A5064298782- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- Sex work and related issues
- HIV/AIDS drug development and treatment
- Genital Health and Disease
- HIV/AIDS Impact and Responses
- Female Genital Mutilation/Cutting Issues
- Global Maternal and Child Health
- HIV-related health complications and treatments
- COVID-19 Clinical Research Studies
- COVID-19 epidemiological studies
- SARS-CoV-2 and COVID-19 Research
- Intimate Partner and Family Violence
- Urologic and reproductive health conditions
- SARS-CoV-2 detection and testing
- Urological Disorders and Treatments
- COVID-19 Digital Contact Tracing
- Poverty, Education, and Child Welfare
- Mobile Health and mHealth Applications
- Liver Disease and Transplantation
- Liver Disease Diagnosis and Treatment
- Data-Driven Disease Surveillance
- Hepatitis C virus research
Rakai Health Sciences Program
2015-2024
Johns Hopkins University
2012-2023
National Institutes of Health
2023
National Institute of Allergy and Infectious Diseases
2023
Centers for Disease Control and Prevention
2023
Imperial College London
2023
Uganda Virus Research Institute
2014-2018
Makerere University
2012
Intimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination IPV prevention and services would reduce incidence in individuals enrolled the Rakai Community Cohort Study (RCCS), Rakai, Uganda.We used pre-existing clusters communities randomised as part previous family planning trial this cohort. Four intervention group from were provided standard care plus community-level mobilisation change attitudes, social norms, behaviours related...
Objective: Most antiretroviral treatment program in resource-limited settings use immunologic or clinical monitoring to measure response therapy and decide when change a second-line regimen. Our objective was evaluate failure criteria against gold standard virologic monitoring. Design: Observational cohort. Methods: Participants enrolled an rural Uganda who had at least 6 months of follow-up were included this analysis. Immunologic performed by CD4 cell counts every 3 during the first year,...
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,...
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...
Although fishing communities have a significantly higher HIV prevalence than the general population, there is paucity of data on burden and service utilization, particularly among youth. We assessed utilization prevention treatment services youth in Kasensero community neighboring communities.Data were derived from Rakai Community Cohort Study (RCCS) surveys conducted between 2013 2014. The RCCS population-based household survey that collects annually individuals aged 15-49 years, resident...
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...
Liver disease is a leading cause of mortality among HIV-infected persons in the United States and Europe. However, data regarding effects HIV antiretroviral therapy (ART) on liver Africa are sparse.A total 500 participants an care programme rural Rakai, Uganda were frequency-matched by age, gender site to HIV-uninfected population cohort. All underwent transient elastography (FibroScan(®)) quantify stiffness measurements (LSM) identify with significant fibrosis, defined as LSM≥9.3 kPa (≈...
To describe trends in age at first sex (AFS), marriage (AFM) and time spent single between events to compare age-specific marital status six cohort studies.
Background. Use of antiretroviral therapy (ART) may be associated with higher pregnancy rates. Methods. The prevalence and incidence was assessed in 712 HIV+ pre-ART women reproductive age (WRA) (15-45) 244 WRA initiating ART. Prevalence rate ratios (PRR), (IRR), 95% confidence interval (CI) were assessed. Results. 13.1/100 py among care compared to 24.6/100 on ART (IRR = 0.54; CI 0.37, 0.81, p < 0.0017). at initiation 12.0% CD4 counts 100-250 3.2% <100 (PRR 3.24, 1.51-6.93), the while...
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...
In Uganda, HIV testing rates are approximately 90% among women in antenatal care, with male much lower. The World Health Organization has recommended self-testing (HIVST), and one promising model is for care to deliver HIVST kits their partners. We investigated the impact of this on partner rates.Three high-volume clinics central Uganda.We implemented a cluster-randomized controlled trial comparing standard intervention, primary outcome self-reported testing. Women partners were followed at...
Female bar or sex workers (FBSWs) in Eastern Africa experience a high burden of HIV. However, there is limited population-level data on HIV seroprevalence, incidence, and viral suppression among their male partners. Men who had with FBSWs the past year were identified through longitudinal population-based surveillance southern Uganda between 2013 2020. Surveillance was conducted over four surveys Lake Victoria fishing communities (HIV seroprevalence∼40%) 37 inland agricultural trading...
