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zimbabwe hiv incidence

John Hargrove, Cari van Schalkwyk, Jean Humphrey, Kuda Mutasa, Robert Ntozini, Michele Owen, Silvina Masciotra, Bharat Parekh, Yen T Duong, Trudy Dobbs, Peter Kilmarx, Elizabeth Gonese
BACKGROUND: Laboratory assays that identify recent HIV infections are important for assessing impacts of interventions aimed at reducing HIV incidence. Kinetics of HIV humoral responses can vary with inherent assay properties, and between HIV subtypes, populations and physiological states. They are important in determining mean duration of recent infection (MDRI) for antibody-based assays for detecting recent HIV infections. METHODS: We determined MDRIs for BED-CEIA, LAg and BRAI assays for 101 seroconverting postpartum women, recruited in Harare in 1997- 2000 during the Zimbabwe Vitamin A for Mothers and Babies (ZVITAMBO) Trial, comparing them against published MDRIs estimated from seroconverting cases in the general population...
April 26, 2017: AIDS Research and Human Retroviruses
Robin Schaefer, Simon Gregson, Jeffrey W Eaton, Owen Mugurungi, Rebecca Rhead, Albert Takaruza, Rufurwokuda Maswera, Constance Nyamukapa
OBJECTIVE: Age-disparate sexual relationships with older men may drive high rates of HIV acquisition in young women in sub-Saharan Africa but evidence is limited. We investigate the association between age-disparate relationships and HIV incidence in Manicaland, Zimbabwe. DESIGN: A general-population open-cohort study (six surveys) (1998-2013). METHODS: 3746 young women aged 15-24 years participated in consecutive surveys and were HIV-negative at the beginning of inter-survey periods...
April 19, 2017: AIDS
Katherine E Schlusser, Jacob Konikoff, Allison R Kirkpatrick, Charles Morrison, Tsungai Chipato, Pai-Lien Chen, Marshall Munjoma, Susan H Eshleman, Oliver Laeyendecker
Accurate methods for cross-sectional incidence estimation are needed for HIV prevention research. The Limiting Antigen Avidity (LAg-Avidity) assay has been marketed by two vendors, Maxim Biomedical and Sedia BioSciences Corporation. Performance differences between the two versions of the assay are unknown. We tested a total 1,410 treatment-naive samples with both versions of the assay. The samples came from 176 seroconverters from the Zimbabwe Hormonal Contraception and HIV Study. The correlation between the two versions of the assay was 0...
March 20, 2017: AIDS Research and Human Retroviruses
Kudzanai Mateveke, Basant Singh, Alfred Chingono, E Sibanda, Ian Machingura
HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale...
August 17, 2016: Journal of Public Health in Africa
Romain Silhol, Simon Gregson, Constance Nyamukapa, Mutsa Mhangara, Janet Dzangare, Elizabeth Gonese, Jeffrey W Eaton, Kelsey K Case, Mary Mahy, John Stover, Owen Mugurungi
BACKGROUND: More cost-effective HIV control may be achieved by targeting geographical areas with high infection rates. The AIDS Impact model of Spectrum - used routinely to produce national HIV estimates - could provide the required subnational estimates but is rarely validated with empirical data, even at a national level. DESIGN: The validity of the Spectrum model estimates were compared with empirical estimates. METHODS: Antenatal surveillance and population survey data from a population HIV cohort study in Manicaland, East Zimbabwe, were input into Spectrum 5...
April 2017: AIDS
Zvavahera Mike Chirenje, Holly M Gundacker, Barbra Richardson, Lorna Rabe, Zakir Gaffoor, Gonasagrie Lulu Nair, Brenda Gati Mirembe, Jeanna M Piper, Sharon Hillier, Jeanne Marrazzo
BACKGROUND: In sub-Saharan Africa, there are limited data on the incidence of sexually transmitted infections (STIs) among women, largely because routine screening for asymptomatic infection is not performed. We conducted a secondary analysis to measure STI incidence rates and determine risk factors for new STI acquisition among women enrolled in the VOICE trial. METHODS: We analyzed data from 4843 women screened for chlamydia, gonorrhoea, syphilis, and trichomonas infection at baseline, annually, at interim visits when clinically indicated and at their study termination visit...
March 2017: Sexually Transmitted Diseases
Joel Negin, Simon Gregson, Jeffrey W Eaton, Nadine Schur, Albert Takaruza, Peter Mason, Constance Nyamukapa
BACKGROUND: With the scale-up of antiretroviral treatment across Africa, many people are living longer with HIV. Understanding the ageing of the HIV cohort and sexual behaviour among older adults are important for appropriately responding to the changing demographics of people living with HIV. METHODS: We used data from a large population-based open cohort in eastern Zimbabwe to examine HIV prevalence trends and incidence among those aged 45 years and older. Five survey rounds have been completed between 1998 and 2011...
