Public Health Commons^™

Early Immune Dysregulation In Mtb/Siv Co-Infection Resists Cart Treatment At The Single-Cell Level, Riti Sharan, Yi Zou, Zhao Lai, Korri Weldon, Todd Bradley, Xi Luo, Hulin Wu, Shabaana A Khader, Deepak Kaushal

Faculty, Staff and Student Publications

Using single-cell transcriptomics of bronchoalveolar lavage cells from Mtb/SIV co-infected rhesus macaques on cART, we reveal profound immune dysregulation during early SIV co-infection of latent tuberculosis. SIV induces a sharp decline in CD4+ T cells, NK, and NKT cells, with incomplete recovery of Mtb-specific TH1 effector responses despite viral suppression. Instead, a persistent TH17-skewed environment emerges, alongside sustained myeloid inflammation driven by Type I interferon signaling and pro-inflammatory regulators such as KLF6 and NFKB1. Ligand-receptor network analyses demonstrate expanded CD4+ T cell-macrophage crosstalk and loss of immune homeostasis that cART fails to fully restore. These findings expose …

The Putative Role Of Oral Microbiome In Premature Aging During Hiv Infection: What Do We Know?, Carlos Solá-Morlá, Daphne Alcalá-Zúñiga, Juan Araujo, Maria Da Gloria Bonecini-Almeida, Upal Roy, Josué Pérez-Santiago

Health & Biomedical Sciences Faculty Publications

Despite improvements in life expectancy, people with HIV (PWH) are at risk of developing HIV-associated comorbidities at a younger age when compared to HIV-uninfected individuals. This premature aging process can be attributed to various factors, such as the prolonged exposure to combination antiretroviral therapy (cART), inflammation, microbial perturbances and oxidative stress. Similarly to the gut, oral dysbiosis occurs in HIV-1 infection, with cART and inflammation playing a crucial role. This gives rise to an enrichment of pathogenic microorganisms that in turn, elicit an immune response tied to chronic inflammation. Consequently, cART exposure, dysbiosis and persistent inflammation in HIV-1 infection have …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Effect Of The Sava Syndemic On Hiv Viral Suppression Among People Living With Hiv In The United States: A Scoping Review And Meta-Analysis, Jacquelyn Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The SAVA syndemic highlights the interconnected and mutually reinforcing nature of substance use, violence victimization, and HIV/AIDS. The synergistic interaction of these conditions creates structural and behavioral barriers that disrupt the HIV care continuum and contribute to significant health inequities. Achieving a suppressed viral load is a critical clinical outcome for people living with HIV, while viral non-suppression can be an indicator of poor health, elevated transmission risk, and disease progression. Still, the association between SAVA factors and viral suppression/non-suppression outcomes within U.S. populations remains inconsistently characterized due to heterogeneous methodologies and variable inclusion of high-risk groups. This mixed-methods study …

Brief Report: Long-Acting Injectable Prep Can Substantially Reduce Hiv Incidence In Los Angeles County: A Simulation Study, Aditya Khanna, Francis Lee, Katrina Schrode, Daniel Sheeler, Anna Hotton, John Schneider, Kayo Fujimoto, Siri Chirumamilla, Ekow Kwa Sey, Nina T Harawa

Faculty, Staff and Student Publications

Background: Although oral pre-exposure prophylaxis (PrEP) has been instrumental in decreasing HIV incidence, its daily dosing regimen poses adherence challenges. Using an agent-based network model informed by empirical data, we simulate the impact of introducing long-acting injectable (LAI) PrEP among young Black men who have sex with men (YBMSM) in Los Angeles County, a group disproportionately affected by HIV.

Setting: Computer simulations using an agent-based network model.

Methods: We modeled HIV transmission among YBMSM over 10 years under scenarios varying the proportion of PrEP users opting for LAI instead of oral medications and adherence levels to LAI retention. The model …

Elevated Serum Lipopolysaccharides And Intrinsic Factor Autoantibodies Correlate With Macrocytic Anemia Among People With Hiv, Daniel Amakye, Samuel Hammond, Osbourne Quaye, Upal Roy, Peter Puplampu, Vincent Ganu, Emmanuel Ayitey Tagoe

Health & Biomedical Sciences Faculty Publications

Introduction: Human immunodeficiency virus (HIV) infection is associated with various comorbidities, including macrocytic anemia, though the role of the infection is unclear. HIV has been implicated in microbial translocation and altered immune responses. This study aimed to establish the relationship between gut microbial translocation and immune response, and macrocytic anemia among people with HIV (PWH).

