PhD
November 18, 2020
Engaging Male Partners in Home-based Couple Education and Testing for Syphilis and HIV
For HIV and other sexually transmitted infections (STIs), men seek care at more advanced stages of disease and are less likely to initiate treatment.1-4 Male partner participation in antenatal care (ANC) has been shown to increase male and female HIV testing,5,6 identification of HIV-discordant couples,7,8 female participation in ANC and uptake of PMTCT services1,9 as…
Investigation of Pertussis Resurgence in King County, Washington
Introduction: Pertussis or “whooping cough” is an infectious disease caused by bacterium Bordetella pertussis. Despite widespread vaccination since the 1950s, it continues to cause epidemics in several countries. In fact, in the last three decades, many countries with high vaccination coverage have reported a resurgence in pertussis activity. Understanding the factors that led to pertussis…
Diet, inflammation, and genetic predictors of tissue-specific gene expression: A functionally-informed gene-environment interaction analysis for risk of colorectal cancer.
Colorectal cancer (CRC) is the second most commonly diagnosed cancer in both sexes combined worldwide, as well as the second leading cause of cancer deaths. Pathogenesis of CRC can be attributed to both genetic (G) and environmental (E) factors. Among environmental risk factors, dietary factors contribute significantly to the etiology of CRC. Extensive research has…
Assessing Optimal Intervention Targets for Respiratory Infections in Structured Populations
Background: Respiratory Viral Infections (RVI) are one of the most common health conditions globally, and are an enormous burden to health systems and society in terms of direct medical expenses and indirect productivity losses. Despite progress made in the 20th century with the introduction of antibiotics, vaccines, and antivirals there are no specific interventions for…
Assessing the Individual and Interactive Associations of Pre- and Postnatal Air Pollution Exposures and Maternal Nutrition During Pregnancy with Child Blood Pressure: A Prospective Study in a Community-based Birth Cohort
Background: Limited data suggest that the intrauterine environment and early life experience may contribute to increased child blood pressure, with effects possibly extending into adulthood. The individual and interactive effects of air pollution exposures and maternal nutrition during pregnancy upon child blood pressure are unclear. Methods: In this dissertation, we conducted two separate prospective studies…
Proximal tubular secretion, cardiovascular events, and kidney clearance of medications
Background: Current detection and monitoring of chronic kidney disease (CKD) rely primarily on glomerular filtration rate (GFR) and albuminuria. However, the kidneys perform many important functions outside of the glomerulus. Among them, the secretion of organic anions and cations by kidney proximal tubules is a vital non-glomerular function for removing retained metabolic wastes, toxins, and…
The Epidemiology, Outcomes, and Prevention of HIV-associated Meningitis in Southern Africa
Central nervous system infection are a primary cause of HIV-associated morbidity and mortality worldwide. In this dissertation, I discuss results from research conducted in Botswana, a country in southern Africa with an HIV prevalence that is among the highest in the world, including the first comprehensive meningitis national incidence estimates in a high HIV prevalence…
November 17, 2020
Depression and HIV pre-exposure prophylaxis use among sub-Saharan African Women
Daily, oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a highly efficacious HIV prevention strategy for key populations at high risk of HIV, including women, in sub-Saharan Africa. However, open-label studies and demonstration projects have reported that young women have difficulty adhering to PrEP over time, which limits its effectiveness as a prevention…
Perpetration of Interpersonal Violence, Incarceration, and Subsequent Risk for Firearm Suicide
Suicide is a major public health concern in the United States. The recent growth in the burden of suicide has disproportionately impacted marginalized communities and those of lower socioeconomic status. This dissertation uses administrative data across public health and public safety sectors to assess whether individuals have a heightened risk of suicide after release from…
Reaching underscreened women: correlates of cervical cancer underscreening, reactions to mailed HPV self-sampling kits, and cost-effectiveness of HPV self-sampling programs
Underscreening is a major risk factor for the development of cervical cancer. This dissertation examines factors associated with clinic-based Pap screening and human papillomavirus (HPV) self-sampling in a U.S. healthcare system and summarizes the existing evidence on the cost-effectiveness of HPV self-screening in order to support health system implementation of new strategies to increase cervical…
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