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Kenya hiv

Emilie Venables, Jeffrey K Edwards, Saar Baert, William Etienne, Kelly Khabala, Helen Bygrave
INTRODUCTION: The number of people on antiretroviral therapy (ART) for the long-term management of HIV in low- and middle-income countries (LMICs) is continuing to increase, along with the prevalence of Non-Communicable Diseases (NCDs). The need to provide large volumes of HIV patients with ART has led to significant adaptations in how medication is delivered, but access to NCD care remains limited in many contexts. Medication Adherence Clubs (MACs) were established in Kibera, Kenya to address the large numbers of patients requiring chronic HIV and/or NCD care...
2016: PloS One
Sonia Menon, Aibibula Wusiman, Marie Claude Boily, Mbabazi Kariisa, Hillary Mabeya, Stanley Luchters, Frode Forland, Rodolfo Rossi, Steven Callens, Davy Vanden Broeck
BACKGROUND: There is a scarcity of data on the distribution of human papillomavirus (HPV) genotypes in the HIV positive population and in invasive cervical cancer (ICC) in Kenya. This may be different from genotypes found in abnormal cytology. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18, and the nonavalent vaccine targeting 90% of all ICC cases, such HPV genotype distribution data are indispensable for predicting the impact of vaccination and HPV screening on prevention...
2016: PloS One
Sergio Bautista-Arredondo, Sandra G Sosa-Rubí, Marjorie Opuni, David Contreras-Loya, Ada Kwan, Claire Chaumont, Abson Chompolola, Jeanine Condo, Omar Galárraga, Neil Martinson, Felix Masiye, Sabin Nsanzimana, Ivan Ochoa-Moreno, Richard Wamai, Joseph Wang'ombe
OBJECTIVE: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. DESIGN: Data collected covered the period 2011-2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. METHODS: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers' perspective using micro-costing...
October 23, 2016: AIDS
Elizabeth M Irungu, Renee Heffron, Nelly Mugo, Kenneth Ngure, Elly Katabira, Nulu Bulya, Elizabeth Bukusi, Josephine Odoyo, Stephen Asiimwe, Edna Tindimwebwa, Connie Celum, Jared M Baeten
BACKGROUND: Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) reduce HIV-1 transmission within heterosexual HIV-1 serodiscordant couples. Prioritizing couples at highest HIV-1 transmission risk for ART and PrEP would maximize impact and minimize costs. METHODS: The Partners Demonstration Project is an open-label, delivery study of integrated PrEP and ART for HIV-1 prevention among high risk HIV-1 serodiscordant couples in Kenya and Uganda. We evaluated the feasibility of using a validated risk score that weighs a combination of easily measurable factors (age, children, marital status, male circumcision status, condom use, plasma HIV-1 levels) to identify couples at highest risk for HIV-1 transmission for enrollment...
October 17, 2016: BMC Infectious Diseases
Wei Chang, Gabriel Chamie, Daniel Mwai, Tamara D Clark, Harsha Thirumurthy, Edwin D Charlebois, Maya Petersen, Jane Kabami, Emmanuel Ssemmondo, Kevin Kadede, Dalsone Kwarisiima, Norton Sang, Elizabeth A Bukusi, Craig R Cohen, Moses Kamya, Diane V Havlir, James G Kahn
BACKGROUND: In 2013-2014, we achieved 89% adult HIV testing coverage using a hybrid testing approach in 32 communities in Uganda and Kenya (SEARCH: NCT01864603). To inform scalability, we sought to determine: (1) overall cost and efficiency of this approach; and (2) costs associated with point-of-care (POC) CD4 testing, multidisease services, and community mobilization. METHODS: We applied microcosting methods to estimate costs of population-wide HIV testing in 12 SEARCH trial communities...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
K J Alcock, Amina Abubakar, Charles R Newton, Penny Holding
BACKGROUND: HIV infection has been associated with impaired language development in prenatally exposed children. Although most of the burden of HIV occurs in sub-Saharan Africa, there have not been any comprehensive studies of HIV exposure on multiple aspects of language development using instruments appropriate for the population. METHODS: We compared language development in children exposed to HIV in utero to community controls (N = 262, 8-30 months) in rural Kenya, using locally adapted and validated communicative development inventories...
October 12, 2016: BMC Research Notes
Stephen Gichuhi, Ephantus Macharia, Joy Kabiru, Alain M'bongo Zindamoyen, Hillary Rono, Ernest Ollando, Joseph Wachira, Rhoda Munene, Timothy Onyuma, Walter G Jaoko, Mandeep S Sagoo, Helen A Weiss, Matthew J Burton
OBJECTIVE: To determine modifiable risk factors of ocular surface squamous neoplasia (OSSN) in Kenya using disease-free controls. METHODS: Adults with conjunctival lesions were recruited at four eye care centres in Kenya and underwent excision biopsy. An equal number of controls having surgery for conditions not affecting the conjunctiva and unrelated to ultraviolet light were group-matched to cases by age group, sex and eye care centre. Associations of risk factors with OSSN were evaluated using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95%CI)...
October 7, 2016: Tropical Medicine & International Health: TM & IH
Angela M Parcesepe, Kelly L L'Engle, Sandra L Martin, Sherri Green, Chirayath Suchindran, Peter Mwarogo
Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger...
October 6, 2016: Journal of Urban Health: Bulletin of the New York Academy of Medicine
T Tony Trinh, Nelly Yatich, Richard Ngomoa, Christine J McGrath, Barbra A Richardson, Samah R Sakr, Agnes Langat, Grace C John-Stewart, Michael H Chung
BACKGROUND: Disclosure of HIV serostatus can have significant benefits for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response. METHODS: We conducted a retrospective cohort study of newly diagnosed, ART-naïve HIV-infected adults (>18 years) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1st 2009 and July 1st 2011 and initiated ART within 3 months. Analysis was restricted to adults who reported to have either disclosed or not disclosed their HIV status to their partner...
2016: PloS One
Ida Pam Ombura, Noel Onyango, Susan Odera, Florence Mutua, Joshua Nyagol
BACKGROUND: Although prevention and control of spread of multi-drug resistant tuberculosis strains is a global challenge, there is paucity of data on the prevalence of DR-TB in patients diagnosed with TB in referral hospitals in Kenya. The present study assessed patients' characteristics and prevalence of drug resistant TB in sputa smear positive TB patients presenting to Coast Provincial General Hospital (CPGH) in Mombasa, Kenya. METHODS: Drug resistance was evaluated in 258 randomly selected sputa smear TB positive cases between the periods of November 2011 to February 2012 at the CPGH-Mombasa...
2016: PloS One
Enos O Masini, Omar Mansour, Clare E Speer, Vittorio Addona, Christy L Hanson, Joseph K Sitienei, Hillary K Kipruto, Martin Muhingo Githiomi, Brenda Nyambura Mungai
Despite high tuberculosis (TB) treatment success rate, treatment adherence is one of the major obstacles to tuberculosis control in Kenya. Our objective was to identify patient-related factors that were associated with time to TB treatment interruption and the geographic distribution of the risk of treatment interruption by county. Data of new and retreatment patients registered in TIBU, a Kenyan national case-based electronic data recording system, between 2013 and 2014 was obtained. Kaplan-Meier curves and log rank tests were used to assess the adherence patterns...
2016: PloS One
Michelle Remme, Mariana Siapka, Olivier Sterck, Mthuli Ncube, Charlotte Watts, Anna Vassall
Despite optimism about the end of AIDS, the HIV response requires sustained financing into the future. Given flat-lining international aid, countries' willingness and ability to shoulder this responsibility will be central to access to HIV care. This paper examines the potential to expand public HIV financing, and the extent to which governments have been utilising these options. We develop and compare a normative and empirical approach. First, with data from the 14 most HIV-affected countries in sub-Saharan Africa, we estimate the potential increase in public HIV financing from economic growth, increased general revenue generation, greater health and HIV prioritisation, as well as from more unconventional and innovative sources, including borrowing, health-earmarked resources, efficiency gains, and complementary non-HIV investments...
September 19, 2016: Social Science & Medicine
Stanley Luchters, Wilkister Bosire, Amy Feng, Marlise L Richter, Nzioki King'ola, Frances Ampt, Marleen Temmerman, Matthew F Chersich
INTRODUCTION: Female sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya. METHODS: A prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV...
2016: PloS One
Charlotte G Neumann, Winstone Nyandiko, Abraham Siika, Natalie Drorbaugh, Goleen Samari, Grace Ettyang, Judith A Ernst
This paper describes morbidity in a group of HIV-positive drug-naïve rural women in western Kenya. A total of 226 drug-naïve HIV-positive women were evaluated for baseline morbidity, immune function, and anthropometry before a food-based nutrition intervention. Kenyan nurses visited women in their homes and conducted semi-structured interviews regarding symptoms and physical signs experienced at the time of the visit and during the previous week and physical inspection. Blood and urine samples were examined for determination of immune function (CD4, CD8, and total lymphocyte counts), anaemia, malaria, and pregnancy status...
September 2016: African Journal of AIDS Research: AJAR
Anjuli D Wagner, Cyrus M Wachira, Irene N Njuguna, Elizabeth Maleche-Obimbo, Kenneth Sherr, Irene W Inwani, James P Hughes, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker
OBJECTIVES: Few routine systems exist to test older, asymptomatic children for HIV. Testing all children in the population has high uptake but is inefficient, while testing only symptomatic children increases efficiency but misses opportunities to optimize outcomes. Testing children of HIV-infected adults in care may efficiently identify previously undiagnosed HIV-infected children before symptomatic disease. METHODS: HIV-infected parents in HIV care in Nairobi, Kenya were systematically asked about their children's HIV status and testing history...
September 19, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Fredrick Kateera, Sam L Nsobya, Steven Tukwasibwe, Emmanuel Hakizimana, Leon Mutesa, Petra F Mens, Martin P Grobusch, Michèle van Vugt, Nirbhay Kumar
Faced with intense levels of chloroquine (CQ) resistance in Plasmodium falciparum malaria, Rwanda replaced CQ with amodiaquine (AQ)+sulfadoxine-pyrimethamine (SP) in 2001, and subsequently with artemether-lumefantrine (AL) in 2006, as first-line treatments for uncomplicated malaria. Following years of discontinuation of CQ use, re-emergence of CQ-susceptible parasites has been reported in countries including Malawi, Kenya and Tanzania. In contrast, high levels of SP resistant mutant parasites continue to be reported even in countries of presumed reduced SP drug selection pressure...
September 17, 2016: Acta Tropica
Josien de Klerk, Eileen Moyer
As part of the chronic disease paradigm now widely used for HIV in sub-Saharan Africa, antiretroviral treatment programs emphasize self-care. In the informal settlements of Mombasa, Kenya, the management of stress-associated with economic precariousness-plays a significant role in self-care practices and ideologies. Based on ethnographic fieldwork, we examine how local narratives of stress and self-care intertwine with social responsibilities of older HIV-positive people. For older Mombassans, living with 'chronic' HIV means living with an unpredictable body, which affects how they are able to care for their kin...
September 20, 2016: Medical Anthropology
Sheri D Weiser, Abigail M Hatcher, Lee L Hufstedler, Elly Weke, Shari L Dworkin, Elizabeth A Bukusi, Rachel L Burger, Stephen Kodish, Nils Grede, Lisa M Butler, Craig R Cohen
This longitudinal qualitative study sought to understand how and why a livelihood intervention affected the health and health behaviors of HIV-infected Kenyan adults. The intervention included a microfinance loan, agricultural and financial training, and a human-powered water pump. In-depth interviews were conducted at two time points with intervention and control participants and program staff. We double coded interviews (n = 117) and used thematic content analysis of transcripts following an integrative inductive-deductive approach...
September 16, 2016: AIDS and Behavior
Matthew Westercamp, Walter Jaoko, Supriya Mehta, Pauline Abuor, Perez Siambe, Robert C Bailey
BACKGROUND: Three randomized controlled trials (RCT) showed that voluntary medical male circumcision (VMMC) reduces the risk of female to male HIV transmission by approximately 60%. However, data from communities where VMMC programs have been implemented are needed to assess changes in circumcision prevalence and whether men and women compensate for perceived reductions in risk by increasing their HIV risk behaviors. METHODS: Scale-up of free VMMC began in Kisumu, Kenya in 2008...
September 13, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Darcy White, Kate S Wilson, Linnet N Masese, George Wanje, Walter Jaoko, Kishorchandra Mandaliya, Barbra A Richardson, John Kinuthia, Jane M Simoni, R Scott McClelland
BACKGROUND: Studies of alcohol use and sexual behavior in African populations have primarily been cross-sectional, used nonvalidated measures of alcohol use, or relied on self-reported sexual risk endpoints. Few have focused on human immunodeficiency virus (HIV)-positive women. METHODS: Longitudinal data were collected from a cohort of HIV-positive Kenyan female sex workers. At enrollment and annual visits, participants were asked about past-year alcohol use using the Alcohol Use Disorders Identification Test (AUDIT)...
October 2016: Sexually Transmitted Diseases
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