Brian W Pence
Biographic Data
| ID | 1736874 |
|---|---|
| NAME | Brian W Pence |
| GIVEN NAMES | Brian W |
| FAMILY NAME | Pence |
| SIGNATURE | PENCE B W |
| AFFILIATIONS | University of North Carolina at Chapel Hill |
| ORCID | 0000-0001-7321-9538 |
| VERIFIED | Yes |
| TOTAL WORKS | 93 |
| TOTAL CITATIONS | 11 |
| AUTHOR COUNT | 93 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2000 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
Beyond Overdose
BACKGROUND: With increasing polydrug overdose deaths, public health messaging has centered around overdose prevention. However, it is important to contextualize overdose risk through the lived experience of people who use drugs (PWUD) and challenge the assumption that overdose is their primary salient risk. PWUD navigate multiple competing risk priorities daily and will adjust their behaviors in response to risks they prioritize. OBJECTIVES: Cond…
The role of medical mistrust in racial and ethnic inequities in postpartum mental health care
Among a sample of people with postpartum depressive symptoms, we examine the relationship between medical mistrust and receipt of a perinatal mood and anxiety disorder (PMAD) diagnosis and postpartum mental health care by race and ethnicity. Data are from the 2020 Postpartum Assessment of Health Survey administered at 12-14 mo. postpartum across 7 US jurisdictions. The analytical sample included 454 respondents with a positive screen on the Patie…
County-level social determinants of health and suicide mortality trends among formerly incarcerated persons in North Carolina, 2010–2018
BACKGROUND: Suicide mortality represents a growing public health crisis in the United States, disproportionately affecting people with recent incarceration histories. The purpose of this study was to assess how county-level Social Determinants of Health—including educational attainment, unemployment, poverty, aging, racial composition, and rurality—are associated with suicide mortality among formerly incarcerated individuals in North Carolina in …
HIV care indicators during the Covid-19 pandemic in relation to pre-pandemic care patterns among people with HIV in North Carolina
The COVID-19 pandemic abruptly altered the way HIV care was accessed and delivered. We sought to assess HIV care indicators during the COVID-19 pandemic in relation to pre-pandemic HIV care patterns in North Carolina. Using statewide HIV surveillance data and group-based trajectory models, we identified pre-pandemic HIV care trajectories in two partially overlapping populations: (1) newly HIV-diagnosed from March 2014 through February 2018, follo…
Providers’ Experiences in Implementation of Friendship Bench
Early life grandmother caregiving trajectories and child development
Grandmothers are influential caregivers for young children, yet their contributions to child development remains understudied. This study characterized trajectories of grandmother caregiving from infancy to 2 years and examined their associations with child development. Data came from a longitudinal birth cohort study in rural Pakistan ( n = 959). Grandmother caregiving behaviors were maternally reported at 3 months, 1 year, and 2 years postpartu…
‘You feel like it’s better to just die’
Suicide is the second leading cause of death for adolescents worldwide. Adolescents living with HIV (ALWH) in Malawi are particularly at risk, due to stigmatization and a high comorbid prevalence of depression. Internalized stigma is an indicator of depression and suicidality, yet we have a limited understanding of the drivers and impacts of internalized stigma. In this analysis, we assessed how death-centric stereotypes and experienced stigma co…
We Need Gentleness”
An Adapted Friendship Bench Counseling Intervention (FB) to Improve Mental Health and HIV Care Engagement Outcomes Among People Living with HIV (PWH) Who Inject Drugs in Hanoi, Vietnam
Homicide Mortality in Formerly Incarcerated People Compared to the General Population in North Carolina, 2000 to 2020
HIV Care Linkage and Initial Viral Suppression Among Persons Newly Diagnosed With HIV in North Carolina Before and After the Start of the Covid-19 Pandemic
Objectives. To examine changes to HIV care outcomes during the COVID-19 pandemic. Methods. We used North Carolina HIV surveillance data between 2018 and 2022 to calculate cumulative incidence differences (CIDs) and subdistribution hazard ratios (sdHRs) for (1) 30-day initial HIV care linkage, (2) 150-day stable linkage, and (3) 180-day viral suppression, comparing persons diagnosed with HIV during (starting March 1, 2020) versus before the pandem…
Association of experienced stigma in healthcare settings with health outcomes among Black women living with HIV
Does biological age mediate the relationship between childhood adversity and depression? Insights from the Detroit Neighborhood Health Study
Mass probation
High community incarceration rates are associated with worse community mental health. However, it remains unknown whether higher rates of probation, a form of criminal legal community supervision, are similarly associated with worse community mental health. Our objective was to evaluate temporal and geographic correlations of county-level probation and mental health rates separately and to assess the association between county-level probation and…
Champion and audit and feedback strategy fidelity and their relationship to depression intervention fidelity
