Digital Commons Network^™

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Acute Kidney Injury, Immune Thrombocytopenic Purpura, And The Infection That Binds Them Together: Disseminated Histoplasmosis, Pooja Sethi, Jennifer Treece, Chidinma Onweni, Vandana Pai, Sowminya Arikapudi, Lakshmi Kallur, Varun Kohli, Jonathan Moorman

ETSU Faculty Works

Untreated human immunodeficiency virus (HIV) can be complicated by opportunistic infections, including disseminated histoplasmosis (DH). Although endemic to portions of the United States and usually benign, DH can rarely act as an opportunistic infection in immunocompromised patients presenting with uncommon complications such as acute kidney injury and idiopathic thrombocytopenic purpura. We report a rare presentation of DH presenting with acute kidney injury and immune thrombocytopenic purpura in an immunocompromised patient with HIV.

Capacity Of Human Immunodeficiency Virus Targeting Chimeric Antigen Receptor T Cells To Eliminate Follicular Dendritic Cells Bearing Human Immunodeficiency Virus Immune Complexes, Matthew T. Ollerton

Theses and Dissertations

An important obstacle to a functional cure for HIV/AIDS is the persistence of viral reservoirs found throughout the body in various cells and tissues. Reservoirs can be latently infected cells, or in the case of follicular dendritic cells (FDC), non-infected cells that trap infectious virus on their surface through immune complexes (HIV-IC). Although several strategies have been employed to target and eliminate viral reservoirs, they are short-lived and ineffective. In an attempt to provide a long-term approach, chimeric antigen receptor T (CAR-T) cells were designed to eliminate native HIV on FDCs. Although effective at eliminating HIV-infected cells, and halting spreading …

Exploring The Relationship Between Silencing The Self And Risky Sexual Behavior In Black Women, Robin Nicole Hardin

Electronic Theses and Dissertations Archive

Black women are disproportionately affected by HIV. Understanding how sociocultural factors and beliefs contribute to Black women's risky sexual behavior is critical in understanding this health disparity. This study investigated the mediating influence of silencing the self (i.e., putting the needs and wants of a romantic partner before one's own needs) on the relationship between risky sexual behaviors and self-esteem, gender role beliefs, and gender ratio imbalance beliefs and behaviors (GRIBBs) in Black female college students. Participants included 99 female undergraduate students enrolled at a regional Mid-South University. Results demonstrated that risky sexual behavior was not significantly associated wtih the …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty and Staff Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Prescribing Hiv Prep And Education Needs Among Care Providers, Martin K. Logo, Hadi Denawi, Aimee Ferraro

Journal of Social, Behavioral, and Health Sciences

Preexposure prophylaxis (PrEP) is a biomedical intervention to prevent the spread of HIV. Underprescribing PrEP could increase the probability of HIV exposure among serodivergent couples/partners and people who do not practice safer sex. Previous research on PrEP did not assess the association between awareness of PrEP, years of experience of the providers, provider types, and the frequency of PrEP among physicians. The purpose of this study is to test the hypothesis that awareness of PrEP, years of experience, and provider types might be predictors of the frequency of PrEP among physicians. Precaution adoption process model and cross-sectional design were applied …

Redefining Aging In Hiv Infection Using Phenotypes, David M. Stoff, Karl Goodkin, Dilip Jeste, Maria Marquine

ETSU Faculty Works

Purpose of review: This article critically reviews the utility of “phenotypes” as behavioral descriptors in aging/HIV research that inform biological underpinnings and treatment development. We adopt a phenotypic redefinition of aging conceptualized within a broader context of HIV infection and of aging. Phenotypes are defined as dimensions of behavior, closely related to fundamental mechanisms, and, thus, may be more informative than chronological age. Primary emphasis in this review is given to comorbid aging and cognitive aging, though other phenotypes (i.e., disability, frailty, accelerated aging, successful aging) are also discussed in relation to comorbid aging and cognitive aging. Recent findings: The …

