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From The Headlines: A Textual Analysis Of Social Polarization And Discord In Times Of Pandemic Across A Century In The United States, Alexa Demarco

Undergraduate Honors Theses

Within the past century, three major pandemics have affected the United States – the Spanish Flu, AIDS, and COVID-19. Each of these pandemics has tested the capabilities of the public health sector and the social resilience of the population. Scientists have studied the viruses and implemented public health measures to limit viral transmission, but the social responses to these preventative measures proved to be difficult to predict and control. The dissonance and polarization between the public health initiatives and the response of the general public in the most recent pandemic was apparent. Was this a pattern in other pandemics? Was …

Optimizing Antiretroviral Therapy With Modern Rifapentine Containing Tb Treatment, Anthony T. Podany

Theses & Dissertations

In the past decade there has been a multitude of phase 3 clinical trials targeting treatment shortening for tuberculosis (TB). The synthetic rifamycin derivative rifapentine (RPT) has been at the forefront of many of the treatment shortening approaches. RPT possesses greater potency and a longer pharmacokinetic (PK) half-life (t_1/2) as compared with the long used rifamycin, rifampin (RIF). For TB preventative treatment, a 3-month, once weekly regimen of RPT and isoniazid (INH; 3HP) was shown to be as effective as 9-months of daily INH therapy in the PREVENT TB trial. Similarly, a 4-week course of daily RPT and …

New Antiretroviral Drugs In The Pandemic, Thana Khawcharoenporn

Asian Medical Journal and Alternative Medicine

The pandemic of coronavirus disease-19 (COVID-19) has impacted the care of people living with human immunodeficiency virus (HIV) and HIV prevention in several ways. Locking down and limiting transportation to slow down COVID-19 transmission can cause difficulty accessing and non-compliance to daily-dosing antiretroviral drugs (ARVs). The new formu-lations of ARVs, including long-acting ones administered as injections and implants are being approved and developed for HIV treatment and prevention. Intramuscular cabotegravir and rilpivirine co-formulation is approved by the US Food and Drug Administration for HIV treatment in virologically suppressed adults on a stable regimen, while intramuscular cabotegravir is approved for HIV …

Acylcarnitines And Genetic Variation In Fat Oxidation Genes In Hiv-Infected, Antiretroviral-Treated Children With And Without Myopathy, Brian Kirmse, Charlotte Hobbs, Lisa Aaron, Grace Montepiedra, Marshall Summar, Paige L Williams, Caitlin J Smith, Russell Van Dyke, Chunli Yu, Kelli K Ryckman, William Borkowsky

Faculty, Staff and Student Publications

BACKGROUND: Mitochondrial toxicity resulting in myopathy and lactic acidosis has been described in antiretroviral (ARV)-exposed patients. We hypothesized that myopathy in HIV-infected, ARV-treated children would be associated with metabolic (acylcarnitines) and genetic (variants in metabolic genes) markers of dysfunctional fatty acid oxidation (FAO).

METHODS: Acylcarnitine profiles (ACP) were analyzed for 74 HIV-infected children on nucleoside reverse transcriptase inhibitor (NRTI)-containing ARV. Thirty-seven participants with ≥2 creatine kinase measurements >500 IU (n = 18) or evidence of echocardiographic cardiomyopathy (n = 19) were matched with 37 participants without myopathy. Single nucleotide polymorphisms (SNPs) in FAO genes were also evaluated.

RESULTS: Abnormal ACP …

Capturing The Pool Dilution Effect In Group Testing Regression: A Bayesian Approach, Stella Self Ph.D., Ms, Christopher Mcmahan, Stefani Mokalled

Faculty Publications

Group (pooled) testing is becoming a popular strategy for screening large populations for infectious diseases. This popularity is owed to the cost savings that can be realized through implementing group testing methods. These methods involve physically combining biomaterial (eg, saliva, blood, urine) collected on individuals into pooled specimens which are tested for an infection of interest. Through testing these pooled specimens, group testing methods reduce the cost of diagnosing all individuals under study by reducing the number of tests performed. Even though group testing offers substantial cost reductions, some practitioners are hesitant to adopt group testing methods due to the …

Congenital Co-Infections Among Hiv-Exposed Infants Born To Mothers On Antiretroviral Treatment In The United States., Christiana Smith, Lori Silveira, Megan Crotteau, Krystle Garth, Jennifer Canniff, Kirk B. Fetters, Sarah Lazarus, Shannon Capraro, Adriana Weinberg, Chip Perinatal Team

Manuscripts, Articles, Book Chapters and Other Papers

Background: Many women living with HIV (WLHIV) are co-infected with cytomegalovirus (CMV), Toxoplasma gondii (T gondii), and/or hepatitis C virus (HCV). The rates of congenital or perinatal transmission of these co-infections are not well defined in the current era, when most WLHIV receive antiretroviral therapy (ART) during pregnancy.

