2022
“If it weren’t for my traditional healer, I would be dead”: Engaging traditional healers to support people living with HIV in rural Mozambique
Audet CM, Pettapiece-Phillips M, Tian Y, Shepherd BE, Vermund SH, Salato J. “If it weren’t for my traditional healer, I would be dead”: Engaging traditional healers to support people living with HIV in rural Mozambique. PLOS ONE 2022, 17: e0270565. PMID: 35763519, PMCID: PMC9239464, DOI: 10.1371/journal.pone.0270565.Peer-Reviewed Original ResearchMeSH KeywordsHealth FacilitiesHIV InfectionsHumansMedicine, African TraditionalMozambiqueRural PopulationConceptsTraditional healersPsychosocial supportCommunity health worker interventionPre-post intervention study designWorker interventionHealth worker interventionMedication possession ratioMedication side effectsIntervention study designPositive test resultsHome-based supportObserved therapyPossession ratioClinical outcomesHIV treatmentPoor adherencePost-intervention participantsHealth facilitiesPatient's desireSide effectsZambézia ProvinceCare servicesStudy designHIVTherapy
2021
Poor retention and care-related sex disparities among youth living with HIV in rural Mozambique
Ahonkhai AA, Aliyu MH, Audet CM, Bravo M, Simmons M, Claquin G, Memiah P, Fernando AN, Carlucci JG, Shepherd BE, Van Rompaey S, Yu Z, Gong W, Vermund SH, Wester CW. Poor retention and care-related sex disparities among youth living with HIV in rural Mozambique. PLOS ONE 2021, 16: e0250921. PMID: 34019582, PMCID: PMC8139489, DOI: 10.1371/journal.pone.0250921.Peer-Reviewed Original ResearchConceptsHigher oddsCombination antiretroviral therapy (cART) initiationCox proportional hazards modelCare continuum outcomesComprehensive HIV programsPost-ART initiationYoung adults 15Antiretroviral therapy initiationRetrospective cohort studySex-related disparitiesMultivariable logistic regressionOne-year followProportional hazards modelYears of agePL femalesSex-related differencesART initiationAYA cohortTherapy initiationCohort studyContinuum outcomesHIV outcomesClinical visitsAdults 15HIV programs
2020
Monitoring Pharmacy and Test Kit Stocks in Rural Mozambique: U.S. President's Emergency Plan for AIDS Relief Surveillance to Help Prevent Ministry of Health Shortages
Bravo M, Peratikos MB, Muicha AS, Mahagaja E, Alvim MFS, Green AF, Wester CW, Vermund SH. Monitoring Pharmacy and Test Kit Stocks in Rural Mozambique: U.S. President's Emergency Plan for AIDS Relief Surveillance to Help Prevent Ministry of Health Shortages. AIDS Research And Human Retroviruses 2020, 36: 415-426. PMID: 31914787, PMCID: PMC7232670, DOI: 10.1089/aid.2019.0057.Peer-Reviewed Original ResearchConceptsRural Zambézia ProvinceHuman immunodeficiency virusPresident's Emergency PlanMedication supplyU.S. President's Emergency PlanTimes higher oddsMedication classesViral suppressionDiagnostic test kitsImmunodeficiency virusPharmacy dataStudy midpointOrdinal logistic regressionHigher oddsCare providersLower oddsZambézia ProvinceTuberculosis testingMonitoring of drugsLogistic regressionAIDS ReliefHealth shortagesARVEmergency plansCalendar time
2018
Partners-based HIV treatment for seroconcordant couples attending antenatal and postnatal care in rural Mozambique: A cluster randomized trial protocol
