This document provides instructions for a multi-part assignment on HIV. It outlines the requirements for Part 4, including writing a 1-page narrative describing statistical analyses conducted, including tables, graphs and SPSS code. It also provides instructions for Paper 1, which involves selecting HIV or another disease as the dependent variable, identifying 1-2 independent variables, and writing a 2-3 page paper with background on the disease, description of variables, research question, and annotated bibliography of 4 sources. Finally, it provides instructions for Paper 2, which involves summarizing related studies, restating the research question, and identifying null and alternative hypotheses and the significance of the topic.

1. DUE 10/28 AT 8P.M EST
Part 4 of 3 parts HIV
1ST 3 PARTS IS ATTACHED WITH DATA (TEMPLATE
INCLUDED)
PART 4 ASSIGNMENT
The Assignment: ( 1 page of narrative plus charts and
SPSS
syntax code)
· Description of the steps you took to conduct your statistical
analyses.
· Summary of your statistical ***
o Narrative description
o Tables and graphs (Be careful – too many tables and graphs
decreases clarity)
o Be sure to include your
SPSS
codebook as well as the syntax code used in SPSS to conduct
your statistical analyses. The page length of your code may vary
according to the types of analyses conducted.
**Please include the following header on this Assignment.**

2. One simple statement for each. This helps you and the instructor
keep track of what you are attempting.
THIS IS INCLUDED IN THE FOLLOWING ATTACHMENT
RQ:
Dependent Variable:
Independent Variable(s):
Null
Hypothesis
:
Alternate
Hypothesis
:
Statistical Test:
Paper 1 Instructions
As a public health professional, you may research many areas of
interest. For example, in studying how economics affects global
health, what variables might you consider? In examining these
variables, you may consider the significance of why this issue is
essential for analysis.
For this Assignment, you will explore the Final Project dataset
provided in the Course Information tab and select one of the
following diseases HIV, You will examine the other
(independent) variable They include demographic variables

3. (i.e., gender, age, race/ethnicity, income, education, insurance,
urban residence, and region), clinical risk factors (i.e., BMI and
cholesterol), and behavioral risk factors (i.e., alcohol and
tobacco consumption, injection drug use, condom use, exercise,
and fruit/vegetable intake). You will then develop a problem
statement (or research question) related to your disease and 1–2
independent variables of your choice. Finally, you will begin to
research this disease in the literature.
The Assignment: (2–3 pages)
· Provide a brief (e.g., 2-paragraph) background summary of the
disease (dependent variable) you have selected from the Final
Project dataset.
· Identify and provide a brief description of the independent and
dependent variables you will consider for your Final Project.
· Run and save the Data Dictionary from the Final Project
SPSS
datafile. Include the output as an appendix to your assignment.
· Identify your “Statement of the Problem” (or research
question). Be sure your statement or question makes mention of
both the independent and dependent variables you are
examining. (This will be important for later assignments when
you complete
statistical analysis
using the Final Project dataset.).
· Provide an Annotated bibliography which is to include:
o Sources: Four recent (less than 3 years old) primary peer-
reviewed research articles related to the disease of your paper.
Beyond the minimum four primary research articles, you may
add additional, high-quality secondary literature (reviews or

4. meta-analyses), and you may use websites if from a scholarly
and relevant source (e.g. CDC, NCHS, etc.). Your sources must
follow APA formatting.
o Annotation: For each research article, include a brief
description of the study aim, the methods used, and the major
findings. For each non research source, provide a concise
description of the relevant key points addressed in the source.
Include in the annotation a brief description of how you plan to
use each source (e.g. provides statistics for the problem, etc.)
RQ:
Is there an association between condom use and HIV?
Dependent Variable:
HIV
Independent Variable(s):
Condoms
Null Hypothesis:
There is no association between condom use and HIV
Alternate Hypothesis:
There is an association between condom use and HIV
Statistical Test:
(To be determined in Week 7)
_____________________________________________________
________________________
Introduction
According to a study carried out in Mozambique, an estimation
of adults between fifteen and forty-nine, 12% were HIV

