Masters of Science in Kinesiology and Health, Miami University, 2024, Kinesiology, Nutrition, and Health

The purpose of this study was to determine themes on the experiences and insights of Human Immunodeficiency Virus (HIV) stigma and queer stigma in men who have sex with men (MSM) aged 18-35 in a Freirean problem-posing education approach through a focus group. This project used a qualitative descriptive approach in thematic analysis. This study involved a focus group using Freirean education methods of coding, naming, and praxis to help the participants achieve critical consciousness and self-actualization on how to combat HIV stigma in their personal lives, and help those around them, as well as the greater MSM community. The transcript was coded via Dedoose qualitative software and underwent thematic analysis to get a better understanding of the research question. Based on previous research done on critical pedagogy and community capacity building in public health, it is expected that utilizing critical approaches more in public health on health behaviors and outcomes that involve systemic processes such as stigma can be empowering and effective in health education and promotion on a wide range of issues.

Committee: Paul Branscum (Advisor); Darren Cosgrove (Committee Member); Kyle Timmerman (Committee Member); Brandy Reeves-Doyle (Committee Member) Subjects: Gender Studies; Health; Health Education; Public Health; Public Health Education

Doctor of Philosophy, The Ohio State University, 2023, Public Health

Introduction: Hepatitis C virus (HCV) causes more morbidity and mortality in the US than any other bloodborne infectious disease, despite highly effective treatments. Significant challenges remain in identifying patients with HCV and linking them to care. IV drug use is widely recognized as the most important driver of current HCV transmission. However, other routes, such as sexual transmission, also occur but are comparatively understudied except in certain subpopulations such as men who have sex with men (MSM). It is unknown how gender and sexual orientation interact to modify the importance of sexual risk factors for HCV for the entire population. This research aimed to explore correlates to HCV seropositivity across patient subpopulations and investigate factors associated with linkage to care. Methods: For 14,718 patients tested for HCV between 2017-2020 at the Columbus, Ohio public health department, multivariate logistic regression was used to investigate how HCV seropositivity was associated with patient characteristics, health behaviors, and history of sexually transmitted infections (STI) including HIV, and how gender and sexual orientation modified these associations. A second analysis of correlates to linkage to care used logistic regression models to explore how patient characteristics and Medicaid policy changes were associated with linkage to care outcomes, using data from the Ohio Disease Reporting System (ODRS) for a cohort of HCV RNA-positive patients in urban central Ohio. Results: There were differences in how sexual risk behaviors were associated with HCV between strata of gender and sexual orientation in multivariate models. IV drug use was positively associated with HCV for all strata; however, number of sexual partners was associated with HCV for MSM (AOR 1.01; 95% CI 1.00-1.02) and WSM (AOR 1.02; 95% CI 1.00-1.03) but not MSW or WSW. Sex with an IV drug user was positively associated with HCV across all strata except MSM (AOR 6.72; 95% (open full item for complete abstract)

Committee: JaNelle Ricks (Advisor); Alison Norris (Committee Member); Jose Bazan (Committee Member); Maria Gallo (Committee Member) Subjects: Public Health

Doctor of Philosophy (PhD), Ohio University, 2022, Mechanical and Systems Engineering (Engineering and Technology)

IRF3 dimerization is an important step during the innate immune signal transduction in the human body. However, abnormal dimerization of IRF3 has been linked to a number of diseases, including autoimmune diseases [46], diabetes [35], and cancer [73]. In this dissertation, I focus on understanding the molecular-level processes involved in the dimerization of two interferon regulatory factor 3 (IRF3) proteins. This investigation begins with a fundamental study in which I explore the role of water-mediated interactions in the association of the hydrophobic domains of the protein. I examine the role of hydrophobicity, flexibility, and density of the flexible side chains in systematic simulations using a highly simplified model. Next, I study molecular processes involved in IRF3 protein dimerization. For this study, I first calculate free energy along pathways associated with the association of two IRF3 chains and then determine the most stable dimeric configuration. I extend this investigation to determine how the stable dimeric configuration of IRF3 changes with its phosphorylation state by studying phosphorylation at six different serine residues. This work shows that phosphorylation of different residues of IRF3 protein can significantly change the stable dimeric configuration. Finally, I estimate the protein-ligand binding affinity via Markov state analysis applied to fully atomistic simulations. I apply this technique to study the binding affinities of six different ligands for the ATP binding site of Glycogen synthase kinase-3β (GSK-3β). The binding affinity prediction from Markov state analysis is in strong agreement with the experimental results. My MD simulations show that the ligands that have a higher propensity of attaining a compact conformation due to the stacking of their aromatic groups also show stronger inhibition of GSK-3β activity.

