Hellen Moraa
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View article: Intact HIV DNA decays in children with and without complete viral load suppression
Intact HIV DNA decays in children with and without complete viral load suppression Open
To inform cure in children living with HIV (CWH), we elucidated the dynamics and mechanisms underlying HIV persistence during antiretroviral therapy (ART). In 120 Kenyan CWH who initiated ART between 1-12 months of age, 55 had durable vira…
View article: Sustainability of an evidence-based intervention supporting transition to independent care for youth living with HIV in Kenya
Sustainability of an evidence-based intervention supporting transition to independent care for youth living with HIV in Kenya Open
Integrating and sustaining evidence-based interventions (EBIs) in routine care is crucial to improving HIV treatment outcomes among youth living with HIV (YLH). However, EBIs are often not sustained post clinical trial. An Adolescent Trans…
View article: Patterns and Cofactors of Polyfunctional Mycobacteria-Specific T-Cell Response Restoration Following 6-Month Antiretroviral Treatment in Children With HIV
Patterns and Cofactors of Polyfunctional Mycobacteria-Specific T-Cell Response Restoration Following 6-Month Antiretroviral Treatment in Children With HIV Open
Background Despite immune restoration after initiation of antiretroviral treatment (ART), the risk of tuberculosis (TB) persists in children with HIV (CHIV). We determined patterns of immune restoration of mycobacteria-specific T cells fol…
View article: Association between HIV and cytomegalovirus and neurocognitive outcomes among children with HIV
Association between HIV and cytomegalovirus and neurocognitive outcomes among children with HIV Open
Objectives: Children with HIV may experience adverse neurocognitive outcomes despite antiretroviral therapy (ART). Cytomegalovirus (CMV) is common in children with HIV. Among children on ART, we examined the influences of early HIV viral l…
View article: Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review
Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review Open
Objectives Daily calcium supplements are recommended for pregnant women from 20 weeks’ gestation to prevent pre-eclampsia in populations with low dietary calcium intake. We aimed to improve understanding of barriers and facilitators for ca…
View article: Effect of tuberculosis–HIV co-treatment on clinical and growth outcomes among hospitalized children newly initiating antiretroviral therapy
Effect of tuberculosis–HIV co-treatment on clinical and growth outcomes among hospitalized children newly initiating antiretroviral therapy Open
Objective: Evaluate effects of tuberculosis (TB)–HIV co-treatment on clinical and growth outcomes in children with HIV (CHIV). Design: Longitudinal study among Kenyan hospitalized ART-naive CHIV in the PUSH trial (NCT02063880). Methods: CH…
View article: Neurodevelopment of children who are HIV‐exposed and uninfected in Kenya
Neurodevelopment of children who are HIV‐exposed and uninfected in Kenya Open
Introduction Predictors of neurodevelopment among children who are HIV‐exposed uninfected (CHEU) are poorly understood. Methods Mothers with and without HIV and their children were enrolled during 6‐week postnatal care visits across seven …
View article: “We can tell a good teacher who cares, understands, and can be confidential about it”: youth and caregiver experiences with HIV disclosure to schools in Kenya
“We can tell a good teacher who cares, understands, and can be confidential about it”: youth and caregiver experiences with HIV disclosure to schools in Kenya Open
Introduction Disclosure of one's HIV status to others is often difficult due to the fear of stigma. However, disclosure may facilitate receiving social support. Many youth living with HIV (YLH) are enrolled in school as better treatments h…
View article: Mortality and Loss to Follow-Up Among Adolescents and Young Adults Attending HIV Care Programs in Kenya
Mortality and Loss to Follow-Up Among Adolescents and Young Adults Attending HIV Care Programs in Kenya Open
Mortality and loss to follow-up (LTFU) among adolescents and youth living with HIV (AYLHIV) remain high. We evaluated mortality and LTFU during the test and treat era. We abstracted medical records of AYLHIV for 10-24 years between January…
View article: ‘They should show them love even if their status of being<scp>HIV</scp>positive is known’: Youth and caregiver stigma experience and strategies to end<scp>HIV</scp>stigma in schools
‘They should show them love even if their status of being<span>HIV</span>positive is known’: Youth and caregiver stigma experience and strategies to end<span>HIV</span>stigma in schools Open
Objective HIV stigma and discrimination is widespread in sub‐Saharan Africa and is associated with poor clinical outcomes. Schools play a critical role in the life of youth and have been identified as a potentially stigmatising environment…
View article: Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial Open
Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW tra…
View article: Predictors of intact HIV DNA levels among children in Kenya
Predictors of intact HIV DNA levels among children in Kenya Open
Objective: We determined predictors of both intact (estimate of replication-competent) and total (intact and defective) HIV DNA in the reservoir among children with HIV. Design: HIV DNA in the reservoir was quantified longitudinally in chi…
View article: “[T]he laws need to change to reflect current society”: Insights from stakeholders involved in development, review or implementation of policies about adolescent consent for HIV testing, care and research in Kenya
“[T]he laws need to change to reflect current society”: Insights from stakeholders involved in development, review or implementation of policies about adolescent consent for HIV testing, care and research in Kenya Open
Introduction Engaging adolescents in HIV care and research promotes the development of interventions tailored to their unique needs. Guidelines generally require parental permission for adolescents to receive HIV care/testing or participat…
View article: ‘They can stigmatize you’: a qualitative assessment of the influence of school factors on engagement in care and medication adherence among adolescents with HIV in Western Kenya
‘They can stigmatize you’: a qualitative assessment of the influence of school factors on engagement in care and medication adherence among adolescents with HIV in Western Kenya Open
School-related factors may influence retention in care and adherence to antiretroviral therapy (ART) among adolescents with human immunodeficiency virus (HIV). We analyzed data from in-depth interviews with 40 adolescents with HIV (aged 14…
View article: “They have given you the morale and confidence:” adolescents and young adults want more community-based oral HIV self-testing options in Kenya
“They have given you the morale and confidence:” adolescents and young adults want more community-based oral HIV self-testing options in Kenya Open
Community-based delivery of oral HIV self-testing (HIVST) may expand access to testing among adolescents and young adults (AYA). Eliciting youth perspectives can help to optimize these services. We conducted nine focus group discussions (F…
View article: Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya Open
Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. M…
View article: “They Just Tell Me to Abstain:” Variable Access to and Uptake of Sexual and Reproductive Health Services Among Adolescents Living With HIV in Kenya
“They Just Tell Me to Abstain:” Variable Access to and Uptake of Sexual and Reproductive Health Services Among Adolescents Living With HIV in Kenya Open
Background: To improve holistic care for adolescents living with HIV (ALHIV), including integration of sexual and reproductive health services (SRHS), the Kenya Ministry of Health implemented an adolescent package of care (APOC). To inform…
View article: From research to international scale-up: stakeholder engagement essential in successful design, evaluation and implementation of paediatric HIV testing intervention
From research to international scale-up: stakeholder engagement essential in successful design, evaluation and implementation of paediatric HIV testing intervention Open
Stakeholder engagement between researchers, policymakers and practitioners is critical for the successful translation of research into policy and practice. The Counseling and Testing for Children at Home (CATCH) study evaluated a paediatri…
View article: Assisted partner notification services for patients receiving HIV care and treatment in an HIV clinic in Nairobi, Kenya: a qualitative assessment of barriers and opportunities for scale‐up
Assisted partner notification services for patients receiving HIV care and treatment in an HIV clinic in Nairobi, Kenya: a qualitative assessment of barriers and opportunities for scale‐up Open
Introduction Identifying HIV‐positive individuals is increasingly recognized as one of the most important and most challenging of the UNAIDS 90‐90‐90 goals. Assisted partner notification services (aPNS) involves tracing and offering HIV te…
View article: Health provider training is associated with improved engagement in HIV care among adolescents and young adults in Kenya
Health provider training is associated with improved engagement in HIV care among adolescents and young adults in Kenya Open
Adolescent-specific health provider training and tools may improve quality of care and subsequent AYA engagement. Health provider interventions are needed to achieve the '95-95-95' targets for AYA.
View article: Implications of Combined Exposure to Household Air Pollution and HIV on Neurocognition in Children
Implications of Combined Exposure to Household Air Pollution and HIV on Neurocognition in Children Open
Air pollution exposure and HIV infection can each cause neurocognitive insult in children. The purpose of this study was to test whether children with combined high air pollution exposure and perinatal HIV infection have even greater risk …