Background: Globally, mental health disorders rank as the greatest cause of disability. Low and middle-income countries (LMICs) hold a disproportionate share of the mental health burden, especially as it pertains to depression. Depression is highly prevalent among those with non-communicable diseases (NCDs), creating a barrier to successful treatment. While some treatments have proven efficacy in LMIC settings, wide dissemination is challenged by…
Evaluating the validity of depression-related stigma measurement among diabetes and hypertension patients receiving depression care in Malawi
Mental illness stigma research is sparse in Malawi. Our team previously analyzed the reliability and statistical validity of a quantitative tool to measure depression-related stigma among participants with depressive symptoms using quantitative psychometric methods. This analysis aims to further evaluate the content validity of the stigma tool by comparing participants’ quantitative responses with qualitative data. The SHARP project conducted dep…
Alcohol use as a mediator of the effect of two alcohol reduction interventions on mental health symptoms of ART clients in Vietnam
We aimed to examine the mediating role of alcohol use in the pathway from the interventions to depression and anxiety symptoms using data from a randomized controlled trial among people living with HIV (PWH) with hazardous alcohol use (n = 440) in Thai Nguyen, Vietnam. Participants were randomized into either a combined intervention (CoI), a brief intervention (BI) and a standard of care arm. Both interventions were based on cognitive behavioral …
The acceptability of antidepressant treatment in people living with HIV in Malawi
Depression is common among people living with HIV (PLWH). Measurement-based care models that measure depression severity and antidepressant side effects, and use an algorithm to guide antidepressant prescription by non-specialized health workers represent an evidence-based treatment for severe depression in sub-Saharan Africa. We conducted in-depth interviews from June to December 2018 with eleven patients enrolled in Project SOAR-Mental Health, …
Understanding the effects of universal test and treat on longitudinal HIV care outcomes among South African youth
Implementation of UTT yielded modest improvements in time spent on ART and virally suppressed among South African YLHIV- however, meeting UNAIDS' 95-95-95 targets remains a challenge. Retention in care and re-engagement interventions that can be implemented between diagnosis and linkage to care and between ART initiation and viral suppression (e.g., longitudinal counseling) may be particularly important to improving care outcomes among South Afri…
Preferences for enhanced treatment options to address HIV care engagement among women living with HIV and perinatal depression in Malawi
This study highlights the importance of peer encouragement to support perinatal HIV care engagement among women with HIV and PND. The results from this study can be used to support intervention development to increase HIV care engagement and improve long-term HIV outcomes in women with PND
Depression and Anxiety Symptoms and Treatment Utilization, and Associated HIV Outcomes among Adults with HIV in Rural Florida
An Intervention to Improve Mental Health and HIV Care Engagement Among Perinatal Women in Malawi
Coping Strategies and Symptoms of Mental Health Disorders Among People with HIV Initiating HIV Care in Cameroon
Little is known about the coping strategies used among people with HIV (PWH), especially in sub-Saharan Africa, and the extent to which adaptive or maladaptive coping strategies are associated with symptoms of mental health disorders. We interviewed 426 PWH initiating HIV care in Cameroon and reported the prevalence of adaptive and maladaptive coping strategies, overall and by presence of symptoms of depression, anxiety, and PTSD. Log binominal r…
Trajectories of fertility intentions among women living with HIV in South Africa
Fertility intentions are thought to be dynamic among women of reproductive age, yet few studies have assessed fertility intentions over time among women with HIV. We examine temporal patterns of fertility intentions in women with HIV to assess the extent to which fertility intentions - and the corresponding need for safer conception and judicious antiretroviral therapy (ART) regimen selection - vary over time. 850 non-pregnant HIV-positive women …
The relationship between social support and experienced and internalized HIV-related stigma among people living with HIV in the Deep South
Accuracy of Standard Measures of Family Planning Service Quality
In the field of international family planning, quality of care as a reproductive right is widely endorsed, yet we lack validated data‐collection instruments that can accurately assess quality in terms of its public health importance. This study, conducted within 19 public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data‐collection instruments used in large‐scale facility surveys…
Association of experienced stigma in healthcare settings with health outcomes among Black women living with HIV
Does biological age mediate the relationship between childhood adversity and depression? Insights from the Detroit Neighborhood Health Study
Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania
The Household Registration System
Although longitudinal experimental community health research is crucial to testing hypotheses about the demographic impact of health technologies, longitudinal demographic research field stations are rare, owing to the complexity and high cost of devel
The Household Registration System