Committee: Sumit Sharma (Advisor) Subjects: Bioinformatics; Biomedical Engineering; Biomedical Research; Biophysics; Biostatistics; Chemical Engineering; Chemistry; Pharmaceuticals; Physical Chemistry

Master of Mathematical Sciences, The Ohio State University, 2015, Mathematical Sciences

The emergence of social media in the 21st century has led to an increase in the speed of interacting with new individuals on both intimate and non-intimate levels. In this thesis we explore the use of social media applications (apps) on smartphones and its impact on men who have sex with men (MSM). The purpose of this thesis is two-fold: we first examined if social media use led to a higher rate of sexually transmitted infections (STIs) and second, we developed a mathematical model to determine the most effective point of intervention to reduce STI incidence. Our data consisted of 195 men adapted from a prior study conducted by Dr. Cara Rice at the Department of Public Health in Columbus, Ohio. We created and non-dimensionalized a closed susceptible-infected (SI) ordinary differential equation (ODE) model to illustrate how sexually transmitted infections impacted two different MSM populations, one that used social media, and one that did not. The computer software XPP was used to vary the population dynamics in different scenarios to test STI incidence in order to gain insight on efficacy of interventions. Our results showed that those men who use social media apps are more likely to be afflicted with STIs and that the greatest intervention to reduce STI incidence was the use of advertisements on apps and on display in public venues.

Committee: Adriana Dawes PhD (Advisor); Alison Norris PhD (Committee Member) Subjects: Epidemiology; Mathematics; Public Health

Doctor of Philosophy, The Ohio State University, 2014, Public Health

Introduction: Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) are significant public health problems. While these diseases are associated with detrimental health outcomes in many populations, no group is more affected than men who have sex with men (MSM). Despite this, significant gaps exist in the understanding of the increased incidence of infection in this population. We examined three distinct topics that would make substantial contributions to the HIV/STI prevention among MSM literature. First, research related to HIV/STI transmission from sexual intercourse in MSM has relied on self-reports of sexual activity, which is flawed because participants may misreport behavior. A biological marker of semen exposure in rectal swabs, indicative of unprotected receptive anal intercourse (uRAI), would reduce or eliminate researchers' reliance on self-reported behavior. Second, little is known about the spectrum of sexual behaviors being practiced within the MSM community. Because of the paucity of information on the prevalence of specific sexual practices, even less is known about the risks associated with these behaviors. Third, preliminary information suggests that MSM with negative or positive body image, compared to MSM with moderate body image, may be more likely to engage in risky sexual behaviors. No prior study has examined the direct association between body image and STI in MSM. Methods: We conducted a cross-sectional study of MSM (N=235) recruited from the Sexual Health Clinic (SHC) at an urban health department. Clinical and behavioral data were collected from each participant. For the first aim (n=54), we quantified PSA from rectal swabs collected from MSM and compared PSA results to self-reports of unprotected RAI. For the second aim (n=231), we used data from the self-administered behavioral survey to calculate the prevalence of specific sexual behaviors and substance use in the past three months and over a man's li (open full item for complete abstract)

Committee: Abigail Norris Turner PhD (Advisor) Subjects: Public Health

Doctor of Philosophy, The Ohio State University, 2012, EDU Policy and Leadership

The use of a measure of HIV transmission risk which incorporates seroadaptive behaviors is needed in order to assess the complex effects of disclosure on HIV transmission. The purpose of this study was to explore the use of a modified version of the ordinal scale of HIV risk behavior proposed by Osmond, Pollack, Paul, and Catania (2007) to operationalize the risk of HIV transmission among HIV-positive MSM and to establish the strength of the empirical evidence supporting the use of these scores for inference about HIV transmission. The original measure was modified to include the full potential for seropositioning (i.e., with and without 100% condom use) as a potential preventive strategy used by MSM to reduce the risk of HIV transmission. Additionally, the measure was applied to individual sexual encounters rather than globally so that the frequency of risk behaviors can be accurately modeled. The appropriateness of these methods was explored using data from a study involving the disclosure of serostatus to sexual partners in a sample of HIV-positive MSM. Results of the study are promising for the refinement of measurements of HIV transmission risk, and for the understanding of seroadaptive behavior in MSM. For researchers who are seeking to demonstrate the effectiveness of interventions designed to reduce HIV transmission risk, the ordinal measure provides a means for detecting qualitative shifts in sexual activity which can be critical to the question of effectiveness.

