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Respiratory Function Amongst Asymptomatic Hiv Positive And Hiv Negative Clients At Aga Khan University Hospital, Nairobi, Noah Kipkemei Murbiy

Master of Medicine in Internal Medicine

Background: Spirometry is used to asses respiratory function abnormalities. This is usually in reference to a validated normal range unique to a particular gender, race, age, weight and height. Majority of persons are usually asymptomatic until the expected FEV1 has decreased by 50%. Early intervention on the abnormalities even in this asymptomatic group has been shown to retard the rate of pulmonary deterioration. An unpublished audit at the Aga Khan University Hospital, Nairobi, revealed that majority of newly diagnosed HIV positive persons were admitted at the Critical Care Units with a pulmonary cause which later resulted in poor outcomes. This …

Plague Inc: Distribution Of Health Resources In The Modern World, Allison Rump

Honors Theses

Due to the ever increasing connectedness of our world, disease can spread faster than ever before. Therefore global health care is a pressing issue in the modern world. The Ebola epidemic of 2014, which infected an unprecedented number of people, was reminder of not only of human fragility but of the state modern medicine, especially when deployed in economically developing areas. Not only is medicine about the science and treatment of disease, it also is about economics and the ability to pay for treatment. This can manifest in many forms, for the Ebola epidemic there often were not enough equipment …

Structural And Functional Interactions Between Bro1 Domain Of Human Alix Protein And Nucleocapsid Packaging Rna Complex From Hiv, Scott Gross

Graduate School of Biomedical Sciences Theses and Dissertations

A virus is only as powerful as its ability to spread. Enveloped retroviruses, namely HIV-1, use exocytosis pathways that normal host cells use to release particles from the plasma membrane. The main pathways of interest in this study are the Endosomal Sorting Complex Required for Transport (ESCRT) and adjacent ALIX pathways. The ESCRT pathway is especially important for degradation of receptor/cargo complexes that form Multi-Vesicular Bodies (MVBs). Currently, there is no known therapy that targets this endosomal pathway, which would prevent the spread of the virus to other cells. The virus has adapted to jump from pathway to pathway when …

Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers

Economics Faculty Publications

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion: Examination of the …

Influence Of The Anti-Hiv Drug Elvitegravir On Chlamydial Development And The Characterization Of Chlamydial Polymorphic Membrane Protein Expression In Herpes Simplex Virus (Hsv)/C. Trachomatis Co-Infected Cells, Hena Yakoob

Undergraduate Honors Theses

Chlamydia trachomatis is the most common bacterial agent of sexually transmitted infections worldwide and a common co-infection in AIDS patients. Chlamydial genital tract infections are often asymptomatic; therefore many infections go untreated and result in complications like chronic inflammation, ectopic pregnancy, and pelvic inflammatory disease. Chlamydia share a unique developmental cycle and under stress, can enter a state known as persistence, in which the bacteria are noninfectious but still viable. Removal of the stressor allows the chlamydiae to re-enter and complete the developmental cycle. Exposure to low-dose quinolones can cause the chlamydiae to enter persistence and halt the developmental cycle. …

Mathematical Modeling Of Communicable Imported Diseases Screening In The United Arab Emirates, Lahbib Ben Ahmadi

Theses

The United Arab Emirates (UAE), as one of the countries with high numbers of expatriates in the world, is expected to face public health challenges. The reason for this situation is that the majority of those expatriates belong to regions where health issues are usually left behind. This may create the possibility of having imported communicable diseases. However, screening policy should be tested and adapted to protect the population from any imported communicable disease. This study aims at identifying an approach and method to deal with these imported diseases via a set of differential equations. The spread of a communicable …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

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

Journal of the Georgia Public Health Association

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

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

Results: The …

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

Journal of the Georgia Public Health Association

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

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

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

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

Journal of the Georgia Public Health Association

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

Methods: Data on current smoking, derived from the …

Characterizing Hiv-Associated Neurocognitive Disorder In Two Underserved Sociodemographic Groups, Julia S. Seay

Open Access Dissertations

The purpose of this project is to characterize neurocognitive functioning and correlates of neurocognitive functioning, as well as to examine the diagnostic accuracy of relatively promising neurocognitive tests in two underserved sociodemographic groups living with HIV: monolingual Spanish-speaking Hispanics and English-speaking African-Americans, in order to better understand HIV-Associated Neurocognitive Disorder (HAND) within these groups. Examining HAND in underserved groups is paramount to the development of effective HAND screening and treatment algorithms in clinics that serve these groups, such as the AIDS Clinical Research Unit (ACRU) at the University of Miami. The current project was drawn from an initiative to develop …

Fighting Microbial Drug Resistance: A Primer On The Role Of Evolutionary Biology In Public Health, Gabriel Perron, R. Inglis, Pleuni Pennings, Sarah Cobey

Biology Department Faculty Works

Although microbes have been evolving resistance to antimicrobials for millennia, the spread of resistance in pathogen populations calls for the development of new drugs and treatment strategies. We propose that successful, long-term resistance management requires a better understanding of how resistance evolves in the first place. This is an opportunity for evolutionary biologists to engage in public health, a collaboration that has substantial precedent. Resistance evolution has been an important tool for developing and testing evolutionary theory, especially theory related to the genetic basis of new traits and constraints on adaptation. The present era is no exception. The articles in …

Project Thanks: A Socio-Ecological Framework For An Intervention Involving Hiv Positive African American Women With Comorbidities, Meena Mahadevan, Ndidiamaka Amutah, Lauren Juliette Ramos, Emily Rose Raines, Jerome King, Jodyann Mcintosh, Constance Leverett

Journal of Health Disparities Research and Practice

HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of …

Prevention, Not Prejudice: The Role Of Federal Guidelines In Hiv-Criminalization Reform, Sarah J. Newman

Northwestern University Law Review

Thirty-four states and two U.S. territories have criminal statutes that specifically impose criminal liability for HIV transmission, exposure, or nondisclosure. With possible sentences ranging up to thirty years, these statutes have even provided the basis for convicting HIV positive individuals who never actually transmitted the virus. To address the unreasonable prosecutions of these individuals, Representative Barbara Lee of California introduced the Repeal Existing Policies that Encourage and Allow Legal HIV Discrimination Act (REPEAL Act) to the U.S. House of Representatives on September 23, 2011. If passed, the REPEAL Act would require a systematic review of these statutes and the development …

Evaluating The Effects Of An Interdisciplinary Practice Model With Pharmacist Collaboration On Hiv Patient Co-Morbidities, Rebecca Cope, Leonard Berkowitz, Rebecca Arcebido, Jun-Yen Yeh, Nathan Trustman, Agnes Cha

Touro College of Pharmacy (New York) Publications and Research

Treatment of HIV now occurs largely within the primary care setting, and the principal focus of most visits has become the management of chronic disease states. The clinical pharmacist’s potential role in improving chronic disease outcomes for HIV patients is unknown. A retrospective cohort study was performed for HIV-positive patients also diagnosed with diabetes, hypertension, or hyperlipidemia. Characteristics and outcomes in 96 patients treated by an interdisciplinary team which included a clinical pharmacist (i.e., the intervention group) were compared to those in 50 patients treated by an individual healthcare provider (i.e., the control group). Primary outcomes were changes from baseline …

Customized Order-Entry Sets Can Prevent Antiretroviral Prescribing Errors: A Novel Opportunity For Antimicrobial Stewardship, Yi Guo, Philip Chung, Caryn Weiss, Keith Veltri, Grace Y. Minamoto

Touro College of Pharmacy (New York) Publications and Research

Background: Patients with human immunodeficiency virus (HIV) infection on antiretroviral (ARV) therapy are at increased risk for medication errors during transitions of care between the outpatient and inpatient settings. This can lead to treatment failure or toxicity. Previous studies have emphasized the prevalence of medication errors in such patients, but few have reported initiatives to prevent errors from occurring.

