International Mentored Scientist Award

There are more than 3 million children 15 years estimated to be living with HIV, with almost 90% residing in sub-Saharan Africa (SSA). This presents a growing challenge to health providers and caregivers concerning the disclosure of HIV serostatus to infected children. Studies conducted in SSA have indicated that only 2% to 37.8% of HIV-infected children 15 years know their HIV status. Despite formal recommendations for disclosure, there are no tested models for supporting caregivers and HIV-infected children in SSA through the process of disclosure.

Human papillomavirus (HPV) is associated with cervical, vulvar, anal and penile cancers. High incidence rates of these cancers are observed in Africa compared to other parts of the world. Severa studies have implicated that the sexual behavior of the male partner is or even more important than women?s personal sexual behavior in predicting her risk of HPV associated cancers. Little is known about the natural history of HPV infections among men; thus hampering efforts to control infection in both men and women.

Human papillomavirus (HPV) is associated with cervical, vulvar, anal and penile cancers. High incidence rates of these cancers are observed in Africa compared to other parts of the world. Severa studies have implicated that the sexual behavior of the male partner is or even more important than women?s personal sexual behavior in predicting her risk of HPV associated cancers. Little is known about the natural history of HPV infections among men; thus hampering efforts to control infection in both men and women.

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.

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 sub-Saharan Africa, screening and brief intervention (SBI) to reduce alcohol consumption may improve HIV treatment outcomes in HIV-infected hazardous drinkers. However, the feasibility, efficacy and effectiveness of this intervention in this region remains unknown. We propose to carry out a qualitative study to describe the feasibility of using SBI to reduce hazardous alcohol use in HIV infected adults in Uganda.

In sub-Saharan Africa, screening and brief intervention (SBI) to reduce alcohol consumption may improve HIV treatment outcomes in HIV-infected hazardous drinkers. However, the feasibility, efficacy and effectiveness of this intervention in this region remains unknown. We propose to carry out a qualitative study to describe the feasibility of using SBI to reduce hazardous alcohol use in HIV infected adults in Uganda.