Browsing by Author "Ndyanabo, Anthony"

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    Age-Disparate Relationships and HIV Prevalence among Never Married Women in Rakai, Uganda
    (Journal of acquired immune deficiency syndromes, 2018) Mwinnyaa, George; Gray, Ronald H.; Grabowski, Mary K.; Ssekasanvu, Joseph; Ndyanabo, Anthony; Ssekubugu, Robert; Kagaayi, Joseph; Kigozi, Godfrey; Nakigozi, Gertrude; Serwadda, David M.; Laeyendecker, Oliver
    Age-disparate relationships are associated with increased HIV prevalence. We determined whether the frequency of age-disparate relationships in never married women changed over time and whether they are associated with HIV prevalence in Rakai, Uganda. Methods: 10,061 never married women, aged 15–49 in the Rakai Community Cohort Study provided information on the age of their male sexual partners from 1997 to 2013. Logistic regression was used to assess trends in age-disparate relationships (≥5 years) between never married women and their male partners. Log-binomial regression was used to estimate adjusted prevalence ratios (adjPR) of HIV prevalence associated with age-disparate relationships. Results: 2,992 women (30%) had a male partner ≥5 years older which remained stable over time. The prevalence of HIV among women in age-disparate relationships was 14%, 10% for women in relationships with men 0–4 years older (adjPR 1.36, 95% CI 1.22, 1.53) not controlling women’s age, however after age adjustment the impact of age-disparate relationships on HIV prevalence was attenuated. Age-disparate relationships were associated with increased HIV prevalence among women aged 15–17 (adjPR 1.83, 95% CI 1.10, 3.19), but not in other age groups. Conclusions: The frequency of age-disparate relationships among never married women were unchanged over a 15-year period in Rakai, Uganda. Age-disparate relationships were associated with increased HIV prevalence among adolescents 15–17, but not older women.
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    Association of Medical Male Circumcision and Antiretroviral Therapy Scale-up With Community HIV Incidence in Rakai,Uganda
    (American Medical Association, 2016) Kong, Xiangrong; Kigozi, Godfrey; Ssekasanvu, Joseph; Nalugoda, Fred; Nakigozi, Gertrude; Ndyanabo, Anthony; Lutalo, Tom; Reynolds, Steven J.; Ssekubugu, Robert; Kagaayi, Joseph; Bugos, Eva; Chang, Larry W.; Nanlesta, Pilgrim; Mary, Grabowski; Berman, Amanda; Quinn, Thomas C.; Serwadda, David; Wawer, Maria J.; Gray, Ronald H.
    Randomized trials have shown that medical male circumcision( MMC)reduces maleHIVacquisition by50% to 60%,1-3 and that early initiation of antiretroviral therapy (ART) reduces HIV transmission by more than90%in HIV-discordant couples.4Mathematical modeling suggests that these interventions could mitigate the HIV epidemic in sub- Saharan Africa,5-7 but there is limited empirical evidence for the population-level effects of these interventions on HIV incidence in real-world programs. MMC provides direct protection against male HIV acquisition by removing the foreskin, which is rich in HIV target cells.8-10 The potential effect ofMMCon population-level HIV incidence depends on this biological effect, the level ofMMC coverage, risk profiles ofmenacceptingMMC,and whether behavioral disinhibition occurs following circumcision.
