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The Challenge<\/h2>\n<\/p>\n
The Challenge<\/h2>\nWomen, adolescents, and children bear a disproportionate burden of HIV prevalence, incidence, and associated mortality globally. HIV and co-infections — including tuberculosis (TB) and viral infections — present unique health risks to children, adolescents, and women and have interconnected roots of susceptibility and interaction in an individual\u2019s body. Without interventions, the implications of living with HIV and co-infections can persist throughout the lifecycle and into the next generation.<\/p>\n
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<\/h2>\nWe have cultivated expertise in HIV, TB, and other viral infections, particularly as they relate to women, adolescents, and children in resource-limited settings. We leverage that expertise to commit to a vision of transforming testing, diagnostic, and treatment approaches through integrated, innovative, and impactful research that consciously adopts the perspectives of these diverse age groups.<\/p>\n
Our research touches all areas of the translational scientific spectrum from making basic and clinical scientific discoveries to applying implementation science to deliver proven interventions that improve health outcomes. Our clinical science focus supports discoveries in immunology, molecular epidemiology, clinical trials, and clinical management in HIV prevention, diagnosis, care, and co-infections. <\/span><\/p>\n Our implementation science<\/a><\/span> <\/i>focus moves clinical discoveries forward, through optimizing delivery in health facilities, supporting providers, and strengthening policies and practices. <\/span>We aim to serve as a hub for information, expertise, and collaboration in infectious disease research across the lifecycle. In addition, this Scientific Priority area includes studies of children with HIV exposure and studies of neurodevelopment in children with HIV exposure and infection.<\/p>\n <\/p>\n We are committed to preventing transmission of HIV, TB, and other viral infections from mother-to-child by prioritizing biologic determinants of conveyance, mobile health (mHealth) interventions to maximize prevention intervention adherence, and systematic evaluations of the programs currently in place. We further prioritize preventing and detecting HIV acquisition for pregnant and postpartum women. We center our research efforts for this population on pre-exposure prophylaxis (or PrEP) in pregnancy and repeat HIV testing.<\/p>\n<\/div>\n Meeting the unique needs of adolescents living with HIV, TB, and other pathogens necessitate improvements to the quality, level of engagement, and adherence to HIV care. We make these improvements by conducting research using simulated patient training, qualitative studies, continuing quality improvement, program evaluations, mHealth, social media, schools, and service delivery evaluations.<\/p>\n<\/div>\n Interventions during childhood have a substantial impact on the quality of HIV care and management of other illnesses throughout the remainder of a child\u2019s life. That\u2019s why our research in this population area is focused on expediting diagnosis, understanding pathogenesis, optimizing treatment and long-term outcomes, and reducing mortality. These research efforts focus on HIV testing models, financial incentives, immunologic and virologic determinants of acquisition and disease, co-infections, HIV-exposed uninfected children\u2019s adherence and disclosure within care, treatment interruption, and accelerated ART.<\/p>\n<\/div>\n<\/div>\n<\/div>\n <\/p>\n An asterisk (*) indicates the study has ended.<\/em><\/p>\n ATTACH aimed to evaluate rates and co-factors of effective transition in HIV treatment programs in Kenya and to adapt, implement, and evaluate an Adolescent Transition Package (ATP) that combines an adapted US-based transition tool and a disclosure tool associated with improved disclosure outcomes in Namibia.<\/p>\n Nested in this study, Danae Black, PhD (UW Epidemiology) led a NIH-funded Administrative Diversity Supplement study titled, “Evaluating TB prevention strategies for adolescents and young adults in Kenya,” to identify individual and facility-level determinants of ICF, TPT initiation and completion.