A5017723469- 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
- HIV/AIDS Impact and Responses
- ICT in Developing Communities
- Adolescent and Pediatric Healthcare
- HIV Research and Treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- Data Quality and Management
- HIV-related health complications and treatments
- Sex work and related issues
- Child Nutrition and Water Access
- HIV/AIDS drug development and treatment
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Ethics in Clinical Research
- Blood Pressure and Hypertension Studies
University of Washington
2018-2024
Kenyatta National Hospital
2020-2024
Seattle University
2024
GoCare Health Solutions Limited
2021
University of Nairobi
2018-2020
Background Young women account for a disproportionate fraction of new HIV infections in Africa and are priority population prevention, including implementation preexposure prophylaxis (PrEP). The overarching goal this project was to demonstrate the feasibility integrating PrEP delivery within routine family planning (FP) clinics serve as platform efficiently reach at-risk adolescent girls young (AGYW) high-burden settings. Methods findings Implementation Women Adolescents (PrIYA) program is...
Programmatic approaches for delivering pre-exposure prophylaxis (PrEP) to pregnant and postpartum women in settings with high HIV burden are undefined. The PrEP Implementation Young Women Adolescents (PrIYA) Program developed maternal child health (MCH) clinics.Under the PrIYA Program, nurse-led teams worked MCH staff at 16 public, faith-based, private facilities Kisumu, Kenya, determine optimal clinic flow integration into antenatal care (ANC) postnatal (PNC). A program-dedicated nurse...
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...
Understanding the cost of strategies to reach and deliver pre-exposure prophylaxis (PrEP) priority populations is essential assess cost-effectiveness budget impact HIV prevention programmes. Providing PrEP through maternal child health family planning clinics offers a promising strategy women in high burden settings. We estimated incremental costs explored drivers integrating delivery into routine services Kenya.We conducted costing study from provider perspective within Implementation for...
<h3>ABSTRACT</h3> <h3>Introduction:</h3> We evaluated a 2-way short message service (SMS) communication platform to improve continuation of pre-exposure prophylaxis (PrEP) for HIV prevention among Kenyan women who initiated PrEP within routine maternal child health (MCH) and family planning clinics. <h3>Methods:</h3> adapted an existing SMS (Mobile WACh [mWACh]) send PrEP-tailored, theory-based allow clients communicate with remote nurse. Women did not have were initiating at 2 MCH/family...
Abstract Introduction Assisted partner services (APS) is an effective strategy for increasing HIV testing, new diagnosis, and linkage to care among sexual partners of people living with (PLWH). APS can be resource intensive as it requires community tracing locate each named offer them testing. There limited evidence the effectiveness offering self‐testing (HIVST) option testing within APS. Methods We conducted a cluster randomized controlled trial comparing provider‐delivered (Standard APS)...
Objectives This study explores factors affecting community-level demand for assisted partner services (APS) and HIV testing (HTS) in western Kenya. Design is a multilevel qualitative analysis conducted as part of the APS Scale-up Study, hybrid type 2 implementation-effectiveness integrated within routine HTS. For this analysis, in-depth phone interviews assessed influencing decisions to participate APS. Setting Participants were recruited from eight healthcare facilities (for stakeholders)...
Abstract Introduction The World Health Organization, while recommending pre‐exposure prophylaxis (Pr EP ) for HIV ‐negative pregnant and postpartum women in high‐burden settings, advocates continued safety evaluation of Pr this population. Methods Implementation Young Women Adolescents IYA program delivered to integrated within routine maternal child health clinics ( MCH at 16 sites Western Kenya. exposure perinatal outcome data were collected among obtaining postnatal services during...
Background Delivery of PrEP to adolescent girls and young women (AGYW) pregnant through maternal child health (MCH) family planning (FP) clinics is scaling up in Kenya. Evaluation implementation challenges strategies critical optimize delivery. Methods We conducted focus group discussions (FGDs) with healthcare workers (HCWs) MCH FP offering a large project Kisumu, Discussion guides were based on the Consolidated Framework for Implementation Research (CFIR). FGDs audio recorded transcribed....
HIV assisted partner services (aPS) is an intervention to improve status awareness among sex and drug-injecting partners of people newly diagnosed with (index clients). Implementation fidelity-the degree which conducted as intended - critical effectiveness, but there are limited data about aPS fidelity when delivered by testing service (HTS) providers. We explored factors affecting implementation in two high-HIV prevalence counties western Kenya.
We assessed prevalence of human immunodeficiency virus (HIV) risk behaviors and depressive symptoms among adolescent girls young women (AGYW) aged 15–24 years attending four public family planning clinics in Western Kenya from January to June 2019. Moderate-to-severe depression (MSD) was defined as a Center for Epidemiologic Studies Depression Scale (CESD-10) score ≥10. Among 487 AGYW, the median age 22 (interquartile range 20–23), 59 (12%) AGYW reported MSD. MSD more prevalent without...
Despite the effective scale-up of HIV testing and treatment programs, only 75% people living with (PLWH) globally know their status, this rate is lower among men. This highlights importance implementing linkage interventions a high uptake in population. In cluster randomized controlled trial conducted Kenya between 2013 2015, we found that assisted partner services (APS) for HIV-exposed partners newly diagnosed PLWH safely reached more individuals compared client referral alone. However,...
Assisted partner service (APS) is effective for increasing HIV testing services (HTS) uptake among sexual partners of people diagnosed with rare social harm. The acceptability APS to HTS providers important the quality and effectiveness delivery. Within a larger ongoing implementation science study in western Kenya, we qualitatively evaluated provider APS.From May-June 2020, conducted virtual, semi-structured in-depth interviews 14 recruited from 8 31 health facilities Homa Bay Kisumu...
In a pre-exposure prophylaxis program for Kenyan women, we detected tenofovir-diphosphate in 61% (125/201) of randomly selected dried blood spots collected at the first follow-up visit. Tenofovir-diphosphate was more frequently among women who had partners living with human immunodeficiency virus, were not pregnant, and ≥24 years.
Introduction Adolescent girls and young women (AGYW) in sub-Saharan Africa are at high risk of HIV acquisition. Pre-exposure prophylaxis (PrEP) demonstration projects observe that AGYW uptake adherence to PrEP during periods is suboptimal. Judgemental interactions with healthcare workers (HCW) inadequate counselling can be barriers use among AGYW. Improving HCW competency communication support delivery requires new strategies. Methods analysis Implementation for Young Women Adolescents...
Escudero, Jaclyn N. MPH; Dettinger, Julia C. Pintye, Jillian RN, MPH, PhD; Kinuthia, John MBChB, MMed, Lagat, Harison BSN, Abuna, Felix BA; Kohler, Pamela Baeten, Jared M. MD, O'Malley, Gabrielle John-Stewart, Grace Beima-Sofie, Kristin PhD Author Information
Assisted partner services (aPS) involves notification and HIV testing for sexual partners of persons diagnosed HIV-positive (index clients). Because the impact aPS is contingent on high acceptance, we assessed characteristics reasons nonenrollment among female index clients in an ongoing scale-up project.We analyzed data from females offered 31 facilities May 2018 to August 2019. We compared sociodemographic by enrollment (accepted, refused, ineligible) used multivariate binomial regression...
Assisted partner services (APS), or notification for sexual partners of people diagnosed with HIV, is an efficient, effective, and high yield strategy to identify living HIV recommended by the World Health Organization (WHO). However, there remains a need further understand acceptability APS qualitatively from client lens, particularly when integrated into national health system. We investigated in Kenya.Starting May 2018, was implemented 31 facilities Kisumu Homa Bay counties western Kenya....
Abstract Background In Kenya, 65% of sexually active unmarried women use modern contraceptives, a population at increased risk HIV acquisition compared to other populations. Anchoring prevention services, including pre-exposure prophylaxis (PrEP), trusted contraceptive delivery settings offers opportunities efficiently reach this important population. almost half (40%) accessing contraception services do so outside traditional healthcare facilities, such as retail pharmacies. Thus,...
Abstract Introduction Assisted partner services (APS), or exposure notification and HIV testing for sexual partners of persons diagnosed positive (index clients), is recommended by the World Health Organization. Most APS literature focuses on outcomes among index clients their partners. There little data benefits providing to with HIV. Methods We utilized from a large‐scale implementation project across 31 facilities in western Kenya 2018 2022. Females at were offered APS; those who...
Assisted partner service (aPS) augments HIV case-finding among sex partners to individuals newly diagnosed with HIV. In 2016, aPS was incorporated into the national testing services (HTS) program in Kenya. We evaluated extent of, barriers to, and facilitators of integration HTS. conducted semi-structured in-depth interviews (IDIs) 32 stakeholders selected using purposive sampling at national, county, facility, community levels. IDIs were two timepoints, baseline from August-September 2018...
Pre-exposure prophylaxis (PrEP) uptake and adherence among adolescent girls young women (AGYW) may be negatively influenced by poor interactions with health care providers. We assessed PrEP counseling using unannounced standardized patient actors (USPs) at routine clinics in Kenya. Trained posed as AGYW seeking services following case scripts completed a checklist of provider to national guidelines communication skills. Scores were converted into percentage compared linear regression. The...