A5075733760- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- Genital Health and Disease
- HIV, Drug Use, Sexual Risk
- Female Genital Mutilation/Cutting Issues
- Sex work and related issues
- Reproductive tract infections research
- Urologic and reproductive health conditions
- HIV/AIDS Impact and Responses
- Global Maternal and Child Health
- HIV/AIDS drug development and treatment
- Cervical Cancer and HPV Research
- HIV-related health complications and treatments
- Urological Disorders and Treatments
- Herpesvirus Infections and Treatments
- Intimate Partner and Family Violence
- Poverty, Education, and Child Welfare
- Syphilis Diagnosis and Treatment
- Hepatitis B Virus Studies
- Vaccine Coverage and Hesitancy
- Ethics and Legal Issues in Pediatric Healthcare
- Reproductive Health and Contraception
- Child Nutrition and Water Access
- Food Security and Health in Diverse Populations
Johns Hopkins University
2016-2025
Bloomberg (United States)
2011-2025
Rakai Health Sciences Program
2015-2024
Johns Hopkins Medicine
2017-2023
University of Oxford
2023
Centre for Human Genetics
2023
Makerere University
2000-2022
National Institute of Allergy and Infectious Diseases
1997-2021
Uganda Virus Research Institute
1994-2021
National Institutes of Health
1997-2021
We examined the influence of viral load in relation to other risk factors for heterosexual transmission human immunodeficiency virus type 1 (HIV-1). In a community-based study 15,127 persons rural district Uganda, we identified 415 couples which one partner was HIV-1–positive and initially HIV-1–negative followed them prospectively up 30 months. The incidence HIV-1 infection per 100 person-years among seronegative partners behavioral biologic variables.
We estimated rates of human immunodeficiency virus (HIV)-1 transmission per coital act in HIV-discordant couples by stage infection the index partner.We retrospectively identified 235 monogamous, a Ugandan population-based cohort. HIV within pairs was confirmed sequence analysis. Rates were partner's (recent seroconversion or prevalent late-stage infection). The adjusted rate ratio multivariate Poisson regression.The average 0.0082/coital (95% confidence interval [CI], 0.0039-0.0150)...
The study tested the hypothesis that community-level control of sexually transmitted disease (STD) would result in lower incidence HIV-1 infection comparison with communities.This randomised, controlled, single-masked, community-based trial intensive STD control, via home-based mass antibiotic treatment, took place Rakai District, Uganda. Ten community clusters were randomly assigned to intervention or groups. All consenting residents aged 15-59 years enrolled; visited home every 10 months;...
Male circumcision significantly reduced the incidence of human immunodeficiency virus (HIV) infection among men in three clinical trials. We assessed efficacy male for prevention herpes simplex type 2 (HSV-2) and papillomavirus (HPV) infections syphilis HIV-negative adolescent boys men.We enrolled 5534 HIV-negative, uncircumcised subjects between ages 15 49 years two trials HIV other sexually transmitted infections. Of these subjects, 3393 (61.3%) were HSV-2-seronegative at enrollment....
To assess the effect of a combination strategy for prevention human immunodeficiency virus (HIV) on incidence HIV infection, we analyzed association between and scale-up antiretroviral therapy (ART) medical male circumcision in Rakai, Uganda. Changes population-level viral-load suppression sexual behaviors were also examined.Between 1999 2016, data collected from 30 communities with use 12 surveys Rakai Community Cohort Study, an open, population-based cohort persons 15 to 49 years age. We...
Background To assess the effects of HIV-1 and other sexually transmitted infections on pregnancy, we undertook cross-sectional prospective studies a rural population in Rakai district, Uganda. Methods 4813 active women aged 15–49 years were surveyed to find out prevalence pregnancy by interview selective urinary human chorionic gonadotropin tests. The incidence recognised conception frequency loss assessed follow-up. Samples taken test for infection, syphilis, diseases. Findings At time...
