Faculty Bibliography

The aim of the study was to analyze the results of long-term antiretroviral therapy (ARV) in patients with HIV-infection basing on epidemiological, clinical and economical parameters in the Northwestern Federal District (NFD) of Russia. Materials and methods. Epidemiogical analysis was conducted using the data of reports from 10 NFD regions in the period from 2005 to 2018: morbidity rate, prevalence of HIV-infection, number of people living with HIV-infection (PLWH) and being under regular medical check-up. For clinical analysis were used some key indices of ARV effectiveness such as patients' therapy coverage, clinical stages of HIV-infection, mortality rate and lethality rate in patients. Health costs were calculated basing on ARV procurement in the District from federal and regional programs as well as from funds allocated on diagnostic products and prevention programs. Study results. On the top of administered ARV, rates of mortality and prevalence of HIV-infection in the RF and NFD had increasing tendency. The rate of mortality in PLWH increased in several times while the lethality rate changed insignificantly. Number of PLWH on the stage of clinical signs grew sixfold reaching 63,1%. Questionnaire survey was held in 74 infectious disease physicians with the following estimation of values of some reasons of low effectiveness of ARV and transformation of epidemic into severe and comorbid forms. By reason rating, low ARV coverage in patients was the most common, late detection of HIV-infection and treatment onset, poor adherence and therapy discontinuation, qualified staff shortage, low accessibility of medical organizations, insufficient choice and quality of ARV. In considering financial costs on ARV, insufficient appropriation of funds and insufficient support of other activities including organizational and preventive measures were revealed.

The objective of the survey: to analyze clinical, psychosocial and personal status in women co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), and their alcohol addiction. Materials and methods: the check-up of 191 surveyed women with HIV and HCV co-infection taking into account epidemiologic evidence, laboratory parameters: immunologic (CD4 lymphocyte count), virological (HIV and HCV RNA, HCV genotype) and complete and biochemical blood count was made. Detailed check-up of psychosocial and narcological status with the following assessment of alcohol use in 166 surveyed women was made; clinical, laboratory (ethyl glucuronide (EtG) determination in urine and carbohydrate-deficient transferrin (CDT) determination in serum), and instrumental methods. Results: Mean age of patients was 34,9�3,9 years. Most women (88%) had satisfactory social status. Most women had a long-standing co-infection. 3,7% of women were in the subclinical stage of HIV infection, 92.1% had stage 4A, 4B-11% and 4B-11%. The median number of CD4 lymphocytes was 470 cells/μl. 92,2% received ART, and 96,7% of women showed a high rate of treatment compliance. Among the prevalent HIV-associated diseases were candidiasis (53,2%) and viral infections (8,1%) and bacterial diseases (3%); a high percentage (15%) of past tuberculosis of various localization was noted. In 89,9% of women, a high replicative activity of HCV was detected in the blood. According to the results of indirect liver elastometry, 98,3% had minimal and moderate fibrosis (METAVIR ≤F2). 86,9% of patients showed total bilirubin level within the normal range, median alanine aminotransferase (ALT) was 62 cells/μl and median aspartate aminotransferase (AST) was 48 cells/μl. Comorbid infectious and non-infectious diseases were diagnosed in 65,4% of women. Antiviral therapy (ART) of chronic hepatitis C was performed in 4,7% of surveyed women who received the combination of pegylated interferon (pegIFN) and ribavirin. Mean history of psychoactive drug use was 7,2�4,1 years. By the time of survey, 96,4% of women denied use of any psychoactive drugs other than alcohol. In past medical history, 81,9% of patients used opioids, regular use of alcohol with the following addiction syndrome was diagnosed in 88,6% of patients. Increasing CDT concentration was revealed in 3 patients and in 3 cases, this parameter was within borderline unstable zone. Under assessment of psychopathologic status, prevalent psychopathologic syndromes were insomnia, psychoorganic syndromes and anxiety. According to aggression scale, high indices by �relational aggression�, �irritation �, �grievance�, �suspicion�, �guilt�. Prevalent types of attitude to HIV-infecton were ergopathic, sensitive, anosognosic.

AbstractAcross cultures and belief systems, compassion is widely considered to be beneficial for the development of personal and social wellbeing. Research indicates that compassion-training programs have broad health benefits, but how and why compassion-training programs are effective is still relatively unknown. This paper describes the theoretical underpinnings of a specific compassion-training program, CBCT (Cognitively-Based Compassion Training), and proposes an integrative model that draws on existing health behavior constructs to identify CBCT's core components and hypothesizes their directionality and interaction. The model includes two primary categories of skill development: (1) intrapersonal skills leading to greater resiliency, and (2) interpersonal skills leading to greater compassion. It is hypothesized that these two pathways are mutually reinforcing and both contribute to greater wellbeing. This model provides a foundation for theory-driven research on the underlying mechanisms in CBCT training. An understanding of CBCT's mechanisms is a critical step towards optimizing and personalizing the intervention to meet the needs of specific populations.

OBJECTIVE:Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship. METHODS:= 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening. RESULTS:Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents. CONCLUSIONS:These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

OBJECTIVES/OBJECTIVE:Given earlier effects found in randomized clinical trials of the Nurse-Family Partnership, we examined whether this program would improve 18-year-old first-born youths' cognition, academic achievement, and behavior and whether effects on cognitive-related outcomes would be greater for youth born to mothers with limited psychological resources (LPR) and on arrests and convictions among females. METHODS:= 228). Assessments were completed on 629 18-year-old first-born offspring to evaluate these primary outcomes: (1) cognitive-related abilities (nonverbal intelligence, receptive language, and math achievement) and (2) behavioral health (internalizing behavioral problems, substance use and abuse, sexually transmitted infections, HIV risk, arrests, convictions, and gang membership). RESULTS:= .08). There were no intervention effects on other behaviors. CONCLUSIONS:The program improved the cognitive-related skills of 18-year-olds born to mothers with LPR and, as a trend, reduced female convictions but produced no other effects on youth behavioral health.

BACKGROUND:Pregnancy coercion (PC), defined as a restriction of women's reproductive autonomy, may be associated with increased HIV and sexually transmitted infection (STI) risk. However, there are few empirical studies defining the association between PC and HIV risk, particularly among vulnerable African American women. SETTING AND METHODS/METHODS:African American women (N = 560), ages 17-24, completed an audio computer-assisted self-interview assessing PC prevalence and its association with HIV/STI risk. Women were screened for prevalent STIs using polymerase chain reaction assays. Multivariate logistic and linear regressions evaluated the association of PC and multiple HIV/STI risk-associated outcomes. RESULTS:Women who had experienced PC in the last 3 months, relative to those not experiencing PC, were 78% more likely to test positive for an STI [adjusted odds ratio = 1.78, 95% confidence interval (CI) = 1.10 to 2.90]. Among women who experienced PC, odds of noncondom use in their last sexual encounter were 3.45-fold greater relative to women not experiencing PC (95% CI = 1.55 to 7.85). Women who experienced PC had lower condom use intentions (coefficient, -1.31, P = 0.002), greater fear of condom negotiation, and perceived more barriers to condom use (coefficients, 3.89 and 5.74, respectively, both P < 0.001). Women who experienced PC had 1.98 (95% CI = 1.22 to 3.21) and 1.82 (95% CI = 1.09 to 3.04) odds of depression and HIV worry relative to women not experiencing PC. CONCLUSION/CONCLUSIONS:Among African American women, PC was associated with a range of adverse sexual health outcomes and HIV/STI-related behaviors and attitudes. The findings underscore the need for promoting gender-equitable social norms in HIV prevention interventions.

BACKGROUND:While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist). METHODS:Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items). RESULTS:Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff. CONCLUSIONS:Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.