Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson

Walden Dissertations and Doctoral Studies

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) initially emerged in the 1980s and ever since, a battle has been underway with regard to understanding some of the root issues attributed to behavior and HIV/AIDS. AIDS is prevalent in the men sleeping with men (MSM) community. There is lack of studies evaluating the quality and quantity of communication between MSM and medical professionals, which can be a catalyst to help reduce HIV/AIDS within this community. The aim of this quantitative study was to evaluate the relationship between quantity and quality of medical professionals' communication and regular HIV …

Using Sociodemographic Approach To Examine Health Services And Hiv/Aids Awareness In Nigeria, Mercy I. Ebosie

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine community health services and HIV/AIDS awareness in rural communities in Abia State Nigeria in respect to the sociodemographic factors of level of community health services, level of education, and community leaders' influence. Two questions guided the research process: To what extent are sociodemographic factors associated with HIV/AIDS awareness, and what is the relationship between level of community health services and extent of HIV/AIDS, as perceived by residents of these communities. A mixed method paradigm was used. A sample of 131 participants, who were HIV/AIDS patients, were purposively drawn from a population of …

Self-Disclosure Of Human Immunodeficiency Virus Status In Personal Relationships: Perceptions Of South Africans Living With Human Immunodeficiency Virus, Delile Gertrude Langeni

Walden Dissertations and Doctoral Studies

Despite enormous research on the experience of living with HIV, many questions remain regarding self-disclosure of HIV status to sexual partners by people living with HIV (PLWHIV), which is essential to reducing further infection. In this study, a phenomenological approach captured the experience of self-disclosure among South Africans living with HIV in Louwsburg, South Africa. The health belief model served as a theoretical framework, and in-depth interviews were conducted with 12 PLWHIV (8 women, 4 men) who self-disclosed their HIV status to their sexual partners. Their experiences were explored, discovering their illness, motives for self-disclosure, feelings regarding disclosing, responses of …

Designing And Evaluating An Educational Initiative Promoting Condom Use Among Hiv+ Hispanic Men, Gilberto Andino

Walden Dissertations and Doctoral Studies

In 2013, the Centers for Disease Control and Prevention estimated that between 252,000 and 312,000 Hispanic men and women in the United States were unaware of their risk for transmitting HV/AIDS. Guided by the logic model and Leininger's theory, the purpose of this project was to design a culturally sensitive HIV/AIDS educational program for HIV+ Hispanic males and to evaluate the program content with the staff at a medical center in South Florida, with the goal of implementing the program at that center. The educational program content focused on increasing the knowledge of Hispanic HIV+ men on the effectiveness of …

Gender Inequality In Women's Knowledge And Awareness Of Hiv/Aids In Port Harcourt, Maureen A. Wagbara

Walden Dissertations and Doctoral Studies

In Nigeria, gender inequality significantly impacts women's knowledge and awareness of the transmission of the human immunodeficiency virus (HIV) and the proliferation of acquired immunodeficiency syndrome (AIDS). Early marriage, traditional beliefs, religion, and polygamy all contribute to gender inequality. This study explored the role of these and other sociocultural practices in the gender inequalities that increase vulnerability of contracting HIV/AIDS among women in Port Harcourt, Rivers State, Nigeria. The study employed a phenomenological design, collected data through a semistructured interview approach, which was managed using NVivo software. The purposive sample comprised 20 female students from a college in Port Harcourt. …

Adherence Barriers To Healthcare For African Americans With Hiv/Aids On Antiretroviral Medications, Angela Bumphus Corbin

Walden Dissertations and Doctoral Studies

The purpose of this mixed methods research study was to examine the role of adherence barriers to healthcare and the impact that such barriers have on highly active antiretroviral therapy (HAART) compliance for African Americans living with HIV/AIDS. HAART helps reduce HIV/AIDS morbidity and mortality. Of the 49% of study participants who had been out of medical care for more than 12 months, financial concerns were listed as the most common barrier (22.8%). Not having the support from family and friends (17.5%), being tired of going to doctor appointments (15.8%), health challenges (12.3%), lack of transportation (12.3%), and incarceration (12.3%) …

The Influence Of Culture On Hiv Disclosure Among Gay Asian Males, David C. Doan

Walden Dissertations and Doctoral Studies

HIV-positive, Asian Pacific Islander (API) men who have sex with men (MSM) experience triple minority stigma including HIV, sexual orientation, and minority ethnicity. To date, there is no research that examines the influence of cultural factors, level of acculturation, social determinants of health, and other confounding variables (e.g., age, education, level of income, and length of time since diagnosis) on HIV-positive disclosure behaviors, attitudes, and intentions to casual sexual partners for API MSM. The theoretical framework for this study was based on Hofstede's original cultural values and Triandis's cultural dimensions. In this 2-phase, mixed methods, sequential explanatory study, 24 API …

Risk Perception Of Hiv Infection Among The Nigerian African- Immigrant Population In Houston, Texas, Esther Titilayo Ogunjimi

