Background Cervical cancer (CC) is preventable, yet remains a significant public health threat, particularly in Sub-Saharan Africa. Despite considerable awareness, screening rates for CC Kenya are low and loss to follow-up following treatment premalignant cervical lesions high. This study investigates the efficacy of Cancer Tracking System (CATSystem), web-based intervention, improve retention. Methods A matched, cluster randomized controlled trial will be conducted Kenyan government...

Introduction HIV and cervical cancer are intersecting epidemics that disproportionately affect one of the most vulnerable populations in world: women low‐ middle‐income countries (LMICs). Historically, disparity risk for LMICs has been due to lack organized screening prevention programmes. In recent years, this augmented by severity epidemic LMICs. HIV‐positive at increased developing precancer cancer, while introduction antiretroviral therapy dramatically improved life expectancies among it...

Visual inspection with Acetic Acid (VIA) and Inspection Lugol's Iodine (VILI) are increasingly recommended in various cervical cancer screening protocols low-resource settings. Although VIA is more widely used, VILI has been advocated as an easier specific test. not well-validated a stand-alone test, compared to or validated for use HIV-infected women. We carried out randomized clinical trial compare the diagnostic accuracy of among Women attending Family AIDS Care Education Services (FACES)...

Objective To determine the optimal strategy for cervical cancer screening in women with human immunodeficiency virus (HIV) infection by comparing two strategies: visual inspection of cervix acetic acid (VIA) and VIA followed immediately Lugol's iodine (VIA/VILI) a positive result.Methods Data from programme embedded HIV clinic sites western Kenya were evaluated.Women at central site underwent VIA, while peripheral VIA/VILI.All intraepithelial neoplasia grade 2 or worse (CIN 2+) on and/or...

Visual inspection with acetic acid (VIA) is becoming a more widely recommended and implemented screening tool for cervical cancer prevention programs in low-resource settings. Many of these settings have high prevalence HIV-infected women. We carried out cross-sectional validation study to define the sensitivity, specificity predictive values VIA among Women enrolled HIV care at Family AIDS Care Education Services clinic Kisumu, Kenya, were recruited participation. All participants underwent...

The incidence of cervical cancer in Kenya is among the highest world. Few Kenyan women are able to access screening, thus fueling high burden. Self-collected human papilloma Virus (HPV) tests, administered during community-health campaigns rural areas may be a way expand screening.In December 2015, we carried out four-day community health campaign (CHC) educate participants about prevention and offer self-administered HPV screening. Community enumeration, outreach mobilization preceded CHC....

In Brief Objective Approximately 85% of cervical cancer cases and deaths occur in resource-constrained countries where best practices for prevention, particularly women with HIV infection, still need to be developed. The aim this study was assess prevention capacity select clinics located countries. Materials Methods A cross-sectional survey sub-Saharan African sites 4 National Institutes Health–funded HIV/AIDS networks conducted. Sites were surveyed on the availability screening treatment...

HIV and cervical cancer are intersecting epidemics in many low-resource settings, yet there few accurate estimates of the scope this public health challenge. To understand disease prevalence risk factors for intraepithelial neoplasia 2 or greater (CIN2+), we conducted a cross-sectional study women undergoing screening as part routine care Kisumu, Kenya. Women were offered with visual inspection acetic acid, followed by confirmation colposcopy biopsy needed. Univariable multivariable analyses...

HIV-infected women may have higher rates of recurrent cervical precancer after treatment. Knowledge about and predictors recurrence could impact guidelines program planning, especially in low-resource settings.In this prospective cohort study Western Kenya, we followed at 6 12 months treatment for intraepithelial neoplasia 2 or greater (CIN2+) with loop electrosurgical excision procedure (LEEP). All underwent follow-up colposcopy biopsy as indicated the diagnosis CIN2+. We calculated...

Infant HIV diagnosis by DNA polymerase chain reaction (PCR) testing at the standard 6 weeks of age is often late to mitigate mortality peak that occurs in positive infants' first 2-3 months life. Kenya recently revised their early infant (EID) guidelines include PCR birth (pilot only), weeks, months, and 12 postnatal a final 18-month antibody test. The World Health Organization (WHO) approved point-of-care (POC) diagnostic platforms for resource-limited countries could simplify logistics...

