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Technical Assistance
We provide technical research support, such as developing protocols and sampling plans; conducting statistical analysis; coordinating data collection, data entry, and data cleaning; training data collection staff; coordinating study logistics; and troubleshooting for technical issues. We currently support research studies in the following countries:
Botswana:
- Qualitative youth study: The goal of this study is to better understand the complexity of sexual risk and protective behaviors contributing to differing HIV prevalence rates observed among young adults in Botswana
- Mortality validation: The goal of the study is to validate the causes of HIV/AIDS-related infant and adult mortality through a retrospective review of patient charts, to improve the accuracy of mortality reporting and utilization of mortality statistics to improve public health surveillance and policy decision making in Botswana.
- Youth Behavioral Surveillance Study: The goal of the study is to conduct a national baseline assessment of levels of HIV knowledge, prevalence of sexual and other risk behavior patterns, and the factors that contribute to these behaviors among currently enrolled high school students in Botswana
- Sexual behaviors and HIV prevalence among Alcohol users who frequent drinking venues: The goals of this study are to assess HIV prevalence, demographic and sexual risk profiles among customers who frequent drinking establishments in Botswana; to determine if customers who frequent drinking establishments differ from the general population with respect to demographic and sexual risk profiles, and HIV prevalence and; to inform appropriate messages and effective interventions aimed at increasing condom use and reducing concurrent partnerships and other risky behaviors among alcohol users and frequent patrons of drinking establishments.
Uganda:
Adult ART study: UCSF is assisting in conducting a randomized controlled trial to evaluate the effectiveness of clinic-centered, clinic- and home-centered, and standard strategies for reducing HIV-transmission risk and increasing drug adherence in HIV-infected adults initiating antiretroviral therapy (ART) in a peri-urban area of Uganda. The primary objective will be to measure the effects of these strategies on sexual behavior at 6 and 12 months after randomization. We will also examine the effects on drug adherence, family planning, uptake of HIV voluntary counseling and testing among participants’ household members, and drug resistance, as well as the cost-effectiveness of the different approaches. The factors associated with poor adherence and changes in sexual behavior that may occur over time among participants will be explored. The evaluation will be conducted in partnership with the Mildmay Centre near Kampala, Uganda. All clinical care, including provision of antiretroviral therapy, will be provided by the Mildmay Centre following national guidelines that have received approval by the Ministry of Health.
Kenya:
We are assisting CDC Kenya in developing a study on male circumcision and positive prevention in Kisumu, Kenya. The primary goal of this study is to test the effectiveness of two community-based enhanced HIV prevention and care programs (male circumcision and the comprehensive care and treatment package) in reducing all-cause and HIV-related mortality and HIV incidence in a high-HIV prevalence area of rural Kenya.
In order to address the problem of underutilization of existing data for program decision-making, our work can help countries take stock of what data are available and determine whether they can more effectively use them. Examples of activities include the following: assessment and analysis of existing single source of data; rapid multiple-source data synthesis for program planning; GIS and mapping; development of data analysis, use, and dissemination plan; and capacity-building for future data analysis, use, and dissemination.
- Geographic Information Systems (GIS): GIS helps data users to think spatially about available information, and assists in the guidance of strategic decision-making. GIS can be used in a variety of different capacities and tailored to a range of different needs to create a more accurate representation of the real world, link features to information, and assist in solving public health-related questions. We have conducted GIS trainings in Mozambique and use GIS with our Triangulation activities.
- Triangulation: Triangulation is the synthesis and integrated analysis of data from multiple sources for program decision-making. Triangulation seeks to quickly examine existing data to strengthen interpretations and improve policy and programs based on the available evidence. Triangulation is a powerful tool that can be used to demonstrate program impact, identify areas for improvement, direct new programs and enhance existing programs, and help direct policy changes. It can strengthen the understanding of complex health issues and provide support for making evidence-based public health decisions. Click here to learn more.
- PEPFAR Country Data Analyses: We conduct database management and analysis of country-level program indicators in treatment, prevention of mother-to-child transmission, counseling and testing, and orphans and vulnerable children. We also manage data and analyze multi-country ART data to inform CDC and HRSA of program scale-up and quality.
Different evaluation methodologies can be used to analyze the impact and effectiveness of programs with the results used for program improvement.
- ART Outcomes: The goal of this study is to assess the clinical success of National Antiretroviral Therapy Programs in PEPFAR countries through the use of programmatic and clinical indicators: determining compliance with national ART guidelines during rapid scale-up, assessing factors associated with patient retention and clinical treatment success, and identifying program areas that require strengthening. Currently finishing the study in Kenya and beginning one in Tanzania.
- Electronic Patient Monitoring Systems: UCSF staff have developed a guidance document to assist countries in evaluating electronic patient monitoring (EPM) systems. The goal of this targeted evaluation is to assess the effectiveness of an EPM system with regard to the following: completeness of patient data, provider and staff acceptability, time-flow of patient visit, time needed to generate reports, and data quality.
- National Evaluation Agenda Setting: The goal of this project is to develop an evaluation agenda that represents a variety of HIV-related disciplines, is country-driven and integrated into the national monitoring and evaluation plan, improves the quality of evaluation research to enhance policy, planning, and program management, and includes a concrete short and long-term action plan.
- Cost Effectiveness Analysis: UCSF researchers are currently working to refine and parameterize effectiveness and cost-effectiveness models for PEPFAR by updating models with the current body of literature and modifying them using epidemic modeling. Researchers will review existing cost data and collect focused primary cost data. They will expand the model to include ARV provision and potentially other non-prevention modalities such as cotrimoxazole prophylaxis.
We have developed these modules to guide in-country surveillance officers in conducting surveillance activities in their country. Module topics include: Overview of HIV/AIDS epidemic with Introduction to Public Health Surveillance, HIV Clinical Staging and Case Reporting, HIV Sero-Surveillance, Surveillance for Sexually Transmitted Infections, Surveillance of HIV Risk Behaviors, Surveillance of Populations at High Risk for HIV Transmission. Many of the modules have been tailored to specific geographic regions such as the Caribbean, Sub-Saharan Africa, the Middle East, and South/South East Asia.
The Cochrane HIV/AIDS Group brings together people from around the world who share an interest in preparing, disseminating, and updating systematic reviews of rigorous HIV/AIDS prevention, treatment, palliative care and pain management research as well as enhancing the science of evidence-based health care. Click here to learn more.
We work on a variety of different evidence-based reviews, using state-of-the art search strategies and criteria to ensure a comprehensive overview and analysis of specific topic areas.
- Sexual and Reproductive Health (SRH) Linkages: With the Johns Hopkins University, Bloomberg School of Public Health, we have conducted a systematic review to identify articles in the peer-reviewed literature that assessed the efficacy of programs that link SRH services and HIV prevention.
- State Minority AIDS Project (SMAP): In collaboration with the State of California’s Department of Health Services Office of AIDS Administration, this project aims to develop and maintain a database of evidence-based behavioral HIV prevention interventions conducted with people of color (i.e. people from other than European heritage). This project has also led to the development of systematic reviews on HIV prevention programs focusing on particular communities at risk (men of color who have sex with men, African-American heterosexuals, women of color). Click here to learn more.
- Literature Digest: The Literature Digest highlights recently published studies of HIV behavioral, policy and prevention interventions that have one or more of the following aims: to reduce sexual or drug-related risk behaviors, to decrease primary or secondary transmission, to improve health service delivery and quality of life, or to improve HIV treatment and adherence. Included studies were conducted in, or have applications to, resource-limited settings.
- WHO Consensus Document: In early 2006, the World Health Organization asked us to review the evidence for essential care and prevention interventions for people living with HIV/AIDS. With colleagues from WHO and the Johns Hopkins University School of Public Health, we convened a Consensus Conference in Montreux that developed new WHO guidelines for these interventions.
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