A5085083138- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- Mobile Health and mHealth Applications
- Sex work and related issues
- HIV/AIDS Impact and Responses
- Global Maternal and Child Health
- HIV/AIDS drug development and treatment
- Genital Health and Disease
- ICT in Developing Communities
- Female Genital Mutilation/Cutting Issues
- Poverty, Education, and Child Welfare
- HIV-related health complications and treatments
- Behavioral Health and Interventions
- SARS-CoV-2 and COVID-19 Research
- Global Health and Surgery
- Digital Mental Health Interventions
- COVID-19 Clinical Research Studies
- Global Health Workforce Issues
- COVID-19 epidemiological studies
- Food Security and Health in Diverse Populations
- Reproductive tract infections research
- Child Nutrition and Water Access
- Innovations in Medical Education
Johns Hopkins University
2016-2025
Johns Hopkins Medicine
2016-2025
Rakai Health Sciences Program
2016-2025
Office of Infectious Diseases
2008-2023
Centers for Disease Control and Prevention
2023
National Institutes of Health
2023
National Institute of Allergy and Infectious Diseases
2023
Bloomberg (United States)
2021
Uganda Virus Research Institute
2021
Taipei Hospital
2019
After HIV diagnosis, timely entry into medical care and retention in that are essential to the provision of effective antiretroviral therapy (ART). Adherence ART is among key determinants successful treatment outcome minimize emergence drug resistance. The International Association Physicians AIDS Care convened a panel develop evidence-based recommendations optimize adherence for people with HIV.A systematic literature search was conducted produce an evidence base restricted randomized,...
To assess the effect of a combination strategy for prevention human immunodeficiency virus (HIV) on incidence HIV infection, we analyzed association between and scale-up antiretroviral therapy (ART) medical male circumcision in Rakai, Uganda. Changes population-level viral-load suppression sexual behaviors were also examined.Between 1999 2016, data collected from 30 communities with use 12 surveys Rakai Community Cohort Study, an open, population-based cohort persons 15 to 49 years age. We...
Background Human resource limitations are a challenge to the delivery of antiretroviral therapy (ART) in low-resource settings. We conducted cluster randomized trial assess effect community-based peer health workers (PHW) on AIDS care adults Rakai, Uganda. Methodology/Principal Findings 15 clinics were 2∶1 receive PHW intervention (n = 10) or control 5). tasks included clinic and home-based provision counseling, clinical, adherence ART, social support. Primary outcomes cumulative risk...
Background It is often assumed that local sexual networks play a dominant role in HIV spread sub-Saharan Africa. The aim of this study was to determine the extent which continued transmission rural communities—home two-thirds African population—is driven by intra-community versus viral introductions from outside communities. Methods and Findings We analyzed spatial dynamics Rakai District, Uganda, using data cohort 14,594 individuals within 46 applied clustering statistics, phylogenetics,...
Mobile technologies for health (mHealth) represents a growing array of tools being applied in diverse care settings. mHealth interventions improving HIV/AIDS is promising strategy, but its evidence base limited. We conducted formative research evaluation to inform the development novel be used by community workers (CHWs) Kampala, Uganda. A mixed methods approach was utilized. Qualitative included 20 in-depth interviews (IDIs) and six focus groups with CHWs, clinic staff, patients. Thematic...
BackgroundInternational and global organisations advocate targeting interventions to areas of high HIV prevalence (ie, hotspots). To better understand the potential benefits geo-targeted control, we assessed extent which hotspots along Lake Victoria sustain transmission in neighbouring populations south-central Uganda.MethodsWe did a population-based survey Rakai, Uganda, using data from Rakai Community Cohort Study. The study surveyed all individuals aged 15–49 years four high-prevalence...
Abstract To prevent new infections with human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa, UNAIDS recommends targeting interventions to populations that are at high risk of acquiring and passing on the virus. Yet it is often unclear who where these ‘source’ are. Here we demonstrate how viral deep-sequencing can be used reconstruct HIV-1 transmission networks infer direction networks. We able deep-sequence from a large population-based sample infected individuals Rakai...
Persons living with HIV and substance use disorders face barriers to sustained engagement in medical care, leading suboptimal antiretroviral treatment outcomes. Innovative mobile technology tools such as customizable smartphone applications have the potential enhance existing care coordination programs, but not been rigorously studied. We developed implemented a two-component intervention consisting of peer health navigation supported by application conducting ecologic momentary assessment...
Abstract HIV prevalence varies markedly throughout Africa, and it is often presumed areas of higher (i.e., hotspots) serve as sources infection to neighboring lower prevalence. However, the small-scale geography migration networks movement HIV-positive individuals between communities poorly understood. Here, we use population-based data from ~22,000 persons known status characterize migratory patterns their relationship among 38 in Rakai, Uganda with ranging 9 43%. We find that migrants...
Pre-exposure prophylaxis (PrEP) programmes have been initiated in sub-Saharan Africa to prevent HIV acquisition key populations at increased risk. However, data on PrEP uptake and retention high-risk African communities are limited. We evaluated hyperendemic fishing villages trading centres south-central Uganda between April 2018 March 2019.
Background . Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5%) of HIV-positive clients who knew their serostatus did not enroll free services. This qualitative study explored barriers to from had never enrolled and providers. Methods We conducted 48 in-depth interviews among HIV-infected individuals aged 15–49 years, entered within six months result receipt referral for care. Key-informant were with 12 Interviews audio-recorded transcripts subjected...
Switch from first to second-line ART is recommended by WHO for patients with virologic failure. Delays in switching may contribute accumulated drug resistance, advanced immunosuppression, increased morbidity and mortality. The 3rd 90' of UNAIDS 90:90:90 targets 90% viral suppression persons on ART. We evaluated the rate antiretroviral therapy (ART), impact delayed immunologic, virologic, mortality outcomes Rakai Health Sciences Program (RHSP) Clinical Cohort Study which started providing...
Objective: To assess the validity of self-reported antiretroviral therapy use (ART) using population-based cohort data. Methods: Self-reported ART and nonuse was compared with a validated laboratory assay in 557 HIV-positive participants Rakai Community Cohort Study surveyed between September December 2011 Rakai, Uganda. The study population included from seven communities, including one fishing community high HIV prevalence (∼41%). assayed liquid chromatography–tandem mass spectrometry,...
Background Uganda’s efforts to end the HIV epidemic by 2030 are threatened increasing number of PLHIV with low-level viraemia (LLV). We conducted a study determine prevalence LLV and association between subsequent viral non-suppression from 2016 2020 among on ART in Uganda. Method This was retrospective cohort study, using national load (VL) program data 2020. defined as VL result at least 50 copies/ml, but less than 1,000 copies/ml. Multivariable logistic regression used factors associated...
HIV acquisition among adolescents and young adults (AYA, 15-24 years) is influenced by individual factors, community public policies programs. We explored the association of incidence prevalence with these factors over time AYA in Rakai, Uganda. examined trends nine survey rounds (2005-2020) Rakai Community Cohort Study (RCCS), an open population-based surveillance cohort individuals living 30 continuously followed communities south-central Uganda (n= 35,938 person rounds). evaluated...
Recent declines in HIV incidence among adolescent girls and young women (AGYW) Africa are often attributed to the expansion of biomedical interventions such as antiretroviral therapy voluntary medical male circumcision. However, changes sexual behaviour may also play a critical role. Understanding relative contributions these factors is essential for developing strategies sustain further reduce transmission. We conducted mathematical modelling study data from Rakai Community Cohort Study...
Background: Preventing HIV infections among adolescents and young adults (AYA) is crucial for curtailing the epidemic. Oral pre-exposure prophylaxis (PrEP) a highly effective prevention method increasingly available to this age group in sub-Saharan Africa but population-based data on awareness use of PrEP AYA remains limited. Methods: Analyzing survey from two rounds Rakai Community Cohort Study, an open, cohort, we estimated prevalence ratios associating various sociodemographic...