A5003315166- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- HIV, Drug Use, Sexual Risk
- HIV-related health complications and treatments
- HIV/AIDS drug development and treatment
- Global Maternal and Child Health
- Mobile Health and mHealth Applications
- Global Health and Surgery
- Emergency and Acute Care Studies
- Adolescent and Pediatric Healthcare
- Trauma and Emergency Care Studies
- Maternal and fetal healthcare
- Medication Adherence and Compliance
- Electronic Health Records Systems
- COVID-19 and healthcare impacts
- Family Support in Illness
- Moringa oleifera research and applications
- LGBTQ Health, Identity, and Policy
- Cardiac, Anesthesia and Surgical Outcomes
- Global Health Workforce Issues
- Childhood Cancer Survivors' Quality of Life
- ICT in Developing Communities
- Family Caregiving in Mental Illness
- Environmental Monitoring and Data Management
Mbarara University of Science and Technology
2016-2025
Mbarara National Referral Hospital
2009-2025
Weatherford College
2023
Center for Global Health
2020-2023
Pontificia Universidad Católica de Chile
2023
Massachusetts General Hospital
2015-2022
World Health Organization - Uganda
2021
Harvard University
2016-2019
Karolinska Institutet
2019
Creative Commons
2016
Objective: To explore the effects of four types short message service (SMS) plus real-time adherence monitoring on antiretroviral therapy (ART) adherence: daily reminders, weekly reminders triggered after a late or missed dose (delivered to patients), and notifications by sustained lapses patient-nominated social supporters). Design: Pilot randomized controlled trial. Methods: Sixty-three individuals initiating ART received monitor were (1 : 1 1): (1) Scheduled SMS (daily for month, 2...
Abstract Introduction Major depressive disorder, highly prevalent among people with HIV (PWH) globally, including South Africa, is associated suboptimal adherence to antiretroviral therapy. Globally, there are insufficient numbers of mental health providers and tested depression treatments. This study's aim was test task‐shared cognitive‐behavioural therapy for (CBT‐AD) in HIV, delivered by clinic nurses Africa. Methods a two‐arm randomized controlled effectiveness trial (recruitment: 14...
We describe the results of a pilot randomized clinical trial mobile phone-based intervention, InTSHA: Interactive Transition Support for Adolescents with HIV, compared to standard care. Encrypted, closed group chats delivered via WhatsApp provided peer support and improved communication between adolescents their caregivers, healthcare providers. 80 South African ages 15 19 years perinatally-acquired HIV receive either intervention (n=40) or care (n=40). measured acceptability (Acceptability...
The success of universal antiretroviral therapy (ART) access and aspirations for an AIDS-free generation depend on high adherence in individuals initiating ART during early-stage HIV infection; however, may be difficult the absence illness associated support.From March 2015 to October 2017, we prospectively observed three groups routine care Uganda South Africa: men non-pregnant women with infection (CD4 > 350 cells/μL), pregnant late-stage < 200 cells/μL). Socio-behavioural questionnaires...
Introduction: Efficient use of health care resources in low-income countries by providers and local national managers requires timely access to patient data. Objective: To implement electronic records (EHRs) HIV clinics Kenya, Tanzania, Uganda. Results: We initially developed implemented an EHR Kenya through a mature academic partnership. The was then six Tanzania Uganda collaboration with their National AIDS Control Programmes. All implementations were successful, but the system's...
Antiretroviral therapy (ART) adherence interruptions have been associated with viral rebound; however, the true risk is unknown because HIV RNA has never measured during ongoing interruptions.The Uganda AIDS Rural Treatment Outcomes Study an observational longitudinal cohort of adults initiating ART. We monitored device that wirelessly transmits records openings, and routinely assessed quarterly. When lapses 48+ hours between openings were detected, we made unannounced visits to participants...
Background: Preexposure prophylaxis (PrEP) efficacy is highly dependent on adherence. Yet, it unclear which adherence measures perform best for PrEP. Methods: We compared three types of self-reported questions (rating ability to adhere, frequency doses taken, percentage taken) and forms objective measurement [unannounced pill counts (UPC), electronic monitoring, plasma tenofovir levels] using data from an ancillary study within a clinical trial PrEP among East African serodiscordant couples...
Highly active antiretroviral therapy has enabled HIV-infected children to survive into adolescence and adulthood, creating need for their own HIV diagnosis disclosure. Disclosure numerous social medical benefits the child family; however, disclosure rates tend be low, especially in developing countries, further understanding of barriers is needed. This study describes patterns correlates among southwestern Uganda. A cross-sectional was conducted a referral hospital pediatric clinic between...
SMS is a widely used technology globally and may also improve ART adherence, yet notifications to social supporters following real-time detection of missed doses showed no clear benefit in recent pilot trial. We examine the demographic social-cultural dynamics that explain this finding. In trial, 63 HIV-positive individuals initiating received adherence monitor were randomized two types reminder interventions versus control (no SMS). sent 45 patient-identified for sustained lapses. Like...
Background . Preventing unintended pregnancies among women living with HIV is an important component of prevention mother-to-child transmission (PMTCT), yet few data exist on contraceptive use entering care. Methods This was a retrospective study electronic medical records from the initial clinic visits 826 sexually active, nonpregnant, 18–49-year old in southwestern Uganda 2009. We examined whether associated status disclosure to one’s spouse. Results The proportion reporting contraception...
