Research and Professional Experience
I am an physician trained in internal medicine, infectious diseases, and epidemiology with an interest in multidisciplinary, innovative, and pragmatic approaches to impacting the HIV/AIDS pandemic. I have 3 main areas of focus in my scholarship and leadership activities.
1. HIV/AIDS Implementation and Operations Research- My main focus is on developing innovative and pragmatic strategies for improving HIV/AIDS care in low- and middle-income settings and performing implementation and operations research to assess impact and implementation challenges. These strategies include involving community health workers to help address the human resource crisis through improving clinical care, improving linkage, engagement, and retention in care, and through integrating HIV prevention and care interventions. I primarily work in Africa, mostly in Uganda with the Rakai Health Sciences Program, and try to bring to this growing and multidisciplinary field of HIV/AIDS Implementation/Operations Research application of quantitative methods, qualitative methods, community-based trial designs, as well as behavioral science and economic evaluations.
2. Global mHealth-A related and growing focus of my research is using novel mHealth (mobile technologies for health) strategies for improving global public health and clinical care, including novel applications for maternal/child health, intimate-partner violence, and HIV care, surveillance, and prevention. I am the Director of Science and Implementation for the Hopkins-based eMOCHA (electronic Mobile Open-source Comprehensive Health Application) mHealth Platform (www.emocha.org), and I oversee active projects involving eMOCHA in Baltimore, Afghanistan, and Uganda. I am a member of the newly formed Steering Committee for a University-wide Johns Hopkins Global mHealth Initiative.
3. HIV/AIDS Systematic Reviews and Guideline Development-I am also actively involved in systematic reviews on topics in HIV as well as on guideline development. I am an active member of the Cochrane HIV/AIDS group. I have been an active member in WHO guideline development for the past 6 years, most recently having a role in the 2010 update of HIV treatment guidelines. I am currently the Methodology Section Head for the development of new global guidelines on adherence and retention sponsored by the International Association of Providers of AIDS Care (IAPAC).
Selected Publications
Aberg JA, Watson J, Segal M, Chang LW. Clinical utility of monitoring serum cryptococcal antigen (sCRAG) titers in patients with AIDS-related cryptococcal disease. HIV Clinical Trials 2000;1:1-6.
Chang LW, Osei-Kwasi M, Boakye D, Aidoo S, Hagy A, Curran JW, Vermund SH. HIV-1 and HIV-2 Seroprevalence and risk factors among hospital outpatients in the Eastern Region of Ghana, West Africa. JAIDS 2002;29:511-516.
Macharia DK, Chang LW, Lule G, Owili DM, Tesfaledet G, Patel S, Silverstein DM, Ng’ang’a L, Bush T, De Cock KM, Weidle PJ. Antiretroviral therapy in the private sector of Nairobi, Kenya: a review of the experience of five physicians. AIDS 2003;17(6):938-940.
Chang LW, Phipps WP, Kennedy GF, Rutherford GW. Antifungal interventions for the primary prevention of cryptococcal disease in adults with HIV. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd.
Chang LW, Vidyarthi AR, Kohlwes RJ. Baseline duty hours recorded with time-cards: a pre-regulation study of internal medicine residents. Medical Education 2006;40(7):662-667.
Chang LW, Kagaayi J, Nakigozi G, Galiwango R, Mulamba J, Ruwangula A, Gray RH, Quinn TC, Bollinger RC, Reynolds SJ. Telecommunications and health care: An HIV/AIDS Warmline for communication and consultation in Rakai, Uganda. J Int Assoc Physicians AIDS Care 2008;7(3):130-132.
Chang LW, Reller ME, Bishop JA, Talaat K, Nutman TB, Auwaerter PG. A 41 year-old woman from Cameroon with infertility. Clin Infect Dis 2008;47(1):141-143,109.