Methods: Retrospective review of infants of WLHIV born between 2009-2019. Mothers were screened for antibodies to CMV, T. gondii, and HCV; chronic HCV infection was confirmed using plasma RNA PCR. Infants whose mothers had positive/unknown serostatus were screened for CMV using urine or saliva DNA PCR or culture at ≤3 …

The Global Implementation Of Dolutegravir For Hiv Treatment, Matthew L. Romo

Dissertations and Theses

Background
Dolutegravir, an integrase strand transfer inhibitor, is now recommended by international guidelines as part of preferred antiretroviral therapy (ART) regimens for people living with HIV. In low- and middle-income countries (LMICs), HIV treatment programs are transitioning from non-nucleoside reverse transcriptase inhibitors (NNRTIs) to dolutegravir because of its superior efficacy and tolerability, and high genetic barrier to HIV drug resistance. Along with the optimism surrounding widespread dolutegravir use, key questions regarding its implementation have emerged. In this dissertation, I sought to achieve the following specific aims: Aim 1: Characterize dolutegravir uptake in LMICs and identify potential disparities related to sex …

Interventions For Prevention Of Non-Communicable Diseases Among Adolescents Living With Hiv: A Systematic Review, Eunice Ndirangu, Constance Shumba, Peter Gatiti, Bernard Mutwiri, Amina Abubakar

School of Nursing & Midwifery, East Africa

While the uptake of antiretroviral drugs has rapidly expanded among adolescents and adults living with HIV, research evidence suggests that people living with HIV have a higher risk of non-communicable diseases (NCDs). With more than 35% of the global burden of NCDs stemming from adolescence, there is a need to comprehend the existing evidence on early prevention, detection, and disease management, especially among the at-risk population. In line with the WHO Global Action Plan, 2013–2020 and “Best Buys”, recommendations on practical interventions for NCDs prevention, this systematic review seeks to synthesise evidence on the current interventions for preventing NCDs among …

Hiv Response Interventions That Integrate Hiv Molecular Cluster And Social Network Analysis: A Systematic Review, Daniel J Gore, Kellie Schueler, Santhoshini Ramani, Arno Uvin, Gregory Phillips, Moira Mcnulty, Kayo Fujimoto, John Schneider

Faculty, Staff and Student Publications

Due to improved efficiency and reduced cost of viral sequencing, molecular cluster analysis can be feasibly utilized alongside existing human immunodeficiency virus (HIV) prevention strategies. The goal of this paper is to elucidate how HIV molecular cluster and social network analyses are being integrated to implement HIV response interventions. We searched PubMed, Scopus, PsycINFO, and Cochrane Library databases for studies incorporating both HIV molecular cluster and social network data. We identified 32 articles that combined analyses of HIV molecular sequences and social or sexual networks. All studies were descriptive. Six studies described network interventions informed by molecular and social data …

Cardiovascular Risk Factors And Markers Of Myocardial Injury And Inflammation In People Living With Hiv In Nairobi, Kenya: A Pilot Cross-Sectional Study, Hassan Adan Ahmed, Jeilan Mohamed, Isaiah G. Akuku, Kuan Ken Lee, Shirjel R. Alam, Pablo Perel, Jasmit Shah, Mohammed K. Ali, Sherry Eskander, Michael H. Chung

Internal Medicine, East Africa

Objectives: To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya.

Design: Pilot cross-sectional study.

Setting: Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020.

Participants: Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD).

Outcome measures: Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels.

Results: Across 200 PLHIV (median age 46 years, IQR 38–53; 61% women), the …

International Rights Affecting The Covid–19 Vaccine Race, Samantha Johnson

University of Miami Inter-American Law Review

The impact of the COVID–19 pandemic has been felt world-wide, and despite having several vaccines in the market at this point, there are still issues of accessibility for certain countries. International intellectual property law has been a breeding ground for the exploration of intellectual curiosity and creation as it provides strong protections to creators. These strong protections have allowed for the monopolization of certain goods, such as vaccines, under the concept of patents. While patents are important to incentivize pharmaceutical companies to create life–saving medicines, these protections have also become a barrier for access to medicines, especially in less–developed countries. …

