A5002837207- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- Reproductive tract infections research
- HIV/AIDS drug development and treatment
- Syphilis Diagnosis and Treatment
- Vaccine Coverage and Hesitancy
- Reproductive System and Pregnancy
- Global Maternal and Child Health
- Sex work and related issues
- Intimate Partner and Family Violence
- COVID-19 Impact on Reproduction
eThekwini Municipality
2018-2024
Johns Hopkins University
2017
University of Zululand
2017
The effect of the COVID-19 pandemic on HIV outcomes in low-income and middle-income countries is poorly described. We aimed to measure impact 2020 national lockdown testing treatment KwaZulu-Natal, South Africa, where 1·7 million people are living with HIV.In this interrupted time series analysis, we analysed anonymised programmatic data from 65 primary care clinics KwaZulu-Natal province, Africa. included for HIV, initiating antiretroviral therapy (ART), collecting ART at participating...
Introduction In light of the limited impact syndromic management approach has had on global sexually transmitted infection (STI) epidemic, we assessed a care model comprising point-of-care (POC) STI testing, immediate treatment, and expedited partner therapy (EPT) among cohort young women at high HIV risk in South Africa. Methods findings negative presenting for underwent POC testing Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) Trichomonas vaginalis (TV), swabs were sent NG culture...
Objectives Syndromic management of sexually transmitted infections (STIs) omits asymptomatic infections, particularly among women. Accurate point-of-care assays may improve STI care in low- and middle-income countries (LMICs). We aimed to evaluate the diagnostic performance Xpert Chlamydia trachomatis / Neisseria gonorrhoeae (CT/NG) OSOM Trichomonas vaginalis (TV) Test as part a model for young women South Africa. Design Diagnostic evaluation conducted prospective cohort study (CAPRISA 083)...
Introduction Providing antiretroviral therapy (ART) for millions of people living with HIV requires efficient, client-centred models differentiated ART delivery. In South Africa, the Centralised Chronic Medication Dispensing and Distribution (CCMDD) programme allows over 1 million to collect chronic medication, including ART, from community pick-up points. We aimed explore how CCMDD influences engagement in care. Methods performed in-depth interviews focus group discussions clients receiving...
Introduction Achieving the Joint United Nations Programme on HIV and AIDS 90-90-90 targets requires models of care that expand antiretroviral therapy (ART) coverage without overburdening health systems. Point-of-care (POC) viral load (VL) testing has potential to efficiently monitor ART treatment, while enrolled nurses may be able provide safe cost-effective chronic for stable patients with HIV. This study aims demonstrate whether POC VL combined task shifting is non-inferior compared...
Abstract Introduction The World Health Organisation recommends to Treat All people with HIV, irrespective of CD4 count. However, counts >500 cells/µL may be asymptomatic and therefore less motivated adhere antiretroviral therapy (ART). We aimed assess whether initiated had worse treatment outcomes compared those at lower counts. Methods performed a retrospective cohort study among non‐pregnant adults initiating ART eight public clinics in South Africa between September 2016, when was...
Objectives STIs cause inflammation that is detrimental for both HIV risk and reproductive health. We assessed the impact of point-of-care (POC) STI testing, immediate treatment expedited partner therapy (EPT) on genital tract cytokines among a cohort young South African women. Methods HIV-negative women underwent POC testing Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) Trichomonas vaginalis (TV) by Xpert CT/NG OSOM TV, bacterial vaginosis (BV) microscopy. Women with and/or BV...
Providing viral load (VL) results to people living with HIV (PLHIV) on antiretroviral therapy (ART) remains a challenge in low and middle-income countries. Point-of-care (POC) VL testing could improve ART monitoring the quality efficiency of differentiated models care. We assessed acceptability POC within care model that involved task-shifting from professional nurses less highly-trained enrolled nurses, an option collecting treatment community-based delivery programme.We undertook...
