Scholars@Duke
Dorothy Elizabeth Dow

Dorothy Elizabeth Dow

Associate Professor of Pediatrics
Pediatrics, Infectious Diseases
dorothy.dow@duke.edu
DUMC, Box 3499, Durham, NC 27710
2301 Erwin Road, Durham, NC 27710

Selected Publications

Evidence Gaps in Economic Evaluations of HIV Interventions Targeting Young People: A Systematic Review.

Journal Article J Adolesc Health · November 2024 PURPOSE: Young people living with HIV (YPLWH) face the burden of navigating the unique physical, psychological, and social challenges of adolescence while coping with a stigmatized infectious disease that requires lifelong care. Consequently, YPLWH experie ... Full text Link to item Cite

Through the looking glass: empowering youth community advisory boards in Tanzania as a sustainable youth engagement model to inform policy and practice.

Journal Article Front Public Health · 2024 More young people are living in the world than ever before, 90% of whom reside in low and middle income countries (LMICs). To address their needs, it is critical to have sustainable youth engagement when determining policy and to advance effective implemen ... Full text Link to item Cite

Study protocol for Sauti ya Vijana (The Voice of Youth): A hybrid-type 1 randomized trial to evaluate effectiveness and implementation of a mental health and life skills intervention to improve health outcomes for Tanzanian youth living with HIV.

Journal Article PLoS One · 2024 OBJECTIVE: Young people living with HIV (YPLWH) experience increased morbidity and mortality compared to all other age groups. Adolescence brings unique challenges related to sexual reproductive health, the elevated importance of peer groups, and often, em ... Full text Link to item Cite

Building locally anchored implementation science capacity: the case of the adolescent HIV implementation science alliance-supported local iS alliances

Journal Article Frontiers in Health Services · January 1, 2024 Background: The Fogarty International Center-led Adolescent HIV Implementation Science Alliance (AHISA) supports region-/country-specific implementation science (IS) alliances that build collaborations between research, policy, and program partners that re ... Full text Cite

Who Will Suffer Most if US AIDS Funding Ends.

Journal Article J Pediatric Infect Dis Soc · November 30, 2023 The President's Emergency Plan for AIDS Relief (PEPFAR) is among the most successful US global health programs. It has moved HIV/AIDS from a certain death to a treatable disease. PEPFAR is now in danger of not being renewed. This perspective seeks to highl ... Full text Open Access Link to item Cite

"I am not alone with tears": embodying stigma and longing among youth living with perinatally acquired HIV in Tanzania through a collaborative arts-based approach.

Journal Article Med Humanit · September 2023 It is estimated that 4 million youth aged 15-24 years live with HIV globally, 85% of whom live in sub-Saharan Africa. For youth living with perinatally acquired HIV (YPHIV), stigma is frequently linked with negative health outcomes. YPHIV face distinct HIV ... Full text Link to item Cite

Integrated Health Care Delivery for Adolescents Living with and at Risk of HIV Infection:  A Review of Models and Actions for Implementation.

Journal Article AIDS Behav · May 2023 Integrated service delivery, providing coordinated services in a convenient manner, is important in HIV prevention and treatment for adolescents as they have interconnected health care needs related to HIV care, sexual and reproductive health and disease p ... Full text Link to item Cite

Using the Implementation Research Logic Model as a Lens to View Experiences of Implementing HIV Prevention and Care Interventions with Adolescent Sexual Minority Men-A Global Perspective.

Journal Article AIDS Behav · May 2023 Adolescents and sexual minority men (SMM) are high priority groups in the United Nations' 2021 - 2016 goals for HIV prevention and viral load suppression. Interventions aimed at optimizing HIV prevention, testing and viral load suppression for adolescents ... Full text Link to item Cite

Impact of COVID-19 on Adolescent HIV Prevention and Treatment Research in the AHISA Network.

Journal Article AIDS Behav · May 2023 Members of the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) network conduct research aiming to close gaps between what is known to be impactful across the HIV prevention and treatment cascade, and services delivered to op ... Full text Link to item Cite

Integrating Adolescent Mental Health into HIV Prevention and Treatment Programs: Can Implementation Science Pave the Path Forward?