Estimation of the number people in need antiretroviral therapy (ART) resource-limited settings requires information on time from seroconversion to ART eligibility and death.
Traditional herbal medicines are commonly used in sub-Saharan Africa and some herbs known to be hepatotoxic. However little is about the effect of on liver disease Africa.
Background The foreskin is the site of most HIV acquisition in uncircumcised heterosexual men. Although HIV-exposed, seronegative (HESN) men demonstrate HIV-neutralizing IgA and increased antimicrobial peptides (AMPs) prepuce, no prospective studies have examined mucosal immune correlates acquisition. Methods To assess association parameters with acquisition, capacity to neutralize a primary clade C strain were quantified by blinded investigators, using sub-preputial swabs collected...
<h3>Importance</h3> Medical male circumcision (MMC) and antiretroviral therapy (ART) are proven HIV prevention interventions, but there limited data on the population-level effect of scale-up these interventions in sub-Saharan Africa. Such evaluation is important for planning resource allocation. <h3>Objective</h3> To examine whether increasing community MMC ART coverage was associated with reduced incidence Rakai District, Uganda. <h3>Design, Setting, Participants</h3> Using person-level...
Objective: To estimate the survival time from HIV infection to death. Methods: A community cohort in Rakai district, Uganda, identified 837 seroconverters followed annually between 1995 and 2003 until they died, were censored by outmigration or truncated on 31 December because antiretroviral treatment became available. HIV-1 subtype was determined multiple hybridization assay for 396 seroconverters. The median interval death estimated Kaplan–Meier analyses Weibull models. Hazard ratios (HR)...
There are limited data on individual human immunodeficiency virus (HIV) viral load (VL) trajectories at the population-level after introduction of universal test and treat (UTT) in sub-Saharan Africa.
Abstract Introduction Cardiovascular disease is one of the leading causes mortality for people living with HIV, but limited population‐based data are available from sub‐Saharan Africa. This study aimed to determine prevalence key cardiovascular risk factors, 10‐year and type 2 diabetes mellitus through scores by HIV status, as well investigate factors associated hyperglycaemia, hypertension dyslipidaemia in South‐Central Uganda. Methods A cross‐sectional was conducted 37 communities Rakai...
Objectives HIV viral load is recommended for monitoring antiretroviral treatment and identifying failure. We assessed the durability of suppression after load-triggered adherence counseling among patients with viremia 6 months ART initiation. Design Observational cohort enrolled in an program rural Uganda. Methods Participants who underwent routine determination every 24 weeks had at least 48 follow-up were included this analysis. Patients loads >400 copies/ml given additional counseling,...
A cross-sectional study was conducted of 500 human immunodeficiency virus (HIV)-infected adults frequency matched on age, sex, and community to HIV-uninfected individuals in the Rakai District, Uganda evaluate seroprevalence anti-hepatitis E (HEV) IgG antibodies. HEV 47%, 1 HIV-infected individual actively infected with a genotype 3 virus. Using modified Poisson regression, male sex (prevalence ratios [PR] = 1.247; 95% confidence interval [CI], 1.071-1.450) chronic hepatitis B infection (PR...
The efficacy of voluntary male medical circumcision (VMMC) for human immunodeficiency virus (HIV) prevention in men was demonstrated 3 randomized trials. This led to the adoption VMMC as an integral component United States President's Emergency Plan AIDS Relief (PEPFAR) combination HIV program sub-Saharan Africa. However, evidence on individual-level effectiveness programs real-world, programmatic settings is limited.
Studies on long-term nonprogressors (LTNP) have been conducted in the USA and Europe. This study examined frequency of LTNPs HIV controllers among 637 HIV-1 seroconverters rural Uganda.LTNPs were defined as being infected for more than 7 years with a CD4 T-cell count above 600 cells per microliter, having undetectable viral loads 3 separate occasions without antiretroviral treatment. load subtype distribution between LTNP non-LTNP populations determined.Of seroconverters, 9.1% (58/637) 1.4%...
To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression.We extracted data on the location type care services utilized HIV-positive persons accessing ART between February 2015 September 2016 from Rakai Community Cohort Study in Uganda. The distance households to facilities offering was calculated using open street map road network. Modified Poisson regression used identify predictors traveled and, for...