Public Health Commons^™

The Accuracy Of Anal Self- And Companion Exams Among Sexual Minority Men And Transgender Women: A Prospective Analysis, Alan G Nyitray, Timothy L Mcauliffe, Cameron Liebert, Michael D Swartz, Ashish A Deshmukh, Elizabeth Y Chiao, Lou Weaver, Ellen Almirol, Jared Kerman, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Aniruddha Hazra

Faculty, Staff and Student Publications

BACKGROUND: Squamous cell carcinoma of the anus (SCCA) annual incidence among sexual minority men with and without HIV is 85/100,000 and 19/100,000 persons, respectively, which is significantly higher than the overall incidence (2/100,000). Incidence may also be higher in transgender women. Since SCCA tumours average ≥30 mm at diagnosis, we assessed the accuracy of individuals to self-detect smaller anal abnormalities.

METHODS: Using convenience sampling, the study enrolled sexual minority men and transgender women, aged 25-81 years, in Chicago, Illinois and Houston, Texas, USA, during 2020-2022. Individuals were taught the anal self-examination and anal companion examination (ASE/ACE). Then, a clinician performed …

Sexual Orientation And Gender Identity Measures And Viral Suppression For People Living With Hiv: A Protocol For A Population-Based Cohort Study, Xueying Yang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Introduction The measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. …

Knowledge And Attitudes On Contraception And Reproductive Health In Women With Hiv, Anna Henricks, Samantha Singal, Dana Hughes, Sean Kelly, Jessica L Castilho, Jamison Norwood

Faculty, Staff and Student Publications

BACKGROUND: For reasons not fully explained to date, contraception usage among women with HIV remains low. The aim of our study was to understand attitudes toward and lifetime use of contraception among women with HIV.

METHODS: We administered an anonymous, community-informed, voluntary survey to cisgender, English-speaking women with HIV (≥18 years of age) at a Southern urban HIV clinic. It included multiple choice and Likert-scale questions on reproductive health. Participants reported contraception use, recollection of provider conversations about contraception, and perceived empowerment and knowledge regarding reproductive health. We used chi-square and Fisher exact tests to compare attitudes and prior conversations …

A Conceptual Analysis Of Sbirt Implementation Alongside The Continuum Of Prep Awareness: Domains Of Fit And Feasibility., Lesley M. Harris, Kerr C. Jelani, Blake D. Skidmore, Smita Ghare, Andrea Reyes-Vega, Vania Remenik-Zarauz, Harideep Samanapally, Rana U. Anwar, Rishikesh Rijal, Kendall Bryant, Martin T. Hall, Shirish Barve

Faculty and Staff Scholarship

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a supplementary intervention that can be incorporated into the Pre-Exposure Prophylaxis (PrEP) Care Continuum, complementing initiatives and endeavors focused on Human Immunodeficiency Virus (HIV) prevention in clinical care and community-based work. Referencing the Transtheoretical Model of Change and the PrEP Awareness Continuum, this conceptual analysis highlights how SBIRT amplifies ongoing HIV prevention initiatives and presents a distinct chance to address identified gaps. SBIRT's mechanisms show promise of fit and feasibility through (a) implementing universal Screening (S), (b) administering a Brief Intervention (BI) grounded in motivational interviewing aimed at assisting individuals in …

Opportunities For Prep In High Risk Hiv Negative Patients, Steven Veselsky, Erin Smith, Amethyst Wilder, Misty Burkes, Nnamdi Ilouga, Jean B. Wiggins, Erik Shaw, William Hannah

South Atlantic Division GME Research Day 2024

No abstract provided.

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

The Effects Of Stigma Within The Prep Care Cascade Among People Who Inject Drugs In Rural Kentucky, Abby Burton

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

Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis …

Engaging Sexual Minority Adolescents In Nationwide At-Home Hiv Prevention Research In The U.S, Ali J. Talan, Carly Wolfer, Nicola Tavella, Cynthia Cabral, Ricardo Despradel, H. Jonathon Rendina

Publications and Research

Objectives: This study examined research-related privacy and confidentiality concerns among adolescent sexual minority males (ASMM) and provides lessons learned to inform recruitment and enrollment strategies for this population.

