MISSION

We aspire to be a leading academic model of a partnership that optimizes health and well-being globally. We aim to strengthen bilateral institutional capacity through responsive and sustainable program implementation in research, education, medical innovation, and community/clinical care in Uganda and the United States.

ABOUT US

The Global Health Collaborative (GHC) is a partnership between Mbarara University of Science and Technology (MUST), Mbarara Regional Referral Hospital (MRRH), and the Massachusetts General Hospital (MGH) Center for Global Health, as well as other local and international academic institutions. Building on a 20+ year relationship, GHC is a unifying entity that fosters scientific and development growth and leadership. Members share core values of integrity and commitment, excellence, innovation, and collaboration. A resource to the entire MUST research and development community, the Collaborative promotes efficiency, accountability, and cooperation by sharing expertise, facilities, and equipment amongst all studies under their collective banner.

MBARARA UNIVERSITY OF SCIENCE AND TECHNOLOGY (MUST)

The Mbarara University of Science and Technology (MUST) in southwest Uganda is one of Mass General’s longest and strongest partnerships. MUST was founded in 1989 under the auspices of Ministry of Education in response to the increasing demand for health professionals trained to provide healthcare in rural Uganda. After an extensive modification to the physical facilities of the former School of Midwifery at the Mbarara District Hospital, MUST opened with the first class of 43 students in the Bachelor of Medicine and Bachelor of Surgery programs. Today, MUST boasts an enrollment of over 3,500 students across the Faculties of Medicine, Science and Development Studies, and the Institutes for Computer Science and Tropical Forest Conservation. As with Mass General and Harvard Medical School, MUST students learn clinical skills in an affiliated tertiary academic medical center. The hospital is located adjacent to the medical school. Website: https://www.must.ac.ug/

MBARARA REGIONAL REFERRAL HOSPITAL (MRRH)

The 400-bed Mbarara Regional Referral Hospital (MRRH) is a public hospital founded under the auspices of Uganda Ministry of Health in 1956. Built in 2012 the new building houses the Trauma Unit (Emergency Department), Radiology, ICU’s, Private pay inpatient ward pharmacy, laundry and other support services. Inpatient facilities include medicine, surgery, pediatrics, malnutrition, OB/GYN, labor and delivery, ICU, psychiatry, and trauma services. The hospital admits over 30,000 patients each year – at least 30% for obstetrics or pediatrics – and delivers over 10,000 babies each year. By comparison, Mass General delivers about 3,600 babies annually. The children’s ward has 84 beds and admits between 6,000 and 7,000 children a year. The outpatient facilities include clinics for HIV/AIDS, diabetes, cardiology and general medical care. Common diagnosis and presentation include HIV, TB, pneumonia, Cryptococcus, malaria, toxoplasmosis, meningitis, hepatitis B, diarrheal diseases, neurologic disorders, anemia and diabetes. Website: https://mbararahospital.go.ug/

CORE TEAM

STEPHEN ASIIMWE, MBCHB, MS, DRPH
STEPHEN ASIIMWE, MBCHB, MS, DRPH
Program Director
ANNET KEMBABAZI, MSC
ANNET KEMBABAZI, MSC
Senior Program Manager
MARY NAMUKISA
MARY NAMUKISA
Research & Infrastructure Manager
RHINA MUSHAGARA
RHINA MUSHAGARA
Relations Manager
JULIUS TURYASINGURA
JULIUS TURYASINGURA
IT Manager

BY THE NUMBERS

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peer reviewed publications
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Ugandan first authors
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Research projects

RESEARCH

We aim to generate new knowledge and evidence-based interventions for crucial health challenges identified by the communities. Highlights of active study protocols follow.

Quality of Life and Aging with HIV in Rural Uganda (Aging)

The Quality of Life and Aging with HIV in Rural Uganda is a longitudinal study following a cohort of HIV-positive and HIV-negative Ugandans to determine the effects of HIV on aging in rural Uganda. Participants over the age of 48 will be enrolled from two sites in rural Uganda.

Objectives/aims

  1. Use qualitative methods to develop a conceptual framework explaining how HIV influences quality of life among older PLWH in Uganda
  2. Compare trajectories of social, cognitive, and physical functioning, and global quality of life by HIV serostatus in Uganda.
  3. Identify intervention targets, and assess the acceptability and feasibility of promising interventions, to improve functioning and quality of life among older PLWH in Uganda

Principal Investigators: Mark Siedner (MGH) and Stephen Asiimwe (MUST)

Epidemiology of Coronary Artery Disease among People with HIV in Rural sub-Saharan Africa (CAD)

This project intends to determine whether and how HIV infection pre-disposes individuals in rural Uganda to coronary artery disease. We plan to enroll 600 individuals during the study period in a prospective, observational study. Participants will be divided evenly by HIV serostatus, who will be similar in terms of age and sex distribution.  Study participants will undergo comprehensive cardiovascular and infectious disease risk factor assessments.

Objectives/aims

  1. Determine whether CAD is more prevalent and severe among PLWH than HIV-uninfected comparators in rural Uganda
  2. Determine the extent to which the association between HIV infection and CAD is modified by sex and region.
  3. Identify regional correlates of CAD, and develop a risk prediction score for the presence of CAD among PLWH in rural sub-Saharan Africa.
  4. Measure the prevalence of COPD, the co-prevalence of COPD and CAD, and the contribution of HIV to the prevalence of COPD in rural Uganda.
  5. To compare sputum biomarkers of inflammation, immune activation and endothelial function by HIV serostatus and air pollution exposure in rural Uganda.
  6. To determine the comparative prevalence, and correlates of fatty liver disease in people with and without HIV infection in rural Uganda.
  7. To determine the difference in vertebral bone mineral density (BMD), the correlates of decreased vertebral BMD, and the comparative prevalence of compression fractures in people with and without HIV in rural Uganda.

Principal Investigators: Mark Siedner (MGH) and Stephen Asiimwe & Samson Okello (MUST)

Population Effectiveness of Dolutegravir Implementation in Sub-Saharan Africa: A Prospective Observational Cohort Study (DISCO)

DISCO is a prospective observational cohort study at six government-supported HIV clinics in rural South Africa and Uganda. We enrolled 1000 adults (500 in each Country) living with HIV who were switched from first-line antiretroviral therapy (ART) containing non-nucleoside reverse transcriptase inhibitors (NNRTIs) to TLD (Phase 1) and 175 ART-naïve participants who were initiating ART with TLD (Phase 2). We are following participants for one year with study visits at enrollment, 24 weeks, and 48 weeks. Study procedures include interviews, anthropomorphic measurements, chart review, and collection of blood and urine specimens for retrospective testing, including viral load, drug resistance testing, antiretroviral drug level testing, and tests to evaluate the effects of TLD on renal, liver, metabolic, and other organ function.

The aims of the study are

  1. To determine the contribution of drug resistance prior to TLD initiation on the risk of treatment failure
  2. To explore the use of pharmacologic measures of adherence to distinguish virologic failure on TLD due to poor adherence versus due to drug

Principal Investigators: Suzanne McCluskey (MGH) and Winnie Muyindike (MUST)

Cesarean Delivery in Uganda: A Mixed Methods Study (Cradling)

Sub-Saharan Africa (SSA) bears the largest burden of maternal and perinatal mortality, accounting for over 66% of 295,000 maternal and ~6 million perinatal deaths annually.1,2 Access to a safe, and timely cesarean delivery (CD) is a critical component for reducing these mortality rates. Understanding variation in CD rates and associated maternal and perinatal outcomes can inform efforts to optimize the use of CD.

The study aims to;

  1. To use survey methods to explore practice patterns of clinicians around caesarean usage in Uganda
  2. To explore clinician decision-making around the mode of delivery at RRHs in Uganda
  3. To describe CS rates, factors associated with CS, and maternal and neonatal outcomes according to Robson group classification at Regional Referral Hospitals and large private non-profit hospitals in Uganda

Principal Investigators: Adeline Boatin (MGH) and Henry Mark Lugobe (MUST)

Inflammation, Social Networks, and Depression in Rural Uganda (HopeNet)

This study, formerly titled, “Health Outcomes, Progressive Entrepreneurship, and Networks” is a longitudinal, population-based study that aims to measure the health, economic, and social impacts of clean water and microenterprise interventions at the individual, household, and social network levels in Nyakabare Parish, Rwampara District, Uganda. It targets approximately 1,900 adults for each biennial survey since 2012. A sub-component of the HopeNet study titled “Social Networks, HIV Stigma, and the HIV Care Cascade in Rural Uganda” aims to measure (a) the causal effects of injunctive norms on negative attitudes toward people living with HIV (PLWH), (b) the causal effect of HIV stigma on outcomes relevant to HIV prevention for persons known to be HIV-negative or of unknown serostatus and (c) estimate the causal effect of HIV stigma on outcomes relevant to HIV treatment for PLHIV

The longitudinal survey conducted biennially measures key socio-economic variables over time including economic status, water and food security, self-reported physical and mental health, substance use, domestic violence, community norms, and social networks, and collects biomarkers through biennial health fairs to supplement self-report survey data.

Principal Investigators: Alexander Tsai (MGH) and Bernard Kakuhiki (MUST)

Self-Management Study

The study aims at developing a self-management intervention for ALHIV transitioning to adult HIV care and test the impact of the intervention on HIV outcomes. The study has three aims:

  1. To conduct qualitative research to elaborate a conceptual framework of the barriers faced by ALHIV transitioning to adult HIV care in Uganda
  2. Develop a self-management intervention that will enable ALHIV to successfully transition to adult HIV care
  3. Assess feasibility, acceptability, and preliminary effects of the self-management intervention on HIV outcomes for ALHIV transitioning to adult HIV care

Principal Investigators: Alexander Tsai (MGH) and Scholastic Ashaba (MUST)

Placentas, Antibodies, and Child Outcomes (PACO)

PACO is a prospective (birth) cohort study of 600 women and the babies born to them, followed from birth for 2 years (over 8 visits) to measure child growth, development, health outcomes, and antibody levels.

