August 10, 2018

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.

 

Researchers at the HIV Pediatrics Workshop Posterwalk:

• HIV-exposed uninfected children have poorer neurocognitive outcomes than HIV-unexposed children (Rabi Yunusa, MPH Student)
  This abstract compared neurocognitive outcomes in HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) school-aged children in Kenya. The results show that HEU children had significantly lower processing speed, memory, and attention scores.

• Intensified case finding and tuberculosis preventive treatment among HIV-infected adolescents in Kenya (Danae Black, Epidemiology PhD student)
  Danae’s descriptive research methods aim to quantify tuberculosis (TB) symptom screening and isoniazid (an antiobiotic used to treat and prevent TB) preventative treatment use which is not well quantified in Kenya.
• PrEP uptake among pregnant and postpartum women: results from a large implementation program (Dr. John Kinuthia, MBChB, Kenyatta National Hospital, Kenya)
  This abstract was also selected as an oral presentation at the IAS main stage (see summary below).
• Newly diagnosed HIV-infected children: a unique index case to improve HIV diagnosis and linkage to care of parents (Jillian Neary, MPH, Study Coordinator)
  The abstract’s conclusions can inform interventions to improve testing, diagnosis, and linkage to HIV care for previously undiagonsed parents of newly diagnosed HIV-infected children.

• Transitioning adolescents to adult HIV care: Health facility models of care and transition practices in Kenya (Dr. Irene Njuguna, MBChB, Kenyatta National Hospital; Epidemiology PhD Student)
  The abstract described the varying models of care and transition practices among health care facilities that serve adolescents moving to adult HIV care. Developing a consensus in uniform high quality care can help improve the health of this population and lower HIV transmission.
• Cofactors of mortality among hospitalized HIV infected children newly initiating ART in Kenya (Dr. Irene Njuguna, MBChB, Kenyatta National Hospital; Epidemiology PhD Student)
  This abstract highlighted the need to rapidly identify HIV-infected children who are hospitalized for acute infectious diseases, such as pneumonia and tuberculosis, and initiate HIV treatment before symptoms of the disease worsen. This strategy can improve the chances of survival among this vulnerable population.
• Adolescent-specific provider training and provision of services is associated with retention in Kenyan HIV clinics (Dr. Kate Wilson, PhD, Post-Doctoral Fellow, Global Health; with Cyrus Mugo, MBChB, University of Nairobi, Kenya
  This abstract was also featured at AIDS Conference (see summary below).

• Youth perspectives on and access to a WhatsApp-based HIV treatment support tool in Nairobi, Kenya (Dr. Keshet Ronen, PhD, Research Scientist, Global Health)
  This abstract highlighted the desires among youth living with HIV for a free-form communication platform with peers to provide emotional, instrumental, and companionship support. This is a promising strategy to connect this population to health education, motivation and behavioral skills for ART adherence, and social support.

 

 

 

 

 

Oral presentations given by Global WACh researchers at AIDS 2018:

• Dr. Jillian Pintye, PhD, RN, Senior Fellow and Trainee, Global Health presented
  “Uptake of PrEP within clinics providing integrated family planning and PrEP services: Results from a large implementation program in Kenya.”  Dr. Pintye spoke about the PEPFAR and DREAMS-supported PrEP Implementation for Young Women and Adolescents (PrIYA) program, which evaluates integrated PrEP (a daily pill taken to prevent HIV-infection) delivery within routine antenatal, postnatal, and family planning clinics in Kenya.

 

 

 

• Dr. John Kinuthia, MBChB, a long-time collaborator from Kenyatta National Hospital in Nairobi, Kenya, also presented on the success of the PrIYA program in “PrEP uptake among pregnant and postpartum women: results from a large implementation program.” In total, they conducted 9,704 assessments among pregnant/postpartum clients for behavioral risk factors and willingness to consider PrEP.  1,856 (19%) of encounters led to PrEP initiation and PrEP initiators tended to be younger and more likely to have HIV risk factors than those who declined PrEP.

 

 

• Dr. Keshet Ronen, PhD, Research Scientist, presented on, “Food insecurity is common and associated with unsuppressed viral load in HIV-infected pregnant women in Kenya.“ The abstract focused on the impact of food insecurity on viral suppression, which is necessary to prevent transmission from mother to infant in utero, in HIV-infected pregnant women in Kenya.  Nutrition assistance may help support viral suppression for this population.
• Dr. Kristin Beima-Sofie, PhD, Research Scientist, UW Global Health presented
  “Case Studies from AHISA Members” in a panel session.  She is a member of the Fogarty International Center’s Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA), which aims to help overcome challenges to adaptation and scale-up of interventions for HIV prevention, screening, and treatment in adolescents (ages 15-24).

 

 

 

 

 

Selected abstract posters by Global WACh researchers at AIDS 2018:

• Assessment of adolescent HIV service delivery in Kenya: The PHASE Study (Dr. Kristin Beima-Sofie, PhD, Research Scientist, UW Global Health)
  This abstract presented varying results in how a large number of healthcare facilities in Kenya reported on adolescent HIV service provisions, which demonstrates the implementation landscape to continuously train providers to offer uniformly high quality care across regions and facilities.
• Modeling the cost-effectiveness of repeat maternal HIV testing in Kenya and South Africa (Julianne Meisner, Epidemiology PhD Student, and Dr. Alison Drake, PhD, Assistant Professor, Global Health)
  This abstract shared the utilization of a Markov decision model to assess the cost-effectiveness of repeat HIV testing during pregnancy/breastfeeding in Kenya and South Africa.  It also helped detect new maternal HIV infections and prevent mother-to-child HIV transmission.
• Low awareness of pre-exposure prophylaxis (PrEP) for protection against HIV transmission among HIV-infected women in HIV-serodiscordant couples in Kenya: Results from a nationwide survey (Dr. Jillian Pintye, PhD, RN, Senior Fellow and Trainee, Global Health)
  This abstract highlights that PrEP awareness is low among HIV-infected women, who are enrolled in HIV care programs and have known HIV-uninfected male partners.  However, many believe that their partner would likely take PrEP, if it was made available to them.  Sensitizing couples about PrEP may enhance awareness and utilization in this high-risk population.
• HIV disclosure to partners among pregnant women receiving HIV care in Kenya (Dr. Keshet Ronen, PhD, Research Scientist, Global Health)
  This abstract highlights factors associated with HIV disclosure by pregnant women to their partners for developing mobile health interventions to expand HIV testing and linkage to care.  Disclosure among those surveyed and who were on lifelong antiretroviral therapy (ART) was associated with a number of positive outcomes such as health education, motivation and behavioral skills for ART adherence, social support and lower stigma.
• The prevalence and correlates of depression in a cohort of HIV-Infected pregnant women in Kenya (Lusi Osborn, Data Manager, Kenyatta National Hospital, Kenya)
  This abstract presented factors associated with the prevalence of depression in HIV-infected pregnant women in Kenya, and the need for improved depression screening and treatment for this vulnerable group.
• Engagement in bidirectional mobile messaging to support antiretroviral therapy (ART) adherence among peripartum women in Kenya (Dr. Jennifer Unger, MD, Assistant Professor, Global Health and OBGYN and Dr. Keshet Ronen, PhD, Research Scientist, Global Health)
  This abstract presented participant engagement levels and content of their text messages during a mobile health messaging study.  Engagement was particularly high during pregnancy, in which participants requested advice about medication side effects and strategies for improving ART adherence for themselves and their newborn infants.
• Adolescent-specific provider training and provision of services is associated with retention in Kenyan HIV clinics (Dr. Kate Wilson, PhD, Post-Doctoral Fellow, Global Health; with Cyrus Mugo, MBChB, University of Nairobi, Kenya)
  This abstract highlights sub-optimal retention of adolescents and young adults (AYA) in HIV care based on a standardized patient-actor training study. The clinical outcomes of the study suggests that adolescent-specific health provider training and services may improve AYA retention.