Medicine and Health Sciences Commons^™

Burden And Risk Of Non-Aids Defining Cancers In Hiv-Infected Persons Receiving Antiretroviral Therapy, Brittney L. Dickey

Theses & Dissertations

The burden of cancers not previously associated with an HIV infection, called non-AIDS defining cancers (NADCs), have increased in the years since highly active anti-retroviral therapy has been introduced. The studies in this dissertation attempted to quantify this burden via incidence and mortality compared to the general population. Further, an assessment of risk factors and creation of a predictive risk model, a nomogram, were utilized to better understand how factors associated with demographics, lifestyle, and immune response affected risk for an NADC diagnosis once therapy was initiated and HIV better controlled. Standardized incidence and mortality ratios showed that burden of …

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

Electrospun Fibers And Nanoparticles For The Prevention Of Sexually Transmitted Infections., Kevin Michael Tyo

Electronic Theses and Dissertations

Human immunodeficiency virus-1 (HIV-1) and herpes simplex virus 2 (HSV-2) affect hundreds of millions of people worldwide, with women disproportionately impacted by these infections. Currently, only oral pre-exposure prophylaxis (PrEP) is approved specifically for the prevention of HIV-1, but is challenged with adverse side effects associated with long-term use. Topical delivery platforms, such as gels and films, deliver agents directly to the female reproductive tract, but are limited in providing transient-release. The technology of polymeric electrospun fibers may serve as alternative topical delivery platform to the female reproductive tract. In these studies, we fabricated electrospun fibers comprised of different polymers …

Utilizing Fiv (Feline Immunodeficiency Virus) To Develop A Novel Animal Model To Study Hiv (Human Immunodeficiency Virus), Ankita Suryakant Kambli

Electronic Thesis and Dissertation Repository

This project sought to perform the in vitro work needed to accomplish the long-term vision of harnessing the similarities between HIV (Human Immunodeficiency Virus) and FIV (Feline Immunodeficiency Virus) to develop an animal model whereby cats can be used to study HIV pathogenesis and therapeutics. We transfected CRFK (Crandell Rees Feline Kidney) fibroblasts with plasmids that could express human or feline CD4, CCR5, or both, and determined receptor surface expression through flow cytometry. We discovered that HIV envelope expressed on 293T can fuse with huCD4/huCCR5 on CRFK. These cat cell lines were also capable of supporting HIV infection. Additionally, we …

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 …

Women’S Socio-Economic Empowerment And Uptake Of Hiv Testing In Ethiopia, Dawit Alemu

Theses and Dissertations

Introduction: Sub-Sahran Africa constitute two-thirds of all people living with HIV in the world. HIV infection rate is high in the continent with women comprising 56% of new HIV infections among adults 15 and older. Women 15 to 24 are the most affected constituting 66 % of new infections occurring among this age group. The purpose of this study was to examine how gender power relations between men and women affect health seeking behavior, particularly HIV testing, among Ethiopian women age15 to 49.

Methods: The Ethiopian Demographic and Health Survey (EDHS) from 2016 served as the data source for …

Hiv Care Location: An Evaluation Of Single Versus Multi Facility Utilization Of Hiv/Aids Care Services And Patient Health Outcomes And Clinical Indicators In South Carolina, Melanie Gwynn

Theses and Dissertations

Background: On the HIV/AIDS care continuum, the “retention in care” metric does not distinguish between single-facility (SF) or multi-clinic utilization (MC), also described as HIV care location (or type). SF utilization is vital as it has been linked optimal clinical outcomes among People Living with HIV/AIDS (PLWH). Published research detailing the prevalence of HIV care type and its association with health outcomes/clinical indicators, has been studied only in limited urban settings. Additionally, coinfections such as sexually transmitted infections (STIs), have yet to be evaluated as potential predictive factors for HIV care type.

Methods: A cross-sectional design was used …

Depression In Hiv-Positive Individuals Living In A Residential Housing Community, Danielle Njeri

Dissertations

Problem: Depression is the most prevalent psychiatric disorder among individuals living with HIV. Depression rates are three times greater than those found in the general population . Undiagnosed and untreated depression can have a negative effect on the management of HIV infection, resulting in increased mortality and a poorer quality of life. The purpose of this quality improvement initiative was to assess the incidence of depression in HIV-positive individuals living in a residential community.

