Center for Health Equity, Department of Health Science and Human Ecology, California State University, San Bernardino, 5500 University Parkway, San Bernardino, CA 92407, USA
Dr. Robert Avina Jr.
Center for Health Equity, Department of Health Science and Human Ecology, California State University, San Bernardino, 5500 University Parkway, San Bernardino, CA 92407, USA
Objective: Human immunodeficiency virus (HIV) remains a major public health issue with young adults facing a disproportionately higher rate of the burden. Our goal was to address the current literacy related to HIV, including biomedical prevention methods and barriers to care, such as cultural factors, from a sample of college students. Methods: We conducted a convergent parallel mixed methods analysis where both qualitative and quantitative data were collected and analyzed separately. A thematic analysis was conducted to assess qualitative results, while descriptive statistics were conducted to assess quantitative survey results. Results: HIV literacy was limited, with several participants reporting that they did not understand what HIV meant. While the majority knew the use of condoms, knowledge of other biomedical prevention methods was limited, as was the understanding the risk factors of HIV, with participants noting sharing a toilet seat and promiscuity as risk factors. Self-efficacy for HIV prevention was low among participants with many reporting that cultural barriers prevented discussion of risky behaviors and prevention methods in their families and social groups. Conclusion: Targeted, culturally sensitive, health education initiatives are needed to understand the high, low, or no risks of HIV as well as address stigmas related to HIV.
Background: During the COVID-19 pandemic, college students faced health disparities in addition to a negative burden on academic performance; however, little is reported in the literature regarding healthcare utilization. Methods: A cross-sectional survey was conducted among consenting college student participants aged 18 or older from a Hispanic-serving institution. Descriptive and bivariate statistics were used to analyze demographic characteristics and the types of healthcare services needed by such characteristics. Logistic regression was used to adjust for noted sex differences in associations between reporting limited healthcare services and types of healthcare services. Results: The study population of 223 participants was mostly Hispanic/Latino (65%) and female (73%). Of the population, 11% reported they could not obtain needed healthcare services, with time being reported as the most common reason. Significant associations were found between seeking general healthcare services/routine screening, seeking mental health services, and seeking sexual health services with reporting limited healthcare services, with sex-adjusted odds ratios and 95% confidence intervals of 1.90 (95% CI: 1.08, 3.36), 3.21 (95% CI: 1.44, 4.15), and 2.58 (95% CI: 1.05, 6.35), respectively. Conclusions: Availability and inability to obtain health services may exacerbate college student health disparities. Targeted interventions are needed in the population to mitigate the potential burdens of unmet healthcare needs, particularly among minority college students.
Background: Empirical evidence demonstrates the substantial burden of mental illness among people living with HIV and AIDS (PLWHA). Current literature also notes the co-morbidity of these two illnesses and its impact on quality of life and mortality. However, little evidence exists on patient outcomes, such as hospital length of stay or post-discharge status. Methods: A retrospective analysis of National Inpatient Sample data was conducted. The study population was defined as discharges having a primary diagnosis of HIV based on International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes in primary diagnosis field. Clinical Classification Software (CCS) codes are used to identify comorbid mental illness. Length of stay was defined as number of days between hospital admission and discharge. Disposition (or post-discharge status) was defined as routine versus not routine. Patient and hospital characteristics were used as control variables. All regression analyses were survey-weighted and adjusted for control variables. Results: The weighted population size (N) for this study was 26,055 (n = 5211). Among primary HIV discharges, presence of any mental illness as a secondary discharge was associated with 12% higher LOS, when compared to a lack of such comorbidity (incidence rate ratio [IRR] = 1.12, 95% confidence interval [CI] = 1.05, 1.22, p < 0.01). Likewise, among primary HIV discharges, those with mental illness had a 21% lower routine disposition, when compared to those without any mental illness (OR = 0.79, 95% CI = 0.68, 0.91, p < 0.001). Conclusion: Our results highlight the need for improved mental health screening and coordinated care to reduce the burden of mental illness among HIV discharges.