Glenn J Wagner
Biographic Data
| ID | 166231 |
|---|---|
| NAME | Glenn J Wagner |
| GIVEN NAMES | Glenn J |
| FAMILY NAME | Wagner |
| SIGNATURE | WAGNER G J |
| AFFILIATIONS | RAND Corporation |
| ORCID | 0000-0001-9081-3299 |
| VERIFIED | Yes |
| TOTAL WORKS | 110 |
| TOTAL CITATIONS | 199 |
| AUTHOR COUNT | 110 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1994 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 8 |
Longitudinal Correlates of Internalized HIV Stigma Among Ugandan PLWH
Internalized HIV stigma, defined as negative self-perceptions among people living with HIV (PLWH) based on the societal stereotype, is a significant barrier to effective HIV prevention and care in Sub-Saharan Africa. This study examined longitudinal correlates of internalized HIV stigma among PLWH in Uganda. The sample included 105 participants (mean age = 39.3 years (SD = 10.5); 69.5% women). Surveys were conducted at baseline, and 6, 12, and 18…
HIV Disclosure and Prevention Advocacy Partially Mediate Advocacy Training Intervention Effect on Reduced Internalized HIV Stigma
Reduction of internalized HIV stigma is key to increasing HIV disclosure and engagement in peer advocacy for HIV prevention—and these latter processes may also be important for making further inroads into minimizing stigma. We examined mediators of the effect of a peer advocacy training intervention, Game Changers for HIV Prevention (GC-HIV), on reduced internalized HIV stigma among persons living with HIV (PLWH) in Uganda. A randomized controlle…
Qualitative findings on the benefits of depression treatment for pregnant women living with HIV in Uganda
Depression among women living with HIV affects their psychological well-being, HIV disease management, and prevention of mother-to-child transmission. A subset of 25 women selected from the intervention arm of the Maternal Depression Treatment in HIV (M-DEPTH) cluster randomized trial were interviewed; they had received either antidepressant therapy (ADT) or problem-solving therapy (PST). Their experiences as new mothers with the effects of depre…
Persistence of Intimate Partner Violence and Its Relationship to HIV Prevention Behaviors and Attitudes
Attitudes toward and use of pre-exposure prophylaxis (PrEP) by coupled sexual minority men (SMM) may be influenced by exposure to intimate partner violence (IPV) and sexual agreements regarding non-monogamy. We examined IPV (victimization and perpetration) persistence over 12 months and its association with HIV prevention behaviors and attitudes among 271 coupled, HIV-negative SMM, and the moderating role of sexual agreements. The sample had dive…
Examining Intrapersonal and Social Environment Factors Associated with Condom Use and HIV Testing Among Young Adult MSM Living in Beirut, Lebanon
Men who have sex with men (MSM) are disproportionately affected by HIV, particularly in urban Middle Eastern areas like Beirut, Lebanon. Understanding factors influencing HIV prevention, such as condom use and HIV testing is crucial. This study used the Information-Motivation-Behavioral Skills (IMB) Model determinants and explored social environment factors to assess their associations with condomless sex and HIV testing. Model fit was also exami…
Randomized Controlled Trial of Game Changers, a Social Network Intervention for HIV Prevention in Uganda
In Uganda, where HIV prevalence remains above 5% among those aged 15 and older, we conducted a randomized controlled trial of Game Changers, an 8-session peer-facilitated group intervention that empowers people living with HIV (PLHIV) to engage in HIV prevention advocacy with their social network members ("alters"). A total of 210 index PLHIV participants (105 intervention, 105 control) and 599 alters were enrolled; assessments were conducted at …
Leading with Hope
Among heterosexual couples in sub-Saharan Africa, fears of relationship dissolution and inability to bear healthy children following an HIV-positive result remain barriers to HIV testing. Recently expanded availability of pre-exposure prophylaxis (PrEP) affords a critical opportunity to promote HIV testing with reassuring communication that highlights use for relationship preservation and healthy childbearing. We aimed to develop a theoretically-…
Intimate Partner Violence Perpetration and PrEP Use Among Sexual Minority Men
Cisgender sexual minority men (SMM) report intimate partner violence (IPV) at rates comparable to or higher than heterosexual cisgender women, often linked to increased HIV risk. This study explores the relationship between IPV perpetration and pre-exposure prophylaxis (PrEP), considering the potential mediating effects of sexual orientation related minority stress and PrEP stigma. Utilizing baseline data from the Empowering Relationships and Opp…
