Browsing by Author "Ryan Wagner"
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Item A community mobilization intervention to improve engagement in HIV testing, linkage to care, and retention in care in South Africa: a cluster-randomized controlled trial(2022-09) Sheri A. Lippman; Audrey Pettifor; Mi-Suk Kang Dufour; Chodziwadziwa Whiteson Kabudula; Rhian Twine; Dean Peacock; Rhandzekile Mathebula; Aimée Julien; Rebecca West; Torsten B. Neilands; Ryan Wagner; Ann Gottert; F. Xavier Gómez Olivé; Dumisani Rebombo; Nicole Haberland; Julie Pulerwitz; Louis Pappie Majuba; Stephen Tollman; Kathleen KahnBackground: Community Mobilization (CM), engaging communities in a process to collectively enact change, could improve HIV testing and care engagement. We assessed whether CM increased HIV testing, linkage to, and retention in care over time in intervention relative to control communities. Methods: Fifteen communities in Mpumalanga, South Africa were randomized to either a CM intervention engaging residents to address social barriers to HIV testing and treatment or to control. Implementation occurred from August 2015-July 2018. Outcomes included quarterly rates of HIV testing, linkage to care, and retention in care documented from health facility records among 18-49 year-old residents of intervention and control communities over the three years of study. Intention-to-treat analyses employed generalized estimating equations stratified by sex. ClinicalTrials.gov number NCT02197793. Findings: Residents in eight intervention communities (N=20,544) and seven control communities (N=17,848) contributed data. Among men, HIV testing increased quarterly by 12·1% (Relative Change (RC):1·121, 95%CI:1·099-1·143) in intervention communities and 9·5% (RC:1·095, 95%CI:1·075-1·114) in control communities; differences by arm were marginally significant (exponentiated interaction coefficient:1·024, 95%CI:0·997-1·052, p-value=0·078). Among women, HIV testing increased quarterly by 10·6% (RC:1·106, 95%CI:1·097-1·114) in intervention and 9·3% (RC:1·093, 95%CI:1·084-1·102) in control communities; increases were greater in intervention communities (exponentiated interaction coefficient:1·012, 95%CI:1·001-1·023, p-value=0·043). Quarterly linkage increased significantly among intervention community women (RC:1·013, 95%CI:1·002-1·023) only. Quarterly retention fell among women in both arms; however, reductions were tempered among intervention women (exponentiated interaction coefficient:1·003, 95%CI:<1·000-1·006, p-value=0·062). No significant differences were detected in linkage or retention among men. Interpretation: CM was associated with modest improvements in select trial outcomes. The sum of these incremental, quarterly improvements achieved by addressing social barriers to HIV care engagement can impact epidemic control. However, achieving optimal impacts will likely require integrated efforts addressing both social barriers through CM and provision of improved service delivery.Item Asociation of brain arterial diameters with demographic and anatomical factors in a multinational pooled analysis of cohort studiesVJ Del Brutto; F Khasiyev; A Spagnollo-Allende; M Liu; Ryan Wagner; Victor Mngomezulu; Lisa Berkman; E et alItem Assessing risk for HIV infection among adolescent girls in SouthAfrica: an evaluation of the VOICE risk score (HPTN 068)(2019-07) Danielle Giovenco; Audrey Pettifor; Catherine MacPhail; Kathleen Kahn; Ryan Wagner; Estelle Piwowar-Manning; Jing Wang; James P HughesAbstractIntroduction:To maximize impact and minimize costs, antiretroviral pre-exposure prophylaxis (PrEP) interventions should beoffered to those at highest risk for HIV infection. The risk score derived from the VOICE trial is one tool currently being uti-lized to determine eligibility in adolescent PrEP trials in sub-Saharan Africa. This study is aimed at evaluating the utility of therisk score in predicting HIV incidence among a cohort of adolescent girls in rural South Africa.Methods:We utilized data from HIV Prevention Trials Network (HPTN) 068, a phase III randomized controlled trial con-ducted in rural Mpumalanga province, South Africa. School-attending young women aged 13 to 20 years were enrolled intothe trial from 2011 to 2012 and followed for up to three years. A risk score based on individual-level risk factors measuredat enrolment was calculated for HPTN 068 participants who completed a one-year follow-up visit and were HIV seronegativeat enrolment. Possible scores ranged from 0 to 10. A proportional hazards model was then used to determine if risk score atenrolment was predictive of incident HIV infection at follow-up and an area under the curve analysis was used to examine thepredictive ability of the score.Results and Discussion:The risk score had limited variability in the HPTN 068 sample. Scores≥5 identified 85% of incidentinfections from 94% of the sample, compared to the VOICE sample in which scores≥5 identified 91% of incident infectionsfrom only 64% of participants. The risk score did not predict HIV incidence after one year of follow-up (hazardratio=1.029; 95% confidence interval (CI): 0.704, 1.503,p=.884) and showed poor predictive ability (area under thecurve=0.55; 95% CI: 0.44, 0.65). Certain individual risk factors that comprise the risk score may be context specific or notrelevant for adolescent populations. Additional factors should be considered when assessing risk for the purposes of deter-mining PrEP eligibility.Conclusions:The VOICE risk score demonstrated low utility to predict HIV incidence in the HPTN 068 sample. Findings high-light the need for an age and developmentally appropriate tool for assessing risk for HIV infection among adolescents. Use ofthe VOICE risk score for determining PrEP eligibility in younger populations should be carefully considered.Item Associations between WASHrelated violence and depressive symptoms in adolescent girls and young women in South Africa HPTN 068 a crosssectional analysisRuvani T Jayaweera; Dana Goin; Rhian Twine; Torsten B Neilands; Ryan Wagner; Sheri Lippman; Kathleen Kahn; Audrey Pettifor; Jennifer AhernItem Cohort Profile Update Cognition and dementia in the Health and Aging in Africa Longitudinal Study of an INDEPTH community in South Africa HAALSI dementiaD T Bassil; M T Farrell; Ryan Wagner; A D Brickman; M M Glymour; Brent Tipping; Stephen Tollman; E et alItem Development and validation of a diagnostic aid for convulsive epilepsy in subSaharan Africa a retospective casecontrol studyGD Jones; SM Kariuki; AK Ngugi; AK Mwesige; E et al; Ryan WagnerItem Development and validation of a diagnostic aid for convulsive epilepsy in subSaharan Africa a retrospective casecontrol studyG D Jones; S M Kariuki; A K Ngugi; A K Mwesige; Ryan Wagner; E et alItem Estimating dementia prevalence using remote diagnoses and algorithmic modelling a populationbased study of a rural region in South Africa(ELSEVIER SCI LTD) M Farrell; D Bassil; M Guo; M Glymour; Ryan Wagner; Stephen Tollman; E et al; Lisa BerkmanItem Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa Kenya Burkina Faso and GhanaRyan Wagner; Nigel Crowther; Lisa Micklesfield; R Boua; E Nonterah; F Mashinya; S Mohamed; E et al; Stephen Tollman; Michele Ramsay; Justine DaviesItem An individually randomised controlled trial comparing Healerled versus Clinicalled training to improve personal protective equipmenet use among traditional Hearlers in South AfricaCarolyn Audet; Tshegofatso Seabi; Jennifer Hove; Ryan Wagner; T OyekunleItem A individually randomized controlled trial comparing Healerled vs clinicianled training to improve personal protective equipment use among traditional healers in South Africa(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD) C Audet; Tshegofatso Seabi; T Oyekunle; Jennifer Hove; Ryan WagnerItem Magnetic resonance imaging findings in Kenyans and South Africans with active convulsive epilepsyAn observational study(WILEY-BLACKWELL) S M Kariuki; Ryan Wagner; R Gunny; F D'Arco; M Kombe; E et alItem Mental distress food insecurity and university students dropout during the COVID19 pandemic in 2020 evidence from South AfricaFezile Wagner; Ryan Wagner; Lerato Makuapane; M Masango; U Kolanisi; Francesc Gomez-Olive CasasItem Mental health and wellbeing of older adults living with HIV in subSaharan Africa A systematic reviewPatrick Mwangala; Adam Mabrouk; Ryan Wagner; Charles R J C Newton; Amina A AbubakarItem Midlife employment trajectories and subsequent memory function and rate of decline in rural South Africa 200022(OXFORD UNIV PRESS) Xuexin Yu; Chodziwadziwa Kabudula; Ryan Wagner; D Bassil; M Farrell; Stephen Tollman; Kathleen Kahn; Lisa Berkman; Molly Rosenberg; Lindsay KobayashiItem Navigating Life With HIV as an Older Adult on the Kenyan Coast Perceived Health Challenges Seen Through the Biopsychosocial Model(SPRINGER BASEL AG) Patrick Mwangala; Ryan Wagner; C R Newton; A AbubakarItem Prevalence and Factors Associated With Frailty Among Older Adults Living With HIV Compared to Their Uninfected Peers From the Kenyan Coast(SPRINGER BASEL AG) Patrick Mwangala; C Nasambu; Ryan Wagner; C Newton; A AbubakarItem Transient increased risk of influenza infection following RSV infection in South Africa findings from the PHIRST study South Africa 20162018(BIOMED CENTRAL LTD) N.R Waterlow; Jacoba Kleynhans; Nicole Wolter; Stefano Tempia; R.M Eggo; Orienka Hellferscee; Limakatso Lebina; Neil Martinson; Ryan Wagner; J Moyes; Anne Von Gottberg; Cheryl Cohen; S Flasche