Community Health and Preventive Medicine Commons^™

Exploring Disparities In Prep Prescriptions For High-Risk Hiv Patients Using Real-World Data, Andrew Murdock, Farah Pathan, Sibyl Munson, Fabian D'Souza

Tower Health Research Day

No abstract provided.

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

The Red Ribbon And The Black Cross: A Qualitative Study Of The Relationship Between Social Activism And Contemporary Black Church Responses To Hiv In Oakland, Ca, Justise Wattree

McNair Research Journal SJSU

The Black Church as a social institution has been a source of social activism during racial crises, but there is a lacking social activist response by Black churches to HIV’s disparate impact on Black communities. Previous research does not adequately explore the influence of community-based organizations on Black church responses to HIV in the context of social activism. This study examines the relationship between social activism and contemporary Black church responses to HIV in Oakland. It considers community-based organizations (CBOs) as potential drivers of social activism. Semi-structured interviews with Black church leaders in Oakland were conducted and content analyzed along …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

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 …

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 …

Impact Of The Covid-19 Pandemic On The Care Continuum Of Youth Living With Hiv: Qualitative Study Of The Scale It Up Program Clinical Sites, Tyra Dark, Sitaji Gurung, Mary Dooley, Kit N. Simpson, Seyram A. Butame, Sylvie Naar

Publications and Research

The study objective was to explore the impact of COVID-19 pandemic restrictions on the clinics’ ability to provide continuous healthcare services to youth (15–24 years) living with HIV (YLWH). One focused semi-structured interview was conducted with each HIV clinic site—resulting in ten interviews. Data were analyzed using thematic analysis techniques assisted by NVIVO coding software and themes indicating barriers and facilitators to providing uninterrupted healthcare were elicited. Six themes were identified that affected the care continuum of YLWH: Timeframe of clinic preparation to address COVID-19 restrictions; impact on treatment cascade monitoring data; impact on patient care; impact on staff and …

Exploring The Experience Of Stigma Among People Living With Hiv In Bali, Indonesia: Qualitative Phenomenological Study, Jufri Hidayat, Xuan-Yi Huang, Hung-Ru Lin, Shiow-Jing Wei, Miao-Yen Chen, Satriya Pranata

Makara Journal of Health Research

Background: Human immunodeficiency virus (HIV)-related stigma continues to be a serious problem for people living with HIV (PLWH). This study aimed to explore stigma experience among PLWH in Bali, Indonesia.

Methods: This research was a qualitative descriptive phenomenological study. With the help of a local clinician–researcher and the staff of the United Nations Program on AIDS Commission, Bali, 10 participants were recruited by purposive sampling and participated in semi-structured interviews via WhatsApp online audio from April to December 2021. Data were analyzed using Colaizzi’s process.

Results: The following three themes emerged: (1) experiencing discrimination, (2) getting stronger …

Feasibility Of Using Electronic Health Records For Cascade Monitoring And Cost Estimates In Implementation Science Studies In The Adolescent Trials Network For Hiv/Aids Interventions, Tyra Dark, Kit N. Simpson, Sitaji Gurung, Amy L. Pennar, Marshall Chew, Sylvie Naar

Publications and Research

Background:One of the most difficult areas in the fight against HIV/AIDS is reaching out to youth aged 13 to 24 years. The proportion of youth living with HIV/AIDS on antiretroviral therapy (ART) and who are virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets.

Objective:This study aimed to assess the feasibility of obtaining key clinical indicators and monitoring treatment, viral suppression, and retention components of the youth HIV treatment cascade in Adolescent Trials Network for HIV/AIDS Interventions clinics using electronic health record (EHR) downloads and to provide baseline characteristics for the study …

Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk

Senior Theses

The Latino population in the United States faces a heightened risk in terms of contracting HIV/AIDS and experiencing negative health outcomes from said infection. HIV/AIDS continues to disproportionately impact ethnic/racial minorities, and the Latino population exemplifies this unfortunate trend, with Latino Americans making up around 18.4% of the national population, but nearly 30% of the HIV/AIDS infections (US Office of Minority Health, 2021). More enduring changes to the current resources available to this population will need to be made in order to address this disparity. Thus, the current study examined social determinants, how they increase risk of infection, and how …

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …

Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström

Community Health Sciences

Background: Anal squamous intraepithelial lesions (ASIL), strongly related to human papilloma virus (HPV) infection, is more prevalent among men who have sex with men (MSM). However, no such data are available for Pakistan yet, and neither HPV vaccination nor anal-cytology screening is implemented in Pakistan. The purpose of this first ever study was to assess the prevalence of HPV-related anal cytological abnormalities among MSM and transgender women living with and without HIV infection in Pakistan.
Methods: We conducted a cross-sectional study from March 2016 to November 2017 at sexual health centers run by the Perwaaz Trust and the National AIDS …

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 …

Characteristics And Outcomes Of Bacteremic Pneumococcal Pneumonia Of Patients With And Without Hiv Infection In Argentina, Alejandra González

The University of Louisville Journal of Respiratory Infections

Streptococcus pneumoniae is the main causative agent of pneumonia, with a 10 to 25 percent rate of isolation in blood cultures. Controversies exist regarding the prognostic impact of a history of human immunodeficiency virus (HIV) infection on community-acquired pneumonia.

The aim of our work was to analyze and compare the clinical presentation, radiological findings and progression of pneumococcal pneumonia in patients infected with and not infected with HIV. We retrospectively analyzed adult patients with positive blood cultures for Streptococcus pneumoniae and clinical and radiological findings compatible with pneumonia in the period between January 2012 and May 2017. Age, sex, comorbidities, …

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 …

Relationship Between Treatment Comorbidities And Viral Suppression Of Hiv Infections In Johannesburg, Nwogo Ekeji, Nwogo Immaculata Ekeji

School of Health Sciences Publications

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for …

Relationship Between Treatment Comorbidities And Viral Suppression Of Hiv Infections In Johannesburg, Nwogo Ekeji, Nwogo Immaculata Ekeji

Walden Faculty and Staff Publications

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for …

Hiv Preexposure Prophylaxis And Treatment As Prevention — Beliefs And Access Barriers In Men Who Have Sex With Men (Msm) And Transgender Women: A Systematic Review, Joshua J. Matacotta, Francisco J. Rosales-Perez, Christian M. Carrillo

Journal of Patient-Centered Research and Reviews

Purpose: While the annual rate of new HIV infections and diagnoses has remained stable for most groups, troubling increases are seen in transgender women and racial/ethnic-minority men who have sex with men (MSM), groups that are disproportionately affected by HIV. The primary purpose of this systematic review is to examine factors that impact attitudes and beliefs about preexposure prophylaxis (PrEP) and treatment as prevention (TasP) and to explore barriers to PrEP uptake in MSM and transgender women.

Methods: Using MeSH terms and relevant keywords, we conducted a systematic review of studies published between 2010 and 2019. We searched 4 literature …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

A Novel Approach To Hiv Prevention: Understanding Multi-Level Influences On Hiv Pre-Exposure Prophylaxis (Prep) Uptake And Outreach Among African Americans., Suur Debrah Ayangeakaa

Electronic Theses and Dissertations

This dissertation examined and provided basis for addressing factors related to HIV pre-exposure prophylaxis (PrEP) engagement, outreach, and uptake among high-risk African American youth groups in Louisville, KY. This qualitative dissertation study was designed through the lens of an interpretive framework of social constructivism which holds that multiple realities and interpretations exist and are socially constructed through the lived experiences of individuals and their interactions with others. Thus, lived experiences of various African American youth groups in Louisville as well as key informants of AIDS service organizations (ASOs) across the U.S. (including Louisville) were explored to develop a deeper understanding …

Factors Associated With Prep And Pep Uptake Among The Latinx Population, Santiago Gudiño-Rosales, Melva Thompson-Robinson, Johanna Andrews

Calvert Undergraduate Research Awards

Advanced Undergraduate Winner

Uptake of PrEP and PEP amongst LatinX population has been low, despite being a population disproportionately affected by HIV. Systemic barriers and cultural factors affect general LatinX approaches to healthcare and may impact uptake of these medications. The purpose of this study is to assess the factors that are associated with the likelihood to take PrEP and PEP in the LatinX population. In this cross-sectional study, survey data was collected from 169 LatinXs from January - March 2020. Using the Sexual Health Model as the theoretical framework, the survey examined the following four constructs to identify factors …

Impact Of The Affordable Care Act On Referral To Care For People Living With Hiv In Appalachia, Cameron A. Wade, Timothy N. Crawford, Nicole Leedy, Alice C. Thornton

Journal of Appalachian Health

Introduction: The Affordable Care Act (ACA) enacted on March 23, 2010 significantly impacted access to healthcare for people living with HIV (PLWH). Expansion of care was accomplished in three areas: eliminating exclusions for pre-existing conditions, elimination of lifetime caps on healthcare expenditures, and expansion of Medicaid eligibility.

Purpose: This study evaluated the impact of state implementation of the ACA Medicaid expansion on referral to HIV care at a Ryan White federally funded clinic in Kentucky (University of Kentucky Bluegrass Care Clinic [UK BCC]).

Methods: Retrospective chart review of all newly enrolled patients at the UK BCC between March 2010 and …

Hivanish: A Program Addressing Hiv Rates In Transgender Sex Workers In Washington D.C., Evangeline Wang

Capstone Showcase

HIVanish: A Program Addressing HIV Rates in Transgender Sex Workers in Washington D.C.

Evangeline Wang

Faculty Advisor: Dr Olorunsaiye

As of 2013 around 16, 500 residents in Washington D.C. were living with HIV. Of the 16,500 residents, 1.5% or 246 cases were among the transgender population. The majority of those cases were among transgender women at 67.5%¹. Gaps remain in addressing HIV among transgender sex workers, most of them on a systemic level. This could be attributed to misclassification of transgender women as men who have sex with men, or systemic neglect². This lack of knowledge …

Barriers To Hiv Testing Within A Sample Of Spanish-Speaking Latinx Gay, Bisexual, And Other Men Who Have Sex With Men: Implications For Hiv Prevention And Care, Danielle N. Horridge, Timothy S. Oh, Jorge Alonzo, Lilli Mann-Jackson, Amanda E. Tanner, Eunyoung Y. Song, Benjamin D. Smart, Cornelius N. Van Dam, Logan S. Baker, Scott D. Rhodes

Health Behavior Research

Gay, bisexual, and other men who have sex with men (GBMSM) have higher rates of HIV infection compared to the general population in the United States, and the infection rate is growing among Latinx GBMSM, compared to a decline in most other demographic subgroups. Uptake of pre-exposure prophylaxis (PrEP), a biomedical strategy designed to reduce HIV transmission, is very low among Latinx GBMSM. HIV testing is a critical first step in the HIV prevention and care continua. We analyzed data from a community-based sample of Latinx GBMSM in the southeastern United States to identify the most common HIV testing barriers …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

Hiv Diagnosis Disclosure To Infected Children And Adolescents; Challenges Of Family Caregivers In The Central Region Of Ghana, Anna Hayfron-Benjamin, Dorcas Obiri-Yeboah, Stephen Ayisi-Addo, Peter Mate Siakwa, Sylvia Mupepi

Peer Reviewed Articles

Background

Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …