Community Health and Preventive Medicine Commons^™

Relationship Between Treatment Comorbidities And Viral Suppression Of Hiv Infections In Johannesburg, Nwogo Ekeji, Nwogo Immaculata Ekeji

School of Health Sciences Publications

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for …

Relationship Between Treatment Comorbidities And Viral Suppression Of Hiv Infections In Johannesburg, Nwogo Ekeji, Nwogo Immaculata Ekeji

Walden Faculty and Staff Publications

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for …

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty and Staff Scholarship

Background:

Chronic immune activation and CD4⁺ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4⁺ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4⁺ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …

Hiv Preexposure Prophylaxis And Treatment As Prevention — Beliefs And Access Barriers In Men Who Have Sex With Men (Msm) And Transgender Women: A Systematic Review, Joshua J. Matacotta, Francisco J. Rosales-Perez, Christian M. Carrillo

Journal of Patient-Centered Research and Reviews

Purpose: While the annual rate of new HIV infections and diagnoses has remained stable for most groups, troubling increases are seen in transgender women and racial/ethnic-minority men who have sex with men (MSM), groups that are disproportionately affected by HIV. The primary purpose of this systematic review is to examine factors that impact attitudes and beliefs about preexposure prophylaxis (PrEP) and treatment as prevention (TasP) and to explore barriers to PrEP uptake in MSM and transgender women.

Methods: Using MeSH terms and relevant keywords, we conducted a systematic review of studies published between 2010 and 2019. We searched 4 literature …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

A Novel Approach To Hiv Prevention: Understanding Multi-Level Influences On Hiv Pre-Exposure Prophylaxis (Prep) Uptake And Outreach Among African Americans., Suur Debrah Ayangeakaa

Electronic Theses and Dissertations

This dissertation examined and provided basis for addressing factors related to HIV pre-exposure prophylaxis (PrEP) engagement, outreach, and uptake among high-risk African American youth groups in Louisville, KY. This qualitative dissertation study was designed through the lens of an interpretive framework of social constructivism which holds that multiple realities and interpretations exist and are socially constructed through the lived experiences of individuals and their interactions with others. Thus, lived experiences of various African American youth groups in Louisville as well as key informants of AIDS service organizations (ASOs) across the U.S. (including Louisville) were explored to develop a deeper understanding …

Factors Associated With Prep And Pep Uptake Among The Latinx Population, Santiago Gudiño-Rosales, Melva Thompson-Robinson, Johanna Andrews

Calvert Undergraduate Research Awards

Advanced Undergraduate Winner

Uptake of PrEP and PEP amongst LatinX population has been low, despite being a population disproportionately affected by HIV. Systemic barriers and cultural factors affect general LatinX approaches to healthcare and may impact uptake of these medications. The purpose of this study is to assess the factors that are associated with the likelihood to take PrEP and PEP in the LatinX population. In this cross-sectional study, survey data was collected from 169 LatinXs from January - March 2020. Using the Sexual Health Model as the theoretical framework, the survey examined the following four constructs to identify factors …

Impact Of The Affordable Care Act On Referral To Care For People Living With Hiv In Appalachia, Cameron A. Wade, Timothy N. Crawford, Nicole Leedy, Alice C. Thornton

Journal of Appalachian Health

Introduction: The Affordable Care Act (ACA) enacted on March 23, 2010 significantly impacted access to healthcare for people living with HIV (PLWH). Expansion of care was accomplished in three areas: eliminating exclusions for pre-existing conditions, elimination of lifetime caps on healthcare expenditures, and expansion of Medicaid eligibility.

Purpose: This study evaluated the impact of state implementation of the ACA Medicaid expansion on referral to HIV care at a Ryan White federally funded clinic in Kentucky (University of Kentucky Bluegrass Care Clinic [UK BCC]).

Methods: Retrospective chart review of all newly enrolled patients at the UK BCC between March 2010 and …

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

Capstone Showcase

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

Evangeline Wang

Faculty Advisor: Dr Olorunsaiye

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

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

Hiv Diagnosis Disclosure To Infected Children And Adolescents; Challenges Of Family Caregivers In The Central Region Of Ghana, Anna Hayfron-Benjamin, Dorcas Obiri-Yeboah, Stephen Ayisi-Addo, Peter Mate Siakwa, Sylvia Mupepi

Peer Reviewed Articles

Background

Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

School of Public Health Faculty Research

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

Injection Partners, Hcv, And Hiv Status Among Rural Persons Who Inject Drugs In Puerto Rico, Patrick Habecker, Roberto Abadie, Melissa L. Welch-Lazoritz, Juan Carlos Reyes, Bilal Khan, Kirk Dombrowski

Department of Sociology: Faculty Publications

Background—The prevalence of hepatitis C (HCV) and HIV among persons who inject drugs (PWID) and the ability of these diseases to spread through injection networks are well documented in urban areas. However, less is known about injection behaviors in rural areas.

