Epidemiology Commons^™

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa., Felix Ikechi Woke

Walden Dissertations and Doctoral Studies

Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in …

Interrelationships Of Colorism, Violence, And Sexual Behaviors Among Southern African American Women., Phaedra Christensen

Walden Dissertations and Doctoral Studies

Two significant public health concerns that threaten both the physical and mental health of African-American women are Intimate Partner Violence (IPV) and Human Immunodeficiency Virus (HIV). African-American women (AAW) in the south carry the greatest burden of HIV and disproportionately represent the region with an incidence of 71% for new HIV infections, and elevated rates of morbidity and mortality. In 2013, the murder rate among AAW was 2.5 times higher than it was among Caucasian women. Most of the published studies that explored the association between IPV and HIV had mixed populations, did not explore topics unique to AAs, or …

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

The Influence Of Race And Gender On Hiv Risk Behaviors In High School Students In The Southern States Of The United States, Malendie T. Gaines

Electronic Theses and Dissertations

The incidence of the Human Immunodeficiency Virus (HIV) is highest in the southern states of the United States (US), with adolescents in this region being one of the most affected populations in the country. A limited amount of information is available on adolescent HIV risk behaviors in the southern states, specifically focusing on race and gender. The purpose of this study was to use the Centers for Disease Control and Prevention’s National Youth Risk Behaviors Survey (YRBS) for high school students in the southern states for 2011 and 2013 to examine the influence of race and gender on 1) early …

Fighting Microbial Drug Resistance: A Primer On The Role Of Evolutionary Biology In Public Health, Gabriel Perron, R. Inglis, Pleuni Pennings, Sarah Cobey

Biology Department Faculty Works

Although microbes have been evolving resistance to antimicrobials for millennia, the spread of resistance in pathogen populations calls for the development of new drugs and treatment strategies. We propose that successful, long-term resistance management requires a better understanding of how resistance evolves in the first place. This is an opportunity for evolutionary biologists to engage in public health, a collaboration that has substantial precedent. Resistance evolution has been an important tool for developing and testing evolutionary theory, especially theory related to the genetic basis of new traits and constraints on adaptation. The present era is no exception. The articles in …

Untreated Depression In Persons Living With Hiv In Kazakhstan, Dina Terloyeva

Legacy Theses & Dissertations (2009 - 2024)

Objective:This study investigates the occurrence of depressive symptoms among persons living with HIV, and the relationship between depressive symptoms and HIV treatment initiation and adherence.

Trends Of Injecting Risk Behaviors Among People Who Inject Drugs In Ukraine : The Analysis Of Bio-Behavioral Surveillances Conducted In 2007-2013, Iuliia Makarenko

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Assessment Of Quality Of Life (Qol) In People Living With Hiv In Georgia, Ekaterine Karkashadze

Legacy Theses & Dissertations (2009 - 2024)

Background: Identification of factors that influence quality of life (QoL) is important in order to improve health and social care services. No prior research is available on QoL in people living with HIV in the country of Georgia. The purpose of our study was to assess QoL among Georgian HIV-infected individuals and to examine associations of socio-demographic and disease-related factors with general and domain-specific QoL.

Trends In Risky Sexual Behavior Among Men Who Have Sex With Men : Analysis Of Repeated Cross-Sectional Survey Data From Ukraine, 2007-2013, Roksolana Kulchynska

Legacy Theses & Dissertations (2009 - 2024)

Objective: To examine changes in risky sexual behavior over time, i.e., unprotected anal intercourse (UAI) among men who have sex with men (MSM) in Ukraine.

Correlates Of Life-Time History Of Purchasing Sex Services By Men In Saint Petersburg And Leningrad Oblast, Russian Federation, Polina Girchenko

Legacy Theses & Dissertations (2009 - 2024)

Background. Commercial sex workers (CSW) in Russian Federation are at high risk of HIV infection and transmission as a result of unsafe sexual and injecting behaviors. Their clients might be at increased risk of acquiring HIV; however, little is known about the population of men purchasing sex services. This study’s goal is to investigate factors associated with a history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation.

Social Network Correlates Of Hcv And Hiv Transmission Risk Behaviors Among Injecting Drug Users, Victor Emanuel Reyes-Ortiz

Walden Dissertations and Doctoral Studies

Drug injection is an increasingly important risk factor in the transmission of blood-borne pathogens, including the hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The purpose of the study was to examine the influence of social network factors on HCV and HIV. The study was grounded in social network theory and sought to determine whether social network characteristics affect high-risk sexual and drug injection behavior as well as self-reported HIV and HCV status. The study design was a quantitative cross-sectional survey. A total of 181 participants in a needle exchange program completed a survey in Spanish assessing individual drug …

Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail

Walden Dissertations and Doctoral Studies

Vitamin D deficiency is common in individuals diagnosed with HIV and is known for its detrimental health effects. Its recognition as a potent immune-modulator with possible immune health implications in HIV disease progression was the main impetus for this study. The association between Vitamin D and CD4 count falls short of being consistent and is too weak to allow conclusions. Similarly, the literature is inconsistent with regard to the impact of Vitamin D supplementation on CD4. This observational, retrospective chart review study aimed to explore the relationship between Vitamin D deficiency and CD4 count/percent, and to evaluate whether changes in …

The Revolving Door Pattern Of Jail Incarceration And Homelessness And Its Influence On Mortality And Morbidity Among New York City Adults, Sungwoo Lim

Dissertations, Theses, and Capstone Projects

Objectives

The purpose of this dissertation study was to identify timing and sequencing of jail incarceration and homelessness by utilizing sequence analysis and to test whether a particular trajectory contributes to mortality risk and discontinuity of HIV care.

Methods

The main data source was an existing matched dataset, constructed using administrative data from the New York City (NYC) Departments of Health and Mental Hygiene, Correction, and Homeless Services. The study cohort consisted of 15,620 NYC adults with recent histories of both jail incarceration and homelessness. Monthly experiences of jail incarceration, homelessness, and community-dwelling in 2001-03 were summarized into trajectory groups …

Hiv Vaccine Acceptability Among High-Risk Drug Users In Appalachia: A Cross-Sectional Study, April M. Young, Ralph J. Diclemente, Daniel S. Halgin, Claire E. Sterk, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: A vaccine could substantially impact the HIV epidemic, but inadequate uptake is a serious concern. Unfortunately, people who use drugs, particularly those residing in rural communities, have been underrepresented in previous research on HIV vaccine acceptability. This study examined HIV vaccine acceptability among high-risk drug users in a rural community in the United States.

METHODS: Interviewer-administered questionnaires included questions about risk behavior and attitudes toward HIV vaccination from 433 HIV-negative drug users (76% with history of injection) enrolled in a cohort study in Central Appalachia. HIV vaccine acceptability was measured on a 4-point Likert scale. Generalized linear mixed models …

Medication Use And Patients Co-Infected With Human Immunodeficiency Virus And Hepatitis C Virus : Quantifying The Prevalence And Identifying The Predictors Of Clinically Significant Drug-Drug Interactions Associated With Therapy Containing First Generation Non-Structural 3a Serine Protease Inhibitors, Nimish Patel

Legacy Theses & Dissertations (2009 - 2024)

This dissertation enhances our understanding of clinically significant drug-drug interactions (CSDDIs) and contraindicated drug interactions among patients with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection before and after the addition of HCV therapy including first generation non-structural (NS) 3A serine protease inhibitors. This is important to understand because the clinical sequelae of untreated chronic HCV infection are devastating yet drug-drug interactions greatly complicate treatment for these patients. The HIV/HCV coinfected population is a population that is particularly vulnerable because they are using a high volume of medications. Specifically, the standard of care for patients with HIV infection …

Maternal Characteristics And Factors Associated With Hepatitis C (Hcv) Infection Among Hiv-Positive Pregnant Women In Ukraine, 2010-2011, Liudmyla Slobodianyk

Legacy Theses & Dissertations (2009 - 2024)

Objective: Determine the association between risk factors for Hepatitis C and hepatitis C (HCV) infection among HIV-positive pregnant women in Ukraine.

Research Fatigue Among Injecting Drug Users In Karachi, Pakistan, Aysha Zahidie, Arshad Altaf, Adeel Ahsan, Tanzil Jamali

Community Health Sciences

Background

Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study …

Condom Negotiation Across Different Relationship Types By Young Women Engaged In Sex Work In Phnom Penh, Cambodia, Lisa Maher, Julie Mooney-Somers, Pisith Phlong, Marie-Claude Couture, Serey Serey Kien, Ellen Stein, Anna Juong Bates, Neth Sansothy, Kimberly Page, Young Women's Health Study Collaborative

Nursing and Health Professions Faculty Research and Publications

Cambodia’s 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an …

The Potential For Bridging : Hiv Status Awareness And Risky Sexual Behavior Of Injection Drug Users Who Have Non-Injecting Permanent Partners In Ukraine, Alyona Mazhnaya

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Prognostic Implications Of Oral Health Status In Hiv-Positive Women In St. Petersburg, Russia, Anna Vinogradova

Legacy Theses & Dissertations (2009 - 2024)

Objective: To assess state of oral health in HIV-positive women in St. Petersburg, Russia and to study the association of oral health with pregnancy status and other factors in this sample.

