Program

Serena Hotel and Conference Centre Kampala, May 26–27, 2011 Table of Contents

Welcome Letter ...... 3

Acknowledgements ...... 4

General Information ...... 5

Agenda ...... 9

u Wednesday, May 25, 2011 ...... 9

u Thursday, May 26, 2011 ...... 9

u Friday, May 27, 2011 ...... 11

Conference Centre Floor Plan ...... 13

Abstracts ...... 14

Attendee List ...... 38

Attendee Collaboration Information ...... 47

SUB-SAHARAN CFAR CONFERENCE 2011 1

Dear CFAR Colleagues and Partners!

On behalf of the U S. . National Institutes of Health-sponsored Centers for AIDS Research, and ’s Infectious Diseases Institute, welcome to Kampala! It is our pleasure and honor to have you join us for the 2011 Sub-Saharan Africa CFAR Conference as we gather to feature some of the important research being conducted by African investigators collaborating with the 21 Centers for AIDS Research (CFARs) .

Our Conference Steering Committee is planning an exciting program focusing on three priority themes:

u Integrating Treatment and Prevention in HIV Care u HIV Comorbidities u HIV and Women

Through a combination of plenary and poster presentations, panel discussions, and networking sessions, this meeting will present a unique opportunity for both scientific and information exchange . A special effort will be made to provide a platform for sharing information on existing scientific resources and infrastructure at leading African institutions that support AIDS research and training – a critical prerequisite for the exchange of scientific resources, capacity building, and the fostering of new collaborations among African institutions .

The conference has already generated much energy and interest . We envision this momentum leading to the emergence of an African-led network that will build on existing collaborations and begin to explore potential synergies with new partners – including other CFARs, other complementary networks active in Africa, and in particular, South-South partnerships among African institutions – to strengthen the community of science on the continent .

We hope you find the conference enriching and thank you in advance for your commitment to making it a success .

Sincerely, Co-Chairs, 2011 Sub-Saharan Africa CFAR Conference

Moses Kamya Doreen Ramogola-Masire Makerere University, Kampala Botswana-U Penn Partnership, Gaborone

Paul Volberding Warner Greene UCSF-GIVI CFAR, San Francisco UCSF-GIVI CFAR, San Francisco

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 3 Acknowledgements

We would like to gratefully acknowledge the African and U.S. members of the Program and Steering Committees for their hard work and dedication in developing the conference program; the NIH Office of AIDS Research and the U.S. State Department Office of the Global AIDS Coordinator for their generous meeting support; our colleagues at each of the NIH-sponsored Centers for AIDS Research for their responsiveness, contributions, and support of participants and collaborators; and our Ugandan partners for their hospitality. A sincere thanks to all of you for ensuring the success of the 2011 Sub-Saharan Africa CFAR Conference in Kampala!

CFARs African Partners David Bangsberg Kasonde Bowa Sara Burke Elizabeth Bukusi Benjamin Chi Moses Kamya (co-chair) Susan Cu-Uvin Victoria Kasprowicz Warner Greene (co-chair) Ruth Nduati Mina Hosseinipour Thumbi Ndung’u James Hoxie Emilia Virginia Noormahomed Grace John-Stewart Doreen Ramogola-Masire (co-chair) Alan Landay Mohsin Sidat Robert Schooley Abraham Siika Natalie Tomitch Andrew Steenhoff Sten Vermund Michael Tolle Paul Volberding (co-chair)

Sponsored by:

4 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 General Information General Information General Airline Clothing You may have to reconfirm your departing flight three days Conference attire is business casual. As temperatures may drop in advance to prevent your reservation from being cancelled. significantly in the evening, we suggest that you layer your Please check with your airline if this is necessary prior to your clothing. departure. Phone numbers for specific airlines are on the back of your name badge. If you are unable to contact the airline yourself, please visit the reservation desk at the Serena Contact Information Conference Centre by 12.00 on May 26. For assistance while onsite, please contact the Conference Secretariat at the number below. You do not need to dial (256) from within Uganda. The (0) does not need to be dialed if Badges calling from outside Uganda. Conference badges must be worn at all times for access to meeting rooms and sessions. If you misplace your badge, you Conference Line ...... 0702-268290 will be required to show photo identification at the registration desk to obtain a new one. Child Care Child care services will not be provided during the conference. Cell Phones Telephone connections are good and operated by Uganda Telecom (UTL), MTN, Airtel (formerly Celtel Uganda Limited and Credit Cards and Currency Zain) and Warid. Phone cards for all four networks are available The official currency of Uganda is the shilling (UGX). The throughout the city. Rates are approximately UGX 220 per shilling is not tied to the Euro and is subject to fluctuations. minute for international calls and UGX 120 for local calls, The shilling exchanges at approximately 2,300 shillings to the depending on the network. Please be aware that telephone calls U.S. dollar; however, you should check with your local bank for made from a landline phone are considerably more expensive. current exchange rates.

The country code for calling Uganda is 256. Dial 000 to make Credit cards are accepted in many hotels and restaurants but an international call from Uganda. not in outlying areas. Visa is the most commonly accepted credit card. Euros or U.S. dollars can be exchanged at local Mobile codes include 071 (UTL), 075 (Zain), 077 and 078 (MTN) banks or foreign exchange bureaus. Travelers’ cheques are not and 070 (Warid). All mobile phone companies sell prepaid recommended as they are difficult to exchange and rates are starter packs with SIM cards and airtime vouchers for adding significantly lower than for cash. Visa credit and debit cards are credit. MTN is known to have the best coverage across the accepted by all Automated Teller Machines (ATMs). However, country. Uganda SIM cards require a SIM-unlocked GSM cell the only banks in Uganda with ATMs that accept MasterCard/ phone that supports the 900 and 1800 frequencies. Maestro/Cirrus cards are Standard Chartered Bank and Stanbic Bank. Climate In Kampala, most of the banks and many foreign exchange The average temperature in May is 21°C (70°F) during the day bureaus are located on Kampala Road. The foreign exchange and approximately 14°C (57°F) at night. bureaus generally stay open later than the banks and offer competitive rates with no commission. Rates at the main bureaus are usually listed in the daily newspaper.

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 5 Suggested exchange locations in Kampala are listed below: u U. S. Embassy Kampala Plot 1577 Ggaba Road u Crane Bank: Generally offers the best exchange rates. P.O. Box 7007 Kampala, Uganda u Barclays Bank: Offers the same rates for large and small bills. Phone: 0414 25 97 91

u Standard Chartered Bank: The head office has credit card- Fax: 0414 25 97 94 compatible ATMs. As the ATMs are not always reliable, it is best to use them during business hours in case problems Email: [email protected] occur. For all Visa inquiries: [email protected] u The conference hotels offer currency exchange at their For all American Citizen Services inquiries:

General Information General front desk and exchange rates will vary. [email protected] Credit and debit card fraud is something to be aware of when traveling. Be wary of possible scams; some tips include always watch your credit card being swiped and do not use Internet non-bank ATMs. Furthermore, advise your credit card company A cyber cafe will be set up in the Foyer Bar Room adjacent of the dates that you will be out of the country and review your to the CFAR registration desk during the Conference; however, credit card statement for any irregularities. wireless Internet access is also available at all conference hotels. Although speeds are not optimal, Internet service is easily accessible in Kampala. Please be advised that as rates Cultural Considerations may vary, be sure to check with the service provider for specific Kampala is regarded as one of the safest cities in Africa. rates. Pleasantries are very important and should be exchanged prior to engaging in any conversation. Language After becoming an independent nation in 1962, the official Dining language of Uganda became English. In 2005, Swahili was Dining options in Kampala are extensive with a range of prices. approved as the second official language. Some of the least expensive places to eat in Kampala are the takeaways that are found around the city center. Additional cuisine includes Ugandan, Chinese, Thai, Continental, Local Time and Ethiopian, Indian, and Italian. Please note that many of the finer restaurants are closed on Sundays or Mondays. However, Operating Hours please contact the restaurant directly or check with your hotel Uganda is three hours ahead of Greenwich Mean Time (GMT) concierge before venturing out. and seven hours ahead of USA Eastern Daylight Time. As a general rule, shops and offices are open Monday through Electrical Power Friday from 08.30 to 16.30 or 17.30. Electrical current is 240 volts, 50Hz. Three-pin, rectangular blade plugs are used. Lost and Found Please turn in any found items to the conference Registration Emergencies Desk. If you misplace an item, please be sure to check during registration hours to see if it has been found. When traveling internationally, it is best to be prepared for any unforeseen events. Any medications being carried overseas should be clearly labeled and left in their original containers. Luggage Storage It is advisable to carry an emergency medical card written in English and detailing allergies; reactions to certain medications, For attendees departing on May 27, luggage storage will be foods, or insect bites; or other unique medical problems. You available at the Registration Area until 17.00. may also wish to carry a letter from your physician explaining any required treatment you may need if you become ill.

In the event of an emergency, it is imperative that you contact your embassy or consulate in Uganda.

6 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Meals Message Board The following will be provided during the conference: A message board is located at the Serena Conference Centre near the CFAR registration desk for attendees to leave messages u AM/PM Breaks will be provided daily for other registered delegates. Conference updates will also be posted here. u Working lunches (buffet) will be provided daily u On May 25, CFAR and Accordia will co-host the Welcome Reception Registration Hours Tuesday, May 24 ...... 14.00 – 17.00 u May 26 will include a networking dinner Wednesday, May 25 ...... 08.00 – 18.00 u Daily breakfast is included at all the conference hotels Thursday, May 26 ...... 07.30 – 18.30 Information General All food will be local in fare; attendees with dietary restrictions or questions, please see the registration desk. Friday, May 27 ...... 07.30 – 17.00

Medical Care Safety and Security It is important to stay well hydrated while traveling in Uganda. Kampala is rated a critical crime threat post. Most instances of Bottled mineral water is available in all major towns including crime tend to be opportunistic in nature; travelers should take Kampala. It is not recommended to drink the tap water. all prudent measures in order not to become a victim of criminal activity. As in most urban areas, pick-pocketing in crowded If you need medical assistance while in Uganda, you will be public places is common, as is petty theft from cars and hotel expected to pay in full at the time of your treatment. It is rooms. Attendees are advised to remain alert, exercise caution, recommended that you contact your health insurance provider and follow appropriate personal safety measures. Although to discuss your international coverage and/or research travel many parts of Kampala are safe at night, walking alone after health insurance options. dark is not recommended. Be aware of your environment and Kampala offers multiple medical facilities, three of which belongings at all times. are listed below. Please note that most patients requiring emergency surgical attention are transported to Nairobi or Pretoria. Shuttle Service Complimentary shuttle service is available to and from the u Case Clinic hotels and the conference site in the mornings and evenings P.O. Box 4547 throughout the conference. Please consult the schedule Plot 9 Bombo Road provided to you at your conference hotel for detailed routes Kampala, Uganda and times. Phone: +256 41 250 362 or +256 75 750 362 Airport Shuttle Service u International Hospital of Kampala Go to the CFAR registration desk to pick up your airport transfer Plot 4686 Kisugu – Namuwongo confirmation. This will provide vital information on when your P.O. Box 8177 shuttle is departing the hotel for the airport. Out of respect for Kampala, Uganda your fellow travelers, please adhere to the times provided on Phone: +256 41 200444 or +256 31 2200400 the confirmation. Fax: + 256 41 345768 u Surgery Smoking Policy 2 Acacia Drive In accordance with the Uganda Government’s Regulations P.O. Box 24100 on smoking in premises open to the public, smoking is not Kampala, Uganda permitted in any public area. Phone: +256 75 2 756 003 Hours: Speaker Ready Rooms • Monday-Friday from 08.00 to 18.00 A speaker ready room is available in the Serena Conference • Saturday from 09.00 to 13.00 Centre Foyer Bar Room, adjacent to the CFAR registration desk. • Sunday from 10.00 to 12.00 Speakers may visit these rooms anytime during conference registration hours to upload their presentations. We ask that speakers please upload their presentations no less than two hours prior to their scheduled session.

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 7 Telecommunications Transportation in Kampala BlackBerry and other wireless pda and smart phone service is Kampala is known for its frequent traffic jams and sometimes normally reliable, however, we recommend you contact your harrowing taxi rides. Although many of the conference hotels service provider prior to departing for Uganda to confirm that are within walking distance of the conference location, shuttle your service plan will enable you to receive and send messages service will be offered between all conference hotels and the while in Kampala and that your mobile device is configured conference venue. A shuttle schedule will be available upon properly. arrival in Kampala and also posted on the Shuttle Service page of the website a few days prior to the conference. Also, shuttle service between the airport and conference hotels will be provided to registered conference participants.

Reputable taxis are marked with yellow and blue. These are General Information General metered. Most of the other taxis are not metered and it is recommended to agree on a fare before beginning the trip. A standard short distance fare ranges from UGX 3,000-5,000. Tipping is not expected.

8 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Agenda

Wednesday, May 25, 2011

09.00-14.30 Training Workshop, Tour of Infectious Diseases Institute (optional)

15.30 Merle Sande Memorial Lecture VICTORIA HALL

17.00 Welcome Reception Serena Lower Grounds Agenda Thursday, May 26, 2011 08.30-09.00 Opening Session: Welcome Remarks VICTORIA HALL • (Makerere University, Uganda) • Elly Katabira (International AIDS Society and Makerere University, Uganda) • Moses Kamya (Makerere University and African co-chair, Uganda) • Doreen Ramogola-Masire (Botswana-UPenn Partnership and African co-chair, Botswana) • Paul Volberding (UCSF-GIVI CFAR and US co-chair, USA) • Warner Greene (UCSF-GIVI CFAR and US co-chair, USA) 09.00-09.30 Keynote Presentation: VICTORIA HALL Overview of Recent Research Developments in Africa HIV and Women in Africa: New Hope in Antiretroviral Microbicides to Prevent HIV Salim Abdool Karim (Centre for the AIDS Programme of Research in South Africa, South Africa) 09.30-12.30 Plenary Session 1: Integrating Treatment and Prevention in Hiv Care VICTORIA HALL • U.S. co-chair: Benjamin Chi (University of Alabama, Birmingham/CIDRZ, Zambia) • African co-chair: Ruth Nduati (University of Nairobi, Kenya) This session will consider challenges specific to secondary prevention, family issues and engaging multiple partners, maximizing adherence and ARV resistance, integration of services, and implementation/ translation into practice.

09.30-10.00 Plenary Lecture VICTORIA HALL • Alex Coutinho (Infectious Diseases Institute, Uganda)

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 9 Thursday, May 26, 2011 (continued) 10.00-10.30 Tea Break FOYER

10.30-11.30 Panel on Interdisciplinary Scientific Perspectives: Examples of Cross-Institutional VICTORIA HALL Collaborations, Resources, and Case Studies Moderator: Ruth Nduati Panelists: • Elioda Tumwesigye (Kabwobe Clinical Research Centre, Uganda): Integrating HIV Treatment and Prevention in Ugandan Households • Gabriel M. Anabwani (Botswana-Baylor Children’s Clinical Centre of Excellence, Botswana): Prevention Efforts Among Adolescents and Multiple Partners • Janet Fröhlich (Centre for the AIDS Programme of Research in South Africa, South Africa): A Comprehensive Programme: The CAPRISA Vulindlela Experience • Robert C. Bailey (Rush/University of Illinois, Chicago D-CFAR, USA): The Place of Male Circumcision in a Comprehensive Approach to HIV Prevention, Care and Treatment • Immaculate Nankya (Joint Clinical Research Centre, Uganda): Trends of HIV-1 Drug Resistance during the Past 12 Years of ARV Treatment in Uganda

11.30-12.30 Discussion VICTORIA HALL

12.30-13.50 Working Lunch (breakout groups) Agenda ACHWA, PRESS, NILE, ADDIS 14.00-16.20 Plenary Session 2: Hiv and Women VICTORIA HALL • U.S. co-chair: Susan Cu-Uvin (Lifespan/Brown/Tufts CFAR, USA) • African co-chair: Elizabeth Bukusi (Kenya Medical Research Institute, Kenya) This session will consider challenges specific to reproductive choices for HIV+ women, prevention of mother-to-child transmission, microbicides, cervical cancer screening, and behavioral issues related to prevention in women.

14.00-14.30 Plenary Lecture VICTORIA HALL • James Kiarie (Kenyatta National Hospital, and University of Nairobi, Kenya): Reproductive Health and HIV: The African Woman’s Dilemma

14.30-15.20 Panel on Interdisciplinary Scientific Perspectives, Examples of Cross-Institutional VICTORIA HALL Collaborations, Resources, and Case Studies ModeratorS: Susan Cu-Uvin, Elizabeth Bukusi Panelists: • Sam Phiri (Lighthouse Trust, Kamuza Central Hospital, Malawi): Successful Integration of Family Planning into HIV Care in Lilongwe, Malawi • Josaphat Byamugisha (Makerere University, Uganda): Use of Hormonal Contraception and the Risk of HIV-1 Acquisition and the Impact on Subsequent Disease Progression • Elizabeth Bukusi (Kenya Medical Research Institute, Kenya): “I do not know about female microbicides!” • Carla Chibwesha (Centre for Infectious Disease Research in Zambia, Zambia): Screen-and-Treat Approaches to Cervical Cancer Prevention • Samuel Obed (University of Ghana, Ghana): Prevention of Mother-to-Child Transmission of HIV: The Korle-Bu Experience

10 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Thursday, May 26, 2011 (continued) 15.20-16.20 Discussion VICTORIA HALL 16.30-18.30 Poster Session: Institutional Resources and Scientific Posters Katonga HALL (junior investigators to stand by their posters 17.30-18.30)

19.00 CFAR Networking Dinner Serena Lower Grounds

Friday, May 27, 2011 08.30-09.00 Keynote Presentation: VICTORIA HALL Research Challenges in HIV Prevention and Treatment Murder on the HIV Express Warner Greene (Gladstone Institute of Virology and , and UCSF-GIVI CFAR, USA) 09.00-12.45 Plenary Session 3: HIV Comorbidities VICTORIA HALL

09.00-10.30 HIV Comorbidities: Tuberculosis Agenda VICTORIA HALL • U.S. co-chair: Robert “Chip” Schooley (University of California, San Diego CFAR, USA) • African co-chair: Victoria Kasprowicz (KwaZulu-Natal Research Institute of TB and HIV, South Africa) This session will consider challenges specific to reducing morbidity and mortality from HIV-1 related Mycobacterium tuberculosis in sub Saharan Africa.

09.00-09.30 Plenary Lecture VICTORIA HALL • Umesh Lalloo (University of KwaZulu-Natal, South Africa): Eradicating HIV and TB in Sub-Saharan Africa: What Will it Take to Achieve This Ideal?

09.30-10.00 Panel on Interdisciplinary Scientific Perspectives, Examples of Cross-Institutional VICTORIA HALL Collaborations, Resources, and Case Studies Moderator: Yuka Manabe (Infectious Diseases Institute, Uganda) Panelists: • Willem Henry Boom (Case Western Reserve University CFAR, USA): Advances in Immunology of TB: Maintenance of Latency and Prospects for a Vaccine • Harriet Mayanja-Kizzi (Makerere University, Uganda): Decreasing HIV-TB Comorbidity: What Options Are Available in Uganda • Awewura Kwara (Lifespan/Brown/Tufts CFAR, USA): Challenges to Controlling HIV-Associated TB in Sub-Saharan Africa

10.00-10.30 Discussion VICTORIA HALL

10.30-11.00 Tea Break FOYER

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 11 Friday, May 27, 2011 (continued)

11.00-12.45 HIV Comorbidities: AIDS-Related Malignancies VICTORIA HALL • US co-chair: Jim Hoxie (University of Pennsylvania CFAR, USA) • African co-chair: Doreen Ramogola-Masire (Botswana-UPenn Partnership, Botswana) This session will consider challenges related to screening, diagnosis, and treatment and care for AIDS-related malignancies most prevalent in Sub-Saharan Africa, including Kaposi’s sarcoma, cervical cancer, and lymphoma.

11.00-11.45 Plenary Lectures VICTORIA HALL • Lynette Denny (University of Capetown, South Africa): Preventing Cervical Cancer in the Midst of the HIV/AIDS Epidemic • Margaret Borok (University of Zimbabwe, Zimbabwe): Kaposi’s Sarcoma in the Setting of Sub-Saharan Africa

11.45-12.15 Panel on Interdisciplinary Scientific Perspectives, Examples of Cross-Institutional VICTORIA HALL Collaborations, Resources, and Case Studies ModeratoR: Edward Mbidde (Ugandan Virology Research Institute, Entebbe, Uganda) Panelists: • Jackson Orem (Uganda Cancer Institute and UPCID, Uganda): The Impact of HIV on Lymphomas in Africa, Lessons Learnt, and Possible Interventions • Elizabeth Namukwaya (Makerere University, Uganda): Palliative Care in HIV-Associated Malignancies Agenda • Ann Marie Nelson (U.S. Department of Defense, Joint Pathology Center, USA): Challenges of Cancer Diagnosis in Resource Limited Settings: Optimizing Pathology Support

12.15-12.45 Discussion VICTORIA HALL

13.00-14.20 Working Lunch SERENA LOWER GROUNDS 14.30-15.30 Junior Investigators Poster Plenary Session VICTORIA HALL 15.30-17.00 Working Group Breakout Session ACHWA, PRESS, NILE, ADDIS

17.00 Adjourn

12 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Kampala Serena Conference Centre

KATONGA Floor Plan HALL Poster Session

MAIN HALL (GALLERY LEVEL)

ACHWA

PRESS

GALLERY FOYER ADDIS NILE

Upper Level Plan Floor

VICTORIA HALL General Session

FOYER BAR Speaker Ready Cyber Café MAIN FOYER Registration Toilets

Fire Escape

DROP OFF POINT

Ground Level KAMPALA SERENA CONFERENCE CENTRE SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 GROUND LEVEL 13 Abstracts

Abstract 1 Abstract 2 HIV and Women HIV and Women Perception of Elderly People Regarding Incidence and Predictors of Pregnancy Use of Condoms and HIV/AIDS Infection Among Women Receiving HIV Care and in Nigeria Treatment at a Large Urban Facility in Authors: Rose Opara, Sure Health Organization, King Western Uganda Odor, University of Ibadan, Nigeria, and Tbebwa Begashaw, Authors: Jane Kabami and Francis Bajunirwe, Ethiopian Health Foundation University of Science and Technology

Background/Significance: HIV/AIDS continues to pose Background: HIV infection has been associated with adverse a challenge in Sub-Saharan Africa, with the pregnancy outcomes and substantial mortality even in the pandemic cutting across borders. Affecting all the age early stages of the infection. Counseling is given to HIV positive group strata including the elderly people, however, despite women to create awareness and to provide information on the engagement in risky sexual activities which increases HIV/ consequences of pregnancy in HIV infection. The purpose of AIDS infection. There is limited attention paid to the elderly this study was to determine the incidence of pregnancy and population in mitigating the pandemic. This study therefore factors that predict pregnancy among women of reproductive examined condom use and perception among elderly about age and receiving HIV care and treatment at a large urban HIV/AIDS infection in Nigeria. center in western Uganda.

Methodology: The study was cross-sectional in design. Methods: We conducted a retrospective cohort study using A multi-stage sampling procedure was used to select 400 routine data at the Immune Suppression Clinic of Mbarara geriatrics. A pre-tested questionnaire, developed using Regional Referral Hospital located in Mbarara District, western information obtained from 10 Focus Group Discussions (FGD), Uganda, collected between January 2006 and June 2010 using Abstracts was used to collect information. FGD data were analyzed a standard clinic medical form adapted from the Open Medical thematically, while questionnaire data were analyzed using Record system (Open-MRS), which is an electronic database. descriptive and statistically. The primary outcome was incidence of pregnancy calculated as number of pregnancies per 1000 woman years (WY). Data Findings: Twenty-five percent of the participants had was analyzed by calendar year and year of enrollment into care extramarital sex since they attained geriatric age. However, and we used Cox Proportional Hazards model to determine the among this subgroup that had extramarital sex, few (6.8%) predictors of pregnancy. used a condom. More males (5.3%) than females (1.5%) used condom during the last extramarital sex. Low level of Results: The overall incidence rate was found to be 86 condom use was attributed to condom being not worthwhile pregnancies per 1000 woman years. Incidence increased (34.5%) and the opinion (50.0%) that condom is not made for significantly from 60 pregnancies per 1000 WY in 2006 to geriatrics. Moreover, FGD participants viewed sex could not 118 pregnancies per 1000 WY in 2010 (p<0.001). Significant lead to pregnancy and majority (60.3%) posited patronizing predictors for pregnancy were younger age (HR 9.96, 95% traditional healers and few (10.3%) use of herbs/concussion CI 6.27-15.8), married (HR 2.03, 95% CI 1.65-2.5) and single could prevent HIV/AIDS. Similarly, non-condom use was due (HR 1.87, 95% CI 1.3-2.7) compared to widowed or separated, to confidence in traditional herbs, perceived to protect against lower income (HR 2.47, 95% CI 1.42-4.33), knowing the HIV STIs including HIV/AIDS. status of the spouse (HR 1.95, 95% CI 1.16-3.29) compared to not knowing, use of family planning (HR 0.20, 95% CI 0.15- Conclusion: Engagement in risky activities among geriatrics 0.26) was protective against pregnancy. The survival probability is a growing HIV/AIDS challenge. Condom use is misconstrued declined as the study proceeded and 80% of women who had probably due to knowledge gap. Without urgent measures to ever used any family planning method were still not pregnant enable them to protect themselves, development efforts will by the end of the follow up period compared to about 60% be in jeopardy. Investing in geriatric SRH is a cost-effective among those who had never used family. Factors that did intervention in mitigating the HIV/AIDS pandemic.

14 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Abstracts 15 In settings where potential participants Abstract 4 Abstract HIV and Women Use Among Contraceptive Verifying I/II Phase of Two Participants Potential in Kisumu, Microbicide Trials Vaginal Kenya Betty Njoroge Adudans, Authors: Serah Gitome, Maureen Program, Research Care and Training and Elizabeth Bukusi, Medical Research Centre for Microbiology Research, Kenya Institute Background: Non-conventional sources of contraceptive services as contraceptive of well documentation proper of lack as the to contribute disempowerment among women may use often seen microbicide among trials. This potential poses a participants great challenge verify to used approach stepwise a describe We determination. to of eligibility vaginal contraceptive use during screening of potential participants Kenya. for two vaginal microbicide trials in Kisumu, Methods: Part of the eligibility criteria for the microbicide safety and acceptability trials in Kisumu participants to have been on stable required contraception for a period potential of 3 to 6 months prior intrauterine patches, transdermal to contraceptives, oral included: enrollment. Stable contraception During sterilization. surgical and progestins long-acting devices, screening, steps taken to verify self-reported use contraceptive were: review of authenticity, contraceptive card history-taking for to accuracy reported counter-check and method participant’s and duration of on use the against information contraceptive card, palpation physical for confirmation implants, through pelvic examination devices, inspection for of intrauterine incision scars for surgical sterilization and evidence of pill packets used in the previous 3 months for oral contraceptives. : Results Women accessing lay contraceptive healthcare providers and pharmacies services often lacked proper from documentation of their verification process provided numerous opportunities for staff contraceptive use. responses biased minimizing while use contraceptive The confirm to stepwise from the participant. Among it was covertly, common to find that women their contraceptive cards using contraception bore different names from those documents. This on made verification of their authenticity difficult as age-verification the contraceptive cards did not bear challenge was that photographs. actual consistent use of oral and injectable Another contraceptives could not be verified beyond the participant’s self-report. Conclusion: lack proper documentation of contraceptive faceted approach offers a realistic way of helping to verify use, a multi- contraceptive use. : ons Conclusi VIA is cervical acceptable cancer for screening population among western Kenya. There based HIV is a high prevalence infected of cervical disease women and affordable, and practical, safe, is VIA women. these among in a clinic setting. available within can be readily

3 , Kareem , Kareem 1 University of 2 and Susan Cu-Uvin 3 , Hillary Mabeya 1 , Tao Liu , Tao 1 Brown University VIA was abnormal in 83/150 (55%); Pap smear 3 , David Chumba 2 Moi University School of Medicine, 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Cincinnati,

Authors: Omenge Orango Abstract 3 Abstract HIV and Women Conventional Cervical Comparison of with Cytology versus Visual Inspection Acetic Acid (VIA) among HIV-Infected Kenya in Western Women on: Conclusi Incidence of Routine pregnancy population. general among the in that HIV to comparable positive is women HIV care should integrate reproductive health needs for these pregnancy of incidence in trend increasing an is There women. among HIV positive women receiving care at Mbarara Hospital with no significant difference observed between HIV positive and HIV negative. not show any significant association included number woman, religion, the of WHO status disclosure use, ARV stage, disease cell count at enrollment. children and CD4 of HIV positive Khozaim : Results Methods: 150 HIV-infected women attending the HIV clinic at the Moi Teaching and Referral Hospital in Eldoret, underwent Kenya concurrent screening methods: conventional Pap smear and VIA. All women underwent colposcopy and biopsy. VIA and Pap smears were done by clinic nurses. ROC analysis was conducted to compare the accuracy methods between in the two sensitivity, specificity, positive (PPV) and negative predictive value (NPV). predictive value showed atypical squamous cells of undetermined significance (ASCUS) or worse in 59/135 (44%). Ten smears percent were of unsatisfactory. the Of Pap the abnormal Pap smears, (3%) 2 had ASCUS, 4 (7%) had ASC-high grade, 35 (60%) had low-grade squamous intraepithelial lesions (LSIL), 17 cancer. cervical for suspicious was one and SIL, grade high had (29%) disease higher or II (CIN) neoplasia intraepithelial cervical Using on biopsy as an end point, the sensitivity of VIA was (95%CI=55.1-81.0%) 69.6% , specificity of 51.0% (CI=41.5-60.4%), PPV of 38.6% (CI=28.8-49.3%) and NPV of 79.1% (CI=67.8- 87.2%). For conventional Pap smear, sensitivity specificity (CI=42.1-71.5%), of 66.3% PPV was (CI=52.0-71.2%), of 52.5% and NPV of 76.8% (CI=67.0-85.6%). 39.7% (CI=27.6-51.8%) As HIV-infected women in Africa are living longer with highly active antiretroviral therapy, it is important to have services for cervical cancer can maintain screening. a high Few quality Pap smear developing We screening compared program. countries visual inspection conventional with Pap acetic smear acid Kenya. Western in women HIVinfected (VIA) among to neoplasia/cancer to detect cervical intraepithelial Over half of HIV-infected persons in Kenya are cervical women cancer and is the most common cancer among Cervical women. cancer is more prevalent and has poorer among HIV-infected women. prognosis As we plan improvement : the Study The above data show low use of family SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Abstract 6 Abstract HIV and Women the Widows’ Sexual Behaviors in Widow Context of the Practice of Implications Inheritance in Kenya: for the Spread Of HIV Onyango, Impact- Agot and Jacob O. Authors: Kawango Research & Development Organization, Kisumu, Kenya Introduction: The culture of widow cleansing (WC) widow and inheritance (WI) are integral practices among the Luo ethic community in Kenya. WC refers to a practice widow where engages in a sexual intercourse to cleanse herself from perceived impurities conferred by the death of a husband; WI is a practice where a brother-in-law or other male performs sexual intercourse with a widow when specific social events during the course of widowhood call for sexual ritual observed. The practices are perceived to contribute to the to high be prevalence of HIV the among epicenter the of Luo community, HIV in Kenya. their and widows of behaviors sexual the assess To Objective: association potential the towards perceptions and of knowledge between WI and risk of HIV infection or transmission. collect to used was design study cross-sectional A Methods: baseline socio-cultural, sexual and HIV 2,379 widows. A total prevalence of 1,987 had complete data on HIV and data of inheritance, of whom 894 HIV-negative widows were enrolled : ons Conclusi planning at clinic entry. Hormonal methods of contraception with associated were factors Several used. commonly more are use. increased FP ons Implicati of in women infected HIV among uptake FP enhance to strategies partners to disclosure status sero HIV, of MTCT prevent to order emphasized be to need methods FP Dual encouraged. be should for maximum benefits. , Nneka I. 2 , Robin Fatch 1 2 This was a retrospective study of information of study retrospective a was This : The primary goal of this study was to determine to was study this of goal primary The , Judith A. Hahn 2 University of California San Francisco. University of California 2

Mbarara University of Science and Technology, Mbarara 1 16 Emenyonu

Authors: Winnie Muyindike Family Planning Use Among Female Among Female Planning Use Family Hiv/Aids Clinic Attending the Clients Referral Hospital Regional in Mbarara Abstract 5 Abstract Women HIV and Uganda, HIV sero status disclosure to monthly partner, income, being married, younger higher educational level, age, and higher less severe WHO clinical stage associated were with significantly increased (p<0.01) odds of Enrollment into HIV care in bivariate analysis. family planning use at Preliminary : Results Of the 3900 clients was whose analyzed over data clients 618 the which of females period 2342 for available February was information 2007-Dec 2009, FP (26.4 %) reported use of family planning at first encounter to the HIV clinic. Commonly reported methods oral reported few were a while (28.8%), condoms (51.8%), injectable hormones contraceptives (9%). 31. 6% of the clients had disclosed their HIV status to partners. Methodology collected from initial and subsequent quarterly clinical clinic visits HIV/AIDS person 8500 a attending females adult by made at Mbarara Regional Referral Hospital 2010, utilizing from an electronic clinical 2007 data through base that has been in operation since 2007 (and partially supported by the UCSF reproductive of women of proportion the estimated We CFAR). age using FP method(s), and using longitudinal data analysis methods examined the association between FP use and status disclosure to sexual partner(s). HIV Objectives: the proportion of HIV positive women using FP at HIV clinic entry, at subsequent visits in HIV care, by contraception type and associated factors Introduction: The World Health Organization (WHO) lists preventing unwanted pregnancies among people living with HIV/AIDS as an important component of preventing mother to child transmission (PMTCT). The 2008 Uganda HIV Modes of Transmission and Prevention Response Analysis estimated occurred 2008 in Uganda in HIV new all of 18% that through mother-to-child transmission (MTCT). Uganda one of the has highest total fertility rates (TFR) worldwide of 6.7 children per woman and use of family planning (FP) Use of FP is has been shown low. to have strong potential to reduce new HIV infections in with Uganda the effect on due PMTCT equal to to or greater unwanted than to that due fertility, using antiretroviral medications to prevent in transmission pregnancy. Therefore it is important to determine factors associated with the use of FP in order to determine ways to increase its use.

Abstracts Abstracts 17 Our preliminary conceptual framework is based common common among reproductive aged implicated women have studies in few both A settings. resource limited resource and rich depression in adherence to the (PMTCT) transmission mother-to-child to preventing as known series of health behaviors of HIV. Women living in resource limited settings are likely to face additional barriers to PMTCT adherence, including stigma and structural barriers. While some structural barriers may be circumvented by relying on community resources, depression and stigma may make it difficult to access Thus, these understanding resources. the role of modifiable factors, depression, such that contribute as to PMTCT adherence is critical to the MDGs. meeting the goals of Objectives: The proposed study seeks to: (1.) relationship explore the among perinatal depression, stigma, and capital social utilization, and adherence to PMTCT, and (2.) group pilot based counseling intervention a for HIV-infected women in the perinatal period in reducing depression and internalized stigma, and increasing social capital utilization and adherence to ARVs, among women living in the province Natal, South Africa. of KwaZulu- Method: on work by Bangsberg and Deeks (2010), who propose HIV-infected individuals living in SSA manage both “standard” that barriers to HIV adherence (such as side effects and forgetting), and unique economic and of loss structural or costs,” “opportunity and costs clinic barriers to transportation such as high income that may result from time spent obtaining HIV related care. Bangsberg and Deeks propose stigma ability to one’s make use of their social capital and can lead to greatly reduces lapses in adherence to ARVs. Stigma may be especially salient during the perinatal period, due to fears of disclosure the demands amid that managing a pregnancy while HIV positive place on women, including delivering in healthcare regular facilities, and breastfeeding behavior. PMTCT appointments, We have expanded the original model to include depression as an important determinant of the use of social capital in the perinatal period. In addition to stigma, we hypothesize depression that may also impact social capital through behavioral hopelessness, (e.g., pathways cognitive or isolation) social (e.g., decreased problem-solving ability). This is a work in progress, and will be submitted to NIMH for funding via the K23 Career Development Award mechanism. Abstract 8 Abstract HIV and Women and Expectations, Future Aspirations, Sexual Behavior In Ghanaian Youth Authors: Elizabeth Asante, Institute for Statistical, Social, and Economic Research, University of Ghana and University The George Washington Jeffrey Bingenheimer, School of Public Health and Health Services Background: Research on adolescents in the US suggests that perceptions about “hopelessness,” “fatalism,” or “optimism”) life may be important chances (variously termed ,

2 , Steven Safren 2 Massachusetts General 2 , David Bangsberg 1 2 The United Nations Millennium Development MatCH (Maternal, Adolescent and Child Health), 1 Goals (MDGs) illustrate key areas in which the lives of women and children worldwide are success The mortality. childhood reducing and health maternal in need, including improving of reducing rates of childhood mortality in regions that bear a substantial degree of HIV disease achievement the HIV, of transmission vertical of burden rates reducing will depend on of which is indisputably tied MDGs. the by to targeted areas the of one is (SSA) Africa Saharan maternal well-being. Sub- At the end of 2008, well over 22 million people in SSA were living with HIV, a significant number of who were predictor women robust of a as recognized is Depression age. reproductive of non-adherence to antiretroviral therapy (ARVs) and is Background: Hospital / Harvard Medical School SUB-SAHARAN AFRICA CFAR CONFERENCE 2011

Authors: Jennifer Smit HIV and Women Depression, Stigma, Social Perinatal Adherence PMTCT and Utilization, Capital Abstract 7 Abstract Conclusion: There is a glaring disconnect between that knowing WI is a potential risk behavior for HIV not and deciding practice to it. There appears push the to widows be to external be factors inherited potential despite risk that for knowledge HIV and of overwhelming its lack of support the tradition. for Intervention programs addressing WI and other deeply engrained cultural practices that may pose risk for HIV that pressures external of sources address and identify to need continue to sustain such practices. : Results At enrollment, inherited and 56.4% about of 63% status were the notwithstanding. HIV widows However, infected, disaggregated inheritance were when by inheritance non-relatives by inherited widows purpose inheritor, the was to relationship of inheritance of the husband for and sexual ritual had the widow’s highest (73.8%) prevalence while widows inherited by companionship has husbands’ the least prevalence relatives (54.8%). Of the 63% for 21.9% husband, the of death the after sex in engaged had who stated that they were in on-going sexual relationships at reported the was partnerships sexual Multiple interview. the of time had had who those of % 2.9 only and widows, the of 16.3% by any during condom using ever reported widowhood during sex in practice the supporting not 70% despite is This relationship. is WI that aware being (99.7%) all almost and age and day this likely to increase the spread of HIV. and followed up at Months one and three and three-monthly thereafter for 24 months. At every study visit, behavioral a questionnaire structured was administered to obtain sexual behavior and inheritance status present We of acquisition/infection. HIV for factors risk behavioral widows to assess their data collected at baseline. results for University of the Witwatersrand, and Christina Psaros , 1 2 , 1 University 3 , Nande Putta 1 , Benjamin Chi 1 , and Elizabeth Stringer 2 , Mark Giganti 1 , Benjamin Dorton 3 , Namwinga Chintu 1 To determine the impact of time between initiating between time of impact the determine To We We examined factors associated with infant HIV From January 2007 to March 2010, 1,813 HIV- We We conducted a retrospective cohort analysis of UAB – Centre for Infectious Disease Research in Zambia, UAB – Centre for Infectious 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Centre for Infectious Disease Research in Zambia, Centre for Infectious Women HIV and for Prevention Time on HAART Optimal of HIV Transmission of Mother-to-Child Authors: Carla, Chibwesha 2 Abstract 9 Abstract Teaching Hospital Teaching Objective: Highly Active Antiretroviral Therapy (HAART) and delivery – ” interval” – on perinatal HIV infection. the maternal HAART Design: pregnant HIV-infected women in in Lusaka, our cohort Zambia. were receiving Women HAART and had polymerase chain reaction an (PCR) test between 3 and 12 infant weeks HIV of life. Methods: analysis regression weighted locally a performed and infection to examine the effect of maternal HAART interval on perinatal HIV infection. : Results infected pregnant women gestational age at first antenatal visit was weeks 21 (SD +/- 6 met inclusion weeks), median criteria. CD4+ cell count Mean was 231 cells/uL (IQR 329 164- cells/uL), and median maternal HAART interval weeks (IQR 8-19 weeks). was 59 (3.3%) infants 13 were HIV-infected. Maternal HAART interval was the most important of perinatal predictor HIV transmission. Compared to women initiating HAART at least 13 weeks prior to delivery, women on HAART for 4 weeks had a 5.2-fold increased odds of HIV transmission (95% CI 2.5-11.0). 13- a beyond benefit prophylactic additional limited suggested Locally weighted week maternal HAART interval. regression analysis Conclusions: Low transmission can be achieved within programmatic settings in rates mother-to-child of prevention of effectiveness Maximal Africa. of HAART initiating by achieved is programs mother-to-child (PMTCT) transmission HIV at least 13 weeks prior to delivery. Jeffrey Stringer Jessica, Mulindwa Practically all youth reported that Preliminary results provide some indication We We conducted a survey of youth aged 13-14 and

18 that you who are oriented toward achievement in education and employment are less likely to have sex, while youth who are oriented toward traditional values of early marriage and large family size are more likely to have sex. Conclusion: avoiding HIV/AIDS was very important to them and very likely for them. Youth also attached high levels of educational importance attainment, to employment, and future health and Although most longevity. said that marriage and reproduction married getting that reported few them, to important very were by age 25 or having domains the many in outcomes children desired that reported were also Most them. very important to of education, employment, marriage, reproduction, and future health and longevity were very likely for them. statistically Modest significant but gender differences were observed the domains in of employment, marriage, and childbearing. Boys attached more importance to did than finding children many having a to and someday, high married getting paying job, to age by married getting to importance more attached Girls girls. 25, and more often described themselves as being likely to do so, than did boys. Aspirations and expectations in the domains with associated negatively were employment and education of self-reported sexual intercourse. Aspirations and expectations in the domains of marriage and childbearing (especially early marriage and many children) were positively associated with domain the in expectations and Aspirations intercourse. sexual of health and longevity were not related reported sexual activity. to sex or to self- Methods: Preliminary : Results determinants determinants of risky behaviors. The goals of this paper (1) to are characterize the aspirations and future expectations of associated are these how describe to (2) Ghana; in adolescents with sociodemographic factors including gender, schooling, and household wealth; and (3) associations to between aspirations examine and cross-sectional expectations and self- behaviors. reported sexual 18-19 years in two towns in southeastern each whether state to asked were Ghana Youth 75%). = rate response (N=1275, of twelve future outcomes was very, somewhat, or not at all each considered they whether state to and them; to important outcomes very, somewhat, or not at all likely for future them. events were: The completion of secondary school, getting some education beyond secondary employment, getting a school, high-paying job, getting married finding ever, steady getting married by age 25, having many children, having least at one child, avoiding HIV/AIDS, staying healthy until age 50, being alive at age 30, and being alive at age 75. We cross- tabulated responses to each of these further questions conduct with to plan sex We and activity. sexual of self-reported with bivariate analyses and to develop a logistic regression model and aspirations and factors, sociodemographic other sex, using expectations to predict sexual behaviors.

Abstracts Abstracts 19 , 1 4 , Hannock Tweya 1 University of North and Lisa Haddad 3 3 UNC Project , , Caryl Feldacker 2 1 , Irving Hoffman 2 We successfully integrated acceptable We family Our multifaceted approach to integration We held 6 clinic staff education sessions, developed sessions, education staff clinic 6 held We Emory University School of Medicine Emory University School 4 Lighthouse Trust, Lighthouse Trust, Initiation of comprehensive staff training and education Initiation of comprehensive staff training Establishment of a private provision and safe place for service Coordination of flow between family planning care and HIV education Promotion of multiple modalities of client Management of other gynecologic problems Clear monitoring and evaluation protocols 1 Women HIV and of Family Integration Successful in Lilongwe, into HIV Care Planning Malawi Authors: Sam Phiri Abstract 11 Abstract Carolina, Mina Hosseinipour Background: As HIV care expands in developing countries, this infrastructure can be used to integrate contraceptive reversible family Long-acting provision. service HIV planning into (LARC) methods, specifically the intrauterine device (IUD) and contraceptive implants, remain poorly used in regions where HIV is highly prevalent. LARC methods are the most effective birth control methods and may be ideal for use in individuals with HIV. We developed a model for both increase service overall integration acceptance to of family planning specifically prioritize uptake and of LARC methods. The Lighthouse to Clinic in integration, Lilongwe, service planning Malawi family to provides Prior HIV. services with individuals for over 6,000 Lighthouse offered only condoms and referred clients desiring other contraceptive methods to other clinics. Methods: incorporated the following elements: • • • • • • : Results a flipbook and consolidated education sensitization materials, and built technical, script clinical for capacity to provide client family planning services. During education, the first 4 months of family planning provision at family Lighthouse, planning daily education sessions 2800 reached women of reproductive age. approximately Of these, 279 HIV-infected women (10%) received contraception with 109 women (39%) receiving an IUD. Conclusions: planning services for HIV+ clients in an ART clinic in Malawi. Despite the low uptake of the IUD throughout sub-Saharan Africa, we demonstrated that systematic introduction of this method may increase uptake of the IUD among HIV infected women. ; 2

Institute 2 1 ; Eugene Mutimura 1 ; Donald Hoover PhD 1 NY Medical College Valhalla NY; NY; NY Medical College Valhalla 3 ; Kathryn Anastos MD Anastos ; Kathryn 4 ; Elizabeth Kiefer MD MPH ; Elizabeth Kiefer MD Serum albumin did not predict BMI, FFMI or FI Albumin, nutritional status, body composition, 3 In unadjusted models for each outcome in HIV- Women’s Equity in Access to Care and Treatment in Access to Care and Treatment Equity Women’s 5 ; Mardge Cohen MD 5 Albert Einstein College of Medicine, Bronx NY; of Medicine, Bronx NY; Albert Einstein College 1 Stroger (Cook County) Hospital and Rush University, Chicago, Hospital and Rush University, Stroger (Cook County) for Health, Health Care Policy and Aging Research, Rutgers Policy for Health, Health Care NJ; Piscataway, University, SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 PhD 4

Jean-Claude Dusingize MD Authors: Jean-Claude Dusingize Association of Serum Albumin with Albumin with of Serum Association Status Among of Nutritional Markers Rwandan and Uninfected HIV-Infected Women Abstract 10 10 Abstract Women HIV and Qiuhu Shi PhD Illinois; RESULTS: RESULTS: DISCUSSION: Keywords: METHODS: In 2005, uninfected women were 710 enrolled in The HIV-infected Rwandan Women’s Interassociation Study and Assessment. Medical/demographic and 226 parameters; CD4 HIV- count, albumin; hemoglobin, liver function parameters; anthropometric measurements and Bioelectrical Impedance Analysis (BIA) were performed by nurses. Outcomes trained were body mass study index (BMI), Fat-free mass index (FFMI) and Fat mass women negative HIV by defined categories 4 within performed index (FMI). Data analysis was 200-350 and <200). and HIV positive by CD4 strata (CD4>350, negative women and HIV positive with CD4 count >350 cells/ µl, serum albumin was not significantly associated with BMI, 200-350 between count CD4 with women HIV+ In FI. and FFMI outcomes all with associated significantly was albumin cells/µl, (p<0.05) and highly significant in (P<0.001). In the multivariable linear CD4 regression model, serum count<200 cells/µl albumin was associated with FFM in women with CD4 count <200cells/µl (p<0.01) but there was no significant association in the group of women with significant association of serum albumin with fat mass. CD4>200. There was also no a not is it that suggesting women, positive and HIV-negative in good marker of nutritional status. However it’s widely used as This settings. clinical many in status nutritional of indicator an for proxy a as used be not should albumin that suggests result nutritional status without further study of its association with validated measures. HIV, women INTRODUCTION: Considering the burden of malnutrition in sub-Saharan Africa, and the catabolic condition found in HIV positive patients, it’s crucial to know how early to in order to monitor assess closely these patients. it An important very question in treating HIV-infection in Africa is It comorbid malnutrition on response to antiretroviral therapy. the effect of is therefore important to know if albumin, an inexpensive and malnutrition. of indication an as used be can measure, available (WE-ACTx) and Kigali Health Institute, Kigali, Rwanda. (WE-ACTx) and Kigali Health Institute, Kigali, , 2 , 3 , Moses Kigundu 2 , Diane Havlir 3 University of California 3 3 , Anne Gasasira 1 HIV is associated with an increased and Grant Dorsey , Edwin D, Charlebois 3 2 Makerere University, Makerere University, 2 Among 4467 77 children aged 16 years or younger, Columbia University College of Physicians and Surgeons, and Surgeons, Columbia University College of Physicians 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 San Francisco Background: incidence of malaria in adult African populations. In children, the relationship between HIV and malaria investigated is less the clear. We relationship blood malaria for referred between children and adults among infection malaria and HIV-1 smears at government health clinics in Uganda. Methods: This was a cross-sectional study in which 1000 consecutive patients referred for malaria blood smears over the course of 1 to 2 months at each of 7 government clinics were tested for HIV-1 from dried blood (N spots = using 7000) enzyme-linked immunosorbent assay (ELISA) screening HIV-1 for factors Risk testing. confirmatory acid-based nucleic and infection were identified using multivariate logistic regression. : Results (1.7%) were HIV-1 infected. Of 2533 adults, 270 (10.7%) were HIV-1 infected. In children, having a negative malaria blood smear was associated with higher odds (odds ratio of [OR] = 1.90, HIV-1 95% confidence interval infection [CI]: 1.18 to 3.06) after controlling for age and gender. In adults, having a positive malaria blood smear was moderately associated with 1.97) to 1.01 CI: 95% 1.41, = (OR infection HIV-1 of odds higher after controlling for age and gender. Conclusions: In malaria, Ugandans associations between malaria smear results evaluated and HIV infection for differed suspected between children further operations research is needed, our results suggest that and adults. importance particular of Although be may HIV for testing and counseling in children suspected of malaria but with smears and in adults with positive malaria smears. negative malaria Keywords: malaria, HIV, Africa, human immunodeficiency virus (J Acquir Immune Defic Syndr 2007;46:624-630) Abstract 13 Abstract HIV Co-Morbidities Referred for in Patients HIV-1 Infection Malaria Blood Smears at Government Health Clinics in Uganda Authors: Lisa M. Bebell

T-cell count were not significantly associated with risk of with risk associated were not significantly count T-cell STI. In a multivariate model adjusting for age, site, CD4+ T-cell count and number parity of < partners, 2 increased risk of any CI 1.2, 23.9; p=0.03). 5-fold (OR 5.3; 95% STI more than on: Conclusi Despite prior experience HIV in prevention study, a active STI longitudinal were positive common women among enrolled HIV in MTN 015. With demographic few characteristics exceptions, were not predictive of STI Ongoing risk. surveillance and treatment behavioral counseling interventions are as needed to modify the well as improved risk of STI acquisition. Philip Rosenthal New York, NY, NY, New York, Moses R. Kamya , 3 8 College of 5 , Francis , Lei Wang 5 2 UNC Project – 6 , Felix Muhlanga , and Sharon Riddler 1 , Bonus Makanani 1,7 4 HIV-STI co-infections are a public health University of Zimbabwe, Harare, Zimbabwe; University of Zimbabwe, 2 , Nicola Coumi 99 HIV-infected women from HPTN 035 were 3 , M. Brad Guffey 6

Centre for Infectious Disease Research in Zambia, Centre for Infectious 1 20 University of Alabama at Birmingham, Alabama, USA; University of Alabama at Birmingham, Alabama, USA University of Pittsburgh, Pennsylvania, Statistical Center for HIV/AIDS Research and Prevention, Statistical Center for Unit, Medical Research HIV Prevention and Research Medicine-John Hopkins University Research Project, Queen Medicine-John Hopkins University Research Elizabeth Central Hospital, Blantyre, Malawi; Tidziwe Centre, Kamuzu Central Hospital, Lilongwe, Malawi; Central Hospital, Tidziwe Centre, Kamuzu 7 8 3 4

Authors: Margaret Kasaro Recent HIV Seroconverters Are at Are at HIV Seroconverters Recent Transmitted for Sexually High Risk (MTN-015) Infections Absract 12 Absract rbidities HIV Co-Mo San-San Ou Martinson : Results enrolled. At enrollment: median age was time since seroconversion 27 was 18 mo, 49% years, were married and median 99% reported 0 or 1 sexual partner in the prior 3 mo. Median time from the final study visit for HPTN 035 and enrollment was 8 mo. Clinical parameters included median CD4+ T-cell count of 431/mm3 and a median parity of 2. GC, CT, Prevalence syphilis or of any STI was 8.1%, 10.1%, 1%, and highest the with 17.2%, sites the between varied rates STI respectively. prevalence of any STI at the Zambia and Durban SA sites (26% and 43%, respectively). In univariate analysis, parity of 1 or 0 was associated with increased risk of CT (OR 7.7; 95% CI 1.4, 78.9; p=0.01) or any STI (OR 5.1; was age Younger children. 95% more or 2 with women to compared CI 1.5, 20.4; p=0.01) associated with increased risk of CT (OR 1.4 per year decrease; partner, primary of age status, Marital p=0.01). 1.8; 1.1, CI 95% number of partners, time from HIV seroconversion, and CD4+ Background: Methods: MTN 015 enrolled women who experienced HIV seroconversion during HPTN 035 at assessed was information 5 clinical and behavioral demographic, African sites. Socio- at study entry and clinical testing including was performed Neisseria for gonorrhea(GC), STIs Chlamydia (CT), Trichomonas trachomatis Vaginalis (TV) and syphilis. 035 STIs exit and at at HPTN MTN 015 baseline data was also collected for follow up were for visits. Univariate and compared and STI multivariate logistic regression models were used to assess for characteristics associated with STI risk at enrollment into MTN 015. Lusaka, Zambia; priority because of an increased risk of HIV transmission and the negative impact of STIs in these individuals. We evaluated an observational cohort women study enrolled of in MTN-015, women with HIV-1 seroconversion during microbicide trials, for STI burden and associated risk could inform factors. STI prevention strategies This in women co-infected knowledge with HIV. University of Washington, Seattle Washington, USA; Seattle Washington, University of Washington, Durban, South Africa; Council of South Africa,

Abstracts Abstracts , 1 21 Division 2

2 , Andrew Kambugu 1 , Barbara 1 , David Boulware 2 , Ali Elbireer 2 , Yuka Manabe , Yuka 1 Cryptococcal meningitis (CM) remains a , Paul Bohjanen , Paul 3 , Bethany Cook Makerere University College of Health Sciences, Makerere University College of Health Sciences, 1 3 Infectious Disease Institute, Makerere University, Makerere University, Infectious Disease Institute, 1 Moses Kamya Castelnuovo rbidities HIV Co-Mo Serum of Cost-Effectiveness Screening to Antigen Cryptococcal HIV-infected Deaths Among Prevent cells/ CD4+ Count <=100 with a Persons HIV Therapy in Resource mcL Who Start Limited Settings Authors: David Meya & International Medicine, University of of Infectious Disease Minnesota, Abstract 15 Abstract

School of Medicine Background: common AIDS-defining illness in Africa and Asia. Subclinical cryptococcal antigenemia is antiretroviral therapy (ART). frequently We sought to unmasked define effectiveness of serum cryptococcal antigen (CRAG) the screening cost- with to identify persons with subclinical cryptococcosis efficacy of preemptive fluconazole therapy. and the Methods: There were 609 who started ART ART-naive in Kampala, Uganda, and adults who had a with serum CRAG prospectively measured AIDS during 2004-2006. The number for assessed was CRAG positive a with treat and test to needed 30-month outcomes. serum were (8.2%) persons 50 cohort, overall the In : Results CRAG positive when starting Of ART. 295 people with a CD4+ cell count 100 cells/mL and without prior CM, 26 (8.8%; 95% confidence interval [CI], 5.8%-12.6%) were CRAG positive, of whom 21 were promptly treated with fluconazole (200-400 mg) for 2-4 weeks. Clinical CM developed in 3 treated fluconazole- persons, and 30-month survival was 48%-89%). 71% In (95% the 5 CRAG-positive CI, persons with a CD4+ cell count 100 cells/mL treated with ART but not fluconazole, all died within 2 months of ART initiation. The number needed to prevent to fluconazole and screening CRAG with treat and test 1 (95% CM CI, case 7.9-17.1) is at 11.3 costs of $190 (95% CI, $132-$287). The number needed to test and treat to $185- CI, (95% save $266 of costs at 1 11.1-24.0) CI, (95% 15.9 is life $402). The cost per disability-adjusted life year saved is $21 (95% CI, $15-$32). Conclusions: Integrating CRAG screening into HIV specifically care, targeting people with severe immunosuppression (CD4+ cell count 100 cells/mL) treatment programs should in resource-limited settings. ART alone be is implemented in insufficient treatment for CRAG-positive persons.