Methods: A prospective, descriptive, cohort design. Convenience sample of HIV-positive adult residents living in an HIV residential community. The nine-question patient health questionnaire (PHQ-9) …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

Social Determinants Of Health And Substance Use Among Women Living With Hiv In Canada: Inequalities And Impacts, Mostafa Shokoohi

Electronic Thesis and Dissertation Repository

The objective of this doctoral research was two-fold: 1) to estimate inequalities in social determinants of health (SDoH), health-related quality of life, and substance use among women living with HIV (WLWH) compared to the general population of women; and 2) to assess the impact of the SDoH clusters on illicit drug use and heavy alcohol drinking among WLWH. For the first objective, estimates were obtained from 1,422 WLWH aged 16+ in the 2013-2015 Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS, time-point 1), and then compared with their counterparts estimated in 46,831 general population women in the 2013-2014 …

Pre-Exposure Prophylaxis (Prep) For Hiv Prevention: A Mixed-Methods Study Of Sexual Risks And Knowledge, Perceptions, And Willingness Of Prep Use Among African American Women In The South, Jamie Troutman

Theses and Dissertations

There are approximately 1.1 million people living with HIV in United States, with nearly 40,000 new diagnoses annually. Significant regional and racial disparities are associated with HIV diagnoses — with the South experiencing the greatest burden of HIV and African American women accounting for 60% of new diagnoses among women. Pre-exposure prophylaxis (PrEP) has been designated as an effective tool to prevent HIV transmission among individuals who may be at risk of HIV infection. Earlier PrEP research has focused mainly on at-risk groups such as men who have sex with men (MSM). Previous PrEP research involving African American women included …

Effects Of Human Dopamine Transporter (Dat) Mutations And Novel Allosteric Modulatory Compounds In Disrupting Hiv-1 Tat-Dat Protein Interaction, Pamela Marie P. Quizon

Theses and Dissertations

More than 37 million people are living with HIV worldwide. Despite the widespread use of antiretroviral therapy (ART), up to 70% of HIV-positive individuals suffer from cognitive and behavioral deficits collectively known as HIV-associated neurocognitive disorders (HAND). HIV-mediated damage to the dopaminergic system is a mediating factor in HAND. Dopamine (DA) transporter (DAT)-mediated reuptake is essential for maintaining DA homeostasis. Because most ART cannot efficiently cross the blood-brain barrier (BBB), the brain serves as a viral reservoir that facilitates the spread of infection to microglia and astrocytes. Infected cells shed viral proteins such as Tat, which plays a critical role …

Chronic Nucleoside Reverse Transcriptase Inhibitors Disrupt Mitochondrial Homeostasis And Promote Premature Endothelial Senescence, Yi-Fan Chen

LSU Doctoral Dissertations

Combination antiretroviral therapy (cART) has been hugely successful in reducing the mortality associated with human immunodeficiency virus (HIV) infection, resulting in a growing population of people living with HIV (PLWH). Since PLWH now have a longer life expectancy, chronic comorbidities have become the focus of the clinical management of HIV. For example, cardiovascular complications are now one of the most prevalent causes of death in PLWH. Nucleoside reverse transcriptase inhibitors (NRTIs) are the backbone of cART, and two NRTIs are typically used in combination with one drug from another drug class, such as a non-NRTI, a protease inhibitor or an …

Optimizing An Order Set To Streamline Health Care Delivery In The Emergency Department For Patients Requiring Hiv Post-Exposure Care, Marlisha Smith

Doctor of Nursing Practice Final Manuscripts

Background: The Centers for Disease Control and Prevention (CDC) updated guidelines to support efforts to decrease the number of Human Immunodeficiency Virus (HIV) incidences. The principle method for risk reduction utilized in the guidelines is the 28-day non-occupational post-exposure prophylaxis (nPEP) antiretroviral course administered within 72 hours of exposure. Despite this recommendation, adherence to a full 28-day course nPEP is very low nationally. Root cause analysis completed at the study site indicated that the use of an outdated order set caused unwarranted variability in care which accounted for failure in the delivery of appropriate nPEP care and low medication adherence. …

Implementing Routine Hiv Testing And Prevention In A Primary Care Setting, Michelle Bassett

Doctor of Nursing Practice Projects

Evidenced-based research has identified that routine HIV testing and education is pivotal in identifying new infections, providing access to treatment, and decreasing the rates of transmission. In 2006, the CDC implemented new guidelines recommending that all persons aged 13-64 years be tested yearly for HIV regardless of risk factors. Despite these recommendations, the CDC estimated that less than 37% of people were tested in 2017 and in the years prior. In this project, a protocol for routine testing and education was developed and implemented in a private Southern Illinois primary care practice. Providers and staff were educated on HIV and …

Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva

School of Professional Studies

There are approximately 122,000 people of Latino origin in San Francisco, which account for 15% of the total population (Census, 2010). Historically, Latinos have and still face several barriers to access healthcare and improvements in health (Aguirre-Molina, Molina & Zambrana, 2001). When the world was exposed to the spread of a new and unknown virus, the broader population suffered from the epidemic. The Latino community in San Francisco was and still is one of the hardest hit by the virus.

Development Of A Lectin-Fc Fusion Protein With Antiviral And Anti-Cancer Activity., Matthew William Dent

Electronic Theses and Dissertations

This thesis describes the development of a novel lectin-Fc fusion protein and its antiviral and anti-cancer activity. The molecule, Avaren-Fc (AvFc), is a fusion of a variant of the actinomycete lectin actinohivin (Avaren) and the Fc region of human IgG1, and is selective for the terminal α1,2-mannose residues found at the ends of high-mannose-type glycans that can be found on the surface of certain heavily glycosylated viruses and cancer cells. Here, AvFc was found to be able to neutralize simian immunodeficiency virus as well as Hepatitis C virus with nanomolar IC₅₀ values. Furthermore, AvFc recognizes a number of cell …

Role Of Atm In T Cell Dysfunction During Chronic Viral Infections, Juan Zhao

Electronic Theses and Dissertations

Hepatitis C virus (HCV) or human immunodeficiency virus (HIV) infection leads to a phenomenon of inflammaging, in which chronic infection or inflammation induces an immune aged phenotype with T cell dysfunction. Thus, HCV or HIV infection has been deemed as a model to study the mechanisms of T cell infammaging and viral persistence in humans. In this dissertation, T cell homeostasis, DNA damage and repair machineries were investigated in patients with chronic HCV or HIV infection at risk for inflammaging. We found a significant depletion in CD4 T cells, which was correlated with their apoptosis in chronically HCV/HIVinfected patients, compared …

Csf Lymphocyte And Monocyte Activation And Trafficking In Primary Hiv Infection, Aveline Xiang Li

Yale Medicine Thesis Digital Library

Trafficking of immune cells to the central nervous system (CNS) is hypothesized to facilitate HIV entry and immune-induced neuronal injury, and is mediated by cell surface proteins such as chemokine receptors and integrins. We longitudinally assessed immune cell activation and surface marker expression in cerebrospinal fluid (CSF) and blood and their relationship with CSF HIV RNA during primary HIV infection (PHI) before and after combination antiretroviral therapy (ART). Longitudinal paired blood and CSF were obtained in initially ART-naïve PHI (infection) participants; some subjects independently initiated ART during follow up. Multiparameter flow cytometry was used to determine activation (% CD38+HLADR+) and …

Hiv Testing Among Nigerian Men Who Have Sex With Men After Criminalization Of Homosexuality, Gerald Onyeka Ileka

Walden Dissertations and Doctoral Studies

Men who have sex with men (MSM) are at high risk of HIV in Nigeria. However, African countries like Nigeria, Botswana, Mali, and Mozambique have laws that prohibit homosexuality, making it a punishable crime in these countries. For example, the Nigerian government signed the anti-gay law in 2014. Laws like these affect the health status and outcomes among Nigerian MSM. The purpose of this qualitative study was to examine the influence criminalization of homosexuality has on the willingness to test for HIV among MSM in Abuja, Nigeria. Guided by the socio-political theory (SP) as the theoretical framework, a qualitative approach …

Stigma In The Post Crisis Age: External Barriers To Accessing Hiv Treatment, Internalized Trauma, And Strategies Of Support In Orlando, Florida, Julian Cerrell Nilsson

Electronic Theses and Dissertations

In 2017, The CDC (center for disease control and prevention) released a memo confirming popular medical opinion that an HIV positive person with an undetectable viral load was unable to transmit the HIV virus. While treatment and prevention options are advancing, this advancement may not translate directly into reduced stigma, which is produced and reproduced by external barriers to accessing healthcare, and internalized by HIV positive people as emotional trauma. This research explores the relationship between the availability of contemporary resources for the treatment and prevention of HIV/AIDS, and the environment of stigma experienced by positive gay and bisexual men …

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

Social And Structural Barriers To Safer Sex Among Heterosexual Female Sex Workers, Erika Nikole Harding-Davis

