2024
Prior tuberculosis, radiographic lung abnormalities and prevalent diabetes in rural South Africa
Castle A, Moosa Y, Claassen H, Shenoi S, Magodoro I, Manne-Goehler J, Hanekom W, Bassett I, Wong E, Siedner M. Prior tuberculosis, radiographic lung abnormalities and prevalent diabetes in rural South Africa. BMC Infectious Diseases 2024, 24: 690. PMID: 38992607, PMCID: PMC11238449, DOI: 10.1186/s12879-024-09583-8.Peer-Reviewed Original ResearchConceptsPrevalent diabetesChest X-rayChest X-ray abnormalitiesX-ray abnormalitiesOdds of prevalent diabetesHemoglobin A1c testingPost-TB lung diseaseHistory of TB diseaseAssociated with prevalent diabetesPulmonary abnormalitiesExposure of interestRural South AfricaPrevalence of diabetesTB diseaseCohort of peopleCAD4TBMethodsWe analyzed dataCross-sectional studyCompare groupsLogistic regression modelsIncidence of diabetesDiabetes prevalenceA1c testingConclusionsAmong peopleDigital chest X-ray
2023
Community health workers can be trained to identify patients eligible for tuberculosis preventive therapy, but encounter barriers to programme implementation in KwaZulu-Natal, South Africa
Norton S, Moll A, Madi J, Nkomo N, Brooks R, Andrews L, Shenoi S. Community health workers can be trained to identify patients eligible for tuberculosis preventive therapy, but encounter barriers to programme implementation in KwaZulu-Natal, South Africa. African Journal Of AIDS Research 2023, 22: 131-135. PMID: 37337826, DOI: 10.2989/16085906.2023.2213213.Peer-Reviewed Original ResearchMeSH KeywordsAdultCommunity Health WorkersHIV InfectionsHumansNoncommunicable DiseasesSouth AfricaTuberculosisConceptsTuberculosis preventive therapyCommunity health workersLargest HIV epidemicCause of deathNon-communicable diseasesHealth workersPreventive therapyRural resource-limited settingsHigh TB incidence ratesFurther implementation researchTB incidence rateRate of referralResource-limited settingsMedian ageTreatment initiationHIV epidemicIncidence rateRural South AfricaHIVInfectious diseasesTuberculosisImplementation researchScreening resultsDiseasePatientsPerceived stigma related to TB preventive therapy
Palacios C, Hough M, Shrestha R, Moll A, Kompala T, Andrews L, Shenoi S. Perceived stigma related to TB preventive therapy. The International Journal Of Tuberculosis And Lung Disease 2023, 27: 209-214. PMID: 36855038, DOI: 10.5588/ijtld.22.0570.Peer-Reviewed Original ResearchConceptsTB preventative therapyTB preventive therapyAnonymous cross-sectional surveyBurden of TBCommunity-dwelling adultsRural South African communityCross-sectional surveyPreventive therapyMean agePreventative therapyEndemic settingsPatient's familyKruskal-Wallis testStigma scoresRural South AfricaPoisson regressionNovel interventionsSouth African communityTherapyLess stigmaDescriptive statisticsFamily membersStigmaTBTwo-factor solution
2021
Feasibility of a community‐based delivery model for HIV pre‐exposure prophylaxis among bar patrons in rural South Africa
Grammatico MA, Moll AP, Choi K, Springer SA, Shenoi SV. Feasibility of a community‐based delivery model for HIV pre‐exposure prophylaxis among bar patrons in rural South Africa. Journal Of The International AIDS Society 2021, 24: e25848. PMID: 34826363, PMCID: PMC8625837, DOI: 10.1002/jia2.25848.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisAlcohol Use Disorders Identification TestLargest HIV epidemicCommunity-based delivery modelPrEP uptakeHIV testingOdds ratioOral tenofovir disoproxil fumarate/emtricitabineTenofovir disoproxil fumarate/emtricitabineRural South AfricaHazardous drinkingDisoproxil fumarate/emtricitabineHIV pre-exposure prophylaxisUptake of PrEPHIV care cascadeRapid HIV testingAdjusted odds ratioYoung menRural KwaZulu-Natal ProvinceAlcohol use disorderSexual risk behaviorsDisorders Identification TestBar patronsPrEP deliveryPrEP initiatorsExpansion of a national differentiated service delivery model to support people living with HIV and other chronic conditions in South Africa: a descriptive analysis
Liu L, Christie S, Munsamy M, Roberts P, Pillay M, Shenoi SV, Desai MM, Linnander EL. Expansion of a national differentiated service delivery model to support people living with HIV and other chronic conditions in South Africa: a descriptive analysis. BMC Health Services Research 2021, 21: 463. PMID: 34001123, PMCID: PMC8127180, DOI: 10.1186/s12913-021-06450-z.Peer-Reviewed Original ResearchMeSH KeywordsChronic DiseaseHealth FacilitiesHIV InfectionsHumansNoncommunicable DiseasesSouth AfricaConceptsNon-communicable diseasesDifferentiated service delivery modelsChronic conditionsChronic diseasesCentral Chronic Medicine DispensingLargest antiretroviral therapy (ART) programmeService delivery modelsManagement of HIVType of medicationAntiretroviral therapy programsHIV service deliveryChronic disease conditionsResource-limited settingsMedicine DispensingMixed-methods evaluationDelivery modelHealth districtHealth facilitiesNoncommunicable diseasesHIVPatientsPatient volumeTherapy programMedicationsDisease“We’ve Got Our Own Beliefs, Attitudes, Myths”: A Mixed Methods Assessment of Rural South African Health Care Workers' Knowledge of and Attitudes Towards PrEP Implementation
Asabor EN, Lett E, Moll A, Shenoi SV. “We’ve Got Our Own Beliefs, Attitudes, Myths”: A Mixed Methods Assessment of Rural South African Health Care Workers' Knowledge of and Attitudes Towards PrEP Implementation. AIDS And Behavior 2021, 25: 2517-2532. PMID: 33763802, PMCID: PMC8450017, DOI: 10.1007/s10461-021-03213-z.Peer-Reviewed Original ResearchConceptsLocal healthcare workersHealthcare workersPrEP implementationHealth care workers' knowledgeHIV pre-exposure prophylaxisSkilled clinical staffPre-exposure prophylaxisImpact of HIVPrEP interventionsHIV prevalenceHCW roleClinical staffTravel burdenMixed-methods assessmentDisproportionate burdenHIVWorkers' knowledgeAdditional concernsSexual behaviorBlack South AfricansBarriers researchersPrEPRisk compensationBurdenImplementation scientistsStructural barriers to implementing recommended tuberculosis preventive treatment in primary care clinics in rural South Africa
Chandra DK, Moll AP, Altice FL, Didomizio E, Andrews L, Shenoi SV. Structural barriers to implementing recommended tuberculosis preventive treatment in primary care clinics in rural South Africa. Global Public Health 2021, 17: 555-568. PMID: 33650939, PMCID: PMC8410883, DOI: 10.1080/17441692.2021.1892793.Peer-Reviewed Original ResearchConceptsTuberculosis preventive treatmentPrimary healthcare clinicsTPT initiationWorld Health OrganizationAntiretroviral therapyPreventive treatmentRural South AfricaHIV/TB servicesBurden of HIVOnly independent correlatePrimary care clinicsClinic-level factorsPatient-level characteristicsPrimary care providersHealth Services frameworkEvidence-based strategiesQuality improvement strategiesTB servicesClinical factorsCare clinicsIndependent correlatesMedical recordsPromoting ActionCare providersHealthcare clinicsFactors associated with low tuberculosis preventive therapy prescription rates among health care workers in rural South Africa
Ahmed AA, Grammatico M, Moll AP, Malinga S, Makhunga P, Charalambous S, Ladines-Lim JB, Jones J, Choi K, Shenoi SV. Factors associated with low tuberculosis preventive therapy prescription rates among health care workers in rural South Africa. Global Health Action 2021, 14: 1979281. PMID: 34652990, PMCID: PMC8525921, DOI: 10.1080/16549716.2021.1979281.Peer-Reviewed Original ResearchConceptsTuberculosis preventive therapyHealth care workersPrimary healthcare clinicsLower prescription ratesPrescription ratesRural South AfricaCare workersIsoniazid preventative therapyIncidence of tuberculosisCross-sectional studyGovernment district hospitalsPreventive therapyMedian ageMultivariable analysisPreventative therapyDistrict hospitalHealthcare clinicsHCW trainingPatient disclosureTPT useConsolidated FrameworkLogistic regressionImplementation researchSelf-reported dataPrescribers
2020
Mobility and structural barriers in rural South Africa contribute to loss to follow up from HIV care
Hannaford A, Moll AP, Madondo T, Khoza B, Shenoi SV. Mobility and structural barriers in rural South Africa contribute to loss to follow up from HIV care. AIDS Care 2020, 33: 1436-1444. PMID: 32856470, PMCID: PMC8043244, DOI: 10.1080/09540121.2020.1808567.Peer-Reviewed Original ResearchConceptsHIV careRural South AfricaHIV transmissionLongitudinal HIV careViral load suppressionRisk of tuberculosisRural settingsStructural barriersART discontinuationPill fatigueMedian durationMixed-methods evaluationART accessMajor precipitantFuture interventionsCareDistant clinicsPLWHFamily needsConvenience samplingSocial supportMethods evaluationLTFUDiscontinuationMajor contributorMobile Device Usage by Gender Among High-Risk HIV Individuals in a Rural, Resource-Limited Setting
Campbell BR, Choi K, Neils MG, Canan C, Moll A, Dillingham R, Shenoi SV. Mobile Device Usage by Gender Among High-Risk HIV Individuals in a Rural, Resource-Limited Setting. Telemedicine Journal And E-Health 2020, 27: 615-624. PMID: 32835638, PMCID: PMC8215405, DOI: 10.1089/tmj.2020.0218.Peer-Reviewed Original ResearchConceptsMHealth interventionsRural KwaZulu-NatalCare of HIVLack of circumcisionMultivariable logistic regressionMedical male circumcisionResource limited settingsHealthcare messagesCircumcision statusHIV counselingHIV individualsMiddle-income countriesCondomless sexMale circumcisionCondom useCommunity settingsLogistic regressionHIVYoung womenHealthcare interventionsUnderserved populationsKwaZulu-NatalHealth information seekingHealth informationIntervention‘PrEP should be for men only’: Young heterosexual men’s views on PrEP in rural South Africa
Hannaford A, Lim J, Moll AP, Khoza B, Shenoi SV. ‘PrEP should be for men only’: Young heterosexual men’s views on PrEP in rural South Africa. Global Public Health 2020, 15: 1337-1348. PMID: 32207661, DOI: 10.1080/17441692.2020.1744680.Peer-Reviewed Original ResearchMeSH KeywordsAdultHeterosexualityHIV InfectionsHumansMaleMenPre-Exposure ProphylaxisRural PopulationSouth AfricaYoung AdultConceptsRural South AfricaSouth AfricaYoung men's perspectivesHeterosexual menCommunity-based servicesYoung heterosexual menMen's perspectivesPrevention servicesService delivery modelsMen's viewsHIV prevention servicesStructural barriersFemale partnersKey themesHIV prevention knowledgeGender-specific interventionsCasual sexual partnersDifferentiated service delivery modelsGaps persistHigh HIV risk behaviorHIV-negative heterosexual menHigh-risk sexual behaviorPre-exposure prophylaxisHigh attributable mortalityHIV risk behaviors
2019
Perceptions of HIV Preexposure Prophylaxis Among Young Pregnant Women from Rural KwaZulu-Natal, South Africa
Vazquez L, Moll AP, Kacin A, Ndlovu NE, Shenoi SV. Perceptions of HIV Preexposure Prophylaxis Among Young Pregnant Women from Rural KwaZulu-Natal, South Africa. AIDS Patient Care And STDs 2019, 33: 214-219. PMID: 31067125, PMCID: PMC6531897, DOI: 10.1089/apc.2018.0242.Peer-Reviewed Original ResearchConceptsYoung pregnant womenPreexposure prophylaxisPregnant womenHIV riskCondom useSexual partnersHIV preexposure prophylaxisLast monthPregnant women 18Rural South African womenSub-Saharan womenRural KwaZulu-NatalSouth African womenHIV acquisitionNonpregnant womenPrEP effectivenessPrEP knowledgeMean agePrEP rolloutPostpartum periodHIV preventionWomen 18HIV stigmaHigh riskMost women
2018
Synergism between diabetes and human immunodeficiency virus in increasing the risk of tuberculosis
Sinha P, Moll AP, Brooks RP, Deng YH, Shenoi SV. Synergism between diabetes and human immunodeficiency virus in increasing the risk of tuberculosis. The International Journal Of Tuberculosis And Lung Disease 2018, 22: 793-799. PMID: 29914606, PMCID: PMC6050202, DOI: 10.5588/ijtld.17.0936.Peer-Reviewed Original ResearchConceptsRisk of tuberculosisDiabetes mellitusTB symptomsOdds ratioHuman immunodeficiency virus (HIV) infectionImmunodeficiency virus infectionHuman immunodeficiency virusCommunity health screeningCross-sectional studyCommunity health projectsActive tuberculosisHIV infectionHIV positivityPrimary outcomeImmunodeficiency virusScreening servicesHealth screeningCongregate settingsVirus infectionResource-limited regionsMultiplicative scaleHIVMultivariate analysisRetrospective dataTuberculosis
2017
Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa
Arnesen R, Moll AP, Shenoi SV. Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa. PLOS ONE 2017, 12: e0177168. PMID: 28542309, PMCID: PMC5443492, DOI: 10.1371/journal.pone.0177168.Peer-Reviewed Original ResearchConceptsPrimary health clinicsPredictors of lossART clinicsSouth African HIV clinicAntiretroviral therapy accessInadequate medical recordsCells/μLART initiationLow CD4LTFU ratesCD4 countHIV careHIV clinicHIV outcomesRetrospective reviewMedical recordsHealth clinicsTherapy accessHigh riskLTFUPatientsRural hospitalsRural South AfricaNovel interventionsClinic“It’s about my life”: facilitators of and barriers to isoniazid preventive therapy completion among people living with HIV in rural South Africa
Jacobson KB, Niccolai L, Mtungwa N, Moll AP, Shenoi SV. “It’s about my life”: facilitators of and barriers to isoniazid preventive therapy completion among people living with HIV in rural South Africa. AIDS Care 2017, 29: 936-942. PMID: 28147705, PMCID: PMC5545149, DOI: 10.1080/09540121.2017.1283390.Peer-Reviewed Original ResearchMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsAmbulatory Care FacilitiesAntitubercular AgentsCounselingFemaleHealth Knowledge, Attitudes, PracticeHealth Services AccessibilityHIV InfectionsHumansIncidenceInterviews as TopicIsoniazidMalePatient ComplianceQualitative ResearchRural PopulationSocial StigmaSouth AfricaTrustTuberculosisConceptsIsoniazid preventive therapyIPT completionPreventive roleAbsence of symptomsHealth care workersKnowledge of TBHealth service deliveryResource-limited settingsHealth care systemRural KwaZulu-NatalAntiretroviral therapyHIV patientsHIV diagnosisPreventive therapyTherapy completionTB incidenceAppropriate counselingHealthcare workersIndividual patientsCare workersRural South AfricaHIVPatientsUnrelated conditionsIndividual semi-structured interviews
2016
Cost-Effectiveness of Community-Based TB/HIV Screening and Linkage to Care in Rural South Africa
Gilbert JA, Shenoi SV, Moll AP, Friedland GH, Paltiel AD, Galvani AP. Cost-Effectiveness of Community-Based TB/HIV Screening and Linkage to Care in Rural South Africa. PLOS ONE 2016, 11: e0165614. PMID: 27906986, PMCID: PMC5131994, DOI: 10.1371/journal.pone.0165614.Peer-Reviewed Original ResearchConceptsTB/HIVTB/HIV controlHIV screeningHIV controlRural South AfricaLife yearsMonths of IPTMost life yearsHigh-incidence settingsWidespread prevalenceCost-effectiveness resultsProbabilistic sensitivity analysesHIV transmissionHigh burdenTreatment coverageUnknown patientsHIVHealthcare accessDrug resistanceActive casesMonthsLifetime usePatientsYearsScreeningImpact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa
Kompala T, Moll AP, Mtungwa N, Brooks RP, Friedland GH, Shenoi SV. Impact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa. BMC Health Services Research 2016, 16: 374. PMID: 27515233, PMCID: PMC4982129, DOI: 10.1186/s12913-016-1627-8.Peer-Reviewed Original ResearchConceptsPre-ART careAntiretroviral treatmentCD4 testingCBVCT servicesTreatment cascadeRural South AfricaLocal primary care clinicsCD4 count resultsCommunity-based voluntary counselingPrimary care clinicsHIV-positive clientsPhlebotomy servicesResource-limited settingsART initiationHIV careART eligibilityCare cascadeCare clinicsHIV-positiveVoluntary counselingTreatment eligibilityCD4 resultsResult notificationResultsBetween 2010Nurse presence“I Have to Push Him with a Wheelbarrow to the Clinic”: Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa
Loeliger KB, Niccolai LM, Mtungwa LN, Moll A, Shenoi SV. “I Have to Push Him with a Wheelbarrow to the Clinic”: Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa. AIDS Patient Care And STDs 2016, 30: 385-394. PMID: 27509239, PMCID: PMC4991585, DOI: 10.1089/apc.2016.0096.Peer-Reviewed Original ResearchConceptsCommunity health workersHIV careCommunity health worker rolesHIV care provisionAntiretroviral therapy initiationHIV treatment outcomesHealth worker rolesHealthcare systemBasic emergency careHIV/AIDS epidemicRural KwaZulu-NatalCommunity-based programsAdherence persistTherapy initiationAntiretroviral medicationsHIV prevalenceTreatment outcomesCHW rolesHealth workersHolistic careCentered careHIV resourcesEmergency careClinical practiceRural South AfricaAntiretroviral therapy initiation and adherence in rural South Africa: community health workers’ perspectives on barriers and facilitators
Loeliger KB, Niccolai LM, Mtungwa LN, Moll A, Shenoi SV. Antiretroviral therapy initiation and adherence in rural South Africa: community health workers’ perspectives on barriers and facilitators. AIDS Care 2016, 28: 982-993. PMID: 27043077, PMCID: PMC4917424, DOI: 10.1080/09540121.2016.1164292.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsAnti-Retroviral AgentsAntiretroviral Therapy, Highly ActiveBlack PeopleCommunity Health WorkersCounselingFocus GroupsHealth Services AccessibilityHIV InfectionsHumansInterviews as TopicLost to Follow-UpMaleMedication AdherenceQualitative ResearchRural PopulationSocial StigmaSocial SupportSocioeconomic FactorsSouth AfricaTruth DisclosureConceptsCommunity health workersAntiretroviral therapyART initiationHealth workersAntiretroviral therapy initiationInsufficient patient educationLong-term adherenceAcute infectious diseasesGlobal HIV/AIDS epidemicPublic health strategiesHealthcare servicesHIV/AIDS managementAlternative medicine (CAM) providersHIV/AIDS epidemicHIV/AIDSTherapy initiationInitial diagnosisLifelong therapyPrevent patientsAdherence ratesPatient counsellingPatient educationPatient dissatisfactionCHW rolesMedicine providers
2015
What motivates use of community-based human immunodeficiency virus testing in rural South Africa?
Upadhya D, Moll AP, Brooks RP, Friedland G, Shenoi SV. What motivates use of community-based human immunodeficiency virus testing in rural South Africa? International Journal Of STD & AIDS 2015, 27: 662-671. PMID: 26134323, PMCID: PMC4851612, DOI: 10.1177/0956462415592789.Peer-Reviewed Original ResearchConceptsHIV testingRural South AfricaRural resource-limited settingsHuman immunodeficiency virus (HIV) testingCommunity-based HIVCommunity-based testingMedian CD4 countRecent HIV exposureCommunity-based HIV testing programmeFirst-time testersHIV testing programsVoluntary HIV testingResource-limited settingsCD4 countHIV exposureMedian ageHIV statusVirus testingCommunity testingHIVCells/Rural settingsFamily membersSix-itemRisky lifestyles