More than one million HIV-exposed, uninfected (HEU) children born annually in Africa have poorer early-life outcomes including increased mortality, higher risk of severe infections, growth stunting, and poorer neurodevelopmental outcomes. The reason for these poor outcomes is not well understood and could be related to maternal inflammation, decreased childhood immunity, trans-placental antibody transfer, or maternal antiretroviral therapy. The study aims to better understand the causes of poor HEU child health outcomes.

Study Objectives:

  1. Compare the prevalence of placental abnormalities by maternal HIV serostatus and PrEP use.
  2. Determine the correlates placental abnormalities among women with HIV, including maternal systemic factors(CD4 count, ART regimen, CMV viremia) and placental factors (detectable placental HIV and placental infections).
  3. Determine whether the placenta acts as a mediator of the association between maternal HIV infection and 1) infant hospitalization or death, or 2) quantity of transplacental antibody transfer among women with HIV.

Principal Investigators: Lisa Bebell (MGH) and Joseph Ngonzi (MUST)

TB Risk by Alcohol Consumption (TRAC)

Tuberculosis (TB) is the leading cause of death among persons living with HIV (PLWH). TB disease rates for PLWH engaging in heavy alcohol use are 2-3 times those of abstainers and TB treatment outcomes are poorer. TB preventive Therapy (TPT) reduces the risk of progression from latent TB infection (LTBI) to TB disease and has been scaled up for PLWH in many high HIV/TB incidence settings. There has been little research examining the impact of alcohol use on acquiring new TB infection separately from progressing to active TB disease which limits our ability to understand the role of alcohol use on the separate phases of TB to optimize intervention strategies most appropriate for each.

Main Objective: To examine the risk of acquiring TB infection and of incident TB disease among PLWH with heavy alcohol use after receipt of TB Preventive Therapy in Uganda.

Specific Objectives:

  1. To estimate the incidence rate of new active TB infection among PLWH with prior negative TST results by level of alcohol use.
  2. To determine the incidence of active TB disease among PLWH with prior latent TB who received TB preventive therapy, by the level of alcohol use.

Principal Investigators: Judith Hahn (UCSF) and Winnie Muyindike (MUST)

Exploring experiences of intersectional stigma among Men with HIV and their partners who have unmet reproductive goals (SHINE)

SHINE study is funded by the University of Alabama at Birmingham Centre for AIDS Research. This study aims to explore experiences of intersectional stigma among Men Living with HIV (MLWH) and their partners who have unmet reproductive goals knowing that MWLH with unmet reproductive goals experiences infertility stigma which when combined with other stigmas and socio-ecologic factors, may be an under-appreciated contributor to poor engagement in HIV care, HIV-viremia, STIs and thus contribute to HIV incidence.

Principal Investigators: Lynn Mathews (Albama) and Esther Atukunda (MUST)

Factors affecting the supply and use of COVID-19 vaccines in western Uganda

Inequitable global access to COVID-19 vaccines globally continues to be a public health crisis. In Uganda, only 34% of people are reported to have been fully vaccinated due to insufficient vaccine supply and multiple delivery challenges. Much as Uganda’s MoH provides some statistics on COVID-19 vaccine supply and distribution barriers, there is still less exploration of these key indicators at the local level, where vaccines are actually administered, justifying a need to improve understanding of vaccine availability and use at local level in Uganda to provide a clearer picture of the largest barriers to improving vaccination rates

Study aims

  1. To assess the availability of COVID-19 vaccines at four vaccination sites in western Uganda since March 2021
  2. To assess the use of COVID-19 vaccines received at four vaccination sites in western Uganda since March 2021
  3. To assess allotment challenges to COVID-19 vaccination at four vaccination sites in western Uganda since March 2021

Principal Investigators: Louise Ivers (MGH) and Stephen Asiimwe (MUST)

Improved Pediatric In-patient Morbidity and Mortality and Community-based Management of Malnutrition in Uganda (IZUMI FTF – Phase V)

The Pediatrics Ward of the Mbarara University Teaching Hospital (MUTH) currently admits approximately 5,000 children annually; newborns and premature babies account for about 45% of admissions, the majority being born within the hospital. While the ward officially has a 70-bed capacity, bed occupancy rates average 120%. Our children primarily suffer from infectious diseases and malnutrition. Although the hospital is supported by the Ugandan government, limited resources often result in shortages of critical medicines and basic supplies, and our families can rarely afford to pay for their care themselves. The IZUMI Foundation has supported the pediatric unit since 2010 to address the considerable morbidity and mortality faced.

Specific Objectives are:

  1. To purchase and distribute otherwise unavailable medications (e.g., antibiotics) and basic medical supplies (e.g., IV tubing and gloves)
  2. To regularly monitor the Pediatric Ward for morbidity and mortality levels and coordinate prioritization of care delivery and resource allocation.
  3. To provide nursing care for the most vulnerable admissions to the Paediatric Ward – particularly sick newborns, premature babies, and other critically ill children;
  4. To reduce childhood malnutrition in Isingiro District through enhanced community education, plus the development of alcohol-free men’s clubs as a way to improve household food security and prevent malnutrition;
  5. To continue to seek permanent solutions for supplying medications and basic medical supplies.

Principal Investigators: Jessica Haberer (MGH) and Elias Kumbakumba (MUST)

HIV in epidemiology Land

The objectives of this study are:

  1. To understand the perspectives of those working in public health research partnerships on research design, implementation, analysis, and findings-dissemination in the context of transnational collaborations
  2. To generate ideas of how research collaborations can be made more equitable
  3. To understand how social science feature in scientific public health research.

Principal Investigator: Joshua Parker (Harvard)

The International Epidemiological Databases to evaluate Aids in East Africa (IeDEA

The International Epidemiological Databases to evaluate Aids in East Africa (IeDEA) is network of international research consortium established in 2005 by the National Institute of Allergy and Infectious Diseases (NIAID) to provide a rich resource for globally diverse HIV/AIDS data. Sites in various regions throughout the world collaborate to collect and define key variables, and implement methodology to effectively analyze data as a cost-effective means of generating large data sets to address the high priority HIV/AIDS research questions that are unanswerable by a single cohort.

Principal Investigators: Kara Weisten (University of Indiana) and Winnie Muyindike (MUST)

Wireless Physiologic Monitoring in Postpartum Women (WIMS)

This study aims to;

  1. To Estimate the clinical effectiveness of wireless physiologic monitoring of women in the first 24 hours after Caesarean delivery at Mbarara Regional Referral Hospital (MRRH)
  2. To evaluate the clinical adoption of wireless physiologic monitoring at MRRH using an implementation science approach.
  3. To use qualitative methods to explore clinical adoption by doctors and acceptability of wireless physiologic monitoring among postpartum women at MRRH and understand facilitators and barriers to uptake of wireless physiologic monitoring.
  4. To estimate the cost of providing wireless physiologic monitoring of women in the first 24 hours after caesarean delivery at MRRH.

Principal Investigators: Lisa Bebell (MGH) and Joseph Ngonzi (MUST)

Optimizing Adherence through Implementation Science (OAsIS)

High and sustained adherence is critical for achieving the individual and public health benefits of HIV antiretroviral therapy (ART). Electronic adherence monitors provide a detailed understanding of adherence and enable real-time interventions. Research has shown the benefit of these monitors and low-cost models have recently become available; however, their use to date has largely been confined to the research context.

This study is an implementation science-driven assessment of strategies to improve the uptake of electronic adherence monitoring and associated interventions for routine, clinical delivery of ART in Uganda. The study consists of two aims. In Aim 1, we will conduct multi-level formative interviews to design a preliminary implementation strategy. In Aim 2, we will use an iterative approach to optimize the implementation strategy. All work will be guided by the Consolidated Framework for Research Implementation.

The electronic adherence monitors to be assessed in this study are pill bottles that record each opening as a proxy for pill-taking behavior. They provide day-to-day information about adherence that can be used to provide informed counseling at clinic visits, as well as SMS reminders and notifications for missed or late doses.

Study Aims;

  1. Define a preliminary implementation strategy for real-time electronic adherence monitoring plus associated interventions for routine HIV clinical care in Uganda.
  2. Deploy and optimize an implementation strategy for real-time electronic ART adherence monitoring plus associated interventions in routine HIV clinical care in Uganda.

Principal Investigators: Jessica Haberer (MGH) and Stephen Asiimwe (MUST)

Mobile technology to extend clinic-based counseling for HIV Positives in Uganda (Extend)

The main aims of this R01 are to adapt and test an effective alcohol intervention leveraging phone-based technology to reduce alcohol use and improve HIV outcomes in persons with HIV in Uganda. Alcohol reduction counseling is most effective when delivered over multiple sessions, thus we used cell phones to deliver multiple booster sessions to supplement in-person counseling. The project had a formative phase in the first two years, which involved qualitative research to adapt the existing intervention and to develop the cell phone-based components of the intervention. Following the formative work, we conducted a randomized controlled trial to compare the uptake, acceptability, efficacy, and cost in reducing unhealthy alcohol use and increasing viral suppression.

Summarily, this study will adopt a successful intervention and develop low-cost delivery methods that fit the needs of the target populations while keeping in mind its low-resource setting. The pilot RCT results will inform the design of a larger trial of a low-cost intervention to reduce alcohol use and increase viral suppression among those with HIV in SSA.

Specific Study Aims:

  1. To adapt an existing intervention and develop a tailored 2-way automated SMS/IVR-based system for tech booster sessions as part of an intervention to reduce unhealthy alcohol use among persons with HIV in rural Uganda.
  2. To estimate the uptake and acceptability, preliminary efficacy, and cost of methods of delivery of an intervention to reduce unhealthy drinking and HIV viral failure in a pilot randomized controlled trial (RCT) among persons in HIV care in rural Uganda (n=270)

Principal Investigators: Judith Hahn (UCSF) and Winnie Muyindike (MUST)

Transition Readiness Among Adolescents Living with HIV in Uganda (Transition Readiness)

Adolescents and young adults living with HIV (AYLHIV) should be transitioned from pediatric to adult HIV care for age and developmentally-appropriate care to maximize life-long term functioning. AYLHIV often fail to transition smoothly to adult care due to inadequate preparedness and this elevates their risks of disengagement from care and loss of follow-up, worsened immunological outcomes, and increased mortality. Assessment of transition readiness should be the first step, but HIV care centers in sub-Saharan Africa generally do not undertake these assessments due to a lack of validated scales for assessing transition readiness. This study is being conducted among AYLHIV aged 15-24 years, caregivers, and health care providers to develop and validate a transition readiness scale for use among perinatally-infected ALHIV in Uganda. The study’s main objectives are;

  1. To use qualitative methods to elaborate a conceptual model of transition readiness for perinatally-infected ALHIV in Mbarara, Uganda (n=50 in-depth interviews. 30 AYLHIV, 10 caregivers, and 10 health care providers)
  2. To develop and validate a transition readiness scale for perinatally-infected ALHIV in Mbarara, Uganda (n=300 structured interviews with perinatal infected ALHIV).