Timely initiation of and adherence to antiretroviral therapy (ART) is critical for improving HIV outcomes reducing transmissibility. Social networks, or the social relationships individuals have with each other, been linked positive health outcomes, but less known about extent which network composition structure are associated improved ART among people living (PLWH). We conducted an ego-centric study 828 previously ART-naïve PLWH presenting at 11 clinics in Mbarara, Uganda (rural population)...
Abstract Background Lenacapavir, a novel HIV-1 capsid inhibitor, shows promise for treating MDR HIV-1, as well pre-exposure prophylaxis (PrEP) in prevention of HIV infection. Its unique mechanism and lack cross-resistance with other antiretroviral classes make lenacapavir significant addition to therapy. The clinical trials CALIBRATE CAPELLA have demonstrated high viral suppression rates both ART-naive individuals HIV-1. Lenacapavir-associated resistance mutations, such M66I Q67H, rarely...
The health care systems in low-income countries have extremely limited capacity to treat surgical diseases. perioperative mortality rate has been suggested as a key quality metric guide the expansion of care, but there is little information on how risk-adjust this outcome measure. We did 42-month observational cohort study operations at Ugandan secondary referral hospital. examined factors associated with in-hospital 30-day outcomes. aim was suggest suitable indicator for comparative service...
Background The impact of flat-line funding in the global scale up antiretroviral therapy (ART) for HIV-infected patients Africa has not yet been well described. Methods We evaluated ART-eligible and starting ART at a prototypical clinic Mbarara, Uganda between April 1, 2009 May 14, 2010 where four stakeholders sponsor treatment – two PEPFAR implementing organizations, Ugandan Ministry Health Global Fund (MOH-GF) private foundation named Family Treatment (FTF). assessed temporal trends number...
Although clinic-based cohorts are most representative of the “real world,” they susceptible to loss follow-up. Strategies for managing impact follow-up therefore needed maximize value studies conducted in these cohorts. The authors evaluated adult patients starting antiretroviral therapy at an HIV/AIDS clinic Uganda, where 29% were lost after 2 years (January 1, 2004–September 30, 2007). Unweighted, inverse probability censoring weighted (IPCW), and sampling-based approaches (using...
The impact of real-time electronic monitoring on antiretroviral therapy adherence warrants further study. We conducted an analysis cohort participants that initially involved standard (EAM), followed by EAM and home visits for sustained at least 48-h interruptions. Immediately after switching between the two types EAM, mean among 112 increased from 84% to 93% remained elevated 6 months (P < 0.001). Real-time is a promising approach improving adherence.
Background Accurate estimation of blood loss is central to prompt diagnosis and management post-partum hemorrhage (PPH), which remains a leading cause maternal mortality in low-resource countries. In such settings, often estimated visually subjectively by attending health workers, due inconsistent availability laboratory infrastructure. We evaluated the diagnostic accuracy weighed (WBL) versus changes peri-partum hemoglobin detect PPH. Methods Data from this analysis were collected as part...
To determine rates of retention and viral suppression among adolescents living with perinatally-acquired HIV who remained in pediatric care compared to those transitioned adult care.We evaluated a natural experiment involving were attending government-supported antiretroviral clinic KwaZulu-Natal, South Africa. Prior 2011, all at 12 years age. Due policy change, retained after 2011. We analyzed two before this change. Outcomes one year transition or the 13th birthday if remaining care.In...
Background Intimate partner violence (IPV) is a significant global health problem. Women who experience IPV have increased HIV incidence, reduced antiretroviral adherence, and lower likelihood of viral load suppression. There lack evidence regarding how to effectively identify support women living with (WLWH) experiencing IPV, including uncertainty whether universal or targeted screening most appropriate for lower-resourced settings. We examined physical sexual prevalence correlates among...
Residual systemic inflammation persists despite suppressive antiretroviral therapy (ART) and is associated with non-AIDS clinical outcomes. We aimed to evaluate the association between ART adherence in Ugandans living HIV who were predominantly receiving nevirapine-based a thymidine analog backbone virologically suppressed by conventional assays.Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble (s)CD14, sCD163, kynurenine/tryptophan ratio, addition CD8 T-cell activation,...
To present detailed analyses of long-term pre-exposure prophylaxis (PrEP) use and associated behaviors perceptions among young Kenyan women.Prospective, observational cohort.The Monitoring PrEP Young Adult women Study involved 18 to 24-year-old at high HIV risk initiating in Kisumu Thika, Kenya. Visits for counseling dispensing, testing, socio-behavioral data collection occurred Month 1 quarterly 2 years. adherence was measured with pharmacy refill real-time electronic monitoring, plus...
HIV-infected women risk sexual and perinatal HIV transmission during conception, pregnancy, childbirth, breastfeeding. We compared HIV-1 RNA suppression medication adherence across periconception, postpartum periods, among on antiretroviral therapy (ART) in Uganda.We analyzed data from a prospective cohort study, aged 18-49 years, enrolled at ART initiation with ≥1 pregnancy between 2005 2011. Participants were seen quarterly. The primary exposure of interest was period, including...