Digital Commons Network^™

Patient Predictors Of Poor Drug Sensitive Tuberculosis Treatment Outcomes In Kyiv Oblast, Ukraine, Omowunmi Aibana, Andrej Slavuckij, Mariya Bachmaha, Viatcheslav Krasiuk, Natasha Rybak, Timothy P Flanigan, Vasyl Petrenko, Megan B Murray

Faculty, Staff and Student Publications

Background: Ukraine has high rates of poor treatment outcomes among drug sensitive tuberculosis (DSTB) patients, while global treatment success rates for DSTB remain high.

We evaluated baseline patient factors as predictors of poor DSTB treatment outcomes.

Methods: We conducted a retrospective analysis of new drug sensitive pulmonary TB patients treated in Kyiv Oblast, Ukraine between November 2012 and October 2014. We defined good treatment outcomes as cure or completion and poor outcomes as death, default (lost to follow up) or treatment failure. We performed logistic regression analyses, using routine program data, to identify baseline patient factors associated with poor outcomes. …

Double Whammy: Interpretive Phenomenological Analysis Of Older African Americans Experiencing Hiv & Age Related Comorbidities, James W. Chavers

Antioch University Dissertations & Theses

HIV among older African Americans represents one of the fastest and largest growing populations of infected groups in America (CDC, 2008). With the availability of anti-retrovirals (ARV), or AIDS cocktail drugs, HIV has become a chronic illness. As African Americans are living longer with HIV, they are encountering the diseases that are consonant with aging. The effect of aging with HIV and an age-related comorbid condition can be physically and emotionally debilitating. Many of these older adults are also dealing with poverty, stigma, poor healthcare access, and limited social support. The purpose of this study was to explore how these …

Using Risk-Tracing Snowball Approach To Increase Hiv Case Detection Among High-Risk Populations In Cambodia: An Intervention Study, Srean Chhim, John Macom, Chettana Pav, Nirada Nim, Phearun Yun, Sopheap Seng, Siyan Yi

Background: Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.

Methods: This study was conducted from April 1 to September 30, 2016 at two …

Transition Into Adult Care: Factors Associated With Level Of Preparedness Among Adolescents Living With Hiv In Cambodia, Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Penhsun Ly

Background: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a …

Hiv Glycoprotein Gp120 Impairs Fast Axonal Transport By Activating Tak1 Signaling Pathways, Sarah H. Berth, Nichole Mesnard-Hoaglin, Bin Wang, Hajwa Kim, Yuyu Song, Maria Sapar, Gerardo Morfini, Scott T. Brady

Publications and Research

Sensory neuropathies are the most common neurological complication of HIV. Of these, distal sensory polyneuropathy (DSP) is directly caused by HIV infection and characterized by length-dependent axonal degeneration of dorsal root ganglion (DRG) neurons. Mechanisms for axonal degeneration in DSP remain unclear, but recent experiments revealed that the HIV glycoprotein gp120 is internalized and localized within axons of DRG neurons. Based on these findings, we investigated whether intra-axonal gp120 might impair fast axonal transport (FAT), a cellular process critical for appropriate maintenance of the axonal compartment. Significantly, we found that gp120 severely impaired both anterograde and retrograde FAT. Providing a …

Towards An Integrated Primary And Secondary Hiv Prevention Continuum For The United States: A Cyclical Process Model, Tim Horn, Jennifer Sherwood, Robert H. Remien, Denis Nash, Judith D. Auerbach

Publications and Research

Introduction: Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized.

Discussion: We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well …

Importance And Value Of Hiv Education Amongst Dental Hygiene Student Providers, Shawndell Bowers

Dental Hygiene ETDs

Persons living with HIV have an increased risk of complications and manifestations that may include the oral cavity. They are also more susceptible to dental implications such as dental decay and periodontal disease. Their oral health management is dependent on capable dental providers that understand and comprehend their specific needs. Those providers must also demonstrate ethical and clinical competence in order to provide comprehensive care. Preparing capable dental hygiene providers is essential to their long-term management of their oral health. These foundational skills are developed during their academic years and therefore, this qualitative survey was aimed at gaining student perceived …

Accuracy Of Name And Age Data Provided About Network Members In A Social Network Study Of People Who Use Drugs: Implications For Constructing Sociometric Networks, April M. Young, Abby E. Rudolph, Amanda E. Su, Lee King, Susan Jent, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Purpose—Network analysis has become increasingly popular in epidemiologic research, but the accuracy of data key to constructing risk networks is largely unknown. Using network data from people who use drugs (PWUD), the study examined how accurately PWUD reported their network members’ (i.e., alters’) names and ages.

