Medicine and Health Sciences Commons^™

Evaluating Attitudes On Health-Seeking Behavior Among A Network Of People Who Inject Drugs, Ayako Shimada, Ashley Buchanan, Natallia Katenka, Benjamin Skov, Gabrielle Lemire, Stephen Kogut, Samuel Friedman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

People who inject drugs (PWID) are often members of HIV/AIDS risk networks, where individuals engage in sexual and injection risk behavior. Engagement in HIV care is important for this population. Low socioeconomic status, stigmatization, and lack of access to medical care often complicate successful engagement in the HIV cascade of care for PWID. This study investigates how individual’s attitudes about how much control they have over HIV/AIDS risk in their life (i.e., locus of control and self-blame) affect health-seeking behavior in PWID participants and their community members. We applied causal inference methodology to PWID HIV risk networks ascertained from the …

A Case Study To Investigate Factors Influencing The Santa Clara County Getting To Zero Initiative’S Collective Impact Model, Harit Agroia, Rebecca Reno, Jenette Spezeski, Leyla Mousli, Richard Sarabia, Erin Starzyk

Journal of Social, Behavioral, and Health Sciences

Our objective was to explore how factors, such as backbone organization changes and COVID-19, affected a collective impact (CI) initiative’s progression through the five CI phases and its components of success. We conducted a case study using semistructured interviews with 17 representatives from the action committee, community-based organization, and health department between January and February 2023 in Santa Clara County, California. Participants were asked how internal and external factors affected their engagement and experiences with the CI initiative. We analyzed the data using structural and holistic coding. Results showed that the initiative’s progression was impacted by intersecting factors; overall findings …

Introducing Comprehensive Sexuality Education And Hiv Prevention And Treatment Methods Through Pop-Up Clinics To Secondary School Girls In Kwazulu-Natal, South Africa, Eliza I. Tobin, Joaquin Carlos Pinga, Caitlyn Stanya

Capstone Showcase

Human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system leading to people living with HIV (PLHIV) immunodeficient and more susceptible to other infections or diseases (UNAIDS, 2023b). This can lead to acquired immunodeficiency syndrome (AIDS) within 8-10 years of infection (UNAIDS, 2023b). HIV does not always present symptoms, making it hard for people to identify their HIV status without proper screening. The lack of awareness around a person’s status has led HIV to spread worldwide. In addition to the worldwide spread of HIV, there is no cure for the disease, however, antiretroviral therapy (ART) is mainly used …

Facilitators And Barriers To Effective Scale-Up Of Evidence-Based Nonprofit-Level Hiv Prevention And Treatment Interventions Among Black Men Who Have Sex With Men (Msm), Ugochukwu C. Uzoeghelu

Master's Projects and Capstones

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple in nonprofit settings, it is crucial to examine processes that occur in the translation of the EBIs into practice that affect successful implementation through the lens of nonprofit principles and practices. This paper examines the facilitators and barriers to effective scale-up of evidence-based HIV prevention and treatment services for nonprofit health organizations that serve Black men who have sex with men (MSM). I interviewed nonprofit health organizations (n = 4) engaged in the global response to end the HIV epidemic, specifically those who provide HIV prevention and …

Oral Health Considerations For Aging Patients Living With Hiv/Aids, Madeleine Daily Dds, Susan Liu Dds, Yuna Park Dds, Mph, Ms, Emily Byington Msw, Ivette Estrada Ma, Mphil, Sunil Wadhwa Dds, Carol Kunzel Phd

The New York State Dental Journal

People living with HIV/AIDS (PLWH) have an increased life expectancy due to advances in antiretroviral therapy. In 1996, the life expectancy for a 20-year old living with HIV was 39-years old; today, it is >70-years old. As life expectancy increases, PLWH are burdened with age-associated comorbidities. This paper reviews the interaction between aging and HIV and how it affects social, physical, and oral health issues. The shift in demographics presents new challenges for clinicians in how to identify, address, and manage these complex manifestations. This review summarizes how to approach HIV-related changes when providing care as a dental clinician.

Covid-19-Related Stressful Experiences And Posttraumatic Stress Disorder Symptoms Among College Students In China: A Moderated Mediation Model Of Perceived Control Over The Future And Empathy, Zhi Ye, Chengbo Zeng, Xueying Yang, Cheuk-Chi Tam, Yuyan Wang, Shan Qiao Ph.D., Xiaoming Li Ph.D., Danhu Lin

Faculty Publications

The current study aims to investigate the mediating effect of perceived control over the future and the moderating effect of empathy on the association between stressful experiences and PTSD symptoms among college students in China in response to COVID-19. A sample of 1,225 college students (70.69% were female, M age=20.22 years, SD=2.02) were recruited using web-based surveys at wave 1 (W1) and wave 2 (W2) longitudinally. Results showed that COVID-19-related stressful experiences were significantly associated with PTSD symptoms. Perceived control over the future partially mediated the relationship between these two variables (indirect effect size=0.09, p < 0.01). Empathy significantly moderated the path from perceived control over the future to PTSD symptoms, suggesting that the association was stronger for individuals with higher levels of empathy. Findings suggest a protective effect of perceived control over the future on college students’ PTSD symptoms during the COVID-19 pandemic. Such a protective effect was intensified by empathy. Future intervention to manage PTSD symptoms should be tailored to positive future expectations and empathy.

The Communicative Capacities Of The Medical Discourse In Authoritarian Societies : The Case Of Aids In Iran, Elham Pourtaher

Legacy Theses & Dissertations (2009 - 2024)

This study explores the role of medical discourse in the Iranian formal public sphere. It examines how an epidemiological wave of HIV/AIDS—known as "the third wave"—highlighted nontraditional sexual behaviors in public and enabled a shift in policy and discourse by the Islamic Republic State. Through analyzing published content on HIV/AIDS from five major Iranian newspapers between 2009 and 2013, this study identified four competing narratives of the third wave which coexist and have a dynamic relationship with one another. First, the medical narrative warns of an unfolding public health crisis and provides a technical perspective to make sense of the …

Identification Of Individual And Regional Features Impacting Hiv/Aids Knowledge And Sentiment, Stetson Ledbetter

Health, Human Performance and Recreation Undergraduate Honors Theses

Despite constant media coverage and public interest in current epidemics, the prevalence and lack of awareness of HIV/AIDS is often overlooked on campuses and communities associated with colleges and universities. Several interrelated factors, such as LGBTQ+ status, being a college student, gender, coming from a rural area, ethnicity, and educational attainment are known to contribute to behaviors regarding sexual health, especially non-curable diseases such as HIV/AIDS. Consequently, it is imperative to explore trends in both the HIV/AIDS knowledge and sentiments towards individuals with HIV/AIDS in college environments. Current work utilizes a nonprobability sample recruited through media platforms, representing individuals that …

Future Orientation Among Children Affected By Parental Hiv In China: An Exploratory Analysis Of Complex Interactions, Heather L. Mcdaniel, Sayward E. Harrison, Amanda J. Fairchild, Xiaoming Li Ph.D.

Faculty Publications

We utilized an exploratory analytic approach to examine predictors of children's future beliefs, an internal asset associated with resilience among children affected by HIV, with emphasis on complex interactions among multisystem factors. Children (N = 1221) affected by parental HIV in China reported on psychosocial functioning, as well as internal, familial, and community resilience assets. Exploratory data analysis was conducted using a binary segmentation program. Six binary splits on predictors accounted for 22.78% of the variance in future expectation, suggesting interactions between children's perceived control of their future, loneliness, caregiver trust, and social support. Four binary splits accounted for …

Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo

Walden Dissertations and Doctoral Studies

AbstractHIV and TB have merged into a deadly co-epidemic in Namibia. Currently, though, TB and HIV data at the national, regional, and district level might be underreported and insufficient to understand the full burden and outcome rates of TB and HIV. Targeting the TB outcomes rate among TB/HIV-coinfected individuals is an effective strategy for decreasing future TB burden and furthering the gains in the control of both diseases. The objective of this study was: to assess the outcomes of patients registered for anti-TB treatment in //Karas Region which has the largests burden of TB in Namibia. A 5-year retrospective cohort …

Perspectives Of Girls, Families, And Healthcare Workers On Accessing Services For Adolescents With Perinatal Hiv In Nigeria, Joseph Fabian Inyang

Walden Dissertations and Doctoral Studies

Adolescents living with Human Immunodeficiency Virus (HIV) include those who were infected from their mother perinatally (PHIV) and those who were infected through sexual behaviors or drug use. Nigeria contributes the largest burden of children born with HIV globally, due to poor implementation of its prevention of mother-to-child transmission program. With advances in antiretroviral therapy (ART), more children and adolescents with HIV survive into adulthood. However, there are challenges to ART including access, uptake, adherence, and risks of long-term exposure. Using the social ecological model and a phenomenological approach, this qualitative study was designed to understand the experiences of adolescent …

Examining The Effects Of Neighborhood Factors And Geography On Racial/Ethnic Disparities In Achieving Sustained Viral Suppression, Rahel Dawit

FIU Electronic Theses and Dissertations

Sustained viral suppression (all viral load tests/mL in a year) decreases the risk of HIV transmission and disease progression to AIDS for people with HIV. Racial/ethnic minorities living with HIV are particularly challenged by barriers, including neighborhood factors, to maintain viral suppression. This dissertation examined the contribution of neighborhood and geographic factors on racial/ethnic disparities in achieving sustained viral suppression. A cross-sectional analysis of secondary data collected in 2017 for 6491 clients enrolled in the Miami-Dade County Ryan White Program (RWP) was conducted.

The first study examined the moderating role of neighborhood level factors on the association between race/ethnicity and …

Psychometric Properties Of The Berger Hiv Stigma Scale: A Systematic Review, Stanley W. Wanjala, Ezra Too, Stanley Luchters, Amina Abubakar

Institute for Human Development

Addressing HIV-related stigma requires the use of psychometrically sound measures. However, despite the Berger HIV stigma scale (HSS) being among the most widely used measures for assessing HIV-related stigma, no study has systematically summarised its psychometric properties. This review investigated the psychometric properties of the HSS. A systematic review of articles published between 2001 and August 2021 was undertaken (CRD42020220305) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we searched the grey literature and screened the reference lists of the included studies. Of the total 1241 studies that were screened, 166 were included in the …

Validity, Reliability, And Measurement Invariance Of An Adapted Short Version Of The Hiv Stigma Scale Among Perinatally Hiv Infected Adolescents At The Kenyan Coast, Stanley W. Wanjala, Derrick Ssewanyana, Patrick N. Mwangala, Carophine Nasambu, Esther Chongwo, Stanley Luchters, Charles R. J. C. Newton, Amina Abubakar

Population Health, East Africa

Background: There is a dearth of instruments that have been developed and validated for use with children living with HIV under the age of 17 years in the Kenyan context. We examined the psychometric properties and measurement invariance of a short version of the Berger HIV stigma scale administered to perinatally HIV-infected adolescents in a rural setting on the Kenyan coast.

Methods: A cross-sectional study was conducted among 201 perinatally HIV-infected adolescents aged 12-17 years between November 2017 and October 2018. A short version of the Berger HIV stigma scale (HSS-40) containing twelve items (HSS-12) covering the four dimensions of …

Building Patient Participation In Quality Of Care Through The Healthcare Stories Project: A Demonstration Program In New York State Hiv Clinics, Abigail Baim-Lance, Freda Coren, Margaret Brown, Hazel Lever, Daniel Tietz, Bruce Agins

Patient Experience Journal

There is growing recognition that patients should play a central role in defining, assessing, and improving the quality of healthcare, thereby enhancing patient experiences. Healthcare organizations struggle to meet these goals, which require becoming more patient-centered and patient-involved. The Healthcare Stories Project (HCSP), a demonstration program of the NYS Department of Health AIDS Institute, aimed to address this. HCSP comprises three, stepwise activities to: 1) Capture how patients define and experience ‘quality of care’ in the clinic; 2) Engage patients and providers as equal partners in understanding and improving the quality of care; and through partnerships, 3) Support the building …

Assessing Hiv Risk, Syndemics, Resilience And Engagement In Care In A Large National Cohort Of Gay, Bisexual And Other Men Who Have Sex With Men In The United States, Javier Lopez-Rios

Dissertations and Theses

Background: HIV continues to be a pervasive public health issue in the United States with more than 1.2 million people living with HIV (PLWHIV) across the nation. Gay, bisexual and other men who have sex with men (GBM) account for over two-thirds of all new HIV diagnoses with racial and ethnic minorities shouldering a large proportion of the burden of disease. Although HIV transmission is predominantly driven by sexual behaviors, there are underlying complex individual, behavioral, and structural factors that contribute to high rates of sexual behavior and subsequent HIV acquisition. Moreover, difficulties remain in maximizing linkage to care …

Impact Of Adverse Childhood Events On The Psychosocial Functioning Of Children Affected By Parental Hiv In Rural China, Jordan Ezell, Sayward E. Harrison, Yanping Jiang, Xiaoming Li Ph.D.

Faculty Publications

Introduction: Children affected by parental HIV are more likely than unaffected peers to experience trauma and are at-risk for negative psychological and social outcomes. This study aimed to examine the relationship between adverse childhood events and psychosocial functioning among children affected by parental HIV.

Methods: A total of 790 children ages 6–17 from Henan, China were enrolled in a longitudinal, randomized controlled trial of a resilience-based psychosocial intervention. At baseline, children reported on numerous psychosocial factors, including trauma exposure, symptoms of anxiety and depression, and peer social functioning. We used linear regression analysis to test the direct effect of trauma …

Marital Status And Human Immunodeficiency Virus Mortality In A Southern County, Javis Nkwanwoh

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a substantial cause of mortality, particularly among U.S. segments of the population. Marriage is protective of HIV/AIDS mortality due to monogamy; however, the increased risk of HIV/AIDS mortality among other marital subgroups is understudied. The purpose of this study was to examine the association between marital status and HIV/AIDS mortality among a cohort of HIV infected individuals in a southern county. Mills' behavior theory guided this research as it posits that all behaviors are acquired through conditioning, which occurs through the interaction with the environment. The study had a quantitative research design …

The Role Of Mental Health On The Relationship Between Food Insecurity And Immunologic Outcome Among People Living With Hiv In Guangxi, China, Cheng Chen, Xueying Yang, Chengbo Zeng, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

BACKGROUND

Previous studies showed that food insecurity could adversely affect clinical outcomes of people living with HIV (PLWH). The mental health pathways of such effects are suggested in existing literature, but empirical data are limited in resource-limited settings.

METHODS

This cross-sectional study aims to explore the role of depressive symptoms and anxiety on the association between food insecurity and CD4 counts among a sample of 2,987 PLWH in Guangxi, China. Path analysis was used to examine a hypothetical model and delta ztest was used to assess the indirect effects of food insecurity on CD4 counts through depressive symptoms and …

Validation Of Kiswahili Version Of Hoqolhivbref Questionnaire Among People Living With Hiv/Aids In Tanzania: A Cross-Sectional Study, Nuru Kondo, Tumbwene Mwansisya, Eric Aghan, Riaz Ratansi

Faculty of Health Sciences, East Africa

Background: Quality of life is an important element of surveillance in people living with HIV/AIDS. WHO has developed an HIV specific quality of life tool (WHOQOLHIV-Bref) for assessing Quality of life of HIV individuals. This tool takes into account the different cultural variations that exist worldwide and hence enable assessment of the quality of life across different cultures. Despite its preliminary sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to fully assess its psychometric properties before its adaptation.

Objectives: To evaluate the validity and reliability of WHOQOLHIV-Bref questionnaire in …

Performance Characteristics Of An Instrument-Free Point-Of-Care Cd4 Test (Visitectvr Cd4) For Use In Resource-Limited Settings, Vairamohan Vidhyavathi, Hussain Syed Iqbal, Kannaiyan Kanthamani, Sunil Suhas Solomon, Paneerselvam Nandagopal, Stanley Luchters, Minh D. Pham, James Forbes, Suzanne M. Crowe, Christopher Mcmurran, David A. Anderson, Pachamuthu Balakrishnan

Population Health, East Africa

Objective: CD4þ T lymphocyte count remains the most common biomarker of immune status and disease progression in human immunodeficiency virus (HIV)-positive individuals. VISITECTVR CD4 is an instrument-free, low-cost point-of-care CD4 test with a cut-off of 350 CD4 cells/lL. This study aimed to evaluate VISITECTVR CD4 test’s diagnostic accuracy.

Methods: Two hundred HIV-positive patients attending a tertiary HIV centre in South India were recruited. Patients provided venous blood for reference and VISITECTVR CD4 tests. An additional finger-prick blood sample was obtained for VISITECTVR CD4. VISITECTVR CD4’s diagnostic performance in identifying individuals with CD4 counts 350 cells/lL was assessed by calculating sensitivity, …

Associations Of Depression And Anxiety With Substance Use And Social Health Among Older Adults Living With Hiv, Sarah Soliman, David Seal, Omar Bruce, Margarida Dalton, Allison Palmer, Marissa Pardini, Bailey Quiroga, Jenica Ryu, James Welty, Imamah Younus, Annie L. Nguyen

Health Behavior Research

Life expectancy after HIV infection dramatically increased following the development of antiretroviral therapies (ART) in 1996. As the population of older adults living with HIV increases, concerns have grown about possible disparities in mental health. We evaluated mental health outcomes, specifically depressive symptoms and anxiety, among older adults living with HIV in two large urban cities. We also examined the relationship between mental health outcomes and substance use and social health. We recruited 154 participants from infectious disease clinics in Los Angeles, CA and New Orleans, LA to complete cross-sectional surveys. We assessed prevalence of depressive symptoms (CES-D-10) and anxiety …

Psychosocial Impacts And Employment Preparedness Of Participating In An Hiv Peer Program: Implications For Tailoring A Vocational Counseling Model For Plwh, Erin R. Mckinney-Prupis

Dissertations and Theses

Background:

Medical advancements in HIV care should have reduced barriers to employment for PLWH, yet in 2017 only 47.7% of PLWH reported being employed, as compared to 62.9% in the general population. Employment is a significant social determinant of health, it impacts a variety of factors related to health, including earned income, access to healthcare, and social connectedness. Quantitative and qualitative studies have identified several concerns PLWH have about entering the workforce; the most pressing being fear of losing benefits. Targeted work readiness programs for PLWH is an important approach to help PLWH overcome their unique barriers to work, such …

Icope A Multi-Level, Cluster Randomized, 36-Month, Parallel-Group Study To Assess The Efficacy Of Hiv Disclosure Intervention In Hiv Parental Disclosure Among Parents Living With Hiv In China, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

Objectives: Parents living with HIV who disclose their HIV status to their children could benefit from the parental HIV disclosure. However, it is also very challenging because of persistent stigma and discrimination against HIV. This report describes the study design and protocol of the “Interactive Communication with Openness, Passion, and Empowerment (iCOPE)” randomized controlled trial aimed at assisting parents living with HIV in conducting culturally and developmentally appropriate disclosure to their uninfected children in China through trainings among both parents living with HIV and healthcare providers.

