Public Health Commons^™

The Potential For Bridging : Hiv Status Awareness And Risky Sexual Behavior Of Injection Drug Users Who Have Non-Injecting Permanent Partners In Ukraine, Alyona Mazhnaya

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Knowledge, Perceptions, Discrimination, Health Self-Efficacy, And Risky Behaviors For Hiv/Aids And Its Association With Migration Time Among Mixtec And Zapotec Men Who Migrate, 2012, Sandra Iveth Bejarano

Open Access Theses & Dissertations

BACKGROUND AND SIGNIFICANCE: Historically, there has been a transnational migration flow from Mexico to the United States. There are many reasons for which people make the decision to migrate; the most common ones are unemployment and economic hardship. Currently, Oaxaca is considered one of the states with the highest poverty levels in Mexico. As a result of extreme poverty groups of indigenous people, such as Zapotec and Mixtec, are forced to migrate out of their communities in order to find jobs. Migration has been associated with various health outcomes, including diabetes, high blood pressure, and heart disease as well as …

Host Genetic Factors Associated With Cervical Human Papillomavirus Clearance, Staci Lynn Sudenga

All ETDs from UAB

This dissertation research focuses on how variants in various host genes are associated with clearance of HPV in three longitudinal cohorts from the United States. I first examined the definition of the intermediate phenotype to cervical cancer, HPV persistence and then I incorporated this phenotype in all my three aims by examining variations in xenobiotic metabolism genes in HIV-1 negative and immune-related genes in HIV-1 positive females and how these contribute to HPV infection outcomes. Several significant variants were associated with HPV clearance for the three aims. For the first aim, in ALTS assessing functional variants within xenobiotic metabolism genes …

Tuberculosis Screening And Treatment Outcomes In Zambia, Jennifer Harris

All ETDs from UAB

Zambia is a country in Southern Africa with dual HIV and tuberculosis (TB) epidemics. The annual TB incidence is 444/100,000 and 64% of TB patients are co-infected with HIV. Accurate screening and diagnosis for TB is challenging since it often presents with non-specific signs and symptoms and the available diagnostics are neither sensitive nor specific. Papers one and two of this dissertation focus on the derivation of TB screening rules to more accurately identify high-risk persons in two Zambian populations: inmates and HIV clinic patients. Among inmates, being HIV positive and having a body mass index < 18.5 most strongly predicted HIV disease. Chest pain was also strongly associated, but this may have been a chance finding. For HIV clinic patients, we developed four rules with increasing complexity of clinical tools used for screening. Sensitivity was very high with all rules; the addition of vital signs and pulmonary exam findings to symptom-based screening rules greatly increased the rules' specificity. Furthermore, a rule incorporating pulmonary exam findings performed similarly to a rule with chest radiography suggesting pulmonary exam may be an inexpensive alternative to x-ray. The final paper looks at TB incidence, mortality and intermediate clinical outcomes in a cohort of HIV clinic patients with and without TB during their first 12 months of HIV care. TB incidence was very high during this time period, despite thorough screening at baseline. Mortality was elevated in both culture-confirmed and clinically-diagnosed TB patients, with much of the elevated risk concentrated in TB patients who had culture-confirmed but clinically-unapparent disease. Looking at intermediate outcomes among patients who started anti-retroviral therapy, the change in CD4 cell count was similar for patients with and without TB. TB patients started off with lower mean body weights and hemoglobin concentrations but also showed greater increases over 12 months, thus `catching up' with the TB-negative patients. If these findings are replicable in other cohorts they could have substantial impact on TB screening and diagnostic procedures in resource limited, high burden countries like Zambia.

