Full Text Journal Articles by
Author Grace John Stewart

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Association of experienced and internalized stigma with self-disclosure of HIV status by youth living with HIV.

Cyrus Mugo, David Seeh, Brandon Guthrie, Megan Moreno, Manasi Kumar, Grace John-Stewart, Irene Inwani, Keshet Ronen,

We examined patterns of disclosure among youth living with HIV (YLHIV) in Kenya, and the association between self-disclosure and antiretroviral therapy adherence, stigma, depression, resilience, and social support. Of 96 YLHIV, 78% were female, 33% were ages 14-18, and 40% acquired HIV perinatally. Sixty-three (66%) YLHIV had self-disclosed their HIV ... Read more >>

AIDS Behav (AIDS and behavior)
[2021, :]

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Urine Biomarker Assessment of Infant Adherence to Isoniazid Prophylaxis.

Sylvia M LaCourse, Daniel Leon, Nuttada Panpradist, Barbra A Richardson, Elizabeth Maleche-Obimbo, Jerphason Mecha, Daniel Matemo, Jaclyn N Escudero, John Kinuthia, Barry Lutz, Grace John-Stewart,

We assessed adherence in an infant tuberculosis prevention trial in Kenya with a urine isoniazid metabolite-detecting dipstick. Ninety-seven infants had 155 assays performed; 77 (49.7%) were found to be positive despite caregiver-reported adherence. Positive assays were associated with maternal secondary education, HIV suppression and no reported missed doses in past ... Read more >>

Pediatr Infect Dis J (The Pediatric infectious disease journal)
[2021, 40(1):e43-e45]

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Financial incentives to increase pediatric HIV testing: a randomized trial.

Irene N Njuguna, Anjuli D Wagner, Jillian Neary, Vincent O Omondi, Verlinda A Otieno, Anita Orimba, Cyrus Mugo, Joseph B Babigumira, Carol Levin, Barbra A Richardson, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace John-Stewart, Jennifer Slyker,

<h4>Background</h4>Financial incentives can motivate desirable health behaviors, including adult HIV testing. Data regarding the effectiveness of financial incentives for HIV testing in children, who require urgent testing to prevent mortality, are lacking.<h4>Methods</h4>In a five-arm unblinded randomized controlled trial, adults living with HIV attending 19 HIV clinics in Western Kenya, with ... Read more >>

AIDS (AIDS (London, England))
[2021, 35(1):125-130]

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Caregivers' report of HIV-associated oral manifestations among HIV-unexposed, exposed, and infected Kenyan children.

Ana Lucia Seminario, Arthur Kemoli, Sarah Benki-Nugent, Daisy Chebet, Lauren Gomez, Dalton Wamalwa, Grace John-Stewart, Jennifer A Slyker,

<h4>Background</h4>Few oral health studies have been conducted in HIV-exposed uninfected children, who, like their HIV-infected peers, have altered immunity and perinatal drug exposures.<h4>Aim</h4>To compare caregiver' self-report of oral diseases, hygiene practices and utilization of routine dental care, between HIV-infected (HIV), exposed uninfected (HEU), and unexposed uninfected (HUU) children in Kenya.<h4>Design</h4>This ... Read more >>

Int J Paediatr Dent (International journal of paediatric dentistry)
[2020, :]

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Brief Report: Time to Repeat Viral Load Testing Among Unsuppressed Adolescents and Young Adults Living With HIV in Kenya.

Cyrus Mugo, Wilson S Katherine, Onyango Alvin, Irene N Njuguna, Caren W Mburu, Richardson A Barbra, Oyiengo Laura, Inwani Irene, John-Stewart Grace, Wamalwa C Dalton, Kohler K Pamela,

<h4>Background</h4>Repeat HIV viral load (VL) testing is required after unsuppressed VL to confirm treatment failure. We assessed proportion of adolescents and young adults living with HIV (AYALHIV) in Kenya with a confirmatory VL test and time to repeat testing.<h4>Design</h4>A retrospective analysis of longitudinal data abstracted from Kenya's national VL database.<h4>Methods</h4>VL ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2020, 85(5):606-611]

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Growth patterns and their contributing factors among HIV-exposed uninfected infants.

Aminata Ndiaye, Klara Suneson, Irene Njuguna, Gwen Ambler, Tomas Hanke, Grace John-Stewart, Walter Jaoko, Marie Reilly,

With expanded HIV treatment and prevention programmes, most infants born to HIV-positive women are uninfected, but the patterns and determinants of their growth are not well described. This study aimed to assess growth patterns in a cohort of HIV-exposed uninfected (HEU) infants who participated in an experimental HIV vaccine trial ... Read more >>

Matern Child Nutr (Maternal & child nutrition)
[2020, :e13110]

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Home- and Clinic-Based Pediatric HIV Index Case Testing in Kenya: Uptake, HIV Prevalence, Linkage to Care, and Missed Opportunities.

Cyrus Mugo, Jiayu Wang, Emily R Begnel, Irene N Njuguna, Elizabeth Maleche-Obimbo, Irene Inwani, Jennifer A Slyker, Grace John-Stewart, Dalton C Wamalwa, Anjuli D Wagner,

<h4>Introduction</h4>Gaps in HIV testing of children persist, particularly among older children born before the expansion of the prevention of mother-to-child transmission of HIV programs.<h4>Methods</h4>The Counseling and Testing for Children at Home study evaluated an index-case pediatric HIV testing approach. Caregivers receiving HIV care at 7 health facilities in Kenya (index ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2020, 85(5):535-542]

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Frequency and Predictors of Tenofovir-diphosphate Detection Among Young Kenyan Women in a Real-world Pre-exposure Prophylaxis Implementation Program.

Jillian Pintye, John Kinuthia, Felix Abuna, Kenneth Mugwanya, Harison Lagat, Julia C Dettinger, Daniel Odinga, Joseph Sila, Peter L Anderson, Grace John-Stewart, Jared M Baeten,

In a pre-exposure prophylaxis program for Kenyan women, we detected tenofovir-diphosphate in 61% (125/201) of randomly selected dried blood spots collected at the first follow-up visit. Tenofovir-diphosphate was detected more frequently among women who had partners living with human immunodeficiency virus, who were not pregnant, and who were ≥24 years. ... Read more >>

Clin Infect Dis (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2020, 71(9):e509-e512]

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Adolescent transition to adult care for HIV-infected adolescents in Kenya (ATTACH): study protocol for a hybrid effectiveness-implementation cluster randomised trial.

Irene N Njuguna, Kristin Beima-Sofie, Caren W Mburu, Cyrus Mugo, Jillian Neary, Janet Itindi, Alvin Onyango, Barbra A Richardson, Arianna Rubin Means, Monisha Sharma, Bryan J Weiner, Anjuli D Wagner, Laura Oyiengo, Dalton Wamalwa, Grace John-Stewart,

<h4>Introduction</h4>Successfully transitioning adolescents to adult HIV care is critical for optimising outcomes. Disclosure of HIV status, a prerequisite to transition, remains suboptimal in sub-Saharan Africa. Few interventions have addressed both disclosure and transition. An adolescent transition package (ATP) that combines disclosure and transition tools could support transition and improve outcomes.<h4>Methods ... Read more >>

BMJ Open (BMJ open)
[2020, 10(12):e039972]

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Influences on early discontinuation and persistence of daily oral PrEP use among Kenyan adolescent girls and young women: a qualitative evaluation from a PrEP implementation program.

Jillian Pintye, Gabrielle O'Malley, John Kinuthia, Felix Abuna, Jaclyn N Escudero, Melissa Mugambi, Mercy Awuor, Annabell Dollah, Julia C Dettinger, Pamela Kohler, Grace John-Stewart, Kristin Beima-Sofie,

<h4>Background</h4>Discontinuation of daily oral PrEP is frequent among adolescent girls and young women (AGYW) in African settings. We explored factors influencing early PrEP discontinuation and persistence among Kenyan AGYW who accepted PrEP within a programmatic setting.<h4>Methods</h4>We conducted in-depth interviews (IDI) with AGYW (aged 15-24 years) who accepted PrEP from 4 ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2020, :]

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Optimizing viral load suppression in Kenyan children on antiretroviral therapy (Opt4Kids).

Rena C Patel, Patrick Oyaro, Beryne Odeny, Irene Mukui, Katherine K Thomas, Monisha Sharma, James Wagude, Eunice Kinywa, Frederick Oluoch, Francesca Odhiambo, Boaz Oyaro, Grace C John-Stewart, Lisa L Abuogi,

<h4>Background</h4>As many as 40% of the 1 million children living with HIV (CLHIV) receiving antiretroviral treatment (ART) in resource limited settings have not achieved viral suppression (VS). Kenya has a large burden of pediatric HIV with nearly 140,000 CLHIV. Feasible, scalable, and cost-effective approaches to ensure VS in CLHIV are ... Read more >>

Contemp Clin Trials Commun (Contemporary clinical trials communications)
[2020, 20:100673]

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Community Perceptions About Use of Pre-exposure Prophylaxis Among Adolescent Girls and Young Women in Kenya.

Jaclyn N Escudero, Julia C Dettinger, Jillian Pintye, John Kinuthia, Harison Lagat, Felix Abuna, Pamela Kohler, Jared M Baeten, Gabrielle OʼMalley, Grace C John-Stewart, Kristin M Beima-Sofie,

J Assoc Nurses AIDS Care (The Journal of the Association of Nurses in AIDS Care : JANAC)
[2020, 31(6):669-677]

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Acceptability and Impact of Group Interpersonal Therapy (IPT-G) on Kenyan Adolescent Mothers Living with HIV: A Qualitative Analysis

Obadia Yator, Lincoln Khasakhala, Grace John Stewart, Manasi Kumar,

<h4>Background: </h4> Task shifting is a well-tested implementation strategy, within low- and middle-income countries (LMICs), that addresses the shortage of trained mental health personnel. Task sharing can increase access to care for patients with mental illnesses. In Kenya, community health workers [CHWs are a combination of community health assistants (CHAs) ... Read more >>

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From research to international scale-up: stakeholder engagement essential in successful design, evaluation and implementation of paediatric HIV testing intervention.

Cyrus Mugo, Irene Njuguna, Margaret Nduati, Vincent Omondi, Verlinda Otieno, Florence Nyapara, Elizabeth Mabele, Hellen Moraa, Kenneth Sherr, Irene Inwani, Elizabeth Maleche-Obimbo, Dalton Wamalwa, Grace John-Stewart, Jennifer Slyker, Anjuli D Wagner,

Stakeholder engagement between researchers, policymakers and practitioners is critical for the successful translation of research into policy and practice. The Counseling and Testing for Children at Home (CATCH) study evaluated a paediatric index case testing model, targeting the children of HIV-infected adults in care in Kenya. Researchers collaborated with stakeholders ... Read more >>

Health Policy Plan (Health policy and planning)
[2020, 35(9):1180-1187]

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A risk scoring tool for predicting Kenyan women at high risk of contraceptive discontinuation.

Claire W Rothschild, Barbra A Richardson, Brandon L Guthrie, Peninah Kithao, Tom Omurwa, James Mukabi, Erica M Lokken, Grace John-Stewart, Jennifer A Unger, John Kinuthia, Alison L Drake,

<h4>Objective</h4>We developed and validated a pragmatic risk assessment tool for identifying contraceptive discontinuation among Kenyan women who do not desire pregnancy.<h4>Study design</h4>Within a prospective cohort of contraceptive users, participants were randomly allocated to derivation (<i>n</i> = 558) and validation (<i>n</i> = 186) cohorts. Risk scores were developed by selecting the Cox proportional hazards model ... Read more >>

Contracept X (Contraception: X)
[2020, 2:100045]

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Recent Diagnosis, Lower Rates of HIV Disclosure, and High Technology Access in Pregnant Adolescent Girls and Young Women Living With HIV: A Descriptive Study.

Wenwen Jiang, Lusi Osborn, Alison L Drake, Jennifer A Unger, Daniel Matemo, John Kinuthia, Grace John-Stewart, Keshet Ronen,

J Assoc Nurses AIDS Care (The Journal of the Association of Nurses in AIDS Care : JANAC)
[2020, :]

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Cytomegalovirus and Epstein-Barr virus viremia are associated with HIV DNA levels in the reservoir of Kenyan infants on antiretroviral therapy.

Jennifer A Slyker, Brandon Guthrie, Mark Pankau, Kenneth Tapia, Dalton Wamalwa, Sarah Benki-Nugent, Evelyn Ngugi, Meei-Li Huang, Irene Njuguna, Agnes Langat, Grace John-Stewart, Dara Lehman,

Identifying determinants of HIV reservoir levels may inform novel viral eradication strategies. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) co-infections were assessed as predictors of HIV proviral DNA level in 26 HIV RNA-suppressed Kenyan children starting antiretroviral therapy (ART) before 7 months of age. Earlier acquisition of CMV and EBV, and ... Read more >>

J Infect Dis (The Journal of infectious diseases)
[2020, :]

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An Interactive Text Messaging Intervention to Improve Adherence to Option B+ Prevention of Mother-to-Child HIV Transmission in Kenya: Cost Analysis.

Yilin Chen, Keshet Ronen, Daniel Matemo, Jennifer A Unger, John Kinuthia, Grace John-Stewart, Carol Levin,

<h4>Background</h4>Mobile health (mHealth) approaches offer potentially affordable ways to support the care of HIV-infected patients in overstretched health care systems. However, only few studies have analyzed the costs associated with mHealth solutions for HIV care.<h4>Objective</h4>The aim of this study was to estimate the total incremental costs and incremental cost per ... Read more >>

JMIR Mhealth Uhealth (JMIR mHealth and uHealth)
[2020, 8(10):e18351]

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Elevation of cervical C-X-C motif chemokine ligand 10 levels is associated with HIV-1 acquisition in pregnant and postpartum women.

Michelle C Sabo, Dara A Lehman, Jillian C Pintye, Bingjie Wang, Alison L Drake, John Kinuthia, Lusi Osborn, Daniel Matemo, Barbra A Richardson, Julie Overbaugh, Grace John-Stewart, Susan M Graham,

<h4>Objective</h4>To evaluate the relationship between cervical cytokine/chemokine concentrations and HIV-1 acquisition in peripartum Kenyan women.<h4>Design</h4>Nested case-control study.<h4>Methods</h4>Women participating in a prospective study of peripartum HIV acquisition in Kenya (the Mama Salama Study), were tested for HIV-1 at 1-3 month intervals during pregnancy and through 9 months postpartum. Cases positive for ... Read more >>

AIDS (AIDS (London, England))
[2020, 34(12):1725-1733]

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Prevalence and Correlates of Pregnancy Self-Testing Among Pregnant Women Attending Antenatal Care in Western Kenya

Nina Njeri Nganga, Julia Dettinger, John Kinuthia, Jared Baeten, Grace John-Stewart, Laurén Gómez, Ben Ochieng, Mary Marwa, Kenneth Mugwanya, Melissa Mugambi,

In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) attendance. Understanding the characteristics of women who use pregnancy self-tests may facilitate early access to ANC and preventive interventions in ... Read more >>

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The Psychosocial Effects of the COVID-19 Pandemic on Youth Living with HIV in Western Kenya.

Jessica Dyer, Kate Wilson, Jacinta Badia, Kawango Agot, Jillian Neary, Irene Njuguna, James Kibugi, Elise Healy, Kristin Beima-Sofie, Grace John-Stewart, Pamela Kohler,

The objective of this study was to assess psychosocial effects of COVID-19 among adolescents living with HIV (ALHIV) in Kenya and to assess the feasibility of conducting behavioral surveys by phone. We adapted our protocol to administer telephone rather than in-person follow-up surveys and included questions about COVID-19. The majority ... Read more >>

AIDS Behav (AIDS and behavior)
[2020, :]

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High Awareness, Yet Low Uptake, of Pre-Exposure Prophylaxis Among Adolescent Girls and Young Women Within Family Planning Clinics in Kenya.

Joseph Sila, Anna M Larsen, John Kinuthia, George Owiti, Felix Abuna, Pamela K Kohler, Grace John-Stewart, Jillian Pintye,

Adolescent girls and young women (AGYW) are a priority population for HIV prevention in high-burden settings. We evaluated psychosocial characteristics, behavioral risk factors for HIV, and pre-exposure prophylaxis (PrEP) awareness and uptake among AGYW seeking contraceptive services at four public sector family planning (FP) clinics offering integrated PrEP delivery in ... Read more >>

AIDS Patient Care STDS (AIDS patient care and STDs)
[2020, 34(8):336-343]

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Zika Virus Circulates at Low Levels in Western and Coastal Kenya.

Theodore A Gobillot, Caroline Kikawa, Dara A Lehman, John Kinuthia, Alison L Drake, Walter Jaoko, Kishorchandra Mandaliya, Grace John-Stewart, R Scott McClelland, Julie Overbaugh,

BACKGROUND:Zika virus (ZIKV) was discovered over 70 years ago in East Africa, but little is known about its circulation and pathogenesis there. METHODS:We screened 327 plasma samples collected 2-12 months after febrile illness in Western and coastal Kenya (1993-2016) for binding and neutralizing antibodies to distinguish ZIKV and dengue virus ... Read more >>

J Infect Dis (The Journal of infectious diseases)
[2020, 222(5):847-852]

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Task-sharing and piloting WHO group interpersonal psychotherapy (IPT-G) for adolescent mothers living with HIV in Nairobi primary health care centers: a process paper.

Obadia Yator, Martha Kagoya, Lincoln Khasakhala, Grace John-Stewart, Manasi Kumar,

This paper describes a sustainable structure to deliver the World Health Organization (WHO) endorsed group Interpersonal Psychotherapy (IPT-G) for Postpartum Adolescent (PPA) mothers living with HIV in Nairobi. It documents the process of mobilizing, training, and engaging Community Health Workers (CHWs) and Key Informants (health facility staff) involved in the ... Read more >>

AIDS Care (AIDS care)
[2020, :1-6]

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Examining the relationship between diarrhea and linear growth in Kenyan HIV-exposed, uninfected infants.

Emily L Deichsel, Grace C John-Stewart, Judd L Walson, Dorothy Mbori-Ngacha, Barbra A Richardson, Brandon L Guthrie, Carey Farquhar, Rose Bosire, Patricia B Pavlinac,

<h4>Background</h4>Diarrhea in infancy can compromise linear growth and this relationship is likely influenced by diarrhea severity, number of episodes, and the timing of those episodes. HIV exposed, uninfected infants (HEU) have higher risk of growth faltering, infectious morbidity and mortality than HIV-unexposed infants and may be representative of children particularly ... Read more >>

PLoS One (PloS one)
[2020, 15(7):e0235704]

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