Medicine and Health Sciences Commons^™

Adverse Childhood Experiences And Hiv Risk Behaviors Among Transgender Populations, Linda Baggio

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have a negative impact on health and have created a social challenge in managing HIV risk behavior in the transgender population. The aim of this study was to determine the association between ACEs and HIV risk behavior among the transgender population and identify the association between ACE score (1, 2, 3, 4, or more) and HIV risk behavior among the transgender population. This involved a quantitative methodology using a Behavioral Risk Factor Surveillance System (BRFSS) questionnaire to obtain data from 323 transgender participants. Multivariable regression analyses were conducted to determine the association between ACEs and HIV …

Effects Of Perpetrator Types And Gender-Based Violence On Condom Use Among Tanzanian Female Sex Workers, Lashonda Hall

Walden Dissertations and Doctoral Studies

HIV status among female sex workers (FSWs) continues to be a significant public health concern. Condom use is associated with HIV cases among FSWs. Gender-based violence (GBV) plays a role in FSWs HIV status. While studies have investigated the relationship between GBV and condom use, little is known about the impact of factors such as perpetrator type and substance use. I aimed to examine whether perpetrator type and substance use affect the relationship between GBV and condom use among FSWs in Tanzania. Secondary data analysis was performed on 1,502 FSWs extracted from the 2020 Tanzanian, John Hopkins Program for International …

Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King

Walden Dissertations and Doctoral Studies

Age of consent policies have recently been identified as a barrier to HIV testing among adolescents in HIV endemic Sub-Sahara Africa. Grounded in the modified social ecological model, the purpose of this study was to determine if these policies were related to HIV testing rates and prevalence. In this quantitative research secondary data sets from the Demographic Health Survey were used. This study included all sexually active respondents aged 18 years or below (N=37,015) and then was further limited by respondents that had HIV test results (N=25,107). Binary logistic regression showed that respondents with lower age of consent had higher …

Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …

Multimorbidity, Healthcare Processes, And Mortality Among Tb/Hiv Patients Treated With Antiretroviral Therapy In Uganda, Abel Nkolo

Walden Dissertations and Doctoral Studies

Globally, Uganda is one of the 30 tuberculosis (TB) and human immunodeficiency virus (HIV) high burden countries with high antiretroviral therapy (ART) coverage, yet mortality is still high among TB/HIV patients on ART. The reasons for the high mortality have not been fully explored. The purpose of this study was to determine the association between multimorbidity, age, sex, marital status, phase of TB treatment, timing of initiation for ART, and type of TB and mortality among TB/HIV patients on ART in Uganda. The health outcomes conceptual framework with 3 domains that directly or indirectly affect the outcome domain was used …

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

Voluntary Male Circumcision And Risk For Human Immunodeficiency Virus In Homa Bay, Kenya, George Obhai Gabriel

Walden Dissertations and Doctoral Studies

The role played by the belief about voluntary medical male circumcision (VMMC) in predicting HIV status has not been examined. The purpose of this study was to investigate whether there were any differences between belief about VMMC, unprotected sex, age, number of sexual partners, relationship status, and HIV status among circumcised males aged between 18-49 years in Homa Bay County, Kenya. Drawing from the health belief model and case-control study design, 936 men were recruited based on their HIV status (468 HIV cases and 468 controls). A bivariate logistic regression was applied, and the results indicated that unprotected sex, age, …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Hiv/Sti Screening, Testing, And Prophylaxis Among Sexual Assault Survivors In U. S. Emergency Departments, Elizabeth A. Cita

