2024
Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol
Chebet J, Akyoo W, Goymann H, Harling G, Barnhart D, Mosha I, Kamori D, Gandhi M, Mbunda T, Kipeleka J, Sando D, Spiegelman D, Mpembeni R, Bärnighausen T. Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol. PLOS ONE 2024, 19: e0304077. PMID: 38935796, PMCID: PMC11210872, DOI: 10.1371/journal.pone.0304077.Peer-Reviewed Original ResearchConceptsFemale bar workersPre-exposure prophylaxisIntention-to-treatBar workersPrimary outcomeRisk of HIV infectionAdherence to PrEPRisk of HIV acquisitionImprove PrEP adherenceGerman Clinical Trials RegisterPublic sector clinicsService delivery modelsRandomized trial designHIV negative womenPrevent HIV infectionHIV infectionPrEP provisionClinical Trials RegisterHIV testingPrEP initiationHealth facilitiesPromote PrEPPrEP adherenceDelivery modelsReduce barriers
2022
Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama
Humphries D, Rhodes E, Simon C, Wang V, Spiegelman D, Ott C, Hicks D, Marcus J, Krakower D, Rana A. Using Health Care Professionals’ Perspectives to Refine a Clinical Decision Support Implementation Strategy for Increasing the Prescribing of HIV Preexposure Prophylaxis (PrEP) in Alabama. Journal Of The International Association Of Providers Of AIDS Care (JIAPAC) 2022, 21: 23259582221144451. PMID: 36537589, PMCID: PMC9772965, DOI: 10.1177/23259582221144451.Peer-Reviewed Original ResearchConceptsCDS toolsHigh HIV incidenceHIV preexposure prophylaxisPre-exposure prophylaxisClinical decision support toolQualified health centersHealth care providersHealth care professionalsElectronic health recordsPrEP deliveryPrEP prescribingPreexposure prophylaxisPrEP prescriptionClinical visitsHIV incidenceCDS toolHealth centersClinic staffCare providersCare professionalsSide effectsProviders' lackImplementation strategiesPrEPHealth records
2021
Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial
Boeke CE, Khan S, Walsh FJ, Lejeune C, Hettema A, Spiegelman D, Okello V, Bärnighausen T. Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial. HIV Medicine 2021, 22: 854-859. PMID: 34293243, DOI: 10.1111/hiv.13144.Peer-Reviewed Original ResearchConceptsImpact of UTTStepped-wedge trialAntiretroviral therapyAppointment adherencePublic sector health systemJoint United Nations ProgrammeMultivariable-adjusted modelsHIV/AIDSUniversal testClient adherenceUTT strategyVisit adherenceHIV clientsUnited Nations ProgrammeStudy enrollmentClinical benefitTreat strategyHealth facilitiesART statusHealth systemAdherenceMarital statusNations ProgrammeMeasures analysisLongitudinal analysis
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 lossProgressionHIVImpaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania
Noor RA, Abioye AI, Hertzmark E, Darling AM, Aboud S, Mugusi FM, Sudfeld CR, Spiegelman D, Fawzi WW. Impaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania. Journal Of Nutrition 2020, 150: 2375-2382. PMID: 32621487, PMCID: PMC7540061, DOI: 10.1093/jn/nxaa172.Peer-Reviewed Original ResearchConceptsRisk of mortalityPrevalence of anemiaHAART initiationHematological statusIron deficiencyAntiretroviral therapySerum ferritinSevere anemiaIncident clinical outcomesRelation of anemiaTrial of multivitaminsActive antiretroviral therapyHIV disease progressionCase-cohort studyIron deficiency anemiaProportional hazards modelElevated ironNonanemic participantsHIV patientsMultivariate adjustmentClinical outcomesMorbidity outcomesAnemia etiologyDeficiency anemiaIron supplementationGetting 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
2005
Increasing Risk of 5% or Greater Unintentional Weight Loss in a Cohort of HIV-Infected Patients, 1995 to 2003
Tang AM, Jacobson DL, Spiegelman D, Knox TA, Wanke C. Increasing Risk of 5% or Greater Unintentional Weight Loss in a Cohort of HIV-Infected Patients, 1995 to 2003. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 40: 70-76. PMID: 16123685, DOI: 10.1097/01.qai.0000159627.54149.2e.Peer-Reviewed Original ResearchConceptsCohort of HIVUnintentional weight lossWeight lossAntiretroviral therapyBody compositionLow CD4 cell countsHigher HIV viral loadHigher body mass indexCare of HIVHealthy Living cohortActive antiretroviral therapyCD4 cell countCombination antiretroviral therapyHIV viral loadBody mass indexRisk of deathPresence of diarrheaFederal poverty levelLiving cohortHIV infectionMass indexMost AIDSOpportunistic infectionsViral loadPatient population
2004
Understanding the Role of HIV Load in Determining Weight Change in the Era of Highly Active Antiretroviral Therapy