Cultivating Compassion In Catholic Teachings: An Invitation To Relationship With Immigrants And Refugees With Hiv/Aids, Anna Salvestrin

Undergraduate Honors Theses

In 1989 the United States Conference of Catholic Bishops released Called to Compassion and Responsibility. This document, which articulates the official Catholic Church teaching on HIV/AIDS, emphasizes personal responsibility in limiting the spread of HIV and calls for compassion toward the sick. The bishops direct their document to Catholic clergy and parishioners and offer recommendations for government policy and parish actions that affirm human dignity. This thesis argues that the document's recommendations do not adequately consider the experiences of immigrants and refugees with HIV/AIDS and neglect sufficient attention to their lived experiences. In future documents, the bishops should use the …

Correlates Of Sexualized Drug Use Among Men Who Have Sex With Men (Msm) In Malaysia, Sydney Osborne

Honors Scholar Theses

Sexualized drug use (SDU), also known as ‘chemsex’ or ‘chem-fun,’ is an emerging public health concern. This HIV risk behavior is a major issue and marginalized communities such as men who have sex with men (MSM) may be overlooked for prevention efforts or struggle to access adequate treatment. This study aims to determine the correlates of SDU to inform interventions, policy, and prevention of SDU. A convenience sample of Malaysian MSM were recruited through advertisements on geosocial networking apps (GSN) for gay men (e.g., Grindr, Hornet) and on popular social media platforms (i.e. Facebook). From June-July 2020, participants completed an …

Gut Commensals Modulate Siv/Shiv Pathogenesis And Therapeutics, Samuel Johnson

Theses & Dissertations

Despite significant advancements in combination antiretroviral therapy (cART), ongoing inflammation in the brain and gut remain two of the most significant hurdles in the health of people living with human immunodeficiency virus (HIV). Additionally, a viral reservoir in each compartment inhibits cure efforts by allowing rapid viral rebound following cART interruption. Emerging understanding of the gut-brain axis (GBA) implicates each compartment in the modulation of the other in a complex bi-directional interaction mediated by vagus innervation, circulating lymphocytes, and microbiome composition and biproducts. Using multiple models of the simian (and simian-human) immunodeficiency virus (SIV/SHIV) and therapeutic intervention, I present how …

Implementation Of Prep Protocol In Primary Care, Myia Harper, Catalina West

Doctor of Nursing Practice Projects

Human immunodeficiency virus (HIV) is an incurable condition that continues to be a public health threat. Approximately 38 million people live with the disease worldwide, and one out of seven are unaware they have the disease. Pre-exposure prophylaxis (PrEP) is a medication that can be prescribed to individuals at risk of acquiring HIV. PrEP can be prescribed by any healthcare provider who deems a patient at risk for HIV. However, a primary care practice in central Illinois previously had no protocol for initiation of PrEP. This quality improvement (QI) project aimed to implement a PrEP protocol in the department of …

Refractory Herpes Virus Pseudotumor In An Immunocompromised Patient, Pavan Patel, Smera Saikumar, David York

Research Day

Background: HSV infections can characteristically present as pseudotumor in patients with uncontrolled HIV infection. Herpes simplex virus type 2 (HSV-2) infection rates range from 60% to 90% in individuals who are co-infected with HIV.

Case Presentation: A 48-year-old patient who presented with large fungating mass near her right inferior vulva with hardness and induration. The mass was 4 cm x 3 cm in size and was excised in the operating room. The pathology was negative for malignancy, however, it showed lymphoplasmacytic proliferation with immunostaining positive for HSV virus.

Conclusion: Any patient that presents with a tumor-like mass in their perineum …

Quality Improvement Study On Human Papilloma Virus (Hpv) Vaccination Uptake In Hiv Patients, Hassan Akram, Paul Johnson, Trini A Mathew

Posters

INTRODUCTION HPV is strongly associated with cervical cancer and cancers of vagina, vulva, penis, anus, rectum. In 2019, WHO identified vaccine hesitancy as top 10 global threats and planned to increase the HPV vaccine coverage. In June 2019 Advisory Committee on Immunization Practices (ACIP) in the US recommended shared clinical decision-making regarding HPV vaccinations in adults aged 26 through 45 years. The goal of this project is to evaluate the uptake of HPV vaccination and challenges in the HIV patients at Beaumont Hospital.

