David Serwadda
Dados Biográficos
| ID | 198495 |
|---|---|
| NOME | David Serwadda |
| PRENOMES | David |
| SOBRENOME | Serwadda |
| ASSINATURA | SERWADDA D |
| AFILIAÇÕES | Makerere University |
| ORCID | 0000-0001-6532-6587 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 62 |
| TOTAL DE CITAÇÕES | 69 |
| TOTAL COMO AUTOR | 62 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2000 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 4 |
Time to control of anthrax outbreaks in Africa, 2014–2023
Anthrax is a notifiable zoonotic disease targeted for control in Africa, however, outbreaks due to anthrax are still frequent and large. Surveillance systems should monitor and detect anthrax outbreaks early for prompt response. This systematic review and meta-analysis aimed to determine anthrax outbreaks epidemiological investigations gaps and time to control in Africa, Jan 2014-Dec 2023. We searched MEDLINE, PubMed, Scopus, Embase, Google Schol…
HIV epidemiologic trends among occupational groups in Rakai, Uganda
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…
Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019
BACKGROUND: There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status. OBJECTIVES: To estimate and analyse adult cause-specific mortality trends in Rakai, Uganda. METHODOLOGY: Mortality information by cause, age, sex, and HIV status was recorded in the Rakai Community Cohort study using verbal …
Use of mobile phones to collect data on Covid-19
During the COVID-19 pandemic lockdown, we deployed a rapid, mobile phone-based survey to assess access and participation rates when using mobile phones to collect data on COVID-19 in Rakai, south-central Uganda. We sampled prior Rakai Community Cohort Study (RCCS) participants based on HIV status using mobile phone contacts. We administered a 30-minute phone-based interview to consenting participants to assess their knowledge about different aspe…
Secondary distribution of HIV self-test kits from males to their female sexual partners in two fishing communities in rural Uganda
Secondary distribution of HIV self-test kits from females to their male partners has increased HIV testing rates in men but little evidence exists on the potential for HIV self-test kits distribution from males to their female partners. We assessed the acceptability of secondary HIV self-test kits distribution from males to their female sexual partners in a fishing community context. This secondary analysis used data from the PE er-led HIV S elf-…
Sexual and nonsexual violence and mental health among male refugees from the Democratic Republic of Congo residing in Kampala, Uganda
We conducted a population-based survey in 2013 in Kampala, Uganda, to examine violence and mental health outcomes among self-settled male refugees from the Eastern Democratic Republic of Congo (DRC). Male DRC refugees aged 18+ years were sampled through respondent-driven sampling. Key interview domains included demographics, experiences of sexual and nonsexual violence, social support, PTSD, depression and suicide ideation. Data analysis was weig…
Social Influences on Engagement With HIV Testing, Treatment and Care Services Among Men Who Have Sex With Men Living in Rural Uganda
Men who have sex with men in Uganda are a heterogenous, discriminated population, experiencing high HIV burden, limited access to HIV testing, and low treatment adherence. We contribute to the lack of information about men who have sex with men in rural Uganda by using socio-ecological analyses to examine the social influences shaping their engagement with HIV services. Based on in-depth interviews with 16 men, our findings reveal the inhibitive …
Cardiovascular (Framingham) and type II diabetes (Finnish Diabetes) risk scores
While most items of the FRS and FINDRISC were generally well understood, physical activity needs further clarification. It is important to consider the seasonality of fruits and vegetables, especially in rural resource-poor settings. Current risk scores will need to be locally adapted to estimate the 10-year risk of cardiovascular diseases and type 2 diabetes in this setting
Conflict-related violence and mental health among self-settled Democratic Republic of Congo female refugees in Kampala, Uganda – a respondent driven sampling survey
Refugee women self-settled in Kampala reported high lifetime experiences of violence and traumatic events including rape, as well as high rates of PTSD and depression. Future programming addressing self-settled refugees and their settlement in host countries may benefit from including local and national integration strategies
Peer-leaders’ experiences and challenges in distributing HIV self-test kits in a rural fishing community, Rakai, Uganda
A majority of the peer-leaders successfully distributed the kits to their social network members save for a few who experienced challenges. These findings suggest that lay people can be trained as effective HIV self-test kits distributors to improve the distribution of kits in the community
Understanding and managing HIV infection risk among men who have sex with men in rural Uganda
Our findings illustrate that MSM in rural settings in Uganda are making concerted efforts to implement strategies that might reduce risk of HIV transmission and infection within their sexual relationships. Key HIV health promotion and service-related strategies to support MSM with these efforts include an effective condom and lubricant supply chain; a PrEP program in trusted local health units, implemented via discreet community-outreach mechanis…
