A5061093530- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- HIV-related health complications and treatments
- Adolescent Sexual and Reproductive Health
- HIV/AIDS drug development and treatment
- Genital Health and Disease
- Mobile Health and mHealth Applications
- Urological Disorders and Treatments
- HIV, Drug Use, Sexual Risk
- Behavioral Health and Interventions
- Digital Mental Health Interventions
- Neuroinflammation and Neurodegeneration Mechanisms
- Urban Transport and Accessibility
- Urologic and reproductive health conditions
- Ethics and Legal Issues in Pediatric Healthcare
- Mosquito-borne diseases and control
- Reproductive tract infections research
- Maternal Mental Health During Pregnancy and Postpartum
- Neurological Complications and Syndromes
- Health Policy Implementation Science
- Innovative Approaches in Technology and Social Development
- COVID-19 epidemiological studies
- Urinary and Genital Oncology Studies
- Bacterial Infections and Vaccines
- Migraine and Headache Studies
Rakai Health Sciences Program
2018-2025
Uganda Virus Research Institute
2022
National Institute of Allergy and Infectious Diseases
2018
National Institutes of Health
2018
Genital inflammation increases HIV susceptibility and is associated with the density of pro-inflammatory anaerobes in vagina coronal sulcus. The penile urethra a critical site acquisition, although correlates urethral acquisition are largely unknown. While Streptococcus mitis consistent component flora, presence Gardnerella vaginalis has been linked prior penile-vaginal sex inflammation. Here, we use flow cytometry-based bacterial assay to quantify IgA IgG that bind G. S. cross-sectional...
SummaryBackgroundThe persistence of a replication-competent latent viral reservoir (RC-LVR) during antiretroviral therapy (ART) is barrier to the development cure for HIV-1, but role genes in influencing RC-LVR size unclear. We aimed assess whether magnitude by which HIV-1 accessory protein Nef evades adaptive immune response downregulating MHC-I or CD4, both, from surface infected cells associated with rate at people changes long-term ART (>1 year).MethodsWe conducted an exploratory cohort...
To date, an affordable, effective treatment for HIV-1 cure remains only a concept with most "latency reversal" agents (LRAs) lacking specificity the latent reservoir and failing in early clinical trials. We assessed latency reversal using multivalent HIV-1-derived virus-like particle (HLP) to treat samples from 32 people living (PLWH) Uganda, US Canada who initiated combined antiretroviral therapy (cART) during chronic infection. Even after 5-20 years on stable cART, HLP could target CD4
Introduction The phenotypic expression of mental health (MH) conditions among people with HIV (PWH) in Uganda and worldwide are heterogeneous. Accordingly, there has been a shift toward identifying MH phenotypes using data-driven methods capable novel insights into mechanisms divergent PWH. We leverage the analytic strengths machine learning combined inferential to identify PWH underlying explanatory features. Methods A total 277 (46% female, median age = 44; 93% virally suppressed...
Background: HIV infection results in immunometabolic reprogramming. While we are beginning to understand how this metabolic reprogramming regulates the immune response infection, do not currently impact of ART on immunometabolism people with (PWH). Methods: Serum obtained from HIV-infected (n = 278) and geographically matched seronegative control subjects 300) Rakai Uganda were used study. was before ~2 years following initiation individuals. We conducted metabolomics profiling serum focused...
Coronal sulcus (CS) anaerobe abundance and IL-8 levels are linked to HIV acquisition, dramatically reduced after penile circumcision (PC). The distal urethra may be the site of some acquisition before PC, presumably most post PC. We describe immune milieu microbiome in uncircumcised Ugandan men, define impact Participants consisted HIV-negative, genital symptom-free adult men undergoing PC (n = 51). Urethral coronal swabs were collected at baseline 6- 12-months post-PC. Soluble factors...
Abstract The primary obstacle to curing HIV-1 is a reservoir of CD4+ cells that contain stably integrated provirus. Previous studies characterizing the proviral landscape, which have been predominantly conducted in males United States and Europe living with subtype B, revealed most proviruses persist during antiretroviral therapy (ART) are defective. In contrast, less known about landscapes females non-B subtypes, represents largest group individuals HIV-1. Here, we analyze genomic DNA from...