Walden Dissertations and Doctoral Studies

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. …

Social Support And Hiv Among Young Transwomen Of Color, Cynthia Joycelle Tucker

Walden Dissertations and Doctoral Studies

HIV is an emerging epidemic among young transgender women of color (YTWC). Researchers have documented the challenges and issues that YTWC encounter, including discrimination, isolation, and violence. However, little is known about whether social support can impact these challenges as an avenue to improve HIV preventive behaviors and HIV status. Using secondary data from the Life Skills HIV study, this research assessed how social support affects HIV preventive behaviors among 298 YTWC residing in Chicago. The study was grounded in the modified social-ecological model and Spearman’s rank correlation and logistic regression analyses was used to determine whether there was an …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Hiv Testing Among Nigerian Men Who Have Sex With Men After Criminalization Of Homosexuality, Gerald Onyeka Ileka

Walden Dissertations and Doctoral Studies

Men who have sex with men (MSM) are at high risk of HIV in Nigeria. However, African countries like Nigeria, Botswana, Mali, and Mozambique have laws that prohibit homosexuality, making it a punishable crime in these countries. For example, the Nigerian government signed the anti-gay law in 2014. Laws like these affect the health status and outcomes among Nigerian MSM. The purpose of this qualitative study was to examine the influence criminalization of homosexuality has on the willingness to test for HIV among MSM in Abuja, Nigeria. Guided by the socio-political theory (SP) as the theoretical framework, a qualitative approach …

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

Social And Structural Barriers To Safer Sex Among Heterosexual Female Sex Workers, Erika Nikole Harding-Davis

Walden Dissertations and Doctoral Studies

Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers …

The Self-Perceived Cultural Competency Of Hiv Interventionists, Tonya Herring

Walden Dissertations and Doctoral Studies

Despite significant research and inroads with the human immunodeficiency virus (HIV), disparities in HIV infection continue to widen for African American (AA) men who have sex with men (MSM). In recent times, cultural competence has been receiving increased attention as a possible factor to enhance the quality of health messaging and lessening HIV disparities. However, there is a dearth of research specifically dedicated to AA MSM and culturally competent HIV health messages. To address this gap, this qualitative research was designed to investigate the self-perceived cultural competency among HIV counselors. The theoretical framework for the project was the PEN-3 cultural …

Assessing Condom Use Among Navajo Men In The Southwest, Terra E. Yabeny

Walden Dissertations and Doctoral Studies

The Navajo tribe reports extraordinarily high number of cases of sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, and human immunodeficiency virus (HIV) among men who have sex with men (MSM) and heterosexual populations. The purpose of this qualitative study was to explore the cultural value of adil' idli (self-respect) and how this cultural practice might influence health behaviors in sexual activity, condoms use, and acquiring of STDs among Navajo men. The Health Belief Model (HBM) was the theoretical foundation for providing a deeper understanding of the social, environmental, and cultural factors of condom use among Navajo men. Research questions …

Exposure To Hiv Prevention Messages On Social Media And Behavior Change Intent, Yoshika Shajuan Eason

Walden Dissertations and Doctoral Studies

African Americans living in the Southeastern region of the United States disproportionately contract sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Facebook and other social media sites are becoming a way to deliver health-related messaging to targeted populations. The purpose of this quantitative, cross-sectional study was to examine the association between selected demographic factors and impact of social media on intent to change sexual behaviors among 112 African Americans between the ages of 18 and 49 in the Southeastern United States who viewed STI/HIV prevention materials on Facebook within 1 year prior to the study. The theory of planned …

Determinants Of Hiv Screening Among Adults In New Jersey After Hurricane Sandy, Nathaniel R. Geyer

Walden Dissertations and Doctoral Studies

HIV screening is recommended to destigmatize the condition, prevent partner transmission, and postpone AIDS progression. However, determinants associated with implementation of opt-out HIV screening are not well understood. The purpose of the study was to examine determinants that predicted odds of HIV screening for persons impacted by Hurricane Sandy, and how these factors differed according to demographic characteristics, geographical attributes, health-related quality of life score, access-to-care, and health insurance status. The social ecologic model provided the framework for this multilevel cross-sectional study that included New Jersey data from the Behavior Risk Factor Surveillance System. Bivariate chi-square, simple logistic regression, and …