Neurosyphilis Increases Human Immunodeficiency Virus (Hiv)-Associated Central Nervous System Inflammation But Does Not Explain Cognitive Impairment In Hiv-Infected Individuals With Syphilis., Emily L Ho, Clare L Maxwell, Shelia B Dunaway, Sharon K Sahi, Lauren C Tantalo, Sheila A Lukehart, Christina M Marra

Articles, Abstracts, and Reports

Background: Individuals infected with human immunodeficiency virus (HIV) who have previously had syphilis may have cognitive impairment. We tested the hypothesis that neurosyphilis causes cognitive impairment in HIV by amplifying HIV-related central nervous system (CNS) inflammation.

Methods: HIV-infected participants enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent the mental alternation test (MAT), venipuncture, and lumbar puncture. CSF concentrations of chemokine (C-X-C motif) ligand 10 (CXCL10), chemokine (C-C motif) ligand 2 (CCL2), and neurofilament light (NFL) were determined by commercial assays. The proportion of peripheral blood mononuclear cells (PBMCs) and of CSF white blood cells (WBCs) that …

Persistence Of Macrocytosis After Discontinuation Of Zidovudine In Hiv-Infected Patients, Inski Yu, Richard N. Greenberg, Timothy N. Crawford, Alice C. Thornton, Thein Myint

Internal Medicine Faculty Publications

The duration of macrocytosis after stopping zidovudine (ZDV) is unknown. Among 104 HIV-infected patients treated with ZDV for more than 1 year, 84 patients had macrocytosis at ZDV discontinuation. The median mean corpuscular volume (MCV) was 114.6 fL (range 100-128 fL). Patients were divided into 2 groups: those who did (resolved macrocytosis, n = 36) and did not (persistent macrocytosis, n = 48) normalize MCV at 3 to 6 months after ZDV discontinuation. Alcohol use (P = .02), smoking (P = .03), and lower (but within normal range) folic acid levels (P = .05) were related to …

Prevalence, Virological Status, And Improvement Of Depression Symptoms During A One-Year Hiv Cohort Study, Yeow Chye Ng, Sandra C. Jones

International Nursing Research Congress (INRC)

Depression is still an under diagnosed condition in HIV infected population. Implementation of PHQ-9 screening at all the clinical level could be the first step to alleviating this concern, regardless of the patient"s current virological status.

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 …

Predicting Death Over 8 Years In A Prospective Cohort Of Hiv-Infected Women: The Women's Interagency Hiv Study, Deborah Gustafson, Qiuhu Shi, Susan Holman, Howard Minkoff, Mardge Cohen, Michael Plankey, Donald Hoover

NYMC Faculty Publications

OBJECTIVES: Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, Veterans Aging Cohort Study (VACS); (2) a physical index, Fried Frailty Index (FFI); and (3) a mental health index, Center for Epidemiologic Studies-Depression (CES-D). Proportional hazards regression analyses were used to predict death and included relevant covariates.

DESIGN: Prospective, observational cohort.

SETTING: Multicentre, across six sites in the USA.

PARTICIPANTS: 1385 multirace/ethnic ART-experienced HIV+ women in 2005.

PRIMARY …

Transitional Healthcare Coordination In New York City Jails Among People With Chronic Health Conditions: Contributions To Reduced Reincarceration And Improved Health, Janet J. Wiersema

Dissertations and Theses

People in correctional settings often have poorer health than the general US population. For example, it is estimated that 27.9% of persons in jail have hypertension, 8.1% have diabetes, and 1.6% have HIV, compared to 25.6%, 6.5%, and 0.5%, respectively, in the general population. Jail and other correctional settings are also increasingly recognized as viable places to engage poor and underserved communities into the healthcare system by offering transitional care coordination services to connect people to healthcare and other services to meet priorities after incarceration. At the same time, recidivism is an issue—over 50% of persons in New York City …

