A5058881734- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Adolescent Sexual and Reproductive Health
- HIV/AIDS drug development and treatment
- HIV-related health complications and treatments
- HIV, Drug Use, Sexual Risk
- Global Maternal and Child Health
- Pneumocystis jirovecii pneumonia detection and treatment
- Adolescent and Pediatric Healthcare
- Poverty, Education, and Child Welfare
- Maternal Mental Health During Pregnancy and Postpartum
- Gestational Diabetes Research and Management
- HIV/AIDS Impact and Responses
- Pregnancy and Medication Impact
- Sex work and related issues
- Breastfeeding Practices and Influences
- Tuberculosis Research and Epidemiology
- Child Nutrition and Water Access
- Homelessness and Social Issues
- Pregnancy and preeclampsia studies
- Pharmacological Effects and Toxicity Studies
- Immunodeficiency and Autoimmune Disorders
- Cytomegalovirus and herpesvirus research
- Intimate Partner and Family Violence
- Child Abuse and Trauma
Columbia University
2016-2025
ICAP Global Health
2015-2024
Columbia University Irving Medical Center
2019-2024
University of Cape Town
2016-2024
Columbia College
2013-2022
Royal College of Physicians
2013-2022
University of the Witwatersrand
2011-2020
Chris Hani Baragwanath Hospital
2011-2020
Rutgers, The State University of New Jersey
2020
Perinatal HIV Research Unit
2018-2020
Two drugs under consideration for inclusion in antiretroviral therapy (ART) regimens human immunodeficiency virus (HIV) infection are dolutegravir (DTG) and tenofovir alafenamide fumarate (TAF). There limited data on their use low- middle-income countries.
The early diagnosis of infection with human immunodeficiency virus (HIV) in infants born to infected mothers is essential for treatment, but current tests cannot detect HIV newborns because the presence maternal antibodies. We used polymerase chain reaction, a new technique that amplifies proviral sequences within DNA, peripheral-blood mononuclear cells obtained from seropositive women during neonatal (age less than 28 days) and postneonatal periods. In blood period, reaction was positive...
The Zambian Ministry of Health provides pediatric antiretroviral therapy (ART) at primary care clinics in Lusaka, where, despite scale-up perinatal prevention efforts, many children are already infected with the human immunodeficiency virus (HIV).To report early clinical and immunologic outcomes enrolled treatment program.Open cohort assessment using routinely collected outcome data from an electronic medical record system use 18 government health facilities Zambia. Care was provided...
An increasing number of adolescents born with HIV in South Africa are on antiretroviral treatment and have to confront complex issues related coping a chronic, stigmatizing transmittable illness. Very few evidence-based mental health promotion programs for this population exist Africa. This study builds previous collaboratively designed developmentally timed family-based intervention early (CHAMP). The uses community-based participatory approach as part formative research evaluate pilot...
In a collaboration of 7 European and United States prospective studies, 44 cases vertical human immunodeficiency virus type 1 (HIV-1) transmission were identified among 1202 women with RNA loads <1000 copies/mL at delivery or the measurement closest to delivery. For mothers receiving antiretroviral treatment during pregnancy time (or both), there was 1.0% rate (8 834; 95% confidence interval [CI], 0.4%-1.9%), compared 9.8% (36 368; CI, 7.0%-13.4%) for untreated (risk ratio, 0.10; 0.05-0.21)....
Background: The toxicity and complexity of antiretroviral therapy (ART) regimens are substantial challenges in the context patients' lives. This study examines child psychosocial caregiver/family factors influencing adherence to ART perinatally human immunodeficiency virus (HIV)-infected children. Methods: Seventy-five children (ages 3–13 years) prescribed ART, their primary caregivers were recruited from 2 urban pediatric HIV programs. A battery psychologic assessments self-report data...
Single-dose nevirapine is the cornerstone of regimen for prevention mother-to-child transmission human immunodeficiency virus (HIV) in resource-limited settings, but frequently selects resistant mothers and children who become infected despite prophylaxis. The optimal antiretroviral treatment strategy have had prior exposure to single-dose unknown.
With the rapid expansion of antiretroviral therapy (ART) services in sub-Saharan Africa there is growing recognition importance fertility and childbearing among HIV-infected women. However are few data on whether ART initiation influences pregnancy rates.We analyzed from Mother-to-Child Transmission-Plus (MTCT-Plus) Initiative, a multicountry HIV care treatment program for women, children, families. From 11 programs seven African countries, women were enrolled into regardless disease stage...
