Public Health Commons^™

Timing Of Antiretroviral Initiation And Virologic Outcomes Among Hiv-Positive Adults In Ukraine (2010--2015), Yaroslav Zelinskyi

Legacy Theses & Dissertations (2009 - 2024)

Background and introduction:

Traditional Latinx Gender Role Norms And Exposure To Sexual Health Programming For Latinx Men Who Have Sex With Men (Lmsm), Austin Connor Eklund

Legacy Theses & Dissertations (2009 - 2024)

Latinx men who have sex with men (LMSM) are at significantly greater risk for HIV infection than their non-Latinx peers. One important way of helping prevent the spread of HIV is exposing vulnerable populations to HIV prevention programming. Little is known about what factors predict exposure to HIV prevention programming for LMSM. Given extant links between traditional masculine gender role norms and health outcomes, this study sought to examine possible relations between constructs of machismo, caballerismo, and heterosexual self-presentation, along with demographic covariates, and exposure to HIV prevention programming among LMSM. Among the 530 LMSM in our sample, 89% reported …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Hiv/Sti Screening, Testing, And Prophylaxis Among Sexual Assault Survivors In U. S. Emergency Departments, Elizabeth A. Cita

Walden Dissertations and Doctoral Studies

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. …

Tuberculoma Presenting As Paradoxical Iris In A Hiv Positive Patient, Dr. Supritha Chintamaneni, Dr.Rajendra Prasad S, Dr.Bhanukumar M, Dr.Adarsh L S

Digital Journal of Clinical Medicine

No abstract provided.

Social Support And Hiv Among Young Transwomen Of Color, Cynthia Joycelle Tucker

Walden Dissertations and Doctoral Studies

HIV is an emerging epidemic among young transgender women of color (YTWC). Researchers have documented the challenges and issues that YTWC encounter, including discrimination, isolation, and violence. However, little is known about whether social support can impact these challenges as an avenue to improve HIV preventive behaviors and HIV status. Using secondary data from the Life Skills HIV study, this research assessed how social support affects HIV preventive behaviors among 298 YTWC residing in Chicago. The study was grounded in the modified social-ecological model and Spearman’s rank correlation and logistic regression analyses was used to determine whether there was an …

Hivanish: A Program Addressing Hiv Rates In Transgender Sex Workers In Washington D.C., Evangeline Wang

Capstone Showcase

HIVanish: A Program Addressing HIV Rates in Transgender Sex Workers in Washington D.C.

Evangeline Wang

Faculty Advisor: Dr Olorunsaiye

As of 2013 around 16, 500 residents in Washington D.C. were living with HIV. Of the 16,500 residents, 1.5% or 246 cases were among the transgender population. The majority of those cases were among transgender women at 67.5%¹. Gaps remain in addressing HIV among transgender sex workers, most of them on a systemic level. This could be attributed to misclassification of transgender women as men who have sex with men, or systemic neglect². This lack of knowledge …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Adolescent Hiv Pre-Exposure Prophylaxis Prescribing Practices Among Family Medicine Physicians: Limited Immediate Uptake, Emma T. Cooper, Steven A. Elsesser, Md, Amy Cunningham, Phd, Mph, Marshal Miller, Md

Phase 1

Introduction: In the United States, individuals aged 13-24 made up 21% of new HIV infections in 2016. In 2018, the FDA approved tenofovir/emtricitabine as HIV pre-exposure prophylaxis (PrEP) for adolescents aged 15-17. In 2019, we examined adolescent PrEP prescribing practices among family medicine physicians at an academic family medicine practice.

Methods: Physicians were invited to complete an online questionnaire assessing PrEP knowledge, attitudes, and prescribing practices. Differences in PrEP knowledge and attitudes among providers who prescribe PrEP to adolescents versus those who do not were examined using independent samples t-tests.

Results: 50 out of 99 surveys were completed. Respondents were …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

Voluntary Male Circumcision And Risk For Human Immunodeficiency Virus In Homa Bay, Kenya, George Obhai Gabriel

Walden Dissertations and Doctoral Studies

The role played by the belief about voluntary medical male circumcision (VMMC) in predicting HIV status has not been examined. The purpose of this study was to investigate whether there were any differences between belief about VMMC, unprotected sex, age, number of sexual partners, relationship status, and HIV status among circumcised males aged between 18-49 years in Homa Bay County, Kenya. Drawing from the health belief model and case-control study design, 936 men were recruited based on their HIV status (468 HIV cases and 468 controls). A bivariate logistic regression was applied, and the results indicated that unprotected sex, age, …

Validity Study Of The R-Pla, A Resilience Scale For People Living With Hiv, Jinxiang Hu, Julianne M. Serovich, Monique J. Brown, Judy A. Kimberly, Yi-Hsin Chen

