Research

Global WACh Researchers Share Latest Science at CROI 2019

Last week, Global WACh researchers participated in the Conference on Retroviruses and Opportunistic Infections (CROI) held in Seattle from March 5-7, 2019.  The annual conference brings together top basic, translational, and clinical researchers from around the world to share the latest studies, important developments, and best research methods in the ongoing battle against HIV/AIDS and related infectious diseases.  Our researchers shared their latest findings on testing for HIV, human papillomavirus (HPV), tuberculosis (TB), and on PrEP delivery practices.  Continue reading for highlights and a list of accepted posters by Global WACh researchers.

ATTACH Team Shares Findings at the Inter-CFAR Sub-Saharan Africa Symposium 2019

Global WACh’s ATTACH team shared scientific findings at the annual Inter-CFAR Sub-Saharan Africa Symposium from January 31st to February 2nd, 2019 in Nairobi, Kenya.  The annual symposium incorporates career development activities targeted to the needs of early career investigators, hold keynote talks addressing scientific topics of interest for African HIV research, and identify novel future research directions.  The team’s research posters generated a lot of interest in how adolescents transition from pediatric to adult HIV care, and opportunities to discuss overcoming challenges.

Global WACh Student Researchers Feature Posters at the 2019 Global Healthies

Photo credit: UW School of Public Health

On January 23rd, the University of Washington Department of Global Health held its annual Global Healthies Opportunities Fair and Poster Competition, which seeks to strengthen connections and start new collaborations for better global health impacts.  It was an exciting evening with a large presence of Global WACh faculty, staff, students and colleagues engaging around our Center’s research and training opportunities.

This year, 12 Global WACh research assistants and Certificate students competed in the poster competition across four distinct categories (Discovery and Development, Education and Training, Implementation and Application, and Public Health Service and Direct Care).  Research assistant, Danae Black (PhD Candidate in Epidemiology), had the winning poster in the Public Service and Direct Care category!  Her research unveiled new data in an area not well studied—the burden of tuberculosis (TB) and utilization of TB preventative therapies for HIV-infected adolescents in Kenya.  These therapies entail daily oral medication taken for up to six months without interruption to effectively prevent TB.  Danae’s findings identified frequent medication shortages across 101 HIV care facilities, meaning that a large number of patients exposed to TB have started therapy, but few have completed it.  The gaps leave patients, whose immune systems are weakened by HIV, at higher risk of developing potentially severe forms of TB.  The impact of Danae’s findings can help researchers better understand the current TB prevention efforts in Kenya and find ways to systematically improve health outcomes in this vulnerable population.

We are so proud of all our student researchers and their achievements.  Well done!

Global WACh Shares Novel Research Findings at International Conferences

Over Fall quarter, Global WACh researchers shared novel research findings from our three scientific priority areas (HIV Through the Lifecycle, Family Planning and Decision Support, and Gut Health and Child Survival) at several international conferences: The HIV Prevention for HIV Conference (HIVR4P), Union World Conference on Lung Health, and American Society of Tropical Medicine & Hygiene (ASTMH) Continue reading for conference highlights and photos!

Global WACh Attends 2018 AIDS Conference in Amsterdam

The International Aids Society hosted the 22nd International AIDS Conference (AIDS 2018) in Amsterdam from July 23-27, 2018.  This year, the conference objectives focused on advancing knowledge of HIV through research findings, promoting evidence-based HIV responses tailored to key populations, activating and galvanizing political commitment and accountability, addressing gaps in and highlighting the critical role of HIV prevention, as well as spotlighting the epidemic and HIV response in Eastern Europe and Central Asia.

Global WACh faculty, staff, student research assistants, and international collaborators had a strong presence at the conference to share and discuss a number of selected abstracts.  In total, 12 members attended, with four selected abstracts for oral presentations and seven poster abstracts at AIDS 2018.  Some members participated in the pre-conference event, the 10th Workshop on HIV Pediatrics from July 20-21, where eight selected poster abstracts were featured.

Global WACh researchers at the HIV Pediatrics Workshop, a pre-conference event to the International AIDS Conference in Amsterdam. Pictured from top left to right: Grace John-Stewart, Anjuli Wagner, Danae Black, Kristin Beima-Sofie, Irene Nujunga. From bottom left to right: Cyrus Mugo and Dr. Keshet Ronen

 

Global WACh Researchers Head to 2018 AIDS Conference!

 

Several Global WACh researchers are heading to Amsterdam, Netherlands for the 22nd International AIDS Conference (AIDS 2018)!  Many are also attending the pre-conference Workshop on HIV Pediatrics. Whether attending as invited speakers or participants, we’re pleased that our researchers have a presence at IAS, the largest conference on any global health or development issue, and provides a unique forum for the intersection of science, advocacy, and human rights.  Global WACh is proud to support global leaders who are committed to positively impact the lives of women, adolescents, and children.  See the full list of selected abstracts here.

Study to make HIV testing informational videos and use saliva-based HIV testing in children launched in Kenya

Most people assume HIV testing involves blood.  While blood is the most commonly used, saliva is an alternative specimen to test and diagnose HIV in adults and adolescents.  Benefits of saliva-based testing include the ease of collecting samples and increased acceptability of HIV testing.  One example of a saliva-based test is OraQuick, a device used to collect and rapidly test saliva.

The OraQuick test strip collects saliva from patients’ upper and lower gums, then is inserted into a tube to test for HIV.  The saliva reacts to liquid in the tube and travels up the stick.  If only the upper line appears, the test is negative. If both lines appear, the test is positive.

Saliva-based testing has produced very good results in adults; however, very few studies have evaluated this method among children Considering the ease of collecting saliva compared to drawing blood using a finger prick (ouch!), saliva-based testing is a good alternative for this population in need of early HIV testing, diagnosis, and care.

Last week, Global WACh and the University of Nairobi launched a new study to address this need.  Led by Post-Doctoral Fellows, Drs. Anjuli Wagner and Irene Njuguna, the Saliva Testing and Video Information to Expand Uptake of Pediatric Testing (STEP-UP) project aims to validate the OraQuick test in children ages 18 months to 12 years old.  The project will also develop and evaluate the effectiveness of video pre-test information session prior to HIV testing.  Both strategies aim to increase pediatric HIV testing in outpatient clinics in Kenya, where high patient volumes make it difficult for healthcare staff to offer adequate HIV counseling to every client.

The STEP-UP study team completed a training to learn about OraQuick and how to perform the test.  The team had a great time participating in team building exercises, practicing collecting saliva from one another, and ending the training with a team dinner.  Check out photos below!

The STEP-UP study team from UW and the University of Nairobi

Lukio fills in questionnaire answers to a mobile data collection tool called Open Data Kit (ODK), while the OraQuick reaction is taking place in the background.

Tamasha practices using the OraQuick test kit, placing the test strip in the reaction fluid.

Tamasha practices using the OraQuick test kit, placing the test strip in the reaction fluid.

The study team will start recruiting participants this month in multiple clinics in Kisumu, Siaya, and Homa Bay counties in Kenya.  They hope to test 1,050 children for HIV and the HIV video consultation in 150 participants.  The team will also include a series of focus group discussion about patient and health care workers’ perceptions about using the OraQuick test and video consultation.  The STEP-UP project is anticipated to end in August 2019.

Successful staff training for PrIYA and PrIMA, HIV-prevention projects

We love receiving updates from our research partners in Kenya!  Last week, two HIV-focused projects, led by the Kenyatta National Hospital, Global WACh, and International Clinical Research Center (ICRC), held successful staff trainings in Kisumu, Kenya.  Both projects emphasize the use of oral pre-exposure antiretroviral prophylaxis, or PrEP, among adolescent girls and women who are at the greatest risk of HIV infection.  PrEP is a daily anti-HIV medication that a person who does not have HIV takes to prevent infection.  If taken daily as prescribed, PrEP is highly effective in stopping the HIV virus from taking hold and spreading throughout the body.


PrEP Implementation for Young Women and Adolescents (PrIYA) seeks to programmatically evaluate PrEP implementation, and determine best practices for providing PrEP to young women and adolescent girls in Maternal and Child Health (MCH) and Family Planning Clinics.  At the training, PrIYA study staff discussed their successes and challenges after four months of providing PrEP clinical services, such as prescribing and counseling for the drug, follow-up care, and blood spot testing to measure drug levels to over 3,000 women.  They also discussed their experiences to establish data tracking systems and improve ways to procure PrEP for their patients.  More information on PrIYA is available here.

PrEP Implementation for Mothers in Antenatal Care (PrIMA) is a cluster-randomized trial in 20 MCH clinics that follows women during their pregnancies through nine months postpartum to assess HIV incidence and other outcomes among those who use PrEP and those who do not.  Offering PrEP to women at the greatest risk of HIV may maximize effectiveness, safety, and cost-effectiveness.  In anticipation of the study’s launch in October, forty new PrIMA staff members received training on the study procedures.