Bmi At Diagnosis And Its Association With Markers Of Hiv Disease Progression And Cardiovascular Disease Risk., Kelly Deshon Johnson

Theses and Dissertations

Highly active antiretroviral treatment (HAART) has transformed the state of human immunodeficiency virus (HIV) from acute to chronic. As a result, the long-term effect of HAART has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcomes in non-HIV and HIV populations, yet among HIV-infected individuals, a higher BMI at diagnosis offers a slower progression from HIV to AIDS. Pre-HAART, studies reported that obese HIV-infected individuals have higher increases in CD4 count over time. However post-HAART, some report that overweight HIV-infected individuals with …

Mother- To - Child Transmission Of Hiv And Congenital Syphilis: A Snapshot Of An Epidemic In The Republic Of Panama, Lorna Elizabeth Jenkins

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Background: Worldwide HIV is going through a feminization and rejuvenation as more women are living with HIV/AIDS, increasing the risk of vertical transmission. Despite the efforts in Latin America and the Caribbean (LAC) by 2010, Panama was the third most affected country in the region with HIV/AIDS, with females aged 15-24 twice as affected as men.

Methods: This descriptive epidemiological study of HIV vertical transmission in Panama reviewed clinical charts to identify health care personnel's practices during pregnancies in 2008. This study also examines the impact of interventions comparing the HIV outcome of the children at the end of …

Parallel Ngo Networks For Hiv Control: Risks And Opportunities For Ngo Contracting., Shehla Zaidi, Xaher Gul, Noureen Aleem Nishtar

Community Health Sciences

Policy measures for preventive and promotive services are increasingly reliant on contracting of NGOs. Contracting is a neo-liberal response relying on open market competition for service delivery tenders. In contracting of health services a common assumption is a monolithic NGO market. A case study of HIV control in Pakistan shows that in reality the NGO market comprises of parallel NGO networks having widely different service packages, approaches and agendas. These parallel networks had evolved over time due to vertical policy agendas. Contracting of NGOs for provision of HIV services was faced with uneven capacities and turf rivalries across both NGO …

Comparison Of Need And Supply Of Syringes For Therapeutic Injections In Pakistan, Adnan Ahmad Khan, Momina Saleem, Huma Qureshi, Rashid Jooma, Ayesha Khan

Section of Neurosurgery

Objectives: To determine the extent of shortfall in syringes by measuring the need from nationally validated sources and comparing it with position on the supply side. This was done in order to contribute to the ongoing national discussions that have focused on increasing syringe supply to curtail syringe reuse.
Methods: Using 'Injections received' data from the Pakistan Demographic Health Survey 2006-7 (N: 5429) and the National Hepatitis Survey (N: 47,043), the study estimated the number of injections received in Pakistan. We matched these against the local syringe production figures from the syringe manufacturers' association and import figures from the Federal …

Female Sex Work And International Sport Events - No Major Changes In Demand Or Supply Of Paid Sex During The 2010 Soccer World Cup: A Cross-Sectional Study, Marlise Richter, Stanley Luchters, Dudu Ndlovu, Marleen Temmerman, Matthew Francis Chersich

Population Health, East Africa

Background: Important unanswered questions remain on the impact of international sporting events on the sex industry. Speculation about increased demand and supply of sex work often generates significant attention, but also additional funding for HIV programmes. This study assessed whether changes occurred in the demand and supply of paid sex during the 2010 Soccer World Cup in South Africa.

Methods: Trained sex worker interviewers conducted face-to-face semi-structured interviews among consenting female sex workers during May-September 2010. Using bivariate analyses we compared supply, demand, sexual risk-taking, and police and health services contact pre-World Cup, to levels during the World …

A Pilot Self-Care Group Intervention For Low-Income Hiv-Positive Women, Maithe Enriquez, Margaret S. Miles, Jacki Witt, Paul Gore, Nancy Lackey

Journal of Health Disparities Research and Practice

This article describes the development of a self-care intervention and examines its efficacy with low-income HIV-positive women (n=34) in the Midwestern United States. Adapted from an individual nurse-led intervention, this effort focused on increasing self-care behaviors through enhancing self-esteem and social support. The investigators used a community-based participatory approach and partnered with three HIV-positive women to adapt and pilot test the new group intervention. A within-group, repeated-measures, pre-/post-test design, together with participant interviews, was used to evaluate the intervention. Mean scores on measures of self-care behaviors, self-esteem, social support and depressive symptoms all changed in the clinically desirable direction. Group …

