Publications by authors named "Leilani Francisco"

Background: In Thailand, HIV transmission is well characterized in large urban centers such as Bangkok and Chiang Mai but less so outside of these areas. The main purpose of this study was to assess HIV incidence and associated risk factors in Nakhon Ratchasima and Ratchaburi.

Methods: Participants assigned male sex at birth were enrolled in this prospective observational cohort study between November 2017 and July 2018.

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Article Synopsis
  • Nearly all transmitted HIV-1 cases are CCR5 (R5)-tropic, but this research identifies a case of CXCR4 (X4)-tropic HIV-1 in a participant from the RV217 cohort, highlighting its transmissibility.
  • The X4 HIV-1 caused faster depletion of CD4 T cells compared to R5 infections, affecting naive and central memory CD4 subsets more severely, while showing resistance to certain broadly neutralizing antibodies (bNAbs).
  • This study suggests that X4-tropic HIV-1 can be transmitted among individuals with a normal CCR5 gene, indicating that the specific tropism of HIV-1 could influence its transmission potential and
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Background: The CCR5 (R5) to CXCR4 (X4) coreceptor switch in natural HIV-1 infection is associated with faster progression to AIDS, but the mechanisms remain unclear. The difficulty in elucidating the evolutionary origin of the earliest X4 viruses limits our understanding of this phenomenon.

Methods: We tracked the evolution of the transmitted/founder (T/F) HIV-1 in RV217 participants identified in acute infection.

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Nearly all transmitted/founder (T/F) HIV-1 are CCR5 (R5)-tropic. While previous evidence suggested that CXCR4 (X4)-tropic HIV-1 are transmissible, detection was not at the earliest stages of acute infection. Here, we identified an X4-tropic T/F HIV-1 in a participant in acute infection cohort.

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Nearly all transmitted/founder (T/F) HIV-1 are CCR5 (R5)-tropic. While previous evidence suggested that CXCR4 (X4)-tropic HIV-1 are transmissible, detection was not at the earliest stages of acute infection. Here, we identified an X4-tropic T/F HIV-1 in a participant in acute infection cohort.

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Objective: Viral failure in people with HIV (PWH) may be influenced by multiple sociobehavioral, clinical, and context-specific factors, and supervised learning approaches may identify novel predictors. We compared the performance of two supervised learning algorithms to predict viral failure in four African countries.

Design: Cohort study.

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  • * Among 314 bats captured, only three tested positive for CoV RNA, with sequences closely resembling previously identified Kenyan bat coronaviruses, suggesting varied host-virus evolution.
  • * Human surveillance showed no CoV infections among 401 participants, but individuals with higher exposure to bats (like those involved in crop production and hunting) indicated a need for cautious monitoring of potential spillover risks.
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The increasing global emergence of zoonoses warrants improved awareness of activities that predispose vulnerable communities to greater risk of disease. Zoonotic disease outbreaks regularly occur within Myanmar and at its borders partly due to insufficient knowledge of behavioral risks, hindering participatory surveillance and reporting. This study employed a behavioral surveillance strategy among high-risk populations to understand the behavioral risks for zoonotic disease transmission in an effort to identify risk factors for pathogen spillover.

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As part of a public health behavior change and communication strategy related to the identification of a novel ebolavirus in bats in Sierra Leone in 2016, a consortium of experts launched an effort to create a widely accessible resource for community awareness and education on reducing disease risk. The resulting picture book, , includes technical content developed by a consortium of experts in public health, animal health, conservation, bats, and disease ecology from 30 countries. The book has now been adapted, translated, and used in more than 20 countries in Africa and Asia.

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The CCR5 (R5) to CXCR4 (X4) coreceptor switch in natural HIV-1 infection is associated with faster progression to AIDS, but the underlying mechanisms remain unclear. The difficulty in capturing the earliest moment of coreceptor switch limits our understanding of this phenomenon. Here, by tracking the evolution of the transmitted/founder (T/F) HIV-1 in a prospective cohort of individuals at risk for HIV-1 infection identified very early in acute infection, we investigated this process with high resolution.

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Prior immune responses to coronaviruses might affect human SARS-CoV-2 response. We screened 2,565 serum and plasma samples collected from 2013 through early 2020, before the COVID-19 pandemic began, from 2,250 persons in 4 countries in Africa (Kenya, Nigeria, Tanzania, and Uganda) and in Thailand, including persons living with HIV-1. We detected IgG responses to SARS-CoV-2 spike (S) subunit 2 protein in 1.

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Background: Analytic treatment interruption (ATI) studies evaluate strategies to potentially induce remission in people living with HIV-1 but are often limited in sample size. We combined data from four studies that tested three interventions (vorinostat/hydroxychloroquine/maraviroc before ATI, Ad26/MVA vaccination before ATI, and VRC01 antibody infusion during ATI).

Methods: The statistical validity of combining data from these participants was evaluated.

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Article Synopsis
  • - Routine HIV and STI screenings can help with early diagnosis and treatment, reducing health risks and spreading infections, especially among men who have sex with men (MSM) and transgender women (TGW) in Bangkok, Thailand.
  • - A study involving 1,014 participants showed that 41.5% had previously tested for HIV and 26.4% for other STIs, with higher testing rates among those aged 22+, those with a college education, and those meeting partners online.
  • - Factors contributing to lower testing rates included attraction to both men and women and meeting partners in bars, indicating variations in testing behaviors within this population.
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  • - The study examines the knowledge, attitudes, and practices (KAP) regarding zoonotic disease transmission among communities involved in wildlife trade in North Sulawesi, Indonesia, to help prevent future outbreaks.
  • - Researchers employed both qualitative (interviews and focus groups) and quantitative (questionnaires) methods, sampling 477 participants for surveys and collecting biological specimens from 254 individuals in targeted areas known for wildlife consumption.
  • - Findings revealed that while participants had some awareness of zoonotic diseases like rabies and bird flu, only 1% of the quantitative study group believed that contact with wild animals could lead to illness; biological tests found only one participant with evidence of a zoonotic infection.
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Background: Interactions between humans and animals are the key elements of zoonotic spillover leading to zoonotic disease emergence. Research to understand the high-risk behaviors associated with disease transmission at the human-animal interface is limited, and few consider regional and local contexts.

Objective: This study employed an integrated behavioral-biological surveillance approach for the early detection of novel and known zoonotic viruses in potentially high-risk populations, in an effort to identify risk factors for spillover and to determine potential foci for risk-mitigation measures.

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Anthropogenic land-use changes increase the frequency of interactions and habitat overlap between humans and macaques which play an important role in zoonotic disease transmission. This exploratory qualitative study aimed to examine connections between land-use change and macaque-human interactions and assess the chance of zoonotic disease transmission. We conducted ethnographic interviews and focus group discussions in Old Dhaka, Madaripur, and Chandpur, Bangladesh.

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Background: We measured Human Immunodeficiency (HIV) incidence, retention, and assessed risk factors for seroconversion among two previously unreported cohorts of men who have sex with men (MSM) and Transgender Women (TGW) in Bangkok, Thailand between 2017 and 2019.

Methods: We conducted an 18-month prospective cohort study of HIV-uninfected Thai cisgender men and TGW aged between 18 and 35 years who reported sex with men in the past six months and at least one additional risk factor for HIV infection. HIV and syphilis testing and computer-based behavioral questionnaires were administered at each visit.

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  • The USAID's PREDICT project is working to improve how we prevent and control diseases that can spread between animals and people.
  • They want to understand the risky behaviors of communities that live near animals and nature, to better detect and respond to potential diseases.
  • Researchers talked to people in high-risk jobs to learn what they think about the dangers of their work, finding that many don't see their activities as risky, which could make disease spread more likely.
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Background: Strategies are urgently needed to mitigate the risk of zoonotic disease emergence in southern China, where pathogens with zoonotic potential are known to circulate in wild animal populations. However, the risk factors leading to emergence are poorly understood, which presents a challenge in developing appropriate mitigation strategies for local communities.

Methods: Residents in rural communities of Yunnan, Guangxi and Guangdong provinces were recruited and enrolled in this study.

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Background: Intimate partner violence (IPV) and HIV are important and interconnected public health concerns. While it is recognized that they share common social drivers, there is limited evidence surrounding the potential of community interventions to reduce violence and HIV risk at the community level. The SASA! study assessed the community-level impact of SASA!, a community mobilization intervention to prevent violence and reduce HIV-risk behaviors.

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This article presents baseline data from the SASA! (this is the Swahili for 'now') Study, a cluster randomized trial of a community-mobilization intervention to prevent violence against women and HIV/AIDS in Kampala, Uganda. Logistic regression was used to explore associations between intimate partner violence (IPV) and sexual risk behaviors, among 1,206 ever-partnered men and women (18-49 years). Twenty-seven percent of women reported past-year experience of physical and/or sexual IPV.

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Polygyny has been identified both as a 'benign' form of concurrency and as the cultural basis of concurrent partnerships that are considered important drivers of the HIV epidemic in sub-Saharan Africa. This paper investigates the changing cultural and economic dynamics of polygyny in concurrency in Iringa, Tanzania, a region with traditions of polygyny and high prevalence of HIV. Our analysis of focus group discussions, in-depth interviews and key informant interviews indicate that contemporary concurrent partnerships differ from regional traditions of polygyny.

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Background: Gender based violence, including violence by an intimate partner, is a major global human rights and public health problem, with important connections with HIV risk. Indeed, the elimination of sexual and gender based violence is a core pillar of HIV prevention for UNAIDS. Integrated strategies to address the gender norms, relations and inequities that underlie both violence against women and HIV/AIDS are needed.

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