Public Health Commons^™

Similarities And Differences In Sexual Risk Behaviors Between Young Black Msm Who Do And Do Not Have Sex With Females, Richard A. Crosby, Leandro Mena, Angelica Geter, Demarc Hickson

Health, Behavior & Society Faculty Publications

The objective of this study is to determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. YBMSM (N = 400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P = .01), unprotected fellatio (P = .04), multiple partners as a bottom (P < .02), any unprotected anal sex as a bottom (P < .013), and any anal sex (P = .007). They were equally likely …

Superman And Wonder Woman: French Champions For Hiv/Aids Prevention Of Failed Aids Campaign?, Stephen M. Croucher, Terry L. Rentner

Speaker & Gavel

In 2004, the French government sponsored an AIDS/HIV prevention campaign; AIDES.ORG using photos of AIDS infected Superman and Wonder Woman to persuade adolescents to adopt preventative behaviors. This article asserts campaign organizers cancelled the campaign because it failed to provide audience efficacy and incorrectly manipulated fear in its campaign messages. Moreover, this article compares the AIDES.ORG campaign to other AIDS/HIV campaigns and argues effective health communication campaigns must provide efficacy to facilitate adoption of desired preventative behaviors. The Social Norms Approach is offered as an alternative method for developing effective health communication campaigns.

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Hiv Risk And Psychological Distress Among Female Entertainment Workers In Cambodia: A Cross-Sectional Study, Carinne M. Brody, Pheak Chhoun, Sovannary Tuot, Khuondyla Pal, Siyan Yi

Background: In Cambodia, there has been an increase in entertainment work as a result of the breakdown of the traditional brothel-based sex industry, presenting new challenges to addressing the health issues and needs of people working in the entertainment industry. This study aims to identify factors associated with psychological distress among female entertainment workers (FEWs) in Cambodia.

Methods: A two-stage cluster sampling method was used to randomly select 657 FEWs from entertainment establishments in Phnom Penh and Siem Reap in April and May 2014 for interviews using a structured questionnaire. Psychological distress was measured using the General Health …

Improving Prevention And Care For Hiv And Sexually Transmitted Infections Among Men Who Have Sex With Men In Cambodia: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Sok Chamreun Choub, Carinne M. Brody

Background: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia.

Methods: We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang …

Determinants Of Inconsistent Condom Use Among Hiv Serodiscordant Couples In Cambodia, Sovannary Tuot, Khuondyla Pal, Kouland Thin, Chrysanta Patio, Kelly Allbritton, Christie Blondek, Siyan Yi

Background: Globally, heterosexual transmission within serodiscordant relationships is a significant source of new HIV infections. In 2012, there were an estimated 1,350 incident cases of HIV in Cambodia, of which 37% were between heterosexual couples and 30% among sex workers. In combination with antiretroviral therapy (ART), consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples. This study explored determinants of inconsistent condom use among serodiscordant couples in Cambodia. Methods: A cross-sectional study was conducted in Battambang, Pursat and Takeo provinces in September 2013. A structured questionnaire was used to collect data on condom use and …

The Stigma Effect: The Role Of Internalized Racism And Internalized Homophobia In Risky Sexual Behavior Among Black Gay Men, Darren Lovell Whitfield

Electronic Theses and Dissertations

Black gay, bisexual, queer, and same-gender-loving (GBQSGL) men account for less than 1% of US population, yet account for 36% of all new HIV infections. While, Black GBQSGL men experience higher rates of HIV infection compared to other gay, bisexual, and men who have sex with men (MSM) from other racial groups, they are no more likely to report engaging in condomless anal sex (CAS). These findings suggest that one possible explanation is that the context of sexual behavior for Black GBQSGL men may be riskier because of the prevalence of HIV in the community. Furthermore, research suggests that racism …

Are Text Messages A Feasible And Acceptable Way To Reach Female Entertainment Workers In Cambodia With Health Messages? A Cross-Sectional Phone Survey, Carinne M. Brody, Sukhmani Dhaliwal, Sovannary Tuot, Michael Johnson, Khuondyla Pal, Siyan Yi

Background: Despite great achievements in reducing the prevalence of HIV, eliminating new HIV infections remains a challenge in Cambodia. Entertainment venues such as restaurants, karaoke bars, beer gardens, cafes, pubs, and massage parlors are now considered important venues for HIV prevention efforts and other health outreach interventions.

Objective: The purpose of this study was to explore phone use and texting practices of female entertainment workers (FEWs) in order to determine if text messaging is a feasible and acceptable way to link FEWs to health services.

