Medicine and Health Sciences Commons^™

Identifying Important Explanatory Variables For Time-Varying Outcomes., Oliver Bembom, Maya L. Petersen, Mark J. Van Der Laan

Maya Petersen

This chapter describes a systematic and targeted approach for estimating the impact of each of a large number of baseline covariates on an outcome that is measured repeatedly over time. These variable importance estimates can be adjusted for a user-specified set of confounders and lend themselves in a straightforward way to obtaining confidence intervals and p-values. Hence, they can in particular be used to identify a subset of baseline covariates that are the most important explanatory variables for the time-varying outcome of interest. We illustrate the methodology in a data analysis aimed at finding mutations of the human immunodeficiency virus …

Assessing The Effectiveness Of Antiretroviral Adherence Interventions: Using Marginal Structural Models To Replicate The Findings Of Randomized Controlled Trials., Maya L. Petersen, Yue Wang, Mark J. Van Der Laan, David R. Bangsberg

Maya Petersen

Randomized controlled trials of interventions to improve adherence to antiretroviral medications are not always feasible. Marginal Structural Models (MSM) are a statistical methodology that aims to replicate the findings of randomized controlled trials using observational data. Under the assumption of no unmeasured confounders, three MSM estimators are available to estimate the causal effect of an intervention. Two of these estimators, G-computation and Inverse Probability of Treatment Weighted, can be implemented using standard software. G-computation relies on fitting a multivariable regression of adherence on the intervention and confounders. Thus, it is related to the standard multivariable regression approach to estimating causal …

Revisiting The Ethics Of Hiv Prevention Research In Developing Countries, Charles Weijer, Guy Leblanc

Philosophy Presentations

Issues: We present key aspects of our paper, commissioned by UNAIDS in 2005, entitled, “Revisiting the ethics of HIV prevention research in developing countries.” In 2004 and 2005 we witnessed the closure or suspension of three international clinical trials testing tenofovir in the prevention of HIV infection in high risk groups due to the failure to provide free treatment to those who seroconvert during the conduct of the study. We examine critically moral claims for the provision of treatment to those who seroconvert in HIV prevention trials and ask whether it is a matter of moral obligation or moral negotiation? …

Alpha Interferon Potently Enhances The Anti-Human Immunodeficiency Virus Type 1 Activity Of Apobec3g In Resting Primary Cd4 T Cells, Keyang Chen, Jialing Huang, Chune Zhang, Sophia Huang, Guiseppe Nunnari, Feng-Xiang Wang, Xiangrong Tong, Ling Gao, Kristi Nikisher, Hui Zhang

Department of Medicine Faculty Papers

The interferon (IFN) system, including various IFNs and IFN-inducible gene products, is well known for its potent innate immunity against wide-range viruses. Recently, a family of cytidine deaminases, functioning as another innate immunity against retroviral infection, has been identified. However, its regulation remains largely unknown. In this report, we demonstrate that through a regular IFN-{alpha}/ß signal transduction pathway, IFN-{alpha} can significantly enhance the expression of apolipoprotein B mRNA-editing enzyme-catalytic polypeptide-like 3G (APOBEC3G) in human primary resting but not activated CD4 T cells and the amounts of APOBEC3G associated with a low molecular mass. Interestingly, short-time treatments of newly infected resting …

Revisiting The Ethics Of Hiv Prevention Research In Developing Countries, Charles Weijer, Guy Leblanc

Charles Weijer

Issues: We present key aspects of our paper, commissioned by UNAIDS in 2005, entitled, “Revisiting the ethics of HIV prevention research in developing countries.” In 2004 and 2005 we witnessed the closure or suspension of three international clinical trials testing tenofovir in the prevention of HIV infection in high risk groups due to the failure to provide free treatment to those who seroconvert during the conduct of the study. We examine critically moral claims for the provision of treatment to those who seroconvert in HIV prevention trials and ask whether it is a matter of moral obligation or moral negotiation? …

