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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Development and preliminary validation of the PrEP empowerment scale(Springer/Plenum Publishers, 2023) Crockett, Kaylee B.; Batey, D. Scott; Department of Psychology; Turan, Bülent; Department of Psychology; College of Social Sciences and HumanitiesInformed by the Health Care Empowerment Model, a measure of PrEP Empowerment was developed and assessed for preliminary reliability and validity. Participants (N = 100) were invited to complete a survey during regular clinic visits. A subset (n = 84) volunteered to provide blood samples to assess plasma tenofovir (TFV) levels for recent PrEP adherence. A five-factor measure explained 70% of the total variance. Associations with internalized PrEP stigma, PrEP adherence self-efficacy, and plasma TFV were assessed. Results supported the multidimensional nature of PrEP Empowerment and reliability and validity. Additional research is needed in populations with varying PrEP experience and greater gender and ethnic representation.Publication Metadata only Acceptability, feasibility and potential of an intervention using secret Facebook groups to complement existing HIV prevention strategies among female sex workers in Cameroon, a randomized pilot study(Routledge Journals, Taylor & Francis Ltd, 2023) Vazquez Guillamet, Laia J.; Babey, Mary Mah; Njah, Mercy; Blake, Hassanatu; Jasani, Amy; Kyeng, Rahel; Hao, Jiaying; Long, Dustin; Tih, Pius; Turan, Janet M.; Khan, Eveline Mboh; Dionne, Jodie; Turan, Janet Molzan; School of MedicineThis randomized pilot project evaluated an intervention promoting health care literacy around HIV, pre-exposure prophylaxis (PrEP), and stigma reduction using private social media groups that complemented existing HIV prevention services among female sex workers (FSWs) in Cameroon. The intervention was 12 HIV and sexual health videos tailored to FSWs that were released over 8 weeks through a secret Facebook group platform. In-person surveys were administered before, after the intervention, and three months later. No HIV seroconversions were detected; all participants completed follow-up and agreed to recommend the intervention to a coworker. Although the intervention was assessed to be acceptable and feasible to implement, poor internet connectivity was a key barrier. In time-series analysis, the intervention group participants reported improved PrEP interest, PrEP knowledge, and condom use along with reduced PrEP and HIV-related stigma, but no impact on sex-work related stigma or social cohesion. Similar results occurred in the control group. Cross-contamination and small pilot study size might have hindered the ability to detect the differential impact of this intervention. As communications technology increases in Cameroon, it is essential to learn more about FSWs preferences on the use of social media platforms for HIV prevention strategies.Publication Metadata only The relationship between HIV pre-exposure prophylaxis stigma and treatment adherence among current HIV pre-exposure prophylaxis users in the Southeastern US(Springer, 2023) Van Gerwen, Olivia T.; Yigit, Ibrahim; Crockett, Kaylee B.; Department of Psychology; Turan, Bülent; Department of Psychology; College of Social Sciences and HumanitiesDespite efficacy in HIV prevention, Pre-exposure Prophylaxis (PrEP) is underutilized in the US, especially among populations at highest risk. PrEP-related stigma may play a role. We developed measures of PrEP-related stigma dimensions and PrEP adherence. We administered them to current PrEP users. We hypothesized that PrEP-related stigma would negatively impact PrEP adherence. Questionnaire measures were developed using data from previous qualitative work and existing validated HIV-related stigma measures. The resultant survey was administered to current PrEP users from two Birmingham, Alabama PrEP clinics. Plasma tenofovir disoproxil fumarate levels were collected to measure PrEP adherence. Exploratory factor analyses were performed to determine the factor structure of each PrEP-related stigma dimension (internalized, perceived, experienced, anticipated, disclosure concerns). Separate binary logistic (or linear) regressions were performed to assess associations between PrEP-related stigma dimensions and adherence (treatment adherence self-efficacy, self-reported adherence, and plasma tenofovir levels), adjusting for education, race, and time on PrEP. In 2018, 100 participants completed the survey, with 91 identifying as male and 66 as white. Only internalized stigma was associated with lower self-reported PrEP adherence. Exploratory mediation analyses suggested that the association between all stigma dimensions and self-reported PrEP adherence is mediated by PrEP adherence self-efficacy. No associations were found between any PrEP-related stigma measures and plasma tenofovir levels. Internalized PrEP stigma may reduce PrEP adherence, possibly by reducing PrEP adherence self-efficacy among experienced PrEP users. Further investigation of how stigma dimensions affect PrEP adherence in populations at risk for HIV may shed light on drivers of PrEP underutilization.Publication Metadata only Attitudes of medical students toward sexual minorities: a multicentric survey from the Medical Education without Discrimination Project(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2024) Bayramlar, Osman Faruk; Nalbant, Hacer; Yasin, Yesim; Mardin, Deniz; Karabey, Selma; Kayı, İlker; School of MedicineThis study, as a part of the 'Medical Education without Discrimination (MED) Project," focuses on investigating attitudes toward sexual minorities and demographics among Turkish medical students. In the needs assessment phase of MED Project, a survey covering demographics, sexual orientation, attitudes toward sexual minorities, and Index of Attitudes Toward Homosexuals by Hudson & Ricketts (6-point Likert) was conducted among 523 medical students of one public and two nonprofit private medical schools in Istanbul. Of the students, 4.2% declared themselves as non-heterosexual. The findings highlight that medical students are on the verge of homophobia (44th percentile). Homophobia was significantly higher among public university students, males, younger individuals, those who originated from underdeveloped settlements, those who grew up with mothers who did not graduate from university, those who considered themselves less happy, and those without LGBTI+ acquaintances. Of the respondents, 14.1% do not perceive LGBTI+ people as equals within the community, and 75.7% assert that they would conceal their own LGBTI+ identity if they were part of this community. This study highlights that the need for targeted interventions in medical education in line with the global commitment to reduce inequalities and promote inclusive health care.Publication Metadata only Consanguineous marriage and its effect on reproductive behavior and uptake of prenatal screening(Wiley) Şahin, Eda; N/A; Paşalak, Şeyma İnciser; Seven, Memnun; PhD Student; Faculty Member; Graduate School of Health Sciences; School of Nursing; 125009; 32470The study aimed to determine the prevalence of consanguinity among pregnant women, its effect on reproductive behavior and the uptake of prenatal screening. The sample consisted of 842 pregnant women recruited to a prospective cohort study conducted in twenty-three cities from different regions in Turkey between June 2017 and March 2018. of the women, 17.7% (n = 149) were in consanguineous marriages. The consanguineous couples were younger at the time of their marriages than non-consanguineous couples, and 49% of the consanguineous marriages were arranged. The educational levels of both spouses in consanguineous marriages were lower than those in non-consanguineous marriages. There was a statistically significant difference in the prevalence of the pregnant women having a prenatal screening test between women in consanguineous marriages (53%) and those in non-consanguineous marriages (78.2%). There were no statistically significant differences between the two groups in terms of having health problems during pregnancy, the number of pregnancies, abortions and/or stillbirths, the week of delivery and the birthweight of the baby. Healthcare providers play a key role in eliciting whether or not pregnant couples are consanguineous, providing a tailored risk assessment, education, and counseling about screening and diagnostic tests for early diagnosis and management of the fetus, explaining the testing process and possible outcomes, and helping couples make informed decisions regarding their reproductive options or pregnancy management.Publication Metadata only The first biallelic missense mutation in the fxn gene in a consanguineous turkish family with charcot-marie-tooth-like phenotype(2020) Candayan, Ayşe; Yunisova, Gülşhan; Çakar, Arman; Durmuş, Hacer; Parman, Yeşim; Battaloğlu, Esra; N/A; Başak, Ayşe Nazlı; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 1512Charcot-Marie-Tooth (CMT) disease is the most common inherited neuropathy with a prevalence of 1 in 2500 individuals worldwide. Here, we report three Turkish siblings from consanguineous parents presenting with a CMT-like phenotype who carry a homozygous c.493C>T, p.Arg165Cys mutation in the FXN gene that is the only known causative gene for Friedreich’s ataxia (FRDA). The identified missense mutation has been reported previously in two FRDA cases in compound heterozygosity with the common GAA repeat expansion in the first intron of the FXN gene. Analysis of skin biopsy samples from our family indicated that the mutation does not affect the expression levels of the frataxin, pointing to functional impairment of the corresponding protein. The CMT phenotype in the siblings was associated with visual impairment, optic nerve atrophy, and dysarthria. To the best of our knowledge, this family represents the first FXN missense mutation in homozygosity and challenges the notion that missense mutations have not been reported yet due to their embryonic lethality. Furthermore, this finding poses an interesting genetic overlap between autosomal recessive CMT and FRDA that we believe may have important implications on understanding the pathogenesis of these neurological disorders.Publication Metadata only Living with hiv during COVID-19: knowledge and worry about COVID-19, adherence to COVID-19-related precautions, and hiv health outcomes(Taylor & Francis, 2023) Nemli, Salih Atakan; Yigit, Ibrahim; Agrali, Burcu; Gokengin, Deniz; Department of Psychology; Turan, Bülent; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 219712The COVID-19 pandemic has been profound impacts on mental and physical health of individuals with chronic diseases. Thus, it is important to understand the effects of the COVID-19 pandemic on people living with HIV. We aimed to assess the association between COVID-19-related knowledge and worry, HIV-related health practices and outcomes, and adherence to precautions related to COVID-19, and possible associations of these factors with HIV treatment outcomes (ART adherence and viral load). A cross-sectional survey was conducted