Audet CM, Graves E, Barreto E, De Schacht C, Gong W, Shepherd BE, Aboobacar A, Gonzalez-Calvo L, Alvim MF, Aliyu MH, Kipp AM, Jordan H, Amico KR, Diemer M, Ciaranello A, Dugdale C, Vermund SH, Van Rompaey S. Partners-based HIV treatment for seroconcordant couples attending antenatal and postnatal care in rural Mozambique: A cluster randomized trial protocol. Contemporary Clinical Trials 2018, 71: 63-69. PMID: 29879469, PMCID: PMC6067957, DOI: 10.1016/j.cct.2018.05.020.Peer-Reviewed Original ResearchConceptsChild transmissionSeroconcordant couplesMale partnersResource-limited rural settingsElimination of motherRoutine clinical dataUptake of servicesClinical trial designMale partner approvalAntiretroviral therapyHIV careAntenatal careRural MozambiqueHIV servicesPostnatal carePregnant womenHIV treatmentTrial protocolClinical dataHealth facilitiesTrial designHIVNewborn childrenPartner approvalEngagement interventionsBuilding capacity for global mental health research: challenges to balancing clinical and research training
Oquendo MA, Duarte C, Gouveia L, Mari JJ, Mello MF, Audet CM, Pinsky I, Vermund SH, Mocumbi AO, Wainberg ML. Building capacity for global mental health research: challenges to balancing clinical and research training. The Lancet Psychiatry 2018, 5: 612-613. PMID: 29628365, PMCID: PMC6402326, DOI: 10.1016/s2215-0366(18)30097-x.Peer-Reviewed Original Research
2017
Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique
Audet CM, Salato J, Vermund SH, Amico KR. Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique. Implementation Science 2017, 12: 50. PMID: 28407813, PMCID: PMC5390357, DOI: 10.1186/s13012-017-0582-z.Peer-Reviewed Original ResearchConceptsCommunity health workersAntiretroviral therapyWorker interventionTraditional healersHealth workersHealth systemAllopathic health systemEvidence-informed interventionsLow-literacy populationsHIV careHIV diagnosisRural MozambiquePatient adherenceHIV epidemicHealth facilitiesClinical careHealthcare providersHealth workforceHIVTraditional treatmentCommunity-based activitiesInterventionTraditional medicineCareSuccessful program implementation
2016
Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission
Audet CM, Salato J, Blevins M, Silva W, González‐Calvo L, Vermund SH, Gaspar F. Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission. Tropical Medicine And International Health 2016, 21: 1476-1480. PMID: 27580349, PMCID: PMC5093076, DOI: 10.1111/tmi.12775.Peer-Reviewed Original ResearchConceptsBlood exposureOccupational hazardsBlood-borne agentsTraditional healersWilcoxon rank sum testRank sum testHepatitis BC virusChronic illnessInfectious disease transmissionHigh prevalenceZambézia ProvincePast monthHealers' practicesChi-squareTraditional practitionersMedianPatientsDisease transmissionInjectionRandom sampleRural MozambiqueExposureHealersSimple random sampleMeasuring Health Literacy Among Adults with HIV Infection in Mozambique: Development and Validation of the HIV Literacy Test
Tique JA, Howard LM, Gaveta S, Sidat M, Rothman RL, Vermund SH, Ciampa PJ. Measuring Health Literacy Among Adults with HIV Infection in Mozambique: Development and Validation of the HIV Literacy Test. AIDS And Behavior 2016, 21: 822-832. PMID: 26961538, PMCID: PMC5306223, DOI: 10.1007/s10461-016-1348-3.Peer-Reviewed Original ResearchConceptsLiteracy skillsParticipants' literacy skillsLiteracy-related tasksLiteracy testHIV careHigher literacy skillsLiteracy measuresHealth literacyInternal reliabilityConstruct validityRelationship of literacyHigher scoresSkillsHealth communicationConvenience sampleHypothetical modelAntiretroviral treatmentHIV infectionHIV outcomesDiverse settingsLiteracyAdultsCareHIVTaskEngagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique
Audet CM, Blevins M, Chire YM, Aliyu MH, Vaz LM, Antonio E, Alvim F, Bechtel R, Wester CW, Vermund SH. Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique. AIDS And Behavior 2016, 20: 2090-2100. PMID: 26906021, PMCID: PMC4995150, DOI: 10.1007/s10461-016-1341-x.Peer-Reviewed Original ResearchConceptsAntenatal careHIV testingPregnant womenProvider-initiated counselingAntenatal care servicesAntiretroviral therapy servicesPre-post intervention designUptake of ARTTraditional birth attendantsMale engagementCommunity health agentsRate of testingANC servicesTreatment uptakeBirth attendantsService uptakePartner's pregnancyCare servicesTherapy servicesHealth agentsTreatment acceptabilityMale partnersSimilar interventionsMale championsPregnancy
2015
Practical Management of HIV-Associated Anemia in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline
Brentlinger PE, Silva WP, Vermund SH, Valverde E, Buene M, Moon TD. Practical Management of HIV-Associated Anemia in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline. AIDS Research And Human Retroviruses 2015, 32: 12-25. PMID: 26178574, PMCID: PMC4692124, DOI: 10.1089/aid.2015.0030.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnemiaAnthelminticsAnti-HIV AgentsAntimalarialsAntitubercular AgentsCD4 Lymphocyte CountCoinfectionDeveloping CountriesDisease ManagementFemaleHelminthiasisHemoglobinsHIV InfectionsHumansLost to Follow-UpMalaria, FalciparumMaleMozambiquePractice Guidelines as TopicProspective StudiesRural PopulationTuberculosis, PulmonaryConceptsHIV-associated anemiaAdverse drug reactionsDrug reactionsHemoglobin responseGuideline revisionsIron deficiencyLower body mass indexCo-trimoxazole prophylaxisDiscontinuation of zidovudineLaboratory-confirmed malariaProspective observational evaluationRural Zambézia ProvinceT-cell countsT-lymphocyte countsSmear-positive tuberculosisBody mass indexResource limited settingsResource-limited settingsLogistic regression modelsAnaemic HIVStudy cliniciansAntiretroviral therapyEsophageal candidiasisPresumptive treatmentAnemia managementImplementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique
Edwards LJ, Moisés A, Nzaramba M, Cassimo A, Silva L, Mauricio J, Wester CW, Vermund SH, Moon TD. Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique. International Journal Of Health Policy And Management 2015, 4: 353-361. PMID: 26029894, PMCID: PMC4450730, DOI: 10.15171/ijhpm.2015.58.Peer-Reviewed Original ResearchConceptsHealth systemZambézia ProvinceRural Zambézia ProvinceDistrict-level health systemGlobal healthHealth system capacityFirst yearHealth system performanceMonthly complianceMozambican MinistrySite mentoringOutcome evaluationLinear regressionVanderbilt InstituteCapacity domainsHealthOverall improvementZambéziaRegressionMentorship programHIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey
Paulin HN, Blevins M, Koethe JR, Hinton N, Vaz L, Vergara AE, Mukolo A, Ndatimana E, Moon TD, Vermund SH, Wester CW. HIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey. BMC Public Health 2015, 15: 132. PMID: 25881182, PMCID: PMC4339241, DOI: 10.1186/s12889-015-1388-z.Peer-Reviewed Original ResearchConceptsHealth service accessService uptakeVCT servicesRural Zambézia ProvinceHigh HIV prevalencePopulation-based surveyRemote rural settingsConclusionsMost womenRural MozambiqueHigh HIVVoluntary counselingTwo-stage cluster sampleHIV prevalenceProvince-wide surveyService accessHIV stigmaHealth facilitiesZambézia ProvinceStigma scoresTesting utilizationStigma reductionLogistic regressionBaseline measuresSurvey domainsVCT
2014
Two-Year Death and Loss to Follow-Up Outcomes by Source of Referral to HIV Care for HIV-Infected Patients Initiating Antiretroviral Therapy in Rural Mozambique
Blevins M, José E, Bilhete FR, Vaz LM, Shepherd BE, Audet CM, Vermund SH, Moon TD. Two-Year Death and Loss to Follow-Up Outcomes by Source of Referral to HIV Care for HIV-Infected Patients Initiating Antiretroviral Therapy in Rural Mozambique. AIDS Research And Human Retroviruses 2014, 31: 198-207. PMID: 25381732, PMCID: PMC4532902, DOI: 10.1089/aid.2014.0007.Peer-Reviewed Original ResearchConceptsSource of referralCombination antiretroviral therapyRural Zambézia ProvinceReferral sitesAntiretroviral therapyAntenatal careGeneral outpatient clinicCumulative incidence estimatesAdditional unmeasured factorsCART initiationHIV careHazard ratioPatient characteristicsHIV testingMedian ageVoluntary counselingCox regressionOutpatient clinicKaplan-MeierPatient populationMedication pickupPatient outcomesInpatient careLTFUIncidence estimatesAssessing spatial patterns of HIV knowledge in rural Mozambique using geographic information systems
Buehler CP, Blevins M, Ossemane EB, González‐Calvo L, Ndatimana E, Vermund SH, Sidat M, Olupona O, Moon TD. Assessing spatial patterns of HIV knowledge in rural Mozambique using geographic information systems. Tropical Medicine And International Health 2014, 20: 353-364. PMID: 25430042, DOI: 10.1111/tmi.12437.Peer-Reviewed Original ResearchConceptsHIV knowledgeAntiretroviral therapyEnumeration areasMedian scorePopulation-based cluster surveyMore HIV knowledgeHIV knowledge scoresMultivariable linear regression modelsLow HIV knowledgePoor HIV knowledgeHIV knowledge levelsDistrict of residenceHealth facilitiesZambézia ProvinceNumber of childrenKnowledge scoreProgram plannersTherapyMore educationLinear regression modelsScoresAssessment toolRural MozambiqueRegression modelsRespondent agePoor Clinical Outcomes for HIV Infected Children on Antiretroviral Therapy in Rural Mozambique: Need for Program Quality Improvement and Community Engagement
Vermund SH, Blevins M, Moon TD, José E, Moiane L, Tique JA, Sidat M, Ciampa PJ, Shepherd BE, Vaz LM. Poor Clinical Outcomes for HIV Infected Children on Antiretroviral Therapy in Rural Mozambique: Need for Program Quality Improvement and Community Engagement. PLOS ONE 2014, 9: e110116. PMID: 25330113, PMCID: PMC4203761, DOI: 10.1371/journal.pone.0110116.Peer-Reviewed Original ResearchConceptsCombination antiretroviral therapyAntiretroviral therapyInfant diagnosisClinical outcomesEarly infant diagnosisPoor clinical outcomeYears of ageResource-limited settingsUnknown clinical outcomesCohort mortality ratesQuality improvement effortsART initiationCART initiationRural MozambiqueHIV servicesAdults 15HIV prevalenceKaplan-MeierHigher hemoglobinMedication pickupClinical dataOutcome treatmentNational guidelinesCase findingZambézia ProvinceAntiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning
Moon TD, Ossemane EB, Green AF, Ndatimana E, José E, Buehler CP, Wester CW, Vermund SH, Olupona O. Antiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning. PLOS ONE 2014, 9: e109653. PMID: 25329169, PMCID: PMC4201452, DOI: 10.1371/journal.pone.0109653.Peer-Reviewed Original ResearchConceptsHIV populationZambézia ProvinceCommunity-based VCTCommunity-based voluntary counselingHIV testing resultsProgram demographic informationHIV seropositivity rateHealth facility dataProgram expansionHIV careVoluntary counselingSeropositivity rateTesting deliveryEvidence-based decisionsHealth planningTreatment monitoringGeospatial mappingDemographic informationHealth estimatesClinicFacility dataCommunity-BasedProgram planningCareVCTMultidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions
Victor B, Blevins M, Green AF, Ndatimana E, González-Calvo L, Fischer EF, Vergara AE, Vermund SH, Olupona O, Moon TD. Multidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions. PLOS ONE 2014, 9: e108654. PMID: 25268951, PMCID: PMC4182519, DOI: 10.1371/journal.pone.0108654.Peer-Reviewed Original ResearchConceptsMultidimensional poverty measuresMultidimensional poverty measurementMultidimensional poverty indexContext-specific indicatorsMultidimensional povertyPoverty measurementPoverty measuresEvidence-based planningPoverty gapPoverty indexPoverty conditionsAverage deprivationPovertyPublic health interventionsFemale headsSocial determinantsMultidimensional phenomenonIntervention deploymentRural MozambiqueHouseholdsProgram implementersHealth interventionsLocal languageGeospatial mapsGeospatial visualizationSymptomatic HIV-Positive Persons in Rural Mozambique Who First Consult a Traditional Healer Have Delays in HIV Testing
Audet CM, Blevins M, Rosenberg C, Farnsworth S, Salato J, Fernandez J, Vermund SH. Symptomatic HIV-Positive Persons in Rural Mozambique Who First Consult a Traditional Healer Have Delays in HIV Testing. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2014, 66: e80-e86. PMID: 24815853, PMCID: PMC4077983, DOI: 10.1097/qai.0000000000000194.Peer-Reviewed Original ResearchConceptsHIV testingTraditional healersHealth facility visitsLow CD4 cellsCD4 cell countHIV-seropositive personsHIV-positive personsCross-sectional studyPrevious health careLocal health facilitiesHIV/AIDSTime of HIVAntiretroviral therapyTherapy delayCD4 cellsHIV diagnosisMedian timeSicker patientsInitial careTime of entrySymptomatic individualsFacility visitsRelevant symptomsEarly diagnosisHealth facilitiesClosing the Mental Health Gap in Low-income Settings by Building Research Capacity: Perspectives from Mozambique
Sweetland AC, Oquendo MA, Sidat M, Santos PF, Vermund SH, Duarte CS, Arbuckle M, Wainberg ML. Closing the Mental Health Gap in Low-income Settings by Building Research Capacity: Perspectives from Mozambique. Annals Of Global Health 2014, 80: 126-133. PMID: 24976551, PMCID: PMC4109687, DOI: 10.1016/j.aogh.2014.04.014.Peer-Reviewed Original ResearchConceptsLow-income settingsMental health treatmentHealth treatmentUniversidade Federal de São PauloMental health treatment gapEvidence-based mental health interventionsImplementation researchCause of disabilityEffective treatment interventionsHigh-income settingsMental health careMental health gapHigh-resource countriesMental health interventionsMental health professionalsTreatment gapResearch capacityGlobal burdenPsychopharmacological interventionsTreatment interventionsHealth professionalsHealth interventionsHealth gapMental disordersTest interventionsMobile clinics for antiretroviral therapy in rural Mozambique
Moon TD, Jequicene T, Blevins M, José E, Lankford JR, Wester CW, Fuchs MC, Vermund SH. Mobile clinics for antiretroviral therapy in rural Mozambique. Bulletin Of The World Health Organization 2014, 92: 680-684. PMID: 25378759, PMCID: PMC4208568, DOI: 10.2471/blt.13.129478.Peer-Reviewed Original ResearchConceptsHIV careClinic strategyHealth care infrastructureAntiretroviral therapy programsHuman immunodeficiency virusUptake of servicesPresident's Emergency PlanLocal health systemsMonths of implementationAntiretroviral therapyImmunodeficiency virusPeripheral clinicsNew patientsMobile clinicsAdult populationART expansionClinicTherapy programAIDS ReliefHealth systemCareTreatmentRural MozambiqueRural regionsNational coverage