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    Failure of immunologic criteria to appropriately identify antiretroviral treatment failure in Uganda
    (AIDS, 2009) Reynolds, Steven J.; Nakigozi, Gertrude; Newell, Kevin; Ndyanabo, Anthony; Galiwongo, Ronald; Iga, Boaz; Quinn, Thomas C.; Gray, Ron; Wawer, Maria; Serwadda, David
    Most antiretroviral treatment program in resource-limited settings use immunologic or clinical monitoring to measure response to therapy and to decide when to change to a second line regimen. Our objective was to evaluate immunologic failure criteria against gold standard virologic monitoring. Design—Observation cohort Methods—Participants enrolled in an antiretroviral treatment program in rural Uganda who had at least 6 months of follow-up were included in this analysis. Immunologic monitoring was performed by CD4 cell counts every 3 months during the first year, and every 6 months thereafter. HIV-1 viral loads were performed every 6 months. Results—1133 participants enrolled in the Rakai Health Sciences Program antiretroviral treatment program between June 2004 and September 2007 were followed for up to 44.4 months (median follow-up 20.2 months; IQR 12.4–29.5 months). WHO immunologic failure criteria were reached by 125 (11.0%) participants. A virologic failure endpoint defined as HIV-1 viral load (VL) >400 copies/ml on two measurements was reached by 112 participants (9.9%). Only 26 participants (2.3%) experienced
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    Failure of immunologic criteria to appropriately identify antiretroviral treatment failure in Uganda
    (AIDS (London, England), 2009-03) Reynolds, Steven J.; Nakigozi, Gertrude; Newell, Kevin; Ndyanabo, Anthony; Ronald, Galiwongo; Iga, Boaz; . Quinn, Thomas C; Gray, Ron; Wawer, Maria; Serwadda, David
    Objective—Most antiretroviral treatment program in resource-limited settings use immunologic or clinical monitoring to measure response to therapy and to decide when to change to a second line regimen. Our objective was to evaluate immunologic failure criteria against gold standard virologic monitoring. Design—Observation cohort Methods—Participants enrolled in an antiretroviral treatment program in rural Uganda who had at least 6 months of follow-up were included in this analysis. Immunologic monitoring was performed by CD4 cell counts every 3 months during the first year, and every 6 months thereafter. HIV-1 viral loads were performed every 6 months. Results—1133 participants enrolled in the Rakai Health Sciences Program antiretroviral treatment program between June 2004 and September 2007 were followed for up to 44.4 months (median follow-up 20.2 months; IQR 12.4–29.5 months). WHO immunologic failure criteria were reached by 125 (11.0%) participants. A virologic failure endpoint defined as HIV-1 viral load (VL) >400 copies/ml on two measurements was reached by 112 participants (9.9%). Only 26 participants (2.3%) experienced both an immunologic and virologic failure endpoint (2 VL>400 copies/ml) during follow-up. Conclusions—Immunologic failure criteria performed poorly in our setting and would have resulted in a substantial proportion of participants with suppressed HIV-1 VL being switched unnecessarily. These criteria also lacked sensitivity to identify participants failing virologically. Periodic viral load measurements may be a better marker for treatment failure in our setting
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    Hepatitis E Virus Seroprevalence and Correlates of Anti-HEV IgG Antibodies in the Rakai District, Uganda
    (The Journal of Infectious Diseases, 2018) Boon, Denali; Redd, Andrew D.; Laeyendecker, Oliver; Engle, Ronald E.; Nguyen, Hanh; Ocama, Ponsiano; Boaz, Iga; Ndyanabo, Anthony; Kiggundu, Valerian; Reynolds, Steven J.; Gray, Ronald H.; Wawer, Maria J.; Purcell, Robert H.; Kirk, Gregory D.; Quinn, Thomas C.; Stabinski, Lara
    A cross-sectional study was conducted of 500 human immunodeficiency virus (HIV)-infected adults frequency matched on age, sex, and community to 500 HIV-uninfected individuals in the Rakai District, Uganda to evaluate seroprevalence of anti-hepatitis E virus (HEV) IgG antibodies. HEV seroprevalence was 47%, and 1 HIV-infected individual was actively infected with a genotype 3 virus. Using modified Poisson regression, male sex (prevalence ratios [PR] = 1.247; 95% confidence interval [CI], 1.071–1.450) and chronic hepatitis B virus infection (PR = 1.377; 95% CI, 1.090–1.738) were associated with HEV seroprevalence. HIV infection status (PR = 0.973; 95% CI, 0.852–1.111) was not associated with HEV seroprevalence. These data suggest there is a large burden of prior exposure to HEV in rural Uganda.
