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Sample records for high hiv risk

  1. High risk populations and HIV-1 infection in China

    Institute of Scientific and Technical Information of China (English)

    Tuo Fu ZHU; Chun Hui WANG; Peng LIN; Na HE

    2005-01-01

    China is currently experiencing one of the most rapidly expanding HIV epidemics in the world. Although the overall prevalence rate is still low, with a population of 1.3 billion, high-risk factors which have contributed to the HIV/AIDS epidemics worldwide continue to prevail in China, including a high rate of injecting drug use and needle sharing,commercial sex with low rates of condom use, and concurrent sex with both commercial sex workers and noncommercial casual or steady sex partners. In addition, there are increasing "double risk" populations overlapping drug users and sex workers, as well as increasing rates of STDs and HIV among high-risk populations. Sexual transmission,therefore, may serve as a bridge connecting high-risk populations with general populations. There is an urgent need to prevent the spread of HIV from these high-risk populations into the general population of China.

  2. Endorsement of compulsory HIV vaccination policy among populations at high risk of HIV exposure (LA VOICES).

    Science.gov (United States)

    Newman, Peter A; Lee, Sung-Jae; Rudy, Ellen T; Diamant, Allison; Duan, Naihua; Nakazono, Terry; Nakazano, Terry; Cunningham, William E

    2014-06-01

    Compulsory vaccination is a frequently implemented policy option for ensuring comprehensive vaccine coverage. Ongoing controversies around human papillomavirus vaccine dissemination, and suboptimal coverage, suggest the value of assessing acceptability of compulsory vaccinations-particularly among likely target populations-in advance of their public availability to support evidence-informed interventions. With the first HIV vaccine to demonstrate partial efficacy in a large-scale clinical trial, we examined individual characteristics and attitudes associated with support for compulsory HIV vaccination policy among a diverse, representative sample of adults attending probable HIV vaccine dissemination venues in a large urban county. Participants were recruited using three-stage probability sampling from likely venues for future HIV vaccine dissemination. We used Audio-CASI to administer a 60-min structured questionnaire. Items included endorsement of compulsory HIV vaccination policy, sociodemographic characteristics, injecting drug use, vaccine attitudes and perceived HIV risk. Among 1,225 participants (mean age = 36.8 years; 55.6 % males, 37.6 % non-English speaking Hispanic, 78.8 % heterosexual, 25.7 % injection drug users), almost half (48.2 %) endorsed a compulsory HIV vaccination policy. Non-English speaking Hispanics compared to whites, participants with less than high school education, higher positive vaccine attitude scores and higher perceived HIV risk were significantly more likely, and people who inject drugs significantly less likely to endorse compulsory HIV vaccination. Public health interventions to promote positive vaccine attitudes and accurate perceptions of HIV risk among vulnerable populations, and strategies tailored for people who inject drugs, may build support for compulsory HIV vaccination policy and promote broad HIV vaccine coverage.

  3. Risk factors for high-risk human papillomavirus detection among HIV-negative and HIV-positive women from Tanzania.

    Science.gov (United States)

    Dartell, Myassa; Rasch, Vibeke; Munk, Christian; Kahesa, Crispin; Mwaiselage, Julius; Iftner, Thomas; Kjaer, Susanne Krüger

    2013-09-01

    Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The prevalence is dependent on several known factors notably sexual behavior and age, and factors still under scrutiny. This study aimed to examine risk factors for high-risk (HR) HPV infection among HIV-positive and HIV-negative women from the general population of Tanzania and to assess whether specific risk factors could contribute to the high prevalence of HR HPV infection in older age found in some populations including Tanzanian women. A cross-sectional study of 3699 women from Tanzania was conducted. We obtained information on sociodemographic and lifestyle factors through personal interview. Cervical swabs were collected for detection of HR HPV (Hybrid Capture 2; Qiagen, Hildesheim, Germany) and genotyping (LiPaExtra; Innogenetics, Gent, Belgium). Finally, we obtained a blood sample for HIV testing. HIV positivity was the strongest risk factor for HR HPV (odds ratio, 4.1; 95% confidence interval, 3.3-5.3). Young age, shorter duration of present relationship, and increasing number of sex partners were also associated with higher risk for HR HPV. Among women 20 to 29 years old, especially number of partners (P = 0.005) and HIV positivity (P HIV positivity (P = 0.0009) increased the risk, whereas increasing number of partners was not related to the risk of HR HPV (P = 0.46). Human papillomavirus risk factors among HIV-positive and HIV-negative women were similar, but the strength of association was greater among HIV-positive women, notably for lifetime number of sex partners, time in present relationship, genital warts, and body mass index. We were not able to identify a clear explanation for the high HPV prevalence among older women. However, in the age-stratified analysis, potential indicators of decreased immunity increased the risk for HPV infection among older women, whereas in younger women, risk was particularly associated with sexual activity.

  4. HIV Sentinel Surveillance Among High Risk Groups: Scenario In Gujarat

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    L B Chavan, Prakash Patel, Vaibhav Gharat

    2011-01-01

    Full Text Available Background: Surveillance is the ongoing systematic collection, collation, analysis and interpretation of data so that appropriate action can be taken within time. Aims and Objective: The present annual HIV sentinel surveillance (HSS was carried out for monitoring trends of HIV epidemic in high risk group populations in selected sites of Gujarat state.. Methodology: The HSS was carried out in representative populations from High Risk Group (HRG like Female Sex Workers (FSW, Man having Sex with Man (MSM and Single Male Migrant. Target sample size was 250 at each HRG site (Female Sex Worker, Male Sex Male & SMM. Consecutive sampling was done at designated sentinel site for selecting the survey participants. Results: Overall 3726 samples (1494 FSWs, 1732 MSMs & 500 SMM were tested in the High risk group of HSS 2008. The overall sero-positivity in samples from FSWs, MSMs sites was 4.5%. Sero-positivity was more or less high (? 5% among FSWs as well as MSMs irrespective of age, place of residence, literacy level, occupation; and migration status. Conclusion: The overall trend of sero-positivity in High risk groups shows decreasing trend of HIV in the state from 2004 to 2008.

  5. Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.

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    Susan C Irvin

    Full Text Available Epidemiological studies suggest that medroxyprogesterone acetate (MPA may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms.Human vaginal epithelial (VK2/E6E7, peripheral blood mononuclear (PBMC, and polarized endometrial (HEC-1-A cells were treated with a range of concentrations of MPA (0.015-150 μg/ml and the impact on gene expression, protein secretion, and HIV infection was evaluated.Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively.We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.

  6. Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.

    Science.gov (United States)

    Irvin, Susan C; Herold, Betsy C

    2015-01-01

    Epidemiological studies suggest that medroxyprogesterone acetate (MPA) may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms. Human vaginal epithelial (VK2/E6E7), peripheral blood mononuclear (PBMC), and polarized endometrial (HEC-1-A) cells were treated with a range of concentrations of MPA (0.015-150 μg/ml) and the impact on gene expression, protein secretion, and HIV infection was evaluated. Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively. We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml) MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.

  7. Factors Associated with Recent HIV Testing among Heterosexuals at High-Risk for HIV Infection in New York City

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    Marya eGwadz

    2016-04-01

    Full Text Available Background. The CDC recommends persons at high-risk for HIV infection in the United States receive annual HIV testing to foster early HIV diagnosis and timely linkage to health care. Heterosexuals make up a significant proportion of incident HIV infections (>25%, but test for HIV less frequently than those in other risk categories. Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high-risk for HIV. Methods. Participants were African American/Black and Hispanic heterosexual adults (N=2307 residing in an urban area with both high poverty and HIV prevalence rates. Participants were recruited by respondent-driven sampling (RDS in 2012-2015 and completed a computerized structured assessment battery covering background factors, multi-level putative facilitators of HIV testing, and HIV testing history. Separate logistic regression analysis for males and females identified factors associated with past-year HIV testing.Results. Participants were mostly male (58%, African American/Black (75%, and 39 years old on average (SD = 12.06 years. Lifetime homelessness (54% and incarceration (62% were common. Half reported past-year HIV testing (50% and 37% engaged in regular, annual HIV testing. Facilitators of HIV testing common to both genders included sexually transmitted infection (STI testing or STI diagnosis, peer norms supporting HIV testing, and HIV testing access. Among women, access to general medical care and extreme poverty further predicted HIV testing, while recent drug use reduced the odds of past-year HIV testing. Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment.Conclusions. The present study identified gaps in rates of HIV testing among heterosexuals at high-risk for HIV, and both common and

  8. Thoughts, Attitudes, and Feelings of HIV-Positive MSM Associated with High Transmission-Risk Sex

    Science.gov (United States)

    Skinta, Matthew D.; Murphy, Jessie L.; Paul, Jay P.; Schwarcz, Sandra K.; Dilley, James W.

    2012-01-01

    This study presents survey data collected from a sample of HIV-positive men (N = 182) who had high transmission-risk sex, defined as unprotected anal intercourse with a man whose HIV-status was negative or unknown, in the previous 6 months. Despite the tremendous changes in HIV treatment and their impact on people living with HIV, little recent…

  9. Effect of rapid HIV testing on HIV incidence and services in populations at high risk for HIV exposure: an equity-focused systematic review

    OpenAIRE

    Pottie, Kevin; Medu, Olanrewaju; Welch, Vivian; Dahal, Govinda P.; Tyndall, Mark; Rader, Tamara; Wells, George

    2014-01-01

    Objective To assess the effects of rapid voluntary counselling and testing (VCT) for HIV on HIV incidence and uptake of HIV/AIDS services in people at high risk for HIV exposure. Design Cochrane systematic review and meta-analysis. Data sources We searched PubMed, EMBASE, AIDSearch, LILACS, Global Health, Medline Africa, PsychInfo, CINAHL, Cochrane CENTRAL, Cochrane HIV/AIDS Group Specialized Register and grey literature from 1 January 2001 to 5 June 2014 without language restriction. Data se...

  10. Perceptions of Community HIV/STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates.

    Science.gov (United States)

    Blackstock, Oni J; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L; Justman, Jessica; Golin, Carol E; Haley, Danielle F; Kuo, Irene; Adimora, Adaora A; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing; Mannheimer, Sharon B

    2015-08-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community's HIV/STI risk. We explored perceptions of community HIV/STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women's HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/STI risk driven by structural factors.

  11. Prevalence of HIV infection in seronegative high-risk individuals examined by virus isolation and PCR

    DEFF Research Database (Denmark)

    Nielsen, C; Teglbjærg, Lars Stubbe; Pedersen, C

    1991-01-01

    HIV seronegative individuals with high-risk behavior were tested for HIV infection by sensitive virus isolation techniques using T4 lymphocytes and monocyte/macrophages, and by detection of proviral DNA using PCR with three different sets of nested primers. No evidence of HIV infection was found...... among the 31 seronegative high-risk subjects, either by virus isolation of by PCR (97.5% confidence limits, 0-11). Our results indicate that ongoing HIV infection in seronegative persons at high risk of infection is a rare event....

  12. Risk factors and characteristics of youth living with, or at high risk for, HIV

    NARCIS (Netherlands)

    Huba, GJ; Melchior, LA; Panter, AT; Trevithick, L; Woods, ER; Wright, E; Feudo, R; Tierney, S; Schneir, A; Tenner, A; Remafedi, G; Greenberg, B; Sturdevant, M; Goodman, E; Hodgins, A; Wallace, M; Brady, RE; Singer, B

    2000-01-01

    Over 8,000 adolescents and young adults (4,111 males; 4,085 females) reported on several HIV-related risk behaviors during enrollment into 10 service demonstration projects targeted to youth living with, or at risk for, HIV. Distinct risk patterns emerged by gender when predicting HIV serostatus (ve

  13. Erectile Dysfunction Among HIV Patients Undergoing Highly Active Antiretroviral Therapy: Dyslipidemia as a Main Risk Factor

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    Gustavo Romero‐Velez, MD

    2014-04-01

    Conclusions: ED is highly prevalent in HIV patients. Dyslipidemia should be considered as a risk factor for ED in HIV patients. Romero‐Velez G, Lisker‐Cervantes A, Villeda‐Sandoval CI, Sotomayor de Zavaleta M, Olvera‐Posada D, Sierra‐Madero JG, Arreguin‐Camacho LO, and Castillejos‐Molina RA. Erectile dysfunction among HIV patients undergoing highly active antiretroviral therapy: Dyslipidemia as a main risk factor. Sex Med 2014;2:24–30.

  14. High risk behavior for HIV transmission among former injecting drug users:a survey from Indonesia

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    Iskandar Shelly

    2010-08-01

    Full Text Available Abstract Background Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use. Methods Current and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test. Results Ninety-two out of 210 participants (44% were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66% and current (60% IDUs. Conclusion Former IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.

  15. Bullying and HIV Risk Among High School Teenagers: The Mediating Role of Teen Dating Violence.

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    Okumu, Moses; Mengo, Cecilia; Ombayo, Bernadette; Small, Eusebius

    2017-10-01

    Teen dating violence (TDV), bullying, and HIV risk behaviors are public health concerns that impact adolescents in the United States. National estimates reveal high rates of these risk behaviors among high school students. Based on theoretical and empirical evidence, we hypothesized that experiencing teen dating violence (sexual and physical) would mediate the impact of bullying on HIV risk. Data were from the 2013 National Youth Behavior Risk Surveillance Survey (YRBSS) among students who answered questions on bullying, TDV, and HIV risk (N = 13,571). The YRBSS is conducted biennially among 9th- to 12th-grade students nationally. We used multiple regression analysis and Hayes' SPSS process macro to examine the 2 study hypotheses. Findings from bivariate analysis suggest an association between bullying and HIV risk. The study also found associations between physical, sexual teen dating violence and HIV risk. Results also indicate that both physical and sexual teen dating violence mediate the association between bullying and HIV risk. Our findings suggest that multidimensional interventions should be developed to reduce the rate of teen dating violence and combat bullying as a preventative method for HIV risk among high school students. © 2017, American School Health Association.

  16. T-lymphocyte subsets in HIV-infected and high-risk HIV-uninfected adolescents - Retention of naive T lymphocytes in HIV-infected adolescents

    NARCIS (Netherlands)

    Douglas, SD; Rudy, B; Muenz, L; Starr, SE; Campbell, DE; Wilson, C; Holland, C; Crowley-Nowick, P; Vermund, SH

    2000-01-01

    Background: The capacity of the immune system of adolescents to generate and repopulate naive and memory cell populations under conditions of normal homeostasis and human immunodeficiency virus (HIV) infection is largely unknown. Objective: To assess lymphocyte subsets in HIV-infected and high-risk

  17. Doctors May Not Be Telling High-Risk Patients about HIV Prevention Drug

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    ... news/fullstory_161405.html Doctors May Not Be Telling High-Risk Patients About HIV Prevention Drug Less ... Copyright (c) 2016 HealthDay . All rights reserved. News stories are provided by HealthDay and do not reflect ...

  18. It’s a Process: Reactions to HIV Diagnosis and Engagement in HIV Care among High-Risk Heterosexuals

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    Alexandra H. Kutnick

    2017-05-01

    Full Text Available After HIV diagnosis, heterosexuals in high-poverty urban areas evidence delays in linkage to care and antiretroviral therapy initiation compared to other groups. Yet barriers to/facilitators of HIV care among these high-risk heterosexuals are understudied. Under the theory of triadic influence, putative barriers to HIV care engagement include individual/attitudinal-level (e.g., fear, medical distrust, social-level (e.g., stigma, and structural-level influences (e.g., poor access. Participants were African-American/Black and Hispanic adults found newly diagnosed with HIV (N = 25 as part of a community-based HIV testing study with heterosexuals in a high-poverty, high-HIV-incidence urban area. A sequential explanatory mixed-methods design was used. We described linkage to HIV care and clinical outcomes [CD4 counts, viral load (VL levels] over 1 year, and then addressed qualitative research questions about the experience of receiving a new HIV diagnosis, its effects on timely engagement in HIV care, and other barriers and facilitators. Participants were assessed five times, receiving a structured interview battery, laboratory tests, data extraction from the medical record, a post-test counseling session, and in-person/phone contacts to foster linkage to care. Participants were randomly selected for qualitative interviews (N = 15/25 that were recorded and transcribed, then analyzed using systematic content analysis. Participants were 50 years old, on average (SD = 7.2 years, mostly male (80%, primarily African-American/Black (88%, and low socioeconomic status. At the first follow-up, rates of engagement in care were high (78%, but viral suppression was modest (39%. Rates improved by the final follow-up (96% engaged, 62% virally suppressed. Two-thirds (69% were adequately retained in care over 1 year. Qualitative results revealed multi-faceted responses to receiving an HIV diagnosis. Problems accepting and internalizing one

  19. HIV Prevalence Correlates with High-Risk Sexual Behavior in Ethiopia's Regions

    Science.gov (United States)

    Kenyon, Chris R.; Tsoumanis, Achilleas; Schwartz, Ilan Steven

    2015-01-01

    Background HIV prevalence varies between 0.9 and 6.5% in Ethiopia’s eleven regions. Little has been published examining the reasons for this variation. Methods We evaluated the relationship between HIV prevalence by region and a range of risk factors in the 2005 and 2011 Ethiopian Demographic Health Surveys. Pearson’s correlation was used to assess the relationship between HIV prevalence and each variable. Results There was a strong association between HIV prevalence and three markers of sexual risk: mean lifetime number of partners (men: r = 0.87; P cohabiting partner (men: r = 0.92; P premarital sex. Condom usage and HIV testing were positively associated with HIV prevalence, while the prevalence of circumcision, polygamy, age at sexual debut and male migration were not associated with HIV prevalence. Conclusion Variation in sexual behavior may contribute to the large variations in HIV prevalence by region in Ethiopia. Population-level interventions to reduce risky sexual behavior in high HIV incidence regions should be considered. PMID:26496073

  20. HIV Prevalence Correlates with High-Risk Sexual Behavior in Ethiopia's Regions.

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    Chris R Kenyon

    Full Text Available HIV prevalence varies between 0.9 and 6.5% in Ethiopia's eleven regions. Little has been published examining the reasons for this variation.We evaluated the relationship between HIV prevalence by region and a range of risk factors in the 2005 and 2011 Ethiopian Demographic Health Surveys. Pearson's correlation was used to assess the relationship between HIV prevalence and each variable.There was a strong association between HIV prevalence and three markers of sexual risk: mean lifetime number of partners (men: r = 0.87; P < 0.001; women: r = 0.60; P = 0.05; reporting sex with a non-married, non-cohabiting partner (men: r = 0.92; P < 0.001, women r = 0.93; P < 0.001; and premarital sex. Condom usage and HIV testing were positively associated with HIV prevalence, while the prevalence of circumcision, polygamy, age at sexual debut and male migration were not associated with HIV prevalence.Variation in sexual behavior may contribute to the large variations in HIV prevalence by region in Ethiopia. Population-level interventions to reduce risky sexual behavior in high HIV incidence regions should be considered.

  1. Strategies to uncover undiagnosed HIV infection among heterosexuals at high risk and link them to HIV care with high retention: a "seek, test, treat, and retain" study.

    Science.gov (United States)

    Gwadz, Marya; Cleland, Charles M; Hagan, Holly; Jenness, Samuel; Kutnick, Alexandra; Leonard, Noelle R; Applegate, Elizabeth; Ritchie, Amanda S; Banfield, Angela; Belkin, Mindy; Cross, Bridget; Del Olmo, Montserrat; Ha, Katharine; Martinez, Belkis Y; McCright-Gill, Talaya; Swain, Quentin L; Perlman, David C; Kurth, Ann E

    2015-05-10

    Over 50,000 individuals become infected with HIV annually in the U.S., and over a quarter of HIV infected individuals are heterosexuals. Undiagnosed HIV infection, as well as a lack of retention in care among those diagnosed, are both primary factors contributing to ongoing HIV incidence. Further, there are racial/ethnic disparities in undiagnosed HIV and engagement in care, with African Americans/Blacks and Latinos remaining undiagnosed longer and less engaged in care than Whites, signaling the need for culturally targeted intervention approaches to seek and test those with undiagnosed HIV infection, and link them to care with high retention. The study has two components: one to seek out and test heterosexuals at high risk for HIV infection, and another to link those found infected to HIV care with high retention. We will recruit sexually active African American/Black and Latino adults who have opposite sex partners, negative or unknown HIV status, and reside in locations with high poverty and HIV prevalence. The "Seek and Test" component will compare the efficacy and cost effectiveness of two strategies to uncover undiagnosed HIV infection: venue-based sampling and respondent-driven sampling (RDS). Among those recruited by RDS and found to have HIV infection, a "Treat and Retain" component will assess the efficacy of a peer-driven intervention compared to a control arm with respect to time to an HIV care appointment and health indicators using a cluster randomized controlled trial design to minimize contamination. RDS initial seeds will be randomly assigned to the intervention or control arm at a 1:1 ratio and all recruits will be assigned to the same arm as the recruiter. Participants will be followed for 12 months with outcomes assessed using medical records and biomarkers, such as HIV viral load. Heterosexuals do not test for HIV as frequently as and are diagnosed later than other risk groups. The study has the potential to contribute an efficient, innovative

  2. HIV seroprevalence in various high risk groups at Jaipur

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    Narayan Raj

    1994-01-01

    Full Text Available 100 patients of STD were subjected to HIV testing and this included cases of genital warts, chancroid, shyphilis, genital herpes, balanoposthitis and gonorrhoea. 5% cases were positive for antibodies by ELISA/particle agglutination test and all were confirmed by W.B. test. 25 prostitutes showed 28% positivity for antibodies to HIV. This is an alarming fact and more stress for HIV positivity to be given in STD patients and prostitutes.

  3. HIV seroprevalence in various high risk groups at Jaipur

    OpenAIRE

    Narayan Raj; Mathur Deepak; Bhargava Rishi; Agarwal U; Sexena V

    1994-01-01

    100 patients of STD were subjected to HIV testing and this included cases of genital warts, chancroid, shyphilis, genital herpes, balanoposthitis and gonorrhoea. 5% cases were positive for antibodies by ELISA/particle agglutination test and all were confirmed by W.B. test. 25 prostitutes showed 28% positivity for antibodies to HIV. This is an alarming fact and more stress for HIV positivity to be given in STD patients and prostitutes.

  4. High HCV seroprevalence and HIV drug use risk behaviors among injection drug users in Pakistan

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    Zafar Tariq

    2006-08-01

    Full Text Available Abstract Introduction HIV and HCV risk behaviors among injection drug users (IDUs in two urban areas in Pakistan were identified. Methods From May to June 2003, 351 IDUs recruited in harm-reduction drop-in centers operated by a national non-governmental organization in Lahore (Punjab province and Quetta (Balochistan province completed an interviewer-administered survey and were tested for HIV and HCV. Multivariable logistic regression identified correlates of seropositivity, stratifying by site. All study participants provided written, informed consent. Results All but two were male; median age was 35 and Discussion Despite no HIV cases, overall HCV prevalence was very high, signaling the potential for a future HIV epidemic among IDUs across Pakistan. Programs to increase needle exchange, drug treatment and HIV and HCV awareness should be implemented immediately.

  5. Recruitment of Caribbean female commercial sex workers at high risk of HIV infection

    Science.gov (United States)

    Deschamps, Marie Marcelle; Zorrilla, Carmen D.; Morgan, Cecilia A.; Donastorg, Yeycy; Metch, Barbara; Madenwald, Tamra; Joseph, Patrice; Severe, Karine; Garced, Sheyla; Perez, Marta; Escamilia, Gina; Swann, Edith; Pape, Jean William

    2014-01-01

    Objective To evaluate novel eligibility criteria and outreach methods to identify and recruit women at high risk of HIV-1 infection in the Caribbean. Methods A prospective cohort study was conducted in 2009–2012 among 799 female commercial sex workers in the Dominican Republic, Haiti, and Puerto Rico. Minimum eligibility criteria included exchange of sex for goods, services, or money in the previous 6 months and unprotected vaginal or anal sex with a man in the previous 6 months. Sites used local epidemiology to develop more stringent eligibility criteria and recruitment strategies. Participants were asked questions about HIV/AIDS and their level of concern about participating in an HIV vaccine trial. Logistic regression modeling was used to assess predictors of prevalent HIV infection and willingness to participate in a future HIV vaccine study. Results HIV prevalence at screening was 4.6%. Crack cocaine use [odds ratio (OR) = 4.2, 95% confidence interval (CI) (1.8–9.0)] was associated with and having sex with clients in a hotel or motel [OR = 0.5, CI (0.3–1.0)] was inversely associated with HIV infection. A total of 88.9% of enrolled women were definitely or probably willing to participate in a future HIV vaccine trial. Conclusions This study indicated that local eligibility criteria and recruitment methods can be developed to identify and recruit commercial sex workers with higher HIV prevalence than the general population who express willingness to join an HIV vaccine trial. PMID:24096973

  6. HIV and sexual risk behaviors among recognized high-risk groups in Bangladesh: need for a comprehensive prevention program.

    Science.gov (United States)

    Islam, Md Mofizul; Conigrave, Katherine M

    2008-07-01

    To examine trends in HIV and related risk behaviors among recognized high-risk groups in Bangladesh, the types and extent of prevention initiatives that have been undertaken, and highlight the immediate needs. Journal publications and conference abstracts and proceedings were reviewed. Experts involved in the development and evaluation of current programs or policy were contacted for official reports and policy documents. The trends in sexual risk behaviors over five rounds of national surveillance were tabulated. Gaps in the ongoing prevention interventions have been assessed in the light of the Anderson-May equation. Periodic surveillance on recognized high-risk groups shows that HIV prevalence has been increasing steadily. In the capital city, HIV prevalence in one subset of a high-risk group is close to the level of a concentrated epidemic (4.9%). The high prevalence of sexual risk behaviors among drug users and sex workers and their clients is alarming. Although a small increase in condom use and a reduction of syphilis have been noted among subsets of high-risk groups in recent years, this is clearly not enough to curb the threat of a possible HIV epidemic. There is an urgent need for a comprehensive prevention program that should include more efforts on education and condom promotion, effective management of all sexually transmitted infections, a screening program for migrant workers, the continuation of both behavioral and serological components of HIV surveillance, and the expansion of surveillance to cover the remaining high-risk groups, with due consideration to the consistency of surveillance indicators.

  7. HIV infection and high-risk behaviours in a Paraguayan military population.

    Science.gov (United States)

    Laguna-Torres, V Alberto; Aguayo, Nicolás; Aguilar, Gloria; Ampuero, Julia S; Galeano, Adolfo; Barboza, Alma; Villafane, Margarita; Jiménez, Liliana; Perez, Juan; Kochel, Tadeusz J; Halsey, Eric S

    2014-10-01

    Between July 2005 and January 2006 we evaluated 1248 Paraguayan active duty military volunteers. Participants provided a blood sample for HIV testing and answered an anonymous survey. HIV seroprevalence was 0.4% (5 of 1248) among participants. The median age at first sexual intercourse was 16 years. Only 14.8% of participants reported condom use with every sexual encounter. Military students used condoms the most. Participants older than 45 years, compared with younger participants, had a fourfold (adjusted odds ratio 4.3) increased risk of not using condoms. Men were less likely to use a condom, more likely to practice anal intercourse, and had more sexual partners than women. Officers and non-commissioned officers were identified to have a twofold (as measured by adjusted odds ratio = 2.00 and 2.22, respectively) increased risk of having more than two sexual partners in the last month compared with students. Both officers and non-commissioned officers were twice as likely as students to practice anal intercourse. Despite the high-risk behaviours reported by those surveyed, HIV seroprevalence in active duty personnel was low. Future efforts should emphasize on the correct condom use keeping focus on the high-risk behaviours of groups at risk, and on routinely testing the military personnel for HIV.

  8. Effect of rapid HIV testing on HIV incidence and services in populations at high risk for HIV exposure: an equity-focused systematic review.

    Science.gov (United States)

    Pottie, Kevin; Medu, Olanrewaju; Welch, Vivian; Dahal, Govinda P; Tyndall, Mark; Rader, Tamara; Wells, George

    2014-12-15

    To assess the effects of rapid voluntary counselling and testing (VCT) for HIV on HIV incidence and uptake of HIV/AIDS services in people at high risk for HIV exposure. Cochrane systematic review and meta-analysis. We searched PubMed, EMBASE, AIDSearch, LILACS, Global Health, Medline Africa, PsychInfo, CINAHL, Cochrane CENTRAL, Cochrane HIV/AIDS Group Specialized Register and grey literature from 1 January 2001 to 5 June 2014 without language restriction. We included controlled studies that compared rapid VCT with conventional testing among people at risk for HIV exposure. Two reviewers extracted data. We used Cochrane risk of bias tool and GRADE criteria: risk of bias, inconsistency, indirectness, imprecision and publication bias. For observational studies we used the Newcastle-Ottawa Scale. We used the PRISMA-Equity reporting guideline. From 2441 articles, we included 8 randomised controlled trials and 5 observational studies. Rapid VCT was associated with a threefold increase in HIV-testing uptake (relative risk (RR)=2.95 95% CI 1.69 to 5.16) and a twofold increase in the receipt of test results (RR=2.14, 95% CI 1.08 to 4.24). Women accepted testing more often than men in rapid VCT arm, but no differences in effect for age or socioeconomic status. Observational studies also showed rapid VCT led to higher rates of uptake of testing. Heterogeneity was high. A cluster-randomised trial reported an 11% reduction in HIV incidence in intervention communities (RR=0.89, 95% CI=0.63 to 1.24) over 3 years trial. Rapid VCT in health facilities and communities was associated with a large increase in HIV-testing uptake and receipt of results. This has implications for WHO guidelines. The routine use of rapid VCT may also help avoid human rights violations among marginalised populations where testing may occur without informed consent and where existing stigma may create barriers to testing. Published by the BMJ Publishing Group Limited. For permission to use (where not

  9. High Blood Pressure and Related Factors Among Individuals at High Risk for HIV/Sexually Transmitted Infections.

    Science.gov (United States)

    Nam, Soohyun; Whittemore, Robin; Jeon, Sangchoon; Davey-Rothwell, Melissa A; Latkin, Carl

    2016-06-01

    Data from a social network-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention study with a total of 330 men and women at high risk for HIV/STIs were used to examine the relationships between substance use, depressive symptoms, general health, cardiovascular disease risk factors, sociodemographic characteristics, and systolic/diastolic blood pressure (SBP/DBP). Approximately 60% of the participants had prehypertension to stage 2 hypertension. In the base model, older patients (Phigh SBP, whereas older age (Phigh frequency of alcohol drinking and high frequency of binge drinking remained significant for high SBP and DBP. These data suggest that future cardiovascular disease programs should target moderate alcohol consumption to improve blood pressure among individuals at high risk for HIV/STIs. © 2015 Wiley Periodicals, Inc.

  10. HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) TYPE-1 INFECTION STATUS AND IN-VITRO SUSCEPTIBILITY TO HIV-INFECTION AMONG HIGH-RISK HIV-1 SERONEGATIVE HEMOPHILIACS

    NARCIS (Netherlands)

    LEDERMAN, MM; JACKSON, JB; KRONER, BL; WHITE, GC; EYSTER, ME; ALEDORT, LM; HILGARTNER, MW; KESSLER, CM; COHEN, AR; KIGER, KP; GOEDERT, JJ

    1995-01-01

    Blood samples were obtained from 16 hemophiliacs who had a 50%-94% defined risk of human immunodeficiency virus (HIV type 1 infection on the basis of treatment history and from 14 controls not at risk for HIV infection. HIV-1 was not detected in any of 12 patient samples by cocultivation nor in 14 p

  11. Barriers and facilitators to voluntary HIV testing uptake among communities at high risk of HIV exposure in Chennai, India.

    Science.gov (United States)

    Woodford, Michael R; Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali

    2015-08-28

    In India, increasing uptake of voluntary HIV testing among 'core risk groups' is a national public health priority. While HIV testing uptake has been studied among key populations in India, limited information is available on multi-level barriers and facilitators to HIV testing, and experiences with free, publicly available testing services, among key populations. We conducted 12 focus groups (n = 84) and 12 key informant interviews to explore these topics among men who have sex with men, transgender women, cisgender female sex workers, and injecting drug users in the city of Chennai. We identified inter-related barriers at social-structural, health-care system, interpersonal, and individual levels. Barriers included HIV stigma, marginalised-group stigma, discrimination in health-care settings, including government testing centres, and fears of adverse social consequences of testing HIV positive. Facilitators included outreach programmes operated by community-based/non-governmental organisations, accurate HIV knowledge and risk perception for HIV, and access to drug dependence treatment for injecting drug users. Promoting HIV testing among these key populations requires interventions at several levels: reducing HIV-related and marginalised-group stigma, addressing the fears of consequences of testing, promoting pro-testing peer and social norms, providing options for rapid and non-blood-based HIV tests, and ensuring non-judgmental and culturally competent HIV counselling and testing services.

  12. Predicting substance abuse among youth with, or at high risk for, HIV

    NARCIS (Netherlands)

    Huba, GJ; Melchoir, LA; Greenberg, B; Trevithick, L; Feudo, R; Tierney, S; Sturdevant, M; Hodgins, A; Remafedi, G; Woods, ER; Wallace, M; Schneir, A; Kawata, AK; Brady, RE; Singer, B; Marconi, K; Wright, E; Panter, AT

    2000-01-01

    This article describes data from 4,111 males and 4,085 females participating in 10 HIV/AIDS service demonstration projects. The sample was diverse in age, gender, ethnicity, HIV status, and risk for HIV transmission. Logistic regression was used to determine the attributes that best predict substanc

  13. The epidemiology of human papillomavirus infection in HIV-positive and HIV-negative high-risk women in Kigali, Rwanda

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    Veldhuijzen Nienke J

    2011-12-01

    Full Text Available Abstract Background The prevalence, incidence and persistence of human papillomavirus (HPV types in sub-Saharan Africa are not well established. The objectives of the current study are to describe (predictors of the epidemiology of HPV among high-risk women in Kigali, Rwanda. Methods HIV-negative, high-risk women were seen quarterly for one year, and once in Year 2. HIV serostatus, clinical, and behavioral information were assessed at each visit, HPV types at Month 6 and Year 2, and other sexually transmitted infections (STI at selected visits. HPV prevalence was also assessed in HIV-positive, high-risk women. Results Prevalence of any HPV was 47.0% in HIV-negative women (median age 25 years compared to 72.2% in HIV-positive women (median age 27 years; OR 2.9, 95% CI 1.9-4.6. Among HIV-negative women, cumulative incidence of high-risk (HR-HPV was 28.0% and persistence 32.0% after a mean period of 16.6 and 16.9 months, respectively. Prior Chlamydia trachomatis and Neisseria gonorrhoeae infection, concurrent low-risk (LR-HPV infection and incident HSV-2 were associated with HR-HPV prevalence among HIV-negative women; prior C. trachomatis infection and co-infection with LR-HPV and HPV16-related HPV types with HR-HPV acquisition. HPV16-related types were the most prevalent and persistent. Conclusions High HPV prevalence, incidence and persistence were found among high-risk women in Kigali. HPV52 had the highest incidence; and, together with HPV33 and HPV58, were strongly associated with acquisition of other HR-HPV types in HIV-negative women.

  14. High risk of HIV in non-brothel based female sex workers in India

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    McPherson Sam

    2005-08-01

    Full Text Available Abstract Background Heterosexual contact is the most common mode of HIV transmission in India that is largely linked to sex work. We assessed the non-use of condoms in sex work and with regular sex partners by female sex workers (FSWs, and identified its associations that could assist in planning HIV prevention programmes. Methods Detailed documentation of various aspects of sex work, and sexual behaviour with regular sex partners, was done through confidential interviews for 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. Multivariate analysis was done to understand condom non-use with clients. Results 5010 (75.4%, 1499 (22.5%, and 139 (2.1% FSWs were street-, home-, and brothel-based, respectively. Of the total 6648 FSWs, 6165 (92.7% had penetrative vaginal/anal sex with at least one client in the last 15 days, and of these 2907 (47.2%; 95% CI 41.2–53.2% reported non-use of condom with at least one of her last three clients. Lack of knowledge that HIV could be prevented (odds ratio 5.01; 95% CI 4.38–5.73, no access to free condoms (odds ratio 3.45; 95% CI 2.99–3.98, being street-based as compared with brothel-based (odds ratio 3.36; 95% CI 1.87–6.04, and no participation in FSW support groups (odds ratio 2.02; 95% CI 1.50–2.70 were the most significant predictors of condom non-use with clients. Other associations included lower social support, lower income, age >24 years, illiteracy, and living in medium-size urban or rural areas. Of the 2582 who had penetrative sex with regular sex partner within the last 7 days, 2428 (94%; 95% CI 92.1–95.9% had not used condom at last sex, and 1032 (41.8% had neither used condom consistently with clients nor with regular sex partner. Conclusion About half the FSWs do not use condom consistently with their clients in this Indian state putting them at high risk of HIV infection. Non-brothel-based FSWs, who form the majority of sex workers in India, were at a significantly higher

  15. HIV prevalence and high-risk sexual behaviours among MSM repeat and first-time testers in China: implications for HIV prevention

    Directory of Open Access Journals (Sweden)

    Xue Bai

    2014-07-01

    Full Text Available Introduction: Little is known about HIV testing, HIV infection and sexual behaviour among bathhouse patrons in China. This study aims to assess differences in HIV prevalence and high-risk sexual behaviours between repeat and first-time testers among men who have sex with men (MSM attending bathhouse in Tianjin, China. Methods: Between March 2011 and September 2012, a HIV voluntary counselling and testing station was established in a gay bathhouse, which provided HIV testing and conducted a survey among participants recruited through snowball sampling. Differences in demographic and high-risk sexual behaviours between repeat and first-time testers were assessed using the chi-square test. Univariate and multivariate logistic regression analyses were conducted to identify predictors for HIV infection. Results: Of the 1642 respondents, 699 (42.6% were repeat testers and 943 (57.4% were first-time testers. Among repeat testers, a higher proportion were men aged 18 to 25, single, better educated, had a history of STIs and worked as male sex workers or “money boys” (MBs. Repeat testers were less likely to report having unprotected anal intercourse in the past six months. The overall HIV prevalence was 12.4% (203/1642. There was no difference in HIV prevalence between repeat (11.2%, 78/699 and first-time (13.3%, 125/943 testers. The HIV prevalence increased with age among first-time testers (χ 2 trend=9.816, p=0.002. First-time MB testers had the highest HIV prevalence of 34.5%. Conclusions: MSM attending bathhouse had an alarmingly high HIV infection rate, particularly in MB. Targeted interventions are urgently needed especially focusing on older MSM and MBs.

  16. Reduce HIV Risk

    Science.gov (United States)

    ... Our research has demonstrated remarkable success in reducing HIV risk-associated sexual behaviors among African American adolescents and adults." Read More "Nursing Research" Articles Nursing Research / Improve Hospital-to-Home Transitions / Reduce ...

  17. Rural Indian tribal communities: an emerging high-risk group for HIV/AIDS

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    Galwankar Sagar

    2005-02-01

    Full Text Available Abstract Background Rural Indian tribes are anthropologically distinct with unique cultures, traditions and practices. Over the years, displacement and rapid acculturation of this population has led to dramatic changes in their socio-cultural and value systems. Due to a poor health infrastructure, high levels of poverty and ignorance, these communities are highly vulnerable to various health problems, especially, communicable diseases including HIV/AIDS. Our study sought to assess knowledge, attitudes and practices regarding sexuality, and the risk factors associated with the spread of HIV/AIDS and STDs among these communities. Methods A nested cross sectional study was undertaken as part of the on going Reproductive and Child Health Survey. A total of 5,690 participants age 18–44 were recruited for this study. Data were obtained through home interviews, and focused on socio-demographics, knowledge, attitudes and behaviors regarding sexuality, HIV/AIDS and other STDs. Results The study revealed that only 22% of adults had even heard of AIDS, and 18 % knew how it is transmitted. In addition, only 5% knew that STDs and AIDS were related to each other. AIDS awareness among women was lower compared to men (14% vs.30 %. Regarding sexual practices, 35% of the respondents reported having had extramarital sexual encounters, with more males than females reporting extramarital affairs. Conclusion Lack of awareness, permissiveness of tribal societies for premarital or extra-marital sexual relationships, and sexual mixing patterns predispose these communities to HIV/AIDS and STD infections. There is a dire need for targeted interventions in order to curtail the increasing threat of HIV and other STDs among these vulnerable populations.

  18. Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda.

    Science.gov (United States)

    King, Rachel; Barker, Joseph; Nakayiwa, Sylvia; Katuntu, David; Lubwama, George; Bagenda, Danstan; Lane, Tim; Opio, Alex; Hladik, Wolfgang

    2013-01-01

    In Uganda, men who have sex with men (MSM) are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS) to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors.

  19. Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Rachel King

    Full Text Available In Uganda, men who have sex with men (MSM are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors.

  20. Estimating the sizes of populations at high risk for HIV: a comparison study.

    Directory of Open Access Journals (Sweden)

    Liwei Jing

    Full Text Available OBJECTIVES: Behavioral interventions are effective strategies for HIV/AIDS prevention and control. However, implementation of such strategies relies heavily on the accurate estimation of the high-risk population size. The multiplier method and generalized network scale-up method were recommended to estimate the population size of those at high risk for HIV by UNAIDS/WHO in 2003 and 2010, respectively. This study aims to assess and compare the two methods for estimating the size of populations at high risk for HIV, and to provide practical guidelines and suggestions for implementing the two methods. METHODS: Studies of the multiplier method used to estimate the population prevalence of men who have sex with men in China published between July 1, 2003 and July 1, 2013 were reviewed. The generalized network scale-up method was applied to estimate the population prevalence of men who have sex with men in the urban district of Taiyuan, China. RESULTS: The median of studies using the multiplier method to estimate the population prevalence of men who have sex with men in China was 4-8 times lower than the national level estimate. Meanwhile, the estimate of the generalized network scale-up method fell within the range of national level estimate. CONCLUSIONS: When high-quality existing data are not readily available, the multiplier method frequently yields underestimated results. We thus suggest that the generalized network scale-up method is preferred when sampling frames for the general population and accurate demographic information are available.

  1. High HIV-1 prevalence, risk behaviours, and willingness to participate in HIV vaccine trials in fishing communities on Lake Victoria, Uganda

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    Noah Kiwanuka

    2013-07-01

    Full Text Available Introduction: HIV epidemics in sub-Saharan Africa are generalized, but high-risk subgroups exist within these epidemics. A recent study among fisher-folk communities (FFC in Uganda showed high HIV prevalence (28.8% and incidence (4.9/100 person-years. However, those findings may not reflect population-wide HIV rates in FFC since the study population was selected for high-risk behaviour. Methods: Between September 2011 and March 2013, we conducted a community-based cohort study to determine the population representative HIV rates and willingness to participate (WTP in hypothetical vaccine trials among FFC, Uganda. At baseline (September 2011–January 2012, a household enumeration census was done in eight fishing communities (one lakeshore and seven islands, after which a random sample of 2200 participants aged 18–49 years was selected from 5360 individuals. Interviewer-administered questionnaire data were collected on HIV risk behaviours and WTP, and venous blood was collected for HIV testing using rapid HIV tests with enzyme-linked immunosorbent assay (EIA confirmation. Adjusted prevalence proportion ratios (adj.PPRs of HIV prevalence were determined using log-binomial regression models. Results: Overall baseline HIV prevalence was 26.7% and was higher in women than men (32.6% vs. 20.8%, p<0.0001. Prevalence was lower among fishermen (22.4% than housewives (32.1%, farmers (33.1% and bar/lodge/restaurant workers (37%. The adj.PPR of HIV was higher among women than men (adj.PPR =1.50, 95%; 1.20, 1.87 and participants aged 30–39 years (adj.PPR=1.40, 95%; 1.10, 1.79 and 40–49 years (adj.PPR=1.41, 95%; 1.04, 1.92 compared to those aged 18–24 years. Other factors associated with HIV prevalence included low education, previous marriage, polygamous marriage, alcohol and marijuana use before sex. WTP in hypothetical vaccine trials was 89.3% and was higher in men than women (91.2% vs. 87.3%, p=0.004 and among island communities compared to

  2. High-risk sexual behavior, HIV/STD prevalence, and risk predictors in the social networks of young Roma (Gypsy) men in Bulgaria.

    Science.gov (United States)

    Amirkhanian, Yuri A; Kelly, Jeffrey A; Kabakchieva, Elena; Antonova, Radostina; Vassileva, Sylvia; Difranceisco, Wayne J; McAuliffe, Timothy L; Vassilev, Boyan; Petrova, Elena; Khoursine, Roman A

    2013-02-01

    Roma (Gypsies), the largest and most disadvantaged ethnic minority group in Europe, are believed to be vulnerable to HIV/AIDS. This study's aim was to examine HIV risk in 6 Roma male sociocentric networks (n = 405 men) in Bulgaria. Participants were interviewed concerning their risk practices and tested for HIV/STDs. High-risk sexual behaviors were common. Over 57% of men had multiple sexual partners in the past 3 months. Over one-third of men reported both male and female partners in the past year. Condom use was low. Greater levels of sexual risk were associated with lower intentions and self-efficacy for using condoms, drug use, having male partners, knowing HIV-positive persons, and having higher AIDS knowledge but no prior HIV testing. Two men had HIV infection, 3.7% gonorrhea, and 5.2% chlamydia. HIV prevention interventions directed toward high-risk social networks of Roma are needed before HIV infection becomes more widely established.

  3. Bacterial vaginosis among women at high risk for HIV in Uganda: high rate of recurrent diagnosis despite treatment.

    Science.gov (United States)

    Francis, Suzanna C; Looker, Clare; Vandepitte, Judith; Bukenya, Justine; Mayanja, Yunia; Nakubulwa, Susan; Hughes, Peter; Hayes, Richard J; Weiss, Helen A; Grosskurth, Heiner

    2016-03-01

    Bacterial vaginosis (BV) is associated with increased risk for sexually transmitted infections (STIs) and HIV acquisition. This study describes the epidemiology of BV in a cohort of women at high risk for STI/HIV in Uganda over 2 years of follow-up between 2008-2011. 1027 sex workers or bar workers were enrolled and asked to attend 3-monthly follow-up visits. Factors associated with prevalent BV were analysed using multivariate random-effects logistic regression. The effect of treatment on subsequent episodes of BV was evaluated with survival analysis. Prevalences of BV and HIV at enrolment were 56% (573/1027) and 37% (382/1027), respectively. Overall, 905 (88%) women tested positive for BV at least once in the study, over a median of four visits. Younger age, a higher number of previous sexual partners and current alcohol use were independently associated with prevalent BV. BV was associated with STIs, including HIV. Hormonal contraception and condom use were protective against BV. Among 853 treated BV cases, 72% tested positive again within 3 months. There was no difference in time to subsequent BV diagnosis between treated and untreated women. BV was highly prevalent and persistent in this cohort despite treatment. More effective treatment strategies are urgently needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Structural impediments to condom access in a High HIV/STI-risk area.

    Science.gov (United States)

    Rizkalla, Christine; Bauman, Laurie J; Avner, Jeffrey R

    2010-01-01

    As embarrassment is a known obstacle to condom acquisition, selling condoms from physically inaccessible places that require personnel assistance constitutes a barrier to access. This study investigates the extent of this barrier in the Bronx, a high HIV/STI prevalence county of New York. 75 of 320 listed Bronx pharmacies were sampled via computer randomization. Investigators coded condom placement and physical accessibility within these pharmacies and 140 surrounding stores. 91% of sites sold condoms. In 82%, condoms could not be accessed without assistance. Condoms were physically inaccessible in venues most encountered in the community: grocery stores versus pharmacies (OR=15; 95% CI, 5-48), independent versus chain pharmacies (OR=32; 95% CI, 6-235). They were physically inaccessible more in the lowest SES/highest HIV prevalence areas versus the highest SES/lowest HIV prevalence areas (OR = 4.3, 95% CI, 1.1-17). Findings can inform efforts to increase accessibility of condoms, distribute condoms in alternative settings, and prompt similar investigations in other high-risk communities.

  5. Structural Impediments to Condom Access in a High HIV/STI-Risk Area

    Directory of Open Access Journals (Sweden)

    Christine Rizkalla

    2010-01-01

    Full Text Available As embarrassment is a known obstacle to condom acquisition, selling condoms from physically inaccessible places that require personnel assistance constitutes a barrier to access. This study investigates the extent of this barrier in the Bronx, a high HIV/STI prevalence county of New York. 75 of 320 listed Bronx pharmacies were sampled via computer randomization. Investigators coded condom placement and physical accessibility within these pharmacies and 140 surrounding stores. 91% of sites sold condoms. In 82%, condoms could not be accessed without assistance. Condoms were physically inaccessible in venues most encountered in the community: grocery stores versus pharmacies (OR=15; 95% CI, 5–48, independent versus chain pharmacies (OR=32; 95% CI, 6–235. They were physically inaccessible more in the lowest SES/highest HIV prevalence areas versus the highest SES/lowest HIV prevalence areas (OR = 4.3, 95% CI, 1.1–17. Findings can inform efforts to increase accessibility of condoms, distribute condoms in alternative settings, and prompt similar investigations in other high-risk communities.

  6. High lifetime risk of cardiovascular disease vs low 10-year Framingham risk score in HIV-infected subjects under ART in Spain: the Coronator study

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    C Miralles

    2012-11-01

    Full Text Available Purpose: Due to the relative low age of HIV-infected patients, Framingham risk score (FRS usually estimates a low CVD risk. Lifetime risk estimations use the risk of developing CVD over the course of an individual's remaining lifetime and may be useful in communicating the risk of CVD to young patients. Our aim is to estimate the lifetime risk of CVD in a representative sample of HIV patients under antiretroviral therapy in Spain. Methods: Cross-sectional analysis in 10 HIV units across Spain, including information on demographics, HIV disease status, treatment history and cardiovascular risk factors of subject under ART. Lifetime CVD risk was calculated with the method of Berry et al, which classifies the lifetime risk in five mutually exclusive categories: 1. All risk factors are optimal; 2. At least one risk factor is not optimal; 3. At least one risk factor is elevated; 4. One major risk factor is present; and 5. Two or more major risk factors are present. Risk factors included are cholesterol level, blood pressure, diabetes and tobacco smoking. We grouped these five categories in two major groups, low-risk (groups 1+2+3 and high-risk category (groups 4+5. We calculated the prevalence of having a high lifetime risk, and its crude and aOR (adjusted by age, sex, place of origin, education level, transmission category, time since HIV diagnosis, CDC stage, current and nadir CD4 count, HCV coinfection, time on current and total ART, being on the first ART regimen, and PI vs. NNRTI regimen. Results: We included 839 subjects free of previous CVD disease: 72% men, median age 45.6y, median CD4 count 598 cells, median time since HIV diagnosis 11y, median time on ART 6.3y, 87% had undetectable VL. Estimated 10-year CVD risk was low (<5% in 78% of the patients, and intermediate (5–10% in 20%. Lifetime risk estimation shows a high risk profile for 71.4% of the population studied (≥1 major risk factors. Factors significantly and independently

  7. Feasibility of Identifying a Female Sex Worker Cohort at High Risk of HIV Infection in the Caribbean for HIV Vaccine Efficacy Trials: Longitudinal Results of HVTN 907

    Science.gov (United States)

    Deschamps, Marie Marcelle; Metch, Barbara; Morgan, Cecilia A; Zorrilla, Carmen D; Donastorg, Yeycy; Swann, Edith; Taina, Dadaille; Patrice, Joseph; JW, Pape

    2015-01-01

    Background Identifying cohorts of Caribbean women with HIV infection rates sufficient for inclusion in HIV vaccine efficacy trials has been challenging. HVTN 907 determined the feasibility of identifying and retaining a cohort of women at high risk for HIV acquisition by focusing recruitment on female sex workers (FSW). Methods HIV uninfected FSWs, residing in Haiti, Dominican Republic (DR) and Puerto Rico (PR), who reported unprotected sex and met previously described more stringent site-specific eligibility criteria14, were eligible. Behavioral risk assessment, HIV counseling and testing and pregnancy testing were done at baseline, 6, 12, and 18 months. Results Among 799 FSWs (264 from DR, 334 from Haiti, 201 from PR), the median age was 26 years, with 54% having less than a high school education and 45% having a monthly household income of less than $US100. Median number of male partners six months prior to screening was 200. Retention at 18 months was 93%. Twelve women became HIV infected, nine from Haiti. The annualized HIV incidence was 1.07 % (95% CI 0.55%, 1.87%). Pregnancy incidence was 22.5% (95% CI 21.9, 29.5%). Statistically significant declines in risk behaviors occurred between screening and the 18 month visit assessment. Discussion The HVTN 907 study identified a high risk cohort of women with excellent retention for all 3 sites, despite major challenges especially in Haiti. These results show that a bridging study of a vaccine shown to be efficacious in other clade settings would be possible among FSW in the region, particularly in Haiti. PMID:26761272

  8. The disproportionate high risk of HIV infection among the urban poor in sub-Saharan Africa.

    Science.gov (United States)

    Magadi, Monica A

    2013-06-01

    The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects the situation in the rural areas where the majority of the SSA populations reside.