Methods: A total of 791 parents living with HIV with children aged between 6 …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

“Malicious Medicine”: A Qualitative Study Of Medical Mistrust And Prep Perceptions For African American And Hispanic Men And Women In New Haven, Ct, Alexandra Lee Grimaldi

Public Health Theses

Objective: To understand how medical mistrust impacts perceptions of PrEP and willingness to use PrEP for African American and Hispanic men and women in New Haven, Connecticut.

Methods: This qualitative study utilized semi-structured interviews to examine medical mistrust, PrEP awareness, and willingness to use PrEP amongst African American and Hispanic men and women in New Haven, Connecticut.

Results: The majority of participants did not know about PrEP before their first interview of this study and the majority of participants did not decide to use PrEP over the course of this study. For those who are not interested in using PrEP, …

Least Of My Worries: Food Security, Diet Quality, And Antiretroviral Adherence Among People Living With Hiv, Charlotte Ann Noble

USF Tampa Graduate Theses and Dissertations

More than forty years into the epidemic, HIV continues to impact the health and well-being of millions of people – nearly 37 million across the globe and in excess of 1 million in the U.S. – more than 44% of which live in the Southern United States. HIV continues to disproportionally affect marginalized populations, and vast amounts of money, time, and effort have been spent to understand how to slow the rate of new infections and improve health outcomes for People Living with HIV (PLWH). This study aims to understand the experience of living with and managing HIV while on …

Swiping Right And Sexually Transmitted Diseases (Std): Examining Venue Selection, Risky Sexual Behaviors, And Std Among Persons Living With Hiv, Florida, 2014-2017, Isabel S. Griffin

FIU Electronic Theses and Dissertations

The incidence of sexually transmitted diseases (STDs) are on the rise, nationwide (World Health Organization, 2015). In Florida, the incidence of bacterial STDs has increased from 425.3 per 100,000 persons per year in 2006 to 684.7 per 100,000 persons per year in 2017 (Florida Charts, 2018). This rise in STDs has gone hand-in-hand with the recent advancement of technology, beginning with at-home internet in the early 1990s to the introduction of social networking smartphone applications (SNSA) on mobile Smartphones in the late 2000s (Grov et al., 2011; Klausner et al., 2011; Winetrobe et al., 2014). In fact, some STDs, such …

The Effect Of Disclosure On Adherence To Antiretroviral Therapy Among Adults Living With Hiv In Ethiopia: A Systematic Review And Meta-Analysis., Getenet Dessie, Fasil Wagnew, Henok Mulugeta, Dessalegn Amare, Dube Jara, Cheru Tesema Leshargie, Ayenew Negesse, Swati Rayasam, Sahai Burrowes

BACKGROUND: Several factors have been identified as being associated with increased adherence to antiretroviral therapy, including sero-status disclosure; however, studies examining the effect of disclosure on ART adherence in Ethiopia have had inconsistent findings. This systematic review and meta-analysis therefore aims to estimate the pooled effect of disclosure on adherence to ART among adults living with HIV in Ethiopia.

METHODS: We performed a systematic search for articles reporting on peer-reviewed, quantitative, English-language observational studies of reporting the association between self sero-status disclosure and good ART adherence in adults living with HIV/AIDS in Ethiopia during published from 2010 to 2015. We …

Oral Rapid Hiv Testing In The Dental Setting: Experiences From Three Dental Hygiene Clinics, Anthony J. Santella, Petal Leuwaisee, Susan H. Davide, Hanna Horowitz, Bhuma Krishnamachari

Publications and Research

Background: Oral rapid HIV testing (ORHT) is implemented in the dental setting to make individuals aware of their possibly undiagnosed HIV infection. The testing process and characteristics of clients willing to receive ORHT has yet, however, to be systematically collected. Case description: Three dental hygiene clinics located in academic institutions implemented ORHT from March 2016 to April 2017. Results: 231 persons received ORHT; all had non-reactive results. Most had seen a primary care provider in the past year (n = 130), had had a previous ORHT (n = 111), and described themselves as extremely likely or likely to accept a …