Effects of the COVID-19 Pandemic on Human Immunodeficiency Virus Care (HIV) in the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu County, Kenya

Isabel Brum, Carnegie Mellon University

Abstract
Known as the “jaboya” system or “sex for fish”, many women in Western Kenya are coerced into prostitution in exchange for sustenance. This system contributes to a high incidence of Human Immunodeficiency Virus (HIV) in the counties surrounding Lake Victoria where fishing is a dominant industry. Many obstacles—such as the COVID-19 pandemic—have hindered efforts to decrease the burden of HIV in the region. The pandemic led to a disruption of hospital resources worldwide, and many people avoided seeking medical services for fear of becoming infected. No study had analyzed the effects that the COVID-19 pandemic had on pivotal HIV services in Western Kenya. Therefore, this research analyzes the impact that the COVID-19 pandemic might have had on the HIV services provided at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), a major hospital in Kisumu County, Kenya. The possible effects on patients’ health outcomes (e.g., CD4 count) were also analyzed. To answer these questions, data were collected from the central registries at JOOTRH and analyzed using exploratory methods. Women and youth were identified as at-risk groups, so the analyses focus largely on both. The findings suggest that HIV testing services were affected between March 2020 and April 2022, but it is unclear to what extent this was due to the COVID-19 pandemic. Recommendations are provided to the hospital based on the findings

Predicting the Occurrence of Anxiety Disorders Based on Poverty Level and Type of Homelessness on a Health Center Level

Savannah Vetterly, University of Notre Dame

Abstract
The prevalence rate of anxiety disorders amongst the homeless population is high, which has been seen up to 32% (Hossain et al., 2020). Given the extreme stress that individuals experiencing homelessness often face as well as other factors (Wiewel & Hernandez, 2022), it can be understood why anxiety is a particular issue with this population. However, questions remain regarding the long-term predictive utility of poverty level and type of homelessness (street, emergency shelter, transitional housing, etc.) on anxiety disorders. As such, the following questions will be answered by the study: 1) What is the relationship between the percentage of patients in poverty (stratified by poverty level) and the percentage of patients with anxiety disorders over time? and 2) What is the relationship between the type of homelessness and the percentage of patients with anxiety disorders over time? The present study utilizes data from the Uniform Data System, an annual reporting system for health centers in the United States. Centers that exclusively received Health Care for the Homeless funding were used in analyses. Two longitudinal models were proposed to answer the research questions, using data between 2018 - 2021. While the analyses are currently underway, the findings have the potential to inform future longitudinal research regarding anxiety outcomes for individuals experiencing homelessness. At a health center level, clinics may be able to generally predict cases of anxiety based on patient demographics over time. Future implications from a policy standpoint will be discussed.

Diabetes and Emotional Wellbeing in the Philippines

Dana Hergenrother, University of Notre Dame

Abstract
Imagine losing your job because of a cut that would not heal. Imagine being ostracized from your community because no one understands your restrictive diet.  Imagine having to choose between your medical treatment and your child’s education. These scenarios are common for people with diabetes, especially those living in Low and Middle Income Countries such as the Philippines. Diabetes is one of the most common chronic conditions throughout the whole world, and the fourth common leading cause of death for the Philippines (Eala et. al, 2021). It has also been found that the depression or stress linked to diabetes, also known as Diabetes Distress Syndrome, can lead to worse health outcomes (Francisco et. al, 2022; Lee et. al, 2014). Through my research in Quezon, Quezon, a small municipality in northern Philippines, I investigated the link between the emotional and medical care for diabetic patients through surveys and interviews in order to determine best practices and opportunities for improvement. My results showed that 61% of patients experience a significant amount of distress related to diabetes, as determined by the PAID-5 Scale. Ultimately, I argue that the patients will have better outcomes if there is an emphasis on addressing physical and mental factors. I also will present examples from other countries of how gaps in care are addressed, and suggest ways to implement these in the context of the Philippines.