Mwamburi DM, Wilson IB, Jacobson DL, Spiegelman D, Gorbach SL, Knox TA, Wanke CA. Understanding the Role of HIV Load in Determining Weight Change in the Era of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases 2004, 40: 167-173. PMID: 15614708, DOI: 10.1086/426591.Peer-Reviewed Original ResearchConceptsActive antiretroviral therapyVirus loadBody weightAntiretroviral therapyHIV infectionWeight changeStudy visitHuman immunodeficiency virus RNA loadHighly Active Antiretroviral TherapyAbsence of HAARTProspective cohort studyCell count decreaseVirus RNA loadTime of enrollmentStudy intervalRepeated-measures analysisHIV loadHAART useCohort studyRNA loadHAARTPatientsEligible sampleCell countCount decrease
2003
Difficulty Swallowing and Lack of Receipt of Highly Active Antiretroviral Therapy Predict Acute Weight Loss in Human Immunodeficiency Virus Disease
Jacobson DL, Bica I, Knox TA, Wanke C, Tchetgen E, Spiegelman D, Silva M, Gorbach S, Wilson IB. Difficulty Swallowing and Lack of Receipt of Highly Active Antiretroviral Therapy Predict Acute Weight Loss in Human Immunodeficiency Virus Disease. Clinical Infectious Diseases 2003, 37: 1349-1356. PMID: 14583869, DOI: 10.1086/379072.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveFemaleHIV InfectionsHumansMaleRiskWeight LossConceptsAcute weight lossHuman immunodeficiency virus (HIV) diseaseOral symptomsWeight lossLack of receiptActive antiretroviral therapyUpper respiratory symptomsVirus diseaseTrouble swallowingAbdominal painAntiretroviral therapyRespiratory symptomsDifficulty swallowingNutrient malabsorptionSkin symptomsCommon symptomsRecent symptomsCaloric intakeSymptom complexSymptomsWeight changeDiarrheaMetabolic needsSwallowingDisease
2002
Weight Loss and Survival in HIV-Positive Patients in the Era of Highly Active Antiretroviral Therapy
Tang AM, Forrester J, Spiegelman D, Knox TA, Tchetgen E, Gorbach SL. Weight Loss and Survival in HIV-Positive Patients in the Era of Highly Active Antiretroviral Therapy. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2002, 31: 230-236. PMID: 12394802, DOI: 10.1097/01.qai.0000026514.98625.8f.Peer-Reviewed Original ResearchConceptsActive antiretroviral therapyWeight lossAntiretroviral therapyHAART useIndependent predictorsPrevious visitHighly Active Antiretroviral TherapyHealthy Living StudyCD4 cell countHIV-positive patientsHIV-positive participantsBody mass indexStrong independent predictorFurther prognostic valueProportional hazards modelBioelectrical impedance analysisFour- to sixfold increaseImportant comorbidityMass indexPrognostic valuePotential confoundersRelative riskStudy populationLiving StudyHazards model
2001
Do HIV Type 1 RNA Levels Provide Additional Prognostic Value to CD4+ T Lymphocyte Counts in Patients with Advanced HIV Type 1 Infection?
Arduino J, Fischl M, Stanley K, Collier A, Spiegelman D. Do HIV Type 1 RNA Levels Provide Additional Prognostic Value to CD4+ T Lymphocyte Counts in Patients with Advanced HIV Type 1 Infection? AIDS Research And Human Retroviruses 2001, 17: 1099-1105. PMID: 11522179, DOI: 10.1089/088922201316912709.Peer-Reviewed Original ResearchConceptsHIV-1 RNA levelsHIV-1 disease progressionBaseline HIV-1 RNA levelsT-lymphocyte countsT lymphocytesDisease progressionLymphocyte countRNA levelsCells/Prognostic informationHigh baseline HIV-1 RNA levelsHIV type 1 RNA levelsPlasma HIV-1 RNA levelsSubsequent HIV-1 disease progressionAdvanced HIV-1 diseaseHIV Type 1 InfectionConditional logistic regression analysisDisease progression independentHIV-1 diseaseAdditional prognostic informationAdditional prognostic valueType 1 infectionCase-control studyLogistic regression analysisClinical status
2000
Predictors of Change in the Functional Status of Children With Human Immunodeficiency Virus Infection
Missmer S, Spiegelman D, Gorbach S, Miller T. Predictors of Change in the Functional Status of Children With Human Immunodeficiency Virus Infection. Pediatrics 2000, 106: e24-e24. PMID: 10920180, DOI: 10.1542/peds.106.2.e24.Peer-Reviewed Original ResearchConceptsHeight z-scoreHuman immunodeficiency virus (HIV) infectionImmunodeficiency virus infectionTotal health scoreFunctional statusHealth scoresZ-scoreGeneral healthVirus infectionBaseline evaluationCD4 T-lymphocyte countFunctional status parametersFunctional status surveyHIV disease stageT-lymphocyte countsAbsolute CD4 countGeneral health scoresImportant clinical predictorsSignificant univariate predictorsFunctional status scoresMain outcome measuresNon-white raceResponsiveness scoresPredictors of changeCD4 count
1999
Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy
Shevitz A, Knox T, Spiegelman D, Roubenoff R, Gorbach S, Skolnik P. Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy. AIDS 1999, 13: 1351-1357. PMID: 10449288, DOI: 10.1097/00002030-199907300-00012.Peer-Reviewed Original ResearchConceptsFat-free massActive antiretroviral therapyHAART useHIV RNAAntiretroviral therapyCohort studyViral burdenKJ/dayHIV-seropositive menCD4 cell countHIV-seropositive personsLog10 copies/Energy expenditureLarge cohort studyIndependent effectsCross-sectional analysisHIV diseaseMedication regimensViral loadCopies/Adjusted REECell countElevated REEViral replicationHAART