2023
Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini
Molemans M, Reis R, Shabalala F, Dlamini N, Masilela N, Simelane N, Pell C, Chao A, Spiegelman D, Vernooij E, van Leth F. Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini. BMC Complementary Medicine And Therapies 2023, 23: 350. PMID: 37794359, PMCID: PMC10548651, DOI: 10.1186/s12906-023-04184-5.Peer-Reviewed Original ResearchConceptsInterrupted careAntiretroviral therapyType of illnessCurrent usersTCAM providersTCAM usersHIV diagnosisHIV continuumClinic recordsMultivariable analysisComplementary careVisit dateHealth facilitiesAlternative medicineTCAM useBiomedical careCareAdditional careMixed-methods studyHIVTherapyQualitative content analysisOpen-ended questionsMethods studyContextual factors
2022
Is the Product Method More Efficient Than the Difference Method for Assessing Mediation?
Cheng C, Spiegelman D, Li F. Is the Product Method More Efficient Than the Difference Method for Assessing Mediation? American Journal Of Epidemiology 2022, 192: 84-92. PMID: 35921210, PMCID: PMC10144745, DOI: 10.1093/aje/kwac144.Peer-Reviewed Original ResearchMeSH KeywordsBiomedical ResearchEpidemiologic StudiesEswatiniHumansMediation AnalysisModels, Statistical
2020
Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial
Khan S, Spiegelman D, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Chao A, Bärnighausen T, Okello V. Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial. Journal Of The International AIDS Society 2020, 23: e25610. PMID: 32949103, PMCID: PMC7507004, DOI: 10.1002/jia2.25610.Peer-Reviewed Original ResearchConceptsViral suppressionStandard of careAntiretroviral treatmentCox proportional hazards modelHealth systemART-naïve participantsHIV-positive patientsHIV-positive adultsViral load monitoringHIV-positive participantsAppropriate care managementProportional hazards modelEarly accessPublic sector health facilitiesHealth system effectsPublic health systemHealth system's abilityClinic transitionAntiretroviral therapyCD4 countCare retentionVL monitoringPublic health sectorDisease stageEndpoint rateUniversal test and treat in relation to HIV disease progression: results from a stepped‐wedge trial in Eswatini
Boeke C, Khan S, Walsh F, Hettema A, Lejeune C, Spiegelman D, Okello V, Harwell J, Mazibuko S, Bärnighausen T. Universal test and treat in relation to HIV disease progression: results from a stepped‐wedge trial in Eswatini. HIV Medicine 2020, 22: 54-59. PMID: 32876360, DOI: 10.1111/hiv.12941.Peer-Reviewed Original ResearchConceptsBody mass indexStepped-wedge trialDisease progressionCD4 countSevere diseaseMultivariate Cox proportional hazards modelWorld Health Organization stageCox proportional hazards modelHIV disease progressionMorbidity/mortalityCells/Proportional hazards modelLower ratesIncident tuberculosisCD4 declineMass indexUniversal testHealth facilitiesBaseline valuesHazards modelHealth outcomesCrowded hospitalsWeight lossProgressionHIVGetting to 90–90–90: Experiences from the MaxART Early Access to ART for All (EAAA) Trial in Eswatini
Walsh F, Khan S, Bärnighausen T, Hettema A, Lejeune C, Mazibuko S, Mlambo CK, Reis R, Fleming Y, Khumalo G, Zwane M, Okello V, Spiegelman D. Getting to 90–90–90: Experiences from the MaxART Early Access to ART for All (EAAA) Trial in Eswatini. Current HIV/AIDS Reports 2020, 17: 324-332. PMID: 32474844, DOI: 10.1007/s11904-020-00501-6.Peer-Reviewed Original ResearchConceptsTreatment guidelinesRoutine viral load monitoringNational HIV careViral load monitoringAdolescent malesSystem-level barriersEarly accessInnovative community-based approachesPublic health systemCommunity outreach strategiesImplementation science researchART initiationHIV careHIV testHIV testingMiddle-income countriesUNAIDS 90Adult menMultiple interventionsHealth systemAdolescent femalesEswatini MinistryTrialsFast trackBaseline dataMortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial
Chao A, Spiegelman D, Khan S, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Bärnighausen T, Okello V. Mortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial. HIV Medicine 2020, 21: 429-440. PMID: 32458567, DOI: 10.1111/hiv.12876.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMortality rateDisease-related mortality rateCox proportional hazards modelCause mortality ratesStepped-wedge trialProportional hazards modelStepped-wedge designQuality of lifeEvidence of harmClinic transitionSecondary outcomesSOC participantsHealth clinicsLong-term consequencesImplementation trialHazards modelHIVStudy participantsMortalityHealth systemDecrease infectionEarly accessClinicTherapy