  9. High HIV incidence and sexual behavior change among pregnant women in Lilongwe, Malawi: implications for the risk of HIV acquisition.

    Science.gov (United States)

    Keating, Maria A; Hamela, Gloria; Miller, William C; Moses, Agnes; Hoffman, Irving F; Hosseinipour, Mina C

    2012-01-01

    HIV incidence is higher among pregnant women than their non-pregnant counterparts in some sub-Saharan African settings. Our aims were (1) to estimate HIV incidence during pregnancy and (2) to compare sexual activity between pregnant, postpartum, and non-pregnant women. We examined a retrospective cohort of 1087 women to identify seroconverters using antenatal and labor ward HIV test results. We also conducted a cross-sectional survey, including a quantitative questionnaire (n = 200) and in-depth interviews (n = 20) among women in early pregnancy, late pregnancy, postpartum, and non-pregnancy. Outcomes included measures of sexual activity, reported spouse's risky behavior, and beliefs about abstinence. 11 of 1087 women seroconverted during pregnancy yielding a 1% seroconversion risk and an incidence rate of 4.0/100 person years (95% CI 2.2-7.2). The reported sexual activity of the early pregnancy and non-pregnancy groups was similar, but significantly higher than the late pregnancy and postpartum groups (psexual activity decreases during pregnancy and postpartum. Pregnant women need to be informed of their increased risk for HIV and the importance of using condoms throughout pregnancy and the postpartum period.

  10. High-risk behaviors among adult men and women in Botswana: Implications for HIV/AIDS prevention efforts

    Science.gov (United States)

    Keetile, Mpho

    2014-01-01

    Abstract The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20–64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors. PMID:25293869

  11. High-risk behaviors among adult men and women in Botswana: implications for HIV/AIDS prevention efforts.

    Science.gov (United States)

    Keetile, Mpho

    2014-01-01

    The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20-64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors.

  12. Prevalence of HIV, syphilis, HCV and their high risk behaviors among migrant workers in eastern China.

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    Xiaohong Pan

    Full Text Available OBJECTIVE: The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. METHODS: A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. RESULTS: 17,377 (92.8% of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73% of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4% had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently was associated with being divorced or widowed (P<0.05 for single; male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job; having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%-0.06% and 0.40% (95%CI: 0.31%-0.51%, respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%-0.70%. Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. CONCLUSIONS: Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant

  13. Prevalence of HIV, Syphilis, HCV and Their High Risk Behaviors among Migrant Workers in Eastern China

    Science.gov (United States)

    Wang, Qing; Zheng, Hui; Chen, Xin; Su, Jing; Peng, Zhihang; Yu, Rongbin; Wang, Ning

    2013-01-01

    Objective The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. Methods A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. Results 17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (Pmarket or domestic service (Pjob); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. Conclusions Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers in China. PMID:23451193

  14. The Relationship Between HIV Risk, High-Risk Behavior, Religiosity, and Spirituality Among Black Men Who Have Sex with Men (MSM): An Exploratory Study.

    Science.gov (United States)

    Watkins, Tommie L; Simpson, Cathy; Cofield, Stacey S; Davies, Susan; Kohler, Connie; Usdan, Stuart

    2016-04-01

    Blacks in the USA, including black men who have sex with men (MSM), tend to have stronger religious and spiritual affiliations compared with other racial/ethnic populations. HIV and STD incidence rates continue to rise among Black MSM. Using data from the CDC Brothers y Hermanos (ByHS) project, this study examined correlations between high-risk behavior, e.g., substance use and high-risk sexual behavior (e.g., condom use history, unprotected sexual intercourse, HIV infection status, and STD infection status) religiosity, spirituality, age, among Black MSM (N = 1141). This exploratory study examined whether religiosity and spirituality were associated with high-risk behavior and high-risk sexual behavior among Black MSM. Religiosity and spirituality indices were compiled from the ByHS data. The religiosity index was significantly associated with HIV infection and use of cocaine, crack, and poppers as well as marginally associated with ecstasy use. Spirituality was significantly associated with HIV infection status, STD infection status, alcohol use, and crack use. Given these relationships, current and future HIV prevention models targeting Black MSM should consider the potential importance of the roles of religiosity and spirituality in the lives of Black MSM to increase the efficacy of risk reduction interventions.

  15. Factors Related to Family Therapists' Breaking Confidence When Clients Disclose High-Risks-to-HIV/AIDS Sexual Behaviors.

    Science.gov (United States)

    Pais, Shobha; Piercy, Fred; Miller, JoAnn

    1998-01-01

    Through a national survey of marriage and family therapists, this study examines what therapists do when their HIV-positive clients disclose that they are engaging in high-risk sexual behavior. Participants (N=309) were more likely to break confidence when their clients were male, young, gay, or African American. Describes characteristic of…

  16. Impact of High-Risk Sex and Focused Interventions in Heterosexual HIV Epidemics: A Systematic Review of Mathematical Models

    NARCIS (Netherlands)

    S. Mishra (Sharmistha); R. Steen (Richard); A. Gerbase (Antonio); Y-R. Lo (Ying-Ru); M-C. Boily (Marie-Claude)

    2012-01-01

    textabstractBackground: The core-group theory of sexually transmitted infections suggests that targeting prevention to high-risk groups (HRG) could be very effective. We aimed to quantify the contribution of heterosexual HRGs and the potential impact of focused interventions to HIV transmission in t

  17. Factors Related to Family Therapists' Breaking Confidence When Clients Disclose High-Risks-to-HIV/AIDS Sexual Behaviors.

    Science.gov (United States)

    Pais, Shobha; Piercy, Fred; Miller, JoAnn

    1998-01-01

    Through a national survey of marriage and family therapists, this study examines what therapists do when their HIV-positive clients disclose that they are engaging in high-risk sexual behavior. Participants (N=309) were more likely to break confidence when their clients were male, young, gay, or African American. Describes characteristic of…

  18. HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.

    Directory of Open Access Journals (Sweden)

    Keshet Ronen

    Full Text Available HIV superinfection (reinfection has been reported in several settings, but no study has been designed and powered to rigorously compare its incidence to that of initial infection. Determining whether HIV infection reduces the risk of superinfection is critical to understanding whether an immune response to natural HIV infection is protective. This study compares the incidence of initial infection and superinfection in a prospective seroincident cohort of high-risk women in Mombasa, Kenya. A next-generation sequencing-based pipeline was developed to screen 129 women for superinfection. Longitudinal plasma samples at 2 years and one intervening time after initial HIV infection were analyzed. Amplicons in three genome regions were sequenced and a median of 901 sequences obtained per gene per timepoint. Phylogenetic evidence of polyphyly, confirmed by pairwise distance analysis, defined superinfection. Superinfection timing was determined by sequencing virus from intervening timepoints. These data were combined with published data from 17 additional women in the same cohort, totaling 146 women screened. Twenty-one cases of superinfection were identified for an estimated incidence rate of 2.61 per 100 person-years (pys. The incidence rate of initial infection among 1910 women in the same cohort was 5.75 per 100 pys. Andersen-Gill proportional hazards models were used to compare incidences, adjusting for covariates known to influence HIV susceptibility in this cohort. Superinfection incidence was significantly lower than initial infection incidence, with a hazard ratio of 0.47 (CI 0.29-0.75, p = 0.0019. This lower incidence of superinfection was only observed >6 months after initial infection. This is the first adequately powered study to report that HIV infection reduces the risk of reinfection, raising the possibility that immune responses to natural infection are partially protective. The observation that superinfection risk changes with time

  19. High prevalence and genetic diversity of HCV among HIV-1 infected people from various high-risk groups in China.

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    Hong Shang

    Full Text Available BACKGROUND: Co-infection with HIV-1 and HCV is a significant global public health problem and a major consideration for anti-HIV-1 treatment. HCV infection among HIV-1 positive people who are eligible for the newly launched nationwide anti-HIV-1 treatment program in China has not been well characterized. METHODOLOGY: A nationwide survey of HIV-1 positive injection drug uses (IDU, former paid blood donors (FBD, and sexually transmitted cases from multiple provinces including the four most affected provinces in China was conducted. HCV prevalence and genetic diversity were determined. We found that IDU and FBD have extremely high rates of HCV infection (97% and 93%, respectively. Surprisingly, people who acquired HIV-1 through sexual contact also had a higher rate of HCV infection (20% than the general population. HIV-1 subtype and HCV genotypes were amazingly similar among FBD from multiple provinces stretching from Central to Northeast China. However, although patterns of overland trafficking of heroin and distinct HIV-1 subtypes could be detected among IDU, HCV genotypes of IDU were more diverse and exhibited significant regional differences. CONCLUSION: Emerging HIV-1 and HCV co-infection and possible sexual transmission of HCV in China require urgent prevention measures and should be taken into consideration in the nationwide antiretroviral treatment program.

  20. HIV-related high-risk behaviors among Chinese migrant construction laborers in Nantong, Jiangsu.

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    Xun Zhuang

    Full Text Available BACKGROUND: HIV transmission in rural areas of China is being fueled in part by migrant workers who acquire HIV outside of their hometowns. Recent surveillance statistics indicate that HIV prevalence among returning migrants has increased significantly. METHODS: We conducted a community-based cross-sectional study to assess HIV-related knowledge, attitudes and behaviors among migrant returnees in Nantong, Jiangsu Province, one of the largest exporters of migrant laborers. RESULTS: A total of 1625 subjects were enrolled with a response rate of 89%. All participants were male and of the majority Han ethnicity. The mean age was 39.0 years (SD = 6.7; range: 18 to 63, and most had a stable partner (N = 1533, 94.3%. Most correctly identified the major modes of HIV transmission (68.9%-82.0%, but fewer were able to identify ways that HIV cannot be transmitted. Nearly one-third of participants held positive attitudes toward having multiple sex partners, and nearly half believed that sex work should be legalized. Multiple logistic regression analysis indicated that risky sexual behavior (defined as sex with a casual or commercial sex partner was associated with no stable partner; working abroad; correct condom use; age <22 at first sex; higher coital frequency; and having a positive attitude towards multiple sex partners. CONCLUSIONS: We found high levels of reported sex with a casual or commercial sex partner and low levels of consistent condom use. HIV prevention interventions among migrant workers need to focus on younger migrants, migrants without stable partners, and migrants who travel abroad for work.

  1. Smoking, HIV, and risk of pregnancy loss.

    Science.gov (United States)

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A; Mehta, C Christina; Gustafson, Deborah R; Golub, Elizabeth T; Fischl, Margaret A; Adimora, Adaora A

    2017-02-20

    Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9-27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0-19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant.

  2. Smoking, HIV, and risk of pregnancy loss

    Science.gov (United States)

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M.; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A.; Mehta, C. Christina; Gustafson, Deborah R.; Golub, Elizabeth T.; Fischl, Margaret A.; Adimora, Adaora A.

    2017-01-01

    Objective: Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. Design: We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. Methods: We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Results: Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9–27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0–19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Conclusion: Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant. PMID:27902507

  3. HIV/STI risk by migrant status among workers in an urban high-end entertainment centre in Eastern China.

    Science.gov (United States)

    Mantell, Joanne E; Kelvin, Elizabeth A; Sun, Xiaoming; Zhou, Jianfang; Exner, Theresa M; Hoffman, Susie; Zhou, Feng; Sandfort, Theo G M; Leu, Cheng-Shiun

    2011-04-01

    Large-scale internal migration in China may be an important mechanism for the spread of HIV/sexually transmitted infections (STIs) because of the risk behaviours of migrants. We conducted a self-administered survey among 724 employees of a high-end entertainment centre in Kunshan, Jiangsu Province, China. Using logistic regression, we examined the association of hometown of origin (Kunshan city, elsewhere in Jiangsu Province, or another province in China) and consecutive years living in Kunshan with measures of HIV/STI risk behaviour. We found that increased time living in Kunshan was associated with lower odds of using condoms as contraception [odds ratio (OR) = 0.78, 95% confidence interval (CI): 0.64-0.95] and consistent condom use with a casual partner (OR = 0.66, 95% CI: 0.47-0.93), after controlling for gender, marital status age and income. The odds of having had an STI were significantly lower for Kunshan natives than those originally from outside provinces (OR = 0.25, 95% CI: 0.07-0.96), but increasing years living in Kunshan was not related to lower risk for an STI. Our findings do not support the hypothesis that migrants living far from home participate in higher risk behaviour than locals. Findings suggest that adaptation to local culture over time may increase HIV/STI risk behaviours, a troublesome finding.

  4. HIV and Hepatitis B and C incidence rates in US correctional populations and high risk groups: a systematic review and meta-analysis

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    Hook Edward W

    2010-12-01

    Full Text Available Abstract Background High Human Immunodeficiency Virus (HIV prevalence and high risk behaviors have been well documented within United States (US correctional systems. However, uncertainty remains regarding the extent to which placing people in prison or jail increases their risk of HIV infection, and regarding which inmate populations experience an increased incidence of HIV. Describing these dynamics more clearly is essential to understanding how inmates and former detainees may be a source for further spread of HIV to the general US population. Methods The authors conducted a systematic review and meta-analysis of studies describing HIV incidence in US correctional facility residents and, for comparison, in high risk groups for HIV infection, such as non-incarcerated intravenous drug users (IVDU and men who have sex with men (MSM in the US. HIV incidence rates were further compared with Hepatitis B and Hepatitis C Virus rates in these same populations. Results Thirty-six predominantly prospective cohort studies were included. Across all infection outcomes, continuously incarcerated inmates and treatment recruited IVDU showed the lowest incidence, while MSM and street recruited IVDU showed the highest. HIV incidence was highest among inmates released and re-incarcerated. Possible sources of heterogeneity identified among HIV studies were risk population and race. Conclusions Although important literature gaps were found, current evidence suggests that policies and interventions for HIV prevention in correctional populations should prioritize curtailing risk of infection during the post-release period. Future research should evaluate HIV incidence rates in inmate populations, accounting for proportion of high risk sub-groups.

  5. The impact of ethnic identity on changes in high risk HIV behaviors in sexually active migrant workers.

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    Shehadeh, Nancy; Virginia McCoy, H; Rubens, Muni; Batra, Anamica; Renfrew, Roderick; Winter, Kelly

    2012-02-01

    Among migrant workers (MWs) in the US, HIV/AIDS prevalence may be as high as 13.5%. This serial cross-sectional study examines associations between Ethnic Identity (EI) in African American and Hispanic MWs and short-term changes in high-risk sexual behaviors. Baseline and 3-month follow-up data was collected from a larger HIV intervention study among MWs in Immokalee, Florida (n = 119) who reported unprotected sex in the past 30 days. The Multigroup Identity Measure was used to assess EI. A high EI score indicates less acculturation to one's new surroundings. Females had higher levels of positive behavior change. Lower EI was associated with higher levels of positive change in relation to HIV/AIDS risk behavior. Among Hispanics, education was negatively correlated with EI. Education was a predictor of behavior change. Future interventions should focus on reducing acculturation stress, which may prompt harmful coping behaviors, such as high-risk sex and substance abuse.

  6. High-risk human papillomavirus in HIV-infected women undergoing cervical cancer screening in Lilongwe, Malawi: a pilot study.

    Science.gov (United States)

    Reddy, Deepa; Njala, Joseph; Stocker, Penny; Schooley, Alan; Flores, Martiniano; Tseng, Chi-Hong; Pfaff, Colin; Jansen, Perry; Mitsuyasu, Ronald T; Hoffman, Risa M

    2015-05-01

    Rates of abnormal visual inspection with acetic acid and prevalence of high-risk human papillomavirus (HPV) subtypes have not been well characterized in HIV-infected women in Malawi. We performed a prospective cohort study of visual inspection with acetic acid (N = 440) in HIV-infected women aged 25--59 years, with a nested study of HPV subtypes in first 300 women enrolled. Of 440 women screened, 9.5% (N = 42) had abnormal visual inspection with acetic acid with 69.0% (N = 29) having advanced disease not amenable to cryotherapy. Of 294 women with HPV results, 39% (N = 114) of women were positive for high-risk HPV infection. Only lower CD4 count (287 cells/mm(3) versus 339 cells/mm(3), p = 0.03) and high-risk HPV (66.7% versus 35.6%, p < 0.01) were associated with abnormal visual inspection with acetic acid. The most common high-risk HPV subtypes in women with abnormal visual inspection with acetic acid were 35 (33.3%), 16 (26.7%), and 58 (23.3%). Low CD4 cell count was associated with abnormal visual inspection with acetic acid and raises the importance of early antiretroviral therapy and expanded availability of visual inspection with acetic acid. HPV vaccines targeting additional non-16/18 high-risk HPV subtypes may have greater protective advantages in countries such as Malawi.

  7. HIV-Risk Reduction with Juvenile Offenders on Probation

    OpenAIRE

    Donenberg, Geri R.; Emerson, Erin; Mackesy-Amiti, Mary Ellen; Udell, Wadiya

    2014-01-01

    Youth involved in the juvenile justice system are at elevated risk for HIV as a result of high rates of sexual risk taking, substance use, mental health problems and sexually transmitted infections. Yet few HIV prevention programs exist for young offenders. This pilot study examined change in juvenile offenders’ sexual activity, drug/alcohol use, HIV testing and counseling, and theoretical mediators of risk taking following participation in PHAT Life, an HIV-prevention progr...

  8. Risk Denial and Socio-Economic Factors Related to High HIV Transmission in a Fishing Community in Rakai, Uganda: A Qualitative Study.

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    Muhamadi Lubega

    Full Text Available In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission is still very high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44%, reaching up to 74% among female sex workers. We explored drivers for the high HIV transmission at Kasensero from the perspective of fishermen and other community members to inform future policy and preventive interventions.20 in-depth interviews including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community were conducted during April-September 2014. Content analysis was performed to identify recurrent themes.The socio-economic risk factors for high HIV transmission in Kasensero fishing community cited were multiple and cross-cutting and categorized into the following themes: power of money, risk denial, environmental triggers and a predisposing lifestyle and alcoholism and drug abuse. Others were: peer pressure, poor housing and the search for financial support for both the men and women which made them vulnerable to HIV exposure and or risk behavior.There is a need for context specific combination prevention interventions in Kasensero that includes the fisher folk and other influential community leaders. Such groups could be empowered with the knowledge and social mobilization skills to fight the negative and risky behaviors, perceptions, beliefs, misconceptions and submission attitudes to fate that exposes the community to high HIV transmission. There is also need for government/partners to ensure effective policy implementation, life jackets for all fishermen, improve the poor housing at the community so as to reduce overcrowding and other housing related predispositions to high HIV rates at the community. Work place AIDS-competence teams have been successfully used to address high HIV transmission in similar

  9. High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India

    OpenAIRE

    Mukesh Shukla; Monica Agarwal; Jai Vir Singh; Anil Kumar Tripathi; Anand Kumar Srivastava; Vijay Kumar Singh

    2016-01-01

    Context: Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. Aims: This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA). Settings and Design: A hospital-based cross-sectional study was con...

  10. Changes in transmission risk behaviors across stages of HIV disease among people living with HIV.

    Science.gov (United States)

    Eaton, Lisa A; Kalichman, Seth C

    2009-01-01

    Advances in treatments for HIV infection and related opportunistic illnesses have significantly extended the life expectancy of people living with HIV. A review of the literature on HIV transmission risks among HIV-infected individuals shows patterns of risk behavior that vary according to HIV disease stage. Studies confirm that the period immediately preceding HIV infection is characterized by high rates of risk behaviors, indicating the potential for rapid spread of HIV during acute infection. Reductions in risk behavior are often seen immediately following an HIV diagnosis. However, these behavioral changes are not universal, and an individual's state of health is an important factor relating to transmission risks. Chronic periods of asymptomatic HIV infection are generally associated with some degree of reverting to risky behaviors. CD4 cell counts below 200 cells/mm(3), resulting in a formal diagnosis of AIDS, are associated with decreased sexual and drug-related risk behaviors. HIV risk reduction interventions for HIV-infected persons, therefore, require tailoring to address the health and psychological challenges individuals face as they progress through stages of HIV disease. Additional research on both risk behaviors of long-term HIV-infected persons and longitudinal data on risk behaviors is needed.

  11. Using the Information-Motivation-Behavioral Skills Model to Guide the Development of an HIV Prevention Smartphone Application for High-Risk MSM.

    Science.gov (United States)

    Aliabadi, Negar; Carballo-Dieguez, Alex; Bakken, Suzanne; Rojas, Marlene; Brown, William; Carry, Monique; Mosley, Jocelyn Patterson; Gelaude, Deborah; Schnall, Rebecca

    2015-12-01

    HIV remains a significant public health problem among men who have sex with men (MSM). MSM comprise 2% of the U.S. population, but constitute 56% of persons living with HIV. Mobile health technology is a promising tool for HIV prevention. The purpose of this study was to identify the desired content, features and functions of a mobile application (app) for HIV prevention in high-risk MSM. We conducted five focus group sessions with 33 MSM. Focus group recordings were transcribed and coded using themes informed by the information-motivation-behavioral (IMB) skills model. Participants identified information needs related to HIV prevention: HIV testing and prophylaxis distribution centers, support groups/peers, and HIV/STI disease/treatment information. Areas of motivation to target for the app included: attitudes and intentions. Participants identified behavioral skills to address with an app: using condoms correctly, negotiating safer sex, recognizing signs of HIV/STI. Findings from this work provide insight into the desired content of a mobile app for HIV prevention in high-risk MSM.

  12. HIV-1 diversity, drug-resistant mutations, and viral evolution among high-risk individuals in phase II HIV vaccine trial sites in southern China.

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    Haiyan Qi

    Full Text Available HIV-1 prevalence in Guangxi, China, has been growing since 1996, when the first case was reported. Over half of HIV-1 positive patients in Guangxi Province were injecting drug users (IDUs, possibly because of the province's location near drug-trafficking routes. Since a phase II HIV vaccine trial is ongoing there, a current characterization of the subtypes of HIV-1 among IDUs in Guangxi would provide critical information for future HIV vaccine trials, as well as further control and prevention of HIV-1 transmission. Thus, we conducted a molecular epidemiological investigation of HIV-1 samples from 2008-2010 among IDUs in multiple cities in Guangxi Province. Our results, based on the gag/pol fragment, indicated a very high proportion (78.47% of HIV-1 CRF08_BC recombinants, some CRF01_AE (15.38% recombinants, and a low proportion of CRF07_BC (6.15% recombinants among the IDUs. The high proportion of CRF08 HIV-1 strains among recent IDUs matches the vaccine candidate constructs. However, future vaccine development should also incorporate CRF01-targeted vaccine candidates. Distinct Env sequence evolution patterns were observed for CRF08_BC and CRF01_AE, indicating that different local selection pressures have been exerted on these two HIV-1 subtypes. Unique drug-resistant mutations were also detected, and our data indicate that HIV treatment programs should consider pre-existing drug-resistant mutations.

  13. The Influence of Neurocognitive Impairment on HIV Risk Behaviors and Intervention Outcomes among High-Risk Substance Users: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Roman eShrestha

    2016-02-01

    Full Text Available Neurocognitive impairment (NCI among high-risk substance users poses a substantial barrier to reducing risk behaviors in this populations. Previous work suggest that NCI is intertwined in a close, reciprocal relationship with risk behaviors. Not only does substance use worsen cognitive impairment, but cognitive impairment may also reduce the efficacy of interventions aimed at reducing risk and improving medication adherence. In this systematic review, we examine the potential impact of substance abuse and cognitive functioning in the context of HIV risk behaviors and risk-reduction intervention outcomes. The findings thus far suggest that, in order to be effective, risk-reduction interventions must take into account the impact of NCI on learning, memory, and behavior.

  14. Combined use of waist and thigh circumference to identify high-risk, abdominally obese HIV+ patients

    Directory of Open Access Journals (Sweden)

    T O'Neil

    2012-11-01

    Full Text Available Background We examined whether the combination of waist (WC and thigh (ThC circumference improves the prediction of visceral adipose tissue (VAT over WC and ThC independently in HIV-infected men and women after correction for age. We also examined the independent associations between VAT, and the combination of WC and ThC with metabolic risk factors, metabolic syndrome, type 2 diabetes mellitus (T2DM and prior cardiovascular events in HIV-infected individuals. Methods Consecutive patients attending the metabolic clinic of the University of Modena in Italy between 2005 and 2009 were recruited in this cross-sectional study. Total and regional fat mass and lean mass were quantified using DEXA. A single CT image was taken for quantification of VAT and CAC. Prior cardiovascular events which occurred within a 5-year period of the clinical evaluation were analysed. A cross-fold test was used to explore different models in the ability to predict VAT in order to build an algorithm for VAT estimation (e-VAT. Regression analysis were performed to determine the univariate and multivariate relations between WC, ThC, and age with VAT. A comparison of beta coefficients for VAT and e-VAT to predict cardio-metabolic risk and events were performed using multivariable regression models after correction for BMI and age. Results 2322 HIV-infected patients were recruited: median duration of HIV infection was 182 months (IQR 126–236; median nadir and current CD4 were 172 (IQR 68–262 and 515.5 (IQR 369–700 and 75% of them had undetectable HIV1-VL. In this abstract only the results of men will be presented. Men (n=1481 had a mean age of 45.9±7.3 years, a BMI of 24.1 ± 3.8 kg/m2, a WC of 88.0±10.1 cm and a ThC of 47.8±4.3 cm. e-VAT algorithm for men was: (5.44*WC−(1.35*ThC−(1.70*age−348.1 In men, at multivariable regression models after correction for BMI and age, e-VAT was concordant to VAT in predicting HOMA, MetS Risk, prior cardiovascular events (OR=1

  15. High HIV prevalence and risk of infection among rural-to-urban migrants in various migration stages in China: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Lei; Chow, Eric P F; Jahn, Heiko J; Kraemer, Alexander; Wilson, David P

    2013-02-01

    Rural-to-urban migrants represent 17% of the total Chinese population and are considered a potential high-risk bridging population of HIV infection between urban and rural China. Based on a systematic review and meta-analysis, this study determined HIV prevalence among rural-to-urban migrants in different stages of migration. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified 54 studies reporting 59 HIV prevalence levels among rural-to-urban migrants in China. Overall, 53.4% (95% confidence interval, 33.5%-72.4%) of urban patients with HIV have migratory background. The floating-out population showed a higher HIV prevalence (0.15% [0.06%-0.34%]) than did the Chinese population (0.057%; odds ratio, 2.63 [1.35-5.14]). The floating-in population showed a higher HIV prevalence (0.38% [0.29%-0.50%]), corresponding to 6.70 (6.05-7.41) times greater odds of HIV infection. Higher prevalence levels were observed among female migrants (0.69% [0.51%-0.93%]), reflecting a much higher odds of HIV infection (12.18 [11.11-13.35]). Infection risk among returning migrants (0.18% [0.12%-0.29%]) was 3.16 (2.06-4.84) times higher than the overall Chinese population. Chinese internal migrants contribute to a substantial amount of the overall HIV epidemic in China. Migrants are at greater risk for HIV infection than the general Chinese population and likely to facilitate the geographical spread of HIV in China. Targeted strategies for health promotion and HIV prevention for migrants in China should be developed.

  16. Feasibility of Measuring Immune Resp, Activation in Foreskin/Mucosa in HIV-, Uncircumcised High-HIV-risk MSM, Lima Peru

    Science.gov (United States)

    2015-12-10

    HIV Infections; Acquired Immunodeficiency Syndrome; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases

  17. High heterogeneity of HIV-related sexual risk among transgender people in Ontario, Canada: a province-wide respondent-driven sampling survey

    Directory of Open Access Journals (Sweden)

    Bauer Greta R

    2012-04-01

    Full Text Available Abstract Background Studies of HIV-related risk in trans (transgender, transsexual, or transitioned people have most often involved urban convenience samples of those on the male-to-female (MTF spectrum. Studies have detected high prevalences of HIV-related risk behaviours, self-reported HIV, and HIV seropositivity. Methods The Trans PULSE Project conducted a multi-mode survey using respondent-driven sampling to recruit 433 trans people in Ontario, Canada. Weighted estimates were calculated for HIV-related risk behaviours, HIV testing and self-reported HIV, including subgroup estimates for gender spectrum and ethno-racial groups. Results Trans people in Ontario report a wide range of sexual behaviours with a full range of partner types. High proportions – 25% of female-to-male (FTM and 51% of MTF individuals – had not had a sex partner within the past year. Of MTFs, 19% had a past-year high-risk sexual experience, versus 7% of FTMs. The largest behavioural contributors to HIV risk were sexual behaviours some may assume trans people do not engage in: unprotected receptive genital sex for FTMs and insertive genital sex for MTFs. Overall, 46% had never been tested for HIV; lifetime testing was highest in Aboriginal trans people and lowest among non-Aboriginal racialized people. Approximately 15% of both FTM and MTF participants had engaged in sex work or exchange sex and about 2% currently work in the sex trade. Self-report of HIV prevalence was 10 times the estimated baseline prevalence for Ontario. However, given wide confidence intervals and the high proportion of trans people who had never been tested for HIV, estimating the actual prevalence was not possible. Conclusions Results suggest potentially higher than baseline levels of HIV; however low testing rates were observed and self-reported prevalences likely underestimate seroprevalence. Explicit inclusion of trans people in epidemiological surveillance statistics would provide much

  18. A novel time-limited pop-up HIV testing service for gay men in Sydney, Australia, attracts high-risk men.

    Science.gov (United States)

    Knight, Vickie; Gale, Marianne; Guy, Rebecca; Parkhill, Nicolas; Holden, Jo; Leeman, Craig; McNulty, Anna; Keen, Phillip; Wand, Handan

    2014-09-01

    Background HIV diagnoses have been increasing steadily in Australia and are concentrated among gay, bisexual and other men who have sex with men (GBM). HIV testing is a key control strategy, and in 2013, a novel time-limited pop-up community HIV testing service (Pop-up) was introduced to raise awareness and increase testing options for GBM. The Pop-up service offered rapid HIV tests only. We compared uptake and outcomes of the Pop-up service to an established clinical model [a fast-track screening service in a sexual health clinic offering rapid and/or conventional HIV tests and sexually transmissible infection (STI) tests]. Service delivery data was collated and analysed from the HIV Pop-up (25 November to 1 December 2013) and the fast-track HIV/STI screening service (Xpress) in a sexual health clinic immediately before the Pop-up (1 August to 22 November 2013). A comparison of all the HIV tests and results, tests per hour and characteristics of new clients (demographics, risk behaviour, testing history) was conducted using χ(2), Poisson distribution and Ranksum tests. At the Pop-up service, 182 GBM had a rapid HIV test conducted over the 5-day period (average: seven HIV tests per hour) and no HIV tests were reactive (0%, 95% confidence interval: 0-1.8%). At the Xpress service, 1075 asymptomatic GBM had at least one STI test and 957 GMB had a HIV test (rapid or conventional) conducted over the 3-month period (average: four HIV tests per hour), with two positive HIV tests (0.2%, 95% confidence interval: 0.02-0.7) and 151 positive STI tests (14%, 95% confidence interval: 12-16.2). Compared with new patients at the Xpress service, GBM attending the Pop-up service were older (median of 39 vs 29 years, PPop-up community HIV testing is feasible and reached high-risk GBM, but compared with a clinic-based model, it only reached a smaller proportion of GBM who test infrequently or who have never been tested and are unaware of their HIV status. No STI testing was conducted

  19. Changes in Transmission Risk Behaviors Across Stages of HIV Disease among People Living with HIV/AIDS

    Science.gov (United States)

    Eaton, Lisa A.; Kalichman, Seth C.

    2013-01-01

    Advances in HIV treatment and opportunistic illness prophylaxis have significantly extended the life expectancy of people living with HIV/AIDS. Increased HIV/AIDS longevity is also marked by changes in HIV transmission risk behaviors. Here we review the literature on HIV transmission risk behaviors as they change in relation to stages of HIV disease among persons who are infected with HIV/AIDS. Studies confirm that the time period immediately preceding testing HIV positive is characterized by high risk behaviors indicating the potential for rapid spread of HIV during acute infection. For many people, reductions in risk behavior are seen immediately following HIV diagnosis. However, these changes in risk taking are not universal and great variability exists in terms of how HIV diagnosis influences risk behaviors. Chronic periods of asymptomatic HIV infection are generally associated with some degree of reverting to high risk behaviors. Also, a CD4 count below 200 cells/mm3 resulting in a formal diagnosis of AIDS, is associated with decreased sexual and drug-related risk behaviors. HIV risk reduction interventions that target men and women living with HIV/AIDS therefore require tailoring to stages of HIV disease. Additional research on risk behaviors of long term HIV positive persons is needed. PMID:19118770

  20. The Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda.

    Science.gov (United States)

    Kiene, Susan M; Bateganya, Moses H; Lule, Haruna; Wanyenze, Rhoda K

    2016-09-01

    Provider-initiated HIV testing and counseling (PITC) has rapidly expanded in many countries including Uganda. However, because it provides HIV prevention information without individualized risk assessment and risk reduction counseling it may create missed opportunities for effective HIV prevention counseling. Our objective was to assess the effect of a brief motivational interviewing-based intervention during outpatient PITC in rural Uganda compared to Uganda's standard-of-care PITC at reducing HIV transmission-relevant sexual risk behavior. We enrolled 333 (160 control, 173 intervention) participants in a historical control trial to test the intervention vs. standard-of-care. Participants received PITC and standard-of-care or the intervention counseling and we assessed sexual risk behavior at baseline and 3 and 6 months follow-up. The intervention condition showed 1.5-2.4 times greater decreases in high risk sexual behavior over time compared to standard-of-care (p = 0.015 and p = 0.004). These data suggest that motivational interviewing based counseling during PITC may be a promising intervention to reduce high-risk sexual behavior and potentially reduce risk of HIV infection.

  1. Psychosocial and Behavioral Characteristics of High-Risk Men Who Have Sex with Men (MSM) of Unknown HIV Positive Serostatus in Bangkok, Thailand.

    Science.gov (United States)

    Sapsirisavat, Vorapot; Phanuphak, Nittaya; Keadpudsa, Siriwan; Egan, James E; Pussadee, Kanitta; Klaytong, Preeyarach; Reuel Friedman, M; van Griensven, Frits; Stall, Ron

    2016-12-01

    HIV prevalence remains high in men who have sex with men (MSM) in Bangkok. Even though resources for HIV testing and treatment are available for all, a large proportion of MSM still do not get HIV tested. We studied high risk MSM who are unaware of their HIV status to help maximize effectiveness of our resources. Convenience sampling was conducted among MSM who came for HIV testing at the Thai Red Cross Anonymous Clinic and two popular drop-in centers in Bangkok. Inclusion criteria were MSM aged >18 years, have not been tested positive for HIV, who reported ≥1 of the following in the previous 6 months: condomless sex with a male, being a sex worker, or having a sexual transmitted infection diagnosis. Audio-Computer-Assisted Self-Interview was used to assess psychosocial profile, sexual risks, and HIV testing patterns prior to being informed of their HIV positive status. Among 499 high-risk MSM enrolled, the median age was 24.8 years and 112 (22 %) tested HIV-positive. Among the HIV-positive participants, 92 % self-identified as gay (versus bisexual), 39 % attained a bachelors degree or higher, 65 % had monthly income 10,000-29,999 baht ($280-830 USD), 10 % had vaginal or anal sex with a woman in the past 12 months, 39 % had condomless receptive sex with men and 21 % went to Lat Phrao to find a sexual partner. Compared to HIV negative MSM, HIV-positive MSM had less HIV testing: 31 % had ever been tested for HIV, 12 % had been tested in the past 6 months; but were more likely to guess correctly their positive status (31 %). Regarding psychosocial variables among HIV-positive MSM, 7 % had regular methamphetamine use in the past 3 months, 10 % had >2 sources of discrimination, and 8 % had >2 sources of discrimination due to being MSM. In multivariable model, age2 sources of discrimination because of being MSM, did not get HIV test in past 6 months, and guess of positive HIV were significantly associated with HIV positive status. Young MSM with

  2. HIV Risk Behavior among Delinquent and Mentally Ill Teens: Case Manager Perspectives

    Science.gov (United States)

    Smith, Michael D.; Seal, David Wyatt; Hartley, Shannon

    2006-01-01

    An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual…

  3. Field-Based Video Pre-Test Counseling, Oral Testing, and Telephonic Post-Test Counseling: Implementation of an HIV Field Testing Package among High-Risk Indian Men

    Science.gov (United States)

    Snyder, Hannah; Yeldandi, Vijay V.; Kumar, G. Prem; Liao, Chuanhong; Lakshmi, Vemu; Gandham, Sabitha R.; Muppudi, Uma; Oruganti, Ganesh; Schneider, John A.

    2012-01-01

    In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling…

  4. Comfort Levels Among Predoctoral Dental and Dental Hygiene Students in Treating Patients at High-Risk for HIV/AIDS.

    Science.gov (United States)

    Natto, Zuhair S; Aladmawy, Majdi; Rogers, Thomas C

    2015-06-01

    The purpose of this article is to discuss the impact of the training program for predoctoral dental and hygiene students at Loma Linda University School of Dentistry (LLUSD) with regard to issues related to treating patients with a high risk of having HIV/AIDS. LLUSD offers a training program for fourth-year dental hygiene and predoctoral dental students that addresses the oral health care needs of persons with HIV disease. The training occurs in small groups 2 days per week at a community clinic serving HIV-positive individuals. Three academic quarters are required to train all fourth-year students each year. Evaluation of program effectiveness is conducted by means of pre- and post-session surveys. Dental hygiene and dental students completed the pre-survey during the spring quarter of their third year in public health dentistry courses. The same students completed the post-session survey at the end of their weekly training sessions during the fourth year. The overall change in all areas related to the students' comfort level in treating patients in the 3 defined categories is in a positive direction (p-valuedental hygiene students compared with predoctoral dental students. A comparison of pre- and post-session surveys reveals a significant improvement in students' perception of and comfort level with treating patients who are homosexual/bisexual or intravenous drug users, or who have a history of blood transfusion in both student groups upon completion of the HIV and the Dentist training program at LLUSD. Copyright © 2015 The American Dental Hygienists’ Association.

  5. Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

    Science.gov (United States)

    Jacobson, Jerry O; Cueto, Carmen; Smith, Jennifer L; Hwang, Jimee; Gosling, Roly; Bennett, Adam

    2017-01-18

    To eliminate malaria, malaria programmes need to develop new strategies for surveillance and response appropriate for the changing epidemiology that accompanies transmission decline, in which transmission is increasingly driven by population subgroups whose behaviours place them at increased exposure. Conventional tools of malaria surveillance and response are likely not sufficient in many elimination settings for accessing high-risk population subgroups, such as mobile and migrant populations (MMPs), given their greater likelihood of asymptomatic infections, illegal risk behaviours, limited access to public health facilities, and high mobility including extended periods travelling away from home. More adaptive, targeted strategies are needed to monitor transmission and intervention coverage effectively in these groups. Much can be learned from HIV programmes' experience with "second generation surveillance", including how to rapidly adapt surveillance and response strategies to changing transmission patterns, biological and behavioural surveys that utilize targeted sampling methods for specific behavioural subgroups, and methods for population size estimation. This paper reviews the strategies employed effectively for HIV programmes and offers considerations and recommendations for adapting them to the malaria elimination context.

  6. HIV/STI Risk Behavior of Drug Court Participants

    Science.gov (United States)

    Robertson, Angela A.; St. Lawrence, Janet S.; McCluskey, D. Lee

    2012-01-01

    Drug abusing offenders have high rates of HIV and other sexually transmitted infections (STI). To date, the HIV/STI prevention needs of offenders in drug court programs have been ignored. This multi-method study employed interviews to assess drug court professionals' perceptions of the need for an HIV risk reduction intervention to be integrated…

  7. HIV/STI Risk Behavior of Drug Court Participants

    Science.gov (United States)

    Robertson, Angela A.; St. Lawrence, Janet S.; McCluskey, D. Lee

    2012-01-01

    Drug abusing offenders have high rates of HIV and other sexually transmitted infections (STI). To date, the HIV/STI prevention needs of offenders in drug court programs have been ignored. This multi-method study employed interviews to assess drug court professionals' perceptions of the need for an HIV risk reduction intervention to be integrated…

  8. Smoking and anal high-risk human papillomavirus DNA loads in HIV-positive men who have sex with men.

    Science.gov (United States)

    Wieland, Ulrike; Hellmich, Martin; Wetendorf, Janna; Potthoff, Anja; Höfler, Daniela; Swoboda, Jochen; Fuchs, Wolfgang; Brockmeyer, Norbert; Pfister, Herbert; Kreuter, Alexander

    2015-10-01

    HIV-positive men who have sex with men (MSM) have an increased risk for anal human papillomavirus (HPV) infection, anal high-grade intraepithelial lesions (HSIL), and anal cancer. Smoking is associated with abnormal anal cytology and with an increased risk for anal cancer. We collected 3736 intraanal swabs from 803 HIV-positive MSM who participated in an anal cancer screening program between October 2003 and August 2014. HPV prevalence, anal cytology and HPV DNA load of high-risk (HR) HPV-types 16, 18, 31 and 33 of non-smokers and smokers were compared. HPV-typing was performed by alpha-HPV genus-specific PCR and hybridization with 38 type-specific probes using a multiplex genotyping assay. In samples positive for HPV16, 18, 31, or 33, HPV DNA loads were determined by type-specific real-time PCRs and expressed as HPV DNA copies per betaglobin gene copy. At baseline, HR-HPV DNA (80.5 vs. 89.0%, p=0.001), HPV16 DNA (41.6 vs. 52.3%, p=0.003), HPV18 DNA (15.5 vs. 26.0%, panal dysplasia (LSIL+HSIL; 51.5 vs. 58.4%, p=0.045) and HSIL (17.2 vs. 22.7%, p=0.048) were detected more frequently in smokers compared to non-smokers. Throughout the study period 32.7% of non-smokers and 39.9% of smokers developed HSIL (p=0.011), and three smokers developed anal cancer. Considering swabs from the entire study period (median HPV load value per patient per cytology grade), smokers with normal anal cytology had significantly higher HPV16 loads (median 0.29 vs. 0.87, n=201, p=0.007) and cumulative high-risk-HPV loads (median 0.53 vs. 1.08, n=297, p=0.004) than non-smokers. Since elevated HR-HPV DNA loads are associated with an increased risk for HPV-induced anogenital cancers, HPV-infected HIV-positive MSM should be counseled to refrain from smoking. Additionally, for smokers, shorter anal cancer screening intervals than for non-smokers may be appropriate.

  9. A Clinical Algorithm to Identify HIV Patients at High Risk for Incident Active Tuberculosis: A Prospective 5-Year Cohort Study.

    Directory of Open Access Journals (Sweden)

    Susan Shin-Jung Lee

    Full Text Available Predicting the risk of tuberculosis (TB in people living with HIV (PLHIV using a single test is currently not possible. We aimed to develop and validate a clinical algorithm, using baseline CD4 cell counts, HIV viral load (pVL, and interferon-gamma release assay (IGRA, to identify PLHIV who are at high risk for incident active TB in low-to-moderate TB burden settings where highly active antiretroviral therapy (HAART is routinely provided.A prospective, 5-year, cohort study of adult PLHIV was conducted from 2006 to 2012 in two hospitals in Taiwan. HAART was initiated based on contemporary guidelines (CD4 count < = 350/μL. Cox regression was used to identify the predictors of active TB and to construct the algorithm. The validation cohorts included 1455 HIV-infected individuals from previous published studies. Area under the receiver operating characteristic (ROC curve was calculated.Seventeen of 772 participants developed active TB during a median follow-up period of 5.21 years. Baseline CD4 < 350/μL or pVL ≥ 100,000/mL was a predictor of active TB (adjusted HR 4.87, 95% CI 1.49-15.90, P = 0.009. A positive baseline IGRA predicted TB in patients with baseline CD4 ≥ 350/μL and pVL < 100,000/mL (adjusted HR 6.09, 95% CI 1.52-24.40, P = 0.01. Compared with an IGRA-alone strategy, the algorithm improved the sensitivity from 37.5% to 76.5%, the negative predictive value from 98.5% to 99.2%. Compared with an untargeted strategy, the algorithm spared 468 (60.6% from unnecessary TB preventive treatment. Area under the ROC curve was 0.692 (95% CI: 0.587-0.798 for the study cohort and 0.792 (95% CI: 0.776-0.808 and 0.766 in the 2 validation cohorts.A validated algorithm incorporating the baseline CD4 cell count, HIV viral load, and IGRA status can be used to guide targeted TB preventive treatment in PLHIV in low-to-moderate TB burden settings where HAART is routinely provided to all PLHIV. The implementation of this algorithm will avoid unnecessary

  10. Neisseria gonorrhoeae prevalence, incidence and associated risk factors among female sex workers in a high HIV-prevalence area of China

    Directory of Open Access Journals (Sweden)

    Li Luo

    2015-09-01

    Conclusions: A relatively high prevalence and incidence of N. gonorrhoeae among a prospective cohort of FSWs underscore the urgency for traditional HIV/STIs prevention methods among FSWs, such as condom promotion, screening and treatment of STIs, considering the high prevalence of STIs. Significant attention should focus on FSWs working in higher risk commercial sex venues as they are at higher risk for N. gonorrhoeae and transmission than those in lower risk commercial sex venues.

  11. Childhood Exposure to Religions With High Prevalence of Members Who Discourage Homosexuality Is Associated With Adult HIV Risk Behaviors and HIV Infection in Black Men Who Have Sex With Men.

    Science.gov (United States)

    Nelson, LaRon E; Wilton, Leo; Zhang, Nanhua; Regan, Rotrease; Thach, Chia T; Dyer, Typhanye V; Kushwaha, Sameer; Sanders, Rev Edwin C; Ndoye, Omar; Mayer, Kenneth H

    2016-01-12

    Exposure to childhood religious affiliations where the majority of members discourage homosexuality may have negative psychological impacts for Black men who have sex with men. This study tested the hypothesis that exposures to these environments during childhood were associated with adulthood human immunodeficiency virus (HIV)/sexually transmitted infection (STI) behavioral risk and HIV infection, because these exposures influenced HIV/STI risk by undermining race/sexual identity congruence and increasing internalized homophobia and interpersonal anxiety. Structural equation modeling as well as logistic and Poisson regressions were performed using baseline data from HIV Prevention Trials Network 061 (N = 1,553). Childhood religion affiliations that were more discouraging of homosexuality were associated with increased likelihood of HIV infection; however, the association was no longer significant after adjusting for age, income, and education. Having a childhood religion affiliation with high prevalence of beliefs discouraging homosexuality was associated with increased numbers of sexual partners (adjusted odds ratio = 4.31; 95% confidence interval [3.76, 4.94], p < .01). The hypothesized path model was largely supported and accounted for 37% of the variance in HIV infection; however, interpersonal anxiety was not associated with HIV/STI risk behaviors. Structural interventions are needed that focus on developing affirming theologies in religious institutions with Black men who have sex with men congregants.

  12. Risk behavior and correlates of risk for HIV infection in the Dallas County Household HIV survey.

    Science.gov (United States)

    McQuillan, G M; Ezzati-Rice, T M; Siller, A B; Visscher, W; Hurley, P

    1994-01-01

    OBJECTIVES. The Dallas County study of a proposed national household seroprevalence survey was designed to assess the feasibility of conducting a national survey and to estimate the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus infection for Dallas County. Risk behavior data were collected and correlated with HIV infection. METHODS. Participants in this survey represented a probability sample of the county. A self-administered questionnaire on demographic characteristics and HIV risk behavior was completed and a blood sample was obtained. RESULTS. Of the 1724 adults eligible for the survey, 1446 completed the questionnaire and 1374 provided a blood sample. The prevalence estimates were 0.4% for HIV and 7.3% for hepatitis B virus. A strong relationship was observed between HIV and hepatitis B status and risk behavior. CONCLUSIONS. In this study population, receptive anal intercourse and increasing numbers of male partners had the strongest correlation with the prevalence of HIV and hepatitis B virus infection in men. The high level of risk reporting for individuals positive for HIV or hepatitis B suggests that survey participants who engage in risk behaviors were willing to report those behaviors. PMID:8179043

  13. The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and tuberculosis in Eastern Europe and Central Asia.

    Science.gov (United States)

    Altice, Frederick L; Azbel, Lyuba; Stone, Jack; Brooks-Pollock, Ellen; Smyrnov, Pavlo; Dvoriak, Sergii; Taxman, Faye S; El-Bassel, Nabila; Martin, Natasha K; Booth, Robert; Stöver, Heino; Dolan, Kate; Vickerman, Peter

    2016-09-17

    Despite global reductions in HIV incidence and mortality, the 15 UNAIDS-designated countries of Eastern Europe and Central Asia (EECA) that gained independence from the Soviet Union in 1991 constitute the only region where both continue to rise. HIV transmission in EECA is fuelled primarily by injection of opioids, with harsh criminalisation of drug use that has resulted in extraordinarily high levels of incarceration. Consequently, people who inject drugs, including those with HIV, hepatitis C virus, and tuberculosis, are concentrated within prisons. Evidence-based primary and secondary prevention of HIV using opioid agonist therapies such as methadone and buprenorphine is available in prisons in only a handful of EECA countries (methadone or buprenorphine in five countries and needle and syringe programmes in three countries), with none of them meeting recommended coverage levels. Similarly, antiretroviral therapy coverage, especially among people who inject drugs, is markedly under-scaled. Russia completely bans opioid agonist therapies and does not support needle and syringe programmes-with neither available in prisons-despite the country's high incarceration rate and having the largest burden of people with HIV who inject drugs in the region. Mathematical modelling for Ukraine suggests that high levels of incarceration in EECA countries facilitate HIV transmission among people who inject drugs, with 28-55% of all new HIV infections over the next 15 years predicted to be attributable to heightened HIV transmission risk among currently or previously incarcerated people who inject drugs. Scaling up of opioid agonist therapies within prisons and maintaining treatment after release would yield the greatest HIV transmission reduction in people who inject drugs. Additional analyses also suggest that at least 6% of all incident tuberculosis cases, and 75% of incident tuberculosis cases in people who inject drugs are due to incarceration. Interventions that reduce

  14. Risk of discontinuation of nevirapine due to toxicities in antiretroviral-naive and -experienced HIV-infected patients with high and low CD4+ T-cell counts

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Staszewski, Schlomo; Weber, Rainer;

    2007-01-01

    It is unknown whether the increased risk of toxicities in antiretroviral-naive HIV-infected patients initiating nevirapine-based (NVPc) combination antiretroviral therapy (cART) with high CD4+ T-cell counts is also observed when NVPc is initiated in cARTexperienced patients.......It is unknown whether the increased risk of toxicities in antiretroviral-naive HIV-infected patients initiating nevirapine-based (NVPc) combination antiretroviral therapy (cART) with high CD4+ T-cell counts is also observed when NVPc is initiated in cARTexperienced patients....