Race-Based Discrimination, Internalized Racism, and Anticipatory Stigma Among Sexual Minority Men in Same-Race and Interracial Relationships
Sexual minority men (SMM) of color in inter-racial/ethnic relationships experience more stress than those in same-race/ethnic relationships. While minority stress in SMM couples has been studied, few studies have examined race/ethnicity and SMM relationship dynamics in an integrative manner, especially at the individual level. This study examined race-based discrimination, internalized racism, and anticipatory stigma among 391 U.S. SMM who report…
Sleep Disturbance Mediates the Associations Between HIV Stigma and Mental and Physical Health Among Black Adults with HIV
Objectives Black Americans have been disproportionally affected by the HIV epidemic, and experience significant disparities in sleep health, mental health, and physical health domains. Using longitudinal data from a sample of Black adults with HIV, the current study examined the associations between stigma and mental and physical health outcomes and how sleep disturbance may play a mediating role. Methods Data were drawn from a recent randomized …
Trajectories of perinatal depression among women living with HIV in Uganda
Background: Perinatal depression affects one-third of pregnant women living with HIV (WLH). We examined patterns of treatment response to a novel stepped model of depression care among WLH with perinatal depression in Uganda. Methods: As part of the Maternal Depression Treatment in HIV (M-DEPTH) cluster randomised controlled trial, 191 women were enrolled across four antenatal care clinics assigned to provide stepped care including behavioural an…
Characteristics of Received HIV Prevention Advocacy from Persons Living with HIV in Uganda, and Associations with HIV Testing and Condom Use Among Social Network Members
Receiving peer advocacy has been shown to result in increased HIV protective behaviors, but little research has gone beyond assessment of the mere presence of advocacy to examine aspects of advocacy driving these effects. With baseline data from a controlled trial of an advocacy training intervention, we studied characteristics of HIV prevention advocacy received among 599 social network members of persons living with HIV in Uganda and the associ…
Concordance of HIV Prevention Advocacy Reports and its Associations with HIV Protective Behaviors
Peer advocacy can promote HIV protective behaviors, but little is known about the concordance on prevention advocacy(PA) reports between people living with HIV(PLWH) and their social network members. We examined prevalence and correlates of such concordance, and its association with the targeted HIV protective behavior of the social network member. Data were analyzed from 193 PLWH(index participants) and their 599 social network members(alters). …
Loneliness Among Black/African American Adults Living with HIV
Loneliness, an emerging public health problem, is higher among people living with HIV and is associated with negative health outcomes. Black/African Americans have a high burden of HIV, and little is known about the characteristics of loneliness among Black adults living with HIV; therefore, this study sought to understand the sociodemographic and psychosocial correlates of Black adults living with HIV who are lonely and the implications of lonel…
Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi
Internalized stigma is common among individuals with sexually transmitted infections such as HIV and among those with mental health conditions such as major depressive disorder (MDD). As part of a cluster randomized trial, we investigated the prevalence and correlates of internalized stigma among adults living with comorbid HIV and MDD in rural Malawi (n = 339). We found heightened stigma toward HIV and mental illness among those in the cohort: m…
Treatment of Perinatal Depression and Correlates of Treatment Response Among Pregnant Women Living with HIV in Uganda
Both depression treatment modalities yielded high response rates in Ugandan PWLWH; ADT was well-tolerated. Our results highlight a need to build capacity to implement the stepped-care protocol for non-responders and screen for social support and interpersonal violence
Culturally Relevant Africultural Coping Moderates the Association Between Discrimination and Antiretroviral Adherence Among Sexual Minority Black Americans Living with HIV
Exposure to discrimination has been linked to lower HIV antiretroviral therapy (ART) adherence and poor HIV care outcomes among Black Americans. Coping has been shown to mitigate the harmful effects of discrimination on health behaviors, but the use of cultural relevant Africultural coping strategies is understudied as a moderator of the association between intersectional discrimination and ART adherence among Black Americans. We used adjusted lo…
