Publications

Effect of peer health workers on AIDS care in Rakai, Uganda: a cluster-randomized trial

Post Date: 
2010-06-02
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Publication: 
PLOS
Background: Human resource limitations are a challenge to the delivery of antiretroviral therapy (ART) in low-resource settings. We conducted a cluster randomized trial to assess the effect of community-based peer health workers (PHW) on AIDS care of adults in Rakai, Uganda. ...

Developing WHO guidelines with pragmatic, structured, evidence-based processes: a case study

Post Date: 
2010-05-15
Publication: 
Global Public Health
Many guidelines, including those produced by the World Health Organisation (WHO), have failed to adhere to rigorous methodological standards. Operational examples of guideline development processes may provide important lessons learned to improve the rigour and quality of future guidelines. To this...

Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure among adults and adolescents living with HIV in low-resource settings

Post Date: 
2010-04-14
Publication: 
Cochrane Database of Systematic Reviews
Background: One of the critical clinical decisions made in antiretroviral therapy (ART) is when to switch from an initial regimen to another due to treatment failure. This complex process requires consideration of multiple factors including: (1) what type of monitoring (e.g. clinical, immunologic,...

Physician estimate of antiretroviral adherence: poor correlation with patient self-report and viral load

Post Date: 
2010-03-15
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Publication: 
AIDS Patient Care and STDs
Adherence to antiretroviral therapy (ART) is critical in maintaining viral suppression and minimizing resistance in HIV-infected patients. We compared physician estimates of their patients' ART adherence with participant's self-reported adherence to determine patient-provider agreement and identify...

Sexually transmitted infection prevalence and behavioral risk factors among Latino and non-Latino patients attending the Baltimore City STD clinics

Post Date: 
2010-03-15
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Sexually Transmitted Diseases
Background: Many studies have evaluated factors influencing STD/HIV disparities between African-American and white populations, but fewer have explicitly included Latinos for comparison. Methods: We analyzed demographic and behavioral data captured in electronic medical records of patients first...

One-, two-, and three-class resistance among HIV-infected patients on antiretroviral therapy in private care clinics: Mumbai, India

Post Date: 
2010-01-26
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AIDS Research and Human Retroviruses
HIV-infected patients receiving antiretroviral (ARV) therapy (ART) in India are not all adequately virally suppressed. We analyzed ARV drug resistance in adults receiving ART in three private clinics in Mumbai, India. HIV viral load was measured in 200 patients with the Roche AMPLICOR HIV-1 Monitor...

Diagnostic accuracy of a urine lipoarabinomannan test for tuberculosis in hospitalized patients in a high HIV prevalence setting

Post Date: 
2009-10-01
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Publication: 
Journal of Acquired Immune Deficiency Syndromes
We evaluated the accuracy of a urine lipoarabinomannan (LAM) test for TB diagnosis in South Africa.

Extended-dose nevirapine to 6 weeks of age for infants to prevent HIV transmission via breastfeeding in Ethiopia, India, and Uganda: an analysis of three randomized controlled trials

Post Date: 
2009-07-26
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Publication: 
The Lancet
Background: UNICEF/WHO recommends that infants born to HIV-infected mothers who do not have access to acceptable, feasible, affordable, sustainable, and safe replacement feeding should be exclusively breastfed for at least 6 months. The aim of three trials in Ethiopia, India, and Uganda was to...

Strategies for gender-equitable HIV services in rural India

Post Date: 
2009-05-15
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Health Policy and Planning
The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt...

Highly complex neutralization determinants on a monophyletic lineage of newly transmitted subtype C HIV-1 Env clones from India

Post Date: 
2009-03-15
Publication: 
Virology
Little is known about the neutralization properties of HIV-1 in India to optimally design and test vaccines. For this reason, a functional Env clone was obtained from each of ten newly acquired, heterosexually transmitted HIV-1 infections in Pune, Maharashtra. These clones formed a phylogenetically...

Two year virologic outcomes of an alternative AIDS care model: evaluation of a peer health worker and nurse-staffed community-based program in Uganda

Post Date: 
2009-03-01
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Publication: 
Journal of Acquired Immune Deficiency Syndromes
Background: There is growing concern about the human resources needed to care for increasing numbers of patients receiving antiretroviral therapy in resource-limited settings. We evaluated an alternative model, community-based, comprehensive antiretroviral program staffed primarily by peer health...

Nevirapine resistance and breast-milk HIV transmission: effects of single and extended-dose nevirapine prophylaxis in subtype C HIV-infected infants

Post Date: 
2009-01-01
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Publication: 
PLOS One
Background: Daily nevirapine (NVP) prophylaxis to HIV-exposed infants significantly reduces breast-milk HIV transmission. We assessed NVP-resistance in Indian infants enrolled in the “six-week extended-dose nevirapine” (SWEN) trial who received single-dose NVP (SD-NVP) or SWEN for prevention of...

Traditional Indian medicine and homeopathy for HIV/AIDS: a review of the literature

Post Date: 
2008-12-22
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Publication: 
AIDS Research and Therapy
Background: Allopathic practitioners in India are outnumbered by practitioners of traditional Indian medicine and homeopathy (TIMH), which is used by up to two-thirds of its population to help meet primary health care needs, particularly in rural areas. India has an estimated 2.5 million HIV...

Neutralizing antibody responses in recent seroconverters with HIV-1 subtype C infections in India

Post Date: 
2008-10-25
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Publication: 
AIDS Research and Human Retroviruses
The longitudinal heterologous neutralization response against two HIV-1 subtype C isolates was studied in 33 ART-naive individuals recently infected with HIV-1 subtype C from India. Seven of 33 (21%) seroconverters demonstrated a consistent response against both isolates (65-100% neutralization),...

High risk for occupational exposure to HIV and utilization of post-exposure prophylaxis in a teaching hospital in Pune, India

Post Date: 
2008-10-21
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Publication: 
BMC Infectious Diseases
Background: The risk for occupational exposure to HIV has been well characterized in the developed world, but limited information is available about this transmission risk in resource-constrained settings facing the largest burden of HIV infection. In addition, the feasibility and utilization of...

Neisseria gonorrhea and Chlamydia trachomatis among Human Immunodeficiency Virus-infected women

Post Date: 
2008-10-15
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Publication: 
Sexually Transmitted Diseases
In this study, we determine risk factors for CT and GC infection in women receiving HIV continuity care using data from the Johns Hopkins HIV Clinical Cohort. The Johns Hopkins HIV Clinical Cohort is a longitudinal observational study of adult patients (≥18 years old) in HIV care in the Johns...

Repeated pregnancy in HIV positive Indian women with known HIV status

Post Date: 
2008-09-29
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Publication: 
AIDS Care
HIV-positive women of reproductive age face challenges in decision making related to pregnancy. Understanding factors influencing repeat pregnancies in women with known HIV status are necessary to guide interventions and counseling strategies to better inform and support them. We compared three...

The Indian pediatric HIV epidemic: a systematic review

Post Date: 
2008-09-15
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Publication: 
Current HIV Research
Despite an estimated 70,000 Indian children living with HIV infection, little is known about India's pediatric HIV epidemic. Generalizations about epidemiology, natural history, and treatment outcomes from other resource-limited settings (RLS) may be inaccurate for several biologic and social...

Incidence of common opportunistic infections in HIV-infected individuals in Pune, India: analysis by stages of immunosuppression represented by CD4 counts

Post Date: 
2008-07-02
Publication: 
International Journal of Infectious Diseases
Background: Opportunistic infections (OIs) influence the morbidity and mortality due to HIV infections. Data from India on the incidence of OIs among HIV-infected individuals by stages of immunodeficiency are scarce. Methods: Between September 2002 and November 2004, HIV-infected individuals were...

Timing of therapy for latent tuberculosis infection among immigrants presenting to a U.S. public health clinic: a retrospective study

Post Date: 
2008-05-12
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Publication: 
BMC Public Health
Background: In the U.S. more than half of incident tuberculosis (TB) cases occur in immigrants. Current guidelines recommend screening and treatment for latent TB infection (LTBI) within 5 years of arrival to the U.S. This study evaluates the timing of LTBI therapy among immigrants presenting for...

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