HRSA's PEPFAR-Supported Resilient and Responsive Health Systems Initiative in Liberia.

During the 2014-16 Ebola outbreak, Liberia suffered 2,544 deaths, including 8% of its doctors, nurses and midwives. The Government responded in 2016 with a seven-year Health Workforce Program (HWP), the goal of which was "the creation of a fit-for-purpose, motivated, and highly-skilled workforce." The US Health Resources and Services Administration (HRSA) with the support from the US President's Emergency Plan for AIDS Relief (PEPFAR), established Resilient and Responsive Health Systems project to assist Liberia in strengthening health workforce and health systems.

The Medical Education Partnership Initiative: Strengthening Human Resources to End AIDS and Improve Health in Africa.

Faced with a critical shortage of physicians in Africa, which hampered the efforts of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Medical Education Partnership Initiative (MEPI) was established in 2010 to increase the number of medical graduates, the quality of their education, and their retention in Africa.

An effective tool for identifying HIV-1 subtypes B, C, CRF01_AE, their recombinant forms, and dual infections in Southeast Asia by the multi-region subtype specific PCR (MSSP) assay.

The RV144 Thai vaccine trial has been the only vaccine study to show efficacy in preventing HIV infection. Ongoing molecular surveillance of HIV-1 in Southeast Asia is vital for vaccine development and evaluation. In this study a novel tool, the multi-region subtype specific PCR (MSSP) assay, that was able to identify subtypes B, C, CRF01_AE for Thailand, other Southeast Asian countries, India and China is described.

The importance of research in the MEPI program: perspectives from the National Institutes of Health.

The Medical Education Partnership Initiative (MEPI), which aims to strengthen and transform education in medicine and the health sciences in Africa, has placed special emphasis on including research as part of new curricula. The great progress achieved against HIV/AIDS globally has been based in part on major research conducted by African investigators working in African institutions at African field sites in collaboration with international partners. This experience demonstrates the key role of academic institutions in generating knowledge while training the next generation of health professionals.

Predictors of mortality among injecting and non-injecting HIV-negative drug users in northern Thailand.

Aims: To estimate mortality rates among HIV-negative injecting drug users (IDUs) and non-injecting drug users (non-IDUs), and to assess predictors for mortality among the IDUs.

Design: Prospective cohort study in northern Thailand with 2-year follow-up.

Setting: IDUs and non-IDUs who were admitted for detoxification treatment for opiate or amphetamine dependence in a regional drug treatment center were screened.

Hepatitis C infection among drug users in northern Thailand.

Illicit drug users are commonly infected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV). We evaluated the prevalence, incidence, and risk behaviors associated with HCV infection in 1,859 drug users in northern Thailand. The HCV prevalence was 27.

Risk factors associated with injection initiation among drug users in Northern Thailand.

Background: Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand.

Methods: A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000.

HIV voluntary counseling and testing and HIV incidence in male injecting drug users in northern Thailand: evidence of an urgent need for HIV prevention.

HIV voluntary counseling and testing (VCT), an important strategy for HIV prevention and care, has been available in all government hospitals in Thailand since 1992. We assessed factors associated with HIV testing, its uptake, and estimates of HIV incidence after HIV testing among male northern Thai injecting drug users (IDUs) admitted for inpatient drug treatment. Participants were interviewed about risk behaviors and HIV testing history before VCT was provided as part of the study.

High HIV, hepatitis C and sexual risks among drug-using men who have sex with men in northern Thailand.

Background: Men who have sex with men (MSM) and who use drugs have shown high HIV risks in Europe, and the Americas. We investigated MSM-drug user demographics, HIV sexual and drug use risks and behaviors in Chiang Mai, northern Thailand to identify prevention targets.

Methods: A total of 2005 males aged 13 years and older were enrolled during inpatient drug treatment from 1999-2000 and assessed for HIV, hepatitis C virus (HCV), syphilis, and for demographics and risks by questionnaire.

HIV infection among female drug users in Northern Thailand.

Reports on HIV infection and risk behaviors among female drug users in developing countries, particularly in Asia, are limited. In this study, we investigated HIV prevalence and risk factors for HIV infection among 200 women admitted for 21-day inpatient drug detoxification in Chiang Mai, Thailand. Volunteers completed a face-to-face interview using a structured interview, HIV pre-test counseling, specimen collection for HIV and STD tests, and were provided test results and HIV post-test counseling 1 week later.

The changing molecular epidemiology of HIV type 1 among northern Thai drug users, 1999 to 2002.

CRF01_AE and subtype B have dominated the HIV-1 epidemic in Thailand since 1989. We reported a new circulating recombinant form of HIV-1, CRF15_01B, as well as other unique CRF01_AE/B recombinants among prevalent HIV infections in Thailand. We sought to study this challenging molecular picture through assessment of subtypes among recent HIV-1 seroconverters in northern Thai drug users.

Drug use, increasing incarceration rates, and prison-associated HIV risks in Thailand.

Background: Incarceration is a known risk for HIV infection in Thai drug users. Through the 1990s, incarceration rates for drug-related offenses rose sharply, whereas HIV prevention and drug treatment in prisons remained limited.

Methods: We assessed HIV and incarceration risks for injection drug users (IDU) and non-IDU in a large treatment center cohort in northern Thailand to investigate HIV and prison risks in this period.

A new circulating recombinant form, CRF15_01B, reinforces the linkage between IDU and heterosexual epidemics in Thailand.

HIV-1 subtype B and CRF01_AE have been in circulation in Thailand and Southeast Asia for more than a decade. Initially separated by risk group, the two strains are increasingly intermixed, and two recombinant strains of essentially reciprocal structure have been recently reported. Here we identify additional CRF_01B recombinants and provide the evidence that HIV-1 strains now pass freely between the two high-risk populations.

HIV prevalence and risks among injection and noninjection drug users in northern Thailand: need for comprehensive HIV prevention programs.

The authors sought to determine sociodemographic and sexual and drug use risk factors for HIV infection among drug users in northern Thailand adjacent to the Golden Triangle. The authors enrolled patients admitted for inpatient drug detoxification at one treatment center in northern Thailand and studied HIV risks and prevalence using an interviewer-administered questionnaire and serum collection with HIV pretest and posttest counseling. Between February 1, 1999 and January 31, 2000, 1865 patients admitted for opiate and methamphetamine dependence completed study procedures.

Assessing the magnitude of the HIV/AIDS epidemic in Burma.

Objectives: Estimates of the HIV/AIDS burden in Burma (Myanmar) are uncertain. Using data from the 1999 national HIV sentinel surveillance and available population data, we generated estimates of Burma's HIV burden in 1999.

Methodology: The 1999 sentinel surveillance included women attending antenatal clinics, male military recruits, blood donors, injecting drug users, patients of sexually transmitted disease clinics, and sex workers.