Principal Investigators: Alexander Tsai (MGH) and Scholastic Ashaba (MUST)

Alcohol Drinkers Exposure to prevent Therapy for Tuberculosis (ADEPTT)

The ADEPT study is a one arm trial of INH preventive therapy among HIV positive adults with latent TB at ISS Clinic (n=300).

Study aims

Aim 1: To examine the safety and tolerability of TB preventive therapy for HIV-infected drinkers (6 months of isoniazid -INH), measured by hepatotoxicity and treatment discontinuation rates overall and by level of drinking.

Aim 2: To compare the level of TB preventive therapy adherence by level of drinking.

Aim 3: To determine whether the benefits of providing TB preventive therapy to HIV-infected drinkers in resource-limited settings outweigh the risks compared to no treatment.

Principle Investigators: Judith Hahn (UCSF) and Winnie Muyindike (MUST)

Augmented Infant Resuscitator (AIR)

Preventing newborn mortality and brain damage due to asphyxia. AIR device is a low-cost add-on accessory to existing bag-mask valve (BVM) resuscitators that provide simple, actionable, real time feedback to users about effective ventilation by measuring three parameters; Respiratory rate – Air volume – Air pressure. AIR not only provides real-time resuscitation feedback but also stores this data and provides users with meaningful performance feedback through analytics that aid skills training in low-resource settings.

Cell-Phone Study

Dr. Siedner’s research focuses on barriers to optimal care and quality of life for HIV-infected persons in Uganda, and interventions to mitigate these barriers. Current projects include study of a mobile health application to improve linkage to HIV care, study of the epidemiology of cardiovascular disease among people living with HIV, and evaluation of the social and ethical considerations of HIV cure research. He also thoroughly enjoys mentoring Ugandan trainees on development, conduct, and analysis of their clinical research projects.

Principal Investigators: Mark Siedner and Annabella Habinka Ejiri

Ethics of Electronic Adherence Monitoring

EAM-Ethics focuses on understanding perspectives on ethical challenges surrounding electronic adherence monitoring (EAM) use (specifically, Wisepill). Several ethical challenges to EAM use have been hypothesized, but little is known about their relevance to individual users’ and researchers’ experiences of these devices. We are conducting qualitative interviews with UARTO participants who use Wisepill and who don’t use Wisepill, as well as interviews with UARTO RAs and local HIV physicians/ethics board members’/community leaders

Family Treatment Fund

The Family Treatment Fund (FTF) purpose is to save lives by providing HIV treatment to the neediest patients in Mbarara University HIV Clinic (ISS Clinic). Currently we provide opportunistic Infection Drugs to Patients at ISS Clinic in Mbarara Regional Referal Hospital.

Health Families

The primary objective is to support HIV affected men and women who desire to have children.  The program assists these couples in meeting their fertility goals through offering safer conception services to minimize the risk of HIV transmission to uninfected partners and baby while keeping persons living with HIV healthy. Safer conception services are offered as a component of the clinical services available at the ISS clinic. In addition, research is conducted to explore client and partner experiences of the safer conception intervention, and assessment will be done on how this intervention impacts providers and HIV care using mixed methods.

Principal Investigators: Lynn Mathews (Albama) and Esther Atukunda (MUST)

LabourBand

The LabourBand Study is an observational assessment of two wireless devices for maternal and fetal monitoring during the late stages of pregnancy. The first device, the Zephyr BioHarness3, monitors maternal heart rate, temperature, and respirations and triggers alerts when abnormal values are detected. The second device, Sense4Baby, monitors uterine contractions and fetal heart rate. The goals of this study are to assess the feasibility of using these devices on a labour and delivery ward in a rural, sub-Saharan African setting, as well as the acceptability of these devices to the pregnant women and the clinicians on the ward. The study involves documentation of technical function, comparison of wireless and traditional monitoring, and quantitative and qualitative assessments of the user experience

The Men’s Study

This is a mixed methods pilot study. The purpose of this study is to explore communication about reproduction between HIV-positive men reporting desire to have a child and their uninfected or unknown status partner. In phase 1, we will explore practices and motivations of HIV disclosure and discussion of family planning goals among men. We will also explore feasibility of safer conception intervention approaches. In phase 2, we will develop a quantitative survey designed to assess generalizability of the qualitative data. Harnessing motivations to have healthy children is a novel HIV prevention approach for serodiscordant partners. This project will inform future funding proposals to develop acceptable safer conception interventions in Uganda.

Measuring Early HIV Treatment Adherence (META)

The study main objective is to “Examine Early HIV Treatment Adherence in different populations”. Specifically, looking on how people with high CD4 count (>350) adhere compared to people who have low CD4 count (<200) and how pregnant women adhere compared to non- pregnant women. Participants are monitored for 12 months using an electronic monitoring wireless adherence device (wisepill). META has two sites in Uganda; Mbarara and Kabwohe.

Principal Investigators: Jessica Harberer (MGH) and Dr. Bosco Bwana Mwebesa (MUST)

OpenSMS

The OpenSMS is an implementation study with the goal of evaluating the implementation of a mHealth intervention to improve clinical care for People Living with HIV/AIDS in Uganda. The study recruits adult patients at the Immune Suppression Syndrome Clinic at the Mbarara Regional Referral Hospital who are initiating anti-retroviral therapy and are enrolling in the clinic text messaging reminder program. Participants are interviewed on their day of registration at the clinic, where data is collected on their cellular phone experience, illiteracy, social norms, HIV disclosure, stigma, social support, technology anxiety, and intentions to use the text messaging program. The overarching aims of the study are to 1) measure the effectiveness of the SMS application in a real-world setting and 2) validate a conceptual framework about the facilitators and barriers of mobile health technologies in Uganda, and enhance the use of such technologies to improve health of people with HIV in rural Uganda.

Principal Investigators: Mark Siedner and Annabella Habinka Ejiri

Post-Partum Depression

Untreated depression is associated with an increase in high-risk sexual behavior, poor ART adherence, and worse health outcomes for HIV-infected patients. For pregnant HIV-infected women, untreated depression may increase perinatal transmission through poor ART adherence. An important first step to this process is to understand the experiences of women with HIV who have had a recent pregnancy and/or live birth.

Resistance Testing Versus Adherence Support for Management of Patients with Virologic Failure on First-Line Antiretroviral Therapy (REVAMP)

REVAMP study is an open-label randomized controlled trial being conducted in Uganda and South Africa. It enrolls people living with HIV who have virologic failure on first line antiretroviral therapy and randomizes them to standard of care or immediate HIV resistance testing. The overarching goal of the study is to assess the efficacy, measured by viral resuppression, and cost-effectiveness of adding routine resistance testing to the management first-line treatment failure in sub-Saharan Africa.

Principal Investigators

Dr. Mark Siedner (MGH) and Dr. Bosco Bwana Mwebesa (MUST)

Self-Administered digital Health Screener (SASH)

The objective of this study is to develop and pilot a brief (3-5 minute) self-administered digital health screener (SASH) to increase the reporting of unhealthy alcohol consumption among those in HIV care in Uganda. The central hypothesis is that a SASH can increase reporting of unhealthy alcohol use. The rationale is that digital technologies such as Audio Computer-Assisted Self Interviewing (ACASI) have increased the rate of reporting of sensitive behaviors in several settings. Developed countries increasingly use tablets for the self-completion of clinic entry forms, and a few clinics have examined the use of digital screening for risk behaviors with promising results(?). The rise of mobile device use worldwide makes digital screening technology feasible in resource poor settings, and the simplicity of touch-screen computers (tablets or smartphones) allow for use by low-literacy populations. Thus, SASH may provide an acceptable conduit to ABI, delivered in-person or electronically.

Specific Aims:

Aim 1. To develop a brief touch-screen tablet based SASH, to be administered in an HIV clinic waiting room, to increase reporting of unhealthy alcohol use for persons with HIV in Uganda.

  1. We will conduct focus group discussions (FGDs) with clinic staff and clinicians, and patients who have previously under-reported their drinking and patients with low/no literacy (4 FGDs, 4-6 persons each). These groups will provide input into the format and content of the SASH as well as facilitators and barriers to eventual implementation.
  2. We will undergo an iterative process to develop the SASH, demonstrating and testing the SASH prototype and modifying after each round according to feedback. This will be conducted iteratively with 4-6 patients and clinic staff who emerge from the FGDs as opinion leaders.

Aim 2. To pilot the SASH developed in Aim 1 to examine acceptability, ease of use, comfort with reporting, and to discuss how the results of such screening might be used.

  1. We will pilot the SASH with 10 clinic patients who have previously under-reported their drinking, and 10 patients with low/no literacy. After piloting the SASH we will conduct qualitative interviews with these patients to examine their experience using the SASH and discuss the above issues.

Principal Investigators: Judy Hahn (UCSF) and   Dr. Winnie Muyindike (MUST)

Screening and brief intervention for unhealthy alcohol consumption among HIV-infected adults in Uganda: A qualitative study (SBI)

Specific aims

  • Assess patients’ and providers’ attitudes towards the implementation of a protocol screening and brief intervention (SBI) for unhealthy alcohol use among HIV-infected adults in Uganda
  • Assess patients’, providers’, and community’s, attitudes towards alcohol consumption among HIV-infected adults, and assess current alcohol-related communication practices among health workers and their HIV-infected patients in Uganda.

Principal Investigators: Stephen Asiimwe (MUST), Sarah Woolf-King, Judith Hahn

Surgical Services QUality Assurance Database (SQUAD)

SQUAD is the Surgical Services Quality Assurances Database. The project has created and maintains a quality assurance database in Mbarara Regional Referral Hospital, tracking the burden of surgical disease, interventions and outcomes.

Principal Investigators: Paul Firth (MGH) and Steven Ttendo (MUST)

Uganda Aids Rural Treatment Outcomes (UARTO)

UARTO is an observational longitudinal study of HIV-infected adults initiating antiretroviral therapy in southwestern Uganda. The study began in 2005 and has enrolled 750 participants. Sociodemographic, behavioral, and reproductive health data are assessed by questionnaire every four months. Biologic specimens are also collected to determine HIV RNA levels, drug resistance, alcohol consumption, pregnancy, and other tests related to immunology, microbiology, and virology. Adherence is monitored with the Wisepill pill container, which cellularly transmits a date-and-time stamp every time it is opened. Interruptions are investigated in real-time to determine the cause and if loss of viral suppression has occurred.

Principal Investigators: Jessica Harberer (MGH) and Dr. Bosco Bwana Mwebesa (MUST)

Uganda Non-Communicable Diseases and Aging Cohort Study (UGANDAC)

UGANDAC is an ongoing, longitudinal cohort study with an overarching goal of elucidating the impact of HIV infection on health among older-aged people in rural Uganda. The study recruits and follows two groups of participants: 1) people living with HIV who are over 45 years old and on stable HIV therapy and in care at Mbarara Regional Referral Hospital ISS clinic; and 2) age and gender-matched individuals without HIV infection who live in the Mbarara region. Study participants are seen once per year to collect data on socio-demographics, diet, exercise, tobacco use, and undergo clinical testing for cardiovascular, pulmonary, metabolic and geriatric health conditions.

Principal Investigators Mark Siedner (MGH) and Samson Okello (MUST)

Uganda Peripartum Infection and Mortality (UPIM)

UPIM was a research study conducted for 7 months in 2015 by Principal Investigators Dr. Joseph Ngonzi (MUST OB/GYN) and Dr. Lisa Bebell (MGH Infectious Diseases). The research team consisted of 10 research assistants and nurses who enrolled 4,231 participants to study the incidence, microbiology, and risk factors for postpartum pregnancy-related infection on the Mbarara Regional Referral Hospital maternity ward. The project completed follow-up in December, 2016. To date, the UPIM work has been presented orally at the American Society of Tropical Medicine and Hygiene (ASTMH) conference, by posted at the Conference on Retroviruses and Opportunistic Infections (CROI). There is one published manuscript detailing the findings by Bebell et al. in PLOS ONE, and a second manuscript by Ngonzi et al. currently under review.

Wise-Pill Intervention

This study is a pilot three-arm randomized controlled trial designed to develop an adherence intervention based on real-time monitoring with the Wisepill pill container, which cellularly transmits a date-and-time stamp every time it is opened. A total of 60 HIV-individuals initiating antiretroviral therapy in southwestern Uganda are being followed for nine months each. In Arm A, participants initially receive short message service (SMS) reminders on a fixed schedule: daily for one month, then weekly for two months. In the remaining six months, they receive an SMS reminder each time they do not open their Wisepill device during a prescribed dosing window. If they do not open the Wisepill device for 48+ hours, SMS notifications are also sent to social supporters. In Arm B, SMS reminders are sent based on Wisepill dosing for the first three months and the SMS notifications to social supporters are added in the remaining six months. In Arm C, no SMS reminders or notifications are sent. Questionnaire data are collected on socio-demographics, including measures of social support and stigma. HIV RNA levels are determined at three and nine months. The primary outcomes compared among the arms will be adherence levels and patterns, as well as virologic suppression. Additionally, qualitative interviews are conducted to understand the mechanisms by which SMS may support adherence.

First Mile Program

The First Mile is supported by Hansjoerg Wyss through a gift to Massachusetts General Hospital and was Launched in May 2018. The First Mile: Powering the Academic Medical Center to Deliver Healthcare in the Community in Uganda is a program partnership between Massachusetts General Hospital (MGH), Mbarara University of Science and Technology (MUST) and Mbarara Regional Referral Hospital (MRRH). The program focuses on improving patient care through nursing and community care initiatives. The First Mile program seeks to achieve the following four interrelated aims: i) Empower nursing leadership to develop and implement innovative models of care, ii) Establish MUST as a premier academic medical center focused on community-based healthcare delivery, research and innovation, iii) Equip the Mbarara Regional Referral Hospital and affiliated community health facilities to better understand and meet the burden of disease, and iv) Leverage technology innovation through co-creation to support patients, community health workers, and frontline nurses.

INNOVATION

CAMTech (https://camtechuganda.must.ac.ug/)

Resource constraints in Uganda require creative and tailored innovations that address health challenges facing patients and providers. The Consortium for Affordable Medical Technologies (CAMTech) provides the necessary infrastructure, expertise, methods and resources to develop bold solutions and strengthen the region as an innovation hub. CAMTech’s model promotes collaboration amongst academic, clinical, corporate and implementation partners to accelerate high-quality, affordable medical technology development suited to the working environment.

EDUCATION

We aim to strengthen nursing and medical education at MUST’s Master of Nursing (MNS) and Master of Medicine (MMED) programs, respectively. Our bi-directional learning approach includes fellowships to address specialty care, nurse leadership training, faculty support, mentoring, etc.

We also provide scholarships for MMED and MNS students to increase the number of physician and nurse educators and practitioners. This is an essential step towards expanding human resource capacity, and ultimately improving access to high quality health services in rural Uganda.

CLINICAL CARE

We aim to equip the Mbarara Regional Referral Hospital (MRRH) and affiliated community health facilities to better understand and meet the burden of disease. Specialized clinical collaborations to improve patient care in key hospital departments include:

Oncology:
Collaborating with the public sector to offer state-of-the-art comprehensive cancer care to the local community in southwestern Uganda. Includes support for short-term hiring and training of essential staff and maintain the MUST Cancer Unit to improve cancer care for both adults and children, and to raise awareness, early diagnosis and early treatment of pediatric cancer.

Pediatrics:
Supported construction, equipping and staffing of dedicated pediatric oncology ward. Also, provide food support to patients and caregivers to improve care and inpatient retention.

Pathology:
Bolstering critical diagnostic services through enhanced education, training, research, and clinical care. Provide essential equipment and supplies that lead to improved cancer detection and targeted care.

COVID-19 / Special Pathogens Unit:
Supported construction of COVID treatment / special pathogens unit with 40-bed capacity. Equipped and installed oxygen plant. Supplement staffing during crisis.

Obstetrics and Gynecology | Emergency Medicine | Intensive Care Unit:
Supporting advanced level nursing care for high-risk patients.

Biomedical Engineering:
Ensuring critical services are available by supporting equipment maintenance and repair. Includes specialized training for technicians as well as procurement of tools and test equipment, basic spare parts, and critical supplies.

Community Health:
Providing practical and educational opportunities for students and doctors in the form of community placements. Includes grants, research grants, post-graduate rotations, faculty mentorships, and continuing medical education.

PUBLICATIONS

Reynolds, Z., Gilbert, R., Sentongo, R., Meyer, A.C., Saylor, D., Okello, S., Nakasujja, N., Greene, M., Seeley, J., Tsai, A.C. and Asiimwe, S., 2022. Priorities for health and wellbeing for older people with and without HIV in Uganda: a qualitative methods study. Journal of the International AIDS Society, 25, p.e26000.

Ashaba S, Kakuhikire B, Baguma C, Satinsky EN, Perkins JM, Rasmussen JD, Cooper-Vince CE, Ahereza P, Gumisiriza P, Kananura J, Bangsberg DR, Tsai AC. Adverse childhood experiences, alcohol consumption, and the modifying role of social participation: population-based study of adults in southwestern Uganda. Soc Sci Med Ment Health. 2022 Dec; 2:100062.

Perkins JM, Kakuhikire B, Baguma C, Meadows M, Evans CQ, Rasmussen JD, Satinsky EN, Ayebare P, Kyokunda V, Juliet M, Bangsberg DR, Tsai AC. Accuracy and correlates of perceived norms about khat/cannabis use among adults in southwest Uganda. Int J Drug Policy. 2022 Mar; 101:103527.

Jurinsky J, Perkins JM, Kakuhikire B, Nyakato V, Baguma C, Ahereza P, Kananura J, Rasmussen JD, Satinsky EN, Audet CM, Bangsberg DR, Tsai AC. Ease of marital communication and depressive symptom severity among men and women in rural Uganda: cross-sectional, whole-population study. Soc Psychiatry Psychiatr Epidemiol. 2021 Aug;10.1007/s00127-021-02135-4.

Perkins JM, Kakuhikire B, Baguma C, Rasmussen JD, Satinsky EN, Kiconco A, Kananura J, Audet CM, Siedner MJ, Haberer JE, Bangsberg DR, Tsai AC. Perceived ART adherence norms and personal adherence behavior among adults living with HIV in rural Uganda. AIDS Behav. 2022 Jan:1-13.

Castillo‐Mancilla, J.R., Musinguzi, N., Asiimwe, S., Siedner, M.J., Orrell, C., Bangsberg, D.R. and Haberer, J.E., 2022. High residual inflammation despite HIV viral suppression: Lessons learned from real‐time adherence monitoring among people with HIV in Africa. HIV medicine, 23(5), pp.465-473.

Quach, L.T., Ritchie, C.S., Tsai, A.C., Reynolds, Z., Paul, R., Seeley, J., Tong, Y., Hoeppner, S., Okello, S., Nakasujja, N. and Olivieri-Mui, B., 2022. The benefits of care: treated HIV infection and health-related quality of life among older-aged people in Uganda. Aging & Mental Health, pp.1-7.

Tyagi, A., Tong, Y., Rabideau, D.J., Reynolds, Z., De Oliveira, T., Lessells, R., Amanyire, G., Orrell, C., Asiimwe, S., Chimukangara, B. and Giandhari, J., 2022. Antiretroviral therapy adherence patterns, virological suppression, and emergence of drug resistance: A nested case–control study from Uganda and South Africa. Antiviral Therapy, 27(5), p.13596535221114822.

