A5091332269- Sex work and related issues
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV/AIDS Research and Interventions
- Poverty, Education, and Child Welfare
- HIV Research and Treatment
- Child Nutrition and Water Access
- Global Maternal and Child Health
- Immune Cell Function and Interaction
- Sexuality, Behavior, and Technology
- T-cell and B-cell Immunology
- Reproductive tract infections research
- Pelvic floor disorders treatments
- Gender Roles and Identity Studies
- Early Childhood Education and Development
- Immunotherapy and Immune Responses
- HIV/AIDS Impact and Responses
- Urinary Tract Infections Management
- vaccines and immunoinformatics approaches
- Mental Health Treatment and Access
- Gender, Feminism, and Media
- South Asian Studies and Conflicts
- Child and Adolescent Psychosocial and Emotional Development
- Intimate Partner and Family Violence
- Child Abuse and Trauma
London School of Hygiene & Tropical Medicine
2016-2025
University of Toronto
2002-2024
University of London
2009-2024
Faculty of Public Health
2019-2024
Royal Society of Tropical Medicine and Hygiene
2022
Karnataka Health Promotion Trust
2014
University of Oxford
2004-2008
Medical Research Council
2006
John Radcliffe Hospital
2006
MRC Human Immunology Unit
2004-2006
Violence against female sex workers (FSWs) can impede HIV prevention efforts and contravenes their human rights. We developed a multi-layered violence intervention targeting policy makers, secondary stakeholders (police, lawyers, media), primary (FSWs), as part of wider programming involving >60,000 FSWs in Karnataka state. This study examined if is associated with reduced condom use increased STI/HIV risk, addressing within large-scale program reduce levels them. were randomly selected to...
The immunogenicities of candidate DNA- and modified vaccinia virus Ankara (MVA)-vectored human immunodeficiency (HIV) vaccines were evaluated on their own in a prime-boost regimen phase I clinical trials healthy uninfected individuals the United Kingdom. Given current lack approaches capable inducing broad HIV-neutralizing antibodies, pTHr.HIVA DNA MVA.HIVA focus solely induction cell-mediated immunity. expressed common immunogen, HIVA, which consists consensus HIV-1 clade A Gag p24/p17...
To investigate the impact on sexual behaviour and sexually transmitted infections (STI) of a comprehensive community-led intervention programme for reducing risk among female sex workers (FSW) in Mysore, India. The key components were: community mobilization peer-mediated outreach; increasing access to utilization health services; enhancing enabling environment support activities.Two cross-sectional surveys random samples FSW were conducted 30 months apart, 2004 2006.Of over 1000 women who...
Despite high HIV prevalence rates among most-at-risk groups, utilisation of testing, treatment and care services was relatively low in Karnataka prior to 2008. The authors aimed understand the barriers identify potential solutions for improving service utilisation.Focus group discussions were carried out homogeneous groups female sex workers, men who have with transgenders, programme peer educators six districts across March April 2008.26 focus conducted, involving 302 participants....
<h3>Objectives</h3> To examine the impact of a large-scale HIV prevention programme for female sex workers (FSW) in Karnataka state, south India, on prevalence HIV/sexually transmitted infections (STI), condom use and coverage. <h3>Methods</h3> Baseline follow-up integrated biological behavioural surveys were conducted random samples FSW five districts between 2004 2009. <h3>Results</h3> 4712 participated study (baseline 2312; 2400), with 28–37 months after baseline. By follow-up, over 85%...
Secondary education among lower caste adolescent girls living in rural Karnataka, South India, is characterized by high rates of school drop-out and absenteeism. A cross-sectional baseline survey (N=2275) was conducted 2014 as part a cluster-randomized control trial (13-14 year) their families from marginalized communities two districts north Karnataka. Bivariate multivariate logistic regression models were used. Overall, 8.7% reported secondary dropout 8.1% frequent absenteeism (past...
Structural factors are known to affect individual risk and vulnerability HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs) in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media) primary (FSWs themselves). The purpose was address context-specific (social inequity, violence harassment, stigma discrimination) contributing vulnerability. We advocated with...
This qualitative study explored the barriers and enablers to scheduled caste/scheduled tribe (SC/ST) adolescent girls entering into, completing secondary education in northern Karnataka, South India. In-depth interviews were conducted with 22 girls, their respective parent/guardian (n = 22) 11 teachers, recruited purposively from villages within two districts Karnataka. Multiple identified disadvantaged caste girls’ entry into retention this setting, these operated at individual, family,...
We examined the impact of community mobilization (CM) on empowerment, risk behaviors, and prevalence HIV sexually transmitted infection in female sex workers (FSWs) Karnataka, India.We conducted behavioral-biological surveys 2008 2011 4 districts India. defined exposure to CM as low, medium (attended nongovernmental organization meeting or drop-in centre), high (member collective peer group). used regression analyses explore whether was associated with preceding outcomes. Pathway explored...
Introduction Female sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to impact that such factors may have on HIV risk whether community interventions could mitigate this impact. Methods As part of evaluation Avahan programme in Karnataka, serial integrated behavioural biological assessment (IBBA) surveys (four districts) (2005 2011) anonymous polling booth (PBS) (16 (2007 were conducted with random...
Mental health disorders among adolescents have emerged as a major public issue in many low and middle-income countries, including India. There is paucity of research on the determinants psychological distress, particularly poorest girls communities. The purpose this study was to assess prevalence correlates different indicators distress 13–14 year old caste rural, south Cross-sectional survey 1191 two districts north Karnataka, conducted part cluster randomised-control trial. Bivariate...
Abstract Background The composition of the vaginal microbiota is closely linked to adverse sexual and reproductive health outcomes, due in part effects on genital immunology. Compositional approaches such as metagenomic sequencing provide a snapshot all bacteria sample have become standard for characterizing microbiota, but only microbial relative abundances. We hypothesized that addition absolute abundance data would more complete picture host-microbe interactions female tract. Results...
Low caste adolescent girls living in rural northern Karnataka are at increased risk of school drop-out, child marriage, and entry into sex-work, which enhances their vulnerability to HIV, early pregnancy adverse maternal health outcomes. This protocol describes the evaluation Samata, a comprehensive, multi-level intervention designed address these structural drivers HIV vulnerability.The Samata study is cluster randomised controlled trial that will be conducted eighty village clusters (40...
Background Gender-related norms and poverty remain important structural barriers to secondary school attendance among adolescent girls in southern India. We analyse how gender interact with family deprivation dynamics result dropping out of school; we identify the main facilitators retention changes socialisation. Methods Longitudinal qualitative case studies 36 were nested within a cluster randomized trial evaluate Samata intervention targeting Bagalkote Vijayapura districts northern...
This analysis estimates prevalence of intimate partner violence (IPV) and its association with probable depression among adolescent girls young women (AGYW) in Lilongwe, Malawi, whether partner's controlling behaviour modifies this relationship. Baseline data was utilised from the Girl Power-Malawi study 1000 15–24-year-old AGYW Lilongwe. Emotional, physical, sexual IPV experiences a current or recent were measured using modified Conflict Tactics Scale. Probable by scoring ≥10 on Centre for...
The Samata intervention to increase secondary school completion and reduce child marriage among adolescent girls: results from a clusterrandomised control trial in India Background Secondary education delayed provide long-term socio-economic health benefits girls.We tested whether structural norms-based intervention, which worked with girls, their families, communities, schools address poverty, schooling quality gender norms, could drop-out scheduled-caste/scheduled-tribe (SC/ ST) girls...
UNAIDS has identified female sex workers (FSW) as a key HIV at-risk population. FSW disproportionately experience gender-based violence, which compounds their risk of acquisition and may contribute to adverse mental health outcomes. Pre-exposure prophylaxis (PrEP) is powerful but underused prevention tool for these women. This study explored the associations between intimate partner violence (IPV) client-perpetrated against FSW, outcomes PrEP use.An anonymous questionnaire was administered...
Abstract HLA-B*57 is associated with slower disease progression to AIDS, and CD8+ T cell responses B*57-restricted epitopes are thought contribute this protective effect. In study, we evaluate the p24 KAFSPEVIPMF (KF11) immune response which immunodominant during chronic infection. Previously, observed that KF11 clade variants KGFNPEVIPMF [A2G,S4N] KAFNPEIIMPF [S4N,V7I], sharing a position 4 mutation, differentially recognized by KF11-specific cells. By combining structural cellular studies,...
Background Most HIV prevention for female sex workers (FSWs) focuses on individual behaviour change involving peer educators, condom promotion and the provision of sexual health services. However, there is a growing recognition need to address broader societal, contextual structural factors contributing FSW risk behaviour. We assess cost-effectiveness adding community mobilisation (CM) empowerment interventions (eg. mobilisation, involvement in programme management services, violence...
Abstract Background Adverse childhood experiences (ACEs), poverty, violence and harmful alcohol/substance use are associated with poor mental health outcomes, but few studies have examined these risks among Female Sex Workers (FSWs). We examine the prevalence correlates of common problems including suicidal thoughts behaviours FSWs in Kenya. Methods Maisha Fiti is a longitudinal study randomly selected from Worker Outreach Programme (SWOP) clinics across Nairobi. Baseline...