Methods—Data were collected from 2008 to 2010 from 503 PWUD residing in rural Appalachia. Network ties (n=897) involved recent (past 6 months) sex, drug co-usage, and/or social support. Participants provided alters’ names, ages, and relationship-level characteristics; these data were cross-referenced to that of other participants to identify participant-participant relationships and to determine …

Progress Toward Eliminating Mother To Child Transmission Of Hiv In Kenya: Review Of Treatment Guideline Uptake And Pediatric Transmission At Four Government Hospitals Between 2010 And 2012., Sarah Finocchario-Kessler, Kristine F. Clark, Samoel Khamadi, Brad J. Gautney, Vincent Okoth, Kathy Goggin, Hitsystem Study Team

Manuscripts, Articles, Book Chapters and Other Papers

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.001). Pediatric HIV infection was halved (8.6-4.3 %), yet varied significantly by hospital. In multivariable analyses, HIV-exposed infants who received no PMTCT (AOR 4.6 [2.49, 8.62], p < 0.001), mixed foods (AOR 5.0 [2.77, 9.02], p < 0.001), and care at one of the four hospitals (AOR 3.0 [1.51, 5.92], p = 0.002) were more likely to be HIV-infected. While the administration and uptake of WHO PMTCT guidelines is improving, an expanded focus on retention and medication adherence will further reduce pediatric HIV transmission.

Hiv And Aging: Global Implications For Social Care Of A Vulnerable Population, Mark Brennan-Ing

Aging Studies Institute

In the early 1980s when Human Immunodeficiency Virus (HIV), the cause Acquired Immune Deficiency Syndrome (AIDS), was first identified, life expectancy following diagnosis was approximately two years (Halkitis, 2013). With the advent of highly-active antiretroviral therapy (HAART) in the mid-1990s, life expectancy for people with HIV (PWH) increased sharply. PWH receiving HAART treatment shortly after diagnosis can now expect to live as long as uninfected individuals (van Sighem, Gras, Reiss, Brinkman, & de Wolf, 2010). As a result the population with HIV is aging. It is estimated that in 2015, 50% of PWH in the U.S. were age 50 and …

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 …

Epidemiology Of Hpv Genotypes Among Hiv Positive Women In Kenya: A Systematic Review And Meta-Analysis, Sonia Menon, Aibibula Wusiman, Marie Claude Boily, Mbabazi Kariisa, Hillary Mabeya, Stanley Luchters, Frode Forland, Rodolfo Rossi, Steven Callens, Davy Vanden Broeck

Population Health, East Africa

Background: There is a scarcity of data on the distribution of human papillomavirus (HPV) genotypes in the HIV positive population and in invasive cervical cancer (ICC) in Kenya. This may be different from genotypes found in abnormal cytology. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18, and the nonavalent vaccine targeting 90% of all ICC cases, such HPV genotype distribution data are indispensable for predicting the impact of vaccination and HPV screening on prevention. Even with a successful vaccination program, vaccinated women will still require screening to detect those who will develop ICC from …

Clinical Care Of Incarcerated People With Hiv, Viral Hepatitis, Or Tuberculosis, Josiah D. Rich, Curt G. Beckwith, Alexandria Macmadu, Brandon D L Marshall, Lauren Brinkley-Rubinstein, Joseph J. Amon, M-J Milloy, Maximilian R F King, Jorge Sanchez, Lukoye Atwoli

