Francisco Mbofana

• Ministry of Health, Mozambique

Background: In sub-Saharan Africa (SSA), integrating HIV testing into antenatal care (ANC) has been crucial toward reducing mother-to-child transmission of HIV. With the introduction of new testing modalities, we explored temporal trends in HIV testing within and outside of ANC and identified sociodemographic determinants of testing during ANC. Me...

Intimate partner violence (IPV) may increase women’s HIV acquisition risk. Still, knowledge on pathways through which IPV exacerbates HIV burden is emerging. We examined the individual and partnership-level characteristics of male perpetrators of physical and/or sexual IPV and considered their implications for women’s HIV status. We pooled individu...

Background Achieving the 95-95-95 targets for HIV diagnosis, treatment, and viral load suppression to end the HIV epidemic hinges on eliminating structural inequalities, including intimate partner violence (IPV). Sub-Saharan Africa has among the highest prevalence of IPV and HIV worldwide. We aimed to examine the effects of IPV on recent HIV infect...

Background: Achieving the 95-95-95 targets for HIV diagnosis, treatment, and viral load suppression (VLS) to end the HIV/AIDS epidemic hinges on eliminating structural inequalities, including intimate partner violence (IPV). Sub-Saharan Africa (SSA) has among the world's highest prevalence of IPV and HIV. We aim to examine the impact of IPV on rece...

Background: Measuring recent HIV infections from routine surveillance systems could allow timely and granular monitoring of HIV incidence patterns. We evaluated the relationship of two recent infection indicators with alternative denominators to true incidence patterns. Methods: We used a mathematical model of HIV testing behaviors, calibrated t...

Background: Monitoring knowledge of HIV status among people living with HIV is essential for an effective national HIV response. This study estimates progress and gaps in reaching the UNAIDS 2020 target of 90% knowledge of status, and the efficiency of HIV testing services in sub-Saharan Africa, where two thirds of all people living with HIV reside...

Background Knowledge of HIV status (KOS) among people living with HIV (PLHIV) is essential for an effective national HIV response. This study estimates progress and gaps in reaching the UNAIDS 2020 target of 90% KOS, and the efficiency of HIV testing services (HTS) in sub-Saharan Africa (SSA), where two thirds of all PLHIV live. Methods We used da...

Background From 2009 to 2014, the prevalence of HIV among adults in Mozambique increased from 11.5% to 13.2%. To reduce disease progression and prevent transmission, HIV-infected persons must have access to timely, continuous, high-quality HIV care and treatment services. This study aim to identify the barriers to early diagnosis, access to medical...

According to 'Countdown to 2015', more than 114,000 children die each year in Mozambique before reaching their fifth birthday. And is estimated 45% of these deaths is linked to malnutrition. The purpose of this study was to determine the prevalence of chronic malnutrition, acute malnutrition and underweight in children under 2 years of age. A cross...

Objective: HIV testing services (HTS) are a crucial component of national HIV responses. Learning one's HIV diagnosis is the entry point to accessing life-saving antiretroviral treatment and care. Recognizing the critical role of HTS, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the 90-90-90 targets stipulating that by 2020, 90...

A bstract Objective HIV testing services (HTS) are a crucial component of national HIV responses. Learning one’s HIV diagnosis is the entry point to accessing life-saving antiretroviral treatment and care. Recognizing the critical role of HTS, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the 90-90-90 targets stipulating that by...

HIV test-and-treat programmes are being implemented throughout sub-Saharan Africa, enrolling HIV-positive clients into antiretroviral treatment (ART) immediately after diagnosis, regardless of clinical stage or CD4 count. This study conducted in Mozambique examined what influenced clients who tested HIV-positive in the context of test-and-treat to...

Background In mid-2016, Mozambique began phased implementation of the ‘Test-and-Treat’ policy, which enrolls HIV positive clients into antiretroviral treatment (ART) immediately regardless of CD4 cell count or disease stage. Novel insights into barriers and facilitators to ART initiation among healthy clients are needed to improve implementation of...

The purpose of this study was to determine the prevalence of chronic malnutrition, acute malnutrition, and underweight in children under 2 years of age. Main messages: • The prevalence of chronic malnutrition was high in the three provinces, although with different magnitudes. • Our findings allowed us to draw recommendations in order to improve...

