PhD
December 26, 2023
Novel Testing Strategies to Support HIV Treatment and Prevention: Acceptability, Preferences, and Impact on Engagement in Care and Sexual Behaviors
The primary goal of this dissertation project was to advance our understanding of the impact of novel testing strategies to support HIV treatment and prevention. Despite significant advancements in antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP), rates of suboptimal medication adherence and disengagement from care, particularly in the first year of care, remain extraordinarily high….
Empowerment, Stigma, and Structural Factors and their Influences on Sexual and Reproductive Health Care of Young Women
Adolescent girls and young women (AGYW) in East and southern Africa face parallel epidemics of HIV incidence and unintended pregnancy. AGYW in Kenya, specifically, confront unique challenges to sexual and reproductive health access, quality, and wellbeing. To understand the social and structural barriers that impede optimal reproductive health outcomes, it is crucial to understand the…
December 22, 2023
Trajectories, predictors, and impact on neurocognition of viral control among children living with HIV in Kenya
Children with HIV have poorer viral control than adults. Early initiation of effective antiretroviral therapy (ART) is essential for suppressing virus and recovering immunity; however, children are less likely to attain viral suppression than adults due to inadequate treatment dosing for weight, drug resistance, and barriers to adherence. Similar to adults, during viral suppression replication-competent…
Multilevel sociodemographic and socioeconomic disparities in COVID-19 outcomes in the Central Puget Sound region, 2020-2021
Presence of at least one underlying health condition (UHC) is positively associated with severe COVID-19. Although disparities in severe COVID-19 outcomes by race, ethnicity, and socioeconomic position (SEP) are extensively documented, there is little research examining these associations beyond the effect of UHCs. Studies also show regions of lower SEP and higher racial residential segregation…
Characterizing modifiable risk factors of breast cancer recurrence and mortality in a cohort of women with luminal, triple-negative, and HER2-overexpressing breast cancer
Breast cancer is the most common cancer diagnosed among women in the United States; ten to 20% of survivors will experience a recurrence in the decade after diagnosis. To improve the understanding of the relationship between modifiable risk factors and breast cancer recurrence and mortality, overall and by subtype, we evaluated the relationship between smoking,…
December 21, 2023
FAMILY MATTERS: Relationship dynamics among couples affected by HIV during pregnancy, and neurodevelopment of HIV-exposed uninfected infants in sub-Saharan Africa
Relationship dynamics among couples affected by HIV during pregnancy, and neurodevelopment of HIV-exposed uninfected infants in sub-Saharan Africa Michelle A Bulterys Chair of the Supervisory Committee:Dr. Grace John-Stewart Departments of Epidemiology, Global Health and Pediatrics Introduction: Caregiver wellbeing is closely linked to child health and neurodevelopmental outcomes. Families affected by HIV in sub-Saharan Africa (SSA)…
December 21, 2022
Heterogeneity in HIV/STI Prevalence, Testing, and PrEP Use among Transgender and Non-binary People and their Partners in the US
Transgender and non-binary (TNB) people in the U.S. are disproportionately impact by HIV and sexually transmitted infections (STIs). As a result of socio-structural stigma, institutional barriers, and fear of mistreatment, and discrimination, TNB people experience significant barriers to engaging in health care, including HIV/STI prevention. In addition, the HIV/STI prevalence and behaviors of their sex…
New Insights into Neisseria gonorrhoeae (NG): Geographic heterogeneity in Black-White disparities and spatiotemporal trends among US females and the role of azithromycin use for STI treatment in antibiotic resistance
Gonorrhea (caused by the Neisseria gonorrhoeae (NG) bacterium) is the second most-commonly reported sexually transmitted infection (STI) in the United States (US) and can cause serious, permanent reproductive sequalae in females. Gonorrhea rates have increased rapidly in the US throughout the last 3 decades, while profound racial disparities have stubbornly persisted with non-Hispanic Black (NHB)…
Assessing Helicobacter pylori infections among adults from the Navajo Nation
Background: Although the burden of gastric cancer is low in the United States (US) overall, a substantial burden of gastric cancer continues to be observed in American Indians and Alaska Natives (AI/AN), particularly in the Southwest and Alaska regions of the US. In particular, gastric cancer incidence is 3.5 times higher in the Navajo Nation,…
The Association of Upper Airway Anatomy with Cognitive Test Performance and Brain Structure: The Multi-Ethnic Study of Atherosclerosis
Sleep apnea, affecting an estimated 1 in 4 American adults, has been reported to be associated with both impaired cognitive function and brain structural abnormality. It is important to explore upper airway anatomy as a risk factor for brain structural abnormality and poor cognitive function both overall and above and beyond its effect on sleep….
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