Health Focused Education And Counseling For A Patient Diagnosed As Hiv Positive, Thomas W. Miller, Kate E. Bousaada, Lisa-Rose Rodriguez, Timothy Maggio, Jeanne Chadwick

Internet Journal of Allied Health Sciences and Practice

AIDS is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). Examined is a patient education and counseling model applied to a patient with AIDS. Offered is a model utilizing problem based questions, goals and objectives and applied theory that is summarized in an algorithm of care for the patient with AIDS. Stages of HIV infection are used to facilitate clinical evaluation and plan therapeutic interventions. The process of health-focused counseling involves a number of critical components: assessment, patient education, health focused counseling, treatment intervention, and follow-up. The use of the health focused education and counseling model has …

Antioxidant Enzyme Gene Delivery To Protect From Hiv-1 Gp120-Induced Neuronal Apoptosis, Lokesh Agrawal, Jean-Pierre Louboutin, Beverly A.S. Reyes, Elisabeth J. Van Bockstaele, David S. Strayer

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Human immunodeficiency virus-1 (HIV-1) infection in the central nervous system (CNS) may lead to neuronal loss and progressively deteriorating CNS function: HIV-1 gene products, especially gp120, induce free radical-mediated apoptosis. Reactive oxygen species (ROS), are among the potential mediators of these effects. Neurons readily form ROS after gp120 exposure, and so might be protected from ROS-mediated injury by antioxidant enzymes such as Cu/Zn-superoxide dismutase (SOD1) and/or glutathione peroxidase (GPx1). Both enzymes detoxify oxygen free radicals. Because they are highly efficient gene delivery vehicles for neurons, recombinant SV40-derived vectors were used for these studies. Cultured mature neurons derived from NT2 cells …

Bronchoscopic Study On Aetiology Of Chronic Cough In Hiv-Infected Adults With Negative Sputum Smears For Mycobacterium Tuberculosis At Kenyatta National Hospital, Nairobi, A. M. Siika, J. M. Chakaya, Gunturu Revathi, S. S. Mohamed, K.M .. Bhatt

Pathology, East Africa

Objective: To establish the aetiology of chronic cough in HIV-infected patients with negative sputum smears for Acid Fast Bacilli (AFB).

Design: A cross-sectional descriptive study.

Setting: Kenyatta National Hospital, a tertiary referral centre in Kenya

Subjects: Sixty five HIV-infected adults presenting with chronic cough and negative sputum smears for AFBs.

Results: Sixty-two patients were included in the final analysis. Aetiology of chronic cough was established in 42 (68%) patients. Pneumocystis jiroveci, bacterial pneumonia and Mycobacterium tuberculosis were diagnosed in 22 (35.5%),17 (27.4%) and 14 (22.5%) patients respectively. Majority (98%) of patients with a diagnosis had multiple causes established …

Treatment Of Chronic Hepatitis C In Hiv-Infected Patients, P. Petcharapirat, R. Rerknimite

Chulalongkorn Medical Journal

No abstract provided.

Predictors Of Quality Of Life In Hiv-Infected Rural Women: Psychometric Test Of The Chronic Illness Quality Of Life Ladder, C. Murdaugh, L. Moneyham, K. Jackson, Kenneth D. Phillips, A. Tavakoli

Faculty Publications and Other Works -- Nursing

The Chronic Illness Quality of Life Ladder (CIQOLL) underwent psychometric testing in a sample of 278 women with HIV disease. The CIQOLL, a self-anchoring striving scale based on Cantril’s Ladder, measures seven domains (physical , emotional, financial, family and friends, spiritual well-being, peace of mind, and overall life satisfaction) across four time periods (present, past, future, life without a diagnosis of HIV). The domains were derived from focus groups with persons with HIV disease. Women with a diagnosis of HIV Infection, age 18 or older, residing in rural areas in the southeastern United States, completed questionnaires that measured physical functioning, …

Machismo As A Determinant For Hiv/Std Risk Behavior Among Latino Msm, Jacqueline L. Sears