The Relationship Between Hispanics/Latino Men Who Have Sex With Men And Women Cultural Beliefs, Risk Behaviors And Self-Disclosure, Donnalee Maria Lawson-Williams

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the relationships among cultural/spiritual beliefs, risk behaviors, and disclosure among Hispanic/Latino men who have sex with men and women (MSMW). Minority men who have sex with men are disproportionately affected by HIV, in particular MSM who are Hispanic/Latino or African American. Limited research is available on the link between Hispanic/Latino MSMW, their cultural/spiritual beliefs, risk behavior, and disclosure about risk behaviors to friends and family. The data were obtained from the SJS Project, which used survey methods to gather data on participants from all 50 states and Puerto Rico. Among the participants …

Behaviors Related To Hiv Infections In Rural Versus Urban Regions Of Nigeria, Michael Ifeanyi Okeke

Walden Dissertations and Doctoral Studies

Efforts by the Federal Republic of Nigeria and international nongovernmental agencies to reduce the impact of HIV in Nigeria have not yielded the anticipated results. This study focused on the association between attitude, religious beliefs, knowledge of HIV, sexual risk behavior, and HIV epidemiology in rural and urban Nigeria. This quantitative study used social-cognitive theory and problem theory. The study was based on the Nigerian Demographic and Health Survey (NDHS) 2013 data including a sample of 33,006 participants. Specific covariates including gender, sexual partners over the past years, age at first sexual encounter, socioeconomic status, and literacy level were obtained …

Experiences Of Heterosexual Couples Who Undergo Hiv Counseling And Testing In Nakuru-Kenya, Stephen Kinyua Mucheke

Walden Dissertations and Doctoral Studies

The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of …

The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa., Felix Ikechi Woke

Walden Dissertations and Doctoral Studies

Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in …

Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson

Walden Dissertations and Doctoral Studies

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience …

Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail

Walden Dissertations and Doctoral Studies

Vitamin D deficiency is common in individuals diagnosed with HIV and is known for its detrimental health effects. Its recognition as a potent immune-modulator with possible immune health implications in HIV disease progression was the main impetus for this study. The association between Vitamin D and CD4 count falls short of being consistent and is too weak to allow conclusions. Similarly, the literature is inconsistent with regard to the impact of Vitamin D supplementation on CD4. This observational, retrospective chart review study aimed to explore the relationship between Vitamin D deficiency and CD4 count/percent, and to evaluate whether changes in …

Predictors Of Condom Use Among Middle-Income, African American Women, Yvonne Maire Reed

Walden Dissertations and Doctoral Studies

Abstract

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and …

Social Network Correlates Of Hcv And Hiv Transmission Risk Behaviors Among Injecting Drug Users, Victor Emanuel Reyes-Ortiz

Walden Dissertations and Doctoral Studies

Drug injection is an increasingly important risk factor in the transmission of blood-borne pathogens, including the hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The purpose of the study was to examine the influence of social network factors on HCV and HIV. The study was grounded in social network theory and sought to determine whether social network characteristics affect high-risk sexual and drug injection behavior as well as self-reported HIV and HCV status. The study design was a quantitative cross-sectional survey. A total of 181 participants in a needle exchange program completed a survey in Spanish assessing individual drug …

Provider-Initiated Condom Education, Hiv, And Stds Among Older African American Women, Natasha Hall

Walden Dissertations and Doctoral Studies

Older African American (AA) women are at increased risk for HIV and STDs. The purpose of this quantitative study was to examine the influence of provider-initiated condom use education on condom use among unmarried, heterosexually active AA women aged 50 and over using the constructs of self-efficacy and attitudes of the health belief theoretical model. The relationships between provider education on condom use, condom use self-efficacy, condom use attitudes, and actual condom use were tested individually, and provider education on actual condom use was tested after controlling for condom use self-efficacy and attitudes among 95 study participants recruited primarily from …