1

Makerere 2 , Humphrey Wanzira 2 ≥ 38.00 C had an urgent thick blood , Moses Kamya 1 1 Infectious Diseases Research Collaboration, Infectious Diseases Research 1 and Anne Gasasira SUB-SAHARAN AFRICA CFAR CONFERENCE 2011

Authors: Abel Kakuru Risk Factors for Malaria in a Cohort of in a Cohort for Malaria Risk Factors in Children Living Ugandan HIV-Infected Transmission of High Malaria an Area Abstract 14 Abstract rbidities HIV Co-Mo We We evaluated risk factors for malaria in a prospective cohort 6 of ages the at enrolled were who children HIV-infected 57 of Children were followed up for weeks to all 1 their year. clinical care at a dedicated study clinic which was open 7 days of the prophylaxis. (CTX) cotrimoxazole taking were children All week. Children who were eligible for according antiretroviral to the drugs WHO (ARVs) guidelines Children who were presented to initiated the clinic on with a ARVs. history of or with a fever temperature of smear done for malaria parasites. Children who had positive with diagnosed were parasites malaria for smears blood urgent malaria uncomplicated with Children malaria. of episode new a were randomized to receive either artemether-lumefantrine or dihydroartemisinin-piperaquine while those with complicated malaria were treated with quinine. Using binomial generalized estimating equations, we evaluated associations between Taking ARVs, a low CD% and not taking CTX were associated with a higher risk of malaria. The unusual association of ART use with a higher risk of malaria could be due to interaction with artemesinin combination treatment. More therapy studies are needed to evaluate the used effect of for ARVs on malaria malaria and antimalaria treatment in children. HIV-infected HIV-infection has incidence of been malaria in adults with the effect increasing with associated immunosuppression. However data is with limited on the effect of an in children. HIV on malaria incidence increased Fifty seven children were included were in not on ART the at enrollment. analysis By the end and of follow-up, all 52 (91%) had been initiated on ARVs. A total of 26 children were withdrawn before the end of follow-up. Overall, there 213 episodes were of malaria during the observation period with a malaria incidence of 2.09 episodes per person year. ART use in children was significantly associated with an increased risk of malaria compared to children who were not on ART (aRR 2.47, P=0.01). Children with CD4% < 20% more were likely 2.23 to have times malaria compared to with associated was children CTX taking with Not <0.001). CD% P 2.23, (aRR ≥20% a higher risk of malaria compared with taking CTX (aRR 2.43, P=0.001). University ART use, CTX use, and CD4 percentage category with the risk of malaria adjusting for residence, age, and insecticide treated net use. , , 1 3 Fred 3 , Fred Okuku 2 , Warren Phipps , Warren 4 Kampala Cancer Registry Cancer Kampala 4

3 , Jason Goldman 1 University of Washington, University of Washington, 2 , Henry Wabinga 3 Antiretroviral therapy (ART) has decreased and Corey Casper From 1999-2008, annual age-standardized , Alan Kristal 1 To To evaluate the association between increasing 3 ASR per 100,000 in 1999 was 31.7(KS), 6.5(NHL) and 6.5(NHL) 31.7(KS), was 1999 in 100,000 per ASR Uganda Cancer Institute, 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 APC and T cells through cognate recognition of MTB peptide(s) peptide(s) MTB of recognition cognate through cells T and APC may be conducive to transmission of HIV from APC to T cell. This is likely to be an important mechanism for the increased of regardless individuals infected dually in disease TB of burden disease. count or stage of HIV CD4+ T cell Jackson Orem

Abstract 17 Abstract HIV Co-Morbidities Association of Measuring the Therapy Coverage and Antiretroviral Incidence of AIDS-Defining in Uganda Malignancies Authors: Innocent Mutyaba Hutchinson Cancer Research Center, Center, Research Cancer Hutchinson Background: the incidence of the AIDS-defining KS malignancies and NHL, but not (ADM) invasive cervical cancer (ICC) of in the USA and Europe. These cancers have common become in sub-Saharan among Africa, where the a most high prevalence of viral oncogens and HIV infections overlap. Objective: availability of ART in Uganda and ADM incidence. Methods: Cancer Kampala the from calculated were (ASR) rates incidence obtained we and Population, Standard World the using Registry ART coverage (defined as number of persons divided by number on of persons eligible treatment under WHO guidelines) from UNAIDS. Poisson regression modeled the effects of ART coverage on incidence rates for each ADM. : Results 34.7(ICC). ART coverage increased from 0 to 43% from 1999 increase in to ART 2008. coverage, With the each number 10% of incident cases decreased by 4.1% (IRR:0.996, p=0.001) for KS and increased by 6.5% (IRR:1.0065, p=0.003) for NHL. No p=0.3). association was found for ICC (IRR:1.002, Conclusions: ART scale-up in Uganda was associated with in change no but NHL, in increase and KS in decrease modest a ICC. Possible explanations include a relatively low population or lag time. Future ART analyses coverage, late delivery of ART, will expand to other African countries and cancers. Increasing access to ART and other strategies may be needed to manage the burden of cancer among persons with HIV limited settings. in resource- Marla Husnik and 2 Makerere University 2 , Harriet Mayanja-Kizza 1 1

Case Western Reserve University Division of Infectious Reserve Case Western 1 22 One of the mechanisms for this increased HIV in MTB-specific CD4+ T cell could be preferential antigen specific transmission from macrophages and or DC to MTB-specific memory CD4+ T cells in the milieu of infected monocyte derived dual macrophages (MDM) or infection. monocyte We generated HIV- derived DC (MDDC). Autologous CD4+ subjects were added to HIV/MDM T or HIV/MDDC with MTB cells for from PPD+ overnight incubation. MTB-specific CD4+ T cells were purified and compared to those memory CD4+ T cells that CD4+ MTB-specific that were demonstrate results Our MTB-specific. not T cells had a median of 4.0 fold (range 3.0-11.9) higher transferred by HIV HIV/MDM and 7.4 fold (range 7.2-12.4) higher HIV transferred by HIV/MDDC than non-MTB-specific memory between contact prolonged The wells. same the in cells T CD4+ To To determine if MTB-specific CD4+ T-cells are more HIV-infected heavily than non-MTB specific cells, we isolated MTB- specific cells and non-specific CD4+ T cells and performed HIV strong stop (SS) DNA by real-time PCR. MTB-specific cells had 2.3 range fold 3.6 (mean rates infection HIV higher significantly and 4.9. p<0.02) than the non-MTB specific CD4+ population in the same culture. These results are consistent with Douek et al. who found a range of ratios of 2.1- 5.3 fold more gag DNA HIV in the HIV-specific CD4+ T cells than total a suggests memory finding This individuals. HIV-infected of cells T CD4+ infection. dual during cells MTB-specific of loss for mechanism Containment of MTB is primarily involving CD4+ T through cells and antigen presenting cell-mediated cells HIV (DC). cells dendritic and macrophages immunity both including (APC) productively infects these same three cell types. This provides interactions cellular significant for opportunity and setting the between CD4+ T cells and APC overall hypothesis is during that specific interactions dual between CD4+ infection. Our promote infection dual HIV/TB of setting the in APC and cells T HIV infection of MTB-specific CD4+ T cells resulting in their loss thus increasing the risk progressive primary TB. of developing reactivation or HIV is fueling a dramatic increase in the M. tuberculosis (MTB) most to contrast In Africa. sub-Saharan in particularly epidemic other opportunistic infections associated with HIV, increased risk of developing TB occurs early during the disease. course of A HIV better understanding of that allows the HIV basic to immunology dramatically urgently needed increase to identify specific the clinical and immunologic risk of TB at greatest risk. characteristics of co-infected individuals is

Authors: David Canaday Antigen Specific Preferential Specific Preferential Antigen CD4+ of MTB-specific HIV Infection Cells and Dendritic Macrophages Cells by Abstract 16 Abstract rbidities HIV Co-Mo Zahra Toossi Disease, CFAR, TB Research Unit (TBRU), , Disease, CFAR, TB Research

Abstracts Abstracts 23 , 3 The Methodist , Adeodata Makerere 3 2 4

1 , Edward Graviss 2 , Asha Kapadia 4 and Mark Kline , Jan Risser 1 1 T®TB Test in Latent TB in T®TB Test Before promoting use of IGRAs in children , Moses Joloba 2 ,Alice Asiimwe 1 Baylor College of Medicine – Texas Children’s Hospital, Children’s – Texas Baylor College of Medicine 1 University of Texas School of Public Health, University of Texas Hospital Research Institute, Houston, Texas, Houston, Texas, Hospital Research Institute, rbidities HIV Co-Mo O T-SP Use of HIV-Infected Diagnosis in Infection Uganda in Kampala, Children Authors: Betty Nsangi 2 Abstract 19 Abstract Kekitiinwa

University College of Health Sciences University College of Background: It is estimated that children age 0-14 years account for a third of all TB cases. Tuberculosis is the leading cause of mortality in HIV infected individuals with 56% of TB be can TB Active co-infection. HIV/TB reporting Uganda, in cases prevented (or possibly delayed) if latent TB (LTBI) is diagnosed and treated with isoniazid. For over a century, the Tuberculin Skin Test (TST) was used for LTBI diagnosis but adult studies have shown that IGRAs are superior to the TST. Few pediatric studies especially in high TB/HIV endemic areas the confirm whether examine to this was study this of objective The finding. T-SPOT®.TB assay has a role in LTBI diagnosis in HIV infected children in Uganda. Methods: Using a cross-sectional study design, 381 at clinic Baylor-Uganda the at recruited were children infected HIV- August and March between Uganda Kampala, Hospital, 2010. All children had a TST planted and a T-SPOT®.TB assay drawn and run. Sputum examination (AFB culture and smear) TB. and chest x-rays were done to rule out active : Results Fifty-four percent of the recruited population was female with a mean age of 7.7 positive test was 6.8% years. for the T-SPOT®.TB test and The 7.9% with prevalence of a the TST. There was no statistical difference between the two assays (p-value 0.59). The agreement between the two assays was 95.9% and the kappa was 0.7 (95% CI: 0.55-0.85, p-value < 0.05) indicating substantial or positive on the TST good was associated with older agreement. age and higher tests Both Testing T-SPOT®.TB. the with not but z-scores age for weight therapy anti-retroviral taking of history a with associated were (ART). Conclusion: living in HIV/TB endemic countries, more clinical role research in TB diagnosis and cost-benefit analysis needs to on their be done. Hwang Lu-Yu

, 1 2 , James Kafeero 1 , and Corey Casper 1 , Jackson Orem 1 The individual ACTG staging criteria predict , Moses R, Kamya 2 The cohort included 387 KS patients: 53.3 % were Uganda Cancer Institute, Kampala Uganda. Makerere Uganda. Uganda Cancer Institute, Kampala 1 0.001), immune status (HR 1.5 for I0 vs. I1, 95% CI 1.0-2.3, ≤ 0.001), Fred Hutchinson Cancer Research Center, Seattle Seattle Fred Hutchinson Cancer Research Center, SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 2 Authors: Fred Okuku HIV Co-Morbidities Staging Evaluation of the AIDS Clinical Sarcoma in a Criteria for Kaposi Resource Limited Setting Abstract 18 Abstract Warren Phipps Warren Conclusion: examine will analyses Future Uganda. in patients KS of survival whether combinations of ACTG criteria or other demographic, medical and biologic predictors are useful in KS prognosis and response to treatment. In univariate analysis, persons in the good risk category each for variable were more likely to diagnosis: Tumor status (HR 3.2 be for T0 vs. T1, 95% CI alive 1.8-5.6 , two years after p CI 95% S1, vs. S0 for 2.1 (HR symptoms systemic and =0.02), p 1.4-3.1, p ≤0.001). : Results male, the median age was 35 years median CD4 (range count at 18-74 diagnosis yrs), was 96 the cells/ul (IQR 25, 231 cells/ul). The median survival was 474 days days). (IQR 141, 1372 Methods: Data were abstracted from medical adult records patients of with HIV-associated association the evaluated KS We 2001-2006. from seen Institute Cancer at the Uganda between criteria ACTG and two-year overall survival using Cox proportional hazards. Kaposi sarcoma (KS) is commonly staged using staged commonly is (KS) sarcoma Kaposi Background: criteria established by the AIDS Clinical Trials Group (ACTG). ACTG staging is comprised of three dichotomous Tumor extent variables: (T), immune status (I) and systemic symptoms (S). Although validated in the US and Europe, no evaluation has been done in resource-limited settings during the HAART criteria staging ACTG the whether determine to sought We era. is predictive of survival among Ugandan patients with associated KS. HIV- Washington, USA Washington, University, College of Health Sciences, Kampala, Uganda, Kampala, College of Health Sciences, University,

2 Mbarara 2 , Nicholas Kamara 1 1 of Science and Technology, Science and Technology, Mbarara University of 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Regional Referral Hospital Zidovudine (AZT), a potent nucleoside reverse is inhibitor, recommended in Uganda as part transcriptase of first line anti- retroviral therapy (ART). It is however known to cause anemia and neutropenia as serious side effects among others. Studies a is anemia that shown have (SSA) Africa sub-Saharan in done significant problem among HIV patients. Despite the difficulty patients SSA that possible is it contribution, its investigating in starting AZT are at an increased risk of anemia. Neutropenia among HIV patients whether or not taking studied in SSA. AZT We carried out a is retrospective chart review to not well among counts neutrophil and hemoglobin in changes describe patients taking AZT for at least 6 months. The study was done at the positive HIV 2009. May starting months 3 for Hospital Referral ISS clinic of Mbarara Regional adults who had been started on AZT containing ART regimens at the clinic during the year 2008 were included in the study. A sample size of 270 patients obtained Leslie using formula the for Kish a and precision of 5% and a interval 95% around confidence a presumed prevalence of 22.8% for numbers clinic retrieve to used was was database computer The used. patients who started AZT in 2008. These numbers were then used to create the sampling frame of 828 patients from which selected the Of obtained. was patients 276 of sample random a 276 patients, 55 were excluded because 3 did not start ART in 2008, files could not be traced for 27 and for 25, there was no baseline CBC. Information for 221 patients was then analysed CBC a had patients (58.4%) 129 patients, 221 the Of SPSS. using abnormality along the lines of either anemia or neutropenia or both either at baseline or at 6 months and patients who were included in the final analysis. these are the The median age for these patients was 34. Females were 64%. The average CD4 at start of ART baseline was weight 144 was cells/cc. Average 56kg and of alcohol 95 history patients documented, who had the an majority (80%) taken any alcohol. All had the 129 patients analysed had never a CBC at baseline but 101 had a CBC at 6 months and only 34 CBC had at a one year available on file. The prevalence appeared of to decrease with anemia time, being 50%, 41% and 12% at baseline, at 6 months and at 1 year respectively. The average hemoglobin appeared to increase with time, being for males 13.7g/dl, 12.9, and 15 at respectively and 12, for and females 12.8 11.7g/dl, at baseline, baseline, 6 months and 6 months and 1 Of year. 50 patients who had normal baseline 1 year hemoglobin, 30 (60%) had normal hemoglobin at 6 months. and Tony Wilson and Tony rbidities HIV Co-Mo Among and Neutropenia Anemia on Zidovudine- Patients HIV Positive Therapy Anti-Retroviral Containing of Mbarara Regional at the ISS Clinic Referral Hospital Authors: Stephen Asiimwe Bambeiha Abstract 21 Abstract 2 , Malathi Ram, 2 and Gary Maatrens 3 University of Cape Town, University of Cape Town, 2 We conducted a secondary analysis secondary a conducted We , Chelsea Morroni 1 Our data suggests that the impact of , Richard Chaisson Median (IQR) age 34 years (30-40), 60% female, 3 Methods: and

Stellenbosch University, Stellenbosch University, 1 24 Johns Hopkins University Anne Efron 3 Authors: Jean Nachega Impact of Concurrent Tuberculosis Tuberculosis of Concurrent Impact Therapy Antiretroviral on Treatment in Toxicity and Liver Adherence Adults HIV-Infected Abstract 20 Abstract rbidities HIV Co-Mo concurrent TB treatment on ART adherence with is those in commonly more occurred toxicity liver 3-4 grade minimal, but mortality and morbidity high the given However, treatment. TB of late ART initiation, these considerations should limiting not factor of be early ART a initiation. Intervention to prevent alcohol abuse is sorely needed in this population. Conclusions: Design : Results median (IQR) CD4 count 98 99 cells/mL patients (36%) were (43-148) on anti-TB at drugs at the baseline. time of ART initiation (prevalent TB), 55% of whom were in the intensive phase of TB therapy. After months. (2-13.75) 7 of starting (IQR) median a at TB incident developed ART, 28 patients (11%) Median (IQR) cumulative ART adherence at 98.2% (95.5-99.5) 6 among months those without was TB, compared with 98.3% (93.42-99.45) in those with prevalent TB (p=0.38); and 96.83% (88.33-99.0) in those with incident TB (p=0.03). Grade with co-infected TB-HIV in occur to likely was toxicity liver 3-4 incident TB as compare patients without TB (1.3% vs. p 7.1%, =0.03). The only baseline adherence below the median was alcohol abuse (OR: 2.4; 95% independent predictor of ART CI: 1.20-5.0). Of note, supervised ART was not associated with improved adherence in the parent study (RCT). Background: In will (ART) high therapy antiretroviral initiating patients of proportion HIV-burdened countries a be large on tuberculosis (TB) treatment and many will also develop incident TB. Concerns have been raised about and adherence treatment ART on treatment TB-HIV concurrent the effect of are sketchy. adverse events but specific data on this issue trial controlled randomized, a in enrolled patients of data from (RCT) of partially supervised ART, to determine the impact of concomitant ART and Rifampin-based TB treatment on ART adherence and adverse events adults in 274 commencing HIV-infected NNRTI-based-ART. South 3-4 ACTG/DAIDS liver toxicity grade and median (IQR) cumulative count monthly ART adherence were pill documented over a 6-month post ART initiation for patients with and without treatment of TB. Multivariate logistic regression was performed to investigate baseline independent predictors of ART adherence above the median adherence. Baseline alcohol abuse was evaluated by the CAGE questionnaire.

Abstracts Abstracts 25 , 4 5 , 2 University of 3 Korle-Bu Teaching Hospital, Teaching Korle-Bu and Michael Court 4 3 , Margaret Lartey 1 , Joseph Oliver-Commey 3 There are limited data on the pharmacokinetics the on data limited are There Kaposi’s Kaposi’s sarcoma and NHL remain common 30 Ghanaian HIV/TB co-infected patients , Naser, Rezk , Naser, 2 , Angela Kashuba 4 Warren Alpert Medical School of Brown University, University, Alpert Medical School of Brown Warren 1 University of Ghana Medical School, University School of Medicine Tufts Of 83 patients that started ART, 39 were on a PI-based regimen regimen PI-based a on were 39 ART, started that patients 83 Of and 44 were on treatment, an CD4 NNRTI-based cell regimen. percentage Upon increased median starting of from 6%, IQR a (0%-24%) baseline to 14%, and months,( p<0.001) to 15.8%, IQR (3%-33%) IQR at 12 months (5%-33%) at 6 increase). for the 6- 12 month of ART,(p=0.032 In multivariable Cox regression analysis, the risk of death was 2.19); (0.31, CI 95% 0.8, = (HR) Ratio Hazard sex, to related not age category (≤12 years), HR=0.7, 95%CI baseline (0.24, 2.11); CD4 percentage, HR=0.9, 95%CI (0.88, (NNRTI 1.02); versus ART PI), regimen HR=1.2, 95%CI 95%CI (0.08, 5.58). malignancy(KS), HR=0.7, (0.46, 2.97); or type of Death during follow-up was seen more frequently in the first 6 months compared to the rest of the follow-up period. Only 3 patients (2 KS and 1 NHL) died after their follow-up. second year of Conclusion: malignancies in children with HIV/AIDS. Many children die a survive that those but ART, starting after months to weeks few mount good immunologic recovery. Variability in the Pharmacokinetics Variability of Nucleoside Reverse Transcriptase Inhibitors in TB/HIV Co-infected Ghanaian Patients Authors: Awewura Kwara 2 5 Abstract 23 Abstract HIV Co-Morbidities North Carolina at Chapel Hill, Isaac Boamah Ernest Kenu Background: (PK) of generic nucleoside (NRTIs) in populations in reverse Africa, where they trancriptase are widely used. inhibitors We evaluated the PK profiles of lamivudine (3TC), zidovudine (ZDV) and stavudine (d4T) as interindividual variability. well as the determinants of Methods: on rifampin-containing sulfamethoxazole TB were enrolled therapy and treated with plus and Combivir efavirenz (3TC hours 12 and and 8, 6, 4, trimethoprim- 3, ZDV) 2, 1.5, 1, 0.5, 0, or at obtained were samples 3TC and d4T. Steady-state post-dosing. Drug levels were determined by a validated HPLC UDP-glucuronosyltransferase the of sequencing Direct method. 2B7 gene exon 2 was performed. The patient relationship between covariates, UGT2B7 genotype, assessed by t-test, ANOVA and linear regression. PK data were and PK achieve to appropriate as data rank-transformed or log-transformed were data normality and equal variance. Results are expressed as mean values (SD).