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    HIV epidemiologic trends among occupational groups in Rakai, Uganda: A population-based longitudinal study, 1999–2016
    (Public Library of Science, 2024-02-20) Popoola, Victor O; Kagaayi, Joseph; Ssekasanvu, Joseph; Ssekubugu, Robert; Kigozi, Grace; Ndyanabo, Anthony; Nalugoda, Fred; Chang, Larry W; Lutalo, Tom; Tobian, Aaron A. R; Kabatesi, Donna; Alamo, Stella; Mills, Lisa A; Kigozi, Godfrey; Wawer, Maria J; Santelli, John; Gray, Ronald H; Reynolds, Steven J; Serwadda, David; Lessler, Justin; Grabowski, M. Kate
    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. Adjusted prevalence risk ratios for overall, treated, and untreated, prevalent HIV infection, and incidence rate ratios for HIV incidence with 95% confidence intervals were estimated using Poisson regression to assess changes in HIV outcomes by occupation. Analyses were stratified by gender. There were 33,866 participants, including 19,113 (56%) women. Overall, HIV seroprevalence declined in most occupational subgroups among men, but increased or remained mostly stable among women. In contrast, prevalence of untreated HIV substantially declined between 1999 and 2016 in most occupations, irrespective of gender, including by 70% among men (12.3 to 4.2%; adjPRR = 0.30; 95%CI:0.23–0.41) and by 78% among women (14.7 to 4.0%; adjPRR = 0.22; 95%CI:0.18–0.27) working in agriculture, the most common self-reported primary occupation. Exceptions included men working in transportation. HIV incidence similarly declined in most occupations, but there were no reductions in incidence among female bar and restaurant workers, women working in local crafts, or men working in transportation. In summary, untreated HIV infection and HIV incidence have declined within most occupational groups in Uganda. However, women working in bars/restaurants and local crafts and men working in transportation continue to have a relatively high burden of untreated HIV and HIV incidence, and as such, should be considered priority populations for HIV programming.
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    HIV prevalence and uptake of HIV/AIDS services among youths (15–24 Years) in fishing and neighboring communities of Kasensero, Rakai District, South Western Uganda
    (BMC public health, 2017) Mafigiri, Richardson; Matovu, Joseph K. B.; Makumbi, Fredrick Edward; Ndyanabo, Anthony; Nabukalu, Doreen; Sakor, Moses; Kigozi, Godfrey; Nalugoda, Fred; Wanyenze, Rhoda K.
    Although fishing communities have a significantly higher HIV prevalence than the general population, there is paucity of data on the burden of HIV and service utilization, particularly among the youth. We assessed the HIV prevalence and utilization of HIV prevention and treatment services among youth in Kasensero fishing community and the neighboring communities.Data were derived from the Rakai Community Cohort Study (RCCS) surveys conducted between 2013 and 2014. The RCCS is a population-based household survey that collects data annually from individuals aged 15–49 years, resident in 48 communities in Rakai and neighboring districts in Uganda. For this analysis, socio-demographic, behavioral and HIV-related data were obtained for 792 individuals aged 15–24 years. We used logistic regression to conduct bivariate and multivariable analysis to determine the factors that are independently associated with HIV-positive status and their corresponding 95% confidence intervals. Data were analyzed using STATA version 13.Overall HIV prevalence was 19.7% (n = 155); higher in Kasensero (n = 141; 25.1%) and Gwanda (n = 8; 11%) than in Kyebe (n = 6; 3.9%), p < 0.001 and among females (n = 112; 26.0%) than males (n = 43; 12.0%), p < 0.001. Uptake of HIV testing was high in both HIV-positive (n = 136; 89.5%) and HIV-negative youth (n = 435; 92%). Consistent condom use was virtually non-existent in HIV-positive youth (n = 1; 0.6%) compared to HIV-negative youth (n = 20; 4.2%). Only 22.4% (n = 34) of the HIV-positive youth were receiving antiretroviral therapy (ART) in 2013–2014; higher in the HIV-positive females (n = 31; 28.4%) than HIV-positive males (n = 03; 6.7%). Slightly more than half of males (n = 134; 53.8%) reported that they were circumcised; the proportion of circumcised youth was higher among HIV-negative males (n = 122; 58%) than HIV-positive males (n = 12; 27.9%). Factors significantly associated with HIV-positive status included living in Kasensero landing site (adjusted Odds Ratio [aOR] = 5.0; 95%CI: 2.22–13.01) and reporting one (aOR = 5.0; 95%CI: 1.33–15.80) or 2+ sexual partners in the past 12 months (aOR = 11.0; 95% CI; 3.04–36.72).The prevalence of HIV is high especially among young females and in landing site communities than in the peripheral communities. Uptake of HIV prevention and treatment services is very low. There is an urgent need for youth-friendly services in these communities.
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    HIV prevalence and uptake of HIV/AIDS services among youths (15–24 Years) in fishing and neighboring communities of Kasensero, Rakai District, South Western Uganda
    (BMC public health, 2017) Mafigiri, Richardson; Matovu, Joseph K. B.; Makumbi, Fredrick Edward; Ndyanabo, Anthony; Nabukalu, Doreen; Sakor, Moses; Kigozi, Godfrey; Nalugoda, Fred; Wanyenze, Rhoda K.
    Although fishing communities have a significantly higher HIV prevalence than the general population, there is paucity of data on the burden of HIV and service utilization, particularly among the youth. We assessed the HIV prevalence and utilization of HIV prevention and treatment services among youth in Kasensero fishing community and the neighboring communities. Method: Data were derived from the Rakai Community Cohort Study (RCCS) surveys conducted between 2013 and 2014. The RCCS is a population-based household survey that collects data annually from individuals aged 15–49 years, resident in 48 communities in Rakai and neighboring districts in Uganda. For this analysis, socio-demographic, behavioral and HIV-related data were obtained for 792 individuals aged 15–24 years. We used logistic regression to conduct bivariate and multivariable analysis to determine the factors that are independently associated with HIV-positive status and their corresponding 95% confidence intervals. Data were analyzed using STATA version 13. Results: Overall HIV prevalence was 19.7% (n = 155); higher in Kasensero (n = 141; 25.1%) and Gwanda (n = 8; 11%) than in Kyebe (n = 6; 3.9%), p < 0.001 and among females (n = 112; 26.0%) than males (n = 43; 12.0%), p < 0.001. Uptake of HIV testing was high in both HIV-positive (n = 136; 89.5%) and HIV-negative youth (n = 435; 92%). Consistent condom use was virtually non-existent in HIV-positive youth (n = 1; 0.6%) compared to HIV-negative youth (n = 20; 4.2%). Only 22.4% (n = 34) of the HIV-positive youth were receiving antiretroviral therapy (ART) in 2013–2014; higher in the HIV-positive females (n = 31; 28.4%) than HIV-positive males (n = 03; 6.7%). Slightly more than half of males (n = 134; 53.8%) reported that they were circumcised; the proportion of circumcised youth was higher among HIV-negative males (n = 122; 58%) than HIV-positive males (n = 12; 27.9%). Factors significantly associated with HIV-positive status included living in Kasensero landing site (adjusted Odds Ratio [aOR] = 5.0; 95%CI: 2.22–13.01) and reporting one (aOR = 5.0; 95%CI: 1.33–15.80) or 2+ sexual partners in the past 12 months (aOR = 11.0; 95% CI; 3.04–36.72). Conclusion: The prevalence of HIV is high especially among young females and in landing site communities than in the peripheral communities. Uptake of HIV prevention and treatment services is very low. There is an urgent need for youth-friendly services in these communities.
