About

Typhanye Vielka Dyer is an associate professor in the Department of Epidemiology at the University of Maryland School of Public Health. She is an epidemiologist and health disparities scholar whose research examines the influence of social, psychological, and behavioral factors on STI and HIV risk in Black populations. Her work focuses on syndemics, which involve intersecting psychosocial and structural barriers, including the impact of trauma, poor mental health, and criminal justice involvement on STI and HIV outcomes among Black sexual and gender minorities, as well as Black women living with HIV in the DC Metro Area. With over 15 years of research experience, her educational background includes a PhD in Public Health with a cognate in Social Epidemiology from UCLA, an MPH in Community Health from California State University Long Beach, and a BA in Neuroscience from UCLA. Her research emphasizes community-engaged approaches and aims to develop best practices at both provider and community levels to improve engagement in HIV care and reduce disparities. She is actively involved in exploring compound stigma, engagement in the HIV care continuum, and health disparities related to infectious diseases, mental health, and substance use among underserved Black populations.

Research topics

• Political Science
• Environmental health
• Medicine
• Demography
• Gerontology

Selected publications

• “Healthcare Doesn’t Care”: A Mixed-Methods Study on Healthcare Stigma and PrEP Use Among Black Sexual Minority Men

  American Journal of Health Promotion · 2025-04-02 · 6 citations

  article

  BackgroundPre-exposure prophylaxis (PrEP) is a critical tool for HIV-prevention, yet PrEP uptake among Black sexual minority men (BSMM) is relatively low, despite greater HIV vulnerability. Stigma in healthcare settings can be a substantial barrier to PrEP use among BSMM, with implications for the HIV epidemic. We used a sequential explanatory mixed-methods approach to assess quantitative relationships between anticipated healthcare stigma and reduced PrEP use among BSMM, and qualitatively explore stigmatizing experiences within healthcare settings among this population.MethodsWe utilized 2 data sources. First, cross-sectional data from a pilot sample of BSMM (n = 151) was collected in late 2020 in the United States. We tested for associations between healthcare stigma and PrEP use using modified Poisson regression. Subsequently, we selected participants (n = 23) from this sample in the D.C. metropolitan area for qualitative interviews starting in 2022; we used thematic analysis to investigate forms of experienced and anticipated healthcare stigma related to PrEP use.ResultsWe found 82% lower PrEP use associated with an interquartile range increase in anticipated healthcare stigma after adjustment (aPR = 0.18, 95% CI 0.06, 0.59). Subsequently, our qualitative investigation revealed that identity-specific stigma, negative socioeconomic assumptions, and assumptions of sexual risk were prevalent themes in the healthcare stigmatization experienced by BSMM. Identity-based and socioeconomic stigma were heavily interlinked due to longstanding structural racism and homophobia. Assumptions of sexual risk were particularly complex.ConclusionWe discovered a significant negative relationship between anticipated healthcare stigma and PrEP use, further elucidated in our qualitative findings. This builds upon our previous work exploring intracommunity PrEP stigma among BSMM. Healthcare stigma serves as an additional obstacle to accessing PrEP for BSMM. This highlights its importance as a target for provider-level health equity policy and research interventions. Future research exploring this stigma in specific healthcare settings is recommended.

  PublisherDOI

• Supplemental Table 2 from Healthy Lifestyle Index and Breast Cancer Risk among Postmenopausal Women: The Multiethnic Cohort Study

  2025-06-03

  preprintOpen access

  <p>Supplemental Table 2 shows adjusted hazard ratios and 95% confidence intervals for the association between the five-component Healthy Lifestyle Index and hormone-receptor-positive and negative invasive breast cancer risk among postmenopausal women overall and by race and ethnicity in the Multiethnic Cohort study</p>

  PublisherOA PDFDOI

• Supplemental Table 4 from Healthy Lifestyle Index and Breast Cancer Risk among Postmenopausal Women: The Multiethnic Cohort Study

  2025-06-03

  preprintOpen access

  <p>Supplemental Table 4 shows adjusted hazard ratios and 95% confidence intervals for the association between the HLI (operationalized using EPIC scoring) and invasive breast cancer risk among postmenopausal women overall and by race and ethnicity in the Multiethnic Cohort study</p>

  PublisherOA PDFDOI

• Assessing a Syndemic of Discrimination, Material Insecurity, Depression, Substance Use, and Violence Among Sexual and Gender Minorities in Nigeria Using Mixed Methods

  AIDS and Behavior · 2025-08-23

  articleOpen access

  Sexual and gender minority people (SGM) in Nigeria experience disproportionate HIV burden, with an HIV prevalence four to ten times higher than the national average. Better understanding the factors that create HIV vulnerability in this population is important for designing effective interventions, particularly in a context largely hostile to SGM. We assessed a conceptual model describing a syndemic of discrimination, material insecurity, depression, substance use, intimate partner violence, and police and other violence among SGM in Abuja, Nigeria. As part of a larger, longitudinal study examining noncommunicable disease outcomes within this population, we conducted a mixed methods analysis using both quantitative intake data (n=515) as well as data from three focus groups (n=36), collected from July 2023 through May 2024. We tested for intercorrelations among syndemic components, and associations between a cumulative syndemic index and HIV status using modified Poisson regression. We also conducted a convergent qualitative assessment of the conceptual model in three focus group discussions. Finally, we examined co-prevalence of syndemic components highlighted in our qualitative findings. There were consistent intercorrelations among syndemic components, supporting the presence of a syndemic. After adjustment for sociodemographic factors, every quartile-unit increase in the syndemic index was associated with an 18% increase in prevalence of HIV (aPR=1.18, 95% CI 1.07, 1.29). Additionally, our qualitative findings highlighted relationships between discrimination, material insecurity, and depression as especially relevant among this population. When using our quantitative data to examine the co-prevalence of pairs of syndemic components identified as particularly salient in our qualitative analyses, nearly every relationship was significantly stronger than expected. We found strong evidence of a syndemic of discrimination, material insecurity, depression, substance use, intimate partner violence, and police and other violence among SGM in Abuja, Nigeria as salient to the health outcomes of SGM in Nigeria. Overall, our findings highlight the presence of a multilevel syndemic that informs multilevel intervention targets. Interventions must target not simply the individual level, but also incorporate larger scale social and structural change efforts.

  PublisherOA PDFDOI

• Supplemental Table 1 from Healthy Lifestyle Index and Breast Cancer Risk among Postmenopausal Women: The Multiethnic Cohort Study

  2025-06-03

  preprintOpen access

  <p>Supplemental Table 1 shows adjusted hazard ratios and 95% confidence intervals for the association between the Healthy Lifestyle Index without sleep and sedentary behavior components and breast cancer risk among postmenopausal women overall and by race and ethnicity in the Multiethnic Cohort study</p>

  PublisherOA PDFDOI

• Data from Healthy Lifestyle Index and Breast Cancer Risk among Postmenopausal Women: The Multiethnic Cohort Study

  2025-06-03

  preprintOpen access

  <div>AbstractBackground:<p>Consistent evidence supports a reduction in breast cancer risk with a high healthy lifestyle index (HLI) score; however, this relationship has not been well studied in multiethnic populations.</p>Methods:<p>Within the multiethnic cohort study, we followed 65,561 African American, Japanese American, Latina, Native Hawaiian, and White postmenopausal women for incident invasive breast cancer (<i>n</i> = 4,555, mean 19.2 years). The HLI summed seven components with higher scores assigned to healthier behaviors: diet quality, physical activity, sedentary behavior, smoking status, alcohol consumption, body mass index, and sleep duration. Multivariable Cox proportional hazards models estimated adjusted HRs (aHR) and 95% confidence intervals (CI) for associations between the HLI score [continuous and tertiles (T)] and breast cancer risk overall, stratified by race and ethnicity and hormone receptor status. Multiplicative interaction by race and ethnicity (<i>P</i>-int) and heterogeneity of effect by hormone receptor status (<i>P-</i>het) were assessed by the Wald test.</p>Results:<p>Higher HLI scores were associated with reduced postmenopausal breast cancer risk [aHR<sub>cont</sub>: 0.95 (95% CI, 0.94–0.97), <i>P</i> < 0.0001; aHR<sub>T2vsT1</sub>: 0.92 (95% CI, 0.85–0.99), aHR<sub>T3vsT1</sub>: 0.81 (95% CI, 0.75–0.87), <i>P</i>-trend < 0.01] with similar risk reductions observed across racial and ethnic groups (<i>P</i>-trend ≤ 0.05; <i>P-</i>int = 0.96). Similar findings were observed with hormone receptor–positive breast cancer (overall: <i>P</i>-trend < 0.01; <i>P</i>-int = 0.90); no significant associations were observed with hormone receptor–negative breast cancer (<i>P-</i>trend > 0.05; <i>P</i>-int = 0.64; <i>P</i>-het = 0.79).</p>Conclusions:<p>Higher HLI scores are associated with breast cancer risk reductions overall by race and ethnicity and hormone receptor status.</p>Impact:<p>Engaging in healthy lifestyle behaviors may reduce breast cancer risk among a multiethnic population of postmenopausal women.</p><p><a href="https://aacrjournals.org/cebp/article-abstract/doi/10.1158/1055-9965.EPI-25-0189" target="_blank"><i>See related In the Spotlight, p. 833</i></a></p></div>

  PublisherDOI

• Estimating the Influence of Incarceration on Subsequent Experience With Violence Among Black Men Who Have Sex With Men in the HPTN061 Study

  UNC Libraries · 2025-06-21

  articleOpen access

  Black men who have sex with men (BMSM) are disproportionately incarcerated in the United States. Incarceration is a barrier to health equity and may be a risk factor for experiences of interpersonal violence. However, the effect of incarceration on experienced violence among BMSM is understudied. We examined associations between recent incarceration on subsequent experiences of race- or sexuality-based violence, intimate partner violence, or community violence. We analyzed data from the HPTN 061 study. Analysis includes data on 1,169 BMSM recruited from 6 U.S. cities who were present at baseline as well as 6- and 12-month follow-up interview. We tested if self-reported incarceration between baseline and 6 months was associated with self-reported outcomes between 6 and 12 months using logistic regression with inverse probability of treatment weighting and multiple imputation methods. Experienced outcomes included violence due to race or sexuality, intimate partner violence and aggression, and community violence (i.e., gang violence, robbery, shooting). Approximately 14% reported incarceration between baseline and 6 months and 90% reported experiencing violence between 6 and 12 months. In adjusted analyses, incarceration was associated with subsequent race- or sexuality-based violence [a<em>OR</em> (adjusted odds ratio) range: 1.25-1.41, 95% CI (confidence interval) range: 1.00-1.74], experiences of physical abuse and aggression from intimate partners (a<em>OR</em>: 2.35; 95% CI: 1.50, 3.70) and community violence (<em>OR</em> 1.82; 95% CI: 1.23, 2.72). Recent incarceration experience increased risk of exposure to future violence in this population. Mixed methods research examining mediating paths between and downstream effects of incarceration and violence on the wellbeing and health of BMSM is needed. We implore researchers to study violence and incarceration among BMSM. Practitione should implement strategies such as trauma-informed interventions, and policies strengthening the social and economic support needs of Black populations.

  PublisherDOI

• Supplemental Table 3 from Healthy Lifestyle Index and Breast Cancer Risk among Postmenopausal Women: The Multiethnic Cohort Study

  2025-06-03

  preprintOpen access

  &lt;p&gt;Supplemental Table 3 shows the adjusted hazard ratios and 95% confidence intervals for the association between individual HLI components and risk of invasive breast cancer overall and by race and ethnicity among postmenopausal women in MEC&lt;/p&gt;

  PublisherOA PDFDOI

• Characterisation of a syndemic of STI symptoms, substance use and violence among incarcerated Peruvian women

  Sexually Transmitted Infections · 2025-03-12

  articleOpen access

  OBJECTIVES: Despite parallel global trends of increasing incarceration rates and sexually transmitted infections (STIs) among women, STI epidemiological data for this vulnerable at-risk population are limited. The study objective was to characterise patterns of STI symptoms and explore covariates and drivers of indicating STI symptoms using syndemic theory among a population of incarcerated women in Peru. METHODS: In a cross-sectional study, a sample of 249 incarcerated women responded to a questionnaire on substance use, depression, sexual behaviour, STI symptoms and violence, among other variables, between May and July 2015 in Santa Manica Prison (Lima, Peru). Univariate and bivariate analyses informed a latent profile analysis (LPA) and logistic regression. RESULTS: Most women (93.5%) were Peruvian; 86.6% had prison sentences <5 years; the median age was 37 years (range 18-70 years); 2.6% were pregnant, 7.2% had children residing with them in prison; most women (78.7%) had a high school degree; >1/3 of the sample had ≥2 STI symptoms. The LPA analysis revealed that 39% of the sample had a 'syndemic' profile (co-occurrence of multiple STI symptoms, experiences of violence and substance use). Approximately 87% of women who were characterised by the syndemic profile were <50 years of age. The 'syndemic' profile was associated with double the prevalence of having multiple STI symptoms (≥2 symptoms: Prevalence Ratio (PR)=1.88 (95% CI 1.18, 2.99); ≥3 symptoms: PR=2.55 (95% CI 1.32, 4.93)). CONCLUSIONS: To address this syndemic, younger incarcerated women presenting with co-occurring STI symptoms (>2) can be clinically screened for diagnosis and treatment and assessed for substance use and risk of violence. Further research in this area may help stem and prevent deleterious health outcomes, including STIs, abuse and substance misuse, that can impact the individual and families.

  PublisherOA PDFDOI

• The associations of incarceration and depression with healthcare experiences and utilization among Black men who have sex with men in HPTN 061

  UNC Libraries · 2025-05-17

  articleOpen accessSenior author

  Associations of incarceration with healthcare access and utilization among Black sexual minority men (BSMM) and differences in association among those with and without pre-incarceration symptoms of depression were measured. Secondary analysis using survey data from the longitudinal cohort HIV Prevention Trials Network 061 study was conducted among 1553 BSMM from six major U.S. cities from 2009 to 2011. We used modified log-binomial regression with robust standard errors to estimate associations of incarceration (reported at 6 month follow-up) on next six-month healthcare utilization and access (reported at the 12 month follow-up). We tested the significance of baseline depressive symptoms by incarceration interaction and reported differences in associations when observed. Participants with a history of incarceration were more likely to have depressive symptoms at baseline compared to those without. Recent incarceration was associated with almost twice the risk of mistrust in healthcare providers and emergency room utilization. Among men reporting depressive symptoms, a history of incarceration was associated with almost tripled risk of reporting providers do not communicate understandably. Among those with depression, one in five reported a missed visit regardless of incarceration status.

  PublisherDOI

Recent grants

• NIH Grant R03DA037131

  NIH · $151k · 2017

Frequent coauthors

• Kenneth H. Mayer

  Fenway Health

  56 shared

• Maria R. Khan

  Nishtar Medical College and Hospital

  38 shared

• Rodman E. Turpin

  38 shared

• Joy D. Scheidell

  30 shared

• Christopher Hucks‐Ortiz

  28 shared

• Leo Wilton

  Binghamton University

  23 shared

• Charles M. Cleland

  New York University

  22 shared

• Russell Brewer

  University of Chicago

  20 shared

Education

• Post Doctoral Researcher, Mental Health

  Johns Hopkins University

  2011

• PhD, Public Health

  University of California Los Angeles

  2009

• MPH, Health and Human Services

  California State University Long Beach

  2002

• BA, Psychology

  University of California Los Angeles

  1994

Awards & honors

• Doris Sands “Excellence in Teaching Award,” 2019