Doctoral Degree Granting Institutions: Recent submissions
Now showing items 41-60 of 1378
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Designing accessible websites is crucial for creating an inclusive online environment, as it enhances usability, ensures equal access to information and services, and promotes the principles of universal designThis paper outlines the author's proposal to create a responsive website showcasing their creative work and skills as a visual and information designer. The website adheres to the most recent Website Content Accessibility Guidelines (WCAG 2.0) and incorporates best website design practices. The website includes a homepage and four main landing pages (Audio, Video, Image, and Text), displaying various content types cohesively through an emphasis on universal design principles. The author aims to achieve a high Signal-to-Noise Ratio, providing clear visual and textual hierarchy, while integrating various media elements effectively. The paper conducts a literature review, exploring effective website design elements, usability, and future design trends. It highlights the significance of accessibility for individuals with cognitive disabilities and the importance of combining aesthetics with functionality. The research outcomes discuss the evolution of WCAG, from version 2.0 to the upcoming version 3.0. It emphasizes the relevance of adhering to accessibility guidelines and incorporating alternative text, captions, and keyboard support to ensure an inclusive user experience. The paper concludes by stating the importance of ongoing improvements to meet evolving accessibility requirements and standards.
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Food Insecurity Is Associated With Inflammation Among Women Living With HIV.Background: Chronic inflammation is associated with AIDS-defining and non-AIDS-defining conditions. Limited research has considered how food insecurity influences chronic inflammation among people living with human immunodeficiency virus (HIV). We examined whether food insecurity was associated with higher levels of inflammation among women living with HIV (WWH) in the United States.
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Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States.Background: Food insecurity and mental health negatively affect the lives of women in the United States. Participants in the Women's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time.
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Defining the mechanism of STAT3 regulation by ABI1 in prostate cancerProstate cancer, driven by hormones and the androgen receptor (AR), initially responds to AR pathway-targeted treatments. However, tumor relapse arises from a process called the prostate cancer cell lineage switch. This switch involves transcriptional and epigenetic reprogramming, allowing cancer cells to acquire a new identity and bypass the stress caused by anti-AR treatments, resulting in increased proliferation and metastasis. Our study delves into the regulatory mechanism of STAT3, a key modulator, by the tumor suppressor ABI1 during the process of lineage switch. We observed an inverse correlation between ABI1 expression and the progression of the lineage switch. Using tumor models, we demonstrated that ABI1 modulates the phosphorylation of STAT3 by regulating kinase activities. Additionally, we discovered that ABI1 interacts with DNA through unique intrinsic disordered DNA binding regions. Notably, during prostate cancer lineage switch, a specific ABI1 EXON4 undergoes abnormal splicing, enhancing the ABI1-DNA interaction and influencing epigenetic remodeling by modulating chromatin accessibility. Our findings highlight the role of ABI1 in regulating STAT3 activities through its DNA interaction and reveal a reciprocal regulation between ABI1 and STAT3 in terms of nuclear localization, thereby influencing the lineage switch driven by STAT3. Overall, we propose that ABI1 acts as a master regulator of the lineage switch by maintaining the homeostasis of epigenetic and transcriptional processes.
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Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: the mediating role of depression.Objective: We investigated whether internalized HIV-related stigma predicts adherence to antiretroviral therapy (ART) longitudinally in women living with HIV in the United States, and whether depression symptoms mediate the relationship between internalized stigma and suboptimal ART adherence.
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Buffering Internalization of HIV Stigma: Implications for Treatment Adherence and Depression.Background: One mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. We examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. Furthermore, we investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.
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A Mixed Methods Study of Anticipated and Experienced Stigma in Health Care Settings Among Women Living with HIV in the United States.Among places where people living with HIV experience and anticipate HIV-related stigma, stigma in health care settings may be particularly harmful. Utilizing an exploratory sequential mixed methods approach, we conducted interviews (n = 76) and questionnaires (N = 460) with older adult women living with HIV enrolled in the Women's Interagency HIV Study in Birmingham, AL; Jackson, MS; Atlanta, GA; and San Francisco, CA. Interviews addressed facilitators and barriers to HIV treatment adherence, including HIV-related stigma. Qualitative data were coded using thematic analysis. Questionnaires assessed self-reported antiretroviral therapy (ART) adherence and experienced and anticipated HIV-related stigma from various sources (i.e., health care personnel, family, partner, and community). Covariate-adjusted logistic regression analyses examined total and mediated effects of stigma on ART adherence. Interviewees described fears and experiences of stigma in health care settings; including privacy violations, disrespect for patient autonomy, and reproductive coercion; and how these influenced their adherence to HIV treatment recommendations. Experienced and anticipated HIV-related stigma in health care settings were associated with suboptimal (or <95%) ART adherence in separate models controlling for experienced or anticipated stigma, respectively, from other sources. When entered together, only anticipated stigma in health care settings was associated with suboptimal ART adherence, controlling for anticipated and experienced stigma from other sources. The effect of anticipated stigma in health care settings on suboptimal ART adherence may work through the pathways of lower adherence self-efficacy, higher depressive symptoms, and higher coping by substance use. These findings indicate that interventions should promote cultures of acceptance within health care settings and resilience-based strategies for women to combat stigma and promote life-sustaining behaviors.
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Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the U.S.Background: Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women's Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV.
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Viremia Trajectories of HIV in HIV-Positive Women in the United States, 1994-2017.Importance: Viral suppression of HIV is an important treatment goal to decrease morbidity, mortality, and risk of transmission to others.
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Neighborhood Racial Diversity, Socioeconomic Status, and Perceptions of HIV-Related Discrimination and Internalized HIV Stigma Among Women Living with HIV in the United States.Relationships that traverse sociodemographic categories may improve community attitudes toward marginalized groups and potentially protect members of those groups from stigma and discrimination. The present study evaluated whether internalized HIV stigma and perceived HIV-related discrimination in health care settings differ based on individual- and neighborhood-level characteristics of women living with HIV (WLHIV). We also sought to extend previous conceptual and empirical work to explore whether perceived HIV-related discrimination mediated the association between neighborhood racial diversity and internalized HIV stigma. A total of 1256 WLHIV in the Women's Interagency HIV Study (WIHS) attending 10 sites in metropolitan areas across the United States completed measures of internalized HIV stigma and perceived HIV-related discrimination in health care settings. Participants also provided residential information that was geocoded into Federal Information Processing Standard (FIPS) codes and linked with census-tract level indicators. In cross-sectional analyses, greater neighborhood racial diversity was associated with less internalized HIV stigma and less perceived HIV-related discrimination regardless of individual race. Neighborhood median income was positively associated with internalized HIV stigma and perceived discrimination, while individual income was negatively associated with perceptions of stigma and discrimination. In an exploratory mediation analysis, neighborhood racial diversity had a significant indirect effect on internalized HIV stigma through perceived HIV-related discrimination. An indirect effect between neighborhood income and internalized stigma was not supported. These findings suggest that greater neighborhood racial diversity may lessen HIV stigma processes at the individual level and that HIV stigma-reduction interventions may be most needed in communities that lack racial diversity.
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Health Disparities and the Digital Divide: The Relationship between Communication Inequalities and Quality of Life among Women in a Nationwide Prospective Cohort Study in the United States.Background: Communication inequalities can affect health-seeking behaviors yet the relationship between Internet use and overall health is inconclusive. Communication-related inequalities vary by race/ethnicity and SES but existing research primarily includes middle-class Whites. We therefore examined the relationship between communication-related inequalities-measured by daily Internet use-and health-related quality of life (QOL) using a nationwide prospective cohort study in the United States that consists of primarily low income, minority women. Methods: We examined Internet use and QOL among participants in the Women's Interagency HIV Study. Data collection occurred from October 2014-September 2015 in Chicago, New York, Washington DC, San Francisco, Atlanta, Chapel Hill, Birmingham/Jackson and Miami. We used multi-variable analyses to examine the relationship between daily Internet use and QOL. Results: The sample of 1,915 women was 73% African American and 15% Hispanic; 53% reported an annual income of ≤$12,000. Women with daily Internet use reported a higher QOL at six months, as did women with at least a high school diploma, income >$12,000, and non-White race; older women and those with reported drug use, depressive symptoms and loneliness had lower QOL. Conclusions: Overcoming communication inequalities may be one pathway through which to improve overall QOL and address public health priorities. Reducing communication-related inequalities-e.g, by providing reliable Internet access-and thus improving access to health promoting information, may lead to improved health outcomes.
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HIV Prevention for Black Heterosexual Men: The Barbershop Talk with Brothers Cluster Randomized Trial.Objectives: To identify the impact of a strengths-focused HIV prevention program among high-risk heterosexual Black men. Methods: Barbershops in Brooklyn, New York, neighborhoods with high rates of heterosexually transmitted HIV were randomized to the intervention or an attention control program. Men were recruited from barbershops between 2012 and 2016 and participated in a single small group, peer-led session focused on HIV risk reduction skills and motivation, community health empowerment, and identification of personal strengths and communication skills. The outcome was defined as 1 or more acts of condomless anal or vaginal sex in the preceding 90 days at a 6-month interview. Results: Fifty-three barbershops (24 intervention, 29 control) and 860 men (436 intervention, 424 control) were recruited; follow-up was completed by 657 participants (352 intervention, 305 control). Intervention exposure was associated with a greater likelihood of no condomless sex (64.4%) than control group participation (54.1%; adjusted odds ratio = 1.61; 95% confidence interval = 1.05, 2.47). Conclusions: Program exposure resulted in reduced sexual risk behaviors, and the program was acceptable for administration in partnership with barbershops. Public Health Implications: Dissemination of similar programs could improve public health in communities with high rates of HIV attributable to heterosexual transmission.
