A5025813163- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV-related health complications and treatments
- HIV Research and Treatment
- Poverty, Education, and Child Welfare
- Global Maternal and Child Health
- Pneumocystis jirovecii pneumonia detection and treatment
- Child Nutrition and Water Access
- HIV/AIDS drug development and treatment
- Migration, Health and Trauma
- HIV/AIDS Impact and Responses
- Acute Myocardial Infarction Research
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Viral gastroenteritis research and epidemiology
- Blood Pressure and Hypertension Studies
- Tuberculosis Research and Epidemiology
- Global Public Health Policies and Epidemiology
- Family Caregiving in Mental Illness
- Emergency and Acute Care Studies
- Sex work and related issues
- Viral Infections and Outbreaks Research
- Healthcare Systems and Reforms
- Maternal Mental Health During Pregnancy and Postpartum
- Heart Failure Treatment and Management
Duke University
2016-2025
Duke Medical Center
2013-2024
Duke Institute for Health Innovation
2015-2024
University Medical Center
2024
Kilimanjaro Christian Medical Centre
2022-2024
Duke University Hospital
2004-2023
Clinical Research Institute
2023
Duke University Health System
2006-2023
UNC Lineberger Comprehensive Cancer Center
2023
Office of Infectious Diseases
2019-2021
The widening array of recognized enteric pathogens and the increasing demand for cost-containment sharpen need careful clinical public health guidelines based on best evidence currently available.Adequate fluid electrolyte replacement maintenance are key to managing diarrheal illnesses.Thorough epidemiological evaluation must define severity type illness (e.g., febrile, hemorrhagic, nosocomial, persistent, or inflammatory), exposures travel, ingestion raw undercooked meat, seafood, milk...
We examined associations between trust of health care providers and the government service use outcomes.Interviews with a sample 611 HIV-positive individuals included an attitudinal assessment measuring beliefs concerning creation AIDS, information being withheld about disease, providers.Trust in was associated increased HIV-related out-patient clinic visits, fewer emergency room antiretroviral medications, improved reported physical mental health. Trusting visits better More than one...
In an era of highly active antiretroviral therapies, the authors needed to confirm previous findings showing that stress and depression have impact on HIV disease progression. The goal current study was examine effects lifetime trauma, recent stressful events, all-cause AIDS-related mortality among HIV-infected men women. hypothesized these psychosocial variables would predict significantly faster HIV-specific mortality.The consecutively sampled women who received care at one eight...
Among HIV-infected persons, high-level adherence to antiretroviral medications (>90%–95%) is associated with improved immunologic, virologic, and clinical outcomes, necessary prevent the emergence of viral resistance. This study examines whether lifetime traumatic events including physical sexual abuse, are nonadherence. We present a cross-sectional analysis Coping HIV/AIDS in Southeast (CHASE) Study, analyzing data from enrollment interview medical records subjects. The CHASE Study...
Background. Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance essential achieving long-term success.
Objective: In addition to biological markers of human immunodeficiency virus (HIV) disease progression, physical functioning, and utilization health care may also be important indicators status in HIV-infected patients. There is insufficient understanding the psychosocial predictors health-related functioning use services among those with this chronic disease. Therefore, current study examines how trauma, severe stressful events, posttraumatic stress disorder (PTSD), depressive symptoms are...
Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed between religious HIV stigma, disclosure, toward antiretroviral (ARV) treatment. A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, Pentecostal churches both urban rural areas. The included questions beliefs, opinions HIV, knowledge ARVs. Multivariate logistic...
Background Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers advocating that institution-living (OAC) be moved as quickly possible a residential family setting institutional used last resort. This analysis tests hypothesis OAC aged 6–12 is associated with worse health wellbeing than community using conservative two-tail tests. Methodology The Positive Outcomes Orphans (POFO) study employed two-stage...
Alcohol and drug use are common among HIV-infected patients important determinants of secondary transmission risk medication adherence. As part the Coping with HIV/AIDS in Southeast (CHASE) Study, 611 were consecutively recruited from eight clinical care sites five southeastern U.S. states 2001-2002. We examined distribution predictors alcohol this sample an emphasis on psychosocial use. In prior 9 months, 27% participants drank 7% to intoxication at least weekly. The most drugs used weekly...