Faculty Publications

This study provides psychometric assessment of a resilience scale with a sample of women living with HIV. Baseline data were used from a longitudinal HIV disclosure study of 124 women aged between 18-63 collected between 2001 and 2004 in a large Midwestern city. The Rasch model was used to examine the psychometric properties of the resilience scale. Results indicated that the resilience instrument meets the Rasch model application assumptions. Evidence of validity suggested the resilience instrument demonstrated good item and person fit, as well as good item and person reliability. Most items showed measurement invariance across different age and racial …

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 …

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 …

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 …

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 …

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 …

Determinan Yang Meningkatkan Risiko Terinfeksi Hiv Pada Wargabinaan Lembaga Pemasyarakatan Dan Rumah Tahanan Di Indonesia: Studi Tinjauan Pustaka 2007-2017, Mondastri Korib Sudaryo

Jurnal Epidemiologi Kesehatan Indonesia

Wargabinaan pemasyarakatan (WBP) diduga berisiko terinfeksi HIV selama tinggal di lembaga pemasyarakatan (lapas) dan rumah tahanan (rutan) akibat menyuntik narkotika dan perilaku berisiko lainnya. Studi ini bertujuan mengetahui determinan yang meningkatkan faktor risiko terinfeksi HIV di kalangan WBP di lapas/rutan di Indonesia. Rancangan studi adalah tinjauan pustaka sistematik (systematic literature review) yang merangkum dan membandingkan hasil studi dari 12 artikel yang diterbitkan sejak 2007 2017 di jurnal nasional/internasional berbahasa Inggris/Indonesia mengenai karakteristik dan determinan infeksi HIV pada populasi WBP yang tinggal di lapas/rutan di Indonesia. Karakteristik demografis WBP: umumnya laki laki; usia rata-rata 30 tahun (rentang: 21-51 tahun); sebagian besar <=SMU; setengahnya menikah. Prevalensi HIV di kalangan WBP di beberapa lapas: 10%-56%. Tiga survei nasional tahun 2011, 2013, 2015 menunjukkanprevalence rate antara 1,2% – 3%. Proporsi perilaku berisiko: menyuntik narkotika (antara 5% - 66%), berbagi jarum suntik (28%-47%), kontak seksual tidak aman dengan sesama WBP (2%-13%), atau dengan WPS (96%), pakai tattoo (2%-56%), atau tindik (5%-13%), minum alkohol (47%). Dari 3 survey yang sama tingkat prevalensi Sifilis antara 2,1%– 5%. Determinan/faktor risiko terinfeksi HIV: menggunakan narkotika suntik (OR antara 11,4 - 104,8), pakai tatoo (OR: 1,7 -2,4), pakai tindik (OR = 4,4), seks tidak aman (OR=1,9), terinfeksi Sifilis (OR=4,2). Faktor-faktor penting yang meningkatkan risiko terinfeksi HIV di kalangan WBP di lapas/rutan adalah penggunaan narkotika suntik, berbagi jarum suntik tidak steril, kontak seksual dengan sesama WBP &/ WPS, terinfeksi Sifilis dan memakai tato/tindik.

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 …

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. …

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.

Information Seeking Behaviour And Risk Practices Among People Living With Hiv/Aids In South-West, Nigeria, Tajudeen Temitayo Adebayo

Library Philosophy and Practice (e-journal)

People living with HIV/AIDS (PLWHA) need to seek information on set of all-encompassing phenomenon which include information on medical and social packages, medication adherence, indicators of improvement, death and well-being among others. But more importantly, they need to seek information about risk practises to reduce the spread of this virus because they are the main reservoir of the HIV virus and main source of transmission. This work explored the common available sources of information seeking processes to PLWHA and some risk reduction topics.

The study adopted a survey research design which was conducted among PLWHA attending outpatient departments from four …

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 …

Qualitative Assessment Of South African Healthcare Worker Perspectives On An Instrument-Free Rapid Cd4 Test, Fiona Scorgie, Yasmin Mohamed, David Anderson, Suzanne M. Crowe, Stanley Luchters, Matthew F. Chersich

Population Health, East Africa

Background: Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people living with HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow principle, which gives visual results after 40 min. The test involves five steps and categorises CD4 counts as above or below 350 cells/μL. As one component of a performance evaluation of the test, this qualitative study explored the views of healthcare workers in a large women and children’s hospital on the acceptability and feasibility of the test.

Methods: Perspectives on the VISITECT® CD4 test were elicited through …

Fraud Detection Protocol For Web-Based Research Among Men Who Have Sex With Men: Development And Descriptive Evaluation, April M. Ballard, Trey Cardwell, April M. Young

Epidemiology and Environmental Health Faculty Publications

Background: Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity.

Objective: The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research.

Methods: This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM …