Principal Investigator(s):Timothy R. Sterling, M.D. Valeria Cavalcanti Rolla, M.D., Ph.D.
Principal Investigator(s): Carolyn Audet, Ph.D.
Principal Investigator(s): Kate Clouse, Ph.D., M.P.H.
Traditional healers, community-based partners with the national health system of South Africa, are exposed to patient blood an average of 1,500 times during their careers due to the practice of delivering herbal remedies via herbs rubbed into dozens of sub-cutaneous cuts. The purpose of this proposal is to compare two implementation strategies to increase consistent use of PPE: (1) a health care worker provided training program followed by 3 educational outreach and coaching visits at the healer's place of practice vs.
In South Africa, HIV testing has been undermined by HIV stigma, distrust in the allopathic health system, a preference for traditional medicine, and distance to the health facility. South Africa has made progress towards their 90-90-90 goals, yet a substantial proportion of the population do not test regularly; only 33.9% of adults in rural Mpumalanga (our study site) underwent HIV testing in the past year.
The UNZA-Vanderbilt Training Partnership for HIV-Nutrition-Metabolic Research (UVP-1) and the UNZA-Vanderbilt Partnership for HIV-NCD Research (UVP-2) continue a longstanding training collaboration between the University of Zambia School of Medicine/University Teaching Hospital (UNZA/UTH), Vanderbilt University (VU) and the Vanderbilt Institute for Global Health (VIGH).
The Vanderbilt Institute for Global Health (VIGH) and Aminu Kano Teaching Hospital (AKTH) in Kano, Nigeria have received a federal grant to study the factors associated with microalbuminuria among participants in an ongoing clinical trial of genetically at-risk HIV-positive adult Nigerians. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant will provide $2.2 million over the next four years.
Young people living with HIV (Y-PLWH) have poor adherence to antiretroviral therapy and engagement in HIV care, making HIV the leading cause of death for African adolescents. Depression and psychological distress are much more common among Y-PLWH than in the general population, and are associated with significantly worse adherence to care and treatment when compared to Y-PLWH without these co-morbid conditions. Thus, untreated depression and severe psychological distress are important contributors to poor HIV outcomes in this population.
Human Immunodeficiency Virus (HIV) infection remains a significant public health problem in the United States (US). It is estimated that almost 15% of the 1.17 million people living with HIV (PLWH) in the US are unaware of their HIV status. And despite the existence of highly effective HIV treatment (antiretroviral therapy, ART), only 65% of people living with diagnosed HIV have achieved viral suppression. Similarly, among HIV-negative people eligible for PrEP, only 18% have used PrEP.
The scale-up of global antiretroviral therapy (ART) represents an unparalleled global health success story, leading to impressive overall reductions in HIV-related morbidity and mortality. However, adolescents and young adults (AYA), especially those in Sub-Saharan Africa, have largely been left out of this story. While AIDS-related deaths declined by 30% for adults from 2005-2012, they increased by 50% among AYA over the same period, making AIDS the leading cause of death among African youth. AYA living with HIV perform poorly across the entire care continuum.