To assess whether differences in age between sexual partners affect the risk of HIV infection female adolescents and young adults.A total 6177 ever sexually active women aged 15 to 29 years completed a sociodemographic behavior questionnaire provided blood sample for HIV-1 serology. The difference was categorized as men 0 4 older (referent group), 5 9 10 or more older. prevalence incidence were assessed, adjusted RR estimated by multivariate regression.Prevalent participants increased with...
Human immunodeficiency virus type 1 (HIV-1) subtypes differ in biological characteristics that may affect pathogenicity.We determined the HIV-1 subtype-specific rates of disease progression among 350 seroconverters. Subtype, viral load, and CD4(+) cell count were determined. Cox proportional hazards regression modeling was used to estimate adjusted hazard ratios (HRs) acquired syndrome (AIDS) (defined as a < or =250 cells/mm(3)) AIDS-associated death.A total 59.1% study subjects had subtype...
Objective Evidence of condom effectiveness for HIV and sexually transmitted disease (STD) prevention is based primarily on high-risk populations. We examined in a general population with high prevalence rural Africa. Methods Data were from randomized community trial Rakai, Uganda. Condom usage information was obtained prospectively 17 264 active individuals aged 15–59 years over period 30 months. incidence STD determined consistent irregular users, compared to non-users. Adjusted rate ratios...
Background Male circumcision is associated with reduced HIV acquisition. Methods acquisition was determined in a cohort of 5507 HIV-negative Ugandan men, and 187 men discordant relationships. Transmission 223 HIV-positive partners. incidence per 100 person years (py) adjusted rate ratios (RR) 95% confidence intervals (CI) were estimated by Poisson regression. HIV-1 serum viral load for the seropositive partners HIV-discordant couples. Results The prevalence 16.5% all men; 99.1% Muslims 3.7%...
Circumcision is associated with significant reductions in HIV, HSV-2 and HPV infections among men bacterial vaginosis their female partners.We assessed the penile (coronal sulci) microbiota 12 HIV-negative Ugandan before after circumcision. Microbiota were characterized using sequence-tagged 16S rRNA gene pyrosequencing targeting V3-V4 hypervariable regions. Taxonomic classification was performed RDP Naïve Bayesian Classifier. Among 42 unique families identified, Pseudomonadaceae...
Objective: To determine the extent of HIV-1 epidemic in Peru. Design: Part a national serosurvey Methods: Between January 1986 and December 1990, 140 976 serum samples were tested for antibody. Results: antibody was found high percentage provided by 4300 homosexual men (26%), 2204 male sexually transmitted disease patients (10%), 145 drug users (13%), 269 hemophiliacs 146 unlicensed female prostitutes (10%). In addition, prevalence infection increased substantially among these groups between...
Objective: To describe the design and first-round survey results of a trial intensive sexually transmitted disease (STD) control to reduce HIV-1 incidence. Study design: Randomized, controlled, community-based in Rakai District, Uganda. Methods: In this ongoing study, 56 communities were grouped into 10 clusters designed encompass social/sexual networks; within blocks randomly assigned intervention or arm. Every months, all consenting resident adults aged 15–59 years are visited home for...
Background: The efficacy of male circumcision for HIV prevention over 2 years has been demonstrated in three randomized trials, but the longer-term effectiveness is unknown. Methods: We conducted a trial 4996 HIV-negative men aged 15–49 Rakai, Uganda. Following closure, we offered to control participants and have maintained surveillance up 4.79 years. incidence per 100 person-years was assessed an as-treated analysis, estimated using Cox regression models, adjusted sociodemographic...
To estimate 2-year mortality rates in HIV-1-infected and uninfected infants born to HIV mothers.Data are from a prospective study rural Rakai District, Uganda. Infant status (determined by polymerase chain reaction) was evaluated at 1 6 weeks postpartum during breast-feeding, maternal viral load CD4 levels were measured the visit. Multivariate Cox proportional hazards models Kaplan-Meier survival analysis used assess of infant quartiles load. Log-rank tests test equality functions.Of 4604...
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,...
To evaluate the impact of antiretroviral therapy (ART) on HIV-1 transmission rates among discordant couples in Rakai, Uganda.