Public Health Commons^™

The Dynamic Risk Factors Of Cardiovascular Disease Among People Living With Hiv: A Real-World Data Study, Ziang Liu, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Haoyuan Gao, Shujie Chen, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: This study aims to investigate the incidence and dynamic risk factors for cardiovascular diseases (CVD) among people living with HIV (PLWH).

Methods: In this population-based statewide cohort study, we utilized integrated electronic health records data to identify adult (age ≥ 18) who were diagnosed with HIV between 2006 and 2019 and were CVD event-free at the HIV diagnosis in South Carolina. The associations of HIV-related factors and traditional risk factors with the CVD incidence were investigated during the overall study period, and by different follow-up periods (i.e., 0-5yrs, 6-10yrs 11-15yrs) using multivariable logistic regression models.

Results: Among 9,082 eligible …

The Impact Of Armed Conflicts On Hiv Treatment Outcomes In Sub-Saharan Africa: A Systematic Review And Meta-Analysis, Hafte Kahsay Kebede, Hailay Abrha Gesesew, Amanuel Tesfay Gebremedhin, Paul Ward

Research outputs 2022 to 2026

Background: Despite the fact that Sub-Saharan Africa bears a disproportionate burden of armed conflicts and HIV infection, there has been inadequate synthesis of the impact of armed conflict on HIV treatment outcomes. We summarized the available evidence on the impact of armed conflicts on HIV treatment outcomes in Sub-Saharan Africa from 2002 to 2022. Methods: We searched four databases; MEDLINE, PubMed, CINHAL, and Scopus. We also explored grey literature sources and reviewed the bibliographies of all articles to identify any additional relevant studies. We included quantitative studies published in English from January 1, 2002 to December 30, 2022 that reported …

Chronic Illness Education 2024: Resources For The Providers To Improve Adult Hiv Outcome, Amolak Jhand, Ariana Cho, Brayden Bitterman, Jhonny Avila Mendoza, Madeline Evans, Sabrina Khan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2024: Educational Resources To Reduce Hiv Stigma, Joshua Sternberg, Akash Gopal, Anna Karle, Derek Zahnleuter, Gloria Fung, Surbhi Neole

Patient Education Projects

No abstract provided.

Chronic Illness Education 2024: Strategies To Improve Hiv Management, Fabiola Cuellar, Farheen Vali, Hana Jiang, Kevin Chau, Rahul Babu

Patient Education Projects

No abstract provided.

Chronic Illness Education 2024: Resources For A Transgender Person Living With Hiv Using The Chronic Illness Model., Alec Landau, Emma Keer, Francis Hernandez, Meena Kian, Reid Gordon, Vanessa Parada

Patient Education Projects

No abstract provided.

Chronic Illness Education 2024: Comprehensive Care For Patients With Hiv, Annie Hillenberg, Ibrahim Malik, Reema Smadi, Sanjeev Bola, Sean Carroll

Patient Education Projects

No abstract provided.

Gut Microbiota Profiling In Injection Drug Users With And Without Hiv-1 Infection In Puerto Rico, Nirosh Aluthge, Seidu Adams, Carmen A. Davila, Nova R. Gocchi Carrasco, Kathy S. Chiou, Roberto Abadie, Sydney J. Bennett, Kirk Dombrowski, Angel M. Major, Aníbal Valentín-Acevedo, John T. West, Charles Wood, Samodha C. Fernando

School of Medicine Faculty Publications

INTRODUCTION: The full extent of interactions between human immunodeficiency virus (HIV) infection, injection drug use, and the human microbiome is unclear. In this study, we examined the microbiomes of HIV-positive and HIV-negative individuals, both drug-injecting and non-injecting, to identify bacterial community changes in response to HIV and drug use. We utilized a well-established cohort of people who inject drugs in Puerto Rico, a region with historically high levels of injection drug use and an HIV incidence rate disproportionately associated with drug use. METHODS: Using amplicon-based 16S rDNA sequencing, we identified amplicon sequence variants (ASVs) that demonstrated significant variations in the …

Preferences For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Preexposure Prophylaxis Among Men Who Have Sex With Men In The United States (2021-2022): Nationwide Online Cross-Sectional Study, Duygu Islek, Travis Sanchez, Jennifer L. Glick, Jeb Jones, Keith Rawlings, Supriya Sarkar, Patrick S. Sullivan, Vani Vannappagari

School of Public Health Faculty Publications

BACKGROUND: Long-acting (LA) injectable preexposure prophylaxis (PrEP) and on-demand PrEP may improve overall PrEP uptake among men who have sex with men (MSM), but little is understood about the PrEP option preferences of MSM in practical scenarios where they may choose between various PrEP options. OBJECTIVE: This study aims to examine the preferences for starting various PrEP options among a US nationwide online convenience sample of MSM from September 2021 to February 2022. METHODS: Participants reporting no prior HIV diagnosis were provided brief descriptions of each PrEP option and were asked, "If [PrEP option] were available from your local doctor …

Covid-19 Breakthrough Infection After Vaccination And Substance Use Disorders: A Longitudinal Cohort Of People With And Without Hiv Receiving Care In The United States Veterans Health Administration, Elena M Soyer, Kathleen A Mcginnis, Amy C Justice, Evelyn Hsieh, Maria C Rodriguez-Barradas, Emily C Williams, Lesley S Park

Faculty, Staff and Students Publications

Research regarding HIV, substance use disorders (SUD), and SARS-CoV-2 infections after COVID-19 vaccination is limited. In the Veterans Aging Cohort Study (VACS)-HIV cohort, we followed vaccinated persons with HIV (PWH) and without HIV (PWoH) from 12/2020 to 3/2022 and linked SARS-CoV-2 test results for laboratory-confirmed breakthrough infection through 9/2022. We examined associations of substance use (alcohol use disorder [AUD], other SUD, smoking status) and HIV status and severity with breakthrough infections, using Cox proportional hazards regression hazard ratios (HR). To test for potential interactions between substance use and HIV, we fit survival models with a multiplicative interaction term. Among 24,253 …

Using Geographic Momentary Assessment To Explore Spatial Environment Influences On Wellbeing In People With Hiv, Rayna E. Gasik, Ethan A. Smith, Simone J. Skeen, Stephanie Tokarz, Gretchen Clum, Erica Felker-Kantor, Katherine P. Theall

School of Public Health Faculty Publications

Place-based socio-economic and racial inequities contribute to health disparities among people with HIV (PWH). We used geographic ecological momentary assessment (GEMA) methodologies to explore the interplay between psychosocial outcomes in daily diaries and community spatial measures among PWH in New Orleans. PWH (N = 69) were recruited from a clinic-based cohort study. Micro-longitudinal data were collected via smartphone-based daily diaries and geospatial tracking over 14 days. First, correlations were run between diary derived outcomes (e.g., feeling safe in current location, stress), and spatial measures (e.g., violent crime, alcohol outlets, and vacant lots) within a half-mile buffer around each diary point …

The Price Of Prevention: Spain And Italy's Approach To National Prep, Jon Burkart

Claremont-UC Undergraduate Research Conference on the European Union

While recent advancements in antiretroviral therapy (ART) continue to improve the outlook for people living with HIV (PLHIV), new infections remain a concern for health authorities around the world. A clinically proven intervention holds the potential to dramatically reduce new infections: Pre-exposure prophylaxis (PrEP) is a once-daily pill for high-risk populations, including men who have sex with men (MSM), that substantially reduces HIV infection risk. However—much like rates of new infection—public provision of PrEP varies considerably among OECD countries. This case study thus seeks to answer the question: What might explain the disparate timeline of adopting public reimbursement for PrEP …

The Prevalence Rate Of Syphilis And Hiv Across Different Genders, Races, And Ages From 2017 To 2021 In The Southern Region Of The United States, Nafiseh Gavari, Rita Momah, Jessica Green Collins, Elizabeth Jones

Journal of Public Health in the Deep South

This study investigates the prevalence rates of Syphilis and HIV across different genders, races, and ages from 2017 to 2021 in regions 4 (Kentucky, North Carolina, Mississippi, Tennessee, South Carolina, Georgia, Florida, and Alabama) and 6 (New Mexico, Oklahoma, Texas, Arkansas, and Louisiana). These regions have been identified as high-risk areas for sexually transmitted diseases (STDs). Our study seeks to shed light on the trends and disparities in STD prevalence within these specific regions over the specified timeframe. Data were collected and analyzed from the AtlasPlus database, providing insights into the epidemiology of these diseases. The findings reveal increasing trends …

