Publications by authors named "Haddi J Cham"

Article Synopsis
  • Adolescent girls and young women (AGYW) aged 15-24 are at a higher risk for HIV compared to young men, highlighting the need for targeted prevention strategies.
  • A Bayesian spatial model was created to analyze household health survey data from 13 sub-Saharan African countries, estimating individual risk factors and population viral load (PVL) to identify high-risk AGYW districts.
  • The study found that PVL is the strongest predictor of HIV positivity, with significant increases in risk associated with having an HIV-positive partner, enabling better targeting of prevention efforts.
View Article and Find Full Text PDF
Article Synopsis
  • Effective services for HIV care, from testing to antiretroviral therapy (ART), are essential for better health outcomes in people living with HIV.
  • A study in Bukoba, Tanzania, assessed the costs and effectiveness of various HIV testing and linkage programs to optimize resource allocation for achieving UNAIDS goals.
  • Provider-initiated testing was found to be the most cost-effective, and targeting high positivity rate populations could enhance testing efficiency, alongside expanded ART eligibility and high linkage rates improving overall service effectiveness.
View Article and Find Full Text PDF

Gender-based violence (GBV) is a complex issue deeply rooted in social structures, making its eradication challenging. GBV increases the risk of HIV transmission and is a barrier to HIV testing, care, and treatment. Quality clinical services for GBV, which includes the provision of HIV postexposure prophylaxis (PEP), vary, and service delivery data are lacking.

View Article and Find Full Text PDF

Background: Community randomised trials have had mixed success in implementing combination prevention strategies that diagnose 90% of people living with HIV, initiate and retain on antiretroviral therapy (ART) 90% of those diagnosed, and achieve viral load suppression in 90% of those on ART (90-90-90). The Bukoba Combination Prevention Evaluation (BCPE) aimed to achieve 90-90-90 in Bukoba Municipal Council, Tanzania, by scaling up new HIV testing, linkage, and retention interventions.

Method: We did population-based, cross-sectional surveys before and after our community-wide intervention in Bukoba-a mixed urban and rural council of approximately 150 000 residents located on the western shore of Lake Victoria in Tanzania.

View Article and Find Full Text PDF

Reducing HIV-related morbidity and mortality, and effectively eliminating HIV transmission risk, depends on use of antiretroviral therapy (ART) to achieve and maintain viral load suppression (VLS)* (1,2). By 2020, sub-Saharan African countries are working to achieve VLS among 90% of persons using ART and 73% of all persons living with HIV infection (1). In Tanzania, a country with 1.

View Article and Find Full Text PDF

To diagnose ≥90% HIV-infected residents (diagnostic coverage), the Bukoba Combination Prevention Evaluation (BCPE) implemented provider-initiated (PITC), home- (HBHTC), and venue-based (VBHTC) HIV testing and counseling (HTC) intervention in Bukoba Municipal Council, a mixed urban and rural lake zone community of 150,000 residents in Tanzania. This paper describes the methods, outcomes, and incremental costs of these HTC interventions. PITC was implemented in outpatient department clinics in all eight public and three faith-based health facilities.

View Article and Find Full Text PDF

Providing adolescents with evidence-based sexual risk reduction interventions is critical to addressing the HIV/AIDS epidemic among adolescents in sub-Saharan Africa. Project AIM (Adult Identity Mentoring) is an innovative, evidence-based, youth development intervention that is being evaluated for the first time in Botswana through a 3-year (2015-2017), 50-school cluster randomized controlled trial, including testing for herpes simplex virus type 2 as a sexual activity biomarker. Conducting a trial of this magnitude requires the support and collaboration of government and community stakeholders.

View Article and Find Full Text PDF

Unlabelled: Background Use of sexual activity biomarkers in HIV prevention trials has been widely supported to validate self-reported data. When such trials involve minors, researchers may face challenges in obtaining parental buy-in, especially if return of results procedures uphold the confidentiality and privacy rights of minors and preclude parental access to test results. In preparation for a randomised controlled trial (RCT) with junior secondary school (JSS) students in Botswana, a formative assessment was conducted to assess parents' opinions and concerns about testing for herpes simplex virus type 2 (HSV-2) (biomarker of sexual activity) as part of the RCT.

View Article and Find Full Text PDF