The study’s purpose was to obtain data on program’s key indicators such as the percentage of women with children under 2 years old which attended both prenatal and postpartum consultation and which had institutional delivery.

What is already known about this topic? Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/µL) among persons initiating antiretroviral therapy (ART) is important to help understand ART program outcomes, inform HIV prevention strategies, and forecast need for adjunctive therapies. What is...

Introduction: This study describes the development of a self-audit tool for public health and the associated methodology for implementing a district health system self-audit tool that can provide quantitative data on how district governments perceive their performance of the essential public health functions. Methods: Development began with a co...

Background: During 2004-2013 in Mozambique, 455,600 HIV-positive adults (≥15 years old) initiated antiretroviral therapy (ART). We evaluated trends in patient characteristics and outcomes during 2004-2013, outcomes of universal treatment for pregnant women (Option B+) implemented since 2013, and effect on outcomes of distributing ART to stable pat...

Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLH...

Equitable access to antiretroviral therapy (ART) for men and women with human immunodeficiency virus (HIV) infection is a principle endorsed by most countries and funding bodies, including the U.S. President's Emergency Plan for AIDS (acquired immunodeficiency syndrome) Relief (PEPFAR) (1). To evaluate gender equity in ART access among adults (defi...

Medication adherence is an effective approach to prevent HIV transmission. In Mozambique, a country with a generalized epidemic, the government has adopted Positive Prevention (PP) training for clinicians as part of its national strategy. Our study, conducted after trainings in five clinics, examined the understanding of trained health care staff a...

Mozambique suffers from critical shortages of healthcare workers including non-physician clinicians, Tecnicos de Medicina Geral (TMGs), who are often senior clinicians in rural health centres. The Mozambique Ministry of Health and the International Training and Education Center for Health, University of Washington, Seattle, revised the national cur...

Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines of about 30% in the global annual number of human immunodeficiency (HIV)-related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50% and estimated adolescent HIV incidence has been relat...

Objective: To determine factors associated with HIV status unawareness and assess HIV prevention knowledge and condom use among people living with HIV/AIDS (PLHIV) in Mozambique. Design: Cross-sectional household-based nationally representative AIDS Indicator Survey. Methods: Analyses focused on HIV-infected adults and were weighted for the co...

Introduction: Mozambique suffers from a critical shortage of healthcare workers. Mid-level healthcare workers, (Tecnicos de Geral (TMG)), in Mozambique require less money and time to train than physicians. From 2009-2010, the Ministry of Health (MoH) and the International Training and Education Center for Health (I-TECH), University of Seattle, rev...

To improve retention on ART, Médecins Sans Frontières, the Ministry of Health and patients piloted a community-based antiretroviral distribution and adherence monitoring model through Community ART Groups (CAG) in Tete, Mozambique. By December 2012, almost 6000 patients on ART had formed groups of whom 95.7% were retained in care. We conducted a qu...

Evaluation of differences between human immunodeficiency virus (HIV)-infected men and women in antiretroviral therapy (ART) enrollment characteristics and outcomes might identify opportunities to improve ART program patient outcomes and prevention impact. During September 2008-February 2012, retrospective cohort studies to estimate attrition of enr...

The rapid scale-up of HIV care and treatment in Mozambique has provided an opportunity to reach people living with HIV (PLHIV) with prevention interventions in HIV care and treatment settings. A three-day Positive Prevention (PP) training intervention for health care providers that focused on pressing issues for PLHIV in Mozambique was adapted and...

In Mozambique, tuberculosis (TB) is thought to be the most common cause of death among antiretroviral therapy (ART) enrollees. Monitoring proportions of enrollees screened for TB, and incidence and determinants of TB during ART can help clinicians and program managers identify program improvement opportunities. We conducted a retrospective cohort s...

In Mozambique during 2004-2007 numbers of adult patients (≥15 years old) enrolled on antiretroviral therapy (ART) increased about 16-fold, from <5,000 to 79,500. All ART patients were eligible for co-trimoxazole. ART program outcomes, and determinants of outcomes, have not yet been reported. In a retrospective cohort study, we investigated rates of...