Digital Commons Network^™

Decriminalizing Disease: A Health Justice Approach To Infectious Diseases And Criminal Law, Sean E. Bland

Arkansas Law Review

Infectious diseases, also called communicable diseases, are largely a public health issue and should not be criminalized. This Article seeks to re-frame the discussion around the legal framework for infectious diseases in a way that moves beyond a punishment mindset and toward a health justice mindset. The focus in this Article is on health justice rather than traditional understandings of public health, defined as the science and practice of improving the health of people and their communities. The Article makes three novel contributions. First, it applies a health justice framework to the critique of infectious disease criminalization. Second, the Article …

Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, And Testing (Adapt-Itt) Framework To Tailor Evidence-Based Posttraumatic Stress Disorder Treatment For People With Hiv To Enhance Engagement And Adherence: Qualitative Results From A Feasibility Randomized Controlled Trial, Cristina M. Lopez, Angela D. Moreland, Stephanie Amaya, Erin Bisca, Christin Mujica, Tayler Wilson, Nathaniel Baker, Lauren Richey, Allison Ross Eckard, Patricia A. Resick, Steven A. Safren, Carla Kmett Danielson

School of Medicine Faculty Publications

BACKGROUND: Individuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist. OBJECTIVE: This study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV. METHODS: The Assessment, Decision, Adaptation, Production, Topical experts-integration, Training, and Testing (ADAPT-ITT) …

Acute Hepatitis B Infection In A Patient With Confirmed Immunity On Long-Acting Cabotegravir/Rilpivirine, William K B Boateng, Neil Carlin, Etan Spira, Maria E Szabela, Kosisochukwu J Ezeh

Faculty and Staff Publications

Long-acting injectable formulation of cabotegravir/rilpivirine (CAB/RPV) is a promising novel maintenance therapy for HIV infection. However, coinfection with active hepatitis B virus (HBV) infection is a contraindication to initiating this therapy. Despite guidelines, patients with HBV immunity can still contract acute HBV infection. We report a case of a 30-year-old man with HIV who transitioned from antiretroviral therapy to CAB/RPV and had confirmed HBV immunity. The patient, though asymptomatic, showed significantly elevated liver function tests (LFTs) before his monthly CAB/RPV injection. He was hospitalized and diagnosed with acute HBV infection. His LFTs improved, and he was taken off CAB/RPV and …

Managing Kaposi Sarcoma In Controlled Hiv: A Case Study On Cutaneous Manifestations And Multidisciplinary Care, Rafael Do Valle, Reem Ayoub, Henry Lim, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Kaposi Sarcoma (KS) is a soft tissue sarcoma that affects the linings of blood and lymphatic vessels. It occurs, primarily in immunocompromised individuals. It is caused by the Human Herpesvirus 8. There are four recognized forms of KS: AIDS-related, iatrogenic, classic, and endemic. Each form varies in demographics and manifestation. AIDS-related KS occurs in HIV-positive individuals, while iatrogenic KS develops in transplant patients undergoing immunosuppressive therapy. Classic KS is typically seen in elderly males from specific geographic regions, and endemic KS affects young individuals in certain areas of Africa. Clinical manifestations of KS include red, purple, or brown papules …

Week 96 Results Of Bictegravir/Emtricitabine/Tenofovir Alafenamide For Hiv Treatment In People With Substance Use Disorders, Joshua P. Havens, Sara Bares, Elizabeth Lyden, Nada A. Fadul, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: The BASE study (NCT03998176), a phase 4, 48-week (W), single-arm, prospective trial, revealed that the use of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV and substance use disorders (PWH/SUD) was safe and effective without emergent antiretroviral resistance despite incomplete adherence. Here, we present the W96 results.

METHODS: A retrospective analysis of all participants enrolled in the BASE study was completed from W48 to W96. End points of interest at W96 included the proportion of participants with viral suppression (VS; HIV RNA < 50 copies/mL [c/mL]), incidence of protocol-defined virologic failure (PDVF; 2 consecutive ≥400 c/mL), safety, adherence (percentage of days covered [PDC]), retention in care, and prevalence of ongoing substance use.

RESULTS: All enrolled BASE participants (n = 43) were included in the W96 analysis. At W48, 21 participants …

Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Longitudinal measures of viral load (VL) are critical in monitoring the HIV status. While multiple lab indicators exist for monitoring measures of VL, research on clustering historical/longitudinal VL measures is limited. Analyzing longitudinal VL patterns rather than aggregated measures offers deeper insights into HIV status. This study uses functional data clustering to classify longitudinal VL patterns and characterize each cluster by demographics, comorbidities, social behaviors, and CD4 count.

Methods: Adult PWH diagnosed from 2005 to 2015 in South Carolina with a 5-year minimum follow-up were included. We compared functional principal component analysis (FPCA), K-means, hierarchical clustering, and Gaussian mixture …

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …

Investigating Risk Of Suboptimal Hiv Treatment Outcomes (Treatment Failure And Disengagement) Among Pregnant And Postpartum Women Living With Hiv, Kevin Owuor

All ETDs from UAB

The joint United Nations Programme on HIV/AIDS (UNAIDS) has set targets to end the HIV epidemic by improving HIV diagnosis, treatment, and viral suppression to reduce new infections and improve health outcomes for people living with HIV (PLHIV), including pregnant and postpartum women living with HIV (PPWH). After diagnosis, linking PPWH to antiretroviral (ART) treatment is critical to suppress the virus and prevent mother-to-child transmission (MTCT) of HIV. Continuous engagement in care is essential for achieving and maintaining virologic suppression in the peripartum and postpartum period for PPWH, both for their own health and the health of their family. Disengagement …

Concomitant Diagnoses Of Lymphoma And Pml In An Hiv-Positive Patient, Madelaine Duarte, Delon Altherr, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Viral Vengeance: A Case Of Hiv Induced Myocarditis, Jacob Keesee, Brenden Pearce, Mohammed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Predictors Of Viral Suppression Among People Living With Hiv (Plhiv) On Antiretroviral Treatment In Almaty, Kazakhstan, Ainur Kussainova

Electronic Theses & Dissertations (2024 - present)

ABSTRACT

Introduction

The Eastern Europe and Central Asia (EECA) region is experiencing the world’s fastest-growing HIV epidemic, with Kazakhstan among the countries most affected. Despite progress in HIV testing and treatment, Kazakhstan continues to face significant challenges in achieving optimal viral suppression among PLHIV. While 82% of PLHIV in Kazakhstan know their HIV status, only 73% are on ART, and just 67% of those on treatment achieve viral suppression. Adherence to ART remains a critical barrier, influenced by a complex interplay of individual, social, and structural factors, including mental health disorders such as depression, substance use, stigma and discrimination. Understanding …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …

Toward Improving Retention In Hiv Care After Pregnancy: Lessons From A Post-Pandemic Cohort In The United States, Alexandra H Latham, Andrea Lugo Morales, Elizabeth Barba Gutierrez, Michael Jochum, Sarah Conrad, Eva H Clark, Kassandra Goytia, Megan Alam, Jessica Gerard, Jennifer Mckinney

Faculty, Staff and Students Publications

Introduction: People living with HIV (PLWH) often experience low rates of retention in HIV care (RIC) and suboptimal viral suppression postpartum. Understanding contemporary barriers to RIC is crucial to identify risk factors for loss to care and thereby improve support during this vulnerable transition. This work aimed to identify factors associated with adequate RIC, defined as two HIV care visits ≥90 days apart in the first year postpartum.