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    HIV serologically indeterminate individuals: Future HIV status and risk factors
    (PLoS ONE, 2020) Mwinnyaa, George; Grabowski, Mary K.; Gray, Ronald H.; Wawer, Maria; Chang, Larry W.; Ssekasanvu, Joseph; Kagaayi, Joseph; Kigozi, Godfrey; Kalibbala, Sarah; Galiwango, Ronald M.; Ndyanabo, Anthony; Serwadda, David; Quinn, Thomas C.; Reynolds, Steven J.; Laeyendecker, Oliver
    Indeterminate HIV test results are common, but little is known about the evolution of indeterminate serology and itssociodemographic and behavioral correlates. We assessed future HIV serological outcomes for individuals with indeterminate results and associated factors in Rakai, Uganda. Methods 115,944 serological results, defined by two enzyme immunoassay (EIAs), among 39,440 individuals aged 15–49 years in the Rakai Community Cohort Study were assessed. Indeterminate results were defined as contradictory EIAs. Modified Poisson regression models with generalized estimating equations were used to assess prevalence ratios (PRs) of subsequent HIV serological outcomes and factors associated with HIV indeterminate results.
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    HIV viral suppression and geospatial patterns of HIV antiretroviral therapy treatment facility use in Rakai, Uganda
    (AIDS (London, England), 2018) Billioux, Veena G.; Grabowski, Mary K.; Ssekasanvu, Joseph; Reynolds, Steven J.; Berman, Amanda; Bazaale, Jeremiah; Patel, Eshan U.; Bugos, Eva; Ndyanabo, Anthony; Kisakye, Alice; Kagaayi, Joseph; Gray, Ronald H.; Nakigozi, Gertrude; Ssekubugu, Robert; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.; Chang, Larry W.
    To assess geospatial patterns of HIV antiretroviral therapy (ART) treatment facility use and whether they were impacted by viral load (VL) suppression. Methods—We extracted data on the location and type of care services utilized by HIV-positive persons accessing ART between February 2015 and September 2016 from the Rakai Community Cohort Study (RCCS) in Uganda. The distance from RCCS households to facilities offering ART was calculated using the open street map road network. Modified Poisson regression was used to identify predictors of distance traveled and, for those traveling beyond their nearest facility, the probability of accessing services from a tertiary care facility. Results—1554 HIV-positive participants were identified, of whom 68% had initiated ART. The median distance from households to the nearest ART facility was 3.10 km (Interquartile range, IQR, 1.65–5.05), but the median distance traveled was 5.26 km (IQR, 3.00–10.03, p<0.001) and 57% of individuals travelled further than their nearest facility for ART. Those with higher education and wealth were more likely to travel further. 93% of persons on ART were virally suppressed, and there was no difference in the distance traveled to an ART facility between those with suppressed and unsuppressed VLs (5.26 km vs. 5.27 km, p=0.650). Conclusions—Distance traveled to HIV clinics was increased with higher socioeconomic status, suggesting that wealthier individuals exercise greater choice. However, distance traveled did not vary by those who were or were not virally suppressed.
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    Intimate partner violence as a predictor of marital disruption in rural Rakai, Uganda: a longitudinal study
    (International journal of public health, 2016) Wagman, Jennifer A.; Charvat, Blake; Thoma, Marie E.; Ndyanabo, Anthony; Nalugoda, Fred; Ssekasanvu, Joseph; Kigozi, Grace; Serwadda, David; Kagaayi, Joseph; Wawer, Maria J.; Gray, Ronald H.
    We assessed the association between intimate partner violence (IPV) and union disruption (divorce or separation) in the rural Ugandan setting of Rakai District. We analyzed longitudinal data collected from April 1999 to June 2006, from 6834 women (15–49 years) living in 50 communities in Rakai. Participants were either married, traditionally married or in a consensual union during one or more surveys and completed at least one follow-up survey. The primary outcome was union disruption through divorce or separation from the primary sexual partner.
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    Prevalence and Predictors of Persistent Human Immunodeficiency Virus Viremia and Viral Rebound After Universal Test and Treat: A Population-Based Study
    (The Journal of infectious diseases, 2021) Grabowski, M. Kate; Patel, Eshan U.; Nakigozi, Gertrude; Ssempijja, Victor; Ssekubugu, Robert; Ssekasanvu, Joseph; Ndyanabo, Anthony; Kigozi, Godfrey; Nalugoda, Fred; Gray, Ronald H.; Kalibbala, Sarah; Serwadda, David M.; Laeyendecker, Oliver; Wawer, Maria J.; Chang, Larry W.; Quinn, Thomas C.; Kagaayi, Joseph; Tobian, Aaron A. R.; Reynolds, Steven J.