Long Term Outcomes Of Anti-Retroviral Treatment Vs. Additional Nutritional Supplementation For Hiv Patients, Michael P. Gillispie

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is not to determine the best treatment for human immunodeficiency virus HIV but to analyze additional supplementation that can prolong the progression of the disease process. Zinc, vitamin A, D, and E will be evaluated additionally with the antiretroviral treatment ART. The cost of an ART Regimen can be very expensive and challenging for patients to afford. The goal is to find an acceptable option to complement ART with a sensible cost to prolong disease progression and minimize additional costs of health care. With the advances of ART, more and more patients can …

Heightened Levels Of Plasma Growth Differentiation Factor 15 In Men Living With Hiv, Neeti Agarwal, Claudia E Ramirez Bustamante, Huaizhu Wu, Reina Armamento-Villareal, Jordan E Lake, Ashok Balasubramanyam, Sean M Hartig

Faculty, Staff and Students Publications

Plasma biomarkers that reflect energy balance disorders in people living with HIV (PLWH) remain limited. Growth differentiation factor 15 (GDF15) abundance in plasma of mice and humans induces negative energy balance but also becomes highly elevated in obesity and other metabolic diseases. We sought to compare plasma GDF15 levels in PLWH and HIV-negative persons and mouse models expressing the HIV accessory protein Vpr (that recapitulate HIV-associated metabolic disorders) and determine their relationship to metabolic parameters. We measured liver Gdf15 mRNA levels and plasma GDF15 levels in male Vpr mice and littermate controls. In parallel, we analyzed plasma GDF15 levels in …

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine As An Alternative For Treatment In Hiv Positive Patients, Aravindh Nirmalan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Mantsios A, Murray M, Karver TS, et al. Efficacy and Freedom: Patient Experiences with the Transition from Daily Oral to Long-Acting Injectable Antiretroviral Therapy to Treat HIV in the Context of Phase 3 Trials. AIDS Behav. 2020;24(12):3473-3481. https://doi.org/10.1007/s10461-020-02918-x

for a young adult patient struggling with adherence.

Emerging Viral Diseases: Generation Z'S Outlook, Ian Mcwhorter

Honors Projects

Generation Z differs notably from previous generations like Baby Boomers or Generation X. In recent years, young adults have been persisting through the COVID-19 pandemic, though not unscathed. This paper seeks to answer the following question: How does Generation Z differ in its outlook on Viral diseases compared to previous generations? Using a series of three surveys conducted on three seperate Viral diseases (HIV, Zika, and COVID 19), it was found that while Generation Z has improved in its ability to combat Viral outbreaks due to factors like high digital literacy, other factors such as poorer mental health show that …

The Obstetrical Management Of Hiv-Positive Pregnancy, Mihai George Loghin, Petre Gabriel Gorescki, Romina Marina Sima, Liana Pleș, Daniela Gabriela Balan, Ioana Paunica, Oana Denisa Bălălău

Journal of Mind and Medical Sciences

The human immunodeficiency virus (HIV) infection is a real public health problem in both developing and developed countries. HIV infection has not been treated efficiently for a long time, with HIV-positive women at increased risk of transmitting the infection to their newborns. Without the appropriate treatment, the evolution of the infection is relatively fast. Due to the antiretroviral treatment, the progression of the disease is blocked during the period of asymptomatic infection, and the risk of neonatal transmission is very low. HIV-positive patients undergoing antiretroviral therapy develop undetectable viremia and, in such situations, patients no longer have a risk of …

S-Equol: A Novel Therapeutic For Hiv-1 Induced Gut Dysbiosis, Mason T. Rodriguez

Theses and Dissertations

HIV-1 infection affects approximately 38 million people around the world. The advent of cART has greatly improved the quality of life of infected individuals; however, roughly 50% of these individuals will still experience HIV-1 associated neurocognitive disorders (HAND). Additionally, the gut microbiome has been reported to be dysbiotic in HIV-1 infected individuals, regardless of adherence to cART. Current research has pointed to the gut-brain-microbiota axis as a potential target to treat both cognitive deficits and microbial changes. The present study investigated S-equol (SE) as a potential therapeutic for HAND by modulating the gut microbiome. The study included 21 HIV-1 Tg …

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

Assessing Influenza Vaccination Coverage And Predictors In Persons Living With Hiv/Aids In Louisiana, June 2002-June 2013, Patrick Maloney, Ariane Rung, Stephanie Broyles, John Couk, Edward Peters, Susanne Straif-Bourgeois