Methods: Participants were a 2017-2018 internet-based U.S. national sample of sexual minority adolescents who responded to self-report measures of privacy and confidentiality concerns. Results: Bivariate chi-square tests were used to identify participants’ mean differences in worry and likelihood of privacy breach occurrences. Many participants reported privacy-related concerns within remote HIV prevention research.

Conclusions: Study protocols were designed to ensure participants felt safe participating in online HIV prevention research. However, there are challenges …

Use Of Machine Learning Approaches To Predict Transition Of Retention In Care Among People Living With Hiv In South Carolina: A Real-World Data Study, Ruilie Cai, Xueying Yang Ph.D., Yunqing Ma, Hao H. Zhang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Maintaining retention in care (RIC) for people living with HIV (PLWH) helps achieve viral suppression and reduce onward transmission. This study aims to identify the best machine learning model that predicts the RIC transition over time. Extracting from the enhanced HIV/AIDS reporting system, this study included 9765 PLWH from 2005 to 2020 in South Carolina. Transition of RIC was defined as the change of RIC status in each two–year time window. We applied seven classifiers, such as Random Forest, Support Vector Machine, eXtreme Gradient Boosting and Long–short–term memory, for each lagged response to predict the subsequent year's RIC transition. Classification …

Assessment Of Deficits In Specific Cognitive Domains In Older Adults Living With Hiv., Andrea Reyes-Vega, Harideep Samanapally, Rishikesh Rijal, Stephen P. Furmanek, Christopher B. Shields, Brandon C. Dennis, Smita Ghare, Shirish Barve

Faculty and Staff Scholarship

A significant proportion of people living with HIV (PLWH) have cognitive impairment. Moreover, approximately 70% of PLWH in the United States will be ≥50 years old by 2030, raising concerns of a higher incidence of dementia as they age. Accordingly, there is a clinical need to monitor their cognitive status. The aim of this study was to delineate specific cognition areas impacted in OALWH with a clinical diagnosis of neurocognitive impairment. We used a comprehensive set of tests (paper and NIH Toolbox Cognition Battery), to assess different cognitive domains in a total of 25 OALWH ≥ 50 years. 64% were …

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …

The Perpetuation Of Hiv Risk In Latinx Immigrations: A Cross-National Perspective, J. M. Aleman

Open Access Theses & Dissertations

Research indicates that migration is a social determinant of health that increases the risk of acquiring HIV. What is less understood, however, are the pathways through which immigration influences HIV risk. This study employed a cross-national perspective and utilized a social determinants of health framework to understand how structural factors, such as economic conditions and immigration policies and their enforcement, influence HIV risk among migrants. While mobility, migration and displacement are associated with increased HIV risk, they are not inherently the cause but rather a condition under which vulnerability is increased indicating that other distal, upstream, or structural forces are …

Covid-19 Prevention, Testing, And Treatment Seeking Among People Who Inject Drugs (Pwid) On The Us Mexico Border, Jorge Raul Puentes

Open Access Theses & Dissertations

The outbreak of the COVID-19 pandemic exacerbated the negative social determinants of health that affect medically underserved people who inject drugs (PWID) inhibiting their access to services, promoting infectious disease acquisition such as HIV and HCV, and overdose rates. The effects of the pandemic were more pronounced among Latino PWID communities. Participants of this study are 194 PWID residing in El Paso, Texas, and Cd. Juarez, Chihuahua along the US-Mexico border. Cross-sectional surveys were administered assessing environmental risk factors that impact COVID-19 acquisition and engagement in preventive behaviors. The purpose of this secondary data analysis study was to describe the …