Materials and methods: Fifty-five PWH on combination antiretroviral therapy (cART) were age-matched with 55 HIV-negative individuals. Demographic data and blood samples were collected from February to July 2023. Hematological indices, including red blood cell (RBC) count, hemoglobin concentration, and mean corpuscular volume (MCV), were measured. …

Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Mental health diagnoses have been linked to poor HIV treatment outcomes and poorer quality of life among people living with HIV (PLWH). Therefore, this study aimed to investigate the association between sociodemographic and HIV-related characteristics, and common and serious mental health disorders among PLWH in South Carolina (SC). Data were obtained from the integrated system of statewide electronic health record (EHR) data in SC (2006–2019; N = 8,124). Multivariable logistic regression models were used to determine the associations between sociodemographic and HIV-related characteristics, and common mental health disorders and serious mental health disorders. Among the study population, 4% were 60 …

The Longitudinal Effect Of Repetition And Practice On The Accuracy Of Lay Anal Examinations For Detecting Perianal And Anal Canal Abnormalities: A Prospective Study, Alan G Nyitray, Timothy L Mcauliffe, Jenna Nitkowski, Cameron Liebert, Michael D Swartz, Ashish A Deshmukh, Jared Kerman, Ellen Almirol, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Duo Yu, Aniruddha Hazra, Elizabeth Y Chiao

Faculty, Staff and Student Publications

Background: While anal cancer screening is now recommended in several countries for high-incidence populations, barriers impede screening uptake. It is well known that patient recognition of symptoms increases cancer screening uptake, and we previously demonstrated that patients can detect small masses at the perianus and in the anal canal. In this current analysis, we aimed to longitudinally assess the effect of repetition and practice on patient self-recognition of small masses.

Methods: Individuals and couples of sexual minority men and transgender women were taught to conduct an anal self-examination or anal companion examination (ASE/ACE) at visit 1 and then randomized to …

Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli

Antioch University Dissertations & Theses

This qualitative study explored the lived experiences of men (18+ years old) living with HIV to better understand how they navigate identity, mental health, relationships, and healthcare systems after diagnosis. The method included a qualitative thematic analysis with 10 participants. Eight themes emerged from the data: (1) reactions, reflections, and meaning-making after diagnosis; (2) managing medication, treatment, and co-occurring conditions; (3) stigma, disclosure, and negotiation of identity; (4) substance use, housing instability, and socioeconomic stressors; (5) navigating the changing HIV landscape; (6) experiences with family and intimate relationships; (7) implications for mental health counseling; and (8) the role of community …

Micrornas Regulated By Pregnancy Target Antiviral And Cancer Immunity Overlapping With The Hiv Interactome, Paula F. T. Cezar-De-Mello, Jonathan M. Dreyfuss, Pai-Lien Chen, Hidemi Yamamoto, Xiaoming Gao, Hui Pan, Charles Morrison, Gustavo F. Doncel, Robert L. Barbieri, Raina N. Fichorova

CONRAD Publications

Innate immunity predictors of HIV-1 risk and pathogenesis vary with reproductive hormones, pregnancy, and lactation, yet the underlying mechanisms remain unclear. We hypothesized that pregnancy-associated physiological adaptations alter systemic microRNA (miRNA) expression, thereby regulating immunity, pathogenesis and susceptibility to infection. We analyzed 174 serum samples from 88 participants in a longitudinal cohort from Uganda and Zimbabwe across pre-pregnancy (PP), pregnancy (P), and postpartum breastfeeding (BF). Cell-free peripheral blood miRNAs (n = 2083) were profiled using HTG EdgeSeq. Pregnancy-specific miRNAs were identified by intersecting differentially expressed (DE) miRNAs from P vs. PP and P vs. BF comparisons. miRNA targets and pathways …

Analisis Cakupan Penemuan Kasus Tuberkulosis (Treatment Coverage) Berdasarkan Faktor Demografis Dan Komorbiditas Di Puskesmas Ciracas Tahun 2023-2024, Anggie Hardiyanti, Helda Helda, Mufti As Siddiq M. Irzal, Mareska Monica

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major global and national health burden, with case detection coverage still below target in several regions. The success of TB control programs largely depends on achieving adequate treatment coverage. In East Jakarta, Ciracas Primary Health Center recorded a treatment coverage of 75% (497 cases) in 2023, the lowest among ten centers, and an increase to 84% (509 cases) in 2024, though still below the national target of 90%. To analyze TB case detection coverage based on demographic factors and comorbidities (diabetes mellitus and Human Immunodeficiency Virus) at Ciracas Primary Health Center during 2023–2024. This study …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

Cutting Through The Fog: Recognising Brain Fog As A Significant Public Health Concern, Darren Haywood, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

Brain fog is a highly common condition that can have significant impacts on quality of life and functioning. Most people will experience a condition, illness, or infection that might result in the development of brain fog. We provide a call to action to minimise the impacts of brain fog.

Clinical Phenotypes Of Motor Neurone Disease In A Kenyan Hospital-Based Population, Effie Nailah Kamadi, Jasmit Shah, Juzar Hooker, Thomas Jenkins, Dilraj Sokhi

Internal Medicine, East Africa

Background: Motor neurone disease (MND) presentation is globally heterogenous and data on the clinical phenotype in Sub-Saharan Africa (SSA) is scarce. We sought to address this by describing the profile of MND patients in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed in the facility between January 2010 and December 2023 were retrospectively reviewed. The biographical data and clinical features of these patients were captured from their electronic and manual health records and statistical analysis performed.

Results: In total, 160 patients had their data analyzed. The male to female ratio was 1.76:1. The median …

Sex Differences In Cardiovascular Disease And Associated Factors In People Living With Hiv: Evidence From All Of Us Program, Hao Zhang, Huiyi Xia, Fanghui Shi, Qingyang Li, Sharon Weissman, Xiaoming Li, Xueying Yang

Faculty Publications

Background

People living with HIV (PLWH) face a higher risk of cardiovascular disease (CVD), with significant sex differences in outcomes. However, it is unclear whether these differences are driven by distinct risk factor profiles or by a differential impact of shared risk factors. This study aimed to identify factors associated with CVD among PLWH and to specifically assess for effect modification by sex using a large, diverse nationwide database.

Methods

We utilized data from the All of Us Research Program (AoU). The primary outcome was a composite of coronary artery disease or stroke. We used multivariable logistic regression to identify …

Characterization Of Antiretroviral Therapy (Art) Adherence Phenotypes And Psychosocial Symptom Clusters Among Black/African American (Aa) And Hispanic/Latine Adolescents And Young Adults (Ayas) With Hiv In The Adherence Connection For Counseling, Education, And Support (Access-Ii) Trial, Ann-Margaret Navarra, Taehoon Ha, Eva Liang, Maurade Gormley, David R. Garcia, Jason Fletcher, Lloyd A. Goldsamt, Michael G. Rosenberg, Karin Hasegawa, Jie Yang

School of Nursing Faculty Publications

Antiretroviral therapy (ART) adherence behavior is heterogeneous among adolescents and young adults (AYAs) with HIV and influenced by individual and interpersonal psychosocial factors. The primary objective of this study is to characterize ART adherence phenotypes and psychosocial symptom clusters, as related to ART adherence and HIV viral load suppression. This analysis included 60 AYAs with HIV enrolled in an ART adherence support clinical trial. Self-reported ART adherence at baseline, 12-weeks, and 24-weeks was used to define four ART adherence phenotypes: consistently high adherence (YY), early-only adherence (YN), late-only adherence (NY), and consistently low adherence (NN). Symptom clusters were empirically derived …

Sex Differences In Cardiovascular Disease And Associatedfactors In People Living With Hiv: Evidence From All Of Us Program, Hao Zhang, Huiyi Xia, Fanghui Shi, Qingyang Li, Sharon Weissman, Xiaoming Li Ph.D., Xueying Yang

Faculty Publications

Background

People living with HIV (PLWH) face a higher risk of cardiovascular disease (CVD), with significant sex differences in outcomes. However, it is unclear whether these differences are driven by distinct risk factor profiles or by a differential impact of shared risk factors. This study aimed to identify factors associated with CVD among PLWH and to specifically assess for effect modification by sex using a large, diverse nationwide database.

