African Americans living in the Southeastern region of the United States disproportionately contract sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Facebook and other social media sites are becoming a way to deliver health-related messaging to targeted populations. The purpose of this quantitative, cross-sectional study was to examine the association between selected demographic factors and impact of social media on intent to change sexual behaviors among 112 African Americans between the ages of 18 and 49 in the Southeastern United States who viewed STI/HIV prevention materials on Facebook within 1 year prior to the study. The theory of planned behavior was used to help understand and interpret the findings. Participants completed an online self-report survey containing questions about their exposure to sexual health messages on Facebook and their intent to change behavior. Results of the multiple logistic regression analyses indicated that gender (p =.462), age (p =.122), education (p =.593), and income (p =.200) were not statistically associated with the dependent variable, intent to change risky sexual behaviors. A majority of respondents indicated the intention to change their sexual behaviors as a result of viewing HIV prevention messages on Facebook, and that the messages were the most important factor in their decision to change behavior. Facebook messaging may be an effective platform for reaching African Americans and influencing behavior; however more research is needed to fully understand the use of social media for STI prevention. The social change implication of this research is the potential to decrease HIV/STI associated morbidity and mortality among this population.

Community service projects have consistently been an effective means of community involvement and an avenue in which improvement in an area may be measured. Although the roles each participant assumes may differ, the ultimate accomplishment of the project is paramount to each person involved. This paper will explore the Governor's Task Force on Venereal Disease to determine both the effectiveness of the Task Force and the methods utilized to accomplish the task force goals. Primarily, this group of selected individuals will be reviewed to determine whether they were effective due to their ability to influence others, or simply through a great deal of hard work and co-operation. Data for this work was collected from individual written responses from Task Force participants, the Governor's Commission on Youth, various medical professionals, several works of other authors (see bibliography), data gathered by me as participant-observer, and through interviews from selected Task Force participants. Upon compiling the data, several concepts were revealed. I found that the influence that each participant enjoyed in the community was a primary factor of the effectiveness of the Task Force. Moreover, it was the influence of the particular individual with others who could assist with this particular problem which created a positive response, and thus effective results. This paper also explores the Task Force as a politically appointed group chosen to complete a specific project. The goals, operations, and accomplishments are detailed in an effort to measure the significance of the Task Force in the community.

Trichomonas vagina/is, one of the most common sexually transmitted diseases, has been shown to increase patients' susceptibility to HIV infection and cervical cancer; moreover, resistance to metronidazole is increasing, and new drug targets must be identified in order to combat resistant strains. T vagina/is expresses cysteine proteases that have been implicated in vaginal epithelial apoptosis as well as immune system evasion. In the past the various cysteine proteases have been studied as a group, and the following work examines, one specific protease, TvCP2, in detail through Western blot analysis, immunofluorescent staining, and recombinant expression. The experiments 5 presented here suggest that aT l-CP2 over-expressing transfectant line processes CP2 and sequesters it in cellular compartments. Previous data gives strong evidence of the secretion of cysteine protease CP4 and hints at the possibility of CP2 secretion as well; however, our results show no co-localization between CP2 and CP4 in T l-CP2 over expressing transfectants, suggesting separate trafficking and different roles. To better characterize CP2 function, we attempted to express active, recombinant protein. Although Pichia pastoris serves as a reliable expression vehicle, a processing event following translation ofTvCP2 appears to have cleaved the pro-domain and, along with it, the a-secretion signal, trapping active TvCP2 within the cellular pellet. A thioreoxintagged version ofTvCP2 has been expressed in E. coli, and preliminary experiments show it may auto-activate under certain conditions, but further experimentation is required to confirm the presence of active CP2 within the fraction purified from these cells.

Trichomoniasis affects 170 million people worldwide, and 7.4 million in the USA. There is increasing focus on the role of cysteine proteases in Trichomonas vaginalis because of their role in virulence of other parasitic protozoa. Determining their location and function will provide insight about their role in the pathogenicity of T. vaginalis and their feasibility as a drug target. This study begins to characterize the first sequenced cysteine protease (CP1). E. coli and P. pastoris expression systems were developed to produce CP1 to generate antiserum, and to have enough active protein for biochemical characterization. Secondly, endogenous and epitope tagged CP1 were localized in T. vaginalis vesicles. These vesicles were confirmed to have alkaline phosphatase activity which is a characteristic of lysosomes. Lastly, deletion mutants of CP1 were created to determine the role of the prodomain in targeting CP1 to vesicles.

This research analyzed themes relating to the concepts of risk, risk taking, and pleasure by completing a secondary analysis of participant transcripts collected from the PrEP-RN study conducted by Dr. O'Byrne at the University of Ottawa in collaboration with Ottawa Public Health. Analysis was completed to relate risk, risk taking and pleasure in the context of PrEP-RN, but also identify areas for educational improvement in relation to the selected concepts. The research question sought explanation on the relationship that risk has with risk reduction and risk taking, including analysis of condom usage, risk conversation with partners and general sexual health practices while on PrEP. Additionally, the research sought to answer if PrEP-RN participation had any impact on sexual pleasure, analyzing subthemes of stereotyping, security and desire relating to pleasure. Transcript analysis identified that a reduction in condom usage, improved frequency of sexually transmitted infection testing, promotion of conversations with partners surrounding PrEP and sexual health, and a reduction in sexual fear and anxiety with partners were major themes stemming from PrEP-RN participation. A need to increase education surrounding continued condom usage while on PrEP and identify ways to reduce stigmatization of PrEP were identified as ways to improve the PrEP-RN program.

The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic has surpassed forty years with many medical advancements in prevention and treatment. Often believed to be at negligible or low risk by society at large, sexual minority women have remained understudied regarding their risk of HIV and other sexually transmitted infections (STIs), leaving their sexual health inadequately understood and supported in healthcare and social services. The sexual health of young South Asian sexual minority women, who are multiply minoritized due to their intersecting identities, has been entirely overlooked. This qualitative study aimed to understand the knowledge, attitudes, and practices of young South Asian sexual minority women as it pertains to their HIV/STI risk. Barriers and facilitators to accessing community-based sexual health supports and services were also investigated. A community-engaged approach was taken to develop this study in partnership with the Alliance for South Asian AIDS Prevention to investigate the HIV/STI risk context and sexual health needs of this group residing in the Greater Toronto Area. A maximum variation sampling strategy was used to recruit six young South Asian sexual minority women and semi-structured in-depth interviews were conducted to collect narrative data. Narrative analysis of the data found socio-cultural and structural influences which guide the HIV/STI risk context for this group. The participants illuminated an inadequate understanding of sexual health when engaging in sex with women, an overall low HIV/STI risk perception, barriers to adequate sexual healthcare and health promotion resources, and multiple minority stressors which impacted their access to safe sex. These findings have major implications for school-based sexual health education, medical training for healthcare practitioners, and sexual health support and services provided by community-based sexual health organizations in the Greater Toronto Area. / Thesis / Master of Public Health (MPH)

No description available.

Malaria is one of the most prevalent vector-borne infectious diseases with major morbidity and mortality in sub-Saharan Africa and Southeast Asia. Recent epidemiological studies have shown that co-occurrence of soil-transmitted helminth (STH) infections, or infection caused by parasitic worms, are associated with increased risk of malaria infection. However, studies of the association between STH and malaria, and the effect of antihelminth (deworming) treatments that are more commonly used in areas with high STH infection rates, are sparse. Therefore, we explored the relationship between STH and malaria infection in an Indonesian community (N=1997) with high prevalence of both STH and malaria while controlling for covariates and evaluating the role of deworming treatment as a covariate. Participants with STH infection and/or malaria infection were categorized as either infected or uninfected using PCR testing (cycle threshold count) at both baseline and end of study. Self-report, blood, and stool samples were used to assess overall STH and malaria infection from September 2008 to July 2010. Descriptive statistics were used to assess the impact of STH infection on malaria outcomes. To quantify these associations, robust Poisson regression models were used to assess the impact of baseline infections including STH infection on malaria while adjusting for age, sex, and the use of deworming treatment. Approximately 39.5% and 19.1% of all participants were infected with Plasmodium vivax and P. falciparum, respectively, at the start, while 18.0% and 9.96%, respectively, were infected at the end. A positive association was observed between Ascaris lumbricoides and P. vivax, and between Necator americanus and P. falciparum (PR = 1.04, 95% CI = 0.53 to 2.04; PR = 2.07, 95% CI = 1.00 to 4.29, respectively). While a negative association was observed between N. americanus and P. vivax, and between A. lumbricoides and P. falciparum (PR = 0.91, 95% CI = 0.44 to 1.89; PR = 0.66, 95% CI = 0.27 to 1.65, respectively). Overall, two of these models were significant (p = 0.062; p = 0.008; p = 0.030; p = 0.062, respectively). Similarly, there was a positive association observed between the use of albendazole treatment and STH and malaria outcomes.

Sex education policies and programs in Florida are largely dominated by the abstinence-only approach. This paper makes the case that abstinence-only education is a failing policy in Florida, and evaluates strategies advocates may use in order to accomplish reform. Three different strategies are evaluated: countywide school district reform, statewide rejection of federal abstinence-only funding, and statewide standardization of sex education via legislation. Contrasts are drawn between all three strategies with regard to their potential impact on sex education policy in Florida, viability, and the challenges they present to advocates. This paper concludes that statewide standardization of sex education in Florida represents the best way to remedy the problem of insufficient sex education, but is unlikely to occur without increased bipartisan support in the Florida legislature. Statewide rejection of Title V federal abstinence-only funds remains an important policy goal for the purpose of accomplishing an end to federal abstinence grants but would likely achieve very little for Florida's students. Countywide sex education changes are thus far the only substantive victory for sex education advocates in Florida and should be instituted across the state with advocates taking special care to engage teachers, medical professionals, parents and local community leaders.

PROBLEM STATEMENT: Globally, 70% of more than three million new curable sexually transmitted infections (STI) are among 15-24 year olds, with young people in developing countries bearing the highest burden. Chlamydia Trachomatis prevalence, for example, is 15.4% and 20.5% in young women and men attending STD clinics in the U.S. However, Caribbean STI data for young men are particularly scarce and inconsistent and cases are under-reported due to poor health seeking behavior. In Guyana, 42% of the STI cases from 2010 -2014 occurred in young people, aged 15- 24. Moreover, few programs and policies focus specifically on the sexual and reproductive health (SRH) needs of young men. This dissertation explores the contextual and behavioral factors that cause young men’s vulnerability to STI and proposes recommendations for the national response in Guyana. METHODS: Research methods included: 9 focus group discussions (FGDs) with young men, aged 15-18, mothers and fathers and 25 in-depth interviews with representatives from government, community, faith-based and donor organizations. Interviews and FGDs were audiotaped, transcribed, and analyzed for major themes among and across each stakeholder group. Analysis was guided by a socio-ecologic framework and resulted in program and policy recommendations to address vulnerability to STI and augment protective factors against STI in young men in Guyana. RESULTS: Salient overarching themes include: Poverty and Disenfranchisement “Yes, this is a Man”: Early Sex, Fast Money, and Risk”, “The Empty Room: Young Men without Male Roles Models”, “Sex in a violent society”, “Stigma, Discrimination, and Shame: Road blocks to young men’s sexual health” and Young men’s Sexual and Reproductive Health: Young men’s Sexual and Reproductive Health: It all depends on family, religion, education, music and media (or not). Participants highlighted a lack of SRH awareness and health care seeking resulting from insufficient male SRH promotion and services. Parental engagement, school attendance, supportive peers, religious commitment and internet use for SRH information were described as protective factors. CONTRIBUTION: A socio-ecological model helped to comprehensively identify and organize broad social determinants of SRH and high risk sexual behaviors for young men. The resulting program and policy recommendations are proposed for implementation in Georgetown, Guyana. / 2018-11-08T00:00:00Z