A5032142932- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV, Drug Use, Sexual Risk
- Global Maternal and Child Health
- Mobile Health and mHealth Applications
- Reproductive tract infections research
- HIV Research and Treatment
- COVID-19 Impact on Reproduction
- ICT in Developing Communities
- Reproductive System and Pregnancy
- Herpesvirus Infections and Treatments
- Reproductive Health and Contraception
- Pregnancy and Medication Impact
- Vaccine Coverage and Hesitancy
- Cytomegalovirus and herpesvirus research
- Preterm Birth and Chorioamnionitis
- Maternal Mental Health During Pregnancy and Postpartum
- Syphilis Diagnosis and Treatment
- HIV/AIDS Impact and Responses
- Cervical Cancer and HPV Research
- Pregnancy and preeclampsia studies
- Diabetes Management and Research
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Immune Cell Function and Interaction
- Neonatal and Maternal Infections
University of Washington
2015-2024
Kenyatta National Hospital
2020-2022
Seattle University
2016-2021
Harborview Medical Center
2019
University of Nairobi
2019
Alberta Bible College
2017
Alberta Health Services
2017
Centers for Disease Control and Prevention
2005
Human natural killer cell diversity is a metric of immune function associated with less effective antiviral response.
Vaccines against SARS-CoV-2 are highly effective in preventing COVID-19 illness. 1,2Research has found that is associated with adverse events pregnancy, 3 and recommendations therefore include offering vaccines to pregnant lactating individuals, despite their lack of inclusion initial clinical trials. 4,5To date, limited data on vaccine pregnancy outcomes exist for lactation. 6The objective this study was investigate experiences individuals after receiving vaccines. MethodsIn January 2021,...
Abstract Background. A human immunodeficiency virus (HIV) risk assessment tool for pregnant women could identify who would most benefit from preexposure prophylaxis (PrEP) while minimizing unnecessary PrEP exposure. Methods. Data a prospective study of incident HIV among pregnant/postpartum in Kenya were randomly divided into derivation (n = 654) and validation 650) cohorts. score was derived using multivariate Cox proportional hazards models standard clinical prediction rules. Ability the...
The objective of this study is to determine the risk and cofactors for HIV acquisition during pregnancy postpartum.
There is growing evidence that mobile health (mHealth) approaches including short messaging service (SMS) can improve antiretroviral therapy (ART) adherence, but consensus lacking regarding communication of HIV-related information. Most interventions to date have delivered SMS do not overtly refer HIV or ART in order avoid risk status disclosure. In formative work for an ongoing randomized controlled trial (RCT) evaluating one-way and two-way educational prevention...
Objectives. To assess the effect of 2-way short message service (SMS) with a nurse on postpartum contraceptive use among individual women and couples. Methods. From 2016 to 2017, we conducted randomized controlled trial at 2 public hospitals in western Kenya. We assigned eligible pregnant receive SMS or no SMS, option include male partners. delivered automated family planning-focused messages weekly until 6 months postpartum. Women men receiving could interact nurses via SMS. In...
Objectives We evaluated the relationship of sexually transmitted infections (STIs) and genital during pregnancy subsequent risk for infant mortality stillbirth. Methods This was a nested longitudinal analysis using data from study peripartum HIV acquisition in Kenya. In parent study, HIV-uninfected women were enrolled followed until 9 months postpartum. For this analysis, who tested positive at any point, had non-singleton or spontaneous abortion <20 weeks excluded. At enrolment,...
Background: Providing HIV self-tests to women for distribution male partners may provide a unique opportunity increase partner and couples testing among in high-burden settings. Methods: Between November 2017 June 2018, we offered at-home or HIV-uninfected seeking routine maternal child health family planning services at eight facilities Kisumu, Kenya. Women accepting were least two (OraQuick) take their partner(s) with instructions on use. self-testing (HIVST) outcomes evaluated using...
Dual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of through increased case detection treatment. We aimed model assess the cost-effectiveness dual during antenatal care in four countries with varying prevalence.In this modelling study, we developed Markov models pregnant women estimate costs infant health outcomes maternal at first visit individual tests (base case) a rapid diagnostic test (scenario one). additionally evaluated retesting late delivery...
Background Pregnant and postpartum women living with HIV (WLWH) need support for maternal child health (MCH) care, which could be provided using short message service (SMS). Methods findings We compared 2-way (interactive) 1-way SMS messaging to no in a 3-arm randomized trial 6 MCH clinics Kenya. Messages were developed the Health Belief Model Social Cognitive Theory; messages integrated into an existing platform. Intervention participants received visit reminders prespecified weekly on...
In Brief OBJECTIVE: To determine whether herpes simplex virus type 2 (HSV-2) infection was associated with risk of intrapartum human immunodeficiency 1 (HIV-1) transmission and to define correlates HSV-2 among HIV-1-seropositive pregnant women. METHODS: We performed a nested case control study within perinatal cohort in Nairobi, Kenya. Herpes serostatus the presence genital ulcers were ascertained at 32 weeks gestation. Maternal cervical plasma HIV-1 RNA HSV DNA measured delivery. RESULTS:...
Background. Cytomegalovirus (CMV) infection is associated with adverse outcomes in human immunodeficiency virus (HIV)–exposed infants. Determinants of vertical CMV transmission the setting maternal HIV-1 are not well-defined. Methods. and levels were measured plasma, cervical secretions, breast milk 147 HIV-1–infected women to define correlates replication infant acquisition. Results. Although few had detectable plasma (4.8%), majority DNA secretions (66%) (99%). There was a strong...
Involving male partners in family planning (FP) education and counseling may improve FP utilization help meet couples' reproductive health needs the postpartum period. We aimed to explore Kenyan men's women's perspectives on an interactive short message service (SMS) approach support decision-making, inform intervention content for a randomized controlled trial (RCT). conducted four focus group discussions (FGD) among men (n = 35) two pregnant/postpartum women 15) western Kenya. Female...
Unmet need for contraception is high during the postpartum period, increasing risk of unintended subsequent pregnancy. We developed a client facing mobile phone-based family planning (FP) decision aid and assessed acceptability, feasibility, utility tool among health care providers women.
Background Studies in HIV-1-infected infants and HIV-1-exposed, uninfected link early cytomegalovirus (CMV) acquisition with growth delay cognitive impairment. We investigated maternal valacyclovir to infant of CMV. Methods Pregnant women HIV-1, HSV-2 CD4 count >250 cells/µl were randomized at 34 weeks gestation 500 mg twice-daily or placebo for 12 months. Maternal CMV DNA was measured plasma gestation, cervical secretions 38 breast milk 7 postpartum timepoints; dried blood spots 8...
Understanding sexual behaviors and vaginal practices of pregnant breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods.HIV-uninfected presenting for antenatal care western Kenya were enrolled followed through 36 weeks postpartum. Sexual behavior ascertained by structured questionnaires. Logistic regression was used assess correlates unprotected sex, washing, drying.Among 1252 enrolled, 78.4% married (of whom 15.1% polygamous unions),...
Abstract While unmet need for contraception is commonly used to assess programmatic needs, it inadequately captures the complexity of fertility and contraceptive preferences, including women's satisfaction with their method. In 2019 commentary, Sarah Rominski Rob Stephenson propose reclassifying dissatisfied current users as having an contraception. As revising definition based on proposal would require significant investment update survey monitoring systems, understanding potential impact...
<h3>Importance</h3> COVID-19 vaccine boosters or third doses are recommended for adolescents and adults who completed their initial course more than 5 months prior. Minimal data available on booster dose reactogenicity among pregnant lactating individuals. <h3>Objective</h3> To describe the reactions to of experiences <h3>Design, Setting, Participants</h3> Beginning in October 2021, a follow-up Research Electronic Data Capture (REDCap) survey regarding was sent 17 504 participants an ongoing...
Objectives Recent studies have identified vaginal bacterial taxa associated with increased HIV risk. A possible mechanism to explain these results is that individual differentially promote cervicovaginal inflammation. This study aimed explore relationships between concentrations of bacteria previously linked acquisition and proinflammatory cytokines chemokines. Methods In this cross-sectional analysis, 17 four (interleukin (IL)-1β, IL-6, IL-10 tumour necrosis factor alpha (TNFα)) two...
Objectives Despite significant public health emphasis on unintended pregnancy prevention among adolescent girls and young women in Sub-Saharan Africa, there is a gap understanding how adolescents’ own reproductive priorities the social influences their decision-making align compete. We examined context of contraceptive Kenyan female adolescents. Methods Using community-based sampling, we conducted 40 in-depth interviews 6 focus group discussions sexually-active or partnered aged 15–19 Nyanza...