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, Westreich D, Maseko B, Phanga T, Nthani T, Vansia D, Chi BH, Daniels JL, Tang JH, Bekker LG, Pettifor AE, Rosenberg NE. 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 Jul 11:kwae193. doi: 10.1093/aje/kwae193. Epub ahead of print. PMID: 38992859. [PubMed]

    2. Grundy SJ, Maman S, Graybill L, Phanga T, Vansia D, Nthani T, Tang JH, Bekker LG, Pettifor A, Rosenberg NE. 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 Dec;35(6):662-668. doi: 10.1016/j.jpag.2022.06.005. Epub 2022 Jul 6. PMID: 35809851; PMCID: PMC10071546. [Full Text]

    3. Bhushan NL, Fisher EB, Gottfredson NC, Maman S, Speizer IS, Phanga T, Vansia D, Mtawali A, Chisinga R, Kapira M, Pettifor AE, Rosenberg NE. 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 Jul;17(7):1392-1405. doi: 10.1080/17441692.2021.1924823. Epub 2021 May 12. PMID: 33977862; PMCID: PMC8586050. [Full Text]

    4. Bhushan NL, Phanga T, Maseko B, Vansia D, Kamtsendero L, Gichane MW, Maman S, Pettifor AE, Rosenberg NE. 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 Dec;52(4):397-413. doi: 10.1111/sifp.12174. Epub 2021 Sep 29. PMID: 34585384; PMCID: PMC8664985. [Full Text]

    5. Gichane MW, Rosenberg NE, Zimmer C, Pettifor AE, Maman S, Maseko B, Moracco KE. Individual and Relationship-Level Correlates of Transactional Sex Among Adolescent Girls and Young Women in Malawi: A Multilevel Analysis. AIDS Behav. 2022 Mar;26(3):822-832. doi: 10.1007/s10461-021-03442-2. Epub 2021 Aug 23. PMID: 34426863; PMCID: PMC8840914. [Full Text]

    6. Bhushan NL, Fisher EB, Maman S, Speizer IS, Gottfredson NC, Phanga T, Vansia D, Pettifor AE, Rosenberg NE. Communication, social norms, and contraceptive use among adolescent girls and young women in Lilongwe, Malawi. Women Health. 2021 May-Jun;61(5):440-451. doi: 10.1080/03630242.2021.1917479. Epub 2021 May 4. PMID: 33941050; PMCID: PMC8182971. [Full Text]

    7. Rosenberg NE, Kudowa E, Price JT, Pettifor A, Bekker LG, Hosseinipour MC, Chagomerana M. 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 Nov;47(11):760-766. doi: 10.1097/OLQ.0000000000001242. PMID: 33045165; PMCID: PMC7574336. [Full Text]

    8. Gichane MW, Moracco KE, Pettifor AE, Zimmer C, Maman S, Phanga T, Nthani T, Rosenberg NE. Socioeconomic Predictors of Transactional Sex in a Cohort of Adolescent Girls and Young Women in Malawi: A Longitudinal Analysis. AIDS Behav. 2020 Dec;24(12):3376-3384. doi: 10.1007/s10461-020-02910-5. PMID: 32405725. [PubMed]

    9. Hill LM, Maseko B, Chagomerana M, Hosseinipour MC, Bekker LG, Pettifor A, Rosenberg NE. 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 Jun;23 Suppl 3(Suppl 3):e25502. doi: 10.1002/jia2.25502. PMID: 32602649; PMCID: PMC7325511. [Full Text]

    10. Brar SK, Beattie TSH, Abas M, Vansia D, Phanga T, Maseko B, Bekker LG, Pettifor AE, Rosenberg NE. The relationship between intimate partner violence and probable depression among adolescent girls and young women in Lilongwe, Malawi. Glob Public Health. 2020 Jun;15(6):865-876. doi: 10.1080/17441692.2020.1718732. Epub 2020 Jan 29. PMID: 31994453. [PubMed]

    11. Maseko B, Hill LM, Phanga T, Bhushan N, Vansia D, Kamtsendero L, Pettifor AE, Bekker LG, Hosseinipour MC, Rosenberg NE. Perceptions of and interest in HIV pre-exposure prophylaxis use among adolescent girls and young women in Lilongwe, Malawi. PLoS One. 2020 Jan 13;15(1):e0226062. doi: 10.1371/journal.pone.0226062. PMID: 31929547; PMCID: PMC6957134. [Full Text]

    12. Price JT, Rosenberg NE, Vansia D, Phanga T, Bhushan NL, Maseko B, Brar SK, Hosseinipour MC, Tang JH, Bekker LG, Pettifor A. Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi. J Acquir Immune Defic Syndr. 2018 Jan 1;77(1):53-63. doi: 10.1097/QAI.0000000000001567. PMID: 28991885; PMCID: PMC5720919. [Full Text]

