Social and Behavioral Sciences Commons^™

Link, Retain, Suppress: A Grounded Theory Study Of Medical Case Management In The Philadelphia Hiv Service Agencies, Shakeera Wynne

Social Work Doctoral Dissertations

Medical case management (MCM) plays a critical role in supporting engagement in HIV care; however, differences in implementation across agencies may influence service delivery and outcomes. Existing research has focused primarily on outcomes such as retention in care and viral suppression, while less is known about how the MCM intervention is implemented in practice. The purpose of this grounded theory study was to explore how medical case management is implemented within HIV care settings and to examine the structural, organizational, and relational factors that shape service delivery. Semi-structured interviews were conducted with medical case managers working within Ryan White-funded agencies …

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 …

“We Try To Act So Progressive”: A Multivariate And Interpretive Methods Study Examining Equity, Racialization And Interrelated Systems Of Oppression And Privilege Within Hiv Service Organizations, Gregory Joseph Gross

Brown School Graduate Student Theses and Dissertations

Current data suggests that the U.S. is on track to end the HIV epidemic for white people but not for Black, Latine, and other people of color. National initiatives have emphasized diversifying the workforce as part of the response to inequities in HIV outcomes, and yet the field remains staffed predominantly by white service professionals. Moreover, diversifying the workforce without broader systems change will likely be insufficient to address inequities both for professionals and for oppressed communities. The goal of this dissertation was to examine racialization and interrelated systems of privilege and oppression within HIV service organizations, including public health …

Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli

Antioch University Dissertations & Theses

This qualitative study explored the lived experiences of men (18+ years old) living with HIV to better understand how they navigate identity, mental health, relationships, and healthcare systems after diagnosis. The method included a qualitative thematic analysis with 10 participants. Eight themes emerged from the data: (1) reactions, reflections, and meaning-making after diagnosis; (2) managing medication, treatment, and co-occurring conditions; (3) stigma, disclosure, and negotiation of identity; (4) substance use, housing instability, and socioeconomic stressors; (5) navigating the changing HIV landscape; (6) experiences with family and intimate relationships; (7) implications for mental health counseling; and (8) the role of community …

Filling The Gap: Integrating Hiv Into The Counselor Education Curriculum, J. Richelle Joe, Roseina D. Britton, Tiffany Hairston

Teaching and Supervision in Counseling

People living with HIV (PLWH) are vulnerable to mental health conditions including depression, anxiety, and substance use disorders, which in turn, often affect their health outcomes. Multiple, overlapping structural and social determinants of health exacerbate the physical and mental health concerns of PLWH, presenting a need for services that are responsive to the unique implications of the illness. Professional counselors have the potential to provide such services but must be adequately prepared to do so. In response to the lack of HIV-related professional development for counselors and the minimal preparation of counselors-in-training to serve clients with HIV, this article uses …

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 …

A Qualitative Examination Of Peer Navigation For Smoking Cessation In People With Hiv, Garrett S. Stang, Bianca Camacho, Megan Pinkston, Karen Tashima, Christopher W. Kahler, Patricia A. Cioe

Psychological Science Faculty Publications

Introduction: People with HIV (PWH) are disproportionately affected by cigarette use, with a 40-60% prevalence rate. They achieve relatively low cessation rates following traditional interventions and often confront compounded challenges related to social factors. HIV care services have integrated Peer Navigators (PNs) into clinical care for many years, but not in the context of smoking cessation. The purpose of this study was to describe the experiences of PWH on a novel smoking cessation intervention that integrated PNs as part of a pilot randomized controlled trial.

Methods: This qualitative examination was conducted among PWH who smoke cigarettes and who participated in …

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: …

The Rhetoric Of Responsibilization: A Rhetorical Analysis Of Pre-Exposure Prophylaxis Campaigns For Hiv Prevention, Catherine M. Pabalate

Kentucky Undergraduate Journal for the Health Humanities

Responsibilization refers to the process by which patients are made accountable for their health and wellbeing, which is determined by their habits and behaviors. Though responsibilization affords greater agency to patients, it can also result in anxiety and guilt when the patient appears "deviant" or "noncompliant." Because sexual behavior is attributed to the causality of HIV/AIDS, patients’ sexual patterns and choices are included within their medical decision-making. This rhetorical analysis focuses on pharmaceutical campaigns and commercials for pre-exposure prophylaxis (PrEP), which were released between 2012 and 2024 and are targeted towards patients at-risk for HIV/AIDS. Findings suggest that specific rhetorical …

Perceived Adherence-Related Barriers For Youth Living With Hiv In The Southern United States, Kate Weaver, Sarah J. Miller, Sayward Harrison

Faculty Publications

Objective: Youth are at high risk for HIV, accounting for 19% of new diagnoses in the United States (US) in 2021. Highly effective HIV treatment is available in the form of antiretroviral therapy (ART), which enables individuals with HIV to achieve viral suppression. However, youth living with HIV (YLHIV) have poorer ART adherence and lower rates of viral suppression than adults. This study aimed to explore the perspectives of YLHIV and their HIV care providers on barriers and facilitators to ART adherence for YLHIV in the southern US. Methods: Semi-structured qualitative interviews were conducted with YLHIV (n = 16) …

Hiv Funding Matters: Sustaining Progress, Saving Lives, Paulina Camacho, Gordon Culley, Sharlett Smith, Roxanne Watkins

Master of Social Work Student Policy Advocacy Briefs

By 2023, 39.9 million people globally live with HIV, 1.4 million children and 38.6 million adults (WHO, 2025), yet unstable funding threatens progress in prevention and treatment. This fragility is starkly illustrated by Minnesota’s 24% HIV case surge in 2023, the largest increase in a decade, signaling urgent needs for sustained investment. Simultaneously, older adults with HIV endure compounding vulnerabilities in long-term care (LTC) systems, where stigma, discrimination, and culturally incompetent care violate their rights. Legislative action, such as the HIV Long-Term Care Bill of Rights, is needed in Minnesota to ensure equitable access and protections for aging individuals living …

Dissemination And Implementation Approach To Increasing Access To Local Pre-Exposure Prophylaxis (Prep) Resources With Black Cisgender Women: Intervention Study With Vlogs Shared On Social Media, Diane M Santa Maria

Faculty, Staff and Student Publications

Background: Black cisgender women account for only 2% of pre-exposure prophylaxis (PrEP)-eligible people in the United States who use PrEP to prevent HIV. Owing to the low PrEP use, Black cisgender women continue to contract HIV more frequently than women from every other racial group. Intervention efforts that can bridge the link between knowing that PrEP prevents HIV and support with access to PrEP are necessary for Black cisgender women.

Objective: The purposes of the vlogs through the campaign were to share information about ways to prevent HIV using PrEP and fact-based education and provide access to PrEP resources with …

The Role Of Acculturative Stress, Discrimination In Healthcare Settings, And Migration-Related Trauma On Hiv Prevention And Mental Health Among Immigrant Hispanic Sexual Minority Men: An Integrated Model Of Acculturation And Minority Stress, Jonathan Lopez Matos

Dissertations, Theses, and Capstone Projects

This dissertation expands Minority Stress Theory (MST) by integrating the Fourfold Acculturation Model (FAM) to examine the impact of psycho-sociocultural stressors on health outcomes among immigrant Hispanic sexual minority men (HSMM) in the U.S. The study explored how language proficiency, acculturative stress, discrimination in healthcare, migration-related trauma, and stress-related growth influence HIV prevention behaviors and mental health. Survey data from 194 Spanish-speaking immigrant HSMM revealed that monolingual Spanish speakers experienced significantly higher acculturative stress than bilinguals. Acculturative stress significantly mediated the association between stressors and health outcomes, such as HIV testing and mental health symptoms. Discrimination and trauma were directly …

Legacy Of The Voices Project: Pausing For, Listening To, And Sharing Patient Narratives, Ryan N. Heine, Gheri Terry, Aditya H. Gaur

Journal of Patient-Centered Research and Reviews

In today’s information-overloaded and fast-paced world, it is imperative that healthcare providers, including clinical care and research teams, “Pause” for, “Listen” to, and “Share” what their patients and research participants have to say. The VOICES Project at St. Jude Children's Research Hospital offers that opportunity and is creating an everlasting, powerful legacy – one that could meaningfully change the healthcare and clinical research landscape.

Diseño De Experiencia De Usuario En El Continuo Del Cuidado Del Vih. Revisión Sistemática De Literatura Científica (Análisis Bibliográfico Y Bibliométrico), Marco Antonio Guzmán Garnica, Marco Vinicio Ferruzca Navarro, Román A. Mora

GDI. Revista de investigación de Género, Diseño e Innovación

Resumen: Introducción: En los últimos años, el UX design ha ganado terreno en el desarrollo de intervenciones para la atención del continuo del cuidado del VIH. Sin embargo, no existe claridad sobre el desarrollo epistemológico de la disciplina. Metodología: Se recolectaron 180 materiales publicados entre 2014 y 2024 en cuatro bases de datos especializadas a través del método P.R.I.S.M.A. y se realizó un análisis bibliográfico de la literatura encontrada y su contenido con el método L.A.T.C.H. y un análisis bibliométrico a través de procesamiento de lenguaje natural. Resultados: Se encontró que los trabajos tendieron a concentrarse en tres modelos de …

An Examination Of Sleep Quality And Experimental Pain Sensitivity In People With Hiv And Insomnia, Caroline Kathryn Webb

All ETDs from UAB

Prior research has established a bidirectional relationship between sleep and pain, yet this relationship has been understudied in people living with HIV. The current study investigated the relationship between HIV status (H+/H-) and insomnia status (I+/I-) on sleep and quantitative sensory testing (QST) variables. The study was comprised of two research visits where participants were screened and completed the QST protocol. Participants completed the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), and actigraphy as subjective and objective measures of sleep. There were four groups: H-/I- (n=46), H-/I+ (n=37), H+/I- (n=14), and H+/I+ (n=39) (N=136). Results showed …

Aging With Hiv In Nigeria: A Narrative Review Of Multimorbidity And Healthcare Access Challenges, Sunkanmi Folorunsho, Beulah Suleman

Department of Sociology: Faculty Publications

Background and Aims: The population of older adults living with HIV (OALHIV) in Nigeria is growing, bringing forth a dual challenge of chronic comorbidities and barriers to adequate healthcare. This narrative review aims to synthesize empirical evidence on multimorbidity, treatment access, and systemic healthcare gaps affecting OALHIV in Nigeria.

Methods: A structured narrative review was conducted using peer‐reviewed articles and institutional reports published between 2005 and 2024. Searches were performed across PubMed, Google Scholar, African Journals Online (AJOL), Science Direct, and WHO and UNAIDS databases. Eligible studies focused on individuals aged 50 years and older living with HIV in Nigeria …

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 …

The Price Of Prevention: Spain And Italy's Approach To National Prep, Jon Burkart

Claremont-UC Undergraduate Research Conference on the European Union

While recent advancements in antiretroviral therapy (ART) continue to improve the outlook for people living with HIV (PLHIV), new infections remain a concern for health authorities around the world. A clinically proven intervention holds the potential to dramatically reduce new infections: Pre-exposure prophylaxis (PrEP) is a once-daily pill for high-risk populations, including men who have sex with men (MSM), that substantially reduces HIV infection risk. However—much like rates of new infection—public provision of PrEP varies considerably among OECD countries. This case study thus seeks to answer the question: What might explain the disparate timeline of adopting public reimbursement for PrEP …

The Prevalence Rate Of Syphilis And Hiv Across Different Genders, Races, And Ages From 2017 To 2021 In The Southern Region Of The United States, Nafiseh Gavari, Rita Momah, Jessica Green Collins, Elizabeth Jones

Journal of Public Health in the Deep South

This study investigates the prevalence rates of Syphilis and HIV across different genders, races, and ages from 2017 to 2021 in regions 4 (Kentucky, North Carolina, Mississippi, Tennessee, South Carolina, Georgia, Florida, and Alabama) and 6 (New Mexico, Oklahoma, Texas, Arkansas, and Louisiana). These regions have been identified as high-risk areas for sexually transmitted diseases (STDs). Our study seeks to shed light on the trends and disparities in STD prevalence within these specific regions over the specified timeframe. Data were collected and analyzed from the AtlasPlus database, providing insights into the epidemiology of these diseases. The findings reveal increasing trends …

Cognition And Inflammation In Youth With Perinatal Hiv, Megan Niehaus, Julie Mannarino, Jacob Bolzenius, Tori Frerichs, Robert Paul

Undergraduate Research Symposium

Background: Perinatally acquired HIV (PHIV) remains a major global health challenge. Approximately 90% of the global population of PHIV reside in low- or middle-income countries (LMICs) where access to antiretroviral therapy (ART) remains incomplete, particularly for PHIV. With PHIV, the brain is exposed to the virus during critical periods of brain development without the immunological benefits from ART. Unlike adults with horizontally acquired HIV whose nadir CD4+ Tcell count is a strong correlate of cognitive difficulties that persist after sustained use of ART, cognitive symptoms among PHIV youth are independent of traditional HIV disease metrics. Prior studies indicate that PHIV …

Factors Influencing Engagement Across The Motivational Prep Cascade Among Latino Smm: A Mixed-Methods Analysis From The Perspectives Of Community Providers And Latino Smm, Juan Pablo Zapata, Manuel Hurtado, Andrés Alvarado Avila, Steven A. John, Carlos E. Rodriguez-Diaz, Ed De St. Aubin

Psychology Faculty Research and Publications

Latino sexual minority men (SMM) are a highly vulnerable population to HIV, and while pre-exposure prophylaxis (PrEP) has emerged as a promising biomedical tool for HIV prevention among them, its utilization remains disproportionately low in this community despite its potential. Understanding the barriers along the PrEP continuum of care, known as the “PrEP cascade,” is crucial for effectively implementing PrEP interventions. Therefore, the objective of our study was twofold: first, to explore the stage of Latino SMM in the PrEP cascade by examining disparities in demographics, social factors, and healthcare aspects; second, to gain insights from healthcare providers who have …

Therapeutic Potentials Of The Gut-Brain-Microbiota Axis For Prevention And Treatment Of Motivational Deficits In Ecohiv Infected Rats, Mason T. Rodriguez

Theses and Dissertations

People living with HIV begin to experience gastrointestinal disturbances as early as 6 months after initial infection. Regardless of adherence to combination antiretroviral therapy (cART), the gut microbiome of people living with HIV maintains a state of dysbiosis throughout the rest of their lives, providing potential for a novel target for improving the lives of those living with HIV. The present study investigated the impact EcoHIV and cocaine have on the gut microbiome of F344/N rats. Fecal samples were collected from 20 female and 20 male animals at baseline, following self-administration of cocaine, and following inoculation with EcoHIV or Saline. …

Hiv Estimation Using Population-Based Surveys With Non-Response: A Partial Identification Approach, Oyelola A. Adegboye, Tomoki Fujii, Denis H. Y. Leung, Siyu Li

Research Collection School Of Economics

HIV estimation using data from the demographic and health surveys (DHS) is limited by the presence of non-response and test refusals. Conventional adjustments such as imputation require the data to be missing at random. Methods that use instrumental variables allow the possibility that prevalence is different between the respondents and non-respondents, but their performance depends critically on the validity of the instrument. Using Manski's partial identification approach, we form instrumental variable bounds for HIV prevalence from a pool of candidate instruments. Our method does not require all candidate instruments to be valid. We use a simulation study to evaluate and …

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) …

Examining The Risks And Resilience Of Older Adults Living With Hiv/Aids: Qualitative Community-Based Participatory Research Studies In Southern Nevada, Brandon Ranuschio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since the height of the HIV pandemic in the 1980s, medical interventions have significantly increased the life expectancy of people living with HIV/AIDS (PLWH) and made HIV/AIDS a livable, chronic health condition. Because of this, PLWH have been living longer lives and thriving with the help of HIV sector healthcare and service providers. However, with their longer life expectancy, older PLWH have been experiencing other health challenges. One such challenge is the risk of developing HIV-Associated Neurocognitive Disorder (HAND), which is a condition that affects up to 50% of PLWH at some point in their lifetime, with middle-aged and older …

Standing At The Back Of The Bar, Lawrance Cuellar

Open Access Theses & Dissertations

Standing at the Back of the Bar is a collection of semi-autobiographical literary pieces, a hybrid of lyrical essays, poetry, and short stories, that are based on life experiences of the author, Lawrance Cuellar. The book begins with stories of the narrator growing up as a gay Latino in the very conservative, West Texas town of Amarillo in the 1960s and 1970s. The narrator describes and expresses the normalized and internalized homophobia and racism he experienced in the city. As the title for the manuscript implies, he is expected to “stand at the back of the bar” in deference to …

Prescription For Prosperity: The Dual Miracle Of Antiretroviral Therapy And African Growth, Robert W. F. Pennington

Economics Honors Projects

This paper investigates the effect of antiretroviral therapy (ART) coverage on economic growth in Sub-Saharan Africa. I model the relationship following the expanded Solow Growth Model, proposing a dual health capital and educational human capital mechanism through which ART impacts growth. While previous studies propose conflicting results, I use the most comprehensive dataset, and employ theory-backed specifications to provide the most accurate and reliable estimates of the effect. Using a panel of all 48 countries in Sub-Saharan Africa, I employ a two-stage least squares shift-share/Bartik instrumental variable approach, including two-way fixed effects to estimate the effect of a rapid expansion …

Hiv Estimation Using Population Based Surveys With Non-Response: A Partial Identification Approach, Oyelola A Adegboye, Tomoki Fujii, Denis H. Y. Leung, Siyu Li

Research Collection School Of Economics

HIV estimation using data from the Demographic and Health Surveys (DHS) is lim-ited by the presence of non-response and test refusals. Conventional adjustments such as imputation require the data to be missing at random. Methods that use instrumental variables allow the possibility that prevalence is different between the respondents and non-respondents, but their performance depends critically on the validity of the instru-ment. Using Manski’s partial identification approach, we form instrumental variable bounds for HIV prevalence from a pool of candidate instruments. Our method does not require all candidate instruments to be valid. We use a simulation study to evaluate and …

The Accuracy Of Anal Self- And Companion Exams Among Sexual Minority Men And Transgender Women: A Prospective Analysis, Ashish A Deshmukh, Ellen Almirol, Jared Kerman, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Aniruddha Hazra

Faculty, Staff and Student Publications

BACKGROUND: Squamous cell carcinoma of the anus (SCCA) annual incidence among sexual minority men with and without HIV is 85/100,000 and 19/100,000 persons, respectively, which is significantly higher than the overall incidence (2/100,000). Incidence may also be higher in transgender women. Since SCCA tumours average ≥30 mm at diagnosis, we assessed the accuracy of individuals to self-detect smaller anal abnormalities.

METHODS: Using convenience sampling, the study enrolled sexual minority men and transgender women, aged 25-81 years, in Chicago, Illinois and Houston, Texas, USA, during 2020-2022. Individuals were taught the anal self-examination and anal companion examination (ASE/ACE). Then, a clinician performed …