Immune System Diseases Commons^™

Sexual Relationships Outside Primary Partnerships And Abstinence Are Associated With Lower Adherence And Adherence Gaps: Data From The Partners Prep Ancillary Adherence Study, Alexander Kintu, Susan E. Hankinson, Raji Balasubramanian, Karen Ertel, Elioda Tumwesigye, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis (PrEP) against HIV.

Methods—We enrolled 1,147 HIV-negative individuals in long-term serodiscordant relationships at three sites in Uganda from the Partners PrEP Study- a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (

Results—Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with

Conclusions—Risk of low overall adherence …

Super Learner Analysis Of Electronic Adherence Data Improves Viral Prediction And May Provide Strategies For Selective Hiv Rna Monitoring, Maya L. Petersen, Erin Ledell, Joshua Schwab, Varada Sarovar, Robert Gross, Nancy Reynolds, Jessica E. Haberer, Kathy Goggin, Carol E. Golin, Julia Arnsten, Marc Rosen, Robert H. Remien, David Etoori, Ira B. Wilson, Jane M. Simoni, Judith A. Erlen, Mark J. Van Der Laan, Honghu Liu, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—Regular HIV RNA testing for all HIV positive patients on antiretroviral therapy (ART) is expensive and has low yield since most tests are undetectable. Selective testing of those at higher risk of failure may improve efficiency. We investigated whether a novel analysis of adherence data could correctly classify virological failure and potentially inform a selective testing strategy.

Design—Multisite prospective cohort consortium.

Methods—We evaluated longitudinal data on 1478 adult patients treated with ART and monitored using the Medication Event Monitoring System (MEMS) in 16 United States cohorts contributing to the MACH14 consortium. Since the relationship between adherence and virological failure is …

A Systematic Literature Review Of The Relationship Between Alcohol Consumption And Highly Active Anti-Retroviral Therapy (Haart) In Patients Diagnosed With Hiv/Aids, Charmaine M. Lapre'

Honors Theses

According to the Global Information System on Alcohol and Health (GISAH), alcohol consumption causes more than 2.5 million deaths annually. This organization also attributes more than sixty different diseases in which alcoholism plays a significant role. Such diseases include the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) (WHO, 2014). There are over 50,000 new cases of HIV reported each year. In the United States, it is estimated that more than 1.1 million people are infected with HIV, and about one in six people are completely unaware that they are infected (CDC.gov, 2013). A systematic literature review was …

Estrogen, Bisphenol A, And Bisphenol S: Regulation Of Cathepsin L Activity And Its Relation To Systemic Lupus Erythematosis, Regina M. Powers

Biology Honors Papers

Systemic Lupus Erythematosis (SLE) is an autoimmune disease that causes the immune system to self-destruct. SLE is nine times more frequent in women than in men, and it has been shown that there is a correlation between high estrogen levels and an increased severity of the disease. This raises a concern about environmental estrogens, including Bisphenol A (BPA) which is found in many plastic products in the United States. BPA can be absorbed by the foods and liquids that are held in the plastic containers and then can enter into the human body. Because of its structural similarity to estrogen, …

Impact Of Social And Cultural Factors On Teenage Pregnancy, Devi Akella, Melissa Jordan

Journal of Health Disparities Research and Practice

United States has the highest level of teenage pregnancy amongst the industrialized nations. Further, the level of teenage pregnancy is highest amongst the minority population. This research study examines the reasons behind high rates of early childbirth amongst African American teenagers. This study uses Bandura’s (1977) Social Learning Theory to deconstruct the factors, which influence and manipulate the overall behavior of the teenagers and initiates them to choose early motherhood over education and career. To ensure better quality of empirical data, the authors collaborated with the pregnant teenagers and a local non-profit community agency using a phenomenological analysis.

Cus M! Let’S Go!: The Flourishing Of Bali’S Komunitas Gay In The Hiv/Aids Crisis, Ikaika Ramonès

Independent Study Project (ISP) Collection

This paper draws on approximately one month of field research with two Indonesian Non-Governmental Organisations (NGOs), exploring how Bali’s komunitas gay has been affected by, reacted to, proactively combated, and even transcended the ongoing HIV/AIDS epidemic. This paper first situates the argument by explaining the uniqueness of Bali as a site of HIV/AIDS resurgence and centre of gay life in Indonesia. In this context, the paper discusses the observed phenomena, testimony of experiences from collaborators, and the role one of these NGOs plays in the community. This paper argues against the commonly-held static and victimizing notion that the HIV/AIDS crisis …

Know Your Audience: Predictors Of Success For A Patient-Centered Texting App To Augment Linkage To Hiv Care In Rural Uganda, Mark J. Siedner, Data Santorino, Jessica E. Haberer, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Despite investments in infrastructure and evidence for high acceptability, few mHealth interventions have been implemented in sub-Saharan Africa.

