A5073728037- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- Reproductive tract infections research
- HIV-related health complications and treatments
- Syphilis Diagnosis and Treatment
- HIV/AIDS Impact and Responses
- Cervical Cancer and HPV Research
- HIV, Drug Use, Sexual Risk
- Herpesvirus Infections and Treatments
- Sex work and related issues
- Genital Health and Disease
- Female Genital Mutilation/Cutting Issues
- Urologic and reproductive health conditions
- Global Maternal and Child Health
- Cytomegalovirus and herpesvirus research
- HIV/AIDS drug development and treatment
- Food Security and Health in Diverse Populations
- Urological Disorders and Treatments
- Breastfeeding Practices and Influences
- Parvovirus B19 Infection Studies
- COVID-19 epidemiological studies
- Blood groups and transfusion
- Urinary Tract Infections Management
- COVID-19 Digital Contact Tracing
African Institute for Development Policy
2020
University of North Carolina at Chapel Hill
2004-2015
Kamuzu Central Hospital
2003-2011
University of Alabama at Birmingham
2008
University of Malawi
2006-2007
Johns Hopkins University
2006
National Center for Infectious Diseases
2003
This study was conducted to compare viral dynamics in blood and semen between subjects with antibody negative, acute HIV-1 infection other later stages of infection.A prospective cohort embedded within a cross-sectional HIV screening Lilongwe, Malawi STD clinic.Blood samples from negative or indeterminate volunteers were used detect RNA plasma using pooling strategy. Blood seminal concentrations measured over 16 weeks.Sixteen men 25 chronic studied. load highest about 17 days after (mean +/-...
Objectives: To estimate the effect of receiving HIV-positive test results on intentions to have future children and contraceptive use assess association between pregnancy incidence among women in Malawi. Methods: Women unknown HIV status completed a questionnaire about then received voluntary counseling testing (VCT). who were not pregnant enrolled followed for 1 year while care access family planning (FP) services. Results: Before their results, 33% reported desire children; this declined...
Objective: Individuals with acute (preseroconversion) HIV infection (AHI) are important in the spread of HIV. The identification AHI requires detection viral proteins or nucleic acids techniques that often unaffordable for routine use. To facilitate efficient use these tests, we sought to develop a risk score algorithm identifying likely cases and targeting tests towards those individuals. Design: A cross-sectional study 1448 adults attending sexually transmitted infections (STI) clinic...
Background. We conducted a prospective study to evaluate methods of detecting clients with sexually transmitted diseases (STDs) who were acutely coinfected human immunodeficiency virus (HIV) in Lilongwe, Malawi. Methods. After informed consent was obtained, all acute STDs offered voluntary HIV counseling and testing by 2 rapid antibody tests. Samples from test-negative or -discordant subjects pooled (50:5:1) tested for RNA. Western blots performed on test-discordant specimens detectable A...
Morbidity and mortality patterns among pregnant women their infants (before antiretroviral therapy was widely available) determines HIV-1 diagnostic, monitoring, care interventions.Data from mothers enrolled in a trial of antibiotics to reduce mother-to-child-transmission at 4 sub-Saharan African sites were analyzed. Women during pregnancy follow-up continued until the reached 12 months age. We describe maternal infant morbidity cohort HIV-1-infected HIV-1-uninfected mothers. Maternal...
In Brief Background Male urethritis is generally treated syndromically, but failure of empirical treatment common. Goal The study goal was to evaluate the addition metronidazole syndromic management in Malawi a randomized clinical trial. Study Design Men with were receive either 2 g by mouth or placebo, standard care for (i.e., single intramuscular dose 240 mg gentamicin and 100 doxycycline twice daily 7 days). primary endpoints included measurement effects on Trichomonas vaginalis, signs...
To estimate the effectiveness of candidate microbicides BufferGel and 0.5% PRO 2000 Gel (P) (PRO 2000) for prevention non-ulcerative sexually transmitted infections (STIs).Between 2005 2007, 3099 women were enrolled in HIV Prevention Trials Network (HPTN) protocol 035, a phase II/IIb evaluation safety STIs, including Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) Trichomonas vaginalis (TV). Incidences STIs determined by study arm, HRs versus placebo gel or no control groups computed...
Global policy recommendations to scale up of male circumcision (MC) for HIV prevention tend frame the procedure as a simple and efficacious public health intervention. However, there has been variable uptake MC in countries with significant epidemics. Kenya, example, embraced dubbed 'leader' by global community, while Malawi branded 'laggard' its slow adoption national programme, strong political discourse resistance forming around MC. Regardless any epidemiological or technical evidence,...
Despite progress in improving antiretroviral therapy (ART) for people with HIV Malawi, the burden of infections and treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing prevention needs Malawi.De-identified program data routinely collected as part LINKAGES project-Malawi were assembled from October 2017 to September 2019. case finding was compared across different testing modalities each population....
<b>Background:</b> Understanding HIV risk perception is important for designing appropriate strategies HIV/AIDS prevention, because these interventions often rely on behaviour modification. A key component of the individual's own assessment status, and extent to which this correct. However, issue has received limited attention. <b>Objectives:</b> To examine validity self-reported likelihood current infection among general population in rural Malawi. <b>Methods:</b> As part a panel household...
Assessing safety outcomes is critical to inform optimal scale-up of voluntary medical male circumcision (VMMC) programs. Clinical trials demonstrated adverse event (AE) rates from 1.5 8 %, but we have limited data on AEs VMMC programs.A group problem-solving, quality improvement (QI) project involving retrospective chart audits, case-conference AE classification, and provider training was conducted at a clinic in Malawi. For each identified potential AE, the timing, assessment, treatment,...
The objective of this study was to determine the incidence HIV-1.The goal inform HIV prevention and vaccine trials by conducting a multisite in Malawi Zimbabwe.Women reproductive age were enrolled prospective study. They received 5 intensive counseling condom promotion sessions over 2 months. Subsequently, HIV-negative women completed quarterly follow-up visits. rates predictors acquisition assessed.A total 2016 phase Of these, 1679 tested for during follow up 113 seroconverted, resulting an...
Concurrent sexual partnerships are believed to play an important role in HIV transmission sub-Saharan Africa, but the contributions of concurrency and sexually transmitted infection (STI) spread depend on details infectious periods relationship patterns. To contribute understanding partnership patterns this region, we estimated lengths, temporal gaps between partners, overlap across partners at STI clinic Lilongwe, Malawi.Participants underwent physical examinations tests, responded...
Background. Combination antiretroviral therapy (cART) reduces genital tract human immunodeficiency virus type 1 (HIV-1) load and the risk of sexual transmission, but little is known about efficacy cART for decreasing viral (GTVL) differences in sex or HIV-1 subtype.
Variations in estimates of prevalence trichomoniasis men may reflect true differences the burden disease but are also affected by performance diagnostic methods and type specimen tested. In this study, were evaluated at baseline follow-up, to evaluate syndromic management urethritis effects human immunodeficiency virus trichomoniasis, Lilongwe, Malawi. First-void urine specimens urethral swabs obtained enrollment, for Trichomonas vaginalis culture; semen follow-up. The sensitivities testing...
<h3>Objective</h3> By a randomised, double-blind, placebo-controlled trial of aciclovir 800 mg twice daily for 5 days added to the syndromic management genital ulcer disease (GUD) determine impact on healing and HIV outcomes. <h3>Methods</h3> Patients presenting with GUD in Malawi were evaluated herpes simplex virus type-2 (HSV-2) serologies, aetiology, lesional, plasma HIV-1 RNA CD4+ count. followed up at 2, 4, 7, 14 28. The primary study outcome was day 14, secondary outcomes being...
Objective: Allocation of funds to program areas where they may have an impact is critical the success any HIV control program. We examined cost-effectiveness providing first-line treatment for male trichomoniasis in Malawi, a condition not commonly considered syndromic management throughout sub-Saharan Africa. Methods: used decision tree analysis assess costs and outcomes among 1-year population sexually transmitted disease (STD) clinic attendees estimated at 10,000 Lilongwe. Our main were...
To evaluate the safety of 100 mg nonoxynol-9 (N-9) gel, a vaginal microbicide, on genital mucosa women from Malawi and Zimbabwe in preparation for phase III efficacy study.HIV-uninfected (180) were enrolled randomized to either N-9 or placebo gel instructed insert into vagina twice daily 14 days. Follow up examinations conducted at 7 days.The number adverse events group was higher than (40% versus 13%; P < 0.01). Reported any symptoms significantly (38% N-9, 13% placebo; = The total...
Abstract There is on-going global debate and policy-setting concerning researchers' obligations to meet the health needs of people participating in HIV prevention trials resource-poor settings. The perspectives local community stakeholders on this issue are poorly understood as most what presented behalf communities where research takes place anecdotal commentary. Using qualitative methods (130 in-depth interviews 20 focus groups) we assessed perceived fairness different strategies women who...
We conducted the present study to determine which of 4 components breast milk (whole milk, skim lipid layer, and breast-milk cells) had highest sensitivity concentration human immunodeficiency virus (HIV) type 1 RNA burden biological correlates these factors. The probability detection HIV (sensitivity) HIV-1 were both associated with choice component, CD4+ cell count, blood serum RNA, presence inflammation. Whole demonstrated higher mean than any other single component. Sensitivity was...
The protease (PR) and reverse transcriptase (RT) regions of HIV-1 isolates from 21 antiretroviral (ARV)- naive Malawian adults were sequenced analyzed to determine the prevalence drug resistance-associated mutations in this population. Phylogenetic analysis confirmed that all grouped with subtype C, predominant Malawi. No major associated resistance PR inhibitors (PIs), nucleoside RT (NRTIs), or nonnucleoside (NNRTIs) found. In contrast, accessory found region at positions 10, 20, 36, 63,...
Background: Restrictions on public gatherings and movement to mitigate the spread of COVID-19 may have disrupted access availability HIV services in Malawi. We quantified impact these restrictions testing Malawi.Methods: conducted an interrupted time series analysis routine aggregated programme data from 808 private, adult paediatric health facilities across rural urban communities Malawi between January 2018 March 2020 (pre-restrictions) April December (post restrictions), with as month...
Background. Little is known about the epidemiologic profile of trichomoniasis in men and its relationship to human immunodeficiency virus (HIV) infection. Among presenting for care symptomatic sexually transmitted infections (STIs) Malawi, not considered first-line treatment.
Background/Aims Retaining patients in prevention of mother-to-child transmission HIV studies can be challenging resource-limited settings, where high lost to follow-up rates have been reported. In this article, we describe the effectiveness methods used encourage retention Breastfeeding, Antiretrovirals, and Nutrition study analyze factors associated with study. Methods The clinical trial was designed evaluate efficacy three different strategies. Lower than expected participant prompted...