Mutekanga, A., Nuwagira, E., Kumbakumba, E., Nyaiteera, V., Asiimwe, S., Gasumuni, M., Wandera, N., Natumanya, R., Akena, D., Senoga, S. and Kyobe Kiwanuka, J., 2022. Factors Associated with 30-Day in-Hospital Mortality Among Patients Admitted with Severe Covid-19 in Mbarara Regional Referral Hospital. Infection and Drug Resistance, pp.7157-7164.

Haberer, J.E., Baijuka, R., Tumuhairwe, J.B., Tindimwebwa, E.B., Tinkamanyire, J., Tuhanamagyezi, E., Musoke, L., Garrison, L.E., DelSignore, M., Musinguzi, N. and Asiimwe, S., 2022. Implementation of Electronic Adherence Monitors and Associated Interventions for Routine HIV Antiretroviral Therapy in Uganda: Promising Findings. Frontiers in Digital Health, 4.

Olamijuwon, E., Konje, E., Kansiime, C., Kesby, M., Keenan, K., Neema, S., Asiimwe, B., Mshana, S.E., Mushi, M.F., Loza, O. and Sunday, B., 2022. Antibiotic dispensing practices during COVID-19 and implications for Antimicrobial Resistance (AMR): Parallel mystery client studies in Uganda and Tanzania.

Atukunda, E.C., Matthews, L.T., Musiimenta, A., Agaba, A., Najjuma, J.N., Lukyamuzi, E.J., Kaida, A., Obua, C. and Mugyenyi, G.R., 2022. Understanding the effect of a healthcare provider-led family planning support intervention on contraception use and pregnancy desires among postpartum women living with HIV in Southwestern Uganda. AIDS and Behavior, 26(1), pp.266-276.

Atukunda, E.C., Owembabazi, M., Pratt, M.C., Psaros, C., Muyindike, W., Chitneni, P., Bwana, M.B., Bangsberg, D., Haberer, J.E., Marrazzo, J. and Matthews, L.T., 2022. A qualitative exploration to understand barriers and facilitators to daily oral PrEP uptake and sustained adherence among HIV‐negative women planning for or with pregnancy in rural Southwestern Uganda. Journal of the International AIDS Society, 25(3), p.e25894.

Musiimenta, A., Tumuhimbise, W., Atukunda, E.C., Ayebaza, S., Kobutungi, P., Mugaba, A.T., Asasira, J., Mugyenyi, G.R., Katusiime, J., Zender, R. and Pinkwart, N., 2022. Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies. Digital Health, 8, p.20552076221086769.

Kushemererwa, J., Muwanguzi, M., Atukunda, E.C., Kikomeko, H.N., Ambrose, O., Androdri, D., Kembabazi, B. and Najjuma, J.N., 2022. Barriers and facilitators of male engagement in Community Client-Led Antiretroviral therapy Delivery groups (CCLADS) for HIV care and treatment in Southwestern Uganda: a qualitative study. BMC Health Services Research, 22(1), pp.1-9.

Stanton, A.M., Bwana, M., Owembabazi, M., Atukunda, E., Musinguzi, E., Ezegbe, H., Smith, P., Psaros, C., Matthews, L.T. and Kaida, A., 2022. Sexual and relationship benefits of a safer conception intervention among men with HIV who seek to have children with serodifferent partners in Uganda. AIDS and Behavior, 26(6), pp.1841-1852.

Nakandi, R.M., Kiconco, P., Musiimenta, A., Bwengye, J.J., Nalugya, S., Kyomugisa, R., Obua, C. and Atukunda, E.C., 2022. Understanding patterns of family support and its role on viral load suppression among youth living with HIV aged 15 to 24 years in southwestern Uganda. Health Science Reports, 5(1), p.e467.

Matthews, L.T., Atukunda, E.C., Owembabazi, M., Kalyebera, K.P., Psaros, C., Chitneni, P., Hendrix, C.W., Marzinke, M.A., Anderson, P.L., Isehunwa, O.O. and Wirth, K.E., 2022. High PrEP uptake and objective longitudinal adherence among HIV-exposed women with personal or partner plans for pregnancy in rural Uganda. medRxiv.

Pratt, M.C., Owembabazi, M., Muyindike, W., Kaida, A., Marrazzo, J.M., Bangsberg, D.R., Bwana, M.B., Psaros, C., Turan, J., Atukunda, E.C. and Matthews, L.T., 2022. I still desire to have a child.

Muyindike, W.R., Fatch, R., Cheng, D.M., Emenyonu, N.I., Forman, L., Ngabirano, C., Adong, J., Linas, B., Jacobson, K.R. and Hahn, J.A., 2022. Unhealthy Alcohol Use Is Associated With Suboptimal Adherence to Isoniazid Preventive Therapy in Persons With HIV in Southwestern Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes, 91(5), pp.460-468.

Young, C.R., Gill, E., Bwana, M., Muyindike, W., Hock, R.S., Pratt, M.C., Owembabazi, M., Tukwasibwe, D., Najjuma, A., Kalyebara, P. and Natukunda, S., 2022. Client and provider experiences in Uganda suggest demand for and highlight the importance of addressing HIV stigma and gender norms within safer conception care. AIDS and Behavior, 26(1), pp.76-87.

Ponticiello, M., Mwanga-Amumpaire, J., Tushemereirwe, P., Nuwagaba, G., Nansera, D., King, R., Muyindike, W. and Sundararajan, R., 2022. How informal healthcare providers improve uptake of HIV testing: qualitative results from a randomized controlled trial. AIDS, 36(8), pp.1161-1169.

Reynolds, Z., McCluskey, S.M., Moosa, M.Y.S., Gilbert, R.F., Pillay, S., Aturinda, I., Ard, K.L., Muyindike, W., Musinguzi, N., Masette, G. and Moodley, P., 2022. Who’s slipping through the cracks? A comprehensive individual, clinical and health system characterization of people with virological failure on first‐line HIV treatment in Uganda and South Africa. HIV medicine, 23(5), pp.474-484.

Miller, A.P., Fatch, R., Lodi, S., Marson, K., Emenyonu, N., Kekibiina, A., Beesiga, B., Chamie, G., Muyindike, W.R. and Hahn, J.A., 2022. Unhealthy alcohol use and intimate partner violence among men and women living with HIV in Uganda. BMC public health, 22(1), pp.1-12.

Ngabirano, C., Fatch, R., Muyindike, W.R., Emenyonu, N.I., Adong, J., Weiser, S.D., Samet, J.H., Cheng, D.M. and Hahn, J.A., 2022. Exploring the Association Between Social Support and Hazardous Alcohol Use Among Persons Living with HIV in South Western Uganda. AIDS and Behavior, pp.1-10.

Asiimwe, C., Fatch, R., Cheng, D.M., Emenyonu, N.I., Ngabirano, C., Muyindike, W.R. and Hahn, J.A., 2022. Bar Attendance and Alcohol Use Before and After COVID-19 Related Restrictions Among HIV-infected Adults in South-Western Uganda. AIDS and Behavior, pp.1-10.

Mutumba, M., Woolf-King, S., Carrico, A.W., Emenyonu, N.I., Fatch, R., Kekibiina, A., Muyindike, W. and Hahn, J.A., 2022. Correlates and Effects of Alcohol Use Expectancies Among Persons Living with HIV in Uganda. AIDS and Behavior, 26(4), pp.1110-1125.

Kim, T.W., Heeren, T.C., Samet, J.H., Bertholet, N., Lloyd‐Travaglini, C., Winter, M.R., Magane, K.M., Gnatienko, N., Bryant, K., Rateau, L.J. and Muyindike, W.R., 2022. Alcohol and falls among people with HIV infection: A view from Russia and the United States. Alcoholism: clinical and experimental research, 46(9), pp.1742-1752.

Romo, M.L., Brazier, E., Mahambou‐Nsondé, D., De Waal, R., Sekaggya‐Wiltshire, C., Chimbetete, C., Muyindike, W.R., Murenzi, G., Kunzekwenyika, C., Tiendrebeogo, T. and Muhairwe, J.A., 2022. Real‐world use and outcomes of dolutegravir‐containing antiretroviral therapy in HIV and tuberculosis co‐infection: a site survey and cohort study in sub‐Saharan Africa. Journal of the International AIDS Society, 25(7), p.e25961.

Emenyonu, N., Kekibiina, A., Woolf-King, S., Kyampire, C., Fatch, R., Dawson-Rose, C., Muyindike, W. and Hahn, J., 2022. Digital Health Screening in People With HIV in Uganda to Increase Alcohol Use Reporting: Qualitative Study on the Development and Testing of the Self-administered Digital Screener for Health. JMIR formative research, 6(9), p.e35015.

Rücker, S.C.M., Lissouba, P., Akinyi, M., Lubega, A.V., Stewart, R., Antabak, N.T., Mugisha, I.T., Ohler, L., Macuácua, H., Atieno, M. and Muyindike, W., 2022. Feasibility and acceptability of using the novel urine-based FujiLAM test to detect tuberculosis: A multi-country mixed-methods study. Journal of clinical tuberculosis and other mycobacterial diseases, 27, p.100316.

Chitneni, P., Muyindike, W., Bwana, M.B., Owembabazi, M., O’Neil, K., Kalyebara, P.K., Hedt-Gauthier, B., Bangsberg, D.R., Marrazzo, J.M., Kaida, A. and Haberer, J.E., 2022. STI prevalence, incidence, and partner notification among women in a periconception HIV prevention program in Uganda. International journal of STD & AIDS, 33(9), pp.856-863.

Adong, J., Fatch, R., Emenyonu, N., Muyindike, W., Ngabirano, C., Cheng, D. and Hahn, J., 2022. Cell Phone Availability and Usage for mHealth and Intervention Delivery to Persons Living With HIV in a Low-Resource Setting: Cross-sectional Study. JMIR formative research, 6(8), p.e35631.

Fatch, R., Luginbühl, M., Cheng, D.M., Gaugler, S., Emenyonu, N.I., Ngabirano, C., Adong, J., Muyindike, W.R., Samet, J.H., Bryant, K. and Hahn, J.A., 2022. Comparison of automated determination of phosphatidylethanol (PEth) in dried blood spots (DBS) with previous manual processing and testing. Alcohol, 98, pp.51-54.

Namulindwa, A., Wasswa, J.H., Muyindike, W., Tamukong, R. and Oloro, J., 2022. Prevalence and factors associated with adverse drug events among patients on dolutegravir-based regimen at the Immune Suppression Syndrome Clinic of Mbarara Regional Referral Hospital, Uganda: a mixed design study. AIDS Research and Therapy, 19(1), pp.1-8.

Ng’umbi, J.P., Nuwagira, E., Kanyesigye, M., Muyindike, W. and Muhindo, R., 2022. Renal Tubular Dysfunction Among People Living with HIV on Tenofovir Disoproxil Fumarate in Uganda: A Hospital-Based Cross-Sectional Study.

Ainamani HE, Bamwerinde WM, Rukundo GZ, Tumwesigire S, Kalibwani RM,Bikaitwaho EM, Tsai AC. Participation in gardening activity and its associationwith improved mental health among family caregivers of people with dementia inrural Uganda. Prev Med Rep. 2021 May 30;23:101412. doi:10.1016/j.pmedr.2021.101412. PMID: 34159048; PMCID: PMC8193614.

Arinaitwe I, Amutuhaire H, Atwongyeire D, Tusingwire E, Kawungezi PC,Rukundo GZ, Ashaba S. Social Support, Food In- security, and HIV Stigma Among MenLiving with HIV in Rural Southwestern Uganda: A Cross-Sectional Analysis. HIVAIDS (Auckl). 2021 Jun 16;13:657-666. doi: 10.2147/HIV.S316174. PMID: 34163254;PMCID: PMC8216066.

Atukunda EC, Matthews LT, Musiimenta A, Agaba A, Najjuma JN, Lukyamuzi EJ,Kaida A, Obua C, Mugyenyi GR. Un- derstanding the Effect of a Healthcare Provider-Led Family Planning Support Intervention on Contraception use and PregnancyDesires among Postpartum Women Living with HIV in Southwestern Uganda. AIDSBehav. 2021 Jul 22. doi: 10.1007/s10461-021-03380-z. Epub ahead of print. PMID:34292430

Atukunda EC, Mugyenyi GR, Musiimenta A, Kaida A, Atuhumuza EB, LukyamuziEJ, Agaba AG, Obua C, Matthews LT. Structured and sustained family planningsupport facilitates effective use of postpartum contraception amongst wom- enliving with HIV in South Western Uganda: A randomized controlled trial. J GlobHealth. 2021 Jun 5;11:04034. doi: 10.7189/jogh.11.04034. PMID: 34131487; PMCID:PMC8183159.

Atwiine B, Busingye I, Kyarisiima R, Baluku E, Mbabazi R, Bamwine B,Ankunda S, Libes J, Weinstein H, Schwartz K, Kiwa- nuka G. “Money was theproblem”: Caregivers’ self-reported reasons for abandoning their children’scancer treatment in southwest Uganda. Pediatr Blood Cancer. 2021Nov;68(11):e29311. doi: 10.1002/pbc.29311. Epub 2021 Aug 29. PMID: 34459106.

Bebell LM, Kembabazi A, Musinguzi N, Martin JN, Hunt PW, Boum II Y, O’Laughlin K, Muzoora C, Haberer JE, Bwana MB, Bangsberg DR. Internalized stigma, depressive symptoms, and the modifying role of antiretroviral therapy: A cohort study in rural Uganda. SSM-Mental Health. 2021 Oct 20:100034.

Bebell LM, Parks K, Le MH, Ngonzi J, Adong J, Boatin AA, Bassett IV,Siedner MJ, Gernand AD, Roberts DJ. Placental de- cidual arteriopathy and vascularendothelial growth factor A (VEGF-A) expression among women with and withoutHIV. J Infect Dis. 2021 Apr 21:jiab201. doi: 10.1093/infdis/jiab201. Epub aheadof print. PMID: 33880547.

Boatin AA, Ngonzi J, Ganyaglo G, Mbaye M, Wylie BJ, Diouf K. Cesareandelivery in low- and middle-income countries: A review of quality of caremetrics and targets for improvement. Semin Fetal Neonatal Med. 2021Feb;26(1):101199. doi: 10.1016/j.siny.2021.101199. Epub 2021 Jan 27. PMID:33546999; PMCID: PMC8026747.

Boatin AA, Ngonzi J, Wylie BJ, Lugobe HM, Bebell LM, Mugyenyi G, Mohamed S,Martinez K, Musinguzi N, Psaros C, Met- lay JP, Haberer JE. Wireless versusroutine physiologic monitoring after cesarean delivery to reduce maternalmorbidity and mortality in a resource-limited setting: protocol of type 2 hybrideffectiveness-implementation study. BMC Preg- nancy Childbirth. 2021 Feb12;21(1):124. doi: 10.1186/s12884-021-03550-w. PMID: 33579213; PMCID:PMC7880025.

Boyce RM, Hollingsworth BD, Baguma E, Xu E, Goel V, Brown-Marusiak A,Muhindo R, Reyes R, Ntaro M, Siedner MJ, Staedke SG, Juliano JJ, Mulogo EM.Dihydroartemisinin-piperaquine chemoprevention and malaria incidence afterse- vere flooding: evaluation of a pragmatic intervention in rural Uganda. ClinInfect Dis. 2021 Sep 9:ciab781. doi: 10.1093/cid/ciab781. Epub ahead of print.PMID: 34499116.

Broderick K, Ponticiello M, Nabukalu D, Tushemereirwe P, Nuwagaba G, King R,Mwanga-Amumpaire J, Sundararajan R. Shortening “the Road” to Improve Engagementwith HIV Testing Resources: A Qualitative Study Among Stakeholders in RuralUganda. AIDS Patient Care STDS. 2021 Feb;35(2):56-62. doi:10.1089/apc.2020.0235. Epub 2021 Jan 20. PMID: 33471578; PMCID: PMC7885900.

Byakwaga H, Barbachano-Guerrero A, Wang D, McAllister S, Naphri K, Laker-Oketta M, Muzoora C, Hunt PW, Martin J, King CA. Association BetweenImmunoglobulin E Levels and Kaposi Sarcoma in African Adults With HumanImmunode- ficiency Virus Infection. J Infect Dis. 2021 Jan 4;223(1):101-108. doi:10.1093/infdis/jiaa340. PMID: 32561934; PMCID: PMC7781465.

Castillo-Mancilla JR, Musinguzi N, Asiimwe S, Siedner MJ, Orrell C,Bangsberg DR, Haberer JE. High residual inflamma- tion despite HIV viralsuppression: Lessons learned from real-time adherence monitoring among peoplewith HIV in Africa. HIV Med. 2021 Oct 26. doi: 10.1111/hiv.13200. Epub ahead ofprint. PMID: 34704355.

Chitneni P, Bwana MB, Muyindike W, Owembabazi M, Kalyebara PK, Byamukama A,Mbalibulha Y, Smith PM, Hsu KK, Haberer JE, Kaida A, Matthews LT. STI prevalenceamong men living with HIV engaged in safer conception care in rural,- southwestern Uganda. PLoS One. 2021 Mar 3;16(3):e0246629. doi:10.1371/journal.pone.0246629. PMID: 33657120; PMCID: PMC7928454.

Fatch R, Luginbühl M, Cheng DM, Gaugler S, Emenyonu NI, Ngabirano C, AdongJ, Muyindike WR, Samet JH, Bryant K, Hahn JA. Comparison of automateddetermination of phosphatidylethanol (PEth) in dried blood spots (DBS) withprevi- ous manual processing and testing. Alcohol. 2021 Nov9:S0741-8329(21)00136-1. doi: 10.1016/j.alcohol.2021.11.001. Epub ahead ofprint. PMID: 34767948.

Firth PG, Mushagara R, Musinguzi N, Liu C, Boatin AA, Mugabi W, Kayaga D,Naturinda P, Twesigye D, Sanyu F, Mugyenyi G, Ngonzi J, Ttendo SS; Mbarara SQUADConsortium. Surgical, Obstetric, and Anesthetic Mortality Measurement at aUgan- dan Secondary Referral Hospital. Anesth Analg. 2021 Dec 1;133(6):1608-1616.doi: 10.1213/ANE.0000000000005734. PMID: 34415855.

Freeman EE, Semeere A, McMahon DE, Byakwaga H, Laker-Oketta M, Regan S,Wenger M, Kasozi C, Ssemakadde M, Bwana M, Kanyesigye M, Kadama-Makanga P,Rotich E, Kisuya J, Wools-Kaloustian K, Bassett IV, Busakhala N, Martin J.Beyond T Staging in the “Treat-All” Era: Severity and Heterogeneity of KaposiSarcoma in East Africa. J Acquir Im- mune Defic Syndr. 2021 Aug15;87(5):1119-1127. doi: 10.1097/QAI.0000000000002699. PMID: 33871409; PMCID:P- MC8263487.

Freiman JM, Fatch R, Cheng D, Emenyonu N, Ngabirano C, Geadas C, Adong J,Muyindike WR, Linas BP, Jacobson KR, Hahn JA. Prevalence of elevated livertransaminases and their relationship with alcohol use in people living with HIVon anti-retroviral therapy in Uganda. PLoS One. 2021 Jun 1;16(6):e0250368. doi:10.1371/journal.pone.0250368. PMID: 34061870; PMCID: PMC8168875.

Gilbert HN, Wyatt MA, Pisarski EE, Asiimwe S, van Rooyen H, Seeley J,Shahmanesh M, Turyamureeba B, van Heerden A, Adeagbo O, Celum CL, Barnabas RV,Ware NC; Delivery Optimization of Antiretroviral Therapy (DO ART) Study Team. How community ART delivery may improve HIV treatment outcomes: Qualitativeinquiry into mechanisms of effect in a randomized trial of community-based ARTinitiation, monitoring and re-supply (DO ART) in South Africa and Uganda. J IntAIDS Soc. 2021 Oct;24(10):e25821. doi: 10.1002/jia2.25821. PMID: 34624173;PMCID: PMC8500674.

Hahn JA, Murnane PM, Vittinghoff E, Muyindike WR, Emenyonu NI, Fatch R,Chamie G, Haberer JE, Francis JM, Kapiga S, Jacobson K, Myers B, Couture MC,DiClemente RJ, Brown JL, So-Armah K, Sulkowski M, Marcus GM, Woolf-King S, CookRL, Richards VL, Molina P, Ferguson T, Welsh D, Piano MR, Phillips SA, StewartS, Afshar M, Page K, McGinnis K, Fiellin DA, Justice AC, Bryant K, Saitz R.Factors associated with phosphatidylethanol (PEth) sensitivity for detectingun- healthy alcohol use: An individual patient data meta-analysis. Alcohol ClinExp Res. 2021 Jun;45(6):1166-1187. doi: 10.1111/acer.14611. Epub 2021 May 7.PMID: 33837975; PMCID: PMC8254773.

Herbst AG, Olds P, Nuwagaba G, Okello S, Haberer J. Patient experiences andperspectives on hypertension at a major re- ferral hospital in rural southwesternUganda: a qualitative analysis. BMJ Open. 2021 Jan 6;11(1):e040650. doi:10.1136/ bmjopen-2020-040650. PMID: 33408202; PMCID: PMC7789452.

Jurinsky J, Perkins JM, Kakuhikire B, Nyakato VN, Baguma C, Rasmussen JD,Satinsky EN, Ahereza P, Kananura J, Audet CM, Bangsberg DR, Tsai AC. Ease ofmarital communication and depressive symptom severity among men and women inrural Uganda: cross-sectional, whole-population study. Soc Psychiatry PsychiatrEpidemiol. 2021 Aug 6. doi: 10.1007/ s00127-021-02135-4. Epub ahead of print.PMID: 34355265.

Kakuhikire B, Satinsky EN, Baguma C, Rasmussen JD, Perkins JM, GumisirizaP, Juliet M, Ayebare P, Mushavi RC, Burns BFO, Evans CQ, Siedner MJ, BangsbergDR, Tsai AC. Correlates of attendance at community engagement meetings held inadvance of bio-behavioral research studies: A longitudinal, sociocentric socialnetwork study in rural Uganda. PLoS Med. 2021 Jul 16;18(7):e1003705. doi:10.1371/journal.pmed.1003705. PMID: 34270581; PMCID: PMC8323877.

Katz IT, Musinguzi N, Bell K, Cross A, Bwana MB, Amanyire G, Asiimwe S,Orrell C, Bangsberg DR, Haberer JE; META (Measuring Early Treatment Adherence)Team Investigators. Brief Report: The Impact of Disease Stage on Early Gaps inART in the “Treatment for All” Era-A Multisite Cohort Study. J Acquir ImmuneDefic Syndr. 2021 Apr 15;86(5):562-567. doi: 10.1097/QAI.0000000000002605. PMID:33351529; PMCID: PMC7938906.

Kekibiina A, Adong J, Fatch R, Emenyonu NI, Marson K, Beesiga B, Lodi S,Muyindike WR, Kamya M, Chamie G, McDonell MG, Hahn JA. Post-traumatic stressdisorder among persons with HIV who engage in heavy alcohol consumption in- southwestern Uganda. BMC Psychiatry. 2021 Sep 18;21(1):457. doi:10.1186/s12888-021-03464-z. PMID: 34535103; PMCID: PMC8449437.

Kim AW, Kakuhikire B, Baguma C, North CM, Satinsky EN, Perkins JM, AyebareP, Kiconco A, Namara EB, Bangsberg DR, Siedner MJ, Tsai AC. Adverse childhoodexperiences and adult cardiometabolic risk factors and disease outcomes: Cross-sectional, population-based study of adults in rural Uganda. J Glob Health. 2021Jul 24;11:04035. doi: 10.7189/ jogh.11.04035. PMID: 34386213; PMCID: PMC8325920.

Leddy AM, Hahn JA, Getahun M, Emenyonu NI, Woolf-King SE, Sanyu N,Katusiime A, Fatch R, Chander G, Hutton HE, Muyindike WR, Camlin CS. CulturalAdaptation of an Intervention to Reduce Hazardous Alcohol Use Among PeopleLiv- ing with HIV in Southwestern Uganda. AIDS Behav. 2021 Feb15:10.1007/s10461-021-03186-z. doi: 10.1007/s10461- 021-03186-z. Epub ahead ofprint. PMID: 33590322; PMCID: PMC8364558.

Lodi S, Emenyonu NI, Marson K, Kwarisiima D, Fatch R, McDonell MG, ChengDM, Thirumurthy H, Gandhi M, Camlin CS, Muyindike WR, Hahn JA, Chamie G. TheDrinkers’ Intervention to Prevent Tuberculosis (DIPT) trial among heavy drinkersliving with HIV in Uganda: study protocol of a 2×2 factorial trial. Trials. 2021May 20;22(1):355. doi: 10.1186/ s13063-021-05304-7. PMID: 34016158; PMCID:PMC8136096.

McCluskey SM, Kamelian K, Musinguzi N, Kigozi S, Boum Y 2nd, Bwana MB,Muzoora C, Brumme ZL, Carrington M, Carl- son J, Foley B, Hunt PW, Martin JN,Bangsberg DR, Harrigan PR, Siedner MJ, Haberer JE, Lee GQ. Pre-treatmentintegrase inhibitor resistance is uncommon in antiretroviral therapy-naiveindividuals with HIV-1 subtype A1 and D infections in Uganda. AIDS. 2021 Jun1;35(7):1083-1089. doi: 10.1097/QAD.0000000000002854. PMID: 33635845; PMCID:P- MC8102316.

McDiehl RP, Boatin AA, Mugyenyi GR, Siedner MJ, Riley LE, Ngonzi J, BebellLM. Antenatal Care Visit Attendance Fre- quency and Birth Outcomes in RuralUganda: A Prospective Cohort Study. Matern Child Health J. 2021Feb;25(2):311-320. doi: 10.1007/s10995-020-03023-0. Epub 2020 Nov 17. PMID:33201450; PMCID: PMC7878332.

Migisha R, Agaba DC, Katamba G, Manne-Goehler J, Muyingo A, Siedner MJ.Postural changes in blood pressure among patients with diabetes attending areferral hospital in southwestern Uganda: a cross-sectional study. BMCCardiovasc Disord. 2021 Apr 27;21(1):213. doi: 10.1186/s12872-021-02022-5. PMID:33906603; PMCID: PMC8077796.

Miller JS, Mbusa RK, Baguma S, Patel P, Matte M, Ntaro M, Bwambale S,Kenney J, Guiles D, Mulogo EM, Stone GS. Assessing Village Health Workers’Ability to Perform and Interpret Rapid Diagnostic Tests for Malaria 4 Yearsafter Initial Training: A Cross-Sectional Study. Am J Trop Med Hyg. 2021Jan;104(1):294-297. doi: 10.4269/ajtmh.20-0747. PMID: 33146114; PMCID:PMC7790071.

Miller JS, Mbusa RK, Baguma S, Patel P, Matte M, Ntaro M, Wesuta AC,Mumbere N, Bwambale S, Mian-McCarthy S, Kenney J, Guiles D, Mulogo EM, Stone GS.A cross-sectional study comparing case scenarios and record review to mea- surequality of Integrated Community Case Management care in western Uganda. Trans RSoc Trop Med Hyg. 2021 Jun 2;115(6):627-633. doi: 10.1093/trstmh/traa097. PMID:33002128

Miller JS, Patel P, Mian-McCarthy S, Wesuta AC, Matte M, Ntaro M, BwambaleS, Kenney J, Stone GS, Mulogo EM. Usage of and satisfaction with IntegratedCommunity Case Management care in western Uganda: a cross-sectional survey. Malar J. 2021 Jan 30;20(1):65. doi: 10.1186/s12936-021-03601-9. PMID: 33516205;PMCID: PMC7847039.

Movassagh M, Bebell LM, Burgoine K, Hehnly C, Zhang L, Moran K, Sheldon K,Sinnar SA, Mbabazi-Kabachelor E, Kum- bakumba E, Bazira J, Ochora M, Mulondo R,Nsubuga BK, Weeks AD, Gladstone M, Olupot-Olupot P, Ngonzi J, Rob- erts DJ, MeierFA, Irizarry RA, Broach JR, Schiff SJ, Paulson JN. Vaginal microbiome topicmodeling of laboring Ugandan women with and without fever. NPJ BiofilmsMicrobiomes. 2021 Sep 10;7(1):75. doi: 10.1038/s41522-021-00244-1. PMID:34508087; PMCID: PMC8433417.

Mugyenyi GR, Ngonzi J, Wylie BJ, Haberer JE, Boatin AA. Quality of vitalsign monitoring during obstetric hospitaliza- tions at a regional referral andteaching hospital in Uganda: an opportunity for improvement. Pan Afr Med J. 2021Mar 11;38:252. doi: 10.11604/pamj.2021.38.252.21749. PMID: 34104300; PMCID:PMC8164430.

Musiimenta A, Campbell JI, Tumuhimbise W, Burns B, Atukunda EC, Eyal N,Haberer JE. Electronic Adherence Monitor- ing May Facilitate Intentional HIVStatus Disclosure Among People Living with HIV in Rural Southwestern Uganda.AIDS Behav. 2021 Jul;25(7):2131-2138. doi: 10.1007/s10461-020-03143-2. Epub 2021Jan 2. PMID: 33389324.

Musinguzi N, Stanford FC, Boatin AA, Orrell C, Asiimwe S, Siedner M,Haberer JE; META team. Association between obesity and combinationantiretroviral therapy (cART) adherence among persons with early-stage HIVinfection initiat- ing cART. Int J Obes (Lond). 2021 Aug;45(8):1855-1859. doi:10.1038/s41366-021-00837-y. Epub 2021 May 18. PMID: 34007011; PMCID: PMC8316269.

Mutumba M, Woolf-King S, Carrico AW, Emenyonu NI, Fatch R, Kekibiina A,Muyindike W, Hahn JA. Correlates and Effects of Alcohol Use Expectancies AmongPersons Living with HIV in Uganda. AIDS Behav. 2021 Oct 1. doi:10.1007/ s10461-021-03465-9. Epub ahead of print. PMID: 34599420.

Nabifo SC, Tsai AC, Bajunirwe F. HIV-related stigma and its associationwith HIV transmission risk behaviors among boda boda motorcyclists inMbarara Municipality, southwestern Uganda. Int J STD AIDS. 2021Aug;32(9):791-798. doi: 10.1177/0956462420987760. Epub 2021 Mar 26. PMID:33769905

Ngonzi J, Bebell LM, Boatin AA, Owaraganise A, Tiibajuka L, Fajardo Y,Lugobe HM, Wylie BJ, Jacquemyn Y, Obua C, Ha- berer JE, Geertruyden JV. Impact ofan educational intervention on WHO surgical safety checklist and pre-operativean- tibiotic use at a referral hospital in southwestern Uganda. Int J Qual HealthCare. 2021 Aug 13;33(3):mzab089. doi: 10.1093/intqhc/mzab089. PMID: 34390247.

Ngure K, Mugo NR, Bukusi EA, Kiptinness C, Oware K, Gakuo S, Musinguzi N,Pyra M, Garrison L, Baeten JM, Haberer JE. Pills, Injections, Rings, orImplants? PrEP Formulation Preferences of PrEP-Experienced African Women for HIVPreven- tion. J Acquir Immune Defic Syndr. 2021 Dec 1;88(4):e30-e32. doi:10.1097/QAI.0000000000002793. PMID: 34446676; PMCID: PMC8556312.

Nuwagira E, Lumori BAE, Muhindo R, Kanyesigye M, Amir A, Muyindike W,Muzoora C. Incidence and predictors of early loss to follow up among patientsinitiated on protease inhibitor-based second-line antiretroviral therapy insouth- western Uganda. AIDS Res Ther. 2021 Mar 20;18(1):7. doi:10.1186/s12981-021-00331-5. PMID: 33743748; PMCID: PMC7980600.

Peake D, Black J, Kumbakumba E, Bagayana S, Barigye C, Moschovis P,Muhumuza I, Kiwanuka F, Semata P, Rassool K, So- bott B, Rassool R. Technicalresults from a trial of the FREO2 Low-Pressure Oxygen Storage system, MbararaRegional Re- ferral Hospital, Uganda. PLoS One. 2021 Mar 9;16(3):e0248101. doi:10.1371/journal.pone.0248101. PMID: 33690713; PMCID: PMC7942979.

Perkins JM, Kakuhikire B, Baguma C, Jurinsky J, Rasmussen JD, Satinsky EN,Namara E, Ahereza P, Kyokunda V, Perkins HW, Hahn JA, Bangsberg DR, Tsai AC.Overestimation of alcohol consumption norms as a driver of alcohol consump- tion:a whole-population network study of men across eight villages in rural,southwestern Uganda. Addiction. 2021 Jun 22 doi: 10.1111/add.15615. Epub aheadof print. PMID: 34159646.

Pierre F, Forman LS, Winter M, Cheng D, Ngabirano C, Emenyonu N, Hunt PW,Huang Y, Muyindike W, Samet J, Hahn JA, So-Armah K. Alcohol Consumption andTryptophan Metabolism Among People with HIV Prior to Antiretroviral Therapy- Initiation: The Uganda ARCH Cohort Study. Alcohol Alcohol. 2021 May 24:agab033.doi: 10.1093/alcalc/agab033. Epub print. PMID: 34027552.

Puryear SB, Fatch R, Beesiga B, Kekibiina A, Lodi S, Marson K, Emenyonu NI,Muyindike WR, Kwarisiima D, Hahn JA, Chamie G. Higher Levels of Alcohol Use AreAssociated With Latent Tuberculosis Infection in Adults Living With Hu- manImmunodeficiency Virus. Clin Infect Dis. 2021 Mar 1;72(5):865-868. doi:10.1093/cid/ciaa527. PMID: 32374867; PMCID: PMC7935375.

Reynolds Z, McCluskey SM, Moosa MYS, Gilbert RF, Pillay S, Aturinda I, ArdKL, Muyindike W, Musinguzi N, Masette G, Moodley P, Brijkumar J, Rautenberg T,George G, Johnson BA, Gandhi RT, Sunpath H, Marconi VC, Bwana MB, Siedner MJ.Who’s slipping through the cracks? A comprehensive individual, clinical andhealth system characterization of peo- ple with virological failure on first-lineHIV treatment in Uganda and South Africa. HIV Med. 2021 Nov 9. doi:10.1111/ hiv.13203. Epub ahead of print. PMID: 34755438.

Satinsky EN, Kakuhikire B, Baguma C, Rasmussen JD, Ashaba S, Cooper-VinceCE, Perkins JM, Kiconco A, Namara EB, Bangsberg DR, Tsai AC. Adverse childhoodexperiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study. PLoS Med. 2021 May 12;18(5):e1003642. doi:10.1371/journal.pmed.1003642. PMID: 33979329; PMCID: PMC8153443.

Schnittman SR, Byakwaga H, Boum Y, Kabakyenga J, Matthews LT, Burdo TH,Huang Y, Tracy RP, Haberer JE, Kembabazi A, Kaida A, Moisi D, Lederman MM,Bangsberg DR, Martin JN, Hunt PW. Changes in Immune Activation During Pregnan- cyand the Postpartum Period in Treated HIV Infection. Open Forum Infect Dis. 2021May 17;8(6):ofab245. doi: 10.1093/ ofid/ofab245. PMID: 34159218; PMCID:PMC8214017.

Semeere A, Byakwaga H, Laker-Oketta M, Freeman E, Busakhala N, Wenger M,Kasozi C, Ssemakadde M, Bwana M, Kanyesigye M, Kadama-Makanga P, Rotich E,Kisuya J, Sang E, Maurer T, Wools-Kaloustian K, Kambugu A, Martin J. Fea- sibilityof Rapid Case Ascertainment for Cancer in East Africa: An Investigation ofCommunity-Representative Kaposi Sar- coma in the Era of Antiretroviral Therapy.Cancer Epidemiol. 2021 Oct;74:101997. doi: 10.1016/j.canep.2021.101997. Epub2021 Aug 9. PMID: 34385076; PMCID: PMC8480528.

Siedner MJ, Bibangambah P, Kim JH, Lankowski A, Chang JL, Yang IT, Kwon DS,North CM, Triant VA, Longenecker C, Ghoshhajra B, Peck RN, Sentongo RN, GilbertR, Kakuhikire B, Boum Y 2nd, Haberer JE, Martin JN, Tracy R, Hunt PW, BangsbergDR, Tsai AC, Hemphill LC, Okello S. Treated HIV Infection and Progression ofCarotid Atherosclerosis in Ru- ral Uganda: A Prospective Observational CohortStudy. J Am Heart Assoc. 2021 Jun 15;10(12):e019994. doi:10.1161/ JAHA.120.019994. Epub 2021 Jun 5. PMID: 34096320; PMCID: PMC8477876.

Siedner MJ, Moosa MS, McCluskey S, Gilbert RF, Pillay S, Aturinda I, Ard K,Muyindike W, Musinguzi N, Masette G, Pillay M, Moodley P, Brijkumar J,Rautenberg T, George G, Gandhi RT, Johnson BA, Sunpath H, Bwana MB, Marconi VC.Resis- tance Testing for Management of HIV Virologic Failure in Sub-Saharan Africa: An Unblinded Randomized Controlled Trial. Ann Intern Med. 2021 Oct 26. doi:10.7326/M21-2229. Epub ahead of print. PMID: 34698502.

Stanton AM, Bwana M, Owembabazi M, Atukunda E, Musinguzi E, Ezegbe H, SmithP, Psaros C, Matthews LT, Kaida A. Sexual and Relationship Benefits of a SaferConception Intervention Among Men with HIV Who Seek to Have Children withSerodifferent Partners in Uganda. AIDS Behav. 2021 Nov 19. doi:10.1007/s10461-021-03533-0. Epub ahead of print. PMID: 34796420.

Sundararajan R, Ponticiello M, Lee MH, Strathdee SA, Muyindike W, Nansera D,King R, Fitzgerald D, Mwanga-Amump- aire J. Traditional healer-delivered point-of-care HIV testing versus referral to clinical facilities for adults of unknownse- rostatus in rural Uganda: a mixed-methods, cluster-randomised trial. LancetGlob Health. 2021 Nov;9(11):e1579-e1588. doi: 10.1016/S2214-109X(21)00366-1.PMID: 34678199; PMCID: PMC8562591.

Tibaijuka L, Bawakanya SM, Owaraganise A, Kyasimire L, Kumbakumba E, BoatinAA, Kayondo M, Ngonzi J, Asiimwe SB, Mugyenyi GR. Incidence and predictors ofpreterm neonatal mortality at Mbarara Regional Referral Hospital in South- Western Uganda. PLoS One. 2021 Nov 2;16(11):e0259310. doi:10.1371/journal.pone.0259310. PMID: 34727140; PM- CID: PMC8562818.

Tsai AC, Kakuhikire B, Perkins JM, Downey JM, Baguma C, Satinsky EN,Gumisiriza P, Kananura J, Bangsberg DR. Norma- tive vs personal attitudes towardpersons with HIV, and the mediating role of perceived HIV stigma in ruralUganda. J Glob Health. 2021 Sep 15;11:04956. doi: 10.7189/jogh.11.04056. PMID:34552725; PMCID: PMC8442577.

Young CR, Gill E, Bwana M, Muyindike W, Hock RS, Pratt MC, Owembabazi M,Tukwasibwe D, Najjuma A, Kalyebara P, Natukunda S, Kaida A, Matthews LT. Clientand Provider Experiences in Uganda Suggest Demand for and Highlight theImportance of Addressing HIV Stigma and Gender Norms Within Safer ConceptionCare. AIDS Behav. 2021 Jun 21. doi: 10.1007/s10461-021-03343-4. Epub ahead ofprint. PMID: 34152530.

Zanoni BC, Archary M, Sibaya T, Musinguzi N, Kelley ME, McManus S, HabererJE. Development and validation of the HIV adolescent readiness for transitionscale (HARTS) in South Africa. J Int AIDS Soc. 2021 Jul;24(7):e25767. doi:10.1002/ jia2.25767. PMID: 34235876; PMCID: PMC8264413.

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