Epidemiology Commons^™

Structural Violence & Small Victories: Political Epidemiology Of Hiv Among Msm In Nigeria, 2000-2010, Debbie A. Dada

Harvey M. Applebaum ’59 Award

No abstract provided.

Men’S Comfort In Distributing Or Receiving Hiv Self-Test Kits From Close Male Social Network Members In Dar Es Salaam, Tanzania: Baseline Results From The Step Project, Joseph K.B. Matovu, Gaspar Mbita, Akeen Hamilton, Frank Mhando, Wynton M. Sims, Noah Thompson, Albert N. Komba, Jackson Lija, Jiajia Zhang Ph.D., Thomas Van Den Akker, Dustin T. Duncan, Augustine T. Choko, Donaldson F. Conserve

Faculty Publications

Background

A variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. However, few studies have assessed men’s comfort to distribute to or receive HIV self-test kits from close male friends within the same social network. In this study, we assessed men’s comfort to distribute to and/or receive HIV self-test kits from close male friends and associated factors among men who socialize in networks locally referred to as “camps” in Tanzania.

Methods

Data are from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social …

The Histories Of Hivs : The Emergence Of The Multiple Viruses That Caused The Aids Epidemics, William H. Schneider

Ohio University Press Open Access Books

This new collection of essays on HIV viruses spans disciplines to topple popular narratives about the origins of the AIDS pandemic and the impact of the disease on public health policy.

With a death toll in the tens of millions, the AIDS pandemic was one of the worst medical disasters of the past century. The disease was identified in 1981, at the height of miraculous postwar medical achievements, including effective antibiotics, breakthrough advances in heart surgery and transplantations, and cheap, safe vaccines—smallpox had been eradicated just a few years earlier. Arriving as they did during this era of confidence in …

Chagas Disease In Hiv-Infected Patients: It’S Time To Consider The Diagnosis, Melissa Nolan Ph.D., Mph, Natasha S. Hochberg

Faculty Publications

No abstract provided.

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

Determinan Konsistensi Penggunaan Kondom Pada Laki-Laki Seks Dengan Laki-Laki (Lsl) Non-Pekerja Seks: Studi Potong Lintang, Arum Zulaikhah, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Kasus baru HIV di Indonesia cenderung terus mengalami peningkatan. Sedangkan, tren kasus baru di dunia sudah mengalami penurunan. Laki-laki Seks dengan laki-laki (LSL) merupakan kelompok risiko tinggi HIV. Upaya pencegahan penularan HIV erat kaitannya dengan perilaku seks. Studi ini menggunakan 1.161 sampel Survei Terpadu Biologi dan Perilaku (STBP) 2015 pada kelompok LSL yang termasuk bukan pekerja seks. Studi cross sectional ini bertujuan untuk menganalisis determinan perilaku seks konsistensi penggunaan kondom dengan analisis hingga bivariat dengan menggunakan chi-square dan prevalence ratio. Data didapatkan dengan metode respondent driven sampling (RDS) yang kemudian mengeksklusi LSL pekerja seks. Hasil menunjukkan bahwa faktor-faktor yang berhubungan …

Inter-Related Factors Influencing Sexual Quality Of Life Among Women Living With Hiv In Banten Province, Indonesia: A Mixed Methods Study, Dyah Juliastuti, Judith Dean, Yati Afiyanti, Lisa Fitzgerald

Kesmas

Socio-cultural concerns often restrict women's sexual rights and well-being living with HIV (WLHIV) in developing countries. These convergent parallel mixed methods study combined quantitative and qualitative approaches to explore factors influencing WLHIV sexual quality of life in Banten Province, Indonesia. A 2017 cross-sectional survey of 207 reproductive-aged WLHIV was analyzed using univariate and multivariate logistic regression statistics. Furthermore, in-depth interviews with a sub-sample of survey participants (n = 30) were thematically analyzed. Most of the women (60%) involved reported loss of sexual pleasure and depressed sexual life. Meanwhile, 48% affirmed low sexual quality of life which was associated with unemployment …