    UNAIDS targets for human immunodeficiency virus (HIV) epidemic control by 2030 include that 86% of all HIV-positive persons be on antiretroviral therapy (ART) and achieve HIV viral load (VL) suppression [1]. The major policy initiative underpinning this target is universal test and treat (UTT), whereby all HIV-positive persons, irrespective of CD4 count or severity of illness, are immediately prescribed ART [2]. In sub-Saharan Africa, which accounts for more than half of all new HIV diagnoses globally, there has been considerable progress in increasing ART coverage [
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    Severe Acute Respiratory Syndrome Coronavirus-2 Seropositivity in South-Central Uganda, During 2019 - 2021
    (Research Square, 2021) Ssuuna, Charles; Galiwango, Ronald Moses; Kankaka, Edward Nelson; Kagaayi, Joseph; Ndyanabo, Anthony; Kigozi, Godfrey; Nakigozi, Gertrude; Lutalo, Tom; Ssekubugu, Robert; Wasswa, John Bosco; Mayinja, Anthony; Nakibuuka, Martina Cathy; Jamiru, Samiri; Oketch, John Baptist; Muwanga, Edward; Chang, Larry William; Grabowski, Mary Kate; Wawer, Maria; Gray, Ronald; Anderson, Mark; Serwadda, David
    Globally, key subpopulations such as healthcare workers (HCWs) have a higher risk of contracting SARS-CoV-2. In Uganda, limited access to personal protective equipment amidst lack of clarity on the extent and pattern of the community disease burden may exacerbate this situation. We assessed SARS-CoV-2 antibody seroprevalence among high-risk sub-populations in South-central Uganda, including HCWs, persons within the general population previously reporting experiencing key COVID-19 like symptoms (fever, cough, loss of taste and smell) and archived plasma specimens collected between October 2019 – 18th March 2020, prior to confirmation of COVID-19 in Uganda.
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    Traditional Herbal Medicine Use Associated with Liver Fibrosis in Rural Rakai, Uganda
    (PLoS ONE, 2012) Auerbach, Brandon J.; Reynolds, Steven J.; Lamorde, Mohammed; Merry, Concepta; Kukunda-Byobona, Collins; Ocama, Ponsiano; Semeere, Aggrey S.; Ndyanabo, Anthony; Boaz, Iga; Kiggundu, Valerian; Nalugoda, Fred; Gray, Ron H.; Wawer, Maria J.; Thomas, David L.; Kirk, Gregory D.; Quinn, Thomas C.; Stabinski, Lara
    Traditional herbal medicines are commonly used in sub-Saharan Africa and some herbs are known to be hepatotoxic. However little is known about the effect of herbal medicines on liver disease in sub-Saharan Africa. Methods: 500 HIV-infected participants in a rural HIV care program in Rakai, Uganda, were frequency matched to 500 HIVuninfected participants. Participants were asked about traditional herbal medicine use and assessed for other potential risk factors for liver disease. All participants underwent transient elastography (FibroScanH) to quantify liver fibrosis. The association between herb use and significant liver fibrosis was measured with adjusted prevalence risk ratios (adjPRR) and 95% confidence intervals (CI) using modified Poisson multivariable logistic regression. Results: 19 unique herbs from 13 plant families were used by 42/1000 of all participants, including 9/500 HIV-infected participants. The three most-used plant families were Asteraceae, Fabaceae, and Lamiaceae. Among all participants, use of any herb (adjPRR = 2.2, 95% CI 1.3–3.5, p = 0.002), herbs from the Asteraceae family (adjPRR = 5.0, 95% CI 2.9–8.7, p,0.001), and herbs from the Lamiaceae family (adjPRR = 3.4, 95% CI 1.2–9.2, p = 0.017) were associated with significant liver fibrosis. Among HIV infected participants, use of any herb (adjPRR = 2.3, 95% CI 1.0–5.0, p = 0.044) and use of herbs from the Asteraceae family (adjPRR = 5.0, 95% CI 1.7–14.7, p = 0.004) were associated with increased liver fibrosis. Conclusions: Traditional herbal medicine use was independently associated with a substantial increase in significant liver fibrosis in both HIV-infected and HIV-uninfected study participants. Pharmacokinetic and prospective clinical studies are needed to inform herb safety recommendations in sub-Saharan Africa. Counseling about herb use should be part of routine health counseling and counseling of HIV-infected persons in Uganda.
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    Using publicly available, interactive epidemiological dashboards: an innovative approach to sharing data from the Rakai Community Cohort Study
    (Oxford University Press, 2024-10) Footer, Kevin; Lake, Camille M; Porter, Joshua R; Ha, Grace K; Ahmed, Tanvir; Glogowski, Alex; Ndyanabo, Anthony; Grabowski, M Kate; Chang, Larry W; Ssekasanvu, Joseph; Kagaayi, Joseph; Serwadda, David M; Mckina, Jackie; Whalen, Christopher; Ssentongo, Lloyd; Nsimbi, Ivan; Kakeeto, Benedicto; Kigozi, Godfrey; Ssekubugu, Robert; Lutalo, Tom; Wawer, Maria J; Gray, Ronald H; Reynolds, Steven J; Rosenthal, Alex; Quinn, Thomas C; Tartakovsky, Michael
    Public sharing of de-identified biomedical data promotes collaboration between researchers and accelerates the development of disease prevention and treatment strategies. However, open-access data sharing presents challenges to researchers who need to protect the privacy of study participants, ensure that data are used appropriately, and acknowledge the inputs of all involved researchers. This article presents an approach to data sharing which addresses the above challenges by using a publicly available dashboard with de-identified, aggregated participant data from a large HIV surveillance cohort.ObjectivesPublic sharing of de-identified biomedical data promotes collaboration between researchers and accelerates the development of disease prevention and treatment strategies. However, open-access data sharing presents challenges to researchers who need to protect the privacy of study participants, ensure that data are used appropriately, and acknowledge the inputs of all involved researchers. This article presents an approach to data sharing which addresses the above challenges by using a publicly available dashboard with de-identified, aggregated participant data from a large HIV surveillance cohort.Data in this study originated from the Rakai Community Cohort Study (RCCS), which was integrated into a centralized data mart as part of a larger data management strategy for the Rakai Health Sciences Program in Uganda. These data were used to build a publicly available, protected health information (PHI)-secured visualization dashboard for general research use.Materials and MethodsData in this study originated from the Rakai Community Cohort Study (RCCS), which was integrated into a centralized data mart as part of a larger data management strategy for the Rakai Health Sciences Program in Uganda. These data were used to build a publicly available, protected health information (PHI)-secured visualization dashboard for general research use.Using two unique case studies, we demonstrate the capability of the dashboard to generate the following hypotheses: firstly, that HIV prevention strategies ART and circumcision have differing levels of impact depending on the marital status of investigated communities; secondly, that ART is very successful in comparison to circumcision as an interventional strategy in certain communities.ResultsUsing two unique case studies, we demonstrate the capability of the dashboard to generate the following hypotheses: firstly, that HIV prevention strategies ART and circumcision have differing levels of impact depending on the marital status of investigated communities; secondly, that ART is very successful in comparison to circumcision as an interventional strategy in certain communities.The democratization of large-scale anonymized epidemiological data using public-facing dashboards has multiple benefits, including facilitated exploration of research data and increased reproducibility of research findings.DiscussionThe democratization of large-scale anonymized epidemiological data using public-facing dashboards has multiple benefits, including facilitated exploration of research data and increased reproducibility of research findings.By allowing the public to explore data in depth and form new hypotheses, public-facing dashboard platforms have significant potential to generate new relationships and collaborations and further scientific discovery and reproducibility.ConclusionBy allowing the public to explore data in depth and form new hypotheses, public-facing dashboard platforms have significant potential to generate new relationships and collaborations and further scientific discovery and reproducibility. MEDLINE - Academic