A5006729245- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- Adolescent Sexual and Reproductive Health
- COVID-19 Clinical Research Studies
- SARS-CoV-2 and COVID-19 Research
- HIV-related health complications and treatments
- COVID-19 Impact on Reproduction
- Syphilis Diagnosis and Treatment
- COVID-19 and healthcare impacts
- COVID-19 epidemiological studies
- HIV/AIDS Impact and Responses
- Reproductive tract infections research
- Hepatitis C virus research
- Cardiac Arrest and Resuscitation
- Global Public Health Policies and Epidemiology
- Global Maternal and Child Health
- Bone health and osteoporosis research
- Bacterial Infections and Vaccines
- Healthcare Systems and Public Health
- Trauma and Emergency Care Studies
- Emergency and Acute Care Studies
- Sex work and related issues
- SARS-CoV-2 detection and testing
- Homelessness and Social Issues
Emory University
2024
Johns Hopkins University
2024
Grady Memorial Hospital
2024
University College London
2023
Medical Research Council
2023
MRC Clinical Trials Unit at UCL
2023
Gilead Sciences (United States)
2022
University of California, San Francisco
2016-2021
San Francisco Department of Public Health
2021
San Francisco General Hospital
2016-2021
Universal antiretroviral therapy (ART) with annual population testing and a multidisease, patient-centered strategy could reduce new human immunodeficiency virus (HIV) infections improve community health.We randomly assigned 32 rural communities in Uganda Kenya to baseline HIV multidisease national guideline-restricted ART (control group) or plus testing, eligibility for universal ART, care (intervention group). The primary end point was the cumulative incidence of infection at 3 years....
BackgroundMost cohorts show similar or lower COVID-19 incidence among people living with HIV compared the general population. However, might be affected by testing rates vulnerable populations. We aimed to compare SARS-CoV-2 IgG seroprevalence, disease severity, and neutralising antibody activity after infection without receiving care in a county hospital system over 3-month period.MethodsIn this matched case-control observational study, remnant serum samples were collected between Aug 1 Oct...
BackgroundTwice-yearly subcutaneous lenacapavir has been shown to be efficacious for prevention of HIV infection in cisgender women. The efficacy preexposure prophylaxis (PrEP) men, transgender women, and gender-nonbinary persons is unclear.MethodsIn this phase 3, double-blind, randomized, active-controlled trial, we randomly assigned participants a 2:1 ratio receive every 26 weeks or daily oral emtricitabine–tenofovir disoproxil fumarate (F/TDF). primary analysis compared the incidence...
Sexual partners of persons with newly diagnosed HIV infection require counseling, testing and, if necessary, evaluation for therapy. However, many African countries do not have a standardized protocol partner notification, and the effectiveness notification has been evaluated in developing .Individuals presenting to sexually transmitted clinics Lilongwe, Malawi, were randomized 1 3 methods notification: passive referral, contract or provider referral. The referral group was responsible...
Antiretroviral treatment (ART) is now recommended for all HIV-positive persons. UNAIDS has set global targets to diagnose 90% of individuals, treat diagnosed individuals with ART, and suppress viral replication among treated a population-level target 73% persons HIV suppression.To describe changes in the proportions suppression, who had received diagnosis, following implementation community-based testing program rural East Africa.Observational analysis based on interim data from 16 Kenyan (n...
Optimal strategies for pre-exposure prophylaxis (PrEP) engagement in generalised HIV epidemics are unknown. We aimed to assess PrEP uptake and after population-level testing universal access characterise gaps the cascade rural Kenya Uganda.
(See the editorial commentary by Branson and Stekler, on pages 521–4.) Background. Most human immunodeficiency virus (HIV) point-of-care tests detect antibodies (Ab) but not p24 antigen (Ag) or RNA. In absence of antibodies, RNA typically indicate acute HIV infection. We conducted a field evaluation Determine® HIV-1/2 Ag/Ab Combo rapid test (Combo RT). Methods. The portion RT (for infection) was compared with Roche Monitor polymerase chain reaction assay. antibody established algorithms....
There is an increasing burden of hypertension (HTN) across sub-Saharan Africa where HIV prevalence the highest in world, but current care models are inadequate to address dual epidemics. treatment infrastructure could be leveraged for other chronic diseases, including HTN. However, little data exist on effectiveness integrated and disease delivery systems blood pressure control over time.Population screening HTN, among was conducted ten communities rural Uganda as part SEARCH study...
Oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but data are limited on incidence among PrEP users in generalized epidemic settings, particularly outside of selected risk groups. We performed a population-based study rural Kenya and Uganda sought to evaluate both changes clinical virologic outcomes following seroconversion PrEP.During population-level testing individuals ≥15 years 16 communities the Sustainable East Africa Research Community Health (SEARCH)...
In Brief Background: Malawi adopted syndromic management of sexually transmitted infections in 1993. Based on clinical efficacy and cost, gentamicin 240 mg intramuscularly, doxycycline 100 twice daily × 7 days was selected as the first line regimen to treat urethritis. We sought establish current laboratory-based Neisseriagonorrhoeae antibiotic susceptibility patterns for describe pattern since began. Methods: Between May 15 August 10, 2007, 126 men with urethritis attending STD clinic at...
In antiretroviral therapy (ART) scale-up programmes in sub-Saharan Africa viral load monitoring is not recommended. We wanted to study the impact of only using clinical and immunological on diagnosis virological ART failure under routine circumstances.Clinicians two urban clinics Malawi used identify adult patients for switching second-line ART. If met and/or criteria WHO guidelines had a <400 copies/ml there was misclassification failure.Between January 2006 July 2007, we identified 155...
Abstract Introduction : The 2015 WHO recommendation of antiretroviral therapy (ART) for all HIV‐positive persons calls treatment initiation in millions newly eligible with high CD4+ counts. Efficient and effective care models are urgently needed this population. We evaluated clinical outcomes asymptomatic adults children starting ART counts using a novel streamlined model rural Uganda Kenya. Methods In the 16 intervention communities HIV test‐and‐treat Sustainable East Africa Research...
We sought to measure retention in care and identify predictors of nonretention among patients receiving antiretroviral therapy (ART) with streamlined delivery during the first year ongoing Sustainable East Africa Research on Community Health (SEARCH) 'test-and-treat' trial (NCT 01864603) rural Uganda Kenya.Prospective cohort intervention arm SEARCH study.We measured at 12 months HIV-infected adults who linked were offered ART regardless CD4 cell count, following community-wide HIV-testing....
Background Despite substantial progress, gaps in the HIV care cascade remain large: globally, while about 36.7 million people were living with 2015, 11.9 of these individuals did not know their status, 12.7 need antiretroviral therapy (ART) and 13.0 virally suppressed. We sought to deepen understanding barriers engagement at three critical steps proposed make greatest impact for attaining UNAIDS 90-90-90 targets aimed shutting down epidemic. Methods Analyses conducted among HIV-infected...
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...
Background Previous research indicates clinical outcomes among HIV-infected men in sub-Saharan Africa are sub-optimal. The SEARCH test and treat trial (NCT01864603) intervention included antiretroviral care delivery designed to address known barriers HIV-care by decreasing clinic visit frequency providing flexible, patient-centered with retention support. We sought understand facilitators this universal treatment setting through quantitative qualitative data analysis. Methods used a...
Abstract Background Preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2_ infections in healthcare workers (HCWs) is critical for delivery. We aimed to estimate and characterize the prevalence incidence of disease 2019 (COVID-19) a US HCW cohort identify risk factors associated with infection. Methods conducted longitudinal study HCWs at 3 Bay Area medical centers using serial surveys SARS-CoV-2 viral orthogonal serological testing, including measurement neutralizing...
Introduction HIV testing and counselling (HTC) is important to effect positive sexual behaviour change an entry point treatment, care, psychosocial support. One of the most practical initiatives increase HTC encourage partners HIV-infected persons test for HIV. However, partner notification strategies must be feasible in healthcare setting acceptable population.Methods We conducted a qualitative study during pilot phase trial complement its assessment feasibility acceptability methods...
As antiretroviral therapy (ART) rapidly expands in sub-Saharan Africa using new efficient care models, data on costs of these approaches are lacking. We examined a streamlined HIV delivery model within large test-and-treat study Uganda and Kenya.We calculated observed per-person-per-year (ppy) 17 health facilities SEARCH Study intervention communities (NCT: 01864603) via micro-costing techniques, time-and-motion studies, staff interviews, administrative records. Cost categories included...
As countries move toward universal HIV treatment, many individuals fail to link care after diagnosis of HIV. Efficient and effective linkage strategies are needed.We implemented a patient-centered, multicomponent strategy in the SEARCH "test-and-treat" trial (NCT 01864603) Kenya Uganda. After population-based, community-wide testing, eligible participants were (1) introduced clinic staff (2) provided telephone "hot-line" for enquiries, (3) an appointment reminder phone call, (4) given...