Diane V Havlir
Dados Biográficos
| ID | 1724704 |
|---|---|
| NOME | Diane V Havlir |
| PRENOMES | Diane V |
| SOBRENOME | Havlir |
| ASSINATURA | HAVLIR D V |
| AFILIAÇÕES | University of California, San Francisco |
| ORCID | 0000-0003-0761-3136 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 38 |
| TOTAL DE CITAÇÕES | 3 |
| TOTAL COMO AUTOR | 38 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2011 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 1 |
Family contributions and challenges to HIV care support among youth in rural Kenya and Uganda during the SEARCH-Youth study
Influence of alcohol-serving venue characteristics on yield of HIV status-neutral screening in rural East Africa
Alcohol-serving venues are high-risk sites for HIV transmission in East Africa. Understanding how venue characteristics influence HIV screening outcomes may help to target venue-based outreach. In eight rural communities in Kenya and Uganda, we mapped all alcohol-serving venues (N = 530) and invited owners to participate in a cluster-randomized trial to promote biomedical HIV prevention uptake: 527 (99%) owners agreed to participate. We distribut…
Perceived benefits of community-based TB preventive treatment in children in Uganda
Tuberculosis preventive treatment (TPT) uptake among children at risk for TB remains low in sub-Saharan Africa. Community-based TPT delivery is effective at increasing uptake and completion in children compared to clinic-based models, but implementation research is needed to inform scale-up in real-world settings. In this qualitative study, we assessed community and health care provider perspectives on the anticipated benefits and barriers of a c…
Association between Levels of Alcohol Use, Perceived HIV Risk, and Untreated HIV Among Persons at Alcohol-Serving Venues in Kenya and Uganda
Alcohol-serving venues in East Africa are high-risk environments for HIV transmission but few studies in sub-Saharan Africa (SSA) have examined perceived HIV risk and sexual risk behaviors by alcohol use levels on a broader population of persons at alcohol-serving venues in the era of biomedical HIV prevention. We conducted a cross-sectional analysis of adults (≥ 18 years) at alcohol-serving venues in eight communities (~ 10,000 residents/communi…
Youths' strategies for HIV status disclosure in rural Kenya and Uganda
Background: HIV status disclosure is influenced by social values, roles, and rules people take on and adapt, aligned with developmental transitions and cultural expectations. Understanding motivations for disclosure among adolescents and young adults with HIV (AYAH) is important for promoting HIV care engagement. Methods: A cluster-randomized controlled trial in 28 rural communities in Kenya and Uganda tested an intervention to improve viral supp…
Metrics of Mobility by Sex are Associated with HIV Incidence in Rural Kenya and Uganda
The complex and dynamic nature of human mobility requires use of multiple measures and sex-stratified analyses to fully understand its influence on HIV acquisition risk in specific populations and settings. Longitudinal population-based studies designed to measure the influence of mobility (which includes both short and long-term, temporary and permanent changes of residence across defined geopolitical boundaries) on HIV acquisition risk are rare…
Exploring HIV risk perception mechanisms among youth in a test-and-treat trial in Kenya and Uganda
Understanding risk perception and risk-taking among youth can inform targeted prevention efforts. Using a health beliefs model-informed framework, we analysed 8 semi-structured, gender-specific focus group discussions with 93 youth 15–24 years old (48% male, 52% female), drawn from the SEARCH trial in rural Kenya and Uganda in 2017–2018, coinciding with the widespread introduction of PrEP. Highly connected social networks and widespread uptake of…
Five lessons from a mid-level health manager intervention to increase uptake of tuberculosis prevention therapy in Uganda
BACKGROUND: Leadership skills are essential for middle-level healthcare manager efficacy. Capacity-building efforts may attempt behavioural change by filling 'knowledge gaps' while neglecting a sustainable application of that knowledge. Sustainable application of that knowledge, or implementation know-how, must resonate with local cultural patterns. When it is neglected, root issues like unclear decision-making space and local authority to interp…
Illness Narratives Without the Illness
Illness narratives invite practitioners to understand how biomedical and traditional health information is incorporated, integrated, or otherwise internalized into a patient’s own sense of self and social identity. Such narratives also reveal cultural values, underlying patterns in society, and the overall life context of the narrator. Most illness narratives have been examined from the perspective of European-derived genres and literary theory, …
