A5029623497- HIV, Drug Use, Sexual Risk
- Hepatitis C virus research
- Hepatitis B Virus Studies
- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV/AIDS Impact and Responses
- Data Quality and Management
- Sex work and related issues
- Liver Disease Diagnosis and Treatment
- Electronic Health Records Systems
- Mobile Health and mHealth Applications
Yale University
2016-2025
University of Bristol
2024
New York University
2013-2015
HIV infection in sub-Saharan Africa increasingly occurs among people who inject drugs (PWID). Kenya is one of the first to implement a national needle and syringe program. Our study undertook baseline assessment as part evaluating program seek, test, treat, retain approach.Participants enrolled between May December 2012 from 10 sites. Respondent-driven sampling was used reach 1785 PWID for HIV-1 prevalence viral load determination survey data.Estimated prevalence, adjusted differential...
Hepatitis C (HCV) disproportionately affects people who inject drugs (PWID). Despite availability of safe and effective treatment, HCV treatment access uptake among PWID in low- middle-income countries (LMICs) has been limited. Understanding the lived experiences these settings have undergone provides opportunity to gain insight into how implement programs that meet needs this population. Using Rhodes’ Risk Environment Framework guide our work, we conducted semi-structured interviews with 35...
Human immunodeficiency virus (HIV) disease in the United States disproportionately affects minorities, including Latinos. Barriers language are associated with lower antiretroviral therapy (ART) adherence seen among Latinos, yet ART and interventions for clinic visit rarely developed or delivered Spanish.The aim was to adapt a computer-based counseling tool, demonstrated reduce HIV-1 viral load sexual risk transmission population of English-speaking adults, use during routine clinical visits...
People who inject drugs (PWID) in Kenya have high HIV (range across settings: 14-26%) and hepatitis C virus (HCV; 11-36%) prevalence. We evaluated the impact of existing scaled-up interventions on HCV incidence among PWID Kenya.HIV transmission model PWID, calibrated to Nairobi Kenya's Coastal region.For each setting, we projected (percent HIV/HCV infections averted 2020) coverages antiretroviral therapy (ART; 63-79%), opioid agonist (OAT; 8-13%) needle syringe programmes (NSP; 45-61%). then...
Background: Data are limited on HCV treatment outcomes among people who inject drugs (PWID) in low-and middle-income countries (LMICs) and particularly sub-Saharan Africa.Methods: We provided ledipasvir/sofosbuvir under directly observed therapy (DOT) to 95 PWID accessing medication-assisted (MAT) needle syringe programs (NSP) Nairobi Coastal Kenya.Results: Participants were predominantly male (n=81, 85.3%), mean age of 36.5 years (SD=±6.5);38 (40%) HIV-positive, 12 (12.6%)were cirrhotic, 87...
Despite disproportionately high rates of Hepatitis C (HCV) among people who inject drugs (PWID) in low- and middle-income countries (LMICs), understanding HCV-related knowledge, attitudes perceived risk behaviours this population remains limited. We aimed to elucidate experiences that could minimise transmission maximise HCV treatment engagement PWID Kenya following the integration screening education with needle syringe programmes drop-in-centres (DICs). recruited 40 chronic attending DICs...
Background: Hepatitis C virus (HCV) infection is a global health problem especially among people who inject drugs (PWID). Low-and-middle income countries (LMIC) carry high burden of HCV, but little known about the HCV transmission dynamics in these settings.Methods: We recruited PWID Nairobi and coastal cities Mombasa, Kilifi Malindi Kenya at needle syringe programs using respondent-driven sampling. Next-generation sequencing (NGS) data from hypervariable region 1 were analyzed Global...
In countries experiencing the dual burden of HIV disease and health care worker shortages, information communication technology tools offer potential to help support treatment adherence secondary transmission risk reduction for people living with HIV/AIDS. We conducted a randomized controlled trial (September 1, 2011-July 12, 2012) follow-up through April 2013. Participants were recruited from two clinics affiliated Academic Model Providing Access Healthcare program in western Kenya. A total...
Abstract Background and aims Hepatitis C virus (HCV) treatment is essential for eliminating HCV in people who inject drugs (PWID), but has limited coverage resource‐limited settings. We measured the cost‐effectiveness of a pilot screening intervention using directly observed therapy among PWID attending harm reduction services Nairobi, Kenya. Design utilized an existing model HIV transmission current former Nairobi to estimate HCV, including prevention benefits versus no treatment. The cure...
People who inject drugs (PWID) living with Hepatitis C (HCV) in low- and middle-income countries face substantial barriers to HCV care. We sought gain healthcare providers' perspectives on challenges best practices for care provision among PWID Kenya. conducted three focus group discussions (FGD) 23 providers working Nairobi Mombasa. Transcribed interviews were analysed thematically. Overarching themes regarding prevention treatment were: (1) lack of HCV-related knowledge at the provider...
Shortages of health workers and large number HIV-infected persons in Africa mean that time to provide antiretroviral therapy (ART) adherence other messages patients is limited.Using time-motion methodology, we documented the intensity nature counseling delivered patients. The study was conducted at a rural an urban HIV clinic western Kenya. We recorded all activities 190 adult on ART during their return visits assess type, frequency, duration messages.Mean visit length for 44.5 (SD = 27.9)...
Abstract Background People who inject drugs (PWID) in Kenya have a high prevalence of HIV (14-26%) and HCV (11-36%). Needle syringe programmes (NSP) antiretroviral therapy (ART) coverage among PWID, while treatment opioid substitution (OST) access is low. Methods A dynamic model (sexual injecting-related) (injecting-related) transmission PWID was calibrated using Bayesian methods to data from Nairobi the Coastal region. We projected impact existing levels interventions (ART: 64-66%; OST:...
Polysubstance use (PSU), injection drug (IDU), and equipment sharing are associated with bloodborne infection (BBI) transmission risk, particularly Hepatitis C Virus (HCV), yet data on PSU in low- middle-income countries (LMICs) is limited. We report baseline PSU, medication-assisted treatment (MAT) engagement, motivation to reduce IDU among 95 people who inject drugs (PWID) accessed needle syringe programs (NSP) Nairobi Coastal Kenya prior HCV treatment. Bivariate multivariate logistic...
Hepatitis C virus (HCV) disproportionately affects people who inject drugs (PWID) worldwide. Despite carrying a high HCV burden, little is known about transmission dynamics in low- and middle-income countries.
Background: Sub-Saharan Africa has one of the highest global HCV prevalence rates. PWID are at risk for transmission. Yet, little is known about and HIV/HCV co-infection behaviors among in sub-Saharan Africa.