Of 6530 patients seen during the study period, 108 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Of the 108 patients with malignancies, 33 died and 21 were lost were 21 and died 33 malignancies, with patients 108 the Of to Eleven follow of up those (LTF). that died and 14 of patients did not start antiretroviral therapy (ART). LTF Among KS patients, 32.6% had lesions in lymph nodes, 26.3% were cutaneous, 7.4% were mucosal, 5.3% were visceral and the rest were disseminated. Sixty two patients (57.4%) were male; of these, 54 had KS and 8 had NHL. Only 2 types of malignancies: Kaposi’s sarcoma (KS) 98 (90.7%) 98 (KS) sarcoma Kaposi’s malignancies: of types 2 Only and Non-Hodgkin’s lymphoma (NHL) 10 (9.3%) were seen. No patient had both malignancies. (1.65%) had malignancies. The median age for patients with IQR (5-12 years). malignancy was 9 years, : Results Proportions of patients with malignancies Survival were computed. was assessed by association Kaplan with Meier other variables analysis regression. was and Variables determined its associated by univariate analysis and with other clinically relevant variables Cox were death at fitted in the final model. P<0.2 in Methods: We conducted a retrospective case involved review series of that records of all HIV-infected patients aged 6 weeks to 18 years who received care at the Baylor-Uganda 2008. 31, Clinic between January 1, 2004 and December Introduction: The objective of this study was to and outcome of determine the prevalence, associated factors, attending the HIV-associated malignancies among children Baylor-Uganda Clinic in Kampala. Vincent Tukei and Adeodata Kekitiinwa, and Adeodata Kekitiinwa, Authors: Vincent Tukei Foundation-Uganda Baylor College of Medicine Children’s (Baylor-Uganda) Prevalence and Outcome of Among HIV-Associated Malignancies Clinic Children Attending a Referral Uganda in Kampala, Abstract 22 Abstract HIV Co-Morbidities Our findings indicate significant that problem than anemia among HIV positive patients neutropenia may ART at this clinic. taking AZT containing be a more The prevalence of severe neutropenia (less than 1000cells/cc) was 19% at baseline and 39% at six months. We found that had baseline at counts neutrophil normal with patients of 53% neutropenia at 6 months. The average MCV increased from 84 at baseline to 102 months The at at and prevalence one 106 of year. neutropenia at 6 78% and months 6 at 81% to increased and 64% was baseline at 1 year. The average neutrophil counts appeared to reduce with time decreasing from 2000 cells/cc to 1500cells/cc both and at 1 year. at 6 months Cancer Clinic staff at Kamuzu Central Kamuzu at staff Clinic Cancer : More than a third of the diagnosed SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 village), family history of malignancy, exposure to carcinogens potential (tobacco, alcohol, source, and cooking marijuana materials, use, and medical water insecticide history exposure), (including past HIV, schistosomiasis), tumor malaria, location, tuberculosis, histology diagnosis, and stage, and treatment received. The questionnaire data were entered into a Web-based metaclinics with performed database were analysis and Calculations Excel. Microsoft and extracted into at least 2013. Excel. The cancer database will continue until : Results From January 2010 to March 2011, patients 1188 have cancer been identified, with 48.3% HIV positive, 11.4% of unknown HIV status, and the majority 40.3% of registered HIV-negative. patients Initially, came from the Department, Medicine suggesting possible under-reporting from other departments. Subsequently there was number gradual of increase patients in referred representation across from different the departments, departments. there were from patients Pediatrics, from For Medicine, 357 from Surgery,168 399 Dental from 22 Ophthalmology, from 53 Gynecology, from 171 the were cancers Major department. of indication no had 14 and cervical %), (30.7 sarcoma Kaposi’s with cancers associated HIV Cancer 15.2% and lymphomas 10.9%. 98% of patients used sarcoma Kaposi’s with with Patients HIV. had sarcoma Kaposi’s malignancies. other with patients HIV than alcohol and tobacco Among HIV-positive patients, 82.9% had a history of malaria infection, and 22.4% had a history of TB infection. Conclusions: malignancies registered occurred patients in with known Kaposi’s malignancy. HIV-positive Analysis of sarcoma broader epidemiological data as about malignancies of HIV patients in the Malawi will aid future efforts most for prevention common and treatment. Treatment of Kaposi’s sarcoma has since been expanded to ART clinic and prospective data is being collected. Acknowledgement Hospital; UNC Project; UNC-Chapel Hill, Light House Trust.

There is significant variability in 27 patients (74% males) with complete data were Malawi lacks an operational cancer operational an lacks Malawi background:

UNC Project-Lilongwe and Kamuzu Central Hospital, Central UNC Project-Lilongwe and Kamuzu 26 Conclusions: : Results included in this analysis. The AUC [coefficient of variation] of 3TC (n=27) was 5843 (2581) h*ng/mL [44%], ZDV (n=16) was 3368 (2747) h*ng/mL [82%] and d4T (n=11) was h*ng/mL [26%]. 865 3TC (223) AUC was significantly lower in patients who received Combivir compared 3TC and to d4T those (5474 vs. who 6911 h*ng/mL, normalized received apparent P=.031) oral clearance (CL/F) but were similar weight- (459.2 vs. 406.0, P=.824). Compared with carriers non-carriers, of the UGT2B7 haplotype tagSNP 749A>G had lower mean ZDV AUC (2160 vs. 4997 h*ng/mL, P=.028), shorter plasma half-life (4.0 and vs. higher P=.020), 12.2 CL/F hours, (2853 vs. 969 mL/min/ kg, P=.009). We did not find sex differences in PK for ZDV and 3TC in this small population. d4T However, CL/F was higher in females than males (528.6 vs. 360.7 mL/min/kg, P=012). Age and BMI were not associated with the PK evaluated of patients had suppressed plasma any HIV-1 levels within NRTIs. All 24 weeks of therapy. pharmacokinetic profile of commonly used NRTIs in Ghanaian HIV/TB co-infected patients on TB therapy but no difference in short-term virologic suppression. Also, we found a association novel between UGT2B7 genetic variation and ZDV The PK. relationships between variable PK profiles, concentrations, clinical effect intracellular and long-term toxicity need to be evaluated. Methods: Patients clinically diagnosed with malignancies were identified at Kamuzu histologically Central Hospital’s departments of confirmed Medicine, General Surgery, or Gynecology, Dental, Pediatrics, and September 2009, patients underwent Ophthalmology. interviews and medical From chart reviews to complete database questionnaires. Collected information included demographic data (age, sex, race, home Clinical evidence- develop to data epidemiological reliable thus registry, based care and focused research. HIV, infecting approximately 20% of urban Malawians contributes to the pathogenesis of cancers, particularly AIDS-defining sarcoma, malignancies non-Hodgkin’s lymphoma, (Kaposi’s and cervical cancer. antiretroviral As use morbidity expands of cause significant more a become will malignancies and life expectancy and mortality increases, in this population. To gain understanding about malignancies in Malawians, we designed a database to collect clinical data for all presenting Central Hospital (KCH) in Lilongwe, Malawi. cancer patients at Kamuzu Chapel Hill Elizabeth Bigger, Carol Shores, Mina Hosseinipour, Mina Hosseinipour, Carol Shores, Authors: Elizabeth Bigger, Agnes Moses and Albert Mwafongo Carolina- Lilongwe, Malawi; and University of North Abstract 24 Abstract HIV Co-Morbidities Kamuzu Epidemiology of Cancers at Central Hospital, Malawi

Abstracts Abstracts 27 , 1 and Corey, and Corey, 1 , Innocent , Meei-Li Huang 2 1 , Jackson Orem 1 , Lawrence Corey , Misty Saracino 1 2 Uganda Cancer Institute, Makerere Uganda Cancer Institute, 2 KS biopsy specimens were obtained from , Anna Wald Thirteen Ugandans with HIV-associated KS 1 , James Kafeero 2 1 University of Washington, Fred Hutchinson Cancer University of Washington, 1 Jeffrey Vieira Mutyaba rbidities HIV Co-Mo of Human Characterization Expression in Gene Herpesvirus-8 Tumor Sarcoma Kaposi HIV-Associated Clinical Correlates Tissue and Its Phipps Authors: Warren Abstract 26 Abstract Casper Research Center, Research Center, University Background: Human herpesvirus 8 (HHV-8) replication is necessary for KS tumor growth, and quantities of HHV-8 lytic HHV- quantified We tissue. biopsy KS in vary mRNA latent and 8 gene transcripts in KS tumors from associated KS and Ugandans examined the associations with between HHV-8 HIV- HHV- systemic and morphotype, KS tumors, in expression gene 8 replication. Methods: treatment-naïve, HIV-infected histologically-confirmed KS. Participants also Ugandan collected swabs oral daily and adults plasma samples quantify weekly HHV-8 replication. over with HHV-8 4 mRNA weeks gene including transcripts, to 2 lytic genes (K8 and (ORF73), ORF50) and and GAPDH 1 latent were gene quantified using in RT-PCR; total biopsy RNA was specimens determined by optical density. Only specimens with total RNA >10 ng and GAPDH threshold cycle <35 were included in analysis. HHV-8 mRNA log copies were normalized to total ng of RNA in samples. : Results contributed biopsy specimens. Eleven (85%) were were (92%) male, Twelve 24-42). (range years 35 and was age median the classified as tumor stage T1, 10 (77%) had median macular lesions, CD4 T cell count was HIV viral load was 5.1 (range 2.3-5.8). median log10 144 (range 5, 265), and the biopsy KS 13 all in detected were transcripts gene mRNA HHV-8 ORF50) or (K8 genes lytic from mRNA of quantity The samples. exceeded that from latent ORF73 in all samples [median (IQR) 3.0), (2.2, ORF50=2.7 3.2), (2.2, 2.6 K8= RNA total copies/ng log ORF73= 1.7 (1.2, 1.9)]. The quantity of HHV-8 mRNA detected was also highly correlated within Spearman samples (K8 coefficient and (Sp)=0.92; ORF50 K8 ORF50 and ORF73 Sp=0.84). and ORF73 Sp=0.78; Quantity of lytic gene expression differed morphotype, with based nodular tumors having on a lower tumor proportion of lytic genes compared to macular characteristics clinical morphotype other No p=0.04). ORF50/ORF73 (K8/ORF73 p=0.13; were significantly associated with HHV-8 gene expression in tumor tissue. , 3

4 , Julius 3 , Hongmei 1 Korle-Bu Korle-Bu 3 University of 2 and Awewura Kwara 2 , Joseph Oliver-Commey 3 , Augustine Sagoe 1 , Kwamena Sagoe 1 , Hulin Wu 4 Warren Alpert Medical School of Brown Alpert Medical Warren , Fafa Xexemeku 4 3 , Markafui Seshie 3 , Timothy Flanigan 1 , Ernest Kenu 2 University of Ghana Medical School, University of Ghana 1 Teaching Hospital, Hospital, Teaching SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Authors: Margaret Lartey Viral Decay Rates are Similar in HIV- Rates are Viral Decay and Without With Patients Infected Efavirenz- With Treated TB Coinfection Therapy Containing Antiretroviral Abstract 25 Abstract rbidities HIV Co-Mo

Rochester School of Medicine and Dentistry, Medicine and Dentistry, Rochester School of Yang Conclusions: Tuberculosis coinfection antituerculous and therapy concurrent did efficacy not or compromise long-term effect antiretroviral of Ghanaian HIV-infected patients. efavirenz-based therapy in Four patients (three with TB coinfection) died before died coinfection) TB with (three patients Four : Results day-28 and another 4 patients (two from each group) did not complete sampling. The mean ± SD phase 1 viral decay rate was 0.586 ± 0.107/day in the co-infected patients and 0.600 ± 0.094/day in the patient without 0.021/ active ± TB 0.025 (P and = 0.021 0.726). The 0.023± were rates decay II phase mean day respectively, in patients with and without active TB (P = 0.415). The proportion of patients with HIV RNA < 50 copies/ 48 week at baseline from count cell CD4 in increase the and mL of antiretroviral therapy were not different between the two groups. Log-rank test showed that phase I viral decay rate (P with associated were 0.01) = (P rate decay II phase and 0.04) = the risk of virologic failure and time-to-virological failure. Methods: 74 HIV-infected patients (34 with TB coinfection) were prospectively enrolled in a pilot study and treated with a once-daily combination regimen of lamivudine, didanosine, and efavirenz. HAART was initiated within 2 to 8 weeks of TB treatment in co-infected patients. Viral loads were determined on days 0, 3, 7, 14 and 28 of HAART. Plasma viral loads were fitted to a biexponential nonlinear mixed-effects HIV viral model dynamics. The of estimated viral decay rates, baseline characteristics and treatment tests. between the two groups using the nonparametric responses were compared Background: While concurrent highly active antiretroviral therapy (HAART) during TB substantially treatment survival is benefit, associated perceived overlapping with drug high toxicities, and pill drug-drug interactions burden, often cited as are reasons to defer HAART. We hypothesized that early HIV clearance rates in HIV/TB co-infected patients would a with treated when patients HIV-infected in that to similar be similar simplified HAART regimen. University Mingle Vincent Boima : Data collection began March 28, 2011 and is SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Because I Really Trust Doctors” Abstract 28 Abstract and Treatment Integrating Prevention in HIV Care ”I Had No Negative Expectations Authors: Violet Naanyu, Fatuma Some and Abraham Siika, Program Moi University and USAID-AMPATH Moi University Clinical Research Center (MU its first CRC) AIDS Clinical Trials Group (ACTG) initiated study in 2006. Since then, several clinical trials have been initiated. regulatory The international and trials national institutional, by are approved committees to ensure participants are African culture well-protected. generally The upholds great respect and clinicians. for The healers same view may be anticipated the to forward look held only may participants meaning in clinical trials, good, and never think of potential harm in participating in a clinical trial. Thus we explore whether trial participants fully understand the consent form, and how participants one Sixty trials. clinical in participants being about they generally feel were enrolled in the second clinical trial conducted by the MU CRC. In depth interviews were conducted on 21 participants after completion of their clinic visit. Domains were covered in a logically unfolding format including: the informed consent document; participants’ understanding of informed consent; benefits associated with participation; personal experiences Informed Consent, Experiences, and Informed Consent, Experiences, Participants of Clinical Trial Perception in Eldoret, Kenya expected to be complete after 12 months. Data analysis will examine factors associated with delayed wound healing and premature resumption of sex. HIV status, baseline CD4, viral load, age, time to resumption of adverse sex, events will HSV be examined 2 for association infection with wound and healing. Demographic and behavioral characteristics will Level sex. of resumption to time with association be for examined of concordance between reported wound on photographs will be assessed. direct observation and status based on Discussion: Although the post-circumcision WHO abstinence, recommends precise 6 data post on weeks circumcision wound duration healing are of lacking. A longer than necessary period of abstinence may accepting discourage circumcision, men whereas from a period shorter may than expose men necessary or their partners study to will infection. This generate information clients with risk factors for delayed wound healing and inform applicable for identifying the tailoring of counseling abstinence messages recommended of period the reducing possibly specifically while for them, for others. The study will also contribute to further refinement healing. wound evaluating for methods of standardization and to assess how they are affected by circumcision. Keratinization Keratinization circumcision. by affected are they how assess to percent measuring by assessed is scar post-circumcision the of keratin in desquamated cells collected slides. using poly-L lysine : Results ≥1 , Walter , Walter 2,4 University of 2 University of Nairobi, 3 , John Rogers 1,3,4

2,4 KS tumors in our cohort express a

and Robert C. Bailey 3 Nyanza Reproductive Health Society, Nyanza Reproductive Health Society, 1 28 Male Circumcision Consortium Illinois at Chicago, Chicago DCFAR, preponderance of lytic HHV-8 gene products. The quantity of lytic HHV-8 mRNA detected in KS tumors is associated with tumor morphotype and the detection of replicating HHV-8 in tissue KS from mRNA HHV-8 of Quantification oropharynx. the may provide insight into the pathophysiology of KS and could to treatment. help predict disease progression and response Conclusions: Evaluation Evaluation of systemic HHV-8 participants had replication HHV-8 detected in found peripheral blood that The on day. median oral HHV-8 shedding rate all was 50% (IQR 3%, 2.6, (range 3.3 of number copy log median a with days, of 61%) 4.2) on days HHV-8 was detected. The quantity of K8, ORF50, and ORF73 log copies mRNA in associated KS with the detection biopsies of any was oral HHV-8 positively (K8 p=0.01; ORF50 p=0.009; ORF73 p=0.004). The quantity of lytic K8 and ORF50 mRNA, but not latent ORF73 mRNA, was also positively correlated with the quantity of HHV-8 detected in saliva (K8 Sp=0.6; ORF50 Sp=0.8). 4 Authors: Elijah Odoyo-June Wound Healing and Resumption of Sex Wound Following Medical Male Circumcisions in Kisumu, Kenya Abstract 27 Abstract and Treatment Integrating Prevention in HIV Care

Jaoko Methods: A cohort of (n=115) and negative newly (n=215) men are circumcised being followed HIV three over positive months to determine resumption time of sex. Wound healing to is assessed through visual healing and inspection for apposition time of edges, presence and color of scar to formation, and presence of gaps as indicators of restoration of function. Independent observers report on wound healing are results and photographs on based intervals weekly at status Participants observation. direct with concordance for compared are interviewed weekly over a period of three circumcision months after and self-reported recorded for date each individual. Pre- and post-circumcision viral of resuming load and shedding sex in HIV-infected participants are measured is Introduction: Resumption of sex before complete wound healing in men who undergo circumcision public is health an concern emerging because the it benefits of may male circumcision significantly (MC). Programs erode recommend currently six weeks of abstinence following circumcision, though the true timing for sufficient wound healing known. Sex before complete healing likely increases the risk of is not post- prolonged Conversely, HIV. of acquisition or transmission study A uptake. MC to barrier a be may abstinence circumcision to evaluate post-circumcision wound healing, resumption of sex and associated determinants is therefore being conducted in Kisumu, Kenya.

Abstracts Abstracts 29 ART adverse events are frequent, but are largely are but frequent, are events adverse ART We We assembled an observational cohort of 378 ods: Meth HIV-infected children and adolescents who started ART at the Baylor-Uganda Clinic during the period July 2004-July 2009. During the study period, patients were started on Zidovudine or Stavudine , plus lamivudine, and Efavirenz or Nevirapine. Adverse events were recorded as they occurred. carried out. analysis were Meier survival Kaplan analyses and Descriptive : A total of Results 126 adverse events were reported among patients. 107(28.3%) Ninety six of the experienced 107 only 1 events adverse The events. 3 or 2 had patients 11 event; adverse included: anorexia 3(2.4%), nausea and vomiting 18(14.3%), diarrhea 17(13.5%), abdominal pain 4(4.8%), hepatitis 3(2.4), somnolence/drowsiness 4(3.2%), dizziness 22(17.5%), amnesia 1(0.8%), anxiety/nightmares 12(9.5%), lactic acidosis 1(0.8%), skin rash 7(5.5%), nail discoloration 8(6.3%), gynaecomastia cardiomyopathy 1(0.8%), peripheral 1(0.8%), anemia 10(7.9%), neuritis 1(0.8%), and lipodystrophy 11(8.7%). to lost were (2.1%) 8 and died patients (8.2%) 31 ART, on While follow up. Only 6 of the that 31 died had experienced adverse effects before death. None of ART the related. deaths Twenty were four considered patients changed ART of adverse as events. Of a the 24, result 10 patients had anemia; 1 had cardiomyopathy; 1 amnesia; 1 was patients had lipodystropy. with hepatitis and 11 The median duration from start of ART to detection of adverse according varied duration This 3-24). (IQR: weeks 12 was event to adverse event: Anorexia 16.7 (IQR: 2-24) vomiting weeks; 9.3 nausea/ (IQR: 2-12.1) weeks; diarrhea (IQR: 11.9 weeks; 4.7-13) 5-31) (IQR: 14.5 anemia weeks; 2 pain abdominal weeks; (IQR: 10 anxiety/nightmares weeks; 3-98.7) (IQR: 50.8 hepatitis 2-12) weeks; drowsiness/somnolence 3 cardiomyopathy 35.4 weeks; nail discoloration 24 (IQR: 12-71) (IQR: 2-8) weeks; weeks; lipodystrophy 207 (IQR: 96-224) weeks; 52 amnesia dizziness weeks; 4-12) (IQR: 9.4 11 rash skin weeks; 2.6-12) (IQR: weeks; peripheral neuritis 13 weeks; lactic acidosis 50 weeks; and gynaecomastia 52 weeks. The probability of occurrence of adverse events was 8.4 % ( at n=341) 95% month-1 CI: of 5.95-11.68, ART; 17.4 % ( 95% CI: 13.84-21.69, n=290) at month-3; 22.9% (95% CI: 18.87- 27.62, n=259) at month-6; and 24.7% (95% CI: 20.56-29.57, n=239) at 1 year of At ART. 2 and 4 years after ART initiation, the cumulative probability of occurrence CI: of 95% ( % 28.7 and n=217) 23.55-33.03, CI: (95% 28.0% was adverse events n=185) respectively. 24.22-33.81, Conclusion: at occur events The therapy. of change require not do and mild specific times during treatment. One half of the events occur within the first 3 months of ART. To be able to capture these clinicians need to look for them at the specified times. events,

Antiretroviral therapy (ART) is known to cause to known is (ART) therapy Antiretroviral SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 a number of adverse effects. The objective of this study was to patients among events adverse ART of frequency the determine aged 6 weeks to 18 years and to assess the outcome of these events. Background: Vincent Tukei, Isaac Sebuliba and Adeodata Authors: Vincent Tukei, Foundation- Baylor College of Medicine Children’s Kekitiinwa, Uganda (Baylor- Uganda) Adverse Reactions to Antiretroviral Therapy Among HIV-Infected Ugandan Children Abstract 29 Abstract and Treatment Integrating Prevention in HIV Care All participants recalled being informed about the trial and its voluntary nature. they Consequently, signed the consent form and joined the trial. However, some participants were too ill and desperate to fuss about details of the trial. Some of them relied heavily on providers’ advice on what to do while others left the decision to their understand’ to ’easy from ranged content its and guardians. form consent Their opinions on the to ’difficult but, to they grasp,’ got many opportunities to ask questions regarding the consent form and to allay any fears. For the most part, participants understood was what the about. study Participants praised study friendly staff, efficient and and professional timely remarkable changes services, in good well-being, sanitation, and supportive and financial communication services offered. On the contrary, some reported negative side effects and troublesome social Nonetheless, all lives. participants were happy to volunteer again in future due to the good services enjoyed, of improved clear well-being, probability of being indication part of a medical discovery, and provision of transport reimbursement. Indeed, all were optimistic about encouraging others to participate in seem generally Eldoret in participants trial Clinical trials. future to understand their role but rely on providers and guardians when deciding to consent. Trust in providers, advanced illness, and desperation to get better may encourage Happily, participation. trial experiences have also been rewarding. Further evaluation of very trial participant opinions can positive and monitoring and development shape and protocols trial improve of future clinical trials. This study also serves as an important exemplar for scholars interested in developing world. research ethics in the in the trial; and possibility of future participation. Interviews were offered in Kiswahili, English, or notes both languages. were Field taken transcription. and Transcripts were coded audio and emerging recording were themes logically connected to provide a complete were description of made and thoughts. feelings, for experiences, trial participants’

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Abstract 31 Abstract and Treatment Integrating Prevention in HIV Care Behaviours HIV/AIDS Preventive Health the University Among Undergraduates of of Ibadan, Nigeria Authors: Obinna Odor and Ngozi Ezeajughi-Obunezi, University of Ibadan, Nigeria Studies show that HIV/AIDS remains a challenge major public worldwide health and however, known, is Little mitigation. its to key holds behaviours adoption of preventive about typology health of preventive health behaviours adopted undergraduates by against the disease therefore condition. determined This pattern and study, types in Nigeria. health behaviour among undergraduates of HIV preventive sampling two-stage A design. in cross-sectional was study The procedure was adopted. assessed the students’ preventive health Validated behaviours and the questionnaire antecedent factors was used which for data collection. Descriptive and Chi-square statistics were used for data analysis. Participants’ overall mean knowledge score on HIV was 18.9 out of 25 points. Most having unprotected participants sexual (97.3%) intercourse was believed risky. A that majority (96.3%) reported that blood transfusion could transmit HIV. The preventive health practices adopted by the were: participants avoiding sharing of skin-piercing instruments (93.6%); (58.6%). use condom consistent and (70.3%) abstinence sexual The prevalence of condom use by religion was as follow: More females (57.5%) than males use of (42.5%) condom. practiced More females consistent (54.2%) abstained from than sex. A majority males (77.7%) of those (45.8%) that avoided skin-piercing instruments did so ”always”. The topped the list of the sources of motivation to adopt HIV/AIDS mass media preventive health behaviours. The prevalence of adoption of the health types of behaviours HIV was preventive low in of spite knowledge of of general the high disease. level Health education strategies are needed to promote adoption of preventive health behaviours among Nigerian students. CI: 1.22-1.66; P<0.001); living in Asia/South Pacific vs. other regions (OR:1.77 95%CI: 1.96-3.92 and have not experienced body face changes (OR: 0.90; 95%CI: 0.81-1.00; P=0.04); No reported depression (OR: 0.80; 95%CI: and Non-Disclosure 0.72-0.90; of HIV status (OR:1.75; 95%CI: 1.28-2.41; p<0.001) P<0.001). CONCLUSIONS: Three decades into the HIV/AIDS pandemic, despite gains with increased access to stigma, ART, HIV-associated isolation, and associated with loneliness and depression in over one quarter discrimination persist, of PLWHA surveyed. There and is a critical need to address were these challenges as effective targeted interventions impact public health. benefit individuals and are likely to , 2 and 5 YRG 3 , Renslow Sherer 1 University of Bonn, , Jürgen Rockstroh 5 4 ≥60 years, respectively. 37% of University of Chicago, University of Chicago, 2 , Chelsea Morroni A cross-sectional study was undertaken was study cross-sectional A 1 , Mauro Schechter 3 6 2035 HIV-infected adults (1275 males, 749 females, females, 749 males, (1275 adults HIV-infected 2035

University of Rio de Janeiro, University of Rio de Janeiro, 4 Stellenbosch University, Stellenbosch University, 1 30 International Association of Physicians in AIDS Care International Association 6

Authors: Jean Nachega HIV Associated Stigma, Isolation, Stigma, HIV Associated and Serostatus Discrimination, Global Survey in Disclosure: A Adults Three Decades HIV-Infected Pandemic Into the HIV/AIDS Abstract 30 Abstract and Treatment Integrating on in HIV Care Preventi Care, participants reported loneliness and social isolation as a result of their HIV-status (42% in NA, 28% in LA, 35% in EU, 52% in A/P vs. 24% in AF, p<0.01). Overall, self-reported depression was reported by 27% of respondents (47% in NA, 28% in LA, 27% in EU, 25% in A/P vs.13% in AF, p<0.01). responders, According the biggest to misperceptions from the public about PLWHAs are that they lead risky lifestyles (sexual promiscuity, in NA 49% in EU, 41% in A/P, drug use, and prostitution) (71% a is HIV/ADS that and p<0.01); LA, in 29% and Africa in 31% vs. PLWHA of 42% avoided; be should PLWHA and sentence death cited “strong concerns” about others 96% learning of respondents reported disclosing their HIV their status to at status. least one person – most commonly a family member (89%), and 17% of respondents who reported being in a long-term relationship indicated they had not disclosed their HIV status to their partner. Independent predictors of perceived stigma were duration HIV infection <5 vs. > 5 years (OR: 1.42; 95% Overall, 40%, 53% and 6% of participants were aged 39 years, 18 40 to to 59 years and RESULTS: RESULTS: 2 unspecified) were recruited. 9 transgender, from January 2010 to March 2010 in 12 countries in America (NA), North Latin America (LA), Europe (EU), Africa (AF) and Asia/Pacific (A/P), to assess experiences and attitudes related to people living with HIV/AIDS including (PLWHA), perceptions of stigma. A face-to-face interview was HIV-infected conducted adults among on antiretroviral Multivariate language. therapy local patient’s in (ART) questionnaire validated using a logistic regression was performed to investigate independent predictors of perceived HIV related stigma. DESIGN & METHODS: & DESIGN BACKGROUND: Despite the recent global drive for universal on known is little treatment, and care to access and testing HIV a global scale about patients’ perspectives on HIV-associated critical is knowledge This disclosure. serostatus HIV and stigma designing in assist to and services support of planning in help to and/or expanding strategies. targeted public health interventions Jose Zuniga Suniti Solomon