To determine whether the Centralized Chronic Medication Dispensing and Distribution (CCMDD) program in South Africa's differentiated ART delivery model affects clinical outcomes, we assessed viral load (VL) suppression retention care between patients participating those receiving clinic-based standard of care.
Introduction Access to HIV viral load testing remains difficult for many people on antiretroviral therapy (ART) in low-income and middle-income countries. Weak laboratory clinic systems often delay the detection management of viraemia, which can lead morbidity, drug resistance transmission. Point-of-care could overcome these challenges. We aim assess whether it is feasible conduct a randomised trial point-of-care manage viraemia. Methods analysis will an open-label, single-site, individually...
Substantial improvements in viral suppression among people living with HIV (PLHIV) are needed to end the epidemic, requiring extensive scale-up of low-cost monitoring services. Point-of-care (POC) tests for antiretroviral therapy (ART) adherence and load (VL) may be efficient effective tools real-time clinical decision making. We aim evaluate effects a combined intervention POC ART VL testing compared standard-of-care on adherence, retention at 6 18 months post-ART initiation...
Abstract Introduction Evidence is needed to guide the inclusion of broader groups people living with HIV (PLHIV) in differentiated service delivery (DSD) programmes. We assessed treatment outcomes among PLHIV on second‐line regimens a community antiretroviral therapy (ART) programme, compared those who remained at clinics. Methods Using data from 61 public clinics, we did retrospective cohort study receiving ART following rollout Centralized Chronic Medicines Dispensing and Distribution...
We examined the impact of past-year intimate partner violence (IPV) on HIV outcomes among women living with (WLHIV) in Durban, South Africa. assessed IPV using WHO Violence Against Women Questionnaire. conducted logistic regression to assess associations between demographic variables and at baseline, baseline longitudinal outcomes. Among 235 WLHIV, 17% reported emotional, physical, or sexual IPV. At HIV-disclosure was associated 4.35-fold odds (95% CI 1.17-16.10) after controlling for...
Introduction Most low-and middle-income countries (LMICs) rely on syndromic management to guide diagnosis and treatment of sexually transmitted infections (STIs).Syndromic is less expensive but has poor diagnostic accuracy compared conventional laboratory testing.The goal this study was determine the incremental cost implementing a rapid, near-patient care model at an infectious disease centre in Durban, South Africa.Methods As part cohort assess pointof-care testing with expedited partner...
<h3>Introduction</h3> Most low- and middle-income countries (LMICs) rely on syndromic management to guide diagnosis treatment of sexually transmitted infections (STIs). Syndromic is less expensive but has poor diagnostic accuracy compared conventional laboratory testing. The goal this study was determine the incremental cost implementing a rapid, near-patient care model at an infectious disease centre in Durban, South Africa. <h3>Methods</h3> As part cohort assess point-of-care testing with...
With the largest antiretroviral therapy (ART) programme globally, demand for effective HIV management is increasing in South Africa. While viral load (VL) testing conducted, VL follow-up and are sub-optimal.The objective of this study was to address gaps cascade improve management.Antiretroviral records were sampled an in-depth review. The team then reviewed individual records, focusing on ART management, virological suppression retention. Multifaceted interventions focused control,...
<h3>Introduction</h3> As long as syndromic management of sexually transmitted infections (STI) remains the main model care in low and middle income countries, diagnostic surveillance is essential for STI control, especially high HIV incidence settings. Here, we present baseline data from CAPRISA 083 cohort study that was conducted a large urban primary health clinic KwaZulu-Natal, South Africa. <h3>Methods</h3> Women aged 18–40 presenting at facility were assessed participation. positive...
<h3>Introduction</h3> Expedited Partner Therapy (EPT) for STIs delivered by the index case or through pharmacies has been implemented in some settings US. In South Africa, partner notification provision of a contact card to patient reminding seek treatment unsuccessful (partner rates 17%). Here, we explored feasibility and acceptability EPT among young women high HIV incidence setting. <h3>Methods</h3> negative women, aged 18–40 years were screened chlamydia, gonorrhoea (Xpert CT/NG)...