Walden Dissertations and Doctoral Studies

HIV/AIDS studies mostly lack distinction between the US-born Blacks and non-US-born Blacks while African Americans (AAs) continues to represent the group with the heaviest burden of AIDS deaths and new diagnosis of HIV. A review of studies on HIV infection in the US, Europe, and other Western countries revealed a knowledge gap on HIV infection with non-refugee African immigrants (NRAIs), especially the Nigerian African Immigrants (NAIs) who are non-US-born Blacks. The purpose of this descriptive phenomenological study is to address this gap by exploring the expressed views of NAIs, a sub-group of the NRAIs living in Houston, Texas, on the …

The Impact Of Palliative Care On Health Status In Hiv-Positive Children, Aabid Abdulmajid Ahmed

Walden Dissertations and Doctoral Studies

HIV-positive children in sub-Saharan Africa have numerous challenges to overcome. These challenges increase psychosocial stress as well as symptom burden including fatigue, weight loss, pain, and mental changes. The symptoms may persist even after initiation of antiretroviral therapy, so such children need additional care. Palliative care lays emphasis on holistic patient-centered care, including physical, psychological, social, and spiritual symptoms, alongside antiretroviral therapy. There is limited data on the impact of integrating palliative care with standard HIV care and treatment in children. The purpose of this study was to fill the gap in the literature by investigating the impact of palliative …

Treatment Adherence Among Women Infected With Human Immunodeficiency Virus With A History Of Gender-Based Violence, Olivia Mcgregor

Walden Dissertations and Doctoral Studies

Women infected with Human Immunodeficiency Virus (HIV) are at high risk of myriad conditions, especially gender-based violence (GBV). GBV can be a hindrance to treatment adherence, which is pertinent to improving the health of people living with HIV. The purpose of this longitudinal research study was to assess the effects of GBV on treatment adherence among HIV infected women, with specific focus on when the violence occurred (recent or lifetime) and the stratifying type of GBV (sexual, physical, and psychological). The health belief model (HBM) served as a theoretical groundwork. Participants were selected from secondary data, collected by the Women’s …

A Model For Hiv Disclosure Of A Parent's And/Or A Child's Illness, Gary J. Burkholder Jr, Grace Gachanja

Walden Faculty and Staff Publications

HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent's and/or a child's HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an …

A Rapid Assessment Of Post-Disclosure Experiences Of Urban Hiv-Positive And Hiv-Negative School-Aged Children In Kenya, Grace Gachanja

Walden Faculty and Staff Publications

There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into …

Completion Of Preventive Health Care Actions By Older Women With Hiv/Aids, Patricia Kay Correll

Walden Dissertations and Doctoral Studies

The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the …

Evaluation Of A Mobile Health Intervention To Improve Anti-Retroviral Treatment Retention In South Africa, Ambereen Jaffer

Walden Dissertations and Doctoral Studies

South Africa has one of the highest HIV prevalence rates globally, with nearly 2.5 million people accessing antiretroviral treatment (ART) at the end of 2013. Retaining patients on ART has become a major problem in this country. When patients no longer show up for ART for unknown reasons, they are considered lost to follow-up (LTF). LTF is the highest contributor to ART attrition. This study, guided by the health belief model, evaluated the effectiveness of a technology-based, mobile health (mHealth) appointment reminder intervention on LTF among patients accessing ART services. The study ascertained differences in 6- and 12-month LTF rates …

Psycho-Social Resilience And Risky Hiv Behaviors Among Black Males Who Have Sex With Males, Wilson Osaro Iyokho

Walden Dissertations and Doctoral Studies

The incidence rate of HIV among Black males having sex with Black males (BMSM) is high compared to that of other racial groups. Researchers have established the association between inappropriate sexual practices, age, income, and environmental determinants and HIV positive status among BMSM. Guided by resilience theory, the purpose of this study was to examine the relationship between HIV risk behavior and resiliency with the goal of identifying a new intervention to mitigate the HIV infection rate in the BMSM community. The theoretical framework used for this study was the resilience theory. This theory is concern with the phenomenon of …

Health Literacy And Health Decision Making Attitudes In People With Human Immunodeficiency Virus, Christine Miranda

Walden Dissertations and Doctoral Studies

Health literacy has been recognized as a vital issue in the self-care management of persons living with HIV/AIDS (PLWHA). The purpose of this study was to determine the impact of functional, communicative, and critical health literacy dimensions on positive and negative attitudes toward health decision making. The transtheoretical model of health behavior change (TTM) provided the theoretical framework to explain this association. A culturally-adapted survey was used in this cross-sectional study to measure health literacy dimensions, positive and negatives attitudes toward health decision making, and other factors in 100 Puerto Ricans living with HIV/AIDS. Demographic factors and clinical and immunological …

Contextual Factors And Direct Exposure To Hiv: Influences On Youth Sexual Intention, Hadiza Ladidi Osuji