  15. High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India

    Directory of Open Access Journals (Sweden)

    Mukesh Shukla

    2016-01-01

    Full Text Available Context: Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. Aims: This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA. Settings and Design: A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow. Materials and Methods: A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire. Statistical Analysis Used: Probability (p was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression. Results: Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4–225.5; P = 0.02 and alcohol consumption (OR: 9.3; 95% CI: 2.4–35.4; P = 0.001. Conclusions: Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge.

  16. High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India

    Science.gov (United States)

    Shukla, Mukesh; Agarwal, Monica; Singh, Jai Vir; Tripathi, Anil Kumar; Srivastava, Anand Kumar; Singh, Vijay Kumar

    2016-01-01

    Context: Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. Aims: This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA). Settings and Design: A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow. Materials and Methods: A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire. Statistical Analysis Used: Probability (p) was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression. Results: Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4–225.5; P = 0.02) and alcohol consumption (OR: 9.3; 95% CI: 2.4–35.4; P = 0.001). Conclusions: Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge. PMID:27190412

  17. Effect of rapid HIV testing on HIV incidence and services in populations at high risk for HIV exposure: an equity-focused systematic review

    National Research Council Canada - National Science Library

    Pottie, Kevin; Medu, Olanrewaju; Welch, Vivian; Dahal, Govinda P; Tyndall, Mark; Rader, Tamara; Wells, George

    2014-01-01

    .... Cochrane systematic review and meta-analysis. We searched PubMed, EMBASE, AIDSearch, LILACS, Global Health, Medline Africa, PsychInfo, CINAHL, Cochrane CENTRAL, Cochrane HIV/AIDS Group Specialized Register and grey literature from 1 January 2001...

  18. High risk behavior for HIV transmission among former injecting drug users: A survey from Indonesia

    NARCIS (Netherlands)

    Iskandar, S.; Basar, D.; Hidayat, T.; Siregar, I.M.P.; Pinxten, W.J.L.; Crevel, R. van; Ven, A.J.A.M. van der; Jong, C.A.J. de

    2010-01-01

    Background: Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce

  19. High risk behavior for HIV transmission among former injecting drug users: A survey from Indonesia

    NARCIS (Netherlands)

    Iskandar, S.; Basar, D.; Hidayat, T.; Siregar, I.M.; Pinxten, L.; Crevel, R. van; Ven, A.J.A.M. van der; Jong, C.A.J. de

    2010-01-01

    BACKGROUND: Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce

  20. Perception of risk of HIV and sexual risk behaviors among University students: implication for planning interventions.

    Science.gov (United States)

    Shiferaw, Yitayal; Alemu, Abebe; Assefa, Abate; Tesfaye, Berihun; Gibermedhin, Etsegenet; Amare, Misiker

    2014-03-19

    The university environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. Despite recently gained decline of the overall incidence of HIV infection, still significant proportion of youth population are at high risk of HIV infection. The aims of this study were to assess the perception of HIV risk and factors associated with risk perception among students at University of Gondar, Northwest Ethiopia. A cross sectional study was conducted between February and April, 2012 among health science students. A total of 384 students were involved in the study using stratified sampling technique. Chi-square test and logistic regression analysis were employed. P-value perception of HIV risk were observed. Attention has to be given on the role of alcohol and/or drug abuse in the participation of HIV risk behaviors in the design and implementation of HIV prevention for university students.

  1. High-risk human papillomavirus and cervical lesions among women living with HIV/AIDS in Brazilian Amazon, Brazil

    Directory of Open Access Journals (Sweden)

    Leila da Silva

    Full Text Available ABSTRACT OBJECTIVE: The goal of this study was to determine the prevalence of human papillomavirus infection infection and cervical lesions and its associated factors among HIV infected women attending an AIDS clinic in Amazonas state, Brazil. METHODS: Cross-sectional study. Women attending an AIDS clinic in the city of Manaus between March and December 2011 for gynecological examination were invited to participate. Enrolled patients answered a standardized interview including demographical, behavioral, and clinical data. Additionally, patients underwent a gynecological evaluation with collection of cervical samples for cytological analysis and high-risk human papillomavirus infection hybrid capture. A blood sample was also obtained to determine CD4 and viral load levels. RESULTS: A total of 310 (82.9% women participated in the study. High-risk human papillomavirus infection was detected in 191 (61.6% cases; 24 (13.5% had low-grade squamous intraepithelial lesion (SIL and 4 (2.2% high-grade SIL. No invasive cervical cancer was diagnosed. Median age was 32 (interquartile range (IQR: 27-38 years and median of education was 8.5 (IQR 4-11 years of schooling and 56.1% had a monthly income up to US$180. In multivariate analysis, being less than 30 years old [OR = 1.7 (95% CI: 1.2-2.4,p = 0.005], high-grade SIL [OR = 6.5 (95% CI: 1.6-23.0, p = 0.009], and CD4 counts <200 cells/mm3 [OR = 1.6 (95% CI: 1.2-2.0, p < 0.001] were associated with high risk human papillomavirus infection infection. CONCLUSIONS: In the present study high-risk human papillomavirus infection was frequent and it was associated to high-SIL. These results show the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.

  2. Smoking, HIV, and risk of pregnancy loss

    OpenAIRE

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M.; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A.; Mehta, C. Christina; Gustafson, Deborah R.; Golub, Elizabeth T.; Margaret A Fischl; Adimora, Adaora A.

    2017-01-01

    Objective: Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. Design: We analyzed...

  3. Sexual partnerships and considerations for HIV antiretroviral pre-exposure prophylaxis utilization among high-risk substance using men who have sex with men.

    Science.gov (United States)

    Mimiaga, Matthew J; Closson, Elizabeth F; Kothary, Vishesh; Mitty, Jennifer A

    2014-01-01

    Men who have sex with men (MSM) remain at great risk of HIV in the United States, representing 65 % of incident HIV infections. One factor contributing to the high rate of HIV infection among MSM is use of "recreational" drugs that are highly associated with unprotected anal sex. Pre-exposure chemoprophylaxis (PrEP) is a novel biomedical HIV prevention strategy that has the potential to reduce HIV transmission in MSM. Main and casual sex partners play a role in HIV prevention efforts for MSM. The study aimed to qualitatively explore the perceived influences of sexual relationships on promoting and inhibiting PrEP use among high-risk MSM who report regular drug use. Semi-structured qualitative interviews were conducted with 40 participants recruited in Boston, Massachusetts. Data were analyzed using descriptive qualitative analysis. Casual partners presented a distinct set of concerns from primary partnerships. MSM generally viewed main partners as a potential source of support for taking PrEP. Given their informal and often temporary nature, PrEP disclosure to casual partners was considered unnecessary. HIV-related stigma and substance use were also perceived as barriers to discussing PrEP use with casual partners. MSM articulated a high degree of personal agency regarding their ability to take PrEP. Findings suggest that behavioral interventions to improve PrEP utilization and adherence for high-risk MSM should be tailored to sex partner type and the parameters established between sex partners. Approaches to PrEP disclosure and partner engagement should be informed by the relative benefits and limitations characterized by these different types of relationships.

  4. Predictors of identifying as a barebacker among high-risk New England HIV seronegative men who have sex with men.

    Science.gov (United States)

    Reisner, Sari L; Mimiaga, Matthew J; Case, Patricia; Johnson, Carey V; Safren, Steven A; Mayer, Kenneth H

    2009-03-01

    Studies have found that between 14% and 46% of US men who have sex with men (MSM) consistently report "barebacking" behavior (i.e., intentional unprotected anal intercourse) with other men. This is of public health significance because MSM continue to constitute more than 50% of new HIV infections in the USA. Men who self-identify as barebackers may represent a different and unique subset of MSM with distinct HIV prevention needs. In 2007, 227 HIV seronegative MSM recruited through modified respondent-driven sampling completed an interviewer-administered survey which assessed barebacker identity (i.e., personally identifying with the barebacker scene), demographics, sexual risk behaviors, psychosocial variables, and drug/alcohol use. Bivariate and multivariable logistic regression procedures were used to examine predictors of barebacker identity in relation to HIV risk behavior. Overall, 31% of participants identified as a barebacker. In bivariate analyses, lower education (OR = 1.76; 95% CI = 0.99-3.13; p private sex parties (OR = 2.47; 95% CI = 1.28-4.74; p risk taking and alcohol abuse. Furthermore, strategic positioning (i.e., engaging in insertive rather than receptive sex) might be associated with barebacker identification and may indicate a harm-reduction strategy being used among some HIV-uninfected MSM to reduce their risk of becoming infected. Additional research is warranted to understand the social identity of barebacking among MSM in order to develop more nuanced prevention strategies.

  5. Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk.

    Science.gov (United States)

    Couture, Marie-Claude; Sansothy, Neth; Sapphon, Vonthanak; Phal, Serey; Sichan, Keo; Stein, Ellen; Evans, Jennifer; Maher, Lisa; Kaldor, John; Vun, Mean Chhi; Page, Kimberly

    2011-01-01

    To estimate prevalence and incidence of HIV and sexually transmitted infections (STI) and associated risk factors among young women working as sex workers (SWs) in Phnom Penh, Cambodia. A prospective study of young (freelance. Sociodemographics, sexual risk, and use of amphetamine-type stimulants (ATS) ("yama" and "crystal") were assessed by self-report. HIV and STI (Chlamydia trachomatis and Neisseria gonorrhoeae) testing were conducted on blood and urine specimens, respectively. Baseline prevalences of HIV, C. trachomatis, and N. gonorrhoeae were 23%, 11.5%, and 7.8%, respectively. HIV incidence was 3.6 per 100 person-years (95% confidence interval [CI], 1.2%-11.1%); STI incidence was 21.2 per 100 person-years (95% CI, 12.6%-35.8%). At baseline, 26.5% reported recent ATS use. HIV infection was associated with freelance SW (adjusted odds ratio, 5.85; 95% CI, 1.59-21.58) and younger age of first sex (≤15 years; adjusted odds ratio, 3.06; 95% CI, 1.01-8.46). Incident STI was associated with duration (per year) of SW (adjusted hazard ratio, 1.1; 95% CI, 1.1-1.2) and recent yama use (adjusted hazard ratio, 3.9; 95% CI, 1.5-10.3). HIV and STI infection rates were high among SWs working in various settings; freelancers had highest risk. ATS use was associated with incident STI. Venue of sex work and drug prevention should be considered in prevention programs.

  6. Lower Your Sexual Risk of HIV

    Science.gov (United States)

    ... Text Size Print Lower Your Sexual Risk for HIV How Can I Reduce My Risk of Getting HIV Through Sexual Contact? Not having sex is the ... Notice Network blog.aids.gov • locator.aids.gov • HIV/AIDS Service Locator Locator Widgets • Instructions • API Find ...

  7. Why are the benefits of increased resources not impacting the risk of HIV infection for high SES women in Cameroon?

    Directory of Open Access Journals (Sweden)

    Joyce N Mumah

    Full Text Available BACKGROUND: Despite evidence of a positive SES-HIV gradient in some SSA countries, researchers and policy-makers frequently assume that a range of protective interventions--increasing awareness of mechanisms of HIV transmission, techniques for prevention, greater access to health care facilities, and greater availability of condoms--will reduce the likelihood of contracting HIV, even among higher SES populations. We therefore explore the relationships between SES and these intervening behaviors to illuminate the complex factors that link SES and HIV among women in Cameroon. METHODS: We use bivariate and multivariate statistical analysis to examine patterns among the 5, 155 women aged 15-49 who participated in the 2004 CDHS. RESULTS: The results show a strong pattern where higher SES women have greater access to and use of health care facilities, higher levels of condom use, more HIV knowledge, and command higher power within their relationships, yet also have higher rates of HIV. These traditionally protective factors appear to be offset by riskier sexual behaviors on the part of women with increased resources, most notably longer years of premarital sexual experience, multiple partners in last 12 months, and sexual encounters outside of relationship. Multivariate analyses suggests net of the effect of other factors, women who command higher decision-making power, have greater access to health care, more negative attitudes toward wife beating, longer years of premarital sexual exposure, and partners with professional/white collar jobs (characteristics associated with rising SES had higher odds of testing positive for HIV. CONCLUSION: Results show that higher riskier sexual practices on part of high SES women offset benefits that may have accrued from their increased access to resources. The results suggest that traditional approaches to HIV prevention which rely on poverty reduction, improving access to health care, improving HIV knowledge, and

  8. Cervical Dysplasia and High-Risk Human Papillomavirus Infections among HIV-Infected and HIV-Uninfected Adolescent Females in South Africa

    Directory of Open Access Journals (Sweden)

    David H. Adler

    2014-01-01

    In this cross-sectional study, we compared the HPV DNA and Pap smear results between 35 HIV-infected and 50 HIV-uninfected adolescents in order to determine the prevalence of HR-HPV genotypes and cervical cytological abnormalities. Comparisons were made using Pearson χ2 and independent-samples t-tests analyses, and associations between demographic and behavioral characteristics and HPV infections were examined. Results. HIV-infected participants were more likely to be infected with any HPV (88.6% versus 48.0%; P<0.001 and with at least one HR-HPV (60.0% versus 24.0%; P=0.001, and to have multiple concurrent HPV infections (68.6% versus 22.0%; P<0.001. HPV 16 and 18 were relatively underrepresented among HR-HPV infections. Abnormal Pap test results were more common among HIV-infected participants (28.8% versus 12.0%; P=0.054. A history of smoking was associated with HR-HPV infection. Conclusions. HIV-infected adolescents have an increased risk of infection with HR-HPV and of Pap test abnormalities. The majority of HR-HPV infections among our participants would not be prevented by the currently available vaccinations against HPV.

  9. Risk of tuberculosis during pregnancy in Mongolia, a high incidence setting with low HIV prevalence.

    Science.gov (United States)

    Rendell, N L; Batjargal, N; Jadambaa, N; Dobler, C C

    2016-12-01

    To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records. The overall incidence of TB among pregnant women was 228 (95%CI 187276) per 100000 person-years, resulting in an incidence rate ratio of 1.31 (95%CI 1.081.59) in pregnant women compared to the general population. Twelve per cent of the pregnant women with TB chose to have an abortion. In this study, pregnant women had a 1.3-fold higher risk of developing TB than the general population. Based on a moderately increased risk of TB during pregnancy in our study and the potential for adverse health outcomes, TB screening among pregnant women can currently be justified, but the cost-effectiveness of this intervention remains unclear. Patients and doctors need to be educated about the safety of standard TB treatment in pregnancy to reduce the rate of abortions.

  10. Protocol for an open-label, single-arm trial of HIV pre-exposure prophylaxis (PrEP) among people at high risk of HIV infection: the NSW Demonstration Project PRELUDE

    Science.gov (United States)

    Vaccher, S; Grulich, A; McAllister, J; Templeton, D J; Bloch, M; McNulty, A; Holden, J; Poynten, I M; Prestage, G; Zablotska, I

    2016-01-01

    Introduction Despite a number of HIV prevention strategies, the number of new HIV infections remains high. In Australia, over three-quarters of new HIV diagnoses are in gay and bisexual men (GBM). Pre-exposure prophylaxis (PrEP) has been shown to be effective at preventing new HIV infections in several randomised trials. The PRELUDE study aims to evaluate the implementation of PrEP in healthcare settings in New South Wales (NSW), Australia, among a sample of high-risk adults. Methods and analysis PRELUDE is an ongoing open-label, single-arm demonstration project, conducted in public and private clinics across NSW, Australia. Enrolment began in November 2014. The study is designed for 300 high-risk participants—mainly GBM and heterosexual women. Participants receive daily oral PrEP, composed of emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF), for up to 2.5 years. Quarterly study visits include testing for HIV and sexually transmitted infections (STIs), assessment of ongoing eligibility and side effects, and self-reported adherence. Following each study visit, online behavioural surveys are administered to collect information on medication adherence, risk behaviours and attitudes. Blood samples will be collected in a subset of patients 1, 6 and 12 months after PrEP initiation to measure FTC/TDF concentrations. Analyses using longitudinal regression models will focus on feasibility, adherence, safety, tolerability and effects of PrEP on behaviour. This study will inform PrEP policy and guide the implementation of PrEP in Australia in people at high risk of HIV. Ethics and dissemination The study will be conducted in accordance with the Declaration of Helsinki. All patients will provide written informed consent prior to participation in the study. Publications relating to each of the primary end points will be gradually released after 12 months of follow-up is complete. Trial registration number NCT02206555; Pre-results. PMID:27324719

  11. Uptake of HIV testing and counseling, risk perception and linkage to HIV care among Thai university students.

    Science.gov (United States)

    Khawcharoenporn, Thana; Chunloy, Krongtip; Apisarnthanarak, Anucha

    2016-07-12

    HIV testing and counseling (HTC) with linkage to care after known infection are key components for HIV transmission prevention. This study was conducted to assess HTC uptake, HIV risk perception and linkage to care among Thai university students. An outreach HTC program was conducted in a large public university in Thailand from January 2013 to December 2014. The program consisted of brief HIV knowledge assessment, free HTC, HIV risk assessment and education provided by the healthcare personnel. Students were categorized into low, moderate and high-risk groups according to the pre-defined HIV risk characteristics. One-thousand-eight-hundred-one students participated in the program, 494 (27 %) underwent HTC. Independent characteristics associated with no HTC uptake included female sex (P perception of low HIV risk. Being heterosexual was independently associated with false perception of low HIV risk (P = 0.04). The rate of new HIV infection diagnosis was 4/494 (0.8 %). Of these 4 HIV-infected students, 3 (75 %) were men who have sex with men and only 2 of the 4 students (50 %) showed up for HIV continuity care. An outreach HIV prevention program with HTC was feasible and beneficial in detecting HIV risk and infection among the university students. However, interventions to improve HTC uptake, HIV risk perception and linkage to care are needed.

  12. Relationship Factors Associated with Sexual Risk Behavior and High-Risk Alcohol Consumption Among Latino Men Who Have Sex with Men: Challenges and Opportunities to Intervene on HIV Risk.

    Science.gov (United States)

    Martinez, Omar; Muñoz-Laboy, Miguel; Levine, Ethan C; Starks, Tyrel; Dolezal, Curtis; Dodge, Brian; Icard, Larry; Moya, Eva; Chavez-Baray, Silvia; Rhodes, Scott D; Fernandez, M Isabel

    2016-09-15

    The HIV epidemic continues to be a major public health concern, affecting communities with varying prevention and treatment needs. In the U.S., Latino men who have sex with men (MSM) bear a disproportionate burden of HIV incidence. While recent studies have highlighted the relevance of relationship factors for HIV transmission among MSM generally, the unique needs and experiences of Latino MSM have received relatively little attention. Consequently, associations between relationship factors and HIV risk among Latino MSM remain unknown. This mixed-method study examined relationship status and dynamics and potential HIV-related risk behaviors among Latino MSM. Quantitative analyses with 240 Latino MSM investigated associations between relationship status and engagement in condomless anal intercourse (CAI). Focus groups with 20 Latino male couples and 10 health service providers explored the impact of relationship dynamics on sexual behaviors, as well as opportunities to intervene on HIV risk. The majority of participants were predominantly Spanish speaking, most screened positive for high-risk alcohol consumption in the past month, more than half engaged in CAI in the past 3 months, and a majority reported multiple sexual partners in this period. Among participants in same-sex relationships (n = 175), approximately half reported multiple partners in the previous 3 months and more than two-thirds reported CAI in this time period. Being in a same-sex relationship was positively associated with high-risk alcohol consumption and being age 30 or older and negatively associated with having multiple partners. Moreover, being in a same-sex relationship significantly increased the likelihood that participants would report engaging in CAI. Qualitative analyses identified themes related to relationship dynamics and sexual behavior, as well as opportunities to intervene on HIV risk. Despite the challenges encountered by Latino male couples, most participants expressed

  13. Community-Level HIV Risk Behaviors and HIV Prevalence among Women and Men in Zimbabwe

    Science.gov (United States)

    Speizer, Ilene S.; Gómez, Anu Manchikanti; Stewart, James; Voss, Paul

    2013-01-01

    Most studies on HIV risk in sub-Saharan Africa focus on individual-level socio-demographic and behavioral correlates of risk. Only recently have researchers and programmers considered the context within which individuals live. This study uses the 2005–6 Zimbabwe Demographic and Health Survey to examine the correlation between the prevalence of HIV at the community level and the prevalence of HIV risk-taking behaviors. Results show that women and men living in communities with higher HIV prevalence in the opposite sex are at increased risk of HIV. In addition, rural women and men living in communities with greater premarital and non-marital sex are at greater risk of HIV. Finally, HIV prevalence is higher among women and men living in urban areas with higher intimate partner violence. Programs should address community-level social norms that make high-risk behaviors acceptable and thus increase all women and men’s risk of HIV, not just those engaged in high-risk behaviors. PMID:22010807

  14. High risk for occupational exposure to HIV and utilization of post-exposure prophylaxis in a teaching hospital in Pune, India.

    Science.gov (United States)

    Gupta, Amita; Anand, Shuchi; Sastry, Jayagowri; Krisagar, Anandini; Basavaraj, Anita; Bhat, Shreepad M; Gupte, Nikhil; Bollinger, Robert C; Kakrani, Arjun L

    2008-10-21

    The risk for occupational exposure to HIV has been well characterized in the developed world, but limited information is available about this transmission risk in resource-constrained settings facing the largest burden of HIV infection. In addition, the feasibility and utilization of post-exposure prophylaxis (PEP) programs in these settings are unclear. Therefore, we examined the rate and characteristics of occupational exposure to HIV and the utilization of PEP among health care workers (HCW) in a large, urban government teaching hospital in Pune, India. Demographic and clinical data on occupational exposures and their management were prospectively collected from January 2003-December 2005. US Centers for Diseases Control guidelines were utilized to define risk exposures, for which PEP was recommended. Incidence rates of reported exposures and trends in PEP utilization were examined using logistic regression. Of 1955 HCW, 557 exposures were reported by 484 HCW with an incidence of 9.5 exposures per 100 person-years (PY). Housestaff, particularly interns, reported the greatest number of exposures with an annual incidence of 47.0 per 100 PY. Personal protective equipment (PPE) was used in only 55.1% of these exposures. The incidence of high-risk exposures was 6.8/100 PY (n = 339); 49.1% occurred during a procedure or disposing of equipment and 265 (80.0%) received a stat dose of PEP. After excluding cases in which the source tested HIV negative, 48.4% of high-risk cases began an extended PEP regimen, of whom only 49.5% completed it. There were no HIV or Hepatitis B seroconversions identified. Extended PEP was continued unnecessarily in 7 (35%) of 20 cases who were confirmed to be HIV-negative. Over time, there was a significant reduction in proportion of percutaneous exposures and high-risk exposures (p risk exposures (44% in 2003 to 100% in 2005, p = 0.002). Housestaff are a vulnerable population at high risk for bloodborne exposures in teaching hospital settings

  15. Church Attendance as a Predictor of Number of Sexual Health Topics Discussed Among High-Risk HIV-Negative Black Women.

    Science.gov (United States)

    Williams, Terrinieka T; Pichon, Latrice C; Davey-Rothwell, Melissa; Latkin, Carl A

    2016-02-01

    Research suggests that sexual health communication is associated with safer sex practices. In this study, we examined the relationship between church attendance and sexual health topics discussed with both friends and sexual partners among a sample of urban Black women. Participants were 434 HIV-negative Black women who were at high risk for contracting HIV through heterosexual sex. They were recruited from Baltimore, Maryland using a network-based sampling approach. Data were collected through face-to-face interviews and Audio-Computer-Assisted Self-Interviews. Fifty-four percent of the participants attended church once a month or more (regular attendees). Multivariate logistic regression analyses revealed that regular church attendance among high-risk HIV-negative Black women was a significant predictor of the number of sexual health topics discussed with both friends (AOR = 1.85, p = .003) and sexual partners (AOR = 1.68, p = .014). Future efforts to reduce HIV incidence among high-risk Black women may benefit from partnerships with churches that equip faith leaders and congregants with the tools to discuss sexual health topics with both their sexual partners and friends.

  16. High dead-space syringes and the risk of HIV and HCV infection among injecting drug users.

    Science.gov (United States)

    Zule, William A; Bobashev, Georgiy

    2009-03-01

    This study examines the association between using and sharing high dead-space syringes (HDSSs)--which retain over 1000 times more blood after rinsing than low dead-space syringes (LDSSs)--and prevalent HIV and hepatitis C virus (HCV) infections among injecting drug users (IDUs). A sample of 851 out-of-treatment IDUs was recruited in Raleigh-Durham, North Carolina, between 2003 and 2005. Participants were tested for HIV and HCV antibodies. Demographic, drug use, and injection practice data were collected via interviews. Data were analyzed using multiple logistic regression analysis. Participants had a mean age of 40 years and 74% are male, 63% are African American, 29% are non-Hispanic white, and 8% are of other race/ethnicity. Overall, 42% of participants had ever used an HDSS and 12% had shared one. HIV prevalence was 5% among IDUs who had never used an HDSS compared with 16% among IDUs who had shared one. The HIV model used a propensity score approach to adjust for differences between IDUs who had used an HDSS and those who had never used one. The HCV models included all potential confounders as covariates. A history of sharing HDSSs was associated with prevalent HIV (odds ratio=2.50; 95% confidence interval=1.01, 6.15). Use and sharing of HDSSs were also associated with increased odds of HCV infection. Prospective studies are needed to determine if sharing HDSSs is associated with increased HIV and HCV incidence among IDUs.

  17. HIV Risk Behaviors Among Latina Women Tested for HIV in Florida by Country of Birth, 2012.

    Science.gov (United States)

    Taveras, Janelle; Trepka, Mary Jo; Khan, Hafiz; Madhivanan, Purnima; Gollub, Erica L; Devieux, Jessy

    2016-10-01

    Latina women in the United States (US) are disproportionately affected by human immunodeficiency virus (HIV) infection. Data are limited on the risk differences in HIV among Latinas by country of birth. This paper describes the risk behaviors among Latina women tested for HIV at public sites in Florida. Multivariate logistic regression was used to assess the demographic characteristics associated with the report of specific risk behaviors. Results indicate that foreign-born Latina women were 54 % less likely to report partner risk [95 % confidence interval (CI) 0.40, 0.54] than US-born Latina women. Reported risk behaviors varied by race/ethnicity, US-born versus foreign-born status, and by Latina country of origin. Knowledge of these differences can aid in targeting HIV prevention messaging, program decision-making, and allocation of resources, corresponding to the central approach of High Impact Prevention and the National HIV/AIDS Strategy.

  18. High-risk alcohol use and associated socio-demographic, health and psychosocial factors in patients with HIV infection in three primary health care clinics in South Africa.

    Science.gov (United States)

    Veld, Diana Huis In 't; Pengpid, Supa; Colebunders, Robert; Skaal, Linda; Peltzer, Karl

    2017-06-01

    Alcohol use may have a negative impact on the course of HIV disease and the effectiveness of its treatment. We studied patients with HIV who use alcohol and associated socio-demographic, health and psychosocial factors. Outcomes from this study may help in selecting patients from clinical practice with high-risk alcohol use and who are likely to benefit most from alcohol reduction interventions. In a cross sectional study in three primary health care clinics in Pretoria, South Africa, from January 2012 to June 2012, patients with HIV infection were interviewed and patients' medical files were reviewed to obtain data on levels of alcohol use (Alcohol Use Disorder Identification Test), patients' socio-demographic characteristics, HIV-related information, health related quality of life (WHOQoL-HIVBref), internalized AIDS stigma, symptoms of depression and adherence to antiretroviral therapy. Analyses consisted of descriptive statistics, bi- and multivariate logistic regression models. A total of 2230 patients (1483 [66.5%] female) were included. The median age was 37 years (interquartile range 31-43), 99.5% were black Africans, 1975 (88.6%) had started ART and the median time on ART was 22 months (interquartile range 9-40). No alcohol was used by 64% of patients, 8.9% were low risk drinkers, 25.1% of patients were hazardous or harmful drinkers and 2.0% had possible alcohol dependence. In multivariate analysis high-risk drinking was positively associated with male gender, never being married, tobacco use, a higher score for the 'level of independence'-domain measured with the WHOQoL-HIVBref questionnaire, and with more depressive symptoms compared to low-risk drinking. This study shows a high prevalence of hazardous or harmful drinking in patients with HIV infection (especially men) attending primary health care clinics in South Africa. Routine screening for alcohol use should be introduced in these clinics and harm reduction interventions should be evaluated, taking

  19. High HIV incidence among persons who inject drugs in Pakistan: greater risk with needle sharing and injecting frequently among the homeless.

    Directory of Open Access Journals (Sweden)

    Rab Nawaz Samo

    Full Text Available BACKGROUND: The incidence of HIV among persons who inject drugs (PWIDU has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted. METHODS: We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June and PWID were followed for two years. We measured incidence rates and risk factors associated with HIV seroconversion. RESULTS: Incidence of HIV was 12.4 per 100 person-years (95% exact Poisson confidence interval [CI]: 10.3-14.9. We followed 474 of 636 HIV seronegative persons (74.5% for two years, an annual loss to follow-up of <13 per 100 person years. In multivariable Cox regression analysis, HIV seroconversion was associated with non-Muslim religion (Adjusted risk ratio [ARR] = 1.7, 95%CI:1.4, 2.7, p = 0.03, sharing of syringes (AR  = 2.3, 95%CI:1.5, 3.3, p<0.0001, being homeless (ARR = 1.7, 95%CI:1.1, 2.5, p = 0.009, and daily injection of drugs (ARR = 1.1, 95%CI:1.0, 1.3, p = 0.04. CONCLUSIONS: Even though all members of the cohort of PWID were attending risk reduction programs, the HIV incidence rate was very high in Karachi from 2009-2011. The project budget was low, yet we were able to retain three-quarters of the population over two years. Absence of opiate substitution therapy and incomplete needle/syringe exchange coverage undermines success in HIV risk reduction.

  20. Implementation and Operational Research: A Cost-Effective, Clinically Actionable Strategy for Targeting HIV Preexposure Prophylaxis to High-Risk Men Who Have Sex With Men.

    Science.gov (United States)

    Ross, Eric L; Cinti, Sandro K; Hutton, David W

    2016-07-01

    Preexposure prophylaxis (PrEP) is effective at preventing HIV infection among men who have sex with men (MSM), but there is uncertainty about how to identify high-risk MSM who should receive PrEP. We used a mathematical model to assess the cost-effectiveness of using the HIV Incidence Risk Index for MSM (HIRI-MSM) questionnaire to target PrEP to high-risk MSM. We simulated strategies of no PrEP, PrEP available to all MSM, and eligibility thresholds set to HIRI-MSM scores between 5 and 45, in increments of 5 (where a higher score predicts greater HIV risk). Based on the iPrEx, IPERGAY, and PROUD trials, we evaluated PrEP efficacies from 44% to 86% and annual costs from $5900 to 8700. We designate strategies with incremental cost-effectiveness ratio (ICER) ≤$100,000/quality-adjusted life-year (QALY) as "cost-effective." Over 20 years, making PrEP available to all MSM is projected to prevent 33.5% of new HIV infections, with an ICER of $1,474,000/QALY. Increasing the HIRI-MSM score threshold reduces the prevented infections, but improves cost-effectiveness. A threshold score of 25 is projected to be optimal (most QALYs gained while still being cost-effective) over a wide range of realistic PrEP efficacies and costs. At low cost and high efficacy (IPERGAY), thresholds of 15 or 20 are optimal across a range of other input assumptions; at high cost and low efficacy (iPrEx), 25 or 30 are generally optimal. The HIRI-MSM provides a clinically actionable means of guiding PrEP use. Using a score of 25 to determine PrEP eligibility could facilitate cost-effective use of PrEP among high-risk MSM who will benefit from it most.

  1. Missed opportunities to offer HIV tests to high-risk groups during general practitioners' STI-related consultations: an observational study

    NARCIS (Netherlands)

    Joore, I.K.; Reukers, D.F.M.; Donker, G.A.; Sighem, A.I. van; Coul, E.L. Op de; Prins, J.M.; Geerlings, S.E.; Barth, R.E.; Bergen, J.E. van; Broek, I.V. van den

    2016-01-01

    OBJECTIVES: Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV

  2. Missed opportunities to offer HIV tests to high-risk groups during general practitioners’ STI-related consultations: an observational study.

    NARCIS (Netherlands)

    Joore, I.K.; Reukers, D.F.M.; Donker, G.A.; Sighem, A.I. van; Coul, E.L.M. Op de; Prins, J.M.; Geerlings, S.E.; Barth, S.R.E.; Bergen, J.E.A.M. van; Broek, I.V.F. van den

    2016-01-01

    Objectives: Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV

  3. Missed opportunities to offer HIV tests to high-risk groups during general practitioners’ STI-related consultations: an observational study.

    NARCIS (Netherlands)

    Joore, I.K.; Reukers, D.F.M.; Donker, G.A.; Sighem, A.I. van; Coul, E.L.M. Op de; Prins, J.M.; Geerlings, S.E.; Barth, S.R.E.; Bergen, J.E.A.M. van; Broek, I.V.F. van den

    2016-01-01

    Objectives: Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV

  4. Socialization patterns and their associations with unprotected anal intercourse, HIV, and syphilis among high-risk men who have sex with men and transgender women in Peru.

    Science.gov (United States)

    Verre, Michael C; Peinado, Jesus; Segura, Eddy R; Clark, Jesse; Gonzales, Pedro; Benites, Carlos; Cabello, Robinson; Sanchez, Jorge; Lama, Javier R

    2014-10-01

    The association of socialization patterns with unprotected anal intercourse (UAI) and HIV/STI prevalence remains underexplored in men who have sex with men (MSM) and transgender women (TW) in developing country settings. We evaluated the correlation of UAI, HIV, and syphilis with MSM/TW venue attendance and social network size among high-risk MSM and TW in Peru according to self-reported sexual identity. Frequency of venue attendance and MSM/TW social network size were lowest among heterosexual MSM and highest among TW respondents. Attendance (frequent or occasional) at MSM/TW venues was associated with increased odds of insertive UAI among heterosexual participants. Frequent venue attendance was associated with increased odds of receptive UAI among gay/homosexual, bisexual, and TW participants. Further investigation of the differing socialization patterns and associations with HIV/STI transmission within subgroups of Peruvian MSM and TW will enable more effective prevention interventions for these populations.

  5. Socialization Patterns and Their Association with Unprotected Anal Intercourse, HIV, and Syphilis Among High-Risk Men Who Have Sex with Men and Transgender Women in Peru

    Science.gov (United States)

    Verre, MC; Peinado, J; Segura, ER; Clark, JC; Gonzales, P; Benites, C; Cabello, R; Sanchez, J; Lama, JR

    2014-01-01

    The association of socialization patterns with unprotected anal intercourse (UAI) and HIV/STI prevalence remains underexplored in men who have sex with men (MSM) and transgender women (TW) in developing country settings. We evaluated the correlation of UAI, HIV, and syphilis with MSM/TW venue attendance and social network size among high-risk MSM and TW in Peru according to self-reported sexual identity. Frequency of venue attendance and MSM/TW social network size were lowest among heterosexual MSM and highest among TW respondents. Attendance (frequent or occasional) at MSM/TW venues was associated with increased odds of insertive UAI among heterosexual participants. Frequent venue attendance was associated with increased odds of receptive UAI among gay/homosexual, bisexual, and TW participants. Further investigation of the differing socialization patterns and associations with HIV/STI transmission within subgroups of Peruvian MSM and TW will enable more effective prevention interventions for these populations. PMID:24788782

  6. Risk analysis. HIV / AIDS country profile: Mozambique.

    Science.gov (United States)

    1996-12-01

    Mozambique's National STD/AIDS Control Program (NACP) estimates that, at present, about 8% of the population is infected with human immunodeficiency virus (HIV). The epidemic is expected to peak in 1997. By 2001, Mozambique is projected to have 1,650,000 HIV-positive adults 15-49 years of age, of whom 500,000 will have developed acquired immunodeficiency syndrome (AIDS), and 500,000 AIDS orphans. Incidence rates are highest in the country's central region, the transport corridors, and urban centers. The rapid spread of HIV has been facilitated by extreme poverty, the social upheaval and erosion of traditional norms created by years of political conflict and civil war, destruction of the primary health care infrastructure, growth of the commercial sex work trade, and labor migration to and from neighboring countries with high HIV prevalence. Moreover, about 10% of the adult population suffers from sexually transmitted diseases (STDs), including genital ulcers. NACP, created in 1988, is attempting to curb the further spread of HIV through education aimed at changing high-risk behaviors and condom distribution to prevent STD transmission. Theater performances and radio/television programs are used to reach the large illiterate population. The integration of sex education and STD/AIDS information in the curricula of primary and secondary schools and universities has been approved by the Ministry of Education. Several private companies have been persuaded to distribute condoms to their employees. Finally, the confidentiality of HIV patients has been guaranteed. In 1993, the total AIDS budget was US $1.67 million, 50% of which was provided by the European Union. The European Commission seeks to develop a national strategy for managing STDs within the primary health care system.

  7. HIV-infected Female Sex Workers High Risk Behavior and Attitude Changes in Kaiyuan City, Yunnan Province, China

    Institute of Scientific and Technical Information of China (English)

    DING Guo Wei; WANG Ning; HSI Jenny H; LIU Hui Xin; SU Ying Ying; WANG Jun Jie; BAI Jun; WANG Gui Xiang; WANG Hai Bo; DONG Rui Ling

    2014-01-01

    Objective To investigate the attitude and sexual behavior status and change among HIV positive female workers in entertainment sites in Kaiyuan city, Yunnan province, China. The key information should be applied in the integrated intervention program in future. Methods A cohort survey among HIV positive female workers was conducted during 12 months, between 2010 and 2012. All the risk sexual behavior and attitude were collected for assessment for the potential secondary transmission to sexual partners. Results Of 99 HIV positive women who sell sex in Kaiyuan city, 99 participated in the survey at baseline, 80, 80, 75, and 75 at 3-, 6-, 9-, and 12-month follow-ups. The percentage of participants who reported consistently used condoms in the last one month ranged between 94.5%and 95.5%. The client volume in the last one month, income per sex and age group were significant related with non-insistent condom use with their clients. Conclusion It was suggested that integrated intervention program package should include 100 percent condom use promotion for the HIV positive FSW with all sexual partners, and also, include socially support involved.

  8. Predicting risk of cancer during HIV infection

    DEFF Research Database (Denmark)

    Borges, Álvaro H; Silverberg, Michael J; Wentworth, Deborah

    2013-01-01

    To investigate the relationship between inflammatory [interleukin-6 (IL-6) and C-reactive protein (CRP)] and coagulation (D-dimer) biomarkers and cancer risk during HIV infection.......To investigate the relationship between inflammatory [interleukin-6 (IL-6) and C-reactive protein (CRP)] and coagulation (D-dimer) biomarkers and cancer risk during HIV infection....

  9. Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users.

    Science.gov (United States)

    Shrestha, Roman; Karki, Pramila; Altice, Frederick L; Dubov, Oleksandr; Fraenkel, Liana; Huedo-Medina, Tania; Copenhaver, Michael

    2017-07-10

    Although people who use drugs (PWUD) are one of the key risk populations who could benefit from the use of pre-exposure prophylaxis (PrEP), to date, little attention has been given to incorporating PrEP into HIV prevention approaches targeting this underserved group. This study investigated the acceptability of PrEP based on a number of known PrEP attributes among high-risk PWUD in a drug treatment setting. A total of 400 HIV-negative PWUD, who reported drug- and/or sex-related risk behaviors were recruited from a methadone clinic to complete a stated preference (full-profile conjoint) survey. Participants ranked the eight hypothetical PrEP program scenarios with varied combinations of six attributes related to PrEP (cost, dosing, efficacy, side-effects, treatment setting, and frequency of HIV testing). SPSS conjoint procedure was used to estimate the relative importance of each attribute and preferences across eight possible PrEP delivery programs. PrEP acceptability ranged from 30.6 to 86.3% with a mean acceptability of 56.2% across the eight hypothetical PrEP program scenarios. The PrEP program scenario with the highest acceptability had the following attribute levels: insurance covered, daily dosing, 95% effective, no side-effects, treatment at HIV clinic, and HIV testing needed every 6 months. The cost associated with PrEP was the most important attribute (relative importance score: RIS = 38.8), followed by efficacy (RIS = 20.5) and side effects (RIS = 11.9); other attributes had no significant effect. Our findings reported a high acceptability of PrEP in response to different PrEP program scenarios with different attribute profiles. As the result of having this information, researchers and policymakers will be better equipped for evidence informed targeting and dissemination efforts to optimize PrEP uptake among this underserved population.

  10. Social network-based recruitment successfully reveals HIV-1 transmission networks among high-risk individuals in El Salvador.

    Science.gov (United States)

    Dennis, Ann M; Murillo, Wendy; de Maria Hernandez, Flor; Guardado, Maria Elena; Nieto, Ana Isabel; Lorenzana de Rivera, Ivette; Eron, Joseph J; Paz-Bailey, Gabriela

    2013-05-01

    HIV in Central America is concentrated among certain groups such as men who have sex with men (MSM) and female sex workers (FSWs). We compared social recruitment chains and HIV transmission clusters from 699 MSM and 787 FSWs to better understand factors contributing to ongoing HIV transmission in El Salvador. Phylogenies were reconstructed using pol sequences from 119 HIV-positive individuals recruited by respondent-driven sampling (RDS) and compared with RDS chains in 3 cities in El Salvador. Transmission clusters with a mean pairwise genetic distance ≤ 0.015 and Bayesian posterior probabilities =1 were identified. Factors associated with cluster membership were evaluated among MSM. Sequences from 34 (43%) MSM and 4 (10%) FSW grouped in 14 transmission clusters. Clusters were defined by risk group (12 MSM clusters) and geographic residence (only 1 spanned separate cities). In 4 MSM clusters (all n = 2), individuals were also members of the same RDS chain, but only 2 had members directly linked through recruitment. All large clusters (n ≥ 3) spanned >1 RDS chain. Among MSM, factors independently associated with cluster membership included recent infection by BED assay (P = 0.02), sex with stable male partners (P = 0.02), and sex with ≥ 3 male partners in the past year (P = 0.04). We found few HIV transmissions corresponding directly with the social recruitment. However, we identified clustering in nearly one-half of MSM suggesting that RDS recruitment was indirectly but successfully uncovering transmission networks, particularly among recent infections. Interrogating RDS chains with phylogenetic analyses may help refine methods for identifying transmission clusters.

  11. Social network based recruitment successfully reveals HIV-1 transmission networks among high risk individuals in El Salvador

    Science.gov (United States)

    Dennis, Ann M.; Murillo, Wendy; de Maria Hernandez, Flor; Guardado, Maria Elena; Nieto, Ana Isabel; de Rivera, Ivette Lorenzana; Eron, Joseph J.; Paz-Bailey, Gabriela

    2013-01-01

    Objective HIV in Central America is concentrated among certain groups such as men who have sex with men (MSM) and female sex workers (FSW). We compared social recruitment chains and HIV transmission clusters from 699 MSM and 757 FSW to better understand factors contributing to ongoing HIV transmission in El Salvador. Methods Phylogenies were reconstructed using pol sequences from 119 HIV-positive individuals recruited by respondent driven sampling (RDS) and compared to RDS chains in three cities in El Salvador. Transmission clusters with a mean pairwise genetic distance ≤0.015 and Bayesian posterior probabilities=1 were identified. Factors associated with cluster membership were evaluated among MSM. Results Sequences from 34 (43%) MSM and 4 (10%) FSW grouped in 14 transmission clusters. Clusters were defined by risk group (12 MSM clusters) and geographic residence (only one spanned separate cities). In 4 MSM clusters (all n=2), individuals were also members of the same RDS chain but only 2 had members directly linked through recruitment. All large clusters (n≥3) spanned more than one RDS chain. Among MSM, factors independently associated with cluster membership included recent infection by BED assay (P=0.02), sex with stable male partners (P=0.02), and sex with ≥3 male partners in past year (P=0.04). Conclusions We found few HIV transmissions corresponding directly with the social recruitment. However, we identified clustering in nearly one half of MSM suggesting RDS recruitment was indirectly but successfully uncovering transmission networks, particularly among recent infections. Interrogating RDS chains with phylogenetic analyses may help refine methods for identifying transmission clusters. PMID:23364512

  12. HIV transmission and related risk factors among serodiscordant couples in Liuzhou, China.

    Science.gov (United States)

    Zhang, Yu-Jing; Feng, Xian-Xiang; Fan, Yin-Guang; Jiang, Zhi-Yu; Zhong, Xiang-Hai; Li, Ming-Qiang; Ye, Dong-Qing

    2015-04-01

    To evaluate the incidence and risk factors for human immunodeficiency virus (HIV) seroconversion of HIV-negative partners among HIV-discordant couples in Liuzhou, China, 1854 eligible HIV-serodiscordant couples were retrospectively identified through the HIV epidemiology and follow-up database from January 1, 1996 to June 30, 2013. Cox proportional-hazards model was used to examine risk factors related to HIV seroconversion of negative partners. Finally, 125 HIV seroconversion occurred over 4963.5 person-years, resulting in an overall HIV incidence of 2.52/100 person-years. HIV-positive partners with the last CD4 counts of 350 cells/ul or more were significantly protected against HIV seroconversion compared with those CD4 counts of less than 200 cells/ul (aHR = 0.46, 95% CI: 0.27-0.81, P HIV-positive wives (aHR: 1.96, 95% CI: 1.27-3.02, P HIV-positive partners who did not receive ART before their HIV-negative partners' seroconversion (aHR: 2.22, 95% CI, 1.41-3.51, P HIV seroconversion. HIV-negative partners remain high risk of HIV infection in Liuzhou city. Comprehensive package of HIV prevention services should contribute to reduction in HIV transmission of discordant couples.

  13. Use of a risk scoring tool to identify higher-risk HIV-1 serodiscordant couples for an antiretroviral-based HIV-1 prevention intervention.

    Science.gov (United States)

    Irungu, Elizabeth M; Heffron, Renee; Mugo, Nelly; Ngure, Kenneth; Katabira, Elly; Bulya, Nulu; Bukusi, Elizabeth; Odoyo, Josephine; Asiimwe, Stephen; Tindimwebwa, Edna; Celum, Connie; Baeten, Jared M

    2016-10-17

    Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) reduce HIV-1 transmission within heterosexual HIV-1 serodiscordant couples. Prioritizing couples at highest HIV-1 transmission risk for ART and PrEP would maximize impact and minimize costs. The Partners Demonstration Project is an open-label, delivery study of integrated PrEP and ART for HIV-1 prevention among high risk HIV-1 serodiscordant couples in Kenya and Uganda. We evaluated the feasibility of using a validated risk score that weighs a combination of easily measurable factors (age, children, marital status, male circumcision status, condom use, plasma HIV-1 levels) to identify couples at highest risk for HIV-1 transmission for enrollment. Couples scoring ≥5 met the risk score eligibility criteria. We screened 1694 HIV-1 serodiscordant couples and enrolled 1013. Of the screened couples, 1331 (78.6 %) scored ≥5 (with an expected incidence >3 % per year) and 76 % of these entered the study. The median age of the HIV-1 uninfected partner was 29 years [IQR 26, 36] and 20 % were 50,000 copies/ml. A risk scoring tool identified HIV-1 serodiscordant couples for a demonstration project of PrEP and ART with high HIV-1 risk. The tool may be feasible for research and public health settings to maximize efficiency and minimize HIV-1 prevention costs.

  14. High risk sexual behaviors for HIV among the in-school youth in Swaziland: a structural equation modeling approach.

    Directory of Open Access Journals (Sweden)

    Hlengiwe Nokuthula Sacolo

    Full Text Available BACKGROUND: Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned behavior (TPB for predicting factors associated with protective sexual behaviors, including sexual abstinence and condom use, among in-school youths aged between 15 and 19 years in Swaziland. METHODS: This cross-sectional survey was conducted using a anonymous questionnaire. A two-stage stratified and cluster random sampling method was used. Approximately one hundred pupils from each of four schools agreed to participate in the study, providing a total sample size of 403 pupils of which 369 were ultimately included for data analysis. The response rate was 98%. Structural equation modeling was used to analyse hypothesized paths. RESULTS: The TPB model used in this study was effective in predicting protective sexual behavior among Swazi in-school youths, as shown by model fit indices. All hypothesized constructs significantly predicted intentions for abstinence and condom use, except perceived abstinence controls. Subjective norms were the strongest predictors of intention for premarital sexual abstinence; however, perceived controls for condom use were the strongest predictors of intention for condom use. CONCLUSIONS: Our findings support application of the model in predicting determinants of condom use and abstinence intentions among Swazi in-school youths.

  15. HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

    Science.gov (United States)

    Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Castro-Calvo, Jesús; Giménez-García, Cristina

    2016-08-01

    The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people.

  16. Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women.

    Science.gov (United States)

    Adedimeji, Adebola A; Hoover, Donald R; Shi, Qiuhu; Gard, Tracy; Mutimura, Eugene; Sinayobye, Jean d'Amour; Cohen, Mardge H; Anastos, Kathryn

    2015-07-01

    It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75 % of participants were HIV positive and ~50 % reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents' age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors.

