*Division of Internal Medicine, Department of Medicine, San Francisco General Hospital, University of California, San Francisco (UCSF), San Fransisco, CA;†Mfangano Island Research Group, Organic Health Response, Homa Bay, Kenya;‡Microclinic International (MCI), San Francisco, CA;§Department of Family and Community Medicine, University of Minnesota, Minneapolis, MN;‖Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA;¶Department of Medicine, Division of HIV/AIDS, University of California, San Francisco (UCSF), San Francisco, CA;#Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, CA;**Department of Surgery, University of California, San Francisco (UCSF) East Bay, Oakland, CA;††Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA;‡‡Centre for Microbial Research, Kenya Medical Research Institute, Nairobi, Kenya; and§§Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA.