A5067477632- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- HIV/AIDS Impact and Responses
- Adolescent and Pediatric Healthcare
- HIV/AIDS drug development and treatment
- Menstrual Health and Disorders
- Global Maternal and Child Health
- Maternal Mental Health During Pregnancy and Postpartum
- Poverty, Education, and Child Welfare
- Sex work and related issues
- Vaccine Coverage and Hesitancy
- HIV/AIDS oral health manifestations
- Ethics in Clinical Research
- Reproductive Health and Contraception
- Viral gastroenteritis research and epidemiology
- Qualitative Research Methods and Ethics
- Healthcare Systems and Reforms
- Open Source Software Innovations
- Healthcare Policy and Management
- Behavioral Health and Interventions
- Child Nutrition and Water Access
- Global Educational Reforms and Inequalities
- Innovative Approaches in Technology and Social Development
Zambart
2017-2025
Zero to Three
2022
University of Zambia
2018-2021
Imperial College London
2019
Johns Hopkins University
2019
National Institute for Health Research
2019
Uganda Virus Research Institute
2014
Joint Clinical Research Centre
2013
Medical Research Council
2012
A universal testing and treatment strategy is a potential approach to reduce the incidence of human immunodeficiency virus (HIV) infection, yet previous trial results are inconsistent.
The HPTN 071 (PopART) cluster-randomised trial provided door-to-door HIV testing services to a large proportion of individuals residing in 21 intervention communities Zambia and South Africa from 2014 2017 reached the UNAIDS first 90 target among women Zambia, yet gaps remained men young adults. This study nested sought increase knowledge status across all groups by offering choice oral self-testing addition routine services.
To achieve UNAIDS 90:90:90 targets at population-level, knowledge of HIV status must be followed by timely linkage to care, initiation and maintenance antiretroviral therapy (ART) for all people living with (PLHIV). Interpreting quantitative patterns using qualitative data, we investigate time taken link care initiate ART amongst individuals aware their HIV-status in high HIV-prevalence urban communities the HPTN 071 (PopART) study, a community-randomised trial combination prevention...
Background The growing population of adolescents and young people (AYP) aged 15 to 24 in sub-Saharan Africa face a high burden HIV many settings. Unintended pregnancies among adolescent girls the region remain high. Nonetheless, sexual reproductive health (SRH) service needs AYP have remained underserved. We conducted cluster-randomised trial (CRT) estimate impact community-based, peer-led SRH provision on knowledge status other outcomes, including met need for contraceptives. Methods...
Menstrual cups could be a sustainable menstrual material for adolescent girls and young women (AGYW) in sub-Saharan Africa. Yathu was cluster-randomized trial of community-based delivery HIV sexual reproductive health services to people Lusaka, Zambia. Among available through the intervention were products, including cups. We explored knowledge menstruation acceptability, experiences using among AGYW aged 15–24. share lessons learned on how distribute strategies urban communities. Through...
HPTN071(PopART) is a 3-arm community-randomised study in 21 peri-urban/urban communities Zambia and the Western Cape of South Africa, with high HIV prevalence mobility especially among young adults. In Arm A communities, from November 2013 community care providers (CHiPs) have delivered "PopART" universal-test-and-treat (UTT) package annual rounds, during which they visit all households offer testing. CHiPs refer HIV-positive (HIV+) individuals to routine clinic services, where universal ART...
Abstract Background Door-to-door distribution of HIV self-testing kits (HIVST) has the potential to increase uptake testing services (HTS). However, very few studies have explored social response and implications door-to-door including secondary HIVST on household relations ability individuals self-test with or without supervision within households. Methods A CRT was nested HPTN 071 (PopART) trial, in four Zambian communities randomised receive PopART intervention. The trial aimed knowledge...
In a randomized comparison of nevirapine or abacavir with zidovudine plus lamivudine, routine viral load monitoring was not performed, yet 27% individuals failure at week 48 experienced resuppression by 96 without switching. This supports World Health Organization recommendations that suspected should trigger adherence counseling and repeat measurement before treatment switch is considered.
Objective: To determine the uptake of home-based HIV counselling and testing (HCT) in four HPTN 071 (PopART) trial communities (implementing a ‘full’ combination prevention package that includes universal treatment) Zambia. We also explore factors associated with HCT these communities. Design: is three-arm community-randomized 12 Zambia nine South Africa evaluating impact package, including treatment, on incidence. Methods: Using door-to-door approach systematically revisiting households,...