Effects of M-DEPTH Model of Depression Care on Maternal HIV Viral Suppression and Adherence to the PMTCT Care Continuum Among HIV-Infected Pregnant Women in Uganda
Perinatal depression has been shown to impede adherence to antiretroviral therapy (ART) and the prevention of mother-to-child transmission (PMTCT) care continuum; therefore, treating perinatal depression may result in increased viral suppression and PMTCT adherence. We examined the effects of the M-DEPTH (Maternal Depression Treatment in HIV) depression care model (including antidepressants and individual Problem Solving Therapy) on depression, m…
Unmet Social Needs are Associated with Lower Adherence to Antiretroviral Therapy (ART) Medication Among a Sample of Black People Living with HIV (PLHIV)
Exploring antiretroviral therapy adherence, competing needs, and viral suppression among people living with HIV and food insecurity in the Dominican Republic
Understanding factors related to suboptimal adherence to antiretroviral therapy (ART) and detectable viral load (VL), especially among vulnerable populations, is needed to improve HIV outcomes. The Caribbean is highly impacted by HIV and socioeconomic inequalities, but few studies have been conducted there to explore food insecurity among people with HIV and factors associated with viral suppression in this vulnerable population. Using baseline d…
Mediators and moderators of ART adherence effects of supporting treatment adherence readiness through training (START)
Supporting Treatment Adherence Readiness through Training (START) is an HIV antiretroviral adherence intervention, based on the Information Motivation and Behavioral skills (IMB) model, that significantly improved adherence in our randomized controlled trial. To understand how and for whom START had its effects on adherence, we examined mediators and moderators. Ninety-nine HIV-patients (53 control, 46 intervention) who enrolled in the trial and …
Association of Condom Use Advocacy with Perceived Condom Use Among Social Network Members
Randomized Controlled Trial of Rise, A Community-Based Culturally Congruent Counseling Intervention to Support Antiretroviral Therapy Adherence Among Black/African American Adults Living with HIV
Preliminary Effects of an Urban Gardens and Peer Nutritional Counseling Intervention on HIV Treatment Adherence and Detectable Viral Load Among People with HIV and Food Insecurity
Psychometric Properties of a Scale on Judgmental Communication with Peers About Sex Among YMSM and Their Close Friends in Lebanon
Perceived discrimination and mental health symptoms among Black men with HIV
People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination …
Integration of One's Religion and Homosexuality
Internalized homophobia as a psychological phenomenon has attracted little systematic research despite its destructive impact on the mental health of the gay community. This study looks at the relationship between internalized homophobia and the process of integrating one's religious faith and homosexuality by comparing levels of internalized homophobia among male participants of Dignity, an organization of Catholic gay men and lesbians, with a c…
Medical mistrust is related to lower longitudinal medication adherence among African-American males with HIV
African-Americans living with HIV show worse health behaviors (e.g. medication adherence) and outcomes (e.g. viral suppression) than do their White counterparts. In a 6-month longitudinal study, we investigated whether medical mistrust among African-American males with HIV (214 enrolled, 140 with longitudinal data) predicted lower electronically monitored antiretroviral medication adherence. General medical mistrust (e.g. suspicion toward provide…
Prevalence of Extradyadic Sex in Male Couples of Mixed HIV Status and Its Relationship to Psychological Distress and Relationship Quality
This study assessed the prevalence of extradyadic sex and the relationship between such activity and psychological distress and relationship quality in male couples of mixed HIV serostatus. Sixty-three couples were interviewed and had sufficient data for inclusion in all analyses. With regard to sexual activity during the year prior to being interviewed, 19 (30%) couples were monogamous, 18 (29%) described themselves as "open," 13 (21%) kept extr…
Internalized Homophobia in a Sample of HIV+ Gay Men, and Its Relationship to Psychological Distress, Coping, and Illness Progression