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Child Health & Human Development (NICHD) (R01HD089850<\/a>)<\/p>\n Award Years:<\/strong>\u00a0 08\/01\/2016 – 06\/30\/2023 (NCE)<\/p>\n Principal Investigator:\u00a0<\/strong> Grace John-Stewart, UW<\/a><\/p>\n View the study protocol.<\/strong><\/a><\/p>\n View the study charter agreement.<\/strong><\/a><\/p>\n View the study materials.<\/a>\u00a0<\/strong><\/p>\n <\/p>\n<\/div>\n Ending the HIV epidemic for youth living with HIV (YLH) will require implementation and optimization of evidence-based interventions that address barriers to treatment. The proposed implementation study will test a youth-led data-driven implementation strategy to scale-up an evidence-based Adolescent Transition Package (ATP) aimed at improving transition processes and post-transition clinical outcomes for YLH in Kenya.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Mental Health (R01MH136897<\/a>)<\/p>\n Award Years:<\/strong>\u00a0 07\/01\/2024 – 06\/30\/2029<\/p>\n Principal Investigator:\u00a0<\/strong> Grace John-Stewart, UW<\/a><\/p>\n <\/p>\n<\/div>\n Among youth living with HIV in Kenya, there is a trend of increasing morbidity and mortality despite dramatic improvements in HIV care and survival in all other age strata. A leading driver of this trend is poor transition from pediatrics to adult HIV care programs. This project will design and pilot the mPACT intervention that will address poor transition to adult care through an mHealth support tool that will facilitate virtual peer groups and 1-to-1 communication between youth and healthcare providers. This development will set the stage for a future cluster randomized trial.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Mental Health (R34MH114834<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 07\/01\/2018 – 04\/30\/2021<\/p>\n Principal Investigator:\u00a0<\/strong> Brandon Guthrie, UW<\/a><\/p>\n <\/p>\n<\/div>\n Adolescents (ages 10-19) experience disproportionately low retention, adherence, and viral suppression compared to other age groups. The DiSC study aims to implement a combination of data-driven interventions using a stepped care model to improve adolescent HIV engagement and clinical outcomes in Kenya. This generalizable systematic approach to deliver differentiated adolescent HIV care that integrates with diverse HIV care programs contributes to the acceleration of progress towards achieving 90-90-90 targets for adolescents.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Child Health and Development (UG3HD096906<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 09\/01\/2018 – 08\/31\/2020<\/p>\n Principal Investigators:\u00a0<\/strong> Grace John-Stewart, UW<\/a>; Pamela Kohler, UW<\/a><\/p>\n <\/p>\n<\/div>\n Reaching 95-95-95 targets for adolescents living with HIV (ALHIV) will require the development and diffusion of evidence-based interventions that address barriers to treatment and care.\u00a0 Primary caregivers of adolescents are an untapped support resource.\u00a0 Comprehensive, data-driven interventions that are responsive to caregiver, adolescent, healthcare worker, and policy-maker needs could substantially improve adolescent HIV outcomes.\u00a0 The proposed study will leverage an ongoing UG3\/UH3 grant focused on identifying risk factors for viral non-suppression and loss-to-follow-up and optimizing health service provision for adolescents to develop an intervention that will empower caregivers to support ALHIV in Kenya.<\/p>\n Sponsor:\u00a0<\/strong> UW\/Fred Hutch Center for AIDS Research (CFAR) New Investigator Award<\/p>\n Award Years:\u00a0<\/strong> 07\/01\/2019 – 6\/30\/2020<\/p>\n Principal Investigator:<\/strong>\u00a0 Kristin Beima-Sofie, UW<\/p>\n <\/p>\n<\/div>\n This one year project\u00a0aims to test new technology-based approaches to engage adolescents who do not typically seek HIV preventative and treatment services, and determine whether adolescents recruited via WhatsApp are demographically distinct from those identified in a clinical setting.\u00a0 This project will test respondent-driven sampling\u2014a social network-based strategy used to collect data from hard-to-reach populations who may fear being identified with stigmatized behavior, such as injection drug users, female sex workers, and men having sex with men\u2014in hopes of reaching adolescents from diverse backgrounds and health-seeking behaviors.\u00a0 They will also compare the WhatsApp virtual focus groups to traditional in-person focus groups in terms of content and depth of responses, and costs.