Chang LW, Kagaayi J, Nakigozi G, Packer AH, Serwadda D, Quinn TC, Gray RH, Bollinger RC, Reynolds SJ. Responding to the human resource crisis: peer health workers, mobile phones, and HIV care in Rakai, Uganda. AIDS Patient Care STDS 2008;22(3):173-174.
Chang LW, Slamo S, Guma S, Christopher J, Suntoke T, Omeste R, Montis J, Quinn T, Juncker M, Reynolds SJ. Two year virologic outcomes of an alternative AIDS care model: evaluation of a peer health worker and nurse-staffed community-based program in Uganda. JAIDS 2009;50:276-282.
Chang LW, Kennedy CE, Kennedy GE, Lindegren ML, Barston BJ, Kaplan JE, Sweat MD, Bunnell RE, O’Reilly K, Rutherford GW, and Mermin JH. Developing guidelines with pragmatic, structured, evidence-based processes: a case study. Global Public Health 2010;5(4):395-412.
Chang LW, Harris J, Humphreys E. Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure among adults and adolescents living with HIV in low-resource settings. Cochrane Database Syst Rev 2010;Apr 13(4):CD008494.
Chang LW, Kagaayi J, Nakigozi G, Ssempijja V, Packer A, Serwadda D, Quinn TC, Gray RH, Quinn TC, Bollinger RC, Reynolds SJ. Effect of Peer Health Workers on AIDS Care in Rakai, Uganda: a Cluster-Randomized Trial. PLoS ONE 2010;5(6):e10923. doi:10.1371/journal.pone.0010923.
Humphreys EH, Chang LW, Harris J. Antiretroviral regimens for patients with HIV who fail first-line antiretroviral therapy. Cochrane Database Syst Rev 2010; Jun 16(6):CD006517.
Chang LW, Kaye D, Muhwezi WW, Nabirye RC, Mbalinda S, Okullo I, Groves S, Kennedy CE, Bollinger RC, Sisson S, Burnham G, Mwanika A. Perceptions and Valuation of a Community-Based Education and Service (COBES) Program in Uganda. Medical Teacher 2011;33:e9-e15.
Kaye D, Mwanika A, Burnham G, Chang LW, Mbalinda S, Okullo I, Nabirye RC, Muhwezi W, Oria H, Kijjambu S, Atuyambe L, Aryeija W. The organization and implementation of community-based education programs for health worker training institutions in Uganda. BMC International Health and Human Rights 2011;11(Suppl 1):S4
Mwanika A, Okullo I, Kaye D, Muhwezi W, Atuyambe L, Nabirye RC, Groves S., Mbalinda S, Burnham G, Chang LW, Oria H, Sewankambo N. Perception and valuations of community-based education and service by alumni at Makerere University College of Health Sciences. BMC International Health and Human Rights 2011;11(Suppl 1):S5
Chang LW, Mwanika A, Kaye D, Muhwezi W, Nabirye RC, Mbalinda S, Okullo I, Kennedy CE Groves S, Sisson SD, Burnham G, Bollinger RC. Information and communication technology and community-based health sciences training in Uganda: perceptions and experiences of educators and students [in press]. Informatics for Health and Social Care 2011.
Arem H, Nakyanjo N, Kagaayi J, Mulamba J, Nakigozi G, Serwadda D, Quinn TC, Gray RH, Bollinger RC, Reynolds SJ, Chang LW. Peer Health Workers and AIDS Care in Rakai, Uganda: a Mixed Methods Operations Research Evaluation of a Cluster-Randomized Trial [in press]. AIDS Patient Care and STDs 2011.
Chang LW, Kagaayi J, Arem H, Nakigozi G, Ssempijja V, Serwadda D, Quinn TC, Gray RH, Bollinger RC, Reynolds SJ. Impact of a mHealth Intervention for Peer Health Workers on AIDS Care in Rural Uganda: a Mixed Methods Evaluation of a Cluster-Randomized Trial [in press]. AIDS and Behavior 2011.
