Browsing by Author "Biribonwoha, Harriet Nuwagaba"

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    HIV Incidence by Male Circumcision Status From the Population-Based HIV Impact Assessment Surveys—Eight Sub-Saharan African Countries, 2015–2017
    (JAIDS Journal of Acquired Immune Deficiency Syndromes, 2021) Hines, Jonas Z.; Sachathep, Karampreet; Pals, Sherri; Davis, Stephanie M.; Toledo, Carlos; Bronson, Megan; Parekh, Bharat; Carrasco, Maria; Xaba, Sinokuthemba; Mandisarisa, John; Kamobyi, Royd; Chituwo, Omega; Kirungi, Wilford L.; Alamo, Stella; Kabuye, Geoffrey; Awor, Anna Colletar; Mmbando, Susan; Simbeye, Daimon; Aupokolo, Mekondjo A.; Zemburuka, Brigitte; Nyirenda, Rose; Msungama, Wezi; Tarumbiswa, Tapiwa; Manda, Robert; Biribonwoha, Harriet Nuwagaba; Kiggundu, Valerian; Thomas, Anne G.; Voetsch, Andrew C.; Williams, Dan B.
    Conducting HIV surveys in resource-limited settings is challenging because of logistics, limited availability of trained personnel, and complexity of testing. We described the procedures and systems deemed critical to ensure high-quality laboratory data in the population-based HIV impact assessments and large-scale household surveys.Laboratory professionals were engaged in every stage of the surveys, including protocol development, site assessments, procurement, training, quality assurance, monitoring, analysis, and reporting writing. A tiered network of household, satellite laboratories, and central laboratories, accompanied with trainings, optimized process for blood specimen collection, storage, transport, and real-time monitoring of specimen quality, and test results at each level proved critical in maintaining specimen integrity and high-quality testing. A plausibility review of aggregate merged data was conducted to confirm associations between key variables as a final quality check for quality of laboratory results.Overall, we conducted a hands-on training for 3355 survey staff across 13 surveys, with 160–387 personnel trained per survey on biomarker processes. Extensive training and monitoring demonstrated that overall, 99% of specimens had adequate volume and 99.8% had no hemolysis, indicating high quality. We implemented quality control and proficiency testing for testing, resolved discrepancies, verified >300 Pima CD4 instruments, and monitored user errors. Aggregate data review for plausibility further confirmed the high quality of testing.Ongoing engagement of laboratory personnel to oversee processes at all levels of the surveys is critical for successful national surveys. High-quality population-based HIV impact assessments laboratory data ensured reliable results and demonstrated the impact of HIV programs in 13 countries.
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    Unawareness of HIV Infection Among Men Aged 15–59 Years in 13 Sub-Saharan African Countries: Findings From the Population-Based HIV Impact Assessments, 2015–2019
    (JAIDS Journal of Acquired Immune Deficiency Syndromes, 2021) West, Christine A.; Chang, Gregory C.; Currie, Dustin W.; Bray, Rachel; Biribonwoha, Harriet Nuwagaba; Kingwara, Leonard; Remera, Eric; Rwibasira, Gallican N.; Mugisha, Veronicah; Kirungi, Wilford L.; Biraro, Sam; Mugurungi, Owen
    Identifying men living with HIV in sub-Saharan Africa (SSA) is critical to end the epidemic. We describe the underlying factors of unawareness among men aged 15–59 years who ever tested for HIV in 13 SSA countries.Using pooled data from the nationally representative Population-based HIV Impact Assessments, we fit a log-binomial regression model to identify characteristics related to HIV positivity among HIV-positive unaware and HIV-negative men ever tested for HIV.A total of 114,776 men were interviewed and tested for HIV; 4.4% were HIV-positive. Of those, 33.7% were unaware of their HIV-positive status, (range: 20.2%–58.7%, in Rwanda and Cote d’Ivoire). Most unaware men reported they had ever received an HIV test (63.0%). Age, region, marital status, and education were significantly associated with HIV positivity. Men who had HIV-positive sexual partners (adjusted prevalence ratio [aPR]: 5.73; confidence interval [95% CI]: 4.13 to 7.95) or sexual partners with unknown HIV status (aPR: 2.32; 95% CI: 1.89 to 2.84) were more likely to be HIV-positive unaware, as were men who tested more than 12 months compared with HIV-negative men who tested within 12 months before the interview (aPR: 1.58; 95% CI: 1.31 to 1.91). Tuberculosis diagnosis and not being circumcised were also associated with HIV positivity.Targeting subgroups of men at risk for infection who once tested negative could improve yield of testing programs. Interventions include improving partner testing, frequency of testing, outreach and educational strategies, and availability of HIV testing where men are accessing routine health services.