5. positive. Most studies indicated an increased prevalence of the
infection, and new opportunistic infections occurring among
fifteen to twenty-four-year olds. Nevertheless, as per
Mozambique DHS 1997, the rate of condom use was low among
young adults. These citizens are educated on the use of condoms
in prevention of HIV and its opportunistic infections, thereby
allowing room for informed choices. However, program
officials and policymakers lack access to key population data
for young adults to assist in development of evaluation
strategies and targeted programs according to Dokubo et al.
2014. It is a prerequisite to be informed about HIV and AIDS in
recognition of risky behavior, avoidance and changing it, based
on the model that reduces the risk, though findings related to
the relationship of HIV and condom use have been inconsistent.
There is no association between [condom use] and [HIV] with
prevalent infection because the recall period of prevention
practice was short during the whole study, with a possible
reflection of an increased-reporting use, and reduced exposure
to the infection among the never-users, resulting from engaging
with fewer partners. The Final Project dataset includes a variety
of independent and dependent variables. The present study will
utilize the following variables: [HIV] as the dependent variable
and [condom use] as the independent variable(s). Therefore, this
study will examine whether there is an association between
[condom use] and [HIV].
Annotated Bibliography
Coates, T. J., Kulich, M., Celentano, D. D., Zelaya, C. E.,
Chariyalertsak, S., Chingono, A., ... & Sweat, M. (2014).
Effect of community-based voluntary counselling and testing
on HIV incidence and social and behavioral outcomes (NIMH
Project Accept; HPTN 043): a cluster-randomized trial.
The lancet global health

6. , version 2, number 5, e267-e277.
Condom use is also high among those that knew their HIV
status through testing but it varied among unmarried partners
and couples. The use of protection was high among the
unmarried and males than females. Similarly, condom use was
high among those who utilized testing and counseling services,
but only the unmarried men and women. These differences
could be caused by the factors influencing one’s decision to
utilize the testing and counseling services. According to Sweat
et al., those that obtained the services reported a high risk of
unprotected sex with commercial and non-primary partners, and
an increase in the use of condoms by 66% upon utilization of
the testing and counseling services. In addition, condom use is
less likely associated with the use of these services in
Mozambique due to their inaccessibility and unavailability. In
Africa, sub-Saharan, 90% of those in the reproductive age
would utilize the testing services if they were accessible and
available. With a high prevalence of HIV infection, it is
essential to educate both unmarried and married partners on the
infection and the disease, and the use of condoms to prevent the
spread, since they are all involved in various sexual
relationships, including legal and consensual unions.
Furthermore, most people believe that condom use signals
mistrust and hence the need to sensitize the importance of
protection, including the use of testing and counseling services
to increase self-awareness. The study was used to determine the
effects of voluntary counseling practiced in communities and
HIV testing on its incidence and behavioral and social outcomes
through a trial that is cluster-randomized.
Dokubo, E. K., Shiraishi, R. W., Young, P. W., Neal, J. J.,
Aberle-Grasse, J., Honwana, N., & Mbofana, F. (2014).
Awareness of HIV status, prevention knowledge and condom

7. use among people living with HIV in Mozambique.
Plos one
, version 9, number 9, e106760.
Other studies reported a null hypothesis between sexual
behavior and HIV knowledge. A survey carried out among
Rwandan women indicated only a small portion of most who
were informed about HIV used protection. In Tanzania, those
who knew condom use prevents the spread of HIV had reduced
chances of using protection. In Ethiopia, a study among factory
workers who were HIV pervasive reported an increased sexual
behavior risk and low condom use, though most knew about the
advantages of using condoms to prevent the spread of the
infection. Based on the Kenyan health survey and demographic
data, sexual behavior was risky and very high among women
and men who knew their risk was high and a lack of association
between sexual behavior and HIV spread knowledge. The
various variables that are associated with HIV risk awareness
vary from fear and shame of the disease, number of active
sexual partners, awareness of your partner’s sexual status or
past sexual behaviors, AIDS discussion with family members,
religious affiliation, and the community’s perception of AIDS.
In the sub-Saharan, sociocultural practices and norms,
determine the risk s in sexual behavior. A study among South
African partners indicated that women who knew they were at
risk of the infection used condoms unlike those who lacked
awareness. Students in university in Nigeria and Zimbabwe that
used condoms were more informed about the infection than
those that did not use protection. In Ghana and Cameroon,
youths increased condom use, as they perceived themselves as
vulnerable persons. This study examines correct HIV risk
assessment associated with the use of condoms among youths or
young adults.

