Evaluating the Impact of the Positive Choices Intervention on Substance Use, Psychological, and Care Engagement Outcomes Relevant to Current National HIV Prevention Goals

The HIV epidemic in the United States continues to be a significant public health problem, with approximately 50,000 new infections occurring each year. National public health priorities have shifted in recent years towards targeted HIV prevention efforts among people living with HIV/AIDS (PLWHA) that include: increasing engagement in and retention in care, improving HIV treatment adherence, and increasing screening for and treatment of substance use and psychological difficulties. This study evaluated the efficacy of Positive Choices (PC), a brief, care-based, theory-driven, 3-session counseling intervention for newly HIV-diagnosed men who have sex with men (MSM), in the context of current national HIV prevention priorities. The study involved secondary analysis of data from a preliminary efficacy trial of the PC intervention (n=102). Descriptive statistics examined baseline substance use, psychological characteristics and strategies, and care engagement and HIV-related biological outcomes. Generalized Estimating Equations (GEE) examined longitudinal changes in these variables by study condition. Results indicated that PC improved adherence to HIV treatment, but increased use of illicit drugs, specifically amyl nitrates and other stimulant drugs; additionally, moderation analyses indicated differences in patterns of change over time in viral load by baseline depression status. Implications of the findings and suggestions for future research are discussed.

Using GIS and Remote Sensing Technologies to Identify Environmental Variables of Malaria Vector Breeding Sites in Western Kenya

This study used Landsat 8 satellite imagery to identify environmental variables of households with malaria vector breeding sites in a malaria endemic rural district in Western Kenya. Understanding the influence of environmental variables on the distribution of malaria has been critical in the strengthening of malaria control programs. Using remote sensing and GIS technologies, this study performed a land classification, NDVI, Tasseled Cap Wetness Index, and derived land surface temperature values of the study area and examined the significance of each variable in predicting the probability of a household with a mosquito breeding site with and without larvae. The findings of this study revealed that households with any potential breeding sites were characterized by higher moisture, higher vegetation density (NDVI) and in urban areas or roads. The results of this study also confirmed that land surface temperature was significant in explaining the presence of active mosquito breeding sites (P< 0.000). The present study showed that freely available Landsat 8 imagery has limited use in deriving environmental characteristics of malaria vector habitats at the scale of the Bungoma East District in Western Kenya.