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2. Safety, reactogenicity, and immunogenicity of a 2-dose Ebola vaccine regimen of Ad26.ZEBOV followed by MVA-BN-Filo in healthy adult pregnant women: study protocol for a phase 3 open-label randomized controlled trial

Author

Karita, Etienne, Nyombayire, Julien, Ingabire, Rosine, Mazzei, Amelia, Sharkey, Tyronza, Mukamuyango, Jeannine, Allen, Susan, Tichacek, Amanda, Parker, Rachel, Priddy, Frances, Sayinzoga, Felix, Nsanzimana, Sabin, Robinson, Cynthia, Katwere, Michael, Anumendem, Dickson, Leyssen, Maarten, Schaefer, Malinda, and Wall, Kristin M.

Published
2022
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6. HIV infection and engagement in HIV care cascade among men who have sex with men and transgender women in Kigali, Rwanda: a cross-sectional study

Author

Rwema, Jean Olivier Twahirwa, Lyons, Carrie E., Herbst, Sara, Liestman, Benjamin, Nyombayire, Julien, Ketende, Sosthenes, Mazzei, Amelia, Olawore, Oluwasolape, Nsanzimana, Sabin, Mugwaneza, Placidie, Kagaba, Aflodis, Sullivan, Patrick S., Allen, Susan, Karita, Etienne, and Baral, Stefan D.

Subjects
Transgender people -- Health aspects, HIV infections -- Diagnosis -- Care and treatment, MSM (Men who have sex with men) -- Health aspects, Medical care quality -- Evaluation, Health
Abstract

Introduction: Given intersecting biological, network and structural risks, men who have sex with men (MSM) and transgender women (TGW) consistently have a high burden of HIV. Although MSM are a key population in Rwanda, there are limited epidemiologic data to guide programming. This study aimed to characterize HIV prevalence and care cascade among MSM and TGW in Kigali. Methods: MSM and TGW [greater than or equal to] 18 years were recruited using respondent-driven sampling (RDS) from March-August 2018 in Kigali. Participants underwent a structured interview including measures of individual, network and structural determinants. HIV and sexually transmitted infections (STI) including syphilis, Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) were tested. Viral load was measured for MSM living with HIV. Robust Poisson regression was used to characterize the determinants of HIV infection and engagement in the HIV treatment cascade. Results: A total of 736 participants were enrolled. The mean age was 27 years (range:18 to 68) and 14% (106) were TGW. HIV prevalence was 10% (RDS-adjusted: 9.2% (95% CI: 6.4 to 12.1)). Unadjusted prevalence of any STI was 20% (147); syphilis: 5.7% (42); CT: 9.1% (67) and NG: 8.8% (65). Anticipated (41%), perceived (36%) and enacted stigmas (45%) were common and higher among TGW (p < 0.001). In multivariable RDS adjusted analysis, higher age (aPR: 1.08 (95% CI: 1.05 to 1.12)) and ever having sex with women (aPR: 3.39 (95% CI: 1.31 to 8.72)) were positively associated with prevalent HIV. Being circumcised (aPR: 0.52 (95% CI: 0.28 to 0.9)) was negatively associated with prevalent HIV infection. Overall, 61% (45/74) of respondents reported knowing their HIV-positive status. Among these, 98% (44/45) reported antiretroviral therapy use (ART); 75% (33/44) were virally suppressed using a cut-off of Conclusions: These data show a high burden of HIV among MSM/TGW in Kigali, Rwanda. Bisexual concurrency was common and associated with prevalent HIV infection, demonstrating the need of comprehensive screening for all sexual practices and preferences in the provision of comprehensive HIV prevention services in Rwanda. Viral suppression was below the UNAIDS target suggesting poor adherence and potential ART resistance. There is a need for adherence support, screening for primary and secondary ART resistance and stigma mitigation interventions to optimize HIV-related outcomes for MSM in Rwanda. Keywords: HIV care continuum; structural determinants; men who have sex with men; Kigali; Rwanda, 1 | INTRODUCTION Traditionally, HIV epidemics in eastern and southern African countries have been described as generalized epidemics. This definition is predicated on an assumption that HIV risks are homogenous [...]

Published
2020
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8. Uptake of long acting reversible contraception following integrated couples HIV and fertility goal-based family planning counselling in Catholic and non-Catholic, urban and rural government health centers in Kigali, Rwanda

Author

Mukamuyango, Jeannine, Ingabire, Rosine, Parker, Rachel, Nyombayire, Julien, Abaasa, Andrew, Asiki, Gershim, Easter, Sarah Rae, Wall, Kristin M., Nyirazinyoye, Laetitia, Tichacek, Amanda, Kaslow, Nadine, Price, Matt A., Allen, Susan, and Karita, Etienne

Published
2020
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9. First-in-Human Evaluation of the Safety and Immunogenicity of an Intranasally Administered Replication-Competent Sendai Virus–Vectored HIV Type 1 Gag Vaccine: Induction of Potent T-Cell or Antibody Responses in Prime-Boost Regimens

Author

S001 Study Team, Nyombayire, Julien, Anzala, Omu, Gazzard, Brian, Karita, Etienne, Bergin, Philip, Hayes, Peter, Kopycinski, Jakub, Omosa-Manyonyi, Gloria, Jackson, Akil, Bizimana, Jean, Farah, Bashir, Sayeed, Eddy, Parks, Christopher L., Inoue, Makoto, Hironaka, Takashi, Hara, Hiroto, Shu, Tsugumine, Matano, Tetsuro, Dally, Len, Barin, Burc, Park, Harriet, Gilmour, Jill, Lombardo, Angela, Excler, Jean-Louis, Fast, Patricia, Laufer, Dagna S., and Cox, Josephine H.

Published
2017

11. A mixed-methods study of factors influencing postpartum intrauterine device uptake after family planning counseling among women in Kigali, Rwanda

Author

Tounkara, Mariama S., primary, Ingabire, Rosine, additional, Comeau, Dawn L., additional, Karita, Etienne, additional, Allen, Susan, additional, Nyombayire, Julien, additional, Parker, Rachel, additional, Haddad, Lisa B., additional, Da Costa, Vanessa, additional, Tichacek, Amanda, additional, Mazzei, Amelia, additional, Mukamuyango, Jeannine, additional, and Wall, Kristin M., additional

Published
2022
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12. Monitoring of Adverse Events in Recipients of the 2-Dose Ebola Vaccine Regimen of Ad26.ZEBOV Followed by MVA-BN-Filo in the UMURINZI Ebola Vaccination Campaign

Author

Nyombayire, Julien, primary, Ingabire, Rosine, additional, Magod, Ben, additional, Mazzei, Amelia, additional, Mazarati, Jean-Baptiste, additional, Noben, Jozef, additional, Katwere, Michael, additional, Parker, Rachel, additional, Nsanzimana, Sabin, additional, Wall, Kristin M, additional, Sayinzoga, Felix, additional, Tichacek, Amanda, additional, Robinson, Cynthia, additional, Hammoud, Niina, additional, Priddy, Frances, additional, Allen, Susan, additional, and Karita, Etienne, additional

Published
2022
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13. Antibiotic-resistant Neisseria gonorrhoeae and changes to the 2019 Rwandan National STI Guidelines

Author

Wall, Kristin M, primary, Nyombayire, Julien, additional, Parker, Rachel, additional, Ingabire, Rosine, additional, Bizimana, Jean, additional, Mukamuyango, Jeannine, additional, Mazzei, Amelia, additional, Price, Matt A, additional, Unyuzimana, Marie Aimee, additional, Tichacek, Amanda, additional, Allen, Susan, additional, and Karita, Etienne, additional

Published
2021
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14. Assessment of the Safety and Immunogenicity of 2 Novel Vaccine Platforms for HIV-1 Prevention: A Randomized Trial

Author

Baden, Lindsey R., Karita, Etienne, Mutua, Gaudensia, Bekker, Linda-Gail, Gray, Glenda, Page-Shipp, Liesl, Walsh, Stephen R., Nyombayire, Julien, Anzala, Omu, Roux, Surita, Laher, Fatima, Innes, Craig, Seaman, Michael S., Cohen, Yehuda Z., Peter, Lauren, Frahm, Nicole, McElrath, M. Juliana, Hayes, Peter, Swann, Edith, Grunenberg, Nicole, Grazia-Pau, Maria, Weijtens, Mo, Sadoff, Jerry, Dally, Len, Lombardo, Angela, Gilmour, Jill, Cox, Josephine, Dolin, Raphael, Fast, Patricia, Barouch, Dan H., and Laufer, Dagna S.

Published
2016

15. Monitoring of Adverse Events in Recipients of the 2-Dose Ebola Vaccine Regimen of Ad26.ZEBOV Followed by MVA-BN-Filo in the UMURINZI Ebola Vaccination Campaign.

Author

Nyombayire, Julien, Ingabire, Rosine, Magod, Ben, Mazzei, Amelia, Mazarati, Jean-Baptiste, Noben, Jozef, Katwere, Michael, Parker, Rachel, Nsanzimana, Sabin, Wall, Kristin M, Sayinzoga, Felix, Tichacek, Amanda, Robinson, Cynthia, Hammoud, Niina, Priddy, Frances, Allen, Susan, and Karita, Etienne

Subjects
*ADENOVIRUS diseases, *VACCINATION, *EBOLA virus, *VACCINIA, *FEBRILE seizures, *VACCINATION of children
Abstract

Background From 2019 to 2021, Rwandan residents of the border with the Democratic Republic of the Congo were offered the Ad26.ZEBOV (adenovirus type 26 vector vaccine encoding Ebola virus glycoprotein) and MVA-BN-Filo (modified vaccinia virus Ankara vector vaccine, encoding glycoproteins from Ebola, Sudan, Marburg, and nucleoprotein from Tai Forest viruses) Ebola vaccine regimen. Methods Nonpregnant persons aged ≥2 years were eligible. Unsolicited adverse events (UAEs) were reported through phone calls or visits, and serious adverse events (SAEs) were recorded per International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use guidelines. Results Following Ad26.ZEBOV, UAEs were reported by 0.68% of 216 113 vaccinees and were more common in younger children (aged 2–8 years, 1.2%) compared with older children (aged 9–17 years, 0.4%) and adults (aged ≥18 years, 0.7%). Fever and headache were the most reported symptoms. All 17 SAEs related to vaccine were in children aged 2–8 years (10 postvaccination febrile convulsions ± gastroenteritis and 7 fever and/or gastroenteritis). The incidence of febrile seizures was 8 of 26 062 (0.031%) prior to initiation of routine acetaminophen in December 2020 and 2 of 15 897 (0.013%) thereafter. Nonobstetric SAEs were similar in males and females. All 20 deaths were unrelated to vaccination. Young girls and adult women with UAEs were less likely to receive the second dose than those without UAEs. Seven unrelated SAEs occurred in 203 267 MVA-BN-Filo recipients. Conclusions Postvaccination febrile convulsions in young children were rare but not previously described after Ad26.ZEBOV and were reduced with routine acetaminophen. The regimen was otherwise safe and well-tolerated. [ABSTRACT FROM AUTHOR]

Published
2023
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16. The Relationship Between Sexual Behavior Stigma and Depression Among Men Who have Sex with Men and Transgender Women in Kigali, Rwanda: a Cross-sectional Study

Author

Okonkwo, Nneoma, primary, Rwema, Jean Olivier Twahirwa, additional, Lyons, Carrie, additional, Liestman, Benjamin, additional, Nyombayire, Julien, additional, Olawore, Oluwasolape, additional, Nsanzimana, Sabin, additional, Mugwaneza, Placidie, additional, Kagaba, Aflodis, additional, Sullivan, Patrick, additional, Allen, Susan, additional, Karita, Etienne, additional, and Baral, Stefan, additional

Published
2021
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17. Leapfrogging with technology: introduction of a monitoring platform to support a large-scale Ebola vaccination program in Rwanda

Author

Mc Kenna, Paula, primary, Masyn, Serge, additional, Willems, Annik, additional, De Paepe, Anne, additional, Rutten, Romain, additional, Mazarati, Jean Baptiste, additional, Sayinzoga, Felix, additional, Karita, Etienne, additional, Nduwamungu, Jean Nepo, additional, Mazzei, Amelia, additional, Nyombayire, Julien, additional, Ingabire, Rosine, additional, Amponsah, Monica, additional, Egoeh, Seth Gogo, additional, and Ezeanochie, Nnamdi, additional

Published
2021
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18. Additional file 1 of Developing and validating a risk algorithm to diagnose Neisseria gonorrhoeae and Chlamydia trachomatis in symptomatic Rwandan women

Author

Wall, Kristin M., Nyombayire, Julien, Parker, Rachel, Ingabire, Rosine, Bizimana, Jean, Mukamuyango, Jeannine, Mazzei, Amelia, Price, Matt A., Unyuzimana, Marie Aimee, Tichacek, Amanda, Allen, Susan, and Karita, Etienne

Abstract

Additional file 1: Table S1. Baseline characteristics and associations with CT or NG infection in symptomatic women, Kigali (N = 305): external validation cohort.

Published
2021
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20. Long-term follow-up of study participants from prophylactic HIV vaccine clinical trials in Africa

Author

Schmidt, Claudia, Jaoko, Walter, Omosa-Manyonyi, Gloria, Kaleebu, Pontiano, Mpendo, Juliet, Nanvubya, Annet, Karita, Etienne, Bayingana, Roger, Bekker, Linda-Gail, Chomba, Elwyn, Kilembe, William, Nchabeleng, Maphoshane, Nyombayire, Julien, Stevens, Gwynn, Chetty, Paramesh, Lehrman, Jennifer, Cox, Josephine, Allen, Susan, Dally, Len, Smith, Carol, and Fast, Patricia E

Published
2014
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21. Cross-sectional assessment of determinants of STIs among men who have sex with men and transgender women in Kigali, Rwanda

Author

Twahirwa Rwema, Jean Olivier, primary, Herbst, Sara, additional, Hamill, Matthew M, additional, Liestman, Benjamin, additional, Nyombayire, Julien, additional, Lyons, Carrie E, additional, Mugwaneza, Placidie, additional, Makuza, Jean Damascène, additional, Sullivan, Patrick Sean, additional, Allen, Susan, additional, Karita, Etienne, additional, and Baral, Stefan, additional

Published
2021
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22. Etiologies of genital inflammation and ulceration in symptomatic Rwandan men and women responding to radio promotions of free screening and treatment services

Author

Wall, Kristin M., primary, Nyombayire, Julien, additional, Parker, Rachel, additional, Ingabire, Rosine, additional, Bizimana, Jean, additional, Mukamuyango, Jeannine, additional, Mazzei, Amelia, additional, Price, Matt A., additional, Unyuzimana, Marie Aimee, additional, Tichacek, Amanda, additional, Allen, Susan, additional, and Karita, Etienne, additional

Published
2021
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23. Genital Abnormalities, Hormonal Contraception, and Human Immunodeficiency Virus Transmission Risk in Rwandan Serodifferent Couples

Author

Wall, Kristin M, primary, Karita, Etienne, additional, Nyombayire, Julien, additional, Ingabire, Rosine, additional, Mukamuyango, Jeannine, additional, Parker, Rachel, additional, Brill, Ilene, additional, Price, Matt, additional, Haddad, Lisa B, additional, Tichacek, Amanda, additional, Hunter, Eric, additional, and Allen, Susan, additional

Published
2021
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24. Cross-sectional assessment of determinants of STIs among men who have sex with men and transgender women in Kigali, Rwanda.

Author

Rwema, Jean Olivier Twahirwa, Herbst, Sara, Hamil, Matthew M., Liestman, Benjamin, Nyombayire, Julien, Lyons, Carrie E., Mugwaneza, Placidie, Makuza, Jean Damascène, Sullivan, Patrick Sean, Allen, Susan, Karita, Etienne, Baral, Stefan, Twahirwa Rwema, Jean Olivier, and Hamill, Matthew M

Abstract

Background: STIs among men who have sex with men (MSM) and transgender women (TGW) continue to increase. In Rwanda, STI management relies on syndromic management with limited empirical data characterising the burden of specific STIs among MSM/TGW. This study evaluated the prevalence of syphilis, Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) and associated factors among MSM/TGW in Kigali.Methods: From March to August 2018, 737 MSM/TGW >18 years were enrolled using respondent-driven sampling (RDS). Structured interviews and HIV/STI screening were conducted. Syphilis was screened with rapid plasma reagin confirmed by Treponema pallidum hemagglutination assay. CT/NG were tested by Cepheid GeneXpert. RDS-adjusted multivariable Poisson regression models with robust variance estimation were used to evaluate factors associated with any STI, and determinants of urethral and rectal STIs separately.Results: Prevalence of any STI was 20% (RDS adjusted: 16.7% (95% CI: 13.2% to 20.2%)). Syphilis was 5.7% (RDS adjusted: 6.8% (95% CI: 4.3% to 9.4%)). CT was 9.1% (RDS adjusted: 6.1% (95% CI: 3.9% to 8.4%)) and NG was 8.8% (RDS adjusted: 7.1% (95% CI: 4.9% to 9.2%)). STIs were more common among older MSM and those with HIV (p<0.05). Of CT infections, 67% were urethral, 27% rectal and 6% were dual site. For NG infections, 52% were rectal, 29% urethral and 19% were dual site. Overall, 25.8% (23 of 89) of those with confirmed STI and returned for their results were symptomatic at time of testing.STI symptoms in the previous year (adjusted prevalence ratio (aPR): 1.94 (95% CI: 1.26 to 2.98)) were positively associated with any STI. Being circumcised was negatively associated with any STI (aPR: 0.47 (95% CI: 0.31 to 0.73)). HIV was positively associated with rectal STIs (aPR: 3.50 (95% CI: 1.09 to 11.21)) but negatively associated with urethral STIs.Conclusion: MSM/TGW, especially those living with HIV, are at high risk of STIs in Rwanda with the vast majority being asymptomatic. These data suggest the potential utility of active STI surveillance strategies using highly sensitive laboratory methods among those at high risk given the anatomical distribution and limited symptomatology of STIs observed among Rwandan MSM/TGW. [ABSTRACT FROM AUTHOR]

Published
2022
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25. HIV infection and engagement in HIV care cascade among men who have sex with men and transgender women in Kigali, Rwanda: a cross‐sectional study

Author

Twahirwa Rwema, Jean Olivier, primary, Lyons, Carrie E, additional, Herbst, Sara, additional, Liestman, Benjamin, additional, Nyombayire, Julien, additional, Ketende, Sosthenes, additional, Mazzei, Amelia, additional, Olawore, Oluwasolape, additional, Nsanzimana, Sabin, additional, Mugwaneza, Placidie, additional, Kagaba, Aflodis, additional, Sullivan, Patrick S, additional, Allen, Susan, additional, Karita, Etienne, additional, and Baral, Stefan D, additional

Published
2020
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26. Postpartum long-acting contraception uptake and service delivery outcomes after a multilevel intervention in Kigali, Rwanda

Author

Espey, Julie, primary, Ingabire, Rosine, additional, Nyombayire, Julien, additional, Hoagland, Alexandra, additional, Da Costa, Vanessa, additional, Mazzei, Amelia, additional, Haddad, Lisa B, additional, Parker, Rachel, additional, Mukamuyango, Jeannine, additional, Umutoni, Victoria, additional, Allen, Susan, additional, Karita, Etienne, additional, Tichacek, Amanda, additional, and Wall, Kristin M, additional

Published
2020
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27. Acceptability and tolerability of repeated intramuscular electroporation of Multi-antigenic HIV (HIVMAG) DNA vaccine among healthy African participants in a phase 1 randomized controlled trial

Author

Mpendo, Juliet, primary, Mutua, Gaudensia, additional, Nanvubya, Annet, additional, Anzala, Omu, additional, Nyombayire, Julien, additional, Karita, Etienne, additional, Dally, Len, additional, Hannaman, Drew, additional, Price, Matt, additional, Fast, Patricia E., additional, Priddy, Frances, additional, Gelderblom, Huub C., additional, and Hills, Nancy K., additional

Published
2020
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28. Motivational interviewing to promote long-acting reversible contraception among Rwandan couples wishing to prevent or delay pregnancy

Author

Mukamuyango, Jeannine, primary, Ingabire, Rosine, additional, Parker, Rachel, additional, Nyombayire, Julien, additional, Easter, Sarah Rae, additional, Wall, Kristin M., additional, Tichacek, Amanda, additional, Nyirazinyoye, Laetitia, additional, Kaslow, Nadine, additional, Allen, Susan, additional, and Karita, Etienne, additional

Published
2020
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31. Antiretroviral Therapy Use and HIV Transmission Among Discordant Couples in Nonresearch Settings in Kigali, Rwanda.

Author

Nyombayire, Julien, Ingabire, Rosine, Mukamuyango, Jeannine, Karita, Etienne, Mazzei, Amelia, Wall, Kristin M., Parker, Rachel, Tichacek, Amanda, Allen, Susan, Hunter, Eric, and Price, Matt A.

Subjects
*HIV infection epidemiology, *HIV prevention, *HIV infections, *RESEARCH, *COUNSELING, *VIRAL load, *RESEARCH methodology, *MEDICAL cooperation, *EVALUATION research, *COMPARATIVE studies, *RESEARCH funding, *SEXUAL partners
Abstract

Background: Antiretroviral therapy (ART) efficacy for HIV prevention among discordant couples has been demonstrated in clinical trials. Effectiveness outside of research settings is less well understood.Methods: HIV-discordant couples were enrolled in couples' testing and follow-up at 20 government clinics in Kigali from 2010 to 2014. We performed viral linkage analysis on seroconverting couples to determine infection sources (intracouple vs. extracouple). Antiretroviral therapy use in index partners was collected at baseline and during follow-up by self-report with verification of government medical records.Results: A total of 3777 HIV-discordant couples were identified and followed up at government health clinics. Fifty-four incident HIV infections were identified, of which 36 were confirmed linked to the index partner, 4 were unlinked, and 14 were unknown. Among the 50 linked or unknown transmission pairs, 38% occurred among couples in which the index partner was on ART (HIV incidence rate of 0.63/100 person-years), whereas 62% occurred among couples in which the index partner was not on ART (HIV incidence rate of 5.51/100 person-years; adjusted rate ratio, 6.9). HIV acquisition was higher in women than in men with non-ART using index partners (P < 0.001).Conclusions: Couples in a government clinic couples' HIV testing and follow-up program in Rwanda had an 89% reduction in HIV incidence when index partners were using ART, slightly lower than efficacy estimates from randomized trials. Antiretroviral therapy for prevention should be prioritized for key populations including discordant couples identified via couples' voluntary counseling and testing, with increased efforts to improve uptake, adherence, and viral load monitoring. [ABSTRACT FROM AUTHOR]

Published
2021
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32. Female sex workers in Kigali, Rwanda: a key population at risk of HIV, sexually transmitted infections, and unplanned pregnancy

Author

Ingabire, Rosine, primary, Parker, Rachel, additional, Nyombayire, Julien, additional, Ko, Jasmine E, additional, Mukamuyango, Jeannine, additional, Bizimana, Jean, additional, Price, Matt A, additional, Laufer, Dagna, additional, Tichacek, Amanda, additional, Wall, Kristin, additional, Allen, Susan, additional, and Karita, Etienne, additional

Published
2019
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33. Evaluation of a multi-level intervention to improve postpartum intrauterine device services in Rwanda

Author

Ingabire, Rosine, primary, Nyombayire, Julien, additional, Hoagland, Alexandra, additional, Da Costa, Vanessa, additional, Mazzei, Amelia, additional, Haddad, Lisa, additional, Parker, Rachel, additional, Sinabamenye, Robertine, additional, Mukamuyango, Jeannine, additional, Smith, Julie, additional, Umutoni, Victoria, additional, Mork, Ellen, additional, Allen, Susan, additional, Karita, Etienne, additional, and Wall, Kristin M., additional

Published
2019
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34. An Exploratory Analysis of Factors Associated With Interest in Postpartum Intrauterine Device Uptake Among Pregnant Women and Couples in Kigali, Rwanda

Author

Da Costa, Vanessa, primary, Ingabire, Rosine, additional, Sinabamenye, Robertine, additional, Karita, Etienne, additional, Umutoni, Victoria, additional, Hoagland, Alexandra, additional, Allen, Susan, additional, Mork, Ellen, additional, Parker, Rachel, additional, Mukamuyango, Jeannine, additional, Haddad, Lisa, additional, Nyombayire, Julien, additional, and Wall, Kristin M, additional

Published
2019
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35. Cross-sectional assessment of determinants of STIs among men who have sex with men and transgender women in Kigali, Rwanda

Author

Twahirwa Rwema, Jean Olivier, Herbst, Sara, Hamill, Matthew M, Liestman, Benjamin, Nyombayire, Julien, Lyons, Carrie E, Mugwaneza, Placidie, Makuza, Jean Damascène, Sullivan, Patrick Sean, Allen, Susan, Karita, Etienne, and Baral, Stefan

Abstract

BackgroundSTIs among men who have sex with men (MSM) and transgender women (TGW) continue to increase. In Rwanda, STI management relies on syndromic management with limited empirical data characterising the burden of specific STIs among MSM/TGW. This study evaluated the prevalence of syphilis, Neisseria gonorrhoeae(NG) and Chlamydia trachomatis(CT) and associated factors among MSM/TGW in Kigali.MethodsFrom March to August 2018, 737 MSM/TGW >18 years were enrolled using respondent-driven sampling (RDS). Structured interviews and HIV/STI screening were conducted. Syphilis was screened with rapid plasma reagin confirmed by Treponema pallidumhemagglutination assay. CT/NG were tested by Cepheid GeneXpert. RDS-adjusted multivariable Poisson regression models with robust variance estimation were used to evaluate factors associated with any STI, and determinants of urethral and rectal STIs separately.ResultsPrevalence of any STI was 20% (RDS adjusted: 16.7% (95% CI: 13.2% to 20.2%)). Syphilis was 5.7% (RDS adjusted: 6.8% (95% CI: 4.3% to 9.4%)). CT was 9.1% (RDS adjusted: 6.1% (95% CI: 3.9% to 8.4%)) and NG was 8.8% (RDS adjusted: 7.1% (95% CI: 4.9% to 9.2%)). STIs were more common among older MSM and those with HIV (p<0.05). Of CT infections, 67% were urethral, 27% rectal and 6% were dual site. For NG infections, 52% were rectal, 29% urethral and 19% were dual site. Overall, 25.8% (23 of 89) of those with confirmed STI and returned for their results were symptomatic at time of testing.STI symptoms in the previous year (adjusted prevalence ratio (aPR): 1.94 (95% CI: 1.26 to 2.98)) were positively associated with any STI. Being circumcised was negatively associated with any STI (aPR: 0.47 (95% CI: 0.31 to 0.73)). HIV was positively associated with rectal STIs (aPR: 3.50 (95% CI: 1.09 to 11.21)) but negatively associated with urethral STIs.ConclusionMSM/TGW, especially those living with HIV, are at high risk of STIs in Rwanda with the vast majority being asymptomatic. These data suggest the potential utility of active STI surveillance strategies using highly sensitive laboratory methods among those at high risk given the anatomical distribution and limited symptomatology of STIs observed among Rwandan MSM/TGW.

Published
2022
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37. Evaluation of a multi-level intervention to improve postpartum intrauterine device services in Rwanda

Author

Ingabire, Rosine, primary, Nyombayire, Julien, additional, Hoagland, Alexandra, additional, Da Costa, Vanessa, additional, Mazzei, Amelia, additional, Haddad, Lisa, additional, Parker, Rachel, additional, Sinabamenye, Robertine, additional, Mukamuyango, Jeannine, additional, Smith, Julie, additional, Umutoni, Victoria, additional, Mork, Ellen, additional, Allen, Susan, additional, Karita, Etienne, additional, and Wall, Kristin M., additional

Published
2018
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38. Evaluation of a multi-level intervention to improve post-partum intrauterine device services in Rwanda

Author

Ingabire, Rosine, primary, Nyombayire, Julien, additional, Hoagland, Alexandra, additional, Da Costa, Vanessa, additional, Mazzei, Amelia, additional, Haddad, Lisa, additional, Parker, Rachel, additional, Sinabamenye, Robertine, additional, Mukamuyango, Jeannine, additional, Smith, Julie, additional, Umutoni, Victoria, additional, Mork, Ellen, additional, Allen, Susan, additional, Karita, Etienne, additional, and Wall, Kristin M., additional

Published
2018
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40. Postpartum long-acting contraception uptake and service delivery outcomes after a multilevel intervention in Kigali, Rwanda

Author

Espey, Julie, Ingabire, Rosine, Nyombayire, Julien, Hoagland, Alexandra, Da Costa, Vanessa, Mazzei, Amelia, Haddad, Lisa B, Parker, Rachel, Mukamuyango, Jeannine, Umutoni, Victoria, Allen, Susan, Karita, Etienne, Tichacek, Amanda, and Wall, Kristin M

Abstract

IntroductionPostpartum family planning (PPFP) is critical to reduce maternal–child mortality, abortion and unintended pregnancy. As in most countries, the majority of PP women in Rwanda have an unmet need for PPFP. In particular, increasing use of the highly effective PP long-acting reversible contraceptive (LARC) methods (the intrauterine device (IUD) and implant) is a national priority. We developed a multilevel intervention to increase supply and demand for PPFP services in Kigali, Rwanda.MethodsWe implemented our intervention (which included PPFP promotional counselling for clients, training for providers, and Ministry of Health stakeholder involvement) in six government health facilities from August 2017 to October 2018. While increasing knowledge and uptake of the IUD was a primary objective, all contraceptive method options were discussed and made available. Here, we report a secondary analysis of PP implant uptake and present already published data on PPIUD uptake for reference.ResultsOver a 15-month implementation period, 12 068 women received PPFP educational counselling and delivered at a study facility. Of these women, 1252 chose a PP implant (10.4% uptake) and 3372 chose a PPIUD (27.9% uptake). On average providers at our intervention facilities inserted 83.5 PP implants/month and 224.8 PPIUDs/month. Prior to our intervention, 30 PP implants/month and 8 PPIUDs/month were inserted at our selected facilities. Providers reported high ease of LARC insertion, and clients reported minimal insertion anxiety and pain.ConclusionsPP implant and PPIUD uptake significantly increased after implementation of our multilevel intervention. PPFP methods were well received by clients and providers.

Published
2021
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42. First-in-Human Evaluation of the Safety and Immunogenicity of an Intranasally Administered Replication-Competent Sendai Virus–Vectored HIV Type 1 Gag Vaccine: Induction of Potent T-Cell or Antibody Responses in Prime-Boost Regimens

Author

Nyombayire, Julien, primary, Anzala, Omu, additional, Gazzard, Brian, additional, Karita, Etienne, additional, Bergin, Philip, additional, Hayes, Peter, additional, Kopycinski, Jakub, additional, Omosa-Manyonyi, Gloria, additional, Jackson, Akil, additional, Bizimana, Jean, additional, Farah, Bashir, additional, Sayeed, Eddy, additional, Parks, Christopher L., additional, Inoue, Makoto, additional, Hironaka, Takashi, additional, Hara, Hiroto, additional, Shu, Tsugumine, additional, Matano, Tetsuro, additional, Dally, Len, additional, Barin, Burc, additional, Park, Harriet, additional, Gilmour, Jill, additional, Lombardo, Angela, additional, Excler, Jean-Louis, additional, Fast, Patricia, additional, Laufer, Dagna S., additional, and Cox, Josephine H., additional

Published
2016
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43. Assessment of Anti–HIV-1 Antibodies in Oral and Nasal Compartments of Volunteers From 3 Different Populations

Author

Bergin, Philip J., primary, Langat, Robert, additional, Omosa-Manyonyi, Gloria, additional, Farah, Bashir, additional, Ouattara, Gina, additional, Park, Harriet, additional, Coutinho, Helen, additional, Laufer, Dagna, additional, Fast, Pat, additional, Verlinde, Carl, additional, Bizimana, Jean, additional, Umviligihozo, Gisele, additional, Nyombayire, Julien, additional, Ingabire, Rosine, additional, Kuldanek, Kristin, additional, Cox, Josephine, additional, McMorrow, Martin, additional, Fidler, Sarah, additional, Karita, Etienne, additional, Gilmour, Jill, additional, and Anzala, Omu, additional

Published
2016
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44. A Phase I Double Blind, Placebo-Controlled, Randomized Study of the Safety and Immunogenicity of Electroporated HIV DNA with or without Interleukin 12 in Prime-Boost Combinations with an Ad35 HIV Vaccine in Healthy HIV-Seronegative African Adults

Author

Mpendo, Juliet, primary, Mutua, Gaudensia, additional, Nyombayire, Julien, additional, Ingabire, Rosine, additional, Nanvubya, Annet, additional, Anzala, Omu, additional, Karita, Etienne, additional, Hayes, Peter, additional, Kopycinski, Jakub, additional, Dally, Len, additional, Hannaman, Drew, additional, Egan, Michael A., additional, Eldridge, John H., additional, Syvertsen, Kristen, additional, Lehrman, Jennifer, additional, Rasmussen, Beth, additional, Gilmour, Jill, additional, Cox, Josephine H., additional, Fast, Patricia E., additional, and Schmidt, Claudia, additional

Published
2015
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45. First-in-Human Evaluation of the Safety and Immunogenicity of an Intranasally Administered Replication-Competent Sendai Virus-Vectored HIV Type 1 Gag Vaccine: Induction of Potent T-Cell or Antibody Responses in Prime-Boost Regimens.

Author

Nyombayire, Julien, Anzala, Omu, Gazzard, Brian, Karita, Etienne, Bergin, Philip, Hayes, Peter, Kopycinski, Jakub, Omosa-Manyonyi, Gloria, Jackson, Akil, Bizimana, Jean, Farah, Bashir, Sayeed, Eddy, Parks, Christopher L., Makoto Inoue, Takashi Hironaka, Hiroto Hara, Tsugumine Shu, Tetsuro Matano, Dally, Len, and Barin, Burc

Subjects
*SENDAI virus diseases, *RNA virus infections, *T-cell lymphoma, *ANTIBODY formation, *REVERSE transcriptase, *HIV prevention, *INTRANASAL medication, *AIDS vaccines, *CELLULAR immunity, *CLINICAL trials, *COMPARATIVE studies, *GENES, *HIV, *HIV infections, *IMMUNIZATION, *RESEARCH methodology, *MEDICAL cooperation, *PARAMYXOVIRUSES, *RESEARCH, *T cells, *VACCINES, *VIRAL antibodies, *EVALUATION research, *RANDOMIZED controlled trials, *PHYSIOLOGY
Abstract

Background:  We report the first-in-human safety and immunogenicity assessment of a prototype intranasally administered, replication-competent Sendai virus (SeV)-vectored, human immunodeficiency virus type 1 (HIV-1) vaccine.Methods:  Sixty-five HIV-1-uninfected adults in Kenya, Rwanda, and the United Kingdom were assigned to receive 1 of 4 prime-boost regimens (administered at 0 and 4 months, respectively; ratio of vaccine to placebo recipients, 12:4): priming with a lower-dose SeV-Gag given intranasally, followed by boosting with an adenovirus 35-vectored vaccine encoding HIV-1 Gag, reverse transcriptase, integrase, and Nef (Ad35-GRIN) given intramuscularly (SLA); priming with a higher-dose SeV-Gag given intranasally, followed by boosting with Ad35-GRIN given intramuscularly (SHA); priming with Ad35-GRIN given intramuscularly, followed by boosting with a higher-dose SeV-Gag given intranasally (ASH); and priming and boosting with a higher-dose SeV-Gag given intranasally (SHSH).Results:  All vaccine regimens were well tolerated. Gag-specific IFN-γ enzyme-linked immunospot-determined response rates and geometric mean responses were higher (96% and 248 spot-forming units, respectively) in groups primed with SeV-Gag and boosted with Ad35-GRIN (SLA and SHA) than those after a single dose of Ad35-GRIN (56% and 54 spot-forming units, respectively) or SeV-Gag (55% and 59 spot-forming units, respectively); responses persisted for ≥8 months after completion of the prime-boost regimen. Functional CD8+ T-cell responses with greater breadth, magnitude, and frequency in a viral inhibition assay were also seen in the SLA and SHA groups after Ad35-GRIN boost, compared with those who received either vaccine alone. SeV-Gag did not boost T-cell counts in the ASH group. In contrast, the highest Gag-specific antibody titers were seen in the ASH group. Mucosal antibody responses were sporadic.Conclusions:  SeV-Gag primed functional, durable HIV-specific T-cell responses and boosted antibody responses. The prime-boost sequence appears to determine which arm of the immune response is stimulated.Clinical Trials Registration:  NCT01705990. [ABSTRACT FROM AUTHOR]

Published
2017
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47. Prevalence of HIV, Sexual Transmitted Infections and High Risk Sexual Behaviors among Female Sex Workers in Kigali, Rwanda

Author

Mukamuyango, Jeannine, primary, Ingabire, Rosine, additional, Karita, Etienne, additional, Nyombayire, Julien, additional, Sinabamenye, Robertine, additional, Ahmed, Nuri, additional, Nduwamungu, Jean Nepo, additional, Radjabari, Sukaina, additional, Oppert, Marydale, additional, Price, Matt, additional, Priddy, Frances, additional, Fast, Pat, additional, Tichacek, Amanda, additional, and Allen, Susan, additional

Published
2014
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48. Capacity Strengthening and Training of Government Nurses on Long-acting Reversible Contraceptive (LARC) Methods in Kigali, Rwanda

Author

Ingabire, Rosine, primary, Karita, Etienne, additional, Ahmed, Nurilign, additional, Bayingana, Roger, additional, Nyombayire, Julien M., additional, Sinabamenye, Robertine, additional, Nduwamungu, Jean N., additional, Uwamahoro, Honoree, additional, Strunk, Sarah, additional, Tichacek, Amanda, additional, and Allen, Susan, additional

Published
2014
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49. Clinical Safety and Immunogenicity of Two HIV Vaccines SeV-G (NP) and Ad35-GRIN in HIV-uninfected, Healthy Adult Volunteers

Author

Karita, Etienne, primary, Anzala, Omu, additional, Gazzard, Brian, additional, Bergin, Philip, additional, Nyombayire, Julien, additional, Omosa, Gloria, additional, Jackson, Akil, additional, Ingabire, Rosine, additional, Ouattara, Gina, additional, Park, Harriet, additional, Gumbe, Anne, additional, Chinyenze, Kundai, additional, Welsh, Sabrina, additional, Verlinde, Carl, additional, Clark, Lorna, additional, Chetty, Paramesh, additional, Booley, Mumtaz, additional, Bizimana, Jean, additional, Farah, Bashir, additional, Hayes, Peter, additional, Zachariah, Devika, additional, Syvertsen, Kristen, additional, Lim, Michele Fong, additional, Dally, Len, additional, Barin, Burc, additional, Inoue, Makoto, additional, Hara, Hiroto, additional, Hironaka, Takashi, additional, Shu, Tsugumine, additional, Hasegawa, Mamoru, additional, Matano, Tetsuro, additional, Sayeed, Eddy, additional, Parks, Christopher, additional, Ackland, Jim, additional, Fast, Patricia M., additional, Gilmour, Jill, additional, Cox, Josephine H., additional, Lombardo, Angela, additional, and Laufer, Dagna, additional

Published
2014
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50. Long-term follow-up of study participants from prophylactic HIV vaccine clinical trials in Africa

Author

Schmidt, Claudia, primary, Jaoko, Walter, additional, Omosa-Manyonyi, Gloria, additional, Kaleebu, Pontiano, additional, Mpendo, Juliet, additional, Nanvubya, Annet, additional, Karita, Etienne, additional, Bayingana, Roger, additional, Bekker, Linda-Gail, additional, Chomba, Elwyn, additional, Kilembe, William, additional, Nchabeleng, Maphoshane, additional, Nyombayire, Julien, additional, Stevens, Gwynn, additional, Chetty, Paramesh, additional, Lehrman, Jennifer, additional, Cox, Josephine, additional, Allen, Susan, additional, Dally, Len, additional, Smith, Carol, additional, and Fast, Patricia E, additional

Published
2013
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