Although longitudinal experimental community health research is crucial to testing hypotheses about the demographic impact of health technologies, longitudinal demographic research field stations are rare, owing to the complexity and high cost of devel
Prevalence of DSM-IV-Defined Mood, Anxiety, and Substance Use Disorders in an HIV Clinic in the Southeastern United States
BACKGROUND: Mood and anxiety disorders, particularly depression, and substance abuse (SA) commonly co-occur with HIV infection. Appropriate policy and program planning require accurate prevalence estimates. Yet most estimates are based on screening instruments, which are likely to overstate true prevalence. SETTING: Large academic medical center in Southeast. PARTICIPANTS: A total of 1,125 patients, representing 80% of HIV-positive patients seen …
Does distance affect utilization of substance abuse and mental health services in the presence of transportation services
Long travel times have been identified as a significant barrier to accessing mental health and other critical services. This study examines whether distance to treatment was a barrier to receiving outpatient mental health and substance abuse care for HIV-positive persons when transportation was provided. Data from a cohort of HIV-positive persons who participated in a year-long substance abuse and mental health treatment programme were examined l…
Improving health outcomes among individuals with HIV, mental illness, and substance use disorders in the Southeast
Providing behavioral treatment for mental health and substance use disorders among HIV-infected individuals is critical because these disorders have been associated with negative outcomes such as poorer medication adherence. This study examines the effectiveness of an integrated treatment model for HIV-infected individuals who have both substance use and mental disorders. Study participants (n = 141) were recruited through routine mental health a…
The Effect of Women’s Status on Infant and Child Mortality in Four Rural Areas of Bangladesh
In South Asia women are often the primary decision-makers regarding child health care, family health and nutrition. This paper examines the proposition that constraints on women’s status adversely affect the survival of their children. Survey data are used to construct indices of women’s household autonomy and authority, which are then linked to longitudinal data on survival of their children. Proportional hazard models indicate that enhanced aut…
Childhood abuse and initial presentation for HIV care
An alarmingly high prevalence of childhood sexual and physical abuse has been observed in HIV-infected men and women, with rates several times higher than observed in the general population. Childhood abuse history has been associated with worse antiretroviral adherence and negative health behaviours in HIV-infected patients. This study evaluates the relationship between childhood abuse and the timing of presentation for HIV care. Participants in…
Reif Et Al. Respond
Doherty et al. highlight several important social dynamics that likely contribute to the disproportionate HIV incidence rates in the southern United States. Although we touched on most of the areas Doherty et al. mention, including racial disparities in health care and economic conditions, intriguing new information regarding determinants of HIV infection in the South has emerged since our original submission.1–5 We welcome the increased attentio…
Measuring fatigue in people living with HIV/Aids
In the era of life-prolonging antiretroviral therapy, chronic fatigue is one of the most prevalent and disabling symptoms of people living with HIV/AIDS, yet its measurement remains challenging. No instruments have been developed specifically to describe HIV-related fatigue. We assessed the reliability and construct validity of the HIV-Related Fatigue Scale (HRFS), a 56-item self-report instrument developed through formative qualitative research …
Trauma, stressful life events and depression predict HIV-related fatigue
Despite the fact that fatigue is a common and debilitating symptom among HIV-infected persons, we know little about the predictors of fatigue in this population. The goal of this cross-sectional study was to examine the effects of early childhood trauma, recent stressful life events and depression on intensity and impairment of fatigue in HIV, over and above demographic factors and clinical characteristics. We studied 128 HIV-infected men and wom…
Prevalence and Comorbidity of Psychiatric Diagnoses Based on Reference Standard in an HIV+ Patient Population
OBJECTIVE: To study the prevalence of psychiatric comorbidity based on reference standard diagnostic criteria in patients with human immunodeficiency virus (HIV). Psychiatric illness is common in patients with HIV and has been associated with negative health behaviors and poorer clinical outcomes. Among those persons with psychiatric illness, psychiatric comorbidity (multiple simultaneous diagnoses) is associated with increased psychiatric severi…
A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6–12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations
BACKGROUND: Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6-12 is associated with worse heal…
Overload
OBJECTIVE: To examine the influence of incident stressful experiences on antiretroviral medication adherence and treatment outcomes. Past trauma history predicts poorer medication adherence and health outcomes. Human immunodeficiency virus (HIV)-infected individuals experience frequently traumatic and stressful events, such as sexual and physical assault, housing instability, and major financial, employment, and legal difficulties. METHODS: We me…
