BACKGROUND Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples' voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in...

BACKGROUND Sub-Saharan Africa has a high rate of HIV infection, most of which is attributable to heterosexual transmission. Few attempts have been made to assess the extent of HIV transmission within marriages, and HIV-prevention efforts remain focused on abstinence and non-marital sex. We aimed to estimate the proportion of heterosexual transmission of HIV which occurs within married or cohabi...

BACKGROUND As a consequence of the 1994 Rwandan genocide, prevalences of mental disorders are elevated in Rwanda. More knowledge about determinants of mental stress can help to improve mental health services and treatment in the east-central African country. The present study aimed to investigate actual rates of mental stress (posttraumatic stress disorder, syndromal depression and syndromal an...

This paper examines the long-term impact of civil conflict on intimate partner violence and women’s decision-making power using post-genocide data from Rwanda. Household survey data collected 11 years after the genocide show that women who became married after the genocide experienced significantly increased intimate partner violence and decreased decision-making power relative to women who bec...

BACKGROUND Not being able to procreate has severe social and economic repercussions in resource-poor countries. The purpose of this research was to explore the consequences of female and/or male factor infertility for men and women in Rwanda. METHODS Both quantitative and qualitative methods were used. Couples presenting with female and/or male factor infertility problems at the infertility c...

BACKGROUND The HPTN 052 study demonstrated a 96% reduction in HIV transmission in discordant couples using antiretroviral therapy (ART). OBJECTIVE To predict the epidemic impact of treating HIV-discordant couples to prevent transmission. DESIGN Mathematical modeling to predict incidence reduction and the number of infections prevented. METHODS Demographic and epidemiological data from Gha...

The network scale-up method is a promising technique that uses sampled social network data to estimate the sizes of epidemiologically important hidden populations, such as sex workers and people who inject illicit drugs. Although previous scale-up research has focused exclusively on networks of acquaintances, we show that the type of personal network about which survey respondents are asked to ...

BACKGROUND As resource-limited health systems evolve to address complex diseases, attention must be returned to basic primary care delivery. Limited data exists detailing the quality of general adult and adolescent primary care delivered at front-line facilities in these regions. Here we describe the baseline quality of care for adults and adolescents in rural Rwanda. METHODS Patients aged 13...

To begin, I’d like to describe the origins of the research project that ultimately became The Order of Genocide. I first traveled to Rwanda as a journalist in the mid-1990s, and, during my travels there and in what was then Zaire, I became deeply interested in the dynamics that ultimately led to the 1994 genocide. From my perspective as a journalist traveling in the region, the genocide was an ...

The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country's economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recent...