Vinaida Robnett

The correlation between alcohol consumption and risky sexual behaviours among people living with HIV/AIDS

The objectives of this study were to determine if significant correlation exists between drinking any alcoholic beverage and risky sex among 326 AIDS patients. Participants completed anonymous surveys. The result of the regression and Pearson correlation analyses revealed a significant positive correlation between drinking alcohol before sex and frequency of condom use (p<0.0001). The number of sex partners respondents reported was also correlated with the frequency of alcohol use (p = 0.003). The result shows that the quantity of alcohol consumption was correlated with two indicators of risky sex: having multiple sexual partners (p<0.0001) and having sexual intercourse without a condom (p<0.001). Interventions are that integrate HIV risk reduction with alcohol risk reduction is very useful to minimize the risk of new HIV infections and/or manage existing infections.

A risk-assessment model for foot and mouth disease (FMD) virus introduction through deboned beef importation.

We present a risk-assessment model to assess the risk of introduction of foot and mouth disease (FMD) virus associated with deboned beef importation. The model was developed in accordance with the risk-reduction procedures proposed by the European Community for meat importation. The risk reduction procedures include farm-level inspection, ante-mortem inspection, post-mortem inspection, chilling and deboning. The risk assessment was based on the prevalence of FMD-infected cattle in herds as well as the prevalence of infected herds in the exporting country. Computer simulations were carried out to evaluate the probability of FMD virus introduction by importing 100 tons of deboned beef in relation to FMD prevalence, number of cattle selected from each herd, and sample sizes in ante-mortem and post-mortem inspections. The effects of the risk-reduction procedures on the probability of FMD virus introduction were examined.

Conspiracy Beliefs about HIV/AIDS among HIV-Positive African-American Patients in Rural Alabama

This is apparently the first survey examining endorsement of HIV/AIDS conspiracy beliefs and their relations to educational attainment among 205 HIV-positive African-American patients receiving care at an AIDS Outreach Organization in Alabama. 31% somewhat or strongly believed that, “AIDS is a form of genocide against African Americans,” 29% strongly agreed that “AIDS was created by the government to control the black population,” 56.1% agreed that the government is withholding a cure for AIDS, and 69.8% agreed that the government is withholding information about the disease from the public. 52% agreed that “HIV is a manmade virus,” and 43.1% that “AIDS was produced in the governments laboratory.” Respondents with high school or college education were less likely to endorse conspiracy beliefs. Being open and sensitive to questions about conspiracy beliefs plus understanding the historical roots and social context from which such questions arise in African-American communities is needed to counter such beliefs.

Integration of temporal and spatial models for examining the epidemiology of African trypansomiasis

Abstract A stochastic model was first developed to study the spatial dispersal of tsetse fly population, and subsequently integrated with a time oriented epidemiologic model. Such an integrated model was needed to understand better the epidemiology of cattle trypanosomiasis. Pre-existing data were used to determine the distributions of the random variables involved in the model. We used the model to assess several alternatives of preventing the spatial progression of trypanosomiasis. We address the following question: what size of protective barrier is required to prevent the spatial progression of trypanosomiasis? The vector control alternatives considered in this study included insecticide applications, vegetation clearing, wild animal depopulation, use of tsetse traps, and combinations of the above methods within a protective barrier. Simulation results indicated that a protective barrier, about 1000 m wide, was effective in stopping the spatial spread of cattle trypanosomiasis.

A comparative study of substance use before and after establishing HIV infection status among people living with HIV/AIDS

Objective: To determine if significant differences exist in substance use among people living with HIV/AIDS (PLWHA) before and after establishing their HIV infection status. Method: The study participants are HIV positive clients of a community based HIV/AIDS outreach facility located in Montgomery, Alabama. The questionnaire includes demographics, substance use and risky sexual behaviors pertaining to HIV transmission. Each participant completed an anonymous questionnaire. A total of 341 questionnaires were distributed and 326 were fully completed and returned, representing a response rate of 96%. Results: Findings revealed a statistically significant difference in alcohol consumption before sex among PLWHA before and after establishing their HIV infection status (p = .001). No significant differences were observed among participants who reported as having used drugs intravenously (p = .89), and among those sharing the same syringe/needle with another person (p = .87) before and after establishing their HIV infection status. Conclusion: There is continued substance use and alcohol consumption before sex among PLWHA after establishing their HIV status despite clear evidence of such risky behaviors that could lead to an increase in exposure to HIV.

A quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sex among HIV-seropositive men.

Abstract The objective of this study is to conduct a quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sexual practices among HIV-seropositive men. A knowledgebase was developed by reviewing different published sources. The data were collected from different sources including Centers for Disease Control and Prevention, selected journals, and reports. The risk pathway scenario tree was developed based on a comprehensive review of published literature. The variables are organized into nine major parameter categories. Monte Carlo simulations for the quantitative risk assessment of HIV/AIDS transmission was executed with the software @Risk 4.0 (Palisade Corporation). Results show that the value for the likelihood of unprotected sex due to having less knowledge about HIV/AIDS and negative attitude toward condom use and safer sex ranged from 1.24×10−5 to 8.47×10−4 with the mean and standard deviation of 1.83×10−4 and 8.63×10−5, respectively. The likelihood of unprotected sex due to having greater anger-hostility, anxiety, less satisfied with aspects of life, and greater depressive symptoms ranged from 2.76×10−9 to 5.34×10−7 with the mean and standard deviation of 5.23×10−8 and 3.58×10−8, respectively. The findings suggest that HIV/AIDS research and intervention programs must be focused on behavior, and the broader setting within which individual risky behaviors occur.

Psychosocial responses associated with perceived risk of cancer in an African-American community.

This epidemiologic health survey study examined the association between health risk perceptions and psychosocial factors in 145 African Americans in East Montgomery, Alabama. The survey gathered information on demographics, population dynamics, health risk perceptions, and coping behaviors. Psychosocial variables measured were worries, concern, stress, and trauma associated with perceived risk of cancer. Results indicated that women were more concerned about the environmental health risks in their community than men. Compared to men, women were highly concerned about the economic effect of perceived environmental health risk. The findings indicate that an individuals health status and educational level were significant predictors of psychosocial responses.

Research in computational epidemiology

The emerging new area referred to as computational science or science done on a computer adds a third dimension to the traditional methods of theoretical and experimental approaches. Counterparts to computational science such as computational linguistice, computational engineering and others arc beginning to take roots. Naturally, new research paths and opportunities in computational epidemiology must also be explored. One of the major challenges in epidemiologic research is the issue of how to realistically and effectively handle complex bioepidemiologic dynamics involving interactions between humans or animals, etiological agents and the multiple array of environmental and socioeconomic determinants which affect these populations. To understand the behavior of such complex biological systems, it is useful to devise computer based simulation models. Computational epidemiologic approaches now provide alternative avenues to classical laboratory and/or field experimental methods. Systems which may be impractical because they are too large, or, not feasible because the cost is too prohibitive can now be simulated realistically. In the past obtaining solutions to biomathematical equations with any degree of complexity was impossible. However, the availability of powerful computers now makes the quantitative analysis of such systems feasible and indeed practical. With this in mind our research at Tuskegee University has focused on: a) Epidemiologic modelling and expert systems, and, b) Hypertext/hypermedia based epidemiologic knowledge management. The case studies for our research involve the bioepidemiologic dynamics of two complex host-parasite systems of trypanosoma and schistosoma. The ultimate goal is to develop resources and methodologies based on computational technology to advance epidemiologic research. The paper will address the methodological issues and findings as well as questions related to configuring an appropriate research workstation for computational epidemiology.

The Association between Interrelationships and Linkages of Knowledge about HIV/AIDS and its Related Risky Behaviors in People Living with HIV/AIDS

The relationship between knowledge about HIV/AIDS and its associated risky behaviors is complex and has not been sufficiently explored. It is especially important to look at some of the aspects of this relationship among people living with HIV/AIDS (PLWHA) in order to develop effective intervention strategies to reduce HIV/AIDS risky behaviors. The objective of this study was to investigate the association between knowledge about HIV/AIDS and its risky behaviors among PLWHA. Methods Risk taking behavior among the participants was measured as the number of all risky behaviors before and after the knowledge of their HIV/AIDS positive status. Knowledge was measured by the extent to which participants answered the HIV/AIDS related questions. The relationships between the identified HIV/AIDS risky behaviors and the knowledge among PLWHA were analyzed using Structural Equation Modelling. Results 341 questionnaires were administered and 326 (96%) were completed and returned from PLWHA clients of HIV/AIDS outreach facility in Alabama. Analysis revealed that, knowledge of HIV/AIDS, and knowledge of a properly used condom in preventing the infection through sexual activity were positively related with knowledge of where to get tested for HIV/AIDS. Using drugs before sex was significantly related with having sex with prostitutes (total effects’ standardized regression coefficient (TESRC)=0.29, p<0.001). Sharing the same syringe or needle with another person or other people to inject oneself was strongly related with number of sexual partners within one year (TESRC=0.25, p<0.001), and sex with injecting drug users (TESRC=0.45, p<0.001). Conclusion A deeper understanding of HIV/AIDS and some of its transmission pathways appears to be very effective in practicing the taking of preventive measures such as using condoms or getting tested for HIV. Increasing access to HIV/AIDS education could therefore be very useful in providing further gains in HIV/AIDS awareness among PLWHA.

The association between substance use and risky sexual behaviors among middle school children

Objective: The objective of the study was to determine if there was a significant association between substance use and risky sexual behaviors among middle school children. Methods: Data were collected in May 2002 using a questionnaire. A chi-square test was used for data analysis. Results: The results showed that alcohol, cocaine, marijuana, and tobacco use are strong predictors of risky sexual behaviors. Conclusions: These findings will be of use to healthcare practitioners and health educators seeking to reduce the risk of infection with HIV and other sexually transmitted diseases among the middle school children.