Mental Health Treatment to Reduce HIV Transmission Risk Behavior
Incident Stressful and Traumatic Life Events and Human Immunodeficiency Virus Sexual Transmission Risk Behaviors in a Longitudinal, Multisite Cohort Study
Objective: To assess the association between incident stressful life events (e.g., sexual and physical assault; housing instability; and major financial, employment, and legal difficulties) and unprotected anal or vaginal sexual intercourse (unprotected sex) among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (PLWHA). Methods: We assessed incident stressful events and unprotected sex over 27 months in 61…
Prevalence and predictors of HIV-related stigma among institutional- and community-based caregivers of orphans and vulnerable children living in five less-wealthy countries
The caregiver-child relationship is central to a child's development. OAC already face stigma as a result of their orphaned or abandoned status; the addition of HIV-related stigma represents a double burden for these children. Further research on the prevalence of HIV-related acceptance and stigma among caregivers and implications of such stigma for child development will be critical as the policy community responds to the global HIV/AIDS orphan …
Physiological and Psychosocial Factors that Predict HIV-Related Fatigue
Child work and labour among orphaned and abandoned children in five low and middle income countries
BACKGROUND: The care and protection of the estimated 143,000,000 orphaned and abandoned children (OAC) worldwide is of great importance to global policy makers and child service providers in low and middle income countries (LMICs), yet little is known about rates of child labour among OAC, what child and caregiver characteristics predict child engagement in work and labour, or when such work infers with schooling. This study examines rates and co…
Highly stressed
A history of traumatic and/or stressful experiences is prevalent among HIV-infected individuals and has been consistently associated with poorer health outcomes. However, little is known about incident stressful experiences and the factors that predict these experiences among HIV-infected individuals. Data from a longitudinal study of 611 HIV-infected individuals in the Southeastern USA were used to examine the frequency and types of incident str…
Relationship between trauma and high-risk behavior among HIV-positive men who do not have sex with men (MDSM)
The incidence of heterosexual HIV transmission continues to increase in the USA. However, little is known about factors that influence high-risk behavior among men who do not have sex with men (MDSM). This study examines the association of childhood sexual abuse and high-risk behaviors among MDSM. The Coping with HIV/AIDS in the Southeast (CHASE) study included 611 HIV-positive individuals in the Southeastern US Bivariate statistics were used to …
Validity of the patient health questionnaire-9 to screen for depression in a high-HIV burden primary healthcare clinic in Johannesburg, South Africa
HIV/Aids in the Southern USA
This research synthesis examined HIV/AIDS surveillance and health care financing data and reviewed relevant research literature to describe HIV epidemiology, outcomes, funding, and contributing factors to the HIV epidemic in the Southern USA with particular focus on a group of Southern states with similar demographic and disease characteristics and comparable HIV epidemics (Alabama, Georgia, Florida, Los Angeles, Mississippi, North Carolina, Sout…
Low rates of child testing for HIV persist in a high-risk area of East Africa
Children in low- and middle-income countries (LMIC) are the least touched by recent successes in the diagnosis and treatment of HIV/AIDS globally. Early treatment is essential for a child's longer and higher quality of life; however, by 2011, only a small proportion of HIV-seropositive children in LMIC countries were receiving treatment, in part because of persisting low rates of diagnosis. This study of the prevalence and characteristics of chil…
Feasibility, Safety, Acceptability, and Preliminary Efficacy of Measurement-Based Care Depression Treatment for HIV Patients in Bamenda, Cameroon
Accuracy of Standard Measures of Family Planning Service Quality
In the field of international family planning, quality of care as a reproductive right is widely endorsed, yet we lack validated data‐collection instruments that can accurately assess quality in terms of its public health importance. This study, conducted within 19 public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data‐collection instruments used in large‐scale facility surveys…
Improvements in depression and changes in quality of life among HIV-infected adults
Improving quality of life (QOL) for HIV-infected individuals is an important objective of HIV care, given the considerable physical and emotional burden associated with living with HIV. Although worse QOL has been associated with depression, no research has quantified the potential of improvement in depression to prospectively improve QOL among HIV-infected adults. We analyzed data from 115 HIV-infected adults with depression enrolled in a random…
Medicine (84 works) · HIV/AIDS Research and Interventions (69 works) · Psychiatry (56 works) · Public health (41 works) · HIV, Drug Use, Sexual Risk (39 works) · Psychology (38 works) · Family medicine (35 works) · Environmental health (31 works) · Mental health (31 works) · Adolescent Sexual and Reproductive Health (29 works)