Medicine and Health Sciences Commons^™

Preparing To Break Barriers: A Mixed Methods Exploration Of The Knowledge, Attitudes, And Perceptions Of Hiv, Prep, And Hiv Risk Behaviors Among Women Of Color In Miami, Florida, Amanda C. Ichite

FIU Electronic Theses and Dissertations

The U.S. HIV epidemic is characterized by regional, racial, and ethnic disparities. HIV rates are disproportionately higher in the South and Black and Hispanic populations are most impacted. Moreover, the intersectional identity of being a Black or Hispanic woman living in the South has been associated with profound disparities in HIV impact. Prior to the advent of the biomedical HIV prevention tool pre-exposure prophylaxis (PrEP) in 2012, women were limited in their options for female-controlled HIV prevention strategies. Despite the proven efficacy of PrEP, utilization in women is significantly lower than other at-risk groups. In the present study, secondary analysis …

Serpin-Derived Novel Peptide For The Treatment Against Hiv-Induced Inflammation In The Central Nervous System, Yemmy Soler

FIU Electronic Theses and Dissertations

In the brain, HIV predominantly infects microglia/macrophages and astrocytes to a lesser extent. These cells form virus reservoirs with low levels of infection that are very hard to eradicate. Even though the use of cART increases survival rate in HIV patients, the virus persists as a chronic condition. cART is not able to effectively cross the BBB, control HIV replication, or attenuate inflammation in brain reservoirs. Therefore, the virus still causes neuronal dysfunction, pain-related pathology, and ultimately HAND. In this study, we decided to test the hypothesis that a serpin-derived small peptide, SP16, can serve as an anti-viral, anti-inflammatory, pro-survival, …

Understanding Exosomal Extracellular Vesicles And Morphine In The Neuropathology Of Human Immunodeficiency Virus And Differential Zika Virus Strain-Associated Pathology, Allen Caobi

FIU Electronic Theses and Dissertations

Exosomal Extracellular Vesicles (xEVs), integral to intercellular communication and regulation of immune responses, have functional effects based on their contents, which they transport to neighboring cells. However, in the context of infection, EV cargo can be modulated, by either infected or uninfected cells. We hypothesize that CNS-associated neuropathology, is partially, due to the cargo transported by the exosomes. We theorize that the cargo released from infected cell-derived xEVs may either facilitate or inhibit viral neuropathogenicity. Here we investigated xEVs in the case of two neurotropic viruses, Zika virus (ZIKV) and Human Immunodeficiency Virus (HIV). The hallmark characteristic of ZIKV-infection is …

Examining The Effects Of Individual And Neighborhood Factors On Hiv Transmission Risk Potential Among People With Hiv, Semiu Olatunde Gbadamosi

FIU Electronic Theses and Dissertations

HIV transmission risk significantly increases in late-diagnosed HIV and at HIV viral load (VL) >1500 copies/mL. The objective of this dissertation was to examine factors associated with HIV transmission risk potential for persons with HIV (PWH) using measures of time from HIV infection to diagnosis and trajectories of VL suppression. Additionally, we sought to determine whether a single yearly VL measure—the current standard to track the HIV epidemic in the United States—is reliable in assessing viral suppression for PWH. The first study estimated the distribution of time from HIV infection to diagnosis in Florida using a CD4 depletion model and …

The Impact Of Hiv-Related Stigma On The Racial/Ethnic Disparities Across The Hiv Care Continuum Among Adults Living With Hiv In Florida, Derrick James Forney

FIU Electronic Theses and Dissertations

Background: Florida currently has one of the highest rates of new HIV infections in the U.S. As of 2019, Black and Hispanic HIV-positive individuals in Florida were significantly less likely to receive HIV care, remain in care, and achieve viral suppression than white HIV-positive individuals. Several studies have linked HIV-related stigma to poor outcomes among people living with HIV (PLWH). This study examined the impact of distinct HIV-related stigma subtypes on linkage to care, retention in care, and viral suppression among PLWH in Florida and if these associations differed across race/ethnicity.