Population and Public Health Science Faculty Publications

Background. Despite the burden of disease and increased risk of influenza-associated morbidity and mortality among PLWHA, influenza vaccination has been understudied in this population. Methods. We built an 11-year cohort of HIV-infected adults from medical records of PLWHA seeking care within the Louisiana State University medical system from June 2002-June 2013. Influenza vaccination uptake among PLWHA was calculated overall and for each medical facility for each influenza season. Linear regression was used to assess influenza vaccination uptake over time, both overall and by facility. Data were restricted to the final influenza season (2012-13) to assess predictors of PLWHA vaccination. Individuals …

Successful Treatment With Daptomycin Of Mrsa Empyema Complicated By Right-Sided Loculated Pleural Effusion Refractory To Vancomycin, Ava Torjani, Dylan Selbst, Joshua Hamsher, Sahaj Mujumdar, Andie Belkoff, Luis Taboada

Division of Internal Medicine Faculty Papers & Presentations

Empyema is a serious complication of pneumonia and has been reported to have a mortality rate of 8.7%. For methicillin-resistant Staphylococcus aureus (MRSA) empyema, treatment includes drainage and specific antibiotics such as vancomycin and linezolid. Strikingly, there are increasing incidences of empyema refractory to vancomycin and linezolid. Despite being inactivated in the lung parenchyma by pulmonary surfactant, daptomycin can penetrate the pleural space and may be better at treating MRSA empyema than vancomycin and linezolid. Some case reports have shown that daptomycin has been used to successfully treat MRSA empyema refractory to linezolid and vancomycin-resistant enterococcus (VRE) empyema. Here, we …

Studying Patterns And Predictors Of Hiv Viral Suppression Using A Big Data Approach: A Research Protocol, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xueying Yang Ph.D., Zhenglong Li, Jianjun Hu, Xiaoming Li

Faculty Publications

Background: Given the importance of viral suppression in ending the HIV epidemic in the US and elsewhere, an optimal predictive model of viral status can help clinicians identify those at risk of poor viral control and inform clinical improvements in HIV treatment and care. With an increasing availability of electronic health record (EHR) data and social environmental information, there is a unique opportunity to improve our understanding of the dynamic pattern of viral suppression. Using a statewide cohort of people living with HIV (PLWH) in South Carolina (SC), the overall goal of the proposed research is to examine the dynamic …

Clinical Characteristics Of Peripheral Neuropathy In Kenyan Patients With Hiv Infection Compared With Patients With Concurrent Hiv Infection And Diabetes Mellitus, Pascal Kuka, Jasmit Shah, Uazman Alam, Reena Shah, Dilraj Sokhi

Internal Medicine, East Africa

Introduction: Persons living with human immunodeficiency virus (HIV) are living longer and at risk of non-communicable diseases, including diabetes mellitus (DM). Both HIV and DM place patients at risk of peripheral neuropathy (PN). Our aim was to demonstrate the prevalence and characteristics of PN in our population of patients with HIV infection compared with concomitant HIV and DM.

Methods: A prospective cross-sectional study was performed at the Aga Khan Hospital in Nairobi, Kenya. Data were collected on demographics and characteristics of DM and HIV. Symptoms and signs of PN were evaluated by Neuropathy Symptom Score, Neuropathy Disability Score, …

What Do Epidemic History And Sexual Minority Men’S Experiences Of Hiv And Covid-19 Teach Us About Pandemic Preparedness?, Amy Braksmajer, Andrew London

Population Health Research Brief Series

For many, COVID-19 feels like the first, massive, life-threatening epidemic of infectious disease they have faced. However, for sexual minority individuals who have experienced trauma and loss stemming from the HIV epidemic, there are many similarities. This brief summarizes findings from interviews with men who have lived through both pandemics as a way to gain insights into the commonalities and differences of their experiences. Findings show that men who lived through both epidemics believe the government did not do enough to respond to either crisis. To better prepare for future epidemics, public health efforts must be less fragmented, including a …

Hiv-Related Shame: A Grounded Theory Study Exploring The Impact Of Psychoeducation On The Lives Of People Living With Hiv, Melissa Stuntz

DNP Research Projects

Abstract

Over the past 40 years there have been significant advances in medical care for HIV. However, many people living with HIV (PLWH) experience internalized stigma in the form of HIV-related shame. This shame has been found to negatively impact mental health, patient relationships, and adherence to healthcare. This grounded theory DNP scholarly project was aimed at developing a novel theoretical framework and practice to improve quality of life including increased viral load suppression in PLWH. To this aim, a psychoeducation curriculum based on shame resilience theory was implemented with two participants in an inner-city healthcare clinic. While the shame …