Methods

We utilized data from the All of Us Research Program (AoU). The primary outcome was a composite of coronary artery disease or stroke. We used multivariable logistic regression to identify …

Screening For Trypanosoma Cruzi In Patients Living With The Human Immunodeficiency Virus (Pwh) In The Peruvian Amazon, Silvia Otero-Rodriguez, Martin Casapia-Morales, Lilia-Lorena Pinedo-Ramirez, Esperanza Merino, Eva H Clark, José-Manuel Ramos-Rincón

Faculty, Staff and Students Publications

Introduction: Chagas disease (CD) - Trypanosoma cruzi infection - in people living with HIV (PWH), particularly those with advanced CD4 T cell depletion, can lead to severe syndromes affecting the central nervous system and the heart.

Methods: We performed a cross-sectional study to screen for CD among PWH in Iquitos, Peru, between October 2023 and May 2024, with the objective of understanding the frequency of infection in this population. Adults with confirmed HIV attending outpatient services at two regional hospitals were enrolled. Two ELISA tests (lysate and recombinant) were used, and discordant results were adjudicated by indirect chemiluminescence immunoassay (CLIA). …

Impact Of Covid-19 Pandemic On Quality Of Life, Anxiety, Connections To Friends, And Access To Resources Among People With Hiv: Using The Social Ecological Model, Carol Dawson-Rose, Christine Davey, Emily Huang, Laura Cox, Phillips Craig, Motshedisi Sabone, Lufuno Makhado, Emilia Iwu, Kathleen Fitch, Sheila Shaibu

School of Nursing & Midwifery, East Africa

The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had …

Influence Of Institutional Support And Organisational Culture On Hiv And Ncd Integration, David Njuguna, Caroline Kyalo, Eunice Muthoni, Daniel Mwai, Elvis Kirui, Wesley Rotich, Joy Mugambi, James Waweru, Nelson Muriu, Easter Olwanda

Population Health, East Africa

Background: The integration of services for human immunodeficiency virus (HIV) and noncommunicable diseases (NCDs) has gained increasing attention in recent years because of the overlapping prevalence and shared risk factors between these health conditions. However, successful integration requires more than just the alignment of clinical practices. The role of institutional support and organisational culture in promoting effective integration remains an underexplored area.

Aim: This study aims to fill this gap by examining how institutional structures and organisational values influence the integration of HIV and NCD care.

Setting: The study setting was Nakuru County in Kenya.

Methods: …

Sleep Quality, Emotional Moods, And Cognitive Outcomes Among People Living With Hiv: An Ecological Momentary Assessment Study, Shan Qiao Ph.D., Abhishek Aggarwal, Camryn Garrett, Arielle N’Diaye, Atena Pasha, Irene Esu, Chih Hsiang Yang Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Introduction Although studies have explored the relationship between sleep quality, mood, and cognitive outcomes among people living with HIV (PLWH), few use ecological momentary assessment (EMA) techniques to evaluate within-person associations between sleep quality and emotional/cognitive outcomes among PLWH at the day level. This study investigated the association between previous night’s sleep quality and momentary psychological outcomes in participants’ natural setting. Methods Study participants were PLWH in South Carolina who were at least 18 years old, diagnosed with HIV for at least 2 years, and able to operate a cellphone. Participants were sampled using posters posted in AIDS Service organizations, …

Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the profound impact of the COVID-19 pandemic on people living with HIV (PLWH) mental health, large-scale, real-world data on mental healthcare utilisation and associated factors among PLWH remain limited. This study explores mental healthcare utilisation and associated factors among PLWH during the COVID-19 pandemic.