Abstracts Abstracts 31 , Josephat 2

1 AMREF Directorate of AMREF Directorate of 2 , Alice Lakati 1 This cross sectional, mixed methods study The rate of ART adherence at the study : ≥95% adherence considered optimal. Additionally, A total of 206 patients participated (64.1% female, and Mina Houseinipour 2 UNC Project, Lilongwe site, UNC Project, Lilongwe 1 Capacity Building Background: Low level of therapy (ART) is of adherence great public concern to because it increases antiretroviral morbidity and mortality among AIDS patients. Assessment of antiretroviral adherence outside referrals centres in Malawi is lacking. We sought to determine factors affecting adherence to ART among adult AIDS patients attending a decentralized health center. Methodology was conducted at a decentralized site in Structured Lilongwe, Malawi. questionnaires were administered patients obtaining ART services from to the clinic between 30th all adult July and 6th August, 2010. Adherence was measured three methods; three days self recall, one month recall and pill using count with 3 in-depth interviews with staff and 2 focus groups with ART users used were a done. Chi-Square We to test the association of variables and manual methods of qualitative identify themes. analysis to : Results mean age 37.6 years± 10.06). Most males attained education (94%:84.8%). Adherence varied according measurement with best results to in one month recall, better methods in of three days recall and worse in pill count (82.0%, 91.3%, and (80.6%) count and pill by adherence better having men 71.1%), average overall The (94.7%). recall month one in better women adherence rate was 81.46%. associated Adherence with was sex significantly (P<0.001[0.000]), (P<0.05[0.027]), and missed past non appointment education, adherence occupation, (P<0.001). disclosure, Age, side effects Patients’ adherence. with associated significantly not was time and waiting reported reasons for non-adherence included forgetfulness, being busy and travelling. Conclusions: site was lower than the Females WHO consistently reported recommended high adherence rate than their (≥95%). pill count suggested, pill count appeared accurate than self recall methods. Non adherence is common with missing visits.

and Treatment Integrating on in HIV Care Preventi to Affecting Adherence Factors Among Adult Therapy Antiretroviral at Area18 ART Clinic in AIDS Patients Lilongwe, Malawi Authors: Virginia Thonyiwa Abstract 33 Abstract Nyagero

Based on these findings, government should SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Conclusion: The results revealed there was significant main effect main significant was there revealed results The : Results of treatment on teenagers’ achievement. Also, it showed that there was significant main effect of treatment on teenagers’ achievement in health information. (F(1,97) = 145.474’ P<.05). attitude the on treatment of effect main significant a was There of teenagers to health information (F(1,97) = 127.877 P<.05). However, there was no significant main effect of gender on teenagers’ development achievement in HIV/AIDS and health information (F(1,97) = HIV/ to attitude teenagers’ on gender 0.839, of effect main significant P>.05). There was AIDS and also health information and education (F(1,97) no = 0.640; P>.05). There was no significant 2-way interaction effect of treatment and gender on teenagers’ attitude (F(1,97) = 2.041; P>.05). equip public youth-friendly centres with necessary hardware and software facilities, trained teenage instructors should be encouraged to uptake the challenge of Above using this strategy. all, educators packages to be used in youth-friendly centre. should develop video instrumental A total of 102 teenagers in two intact youth friendly youth intact two in teenagers 102 of total A Methods: were hypotheses null Three participants. study the were centres formulated and tested. Four instruments namely: video-tape recorder of lesson used for the study, teenagers’ scale, the social studies and achievement Teachers’ test attitudinal (SSAT), for the study. Guide for conventional teaching were used Learning through information dissemination information through Learning Introduction: is an activity that starts at birth and the lifetime continues both in formal throughout and non-formal settings. Facilities and personnel are employed to provide information for health learning, which aims at preparing meaningfully teenagers to the to society contribute they live in. However, strategy instructional taped video- involving Nigeria in studies empirical have been limited to the teaching and based subjects. This study learning therefore attempts to determine the of science- HIV/AIDS of dissemination in technology video-tape of impacts information among teenagers in Nigeria. King Odor, University of Ibadan, Nigeria University of Author: King Odor, Impact of Videotape Technology on Technology of Videotape Impact Dissemination Information Hiv/Aids Friendly in Youth Among Teenagers Centres in Owerri, Nigeria Abstract 32 Abstract and Treatment Integrating on in HIV Care Preventi , 1 , 2 , Juliet Akao 2 2 , Korey Demers , Korey 2 Case Western Reserve Case Western 2 , Samar Mehta 1 , Denis Tebit 1 and Robert Salata 1 Our results suggest that replication kinetics The HIV global epidemic is still major challenge major still is epidemic global HIV The , Joshua Kayiwa 1 , Peter Mugyenyi , Peter 1 Joint Clinical Research Centre, 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 : ons Conclusi in dendritic cell-T cell cocultures may influence which subtype D HIV-1 viruses are selected during heterosexual transmission capture initial preventing at aimed Strategies Uganda. Rakai, in further HIV-1 transmission. DCs could prevent of HIV-1 by University Background: with about 35 million people living with HIV than globally. 50% of More these live in the sub-Saharan Africa. Of concern still is that after close to 30 years of the epidemic, the number of new infections annually is still alarming with new 2.2 infections million in 2009. With the roll therapy out (ART), of only Anti-retroviral 37% of the estimated number of people that need antiretroviral therapy in sub-Saharan Africa are on major treatment. challenges However, that come with this roll out of therapy include emergence as well as transmission of drug resistance mutations. Methods: We have performed genotypic resistance testing using an in-house technique. With this technique, looked we at drug resistance profiles have from as early as 1999 up to date. genotypes Over have 1000 been performed on patients a viral have load analyzed greater both than 2000 copies/ml. We for regions (PR) protease the and (RT) transcriptase reverse the drug resistance as well as subtypes. : Results We show that with the universal roll out of ART in Uganda, the most frequent drug resistance mutation (DRM) to NRTIs was M184V, conferring 3TC and FTC resistance (>60% of all subtype A and mutations mostly D responsible for thymidine analog resistance samples tested). The collection were and found 219) 215 at a 75, 67, (sites (TAMs) 210, 70, 41, of low but similar frequency in both subtype A and D despite the fact that AZT is one of the most prescribed drugs in Uganda. K103N were EFV) and (NVP NNRTIs to DRMs frequent most The and G190A, similar in both subtype A and D was samples. There slightly less Y181C (conferring mostly in subtype NVP A versus resistance) D samples. We had expected to observe a decrease DRMs/sample/year with the roll out of HAART in Uganda the (2005-2009). level However, of DRMs/sample/year remained remarkably constant. Conclusion: Even with the roll out of ART, the burden of drug resistance is still a major addressed through regular monitoring of patients. challenge that needs to be Abstract 35 Abstract and Treatment Integrating HIV Care Prevention in During of HIV-1 Drug Resistance Trends in of ARV Treatment 12 Years the Past Uganda Authors: Immaculate Nankya Cissy Kityo Fred Kyeyune , 4 , 2 Boston University, Boston University, 4 , Suryaram Gummuluru 3 2 , Oliver Laeyendecker 1 , N. Sewankambo We We have examined viruses from 6 newly infected 3 Samples from the newly infected partner were and Maria Wawer 2

Brigham and Women’s Hospital, Harvard Medical School, Hospital, Harvard Medical School, Brigham and Women’s 1 32 Makerere University, Kampala, Uganda, Kampala, Makerere University, Johns Hopkins University, Bloomberg School of Public Health, Johns Hopkins University, : Results Methods: subjects and their epidemiologically identified monogamous heterosexual partner in a Rakai, Uganda cohort prospectively followed prior to and after subjects, virus HIV-1 envelope acquisition. glycoproteins were From generated these using were products amplified these and PCRs, independent multiple incorporated into an NL4-3 backbone to construct replication competent recombinant viruses. Viruses have been examined for their sensitivity to CD4 antibody, CCR5 blockers inhibitor, and coreceptor usage. fusion Viruses are also being assayed for replication kinetics in macrophages, and lymphocytes, monocyte derived immature monocyte dendritic cell derived – T cell cocultures. examined within 6 Each months recipient’s sequences of clustered with the estimated corresponding donor’s seroconversion. sequences in neighbor joining phylogenetic analysis which confirmed the epidemiological linkage. All couples were infection in early found Viruses HIV-1. D subtype with infected compared to those circulating partner in displayed the no chronically significant difference infected in CD4 antibody, sensitivity CCR5 inhibitor, to maraviroc, and fusion blocker, Virus T-20. found in the newly infected subject did not display significantly different replication Viruses compared to those present in the transmitting partner. kinetics in lymphocytes found early in infection were significantly better at replicating in immature dendritic cell-T matched Wilcoxon 0.03, = cell (p partner transmitting the in cultures viruses compared to the in poorly relatively replicated viruses All test). signed-rank pairs monocyte derived macrophages. Background: A newly infected subject limited acquires number of only HIV-1 a variants from circulating the in diverse the viruses chronically infected transmitting We partner. have previously shown that circulating in the transmitting variants partner, found early in compared to the related closely more are subject infected newly the in infection viruses to ancestral viruses, often have shorter and less glycosylated envelope variable loops. genotypic The characteristics reason are selected viruses remains unclear. during with transmission these School of Medicine 3 2 Authors: Manish Sagar Viruses Found in Subjects During Early During Found in Subjects Viruses at Replicating Are Better Infection Cell Cocultures in Dendritic Cell-T in Circulating the Variants Compared to Partner the Heterosexual Abstract 34 Abstract and Treatment Integrating on in HIV Care Preventi D. Serwadda Ron Gray

Abstracts Abstracts 33 2 , Rebecca 2 University of Malawi 2 , Chrissie Kaponda 1 , and Abigail Kazembe 2 , Eric Umar 2 University of Illinois at Chicago, University of Illinois 1 Ngalande and Treatment Integrating on in HIV Care Preventi HIV Prevention to Delivering Challenges Traditional Yao During Programming Rites in Malawi Male Circumcision Authors: Judith Levy Abstract 37 Abstract Traditional Traditional male circumcision is widely groups practiced throughout sub-equatorial by Africa. Bantu Among the Yao of Malawi, the surgery and ceremonial rites conducted of the in Jando are a special from enclave the geographically village segregated to access. Here participants which collectively practice only age-prescribed circumcised normative roles males within the have rituals and practices status of passage this from boyhood key into manhood. Circumcision is by followed day, first the on circumciser native a by performed a 4-6 week sequestered period of healing and socio-cultural instruction during which initiates learn the expectations and responsibilities of Yao manhood including life and sexual partnering sexual behavior, practices, skills, health Our research team has been exploring the Jando as a potential window of opportunity for transmission AIDS of education HIV and have date to understandings our data, collecting still Although prevention cultural norms (R01 been informed through focus groups and NR010490). in-depth interviews lombwe (counselors), nakanga circumcisers), (male ngaliba with (each boy’s individual caregiver) and former initiates. We also pre- from rites circumcision Jando 4 observed ethnographically surgery through schooling. The data have been coded, and transcribed, analyzed for insights into how HIV prevention can be effectively incorporated. Our data suggest at incorporating HIV least prevention four into the challenges Jando contrast to the to rites. prepubescent adolescents of the First, past, effectively today’s in initiates for religious and economic reasons increasingly are between ages 4-9. Their comprehension of and sexual HIV behavior prevention is developmentally limited. Second, peer socialization into manhood and also the post-surgical wound care that traditionally has been delivered by adolescents and adult males increasingly have become the cohorts of such young boys who post-Jando are considered to responsibility of be men. At such a young age, and without a firm foundation themselves, they are ill equipped to care for young during healing initiates or to transmit lessons of responsible manhood Jando the including men village Third, HIV. preventing including counselors often are absent from the circumcision camps for fishing and trading. Although we only have anecdotal reports that this differs from the past, their absence leaves a serious customs previous the of many Fourth, instruction. Jando in gap the with coincide longer no Jando the of messages cultural and changing nature of the Jando itself. Prior to boys entering the camps to be circumcised, mothers continue to sing sexually

, 2 , Robert Salata 2 Division of Infectious Division of Infectious 2

2 , Denis Tebit 1 There is a high HIV diversity in Sub-Saharan and Korey Demers and Korey 2 Joint Clinical Research Centre, Joint Clinical Research 1

Conclusion: There was a high level of resistance to NNRTI in subtype D virus and therefore predictably higher treatment failure with patients harboring this ART than virus those harboring when other subtypes. they Though resistance start to PIs was minor, this could lead to higher level resistance in therefore can patients A Subtype mutations. major of presence be predicted to fail PI therapy earlier than patients harboring subtype D virus because of the numerous polymorphisms minor resistance that can increase the resistant virus. However this needs to be confirmed by studies fitness of the drug looking at Protease experienced patients. The major HIV-1 subtypes found in this cohort were cohort this in found subtypes HIV-1 major The : Results A and D. Prevalence of resistance to subtype NNRTIs D patients (14.3%) than was other subtypes (C and higher A). All in resistance mutations to PIs were minor drug polymorphisms and were significantly higher in subtype A than D. Proportions of individuals that carried atleast 2 drug resistance mutations for each of the subtypes respectively. A and D were 100% and 50% Background: Method: In a crossectional study of 89 ART naïve patients within 3 months of HIV serocoversion, resistance reverse to HIV-1 The Reverse determined. was (RTI) inhibitors transcriptase transcriptase (RT) and Protease (P) genes were amplified the polymerase by chain reaction (PCR) technique using proviral DNA. After this the genes were then sequenced and analyzed for drug resistance using BioEdit sequence alignment editor (V 7.0.5.3) as well as the Stanford drug resistance data base. 1.83). Subtyping was done using the Clustal X (V Diseases, School of Medicine, Case Western Reserve University Medicine, Case Western School of Diseases, Africa and very few data are diversity may affect drug available susceptibility and resistance. Due to as to how subtype the recently increased access to antiretroviral (ARV) drugs in Uganda there is need to determine whether different subtypes could be associated to drug resistance. Therefore this naïve drug ARV in resistance drug HIV genotypic the examined study patients in a Ugandan cohort as well as determining whether resistance. HIV-1 subtypes can be associated to drug SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Authors: Fred Kyeyune HIV-1 Drug Resistance in a Cohort in a Cohort Drug Resistance HIV-1 Within Women Naïve Ugandan of Drug 3 Months of Seroconversion Abstract 36 Abstract and Treatment Integrating on in HIV Care Preventi Eric Arts ≥18years ≤ 15.4 kg/m2 100 cells/ µL were enrolled between December between enrolled were µL cells/ ≤100 In this 367 cross-sectional adults study, SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 2009 and March 2010. Factors associated with cryptococcal antigenemia were analyzed using multiple logistic regression. : Results Median CD4+ cell count was 23 (IQR: 9-51) cells/ µL. Sixty-nine (19%) of the 367 participants had cryptococcal meningitis cryptococcal had patients four Twenty antigenemia. on CSF analysis and 3 had Cryptococcal antigenemia with no central nervous system involvement. Low BMI (AOR =0.499), CD4+ T cell count <50 cells/ µL (AOR = 2.685), neck pain (AOR= 2.315), recent diagnosis (AOR=1.975) and presence of of meningeal signs HIV (AOR = 7.990) infection were associated with cryptococcal antigenemia. Conclusion: Cryptococcal antigenemia is common among severely immunosuppressed HIV infected patients in Mulago hospital, Uganda. A CD4+ T cell count <50 cells/ µL, low BMI, neck pain, signs of meningeal irritation and a recent diagnosis of HIV infection were independent predictors of cryptococcal antigenemia. Routine screening of this category of patients may detect cryptococcosis hence providing an opportunity for early intervention. Introduction: Cryptococcal opportunistic infection infection is among associated a with common Cryptococcal severely high antigenemia is mortality an death immunosuppressed independent and cryptococcal predictor meningitis of in immunosuppression. We evaluated the prevalence patients and factors HIV with severe with patients among antigenemia cryptococcal with associated patients. Uganda. cells/µl in Mulago Hospital, Kampala, CD4 count≤100 Methods: count CD4 with and 1 , David Meya 1 , Moses Kamya 1 2

Makerere University College of Health Sciences Uganda, 1 34 Mbarara University of Science and Technology Uganda Mbarara University of Science and Technology These findings suggest the need for a life course approach to Jando AIDS prevention that would transmit age-appropriate prevention norms and knowledge to both initiates and post- jando males who participate in the stage rite. calls for Our returning to next the Jando research camps in July to work with village men in developing age-appropriate programming for the prevention ritual that can be piloted for feasibility and cultural acceptability. implicit songs of instruction traditionally pre-adolescents. Sanitation used at with the camps older the tends in conducted is Circumcision oversight. male adult without to be poor traditional manner using local herbs, but western medications also may be used although sometimes improperly. 2 Authors: Jacinta Oyella Prevalence and Factors Associated with Cryptococcal Antigenemia Among Severely Immunosuppressed HIV- Infected Adults in Uganda Mulago Hospital; A Cross-sectional Study Abstract 38 Abstract and Treatment Integrating Prevention in HIV Care Francis Bajunirwe

Abstracts Abstracts 35 , 2 and 2 , 1 ,Takafira Mduluza ,Takafira 2 , Isabelle Dortenne 2 , Rosemary Musonda 2 Botswana Harvard AIDS Institute 2 , Thabo Diphoko 2 , Priti, Dusara It is of interest to determine if the use of 2 2 Harvard College, 1 e have established a multidisciplinary research team to work Partnership, of Immunology and Infectious Diseases, of Immunology and Infectious Diseases, Partnership, Harvard School of Public Health AIDS Initiative Background: Herpes simplex virus type 2 (HSV-2) is one of the most common opportunistic infections of HIV positive patients. HSV-2 co-infection with a HIV variety is of associated medical genital complications, with levels increased of HIV, plasma progression and of AIDS. HIV, Acyclovir is and a drug used the to treat onset HSV-2. Recent of clinical trials have shown that acyclovir reduces plasma levels of HIV and reduces the risk of disease progression. A number of in- vitro studies have shown that acyclovir mutations which also can confer resistance to Nucleoside Reverse select for HIV Transcriptase Inhibitors (NRTI). Some include; V75I, T69N and M184I. of these mutations onale: Rati co-infected HIV-1/HSV-2 in HSV-2 of treatment for acyclovir Abstract 41 Abstract and Treatment Integrating Prevention in HIV Care Mutations HIV Reverse Transcriptase Patients in HIV-1/HSV-2 Co-Infected with Acyclovir Treated Authors: Simani Gaseitsiwe and Treatment Integrating on in HIV Care Preventi Men’s Town / Cape The Rochester Study Network Social Media of Rochester and Authors: Vincent Silenzio, University HIV Foundation Tutu Ben Brown, Desmond W closely with community-based partners and stakeholders in order to develop novel applications of electronic mobile and social media technologies in HIV prevention who targeting have sex men with men (MSM) in Cape Town, Our South team is Africa. currently conducting formative research into the acceptability and feasibility of utilizing e-media networks for HIV prevention interventions platforms technology available among of assessment novel a including targeted populations, to inform future e-media collaboration is supported through based the ongoing development interventions. The of shared team information technology infrastructure to US- support and South Africa-based collaborative data collection for HIV prevention research in electronic social media. Our overall technologies social electronic of applications develop to is goal to decrease the vulnerability of MSM to HIV infection through the adoption of novel, effective HIV prevention interventions that can be dynamically adapted to changes in social media technologies. Abstract 40 Abstract Snusha Ravikumar Sikhulile Moyo Max Essex

The HIV/AIDS epidemic is slowly eroding food food eroding slowly is epidemic HIV/AIDS The A daily balanced diet, while sufficient in both We present qualitative analysis of data collected as collected data of analysis qualitative present We Case Western Reserve University, Joint Clinical Research University, Reserve Case Western SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Conclusion: Gender also plays a central role in the food security of HIV- affected households. While both men and women are actively engaged in food production, women also are responsible for a range of other household activities, including family care and nutrition. When a household member becomes ill due to AIDS, women’s time is increasingly diverted to care and staying away from and food production and preparation, support, and other income generating activities which contribute to food availability. quantity and emphasis quality The medicine. as for rank same the in remaining considered is illness, healthy and alleviating medication pure of one from changes thus health improving on to one which incorporates food and nutrition. Food security must be seen as an essential component towards preventing the spread of AIDS, and of mitigating its food household’s impact a improving at Ultimately, levels. household and national security reduces vulnerability to HIV infection as food secure households’ do not have to resort to detrimental strategies in order to survive. livelihood : Results Results indicate that food is clearly necessary for the health and well-being of all household members, but for people living with HIV, “food Indeed, is households medicine”. directly affected by HIV/AIDS commonly cite food as one of their greatest needs. part of an ongoing NIH sponsored study among 949 participants 949 among study sponsored NIH ongoing an of part in (JCRC) Centre Research Clinical Joint from treatment seeking and Science of University Mbarara in clinic ISS and city Kampala focused data baseline This Uganda. Western South Technology, illness adherence, and experiences treatment demographics, on history, healthcare seeking decisions. Qualitative analysis was performed using content analysis. Background: Methods: Namutiibwa Florence, David Kaawa-Mafigiri, David Kaawa-Mafigiri, Authors: Namutiibwa Florence, Janet McGrath, Winchester, Nalwoga Amina, Margaret Birungi Judith, Charles Emily, Ssendegye George, Kyarikunda Rwabukwali University of Science and Technology Centre, and Mbarara security and exacerbating poverty as incomes assets are depleted. Additionally the epidemic affects different dwindle and households in different ways and produces a variety of coping strategies. “Food is Medicine”: Abstract 39 Abstract and Treatment Integrating on in HIV Care Preventi HIV/AIDS and Food Security and Food Security HIV/AIDS Rural Uganda in Urban and Although tenofovir (TDF) is a common Samples underwent concentration and University of Alabama-Birmingham and Centre for SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 which included LED fluorescent microscopy (FM), liquid media liquid media (FM), microscopy LED fluorescent included which (Hain line probe assays MGIT), MGIT SIRE, and culture (BD was compared and MTBDRsI). This CM MTBDRplus, GenoType of bright field methodologies standard diagnostic to Malawi’s Routine Jensen media (LJ). (BM) and Lowenstein microscopy of care as the standard testing is not performed susceptibility in Malawi. Methods: decontamination processes, inoculation of one LJ Ziehl-Neelsen for one prepared, were slant slides Two tube. MGIT BD and and the other for Auramine-O staining. Detection mean time to positive culture for LJ and MGIT were compared. rate and Sensitivity and specificity were calculated compared for to liquid culture. BM MGIT SIRE and testing was perfomed FM on multi-drug resistant (MDR) samples per MTBDRplus. To rule out extensive Hain drug resistance (XDR), MGIT GenoType SIRE pan-resistant samples were tested MTBDRsI. by Hain GenoType : Results 190 samples smear (AFB) bacilli acid-fast by Malawi Lilongwe, in Laboratory were examined at and culture from UNC October 2009 to May Project 2010. 59 (31%) were culture positive by LJ and 92 Mean (48%) time by (days) MGIT. to positive culture was 22 for specificity and sensitivity stains, AFB both LJ by analysed samples and 15 for MGIT. 10/92 FM. Of for 100% and 92.6 and BM, 109 for 98.3% and 85.2 were (11%) MGIT-positive samples were MDR, pan-resistant, SIRE MGIT were samples MDR 3 4 smear-negative. of which were but no XDR was detected. Two M. intracellulare and two fortuitum isolates were also identified. M. Conclusion: Use of liquid detection culture and an demonstrated increase earlier of 17% in sensitivity. microscopy Fluorescent proved more sensitive than bright field. The Hain assays provided rapid detection and identification of a high prevalence of MDR samples, 4 identifying in as assisted Hain and MGIT of use the Importantly, well as non-MTB missed been have isolates. would who patients MDR-TB smear-negative should Malawi cases. smear-positive to evaluation restricting if consider adopting more efficient technology to diagnose drug resistant TB. Abstract 43 Abstract AND Treatment Integrating Prevention in HIV Care Comparative Outcomes of Tenofovir- and Zidovudine-Based Antiretroviral Therapy Regimens in Lusaka, Zambia Authors: Crispin Moyo, Albert Mwango, Mark J. Giganti, Mulenga, Carolyn Lloyd B. Izukanji Sikazwe, Linnaea Schuttner, Chintu, Robert Sheneberger, Bolton-Moore, Namwinga T. Benjamin H. Chi Jeffrey S. A. Stringer, Elizabeth M. Stringer, Infectious Disease Research in Zambia Background: component of antiretroviral nevirapine with therapy combined is it (ART), when outcomes inferior suggests recent evidence (NVP). Subjects were drawn from methods: Our data validates what has been shown by and Following 24 months of acyclovir use, none of

UNC Project, Lilongwe 36 Conclusion: the 21 patients harboured the V75I mutation, which was the predominant mutation found to be associated with acyclovir in the in-vitro studies. One patient (1/21 or 4.8%) was found to harbour the T69N mutation at 24 months and the baseline sample from the patient did not have the mutation. Further comparison of HIV RT sequences from the point 24 months and time baseline did not disproportionately sure found at any the mutations 24 months that time use. could therefore be associated with acyclovir were point that selected not is mutation V75I RT HIV the that groups other two after mutation this had patients our of none as acyclovir by for 24 months of acyclovir use. However one of the patients our in study developed the T69N mutation at which baseline. The T69N was might be the preferred absent mutation in HIV patients who receive acyclovir treatment. needed More to efforts explore are the frequency of this cohorts. mutation in larger : Results the Botswana participants in the Partners in Prevention HSV/ HIV Transmission Study, a randomized, double blind, placebo- controlled trial of acyclovir prevent HSV-2 HIV-1 transmission. plasma Twenty-one samples were suppressive therapy to collected from participants who were randomized to receive 400 mg of acyclovir twice daily for 24 months. The used samples were from the 24 months time-point for all 21 patients. For 14 of these patients, baseline The samples RNA was were extracted also from the used. plasma samples and population using sequencing, the first 960 nucleotides of the RT HIV were genotyped. The sequences generated were analyzed for drug resistance mutations using the Stanford Resistance Database. HIV Drug Materials patients patients does not result in any of these HIV-1 RT mutations that might compromise the use of NRTI in the future once the there if determine to important also is It HAART. on go patients are any other HIV-1 RT mutations besides the ones that have been identified in-vitro that arise when co-infected patients with acyclovir. undergo treatment Tarsizio Chikaonda, Robert Krysiak, Charles Vorkas, Chikaonda, Robert Krysiak, Charles Vorkas, Authors: Tarsizio and Nelson Nguluwe Creto Kanyemba Mina Hosseinipour, Background: TB requires accurate and rapid diagnosis for proper management. Emergence of multi-drug resistant (MDR) TB may prove detrimental to existing TB programmes improve and evaluate To and contribute to early mortality. TB diagnostic and susceptibility testing in Malawi, rapid identification and susceptibility profiling were introduced Introduction and Evaluation of Advanced of Evaluation and Introduction (TB) Diagnostics: Rapid Tuberculosis Effort to Improve Detection and in Malawi Susceptibility Testing Abstract 42 Abstract and Treatment Integrating Prevention in HIV Care

