Public Health 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 …

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 …

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 …

Laboratory And Epidemiological Characteristics Of Zika Virus Infections In Florida, Stephen L. White

FIU Electronic Theses and Dissertations

Until recently, Zika virus (ZIKV) was an obscure virus that rarely caused infections and was unknown to most. In 2015 and 2016, ZIKV came into the public spotlight as Brazil and other countries began to report large increases in infections with ZIKV and reported potential complications with developing fetuses and neurologic manifestations. In 2016, the state of Florida identified and responded to an outbreak of locally acquired ZIKV infections in Miami-Dade County. This dramatic increase in infections demonstrated both its importance as an emerging infectious disease and the paucity of knowledge surrounding ZIKV. This study seeks to utilize the data …

Carbapenem-Resistant Enterobacteriaceae (Cre): Epidemiology, Duration Of Carriage, And Progression To Infection In A Large Healthcare System In Miami, Fl, Adriana Jimenez

FIU Electronic Theses and Dissertations

Carbapenem-resistant Enterobacteriaceae (CRE) are multidrug-resistant organisms (MDRO) considered by the CDC as an urgent public health threat that is spreading globally. Little is known about the epidemiology of CRE in Miami, FL. The purpose of this dissertation was to 1) Evaluate trends in the epidemiology of CRE among patients admitted to the acute care facilities of the largest healthcare system in Miami, FL between 2012 and 2016, 2) Identify factors associated with progressing to infection among patients colonized with carbapenemase-producing Enterobacteriaceae (CPE), and 3) Determine the duration of CPE carriage and factors associated with long-term carriage in our cohort.

A …

Examining Stigma And Its Effect On Hiv Prevention & Care Among People Living In Florida, Angel B. Algarin

FIU Electronic Theses and Dissertations

Persistent increases of HIV incidence in Florida has made it essential to study ways to improve HIV prevention strategies. Treatment as Prevention (TasP) and Preexposure Prophylaxis (PrEP) are two recent methods in HIV prevention; however, their success may be limited due to barriers such as stigma. This dissertation explored the relationship between HIV-related stigma and 1) antiretroviral therapy adherence and viral suppression and 2) symptoms of anxiety and depression. Additionally, it sought to develop and validate a scale to measure community PrEP-related stigma.

We used data from the Florida Cohort Study which include 932 people living with HIV (PLWH). The …

The Role Of Id3 And Pcb153 In The Hyperproliferation And Dysregulation Of Lung Endothelial Cells, Mayur Arvind Doke

FIU Electronic Theses and Dissertations

Uncontrolled growth of vascular stem cells as a result of endothelial-mesenchymal transition is considered to cause hyper-proliferative vascular remodeling in severe pulmonary arterial hypertension (PAH) patients. Hyperplastic intimal growth is one of the causes of closure of the lumen of pulmonary arterioles. This abnormal vessel remodeling leads to the progressive increase in pressure of the pulmonary arterioles causing severe PAH; and debilitating harm to patients resulting in mortality from right heart failure. Environmental factors, including polychlorinated biphenyls (PCBs), are considered to be involved in hyper-proliferative vascular remodeling because genetic makeup can only explain about 10% of severe PAH cases. PCB …

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 …

Id3, Estrogenic Chemicals, And The Pathogenesis Of Tumor-Like Proliferative Vascular Lesions, Vincent E. Avecilla

FIU Electronic Theses and Dissertations

Tumor-like proliferative vascular lesions manifest in several diseases such as peripheral arterial disease (PAD) and atherosclerosis (AS) after arterial injury. The cause of the vascular cell dysfunction in PAD patients is not known. Our recent novel discovery shows that inhibitor of differentiation 3 (ID3) is highly expressed in intimal lesions of clinical vascular disease samples. The central hypothesis of our study is: estrogenic chemical induced dysregulation of ID3 target genes is involved in the development of vascular disease. NHANES data analysis demonstrated higher geometric levels of all 6 PCB congeners in both PAD diagnosed participants and participants at risk of …

Living With Uncertainty: Acting In The Best Interests Of Women, Erica Gollub, Zena Stein

HWCOM Faculty Publications

A recent multi-country study on hormonal contraceptives (HC) and HIV acquisition and transmission among African HIV-serodiscordant couples reported a statistically significant doubling of risk for HIV acquisition among women as well as transmission from women to men for injectable contraceptives. Together with a prior cohort study on African women seeking health services, these data are the strongest yet to appear on the HC-HIV risk. This paper will briefly review the Heffron study strengths and relevant biological and epidemiologic evidence; address the futility of further trials; and propose instead an alternative framework for next steps. The weight of the evidence calls …