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https://www.readbyqxmd.com/read/28741331/alignment-of-adherence-and-risk-for-hiv-acquisition-in-a-demonstration-project-of-pre-exposure-prophylaxis-among-hiv-serodiscordant-couples-in-kenya-and-uganda-a-prospective-analysis-of-prevention-effective-adherence
#1
Jessica E Haberer, Lara Kidoguchi, Renee Heffron, Nelly Mugo, Elizabeth Bukusi, Elly Katabira, Stephen Asiimwe, Katherine K Thomas, Connie Celum, Jared M Baeten
INTRODUCTION: Adherence is essential for pre-exposure prophylaxis (PrEP) to protect against HIV acquisition, but PrEP use need not be life-long. PrEP is most efficient when its use is aligned with periods of risk - a concept termed prevention-effective adherence. The objective of this paper is to describe prevention-effective adherence and predictors of adherence within an open-label delivery project of integrated PrEP and antiretroviral therapy (ART) among HIV serodiscordant couples in Kenya and Uganda (the Partners Demonstration Project)...
July 25, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28741133/african-and-caribbean-nurses-decisions-about-hiv-testing-a-mixed-methods-study
#2
Jean N Harrowing, Nancy Edwards, Solina Richter, Karin Minnie, Tania Rae
Nurses in Jamaica, Kenya, South Africa, and Uganda are at risk for occupational exposure to HIV. Little is known about the experiences and policy supports related to nurses having themselves tested for the virus. This article reports a mixed-methods study about contextual influences on nurses' decision-making about HIV testing. Individual and focus group interviews, as well as a questionnaire on workplace polices and quality assurance and a human resource management assessment tool provided data. Fear of a positive diagnosis and stigma and lack of confidentiality along with gaps in the policy environment contributed to indecision about testing...
July 24, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28736692/evaluating-the-impact-of-a-hiv-low-risk-express-care-task-shifting-program-a-case-study-of-the-targeted-learning-roadmap
#3
Linh Tran, Constantin T Yiannoutsos, Beverly S Musick, Kara K Wools-Kaloustian, Abraham Siika, Sylvester Kimaiyo, Mark J van der Laan, Maya Petersen
In conducting studies on an exposure of interest, a systematic roadmap should be applied for translating causal questions into statistical analyses and interpreting the results. In this paper we describe an application of one such roadmap applied to estimating the joint effect of both time to availability of a nurse-based triage system (low risk express care (LREC)) and individual enrollment in the program among HIV patients in East Africa. Our study population is comprised of 16,513 subjects found eligible for this task-shifting program within 15 clinics in Kenya between 2006 and 2009, with each clinic starting the LREC program between 2007 and 2008...
December 2016: Epidemiologic Methods
https://www.readbyqxmd.com/read/28736393/traditional-healers-faith-healers-and-medical-practitioners-the-contribution-of-medical-pluralism-to-bottlenecks-along-the-cascade-of-care-for-hiv-aids-in-eastern-and-southern-africa
#4
Mosa Moshabela, Dominic Bukenya, Gabriel Darong, Joyce Wamoyi, Estelle McLean, Morten Skovdal, William Ddaaki, Kenneth Ondeng'e, Oliver Bonnington, Janet Seeley, Victoria Hosegood, Alison Wringe
OBJECTIVES: There are concerns that medical pluralism may delay patients' progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish the manifestation of medical pluralism among PLHIV, and explore mechanisms through which medical pluralism contributes bottlenecks along the HIV care cascade. METHODS: We conducted a multicountry exploratory qualitative study in seven health and demographic surveillance sites in six eastern and southern African countries: Uganda, Kenya, Tanzania, Malawi, Zimbabwe and South Africa...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736392/-i-am-treated-well-if-i-adhere-to-my-hiv-medication-putting-patient-provider-interactions-in-context-through-insights-from-qualitative-research-in-five-sub-saharan-african-countries
