Efficacy of Smoking Cessation Interventions among People with HIV in Kenya.

Background: People with human immunodeficiency virus (HIV) smoke at much higher rates than the general population, resulting in higher risk for tobacco-related morbidity and mortality. The efficacy of smoking cessation interventions among people with HIV in lower-middle-income countries remains unclear.

Methods: We conducted a randomized, 2 × 2 factorial design trial based in Nairobi, Kenya, to evaluate the efficacy of bupropion versus placebo, and a culturally tailored behavioral cessation therapy, called Positively Smoke Free (PSF), versus standard of care for people with HIV who smoke.

Effects of Multimonth Dispensing on Viral Suppression and Continuity in Treatment Among Children Living With HIV Aged 2-9 Years: A Cohort Study in Western Kenya.

Background: In Kenya, of the 82,000 children living with HIV, only 59% are receiving ART and 67% are virally suppressed. Early in the COVID-19 pandemic, the Ministry of Health recommended 3 multimonth dispensing (3MMD) of ART to all people living with HIV, including children. This study assesses the association between 3 MMD and clinical outcomes among children in Western Kenya.

Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya.

Objective: The aim of this study is to estimate the proportion of virologically suppressed People living with HIV on second-line ART and to identify factors associated with virologic suppression. With an increasing population of patients on complex second-line anti retroviral therapy (ART), understanding the factors associated with viral suppression and adherence is critical for ensured longevity of ART.

Methods: A retrospective study was conducted of patients on second-line ART in 17 facilities supported by University of Maryland, Baltimore, in Nairobi, Kenya, covering the period beginning October 2016 up to August 2019.

Scale-up of HIV index testing in an urban population: Experiences and achievements from Nairobi County, Kenya.

Objective: To describe the implementation strategies of the index testing program across Nairobi County in Kenya, assess outcomes along the HIV index testing cascade (acceptance, elicitation ratio, HIV positivity and linkage to treatment), and assess annual changes along the HIV index testing cascade during the first 2 years of implementation.

Methods: Retrospective analysis of programmatic aggregate data collected from October 2017 to September 2019 after the roll-out of index testing services in 48 health facilities in Nairobi County. Proportions and ratios were calculated for acceptance, elicitation ratio, testing uptake and HIV positivity.

Implementing an intensified mentorship approach towards accelerated medical laboratory accreditation in 10 counties in Kenya.

Background: Despite Kenya's roll-out of the Strengthening Laboratory Management Towards Accreditation programme in 2010, most laboratories had not made significant or tangible improvements towards accreditation by 2016. In April 2016, the University of Maryland, Baltimore enrolled 27 facilities in the standard Strengthening Laboratory Management Towards Accreditation programme.

Objective: This study aimed to describe and evaluate the implementation of an intensified mentorship strategy on laboratory accreditation.

Factors Associated with Retention in HIV Prevention and Treatment Clinical Services Among Female Sex Workers Enrolled in a Sex Workers' Outreach Program (SWOP) in Nairobi, Kenya.

Female sex workers (FSWs) are among the key populations (KP) prioritized for comprehensive HIV programming in Kenya. Retention in the program is critical for prevention of HIV acquisition and transmission among FSWs and their sexual partners. We conducted a retrospective cohort analysis of data collected from FSWs enrolled between October 2016 and September 2017 at seven drop-in centers (DICs) in Nairobi, Kenya, to assess factors associated with retention in HIV prevention and treatment services.

Cigarette Smoking Behaviors and Beliefs in Persons Living With HIV in Nairobi, Kenya.

Introduction: Persons living with HIV (PLWH) use tobacco at higher rates than the general population in both high-income countries and low- and middle-income countries. Tobacco use rates are increasing in sub-Saharan Africa, the home to most of the world's PLWH. As the reach of antiretroviral therapy (ART) expands and HIV-related morbidity and mortality wanes, tobacco use is emerging as a leading cause of disease and death in PLWH.

Re-Engagement into HIV Care: A Systematic Review.

Identifying evidence-based interventions that can optimize the re-engagement into care of people living with HIV is necessary to achieve and sustain HIV epidemic control. We conducted a systematic review of interventions for re-engagement into HIV care to examine the accumulated evidence and to identify similarities and differences across studies. Between January and March 2020, we searched MEDLINE, Embase, CINAHL, and PsycINFO databases for publications from 1996 to 2020.

Factors Associated with Loss to Follow-Up Among Patients Receiving HIV Treatment in Nairobi, Kenya.

We investigated factors associated with loss to follow-up (LTFU) in 24 urban health facilities in Nairobi, Kenya. We conducted a retrospective analysis of routinely collected data to assess factors associated with LTFU in the period October 1, 2016, to June 30, 2017. LTFU was defined as no antiretroviral therapy (ART) refill for ≥90 days and no documentation of transfer, death, or treatment cessation in the patient chart, and if no lapse of ≥90 days between ART refills, patients were considered retained in care.

Effectiveness of a Lay Counselor-Led Combination Intervention for Retention of Mothers and Infants in HIV Care: A Randomized Trial in Kenya.

Background: Retention of mothers and infants across the prevention of mother-to-child HIV transmission (PMTCT) continuum remains challenging. We assessed the effectiveness of a lay worker administered combination intervention compared with the standard of care (SOC) on mother-infant attrition.

Methods: HIV-positive pregnant women starting antenatal care at 10 facilities in western Kenya were randomized using simple randomization to receive individualized health education, retention/adherence support, appointment reminders, and missed visit tracking vs.

Characteristics and outcomes of HIV-infected youth and young adolescents enrolled in HIV care in Kenya.

Background: The number of youth and adolescents (10-24 years) with HIV infection has increased substantially presenting unique challenges to effective health service delivery.

Methods: We examined routinely collected patient-level data for antiretroviral treatment (ART)-naive HIV-infected patients, aged 10-24 years, enrolled in care during 2006-2011 at 109 ICAP-supported health facilities in three provinces in Kenya. Loss to follow-up (LTF) was defined as having no clinic visit for 12 months prior to ART initiation (pre-ART) and 6 months for ART patients.

Decentralization of HIV care and treatment services in Central Province, Kenya.

Background: Since 2006, the government of Kenya began decentralizing HIV care from secondary health facilities (SHF) to an expanded network, including primary health facilities (PHF). We evaluated the impact of this strategy on enrollment, care, and outcomes among adult patients in Central Province, Kenya, from 2006 to 2010.

Methods: We analyzed electronic patient-level data for 26,690 patients at 15 SHF and 22 PHF.

Psychosocial functioning and depressive symptoms among HIV-positive persons receiving care and treatment in Kenya, Namibia, and Tanzania.

In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIV attending HIV care and treatment clinics in Kenya, Namibia, and Tanzania.