PhD
December 26, 2023
Tuberculosis Risk and Prevention: Findings from Domestic and Global Cohorts
Tuberculosis is a highly infectious disease, leading to disproportionate morbidity and mortality amongst vulnerable populations such as immigrants, adolescents and young adults (AYA), and people living with HIV (PLWHIV). Approximately one quarter of the global population is infected with TB, which can develop into TB disease due to a myriad of factors. There has been…
Identifying opportunities to reduce cervical cancer prevention disparities in Western Washington
Cervical cancer screening (CCS) and human papillomavirus (HPV) vaccination are at the heart of the global cervical cancer elimination movement. However, in the United States (US), less than two thirds of age-eligible adolescents are up to date for HPV vaccination, and screening coverage among minorities and immigrants is still low. This dissertation addressed critical knowledge…
Exploring the online and in-person epidemiology and etiology of white supremacy
Racism, a common facet of white supremacy, is increasingly understood to be a major threat to both the health of democracy in the United States and to the public’s health. However, our understanding of white supremacy and white supremacy culture is still limited. In this dissertation, we examine two violent examples of where and how…
Improving the Efficiency and Effectiveness of Assisted Partner Services for HIV in Western Kenya
To control the HIV epidemic in Sub-Saharan Africa, it is crucial to increase the proportion of people who know their serostatus. In Kenya, approximately 1.6 million people are living with HIV (PLWH), of whom it is estimated that 21% are unaware of their status. Assisted partner services (APS) are programs that help to identify and…
Adverse pregnancy outcomes, non-retention, eligibility of differentiated care and virologic failure among women living with HIV in prevention of vertical transmission programs
Provision of antiretroviral treatment (ART) to women living with HIV (WLWH) before and during pregnancy is key to prevention of vertical HIV transmission (or prevention of mother-to-child transmission [PMTCT]), including suppressed maternal HIV viral loads (VL) and improved maternal health. Studies have reported that ART use during pregnancy may affect the risks of adverse pregnancy…
Suicide and Firearm Access among Legal System Involved Perpetrators of Domestic Violence
Individuals incarcerated for DV-related offenses or subject to domestic violence protection orders (DVPOs; i.e., respondents) have threatened or engaged in one form of violence perpetration and may be at increased risk for experiencing others forms of violence, including suicide death. Several risk factors for perpetration of DV overlap with suicide; however, few studies have examined…
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…
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