Multi-Level Factors Associated With Hiv Late Presentation With Advanced Disease And Delay Time Of Diagnosis In South Carolina, 2005–2019, Fanghui Shi, Jiajia Zhang Ph.D., Shujie Chen, Xueying Yang Ph.D., Zhenlong Li, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

This study explored individual- and county-level risk factors of late presentation with advanced disease (LPAD) among people with HIV (PWH) and their longer delay time from infection to diagnosis in South Carolina (SC), using SC statewide Enhanced HIV/AIDS Reporting System (eHARS). LPAD was defined as having an AIDS diagnosis within three months of initial HIV diagnosis, and delay time from HIV infection to diagnosis was estimated using CD4 depletion model. 3,733 (41.88%) out of 8,913 adult PWH diagnosed from 2005 to 2019 in SC were LPAD, and the median delay time was 13.04 years. Based on the generalized estimating equations …

Transgender Women With Hiv Demonstrate Unique Non-Alcoholic Fatty Liver Disease Profiles, Jordan E Lake, Ana N Hyatt, Han Feng, Hongyu Miao, Anoma Somasunderam, Netanya S Utay, Kathleen E Corey

Faculty, Staff and Student Publications

Purpose: Non-alcoholic fatty liver disease (NAFLD) prevalence and severity may be higher in people with human immunodeficiency virus (HIV) than the general population, and vary with sex and age. We explored NAFLD characteristics by gender.

Methods: Adult transgender women (TW), cisgender women (CW), and cisgender men (CM) with HIV on antiretroviral therapy and without other known causes of liver disease underwent screening for NAFLD (2017-2020). Circulating factors associated with NAFLD were measured. Hepatic steatosis and fibrosis were assessed using transient elastography by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively. Analysis of variance/Wilcoxon testing compared normally/non-normally distributed variables, …

High Fat, High Sucrose Diet Promotes Increased Expression Of Ace2 Receptor In The Siv-Infected Host: Implications For Sars-Cov-2 Infection, Elizabeth C. Delery, Danielle E. Levitt, Angela M. Amedee, Patricia E. Molina, Liz Simon

School of Graduate Studies Faculty Publications

Introduction: People with pre-existing conditions, including metabolic comorbidities, are at greater risk for complications of SARS-CoV-2 infection and expression of machinery required for viral entry into host cells may be a contributing factor. This study tested the hypothesis that high fat, high sucrose diet (HFSD) and alcohol use increase expression of angiotensin converting enzyme 2 (ACE2) receptor and transmembrane serine protease 2 (TMPRSS2) in tissues isolated from simian immunodeficiency virus (SIV) infected macaques, the most clinically relevant model for the study of HIV. Methods: Biospecimens obtained from a longitudinal study of SIV-infected, antiretroviral therapy (ART)-treated female rhesus macaques (Macaca mulatta) …

Control And Management Of Type-Ii Diabetes Among People Living With Hiv (Plwh) Compared To Hiv-Negative Patients And By Clinic Type In The Bronx, Nyc, Aprielle Wills

Dissertations and Theses

ABSTRACT

Control and Management of Type-II Diabetes Among People Living with HIV (PLWH) compared to HIV-Negative Patients and by Clinic Type in the Bronx, NYC

by

Aprielle Wills

Advisor: Heidi E Jones, MPH PHD

Background: The Centers for Disease Control (CDC) estimated that approximately 1.3 million people in the United States (U.S.) were living with an HIV diagnosis by the end of 2021. With advancements of antiretroviral therapy (ART) and improved access to care, HIV has become a chronic condition in the U.S. As PLWH age, they are experiencing higher rates of other chronic conditions, specifically type-II diabetes (type-II …

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

Using Gps-Defined Venue-Based Affiliation Networks Among Black Sexually Minoritized Men And Transgender Women To Identify Locations For Hiv Prevention Interventions, Yen-Tyng Chen, Cho-Hee Shrader, Dustin T Duncan, Abby E Rudolph, Seann D Regan, Byoungjun Kim, Jade Pagkas-Bather, Justin Knox, Kayo Fujimoto, John A Schneider

Faculty, Staff and Student Publications

Purpose: HIV biomedical intervention uptake is suboptimal among Black sexually minoritized men (SMM) and transgender women (TW). Venues where people meet and interact shape HIV-related risk and prevention behaviors. We aimed to construct GPS-defined venue-based affiliation networks and identify the unique set of venues that could maximize reach of HIV biomedical interventions among Black SMM and TW.

