limited English proficiency have contributed to difficulties in assessing theprovision of recommended routine prenatal HIV screening among this vulnerablepopulation. This qualitative descriptive study examined providers' perceptions andpractices related to obtaining informed consent for routine HIV screening for pregnantLatinas with limited English proficiency. Findings indicate the need for focused educational interventionswith providers and patients and implementation of culturally and linguistically tailoredpractice guidelines to improve patient understanding and acceptance …

Hiv Risk Behaviors, Previous Hiv Testing And Positivity Among Hispanic Women Tested For Hiv In Florida, 2012, Janelle Taveras

FIU Electronic Theses and Dissertations

The prevalence of female adults and adolescents living with diagnosed HIV infection continues to rise. Latina women in the United States (US) are not only disproportionately affected by human immunodeficiency virus (HIV) infection, but also underutilize HIV prevention services, such as HIV testing. Data are limited on the differences in HIV risk among Latinas by country of birth, and opportunities still exist to prevent transmission of HIV and reduce HIV-related disparities. This dissertation describes the risk behaviors, testing behaviors, and test results among women tested for HIV at public sites in Florida. Additionally, it compares these characteristics by HIV testing …

Theory Of Gender And Power: Intimate Partner Violence, Hiv Status And Sexual Risk Behaviors In Haitian Women, Anshul Saxena

FIU Electronic Theses and Dissertations

Among women in Haiti, there are a number of factors, including intimate partner violence (IPV), childhood sexual abuse, and alcohol abuse that lead to increased vulnerability to STI/HIV and its sequelae. This study examined the factors associated with IPV and the associations between IPV and HIV in a sample of adult Haitian women.

The current study is a secondary analysis of data collected from HIV+ and HIV- women attending the GHESKIO centers in Haiti. The measures include: Self-reported Questionnaire-20 (SRQ-20); Attitudes Towards Gender Roles; Partner Violence; Alcohol Use Disorders Identification Test (AUDIT); Partner Support; Sexual Relationship Power Scale (SRPS); Centers …

Hair Measurements Of Cortisol, Dhea, And Dhea To Cortisol Ratio As Biomarkers Of Chronic Stress Among People Living With Hiv In China: Known-Group Validation, Shan Qiao Ph.D., Xiaoming Li, Samuele Zilioli, Zheng Chen, Huihua Deng, Juxian Pan, Weigui Guo

Faculty Publications

Background

Existing literature suggests that endocrine measures, including the steroid hormones of cortisol and Dehydroepiandrosterone (DHEA), as well as the DHEA to cortisol ratio in the human hair can be used as promising biomarkers of chronic stress among humans. However, data are limited regarding the validity of these measures as biomarkers of chronic stress among people living with HIV (PLWH), whose endocrine system or hypothalamic pituitary adrenal (HPA) axis may be affected by HIV infection and/or antiretroviral therapy (ART) medications.

Method

Using hair sample data and self-reported survey from 60 PLWH in China, we examined the validity of three endocrine …

Conceptualizing Care Continua: Lessons From Hiv, Hepatitis C Virus, Tuberculosis And Implications For The Development Of Improved Care And Prevention Continua, David C. Periman, Ashly E. Jordan, Denis Nash

Publications and Research

Background: To examine the application of continuum models to tuberculosis, HIV, and other conditions; to theorize the concept of continua; and to learn lessons that could inform the development of improved care and prevention continua as public health metrics.

Methods: An analytic review of literature drawn from several fields of health care.

Results: The continuum construct is now part of public health evaluation systems for HIV, and is increasingly used in public health and the medical literature. Issues with the comparability and optimal design of care continuum models have been raised, and their methodologic and theoretic underpinnings and scope of …

Using A Network-Based Approach And Targeted Maximum Likelihood Estimation To Evaluate The Effect Of Adding Pre-Exposure Prophylaxis To An Ongoing Test-And-Treat Trial, Laura Balzer, Patrick Staples, Jukka-Pekka Onnela, Victor De Gruttola

Laura B. Balzer

Hiv Prevalence, Risky Behaviors, And Discrimination Experiences Among Transgender Women In Cambodia: Descriptive Findings From A National Integrated Biological And Behavioral Survey, Siyan Yi, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Srean Chhim, Khuondyla Pal, Gitau Mburu

Background: Transgender people are disproportionately affected by HIV. Despite their high vulnerability to HIV, lack of adequate epidemiological and surveillance data related to this population in many countries prevents provision of appropriate services. This paper summarizes descriptive findings from a national integrated biological and behavioral survey and discusses policy implications of the findings on HIV prevention among transgender women in Cambodia.