Enhancers and barriers to uptake of male circumcision services in Northern Uganda
Uganda adopted voluntary medical male circumcision (VMMC) in 2010, but uptake remains disproportionately low in the Northern region despite implementing several demand creation strategies. This study explored the socio-cultural and structural enhancers and barriers to uptake of VMMC services in Gulu, a district in Northern Uganda where uptake is lowest. In September 2016, we conducted 19 focus group discussions, 9 in-depth interviews, and 11 key …
Formative research to inform the development of a peer-led HIV self-testing intervention to improve HIV testing uptake and linkage to HIV care among adolescents, young people and adult men in Kasenser…
Our study shows that peer-led HIVST is potentially acceptable in the fishing community. These findings suggest that this approach can improve uptake of HIV testing and linkage to HIV care services among populations that are usually missed through conventional HIV testing services
Using geographical data and rolling statistics for diagnostics of respondent-driven sampling
Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda
There are limited data on the impact of antiretroviral therapy (ART) on population-level adult mortality in sub-Saharan Africa. We analysed data for 2000-14 from the Rakai Community Cohort Study (RCCS) in Uganda, where free ART was scaled up after 2004. Using non-parametric and parametric (Weibull) survival analysis, we estimated trends in average person-years lived between exact ages 15 and 50, per capita life-years lost to HIV, and the mortalit…
Knowledge on voluntary medical male circumcision in a low uptake setting in northern Uganda
Misconceptions regarding change in sexual drive or performance were associated with circumcision status in this population, while knowledge of VMMC benefits, risks and procedure was not
The impact of intimate partner violence on women's contraceptive use
Perceptions of Adolescent Pregnancy Among Teenage Girls in Rakai, Uganda
The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant g…
Burden and characteristics of HIV infection among female sex workers in Kampala, Uganda – a respondent-driven sampling survey
One in three FSW in Kampala is HIV-infected, suggesting a severe HIV epidemic in this population. Intensified interventions are warranted to increase condom use, HIV testing, STI screening, as well as antiretroviral treatment and pre-exposure prophylaxis along with measures to overcome gender-based violence
Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda
BACKGROUND: Intimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination of IPV prevention and HIV services would reduce IPV and HIV incidence in individuals enrolled in the Rakai Community Cohort Study (RCCS), Rakai, Uganda. METHODS: We used pre-existing clusters of communities randomised as part of a previous family planning trial in this cohort. Four intervention group clusters from th…
Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda
BACKGROUND: Studies show that uptake of couples' HIV counseling and testing (couples' HCT) can be affected by individual, relationship, and socioeconomic factors. However, while couples' HCT uptake can also be affected by background HIV prevalence and awareness of the existence of couples' HCT services, this is yet to be documented. We explored the correlates of previous couples' HCT uptake among married individuals in a rural Ugandan district wi…
Mobility among youth in Rakai, Uganda
Mobility, including migration and travel, influences risk of HIV. This study examined time trends and characteristics among mobile youth (15-24 years) in rural Uganda, and the relationship between mobility and risk factors for HIV. We used data from an annual household census and population-based cohort study in the Rakai district, Uganda. Data on in-migration and out-migration were collected among youth (15-24 years) from 43 communities from 199…
Understanding the socio-structural context of high HIV transmission in kasensero fishing community, South Western Uganda
The current combination HIV prevention services by the RHSP need to be enhanced with more government involvement including ensuring sustainable supply of ART and circumcision services since they are reportedly highly demanded. Community involvement through the engagement of popular peers could also help in the campaign to change the HIV predisposing culture, misconceptions and risky social norms of the population. Social Context HIV Transmission …
Effectiveness of Peer Support on Care Engagement and Preventive Care Intervention Utilization Among Pre-antiretroviral Therapy, HIV-Infected Adults in Rakai, Uganda
Combined Intimate Partner Violence and HIV/Aids Prevention in Rural Uganda
Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from the Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes and Respect for Everyone (SHARE) Project between 2005 and 2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence, …
Coercive sex in rural Uganda
HIV status and union dissolution in Sub-saharan Africa
Little is known about the impact of HIV infection on the disruption of families through separation, divorce, and widowhood. Using life tables and multinomial logistic regression, this research examined the influence of HIV status on the risk of separation or divorce and widowhood among women in Rakai, Uganda. The multivariate results revealed that dissolution is more common among HIV-infected women and that infected women in HIV-discordant couple…
Does biological relatedness affect child survival
Objective: We studied child survival in Rakai, Uganda where many children are fostered out or orphaned. Methods: Biological relatedness is measured as the average of the Wrightâ s coefficients between each household member and the child. Instrumen
Trends and Determinants of Contraceptive Use in Rakai District, Uganda, 1995–98
A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15–49 declined significantly from 15 percent to 13 percent. Women practicing family planning fo…
The impact of intimate partner violence on women's contraceptive use
A Public Health Approach to Intimate Partner Violence Prevention in Uganda
Research from Rakai, Uganda, suggests intimate partner violence (IPV) is common and attitudes condoning it are widespread. We used a public health approach to develop and implement an evidence-based IPV prevention intervention named the Safe Homes and Respect for Everyone (SHARE) Project. SHARE was designed on the Transtheoretical Model of behavior change and adapted IPV prevention strategies from Raising Voices and Stepping Stones. SHARE was imp…
Family structure effects on early sexual debut among adolescent girls in Rakai, Uganda
This study assessed the association between household family structure and early sexual debut among adolescent girls, ages 15-19, in rural Rakai District, Uganda. Early sexual debut is associated with detrimental physical, emotional and social outcomes, including increased risk of HIV. However, research on the family's role on adolescents' sexual risk behaviors in sub-Sahara Africa has been minimal and rarely takes into account the varying family…
A Randomized Community Trial of Enhanced Family Planning Outreach in Rakai, Uganda
A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community‐based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community‐…
Contextual Barriers and Motivators to Adult Male Medical Circumcision in Rakai, Uganda
Medical male circumcision (MMC) is a central component of HIV prevention. In this study we examined barriers to and facilitators of MMC in Rakai, Uganda. Interviews and focus groups with MMC acceptors, decliners, and community members were collected and analyzed iteratively. Themes were developed based on immersion, repeated reading, sorting, and coding of data using grounded theory. Pain, medical complications, infertility, lack of empirical eff…
Sexually Transmitted Infection Management, Safer Sex Promotion and Voluntary HIV Counselling and Testing in the Male Circumcision Trial, Rakai, Uganda
If circumcised men believe that they are protected from HIV there is a possibility that they will compensate for their perceived risk reduction by engaging in higher risk behaviours thereby mitigating any benefit of circumcision in preventing HIV infection. Some observational studies have shown that circumcised men engage in higher risk behaviours than uncircumcised men and the Orange Farm trial in South Africa found circumcised men to have sligh…
Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1
BACKGROUND AND METHODS: We examined the influence of viral load in relation to other risk factors for the heterosexual transmission of human immunodeficiency virus type 1 (HIV-1). In a community-based study of 15,127 persons in a rural district of Uganda, we identified 415 couples in which one partner was HIV-1-positive and one was initially HIV-1-negative and followed them prospectively for up to 30 months. The incidence of HIV-1 infection per 1…
Trends and Determinants of Contraceptive Use in Rakai District, Uganda, 1995–98
A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15–49 declined significantly from 15 percent to 13 percent. Women practicing family planning fo…
Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda
Age Differences in Sexual Partners and Risk of HIV-1 Infection in Rural Uganda
OBJECTIVES: To assess whether differences in age between sexual partners affect the risk of HIV infection in female adolescents and young adults. METHODS: A total of 6177 ever sexually active women aged 15 to 29 years completed a sociodemographic and sexual behavior questionnaire and provided a blood sample for HIV-1 serology. The age difference between partners was categorized as men 0 to 4 years older (referent group), 5 to 9 years older and 10…
Does biological relatedness affect child survival
Objective: We studied child survival in Rakai, Uganda where many children are fostered out or orphaned. Methods: Biological relatedness is measured as the average of the Wrightâ s coefficients between each household member and the child. Instrumen
Measuring quality of life among HIV-infected women using a culturally adapted questionnaire in Rakai district, Uganda
To examine self-reported quality of life and health status of HIV-infected women and a comparison sample of HIV-uninfected women in rural Uganda, we culturally adapted a Lugandan version of the Medical Outcomes Survey-HIV (MOS-HIV). We administered a cross-sectional survey among 803 women (239 HIV-positive and 564 HIV-negative) enrolled in a community study to evaluate maternal and child health in Rakai District, Uganda. The interview took 20 min…
Burden of infection among heads and non-head of rural households in Rakai, Uganda
The objective was to determine HIV prevalence, symptomatology and mortality among adult heads and non-heads of households, in order to assess the burden of HIV on households. It was a community study of 11,536 adults aged 15-59, residing in 4,962 households in 56 villages, Rakai district, Uganda. First, 4,962 heads and 6,574 non-heads of households were identified from censuses. Interviews were then used to determine socio-demographic/behavioural…
HIV status and union dissolution in Sub-saharan Africa
Little is known about the impact of HIV infection on the disruption of families through separation, divorce, and widowhood. Using life tables and multinomial logistic regression, this research examined the influence of HIV status on the risk of separation or divorce and widowhood among women in Rakai, Uganda. The multivariate results revealed that dissolution is more common among HIV-infected women and that infected women in HIV-discordant couple…
Coercive sex in rural Uganda
Rates of HIV‐1 Transmission per Coital Act, by Stage of HIV‐1 Infection, in Rakai, Uganda
BACKGROUND: We estimated rates of human immunodeficiency virus (HIV)-1 transmission per coital act in HIV-discordant couples by stage of infection in the index partner. METHODS: We retrospectively identified 235 monogamous, HIV-discordant couples in a Ugandan population-based cohort. HIV transmission within pairs was confirmed by sequence analysis. Rates of transmission per coital act were estimated by the index partner's stage of infection (rece…
Immunisation coverage among children born to HIV-infected women in Rakai district, Uganda
To evaluate the impact of maternal HIV-infection on routine childhood Immunisation coverage, we compared the Immunisation status of children born to HIV-infected and HIV-uninfected women in rural Uganda. The study population was 214 HIV(+) and 578 HIV(-) women with children aged 6 to 35 months previously enrolled in a community study to evaluate maternal and child health in Rakai District, Uganda. Sampling of subjects for interview was stratified…
Uganda’s HIV Prevention Success
The paper by Green et al. (vol. 10, this issue, AIDS and Behavior). on "Uganda's HIV Prevention Success" concludes that "a decline in multipartner sexual behavior" is the most likely explanation for the declines in HIV prevalence. However, this article neither addresses the inconsistencies in the available behavioral data, nor considers epidemiologic factors that may affect HIV prevalence. The latter include the fact that prevalence is a product …
Repeat Voluntary HIV Counseling and Testing (VCT), Sexual Risk Behavior and HIV Incidence in Rakai, Uganda
Male circumcision for HIV prevention in men in Rakai, Uganda
Alcohol Use, Intimate Partner Violence, Sexual Coercion and HIV among Women Aged 15–24 in Rakai, Uganda
Sexually Transmitted Infection Management, Safer Sex Promotion and Voluntary HIV Counselling and Testing in the Male Circumcision Trial, Rakai, Uganda
If circumcised men believe that they are protected from HIV there is a possibility that they will compensate for their perceived risk reduction by engaging in higher risk behaviours thereby mitigating any benefit of circumcision in preventing HIV infection. Some observational studies have shown that circumcised men engage in higher risk behaviours than uncircumcised men and the Orange Farm trial in South Africa found circumcised men to have sligh…
The history and challenge of HIV prevention
Health professionals for a new century
Disclosure of HIV results among discordant couples in Rakai, Uganda
Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision…
A Randomized Community Trial of Enhanced Family Planning Outreach in Rakai, Uganda
A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community‐based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community‐…
Building capacity for HIV/Aids program leadership and management in Uganda through mentored Fellowships
The Fellowship Program offers a unique opportunity for hands-on training in HIV/AIDS program leadership and management for both Fellows and host institutions
Exploring new health markets
BACKGROUND: Although a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access…
A grander challenge
BACKGROUND: "Grand challenges" in global health have focused on discovery and development of technologies to save lives. The "grander challenge" involves building institutions, systems, capacity and demand to effectively deliver strategies to improve health. In 2008, Makerere University began a radical institutional change to bring together four schools under one College of Health Sciences. This paper's objective is to demonstrate how its leaders…
Increasing access to institutional deliveries using demand and supply side incentives
BACKGROUND: Geographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services a…
Profesionales de la salud para el nuevo siglo
Medicine (57 obras) · Environmental health (37 obras) · Demography (35 obras) · Population (34 obras) · Adolescent Sexual and Reproductive Health (31 obras) · HIV/AIDS Research and Interventions (31 obras) · Public health (21 obras) · Family medicine (20 obras) · Nursing (20 obras) · Demography (18 obras)