Medicine and Health Sciences Commons^™

P16 Expression And Recurrent Cervical Intraepithelial Neoplasia After Cryotherapy Among Women Living With Hiv, Daniel Maina, Michael H. Chung, Marleen Temmerman, Zahir Moloo, Jonathan Wawire, Sharon A. Greene, Elizabeth Unger, Shahin Sayed, Samah Sakr, Nelly Mugo

Pathology, East Africa

Background: The expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV.

Methods: This is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result …

The Effects Of Height-For-Age And Hiv On Cognitive Development Of School-Aged Children In Nairobi, Kenya: A Structural Equation Modelling Analysis, Rachel Maina, Jia He, Amina Abubakar, Miguel Perez-Garcia, Manasi Kumar, Jelte M. Wicherts

Brain and Mind Institute

Background: Empirical evidence indicates that both HIV infection and stunting impede cognitive functions of school-going children. However, there is less evidence on how these two risk factors amplify each other’s negative effects. This study aimed to examine the direct effects of stunting on cognitive outcomes and the extent to which stunting (partially) mediates the effects of HIV, age, and gender on cognitive outcomes.

Methodology: We applied structural equation modelling to cross-sectional data from 328 children living with HIV and 260 children living without HIV aged 6–14 years from Nairobi, Kenya to test the mediating effect of stunting and predictive …

Psychometric Evaluation Of The Computerized Battery For Neuropsychological Evaluation Of Children (Benci) Among School Aged Children In The Context Of Hiv In An Urban Kenyan Setting, Rachel Maina, He Jia, Amina Abubakar, Miguel Perez-Garcia, Manasi Kumar, Jelte M. Wicherts

Brain and Mind Institute

Introduction Culturally validated neurocognitive measures for children in Low‐ and Middle‐Income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform develop‐ ment of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neuropsy‐ chological Evaluation of Children (BENCI) is an openly available, computerized neuropsychological battery specifically developed to evaluate neurocognitive impairment. This study adapted the BENCI and evaluated its reliability and validity in Kenya.

Methodology The BENCI was adapted using translation and back‐translation from Spanish to English. The psy‐ chometric properties were evaluated in a case–control study of 328 …

Human Immunodeficiency Virus Type 1 Rna Genital Tract Shedding After Cryotherapy For Cervical Intraepithelial Neoplasia In Western Kenya, Elkanah Omenge, Anne Bocage, Tao Liu, Peter Itsura, Philip Tonui, Kapten Muthoka, Stephen Kiptoo, Angela Caliendo, Soya Sam, Susan Cu-Uvin

Obstetrics and Gynaecology, East Africa

Abstract :This prospective study of 39 women living with human immunodeficiency virus (HIV) on antiretroviral therapy in Western Kenya aimed to quantify genital tract HIV-1 RNA (GT-HIV RNA) shedding before and after cryotherapy for cervical intraepithelial neoplasia. Most GT-HIV RNA shedding was detected precryotherapy, suggesting that cryotherapy was not the primary cause of shedding.

Cardiovascular Risk Factors And Markers Of Myocardial Injury And Inflammation In People Living With Hiv In Nairobi, Kenya: A Pilot Cross-Sectional Study, Hassan Adan Ahmed, Jeilan Mohamed, Isaiah G. Akuku, Kuan Ken Lee, Shirjel R. Alam, Pablo Perel, Jasmit Shah, Mohammed K. Ali, Sherry Eskander, Michael H. Chung

Internal Medicine, East Africa

Objectives: To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya.

Design: Pilot cross-sectional study.

Setting: Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020.

Participants: Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD).

Outcome measures: Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels.

Results: Across 200 PLHIV (median age 46 years, IQR 38–53; 61% women), the …

Clinical Characteristics Of Peripheral Neuropathy In Kenyan Patients With Hiv Infection Compared With Patients With Concurrent Hiv Infection And Diabetes Mellitus, Pascal Kuka, Jasmit Shah, Uazman Alam, Reena Shah, Dilraj Sokhi

Internal Medicine, East Africa

Introduction: Persons living with human immunodeficiency virus (HIV) are living longer and at risk of non-communicable diseases, including diabetes mellitus (DM). Both HIV and DM place patients at risk of peripheral neuropathy (PN). Our aim was to demonstrate the prevalence and characteristics of PN in our population of patients with HIV infection compared with concomitant HIV and DM.

