A5013608274- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- COVID-19 epidemiological studies
- Global Maternal and Child Health
- HIV/AIDS Impact and Responses
- Vaccine Coverage and Hesitancy
- HIV/AIDS oral health manifestations
- Pharmaceutical Practices and Patient Outcomes
- Pharmaceutical studies and practices
- Empathy and Medical Education
- Pharmaceutical Economics and Policy
- Mobile Health and mHealth Applications
- Innovations in Medical Education
- Adolescent and Pediatric Healthcare
- Hemoglobinopathies and Related Disorders
- Healthcare Systems and Reforms
- Health Sciences Research and Education
- COVID-19 Pandemic Impacts
- Iron Metabolism and Disorders
- Tuberculosis Research and Epidemiology
- SARS-CoV-2 and COVID-19 Research
- Health Systems, Economic Evaluations, Quality of Life
Partners for Health and Development in Africa
2020-2024
Kenya Medical Research Institute
2022-2024
University of Colorado Denver
2021
Kenyatta National Hospital
2013
Adherence challenges with oral tenofovir-based pre-exposure prophylaxis (PrEP) are common. We developed a point-of-care assay to objectively assess tenofovir in urine and conducted pilot trial examining the impact of counselling informed by use this on long-term PrEP adherence. This randomised enrolled women not serodiscordant partnerships 3 months after initiation at Kenya Medical Research Institute compare standard-of-care adherence versus (urine-test group) every for 12 months. In...
Abstract Introduction In Kenya, pre-exposure prophylaxis (PrEP) for HIV prevention is almost exclusively delivered at clinics. Developing novel PrEP delivery models important increasing the reach of PrEP. Delivery through pharmacies one approach utilized in US to improve accessibility. Retail are commonly used as a first-line access point medical care but have not been delivery. We conducted collaborative consultative meeting stakeholders develop pathway pharmacy-based Kenya. Methods January...
As countries scale up pre-exposure prophylaxis (PrEP) for HIV prevention, diverse PrEP delivery models are needed to expand access populations at risk that unwilling or unable clinic-based care. To identify factors may influence implementation of retail pharmacy-based in Kenya, we conducted in-depth interviews with 40 pharmacy clients, 16 providers, and 10 providers from two provinces. Most participants expressed strong support expanding pharmacies, though conditioned their acceptance on...
The delivery of daily, oral HIV pre-exposure prophylaxis (PrEP) at private pharmacies may overcome barriers to PrEP public healthcare facilities, including HIV-associated stigma, long wait times and overcrowding.At five private, community-based in Kenya, a care pathway for (ClinicalTrials.gov: NCT04558554) was piloted-the first its kind Africa. Pharmacy providers screened clients interested risk, then used prescribing checklist identify without medical conditions that might contraindicate...
Background For individuals who face challenges accessing clinic-based HIV pre-exposure prophylaxis (PrEP), differentiated service delivery models are needed to expand access and reach. During a pilot study testing novel pharmacy-delivered oral PrEP model in Kenya, we used routine programmatic data identify early implementation barriers actions that providers staff took response the barriers. Methods We trained pharmacy at five private pharmacies Kisumu Kiambu Counties initiate continue...
Several African countries have recently integrated pre-exposure prophylaxis (PrEP) into their national HIV prevention programmes and are in the process of scaling-up healthcare facility-based PrEP delivery [1]. To maximize public health benefit PrEP, there is need to prioritize access, minimize costs reach at-risk populations. Major barriers exist, including facility-associated stigma, long waiting times, staffing providers' unfamiliarity with delivering interventions [2]. In Africa, also...
HIV pre-exposure prophylaxis (PrEP) delivery at private pharmacies is a promising new differentiated service model that may address barriers to PrEP public health care facilities. We measured the fidelity of this (ie, as intended) in pilot study Kenya.Five private, retail Kisumu and Thika Counties.Trained pharmacy providers delivered services, including identifying eligible clients, counseling on risk, assessing safety, testing for HIV, dispensing PrEP. Pharmacy clients completed surveys...
Background Pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but uptake remains low, especially among adolescent girls and young women (AGYW) in Kenya. A model which trained AGYW using PrEP deliver self-tests to their close friends refer them may help increase this population. To understand AGYW's potential willingness engage such a model, we conducted qualitative formative study Method We semi-structured in-depth interviews (IDIs) with (16 24 years) Kiambu County who...
Importance Daily oral HIV preexposure prophylaxis (PrEP) delivery requires quarterly clinic visits for testing and drug refilling that are costly to health systems clients. Objective To evaluate whether 6-month PrEP dispensing supported with interim self-testing (HIVST) results in noninferior continuation outcomes at 12 months compared standard visits. Design, Setting, Participants This randomized noninferiority trial was conducted from May 2018 2021 of follow-up among clients aged 18 years...
Understanding HCPs COVID-19 vaccine concerns can provide critical insights to optimize success of the rollout program as they are a trusted source health information patients and general population. We sought understand reasons for care providers’ hesitancy in Kenyatta National teaching referral Hospital. From April July 2021, we interviewed 60 purposively sampled from Infectious Disease Unit (IDU) (n=20) other departments (n=40). analyzed data using inductive deductive approaches...
The uptake of daily oral HIV pre-exposure prophylaxis (PrEP)-a highly effective intervention-remains low among African adolescent girls and young women (AGYW) who could benefit. AGYW initiate PrEP often do so through informal peer referral, which may be enhanced with formalized referral peer-delivered self-testing (HIVST). To understand the feasibility this model AGYW, we conducted a pilot study in Kenya.
Abstract Background Oral HIV pre-exposure prophylaxis (PrEP) for prevention is highly effective, but uptake remains low in Africa, especially among young women who are a priority population services. self-testing (HIVST) has been proven to increase testing diverse populations underutilized support linkage Most initiate PrEP Africa do so through informal peer referral. We wanted test model of formalized referral enhanced with HIVST delivery Kenyan women. Methods The Peer Trial two-arm hybrid...
Background: Adherence challenges with oral tenofovir-based pre-exposure prophylaxis (PrEP) are common. We recently developed a point-of-care (POC) urine assay to objectively assess tenofovir in and performed pilot trial examining the impact of targeted counseling using on long-term PrEP adherence among women Kenya.Methods: From March 2021-January 2022, we randomized 100 three months after initiation standard-of-care (SOC) versus informed by (PUMA arm) every 3 for 12 months. In SOC arm,...
Abstract Background In Africa, the delivery of HIV pre-exposure prophylaxis (PrEP) at public healthcare clinics is challenged by understaffing, overcrowding, and HIV-associated stigma, often resulting in low PrEP uptake continuation among clients. Giving clients option to refill nearby private pharmacies, which are more convenient have shorter wait times, may address these challenges improve continuation. Methods This mixed methods study used an explanatory sequential design. At two Kiambu...
In Africa, dispensing oral HIV pre-exposure prophylaxis (PrEP) within already strained public health facilities has led to prolonged waiting periods and suboptimal experiences for clients. We sought explore the acceptability of PrEP semiannually with interim self-testing (HIVST) versus quarterly clinic-based testing optimize clinic-delivered services. conducted a qualitative study non-inferiority individual-level randomized controlled trial effect six-monthly HIVST compared standard-of-care...
Objective measures of oral PrEP adherence – especially point-of-care (POC) that enable real-time assessment, intervention, and feedback have the potential to improve adherence. Our team previously developed validated a novel urine-based POC metric In this study, we sought determine whether assay is acceptable feasible among women taking providers in Kenya. We conducted trial comparing counseling using (intervention) versus standard-of-care counseling. in-depth interviews (IDIs) with...
<h3>Background</h3> For successful implementation of PrEP as a HIV prevention strategy, participant’s adherence to the intervention is vital. Frequent interruption study product, impacts its effectiveness negatively. We documented frequency and causes drug interruptions among participants enrolled in Partners Study, Thika-Kenya <h3>Methods</h3> Between October 2008 November 2010, we 496 serodiscordant couples who were followed up 36 months. categorised time off into two; protocol-defined,...
Background Kenyan adolescent girls and young women (AGYW) experience a dual burden of HIV common mental disorders (CMD). clinics are key entry point for AGYW in need integrated CMD care; however, rates screening referral CMDs low. Our objective was to test an evidence-based provider training strategy, simulated patient encounters (SPEs), on service delivery clinic. Methods This pilot study conducted public clinic Thika, Kenya from January November 2021. The encounter (SPE) implementation...