Methods Using a retrospective cohort design, we identified and included 4575 PLWH through computational phenotyping based on relevant Observational Medical Outcomes Partnership Common Data Model concept sets from the All of Us programme between March 2018 and March 2022. Mental healthcare utilisation was measured using the yearly count of mental healthcare visits and compared …

No Evidence Of Pitavastatin Effect On Muscle Area Or Density Among People With Hiv, Kristine M Erlandson, Triin Umbleja, Heather J Ribaudo, Michael T Lu, Jana Taron, Marissa R Diggs, Pamela S Douglas, Kathleen V Fitch, Carl J Fichtenbaum, Markella V Zanni, Judith A Aberg, Maria C Rodriguez-Barradas, Katharine Breaux, Rosalba Gomez Morones, Craig A Sponseller, Judith S Currier, Gerald S Bloomfield, Sarah M Chu, Alex B Lu, Carlos D Malvestutto, Steven K Grinspoon, Todd T Brown

Faculty, Staff and Students Publications

Background: Skeletal muscle area (MA) and muscle density (MD) are key determinants of physical function and typically decline with increasing age. Statins have well-known musculoskeletal effects but whether statins impact MA or MD is not well established, especially in the setting of randomized treatment.

Methods: REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.

Results: Of 804 substudy participants, 510 remained on study treatment …

No Evidence Of Pitavastatin Effect On Muscle Area Or Density Among People With Hiv, Kristine M Erlandson, Triin Umbleja, Heather J Ribaudo, Michael T Lu, Jana Taron, Marissa R Diggs, Pamela S Douglas, Kathleen V Fitch, Carl J Fichtenbaum, Markella V Zanni, Judith A Aberg, Maria C Rodriguez-Barradas, Katharine Breaux, Rosalba Gomez Morones, Craig A Sponseller, Judith S Currier, Gerald S Bloomfield, Sarah M Chu, Alex B Lu, Carlos D Malvestutto, Steven K Grinspoon, Todd T Brown

Faculty, Staff and Students Publications

Background: Skeletal muscle area (MA) and muscle density (MD) are key determinants of physical function and typically decline with increasing age. Statins have well-known musculoskeletal effects but whether statins impact MA or MD is not well established, especially in the setting of randomized treatment.

Methods: REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.

Results: Of 804 substudy participants, 510 remained on study treatment …

Chronic Illness Education 2025: Holistic Approach To Hiv Treatment And Management, Aniela Crayton, Harvey Sharma, Jacob Saenz, Justin Iqal, Marie Clancy, Olivia Carlisle, Raphaela Varella, Tarun Bomma

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Improving Outcomes Of Hiv In Marginalized Populations, Aidan Bailey, Alexis Bowles, Ammar Chauhdri, Biola Makinde-Odusola, Dea Kanani, Keshav Sharma, Vasanth Palanisamy, Waffa Bakheet

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Managing Hiv In Youth: A Case-Based Application Of The Expanded Chronic Care Model, Adam Kabbani, Ali Nasser, Emi Ueda-Martinez, Kristina Rizo, Mason Gardiner, Matthew Manson, Rachel Chee, Sydni Rosenfeld

Patient Education Projects

No abstract provided.

Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman

Faculty Publications

Background

To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.

Methods

Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time …

Social Exclusion And Mental Health Of Youths Affected By Parental Hiv/Aids In China: Based On A Serial Mediating Model, Jiaojiao Wan, Lili Ji, Zheqian Wang, Junfeng Zhao, Xiaoming Li

Faculty Publications

The mental health of youth living with patients with HIV needs focused attention. The primary source of psychological distress they experience may stem from social exclusion. Therefore, the current study was designed to explore the relationship between social exclusion and mental health among youths affected by parental HIV/AIDS in rural China.

Methods

297 youths affected by parental HIV/AIDS were recruited to completed questionnaires of social exclusion, perceived stress, future orientation and mental health. The bootstrap method was used to examine the mediation effects.

Results

It showed that: (1) the social exclusion (M = 32.48, SD = 15.25) significantly and …

Association Between Health Insurance, Antiretroviral Treatment, And Hiv Preexposure Prophylaxis In Men Aged 20–85 In Virginia, Lauren Elizabeth Maxwell

Walden Dissertations and Doctoral Studies

HIV prevention and treatment disparities persist among men in Virginia, particularly in racial and ethnic minority groups. This study examined how insurance type and demographic factors influence prescriptions for antiretroviral treatment (ART) and preexposure prophylaxis (PrEP). Addressing these disparities is critical to advancing public health equity and reducing HIV rates. The purpose was to assess whether age, race, ethnicity, region, and insurance type are associated with the type of oral HIV medication prescribed. Guided by the HIV prevention and care cascade frameworks, the study focused on access and adherence. Using a cross-sectional quantitative design, the study analyzed secondary data from …