Walden Dissertations and Doctoral Studies

Youth are having sexual intercourse at an early age and as such, are engaging in risky behaviors that are associated with adverse health outcomes, including HIV infection. Little research has been undertaken to examine the influence of contextual factors on youth intentions to delay sexual involvement. To address that gap, this study aimed to examine the influence of age, gender, race, immigration status, HIV knowledge, HIV-related stigma, concern about HIV, direct exposure to HIV/AIDS, peer pressure, and religious influence on youth intentions to delay sexual involvement. Delayed sexual involvement was conceptualized as youth attitudes towards abstaining from sex, their knowledge …

African American Eighth Grade Students' Attitudes Toward Hiv/Aids In The District Of Columbia, Enock Kolawole Adewuyi

Walden Dissertations and Doctoral Studies

The group most affected by HIV/AIDS, according to the Centers for Disease Control and Prevention (CDC), is African Americans. The purpose of this study was to explore the knowledge of HIV/AIDS held by African American children as a first step towards developing prevention strategies for these youths. In order to bridge the knowledge-behavior gap, this study sought to investigate the attitude towards HIV/AIDS of African American 8th grade students. The study involved secondary data from the 2012 District of Columbia (DC) Middle School Youth Risk Behavior Survey, obtained from the District of Columbia Office of Superintendent of Education (OSSE). Guided …

Mining And Hiv/Aids Transmission Among Marampa Mining Communities In Lunsar, Sierra Leone, Alphajoh Cham

Walden Dissertations and Doctoral Studies

Since the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was first reported in Sierra Leone in 1987, its prevalence rate has stabilized at 1.5% in the nation's general population. However, concerns exist regarding the potential increase in high-risk populations, particularly among mineworkers and commercial sex workers. The potential spread of HIV/AIDS as a result of labor migration may threaten the mining sector, which has been identified as a critical driver of recent economic growth and development. A gap remains in the literature regarding the contextual factors in mining communities that lead to high rates of HIV/AIDS. Therefore, the purpose of …

Effect Of Social Support And Hiv-Related Stigma On Depression In Hiv/Aids Patients, Chinedu Anthony Umeadi

Walden Dissertations and Doctoral Studies

HIV has remained a public health problem in Nigeria. The purpose of this cross-sectional study was to examine the effect of social support and HIV-related stigma on depression in people living with HIV/AIDS (PLWHA) and to examine the moderating effect of sociodemographic factors, Quality of Life (QOL), and time since HIV diagnosis on this relationship. This study was based on the social cognitive theory. Data were collected from 98 PLWHA attending the antiretroviral clinic of Federal Medical Center, Umuahia, Nigeria. Regression analyses were used to examine the relationships between the variables. Some 24.5% of the study participants were depressed. Significant …

Hiv Stigma Within Religious Communities In Rural India, Krutarth J. Vyas

Walden Dissertations and Doctoral Studies

This study was conducted to gain a better understanding of HIV/AIDS-related stigma within religious communities in rural Gujarat, India. This study used the hidden distress model of HIV stigma and the HIV peer education model as conceptual frameworks to examine a rural population sample of 100 participants. Regression analysis was conducted to test if school education had a moderating effect on the relationship between illness as punishment for sin (IPS) and HIV stigma. Religiosity was tested for mediating effects on the relationship between early religious involvement (ERI) and HIV stigma. The results of this study indicated that single unemployed men …

Perspectives On Hiv/Aids: American-Based Nigerian Women Who Experienced Polygamy In Rural Nigeria, Christianah Oluseyi Olorunfemi

Walden Dissertations and Doctoral Studies

Traditionally, in Nigeria women play a subservient role in relation to men. While a man can practice polygamy by marrying many wives, women cannot marry more than one husband at a time. Although researchers have documented the effects of polygamy on the spread of HIV/AIDS, little is known about the experiences of polygamy by Nigerian women who stopped practicing polygamy by immigrating to the United States without their husbands. It is important to know the experiences of these women as they pertain specifically to the spread of HIV/AIDS so as to develop a preventive intervention for HIV/AIDS among Nigerian women …

Parents' And Children's Emotions Spanning The Hiv Disclosure Process In Kenya, Grace Gachanja, Gary J. Burkholder Jr, Aimee Ferraro

Walden Faculty and Staff Publications

2014 APHA Annual Conference Tuesday, November 18, 2014 New Orleans, LA

HIV disclosure from parent to child is challenging. While disclosure is expected to be emotion for parents and children, the total disclosure experience has not been described. The purpose of this study was to understand the lived experiences of HIV - positive parents and their children in Kenya during the disclosure process.

Hiv-Positive Parents, Hiv-Positive Children, And Hiv-Negative Children’S Perspectives On Disclosure Of A Parent’S And Child’S Illness In Kenya, Grace Gachanja, Gary J. Burkholder Jr, Aimee Ferraro

Walden Faculty and Staff Publications

HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at …