A5020963118- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- Mental Health Treatment and Access
- Health Policy Implementation Science
- HIV, Drug Use, Sexual Risk
- HIV/AIDS Impact and Responses
- HIV-related health complications and treatments
- Global Maternal and Child Health
- Mental Health and Patient Involvement
- Cardiac Health and Mental Health
- Palliative Care and End-of-Life Issues
- Breastfeeding Practices and Influences
- Family Support in Illness
- Poverty, Education, and Child Welfare
- Cancer survivorship and care
- Child and Adolescent Psychosocial and Emotional Development
- HIV Research and Treatment
- Sex work and related issues
- Health Systems, Economic Evaluations, Quality of Life
- Health disparities and outcomes
- Global Public Health Policies and Epidemiology
- Female Genital Mutilation/Cutting Issues
- COVID-19 and Mental Health
- Cytomegalovirus and herpesvirus research
- Food Security and Health in Diverse Populations
Malawi University of Science and Technology
2025
University of Malawi
2019-2024
University of North Carolina at Chapel Hill
2015-2023
Lilongwe University of Agriculture and Natural Resources
2019-2021
Objective(s): To evaluate uptake of HIV testing in a prevention mother-to-child transmission program (PMTCT) Lilongwe, Malawi from April 2002 until December 2006. Design: Retrospective analysis monthly reports the beginning program. Setting: Four antenatal clinics Malawi. Methods: Pregnant women attending urban Lilongwe were invited to participate PMTCT Women given information and education on care groups 8 12. Written informed consent for was obtained privately. returned test result 1–2...
Background Pregnant and post-partum adolescent girls young women (AGYW) living with HIV in sub-Saharan Africa experience inferior outcomes along the prevention of mother-to-child transmission (PMTCT) cascade compared to their adult counterparts. Yet, despite this inequality outcomes, scarce data from region describe AGYW perspectives inform adolescent-sensitive PMTCT programming. In paper, we report findings formative implementation research examining barriers to, facilitators of, care for...
Stigma is an impediment across the cancer care continuum, leading to delayed presentation care, elevated morbidity and mortality, reduced quality of life. The goal this study was qualitatively examine drivers, manifestations, impacts cancer-related stigma among individuals who received treatment in Malawi, identify opportunities address stigma.
MTN-020/ASPIRE trial and IPM-027/Ring Study recently proved the dapivirine vaginal ring was safe effective with consistent use. To optimize ring's impact, barriers facilitators to adherence must be understood addressed.
BackgroundAlthough evidence-based treatments for depression in low-resource settings are established, implementation strategies to scale up these remain poorly defined. We aimed compare two achieving high-quality integration of care into chronic medical and improving mental health outcomes patients with hypertension diabetes.MethodsWe conducted a parallel, cluster-randomised, controlled, trial ten facilities across Malawi. Facilities were randomised (1:1) by covariate-constrained...
Abstract Introduction HIV testing male partners of pregnant and postpartum women can lead to improved health outcomes for women, infants. However, in sub‐Saharan Africa, few get tested during their partner's pregnancy spite several promising approaches increase partner uptake. We assessed stakeholders’ views preferences notification, home‐based secondary distribution self‐test kits understand whether offering choices may acceptability. Methods Interviewers conducted semi‐structured...
High HIV incidence rates have been observed among pregnant and breastfeeding women in sub-Saharan Africa. Oral pre-exposure prophylaxis (PrEP) can effectively reduce acquisition during these periods; however, understanding of its acceptability feasibility antenatal postpartum populations remains limited. To address this gap, we conducted in-depth interviews with 90 study participants Malawi Zambia: 39 HIV-negative pregnant/breastfeeding women, 14 male partners, 19 healthcare workers, 18...
Depression is a major contributor to morbidity and mortality in sub-Saharan Africa. Due low system capacity, three four patients with depression Africa go untreated. Despite this, little attention has been paid the cost-effectiveness of implementation strategies scale up evidence-based treatment region. In this study, we investigate two different integrate Friendship Bench approach measurement-based care non-communicable disease clinics Malawi.
The scientific and ethical importance of including women reproductive age in biomedical research is widely acknowledged. Concerns about preventing fetal exposure to interventions have motivated requirements for contraception among aged studies–often irrespective risks benefits or a woman's actual potential pregnancy, raising important questions when such are appropriate. perspectives themselves on these issues largely unexplored. We conducted 140 interviews, 70 the U.S. Malawi, with either...
Globally, mental health disorders rank as the greatest cause of disability. Low and middle-income countries (LMICs) hold a disproportionate share burden, especially it pertains to depression. Depression is highly prevalent among those with non-communicable diseases (NCDs), creating barrier successful treatment. While some treatments have proven efficacy in LMIC settings, wide dissemination challenged by multiple factors, leading researchers call for implementation strategies overcome...
The sub-Saharan African Regional Partnership for mental health and capacity building (SHARP) study was a clinic-randomized trial of two implementation strategies integrating depression screening treatment into non-communicable diseases' (NCD) clinics in Malawi between 2019 2022. We report on the barriers to implementing care integration at SHARP sites potential solutions. N = 39 in-depth interviews with participants from all ten were conducted, recorded, transcribed, coded NVivo 12 analyzed...
Abstract Background Integration of depression services into infectious disease care is feasible, acceptable, and effective in sub-Saharan African settings. However, while the region shifts focus to include chronic diseases, additional information required integrate We assessed service providers’ views on concept integrating non-communicable diseases’ (NCD) clinics Malawi. The aim this analysis was better understand barriers, facilitators, solutions NCD services. Methods Between June August...
To eliminate mother-to-child transmission of HIV (EMTCT), scalable strategies to enhance antiretroviral adherence for both therapy (ART) and pre-exposure prophylaxis (PrEP) are needed as part integrated maternal-child health services. We developed Tonse Pamodzi (“all us together”), an adaptable intervention integrating biomedical behavioral components support treatment prevention. describe our development process, which comprised formative qualitative research, a review the literature,...
Socio-cultural beliefs and practices surrounding menses influence women's sexual reproductive health behaviors decision-making. We analyzed menstrual experiences within the context of MTN-020/ASPIRE clinical trial during which women were asked to use a monthly vaginal ring for HIV prevention. The qualitative component was conducted February 2013-June 2015, included interviews focus group discussions with 214 aged 18–42, in Malawi, Zimbabwe, Uganda, South Africa. Emotions shame, embarrassment...
Background: Depression is a leading cause of death and disability worldwide, including in low- middle-income countries (LMICs). often coexists with chronic medical conditions associated worse clinical outcomes. This confluence has led to calls integrate mental health treatment disease care systems LMICs. article describes the rationale protocol for trial comparing effectiveness cost-effectiveness two different intervention packages implement evidence-based antidepressant management...
The SARS-CoV-2 pandemic led to the rapid transition of many research studies from in-person telephone follow-up globally. For mental health in low-income settings, tele-follow-up raises unique safety concerns due potential identifying suicide risk participants who cannot be immediately referred care. We developed and iteratively adapted a telephone-delivered protocol designed follow positive assessment (SRA) screening. describe development implementation this SRA during cohort adults with...
Clinical research to inform the evidence base guide nonobstetrical care during pregnancy is critically important for well-being of women and their future offspring. Conversations about regulations such research, including whether paternal consent should ever be required, informed by perspectives those most affected, namely, pregnant women. We conducted in-depth interviews with 140 living or at risk HIV-70 in Malawi, 70 United States-exploring views on requiring women's participation trials...
Abstract Background The pressing need to expand the biomedical HIV prevention evidence base during pregnancy is now increasingly recognized. Women’s views regarding participation in such trials and initiating PrEP while pregnant are critical inform evolving policy best practices aimed at responsibly expanding evidence-based access for this population. Methods We conducted 35 semi-structured interviews with reproductive-aged women Malawi local language, Chichewa. Participants were...