Beyond The It Magic Bullet: Hiv Prevention Education And Public Policy, Fay C. Payton

Journal of Health Disparities Research and Practice

Analytic applications are vital in the assessments of public health and surveillance as these applications can drive resource allocation, community assessment and public policy. Using a dataset of nearly 90,000 patient hospital encounters, the number of instances with an ICD code of HIV and co-morbidities was identified. Blacks accounted for 75 percent of HIV hospital encounters in the dataset. While business analytic applications informed this study of cross-tabulations and interaction effects among race, age and gender, there appears to be a significant relationship among HIV diagnoses and substance abuse. Payer data is informed by the Healthcare Cost and Utilization Project …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

Hiv And Aids Education: The Tanzanian Case, Katherine Ellison

Social Sciences

This project takes a look at the cultural, religious, and socio-economic roles that affect the spread of education regarding HIV/AIDS in Tanzania. A personal experience in Zanzibar, Tanzania was the incentive to spark interest in teaching. HIV/AIDS is a powerful epidemic that has taken the lives away from millions. This article takes a deeper look at the transmission, stigmas, and pathways for change.

Epidemiology Of Contemporary Seroincident Hiv Infection In The Navy And Marine Corps, David Brett-Major, Shilpa Hakre, Neal A. Naito, Adam Armstrong, Eric A. Bower, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

Human Immunodeficiency Virus (HIV) infection continues at a steady rate among U.S. Sailors and Marines. This study provides the first service-specific description of HIV infection demographics. All Sailors and Marines identified as HIV infected between January 2005 and August 2010 were included. The project compared personnel and epidemiologic data, and tested reposed sera in the Department of Defense Serum Repository. This group comprised 410 Sailors and 86 Marines, predominantly men. HIV infected Marines were more likely to be foreign born than their Navy counterparts, 42% versus 10%, p < 0.001. Approximately half of the patients had deployed including to the wars in Iraq or Afghanistan. Nearly half of each group was infected by the age of 25. Similar to the U.S. epidemic, Black race was over-represented. Unlike national rates, Hispanic Sailors and Marines were not over-represented. Demographics were distinct for those of specific occupational specialties. Certain ship classes carried lower incidences. Clustering of HIV infection risk occurred around deployment. The Navy and Marine Corps have different patterns of HIV infection, which may merit distinct approaches to prevention. The Navy may have unique targets for prevention efforts to include pipeline training and first assignment as well as particular occupational environments.

Prognostic Implications Of Oral Health Status In Hiv-Positive Women In St. Petersburg, Russia, Anna Vinogradova

Legacy Theses & Dissertations (2009 - 2024)

Objective: To assess state of oral health in HIV-positive women in St. Petersburg, Russia and to study the association of oral health with pregnancy status and other factors in this sample.

Migrant Workers In Kazakhstan : Gender Differences In Hiv Knowledge And Sexual Risk Behaviors, Baurzhan Zhussupov

Legacy Theses & Dissertations (2009 - 2024)

Background:

Love And Risk: Intimate Relationships Among Female Sex Workers Who Inject Drugs And Their Non-Commercial Partners In Tijuana, Mexico, Jennifer L. Syvertsen

USF Tampa Graduate Theses and Dissertations

This dissertation examines the influence of love and other emotions on sexual and drug-related HIV risk among female sex workers who inject drugs and their intimate, non-commercial partners in Tijuana, Mexico. My work on a public health study along the Mexico-U.S. border and independent ethnographic research in Tijuana suggests the importance of emotions in shaping sex workers' relationships and health risks.

Love is a universal human emotional experience embodied within broader cultural, social, and economic contexts. A growing body of cross-cultural research suggests that modern relationships have transformed to emphasize love and emotional intimacy over moral or kinship obligations. Particularly …

Hiv And Concurrent Sexual Partnerships: Modelling The Role Of Coital Dilution, Larry Sawers, Alan G. Isaac, Eileen Stillwaggon

Economics Faculty Publications

Background: The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high HIV levels in sub-Saharan Africa. Earlier simulation models show that the network effect of concurrency can increase HIV incidence, but those models do not account for the coital dilution effect (nonprimary partnerships have lower coital frequency than primary partnerships).