between October 2020 and February 2021 among 291 PLWH at two large university hospital HIV clinics in Izmir, Turkey. Additionally, the most recent HIV-RNA load, CD4 count was recorded using medical records. Logistic regression analyses were performed to determine predictors of self-reported adherence to COVID-19-related precautions, ART adherence and undetectable viral load. COVID-19-related worry, COVID-19-related knowledge, and ART adherence were significant predictors of adherence to COVID-19-related precautions. Furthermore, adherence to COVID-19-related precautions was a significant predictor of both ART adherence and undetectable viral load. Findings provide a unique aspect of the interrelations of COVID and living with HIV. Since health behaviors and outcomes for COVID-19 and HIV seem to be interrelated, treatment practices and interventions that address these simultaneously may enhance their efficacy.Publication Metadata only Speed accuracy trade-off under response deadlines(Frontiers, 2014) Simen, Patrick; Papadakis, Samantha; N/A; Department of Psychology; Karşılar, Hakan; Balcı, Fuat; PhD Student; Faculty Member; Department of Psychology; Graduate School of Social Sciences and Humanities; College of Social Sciences and Humanities; 291441; 51269Perceptual decision making has been successfully modeled as a process of evidence accumulation up to a threshold. In order to maximize the rewards earned for correct responses in tasks with response deadlines, participants should collapse decision thresholds dynamically during each trial so that a decision is reached before the deadline. This strategy ensures on-time responding, though at the cost of reduced accuracy, since slower decisions are based on lower thresholds and less net evidence later in a trial (compared to a constant threshold). Frazier & Yu (2008) showed that the normative rate of threshold reduction depends on deadline delays and on participants' uncertainty about these delays. Participants should start collapsing decision thresholds earlier when making decisions under shorter deadlines (for a given level of timing uncertainty) or when timing uncertainty is higher (for a given deadline). We tested these predictions using human participants in a random dot motion discrimination task. Each participant was tested in free-response, short deadline (800 ms), and long deadline conditions (1000 ms). Contrary to optimal-performance predictions, the resulting empirical function relating accuracy to response time (RT) in deadline conditions did not decline to chance level near the deadline; nor did the slight decline we typically observed relate to measures of endogenous timing uncertainty. Further, although this function did decline slightly with increasing RT, the decline was explainable by the best-fitting parameterization of Ratcliff's diffusion model (Ratcliff, 1978), whose parameters are constant within trials. Our findings suggest that at the very least, typical decision durations are too short for participants to adapt decision parameters within trials.Publication Metadata only Human rights, humanitarianism, and state violence: medical documentation of torture in Turkey(Wiley, 2016) Department of Sociology; Can, Başak Bulut; Faculty Member; Department of Sociology; College of Social Sciences and Humanities; 219278State authorities invested in developing official expert discourses and practices to deny torture in post-1980 coup d''etat Turkey. Documentation of torture was therefore crucial for the incipient human rights movement there in the 1980s. Human rights physicians used their expertise not only to treat torture victims but also to document torture and eventually found the Human Rights Foundation of Turkey (HRFT) in 1990. Drawing on an ethnographic and archival research at the HRFT, this article examines the genealogy of anti-torture struggles in Turkey and argues that locally mediated intimacies and/or hostilities between victims of state violence, human rights physicians, and official forensics reveal the limitations of certain universal humanitarian and human rights principles. It also shows that locally mediated long-term humanitarian encounters around the question of political violence challenge forensic denial of violence and remake the legitimate levels of state violence.Publication Metadata only Taking it to the grave: gender, cultural capital, and ethnicity in turkish death announcements(Sage, 2009) Department of Sociology; Ergin, Murat; Faculty Member; Department of Sociology; College of Social Sciences and Humanities; 106427Popularly considered a great equalizer, death and the rituals around it nevertheless accentuate social distinctions. The present study focuses on a sample (N = 2554) of death announcements in a major Turkish daily newspaper (Hürriyet) from 1970 to 2006. Out of the liminal position of Turkish death announcements between obituaries and death notices emerges a large decentralized collection of private decisions responding to death, reflecting attitudes toward gender, ethnic/religious minority status and cultural capital, and echoing the aggregate efforts of privileged groups to maintain a particular self-image. Class closures lead to openings for traditionally under-represented minorities, such as Jewish Turkish citizens and citizens of Greek or Armenian origin. Results reveal that signs of status and power in announcements are largely monopolized by men of Turkish-Muslim origins. Although the changes in the genre-characteristics of death announcements are slow, they correspond to major turning points in Turkish social history.