  17. Reward, attention, and HIV-related risk in HIV+ individuals.

    Science.gov (United States)

    Anderson, Brian A; Kronemer, Sharif I; Rilee, Jessica J; Sacktor, Ned; Marvel, Cherie L

    2016-08-01

    Human immunodeficiency virus (HIV) is often contracted through engaging in risky reward-motivated behaviors such as needle sharing and unprotected sex. Understanding the factors that make an individual more vulnerable to succumbing to the temptation to engage in these risky behaviors is important to limiting the spread of HIV. One potential source of this vulnerability concerns the degree to which an individual is able to resist paying attention to irrelevant reward information. In the present study, we examine this possible link by characterizing individual differences in value-based attentional bias in a sample of HIV+ individuals with varying histories of risk-taking behavior. Participants learned associations between experimental stimuli and monetary reward outcome. The degree of attentional bias for these reward-associated stimuli, reflected in their ability to capture attention when presented as task-irrelevant distractors, was then assessed both immediately and six months following reward learning. Value-driven attentional capture was related to substance abuse history and non-planning impulsiveness during the time leading up to contraction of HIV as measured via self-report. These findings suggest a link between the ability to ignore reward-associated information and prior HIV-related risk-taking behavior. Additionally, particular aspects of HIV-associated neurocognitive disorders were related to attentional bias, including motor deficits commonly associated with HIV-induced damage to the basal ganglia. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research.

    Science.gov (United States)

    Shrestha, Roman; Altice, Frederick; Karki, Pramila; Copenhaver, Michael

    2017-01-01

    To date, HIV prevention efforts have largely relied on singular strategies (e.g., behavioral or biomedical approaches alone) with modest HIV risk-reduction outcomes for people who use drugs (PWUD), many of whom experience a wide range of neurocognitive impairments (NCI). We report on the process and outcome of our formative research aimed at developing an integrated biobehavioral approach that incorporates innovative strategies to address the HIV prevention and cognitive needs of high-risk PWUD in drug treatment. Our formative work involved first adapting an evidence-based behavioral intervention-guided by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing model-and then combining the behavioral intervention with an evidence-based biomedical intervention for implementation among the target population. This process involved eliciting data through structured focus groups (FGs) with key stakeholders-members of the target population (n = 20) and treatment providers (n = 10). Analysis of FG data followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis and cross-case analysis. Based on all information, we integrated the adapted community-friendly health recovery program-a brief evidence-based HIV prevention behavioral intervention-with the evidence-based biomedical component [i.e., preexposure prophylaxis (PrEP)], an approach that incorporates innovative strategies to accommodate individuals with NCI. This combination approach-now called the biobehavioral community-friendly health recovery program-is designed to address HIV-related risk behaviors and PrEP uptake and adherence as experienced by many PWUD in treatment. This study provides a complete example of the process of selecting, adapting, and integrating the evidence-based interventions-taking into account both empirical evidence and input from target population members and target organization

  19. Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research

    Directory of Open Access Journals (Sweden)

    Roman Shrestha

    2017-05-01

    Full Text Available To date, HIV prevention efforts have largely relied on singular strategies (e.g., behavioral or biomedical approaches alone with modest HIV risk-reduction outcomes for people who use drugs (PWUD, many of whom experience a wide range of neurocognitive impairments (NCI. We report on the process and outcome of our formative research aimed at developing an integrated biobehavioral approach that incorporates innovative strategies to address the HIV prevention and cognitive needs of high-risk PWUD in drug treatment. Our formative work involved first adapting an evidence-based behavioral intervention—guided by the Assessment–Decision–Administration–Production–Topical experts–Integration–Training–Testing model—and then combining the behavioral intervention with an evidence-based biomedical intervention for implementation among the target population. This process involved eliciting data through structured focus groups (FGs with key stakeholders—members of the target population (n = 20 and treatment providers (n = 10. Analysis of FG data followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis and cross-case analysis. Based on all information, we integrated the adapted community-friendly health recovery program—a brief evidence-based HIV prevention behavioral intervention—with the evidence-based biomedical component [i.e., preexposure prophylaxis (PrEP], an approach that incorporates innovative strategies to accommodate individuals with NCI. This combination approach—now called the biobehavioral community-friendly health recovery program—is designed to address HIV-related risk behaviors and PrEP uptake and adherence as experienced by many PWUD in treatment. This study provides a complete example of the process of selecting, adapting, and integrating the evidence-based interventions—taking into account both empirical evidence and input from target

  20. Intimate Partner Violence is Associated with Increased CD4+ T-Cell Activation Among HIV-Negative High-Risk Women

    Directory of Open Access Journals (Sweden)

    Ameeta Shivdas Kalokhe

    2016-09-01

    Full Text Available Background: Biological pathways mediating the link between intimate partner violence (IPV and increased HIV risk remain unexplored. We hypothesized that IPV-induced stress negatively affects HIV systemic immune defenses and aimed to evaluate whether IPV was associated with immune profiles linked to HIV susceptibility: CD4 activation and diminished regulatory T-cell (Treg frequency. Methods: Seventy-five HIV-negative high-risk women were surveyed regarding their IPV experience. They provided blood, urine, and (if present genital ulcer samples for cortisol, immune assays, and STI testing. Using flow cytometry, we assessed activated CD4+ T-cell (%HLA-DR+/CD38+ and Treg (%CD4+CD25+FoxP3+ frequencies and phenotyping. Nonparametric tests evaluated the association between IPV and immune outcomes. Multivariate regression explored confounding and moderation of the IPV-CD4 activation pathway. Results: Lifetime IPV was associated with increased CD4+ activation (r=0.331, P=0.004, a shift in CD4+ phenotype from naïve to effector memory (r=0.343, P=0.003, and a decrease in naive (%HLA-DR+/CD45RA- Treg frequency (r=-0.337, P=0.003. Experiencing IPV over the past year had similar trends. After controlling for sexual IPV, lifetime physical and psychological abuse remained significantly associated with CD4+ activation (P=0.004 and P=0.033, respectively. After controlling for race (the only covariate linked to activation, the lifetime IPV-CD4 activation association remained significant (P=0.012. Alcohol use and depression were identified as potential pathway moderators. Conclusion: Our data is the first to suggest an immune link between IPV and HIV, and may help explain differences at the individual level in HIV susceptibility and response to biological HIV prevention strategies. The association of psychological and physical abuse with CD4 activation independent of sexual abuse further supports the existence of a stress-induced immune pathway.

  1. Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk.

    Science.gov (United States)

    Parsons, Jeffrey T; Rendina, H Jonathon; Ventuneac, Ana; Moody, Raymond L; Grov, Christian

    2016-02-01

    Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups-Neither SC nor HD; SC only, and Both SC and HD-that capture distinct levels of severity across the SC/HD continuum. We examined data from 370 highly sexually active GBM to assess how the three groups compare across a range of risk factors for HIV infection. Comparisons focused on psychosexual measures-temptation for condomless anal sex (CAS), self-efficacy for avoiding CAS, sexual excitation and inhibition-as well as reports of actual sexual behavior. Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts, or anal sex acts with serodiscordant partners, the Both SC and HD group reported higher numbers of CAS acts and CAS acts with serodiscordant partners and also had a higher proportion of their anal sex acts without condoms compared to the SC Only group. Our findings support the validity of a three-group classification system of SC/HD severity in differentiating psychosexual and HIV-related sexual risk behavior outcomes in a sample of GBM who report similarly high levels of sexual activity. Notwithstanding the need for sex positive HIV prevention programs, interventions that attempt to help Both SC and HD men deal with distress and address their psychosexual needs specifically may derive HIV prevention benefits.

  2. Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk

    Science.gov (United States)

    Rendina, H. Jonathon; Ventuneac, Ana; Moody, Raymond L.; Grov, Christian

    2015-01-01

    Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups—Neither SC nor HD; SC only, and Both SC and HD—that capture distinct levels of severity across the SC/HD continuum. We examined data from 370 highly sexually active GBM to assess how the three groups compare across a range of risk factors for HIV infection. Comparisons focused on psychosexual measures—temptation for condomless anal sex (CAS), self-efficacy for avoiding CAS, sexual excitation and inhibition—as well as reports of actual sexual behavior. Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts, or anal sex acts with serodiscordant partners, the Both SC and HD group reported higher numbers of CAS acts and CAS acts with serodiscordant partners and also had a higher proportion of their anal sex acts without condoms compared to the SC Only group. Our findings support the validity of a three-group classification system of SC/HD severity in differentiating psychosexual and HIV-related sexual risk behavior outcomes in a sample of GBM who report similarly high levels of sexual activity. Notwithstanding the need for sex positive HIV prevention programs, interventions that attempt to help Both SC and HD men deal with distress and address their psychosexual needs specifically may derive HIV prevention benefits. PMID:25750052

  3. High risks of HIV transmission for men who have sex with men--a comparison of risk factors of HIV infection among MSM associated with recruitment channels in 15 cities of China.

    Directory of Open Access Journals (Sweden)

    Jinlei Qi

    Full Text Available While the HIV epidemic varies greatly by region and population group throughout China, the HIV incidence among men who have sex with men (MSM continues to rise at an alarmingly fast pace. We seek to analyze the risk factors associated with HIV infection among MSM recruited from different channels in large urban centers across China, in an attempt to shed light on the design of future targeted intervention strategies.A total of 33,684 MSM from 14 cities and one province were recruited from July to December 2011. Demographic (e.g. age, marital status, education and behavioral (e.g. condom use, HIV testing history data were collected using information collection cards. Blood samples were also collected to test for HIV and Syphilis.Participants were recruited from five different channels, and all demonstrated distinct characteristics. The overall rate of positive HIV screening was 6.27% and the rate of syphilis infection was 6.50%. Participants recruited from bathhouses had the highest HIV (11.80% and syphilis infection rates (11.20%. Participants who were infected with syphilis had the highest HIV-positive screening rate (13.75%; 95% CI OR, 2.33-3.06. living in the southwest region of the country (11.64%; OR=2.76, 95%CI OR 2.19-3.47, Being >20 years of age (P<0.001, living in the southwest region of the country (OR=2.76, 95%CI 2.19-3.47, not having sex with female over the previous 3 months (OR=1.27, 95%CI 1.09-1.48, no condom use during the last anal intercourse (OR=1.54, 95%CI 1.39-1.70 and other factors were all associated with a higher probability of having an HIV-positive test result.Depending on the way they are recruited, more targeted interventions are required to prevent the spread of HIV/AIDS among MSM with different characteristics and behaviors. Results from this study could provide evidence for researchers to conduct further studies and policy-makers to establish more effective and strategic interventions for MSM in China.

  4. Supervised and unsupervised self-testing for HIV in high- and low-risk populations: a systematic review.

    Directory of Open Access Journals (Sweden)

    Nitika Pant Pai

    Full Text Available BACKGROUND: Stigma, discrimination, lack of privacy, and long waiting times partly explain why six out of ten individuals living with HIV do not access facility-based testing. By circumventing these barriers, self-testing offers potential for more people to know their sero-status. Recent approval of an in-home HIV self test in the US has sparked self-testing initiatives, yet data on acceptability, feasibility, and linkages to care are limited. We systematically reviewed evidence on supervised (self-testing and counselling aided by a health care professional and unsupervised (performed by self-tester with access to phone/internet counselling self-testing strategies. METHODS AND FINDINGS: Seven databases (Medline [via PubMed], Biosis, PsycINFO, Cinahl, African Medicus, LILACS, and EMBASE and conference abstracts of six major HIV/sexually transmitted infections conferences were searched from 1st January 2000-30th October 2012. 1,221 citations were identified and 21 studies included for review. Seven studies evaluated an unsupervised strategy and 14 evaluated a supervised strategy. For both strategies, data on acceptability (range: 74%-96%, preference (range: 61%-91%, and partner self-testing (range: 80%-97% were high. A high specificity (range: 99.8%-100% was observed for both strategies, while a lower sensitivity was reported in the unsupervised (range: 92.9%-100%; one study versus supervised (range: 97.4%-97.9%; three studies strategy. Regarding feasibility of linkage to counselling and care, 96% (n = 102/106 of individuals testing positive for HIV stated they would seek post-test counselling (unsupervised strategy, one study. No extreme adverse events were noted. The majority of data (n = 11,019/12,402 individuals, 89% were from high-income settings and 71% (n = 15/21 of studies were cross-sectional in design, thus limiting our analysis. CONCLUSIONS: Both supervised and unsupervised testing strategies were highly acceptable, preferred, and more

  5. Supervised and Unsupervised Self-Testing for HIV in High- and Low-Risk Populations: A Systematic Review

    Science.gov (United States)

    Pant Pai, Nitika; Sharma, Jigyasa; Shivkumar, Sushmita; Pillay, Sabrina; Vadnais, Caroline; Joseph, Lawrence; Dheda, Keertan; Peeling, Rosanna W.

    2013-01-01

    Background Stigma, discrimination, lack of privacy, and long waiting times partly explain why six out of ten individuals living with HIV do not access facility-based testing. By circumventing these barriers, self-testing offers potential for more people to know their sero-status. Recent approval of an in-home HIV self test in the US has sparked self-testing initiatives, yet data on acceptability, feasibility, and linkages to care are limited. We systematically reviewed evidence on supervised (self-testing and counselling aided by a health care professional) and unsupervised (performed by self-tester with access to phone/internet counselling) self-testing strategies. Methods and Findings Seven databases (Medline [via PubMed], Biosis, PsycINFO, Cinahl, African Medicus, LILACS, and EMBASE) and conference abstracts of six major HIV/sexually transmitted infections conferences were searched from 1st January 2000–30th October 2012. 1,221 citations were identified and 21 studies included for review. Seven studies evaluated an unsupervised strategy and 14 evaluated a supervised strategy. For both strategies, data on acceptability (range: 74%–96%), preference (range: 61%–91%), and partner self-testing (range: 80%–97%) were high. A high specificity (range: 99.8%–100%) was observed for both strategies, while a lower sensitivity was reported in the unsupervised (range: 92.9%–100%; one study) versus supervised (range: 97.4%–97.9%; three studies) strategy. Regarding feasibility of linkage to counselling and care, 96% (n = 102/106) of individuals testing positive for HIV stated they would seek post-test counselling (unsupervised strategy, one study). No extreme adverse events were noted. The majority of data (n = 11,019/12,402 individuals, 89%) were from high-income settings and 71% (n = 15/21) of studies were cross-sectional in design, thus limiting our analysis. Conclusions Both supervised and unsupervised testing strategies were highly acceptable

  6. Cardiovascular risk and dyslipidemia management in HIV-infected patients.

    Science.gov (United States)

    Stein, James H

    2012-01-01

    HIV infection and antiretroviral therapy each appear to increase cardiovascular disease risk. Increased risk may be attributable to the inflammatory effects of HIV infection and dyslipidemia associated with some antiretroviral agents. The prevalence of cardiovascular disease is increasing as patients live longer, age, and acquire traditional coronary heart disease (CHD) risk factors. In general, any additional cardiovascular risk posed by HIV infection or antiretroviral therapy is of potential concern for patients who are already at moderate or high risk for CHD. Long-term and well-designed studies are needed to more accurately ascertain to what degree HIV infection and antiretroviral therapy affect long-term cardiovascular disease risk. Management of dyslipidemia to reduce CHD risk in HIV-infected patients is much the same as in the general population, with the cornerstone consisting of statin therapy and lifestyle interventions. Smoking cessation is a major step in reducing CHD risk in those who smoke. This article summarizes a presentation by James H. Stein, MD, at the IAS-USA live continuing medical education activity held in New York City in March 2012.

  7. Prevalence, incidence and determinants of herpes simplex virus type 2 infection among HIV-seronegative women at high-risk of HIV infection: a prospective study in Beira, Mozambique.

    Directory of Open Access Journals (Sweden)

    Ivete Meque

    Full Text Available OBJECTIVES: To estimate the prevalence, incidence and determinants of herpes simplex type 2 (HSV-2 infection, and associations between HSV-2 and incident HIV infection, among women at higher risk for HIV infection in Beira, Mozambique. METHODS: Between 2009 and 2012, 411 women aged 18-35 years at higher risk of HIV acquisition (defined as having had two or more sexual partners in the month prior to study enrollment were enrolled and followed monthly for one year. At each study visit, they were counseled, interviewed, and tested for HSV-2 and HIV antibodies. RESULTS: The HSV-2 prevalence at baseline was 60.6% (95% CI: 55.7% -65.4%. Increasing age (aOR = 2.94, 95% CI: 1.74-4.97, P<0.001 and aOR = 3.39, 95% CI: 1.58-7.29, P = 0.002 for age groups of 21-24 and 25-35 years old respectively, lower educational level (aOR = 1.81, 95% CI: 1.09-3.02, P = 0.022, working full time (aOR = 8.56, 95% CI: 1.01-72.53, P = 0.049 and having practiced oral sex (aOR = 3.02, 95% CI: 1.16-7.89, P = 0.024 were strongly associated with prevalent HSV-2 infection. Thirty one participants seroconverted for HSV-2 (20.5%; 95% CI: 14.4% -27.9% and 22 for HIV during the study period. The frequency of vaginal sex with a casual partner using a condom in the last 7 days was independently associated with incident HSV-2 infection (aOR = 1.91, 95% CI: 1.05-3.47, P = 0.034. Positive HSV-2 serology at baseline was not significantly associated with risk of subsequent HIV seroconversion. CONCLUSIONS: Young women engaging in risky sexual behaviors in Beira had high prevalence and incidence of HSV-2 infection. Improved primary HSV-2 control strategies are urgently needed in Beira.

  8. HIV, syphilis, and behavioral risk factors among female sex workers before and after implementation of harm reduction programs in a high drug-using area of China.

    Directory of Open Access Journals (Sweden)

    Li Zhang

    Full Text Available OBJECTIVE: To evaluate the impact of harm reduction programs on HIV and syphilis infection and related risk behaviors among female sex workers (FSWs in a drug trafficking city in Southwest China. DESIGN: Before and after harm reduction program study. METHODS: Two cross-sectional surveys were conducted among FSWs before and after harm reduction programs were launched in Xichang city, Sichuan province. The first and second cross-sectional surveys were conducted in 2004 and 2010, respectively. Temporal changes in odds of HIV, syphilis, and behavioral risk factors were assessed by multivariable logistic regression while controlling for socio-demographics. RESULTS: The 2004 and 2010 cross-sectional surveys recruited 343 and 404 FSWs, respectively. From 2004 to 2010, the odds of syphilis infection decreased by 35% and was of borderline statistical significance (AOR: 0.65, 95% CI: 0.41-1.03, while odds of HIV infection rose, but not significantly (AOR: 4.12, 95% CI: 0.76-22.45. Although odds of unprotected sex with primary sex partners did not significantly change over time (AOR: 0.96; 95% CI: 0.61-1.50, odds of unprotected sex with clients declined significantly and remarkably (AOR: 0.14, 95% CI: 0.09-0.21. Notably, the odds of reporting ≥10 new sex partners in the previous month increased by 37% (AOR: 1.37; 95% CI: 0.98-1.90. CONCLUSIONS: Harm reduction strategies may be an effective means of reducing unprotected sex with clients among FSWs. Future research is needed to better target both FSWs and IDUs and interrupt bridging networks for HIV transmission in high drug-using areas of China.

  9. HIV, Syphilis, and Behavioral Risk Factors among Female Sex Workers before and after Implementation of Harm Reduction Programs in a High Drug-Using Area of China

    Science.gov (United States)

    Pan, Stephen W.; Song, Benli; Liu, Qianping; Xu, Yunan; Dong, Hui; Xing, Hui; Shao, Yiming; Ruan, Yuhua

    2014-01-01

    Objective To evaluate the impact of harm reduction programs on HIV and syphilis infection and related risk behaviors among female sex workers (FSWs) in a drug trafficking city in Southwest China. Design Before and after harm reduction program study. Methods Two cross-sectional surveys were conducted among FSWs before and after harm reduction programs were launched in Xichang city, Sichuan province. The first and second cross-sectional surveys were conducted in 2004 and 2010, respectively. Temporal changes in odds of HIV, syphilis, and behavioral risk factors were assessed by multivariable logistic regression while controlling for socio-demographics. Results The 2004 and 2010 cross-sectional surveys recruited 343 and 404 FSWs, respectively. From 2004 to 2010, the odds of syphilis infection decreased by 35% and was of borderline statistical significance (AOR: 0.65, 95% CI: 0.41–1.03), while odds of HIV infection rose, but not significantly (AOR: 4.12, 95% CI: 0.76–22.45). Although odds of unprotected sex with primary sex partners did not significantly change over time (AOR: 0.96; 95% CI: 0.61–1.50), odds of unprotected sex with clients declined significantly and remarkably (AOR: 0.14, 95% CI: 0.09–0.21). Notably, the odds of reporting ≥10 new sex partners in the previous month increased by 37% (AOR: 1.37; 95% CI: 0.98–1.90). Conclusions Harm reduction strategies may be an effective means of reducing unprotected sex with clients among FSWs. Future research is needed to better target both FSWs and IDUs and interrupt bridging networks for HIV transmission in high drug-using areas of China. PMID:24416319

  10. Mental health and HIV sexual risk behaviour among University of ...

    African Journals Online (AJOL)

    income countries, with depression constituting the heaviest disease burden.[3] The HIV epidemic ... use, and HIV risk behaviour, such as multiple sexual partners and unprotected sex.[6-13] ... HIV prevention in Africa. Objective. To determine ...

  11. Factors associated with HIV stigma and the impact of a nonrandomized multi-component video aimed at reducing HIV stigma among a high-risk population in New York City.

    Science.gov (United States)

    Rivera, Alexis V; DeCuir, Jennifer; Crawford, Natalie D; Amesty, Silvia; Harripersaud, Katherine; Lewis, Crystal F

    2015-01-01

    We examined characteristics associated with HIV stigma and evaluated a multi-component video designed to normalize HIV and reduce HIV stigma. Three pharmacies located in heavy, drug-active neighborhoods in New York City and registered to sell nonprescription syringes were trained to recruit their nonprescription syringe customers who inject drugs and their under/uninsured customers. Syringe customer participants were trained to recruit up to three of their peers. As part of a larger intervention to increase HIV testing, participants in two of three study arms viewed the "Health Screenings for Life" video and were administered pre/post-video surveys capturing HIV stigma. Participants in the nonvideo arm were administered one assessment of HIV stigma. Log-binomial regression with generalized estimating equations to account for clustering of peer networks was used to: (1) determine factors associated with HIV stigma and (2) determine differences in HIV stigma by study arm. A total of 716 participants were recruited. Factor analyses showed HIV stigma measures loading on two factors: HIV blame and HIV shame. After adjustment, HIV blame was positively associated with younger age (PR: 1.24; 95% CI: 1.07-1.43) and inversely associated with educational attainment (PR: 0.66; 95% CI: 0.58-0.76) and employment (PR: 0.76; 95% CI: 0.60-0.96). HIV shame was inversely associated with educational attainment (PR: 0.75; 95% CI: 0.62-0.92), HIV-positive status (PR: 0.60; 95% CI: 0.39-0.92), and injecting drugs (PR: 0.72; 95% CI: 0.54-0.94) and was positively associated with multiple sex partnerships (PR: 1.24; 95% CI: 1.01-1.52). Those who viewed the video were also less likely to report HIV blame and HIV shame, post-video, compared to those in the nonvideo arm. These data provide evidence of an association between HIV stigma and lower socioeconomic status groups, and between HIV stigma and HIV sexual risk. These data also provide evidence that a multi-component video aimed at

  12. Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Kenneth K Mugwanya

    Full Text Available INTRODUCTION: The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future. METHODS: We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods. RESULTS: 318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men's risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14 and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07 were significantly (p≤0.05 more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004 and those who were HIV seropositive (APR 1.09, p = 0.03 were also more likely to be interested in child circumcision for HIV prevention. CONCLUSIONS: A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.

  13. Abacavir and risk of myocardial infarction in HIV-infected patients on highly active antiretroviral therapy: a population-based nationwide cohort study

    DEFF Research Database (Denmark)

    Obel, Niels; Farkas, D K; Kronborg, G;

    2009-01-01

    OBJECTIVE: The aim of the study was to examine whether exposure to abacavir increases the risk for myocardial infarction (MI). DESIGN, SETTING AND SUBJECTS: This was a prospective nationwide cohort study which included all Danish HIV-infected patients on highly active antiretroviral therapy (HAART......) from 1995 to 2005 (N = 2952). Data on hospitalization for MI and comorbidity were obtained from Danish medical databases. Hospitalization rates for MI after HAART initiation were calculated for patients who used abacavir and those who did not. We used Cox's regression to compute incidence rate ratios...... (IRR) as a measure of relative risk for MI, while controlling for potential confounders (as separate variables and via propensity score) including comorbidity. MAIN OUTCOME: Relative risk of hospitalization with MI in abacavir users compared with abacavir nonusers. RESULTS: Hospitalization rates for MI...

  14. Indices to measure risk of HIV acquisition in Rakai, Uganda.

    Directory of Open Access Journals (Sweden)

    Joseph Kagaayi

    Full Text Available INTRODUCTION: Targeting most-at-risk individuals with HIV preventive interventions is cost-effective. We developed gender-specific indices to measure risk of HIV among sexually active individuals in Rakai, Uganda. METHODS: We used multivariable Cox proportional hazards models to estimate time-to-HIV infection associated with candidate predictors. Reduced models were determined using backward selection procedures with Akaike's information criterion (AIC as the stopping rule. Model discrimination was determined using Harrell's concordance index (c index. Model calibration was determined graphically. Nomograms were used to present the final prediction models. RESULTS: We used samples of 7,497 women and 5,783 men. 342 new infections occurred among females (incidence 1.11/100 person years, and 225 among the males (incidence 1.00/100 person years. The final model for men included age, education, circumcision status, number of sexual partners, genital ulcer disease symptoms, alcohol use before sex, partner in high risk employment, community type, being unaware of a partner's HIV status and community HIV prevalence. The Model's optimism-corrected c index was 69.1 percent (95% CI = 0.66, 0.73. The final women's model included age, marital status, education, number of sex partners, new sex partner, alcohol consumption by self or partner before sex, concurrent sexual partners, being employed in a high-risk occupation, having genital ulcer disease symptoms, community HIV prevalence, and perceiving oneself or partner to be exposed to HIV. The models optimism-corrected c index was 0.67 (95% CI = 0.64, 0.70. Both models were well calibrated. CONCLUSION: These indices were discriminative and well calibrated. This provides proof-of-concept that population-based HIV risk indices can be developed. Further research to validate these indices for other populations is needed.

  15. Use of rosuvastatin to treat protease inhibitor-associated hypercholesterolaemia in a HIV-infected patient at high risk of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Leonardo Calza

    2010-09-01

    Full Text Available Rosuvastatin represents one of the latest inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA reductase introduced in clinical practice for the treatment of hypercholesterolaemia. In comparative trials, across dose ranges this statin reduced low-density lipoprotein (LDL cholesterol and total cholesterol significantly more than atorvastatin, simvastatin, and pravastatin, and triglycerides significantly more than simvastatin and pravastatin. In healthy subjects with normal LDL cholesterol and elevated C-reactive protein, rosuvastatin treatment produced a significant decrease in the incidence of cardiovascular events.Its chemical and pharmacokinetic properties suggest a very limited penetration in extrahepatic tissues with a lower risk of muscle toxicity and metabolically mediated drug-drug interactions, suggesting a low risk of pharmacokinetic interactions with antiretroviral drugs in patients with HIV infection. We describe a case of protease inhibitor-associated hypercholesterolaemia in a male HIV-infected patient with high cardiovascular risk. Treatment with rosuvastatin leaded to a significant reduction in total and LDL cholesterol levels, with a good tolerability profile after 15 months of follow-up.

  16. Morbidity and risk of subsequent diagnosis of HIV

    DEFF Research Database (Denmark)

    Søgaard, Ole S; Lohse, Nicolai; Østergaard, Lars Jørgen;

    2012-01-01

    Early identification of persons with undiagnosed HIV infection is an important health care issue. We examined associations between diseases diagnosed in hospitals and risk of subsequent HIV diagnosis.......Early identification of persons with undiagnosed HIV infection is an important health care issue. We examined associations between diseases diagnosed in hospitals and risk of subsequent HIV diagnosis....

  17. Relationship of psychosocial factors to HIV risk among Haitian women.

    Science.gov (United States)

    Malow, R M; Cassagnol, T; McMahon, R; Jennings, T E; Roatta, V G

    2000-02-01

    This study describes the prevalence of HIV risk behaviors among low-income, Haitian women, identifies theoretically relevant mediating psychosocial HIV risk predictors, and provides formative data for developing culturally and gender sensitive interventions for this distinctive, high risk, and understudied population. Confidential interview surveys were administered to 101 women of Haitian descent while they awaited their medical appointments at a local low-income, community medical clinic. Moderately high levels of sexual risk behavior (i.e., unprotected sex with nonmonogamous partners; multiple lifetime partners) were reported. On average, these women reported a belief in their HIV susceptibility, relatively little HIV-related anxiety, somewhat inadequate levels of communication regarding safer sex practices, and lack of adequate confidence in their ability to negotiate safer behaviors in sexual encounters. Both personal and partner condom attitudes were unfavorable and these attitudes predicted condom use levels. It was concluded that interventions need to be developed for Haitian women to improve their attitudes toward condom use and their confidence in negotiating safer sexual practices. However, these interventions cannot be developed in a vacuum. Although it is crucial to consider the woman's individual attitudes and behaviors, it is also important to consider the male partner's attitudes toward sex and the woman's relationship with her male partner within the context of Haitian culture. Only by determining and targeting important potential motivations for safe sex within the cultural context can we most effectively reduce HIV sex risk behavior in Haitian women.

  18. Maternal HIV serostatus, mother-daughter sexual risk communication and adolescent HIV risk beliefs and intentions.

    Science.gov (United States)

    Cederbaum, Julie A; Hutchinson, M Katherine; Duan, Lei; Jemmott, Loretta S

    2013-09-01

    Daughters of HIV-positive women are often exposed to the same factors that placed their mothers at risk. This cross-sectional study (N = 176 dyads) examined HIV status, parent-teen sexual risk communication (PTSRC), and daughters' abstinence and condom use beliefs and intentions. Maternal HIV status was not associated with PTSRC. Path analyses show that maternal depression was associated with PTSRC behavioral and normative beliefs; relationship satisfaction was associated with PTSRC normative and control beliefs. Control beliefs were solely predictive of maternal PTSRC intention. PTSRC was associated with adolescent behavioral and normative beliefs. Abstinence beliefs were associated with abstinence intentions; condom beliefs were associated with condom use intentions. Relationship satisfaction was associated with adolescent control beliefs about both abstinence and condom use. There is a need for interventions that help HIV-positive mothers recognize their daughter's HIV risk and provide them with relationship building and parent process skills to help reduce these risks.

  19. First impressions of HIV risk: it takes only milliseconds to scan a stranger.

    Directory of Open Access Journals (Sweden)

    Britta Renner

    Full Text Available Research indicates that many people do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for HIV infection. The present studies examined neural correlates for first impressions of HIV risk and determined the association of perceived HIV risk with other trait characteristics. Participants were presented with 120 self-portraits retrieved from a popular online photo-sharing community (www.flickr.com. Factor analysis of various explicit ratings of trait characteristics yielded two orthogonal factors: (1 a 'valence-approach' factor encompassing perceived attractiveness, healthiness, valence, and approach tendencies, and (2 a 'safeness' factor, entailing judgments of HIV risk, trustworthiness, and responsibility. These findings suggest that HIV risk ratings systematically relate to cardinal features of a high-risk HIV stereotype. Furthermore, event-related brain potential recordings revealed neural correlates of first impressions about HIV risk. Target persons perceived as risky elicited a differential brain response in a time window from 220-340 ms and an increased late positive potential in a time window from 350-700 ms compared to those perceived as safe. These data suggest that impressions about HIV risk can be formed in a split second and despite a lack of information about the actual risk profile. Findings of neural correlates of risk impressions and their relationship to key features of the HIV risk stereotype are discussed in the context of the 'risk as feelings' theory.

  20. First impressions of HIV risk: it takes only milliseconds to scan a stranger.

    Science.gov (United States)

    Renner, Britta; Schmälzle, Ralf; Schupp, Harald T

    2012-01-01

    Research indicates that many people do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for HIV infection. The present studies examined neural correlates for first impressions of HIV risk and determined the association of perceived HIV risk with other trait characteristics. Participants were presented with 120 self-portraits retrieved from a popular online photo-sharing community (www.flickr.com). Factor analysis of various explicit ratings of trait characteristics yielded two orthogonal factors: (1) a 'valence-approach' factor encompassing perceived attractiveness, healthiness, valence, and approach tendencies, and (2) a 'safeness' factor, entailing judgments of HIV risk, trustworthiness, and responsibility. These findings suggest that HIV risk ratings systematically relate to cardinal features of a high-risk HIV stereotype. Furthermore, event-related brain potential recordings revealed neural correlates of first impressions about HIV risk. Target persons perceived as risky elicited a differential brain response in a time window from 220-340 ms and an increased late positive potential in a time window from 350-700 ms compared to those perceived as safe. These data suggest that impressions about HIV risk can be formed in a split second and despite a lack of information about the actual risk profile. Findings of neural correlates of risk impressions and their relationship to key features of the HIV risk stereotype are discussed in the context of the 'risk as feelings' theory.

  1. First Impressions of HIV Risk: It Takes Only Milliseconds to Scan a Stranger

    Science.gov (United States)

    Renner, Britta; Schmälzle, Ralf; Schupp, Harald T.

    2012-01-01

    Research indicates that many people do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for HIV infection. The present studies examined neural correlates for first impressions of HIV risk and determined the association of perceived HIV risk with other trait characteristics. Participants were presented with 120 self-portraits retrieved from a popular online photo-sharing community (www.flickr.com). Factor analysis of various explicit ratings of trait characteristics yielded two orthogonal factors: (1) a ‘valence-approach’ factor encompassing perceived attractiveness, healthiness, valence, and approach tendencies, and (2) a ‘safeness’ factor, entailing judgments of HIV risk, trustworthiness, and responsibility. These findings suggest that HIV risk ratings systematically relate to cardinal features of a high-risk HIV stereotype. Furthermore, event-related brain potential recordings revealed neural correlates of first impressions about HIV risk. Target persons perceived as risky elicited a differential brain response in a time window from 220–340 ms and an increased late positive potential in a time window from 350–700 ms compared to those perceived as safe. These data suggest that impressions about HIV risk can be formed in a split second and despite a lack of information about the actual risk profile. Findings of neural correlates of risk impressions and their relationship to key features of the HIV risk stereotype are discussed in the context of the ‘risk as feelings’ theory. PMID:22291959

  2. HIV Risk Perception among HIV Negative or Status-Unknown Men Who Have Sex with Men in China

    Directory of Open Access Journals (Sweden)

    Wensheng Fan

    2014-01-01

    Full Text Available Objective. To evaluate HIV risk perception and its associated factors among Chinese MSM. Methods. A cross-sectional study was conducted among MSM with an HIV negative or unknown status in Beijing, China, between 2011 and 2012. A questionnaire interview was conducted and a blood sample was collected for HIV and syphilis testing. Results. Of 887 MSM who reported they were HIV negative or did not know their HIV status before recruitment, only 7.3% reported a high risk of HIV infection, 28.0% medium risk, 52.2% low risk, and 12.5% no risk. In multivariate logistic regression models using those who reported a medium self-perceived risk as a reference group, self-reported high risk of HIV perception was associated with minority ethnicity (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.03–8.19, self-reported history of sexually transmitted diseases (OR: 2.27; 95% CI: 1.25–4.10, and HIV testing times since the last HIV testing (OR: 0.47; 95% CI: 0.26–0.84; low self-perceived risk of HIV infection was related to full-time employment (OR: 1.58; 95% CI: 1.15–2.18 and illicit drug use (OR: 0.28; 95% CI: 0.10–0.75. Conclusions. The HIV/AIDS epidemic is rapidly rising among Beijing MSM, but more than half MSM did not perceive this risk.

  3. The role of acculturation and family functioning in predicting HIV risk behaviors among Hispanic delinquent youth.

    Science.gov (United States)

    Farrelly, Colleen; Cordova, David; Huang, Shi; Estrada, Yannine; Prado, Guillermo

    2013-06-01

    The present study examined the relationship between Berry's acculturation typology and HIV risk behaviors and whether family functioning mediated any such effects. A total of 235 high risk Hispanic adolescents were categorized into one of Berry's four acculturation typologies through the use of cut-off scores on measures of Hispanicism and Americanism. Structural equation modeling was used to examine the effects of acculturation typology on HIV risk behaviors and the indirect effects of acculturation typology on HIV risk behaviors through family functioning. Acculturation typology was related to HIV risk behaviors. Family functioning partially mediated the effects of acculturation typology on the HIV risk behavior outcomes. These findings suggest that both Americanism and Hispanicism play an important role in the etiology of HIV risk behaviors among Hispanic youth and that both, along with family functioning, are important to consider when designing preventive interventions for this population.

  4. Risk of Diabetes Mellitus in Persons with and without HIV

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Mathiesen, Elisabeth; Kronborg, Gitte;

    2012-01-01

    In a nationwide, population-based cohort study we assessed the risk of diabetes mellitus (DM) in HIV-infected individuals compared with the general population, and evaluated the impact of risk factors for DM in HIV-infected individuals.......In a nationwide, population-based cohort study we assessed the risk of diabetes mellitus (DM) in HIV-infected individuals compared with the general population, and evaluated the impact of risk factors for DM in HIV-infected individuals....

  5. Condom negotiation, HIV testing, and HIV risks among women from alcohol serving venues in Cape Town, South Africa.

    Directory of Open Access Journals (Sweden)

    Eileen V Pitpitan

    Full Text Available BACKGROUND: Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. PURPOSE: To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. METHOD: Women (N = 1333 residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. RESULTS: Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. CONCLUSIONS: For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues.

  6. Impact of National HIV and AIDS Communication Campaigns in South Africa to Reduce HIV Risk Behaviour

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2012-01-01

    Full Text Available In South Africa social and behavioural communication interventions are a critical component of HIV/AIDS prevention, and numerous communication campaigns have been implemented intensively across the country through government initiatives and nongovernmental organisations over the past decade. The aim of this paper is to assess the reach of HIV and AIDS communication campaigns in conjunction with contributions to knowledge, attitudes, and HIV risk behaviours in the general population in South Africa. The sample included in this nationally representative cross-sectional survey was 13234 people aged 15–55 years. Overall, the study found that there was high exposure to 18 different HIV communication programmes (median 6 programmes and 14 programmes more than 30% across different age groups. Most programmes were more often seen or heard by young people aged between 15 and 24 years. In multivariate analysis, greater exposure to HIV mass communication programmes was associated with greater HIV knowledge, condom use at last sex, having tested for HIV in the past 12 months, and less stigmatizing attitude toward PLWHA.

  7. HIV risk and prevention among men who have sex with men (MSM) in peri-urban townships in Cape Town, South Africa.

    Science.gov (United States)

    Jobson, Geoffrey; de Swardt, Glenn; Rebe, Kevin; Struthers, Helen; McIntyre, James

    2013-05-01

    Current guidelines on HIV prevention for MSM emphasise the need for 'combination prevention' based on context-specific understandings of HIV risk. MSM in South Africa are a population with a high risk of HIV infection, however there is little research available on the drivers of this risk. In the context of a focus on combination prevention, this paper argues that effective HIV prevention for MSM in South Africa requires an understanding of the factors at multiple 'distances' from individuals that contribute to HIV risk. Based on qualitative research with MSM in Cape Town, South Africa, we situate HIV risk using a socio-ecological framework and identify factors at distal, proximal, and personal, levels that contribute to MSM's high risk of HIV infection. By understanding the interactions and linkages between risk environments and the risk situations in which HIV is transmitted, HIV prevention programmes will be more effectively able to address the multiple drivers of HIV risk in this population.

  8. Adolescents' perceived risk for STDs and HIV infection.

    Science.gov (United States)

    Ellen, J M; Boyer, C B; Tschann, J M; Shafer, M A

    1996-03-01

    In 1991, 881 urban US high school students participated in a survey designed to determine their perceptions of risk for acquiring sexually transmitted diseases (STDs) and to test whether results of a previously reported clinic-based study on perceptions of risk are generalizable. Of the students, 278 had engaged in sexual intercourse, and 231 of these returned questionnaires with usable answers to each question. The analysis was based on this latter cohort. The mean age of this group was 15.5 years. 53% were male, 34% Black, 27% Hispanic, 14% Asian, 9% White, and 16% other. The perceived relative risks for STDs and HIV (dependent measures) were submitted to separate analysis using the 5-point Likert scales. Independent measures included demographic variables, STD and HIV anxiety, condom use, number of partners, and STD and HIV beliefs. It was found that 24% never used a condom and 43% always used condoms. The subjects showed no optimistic bias in their perceptions of the relative risk of STDs or HIV (they believed their risks to be the same as those of other people their age). The only variance found was that the White subjects believed themselves at less relative risk than the other subjects. These findings contrast those of the clinic-based study and suggest that perceptions of risk may vary among different cohorts. Higher levels of anxiety were also found to be associated with higher levels of perceived risk whereas other factors were not. A possible limitation of this study was that the group to which the study population was asked to compare itself was not clearly defined. However, this study indicates that sexually active adolescents are well aware of their STD and HIV risks and that their decision to engage in risky behavior may be due to factors other than a heightened sense of invulnerability (such as perception of social norms or alcohol use).

  9. A Small Dose of HIV? HIV Vaccine Mental Models and Risk Communication

    Science.gov (United States)

    Newman, Peter A.; Seiden, Danielle S.; Roberts, Kathleen J.; Kakinami, Lisa; Duan, Naihua

    2009-01-01

    Existing knowledge and beliefs related to HIV vaccines provide an important basis for the development of risk communication messages to support future HIV vaccine dissemination. This study explored HIV vaccine mental models among adults from segments of the population disproportionately affected by HIV/AIDS. Nine focus groups were conducted with…

  10. Implicit and Explicit Processes in Risk Perception: Neural Antecedents of Perceived HIV Risk

    Science.gov (United States)

    Schmälzle, Ralf; Schupp, Harald T.; Barth, Alexander; Renner, Britta

    2011-01-01

    Field studies on HIV risk suggest that people may rely on impressions they have about the safety of their partner at the dispense of more objective risk protection strategies. In this study, ERP recordings were used to investigate the brain mechanisms that give rise to such impressions. First, in an implicit condition, participants viewed a series of photographs of unacquainted persons while performing a task that did not mention HIV risk. Second, in an explicit condition, participants estimated the HIV risk for each presented person. Dense sensor EEG was recorded during the implicit and explicit conditions. In the analysis, explicit risk ratings were used to categorize ERP data from the implicit and explicit conditions into low and high HIV risk categories. The results reveal implicit ERP differences on the basis of subsequent ratings of HIV risk. Specifically, the processing of risky individuals was associated with an early occipital negativity (240–300 ms) and a subsequent central positivity between 430 and 530 ms compared to safe. A similar ERP modulation emerged in the explicit condition for the central positivity component between 430 and 530 ms. A subsequent late positive potential component between 550 and 800 ms was specifically enhanced for risky persons in the explicit rating condition while not modulated in the implicit condition. Furthermore, ratings of HIV risk correlated substantially with ratings of trustworthiness and responsibility. Taken together, these observations provide evidence for theories of intuitive risk perception, which, in the case of HIV risk, seem to operate via appearance-based stereotypic inferences. PMID:21633492

  11. Survey on HIV risk perception and sexual behaviours among seafarers.

    Science.gov (United States)

    Grappasonni, I; Paci, P; Mazzucchi, F; Amenta, F

    2011-01-01

    Because the nature of their work seafarers spend long periods of time away from their families and therefore represent a group at risk for sexually transmitted diseases, including HIV infection. This paper reports the results of a survey to evaluate awareness and knowledge of the risk of HIV infection among seafarers. Risky behaviours for HIV transmission were also assessed. The survey was conducted using anonymous questionnaires on 197 workers of 9 vessels and 26 office employees of an Italian shipping company (FINAVAL S.p.A., Rome). The respondents considered HIV/AIDS as one of the diseases with a high risk of transmission. Most respondents had a good general knowledge of HIV/AIDS and on the ways of its transmission. However, there is still lack of knowledge on the basics of this disease. On the other hand, in spite of knowledge and awareness about the risks of the disease, only 56.35% of the interviewed crewmembers used protection in sexual intercourse with occasional partners. Compared to data available in literature, the percentage of self-protecting people is increasing, but the number of seafarers exposing themselves to risky behaviours is still high. As expected, condoms are used with regular partners with lower frequency compared to occasional intercourse. The results of this survey indicate that adequate prevention campaigns and major attention paid to seafarers health is useful for stimulating responsible conduct for the prevention of infectious diseases, including HIV infection. Nevertheless, it is still necessary to increase information about the risk of sexually transmitted diseases and how to reduce it.

  12. HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV

    Directory of Open Access Journals (Sweden)

    Marija Pantelic

    2017-01-01

    Conclusions: These findings highlight the complicated nature of internalized HIV stigma. Whilst it is seemingly a psychological process, indirect pathways suggest multi-level mechanisms leading to internalized HIV stigma. Findings suggest that protection from violence within homes, communities and schools may interrupt risk pathways from HIV-related health problems to psychological distress and internalized HIV stigma. This highlights the potential for interventions that do not explicitly target adolescents living with HIV but are sensitive to their needs.

  13. Sexual risk behaviors for HIV/AIDS in Chuuk State, Micronesia: the case for HIV prevention in vulnerable remote populations.

    Directory of Open Access Journals (Sweden)

    Toya V Russell

    Full Text Available BACKGROUND: After the first two cases of locally-acquired HIV infection were recognized in Chuuk State, Federated States of Micronesia (FSM, a public health response was initiated. The purpose of the response was to assess the need for HIV education and prevention services, to develop recommendations for controlling further spread of HIV in Chuuk, and to initiate some of the prevention measures. METHODOLOGY/PRINCIPAL FINDINGS: A public health team conducted a survey and rapid HIV testing among a sample of residents on the outer islands in Chuuk. Local public health officials conducted contact tracing and testing of sex partners of the two locally-acquired cases of HIV infection. A total of 333 persons completed the survey. The majority knew that HIV is transmitted through unprotected sexual contact (81%, injection drug use (61%, or blood transfusion (64%. Sexual activity in the past 12 months was reported among 159 participants, including 90 females and 69 males. Compared to women, men were more likely to have had multiple sex partners, to have been drunk during sex, but less likely to have used a condom in the past 12 months. The two men with locally acquired HIV infection had unprotected anal sex with a third Chuukese man who likely contracted HIV while outside of Chuuk. All 370 persons who received voluntary, confidential HIV counseling and testing had HIV negative test results. CONCLUSIONS/SIGNIFICANCE: Despite the low HIV seroprevalence, risky sexual behaviors in this small isolated population raise concerns about the potential for rapid spread of HIV. The lack of knowledge about risks, along with stigmatizing attitudes towards persons infected with HIV and high risk sexual behaviors indicate the need for resources to be directed toward HIV prevention in Chuuk and on other Pacific Islands.

  14. 采用集合RNA检测方法估计高危人群的HIV感染发病率%Estimation on the HIV-1 incidence among high risk groups using the pooling RNA technique

    Institute of Scientific and Technical Information of China (English)

    董莉娟; 陈敏; 苏莹珍; 李俊杰; 章任重; 杨莉; 杨朝军; 施玉华; 陈会超

    2013-01-01

    -period.Measures should be taken to strengthen the HIV diagnostic programs among MSM and other high risk groups,during the HIV antibody window-period.More frequent detection approach as pooling HIV-1 RNA testing might be a good choice.

  15. Cognition Research on HIV/AIDS Prevention among the High Risk Females%女性高危人群预防HIV/AIDS知识的认知调查

    Institute of Scientific and Technical Information of China (English)

    张实

    2009-01-01

    目的 通过对女性高危人群预防HIV/AIDS知识的认知调查,以保护妇女健康,防止HIV和性传播疾病在社会上的流行和蔓延.方法 以云南省某女子劳教所劳教人员为对象,运用社会学的个案研究、问卷调查,以及开展预防HIV/AIDS知识的培训.结果 女性高危人群大多数受教育程度低,初中文化程度以下的人群占89.66%,无职业者占82.7%,她们对艾滋病的病因、症状和预防方法等问题不是很清楚,只有25%的人对HIV的传播途径有所认识.结论 通过对女性高危人群进行预防:HIV/AIDS感染健康教育的培训后,女性高危人群对艾滋病的病因、传播途径、初期症状、HIV所需的检测时间,以及感染艾滋病高危行为等知识的认知度明显提高,93.10%的人表示赞成预防HIV首先从自己做起.

  16. High HIV Prevalence and Associated Risk Factors Among Female Sexual Partners of Male Injection Drug Users (MWID) in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Nadol, Patrick; Tran, Hoang; Hammett, Theodore; Phan, Son; Nguyen, Duong; Kaldor, John; Law, Matthew

    2016-02-01

    Injection drug use is a major factor in acquiring and transmitting HIV in Vietnam. This analysis aims to present estimates of HIV infection and factors associated with HIV infection among female sex partners (FSP) of MWID in Ho Chi Minh City (HCMC), Vietnam. Cross-sectional surveys were conducted in 2011 and 2013 among males who inject drugs (MWID) who then referred their FSP for a behavioral and biologic survey. In total, 445 MWID and FSPs were enrolled. HIV prevalence among MWID was 50 and 35 % among FSPs. Among FSPs, 60.3 % reported ever using illegal drugs and among those, 72.7 % reported ever injecting illicit drugs. Among FSP, injection drug for >1 year [adjusted Odds Ratio (aOR), 95 % CI 2.94, 1.19-7.26), p value = <0.001] and having a male partner infected with HIV [(aOR 3.35: 1.97-5.69), p value = <0.001] were associated with HIV infection. The prevalence of HIV infection is high among FSP of MWID in HCMC and is highly associated with the injection drug use behavior of the FSP. Harm-reduction intervention programs that focus on the MWID-FSP couple or directly on the FSPs are required.

  17. The epidemiology of HPV and HIV among high-risk women and steady couples in Kigali, Rwanda

    NARCIS (Netherlands)

    Veldhuijzen, N.J.

    2011-01-01

    Nienke Veldhuijzen beschrijft de epidemiologie van het humaan papillomavirus (HPV) en het hiv-virus bij twee verschillende bevolkingsgroepen in Kigali, Rwanda. Hoog-risico(HR)-HPV kan baarmoederhalskanker veroorzaken. Laag-risico(LR)-HPV wordt in verband gebracht met onder andere genitale wratten. H

  18. Estimating the impact of plasma HIV-1 RNA reductions on heterosexual HIV-1 transmission risk.

    Directory of Open Access Journals (Sweden)

    Jairam R Lingappa

    Full Text Available BACKGROUND: The risk of sexual transmission of HIV-1 is strongly associated with the level of HIV-1 RNA in plasma making reduction in HIV-1 plasma levels an important target for HIV-1 prevention interventions. A quantitative understanding of the relationship of plasma HIV-1 RNA and HIV-1 transmission risk could help predict the impact of candidate HIV-1 prevention interventions that operate by reducing plasma HIV-1 levels, such as antiretroviral therapy (ART, therapeutic vaccines, and other non-ART interventions. METHODOLOGY/PRINCIPAL FINDINGS: We use prospective data collected from 2004 to 2008 in East and Southern African HIV-1 serodiscordant couples to model the relationship of plasma HIV-1 RNA levels and heterosexual transmission risk with confirmation of HIV-1 transmission events by HIV-1 sequencing. The model is based on follow-up of 3381 HIV-1 serodiscordant couples over 5017 person-years encompassing 108 genetically-linked HIV-1 transmission events. HIV-1 transmission risk was 2.27 per 100 person-years with a log-linear relationship to log(10 plasma HIV-1 RNA. The model predicts that a decrease in average plasma HIV-1 RNA of 0.74 log(10 copies/mL (95% CI 0.60 to 0.97 reduces heterosexual transmission risk by 50%, regardless of the average starting plasma HIV-1 level in the population and independent of other HIV-1-related population characteristics. In a simulated population with a similar plasma HIV-1 RNA distribution the model estimates that 90% of overall HIV-1 infections averted by a 0.74 copies/mL reduction in plasma HIV-1 RNA could be achieved by targeting this reduction to the 58% of the cohort with plasma HIV-1 levels ≥4 log(10 copies/mL. CONCLUSIONS/SIGNIFICANCE: This log-linear model of plasma HIV-1 levels and risk of sexual HIV-1 transmission may help estimate the impact on HIV-1 transmission and infections averted from candidate interventions that reduce plasma HIV-1 RNA levels.

  19. Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children

    Science.gov (United States)

    Ebonyi, Augustine O.; Oguche, Stephen; Ejeliogu, Emeka U.; Agbaji, Oche O.; Shehu, Nathan Y.; Abah, Isaac O.; Sagay, Atiene S.; Ugoagwu, Placid O.; Okonkwo, Prosper I.; Idoko, John A.; Kanki, Phyllis J.

    2016-01-01

    Introduction Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria. Methods We performed a retrospective analysis of 876 children, aged 2 months – 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection. Results The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007). Conclusion In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes. PMID:27019829

  20. Forced sexual initiation, sexual intimate partner violence and HIV risk in women: a global review of the literature.

    Science.gov (United States)

    Stockman, Jamila K; Lucea, Marguerite B; Campbell, Jacquelyn C

    2013-03-01

    Coerced or forced sexual initiation and sexual intimate partner violence (sexual IPV) contribute significantly to a woman's risk for HIV infection. This review systematically examines global research (n = 21 studies) published since 2000 on the role of coerced/forced sexual initiation and sexual IPV on HIV risk in women. In predominantly low- and middle-income countries, coerced/forced sexual initiation was associated with HIV/STIs, multiple and high-risk sex partners, and no condom use. Most studies using behaviorally specific terms for sexual IPV found strong associations between sexual IPV and HIV risk behaviors. In contrast, studies using less specific definitions often failed to find these significant associations. To develop more comprehensive HIV prevention programs, future efforts should integrate behaviorally specific terms into assessing prevalence of sexual IPV and its association with HIV risk, consider cultural differences, and identify causal pathways between coerced or forced sexual initiation, HIV risk behaviors and HIV/STI infection.

  1. HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth with Psychiatric Disorders: A Longitudinal Study

    Science.gov (United States)

    Elkington, Katherine; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.

    2008-01-01

    The effect of psychiatric disorders on human immunodeficiency virus/sexually transmitted infection (HIV/STI) risk behaviors in juvenile justice youths is examined. Prevalence, persistence and prediction are addressed among four mutually exclusive diagnostic groups and results show a high prevalence rate of many HIV/STI sexual risk behaviors that…

  2. HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth with Psychiatric Disorders: A Longitudinal Study

    Science.gov (United States)

    Elkington, Katherine; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.

    2008-01-01

    The effect of psychiatric disorders on human immunodeficiency virus/sexually transmitted infection (HIV/STI) risk behaviors in juvenile justice youths is examined. Prevalence, persistence and prediction are addressed among four mutually exclusive diagnostic groups and results show a high prevalence rate of many HIV/STI sexual risk behaviors that…

  3. Addressing intravaginal practices in women with HIV and at-risk for HIV infection, a mixed methods pilot study

    Science.gov (United States)

    Alcaide, Maria L; Rodriguez, Violeta J; Fischl, Margaret A; Jones, Deborah L; Weiss, Stephen M

    2017-01-01

    Intravaginal practices (IVPs), include intravaginal cleansing (cleansing the inside of the vagina) or intravaginal insertion of products for hygiene, health or sexuality reasons. IVPs are associated with adverse female health outcomes, development of bacterial vaginosis, HIV acquisition and transmission. A mixed methods approach was used in this study to examine the prevalence of IVP, assess reasons for engagement, and perceptions of IVP among a sample of minority (African-American and Hispanic) women infected, or at-risk, for HIV in Miami, USA, a city with increasing numbers of sexually transmitted infections (STIs) and HIV. Three focus groups (total n=20) and quantitative assessments (n=72) were conducted with women infected or uninfected with HIV. In the qualitative assessments, most women reported engaging in both intravaginal cleansing and intravaginal insertion, and stated the main motivation for IVP was hygiene. The quantitative assessments confirmed that cleansing with water alone, soap with water or using commercial douches was common, as well as intravaginal insertion using a cloth or a rag in both HIV-infected and uninfected women. Women with HIV infection reported less use of water and water and soap for IVPs, and reported learning about the potential harm of IVP from their HIV health care providers. Despite their health risks, IVP appeared common in both HIV-infected and at-risk minority women, and interventions to decrease IVP could have important health implications among populations with high rates of IVP, STIs and HIV. PMID:28280394

  4. Behavioral Risk Reduction in a Declining HIV Epidemic: Injection Drug Users in New York City, 1990-1997.

    Science.gov (United States)

    Des Jarlais, Don C.; Perlis, Theresa; Friedman, Samuel R.; Chapman, Timothy; Kwok, John; Rockwell, Russell; Paone, Denise; Milliken, Judith; Monterroso, Edgar

    2000-01-01

    Assessed trends in HIV risk behaviors among New York City injection drug users from 1990-97. Interviews at a drug detoxification program and a research storefront in a high drug-use area showed continuing risk reduction among users that indicated a declining phase in the large HIV epidemic in New York City. HIV prevention programs appeared to be…

  5. Sexual risk behavior among HIV-positive persons in Jamaica.

    African Journals Online (AJOL)

    program based on the social cognitive theory.19 The pro- gram assists people living ... among HIV-positive people in order to develop risk re- duction interventions; ... defined as adults. 19 years and older who attended HIV treatment sites and.

  6. Information Behavior and HIV Testing Intentions Among Young Men at Risk for HIV/AIDS.

    Science.gov (United States)

    Meadowbrooke, Chrysta C; Veinot, Tiffany C; Loveluck, Jimena; Hickok, Andrew; Bauermeister, José A

    2014-03-01

    Health research shows that knowing about health risks may not translate into behavior change. However, such research typically operationalizes health information acquisition with knowledge tests. Information scientists who investigate socially embedded information behaviors could help improve understanding of potential associations between information behavior-as opposed to knowledge-and health behavior formation, thus providing new opportunities to investigate the effects of health information. We examine the associations between information behavior and HIV testing intentions among young men who have sex with men (YMSM), a group with high rates of unrecognized HIV infection. We used the theory of planned behavior (TPB) to predict intentions to seek HIV testing in an online sample of 163 YMSM. Multiple regression and recursive path analysis were used to test two models: (a) the basic TPB model and (b) an adapted model that added the direct effects of three information behaviors (information exposure, use of information to make HIV-testing decisions, prior experience obtaining an HIV test) plus self-rated HIV knowledge. As hypothesized, our adapted model improved predictions, explaining more than twice as much variance as the original TPB model. The results suggest that information behaviors may be more important predictors of health behavior intentions than previously acknowledged.

  7. HIV infection does not contribute to increased cardiovascular risk as assessed by Framingham risk score

    Directory of Open Access Journals (Sweden)

    I Ramsay

    2012-11-01

    Full Text Available HIV-1-infected patients are thought to be at higher risk of cardiovascular events. Measures of arterial stiffness are independently associated with cardiovascular risk [1]. The aim of our study was to determine if higher Framingham risk is associated with higher carotid femoral pulse wave velocity (cfPWV in HIV-infected volunteers (HIV cohort and to establish whether there is a difference in cfPWV between the HIV cohort and age- and gender-matched controls. We recruited 47 males (HIV cohort on antiretroviral treatment, from a UK HIV clinic between October 2010 and March 2012 (31 low Framingham risk <10% and 16 high risk >20%. This group was matched with 46 healthy subjects from a contemporaneous study performed by our group. The inclusion criteria were: age 35–75 years with Framingham risk >20% or <10%, on antiretroviral treatment with undetectable viral load, no previous coronary heart disease, stroke or insulin therapy. Subjects underwent cfPWV measurement using Complior® (Artech, France. Student's t-test was used to evaluate differences between high- and low-risk groups and also between cases and controls. The mean age of the HIV cohort was 49.43±9.35 years (mean±SD and in the control group 52.20±8.80 years (p=0.15. Mean duration of HIV infection was 13.83±7.25 years, mean CD4 count was 728.81±312.62×106/L and all viral loads were undetectable. In the HIV cohort, cfPWV was 8.39±1.09 m/s in the low-risk group and 10.43±2.93 m/s in the high-risk group (p=0.02. Multivariate analysis with cfPWV as dependent variable, and age, systolic blood pressure, cholesterol, smoking history, duration of HIV infection and antiretroviral therapy, zenith viral loads and nadir CD4 counts as independent variables was performed in the high- and low-risk groups. This showed age alone to be a significant predictive factor (p=0.002. With Framingham risk as dependent variable and using the above factors as independent variables, no HIV-related factors were

  8. Risk management information for HIV infection.

    Science.gov (United States)

    Edwards, A J

    1990-01-01

    This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE.

  9. Truck Drivers And Risk Of STDs Including HIV

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    Bansal R.K

    1995-01-01

    Full Text Available Research Question: Whether long distance truck drivers are at a higher risk of contracting and transmitting STDs including HIV? Objectives: i To study the degree of knowledge of HIV and AIDS among long- distance truck drivers. ii Assess their sexual behaviour including condom use. iii Explore their prevailing social influences and substance abuse patterns. iv Explore their treatment seeking bahaviour as regards STDs. v Deduce their risk of contracting and transmitting STDs including HIV. Study Design: Cross- sectional interview. Setting: Transport Nagar, Indore (M.P Participants: 210 senior drivers (First drivers and 210 junior drivers (Second drivers. Study Variables: Extra-Marital sexual intercourse, condom usage, past and present history of STDs, treatment and counseling, substance abuse, social â€" cultural milieu. Outcome Variables: Risk of contraction of STDs. Statistical Analysis: Univariate analysis. Results: 94% of the drivers were totally ignorant about AIDS. 82.9% and 43.8 % of the senior and junior drivers had a history of extra- marital sex and of these only 2 regularly used condoms. 13.8% and 3.3 % of the senior and junior drivers had a past or present history suggestive of STD infection. Alcohol and Opium were regularly used by them. Conclusion: The studied drivers are at a high risk of contracting and transmitting STDs including HIV.

  10. Epidemiology, risk factors and genotypes of HBV in HIV-infected patients in the northeast region of Colombia: high prevalence of occult hepatitis B and F3 subgenotype dominance.

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    Henry Bautista-Amorocho

    Full Text Available Chronic hepatitis B virus (HBV infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission.Our aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI among patients infected with HIV in a northeastern Colombian city.A cross-sectional study was conducted with 275 HIV-positive patients attending an outpatient clinic in Bucaramanga, Colombia during 2009-2010. Blood samples were collected and screened for serological markers of HBV (anti-HBs, anti-HBc and HBsAg through ELISA assay. Regardless of their serological profile, all samples were tested for the HBV S gene by nested-PCR and HBV genotypes were determined by phylogenetic inference. Clinical records were used to examine demographic, clinical, virological, immunological and antiretroviral therapy (ART variables of HIV infection.Participants were on average 37±11 years old and 65.1% male. The prevalence of HIV-HBV coinfection was 12% (95%CI 8.4-16.4 of which 3.3% had active HBV infection and 8.7% OBI. The prevalence of HIV-HBV coinfection was associated with AIDS stage and ART treatment. Sequence analysis identified genotype F, subgenotype F3 in 93.8% of patients and genotype A in 6.2% of patients. A C149R mutation, which may have resulted from failure in HBsAg detection, was found in one patient with OBI.The present study found a high prevalence of HIV-HBV coinfection with an incidence of OBI 2.6-fold higher compared to active HBV infection. These findings suggest including HBV DNA testing to detect OBI in addition to screening for HBV serological markers in HIV patients.

  11. Multicentre analysis of second-line antiretroviral treatment in HIV-infected children: adolescents at high risk of failure

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    Ragna S. Boerma

    2017-01-01

    Conclusions: In LMIC, paediatric PI-based second-line ART was associated with relatively low virologic failure rates. However, adolescents showed exceptionally poor virologic outcomes in LMIC, and optimizing their HIV care requires urgent attention. In addition, 16% of children and adolescents failed PI-based treatment and will require integrase inhibitors to construct salvage regimens. These drugs are currently not available in LMIC.

  12. SCORE underestimates cardiovascular risk (CVR of HIV+ patients

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    R Ramírez

    2012-11-01

    Full Text Available The new European Guidelines of Dislipidemia Management of the European Societies of Cardiology and Arteriosclerosis consider HIV+ as patients at high risk of developing cardiovascular events and deaths. The objective of the study was to evaluate cardiovascular events and deaths in a series of HIV+ patients. Observational, cross-sectional study, including a cohort of HIV+ and HIV− patients from 2008. CVR was calculated using the SCORE-CVR chart. Variation on lipid profile and incidence of cardiovascular events, cardiovascular death or death related to any cause were recorded. Data was analyzed using SPSS version 20.0 for MAC. 154 HIV+ and 155 HIV− patients were included. Mean age: 44.8±9.5 vs 55.2±14.3 y and 69.5% vs 49% males respectively (p<0.01. Mean time since HIV+ diagnosis was 11±6.2 y. Mean BMI and systolic blood pressure were lower in HIV+ (25.1±6.7 kg/m2 vs 28.7±5.1 kg/m2, (p<0.01 and 119.6±19.4 vs 124.7±14.7 mmHg, (p=0.044; respectively. A lower proportion of hypertense, diabetic and obese patients was observed in HIV+ (25.5% vs 6.5%; 20.6% vs 3.9% and 36.8% vs 12.3% but a larger proportion of smokers (68.8% vs 29.7% was observed (p<0.01 in all cases. Mean cholesterol and LDLc were lower in HIV+ (191.2±41.4 vs 218.5±44.6 mg/dl and 109.5±33.9 vs 134.6±37.7 mg/dl; p<0.01; respectively but with a lower mean HDLc and higher TG (50.3±19 mg/dl vs 55.2±14.9 mg/dl; p=0.013 and 156.7±85.7 vs 135.8±66.2 mg/dl; p=0.017; respectively. There was no significant difference in mean CVR-SCORE (3.5±3.6% vs 4.4±3.8%; p=0.091. With this SCORE, 5.2±5.3 and 6.7±5.8 cardiovascular events or deaths should be expected in HIV+ and HIV− respectively at 10 y. Four years later cholesterol, LDLc, HDLc, TG in HIV+ and HIV− patients did not vary compared with those obtained 4 y before. 5 events and 1 death were seen at 4 y follow-up in HIV+, and in HIV− patients. The incidence of events in HIV+ patients is similar to the expected according

  13. Educational attainment but not literacy is associated with HIV risk behavior among incarcerated women.

    Science.gov (United States)

    Paasche-Orlow, Michael K; Clarke, Jennifer G; Hebert, Megan R; Ray, Moira K; Stein, Michael D

    2005-11-01

    To identify the educational factors associated with HIV risk behaviors among incarcerated women. We evaluated a cohort of female detainees at The Rhode Island Adult Correctional Institute between July and September 2004. Among the 423 women who participated in the study, 55% did not have a high school diploma, 29% had disability, 37% had problem drinking, and 61% (257/423) reported HIV risk behavior. In multiple logistic regression, participants who had completed high school had the lowest likelihood of HIV risk behavior (adjusted odds ratio [OR] 0.35, 95% confidence interval [CI] 0.12-1.00). There was no association between participants? literacy level and HIV risk behavior (adjusted OR 2.02, 95% CI 0.83-4.92). Correctional education programs to reduce HIV risk behavior should focus on those with low educational attainment irrespective of literacy skills.

  14. HIV Risk Sexual Behaviors Among Teachers in Uganda

    Science.gov (United States)

    Atuyambe, Lynn; Bazeyo, William; Tanga, Erasmus Otolok

    2014-01-01

    Recent studies reveal that teachers are more likely to engage in high-risk sexual behavior compared to the rest of the adult population. Yet the education sector could be a major vehicle for imparting knowledge and skills of avoiding and/or coping with the pandemic. This study set out to establish HIV risk behaviors among teachers in Uganda, to inform the design of a behavior change communication strategy for HIV prevention among teachers. It was a cross sectional rapid assessment conducted among primary and secondary school teachers in Kampala and Kalangala districts, in Uganda. A total of 183 teachers were interviewed. HIV risk behavior, in this study was measured as having multiple sexual partners and/or sex with a partner of unknown status without using a condom. We also considered transactional/sex for favors and alcohol use as exposures to HIV risk behavior. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were calculated. All data analysis was performed using SPSS version 17.0 and EPI Info Version 3.5.1. Forty five per cent of teachers reported having multiple concurrent sexual partners in the last three months, of these, only 24% acknowledged having used a condom at their last sexual encounter yet only 9.8% knew their partners’ HIV status. Teachers below 30years of age were more likely to have two or more concurrent sexual partners (OR 2.6, CI 1.31-5.34) compared to those above 30 years. Primary school teachers were less likely to involve with partners of unknown HIV status compared to secondary school teachers (OR 0.43, CI 0.19-0.97). Teachers aged below 30 years were also more likely to engage with partners of unknown HIV status compared to those above 30 years (OR 2.47, CI 1.10-5.59). Primary teachers were also less likely to have given or received gifts, money or other favors in exchange for sex (OR 0.24, CI 0.09-0.58). Teachers engage in risky sexual behaviors, which lead to HIV infection. There is need to promote individual

  15. HIV risk sexual behaviors among teachers in Uganda

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    Lillian Ayebale

    2014-03-01

    Full Text Available Recent studies reveal that teachers are more likely to engage in high-risk sexual behavior compared to the rest of the adult population. Yet the education sector could be a major vehicle for imparting knowledge and skills of avoiding and/or coping with the pandemic. This study set out to establish HIV risk behaviors among teachers in Uganda, to inform the design of a behavior change communication strategy for HIV prevention among teachers. It was a cross sectional rapid assessment conducted among primary and secondary school teachers in Kampala and Kalangala districts, in Uganda. A total of 183 teachers were interviewed. HIV risk behavior, in this study was measured as having multiple sexual partners and/or sex with a partner of unknown status without using a condom. We also considered transactional/sex for favors and alcohol use as exposures to HIV risk behavior. Odds ratios (OR and their corresponding 95% confidence intervals (CI were calculated. All data analysis was performed using SPSS version 17.0 and EPI Info Version 3.5.1. Forty five per cent of teachers reported having multiple concurrent sexual partners in the last three months, of these, only 24% acknowledged having used a condom at their last sexual encounter yet only 9.8% knew their partners’ HIV status. Teachers below 30years of age were more likely to have two or more concurrent sexual partners (OR 2.6, CI 1.31-5.34 compared to those above 30 years. Primary school teachers were less likely to involve with partners of unknown HIV status compared to secondary school teachers (OR 0.43, CI 0.19-0.97. Teachers aged below 30 years were also more likely to engage with partners of unknown HIV status compared to those above 30 years (OR 2.47, CI 1.10-5.59. Primary teachers were also less likely to have given or received gifts, money or other favors in exchange for sex (OR 0.24, CI 0.09-0.58. Teachers engage in risky sexual behaviors, which lead to HIV infection. There is need to promote

  16. Correlates of HIV Risk Reduction Self-Efficacy among Youth in South Africa

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    Julia Louw

    2012-01-01

    Full Text Available Even though a decline in HIV prevalence has been reported among South African youth 15–24 from 10.3% in 2005 to 8.6% in 2008, the prevalence remains disproportionately high for females overall in comparison to males. This study examines factors associated by HIV risk reduction self-efficacy of South African youth as part of an evaluation of the impact of loveLife, a youth focused HIV prevention programme. A cross-sectional population-based household survey was conducted with persons of ages 18 to 24 years in four selected provinces in South Africa. Among female respondents (, factors associated with high self-efficacy in the adjusted model were having a low HIV risk perception, HIV/AIDS stigma, ever using drugs, and having life goals. Male respondents ( with high self-efficacy were more likely to have been tested for HIV, have concurrent sexual partners, have had a transactional sex partner in lifetime, a low HIV risk perception, difficulty in having condoms, agreed with coercive sex, high relationship control, and had loveLife face-to-face programme participation. The factors identified with high self-efficacy and HIV-sexual risk behaviour may be considered to strengthen youth HIV prevention programmes in South Africa.

  17. Contraceptive methods and risk of HIV acquisition or female-to-male transmission.

    Science.gov (United States)

    Haddad, Lisa B; Polis, Chelsea B; Sheth, Anandi N; Brown, Jennifer; Kourtis, Athena P; King, Caroline; Chakraborty, Rana; Ofotokun, Igho

    2014-12-01

    Effective family planning with modern contraception is an important intervention to prevent unintended pregnancies which also provides personal, familial, and societal benefits. Contraception is also the most cost-effective strategy to reduce the burden of mother-to-child HIV transmission for women living with HIV who wish to prevent pregnancy. There are concerns, however, that certain contraceptive methods, in particular the injectable contraceptive depot medroxyprogesterone acetate (DMPA), may increase a woman's risk of acquiring HIV or transmitting it to uninfected males. These concerns, if confirmed, could potentially have large public health implications. This paper briefly reviews the literature on use of contraception among women living with HIV or at high risk of HIV infection. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations place no restrictions on the use of hormonal contraceptive methods by women with or at high risk of HIV infection, although a clarification recommends that, given uncertainty in the current literature, women at high risk of HIV who choose progestogen-only injectable contraceptives should be informed that it may or may not increase their risk of HIV acquisition and should also be informed about and have access to HIV preventive measures, including male or female condoms.

  18. The influence of religion on sexual HIV risk.

    Science.gov (United States)

    Shaw, Stacey A; El-Bassel, Nabila

    2014-08-01

    This systematic review examines the relationship between religion and sexual HIV risk behavior. It focuses primarily on how studies have conceptualized and defined religion, methodologies, and sexual risk outcomes. We also describe regions where studies were conducted and mechanisms by which religion may be associated with sexual risk. We included 137 studies in this review, classifying them as measuring: (1) only religious affiliation (n = 57), (2) only religiosity (n = 48), and (3) both religious affiliation and religiosity (n = 32). A number of studies identified lower levels of sexual HIV risk among Muslims, although many of these examined HIV prevalence rather than specific behavioral risk outcomes. Most studies identified increased religiosity to be associated with lower levels of sexual HIV risk. This finding persists but is weaker when the outcome considered is condom use. The paper reviews ways in which religion may contribute to increase and reduction in sexual HIV risk, gaps in research, and implications for future research on religion and HIV.

  19. Effects of HIV status notification on reducing the risk of sexual transmission of HIV in China

    Institute of Scientific and Technical Information of China (English)

    Bao Yugang; Jing Jun; Zhang Yanhui; Li Huasheng; Feng Liangui; Ning Zhen; Tan Hongzhuan

    2014-01-01

    Background The risk of HIV sexual transmission is much higher among people unaware of their HIV status than among those aware.Only a few studies have indicated that the incidence of unsafe sex can be reduced when people know their HIV status.This study was to investigate this effect in China.Methods A cohort study consisting of two surveys was conducted at two different times among a group of people living with HIV/AIDS,whose status was newly diagnosed with HIV via sexual contact,in Shanghai,Chongqing,and Kunming.The first survey was conducted among 823 people tested positive for HIV before notifying them of the HIV status.The second survey was conducted among 650 HIV-positive people at six months following the first survey (after notification of HIV status).The scope of survey covered unsafe sex practices,number of unsafe sexual partners,and frequency of unsafe sexual behaviors over the prior six months.Unsafe sex is defined as unprotected anal or vaginal sex with partners who are HIV positive or whose HIV status is unknown.Results The proportion of unsafe sex was reduced by about 85% after HIV status notification.The risk of HIV sexual transmission was 15 times higher among persons unaware of their HIV status than among those aware.Approximately 95% of new sexually transmitted HIV infections stemmed from 56% of the infected persons unaware of their HIV status in China.Conclusion Timely HIV status notification has the potential to significantly reduce unsafe sex among HIV-infected persons and reduce the risk for HIV transmission via unsafe sex.

  20. Relationship Characteristics and HIV Transmission Risk in Same-sex Male Couples in HIV Serodiscordant Relationships

    Science.gov (United States)

    Starks, Tyrel J.; Gamarel, Kristi E.; Johnson, Mallory O.

    2014-01-01

    Unprotected anal intercourse (UAI) remains a main risk factor for HIV among men who have sex with men (MSM) and this is of particular concern for partners of HIV serodiscordant status. However, HIV transmission risk has been demonstrated to vary by the sexual position adopted among partners. Guided by interdependence theory, this study examined how relational factors were differentially associated with risk taking (HIV-positive/insertive and HIV-negative/receptive) and strategic positioning (HIV-positive/receptive and HIV-negative/insertive) UAI withinserodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (ncouples=91; nindividuals=182) simultaneously but independently completed computerized questionnaires and HIV-positive men had blood drawn for viral load.A minority of couples (30%) engaged in risk taking and/or strategicpositioning unprotected anal sex. Results of multinomial logistic regressionindicated that HIV-negative partners’ levels of relationship commitment were positively associated with the odds of engaging in both risk taking and strategic positioning sexual behaviors. For HIV-negative partners, reports of relationship intimacy, autonomy, and sexual satisfaction were negatively associated with odds of reporting risk taking behavior. In contrast, HIV-positive partners’reported sexual satisfaction was positively associated with odds of engaging in risk taking behavior. Findings suggested that aspects of relational quality may be differentially associated with sexual decision making for same-sex male couples in serodiscordant relationships. Study findings lend support for the incorporation ofdiscussions of HIV risk reduction strategies, enhancing communication between partners, and support for general relationship functioning in HIV care. PMID:24243004

  1. Survey of MSM HIV high-risk behavior and evaluation of comprehensive intervention%男男性行为人群 HIV 高危行为调查及综合干预评价

    Institute of Scientific and Technical Information of China (English)

    李细苟; 林培森; 唐军

    2015-01-01

    Objective To observe the effect of comprehensive intervention on related awareness rate of knowledge and high-risk behavior of MSM AIDS.Methods Use the self-designed questionnaire and conduct a survey of 94 cases of MSM who seek counseling and testing services in 2014 from Zhongshan affluent rural communities HIV voluntary counseling and testing clinic, comparing the change of related awareness rate of knowledge and high-risk behavior of AIDS before and after intervention.Results After taking comprehensive intervening measures, a general increase (P <0.01) in the awareness rate of basic knowledge of AIDS after intervention compared with before, a general decrease in the incidence rate of high-risk behavior (anal sex and same-sex behavior, with two or more same-sex anal sex, etc.) after intervention compared with before (P <0.01 or P <0.05), the use of condoms was obviously improved (P <0.01 or P <0.05).Conclusions Selecting the appropriate comprehensive intervening measures can effectively improve the awareness rate of basic knowledge of AIDS among MSM, reduce high-risk behavior and help to reduce and control the spread of HIV in the crowd.%目的:观察综合干预对男男性接触者(MSM)艾滋病相关知识知晓率、高危行为的影响。方法采用自行设计的调查表,对94例2014年来自中山市富裕农村社区艾滋病自愿咨询检测门诊寻求咨询检测服务的 MSM 进行调查,比较干预前、后艾滋病相关知识知晓率、高危行为的变化。结果采取综合干预措施后,94名调查对象的艾滋病基本知识知晓率较干预前普遍上升(P <0.01),高危行为(与同性发生肛交行为、与2个或以上同性发生肛交行为等)发生率较干预前普遍下降(P <0.01或 P <0.05),安全套使用情况得到明显改善(P <0.01或 P <0.05)。结论选择合适的综合干预措施,可有效提高 MSM 人群艾滋病基本知识知晓率,减少高危行

  2. Distribution of high-risk human papillomavirus genotypes among HIV-negative women with and without cervical intraepithelial neoplasia in South Africa.

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    Alicia C McDonald

    Full Text Available OBJECTIVE: Large studies describing the profile of high-risk Human papillomavirus (hrHPV genotypes among women in sub-Saharan Africa are lacking. Here we describe the prevalence and distribution of hrHPV genotypes among HIV-negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN. METHODS: We report data on 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies undertaken in Cape Town, South Africa. Women had no history of previous cervical cancer screening. Cervical samples were tested for hrHPV DNA using the Hybrid Capture 2 (HC2 assay and all positive samples were genotyped using a PCR-based assay (Line Blot. Women underwent colposcopy and biopsy/endocervical curettage to determine CIN status. The prevalence and distribution of specific hrHPV genotypes were examined by age and CIN status. RESULTS: Overall, 20.7% (95% CI, 19.9-21.6% of women were hrHPV-positive by HC2, with women with CIN having the highest rates of positivity. Prevalence decreased with increasing age among women without CIN; but, a bimodal age curve was observed among women with CIN. HPV 16 and 35 were the most common hrHPV genotypes in all age and CIN groups. HPV 45 became more frequent among older women with CIN grade 2 or 3 (CIN2,3. Younger women (17-29 years had more multiple hrHPV genotypes overall and in each cervical disease group than older women (40-65 years. CONCLUSION: HPV 16, 35, and 45 were the leading contributors to CIN 2,3. The current HPV vaccines could significantly reduce HPV-related cervical disease; however, next generation vaccines that include HPV 35 and 45 would further reduce cervical disease in this population.

  3. Alcohol Use, Stigmatizing/Discriminatory Attitudes, and HIV High-Risk Sexual Behaviors among Men Who Have Sex with Men in China

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    Meizhen Liao

    2014-01-01

    Full Text Available Objective. This research was conducted to assess the correlates of alcohol consumption and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM in Shandong province, China. Methods. A cross-sectional survey provided demographics, sexual behaviors, illicit drug use, alcohol consumptions, and service utilization. Results. Of 1,230 participants, 82.8% were single, 85.7% aged 3 times per week in the past six months. The average total score of stigmatizing and discriminatory attitude was 37.4 ± 4.4. More frequent episodes of alcohol use were independently associated with higher levels of HIV/AIDS-related stigma and discrimination, unprotected anal sex, bisexual identity, multiple male sex partners, drug use, and lower levels of education. Expressing higher levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with alcohol use, unprotected male anal sex, bisexuals, more male sex partners, commercial sex with men, and non-receipt of peer education in the past year. Conclusion. HIV/AIDS-related stigmatizing and discriminatory attitudes are common and associated with alcohol use and unprotected sex among MSM. The finding highlights the needs to develop programs that would reduce HIV/AIDS-related stigmatizing and discriminatory attitudes and strengthen alcohol use prevention and risk reduction initiatives among MSM.

  4. Performance and comparison of self-reported STI symptoms among high-risk populations - MSM, sex workers, persons living with HIV/AIDS - in El Salvador.

    Science.gov (United States)

    Shah, Neha S; Kim, Evelyn; de Maria Hernández Ayala, Flor; Guardado Escobar, Maria Elena; Nieto, Ana Isabel; Kim, Andrea A; Paz-Bailey, Gabriela

    2014-12-01

    Resource-limited countries have limited laboratory capability and rely on syndromic management to diagnose sexually transmitted infections (STIs). We aimed to estimate the sensitivity, specificity and positive predictive value (PPV) of STI syndromic management when used as a screening method within a study setting. Men who have sex with men (MSM), female sex workers (FSWs) and people living with HIV/AIDS (PLWHA) participated in a behavioural surveillance study. Data were obtained on demographics, sexual behaviours, STI history and service utilisation. Biological specimens were tested for genital inflammatory infections (Neisseria gonorrhoeae [GC], Chlamydia trachomatis [CT], Mycoplasma genitalium [MG], Trichomonas vaginalis [TV]) and genital ulcerative infection (syphilis and Herpes simplex virus-2). There was a high prevalence of Herpes simplex virus-2 (MSM 48.1%, FSW 82.0% and PLWHA 84.4%). Most participants reported no ulcerative symptoms and the majority of men reported no inflammatory symptoms. Sensitivity and PPV were poor for inflammatory infections among PLWHA and MSM. Sensitivity in FSWs for inflammatory infections was 75%. For ulcerative infections, sensitivity was poor, but specificity and PPV were high. Reliance on self-reported symptoms may not be an effective screening strategy for these populations. STI prevention studies should focus on symptom recognition and consider routine screening and referral for high-risk populations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Relationship characteristics and HIV transmission risk in same-sex male couples in HIV serodiscordant relationships.

    Science.gov (United States)

    Starks, Tyrel J; Gamarel, Kristi E; Johnson, Mallory O

    2014-01-01

    Unprotected anal intercourse (UAI) remains a main risk factor for HIV among men who have sex with men (MSM) and this is of particular concern for partners of HIV serodiscordant status. However, HIV transmission risk has been demonstrated to vary by the sexual position adopted among partners. Guided by interdependence theory, this study examined how relational factors were differentially associated with risk taking (HIV-positive/insertive and HIV-negative/receptive) and strategic positioning (HIV-positive/receptive and HIV-negative/insertive) UAI within serodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (n couples = 91; n individuals = 182) simultaneously but independently completed computerized questionnaires and HIV-positive men had blood drawn for viral load. A minority of couples (30 %) engaged in risk taking and/or strategic positioning unprotected anal sex. Results of multinomial logistic regression indicated that HIV-negative partners' levels of relationship commitment were positively associated with the odds of engaging in strategic positioning sexual behaviors. For HIV-negative partners, reports of relationship intimacy, and sexual satisfaction were negatively associated with odds of reporting risk taking behavior. In contrast, HIV-positive partners' reported sexual satisfaction was positively associated with odds of engaging in risk taking behavior. Findings suggested that aspects of relational quality may be differentially associated with sexual decision making for same-sex male couples in serodiscordant relationships. Study findings lend support for the incorporation of discussions of HIV risk reduction strategies, enhancing communication between partners, and support for general relationship functioning in HIV care.

  6. Risk-Taking Behavior for HIV Acquisition during Pregnancy in Porto Alegre, Brazil

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    Nava Yeganeh

    2012-01-01

    Full Text Available Recent studies suggest that acquisition of HIV-1 infection during pregnancy and breastfeeding is associated with a high risk of HIV mother-to-child transmission. This study evaluates risk factors associated with HIV acquisition during pregnancy in women delivering at a large metropolitan medical facility located in the south of Brazil. From February to August 2009, our group conducted a cross-sectional study assessing women’s risk for HIV acquisition by administering an oral survey to peripartum women. Of 2465 participants, 42% (n=1046 knew that partner had been tested for HIV. During pregnancy, 82% (n=2022 of participants never used condoms; yet 97% (n=2399 practiced vaginal sex. Multivariate logistic regression analysis showed that patients with more years of education, in a relationship for more than 1 year, and who knew their own HIV status were more likely to know their partners' HIV status (P<0.05. Those who were in relationship for more than 1 year and were married/living together were more likely to be comfortable discussing HIV testing with partners (P<0.05. In conclusion, women in Brazil are at risk of HIV-infection during pregnancy as they remain sexually active, often do not know their sexual partner’s HIV status, and have minimal condom use.

  7. Maternal Substance Use and HIV Status: Adolescent Risk and Resilience

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    Leonard, Noelle R.; Gwadz, Marya Viorst; Cleland, Charles M.; Vekaria, Pooja C.; Ferns, Bill

    2008-01-01

    We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in…

  8. Seroprevalence of hepatitis B virus among adults at high risk for HIV transmission two decades after implementation of nationwide hepatitis B virus vaccination program in Taiwan.

    Directory of Open Access Journals (Sweden)

    Hsin-Yun Sun

    Full Text Available BACKGROUND: Seroprevalence of hepatitis B virus (HBV after implementation of universal neonatal HBV vaccination and catch-up vaccination programs remains rarely investigated among the adults who were born in the vaccination era (in or after 1986 and engaged in high-risk sexual behaviors. MATERIALS AND METHODS: Between 2006 and 2012, we determined HBV surface antigen ([HBsAg, anti-HBs, and HBV core antibody (anti-HBc, hepatitis C virus antibody (anti-HCV and rapid plasma reagin titers among HIV-infected men who have sex with men (MSM born during 1984-1985 (Group I: 244 persons and those born in or after 1986 (Group II: 523, and HIV-uninfected MSM (Group III: 377 and heterosexuals (Group IV: 217 born in or after 1986. Prevalence and incidence of HBV infection were estimated and multivariate analysis was performed to identify factors associated with HBsAg positivity. RESULTS: Compared with Group I, Groups II-IV had a significantly lower prevalence of HBsAg positivity (7.8% vs 3.7%, 2.4%, and 3.2%, respectively; and the prevalence of anti-HBc positivity was also lower for Groups III and IV (30.3% vs. 19.6%, and 18.0%, respectively, but no difference was observed between Groups I and II (30.3% vs. 26.3%. In multivariate analysis, HBsAg positivity was significantly associated with syphilis (adjusted odds ratio, 2.990; 95% confidence interval, 1.502-5.953 and anti-HCV positivity (adjusted odds ratio, 3.402; 95% confidence interval, 1.091-10.614. In subjects of Group II with all-negative HBV markers at baseline, the incidence rate of HBsAg seroconversion was 0.486 episodes per 100 person-years; and for those who received combination antiretroviral therapy containing lamivudine and/or tenofovir, none developed HBsAg seroconversion during the follow-up. CONCLUSIONS: Among the adults who were born in or after 1986 and engaged in high-risk sexual behaviors in Taiwan, neonatal HBV vaccination and catch-up vaccination programs conferred long-term protection

  9. Group Intervention to Reduce HIV Transmission Risk Behavior Among Persons Living With HIV/AIDS

    Science.gov (United States)

    Kalichman, Seth C.; Rompa, David; Cage, Marjorie

    2005-01-01

    Results of a randomized controlled trial show that a behavioral intervention grounded in social cognitive theory reduces unprotected sexual behaviors among men and women living with HIV infection, with the greatest reductions in HIV transmission risk behaviors occurring with non-HIV-positive sex partners. In this article, the authors describe the…

  10. Associations between substance use, sexual risk taking and HIV treatment adherence among homeless people living with HIV.

    Science.gov (United States)

    Friedman, Mark S; Marshal, Michael P; Stall, Ron; Kidder, Daniel P; Henny, Kirk D; Courtenay-Quirk, Cari; Wolitski, Richard J; Aidala, Angela; Royal, Scott; Holtgrave, David R

    2009-06-01

    Prior research suggests that the interconnections between substance use, HIV risk and lack of adherence to HIV medications are especially strong among homeless individuals. Thus, study of these interconnections warrants public health attention. The objectives of this paper are to describe patterns of alcohol and drug use, associations between substance use and participation in high-risk sex, and associations between substance use and adherence to HIV treatment regimens among a sample of 602 homeless or unstably housed HIV-seropositive individuals who are part of a housing-based intervention--the Housing and Health Study. Participants experienced high levels of substance use. Significant associations were found between substance use and adherence to HIV treatment medications, and between substance use and high-risk sexual practices within the entire group. Group analyses by sexual orientation/gender show that the association between substance use and treatment adherence is found primarily among heterosexual males whereas the relationship between several drugs and high-risk sexual practices is strongest among gay and bisexual men. Health professionals working with HIV-seropositive individuals should routinely ascertain housing status and screen for substance use and risky sex.

  11. An analysis of high risk behaviors of HIV negative spouses of MMT clients and related factors%美沙酮服药人员HIV阴性配偶高危性行为及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    杨丽华; 朵林; 雷宇靖; 薛皓铭; 钟君睿; 邓玲

    2012-01-01

    Objective To understand the high risk behaviors of HIV negative spouses of HIV infected MMT clients in Yunnan Province, and to analyze the related factors in order to provide evidence for further intervention. Methods A total of 107 HIV negative spouses /regular sex partners of HIV infected MMT clients were selected from 13 MMT clinics in Yunnan Province, and were surveyed with self designed questionnaire to collect demographic information, HIV knowledge, sexual risk behavior and the impact factors. Result Condom use among HIV positive MMT clients and their HIV negative spouses/sex partners in the last sexual activities was 74% , of whom 90% and 92% received STI/HIV VCT service. Only 28% received STI examination and treatment. No child status was a factor related to not using condoms (OR = 0. 197). Conclusion HIV positive MMT clients have obviously high risk sexual behavior with their HIV negative spouses/sex partners, as a result, the spouses/sex partners become vulnerable to HIV spread, especially the female spouses/sex partners of ethnic minority without children. Thus, intensive interventions for HIV negative spouses or sex partners should be strengthened, and the condom use should be promoted so as to lower the possibility of HIV spread among them.%目的 了解云南省美沙酮维持治疗人员艾滋病病毒(HIV)阴性配偶(单阳阴配)高危性行为及其影响因素,为针对性地进行干预提供依据.方法 选取云南省13个美沙酮门诊所有HIV阳性服药人员的固定性伴,并通过IIIV阳性检测筛检出阴性者,采用调查问卷收集包括人口学特征、知识知晓率及高危性行为等数据,并对高危性行为及影响因素进行分析.结果 阴性配偶上次发生性关系时使用安全套的占74%;接受过性病、艾滋病免费咨询和HIV检测的较高,分别为90%、92%;但接受过性病检查治疗的仅有28%.无小孩是其不使用安全套的影响因素(OR=0.197).结论 HIV阴性配偶

  12. 海洛因依赖者艾滋病高危行为及其性别差异调查%Survey of HIV high risk behavior and gender difference among heroin dependents in Shanghai

    Institute of Scientific and Technical Information of China (English)

    陆光华; 范成路; 杜江; 江海峰; 赵敏

    2012-01-01

    目的 了解海洛因依赖者艾滋病病毒(Human immunodeficiency virus,HIV)高危行为特征的性别差异.方法 对上海市3个劳教戒毒场所和上海市自愿戒毒中心共计466例海洛因依赖者进行访谈.访谈内容包括HIV高危行为、HIV检测及预防活动等.结果 HIV高危行为较普遍,包括“曾与人共用注射器”(26.3%)、“≥3个性伴”(24.0%)等;HIV检测意愿较低,很有可能“未来1年内做HIV检测”的仅占6.7%;男性多项高危行为包括“与人共用注射器比例”、“一生共有性伴数目”、“1年共有性伴数目”、“3个月内共有性伴数目”、“≥3个性伴”、“≥2个性伴中偶然性伴数”、“性生活中曾有口交”、“性生活中曾有肛交”的比例均高于女性(P<0.05);女性海洛因依赖者“做过HIV检测”,“认为参加HIV教育活动有意义”的比例高于男性(P<0.05).结论 男女海洛因依赖者在HIV高危行为方面存在差异,在海洛因依赖人群的HIV防治过程中,应针对不同性别特征制定个体化的治疗方案,以满足不同性别患者的需求.%Objective To understand the characteristics and gender difference of human immunodeficiency virus ( HIV) related risk behavior among heroin dependents in Shanghai. Methods Four hundred and sixty six heroin dependents recruited from three Compulsory Treatment Centers and a Voluntary Drug Abuse Treatment Center were interviewed about the HIV related risk behavior, HIV test and attitude toward prevention. Results HIV high risk behaviors were common in this population including "sharing syringes with others" (26. 3%) , "multiple sex part-ners(≥ 3)" (24. 0%). Willingness to take HIV testing was low, only 6. 7% of the samples were very likely to do HIV testing in next year. Male dependents had higher proportion of HIV high risk behaviors than females including "share syringes with others", "total number of sex partners in a life", "total

  13. The Age of Initiation of Drug Use and Sexual Behavior May Influence Subsequent HIV Risk Behavior: A Systematic Review.

    Science.gov (United States)

    Baldwin, Patrick; Shrestha, Roman; Potrepka, Jessica; Copenhaver, Michael

    2013-12-07

    Researchers examining injection drug users (IDUs) in drug treatment have been trying for decades to determine the optimal way to intervene to prevent the transmission and spread of human immunodeficiency virus (HIV) in this population. Although efficacious HIV risk reduction interventions are widely available, questions remain about what specific factors are most related to HIV risk behavior and defined as unprotected sexual activity and/or high risk drug use. This review involved an evaluation of the research literature in order to better understand the association between drug use and sexual behavior debut on HIV risk behavior. Findings suggest that drug use debut and sexual behavior debut may be related to subsequent HIV risk behavior. Evidence to date implies that intervening at an earlier age to assist youth to avoid or delay these high risk behaviors may be an additional means of reducing subsequent HIV risk.

  14. Cardiometabolic disease risk and HIV status in rural South Africa : establishing a baseline

    NARCIS (Netherlands)

    Clark, Samuel J.; Gomez-Olive, F. Xavier; Houle, Brian; Thorogood, Margaret; Klipstein-Grobusch, Kerstin; Angotti, Nicole; Kabudula, Chodziwadziwa; Williams, Jill; Menken, Jane; Tollman, Stephen

    2015-01-01

    Background: To inform health care and training, resource and research priorities, it is essential to establish how non-communicable disease risk factors vary by HIV-status in high HIV burden areas; and whether long-term anti-retroviral therapy (ART) plays a modifying role. Methods: As part of a coho

  15. Porn video shows, local brew, and transactional sex: HIV risk among youth in Kisumu, Kenya

    NARCIS (Netherlands)

    C.W. Njue (Carolyne); H.A.C.M. Voeten (Hélène); P. Remes (Pieter)

    2011-01-01

    textabstractBackground: Kisumu has shown a rising HIV prevalence over the past sentinel surveillance surveys, and most new infections are occurring among youth. We conducted a qualitative study to explore risk situations that can explain the high HIV prevalence among youth in Kisumu town, Kenya. Met

  16. Incidence, risk factors and mortality of tuberculosis in Danish HIV patients 1995-2007

    DEFF Research Database (Denmark)

    Taarnhøj, Gry A; Engsig, Frederik N; Ravn, Pernille;

    2011-01-01

    Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods....

  17. Criminal law and HIV testing: empirical analysis of how at-risk individuals respond to the law.

    Science.gov (United States)

    Lee, Sun Goo

    2014-01-01

    This Note assesses the effect of laws that specifically criminalize behaviors that expose others to the human immunodeficiency virus (HIV). This Note examines the relationship between HIV testing decisions by high-risk individuals and the existence of these HIV-specific statutes, as well as the amount of media coverage related to them. One of the main reasons public health experts criticize criminalization of HIV-exposing behavior is that it may discourage at-risk individuals from undergoing HIV testing. This argument, however, remains empirically untested to date. This study quantitatively examines whether at-risk individuals living in jurisdictions with HIV-specific statutes are less likely to report having been tested for HIV in the past year compared to those living in jurisdictions without HIV-specific statutes. Regression analysis is conducted using data collected in the United States over a seven-year span. The results show that at-risk individuals residing in states with HIV-specific statutes are no less likely to report having been tested for HIV than those who live in other states. However, the number of people who reported that they had been tested for HIV is inversely correlated with the frequency of newspaper coverage of criminalization of HIV-exposing behavior. These findings imply that at-risk individuals' HIV testing is associated with media coverage of criminalizing HIV-exposing behavior. The negative impact that criminal law has on HIV testing rates could be a serious public health threat. Testing is often the initial step in public health interventions that most effectively modify the risky behavior of HIV-positive individuals. The adverse consequence of criminalization should weigh heavily in the design and application of criminal sanctions for HIV-exposing behavior. In addition, future research should further explore the relationships between criminalization, media coverage of criminalization, and HIV testing decisions for a more nuanced

  18. Sexual and reproductive health and HIV/AIDS risk perception in the ...

    African Journals Online (AJOL)

    sector. The study concludes that people in the tourism sector are at high risk of HIV/AIDS, sexually transmitted infections and .... with multiple commercial sex workers (CSWs) and hotel ..... Ethnographic Study of Malaria Case Management.

  19. HIV risk behavior among HIV-infected men who have sex with men in Bangkok, Thailand.

    Science.gov (United States)

    Sirivongrangson, Pachara; Lolekha, Rangsima; Charoenwatanachokchai, Angkana; Siangphoe, Umaporn; Fox, Kimberley K; Jirarojwattana, Naiyana; Bollen, Liesbeth; Yenyarsan, Naruemon; Lokpichat, Somchai; Suksripanich, Orapin; McConnell, Michelle

    2012-04-01

    We assessed prevalence of sexually transmitted infection (STIs), sexual risk behaviors, and factors associated with risk behaviors among HIV-infected MSM attending a public STI clinic serving MSM in Bangkok, Thailand. Between October 2005-October 2007, 154 HIV-infected MSM attending the clinic were interviewed about sexual risk behaviors and evaluated for STIs. Patients were examined for genital ulcers and had serologic testing for syphilis and PCR testing for chlamydia and gonorrhea. Results showed that sexual intercourse in the last 3 months was reported by 131 men. Of these, 32% reported anal sex without a condom. STIs were diagnosed in 41%. Factors associated with having sex without a condom were having a steady male partner, having a female partner and awareness of HIV status <1 month. Sexual risk behaviors and STIs were common among HIV-infected MSM in this study. This highlights the need for increased HIV prevention strategies for HIV-infected MSM.

  20. HIV / AIDS: An Unequal Burden

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 ... high-risk category, emphasizes Dr. Cargill. Photo: iStock HIV and Pregnancy Are there ways to help HIV- ...

  1. Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador.

    Science.gov (United States)

    Hernandez, Isabel; Reina-Ortiz, Miguel; Johnson, Ayesha; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo

    2016-05-08

    The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador.

  2. A Brief Assessment for HIV Risk: The TCU HVHP Form

    Science.gov (United States)

    Rowan, Grace A.; Joe, George W.; Lehman, Wayne E. K.; Knight, Kevin

    2016-01-01

    Targeted HIV screens may help identify some risk-related concerns of drug-using offenders. The present study describes the Texas Christian University HIV/Hepatitis Risk Assessment (TCU HVHP) form, a 19-item self-report instrument measuring HIV and hepatitis risks based on a sample (N = 1,056) of offenders in eight prisons. Principal components analysis indicated four scales (Injection Risk, Condom Attitudes, Sex Risk, and AIDS Concern) with reliable psychometric properties with coefficient α reliabilities ranging from .72 to .88. Concurrent validities indicated the four scales were related to motivation for treatment, level of drug use, psychosocial functioning, and criminal thinking, although the patterns varied by gender. The TCU HVHP Form should be attractive to programs needing a brief assessment measuring HIV risk behaviors, attitudes toward condom use, and concerns about acquiring and transmitting HIV. PMID:27302708

  3. HIV/STI risk among male Mexican immigrants in Dallas, Texas: findings from a pilot study.

    Science.gov (United States)

    Wilson, Kate S; Eggleston, Elizabeth; Diaz-Olavarrieta, Claudia; Garcia, Sandra G

    2010-12-01

    Rates of HIV and STIs are higher among Latinos than the general U.S. population. A number of factors place Latino immigrants at particularly high risk. 128 male Mexican immigrants in Dallas, Texas completed personal interviews. We measured the prevalence of HIV/STI risk factors and identified sociodemographic and behavioral characteristics associated with higher risk. 9% of the total sample had 3 or more sexual partners in the past year. 5% had sex with a commercial sex worker (CSW). 11% had sex with another man. 11% had a previous STI diagnosis. Risk behaviors and STI history were more prevalent among men who had used illegal drugs or frequently consumed alcohol (18% of the sample) than among others. The overall prevalence of HIV/STI risk factors in this population was moderate. However, men who drank alcohol frequently and used illegal drugs were more likely than others to report engaging in behaviors that put them at risk for acquiring HIV/STI.