PrIYA_PrIMA Training 1

We look forward to sharing more updates as both studies progress.  Stay tuned for future posts!

Global WACh Seed Grant Recipient Publishes in New Journals

Linnet MaseseEarlier this year, we featured Dr. Linnet Masese, then a Postdoctoral Fellow at the University of Washington’s Department of Medicine, as well as a 2011 Global WACh Integrated Health Seed Grant recipient.  Dr. Masese has conducted meaningful research collaborations around the risk of sexually transmitted infections (STIs) among adolescents and young women in Kenya and the barriers they face to STIs prevention, care, and support.  The first of three papers (“Barriers and Facilitators of Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya”) from her study supported by seed funding was published in PLOS One in January 2017.  We are thrilled to announce the remaining two papers were recently published in scientific journals.

In the paper titled, “Parents’ and teachers’ views on sexual health education and screening for sexually transmitted infections among in-school adolescent girls in Kenya: a qualitative study,” Dr. Masese and her study team focus on the acceptability of STI screening in schools for adolescent girls.  Parents and teachers can play crucial roles to influence adolescents’ reproductive health choices, thus, the study team felt it was important to understand parents’ and teachers’ attitudes towards sexual health education.  Through focus group discussions and in-depth interviews, the team discovered a great need to improve parent-adolescent communication around sexual health, to lessen the taboo nature of discussing sex.  Based on findings from this qualitative study, parents and teachers’ views on the acceptability of school-based STI screening suggest that expanded interventions are possible in this community. Data from this study may assist the work of other researchers and program planners with an interest in STI screening and adolescent sexual health.  This paper is published in Reproductive Health.

Based on findings from the first two papers, Dr. Masese and her team developed a screening intervention.  In the third paper, published in Sexually Transmitted Diseases,  (“Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: Feasibility, Prevalence, and Correlates”), they recruited adolescent girls and young women from high schools and universities to pilot a clinic-based STI screening.  After attending information sessions, a substantial number of interested young women were willing to undergo the screening, many of whom were university students and did not need parental consent.  The study results highlight the strength of using school-based sensitization as a way to encourage adolescents and young women to seek STI diagnosis and care at health clinics.  While the clinic-based STI screening intervention suggested an effective school-based approach to decrease barriers for STI screenings among young women, younger adolescents continue to face the barrier of parental consent for screenings.

Both studies highlight the need to tailor or design reproductive health services to meet the needs of adolescents and young women.  Dr. Masese and her study team’s research achievements conclude school-based STI screening is feasible and acceptable when conducted in collaboration with students, parents, and teachers.  We congratulate Dr. Masese and her team for their excellent work, and look forward to learning how their work informs new approaches to improve sexual health education and STI screenings.

Study achieving optimal neurodevelopmental outcomes in HIV-Infected Infants

HIV infection can result in neurodevelopmental impairment in children. We do not yet understand the extent to which effective antiretroviral therapy (ART) prevents these delays, but Global WACh researcher Dr. Sarah Benki-Nugent’s recent study, conducted in collaboration with researchers at the University of Nairobi, has provided insight to help answer this question. Their study focused on HIV-infected infants in Nairobi Kenya who received ART from the time of infancy and compared their developmental milestone attainment to HIV-unexposed infants.

benki

Sarah Benki-Nugent, MS, PhD, is the study’s lead investigator and Acting Assistant Professor at University of Washington Department of Global Health

Most HIV-infected infants in their study were extremely ill at the time of HIV diagnosis and many were first identified in the hospital. Unfortunately, late diagnosis continues to be common in Africa and UNAIDS has recently estimated that only about half of HIV-infected children are receiving treatment.

The study found that overall, HIV-infected infants had later age at attainment of milestones compared to unexposed infants. However, infants who had better responses to treatment had better developmental outcomes. Benki-Nugent and Kenyan research collaborator Dalton Wamalwa say, “We still don’t’ know how children will do in the long-term; however, this data suggests that effective response to ART provided some benefit, even in a group of infants who were very sick when first diagnosed.”

The study suggests that early HIV diagnosis and successful treatment are likely key factors in retaining cognitive and motor neurodevelopment in HIV-infected children. It is also likely critical, Dr. Benki-Nugent says, to provide additional strategies, such as parenting support for early childhood development alongside HIV treatment to help children reach their full potential.

Click here to read more about the researcher’s work recently featured in Infectious Disease Advisor.