Epidemiology Commons^™

Factors Associated With Hiv Infection Among People Who Inject Drugs In Jakarta, Igo Cahya Negara, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

HIV infection among people who inject drugs (PWID) remains a substantial public health burden, with Jakarta consistently reporting among the highest PWID-associated HIV prevalence in Indonesia. This study aimed to identify factors associated with HIV infection among PWID in Jakarta, utilizing secondary data from the 2023 Integrated Biological and Behavioral Survey (IBBS 2023). A cross-sectional study design was employed using secondary data from 261 PWID recruited in Jakarta. Bivariate associations were examined using Chi-square tests, and multivariate analysis was performed using modified Cox regression with a constant time parameter to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals. The …

Determinants Of Antiretroviral Therapy Status Among Men Who Have Sex With Men (Msm) Living With Hiv In Greater Jakarta, Leonita Agustine, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

Men who have sex with men (MSM) are a key population contributing to the largest proportion of new HIV infections among the adult population in Indonesia, accounting for 44% of new infections in 2024. However, antiretroviral therapy (ART), as a key intervention in HIV control, remains suboptimal among this group, with previous studies showing that only around 57% of MSM living with HIV in Indonesia were receiving ART. In urban settings such as Greater Jakarta, these gaps may be more pronounced due to complex social and structural barriers to care. This study used a cross-sectional design based on data from …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Effect Of The Sava Syndemic On Hiv Viral Suppression Among People Living With Hiv In The United States: A Scoping Review And Meta-Analysis, Jacquelyn Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The SAVA syndemic highlights the interconnected and mutually reinforcing nature of substance use, violence victimization, and HIV/AIDS. The synergistic interaction of these conditions creates structural and behavioral barriers that disrupt the HIV care continuum and contribute to significant health inequities. Achieving a suppressed viral load is a critical clinical outcome for people living with HIV, while viral non-suppression can be an indicator of poor health, elevated transmission risk, and disease progression. Still, the association between SAVA factors and viral suppression/non-suppression outcomes within U.S. populations remains inconsistently characterized due to heterogeneous methodologies and variable inclusion of high-risk groups. This mixed-methods study …

Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Mental health diagnoses have been linked to poor HIV treatment outcomes and poorer quality of life among people living with HIV (PLWH). Therefore, this study aimed to investigate the association between sociodemographic and HIV-related characteristics, and common and serious mental health disorders among PLWH in South Carolina (SC). Data were obtained from the integrated system of statewide electronic health record (EHR) data in SC (2006–2019; N = 8,124). Multivariable logistic regression models were used to determine the associations between sociodemographic and HIV-related characteristics, and common mental health disorders and serious mental health disorders. Among the study population, 4% were 60 …

Analisis Cakupan Penemuan Kasus Tuberkulosis (Treatment Coverage) Berdasarkan Faktor Demografis Dan Komorbiditas Di Puskesmas Ciracas Tahun 2023-2024, Anggie Hardiyanti, Helda Helda, Mufti As Siddiq M. Irzal, Mareska Monica

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major global and national health burden, with case detection coverage still below target in several regions. The success of TB control programs largely depends on achieving adequate treatment coverage. In East Jakarta, Ciracas Primary Health Center recorded a treatment coverage of 75% (497 cases) in 2023, the lowest among ten centers, and an increase to 84% (509 cases) in 2024, though still below the national target of 90%. To analyze TB case detection coverage based on demographic factors and comorbidities (diabetes mellitus and Human Immunodeficiency Virus) at Ciracas Primary Health Center during 2023–2024. This study …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

Clinical Phenotypes Of Motor Neurone Disease In A Kenyan Hospital-Based Population, Effie Nailah Kamadi, Jasmit Shah, Juzar Hooker, Thomas Jenkins, Dilraj Sokhi

Internal Medicine, East Africa

Background: Motor neurone disease (MND) presentation is globally heterogenous and data on the clinical phenotype in Sub-Saharan Africa (SSA) is scarce. We sought to address this by describing the profile of MND patients in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed in the facility between January 2010 and December 2023 were retrospectively reviewed. The biographical data and clinical features of these patients were captured from their electronic and manual health records and statistical analysis performed.

Results: In total, 160 patients had their data analyzed. The male to female ratio was 1.76:1. The median …

Impact Of Covid-19 Pandemic On Quality Of Life, Anxiety, Connections To Friends, And Access To Resources Among People With Hiv: Using The Social Ecological Model, Carol Dawson-Rose, Christine Davey, Emily Huang, Laura Cox, Phillips Craig, Motshedisi Sabone, Lufuno Makhado, Emilia Iwu, Kathleen Fitch, Sheila Shaibu

School of Nursing & Midwifery, East Africa

The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had …

Influence Of Institutional Support And Organisational Culture On Hiv And Ncd Integration, David Njuguna, Caroline Kyalo, Eunice Muthoni, Daniel Mwai, Elvis Kirui, Wesley Rotich, Joy Mugambi, James Waweru, Nelson Muriu, Easter Olwanda

Population Health, East Africa

Background: The integration of services for human immunodeficiency virus (HIV) and noncommunicable diseases (NCDs) has gained increasing attention in recent years because of the overlapping prevalence and shared risk factors between these health conditions. However, successful integration requires more than just the alignment of clinical practices. The role of institutional support and organisational culture in promoting effective integration remains an underexplored area.

Aim: This study aims to fill this gap by examining how institutional structures and organisational values influence the integration of HIV and NCD care.

Setting: The study setting was Nakuru County in Kenya.

Methods: …

Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the profound impact of the COVID-19 pandemic on people living with HIV (PLWH) mental health, large-scale, real-world data on mental healthcare utilisation and associated factors among PLWH remain limited. This study explores mental healthcare utilisation and associated factors among PLWH during the COVID-19 pandemic.

Methods Using a retrospective cohort design, we identified and included 4575 PLWH through computational phenotyping based on relevant Observational Medical Outcomes Partnership Common Data Model concept sets from the All of Us programme between March 2018 and March 2022. Mental healthcare utilisation was measured using the yearly count of mental healthcare visits and compared …

Ocular Surface Squamous Neoplasia (Ossn) Risk Factors In Lusaka, Zambia: The Role Of Hiv And Socioeconomic Status, Stepfanie N. Siyumbwa, Peter Julius, Tabitha Nkhata, Obvious N. Chilyabanyama, Abraham Mengist, Gleb Haynatzki, Charles Wood

Capstone Experience: Master of Public Health

Objective

To identify and evaluate potential risk factors for OSSN at the University Teaching Hospital (UTH) in Lusaka, Zambia.

Methods

Data from 475 patients were analyzed retrospectively, and it included 390 with OSSN and 85 with benign biopsies. Variables with significance values

Results

Several key predictors of OSSN were identified after controlling for confounders in the household cooks sub-population, these were, a lower household income (adjusted odds ratio [aOR] = 0.64, 95% CI: 0.46–0.90, p = .009), a Lab confirmed HIV-positive status (aOR = 3.56, 95% CI: 1.72–7.21, p = .001) and exposure to biomass smoke (aOR = 2.47, 95% …

Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi

Faculty Publications

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …

Social Support And Treatment Outcomes Among Multi-Drug Resistant Tuberculosis And Persons Living With Hiv In Nigeria, Abiodun Olusegun Hassan

Walden Dissertations and Doctoral Studies

An estimated 40% of people with tuberculosis (TB) are missed due to underdiagnosis, and among those previously treated TB cases, about a quarter develop drug-resistant TB in Nigeria. The emergence of multi-drug-resistant TB (MDR-TB) is stalling the effort towards TB’s control and eradication. Few studies have examined the impact of the psychosocial effect and support systems for TB, particularly for MDR-TB. In this quantitative, cross-sectional study, the predictive relationship between social support given to MDR-TB patients and their treatment outcomes was examined using secondary data of 594 MDR-TB cases enrolled between January 2018 and December 2021. The theoretical framework for …

Targets To Increase Hiv Pre-Exposure Prophylaxis (Prep) Uptake Among Communities In Northeast Georgia, Kaley E. Parchinski, Molly Hirsh, Andrew Cheng, Nia Kalifa, Manvi Manyam

Journal of the Georgia Public Health Association

Background: This study seeks to identify targets to increase HIV pre-exposure prophylaxis (PrEP) uptake in Athens-Clarke County, GA, a non-urban area with high HIV burden and poor PrEP utilization.

Methods: A cross sectional survey of adults attending HIV outreach screenings in Athens, GA between November 2022 and March 2023 describes participant demographics and validated scales measuring PrEP knowledge, attitudes, stigma, descriptive norms, and intentions.

Results: Of 136 total participants, key demographic groups included Black (N=84, 61.8%), Latinx (N=10, 8.1%), LGBTQ+ (N=25, 18.4%), and persons who use injection drugs (N=19, 15%); overall, less than half of the PrEP knowledge items were …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …

Review Of Epidemiology, Prevention And Management Of Blood-Borne Viruses Experienced By Aboriginal And Torres Strait Islander Peoples, Katiska Davis, Eliza Lock, Laura Thum, Gemma Crawford, Roanna Lobo, Odette Aung Thein, Shane Kavanagh, Jonathan Hallett

Journal of the Australian Indigenous HealthInfoNet

This review examines the epidemiology, prevention, and management of blood-borne viruses (BBVs) experienced by Aboriginal and Torres Strait Islander peoples in Australia with a focus on hepatitis B, hepatitis C, and HIV. The review highlights the disproportionate burden of BBVs among Aboriginal and Torres Strait Islander peoples in Australia, influenced by historical, social, and cultural factors stemming from colonisation. Key findings include higher prevalence rates of hepatitis B and C compared to non-Indigenous Australians, with some progress in reducing new infections through vaccination and treatment programs. However, significant gaps remain in screening, linkage to care, and treatment uptake. The review …