Combination antiretroviral therapy (ART) improves HIV-associated neurocognitive disorder (HAND) stage in the United States where subtype B predominates, but effect of ART and on HAND individuals Uganda with subtypes D A is largely unknown.A community-based cohort participants residing Rakai, Uganda.Three hundred ninety-nine initially ART-naive HIV-seropositive (HIV+) were followed up over 2 years. Neurological neuropsychological tests functional assessments used to determine stage. Frequency...
Background Effective implementation strategies are needed to increase engagement in HIV services hyperendemic settings. We conducted a pragmatic cluster-randomized trial high-risk, highly mobile fishing community (HIV prevalence: approximately 38%) Rakai, Uganda, assess the impact of health worker-delivered, theory-based (situated Information, Motivation, and Behavior Skills), motivational interviewing-informed, phone application-supported counseling strategy called “Health Scouts” promote...
BackgroundThe principal barrier to an HIV cure is the presence of latent viral reservoir (LVR), which has been understudied in African populations. From 2018 2019, Uganda instituted a nationwide rollout ART consisting Dolutegravir (DTG) with two NRTI, replaced previous regimen one NNRTI and same NRTI.MethodsChanges inducible replication-competent LVR (RC-LVR) ART-suppressed Ugandans (n = 88) from 2015 2020 were examined using quantitative outgrowth assay. Outgrowth viruses for evolution....
Valid, reliable behavioral data and contextually meaningful interventions are necessary for improved health outcomes. Ecological Momentary Assessment Intervention (EMAI), which collects as behaviors occur to deliver real-time interventions, may be more accurate than retrospective methods. The rapid expansion of mobile technologies in low-and-middle-income countries allows unprecedented remote collection intervention opportunities. However, no previous studies have trialed EMAI sub-Saharan...
Background: HIV-associated neurocognitive disorders remain prevalent despite effective antiretroviral therapy (ART), but there are limited longitudinal data on people living with HIV (PLWH) in sub-Saharan Africa. We examined neuropsychological (NP) performance PLWH a study Uganda. Methods: Participants enrolled through the Rakai Community Cohort Study (400 ART-naive and 400 matched HIV-negative persons) were administered NP assessments. In 2017, who had initiated ART underwent 2-year...
An extraordinary increase in mobile phone ownership has revolutionized the opportunities to use health approaches lower- and middle-income countries (LMICs). Ecological momentary assessment intervention (EMAI) uses technology gather data deliver timely, personalized behavior change interventions an individual's natural setting. To our knowledge, there have been no previous trials of EMAI sub-Saharan Africa.
Background Effective models of support for HIV pre-exposure prophylaxis (PrEP) are needed populations at elevated risk. In a hyperendemic Ugandan fishing community, PrEP counseling was provided through situated Information, Motivation, and Behavioral Skills (sIMB)-based community health worker (CHW) intervention. We evaluated the intervention using mixed-methods, implementation science design. Methods surveyed all members aged 15-49 Rakai Community Cohort Study. used multivariable logistic...
BackgroundUse of medical devices represents a unique opportunity to facilitate scale-up early infant male circumcision (EIMC) across sub-Saharan Africa. The ShangRing, device prequalified by WHO, is approved for use in adults and adolescents requires topical anaesthesia only. We aimed investigate the safety efficacy ShangRing versus Mogen clamp EIMC infants eastern Africa.MethodsIn this multicentre, non-inferiority, open-label, randomised controlled trial, we enrolled healthy (aged <60...
Background: We assessed the utility of International HIV Dementia Scale (IHDS) in detecting HIV-associated neurocognitive disorder (HAND) Uganda antiretroviral (ART)-naïve and ART-experienced adults. Setting: A longitudinal observational cohort study Rakai, Uganda. Methods: Three hundred ninety-nine HIV+ ART-naïve adults underwent neurological, functional status, neuropsychological assessments including IHDS. twelve participants who initiated ART were re-evaluated after 2 years. HAND stages...