A5061524973- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV/AIDS Impact and Responses
- Poverty, Education, and Child Welfare
- HIV, Drug Use, Sexual Risk
- Global Maternal and Child Health
- Child Nutrition and Water Access
- Sex work and related issues
- HIV Research and Treatment
- Homelessness and Social Issues
- Food Security and Health in Diverse Populations
- Children's Rights and Participation
- HIV-related health complications and treatments
- Reproductive tract infections research
- COVID-19 epidemiological studies
- African Sexualities and LGBTQ+ Issues
- Syphilis Diagnosis and Treatment
- Vaccine Coverage and Hesitancy
- Family and Disability Support Research
- Microfinance and Financial Inclusion
- Early Childhood Education and Development
- Gender Roles and Identity Studies
- Global Health and Epidemiology
- HIV/AIDS drug development and treatment
- Public Health Policies and Education
Biomedical Research and Training Institute
2016-2025
Imperial College London
2016-2025
Medical Research Council
2023-2025
London Centre for Neglected Tropical Disease Research
2019-2023
London School of Economics and Political Science
2013-2020
St Mary's Hospital
2020
Imperial Valley College
2017-2020
Ministry of Health and Child Welfare
2010-2017
Creative Commons
2016-2017
Joint United Nations Programme on HIV/AIDS
2002-2017
Few sub-Saharan African countries have witnessed declines in HIV prevalence, and only Uganda has compelling evidence for a decline founded on sexual behavior change. We report prevalence eastern Zimbabwe between 1998 2003 associated with change four distinct socioeconomic strata. fell most steeply at young ages-by 23 49%, respectively, among men aged 17 to 29 years women 15 24 years-and more educated groups. Sexually experienced reported reductions casual sex of 49 22%, whereas recent...
A growing number of studies highlight men's disinclination to make use HIV services. This suggests there are factors that prevent men from engaging with health services and an urgent need unpack the forms sociality determine acceptance or rejection services.Drawing on perspectives 53 antiretroviral drug users 25 healthcare providers, we examine qualitatively how local constructions masculinity in rural Zimbabwe impact services.Informants reported a clear hegemonic notion required be act...
Objective: To monitor the HIV-1 epidemic in Western Uganda and possible impact of interventions. Design: Results from sentinel surveillance seroprevalence were compared with cross-sectional serosurvey data model simulations. Methods: Age-specific trends prevalence between 1991 1997 amongst antenatal clinic (ANC) attenders town Fort Portal, where a comprehensive AIDS control programme has been implemented since 1991, analysed. outputs mathematical simulating Uganda. Two scenarios modelled:...
Objectives: To examine the determinants of uptake voluntary counselling and testing (VCT) services, to assess changes in sexual risk behaviour following VCT, compare HIV incidence amongst testers non-testers. Methods: Prospective population-based cohort study adult men women Manicaland province eastern Zimbabwe. Demographic, socioeconomic, VCT utilization data were collected at baseline (1998–2000) follow-up (3 years later). status was determined by HIV-1 antibody detection. In addition...
Sexually transmitted infections spread through a network of contacts created by the formation sexual partnerships. In physics, networks have been characterized as "scale-free" if they follow power law with an exponent between 2 and 3.The objective this study was to test statistically whether distributions numbers partners reported from different populations are well described laws.Power laws exponential null model fitted maximum likelihood techniques partners. Data taken 4 population-based...
We measured the psychosocial effect of orphanhood in a sub-Saharan African population and evaluated new framework for understanding causes consequences distress among orphans other vulnerable children.The was using data from 5321 children aged 12 to 17 years who were interviewed 2004 national survey Zimbabwe. constructed measure principle components analysis. used regression analyses obtain standardized parameter estimates odds ratios early sexual activity.Orphans had more than did...
Abstract An orphan enumeration survey was conducted in 570 households and around Mutare, Zimbabwe 1992; 18.3% (95% CI 15.1-21.5%) of included orphans. 12.8% 11.2-14.3%) children under 15 years old had a father or mother who died; 5% orphans lost both parents. Orphan prevalence highest peri-urban rural area (17.2%) lowest middle income medium density urban suburb (4.3%). Recent increases parental deaths were noted; 50% since 1987 could be ascribed to AIDS. household heads likely older less...
AIDS has increased the number of orphans and vulnerable children (OVCs) in sub-Saharan Africa who could suffer detrimental life experiences. We investigated whether OVCs have heightened risks adverse reproductive health outcomes including HIV infection. Data on infection, sexually transmitted infection (STI) symptoms pregnancy, common risk factors were collected for non-OVCs a population survey 1523 teenage eastern Zimbabwe between July 2001 March 2003. Multivariate logistic regression was...
In Brief Background Social desirability bias hampers measurement of risk behavior for acquiring STDs and evaluation control interventions. More confidential data collection methods reduce this in Western countries but generally require technology not available less developed settings. Goal The goal report was to describe evaluate an informal, confidential, low-technology method—Informal Confidential Voting Interviews (ICVIs)—for collecting sexual Study Design Reports multiple sex partners by...
Recent data from antenatal clinic (ANC) surveillance and general population surveys suggest substantial declines in human immunodeficiency virus (HIV) prevalence Zimbabwe. We assessed the contributions of rising mortality, falling HIV incidence sexual behaviour change to decline prevalence.
Background: Despite the 15 million children orphaned by AIDS, and fears of sexual vulnerability, little is known about link between orphanhood HIV risk. Methods: A random sample 1283 to 19-year-old girls in a high-density suburb Harare was identified cross-sectional survey 2004. total 863 agreed be interviewed 839 provided specimen for herpes simplex virus type-2 (HSV-2) testing. Sexual health outcomes, behaviours marriage were assessed type timing orphanhood. Results: Half participants...
Background HIV surveillance of generalised epidemics in Africa primarily relies on prevalence at antenatal clinics, but estimates incidence the general population would be more useful. Repeated cross-sectional measures are now becoming available for populations many countries, and we aim to develop validate methods that use these data estimate incidence. Methods Findings Two were developed decompose observed changes between two serosurveys into contributions new infections mortality. Method...
Objective: Age-disparate sexual relationships with older men may drive high rates of HIV acquisition in young women sub-Saharan Africa, but evidence is limited. We investigate the association between age-disparate and incidence Manicaland, Zimbabwe. Design: A general-population open-cohort study (six surveys) (1998–2013). Methods: total 3746 aged 15–24 years participated consecutive surveys were HIV-negative at beginning intersurvey periods. Last partner age difference [intergenerational...
Community involvement is increasingly identified as a "critical enabler" of an effective HIV/AIDS response. We explore pathways between community participation and HIV prevention, treatment impact mitigation in Zimbabwe, reviewing six qualitative studies Manicaland. These find that group membership often (not always) associated with decreased incidence, reduced stigma improved access to some services, particularly amongst women. Participation formal groups (e.g., church or women's groups)...
Objective: Increased male participation in antenatal care and uptake of couple voluntary counselling testing (VCT) for HIV could reduce horizontal vertical transmission sub-Saharan Africa. Methods: Randomized controlled trial to compare pregnant women's acceptance written invitations VCT pregnancy information sessions (PISs) – the control group their sexual partners (MSPs) among these Khayelitsha, South Results: All women study accepted invitation letters agreed invite attend or PIS as...
Patterns of person-to-person contacts relevant for infectious diseases transmission are still poorly quantified in Sub-Saharan Africa (SSA), where socio-demographic structures and behavioral attitudes expected to be different from those more developed countries.We conducted a diary-based survey on daily time-use individuals ages one rural peri-urban site Manicaland, Zimbabwe. A total 2,490 diaries were collected used derive age-structured contact matrices, analyze time spent by settings,...
Background: The rollout of antiretroviral therapy (ART) is one the largest public health interventions in Eastern and Southern Africa recent years. Its impact well described clinical cohort studies, but population-based evidence rare. Methods: We use data from seven demographic surveillance sites that also conduct community-based HIV testing collect information on uptake services. present crude death rates adults (aged 15–64) for period 2000–2011 by sex, status, treatment status. Parametric...
BackgroundAs the HIV epidemic in sub-Saharan Africa matures, evidence about age distribution of new infections and how this has changed over is needed to guide prevention. We aimed assess trends age-specific incidence six population-based cohort studies eastern southern Africa, reporting changes mean at infection, infections, birth cumulative incidence.MethodsWe used a Bayesian model reconstruct from repeated observations individuals' serostatus survival collected among population cohorts...