Impact Of Post-Incarceration Care Engagement Interventions On Hiv Transmission Among Young Black Men Who Have Sex With Men And Their Sexual Partners: An Agent-Based Network Modeling Study, Anna L Hotton, Francis Lee, Daniel Sheeler, Jonathan Ozik, Nicholson Collier, Mert Edali, Babak Mahdavi Ardestani, Russell Brewer, Katrina M Schrode, Kayo Fujimoto, Nina T Harawa, John A Schneider, Aditya S Khanna

Faculty, Staff and Student Publications

BACKGROUND: Understanding the impact of incarceration on HIV transmission among Black men who have sex with men is important given their disproportionate representation among people experiencing incarceration and the potential impact of incarceration on social and sexual networks, employment, housing, and medical care. We developed an agent-based network model (ABNM) of 10,000 agents representing young Black men who have sex with men in the city of Chicago to examine the impact of varying degrees of post-incarceration care disruption and care engagement interventions following release from jail on HIV incidence.

METHODS: Exponential random graph models were used to model network formation …

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

Needle Exchange Programs And Their Impact On Hiv Incidence In West Virginia: Is It Working?, Amber Graves, Katie Duty, Thomas Norton, Alberto Coustasse

Management Faculty Research

The opioid epidemic has had a strong impact on West Virginia, due to various social, economic, cultural, and environmental hardships. To aid users, Needle Exchange Programs (NEPs) were created to exchange used needles for new sterile ones and provide awareness of treatment and rehabilitation options. This study aimed to assess the effectiveness of NEPs in reducing HIV and Hepatitis C infections in West Virginia, and the subsequent decrease in healthcare costs. In 2018 and 2019, there was an HIV outbreak in Cabell County, with 85 cases requiring CDC intervention in 2019. This occurred after the county-run needle exchange was reduced. …

Chronic Illness Education 2023: Increasing Prevention And Knowledge Of Hiv Among At-Risk Youth In The Metro Detroit Area, Carly Abrahams, Nicholas Apostolakis, Angelica Cabatu, Era Cobani, Curtis Mack, Michal Ruprecht, Zachary Vaishampayan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: A Comprehensive Survey To Follow-Up With Young Individuals Recently Diagnosed With Hiv, Brock Bradley, Pranally Desai, Nathan Li, Eve Sherbin, Jeremy Taigman, Zachary Vaishampayan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: Five Easy Ways To Stick To Your Perinatal Hiv Treatment Plan, Simran Brar, Gabrielle Cowen, Anastasia Goldbaum, Austin Kim, Cole Sabinash, Kassim Salami, Zachary Vaishampayan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: Increasing Mental Health Resource Availability For Hiv Positive Youth, Abrielle Fretz, Peter Nolan, Daphne Pate, Cassandra Pecarski, Trisha Ray, Anusha Vavilikolanu, Zachary Vaishampayan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: Empowerment Through Connection: Peer-To-Peer Support For At Risk And Hiv Positive Youth, Christian Freitag, Daniel Gealer, Ryan Katz, Abigail Limary, Anne Patterson, Katelyn Toloff, Zachary Vaishampayan

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: Hiv Treatment Accessibility & Access To Clinics (Ages 18+) In Detroit, Brennan Burrows, Gabriella Cascio, Tiffany Chu, Samantha Odeesho, Sumeet Saini, Nickolas Vinokurov, Zachary Vaishampayan

Patient Education Projects

No abstract provided.

Developing An Ethical Framework-Guided Instrument For Assessing Bias In Ehr-Based Big Data Studies: A Research Protocol, Shan Qiao Ph.D., George Khushf, Xiaoming Li, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction The emergence of Big Data health research has exponentially advanced the fields of medicine and public health but has also faced many ethical challenges. One of most worrying but still under-researched aspects of the ethical issues is the risk of potential biases in data sets (eg, electronic health records (EHR) data) as well as in the data curation and acquisition cycles. This study aims to develop, refine and pilot test an ethical framework-guided instrument for assessing bias in Big Data research using EHR data sets.