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 …

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 …

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 …

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) …

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 …

Understanding The Health-Related Quality Of Life Of People Living With Hiv Based On Sexual Orientation, Rico Januar Sitorus, Nyoman Yudi Antara, Reymart Sangalang, Merry Natalia Panjaitan, Nelsensius Klau Fauk

Kesmas

Human immunodeficiency virus (HIV) infection has detrimental impacts on the lives of different population groups living with HIV, including men who have sex with men (MSM). Using the World Health Organization Quality of Life questionnaire, this study aimed to assess the health-related quality of life of men living with HIV with different sexual orientations and to determine the dominant influential factors. This cross-sectional study involved 206 men living with HIV. They were recruited from the Sriwijaya Plus Foundation and a medical facility that provided antiretroviral therapy. The data were analyzed using Chi-square and binomial logistic regression. The analysis showed that …

Proposing An Rna Interference (Rnai)-Based Treatment For Human Immunodeficiency Virus (Hiv) By Analyzing The Post-Transcriptional Gene Targeting Of Sars-Cov-2, Hepatitis C Virus, And A549 Lung Cancer Cells, Arjun Jagdeesh

UROP Posters

Human Immunodeficiency Virus (HIV) is a retrovirus that infects CD4+ T cell lymphocytes in humans, leading to the development of Acquired Immunodeficiency Syndrome (AIDS) if left untreated. While current treatment methods, including antiretroviral combination treatments, effectively limit HIV replication, HIV can evade these treatments due to its high mutation rate. Long-term antiretroviral treatment can also be toxic to patients, meaning patients would benefit from a new mechanism of HIV treatment. RNA interference (RNAi) is an antiviral pathway found in mammals, plants, and insects that involves a small-interfering RNA that is incorporated into a protein complex called the RNA-induced Silencing Complex …

A Systematic Review To Study The Global Patterns And Policies Of Hiv Harm Reduction Programs And Their Impact Among People Who Inject Drugs, Noura Shaltout, Rania Soliman, Lamia Refaey, Rim Ghazal, Mirna Atteya, Nahla Elmedany

Papers, Posters, and Presentations

Aim: This study aims to provide an updated estimate of HIV prevalence among people who inject drugs (PWID) globally, as well as investigate different policies and methods for applying harm reduction. This article focuses on the two major and the most frequently used harm reduction techniques, Syringe-Service Programs (SSPs) and Opioid Agonist Therapy (OAT). Methods: A comprehensive systematic review was undertaken across multiple international databases during the period of (August-December 2021). For studies conducted before 2005, we used data from a previous published systematic review. Thirty-six studies were included, including studies that had performed HIV testing and had a confirmed …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

Examining The Association Between A Modified Quan Charlson Comorbidity Index (Qcci) And Viral Suppression: A Cross Sectional Analysis Of Dc Cohort Participants, Hasmin C. Ramirez, Lauren O’Connor, Morgan Byrne, Anne Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Quality Of Life In Older And Younger People With Hiv And Diabetes, Lauren F. O’Connor, La’Marcus Wingate, Sam Simmens, Amanda D. Castel, Anne K. Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Capturing The Pool Dilution Effect In Group Testing Regression: A Bayesian Approach, Stella Self Ph.D., Ms, Christopher Mcmahan, Stefani Mokalled

Faculty Publications

Group (pooled) testing is becoming a popular strategy for screening large populations for infectious diseases. This popularity is owed to the cost savings that can be realized through implementing group testing methods. These methods involve physically combining biomaterial (eg, saliva, blood, urine) collected on individuals into pooled specimens which are tested for an infection of interest. Through testing these pooled specimens, group testing methods reduce the cost of diagnosing all individuals under study by reducing the number of tests performed. Even though group testing offers substantial cost reductions, some practitioners are hesitant to adopt group testing methods due to the …

Age-Associated Gut Dysbiosis, Marked By Loss Of Butyrogenic Potential, Correlates With Altered Plasma Tryptophan Metabolites In Older People Living With Hiv., Smita Ghare, Richa Singhal, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Praneet Kumar Srisailam, Andrea Reyes-Vega, Dushan Ghooray, Craig J. Mcclain, Kristi Hoffman, Joseph Petrosino, Kendall Bryant, Varand Govind, Ronald Cohen, Robert L. Cook, Shirish Barve

Faculty and Staff Scholarship

Background:

Imbalance in tryptophan (TRP) metabolism and its neuroactive metabolites, serotonin and kynurenine (KYN), is a known pathogenic mechanism underlying neurocognitive impairment. Gut microbiota plays an important role in TRP metabolism, and the production of these neuroactive molecules affects neurocognitive function. Although both HIV infection and normal aging independently induce gut dysbiosis and influence TRP metabolism, their interactive effects on compositional/functional changes in gut microbiota and consequent alterations in TRP metabolites remain largely undetermined.

Methods:

Older people living with HIV infection (PLWH, aged 50–70 years, n = 22) were enrolled in this cross-sectional pilot study. Metagenomic analysis of fecal microbiome …