A5064264671- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- Tuberculosis Research and Epidemiology
- HIV Research and Treatment
- Global Maternal and Child Health
- HIV/AIDS Impact and Responses
- SARS-CoV-2 detection and testing
- SARS-CoV-2 and COVID-19 Research
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV-related health complications and treatments
- Global Public Health Policies and Epidemiology
- HIV/AIDS drug development and treatment
- Vaccine Coverage and Hesitancy
- Sex work and related issues
- Poverty, Education, and Child Welfare
- Respiratory viral infections research
- Blood Pressure and Hypertension Studies
- Biosensors and Analytical Detection
- Advanced Causal Inference Techniques
- COVID-19 epidemiological studies
- Healthcare Systems and Reforms
- Pneumonia and Respiratory Infections
- Viral Infections and Outbreaks Research
- Migration, Health and Trauma
University of California, San Francisco
2016-2025
University of California System
2016-2025
Moscow Institute of Thermal Technology
2024
San Francisco General Hospital
2013-2023
University of San Francisco
2023
Washington University in St. Louis
2022
National Institute of Allergy and Infectious Diseases
2022
Office of Infectious Diseases
2016-2019
Universidade de Pernambuco
2019
San Francisco AIDS Foundation
2010-2017
Neutralizing autoantibodies against type I interferons (IFNs) have been found in some patients with critical coronavirus disease 2019 (COVID-19), the caused by severe acute respiratory syndrome 2 (SARS-CoV-2). However, prevalence of these antibodies, their longitudinal dynamics across severity scale, and functional effects on circulating leukocytes remain unknown. Here, 284 COVID-19, we IFN–specific peripheral blood samples from 19% 6% disease. We no IFN individuals moderate Longitudinal...
Universal antiretroviral therapy (ART) with annual population testing and a multidisease, patient-centered strategy could reduce new human immunodeficiency virus (HIV) infections improve community health.We randomly assigned 32 rural communities in Uganda Kenya to baseline HIV multidisease national guideline-restricted ART (control group) or plus testing, eligibility for universal ART, care (intervention group). The primary end point was the cumulative incidence of infection at 3 years....
Abstract We evaluated the performance of Abbott BinaxNOW rapid antigen test for coronavirus disease 2019 (Binax-CoV2) to detect virus among persons, regardless symptoms, at a public plaza site ongoing community transmission. Titration with cultured severe acute respiratory syndrome 2 yielded human observable threshold between 1.6 × 104-4.3 104 viral RNA copies (cycle [Ct], 30.3–28.8). Among 878 subjects tested, 3% (26 878) were positive by reverse-transcription polymerase chain reaction,...
Men's uptake of HIV testing is critical to the success "test and treat" strategies in generalized epidemics. This study sought identify cultural factors community processes that influence men's baseline year an ongoing test-and-treat trial among 334,479 persons eastern Africa (SEARCH, NCT#01864603). Data were collected using participant observation at mobile health campaigns (CHCs) (n = 28); focus group discussions 8 groups) with CHC participants; in-depth interviews care providers 50),...
Background The high burden of undiagnosed HIV in sub-Saharan Africa limits treatment and prevention efforts. Community-based testing campaigns can address this challenge provide an untapped opportunity to identify non-communicable diseases (NCDs). We tested the feasibility diagnostic yield integrating NCD communicable into a rapid referral campaign for all residents rural Ugandan parish. Methods A five-day, multi-disease campaign, offering diagnostic, preventive, services, was performed May...
Antiretroviral treatment (ART) is now recommended for all HIV-positive persons. UNAIDS has set global targets to diagnose 90% of individuals, treat diagnosed individuals with ART, and suppress viral replication among treated a population-level target 73% persons HIV suppression.To describe changes in the proportions suppression, who had received diagnosis, following implementation community-based testing program rural East Africa.Observational analysis based on interim data from 16 Kenyan (n...
Optimal strategies for pre-exposure prophylaxis (PrEP) engagement in generalised HIV epidemics are unknown. We aimed to assess PrEP uptake and after population-level testing universal access characterise gaps the cascade rural Kenya Uganda.
Achieving HIV epidemic control globally will require new strategies to accelerate reductions in incidence and mortality. Universal test treat (UTT) was evaluated four randomized population-based trials (BCPP/Ya Tsie, HPTN 071/PopART, SEARCH, ANRS 12249/TasP) conducted sub-Saharan Africa (SSA) during expanded antiretroviral treatment (ART) eligibility by World Health Organization guidelines the UNAIDS 90-90-90 campaign.
Abstract Background There is an urgent need to understand the dynamics and risk factors driving ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during shelter-in-place mandates. Methods We offered SARS-CoV-2 reverse-transcription polymerase chain reaction (PCR) antibody (Abbott ARCHITECT IgG) testing, regardless of symptoms, all residents (aged ≥4 years) workers in a San Francisco census tract (population: 5174) at outdoor, community-mobilized events over 4...
Among 3302 persons tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by BinaxNOWTM and reverse transcription polymerase chain reaction (RT-PCR) in a community setting, rapid assay sensitivity was 100%/98.5%/89% using RT-PCR cycle thresholds of 30, 35, no threshold. The specificity 99.9%. Performance high across ages those with without symptoms. Rapid resulting permitted immediate public health action.
There is an increasing burden of hypertension (HTN) across sub-Saharan Africa where HIV prevalence the highest in world, but current care models are inadequate to address dual epidemics. treatment infrastructure could be leveraged for other chronic diseases, including HTN. However, little data exist on effectiveness integrated and disease delivery systems blood pressure control over time.Population screening HTN, among was conducted ten communities rural Uganda as part SEARCH study...
COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized a community-centered vaccination strategy included mobilization, vaccination, "activation" components could successfully reach an underserved population, utilizing its social networks boost coverage.
Oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but data are limited on incidence among PrEP users in generalized epidemic settings, particularly outside of selected risk groups. We performed a population-based study rural Kenya and Uganda sought to evaluate both changes clinical virologic outcomes following seroconversion PrEP.During population-level testing individuals ≥15 years 16 communities the Sustainable East Africa Research Community Health (SEARCH)...
SARS-CoV-2 rapid antigen tests are an important public health tool.
Characterizing the clinical symptoms and evolution of community-based SARS-CoV-2 infections may inform health practitioners public officials in a rapidly changing landscape population immunity viral variants.To compare COVID-19 among people testing positive with rapid antigen test (RAT) during Omicron BA.1 variant period (December 1, 2021, to January 30, 2022) pre-Delta (January 10 May 31, 2021) Delta (June 1 November periods assess duration RAT positivity surge.This cross-sectional study...
Background: Pregnant and postpartum women in Sub-Saharan Africa are at high risk of HIV acquisition. We evaluated a person-centered dynamic choice intervention for prevention (DCP) among attending antenatal postnatal care. Setting: Rural Kenya Uganda. Methods: Women (aged 15 years or older) acquisition seen care clinics were individually randomized to DCP vs. standard (SEARCH; NCT04810650). The included structured client product (daily oral pre-exposure prophylaxis postexposure prophylaxis),...
Background Antiretroviral therapy scale-up in Sub-Saharan Africa has created a growing, aging HIV-positive population at risk for non-communicable diseases such as hypertension. However, the prevalence and factors hypertension this remain incompletely understood. Methods We measured blood pressure collected demographic data on over 65,000 adults attending multi-disease community health campaigns 20 rural Ugandan communities (SEARCH Study: NCT01864603). Our objectives were to determine (i)...
Background The high burden of undiagnosed HIV in sub-Saharan Africa is a major obstacle for prevention and treatment. Multi-disease, community health campaigns (CHCs) offering testing are successful approach to rapidly increase rates identify HIV. However, greater understanding population-level uptake needed maximize effectiveness this approach. Methods After sensitization census, five-day campaign was performed May 2012 rural Ugandan community. census enumerated all residents, capturing...
We sought to measure retention in care and identify predictors of nonretention among patients receiving antiretroviral therapy (ART) with streamlined delivery during the first year ongoing Sustainable East Africa Research on Community Health (SEARCH) 'test-and-treat' trial (NCT 01864603) rural Uganda Kenya.Prospective cohort intervention arm SEARCH study.We measured at 12 months HIV-infected adults who linked were offered ART regardless CD4 cell count, following community-wide HIV-testing....
In generalized epidemic settings, strategies are needed to prioritize individuals at higher risk of human immunodeficiency virus (HIV) acquisition for prevention services. We used population-level HIV testing data from rural Kenya and Uganda construct scores assessed their ability identify seroconversions.During 2013-2017, >75% residents in 16 communities the SEARCH study were tested annually HIV. this population, we evaluated 3 using demographic factors predict 1-year seroconversion:...
Background After a COVID-19 diagnosis, vulnerable populations face considerable logistical and financial challenges to isolate quarantine. We developed evaluated novel, community-based approach ('Test-to-Care' Model) designed address these barriers for socioeconomically Latinx individuals with newly diagnosed their households. Methods This three-week demonstration project was nested within an epidemiologic surveillance study in primarily neighborhood the Mission district of San Francisco,...
ABSTRACT We evaluated the performance of Abbott BinaxNOW™ Covid-19 rapid antigen test to detect virus among persons, regardless symptoms, at a public plaza site ongoing community transmission. Titration with cultured clinical SARS-CoV-2 yielded human observable threshold between 1.6×10 4 -4.3×10 viral RNA copies (cycle (Ct) 30.3-28.8 in this assay). Among 878 subjects tested, 3% (26/878) were positive by RT-PCR, which 15/26 had Ct<30, indicating high load. 40% (6/15) Ct<30...