Publications by authors named "Lylianne Nakabugo"
Antiretroviral therapy (ART) use and HIV suppression among people living with HIV (PLHIV) are critical for HIV control and prevention. Extreme restrictions on movement early during the COVID-19 pandemic in Uganda may have impeded the ability to initiate and sustain access to and use of ART. From our stepped-wedge cluster-randomized trial of an integrated PrEP and ART intervention for HIV-serodifferent couples at 12 ART clinics in Uganda, we identified participants who enrolled and had a 6-month post-ART initiation viral load measured before the beginning of the first COVID-19 lockdown (Period 1), participants whose enrollment and 6-month viral load measurement straddled pre-COVID and COVID lockdown times (Period 2), and participants whose enrollment and 6-month viral load were quantified entirely during COVID-19 (Period 3).
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- * Successful referrals for support services were positively associated with provider awareness and client engagement, but barriers like financial constraints and socio-cultural norms hindered full implementation.
- * The study underscores the importance of GBV screening in HIV care, suggesting that increasing awareness and addressing socio-cultural barriers could enhance outcomes for clients facing violence.
Article Synopsis
- Integrating PrEP with ART programs helps prevent HIV transmission in couples where one partner is HIV-positive before achieving viral suppression.
- The study developed a 24-item scale to measure behavioral modeling among these couples, focusing on how partners influence each other's medication habits.
- A five-factor model was identified, showing that behaviors like attention to partner actions and relationship quality impact medication adherence, highlighting the importance of partner influence in HIV prevention strategies.
Intimate Partner Violence and Adherence to PrEP and ART Among Ugandan HIV Serodifferent Couples.
J Acquir Immune Defic Syndr
April 2024
Article Synopsis
- Intimate partner violence (IPV) has been linked to lower adherence to antiretroviral treatment (ART), particularly in heterosexual serodifferent couples in Uganda, where the partner living with HIV is often female.
- A study of 149 couples showed that those experiencing IPV had significantly lower rates of ART adherence compared to those not exposed to IPV, while PrEP adherence was not notably affected.
- Additionally, individuals in relationships with moderate powerlessness were more likely to adhere to PrEP, suggesting that relationship dynamics can play a role in medication adherence for those in HIV serodifferent partnerships.
"Gender-based Violence (GBV) and HIV, they are like sister and brother": barriers and facilitators to GBV screening and referral in public HIV treatment settings in Uganda.
BMC Health Serv Res
December 2023
Article Synopsis
- People living with HIV in Uganda face a higher risk of gender-based violence (GBV), which negatively affects their treatment outcomes, prompting guidelines for GBV screening in HIV care settings.
- A study was conducted with 30 healthcare providers from 12 ART clinics to identify factors that help or hinder the implementation of GBV screening and referral services.
- Key facilitators included access to training and resources, while barriers consisted of poor referral service quality, lack of financial support, and cultural attitudes affecting client willingness to accept help.
Background: Global scale-up of HIV pre-exposure prophylaxis (PrEP) includes services to HIV-negative people in partnerships with people living with HIV (serodifferent couples). Data are needed on HIV outcomes, including uptake and adherence to PrEP and antiretroviral treatment (ART), to describe the impact of integrating PrEP into an existing HIV program.
Methods: Using a stepped-wedge cluster randomized trial design, we launched PrEP delivery for HIV-negative members of serodifferent couples in Uganda by integrating PrEP into existing ART programs for people living with HIV.
A pragmatic approach to identifying implementation barriers and facilitators for a novel pre-exposure prophylaxis (PrEP) delivery model at public facilities in urban Uganda.
Implement Sci Commun
January 2022
Background: Scalable HIV pre-exposure prophylaxis (PrEP) delivery models for resource-limited settings are critical for improving PrEP coverage and interrupting HIV transmission. This research uses technical assistance (TA) reports to evaluate implementation barriers and facilitators for a novel delivery model integrating PrEP and antiretroviral therapy (ART) delivery for HIV sero-different couples in public health facilities in Kampala, Uganda.
Methods: We used data from the Partners PrEP Program (PPP)-a stepped-wedge cluster randomized trial that is launching PrEP delivery through an integrated model of oral PrEP and antiretroviral therapy (ART) delivery for HIV sero-different couples at public health facilities in Kampala and Wakiso, Uganda (NCT03586128).