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View article: Perspectives on App-Assisted Self-Testing Using Rapid Diagnostic Tests Among Community Members, Health Care Providers, and Public Health Leaders in Kenya, South Africa, and Zambia: Qualitative Study
Perspectives on App-Assisted Self-Testing Using Rapid Diagnostic Tests Among Community Members, Health Care Providers, and Public Health Leaders in Kenya, South Africa, and Zambia: Qualitative Study Open
Background Self-testing using rapid diagnostic tests (RDTs), integrated with mobile phone–based apps, offers potential to improve health outcomes in low-resource settings, including sub-Saharan Africa. Despite its advantages, uptake remain…
View article: Household healthcare seeking patterns for emergent ill-health in Migori, Western Kenya
Household healthcare seeking patterns for emergent ill-health in Migori, Western Kenya Open
Background Healthcare-seeking decisions reflect personal assessments of illness etiology and severity to determine whether, how, and where to seek care. Understanding these contexts enables targeted interventions to address barriers and en…
View article: A prospective cohort study of the SEARCH integrated HIV/hypertension community health worker‐led intervention in rural Kenya and Uganda
A prospective cohort study of the SEARCH integrated HIV/hypertension community health worker‐led intervention in rural Kenya and Uganda Open
Introduction Clinic‐based hypertension screening and treatment for people with and without HIV depends on consistent clinic engagement. Retention is challenging in rural areas, especially for people with severe hypertension, which typicall…
View article: Community health worker–facilitated telehealth for moderate–severe hypertension care in Kenya and Uganda: A randomized controlled trial
Community health worker–facilitated telehealth for moderate–severe hypertension care in Kenya and Uganda: A randomized controlled trial Open
Background Hypertension is underdiagnosed and undertreated in sub-Saharan Africa. Improving hypertension treatment within primary health centers can improve cardiovascular disease outcomes; however, individuals with moderate–severe hyperte…
View article: Enhancing engagement in HIV care among adolescents and young adults: A focus on phone-based navigation and relationship building to address barriers in HIV care
Enhancing engagement in HIV care among adolescents and young adults: A focus on phone-based navigation and relationship building to address barriers in HIV care Open
Structural, psychological, and clinical barriers to HIV care engagement among adolescents and young adults living with HIV (AYAH) persist globally despite gains in HIV epidemic control. Phone-based peer navigation may provide critical peer…
View article: Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: An individual-based modeling study
Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: An individual-based modeling study Open
Background Cardiovascular disease (CVD) morbidity and mortality is increasing in Africa, largely due to undiagnosed and untreated hypertension. Approaches that leverage existing primary health systems could improve hypertension treatment a…
View article: Enhancing engagement in HIV care among adolescents and young adults: A focus on phone-based navigation and relationship building to address barriers in HIV care
Enhancing engagement in HIV care among adolescents and young adults: A focus on phone-based navigation and relationship building to address barriers in HIV care Open
Structural, psychological, and clinical barriers to HIV care engagement among adolescents and young adults living with HIV (AYAH) persist globally despite gains in HIV epidemic control. Phone-based peer navigation may provide critical peer…
View article: Perspectives on App-Assisted Self-Testing Using Rapid Diagnostic Tests Among Community Members, Health Care Providers, and Public Health Leaders in Kenya, South Africa, and Zambia: Qualitative Study (Preprint)
Perspectives on App-Assisted Self-Testing Using Rapid Diagnostic Tests Among Community Members, Health Care Providers, and Public Health Leaders in Kenya, South Africa, and Zambia: Qualitative Study (Preprint) Open
BACKGROUND Self-testing using rapid diagnostic tests (RDTs), integrated with mobile phone–based apps, offers potential to improve health outcomes in low-resource settings, including sub-Saharan Africa. Despite its advantages, uptake remai…
View article: Implementation and Operational Research
Implementation and Operational Research Open
BACKGROUND: In 2013-2014, we achieved 89% adult HIV testing coverage using a hybrid testing approach in 32 communities in Uganda and Kenya (SEARCH: NCT01864603). To inform scalability, we sought to determine: (1) overall cost and efficienc…
View article: Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: an individual-based modelling study
Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: an individual-based modelling study Open
Background Cardiovascular disease (CVD) morbidity and mortality is increasing in Africa, largely due to undiagnosed and untreated hypertension. Approaches that leverage existing primary health systems could improve hypertension treatment a…
View article: User-informed tailoring of electronic and in-person peer navigation strategies to improve retention in HIV care for adolescents and young adults: a qualitative inquiry
User-informed tailoring of electronic and in-person peer navigation strategies to improve retention in HIV care for adolescents and young adults: a qualitative inquiry Open
Poor adherence and retention in HIV care remain a major challenge among adolescents and young adults (AYA) living with HIV in sub-Saharan Africa (SSA). Strategies are urgently required to support AYA to remain in care for better health out…
View article: A community‐based dynamic choice model for HIV prevention improves PrEP and PEP coverage in rural Uganda and Kenya: a cluster randomized trial
A community‐based dynamic choice model for HIV prevention improves PrEP and PEP coverage in rural Uganda and Kenya: a cluster randomized trial Open
Introduction Optimizing HIV prevention may require structured approaches for providing client‐centred choices as well as community‐based entry points and delivery. We evaluated the effect of a dynamic choice model for HIV prevention, deliv…
View article: A youth-centred approach to improving engagement in HIV services: human-centred design methods and outcomes in a research trial in Kisumu County, Kenya
A youth-centred approach to improving engagement in HIV services: human-centred design methods and outcomes in a research trial in Kisumu County, Kenya Open
Introduction Innovative interventions are needed to improve HIV outcomes among adolescents and young adults (AYAs) living with HIV. Engaging AYAs in intervention development could increase effectiveness and youth acceptance, yet research i…
View article: Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya
Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya Open
View article: Effect of a one-time financial incentive on linkage to chronic hypertension care in Kenya and Uganda: A randomized controlled trial
Effect of a one-time financial incentive on linkage to chronic hypertension care in Kenya and Uganda: A randomized controlled trial Open
Background Fewer than 10% of people with hypertension in sub-Saharan Africa are diagnosed, linked to care, and achieve hypertension control. We hypothesized that a one-time financial incentive and phone call reminder for missed appointment…
View article: Providers' Attitudes and Experiences with Pre-Exposure Prophylaxis Implementation in a Population-Based Study in Kenya and Uganda
Providers' Attitudes and Experiences with Pre-Exposure Prophylaxis Implementation in a Population-Based Study in Kenya and Uganda Open
Pre-exposure prophylaxis (PrEP) implementation is underway across sub-Saharan Africa. However, little is known about health care providers' experiences with PrEP provision in generalized epidemic settings, particularly outside of selected …
View article: First cases of SARS-CoV-2 infection and secondary transmission in Kisumu, Kenya
First cases of SARS-CoV-2 infection and secondary transmission in Kisumu, Kenya Open
We investigated the first 152 laboratory-confirmed SARS-CoV-2 cases (125 primary and 27 secondary) and their 248 close contacts in Kisumu County, Kenya. Conducted June 10–October 8, 2020, this study included interviews and sample collectio…
View article: WHO Unity Global SARS-CoV-2 Seroepidemiological Investigations
WHO Unity Global SARS-CoV-2 Seroepidemiological Investigations Open
For First Few X and household transmission investigations of COVID-19 Evidence-based knowledge for public health response. Study conducted in Kisumu, Kenya in the year 2020.
View article: Adapt for Adolescents: Protocol for a Sequential Multiple Assignment Randomized Trial to Improve Retention and Viral Suppression Among Adolescents and Young Adults Living with HIV in Kenya
Adapt for Adolescents: Protocol for a Sequential Multiple Assignment Randomized Trial to Improve Retention and Viral Suppression Among Adolescents and Young Adults Living with HIV in Kenya Open
View article: Dimensions of HIV-related stigma in rural communities in Kenya and Uganda at the start of a large HIV ‘test and treat’ trial
Dimensions of HIV-related stigma in rural communities in Kenya and Uganda at the start of a large HIV ‘test and treat’ trial Open
HIV-related stigma is a frequently cited barrier to HIV testing and care engagement. A nuanced understanding of HIV-related stigma is critical for developing stigma-reduction interventions to optimize HIV-related outcomes. This qualitative…
View article: SEARCH Human Immunodeficiency Virus (HIV) Streamlined Treatment Intervention Reduces Mortality at a Population Level in Men With Low CD4 Counts
SEARCH Human Immunodeficiency Virus (HIV) Streamlined Treatment Intervention Reduces Mortality at a Population Level in Men With Low CD4 Counts Open
Background We tested the hypothesis that patient-centered, streamlined human immunodeficiency virus (HIV) care would achieve lower mortality than the standard treatment model for persons with HIV and CD4 ≤ 350/uL in the setting of populati…
View article: Characteristics of HIV seroconverters in the setting of universal test and treat: Results from the SEARCH trial in rural Uganda and Kenya
Characteristics of HIV seroconverters in the setting of universal test and treat: Results from the SEARCH trial in rural Uganda and Kenya Open
Background Additional progress towards HIV epidemic control requires understanding who remains at risk of HIV infection in the context of high uptake of universal testing and treatment (UTT). We sought to characterize seroconverters and ri…
View article: Provider and Patient Perspectives of Rapid ART Initiation and Streamlined HIV Care: Qualitative Insights From Eastern African Communities
Provider and Patient Perspectives of Rapid ART Initiation and Streamlined HIV Care: Qualitative Insights From Eastern African Communities Open
The Sustainable East Africa Research in Community Health (SEARCH), a universal test and treat (UTT) trial, implemented ‘Streamlined Care’—a multicomponent strategy including rapid linkage to care and antiretroviral therapy (ART) start, 3-m…
View article: Pathways for reduction of HIV‐related stigma: a model derived from longitudinal qualitative research in Kenya and Uganda
Pathways for reduction of HIV‐related stigma: a model derived from longitudinal qualitative research in Kenya and Uganda Open
Introduction The rollout of antiretroviral therapy (ART) has been associated with reductions in HIV‐related stigma, but pathways through which this reduction occurs are poorly understood. In the newer context of universal test and treat (U…
View article: A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study
A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study Open
Despite large investments in HIV testing, only 45% of HIV-infected persons in sub-Saharan Africa are estimated to know their status. Optimal methods for maximizing population-level testing remain unknown. We sought to demonstrate the effec…
View article: Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study
Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study Open
View article: Understanding Demand for PrEP and Early Experiences of PrEP Use Among Young Adults in Rural Kenya and Uganda: A Qualitative Study
Understanding Demand for PrEP and Early Experiences of PrEP Use Among Young Adults in Rural Kenya and Uganda: A Qualitative Study Open
View article: The Influence of Social Networks on Antiretroviral Therapy Initiation Among HIV-Infected Antiretroviral Therapy–Naive Youth in Rural Kenya and Uganda
The Influence of Social Networks on Antiretroviral Therapy Initiation Among HIV-Infected Antiretroviral Therapy–Naive Youth in Rural Kenya and Uganda Open
Background: HIV-infected youth in sub-Saharan Africa are less likely to initiate antiretroviral therapy (ART) than older adults. Setting and Methods: Adult (≥15 years) residents enumerated during a census in 32 communities in rural Kenya a…
View article: Machine Learning to Identify Persons at High-Risk of Human Immunodeficiency Virus Acquisition in Rural Kenya and Uganda
Machine Learning to Identify Persons at High-Risk of Human Immunodeficiency Virus Acquisition in Rural Kenya and Uganda Open
Background In generalized epidemic settings, strategies are needed to prioritize individuals at higher risk of human immunodeficiency virus (HIV) acquisition for prevention services. We used population-level HIV testing data from rural Ken…
View article: Semi-Supervised Record Linkage for Construction of Large-Scale Sociocentric Networks in Resource-limited Settings: An application to the SEARCH Study in Rural Uganda and Kenya
Semi-Supervised Record Linkage for Construction of Large-Scale Sociocentric Networks in Resource-limited Settings: An application to the SEARCH Study in Rural Uganda and Kenya Open
This paper presents a novel semi-supervised algorithmic approach to creating large scale sociocentric networks in rural East Africa. We describe the construction of 32 large-scale sociocentric social networks in rural Sub-Saharan Africa. N…