Objective: We sought to (1) identify predictors of uptake of an mHealth application for a low-literacy population of people living with HIV (PLWH) in rural Uganda and (2) evaluate the efficacy of various short message service (SMS) text message formats to optimize the balance between confidentiality and accessibility.

Methods: The trial evaluated the efficacy of a SMS text messaging app to notify PLWH of their laboratory results and request return to care for those with abnormal test results. Participants with a …

Assessing Usual Care In Clinical Trials, Judith A. Erlen, Lisa K. Tamres, Nancy Reynolds, Carol E. Golin, Marc I. Rosen, Robert H. Remien, Julie W. Banderas, Neil Schneiderman, Glenn Wagner, David Bangsberg, Honghu Liu

OHSU-PSU School of Public Health Faculty Publications and Presentations

Researchers designing clinical trials often specify usual care received by participants as the control condition expecting that all participants receive usual care regardless of group assignment. The assumption is that the groups in the study are affected similarly. We describe the assessment of usual care within the 16 studies in MACH 14, a multi-site collaboration on adherence to antiretroviral therapy. Only five of the studies in MACH 14 assessed usual care. Assessment protocols varied as did the timing and frequency of assessments. All usual care assessments addressed patient education focused on HIV, HIV medications, and medication adherence. Our findings support …

Common Threads: An Integrated Hiv Prevention And Vocational Development Intervention For African American Women Living With Hiv/Aids, Liza Marie Conyers, Yung-Chen Chiu, Aisha Shamburger-Rousseau, Vanessa Johnson, Mark Misrok

Journal of Health Disparities Research and Practice

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social …

Lessons Learned: Exploratory Study Of A Hiv/Aids Prevention Intervention For African American Women Who Have Experienced Intimate Partner Violence, Michele A. Rountree

Journal of Health Disparities Research and Practice

Given the prevalence and co-occurring nature of HIV and intimate partner violence among African American women there is a need for a risk reduction intervention. This study explored the results from an exploratory study of an HIV/AIDS prevention intervention for African-American women who have experienced intimate partner violence. The emphasis of this study is to identify lessons learned to guide future research.

Recruitment for the feasibility study was done in two waves over a period of three months. During the first wave, 22 participants were recruited for the intervention group, and in the second wave, 25 participants were in the …

Editors' Notes-Women Of Color Sexual Health Across The Lifespan, Marya Shegog, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Editors' Notes: Men Of Color Sexual Health Across The Lifespan, Marya Shegog, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Systems Level Analysis Of Systemic Sclerosis Shows A Network Of Immune And Profibrotic Pathways Connected With Genetic Polymorphisms, J. Matthew Mahoney, Jaclyn Taroni, Viktor Martyanov, Tammara A. A. Wood, Casey S. Greene, Patricia A. Pioli, Monique E. Hinchcliff, Michael L. Whitfield

Dartmouth Scholarship

Systemic sclerosis (SSc) is a rare systemic autoimmune disease characterized by skin and organ fibrosis. The pathogenesis of SSc and its progression are poorly understood. The SSc intrinsic gene expression subsets (inflammatory, fibroproliferative, normal-like, and limited) are observed in multiple clinical cohorts of patients with SSc. Analysis of longitudinal skin biopsies suggests that a patient's subset assignment is stable over 6-12 months. Genetically, SSc is multi-factorial with many genetic risk loci for SSc generally and for specific clinical manifestations. Here we identify the genes consistently associated with the intrinsic subsets across three independent cohorts, show the relationship between these genes …

Evaluating The Effects Of An Interdisciplinary Practice Model With Pharmacist Collaboration On Hiv Patient Co-Morbidities, Rebecca Cope, Leonard Berkowitz, Rebecca Arcebido, Jun-Yen Yeh, Nathan Trustman, Agnes Cha

Touro College of Pharmacy (New York) Publications and Research

Treatment of HIV now occurs largely within the primary care setting, and the principal focus of most visits has become the management of chronic disease states. The clinical pharmacist’s potential role in improving chronic disease outcomes for HIV patients is unknown. A retrospective cohort study was performed for HIV-positive patients also diagnosed with diabetes, hypertension, or hyperlipidemia. Characteristics and outcomes in 96 patients treated by an interdisciplinary team which included a clinical pharmacist (i.e., the intervention group) were compared to those in 50 patients treated by an individual healthcare provider (i.e., the control group). Primary outcomes were changes from baseline …

Customized Order-Entry Sets Can Prevent Antiretroviral Prescribing Errors: A Novel Opportunity For Antimicrobial Stewardship, Yi Guo, Philip Chung, Caryn Weiss, Keith Veltri, Grace Y. Minamoto

Touro College of Pharmacy (New York) Publications and Research

Background: Patients with human immunodeficiency virus (HIV) infection on antiretroviral (ARV) therapy are at increased risk for medication errors during transitions of care between the outpatient and inpatient settings. This can lead to treatment failure or toxicity. Previous studies have emphasized the prevalence of medication errors in such patients, but few have reported initiatives to prevent errors from occurring.

Methods: The study was conducted in a 1,400-bed health care center with a state-designated Acquired Immunodeficiency Syndrome (AIDS) Center in the Bronx, New York. The antimicrobial stewardship team and HIV specialists developed customized order-entry sets (COES) to guide ARV …

Majority Of Hiv/Hcv Patients Need To Switch Antiretroviral Therapy To Accommodate Direct Acting Antivirals, Rebecca Cope, Aaron Pickering, Thomas Glowa, Samantha Faulds, Peter Veldkamp, Ramakrishna Prasad

Touro College of Pharmacy (New York) Publications and Research

The impact of drug–drug interactions (DDIs) between interferon-free direct acting antiviral (DAA) regimens and antiretrovirals (ART) among HIV/HCV co-infected individuals in clinical practice settings is unknown. A singlecenter, retrospective chart review of co-infected patients was conducted from June 2014 to February 2015. Significant interactions between simeprevir (SMV), ledipasvir (LDV), and paritaprevir/ritonavir/ombitasvir plus dasabuvir (3D regimen) with ART were identified based on available literature. SMV had the largest number of DDIs and was further investigated to determine the feasibility of ART switch to allow for DAA use. Of 127 subjects, 23% had advanced liver disease; 86% of those with known HCV …

Predictors Of Non-­Adherence To Medical Follow-­Up Care Among African Americans With Hiv/Aids, Phyllis D. Morgan, Cynthia B. Banks, Joshua Fogel

2010-2016 Archived Posters

Persons living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) who do not adhere to their medical follow-­ up appointments tend to have poorer health outcomes compared to HIV/AIDS patients who adhere to their medical follow-­up appointments (Lima et al., 2009). This study examined factors that influence non-­adherence of African-­Americans with HIV/AIDS to medical follow-­up appointments.

Analysis Of Humira, Electro-Acupuncture, And Pulsatile Dry Cupping On Reducing Joint Inflammation In Patients With Rheumatoid Arthritis, Natalie Noll

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Humira, an anti-TNF drug aimed at decreasing inflammation in Rheumatoid Arthritis patients, can cause skin diseases from rashes to skin cancer. Humira works by blocking the chemical receptor RANKL which inhibits the production of osteoclasts. Osteoclasts are cells that attack and eat bone and cartilage therefore an inhibitory mechanism would cause inflammation.. By analyzing Humira’s effect on the human body, Humira can be compared to other treatments such as electro-acupuncture and pulsatile dry cupping to determine the viability of these alternative treatment methods in regards to their abilities to decrease inflammation in Rheumatoid Arthritis patients through blocking RANKL. An analysis …

Design, Synthesis, Antiviral Activity, And Pre-Formulation Development Of Poly-Larginine- Fatty Acyl Derivatives Of Nucleoside Reverse Transcriptase Inhibitors, Bhanu P. Pemmaraju, Swapnil Malekar, Hitesh K. Agarwal, Rakesh Tiwari, Donghoon Oh, Gustavo F. Doncel, David R. Worthen, Keykavous Parang

Pharmacy Faculty Articles and Research

The objective of this work was to design conjugates of anti-HIV nucleosides conjugated with fatty acids and cell-penetrating poly-L-arginine (polyArg) peptides. Three conjugates of polyArg cell-penetrating peptides with fatty acyl derivatives of alovudine (FLT), lamivudine (3TC), and emtricitabine (FTC) were synthesized. In general, the compounds exhibited anti-HIV activity against X4 and R5 cell-free virus with EC50 values of 1.5–16.6 μM. FLT-CO-(CH2)12-CO-(Arg)7 exhibited EC50 values of 2.9 μM and 3.1 μM against X4 and R5 cell-free virus, respectively. The FLT conjugate was selected for further preformulation studies by determination of solution state degradation and lipid solubility. The compound was found to …

Impact Of Estrogen Receptor Alpha Signaling On Plasmacytoid Dendritic Cells In Systemic Lupus Erythematous, Jennifer L. Scott

MUSC Theses and Dissertations

Female lupus prone NZM2410 estrogen receptor alpha (ERα) functionally deficient (ERαKO) mice are protected from renal disease and have prolonged survival compared to wild type (WT) littermates, however the mechanism of protection is unknown. Plasmacytoid dendritic cells (pDCs) and type I interferon (IFN) drive lupus pathogenesis and estrogen acting via ERα enhances both pDC development and IFN production. The objectives for this work were to determine if ERα modulates pDC number, maturation, or function in pre-disease NZM2410 mice as a possible protective mechanism of ERα functional deficiency in lupus prone mice. We measured the effect of ERα functional deficiency on …