Methods: A prospective cross-sectional study was performed at the Aga Khan Hospital in Nairobi, Kenya. Data were collected on demographics and characteristics of DM and HIV. Symptoms and signs of PN were evaluated by Neuropathy Symptom Score, Neuropathy Disability Score, …

Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström

Community Health Sciences

Background: Anal squamous intraepithelial lesions (ASIL), strongly related to human papilloma virus (HPV) infection, is more prevalent among men who have sex with men (MSM). However, no such data are available for Pakistan yet, and neither HPV vaccination nor anal-cytology screening is implemented in Pakistan. The purpose of this first ever study was to assess the prevalence of HPV-related anal cytological abnormalities among MSM and transgender women living with and without HIV infection in Pakistan.
Methods: We conducted a cross-sectional study from March 2016 to November 2017 at sexual health centers run by the Perwaaz Trust and the National AIDS …

Comparing Growth Velocity Of Hiv Exposed And Non-Exposed Infants: An Observational Study Of Infants Enrolled In A Randomized Control Trial In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Natasha Makabilo Laban, Masuzyo Chirwa, Michelo Simunyandi, Luiza Miyanda Hatyoka, Innocent Ngaruye, Najeeha Talat Iqbal, Samuel Bosomprah

Department of Paediatrics and Child Health

Background: Impaired growth among infants remains one of the leading nutrition problems globally. In this study, we aimed to compare the growth trajectory rate and evaluate growth trajectory characteristics among children, who are HIV exposed uninfected (HEU) and HIV unexposed uninfected (HUU), under two years in Zambia.
Method: Our study used data from the ROVAS II study (PACTR201804003096919), an open-label randomized control trial of two verses three doses of live, attenuated, oral RotarixTM administered 6 &10 weeks or at 6 &10 weeks plus an additional dose at 9 months of age, conducted at George clinic in Lusaka, Zambia. Anthropometric measurements …

Barriers To Timely Disclosure Of Hiv Serostatus: A Qualitative Study At Care And Treatment Centers In Dar Es Salaam, Tanzania, Neelam Ismail, Nancy Matillya, Riaz Ratansi, Columba Mbekenga

Family Medicine, East Africa

Introduction: Disclosure of Human Immunodeficiency Virus (HIV) status is important to prevent the spread of HIV and maintain the health of people living with HIV, their spouses, and the community. Despite the benefits of disclosure, many people living with HIV delay disclosing their status to those close to them thereby increasing the risk for disease transmission. This study aimed to determine the barriers to timely disclosure of HIV serostatus for people living with HIV in Dar es Salaam, Tanzania, and identify what motivated disclosure.

Methods: A qualitative descriptive study using in-depth individual interviews was conducted with10 participants attending …

Probabilistic Measures Of Hiv-1 Transmission In Different Hiv-1 Key Population Groups Of Larkana, Pakistan, Syed Rizwan-Ul-Hasa, Abiha Abdullah, Shakil Arshad Siddiqui, Shakil Ahmed, Sharaf Ali Shah, Fatima Mir, Syed Hani Abidi

Medical College Documents

Objective: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling.
Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: 'true' or 'false'; 2) the chance of giving a 'true' result is the same for each replication; and 3) the replications are independent - 'true' in one will not impact the likelihood of 'true' in another.
Results: …

A Prospective Observational Study Of Community Acquired Pneumonia In Kenya: The Role Of Viral Pathogens, Jamila Nambafu, Mary Achakolong, Fridah Mwendwa, Jumaa Bwika, Felix Riunga, Samuel Gitau, Hanika Patel, Rodney Adam

Internal Medicine, East Africa

Background: Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infected patients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence.

Methods: We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. The patients were followed for etiology and clinical outcomes. Viral PCR testing was performed using …

Intimate Partner Violence Is A Barrier To Antiretroviral Therapy Adherence Among Hiv - Positive Women: Evidence From Government Facilities In Kenya, Bornice C. Biomndo, Alexander Bergmann, Nils Lahmann, Lukoye Atwoli

Internal Medicine, East Africa

Introduction: Intimate Partner Violence (IPV) is linked to low engagement with HIV management services and adverse clinical outcomes, including poor ART adherence. In sub-Saharan Africa, studies on pregnant/postpartum women and transactional sex workers have produced divergent evidence regarding IPV’s association with poor ART adherence. We investigate this association among a broad group of women.

