Public Health Commons^™

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

Electronic Theses and Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Using Telemedicine And Telehealth To Extend Services In Hiv Care, Jeffery Dockery Mr., Heather G. Peebles Ms.

Georgia Public Health Association Annual Meeting and Conference

Background

The COVID-19 pandemic posed many barriers to healthcare but especially for HIV Public Health clients who struggle to meet basic socioeconomic needs. Southeast Health District (SEHD) Ryan White clients are immunocompromised increasing isolation and fear. In addition to client barriers, the pandemic resulted in a staffing shortage. The shortages were due to COVID diagnosis and subsequent isolation, staffing turnover, and unfillable vacancies.

Method

A dedicated schedule is utilized for Telehealth/Telemedicine. A patient is scheduled at a remote site and connected with a practitioner at another location. The SEHD Ryan White Program currently has 4 clinics located in Bulloch, Coffee, …

Hiv Viral Load Suppression Before And After Covid-19 In Kinshasa And Haut Katanga, Democratic Republic Of The Congo, Gulzar H. Shah, Gina D. Etheredge, Stacy Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.

Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.

Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.

Results: After controlling for covariates …

Socioeconomic Status And Other Factors Associated With Hiv Status Among Ovc In Democratic Republic Of Congo (Drc), Gulzar H. Shah, Gina D. Etheredge, Lievain Maluantesa, Kristie Cason Waterfield, Osaremhen Ikhile, Elodie Engetele, Astrid Mulenga, Alice Tabala, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa.

Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC.

Methods: For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents' or guardians' characteristics. We …

Barriers To Hiv Related Services Among Men Who Have Sex With Men (Msm) In Rural Georgia, Jordan D. Helms, Alvin Tran, Neal Carnes, Eric J. Nehl

Journal of the Georgia Public Health Association

Background: Gay, bisexual, and men who have sex with men (MSM) living in the Southeastern United States are at high risk of contracting HIV, and those in rural communities experience challenges in accessing HIV prevention and treatment.

Methods: Seven health care workers and 17 MSM in rural health care districts participated in semi-structured interviews. A theory-informed thematic analysis approach was used to summarize and compare perspectives between health care workers and MSM participants.

Results: Stigma, insufficient resources, and social structures of rural life emerged as barriers to accessing HIV-related services

Conclusions: Overcoming these barriers are necessary to reduce HIV infection …

Consequences Of Covid-19 Crisis For Persons With Hiv: The Impact Of Social Determinants Of Health, Kristie Cason Waterfield, Gulzar H. Shah, Gina D. Etheredge, Osaremhen Ikhile

Department of Health Policy and Community Health Faculty Publications

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher …

Exploring Psychosocial Factors And Sexual Risk Behavior Of Men Who Have Sex With Men In The United States Military: Project Minds, Erin Jordan

Electronic Theses and Dissertations

Statement of the Problem: Men who have sex with men (MSM) are at disproportionate risk for HIV infection. While many studies have examined psychosocial factors associated with HIV risk among MSM, few have focused specifically on MSM in the military. The purpose of this exploratory study is to examine ways in which specific psychosocial factors are associated with sexual risk behaviors among MSM in the military.

Methods: Data were collected from 63 MSM who were active duty military personnel or veterans in the Southeastern US. Participants were recruited from geosocial mobile applications, social media platforms, and military LGBT organizations. Logistic …

Physician Attitudes Toward The Ethics Of Pre-Exposure Prophylaxis (Prep): Cost, Safety, And Resource Allocation, Jessica Grippo, Stacy W. Smallwood, Katherine Pincura, Tamara Wright, William A. Mase

Journal of the Georgia Public Health Association

Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP.

Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for …

Associations Between Major Depression, Health-Risk Behaviors, And Medication Adherence Among Hiv-Positive Adults Receiving Medical Care In Georgia, Rachel Culbreth, Shanta R. Dube, David Maggio

Journal of the Georgia Public Health Association

Background: There are approximately 1.2 million people in the United States living with HIV, and 25.6% of HIV-positive adults suffer from depression. The purpose of this study is to examine the contribution of depression to substance use and medication adherence among HIV-positive adults receiving medical care for HIV in Georgia.

Methods: Secondary data with a probability sample of 775 HIV-positive adults who took part in the 2009-2013 Georgia Medical Monitoring Project (MMP) were analyzed. Descriptive analyses and multivariate logistic regressions were conducted to assess relationships between depression and current cigarette smoking, injection drug use, other non-injection drug use, and medication …

The Care Continuum For People Living With Hiv In Georgia: How Can We Raise The Bar?, Jane Kelly, Deepali Rane, C. Drenzek

Journal of the Georgia Public Health Association

Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia.

Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age.

Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage …

Perceptions Of Hiv/Aids Testing Among Urban And Rural African American Church Members, Roblena E. Walker

Journal of the Georgia Public Health Association

Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members.

Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n =114) in the Southern U.S.

Results: The …

Surviving Hiv And Dying For A Smoke: Implications For Tobacco Use Among People Living With Hiv, Rachel Culbreth, Jane Kelly, David Maggio, Pascale M. Wortley, Cherie Drenzek

Journal of the Georgia Public Health Association

Background: Since the advent of highly active antiretroviral therapy in the mid-nineties, deaths among persons living with HIV (PLWH) have declined nationally. Now a controllable condition, HIV has become a chronic disease, highlighting the importance of tobacco cessation in lowering morbidity and premature mortality. Current smoking is approximately twice as high among PLWH compared with the general population. PLWH who smoke experience higher rates of cardiovascular disease, AIDS-defining illnesses, and cancer than PLWH who do not smoke. Loss of life-years associated with smoking among PLWH is greater than life-years lost from HIV.

Methods: Data on current smoking, derived from the …

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Rates of Chlamydia, Gonorrhea, and Genital Herpes
• QI to Improve HIV Reporting

Hiv And Hepatocellular And Esophageal Carcinomas Related To Consumption Of Mycotoxin-Prone Foods In Sub-Saharan Africa, Jonathan H. Williams, Jessica A. Grubbs, Jerry W. Davis, Jia-Sheng Wang, Pauline E. Jolly, Nii-Ayi Ankrah, William O. Ellis, Evans Afriyie-Gyawu, Natalie M. Johnson, Abraham G. Robinson, Timothy D. Phillips

Environmental Health Sciences Faculty Publications

Background: Promotion of the HIV epidemic by aflatoxin is postulated but not yet established. Sub-Saharan populations commonly consume food contaminated by mycotoxins, particularly aflatoxins (predominantly found in peanut, maize, rice, and cassava) and fumonisins, which occur primarily in maize. Aflatoxin promotes hepatocellular cancer, and fumonisin may promote esophageal cancer.

Objectives: This analysis was undertaken to test the hypotheses that consumption of mycotoxin-prone staple foods is 1) related to the incidence of HIV infection in Africa and 2) related to “signature” cancer rates confirming exposure to aflatoxins and fumonisins.

Design: World Health Organization data for causes of death and the Food …

Hiv Rates In The State Of Georgia: A Growing Threat Among Predominately African American Populations, Swati Raychowdhury, Stuart H. Tedders

Epidemiology Faculty Publications

Background: US rates of HIV/AIDS continue to rise with over 55% of new cases identified in southern states in 2003. The objective of this study was to determine the magnitude of HIV/AIDS cases in rural southeast Georgia in comparison to urban areas of the state.

Methods: County level data was acquired using OASIS. Rates of HIV infections by gender and race (black vs. white) were aggregated over a five year period (2000–2005) and indirectly adjusted using Georgia as the standard. Rates for rural counties, (populations less than 35,000), were statistically compared to urban rates (α = 0.05).

Results: HIV infections …

Modelling The Impact And Cost-Effectiveness Of The Hiv Intervention Programme Amongst Commercial Sex Workers In Ahmedabad, Gujarat, India, Isaac Chun-Hai Fung, Lorna Guinness, Peter Vickerman, Charlotte Watts, Gangadhar Vannela, Jagdish Vadhvana, Anna M. Foss, Laxman Malodia, Meena Gandhi, Gaurang Jani

Isaac Chun-Hai Fung

Background: Ahmedabad is an industrial city in Gujarat, India. In 2003, the HIV prevalence among commercial sex workers (CSWs) in Ahmedabad reached 13.0%. In response, the Jyoti Sangh HIV prevention programme for CSWs was initiated, which involves outreach, peer education, condom distribution, and free STD clinics. Two surveys were performed among CSWs in 1999 and 2003. This study estimates the cost-effectiveness of the Jyoti Sangh HIV prevention programme.
Methods: A dynamic mathematical model was used with survey and intervention-specific data from Ahmedabad to estimate the HIV impact of the Jyoti Sangh project for the 51 months between the two CSW …