A5056732157- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- Adolescent Sexual and Reproductive Health
- Sex work and related issues
- Reproductive tract infections research
- Global Maternal and Child Health
- HIV/AIDS drug development and treatment
- Syphilis Diagnosis and Treatment
- Global Peace and Security Dynamics
- Asian Geopolitics and Ethnography
- Clinical Reasoning and Diagnostic Skills
- Climate Change, Adaptation, Migration
- Tuberculosis Research and Epidemiology
- Global Public Health Policies and Epidemiology
- Poverty, Education, and Child Welfare
- Child Nutrition and Water Access
- Healthcare cost, quality, practices
London School of Hygiene & Tropical Medicine
2019-2025
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
2017-2025
University of Liverpool
2017-2025
Faculty of Public Health
2018-2024
The current study identifies young people's preferences for HIV self-testing (HIVST) delivery, determines the relative strength of and explores underlying behaviors perceptions to inform youth-friendly services in southern Africa.A mixed methods design was adopted Malawi Zimbabwe includes focus group discussions, in-depth interviews discrete choice experiments.The conducted during formative phase cluster-randomized trials oral-fluid HIVST distribution. Young people aged 16-25 years were...
Abstract Introduction HIV self‐testing (HIVST) provides couples and individuals with a discreet, convenient empowering testing option. As all testing, potential harms must be anticipated mitigated to optimize individual public health benefits. Here, we describe social (SHs) reported during HIVST implementation in Malawi, propose framework for grading responding harms, according their severity. Methods We report findings from six studies Malawi (2011 2017) that included substudies...
HIV self-testing (HIVST) is recommended by the World Health Organization in addition to other testing modalities increase uptake of testing, particularly among harder-to-reach populations. This study provides first empirical evidence costs door-to-door community-based HIVST distribution Malawi, Zambia and Zimbabwe.HIVST kits were distributed 71 sites across Zimbabwe from June 2016 May 2017. Programme expenditures, supplemented on-site observation monitoring evaluation data used estimate...
Abstract Introduction New HIV testing strategies are needed to reach the United Nations’ 90‐90‐90 target. self‐testing ( HIVST ) can increase uptake, but users’ perspectives on optimal models of distribution and post‐test services uncertain. We used discrete choice experiments DCE s) explore impact service characteristics uptake along cascade. Methods s a quantitative survey method that present respondents with repeated choices between packages characteristics, estimate relative strengths...
<ns3:p><ns3:bold>Background: </ns3:bold>Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) evaluate effectiveness of community-based, integrated HIV and sexual reproductive health services youth on outcomes.</ns3:p><ns3:p> </ns3:p><ns3:p> <ns3:bold>Protocol: </ns3:bold>The CHIEDZA is being conducted in three provinces Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters)...
<ns3:p>Background Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) evaluate effectiveness of community-based, integrated HIV and sexual reproductive health services youth on outcomes. Protocol The CHIEDZA is being conducted in three provinces Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) 1:1 standard care (existing services) or intervention. intervention comprises...
Abstract Background HIV self-testing (HIVST) can use either oral-fluid or blood-based tests. Studies have shown strong preferences for compared to facility-based services. Despite availability of low-cost HIVST options, date, implementation in sub-Saharan Africa has largely been oral-fluid-based. We investigated whether users preferred (i.e. using blood sample derived from a finger prick) oral fluid-based rural and urban Malawi. Methods At clinics providing testing services ( n = 2 urban;...
Abstract Introduction The ability to achieve an accurate test result and interpret it correctly is critical the impact effectiveness of HIV self‐testing (HIVST). Simple easy‐to‐use devices, instructions for use (IFU) other support tools have been shown be key good performance in sub‐Saharan Africa may highly contextual. objective this study was explore utility cognitive interviewing optimizing local understanding manufacturers’ IFUs HIVST result. Methods Functionally literate antiretroviral...
To present findings from implementation and scale-up of human immunodeficiency virus (HIV) self-testing programmes for female sex workers in Malawi Zimbabwe, 2013-2018.In we carried out formative research to assess the acceptability accuracy HIV self-testing. During evaluated workers' preferences for, feasibility of, distribution test kits before programme was scaled-up. In Malawi, conducted a rapid ethnographic assessment explore context needs resources available, leading workshop define...
Control of infectious diseases is a global health priority and target the 2015-2030 Sustainable Development Goals (SDGs). Community participation fundamental to advancing primary care meeting SDGs. We conducted mixed-methods systematic literature review quantitative qualitative evidence understand health, social, economic impact community-led strategies for communicable disease prevention management in low- middle- income countries. searched seven electronic databases through 31 December,...
Knowledge of HIV status remains below target in sub-Saharan Africa, especially among men and adolescents. self-testing (HIVST) is a novel approach that enables unique distribution strategies, with potential to be highly decentralised provide complementary coverage facility-based testing approaches. However, substantial gaps evidence remain on the effectiveness cost-effectiveness HIVST, particularly rural settings, approaches facilitate linkage confirmatory testing, prevention, treatment...
Undiagnosed HIV infection remains substantial in key population subgroups including adolescents, older adults, and men, driving ongoing transmission sub-Saharan Africa. We evaluated the impact, safety, costs of community-led delivery self-testing (HIVST), aiming to increase testing underserved stimulate demand for antiretroviral therapy (ART).
The current research identifies key drivers of demand for linkage into care following a reactive HIV self-test result in Malawi and Zambia. Preferences are explored among the general population groups such as HIV-positive individuals adolescents.We used discrete choice experiments (DCEs) embedded representative household surveys to quantify relative strength preferences various services characteristics.The DCE was designed on basis literature review qualitative studies. Data were collected...
Abstract Background Prevention of new HIV infections is a critical public health issue. The highest testing gaps are in men, adolescents 15–19 years old, and adults 40 older. Community-based services (HTS) can contribute to increased coverage early diagnosis, with self-testing (HIVST) strategies showing promise. strategies, however, resource intensive, costly not widely implemented. A community-led approach interventions involves supporting communities plan implement solutions improve their...
HIV testing is free in Malawi, but users may still incur costs that can deter or delay them accessing these services. We sought to identify and quantify among service clients Malawi. asked residents of communities participating a cluster randomised trial investigating the impact self-testing about their past experiences direct non-medical indirect incurred access testing. recruited 749 participants whose most recent test was within 12 months. The mean total cost US$2.45 (95%CI:...
HIV self-testing (HIVST) is an alternative strategy for reaching population subgroups underserved by available testing services. We assessed individual factors associated with ever HIVST within a community-based program.
Introduction Reaching high coverage of HIV testing remains essential for diagnosis, treatment and prevention. We evaluated the effectiveness safety door-to-door distribution self-testing (HIVST) kits in rural Malawi. Methods This cluster randomised trial, conducted between September 2016 January 2018, used restricted 1:1 randomisation to allocate 22 health facilities their defined areas HIVST alongside standard care (SOC) or SOC alone. The study population included residents (≥16 years)....
Although HIV prevention science has advanced over the last four decades, evidence suggests that technologies do not always reach their full potential. Critical health economics at appropriate decision-making junctures, particularly early in development process, could help identify and address potential barriers to eventual uptake of future products. This paper aims key gaps propose research priorities for field non-surgical biomedical prevention. We used a mixed-methods approach with three...
Abstract Background In Malawi, female sex workers (FSW) have high HIV incidence and regular testing is suggested. self-testing (HIVST) a safe acceptable alternative to standard services. This study assessed; whether social harms were more likely be reported after HIVST distribution FSW by peer distributors than facility-based regretted use or experienced associated relationship problems. Methods Peer distributors, who FSW, recruited in Blantyre district, Malawi between February July 2017....
Community-based strategies can extend coverage of HIV testing and diagnose at earlier stages infection but be costly to implement. We evaluated the costs effects community-led delivery self-testing (HIVST) in Mangochi District, Malawi.This economic evaluation was based within a pragmatic cluster-randomised trial 30 group village heads their catchment areas comparing HIVST intervention addition standard care (SOC) versus SOC alone. The involved mobilising community health groups lead 7-day...
Today, perhaps more than ever, humanitarian crises permeate the lives of millions, triggering increased human movement and repeatedly testing international community’s capacity to respond. Stakeholders within community have recognized that existing legal institutional frameworks for protecting forced migrants are inadequate address diversity movements needs. This article examines situation noncitizens who caught in violence, conflict, disaster, asserts they an at-risk population requiring...