8. Friedman, M. R., Stall, R., Plankey, M., Shoptaw, S.,
Herrick, A. L., Surkan, P. J., ... & Silvestre, A. J. (2017).
Stability of Bisexual Behavior and Extent of Viral Bridging
Behavior Among Men Who Have Sex with Men and Women.
Archives of sexual behavior, 46(4), 903-912.
In a recent review study, Joseph and Becker found an
interrelationship between the two among homosexuals and
heterosexuals, but lacked a solid mechanism evidence of this
relationship and concluded that there could be a third factor
linking knowledge to sexual behavior. The aim was to assess
five hypotheses over viral bridging and bisexual behavior
transience. Men who reported to have (n = 111) female and male
sexual partners were grouped as bisexual behaviorally through
the Cohort study of the Multicenter AIDS. This source will be
used to determine the bisexual behavior in males with both
female and male sexual partners.
Katikiro, E., & Njau, B. Global journal of medicine and
public health.
age
, version 4, edition 6. Pp. 7.
The results on the association between HIV/AIDS and condom
use are mixed and not clearly understood. Some authors and
researchers have concluded positive associations, while others
have found no association among various population subgroups.
A set of questions, for example, “how can someone become
infected?”, were used to measure the level of awareness about
AIDS, HIV transmission, and the accuracy of feedback about
the disease. In this study own risk assessment accuracy is
predicted, based on the past and present sexual behavior. Young
men more than women who thought were at low risk were in

9. reality at high or moderate risk of contracting the infection, and
lacked the knowhow of their risk assessment. This difference is
caused by women being unable to apply that knowledge in their
risk assessment upon sexual intercourse and they were reluctant
to report that self-assessment risk than men. Existing literature
indicates mixed results in the relationship between sexual
behavior and risk perception. In this case, behavioral and
demographic variables were used to determine condom use, and
if there is a positive association between condom use and
education, except among higher educated women.
Tyler, K. A., Handema, R., Schmitz, R. M., Phiri, F., Wood,
C., & Olson, K. (2016). Risk factors for HIV among
Zambian street youth.
Journal of HIV/AIDS & social services
,
15
(3), 254-268.
In Zambia on the other hand, Magnani et al. deduced an
association between HIV knowledge with reduced or lack of
sexual experience and increased condom use among men and
boys. Demographic and health survey model used in Kenya,
Zambia, and Uganda indicated that awareness of someone’s HIV
status led to protective sex, most people were knowledgeable of
condom use in HIV prevention, and most had correct beliefs
about AIDS patients. These authors inferred that someone
knowing of another person’s death out of the infection-
increased awareness of the causes and results, which led to an
increase in condom, use, hence safe sex. The source was used to
know the risk factors for HIV among Zambian street youths.
References

10. Coates, T. J., Kulich, M., Celentano, D. D., Zelaya, C. E.,
Chariyalertsak, S., Chingono, A., ... & Sweat, M. (2014). Effect
of community-based voluntary counselling and testing on HIV
incidence and social and behavioural outcomes (NIMH Project
Accept; HPTN 043): a cluster-randomised trial.
The lancet global health
, version 2, number 5, e267-e277.
Dokubo, E. K., Shiraishi, R. W., Young, P. W., Neal, J. J.,
Aberle-Grasse, J., Honwana, N., & Mbofana, F. (2014).
Awareness of HIV status, prevention knowledge and condom
use among people living with HIV in Mozambique.
Plos one
, version 9, number 9, e106760.
Katikiro, E., & Njau, B. Global journal of medicine and public
health.
age
, version 4, edition 6. Pp. 7.
Tyler, K. A., Handema, R., Schmitz, R. M., Phiri, F., Wood, C.,
& Olson, K. (2016). Risk factors for HIV among Zambian street
youth.
Journal of HIV/AIDS & social services
,
15
(3), 254-268.
PAPER 2 Final Project: Literature Review, Hypothesis, and
Significance
INSTRUCTIONS: With your Final Project disease in mind,
consider other related studies in the literature, reflect on how to
develop a
hypothesis
and consider the significance of the issue you are exploring for

11. your Final Project.
The Assignment: (2–3 pages)
· Provide a summary of other studies that
directly relate
to your identified disease. Be sure to refer back to the sources
used for your annotated bibliography in week 4.
· Considering the feedback you received on your week 4
assignment, restate your “Statement of the Problem” (or
research question).
· Identify both your null and alternative/research
hypothesis
.
· Provide a brief description of the significance of why this
issue is important for examination.
Summary of Sources
According to Coates et al. (2014), most people believe that
condom use signals mistrust and hence the need to sensitize the
importance of protection, including the use of testing and
counseling services to increase self-awareness. This study
determined that effects of voluntary counseling practiced in
communities and HIV testing on its incidence and behavioral
and social outcomes through a trial that is cluster-randomized
which puts it directly related the current study. Specifically, the
study found that condom use is less likely associated with the
use of these services in Mozambique due to their inaccessibility
and unavailability. In Africa, sub-Saharan, 90% of those in the
reproductive age would utilize the testing services if they were
accessible and available.

12. Additionally, Dokubo et al. (2014) is another study specifically
important to the current study. The authors found that Rwandan
women indicated only a small portion of most who were
informed about HIV used protection. They also found that in
Tanzania, those who knew condom use prevents the spread of
HIV had reduced chances of using protection. In Ethiopia, a
study among factory workers who were HIV pervasive reported
an increased sexual behavior risk and low condom use, though
most knew about the advantages of using condoms to prevent
the spread of the infection. Based on the Kenyan health survey
and demographic data, sexual behavior was risky and very high
among women and men who knew their risk was high and a lack
of association between sexual behavior and HIV spread
knowledge.
Friedman et al., (2017) investigated the interrelationship
between the two among homosexuals and heterosexuals and
found that it lacked a solid mechanism evidence of this
relationship and concluded that there could be a third factor
linking knowledge to sexual behavior. The source proved
crucial in determining the bisexual behavior in males with both
female and male sexual partners.
Katikiro and Njau (2011) found concluded positive associations
on the association between HIV/AIDS and condom. This
difference is caused by women being unable to apply that
knowledge in their risk assessment upon sexual intercourse and
they were reluctant to report that self-assessment risk than men.
Close to that, Tyler et al. (2016) established that health survey
model used in Kenya, Zambia, and Uganda indicated that
awareness of someone’s HIV status led to protective sex, most
people were knowledgeable of condom use in HIV prevention,
and most had corrected beliefs about AIDS patients.
Statement of the Problem

13. It is a prerequisite to be informed about HIV and AIDS in
recognition of risky behavior, avoidance and changing it, based
on the model that reduces the risk, though findings related to
the relationship of HIV and condom use have been inconsistent.
There is no association between [condom use] and [HIV] with
prevalent infection because the recall period of prevention
practice was short during the whole study, with a possible
reflection of an increased-reporting use, and reduced exposure
to the infection among the never-users, resulting from engaging
with fewer partners. The Final Project dataset includes a variety
of independent and dependent variables. The present study will
utilize the following variables: [HIV] as the dependent variable
and [condom use] as the independent variable(s). Therefore, this
study will examine whether there is an association between
[condom use] and [HIV].
Significance of the Study
The importance of investigating the HIV scourge is ultimately
to help save lives. A lot of studies have been done all over the
world regarding the disease. However, the use of condoms and
the relationship that it has on the disease as a whole has not
received as much attention because most people assume that it
prevents the disease and that is all there is about it. The study
will be important to scholars in that field in providing empirical
results on the use of condoms. It will also be useful for
governments in the world in making policies that are related to
the HIV.
References
Coates, T. J., Kulich, M., Celentano, D. D., Zelaya, C. E.,
Chariyalertsak, S., Chingono, A., ... & Sweat, M. (2014). Effect
of community-based voluntary counselling and testing on HIV
incidence and social and behavioural outcomes (NIMH Project
Accept; HPTN 043): a cluster-randomised trial.