Methods: This cross-sectional phone survey was conducted in May 2015 with 97 …

Social Return On Investment: A Cost-Benefit Analysis Of The Hiv Integrated Care And Prevention Programs In Cambodia, Sovannary Tuot, Liza Tong, Sopheab Heng, Minh-Anh Luong, Khuondyla Pal, Pheak Chhoun, Siyan Yi

Background: KHANA’s HIV Integrated Care and Prevention (ICP) project provided comprehensive care and support to HIV-affected communities through home and community-based care teams from 2007 to 2011. The aim of this study was to use Social Return on Investment (SROI) methodology to evaluate the social, health, and economic impacts of the ICP project, enabling the calculation of a ratio cost-to-benefit for the community in terms of HIV care, support, and treatment. Methods: The SROI methodology is a social cost-benefit analysis framework that measures and accounts for the values created by a program or series of initiatives. Values were mapped to …

Factors Associated With Married Women’S Support Of Male Circumcision For Hiv Prevention In Uganda: A Population Based Cross–Sectional Study, Komi Mati, Korede K. Adegoke, Hamisu M. Salihu

Epidemiology and Biostatistics Faculty Publications

Background: Despite the protective effect of male circumcision (MC) against HIV in men, the acceptance of voluntary MC in priority countries for MC scale – up such as Uganda remains limited. This study examined the role of women’s sociodemographic characteristics, knowledge of HIV and sexual bargaining power as determinants of women’s support of male circumcision (MC).

Methods: Data from the Uganda AIDS Indicator Survey, 2011 were analyzed (n = 4,874). Bivariate and multivariate logistic regression analyses with random intercept were conducted to identify factors that influence women ’ ssupport of MC.

Results: Overall, 67.0 % (n = 3,276) …

The Impact Of An Ambulatory Clinical Intervention On Viral Load Suppression And Retention In Care For Newly Diagnosed Hiv Persons, Latasha R. Jones

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

Ambulatory clinical healthcare settings that serve patients infected with the human immunodeficiency virus (HIV) are critical in improving access to quality HIV care and treatment, in part due to their ability to streamline patient care along the HIV care continuum. Barriers to HIV care are significant among newly diagnosed HIV patients and in order to engage and retain these individuals in care and treatment, specific interventions must be in place to link these individuals to care. In this study, the difference in differences method was used for data analysis to measure the impact of an ambulatory clinics intervention on their …

Hiv Care Outcomes Among Hiv-Infected Women With A Live Birth In New York State, Carol-Ann Swain

Legacy Theses & Dissertations (2009 - 2024)

Background: Little is known about factors that predict maternal retention in postpartum HIV-related medical care and maternal HIV viral suppression in the first year postpartum among HIV-infected women in the United States.

Hiv Risks, Intimate Partner Violence (Ipv), And Depression Among A Sample Of Women Who Have Sex With Men And Women (Wsmw), Krystal S. Frieson

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

Objective: The purpose of this study is to examine the associations between interpersonal partner violence (IPV), HIV risks, and depression among a sample of adolescent females who have sex with men and women.

Methods: A cross-sectional study was conducted using data from the Youth Risk Behavior Surveillance System (YRBSS). YRBSS data was obtained from representative samples of students in grades 9-12. The study sample was comprised of adolescent and young women who self-identified as having sex with men and women (WSMW)(N=526). The primary exposure was sexual behavior (having sexual intercourse with both male and female partners). The primary outcomes were …

Interrelationships Of Colorism, Violence, And Sexual Behaviors Among Southern African American Women., Phaedra Christensen

Walden Dissertations and Doctoral Studies

Two significant public health concerns that threaten both the physical and mental health of African-American women are Intimate Partner Violence (IPV) and Human Immunodeficiency Virus (HIV). African-American women (AAW) in the south carry the greatest burden of HIV and disproportionately represent the region with an incidence of 71% for new HIV infections, and elevated rates of morbidity and mortality. In 2013, the murder rate among AAW was 2.5 times higher than it was among Caucasian women. Most of the published studies that explored the association between IPV and HIV had mixed populations, did not explore topics unique to AAs, or …

The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa., Felix Ikechi Woke

Walden Dissertations and Doctoral Studies

Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in …

Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson

Walden Dissertations and Doctoral Studies

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience …

Experiences Of Heterosexual Couples Who Undergo Hiv Counseling And Testing In Nakuru-Kenya, Stephen Kinyua Mucheke