Methods: Electronic records were retrospectively reviewed for PLWH who delivered from 2019 to 2023 and received prenatal care within a single county health system. Variables were collected related to both maternal and …

Ccr5-Ligand Decorated Rilpivirine Lipid-Based Nanoparticles For Sustained Antiretroviral Responses, Milankumar Patel

Theses & Dissertations

Antiretroviral therapy (ART) is the standard remedy to improve the health-related quality of life of people living with human immunodeficiency virus (HIV). However, limited access to the viral reservoir has significantly hindered its effectiveness in fully eradicating HIV. Therefore, to improve HIV therapy, here we propose a C-C chemokine receptor type 5 (CCR5)-targeted theranostic lipid Based Nanoparticles (LBNPs) to noninvasively track and specifically deliver the antiretroviral drugs (ARVs) to the viral reservoir. A multi-modular radioactive nanoprobe was synthesized and co-encapsulated with rilpivirine (RPV, an ARV) into the LBNP to achieve a theranostic LBNP that can be tracked by positron emission …

Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Sexual and gender minorities (SGMs) are at higher risk of HIV incidence compared to their heterosexual cisgender counterparts. Despite the high HIV disease burden among SGMs, there was limited data on whether they are at higher risk of virologic failure, which may lead to potential disease progression and increased transmission risk. The All of Us (AoU) Research Program, a national community-engaged program aiming to improve health and facilitate health equity in the United States by partnering with one million participants, provides a promising resource for identifying a diverse and large volunteer TGD cohort. Leveraging various data sources available through …

Chronic Illness Education 2024: Resources For The Providers To Improve Adult Hiv Outcome, Amolak Jhand, Ariana Cho, Brayden Bitterman, Jhonny Avila Mendoza, Madeline Evans, Sabrina Khan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2024: Strategies To Improve Hiv Management, Fabiola Cuellar, Farheen Vali, Hana Jiang, Kevin Chau, Rahul Babu

Patient Education Projects

No abstract provided.

Chronic Illness Education 2024: Comprehensive Care For Patients With Hiv, Annie Hillenberg, Ibrahim Malik, Reema Smadi, Sanjeev Bola, Sean Carroll

Patient Education Projects

No abstract provided.

Covid-19 Breakthrough Infection After Vaccination And Substance Use Disorders: A Longitudinal Cohort Of People With And Without Hiv Receiving Care In The United States Veterans Health Administration, Elena M Soyer, Kathleen A Mcginnis, Amy C Justice, Evelyn Hsieh, Maria C Rodriguez-Barradas, Emily C Williams, Lesley S Park

Faculty, Staff and Students Publications

Research regarding HIV, substance use disorders (SUD), and SARS-CoV-2 infections after COVID-19 vaccination is limited. In the Veterans Aging Cohort Study (VACS)-HIV cohort, we followed vaccinated persons with HIV (PWH) and without HIV (PWoH) from 12/2020 to 3/2022 and linked SARS-CoV-2 test results for laboratory-confirmed breakthrough infection through 9/2022. We examined associations of substance use (alcohol use disorder [AUD], other SUD, smoking status) and HIV status and severity with breakthrough infections, using Cox proportional hazards regression hazard ratios (HR). To test for potential interactions between substance use and HIV, we fit survival models with a multiplicative interaction term. Among 24,253 …

Safety Of Kidney Transplantation From Donors With Hiv, Christine M Durand, Allan Massie, Sander Florman, Tao Liang, Meenakshi M Rana, Rachel Friedman-Moraco, Alexander Gilbert, Peter Stock, Sapna A Mehta, Shikha Mehta, Valentina Stosor, Marcus R Pereira, Michele I Morris, Jonathan Hand, Saima Aslam, Maricar Malinis, Ghady Haidar, Catherine B Small, Carlos A Q Santos, Joanna Schaenman, John Baddley, David Wojciechowski, Emily A Blumberg, Karthik Ranganna, Oluwafisayo Adebiyi, Nahel Elias, Jose A Castillo-Lugo, Emmanouil Giorgakis, Senu Apewokin, Diane Brown, Darin Ostrander, Yolanda Eby, Niraj Desai, Fizza Naqvi, Serena Bagnasco, Natasha Watson, Erica Brittain, Jonah Odim, Andrew D Redd, Aaron A R Tobian, Dorry L Segev

Faculty, Staff and Student Publications

Background: Kidney transplantation from donors with human immunodeficiency virus (HIV) to recipients with HIV is an emerging practice. It has been performed since 2016 under the U.S. congressional HIV Organ Policy Equity Act and is currently approved for research only. The Department of Health and Human Services is considering expanding the procedure to clinical practice, but data are limited to small case series that did not include donors without HIV as controls.

Methods: In an observational study conducted at 26 U.S. centers, we compared transplantation of kidneys from deceased donors with HIV and donors without HIV to recipients with HIV. …

The Price Of Prevention: Spain And Italy's Approach To National Prep, Jon Burkart

Claremont-UC Undergraduate Research Conference on the European Union

While recent advancements in antiretroviral therapy (ART) continue to improve the outlook for people living with HIV (PLHIV), new infections remain a concern for health authorities around the world. A clinically proven intervention holds the potential to dramatically reduce new infections: Pre-exposure prophylaxis (PrEP) is a once-daily pill for high-risk populations, including men who have sex with men (MSM), that substantially reduces HIV infection risk. However—much like rates of new infection—public provision of PrEP varies considerably among OECD countries. This case study thus seeks to answer the question: What might explain the disparate timeline of adopting public reimbursement for PrEP …

The Prevalence Rate Of Syphilis And Hiv Across Different Genders, Races, And Ages From 2017 To 2021 In The Southern Region Of The United States, Nafiseh Gavari, Rita Momah, Jessica Green Collins, Elizabeth Jones

Journal of Public Health in the Deep South

This study investigates the prevalence rates of Syphilis and HIV across different genders, races, and ages from 2017 to 2021 in regions 4 (Kentucky, North Carolina, Mississippi, Tennessee, South Carolina, Georgia, Florida, and Alabama) and 6 (New Mexico, Oklahoma, Texas, Arkansas, and Louisiana). These regions have been identified as high-risk areas for sexually transmitted diseases (STDs). Our study seeks to shed light on the trends and disparities in STD prevalence within these specific regions over the specified timeframe. Data were collected and analyzed from the AtlasPlus database, providing insights into the epidemiology of these diseases. The findings reveal increasing trends …

Transgender Women With Hiv Demonstrate Unique Non-Alcoholic Fatty Liver Disease Profiles, Jordan E Lake, Ana N Hyatt, Han Feng, Hongyu Miao, Anoma Somasunderam, Netanya S Utay, Kathleen E Corey

Faculty, Staff and Student Publications

Purpose: Non-alcoholic fatty liver disease (NAFLD) prevalence and severity may be higher in people with human immunodeficiency virus (HIV) than the general population, and vary with sex and age. We explored NAFLD characteristics by gender.

Methods: Adult transgender women (TW), cisgender women (CW), and cisgender men (CM) with HIV on antiretroviral therapy and without other known causes of liver disease underwent screening for NAFLD (2017-2020). Circulating factors associated with NAFLD were measured. Hepatic steatosis and fibrosis were assessed using transient elastography by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively. Analysis of variance/Wilcoxon testing compared normally/non-normally distributed variables, …

High Fat, High Sucrose Diet Promotes Increased Expression Of Ace2 Receptor In The Siv-Infected Host: Implications For Sars-Cov-2 Infection, Elizabeth C. Delery, Danielle E. Levitt, Angela M. Amedee, Patricia E. Molina, Liz Simon

School of Graduate Studies Faculty Publications

Introduction: People with pre-existing conditions, including metabolic comorbidities, are at greater risk for complications of SARS-CoV-2 infection and expression of machinery required for viral entry into host cells may be a contributing factor. This study tested the hypothesis that high fat, high sucrose diet (HFSD) and alcohol use increase expression of angiotensin converting enzyme 2 (ACE2) receptor and transmembrane serine protease 2 (TMPRSS2) in tissues isolated from simian immunodeficiency virus (SIV) infected macaques, the most clinically relevant model for the study of HIV. Methods: Biospecimens obtained from a longitudinal study of SIV-infected, antiretroviral therapy (ART)-treated female rhesus macaques (Macaca mulatta) …

At A Crossroads: The Crucial Role Of Pharmacists In Healthcare Teams To End The Hiv Epidemic, Jerika Lam, Jennifer M. Cocohoba

