PhD
March 13, 2024
Health and economic impact of COVID-19, surveillance, and vaccination among people experiencing homelessness in Seattle-King County, Washington
The COVID-19 pandemic has disproportionately affected people experiencing homelessness, with shelters often representing a hotspot for outbreaks due to the elevated risk of viral transmission. COVID-19 surveillance in congregate living settings is vital for mitigating pandemic-related harms, especially among high-risk populations. Additionally, ensuring high COVID-19 vaccination coverage is crucial to prevent morbidity and mortality. However,…
December 26, 2023
Clinical Trial Designs that Utilize Historical Controls in the setting of Cystic Fibrosis
In certain rare disease settings, traditional randomized controlled trials face ethical and feasibility challenges that can exclude their use. Adequate participant recruitment can be prohibitively difficult, and a large placebo control arm could unethically expose vulnerable participants to risk. Development of new therapeutics for these diseases still require regulatory grade evidence of a treatment effect,…
Characterizing SARS-CoV-2 infection burden and COVID-19 vaccination intent and uptake in congregate shelters in Seattle, WA
Community-based surveillance studies can be appropriately leveraged to characterize the burden of emerging pathogens, especially in hard-to-reach populations such as people experiencing homelessness (PEH). Prior respiratory viral studies among PEH populations have shown evidence of increased morbidity and mortality compared to the general population, likely associated with a high prevalence of co-occurring health conditions, though…
Understanding methamphetamine and opioid co-use: national trends and local harm reduction strategies for overlapping illicit drug use
In the past 20 years, the United States has seen a remarkable increase the use of both methamphetamine and opioids, used concurrently or simultaneously. A more detailed picture is needed to understand where methamphetamine-opioid co-use is increasing nationally, as well as the characteristics of people who co-use. Methamphetamine-opioid co-use has become particularly prevalent in Seattle,…
Associations of Maternal Exposure and Characteristics with Placental Transcription Regulation and Consequences on Fetal Growth
The placenta is a key organ in pregnancy and its dysfunction can lead to pregnancy complications as well as adverse maternal and fetal outcomes. While evidence for adverse consequences of maternal characteristics (such as obesity) or environmental exposures (e.g. particulate matter under 2.5 μm in diameter, PM2.5) on the course and outcomes of pregnancy has…
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…
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