  4. Impact of HLA-driven HIV adaptation on virulence in populations of high HIV seroprevalence.

    Science.gov (United States)

    Payne, Rebecca; Muenchhoff, Maximilian; Mann, Jaclyn; Roberts, Hannah E; Matthews, Philippa; Adland, Emily; Hempenstall, Allison; Huang, Kuan-Hsiang; Brockman, Mark; Brumme, Zabrina; Sinclair, Marc; Miura, Toshiyuki; Frater, John; Essex, Myron; Shapiro, Roger; Walker, Bruce D; Ndung'u, Thumbi; McLean, Angela R; Carlson, Jonathan M; Goulder, Philip J R

    2014-12-16

    It is widely believed that epidemics in new hosts diminish in virulence over time, with natural selection favoring pathogens that cause minimal disease. However, a tradeoff frequently exists between high virulence shortening host survival on the one hand but allowing faster transmission on the other. This is the case in HIV infection, where high viral loads increase transmission risk per coital act but reduce host longevity. We here investigate the impact on HIV virulence of HIV adaptation to HLA molecules that protect against disease progression, such as HLA-B*57 and HLA-B*58:01. We analyzed cohorts in Botswana and South Africa, two countries severely affected by the HIV epidemic. In Botswana, where the epidemic started earlier and adult seroprevalence has been higher, HIV adaptation to HLA including HLA-B*57/58:01 is greater compared with South Africa (P = 7 × 10(-82)), the protective effect of HLA-B*57/58:01 is absent (P = 0.0002), and population viral replicative capacity is lower (P = 0.03). These data suggest that viral evolution is occurring relatively rapidly, and that adaptation of HIV to the most protective HLA alleles may contribute to a lowering of viral replication capacity at the population level, and a consequent reduction in HIV virulence over time. The potential role in this process played by increasing antiretroviral therapy (ART) access is also explored. Models developed here suggest distinct benefits of ART, in addition to reducing HIV disease and transmission, in driving declines in HIV virulence over the course of the epidemic, thereby accelerating the effects of HLA-mediated viral adaptation.

  5. Social media use and HIV transmission risk behavior among ethnically diverse HIV-positive gay men: results of an online study in three U.S. states.

    Science.gov (United States)

    Hirshfield, Sabina; Grov, Christian; Parsons, Jeffrey T; Anderson, Ian; Chiasson, Mary Ann

    2015-10-01

    Though Black and Hispanic men who have sex with men (MSM) are at an increased risk for HIV, few HIV risk reduction interventions that target HIV-positive MSM, and even fewer that use technology, have been designed to target these groups. Despite similar rates of social media and technology use across racial/ethnic groups, online engagement of minority MSM for HIV prevention efforts is low. Since minority MSM tend to have less representation in online HIV prevention studies, the goals of this online anonymous study of HIV-positive gay-identified men were to test the feasibility of conducting targeted recruitment by race/ethnicity and sexual orientation, to assess technology and social media use, and to assess global HIV transmission risk. In 2011, an anonymous online survey was conducted among 463 members of an HIV-positive personals website. Emails were sent to a subset of HIV-positive male members who self-identified as gay. While 57 % were White, substantial proportions of participants were Black (20 %) or Hispanic (18 %). Median age was 46 (range 18-79). Men who reported using 3 or more websites or apps to meet sex partners were significantly more likely to report anal intercourse (AOR 4.43, p anal sex (CAS) (AOR 2.70, p gay men. Efficacy trials of technology-based HIV prevention interventions targeting high-risk minority HIV-positive MSM are warranted.

  6. Human papillomavirus infection in oral fluids of HIV-1-positive men: prevalence and risk factors.

    Science.gov (United States)

    Gaester, Karen; Fonseca, Luiz A M; Luiz, Olinda; Assone, Tatiane; Fontes, Adriele Souza; Costa, Fernando; Duarte, Alberto J S; Casseb, Jorge

    2014-10-17

    Human papillomavirus is one of the most common sexually transmitted diseases worldwide. The natural history of oral HPV infection is unclear, and its risk factors have not been explored. Immunocompromised individuals, as exemplified by HIV patients, are at high risk for HPV-related diseases. The mean of this study is to determine the prevalence of HPV in the oral tract of HIV-1-positive male subjects and its association with risk factors. A total of 283 oral wash samples from HIV-1-positive men were tested. The oral fluid samples were used for DNA extraction and conventional PCR amplification; HPV genotyping was performed by hybridization. HPV genotyping revealed that nine samples (3.5%) were positive for HPV DNA; the major high-risk HPV types identified were 51 and 66. Worldwide studies have shown a variable prevalence of oral HPV. The diversity of genotypes and the high prevalence of multiple infections in HIV-infected subjects can be better explained by the effects of HIV-induced immunosuppression. The most important risk factors are unprotected sexual intercourse, but other factors for this infection have been described elsewhere including smoking, age and HIV-positive serostatus. In this study, smoking was the most important risk factor for acquiring oral HPV in HIV-1-infected subjects in Brazil.

  7. Risk Factors for Physical Domestic Violence in a High-Prevalence HIV Setting: Findings from Project Accept Baseline Data (HPTN-043).

    Science.gov (United States)

    Kevany, Sebastian; Woelk, Godfrey; Shade, Starley B; Kulich, Michal; Turan, Janet M; Chingono, Alfred; Morin, Stephen F

    2013-06-25

    Zimbabwe faces an acute generalized HIV/AIDS epidemic combined with rapidly deteriorating economic and political conditions, under which levels of domestic violence are on the rise. We aimed to determine possible demographic and behavioral factors associated with physical domestic violence in a rural setting in order to better inform both national and local domestic violence and HIV prevention policies. Using the Project Accept baseline data set, we selected demographic, socio-economic, and behavioral variables that might be associated with physical domestic violence based on a review of the literature. Univariate and multivariate analyses were carried out, and odds ratios (OR) were computed using logistic regression. Women reporting physical domestic violence were significantly more likely to report (i) a history of childhood domestic violence (OR=2.96, Peconomic status as measured by type of homestead (OR=1.4, P=0.04) than women who reported no experience of physical domestic violence. Married women were less likely to experience physical domestic violence than unmarried women (OR=0.65, P=0.011). Women at greatest risk of domestic violence include those with a personal history of violence or sexual abuse, multiple lifetime partners, and low or medium socio-economic status. Risk assessments and joint interventions for both domestic violence reduction and HIV prevention should target these population groups, which are effective both on the public health and global heath diplomacy levels.

  8. A clinician-nurse model to reduce early mortality and increase clinic retention among high-risk HIV-infected patients initiating combination antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Braitstein Paula

    2012-02-01

    Full Text Available Abstract Background In resource-poor settings, mortality is at its highest during the first 3 months after combination antiretroviral treatment (cART initiation. A clear predictor of mortality during this period is having a low CD4 count at the time of treatment initiation. The objective of this study was to evaluate the effect on survival and clinic retention of a nurse-based rapid assessment clinic for high-risk individuals initiating cART in a resource-constrained setting. Methods The USAID-AMPATH Partnership has enrolled more than 140,000 patients at 25 clinics throughout western Kenya. High Risk Express Care (HREC provides weekly or bi-weekly rapid contacts with nurses for individuals initiating cART with CD4 counts of ≤100 cells/mm3. All HIV-infected individuals aged 14 years or older initiating cART with CD4 counts of ≤100 cells/mm3 were eligible for enrolment into HREC and for analysis. Adjusted hazard ratios (AHRs control for potential confounding using propensity score methods. Results Between March 2007 and March 2009, 4,958 patients initiated cART with CD4 counts of ≤100 cells/mm3. After adjusting for age, sex, CD4 count, use of cotrimoxazole, treatment for tuberculosis, travel time to clinic and type of clinic, individuals in HREC had reduced mortality (AHR: 0.59; 95% confidence interval: 0.45-0.77, and reduced loss to follow up (AHR: 0.62; 95% CI: 0.55-0.70 compared with individuals in routine care. Overall, patients in HREC were much more likely to be alive and in care after a median of nearly 11 months of follow up (AHR: 0.62; 95% CI: 0.57-0.67. Conclusions Frequent monitoring by dedicated nurses in the early months of cART can significantly reduce mortality and loss to follow up among high-risk patients initiating treatment in resource-constrained settings.

  9. A Comparison of the Diabetes Risk Score in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART and HAART-Naive Patients at the Limbe Regional Hospital, Cameroon.

    Directory of Open Access Journals (Sweden)

    Christian Akem Dimala

    Full Text Available Highly active antiretroviral therapy (HAART has been associated with dysglycaemia. However, there is scarce data on the risk of developing diabetes mellitus (DM in HIV/AIDS patients in Africa.Primarily to quantify and compare the risk of having diabetes mellitus in HIV/AIDS patients on HAART and HAART-naïve patients in Limbe, Cameroon; and secondarily to determine if there is an association between HAART and increased DM risk.A cross-sectional study was conducted at the Limbe Regional Hospital HIV treatment center between April and June 2013, involving 200 HIV/AIDS patients (100 on first-line HAART regimens for at least 12 months matched by age and gender to 100 HAART-naïve patients. The Diabetes Risk Score (DRS was calculated using a clinically validated model based on routinely recorded primary care parameters. A DRS ≥ 7% was considered as indicative of an increased risk of developing DM.The median DRS was significantly higher in patients on HAART (2.30% than in HAART-naïve patients (1.62%, p = 0.002. The prevalence of the increased DM risk (DRS ≥ 7% was significantly higher in patients on HAART, 31% (95% CI: 22.13-41.03 than in HAART-naïve patients, 17% (95% CI: 10.23-25.82, p = 0.020. HAART was significantly associated with an increased DM risk, the odds ratio of the HAART group compared to the HAART-naïve group was 2.19 (95% CI: 1.12-4.30, p = 0.020. However, no association was found after adjusting for BMI-defined overweight, hypertension, age, sex, family history of DM and smoking (Odds ratio = 1.22, 95% CI: 0.42-3.59, p = 0.708. Higher BMI and hypertension accounted for the increased risk of DM in patients on HAART. Also, more than 82% of the participants were receiving or had ever used Zidovudine based HAART regimens.HIV/AIDS patients on HAART could be at a greater risk of having DM than HAART-naïve patients as a result of the effect of HAART on risk factors of DM such as BMI and blood pressure.

  10. HIV related high risk behavior among drug users receiving methadone maintenance Treatment%参加美沙酮维持治疗海洛因成瘾者传播艾滋病高危行为及应对

    Institute of Scientific and Technical Information of China (English)

    王常合; 庞琳; 吴尊友

    2011-01-01

    美沙酮维持治疗(methadone maintenance treatment,MMT)可以减少海洛因成瘾者感染或传播艾滋病病毒(human immunodeficiency virus,HIV)的相关危险行为,但部分参加者在治疗期间仍然会有吸毒等危险行为发生.治疗期间发生危险行为的原因受治疗前和治疗本身等多种因素影响.采用较高治疗剂量、提高保持率、加强综合干预措施等可以减少海洛因成瘾者治疗期间危险行为的发生,提高MMT预防HIV传播的效果.%Methadone maintenance treatment (MMT) can reduce the risk of HIV related behavior among heroin addicts. However, some of them at the time receiving MMT continue to use heroin occasionally and engage in risk sexual behavior. Continuing use of drugs during receiving MMT is related with the pre-treatment conditions and treatment ser-vice itself. High dosage of methadone, high retention rate, and comprehensive services would reduce the high risk behav-ior during the treatment, and then improve the effect of HIV prevention.

  11. Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

    Science.gov (United States)

    ... Glance Project Connect Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend ... Tweet Share Compartir Many young people engage in sexual risk behaviors that can result in unintended health ...

  12. Sexuality, Sexual Practices, and HIV Risk among Incarcerated African-American Women in North Carolina

    Science.gov (United States)

    Farel, Claire E.; Parker, Sharon D.; Muessig, Kathryn E.; Grodensky, Catherine A.; Jones, Chaunetta; Golin, Carol E.; Fogel, Catherine I.; Wohl, David A.

    2013-01-01

    Background Women who have been in prison carry a greater lifetime risk of HIV for reasons that are not well understood. This effect is amplified in the Southeastern United States, where HIV incidence and prevalence is especially high among African American (AA) women. The role of consensual sexual partnerships in the context of HIV risk, especially same-sex partnerships, merits further exploration. Methods We conducted digitally recorded qualitative interviews with 29 AA women (15 HIV-positive, 14 HIV-negative) within three months after entry into the state prison system. We explored potential pre-incarceration HIV risk factors, including personal sexual practices. Two researchers thematically coded interview transcripts and a consensus committee reviewed coding. Results Women reported complex sexual risk profiles during the six months prior to incarceration, including sex with women as well as prior sexual partnerships with both men and women. Condom use with primary male partners was low and a history of transactional sex work was prevalent. These behaviors were linked to substance use, particularly among HIV-positive women. Conclusions Although women may not formally identify as bisexual or lesbian, sex with women was an important component of this cohort’s sexuality. Addressing condom use, heterogeneity of sexual practices, and partner concurrency among at-risk women should be considered for reducing HIV acquisition and preventing forward transmission in women with a history of incarceration. PMID:24183410

  13. Socio-demographic Risk Factors Associated with HIV Infection In Patients Seeking Medical Advice in a Rural Hospital of India.

    Science.gov (United States)

    Alvarez-Uria, Gerardo; Midde, Manoranjan; Naik, Praveen K

    2012-02-17

    Despite the fact that two thirds of HIV infected people in India are rural residents, risk factors associated with HIV infection in rural areas are not well known. In this study we have collected socio-demographic data of 6406 patients who were tested for HIV infection in a rural hospital of India and we have investigated risk factors associated with HIV. In women the most important risk factor was being a widow and the risk was higher in younger than in older widows. Other variables found to be associated with HIV infection were age between 25 and 45 years in men, low education level (especially those who only completed primary education) and working in a field not related to agriculture in scheduled castes and men from scheduled tribes. The results of this study express the need for HIV screening of widows who live in rural areas of Indian States with high HIV prevalence.

  14. A Review of the Effectiveness of HIV Sexual Risk Prevention Interventions in Adult Prison Inmates.

    Science.gov (United States)

    Senkowski, Valerie; Norris, Katherine; McGaughey, Anthony; Branscum, Paul

    2016-10-01

    This article reviews the effectiveness of HIV sexual risk prevention programs among adult prison inmates. A database search was performed to identify studies that used HIV sexual risk prevention programs with incarcerated adults. Of the 234 articles identified, 9 met the inclusion criteria. In addition, 5 articles were found containing supporting information for the 9 studies reviewed, increasing the number of articles reviewed to 14. All studies reported a significant increase in knowledge or a decrease in high-risk behaviors among the inmates at the conclusion of the interventions. Common limitations included a lack of a theoretical framework used in developing the interventions, a lack of process evaluations to measure program fidelity, and a lack of validity and reliability reporting for the study surveys. However, programs and interventions targeting HIV and sexual risk reduction appear to improve the knowledge of HIV prevention and reduce risk in the adult prison inmate population.

  15. Lifetime ATS use and increased HIV risk among not-in-treatment opiate injectors in Malaysia

    Science.gov (United States)

    Chawarski, Marek C.; Vicknasingam, Balasingam; Mazlan, Mahmud; Schottenfeld, Richard S.

    2015-01-01

    Background Malaysia has been experiencing significant drug abuse problems since the 1970s, and drug abuse is the major driver of HIV transmission in Malaysia. We investigated risk factors for HIV associated with use of amphetamine type stimulants (ATS) among not-in-treatment opiate injectors in Malaysia. Methods Between October of 2006 and May of 2008, we conducted a series of surveys in three major urban areas of Malaysia. A total of 732 opiate IDUs (679 males and 53 females) were enrolled in the three surveys. The survey instruments consisted of a structured interview on demographic characteristics, drug use history (including year of first use, and past month history of use of illicit drugs; lifetime and past month history of IDU or needle or equipment sharing), and HIV status. Results There were 194/704 (27.6%) HIV positive participants in the sample. Two factors were significantly associated with HIV infection in this sample: lifetime history of ATS use (OR [95%CI]: 2.3 [1.5–3.6]) and lifetime history of sharing of injection equipment (OR [95% CI]: 4.2 [1.8–9.8]). Both HIV-positive and HIV-negative participants reported high levels of current needle/equipment sharing practices: 82% vs. 75%, respectively. Conclusions ATS use spread rapidly in the study sample after 1997 and is associated with an increased risk of HIV infection in this population already at high risk because of opiate IDU. Out-of-treatment IDUs in Malaysia engage in high risk behaviors regardless of their HIV status. Increased education and public health prevention measures are needed to reduce HIV transmission risks in this population. PMID:22266088

  16. HIV testing and counselling for migrant populations living in high-income countries: a systematic review.

    Science.gov (United States)

    Alvarez-del Arco, Debora; Monge, Susana; Azcoaga, Amaya; Rio, Isabel; Hernando, Victoria; Gonzalez, Cristina; Alejos, Belen; Caro, Ana Maria; Perez-Cachafeiro, Santiago; Ramirez-Rubio, Oriana; Bolumar, Francisco; Noori, Teymur; Del Amo, Julia

    2013-12-01

    The barriers to HIV testing and counselling that migrants encounter can jeopardize proactive HIV testing that relies on the fact that HIV testing must be linked to care. We analyse available evidence on HIV testing and counselling strategies targeting migrants and ethnic minorities in high-income countries. Systematic literature review of the five main databases of articles in English from Europe, North America and Australia between 2005 and 2009. Of 1034 abstracts, 37 articles were selected. Migrants, mainly from HIV-endemic countries, are at risk of HIV infection and its consequences. The HIV prevalence among migrants is higher than the general population's, and migrants have higher frequency of delayed HIV diagnosis. For migrants from countries with low HIV prevalence and for ethnic minorities, socio-economic vulnerability puts them at risk of acquiring HIV. Migrants have specific legal and administrative impediments to accessing HIV testing-in some countries, undocumented migrants are not entitled to health care-as well as cultural and linguistic barriers, racism and xenophobia. Migrants and ethnic minorities fear stigma from their communities, yet community acceptance is key for well-being. Migrants and ethnic minorities should be offered HIV testing, but the barriers highlighted in this review may deter programs from achieving the final goal, which is linking migrants and ethnic minorities to HIV clinical care under the public health perspective.

  17. HIV incidence and risk factors for acquisition in HIV discordant couples in Masaka, Uganda: an HIV vaccine preparedness study.

    Directory of Open Access Journals (Sweden)

    Eugene Ruzagira

    Full Text Available OBJECTIVES: To determine the incidence of and risk factors for HIV acquisition in a cohort of HIV-uninfected partners from HIV discordant couples in Masaka, Uganda, and to establish its suitability for HIV vaccine trials. METHODS: HIV-uninfected adults living in HIV discordant couple relationships were enrolled and followed for 2 years. Interviews, medical investigations, HIV counseling and testing, syphilis and urine pregnancy (women tests were performed at quarterly visits. Sexual risk behaviour data were collected every 6 months. RESULTS: 495 participants were enrolled, of whom 34 seroconverted during 786.6 person-years of observation (PYO. The overall HIV incidence rate [95% confidence interval (CI] was 4.3 [3.1-6]; and 4.3 [2.8-6.4] and 4.4 [2.5-8] per 100 PYO in men and women respectively. Independent baseline predictors for HIV acquisition were young age [18-24 (aRR = 4.1, 95% CI 1.6-10.8 and 25-34 (aRR = 2.7, 95% CI 1.2-5.8 years]; alcohol use (aRR = 2.6, 95% CI 1.1-6; and reported genital discharge (aRR = 3.4, 95% CI 1.6-7.2 in the past year. Condom use frequency in the year preceding enrolment was predictive of a reduced risk of HIV acquisition [sometimes (aRR = 0.4, 95% CI 0.2-0.8; always (aRR = 0.1, 95% CI 0.02-0.9]. In the follow-up risk analysis, young age [18-24 (aRR = 6.2, 95% CI 2.2-17.3 and 25-34 (aRR = 2.3, 95% CI 1.1-5.0 years], reported genital discharge (aRR = 2.5, 95% CI 1.1-5.5, serological syphilis (aRR 3.2, 95% CI 1.3-7.7 and the partner being ART naïve (aRR = 4.8, 95% CI 1.4-16.0 were independently associated with HIV acquisition. There were no seroconversions among participants who reported consistent condom use during the study. CONCLUSIONS: The study has identified important risk factors for HIV acquisition among HIV discordant couples. HIV-uninfected partners in discordant couples may be a suitable population for HIV vaccine efficacy trials. However, recent confirmation that

  18. HIV/AIDS Knowledge Scores and Perceptions of Risk Among African American Students Attending Historically Black Colleges and Universities

    Science.gov (United States)

    Sutton, Madeline Y.; Hardnett, Felicia P.; Wright, Pierre; Wahi, Sagina; Pathak, Sonal; Warren-Jeanpiere, Lari; Jones, Sandra

    2011-01-01

    Objective African American young adults are disproportionately affected by the HIV/AIDS epidemic and often unaware of their personal risk for HIV. Historically black colleges and universities (HBCUs) enroll 25% of college-educated African American young adults and can play an important role in HIV prevention. We examined HIV/AIDS knowledge of students at HBCUs to inform and strengthen our HIV prevention efforts at HBCUs. Methods African American undergraduate HBCU students completed online surveys assessing HIV/AIDS knowledge and behaviors, and we analyzed data to assess their knowledge and behaviors. Results A total of 1,051 of 1,230 surveys completed (85.4%) were analyzable. Eighty-two percent of students had average/high HIV knowledge scores. Seventy-nine percent of students surveyed perceived themselves to be at low risk for HIV infection; 64% of those who had at least two or more sex partners had not used a condom at last sex encounter. In the final model, significant independent effects were identified for average/high knowledge of HIV risk, including agreeing with assessing a potential partner's HIV risk by all of the five actions listed (adjusted odds ratio [AOR] = 2.7, 95% confidence interval [CI] 1.7, 4.3) and never using a needle to inject drugs (AOR=5.6, 95% CI 3.2, 9.7). Conclusions Educating students about effectively assessing sex partner risk will improve HIV knowledge and prevention efforts at HBCUs. PMID:21886325

  19. Attitudes and stereotypes regarding older women and HIV risk.

    Science.gov (United States)

    Beaulaurier, Richard; Fortuna, Karen; Lind, Danielle; Emlet, Charles A

    2014-01-01

    Persons aged 50 years and over will soon disproportionately represent the future of the HIV/AIDS epidemic. It is estimated that by 2015 older adults will represent 50% of persons living with HIV in the United States. Despite the HIV/AIDS growing population among older adults, attitudes, beliefs, and stereotypes toward older adults that exist in general society have affected HIV prevention, education, and care. Specifically, ageist attitudes about the sexuality of older adults in general and older women in particular, low clinical HIV suspicion among healthcare providers, lack of knowledge about risk among older women, and differentials in power related to negotiating sexual practices all lead to heightened concerns for the prevention, identification, and treatment of HIV disease in mature women. This article examines common attitudes, beliefs, and stereotypes that exist within general society as well as health and social service providers that place older women at a disadvantage when it comes to HIV prevention, education, and treatment.

  20. 2010年陕西省高危人群艾滋病哨点监测分析%Analysis of HIV/AIDS sentinel surveillance among high risk population in Shanxi in 2010

    Institute of Scientific and Technical Information of China (English)

    常文辉; 邢爱华; 王百锁; 李翔; 贾华; 张璐; 董丽芳; 胡婷

    2012-01-01

    [Objective]To understand the HIV/AIDS related epidemic situation and behaviors characteristics among high-risk population in Shaanxi Province, and provide evidence for comprehensive HIV prevention responses and evaluation of intervention. [ Methods] According to the national HIV/AIDS Sentinel Surveillance Project, 4 groups of high-risk population, including drug users( DUS) , men who have sex with men( MSM) , female sex workers(FSW) , men of STD clinic attendees, were interviewed with questionnaire and were screened for HIV antibody. [Results] Among 10305 subjects surveyed in 2010 of 4 high-risk populations, 63 cases were HTV antibody positive. HIV antibody positive were found in 1/3 sentinel sites of drug users, the positive rate of the group was 0.3%. The positive rate of MSM was 8.8%. The positive rate of FSW was 0.0% . The positive rate of men of STD was 0.0% . The proportions of consistently using condom in DUS and FSW were 8.2% and 59.4%. The proportion of consistently u-sing condom during anal sex among MSM was 45.5%. [Conclusion]There are many risk factors involved in the spread of HIV, HIV infection is spreading among high-risk populations in Shaanxi Province. It is necessary to reinforce health education and behavioral intervention among high-risk population.%目的 了解陕西省各类高危人群中艾滋病病毒(HIV)感染流行趋势和相关行为变化信息,为艾滋病综合防治和干预提供依据.方法 按照国家监测方案要求,对吸毒者、男男性行为者、暗娼和性病门诊男性就诊者等高危人群进行问卷调查和HIV抗体检测.结果 2010年陕西省4类高危人群共监测10 305例,检出HIV抗体阳性63例.1/3的吸毒哨点检出HIV抗体阳性,HIV抗体阳性率为0.3%;男男性行为者哨点HIV抗体阳性率为8.8%;暗娼和性病门诊男性就诊者人群哨点HIV抗体阳性率均为0.0%.吸毒人群和暗娼每次性行为都使用安全套的比例分别为8.2%和59.4%,男男性行

  1. Sexual behavior, risk perception, and HIV transmission can respond to HIV antiviral drugs and vaccines through multiple pathways.

    Science.gov (United States)

    Tully, Stephen; Cojocaru, Monica; Bauch, Chris T

    2015-10-28

    There has been growing use of highly active antiretroviral treatment (HAART) for HIV and significant progress in developing prophylactic HIV vaccines. The simplest theories of counterproductive behavioral responses to such interventions tend to focus on single feedback mechanisms: for instance, HAART optimism makes infection less scary and thus promotes risky sexual behavior. Here, we develop an agent based, age-structured model of HIV transmission, risk perception, and partner selection in a core group to explore behavioral responses to interventions. We find that interventions can activate not one, but several feedback mechanisms that could potentially influence decision-making and HIV prevalence. In the model, HAART increases the attractiveness of unprotected sex, but it also increases perceived risk of infection and, on longer timescales, causes demographic impacts that partially counteract HAART optimism. Both HAART and vaccination usually lead to lower rates of unprotected sex on the whole, but intervention effectiveness depends strongly on whether individuals over- or under-estimate intervention coverage. Age-specific effects cause sexual behavior and HIV prevalence to change in opposite ways in old and young age groups. For complex infections like HIV-where interventions influence transmission, demography, sexual behavior and risk perception-we conclude that evaluations of behavioral responses should consider multiple feedback mechanisms.

  2. Sexual risk reduction among HIV-positive drug-using men who have sex with men.

    Science.gov (United States)

    Patterson, Thomas L; Semple, Shirley J

    2003-12-01

    According to the US Centers for Disease Control, the majority of new HIV infections are the direct result of unprotected sexual relations between serodiscordant individuals. Thus, the development of behavioral interventions to increase the safer sex practices of HIV-positive individuals has the potential to reduce the number of new infections. Currently, less than 1% of the total US population is infected with HIV. Targeting behavioral interventions to this smaller group of HIV-positive individuals has the potential for making cost-effective reductions in the number of new infections. Despite reports that some HIV-positive individuals continue to engage in high-risk behaviors, interventions designed to prevent secondary transmission of HIV are rare. In this era of highly active antiretroviral therapy (HAART), interventions for HIV-positive individuals are more critical than ever to address the unique challenges and issues they face regarding disclosure and partner notification, use of HAART and sexual risk behavior, and HIV-related stigma. Although a growing number of reports document the efficacy of sexual risk reduction interventions for HIV-positive individuals, to date none of these studies have focused on drug-using populations. This article focuses on sexual risk reduction interventions for HIV-positive men who have sex with men (MSM), the largest group of HIV-positive individuals in the United States. It reviews factors associated with high-risk behaviors and discusses some findings from research with HIV-positive methamphetamine users, including (1) data from a small qualitative study and its implications for the development of new interventions, and (2) baseline data from an ongoing large-scale study of the efficacy of a theory-based sexual risk reduction intervention for HIV-positive methamphetamine-using MSM. The article concludes with a discussion of future research issues, including, for example: Can sexual risks be reduced in the context of active

  3. Risk Factors for the Spread of HIV and Other Sexually Transmitted Infections Among HIV-infected Men Who Have Sex with Men in Lima, Peru

    Science.gov (United States)

    Clark, JL; Konda, KA; Segura, ER; Salvatierra, HJ; Leon, SR; Hall, ER; Caceres, CF; Klausner, JD; Coates, TJ

    2008-01-01

    Objectives To assess the prevalence of sexually transmitted infections (STIs), frequency of sexual risk behaviors, and relationship between knowledge of HIV infection status and sexual risk behavior among HIV-infected men who have sex with men (MSM) attending an STI clinic in Peru. Methods We recruited a convenience sample of 559 MSM from a municipal STI clinic in Lima, Peru. Participants completed a survey and provided blood for HIV, Syphilis, and HSV-2 antibody testing, and urine for gonorrhea and chlamydia nucleic acid testing. Results Among 124 HIV-infected MSM, 72.6% were aware of their HIV-infected status. Active syphilis (RPR≥1:8) was diagnosed in 21.0% of HIV-infected participants, HSV-2 in 79.8%, urethral gonorrhea in 1.6%, and chlamydia in 1.6%. Among 41 participants reporting insertive anal intercourse with their last sex partner, 34.2% did not use a condom. Of 86 participants reporting receptive anal intercourse, 25.6% did not use a condom. At least one episode of insertive unprotected anal intercourse (UAI) with an HIV-uninfected partner during the previous six months was reported by 33.6% (35/104) of participants, and receptive UAI with an HIV-uninfected partner by 44.6% (45/101). No difference in frequency of UAI, with HIV-uninfected or HIV-infected partners, was observed between men who knew their serostatus compared with those who were previously undiagnosed (all p-values >0.05). Conclusions HIV-infected MSM in Peru engaged in high-risk behaviors for spreading HIV and STIs. Knowledge of HIV-infected status was not associated with a decreased frequency of unprotected anal intercourse. Additional efforts to reduce risk behavior after the diagnosis of HIV infection are necessary. PMID:19028945

  4. Ethnicity and HIV risk behaviour, testing and knowledge in Guatemala

    Science.gov (United States)

    Taylor, Tory M.; Hembling, John; Bertrand, Jane T.

    2015-01-01

    Objectives. To describe levels of risky sexual behaviour, HIV testing and HIV knowledge among men and women in Guatemala by ethnic group and to identify adjusted associations between ethnicity and these outcomes. Design. Data on 16,205 women aged 15–49 and 6822 men aged 15–59 from the 2008–2009 Encuesta Nacional de Salud Materno Infantil were used to describe ethnic group differences in sexual behaviour, HIV knowledge and testing. We then controlled for age, education, wealth and other socio-demographic factors in a multivariate logistic regression model to examine the effects of ethnicity on outcomes related to age at sexual debut, number of lifetime sex partners, comprehensive HIV knowledge, HIV testing and lifetime sex worker patronage (men only). Results. The data show low levels of risky sexual behaviour and low levels of HIV knowledge among indigenous women and men, compared to other respondents. Controlling for demographic factors, indigenous women were more likely than other women never to have been tested for HIV and to lack comprehensive HIV knowledge. They were less likely to report early sexual debut and three or more lifetime sexual partners. Indigenous men were more likely than other men to lack comprehensive HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more lifetime sexual partners and sex worker patronage. Conclusions. The Mayan indigenous population in Guatemala, while broadly socially vulnerable, does not appear to be at elevated risk for HIV based on this analysis of selected risk factors. Nonetheless, low rates of HIV knowledge and testing may be cause for concern. Programmes working in indigenous communities should focus on HIV education and reducing barriers to testing. Further research into the factors that underlie ethnic self-identity and perceived ethnicity could help clarify the relative significance of these measures for HIV risk and other health outcomes. PMID:24834462

  5. HIV Risk Behaviors among African American Women with at-Risk Male Partners

    Science.gov (United States)

    Paxton, Keisha C.; Williams, John K.; Bolden, Sherica; Guzman, Yesenia; Harawa, Nina T.

    2014-01-01

    Background HIV continues to impact African American women at alarming rates. Yet, few researchers have examined the relationship factors promoting unprotected sex within African American communities, especially instances in which women are aware that their male partners are engaging in high risk behaviors. This qualitative study explored the sexual behaviors, relationship characteristics, and HIV prevention strategies utilized by African American women in relationships with African American men at-risk for HIV. Method To understand the issues that should be addressed in a sexual risk-reduction intervention, data were collected from three, two-hour focus group discussions (n=24) comprised primarily of low-income African American women with histories of at-risk male sex partners. At-risk partners included specifically men who had sex with other men or with transgender individuals, used crack cocaine or injection drugs, had lengthy incarceration periods, or an unknown sexual history. Discussion questions examined external factors affecting sexual risk behaviors such as societal pressures, peer norms, and financial vulnerability. Discussions were audiotaped, transcribed, and analyzed using a consensual qualitative research approach. Results Five themes, including self-esteem, social influences on behavior, relationship fidelity, sexual risk behavior, and partners' sexual behaviors, were identified as placing women at increased risk for HIV. Reasons for inconsistent condom use included concern for maintaining the relationship and substance use before and during sex. African American women also believed that men who have sex with men and women (MSMW) were dishonest about their sexuality due to stigma towards homosexuality/bisexuality. Despite these challenges, participants indicated that African American women have a strong sense of pride that can positively impact behaviors in relationships. Conclusion The findings of this study support that social and contextual factor

  6. Condom use, risk perception, and HIV knowledge: a comparison across sexes in Nigeria

    Directory of Open Access Journals (Sweden)

    Lammers J

    2013-10-01

    Full Text Available Judith Lammers,1 Sweder JG van Wijnbergen,2 Daan Willebrands3 1Academic Medical Center, 2Faculty of Economics and Business, University of Amsterdam, 3Atradius Credit Insurance, Amsterdam, The Netherlands Background: This paper analyzes how different types of Human immunodeficiency virus (HIV knowledge influences condom use across the sexes. Methods: The empirical work was based on a household survey conducted among 1979 households of a representative group of stallholders in Lagos, Nigeria in 2008. Condom use during last sexual intercourse was analyzed using a multivariate model corrected for clustering effects. The data included questions on socioeconomic characteristics, knowledge of the existence of HIV, HIV prevention, HIV stigma, intended pregnancy, and risk perceptions of engaging in unprotected sex. Results: A large HIV knowledge gap between males and females was observed. Across the sexes, different types of knowledge are important in condom use. Low-risk perceptions of engaging in unprotected sex and not knowing that condoms prevent HIV infection appear to be the best predictors for risky sexual behavior among men. For females, stigma leads to lower condom use. Obviously, lack of knowledge on where condoms are available (9.4% and 29.1% of male and female respondents, respectively reduced condom use in both males and females. Conclusion: The results call for programmatic approaches to differentiate between males and females in the focus of HIV prevention campaigns. Moreover, the high predictive power of high-risk perceptions of engaging in unprotected sex (while correcting for other HIV knowledge indicators calls for further exploration on how to influence these risk perceptions in HIV prevention programs. Keywords: Africa, condom, males, females, HIV/AIDS, knowledge, prevention, risk perception

  7. Risk factors for helminth, malaria, and HIV infection in pregnancy in Entebbe, Uganda.

    Directory of Open Access Journals (Sweden)

    Patrick William Woodburn

    2009-06-01

    Full Text Available Infections during pregnancy may have serious consequences for both mother and baby. Assessment of risk factors for infections informs planning of interventions and analysis of the impact of infections on health outcomes.To describe risk factors for helminths, malaria and HIV in pregnant Ugandan women before intervention in a trial of de-worming in pregnancy.The trial recruited 2,507 pregnant women between April 2003 and November 2005. Participants were interviewed and blood and stool samples obtained; location of residence at enrolment was mapped. Demographic, socioeconomic, behavioral and other risk factors were modelled using logistic regression.There was a high prevalence of helminth, malaria and HIV infection, as previously reported. All helminths and malaria parasitemia were more common in younger women, and education was protective against every infection. Place of birth and/or tribe affected all helminths in a pattern consistent with the geographical distribution of helminth infections in Uganda. Four different geohelminths (hookworm, Trichuris, Ascaris and Trichostrongylus showed a downwards trend in prevalence during the enrolment period. There was a negative association between hookworm and HIV, and between hookworm and low CD4 count among HIV-positive women. Locally, high prevalence of schistosomiasis and HIV occurred in lakeshore communities.Interventions for helminths, malaria and HIV need to target young women both in and out of school. Antenatal interventions for malaria and HIV infection must continue to be promoted. Women originating from a high risk area for a helminth infection remain at high risk after migration to a lower-risk area, and vice versa, but overall, geohelminths seem to be becoming less common in this population. High risk populations, such as fishing communities, require directed effort against schistosomiasis and HIV infection.

  8. HIV-related risk among female migrants working in entertainment venues in China.

    Science.gov (United States)

    Huang, Wen; Operario, Don; Dong, Yanyan; Zaller, Nickolas; Song, Dandan; He, Huan; Tao, Haidong; Xia, Junrui; Zhang, Hongbo

    2014-06-01

    China has experienced a surge in internal migration during the past decade, and migrant populations have been identified as a high-risk group for HIV and other sexually transmitted infections (STIs). Young female migrants often find employment in entertainment venues (bars, karaoke parlors, and massage parlors) located in metropolitan cities, and sex work transactions frequently occur in these venues. We examined factors associated with risk for HIV, other STIs, and reproductive health challenges in a cross-sectional study of 358 young female migrants, ages 18-29, working in entertainment venues in a rapidly growing urban city in China. Results indicate high levels of behavioral risk for HIV and other STIs, low rates of HIV testing, and high prevalence of problem drinking and mental health problems, including recent depression symptoms and suicidal ideation. Factors associated with increased STIs and genitourinary tract infections included commercial sex work, early sexual debut, abortion history, illicit drug use, and anxiety. Factors associated with increased HIV testing included employment in an affluent entertainment venue, education level, knowledge about where to obtain free HIV tests, condom use, and general HIV/AIDS knowledge. Findings of this study highlight the insufficient coverage of current public health services to female migrants working in entertainment venues and call for more assertive prevention interventions to mitigate risk for sexual, reproductive, behavioral, and mental health problems in this mobile population.

  9. Risk factors for physical domestic violence in a high-prevalence HIV setting: findings from Project Accept baseline data (HPTN-043

    Directory of Open Access Journals (Sweden)

    Sebastian Kevany

    2013-07-01

    Full Text Available Zimbabwe faces an acute generalized HIV/AIDS epidemic combined with rapidly deteriorating economic and political conditions, under which levels of domestic violence are on the rise. We aimed to determine possible demographic and behavioral factors associated with physical domestic violence in a rural setting in order to better inform both national and local domestic violence and HIV prevention policies. Using the Project Accept baseline data set, we selected demographic, socio-economic, and behavioral variables that might be associated with physical domestic violence based on a review of the literature. Univariate and multivariate analyses were carried out, and odds ratios (OR were computed using logistic regression. Women reporting physical domestic violence were significantly more likely to report (i a history of childhood domestic violence (OR=2.96, P<0.001, (ii two or more lifetime partners (OR=1.94, P<0.001, (iii some form of sexual abuse as a child (OR=1.82, not significant, and (iv low or medium socio-economic status as measured by type of homestead (OR=1.4, P=0.04 than women who reported no experience of physical domestic violence. Married women were less likely to experience physical domestic violence than unmarried women (OR=0.65, P=0.011. Women at greatest risk of domestic violence include those with a personal history of violence or sexual abuse, multiple lifetime partners, and low or medium socio-economic status. Risk assessments and joint interventions for both domestic violence reduction and HIV prevention should target these population groups, which are effective both on the public health and global heath diplomacy levels.

  10. Inflammatory cytokine biomarkers to identify women with asymptomatic sexually transmitted infections and bacterial vaginosis who are at high risk of HIV infection.

    Science.gov (United States)

    Masson, Lindi; Arnold, Kelly B; Little, Francesca; Mlisana, Koleka; Lewis, David A; Mkhize, Nonhlanhla; Gamieldien, Hoyam; Ngcapu, Sinaye; Johnson, Leigh; Lauffenburger, Douglas A; Abdool Karim, Quarraisha; Abdool Karim, Salim S; Passmore, Jo-Ann S

    2016-05-01

    Untreated sexually transmitted infections (STIs) and bacterial vaginosis (BV) cause genital inflammation and increase the risk of HIV infection. WHO-recommended syndromic STI and BV management is severely limited as many women with asymptomatic infections go untreated. The purpose of this cross-sectional study was to evaluate genital cytokine profiles as a biomarker of STIs and BV to identify women with asymptomatic, treatable infections. Concentrations of 42 cytokines in cervicovaginal lavages from 227 HIV-uninfected women were measured using Luminex. All women were screened for BV by microscopy and STIs using molecular assays. Multivariate analyses were used to identify cytokine profiles associated with STIs/BV. A multivariate profile of seven cytokines (interleukin (IL)-1α, IL-1β, tumour necrosis factor-β, IL-4, fractalkine, macrophage-derived chemokine, and interferon-γ) most accurately predicted the presence of a treatable genital condition, with 77% classification accuracy and 75% cross-validation accuracy (sensitivity 72%; specificity 81%, positive predictive value (PPV) 86%, negative predictive value (NPV) 64%). Concomitant increased IL-1β and decreased IP-10 concentrations predicted the presence of a treatable genital condition without a substantial reduction in predictive value (sensitivity 77%, specificity 72%, PPV 82% and NPV 65%), correctly classifying 75% of the women. This approach performed substantially better than clinical signs (sensitivity 19%, specificity 92%, PPV 79% and NPV 40%). Supplementing syndromic management with an assessment of IL-1β and IP-10 as biomarkers of genital inflammation may improve STI/BV management for women, enabling more effective treatment of asymptomatic infections and potentially reducing their risk of HIV infection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Time trends for risk of severe age-related diseases in individuals with and without HIV infection in Denmark

    DEFF Research Database (Denmark)

    Rasmussen, Line D; May, Margaret T; Kronborg, Gitte

    2015-01-01

    BACKGROUND: Whether the reported high risk of age-related diseases in HIV-infected people is caused by biological ageing or HIV-associated risk factors such as chronic immune activation and low-grade inflammation is unknown. We assessed time trends in age-standardised and relative risks of nine...... serious age-related diseases in a nationwide cohort study of HIV-infected individuals and population controls. METHODS: We identified all HIV-infected individuals in the Danish HIV Cohort Study who had received HIV care in Denmark between Jan 1, 1995, and June 1, 2014. Population controls were identified...... from the Danish Civil Registration System and individually matched in a ratio of nine to one to the HIV-infected individuals for year of birth, sex, and date of study inclusion. Individuals were included in the study if they had a Danish personal identification number, were aged 16 years or older...

  12. Prevalence, correlates, and risk perception of HIV infection among heroin users in Central Taiwan.

    Science.gov (United States)

    Lin, Tsang-Yaw; Chen, Vincent C H; Lee, Chao-Hui; Chen, Chung-Ying; Shao, Wen-Chuan; Chang, Sheng-Huang; Chou, Jen-Yu; Lai, Te-Jen; Ferri, Cleusa P; Gossop, Michael; Lee, Charles T C

    2013-12-01

    We investigated the prevalence and correlated factors of human immunodeficiency virus (HIV) among heroin users attending methadone maintenance treatment (MMT) programs in Central Taiwan, and explored the degree of risk perception of HIV infection among the participants. Our study participants were 781 heroin users seeking treatment at the MMT program at Tsaotun Psychiatric Center in Taiwan. The presence of HIV antibodies was identified by microparticle enzyme immunoassay and confirmed by western blot. Multivariate logistic regression was used to identify the independent correlates of HIV infection. The mean age of the sample was 36.1 years [standard deviation (SD) = 7.6]; of the patients, 710 (90.9%) were men. The prevalence of HIV infection among our study population was 20.7%. Multivariate logistic regression analysis revealed that HIV infection was independently associated with the age of the patients of initial heroin use, heroin injection use, nondrug-related criminal convictions, needle-sharing behaviors, and sharing injection paraphernalia. A strong agreement existed between self-reported HIV serostatus and the results of laboratory analyses, with 88.8% of patients reporting their condition correctly. We found a high rate of HIV infection among patients in the MMT program. Factors associated with HIV infection were mostly related to drug-use behaviors. These findings stress the importance of education regarding drug-risk behaviors. Copyright © 2013. Published by Elsevier B.V.

  13. Prevalence, correlates, and risk perception of HIV infection among heroin users in Central Taiwan

    Directory of Open Access Journals (Sweden)

    Tsang-Yaw Lin

    2013-12-01

    Full Text Available We investigated the prevalence and correlated factors of human immunodeficiency virus (HIV among heroin users attending methadone maintenance treatment (MMT programs in Central Taiwan, and explored the degree of risk perception of HIV infection among the participants. Our study participants were 781 heroin users seeking treatment at the MMT program at Tsaotun Psychiatric Center in Taiwan. The presence of HIV antibodies was identified by microparticle enzyme immunoassay and confirmed by western blot. Multivariate logistic regression was used to identify the independent correlates of HIV infection. The mean age of the sample was 36.1 years [standard deviation (SD = 7.6]; of the patients, 710 (90.9% were men. The prevalence of HIV infection among our study population was 20.7%. Multivariate logistic regression analysis revealed that HIV infection was independently associated with the age of the patients of initial heroin use, heroin injection use, nondrug-related criminal convictions, needle-sharing behaviors, and sharing injection paraphernalia. A strong agreement existed between self-reported HIV serostatus and the results of laboratory analyses, with 88.8% of patients reporting their condition correctly. We found a high rate of HIV infection among patients in the MMT program. Factors associated with HIV infection were mostly related to drug-use behaviors. These findings stress the importance of education regarding drug-risk behaviors.

  14. Risk of progression to AIDS and death in women infected with HIV-1 initiating highly active antiretroviral treatment at different stages of disease.

    Science.gov (United States)

    Anastos, Kathryn; Barrón, Yolanda; Miotti, Paolo; Weiser, Barbara; Young, Mary; Hessol, Nancy; Greenblatt, Ruth M; Cohen, Mardge; Augenbraun, Michael; Levine, Alexandra; Muñoz, Alvaro

    2002-09-23

    The optimal virologic and immunologic stage at which to initiate antiretroviral therapy in individuals infected with human immunodeficiency virus type 1 (HIV-1) is undefined. Among 1054 HIV-1-infected women in a prospective cohort study, we determined the time from initiation of highly active antiretroviral treatment (HAART) to acquired immunodeficiency syndrome (AIDS) and death. Median follow-up was 3.4 years. Of 553 women without AIDS at HAART initiation, 62 (11%) developed AIDS. Compared with women with CD4(+) cell counts greater than 350/microL at HAART initiation, women with cell counts of 200 to 350/microL and less than 200/microL had relative hazards (RHs) for progression to AIDS of 0.93 (95% confidence interval [CI], 0.46-1.86) and 2.48 (95% CI, 1.39-4.42), respectively. Compared with those with HIV-1 RNA values less than 5000 copies/mL, women with 5000 to 50,000 copies/mL and greater than 50,000 copies/mL had RHs of 1.39 (95% CI, 0.74-2.64) and 2.09 (95% CI, 1.09-3.99), respectively. Among women with AIDS at HAART initiation (n = 501), RHs of death were 1.97 (95% CI, 0.84-4.66) and 3.35 (95% CI, 1.59-7.08) with CD4(+) cell counts of 200 to 350/microL and less than 200/microL, respectively, relative to those with greater than 350/microL, and 1.90 (95% CI, 0.84-4.30) and 3.70 (95% CI, 1.81-7.54) for those with HIV-1 RNA values of 5000 to 50,000 and greater than 50,000 copies/mL, respectively, relative to those with less than 5000 copies/mL. Progression to AIDS and death was predicted by pre-HAART values of less than 200/microL for CD4(+) cells and greater than 50,000 HIV-1 RNA copies/mL, indicating that deferral of HAART until the CD4(+) cell count is between 350 and 200/microL is a valid strategy in the clinical management of HIV-1 infection.

  15. 126例MSM HIV/STD感染状况及高危行为调查%Survey of HIV/STD infections among 126 MSM and their high-risk behavior

    Institute of Scientific and Technical Information of China (English)

    李纲; 韩威

    2012-01-01

    school students or blue-collar workers. Those who were seeking sex partners via internet accounted for 78. 5%. The rate of AIDS related awareness among the local MSM was 73. 81% (93/126). In the last six months, 26. 98% had sex with females, the rate of consistent condom use was only 29. 41 %. One hundred and twenty six blood samples were tested, of which 8 were HIV antibody positive, with an infection rate of 6. 35% , and 10 were confirmed syphilis trepo-nema pallidum particle agglutination (TPPA) positive, with an infection rate of 7. 94%. Conclusion The main risk factors among MSM in Xuzhou are related with younger age, internet-based high risk homosexuality and low level of condom use. It is suggested that publicity and education via the MSM network should be emphasized, and interventions for the MSM population and tests for their hetero-sex partners be strengthened, so that AIDS epidemic among MSM in Xuzhou City may be contained.

  16. Highly effective contraception and acquisition of HIV and other sexually transmitted infections.

    Science.gov (United States)

    Morrison, Charles S; Turner, Abigail Norris; Jones, LaShawn B

    2009-04-01

    A key question for clinicians is whether an aetiological association exists between highly effective contraceptive methods and women's risk of acquiring sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). The authors searched the peer-reviewed literature for prospective studies published from January 1966 to August 2008 that assessed contraception and STI/HIV risk. The focus was on combined oral contraceptives (OCs), depot-medroxyprogesterone acetate (DMPA), the T380a copper intra-uterine device (IUD) and the risk of infection with HIV, Chlamydia trachomatis and Neisseria gonorrhoeae. Current data suggest that neither OCs nor DMPA increase HIV risk among women in the general population. Data are equivocal for women in high-risk groups (e.g. sex workers). Current data suggest an increased risk of chlamydial infection associated with OC use, with weaker evidence supporting a harmful effect of DMPA. Reports of OCs and gonococcal infection are inconsistent, and DMPA does not appear to be associated with gonorrhoea acquisition. Data suggest no increased STI/HIV risk among copper IUD users. Prospective data on highly effective contraceptive methods and women's STI/HIV risk are limited, and many studies have important methodological weaknesses. Additional information about the STI/HIV risks associated with these highly effective contraceptive methods is needed.

  17. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men - United States.

