Renee Heffron
Dados Biográficos
| ID | 6764294 |
|---|---|
| NOME | Renee Heffron |
| PRENOMES | Renee |
| SOBRENOME | Heffron |
| ASSINATURA | HEFFRON R |
| AFILIAÇÕES | University of Washington |
| ORCID | 0000-0001-6039-0352 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 41 |
| TOTAL DE CITAÇÕES | 0 |
| TOTAL COMO AUTOR | 41 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2013 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 0 |
Development of a Self-administered Sexual Behavior Assessment Tool to Facilitate Self-reflection by Young Women in South Africa About HIV/STI Risk
Self-assessment of sexual behavior may empower adolescent girls and young women (AGYW) to reflect on HIV/STI risk and adopt prevention strategies. We developed a web-based sexual behavior self-assessment tool providing real-time feedback based on a numeric score and examined associations of scores with STI detection and HIV pre-exposure prophylaxis (PrEP) initiation among AGYW in South Africa. The tool was implemented as part of PALESA, a pilot r…
Acceptability and Feasibility of Home-Based Human Papillomavirus Self-Testing as Primary Screening for Cervical Cancer Detection in the State of Alabama
Alabama has the highest cervical cancer mortality and sixth highest incidence rates nationwide. We assessed the acceptability and feasibility of at-home HPV self-testing for cervical cancer screening in Alabama. Eligible women (ages 30–64y, no Pap last 3.5y, not being pregnant, no hysterectomy history, and satisfying either rural residency or being African American) were recruited by community health workers (CHW), foodbanks, churches, and truste…
Expanding the reach of HIV pre-exposure prophylaxis (PrEP) among Kenyan adolescent girls and young women
Adolescent girls and young women (AGYW) seeking post-abortal care (PAC) remain at risk of unintended pregnancies and HIV due to infrequent condom use. Integrating HIV prevention services, such as PrEP, into PAC services offers an opportunity to enhance reach, uptake, and efficiency, particularly in high-burden settings like Kenya. However, data on acceptability, feasibility, and sustainability of PAC clinics as entry points for PrEP is limited. A…
Acceptability of secondary distribution of HIV self-testing kits in central Kenya
The secondary distribution of HIV self-testing (HIVST) kits has the potential to improve access and uptake of HIV testing. This study assessed the acceptability of secondary distribution of HIVST by people living with HIV (PLHIV) to their sexual partners in Central Kenya and explored the broader perspectives on this strategy. Conducted between November 2019 and April 2023, the study was nested within an interventional study that implemented two a…
High Preference for Injectable Pre-exposure Prophylaxis among Young Women in Kenya
Impact of Covid-19 Public Health Measures on Antiretroviral Therapy Use Among Ugandans Living with HIV in Sero-Different Couples
Antiretroviral therapy (ART) use and HIV suppression among people living with HIV (PLHIV) are critical for HIV control and prevention. Extreme restrictions on movement early during the COVID-19 pandemic in Uganda may have impeded the ability to initiate and sustain access to and use of ART. From our stepped-wedge cluster-randomized trial of an integrated PrEP and ART intervention for HIV-serodifferent couples at 12 ART clinics in Uganda, we ident…
How PrEP delivery was integrated into public ART clinics in central Uganda
Tailored delivery strategies are important for optimizing the benefit and overall reach of PrEP in sub-Saharan Africa. An integrated approach of delivering time-limited PrEP in combination with ART to serodifferent couples encourages PrEP use in the HIV-negative partner as a bridge to sustained ART use. Although PrEP has been delivered in ART clinics for many years, the processes involved in integrating PrEP into ART services are not well underst…
Implementation of gender-based violence screening guidelines in public HIV treatment programs
Background HIV and gender-based violence (GBV) intersect to threaten population health. The Uganda Ministry of Health recommends routine GBV screening alongside HIV care but evidence detailing its implementation in HIV care settings is limited. We evaluated screening practices in public HIV clinics to generate evidence supporting GBV screening optimization. Methods To evaluate GBV screening implementation in antiretroviral therapy (ART) clinics, …
Efficacy of the Dapivirine Vaginal Ring Accounting for Imperfect Adherence
Behavioral Modeling and its Association with PrEP and ART Use in Ugandan HIV-Serodifferent Couples
Integrating Pre-Exposure Prophylaxis (PrEP) delivery into Antiretroviral Therapy (ART) programs bridges the Human Immunodeficiency Virus (HIV) prevention gap for HIV-serodifferent couples prior to the partner living with HIV achieving viral suppression. Behavioral modeling is one mechanism that could explain health-related behavior among couples, including those using antiretroviral medications, but few tools exist to measure the extent to which …
The Effect of Stigma on Family Planning and HIV Pre-exposure Prophylaxis Decisions of Young Women Accessing Post-Abortion Care in Kenya
Adolescent girls and young women (AGYW) in Eastern and Southern Africa face parallel epidemics of unintended pregnancy and HIV. Their sexual health decisions are often dominated by intersecting stigmas. In an implementation science project integrating delivery of daily, oral pre-exposure prophylaxis (PrEP) for HIV prevention into 14 post-abortion care (PAC) clinics in Kenya, we enrolled a subset of PrEP initiating AGYW (aged 15 to 30 years) into …
Depression and PrEP uptake, interruption, and adherence among young women in Uganda
Depression is a common cause of morbidity globally and can impact adherence to medications, posing challenges to medication-based HIV prevention. The objectives of this work are to describe the frequency of depression symptoms in a cohort of 499 young women in Kampala, Uganda and to determine the association of depression symptoms with use of HIV pre-exposure prophylaxis (PrEP). Mild or greater depression, assessed by the patient health questionn…
Post-trial access to and use of pre-exposure prophylaxis in Durban, South Africa
We identified several barriers to post-trial PrEP access. Strategies to enhance PrEP access such as a reduction in waiting queues, convenient facility operating hours, and making PrEP more widely available and accessible are needed. It is also worth noting that oral PrEP access has expanded in South Africa from 2018 till now and this could improve access to PrEP for participants exiting trials who desire to continue PrEP
Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda
Peer delivery of HIVST and oral PrEP was feasible and acceptable to this sample of young women with suboptimal PrEP adherence in Uganda. Future larger controlled studies should evaluate its effectiveness among African AGWY
How Central Ugandan HIV Clinics Adapted During Covid-19 Lockdown Restrictions to Promote Continuous Access to Care
Health Care Worker Perspectives of HIV Pre-exposure Prophylaxis Service Delivery in Central Uganda
Background: Scale-up of HIV pre-exposure prophylaxis (PrEP) services in Uganda is ongoing. However, health care workers (HCWs) may not be aware of PrEP nor what offering this service entails. We explored the impact of standardized HCW training on the knowledge and perspectives of PrEP service delivery in Uganda. Methods: We recruited HCWs from facilities that offered HIV-related services in Central Uganda. Using the Uganda Ministry of Health curr…
ART initiation among women newly diagnosed with HIV in a contraceptive trial in sub-Saharan Africa
Current guidelines recommend starting antiretroviral therapy (ART) as soon as possible after HIV diagnosis to reduce morbidity, mortality and onward HIV transmission. We examined factors influencing ART initiation by women who seroconverted during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial. ECHO, conducted between 2015 and 2018, enrolled HIV-negative, sexually active women, aged 16-35 years, from four African countries. …
Post-randomization Differences in Condomless Vaginal Sex Among Women Randomized to Intramuscular Depot Medroxyprogesterone Acetate Injections, a Copper Intrauterine Device or a Levonorgestrel Implant …
The Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial found no substantial difference in HIV acquisition risk between women randomised to injectable intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (Cu-IUD) or the levonorgestrel (LNG) implant. We evaluated post-randomization sexual behavior using an objective marker of condomless vaginal sex in a subset of participants. We conducted a sub-study …
A novel “HIV salience and Perception” scale is associated with PrEP dispensing and adherence among adolescent girls and young women in Kampala, Uganda
“Being a Person of Color in This Institution Is Exhausting”
Learning climate greatly affects student achievement. This qualitative study aimed to understand community definitions of climate; share lived experiences of students, faculty, and staff; and define priority areas of improvement in the University of Washington School of Public Health (UWSPH). Between March-May 2019, 17 focus group discussions were conducted–stratified by role and self-identified race/ethnicity, gender and sexual orientation–among…
Perceived Social Influences on Women's Decisions to use Medications not Studied in Pregnancy. A Qualitative Ethical Analysis of Preexposure Prophylaxis Implementation Research in Kenya
Implementation research ethics can be particularly challenging when pregnant women have been excluded from earlier clinical stages of research given greater uncertainty about safety and efficacy in pregnancy. The evaluation of human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) during pregnancy offered an opportunity to understand important ethical considerations and social influences shaping women's decisions to participate in the …
The influence of HIV‐related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082
Adherence to recommendations for ART and targeted PrEP use among HIV serodiscordant couples in East Africa
Half of participants completed the PrEP as a bridge to ART strategy and the majority stopped PrEP as recommended. These findings suggest that targeting PrEP to periods of risk is a promising approach; however, tailoring counseling around aligning PrEP use and HIV risk will be important for optimal strategy implementation
Exploring the Use of Oral Pre-exposure Prophylaxis (PrEP) Among Women from Durban, South Africa as Part of the HIV Prevention Package in a Clinical Trial
HIV endpoint-driven clinical trials in Africa enroll women who are at heightened risk of acquiring HIV. In 2017, the South African Medical Research Council recommended the provision of oral pre-exposure prophylaxis (PrEP) in HIV prevention trials, at which time the Evidence for Contraceptive Options and HIV Outcomes trial was ongoing and began to provide PrEP on-site at some trial sites. We interviewed 132 women who initiated PrEP on-site at the …
The Effect of Depression on Adherence to HIV Pre-exposure Prophylaxis Among High-Risk South African Women in HPTN 067/Adapt
Sem obras proeminentes nesta página.
Daily Short Message Service Surveys to Measure Sexual Behavior and Pre-exposure Prophylaxis Use Among Kenyan Men and Women
My intention was a child but I was very afraid
We sought to understand fertility intentions and HIV risk considerations among Kenyan HIV-serodiscordant couples who became pregnant during a prospective study. We conducted individual in-depth interviews (n = 36) and focus group discussions (n = 4) and performed qualitative data analysis and interpretation using an inductive approach. Although most of the couples were aware of the risk of horizontal and vertical HIV transmission, almost all coup…
Preferences for Daily or Intermittent Pre-exposure Prophylaxis Regimens and Ability to Anticipate Sex Among HIV Uninfected Members of Kenyan HIV Serodiscordant Couples
Gendered differences in the perceived risks and benefits of oral PrEP among HIV-serodiscordant couples in Kenya
Pre-exposure prophylaxis (PrEP) is effective for preventing HIV among HIV-serodiscordant heterosexual couples. Gender roles may influence perceived personal and social risks related to HIV-prevention behaviors and may affect use of PrEP. In this study, interviews and focus groups were conducted with 68 individuals from 34 mutually disclosed serodiscordant heterosexual partnerships in Thika, Kenya. Sociocultural factors that affect adherence to Pr…
“I never thought that it would happen … ” Experiences of HIV seroconverters among HIV-discordant partnerships in a prospective HIV prevention study in Kenya
In spite of access to behavioral and biomedical HIV prevention strategies, HIV transmission occurs. For HIV-serodiscordant couples, prevention programs can be tailored to address individual and couples' needs to preserve their relationship while minimizing HIV risk. Programs for serodiscordant couples may benefit from learning from experiences of couples who transmit HIV. We conducted 20 individual in-depth interviews with 10 initially HIV-serodi…
Objective Measurement of Inaccurate Condom Use Reporting Among Women Using Depot Medroxyprogesterone Acetate for Contraception
Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda
Fertility Intentions, Pregnancy, and Use of PrEP and ART for Safer Conception Among East African HIV Serodiscordant Couples
Consensus statement
Safer conception interventions reduce HIV incidence while supporting the reproductive goals of people living with or affected by HIV. We developed a consensus statement to address demand, summarize science, identify information gaps, outline research and policy priorities, and advocate for safer conception services. This statement emerged from a process incorporating consultation from meetings, literature, and key stakeholders. Three co-authors d…
Fertility desires and preferences for safer conception strategies among people receiving care for HIV at a publicly-funded clinic in Seattle, WA
Understanding fertility desires and preferences for HIV prevention among individuals living with HIV, including the potential use of pre-exposure prophylaxis (PrEP) by HIV uninfected partners, can inform the delivery of safer conception counseling to reduce the risk of HIV transmission during pregnancy attempts. Men and women, predominantly heterosexual, engaged in HIV care in Seattle, WA, self-administered a questionnaire and we abstracted antir…
Safer conception among HIV-1 serodiscordant couples in East Africa
For HIV-1 serodiscordant couples, HIV-1 exposure and risk of transmission is heightened during pregnancy attempts, but safer conception strategies can reduce risk. As safer conception programs are scaled up, understanding couples' preferences and experiences can be useful for programmatic recommendations. We followed 1013 high-risk, heterosexual HIV-1 serodiscordant couples from Kenya and Uganda for two years in an open-label delivery study of in…
Lessons from PrEP
This study explored how multinational HIV experts weigh clinical, evidential, and ethical considerations regarding pre-exposure prophylaxis in pregnant/breastfeeding women. Semi-structured interviews were conducted with experts in HIV policy, research, treatment, and implementation from three global regions. A constant comparative approach identified major themes. Experts noted that exclusion of pregnant women from research limits evidence regard…
Short Message Service (SMS) Surveys Assessing Pre-exposure Prophylaxis (PrEP) Adherence and Sexual Behavior are Highly Acceptable Among HIV-Uninfected Members of Serodiscordant Couples in East Africa
Patterns of Oral PrEP Adherence and HIV Risk Among Eastern African Women in HIV Serodiscordant Partnerships
No Evidence of Sexual Risk Compensation Following PrEP Initiation Among Heterosexual HIV Serodiscordant Couples in Kenya and Uganda
Recent studies among men who have sex with men suggest that sexual behaviors associated with risk of sexually transmitted infections increase following initiation of pre-exposure prophylaxis (PrEP) for HIV prevention. We used longitudinal data from HIV-uninfected participants (n = 1013) enrolled in an open-label study of PrEP delivered to Ugandan and Kenyan heterosexual HIV serodiscordant couples to understand the association between PrEP initiat…
The influence of HIV‐related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082
Adherence to recommendations for ART and targeted PrEP use among HIV serodiscordant couples in East Africa
Half of participants completed the PrEP as a bridge to ART strategy and the majority stopped PrEP as recommended. These findings suggest that targeting PrEP to periods of risk is a promising approach; however, tailoring counseling around aligning PrEP use and HIV risk will be important for optimal strategy implementation
Exploring the Use of Oral Pre-exposure Prophylaxis (PrEP) Among Women from Durban, South Africa as Part of the HIV Prevention Package in a Clinical Trial
HIV endpoint-driven clinical trials in Africa enroll women who are at heightened risk of acquiring HIV. In 2017, the South African Medical Research Council recommended the provision of oral pre-exposure prophylaxis (PrEP) in HIV prevention trials, at which time the Evidence for Contraceptive Options and HIV Outcomes trial was ongoing and began to provide PrEP on-site at some trial sites. We interviewed 132 women who initiated PrEP on-site at the …
The Effect of Depression on Adherence to HIV Pre-exposure Prophylaxis Among High-Risk South African Women in HPTN 067/Adapt
Sexual Behavior and Perceived HIV Risk Among HIV-Negative Members of Serodiscordant Couples in East Africa
“Being a Person of Color in This Institution Is Exhausting”
Learning climate greatly affects student achievement. This qualitative study aimed to understand community definitions of climate; share lived experiences of students, faculty, and staff; and define priority areas of improvement in the University of Washington School of Public Health (UWSPH). Between March-May 2019, 17 focus group discussions were conducted–stratified by role and self-identified race/ethnicity, gender and sexual orientation–among…
Perceived Social Influences on Women's Decisions to use Medications not Studied in Pregnancy. A Qualitative Ethical Analysis of Preexposure Prophylaxis Implementation Research in Kenya
Implementation research ethics can be particularly challenging when pregnant women have been excluded from earlier clinical stages of research given greater uncertainty about safety and efficacy in pregnancy. The evaluation of human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) during pregnancy offered an opportunity to understand important ethical considerations and social influences shaping women's decisions to participate in the …
Health Care Worker Perspectives of HIV Pre-exposure Prophylaxis Service Delivery in Central Uganda
Background: Scale-up of HIV pre-exposure prophylaxis (PrEP) services in Uganda is ongoing. However, health care workers (HCWs) may not be aware of PrEP nor what offering this service entails. We explored the impact of standardized HCW training on the knowledge and perspectives of PrEP service delivery in Uganda. Methods: We recruited HCWs from facilities that offered HIV-related services in Central Uganda. Using the Uganda Ministry of Health curr…
ART initiation among women newly diagnosed with HIV in a contraceptive trial in sub-Saharan Africa
Current guidelines recommend starting antiretroviral therapy (ART) as soon as possible after HIV diagnosis to reduce morbidity, mortality and onward HIV transmission. We examined factors influencing ART initiation by women who seroconverted during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial. ECHO, conducted between 2015 and 2018, enrolled HIV-negative, sexually active women, aged 16-35 years, from four African countries. …
Post-randomization Differences in Condomless Vaginal Sex Among Women Randomized to Intramuscular Depot Medroxyprogesterone Acetate Injections, a Copper Intrauterine Device or a Levonorgestrel Implant …
The Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial found no substantial difference in HIV acquisition risk between women randomised to injectable intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (Cu-IUD) or the levonorgestrel (LNG) implant. We evaluated post-randomization sexual behavior using an objective marker of condomless vaginal sex in a subset of participants. We conducted a sub-study …
HIV/AIDS Research and Interventions (38 obras) · Medicine (37 obras) · Adolescent Sexual and Reproductive Health (28 obras) · Family medicine (28 obras) · Public health (23 obras) · HIV, Drug Use, Sexual Risk (21 obras) · Human immunodeficiency virus (HIV (20 obras) · Nursing (19 obras) · Men who have sex with men (18 obras) · Pre-exposure prophylaxis (18 obras)