Objectives—This study focuses on the association between the number of self-reported injection partners with the PWID’s self-reported HCV and HIV status. Injection networks provide paths for infection and information to flow, and are important to consider when developing prevention and intervention strategies.

Methods—Respondent driven sampling was used to conduct 315 interviews with PWID in rural Puerto Rico during 2015. …

Thrive With Me: Protocol For A Randomized Controlled Trial To Test A Peer Support Intervention To Improve Antiretroviral Therapy Adherence Among Men Who Have Sex With Men, Keith J. Horvath, K. Rivet Amico, Darin Erickson, Alexandra M. Ecklund, Aldona Martinka, James Dewitt, Jeffrey Mclaughlin, Jeffrey T. Parsons

Publications and Research

Background: The suboptimal rate of viral suppression among persons aged 13 years and older and residing in 37 states and the District of Columbia leaves considerable opportunities for onward transmission and contributes to poor health outcomes. Men who have sex with men (MSM) represent one of the most at-risk groups in the United States. There is a clear and continued need for innovative adherence support programs to optimize viral suppression. To address this gap, we designed and are implementing a randomized controlled trial (RCT) to test the efficacy of the Thrive with Me intervention for MSM living with HIV. Critical …

Hiv Mortality Difference Between Black And White Women, Carlos O. Nesbeth, Rajiv Kandala, Syed Najeeb, Ruksana Nazneen, Banglore Murthy

Journal of Health Disparities Research and Practice

OBJECTIVE

In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups^². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities.

METHODS

Information was accessed through public data, the US Census, and the US Compressed Mortality File.

RESULTS

In these descriptive data from 1987 through 2015, including reliable HIV …

An Hiv-Positive Patient With Copd Admitted To The Icu With Respiratory Failure, Bhavani Puskur, Veronica Corcino, Srikant Ramachandruni, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Exploring Psychosocial Factors And Sexual Risk Behavior Of Men Who Have Sex With Men In The United States Military: Project Minds, Erin Jordan

College of Graduate Studies: Theses & Dissertations

Statement of the Problem: Men who have sex with men (MSM) are at disproportionate risk for HIV infection. While many studies have examined psychosocial factors associated with HIV risk among MSM, few have focused specifically on MSM in the military. The purpose of this exploratory study is to examine ways in which specific psychosocial factors are associated with sexual risk behaviors among MSM in the military.

Methods: Data were collected from 63 MSM who were active duty military personnel or veterans in the Southeastern US. Participants were recruited from geosocial mobile applications, social media platforms, and military LGBT organizations. Logistic …

Adolescent Medicine Trials Network For Hiv/Aids Interventions Data Harmonization: Rationale And Development Of Guidelines, Micah Mccumber, Demetria Cain, Sara Legrand, Kenneth H. Mayer, Debra A. Murphy, Matthew A. Psioda, Arlene C. Seña, Tyrel J. Starks, Michael Hudgens

Publications and Research

Background: The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) research program aims to defeat the rising HIV epidemic among adolescents and young adults in the United States.

Objective: This study aims to optimize cross-study analyses and comparisons of standardized measures (variables) collected in the ATN. Methods: Guidelines were developed for harmonizing measures to be collected across ATN studies.

Results: Eight domains were identified for harmonization—Demographics and Socioeconomic Characteristics, Sexual Behavior and Risk, Substance Use and Abuse, HIV-Positive Cascade, HIV-Negative Cascade, Mental Health, Social Support and Isolation, and Pre-exposure Prophylaxis Cascade.

