research & publications

HIV RESEARCH

Results by County (Approx)
  • 552 results found
  • Quality of Life of Women living with HIV and AIDS in Korogocho Slums, Nairobi, Kenya.

    Background:

    Since HIV/AIDS was reported in Kenya the country has been and continues to be impacted negatively in all sectors. Despite Government’s intervention initiatives to mitigate the impact, patients continue to succumb to this condition. The main objective of this study was to assess the factors that affect on the Quality of Life among HIV and AIDS positive women in Korogocho Slums. 


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  • Contribution of microfinance in enhancing food access and coping strategy in AIDS-affected households in Kakamega county, Kenya.

    Background:

    Acquired immune deficiency syndrome (AIDS) pandemic increases a family’s food insecurity by reducing the family’s ability to produce food, which compromises their output and income. This reduces their food availability, accessibility and acquisition, and interferes with regular nutritional intake. In response, households develop various coping strategies, especially in the context of food shortages. Arguably, microfinance (MF) has been advocated by many as an antidote to disasters affecting the households in different disaster contexts, such as famine, poverty, and tsunami occurrences. This study, therefore, sought to find out the contribution of MF to AIDS-affected households in terms of food access and coping strategies in Kakamega County, Kenya.


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  • It's because they care: understanding pathways to classroom concentration problems among HIV-affected children and youth in Western Kenya.

    Background:

    Children and young people living in households affected by HIV are experiencing poorer educational outcomes compared to their peers. This article explores how different forms of marginalisation interface and manifest themselves in classroom concentration problems, undermining their education. 


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  • 'I am treated well if I adhere to my HIV medication': putting patient-provider interactions in context through insights from qualitative research in five sub-Saharan African countries.

    Background:

    The nature of patient-provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient-provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, we seek to unpack local dynamics that serve to hinder or facilitate productive patient-provider interactions.


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  • Overcoming Barriers to HIV/AIDS Care and ART Initiation (LINC)

    Backgound:

    The study will evaluate interventions to improve engagement in HIV care following HIV diagnosis through a voluntary counseling and testing program. The specific aims are to (1) determine if a VCT-based intervention of CD4 count testing, alone or in combination with peer counseling, improves linkage to HIV/AIDS care; (2) assess the impact of the intervention on ART initiation.

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  • Improvements in Physical Well being over the First Two Years on Antiretroviral Therapy in Western Kenya

    Background:

    Improvements in physical wellbeing during the first six months on antiretroviral therapy (ART) are well known, but little is known regarding more long-term follow-up. We conducted a prospective cohort study among 222 HIV-positive adult tea plantation workers in western Kenya to assess wellbeing over their first two years on ART.


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  • Traditional healers, faith healers and medical practitioners: the contribution of medical pluralism to bottlenecks along the cascade of care for HIV/AIDS in Eastern and Southern Africa

    Background:

    There are concerns that medical pluralism may delay patients' progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish the manifestation of medical pluralism among PLHIV, and explore mechanisms through which medical pluralism contributes bottlenecks along the HIV care cascade.

  • A clinician-nurse model to reduce early mortality and increase clinic retention among high-risk HIV-infected patients initiating combination antiretroviral treatment

    Background :

    In resource-poor settings, mortality is at its highest during the first 3 months after combination antiretroviral treatment (cART) initiation. A clear predictor of mortality during this period is having a low CD4 count at the time of treatment initiation. The objective of this study was to evaluate the effect on survival and clinic retention of a nurse-based rapid assessment clinic for high-risk individuals initiating cART in a resource-constrained setting.


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  • Sexual behavior of HIV-positive adults not accessing HIV treatment in Mombasa, Kenya: Defining their prevention needs

    Background :

    HIV spread continues at high rates from infected persons to their sexual partners. In 2009, an estimated 2.6 million new infections occurred globally. People living with HIV (PLHIV) receiving treatment are in contact with health workers and therefore exposed to prevention messages. By contrast, PLHIV not receiving ART often fall outside the ambit of prevention programs. There is little information on their sexual risk behaviors. This study in Mombasa Kenya therefore explored sexual behaviors of PLHIV not receiving any HIV treatment.


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  • HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya

    Background:

    HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews.


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  • Advanced HIV disease at presentation to care in Nairobi, Kenya: late diagnosis or delayed linkage to care?—a cross-sectional study

    Background :

    Presenting to care with advanced HIV is common in sub-Saharan Africa and increases the risk of severe disease and death; however, it remains unclear whether this is a consequence of late diagnosis or a delay in seeking care after diagnosis. The objectives of this cross-sectional study were to determine factors associated with advanced HIV at presentation to care and whether this was due to late diagnosis or delays in accessing care.


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  • Low levels of viral suppression among refugees and host nationals accessing antiretroviral therapy in a Kenyan refugee camp

    Background :

    Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011–2013) were compared on outcome measures that included viral suppression and adherence to ART.


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  • Low levels of viral suppression among refugees and host nationals accessing antiretroviral therapy in a Kenyan refugee camp

    Background :

    Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011–2013) were compared on outcome measures that included viral suppression and adherence to ART.


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  • Low levels of viral suppression among refugees and host nationals accessing antiretroviral therapy in a Kenyan refugee camp

    Background :

    Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011–2013) were compared on outcome measures that included viral suppression and adherence to ART.


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  • Using theories of practice to understand HIV-positive persons varied engagement with HIV services: a qualitative study in six Sub-Saharan African countries.

    Background:

    This article considers the potential of 'theories of practice' for studying and understanding varied (dis)engagement with HIV care and treatment services and begins to unpack the assemblage of elements and practices that shape the nature and duration of individuals' interactions with HIV services.


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  • Protocol of a randomised controlled trial characterising the immune responses induced by varicella-zoster virus (VZV) vaccination in healthy Kenyan women: setting the stage for a potential VZV-based HIV vaccine

    Background:

    A protective HIV vaccine would be expected to induce durable effector immune responses at the mucosa, restricting HIV infection at its portal of entry. We hypothesise that use of varicella-zoster virus (VZV) as an HIV delivery vector could generate sustained and robust tissue-based immunity against HIV antigens to provide long-term protection against HIV. Given that HIV uniquely targets immune-activated T cells, the development of human vaccines against HIV must also involve a specific examination of the safety of the vector. Thus, we aim to evaluate the effects of VZV vaccination on the recipients’ immune activation state, and on VZV-specific circulating humoral and cellular responses in addition to those at the cervical and rectal mucosa.


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  • Gender differentials on the health consequences of care-giving to people with AIDS-related illness among older informal carers in two slums in Nairobi, Kenya.

    Background:

    Informal caregivers, most often older people, provide valuable care and support for people ill due to AIDS, especially in poor-resource settings with inadequate health care systems and limited access to antiretroviral therapy. The negative health consequences associated with care-giving may vary depending on various factors that act to mediate the extent of the effects on the caregiver. This paper investigates the association between care-giving and poor health among older carers to people living with AIDS, and examines potential within-gender differences in reporting poor health.


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  • Self-care among caregivers of people living with HIV and AIDS in Kakola location, Nyando District, Kisumu County, Kenya

    Background:

     A study by World Health Organization approximated that in developing countries, the need for long-term care will increase by as much as 40% in the coming years. HIV/AIDS has been cited as one of the challenges in long-term care. As demand for long-term care increases, the assumption that extended family networks can meet all the needs of their members deteriorates. The community-based survey employed descriptive cross-sectional design, involving primary caregivers of PLWHAs in Kakola location who had practiced care giving for more than 3 months.