Neurocognitive Impairment In People Living With Human Immunodeficiency Virus (Hiv): Risk Factors And Mortality, Zaeema Naveed

Theses & Dissertations

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) persists in people living with HIV (PLWH) with clinical and public health implications. Studies have generated inconsistent results regarding etiological factors for NCI in PLWH and a brief user-friendly predictive tool is desirable in clinical practice to assess the probability of having NCI in PLWH. Furthermore, factors associated with clinically meaningful decline in neurocognitive status and survival disadvantage for patients with NCI are understudied in the post-cART era. The goal of this dissertation was to investigate factors associated with baseline NCI and neurocognitive decline and the association …

Characteristics And Outcomes Of Bacteremic Pneumococcal Pneumonia Of Patients With And Without Hiv Infection In Argentina, Alejandra González

The University of Louisville Journal of Respiratory Infections

Streptococcus pneumoniae is the main causative agent of pneumonia, with a 10 to 25 percent rate of isolation in blood cultures. Controversies exist regarding the prognostic impact of a history of human immunodeficiency virus (HIV) infection on community-acquired pneumonia.

The aim of our work was to analyze and compare the clinical presentation, radiological findings and progression of pneumococcal pneumonia in patients infected with and not infected with HIV. We retrospectively analyzed adult patients with positive blood cultures for Streptococcus pneumoniae and clinical and radiological findings compatible with pneumonia in the period between January 2012 and May 2017. Age, sex, comorbidities, …

Changes In Body Mass Index Among Antiretroviral Therapy Naïve People Living With Hiv In Southeastern Nigeria, John O. Olawepo, Jennifer R. Pharr, Chad L. Cross, Babayemi O. Olakunde, Chinedu Aniekwe, Mercy Niyang, Raisa Kabir, Ayodotun Olutola

Environmental & Global Health Faculty Research

The proportion of people living with HIV (PLHIV) who are overweight or obese is rising, leading to a double epidemic of HIV and obesity. The purpose of this retrospective longitudinal study was to examine changes in body mass index (BMI) among PLHIV who were new to antiretroviral therapy (ART) in two states in Southeastern Nigeria. The BMI at baseline and 12 months were compared and the difference in proportions in each BMI category was tested. The association between the BMI at 12 months and the demographic and/or clinical variables was examined using multiway analysis of covariance. The study included 2,146 …

Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West

Walden Dissertations and Doctoral Studies

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, …

Sexual Behaviors Associated With Online Partner-Seeking Among Men Who Have Sex With Men From Small/Midsized Towns Or Rural Areas In Kentucky, Vira Pravosud

Theses and Dissertations--Epidemiology and Biostatistics

The HIV epidemic remains one of the most significant public health issues in the United States, particularly among men who have sex with men (MSM). New avenues for partner-seeking have emerged over the past three decades, including through the Internet, social media, and geosocial networking applications. Consisting of three cross-sectional studies, this dissertation research aimed to determine associations between the use of various online tools for partner-seeking (hereafter collectively referred to as “apps”) and HIV-related sexual behaviors among 252 young adult MSM residing in small/midsized towns or rural areas in Central Kentucky, a group that has been under-represented in the …

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 …

Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo

Walden Dissertations and Doctoral Studies

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, …

Predictors Of Hiv Testing Amongst Women Of Childbearing Age In Nigeria, Hassana Bashir Yakasai

Walden Dissertations and Doctoral Studies

HIV infection is still a public health issue in Nigeria. One of the sustainable development goal targets is to eliminate new HIV infections by the year 2030. Women of childbearing age are a vital group to focus on in eliminating new infections because HIV infection can be transmitted from women to their partners and their children. Nigeria accounts for about one-third of the cases of mother-to-child infections in the world. The purpose of this three manuscript dissertation was to investigate socioecological factors, demographic factors and knowledge of mother-to-child transmission of HIV infection (MTCT) as they relate to HIV testing in …

Receiving Positive Hiv Test Results From Home Testing And Suicidality, Nekeisha A. Hewitt

