Medicine and Health Sciences Commons^™

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

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

Dissertations and Theses

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

Living Positive, Cheyann Harris, Emani King Mack

Capstones

A short documentary by Emani King Mack & Cheyann Harris, that focuses on Black men who are living with HIV. This film features the stories of Malik Davon, Jah Love, and Melchizedek Roberson to destigmatize, empower, and set a new precedent in media on how to cover people living with HIV.

Link to capstone: https://cheyannharris.wixsite.com/livingpositive

The Gay Men Who Play With Their Hiv Status., Matthew I. Euzarraga

Capstones

• Since the 90’s a group of individuals known as Bug Chasers, predominately gay men have been playing a game of cat and mouse actively wanting to be caught and infected with HIV. This is a dive into the world of bug chasing.

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

Gay Social Networking Apps Are Fueling Crystal Meth Use, Moises A. Mendez Ii

Capstones

Selling crystal meth on gay social networks is a problem nobody is talking about; two men tell their stories. The LGBT+ community has a long standing relationship with the use of drugs. From the 70s to present day, there has been a popular drug used – currently, it's crystal meth. Adam and Christopher have dealt with their addiction to crystal meth for many years and the introduction of gay dating apps like Grindr, Scruff and Jack'd posed new problems for them when they were trying to stay sober.

https://medium.com/@moises.mendez/gay-social-networking-apps-are-fueling-crystal-meth-use-ac34f38fa636

Hypertension And Hiv In An Urban Slum Setting, Port-Au-Prince, Haiti, Olga Tymejczyk

Dissertations and Theses

Background: Rapidly growing urban slum settings increasingly face co-occurring communicable and non-communicable health crises, against the backdrop of extreme poverty, and social and environmental vulnerability. In Haiti, sparse data suggest a growing burden of hypertension and cardiovascular disease (CVD), along with substantial prevalence of HIV, increasingly recognized as a major CVD risk factor. As life-saving antiretroviral treatment (ART) is extended to more people living with HIV (PLWH), their risk of CVD increases with longer life expectancy and possibly cumulative ART exposure. Pregnant HIV-positive women may face additional cardiovascular vulnerability, due to the risk of gestational hypertension and pre-eclampsia. Integration of …

Surviving A Death Sentence, Amy K. Mackinnon

Capstones

Diagnosed with HIV at the peak of the AIDS epidemic, Sean McKenna had planned to die. Now, decades after life-saving drugs were first released, he and other long-term survivors are still figuring out how to live.
https://amykmackinnon.wordpress.com/capstone/

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 …

Effect Of An Internet-Based Education Program On Self-Care Agency In People Living With Human Immunodeficiency Virus, Darcel M. Reyes

Dissertations, Theses, and Capstone Projects

Both low health literacy and insufficient electronic health literacy (ehealth) impede access to reliable internet health information for people living with chronic illnesses such as HIV/AIDS. Use of reliable internet health information has been shown to improve self-care through increased understanding of symptoms, disease processes, and improvements in adherence with treatment plans.

This study examined the effectiveness of two interventions that taught people living with HIV/AIDS (PLWH) how to recognize reliable internet based HIV health information. Orem’s Self-Care Theory was the framework for this quasi-experimental study that used a non-equivalent two-group design with two experimental interventions (MEDLINE and E-HELP). Participants …

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 …

The Revolving Door Pattern Of Jail Incarceration And Homelessness And Its Influence On Mortality And Morbidity Among New York City Adults, Sungwoo Lim

Dissertations, Theses, and Capstone Projects

Objectives

The purpose of this dissertation study was to identify timing and sequencing of jail incarceration and homelessness by utilizing sequence analysis and to test whether a particular trajectory contributes to mortality risk and discontinuity of HIV care.

Methods

The main data source was an existing matched dataset, constructed using administrative data from the New York City (NYC) Departments of Health and Mental Hygiene, Correction, and Homeless Services. The study cohort consisted of 15,620 NYC adults with recent histories of both jail incarceration and homelessness. Monthly experiences of jail incarceration, homelessness, and community-dwelling in 2001-03 were summarized into trajectory groups …