    Science.gov (United States)

    2013-11-29

    The burden of human immunodeficiency virus (HIV) is high among gay, bisexual, and other men who have sex with men (MSM). High HIV prevalence, lack of awareness of HIV-positive status, unprotected anal sex, and increased viral load among HIV-positive MSM not on antiretroviral treatment contribute substantially to new infections among this population. CDC analyzed data from the National HIV Surveillance System (NHSS) to estimate the percentage of HIV diagnoses among MSM by area of residence and data from the National HIV Behavioral Surveillance System (NHBS) to estimate unprotected anal sex in the past 12 months among MSM in 2005, 2008, and 2011; unprotected discordant anal sex at last sex (i.e., with a partner of opposite or unknown HIV status) in 2008 and 2011; and HIV testing history and the percentage HIV-positive but unaware of their HIV status by the time since their last HIV test in 2011. This report describes the results of these analyses. In all but two states, the majority of new HIV diagnoses were among MSM in 2011. Unprotected anal sex at least once in the past 12 months increased from 48% in 2005 to 57% in 2011 (panal sex was 13% in 2008 and 2011. In 2011, 33% of HIV-positive but unaware MSM reported unprotected discordant anal sex. Among MSM with negative or unknown HIV status, 67% had an HIV test in the past 12 months. Among those tested recently, the percentage HIV-positive but unaware of their infection was 4%, 5%, and 7% among those tested in the past ≤3, 4-6, and 7-12 months, respectively. Expanded efforts are needed to reduce HIV risk behaviors and to promote at least annual HIV testing among MSM.

  18. HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions

    Directory of Open Access Journals (Sweden)

    Balogun Joseph A

    2009-08-01

    Full Text Available Abstract Background The college environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. While the overall incidence of HIV infection has seen some decline in recent years, rates of HIV infection among young adults have not seen a proportionate decline. As in the general population, African American young adults have been disproportionately affected by the HIV/AIDS epidemic. This study examined the sexual risk behaviors and perception of HIV risk of students in a predominantly African American commuter urban university in the Midwest. Methods Students enrolled in randomly selected general education courses completed a paper and pencil survey. Data were collected in Fall 2007, and univariate, bivariate, and multivariate analyses were conducted using SPSS for Windows v.16. Results The sample included 390 students, the majority (83% of whom were never married and 87% were sexually experienced. Among males reporting male partnerships those who used marijuana (OR = 17.5, p = 0.01 and those who used alcohol along with illegal drugs (OR = 8.8, p = 0.03 were significantly more likely to report multiple partnerships. Among females reporting male partnerships, those 30 years and older were significantly less likely (OR = 0.09, p = 0.03 to report having multiple male partners. There were significant differences in condom use last sex (p = 0.01 and consistent condom use (p = 0.002 among the different age groups. Older students were less likely to report condom use. Females age 30 years and older (OR = 3.74, p = 0.05 and respondents age 20–29 years (OR = 2.41, p = 0.03 were more likely to report inconsistent condom use than those below 20 years. Marijuana use was correlated with inconsistent condom use (p = 0.02 and alcohol with not using condom last sex among females. Perception of HIV risk was generally poor with 54% of those age 30 years and older, 48.1% of 20–29 year olds, and 57.9% of those

  19. HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

    Science.gov (United States)

    Meade, Christina S; Lion, Ryan R; Cordero, Daniella M; Watt, Melissa H; Joska, John A; Gouse, Hetta; Burnhams, Warren

    2016-10-01

    South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

  20. Prediction of HIV Sexual Risk Behaviors among Disadvantaged African American Adults using a Syndemic Conceptual Framework

    Science.gov (United States)

    Nehl, Eric J.; Klein, Hugh; Sterk, Claire E.; Elifson, Kirk W.

    2015-01-01

    The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1,535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographics, and psychological functioning factors helps explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems. PMID:26188618

  1. Prediction of HIV Sexual Risk Behaviors Among Disadvantaged African American Adults Using a Syndemic Conceptual Framework.

    Science.gov (United States)

    Nehl, Eric J; Klein, Hugh; Sterk, Claire E; Elifson, Kirk W

    2016-02-01

    The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographic, and psychological functioning factors help explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems.

  2. Correlates of HIV Risks Among Women on Probation and Parole.

    Science.gov (United States)

    Engstrom, Malitta; Winham, Katherine M; Golder, Seana; Higgins, George; Renn, Tanya; Logan, T K

    2017-06-01

    This article examines HIV risks among a sample of 406 women on probation and parole with lifetime histories of victimization who were recruited from an urban community in the southern U.S. Guided by the Comprehensive Health Seeking and Coping Paradigm, we analyze the significance of sociodemographic characteristics, substance use, posttraumatic stress disorder, and social support in relationship to three sexual risks and one drug use risk using multivariable regression. Findings indicate that substance use is a significant correlate of nearly all HIV risks examined, including lifetime sexual partners and sexual partners during the past 12 months. Age, race/ethnicity, homelessness, lifetime traumatic event exposure, regular use of alcohol to intoxication and other drugs, functional social support, and substance use treatment in the past 12 months are associated with specific HIV risks. The findings identify potential targets to address in HIV prevention with women on probation and parole who have experienced victimization.

  3. Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe.

    Science.gov (United States)

    Zhou, Danai Tavonga; Kodogo, Vitaris; Chokuona, Kudzai Fortunate Vongai; Gomo, Exnevia; Oektedalen, Olav; Stray-Pedersen, Babill

    2015-01-01

    The chronic inflammation induced by human immunodeficiency virus (HIV) contributes to increased risk of coronary heart disease (CHD) in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years). Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART) for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART-for total cholesterol (TC) and high-density lipoprotein (HDL). Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings were associated with medium to high risk of CHD. There is small risk of developing CHD, during the next decade in HIV infected patients at an HIV treatment clinic in Harare.

  4. Risk factors associated with HIV infection among young persons ...

    African Journals Online (AJOL)

    Joshua Kembo * Joshua Kembo (PhD) is a Senior Researcher in the Bureau of Market Research (BMR) at the University of South Africa (Unisa). He holds a PhD in Epidemiology obtained from the School of Health Systems and Public Health (SHSPH) at the University of Pretoria. kemboj@unisa.ac.za

    2012-05-30

    May 30, 2012 ... To cite this article: Joshua Kembo (2012): Risk factors associated with HIV infection among young .... prevention programmes to combat the spread of HIV and AIDS ... 14.3% (Zimbabwe Ministry of Labour and Social Welfare 2010). Various ...... geted at young persons aged 15–24 years to include promoting.

  5. A survey of risk behaviour for contracting HIV among adult ...

    African Journals Online (AJOL)

    African Journal of Psychiatry • September 2012. 329. Introduction ... behaviour may lead patients to engage in HIV-related risk ... or drugs, having sex with risky partners (intravenous drug users and sex .... Level of education and sexual orientation did not affect HIV .... them in private rooms, and looking after them under one-.

  6. Sexual Behavior and HIV Risk in Kenya: Epowering Youth in HIV Prevention

    NARCIS (Netherlands)

    C.W. Njue (Carolyne)

    2011-01-01

    textabstractThis thesis explores three topics concerning youth in Kenya: their knowledge and information needs regarding sexual and reproductive health including HIV/AIDS; their sexual risk behaviour; and HIV prevention efforts targeted at them. The data on which these studies are based were

  7. HIV tropism and decreased risk of breast cancer.

    Directory of Open Access Journals (Sweden)

    Nancy A Hessol

    Full Text Available BACKGROUND: During the first two decades of the U.S. AIDS epidemic, and unlike some malignancies, breast cancer risk was significantly lower for women with human immunodeficiency virus (HIV infection compared to the general population. This deficit in HIV-associated breast cancer could not be attributed to differences in survival, immune deficiency, childbearing or other breast cancer risk factors. HIV infects mononuclear immune cells by binding to the CD4 molecule and to CCR5 or CXCR4 chemokine coreceptors. Neoplastic breast cells commonly express CXCR4 but not CCR5. In vitro, binding HIV envelope protein to CXCR4 has been shown to induce apoptosis of neoplastic breast cells. Based on these observations, we hypothesized that breast cancer risk would be lower among women with CXCR4-tropic HIV infection. METHODS AND FINDINGS: We conducted a breast cancer nested case-control study among women who participated in the WIHS and HERS HIV cohort studies with longitudinally collected risk factor data and plasma. Cases were HIV-infected women (mean age 46 years who had stored plasma collected within 24 months of breast cancer diagnosis and an HIV viral load≥500 copies/mL. Three HIV-infected control women, without breast cancer, were matched to each case based on age and plasma collection date. CXCR4-tropism was determined by a phenotypic tropism assay. Odds ratios (OR and 95% confidence intervals (CI for breast cancer were estimated by exact conditional logistic regression. Two (9% of 23 breast cancer cases had CXCR4-tropic HIV, compared to 19 (28% of 69 matched controls. Breast cancer risk was significantly and independently reduced with CXCR4 tropism (adjusted odds ratio, 0.10, 95% CI 0.002-0.84 and with menopause (adjusted odds ratio, 0.08, 95% CI 0.001-0.83. Adjustment for CD4+ cell count, HIV viral load, and use of antiretroviral therapy did not attenuate the association between infection with CXCR4-tropic HIV and breast cancer. CONCLUSIONS: Low

  8. Crystal methamphetamine use and sexual risk behaviors among HIV-positive and HIV-negative men who have sex with men in South Florida.

    Science.gov (United States)

    Forrest, David W; Metsch, Lisa R; LaLota, Marlene; Cardenas, Gabriel; Beck, Dano W; Jeanty, Yves

    2010-05-01

    Using data collected through venue-based sampling in South Florida from 2004 to 2005 as part of the Centers for Disease Control and Prevention-funded National HIV Behavioral Surveillance Among Men Who Have Sex with Men, we estimate the prevalence of crystal methamphetamine use and its association with high-risk sexual behaviors among a large and diverse sample of men who have sex with men (MSM) residing in South Florida. We also examine how these associations differ between HIV-positive and HIV-negative men. Bivariate analyses were used to assess the characteristics of study participants and their sexual risk behaviors by drug use and self-reported HIV status group. Of 946 MSM participants in South Florida, 18% reported crystal methamphetamine use in the past 12 months. Regardless of self-reported HIV status, crystal methamphetamine users were more likely to report high-risk sexual behaviors, an increased number of non-main sex partners, and being high on drugs and/or alcohol at last sex act with a non-main partner. Our findings indicate that crystal methamphetamine use is prevalent among the MSM population in South Florida, and this prevalence rate is similar, if not higher, than that found in US cities that have been long recognized for having a high rate of crystal methamphetamine use among their MSM populations. Notably, the use of crystal methamphetamine among both HIV-positive and HIV-negative MSM is associated with increased HIV-related risk behaviors.

  9. Assessment of the Ability of a Fourth-Generation Immunoassay for Human Immunodeficiency Virus (HIV) Antibody and p24 Antigen To Detect both Acute and Recent HIV Infections in a High-Risk Setting ▿

    OpenAIRE

    Mark W Pandori; Hackett, John; Louie, Brian; Vallari, Ana; Dowling, Teri; Liska, Sally; Klausner, Jeffrey D

    2009-01-01

    An immunoassay (IA) that simultaneously detects both antibody to human immunodeficiency virus (HIV) and HIV p24 antigen (Architect HIV Ag/Ab Combo) was evaluated for its ability to detect HIV infection by using a panel of specimens collected from individuals recently infected with HIV type 1 (HIV-1). This IA was found to be capable of detecting the majority (89%) of infections, including 80% of those considered acute infections based on the presence of HIV RNA and the lack of detectable antib...

  10. HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV.

    Science.gov (United States)

    Pantelic, Marija; Boyes, Mark; Cluver, Lucie; Meinck, Franziska

    2017-08-21

    Internalized HIV stigma is a key risk factor for negative outcomes amongst adolescents living with HIV (ALHIV), including non-adherence to anti-retroviral treatment, loss-to-follow-up and morbidity. This study tested a theoretical model of multi-level risk pathways to internalized HIV stigma among South African ALHIV. From 2013 to 2015, a survey using total population sampling of ALHIV who had ever initiated anti-retroviral treatment (ART) in 53 public health facilities in the Eastern Cape, South Africa was conducted. Community-tracing ensured inclusion of ALHIV who were defaulting from ART or lost to follow-up. 90.1% of eligible ALHIV were interviewed (n = 1060, 55% female, mean age = 13.8, 21% living in rural locations). HIV stigma mechanisms (internalized, enacted, and anticipated), HIV-related disability, violence victimization (physical, emotional, sexual abuse, bullying victimization) were assessed using well-validated self-report measures. Structural equation modelling was used to test a theoretically informed model of risk pathways from HIV-related disability to internalized HIV stigma. The model controlled for age, gender and urban/rural address. Prevalence of internalized HIV stigma was 26.5%. As hypothesized, significant associations between internalized stigma and anticipated stigma, as well as depression were obtained. Unexpectedly, HIV-related disability, victimization, and enacted stigma were not directly associated with internalized stigma. Instead significant pathways were identified via anticipated HIV stigma and depression. The model fitted the data well (RMSEA = .023; CFI = .94; TLI = .95; WRMR = 1.070). These findings highlight the complicated nature of internalized HIV stigma. Whilst it is seemingly a psychological process, indirect pathways suggest multi-level mechanisms leading to internalized HIV stigma. Findings suggest that protection from violence within homes, communities and schools may interrupt risk pathways from HIV

  11. Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal

    Science.gov (United States)

    Kakchapati, Sampurna; Singh, Dipendra Raman; Rawal, Bir Bahadhur; Lim, Apiradee

    2017-01-01

    Purpose Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it. Materials and methods The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome. Results A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV. Conclusion HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs.

  12. HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia

    Directory of Open Access Journals (Sweden)

    Kwee Choy Koh

    2014-01-01

    Full Text Available We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM clients who received voluntary counseling and testing (VCT services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9% clients rated themselves as low risk, 118 (27.9% as medium risk, 36 (8.5% as high risk, and 168 (39.7% were unsure of their risk. Twenty-four (9.4% clients tested HIV positive (4 (4% low risk, 9 (7.6% medium risk, 11 (30.6% high risk, and 13 (7.7% unsure risk. We found a positive correlation between risk perception and HIV infection in this study. Clients with high HIV risk perception have 17x the odds of testing HIV positive compared to low risk clients. High HIV risk perception was significantly associated with multiple sex partners, multiple types of sex partners, alcohol use before intercourse, unprotected sex beyond 6 months, and inconsistent condom use during anal sex compared to low risk clients. There were no statistically significant differences between medium risk and unsure risk clients compared to low risk clients. Strategies should be targeted towards change in sexual practices among those who are perceived to be at high risk.

  13. 跨境 HIV 阳性越南籍女性性工作者高危性行为定性分析%The qualitative analysis of high-risk sexual behavior of cross-border HIV-positive in Vietnamese female sex workers

    Institute of Scientific and Technical Information of China (English)

    朵林; 姜荻; 聂沛沛; 罗志; 薛皓铭; 杨丽华; 钟君睿; 季雪

    2012-01-01

      Objective To know the HIV-related high-risk sexual behavior and causes of cross-border Vietnamese HIV-positive female sex workers(FSWs), to provide a basis for developing AIDS preventing and controlling by Sino-Vietnam jointed. Method Selecting Hekou as the investigation site, purpose sampling selected 4 HIV-positive Vietnamese FSWs, 1 whoremaster, 1 outreach person and 1 project administer for the survey with semi-structured interview outline by individual in-depth interviews, to collect the information of their cross-border situation, high-risk sexual behavior and related HIV infectious reason. Results Vietnamese HIV-positive FSWs have a low educational level, come from the rural areas, no one speak Chinese and often being rent out by the bosses. They have high risk sexual behavior with both Chinese and Vietnamese clients, however, most with local Chinese residents and truck drivers. Conclusions Only to provide a few condoms is not enough for HIV/AIDS control of cross border FSWs. The more comprehensive measures should considered as Vietnamese language outreach service, publicity distribution, HIV/AIDS counseling & testing, sex transmitted disease treatment, antiretroviral therapy and cross-border cooperation to decrease the border spread of HIV / AIDS effectively.%  [目的]了解跨境 HIV 阳性越南籍女性性工作者(以下称为 FSWs)感染 HIV 相关高危性行为及原因,为中越跨境合作开展艾滋病防治提供依据。[方法]以河口县为调查点,目的抽样方法选取 HIV 阳性越南籍 FSWs4名、嫖客、项目管理人员及外展各1名为调查对象,按照半结构访谈提纲进行个人深入访谈,收集其跨境、高危性行为及 HIV 感染原因等信息。[结果]越南籍 FSWs 都来自越南农村,文化程度低,都不会说汉语,经常被老板转租。与中国人、越南人发生高危性行为,大部分嫖客为中方当地居民及长卡司机。[结论]仅为跨境 FSWs 提供少

  14. [Competitive karate and the risk of HIV infection--review, risk analysis and risk minimizing strategies].

    Science.gov (United States)

    Müller-Rath, R; Mumme, T; Miltner, O; Skobel, E

    2004-03-01

    Bleeding facial injuries are not uncommon in competitive karate. Nevertheless, the risk of an infection with HIV is extremely low. Guidelines about the prevention of HIV infections are presented. Especially in contact sports and martial arts the athletes, judges and staff have to recognize and employ these recommendations. Bleeding wounds of the hands due to contact with the opponents teeth can be minimized by fist padding.

  15. Epidemiology, Risk Factors and Genotypes of HBV in HIV-Infected Patients in the Northeast Region of Colombia: High Prevalence of Occult Hepatitis B and F3 Subgenotype Dominance

    OpenAIRE

    Henry Bautista-Amorocho; Yeny Zulay Castellanos-Domínguez; Laura Andrea Rodríguez-Villamizar; Sindi Alejandra Velandia-Cruz; Jeysson Andrey Becerra-Peña; Ana Elvira Farfán-García

    2014-01-01

    Introduction Chronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission. Objectives Our aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city. Methods A c...

  16. HIV knowledge, risk perception and pre-exposure prophylaxis interest among Thai university students.

    Science.gov (United States)

    Khawcharoenporn, Thana; Chunloy, Krongtip; Apisarnthanarak, Anucha

    2015-12-01

    To assess HIV risk perception and pre-exposure prophylaxis (PrEP) interest among university students, an anonymous survey was conducted among students from a large public university in Thailand. There were 641 participants; 118 (18%) were categorised into moderate or high-risk group. Of these 118 participants, 111 (94%) perceived themselves as no or low risk. Despite high levels of knowledge about HIV transmission risks, rates of consistent condom use with vaginal, oral and anal sex were all low (43%, 18% and 33%, respectively). The low rates of consistent condom use were significantly associated with false perception of low HIV risk (P perception were male gender (P perception and safe sex practices among the university students. © The Author(s) 2015.

  17. Factors Affecting Behaviours that address HIV Risk among Nigerian ...

    African Journals Online (AJOL)

    Factors Affecting Behaviours that address HIV Risk among Nigerian University Students. ... Design: Cross-sectional survey. ... Main outcome measures: Sexual behavior and condom use, knowledge about correct condom use, intention of ...

  18. Herpes simplex virus 2 infection: A risk factor for HIV infection in heterosexuals

    Directory of Open Access Journals (Sweden)

    Anuradha K

    2008-01-01

    Full Text Available Background: Genital ulcerative disease is one of the risk factors for acquisition of HIV. As HSV-2 infection is currently the most common cause of genital ulcerative disease, it acts as a potential risk factor for HIV infection. The present study was undertaken to know the seroprevalence of antibodies to HSV-2 in HIV seropositive individuals and in the general population, and to ascertain if HSV-2 is a risk factor for developing HIV infection. Methods: The study group included one hundred new HIV seropositive persons irrespective of active genital herpes or history of genital herpes. Fifty age- and sex- matched healthy volunteers were included as controls. In all patients and controls, diagnostic serology was done for HSV-2 using HSV-2-specific glycoprotein IgG2 by indirect immunoassay using the ELISA test. Statistical value ′P′ was calculated using the Chi-squared test. Results: Out of the 100 HIV seropositives, 66 were males and 34 were females with an age range of 20-54 years. In only 22 (19 males and 3 females of these, positive history of genital herpes was obtained. In 49 out of the 100 HIV seropositives, IgG2 antibodies against HSV-2 were detected. In the control group, 11 out of 50 controls were seropositive for HSV-2 IgG2 antibody. There was a statistically significant association between HSV-2 and HIV seropositivity with ′P′ value < 0.005. Conclusion: The high prevalence of HSV-2 seropositivity in the HIV-infected group (49% as compared to normal controls (22% was statistically significant. Prior HSV-2 infection could be an important risk factor for acquisition of HIV in our patients.

  19. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alison L Drake

    2014-02-01

    associations and sources of heterogeneity. CONCLUSIONS: Pregnancy and the postpartum period are times of persistent HIV risk, at rates similar to "high risk" cohorts. MTCT risk was elevated among women with incident infections. Detection and prevention of incident HIV in pregnancy/postpartum should be prioritized, and is critical to decrease MTCT.

  20. High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project.

    Science.gov (United States)

    Hoagland, Brenda; Moreira, Ronaldo I; De Boni, Raquel B; Kallas, Esper G; Madruga, José Valdez; Vasconcelos, Ricardo; Goulart, Silvia; Torres, Thiago S; Marins, Luana M S; Anderson, Peter L; Luz, Paula M; Costa Leite, Iuri da; Liu, Albert Y; Veloso, Valdilea G; Grinsztejn, Beatriz

    2017-04-06

    The efficacy of pre-exposure prophylaxis (PrEP) in preventing sexual acquisition of human immunodeficiency virus (HIV) is well established. Little is known about the feasibility of PrEP implementation in middle-income settings with concentrated epidemics among men who have sex with men (MSM) and transgender women (TGW). PrEP Brasil is a prospective, multicentre, open-label demonstration project assessing PrEP delivery in the context of the Brazilian Public Health System. HIV-uninfected MSM and TGW in 3 referral centres in Rio de Janeiro and São Paulo were evaluated for eligibility and offered 48 weeks of daily emtricitabine/tenofovir for PrEP. Concentrations of tenofovir diphosphate in dried blood spot samples (DBS) at week 4 after enrolment (early adherence) were measured. Predictors of drug levels were assessed using ordinal logistic regression models considering the DBS drug level as a 3 level variable (<350 fmol/punch, ≥350-699 fmol/punch and ≥700 fmol/punch). 1,270 individuals were assessed for participation; n = 738 were potentially eligible and n = 450 were offered PrEP (PrEP uptake was 60.9%). Eligible but not enrolled individuals were younger, had lower HIV risk perception and had lower PrEP awareness. At week 4, 424 participants (of the 450 enrolled) had DBS TFV-DP concentrations, 94.1% in the protective range (≥350 fmol/punch, consistent with ≥2 pills per week), and 78% were in the highly protective range (≥700 fmol/punch, ≥4 pills per week). Participants with ≥12 years of schooling had 1.9 times the odds (95%CI 1.10-3.29) of a higher versus lower drug level than participants with <12 years of schooling. Condomless receptive anal intercourse in the prior 3 months was also associated with higher drug levels (adjusted OR = 1.78; 95% CI 1.08-2.94). The high uptake and early adherence indicate that PrEP for high-risk MSM and TGW can be successfully delivered in the context of the Brazilian Public Health System. Interventions to

  1. HIV risk among Australian men travelling overseas: networks and context matter.

    Science.gov (United States)

    Brown, Graham; Ellard, Jeanne; Mooney-Somers, Julie; Hildebrand, Janina; Langdon, Trish

    2012-01-01

    Increasing international mobility presents a risk for communicable disease transmission. Overseas-acquired HIV infections have been increasingly observed across Australian jurisdictions. This includes a mix of men emigrating from countries with high HIV prevalence and men travelling abroad. There is currently little research exploring international mobility and HIV risk, and as a consequence the increase of men acquiring HIV while travelling overseas is poorly understood. This paper draws on data from a qualitative study exploring the risk perspectives and experiences of 14 Australian men who acquired HIV while travelling overseas in the years between 2000 and 2009. Participants articulated a strong desire to distance themselves from the identity of a tourist. Social networks were highlighted as important entry points to engage with other foreign travellers and expatriates. These networks were highly influential and were understood by the participants to provide guidance on how they should negotiate the local scene, including where to meet sex partners. Limited discussion of safe sex and HIV was mentioned in these contexts. The findings suggest that prevalent social norms and social networks play an influential role in how participants negotiate sex and social relations in overseas settings. These networks could potentially provide sites for effective HIV-prevention programmes.

  2. Self-esteem and "at risk" women:determinants and relevance to sexual and HIV-related risk behaviors.

    Science.gov (United States)

    Sterk, Claire E; Klein, Hugh; Elifson, Kirk W

    2004-01-01

    In this study, we describe the relationship between self-esteem and HIV-related risk behaviors, and explore what factors predict self-esteem levels of "at risk" women. Interviews were conducted with 250 (predominantly African American) women living in the Atlanta, Georgia metropolitan area between August 1997 and August 2000. A community identification process was used to identify potential study participants, with further expansion of the sample via targeted and theoretical sampling and ethnographic mapping procedures. Self-esteem was related to the number of times having oral sex, the number of times having sex with paying partners, the frequency of sexual risk-taking (all during the 90 days prior to interview), the number of different HIV risk behaviors practiced during the previous year, and condom use attitudes and self-efficacy. Greater involvement HIV risk behaviors was associated with lower self-esteem. Multivariate analyses revealed five significant predictors of women's self-esteem levels: race, religiosity, childhood experiences with emotional neglect, the number of money-related problems experienced, and the number of drug-related problems experienced. The findings indicate that self-esteem is highly relevant to "at risk" women's HIV risk behavior practices, and this has important implications for HIV intervention programs.

  3. High-Risk Pregnancy

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications High-Risk Pregnancy: Condition Information Skip sharing on social media links Share this: Page Content A high-risk pregnancy refers to anything that puts the ...

  4. Factors That Influence HIV Risk among Hispanic Female Immigrants and Their Implications for HIV Prevention Interventions

    Directory of Open Access Journals (Sweden)

    Amy M. Hernandez

    2012-01-01

    Full Text Available Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women’s risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication.

  5. Investigation on the Infection of HIV, HCV and Association High Risk Factors among Drug Users%大理州吸毒人群HIV、HCV感染及相关高危因素调查研究

    Institute of Scientific and Technical Information of China (English)

    李泽; 刘继政; 申元英

    2016-01-01

    目的:了解大理州吸毒人群HIV、HCV感染情况及评估相关的高危因素,为更大范围内更有效地推广和完善吸毒哨点监测工作提供科学依据。方法:采集2015年1月至2015年6月大理州戒毒所新入所的423名吸毒人员的血样,检测HIV和HCV的感染情况,结合问卷调查资料,运用统计学方法分析与感染相关的危险因素。结果:在423名吸毒人员中HIV感染率为19.4%(82/423),HCV感染率为46.3%(196/423),在82例HIV感染者中,有96.3%(79/82)感染了HCV。多因素分析结果表明,注射吸毒年限、有注射吸毒史、共用针具不仅是HIV感染的高危因素,也是HCV感染的高危因素;此外,HCV感染还与年龄、每天注射吸毒次数正相关。结论:大理州吸毒人员中由于存在各种高危行为,使得吸毒人群HIV,HCV感染的比例较高,加速了HIV,HCV在该人群中的流行。%Objective:To understand the prevalence of HIV, HCV and estimate high risk factors among drug users in Dali Prefecture, thereby to provide the scientific basis for promoting and perfecting the prevention work more accurately in a larger range. Methods:The blood samples of 423 new drug users in Dali Detoxification Center from January 2015 to June 2015 were collected to detect the infection status of HIV and HCV. Using the data in questionnaire survey and statistical methods, risk factors related to infection were analyzed. Results: The infection rates among total 423 drug users were 19.4%(82/423)for HIV, 46.3%(196/423)for HCV. It is found that 96.3%(79/82)of the 82 HIV positive had infected with HCV. Multiple factor analysis indicated that the prevalence of HIV and HCV among drug users were positively related to drug using time, injection drug use, sharing needles. In addition, HCV infection was associated positively with the age of drug users and the times and quantity of drug addicts using per day. Conclusion:All sorts of high risk

  6. Dairy calcium intake and lifestyle risk factors for bone loss in hiv-infected and uninfected mediterranean subjects

    Directory of Open Access Journals (Sweden)

    Vecchi Valentina

    2012-08-01

    Full Text Available Abstract Background Despite the reported high prevalence of osteoporosis in the human immunodeficiency virus (HIV-population, there have been no previous studies examining dairy calcium intake and bone mineral density (BMD in HIV-subjects. We assessed the prevalence of low BMD in HIV-infected and uninfected subjects and analyzed the effects of calcium intake, lifestyle and HIV-related risk factors on BMD. Methods One hundred and twelve HIV-infected subjects were consecutively enrolled. Seventy- six HIV-uninfected subjects matched for age and sex were enrolled as the control group. The HIV-subjects were interviewed about lifestyle habits and completed a weekly food-frequency questionnaire to estimate calcium intake. HIV-RNA, CD4+ T-cell count and data on antiretroviral therapy were also recorded. Both biochemical bone turnover markers and BMD, assessed by dual-energy radiographic absorptiometry (DXA were recorded in the HIV-cases and controls. We also calculated the 10-year fracture risks using the WHO FRAX equation. Results Osteoporosis prevalence was significantly higher in the HIV-cases than controls (p p p BMI values were significantly correlated with dairy intake quartiles (p p p p p p p Conclusions Among the foods rich in calcium, yogurt was a protective predictor of BMD in HIV-subjects. HIV/HCV co-infection, nadir CD4 + T-cell count

  7. Primary Study on Infection of Sexually Transmitted Disease Pathogens on HIV High Risk Population%HIV性途径传播高危人群STD病原体感染情况研究

    Institute of Scientific and Technical Information of China (English)

    王聪; 白丽

    2013-01-01

    目的:了解HIV性途径感染女性高危人群STD病原体的感染情况,为更好地实施预防治疗及干预活动提供理论基础。方法:采用真菌培养、淋球菌(NG)培养、支原体培养及提取HPV的DNA进行检测。对120例HIV高危人群及73例女性健康体检者泌尿生殖道STD的4种病原体进行检查。结果:HIV高危人群真菌阳性率35.1%,支原体的阳性率74.6%,HPV阳性率为35%。健康体检者真菌阳性率为22.5%,支原体的阳性率52.1%,HPV阳性率为13.3%。两组人群均未分离到淋球菌。结论:除淋球菌外HIV高危人群STD阳性率均高于健康人群,经χ2检验,支原体及HPV差异有统计学意义。%Objective: Investigating 4 sexually transmitted diseases (STD)pathogens infection in HIV high-risk female so as to provide a theoretical basis for prevention and treatment interventions. Methods: One hundred and twenty HIV high-risk females and 73 health volunteers were enrolled into study. Four STD pathogens were detected by fungus culture, Neisseria gonorrhoeae (NG) culture, Ureaplasma urealyticum (UU)/Mycoplasma hominis (MH)culture and HPV-DNA testing. Results: The positive rate of fungus, UU/MH, HPV in HIV high-risk population group was 35.1%, 74.6%, 35%, respectively. In healthy group was 22.5%, 52.1%, and 13.3%, respectively. NG was not found in two groups. Conclusion: With χ2 test, the infection rate of UU/MH and HPV in HIV high-risk population are statistical significant higher then that of healthy group.

  8. KNOWLEDGE, ATTITUDE S , AND PERCEPTIONS ABOUT HIV/AIDS IN TEENAGE STUDENTS IN A HIGH PREVA LENCE DISTRICT IN INDIA

    OpenAIRE

    Gandhi Bhaskar; Kiran kumar; Geethanjali

    2015-01-01

    BACKGROUND: Teenagers form a significant portion of those infected with HIV and the number of young women getting infected with HIV/AIDS is growing rapidly. OBJECTIVES: This study was done to estimate the knowledge attitudes and risk perceptions about HIV/AIDS, in teenage high school students of Guntur. METHODS: A cross sectional study was ...

  9. Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors.

    Science.gov (United States)

    Cade, W T; Reeds, D N; Mondy, K E; Overton, E T; Grassino, J; Tucker, S; Bopp, C; Laciny, E; Hubert, S; Lassa-Claxton, S; Yarasheski, K E

    2010-07-01

    People living with HIV infection are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV infection are high priorities. We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virological or immunological status, or quality of life (QOL) in HIV-infected adults relative to standard of care treatment in a matched control group. Sixty HIV-infected adults with mild-moderate CVD risk were assigned to 20 weeks of supervised yoga practice or standard of care treatment. Baseline and week 20 measures were: 2-h oral glucose tolerance test with insulin monitoring, body composition, fasting serum lipid/lipoprotein profile, resting blood pressures, CD4 T-cell count and plasma HIV RNA, and the Medical Outcomes Study Short Form (SF)-36 health-related QOL inventory. Resting systolic and diastolic blood pressures improved more (P=0.04) in the yoga group (-5 +/- 2 and -3 +/- 1 mmHg, respectively) than in the standard of care group (+1 +/- 2 and+2 +/- 2 mmHg, respectively). However, there was no greater reduction in body weight, fat mass or proatherogenic lipids, or improvements in glucose tolerance or overall QOL after yoga. Immune and virological status was not adversely affected. Among traditional lifestyle modifications, yoga is a low-cost, simple to administer, nonpharmacological, popular behavioural intervention that can lower blood pressure in pre-hypertensive HIV-infected adults with mild-moderate CVD risk factors.

  10. Understanding HIV Risk Behavior among Tuberculosis Patients with Alcohol Use Disorders in Tomsk, Russian Federation.

    Science.gov (United States)

    Miller, Ann C; Nelson, A Katrina; Livchits, Viktoria; Greenfield, Shelly F; Yanova, Galina; Yanov, Sergei; Connery, Hilary S; Atwood, Sidney; Lastimoso, Charmaine S; Shin, Sonya S

    2016-01-01

    Russian Federation's (RF) HIV epidemic is the fastest growing of any country. This study explores factors associated with high HIV risk behavior in tuberculosis (TB) patients with alcohol use disorders in Tomsk, RF. This analysis was nested within the Integrated Management of Physician-delivered Alcohol Care for TB Patients (IMPACT, trial number NCT00675961) randomized controlled study of integrating alcohol treatment into TB treatment in Tomsk. Demographics, HIV risk behavior (defined as participant report of high-risk intravenous drug use and/or multiple sexual partners with inconsistent condom use in the last six months), clinical data, alcohol use, depression and psychosocial factors were collected from 196 participants (161 male and 35 female) at baseline. Forty-six participants (23.5%) endorsed HIV risk behavior at baseline. Incarceration history(Odds Ratio (OR)3.93, 95% confidence interval (CI) 1.95, 7.95), age under 41 (OR:2.97, CI:1.46, 6.04), drug addiction(OR: 3.60 CI:1.10, 11.77), history of a sexually transmitted disease(STD)(OR 2.00 CI:1.02, 3.90), low social capital (OR:2.81 CI:0.99, 8.03) and heavier alcohol use (OR:2.56 CI: 1.02, 6.46) were significantly more likely to be associated with HIV risk behavior at baseline. In adjusted analysis, age under 41(OR: 4.93, CI: 2.10, 11.58), incarceration history(OR: 3.56 CI:1.55, 8.17) and STD history (OR: 3.48, CI: 1.5, 8.10) continued to be significantly associated with HIV risk behavior. Understanding HIV transmission dynamics in Russia remains an urgent priority to inform strategies to address the epidemic. Larger studies addressing sex differences in risks and barriers to protective behavior are needed.

  11. Understanding HIV Risk Behavior among Tuberculosis Patients with Alcohol Use Disorders in Tomsk, Russian Federation.

    Directory of Open Access Journals (Sweden)

    Ann C Miller

    Full Text Available Russian Federation's (RF HIV epidemic is the fastest growing of any country. This study explores factors associated with high HIV risk behavior in tuberculosis (TB patients with alcohol use disorders in Tomsk, RF. This analysis was nested within the Integrated Management of Physician-delivered Alcohol Care for TB Patients (IMPACT, trial number NCT00675961 randomized controlled study of integrating alcohol treatment into TB treatment in Tomsk. Demographics, HIV risk behavior (defined as participant report of high-risk intravenous drug use and/or multiple sexual partners with inconsistent condom use in the last six months, clinical data, alcohol use, depression and psychosocial factors were collected from 196 participants (161 male and 35 female at baseline. Forty-six participants (23.5% endorsed HIV risk behavior at baseline. Incarceration history(Odds Ratio (OR3.93, 95% confidence interval (CI 1.95, 7.95, age under 41 (OR:2.97, CI:1.46, 6.04, drug addiction(OR: 3.60 CI:1.10, 11.77, history of a sexually transmitted disease(STD(OR 2.00 CI:1.02, 3.90, low social capital (OR:2.81 CI:0.99, 8.03 and heavier alcohol use (OR:2.56 CI: 1.02, 6.46 were significantly more likely to be associated with HIV risk behavior at baseline. In adjusted analysis, age under 41(OR: 4.93, CI: 2.10, 11.58, incarceration history(OR: 3.56 CI:1.55, 8.17 and STD history (OR: 3.48, CI: 1.5, 8.10 continued to be significantly associated with HIV risk behavior. Understanding HIV transmission dynamics in Russia remains an urgent priority to inform strategies to address the epidemic. Larger studies addressing sex differences in risks and barriers to protective behavior are needed.

  12. [HIV infection : Reaching a zero risk of transmission].

    Science.gov (United States)

    Henrard, S; Wyndham-Thomas, C; Van Vooren, J P; Goffard, J C

    2016-01-01

    Despite a global reduction in the prevalence of HIV-infection, the HIV-epidemic is far from over. The prevention of HIV-transmission in all its forms (sexual, mother-to-child etc) must therefore remain a pillar in the fight against AIDS, and both potent and accessible prevention strategies are required. In addition to the classical and wellknown methods such as the condom, ant iretroviral therapy represents a potent prevention tool and the residual risk of transmission of correctly treated HIV-positive persons is virtually nihil. Antiretroviral therapy may and should be used in the prevention of HIV-transmission as Treatment as Prevention (TasP), Pre-Exposure Prophylaxis (PrEP), and Post- Exposure Prophylaxis (PEP). However, because of their exorbitant costs, the accessibility of these prevention strategies is limited, particularly for the most vulnerable populations.

  13. 云南省艾滋病高流行区农村留守妇女HIV感染状况及影响因素分析%HIV prevalence and risk factors among left-behind women in high HIV epidemic rural areas of Yunnan province

    Institute of Scientific and Technical Information of China (English)

    张祖样; 肖民扬; 牛瑾; 李雪华; 宋丽军; 梅静远; 罗红兵; 贾曼红

    2016-01-01

    Objective To understand the status of HIV infection and risk factors among those left-behind women (LBW) in high HIV epidemic rural areas.Methods A cross-sectional investigation was conducted between March and May,2015 in Dehong and Lincang prefectures,Yunnan province,where HIV appeared highly epidemic.Probability Proportion to Size (PPS) sampling method was used,and 500 cases were involved and tested for HIV antibody.Results The total rate of HIV infection among LBW was 8.2%(41/500).The rate of HIV infection among LBWs whose husbands were on medication was 22.7%(30/132).Data from Multi-factor logistic regression analysis showed that the risk factors of HIV infection were:being minorities,education background lower than junior high school,widowed,living in Lincang prefecture,husband infected with HIV but did not consistently use condoms,etc.The rate of HIV infection among other LBWs was 2.8% (10/363).Data from Multi-factor logistic regression analysis showed that the risk factors of HIV infection would include:aged between 30-40 years,being minorities,education background lower than junior high school,divorced,living in Dehong prefecture,having had multiple-sex partners,husband coming home less than once a year,etc.The rate of HIV infection among drug users whose husbands did not take HIV medication was 20.0%(1/5).Conclusion HIV prevalence among LBWs in highly HIV epidemic areas was high,and the major risk factors related to their husbands were:being drug users or with HIV infected.Further effort should be made on consistently use of anti-HIV drugs and prevention of inter-marital sexual transmission.Comprehensive intervention should be carried out for LBWs who were having lower education background,being minority and having multiple-sex partners.%目的 了解云南省艾滋病高流行区农村留守妇女HIV感染现况及其影响因素.方法 于2015年3-5月,对云南省艾滋病疫情较为严重的德宏州、临沧市的留守妇女进行横断面

  14. HIV Infection and the Risk of Acute Myocardial Infarction

    Science.gov (United States)

    Freiberg, Matthew S.; Chang, Chung-Chou H.; Kuller, Lewis H.; Skanderson, Melissa; Lowy, Elliott; Kraemer, Kevin L.; Butt, Adeel A.; Bidwell Goetz, Matthew; Leaf, David; Oursler, Kris Ann; Rimland, David; Rodriguez Barradas, Maria; Brown, Sheldon; Gibert, Cynthia; McGinnis, Kathy; Crothers, Kristina; Sico, Jason; Crane, Heidi; Warner, Alberta; Gottlieb, Stephen; Gottdiener, John; Tracy, Russell P.; Budoff, Matthew; Watson, Courtney; Armah, Kaku A.; Doebler, Donna; Bryant, Kendall; Justice, Amy C.

    2016-01-01

    Importance Whether people infected with human immunodeficiency virus (HIV) are at an increased risk of acute myocardial infarction (AMI) compared with uninfected people is not clear. Without demographically and behaviorally similar uninfected comparators and without uniformly measured clinical data on risk factors and fatal and nonfatal AMI events, any potential association between HIV status and AMI may be confounded. Objective To investigate whether HIV is associated with an increased risk of AMI after adjustment for all standard Framingham risk factors among a large cohort of HIV-positive and demographically and behaviorally similar (ie, similar prevalence of smoking, alcohol, and cocaine use) uninfected veterans in care. Design and Setting Participants in the Veterans Aging Cohort Study Virtual Cohort from April 1, 2003, through December 31, 2009. Participants After eliminating those with baseline cardiovascular disease, we analyzed data on HIV status, age, sex, race/ethnicity, hypertension, diabetes mellitus, dyslipidemia, smoking, hepatitis C infection, body mass index, renal disease, anemia, substance use, CD4 cell count, HIV-1 RNA, antiretroviral therapy, and incidence of AMI. Main Outcome Measure Acute myocardial infarction. Results We analyzed data on 82 459 participants. During a median follow-up of 5.9 years, there were 871 AMI events. Across 3 decades of age, the mean (95% CI) AMI events per 1000 person-years was consistently and significantly higher for HIV-positive compared with uninfected veterans: for those aged 40 to 49 years, 2.0 (1.6-2.4) vs 1.5 (1.3-1.7); for those aged 50 to 59 years, 3.9 (3.3-4.5) vs 2.2 (1.9-2.5); and for those aged 60 to 69 years, 5.0 (3.8-6.7) vs 3.3 (2.6-4.2) (P < .05 for all). After adjusting for Framingham risk factors, comorbidities, and substance use, HIV-positive veterans had an increased risk of incident AMI compared with uninfected veterans (hazard ratio, 1.48; 95% CI, 1.27-1.72). An excess risk remained among

  15. Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis.

    Directory of Open Access Journals (Sweden)

    Charles S Morrison

    2015-01-01

    Full Text Available Observational studies of a putative association between hormonal contraception (HC and HIV acquisition have produced conflicting results. We conducted an individual participant data (IPD meta-analysis of studies from sub-Saharan Africa to compare the incidence of HIV infection in women using combined oral contraceptives (COCs or the injectable progestins depot-medroxyprogesterone acetate (DMPA or norethisterone enanthate (NET-EN with women not using HC.Eligible studies measured HC exposure and incident HIV infection prospectively using standardized measures, enrolled women aged 15-49 y, recorded ≥15 incident HIV infections, and measured prespecified covariates. Our primary analysis estimated the adjusted hazard ratio (aHR using two-stage random effects meta-analysis, controlling for region, marital status, age, number of sex partners, and condom use. We included 18 studies, including 37,124 women (43,613 woman-years and 1,830 incident HIV infections. Relative to no HC use, the aHR for HIV acquisition was 1.50 (95% CI 1.24-1.83 for DMPA use, 1.24 (95% CI 0.84-1.82 for NET-EN use, and 1.03 (95% CI 0.88-1.20 for COC use. Between-study heterogeneity was mild (I(2 < 50%. DMPA use was associated with increased HIV acquisition compared with COC use (aHR 1.43, 95% CI 1.23-1.67 and NET-EN use (aHR 1.32, 95% CI 1.08-1.61. Effect estimates were attenuated for studies at lower risk of methodological bias (compared with no HC use, aHR for DMPA use 1.22, 95% CI 0.99-1.50; for NET-EN use 0.67, 95% CI 0.47-0.96; and for COC use 0.91, 95% CI 0.73-1.41 compared to those at higher risk of bias (p(interaction = 0.003. Neither age nor herpes simplex virus type 2 infection status modified the HC-HIV relationship.This IPD meta-analysis found no evidence that COC or NET-EN use increases women's risk of HIV but adds to the evidence that DMPA may increase HIV risk, underscoring the need for additional safe and effective contraceptive options for women at high HIV risk

  16. Psychosocial Implications of Homophobia and HIV Stigma in Social Support Networks: Insights for High-Impact HIV Prevention among Black Men Who Have Sex with Men

    Science.gov (United States)

    Garcia, Jonathan; Parker, Caroline; Parker, Richard G.; Wilson, Patrick A.; Philbin, Morgan; Hirsch, Jennifer S.

    2016-01-01

    Black men who have sex with men (BMSM) bear an increasingly disproportionate burden of HIV in the United States. The Centers for Disease Control and Prevention recommends high-impact combination prevention for populations at high risk for HIV infection, such as BMSM. However, few scholars have considered the types of behavioral interventions that…

  17. Psychosocial Implications of Homophobia and HIV Stigma in Social Support Networks: Insights for High-Impact HIV Prevention among Black Men Who Have Sex with Men

    Science.gov (United States)

    Garcia, Jonathan; Parker, Caroline; Parker, Richard G.; Wilson, Patrick A.; Philbin, Morgan; Hirsch, Jennifer S.

    2016-01-01

    Black men who have sex with men (BMSM) bear an increasingly disproportionate burden of HIV in the United States. The Centers for Disease Control and Prevention recommends high-impact combination prevention for populations at high risk for HIV infection, such as BMSM. However, few scholars have considered the types of behavioral interventions that…

  18. HIV Sexual Risk Behavior and Family Dynamics in a Dominican Tourism Town

    Science.gov (United States)

    Guilamo-Ramos, Vincent; Padilla, Mark; Cedar, Anna Lindberg; Lee, Jane; Robles, Gabriel

    2013-01-01

    Expansion of the tourism industry in the Dominican Republic has had far-reaching health consequences for the local population. Research suggests families with one or more members living in tourism areas experience heightened vulnerability to HIV/STIs due to exposure to tourism environments, which can promote behaviors such as commercial and transactional sex and elevated alcohol use. Nevertheless, little is known about how tourism contexts influence family dynamics, which, in turn, shape HIV risk. This qualitative study examined family relationships through in-depth interviews with 32 adults residing in Sosúa, an internationally known destination for sex tourism. Interviewees situated HIV risk within a context of limited employment opportunities, high rates of migration, heavy alcohol use, and separation from family. This study has implications for effective design of health interventions that make use of the role of the family to prevent HIV transmission in tourism environments. PMID:23436038

  19. HIV sexual risk behavior and family dynamics in a Dominican tourism town.

    Science.gov (United States)

    Guilamo-Ramos, Vincent; Padilla, Mark; Cedar, Anna Lindberg; Lee, Jane; Robles, Gabriel

    2013-10-01

    Expansion of the tourism industry in the Dominican Republic has had far-reaching health consequences for the local population. Research suggests families with one or more members living in tourism areas experience heightened vulnerability to HIV/STIs due to exposure to tourism environments, which can promote behaviors such as commercial and transactional sex and elevated alcohol use. Nevertheless, little is known about how tourism contexts influence family dynamics, which, in turn, shape HIV risk. This qualitative study examined family relationships through in-depth interviews with 32 adults residing in Sosúa, an internationally known destination for sex tourism. Interviewees situated HIV risk within a context of limited employment opportunities, high rates of migration, heavy alcohol use, and separation from family. This study has implications for effective design of health interventions that make use of the role of the family to prevent HIV transmission in tourism environments.

  20. Psychometric assessment of HIV/STI sexual risk scale among MSM: A Rasch model approach

    Directory of Open Access Journals (Sweden)

    Liu Hui

    2011-10-01

    Full Text Available Abstract Background Little research has assessed the degree of severity and ordering of different types of sexual behaviors for HIV/STI infection in a measurement scale. The purpose of this study was to apply the Rasch model on psychometric assessment of an HIV/STI sexual risk scale among men who have sex with men (MSM. Methods A cross-sectional study using respondent driven sampling was conducted among 351 MSM in Shenzhen, China. The Rasch model was used to examine the psychometric properties of an HIV/STI sexual risk scale including nine types of sexual behaviors. Results The Rasch analysis of the nine items met the unidimensionality and local independence assumption. Although the person reliability was low at 0.35, the item reliability was high at 0.99. The fit statistics provided acceptable infit and outfit values. Item difficulty invariance analysis showed that the item estimates of the risk behavior items were invariant (within error. Conclusions The findings suggest that the Rasch model can be utilized for measuring the level of sexual risk for HIV/STI infection as a single latent construct and for establishing the relative degree of severity of each type of sexual behavior in HIV/STI transmission and acquisition among MSM. The measurement scale provides a useful measurement tool to inform, design and evaluate behavioral interventions for HIV/STI infection among MSM.

  1. HIV treatment optimism and sexual risk behaviors among HIV positive African American men who have sex with men.

    Science.gov (United States)

    Peterson, John L; Miner, Michael H; Brennan, David J; Rosser, B R Simon

    2012-04-01

    The association between HIV treatment optimism--beliefs about susceptibility to transmit HIV, motivation to use condoms, and severity of HIV--and sexual risk behavior was examined among HIV-positive African American men who have sex with men (MSM). Participants were 174 men recruited in four major metropolitan areas of the United States to participate in a weekend HIV risk reduction intervention. Baseline results revealed that beliefs in less susceptibility to transmit HIV and less motivation to use condoms were significantly associated with more unprotected anal intercourse among serodiscordant casual partners. Less motivation to use condoms also predicted more unprotected insertive and receptive anal sex and was more important than susceptibility beliefs in predicting these behaviors. Suggestions are offered of ways to better inform HIV-positive African American MSM about their misperceptions about HIV treatment and how their level of optimism about HIV treatment may diminish or encourage condom use.

  2. Masculinity and HIV Risk among Homeless Men in Los Angeles

    Science.gov (United States)

    Kennedy, David P.; Brown, Ryan A.; Golinelli, Daniela; Wenzel, Suzanne L.; Tucker, Joan S.; Wertheimer, Samuel R.

    2012-01-01

    HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women’s HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles’s Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men’s level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development. PMID:23730216

  3. Masculinity and HIV Risk among Homeless Men in Los Angeles.

    Science.gov (United States)

    Kennedy, David P; Brown, Ryan A; Golinelli, Daniela; Wenzel, Suzanne L; Tucker, Joan S; Wertheimer, Samuel R

    2013-01-01

    HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women's HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles's Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men's level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development.