<\/p>\n Sponsor:\u00a0<\/strong> UW\/Fred Hutch Center for AIDS Research (CFAR) International Pilot Award<\/p>\n Award Years:\u00a0<\/strong> 01\/2018 – 01\/2019<\/p>\n Principal Investigator:\u00a0<\/strong> Anjuli Wagner, UW<\/a><\/p>\n <\/p>\n<\/div>\n This pilot study will evaluate the acceptability, feasibility, and costs of offering financial incentives to HIV-infected parents to motivate testing of their HIV-exposed children. 60 parents of children <12 years old who are utilizing HIV treatment services at Kenyatta National Hospital (Nairobi, Kenya) will be randomized to receive $5, $10, or $15 cash payment contingent upon completing pediatric HIV testing. A post-test questionnaire will evaluate acceptability, feasibility, and motivational mechanisms of the intervention. Data will be used to support the future submission of a larger R01-scale grant evaluating the effectiveness of the intervention.<\/p>\n Sponsors:\u00a0<\/strong> UW\/Fred Hutch Center for AIDS Research (CFAR) International Pilot Award and International AIDS Society Collaborative Initiative for Paediatric HIV Education and Research (IAS CIPHER)<\/p>\n Award Years:\u00a0<\/strong> 01\/16\/2015 – 05\/31\/2017<\/p>\n Principal Investigator:\u00a0<\/strong> Jennifer Slyker, UW<\/a>; Irene Njuguna, UW\/Kenyatta National Hospital<\/a><\/p>\n View the study protocol.<\/a><\/strong><\/p>\n <\/p>\n<\/div>\n This study aims to validate saliva-based HIV testing in children and to develop and test a video-based pre-test information session for outpatient HIV testing.<\/p>\n Sponsors:\u00a0<\/strong> Thrasher Research Fund and UW\/Fred Hutch Center for AIDS Research (CFAR) New Investigator Award<\/p>\n Award Years:\u00a0<\/strong> 03\/01\/2017 – 02\/28\/2019<\/p>\n Principal Investigator:\u00a0<\/strong> Grace John-Stewart, UW<\/a>, Anjuli Wagner, UW<\/a><\/p>\n <\/p>\n<\/div>\n We aim to support the World Health Organization (WHO) HIV Department Key Population and Innovative Prevention (KPP) unit\u2019s work on HIV testing services. These tasks focus on three key areas: (1) supporting implementation of partner notification services (PNS) globally, (2) gathering and synthesizing evidence and conducting scoping reviews in order to prepare for the 2019 update to the WHO Consolidated Guidelines on HIV Testing Services, (3) inform implementation of HIV and syphilis testing strategies in maternal and child health programmes, and (4) guide programming for integration of HIV testing into family planning service delivery.<\/p>\n Sponsor:\u00a0<\/strong> World Health Organization<\/p>\n Award Years:\u00a0<\/strong> 04\/01\/2018 – 12\/31\/2019<\/p>\n Principal Investigator:\u00a0<\/strong> Alison Drake, UW<\/a><\/p>\n <\/p>\n<\/div>\n The proposed study aims to quantify maternal-to-infant transfer during pregnancy for a variety of ARVs by employing a novel pharmacokinetic evaluation using maternal and neonatal hair in an unprecedented cohort. We will use validated assays developed by our group to measure ARV levels in hair samples collected at birth from mother-infant pairs enrolled in the Surveillance Monitoring for ART Toxicities Study in HIV-uninfected Children Born to HIV-infected Women (SMARTT Study), a Pediatric HIV\/AIDS Cohort Study (PHACS)-funded prospective study designed to evaluate the effects of ARV exposure on infants born to HIV-infected mothers in the U.S.\u00a0\u00a0Our results will improve understanding of maternal-to-infant transfer for common ARVs used during pregnancy with ultimate implications for worldwide efforts to prevent perinatal HIV transmission with maximum efficacy and minimal toxicity.<\/p>\n S<\/strong>ponsor:\u00a0<\/strong> National Institutes of Allergy and Infectious Diseases (R21AI138618<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 06\/06\/2018 – 05\/31\/2020<\/p>\n Principal Investigator:\u00a0<\/strong> Jillian Pintye, UW<\/a><\/p>\n <\/p>\n<\/div>\n The study will model longitudinal reservoir dynamics, and determine the effects of infant timing of HIV acquisition, ART timing, and the influence of infant immune activation, ADCC, and NK population characteristics on reservoir decline and size. These studies will provide novel data on reservoir dynamics during infancy and early childhood from sub-Saharan Africa and will elucidate potential influence of immune activation, ADCC, and natural killer phenotype in reservoir containment, and ultimately inform intervention strategies for improved long-term management and reservoir control in HIV infected children.<\/p>\n Sponsor:\u00a0<\/strong> National Institutes of Child Health and Human Development (R01HD094718<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 09\/01\/2017 – 06\/30\/2022<\/p>\n Principal Investigators:\u00a0<\/strong> Grace John-Stewart, UW<\/a>; Dara Lehman, Fred Hutch<\/a><\/p>\n <\/p>\n<\/div>\n The proposed studies offer an unprecedented opportunity to understand how HIV, co-infections, malnutrition and inflammation alter early life and long-term immune reactivity in African children. Results from this study have great potential to optimize vaccination strategies for children in areas of HIV prevalence, CMV and malnutrition.<\/span><\/p>\n Sponsor:\u00a0<\/strong> National Institute of Mental Health (R01MH133266<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 09\/01\/2023 – 07\/31\/2025<\/p>\n Principal Investigators:\u00a0<\/strong> John Kinuthia, Kenyatta National Hospital<\/a><\/p>\n <\/p>\n<\/div>\n<\/div>\n<\/div>\n <\/p>\n This award supports leveraging data and archived data collected as part of Dr. Drake’s ongoing K01 study in Kenya, which aims to determine the optimal time to conduct repeat maternal HIV testing.\u00a0 The specific aims are to: 1) externally validate two HIV risk score tools among a cohort of 4600 pregnant\/postpartum women, 2) measure maternal HIV viral load and prevalence of TDR among 100 women with incident HIV infection during pregnancy\/postpartum, and 3) identify biological and behavioral correlates of maternal HIV infection during pregnancy and postpartum. Together, data from the K01 and R03 studies will provide preliminary data to prepare for a large, implementation science trial of repeat maternal HIV testing coupled with targeted screening to determine eligibility for PrEP.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Allergy and Infectious Diseases (R03AI140922<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 07\/06\/2018 – 06\/30\/2021<\/p>\n Principal Investigator:<\/strong> \u00a0Alison Drake, UW<\/a><\/p>\n <\/p>\n<\/div>\n This career development award focuses on HIV viral load and resistance testing among pregnant\/postpartum women with incident maternal HIV infections.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Allergy and Infectious Diseases (K01AI116298<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 07\/10\/2015 – 06\/30\/2020<\/p>\n Principal Investigator:\u00a0<\/strong> Alison Drake, UW<\/a><\/p>\n <\/p>\n<\/div>\n This is a Collaborative Agreement to promote international research efforts and improve the health of Kenyans through medical and preventative health measures. The scope of work includes completion of study activities for the three program evaluations listed below. Specifically, this includes completion of data collection activities, data cleaning and analyses, dissemination of results through report writing, and manuscript development.\u00a0 The funding supports the following studies:<\/p>\n 1. Impact of ART Adherence and Early Infant HIV Diagnosis on the Effectiveness of Option B+ in Kenya (Option B+) Sponsor:\u00a0<\/strong> Christian Health Association of Kenya<\/p>\n Award Years:\u00a0<\/strong> 10\/01\/2018 – 03\/31\/2019<\/p>\n Principal Investigators:\u00a0<\/strong> Grace John-Stewart, UW<\/a>; John Kinuthia, Kenyatta National Hospital<\/a><\/p>\n <\/p>\n<\/div>\n Globally, as prevention of mother-to-child HIV transmission (PMTCT) programs initiate lifelong antiretroviral therapy (ART) for all women, it is important to\u00a0optimize<\/em>\u00a0program retention and\u00a0adherence<\/em>\u00a0to avoid treatment failure and development of drug resistance. In settings with over-extended health workers, mobile phone technology (mHealth<\/em>) can provide education, reminders and counseling and has shown to be effective in decreasing treatment failure in HIV treatment program. In this 3-arm randomized trial, we will determine if\u00a0mHealth<\/em>\u00a0improves PMTCT-ART outcomes by comparing 1-way SMS messaging versus 2-way SMS versus no intervention in HIV-infected pregnant women enrolling in PMTCT-ART programs, and compare the trial arms for effects on maternal ART outcomes and infant HIV transmission.<\/p>\n Sponsor:<\/strong> National Institute of Child Health and Human Development (R01HD080460<\/a>)<\/p>\n Award Years:<\/strong> 05\/01\/2014 \u2013 04\/30\/2021<\/p>\n Principal Investigators:<\/strong> Grace John-Stewart, UW<\/a>; John Kinuthia, Kenyatta National Hospital<\/a><\/p>\n <\/p>\n<\/div>\n The investigators at the University of Washington will contribute expertise on adolescents living with HIV in African contexts and implementation science theoretical frameworks that guide study activities, and will assist in the application of implementation science tools and analysis of implementation science outcome data.\u00a0<\/span><\/p>\n Sponsor:<\/strong> National Institute of Mental Health (R01MH133261<\/a>)<\/p>\n Award Years:<\/strong> 08\/01\/2023 \u2013 05\/31\/2028<\/p>\n Principal Investigator:<\/strong> Dalton Wamalwa, University of Nairobi<\/a><\/p>\n <\/p>\n<\/div>\n<\/div>\n<\/div>\n <\/p>\n PrEP Implementation for Mothers in Antenatal Care (PrIMA) is a cluster-randomized trial to determine the best model for optimized PrEP delivery in pregnancy within maternal-child health systems. We will compare 10 clinics randomized to universal and 10 to targeted (200 women per clinic) and compare HIV incidence among all enrolled women (including those on and not on PrEP) at 9 months postpartum and the proportion of women who take PrEP (PrEP exposure). Our hypothesis is that a targeted approach will be more specific, effective, and cost-effective – maximizing PrEP use among pregnant women at risk and minimizing PrEP use for women without risk – thus providing the best effectiveness\/safety balance.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Allergy and Infectious Diseases (R01AI125498<\/a>)<\/p>\n Award Years:<\/strong> 05\/01\/2016 – 04\/30\/2021<\/p>\n Principal Investigator:\u00a0<\/strong> Grace John-Stewart<\/p>\n Co-Investigators:\u00a0<\/strong> Jared Baeten, Ruanne Barnabas, Barbra Richardson<\/p>\n Staff:\u00a0<\/strong> Julia Dettinger, Laur\u00e9n Gomez<\/p>\n View the study protocol.<\/strong><\/a><\/p>\n <\/p>\n<\/div>\n The proposed study aims to quantify infant pre- and post-natal PrEP exposure and evaluate birth, bone, growth, and neurocognitive outcomes following PrEP exposure through the child\u2019s 5th birthday. Our overall goal is to define a comprehensive safety profile of prenatal\/postpartum PrEP in a unique ongoing cluster-RCT in Kenya that compares PrEP delivery approaches in >4,000 pregnant women. By leveraging existing PrIMA infrastructure, extending follow up from 9 to 60 months, and collecting new infant outcome data in this unprecedented cohort, we are uniquely positioned to assess infant PrEP exposure and outcomes.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Child Health and Human Development (R01HD100201<\/a>)<\/p>\n Award Years:<\/strong>\u00a0 09\/24\/2019 – 06\/30\/2025 (NCE)<\/p>\n Principal Investigator:\u00a0<\/strong> Jillian Pintye, UW<\/a><\/p>\n <\/p>\n<\/div>\n This study will evaluate PrEP adherence in adolescent girls and young women (AGYW) in Kenya using analyses of their adherence in PrEP roll-out programs, in-depth interviews, evaluation of conversations via SMS, and using simulated patients. This multidimensional approach will enable us to understand patterns of adherence in AGYW, reasons for non-adherence, and provide insights on ways to improve adherence.<\/p>\n Sponsor:\u00a0<\/strong> PEPFAR DREAMS, National Institute of Child Health and Human Development (R01HD094630<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 09\/01\/2017 – 06\/30\/2022<\/p>\n Principal Investigators:\u00a0<\/strong> Grace John-Stewart, UW<\/a>; Pamela Kohler, UW<\/a><\/p>\n <\/p>\n<\/div>\n Pregnancy is a high-risk time for acquiring HIV; pre-exposure prophylaxis (PrEP) is an effective, female-controlled, evidence-based intervention that is recommended during pregnancy in high-risk settings. Kenya is one of the few settings where PrEP is being systematically delivered in some regions during pregnancy. This project aims to determine what the barriers are to offering PrEP during routine pregnancy care clinics, test strategies to improve the delivery of PrEP in pregnancy care clinics, and quantify the budget impact of these strategies.