Eryka Wentz | Johns Hopkins Bloomberg School of Public Health (original) (raw)

Publications by Eryka Wentz

ImportancePersistent symptoms after SARS-COV-2 infection, or long-COVID, may occur in anywhere fr... more ImportancePersistent symptoms after SARS-COV-2 infection, or long-COVID, may occur in anywhere from 10-55% of those who have had COVID-19, but the extent of impact on daily functioning and disability remains unquantified.ObjectiveTo characterize physical and mental disability associated with long-COVIDDesignCross-sectional analysis of baseline data from a cohort studySettingOnline US nationwide surveyParticipantsAdults 18 years of age and older who live in the US who either report a history of COVID-19 illness (n=8,874) or report never having had COVID-19 (n=633)Main Outcome and MeasuresSelf-reported mobility disability (difficulty walking a quarter of a mile and/or up 10 stairs, instrumental activities of daily living [IADL] disability (difficulty doing light or heavy housework), and mental fatigue as measured by the Wood Mental Fatigue Inventory (WMFI).ResultsOf 7,926 participants with long-COVID, the median age was 45 years, 84% were female, 89% self-reported white race, and 7.4%...

The American Journal of Medicine

Cancer Research

Background: Colorectal cancer has increased among people living with HIV (PLWH). Studies have rep... more Background: Colorectal cancer has increased among people living with HIV (PLWH). Studies have reported either no difference or lower risk of colorectal cancer incidence among PLWH as compared to the general population. We evaluated the incidence of colon cancer, both average-onset (diagnosed at 50 or older) and early-onset (diagnosed at less than 50), among a diverse population of people with and without HIV who have comparable sociodemographic factors and access to care. Methods: We obtained Medicaid Analytic eXtract (MAX) data from 2001-2015 for 14 states. We included 42,244,679 unique individuals with at least 7 months of continuous eligibility. HIV and colon cancer diagnoses were identified from inpatient and other non-drug claims. We used Cox proportional hazards regression models to assess the incidence of colon cancer, controlling for age, sex, race/ethnicity, calendar year of enrollment, state of enrollment, and number of comorbidities. Analyses were also adjusted for or str...

Clinical Infectious Diseases

Background Food insecurity is associated with increased morbidity and mortality in people with hu... more Background Food insecurity is associated with increased morbidity and mortality in people with human immunodeficiency virus (HIV) on antiretroviral therapy, but its relationship with immune dysregulation, a hallmark of HIV infection and comorbidity, is unknown. Methods In 241 women participating in the Women’s Interagency HIV Study, peripheral blood mononuclear cells were characterized by flow cytometry to identify cell subsets, comprising surface markers of activation (%CD38+HLADR+), senescence (%CD57+CD28−), exhaustion (%PD-1+), and co-stimulation (%CD57− CD28+) on CD4+ and CD8+ T cells. Mixed-effects linear regression models were used to assess the relationships of food insecurity with immune outcomes, accounting for repeated measures at ≤3 study visits and adjusting for sociodemographic and clinical factors. Results At the baseline study visit, 71% of participants identified as non-Hispanic Black, 75% were virally suppressed, and 43% experienced food insecurity. Food insecurity ...

BMJ Open

ObjectivesPeople living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence... more ObjectivesPeople living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS-related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.DesignWomen enrolled in an ongoing longitudinal cohort study from 2013 to 2015.SettingNine participating sites across the USA.Participants2553 participants enrolled in the Food Insecurity Sub-Study of the Women’s Interagency HIV Study, a multisite cohort study of US women living with HIV and demographically similar HIV-seronegative women.OutcomesCurrent cigarette smoking status and intensity were self-reported. We used cross-sectional and longitudinal logistic and Tobit regressions to assess association...

AIDS Patient Care and STDs, 2020

Clinical Infectious Diseases, 2019

Background Food insecurity is a well-established determinant of suboptimal, self-reported antiret... more Background Food insecurity is a well-established determinant of suboptimal, self-reported antiretroviral therapy (ART) adherence, but few studies have investigated this association using objective adherence measures. We examined the association of food insecurity with levels of ART concentrations in hair among women living with human immunodeficiency virus (WLHIV) in the United States. Methods We analyzed longitudinal data collected semiannually from 2013 through 2015 from the Women’s Interagency HIV Study, a multisite, prospective, cohort study of WLHIV and controls not living with HIV. Our sample comprised 1944 person-visits from 677 WLHIV. Food insecurity was measured using the US Household Food Security Survey Module. ART concentrations in hair, an objective and validated measure of drug adherence and exposure, were measured using high-performance liquid chromatography with mass spectrometry detection for regimens that included darunavir, atazanavir, raltegravir, or dolutegravir...

Epidemiology and Psychiatric Sciences

Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies... more Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. Methods We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related ...

AIDS and behavior, 2017

Women in the general population experience more food insecurity than men. Few studies have examin... more Women in the general population experience more food insecurity than men. Few studies have examined food insecurity's impact on HIV treatment outcomes among women. We examined the association between food insecurity and HIV outcomes in a multi-site sample of HIV-infected women in the United States (n = 1154). Two-fifths (40%) of participants reported food insecurity. In an adjusted multivariable Tobit regression model, food insecurity was associated with 2.08 times higher viral load (95% confidence interval (CI): 1.04, 4.15) and lower CD4+ counts (- 42.10, CI: - 81.16, - 3.03). Integration of food insecurity alleviation into HIV programs may improve HIV outcomes in women.

The Journal of infectious diseases, Jan 27, 2018

Chronic inflammation is associated with AIDS-defining and non-AIDS-defining conditions. Limited r... more 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 HIV. We examined whether food insecurity was associated with higher levels of inflammation among women living with HIV (WWH) in the United States. We analyzed cross-sectional data collected in 2015 from 421 participants on antiretroviral therapy from the Women's Interagency HIV Study. The exposure was any food insecurity. The outcome was inflammation, measured by both pro-inflammatory cytokine IL-6 and by tumor necroses factor 1 (TNFR1) levels. We conducted multivariable linear regressions, adjusting for sociodemographic, clinical, and nutritional factors. Nearly one-third of participants (31%) were food insecure and 79% were virally suppressed (<20 copies/ml). In adjusted analyses, food insecurity was associated with 1.23 times the level of IL-6 (95% CI: 1.06, 1.44) and 1.13 times ...

Addiction (Abingdon, England), Jan 14, 2018

Few longitudinal studies have examined the relationship between food insecurity and substance use... more Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. Women's Interagency HIV Study (WIHS), a prospective cohort study. Nine sites across the United States. A total of 2553 women with or at risk for HIV. Semi-annual structured interviews were conducted during April 2013-March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of curr...

The Journal of Nutrition, 2019

Background Food insecurity, which disproportionately affects marginalized women in the United Sta... more 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. Objective The aim of this study was to investigate the associations of food insecurity with symptoms of generalized anxiety disorder (GAD), stress, and posttraumatic stress disorder (PTSD) in the Women's Interagency HIV Study (WIHS), a prospective cohort study of women with or at risk of HIV in the United States. Methods Participants were 2553 women with or at risk of HIV, predominantly African American/black (71.6%). Structured questionnaires were conducted during April 2013–March 2016 every 6 mo. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. We measured longitudinal outcomes for GAD (GAD-7 score and a binary GAD-7 screener for moderate-to-severe GAD). Only cross-sectional data were available ...

AIDS and behavior, Jan 8, 2018

Food insecurity, internalized HIV stigma, and depressive symptoms are independently associated wi... more Food insecurity, internalized HIV stigma, and depressive symptoms are independently associated with poor HIV outcomes. Food insecurity, stigma, and depression may be interrelated among women living with HIV (WLHIV). We hypothesized that food insecurity would be independently associated with internalized stigma and depressive symptoms among WLHIV in the United States (US), and would partially account for associations between stigma and depressive symptoms. We tested hypotheses using regression models and partial correlation analysis with cross-sectional data among 1317 WLHIV from the Women's Interagency HIV Study. In adjusted models, greater food insecurity was associated with internalized HIV stigma and depressive symptoms (all p < 0.05), exhibiting dose-response relationships. Food insecurity accounted for 23.2% of the total shared variance between depressive symptoms and internalized stigma. Food insecurity is associated with depressive symptoms and internalized HIV stigma ...

Journal of acquired immune deficiency syndromes (1999), Aug 20, 2017

A low proportion of CD28-CD8+ T cells that express CD57 is associated with increased mortality in... more A low proportion of CD28-CD8+ T cells that express CD57 is associated with increased mortality in HIV infection. The effect of increasing BMI changes in the proportion of CD57+CD28-CD8+ T cells among HIV-infected individuals on ART is unknown. In a U.S. cohort of HIV-infected women, we evaluated associations of BMI and waist circumference with 3 distinct CD8+ T cell phenotypes: % CD28-CD57+CD8+ T cells, % CD57+ of CD28-CD8+ T cells and % CD28- of all CD8 T cells. Multivariable linear regression analysis was used to estimate beta-coefficients for each of three T cell phenotypes. Covariates included HIV parameters (current and nadir CD4, current viral load), demographics (age, race, income, study site), and lifestyle (tobacco, alcohol use) factors. Of 225 participants, the median age was 46 years and 50% were obese (BMI>30 m/kg). Greater BMI and waist circumference were both associated with higher %CD28-CD57+CD8+ T cells and %CD57+ of all CD28-CD8+ T cells in multivariable analysis...

AIDS and behavior, 2017

Women in the general population experience more food insecurity than men. Few studies have examin... more Women in the general population experience more food insecurity than men. Few studies have examined food insecurity's impact on HIV treatment outcomes among women. We examined the association between food insecurity and HIV outcomes in a multi-site sample of HIV-infected women in the United States (n = 1154). Two-fifths (40%) of participants reported food insecurity. In an adjusted multivariable Tobit regression model, food insecurity was associated with 2.08 times higher viral load (95% confidence interval (CI): 1.04, 4.15) and lower CD4+ counts (- 42.10, CI: - 81.16, - 3.03). Integration of food insecurity alleviation into HIV programs may improve HIV outcomes in women.

AIDS and behavior, Jan 28, 2017

There is insufficient research on the impact of perceived discrimination in healthcare settings o... more There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of 1356 diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study. Indirect effects analysis with bootstrapping was used to examine the potential mediating roles of internalized stigma and depressive symptoms in the association between perceived discrimination in healthcare settings and ART adherence. Perceived discrimination in healthcare settings was negatively associated with optimal (95% or better) ART adherence (adjusted odds ratio (AOR) = 0.81, p = 0.02, 95% confidence interval (CI) [0.68, 0.97]). Furthermore, internalization of stigma and depressive symptoms mediated the perceived discrimination-adher...

Journal of acquired immune deficiency syndromes (1999), Jun 16, 2016

ImportancePersistent symptoms after SARS-COV-2 infection, or long-COVID, may occur in anywhere fr... more ImportancePersistent symptoms after SARS-COV-2 infection, or long-COVID, may occur in anywhere from 10-55% of those who have had COVID-19, but the extent of impact on daily functioning and disability remains unquantified.ObjectiveTo characterize physical and mental disability associated with long-COVIDDesignCross-sectional analysis of baseline data from a cohort studySettingOnline US nationwide surveyParticipantsAdults 18 years of age and older who live in the US who either report a history of COVID-19 illness (n=8,874) or report never having had COVID-19 (n=633)Main Outcome and MeasuresSelf-reported mobility disability (difficulty walking a quarter of a mile and/or up 10 stairs, instrumental activities of daily living [IADL] disability (difficulty doing light or heavy housework), and mental fatigue as measured by the Wood Mental Fatigue Inventory (WMFI).ResultsOf 7,926 participants with long-COVID, the median age was 45 years, 84% were female, 89% self-reported white race, and 7.4%...

The American Journal of Medicine

Cancer Research

Background: Colorectal cancer has increased among people living with HIV (PLWH). Studies have rep... more Background: Colorectal cancer has increased among people living with HIV (PLWH). Studies have reported either no difference or lower risk of colorectal cancer incidence among PLWH as compared to the general population. We evaluated the incidence of colon cancer, both average-onset (diagnosed at 50 or older) and early-onset (diagnosed at less than 50), among a diverse population of people with and without HIV who have comparable sociodemographic factors and access to care. Methods: We obtained Medicaid Analytic eXtract (MAX) data from 2001-2015 for 14 states. We included 42,244,679 unique individuals with at least 7 months of continuous eligibility. HIV and colon cancer diagnoses were identified from inpatient and other non-drug claims. We used Cox proportional hazards regression models to assess the incidence of colon cancer, controlling for age, sex, race/ethnicity, calendar year of enrollment, state of enrollment, and number of comorbidities. Analyses were also adjusted for or str...

Clinical Infectious Diseases

Background Food insecurity is associated with increased morbidity and mortality in people with hu... more Background Food insecurity is associated with increased morbidity and mortality in people with human immunodeficiency virus (HIV) on antiretroviral therapy, but its relationship with immune dysregulation, a hallmark of HIV infection and comorbidity, is unknown. Methods In 241 women participating in the Women’s Interagency HIV Study, peripheral blood mononuclear cells were characterized by flow cytometry to identify cell subsets, comprising surface markers of activation (%CD38+HLADR+), senescence (%CD57+CD28−), exhaustion (%PD-1+), and co-stimulation (%CD57− CD28+) on CD4+ and CD8+ T cells. Mixed-effects linear regression models were used to assess the relationships of food insecurity with immune outcomes, accounting for repeated measures at ≤3 study visits and adjusting for sociodemographic and clinical factors. Results At the baseline study visit, 71% of participants identified as non-Hispanic Black, 75% were virally suppressed, and 43% experienced food insecurity. Food insecurity ...

BMJ Open

ObjectivesPeople living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence... more ObjectivesPeople living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS-related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.DesignWomen enrolled in an ongoing longitudinal cohort study from 2013 to 2015.SettingNine participating sites across the USA.Participants2553 participants enrolled in the Food Insecurity Sub-Study of the Women’s Interagency HIV Study, a multisite cohort study of US women living with HIV and demographically similar HIV-seronegative women.OutcomesCurrent cigarette smoking status and intensity were self-reported. We used cross-sectional and longitudinal logistic and Tobit regressions to assess association...

AIDS Patient Care and STDs, 2020

Clinical Infectious Diseases, 2019

Background Food insecurity is a well-established determinant of suboptimal, self-reported antiret... more Background Food insecurity is a well-established determinant of suboptimal, self-reported antiretroviral therapy (ART) adherence, but few studies have investigated this association using objective adherence measures. We examined the association of food insecurity with levels of ART concentrations in hair among women living with human immunodeficiency virus (WLHIV) in the United States. Methods We analyzed longitudinal data collected semiannually from 2013 through 2015 from the Women’s Interagency HIV Study, a multisite, prospective, cohort study of WLHIV and controls not living with HIV. Our sample comprised 1944 person-visits from 677 WLHIV. Food insecurity was measured using the US Household Food Security Survey Module. ART concentrations in hair, an objective and validated measure of drug adherence and exposure, were measured using high-performance liquid chromatography with mass spectrometry detection for regimens that included darunavir, atazanavir, raltegravir, or dolutegravir...

Epidemiology and Psychiatric Sciences

Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies... more Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. Methods We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related ...

AIDS and behavior, 2017

Women in the general population experience more food insecurity than men. Few studies have examin... more Women in the general population experience more food insecurity than men. Few studies have examined food insecurity's impact on HIV treatment outcomes among women. We examined the association between food insecurity and HIV outcomes in a multi-site sample of HIV-infected women in the United States (n = 1154). Two-fifths (40%) of participants reported food insecurity. In an adjusted multivariable Tobit regression model, food insecurity was associated with 2.08 times higher viral load (95% confidence interval (CI): 1.04, 4.15) and lower CD4+ counts (- 42.10, CI: - 81.16, - 3.03). Integration of food insecurity alleviation into HIV programs may improve HIV outcomes in women.

The Journal of infectious diseases, Jan 27, 2018

Chronic inflammation is associated with AIDS-defining and non-AIDS-defining conditions. Limited r... more 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 HIV. We examined whether food insecurity was associated with higher levels of inflammation among women living with HIV (WWH) in the United States. We analyzed cross-sectional data collected in 2015 from 421 participants on antiretroviral therapy from the Women's Interagency HIV Study. The exposure was any food insecurity. The outcome was inflammation, measured by both pro-inflammatory cytokine IL-6 and by tumor necroses factor 1 (TNFR1) levels. We conducted multivariable linear regressions, adjusting for sociodemographic, clinical, and nutritional factors. Nearly one-third of participants (31%) were food insecure and 79% were virally suppressed (<20 copies/ml). In adjusted analyses, food insecurity was associated with 1.23 times the level of IL-6 (95% CI: 1.06, 1.44) and 1.13 times ...

Addiction (Abingdon, England), Jan 14, 2018

Few longitudinal studies have examined the relationship between food insecurity and substance use... more Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. Women's Interagency HIV Study (WIHS), a prospective cohort study. Nine sites across the United States. A total of 2553 women with or at risk for HIV. Semi-annual structured interviews were conducted during April 2013-March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of curr...

The Journal of Nutrition, 2019

Background Food insecurity, which disproportionately affects marginalized women in the United Sta... more 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. Objective The aim of this study was to investigate the associations of food insecurity with symptoms of generalized anxiety disorder (GAD), stress, and posttraumatic stress disorder (PTSD) in the Women's Interagency HIV Study (WIHS), a prospective cohort study of women with or at risk of HIV in the United States. Methods Participants were 2553 women with or at risk of HIV, predominantly African American/black (71.6%). Structured questionnaires were conducted during April 2013–March 2016 every 6 mo. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. We measured longitudinal outcomes for GAD (GAD-7 score and a binary GAD-7 screener for moderate-to-severe GAD). Only cross-sectional data were available ...

AIDS and behavior, Jan 8, 2018

Food insecurity, internalized HIV stigma, and depressive symptoms are independently associated wi... more Food insecurity, internalized HIV stigma, and depressive symptoms are independently associated with poor HIV outcomes. Food insecurity, stigma, and depression may be interrelated among women living with HIV (WLHIV). We hypothesized that food insecurity would be independently associated with internalized stigma and depressive symptoms among WLHIV in the United States (US), and would partially account for associations between stigma and depressive symptoms. We tested hypotheses using regression models and partial correlation analysis with cross-sectional data among 1317 WLHIV from the Women's Interagency HIV Study. In adjusted models, greater food insecurity was associated with internalized HIV stigma and depressive symptoms (all p < 0.05), exhibiting dose-response relationships. Food insecurity accounted for 23.2% of the total shared variance between depressive symptoms and internalized stigma. Food insecurity is associated with depressive symptoms and internalized HIV stigma ...

Journal of acquired immune deficiency syndromes (1999), Aug 20, 2017

A low proportion of CD28-CD8+ T cells that express CD57 is associated with increased mortality in... more A low proportion of CD28-CD8+ T cells that express CD57 is associated with increased mortality in HIV infection. The effect of increasing BMI changes in the proportion of CD57+CD28-CD8+ T cells among HIV-infected individuals on ART is unknown. In a U.S. cohort of HIV-infected women, we evaluated associations of BMI and waist circumference with 3 distinct CD8+ T cell phenotypes: % CD28-CD57+CD8+ T cells, % CD57+ of CD28-CD8+ T cells and % CD28- of all CD8 T cells. Multivariable linear regression analysis was used to estimate beta-coefficients for each of three T cell phenotypes. Covariates included HIV parameters (current and nadir CD4, current viral load), demographics (age, race, income, study site), and lifestyle (tobacco, alcohol use) factors. Of 225 participants, the median age was 46 years and 50% were obese (BMI>30 m/kg). Greater BMI and waist circumference were both associated with higher %CD28-CD57+CD8+ T cells and %CD57+ of all CD28-CD8+ T cells in multivariable analysis...

AIDS and behavior, 2017

Women in the general population experience more food insecurity than men. Few studies have examin... more Women in the general population experience more food insecurity than men. Few studies have examined food insecurity's impact on HIV treatment outcomes among women. We examined the association between food insecurity and HIV outcomes in a multi-site sample of HIV-infected women in the United States (n = 1154). Two-fifths (40%) of participants reported food insecurity. In an adjusted multivariable Tobit regression model, food insecurity was associated with 2.08 times higher viral load (95% confidence interval (CI): 1.04, 4.15) and lower CD4+ counts (- 42.10, CI: - 81.16, - 3.03). Integration of food insecurity alleviation into HIV programs may improve HIV outcomes in women.

AIDS and behavior, Jan 28, 2017

There is insufficient research on the impact of perceived discrimination in healthcare settings o... more There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of 1356 diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study. Indirect effects analysis with bootstrapping was used to examine the potential mediating roles of internalized stigma and depressive symptoms in the association between perceived discrimination in healthcare settings and ART adherence. Perceived discrimination in healthcare settings was negatively associated with optimal (95% or better) ART adherence (adjusted odds ratio (AOR) = 0.81, p = 0.02, 95% confidence interval (CI) [0.68, 0.97]). Furthermore, internalization of stigma and depressive symptoms mediated the perceived discrimination-adher...

Journal of acquired immune deficiency syndromes (1999), Jun 16, 2016

Journal of Acquired Immune Deficiency Syndromes, Dec 31, 2023

medRxiv (Cold Spring Harbor Laboratory), May 25, 2024

medRxiv (Cold Spring Harbor Laboratory), Apr 26, 2024

Aids and Behavior, Mar 13, 2020

Identifying structural determinants affecting HIV outcomes is important for informing interventio... more Identifying structural determinants affecting HIV outcomes is important for informing interventions across heterogeneous geographies. Longitudinal hierarchical generalized mixed-effects models were used to quantify the associations between changes in certain structural-level factors on HIV care engagement, medication adherence, and viral suppression. Among women living with HIV in the WIHS, ten-unit increases in census-tract level proportions of unemployment, poverty, and lack of car ownership were inversely associated with viral suppression and medication adherence, while educational attainment and owner-occupied housing were positively associated with both outcomes. Notably, increased residential stability (aOR 5.68, 95% CI: 2.93, 9.04) was positively associated with HIV care engagement, as were unemployment (aOR: 1.59, 95% CI: 1.57, 1.60), lack of car ownership (aOR 1.14, 95% CI: 1.13, 1.15), and female-headed households (aOR 1.23, 95% CI: 1.22, 1.23).. This underscores the importance of understanding neighborhood context, including factors that may not always be considered influential, in achieving optimal HIV-related outcomes.

Journal of Nutrition, Feb 1, 2019

medRxiv (Cold Spring Harbor Laboratory), May 13, 2024