#5
Ken Ondenge, Jenny Renju, Oliver Bonnington, Mosa Moshabela, Joyce Wamoyi, Constance Nyamukapa, Janet Seeley, Alison Wringe, Morten Skovdal
OBJECTIVES: The nature of patient-provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient-provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, we seek to unpack local dynamics that serve to hinder or facilitate productive patient-provider interactions...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#6
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736389/hiv-testing-experiences-and-their-implications-for-patient-engagement-with-hiv-care-and-treatment-on-the-eve-of-test-and-treat-findings-from-a-multicountry-qualitative-study
#7
Alison Wringe, Mosa Moshabela, Constance Nyamukapa, Dominic Bukenya, Ken Ondenge, William Ddaaki, Joyce Wamoyi, Janet Seeley, Kathryn Church, Basia Zaba, Victoria Hosegood, Oliver Bonnington, Morten Skovdal, Jenny Renju
OBJECTIVE: In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. METHODS: As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28733854/process-evaluation-of-a-clinical-trial-to-test-school-support-as-hiv-prevention-among-orphaned-adolescents-in-western-kenya
#8
Denise Dion Hallfors, Hyunsan Cho, Shane Hartman, Isabella Mbai, Carolyne Atieno Ouma, Carolyn Tucker Halpern
Orphaned adolescents are a large and vulnerable population in sub-Saharan Africa, at higher risk for HIV than non-orphans. Yet prevention of new infection is critical for adolescents since they are less likely than adults to enter and remain in treatment and are the only age group with rising AIDS death rates. We report process evaluation for a randomized controlled trial (RCT) testing support to stay in school (tuition, uniform, nurse visits) as an HIV prevention strategy for orphaned Kenyan adolescents. The RCT found no intervention effect on HIV/HSV-2 biomarker outcomes...
July 21, 2017: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/28732773/efficacy-of-oral-pre-exposure-prophylaxis-prep-for-hiv-among-women-with-abnormal-vaginal-microbiota-a-post-hoc-analysis-of-the-randomised-placebo-controlled-partners-prep-study
#9
Renee Heffron, R Scott McClelland, Jennifer E Balkus, Connie Celum, Craig R Cohen, Nelly Mugo, Elizabeth Bukusi, Deborah Donnell, Jairam Lingappa, James Kiarie, Tina Fiedler, Matthew Munch, David N Fredricks, Jared M Baeten
BACKGROUND: Daily oral tenofovir-based pre-exposure prophylaxis (PrEP) is high efficacious for HIV prevention among women with high adherence. However, the effect of abnormal vaginal microbiota on PrEP efficacy is of concern. We investigated whether bacterial vaginosis modified the efficacy of oral PrEP. METHODS: We used prospectively collected data from women in the Partners PrEP Study, a placebo-controlled trial of daily oral PrEP (either tenofovir monotherapy or a combination of tenofovir and emtricitabine) in HIV serodiscordant couples aged 18 years or older in Kenya and Uganda that showed high efficacy in women...
July 18, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28728497/the-significance-of-benefit-perceptions-for-the-ethics-of-hiv-research-involving-adolescents-in-kenya
#10
Stuart Rennie, Allison K Groves, Denise Dion Hallfors, Bonita J Iritani, Fredrick S Odongo, Winnie K Luseno
Assessment of benefits is traditionally regarded as crucial to the ethical evaluation of research involving human participants. We conducted focus group discussions (FGDs) with health and other professionals engaged with adolescents, caregivers/parents, and adolescents in Siaya County, Kenya, to solicit opinions about appropriate ways of conducting HIV research with adolescents. Our data revealed that many focus group participants have a profoundly positive conception of participation in health research, including studies conferring seemingly few benefits...
July 1, 2017: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/28725164/cost-effectiveness-of-cervical-cancer-screening-and-preventative-cryotherapy-at-an-hiv-treatment-clinic-in-kenya
#11
Marita R Zimmermann, Elisabeth Vodicka, Joseph B Babigumira, Timothy Okech, Nelly Mugo, Samah Sakr, Louis P Garrison, Michael H Chung
OBJECTIVE: This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. METHODS: A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28723333/enhanced-prophylaxis-plus-antiretroviral-therapy-for-advanced-hiv-infection-in-africa
#12
James Hakim, Victor Musiime, Alex J Szubert, Jane Mallewa, Abraham Siika, Clara Agutu, Simon Walker, Sarah L Pett, Mutsa Bwakura-Dangarembizi, Abbas Lugemwa, Symon Kaunda, Mercy Karoney, Godfrey Musoro, Sheila Kabahenda, Kusum Nathoo, Kathryn Maitland, Anna Griffiths, Margaret J Thomason, Cissy Kityo, Peter Mugyenyi, Andrew J Prendergast, A Sarah Walker, Diana M Gibb
BACKGROUND: In sub-Saharan Africa, among patients with advanced human immunodeficiency virus (HIV) infection, the rate of death from infection (including tuberculosis and cryptococcus) shortly after the initiation of antiretroviral therapy (ART) is approximately 10%. METHODS: In this factorial open-label trial conducted in Uganda, Zimbabwe, Malawi, and Kenya, we enrolled HIV-infected adults and children 5 years of age or older who had not received previous ART and were starting ART with a CD4+ count of fewer than 100 cells per cubic millimeter...
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28717383/what-influences-feeding-decisions-for-hiv-exposed-infants-in-rural-kenya
#13
Helen M Nabwera, Joyline Jepkosgei, Kelly W Muraya, Amin S Hassan, Catherine S Molyneux, Rehema Ali, Andrew M Prentice, James A Berkley, Martha K Mwangome
BACKGROUND: Infant feeding in the context of human immunodeficiency virus (HIV) poses unique challenges to mothers and healthcare workers in balancing the perceived risks of HIV transmission and nutritional requirements. We aimed to describe the decision-making processes around infant feeding at a rural HIV clinic in Kenya. METHODS: We used a qualitative study design. Between March and August 2011, we conducted in-depth interviews (n = 9) and focus group discussions (n = 10) with purposively selected hospital and community respondents at Kilifi County Hospital, Kenya...
2017: International Breastfeeding Journal
https://www.readbyqxmd.com/read/28716065/the-validity-of-the-sf-12-and-sf-6d-instruments-in-people-living-with-hiv-aids-in-kenya
#14
Anik R Patel, Richard T Lester, Carlo A Marra, Mia L van der Kop, Paul Ritvo, Lidia Engel, Sarah Karanja, Larry D Lynd
BACKGROUND: Health-related quality of life (HRQoL) and health state utility value (HSUV) measurements are vital components of healthcare clinical and economic evaluations. Accurate measurement of HSUV and HRQoL require validated instruments. The 12-item Short-Form Health Survey (SF-12) is one of few instruments that can evaluate both HRQoL and HSUV, but its validity has not been assessed in people living with HIV/AIDS (PLWHA) in east Africa, where the burden of HIV is high. METHODS: This cross-sectional study used baseline data from a randomized trial involving PLWHA in Kenya...
July 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28715157/use-of-the-shangring-circumcision-device-in-boys-below-18-years-old-in-kenya-results-from-a-pilot-study
#15
Quentin D Awori, Richard K Lee, Phillip S Li, Jared N Moguche, Dan Ouma, Betsy Sambai, Marc Goldstein, Mark A Barone
INTRODUCTION: Male circumcision is a proven prevention strategy against the spread of HIV. The World Health Organization's new 2016-2021 strategic framework on voluntary medical male circumcision (VMMC) targets 90% of males aged 10-29 years to receive circumcision by 2021 in 14 priority sub-Saharan countries while anticipating an increase in the demand for infant circumcision. It also states that the use of circumcision devices is a safe and efficient innovation to accelerate attainment of these goals...
July 12, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28712360/resisting-and-tolerating-p-falciparum-in-pregnancy-under-different-malaria-transmission-intensities
#16
Nicaise Tuikue Ndam, Emmanuel Mbuba, Raquel González, Pau Cisteró, Simon Kariuki, Esperança Sevene, María Rupérez, Ana Maria Fonseca, Anifa Vala, Sonia Maculuve, Alfons Jiménez, Llorenç Quintó, Peter Ouma, Michael Ramharter, John J Aponte, Arsenio Nhacolo, Achille Massougbodji, Valerie Briand, Peter G Kremsner, Ghyslain Mombo-Ngoma, Meghna Desai, Eusebio Macete, Michel Cot, Clara Menéndez, Alfredo Mayor
BACKGROUND: Resistance and tolerance to Plasmodium falciparum can determine the progression of malaria disease. However, quantitative evidence of tolerance is still limited. We investigated variations in the adverse impact of P. falciparum infections among African pregnant women under different intensities of malaria transmission. METHODS: P. falciparum at delivery was assessed by microscopy, quantitative PCR (qPCR) and placental histology in 946 HIV-uninfected and 768 HIV-infected pregnant women from Benin, Gabon, Kenya and Mozambique...
July 17, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28708845/leveraging-peer-based-support-to-facilitate-hiv-care-in-kenya
#17
Rakhi Karwa, Mercy Maina, Timothy Mercer, Benson Njuguna, Juddy Wachira, Celia Ngetich, Fatma Some, Beatrice Jakait, Regina K Owino, Adrian Gardner, Sonak Pastakia
Rakhi Karwa and colleagues discuss a program in which peer navigators support care for people with HIV at a Kenyan hospital.
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28705204/delay-along-the-care-seeking-journey-of-patients-with-ocular-surface-squamous-neoplasia-in-kenya
#18
Stephen Gichuhi, Joy Kabiru, Alain M'bongo Zindamoyen, Hillary Rono, Ernest Ollando, Joseph Wachira, Rhoda Munene, Timothy Onyuma, Mandeep S Sagoo, David Macleod, Helen A Weiss, Matthew J Burton
BACKGROUND: In Africa, accessing eye health services is a major challenge. Ocular surface squamous neoplasia (OSSN) is a substantial ocular health problem in Africa related to solar UV light exposure and HIV infection among other risk factors. The disease causes visual loss and even death in advanced cases. This study was conducted to assess referral pathway and treatment delay for patients with OSSN in Kenya. METHODS: Adults with conjunctival lesions presenting to four eye centres were asked about their occupations, when they noticed the growth, health facilities visited in seeking care, cost of consultation, surgery, medicines and histopathology and dates at each step...
July 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28694240/feasibility-of-establishing-hiv-case-based-surveillance-to-measure-progress-along-the-health-sector-cascade-situational-assessments-in-tanzania-south-africa-and-kenya
#19
Richelle Harklerode, Sandra Schwarcz, James Hargreaves, Andrew Boulle, Jim Todd, Serge Xueref, Brian Rice
BACKGROUND: To track the HIV epidemic and responses to it, the World Health Organization recommends 10 global indicators to collect information along the HIV care cascade. Patient diagnosis and medical record data, harnessed through case-based surveillance (CBS), can be used to measure 8 of these. While many high burden countries have well-established systems for monitoring patients on HIV treatment, few have formally adopted CBS. OBJECTIVE: In response to the need for improved strategic HIV information and to facilitate the development of CBS in resource-limited countries, we aimed to conduct situational assessments of existing data collection systems in Tanzania, South Africa, and Kenya...
July 10, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28692542/the-effect-of-oral-pre-exposure-prophylaxis-on-the-progression-of-hiv-1-seroconversion
#20
Deborah Donnell, Eric Ramos, Connie Celum, Jared Baeten, Joan Dragavon, Jordan Tappero, Jairam R Lingappa, Allan Ronald, Kenneth Fife, Robert W Coombs
OBJECTIVE: To investigate whether oral pre-exposure prophylaxis (PrEP) alters timing and patterns of seroconversion when PrEP use continues after HIV-1 infection. DESIGN: Retrospective testing of the timing of Fiebig stage HIV-1 seroconversion in the Partners PrEP Study, a randomized placebo-controlled clinical trial of PrEP conducted in Kenya and Uganda. METHODS: Specimens from 138 seroconverters were collected every 3 months and when HIV-1 infection was suspected based on monthly rapid HIV-1 tests...
July 7, 2017: AIDS
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