2016: PloS One
Jessica M Fogel, William Clarke, Michal Kulich, Estelle Piwowar-Manning, Autumn Breaud, Matthew T Olson, Mark A Marzinke, Oliver Laeyendecker, Agnès Fiamma, Deborah Donnell, Jessie K K Mbwambo, Linda Richter, Glenda Gray, Michael Sweat, Thomas J Coates, Susan H Eshleman
BACKGROUND: Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence. METHODS: Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at 4 study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009-2011) using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors, 3 nonnucleoside reverse transcriptase inhibitors, and 9 protease inhibitors; maraviroc; raltegravir)...
February 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Walter Chingwaru, Jerneja Vidmar
Zimbabwe is going through a generalised acquired immunodeficiency syndrome (AIDS) epidemic. The first five years of the epidemic (1985-1990) were characterised by lack of medicines against human immunodeficiency virus (HIV), and an exponential increase in prevalence (65-fold) and incidence (13-fold), which were fuelled by high-risk sexual behaviour. The high HIV prevalence, mortality and stigma yielded great fear and panic in the population, which are thought to have led to confusion and hopelessness, and, in turn, increased risky sexual behaviour...
August 11, 2016: Global Public Health
Severin Guy Mahiané, Oliver Laeyendecker
The study considers the problem of estimating incidence of a non remissible infection (or disease) with possibly differential mortality using data from a(several) cross-sectional prevalence survey(s). Fitting segmented polynomial models is proposed to estimate the incidence as a function of age, using the maximum likelihood method. The approach allows automatic search for optimal position of knots, and model selection is performed using the Akaike information criterion. The method is applied to simulated data and to estimate HIV incidence among men in Zimbabwe using data from both the NIMH Project Accept (HPTN 043) and Zimbabwe Demographic Health Surveys (2005-2006)...
January 30, 2017: Statistics in Medicine
Annick Bórquez, Anne Cori, Erica L Pufall, Jingo Kasule, Emma Slaymaker, Alison Price, Jocelyn Elmes, Basia Zaba, Amelia C Crampin, Joseph Kagaayi, Tom Lutalo, Mark Urassa, Simon Gregson, Timothy B Hallett
BACKGROUND: Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates. METHODS AND FINDINGS: We developed a predictive model, the Incidence Patterns Model (IPM), representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, "key populations" based on risk behaviours (sex work, injecting drug use, and male-to-male sex), HIV and ART status within married or cohabiting unions, and circumcision status...
September 2016: PLoS Medicine
Chloe A Teasdale, Elaine J Abrams, Mary Ann Chiasson, Jessica Justman, Kelly Blanchard, Heidi E Jones
Data suggest that pregnant women in some settings have high prevalence of HIV and other sexually transmitted infections (STI). We examined changes in sexual risk behaviors and intravaginal practices during pregnancy that may contribute to HIV and STI incidence using data from the Methods for Improved Reproductive Health in Africa study conducted in South Africa and Zimbabwe 2003-2006. We used a crossover design and modified Poisson regression to compare behaviors among HIV negative women 18-45 years during pregnant and non-pregnant periods...
September 6, 2016: Archives of Sexual Behavior
Ian Baudi, Sayuki Iijima, Nyasha Chin'ombe, Sekesai Mtapuri-Zinyowera, Shuko Murakami, Masanori Isogawa, Atsuko Hachiya, Yasumasa Iwatani, Yasuhito Tanaka
The objective of this study was to determine the prevalence of co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) and the genetic characteristics of both viruses among pre-HIV-treatment patients in Harare, Zimbabwe. This cross-sectional survey involved 176 remnant plasma samples collected from consenting HIV patients (median age 35 [18-74]) between June and September 2014. HBV seromarkers were determined by high-sensitivity chemiluminescence assays. Molecular evolutionary analyses were conducted on the basal core promoter/precore (BCP/PC) and S regions of HBV, as well as part of the HIV pol region...
February 2017: Journal of Medical Virology
Collin Mangenah, Webster Mavhu, Karin Hatzold, Andrea K Biddle, Getrude Ncube, Owen Mugurungi, Ismail Ticklay, Frances M Cowan, Harsha Thirumurthy
BACKGROUND: The 14 countries that are scaling up voluntary male medical circumcision (VMMC) for HIV prevention are also considering early infant male circumcision (EIMC) to ensure longer-term reductions in HIV incidence. The cost of implementing EIMC is an important factor in scale-up decisions. We conducted a comparative cost analysis of EIMC performed by nurse-midwives and doctors using the AccuCirc device in Zimbabwe. METHODS: Between August 2013 and July 2014, nurse-midwives performed EIMC on 500 male infants using AccuCirc in a field trial...
July 2016: Global Health, Science and Practice
Mufuta Tshimanga, Tonderayi Mangwiro, Owen Mugurungi, Sinokuthemba Xaba, Munyaradzi Murwira, Danuta Kasprzyk, Daniel E Montaño, Daisy Nyamukapa, Basile Tambashe, Pesanai Chatikobo, Patricia Gundidza, Gerald Gwinji
BACKGROUND: The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost) of the PrePex device compared to forceps-guided surgical circumcision...
2016: PloS One
Tinashe K Nyazika, Faith Masanganise, Ferry Hagen, Mutsawashe F Bwakura-Dangarembizi, Ismail M H Ticklay, Valerie J Robertson
Cryptococcal meningitis is a leading infectious disease worldwide as a result of the high burden of HIV and AIDS, although its cumulative incidence is very low in children compared with that in adults. Very few studies involving the disease in children have been reported including sub-Saharan Africa, with the highest prevalence of HIV-infected children in the world. We summarize 5 cases of children diagnosed with cryptococcal meningitis at a tertiary hospital in Harare, Zimbabwe, between October 1, 2013, and September 30, 2014...
September 2016: Pediatric Infectious Disease Journal
James R Hargreaves, Sibongile Mtetwa, Calum Davey, Jeffrey Dirawo, Samson Chidiya, Clemens Benedikt, Sue Naperiela Mavedzenge, Ramona Wong-Gruenwald, Dagmar Hanisch, Tapiwa Magure, Owen Mugurungi, Frances M Cowan
BACKGROUND: HIV epidemiology and intervention uptake among female sex workers (FSW) in sub-Saharan Africa remain poorly understood. Data from outreach programs are a neglected resource. METHODS: Analysis of data from FSW consultations with Zimbabwe's National Sex Work program, 2009-2014. At each visit, data were collected on sociodemographic characteristics, HIV testing history, HIV tests conducted by the program and antiretroviral (ARV) history. Characteristics at first visit and longitudinal data on program engagement, repeat HIV testing, and HIV seroconversion were analyzed using a cohort approach...
May 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Angela M Crook, Anna Turkova, Victor Musiime, Mutsa Bwakura-Dangarembizi, Sabrina Bakeera-Kitaka, Patricia Nahirya-Ntege, Margaret Thomason, Peter Mugyenyi, Philippa Musoke, Adeodata Kekitiinwa, Paula Munderi, Kusum Nathoo, Andrew J Prendergast, A Sarah Walker, Diana M Gibb
BACKGROUND: There are few data on tuberculosis (TB) incidence in HIV-infected children on antiretroviral therapy (ART). Observational studies suggest co-trimoxazole prophylaxis may prevent TB, but there are no randomized data supporting this. The ARROW trial, which enrolled HIV-infected children initiating ART in Uganda and Zimbabwe and included randomized cessation of co-trimoxazole prophylaxis, provided an opportunity to estimate the incidence of TB over time, to explore potential risk factors for TB, and to evaluate the effect of stopping co-trimoxazole prophylaxis...
March 23, 2016: BMC Medicine
Dixon Chibanda, Frances Cowan, Lorna Gibson, Helen A Weiss, Crick Lund
BACKGROUND: In 2014 close to 10 million people living with HIV (PLWH) in sub-Saharan Africa were on highly active anti-retroviral therapy (HAART). The incidence of non-communicable diseases has increased markedly in PLWH as mortality is reduced due to use of HAART. Common mental disorders (CMD) are highly prevalent in PLWH. We aimed to determine factors associated with probable CMD and depression, assessed by 2 locally validated screening tools in a population with high prevalence of HIV in Harare, Zimbabwe...
February 29, 2016: BMC Psychiatry
Jared M Baeten, Thesla Palanee-Phillips, Elizabeth R Brown, Katie Schwartz, Lydia E Soto-Torres, Vaneshree Govender, Nyaradzo M Mgodi, Flavia Matovu Kiweewa, Gonasagrie Nair, Felix Mhlanga, Samantha Siva, Linda-Gail Bekker, Nitesha Jeenarain, Zakir Gaffoor, Francis Martinson, Bonus Makanani, Arendevi Pather, Logashvari Naidoo, Marla Husnik, Barbra A Richardson, Urvi M Parikh, John W Mellors, Mark A Marzinke, Craig W Hendrix, Ariane van der Straten, Gita Ramjee, Zvavahera M Chirenje, Clemensia Nakabiito, Taha E Taha, Judith Jones, Ashley Mayo, Rachel Scheckter, Jennifer Berthiaume, Edward Livant, Cindy Jacobson, Patrick Ndase, Rhonda White, Karen Patterson, Donna Germuga, Beth Galaska, Katherine Bunge, Devika Singh, Daniel W Szydlo, Elizabeth T Montgomery, Barbara S Mensch, Kristine Torjesen, Cynthia I Grossman, Nahida Chakhtoura, Annalene Nel, Zeda Rosenberg, Ian McGowan, Sharon Hillier
BACKGROUND: Antiretroviral medications that are used as prophylaxis can prevent acquisition of human immunodeficiency virus type 1 (HIV-1) infection. However, in clinical trials among African women, the incidence of HIV-1 infection was not reduced, probably because of low adherence. Longer-acting methods of drug delivery, such as vaginal rings, may simplify use of antiretroviral medications and provide HIV-1 protection. METHODS: We conducted a phase 3, randomized, double-blind, placebo-controlled trial of a monthly vaginal ring containing dapivirine, a non-nucleoside HIV-1 reverse-transcriptase inhibitor, involving women between the ages of 18 and 45 years in Malawi, South Africa, Uganda, and Zimbabwe...
December 1, 2016: New England Journal of Medicine
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