Theses and Dissertations

Objective: Male-to-male sexual contact is the most common mode of transmission for HIV among Latino men. Psychosocial factors such as machismo, homophobic discrimination, and internalized homophobia have been hypothesized to greatly impact sexual behaviors among Latinos. However, studies investigating the relationship between these psychosocial factors and risky sexual behaviors are limited. This study examined the impact of machismo on risky sexual behaviors among Latino Male who have Sex with Men (MSM).Methods: This study utilized data collected from 254 Latino MSM in 1999 from selected cities within Virginia. The analysis focused on respondent demographic characteristics, psychosocial factors, acculturation, and sexual risky …

Predictors Of Quality Of Life In Hiv-Infected Rural Women: Psychometric Test Of The Chronic Illness Quality Of Life Ladder, C. Murdaugh, L. Moneyham, K. Jackson, Kenneth D. Phillips, A. Tavakoli

Kenneth D. Phillips

The Chronic Illness Quality of Life Ladder (CIQOLL) underwent psychometric testing in a sample of 278 women with HIV disease. The CIQOLL, a self-anchoring striving scale based on Cantril’s Ladder, measures seven domains (physical , emotional, financial, family and friends, spiritual well-being, peace of mind, and overall life satisfaction) across four time periods (present, past, future, life without a diagnosis of HIV). The domains were derived from focus groups with persons with HIV disease. Women with a diagnosis of HIV Infection, age 18 or older, residing in rural areas in the southeastern United States, completed questionnaires that measured physical functioning, …

Enhancing Human Security: U.S. Policies And Their Health Impact On Women In Sub-Saharan Africa, Tamera Fillinger

University of Maryland Law Journal of Race, Religion, Gender and Class

No abstract provided.

Factors Associated With High Sexual Risk Behavior In Single Women, Thomas B. M. Leecost

Theses and Dissertations

Objective: This study was to identify factors associated with High Sexual Risk Behavior (HSRB) in single Afro American women seen in an Epidemiology/Sexual transmitted disease (EPID/STD) Clinic in Richmond, Virginia from January 2006 through April 2006.Method: Participants were 154 single women (no history of marriage) between the ages of 18-30 visiting the EPID/STD clinic for the first time.Demographic information was obtained from their records. A volunteer interview was given that contained 101 variables to evaluate for High Sexual Risk Behavior (HSRB). HSRB was defined to response 'yes' to the question, "During the past 3 months did you have sex with …

Optimal Therapy Regimens For Treatment-Resistant Mutations Of Hiv, Weiqing Gu, Helen Moore

All HMC Faculty Publications and Research

In this paper, we use control theory to determine optimal treatment regimens for HIV patients, taking into account treatment-resistant mutations of the virus. We perform optimal control analysis on a model developed previously for the dynamics of HIV with strains of various resistance to treatment (Moore and Gu, 2005). This model incorporates three types of resistance to treatments: strains that are not responsive to protease inhibitors, strains not responsive to reverse transcriptase inhibitors, and strains not responsive to either of these treatments. We solve for the optimal treatment regimens analytically and numerically. We find parameter regimes for which optimal dosing …

Lack Of Knowledge Of Mother-To-Child Transmission In Kenya Among Women Ages 15-49, Nisha Warrier

Theses and Dissertations

Purpose: The epidemic of mother-to-child transmission (MTCT) of HIV/AIDS in resource-poor countries is dramatic; it is responsible for nearly 90% of childhood infections. The primary purpose of analysis was to understand the distribution of factors and their association with lack of knowledge of MTCT in Kenya. In parallel, another aim was to identify the relationship between media, particularly frequency of radio exposure, and lack of knowledge.Methods: This study used the 2003 Kenya Demographic and Health Survey (DHS) collected for 8,195 women, ages 15-49. Descriptive analysis, univariate analysis, and logistic regression were completed on SPSS 14 software.Results: In the sample, 1151 …

“You’Re Awfully Old To Have This Disease”: Experiences Of Stigma And Ageism In Adults 50 Years An Older Living With Hiv/Aids., Charles A. Emlet

Charles Emlet

No abstract provided.