Background Prevention of mother to child transmission HIV (PMTCT) services are critical achieve national and global targets 90% antiretroviral therapy (ART) coverage in PMTCT, rates less than 5%. In 2012, Kenya adopted WHO's recommended ART regimen for PMTCT "Option B+". Aims This study assesses progress made adopting these new guidelines associated outcomes. Methods We analysed programmatic data 2604 mother–infant pairs enrolled the Infant Tracking System (HITSystem) at four government...

HIV-infected women are at increased risk for recurrence of cervical dysplasia after treatment. Short-term rates may reflect treatment efficacy and therefore impact screening protocols follow-up planning. We conducted a prospective study 297 undergoing loop electrosurgical excision procedure intraepithelial neoplasia 2+ (CIN2+) in an HIV clinic Kisumu, Kenya. By 6 months the procedure, 20 (7.1%) had recurrent CIN2+. Recurrence was significantly associated with CD4 nadir but not highly active...

Background At-birth and point-of-care (POC) HIV testing are emerging strategies to streamline infant diagnosis expedite ART initiation for HIV-positive infants. The purpose of this qualitative study was evaluate factors influencing the provision acceptance at-birth POC among both care providers parents HIV-exposed infants in Kenya. Methods We conducted semi-structured interviews with 26 35 (including 23 mothers, 6 fathers, 3 mother-father pairs) at four hospitals prior implementation. An...

Abstract Background Some studies indicate that pregnant Kenyan women were concerned about Coronavirus disease 2019 (COVID-19) exposure during maternity care. We assessed concern regarding COVID-19 and any impact on antenatal care (ANC) enrollment and/or hospital delivery among living with human immunodeficiency virus (HIV) in Kenya. Methods Data collected from 1,478 HIV enrolled prevention of mother to child transmission (PMTCT) at 12 hospitals October 2020 July 2022. Surveys conducted when...

Background Current formulations of pediatric antiretroviral therapy (ART) for children with HIV present significant barriers to adherence, leading drug resistance, ART ineffectiveness, and preventable child morbidity mortality. Understanding these challenges how they contribute suboptimal adherence is an important step in improving outcomes. This qualitative study describes regimen-related create impact families. Methods We conducted key informant interviews (KIIs) 30 healthcare providers 9...

Early infant diagnosis (EID) involves age-specific tracking and testing of HIV-exposed infants during the first 18 months life rapid initiation life-saving treatment for those infected. In Kenya, pre-2013 data estimate EID lost to follow-up (LTFU) at 39–65%, yet no study has documented LTFU rates predictors throughout cascade since Option B+ fundamentally changed services by placing all HIV-positive expectant mothers on lifelong treatment. Using an explanatory mixed-method design, we...

Kenya introduced universal antiretroviral treatment (ART) for pregnant and breastfeeding women living with HIV (Option B+) in 2014. A retrospective study was conducted to review consecutive records positive presenting antenatal care (ANC) at five clinics western Kenya. Known (KP :HIV diagnosis prior current pregnancy) were compared newly (NP) regarding virologic suppression retention care. Among 165 included, 71 (43%) NP 94 (57%) KP, younger (24.5 years (SD 4.6) vs. 28.1 5.6) KP (p < .001)....

Background Kenya’s guidelines for prevention of mother-to-child transmission HIV (PMTCT) recommend routine viral load (VL) monitoring pregnant and breastfeeding women. Method We assessed PMTCT VL clinical action occurring between last menstrual period (LMP) 6 months postpartum at 4 Kenyan government hospitals. Pregnant women enrolled in the Infant Tracking System from May 2016-March 2018 were included. computed proportions who received testing within recommended timeframes after unsuppressed...

Background Testing infants at birth and with more efficient point of care (POC) HIV diagnostic can streamline EID expedite infant ART initiation. We evaluated the implementation 6-week POC testing to assess effectiveness feasibility when implemented by existing hospital staff in Kenya. Methods Four government hospitals were randomly assigned receive a GeneXpert HIV-1 Qual (n = 2) or Alere m-PIMA machine for testing. All HIV-exposed enrolled eligible 6-weeks age. The primary outcome was...