Methods: Data from the 2015-2017 Florida Medical Monitoring Project …

Hiv Risk Factors, Enacted Stigma, And Testing Outcomes Among Men Who Have Sex With Men In Florida, Sarah Suarez

FIU Electronic Theses and Dissertations

Crucial to ending the HIV epidemic is the prompt identification of HIV through testing services. National recommendations suggest everyone should test for HIV at least annually, and those with higher risk should test more often (for example, every 3 to 6 months). An estimated 66% of new HIV infections in 2018 occurred among men who have sex with men (MSM). Florida is third in the nation for HIV diagnoses among adults and adolescents (25.0 per 100,000 population) with an estimated 119,661 persons living with HIV; MSM account for 74% of the cases. This dissertation used the American Men’s Internet Survey …

Food Insecurity Is Associated With Nonalcoholic Fatty Liver Disease, Cognitive Impairment, And Immune Activation In People Living With Hiv, Javier A. Tamargo

FIU Electronic Theses and Dissertations

Food insecurity (FI) is a socioeconomic condition characterized by inadequate access to enough food and nutrition to sustain health and wellbeing. Food insecurity is a risk factor for chronic and age-related conditions, raising concerns for the aging population of people living with HIV (PLWH), in whom food insecurity is disproportionately prevalent. PLWH are at increased risk of nutrition-related complications and chronic co-morbidities, thus food insecurity may exacerbate adverse health outcomes in this population. This study investigated whether food insecurity was associated with nonalcoholic fatty liver disease (NAFLD), cognitive impairment, and immune activation among socioeconomically disadvantaged adults living with and without …

Gut Integrity, Microbial Translocation, Immune Activation, Inflammation And Vitamin D In Drug Users Living With Hiv, Jacqueline S. Hernandez

FIU Electronic Theses and Dissertations

The purpose of this study was to examine associations between MT, immune activation, inflammation, gut integrity and vitamin D status in the context of cocaine use among People Living with HIV (PLWH). One hundred cocaine and non-cocaine users living with HIV were selected from the Miami Adult Studies in HIV cohort. Blood samples were collected to assess MT (LPS), immune activation (sCD163 and sCD27), inflammation (IL-6, TNF-a, hs-CRP, IL-17 and IL-22), gut integrity damage (I-FABP) and vitamin D status. Data on socio-demographic characteristics, anthropometrics, diet and disease progression were collected. Descriptive statistics, independent t-test, multiple linear and logistic regressions were …

Randomized Clinical Trial Of The Effect Of Oral Supplementation With N-Acetyl Cysteine And Glycine On Biomarkers Of Oxidative Stress And Inflammation In People Living With Hiv (Plwh) From The Mash Cohort, Alhanoof Al-Ohaly

FIU Electronic Theses and Dissertations

HIV infection has been associated with glutathione (GSH) depletion, oxidatively damaged DNA, and inflammation. People living with HIV (PLWH) have subnormal levels of GSH and elevated levels of inflammation biomarkers such as C-Reactive Protein (CRP). Failure of the antioxidant enzymatic system increases oxidatively damaged DNA. The objective of this double-blinded randomized clinical trial was to supplement PLWH with a combination of N-acetylcysteine, a powerful antioxidant, and glycine, a precursor of GSH or placebo for three months to decrease oxidative stress and inflammation.

The trial recruited 30 PLWH from the Miami Adult Studies on HIV (MASH) cohort at the FIU Research …

Developing Triage Tools For Retention In Care And Viral Suppression, And Identifying Predictors Of Sexually Transmitted Infections Among People With Hiv, Merhawi T. Gebrezgi

FIU Electronic Theses and Dissertations

This study developed risk prediction tools for non-retention in HIV care and non-viral suppression, and identified factors associated with self-reported chlamydia and gonorrhea diagnosis among people with HIV (PHIV) in the Miami-Dade County Ryan White Program (RWP). Using retrospective cohort study data, we used stepwise logistic regression to develop score-based risk prediction tools for non-retention in care and non-viral suppression. We then used bootstrapping to internally validate the risk prediction tools. We also assessed the prevalence of self-reported chlamydia and gonorrhea diagnoses and factors associated with the diagnoses cross-sectionally using multivariate logistic regression.