Internal Medicine, East Africa

The burden of HIV/AIDS and other transmissible diseases is higher in prison and jail settings than in the non-incarcerated communities that surround them. In this comprehensive review, we discuss available literature on the topic of clinical management of people infected with HIV, hepatitis B and C viruses, and tuberculosis in incarcerated settings in addition to co-occurrence of one or more of these infections. Methods such as screening practices and provision of treatment during detainment periods are reviewed to identify the effect of community-based treatment when returning inmates into the general population. Where data are available, we describe differences in the …

Early Haart Should Be Used For Treatment-Naive Hiv Patients With Pneumocystis Pneumonia, Maxwell L. Winkler

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Manzardo C, Esteve A, Ortega N, et al. Optimal timing for initiation of highly active antiretroviral therapy in treatment-naïve human immunodeficiency virus-1-infected individuals presenting with AIDS-defining diseases: the experience of the PISCIS Cohort. Clin. Microbiol. Infect. 2013 July;19(7):646-653. doi: 10.1111/j.1469-0691.2012.03991.x

Potential Cost Savings Of Not Doing Cd4 Counts In Hiv Positive People In Rhode Island With An Undetectable Viral Load, Ruth Dele-Oni, Ferdinand Schumacher, Zachary Markus, Timothy Flanigan, Md

Journal of Health Disparities Research and Practice

CD4 cells fight infections in the body. When someone contacts Human Immunodeficiency Virus (HIV), their CD4 cells are taken over by HIV which turns them into manufacturers of many copies of the virus. The Viral Load (VL) measures the amount of virus in the blood. When HIV takes over the CD4 cells, the VL increases while the number of necessary CD4 cells decreases. When patients maintain stable treatment, their CD4 counts rise, and VLs may become undetectable, indicating the virus is too little to be detected in their blood. Knowing this, is frequent CD4 counts necessary for those with undetectable …

Marijuana Use Among Young Black Men Who Have Sex With Men And The Hiv Care Continuum: Findings From The Uconnect Cohort, Dexter R. Voisin

Faculty Scholarship

Background: Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Objective: Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. Methods: A cohort of YBMSM (n = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression …

Understanding Mediators Of The Relationship Between Hiv-Related Stigma And Medication Adherence Among People Living With Hiv (Hiv), Shannon Marie Sweeney

Dissertations - ALL

Although accumulated research demonstrates that HIV-related stigma is associated with medication adherence difficulties for PLWH, this literature is limited by inconsistencies in the conceptualization and assessment of both stigma and adherence. Additionally, few empirical research studies provide tests of the psychosocial mechanisms that may account for the stigma-adherence relationship. The present study sought to clarify these relationships using more refined measures, which assessed multiple domains of stigma (i.e., internalized, anticipated, and enacted stigmas) and multiple domains of adherence (i.e., global and intentional nonadherence). It was further hypothesized that two mediational pathways, depressive symptoms and disclosure concerns, may mediate the association …

Challenges To Providing Patient-Centered Care For Multidrug-Resistant Tuberculosis (Mdr-Tb) In South Africa, Ana Maria Kelly, Barbara Ann Smith, Jason E. Farley

International Nursing Research Congress (INRC)

Session presented on Sunday, July 24, 2016:

Purpose: The incidence of multidrug-resistant tuberculosis (MDR-TB) is on the rise globally. MDR-TB takes a minimum of 2 years to treat and the treatment regimen produces many adverse drug reactions (ADRs). The World Health Organization (WHO) has called for further research on the treatment of community-based MDR-TB patients as care is being decentralized to outpatient settings. In the WHO's TB progress report for 2015, they note there is a dearth of literature about anti-TB drug-induced mortality, morbidity and loss in quality of life, particularly in low-resource settings. This study directly addresses this gap …

A Survey Of Tuberculosis Infection Control Practices At The Nih/Niaid/Daids-Supported Clinical Trial Sites In Low And Middle Income Countries., Catherine Godfrey, Gail Tauscher, Sally Hunsberger, Melissa Austin, Lesley Scott, Jeffrey T. Schouten, Anne F. Luetkemeyer, Constance Benson, Robert Coombs, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: Health care associated transmission of Mycobacterium tuberculosis (TB) is well described. A previous survey of infection control (IC) practices at clinical research sites in low and middle income countries (LMIC) funded by the National Institute of Allergy and Infectious Diseases (NIAID) conducting HIV research identified issues with respiratory IC practices. A guideline for TB IC based on international recommendations was developed and promulgated. This paper reports on adherence to the guideline at sites conducting or planning to conduct TB studies with the intention of supporting improvement.

METHODS: A survey was developed that assessed IC activities in three domains: facility …

Erythrocyte Sedimentation Rate In Patients With Positive Sputum For Afb And Negative Hiv Serological Test, Ahmad Hasan Raheem

Muthanna Medical Journal

The goals of this study are detection of the prevalence of ESR elevation in patients whosuffering from pulmonary tuberculosis with positive sputum for acid fast bacilli and negative serological test for HIV, and showingthe effect of normal ESR ondiagnosis of active pulmonary tuberculosis. 37 patients of pulmonary TB with sputum positive for AFB and negative serological test for HIV, were involved in this retrospective study over145 days,at major TB center of Al-Hillacity, Iraq.The Westergren method used for detection of ESR for all patients. Of the total 37 patients involved in this study 21(57%) were males and 16(43%) were females. The …

Husband’S Support Towards Unmet Need Of Hiv Positive-Infected Women Of Childbearing Age, Sophia Sophia, Anita Deborah Anwar, Bony Wiem Lestari

Kesmas

Jutaan wanita usia subur (WUS) dengan HIV positif di negara berkembang saat ini tidak menggunakan kontrasepsi untuk menunda atau mengakhiri kehamilan. Pencegahan kehamilan yang tidak diinginkan pada WUS dengan HIV positif sangat penting untuk meningkatkan kualitas hidup ibu dan anak. Tujuan penelitian ini untuk menganalisis faktor-faktor yang berpengaruh terhadap unmet need pada WUS dengan HIV positif. Metode penelitian adalah cross sectional dengan sampel berjumlah 130 WUS dengan HIV positif yang diambil secara consecutive sampling. Penelitian dilakukan pada 24 Maret - 30 Juni 2015 di Klinik Mawar Kota Bandung. Pengumpulan data dilakukan melalui wawancara dengan menggunakan kuesioner, kemudian data dianalisis dengan …

Improving Postexposure Hiv Follow-Up In Healthcare Workers, Linda Valles Gutierrez

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based practice (EBP) project is to improve the HIV postexposure follow-up (PEFU) rate in healthcare workers (HCWs) through implementation of a revised infection control policy and reminder system. Occupational exposure to HIV is a significant risk for all healthcare workers. In the United States every year, 1 out of 10 U.S. healthcare workers suffers a blood or body fluid exposure (BBFE). Transmission of one serious blood-borne infection can cost more than a million dollars for medications, follow-up laboratory testing, clinical evaluation, lost wages, and disability payments. Completion of HIV PEFU in HCWs is very low nationally. …

Hiv Vaccines: Progress, Limitations And A Crispr/Cas9 Vaccine, Omar A. Garcia Martinez

Biology: Student Scholarship & Creative Works

ABSTRACT: The HIV-1 pandemic continues to thrive due to ineffective HIV-1 vaccines. Historically, the world’s most infectious diseases, such as polio and smallpox, have been eradicated or have come close to eradication due to the advent of effective vaccines. Highly active antiretroviral therapy is able to delay the onset of AIDS but can neither rid the body of HIV-1 proviral DNA nor prevent further transmission. A prophylactic vaccine that prevents the various mechanisms HIV-1 has to evade and attack our immune system is needed to end the HIV-1 pandemic. Recent advances in engineered nuclease systems, like the CRISPR/Cas9 system, have …

Sonographic Estimation Of The Prevalence Of Hepatic Steatosis In Hiv Monoinfected Patients At Aga Khan University Nairobi., Bernadette Wambui Muthee

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Human immunodeficiency virus disease (HIV) is a worldwide health problem. It is estimated that 38.6 million people are infected with HIV globally. It has remained endemic in the African continent for close to 20 years and is a long term developmental challenge in Africa which bears 69 % of the HIV/AIDS global burden. The introduction of highly active antiretroviral therapy (HAART) has caused dramatic improvement in prognosis of HIV disease. Consequently, this has resulted in substantial reduction in Acquired Immune Deficiency Syndrome (AIDS) related morbidity and mortality. In contrast, this has been accompanied by an upsurge in liver- related …