Walden Dissertations and Doctoral Studies

Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers …

The Self-Perceived Cultural Competency Of Hiv Interventionists, Tonya Herring

Walden Dissertations and Doctoral Studies

Despite significant research and inroads with the human immunodeficiency virus (HIV), disparities in HIV infection continue to widen for African American (AA) men who have sex with men (MSM). In recent times, cultural competence has been receiving increased attention as a possible factor to enhance the quality of health messaging and lessening HIV disparities. However, there is a dearth of research specifically dedicated to AA MSM and culturally competent HIV health messages. To address this gap, this qualitative research was designed to investigate the self-perceived cultural competency among HIV counselors. The theoretical framework for the project was the PEN-3 cultural …

Examining The Effects Of Indiana’S Syringe Exchange Program On New Hepatitis C And Hiv Diagnoses From 2015-2017, Katherine Youngen

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In 2015, a rural Indiana county experienced an outbreak of HIV related to intravenous drug use. 181 people were diagnosed with HIV between Oct. 1, 2014 and Nov. 1, 2015. This outbreak prompted the state legislature to implement a policy that legalized syringe exchange programs for the first time ever in Indiana. This capstone attempts to summarize the situation that led to the creation of this policy and the effects of this policy, Indiana Senate Enrolled Act 461 (IN SEA 461). Finally, this capstone makes recommendations for modifying the existing policy or implementing a similar policy in an area experiencing …

Association Of Serum Pcsk9 With Carotid Artery Thickness And Carotid Lesions In Women With Hiv And Hepatitis C Virus, Michael Patrick Searles

Legacy Theses & Dissertations (2009 - 2024)

Background: Increase in risk for coronary artery disease (CAD) is a well-documented for HIV-infected (HIV+) populations. A precursor of cardiovascular events in HIV+ populations are non-calcified plaque (lesion) formations and can be associated with arterial inflammation, monocyte aggregation and dendritic cell activation. PCSK9 a known modulator of LDL cholesterol, has also been shown to contribute to inflammation, dendritic cell activation, monocyte aggregation and potentially plaque formations.

Anxiety Among Women Living With Hiv In Kazakhstan, Kathryn Emily Mishkin

Legacy Theses & Dissertations (2009 - 2024)

Research shows that mental illness has an impact on the health and quality of life of women living with HIV. As a result, many countries have adopted integrated care models to provide holistic treatment to women living with HIV. However, some countries, where the HIV burden is particularly high, have been ineffective at addressing the mental health needs of these women, primarily because of a compartmentalized health care structure that limits interaction among sectors. By describing the prevalence of anxiety and comorbid anxiety-depression among women living with HIV in affected areas, there is an opportunity for effective policies to be …

Occupational Health Outcomes In Women Living With And At Risk For Hiv, Jenni Wise

All ETDs from UAB

Women living with HIV (WLWH) are now able to work and need to work to attain the fruitful benefits of employment. Regardless of the need for income, employment provides esteem, confidence, structure, social support, and is associated with improved physical and psychological outcomes. Yet, in spite of the documented benefits associated with employment, an estimated 60% of WLWH are not employed. Thus, occupational disparities among WLWH contribute to disparities in health and quality of life among this population. While the historical trajectory of HIV is unique compared to other populations with chronic disease, evidence suggests that gender-specific difference in socioeconomic, …

Developing An Evidence-Based Hiv Testing Message For Young African American Women, Melanie P. Moore

Theses and Dissertations

African American women have the highest rates of HIV infection among women of all racial/ethnic groups in the United States, and over 50% of HIV infected young adults are unaware of their infection. HIV testing is a cost-effective mechanism for reducing HIV transmission. Despite this, limited research has been devoted to developing interventions specifically promoting HIV testing. This two-part study proposed to address this gap through developing a culturally tailored HIV testing message aimed at increasing HIV test intentions among young African American women. Study 1 was a quantitative study that examined predictors of HIV testing history and future HIV …

Hpv And Hsv Associated Clinical Conditions Among People Living With Hiv-1 Infection, Yuanfan Ye

All ETDs from UAB

This dissertation research focuses on investigating health burdens of HPV- and HSV- associated clinical conditions (CC) in people living with HIV-1 infection (PLWH) in the Southeastern United States. I designed a retrospective study using the UAB 1917 HIV Clinic Cohort. Electronic health records of PLWH attending the clinic for HIV-care between January 2006 and March 2019 were obtained and reviewed. I first examined incidence rates and trends of anogenital HPV- and HSV-associated CC. Then I adopted a new algorithm to group longitudinal CD4 cell counts based on their trajectories. I compared it with nadir and median CD4 cell counts in …