Undergraduate Social Work College Students And Aids And Hiv, Breeanna Edwards

Electronic Theses, Projects, and Dissertations

This proposal discusses some of the stigmas about the transmission of HIV and AIDS, its spread amongst college students and how it can be reduced through the efforts of social work. It attempts to discover these concepts to garner a general view of all unfavorable attitudes, lack of knowledge, perceptions of whether a person is infected or not, risky sexual behaviors and social influence for social workers to better understand the root cause of its rise. The primary problem is the rise of the HIV and AIDS virus amongst the college population. Through surveys and interpreting quantitative data, it is …

Using Network Sampling And Recruitment Data To Understand Social Structures Related To Community Health In A Population Of People Who Inject Drugs In Rural Puerto Rico, Mayra Coronado-García, Courtney R. Thrash, Melissa L. Welch-Lazoritz, G. Robin Gauthier, Juan Carlos Reyes, Bilal Khan, Kirk Dombrowski

Department of Sociology: Faculty Publications

Objective: This research examined the social network and recruitment patterns of a sample of people who inject drugs (PWIDs) in rural Puerto Rico, in an attempt to uncover systematic clustering and between-group social boundaries that potentially influence disease spread.

Methods: Respondent driven sampling was utilized to obtain a sample of PWID in rural Puerto Rico. Through eight initial “seeds”, 317 injection drug users were recruited. Using recruitment patterns of this sample, estimates of homophily and affiliation were calculated using RDSAT.

Results: Analyses showed clustering within the social network of PWID in rural Puerto Rico. In particular, females showed a very …

Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender

Publications and Research

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38% of self-testers did so correctly without …

Non-Medical Use Of Prescription Opioids Is Associated With Heroin Initiation Among Us Veterans, Xiulu Ruan, Jin Jun Luo, Adam M. Kaye, Alan David Kaye

School of Pharmacy Faculty Articles

No abstract provided.

Effects Of Art In Hiv Infected Population On Body Habitus Change: A Multilevel Meta-Analysis, Nusrat Nuireen Habib

Master's Theses

Importance: Different ART treatments to HIV patients has been shown to be effective in improving a variety of disease outcomes, including CD-4 cell count improvements and viral suppressions. In addition to these improvements, investigators are also interested to evaluate the association between ART treatments and the body habitus changes of the HIV patients. It is unclear that which body habitus change outcomes are more greatly associated with what type of ART treatments and how those effects could vary depending on context and sample characteristics.

Objective: To obtain overall effect sizes for the body habitus change outcome variables (weight, body mass …

Hair Measurements Of Cortisol, Dhea, And Dhea To Cortisol Ratio As Biomarkers Of Chronic Stress Among People Living With Hiv In China: Known-Group Validation, Shan Qiao Ph.D., Xiaoming Li, Samuele Zilioli, Zheng Chen, Huihua Deng, Juxian Pan, Weigui Guo

Faculty Publications

Background

Existing literature suggests that endocrine measures, including the steroid hormones of cortisol and Dehydroepiandrosterone (DHEA), as well as the DHEA to cortisol ratio in the human hair can be used as promising biomarkers of chronic stress among humans. However, data are limited regarding the validity of these measures as biomarkers of chronic stress among people living with HIV (PLWH), whose endocrine system or hypothalamic pituitary adrenal (HPA) axis may be affected by HIV infection and/or antiretroviral therapy (ART) medications.

Method

Using hair sample data and self-reported survey from 60 PLWH in China, we examined the validity of three endocrine …

Hiv/Aids, Rachel Muir

Nursing Student Class Projects (Formerly MSN)

Human Immunodeficiency Virus (HIV) is a disease in which the virus attacks and depletes the CD4+ T cells leading to a weakened immune system in which a pMersin can no longer fight pathogens. This weakening of the person's immune system makes them more susceptible to opportunistic infections and malignancies (Coffin & Swanstrom, 2017). In the initial acute HIV infection period the person usually does not show symptoms but is highly infectious which can allow for transmission unknowingly (Center for Disease Control and PrevenBon, 2017). HIV can eventually progress to AIDS without treatment. Admission to the hospital can expose this person …

Governmentality/Animacy/Mythology: A Biopolitical And Rhetorical Mosaic Of Hiv Stigma In A Time Of Prep-Aration, Brendan Geoffrey Aaron Hughes

Electronic Theses and Dissertations

Since 1981, roughly 35 million people have died from the Acquired Immune Deficiency Syndrome (AIDS), the end stages of the Human Immunodeficiency Virus (HIV), and an estimated 39 million are living with HIV today. While various factors such as poverty, lack of education, and poor access to treatment and healthcare compound the epidemic across the world, the endemic in the industrialized west faces specific communication-based challenges to slowing the spread of HIV. Now classified as a "chronic manageable condition", an HIV diagnosis is no longer the death sentence of the early outbreak in the 1980's. A major factor in the …

Improving Hiv Outcomes In Pakistan : The Interaction Between Politics, Power And Implementation, Hina Khalid

Legacy Theses & Dissertations (2009 - 2024)

HIV contributes to the highest number of deaths from infectious diseases in low-income countries. In this three-paper dissertation, using the case of Pakistan, I focus on understanding how the exercise of power by actors at three different levels of the health system, individual, program and societal, influences policy implementation and shapes HIV program outcomes. The objective is to improve HIV service provision thereby achieving improved health policy outcomes. I adopt a mixed-methods approach and use quantitative (logit regression) and qualitative techniques (content analysis of newspapers and semi-structured interviews). One paper tests the role played by network operators in influencing condom …

Prevalence And Associated Factors Of Thrombocytopenia Among Human Immunodeficiency Virus-Infected Patients At A Tertiary Care Hospital In İzmir, Turkey, Can Hüseyi̇n Heki̇moğlu, Fi̇gen Kaptan, İlknur Vardar, Serap Ural, Nesri̇n Türker, Bahar Örmen, Nurbanu Sezak, Si̇bel El

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to determine the prevalence and associated factors of thrombocytopenia in human immunodeficiency virus (HIV)-infected patients. Materials and methods: A cross-sectional study was conducted in a tertiary care hospital in İzmir, Turkey. All HIV-infected patients admitted to the Department of Infectious Diseases and Clinical Microbiology between 2006 and 2011 were recruited. Patients with thrombocytopenia at any time point were defined as the case group and the remaining patients were defined as the control group. Results: The frequency of thrombocytopenia was 35.8%. Thrombocytopenia was more frequent in patients with acquired immune deficiency syndrome (AIDS) than …

Elucidating Structure, Function, And Small Molecular Interactions Of Human Immunodeficiency Virus And Chikungunya Virus, Kristin Nicole Slater

Wayne State University Theses

Abstract HIV-1:

Human immunodeficiency virus-1 (HIV-1) is a widespread, incurable retrovirus known to cause

immunodeficiency and a shortened life span. Despite successful treatment methods, HIV-1

frequently mutates, resulting in antiviral resistance. Many therapies target the HIV-1 protease

(PR), which is responsible for cleaving the viral polyprotein essential for its life cycle. HIV-1 PR

often evades treatment by way of mutations and less commonly through residue insertions. We

have identified a clinical isolate with a five residue insertion between residues 28 and 29.

Through molecular dynamics simulations we analyzed the protease protein structure and

determined that the residue insertion created a …

Exposure To Hiv Prevention Messages On Social Media And Behavior Change Intent, Yoshika Shajuan Eason

Walden Dissertations and Doctoral Studies

African Americans living in the Southeastern region of the United States disproportionately contract sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Facebook and other social media sites are becoming a way to deliver health-related messaging to targeted populations. The purpose of this quantitative, cross-sectional study was to examine the association between selected demographic factors and impact of social media on intent to change sexual behaviors among 112 African Americans between the ages of 18 and 49 in the Southeastern United States who viewed STI/HIV prevention materials on Facebook within 1 year prior to the study. The theory of planned …

Retention In Continuous Care And Sustained Viral Suppression: Examining The Association Among Individuals Living With Hiv, Timothy N. Crawford, Alice C. Thornton

Internal Medicine Faculty Publications

Objectives: To examine the relationship between retention in continuous care and sustained viral suppression.

Methods: The authors retrospectively followed 653 persons who were virally suppressed and seeking care at an infectious disease clinic in Kentucky for an average of 6 years to determine the rates of retention in medical care (≥2 visits separated by ≥3 months within a 12-month period) and sustained viral suppression (<400 copies/mL). A generalized linear mixed model was used to determine an association between retention and suppression over time.

Results: Approximately 61% of the study population were retained in continuous care and 75% had sustained viral suppression for all patient-years. Persons retained in care were 3 times the odds of sustaining viral suppression over …

Barriers And Facilitators Of Linkage To Hiv Care Among Hiv-Infected Young Chinese Men Who Have Sex With Men: A Qualitative Study, Haochu Li, Chongyi Wei, Joseph Tucker, Dianmin Kang, Meizhen Liao, Eleanor Holroyd, Jietao Zheng, Qian Qi, Wei Ma

School of Nursing & Midwifery, East Africa

Background: The Four Free and One Care Policy (HIV/AIDS-related free services) has been in place in China since 2004. However, linkage to human immunodeficiency virus (HIV) care is not yet achieved very well among people living with HIV. We conducted a qualitative study to explore individual and contextual factors that may influence a linkage to HIV care from the perspective of young HIV-infected men who have sex with men (MSM) in a highly centralized HIV care context of China.

Methods: Purposive sampling was used to recruit 21 HIV-infected MSM in Shandong Province, with in-depth interviews conducted between March and July …

Determinants Of Hiv Screening Among Adults In New Jersey After Hurricane Sandy, Nathaniel R. Geyer

Walden Dissertations and Doctoral Studies

HIV screening is recommended to destigmatize the condition, prevent partner transmission, and postpone AIDS progression. However, determinants associated with implementation of opt-out HIV screening are not well understood. The purpose of the study was to examine determinants that predicted odds of HIV screening for persons impacted by Hurricane Sandy, and how these factors differed according to demographic characteristics, geographical attributes, health-related quality of life score, access-to-care, and health insurance status. The social ecologic model provided the framework for this multilevel cross-sectional study that included New Jersey data from the Behavior Risk Factor Surveillance System. Bivariate chi-square, simple logistic regression, and …

Alcohol Use And Immune Reconstitution Among Hiv-Infected Patients On Antiretroviral Therapy In Nairobi, Kenya, Anthony Cagle, Christine Mcgrath, Barbra A. Richardson, Dennis Donovan, Sameh Sakr, Nelly Yatich, Richard Ngomoa, Agnes Chepngeno Langat, Grace John-Stewart, Michael Chung

Internal Medicine, East Africa

Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan African clinic. This was a retrospective cohort study of treatment-naïve HIV-infected adults initiating ART in Nairobi, Kenya and followed for 12 months between January 2009 and December 2012. At enrollment, a standardized questionnaire …

Interventions For Neurocognitive Dysfunction, J Ellero, M Lubomski, B Brew

Medical Papers and Journal Articles

Purpose of review: To evaluate current barriers to HIV cure strategies and interventions for neurocognitive dysfunction with a particular focus on recent advancements over the last three years.

Recent findings: Optimal anti-retroviral therapy (ART) poses challenges to minimise neurotoxicity, whilst ensuring blood brain barrier penetration and minimising the risk of cerebrovascular disease. CSF biomarkers, BCL11B and neurofilament light chain may be implicated with a neuroinflammatory cascade leading to cognitive impairment. Diagnostic imaging with diffusion tensor imaging as well as resting-state fMRI show promise in future diagnosis and monitoring of HAND.

Summary: The introduction of ART has resulted in a dramatic …