Medicine and Health Sciences Commons^™

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

Relationship Between Food Insecurity And Smoking Status Among Women Living With And At Risk For Hiv In The Usa: A Cohort Study, Lila A. Sheira, Edward A. Frongillo Jr., Judith Hahn, Kartika Palar, Elise D. Riley, Tracey E. Wilson, Adebola Adedimeji, Daniel Merenstein, Mardge Cohen, Eryka L. Wentz, Adaora A. Adimora, Ighovwerha Ofotokun, Lisa Metsch, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Objectives People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.

Design Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015.

Setting Nine participating sites across the USA.

Participants 2553 …

Food Insecurity And Frailty Among Women With And Without Hiv In The United States: A Cross-Sectional Analysis, Judy Y. Tan, Lila A. Sheira, Edward A. Frongillo Jr., Deborah Gustafson, Anjali Sharma, Daniel Merenstein, Mardge H. Cohen, Elizabeth Golub, Andrew Edmonds, Igho Ofotokun, Margaret Fischl, Deborah Konkle-Parker, Torsten Neilands, Phyllis Tien, Sheri D. Weiser

Faculty Publications

Introduction: Frailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who maybe particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV.

Methods: There were 1265 participants from the Women’s Interagency HIV Study who participated in frailty assessments in2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre-frailor frail. …

Dietary Intake Is Associated With Neuropsychological Impairment In Women With Hiv, Leah H. Rubin, Deborah R. Gustafson, Lakshmi Warrior, Lila Sheira, Kathryn C. Fitzgerald, Raha Dastgheyb, Kathleen M. Weber, Phyllis C. Tien, Audrey French, Amanda B. Spence, Anjali Sharma, Dionna W. Williams, Cory J. White, Eric C. Seaberg, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Background

Diet is a modifiable risk factor that may influence cognition in people with HIV.

Objectives

We examined the association between dietary intake and cognition in women with HIV (WWH) and HIV-seronegative women.

Methods

An 18-item dietary National Cancer Institute screener was completed by 729 WWH and 346 HIV-seronegative Women's Interagency HIV Study participants. Daily intake frequencies of processed meats, sweet beverages, fish, whole milk, and vegetables were calculated. Participants completed biennial neuropsychological (NP) testing. NP domains included attention/working memory, executive function, processing speed, memory, learning, fluency, and motor function. NP impairment was defined as demographically adjusted T-scores (mean = …

Greater Pain Severity Is Associated With Higher Glucocorticoid Levels In Hair Among A Cohort Of People Living With Hiv, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Shuaifeng Liu, Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background: Pain is a common occurrence and persistent symptom, which has an adverse impact on individual well-being and quality of life among people living with HIV (PLHIV). Alteration in the activity of the Hypothalamic-Pituitary-Adrenal (HPA) axis resulting in abnormal glucocorticoid levels had been proposed to play important roles in those associations. Purpose: This study aimed to investigate whether pain severity was associated with hair glucocorticoid levels, a novel method of measuring long-term glucocorticoid exposure, among a large cohort of Chinese PLHIV. Methods: A measure of pain severity and hair samples were collected from 431 adults PLHIV in Guangxi, China. Glucocorticoid …

Agricultural And Finance Intervention Increased Dietary Intake And Weight Of Children Living In Hiv-Affected Households In Western Kenya, Lisa M. Butler, Shiva Bhandari, Phelgona Otieno, Sheri D. Weiser, Craig R. Cohen, Edward A. Frongillo Jr.

Faculty Publications

We tested whether a multisectoral household agricultural and finance intervention increased the dietary intake and improved the nutritional status of HIV-affected children. Two hospitals in rural Kenya were randomly assigned to be either the intervention or the control arm. The intervention comprised a human-powered water pump, microfinance loan for farm commodities, and training in sustainable farming practices and financial management. In each arm, 100 children (0-59 mo of age) were enrolled from households with HIV-infected adults 18-49 y old. Children were assessed beginning in April 2012 and every 3 mo for 1 y for dietary intake and anthropometry. Children in …

The Role Of Ict In Antiretroviral Therapy-Related Knowledge Seeking Among Older Chinese Living With Hiv, Yao Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Antiretroviral therapy (ART) enables HIV patients to reduce disease progression. ART adherence is closely related to patients’ knowledge about the medical treatment. This study investigated the role of information and communication technologies (ICTs) in supporting ART-related knowledge seeking among older Chinese with HIV, using cross-sectional data collected from 2012 to 2013 in Guangxi, China. Of the 2987 HIV patients, 688 were 45 years or older and going through ART. We used an 11-item scale (α=0.69), which was developed based on existing literature, to assess ART-related knowledge to obtain a composite score (0-11). Less than 5% of the participants sought HIV-related …

Using Big Data Analytics To Improve Hiv Medical Care Utilisation In South Carolina: A Study Protocol, Bankole Olatosi, Jiajia Zhang, Sharon Weissman, Jianjun Hu, Mohammad Rifat Haider, Xiaoming Li

Faculty Publications

Introduction Linkage and retention in HIV medical care remains problematic in the USA. Extensive health utilisation data collection through electronic health records (EHR) and claims data represent new opportunities for scientific discovery. Big data science (BDS) is a powerful tool for investigating HIV care utilisation patterns. The South Carolina (SC) office of Revenue and Fiscal Affairs (RFA) data warehouse captures individual-level longitudinal health utilisation data for persons living with HIV (PLWH). The data warehouse includes EHR, claims and data from private institutions, housing, prisons, mental health, Medicare, Medicaid, State Health Plan and the department of health and human services. The …

Food Insecurity And Violence In A Prospective Cohort Of Women At Risk For Or Living With Hiv In The U.S., Amy A. Conroy, Mardge H. Cohen, Edward A. Frongillo Jr., Alexander C. Tsai, Tracey E. Wilson, Eryka L. Wentz, Adaora A. Adimora, Daniel Merenstein, Ighovwerha Ofotokun, Lisa Metsch, Mirjam-Colette Kempf, Adebola Adedimeji, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Background Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women’s Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV.