    13. Rosenberg NE, Pettifor AE, Myers L, Phanga T, Marcus R, Bhushan NL, Madlingozi N, Vansia D, Masters A, Maseko B, Mtwisha L, Kachigamba A, Tang J, Hosseinipour MC, Bekker LG. 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 Dec 14;7(12):e018480. doi: 10.1136/bmjopen-2017-018480. PMID: 29247104; PMCID: PMC5735401. [Full Text]

    14. Rosenberg NE, Gichane MW, Vansia D, Phanga T, Bhushan NL, Bekker LG, Pettifor AE. 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 May;24(5):1542-1550. doi: 10.1007/s10461-019-02669-4. PMID: 31512067; PMCID: PMC7064392. [Full Text]

    15. Rosenberg NE, Bhushan NL, Vansia D, Phanga T, Maseko B, Nthani T, Libale C, Bamuya C, Kamtsendero L, Kachigamba A, Myers L, Tang J, Hosseinipour MC, Bekker LG, Pettifor AE. 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 Dec 1;79(4):458-466. doi: 10.1097/QAI.0000000000001830. PMID: 30085953; PMCID: PMC6203606. [Full Text]

    16. Turner A, Maierhofer C , Myers L , Vansia D , Phanga T , Pettifor A , Bekker L , Rosenberg N. “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, van Lettow M, Tweya H, Kapito-Tembo A, Bourdon CM, Cataldo F, Chiwaula L, Sampathkumar V, Trapence C, Kayoyo V, Kasende F, Kaunda B, Speight C, Schouten E, Eliya M, Hosseinipour M, Phiri S; PURE Malawi Consortium. 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 Nov 1;67 Suppl 2(0 2):S114-9. doi: 10.1097/QAI.0000000000000319. PMID: 25310116; PMCID: PMC4197136. [Full Text]

    2. Puchalski Ritchie LM, van Lettow M, Pham B, Straus SE, Hosseinipour MC, Rosenberg NE, Phiri S, Landes M, Cataldo F; the PURE consortium. 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 Jul 29;9(7):e024907. doi: 10.1136/bmjopen-2018-024907. Erratum in: BMJ Open. 2019 Aug 18;9(8):e024907corr1. doi: 10.1136/bmjopen-2018-024907corr1. PMID: 31362959; PMCID: PMC6677958. [Full Text]

    3. Phiri S, Tweya H, van Lettow M, Rosenberg NE, Trapence C, Kapito-Tembo A, Kaunda-Khangamwa B, Kasende F, Kayoyo V, Cataldo F, Stanley C, Gugsa S, Sampathkumar V, Schouten E, Chiwaula L, Eliya M, Chimbwandira F, Hosseinipour MC; PURE Malawi Consortium. 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 Jun 1;75 Suppl 2:S140-S148. doi: 10.1097/QAI.0000000000001357. PMID: 28498183. [PubMed]

    4. Hosseinipour M, Nelson JAE, Trapence C, Rutstein SE, Kasende F, Kayoyo V, Kaunda-Khangamwa B, Compliment K, Stanley C, Cataldo F, van Lettow M, Rosenberg NE, Tweya H, Gugsa S, Sampathkumar V, Schouten E, Eliya M, Chimbwandira F, Chiwaula L, Kapito-Tembo A, Phiri S; PURE Malawi Consortium. 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 Jun 1;75 Suppl 2(Suppl 2):S149-S155. doi: 10.1097/QAI.0000000000001368. PMID: 28498184; PMCID: PMC5431274. [Full Text]

    5. van Lettow M, Tweya H, Rosenberg NE, Trapence C, Kayoyo V, Kasende F, Kaunda B, Hosseinipour MC, Eliya M, Cataldo F, Gugsa S, Phiri S; PURE Malawi consortium. 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 Jul 11;14(1):82. doi: 10.1186/s12978-017-0343-0. PMID: 28693525; PMCID: PMC5504621. [Full Text]

    6. Cataldo F, Chiwaula L, Nkhata M, van Lettow M, Kasende F, Rosenberg NE, Tweya H, Sampathkumar V, Hosseinipour M, Schouten E, Kapito-Tembo A, Eliya M, Chimbwandira F, Phiri S; PURE Malawi Consortium. 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 Apr 15;74(5):517-522. doi: 10.1097/QAI.0000000000001273. PMID: 28045712; PMCID: PMC5340586. [Full Text]

    7. Chiwaula LS, Chirwa GC, Cataldo F, Kapito-Tembo A, Hosseinipour MC, van Lettow M, Tweya H, Kayoyo V, Khangamwa-Kaunda B, Kasende F, Trapence C, Gugsa S, Rosenberg NE, Eliya M, Phiri S; PURE Malawi Consortium. The value of informal care in the context of option B+ in Malawi: a contingent valuation approach. BMC Health Serv Res. 2016 Apr 19;16:136. doi: 10.1186/s12913-016-1381-y. Erratum in: BMC Health Serv Res. 2017 Mar 10;17(1):191. doi: 10.1186/s12913-017-2130-6. PMID: 27095249; PMCID: PMC4837588. [Full Text]

    8. Puchalski Ritchie LM, van Lettow M, Hosseinipour MC, Rosenberg NE, Phiri S, Landes M, Cataldo F, Straus SE; PURE consortium. 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 Nov 3;4:144. doi: 10.1186/s13643-015-0136-x. PMID: 26525141; PMCID: PMC4630855. [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, Mtande T, Jaffe E, Rosenberg N, Zimba C, Hoffman I, Little M, Faden R, Lyerly AD. Views among Malawian women about joining HIV prevention clinical trials when pregnant. AIDS Res Ther. 2020 May 27;17(1):27. doi: 10.1186/s12981-020-00271-6. PMID: 32460804; PMCID: PMC7251879. [Full Text]

    2. Sullivan KA, Little MO, Rosenberg NE, Zimba C, Jaffe E, Gilbert S, Coleman JS, Hoffman I, Mtande T, Anderson J, Gross MS, Rahangdale L, Faden R, Lyerly AD. Women's views about contraception requirements for biomedical research participation. PLoS One. 2019 May 8;14(5):e0216332. doi: 10.1371/journal.pone.0216332. Erratum in: PLoS One. 2019 Jun 12;14(6):e0218424. doi: 10.1371/journal.pone.0218424. PMID: 31067273; PMCID: PMC6505940. [Full Text]

    3. Sullivan KA, Little M, Rosenberg NE, Mtande T, Zimba C, Jaffe E, Anderson J, Coleman JS, Gilbert S, Gross Wolf MS, Hoffman I, Rahangdale L, Faden R, Lyerly AD. Women's Views About a Paternal Consent Requirement for Biomedical Research in Pregnancy. J Empir Res Hum Res Ethics. 2018 Oct;13(4):349-362. doi: 10.1177/1556264618783834. Epub 2018 Jul 12. PMID: 29998787; PMCID: PMC6360530. [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, Tang JH, Stuart GS, Miller WC, O'Shea MS, Hosseinipour MC, Bonongwe P, Mwale M, Rosenberg NE. Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study. Infect Dis Obstet Gynecol. 2017;2017:1475813. doi: 10.1155/2017/1475813. Epub 2017 Jul 18. PMID: 28804240; PMCID: PMC5540462. [Full Text]

    2. Lemani C, Tang JH, Kopp D, Phiri B, Kumvula C, Chikosi L, Mwale M, Rosenberg NE. Contraceptive uptake after training community health workers in couples counseling: A cluster randomized trial. PLoS One. 2017 Apr 27;12(4):e0175879. doi: 10.1371/journal.pone.0175879. PMID: 28448502; PMCID: PMC5407810. [Full Text]

    3. Kopp DM, Rosenberg NE, Stuart GS, Miller WC, Hosseinipour MC, Bonongwe P, Mwale M, Tang JH. Patterns of Contraceptive Adoption, Continuation, and Switching after Delivery among Malawian Women. PLoS One. 2017 Jan 20;12(1):e0170284. doi: 10.1371/journal.pone.0170284. PMID: 28107404; PMCID: PMC5249175. [Full Text]

    4. Tang JH, Kopp DM, Stuart GS, O'Shea M, Stanley CC, Hosseinipour MC, Miller WC, Mwale M, Kaliti S, Bonongwe P, Rosenberg NE. Association between contraceptive implant knowledge and intent with implant uptake among postpartum Malawian women: a prospective cohort study. Contracept Reprod Med. 2016 Aug 10;1:13. doi: 10.1186/s40834-016-0026-1. PMID: 29201402; PMCID: PMC5693581. [Full Text]

    5. O'Shea MS, Rosenberg NE, Tang JH, Mukuzunga C, Kaliti S, Mwale M, Hosseinipour MC. Reproductive intentions and family planning practices of pregnant HIV-infected Malawian women on antiretroviral therapy. AIDS Care. 2016 Aug;28(8):1027-34. doi: 10.1080/09540121.2016.1140891. Epub 2016 Feb 10. PMID: 26877194; PMCID: PMC4960313. [Full Text]

    6. Sih AM, Kopp DM, Tang JH, Rosenberg NE, Chipungu E, Harfouche M, Moyo M, Mwale M, Wilkinson JP. Association between parity and fistula location in women with obstetric fistula: a multivariate regression analysis. BJOG. 2016 Apr;123(5):831-6. doi: 10.1111/1471-0528.13901. Epub 2016 Feb 8. PMID: 26853525; PMCID: PMC4860061. [Full Text]

    7. O'Shea MS, Rosenberg NE, Hosseinipour MC, Stuart GS, Miller WC, Kaliti SM, Mwale M, Bonongwe PP, Tang JH. Effect of HIV status on fertility desire and knowledge of long-acting reversible contraception of postpartum Malawian women. AIDS Care. 2015;27(4):489-98. doi: 10.1080/09540121.2014.972323. Epub 2014 Nov 4. PMID: 25367269; PMCID: PMC4312510. [Full Text]