Abstracts Abstracts 37 Liu J, Manheimer E, Tsutani K, Gluud C. Medicinal for herbs hepatitis C virus infection: a Cochrane Gastroenterol J Am trials. randomized of review hepatobiliary systematic 2003;98:538-44. Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hepat 2005;12:559- 67. Seeff LB, Curto TM, Szabo G, Everson GT, Bonkovsky Dienstag HL, JL, Shiffman ML, Lindsay KL, Lok AS, Di Bisceglie AM, Lee WM, Ghany MG. Herbal product use by persons enrolled in the hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial. Hepatology 2008;47:605- 12. Polyak SJ, Morishima C, Shuhart MC, Wang CC, Liu Y, Lee Inhibition of inflammatory hepatocyte T-cell cytokines, DY. NF-kappaB signaling, and HCV infection by standardized silymarin. Gastroenterology 2007;132:1925-36. Wagoner J, Negash A, Kane OJ, Martinez LE, Nahmias Bourne Y, N, Owen DM, Grove J, Brimacombe C, McKeating JA, Pecheur EI, Graf TN, Oberlies NH, Lohmann V, Tavis Cao JE, F, Polyak SJ. Multiple effects of hepatitis C virus lifecycle. Hepatology 2010;51:1912-21. silymarin on the Polyak SJ, Morishima C, Lohmann V, Pal S, Lee DY, Liu Y, Graf TN, Oberlies NH. Identification of flavonolignans hepatoprotective from silymarin. Proc Natl Acad Sci U S A 2010;107:5995-9. DM, Apodaca Morishima CC, C, Paschal Shuhart MC, Wang MC, Liu Y, Sloan DD, Graf TN, Oberlies NH, Lee Jerome DY, SJ. Silymarin KR, inhibits Polyak in vitro proliferation T-cell and cytokine production in e1-2. 681 hepatitis Gastroenterology 2010;138:671-81, C virus infection. Wagoner J, Morishima C, Graf TN, Oberlies NH, Teissier E, Pecheur EI, Tavis JE, Polyak SJ. Differential in vitro effects of intravenous versus oral formulations of silibinin on the HCV life cycle and inflammation. PLoS One 2011;6:e16464. Scherzer Ferenci TM, P, Kerschner H, Rutter K, Beinhardt S, Steindl-Munda H, Holzmann M, Schoniger-Hekele H, Hofer P. Silibinin is a potent interferon/ pegylated to responding not antiviral C hepatitis chronic agent in patients with Gastroenterology 2008;135:1561-7. ribavirin therapy. Rutter K, Beinhardt BA, S, Reiberger Staettermayer T, Payer AF, Peck-Radosavljevic M, intravenous by replication HIV of inhibition and eradication Ferenci P. Successful silibinin HCV in an HIV-HCV coinfected 2010;49:131-3. patient. J Clin Virol load in HCV mono-infected patients9 and inhibits both HCV and HIV loads in an HCV/HIV co-infected patient10. We have found that SIL suppresses HIV infection of PBMC in vitro by both BAL and LAI isolates. Suppression of HIV infection by SIL We preparations. PBMC donor different 5 in validated been has the for mechanism(s) the elucidating on focusing currently are we HCV, with studies prior our on Based SIL. of effects anti-HIV hypothesize that silymarin targets host cells to inhibit HIV by blocking virus entry and/or immune cell activation. Given the large population of HCV/HIV co-infected persons throughout the world and the need to design a therapy that treats both diseases, the proposed studies may offer a cure for HCV and suppression of HIV. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ,

1 Global Health, 2 , Joan Dragavon 1 1,2 , Jessica Wagoner 1 , and Stephen J. Polyak 1 Between July 2007 and November 2010, 18,866 Departments of Laboratory Medicine and 1 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011

Authors: Jan McClure Silibinin Derived From the Milk Thistle Plant Inhibits HIV Infection of Blood Mononuclear Cells Peripheral AND Treatment Integrating Prevention in HIV Care Abstract 44 Abstract Conclusion: In was time-varying associated with analysis, higher ZDV+3TC+NVP mortality TDF+XTC+NVP in when this compared observational to finding cohort; was however, not this consistent in Further other statistical research approaches. is comparative effectiveness of ART urgently regimens currently used in needed resource-constrained settings. to determine the treatment-naïve adults initiated ART: 18.2% on ZDV+3TC+NVP, ZDV+3TC+NVP, on 18.2% ART: initiated adults treatment-naïve 1.8% on ZDV+3TC+EFV, 36.2% on TDF+XTC+NVP, and 43.8% on TDF+XTC+EFV. When exposure was categorized by initial prescription, patients on ratio [AHR]:1.44; TDF+XTC+NVP 95%CI:1.02–2.04) had a higher post-90 (adjusted day hazard mortality compared to those TDF+XTC+NVP exposure, on time-varying a as ZDV+3TC+NVP. treated was When regimen ART was again associated with higher hazard for death (AHR:1.51; 95%CI:1.18–1.95). In our individuals who predominant had been prescribed TDF+XTC+NVP for >75% exposure analysis, of the time had similar hazards for death to those prescribed ZDV+3TC+NVP over the same period. approaches, similar Across trends all were noted analytical when ZDV+3TC+NVP TDF+FTC+EFV. and to was compared to ZDV+3TC+EFV : Results ods: Meth We initiating compared TDF+emtricitabine outcomes TDF+XTC+efavirenz or among (EFV), and (3TC)+NVP, patients lamivudine ZDV+3TC+EFV. We categorized drug exposure zidovudine (XTC)+NVP, by initial (ZDV)+lamuvidine ART dispensation, exposure predominant by by and a substitutions, drug for time-varying accounted analysis that (>75% of drug dispensations) during an initial window period. Risks for death and program failure were estimated using Cox models. proportional hazard Natural Products serve as a rich source of potent medicines such as taxol, aspirin, and artemesenin. Silymarin, an extract of the seeds of the milk thistle plant [Silybum marianum], has liver-protective properties that have a variety of therapeutic applications1-3. We have recently shown that silymarin and silymarin-derived purified natural products block hepatitis C virus (HCV) infection in part by blocking Moreover, virus entry. silymarin inhibits proliferation and production from T cells4-7. inflammatory A soluble version of silibinin (SIL), cytokine a major component of the extract, displays anti-HCV effects in hepatocyte culture and immunomodulatory functions on T cells in vitro8. Intravenous administration of SIL inhibits viral University of Washington, Seattle, WA. University of Washington, Robert W. Coombs Robert W. Attendee List as of April 26, 2011

Jane Achan Kathryn Anastos Robert Bailey Lecturer Professor Professor of Epidemiology Makerere University Einstein College of Medicine/Montefiore Rush University/University of Illinois, P.O. Box 7475 Medical Center Chicago Kampala 256 3311 Bainbridge Avenue 1603 W. Taylor Street Uganda Bronx, NY 10467 Chicago, IL 60612 [email protected] United States United States [email protected] [email protected] Richard Adanu Head of Department/Associate Professor Eric Arts Francis Bajunirwe University of Ghana Professor Lecturer School of Public Health Case Western Reserve University Mbarara University of Science and P.O. Box LG13 2109 Adelbert Road Technology Legon, Accra Biomedical Research Building P.O. Box 1410 Ghana Cleveland, OH 44106 Mbarara [email protected] United States Uganda [email protected] [email protected] Marylyn Addo Assistant Professor Elizabeth Asante John Bartlett Harvard University Research Fellow Professor of Medicine 149 13th Street University of Ghana Duke University Medical Center 6th Floor 6620 P.O. Box LG 74 Box 3238 Charlestown, MA 02476 Legon, Accra Durham, NC 27710 United States Ghana United States [email protected] [email protected] [email protected] Adebola Adedimeji Stephen Asiimwe Roger Bayingana Assistant Professor Mbarara University of Science and Medical Doctor Einstein College of Medicine/Montefiore Technology Rwanda – Zambia HIV Research Group/ Medical Center Mbarara Regional Referral Hospital Project San Francisco Mazer 515 Mbarara P.O. Box 780 1300 Morris Park Avenue Uganda Kigali 250 Bronx, NY 10461 [email protected] Rwanda United States [email protected] [email protected] Amolo Asito Senior Research Officer Anna Baylor Juliet Akao Kenya Medical Research Institute Program Director Physician 40100-1578 Mbarara University of Science and Joint Clinical Research Centre Private Bag, Maseno Technology Plot 893 Ring Road Butikiro House-Mengo Kisumu 254 P.O. Box 1410 P.O. Box 10005 Kenya Mbarara Kampala [email protected] Uganda Uganda [email protected] [email protected] Brandon Auerbach Fogarty International Clinical Research William Bazeyo

Attendees List Attendees Gabriel Anabwani Scholar Dean, Makerere University, Executive Director Infectious Diseases Institute School of Public Health Botswana-Baylor Children’s Clinical Centre College of Health Sciences, Makerere New Mulago Hospital Complex, Room 215 of Excellence University Old Mulago Hill Road Hospital Way, Private Bag BR129 P.O. Box 22418 P. O. Box 22864 Gaborone Kampala Kampala Botswana Uganda Uganda [email protected] [email protected] [email protected] Paul Ayuo Joel Bazira Professor Mbarara University of Science and Moi University Technology P.O. Box 4606 P.O. Box 1410 Eldoret 30100 Mbarara Kenya Uganda [email protected] [email protected]

38 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Attendee List 39 Hospital,Observatory University in Zambia Lynette Denny Lynette Head of Department/Professor University of Cape Town H45, Old Main Building. Groote Schuur 7925 Cape Town South Africa [email protected] Executive Director Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Cranmer Risa Advisory Board Member Children of Grace 1849 Lacassie Avenue APT 3 Creek, CA 94596 Walnut United States [email protected] Cu-Uvin Susan Professor University Lifespan/Tufts/Brown The Miriam Hospital 164 Summit Avenue, RISE Building Providence, RI 02906 United States [email protected] Daud Ibrahim Laboratory Manager Medical Research Institute Kenya Box 54840 KNH Grounds, Nairobi 200 Kenya [email protected] Amon Chirchir Obstetrician & Gynecologist and Referral Hospital Moi Teaching 4606 Box P.O. Eldoret Kenya [email protected] Bhavna Chohan Scientist Research Postdoctoral University of Nairobi 19676-00202 Box P.O. Nairobi Kenya [email protected] Cohen Craig Professor University of California, San Francisco 50 Beale Street, Suite 1200 San Francisco, CA 94105 United States [email protected] Alex Coutinho Namwinga Chintu Namwinga Principal Investigator Disease Research Centre for Infectious Box 34681 Lusaka Zambia [email protected]

in Zambia in Zambia Technology Research Fellow Centre for Infectious Disease Research Box 34681 Lusaka Zambia [email protected] Chikaonda Tarsizio Microbiologist UNC Project, Lilongwe Lilongwe Malawi [email protected] Benjamin Chi Associate Professor Centre for Infectious Disease Research 1275 Lubuto Road Box 34681 Lusaka Zambia [email protected] Carla Chibwesha Merry Ceppie Clinical Researcher Infectious Diseases Institute Mulago Hospital Complex Kampala Uganda [email protected] Edwin Charlebois Associate Professor University of California, San Francisco 50 Beale Street, 13th Floor San Francisco, CA 94105 United States [email protected] Makerere University 7062 Box P.O. Kampala Uganda [email protected] David Canaday Associate Professor Reserve University Case Western BRB 1022 Euclid Avenue 10900 Cleveland, OH 44106-4984 United States [email protected] Casper Corey Center for AIDS Research Associate Director, University of Washington Box 358080 98195 Seattle, WA United States [email protected] Bosco Bwana Bosco Assistant Lecturer of Science and Mbarara University Box 1410 P.O Mbarara Uganda [email protected] Byamugisha Josaphat SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Physician Moi University Box 4606 P.O. Eldoret 30100 Kenya [email protected] Naftali Busakhala Sara Burke Sara Program Manager University of California, San Francisco Clement Street, Building 16 4150 Box 111V San Francisco, CA 94121 United States [email protected] Elizabeth Bukusi Deputy Director Research and Training Medical Research Institute Kenya Box 54840 Nairobi Kenya [email protected] Ben Brown Programmes Manager HIV Foundation Desmond Tutu UCT Medical School, Anzio Road Observatory 7925 Cape Town South Africa [email protected] Kasonde Bowa Kasonde Associate Professor University of Zambia UTH, Nationalist Road, Ridgeway Box 39520 P.O. Lusaka Zambia [email protected] Rose Bosire Research Officer Medical Research Institute Kenya Box 19487 Nairobi 202 Kenya [email protected] William Henry Boom Professor of Medicine Reserve University Case Western Euclid Avenue 10900 Cleveland, OH 44106-4984 United States [email protected] Gregory Bisson Gregory Assistant Professor University of Pennsylvania 832 Blockley Hall 423 Guardian Drive 19104 Philadelphia, PA United States [email protected] Jeffrey Bingerheimer Jeffrey Assistant Professor University Washington The George Suite 700 NW, K Street, 2175 DC 20037 Washington, United States [email protected] as of April 26, 2011 as of April 26, Attendee List Attendee David Kaawa-Mafigiri Makerere University Box 7072 P.O. Kampala Uganda [email protected] Shevin Jacob Shevin Senior Fellow University of Washington Box 359927 325 Ninth Avenue 98104 Seattle, WA United States [email protected] Walter Jaoko Professor University of Nairobi College of Health Sciences Box 19676 P.O Nairobi 202 Kenya [email protected] Diana Jere Pre-Doctoral Trainee University of Malawi Street Taylor 1603 West Chicago, IL 60612 United States [email protected] Elijah June Nyanza Reproductive Health Society University of Nairobi Box 1764 P.O. Kisumu 40100 Kenya [email protected] Peter Hunt Peter Assistant Professor of Medicine San Francisco University of California, Avenue 995 Potrero 84 SFGH Blg 80, Ward San Francisco, CA 94110 United States [email protected] Rebecca Huppi Program Director NIH National Cancer Institute, Center Drive 31 Room 3A33 Bethesda, MD 20892 United States [email protected] Mubiana Inambao Site Director/Principal Investigator Emory University 22A Lupili Road Ndola Zambia [email protected] James Hoxie James CFAR Director, Pennsylvania University of Pavilion 522 Johnson Walk Hamilton 3610 19104-6114 PA Philadelphia, United States [email protected] SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 University Physician/PhD Student Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Mina Hosseinipour Clinical Director University of North Carolina, Chapel Hill Private Bag A/104 Mzimba Road 100 Lilongwe LL3 Malawi [email protected] German Henostroza TB-HIV Consultant/Assistant Professor University of Alabama, Birmingham Thabo Mbeki Road Counting House Square Unit A Lusaka Zambia [email protected] Sabine Hermans Michelle Haas Adjunct Assistant Professor of Medicine University of Pennsylvania Independence Avenue Plot 214 Gaborone Botswana [email protected] Happi Christian Principal Investigator University of Ibadan IMRAT College of Medicine Ibadan Nigeria [email protected] Warner Greene Co-Director Director & Professor; CFAR San Francisco University of California, 1650 Owens Street San Francisco, CA 94158 United States [email protected] Guay Laura Vice President of Research AIDS Foundation Elizabeth Glaser Pediatric Connecticut Avenue NW 1140 DC 20036 Washington, United States [email protected] Judy Gichoya Judy Medical Officer Hospital Kiambu District Box 6945 P.O. Nairobi 200 Kenya [email protected] Gitome Serah Assistant Study Coordinator Research Institute Medical Kenya 614 Box P.O Kisumu 40100 Kenya [email protected]

40 College Partnership for HIV Research & Education Partnership in South Africa Natal Medical School Medical Center Geraldina Dominguez Geraldina 1 Indus close, Maitama Abuja FCT 900001 Nigeria [email protected] Usman Gebi Usman Chief of Party University/Meharry Medical Vanderbilt Private Bag BO 320 Gaborone Botswana [email protected] Simani Gaseitsiwe Deputy Laboratory Director Botswana-Harvard SPH AIDS Initiative Soren Gantt Soren Assistant Professor University of Washington Research Institute Seattle Children’s 1900 Ninth Avenue NE 98101 Seattle, WA United States [email protected] 2nd floor, DDMRI, University of KwaZulu- 2nd floor, Umbilo Road 719 Durban, KwaZulu Natal 4001 South Africa [email protected] Centre for the AIDS Programme of Research Janet Fröhlich Lab Supervisor Joint Clinical Research Centre Plot 893 Ring Road Butikiro House-Mengo Kampala Uganda [email protected] Kyeyune Fred Kyeyune Mission Director, USAID Mission Director, U.S. Embassy Kampala Plot 1577 Ggaba Road Box 7007 P.O. Kampala Uganda David Eckerson J. Claude Dusingize Student Einstein College of Medicine/Montefiore Avenue Bainbridge 3311 Second Floor Bronx, NY 10467 United States [email protected] Program Director Institute, NIH National Cancer Drive Center 31 Room 31/A33 20852 Bethesda, MD United States [email protected]

Attendee List Attendee List 41 Epidemiologist Hospital Bu Teaching Korle- and HIV Susan Krown Susan Vice-Chair for International Activities AIDS Malignancy Consortium 83rd Street 127 W. Box 1051, P.O. Planetarium Station NY 10024 New York, United States [email protected] James Kiarie Senior Lecturer University of Nairobi Box 3085-00506 P.O. Nairobi Kenya [email protected] Timothy Kimuli Lecturer Makerere University Box 7072 P.O. Kampala Uganda [email protected] Kityo Cissy Deputy Executive Director Joint Clinical Research Centre Lubowa Hill Plot 101 Kampala Box10005 P.O. Uganda [email protected] Koyabe Bramwell University of Botswana Private Bag 00702 Gaborone Botswana [email protected] Elly Katabira Professor Makerere University 7072 Box P.O. Kampala Uganda [email protected] Abigail Kazembe Lecturer University of Malawi Private Bag 1 Lilongwe 265 Malawi [email protected] Ernest Kenu Public Health Physician/Clinical University of Ghana Box 15683 P.O. Medical Department, Fevers Unit of Box 77 P.O. Accra Ghana [email protected] Victoria Kasprowicz Victoria Education Director of for TB Research Institute KwaZulu-Natal Road Umbilo 719 Durban 4001 South Africa [email protected]

in South Africa Natal Medical School Research Group Organization Philip Kasirye Paediatrician Mulago Hospital Box 72052 P.O. Kampala Uganda [email protected] Margaret Phiri Kasaro Margaret Investigator of Record Central Hospital at Kamuzu Lighthouse Trust Counting House Square, Thabo Mbeki Road Box 34681 Lusaka Zambia [email protected] Ivy Kasirye Head of Paediatrics Mildmay Uganda Lweza-Naziba Hill, Entebbe Road Kampala Uganda [email protected] Salim Abdool Karim Director Centre for the AIDS Programme of Research DDMRI, University of KwaZulu- 2nd floor, Umbilo Road 719 Durban, KwaZulu-Natal 4001 South Africa [email protected] Etienne Karita Director Project San Francisco/Rwanda-Zambia HIV Box 780 P.O. Kigali Rwanda [email protected] Director University of Malawi College of Nursing Private Bag 1 Lilongwe Malawi [email protected] Karabe Margaret Research Administrator Impact Research and Development Box 9171 P.O. Kisumu 40141 Kenya [email protected] Rami Kantor Rami of Medicine Assistant Professor University Lifespan/Tufts/Brown Hospital The Miriam Avenue, RISE Building 164 Summit RI 02906 Providence, United States [email protected] Kaponda Chrissie Programmes Carolina Project University Technology SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Professor and Chair Makerere University Department of Medicine, Mulago Hospital Box 7051 P.O. 256 Kampala Uganda [email protected] Moses Kamya Andrew Kambugu Andrew Head of Prevention Care and Treatment Infectious Diseases Institute IDI Building Room 149 Ground Floor Box 22418 P.O. 25641 Kampala Uganda [email protected] Gift Kamanga Manager STI Services and Research University of North Carolina Project of North Central Hospital, University Kamuzu Private Bag A104 Lilongwe Malawi [email protected] Abel Kakuru Study Coordinator Makerere University Box 749, Tororo IDRC, P.O 254 Tororo Uganda [email protected] Medical Officer Uganda Cancer Institute Upper Mulago Hill Rd Box 3935 P.O. Kampala Uganda [email protected] James Kafeero Simon Kabututwa Medical Officer Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Jane Kabami and Mbarara University of Science 1410 Box P.O. Kampala Uganda [email protected] Jerome Kabakyenga Kabakyenga Jerome of Medicine Dean, School of Science and Mbarara University Technology Box 1410 P.O. Mbarara Uganda [email protected] Longacres University Education University Executive Director Joint Clinical Research Centre Plot 893 Ring Road Butikiro House-Mengo Box 10005 P.O. Kampala Uganda [email protected] Crispin Moyo Crispin National ART Coordinator Ministry of Health-Zambia Box 30205 P.O. Ndeke House, Haile Selassie Avenue, Lusaka 10101 Zambia [email protected] Alex Muganzi Head of Outreach Programmes Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Mugwanya Kenneth Research Physician Infectious Diseases Institute Mulago Hospital Complex Kampala Uganda [email protected] Mugyenyi Peter William Miller Associate Professor Chapel Hill University of North Carolina, CB#7030 130 Mason Farm Road Chapel Hill, NC 27599 United States [email protected] Ronald Mitsuyasu Professor of Medicine Los Angeles University of California, Center for Clinical AIDS Research and Pico Boulevard, Suite 980 W. 9911 CA 90035 Los Angeles, United States [email protected] Agnes Moses Clinical Investigator Clinical Research Centre Kabwohe UNC Project Private Bag A104 Lilongwe Malawi [email protected] David Meya David Lecturer Institute Infectious Diseases Makerere Sciences, College of Health Box 22418 P.O. Kampala Uganda [email protected] SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 University Chicago Janet McGrath Associate Professor of Anthropology Reserve University Case Western Department of Anthropology Euclid Avenue 10900 Cleveland, OH 44106-7125 United States [email protected] Michele Merkel Laboratory Manager University of Washington Mbagathi Rd, Off Ngong Rd Nairobi Kenya [email protected] Edward Mbidde Edward Director Ugandan Virology Research Institute Entebbe Uganda [email protected] Mbwilo Evalily Resident Makerere University Box 7062 256 Kampala Uganda [email protected] Sarah Manyame Sarah Lecturer/Senior Registrar University of Zimbabwe Box A178 Avondale Harare P.O. Harare 263 Zimbabwe [email protected] Harriet Mayanja-Kizzi Professor Makerere University Box 7072 P.O. Kampala Uganda [email protected] Lecturer Makerere University B24 Building Room Pathology Mulago Hill Road Kampala Uganda [email protected] Manabe Yuka Head of Research Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Judith Levy Judith Associate Professor of Illinois, Rush University/University Street Taylor 1603 W. 60612 Chicago, IL United States [email protected] Robert Lukande

42 Medical Center of Medicine; Head, Department of Pulmonology and Critical Care University Awewura Kwara Awewura Margaret Lartey Margaret Associate Professor University of Ghana Box 4236 P.O. Department of Medicine, KBTH Room 21, Accra Ghana [email protected] Michelle Larsen Assistant Professor Einstein College of Medicine/Montefiore Avenue 1300 Morris Park CGTM 575 Bronx, NY 10461 United States [email protected] Jerry Lanier U.S. Ambassador U.S. Embassy Kampala Plot 1577 Ggaba Road Box 7007 P.O. Kampala Uganda University of KwaZulu-Natal Umbilo Road, Congella 719 Private Bag X7 Durban KwaZulu-Natal 4013 South Africa [email protected] Umesh Lalloo Umesh Dean of the Nelson R Mandela School Miriam Laker Study Coordinator Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Zachary Kwena Social Scientist Research Institute Medical Kenya Lumumba Health Center Box 614 P.O. Kisumu 40100 Kenya [email protected] Judith Kwasa Research Fellow Research Institute Medical Kenya Box 52535-00200 Nairobi Kenya [email protected] Assistant Professor University Lifespan/Tufts/Brown Hospital The Miriam Avenue, RISE Building 164 Summit RI 02864 Providence, United States [email protected]

Attendee List Attendee List 43 Center Betty Njoroge Study Manager Medical Research Institute Kenya Box P.O. Nairobi Kenya [email protected] Rebecca Ngalande Lecturer University of Malawi Private Bag 1 , Blanytre Box 415 P.O. Lilongwe Malawi [email protected] Gabrielle Nickel Research Associate Reserve University Case Western Adelbert Road 2109 Biomedical Research Building 1010 Cleveland, OH 44106 United States [email protected] Niyonzima Nixon Student Duke University 1500 Duke University Road Durham, NC 27701 United States [email protected] Patrick Ndase Patrick Regional Physician University of Washington 325 Ninth Avenue 98104 Seattle, WA Uganda [email protected] James Ndinawe Student Makerere University Kampala Uganda [email protected] Ruth Nduati Professor University of Nairobi Box 19676-00202 P.O. Nairobi Kenya [email protected] Ann Marie Nelson AIDS and Infectious Disease Pathologist, Department of Defense, Joint Pathology 606 Stephen Sitter Avenue Silver Spring, MD 20910 United States [email protected] Immaculate Nankya Immaculate Research Associate Research Centre Joint Clinical Plot 893 Butikiro House Mengo Ring Road, Kampala Uganda [email protected]

Sciences Technology Elizabeth Namukwaya Mulago Hospital Makerere University Box 7072 P.O 256 Kampala Uganda [email protected] Namutiibwa Florence Research and Program Coordinator Reserve University Case Western College of Humanities and Social Sciences Kampala Uganda [email protected] Senior Lecturer Makerere University Box 7072 P.O. Kampala Uganda [email protected] Edith Nakku-Joloba Lecturer Makerere University School of Public Health, College of Health Box 7072 P.O. Kampala Uganda [email protected] Lecturer Moi University Box 4606 P.O. Eldoret 30100 Kenya [email protected] Damalie Nakanjako Lecturer Makerere University Mulago Hospital Complex Kampala Uganda [email protected] Noeline Nakasujja Senior Laboratory Technologist BOMU Medical Center Mombasa Box 95683-80106, Mombasa 254 Kenya [email protected] Julia Mwesigwa Project Coordinator Makerere University 7479 Box P.O. 256 Kampala Uganda [email protected] Violet Naanyu Winnie Muyindike Winnie Director/Physician of Science and Mbarara University Referral Hospital Mbarara Regional Mbarara 256 Uganda [email protected] Mwamzuka Mussa Coordinator in Zambia SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Innocent Mutyaba Medical Officer Uganda Cancer Institute Upper Mulago Hill Rd Box 3935 P.O. Kampala Uganda [email protected] Eugene Mutimura Director of Research and Training Box 5141 P.O. Kigali Rwanda [email protected] Victor Musiime Head, Paediatrics Joint Clinical Research Centre Plot 893 Ring Road Butikiro House-Mengo Kampala Uganda [email protected] Joseph Murungu Deputy National HIV Care & Treatment 5 Prosper Close, Hatfield Harare Zimbabwe [email protected] University of KwaZulu-Natal Umbilo Road, 719 Durban South Africa [email protected] Marianne Mureithi Scholar Kilimanjaro Christian Medical Centre Sokoine Road Moshi 3010 Tanzania [email protected] Michael Munishi Paula Munderi Paula Programme Head of HIV Care Research Unit on AIDS MRC/UVRI Uganda Research Uganda Virus Research Institute 50-59 Nakiwogo Road, P O Box 49 Entebbe Uganda [email protected] Lloyd Mulenga Lloyd Head Clinical Care Research Centre for Infectious Disease Thabo Mbeki Road Counting House Square, Box 34681 Lusaka 10101 Zambia [email protected] Andrew Mujugira Andrew Research Scientist Washington University of Box 5559 P.O. Kampala Uganda [email protected] in Zambia NIH Diseases, Prevention Program Prevention Stephen Polyak Research Associate Professor University of Washington Virology 359743 325 Ninth Avenue 98104 Seattle, WA United States [email protected] Psaros Christina Clinical and Research Fellow Harvard University One Bowdoin Square Boston, MA 02114 United States [email protected] Nande Putta Director PMTCT Centre for Infectious Disease Research Counting House Square, Thabo Mbeki Road Box 34681 Lusaka 10101 Zambia [email protected] Quinn Tom Associate Director for International Research National Institute of Allergy and Infectious Rangos 531 Street 855 N. Wolfe Baltimore, MD 21205 United States [email protected] Barbara Payne Barbara Research Assistant Professor University of Washington 325 Ninth Avenue Box 359909 98104 Seattle, WA Kenya [email protected] Phipps Warren Acting Instructor University of Washington Fairview Avenue North 1100 M1-B140 98109 Seattle, WA Uganda [email protected] Sam Phiri Executive Director Central Hospital Kamuza Lighthouse Trust, Box 106 P.O. Lilongwe Malawi [email protected] Groesbeck Parham Groesbeck Cervical Cancer Professor/Co-Director Alabama, Birmingham University of BBRB 256 AL 2170 Birmingham, Zambia [email protected] SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Hospital and Maternity Organization Coordinator Jackson Orem Jackson Director Uganda Cancer Institute Upper Mulago Hill Road Box 3935 P.O. Kampala Uganda [email protected] Jacinta Oyella Physician Makerere University Box 12256 P.O Kampala Uganda [email protected] Program Officer/Nurse Sure Health Organization/Bestcare Specialist 5 Engr Charles Agwumezie Close Ezra Street, Ikenegbu Kalu Off 11 Owerri Imo 460003 Nigeria [email protected] Omenge Orango Medical Doctor Moi University Box 4606 P.O. Eldoret 30100 Kenya [email protected] Jacob Onyango Project Coordinator Impact Research & Development Box 9171 P.O. Kisumu 40141 Kenya [email protected] Rose Opara Kenya Medical Research Institute Medical Kenya 614-40100 Box P.O. Kisumu Kenya [email protected] John Ong’ech Head of Department Hospital National Kenyatta 26617-00504 Box P.O. Nairobi 254 Kenya [email protected] Maricianah Onono Research Coordinator Medical Research Institute Kenya Box 614-40100 P.O. Kisumu Kenya [email protected] Everlyne Ombati Everlyne Regulatory Affairs Advocacy and Institute Medical Research Kenya Box 19464-00202 P.O. Nairobi Kenya [email protected] Raphael Ondondo

44 Transformation Transformation Federal Housing Authority (FHA), Estate, Lugbe Phase II, Airport Road Foundation Uganda Oathokwa Nkomazana Oathokwa Plot 13B Acacia Avenue, PO Box 9974 Kampala Uganda [email protected] Francis Omaswa Francis Executive Director African Center for Global Health and Social Medical Officer Mulago Hospital Box 3935 Upper Mulago Hill, P.O. Kampala Uganda [email protected] Fred Okuku Fred Abuja FCT 23409 Nigeria [email protected] King Odor Research Fellow Postgraduate University of Ibadan Variety, House # 9, 1(G) Road, by Tasty Samuel Obed Professor University of Ghana Box 4236 P.O. Accra Ghana [email protected] Betty Nsangi Research Coordinator Baylor College of Medicine Children’s Block 5 Mulago Hospital Box 72052 P.O. Kampala Uganda [email protected] Emilia Noormahomed Professor Universidade Eduardo Mondlane 702 Salvador Allende Avenue, Rua da Argelia 116 Maputo 257 Mozambique [email protected] Mostafa Nokta Clinical Program Director of AIDS Cancer NIH National Cancer Institute, Center Drive 31 Room 31/3A35 Bethesda, MD United States [email protected] Acting Head of School Acting Head Botswana University of 00713 Private Bag Gaborone Botswana [email protected]

Attendee List Attendee List 45 Diseases Charles van der Horst Charles van Professor of Medicine and Infectious University of North Carolina, Chapel Hill CB#7030 130 Mason Farm Road Chapel Hill, NC 27599-7030 United States [email protected] International Programs Coordinator University of California, San Francisco Clement Street 4150 Building 16 San Francisco, CA 94121 United States [email protected] Vincent Tukei Pediatrician Houston Baylor/University of Texas, Block 5 Mulago Hospital Box 72052 P.O. Kampala Uganda [email protected] Elioda Tumwesigye CEO Clinical Research Centre Kabwohe Ishaka Road Kabwohe, Box 347, Bushenyi P.O. Council Town Kabwohe-Itendero Uganda [email protected] Eric Umar Senior Lecturer University of Malawi Private Bag 1 Lilongwe Malawi [email protected] Michael Strong PEPFAR Coordinator U.S. Mission Kampala Plot 1577 Ggaba Road 7007 Box P.O. before) had it spelled Kampla (I Kampala Uganda [email protected] Thonyiwa Virginia Research Nurse UNC Project P/Bag A104 Lilongwe Malawi [email protected] Tiam Appolinaire Director Technical AIDS Foundation Elizabeth Glaser Pediatric Box 15670 P.O. Maseru 100 Lesotho [email protected] Natalie Tomitch Andrew Steenhoff Andrew Assistant Professor Pennsylvania University of Box AC 157 P.O. ACH Riverwalk Gaborone Botswana [email protected]

Medical Center Jennifer Skillicorn Administrative Director University The George Washington Avenue Pennsylvania 2100-W 8th Floor DC 20037 Washington, United States [email protected] Stefanie Sowinski Postdoctoral-Fellow The Gladstone Institutes 1650 Owens Street San Francisco, CA 94158 United States [email protected] Jean D’Amour Sinayobye Jean D’Amour Research Fellow Einstein College of Medicine/Montefiore Avenue 1300 Morris Park Avenue 1586 Yates Bronx, NY 10461 United States [email protected] Singa Benson Research Officer Medical Research Institute Kenya Box 20778 KNH Nairobi 202 Kenya [email protected] Moi University Centre at MTRH AMPATH Box 4606 P.O. Eldoret 30100 Rift Valley Kenya [email protected] Vincent Silenzio Associate Professor University of Rochester 300 Crittenden Boulevard Room 1-7285, Box Psych NY 14642-0001 Rochester, United States [email protected] Mohsin Sidat Mohsin Head of Microbiology Department Universidade Eduardo Mondlane 702 Salvador Allende Avenue, Rua da Argelia 116 Maputo Mozambique [email protected] Siika Abraham David Serwadda David Program Director Program HIV/AIDS Fellowship MAKSPH-CDC 7072 P.O.Box Kampala Uganda [email protected] Sewankambo Nelson Sciences President, College of Health Makerere University 25200 Box P.O. 256 Kampala Uganda [email protected] Scholar University Mainstreaming University SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Aggrey Semeere Aggrey Fogarty International Clinical Research Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Moorine Sekadde-Kasirye Resident Makerere University Box 25200 P.O. 256 Kampala Uganda [email protected] Head, Department of HIV Prevention Infectious Diseases Institute Makerere College of Health Sciences, Box 22418 P.O. Kampala Uganda [email protected] Lydia Mpanga Sebuyira Lydia Robert Schooley Professor University of California, San Diego 9500 Gilman Drive Mail Stop 0711 Division of Infectious DIseases San Diego, CA 92130 United States [email protected] Walter Schlech Professor of Medicine Infectious Diseases Institute QEIIHSC ACC 5014, Road 1278 Tower Halifax, NS B3H 2Y9 Canada [email protected] Manish Sagar Manish Assistant Professor Harvard University 65 Landsdowne Street Room 447 Cambridge, MA 02139 United States [email protected] Allan Ronald Professor Emeritus Accordia Foundation Crescent Wellington 1201-99 Winnipeg, MB R3M0A2 Canada [email protected] Doreen Ramogola-Masire Doreen Country Director Partnership Botswana-UPenn Box 404604 P.O. Gaborone Broadhurst, Botswana [email protected] Alma Yates Program Analyst San Francisco University of California, Clement Street 4150 San Francisco, CA 94121 United States [email protected] Brian Zanoni Assistant in Immunology Harvard University Road 98 Vause Inyoni Heights #21 Durban 4001 South Africa [email protected] Nicola Zetola Adjunct Assistant Professor University of Pennsylvania Private Bag 324, Suite 157 Riverwalk Gaborone Botswana [email protected] Jessica Yager Jessica Fellow Washington University of Institute Uganda Cancer Mulago Road Box 3935 Upper Kampala Uganda [email protected] SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Medical Center Tadesse Wuhib Tadesse CDC Country Director (Uganda) U.S. Embassy Kampala Plot 1577 Ggaba Road Box 7007 P.O. Kampala Uganda [email protected] Kara Wools-Kaloustian Kara Medicine Associate Professor of Indiana University 545 Barnhill Drive IN Indianapolis, United States [email protected] Wright Rodney Assistant Professor Einstein College of Medicine/Montefiore 350 W 50th Street #35-I NY 10019 New York, United States [email protected] Margaret Borok Williams Borok Margaret Zimbabwe University of Street Hospital, Mazowe Parirenyatwa Harare Zimbabwe [email protected] Winston Susanna Fellow University Lifespan/Tufts/Brown The Miriam Hospital Building 164 Summit Avenue, RISE Providence, RI 02906 United States [email protected]

46 Service; CFAR Co-Director Study Coordinator Infectious Diseases Institute Mulago Hill Kampala Kampala Uganda [email protected] Bonnie Wandera Paul Volberding Paul Professor of Medicine/Chief of Medical University of California, San Francisco Clement Street, VAMC 111 4150 San Francisco, CA 94121 United States [email protected] Cedric Vista Lecturer University of Botswana Faculty of Education Private Bag 00702 Gaborone Botswana [email protected] Edna Viegas Medical Doctor De Instituto Nacional De Sau Centre Caniqo Health Polana Maputo Mozambique [email protected] Katherine Van Loon Van Katherine Oncology Fellow California, San Francisco University of Center Comprehensive Cancer Mount Zion Street, 4th Floor 1600 Divisadero CA 94109 San Francisco, United States [email protected]

Attendee List Attendee Collaboration Information

Who is Collaborating With Which CFARs (or D-CFARs)?

Case Western Einstein College Orango, Omenge Coutinho, Alex University of Reserve University of Medicine / Siika, Abraham Cranmer, Risa Pennsylvania Akao, Juliet Montefiore Medical Winston, Susanna Daud, Ibrahim Anabwani, Gabriel Asito, Amolo Center Wools-Kaloustian, Kara Gantt, Soren Canaday, David Bajunirwe, Francis Adedimeji, Adebola Gitome, Serah Casper, Corey Boom, W. Henry Anastos, Kathryn New York University Hunt, Peter Haas, Michelle Daud, Ibrahim Canaday, David Dusingize, J Claude Jacob, Shevin Hoxie, James Mwamzuka, Mussa Casper, Corey Kasprowicz, Victoria Kabami, Jane Manabe, Yuka Zetola, Nicola Fred, Kyeyune Larsen, Michelle Kabututwa, Simon Ramogola-Masire, Doreen Kaawa-Mafigiri, David Sinayobye, Jean D’Amour Rush University Kakuru, Abel Steenhoff, Andrew Manabe, Yuka Wright, Rodney / University of Kambugu, Andrew Zetola, Nicola McGrath, Janet Illinois-Chicago Kamya, Moses Mugyenyi, Peter George Washington Kasirye, Ivy University of University Bailey, Robert Washington Musiime, Victor Jaoko, Walter Kimuli, Timothy Bingerheimer, Jeffrey Asante, Elizabeth Mwamzuka, Mussa June, Elijah Kwasa, Judith Guay, Laura Bailey, Robert Nakku-Joloba, Edith Kazembe, Abigail Kwena, Zachary Manabe, Yuka Bosire, Rose Namutiibwa, Florence Levy, Judith Laker, Miriam Naanyu, Violet Bukusi, Elizabeth Orem, Jackson Ngalande, Rebecca Manabe, Yuka Ong’ech, John Chohan, Bhavna Oyella, Jacinta Umar, Eric Munderi, Paula Schooley, Robert Quinn, Tom Muyindike, Winnie Cohen, Craig Tumwesigye, Elioda Skillicorn, Jennifer University Mwesigwa, Julia Daud, Ibrahim Tiam, Appolinaire of Alabama- Nakanjako, Damalie Gantt, Soren Baylor-University Gitome, Serah Harvard University Birmingham Nelson, Ann of Texas-Houston Chi, Benjamin Jacob, Shevin Addo, Marylyn Njoroge, Betty Anabwani, Gabriel Chibwesha, Carla Jaoko, Walter Anabwani, Gabriel Ombati, Everlyne Asito, Amolo Chintu, Namwinga Kafeero, James Asiimwe, Stephen Onono, Maricianah Nsangi, Betty Henostroza, German Kambugu, Andrew Asito, Amolo Orem, Jackson Tukei, Vincent Jaoko, Walter Kiarie, James Bajunirwe, Francis Phipps, Warren Mulenga, Lloyd Manabe, Yuka Duke University Bisson, Gregory Ronald, Allan Phiri Kasaro, Margaret Merkel, Michele Asito, Amolo Bwana, Bosco Tumwesigye, Elioda Putta, Nande Van Loon, Katherine Mugwanya, Kenneth Bartlett, John Gaseitsiwe, Simani Mujugira, Andrew Cu-Uvin, Susan Hunt, Peter University of Wandera, Bonnie Zetola, Nicola Mutyaba, Innocent Larsen, Michelle Kabami, Jane California-Los Naanyu, Violet Mbwilo, Evalily Kasprowicz, Victoria Angeles University of Nakanjako, Damalie Munishi, Michael Larsen, Michelle Asito, Amolo Massachusetts Nakku-Joloba, Edith Naanyu, Violet Manabe, Yuka Brown, Ben Daud, Ibrahim Ndase, Patrick Nelson, Ann Odor, King Casper, Corey Okuku, Fred Niyonzima, Nixon Psaros, Christina Mitsuyasu, Ronald University of Miami Onyango, Jacob Collaboration Attendee Casper, Corey Quinn, Tom Zanoni, Brian Zetola, Nicola Orem, Jackson Umar, Eric Lifespan / Tufts / University of University of North Payne, Barbara Emory University Brown University California-San Diego Carolina-Chapel Hill Phipps, Warren Information Addo, Marylyn Adanu, Richard Noormahomed, Emilia Asito, Amolo Polyak, Stephen Asito, Amolo Addo, Marylyn Schooley, Robert Chikaonda, Tarsizio Quinn, Tom Bailey, Robert Asito, Amolo Cu-Uvin, Susan Ronald, Allan Brown, Ben Ayuo, Paul University of Hosseinipour, Mina Singa, Benson Cu-Uvin, Susan Chirchir, Amon California-San Larsen, Michelle Tumwesigye, Elioda Inambao, Mubiana Kantor, Rami Francisco Miller, William Yager, Jessica Achan, Jane Karita, Etienne Kenu, Ernest Moses, Agnes Vanderbilt University Quinn, Tom Kwara, Awewura Bukusi, Elizabeth Nakasujja, Noeline Bwana, Bosco / Meharry Medical Lartey, Margaret Phiri, Sam College Casper, Corey Thonyiwa, Virginia Naanyu, Violet Cu-Uvin, Susan Obed, Samuel Charlebois, Edwin van der Horst, Charles Cohen, Craig Gebi, Usman Manabe, Yuka Sidat, Mohsin

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 47 Country of Collaboration Focus

Australia Indonesia Netherlands Tanzania United States Odor, King Levy, Judith Hermans, Sabine Addo, Marylyn Achan, Jane Sidat, Mohsin Musiime, Victor Bartlett, John Adanu, Richard Ireland Odor, King Kasirye, Philip Adedimeji, Adebola Austria Adedimeji, Adebola Mbwilo, Evalily Akao, Juliet Odor, King Odor, King New Zealand Munishi, Michael Asante, Elizabeth Odor, King Belgium Japan Van Loon, Katherine Asiimwe, Stephen Achan, Jane Odor, King Niger Thailand Ayuo, Paul Musiime, Victor Adedimeji, Adebola Kantor, Rami Bajunirwe, Francis Kenya Gebi, Usman Borok Williams, Margaret Botswana Anastos, Kathryn Uganda Busakhala, Naftali Addo, Marylyn Asito, Amolo Nigeria Addo, Marylyn Chirchir, Amon Gaseitsiwe, Simani Bailey, Robert Adedimeji, Adebola Arts, Eric Chohan, Bhavna Haas, Michelle Bosire, Rose Gebi, Usman Boom, W. Henry Fred, Kyeyune Hoxie, James Brown, Ben Bwana, Bosco Haas, Michelle Kasirye, Philip Bukusi, Elizabeth Norway Canaday, David Sidat, Mohsin Hermans, Sabine Odor, King Charlebois, Edwin Casper, Corey Kabami, Jane Ramogola-Masire, Doreen Cohen, Craig Papau New Guinea Charlebois, Edwin Kakuru, Abel Steenhoff, Andrew Cu-Uvin, Susan Levy, Judith Cranmer, Risa Kambugu, Andrew Zetola, Nicola Gitome, Serah Fred, Kyeyune Kantor, Rami Huppi, Rebecca Portugal Gantt, Soren Kasirye, Ivy Brazil Jaoko, Walter Sidat, Mohsin Hermans, Sabine Polyak, Stephen Kasirye, Philip June, Elijah Hunt, Peter Kimuli, Timothy Rwanda Huppi, Rebecca Canada Kantor, Rami Adedimeji, Adebola Mbwilo, Evalily Muyindike, Winnie Kiarie, James Jacob, Shevin Moses, Agnes Anastos, Kathryn June, Elijah Odor, King Mwamzuka, Mussa Kimuli, Timothy Muyindike, Winnie Naanyu, Violet Kabututwa, Simon Mwesigwa, Julia Chile Sinayobye, Jean D’Amour Kafeero, James Njoroge, Betty Wright, Rodney Nakku-Joloba, Edith Levy, Judith Odor, King Kamya, Moses Namutiibwa, Florence Payne, Barbara Sierra Leona Kasirye, Ivy Ndase, Patrick China Kimuli, Timothy Kantor, Rami Siika, Abraham Adedimeji, Adebola Ngalande, Rebecca Singa, Benson Kwena, Zachary Nsangi, Betty Levy, Judith South Africa Laker, Miriam Odor, King Thonyiwa, Virginia Odor, King Wools-Kaloustian, Kara Addo, Marylyn Manabe, Yuka van der Horst, Charles Anastos, Kathryn Okuku, Fred Mbwilo, Evalily Ong’ech, John East Timor Lesotho Brown, Ben McGrath, Janet Tiam, Appolinaire Huppi, Rebecca Onono, Maricianah Levy, Judith Meya, David Onyango, Jacob Kantor, Rami Mugwanya, Kenneth Ethiopia Liberia Kasprowicz, Victoria Orango, Omenge Odor, King Mujugira, Andrew Oyella, Jacinta Adedimeji, Adebola Larsen, Michelle Mutyaba, Innocent Wright, Rodney Musiime, Victor Sidat, Mohsin Libya Nakasujja, Noeline Silenzio, Vincent Kimuli, Timothy Odor, King Nelson, Ann Finland Okuku, Fred Sinayobye, Jean D’Amour Odor, King Nickel, Gabrielle Thonyiwa, Virginia Luxembourg Psaros, Christina Niyonzima, Nixon Odor, King Sidat, Mohsin Wandera, Bonnie France Okuku, Fred Wright, Rodney Odor, King Malawi Silenzio, Vincent Phipps, Warren Adedimeji, Adebola Umar, Eric Psaros, Christina Zambia Gambia van der Horst, Charles Quinn, Tom Anastos, Kathryn Anastos, Kathryn Hosseinipour, Mina Jere, Diana Zanoni, Brian Ronald, Allan Chintu, Namwinga Germany June, Elijah Spain Sagar, Manish Henostroza, German Odor, King Kaponda, Chrissie Odor, King Schlech, Walter Inambao, Mubiana Kazembe, Abigail Sidat, Mohsin Tukei, Vincent Karita, Etienne Ghana Levy, Judith Tumwesigye, Elioda Mulenga, Lloyd Adedimeji, Adebola Miller, William Swaziland Wright, Rodney Musiime, Victor Attendee Collaboration Collaboration Attendee Bingerheimer, Jeffrey Phiri, Sam Odor, King Yager, Jessica Putta, Nande Kwara, Awewura Thonyiwa, Virginia Sweden United Kingdom Zimbabwe Lartey, Margaret van der Horst, Charles Information Odor, King Odor, King Kasirye, Ivy Fred, Kyeyune Munderi, Paula Huppi, Rebecca Mozambique Switzerland Guinea Schooley, Robert Musiime, Victor Munderi, Paula Levy, Judith Odor, King Odor, King Murungu, Joseph India Musiime, Victor Kantor, Rami Odor, King

48 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Who is Interested in Developing and/or Expanding Sites into Which Countries?

Australia Democratic Republic India Mozambique Lartey, Margaret Odor, King of Congo Hermans, Sabine Mutyaba, Innocent Murungu, Joseph Thonyiwa, Virginia Anastos, Kathryn Kiarie, James Nsangi, Betty Mutyaba, Innocent Mutyaba, Innocent Odor, King Phiri, Sam Muyindike, Winnie Austria Sagar, Manish Siika, Abraham Mwesigwa, Julia Odor, King Denmark Sidat, Mohsin Umar, Eric Nakasujja, Noeline Asante, Elizabeth Namukwaya, Elizabeth Bahamas Odor, King Indonesia Namibia Gitome, Serah Ngalande, Rebecca Levy, Judith Ayuo, Paul Dominica Nsangi, Betty Bangladesh Ngalande, Rebecca Mutyaba, Innocent Odor, King Umar, Eric Phiri, Sam Gitome, Serah Ireland Onyango, Jacob Dominican Republic Umar, Eric Belgium Odor, King Oyella, Jacinta Umar, Eric Netherlands Phipps, Warren Gitome, Serah Israel Kasirye, Philip East Timor Kasirye, Philip Phiri, Sam Kimuli, Timothy Ramogola-Masire, Doreen Levy, Judith Bhutan Mutyaba, Innocent New Zealand Silenzio, Vincent Ronald, Allan Onyango, Jacob Egypt Kazakhstan Sinayobye, Jean D’Amour Singa, Benson Umar, Eric Levy, Judith Niger Botswana Steenhoff, Andrew Adedimeji, Adebola Kenya Mutyaba, Innocent Eritrea Thonyiwa, Virginia Kiarie, James Adedimeji, Adebola Schlech, Walter Gitome, Serah Tiam, Appolinaire Mbwilo, Evalily Anastos, Kathryn Tukei, Vincent Murungu, Joseph Ethiopia Bingerheimer, Jeffrey Nigeria Tumwesigye, Elioda Mutyaba, Innocent Adanu, Richard Bosire, Rose Mutyaba, Innocent Wright, Rodney Ngalande, Rebecca Brown, Ben Kafeero, James Schlech, Walter Zanoni, Brian Phiri, Sam Gebi, Usman Kamya, Moses Norway Zetola, Nicola Sidat, Mohsin Kafeero, James Kasirye, Ivy Onyango, Jacob Tiam, Appolinaire Kiarie, James Laker, Miriam South Korea Umar, Eric Nakasujja, Noeline Mbwilo, Evalily Papua New Guinea Tukei, Vincent Odor, King Meya, David Levy, Judith Burundi Onono, Maricianah Moses, Agnes Swaziland Anastos, Kathryn Peru Phipps, Warren Musiime, Victor Mugwanya, Kenneth Laker, Miriam Henostroza, German Thonyiwa, Virginia Mutyaba, Innocent Murungu, Joseph Cambodia Wright, Rodney Muyindike, Winnie Qatar Mutyaba, Innocent Umar, Eric Namukwaya, Elizabeth Nakasujja, Noeline Ngalande, Rebecca Fiji Nsangi, Betty Wright, Rodney Nakku-Joloba, Edith Nelson, Ann Ngalande, Rebecca Rwanda Ramogola-Masire, Doreen Cameroon Finland Nickel, Gabrielle Laker, Miriam Sidat, Mohsin Anastos, Kathryn Odor, King Nsangi, Betty Mbwilo, Evalily Kimuli, Timothy Munishi, Michael Sweden Phipps, Warren Asante, Elizabeth Ngalande, Rebecca France Phiri, Sam Mutyaba, Innocent Sinayobye, Jean D’Amour Mutyaba, Innocent Nakasujja, Noeline Hermans, Sabine Ramogola-Masire, Doreen Nakasujja, Noeline Tiam, Appolinaire Onyango, Jacob Tiam, Appolinaire Nsangi, Betty Umar, Eric Sinayobye, Jean D’Amour Onono, Maricianah Odor, King Lesotho Singa, Benson Onyango, Jacob Canada Gambia Nsangi, Betty Kazembe, Abigail Lartey, Margaret Sandwich Islands Switzerland Ramogola-Masire, Doreen Asante, Elizabeth Namukwaya, Elizabeth Sidat, Mohsin Levy, Judith Namutiibwa, Florence Germany Hermans, Sabine Odor, King Asante, Elizabeth Liberia Senegal Mbwilo, Evalily Sinayobye, Jean D’Amour Odor, King Odor, King Addo, Marylyn Odor, King Umar, Eric Onyango, Jacob Brown, Ben Onyango, Jacob Sinayobye, Jean D’Amour Luxenbourg Gitome, Serah Tanzania Central African Odor, King Collaboration Attendee Republic Ghana Seychelles Charlebois, Edwin Anastos, Kathryn Addo, Marylyn Madagascar Brown, Ben Kafeero, James Asante, Elizabeth Gitome, Serah Kasirye, Ivy Sinayobye, Jean D’Amour South Africa Information Brown, Ben Laker, Miriam Malawi Adedimeji, Adebola Chile Cu-Uvin, Susan Musiime, Victor Bailey, Robert Asiimwe, Stephen Levy, Judith Gitome, Serah Mutyaba, Innocent Gitome, Serah Bajunirwe, Francis Odor, King Muyindike, Winnie China Levy, Judith Canaday, David Onono, Maricianah Namukwaya, Elizabeth Kiarie, James Musiime, Victor Chirchir, Amon Nickel, Gabrielle Levy, Judith Gibraltar Mutyaba, Innocent Chohan, Bhavna Nsangi, Betty Murungu, Joseph Umar, Eric Namukwaya, Elizabeth Gaseitsiwe, Simani Onono, Maricianah Odor, King Ramogola-Masire, Doreen Gebi, Usman Onyango, Jacob Silenzio, Vincent Guinea Sidat, Mohsin Gitome, Serah Phiri, Sam Sinayobye, Jean D’Amour Levy, Judith Tiam, Appolinaire Henostroza, German Quinn, Tom Tukei, Vincent Jacob, Shevin Hong Kong Sinayobye, Jean D’Amour Mali Kafeero, James Congo Silenzio, Vincent Mutyaba, Innocent Singa, Benson Anastos, Kathryn Kasirye, Ivy Mutyaba, Innocent Micronesia Kazembe, Abigail Thailand Levy, Judith Kwena, Zachary Murungu, Joseph SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 49 Tonga Phipps, Warren Ong’ech, John Tukei, Vincent Sidat, Mohsin Nakku-Joloba, Edith Phiri, Sam Onyango, Jacob Wright, Rodney Thonyiwa, Virginia Polyak, Stephen Sinayobye, Jean D’Amour Tiam, Appolinaire Uganda Ramogola-Masire, Doreen Tukei, Vincent Vietnam Adanu, Richard Levy, Judith Zimbabwe Sinayobye, Jean D’Amour Anastos, Kathryn Ayuo, Paul Singa, Benson United States Brown, Ben Asante, Elizabeth Zambia Chintu, Namwinga Wright, Rodney Anastos, Kathryn Bukusi, Elizabeth Asito, Amolo Cohen, Craig Brown, Ben Bwana, Bosco United Arab Emirates Busakhala, Naftali Haas, Michelle Gitome, Serah Chohan, Bhavna Gitome, Serah Kabututwa, Simon Kafeero, James Kasirye, Ivy Cranmer, Risa Kafeero, James Kasirye, Ivy Kiarie, James June, Elijah United Kingdom Munderi, Paula McGrath, Janet Achan, Jane Levy, Judith Kafeero, James Musiime, Victor Mutyaba, Innocent Adanu, Richard McGrath, Janet Kambugu, Andrew Mutyaba, Innocent Nakku-Joloba, Edith Asito, Amolo Mutyaba, Innocent Kazembe, Abigail Namukwaya, Elizabeth Nickel, Gabrielle Hermans, Sabine Nakku-Joloba, Edith Mujugira, Andrew Nsangi, Betty Phipps, Warren Kabami, Jane Ngalande, Rebecca Murungu, Joseph Onyango, Jacob Phiri, Sam Kakuru, Abel Onono, Maricianah Ngalande, Rebecca Oyella, Jacinta Ramogola-Masire, Doreen Kasirye, Philip Orango, Omenge Niyonzima, Nixon Sekadde-Kasirye, Moorine Sidat, Mohsin Mutyaba, Innocent Phiri, Sam Onono, Maricianah Silenzio, Vincent Thonyiwa, Virginia Namukwaya, Elizabeth Ramogola-Masire, Doreen Onyango, Jacob Sinayobye, Jean D’Amour Tiam, Appolinaire Areas of Research Interest and/or Experience Integrating Treatment and Prevention in HIV Care ARV Resistance, Phiri Kasaro, Margaret Quinn, Tom Onyango, Jacob Kiarie, James Clinical Outcomes Quinn, Tom Ronald, Allan Phiri Kasaro, Margaret Kwara, Awewura Achan, Jane Sagar, Manish Sagar, Manish Psaros, Christina Kwena, Zachary Akao, Juliet Schlech, Walter Sidat, Mohsin Ronald, Allan Laker, Miriam Anastos, Kathryn Schooley, Robert Sinayobye, Jean D’Amour Sidat, Mohsin Lartey, Margaret Asiimwe, Stephen Sekadde-Kasirye, Moorine Skillicorn, Jennifer Silenzio, Vincent Manabe, Yuka Bartlett, John Sidat, Mohsin Tumwesigye, Elioda Skillicorn, Jennifer McGrath, Janet Bisson, Gregory Siika, Abraham Umar, Eric Thonyiwa, Virginia Meya, David Busakhala, Naftali Sinayobye, Jean D’Amour Wright, Rodney Tumwesigye, Elioda Moses, Agnes Bwana, Bosco Thonyiwa, Virginia Umar, Eric Mulenga, Lloyd Charlebois, Edwin Tiam, Appolinaire Behavioral and Wandera, Bonnie Munderi, Paula Chi, Benjamin Tukei, Vincent Social Science Yager, Jessica Munishi, Michael Chohan, Bhavna Wools-Kaloustian, Kara Aspects Murungu, Joseph Adedimeji, Adebola Fred, Kyeyune Operational Mutyaba, Innocent Akao, Juliet Gantt, Soren New Technologies Research/ Muyindike, Winnie Anastos, Kathryn Gaseitsiwe, Simani in Prevention: PrEP, Implementation Mwamzuka, Mussa Asante, Elizabeth Gebi, Usman Microbicides Science Nakanjako, Damalie Akao, Juliet Asiimwe, Stephen Achan, Jane Haas, Michelle Ndase, Patrick Anastos, Kathryn Ayuo, Paul Adedimeji, Adebola Henostroza, German Nelson, Ann Arts, Eric Bailey, Robert Akao, Juliet Hermans, Sabine Nsangi, Betty Ayuo, Paul Bartlett, John Ayuo, Paul Hosseinipour, Mina Odor, King Brown, Ben Bosire, Rose Bailey, Robert Jaoko, Walter Ong’ech, John Bwana, Bosco Brown, Ben Bajunirwe, Francis Kabututwa, Simon Onono, Maricianah Charlebois, Edwin Bukusi, Elizabeth Bartlett, John Kambugu, Andrew Onyango, Jacob Cohen, Craig Chirchir, Amon Bisson, Gregory Kamya, Moses Oyella, Jacinta Coutinho, Alex Gitome, Serah Bosire, Rose Kantor, Rami Phiri, Sam Cu-Uvin, Susan Jere, Diana Brown, Ben Kasirye, Ivy Phiri Kasaro, Margaret Daud, Ibrahim Kaawa-Mafigiri, David Charlebois, Edwin Kasirye, Philip Putta, Nande Denny, Lynette Kabami, Jane Chi, Benjamin Kenu, Ernest Quinn, Tom Fred, Kyeyune Kasirye, Philip Chikaonda, Tarsizio Kiarie, James Ramogola-Masire, Doreen Attendee Collaboration Collaboration Attendee Gitome, Serah Kazembe, Abigail Chirchir, Amon Lartey, Margaret Ronald, Allan Inambao, Mubiana Kenu, Ernest Cohen, Craig Manabe, Yuka Schlech, Walter Kasirye, Philip Kiarie, James Gebi, Usman Mugwanya, Kenneth Schooley, Robert Information Kiarie, James Kwena, Zachary Gitome, Serah Mugyenyi, Peter Sidat, Mohsin Kimuli, Timothy Levy, Judith Haas, Michelle Mulenga, Lloyd Siika, Abraham Kwena, Zachary McGrath, Janet Henostroza, German Munderi, Paula Sinayobye, Jean D’Amour Mugyenyi, Peter Mugyenyi, Peter Hermans, Sabine Murungu, Joseph Singa, Benson Mujugira, Andrew Musiime, Victor Hosseinipour, Mina Musiime, Victor Steenhoff, Andrew Muyindike, Winnie Muyindike, Winnie June, Elijah Mwamzuka, Mussa Thonyiwa, Virginia Mwamzuka, Mussa Mwamzuka, Mussa Kaawa-Mafigiri, David Mwesigwa, Julia Tiam, Appolinaire Nakku-Joloba, Edith Naanyu, Violet Kabututwa, Simon Nakanjako, Damalie Tukei, Vincent Ndase, Patrick Nakanjako, Damalie Kafeero, James Nickel, Gabrielle Tumwesigye, Elioda Njoroge, Betty Nakasujja, Noeline Kamya, Moses Niyonzima, Nixon van der Horst, Charles Ombati, Everlyne Nakku-Joloba, Edith Kasirye, Philip Odor, King Wools-Kaloustian, Kara Onyango, Jacob Namutiibwa, Florence Kasprowicz, Victoria Oyella, Jacinta Yager, Jessica Phiri Kasaro, Margaret Ngalande, Rebecca Kazembe, Abigail Phiri, Sam Zetola, Nicola Psaros, Christina Odor, King

50 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 HIV Comorbidities HIV/TB and Other Nakanjako, Damalie Kasirye, Philip HIV-Associated Ronald, Allan Opportunistic Nelson, Ann Kenu, Ernest Malignancies Schooley, Robert Infections (OIs) Nickel, Gabrielle Munderi, Paula Anastos, Kathryn Sekadde-Kasirye, Moorine Akao, Juliet Noormahomed, Emilia Mwamzuka, Mussa Asiimwe, Stephen Sidat, Mohsin Anastos, Kathryn Nsangi, Betty Mwesigwa, Julia Asito, Amolo Tukei, Vincent Asiimwe, Stephen Odor, King Nakanjako, Damalie Bartlett, John Van Loon, Katherine Asito, Amolo Okuku, Fred Ndase, Patrick Borok Williams, Margaret Yager, Jessica Bartlett, John Ombati, Everlyne Nelson, Ann Busakhala, Naftali Bisson, Gregory Oyella, Jacinta Ngalande, Rebecca Bwana, Bosco HIV and Chronic Boom, W. Henry Payne, Barbara Nickel, Gabrielle Casper, Corey Diseases Bosire, Rose Phiri, Sam Noormahomed, Emilia Cu-Uvin, Susan Anastos, Kathryn Brown, Ben Phiri Kasaro, Margaret Odor, King Daud, Ibrahim Asito, Amolo Bwana, Bosco Quinn, Tom Ombati, Everlyne Dominguez, Geraldina Bartlett, John Canaday, David Schlech, Walter Oyella, Jacinta Fred, Kyeyune Bisson, Gregory Casper, Corey Schooley, Robert Quinn, Tom Hosseinipour, Mina Fred, Kyeyune Charlebois, Edwin Sekadde-Kasirye, Moorine Schooley, Robert Huppi, Rebecca Hunt, Peter Chikaonda, Tarsizio Sidat, Mohsin Sidat, Mohsin Kabututwa, Simon Kasirye, Philip Gaseitsiwe, Simani Siika, Abraham Sinayobye, Jean D’Amour Kafeero, James Kenu, Ernest Gebi, Usman Sinayobye, Jean D’Amour Thonyiwa, Virginia Kasirye, Philip Manabe, Yuka Haas, Michelle Singa, Benson Tumwesigye, Elioda Kimuli, Timothy Moses, Agnes Henostroza, German Steenhoff, Andrew Krown, Susan Mulenga, Lloyd Hermans, Sabine Thonyiwa, Virginia HPV-Related GYN Laker, Miriam Munderi, Paula Hosseinipour, Mina Tiam, Appolinaire Disease Lartey, Margaret Murungu, Joseph Jacob, Shevin Tukei, Vincent Anastos, Kathryn Manabe, Yuka Mwamzuka, Mussa Kabututwa, Simon Tumwesigye, Elioda Bajunirwe, Francis Mbwilo, Evalily Nakanjako, Damalie Kambugu, Andrew van der Horst, Charles Bukusi, Elizabeth Mitsuyasu, Ronald Nakasujja, Noeline Kamya, Moses Wandera, Bonnie Cu-Uvin, Susan Moses, Agnes Nelson, Ann Kasirye, Ivy Zanoni, Brian Denny, Lynette Mugwanya, Kenneth Niyonzima, Nixon Kasirye, Philip Zetola, Nicola Gitome, Serah Mulenga, Lloyd Odor, King Kasprowicz, Victoria Hosseinipour, Mina Munishi, Michael Polyak, Stephen Kenu, Ernest HIV/Malaria Kiarie, James Murungu, Joseph Sidat, Mohsin Kimuli, Timothy Co-Infection Mitsuyasu, Ronald Mutyaba, Innocent Sinayobye, Jean D’Amour Kwara, Awewura Achan, Jane Nakku-Joloba, Edith Muyindike, Winnie Thonyiwa, Virginia Larsen, Michelle Anastos, Kathryn Nelson, Ann Namukwaya, Elizabeth Lartey, Margaret Asito, Amolo Odor, King Nelson, Ann HIV and Substance Manabe, Yuka Bwana, Bosco Onono, Maricianah Nickel, Gabrielle Abuse Mbwilo, Evalily Charlebois, Edwin Orango, Omenge Niyonzima, Nixon Anastos, Kathryn Meya, David Chikaonda, Tarsizio Phiri Kasaro, Margaret Njoroge, Betty Brown, Ben Moses, Agnes Gebi, Usman Ramogola-Masire, Doreen Nkomazana, Oathokwa Kaawa-Mafigiri, David Mugyenyi, Peter Henostroza, German Sidat, Mohsin Nokta, Mostafa Levy, Judith Mulenga, Lloyd Hermans, Sabine Sinayobye, Jean D’Amour Odor, King Muyindike, Winnie Munderi, Paula Hosseinipour, Mina Singa, Benson Okuku, Fred Mwamzuka, Mussa Murungu, Joseph Jaoko, Walter Wright, Rodney Orango, Omenge Nakku-Joloba, Edith Musiime, Victor June, Elijah Zetola, Nicola Orem, Jackson Ngalande, Rebecca Muyindike, Winnie Kakuru, Abel Phipps, Warren Odor, King Mwamzuka, Mussa Kamya, Moses Polyak, Stephen Sidat, Mohsin Quinn, Tom Wandera, Bonnie HIV and Women Maternal and Inambao, Mubiana Ramogola-Masire, Doreen Chintu, Namwinga Mwesigwa, Julia Reproductive Health Jaoko, Walter Ronald, Allan Chohan, Bhavna Nakanjako, Damalie Issues June, Elijah Schlech, Walter Cohen, Craig Nakku-Joloba, Edith Adanu, Richard Kaawa-Mafigiri, David Sidat, Mohsin Coutinho, Alex Ngalande, Rebecca Adedimeji, Adebola Kabami, Jane Sinayobye, Jean D’Amour Cranmer, Risa Nokta, Mostafa

Anastos, Kathryn Kabututwa, Simon Singa, Benson Cu-Uvin, Susan Nsangi, Betty Collaboration Attendee Asante, Elizabeth Kazembe, Abigail Skillicorn, Jennifer Denny, Lynette Odor, King Bailey, Robert Kiarie, James Thonyiwa, Virginia Fred, Kyeyune Ong’ech, John McGrath, Janet Bajunirwe, Francis Tiam, Appolinaire Gantt, Soren Onono, Maricianah Information Bingerheimer, Jeffrey Mugwanya, Kenneth van der Horst, Charles Guay, Laura Payne, Barbara Bosire, Rose Munishi, Michael Wools-Kaloustian, Kara Hosseinipour, Mina Putta, Nande Bukusi, Elizabeth Muyindike, Winnie Wright, Rodney Kabami, Jane Sekadde-Kasirye, Moorine Bwana, Bosco Nakku-Joloba, Edith Kabututwa, Simon Sidat, Mohsin Chi, Benjamin Ndase, Patrick HIV and Pediatrics, Kasirye, Ivy Sinayobye, Jean D’Amour Chintu, Namwinga Ngalande, Rebecca Prevention of MTCT Kasirye, Philip Singa, Benson Chirchir, Amon Njoroge, Betty Akao, Juliet Kiarie, James Steenhoff, Andrew Cohen, Craig Odor, King Anabwani, Gabriel Moses, Agnes Thonyiwa, Virginia Cranmer, Risa Ong’ech, John Anastos, Kathryn Mugyenyi, Peter Tiam, Appolinaire Cu-Uvin, Susan Onono, Maricianah Asito, Amolo Munishi, Michael Tumwesigye, Elioda Denny, Lynette Onyango, Jacob Bajunirwe, Francis Murungu, Joseph van der Horst, Charles Gebi, Usman Orango, Omenge Bosire, Rose Musiime, Victor Wools-Kaloustian, Kara Gitome, Serah Phiri, Sam Bukusi, Elizabeth Muyindike, Winnie Wright, Rodney Huppi, Rebecca Psaros, Christina Bwana, Bosco Mwamzuka, Mussa Zanoni, Brian Putta, Nande Chi, Benjamin

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 51 HIV Pathogenesis Immunology Mulenga, Lloyd Virology Nickel, Gabrielle Gaseitsiwe, Simani Addo, Marylyn Munderi, Paula Addo, Marylyn Nokta, Mostafa Gitome, Serah Akao, Juliet Musiime, Victor Anastos, Kathryn Odor, King Hoxie, James Anastos, Kathryn Muyindike, Winnie Chohan, Bhavna Ombati, Everlyne Inambao, Mubiana Asiimwe, Stephen Mwamzuka, Mussa Cu-Uvin, Susan Oyella, Jacinta Jaoko, Walter Asito, Amolo Nakanjako, Damalie Fred, Kyeyune Phipps, Warren Kabututwa, Simon Bosire, Rose Niyonzima, Nixon Gantt, Soren Polyak, Stephen Larsen, Michelle Canaday, David Njoroge, Betty Gaseitsiwe, Simani Quinn, Tom Manabe, Yuka Cu-Uvin, Susan Nsangi, Betty Hoxie, James Sagar, Manish Mugyenyi, Peter Daud, Ibrahim Odor, King Kabututwa, Simon Schooley, Robert Mulenga, Lloyd Fred, Kyeyune Ombati, Everlyne Kafeero, James Sinayobye, Jean D’Amour Mwamzuka, Mussa Gantt, Soren Oyella, Jacinta Mugwanya, Kenneth Nakku-Joloba, Edith Gaseitsiwe, Simani Payne, Barbara Mulenga, Lloyd Vaccine Research Odor, King Addo, Marylyn Hunt, Peter Quinn, Tom Murungu, Joseph Ombati, Everlyne Akao, Juliet Kabututwa, Simon Sagar, Manish Musiime, Victor Oyella, Jacinta Anastos, Kathryn Kasprowicz, Victoria Schooley, Robert Muyindike, Winnie Payne, Barbara Asiimwe, Stephen Manabe, Yuka Sekadde-Kasirye, Moorine Mwamzuka, Mussa Sagar, Manish Brown, Ben Mbwilo, Evalily Sinayobye, Jean D’Amour Mwesigwa, Julia Schlech, Walter Fred, Kyeyune Meya, David Nakku-Joloba, Edith Mitsuyasu, Ronald Mugyenyi, Peter

Training and Leadership Development Achan, Jane Gebi, Usman Laker, Miriam Nakanjako, Damalie Putta, Nande Adedimeji, Adebola Gitome, Serah Lartey, Margaret Nakasujja, Noeline Ramogola-Masire, Doreen Akao, Juliet Haas, Michelle Levy, Judith Namutiibwa, Florence Ronald, Allan Asante, Elizabeth Hosseinipour, Mina Manabe, Yuka Nelson, Ann Schlech, Walter Asiimwe, Stephen June, Elijah McGrath, Janet Ngalande, Rebecca Schooley, Robert Ayuo, Paul Kaawa-Mafigiri, David Meya, David Njoroge, Betty Sidat, Mohsin Bosire, Rose Kabututwa, Simon Moses, Agnes Nsangi, Betty Siika, Abraham Brown, Ben Kamya, Moses Mugyenyi, Peter Odor, King Singa, Benson Bwana, Bosco Kasirye, Philip Munishi, Michael Ong’ech, John Thonyiwa, Virginia Charlebois, Edwin Kasprowicz, Victoria Murungu, Joseph Onyango, Jacob van der Horst, Charles Chikaonda, Tarsizio Kazembe, Abigail Muyindike, Winnie Phiri, Sam Yager, Jessica Cohen, Craig Kiarie, James Mwamzuka, Mussa Phiri Kasaro, Margaret Zanoni, Brian

Institution Unique Resources and Capabilities

Laboratory Kabututwa, Simon Tumwesigye, Elioda Gantt, Soren Mulenga, Lloyd Resources Kafeero, James van der Horst, Charles Henostroza, German Munderi, Paula Addo, Marylyn Kakuru, Abel Wright, Rodney Hermans, Sabine Murungu, Joseph Adedimeji, Adebola Kantor, Rami Yager, Jessica Hosseinipour, Mina Musiime, Victor Akao, Juliet Kasirye, Ivy Hunt, Peter Mutyaba, Innocent Asito, Amolo Kasirye, Philip Clinical Cohorts Huppi, Rebecca Muyindike, Winnie Achan, Jane Ayuo, Paul Laker, Miriam Inambao, Mubiana Mwesigwa, Julia Addo, Marylyn Boom, W. Henry Larsen, Michelle Jacob, Shevin Nakanjako, Damalie Adedimeji, Adebola Borok Williams, Margaret Manabe, Yuka Jaoko, Walter Nakasujja, Noeline Akao, Juliet Bosire, Rose Meya, David June, Elijah Nakku-Joloba, Edith Asiimwe, Stephen Bukusi, Elizabeth Moses, Agnes Kabami, Jane Ndase, Patrick Asito, Amolo Canaday, David Mugyenyi, Peter Kafeero, James Ong’ech, John Attendee Collaboration Collaboration Attendee Ayuo, Paul Casper, Corey Mulenga, Lloyd Kakuru, Abel Phipps, Warren Bailey, Robert Chikaonda, Tarsizio Munderi, Paula Kamya, Moses Phiri, Sam Boom, W. Henry Chintu, Namwinga Murungu, Joseph Kantor, Rami Ramogola-Masire, Doreen Information Borok Williams, Margaret Chohan, Bhavna Musiime, Victor Kasirye, Ivy Ronald, Allan Bukusi, Elizabeth Cohen, Craig Muyindike, Winnie Kasirye, Philip Schlech, Walter Busakhala, Naftali Coutinho, Alex Mwamzuka, Mussa Kasprowicz, Victoria Sidat, Mohsin Canaday, David Denny, Lynette Nakasujja, Noeline Kiarie, James Siika, Abraham Casper, Corey Fred, Kyeyune Nelson, Ann Kimuli, Timothy Steenhoff, Andrew Chikaonda, Tarsizio Gantt, Soren Ong’ech, John Kwara, Awewura Tukei, Vincent Chintu, Namwinga Gaseitsiwe, Simani Phipps, Warren Laker, Miriam Tumwesigye, Elioda Chohan, Bhavna Gitome, Serah Polyak, Stephen Lartey, Margaret van der Horst, Charles Cohen, Craig Haas, Michelle Sagar, Manish Manabe, Yuka Wools-Kaloustian, Kara Coutinho, Alex Henostroza, German Schooley, Robert Meya, David Wright, Rodney Cu-Uvin, Susan Hermans, Sabine Sidat, Mohsin Mugwanya, Kenneth Yager, Jessica Denny, Lynette Hunt, Peter Singa, Benson Mugyenyi, Peter Zetola, Nicola Fred, Kyeyune Jacob, Shevin Steenhoff, Andrew Mujugira, Andrew

52 SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 Biological Specimen Support in Data Ndase, Patrick Gitome, Serah Odor, King Repository Management/ Odor, King Haas, Michelle Okuku, Fred Addo, Marylyn Biostatistical Data Okuku, Fred Hosseinipour, Mina Ong’ech, John Adedimeji, Adebola Analysis Phipps, Warren Hunt, Peter Phipps, Warren Asito, Amolo Adanu, Richard Putta, Nande Jaoko, Walter Phiri, Sam Bailey, Robert Addo, Marylyn Sidat, Mohsin Kaawa-Mafigiri, David Polyak, Stephen Canaday, David Akao, Juliet Steenhoff, Andrew Kabututwa, Simon Putta, Nande Casper, Corey Ayuo, Paul Tiam, Appolinaire Kafeero, James Schlech, Walter Chintu, Namwinga Boom, W. Henry Tumwesigye, Elioda Kakuru, Abel Schooley, Robert Coutinho, Alex Bosire, Rose van der Horst, Charles Kamya, Moses Sekadde-Kasirye, Moorine Cu-Uvin, Susan Canaday, David Wools-Kaloustian, Kara Kantor, Rami Sidat, Mohsin Denny, Lynette Casper, Corey Wright, Rodney Kasirye, Ivy Siika, Abraham Fred, Kyeyune Chintu, Namwinga Yager, Jessica Kasirye, Philip Thonyiwa, Virginia Gantt, Soren Denny, Lynette Kazembe, Abigail Tiam, Appolinaire Henostroza, German Fred, Kyeyune Training Kiarie, James Umar, Eric Addo, Marylyn Hunt, Peter Gantt, Soren Laker, Miriam van der Horst, Charles Adedimeji, Adebola Huppi, Rebecca Haas, Michelle Manabe, Yuka Wools-Kaloustian, Kara Anabwani, Gabriel June, Elijah Henostroza, German McGrath, Janet Wright, Rodney Ayuo, Paul Kafeero, James Hunt, Peter Mugyenyi, Peter Yager, Jessica Bailey, Robert Kakuru, Abel Jacob, Shevin Mulenga, Lloyd Zanoni, Brian Boom, W. Henry Kantor, Rami Kabami, Jane Munishi, Michael Bosire, Rose Manabe, Yuka Kafeero, James Murungu, Joseph Other Brown, Ben Adanu, Richard Mugyenyi, Peter Kantor, Rami Musiime, Victor Bukusi, Elizabeth Asante, Elizabeth Munderi, Paula Kwara, Awewura Mutyaba, Innocent Canaday, David Laker, Miriam Murungu, Joseph Laker, Miriam Muyindike, Winnie Casper, Corey Moses, Agnes Phipps, Warren Levy, Judith Nakanjako, Damalie Chintu, Namwinga Mwamzuka, Mussa Sidat, Mohsin Manabe, Yuka Nakasujja, Noeline Cohen, Craig Odor, King Tumwesigye, Elioda Mugyenyi, Peter Nakku-Joloba, Edith Coutinho, Alex Onyango, Jacob van der Horst, Charles Munderi, Paula Namutiibwa, Florence Cu-Uvin, Susan Silenzio, Vincent Yager, Jessica Musiime, Victor Ngalande, Rebecca Denny, Lynette Singa, Benson Zetola, Nicola Mutyaba, Innocent Niyonzima, Nixon Gantt, Soren Thonyiwa, Virginia Muyindike, Winnie Noormahomed, Emilia Gebi, Usman Tiam, Appolinaire Namutiibwa, Florence Nsangi, Betty Attendee Collaboration Collaboration Attendee Information

SUB-SAHARAN AFRICA CFAR CONFERENCE 2011 53 Notes: Notes: Notes: