Publications - Uganda

Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda

Post Date: 
2020-03-17
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Publication: 
The Lancet HIV
BACKGROUND: International and global organisations advocate targeting interventions to areas of high HIV prevalence (ie, hotspots). To better understand the potential benefits of geo-targeted control, we assessed the extent to which HIV hotspots along Lake Victoria sustain transmission...

Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda

Post Date: 
2020-02-20
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Publication: 
Nature Communications
Abstract HIV prevalence varies markedly throughout Africa, and it is often presumed areas of higher HIV prevalence (i.e., hotspots) serve as sources of infection to neighboring areas of lower prevalence. However, the small-scale geography of migration networks and movement of HIV-...

Impact of combination HIV interventions on HIV incidence in hyperendemic fishing communities in Uganda: a prospective cohort study

Post Date: 
2019-10-06
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Publication: 
The Lancet HIV
BACKGROUND: Targeting combination HIV interventions to locations and populations with high HIV burden is a global priority, but the impact of these strategies on HIV incidence is unclear. We assessed the impact of combination HIV interventions on HIV incidence in four HIV-hyperendemic...

Isoniazid preventive therapy in HIV-infected pregnant and postpartum women

Post Date: 
2019-10-03
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Publication: 
New England Journal of Medicine
New England Journal of Medicine: Dr. Amita Gupta and colleagues found that the current standard of care given to HIV+ pregnant women to prevent TB should wait until 12 weeks after delivery. The study underscores the need to include pregnant women in clinical trials.

Adaptive viral load monitoring frequency to facilitate differentiated care: a modeling study from Rakai, Uganda

Post Date: 
2019-09-18
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Publication: 
Clinical Infectious Diseases
INTRODUCTION: After scaleup of antiretroviral therapy (ART), routine annual viral load monitoring has been adopted by most countries, but reduced frequency of viral load monitoring may offer cost savings in resource limited settings. We investigated if viral load monitoring...

Results of early virologic monitoring may facilitate differentiated care monitoring strategies for clients on ART, Rakai, Uganda

Post Date: 
2018-10-15
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Publication: 
Open Forum Infectious Diseases
BACKGROUND: Viral load (VL) monitoring is standard of care in HIV-infected persons initiated on antiretroviral therapy (ART). We evaluated the predictive value of VL measurements at 6 and 12 months after initiation of firstline ART to estimate the future risk of virologic failure (VF...

Group mentorship model to enhance the efficiency and productivity of PhD research training in Sub-Saharan Africa

Post Date: 
2018-05-04
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Publication: 
Annals of Global Health
Annals of Global Health : Systems capacity building approach to PhD training allowed strong outputs at lower cost and with relatively few additional mentors to train independent scientists able to conduct original research and mentor others.

Migration and risk of HIV acquisition in Rakai, Uganda: a population-based cohort study

Post Date: 
2018-04-15
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Publication: 
Lancet HIV
BACKGROUND: In sub-Saharan Africa, migrants typically have higher HIV prevalence than non-migrants; however, whether HIV acquisition typically precedes or follows migration is unknown. We aimed to investigate the risk of HIV after migration in Rakai District, Uganda. ...

HIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda

Post Date: 
2018-03-27
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Publication: 
AIDS
OBJECTIVE: To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load suppression. METHODS: We extracted data on the location and type of care services utilized by HIV-positive persons...

The validity of self-reported antiretroviral use in persons living with HIV: a population-based study

Post Date: 
2018-01-28
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Publication: 
AIDS
OBJECTIVE: To assess the validity of self-reported antiretroviral therapy use (ART) using population-based cohort data. METHODS: Self-reported ART use and nonuse was compared with a validated laboratory assay in 557 HIV-positive participants in the Rakai...

Identifying models of HIV care and treatment service delivery in Tanzania, Uganda, and Zambia using cluster analysis and Delphi survey

Post Date: 
2017-12-06
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Publication: 
BMC Health Services Research
BACKGROUND: Organization of HIV care and treatment services, including clinic staffing and services, may shape clinical and financial outcomes, yet there has been little attempt to describe different models of HIV care in sub-Saharan Africa (SSA). Information about the relative benefits...

HIV prevention efforts and incidence in HIV in Uganda

Post Date: 
2017-11-30
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Publication: 
New England Journal of Medicine
In a large study in Uganda, Dr. Larry Chang and colleagues found that combination HIV prevention has population level implications, reducing new infections by 42%.

Impact of a community health worker HIV treatment and prevention intervention in an HIV hotspot fishing community in Rakai, Uganda (mLAKE): study protocol for a randomized controlled trial

Post Date: 
2017-10-23
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Publication: 
Trials
Abstract Background: Effective yet practical strategies are needed to increase engagement in HIV treatment and prevention services, particularly in high-HIV-prevalence hotspots. We designed a community-based intervention called "Health Scouts" to promote uptake and adherence to...

Design and implementation of a community health worker HIV treatment and prevention intervention in an HIV hot spot fishing community in Rakai, Uganda

Post Date: 
2017-05-22
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Publication: 
Journal of the International Association of Providers of AIDS Care
Abstract Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The...

Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda

Post Date: 
2017-03-23
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Publication: 
BMC Infectious Diseases
Background : Cryptococcal meningitis (CM) constitutes a significant source of mortality in resource-limited regions. Cryptococcal antigen (CRAG) can be detected in the blood before onset of meningitis. We sought to determine the cost-effectiveness of implementing CRAG screening using the...

Qualitative insights into implementation, processes, and outcomes of a randomized trial on peer support and HIV care engagement in Rakai, Uganda

Post Date: 
2017-01-10
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Publication: 
BMC Infectious Diseases
BACKGROUND: People living with human immunodeficiency virus (HIV) who have not yet initiated antiretroviral therapy (ART) can benefit from being engaged in care and utilizing preventive interventions. Community-based peer support may be an effective approach to promote these...

Heterogeneity of the HIV epidemic in agrarian, trading, and fishing communities in Rakai, Uganda: an observational epidemiological study

Post Date: 
2016-08-15
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Publication: 
The Lancet HIV
Background : Understanding the extent to which HIV burden differs across communities and the drivers of local disparities is crucial for an effective and targeted HIV response. We assessed community-level variations in HIV prevalence, risk factors, and treatment and prevention service uptake...

Community-based interventions to improve and sustain antiretroviral therapy adherence, retention in HIV care and clinical outcomes in low- and middle-income countries for achieving the UNAIDS 90-90-90 targets

Post Date: 
2016-07-30
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Publication: 
Current HIV/AIDS Reports
Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically...

Association of medical male circumcision and antiretroviral therapy scale-up with community HIV incidence in Rakai, Uganda

Post Date: 
2016-07-12
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Publication: 
JAMA
Importance Medical male circumcision (MMC) and antiretroviral therapy (ART) are proven HIV prevention interventions, but there are limited data on the population-level effect of scale-up of these interventions in sub-Saharan Africa. Such evaluation is important for planning and resource allocation...

Empirical tuberculosis therapy versus isoniazid in adult outpatients with advanced HIV initiating antiretroviral therapy (REMEMBER): a multicountry open-label randomised controlled trial

Post Date: 
2016-03-19
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Publication: 
The Lancet
Background: Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical...

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