Publications > HIV and sexually transmitted infections

HIV testing and treatment with the use of a community health approach in rural Africa

The Sustainable East Africa Research for Community Health (SEARCH) trial in rural Kenya and Uganda tested universal HIV treatment and annual testing in a community-based, multi-disease, patient-centered approach. After 3 years, the intervention community’s level of viral suppression was 15% higher than those that only received standard care. However, there wasn’t a significant difference in the rate of new HIV infections.

  • Havlir DV et al. The New England Journal of Medicine. July 2019.

Feasibility and acceptability of a behavioral support group intervention among transgender women: a sexual and mental health mixed-methods pilot study in Beirut, Lebanon

This pilot has shown for the first time that a trans-facilitated group support model for HIV prevention can be adapted for Lebanon. It holds great promise for scaling up to assess how it impacts mental and sexual health on a larger scale.

  • Kaplan RL, El Khoury C, Lize N, Wehbe S, Mokhbat J. AIDS Education and Prevention. May 2019.

End-user preference for and choice of four vaginally delivered HIV prevention methods among young women in South Africa and Zimbabwe: the Quatro Clinical Crossover Study

These end-user perspectives provide important information to product developers and funding agencies.

  • Montgomery ET, Beksinska M, Mgodi N, et al. Journal of the International AIDS Society. May 2019.

Increased risk fo HIV acquisition among women throughout pregnancy and during the postpartum period: A prospective per-coital-act analysis among women with HIV-infected partners

This research provides strong evidence that women are at greater risk of HIV-1 infection during late pregnancy and post-partum.

  • Thomson KA, Hughes J, Baeten JM, John-Stewart G, Celum C, Cohen CR, et al. Journal of Infection Diseases. June 2018.

Cervical cancer screening through human papillomavirus testing in community health campaigns versus health facilities in rural western Kenya

The research team compared delivering HPV screening with self-collected samples through community health campaigns (CHCs) and government health clinics.

  • Huchko MJ, Ibrahim S, Blat C, Cohen Cr, Smith JS, Haitt RA, Bukusi E. International Journal of Gynecology & Obstetrics. April 2018.

Optimizing delivery of HIV preexposure prophylaxis for women in the United States

A team of researchers including a Bixby investigator identified challenges and made recommendations to help reduce the rate of HIV infection among women.

  • Aaron E, Blum C, Seidman D, Hoyt MJ, Simone J, Sullivan M, Smith DK. AIDS Patient Care and STDs. January 2018. 

Efficacy of oral pre-exposure prophylaxis (PrEP) for HIV among women with abnormal vaginal microbiota: a post-hoc analysis of the randomised, placebo-controlled Partners PrEP Study

The study found, “No evidence that the protective benefit of daily oral PrEP was reduced” in women with BV or otherwise unhealthy vaginal bacteria

  • Heffron R, McClelland RS, Balkus JE, Celum C, Cohen CR, et al. The Lancet HIV. October 2017.

Association of implementation of a universal testing and treatment intervention with HIV diagnosis, receipt of antiretroviral therapy, and viral suppression in East Africa

In just two years, rates of viral suppression, HIV diagnosis and HIV treatment improved significantly among the study’s 77,774 participants, all of whom live in rural Kenya and Uganda.

  • Petersen M, Balzer L, Kwarsiima D, Sang N, et al. JAMA. June 2017.

Integration of family planning services into HIV care clinics: Results one year after a cluster randomized controlled trial in Kenya

Integrating HIV care and family planning services reduces the pregnancy rate among women living with HIV in Kenya and increases their use of effective birth control methods. Previous research has shown that the majority of women living with HIV in Kenya want to avoid a pregnancy in the near future.

  • Cohen CR, Grossman D, Onono M, Blat C, Newmann SJ, Burger RL, Shade SB, Bett N, Bukusi EA. PLOS One. March 2017. 

Use of a vaginal ring containing dapivirine for HIV-1 prevention in women

This Bixby-supported study in Zimbabwe of a new vaginal ring with the antiretroviral drug dapivirine found that it reduced women’s risk of HIV by nearly a third.

  • Baeten JM, Palanee-Phillips T, Brown ER, et al. The New England Journal of Medicine. December 2016.

Pregnancy rates in HIV-positive women using contraceptives and efavirenz-based or nevirapine-based antiretroviral therapy in Kenya: a retrospective cohort study

HIV-positive women using contraceptive implants and efavirenz-based antiretroviral therapy (ART) had a higher risk of contraceptive failure than did those using nevirapine-based ART, but they still had lower contraceptive failure rates than women using any other contraceptive methods except intrauterine devices.

  • Patel RC, Onono M, Gandhi M, Blat C, Hagey J, Shade SB, Vittinghoff E, Bukusi EA, Newmann SJ, Cohen CR. The Lancet HIV. October 2015.

Clinicians' perceptions and provision of hormonal contraceptives for HIV positive and at-risk women in southern Africa

Clinicians need to improve their knowledge of hormonal contraceptive options safe for women at high risk of HIV and HIV-positive women. Contraceptive education should be integrated into HIV training.

  • Blanchard K, Chipato T, Ramjee G, Nhemachena T, McCulloch C, Grossman D, Morar N, Padian NS, Newmann S, Harper CC. Contraception. May 2014.

A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya

There were no differences between these two visual inspection methods in detection rates for high grade cervical cancer. Visual inspection with acetic acid, an easy testing procedure, can be used alone as a cervical cancer screening strategy in low-income settings.

  • Huchko MJ, Sneden J, Leslie HH, Abdulrahim N, Maloba M, Bukusi E, Cohen CR. Bulletin of the World Health Organization. March 2014.

Integration of family planning services into HIV care and treatment in Kenya: a cluster-randomized trial

Integration of family planning services into HIV care clinics increased use of more effective contraceptive methods with a non-significant reduction in condom use. 

  • Grossman D, Onono M, Newmann SJ, Blat C, Bukusi EA, Shade SB, Steinfeld RL, Cohen CR. AIDS. October 2013.

Integration of HIV care with primary health care services: effect on patient satisfaction and stigma in rural Kenya

Integration of HIV services into primary care services was associated with significant increases in patient satisfaction in certain domains, with no negative effect on satisfaction.

  • Odeny TA, Penner J, Lewis-Kulzer J, Leslie HH, Shade SB, Adero W, Kioko J, Cohen CR, Bukusi EA. AIDS Research and Treatment. April 2013.

The study of HIV and antenatal care integration in pregnancy in Kenya: design, methods, and baseline results of a cluster-randomized controlled trial

This is the first randomized trial of antenatal care and HIV service integration to be conducted in rural Africa. The study will provide critical evidence regarding the effectiveness of this strategy, with important implications for programs striving to eliminate mother-to-child HIV transmission.

  • Turan JM, Steinfeld RL, Onono M, Bukusi EA, Woods M, Shade SB, Washington S, Marima R, Penner J, Ackers ML, Mbori-Ngacha D, Cohen CR. PLoS One. September 2012.

Antiretroviral prophylaxis for HIV prevention in heterosexual men and women

For pre-exposure prophylaxis (PrEP), both oral tenofovir disoproxil fumarate (TDF) and oral tenofovir-emtricitabine (TDF-FTC) protect against HIV-1 infection in heterosexual men and women.

  • Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, Tappero JW, et al; Partners PrEP Study Team. The New England Journal of Medicine. August 2012.

Evaluating safer conception options for HIV-serodiscordant couples (HIV-infected female/HIV-uninfected male): a closer look at vaginal insemination

In serodiscordant partnerships with an HIV-positive female and HIV-negative male, vaginal insemination of a partner's semen during the fertile period coupled with 100% condom use may be the safest method of conception.

  • Mmeje O, Cohen CR, Cohan D. Infectious Diseases in Obstetrics & Gynecology. July 2012.

Safety and effectiveness of BufferGel and 0.5% PRO 2000 gel for prevention of HIV infection in women

The 0.5% PRO2000 gel demonstrated a modest 30% reduction in HIV acquisition in women.

  • Abdool Karim SS, Richardson BA, Ramjee G, Hoffman IF, Chirenje ZM, et al.; HIV Prevention Trials Network (HPTN) 035 Study Team. AIDS. April 2011.

Probiotics: the potential for a live microbicide to prevent HIV

Women are waiting for safe, easy to use, inexpensive and efficacious technologies to help them prevent HIV and other STIs. Probiotics, as a potential live microbicide, offer significant advantages including their safety profile, and a simplified self-replicating drug delivery platform.

  • Hemmerling A, Cohen CR. Journal of Acquired Immune Deficiency Syndromes. March 2011.

Gender, migration and HIV in rural KwaZulu-Natal, South Africa

Higher risk sexual behavior in the context of migration increased women's likelihood of HIV infection.

  • Camlin CS, Hosegood V, Newell ML, McGrath N, Bärnighausen T, Snow RC. PLOS ONE. July 2010.

Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis

Low CD4 cell counts and high plasma HIV-1 concentrations might guide use of anti-retroviral therapy (ART) to achieve an HIV-1 prevention benefit. Provision of ART to HIV-1 infected patients could be an effective strategy to achieve population-level reductions in HIV-1 transmission.

  • Donnell D, Baeten JM, Kiarie J, Thomas KK, Stevens W, Cohen CR, McIntyre J, Lingappa JR, Celum C. Lancet. June 2010.

Sexuality, HIV risk and potential acceptability of involving adolescent girls in microbicide research in Kisumu, Kenya

Microbicide acceptability for youth in sub-Saharan Africa may be bolstered by desperation for new methods to stop the spread of HIV, yet hindered by misgivings about experimental HIV prevention methods for youth.

  • Montandon M, Sahin-Hodoglugil NN, Bukusi E, Agot K, Boland B, Cohen CR. Sex Health. December 2008.