Pharmacy Faculty Articles and Research

"Therapeutic advances in treatment and prevention have slowed the human immunodeficiency virus (HIV) epidemic, yet the virus and complications related to it still claim an alarming 630,000 lives globally every year.^1,2 The United States’ goals for the Ending the HIV Epidemic (EHE) initiative include reducing new infections by 90% by the year 2030 and advancing health equity through key treatment and prevention initiatives.³ Multiple agencies, professions, and patient groups are working diligently to achieve the EHE goals. Pharmacists have long recognized that our profession is a key resource in ending the HIV epidemic. We demonstrate this in the …

A Review Of Studies On Hiv Pre-Exposure Prophylaxis In Community Pharmacies In States With Restrictive Pharmacist Prescription Authority In The United States, Hongmei Wang, Dominique Guinn, Xavier Roshitha Ramisetty, Thomas P Giordano, Ivy O Poon

Faculty, Staff and Students Publications

Community pharmacies have unparalleled potential to increase access to pre-exposure prophylaxis medications (PrEP) for HIV prevention; however, only 17 out of 50 states in the United States have statewide authority for pharmacists to provide PrEP at community pharmacies. Few studies have reported on how pharmacists overcome the legislative barrier and provide PrEP services in restrictive pharmacy prescription states. The objective of this article is to identify the existing primary literature describing pharmacist PrEP services in the community in states with restrictive prescription authority. Methods: A systemic literature review was conducted to identify the primary literature that involved community pharmacy service …

Impact Of Body Mass Index And Vo2 Max On Symptoms, Physical Activity, And Physical Function In A Multinational Sample Of People With Hiv, Christine Horvat Davey, Deepesh Duwadi

Faculty Scholarship

People with HIV (PWH) are at increased risk for metabolic disorders affecting body mass index (BMI), chronic symptoms, and impaired physical function and capacity. Although physical activity improves health and well-being, PWH often do not meet activity recommendations necessary to achieve these benefits. Despite the known impact of symptoms, physical activity, and physical function on health, little is known about the relationships and interactions between these variables and BMI and maximum oxygen consumption during exercise (VO2 max) in a multinational population of PWH. We examined the relationship of BMI with PROMIS-29 measures, physical activity, strength, flexibility, and VO2 max in …

Houston, We Have A Problem: Diagnostic Difficulties In The Aids Patient With Tuberculosis Infection, Hector D. Preciado, Maria E. Torres, Muhammad A. Siddiqui, Liza Salloum, Lee Gelpi, Jose E. Campo Maldonado

Research Colloquium

Background: Tuberculosis (TB) is the leading cause of infectious death worldwide with 1.5 million deaths annually and nearly 1/4th of the world’s population (1.7 billion) infected with latent tuberculosis infection (LTBI) in 2014. Its diagnosis conventionally relies on tuberculin skin testing (TST), and Interferon-Gamma Release Assay (IGRA) which relies on the production of Interferon Gamma (IFN-y) in response to Mycobacterium tuberculosis (MTB) specific antigens. IGRA is a useful tool for detecting latent TB disease, and can be used as an adjunct for the diagnosis of active TB cases. Increases in IFN-y levels might support the diagnosis of a new TB …

Cognition And Inflammation In Youth With Perinatal Hiv, Megan Niehaus, Julie Mannarino, Jacob Bolzenius, Tori Frerichs, Robert Paul

Undergraduate Research Symposium

Background: Perinatally acquired HIV (PHIV) remains a major global health challenge. Approximately 90% of the global population of PHIV reside in low- or middle-income countries (LMICs) where access to antiretroviral therapy (ART) remains incomplete, particularly for PHIV. With PHIV, the brain is exposed to the virus during critical periods of brain development without the immunological benefits from ART. Unlike adults with horizontally acquired HIV whose nadir CD4+ Tcell count is a strong correlate of cognitive difficulties that persist after sustained use of ART, cognitive symptoms among PHIV youth are independent of traditional HIV disease metrics. Prior studies indicate that PHIV …