Use Of Culturally Tailored Media To Increase Hiv Screening Among African Americans, Leda Evans

Doctoral Projects

Over one million people in the United States have HIV with a substantial portion of these individuals being African American. Innovative approaches to improving the HIV disparity among African Americans have been encouraged by the federal government. Culturally tailored HIV risk reduction interventions have been noted as effective in several studies in reducing risk behavior. The purpose of the intervention was to determine if the use of culturally tailored HIV risk reduction media would result in an increase in HIV screening among African Americans. A one-time community based-intervention with no control group was utilized to determine impact of media. Screening …

Proteome And Protein Network Analyses Of Memory T Cells Find Altered Translation And Cell Stress Signaling In Treated Human Immunodeficiency Virus Patients Exhibiting Poor Cd4 Recovery, Sausan Azzam, Daniela M. Schlatzer, Sean Maxwell, Xiaolin Li, Douglas Bazdar, Yanwen Chen, Robert Asaad, Jill S. Barnholtz-Sloan, Mark R. Chance, Scott F. Sieg

Faculty Scholarship

Background. Human immunodeficiency virus (HIV) patients who experience poor CD4 T-cell recovery despite viral suppression during antiretroviral therapy (ART) are known as immunological nonresponders. The molecular mechanism(s) underlying incomplete immune restoration during ART is not fully understood. Methods. Label-free quantitative proteomics on single-cell type central memory T cells were used to reveal relative protein abundance changes between nonresponder, responder (good CD4 recovery during ART), and healthy individuals. Proteome changes were analyzed by protein pathway and network analyses and verified by selected reaction monitoring mass spectrometry. Results. Proteomic analysis across groups detected 155 significant proteins from 1500 nonredundant proteins. Pathway and …

The Association Between Vitamin A Status Or Supplementation And Hiv/Aids, Mikaela Kathleen Curtis

Food Science and Nutrition

The human immunodeficiency virus (HIV) has infected millions of people since the start of the epidemic in the early 1980s. HIV is the etiologic agent of the acquired immunodeficiency syndrome (AIDS), which has taken millions of lives. It is extremely difficult for particular populations to receive medication to treat HIV infection and prevent the progression of HIV to AIDS. Multiple studies have examined the effect of vitamin A on HIV infection, due to its immune stimulating effects. It is unclear whether an association exists between vitamin A and different aspects of HIV. This review examined the effect of vitamin A …

The Significance Of A Common Idiotype (1f7) On Antibodies Against Human Immune Deficiency Virus Type 1 And Hepatitis C Virus, Sybille Muller, Matthew S. Parsons, Heinz Kohler, Michael Grant

Microbiology, Immunology, and Molecular Genetics Faculty Publications

In this review, we trace the concept and potential functional role of regulatory idiotypes in the immune response to human immunodeficiency virus type 1 (HIV-1), simian immunodeficiency virus, and hepatitis C virus (HCV). A major idiotype involved in these viral infections is recognized and defined by a murine monoclonal antibody (1F7). Antibodies expressing the idiotype defined by 1F7 are dominant in HIV-1 infection and are also found on many broadly neutralizing antibodies against HIV-1. This regulatory idiotypic axis offers opportunities for exploitation in vaccine development for HIV-1, HCV, and other chronic viral infections.

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Visualization Of Hiv-Associated Neurocognitive Disorders, Tim Fitzgerald

Theses

It is widely known that human immunodeficiency virus type-1 (HIV-1) can cause acquired immune deficiency syndrome (AIDS), but treatments to prevent the virus from escalating to that severity have come a long way since the virus was first described in the 1980s. The medications, combined antiretroviral therapy (cART), keep the virus from replicating, thus stopping its progression to AIDS. However, this treatment does not seem to ultimately benefit the brain, in part because cART does not uniformly penetrate the blood-brain barrier (BBB), and in part because HIV-1 seems to permanently turn on the part of the immune system that causes …