Background In sub-Saharan Africa, kidney failure has a high morbidity and mortality. Despite this, population-based estimates of prevalence, potential etiologies, awareness are not available. Methods Between January June 2014, we conducted household survey randomly-selected adults in Northern Tanzania. To estimate prevalence screened for CKD, which was defined as an estimated glomerular filtration rate ≤ 60 ml/min/1.73m2 and/or persistent albuminuria. We also human immunodeficiency virus...
Introduction Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that sensitive to traditional medicine practices will require understanding their current use roles, including from a biomedical perspective. Therefore, we conducted mixed-method study Northern Tanzania order characterize the extent reasons for among general population so can better inform public health efforts region. Methods Between December 2013...
We examined prevalence and predictors of trauma among HIV-infected persons in the Deep South using data from Coping with HIV/AIDS Southeast (CHASE) study. Over 50% CHASE participants were abused during their lives, approximately 30% experiencing abuse before age 13, regardless gender. Caregiver characteristics associated childhood abuse. Abuse is related to increases high-HIV-risk activities. The findings help explain why people engage such high-risk activities can provide guidance designing...
Objective: To examine the influence of incident stressful experiences on antiretroviral medication adherence and treatment outcomes. Past trauma history predicts poorer health Human immunodeficiency virus (HIV)-infected individuals experience frequently traumatic events, such as sexual physical assault, housing instability, major financial, employment, legal difficulties. Methods: We measured prospectively adherence, viral load over 27 months in an eight-site, five-state study. Using...
To our knowledge, the antiviral activity of pegylated interferon alfa-2a has not been studied in participants with untreated human immunodeficiency virus type 1 (HIV-1) infection but without chronic hepatitis C (HCV) infection.Untreated HIV-1-infected volunteers HCV received 180 microg weekly for 12 weeks. Changes plasma HIV-1 RNA load, CD4(+) T cell counts, pharmacokinetics, pharmacodynamic measurements 2',5'-oligoadenylate synthetase (OAS) activity, and induction levels...
Background The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of with goals large, diverse, and competent workforce strengthening capacity academic institutions in Rwanda. Methods data this organizational case study was collected through official reports from Ministry (MoH) 22 participating US institutions, databases MoH College Medicine Sciences (CMHS) Rwanda, surveys completed co-authors. Results...
As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons lack of adherence is critical to stemming the tide infections improving health. Understanding effect psychosocial experiences mental health symptomatology on ART can help maximize benefit expanded programs by indicating types services, which could be offered combination with care.The Coping HIV/AIDS Tanzania (CHAT) study a longitudinal cohort Kilimanjaro...
Background: Depression is a major barrier to HIV treatment outcomes. Objective: To test whether antidepressant management decision support integrated into care improves antiretroviral adherence and depression morbidity. Design: Pseudo-cluster randomized trial. Setting: Four US infectious diseases clinics. Participants: HIV-infected adults with depressive disorder. Intervention: Measurement-based (MBC) – managers used systematic metrics give primary-care clinicians standardized...
Background With more than 2 million children living in group homes, or "institutions", worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers. Methods A two-stage random sampling methodology identified community representative samples of 1,357 institution-dwelling orphaned separated (OSC) 1,480 family-dwelling OSC aged 6–12 from 5 low middle income countries. Data were collected their...
Non-communicable diseases (NCDs) are a leading cause of death among adults in sub-Saharan Africa, and chronic kidney disease (CKD) is growing public health threat. Understanding knowledge, attitudes, practices associated with NCDs vital to informing optimal policy responses the region, but few community-based assessments have been performed for CKD. To address this gap, we conducted cross-sectional survey northern Tanzania using validated instrument.Between January June 2014, administered...
Few studies have examined the disproportionate use of restraints for Black adults receiving emergency psychiatric care. This study sought to determine whether odds physical and chemical restraint were higher patients undergoing care compared with their White counterparts.This single-center retrospective cohort 12,977 unique encounters an evaluation between January 1, 2014, September 18, 2020, at a large academic medical center in Durham, North Carolina. Self-reported race categories...
The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward greater proportion of new cases women, African-Americans, and through heterosexual transmission.Using consecutive sampling, 611 participants were interviewed from eight Infectious Diseases clinics five southeastern states 2001 to 2002.Sixty four percent African-American, 31% female, 43% acquired HIV sex; 25% had private health insurance. Eighty-one on antiretroviral therapy, 46% RNA viral loads (VL) <400. Women...