The purpose of this study was to determine whether internalized homophobia is related to psychological distress and coping style and whether these relationships are moderated by illness stage. A sample of gay men, most of whom were HIV+, Caucasian, and well educated, were administered assessments at both baseline and 2-year follow-up, which allowed for the assessment of change over time in the context of HIV illness progression and to determine w…
Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV
Measuring Agreement between Egos and Alters
In personal network studies, respondents (egos) are asked to report information about members of their personal network (alters); egos respond based on their perceptions. Previous studies of informant accuracy present a varied picture: Some find egos' reporting on their relationships with alters to be accurate; others do not. In our study of people living with HIV/AIDS in Uganda, egos were asked to invite up to four alters named during their inte…
Reliability of sexual behavior self‐reports in male couples of discordant HIV status
Seventy‐five male couples, where one member was HIV‐positive and his partner was HIV‐negative, were assessed concerning anal sexual‐risk behavior. Subsequently, the reliability of their self‐reports was determined by two methods: (a) by comparing the separate reports of each member of the couple and (b) by a one week test‐retest of 27 individuals. Both quantitative and qualitative assessment methods were used. Approximately half of the men had pr…
Association of Discrimination-Related Trauma With Sexual Risk Among HIV-Positive African American Men Who Have Sex With Men
Objectives. We investigated whether 1 form of traumatic stress, discrimination-related trauma (e.g., physical assault because of race), was associated with unprotected anal intercourse, especially when compared with non–discrimination-related trauma, among African American men who have sex with men. Methods. A convenience sample of 131 HIV-positive African American men who have sex with men receiving antiretroviral treatment completed audio compu…
HIV fatalism and engagement in transactional sex among Ugandan fisherfolk living with HIV
HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic…
Major Depression Among Young Men Who Have Sex with Men in Beirut, and Its Association with Structural and Sexual Minority-Related Stressors, and Social Support
Text Messaging for Improving Antiretroviral Therapy Adherence
Objectives. To assess the effectiveness of Short Message Service (SMS) reminder messages on antiretroviral and cotrimoxazole prophylaxis adherence among HIV-positive youths as well as the relative effectiveness of SMS with and without a response option. Methods. Eligible HIV-positive patients aged 15 to 22 years at 2 HIV clinics in Kampala, Uganda, participated in a year-long parallel individual-randomized controlled trial and were assigned in a …
Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men
HIV Prevalence and Demographic Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon
Effects of testosterone replacement therapy on sexual interest, function, and behavior in HIV+ men
This report documents findings from the first 80 patients to enter our ongoing clinical trial of testosterone replacement therapy, designed for HIV+ men with low CD4 cell counts and low levels of serum testosterone, who complain of diminished sexual interest and/or sexual dysfunction. Patients were treated with testosterone for 8 weeks with biweekly intramuscular injections, starting at 200 mg. and increasing at Week 2 to 400 mg. biweekly. Week 8…
Integration of One's Religion and Homosexuality
Internalized homophobia as a psychological phenomenon has attracted little systematic research despite its destructive impact on the mental health of the gay community. This study looks at the relationship between internalized homophobia and the process of integrating one's religious faith and homosexuality by comparing levels of internalized homophobia among male participants of Dignity, an organization of Catholic gay men and lesbians, with a c…
Intimacy and sexual risk behaviour in serodiscordant male couples
Several studies have demonstrated individual-level determinants of HIV sexual risk behaviour. Very little research has been conducted to identify couple-level factors associated with unsafe sexual behaviour. As part of a three-year study of more than 100 serodiscordant male couples, we conducted an in-depth qualitative study of 15 Latino and non-Latino male couples via focus groups and a follow-up telephone survey. We identified the sexual risk b…
Unsafe Sex in the Primary Relationships of Puerto Rican Men Who Have Sex with Men
Response to commentaries
Effects of testosterone replacement therapy on sexual interest, function, and behavior in HIV+ men
This report documents findings from the first 80 patients to enter our ongoing clinical trial of testosterone replacement therapy, designed for HIV+ men with low CD4 cell counts and low levels of serum testosterone, who complain of diminished sexual interest and/or sexual dysfunction. Patients were treated with testosterone for 8 weeks with biweekly intramuscular injections, starting at 200 mg. and increasing at Week 2 to 400 mg. biweekly. Week 8…
Internalized Homophobia in a Sample of HIV+ Gay Men, and Its Relationship to Psychological Distress, Coping, and Illness Progression
The purpose of this study was to determine whether internalized homophobia is related to psychological distress and coping style and whether these relationships are moderated by illness stage. A sample of gay men, most of whom were HIV+, Caucasian, and well educated, were administered assessments at both baseline and 2-year follow-up, which allowed for the assessment of change over time in the context of HIV illness progression and to determine w…
Development of the Impact of Weight Loss Scale (IWLS)
The purpose of this study was to assess the psychometric properties of the newly developed Impact of Weight Loss Scale (IWLS), a subjective measure of perceived weight loss and related behaviour, body image perception, and affect, as well as the scale's relationship to mental health and nutritional measures in an HIV sample. Seventy-five HIV-positive men were administered the IWLS along with measures of depression, quality of life and nutritional…
Reliability of sexual behavior self‐reports in male couples of discordant HIV status
Seventy‐five male couples, where one member was HIV‐positive and his partner was HIV‐negative, were assessed concerning anal sexual‐risk behavior. Subsequently, the reliability of their self‐reports was determined by two methods: (a) by comparing the separate reports of each member of the couple and (b) by a one week test‐retest of 27 individuals. Both quantitative and qualitative assessment methods were used. Approximately half of the men had pr…
Measuring medication adherence
Self-reports overestimate adherence compared to more objective measures such as electronic monitoring. However, self-report is the most feasible method for clinical settings; therefore, it is important to identify the context in which this method can provide an accurate assessment. To address whether self-reports are more accurate when missed doses are reported, we conducted a secondary analysis of data from a methodological study comparing multi…
Resilience and Distress Among Amyotrophic Lateral Sclerosis Patients and Caregivers
OBJECTIVES: The objectives of this study were to assess the prevalence of depressive disorders and symptoms and their correlates in patients with amyotrophic lateral sclerosis (ALS) and caregiver spouses and to identify dimensions of resilience as well as distress. METHODS: Fifty-six patients with ALS and 31 caregivers were interviewed on one occasion, and 20 patients were subsequently reinterviewed during a scheduled medical visit at an ALS cent…
Prevalence of Extradyadic Sex in Male Couples of Mixed HIV Status and Its Relationship to Psychological Distress and Relationship Quality
This study assessed the prevalence of extradyadic sex and the relationship between such activity and psychological distress and relationship quality in male couples of mixed HIV serostatus. Sixty-three couples were interviewed and had sufficient data for inclusion in all analyses. With regard to sexual activity during the year prior to being interviewed, 19 (30%) couples were monogamous, 18 (29%) described themselves as "open," 13 (21%) kept extr…
Correlates of adherence to combination antiretroviral therapy among members of HIV-positive mixed status couples
This exploratory study assessed medication adherence and its correlates in HIV-positive members of HIV mixed status couples. Forty couples were interviewed; the HIV-positive participants consisted of 19 gay men, 14 heterosexual men and seven heterosexual women. Mean self-reported adherence (over the past three days) for the whole sample was 95%; the mean adherence rate for gay men (99%) was significantly higher (p < 0.05) than that of heterosexua…
Levels and correlates of psychological distress in male couples of mixed HIV status
Few studies have analyzed the impact of HIV infection on dyadic functioning and on the distress levels of each partner, independently, in HIV-serodiscordant relationships, particularly in same-sex dyads. The main purpose of this study was to assess levels of psychological distress in the HIV-positive and HIV-negative members of HIV-discordant male couples and to explore possible couple-related factors associated with distress. This was done withi…
Correlates of HIV antiretroviral adherence in persons with serious mental illness
Although several studies have examined the relationship between symptoms of depression or psychological distress and medication adherence, this is the first published study of HIV antiretroviral adherence and its correlates among persons diagnosed with serious mental illness. Forty-five of 47 (96%) participants completed a two-week study in which their adherence to antiretroviral medication was measured using electronic monitoring caps. Mean adhe…
Couple-focused support to improve HIV medication adherence
OBJECTIVE: To assess the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems. DESIGN: A randomized controlled trial (SMART Couples Study) conducted between August 2000 and January 2004. SETTING: Two HIV/AIDS outpatient clinics in New York City. PARTICIPANTS: Heterosexual and homosexual HIV-serodiscordant couples (n = 215) in which the HIV-seropositive partner ha…
Longitudinal Relationships Between Antiretroviral Treatment Adherence and Discrimination Due to HIV-Serostatus, Race, and Sexual Orientation Among African–American Men with HIV
African-Americans show worse HIV disease outcomes compared to Whites. Health disparities may be aggravated by discrimination, which is associated with worse health and maladaptive health behaviors. We examined longitudinal effects of discrimination on antiretroviral treatment adherence among 152 HIV-positive Black men who have sex with men. We measured adherence and discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation at b…
Conspiracy Beliefs About HIV Are Related to Antiretroviral Treatment Nonadherence Among African American Men With HIV
BACKGROUND: Medical mistrust is prevalent among African Americans and may influence health care behaviors such as treatment adherence. We examined whether a specific form of medical mistrust-HIV conspiracy beliefs (eg, HIV is genocide against African Americans)-was associated with antiretroviral treatment nonadherence among African American men with HIV. METHODS: On baseline surveys, 214 African American men with HIV reported their agreement with…
Factors Associated with Condom Use Among HIV Clients in Stable Relationships with Partners at Varying Risk for HIV in Uganda
Longitudinal Association of HIV Conspiracy Beliefs with Sexual Risk Among Black Males Living with HIV
Social Networks of PLHA in Uganda
Improving HIV/Aids care through treatment advocacy
Treatment advocacy (TA) programs have been implemented by AIDS service organizations (ASOs) and primary care clinics across the USA to help engage clients with HIV into care and support their adherence to antiretroviral therapy (ART). TA aims to empower people with HIV through education and client-centered counseling regarding HIV, ART, and other health issues; advocate on behalf of patients with providers; and make referrals to healthcare servic…
A qualitative exploration of the impact of HIV and ART on social disruption and household continuity in Uganda
With increased uptake of antiretroviral therapy (ART) throughout sub-Saharan Africa, it is critical to have a better understanding of the impact of ART on all health dimensions since the treatment can have the expected benefits as well as unintended negative consequences. We conducted semi-structured interviews with 24 adult HIV clients (19 women and 5 men) in Uganda who had been on ART for at least six months. A grounded approach and content ana…
An exploratory study of HIV-prevention advocacy by persons in HIV care in Uganda
To explore how people living with HIV (PLHIV) and in care encourage others to adopt HIV-protective behaviours, we conducted in-depth interviews with a purposive sample of 40 HIV clinic patients in Kampala, Uganda. Content analysis was used to examine the message content, trigger events, and outcomes of HIV-prevention advocacy events initiated by the HIV clients with members of their social networks. The content themes included encouraging specifi…
Factors Associated with Intention to Conceive and its Communication to Providers Among HIV Clients in Uganda
Electronic Medical Records and Same Day Patient Tracing Improves Clinic Efficiency and Adherence to Appointments in a Community Based HIV/Aids Care Program, in Uganda
Medicine (98 works) · HIV/AIDS Research and Interventions (96 works) · Psychology (68 works) · Human immunodeficiency virus (HIV (60 works) · Public health (60 works) · Adolescent Sexual and Reproductive Health (57 works) · Family medicine (57 works) · Psychiatry (54 works) · Health psychology (50 works) · Clinical Psychology (49 works)