Methods: The study was conducted in a 1,400-bed health care center with a state-designated Acquired Immunodeficiency Syndrome (AIDS) Center in the Bronx, New York. The antimicrobial stewardship team and HIV specialists developed customized order-entry sets (COES) to guide ARV …

Majority Of Hiv/Hcv Patients Need To Switch Antiretroviral Therapy To Accommodate Direct Acting Antivirals, Rebecca Cope, Aaron Pickering, Thomas Glowa, Samantha Faulds, Peter Veldkamp, Ramakrishna Prasad

Touro College of Pharmacy (New York) Publications and Research

The impact of drug–drug interactions (DDIs) between interferon-free direct acting antiviral (DAA) regimens and antiretrovirals (ART) among HIV/HCV co-infected individuals in clinical practice settings is unknown. A singlecenter, retrospective chart review of co-infected patients was conducted from June 2014 to February 2015. Significant interactions between simeprevir (SMV), ledipasvir (LDV), and paritaprevir/ritonavir/ombitasvir plus dasabuvir (3D regimen) with ART were identified based on available literature. SMV had the largest number of DDIs and was further investigated to determine the feasibility of ART switch to allow for DAA use. Of 127 subjects, 23% had advanced liver disease; 86% of those with known HCV …

Antiretroviral Drug Use In A Cohort Of Hiv-Uninfected Women In The United States: Hiv Prevention Trials Network 064, Iris Chen, William Clarke, San-San Ou, Mark A. Marzinke, Autumn Breaud, Lynda M. Emel, Jing Wang, James P. Hughes, Paul Richardson, Danielle F. Haley, Jonathan Lucas, Anne Rompalo, Jessica E. Justman, Sally L. Hodder, Susan H. Eshleman

Faculty & Staff Scholarship

Antiretroviral (ARV) drug use was analyzed in HIV-uninfected women in an observational cohort study conducted in 10 urban and periurban communities in the United States with high rates of poverty and HIV infection. Plasma samples collected in 2009–2010 were tested for the presence of 16 ARV drugs. ARV drugs were detected in samples from 39 (2%) of 1,806 participants: 27/181 (15%) in Baltimore, MD and 12/179 (7%) in Bronx, NY. The ARV drugs detected included different combinations of non-nucleoside reverse transcriptase inhibitors and protease inhibitors (1–4 drugs/sample). These data were analyzed in the context of self-reported data on ARV drug …

Specific Behaviors Predict Staphylococcus Aureus Colonization And Skin And Soft Tissue Infections Among Human Immunodeficiency Virus- Infected Persons, Nancy F. Crum-Cianflone, Xun Wang, Amy Weintrob, Tahaniyat Lalani, Mary Bavaro, Jason F. Okulicz, Katrin Mende, Michael Ellis, Brian K. Agan

United States Public Health Resources

Background. Few data exist on the incidence and risk factors of Staphylococcus aureus colonization and skin and soft tissue infections (SSTIs) among patients infected with human immunodeficiency virus (HIV).

Methods. Over a 2-year period, we prospectively evaluated adults infected with HIV for incident S aureus colonization at 5 body sites and SSTIs. Cox proportional hazard models using time-updated covariates were performed.

Results. Three hundred twenty-two participants had a median age of 42 years (interquartile range, 32–49), an HIV duration of 9.4 years (2.7–17.4), and 58% were on highly active antiretroviral therapy (HAART). Overall, 102 patients (32%) became colonized with S …

The Threat Lives On: How To Exclude Expectant Mothers From Prosecution For Mere Exposure Of Hiv To Their Fetuses And Infants, Shahabudeen K. Khan

Cleveland State Law Review

There is a renewed interest in HIV/AIDS issues given that better treatment is available. The Department of Justice (DOJ), Civil Rights Division, recently published best practice guidelines to reform HIV-specific criminal laws to conform to modern science. The DOJ’s latest guidelines urge states to “reform and modernize” the laws to reflect modern science. There is a lot of unfinished work regarding the ineffectiveness and stigma associated with HIV criminal transmission laws as a whole. These laws are “no good” and counterintuitive in the fight against this unfortunate disease. There have been calls to repeal these laws in their entirety. That …

Anticipating Hiv Vaccines: Sketching An Agenda For Public Health Ethics And Policy In The United States, James M. Dubois, Amanda Hine, Michele Kennett, Kayla Kostelecky, Joseph Norris, Rachel Presti, Kathryn Raliski, Jessi Roach, Adam Ruggles

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Untreated Depression In Persons Living With Hiv In Kazakhstan, Dina Terloyeva

Legacy Theses & Dissertations (2009 - 2024)

Objective:This study investigates the occurrence of depressive symptoms among persons living with HIV, and the relationship between depressive symptoms and HIV treatment initiation and adherence.