Methods: We modify the model of Eaton et al (AIDS and Behavior, September 2010) to incorporate coital dilution by assigning lower coital frequencies to non-primary partnerships. We parameterize coital dilution based on the empirical work of Morris et al (PLoS ONE, December …

Uganda And The Current Hiv Treatment Crisis - A Perspective, Ellen J. Plumb Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Who Tests, Who Doesn't, And Why? Uptake Of Mobile Hiv Counseling And Testing In The Kilimanjaro Region Of Tanzania, Jan Ostermann, Elizabeth A. Reddy, Meghan M. Shorter, Charles Muiruri, Antipas Mtalo, Dafrosa K. Itemba, Bernard Njau, John A. Bartlett, John A. Crump, Nathan M. Thielman

Faculty Publications

Background: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and highrisk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) campaigns in four rural villages in the Kilimanjaro Region of Tanzania.

Methods: Between December 2007 and April 2008, 878 MVCT participants and 506 randomly selected community residents who did not access MVCT were surveyed. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing between MVCT participants and community residents who …

Evaluation Of A Quality Management Initiative And Hiv Ambulatory Services Performance In Thailand, Meemon Natthani

Electronic Theses and Dissertations

The accomplishment of pilot implementation of the HIVQUAL-T model, an innovative HIV care quality management tool, has led to an authoritative decision to scale up the use of the model nationwide in Thailand. However, the level of implementing this model varies across target hospitals. Some hospitals have fully adopted the model by conducting quality improvement (QI) activities following performance measurement (PM) results while others have partially adopted only PM or have not used this model at all. The differential level of implementation could be a contributing factor accounting for discrepancies in the quality of care across different HIV ambulatory care …

An Investigation On Hiv Related Stigma To Improve Hiv Prevention Efforts In North Dakota, Krissie Lynn Mayer-Guerard

All Graduate Theses, Dissertations, and Other Capstone Projects

This study examines HIV stigma to improve HIV prevention in North Dakota. A survey was administered to North Dakotan adults between January 15 and February 15, 2011, in eight selected towns. The study focused on North Dakotan perceptions of HIV in their state. Research found that most North Dakotans do not view HIV as a problem in their state. There is, however, a belief that there is stigma associated with HIV in North Dakota, as 65 percent of survey respondents believe that. The study also shows that there is a need for education regarding the transmission of HIV. Sixty percent …

Conceptualization Of Cervical Cancer And Screening Experiences Among Zambian Women Attending A Cervical Screening Program, Heather Leah White

All ETDs from UAB

Invasive cervical cancer (ICC) is the second most commonly diagnosed malignancy worldwide, and approximately 85% of the disease burden occurs in underdeveloped countries. In 2006, the Zambian government launched a cervical screening program within primary health clinics using visual inspection with acetic acid (VIA) coupled with immediate treatment via cryotherapy. The objective of this dissertation was to determine whether the VIA screening program is responsive to the needs and concerns of Zambian women in an effort to improve screening uptake, and for human immunodeficiency virus (HIV) positive women who are potentially subject to increased ICC screening and treatment, increase long-term …

Preventing Mother-To-Child Transmission Of Human Immunodeficiency Virus-1 (Hiv-1): Effects Of Intrapartum And Neonatal Single-Dose Nevirapine Prophylaxis And Subsequent Hiv-1 Drug Resistance At Antiretroviral Treatment Initiation, Amanda L. Harmon

CMC Senior Theses

The prevention of mother-to-child transmission is one of the most powerful tools in human immunodeficiency virus type 1 (HIV-1) prevention and has huge potential to improve both maternal and child health. In the absence of any preventative measures, infants born to and breastfed by their HIV-positive mothers have roughly a one-in-three chance of acquiring the infection themselves. HIV can be passed on from mother-to-child during pregnancy, during labor and delivery, and even after during breastfeeding.