Committee: Ann A. O'Connell Ed.D. (Advisor); Julianne M. Serovich Ph.D. (Committee Member); Dorinda J. Gallant Ph.D. (Committee Member) Subjects: Educational Evaluation; Educational Tests and Measurements

Doctor of Philosophy, The Ohio State University, 2003, Social Work

Although the incidence of HIV transmission among other groups is rising, men who have sex with men (MSM) account for more than forty percent of all new HIV infections. It stands to reason then, that both HIV-positive and HIV-negative MSM continue to engage in unsafe sexual behaviors. Efforts to curtail the spread of HIV infection have included safer sex campaigns, education and prevention programs, and the application of risk reduction models typically designed for HIV-negative individuals. Yet, HIV-positive MSM continue to engage in risk-taking sexual behaviors. The quandary with most HIV prevention programs is that they require an elimination of sexual behaviors that MSM have reported as important, in effect reducing their sexual freedom. Therefore, MSM may be motivated to regain the sexual freedom that existed prior to the HIV epidemic. Psychological reactance (Brehm, 1966) is a framework that describes why individuals become motivated to restore freedoms that have been threatened or eliminated. The purpose of this research was to test the theory of psychological reactance as applied to the risk-related sexual behaviors of HIV-positive MSM. According to the theory, the more important a behavior is, the greater the magnitude of reactance. The crux of this research rests on the premise that sexual importance contributes to MSM engaging in risky sexual behaviors. Psychological reactance was measured by the Therapeutic Reactance Scale (TRS) and the Questionnaire for Measuring Psychological Reactance (QMPR). This research utilized multiple linear regression analysis to test hypotheses asserting that the interaction term (reactance X sexual importance) predicts risk-related sexual behaviors in HIV-positive MSM. Results indicated that sexual importance was the most significant predictor of risk-related sexual behaviors of HIV-positive MSM. The interaction term (TRS X sexual importance) was significant for sexual practices, number of sexual encounters, number of sexual p (open full item for complete abstract)

Committee: Thomas Gregoire (Advisor) Subjects: Social Work

Doctor of Philosophy, University of Akron, 2008, Counseling Psychology

The present study investigated associations among African American and same sex attracted identity developmental components, psychological well-being, difficult sexual situations, and sexual risk practices among a sample (N = 73) of HIV-positive African American men who have sex with men (MSMs). The current study responds to Mays, Cochran, and Zamudio's (2004) call for empirical investigations of culturally specific determinants impacting psychological health and sexual risk behaviors among African American MSMs. The current study parallels the methodology of Diaz, Ayala, and Bein (2004) and Diaz, Bein, and Ayala (2006), linking experiences of homophobia, racism, and poverty to psychological health and sexual risk practices among gay identified Latino men. Using a similar framework, the current study investigated the impact of African American and same sex attracted identity development on psychological health and sexual risk practices within a sample of African American HIV-positive MSMs. The current study's sample reported a diverse range of sexual identities (e.g., gay, heterosexual, “on the down low;”), with all participants having engaged in consensual sex with other men. Results indicated that higher endorsement of the Anti-White African American identity (as measured by the Cross Racial Identity Scale [CRIS, Vandiver et al., 2000]), as well as lower levels of psychological well-being, and younger ages, predicted circumstances promoting unsafe sex. Higher endorsements of the African American identities of Multiculturalist Inclusive and Miseducation, as well as the same sex attracted identity of Superiority (as measured by the Lesbian and Gay Identity Scale [LGIS; Mohr & Fassinger, 2000]), predicted interpersonal barriers to unsafe sex. Additional exploratory analyses showed higher endorsements of the same sex identity of Homonegativity to predict lower levels of psychological well-being; higher endorsements of the African American identity of Assimilation, an (open full item for complete abstract)

Committee: Charles Waehler Ph.D. (Advisor) Subjects: African Americans; Behaviorial Sciences; Demographics; Developmental Psychology; Gender; Health; Multicultural Education; Psychology; Psychotherapy; Public Health; Social Psychology