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Using A Network-Based Approach And Targeted Maximum Likelihood Estimation To Evaluate The Effect Of Adding Pre-Exposure Prophylaxis To An Ongoing Test-And-Treat Trial, Laura Balzer, Patrick Staples, Jukka-Pekka Onnela, Victor De Gruttola Jan 2017

Using A Network-Based Approach And Targeted Maximum Likelihood Estimation To Evaluate The Effect Of Adding Pre-Exposure Prophylaxis To An Ongoing Test-And-Treat Trial, Laura Balzer, Patrick Staples, Jukka-Pekka Onnela, Victor De Gruttola

Laura B. Balzer

Background: Several cluster randomized trials are underway to investigate the implementation and effectiveness of a universal test-and-treat strategy on the HIV epidemic in sub-Saharan Africa. We consider nesting studies of pre-exposure prophylaxis (PrEP) within these trials. PrEP is a general strategy where high risk HIV- persons take antiretrovirals daily to reduce their risk of infection from exposure to HIV. We address how to target PrEP to high risk groups and how to maximize power to detect the individual and combined effects of universal test-and-treat and PrEP strategies.
Methods: We simulated 1000 trials, each consisting of 32 villages with 200 individuals …


The Impact Of Hiv-Related Stigma On Older And Younger Adults Living With Hiv Disease: Does Age Matter?, Charles A. Emlet, David J. Brennan, Sarah Brennenstuhl, Sergio Rueda, Trevor A. Hart, Sean B. Rourke Dec 2014

The Impact Of Hiv-Related Stigma On Older And Younger Adults Living With Hiv Disease: Does Age Matter?, Charles A. Emlet, David J. Brennan, Sarah Brennenstuhl, Sergio Rueda, Trevor A. Hart, Sean B. Rourke

Charles Emlet

The purpose of this study was to examine the independent influence of age on levels of HIV-related stigma experienced by adults living with HIV/AIDS.


Sociodemographic Profile Of Older Adults With Hiv/Aids: Gender And Sexual Orientation Differences, David J. Brennan, Charles A. Emlet, Sarah Brennenstuhl, Sergio Rueda Feb 2013

Sociodemographic Profile Of Older Adults With Hiv/Aids: Gender And Sexual Orientation Differences, David J. Brennan, Charles A. Emlet, Sarah Brennenstuhl, Sergio Rueda

Charles Emlet

Using data collected by the Ontario HIV Treatment Network Cohort Study, the primary goal of this study was to describe the socio-demographic characteristics of a sample of older people (age 50 and over) from Ontario ( n = 1,129) living with HIV/AIDS (PHAs). The secondary goal was to compare four sub-samples of older PHAs: women (10.6 % ), heterosexual men (16.7 % ), gay men (65.8 % ), and bisexual men (6.9 % ). These groups differed signifi cantly by age, education, income, nationality, race, and time spent living with HIV. Compared to other groups, gay and bisexual men (GBM) …


Hiv Testing Practices Among Black Primary Care Physicians In The United States, Eric Y. Wong, Wilbert C. Jordan, David J. Malebranche, Lori L. Delaitsch, Rebecca Abravanel, Alisha Bermudez, Bryan P. Baugh Feb 2013

Hiv Testing Practices Among Black Primary Care Physicians In The United States, Eric Y. Wong, Wilbert C. Jordan, David J. Malebranche, Lori L. Delaitsch, Rebecca Abravanel, Alisha Bermudez, Bryan P. Baugh

David J Malebranche

Background: The Centers for Disease Control and Prevention recommends routine HIV testing in all healthcaresettings, but it is unclear how consistently physicians adopt the recommendation. Making the most of each interaction between black physicians and their patients is extremely important to address the HIV health disparities that disproportionately afflict the black community. The goal of this survey-based study was to evaluate the perceptions and practices of black, primary care physicians regarding HIV testing.

Methods: A physician survey was administered at the 2010 National Medical Association Annual Convention, via online physician panels, and by email. Physician eligibility criteria: black race; practicing …


Exposé Of Misleading Claims That Male Circumcision Will Increase Hiv Infections In Africa, Brian J. Morris, Jake H. Waskett, Ronald H. Gray, Daniel T. Halperin, Richard Wamai, Bertran Auvert, Jeffrey D. Klausner Nov 2012

Exposé Of Misleading Claims That Male Circumcision Will Increase Hiv Infections In Africa, Brian J. Morris, Jake H. Waskett, Ronald H. Gray, Daniel T. Halperin, Richard Wamai, Bertran Auvert, Jeffrey D. Klausner

Richard G. Wamai

Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We …


Independent Evolution Of Macrophage-Tropism And Increased Charge Between Hiv-1 R5 Envelopes Present In Brain And Immune Tissue, Maria Paz Gonzalez-Perez, Olivia O’Connell, Rongheng Lin, W Matthew Sullivan, Jeanne Bell, Peter Simmonds, Paul R. Clapham Mar 2012

Independent Evolution Of Macrophage-Tropism And Increased Charge Between Hiv-1 R5 Envelopes Present In Brain And Immune Tissue, Maria Paz Gonzalez-Perez, Olivia O’Connell, Rongheng Lin, W Matthew Sullivan, Jeanne Bell, Peter Simmonds, Paul R. Clapham

Rongheng Lin

Background: Transmitted HIV-1 clade B or C R5 viruses have been reported to infect macrophages inefficiently, while other studies have described R5 viruses in late disease with either an enhanced macrophage-tropism or carrying envelopes with an increased positive charge and fitness. In contrast, our previous data suggested that viruses carrying non-macrophage-tropic R5 envelopes were still predominant in immune tissue of AIDS patients. To further investigate the tropism and charge of HIV-1 viruses in late disease, we evaluated the properties of HIV-1 envelopes amplified from immune and brain tissues of AIDS patients with neurological complications. Results: Almost all envelopes amplified were …


Mexico's Northern Border Conflict: Collateral Damage To Health And Human Rights Of Vulnerable Groups, Leo Beletsky, Gustavo Martinez, Tommi Gaines, Lucie Nguyen, Remedios Lozada, Gudelia Rangel, Alicia Vera, Heather L. Mccauley, Andrea Sorensen, Steffanie A. Strathdee Mar 2012

Mexico's Northern Border Conflict: Collateral Damage To Health And Human Rights Of Vulnerable Groups, Leo Beletsky, Gustavo Martinez, Tommi Gaines, Lucie Nguyen, Remedios Lozada, Gudelia Rangel, Alicia Vera, Heather L. Mccauley, Andrea Sorensen, Steffanie A. Strathdee

Leo Beletsky

Objectives: Given links between policing environment and infectious disease risk among vulnerable groups, we surveyed female sex workers who inject drugs in Tijuana and Ciudad (Cd.) Juarez. Data were used to 1. compare distributions of human rights violations and disease risk, 2. juxtapose these patterns against demographic and structural environment variables, and 3. formulate implications for structural interventions. Methods: Structured interviews and testing for sexually-transmitted infections (STIs) were conducted (October 2008-October 2009). Frequency of individual and environmental factors, including police abuse, HIV risk and protective behaviors were compared between sites using univariate logistic regression. Results: Of 624 women, almost half …


A New Analytical Framework Of 'Continuum Of Prevention And Care' To Maximize Hiv Case Detection And Retention In Care In Vietnam, Masami Fujita, Krishna C. Poudel, Nhan Do Thi, Duong Bui Duc, Kinh Nguyen Van, Kimberly Green, Thu Nguyen Thi Minh, Masya Kato, David Jacka, Thuy Cao Thi Thanh, Long Nguyen Thanh, Masamine Jimba Dec 2011

A New Analytical Framework Of 'Continuum Of Prevention And Care' To Maximize Hiv Case Detection And Retention In Care In Vietnam, Masami Fujita, Krishna C. Poudel, Nhan Do Thi, Duong Bui Duc, Kinh Nguyen Van, Kimberly Green, Thu Nguyen Thi Minh, Masya Kato, David Jacka, Thuy Cao Thi Thanh, Long Nguyen Thanh, Masamine Jimba

Krishna C. Poudel

Background: The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods: We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related …


A New Analytical Framework Of 'Continuum Of Prevention And Care' To Maximize Hiv Case Detection And Retention In Care In Vietnam, Masami Fujita, Krishna C. Poudel, Nhan Do Thi, Duong Bui Duc, Kinh Nguyen Van, Kimberly Green, Thu Nguyen Thi Minh, Masaya Kato, David Jacka, Thuy Cao Thi Thanh, Long Nguyen Thanh, Masamine Jimba Dec 2011

A New Analytical Framework Of 'Continuum Of Prevention And Care' To Maximize Hiv Case Detection And Retention In Care In Vietnam, Masami Fujita, Krishna C. Poudel, Nhan Do Thi, Duong Bui Duc, Kinh Nguyen Van, Kimberly Green, Thu Nguyen Thi Minh, Masaya Kato, David Jacka, Thuy Cao Thi Thanh, Long Nguyen Thanh, Masamine Jimba

Krishna C. Poudel

Background: The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam.
Methods: We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related …


Male Circumcision For Hiv Prevention: Current Evidence And Implementation In Sub-Saharan Africa, Richard G. Wamai, Brian J. Morris, Stefan A. Bailis, David Sokal, Jeffrey D. Klausner, Ross Appleton, Nelson Sewankambo, David A. Cooper, John Bongaarts, Guy De Bruyn, Alex D. Wodak, Joya Banerjee Dec 2011

Male Circumcision For Hiv Prevention: Current Evidence And Implementation In Sub-Saharan Africa, Richard G. Wamai, Brian J. Morris, Stefan A. Bailis, David Sokal, Jeffrey D. Klausner, Ross Appleton, Nelson Sewankambo, David A. Cooper, John Bongaarts, Guy De Bruyn, Alex D. Wodak, Joya Banerjee

Richard G. Wamai

Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major …


Pepfar’S Declining Investment In Treatment, Matthew Kavanagh, Marguerite Thorp Nov 2011

Pepfar’S Declining Investment In Treatment, Matthew Kavanagh, Marguerite Thorp

Matthew M. Kavanagh

Since its inception in 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) has saved millions of lives through providing anti-retroviral (ARV) treatment to people living with HIV/AIDS. However, our analysis of publicly available PEPFAR operational plans shows that funding to AIDS treatment has actually fallen significantly since 2008 in both absolute dollars and as a portion of total budgets—just at a pivotal moment when investment could change the course of the epidemic.


The Effect Of Aids Clinical Trials Group Protocol 5164 On The Time From Pneumocystis Jirovecii Pneumonia Diagnosis To Antiretroviral Initiation In Routine Clinical Practice: A Case Study Of Diffusion, Dissemination And Implementation, Elvin Geng Dec 2010

The Effect Of Aids Clinical Trials Group Protocol 5164 On The Time From Pneumocystis Jirovecii Pneumonia Diagnosis To Antiretroviral Initiation In Routine Clinical Practice: A Case Study Of Diffusion, Dissemination And Implementation, Elvin Geng

Elvin H Geng

No abstract provided.


Retention In Care For Hiv-Infected Patients In Resource-Limited Settings: Challenges And Opportunities, Elvin Geng Dec 2010

Retention In Care For Hiv-Infected Patients In Resource-Limited Settings: Challenges And Opportunities, Elvin Geng

Elvin H Geng

No abstract provided.


Trends In Hiv-Infected Patients Accessing Antiretroviral Therapy In Kenya, Uganda And Tanzania Between 2002 And 2009, Elvin Geng Dec 2010

Trends In Hiv-Infected Patients Accessing Antiretroviral Therapy In Kenya, Uganda And Tanzania Between 2002 And 2009, Elvin Geng

Elvin H Geng

No abstract provided.


Sex And Hiv Disclosure, Aziza Ahmed, Beri Hull Dec 2010

Sex And Hiv Disclosure, Aziza Ahmed, Beri Hull

Aziza Ahmed

No abstract provided.


The Value Of Critique And Distributive Analysis To Addressing The Needs Of Sex Workers In The Context Of Hiv: A Response To Libby Adler’S “Gay Rights And Lefts”, Aziza Ahmed Dec 2010

The Value Of Critique And Distributive Analysis To Addressing The Needs Of Sex Workers In The Context Of Hiv: A Response To Libby Adler’S “Gay Rights And Lefts”, Aziza Ahmed

Aziza Ahmed

No abstract provided.


Diminishing Availability Of Publicly Funded Slots For Antiretroviral Initiation Among Hiv-Infected Art-Eligible Patients In Uganda, Elvin Geng Dec 2009

Diminishing Availability Of Publicly Funded Slots For Antiretroviral Initiation Among Hiv-Infected Art-Eligible Patients In Uganda, Elvin Geng

Elvin H Geng

No abstract provided.


Insert Discourse: Rectal Douching Among Young Hiv-Positive And Hiv-Negative Gay Men In Vancouver, Canada, A. Schilder, Treena Orchard, C. Buchner, S. Strathdee, R. Hogg Dec 2009

Insert Discourse: Rectal Douching Among Young Hiv-Positive And Hiv-Negative Gay Men In Vancouver, Canada, A. Schilder, Treena Orchard, C. Buchner, S. Strathdee, R. Hogg

Dr. Treena Orchard

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention …


Vitamin Content Of Breast Milk From Hiv-1–Infected Mothers Before And After Flash-Heat Treatment, Kiersten Israel-Ballard, Barbara Abrams, Anna Coutsoudis, Lindiwe Sibeko, Lynn Cheryk, Caroline Chantry Jul 2008

Vitamin Content Of Breast Milk From Hiv-1–Infected Mothers Before And After Flash-Heat Treatment, Kiersten Israel-Ballard, Barbara Abrams, Anna Coutsoudis, Lindiwe Sibeko, Lynn Cheryk, Caroline Chantry

Lindiwe Sibeko

(EBM) as one method to reduce postnatal transmission of human immunodeficiency virus (HIV) in developing countries. Flash-heat is a simple heat treatment method shown to inactivate cell-free HIV. Objective—To determine the effect of flash-heat on vitamin content of milk. Methods—Fresh EBM was collected from 50 HIV+ mothers in Durban, South Africa. Mothers washed their hands and then manually expressed 75–150 mL EBM into sterile jars. Milk was aliquoted to unheated controls or flash-heat (50 mL EBM in a glass jar heated in a 450-mL water jacket in an aluminum pan until water boiled, then EBM removed) simulating field conditions with …