Methods: This cross-sectional study was conducted between December 2015 and February 2016. Participants were recruited from 20 sites in the capital city and 12 provinces of Cambodia using Respondent Driven Sampling (RDS) method. Behavioral data were collected …

Awareness And Willingness To Use Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex With Men In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Siyan Yi, Sovannary Tuot, Grace W. Mwai, Chanrith Ngin, Kolab Chhim, Khuondyla Pal, Gitau Mburu

Introduction: To facilitate provision of pre-exposure prophylaxis (PrEP) in low- and middle-income countries (LMIC), a better understanding of potential demand and user preferences is required. This review assessed awareness and willingness to use oral PrEP among men who have sex with men (MSM) in LMIC.

Methods: Electronic literature search of Cochrane library, Embase, PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar was conducted between July and September 2016. Reference lists of relevant studies were searched, and three authors contacted for additional data. Non-peer reviewed publications were excluded. Studies were screened for inclusion, and relevant data abstracted, assessed …

Hiv Prevalence And Factors Associated With Hiv Infection Among Transgender Women In Cambodia: Results From A National Integrated Biological And Behavioral Survey, Srean Chhim, Chanrith Ngin, Pheak Chhoun, Sovannary Tuot, Cheaty Ly, Phalkun Mun, Siyan Yi

Objective To examine factors associated with HIV infection among transgender women in Cambodia.

Design Cross-sectional study.

Settings HIV high-burden sites including the capital city and 12 provinces.

Participants This study included 1375 sexually active transgender women with a mean age of 25.9 years (SD 7.1), recruited by using respondent-driven sampling for structured questionnaire interviews and rapid finger-prick HIV testing.

Primary outcome measure HIV infection detected by using Determine antibody test.

Results HIV prevalence among this population was 5.9%. After adjustment for other covariates, participants living in urban areas were twice as likely to be HIV infected as those living in …

Using Risk-Tracing Snowball Approach To Increase Hiv Case Detection Among High-Risk Populations In Cambodia: An Intervention Study, Srean Chhim, John Macom, Chettana Pav, Nirada Nim, Phearun Yun, Sopheap Seng, Siyan Yi

Background: Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.

Methods: This study was conducted from April 1 to September 30, 2016 at two …

Conventional Early Infant Diagnosis In Lesotho From Specimen Collection To Results Usage To Manage Patients: Where Are The Bottlenecks?, Appolinaire Tiam, Michelle M Gill, Heather J Hoffman, Anthony Isavwa, Mafusi Mokone, Matokelo Foso, Jeffrey T Safrit, Lynne M Mofenson, Thorkild Tylleskär, Laura Guay

Epidemiology Faculty Publications

INTRODUCTION: Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade.

METHODS: We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means …

West Virginia Needle Exchange Program, Briana Washington, Sara Johnson

Theses, Dissertations and Capstones

Introduction: Needle Exchange Programs (NEPs) have been controversial aspects of public healthcare due to conflicting beliefs and opinions for public policies. NEPs allow Injection Drug Users (IDUs) the ability to exchange their used equipment for clean, unused supplies.

Purpose: The purpose of this literature review was to determine the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. It further explores if these strategies have had a positive impact on the reduction of HIV and viral hepatitis C in West Virginia.

Methodology …

Namibia : Hiv As A National Issue, Elisabeth Vlasak

Global Public Health

Namibia is located on the southwestern coast of Africa, bordering Angola, Botswana, Zambia, South Africa, and the Atlantic Ocean. Namibia has a population of 2,265,000, as of 2016. Namibia has many challenges, including food insecurity and malnutrition, access to health services, unequal distribution of wealth, but HIV/AIDS is one of the country’s leading challenges. It is estimated that the overall adult infection rate of HIV/AIDS is 15.4% and it is the leading cause of death in Namibia. Adults ages 18-24 are the most at-risk for the disease. Some of the major risk factors are declining condom use, misinformation, social stigma, …

Gabon : Hiv/Aids, Amanda Lindau

Global Public Health

Gabon is a country in West Africa that has a population of 1.8 million and is a relatively poor nation. It has had quite a few public health and political problems in the last couple of years. These problems include water and electricity shortages along with HIV/AIDS. HIV seems to be one of the biggest public health problems in Gabon at this moment. There is quite a bit of the population that is living with this virus. However, there are many people that are living with this virus but either do not understand the severity of it or just do …