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  • Increasing HIV-1 Pre-Treatment Drug Resistance among Antiretroviral-Naïve Adults Initiating Treatment between 2006 and 2014 in Nairobi, Kenya

    Background:

    Antiretroviral-naïve adults initiating antiretroviral therapy (ART) in Nairobi, Kenya were tested for HIV-1 drug resistance at codons K103N, Y181C, G190A, M184V, and K65R using an oligonucleotide ligation assay (OLA). Prevalence of pre-treatment drug resistance (PDR) increased from 3.89% in 2006 to 10.93% in 2014 (p<0.001), and 95% of those with resistance had at least one non-nucleoside reverse transcriptase inhibitor (NNRTI) mutation. Resistance to tenofovir (K65R) was found in 2014 but not in 2006.Since the widespread introduction of antiretroviral (ARV) therapy (ART) in sub-Saharan Africa there has been concern that HIV-1 drug resistance will become prevalent. Cross-sectional studies have found varying levels of pre-treatment HIV drug resistance (PDR) among ARV-naïve adults that is associated with earlier ART rollout on the continent. This study enrolled ARV-naïve adults at two separate time points in 2006 and 2014 at a single clinic site in Nairobi, Kenya and measured PDR using an oligonucleotide ligation assay (OLA).


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  • Treatment interruption after 2-year antiretroviral treatment (ART) initiated during acute/early HIV in infancy: a randomized trial

    Background:

    Early antiretroviral treatment (ART) is recommended for HIV-infected infants based on significant benefits of early versus eligibility-deferred ART. Prior to widespread ART use, some HIV-infected untreated children had long-term non-progression (LTNP). It is plausible that some children who would be LTNP without therapy, as well as others who control virus following early ART, could benefit from treatment interruption (TI) after immune recovery. This approach could reduce ART toxicity or resistance and preserve ART regimens for later in life.The objective of this study was to compare outcomes in treatment interruption versus continued ART among early-treated infants.


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  • “It's because they care”: understanding pathways to classroom concentration problems among HIV-affected children and youth in Western Kenya

    Background:

    Children and young people living in households affected by HIV are experiencing poorer educational outcomes compared to their peers. This article explores how different forms of marginalisation interface and manifest themselves in classroom concentration problems, undermining their education. This mixed qualitative methods study was conducted with teachers and pupils from three primary and three secondary schools in the Siaya County of Western Kenya. 


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  • Attitudes and beliefs about anti-retroviral therapy are associated with high risk sexual behaviors among the general population of Kisumu, Kenya

    Background:

    In Kenya approximately 1.4 million people are infected with HIV (National AIDS and STI Control Programme, July 2008). Since 2001 access to antiretroviral therapy (ART) in developing countries has moved to the forefront of the global health agenda. By the end of 2009 ART coverage in Kenya reached approximately 42–55% of people in need (Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector, 2010). As ART availability continues to increase in sub-Saharan Africa, global health organizations have recognized the importance of maintaining the gains made through HIV prevention (Bringing HIV Prevention to Scale: an urgent global priority, 2007; HIV Prevention in the Era of Expanded Treatment Access, 2004). However, there is risk that an overemphasis on treatment programs will detract from prevention efforts and lead to reduced public concern about HIV and increased HIV risk behaviors (a phenomenon termed “risk compensation”).


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  • HIV mortality in urban slums of Nairobi, Kenya 2003–2010: a period effect analysis

    Background :

    It has been almost a decade since HIV was declared a national disaster in Kenya. Antiretroviral therapy (ART) provision has been a mainstay of HIV treatment efforts globally. In Kenya, the government started ART provision in 2003 with significantly scale-up after 2006. This study aims to demonstrate changes in population-level HIV mortality in two high HIV prevalence slums in Nairobi with respect to the initiation and subsequent scale-up of the national ART program.


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  • The Efficacy of the HIV/AIDS Symptom Management Manual

    Background:

    People living with HIV/AIDS encounter many psychological, physiological, and cognitive symptoms, such as pain, diarrhea, fever, fatigue, depression, and confusion. These symptoms have been found to restrict a person's daily life significantly. Self-management of multiple HIV and medication side effects symptoms and maintaining optimal quality of life have, therefore, become major daily tasks for people living with HIV/AIDS.


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  • Prevalence, Perceptions and Correlates of Pediatric HIV Disclosure in an HIV Treatment Program in Kenya

    Background:

    Disclosure to HIV-infected children regarding their diagnosis is important as expanding numbers of HIV-infected children attain adolescence and may become sexually active. In order to define correlates of pediatric disclosure and facilitate development of models for disclosure, we conducted a cross-sectional survey of primary caregivers of HIV-1 infected children aged 6 to 16 years attending a pediatric HIV treatment program in Nairobi, Kenya. We conducted focus group discussions with a subset of caregivers to further refine perceptions of disclosure.


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  • Younger age at HAART initiation is associated with more rapid growth reconstitution

    Worldwide, more than 2.5 million children are infected with human immunodeficiency virus (HIV-1), nearly 90% of whom are living in sub-Saharan Africa. A common feature of HIV-1 infection in children is growth failure. HIV-1-infected infants tend to have substantially lower weight and height compared to HIV-1-uninfected children of similar age. In Africa, many HIV-1-infected children also lack adequate nutrition. Malnourished HIV-1-infected children struggle to meet metabolic demands of growth and development, and poor nutrient status weakens the immune system and decreases the likelihood of survival. Growth faltering has been reported in up to 50% of untreated HIV-1-infected children in resource-limited settings.

    Highly active antiretroviral therapy (HAART) suppresses viral replication and results in immune recovery and growth reconstitution in HIV-1-infected children. Although HAART improves growth in pediatric HIV-1, the pattern and determinants of growth reconstitution following HAART are not well defined. In the US, HIV-1-infected children generally achieve normal weight-forage Z-scores (WAZ) within a year of HAART initiation and experience improvement in height-for-age Z-scores (HAZ) by 2 years. In Africa, baseline WAZ and HAZ in untreated HIV-1-infected children are substantially lower (typically with Z-scores <−2 which is <2nd percentile) than reported in US/European cohorts (Z-scores >−0.5, or >30th percentile).


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  • ART treatment costs and retention in care in Kenya: a cohort study in three rural outpatient clinics

    Background:

    After almost 10 years of PEPFAR funding for antiretroviral therapy (ART) treatment programmes in Kenya, little is known about the cost of care provided to HIV-positive patients receiving ART. With some 430,000 ART patients, understanding and managing costs is essential to treatment programme sustainability.


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  • Measuring adherence to antiretroviral therapy in children and adolescents in western Kenya

    Introduction :

    High levels of adherence to antiretroviral therapy (ART) are central to HIV management. The objective of this study was to compare multiple measures of adherence and investigate factors associated with adherence among HIV-infected children in western Kenya.


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  • Effectiveness of option B HAART in prevention of mother-to-child transmission (PMTCT) in pregnant HIV women

    Background :

    Ensuring that no baby is born with HIV is an essential step towards achieving an AIDS-free generation. To achieve this, strategies that decouple links between childbirth and HIV transmission are necessary. Traditional forms of prevention of mother-to-child transmission of HIV (PMTCT), has been recommended. Recognizing the importance and challenges of combination of methods to achieve rapid PMTCT, the World Health Organization (WHO) recommended option B Highly Active Antiretroviral Therapy (HAART) for all HIV-positive pregnant women. This study aimed to evaluate the effectiveness of the HAART in PMTCT. A cohort of HIV-infected pregnant women in Kenya were obtained from the DREAM Center, Nairobi. The study participants underwent adherence counselling and Option B of HAART [Nevirapine(NVP) + Lamivudine + Zidovudine] at the fourth week of gestation followed by an intravenous NVP administration intrapartum and postpartum NVP syrup to the respective infants for six weeks. Absolute pre-HAART and post-HAART CD4 counts and viral loads counts were determined. Comparison of the CD4 counts and viral loads before and after administration of HAART were done using Wilcoxon’s Matched Pairs Signed-Ranks Test.


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  • HIV type 1 drug resistance patterns among patients failing first and second line antiretroviral therapy in Nairobi, Kenya

    Background:

    The ever-expanding roll out of antiretroviral therapy in poor resource settings without routine virological monitoring has been accompanied with development of drug resistance that has resulted in limited treatment success.


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  • Integrating Tuberculosis and HIV Services in rural Kenya: uptake and outcomes

    Background:

    An estimated 35.3 million persons worldwide were living with the human immunodeficiency virus (HIV) in 2012, while 8.6 million people developed tuberculosis (TB), the majority of them in sub-Saharan Africa. Kenya is one of the world’s 22 high TB burden2 and high HIV burden countries.


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  • HIV diversity and drug resistance from plasma and non-plasma analytes in a large treatment program in western Kenya.

    Background:

    Antiretroviral resistance leads to treatment failure and resistance transmission. Resistance data in western Kenya are limited. Collection of non-plasma analytes may provide additional resistance information.


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  • Incident HSV-2 infections are common among HIV-1-discordant couples.

    Background:

    The synergy between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus type 1 (HIV-1) is well known, but lack of knowledge about the epidemiology of HSV-2 acquisition in HIV-1-discordant couples hampers development of HSV-2 prevention interventions that could reduce HIV-1 transmission.


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  • "If I am given antiretrovirals I will think I am nearing the grave:" Kenyan HIV serodiscordant couples' attitudes regarding early initiation of antiretroviral therapy

    Background:

    Initiation of antiretroviral therapy (ART) by HIV-infected persons – that is, at higher CD4+ cell counts (>350 cells/μl) – is a potent HIV prevention strategy.The WHO recommends ART initiation irrespective of CD4+ cell count for HIV-infected members of HIV serodiscordant couples.Studies from a variety of settings have reported that some HIV-infected individuals are not willing to initiate ART, but few studies have directly explored early ART initiation. Among 181 HIV-infected Kenyan individuals with CD4+ cell counts higher than 350 cells/μl and known HIV-uninfected partners, approximately 40% reported reluctance to consider early ART, citing side-effects, stigma, pill burden, and ART resistance.In the control arm of HIV Prevention Trials Network (HPTN) 052, nearly 20% of HIV-infected participants declined ART when offered after the trial demonstrated HIV protection – many stating that they were not ready to begin ART or believed their CD4+ cell count was too high .Recent studies have suggested that higher CD4+ cell counts are associated with delayed ART initiation or refusal .

    Socially constructed perceptions of HIV are important to understand refusal, uptake, and adherence to HIV treatment and prevention. In high-income settings, the social definition of HIV has been shifted from a universally fatal disease to a chronic, manageable illness because of the advent of highly effective ART.The reconceptualization of HIVas a treatable disease has a profound social and psychological impact: restored hope, a return to normalcy, and potentially reduced stigma, but also the burden of managing an ongoing, unpredictable illness and adhering to treatment. It is hypothesized that the transition of HIV to a chronic illness will reduce stigma, an important barrier to engagement in HIV services, as HIV-infected individuals on ART can remain healthy and maintain a `normal' identity and life, concealing their HIV status and avoiding potential negative reactions from others. Less has been described about reconceptualization of HIV as a chronic, treatable illness in Africa, where ART availability is more recent and is generally initiated at low CD4+ cell counts. Particularly unknown is the conceptualization of earlier initiation of ART. This qualitative study explored HIV serodiscordant couples' attitudes toward the early initiation of ART.


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  • Willingness of Kenyan HIV-1 serodiscordant couples to use antiretroviral-based HIV-1 prevention strategies.

    Background:

    Antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) have demonstrated efficacy as new human immunodeficiency virus-1 (HIV-1) prevention approaches for HIV-1 serodiscordant couples.


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  • Preventing HIV infection without targeting the virus: how reducing HIV target cells at the genital tract is a new approach to HIV prevention

    Background:

    According to the latest UNAIDS report, 36.7 million people are living with HIV/AIDS worldwide. Despite the development of new antiretroviral drugs and better access to care and prevention programs, the number of new HIV cases has remained over 2 million per annum over the past 10 years with a very slow rate of decline . Clearly, existing prevention methods are not sufficient and new approaches are required. However, to develop new biomedical prevention methods, we need a better understanding of the factors driving susceptibility to HIV infection.


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  • HIV-associated mortality in the era of antiretroviral therapy scale-up – Nairobi, Kenya, 2015

    Background:

    Declines in HIV prevalence and increases in antiretroviral treatment coverage have been documented in Kenya, but population-level mortality associated with HIV has not been directly measured. In urban areas where a majority of deaths pass through mortuaries, mortuary-based studies have the potential to contribute to our understanding of excess mortality among HIV-infected persons. We used results from a cross-sectional mortuary-based HIV surveillance study to estimate the association between HIV and mortality for Nairobi, the capital city of Kenya.


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  • Pharmacokinetics-based adherence measures for antiretroviral therapy in HIV-infected Kenyan children

    Background:

    Traditional medication adherence measures do not account for the pharmacokinetic (PK) properties of the drugs, potentially misrepresenting true therapeutic exposure.


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  • The Burden of Polypharmacy in Aging Population Living with HIV in Mombasa, Kenya

    Background :


    Kenya has the fourth-largest HIV epidemic in the world. In Kenya 2.92% of the population are 65 years and above. Aging population tend to have health problems like cardiovascular conditions, endocrine disorders and malignancies. These comorbidities are due to aging organs and immunity, with HIV increasing their risk. Polypharmacy is concurrent use of multiple medications for multiple conditions. This study is aimed at establishing the burden of polypharmacy in aging population living with HIV in Mombasa.

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  • Non-Communicable Diseases (NCD) Co-Morbidities in Overweight and Obese Adults Living with HIV: A cross-sectional review of HIV Clinical Routine Data of LVCT Health’s Clinic in Nairobi County

    Background:


    Being overweight is defined as Body Mass Index (BMI) ranging from 25 to 29.9 kg/m² and obesity (BMI greater than 30 kg/m²). Collectively termed as over-nutrition, both are on the increase and are associated with increased non-communicable diseases (NCDs) e.g. diabetes and cardiovascular diseases. Studies show that People Living with HIV (PLHIV) are similarly affected by over-nutrition and related NCDs. We sought to determine the prevalence of over nutrition and related NCD among HIV positive adults attending LVCT Hurlingham clinic in Nairobi county of Kenya, between January and December 2016

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  • Effects Terrorism and HIV prevention and treatment: Case Study of Mpeketoni Terrorist Attack in Lamu West Kenya

    Background:


    Studies show that violent conflicts create disruptive conditions for consistent uptake of health services including HIV treatment and ANC. Lamu West suffered terrorist attacks in 2014 prompting series of security interventions including militarization of some parts of the sub-county. There was massive population dislocation, especially from Witu, Hindi and Mpeketoni. Do these terror attacks affect HIV treatment services in Kenya?

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  • The Molecular Epidemiology of HIV-1 Infection Within and Between Risk Groups in Kenya

    What questions are we trying to answer? We aim to describe introduction, spread and transmission of HIV networks within and between risk groups (MSM, FSW and HET) and geographic locations in Kenya. We also aim to describe the distribution of HIV subtypes, and to determine levels of pretreatment HIV drug resistance over time, within and between risk groups and geographic locations in Kenya. 


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  • HIV AND AIDS-RELATED STIGMA AND DISCRIMINATION: PERSPECTIVE OF PEOPLE LIVING WITH HIV AND AIDS IN GARISSA COUNTY, KENYA

    Abstract

    Purpose: To determine the factors influencing stigmatization and discrimination among people living with HIV and AIDS in Garissa County.

    Methodology: This research utilized a survey research design.

    Findings: Results revealed that people living with HIV and AIDS experienced stigmatization and discrimination. The people were stigmatized and discriminated in ways such as verbal abuse, they were perceived to die soon, being shunned by their families and friends, people avoiding physical contact with them and general fear from the public. Additionally, illiteracy, ignorance and poverty were the factors that promoted stigmatization and discrimination. Binary logistic regression results showed that gender was statistically associated with stigmatization and discrimination. The probability of stigmatization and discrimination increased. The multivariate logistic regression results showed that gender was not statistically associated with stigmatization and discrimination levels. Binary logistic regression results showed that the level of education, level of income, was negatively statistically associated with stigmatization and discrimination levels. The multivariate logistic regression results showed that the level of income was negatively statistically associated with stigmatization and discrimination levels. Binary logistic regression results showed that the likelihood of females spreading HIV, likelihood of unmarried people spreading HIV and likelihood of old people spreading HIV was statistically associated to levels of stigmatization and discrimination. A multivariate logistic regression results revealed that the likelihood of females spreading HIV and likelihood of old people spreading HIV is statistically associated to levels of stigmatization and discrimination. Binary logistic regression results showed that the knowledge level on whether HIV can be spread through a mosquito bite is statistically associated to levels of stigmatization and discrimination. The multivariate logistic regression results showed that the knowledge level on whether HIV can be spread through a mosquito bite is statistically associated to levels of stigmatization and discrimination.

    Unique contribution to theory, practice and policy: This study will benefit various groups of people. These include stakeholders in the management of stigma and discrimination of People Living with HIV and AIDS, Governmental and Non Governmental organizations (NGOs) and people living with HIV and AIDS. The study will also benefit academicians and other researchers.


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  • Trauma, Depression, and Resilience among Women Living with HIV/AIDS in Kenya

    Abstract

    Kenya has one of the world’s worst HIV and AIDS epidemics. In 2011, an estimated 1.6 million people were living with HIV and nearly 62,000 people died from AIDS-related illnesses including Korogocho, the worst slum area with 14% HIV prevalence. Even though awareness of HIV and AIDS in Kenya is high, many people living with the virus still face stigma and discrimination. Studies have shown that although people are aware of the basic facts about HIV and AIDS, many do not have the more in-depth knowledge that address issues of stigma. Especially social stigma of HIV to women is an urgent issue in Kenya. Especially women with HIV suffered from stigma and discrimination to break themselves down. Their severe depression and psychological trauma is the most significant cause of their deprived quality of life. Kenya women have been exposed to intense and ongoing trauma and depression since diagnosis of HIV/AIDS. Among 122 women living with HIV/AIDS in Korogocho, Kenya, we examined the prevalence and severity of pre traumatic experience (PET), impact of event (IES-R), depression (CES-D), internal stigma (ISS), and resilience (RS). Results revealed a high prevalence in emotional impact of event in women living with HIV/AIDS (86%); 65.3% reported severe depression after diagnosis of HIV/AIDS. As expected, depression was significantly correlated with both impact of event and internal stigma. Hierarchical regression analyses revealed the association between IES-R score and CES-D scores persisted even after controlling for relevant demographic variables. The most difficulties on living with HIV/AIDS were emotional distress, physical health, social relationship, and financial problems. Implications for improving the psychological functioning and resilience of women living with HIV/AIDS are discussed.

  • "Once you join the streets you will have to do it": sexual practices of street children and youth in Uasin Gishu County, Kenya.

    BACKGROUND: Adolescents living in HIV endemic settings face unique sexual health risks, and in the context of abject poverty, orphanhood, social marginalization, and discrimination, adolescents may be particularly at-risk of horizontal HIV transmission. Street-connected children and youth are a particularly vulnerable and marginalized population and therefore may be a key population at-risk.


    METHODS: We sought to describe the sexual behaviours of street-connected children and youth in order to comprehend their sexual practices and elucidate circumstances that put them at increased risk of contracting HIV utilizing qualitative methods from a sample of street-connected children and youth in Eldoret, Kenya. We recruited participants aged 11-24 years who had lived on the street for ≥ 3 months to participate in 25 in-depth interviews and 5 focus group discussions stratified by age and sex.


    RESULTS: In total we interviewed 65 street-connected children and youth; 69 % were male with a median age of 18 years (IQR: 14-20.5 years). Participants identified both acceptable and unacceptable sexual acts that occur on the streets between males and females, between males, and between females. We grouped reasons for having sex into four categories based on common themes: pleasure, procreation, transactional, and forced. Transactional sex and multiple concurrent partnerships were frequently described by participants. Rape was endemic to street life for girls.


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  • Health care-seeking behaviour of HIV-infected mothers and male partners in Nairobi, Kenya

    Abstract

    Health care-seeking behaviours of HIV-infected mothers in sub-Saharan Africa are poorly characterised and typically focus on individual health conditions rather than overall health. We conducted a qualitative study to understand how HIV-infected mothers, their male partners and their HIV-exposed infants seek medical services. We performed 32 in-depth interviews (17 female, 15 male) and four focus group discussions among HIV-infected post-partum women and their male partners in Nairobi, Kenya. We used a grounded theory approach to explore the paths followed for health-related concerns. Female participants reported that willingness to be tested for HIV influences whether women sought antenatal care and the type of facility they preferred for childbirth. The need for medical care outside regular clinic hours and securing safe transportation at night were also significant barriers to seeking care. Most men sought services from traditional healers and chemists before HIV diagnosis, and at governmental facilities afterwards. Both men and women sent infants to traditional healers for non-medical conditions such as bewitching and massage but rarely for medical conditions. Strategies to reduce HIV-related stigma and fears in antenatal and maternity settings, increase access to care after-hours and improve linkage to HIV care for men early in their infection are needed. 


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  • Outcomes up to Twelve Months after Treatment with Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia Among HIV-Infected Women

    Introduction

    HIV-infected women may have higher rates of recurrent cervical precancer after treatment. Knowledge about rates and predictors of recurrence could impact guidelines and program planning, especially in low-resource settings.


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  • Incidence and predictors of attrition from antiretroviral care among adults in a rural HIV clinic in Coastal Kenya: a retrospective cohort study

    Background

    Scale up of antiretroviral therapy (ART) has led to substantial declines in HIV related morbidity and mortality. However, attrition from ART care remains a major public health concern and has been identified as one of the key reportable indicators in assessing the success of ART programs. This study describes the incidence and predictors of attrition among adults initiating ART in a rural HIV clinic in Coastal Kenya.


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  • HIV with non-communicable diseases in primary care in Kibera, Nairobi, Kenya: characteristics and outcomes 2010-2013

    BACKGROUND:

    Antiretroviral therapy (ART) has increased the life expectancy of people living with HIV (PLHIV); HIV is now considered a chronic disease. Non-communicable diseases (NCDs) and HIV care were integrated into primary care clinics operated within the informal settlement of Kibera, Nairobi, Kenya. We describe early cohort outcomes among PLHIV and HIV-negative patients, both of whom had NCDs.


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  • "Wan Kanyakla" (We are together): Community transformations in Kenya following a social network intervention for HIV care.

    BACKGROUND:

    In sub-Saharan Africa, failure to initiate and sustain HIV treatment contributes to significant health, psychosocial, and economic impacts that burden not only infected individuals but diverse members of their social networks. Yet, due to intense stigma, the responsibility for managing lifelong HIV treatment rests solely, and often secretly, with infected individuals. We introduce the concept of "HIV risk induction" to suggest that social networks of infected individuals share a vested interest in improving long-term engagement with HIV care, and may represent an underutilized resource for improving HIV/AIDS outcomes within high prevalence populations.


    METHODS:

    In 2012, we implemented a 'microclinic' intervention to promote social network engagement in HIV/AIDS care and treatment. A microclinic is a therapy management collective comprised of a small group of neighbors, relatives, and friends who are trained as a team to provide psychosocial and adherence support for HIV-infected members. Our study population included 369 patients on ART and members of their social networks on Mfangano Island, Kenya, where HIV prevalence approaches 30%. Here we report qualitative data from 18 focus group discussions conducted with microclinic participants (n = 82), community health workers (n = 40), and local program staff (n = 39).


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