Among the 7439 people meeting the inclusion …

Individual Level Factors Associated With Hiv Care Continuum Metrics Among Mash Cohort Participants From 2009-2014, Kristopher Myers

FIU Electronic Theses and Dissertations

This dissertation assessed the following: 1) the individual-level factors’ individual, syndemic, and interactive associations with retention in HIV care; 2) the individual-level factors’ individual, syndemic, and interactive associations with adherence among retained persons; and 3) the individual-level factors’ individual, syndemic, and interactive associations with viral suppression among retained persons. In the first study, Non-Hispanic Black race/ethnicity was associated with improved retention (OR=2.44, 95%CI: 1.06–5.75, p≤0.05). “Black-Hispanic” and “Other” racial/ethnic identities were associated with increased retention among participants (OR=4.84, 95%CI: 1.16–25.79, p≤0.05 and OR=7.24, 95%CI: 1.54–54.05p≤0.05, respectively). The interaction between depressive symptoms and alcohol use disorder was significantly and negatively associated …

Effectiveness Of A 6-Month Nutrition Intervention Targeting Prediabetes In People Living With Hiv (Plwh) And Prediabetes, Alicia Sneij

FIU Electronic Theses and Dissertations

The objective of this study was to assess the effectiveness of a 6-month randomized, controlled nutrition intervention targeting prediabetes in people living with HIV (PLWH) and have prediabetes. Participants (n=38) were randomized into the intervention group (n=20) or the control group (n=18). Participants randomized into the intervention group met once a month for approximately 1 hour to receive medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Fasting blood glucose (FBG) for the 6-month follow-up for the intervention group was significantly reduced compared to baseline (p=0.03). No significant difference was …

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 …

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 …

Strategic Communications To Prevent Hiv Infections Among Black And Hispanic Young Adults, Elena Sebekos

FIU Electronic Theses and Dissertations

Disparities in HIV disease continue to adversely affect Black and Hispanic populations in the United States. Racial and Ethnic Approaches to Community Health (REACH) 2010 in Broward County, Florida, used strategic communications to alert Black and Hispanic young adults of the serious threat and the choices they could make to prevent HIV infection. This study assessed the channels through which 18-39 year-old African American, Haitian, Afro-Caribbean, and Hispanic residents of 12 high AIDS-incidence ZIP-code areas obtained information about HIV/AIDS and which sources they found most helpful. In addition, this study examined how obtaining HIV/AIDS information was associated with histories of …

In Search Of Safety, Negotiating Everyday Forms Of Risk: Sex Work, Criminalization, And Hiv/Aids In The Slums Of Kampala, Serena Cruz

FIU Electronic Theses and Dissertations

This dissertation offers an in-depth descriptive account of how women manage daily risks associated with sex work, criminalization, and HIV/AIDS. Primary data collection took place within two slums in Kampala, Uganda over the course of fourteen months. The emphasis was on ethnographic methodologies involving participant observation and informal and unstructured interviewing. Insights then informed document analysis of international and national policies concerning HIV prevention and treatment strategies in the context of Uganda. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for …

The Influence Of Gene Environment Interaction On The Risk Of Cognitive Impairment: Reducing Sexual Risk Behaviors And Alcohol Use In Hiv-Infected Adults, Karina Villalba Phd

FIU Electronic Theses and Dissertations

Memory deficits and executive dysfunction are highly prevalent among HIV-infected adults. These conditions can affect their quality of life, antiretroviral adherence, and HIV risk behaviors. Several factors have been suggested including the role of genetics in relation to HIV disease progression. This dissertation aimed to determine whether genetic differences in HIV-infected individuals were correlated with impaired memory, cognitive flexibility and executive function and whether cognitive decline moderated alcohol use and sexual transmission risk behaviors among HIV-infected alcohol abusers participating in an NIH-funded clinical trial comparing the efficacy of the adapted Holistic Health Recovery Program (HHRP-A) intervention to a Health Promotion …

The Influence Of Neurocognitive Impairment, Alcohol And Other Drug (Aod) Use, And Psychosocial Factors On Antiretroviral Treatment Adherence, Service Utilization And Viral Load Among Hiv-Seropositive Adults, Jennifer Attonito

FIU Electronic Theses and Dissertations

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL.

The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from …