Methods Study participants completed six assessments from 2013–16 on food insecurity (operationalized as marginal, low, and very low food security) and violence (sexual or physical, and psychological). We used multi-level logistic regression, controlling …

Immunological And Virologic Outcomes Of People Living With Hiv In Guangxi, China: 2012-2017, Xueying Yang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background Limited data are available on clinical outcomes of people living with HIV (PLWH) in China, especially after the implementation of the 2016 national treatment guideline. The objective of the current study is to examine the treatment patterns, clinical outcomes and their associated factors among PLWH in Guangxi, China before and after this new guideline.

Methods Data from three community-based projects conducted at different time points over a period of six years (2012–2017) in Guangxi were analyzed in our study. The interviewer-administered questionnaire was used for data collection. Measures of clinical outcomes were retrieved from the patients’ medical records. Descriptive …

Facilitators And Barriers For Hiv-Testing In Zambia: A Systematic Review Of Multi-Level Factors, Shan Qiao Ph.D., Yao Zhang, Xiaoming Li Ph.D., J. Anitha Menon

Faculty Publications

It was estimated that 1.2 million people live with HIV/AIDS in Zambia by 2015. Zambia has developed and implemented diverse programs to reduce the prevalence in the country. HIVtesting is a critical step in HIV treatment and prevention, especially among all the key populations. However, there is no systematic review so far to demonstrate the trend of HIV-testing studies in Zambia since 1990s or synthesis the key factors that associated with HIVtesting practices in the country. Therefore, this study conducted a systematic review to search all English literature published prior to November 2016 in six electronic databases and retrieved 32 …

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 …

Changing Hearts And Minds: Results From A Multi-Country Gender And Sexual Diversity Training, Tonia Poteat, Chulwoo Park, Diego Solares, John K. Williams, R. Cameron Wolf, Noah Metheny, Andrea Vazzano, Juan Dent, Ashley Gibbs, Bareng Aletta Sanny Nonyane, Nora Toiv

Faculty Publications

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- …

Experiences With Food Insecurity And Risky Sex Among Low-Income People Living With Hiv/Aids In A Resource-Rich Setting, Henry J. Whittle, Kartika Palar, Tessa Napoles, Lee Lemus Hufstedler, Irene Ching, Frederick M. Hecht, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Background: Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM).

Methods: Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted …

Psychological Fears Among Low-Paid Female Sex Workers In Southwest China And Their Implications For Hiv Prevention, Shan Qiao Ph.D., Xiaoming Li Ph.D., Chen Zhang, Yuejiao Zhou, Zhiyong Shen, Zhenzhu Tang, Bonita Stanton

Faculty Publications

Commercial sex plays a critical role in rapidly increasing heterosexual transmission of HIV in China. Low-paid female sex workers (FSWs) are especially vulnerable to HIV/AIDS. Because of the illegality and stigma associated with sex work, FSWs may constantly live with fears in their daily life. Based on cross-sectional study of 794 low-paid FSWs in China we described their psychological fears related to commercial sex and examined the associations between fears and HIV-related behaviors. Fear of HIV infection was significantly associated with consistent use of condoms with clients. However, fear of breaching sex worker identity significantly prevented the FSWs from consistently …

Who Tests, Who Doesn't, And Why? Uptake Of Mobile Hiv Counseling And Testing In The Kilimanjaro Region Of Tanzania, Jan Ostermann, Elizabeth A. Reddy, Meghan M. Shorter, Charles Muiruri, Antipas Mtalo, Dafrosa K. Itemba, Bernard Njau, John A. Bartlett, John A. Crump, Nathan M. Thielman

Faculty Publications

Background: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and highrisk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) campaigns in four rural villages in the Kilimanjaro Region of Tanzania.

Methods: Between December 2007 and April 2008, 878 MVCT participants and 506 randomly selected community residents who did not access MVCT were surveyed. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing between MVCT participants and community residents who …

Religion And Hiv In Tanzania: Influence Of Religious Beliefs On Hiv Stigma, Disclosure, And Treatment Attitudes, James Zou, Yvonne Yamanaka, Muze John, Melissa Watt, Jan Ostermann, Nathan Thielman

Faculty Publications

Background

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment.

Methods

A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and …

Gender Differences In The Risk Of Hiv Infection Among Persons Reporting Abstinence, Monogamy, And Multiple Sexual Partners In Northern Tanzania, Keren Z. Landman, Jan Ostermann, John A. Crump, Anna Mgonja, Meghan K. Mayhood, Dafrosa K. Itemba, Alison C. Tribble, Evaline M. Ndosi, Helen Y. Chu, John F. Shao, John A. Bartlett, Nathan M. Thielman

Faculty Publications

Background: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT) in northern Tanzania.

Methodology/ Principal Findings: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by …