International Mentored Scientist Award

Protection of operating theatre personnel from bloodborne pathogens has been neglected in Uganda. Nature, frequency, risk factors, and preventive measures for perioperative exposure of theatre personnel will be identified by conducting a 6 month cross-sectional study in Mulago Hospital, Uganda. Multiple logistic regression will analyze risk factors for exposure. Case exposure rate and cumulative risk of seroconversion of HIV will be calculated. Surveys of theatre personnel will assess knowledge, attitude, and practice for risks of perioperative bloodborne infections.

Protection of operating theatre personnel from bloodborne pathogens has been neglected in Uganda. Nature, frequency, risk factors, and preventive measures for perioperative exposure of theatre personnel will be identified by conducting a 6 month cross-sectional study in Mulago Hospital, Uganda. Multiple logistic regression will analyze risk factors for exposure. Case exposure rate and cumulative risk of seroconversion of HIV will be calculated. Surveys of theatre personnel will assess knowledge, attitude, and practice for risks of perioperative bloodborne infections.

The use of family planning has been shown to have strong potential to reduce new HIV infections due to unwanted fertility in Uganda. Most prevention of mother to child transmission PMTCT efforts to date have prioritized the provision of antiretroviral prophylaxis to HIV infected pregnant women, leaving voluntary contraception an underutilized approach despite evidence that preventing unintended pregnancies in the HIV infected women is an effective strategy for reducing HIV positive births and is cost effective.

The use of family planning has been shown to have strong potential to reduce new HIV infections due to unwanted fertility in Uganda. Most prevention of mother to child transmission PMTCT efforts to date have prioritized the provision of antiretroviral prophylaxis to HIV infected pregnant women, leaving voluntary contraception an underutilized approach despite evidence that preventing unintended pregnancies in the HIV infected women is an effective strategy for reducing HIV positive births and is cost effective.

Most HIV-infected subjects exhibit a progressive rise in CD4 T-cell counts after initiation of highly active antiretroviral therapy (HAART). However, a subset of individuals exhibit very poor CD4 T cell recovery despite effective control of viremia. Increased activation-induced programmed cell death of CD4 T cells has been proposed as a mechanism underlying poor immune recovery. We propose to perform a nested case control study utilizing a rural cohort of HIV-infected adults whose CD4 T-cell counts have remained low (<50 cell increase) despite HAART for at least six months.

In Sub-Saharan Africa, high hypothetical acceptability of vaginal microbicide trials among women has often been dampened by low male partner support. Formative work recently carried out among women in Kisumu, Kenya indicate that despite a high willingness (80%) to participate in upcoming vaginal microbicide trials, more than a third of the interviewees either did not think their partners would support their trial participation or were unsure of his support.

In Sub-Saharan Africa, high hypothetical acceptability of vaginal microbicide trials among women has often been dampened by low male partner support. Formative work recently carried out among women in Kisumu, Kenya indicate that despite a high willingness (80%) to participate in upcoming vaginal microbicide trials, more than a third of the interviewees either did not think their partners would support their trial participation or were unsure of his support.

In the KwaZulu-Natal (KZN) province of South Africa (SA), where antenatal HIV prevalence is 39.5%, there has been substantial impact of programs to prevent mother-to-child transmission (PMTCT) of HIV.However, despite the recognized benefits of early ART initiation for HIV-infected infants and maternal health care, there is substantial loss to follow-up of HIV-infected mothers and their infants after delivery. Barriers to effective utilization of postnatal HIV care and treatment services include logistical factors, competing demands, and psychological factors such as fear of stigmatization.

In the KwaZulu-Natal (KZN) province of South Africa (SA), where antenatal HIV prevalence is 39.5%, there has been substantial impact of programs to prevent mother-to-child transmission (PMTCT) of HIV.However, despite the recognized benefits of early ART initiation for HIV-infected infants and maternal health care, there is substantial loss to follow-up of HIV-infected mothers and their infants after delivery. Barriers to effective utilization of postnatal HIV care and treatment services include logistical factors, competing demands, and psychological factors such as fear of stigmatization.

Nevirapine (NVP) is the primary antiretroviral (ART) available in Zimbabwe. However, its use as first line ART is complicated by interactions with rifampicin (RIF), the primary drug available for tuberculosis (TB). In some cases ART treatment is delayed or avoided in TB co-infected patients. Previous studies of the effect of RIF on NVP pharmacokinetic (PK) exposure has been inconclusive, failing to generate specific recommendations regarding co-treatment. Moreover, PK and safety data for NVP with RIF have not been generated in our population in Zimbabwe.