UCSF Faculty Spotlight: Dr. Alison Comfort

Left to right are Alison Comfort (UCSF PI), Hadija Nalubwama (Research Manager Makerere University), Umar Senoga (Research Assistant), Sylivia Katusabe (Research Assistant), and Sherinah Nakalembe (Research Assistant)

Dr. Alison Comfort's work with Global Programs in Kampala, Uganda, has laid a strong foundation for advancing maternal health research through successful collaboration and streamlined coordination with local counterparts, including Makerere University. This collaboration has been pivotal in implementing groundbreaking studies such as the START ANC project, which aims to improve maternal and fetal health outcomes by encouraging earlier antenatal care (ANC) initiation.

In her current research, Comfort (along with Drs. Josaphat Byamugisha, Alison El Ayadi, and Cynthia Harper) is exploring how social networks—comprised of partners, family, and community members—can influence when pregnant women seek ANC. The START ANC study, involving 250 women at Kawempe National Referral Hospital, investigates how these networks can be leveraged to promote earlier ANC visits, with a focus on how HIV status may affect this dynamic. 

The strong support and coordination provided by the Global Programs Uganda team has enabled her to focus on research that has the potential to significantly impact maternal health outcomes in Uganda, further strengthening the relationship between her team and their local partners.

Comfort says, “It has been a pleasure to work with Peruth Kyomugisha on this project, and I look forward to our continued collaboration.”

Public Health Response Guide Pilot Phase

During a group discussion in the Kyotera District are (left to right) Aggrey Byaruhanga (MOH), Karija Sylvia (village member), Akampulira Sadress (village member), Aligawesa Paul (VHT), Ronald Kiranda (GP Uganda), Mugerwa Abdu (VHT), Emmy Muramuzi (GP Uganda), Nakalema Florence (Kakuto HC IV), and Alex Mirugwe (METS).

The Recency Public Health Response (PHR) Guide, developed in Uganda, underwent a pilot phase in three districts—Kasanda, Jinja, and Kyotera—to assess its feasibility and effectiveness. The guide aims to pinpoint HIV acquisition hotspots and enhance targeted public health responses.

Teams comprising Ministry of Health officers, technical support members, Global Programs Uganda, implementing partners, and district health teams conducted the pilot. During this phase, the teams analyzed recency infection data, identified high-incidence areas, and engaged with community members to understand HIV transmission drivers, including commercial sex work and substance abuse. Identified gaps, such as insufficient condom distribution and lacking prevention interventions, particularly among key populations like palm tree plantation workers and barmaids, were addressed through community discussions, leading to the development of an action plan.

Overall, the pilot illustrated the PHR guide's effectiveness in hotspot identification and action planning, albeit requiring minor adjustments to some tools.