Intrapartum and neonatal single-dose nevirapine (sd-NVP) is the foundation of preventing mother-to-child transmission in lower resource settings where it has been used alone or as …

Concurrent Sexual And Substance-Use Risk Behaviours Among Female Sex Workers In Kenya's Coast Province: Findings From A Behavioural Monitoring Survey, Simon Pierre Tegang, S. Abdallah, G. Emukule, Stanley Luchters, Nzioka Kingola, M. Barasa, Stephen Mucheke, P. Mwarogo

Population Health, East Africa

While many studies confirm the association between HIV, alcohol and injecting drug use by female sex workers (FSWs), little is known about their use of marijuana, khat and other substances and the association of these substances with HIV, risky sexual behaviour, and sexual violence. To better understand this association, data were analysed from a cross-sectional, behavioural survey of 297 FSWs in Mombasa, a well-known tourist destination and the second largest port in Africa and capital city of the Coast Province in Kenya. Among the FSWs, lifetime use of different substances was reported by 91% for alcohol, 71% for khat, 34% …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Hiv And Hepatocellular And Esophageal Carcinomas Related To Consumption Of Mycotoxin-Prone Foods In Sub-Saharan Africa, Jonathan H. Williams, Jessica A. Grubbs, Jerry W. Davis, Jia-Sheng Wang, Pauline E. Jolly, Nii-Ayi Ankrah, William O. Ellis, Evans Afriyie-Gyawu, Natalie M. Johnson, Abraham G. Robinson, Timothy D. Phillips

Environmental Health Sciences: Faculty Publications

Background: Promotion of the HIV epidemic by aflatoxin is postulated but not yet established. Sub-Saharan populations commonly consume food contaminated by mycotoxins, particularly aflatoxins (predominantly found in peanut, maize, rice, and cassava) and fumonisins, which occur primarily in maize. Aflatoxin promotes hepatocellular cancer, and fumonisin may promote esophageal cancer.

Objectives: This analysis was undertaken to test the hypotheses that consumption of mycotoxin-prone staple foods is 1) related to the incidence of HIV infection in Africa and 2) related to “signature” cancer rates confirming exposure to aflatoxins and fumonisins.

Design: World Health Organization data for causes of death and the Food …

Safety Assessment For Tipranavir : A Protease Inhibitor Treatment For Hiv Infected Adults, Jaromir Mikl

Legacy Theses & Dissertations (2009 - 2024)

Dose-limiting adverse events associated with anti-retroviral therapy (ART) generally include gastro-intestinal (GI) issues such as vomiting and nausea. However, serious adverse events (SAEs) do occur, the most frequent of which include liver toxicities and renal impairment as well as recent evidence of cardio-vascular disease (CVD) risk.

Patterns Of Drug Use And Abuse Among Aging Adults With And Without Hiv: A Latent Class Analysis Of A Us Veteran Cohort, Traci C. Green, Trace Kershaw, Haiqun Lin, Robert Heimer, Joseph L. Goulet, Kevin L. Kraemer, Adam J. Gordon, Steve A. Maisto, Nancy L. Day, Kendall Bryant, David A. Fiellin, Amy C. Justice

United States Public Health Resources

This study characterized the extent and patterns of self-reported drug use among aging adults with and without HIV, assessed differences in patterns by HIV status, and examined pattern correlates. Data derived from 6351 HIV-infected and uninfected adults enrolled in an eight-site matched cohort, the Veterans Aging Cohort Study (VACS). Using clinical variables from electronic medical records and sociodemographics, drug use consequences, and frequency of drug use from baseline surveys, we performed latent class analyses (LCA) stratified by HIV status and adjusted for clinical and socio-demographic covariates. Participants were, on average, age 50 (range 22–86), primarily male (95%) and African-American (64%). …

Psychosocial Correlates Of Adherence To Antiretroviral Therapy (Art) In People Living With Hiv In Kenya, Thomas M. Kamau

Seton Hall University Dissertations and Theses (ETDs)

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