A5023131290- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- Adolescent Sexual and Reproductive Health
- HIV/AIDS drug development and treatment
- HIV/AIDS Impact and Responses
- Sex work and related issues
- Uterine Myomas and Treatments
- HIV-related health complications and treatments
- SARS-CoV-2 and COVID-19 Research
- Global Maternal and Child Health
- Ovarian cancer diagnosis and treatment
- Syphilis Diagnosis and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Health Policy Implementation Science
- LGBTQ Health, Identity, and Policy
- Mobile Health and mHealth Applications
- COVID-19 Clinical Research Studies
- Endometriosis Research and Treatment
- Technology Adoption and User Behaviour
- Viral Infections and Outbreaks Research
- SARS-CoV-2 detection and testing
- Vaccine Coverage and Hesitancy
- HIV/AIDS oral health manifestations
- Cardiac, Anesthesia and Surgical Outcomes
Office of Infectious Diseases
2019-2025
University of North Carolina at Chapel Hill
2015-2024
Kamuzu University of Health Sciences
2024
Public Health Department
2016-2017
Hesco (United States)
2017
University of North Carolina Health Care
2016
National Institute of Allergy and Infectious Diseases
2015
National Institutes of Health
2015
University of North Carolina System
2014
Rutgers, The State University of New Jersey
2012
(See the editorial commentary by Branson and Stekler, on pages 521–4.) Background. Most human immunodeficiency virus (HIV) point-of-care tests detect antibodies (Ab) but not p24 antigen (Ag) or RNA. In absence of antibodies, RNA typically indicate acute HIV infection. We conducted a field evaluation Determine® HIV-1/2 Ag/Ab Combo rapid test (Combo RT). Methods. The portion RT (for infection) was compared with Roche Monitor polymerase chain reaction assay. antibody established algorithms....
Scale-up of viral load (VL) monitoring for HIV-infected patients on antiretroviral therapy (ART) is a priority in many resource-limited settings, and ART providers are critical to effective program implementation. We explored provider-perceived barriers facilitators VL monitoring. interviewed all (n = 17) engaged public health evaluation dried blood spots at five clinics Malawi. All were housed within district hospitals. grouped themes patient, provider, facility, system, policy levels....
In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health prevent pediatric HIV infection. For optimal outcomes, need achieve HIVRNA suppression. We report 6-month suppression drug resistance in the PURE study.PURE study was cluster-randomized controlled trial evaluating 3 strategies promoting uptake retention; arm 1: Standard Care, 2: Facility Peer Support, 3: Community support. Pregnant...
Purpose of review The earliest months HIV infection are characterized by high viral loads and elevated transmissibility, particularly during the acute (preseroconversion) phase. Transmission prevention early requires diagnostic tools that narrow window between acquisition reactive test, followed rapid linkage to effective antiretroviral therapy (ART). Here, we recent advances related diagnosing treating persons HIV, with a particular focus on (AHI). Recent findings Point-of-care (POC)...
Objectives To evaluate the feasibility and effectiveness of dried blood spots (DBS) use for viral load (VL) monitoring, describing patient outcomes programmatic challenges that are relevant DBS implementation in sub-Saharan Africa. Methods We recruited adult antiretroviral therapy (ART) patients from five district hospitals Malawi. Eligibility reflected anticipated Ministry Health VL monitoring criteria. Testing was conducted at a central laboratory. Virological failure defined as >5000...
Index case testing (ICT) is an evidence-based approach that efficiently identifies persons in need of HIV treatment and prevention services. In Malawi, delivery ICT has faced challenges due to limited technical capacity healthcare workers (HCWs) clinical coordination. Digitisation training quality improvement processes presents opportunity address these challenges. We developed implementation package combines digital face-to-face modalities (blended learning) strengthen HCWs skills enhance...
Background: Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) extends dosing intervals from daily to every 8 weeks. Equitable implementation requires anticipating and addressing barriers use. We described LAI-CAB/RPV eligibility initiation among persons with HIV (PWH) receiving care at a Southeastern US academic medical center. Methods: included PWH ≥18 years, in 01/01/2020-12/31/2021, participating the UNC CFAR Clinical Cohort. characterized eligibility, compared those without...
Integrating acute HIV-infection (AHI) testing into clinical settings is critical to prevent transmission, and realize potential treatment-as-prevention benefits. We evaluated acceptability of AHI compared prevalence at sexually transmitted infection (STI) clinics HIV counseling (HTC) in Lilongwe, Malawi.We conducted RNA for HIV-seronegative patients visiting STI HTC clinics. was defined as positive negative/discordant rapid antibody tests. demographic, behavioral, transmission-risk...
Patients with newly diagnosed HIV may be part of social networks elevated prevalence undiagnosed infection. Social network recruitment by persons efficiently identify cases We assessed as a strategy for identifying infection.In sexually transmitted infection (STI) clinic in Lilongwe, Malawi, 3 groups 45 "seeds" were enrolled: STI patients HIV, who HIV-uninfected, and community controls. Seeds asked to recruit up 5 "contacts" (sexual or nonsexual). Mean number contacts recruited per group was...
Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal to inform decision-makers regarding the health benefits associated costs of alternative interventions, helping guide allocation limited resources by prioritising that offer most least money. Although only one component a more complex decision-making process, CEAs influence distribution health-care resources, directly influencing...
High rates of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance was a key consideration in the WHO policies transitioning first-line regimens to include integrase (dolutegravir [DTG]). However, recent data suggests relationship between DTG and neural tube defects among women exposed during conception, giving providers policymakers pause regarding planned regimen changes. We examined HIV drug cohort 46 acutely infected persons Malawi. Our demonstrates high levels transmitted...
Despite progress toward the Joint United Nations Programme on HIV/AIDS "95-95-95" targets (95% of HIV-positive persons tested, 95% tested treatment, and treated virally suppressed), a gap remains in achieving first target. Assisted contact tracing (ACT), which health workers support index clients to recruit their contacts (sexual partners children) for HIV testing, efficiently identifies need treatment. Although many countries, including Malawi, began implementing ACT, testing outcomes...
As access to long-acting injectable antiretroviral therapy (LAI ART) expands, understanding patient perceptions and experiences around LAI should inform equitable scale-up effective implementation strategies. This study used qualitative research design relying on semi-structured interviews conducted among persons with HIV (PWH) who were either virally suppressed oral treatment (