Methods: We used baseline survey and GPS data from 272 Black SMM and TW in the Neighborhoods and Networks (N2) Cohort Study in Chicago, Illinois (2018-2019). We mapped participants' GPS data to the nearest pre-identified SMM- and TW-friendly venue (n = 222) to …

Childhood Sexual Abuse And Compulsive Sexual Behavior Among Men Who Have Sex With Men Newly Diagnosed With Hiv, Monique J. Brown, Medinat Omobola Osinubi, Daniel Amoatika, Mohammad Rifat Haider, Sally Kirklewski, Patrick Wilson, Nathan B. Hansen

Faculty Publications

Childhood sexual abuse (CSA) continues to be a public health challenge. The prevalence of experiencing CSA is higher among men who have sex with men (MSM) than the general population. CSA has been linked to compulsive sexual behavior (CSB) among varying populations but has not been examined among MSM who were newly diagnosed with HIV. Therefore, the aims of this study were to assess the direct association between CSA and CSB among newly diagnosed MSM living with HIV, and to identify the potential mediating roles of depressive symptoms and emotion regulation in the association between CSA and CSB. The study …

Association Of Hiv Status And Other Minoritized Identities With Psychiatric Diagnoses Among Transgender And Gender Diverse Individuals In The All Of Us Research Program, Fanghui Shi

Theses and Dissertations

Background: Transgender and gender diverse (TGD) people, whose gender identities or expressions differ from the sex assigned at birth, are disproportionately affected by adverse health outcomes, including various psychiatric diagnoses such as depression, anxiety, stress, and substance use disorders. The Gender Minority Stress Model emphasizes that TGD people face both proximal stressors at a personal/individual level (e.g., internalized stigma) and distal stressors at a societal level (e.g., discrimination) due to their minority status, which largely contributes to their increased risk of psychiatric diagnoses. Despite these health disparities, there is a paucity of gender identity data collected in large population-based health …

Transgender Women With Suppressed Testosterone Display Lower Burden Of Coronary Disease Than Matched Cisgender Men, Jordan E Lake, Han Feng, Ana N Hyatt, Hongyu Miao, Paula Debroy, Nicholas Funderburg, Kate Ailstock, Adrian Dobs, Sabina Haberlen, Jared W Magnani, Joseph B Margolick, Kate Mcgowan, Frank J Palella, Mallory D Witt, Shalender Bhasin, Matthew J Budoff, Wendy S Post, Todd T Brown

Faculty, Staff and Student Publications

Context: Cardiovascular disease (CVD) in transgender women (TW) may be affected by gender-affirming hormone therapy (GAHT) and HIV, but few data compare TW on contemporary GAHT to well-matched controls.

Objective: We compared CVD burden and biomarker profiles between TW and matched cisgender men (CM).

Methods: Adult TW on GAHT (n = 29) were recruited for a cross-sectional study (2018-2020). CM (n = 48) from the former Multicenter AIDS Cohort Study were matched 2:1 to TW on HIV serostatus, age ±5 years, race/ethnicity, BMI category and antiretroviral therapy (ART) type. Cardiac parameters were measured by CT and coronary atherosclerosis by coronary …

The Impact Of Childhood Adversity On Life Course Alcohol Use Patterns And Health Status Among People Living With Hiv, Rayna E. Gasik, Aubrey Spriggs Madkour, Simone J. Skeen, Gretchen Clum, Tishawn Francis, Erica Felker-Kantor, Tekeda Ferguson, David A. Welsh, Patricia E. Molina, Katherine P. Theall

School of Public Health Faculty Publications

Adverse childhood experiences (ACEs) and financial hardship are associated with increased likelihood of heavier alcohol use and health challenges in adulthood among persons living with HIV (PWH). We examined whether retrospectively captured lifetime drinking trajectories are a pathway through which childhood hardships affect current health in a sample of 365 adult PWH. Childhood economic hardship and ACEs were used as main predictors. Measures of alcohol use included age at first drink and lifetime drinking trajectories. Health indicators included health-related quality of life, frailty, number of comorbidities, and symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Structural equation modeling (SEM) …