Methods: We sampled 408 HIV-positive women receiving free ART from different types of HIV clinics at government health facilities, assessing for IPV exposure by a current partner, ART adherence rate, and other factors that affect ART adherence (e.g. education, disclosure). ART adherence rates were measured using …

Implications Of Covid-19 In High Burden Countries For Hiv/Tb: A Systematic Review Of Evidence, Jacques L. Tamuzi, Birhanu T. Ayele, Constance Shumba, Olatunji O. Adetokunboh, Jeannine Uwimana-Nicol, Zelalem T. Haile, Joseph Inugu, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the twenty-first century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection …

Managing Acute Pain In Hiv+/Aids Patients: Knowledge And Practice Trends Among Emergency Physicians Of Major Tertiary Care Centers Of A Developing Country, Aliya Ahmed, Gauhar Afshan, Robyna Irshad Khan, Badar Afzal Khan, Seemin Jamali, Nighat Farooq, Sarosh Saleem, Rubaba Naeem, Uzma R. Khan

Department of Anaesthesia

Objective: To assess knowledge and practice trends in managing acute pain in patients infected with human immunodeficiency virus (HIV+) or having acquired immunodeficiency syndrome (AIDS) among emergency physicians of four tertiary care hospitals. Acute pain management in such patients is complex because of multiple concomitant painful conditions related to their disease. After obtaining ethical approval and written informed consent, emergency physicians were requested to fill out a questionnaire.
Results: Out of 84 physicians who participated, 49 had managed HIV+/AIDS patients during the preceding year. Out of the 49, 30 (61.2%) physicians stated that they used a combination of analgesics for …

Does A History Of Sexual And Physical Childhood Abuse Contribute To Hiv Infection Risk In Adulthood? A Study Among Post-Natal Women In Harare, Zimbabwe, Simukai Shamu, Patience Shamu, Christina Zarowsky, Marleen Temmerman, Tamara Shefer, Naeemah Abrahams

Obstetrics and Gynaecology, East Africa

Background: Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.

Methods: A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or …

Factors Associated With Substance Use Among Adolescents Living With Hiv In Kenya, Wambui Kagucia

Theses & Dissertations

Background: Substance use is rife in our society and adolescents (10-19 years) do face this problem during this vulnerable period of growth and development. Use of substances is known to be associated with poor health choices and risky sexual behaviour. Since the advent of antiretroviral therapy (ART), significant progress has been made with reduced rates of mother to child transmission (MTCT) and a general downward global trend in acquired immunodeficiency disease (AIDS) related mortalities. However, human immunodeficiency virus (HIV)/AIDS is still a leading cause of mortality in adolescents living in Sub Saharan Africa, with an upward trend in new HIV …

Prevalence And Risk Of Hepatitis E Virus Infection In The Hiv Population Of Nepal, Ananta Shrestha, Anurag Adhikar, Manjula Bhattarai, Ramanuj Rauniyar, Jose D. Debes, André Boonstra, Thupten K. . Lama, Mamun Al Mahtab, Amna Subhan Butt, Sheikh Mohammad Fazle Akbar

Section of Gastroenterology

Background: Infection with the hepatitis E virus (HEV) can cause acute hepatitis in endemic areas in immune-competent hosts, as well as chronic infection in immune-compromised subjects in non-endemic areas. Most studies assessing HEV infection in HIV-infected populations have been performed in developed countries that are usually affected by HEV genotype 3. The objective of this study is to measure the prevalence and risk of acquiring HEV among HIV-infected individuals in Nepal.

Methods: We prospectively evaluated 459 Human Immunodeficiency Virus (HIV)-positive individuals from Nepal, an endemic country for HEV, for seroprevalence of HEV and assessed risk factors associated with HEV infection. …

Alcohol Use And Immune Reconstitution Among Hiv-Infected Patients On Antiretroviral Therapy In Nairobi, Kenya, Anthony Cagle, Christine Mcgrath, Barbra A. Richardson, Dennis Donovan, Sameh Sakr, Nelly Yatich, Richard Ngomoa, Agnes Chepngeno Langat, Grace John-Stewart, Michael Chung

Internal Medicine, East Africa

Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan African clinic. This was a retrospective cohort study of treatment-naïve HIV-infected adults initiating ART in Nairobi, Kenya and followed for 12 months between January 2009 and December 2012. At enrollment, a standardized questionnaire …

Effects Of Injectable Progestogen Contraception Versus The Copper Intrauterine Device On Hiv Acquisition: Sub-Study Of A Pragmatic Randomised Controlled Trial, G. Justus Hofmeyr, Mandisa Singata-Madliki, Theresa A. Lawrie, Eduardo Bergel, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Evidence from observational studies suggests an increased risk of HIV acquisition among women using depot medroxyprogesterone acetate (DMPA) contraception.

Methods: Within the context of a South African programme to increase women's access to the intrauterine contraceptive device (IUD), we conducted a pragmatic, open-label, parallel-arm, randomised controlled trial (RCT) of the IUD versus injectable progestogen contraception (IPC) at two South African hospitals. The primary outcome was pregnancy; secondary outcomes included HIV acquisition. Consenting women attending termination of pregnancy services were randomised after pregnancy termination between July 2009 and November 2012. Condoms were promoted for the prevention of sexually transmitted infections. …

Partner Disclosure And Early Cd4 Response Among Hiv-Infected Adults Initiating Antiretroviral Treatment In Nairobi Kenya, T. Tony Trinh, Nelly Yatich, Richard Ngomoa, Christine J. Mcgrath, Barbra A. Richardson, Samah R. Sakr, Agnes Langat, Grace C. John-Stewart, Michael Chung

Internal Medicine, East Africa

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 1^st2009 and July 1^st 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. Analysis of CD4 response at 6 and 12 months post-ART was …

Sonographic Estimation Of The Prevalence Of Hepatic Steatosis In Hiv Monoinfected Patients At Aga Khan University Nairobi., Bernadette Wambui Muthee

Theses & Dissertations

Introduction: Human immunodeficiency virus disease (HIV) is a worldwide health problem. It is estimated that 38.6 million people are infected with HIV globally. It has remained endemic in the African continent for close to 20 years and is a long term developmental challenge in Africa which bears 69 % of the HIV/AIDS global burden.

The introduction of highly active antiretroviral therapy (HAART) has caused dramatic improvement in prognosis of HIV disease. Consequently, this has resulted in substantial reduction in Acquired Immune Deficiency Syndrome (AIDS) related morbidity and mortality. In contrast, this has been accompanied by an upsurge in liver- related …

Simplified Paper Format For Detecting Hiv Drug Resistance In Clinical Specimens By Oligonucleotide Ligation, Nuttada Panpradist, Ingrid A. Beck, Michael Chung, James N. Kiarie, Lisa M. Frenkel, Barry R. Lutz

Internal Medicine, East Africa

Human immunodeficiency virus (HIV) is a chronic infection that can be managed by antiretroviral treatment (ART). However, periods of suboptimal viral suppression during lifelong ART can select for HIV drug resistant (DR) variants. Transmission of drug resistant virus can lessen or abrogate ART efficacy. Therefore, testing of individuals for drug resistance prior to initiation of treatment is recommended to ensure effective ART. Sensitive and inexpensive HIV genotyping methods are needed in low-resource settings where most HIV infections occur. The oligonucleotide ligation assay (OLA) is a sensitive point mutation assay for detection of drug resistance mutations in HIV pol. The current …

Respiratory Function Amongst Asymptomatic Hiv Positive And Hiv Negative Clients At Aga Khan University Hospital, Nairobi, Noah Kipkemei Murbiy

Theses & Dissertations

Background: Spirometry is used to asses respiratory function abnormalities. This is usually in reference to a validated normal range unique to a particular gender, race, age, weight and height. Majority of persons are usually asymptomatic until the expected FEV1 has decreased by 50%. Early intervention on the abnormalities even in this asymptomatic group has been shown to retard the rate of pulmonary deterioration. An unpublished audit at the Aga Khan University Hospital, Nairobi, revealed that majority of newly diagnosed HIV positive persons were admitted at the Critical Care Units with a pulmonary cause which later resulted in poor outcomes. This …

Accelerating The Dual Elimination Of Mother-To-Child Transmission Of Syphilis And Hiv: Why Now?, James Kiarie, Chandra K. Mishra, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Even though the elimination of congenital syphilis has been on the maternal and child health (MCH) agenda for over a decade, elimination has not yet been achieved; what, then, are the factors currently facilitating the elimination of mother-to-child transmission (MTCT) of syphilis?

Achieving Pregnancy Safely In Hiv-Affected Individuals And Couples: An Important Strategy To Eliminate Hiv Transmission From Mother-To-Child And Between Sexual Partners, Mmeje Okeoma, Betty Njoroge, Craig Cohen, Marleen Temmerman, Sten H. Vermund, Sheryl Van Der Poel

Obstetrics and Gynaecology, East Africa

HIV-infected individuals are living longer, more productive lives. HIV-affected individuals and couples experience personal and social desires to reproduce for all the same reasons as uninfected individuals and couples,1 and thus require safe reproductive options. HIV prevention interventions often do not consider the childbearing desires of HIV-affected individuals or couples, especially in low- and middle-income countries (LMICs). Failure to assist women with desired fertility can contribute to continued HIV transmission and must be addressed within national elimination of mother-to-child transmission (eMTCT) strategies.

A human rights perspective suggests that HIV-affected couples* should have the same ability to choose if and when …

Hiv Prevalence In Blood Donors And Recipients In Pakistan: A Meta-Analysis And Analysis Of Blood-Bank Data, Bushra Moiz, Barkat Ali, Muhammad Hasnain Chatha, Ahmed Raheem, Hasan Abbas Zaheer

Department of Pathology and Laboratory Medicine

Background:
The first instances of HIV-antibody detection in donated blood in Pakistan were reported in 1988. Since then, documentation of HIV in blood donors and of rates of transmission via transfusion has been limited. Previously assumed to have a low prevalence, HIV is an increasing health concern in Pakistan. Since there is no national, centralized blood-banking system, there are no reliable data on which to base estimated risks of transfusion-associated HIV infection. This study was therefore conducted to estimate the prevalence of HIV in blood donors and recipients in Pakistan between 1988 and 2012.
Methods:
Meta-analyses were undertaken of reported …

Interventions To Promote Adherence To Antiretroviral Therapy In Africa: A Network Meta-Analysis, Edward J. Mills, Richard Lester, Kristian Thorlund, Maria Lorenzi, Katherine Muldoon, Steve Kanters, Sebastian Linnemayr, Robert Gross, Yvette Calderon, K Rivet Amico, Harsha Thirumurthy, Cynthia Pearson, Robert H. Remien, Lawrence Mbuagbaw, Lehana Thabane, Michael Chung, Ira B. Wilson, Albert Liu, Olalekan A. Uthman, Jane Simoni, David Bangsberg, Sanni Yaya, Till Bärnighausen, Nathan Ford, Jean B. Nachega

Internal Medicine, East Africa

Background: Adherence to antiretroviral therapy (ART) is necessary for the improvement of the health of patients and for public health. We sought to determine the comparative effectiveness of different interventions for improving ART adherence in HIV-infected people living in Africa.

Methods: We searched for randomised trials of interventions to promote antiretroviral adherence within adults in Africa. We searched AMED, CINAHL, Embase, Medline (via PubMed), and ClinicalTrials.gov from inception to Oct 31, 2014, with the terms “HIV”, “ART”, “adherence”, and “Africa”. We created a network of the interventions by pooling the published and individual patients' data for comparable treatments and comparing …

Intimate Partner Violence After Disclosure Of Hiv Test Results Among Pregnant Women In Harare, Zimbabwe, Simukai Shamu, Christina Zarowsky, Tamara Shefer, Marleen Temmerman, Naeemah Abrahams

Obstetrics and Gynaecology, East Africa

Background: HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women.

Methods: In this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV.

Results: Over …

Hiv-1 Subtype A Gag Variability And Epitope Evolution, Syed Hani Abidi, Marcia L. Kalish, Farhat Abbas, Sarah Rowland-Jones, Syed Ali

Section of Urology

Objective: The aim of this study was to examine the course of time-dependent evolution of HIV-1 subtype A on a global level, especially with respect to the dynamics of immunogenic HIV gag epitopes.
Methods: We used a total of 1,893 HIV-1 subtype A gag sequences representing a timeline from 1985 through 2010, and 19 different countries in Africa, Europe and Asia. The phylogenetic relationship of subtype A gag and its epidemic dynamics was analysed through a Maximum Likelihood tree and Bayesian Skyline plot, genomic variability was measured in terms of G → A substitutions and Shannon entropy, and the time-dependent …

Identifying Factors Associated With The Uptake Of Prevention Of Mother To Child Hiv Transmission Programme In Tigray Region, Ethiopia: A Multilevel Modeling Approach, Wondwossen Lerebo, Steven Callens, Debra Jackson, Christina Zarowsky, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Prevention of mother to child HIV transmission (PMTCT) remains a challenge in low and middle-income countries. Determinants of utilization occur – and often interact - at both individual and community levels, but most studies do not address how determinants interact across levels. Multilevel models allow for the importance of both groups and individuals in understanding health outcomes and provide one way to link the traditionally distinct ecological- and individual-level studies. This study examined individual and community level determinants of mother and child receiving PMTCT services in Tigray region, Ethiopia.

Methods: A multistage probability sampling method was used for this …