Public Health Commons^™

Predictors Of Hiv Molecular Cluster Membership And Implications For Partner Services, Camden J Hallmark, Charles Luswata, Natascha Del Vecchio, Christina Hayford, Ricardo Mora, Michelle Carr, Marlene Mcneese, Nanette Benbow, John A Schneider, Joel O Wertheim, Kayo Fujimoto

Faculty, Staff and Student Publications

Public health surveillance data used in HIV molecular cluster analyses lack contextual information that is available from partner services (PS) data. Integrating these data sources in retrospective analyses can enrich understanding of the risk profile of people in clusters. In this study, HIV molecular clusters were identified and matched to information on partners and other information gleaned at the time of diagnosis, including coinfection with syphilis. We aimed to produce a more complete understanding of molecular cluster membership in Houston, Texas, a city ranking ninth nationally in rate of new HIV diagnoses that may benefit from retrospective matched analyses between …

A Scoping Review Of The Predictive Values And Use Of The Oraquick In-Home Hiv Test, Mariah Zinn

Capstone Experience: Master of Public Health

The OraQuick In-Home HIV Test was FDA-approved for over-the-counter use for people aged 17 years and older in 2012. The FDA reported on the sensitivity and specificity of the test, which looks at the accuracy of a test relative to a reference standard. However, the predictive values that account for prevalence still need to be thoroughly examined among tests distributed through community-based means. In this review, we looked at the predictive values for the OraQuick In-Home HIV Test for people aged 15 years and older when the test is distributed through community-based means. We calculated the predictive values for each …

Smoking Prevalence Amongst People Living With Hiv In Western Jamaica, D Aguilera, B Rinola, S Tundealao, R Klaff, M Aung, M Johnson-Campbell, P Jolly, I Tamí-Maury

GW Research Showcase 2021-2026

No abstract provided.

Are Human Papillomavirus Knowledge And Vaccine Uptake Associated With Hiv Status And Social Determinants Of Health In Young Sexual Minority Men?, Trisha L Amboree, Alan G Nyitray, John Schneider, Nick Gargurevich, Jacky Kuo, Elizabeth Y Chiao, Lu-Yu Hwang, Kayo Fujimoto

Faculty, Staff and Student Publications

This brief report examines the relationship, if any, between human immunodeficiency virus (HIV) status, and individual-level and socio-sexual partner-level factors of social determinants of health (SDOH) that are associated with human papillomavirus (HPV) knowledge and vaccine uptake in young sexual minority men (YSMM). We used data from 126 YSMM recruited by network-based sampling during 2015-2016 in Houston, Texas. Descriptive statistics and regression analyses were conducted to test the association between HIV status, SDOH, and HPV knowledge and vaccine uptake. Those living with HIV had lower odds of knowledge of HPV-associated anal cancer (OR: 0.43, 95% CI: 0.18-0.97) and knowledge of …

Are Human Papillomavirus Knowledge And Vaccine Uptake Associated With Hiv Status And Social Determinants Of Health In Young Sexual Minority Men?, Trisha L Amboree, Alan G Nyitray, John Schneider, Nick Gargurevich, Jacky Kuo, Elizabeth Y Chiao, Lu-Yu Hwang, Kayo Fujimoto

Faculty, Staff and Student Publications

This brief report examines the relationship, if any, between human immunodeficiency virus (HIV) status, and individual-level and socio-sexual partner-level factors of social determinants of health (SDOH) that are associated with human papillomavirus (HPV) knowledge and vaccine uptake in young sexual minority men (YSMM). We used data from 126 YSMM recruited by network-based sampling during 2015-2016 in Houston, Texas. Descriptive statistics and regression analyses were conducted to test the association between HIV status, SDOH, and HPV knowledge and vaccine uptake. Those living with HIV had lower odds of knowledge of HPV-associated anal cancer (OR: 0.43, 95% CI: 0.18-0.97) and knowledge of …