Migrant Workers In Kazakhstan : Gender Differences In Hiv Knowledge And Sexual Risk Behaviors, Baurzhan Zhussupov

Legacy Theses & Dissertations (2009 - 2024)

Background:

Epidemiology Of Contemporary Seroincident Hiv Infection In The Navy And Marine Corps, David Brett-Major, Shilpa Hakre, Neal A. Naito, Adam Armstrong, Eric A. Bower, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

Human Immunodeficiency Virus (HIV) infection continues at a steady rate among U.S. Sailors and Marines. This study provides the first service-specific description of HIV infection demographics. All Sailors and Marines identified as HIV infected between January 2005 and August 2010 were included. The project compared personnel and epidemiologic data, and tested reposed sera in the Department of Defense Serum Repository. This group comprised 410 Sailors and 86 Marines, predominantly men. HIV infected Marines were more likely to be foreign born than their Navy counterparts, 42% versus 10%, p < 0.001. Approximately half of the patients had deployed including to the wars in Iraq or Afghanistan. Nearly half of each group was infected by the age of 25. Similar to the U.S. epidemic, Black race was over-represented. Unlike national rates, Hispanic Sailors and Marines were not over-represented. Demographics were distinct for those of specific occupational specialties. Certain ship classes carried lower incidences. Clustering of HIV infection risk occurred around deployment. The Navy and Marine Corps have different patterns of HIV infection, which may merit distinct approaches to prevention. The Navy may have unique targets for prevention efforts to include pipeline training and first assignment as well as particular occupational environments.

Hiv And Concurrent Sexual Partnerships: Modelling The Role Of Coital Dilution, Larry Sawers, Alan G. Isaac, Eileen Stillwaggon

Economics Faculty Publications

Background: The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high HIV levels in sub-Saharan Africa. Earlier simulation models show that the network effect of concurrency can increase HIV incidence, but those models do not account for the coital dilution effect (nonprimary partnerships have lower coital frequency than primary partnerships).

Methods: We modify the model of Eaton et al (AIDS and Behavior, September 2010) to incorporate coital dilution by assigning lower coital frequencies to non-primary partnerships. We parameterize coital dilution based on the empirical work of Morris et al (PLoS ONE, December …

Preventing Mother-To-Child Transmission Of Human Immunodeficiency Virus-1 (Hiv-1): Effects Of Intrapartum And Neonatal Single-Dose Nevirapine Prophylaxis And Subsequent Hiv-1 Drug Resistance At Antiretroviral Treatment Initiation, Amanda L. Harmon

CMC Senior Theses

The prevention of mother-to-child transmission is one of the most powerful tools in human immunodeficiency virus type 1 (HIV-1) prevention and has huge potential to improve both maternal and child health. In the absence of any preventative measures, infants born to and breastfed by their HIV-positive mothers have roughly a one-in-three chance of acquiring the infection themselves. HIV can be passed on from mother-to-child during pregnancy, during labor and delivery, and even after during breastfeeding.

Intrapartum and neonatal single-dose nevirapine (sd-NVP) is the foundation of preventing mother-to-child transmission in lower resource settings where it has been used alone or as …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Safety Assessment For Tipranavir : A Protease Inhibitor Treatment For Hiv Infected Adults, Jaromir Mikl

Legacy Theses & Dissertations (2009 - 2024)

Dose-limiting adverse events associated with anti-retroviral therapy (ART) generally include gastro-intestinal (GI) issues such as vomiting and nausea. However, serious adverse events (SAEs) do occur, the most frequent of which include liver toxicities and renal impairment as well as recent evidence of cardio-vascular disease (CVD) risk.

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Hiv Rates In The State Of Georgia: A Growing Threat Among Predominately African American Populations, Swati Raychowdhury, Stuart H. Tedders

Epidemiology: Faculty Publications (2002-2018)

Background: US rates of HIV/AIDS continue to rise with over 55% of new cases identified in southern states in 2003. The objective of this study was to determine the magnitude of HIV/AIDS cases in rural southeast Georgia in comparison to urban areas of the state.

Methods: County level data was acquired using OASIS. Rates of HIV infections by gender and race (black vs. white) were aggregated over a five year period (2000–2005) and indirectly adjusted using Georgia as the standard. Rates for rural counties, (populations less than 35,000), were statistically compared to urban rates (α = 0.05).

Results: HIV infections …

Lack Of Knowledge Of Mother-To-Child Transmission In Kenya Among Women Ages 15-49, Nisha Warrier

Theses and Dissertations

Purpose: The epidemic of mother-to-child transmission (MTCT) of HIV/AIDS in resource-poor countries is dramatic; it is responsible for nearly 90% of childhood infections. The primary purpose of analysis was to understand the distribution of factors and their association with lack of knowledge of MTCT in Kenya. In parallel, another aim was to identify the relationship between media, particularly frequency of radio exposure, and lack of knowledge.Methods: This study used the 2003 Kenya Demographic and Health Survey (DHS) collected for 8,195 women, ages 15-49. Descriptive analysis, univariate analysis, and logistic regression were completed on SPSS 14 software.Results: In the sample, 1151 …