Nevirapine-based antiretroviral therapy is the predominant (and often only) regimen available for children in resource-limited settings. Nevirapine resistance after exposure to drug prevention of maternal-to-child human immunodeficiency virus (HIV) transmission common, a problem that has led recommendation ritonavir-boosted lopinavir such Regardless whether there been prior nevirapine, performance nevirapine versus young not rigorously established.
Background: The purpose of this study was to examine 1) the prevalence psychiatric and substance use disorders in perinatally HIV‐infected (HIV+) adolescents 2) association between HIV infection these mental health outcomes by comparing HIV+ youths exposed but uninfected (HIV‐) from similar communities. Methods: Data for paper come baseline interview a longitudinal 9‐16 year old HIV‐exposed (61% HIV+) their caregivers. Three hundred forty primary adult caregivers were recruited four medical...
Abstract Introduction : Globally adolescents and young adults account for more than 40% of new HIV infections, HIV‐related deaths amongst increased by 50% from 2005 to 2012. Adherence antiretroviral therapy (ART) is critical control viral replication preserve health; however, there a paucity research on adherence the growing population living with HIV/AIDS (ALHIV) in Southern Africa. We examined levels self‐reported ART adherence, barriers factors associated non‐adherence ALHIV Malawi....
Background Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric cohorts and cohort networks, allowing comparisons in "real-life" settings across multiple regions. We describe geographic temporal characteristics mortality outcomes APHs regions, including South America Caribbean, North America, Europe, sub-Saharan Africa, Southeast Asia. Methods findings Through Collaborative...
Recent international guidelines call for expanded access to triple-drug antiretroviral therapy (ART) in HIV-positive women during pregnancy and postpartum. However, high levels of non-adherence and/or disengagement from care may attenuate the benefits ART HIV transmission maternal health. We examined frequency predictors among initiating Cape Town, South Africa.We used routine medical records follow-up pregnant within prevention mother-to-child services Africa. Outcomes assessed through six...
Causes for loss-to-follow-up, including early refusals of and stopping antiretroviral therapy (ART), in Malawi’s Option B+ program are poorly understood. This study examines the main barriers facilitators to uptake adherence ART under B+. In depth interviews were conducted with HIV-infected women who pregnant or postpartum Lilongwe, Malawi (N = 65). Study participants included refused initiation 10), initiated then stopped 26), those remained on treatment 29). The varied concerns about...
Abstract As the pediatric HIV epidemic in resource-rich countries evolves into an adolescent epidemic, there is a substantive need for studies elucidating mental health needs of perinatally HIV-infected (PHIV + ) youth as they transition through adolescence. This article examines role perinatal infection influencing by comparing changes psychiatric disorders and substance use (SUD) PHIV HIV-exposed, but uninfected − over time. Participants were recruited from four medical centers New York...
Studies of antiretroviral therapy (ART) use during pregnancy in HIV-infected women have suggested that ART exposure may be associated with adverse birth outcomes. However, there are few data from sub-Saharan Africa where HIV is most common, and studies involving the World Health Organization's (WHO's) recommended first-line regimens. We enrolled consecutive pregnant a comparator cohort uninfected at primary-level antenatal care facility Cape Town, South Africa. Gestational assessment...
Background As the number of HIV-infected women initiating lifelong antiretroviral therapy (ART) during pregnancy increases globally, concerns have emerged regarding low levels retention in HIV services and suboptimal adherence to ART postpartum period. We examined impact integrating for HIV+ mothers alongside infant follow-up within maternal child health (MCH) Cape Town, South Africa. Methods findings conducted a randomised trial among aged ≥18 years who initiated local antenatal care clinic...
To assess neurodevelopment of breastfed HIV-exposed uninfected (HEU) and HIV-unexposed children in the context universal maternal antiretroviral therapy (ART).Prospective study with antenatal enrolment follow-up breastfeeding HEU mother-infant pairs through 12-18 months postpartum.Peri-urban community, Cape Town, South Africa.HEU (n = 215) 306) children.Cognitive, motor language development at median 13 (interquartile range 12-14) age: continuous dichotomous Bayley Scales Infant Toddler...
Abstract Background ADVANCE compared 3 World Health Organization–recommended first-line regimens in participants with HIV who were antiretroviral naive. Methods This randomized, open-label, noninferiority trial enrolled living no exposure the previous 6 months to 1 of following arms: tenofovir alafenamide (TAF) / emtricitabine (FTC) + dolutegravir (DTG) (2 tablets), disoproxil fumarate (TDF) FTC DTG or a fixed-dose combination TDF efavirenz (EFV) (1 tablet). We report final safety and...
Zidovudine has been the drug of choice for initial treatment symptomatic children infected with human immunodeficiency virus (HIV). This trial was designed to assess efficacy and safety zidovudine alone as compared either didanosine or combination therapy plus didanosine.