Area Deprivation Index And Segregation On The Risk Of Hiv: A Us Veteran Case-Control Study, Abiodun O Oluyomi, Angela L Mazul, Yongquan Dong, Donna L White, Christine M Hartman, Peter Richardson, Wenyaw Chan, Jose M Garcia, Jennifer R Kramer, Elizabeth Chiao

Faculty, Staff and Student Publications

BACKGROUND: Preventing HIV infection remains a critically important tool in the continuing fight against HIV/AIDS. The primary aim is to evaluate the effect and interactions between a composite area-level social determinants of health measure and an area-level measure of residential segregation on the risk of HIV/AIDS in U.S. Veterans.

METHODS: Using the individual-level patient data from the U.S. Department of Veterans Affairs, we constructed a case-control study of veterans living with HIV/AIDS (VLWH) and age-, sex assigned at birth- and index date-matched controls. We geocoded patient's residential address to ascertain their neighborhood and linked their information to two measures of …

A Randomized Clinical Trial Of Transgender Women Switching To B/F/Taf: The (Mo)Betta Trial, Jordan E Lake, Ana N Hyatt, Han Feng, Paula Debroy, Aaren Kettelhut, Hongyu Miao, Liming Peng, Shalender Bhasin, Susan Bell, Nahid Rianon, Todd T Brown, Nicholas T Funderburg

Faculty, Staff and Student Publications

Background: Cardiometabolic disease in transgender women (TW) is affected by gender-affirming hormonal therapies (GAHTs), HIV, and antiretroviral therapy (ART). We evaluated the 48-week safety/tolerability of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs continued ART in TW on GAHT.

Methods: TW on GAHT and suppressive ART were randomized 1:1 to switch to B/F/TAF (Arm A) or continue current ART (Arm B). Cardiometabolic biomarkers, sex hormones, bone mineral density (BMD) and lean/fat mass by DXA scan, and hepatic fat (controlled continuation parameter [CAP]) were measured. Wilcoxon rank-sum/signed-rank and χ2 tests compared continuous and categorical variables.

Results: TW (Arm A n = 12, Arm …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Understanding The Health-Related Quality Of Life Of People Living With Hiv Based On Sexual Orientation, Rico Januar Sitorus, Nyoman Yudi Antara, Reymart Sangalang, Merry Natalia Panjaitan, Nelsensius Klau Fauk

Kesmas

Human immunodeficiency virus (HIV) infection has detrimental impacts on the lives of different population groups living with HIV, including men who have sex with men (MSM). Using the World Health Organization Quality of Life questionnaire, this study aimed to assess the health-related quality of life of men living with HIV with different sexual orientations and to determine the dominant influential factors. This cross-sectional study involved 206 men living with HIV. They were recruited from the Sriwijaya Plus Foundation and a medical facility that provided antiretroviral therapy. The data were analyzed using Chi-square and binomial logistic regression. The analysis showed that …

Community Healthcare Providers’ Perspectives On Hiv Pre-Exposure Prophylaxis (Prep) Use Among Black Women, Kayla Pitchford, Sylvia Shangani, Charlotte Dawson, Kristin Heron

College of Sciences Posters

The most at-risk population among women for HIV diagnosis in the U.S. are Black women, who account for 61% of all new HIV cases. Pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention method for people at risk of HIV acquisition. Despite being disproportionately affected by HIV, Black women’s knowledge, perceived benefits, and uptake of PrEP remain low. The socio-ecological model may be useful for understanding why there is a low uptake of PrEP among Black women by examining the complex interplay between individual, relationship, community, and societal factors. The current study used the socio-ecological framework to explore provider …

A Unique Hiv Harm Reduction Perspective From Costa Rica: Hogar De La Esperanza An Ethnographic Case Study And Comparative Examination Of Approach To Hiv Treatment Between The United States And Costa Rica, Kim Marie Day

Theses and Graduate Projects

This case study presents a real, currently operational scenario of harm reduction in action in Costa Rica, focusing on its success and the challenges faced by healthcare professionals, the experiences of those who live at Hogar de la Esperanza, and the implications for healthcare policies and interventions in the United States. By examining this specific case of a Costa Rican community-based HIV treatment model, the aim of this ethnographic report is to shed light on the complexities and factors contributing to the success or failure of harm reduction treatment strategies within the United States and what can be learned by …

Influence Of Stigma On Retention In Hiv Care And Adherence To Antiretroviral Therapy In Specialized Hiv Clinics Targeting Men Who Have Sex With Men And Transgender Women In Lima, Peru, David Oliveros Oliveros

Public Health Theses

HIV stigma is a social determinant of health that can influence adherence to antiretroviraltherapy (ART) and engagement in HIV care that impacts viral suppression levels for people with HIV (PWH). In Peru, a country which lags behind 95-95-95 targets for HIV outcomes, LGBTQ-affirming clinics have the potential to mitigate these negative health effects of stigma and discrimination among men who have sex with men (MSM) and transgender women (TGW), two populations that continue to be disproportionately affected by HIV. Using a validated HIV stigma scale and multivariate logistic regression models, this study assessed the magnitude and types of stigma present …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

College of Graduate Studies: Theses & Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Using Telemedicine And Telehealth To Extend Services In Hiv Care, Jeffery Dockery Mr., Heather G. Peebles Ms.

Georgia Public Health Association Annual Meeting & Conference

Background

The COVID-19 pandemic posed many barriers to healthcare but especially for HIV Public Health clients who struggle to meet basic socioeconomic needs. Southeast Health District (SEHD) Ryan White clients are immunocompromised increasing isolation and fear. In addition to client barriers, the pandemic resulted in a staffing shortage. The shortages were due to COVID diagnosis and subsequent isolation, staffing turnover, and unfillable vacancies.

Method

A dedicated schedule is utilized for Telehealth/Telemedicine. A patient is scheduled at a remote site and connected with a practitioner at another location. The SEHD Ryan White Program currently has 4 clinics located in Bulloch, Coffee, …

A Systematic Review To Study The Global Patterns And Policies Of Hiv Harm Reduction Programs And Their Impact Among People Who Inject Drugs, Noura Shaltout, Rania Soliman, Lamia Refaey, Rim Ghazal, Mirna Atteya, Nahla Elmedany

Papers, Posters, and Presentations

Aim: This study aims to provide an updated estimate of HIV prevalence among people who inject drugs (PWID) globally, as well as investigate different policies and methods for applying harm reduction. This article focuses on the two major and the most frequently used harm reduction techniques, Syringe-Service Programs (SSPs) and Opioid Agonist Therapy (OAT). Methods: A comprehensive systematic review was undertaken across multiple international databases during the period of (August-December 2021). For studies conducted before 2005, we used data from a previous published systematic review. Thirty-six studies were included, including studies that had performed HIV testing and had a confirmed …

The Prepare Mobile Program For Hiv Prevention In Washington D.C., Gabrielle Cochran

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

Incidence rates of HIV have decreased in the United States in the past decade, but the southern United States has higher rates of HIV than other regions, and cities in the south, like Washington D.C., have some of the highest rates of HIV incidence in the nation. Risky sexual behavior, needle sharing, and substance use increase the risk of transmitting or acquiring HIV, and these behaviors are more common among unhoused people (CDC, 2021; CPPH, 2022).

Expansion of community resources in cities with high levels of HIV have allowed for many people at high risk for HIV to comply with …

Trends And Correlates Of Low Hiv Knowledge Among Ever-Married Women Of Reproductive Age: Evidence From Cross-Sectional Bangladesh Demographic And Health Survey 1996–2014, Md Tariqujjaman, Md Mehedi Hasan, Mohammad Abdullah Heel Kafi, Md Alamgir Hossain, Saad A Khan, Nadia Sultana, Rashidul Azad, Md Arif Hossain, Mahfuzur Rahman, Mohammad Bellal Hossain

Faculty, Staff and Student Publications

BACKGROUND: The human immunodeficiency virus (HIV) burden has frequently been changing over time due to epidemiological and demographic transitions. To safeguard people, particularly women of reproductive age, who can be exposed to transmitting this burden to the next generation, knowledge regarding this life-threatening virus needs to be increased. This research intends to identify the trends and associated correlates of "low" HIV knowledge among ever-married women of reproductive age in Bangladesh from 1996 to 2014.

METHODS: We analyzed data derived from six surveys of Bangladesh Demographic and Health Surveys conducted in 1996, 1999, 2004, 2007, 2011, and 2014. Analyses were primarily …

Proposing An Rna Interference (Rnai)-Based Treatment For Human Immunodeficiency Virus (Hiv) By Analyzing The Post-Transcriptional Gene Targeting Of Sars-Cov-2, Hepatitis C Virus, And A549 Lung Cancer Cells, Arjun Jagdeesh

Undergraduate Research Posters

Human Immunodeficiency Virus (HIV) is a retrovirus that infects CD4+ T cell lymphocytes in humans, leading to the development of Acquired Immunodeficiency Syndrome (AIDS) if left untreated. While current treatment methods, including antiretroviral combination treatments, effectively limit HIV replication, HIV can evade these treatments due to its high mutation rate. Long-term antiretroviral treatment can also be toxic to patients, meaning patients would benefit from a new mechanism of HIV treatment. RNA interference (RNAi) is an antiviral pathway found in mammals, plants, and insects that involves a small-interfering RNA that is incorporated into a protein complex called the RNA-induced Silencing Complex …

Hiv Treatment Patterns Across A Us Data Network: 2012-2021, Raechel Elizabeth Davis

Public Health Theses

IntroductionOnce-daily combination antiretroviral therapy is recognized as the standard treatment for people living with Human Immunodeficiency Virus (HIV) in the United States.1,2 Treatment strategies for HIV have changed substantially over the years, influenced by individual and clinical factors, new medication options, and changing clinical guidelines.1–3 Observational data sources provide a unique opportunity to characterize populations and provide insight into medication usage under real-world conditions that differ systematically from controlled trial scenarios.3,4 Methods We evaluated the treatment patterns and characteristics of 12288 individuals diagnosed with HIV and continuously treated with antiretroviral medications across four, US-based observational databases using the Observational Health …

Expanding Medicaid To Reduce Human Immunodeficiency Virus Transmission In Houston, Texas: Insights From A Modeling Study, Francis Lee, Aditya S Khanna, Camden J Hallmark, Richa Lavingia, Marlene Mcneese, Jing Zhao, Melanie L Mcneese, Salma Khuwaja, Babak M Ardestani, Nicholson Collier, Jonathan Ozik, Anna L Hotton, Nina T Harawa, John A Schneider, Kayo Fujimoto

Faculty, Staff and Student Publications

CONTEXT: Medicaid expansion has been nationally shown to improve engagement in the human immunodeficiency virus (HIV) treatment and prevention continua, which are vital steps to stopping the HIV epidemic. New HIV infections in the United States are disproportionately concentrated among young Black men who have sex with men (YBMSM). Houston, TX, is the most populous city in the Southern United States with a racially/ethnically diverse population that is located in 1 of 11 US states that have not yet expanded Medicaid coverage as of 2021.

METHODS: An agent-based model that incorporated the sexual networks of YBMSM was used to simulate …

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …

Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker

All ETDs from UAB

Sexual and reproductive health (SRH) needs for women are not being met globally. In addition to efforts towards providing widespread access to currently available contraceptives and sexually transmitted infection (STI) treatment or prevention products, another focus is the development of multipurpose prevention technologies (MPTs). These MPTs are combination methods that prevent pregnancy, and protect against HIV and/or additional STIs. The objective of this dissertation research was to assess factors related to sexual and reproductive decision-making that may influence interest in MPTs and inform MPT implementation strategies for African and African American (AA) women. The first aim of this research, I …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao

All ETDs from UAB

The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. …

Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel

All ETDs from UAB

Introduction: HIV (Human Immunodeficiency Virus) is a sexually transmitted infection (STI) that is still a major health issue in the United States and the world. Emerging adults are more likely to engage in risky sexual behaviors such as multiple sexual partners and unprotected sex. HIV testing contributes to ending the HIV epidemic by identifying at-risk individuals and promoting early diagnosis.Methods: Secondary data analyses of the City Health II dataset were conducted to 1) identify the association between HIV testing and risky sexual behaviors among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, 2) use social network …

Understanding The Perceived Risk And Biopsychosocial Impact Of The Covid-19 Pandemic On People Living With Hiv And Pre-Exposure Prophylaxis Users In Nebraska: A Mixed Methods Approach, Titilola O. Labisi

Theses & Dissertations

The COVID-19 pandemic disrupted HIV care and prevention services. COVID-19 guidelines required physical and social distancing, resulting in movement restrictions and limited healthcare services. People living with HIV (PLWH) may be more vulnerable to the pandemic’s impact due to immune suppression and socioeconomic status than people without HIV. Consistent use of pre-exposure prophylaxis (PrEP), condoms, and regular sexually transmitted infection tests are critical strategies for HIV prevention. The pandemic’s impact on PLWH have not been thoroughly studied, and whether PLWH may be more impacted than PrEP users is inconclusive.

This research aimed to use an explanatory sequential mixed methods design …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

Freedom As Prevention: Mechanisms Of Autonomy Support For Promoting Hiv Pre-Exposure Prophylaxis Use And Condom Use Among Black Msm In 3 Us Cities—Hptn 073, Laron E Nelson, Donte T Boyd, Geetha Beauchamp, Lynda Emel, Leo Wilton, Darren Whitfield, S Raquel Ramos, Wale Ajiboye, Mandy J Hill, Donaldson F Conserve, Portia Thomas, Lisa Hightow-Weidman, Steve Shoptaw, Manya Magnus, Kenneth H Mayer, Estelle Piwowar-Manning, Sheldon D Fields, Darrell P Wheeler, Hptn 073 Study Team

Faculty, Staff and Student Publications

Healthcare providers who use controlling or coercive strategies may compel short-term enactment of HIV and sexually transmitted infection prevention behaviors but may inadvertently undermine their client's motivation to maintain those behaviors in the absence of external pressure. Autonomous motivation refers to the self-emanating and self-determined drive for engaging in health behaviors. It is associated with long-term maintenance of health behaviors. We used structural equation modeling to investigate whether autonomy support was associated with increased odds of therapeutic serum levels of pre-exposure prophylaxis, through a pathway that satisfies basic psychological needs for autonomous self-regulation and competence regarding pre-exposure prophylaxis use. We …

Measuring Phases Of Employment Decision-Making And The Need For Vocational Services As A Social Determinant Of The Health Of Employed People Living With Hiv, Kb Boomer, Liza M. Conyers, Yili Wang, Yung-Chen Jen Chiu

Publications and Research

(1) Background: Secure employment has been recognized as a social determinant of health for people living with HIV (PLHIV), but limited research has been conducted to understand the employment needs and vocational decision-making process of those who are employed. The purpose of this study is to examine the applicability of the client-focused considering-work model to assess the employment outcomes and employment decision-making phases of a sample of employed PLHIV. (2) Methods: This study analyzed data of 244 employed PLHIV who completed National Working Positive Coalition’s Employment Needs Survey which included a 20-item Considering Work Scale- Employed version (CWS-Employed) and a …