Lessons from Two Latino Communities Working with Academic Partners to Increase Access to Covid-19 Testing
Objective: We sought to examine the experiences of community partners in a community–academic partnership to promote COVID-19 testing in two majority Latino communities. Methods: We conducted semistructured, in-depth interviews in English and Spanish with community-based organization leaders and community health workers/ promotoras ( n = 10) from June to July 2021. Interviews focused on identifying partner roles in planning and testing implementa…
Lessons from Two Latino Communities Working with Academic Partners to Increase Access to Covid-19 Testing
Community-academic partnerships that invest in strong relationships, community leadership, and a commitment to the community's preferred language offer a promising approach to addressing COVID-19 testing barriers. Findings provide direction for future research on how community members and academic partners can come together to inform strategies to continue addressing the COVID-19 pandemic
Geographical, social, and political contexts of tuberculosis control and intervention, as reported by mid-level health managers in Uganda
Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa
Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with…
Feasibility and preliminary effectiveness of integrating HIV prevention into an adolescent empowerment and livelihood intervention at youth clubs in rural Uganda
The uptake of HIV prevention services is lower among youth than adults in sub-Saharan Africa. Existing youth livelihood trainings offer a potential entry point to HIV prevention services. We determined feasibility and preliminary effectiveness of integrating HIV prevention into youth clubs implementing an empowerment and livelihood for adolescents (ELA) intervention in rural Uganda. Staff conducted community mobilization for youth (15-24 years) o…
Two or more significant life-events in 6-months are associated with lower rates of HIV treatment and virologic suppression among youth with HIV in Uganda and Kenya
Youth living with HIV in sub-Saharan Africa have poor HIV care outcomes. We determined the association of recent significant life-events with HIV antiretroviral treatment (ART) initiation and HIV viral suppression in youth aged 15–24 years living with HIV in rural Kenya and Uganda. This was a cross-sectional analysis of 995 youth enrolled in the SEARCH Youth study. At baseline, providers assessed recent (within 6 months) life-events, defined as c…
High Parental Vaccine Motivation at a Neighborhood-Based Vaccine and Testing Site Serving a Predominantly Latinx Community
Purpose: To understand vaccine attitudes of Latinx parents highly impacted by COVID-19. Methods: In April 2021, we surveyed parents about their attitudes for COVID-19 vaccination of their children at a community-based outdoor testing/vaccination site serving predominantly low-income Latinx persons in San Francisco. Results: Among 1033 parents (75% Latinx), 92% would “definitely” or “probably” vaccinate their children. Vaccine concerns were higher…
HIV retesting and risk behaviors among high-risk, HIV-uninfected adults in Uganda
There are limited data characterizing HIV retesting among high-risk adults in sub-Saharan Africa. From October-December 2018, we distributed recruitment cards offering health evaluations with HIV testing at venues frequented by individuals at-risk of HIV infection in Southwest Uganda. Those who attended were asked about their HIV testing history and risk factors: having >1 sexual partner, an HIV+ partner, STIs, and/or transactional sex. We define…
Taking Vaccine to Where the Virus Is—Equity and Effectiveness in Coronavirus Vaccinations
The urgency to accelerate vaccinations in the face of the recent coronavirus disease 2019 pandemic surge and the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has led many to adopt a simplified age-based prioritization strategy for COVID-19 vaccine allocation. The rationale for this approach is that implementation will be simpler
Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV
The combined burden of geriatric conditions, comorbidities, and HIV requires a model of HIV care that offers a comprehensive clinical approach with people 50 years or older with HIV. Golden Compass is an outpatient, multidisciplinary HIV-geriatrics program with an onsite HIV geriatrician, cardiologist, pharmacist, and social worker, offering specialist referrals, care navigation, and classes on improving functional status and cognition. Participa…
Planning prompts to promote uptake of HIV services among men
INTRODUCTION: Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men. METHODS: We randomised adult men in rural Ugandan parishes to receive a calendar plan…
Predictors of isoniazid preventive therapy completion among HIV-infected patients receiving differentiated and non-differentiated HIV care in rural Uganda
Rates of Isoniazid Preventive Therapy (IPT) completion remain low in programmatic settings in sub-Saharan Africa. Differentiated HIV care models may improve IPT completion by addressing joint barriers to IPT and HIV treatment. However, the impact of differentiated care on IPT completion remains unknown. In a cross-sectional study of people with HIV on antiretroviral therapy in 5 communities in rural Uganda, we compared IPT completion between pati…
Understanding Demand for PrEP and Early Experiences of PrEP Use Among Young Adults in Rural Kenya and Uganda
Leveraging incentives to increase HIV testing uptake among men
Registered with ClinicalTrials.gov on 08/10/2016, ID: NCT02890459. The first participant was enrolled on 11th April 2016
Hypertension control in integrated HIV and chronic disease clinics in Uganda in the SEARCH study
The SEARCH Trial was prospectively registered with ClinicalTrials.gov : NCT01864603
Men’s Beliefs About the Likelihood of Serodiscordance in Couples with an HIV-Positive Partner
Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa
Mobility in sub-Saharan Africa links geographically-separate HIV epidemics, intensifies transmission by enabling higher-risk sexual behavior, and disrupts care. This population-based observational cohort study measured complex dimensions of mobility in rural Uganda and Kenya. Survey data were collected every 6 months beginning in 2016 from a random sample of 2308 adults in 12 communities across three regions, stratified by intervention arm, basel…
Prevention of HIV-1 Infection with Early Antiretroviral Therapy
BACKGROUND: Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. METHODS: In nine countries, we enrolled 1763 couples in which one partner was HIV-1-positive and the other was HIV-1-negative; 54% of the subjects were from Africa, and 50% of infected partners were men. HIV-1-infected subjects with CD4 counts between 350 and 550 cells per cubic m…
The end of Aids
Epidemiology and awareness of hypertension in a rural Ugandan community
We found a substantial burden of hypertension in rural Uganda. Awareness and treatment of hypertension is low in this region. Enhanced community-based education and prevention efforts tailored to addressing modifiable factors are needed
Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection
Acceptability and feasibility of serial HIV antibody testing during pregnancy/postpartum and male partner testing in Tororo, Uganda
Our objective was to determine whether serial HIV testing during pregnancy and the postpartum period as well as male partner testing are acceptable and feasible in Tororo, Uganda. This was a prospective study of pregnant women at the Tororo District Hospital (TDH) Antenatal Clinic. Patients presenting for routine antenatal care were asked to participate in a serial HIV testing integrated into standard antenatal and postpartum/child immunization v…
Household Food Insecurity, Maternal Nutritional Status, and Infant Feeding Practices Among HIV-infected Ugandan Women Receiving Combination Antiretroviral Therapy
I Have Remained Strong Because of That Food”
Antiretroviral Therapy for the Prevention of HIV-1 Transmission
BACKGROUND: An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for …
“How can I tell?” Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV “test-and-treat” trial
People living with HIV/AIDS anticipate HIV-related stigma and fear disclosure to intimate partners. Yet, disclosure is critical to reducing HIV transmission and improving care engagement. This qualitative study characterized HIV disclosure experiences and normative beliefs among couples in communities participating in an HIV test-and-treat trial in Kenya and Uganda (Sustainable East Africa Research in Community Health, NCT#01864603). In-depth int…
Men “missing” from population-based HIV testing
Men's uptake of HIV testing is critical to the success of "test and treat" strategies in generalized epidemics. This study sought to identify cultural factors and community processes that influence men's HIV testing uptake in the baseline year of an ongoing test-and-treat trial among 334,479 persons in eastern Africa (SEARCH, NCT#01864603). Data were collected using participant observation at mobile community health campaigns (CHCs) (n = 28); foc…
Expectations about future health and longevity in Kenyan and Ugandan communities receiving a universal test-and-treat intervention in the SEARCH trial
Expectations about future health and longevity are important determinants of individuals' decisions to invest in physical and human capital. Few population-level studies have measured subjective expectations and examined how they are affected by scale-up of antiretroviral therapy (ART). We assessed these expectations in communities receiving annual HIV testing and universal ART. Longitudinal data on expectations were collected at baseline and one…
Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals
Leveraging incentives to increase HIV testing uptake among men
Registered with ClinicalTrials.gov on 08/10/2016, ID: NCT02890459. The first participant was enrolled on 11th April 2016
Hypertension control in integrated HIV and chronic disease clinics in Uganda in the SEARCH study
The SEARCH Trial was prospectively registered with ClinicalTrials.gov : NCT01864603
Men’s Beliefs About the Likelihood of Serodiscordance in Couples with an HIV-Positive Partner
Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa
Mobility in sub-Saharan Africa links geographically-separate HIV epidemics, intensifies transmission by enabling higher-risk sexual behavior, and disrupts care. This population-based observational cohort study measured complex dimensions of mobility in rural Uganda and Kenya. Survey data were collected every 6 months beginning in 2016 from a random sample of 2308 adults in 12 communities across three regions, stratified by intervention arm, basel…
Planning prompts to promote uptake of HIV services among men
INTRODUCTION: Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men. METHODS: We randomised adult men in rural Ugandan parishes to receive a calendar plan…
Predictors of isoniazid preventive therapy completion among HIV-infected patients receiving differentiated and non-differentiated HIV care in rural Uganda
Rates of Isoniazid Preventive Therapy (IPT) completion remain low in programmatic settings in sub-Saharan Africa. Differentiated HIV care models may improve IPT completion by addressing joint barriers to IPT and HIV treatment. However, the impact of differentiated care on IPT completion remains unknown. In a cross-sectional study of people with HIV on antiretroviral therapy in 5 communities in rural Uganda, we compared IPT completion between pati…
Understanding Demand for PrEP and Early Experiences of PrEP Use Among Young Adults in Rural Kenya and Uganda
High Parental Vaccine Motivation at a Neighborhood-Based Vaccine and Testing Site Serving a Predominantly Latinx Community
Purpose: To understand vaccine attitudes of Latinx parents highly impacted by COVID-19. Methods: In April 2021, we surveyed parents about their attitudes for COVID-19 vaccination of their children at a community-based outdoor testing/vaccination site serving predominantly low-income Latinx persons in San Francisco. Results: Among 1033 parents (75% Latinx), 92% would “definitely” or “probably” vaccinate their children. Vaccine concerns were higher…
HIV retesting and risk behaviors among high-risk, HIV-uninfected adults in Uganda
There are limited data characterizing HIV retesting among high-risk adults in sub-Saharan Africa. From October-December 2018, we distributed recruitment cards offering health evaluations with HIV testing at venues frequented by individuals at-risk of HIV infection in Southwest Uganda. Those who attended were asked about their HIV testing history and risk factors: having >1 sexual partner, an HIV+ partner, STIs, and/or transactional sex. We define…
Taking Vaccine to Where the Virus Is—Equity and Effectiveness in Coronavirus Vaccinations
The urgency to accelerate vaccinations in the face of the recent coronavirus disease 2019 pandemic surge and the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has led many to adopt a simplified age-based prioritization strategy for COVID-19 vaccine allocation. The rationale for this approach is that implementation will be simpler
Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV
The combined burden of geriatric conditions, comorbidities, and HIV requires a model of HIV care that offers a comprehensive clinical approach with people 50 years or older with HIV. Golden Compass is an outpatient, multidisciplinary HIV-geriatrics program with an onsite HIV geriatrician, cardiologist, pharmacist, and social worker, offering specialist referrals, care navigation, and classes on improving functional status and cognition. Participa…
Geographical, social, and political contexts of tuberculosis control and intervention, as reported by mid-level health managers in Uganda
Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa
Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with…
Medicine (34 obras) · HIV/AIDS Research and Interventions (28 obras) · Environmental health (15 obras) · Adolescent Sexual and Reproductive Health (13 obras) · Family medicine (13 obras) · Public health (12 obras) · Demography (11 obras) · HIV, Drug Use, Sexual Risk (11 obras) · Population (11 obras) · Psychology (10 obras)