About

Dr. Julie Zuniga is an associate professor at the University of Texas at Austin School of Nursing. Her research interests include the prevention and management of chronic conditions, with a particular focus on diabetes. She has a passion for global health nursing and actively collaborates with colleagues in Kenya and Mexico through her involvement with AMPATH's Nursing Work Group. Dr. Zuniga received her doctorate in nursing from The University of Texas at Austin and completed a post-doctoral fellowship at Emory University in Atlanta, Georgia. Her educational background also includes a Master of Science in Nursing from The University of Texas at Austin and a Bachelor of Arts in History from Austin College. She holds an active RN license in Texas and Kenya. Her contributions to nursing research and global health are recognized through numerous awards, including the Fellow of the American Academy of Nursing, the Latina Legacy Award, and the President’s Award for Global Learning. Dr. Zuniga's work encompasses developing innovative models for treating diabetes in rural Mexican communities and investigating self-management of dual diagnoses such as HIV and diabetes.

Research topics

• Medicine
• Nursing
• Psychology
• Gerontology
• Psychiatry
• Computer Science
• Sociology
• Family medicine
• Clinical psychology
• Political Science
• Intensive care medicine
• Engineering
• Internal medicine
• Medical education
• Pathology
• Physical therapy
• Environmental health
• Management science
• Social psychology
• Virology

Selected publications

• The Effect of Acculturation on Diabetes Knowledge Among Chinese Americans With Type 2 Diabetes

  The Science of Diabetes Self-Management and Care · 2025-03-31 · 1 citations

  article

  PurposeThe purpose of the study was to examine the level of diabetes knowledge among Chinese Americans with type 2 diabetes (T2DM) and the influence of acculturation levels on diabetes knowledge. T2DM is a significant health issue for Chinese Americans because of the unique challenges they face that reflect a complex interplay of culture, language, insufficient numbers of culturally congruent health care providers, and socioeconomic factors. Diabetes knowledge is an essential foundation for effective diabetes self-management behaviors. However, few studies have assessed Chinese Americans' level of diabetes knowledge and its relationship to acculturation.MethodsA secondary analysis of cross-sectional survey data from 110 Chinese Americans with T2DM was conducted. Descriptive analyses summarized specific knowledge deficits, and a hierarchical regression model was used to test the contribution of acculturation to the level of knowledge after controlling for demographics, diabetes duration, treatment, number of comorbidities, and diabetes numeracy.ResultThe average percentage of correct responses on the Diabetes Knowledge Questionnaire-Revised was approximately 77%. Items that were answered incorrectly the most frequently pertained to low or high blood glucose symptoms, desired A1C level, and glucose levels' relation to emotions. Diabetes numeracy and acculturation significantly predicted diabetes knowledge after controlling for demographic and health indicators.ConclusionChinese American patients may have significant gaps in knowledge regarding diabetes and its management that correspond to lower numeracy and acculturation levels. Health care providers should reinforce diabetes education for Chinese American patients who have lower acculturation levels.

  PublisherDOI

• Preferences for longer acting pre-exposure prophylaxis in transgender and gender expansive texans: centering gender affirming hormone therapy

  AIDS Care · 2025-02-17

  articleOpen access1st authorCorresponding

  The prevalence of HIV is higher in the transgender population than in the general population, and pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention strategy for the prevention of HIV. However, the transgender and gender-expansive community faces several challenges to PrEP uptake and adherence. This community-based participatory study was conducted to understand preferences for long-acting PrEP modalities better. Data were collected virtually with an adapted version of the World Café Conversation method and in-depth interviews. A total of 33 transgender and gender-diverse individuals participated in either a World Café conversation or an individual interview about preferences for long-acting PrEP. All qualitative data were transcribed and coded for themes. Two themes emerged: (1) challenges related to long-acting PrEP for transgender and gender-expansive individuals and (2) bundling long-acting PrEP and gender-affirming hormone therapy. To improve access and adherence, HIV prevention needs to be included as part of gender-affirming hormone therapy to align with patients' health priorities.

  PublisherDOI

• Wound burden: A point prevalence study at an academic hospital in Western Kenya

  International Journal of Africa Nursing Sciences · 2025-01-01

  articleOpen access1st authorCorresponding

  Low- and middle-income countries carry a high burden of wounds. In such countries, the prevalence and extent of wound burden are hard to quantify because of systemic barriers associated with limited resources. In this study, we report the prevalence of patients presenting with wounds at a regional hospital in Kenya and describe these patients’ characteristics. A descriptive study of inpatients and outpatients presenting wounds was conducted in Kenya’s teaching and referral hospital. Data on patient characteristics, wound and wound care characteristics, and social determinants of health were collected. The data comprise point-in-time information for wound prevalence and wound types. Participants ( N = 122) were primarily inpatients (68.9 %); 55 % were male. Traumatic chronic wounds were the most prevalent (35.2 %), followed by burn injuries (18.8 %), diabetic foot ulcers (12.3 %), and pressure injuries (9.8 %). Many of the patients (77.9 %) worried at some point that food for their family would run out before they could obtain enough money to buy more, and 75 % reduced their meal portions because they lacked funds to buy sufficient food; almost half (44.1 %) had felt hungry but did not eat due to lack of money to purchase sufficient food for their families. Patients had extensive and multiple wounds, with a history of wounds that were slow-healing, and a large majority suffered from food insecurity. Without addressing social determinants of health, the burden of wound care will remain high in this region.

  PublisherDOI

• Oral Health Knowledge, Risk of Periodontitis, and Diabetes Management Self-Efficacy Among People With Type 2 Diabetes

  The Science of Diabetes Self-Management and Care · 2025-12-18

  article

  PurposeThe purpose of the study was to examine the association between the level of oral health knowledge (OHK), the risk of periodontitis, and diabetes management self-efficacy (DMSE) among individuals with type 2 diabetes (T2DM).MethodsA cross-sectional survey of 93 adults with T2DM in central Texas was used to examine OHK levels with descriptive analyses; 5 hierarchical regression analyses were conducted to explore the impact of OHK and periodontitis risk on DMSE.ResultsParticipants' mean age was 59.60 ± 12.76 years, 54.8% were female, and 54.8% were White. Their average duration of having diabetes was 12.17 ± 11.27 years, and 77.4% took oral medications. Their average A1C was 6.75 ± 1.56; nearly half (47.3%) had more than 1 comorbidity. The risk of periodontitis was high, and the level of OHK was low. On average, 65% of the OHK questions were answered correctly; the 2 questions with the lowest rates of being answered correctly were related to dry mouth risks. Forty-two percent of participants were at risk of periodontitis. Hierarchical regression analyses showed that only the risk of periodontitis significantly predicted DMSE in managing diet, DMSE in managing exercise and weight, and overall DMSE after controlling for age, gender, number of comorbidities, duration of diabetes, and treatment types.ConclusionsHealth care providers should proactively assess OHK and periodontitis risk, especially when patients indicate low efficacy concerning diet and body weight management.

  PublisherDOI

• Burmese Refugees’ Beliefs and Experiences of Diabetes Self-management in Texas

  Advances in Nursing Science · 2025-02-27

  article
  PublisherDOI

• Influence of caregiver knowledge of home asthma management on health outcomes of children in low- and middle-income countries: A systematic review

  Journal of Pediatric Nursing · 2025-06-13 · 2 citations

  review
  PublisherDOI

• Pressure ulcer prevention and treatment interventions in Sub-Saharan Africa: A systematic review

  Nursing Outlook · 2024-03-14 · 8 citations

  reviewOpen access1st authorCorresponding

  BACKGROUND: The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies. PURPOSE: Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA. METHODS: This systematic review of the literature used, PRISMA to guide the search. FINDINGS: The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces. DISCUSSION: There were gaps in the interventions that have been proven successful in other global settings. CONCLUSION: In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.

  PublisherOA PDFDOI

• Symptom phenotyping in people with cystic fibrosis during acute pulmonary exacerbations using machine-learning K-means clustering analysis

  Journal of Cystic Fibrosis · 2024-06-12 · 3 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Sexual Activity as Self-Injury: A Scoping Review

  The Journal of Sex Research · 2024-02-28 · 4 citations

  review

  Suicide and other self-injurious behaviors (SIB) are significant causes of morbidity and mortality as well as healthcare costs. Sexual risk behaviors are associated with many SIB, and sexual activities may act as SIB as well. In this scoping review, we consider ways in which sexual activity has been conceptualized as SIB - types of sexual activities as a form of self-injury - and cases in which sexual activities as SIB have been classified as direct or indirect self-injury. We include English-language publications that discuss any aspect of sexual activity as SIB. Database, citation list, and gray literature searches yielded 33 publications. Sexual activities as a form of self-injury included exposure to HIV/AIDS and other sexually transmitted infections, sadomasochistic behaviors undertaken for punishment rather than pleasure, selling sex, injury to the genitals, and sexual encounters with undesired partners or consisting of undesired acts. Twenty-three publications did not categorize sexual activities to self-injure as either direct or indirect self-injury, three publications categorized them as indirect self-injury, and seven publications as direct self-injury. Sexual activity is used to self-injure in a variety of ways and its conceptualization as indirect or direct self-injury remains unclear.

  PublisherDOI

• Intention to Use Different Formulations of Longer Acting HIV Pre-Exposure Prophylaxis Among Transgender and Gender Expansive Individuals: The Roles of Social Vulnerability and Medical Mistrust

  AIDS Patient Care and STDs · 2024-02-01 · 6 citations

  article

  In 2012, the Federal Drug Administration approved daily oral pre-exposure prophylaxis (PrEP) for HIV prevention in adults. Longer acting injectable PrEP (LA PrEP) has been approved and other formulations are in development. A successful LA PrEP rollout requires examining potential facilitators and barriers to PrEP uptake. Given that transgender and gender expansive (TGE) individuals experience more social vulnerability and higher levels of medical mistrust compared to other populations, examining the role of these two factors in LA PrEP uptake is important. This study, PrEP for ALL , is a community-based participatory research project in Texas that engaged TGE community members and organizational partners through a community advisory board. In total, 482 TGE individuals were recruited and responded to all relevant questions in an online survey, including their intentions to use three formulations: a monthly oral pill, a bimonthly intramuscular injection, and an annual subdermal implant. Multiple regression analysis was used to examine the influence of social vulnerability and medical mistrust on intention to use each LA PrEP formulation adjusting for other relevant factors. Findings suggest that individuals with higher levels of social vulnerability had greater intentions to use the monthly oral pill ( β = 0.12, p = 0.009), the bimonthly intramuscular injection ( β = 0.18, p < 0.001), and annual subdermal implant ( β = 0.17, p < 0.001), whereas medical mistrust reduced intentions to use the bimonthly intramuscular injection ( β = −0.18, p < 0.001) and annual subdermal implant ( β = −0.11, p = 0.021). Improvements in gender-affirming clinical care are needed along with LA PrEP formulations that allow for greater autonomy and reduced clinical contact. Clinical Trial Registration number: NCT05044286.

  PublisherDOI

Recent grants

• Investigating Self-Management of the Dual Diagnosis of HIV and Diabetes

  NIH · $453k · 2018–2021

Frequent coauthors

• Alexandra A. García

  The University of Texas at Austin

  49 shared

• Heather Cuevas

  The University of Texas at Austin

  15 shared

• Davika Reid

  The University of Texas at Austin

  13 shared

• Dinah Chelagat

  Moi University

  12 shared

• Ya‐Ching Huang

  12 shared

• Jungmin Park

  National Institute of Environmental Research

  12 shared

• Chelsi West Ohueri

  11 shared

• Lorraine O. Walker

  The University of Texas at Austin

  10 shared

Awards & honors

• Latina Legacy Award, Greater Austin Hispanic Chamber of Comm…
• Orange Jacket Tenet Award in Service, 2024
• President’s Award for Global Learning, 2023
• Fellow of the American Academy of Nursing, 2019
• Ed and Molly Smith Centennial Fellow of Nursing, The Univers…