High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach.

BACKGROUND: Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana's National Strategic Plan for HIV/AIDS 2016-2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. METHODS: From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. RESULTS: Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). CONCLUSIONS: Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.

Effectiveness of community outreach HIV prevention programs in Vietnam: a mixed methods evaluation.

BACKGROUND: In 2014, Vietnam was the first Southeast Asian country to commit to achieving the World Health Organization's 90-90-90 global HIV targets (90% know their HIV status, 90% on sustained treatment, and 90% virally suppressed) by 2020. This pledge represented further confirmation of Vietnam's efforts to respond to the HIV epidemic, one feature of which has been close collaboration with the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). Starting in 2004, PEPFAR supported community outreach programs targeting high-risk populations (people who inject drugs, men who have sex with men, and sex workers). To provide early evidence on program impact, in 2007-2008 we conducted a nationwide evaluation of PEPFAR-supported outreach programs in Vietnam. The evaluation focused on assessing program effect on HIV knowledge, high-risk behaviors, and HIV testing among high-risk populations-results relevant to Vietnam's push to meet global HIV goals. METHODS: We used a mixed-methods cross-sectional evaluation design. Data collection encompassed a quantitative survey of 2199 individuals, supplemented by 125 in-depth interviews. Participants were members of high-risk populations who reported recent contact with an outreach worker (intervention group) or no recent contact (comparison group). We assessed differences in HIV knowledge, risky behaviors, and HIV testing between groups, and between high-risk populations. RESULTS: Intervention participants knew significantly more about transmission, prevention, and treatment than comparison participants. We found low levels of injection drug-use-related risk behaviors and little evidence of program impact on such behaviors. In contrast, a significantly smaller proportion of intervention than comparison participants reported risky sexual behaviors generally and within each high-risk population. Intervention participants were also more likely to have undergone HIV testing (76.1% vs. 47.0%, p < 0.0001) and to have received pre-test (78.0% vs. 33.7%, p < 0.0001) and post-test counseling (80.9% vs. 60.5%, p < 0.0001). Interviews supported evidence of high impact of outreach among all high-risk populations. CONCLUSIONS: Outreach programs appear to have reduced risky sexual behaviors and increased use of HIV testing services among high-risk populations in Vietnam. These programs can play a key role in reducing gaps in the HIV care cascade, achieving the global 90-90-90 goals, and creating an AIDS-free generation.

Love, power, resilience and vulnerability: relationship dynamics between female sex workers in Ghana and their intimate partners.

Little is known about female sex workers' daily lives or emotional relationships. Using relational-cultural theory, this study explored the relationship dynamics between sex workers and their intimate partners in Kumasi, Ghana. We collected qualitative data from 37 male intimate partners through 24 in-depth interviews and two focus group discussions (FGDs) with 13 male partners. We also conducted three FGDs with 20 women involved in sex work. Relationships between sex workers and their intimate partners were mutual, reciprocal and transactional. Male partners provided protection for financial support, a place to sleep and intimacy. Both men and women described their relationships in terms of friendship, love and a hopeful future. Women were reluctant to quit sex work because they depended on it for income. Most respondents did not use condoms in these romantic relationships, citing trust, love, faithfulness and commitment. Both men and women described high levels of violence in their relationships. The context of sex work heightens vulnerability but also appears to facilitate resilience and creative coping strategies. The relational dynamics between sex workers and their intimate partners in Ghana merit further exploration to examine the extent to which women involved in sex work hold and exert power within these relationships.

Role Bending: Complex Relationships Between Viruses, Hosts, and Vectors Related to Citrus Leprosis, an Emerging Disease.

Citrus leprosis complex is an emerging disease in the Americas, associated with two unrelated taxa of viruses distributed in South, Central, and North America. The cytoplasmic viruses are Citrus leprosis virus C (CiLV-C), Citrus leprosis virus C2 (CiLV-C2), and Hibiscus green spot virus 2, and the nuclear viruses are Citrus leprosis virus N (CiLV-N) and Citrus necrotic spot virus. These viruses cause local lesion infections in all known hosts, with no natural systemic host identified to date. All leprosis viruses were believed to be transmitted by one species of mite, Brevipalpus phoenicis. However, mites collected from CiLV-C and CiLV-N infected citrus groves in Mexico were identified as B. yothersi and B. californicus sensu lato, respectively, and only B. yothersi was detected from CiLV-C2 and CiLV-N mixed infections in the Orinoco regions of Colombia. Phylogenetic analysis of the helicase, RNA-dependent RNA polymerase 2 domains and p24 gene amino acid sequences of cytoplasmic leprosis viruses showed a close relationship with recently deposited mosquito-borne negevirus sequences. Here, we present evidence that both cytoplasmic and nuclear viruses seem to replicate in viruliferous Brevipalpus species. The possible replication in the mite vector and the close relationship with mosquito borne negeviruses are consistent with the concept that members of the genus Cilevirus and Higrevirus originated in mites and citrus may play the role of mite virus vector.

Undernutrition among infants less than 6 months of age: an underestimated public health problem in India.

In India most childhood nutrition recommendations and interventions are still not focused on infants under 6 months. Secondary data analyses of National Family Health Survey-3 data from India were analysed to compare the prevalence of wasting, stunting and underweight in infants less than 6 months and 6-59 months. Our results revealed that wasting was higher (31%) in infants less than 6 months (P < 0.05) as compared with children between 6 and 59 months. Thirteen per cent of infants less than 6 months had severe wasting, 30% were underweight and 20% were stunted. Most infants (69%) were exclusively breastfed (EB) for the first 2 months, but exclusive breastfeeding dropped to 50% at 2-3 months and to 27% at 4-5 months. There was no statistically significant difference in wasting and stunting in the EB and not exclusively breastfed (NEB) groups. Significantly fewer EB infants were underweight (28%) compared with NEB infants (31%) (P = 0.030). However, among EB children, 29% had wasting and 21% were stunted. Eleven per cent of EB infants were severely underweight, 13% were severely wasted and 9% were severely stunted. Diarrhoea was significantly lower among EB infants compared with NEB infants (P < 0.05). We conclude that infants less than 6 months of age are vulnerable to suffer from acute severe malnutrition irrespective of their breastfeeding status and need to be seriously considered for inclusion in national guidelines for early detection and management of undernutrition.

Is Neoseiulus wearnei the Neoseiulus californicus of Australia?

Species of the family Phytoseiidae are known as predatory mites, some of them being used in crops to control mite pests, all around the world. Neoseiulus (=Cydnodromus) californicus is among the most commonly used Phytoseiidae species in biological control programs, especially in vineyards, orchards and vegetable fields. This species is distributed world-wide but has never been reported from Australia. On the other hand, specimens morphologically close to N. californicus have been assigned to a species called Neoseiulus wearnei, only reported from Australia. Investigations based on morphological and molecular comparisons were carried out to investigate whether these two taxa are conspecific. Morphological analyses showed no significant difference between specimens identified as N. wearnei and N. californicus. Similarly, genetic distances between these taxa were null, showing that all these specimens belong to the same species. Although it is not yet possible to conclude that all the specimens identified as N. wearnei are N. californicus, we can conclude that N. californicus is present in Australia. The information about the biology of N. californicus can thus now be applied to the Australian population of this species for biological control purposes.

Tenuipalpidae (Acari: Trombidiformes) from Casuarinaceae (Fagales).

The Tenuipalpidae associated with the Casuarinaceae are reviewed, including one new genus, Palpipalpus gen. nov., twelve new species, and seven redescriptions. Two new generic records for Australia are established, Pentamerismus and Philippipalpus. The new species are: Chaudhripalpus costacola Beard and Seeman sp. nov., Crossipalpus gersoni Beard and Seeman sp. nov., Crossipalpus raveni Beard and Seeman sp. nov., Magdalenapalpus caperatus Beard and Seeman sp. nov., Magdalenapalpus forsteri Seeman and Beard sp. nov., Pentamerismus sititoris Beard and Seeman sp. nov., Pentamerismus hicklingorum Seeman and Beard sp. nov., Pentamerismus wardo Seeman and Beard sp. nov., Palpipalpus hesperius Beard and Seeman sp. nov. gen. nov., Philippipalpus flumaquercus Beard and Seeman sp. nov., Philippipalpus belah Beard and Seeman sp. nov., and Philippipalpus nigraquercus Seeman and Beard sp. nov.  Meyeraepalpus delfinadae Smiley et al., is reinstated based on new material and an analysis of its phylogenetic relationships. Crossipalpus muellerianae Smiley et al., Crossipalpus verticillatae Smiley et al., and Tegopalpus conicus Womersley are redescribed and rediagnosed from the original type specimens and newly collected material; and Chaudhripalpus creelae (Smiley et al.), Magdalenapalpus strandtmanni (Smiley et al.) and Philippipalpus agohoi Corpuz-Raros are redescribed and rediagnosed from type material only. All flat mite species were host-specific. Up to three species of flat mite were collected from a single she-oak species. Leg setation and ontogeny are reviewed for the taxa studied. A key to Tenuipalpidae from Casuarinaceae is provided. A phylogeny of the subfamily Tegopalpinae found the following relationships: Meyeraepalpus (Australopalpus, Crossipalpus, Palpipalpus (Magdalenapalpus (Philippipalpus (Chaudhripalpus + Tegopalpus)))). Our preliminary analysis of the Tegopalpinae suggested the group is monophyletic and its sister group is Phytoptipalpus.

A revision of the genus Extenuipalpus Reck, 1959 (Trombidiformes: Tetranychoidea: Tenuipalpidae), with description of a new species.

Extenuipalpus is reviewed, covering its taxonomic history, a new genus diagnosis, body and leg chaetotaxy, and redescriptions of the three previously known species E. niekerkae (Meyer, 1979), E. quadrisetosus (Lawrence, 1940) and E. sagittus (Meyer, 1993) based on type material. We also describe a new species, E. situngu Beard & Ueckermann sp. nov. from glossy forest grape, Rhoicissus rhomboidea (E. Mey ex Harv.) Planch. (Vitaceae), and provide a key to species of Extenuipalpus.

Strengthening capacity for AIDS vaccine research: analysis of the Pfizer Global Health Fellows program and the International AIDS Vaccine Initiative.

BACKGROUND: Industry partnerships can help leverage resources to advance HIV/AIDS vaccine research, service delivery, and policy advocacy goals. This often involves capacity building for international and local non-governmental organizations (NGOs). International volunteering is increasingly being used as a capacity building strategy, yet little is known about how corporate volunteers help to improve performance of NGOs in the fight against HIV/AIDS. METHODS: This case study helps to extend our understanding by analyzing how the Pfizer Global Health Fellows (GHF) program helped develop capacity of the International AIDS Vaccine Initiative (IAVI), looking specifically at Fellowship activities in South Africa, Kenya, and Uganda. From 2005-2009, 8 Pfizer GHF worked with IAVI and local research centers to strengthen capacity to conduct and monitor vaccine trials to meet international standards and expand trial activities. Data collection for the case study included review of Fellow job descriptions, online journals, evaluation reports, and interviews with Fellows and IAVI staff. Qualitative methods were used to analyze factors which influenced the process and outcomes of capacity strengthening. RESULTS: Fellows filled critical short-term expert staffing needs at IAVI as well as providing technical assistance and staff development activities. Capacity building included assistance in establishing operating procedures for the start-up period of research centers; training staff in Good Clinical Practice (GCP); developing monitoring capacity (staff and systems) to assure that centers are audit-ready at all times; and strategic planning for data management systems. Factors key to the success of volunteering partnerships included similarities in mission between the corporate and NGO partners, expertise and experience of Fellows, and attitudes of partner organization staff. CONCLUSION: By developing standard operating procedures, ensuring that monitoring and regulatory compliance systems were in place, training African investigators and community members, and engaging in other systems strengthening activities, the GHF program helped IAVI to accelerate vaccine development activities in the field, and to develop the organization's capacity to manage change in the future. Our study suggests that a program of sustained corporate volunteering over several years may increase organizational learning and trust, leading to stronger capacity to advance and achieve NGO goals.

A review of Amblypalpus and Priscapalpus (Acari: Trombidiformes: Tenuipalpidae), including two new species of Amblypalpus from Iran.

Two new species of Amblypalpus (Acari: Trombidiformes: Tenuipalpidae) are described from Iran: Amblypalpus iraniensis sp. nov., from Wild Almond, Amygdalus scoparia (Rosaceae), and Amblypalpus thymus sp. nov., from Common Thyme, Thymus vulgaris (Lamiaceae). The new species are classified tentatively in Amblypalpus. The species Priscapalpus thomissus Meyer, 1979 is transferred to Amblypalpus and the genus concept of Priscapalpus is narrowed and therefore redefined. Similarly, we present an expanded concept of Amblypalpus. A key to brevipalpine genera and Amblypalpus species is provided.

Antibiotic resistance trends for common bacterial aetiologies of childhood diarrhoea in low- and middle-income countries: A systematic review.

Background: Diarrhoea is the second most common cause of death among children under the age of five worldwide. The World Health Organization (WHO) recommends treating diarrhoea with oral rehydration therapy, intravenous fluids for severe dehydration, and zinc supplements. Antibiotics are only recommended to treat acute, invasive diarrhoea. Rising antibiotic resistance has led to a decrease in the effectiveness of treatments for diarrhoea. Methods: A systematic literature review in PubMed, Web of Science, and EMBASE was conducted to identify articles relevant to antibiotic-resistant childhood diarrhoea. Articles in English published between 1990 to 2020 that described antibiotic resistance patterns of common pathogens causing childhood diarrhoea in low- and middle-income countries were included. The studies were limited to papers that categorized children as 0-5 years or 0-10 years old. The proportion of isolates with resistance to major classes of antibiotics stratified by major WHO global regions and time was determined. Results: Quantitative data were extracted from 44 articles that met screening criteria; most focused on children under five years. Escherichia coli isolates had relatively high resistance rates to ampicillin and tetracycline in the African (AFR), American (AMR), and Eastern Mediterranean Regions (EMR). There was moderate to high resistance to ampicillin and third generation cephalosporins among Salmonella spp in the AFR, EMR, and the Western Pacific Region (WPR). Resistance rates for ampicillin, co-trimoxazole, and chloramphenicol for Shigella in the AFR started at an alarmingly high rate ( ~ 90%) in 2006 and fluctuated over time. There were limited antibiotic resistance data for Aeromonas, Yersinia, and V. cholerae. The 161 isolates of Campylobacter analysed showed initially low rates of fluoroquinolone resistance with high rates of resistance in recent years, especially in the Southeast Asian Region. Conclusions: Resistance to inexpensive antibiotics for treatment of invasive diarrhoea in children under ten years is widespread (although data on 6- to 10-year-old children are limited), and resistance rates to fluoroquinolones and later-generation cephalosporins are increasing. A strong regional surveillance system is needed to carefully monitor trends in antibiotic resistance, future studies should include school-aged children, and interventions are needed to reduce inappropriate use of antibiotics for the treatment of community-acquired, non-invasive diarrhoea. Registration: This systematic review was registered in Prospero (registration number CRD42020204004) in August 2020.

A New Species of Ultratenuipalpus (Acari: Tenuipalpidae) from Brazil and Re-Description of Ultratenuipalpus meekeri (De Leon), the Type Species of the Genus, with DNA Barcodes.

Species of the genus Ultratenuipalpus bear a broad subquadrate propodosoma with many large, flattened, lanceolate to ovate dorsal setae. They also bear some plesiomorphic character states, such as the presence of three pairs of ventral ps setae. Here, we describe Ultratenuipalpus parameekeri Castro, Ochoa & Feres sp. nov. based on adult females, males, and immatures, collected on ferns from Brazil. We also re-describe Ultratenuipalpus meekeri (De Leon), the type species of the genus, based on types and newly collected material from Mexico, and include additional novel data (e.g., dorsal and ventral ornamentation, leg chaetotaxy, and setal measurements) in a standardized form. We include highly detailed images obtained using LT-SEM, accompanied by DNA barcodes, for both species. The ontogenetic additions of leg chaetotaxy are presented and discussed.

Raoiella indica (Acari: Tenuipalpidae): an exploding mite pest in the neotropics.

Major infestations of the flat mite species Raoiella indica Hirst affecting bananas, palms and other ornamental plants have been reported from the Caribbean islands, Mexico, FL (USA), Venezuela, Colombia and Brazil. Specimens from these localities were examined using traditional light microscopy and low-temperature scanning electron microscopy techniques. While little is known about the biology of this mite, its recent appearance in the Americas in both commercial coconut and banana plantations has raised concerns about its economic impact as an invasive pest.

Report of Tuckerella pavoniformis (Acari: Tuckerellidae) on Mamey, Mammea americana (Calophyllaceae), in Northwestern Peru.

The family Tuckerellidae, or peacock mites, is a monogeneric group comprising approximately 32 species, which are usually collected from the fruits or woody parts of their host plants. Fruits and branchlets of mamey, Mammea americana L. (Calophyllaceae) trees in north-western Peru were sampled for peacock mites throughout spring and summer for two consecutive years. This is the first record of Tuckerella pavoniformis (Ewing) (Acari: Tuckerellidae) feeding on mamey. Aggregations of mites were much higher and more common on the fruit epicarps than on branchlets. Recommendations for the development of an Integrated Pest Management strategy for this peacock mite are included.

"Getting Started": A Pilot Introductory Narrative Writing Session for Interprofessional Faculty in Academic Health Sciences.

Purpose: We designed and implemented a pilot introductory narrative writing session with the two-fold goal of fostering the dissemination of faculty writing for submission to peer-reviewed journals and other publication venues while simultaneously creating a framework for establishing collaborative and empathic interprofessional teams by enhancing narrative-related competencies. Methods: The session was open to interprofessional faculty at our academic health sciences center. Participants were accepted via a competitive application process, with group size limited to 18 individuals due to the workshop-style format. Learners were reflective of our diverse campus regarding sex, race/ethnicity, department, rank, and professional role. The session began with an experiential seminar providing instruction on writing theory and practice, discussion questions, and reflective writing prompts. The seminar was followed by a writing workshop. We conducted a mixed-methods evaluation to gauge participant satisfaction and educational efficacy. Results: The mixed-methods evaluation revealed that faculty reported high satisfaction with the session as a designated space to contemplate, discuss, practice, share, and critique narrative writing. All learners (18, 100%) rated it "very good" or "excellent" in overall quality and value as well as in relevance to personal growth. Participants reported growth in communication (13, 72%), self-reflection (12, 67%), active listening (12, 67%), writing confidence (11, 61%), perspective-taking (11, 61%), writing skills (10, 56%), and empathy (8, 44%). Discussion: Faculty valued the session as a venue for improving their writing skills and sharing with a diverse group of colleagues about the significance of narrative in relation to their professional lives. Conclusion: Seminar outcomes suggest that narrative-based education for interprofessional health sciences faculty can be effective in achieving the two-fold goal of enhancing writing competencies while simultaneously fostering essential skills for building collaborative and empathic teams to promote high-quality education, research, and whole person clinical care.

Importance of breastfeeding and complementary feeding for management and prevention of childhood diarrhoea in low- and middle-income countries.

Background: Early and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea. Methods: We conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding. Results: The literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea. Conclusions: During the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.

Revisiting sphere: new standards of service delivery for new trends in protracted displacement.

The proportion of people living in protracted displacement, as well as the duration of this displacement, is increasing. International humanitarian standards for services provided in protracted displacement are based on the Sphere Standards, which were formulated using evidence and experience from acute phase emergencies. However, the majority of protracted emergencies are in the post-emergency phase. This paper discusses trends in displacement, outlines reasons why using the Sphere Standards as minimum standards of service provision in protracted displacement does not adequately meet the needs of these populations, and analyses areas where greater standards of service provision are necessary. An expansion of the evidence base regarding determinants of morbidity and mortality in protracted emergencies is needed. This, followed by a joint approach to designing new, effective standards focused on proactive policies, will allow the humanitarian community more appropriately to serve and enable the millions of people currently living in protracted displacement.

Lessons Learned From a Peer Writing Coach Program in a School of Public Health.

Clear writing is a critical component of public health research and practice. The ability to convey information in a concise, engaging, and insightful manner influences stakeholder engagement and is the backbone of program and policy development, organization, and implementation. To help master of public health (MPH) students adapt their writing skills to these specialized demands, Boston University School of Public Health launched the Peer Writing Coach Program in 2010 staffed by MPH students. The service is open to all students enrolled in public health classes. They can schedule up to 2 appointments per assignment for both individual and team papers. Student use increased from 55 appointments in academic year 2010-2011 (the first year of the program) to 767 appointments in academic year 2017-2018. For the 2016-2017, 2017-2018, and 2018-2019 academic years, 1128 (74%) of 1530 appointment requests asked for assistance "writing clearly and concisely," 886 (58%) for assistance "organizing and synthesizing main points of argument," and 529 (35%) for assistance "tailoring writing for a specific audience." This case study describes the rationale for creating the program, outlines the chronology of its development since 2010, and provides an overview of peer coach training, student use, and lessons learned as we addressed logistical challenges.

Challenges of developing a district child welfare plan in South Africa: lessons from a community-engaged HIV/AIDS research project.

The Amajuba Child Health and Wellbeing Research Project measured the impact of orphaning due to HIV/AIDS on South African households between 2004 and 2007. Community engagement was a central component of the project and extended through 2010. We describe researcher engagement with the community to recruit participants, build local buy-in, stimulate interest in study findings, and promote integration of government social welfare services for families and children affected by HIV/AIDS. This narrative documents the experience of researchers, drawing also on project reports, public documents, and published articles, with the objective of documenting lessons learned in this collaboration between researchers from two universities and a community in South Africa during a period that spanned seven years. This experience is then analyzed within the context of an applied research, community-engagement framework.