A5016061965- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- HIV/AIDS Impact and Responses
- HIV-related health complications and treatments
- Global Maternal and Child Health
- Pneumocystis jirovecii pneumonia detection and treatment
- Tuberculosis Research and Epidemiology
- LGBTQ Health, Identity, and Policy
- Ethics in Clinical Research
- Sex work and related issues
- Poverty, Education, and Child Welfare
- Health Policy Implementation Science
- African Sexualities and LGBTQ+ Issues
- Healthcare professionals’ stress and burnout
- Reproductive tract infections research
- Shoulder and Clavicle Injuries
- Mental Health Treatment and Access
- Shoulder Injury and Treatment
- Herpesvirus Infections and Treatments
- Pneumonia and Respiratory Infections
- Syphilis Diagnosis and Treatment
- Diagnosis and treatment of tuberculosis
Desmond Tutu HIV Foundation
2016-2025
Stellenbosch University
2016-2025
Imperial College London
2016-2022
Johns Hopkins University
2019-2022
Johns Hopkins Medicine
2022
University of Zambia
2022
London School of Hygiene & Tropical Medicine
2022
Faculty of Public Health
2022
Family Health International 360
2022
National Institute for Health Research
2019
A universal testing and treatment strategy is a potential approach to reduce the incidence of human immunodeficiency virus (HIV) infection, yet previous trial results are inconsistent.
Effective interventions to reduce HIV incidence in sub-Saharan Africa are urgently needed. Mathematical modelling and the Prevention Trials Network (HPTN) 052 trial results suggest that universal testing combined with immediate antiretroviral treatment (ART) should substantially may eliminate as a public health problem. We describe rationale design of evaluate this hypothesis.A rigorously-designed (UTT) is needed because: i) it unknown whether these can be delivered scale adequate uptake;...
Background: Important differences in clinical outcomes likely exist between patients with healed and nonhealed rotator cuff repairs. The survival probability of repairs has not been published a time-dependent manner up to now. Hypotheses: Recurrent tears occur more frequently the early postoperative period. Early failures repair are prognostic factor for long-term outcome. Study Design: Cohort study; Level evidence, 3. Methods: A series 107 consecutive undergoing arthroscopically assisted...
The Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets require that, by 2020, 90% of those living with HIV know their status, known HIV-positive individuals receive sustained antiretroviral therapy (ART), and ART have durable viral suppression. HPTN 071 (PopART) trial is measuring the impact a universal testing treatment intervention population-level incidence in 21 urban communities Zambia South Africa. We report observational data from four to assess progress towards...
There are conflicting reports of antiretroviral therapy (ART) effectiveness comparisons between primary healthcare (PHC) facilities and hospitals in low-income settings. This comparison has not been evaluated on a broad scale South Africa.A retrospective cohort study was conducted including ART-naïve adults from 59 four provinces Africa, enrolled 2004 2007. Kaplan-Meier estimates, competing-risks Cox regression, generalised estimating equation population-averaged models logistic regression...
To achieve UNAIDS 90:90:90 targets at population-level, knowledge of HIV status must be followed by timely linkage to care, initiation and maintenance antiretroviral therapy (ART) for all people living with (PLHIV). Interpreting quantitative patterns using qualitative data, we investigate time taken link care initiate ART amongst individuals aware their HIV-status in high HIV-prevalence urban communities the HPTN 071 (PopART) study, a community-randomised trial combination prevention...
Abstract Introduction HPTN 071 (PopART) implemented a comprehensive HIV prevention package which aimed to reduce incidence within 21 communities of Zambia and South Africa: Arm A, PopART intervention universal testing treatment; B, with ART provided according local guidelines; C, standard care. Analyses so far have not accounted for the sampling design enrolled cohort. We performed sample-weighted re-analysis primary outcome trial derive population-based estimate effect. Methods Enrollment...
Abstract Background : Stigma and discrimination related to HIV key populations at high risk of have the potential impede implementation effective prevention treatment programmes scale. Studies measuring impact stigma on these are rare. We conducting an science study HIV-related in communities health settings within a large, pragmatic cluster-randomized trial universal testing intervention for Zambia South Africa will assess how affects, is affected by, this intervention. Methods/Design A...
The life expectancy of HIV-positive individuals receiving antiretroviral therapy (ART) is approaching that HIV-negative people. However, little known about how these populations compare in terms health-related quality (HRQoL). We aimed to HRQoL between and people Zambia South Africa.As part the HPTN 071 (PopART) study, data from adults aged 18-44 years were gathered Nov 28, 2013, March 31, 2015, large cross-sectional surveys random samples general population 21 communities Africa. collected...
HPTN071(PopART) is a 3-arm community-randomised study in 21 peri-urban/urban communities Zambia and the Western Cape of South Africa, with high HIV prevalence mobility especially among young adults. In Arm A communities, from November 2013 community care providers (CHiPs) have delivered "PopART" universal-test-and-treat (UTT) package annual rounds, during which they visit all households offer testing. CHiPs refer HIV-positive (HIV+) individuals to routine clinic services, where universal ART...
Integrating standardized measures of HIV stigma and discrimination into research studies emerging prevention approaches could enhance uptake retention these approaches, care treatment for people living with (PLHIV), by informing mitigation strategies. We sought to develop a succinct set capture key domains use in on technologies.
Stigma and judgment by health workers toward people living with HIV (PLHIV) key populations can undermine the uptake of services. In 2014, we recruited delivering services from 21 urban communities in South Africa Zambia participating first year HPTN 071 (PopART) cluster-randomized trial. We analyzed self-reported levels stigma (1) PLHIV, (2) women who sell sex, (3) men have sex (MSM), (4) young become pregnant before marriage. Using logistic regression, compared responses between three...
Background Few studies describe temporal trends in pediatric antiretroviral treatment (ART) programs sub-Saharan Africa. Adult show deteriorating patient retention recent years. We baseline characteristics and outcomes amongst ART-naive children between 2004 2009 at 30 facilities 4 South African provinces. Methods Linear trend parameters annual enrolment cohorts was assessed. Corrected mortality estimates were calculated, correcting for deaths those lost to follow-up using...
Objective: To determine the uptake of home-based HIV counselling and testing (HCT) in four HPTN 071 (PopART) trial communities (implementing a ‘full’ combination prevention package that includes universal treatment) Zambia. We also explore factors associated with HCT these communities. Design: is three-arm community-randomized 12 Zambia nine South Africa evaluating impact package, including treatment, on incidence. Methods: Using door-to-door approach systematically revisiting households,...
The impact of HIV stigma on viral suppression among people living with (PLHIV) is not well characterized.Twenty-one communities in Zambia and South Africa, nested within the HPTN 071 (PopART) trial.We analyzed data (<400 copies RNA/mL) 5662 laboratory-confirmed PLHIV aged 18-44 years who were randomly sampled PopART trial population cohort 24 months after enrolment (PC24). We collected experiences internalization from those self-reported their status (n = 3963/5662) perceptions a 20% random...
Abstract Background In a cluster-randomised trial (CRT) of combination HIV prevention (HPTN 071 (PopART)) in 12 Zambian communities and nine South African communities, carried out from 2012 to 2018, the intervention arm A that offered treatment irrespective CD4 count did not have significant impact on population level incidence. Intervention B, where incidence was reduced by 30%, followed national guidelines mid (2016) changed starting according threshold 500 universal treatment. Using...
BackgroundThe HPTN 071 (PopART) trial showed that a combination HIV prevention package including universal testing and treatment (UTT) reduced population-level incidence of compared with standard care. However, evidence is scarce on the costs cost-effectiveness such an intervention.MethodsUsing individual-based model, we simulated PopART intervention care antiretroviral therapy (ART) provided according to national guidelines for 21 communities in Zambia South Africa (for all individuals aged...
Background In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) set 90-90-90 targets: that 90% of people living with HIV know their status, those who HIV-positive status are antiretroviral therapy (ART), and treatment virally suppressed. The aim was to reach these targets by 2020. We assessed feasibility achieving first two targets, corresponding 81% ART coverage target, as part Prevention Trials Network (HPTN) 071 Population Effects Antiretroviral Therapy Reduce Transmission...
Adherence to antiretroviral therapy (ART) leads viral suppression for people living with HIV (PLHIV) and is critical both individual health reducing onward transmission. stigma a risk factor that can undermine adherence. We explored the association between self-reported ART adherence among PLHIV in 21 communities HPTN 071 (PopART) trial Zambia Western Cape of South Africa.We conducted cross-sectional analysis baseline data collected 2013 2015, before roll-out interventions. Questionnaires...