Rural Veterans With Hiv And Alcohol Use Disorder Receive Less Video Telehealth Than Urban Veterans, Alan Z Sheinfil, Giselle Day, Annette Walder, Julianna Hogan, Thomas P Giordano, Jan Lindsay, Anthony Ecker

Faculty, Staff and Students Publications

Purpose: Alcohol use disorder (AUD) is highly prevalent among Veterans with HIV. Rural Veterans with HIV are at especially high risk for not receiving appropriate treatment. This retrospective cohort cross-sectional study aimed to investigate patterns of mental health treatment utilization across delivery modality among Veterans diagnosed with HIV and AUD. It was hypothesized that rural Veterans with HIV and AUD would receive a lower rate of mental health treatment delivered via video telehealth than urban Veterans with HIV and AUD.

Methods: A national Veterans Health Association administrative database was used to identify a cohort of Veterans diagnosed with HIV and …

Institutionalized Stigmas: Hiv Stigma, Racism And Heterosexism Among Medical Students In The Southern United States, Krishen D. Samuel

Graduate Theses and Dissertations

Background: Intersecting and related forms of stigma, including HIV-related stigma, racism, and heterosexism, disproportionately impact both communities vulnerable to acquiring HIV and people living with HIV (PLHIV), ultimately impacting more distal outcomes related to HIV prevention, treatment, and epidemiological patterns in the United States (US). The Southern US is the region most impacted by new HIV diagnoses, mainly among Black men who have sex with men (MSM). However, there is a paucity of research on medical students, specifically those in the Southern US, regarding stigmatizing attitudes they may hold towards PLHIV, and how these associate with racism and heterosexism. This …

A Comparative Analysis Of Hiv/Aids In France And The United States: Historical Context And Preventative Actions, Rebecca A. Liebsack

Honors Program: Senior Projects (Public)

The HIV/AIDS pandemic is the result of transmission of a zoonotic disease known as simian immunodeficiency virus. The pandemic has had profound social and economic consequences and continues to be present today. France and the United States’ response to the discovery of HIV will be compared and the impact that HIV/AIDS had on their countries and future responses. They had rather similar responses, however, the United States had a slower initial response compared to France. Both had similar takeaways such as aiming at improving prevention and utilizing tactics developed during the start of the pandemic like frequent testing and vaccines.

Examining The Relationship Between Mass Incarceration, Gender Norms, And Hiv Vulnerability For Formerly-Incarcerated Black Men Who Have Sex With Men And Women., Adrienne B. Smith

Electronic Theses and Dissertations

In 2018, Black Americans represented 42% of new HIV diagnoses, despite comprising only 13% of the population. Moreover, Black men accounted for three-quarters of new HIV cases in 2016, with Black gay/bisexual men contributing to the majority of incidence among Black Americans. Existing literature suggests that individual behavior alone cannot explain these racial inequities in HIV rates. This study aims to explore the role of the criminal legal system (CLS) as a structural determinant of health, given its historical racial implications that disproportionately affect Black Americans. Additionally, the study examines masculinity’s influence as a predictor of risky sexual behavior. This …

Examining The Risks And Resilience Of Older Adults Living With Hiv/Aids: Qualitative Community-Based Participatory Research Studies In Southern Nevada, Brandon Ranuschio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since the height of the HIV pandemic in the 1980s, medical interventions have significantly increased the life expectancy of people living with HIV/AIDS (PLWH) and made HIV/AIDS a livable, chronic health condition. Because of this, PLWH have been living longer lives and thriving with the help of HIV sector healthcare and service providers. However, with their longer life expectancy, older PLWH have been experiencing other health challenges. One such challenge is the risk of developing HIV-Associated Neurocognitive Disorder (HAND), which is a condition that affects up to 50% of PLWH at some point in their lifetime, with middle-aged and older …

Exploring Disparities In Prep Prescriptions For High-Risk Hiv Patients Using Real-World Data, Andrew Murdock, Farah Pathan, Sibyl Munson, Fabian D'Souza

Tower Health Research Day

No abstract provided.

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …