About

Alicia S. Menendez is a Research Associate Professor at the University of Chicago Harris School of Public Policy and a Senior Fellow at NORC at the University of Chicago. She is a development economist whose research interests include education and health, labor markets, and household behavior. Dr. Menendez has designed and managed numerous quantitative impact evaluations and qualitative evaluations, developing tools and overseeing surveys in various developing countries. Her ongoing research includes evaluating interventions to prevent school-related gender-based violence in Uganda, examining barriers to school continuation for girls in rural Malawi, and assessing improvements in reading performance in Liberia and Nepal. Her work highlights the potential and limits of stand-alone interventions and emphasizes the need for systemic reforms to create safer and more effective learning environments.

Research topics

• Psychology
• Sociology
• Computer Science
• Medicine
• Social Science
• Internal medicine
• Environmental health
• Linguistics
• Pedagogy
• Mathematics education
• Geography
• Gerontology
• Family medicine
• Psychiatry
• Gender studies
• Nursing
• Socioeconomics

Selected publications

• Experience of a Nationwide implementation of single-tablet second-generation integrase inhibitors-based treatment in Mexico

  IJID Regions · 2025-04-08

  articleOpen access1st authorCorresponding

  Objectives: In Mexico, until 2018, antiretroviral therapy (ART) primarily relied on efavirenz-containing regimens or other options suitable for optimization, with ART costs among the highest in the region. This study evaluated the impact of a national strategy using single-tablet, second-generation integrase inhibitors (STSGII)-either bictegravir, emtricitabine, and tenofovir alafenamide or abacavir/lamivudine/dolutegravir-for ART initiation or switch. Methods: Adults initiating or switching to STSGII between June 1, 2019, and June 30, 2021, at clinics for individuals without social security, were categorized into three groups: G1 (initiated with STSGII), G2 (initiated with non-STSGII), and G3 (switched to STSGII). The switch was defined as individuals changing ART in the presence of virological suppression. Viral suppression (VS) at 6 months post-initiation or switch was reported. A Cox model evaluated VS and regimen durability, defined as maintaining VS without ART change, loss to follow-up, or death. Results: A total of 70,732 individuals were included; 24,133 (34.1%) on G1, 4605 (6.5%) on G2, and 41,994 (59.4%) on G3. VS was achieved in 85.7%, 52.7%, and 82.7% of individuals in G1, G2, and G3, respectively. Durability was met in 85.1%, 41.3%, and 90.8% of individuals in G1, G2, and G3. Conclusions: Second-generation INSTIs are effective and durable in this 2-year follow-up analysis, both for ART initiation and optimization in Mexico's population, offering a valuable strategy for improving ART outcomes.

  PublisherDOI

• Access to diagnostic testing for invasive fungal diseases and other opportunistic infections in Mexican health care centers caring for patients living with HIV

  BMC Health Services Research · 2025-02-19 · 2 citations

  articleOpen accessSenior author

  BACKGROUND: The burden of opportunistic infections (OIs) remains high among people living with HIV (PLWH) in Mexico, despite improvements in mortality worldwide. OBJECTIVE: Reporting the current access to diagnostics of OIs in Mexican Health Care Centers offering health-care services to PLWH. METHODS: An online questionnaire was sent to public health care facilities providing HIV care in Mexico. We evaluated capacities to 1) identify individuals with advanced-HIV, and 2) local and/or on-site access to: point-of-care assays, imaging studies, histological analysis, and microbiology tests useful to diagnose a wide variety of OIs. RESULTS: In 2022, 46 centers answered the questionnaire, from 23/32 (71.8%) states of the country; 29 (63%) were primary care facilities, 5 (11%) general hospitals and 12 (26%) tertiary care hospitals, providing health services to 67,000 PLWH. These centers received 1,135 new patients/month, 48% with advance disease. Less than 50% could determine CD4 + T cell count (39%, N = 18), toxoplasma serology (41%, N = 19) and HIV viral load (41%, N = 19). Twenty-five centers could diagnose cryptococcosis and tuberculosis (54%). Meanwhile, 11 centers (24%) had access to aspergillosis or Histoplasma tests. Seven centers (11%) had access to coccidioidomycosis tests, five centers to any Pneumocystis diagnosis. In primary care centers, Mycobacterium tuberculosis complex GeneXPert was accessible in 41%, cryptococcal antigen by latex agglutination was available in one facility (3%), Indian ink in 9 centers (31%). No primary health center had access to lateral flow test for Cryptococcus or Histoplasma antigens. CONCLUSIONS: In Mexico, most public HIV-dedicated health care centers lack on-site capacity to diagnose opportunistic infections, specifically fungal infections. Rapid tests and point-of-care tests are frequently unavailable, which is more pronounced in primary care centres. Considering that IFDs still contribute significantly to mortality among PLWH, better access to diagnostic tools in all levels of HIV-care is urgent.

  PublisherOA PDFDOI

• Understanding Improvements in Reading Performance in Liberia: Investigating the Centrality of Text

  Economic Development and Cultural Change · 2025-09-12

  article1st authorCorresponding
  PublisherDOI

• Comparative effectiveness of bictegravir versus dolutegravir, raltegravir, and efavirenz-based antiretroviral therapy among treatment-naïve individuals with HIV

  European Journal of Internal Medicine · 2025-01-21 · 4 citations

  articleOpen access

  OBJECTIVE: Bictegravir or dolutegravir based antiretroviral therapy are first-line HIV treatments. However, no trial has recruited enough participants to estimate the most effective treatment, and there is little evidence on the comparative effectiveness of bictegravir and other available antiretrovirals, like efavirenz and raltegravir. METHODS: We emulated a four-arm target trial using country-wide data from Mexico. The eligibility criteria of the target trial were people with HIV, treatment naïve with viral load >500 copies/mL, without tuberculosis, not pregnant, and started either bictegravir, dolutegravir, efavirenz or raltegravir-based treatment between July 2019 and September 2021. The main outcome was the probability of viral suppression (HIV-RNA <50 copies/mL) at three months estimated using an adjusted logistic regression model, with assignment assumed to be random within levels of adjusted covariates. Probabilities were compared via differences and non-parametric bootstrapping was used to calculate 95 % confidence intervals. RESULTS: 20,285 individuals were included, of whom 84.3 % started bictegravir, 7.2 % dolutegravir, 6.6 % efavirenz, and 1.8 % raltegravir. The adjusted probability of viral suppression at 3 months was 79.4 % (79.4 %, 80.2 %) with bictegravir, 78.5 % (76.2 %, 81.1 %) with dolutegravir, 63.9 % (60.6 %, 67.7 %) with efavirenz, and 69.8 % (63.8 %, 76.1 %) with raltegravir. When compared with bictegravir, this resulted in differences of -0.8 % (-3.5 %, 1.9 %) for dolutegravir, -15.5 % (-19 %, -11.7 %) for efavirenz, and -9.6 % (-15.9 %, -3.3 %) for raltegravir. Differences shrank at twelve months and with a higher viral threshold (200 copies/mL). CONCLUSIONS: Bictegravir was similar to dolutegravir and slightly more effective than efavirenz or raltegravir at three months, but differences became negligible at twelve months.

  PublisherDOI

• Improving early grade reading performance in Nepal: differences between Nepali and non-Nepali students

  Education Economics · 2025-06-13 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• Prevalence of Albuminuria and Risk Factors for CKD in a Screening Program in Mexico

  Journal of the American Society of Nephrology · 2024-10-01

  article
  PublisherDOI

• Characteristics and outcomes of people living with HIV hospitalised at tertiary healthcare institutions during the COVID-19 pandemic in Mexico City

  BMC Infectious Diseases · 2024-05-24 · 2 citations

  articleOpen accessSenior authorCorresponding

  BACKGROUND: While existing research on people living with HIV (PWH) during the COVID-19 pandemic primarily focused on their clinical outcomes, a critical gap remains in understanding the implications of COVID-19 delivery of in-hospital care services to PWH. Our study aimed to describe the characteristics and outcomes of PWH hospitalised during 2020 in Mexico City, comparing patients admitted due to COVID-19 vs. patients admitted due to other causes. METHODS: All PWH hospitalised for ≥ 24 h at four institutions in Mexico City from January 1st to December 31st, 2020 were included. Patients were classified into two groups according to the leading cause of their first hospitalisation: COVID-19 or non-COVID-19. Characteristics among groups were compared using chi-square and Kruskal tests. A Cox model was used to describe the risk of death after hospitalisation and the characteristics associated with this outcome. Mortality and hospitalisation events were compared to data from 2019. RESULTS: Overall, we included 238 PWH hospitalised in 2020. Among them, 42 (18%) were hospitalised due to COVID-19 and 196 (82%) due to non-COVID-19 causes, mainly AIDS-defining events (ADE). PWH hospitalised due to COVID-19 had higher CD4 + cell counts (380 cells/mm3 [IQR: 184-580] vs. 97 cells/mm3 [IQR: 34-272], p < 0.01) and a higher proportion of virologic suppression (VS) compared to those hospitalised due to non-COVID-19 causes (92% vs. 55%, p < 0.01). The adjusted hazard ratio (aHR) for AIDS was 3.1 (95%CI: 1.3-7.2). COVID-19 was not associated with death (aHR 0.9 [95%CI: 0.3-2.9]). Compared to 2019, mortality was significantly higher in 2020 (19% vs. 9%, p < 0.01), while hospitalisations decreased by 57%. CONCLUSIONS: PWH with COVID-19 had higher VS and CD4 + cell counts and lower mortality compared to those hospitalised due to non-COVID-19-related causes, who more often were recently diagnosed with HIV and had ADEs. Most hospitalisations and deaths in 2020 in PWH were related to advanced HIV disease. The increased mortality and decreased hospitalisations of PWH during 2020 evidence the impact of the interruption of health services delivery for PWH with advanced disease due to the pandemic. Our findings highlight the challenges faced by PWH during 2020 in a country where advanced HIV remains a concern.

  PublisherOA PDFDOI

• Bloodstream Infections in the Context of Hemodialysis Care: Experience in a Wide Mexican Renal Health Network

  Journal of the American Society of Nephrology · 2024-10-01

  article1st authorCorresponding

  Background: Infections are the 2nd cause of morbidity and mortality among hemodyalisis (HD) patients with chronic kidney disease (CKD). Preventing blood stream infections (BSIs) is challenging due to several factors. In our cohort, about 60% of patients use catheters, which is below the national average. Here we detail the experience and trends in BSI rates at our centers from 2019 to 2023, considering the interventions implemented. Methods: Data on BSI rates and isolated microorganisms were extracted from our electronic records. Catheter-days BSI rates were calculated. Through a chronological timeline, we described the interventions implemented in accordance with our protocols. Results: By the end of 2023, around 2,300 individuals were receiving HD at our centers. The annual infection rates from 2019 to 2023 were 0.73, 0.81, 1.24, 0.42, and 0.50, respectively. COVID-19 lockdown in Mexico started on Apr 2020. By 2021, we started taking care of over 1,000 individuals from a new HD clinic, lacking established BSI prevention protocols, which led to a spike in BSI rates. We implemented these measures: Formed small teams within large centers (over 500 patients) to better assess BSI risk (Int 1). Developed an emergency alert and used gentamycin preventive locks when an outbreak was detected (Int 2). The strategies resulted in a 66% reduction in BSIs, sustained during follow-up. The most frequently isolated gram-positive cocci (GPC) and gram-negative rods (GNR) were S. aureus and Enterobacter sp., respectively. We did not observe increased antibiotic resistance with the use of gentamycin locks. Conclusion: The enhancement of surveillance for individuals at higher risk of BSIs through the establishment of specialized teams within large HD centers, and the use of gentamicin preventive locks has proven effective in reducing BSI rates. Funding: Clinical Revenue Support

  PublisherDOI

• Prevalence of Hepatitis B Virus Antibody Levels Seroconversion in Patients on Hemodialysis: Mexican Cohort at Medica Santa Carmen

  Journal of the American Society of Nephrology · 2024-10-01

  article

  Background: Chronic Hemodialysis (HD) patients (px) are immunocompromised and hepatitis B virus (HBV) infection is a major concern due to increased susceptibility and poor vaccine response. Current recommendation related to HBV is to give vaccines during stage 5 in order to reach immunization and generate protective antibody levels of HBV (HbsAb). In Mexico, international HBV vaccination schedules for HD px are not necessarily accomplished (three double doses of 20 mcg/1ml for 6 months) and HbsAb are below what is desirable. Methods: We reviewed 1,967 HD px in Medica Santa Carmen kidney network and the main objective was to analyze seroconversion status with HbsAb over 10 mUI/ml. Vaccination status was uncertain for most px. Median, interquartile range and proportions were estimated. We compared groups with Man-Whitney U-test and chi square test. A regression model adjusted for significant variables was performed. Results: Seroconversion with HbsAb over 10 mUI/ml and 100 mUI/ml were 39% (760px) and 25% (487px) respectively. Comparative results by dividing HbsAb ≥10 vs HbsAb <10 mUI/ml groups are shown in the table. Significant differences were found in the HbsAb ≥10 mUI/ml group related to lower percentage of diabetes, hypertension, smoking and ischemic cardiopathy. In a multivariate analysis, age (OR 0.977, IC 0.970-0.984) and HD vintage (OR 1.004, IC 1.004-1.009) were statistically significant for seroconvertion status. Conclusion: In Mexico, individuals with protective levels of HbsAb is scarce. Immunized against the HBV group had lower weight, BMI and higher Kt/v. Younger patients and vintage in HD are related to better chances of being immunized. Funding: Clinical Revenue Support

  PublisherDOI

• Comparative Effectiveness of Switching to Bictegravir From Dolutegravir-, Efavirenz-, or Raltegravir-Based Antiretroviral Therapy Among Individuals With HIV Who are Virologically Suppressed

  Open Forum Infectious Diseases · 2024-07-30 · 4 citations

  articleOpen access

  Background: We aimed to determine the effectiveness of switching to bictegravir in maintaining an undetectable viral load (<50 copies/mL) among people with HIV (PWH) as compared with continuing dolutegravir-, efavirenz-, or raltegravir-based antiretroviral therapy using nationwide observational data from Mexico. Methods: We emulated 3 target trials comparing switching to bictegravir vs continuing with dolutegravir, efavirenz, or raltegravir. Eligibility criteria were PWH aged ≥16 years with a viral load <50 copies/mL and at least 3 months of current antiretroviral therapy (dolutegravir, efavirenz, or raltegravir) between July 2019 and September 2021. Weekly target trials were emulated during the study period, and individuals were included in every emulation if they continued to be eligible. The main outcome was the probability of an undetectable viral load at 3 months, which was estimated via an adjusted logistic regression model. Estimated probabilities were compared via differences, and 95% CIs were calculated via bootstrap. Outcomes were also ascertained at 12 months, and sensitivity analyses were performed to test our analytic choices. Results: We analyzed data from 3 028 619 PWH (63 581 unique individuals). The probability of an undetectable viral load at 3 months was 2.9% (95% CI, 1.9%-3.8%), 1.3% (95% CI, .9%-1.6%), and 1.2% (95% CI, .8%-1.7%) higher when switching to bictegravir vs continuing with dolutegravir, efavirenz, and raltegravir, respectively. Similar results were observed at 12 months and in other sensitivity analyses. Conclusions: Our findings suggest that switching to bictegravir could be more effective in maintaining viral suppression than continuing with dolutegravir, efavirenz, or raltegravir.

  PublisherOA PDFDOI

Frequent coauthors

• Anne Case

  National Bureau of Economic Research

  30 shared

• Cally Ardington

  University of Cape Town

  16 shared

• Juan Sierra‐Madero

  Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

  11 shared

• Analía Olgiati

  Harvard University

  11 shared

• Anupam Garrib

  University College London

  11 shared

• Murray Leibbrandt

  University of Cape Town

  7 shared

• Alı́cia Adserà

  IZA - Institute of Labor Economics

  7 shared

• David Lam

  6 shared