Journal Article AIDS Behav · May 2023 Adolescent mental health (AMH) is a critical driver of HIV outcomes, but is often overlooked in HIV research and programming. The implementation science Exploration, Preparation, Implementation, Sustainment (EPIS) framework informed development of a questi ... Full text Link to item Cite

Impact of COVID-19 on Adolescent HIV Prevention and Treatment Services in the AHISA Network.

Journal Article AIDS Behav · May 2023 We investigated perceived impacts of COVID-19 on the delivery of adolescent HIV treatment and prevention services in sub-Saharan Africa (SSA) by administering a survey to members of the Adolescent HIV Prevention and Treatment Implementation Science Allianc ... Full text Link to item Cite

Addressing the Know-Do Gap in Adolescent HIV: Framing and Measuring Implementation Determinants, Outcomes, and Strategies in the AHISA Network.

Journal Article AIDS Behav · May 2023 Implementation science (IS) uses systematic methods to close gaps between research and practice by identifying and addressing barriers to implementation of evidence-based interventions (EBIs). To reach UNAIDS HIV targets, IS can support programs to reach v ... Full text Link to item Cite

Sauti ya Vijana (SYV; The Voice of Youth): Longitudinal Outcomes of an Individually Randomized Group Treatment Pilot Trial for Young People Living with HIV in Tanzania.

Journal Article AIDS Behav · June 2022 Sauti ya Vijana is a mental health and life skills intervention delivered by young adult group leaders for the improvement of HIV outcomes in young people living with HIV in Tanzania. This pilot randomized controlled trial estimated exploratory interventio ... Full text Link to item Cite

A group-based mental health intervention for Tanzanian youth living with HIV: Secondary analysis of a pilot trial.

Journal Article Medicine (Baltimore) · February 18, 2022 BACKGROUND: Youth living with human immunodeficiency virus (YLWH) are vulnerable to incomplete adherence to antiretroviral therapy in the context of stigma, decreased hope for future, and mental health challenges. Despite these challenges, few mental healt ... Full text Link to item Cite

Adolescent mental health research in Tanzania: a study protocol for a priority setting exercise and the development of an interinstitutional capacity strengthening programme.

Journal Article BMJ Open · February 2, 2022 INTRODUCTION: Poor adolescent mental health is a barrier to achieving several sustainable development goals in Tanzania, where adolescent mental health infrastructure is weak. This is compounded by a lack of community and policy maker awareness or understa ... Full text Link to item Cite

Feasibility and acceptability of a peer youth led curriculum to improve HIV knowledge in Northern Tanzania: resilience and intervention experience from the perspective of peer leaders.

Journal Article BMC Public Health · October 23, 2021 BACKGROUND: Youth Living with HIV (YLWH) have reduced adherence to antiretroviral therapy (ART) and worse virologic outcomes compared to children and adults. HIV peer youth led (PYL) interventions contribute to improved retention in care and psychosocial w ... Full text Link to item Cite

IMPAACT 2016: Operationalizing HIV Intervention Adaptations to Inform the Science and Outcomes of Implementation

Journal Article Frontiers in Reproductive Health · January 1, 2021 Uptake of evidence-based interventions for adolescents and young adults living with HIV (AYA-LWH) in sub-Saharan Africa (SSA) is complex, and cultural differences necessitate local adaptations to enhance effective implementation. Few models exist toguide i ... Full text Cite

A group-based mental health intervention for young people living with HIV in Tanzania: results of a pilot individually randomized group treatment trial.

Journal Article BMC Public Health · September 4, 2020 BACKGROUND: Increasing numbers of young people living with HIV (YPLWH) have unaddressed mental health challenges. Such challenges are associated with poor antiretroviral therapy (ART) adherence and high mortality. Few evidence-based mental health intervent ... Full text Link to item Cite

Sexual Risk Behaviors and Menstrual and Intravaginal Practices Among Adolescent Girls and Young Women in Tanzania: A Cross-Sectional, School-Based Study

Journal Article International Journal of Sexual Health · January 1, 2020 Objectives: Objectives were to describe menstrual and intravaginal practices and sexual risk behaviors among adolescent girls and young women (AGYW) in Tanzania. Methods: A cross-sectional survey was conducted in secondary schools in Tanzania. Data on mens ... Full text Cite

Challenges and facilitators of transition from adolescent to adult HIV care among young adults living with HIV in Moshi, Tanzania.

Journal Article J Int AIDS Soc · October 2019 INTRODUCTION: Scale up of anti-retroviral therapy has enabled millions of children infected with HIV to survive into adulthood, requiring transition of care to the adult HIV clinic. This transition period is often met with anxiety and reluctance. Youth who ... Full text Open Access Link to item Cite

HIV-1 Drug Resistance and Virologic Outcomes Among Tanzanian Youth Living With HIV.

Journal Article Pediatr Infect Dis J · June 2019 Adolescents living with HIV tend to have poor adherence that often breeds HIV resistance mutations and virologic failure (VF). This study evaluated risk behavior, virologic outcomes and HIV resistance mutations in Tanzanian youth living with HIV. Participa ... Full text Link to item Cite

Caregiver role in HIV medication adherence among HIV-infected orphans in Tanzania.

Journal Article AIDS Care · June 2018 Youth living with HIV in sub-Saharan Africa face numerous challenges in adhering to HIV treatment. The AIDS epidemic has left many of these youth orphaned due to AIDS-related death of one or both parents. It is imperative to understand the family context o ... Full text Link to item Cite

Antiretroviral drug concentrations in hair are associated with virologic outcomes among young people living with HIV in Tanzania.

Journal Article AIDS · June 1, 2018 OBJECTIVE: We assessed the relationship of self-reported adherence versus antiretroviral therapy (ART) concentrations in hair with virologic outcomes among young people living with HIV. DESIGN: This was a cross-sectional study that enrolled young people li ... Full text Link to item Cite

Clostridium difficile cure with fecal microbiota transplantation in a child with Pompe disease: a case report.

Journal Article J Med Case Rep · April 28, 2018 BACKGROUND: Recurrent Clostridium difficile infection is a growing problem among children due to both the increasing survival of medically fragile children with complicated chronic medical conditions resulting in prolonged antibiotic exposure and hospitali ... Full text Link to item Cite

Modality of Primary HIV Disclosure and Association with Mental Health, Stigma, and Antiretroviral Therapy Adherence in Tanzanian Youth Living with HIV.

Journal Article AIDS Patient Care STDS · January 2018 Disclosing HIV status to children before adolescence is a major challenge facing families and healthcare providers. This study used a mixed methods approach to explore the youth perspective of how youth living with HIV (YLHIV) found out their status and to ... Full text Link to item Cite

Building resilience: a mental health intervention for Tanzanian youth living with HIV.

Journal Article AIDS Care · 2018 Despite a growing population of youth living with HIV, few interventions have been developed to address their unique mental health needs and to promote resilience. Based on our prior needs assessment, a mental health intervention, Sauti ya Vijana ( The Voi ... Full text Link to item Cite

HIV Resistance and Prevention of Mother-to-Child Transmission Regimen in HIV-Infected Infants in Northern Tanzania.

Journal Article AIDS Res Hum Retroviruses · November 2017 Prevention of mother-to-child transmission (PMTCT) guidelines recommend that all HIV-infected pregnant women receive antiretroviral therapy (Option B) and HIV-infected infants should initiate therapy with a protease inhibitor-based regimen; however, implem ... Full text Link to item Cite

Multicentre analysis of second-line antiretroviral treatment in HIV-infected children: adolescents at high risk of failure.

Journal Article J Int AIDS Soc · September 15, 2017 INTRODUCTION: The number of HIV-infected children and adolescents requiring second-line antiretroviral treatment (ART) is increasing in low- and middle-income countries (LMIC). However, the effectiveness of paediatric second-line ART and potential risk fac ... Full text Link to item Cite

Providing Safe and Effective Preventative Antiretroviral Prophylaxis to HIV-exposed Newborns via a Novel Drug Delivery System in Tanzania.

Journal Article Pediatr Infect Dis J · September 2016 BACKGROUND: In developing countries, antiretroviral therapy provides life-saving treatment to HIV-positive women and their children before, during and after birth. However, supply chain challenges such as long distances, medication shortages and nonfacilit ... Full text Link to item Cite

Evaluating mental health difficulties and associated outcomes among HIV-positive adolescents in Tanzania.

Journal Article AIDS Care · July 2016 AIDS-related mortality among HIV-positive adolescents has risen by 50% despite the scale up of antiretroviral therapy (ART). ART maladherence likely plays a role in the increase of AIDS-related deaths among adolescents and has shown to be associated with p ... Full text Link to item Cite

A Qualitative Exploration of the Mental Health and Psychosocial Contexts of HIV-Positive Adolescents in Tanzania.

Journal Article PLoS One · 2016 Although 85% of HIV-positive adolescents reside in sub-Saharan Africa, little is known about the psychosocial and mental health factors affecting their daily well-being. Identifying these contextual variables is key to development of culturally appropriate ... Full text Link to item Cite

Dolutegravir, the Second-Generation of Integrase Strand Transfer Inhibitors (INSTIs) for the Treatment of HIV.

Journal Article Infect Dis Ther · December 2014 The integrase strand transfer inhibitors (INSTIs) are the newest antiretroviral class in the HIV treatment armamentarium. Dolutegravir (DTG) is the only second-generation INSTI with FDA approval (2013). It has potential advantages in comparison to first-ge ... Full text Link to item Cite

Durability of antiretroviral therapy and predictors of virologic failure among perinatally HIV-infected children in Tanzania: a four-year follow-up.

Journal Article BMC Infect Dis · November 7, 2014 BACKGROUND: In Tanzania, HIV-1 RNA testing is rarely available and not standard of care. Determining virologic failure is challenging and resistance mutations accumulate, thereby compromising second-line therapy. We evaluated durability of antiretroviral t ... Full text Open Access Link to item Cite

A Review of Human Herpesvirus 8, the Kaposi's Sarcoma-Associated Herpesvirus, in the Pediatric Population.

Journal Article J Pediatric Infect Dis Soc · March 2014 Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma (KS)-associated herpesvirus, is the etiologic agent responsible for all types of KS. Although the majority of pediatric KS cases occur in sub-Saharan Africa, a rise in pediatric transplant KS has ... Full text Link to item Cite

Progress in the prevention of mother to child transmission of HIV in three regions of Tanzania: a retrospective analysis.

Journal Article PLoS One · 2014 BACKGROUND: Mother to child transmission (MTCT) of HIV-1 remains an important problem in sub-Saharan Africa where most new pediatric HIV-1 infections occur. Early infant diagnosis of HIV-1 using dried blood spot (DBS) PCR among exposed infants provides an ... Full text Link to item Cite

Adherence to antiretroviral therapy among HIV-infected children receiving care at Kilimanjaro Christian Medical Centre (KCMC), Northern Tanzania: A cross- sectional analytical study.

Journal Article Pan Afr Med J · 2014 INTRODUCTION: Paediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic process involving many factors. Adherence for the majority on therapy matters to prevent failure of 1(st) and 2(st) line therapy. The purpose of this study was ... Full text Link to item Cite

Low rates of child testing for HIV persist in a high-risk area of East Africa.

Journal Article AIDS Care · 2014 Children in low- and middle-income countries (LMIC) are the least touched by recent successes in the diagnosis and treatment of HIV/AIDS globally. Early treatment is essential for a child's longer and higher quality of life; however, by 2011, only a small ... Full text Link to item Cite

Risk factors influencing antibody responses to Kaposi's sarcoma-associated herpesvirus latent and lytic antigens in patients under antiretroviral therapy.

Journal Article J Acquir Immune Defic Syndr · January 1, 2011 BACKGROUND: Kaposi's sarcoma-associated herpesvirus (KSHV) seropositivity and lytic antibody titer are predictors for Kaposi's sarcoma. METHODS: We examined demographic, viral, and immunologic factors that influence KSHV latent and lytic antibodies in HIV- ... Full text Link to item Cite