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Mental Health (K01MH121124<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 08\/06\/2019 – 05\/15\/2024<\/p>\n Principal Investigator:\u00a0<\/strong> Anjuli Wagner, UW<\/a><\/p>\n <\/p>\n<\/div>\n This study will evaluate PrEP adherence in adolescent girls and young women (AGYW) in Kenya using analyses of their adherence in PrEP roll-out programs, in-depth interviews, evaluation of conversations via SMS, and using simulated patients. This multidimensional approach will enable us to understand patterns of adherence in AGYW, reasons for non-adherence, and provide insights on ways to improve adherence.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Child Health and Human Development (R01HD094630<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 09\/25\/2019 – 06\/30\/2020<\/p>\n Principal Investigators: \u00a0<\/strong>Grace John-Stewart, UW<\/a>; Pamela Kohler, UW<\/a><\/p>\n <\/p>\n<\/div>\n Pregnancy is a high-risk time for acquiring HIV; pre-exposure prophylaxis (PrEP) is an effective, woman- controlled, evidence-based intervention that is recommended during pregnancy in high-risk settings. In Kenya, PrEP is being delivered in some regions during pregnancy and postpartum integrated into maternal and child health services, but scale-up has been sub-optimal. This project aims to develop a community of practice; then test a combination of community of practice, quality improvement, and a training toolkit, to enhance implementation and clinical outcomes; and identify patterns attributes associated with successful implementation.<\/p>\n Sponsor:\u00a0<\/strong> National Institute of Mental Health (R01MH135730<\/a>)<\/p>\n Award Years:\u00a0<\/strong> 01\/01\/2024 – 10\/31\/2028<\/p>\nAreas of Focus<\/h2>\n
\n\n\nWomen<\/h2>\n
\nAdolescents<\/h2>\n
\nChildren<\/h2>\n
<\/div>\nOur Research<\/h2>\n
Improving HIV Testing and Care<\/h3>\n
\n\n\nTransitioning from Pediatric to Adult HIV Care in Kenya (ATTACH)*<\/h2>\n
\nScale-up of an evidence-based Adolescent Transition Package to support transitional care among youth living with HIV (ATTACH-Scale)<\/h2>\n
\nPlanning the mPACT Trial: mHealth Strategies for the Pediatric to Adult HIV Care Transition*<\/h2>\n
\nData-informed Stepped Care to Improve Adolescent HIV Outcomes (DiSC)*<\/h2>\n
\nDeveloping a Data-Informed Caregiver Intervention to Improve Adolescent HIV*<\/h2>\n
\nWhatsApp Focus Group and Respondent-Driven Sampling: Novel Approaches to Engage Diverse Adolescents*<\/h2>\n
\nFinancial Incentives to Increase Update of Pediatric HIV Testing (FIT)*<\/h2>\n
\nDiagnostic Performance and Acceptability of Saliva-based HIV Testing in Children (STEP-UP)*<\/h2>\n
\nTechnical Support on WHO HIV Testing Guidelines*<\/h2>\n
\nAssessing Mother and Infant Antiretroval Exposure Using Hair Measures (Mother\/Infant ART Expo)*<\/h2>\n
\nInfant Immune Mechanisms of HIV Reservoir Size and Decay (HIV PERSISTENCE)*<\/h2>\n
\nIntegration of stepped care for Perinatal Mood and Anxiety Disorders among Women Living with HIV in Kenya*<\/h2>\n
<\/div>\nPreventing Mother-to-Child Transmission (PMTCT) for Women Living with HIV<\/h3>\n
\n\n\nPreventing, Detecting, and Treating Incident Maternal HIV Infection for PMTCT*<\/h2>\n
\nOptimizing Repeat HIV Testing During Pregnancy and Postpartum for PMTCT (OPT)*<\/h2>\n
\nSupporting the Implementation and Expansion of High Quality, Sustainable and Comprehensive HIV Prevention, Care and Treatment Programs in Faith-Based Organization Facilities in the Republic of Kenya under the Presidents Emergency Plan for AIDS Relief*<\/h2>\n
\n2. Prevalence, Cofactors, and Types of Family Planning Methods Used by HIV-infected Women in HIV Care Programs in Kenya (FP)
\n3. Assessment of Adolescents HIV Care in Large HIV Treatment Programs in Kenya (PHASE)<\/p>\n\nEvaluation of mHealth Strategies to Optimize Adherence and Efficacy of PMTCT\/ART (Mobile WACH X)*<\/h2>\n
\nIntegrating a transdiagnostic psychological intervention in the care for adolescents and youth with HIV in Kenya (PROACT)<\/h2>\n
<\/div>\nOptimizing PrEP Delivery<\/h3>\n
\n\n\nPrEP Implementation for Mothers in Antenatal Care (PrIMA)*<\/h2>\n
\nEvaluating Infant PrEP Exposure During Pregnancy and Breastfeeding (PRIMA-EXT)*<\/h2>\n
\nPrEP Implementation for Young Women and Adolescents (PrIYA)*<\/h2>\n
\nTesting Implementation Strategies to Improve Delivery of PrEP for Pregnant and Postpartum Women in Kenya*<\/h2>\n
\nPrEP Optimized for Mothers: Efficient PrEP Integration in MCH Clinics (PrEPARE)*<\/h2>\n
\nScaling up integrated PrEP delivery in Kenyan maternal and child health clinics for pregnant and postpartum women (PrEPARE Scale Up)<\/h2>\n