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Pulmonary Surfactant Fortified With Cath-2 As A Novel Therapy For Bacterial Pneumonia, Brandon J. Baer 2017 University of Western Ontario

Pulmonary Surfactant Fortified With Cath-2 As A Novel Therapy For Bacterial Pneumonia, Brandon J. Baer

Western Research Forum

Background: Bacterial pneumonia is a leading cause of death worldwide, with high mortality rates persisting even after antibiotic treatment. Current treatments for pneumonia involve administration of antibiotics, however after the bacteria are killed they release toxic substances that induce inflammation and lung dysfunction. Host defense peptides represent a potential solution to this problem through their ability to down regulate inflammation. However, effective delivery to the lung is difficult because of the complex branching structure of the airways. My study addresses this delivery problem by using exogenous surfactant, a pulmonary delivery vehicle capable of improving spreading of these peptides throughout the ...


Inside Unlv, Gian Galassi, Jennifer Vaughan, Carol C. Harter, Richard Flaherty, Rebecca Mills 2017 University of Nevada, Las Vegas

Inside Unlv, Gian Galassi, Jennifer Vaughan, Carol C. Harter, Richard Flaherty, Rebecca Mills

Rebecca Mills

No abstract provided.


Taking Be Proud! Be Responsible! To The Suburbs: A Replication Study, Elaine A. Borawski, Erika S. Trapl, Kimberly Adams-Tufts, Laura L. Hayman, Merdith A. Goodwin, Loren D. Lovegreen 2017 Old Dominion University

Taking Be Proud! Be Responsible! To The Suburbs: A Replication Study, Elaine A. Borawski, Erika S. Trapl, Kimberly Adams-Tufts, Laura L. Hayman, Merdith A. Goodwin, Loren D. Lovegreen

Laura L. Hayman

CONTEXT: An important phase of HIV prevention research is replicating successful interventions with different groups and in different settings. METHODS: Be Proud! Be Responsible!, a successful intervention originally targeting black urban males and carried out in nonschool settings, was presented in health classes at urban and suburban schools with diverse student bodies. A group-randomized intervention study, which included 1,357 ninth and 10th graders from 10 paired schools in a Midwestern metropolitan area, was conducted in 2000-2002. Half the schools received the intervention, and half received a general health promotion program. Students' reports of their sexual behavior and selected cognitive ...


A Decade Later: Comparing Knowledge Of Testing And Assessing Hiv Awareness Of University Of Wyoming Students, Anna R. Bertani 2016 University of Wyoming

A Decade Later: Comparing Knowledge Of Testing And Assessing Hiv Awareness Of University Of Wyoming Students, Anna R. Bertani

Honors Theses AY 16/17

In 2006, the Centers for Disease Control recommended that all patients aged 13-64 be tested for HIV, regardless of lifestyle risks. This recommendation was implemented because in 2006, it was shown that risk based screening was insufficient and does not successfully identify all HIV cases. Early detection is beneficial both with respect to improving treatment outcomes in HIV patients and decreasing transmission to previously uninfected individuals. This recommendation still holds true in 2016. In 2007, Kristine Young (a University of Wyoming Honors student) administered a survey that sought to assess University of Wyoming student knowledge regarding the previously mentioned CDC ...


Establishing A Clinically Relevant Mouse Model Of Human Aml To Test Novel Transmethylation Inhibitors., Aditya Barve 2016 University of Louisville

Establishing A Clinically Relevant Mouse Model Of Human Aml To Test Novel Transmethylation Inhibitors., Aditya Barve

Electronic Theses and Dissertations

Acute myeloid leukemia (AML) is a highly heterogeneous clonal disorder characterized by an accumulation of malignant immature myeloid progenitors in the bone marrow (BM) that hinder normal hematopoiesis. Patient AML exhibits a dramatic heterogeneity in terms of cytogenetics, disease morphology, and associated prognoses and/or chemotherapeutic sensitivity. Thus it becomes clearly evident that the investigation of novel therapeutics for AML will require model systems that are capable of recapitulating this stark heterogeneity in a patient specific manner. Furthermore, it is now understood that the surrounding bone marrow (BM) microenvironment and supporting cells play a critical role in leukemic progression as ...


South Africans With Recent Pregnancy Rarely Know Partner’S Hiv Serostatus: Implications For Serodiscordant Couples Interventions, Lynn T. Matthews, Lizzie Moore, Tamaryn L. Crankshaw, Cecilia Milford, Fortunate N. Mosery, Ross Greener, Christina Psaros, Steven A, Safren, David Bangsberg, Jennifer A. Smit 2016 Center for Global Health & Division of Infectious Disease

South Africans With Recent Pregnancy Rarely Know Partner’S Hiv Serostatus: Implications For Serodiscordant Couples Interventions, Lynn T. Matthews, Lizzie Moore, Tamaryn L. Crankshaw, Cecilia Milford, Fortunate N. Mosery, Ross Greener, Christina Psaros, Steven A, Safren, David Bangsberg, Jennifer A. Smit

David Bangsberg

Background: Implementation of safer conception strategies requires knowledge of partner HIV-serostatus. We recruited women and men in a high HIV-prevalence setting for a study to assess periconception risk behavior among individuals reporting HIV-serodiscordant partnerships. We report screening data from that study with the objective of estimating the proportion of individuals who are aware that they are in an HIV-serodiscordant relationship at the time of conception. Methods: We screened women and men attending antenatal and antiretroviral clinics in Durban, South Africa for enrollment in a study of periconception risk behavior among individuals with serodiscordant partners. Screening questionnaires assessed for study eligibility ...


Understanding Treatment Refusal Among Adults Presenting For Hiv-Testing In Soweto, South Africa: A Qualitative Study, Ingrid T. Katz, Janan Dietrich, Gugu Tshabalala, Thandekile Essien, Kathryn Rough, Alexi A. Wright, David Bangsberg, Glenda E. Gray, Norma C. Ware 2016 Division of Women’s Health, Brigham and Women’s Hospital

Understanding Treatment Refusal Among Adults Presenting For Hiv-Testing In Soweto, South Africa: A Qualitative Study, Ingrid T. Katz, Janan Dietrich, Gugu Tshabalala, Thandekile Essien, Kathryn Rough, Alexi A. Wright, David Bangsberg, Glenda E. Gray, Norma C. Ware

David Bangsberg

HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described ...


Time Preferences Predict Mortality Among Hiv-Infected Adults Receiving Antiretroviral Therapy In Kenya, Harsha Thirumurthy, Kami Hayashi, Sebastian Linnemayr, Rachel C. Vreeman, Irwin P. Levin, David Bangsberg, Noel T. Brewer 2016 University of North Carolina at Chapel Hill

Time Preferences Predict Mortality Among Hiv-Infected Adults Receiving Antiretroviral Therapy In Kenya, Harsha Thirumurthy, Kami Hayashi, Sebastian Linnemayr, Rachel C. Vreeman, Irwin P. Levin, David Bangsberg, Noel T. Brewer

David Bangsberg

Identifying characteristics of HIV-infected adults likely to have poor treatment outcomes can be useful for targeting interventions efficiently. Research in economics and psychology suggests that individuals’ intertemporal time preferences, which indicate the extent to which they trade-off immediate vs. future cost and benefits, can influence various health behaviors. While there is empirical support for the association between time preferences and various non-HIV health behaviors and outcomes, the extent to which time preferences predict outcomes of those receiving antiretroviral therapy (ART) has not been examined previously. HIV-infected adults initiating ART were enrolled at a health facility in Kenya. Participants’ time preferences ...


The Meanings In The Messages: How Sms Reminders And Real-Time Adherence Monitoring Improve Antiretroviral Therapy Adherence In Rural Uganda, Norma C. Ware, Emily A. Pisarski, Melanie Tam, Monique A. Wyatt, Esther Atukunda, Angella Musimenta, David Bangsberg, Jessica E. Haberer 2016 Harvard Medical School

The Meanings In The Messages: How Sms Reminders And Real-Time Adherence Monitoring Improve Antiretroviral Therapy Adherence In Rural Uganda, Norma C. Ware, Emily A. Pisarski, Melanie Tam, Monique A. Wyatt, Esther Atukunda, Angella Musimenta, David Bangsberg, Jessica E. Haberer

David Bangsberg

To understand how a pilot intervention combining SMS reminders with real-time adherence monitoring improved adherence to HIV antiretroviral therapy (ART) for adults initiating treatment in rural Uganda. Design: Qualitative study, conducted with a pilot randomized controlled trial. Methods: Sixty-two pilot intervention study participants took part in qualitative interviews on: preferences for content; frequency and timing of SMS adherence reminders; understandings and experiences of SMS reminders; and understandings and experiences of real-time adherence monitoring. Analysis of interview data was inductive and derived categories describing how participants experienced the intervention, and what it meant to them. Results: SMS reminders prompted taking individual ...


Super Learner Analysis Of Electronic Adherence Data Improves Viral Prediction And May Provide Strategies For Selective Hiv Rna Monitoring, Maya L. Petersen, Erin LeDell, Joshua Schwab, Varada Sarovar, Robert Gross, Nancy Reynolds, Jessica E. Haberer, Kathy Goggin, Carol E. Golin, Julia Arnsten, Marc Rosen, Robert H. Remien, David Etoori, Ira B. Wilson, Jane M. Simoni, Judith A. Erlen, Mark J. van der Laan, Honghu Liu, David Bangsberg 2016 University of California, Berkeley

Super Learner Analysis Of Electronic Adherence Data Improves Viral Prediction And May Provide Strategies For Selective Hiv Rna Monitoring, Maya L. Petersen, Erin Ledell, Joshua Schwab, Varada Sarovar, Robert Gross, Nancy Reynolds, Jessica E. Haberer, Kathy Goggin, Carol E. Golin, Julia Arnsten, Marc Rosen, Robert H. Remien, David Etoori, Ira B. Wilson, Jane M. Simoni, Judith A. Erlen, Mark J. Van Der Laan, Honghu Liu, David Bangsberg

David Bangsberg

Objective—Regular HIV RNA testing for all HIV positive patients on antiretroviral therapy (ART) is expensive and has low yield since most tests are undetectable. Selective testing of those at higher risk of failure may improve efficiency. We investigated whether a novel analysis of adherence data could correctly classify virological failure and potentially inform a selective testing strategy.

Design—Multisite prospective cohort consortium.

Methods—We evaluated longitudinal data on 1478 adult patients treated with ART and monitored using the Medication Event Monitoring System (MEMS) in 16 United States cohorts contributing to the MACH14 consortium. Since the relationship between adherence and ...


Tobacco Use Among Adults Initiating Treatment For Hiv Infection In Rural Uganda, Gina R. Kruse, David Bangsberg, Judith A. Hahn, Jessica E. Haberer, Peter Hunt, Conrad Muzoora, John P. Bennett, Jeffrey N. Martin, Nancy A, Rigotti 2016 Massachusetts General Hospital

Tobacco Use Among Adults Initiating Treatment For Hiv Infection In Rural Uganda, Gina R. Kruse, David Bangsberg, Judith A. Hahn, Jessica E. Haberer, Peter Hunt, Conrad Muzoora, John P. Bennett, Jeffrey N. Martin, Nancy A, Rigotti

David Bangsberg

We conducted a longitudinal study of tobacco use among adults initiating antiretroviral therapy (ART) in Mbarara, Uganda where 11% of men and 3% of women use tobacco according to the 2011 Demographic and Health Survey. In a prospective cohort, self-reported tobacco use was assessed before starting ART and reassessed every 3–4 months. Plasma cotinine, a nicotine metabolite, was measured in a subset of adults pre-ART to verify self-report. Among 496 subjects, 50 (10%) reported current tobacco use (20% of men, 6% of women). Most (53%) adults with elevated cotinine levels (>15 ng/mL) reported no tobacco use. By 6 ...


Understanding Adherence To Daily And Intermittent Regimens Of Oral Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex With Men In Kenya, Peter Mwangi Mugo, Eduard J. Sanders, Gaudensia Mutua, Elisabeth van der Elst, Omu Anzala, Burc Barin, David Bangsberg, Frances H. Priddy, Jessica E. Haberer 2016 Kenya Medical Research Institute

Understanding Adherence To Daily And Intermittent Regimens Of Oral Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex With Men In Kenya, Peter Mwangi Mugo, Eduard J. Sanders, Gaudensia Mutua, Elisabeth Van Der Elst, Omu Anzala, Burc Barin, David Bangsberg, Frances H. Priddy, Jessica E. Haberer

David Bangsberg

A qualitative assessment of Kenyan men who have sex with men taking daily and intermittent oral HIV preexposure prophylaxis (PrEP) found stigma, sex work, mobility, and alcohol impacted adherence. We analyzed quantitative data from the same cohort to explore different definitions of intermittent adherence. Volunteers were randomized to daily emtricitabine/tenofovir or placebo, or intermittent (prescription: Mondays/Fridays/after sex, maximum1 dose/day)emtricitabine/tenofovir or placebo (2:1:2:1), and followed for 4 months. By electronic monitoring, median adherence for daily dosing was 80 %. Median adherence for intermittent dosing was 71 % per a ‘‘relaxed’’ definition (accounting for off-prescription ...


Re-Inventing Adherence: Toward A Patient-Centered Model Of Care For Drug-Resistant Tuberculosis And Hiv, Max R. O'Donnell, A. Daftary, M. Frick, Y. Hirsch-Moverman, K. R. Amico, M. Senthilingam, A. Wolf, J. Z. Metcalfe, P. Isaakidis, J. L. Davis, J. R. Zelnick, J.C.M. Brust, N. Naidu, M. Garretson, David Bangsberg, N. Padayatchi, G. Friedland 2016 Columbia University Medical Center

Re-Inventing Adherence: Toward A Patient-Centered Model Of Care For Drug-Resistant Tuberculosis And Hiv, Max R. O'Donnell, A. Daftary, M. Frick, Y. Hirsch-Moverman, K. R. Amico, M. Senthilingam, A. Wolf, J. Z. Metcalfe, P. Isaakidis, J. L. Davis, J. R. Zelnick, J.C.M. Brust, N. Naidu, M. Garretson, David Bangsberg, N. Padayatchi, G. Friedland

David Bangsberg

BACKGROUND—Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care. OBJECTIVE—To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support. DISCUSSION—Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TB-HIV could be improved by fully ...


Persistent Hiv-Related Stigma In Rural Uganda During A Period Of Increasing Hiv Incidence Despite Treatment Expansion, Brian T. Chan, Sheri D. Weiser, Yap Boum II, Mark J. Siedner, Rain Mocello, Jessica E. Haberer, Peter Hunt, Jeffrey N. Martin, Kenneth H. Mayer, David Bangsberg, Alexander C. Tsai 2016 Massachusetts General Hospital

Persistent Hiv-Related Stigma In Rural Uganda During A Period Of Increasing Hiv Incidence Despite Treatment Expansion, Brian T. Chan, Sheri D. Weiser, Yap Boum Ii, Mark J. Siedner, Rain Mocello, Jessica E. Haberer, Peter Hunt, Jeffrey N. Martin, Kenneth H. Mayer, David Bangsberg, Alexander C. Tsai

David Bangsberg

Objective—Program implementers have argued that the increasing availability of anti-retroviral therapy (ART) will reduce the stigma of HIV. We analyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion.

Design—Serial cross-sectional surveys.

Methods—We analyzed data from the Uganda AIDS Rural Treatment Outcomes (UARTO) study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys (DHS) from 2006 and 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the ...


Pitfalls Of Practicing Cancer Epidemiology In Resource-Limited Settings: The Case Of Survival And Loss To Follow-Up After A Diagnosis Of Kaposi’S Sarcoma In Five Countries Across Sub-Saharan Africa, Esther Freeman, Aggrey Semeere, Megan Wenger, Mwebesa B. Bwana, F. Chite Asirwa, Naftali Busakhala, Emmanuel Oga, Elima Jedy-Agba, Vivian Kwaghe, Kenneth Iregbu, Antoine Jaquet, Francois Dabis, Habakkuk Azinyui Yumo, Jean Claude Dusingize, David Bangsberg, Kathryn Anastos, Sam Phiri, Julia Bohlius, Matthias Egger, Constantin T. Yiannoutsos, Kara Wools-Kaloustian, Jeffrey Martin 2016 Harvard Medical School

Pitfalls Of Practicing Cancer Epidemiology In Resource-Limited Settings: The Case Of Survival And Loss To Follow-Up After A Diagnosis Of Kaposi’S Sarcoma In Five Countries Across Sub-Saharan Africa, Esther Freeman, Aggrey Semeere, Megan Wenger, Mwebesa B. Bwana, F. Chite Asirwa, Naftali Busakhala, Emmanuel Oga, Elima Jedy-Agba, Vivian Kwaghe, Kenneth Iregbu, Antoine Jaquet, Francois Dabis, Habakkuk Azinyui Yumo, Jean Claude Dusingize, David Bangsberg, Kathryn Anastos, Sam Phiri, Julia Bohlius, Matthias Egger, Constantin T. Yiannoutsos, Kara Wools-Kaloustian, Jeffrey Martin

David Bangsberg

Background: Survival after diagnosis is a fundamental concern in cancer epidemiology. In resource-rich settings, ambient clinical databases, municipal data and cancer registries make survival estimation in real-world populations relatively straightforward. In resource-poor settings, given the deficiencies in a variety of health-related data systems, it is less clear how well we can determine cancer survival from ambient data.

Methods: We addressed this issue in sub-Saharan Africa for Kaposi’s sarcoma (KS), a cancer for which incidence has exploded with the HIV epidemic but for which survival in the region may be changing with the recent advent of antiretroviral therapy (ART). From ...


Incomplete Adherence Among Treatment-Experienced Adults On Antiretroviral Therapy In Tanzania, Uganda And Zambia, Julie A. Denison, Olivier Koole, Sharon Tsui, Joris Menten, Kwasi Torpey, Eric van Praag, Ya Diul Mukadi, Robert Colebunders, Andrew F. Auld, Simon G. Agolory, Jonathan Kaplan, Modest Mulenga, Gideon Kwesigabo, Fred Wabwire-Mangen, David Bangsberg 2016 Social and Behavioral Health Sciences, FHI 360, Washington, DC

Incomplete Adherence Among Treatment-Experienced Adults On Antiretroviral Therapy In Tanzania, Uganda And Zambia, Julie A. Denison, Olivier Koole, Sharon Tsui, Joris Menten, Kwasi Torpey, Eric Van Praag, Ya Diul Mukadi, Robert Colebunders, Andrew F. Auld, Simon G. Agolory, Jonathan Kaplan, Modest Mulenga, Gideon Kwesigabo, Fred Wabwire-Mangen, David Bangsberg

David Bangsberg

Objectives—To characterize antiretroviral therapy (ART) adherence across different programmes and examine the relationship between individual and programme characteristics and incomplete adherence among ART clients in sub-Saharan Africa.

Design—A cross-sectional study.

Methods—Systematically selected ART clients (≥18 years; on ART ≥6 months) attending 18 facilities in three countries (250 clients/facility) were interviewed. Client self-reports (3-day, 30-day, Case Index ≥48 consecutive hours of missed ART), healthcare provider estimates and the pharmacy medication possession ratio (MPR) were used to estimate ART adherence. Participants from two facilities per country underwent HIV RNA testing. Optimal adherence measures were selected on the basis ...


High Medication Adherence During Periconception Periods Among Hiv-1–Uninfected Women Participating In A Clinical Trial Of Antiretroviral Pre-Exposure Prophylaxis, Lynn T. Matthews, Renee Heffron, Nelly R. Mugo, Craig R. Cohen, Craig W. Hendrix, Connie Celum, David Bangsberg, Jared M. Baten 2016 Center for Global Health & Division of Infectious Disease

High Medication Adherence During Periconception Periods Among Hiv-1–Uninfected Women Participating In A Clinical Trial Of Antiretroviral Pre-Exposure Prophylaxis, Lynn T. Matthews, Renee Heffron, Nelly R. Mugo, Craig R. Cohen, Craig W. Hendrix, Connie Celum, David Bangsberg, Jared M. Baten

David Bangsberg

Introduction: Pre-exposure prophylaxis (PrEP) may be an important safer conception strategy for HIV-1–uninfected women with HIV-1–infected partners. Understanding medication adherence in this population may inform whether PrEP is a feasible safer conception strategy. Methods: We evaluated predictors of pregnancy and adherence to study medication among HIV-1–uninfected women enrolled in a randomized placebo-controlled trial of PrEP among African HIV-1– serodiscordant couples. Participants were counseled on HIV-1 risk reduction, contraception, and adherence and tested for pregnancy at monthly study visits. Pill counts of dispensed drug were performed and, at a subset of visits, plasma was collected to measure active ...


Know Your Audience: Predictors Of Success For A Patient-Centered Texting App To Augment Linkage To Hiv Care In Rural Uganda, Mark J. Siedner, Data Santorino, Jessica E. Haberer, David Bangsberg 2016 Harvard Medical School

Know Your Audience: Predictors Of Success For A Patient-Centered Texting App To Augment Linkage To Hiv Care In Rural Uganda, Mark J. Siedner, Data Santorino, Jessica E. Haberer, David Bangsberg

David Bangsberg

Background: Despite investments in infrastructure and evidence for high acceptability, few mHealth interventions have been implemented in sub-Saharan Africa.

Objective: We sought to (1) identify predictors of uptake of an mHealth application for a low-literacy population of people living with HIV (PLWH) in rural Uganda and (2) evaluate the efficacy of various short message service (SMS) text message formats to optimize the balance between confidentiality and accessibility.

Methods: The trial evaluated the efficacy of a SMS text messaging app to notify PLWH of their laboratory results and request return to care for those with abnormal test results. Participants with a ...


Sexual Relationships Outside Primary Partnerships And Abstinence Are Associated With Lower Adherence And Adherence Gaps: Data From The Partners Prep Ancillary Adherence Study, Alexander Kintu, Susan E. Hankinson, Raji Balasubramanian, Karen Ertel, Elioda Tumwesigye, David Bangsberg, Jessica E. Haberer 2016 Harvard School of Public Health

Sexual Relationships Outside Primary Partnerships And Abstinence Are Associated With Lower Adherence And Adherence Gaps: Data From The Partners Prep Ancillary Adherence Study, Alexander Kintu, Susan E. Hankinson, Raji Balasubramanian, Karen Ertel, Elioda Tumwesigye, David Bangsberg, Jessica E. Haberer

David Bangsberg

Objective—To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis (PrEP) against HIV. Methods—We enrolled 1,147 HIV-negative individuals in long-term serodiscordant relationships at three sites in Uganda from the Partners PrEP Study- a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence ( Results—Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with Conclusions ...


Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire- Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders 2016 London School of Hygiene and Tropical Medicine

Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire- Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric Van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders

David Bangsberg

Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as ...


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