14. The lancet global health
, version 2, number 5, e267-e277.
Dokubo, E. K., Shiraishi, R. W., Young, P. W., Neal, J. J.,
Aberle-Grasse, J., Honwana, N., & Mbofana, F. (2014).
Awareness of HIV status, prevention knowledge and condom
use among people living with HIV in Mozambique.
Plos one
, version 9, number 9, e106760.
Katikiro, E., & Njau, B. Global journal of medicine and public
health.
age
, version 4, edition 6. Pp. 7.
Tyler, K. A., Handema, R., Schmitz, R. M., Phiri, F., Wood, C.,
& Olson, K. (2016). Risk factors for HIV among Zambian street
youth.
Journal of HIV/AIDS & social services
,
15
(3), 254-268.
PAPER 3 Final Project Results
INSTRUCTIONS: For this Assignment, consider the data
gathering method(s) that would be necessary to examine your
statement of the problem (research question) as well as the
statistical analyses required to test your null
hypothesis
. Review this week’s Learning Resources and reflect on the
types of statistical analyses you may use to explore the
variables of interest for your Final Project.
The Assignment (1 page)

15. · Methods
· Brief description of possible study participants*
· Description of the possible data gathering methods*
· Explanation of the types of statistical analyses you will
conduct and why (Be sure to include an explanation of how your
variables of interest helped determine the appropriate analyses.)
*Must relate to the information (variables) you selected in the
Final Project dataset.
RQ:
Is there an association between condom use and HIV?
Dependent Variable:
HIV
Independent Variable(s):
Condoms
Null Hypothesis:
There is no association between condom use and HIV
Alternate Hypothesis:
There is an association between condom use and HIV
Statistical Test:
Mean, Standard Deviation, and Regression - Linear
Methods
Study sample
The population for this study was made up of 280 patients

16. diagnosed with HIV at John Kennedy Hospital between the
years 2015 and 2016. Staging of the disease would be
determined by the following criteria. Firstly, the patient must
have been diagnosed with the illness after 2015 and be above 21
years of age. They must also have been able to lender consent
for the study to be done on them. The patients would be
excluded from the study if they did not meet the minimum age,
and were not in a position to communicate their consent to the
researchers.
A majority of the cases were male (52.5%) with a mean age was
(41.5 ±). The standard deviation was 14 for the ages within the
cohort. Further, the HIV infection spread amongst the cohort
was at 41.8% which means the rest of the cohort had a single
strain of HIV in their blood stream as opposed to many. Further,
it was established that 68.6% of the patients had used condoms
which prevented further infection.
Data collection
The collection of data was through the medical files provided
by the institution. All that was needed was the blood results
showing the number if HIV infections in the blood as well as
the sputum samples. These documents were used to compare
patients who used a condom after being diagnosed and those
that did not. It was hoped that the data would answer the
question as to whether the condom use affected the rate of
further infection in HIV patients (Little & Rubin, 2014).
Statistical analyses
In describing the sample, mean and standard deviation were
used to analyze the age and gender of the cohort. From there,
the use of condoms and HIV infection were analyzed through
regression process to establish if there was significance. The
dependent variable was HIV while the independent was the use

17. of condoms. From the results tabled in the attached output, use
of condom was negatively and significantly related to HIV
infection at significance of .302. This implies that the reduction
of lack of use of the condom led to an increase in HIV or led to
further HIV infections. Therefore, the alternative hypothesis
was proven right (Selvin, 2004).
References
Little, R. J., & Rubin, D. B. (2014).
Statistical analysis with missing data
. John Wiley & Sons.
Selvin, S. (2004).
Statistical analysis of epidemiologic data
. Oxford University Press.