Conclusions: The collection of selected key measures in a …

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

The Impact Of African American Male Incarceration Rates On The Racial Disparities In Hiv/Aids Rates, Michelle S. Aelion

DePaul Discoveries

In the United States, HIV/AIDS disproportionately impacts African Americans and African American communities. The nature of this national health disparity is complex and cannot be explained simply by one factor or an individual’s behavior within a given community. This paper suggests that the disparity in African American male incarceration rates is among the most important factors to consider in the racial disparities of HIV/AIDS rates. Existing studies on relevant subjects were examined and used to create a conceptual model of factors. This model presents an outline of factors during pre-incarceration, incarceration, and post-incarceration that contribute to the racial disparities in …

Prenatal Care Providers’ Perspectives And Practices: Informed Consent For Hiv Screening Among Latinas With Limited English Proficiency In South Carolina, Edena G. Meetze

Journal of Health Disparities Research and Practice

Abstract

The rapid increase in Latinos in South Carolina that has occurred within the past 15 years is associated with both in-migrationand high birth rates. Limited ethnic-specific data and communication barriers betweenLatinas with limited English proficiency have contributed to difficulties in assessing theprovision of recommended routine prenatal HIV screening among this vulnerablepopulation. This qualitative descriptive study examined providers' perceptions andpractices related to obtaining informed consent for routine HIV screening for pregnantLatinas with limited English proficiency. Findings indicate the need for focused educational interventionswith providers and patients and implementation of culturally and linguistically tailoredpractice guidelines to improve patient understanding and acceptance …

Namibia : Hiv As A National Issue, Elisabeth Vlasak

Global Public Health

Namibia is located on the southwestern coast of Africa, bordering Angola, Botswana, Zambia, South Africa, and the Atlantic Ocean. Namibia has a population of 2,265,000, as of 2016. Namibia has many challenges, including food insecurity and malnutrition, access to health services, unequal distribution of wealth, but HIV/AIDS is one of the country’s leading challenges. It is estimated that the overall adult infection rate of HIV/AIDS is 15.4% and it is the leading cause of death in Namibia. Adults ages 18-24 are the most at-risk for the disease. Some of the major risk factors are declining condom use, misinformation, social stigma, …

West Virginia Needle Exchange Program, Briana Washington, Sara Johnson

Theses, Dissertations and Capstones

Introduction: Needle Exchange Programs (NEPs) have been controversial aspects of public healthcare due to conflicting beliefs and opinions for public policies. NEPs allow Injection Drug Users (IDUs) the ability to exchange their used equipment for clean, unused supplies.

Purpose: The purpose of this literature review was to determine the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. It further explores if these strategies have had a positive impact on the reduction of HIV and viral hepatitis C in West Virginia.

Methodology …

What Are The Most Commonly Used Tools To Screen Depression In Hiv-Infected Gay And Bisexual Men?, Michael Isner

Honors Undergraduate Theses

Gay and bisexual men infected with human immunodeficiency virus (HIV) comprise a sizable, medically vulnerable population. Depression is the most commonly experienced mental health disorder affecting this group of people, lending itself to a host of risks associated with depression. As screening of depression in this population can be challenging, it is vital that clinicians have the best available tools and guidelines to detect depressive symptomology. This focused, comprehensive review of the literature examined current data describing the clinical instruments used to detect depressive symptoms in HIV-infected gay and bisexual men. The aim of this analysis was to seek out …

Hiv Vaccines: Progress, Limitations And A Crispr/Cas9 Vaccine, Omar A. Garcia Martinez

Biology: Student Scholarship & Creative Works

ABSTRACT: The HIV-1 pandemic continues to thrive due to ineffective HIV-1 vaccines. Historically, the world’s most infectious diseases, such as polio and smallpox, have been eradicated or have come close to eradication due to the advent of effective vaccines. Highly active antiretroviral therapy is able to delay the onset of AIDS but can neither rid the body of HIV-1 proviral DNA nor prevent further transmission. A prophylactic vaccine that prevents the various mechanisms HIV-1 has to evade and attack our immune system is needed to end the HIV-1 pandemic. Recent advances in engineered nuclease systems, like the CRISPR/Cas9 system, have …

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 …

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 …

Loneliness And Drinking In An Hiv Positive Population, Erica Kiernan, Krishna Chhabria

Public Health Collection

Background: Loneliness is a common outcome in the HIV+ community due to the stigma associated with it leading to social isolation. Studies show HIV+ individuals who experience significant loneliness do engage in risky sexual behaviors. Alcohol use also has adverse consequences in this population, interfering with antiretroviral medication adherence thus an increased likelihood of further risky sexual behaviors.

Hypothesis: HIV+ individuals who experience an increase in loneliness will have an increase in hazardous drinking behaviors.

Methods: 100 patients from an HIV treatment clinic in Jacksonville, Florida were administered the AUDIT scale to measure drinking habits and UCLA loneliness scale. …