Public Health Education and Promotion Commons^™

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 …

Cutting Through The Fog: Recognising Brain Fog As A Significant Public Health Concern, Darren Haywood, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

Brain fog is a highly common condition that can have significant impacts on quality of life and functioning. Most people will experience a condition, illness, or infection that might result in the development of brain fog. We provide a call to action to minimise the impacts of brain fog.

Sex Differences In Cardiovascular Disease And Associated Factors In People Living With Hiv: Evidence From All Of Us Program, Hao Zhang, Huiyi Xia, Fanghui Shi, Qingyang Li, Sharon Weissman, Xiaoming Li, Xueying Yang

Faculty Publications

Background

People living with HIV (PLWH) face a higher risk of cardiovascular disease (CVD), with significant sex differences in outcomes. However, it is unclear whether these differences are driven by distinct risk factor profiles or by a differential impact of shared risk factors. This study aimed to identify factors associated with CVD among PLWH and to specifically assess for effect modification by sex using a large, diverse nationwide database.

Methods

We utilized data from the All of Us Research Program (AoU). The primary outcome was a composite of coronary artery disease or stroke. We used multivariable logistic regression to identify …

Sex Differences In Cardiovascular Disease And Associatedfactors In People Living With Hiv: Evidence From All Of Us Program, Hao Zhang, Huiyi Xia, Fanghui Shi, Qingyang Li, Sharon Weissman, Xiaoming Li Ph.D., Xueying Yang

Faculty Publications

Background

People living with HIV (PLWH) face a higher risk of cardiovascular disease (CVD), with significant sex differences in outcomes. However, it is unclear whether these differences are driven by distinct risk factor profiles or by a differential impact of shared risk factors. This study aimed to identify factors associated with CVD among PLWH and to specifically assess for effect modification by sex using a large, diverse nationwide database.

Methods

We utilized data from the All of Us Research Program (AoU). The primary outcome was a composite of coronary artery disease or stroke. We used multivariable logistic regression to identify …

Sleep Quality, Emotional Moods, And Cognitive Outcomes Among People Living With Hiv: An Ecological Momentary Assessment Study, Shan Qiao Ph.D., Abhishek Aggarwal, Camryn Garrett, Arielle N’Diaye, Atena Pasha, Irene Esu, Chih Hsiang Yang Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Introduction Although studies have explored the relationship between sleep quality, mood, and cognitive outcomes among people living with HIV (PLWH), few use ecological momentary assessment (EMA) techniques to evaluate within-person associations between sleep quality and emotional/cognitive outcomes among PLWH at the day level. This study investigated the association between previous night’s sleep quality and momentary psychological outcomes in participants’ natural setting. Methods Study participants were PLWH in South Carolina who were at least 18 years old, diagnosed with HIV for at least 2 years, and able to operate a cellphone. Participants were sampled using posters posted in AIDS Service organizations, …

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 …

Social Exclusion And Mental Health Of Youths Affected By Parental Hiv/Aids In China: Based On A Serial Mediating Model, Jiaojiao Wan, Lili Ji, Zheqian Wang, Junfeng Zhao, Xiaoming Li

Faculty Publications

The mental health of youth living with patients with HIV needs focused attention. The primary source of psychological distress they experience may stem from social exclusion. Therefore, the current study was designed to explore the relationship between social exclusion and mental health among youths affected by parental HIV/AIDS in rural China.

Methods

297 youths affected by parental HIV/AIDS were recruited to completed questionnaires of social exclusion, perceived stress, future orientation and mental health. The bootstrap method was used to examine the mediation effects.

Results

It showed that: (1) the social exclusion (M = 32.48, SD = 15.25) significantly and …

A Whole Person Care Approach To Ending The Hiv Epidemic In The Inland Empire, Roberto Daniel Gonzalez Coronado

Electronic Theses, Projects, and Dissertations

In the last 40 years, the United States has seen remarkable progress in the field of HIV treatment; however, the virus continues to burden the most vulnerable members of society, such as Men Who Have Sex with Men (MSM) and Intravenous Drug Users (IVDU). Unfortunately, these vulnerable members of society continue to lack stable social conditions to get into proper HIV treatment. These social conditions are referred to as social determinants of health, which are non-medical factors that influence whole-person care. With these members of society continuing to face greater social disparities, their linkage to care and retention to care …

Telehealth Or In-Person Hiv Care? Qualitative Study Findings On Decision-Making From People With Hiv And Hiv Care Providers In South Carolina During The Covid-19 Pandemic, Valerie Yelverton, Salome Joelle Gass, Daniel Amoatika, Christopher Cooke, Jan Ostermann, Nabil Natafgi, Nicole L. Hair Ph.D., Bankole Olatosi Ph.D., Otis L. Owens, Shan Qiao Ph.D., Xiaoming Li Ph.D., Caroline Derrick, Sharon Weissman, Helmut Albrecht

Faculty Publications

The COVID-19 pandemic disrupted HIV care services across the United States. Telehealth was rapidly implemented to ensure HIV care continuity. Despite the evidence of unequal telehealth uptake among some people with HIV (PWH), the decision-making processes to determine who received telehealth or in-person care are under-researched. This study assessed which decision criteria and processes determined which HIV care visit type was used by PWH and HIV care providers during the COVID-19 pandemic. Qualitative in-depth interviews with 18 PWH and 10 HIV care providers from South Carolina assessed PWHs’ and HIV care providers’ decision-making criteria and processes for telehealth HIV care …

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 …

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

Association Of Hiv Status And Other Minoritized Identities With Psychiatric Diagnoses Among Transgender And Gender Diverse Individuals In The All Of Us Research Program, Fanghui Shi

Theses and Dissertations

Background: Transgender and gender diverse (TGD) people, whose gender identities or expressions differ from the sex assigned at birth, are disproportionately affected by adverse health outcomes, including various psychiatric diagnoses such as depression, anxiety, stress, and substance use disorders. The Gender Minority Stress Model emphasizes that TGD people face both proximal stressors at a personal/individual level (e.g., internalized stigma) and distal stressors at a societal level (e.g., discrimination) due to their minority status, which largely contributes to their increased risk of psychiatric diagnoses. Despite these health disparities, there is a paucity of gender identity data collected in large population-based health …

A Comparative Analysis Of Hiv/Aids In France And The United States: Historical Context And Preventative Actions, Rebecca A. Liebsack

Honors Program: Senior Projects (Public)

The HIV/AIDS pandemic is the result of transmission of a zoonotic disease known as simian immunodeficiency virus. The pandemic has had profound social and economic consequences and continues to be present today. France and the United States’ response to the discovery of HIV will be compared and the impact that HIV/AIDS had on their countries and future responses. They had rather similar responses, however, the United States had a slower initial response compared to France. Both had similar takeaways such as aiming at improving prevention and utilizing tactics developed during the start of the pandemic like frequent testing and vaccines.

Examining The Relationship Between Mass Incarceration, Gender Norms, And Hiv Vulnerability For Formerly-Incarcerated Black Men Who Have Sex With Men And Women., Adrienne B. Smith

Electronic Theses and Dissertations

In 2018, Black Americans represented 42% of new HIV diagnoses, despite comprising only 13% of the population. Moreover, Black men accounted for three-quarters of new HIV cases in 2016, with Black gay/bisexual men contributing to the majority of incidence among Black Americans. Existing literature suggests that individual behavior alone cannot explain these racial inequities in HIV rates. This study aims to explore the role of the criminal legal system (CLS) as a structural determinant of health, given its historical racial implications that disproportionately affect Black Americans. Additionally, the study examines masculinity’s influence as a predictor of risky sexual behavior. This …

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …

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

Open Access Theses & Dissertations

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

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

Open Access Theses & Dissertations

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

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Latent Class Analysis Of Polysubstance Use And Sexual Risk Behaviors Among Men Who Have Sex With Men Attending Sexual Health Clinics In Mexico City, Rosibel Rodríguez-Bolaños, Ricardo Baruch-Dominguez, Edna Aril, Elsa Yunes-Díaz, Leonor Rivera-Rivera, Lizeth Cruz-Jiménez, Jim F. Thrasher Ph.D., Ma, Ms, Alan G. Nyitray, Eduardo Lazcando-Ponce

Faculty Publications

Men who have sex with men (MSM) are more likely to use drugs and other substances compared to their heterosexual peers. No studies have evaluated patterns of substance use among MSM adults in Mexico. We used latent class analysis (LCA) to identify MSM subgroups with specific substance use patterns and their associations with sexual behaviors. Methods: Data from 1850 adult MSM were collected at HIV clinics in Mexico City between September 2018 and December 2019. The structural equation modeling approach was used to estimate a LC model to identify patterns of substance use by self-report of substance use (i.e., cigarette …

Hiv-Related Stigma, Sexual And Gender Minority-Related Stigma, And Health Outcomes Among Msm Living With Hiv: Measurement, Impact, And Intersectionality, Tianyue Mi

Theses and Dissertations

Background: Many men who have sex with men (MSM) living with human immunodeficiency virus (HIV) experience suboptimal health outcomes compared to nonMSM males living with HIV, including a faster decline in CD4 count before initiating antiretroviral therapy (ART), slower immune recovery after initiating ART, more mental health problems, suboptimal ART adherence, and lower retention in care. MSM living with HIV are often exposed to multiple layered stigmas, including, but not limited to, stigma related to being infected with HIV and stigma related to sexual and gender minority (SGM) status. Although various scales of HIV-related stigma have been frequently used for …

Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk

Senior Theses

The Latino population in the United States faces a heightened risk in terms of contracting HIV/AIDS and experiencing negative health outcomes from said infection. HIV/AIDS continues to disproportionately impact ethnic/racial minorities, and the Latino population exemplifies this unfortunate trend, with Latino Americans making up around 18.4% of the national population, but nearly 30% of the HIV/AIDS infections (US Office of Minority Health, 2021). More enduring changes to the current resources available to this population will need to be made in order to address this disparity. Thus, the current study examined social determinants, how they increase risk of infection, and how …

A Resilience-Based Intervention To Mitigate The Effect Of Hiv-Related Stigma: Protocol For A Stepped Wedge Cluster Randomized Trial, Xiaoming Li Ph.D., Shan Qiao Ph.D., Xueying Yang, Sayward E. Harrison, Cheuk Chi Tam, Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background: Despite decades of global efforts to tackle HIV-related stigma, previous interventions designed to reduce stigma have had limited effects that were typically in the small- to-moderate range. The knowledge gaps and challenges for combating HIV-related stigma are rooted both in the complexity of the stigma and in the limitations of current conceptualizations of stigma reduction efforts. Recent research has shown the promise of resilience-based approaches that focus on the development of strengths, competencies, resources, and capacities of people living with HIV (PLWH) and their key supporting systems (e.g., family members and healthcare providers) to prevent, reduce, and mitigate the …

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

What Do Epidemic History And Sexual Minority Men’S Experiences Of Hiv And Covid-19 Teach Us About Pandemic Preparedness?, Amy Braksmajer, Andrew London

Population Health Research Brief Series

For many, COVID-19 feels like the first, massive, life-threatening epidemic of infectious disease they have faced. However, for sexual minority individuals who have experienced trauma and loss stemming from the HIV epidemic, there are many similarities. This brief summarizes findings from interviews with men who have lived through both pandemics as a way to gain insights into the commonalities and differences of their experiences. Findings show that men who lived through both epidemics believe the government did not do enough to respond to either crisis. To better prepare for future epidemics, public health efforts must be less fragmented, including a …

Adverse Childhood Experiences And Hiv Risk Behaviors Among Transgender Populations, Linda Baggio

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have a negative impact on health and have created a social challenge in managing HIV risk behavior in the transgender population. The aim of this study was to determine the association between ACEs and HIV risk behavior among the transgender population and identify the association between ACE score (1, 2, 3, 4, or more) and HIV risk behavior among the transgender population. This involved a quantitative methodology using a Behavioral Risk Factor Surveillance System (BRFSS) questionnaire to obtain data from 323 transgender participants. Multivariable regression analyses were conducted to determine the association between ACEs and HIV …

Clinicians Experience Using The Family As A Unit Of Treatment For Black Hiv-Positive Men Who Have Sex With Men, Steffen Gillom

Antioch University Dissertations & Theses

The present study examines the experiences of five licensed clinicians as they attempted to integrate the family as a unit of treatment into the treatment of Black HIV-positive men who have sex with men (BHPMSM). A single 90-minute focus group study using an interpretive phenomenological approach (IPA) was conducted with five clinicians from diverse backgrounds. The results of the study show that clinicians attempting to integrate the family into the treatment of BHPMSM shared common experiences in the areas of building community through encouraging client self-determination, navigating religion, navigating HIV stigma, feelings of incompetence, and feelings of gratification after successful …

Effects Of Perpetrator Types And Gender-Based Violence On Condom Use Among Tanzanian Female Sex Workers, Lashonda Hall

Walden Dissertations and Doctoral Studies

HIV status among female sex workers (FSWs) continues to be a significant public health concern. Condom use is associated with HIV cases among FSWs. Gender-based violence (GBV) plays a role in FSWs HIV status. While studies have investigated the relationship between GBV and condom use, little is known about the impact of factors such as perpetrator type and substance use. I aimed to examine whether perpetrator type and substance use affect the relationship between GBV and condom use among FSWs in Tanzania. Secondary data analysis was performed on 1,502 FSWs extracted from the 2020 Tanzanian, John Hopkins Program for International …

Pre-Exposure Prophylaxis (Prep) Uptake Among Black Men Who Have Sex With Men (Bmsm) In The Southern U.S, Oluwafemi Adeagbo, Sayward Elizabeth Harrison, Shan Qiao Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Black men who have sex with men (BMSM) living in the United States (U.S.) South are disproportionately affected by HIV and experience significant disparities in HIV incidence, access to HIV care, and prevention across ages and socio-economic statuses. The aim of this commentary is to critically review current literature on the state of PrEP use among BMSM in the U.S. South, including identifying barriers and facilitators to PrEP use in order to inform intervention development. Extant literature shows that despite the documented benefits of PrEP as an effective HIV-prevention method, its uptake among BMSM is limited across the U.S. South. …