Walden Dissertations and Doctoral Studies

The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of …

Behaviors Related To Hiv Infections In Rural Versus Urban Regions Of Nigeria, Michael Ifeanyi Okeke

Walden Dissertations and Doctoral Studies

Efforts by the Federal Republic of Nigeria and international nongovernmental agencies to reduce the impact of HIV in Nigeria have not yielded the anticipated results. This study focused on the association between attitude, religious beliefs, knowledge of HIV, sexual risk behavior, and HIV epidemiology in rural and urban Nigeria. This quantitative study used social-cognitive theory and problem theory. The study was based on the Nigerian Demographic and Health Survey (NDHS) 2013 data including a sample of 33,006 participants. Specific covariates including gender, sexual partners over the past years, age at first sexual encounter, socioeconomic status, and literacy level were obtained …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

Criminal Laws On Sex Work And Hiv Transmission: Mapping The Laws, Considering The Consequence, Sienna Baskin, Aziza Ahmed, Anna Forbes

Faculty Scholarship

Lawmakers historically justify the mobilization of criminal laws on prostitution and HIV as a means of controlling the spread of disease. Over time, however, public health research has conclusively demonstrated that criminal laws on prostitution and HIV significantly impede the ability of sex workers to access services and to live without the stigma and blame associated with being a transmitter of HIV. In turn, mainstream public health approaches to sex work and HIV emphasize decriminalization as a way to improve the lives of sex workers in need of care, treatment, and services. Our current legal system, which criminalizes both prostitution …

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

Faculty Publications

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

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

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers

Economics Faculty Publications

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion: Examination of the …

The Influence Of Race And Gender On Hiv Risk Behaviors In High School Students In The Southern States Of The United States, Malendie T. Gaines

Electronic Theses and Dissertations

The incidence of the Human Immunodeficiency Virus (HIV) is highest in the southern states of the United States (US), with adolescents in this region being one of the most affected populations in the country. A limited amount of information is available on adolescent HIV risk behaviors in the southern states, specifically focusing on race and gender. The purpose of this study was to use the Centers for Disease Control and Prevention’s National Youth Risk Behaviors Survey (YRBS) for high school students in the southern states for 2011 and 2013 to examine the influence of race and gender on 1) early …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

Surviving Hiv And Dying For A Smoke: Implications For Tobacco Use Among People Living With Hiv, Rachel Culbreth, Jane Kelly, David Maggio, Pascale M. Wortley, Cherie Drenzek

Journal of the Georgia Public Health Association

Background: Since the advent of highly active antiretroviral therapy in the mid-nineties, deaths among persons living with HIV (PLWH) have declined nationally. Now a controllable condition, HIV has become a chronic disease, highlighting the importance of tobacco cessation in lowering morbidity and premature mortality. Current smoking is approximately twice as high among PLWH compared with the general population. PLWH who smoke experience higher rates of cardiovascular disease, AIDS-defining illnesses, and cancer than PLWH who do not smoke. Loss of life-years associated with smoking among PLWH is greater than life-years lost from HIV.

Methods: Data on current smoking, derived from the …

The Care Continuum For People Living With Hiv In Georgia: How Can We Raise The Bar?, Jane Kelly, Deepali Rane, C. Drenzek

Journal of the Georgia Public Health Association

Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia.

Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age.

Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage …

Perceptions Of Hiv/Aids Testing Among Urban And Rural African American Church Members, Roblena E. Walker

Journal of the Georgia Public Health Association

Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members.

Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n =114) in the Southern U.S.

Results: The …

Fighting Microbial Drug Resistance: A Primer On The Role Of Evolutionary Biology In Public Health, Gabriel Perron, R. Inglis, Pleuni Pennings, Sarah Cobey

Biology Department Faculty Works

Although microbes have been evolving resistance to antimicrobials for millennia, the spread of resistance in pathogen populations calls for the development of new drugs and treatment strategies. We propose that successful, long-term resistance management requires a better understanding of how resistance evolves in the first place. This is an opportunity for evolutionary biologists to engage in public health, a collaboration that has substantial precedent. Resistance evolution has been an important tool for developing and testing evolutionary theory, especially theory related to the genetic basis of new traits and constraints on adaptation. The present era is no exception. The articles in …

Project Thanks: A Socio-Ecological Framework For An Intervention Involving Hiv Positive African American Women With Comorbidities, Meena Mahadevan, Ndidiamaka Amutah, Lauren Juliette Ramos, Emily Rose Raines, Jerome King, Jodyann Mcintosh, Constance Leverett

Journal of Health Disparities Research and Practice

HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of …