News & Events

New England Journal of Medicine Perspective article by Ingrid T. Katz, M.D., M.H.S., and Alexi A. Wright, M.D., M.P.H.

BMJ Innovations Article. Authors: Kristian R Olson, Madeline Walsh, Priya Garg, Alexis Steel, Sahil Mehta, Santorino Data, Rebecca Petersen, Anthony J Guarino, Elizabeth Bailey, David R Bangsberg

The Lancet Public Health article. Authors: Dr Atheendar S Venkataramani, MD, Rachel Brigell, MPH, Rourke O'Brien, PhD, Paula Chatterjee, MD, Prof Ichiro Kawachi, PhD, Alexander C Tsai, MD

Medical Clinics of North America article by Geren S. Stone, MD, DTM&H and Kristian R. Olson, MD, MPH, DTM&H, of Mass General Global Health.

BMJ Innovations Commentary. Authors: J W DePasse, A Caldwell, D Santorino, E Bailey, S Gudapakkam, D Bangsberg, K R Olson.

American Journal of Public Health article which assesses whether economic opportunity was independently associated with health behaviors and outcomes in the United States. Authors include Atheendar S. Venkataramani and Alexander C. Tsai.

AIDS and Behavior article by Alexander C. Tsai M.D and Atheendar S. Venkataramani

Responder Tools: Academic Institutions’ Critical Guidelines for Health Care Workers Who Deploy to West Africa for the Ebola Response and Future Crises*. Disaster Medicine and Public Health Preparedness.

A combination SMS and transportation reimbursement intervention to improve HIV care following abnormal CD4 test results in rural Uganda: a prospective observational cohort study. BMC Medicine. Authors: Mark Siedner, Data Santorino, Alexander Lankowski, Michael Kanyesigye, Mwebesa Bwana, Jessica Haberer, David Bangsberg.

Syndemics of psychosocial problems and HIV risk: A systematic review of empirical tests of the disease interaction concept. ScienceDirect. Authors: Alexander C. Tsai, Bridget F.O. Burns.

New England Journal of Medicine Perspective article by Renee N. Salas, M.D.

New England Journal of Medicine Perspective article by Annekathryn Goodman, M.D..

An important benefit of ART scale-up may be the diminution of HIV-related stigma in the general population. American Journal of Public Health

"Strengthening the Detection of and Early Response to Public Health Emergencies: Lessons from the West African Ebola Epidemic" An article published in PLOS co-authored by CGH affiliates Mark Seidner and Hilarie Cranmer.

The current Ebola outbreak is the worst global public health emergency of our generation, and our global health care community must and will rise to serve those affected. Aid organizations participating in the Ebola response must carefully plan to carry out their responsibility to ensure the health, safety, and security of their responders. At the same time, individual health care workers and their employers must evaluate the ability of an aid organization to protect its workers in the complex environment of this unheralded Ebola outbreak. We present a minimum set of operational standards developed by a consortium of Boston-based hospitals that a professional organization should have in place to ensure the health, safety, and security of its staff in response to the Ebola virus disease outbreak. Disaster Medicine and Public Health Preparedness, Vol 9, Num 1, Feb 2015.

Assessing self-efficacy of frontline providers to perform newborn resuscitation in a low-resource setting. Kristian R. Olson, Aya Caldwell, Melva Sihombing, A.J. Guarino, Brett D. Nelson, Rebecca Petersen. Resuscitation 89 (2015) 58–63.

An Intervention to Support HIV Preexposure Prophylaxis Adherence in HIV-Serodiscordant Couples in Uganda

Reliability and Validity of Depression Assessment Among Persons With HIV in Sub-Saharan Africa: Systematic Review and Meta-analysis. In his most recent meta-analysis, CGH affiliate Alexander Tsai reveals the paucity of evidence on the validity of depression assessment among people living with HIV in sub-Saharan Africa.

CGH affiliates Ingrid Katz and David Bangsberg co-authored this article in AIDS and Behavior.

Social Integration and Suicide Mortality Among Men: 24-Year Cohort Study of U.S. Health Professionals. Social Integration and Suicide Mortality Among Men: 24-Year Cohort Study of U.S. Health Professionals CGH affiliate Alexander Tsai leads a study published in the Annals of Internal Medicine showing that social networks drastically reduce the risk of suicide deaths among men. An accompanying editorial (http://annals.org/article.aspx?articleid=1887035) reinforces their argument that a public health approach to suicide prevention is urgently needed.

Less Noise, More Hacking: How to Deploy Principles from MIT’s Hacking Medicine to Accelerate Health Care. Jacqueline W. DePasse, Ryan Carroll, Andrea Ippolito, Allison Yost, Data Santorino, Zen Chu, Kristian R. Olson. International Journal of Technology Assessment in Health Care, 30:3 (2014), 260–264.

Impact of Geographic and Transportation-Related Barriers on HIV Outcomes in Sub-Saharan Africa: A Systematic Review. CGH affiliates Mark Siedner and Alexander Tsai, and director David Bangsberg, summarize the extensive body of literature linking geographic and transportation-related barriers in sub-Saharan Africa to poor outcomes across the continuum of HIV care.

A study conducted in Khayelitsha, South Africa led by CGH affiliate Alexander Tsai demonstrates the feasibility of using community health workers to conduct community-based screening for postpartum depression.

Although omega-3 and fatty fish intake are popularly believed to have important mental health benefits, CGH affiliate Alexander Tsai leads a study published in the American Journal of Epidemiology showing this not to be the case.

Latest findings from the NIH-funded UARTO study led by CGH director David Bangsberg reveal important aspects of how depression presents among people living with HIV in rural Uganda.

Participants in the NIH-funded UARTO study who initiated HIV treatment experienced important economic benefits in addition to the health benefits, and early treatment initiation could avert HIV illness-related job loss altogether.

Population-Based Study of Food Insecurity and HIV Transmission Risk Behaviors and Symptoms of Sexually Transmitted Infections Among Linked Couples in Nepal. CGH affiliate Alexander Tsai shows that food insecurity is linked with HIV risk among women, but not men, in Nepal.

Declining Prevalence of Probable Depression Among Patients Presenting for Antiretroviral Therapy in Rural Uganda: The Role of Early Treatment Initiation. Depression severity at enrollment appears to be declining among participants in the NIH-funded UARTO study led by CGH director David Bangsberg, and this finding may be driven by the push for earlier treatment initiation.

Reversal of the Kynurenine Pathway of Tryptophan Catabolism May Improve Depression in ART-Treated HIV-Infected Ugandans. Latest findings from the NIH-funded UARTO study led by CGH director David Bangsberg, published in JAIDS, suggest that HIV treatment may be partly responsible for improvements in depression symptoms via immunologic mechanisms.

Caregiver Perceptions and Motivation for Disclosing or Concealing the Diagnosis of HIV Infection to Children Receiving HIV Care in Mbarara, Uganda: A Qualitative Study. A study published in PLOS co-authored by CGH Affiliate Jessica Haberer.

Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application. A multi-site study led by CGH affiliate Alexander Tsai and UCLA researcher Mary-Jane Rotheram-Borus, and published in the Archives of Women's Mental Health, shows that community health workers can be trained to screen for depression during pregnancy using a simple mHealth application.

CGH affiliates Vanessa Kerry, Alexander Tsai, Courtney Ng, and David Bangsberg report in Academic Psychiatry their findings from a systematic review of global health training in U.S. psychiatry residency training programs.

NEJM Perspective article by Hilarie Cranmer, M.D., M.P.H., Director of Disaster Response, Mass General Center for Global Health and Paul D. Biddinger, M.D.

In an analysis of data from the NIH-funded UARTO study led by CGH director David Bangsberg, researchers find important evidence of a dynamic relationship between social support and HIV-related stigma. An editorial by Seth Kalichman (http://link.springer.com/article/10.1007%2Fs12160-014-9620-0) accompanying their publication in the Annals of Behavioral Medicine emphasizes the need for new theoretical advances in HIV stigma like these.

Conducted by the Ministry of Health of the Hashemite Kingdom of Jordan, with support from the World Health Organization, the International Advisory, Products and Systems, the Massachusetts General Hospital Center for Global Health, Harvard University and the Jordan University for Science and Technology

Treatment as long-term prevention: sustained reduction in HIV sexual transmission risk with use of antiretroviral therapy in rural Uganda. Mark Siedner and other CGH affiliates on the NIH-funded UARTO study led by CGH director David Bangsberg identified a long-term, sustained reduction in HIV transmission risk behaviors during the course of HIV treatment and published these findings in AIDS.

Reliability and Validity of Instruments for Assessing Perinatal Depression in African Settings: Systematic Review and Meta-Analysis. A systematic review and meta-analysis led by CGH affiliate Alexander Tsai and published in PLoS One shows that a well-known screening instrument for postpartum depression functions well in sub-Saharan Africa contexts.

CGH affiliates Vanessa Kerry, Alexander Tsai, and David Bangsberg report in the Journal of Global Health their findings from a systematic review of global health training in U.S. residency training programs, showing that global health programs tend to track with the global burden of disease.

Adherence to HIV antiretroviral therapy (ART) is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence.

CGH affiliate Alexander Tsai and director David Bangsberg advance the argument, in a PLoS Medicine essay, that poverty alleviation efforts may hold the key to ending the stigma of HIV.

Article by Brigham and Women's Hospital physician, Ingrid Katz, MD, MHS

Over the past decade, PEPFAR has funded HIV–AIDS treatment for more than 5 million people in resource-limited settings in sub-Saharan Africa. Now, the U.S. government has reached a turning point in its emergency response and has decided to reduce funding to many of these countries, including South Africa, recipient of the most PEPFAR dollars.

Journal of the American Medical Association article about Seed Global Health, which will send medical professionals to assist and educate physicians in developing countries

A study supervised by CGH affiliate Jessica Haberer demonstrates poor uptake of an mHealth intervention in tuberculosis care in South Africa.

Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa. Food insecurity and its association with co-occurring postnatal depression, hazardous drinking, and suicidality among women in peri-urban South Africa.

CGH affiliate Alexander Tsai leads an evaluation study showing that a unique research residency training program implemented at UCSF can potentially address the shortage of research psychiatrists by increasing the numbers of new trainees entering research-oriented fellowships after graduation.

Incidence and Predictors of Pregnancy among a Cohort of HIV-Positive Women Initiating Antiretroviral Therapy in Mbarara, Uganda. Research from the Uganda AIDS Rural Treatment Outcomes (UARTO) study, led by CGH director Dr. David Bangsberg with collaborators at UCSF and Mbarara University, documents the incidence of pregnancy among HIV-positive women on treatment and call for more integrated services to prevent unintended pregnancies and reduce periconception risks for HIV-positive women who choose to conceive.

CGH affiliate Alexander Tsai, commenting on a meta-analysis of intimate partner violence and depression, redirects attention to the broader structural determinants of both violence and depression among women.

Research from the Uganda AIDS Rural Treatment Outcomes (UARTO) study, led by CGH director Dr. David Bangsberg with collaborators at UCSF and Mbarara University, finds that the stigma of HIV threatens to undermine HIV treatment and prevention by inhibiting serostatus disclosure to intimate partners and other social network ties.

A study conducted by colleagues from Mbarara, Uganda along with CGH affiliate Mark Siedner finds that malaria is an uncommon cause of adult sepsis and that adult patients presenting for sepsis should be investigated thoroughly for other potential causes of disease.

How Does Antiretroviral Treatment Attenuate the Stigma of HIV? Evidence from a Cohort Study in Rural Uganda. Research from the Uganda AIDS Rural Treatment Outcomes (UARTO) study, led by CGH director Dr. David Bangsberg with collaborators at UCSF and Mbarara University, finds that HIV treatment leads to long-term reductions in HIV-related stigma.

Shang Ring versus forceps-guided adult male circumcision: a randomized controlled effectiveness study in southwestern Uganda. A randomized controlled trial from Uganda supervised by CGH affiliate Mark Siedner found that adult male circumcision using the Shang Ring was acceptable and achieved comparable outcomes to forceps-guided adult male circumcision.

CGH affiliate Alexander Tsai and colleagues from South Africa describe a novel mobile phone-based information system platform to provide real-time supervision for community health workers in the field.

Adjunctive Atypical Antipsychotic Treatment for Major Depressive Disorder: A Meta-Analysis of Depression, Quality of Life, and Safety Outcomes. A study supervised by CGH affiliate Alexander Tsai finds that atypical antipsychotic medications used for adjunctive treatment of depression provide some mind evidence of reducing depression symptoms, minimal evidence of improving overall well being and quality of life, and abundant evidence of potential treatment-related harm

Community participatory research emphasizes communication of study findings to research participants of vulnerable populations. Most dissemination activities in sub-Saharan Africa have occurred after the completion (or termination) of randomized clinical trials of a defined intervention. Sharing research findings with participants during observational research can avoid therapeutic misconception as well as evaluate the validity of research involving knowledge, attitudes, or behavior through a “member check” procedure in which investigators conduct interviews regarding the relevancy and saliency of their findings. Nonetheless, the communication of research findings to participants living with HIV enrolled in observational research in a rural sub-Saharan African setting is less straightforward and presents significant challenges with respect to literacy, language, logistics, and confidentiality.

Women with Pregnancies Had Lower Adherence to 1% Tenofovir Vaginal Gel as HIV Preexposure Prophylaxis in CAPRISA 004, a Phase IIB Randomized-Controlled Trial. CGH affiliate Lynn Matthews and David Bangsberg, with colleagues from South Africa, find that pregnant women were less adherent to tenofovir gel in a prominent HIV prevention trial.

CGH collaborator and maternal-fetal medicine specialist Blair Wylie reflects on her experience helping to address the problem of stillbirth at Mbarara Regional Referral Hospital.

Higher Baseline CD4 Cell Count Predicts Treatment Interruptions and Persistent Viremia in Patients Initiating ARVs in Rural Uganda: Based on their research from rural Uganda, CGH researchers show that early HIV treatment may be associated with lower adherence, suggesting the need for adherence support interventions to accompany the expansion of drug access to healthy populations.

CGH director David Bangsberg, commenting on a counseling intervention study published in JAMA Internal Medicine, describes how real-time HIV treatment adherence monitoring may make it feasible to support efforts to improve lifetime adherence.

coverage of study led by MGH investigator Paul Goss

There have been hundreds of mHealth pilot studies, but the evidence base to support their scale-up has lagged. Researchers from Stellenbosch University, UCLA, and CGH recommend the development of robust standards to facilitate scalable and sustainable health information systems.

Sexual Relationship Power and Depression among HIV-Infected Women in Rural Uganda Among women living with HIV in rural Uganda, CGH researchers show that relationship power and gender equity are important determinants of emotional wellbeing.