Integration of HIV and Sexual and Reproductive Health Services

Girl Power

Evaluating a Combination HIV Prevention and Sexual and Reproductive Health Package for at-risk Young Women: A Demonstration Project

Girl Power was a multi-site study designed to compare models of sexual and reproductive health service delivery for adolescent girls and young women. Girl Power compared a model of youth-friendly health services to the standard of care in Lilongwe, Malawi and Cape Town, South Africa. This model resulted in nearly universal uptake of HIV testing and condoms among young women. We also developed a clinical risk score for identifying which adolescent girls and young women were most likely to acquire HIV and benefit from additional prevention interventions.

    1. Graybill LA, et al. The effect of youth-friendly health services on risk of pregnancy among adolescent girls and young women in Lilongwe, Malawi: a secondary analysis of the girl power-Malawi study. Am J Epidemiol. 2024. [PubMed]

    2. Grundy SJ, et al. Intimate Partner Violence and Contraception among Adolescent Girls and Young Women: A Longitudinal Analysis of the Girl Power-Malawi Cohort. J Pediatr Adolesc Gynecol. 2022. [Full Text]

    3. Bhushan NL, et al. The mediating role of partner communication on contraceptive use among adolescent girls and young women participating in a small-group intervention in Malawi: A longitudinal analysis. Glob Public Health. 2022. [Full Text]

    4. Bhushan NL, et al. Contraceptive Conversations among Adolescent Girls and Young Women and Their Partners, Peers, and Older Female Family Members in Lilongwe, Malawi: A QualitativeAnalysis. Stud Fam Plann. 2021. [Full Text]

    5. Gichane MW, et al. Individual and Relationship-Level Correlates of Transactional Sex Among Adolescent Girls and Young Women in Malawi: A Multilevel Analysis. AIDS Behav. 2022. [Full Text]

    6. Bhushan NL, et al. Communication, social norms, and contraceptive use among adolescent girls and young women in Lilongwe, Malawi. Women Health. 2021. [Full Text]

    7. Rosenberg NE, et al. Identifying Adolescent Girls and Young Women at High Risk for HIV Acquisition: A Risk Assessment Tool From the Girl Power-Malawi Study. Sex Transm Dis. 2020. [Full Text]

    8. Gichane MW, et al. Socioeconomic Predictors of Transactional Sex in a Cohort of Adolescent Girls and Young Women in Malawi: A Longitudinal Analysis. AIDS Behav. 2020. [PubMed]

    9. Hill LM, et al. HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade. J Int AIDS Soc. 2020. [Full Text]

    10. Brar SK, et al. The relationship between intimate partner violence and probable depression among adolescent girls and young women in Lilongwe, Malawi. Glob Public Health. 2020. [PubMed]

    11. Maseko B, et al. Perceptions of and interest in HIV pre-exposure prophylaxis use among adolescent girls and young women in Lilongwe, Malawi. PLoS One. 2020. [Full Text]

    12. Price JT, et al. Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi. J Acquir Immune Defic Syndr. 2018. [Full Text]

    13. Rosenberg NE, et al. Comparing four service delivery models for adolescent girls and young women through the 'Girl Power' study: protocol for a multisite quasi-experimental cohort study. BMJ Open. 2017. [Full Text]

    14. Rosenberg NE, et al. Assessing the Impact of a Small-Group Behavioral Intervention on Sexual Behaviors Among Adolescent Girls and Young Women in Lilongwe Malawi: A Quasi-Experimental Cohort Study. AIDS Behav. 2020.[Full Text]

    15. Rosenberg NE, et al. Comparing Youth-Friendly Health Services to the Standard of Care Through "Girl Power-Malawi": A Quasi-Experimental Cohort Study. J Acquir Immune Defic Syndr. 2018. [Full Text]

    16. Turner A, et al. “Prevalence and Correlates of Anal Sex among Adolescent Girls and Young Women in Lilongwe, Malawi and Cape Town, South Africa.” IUSTI World + European Congress, Dublin, Ireland, 2018 (oral presentation).

Project Dates:
04/2015 - 10/2017

Role:
Principal Investigator

Funder:
Evidence for HIV Prevention in Southern Africa, a DFID program, managed by Mott MacDonald

VITAL Start for Adolescents (VS4A)

Project Dates:
07/2023 - 06/2028

Role:
Co-Investigator

PI:
Saeed Ahmed

Funder:
NIMHD
1UG1HD113252

VS4A: Video-Intervention to Inspire Treatment Adherence for Adolescents living with HIV

We are adapting and evaluating a tailored video-based counseling package for adolescents living with HIV. If effective, VS4A can be a scalable tool to improve service delivery, while also liberating health worker time and reducing health system burden in Malawi.

PURE Malawi

Project Dates:
09/2012 - 08/2016

Role:
Co-Investigator

PI:
Sam Phiri

Funder:
Canadian International Development Agency (CIDA); Mechanism: INSPIRE

Improving uptake and retention in PMTCT services through novel approaches in family supported care and in community peer outreach support in Malawi

The PMTCT Uptake and Retention study (PURE Malawi) was a cluster randomized controlled trial that compared two models of peer support to the standard of care. Our study found that both models of care improved retention for pregnant women living with HIV in Malawi.

    1. Rosenberg NE, et al. Improving PMTCT uptake and retention services through novel approaches in peer-based family-supported care in the clinic and community: a 3-arm cluster randomized trial (PURE Malawi). J Acquir Immune Defic Syndr. 2014. [Full Text]

    2. Puchalski Ritchie LM, et al. What interventions are effective in improving uptake and retention of HIV-positive pregnant and breastfeeding women and their infants in prevention of mother to child transmission care programmes in low-income and middle-income countries? A systematic review and meta-analysis. BMJ Open. 2019. [Full Text]

    3. Phiri S, et al. Impact of Facility- and Community-Based Peer Support Models on Maternal Uptake and Retention in Malawi's Option B+ HIV Prevention of Mother-to-Child Transmission Program: A 3-Arm Cluster Randomized Controlled Trial (PURE Malawi). J Acquir Immune Defic Syndr. 2017. [PubMed]

    4. Hosseinipour M, et al. Viral Suppression and HIV Drug Resistance at 6 Months Among Women in Malawi's Option B+ Program: Results From the PURE Malawi Study. J Acquir Immune Defic Syndr. 2017. [Full Text]

    5. van Lettow M, et al. Baseline characteristics of study sites and women enrolled in a three-arm cluster randomized controlled trial: PMTCT uptake and retention (pure) Malawi. Reprod Health. 2017. [Full Text]

    6. Cataldo F, et al. Exploring the Experiences of Women and Health Care Workers in the Context of PMTCT Option B Plus in Malawi. J Acquir Immune Defic Syndr. 2017. [Full Text]

    7. Chiwaula LS, et al. The value of informal care in the context of option B+ in Malawi: a contingent valuation approach. BMC Health Serv Res. 2016. [Full Text]

    8. Puchalski Ritchie LM, et al. The effectiveness of interventions to improve uptake and retention of HIV-infected pregnant and breastfeeding women and their infants in prevention of mother-to-child transmission care programs in low- and middle-income countries: protocol for a systematic review and meta-analysis. Syst Rev. 2015. [Full Text]

PHASES

Project Dates:
01/2017 - 07/2017

Role:
Co-Investigator

PI:
Anne Lyerly

Funder:
NIH

The PHASES Project: Pregnancy and HIV/AIDS Seeking Equitable Study

This project characterized reasoning around participation in HIV research during pregnancy from the viewpoints of women to inform development of consensus-driven guidance for conducting HIV research in pregnancy. 

    1. Sullivan K, et al. Views among Malawian women about joining HIV prevention clinical trials when pregnant. AIDS Res Ther. 2020. [Full Text]

    2. Sullivan KA, et al. Women's views about contraception requirements for biomedical research participation. PLoS One. 2019. [Full Text]

    3. Sullivan KA, et al. Women's Views About a Paternal Consent Requirement for Biomedical Research in Pregnancy. J Empir Res Hum Res Ethics. 2018. [Full Text]

Reproductive Health Research

Integrating HIV and reproductive health interventions in settings with high pregnancy incidence and HIV prevalence is critical. I have been a co-investigator on a body of work assessing pregnancy intentions and family planning utilization among a cohort of postpartum women living with and without HIV. I have also supported research around the outcomes of obstetric fistula repair.

    1. Kopp DM, et al. Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study. Infect Dis Obstet Gynecol. 2017. [Full Text]

    2. Lemani C, et al. Contraceptive uptake after training community health workers in couples counseling: A cluster randomized trial. PLoS One. 2017. [Full Text]

    3. Kopp DM, et al. Patterns of Contraceptive Adoption, Continuation, and Switching after Delivery among Malawian Women. PLoS One. 2017. [Full Text]

    4. Tang JH, et al. Association between contraceptive implant knowledge and intent with implant uptake among postpartum Malawian women: a prospective cohort study. Contracept Reprod Med. 2016. [Full Text]

    5. O'Shea MS, et al. Reproductive intentions and family planning practices of pregnant HIV-infected Malawian women on antiretroviral therapy. AIDS Care. 2016. [Full Text]

    6. Sih AM, et al. Association between parity and fistula location in women with obstetric fistula: a multivariate regression analysis. BJOG. 2016. [Full Text]

    7. O'Shea MS, et al. Effect of HIV status on fertility desire and knowledge of long-acting reversible contraception of postpartum Malawian women. AIDS Care. 2015. [Full Text]