Trends Of Injecting Risk Behaviors Among People Who Inject Drugs In Ukraine : The Analysis Of Bio-Behavioral Surveillances Conducted In 2007-2013, Iuliia Makarenko

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Assessment Of Quality Of Life (Qol) In People Living With Hiv In Georgia, Ekaterine Karkashadze

Legacy Theses & Dissertations (2009 - 2024)

Background: Identification of factors that influence quality of life (QoL) is important in order to improve health and social care services. No prior research is available on QoL in people living with HIV in the country of Georgia. The purpose of our study was to assess QoL among Georgian HIV-infected individuals and to examine associations of socio-demographic and disease-related factors with general and domain-specific QoL.

Trends In Risky Sexual Behavior Among Men Who Have Sex With Men : Analysis Of Repeated Cross-Sectional Survey Data From Ukraine, 2007-2013, Roksolana Kulchynska

Legacy Theses & Dissertations (2009 - 2024)

Objective: To examine changes in risky sexual behavior over time, i.e., unprotected anal intercourse (UAI) among men who have sex with men (MSM) in Ukraine.

Correlates Of Life-Time History Of Purchasing Sex Services By Men In Saint Petersburg And Leningrad Oblast, Russian Federation, Polina Girchenko

Legacy Theses & Dissertations (2009 - 2024)

Background. Commercial sex workers (CSW) in Russian Federation are at high risk of HIV infection and transmission as a result of unsafe sexual and injecting behaviors. Their clients might be at increased risk of acquiring HIV; however, little is known about the population of men purchasing sex services. This study’s goal is to investigate factors associated with a history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation.

The Influence Of Self-Reported Degree Of Masculinity/Femininity On Condom Use Among Black Men Who Have Sex With Men In The Deep South, Elizabeth D. Peeler

Theses and Dissertations

In the United States, 50,000 Americans are diagnosed with HIV each year (CDCa, 2014). The HIV/AIDS epidemic has had a particularly devastating impact on the southern U.S., especially the Deep South – Alabama, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina (Reif, Whetten, Wilson, McAllaster, Pence, Legrand, & Gong, 2014). The Deep South, while only composing of 36% of the national population, accounts for 50% of all people living with HIV/AIDS in the nation (Human Rights Watch, 2010). No other population has been hit harder than men who have sex with men (MSM; Prejean, Tang, & hall, 2013). Black MSM …

The Relationship Between Poverty And Hiv/Aids In Sudan / Salwa Muddthir Ismail, Salwa Muddthir Ismail

Student Works (2010-2019)

This thesis investigates the complex and vicious circle of poverty and Human Immune Virus (HIV)/Acquired Immune Deficiency Syndromes (AIDS) in Sudan. The study focuses on selected dimensions of poverty that increase the risk and vulnerability to HIV/AIDS, which is pertinent as poverty can hamper mitigating efforts. The study adopted the livelihood, drive and structuration theories approach as the theoretical framework, to investigate the relationship between poverty and HIV/AIDS in Sudan. The study was conducted using a mixed method approach. Quantitative data from people living with HIV/AIDS was compiled using survey questionnaires while qualitative data gathered from Focus Group Discussions. The …

Predictors Of Condom Use Among Middle-Income, African American Women, Yvonne Maire Reed

Walden Dissertations and Doctoral Studies

Abstract

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and …

Novel Interventions For Hiv Self-Management In African American Women: A Systematic Review Of Mhealth Interventions, Kimberly Adams Tufts, Kaprea F. Johnson, Jewel Goodman Shepherd, Juyoung Lee, Muna S. Bait Ajzoon, Lauren B. Mahan, Miyoung Kim

Ellmer School of Nursing Faculty Publications

The purpose of this systematic review was to assess the quality of interventions using mobile health (mHealth) technology being developed for and trialed with HIV-infected African American (AA) women. We aimed to assess rigor and to ascertain if these interventions have been expanded to include the broad domain of self-management. After an extensive search using the PRISMA approach and reviewing 450 records (411 published studies and 39 ongoing trials atclinicaltrials.gov), we found little completed research that tested mHealth HIV self-management interventions for AA women. Atclinicaltrials.gov, we found several mHealth HIV intervention studies designed for women in general, forecasting a promising …