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Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the United States.Objective: To examine whether experienced poverty stigma is associated with worse HIV care and treatment outcomes.
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The Longitudinal Association between Social Support on HIV Medication Adherence and Healthcare Utilization in the Women's Interagency HIV Study.Social support is associated with HIV-related health outcomes. However, few studies have explored this longitudinally. We assessed psychometric properties of the Medical Outcomes Study's Social Support Survey among women in the Women's Interagency HIV Study, and explored the longitudinal effects of social support on HIV medication adherence (HIV-positive women) and healthcare utilization (HIV-positive and negative women). The 15 questions loaded into two factors, with Cronbach's Alpha > 0.95. Over 3 years, perceived emotional support was associated with optimal medication adherence (OR 1.19, 95% CI 1.10-1.28) and healthcare utilization (OR 1.16, 95% CI 1.05-1.27), and tangible social support with adherence only (OR 1.18, 95% CI 1.08-1.27) when controlling for covariates, including core sociodemographic characteristics and depressive symptoms. Interventions to further understand the drivers of sub-types of social support as well as enhance sustained social support may assist with optimizing care of women with and at risk for HIV.
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Food insecurity is associated with anxiety, stress, and symptoms of posttraumatic stress disorder in a cohort of women with or at risk of HIV in the United States.Background: Food insecurity, which disproportionately affects marginalized women in the United States, is associated with depressive symptoms. Few studies have examined relations of food insecurity with other mental health outcomes.
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Health, Human Capital and Domestic Violence.We treat health as a form of human capital and hypothesize that women with more human capital face stronger incentives to make costly investments with future payoffs, such as avoiding abusive partners and reducing drug use. To test this hypothesis, we exploit the unanticipated introduction of an HIV treatment, HAART, which dramatically improved HIV+ women's health. We find that after the introduction of HAART HIV+ women who experienced increases in expected longevity exhibited a decrease in domestic violence of 15% and in drug use of 1520%. We rule out confounding via secular trends using a control group of healthier women.
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The Relationship Between Discrimination and Missed HIV Care Appointments Among Women Living with HIV.Receiving regular HIV care is crucial for maintaining good health among persons with HIV. However, racial and gender disparities in HIV care receipt exist. Discrimination and its impact may vary by race/ethnicity and gender, contributing to disparities. Data from 1578 women in the Women's Interagency HIV Study ascertained from 10/1/2012 to 9/30/2016 were used to: (1) estimate the relationship between discrimination and missing any scheduled HIV care appointments and (2) assess whether this relationship is effect measure modified by race/ethnicity. Self-reported measures captured discrimination and the primary outcome of missing any HIV care appointments in the last 6 months. Log-binomial models accounting for measured sources of confounding and selection bias were fit. For the primary outcome analyses, women experiencing discrimination typically had a higher prevalence of missing an HIV care appointment. Moreover, there was no statistically significant evidence for effect measure modification by race/ethnicity. Interventions to minimize discrimination or its impact may improve HIV care engagement among women.
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Effectiveness of interventions targeting self-regulation to improve adherence to chronic disease medications: a meta-review of meta-analyses.Adherence to chronic disease medication regimens depends in part on successful self-regulation. However, the overall benefit of interventions targeting self-regulatory mechanisms is not well-understood. Accordingly, we conducted a meta-review of meta-analyses assessing the effect of interventions targeting self-regulation on medication adherence. For this meta-review, meta-analyses appearing between January 2006 and March 2019 were eligible if they included experimental trials that assessed the effect of an intervention targeting self-regulation on adherence to chronic disease medication. A systematic literature search of multiple databases for published and unpublished literature identified 16,001 abstracts. Twelve meta-analyses met eligibility criteria and had variable quality according to AMSTAR 2 item completion ( = 50%; range: 31-66%). Overall, meta-reviews showed small to medium effect sizes for interventions that targeted self-monitoring, provided personalised feedback on adherence, or involved complete self-management. Other interventions, such as goal setting, barrier identification and problem solving, and stress management showed little evidence of improving adherence. Only a limited number of self-regulation intervention components were able to be evaluated. Additional research is needed to advance the understanding of the efficacy of adherence interventions focussed on self-regulation by expanding the scope of self-regulation elements targeted (e.g., emotion regulation).
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Brief Report: Linking Depressive Symptoms to Viral Nonsuppression Among Women With HIV Through Adherence Self-Efficacy and ART Adherence.Background: Depression plays a key role in suboptimal HIV outcomes, possibly mediated by adherence self-efficacy beliefs and antiretroviral treatment (ART) adherence behavior. Applying social-cognitive theory, we examined a longitudinal sequential path model of the association between depressive symptoms and viral nonsuppression in women with HIV (WWH) through these mediating mechanisms.
