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Past Research

2020-2021

Bending the Mental Distress Curve Among COVID-19 Responders: A Pilot Feasibility Study

This project developed and tested for feasibility and acceptability a chatbot aimed at screening and referring first responders experiencing mental distress to care matching their intensity of need, readiness for change, care preferences, and level of stigma surrounding help seeking.

2020-2021

Developing a Business Model for the 鈥淭ABATHA鈥� (Tampa Bay Area Treatment
& Health Advisor) Chatbot

This funding supported the exploration of the potential business market for the TABATHA chatbot, which aims to address behavioral healthcare systems demands and also the mental health care gap through screening and referral to services matching the intensity of one鈥檚 needs.

2019-2021

Transitioning from the Pediatric to the Adult Care Setting 鈥� Project PASEO

By building on our well-established community-health platform and existing
intervention research with HIV-positive adolescents in urban Lima, Peru, we sought to fill a key implementation gap by examining whether a community-based accompaniment intervention delivered by community health workers is efficacious in bridging the transition for adolescents from pediatric to adult HIV care. This study sought to determine the feasibility of community-based accompaniment as an intervention for bridging the transition to adult HIV care in two groups of adolescents in Peru (perinatally infected adolescents and newly diagnosed young men who have sex with men and transgender women) and collect information critical to informing a future
randomized, clinical trial.

2018-2020

Halting All Types of Tuberculosis (HALT-TB)

This project comprised implementation research and impact evaluation of interventions for tuberculosis (TB) active case-finding and treatment of tuberculosis infection in Peru, Kenya, and Pakistan. In each of these sites, mobile digital radiograph units provided rapid screening of TB hotspots previously identified by epidemiological surveillance; in Peru, we plan to screen 100,000 persons. A major component of this project involved community engagement. Using a social justice/rights-based perspective and informed by the theory of diffusion of innovations, we promoted TB screening by working with community leaders and other stakeholders to disseminate messages encouraging uptake of TB screening and linkage to care and provision of community-based mental health
services

2019-2020

WHO EQUIP: Ensuring Quality in Psychological Support. Funder: WHO (PI: Lecca, L - Peru Site)

The goal of this project was to test a platform for training and supervision of mental health and psychosocial support helpers (particularly non-specialist providers) by applying the platform to helpers who will deliver WHO low-intensity psychological interventions and related non-WHO psychological interventions. This platform, entitled Ensuring Quality in Psychological Support (EQUIP), is an online resource being developed to include materials for evaluating core and specific competencies, training and training remediation for learning and attaining core competencies, and implementation guidance on designing and conducting competency-based trainings and supervision. The research evaluated the feasibility, acceptability, perceived utility, reliability and validity of the EQUIP platform and its materials in seven (7) countries: Jordan, Kenya, Lebanon, Peru, Uganda, Zambia and Ethiopia.

Project SexFlow: Mapping HIV among Venezuelan migrants in Peru

This was a large epidemiological study of HIV, sexually transmitted infections and associated risk factors among recent Venezuelan migrants in Peru.

2015-2019

Investigating off-prescription use of pre-exposure prophylaxis for HIV prevention

This project investigated the use of antiretroviral medication (ARV) to prevent people from acquiring HIV in countries where these drugs were not formally approved for such use. The aim is to understand, at a global level, the current practices and experiences of the clinicians who prescribe ARV and the patients who take them.

2016-2018

Diagnostic and treatment delays in pediatric tuberculosis.

TB is difficult to diagnose in children. Treatment delays can lead to severe and fatal forms of TB which itself is often undetectable with usual tests in children. As a result, clinicians must diagnose TB based on signs and symptoms. This study examined two key knowledge gaps about TB treatment delays in children to: (1) Understand how recently revised consensus criteria for standardized clinical case definitions for pediatric TB intersect with clinical diagnoses; and, (2) identify the factors that impede or facilitate rapid TB treatment initiation following a TB diagnosis through qualitative interviews with parents, providers, and field workers.

2015-2018

Metabolic factors that control the spectrum of human tuberculosis

This project addressed the link between metabolic and immunological determinants of TB, the function of T cells in TB infection, the determinants of TB drug resistance and the potential for improved diagnostics that identify pathogen-shed molecules in human samples.

2014-2018

Integrated discovery and development of innovative TB Diagnostics

This study laid the foundation for the development of a rapid, inexpensive tool to address these challenges through biomarker discovery and analysis, optimization of sampling strategies for children and the development and optimization of a microarray based test for TB and drug resistance.

2011-2016

The role of genital warts in HIV acquisition among MSM in Lima, Peru

The primary objective of this study was to determine the role of GW on HIV acquisition among MSM in Peru. The secondary objectives were to determine HPV prevalence in HIV positive MSM in Peru, and the knowledge of HPV and HIV among MSM.

2011-2012

Sexual health, community education, and STI outreach activities for MSM

This project implemented a community-based HIV/STI clinic for MSM and provided training for volunteer counselors and clinicians.

2009-2011

Acceptability of Rectal Microbicides (RM): Barriers and facilitators of RM use among MSM in four South American cities

This study examined the acceptability of using rectal microbicides (RM) and participating in RM clinical trials among MSM and TGW in Peru, Ecuador and Brazil

2010-2015

Using online social networks for HIV prevention in African American/Latino MSM

This study evaluated the acceptability, feasibility, and preliminary effectiveness of using online social networks to increase HIV prevention among Peruvian MSM.

2010-2014

Prevalence, risk factors and consequences of complex M. Tuberculosis infections

This study evaluated the prevalence, risk factors and consequences of complex M. tuberculosis infection in Pietermaritzburg, South Africa.

2007-2014

Epidemiology and transmission dynamics of MDR/XDR tuberculosis

This multidisciplinary study explored pathogen, host, and environmental factors on the distribution and dynamics of highly drug-resistant tuberculosis in Lima, Peru among a population-based cohort of 15,000 participants.

2006-2012

Comunidades positivas and enhanced partner therapy in Peru

This project tested two interventions (one behavioral and one biomedical) to prevent HIV and STI transmission among HIV- or STI-positive men who have sex with men in Lima, Peru.

2006-2011

Epidemiology of multidrug-resistant tuberculosis

The goal of this project was to provide new knowledge about the transmission dynamics of multidrug-resistant tuberculosis in a high TB-burden area in Peru and included measurement of within-household transmission of various strains of TB, the impact of socio-demographic and clinical confounders and risk modifiers, and measure associations between specific resistance mutations and phenotypes.

2008-2009

Effectiveness of Community-Level Behavioral and Biomedical Interventions for Reducing HIV/STIs in Men in Peru

This tested two interventions (one behavioral and one biomedical) to prevent HIV and STI transmission among HIV- or STI-positive men who have sex with men in Lima, Peru.

2005-2009

Integrating HIV/STI Prevention/Treatment in China

This collaboration between the University of California, Los Angeles, University of California, San Francisco, University of Oxford and Anhui Medical University aimed to teach physicians how to enhance and integrate prevention and care for HIV and STIs.

2004-2009

NIMH Collaborative HIV/STD Prevention Trial

The NIMH Collaborative HIV/STD Prevention Trial was a two-arm randomized, community-level trial conducted in five countries--China, India, Peru, Russia, and Zimbabwe. It was the first international test of a community-level prevention program based on the theory of diffusion of innovations utilizing Community Public Opinion Leaders (C-POLs). Based on a set of ethnographic studies conducted over 18 months and a series of epidemiological studies with over 9000 participants in the five countries, an assessment and the CPOL intervention was culturally adapted, piloted and mounted in randomly chosen venues in each country. The intervention's efficacy in reducing selfreported behavioral risk with non-spousal partners and incident sexually transmitted diseases was on a baseline, 12- and 24- month interviews and collection of biological specimens. 

2004-2009

Rectal Health, Behaviors and Microbicide Acceptability

This study guided the development of rectal microbicides by providing descriptive data on anal sex, anal health, and the acceptability of carrier methods for rectal microbicides. We tested hypotheses associating sexual behaviors (receptive anal intercourse) and anal health among 896 men and women including HIV positive and negative subjects in Los Angeles and Baltimore.

2003-2008

HIV/AIDS Risk Behaviors in Methamphetamine User Networks

This was a cohort study of drug using men who have sex with men (MSM), drug using MSM/W, and non-drug using MSM and their male and female sexual partners that examined the diffusion of HIV and STI in drug users in LA County to identify the individual-level, partnership-level, and environmental factors that promoted the spread of these diseases.

1998-2004

STDS and Heterosexual 鈥楤ridging鈥� Among Men Who Have Sex with Men: Project Explore

This study tested a 10-session behavioral, motivational interviewing counseling intervention based on the theory of Stages of Change among 725 men who have sex with men in Seattle, WA.