Walden Dissertations and Doctoral Studies

Limited studies have been conducted on whether receiving a positive result from at-home HIV testing correlates with suicidality (suicidal attempt or ideation). Based on the Ajzen theory of planned behavior, this cross-sectional study comprises a surveyed convenience sample of (N = 213) HIV -positive or negative adults who either tested for HIV at home or in-clinic. The purpose of this study was to explore any association between testing positive for HIV using the HIV at-home test kit and (a) suicidal attempt and (b) suicidal ideation; also, to discover any association between (c) HIV-negative and suicidality and (d) all HIV-positives …

Substance Use, Mental Health Problems And Missed Appointments By Race, Gender, And Sexual Orientation Among Hiv-Infected Individuals, Abraham Adonis Anderson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) disproportionately affects African American men who have sex with men. According to the Centers for Disease Control and Prevention, in 2020 African American adult and adolescent African American men accounted for 42% (16,002) of all HIV diagnoses (37,968). Furthermore, while substance use is common among this population, in previous studies very few individuals with HIV have reported receiving substance abuse treatment or discussing substance use with HIV medical providers. The purpose of this study was to examine the differences in substance use/mental health problems by race, gender, and sexual orientation among HIV-infected individuals. This study also …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

Structural Magnetic Resonance Imaging As A Diagnostic Biomarker Of Hiv-Associated Neurocognitive Disorders (Hand), Mikki Schantell

Capstone Experience: Master of Public Health

Objective: The goal of this study was to do an exploratory analysis to determine if gray matter brain volumes and cortical thickness measures obtained from structural magnetic resonance imaging (sMRI) can discriminate people with HIV-associated neurocognitive disorders (HAND), neurocognitively unimpaired people with HIV (NU PWH), and HIV-negative controls (HIV- controls) using linear discriminant analyses.

Methods: A total of 231 participants, including 110 PWH and 121 HIV- controls, completed a neuropsychological (NP) battery and an sMRI protocol. The bilateral gray matter volumes and cortical thickness brain regions were analyzed using 18 linear discriminant models to assess the discriminability of gray matter …

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 …

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 …

El Rol Del Gobierno En Las Campañas Sanitarias De Vih, Covid-19 E Influenza, Sydney Reyes

Independent Study Project (ISP) Collection

Research Question: What are the differences and similarities between the three health campaigns — the flu, HIV, and COVID-19 — that the Chilean government has spread to population?

Objectives: The primary objective of this study was to describe and compare the three public health campaigns — the flu, HIV, and COVID-19 — to examine the role that the Chilean government has in health education and heath promotion. The secondary objectives were to identify the differences in national health campaigns and regional campaigns as well as to show the interactions between health campaigns and indigenous people. Overall, the research project looked …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Voluntary Male Circumcision And Risk For Human Immunodeficiency Virus In Homa Bay, Kenya, George Obhai Gabriel

Walden Dissertations and Doctoral Studies

The role played by the belief about voluntary medical male circumcision (VMMC) in predicting HIV status has not been examined. The purpose of this study was to investigate whether there were any differences between belief about VMMC, unprotected sex, age, number of sexual partners, relationship status, and HIV status among circumcised males aged between 18-49 years in Homa Bay County, Kenya. Drawing from the health belief model and case-control study design, 936 men were recruited based on their HIV status (468 HIV cases and 468 controls). A bivariate logistic regression was applied, and the results indicated that unprotected sex, age, …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

Burden And Risk Of Non-Aids Defining Cancers In Hiv-Infected Persons Receiving Antiretroviral Therapy, Brittney L. Dickey

Theses & Dissertations

The burden of cancers not previously associated with an HIV infection, called non-AIDS defining cancers (NADCs), have increased in the years since highly active anti-retroviral therapy has been introduced. The studies in this dissertation attempted to quantify this burden via incidence and mortality compared to the general population. Further, an assessment of risk factors and creation of a predictive risk model, a nomogram, were utilized to better understand how factors associated with demographics, lifestyle, and immune response affected risk for an NADC diagnosis once therapy was initiated and HIV better controlled. Standardized incidence and mortality ratios showed that burden of …

Validity Study Of The R-Pla, A Resilience Scale For People Living With Hiv, Jinxiang Hu, Julianne M. Serovich, Monique J. Brown, Judy A. Kimberly, Yi-Hsin Chen

Faculty Publications

This study provides psychometric assessment of a resilience scale with a sample of women living with HIV. Baseline data were used from a longitudinal HIV disclosure study of 124 women aged between 18-63 collected between 2001 and 2004 in a large Midwestern city. The Rasch model was used to examine the psychometric properties of the resilience scale. Results indicated that the resilience instrument meets the Rasch model application assumptions. Evidence of validity suggested the resilience instrument demonstrated good item and person fit, as well as good item and person reliability. Most items showed measurement invariance across different age and racial …

Hypertension And Hiv In An Urban Slum Setting, Port-Au-Prince, Haiti, Olga Tymejczyk

Dissertations and Theses

Background: Rapidly growing urban slum settings increasingly face co-occurring communicable and non-communicable health crises, against the backdrop of extreme poverty, and social and environmental vulnerability. In Haiti, sparse data suggest a growing burden of hypertension and cardiovascular disease (CVD), along with substantial prevalence of HIV, increasingly recognized as a major CVD risk factor. As life-saving antiretroviral treatment (ART) is extended to more people living with HIV (PLWH), their risk of CVD increases with longer life expectancy and possibly cumulative ART exposure. Pregnant HIV-positive women may face additional cardiovascular vulnerability, due to the risk of gestational hypertension and pre-eclampsia. Integration of …

Determinan Yang Meningkatkan Risiko Terinfeksi Hiv Pada Wargabinaan Lembaga Pemasyarakatan Dan Rumah Tahanan Di Indonesia: Studi Tinjauan Pustaka 2007-2017, Mondastri Korib Sudaryo

Jurnal Epidemiologi Kesehatan Indonesia

Wargabinaan pemasyarakatan (WBP) diduga berisiko terinfeksi HIV selama tinggal di lembaga pemasyarakatan (lapas) dan rumah tahanan (rutan) akibat menyuntik narkotika dan perilaku berisiko lainnya. Studi ini bertujuan mengetahui determinan yang meningkatkan faktor risiko terinfeksi HIV di kalangan WBP di lapas/rutan di Indonesia. Rancangan studi adalah tinjauan pustaka sistematik (systematic literature review) yang merangkum dan membandingkan hasil studi dari 12 artikel yang diterbitkan sejak 2007 2017 di jurnal nasional/internasional berbahasa Inggris/Indonesia mengenai karakteristik dan determinan infeksi HIV pada populasi WBP yang tinggal di lapas/rutan di Indonesia. Karakteristik demografis WBP: umumnya laki laki; usia rata-rata 30 tahun (rentang: 21-51 tahun); sebagian besar <=SMU; setengahnya menikah. Prevalensi HIV di kalangan WBP di beberapa lapas: 10%-56%. Tiga survei nasional tahun 2011, 2013, 2015 menunjukkanprevalence rate antara 1,2% – 3%. Proporsi perilaku berisiko: menyuntik narkotika (antara 5% - 66%), berbagi jarum suntik (28%-47%), kontak seksual tidak aman dengan sesama WBP (2%-13%), atau dengan WPS (96%), pakai tattoo (2%-56%), atau tindik (5%-13%), minum alkohol (47%). Dari 3 survey yang sama tingkat prevalensi Sifilis antara 2,1%– 5%. Determinan/faktor risiko terinfeksi HIV: menggunakan narkotika suntik (OR antara 11,4 - 104,8), pakai tatoo (OR: 1,7 -2,4), pakai tindik (OR = 4,4), seks tidak aman (OR=1,9), terinfeksi Sifilis (OR=4,2). Faktor-faktor penting yang meningkatkan risiko terinfeksi HIV di kalangan WBP di lapas/rutan adalah penggunaan narkotika suntik, berbagi jarum suntik tidak steril, kontak seksual dengan sesama WBP &/ WPS, terinfeksi Sifilis dan memakai tato/tindik.