Publications by authors named "Lisa Mills"

Article Synopsis
  • Voluntary medical male circumcision (VMMC) significantly reduces HIV transmission risk, but many men in Uganda resume sexual activity before the recommended 42-day healing period.
  • A study analyzing data from 1,832 VMMC clients in Rakai, Uganda (2013-2020) found that early sex resumption (ESR) decreased from 45.1% to 14.9% over the years.
  • Factors associated with higher ESR included being married and having multiple sexual partners, while those with primary education and younger age groups (15-19 years) were more likely to resume sex early compared to their counterparts with higher education and older age.
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Introduction: Adolescent girls and young women (AGYW) who may benefit from HIV pre-exposure prophylaxis (PrEP) face high levels of common mental disorders (e.g. depression, anxiety).

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We report that unsuccessful treatment outcomes were 11.8% for tuberculosis (TB) disease and 21.8% for TB infection among persons deprived of liberty in Uganda Prisons Service facilities.

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Background: There are limited population-level data on the pre-exposure prophylaxis (PrEP) care continuum in eastern Africa. Here, we assessed the PrEP care continuum following PrEP rollout in a Ugandan community with ~40% HIV seroprevalence.

Methods: We used cross-sectional population-based data collected between September 3 and December 19, 2018 from a Lake Victoria fishing community in southern Uganda to measure levels of self-reported PrEP knowledge, ever use, and discontinuation following 2017 PrEP rollout via a U.

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Article Synopsis
  • SARS-CoV-2, the virus responsible for COVID-19, was identified in 2019 and has led to a significant global health crisis.
  • The study evaluated the effectiveness of various serological tests for detecting SARS-CoV-2 specific antibodies, including in-house ELISA and commercial assays, using samples from confirmed COVID-19 patients and a control group.
  • All tests showed high sensitivity (95.4-96.6%) and diagnostic accuracy, but the researchers emphasized the need for independent evaluations to enhance the interpretation of serological test results.
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Certain occupations have been associated with heightened risk of HIV acquisition and spread in sub-Saharan Africa, including female bar and restaurant work and male transportation work. However, data on changes in population prevalence of HIV infection and HIV incidence within occupations following mass scale-up of African HIV treatment and prevention programs is very limited. We evaluated prospective data collected between 1999 and 2016 from the Rakai Community Cohort Study, a longitudinal population-based study of 15- to 49-year-old persons in Uganda.

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Article Synopsis
  • The study assessed HIV viral load suppression in 40 Ugandan communities during the implementation of Universal Test and Treat (UTT) from 2015 to 2020.
  • Out of 3080 participants, 72.4% showed durable viral load suppression, while 23.5% had some level of viraemia at initial visits, with a significant portion remaining persistently viraemic.
  • High-level viraemia was more common in younger individuals (ages 15-29) and varied widely by community, highlighting the need for tailored interventions in HIV treatment strategies.
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HIV incidence in eastern and southern Africa has historically been concentrated among girls and women aged 15-24 years. As new cases decline with HIV interventions, population-level infection dynamics may shift by age and gender. Here, we integrated population-based surveillance of 38,749 participants in the Rakai Community Cohort Study and longitudinal deep-sequence viral phylogenetics to assess how HIV incidence and population groups driving transmission have changed from 2003 to 2018 in Uganda.

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In a population-based representative sample of adults residing in 22 communities in Botswana, a southern African country with high HIV prevalence, 1 in 4 individuals had high blood pressure. High blood pressure was less prevalent in adults with HIV than without HIV. Sixty percent of persons with high blood pressure had not previously been diagnosed.

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Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with HIV (PLHIV).

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Introduction: Population-level data on durable HIV viral load suppression (VLS) following implementation of Universal Test and Treat (UTT) in Africa are limited. We assessed trends in durable VLS and viremia among persons living with HIV in 40 Ugandan communities during UTT scale-up.

Methods: In 2015-2020, we measured VLS (defined as <200 RNA copies/mL) among participants in the Rakai Community Cohort Study, a longitudinal population-based HIV surveillance cohort in southern Uganda.

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Rationale: Challenges unique to abortion care have negative implications for access to safe abortion and the psychosocial well-being of healthcare providers. A deeper understanding of the experience of providing abortion care can inform responsive interventions toward supporting abortion providers and strengthening health systems.

Objective: A meta-ethnography was conducted to describe the experiences of providing abortion care and offer broad conceptual implications of abortion providers' experiences on their psychosocial coping and well-being.

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HIV incidence in eastern and southern Africa has historically been concentrated among girls and women aged 15-24 years. As new cases decline with HIV interventions, population-level infection dynamics may shift by age and gender. Here, we integrated population-based surveillance of 38,749 participants in the Rakai Community Cohort Study and longitudinal deep sequence viral phylogenetics to assess how HIV incidence and population groups driving transmission have changed from 2003 to 2018 in Uganda.

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During October 2016-March 2022, Uganda increased tuberculosis (TB) preventive therapy coverage among persons living with HIV from 0.6% to 88.8%.

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Background: Research on the effects of the COVID-19 pandemic on people with rare diseases is limited. Few studies compare healthcare throughout the progression of the ongoing pandemic.

Aims: To assess the impact of the pandemic on individuals with osteogenesis imperfecta across two consecutive years, understand what challenges were encountered, and analyse the experience of remote consultation.

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Article Synopsis
  • * Out of 11 participants, the majority showed strong antibody responses post-infection, with 90% having detectable antibodies and 67% testing positive for the virus initially.
  • * After vaccination, all participants maintained detectable antibodies, with significantly higher IgG levels compared to infection alone, suggesting vaccination enhances protection in previously infected residents.
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Despite implementing measures to prevent introduction of COVID-19 in prisons, a COVID-19 outbreak occurred at Moroto Prison, northern Uganda in September 2020. We investigated factors associated with the introduction and spread of COVID-19 in the prison. A case was PCR-confirmed SARS-CoV-2 infection in a prisoner/staff at Moroto Prison during August-September 2020.

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Article Synopsis
  • The ongoing evolution of SARS-CoV-2 has led to new variants that heighten the severity of the COVID-19 pandemic, classified as variants of concern or interest (VOC/VOI) due to their impact on vaccine effectiveness.
  • A study analyzing 14 different variants found varying levels of resistance to neutralization by antibodies from vaccinated individuals, with the Omicron variant being the most adept at evading these defenses.
  • Despite Omicron's escape ability, individuals who received a booster vaccination still showed moderate effectiveness in neutralizing this variant, reinforcing the importance of vaccination in combating COVID-19.
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Article Synopsis
  • The study looked at serum samples from people living with SARS-CoV-2 positive individuals, comparing those who developed antibodies to those who did not.
  • Researchers found that having antibodies from human coronaviruses did not prevent SARS-CoV-2 infection.
  • However, higher levels of common betacoronavirus antibodies were linked to seroconversion in individuals with mild to moderate SARS-CoV-2 illness.
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Introduction: Voluntary medical male circumcision (VMMC) uptake has been slow in some countries, including Botswana. To inform demand creation efforts, we examined sociodemographic characteristics and referral procedures associated with VMMC uptake in the Botswana Combination Prevention Project (BCPP) and examined the effectiveness of referral of men to MC services from HIV testing venues.

Design: BCPP was a community-randomized trial evaluating the impact of a combination HIV prevention package which included VMMC on community HIV incidence.

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Despite remarkable progress in controlling HIV and TB, Uganda is one of the 30 high-burden TB/HIV countries. Approximately 53,000 Ugandans had a new HIV diagnosis in 2019, and approximately 88,000 Ugandans had a TB diagnosis in 2020. Fellows in the Uganda Public Health Fellowship Program (UPHFP) work directly with the Ministry of Health AIDS and TB Control Programs, the U.

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We quantify antibody and memory B-cell responses to severe acute respiratory syndrome coronavirus 2 at 6 and 12 months postinfection among 7 unvaccinated US coronavirus disease 2019 cases. All had detectable S-specific memory B cells and immunoglobulin G at both time points, with geometric mean titers of 117.2 BAU/mL and 84.

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The mRNA COVID-19 vaccines (Moderna and Pfizer-BioNTech) provide strong protection against severe COVID-19, including hospitalization, for at least several months after receipt of the second dose (1,2). However, studies examining immune responses and differences in protection against COVID-19-associated hospitalization in real-world settings, including by vaccine product, are limited. To understand how vaccine effectiveness (VE) might change with time, CDC and collaborators assessed the comparative effectiveness of Moderna and Pfizer-BioNTech vaccines in preventing COVID-19-associated hospitalization at two periods (14-119 days and ≥120 days) after receipt of the second vaccine dose among 1,896 U.

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Article Synopsis
  • - A study was conducted on nursing home residents who were infected with SARS-CoV-2 to analyze immune responses in both plasma and gingival crevicular fluid (GCF) during and after their infection.
  • - 14 residents participated, with antibody levels measured at multiple time points; results showed that most participants had robust immune responses, with key antibodies detected in both plasma and GCF.
  • - The findings suggest that GCF could be a noninvasive and effective way to monitor immune responses to SARS-CoV-2, especially in individuals who may have difficulty with blood draws.
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Three COVID-19 vaccines are authorized or approved for use among adults in the United States (1,2). Two 2-dose mRNA vaccines, mRNA-1273 from Moderna and BNT162b2 from Pfizer-BioNTech, received Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) in December 2020 for persons aged ≥18 years and aged ≥16 years, respectively. A 1-dose viral vector vaccine (Ad26.

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