BackgroundThe HPTN 071 (PopART) trial showed that a combination HIV prevention package including universal testing and treatment (UTT) reduced population-level incidence of compared with standard care. However, evidence is scarce on the costs cost-effectiveness such an intervention.MethodsUsing individual-based model, we simulated PopART intervention care antiretroviral therapy (ART) provided according to national guidelines for 21 communities in Zambia South Africa (for all individuals aged...
Meeting the sexual and reproductive health (SRH) needs of adolescents young people (AYP) requires their meaningful engagement in intervention design. We describe an iterative process engaging AYP to finalise design a community-based, peer-led incentivised SRH for aged 15-24 Lusaka lessons learnt.Between November 2018 March 2019, 18 focus group discussions, eight in-depth interviews six observations were conducted assess AYP's knowledge HIV/SRH services, factors influencing behaviour elicit...
Background In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) set 90-90-90 targets: that 90% of people living with HIV know their status, those who HIV-positive status are antiretroviral therapy (ART), and treatment virally suppressed. The aim was to reach these targets by 2020. We assessed feasibility achieving first two targets, corresponding 81% ART coverage target, as part Prevention Trials Network (HPTN) 071 Population Effects Antiretroviral Therapy Reduce Transmission...
HPTN 071 (PopART) was a community-randomized trial of universal testing-and-treatment intervention on HIV incidence at population level in Zambia and South Africa. In Zambia, community-based distribution self-testing (HIVST) kits, including secondary distribution, as an option for HIV-testing nested within 4 PopART communities. We used data from the arm to measure levels factors associated with acceptance use HIVST kits.
Across Sub-Saharan Africa, adolescents and young people (AYP) aged 15-24 have limited access to sexual reproductive health (SRH) services, including HIV testing services (HTS). In response, the Yathu study was implemented in two high-density communities Lusaka, Zambia. provides comprehensive, community-based, peer-led SRH differentiated HTS (finger-prick self-testing) comprehensive sexuality education (CSE). We describe adaptations intervention response COVID-19 epidemic, implications on...
Abstract Background The Yathu (“For Us, By Us”) cluster-randomized trial (CRT) evaluated a peer-led community-based sexual and reproductive health(SRH) intervention implemented to address persistent barriers SRH service use among adolescents young people (AYP). We report the impact of on coverage key services AYP. Methods was conducted from Jul 2019-Oct 2021 in two urban communities Lusaka, Zambia, divided into 20 zones (~ 2350 AYP/zone). Zones were randomly allocated ( N = 10) or control...
Abstract Background Globally, millions of adolescent girls and young women (AGYW) who menstruate have limited access to appropriate comfortable products manage their menstruation. Yathu was a cluster randomised trial (CRT) that estimated the impact community-based, peer-led sexual reproductive health (SRH) services on knowledge HIV status among adolescents people aged 15–24 (AYP). Among offered through were free disposable pads menstrual cups. This study aimed investigate whether...
The HPTN 071 (PopART) trial demonstrated that universal HIV testing-and-treatment reduced community-level incidence. Door-to-door delivery of testing services (HTS) was one the main components intervention. From an early stage, men were less likely to know their status than women, primarily because they not home during service delivery. To reach more men, different strategies implemented trial. We present relative contribution these coverage HTS and impact community hubs after completion...
Abstract Background Access to affordable and effective menstrual hygiene products (MHP) is critical the health of adolescent girls young women (AGYW). In this mixed-methods analysis, we use data from a programme delivering comprehensive sexual reproductive (SRH) services describe access MHP how COVID-19-related closures affected MHP; qualitative understand AGYW’s experience accessing during study. Methods Between September 2019-January 2021, used routinely collected ten Yathu hubs offering...
Abstract Background Mobile phone-based interventions have been demonstrated in different settings to overcome barriers accessing critical psychosocial support. In this study, we aimed assess the acceptability and feasibility of a phone-based, peer-to-peer support group intervention for adolescent pregnant women aged 15–24 years living with HIV Zambia. Methods Sixty-one consenting participants were recruited from Antenatal Clinics two large urban communities Lusaka. They invited participate...
The global expansion of HIV testing, prevention and treatment services is necessary to achieve epidemic control promote individual population health benefits for people living with (PLHIV) in sub-Saharan Africa. Community-based workers (CHWs) could play a key role supporting implementation at scale. In the HPTN 071 (PopART) trial Zambia South Africa, cadre 737 study-specific CHWs, working closely government-employed CHW, were deployed deliver 'universal' door-to-door package, including an...