La Romana

Researchers are evaluating a screening and treatment approach for cervical cancer among women living with HIV in La Romana, Dominican Republic. Cervical cancer is a leading cause of death in this group, partly due to low screening coverage and incomplete follow-up care. This study aims to assess the effectiveness of a same-day HPV-based screen and treat method compared to the standard care, using a clinical decision support system to improve implementation and scale-up. The study compares the iSTAR approach, which provides HPV screening, triage with HPV viral load testing, and same-day ablative treatment for eligible women in a single visit, against standard care. Women positive for HPV but not suitable for ablative therapy are referred to colposcopy services for further management. This method avoids multiple visits and steps, aiming to increase treatment completion and reduce cervical cancer deaths. Participants will be women aged 25 and older who are HIV-positive and speak Spanish. The study will track the percentage of women completing the full screening and treatment process within two months and those testing negative in the HPV viral load triage group. Researchers will monitor adherence, treatment suitability, and outcomes through follow-up visits, ensuring safety and evaluating the potential for wider use of this screen, triage, and treat strategy.

Researchers are evaluating the WiseApp, a mobile app linked to a smart pill dispenser, CleverCap, to support Spanish-speaking people living with HIV (PLWH) in New York City and the Dominican Republic. This study aims to improve adherence to antiretroviral therapy (ART) among Latinos, who face high HIV rates and challenges in treatment success. The project focuses on adapting the app for Spanish speakers, assessing its effectiveness, and understanding barriers to its use in these communities. Participants will use the WiseApp connected to the CleverCap pill bottle, which dispenses the correct medication amount and sends reminders to improve medication adherence. The study is a 12-month randomized controlled trial involving Spanish-speaking PLWH, with some participants receiving smartphones if needed. The intervention will be tested in both the US and Dominican Republic, considering cultural and contextual factors. During the study, researchers will track self-reported ART adherence at the start and at 3, 6, and 12 months. Participants will provide informed consent and allow access to medical records. The study will monitor medication adherence, quality of life, and symptom burden using the app and smart pill dispenser. The goal is to support sustained engagement with HIV treatment through technology tailored to Spanish-speaking populations.