Grace John-Stewart
Datos Biográficos
| ID | 6084401 |
|---|---|
| NOMBRE | Grace John-Stewart |
| NOMBRES | Grace |
| APELLIDO | John-Stewart |
| FIRMA | JOHN-STEWART G |
| AFILIACIONES | University of Washington |
| VERIFICADO | No |
| TOTAL DE OBRAS | 24 |
| TOTAL DE CITAS | 0 |
| TOTAL COMO AUTOR | 24 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2012 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 0 |
“When a man is stressed, it replicates in the house”
Mental health conditions are a major public health concern in the African region, where women experience a high prevalence of maternal mental health conditions and limited access to adequate care. This issue is particularly severe among women living with HIV (WLHIV), who face a heightened risk of depression and anxiety. Despite the well-documented association between male partner-related factors and maternal/child health outcomes, their impact on…
Prevalence, severity and correlates of dysmenorrhea among postpartum women in Western Kenya
Dysmenorrhea is the most common menstrual disorder globally, contributing the highest disease burden of any gynecological issue in low- and middle-income countries (LMICs). Yet, limited data exist on dysmenorrhea among women in LMICs, particularly in Sub-Saharan Africa, including countries like Kenya. We conducted a cross-sectional analysis using data from the PrIMA-Extension Study, a large prospective cohort study that enrolled women during preg…
Evaluating the safety of prenatal HIV PrEP use
Existing data support the safety of daily oral tenofovir disoproxil fumarate (TDF)-based HIV pre-exposure prophylaxis (PrEP) use in pregnancy, yet ongoing monitoring is needed. We analyzed data from three recently completed HIV PrEP safety and implementation studies (PrIMA, PrIMA-X, and mWACh-PrEP) that enrolled women who were offered and/or initiated TDF-based HIV PrEP at routine health clinics in Western Kenya to summarize perinatal outcomes fo…
Sustainability of an evidence-based intervention supporting transition to independent care for youth living with HIV in Kenya
Integrating and sustaining evidence-based interventions (EBIs) in routine care is crucial to improving HIV treatment outcomes among youth living with HIV (YLH). However, EBIs are often not sustained post clinical trial. An Adolescent Transition Package (ATP) delivered by health care workers (HCWs) and tested in Kenya in 2021 significantly improved YLH readiness to transition to independent care. Post-trial, participating clinics could continue us…
Multiple Adverse Childhood Experiences and Maternal Mental Health Outcomes Among Kenyan Mothers With and Without HIV
Simulated patient training to improve youth engagement in HIV care in Kenya
Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 …
“Whenever you need support, you first turn to the group”
Social support is a critical component of achieving positive health outcomes for youth living with HIV (YLWH). Mobile health (mHealth) has significant potential for providing social support to YLWH. However, little is known about the domains of social support most needed by YLWH which mHealth interventions might address. Drawing on the spontaneous creation of WhatsApp support groups by YLWH in Nairobi, Kenya, we characterized Kenyan YLWH's social…
Fertility Desire and Associations with Condomless Sex, Antiretroviral Adherence, and Transmission Potential in a Cohort of Kenyan Women Living with HIV in Sero-discordant Relationships
For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can challenge condom use and antiretroviral adherence. In a prospective cohort of 148 WLH in serodiscordant partnerships, 58 (39%) wanted more children in the future but were not currently trying to conceive (fertility desire), and 32 (22%) were currently trying to become pregnant (fertility intent). Detection of prostate specific antigen (PSA) in vaginal…
Risk factors for stillbirth and neonatal mortality among participants in Mobile WACh NEO pilot, a two-way SMS communication program in Kenya
Globally, 2.5 million neonates die and 2 million more are stillborn each year; the vast majority occur where access to life-saving care is limited. High quality, feasible interventions are needed to reach, educate and empower pregnant women and new mothers to improve care-seeking behaviors. Mobile WACh (Mobile solutions for Women’s and Children’s health) NEO is a human-computer hybrid mobile health (mHealth) system that allows for two-way short m…
Key influences on the decision to initiate PrEP among adolescent girls and young women within routine maternal child health and family planning clinics in Western Kenya
We sought to understand influences on PrEP uptake among Kenyan adolescent girls and young women (AGYW) whose decision on PrEP use was misaligned with their risk for HIV acquisition. In-depth interviews were conducted with 47 Kenyan HIV-negative AGYW aged 15-24 years who were offered PrEP during routine maternal and child health and family planning services. AGYW were sampled from two groups (1) declined PrEP and had ≥1 sexual partner(s) of unknow…
“It’s about making adolescents in charge of their health”
The health care transition (HCT) from pediatric to adult care is a potential contributor to poor clinical outcomes among adolescents living with HIV (ALHIV). In sub-Saharan Africa (SSA), there is limited information on effective tools and processes to prepare and support ALHIV through this transition. This study elicited perspectives of policy-makers regarding barriers and facilitators to successful HCT among ALHIV in Kenya. Twenty in-depth inter…
Antenatal depressive symptoms in Kenyan women living with HIV
Depression among pregnant women living with HIV (WLWH) in sub-Saharan Africa leads to poor pregnancy and HIV outcomes. This cross-sectional analysis utilized enrollment data from a randomized trial (Mobile WAChX, NCT02400671) in six Kenyan public maternal and child health clinics. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), stigma with the Stigma Scale for Chronic Illness, and intimate partner violence (IPV)…
Is there an optimal screening tool for identifying perinatal depression within clinical settings of sub-Saharan Africa
Depression is a leading cause of maternal morbidity and mortality worldwide and the most common complication of the perinatal period. Women in sub-Saharan Africa (SSA) are disproportionately impacted by perinatal depression. Maternal and child health (MCH) clinics are widely attended in SSA, offering a potential access point for depression screening. Yet, selection of optimal depression screening instruments for use within MCH clinics in SSA rema…
Task-sharing and piloting WHO group interpersonal psychotherapy (IPT-G) for adolescent mothers living with HIV in Nairobi primary health care centers
This paper describes a sustainable structure to deliver the World Health Organization (WHO) endorsed group Interpersonal Psychotherapy (IPT-G) for Postpartum Adolescent (PPA) mothers living with HIV in Nairobi. It documents the process of mobilizing, training, and engaging Community Health Workers (CHWs) and Key Informants (health facility staff) involved in the Prevention of Mother-To-Child Transmission (PMTCT) in two Primary Health Care (PHC) f…
Financial Incentives for Pediatric HIV Testing (FIT)
Association of experienced and internalized stigma with self-disclosure of HIV status by youth living with HIV
The Psychosocial Effects of the Covid-19 Pandemic on Youth Living with HIV in Western Kenya
The objective of this study was to assess psychosocial effects of COVID-19 among adolescents living with HIV (ALHIV) in Kenya and to assess the feasibility of conducting behavioral surveys by phone. We adapted our protocol to administer telephone rather than in-person follow-up surveys and included questions about COVID-19. The majority of participants (99%) reported having heard of COVID-19; 23% reported no longer being able to go outside, 17% r…
From research to international scale-up
Stakeholder engagement between researchers, policymakers and practitioners is critical for the successful translation of research into policy and practice. The Counseling and Testing for Children at Home (CATCH) study evaluated a paediatric index case testing model, targeting the children of HIV-infected adults in care in Kenya. Researchers collaborated with stakeholders in the planning, execution and evaluation, and dissemination phases of CATCH…
Pilot evaluation of a standardized patient actor training intervention to improve HIV care for adolescents and young adults in Kenya
Poor retention in HIV care remains a major problem for Adolescents and Young Adults (AYA). A Standardized Patient (SP) clinical training intervention was developed to improve healthcare worker (HCW) "adolescent-friendly" competencies in Kenya. Professional actors were trained to portray HIV-infected AYA according to standardized scripts. HCWs completed a 2-day SP training that included didactic sessions, 7 video-recorded SP encounters, and group …
An mHealth SMS intervention on Postpartum Contraceptive Use Among Women and Couples in Kenya
Objectives. To assess the effect of 2-way short message service (SMS) with a nurse on postpartum contraceptive use among individual women and couples. Methods. From 2016 to 2017, we conducted a randomized controlled trial at 2 public hospitals in western Kenya. We assigned eligible pregnant women to receive 2-way SMS with a nurse or no SMS, with the option to include male partners. We delivered automated family planning–focused SMS messages weekl…
SMS messaging to improve ART adherence
There is growing evidence that mobile health (mHealth) approaches including short messaging service (SMS) can improve antiretroviral therapy (ART) adherence, but consensus is lacking regarding communication of HIV-related information. Most interventions to date have delivered SMS that do not overtly refer to HIV or ART in order to avoid risk of status disclosure. In formative work for an ongoing randomized controlled trial (RCT) evaluating one-wa…
Prevalence and correlates of non-disclosure of maternal HIV status to male partners
HIV-infected women were less likely to disclose their status to partners than HIV-uninfected women. Non-disclosure was associated with lower use of PMTCT services. Facilitating maternal disclosure to male partners may enhance PMTCT uptake
Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya
Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan Africa…
Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women
BACKGROUND: Antiretroviral preexposure prophylaxis is a promising approach for preventing human immunodeficiency virus type 1 (HIV-1) infection in heterosexual populations. METHODS: We conducted a randomized trial of oral antiretroviral therapy for use as preexposure prophylaxis among HIV-1-serodiscordant heterosexual couples from Kenya and Uganda. The HIV-1-seronegative partner in each couple was randomly assigned to one of three study regimens-…
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Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women
BACKGROUND: Antiretroviral preexposure prophylaxis is a promising approach for preventing human immunodeficiency virus type 1 (HIV-1) infection in heterosexual populations. METHODS: We conducted a randomized trial of oral antiretroviral therapy for use as preexposure prophylaxis among HIV-1-serodiscordant heterosexual couples from Kenya and Uganda. The HIV-1-seronegative partner in each couple was randomly assigned to one of three study regimens-…
Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya
Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan Africa…
SMS messaging to improve ART adherence
There is growing evidence that mobile health (mHealth) approaches including short messaging service (SMS) can improve antiretroviral therapy (ART) adherence, but consensus is lacking regarding communication of HIV-related information. Most interventions to date have delivered SMS that do not overtly refer to HIV or ART in order to avoid risk of status disclosure. In formative work for an ongoing randomized controlled trial (RCT) evaluating one-wa…
Prevalence and correlates of non-disclosure of maternal HIV status to male partners
HIV-infected women were less likely to disclose their status to partners than HIV-uninfected women. Non-disclosure was associated with lower use of PMTCT services. Facilitating maternal disclosure to male partners may enhance PMTCT uptake
Pilot evaluation of a standardized patient actor training intervention to improve HIV care for adolescents and young adults in Kenya
Poor retention in HIV care remains a major problem for Adolescents and Young Adults (AYA). A Standardized Patient (SP) clinical training intervention was developed to improve healthcare worker (HCW) "adolescent-friendly" competencies in Kenya. Professional actors were trained to portray HIV-infected AYA according to standardized scripts. HCWs completed a 2-day SP training that included didactic sessions, 7 video-recorded SP encounters, and group …
An mHealth SMS intervention on Postpartum Contraceptive Use Among Women and Couples in Kenya
Objectives. To assess the effect of 2-way short message service (SMS) with a nurse on postpartum contraceptive use among individual women and couples. Methods. From 2016 to 2017, we conducted a randomized controlled trial at 2 public hospitals in western Kenya. We assigned eligible pregnant women to receive 2-way SMS with a nurse or no SMS, with the option to include male partners. We delivered automated family planning–focused SMS messages weekl…
The Psychosocial Effects of the Covid-19 Pandemic on Youth Living with HIV in Western Kenya
The objective of this study was to assess psychosocial effects of COVID-19 among adolescents living with HIV (ALHIV) in Kenya and to assess the feasibility of conducting behavioral surveys by phone. We adapted our protocol to administer telephone rather than in-person follow-up surveys and included questions about COVID-19. The majority of participants (99%) reported having heard of COVID-19; 23% reported no longer being able to go outside, 17% r…
From research to international scale-up
Stakeholder engagement between researchers, policymakers and practitioners is critical for the successful translation of research into policy and practice. The Counseling and Testing for Children at Home (CATCH) study evaluated a paediatric index case testing model, targeting the children of HIV-infected adults in care in Kenya. Researchers collaborated with stakeholders in the planning, execution and evaluation, and dissemination phases of CATCH…
Is there an optimal screening tool for identifying perinatal depression within clinical settings of sub-Saharan Africa
Depression is a leading cause of maternal morbidity and mortality worldwide and the most common complication of the perinatal period. Women in sub-Saharan Africa (SSA) are disproportionately impacted by perinatal depression. Maternal and child health (MCH) clinics are widely attended in SSA, offering a potential access point for depression screening. Yet, selection of optimal depression screening instruments for use within MCH clinics in SSA rema…
Task-sharing and piloting WHO group interpersonal psychotherapy (IPT-G) for adolescent mothers living with HIV in Nairobi primary health care centers
This paper describes a sustainable structure to deliver the World Health Organization (WHO) endorsed group Interpersonal Psychotherapy (IPT-G) for Postpartum Adolescent (PPA) mothers living with HIV in Nairobi. It documents the process of mobilizing, training, and engaging Community Health Workers (CHWs) and Key Informants (health facility staff) involved in the Prevention of Mother-To-Child Transmission (PMTCT) in two Primary Health Care (PHC) f…
Financial Incentives for Pediatric HIV Testing (FIT)
Association of experienced and internalized stigma with self-disclosure of HIV status by youth living with HIV
Risk factors for stillbirth and neonatal mortality among participants in Mobile WACh NEO pilot, a two-way SMS communication program in Kenya
Globally, 2.5 million neonates die and 2 million more are stillborn each year; the vast majority occur where access to life-saving care is limited. High quality, feasible interventions are needed to reach, educate and empower pregnant women and new mothers to improve care-seeking behaviors. Mobile WACh (Mobile solutions for Women’s and Children’s health) NEO is a human-computer hybrid mobile health (mHealth) system that allows for two-way short m…
Key influences on the decision to initiate PrEP among adolescent girls and young women within routine maternal child health and family planning clinics in Western Kenya
We sought to understand influences on PrEP uptake among Kenyan adolescent girls and young women (AGYW) whose decision on PrEP use was misaligned with their risk for HIV acquisition. In-depth interviews were conducted with 47 Kenyan HIV-negative AGYW aged 15-24 years who were offered PrEP during routine maternal and child health and family planning services. AGYW were sampled from two groups (1) declined PrEP and had ≥1 sexual partner(s) of unknow…
“It’s about making adolescents in charge of their health”
The health care transition (HCT) from pediatric to adult care is a potential contributor to poor clinical outcomes among adolescents living with HIV (ALHIV). In sub-Saharan Africa (SSA), there is limited information on effective tools and processes to prepare and support ALHIV through this transition. This study elicited perspectives of policy-makers regarding barriers and facilitators to successful HCT among ALHIV in Kenya. Twenty in-depth inter…
Antenatal depressive symptoms in Kenyan women living with HIV
Depression among pregnant women living with HIV (WLWH) in sub-Saharan Africa leads to poor pregnancy and HIV outcomes. This cross-sectional analysis utilized enrollment data from a randomized trial (Mobile WAChX, NCT02400671) in six Kenyan public maternal and child health clinics. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), stigma with the Stigma Scale for Chronic Illness, and intimate partner violence (IPV)…
Simulated patient training to improve youth engagement in HIV care in Kenya
Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 …
“Whenever you need support, you first turn to the group”
Social support is a critical component of achieving positive health outcomes for youth living with HIV (YLWH). Mobile health (mHealth) has significant potential for providing social support to YLWH. However, little is known about the domains of social support most needed by YLWH which mHealth interventions might address. Drawing on the spontaneous creation of WhatsApp support groups by YLWH in Nairobi, Kenya, we characterized Kenyan YLWH's social…
Fertility Desire and Associations with Condomless Sex, Antiretroviral Adherence, and Transmission Potential in a Cohort of Kenyan Women Living with HIV in Sero-discordant Relationships
For women living with HIV (WLH) in serodiscordant partnerships, decisions about childbearing can challenge condom use and antiretroviral adherence. In a prospective cohort of 148 WLH in serodiscordant partnerships, 58 (39%) wanted more children in the future but were not currently trying to conceive (fertility desire), and 32 (22%) were currently trying to become pregnant (fertility intent). Detection of prostate specific antigen (PSA) in vaginal…
Sustainability of an evidence-based intervention supporting transition to independent care for youth living with HIV in Kenya
Integrating and sustaining evidence-based interventions (EBIs) in routine care is crucial to improving HIV treatment outcomes among youth living with HIV (YLH). However, EBIs are often not sustained post clinical trial. An Adolescent Transition Package (ATP) delivered by health care workers (HCWs) and tested in Kenya in 2021 significantly improved YLH readiness to transition to independent care. Post-trial, participating clinics could continue us…
Multiple Adverse Childhood Experiences and Maternal Mental Health Outcomes Among Kenyan Mothers With and Without HIV
“When a man is stressed, it replicates in the house”
Mental health conditions are a major public health concern in the African region, where women experience a high prevalence of maternal mental health conditions and limited access to adequate care. This issue is particularly severe among women living with HIV (WLHIV), who face a heightened risk of depression and anxiety. Despite the well-documented association between male partner-related factors and maternal/child health outcomes, their impact on…
Prevalence, severity and correlates of dysmenorrhea among postpartum women in Western Kenya
Dysmenorrhea is the most common menstrual disorder globally, contributing the highest disease burden of any gynecological issue in low- and middle-income countries (LMICs). Yet, limited data exist on dysmenorrhea among women in LMICs, particularly in Sub-Saharan Africa, including countries like Kenya. We conducted a cross-sectional analysis using data from the PrIMA-Extension Study, a large prospective cohort study that enrolled women during preg…
Evaluating the safety of prenatal HIV PrEP use
Existing data support the safety of daily oral tenofovir disoproxil fumarate (TDF)-based HIV pre-exposure prophylaxis (PrEP) use in pregnancy, yet ongoing monitoring is needed. We analyzed data from three recently completed HIV PrEP safety and implementation studies (PrIMA, PrIMA-X, and mWACh-PrEP) that enrolled women who were offered and/or initiated TDF-based HIV PrEP at routine health clinics in Western Kenya to summarize perinatal outcomes fo…
Medicine (19 obras) · HIV/AIDS Research and Interventions (17 obras) · Family medicine (13 obras) · Nursing (12 obras) · Adolescent Sexual and Reproductive Health (11 obras) · Public health (9 obras) · Psychology (8 obras) · Health care (7 obras) · Internal Medicine (6 obras) · Psychiatry (6 obras)