Methods and analysis Ethical analysis and instrument development (ie, the EHR bias assessment guideline) …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

Who Is At Risk For New Hepatitis B Infections Among People With Hiv?, John M Sladic, Barbara S Taylor, Mae Thamer, Karen J Vigil, Onkar Kshirsagar, Anna Taranova, Andrew Mccracken, Carmen G Sanchez, Mamta K Jain

Faculty, Staff and Student Publications

Hepatitis B virus (HBV) increases morbidity and mortality among people with HIV (PWH). We retrospectively analyzed HBV incidence among 5785 PWH. Fourteen had newly positive hepatitis B s antigen (mean 5.2 person-years of follow-up, 46.4/100 000 infections/year). These data show gaps in HBV vaccination and in the preventative efficacy of HBV-specific antiretroviral therapy.

The Red Ribbon And The Black Cross: A Qualitative Study Of The Relationship Between Social Activism And Contemporary Black Church Responses To Hiv In Oakland, Ca, Justise Wattree

McNair Research Journal SJSU

The Black Church as a social institution has been a source of social activism during racial crises, but there is a lacking social activist response by Black churches to HIV’s disparate impact on Black communities. Previous research does not adequately explore the influence of community-based organizations on Black church responses to HIV in the context of social activism. This study examines the relationship between social activism and contemporary Black church responses to HIV in Oakland. It considers community-based organizations (CBOs) as potential drivers of social activism. Semi-structured interviews with Black church leaders in Oakland were conducted and content analyzed along …

Strategies For Improving Mental Health And Wellbeing Used By Adults Ageing With Hiv From The Kenyan Coast: A Qualitative Exploration, Peter Mwangala, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing.

Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in …

Designing A Local Policy To Reduce Hiv In Mexico City, Mayar Al Mohajer

Faculty, Staff and Students Publications

The Joint United Nations Program on human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (Joint United Nations Program on HIV/AIDS, UNAIDS) has recommended 90-90-90 goals to increase the number of patients who are aware of their status, on antiretroviral therapy, and have undetectable viral loads. Mexico City has made several achievements to aid in prevention, early diagnosis, and treatment; however, the incidence of HIV has not decreased over the past decade. This article reviews global initiatives that were successful in achieving some or all these metrics and provide a road map for Mexico to reach the desired goals.

Navigating Life With Hiv As An Older Adult On The Kenyan Coast: Perceived Health Challenges Seen Through The Biopsychosocial Model, Patrick Mwangala, Ryan G. Wagner, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Objectives: This study explores the perceptions of adults living with HIV aged ≥50 years (recognized as older adults living with HIV—OALWH), primary caregivers and healthcare providers on the health challenges of ageing with HIV at Kilifi, a low literacy setting on the coast of Kenya.

Methods: We utilized the biopsychosocial model to explore views from 34 OALWH and 22 stakeholders on the physical, mental, and psychosocial health challenges of ageing with HIV in Kilifi in 2019. Data were drawn from semi-structured in-depth interviews, which were audio-recorded and transcribed. A framework approach was used to synthesize the data.

Results: Symptoms of …

Protocol For Developing A Personalised Prediction Model For Viral Suppression Among Under-Represented Populations In The Context Of The Covid-19 Pandemic, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction Sustained viral suppression, an indicator of long-term treatment success and mortality reduction, is one of four strategic areas of the 'Ending the HIV Epidemic' federal campaign launched in 2019. Under-represented populations, like racial or ethnic minority populations, sexual and gender minority groups, and socioeconomically disadvantaged populations, are disproportionately affected by HIV and experience a more striking virological failure. The COVID-19 pandemic might magnify the risk of incomplete viral suppression among under-represented people living with HIV (PLWH) due to interruptions in healthcare access and other worsened socioeconomic and environmental conditions. However, biomedical research rarely includes under-represented populations, resulting in biased …