  4. Hypertriglyceridemia and waist circumference predict cardiovascular risk among HIV patients: a cross-sectional study.

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    Peter M Janiszewski

    Full Text Available BACKGROUND: Although half of HIV-infected patients develop lipodystrophy and metabolic complications, there exists no simple clinical screening tool to discern the high from the low-risk HIV-infected patient. Thus, we evaluated the associations between waist circumference (WC combined with triglyceride (TG levels and the severity of lipodystrophy and cardiovascular risk among HIV-infected men and women. METHODS: 1481 HIV-infected men and 841 HIV-infected women were recruited between 2005 and 2009 at the metabolic clinic of the University of Modena and Reggio Emilia in Italy. Within each gender, patients were categorized into 4 groups according to WC and TG levels. Total and regional fat and fat-free mass were assessed by duel-energy x-ray absorptiometry, and visceral adipose tissue (VAT and abdominal subcutaneous AT (SAT were quantified by computed tomography. Various cardiovascular risk factors were assessed in clinic after an overnight fast. RESULTS: The high TG/high WC men had the most VAT (208.0 ± 94.4 cm(2, as well as the highest prevalence of metabolic syndrome (42.2% and type-2 diabetes (16.2%, and the highest Framingham risk score (10.3 ± 6.5 in comparison to other groups (p<0.05 for all. High TG/high WC women also had elevated VAT (150.0 ± 97.9 cm(2 and a higher prevalence of metabolic syndrome (53.3%, hypertension (30.5% and type-2 diabetes (12.0%, and Framingham risk score(2.9 ± 2.8 by comparison to low TG/low WC women (p<0.05 for all. CONCLUSIONS: A simple tool combining WC and TG levels can discriminate high- from low-risk HIV-infected patients.

  5. Hegemonic Masculinity, HIV/AIDS Risk Perception, and Sexual Behavior Change Among Young People in Ghana.

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    Ganle, John Kuumuori

    2016-05-01

    Among the youth in some parts of sub-Saharan Africa, a paradoxical mix of adequate knowledge of HIV/AIDS and high-risk behavior characterizes their daily lives. Based on original qualitative research in Ghana, I explore in this article the ways in which the social construction of masculinity influences youth's responses to behavior change HIV/AIDS prevention interventions. Findings show that although awareness of the HIV/AIDS epidemic and the risks of infection is very high among the youth, a combination of hegemonic masculinity and perceptions of personal invulnerability acts to undermine the processes of young people's HIV/AIDS risk construction and appropriate behavioral change. I argue that if HIV/AIDS prevention is to be effective and sustained, school- and community-based initiatives should be developed to provide supportive social spaces in which the construction of masculinity, the identity of young men and women as gendered persons, and perceptions of their vulnerability to HIV/AIDS infection are challenged.

  6. Optimal antiviral switching to minimize resistance risk in HIV therapy.

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    Rutao Luo

    Full Text Available The development of resistant strains of HIV is the most significant barrier to effective long-term treatment of HIV infection. The most common causes of resistance development are patient noncompliance and pre-existence of resistant strains. In this paper, methods of antiviral regimen switching are developed that minimize the risk of pre-existing resistant virus emerging during therapy switches necessitated by virological failure. Two distinct cases are considered; a single previous virological failure and multiple virological failures. These methods use optimal control approaches on experimentally verified mathematical models of HIV strain competition and statistical models of resistance risk. It is shown that, theoretically, order-of-magnitude reduction in risk can be achieved, and multiple previous virological failures enable greater success of these methods in reducing the risk of subsequent treatment failures.

  7. Risk sexual behavior of adolescents and HIV / AIDS prevention

    OpenAIRE

    Balážová, Martina

    2016-01-01

    Bachelor thesis titled Risk sexual behavior of adolescents and HIV / AIDS prevention focuses on biological and emotional development of adolescents, describes sexual behaviors, sexually transmitted diseases and focuses on the prevention of STDs, especially HIV and AIDS. The practical part determines, based on a quantitative questionnaire survey, knowledge of pupils, secondary vocational schools in the prevention of sexual diseases and compares students' knowledge about specific sexual dise...

  8. HIV testing uptake and risk behaviours in Spain

    OpenAIRE

    De La Fuente, Luis; Suarez, Monica; Belza, Maria Jose; Vallejo, Fernando; Garcia, Margarita; Alvarez, Raquel; Castilla, Jesus; Rodes, Anna; ., The Health And Sexual Behaviour Survey Group

    2009-01-01

    Abstract Objectives: To estimate the prevalence of HIV testing in the general population; to analyse factors related to voluntary testing; and to describe the main reasons for testing, the kinds of health services where testing takes place, and the relations between self-risk perception and HIV testing. Design and methods: Probability sample survey of health and sexual behaviour in men and women aged 18-49 years and resident in Spain in 2003 (n=10980). A combination...

  9. HIV Prevalence, Substance Use, and Sexual Risk Behaviors among Transgender Women Recruited Through Outreach

    Science.gov (United States)

    Reback, Cathy J.; Fletcher, Jesse B.

    2014-01-01

    Transgender women (“transwomen”) face a disproportionate HIV disease burden; the odds of being HIV-positive are estimated to be 34.2 times higher for transwomen than the United States adult population. From January 1, 2005 through December 31, 2011, HIV prevention outreach encounters were conducted with 2,136 unique transwomen on the streets and at high-risk venues in Los Angeles County. The outreach encounters were comprised of a low-intensity health education and risk reduction intervention, which included referrals to needed services. The goal of the encounters was to assess the participant's level of substance use and sexual risk behaviors to provide appropriate risk reduction strategies and supplies. The sample evidenced high rates of recent alcohol (57.7%), marijuana (25.6%), and methamphetamine (21.5%) use, lifetime injection drug or illegal hormone use (66.3%), and recent engagement in sex work (73.3%). Multivariate logistic regression analysis revealed that recent methamphetamine (AOR=2.09; p<.001) and/or crack cocaine (AOR=2.19; p=0.010) use, injection drug/hormone use (AOR=1.65; p≤0.001), unprotected anal intercourse during sex work (AOR=2.24; p=0.029), and any non-Hispanic minority racial status were all associated with increased odds of reporting a HIV-positive status. The transwomen encountered via outreach exhibited many risk co-factors for HIV infection and transmission. PMID:24287786

  10. Risk Factors for Preterm Birth among HIV-Infected Tanzanian Women: A Prospective Study

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    Rachel M. Zack

    2014-01-01

    Full Text Available Premature delivery, a significant cause of child mortality and morbidity worldwide, is particularly prevalent in the developing world. As HIV is highly prevalent in much of sub-Saharan Africa, it is important to determine risk factors for prematurity among HIV-positive pregnancies. The aims of this study were to identify risk factors of preterm (<37 weeks and very preterm (<34 weeks birth among a cohort of 927 HIV positive women living in Dar es Salaam, Tanzania, who enrolled in the Tanzania Vitamin and HIV Infection Trial between 1995 and 1997. Multivariable relative risk regression models were used to determine the association of potential maternal risk factors with premature and very premature delivery. High rates of preterm (24% and very preterm birth (9% were found. Risk factors (adjusted RR (95% CI for preterm birth were mother <20 years (1.46 (1.10, 1.95, maternal illiteracy (1.54 (1.10, 2.16, malaria (1.42 (1.11, 1.81, Entamoeba coli (1.49 (1.04, 2.15, no or low pregnancy weight gain, and HIV disease stage ≥2 (1.41 (1.12, 1.50. Interventions to reduce pregnancies in women under 20, prevent and treat malaria, reduce Entamoeba coli infection, and promote weight gain in pregnant women may have a protective effect on prematurity.

  11. Perceptions of HIV transmission risk in commercial and public sex venues.

    Science.gov (United States)

    Downing, Martin J

    2012-09-01

    BACKGROUND: Sexual behaviors of men who have sex with men (MSM) that occur in sexually charged venues (e.g., bathhouse, sex club, public park) are a target for research and intervention due to concerns about the role these venues may have in the transmission of HIV and other sexually transmitted infections (STIs). However, these efforts often exclude how individuals perceive HIV risk in terms of sex venue use. This paper analyzes how venue-specific perceptions of HIV transmission risk differ across venues and by onsite sexual behavior. METHOD: Cross-sectional data collected using an Internet survey completed by 139 MSM who attended at least one sex venue (e.g., bathhouse, sex club, gym/health club, public park) in the past month. RESULTS: Risk perceptions were highest for bathhouses and sex clubs, though no significant differences were detected between any of the venues. With few exceptions, men who reported not engaging in sex or low-risk behaviors (i.e., masturbation or mutual masturbation) during venue attendance perceived higher risks than those who engaged in high-risk behaviors (i.e., anal sex). Interestingly, risk perceptions of public bathrooms, parks, and video/buddy booths were lower for attendees who reported unprotected oral sex with ejaculation than men who reported safer or riskier behaviors. CONCLUSION: These findings provide important insights into how MSM perceive HIV risk in sex venues and highlight a need for expanded outreach and education in locations where sexual risk taking may be underestimated.

  12. Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments.

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    Erin E Conners

    Full Text Available Increasingly, 'place', including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC, whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1 Participatory mapping; 2 Quantitative interviews; 3 Sex work venue field observation; 4 Time-location-activity diaries; 5 In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions.

  13. Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments

    Science.gov (United States)

    Conners, Erin E.; West, Brooke S.; Roth, Alexis M.; Meckel-Parker, Kristen G.; Kwan, Mei-Po; Magis-Rodriguez, Carlos; Staines-Orozco, Hugo; Clapp, John D.; Brouwer, Kimberly C.

    2016-01-01

    Increasingly, ‘place’, including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC), whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs) in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1) Participatory mapping; 2) Quantitative interviews; 3) Sex work venue field observation; 4) Time-location-activity diaries; 5) In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions. PMID:27191846

  14. HIV Prevalence and Risk Factors Among Male Foreign Migrants in Cape Town, South Africa.

    Science.gov (United States)

    Giorgio, Margaret; Townsend, Loraine; Zembe, Yanga; Cheyip, Mireille; Guttmacher, Sally; Carter, Rebecca; Mathews, Cathy

    2017-03-01

    While migration has been shown to be a risk factor for HIV, variation in HIV prevalence by subgroups of migrants needs further exploration. This paper documents the HIV prevalence and key characteristics among male foreign migrants in Cape Town, South Africa and the effectiveness of respondent-driven sampling (RDS) to recruit this population. Participants in this cross-sectional study completed a behavioral risk-factor questionnaire and provided a dried blood sample for HIV analysis. Overall HIV prevalence was estimated to be 8.7 % (CI 5.4-11.8) but varied dramatically by country of origin. After adjusting for country of origin, HIV sero-positivity was positively associated with older age (p = 0.001), completing high school (p = 0.025), not having enough money for food (p = 0.036), alcohol use (p = 0.049), and engaging in transactional sex (p = 0.022). RDS was successful in recruiting foreign migrant men. A better understanding of the timing of HIV acquisition is needed to design targeted interventions for migrant men.

  15. Seroprevalence of HBV, HCV & HIV co-infection and risk factors analysis in Tripoli-Libya.

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    Mohamed A Daw

    Full Text Available BACKGROUND: In 1998 Libya experienced a major outbreak of multiple blood borne viral hepatitis and HIV infections. Since then, no studies have been done on the epidemic features and risk factors of HBV, HCV, HIV and co-infection among the general population. METHODS: A prospective study was carried out using a multi-centre clustering method to collect samples from the general population. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. This information was correlated with the risk factors involved in the transmission of HBV, HCV and HIV. Blood samples were collected and the sera were tested for HBsAg, anti-HCV and anti-HIV using enzyme immunoassay. RESULTS: A total of 9,170 participants from the nine districts of Tripoli were enrolled. The average prevalence of HBsAg was 3.7%, anti-HCV 0.9%, anti-HIV 0.15% and co-infection 0.02%. The prevalence varied from one district to another. HBV was more prevalent among those aged over 50 years and was associated with family history. Anti-HCV and anti-HIV were more prevalent among those aged 20-40 years. Intravenous drug use and blood transfusion were the main risk factors for HCV and HIV infection. CONCLUSION: HBV, HCV, HIV and co-infection are relatively common in Libya. High prevalence was associated with geographic, ethnic and socioeconomic variability within the community. HCV and HIV infections among the younger age groups are becoming an alarming issue. Regulations and health care education need to be implemented and longer term follow-up should be planned.

  16. Seroprevalence of HBV, HCV & HIV co-infection and risk factors analysis in Tripoli-Libya.

    Science.gov (United States)

    Daw, Mohamed A; Shabash, Amira; El-Bouzedi, Abdallah; Dau, Aghnya A

    2014-01-01

    In 1998 Libya experienced a major outbreak of multiple blood borne viral hepatitis and HIV infections. Since then, no studies have been done on the epidemic features and risk factors of HBV, HCV, HIV and co-infection among the general population. A prospective study was carried out using a multi-centre clustering method to collect samples from the general population. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. This information was correlated with the risk factors involved in the transmission of HBV, HCV and HIV. Blood samples were collected and the sera were tested for HBsAg, anti-HCV and anti-HIV using enzyme immunoassay. A total of 9,170 participants from the nine districts of Tripoli were enrolled. The average prevalence of HBsAg was 3.7%, anti-HCV 0.9%, anti-HIV 0.15% and co-infection 0.02%. The prevalence varied from one district to another. HBV was more prevalent among those aged over 50 years and was associated with family history. Anti-HCV and anti-HIV were more prevalent among those aged 20-40 years. Intravenous drug use and blood transfusion were the main risk factors for HCV and HIV infection. HBV, HCV, HIV and co-infection are relatively common in Libya. High prevalence was associated with geographic, ethnic and socioeconomic variability within the community. HCV and HIV infections among the younger age groups are becoming an alarming issue. Regulations and health care education need to be implemented and longer term follow-up should be planned.

  17. Sex and HIV serostatus differences in decision making under risk among substance-dependent individuals.

    Science.gov (United States)

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV- substance-dependent men and women. HIV+ participants made significantly poorer decisions than HIV- participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ substance-dependent individuals (SDIs). Potential factors for the HIV+ women's relatively greater impairment are discussed.

  18. HPV types, HIV and invasive cervical carcinoma risk in Kampala, Uganda: a case-control study

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    Kleter Bernhard

    2011-06-01

    Full Text Available Abstract Background While the association of human papillomavirus (HPV with cervical cancer is well established, the influence of HIV on the risk of this disease in sub-Saharan Africa remains unclear. To assess the risk of invasive cervical carcinoma (ICC associated with HIV and HPV types, a hospital-based case-control study was performed between September 2004 and December 2006 in Kampala, Uganda. Incident cases of histologically-confirmed ICC (N=316 and control women (N=314, who were visitors or care-takers of ICC cases in the hospital, were recruited. Blood samples were obtained for HIV serology and CD4 count, as well as cervical samples for HPV testing. HPV DNA detection and genotyping was performed using the SPF10/DEIA/LiPA25 technique which detects all mucosal HPV types by DEIA and identifies 25 HPV genotypes by LiPA version 1. Samples that tested positive but could not be genotyped were designated HPVX. Odds ratios (OR and 95% confidence intervals (CI were calculated by logistic regression, adjusting for possible confounding factors. Results For both squamous cell carcinoma (SCC and adenocarcinoma of the cervix, statistically significantly increased ORs were found among women infected with HPV, in particular single HPV infections, infections with HPV16-related types and high-risk HPV types, in particular HPV16, 18 and 45. For other HPV types the ORs for both SCC and adenocarcinoma were not statistically significantly elevated. HIV infection and CD4 count were not associated with SCC or adenocarcinoma risk in our study population. Among women infected with high-risk HPV types, no association between HIV and SCC emerged. However, an inverse association with adenocarcinoma was observed, while decrease in CD4 count was not associated with ICC risk. Conclusions The ORs for SCC and adenocarcinoma were increased in women infected with HPV, in particular single HPV infections, infections with HPV16- and 18-related types, and high-risk HPV types

  19. Decline in HIV infectivity following the introduction of highly active antiretroviral therapy

    Science.gov (United States)

    Porco, Travis C.; Martin, Jeffrey N.; Page-Shafer, Kimberly A.; Cheng, Amber; Charlebois, Edwin; Grant, Robert M.; Osmond, Dennis H.

    2008-01-01

    Objective Little is known about the degree to which widespread use of antiretroviral therapy in a community reduces uninfected individuals’ risk of acquiring HIV. We estimated the degree to which the probability of HIV infection from an infected partner (the infectivity) declined following the introduction of highly active antiretroviral therapy (HAART) in San Francisco. Design Homosexual men from the San Francisco Young Men’s Health Study, who were initially uninfected with HIV, were asked about sexual practices, and tested for HIV antibodies at each of four follow-up visits during a 6-year period spanning the advent of widespread use of HAART (1994 to 1999). Methods We estimated the infectivity of HIV (per-partnership probability of transmission from an infected partner) using a probabilistic risk model based on observed incident infections and self-reported sexual risk behavior, and tested the hypothesis that infectivity was the same before and after HAART was introduced. Results A total of 534 homosexual men were evaluated. Decreasing trends in HIV seroincidence were observed despite increases in reported number of unprotected receptive anal intercourse partners. Conservatively assuming a constant prevalence of HIV infection between 1994 and 1999, HIV infectivity decreased from 0.120 prior to widespread use of HAART, to 0.048 after the widespread use of HAART – a decline of 60% (P = 0.028). Conclusions Use of HAART by infected persons in a community appears to reduce their infectiousness and therefore may provide an important HIV prevention tool. PMID:15090833

  20. Mental health of early adolescents from high-risk neighborhoods: the role of maternal HIV and other contextual, self-regulation, and family factors.

    Science.gov (United States)

    Mellins, Claude A; Brackis-Cott, Elizabeth; Dolezal, Curtis; Leu, Cheng Shiun; Valentin, Cidna; Meyer-Bahlburg, Heino F L

    2008-01-01

    To examine the effect of maternal HIV infection, as well as other individual, family, and contextual factors on the mental health of inner-city, ethnic minority early adolescents. Participants included 220 HIV-negative early adolescents (10-14 years) and their mothers, half of whom were HIV-infected. Individual interviews were conducted regarding youth depression, anxiety, externalizing and internalizing behaviour problems, as well as a range of correlates of youth mental health guided by a modified version of Social Action Theory, a theoretical model of behavioral health. Although the HIV status of mothers alone did not predict youth mental health, youth knowledge of mother's HIV infection and mother's overall health were associated with worse youth mental health outcomes, as were contextual, self-regulation, and family interaction factors from our theoretical model. There is a need for family-based mental health interventions for this population, particularly focusing on parent-child relationships, disclosure, and youth self-esteem.

  1. Assessment of the risk of pressure ulcer development among hospitalized HIV/Aids patients.

    Science.gov (United States)

    Cidral, Silvana; Silva, Waldirene Fernandes; Visentin, Angelita; Borghi, Angela Cristina da Silva; Mantovani, Maria de Fátima; Hey, Ana Paula

    2016-01-01

    to assess the risk of pressure ulcer development among hospitalized HIV/Aids. Metod: study quantitative descriptive with 35 patients admitted to an infectious diseases hospital in Curitiba-PR-BR. Characterized clinical and epidemiological of patients using a data collection instrument and the Braden Scale. Data was compiled using Excel® and a simple descriptive analysis. two patients were found to have pressure ulcers and the most common comorbidities associated with HIV/Aids were pneumocystis pneumonia, caused by pneumocisti cariini (16), and pulmonary tuberculosis (13). The lowest scores were obtained in the friction and shear subscale, followed by the activity, nutrition, mobility and moisture subscales. The highest score was obtained in the sensory perception subscale. Two patients were classified as 'very high risk', six as 'high risk', three as 'low risk', and the rest as 'no risk'. risk assessment using scales provides objective information to assist with systemized and targeted nursing decision-making.

  2. Elevated triglycerides and risk of myocardial infarction in HIV-positive persons

    DEFF Research Database (Denmark)

    Worm, Signe W; Kamara, David Alim; Reiss, Peter;

    2011-01-01

    Objectives: To explore the relationship between elevated triglyceride levels and the risk of myocardial infarction (MI) in HIV-positive persons after adjustment for total cholesterol (TC), high-density lipoprotein–cholesterol (HDL-C) and nonlipid risk factors. Background: Although elevated...... the independent association between the latest triglyceride level and MI risk after adjusting for TC and HDL-C, nonlipids cardiovascular disease (CVD) risk factors, HIV and treatment-related factors. Results: The 33 308 persons included in the study from 1999 to 2008 experienced 580 MIs over 178 835 person......-years. Unadjusted, the risk of MI increased by 67% [relative risk (RR) 1.67, 95% confidence interval 1.54–1.80] per doubling in triglyceride level. After adjustment for the latest TC and HDL-C level, the RR dropped to 1.33 (95% confidence interval 1.21–1.45); this effect was further attenuated by other CVD risk...

  3. Risk factors for incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Charles Bitamazire Businge

    2016-01-01

    Full Text Available Background: The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa. Objective: To establish the risk factors for incident HIV infection among antenatal clients aged 18–49 years attending public antenatal clinics in rural Eastern Cape, South Africa. Design: This was an unmatched case–control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant. Results: The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol. Conclusions: Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.

  4. Social risk factors that influence the spread of HIV among pregnant women in Ukraine

    Directory of Open Access Journals (Sweden)

    Slobodianyk, Liudmyla

    2011-05-01

    who do not belong to HIV high-risk groups.

  5. Evaluation of QQ-based HIV high-risk behavior interventions for MSM population%利用QQ开展MSM人群艾滋病高危行为干预效果评估

    Institute of Scientific and Technical Information of China (English)

    闫红梅; 高聪; 李一; 佟雪; 惠珊; 于兰

    2013-01-01

    Objective To understand the effectiveness of intervention services among a HIV high-risk population through one-to-one QQ-based internet counseling. Methods A MSM cohort was established and subjected to interventions with standardized one-to-one QQ-based internet counseling. The first evaluation survey was conducted on line after the initial internet interventions. After the routine interventions for six months, the second on-line survey was conducted in all cohort members with the same questionnaire. Results Four hundred subjects were recruited. After 6-month QQ-based internet counseling interventions, the rate of taking HIV antibody test increased from 57. 3% to 68. 3%(P=0. 007. The rate of expressing willingness to take HIV antibody test increased from 67. 0% to 77. 5%(P = 0. 001); among the MSM who had anal sex in the last six months, the rate of condom use during the latest anal sex increased from 66. 4% to 81. 5%(P = 0. 000) , the rate of using condoms consistently in the last six months increased from 31. 1% to 59. 6%(P = 0. 000), and the rate of expressing willingness to use condom during the next anal sex increased from 83. 0% to 89. 5%(P = 0. 018). Conclusion One-to-one QQ-based internet interventions significantly reduced HIV high-risk sex behaviors and improved HIV antibody test behavior in the MSM population. The method could be promoted in interventions for HIV high-risk sex behavior in this population.%目的 了解利用QQ开展男男性行为人群(MSM)艾滋病高危行为一对一网络干预服务的效果.方法 建立接受规范化一对一QQ网络干预服务的MSM队列,初期网络干预后做首轮在线评估调查,进行6个月的常规干预后,做第2轮相同评估内容的在线调查.结果 400名调查对象经过6个月的干预后,做过HIV抗体检测的比例从57.3%上升到68.3% (P=0.007),与志愿者交流后表示愿意接受HIV抗体检测服务的比例从67.0%上升到77.5%(P=0.001);最近6个

  6. Newcomer Status as a Protective Factor among Hispanic Migrant Workers for HIV Risk

    Directory of Open Access Journals (Sweden)

    H Virginia McCoy

    2014-11-01

    Full Text Available The HIV rate among U.S. migrant workers is ten times that of the national rate. Due to the highly unstable lifestyle of migrant workers, which places them at heightened vulnerability to sexually transmitted infections (STIs; hence, there is a need to investigate the attitudes and sexual risk factors that may play a protective role in the transmission of HIV in this population. This study examines the association between attitudes and HIV risk behaviors among Hispanic male and female migrant workers (N=255 and their length of stay (shorter length of stay as a protective factor in Immokalee, Florida. Pearson’s correlation and regression analyses were utilized to analyze the relationship between HIV risk behaviors (intention to use condoms and alcohol use with length of stay in Immokalee. Longer length of stay positively correlated with number of drinks (p<0.05 and frequency of drinks (p<0.01 and negatively correlated with ethnic identity search (p<0.05. Regression analysis showed that length of stay predicted both behavioral intention to use condoms (p<0.05 and alcohol consumption (p<0.05. The findings suggest that migrant workers who are new to Immokalee may have a higher likelihood of practicing protective HIV risk behaviors and having more favorable attitudes toward risk reduction than long-timers. This study might provide important new evidence on the drivers of multiple concurrent and potential protective factors against risky sexual behaviors among Hispanic migrant workers.

  7. HIV-related risk perception among female sex workers in Nigeria.

    Science.gov (United States)

    Ankomah, Augustine; Omoregie, Godpower; Akinyemi, Zacch; Anyanti, Jennifer; Ladipo, Olaronke; Adebayo, Samson

    2011-01-01

    Over one-third of sex workers in Nigeria are infected with human immunodeficiency virus (HIV), yet there is a lack of understanding of sex workers' own perception of sexual risk-taking. Applying the theory of cognitive dissonance, this paper examined the personal HIV risk perception of brothel-based sex workers. The study is based on 24 focus group discussions held among brothel-based sex workers in four geographically and culturally dispersed cities in Nigeria. It was found that sex workers underestimated their risk of infection and rationalized, defended, or justified their behaviors, a typical psychological response to worry, threat, and anxiety arising from the apparent discrepancies between beliefs and behaviors. To reduce dissonance, many sex workers had a strong belief in fatalism, predestination, and faith-based invulnerability to HIV infection. Many believed that one will not die of acquired immune deficiency syndrome if it is not ordained by God. The sex workers also had a high level of HIV-related stigma. From these findings, most sex workers considered risk reduction and in particular condom use as far beyond their control or even unnecessary, as a result of their strong beliefs in fatalism and predestination. Therefore, one critical area of intervention is the need to assist sex workers to develop accurate means of assessing their personal vulnerability and self-appraisal of HIV-related risk.

  8. Mobility among youth in Rakai, Uganda: Trends, characteristics, and associations with behavioural risk factors for HIV.

    Science.gov (United States)

    Schuyler, Ashley C; Edelstein, Zoe R; Mathur, Sanyukta; Sekasanvu, Joseph; Nalugoda, Fred; Gray, Ronald; Wawer, Maria J; Serwadda, David M; Santelli, John S

    2015-08-27

    Mobility, including migration and travel, influences risk of HIV. This study examined time trends and characteristics among mobile youth (15-24 years) in rural Uganda, and the relationship between mobility and risk factors for HIV. We used data from an annual household census and population-based cohort study in the Rakai district, Uganda. Data on in-migration and out-migration were collected among youth (15-24 years) from 43 communities from 1999 to 2011 (N = 112,117 observations) and travel among youth residents from 2003 to 2008 (N = 18,318 observations). Migration and travel were more common among young women than young men. One in five youth reported out-migration. Over time, out-migration increased among youth and in-migration remained largely stable. Primary reasons for migration included work, living with friends or family, and marriage. Recent travel within Uganda was common and increased slightly over time in teen women (15-19 years old), and young adult men and women (20-24 years old). Mobile youth were more likely to report HIV-risk behaviours including: alcohol use, sexual experience, multiple partners, and inconsistent condom use. Our findings suggest that among rural Ugandan youth, mobility is increasingly common and associated with HIV-risk factors. Knowledge of patterns and characteristics of a young, high-risk mobile population has important implications for HIV interventions.

  9. Parents matter in HIV-risk among probation youth.

    Science.gov (United States)

    Udell, Wadiya; Donenberg, Geri; Emerson, Erin

    2011-10-01

    We investigated the relationship between parenting practices (i.e., parental monitoring, parent permissiveness, and parent-teen communication), and probation youth's HIV-related sexual risk behavior (i.e., ever having sex, condom use, alcohol and marijuana use before sex). Participants were 61 male and female juvenile offenders, ages 13-17, on probation and awaiting sentencing. Results indicated different relationships between parenting and HIV-related sexual risk behavior for probation boys and girls. Parental monitoring, parenting permissiveness, and parent-teen communication were collectively related to whether girls' ever had sex and with boys' use of alcohol and marijuana use before last sex. Findings underscore the important role of parenting on probation teens' HIV risk behaviors.

  10. The association between social networks and self-rated risk of HIV ...

    African Journals Online (AJOL)

    The association between social networks and self-rated risk of HIV infection ... bridging networks were groups that included students participating in social ... Efforts to raise adolescents' self-awareness of risk of HIV infection through life skills ...

  11. The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: Moving toward effective harm reduction

    Directory of Open Access Journals (Sweden)

    Thanh Duong

    2009-04-01

    Full Text Available Abstract Background Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices. Methods This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users. Results The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals. Conclusion HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.

  12. Reaching and identifying the STD/HIV risk of sex workers in Beijing.

    Science.gov (United States)

    Rogers, Susan J; Ying, Liu; Xin, Yan Tao; Fung, Kee; Kaufman, Joan

    2002-06-01

    China's HIV cases are growing by more than 30% annually. Few researchers have been able to reach sex workers and examine their risk behavior patterns. Key informants in illegal prostitution connected with owners of establishments in Beijing to recruit the involvement of sex workers. A total of 69 were surveyed about their background and risk behaviors in spring, 2000 in four venues; hair salons, bathing centers, karaoke bars, and the street. The women were mostly young (in their 20s), of low socioeconomic status, and from small towns and villages. They worked about 3 to 4 days a week, averaged one to two clients per day, made the equivalent of about U.S. $135 a week, and averaged about 3 months at any one establishment. They lacked accurate knowledge of STDs/HIV, and although 61% reported consistent condom usage 93% associated usage with prevention of pregnancy and 72% perceived a low risk of HIV infection. Nearly all (98%) felt condoms were affordable, yet 37% reported they were not accessible; 74% had obtained a medical exam in the last year, but 29% were examined when sick; only 10% received prevention information during medical visits, and 55% did not know where to go for HIV testing. Based on venue, stratification among sex workers existed, impacting their risk. Sex workers are at high risk of HIV infection/transmission, especially as the virus becomes more established in Beijing. Although risk factors were consistent with those of sex workers in other countries, the variation by venue, the low perceived vulnerability to HIV, the highly illegal nature of prostitution, and high mobility of sex workers in Beijing calls for a tailored intervention approach. Prevention messages/strategies should be responsive to the differing background, knowledge,

  13. Gender Differences in Associations between Exposure to School HIV Education and Protective Sexual Behaviors and Sexually Transmitted Disease/HIV Diagnosis among High School Students

    Science.gov (United States)

    Raj, Anita; Decker, Michele R.; Murray, Jessica E.; Silverman, Jay G.

    2007-01-01

    This study aimed to assess associations between school HIV education and protective sexual behaviors and sexually transmitted disease (STD)/HIV diagnosis with a representative sample of male and female high school students. Data from male and female adolescent participants in the 1999, 2001 and 2003 Massachusetts Youth Risk Behavior Survey (n =…

  14. Investigation on HIV infection and related behaviors among high risk population in Urumqi%乌鲁木齐市高危人群HIV感染情况和相关行为学调查

    Institute of Scientific and Technical Information of China (English)

    张曼; 芮宝玲; 王云霞; 杨阳

    2013-01-01

    目的 了解乌鲁木齐市高危人群HIV感染情况和相关行为.方法 2009-2011年对3 791名暗娼、3162名吸毒者和2129名男男性行为者(MSM)进行HIV血清学监测,对调查对象采用一对一问卷方式进行调查.结果 暗娼、吸毒者、MSM人群HIV抗体阳性率分别为0.40%、20.78%、4.23%,吸毒者HIV抗体的阳性率有所下降.3类高危人群中维吾尔族HIV抗体的阳性率高于汉族及其他民族,吸毒者维吾尔族共用针具比例高于汉族及其他民族,吸毒者和MSM维吾尔族使用安全套比例低于汉族及其他民族.结论 加大乌鲁木齐市少数民族及MSM高危行为干预迫在眉睫.%[ Objective ] To know the status of HIV infection and related behaviors among high risk population in Urumqi. [ Methods ] The monitoring of HIV antibody was conducted in 3 791 FCSW, 3 162 DUs and 2 129 MSM, and they were investigated by questionnaire face to face. [ Results] The positive rate of HIV antibody in FCSW, DUs and MSM was respectively 0. 40% , 20. 78% and 4. 23% , and the positive rate in DUs had decreased. Among three kinds of high risk population, the positive rate in Uigur was higher than that in other nationalities, the rate of needle sharing in Uigur DUs was higher than that in other nationalities, and the rate of using condom in Uigur DUs and MSM was lower than that in other nationalities. [ Conclusion ] It is urgent to strengthen the HIV behavior intervention among minority nationality and MSM in Urumqi.

  15. Recognising and managing increased HIV transmission risk in newborns

    Directory of Open Access Journals (Sweden)

    Max Kroon

    2015-04-01

    Full Text Available Prevention of mother-to-child transmission (PMTCT programmes have improved maternalhealth outcomes and reduced the incidence of paediatric HIV, resulting in improved childhealth and survival. Nevertheless, high-risk vertical exposures remain common and areresponsible for a high proportion of transmissions. In the absence of antiretrovirals (ARVs,an 8- to 12-hour labour has approximately the same 15% risk of transmission as 18 monthsof mixed feeding. The intensity of transmission risk is highest during labour and delivery;however, the brevity of this intra-partum period lends itself to post-exposure interventions toreduce such risk. There is good evidence that infant post-exposure prophylaxis (PEP reducesintra-partum transmission even in the absence of maternal prophylaxis. Recent reports suggestthat infant combination ARV prophylaxis (cARP is more efficient at reducing intra-partumtransmission than a single agent in situations of minimal pre-labour prophylaxis. Guidelinesfrom the developed world have incorporated infant cARP for increased-risk scenarios. Incontrast, recent guidelines for low-resource settings have rightfully focused on reducingpostnatal transmission to preserve the benefits of breastfeeding, but have largely ignored thepotential of augmented infant PEP for reducing intra-partum transmissions. Minimal prelabourprophylaxis, poor adherence in the month prior to delivery, elevated maternal viralload at delivery, spontaneous preterm labour with prolonged rupture of membranes andchorioamnionitis are simple clinical criteria that identify increased intra-partum transmissionrisk. In these increased-risk scenarios, transmission frequency may be halved by combiningnevirapine and zidovudine as a form of boosted infant PEP. This strategy may be important toreduce intra-partum transmissions when PMTCT is suboptimal.

  16. Forced sexual initiation, sexual intimate partner violence and HIV risk in women: A global review of the literature

    OpenAIRE

    Stockman, Jamila K.; Lucea, Marguerite B.; CAMPBELL, JACQUELYN C.

    2013-01-01

    Coerced or forced sexual initiation and sexual intimate partner violence (sexual IPV) contribute significantly to a woman’s risk for HIV infection. This review systematically examines global research (n=21 studies) published since 2000 on the role of coerced/forced sexual initiation and sexual IPV on HIV risk in women. In predominantly low- and middle-income countries, coerced/forced sexual initiation was associated with HIV/STIs, multiple and high-risk sex partners, and no condom use. Most s...

  17. [Elevated risk of HIV infection in homosexual men even after contact with the health system].

    Science.gov (United States)

    Barrasa, Alicia; Lorenzo, José Manuel; Sáez de Vicuña, Luis María; Saladié, Pilar; Arellano, Encarnación; Larrañaga, Guendane; Castro, Esperanza; Losas, Araceli; Neira, María Angeles; Cuesta, María Mar; Mendo, Antonia; Castilla, Jesús

    2007-01-01

    To determine the incidence of HIV seroconversion and to evaluate the characteristics associated with a greater risk of seroconversion in homosexual men in the period 2000-2003. We performed a dynamic cohort study of all homosexual men tested for HIV in 20 ambulatory care centers specialized in diagnosing HIV, located in 19 cities in Spain. The characteristics of the men were analyzed and the seroconversion incidence rate was calculated among those who were followed up. In the period 2000-2003, a total of 10,189 persons-year of follow-up were accumulated and 167 seroconversions were diagnosed with a seroconversion incidence rate of 16.4 per 1,000 persons-year. Most of the seroconversions (63%) occurred in men younger than 30 years old. The seroconversion rate was higher among homosexual men from Latin America and sub-Saharan Africa than among Spanish men. In Spain, the risk of HIV transmission among men who have sex with men is still high. Therefore, this population continues to be a high priority group in HIV prevention. A proportion of HIV diagnoses among immigrants concern infections acquired after their arrival to Spain, probably due to conditions of greater social vulnerability. Reinforcing and renewing prevention strategies directed at this population would be timely.

  18. Risk and vulnerability: do socioeconomic factors influence the risk of acquiring HIV in Asia?

    Science.gov (United States)

    Greener, Robert; Sarkar, Swarup

    2010-09-01

    HIV epidemics in Asia have been mainly concentrated among certain population groups such as injecting drug users, sex workers and their clients and men who have sex with men (MSM). HIV risk has also been associated with labour migrants and their partners. Many of the people at risk through these behaviours are very poor, and this raises the question that poverty and social deprivation may be underlying factors that drive the adoption of risk behaviours and can be regarded as 'determinants' of vulnerability to HIV infection in Asia. The study presents some observations of the socioeconomic pattern of HIV spread in Asia, using country-level and household-level data. The discussion then draws tentative conclusions about what is known concerning the mechanisms influencing the risk of HIV acquisition in Asia and what they might imply for programme design and policy. In summary, the data presented here do not support the hypothesis that HIV epidemics in Asia are primarily driven by poverty and social deprivation, though sex inequality and education for women and girls are strongly associated factors. There is clearly a multidimensional relationship between the risk of HIV infection and a host of underlying social and cultural factors that confound any attempt at a single explanation for the HIV epidemic in Asia or elsewhere. There is an undeniable need for further research through multicountry studies and better analysis of existing household data, as well as through further investigation of the quantitative relationship between the barriers to HIV services and the risk of infection. The key message for policy is to seek a broad balance between a focus on prevention and treatment for the higher-risk behaviours without losing sight of the importance of programmes that address vulnerability and behavioural change among the sexually active adult population. The implication of these findings for the allocation of resources for downstream factors such as risk behaviours as

  19. HIV/AIDS Knowledge, Self-Efficacy for Limiting Sexual Risk Behavior and Parental Monitoring.

    Science.gov (United States)

    Mahat, Ganga; Scoloveno, Mary Ann; Scoloveno, Robert

    2016-01-01

    The purpose of this study was to explore HIV/AIDS knowledge, self-efficacy for sexual risk behaviors, and parental monitoring in a sample of 140 7th and 9th grade adolescents studying in an urban high school in the United States. Further, the study examined differences in HIV/AIDS knowledge, self-efficacy and parental monitoring by grade and gender. This study also investigated the effectiveness of an HIV/AIDS peer education program, Teens for AIDS Prevention (TAP), on improving adolescents' HIV/AIDS knowledge. A quasi-experimental design was used to examine effects of the peer education program (TAP) on adolescents' HIV/AIDS knowledge. Pearson-product-moment correlation coefficients were calculated to examine the relationships among the variables. Independent t-tests were used to compare adolescents' HIV/AIDS knowledge, self-efficacy, and parental monitoring scores by grade and gender. Paired t-tests were used to determine differences in pre-intervention and post-intervention HIV/AIDS knowledge. The results showed that HIV/AIDS knowledge improved significantly in both 7th and 9th grade students after the intervention. HIV/AIDS knowledge was associated with self-efficacy; however it was not associated with parental monitoring. There were no significant differences in HIV/AIDS knowledge and self-efficacy by gender. However, there was a significant difference in parental monitoring by gender. Pediatric nurses are well-positioned to develop and implement evidence-based programs for adolescents. It is essential that pediatric nurses, in conjunction with other professionals and parent groups, take the initiative in implementing peer education programs in schools and community centers to promote healthy behaviors among adolescents. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Do oral contraceptives increase risk of contracting HIV?

    Science.gov (United States)

    1988-12-01

    Some clinicians claim that the potential association between oral contraceptive (OC) use and HIV infection is cause for concern. A study of prostitutes conducted in Kenya showed OC use to be the single most common cofactor in sexually transmitted human immunodeficiency virus infection. A similar study conducted in the US was unable to confirm an association. In the Kenya study, 123 HIV seronegative prostitutes in Nairobi were followed for 54 months and assessed for seroconversion to HIV and occurrence of sexually transmitted diseases. 91% of the women who seroconverted were using OCs; 73% of the women who remained seronegative were using OCs. Demographic features, sexual behavior, number of daily sex partners, and parenteral exposure were not related to seroconversion. No significant associations were found between HIV infection and sexual activity and condom use. Independent associations were found between seroconversion and OC use, genital ulcer disease (GUD), and chlamydia trachomatis infections. It is possible that OCs increase the risk of acquiring chlamydia because cervical ectropion creates a greater exposure of columnar epithelium to infecting agents. The multicenter, cross-sectional, collaborative study of 638 prostitutes in 8 areas of the US found that HIV infection was totally unrelated to OC use. Prostitutes with no evidence of intravenous drug use were studied. 5% of the women were found to be infected with HIV. The most common variables associated with HIV infection were seromarkers for hepatitis B and syphilis and sex with "nonpaying partners." About 80% of the prostitutes reported using condoms regularly with clients; only 16% used condoms with their boyfriends or husbands. About 30% (194) of the prostitutes reported they had used OCs for at least 1 month out of the past 5 years. 9 of those women (4.6%) were positive for HIV. Of 444 prostitutes who had never used OC during the past 5 years, 21 or 4.73% were HIV positive.

  1. Genital Tract HIV RNA Levels and Their Associations with Human Papillomavirus Infection and Risk of Cervical Pre-Cancer

    Science.gov (United States)

    GHARTEY, Jeny; KOVACS, Andrea; BURK, Robert D.; MASSAD, L. Stewart; MINKOFF, Howard; XIE, Xianhong; D’SOUZA, Gypsyamber; XUE, Xiaonan; WATTS, D. Heather; LEVINE, Alexandra M.; EINSTEIN, Mark H.; COLIE, Christine; ANASTOS, Kathryn; ELTOUM, Isam-Eldin; HEROLD, Betsy C.; PALEFSKY, Joel M.; STRICKLER, Howard D.

    2014-01-01

    Objective Plasma HIV RNA levels have been associated with risk of human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive women. However, little is known regarding local genital tract HIV RNA levels and their relation with cervical HPV and neoplasia. Design/Methods In an HIV-seropositive women’s cohort with semi-annual follow-up, we conducted a nested case-control study of genital tract HIV RNA levels and their relation with incident high-grade squamous intraepithelial lesions sub-classified as severe (severe HSIL), as provided for under the Bethesda 2001 classification system. Specifically, 66 incident severe HSIL were matched to 130 controls by age, CD4+ count, HAART use, and other factors. We also studied HPV prevalence, incident detection, and persistence in a random sample of 250 subjects. Results Risk of severe HSIL was associated with genital tract HIV RNA levels (odds ratio comparing HIV RNA ≥ the median among women with detectable levels versus undetectable [ORVL] 2.96; 95% CI: 0.99–8.84; Ptrend=0.03). However, this association became non-significant (Ptrend=0.51) following adjustment for plasma HIV RNA levels. There was also no association between genital tract HIV RNA levels and the prevalence of any HPV or oncogenic HPV. However, the incident detection of any HPV (Ptrend=0.02) and persistence of oncogenic HPV (Ptrend=0.04) were associated with genital tract HIV RNA levels, after controlling plasma HIV RNA levels. Conclusion These prospective data suggest that genital tract HIV RNA levels are not a significant independent risk factor for cervical pre-cancer in HIV-seropositive women, but leave open the possibility that they may modestly influence HPV infection, an early stage of cervical tumoriogenesis. PMID:24694931

  2. Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Rhoades, Harmony; Harris, Taylor; Winetrobe, Hailey; Rice, Eric; Henwood, Ben

    2016-09-21

    Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.e., education, testing, medication) among homeless persons preparing to move into PSH. Data come from interviews with 421 homeless adults before they moved into PSH. Thirty-seven percent of the respondents were sexually active; of those, 75.7% reported unprotected sex. Nearly two-thirds (64%) reported past year HIV testing and 40% reported testing for another STI. Fewer than one-third (31%) of respondents reported receiving posttest counseling at their last HIV test. HIV seropositivity was self-reported by 10%. Among those persons who were HIV-positive, 57.1% reported less than 100% antiretroviral (ARV) adherence. Among HIV-negative respondents, less than 1% had been prescribed preexposure prophylaxis (PrEP). Less than half (46.4%) of the sample reported any HIV prevention education in the past year. This population of homeless adults about to move into PSH report high rates of HIV risk behavior, but low rates of HIV prevention education and very little PrEP utilization. Further, low rates of ARV adherence among HIV-positive respondents indicate significant risk for HIV transmission and acquisition. Entering PSH is a period of transition for homeless persons when integrated care is critically important to ensure positive health outcomes, but these data suggest that PrEP and other HIV prevention services are poorly accessed among this population. As such, multipronged services that integrate PrEP and other HIV prevention services are needed to prevent transmission and acquisition of HIV in this high-risk, vulnerable population and ensure the

  3. Risk factors for HIV and unprotected anal intercourse among men who have sex with men (MSM in Almaty, Kazakhstan.

    Directory of Open Access Journals (Sweden)

    Mark Berry

    Full Text Available INTRODUCTION: Men who have sex with men (MSM are at high risk for HIV infection. MSM in Central Asia, however, are not adequately studied to assess their risk of HIV transmission. METHODS: This study used respondent driven sampling methods to recruit 400 MSM in Almaty, the largest city in Kazakhstan, into a cross-sectional study. Participation involved a one-time interviewer-administered questionnaire and rapid HIV screening test. Prevalence data were adjusted for respondent network size and recruitment patterns. Multivariate logistic regression was used to investigate the association between HIV and selected risk factors, and unprotected anal intercourse (UAI and selected risk factors. RESULTS: After respondent driven sampling (RDS weighted analysis, 20.2% of MSM were HIV-positive, and 69.0% had unprotected sex with at least one male partner in the last 12 months. Regression analysis showed that HIV infection was associated with unprotected receptive anal sex (AOR: 2.00; 95% CI: 1.04-3.84. Having unprotected anal intercourse with male partners, a measure of HIV risk behaviors, was associated with being single (AOR: 0.38; 95% CI: 0.23-0.64; very difficult access to lubricants (AOR: 11.08; 95% CI: 4.93-24.91; STI symptoms (AOR: 3.45; 95% CI: 1.42-8.40; transactional sex (AOR: 3.21; 95% CI: 1.66-6.22; and non-injection drug use (AOR: 3.10; 95% CI: 1.51-6.36. CONCLUSIONS: This study found a high HIV prevalence among MSM in Almaty, and a population of MSM engaging in multiple high-risk behavior in Almaty. Greater access to HIV education and prevention interventions is needed to limit the HIV epidemic among MSM in Almaty.

  4. Seroprevalence and factors associated with herpes simplex virus type 2 among HIV-negative high-risk men who have sex with men from Rio de Janeiro, Brazil: a cross-sectional study

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    Pilotto Jose H

    2009-04-01

    Full Text Available Abstract Background Herpes simplex virus type 2 (HSV-2 is the leading cause of genital ulcer disease in developing countries, including Brazil, and is especially prevalent among men who have sex with men (MSM. HSV-2 infection represents a risk factor for the acquisition and transmission of other sexually transmitted diseases. The goal of the present cross-sectional study was to estimate HSV-2 seroprevalence and to determine the factors associated with HSV-2 seropositivity in HIV-negative high-risk MSM from Rio de Janeiro, Brazil. Methods Stored sera were tested to estimate HSV-2 seroprevalence, while socio-demographic and sexual behavior data were used to measure associations between risk factors and HSV-2 seropositivity. Using the Poisson regression model with robust variance, prevalence ratios (PR were used to estimate de degree of association between risk factors and HSV-2 seropositivity in bivariate and multivariate analyses. Results Seroprevalence of HSV-2 was of 45.7% (184 out of 403. Factors independently associated with HSV-2 seroprevalence in the multivariate model were: older age (≥ 26 years, PR: 1.41 95% Confidence Interval: 1.11–1.78, non-white race (PR: 1.32 95%CI: 1.06–1.64, positive serology for syphilis (PR: 1.65 95%CI: 1.33–2.05, positive serology for hepatitis B (PR: 1.25 95%CI: 0.99–1.57, stable male partner in the past 6 months (PR: 1.42 95%CI: 1.12–1.79, and unprotected anal sex with a stable female partner (PR: 1.46 95%CI: 1.05–2.04 in the 6 months preceding the cross-sectional assessment. Conclusion The present study made evident a high prevalence of HSV-2 infection in a sample of HIV-negative high-risk MSM from Rio de Janeiro. This finding indicates the need and urgency for implementing integrated programs for the prevention of HSV-2 and other sexually transmitted diseases, and, in particular, programs targeting high-risk MSM.

  5. Cervical Precancer Risk in HIV-Infected Women Who Test Positive for Oncogenic Human Papillomavirus Despite a Normal Pap Test

    Science.gov (United States)

    Keller, Marla J.; Burk, Robert D.; Massad, L. Stewart; Eltoum, Isam-Eldin; Hessol, Nancy A.; Castle, Philip E.; Anastos, Kathryn; Xie, Xianhong; Minkoff, Howard; Xue, Xiaonan; D'Souza, Gypsyamber; Flowers, Lisa; Levine, Alexandra M.; Colie, Christine; Rahangdale, Lisa; Fischl, Margaret A.; Palefsky, Joel M.; Strickler, Howard D.

    2015-01-01

    Background. Determining cervical precancer risk among human immunodeficiency virus (HIV)–infected women who despite a normal Pap test are positive for oncogenic human papillomavirus (oncHPV) types is important for setting screening practices. Methods. A total of 2791 HIV-infected and 975 HIV-uninfected women in the Women's Interagency HIV Study were followed semiannually with Pap tests and colposcopy. Cumulative risks of cervical intraepithelial neoplasia grade 2 or greater (CIN-2+; threshold used for CIN treatment) and grade 3 or greater (CIN-3+; threshold to set screening practices) were measured in HIV-infected and HIV-uninfected women with normal Pap tests, stratified by baseline HPV results, and also in HIV-infected women with a low-grade squamous intraepithelial lesion (LSIL; benchmark indication for colposcopy). Results. At baseline, 1021 HIV-infected and 518 HIV-uninfected women had normal Pap tests, of whom 154 (15%) and 27 (5%), respectively, tested oncHPV positive. The 5-year CIN-2+ cumulative risk in the HIV-infected oncHPV-positive women was 22% (95% confidence interval [CI], 9%–34%), 12% (95% CI, 0%–22%), and 14% (95% CI, 2%–25%) among those with CD4 counts CIN-3+, the cumulative risk averaged 4% (95% CI, 1%–8%) in HIV-infected oncHPV-positive women, and 10% (95% CI, 0%–23%) among those positive for HPV type 16. In HIV-infected women with LSIL, CIN-3+ risk was 7% (95% CI, 3%–11%). In multivariate analysis, HIV-infected HPV16-positive women had 13-fold (P = .001) greater CIN-3+ risk than oncHPV-negative women (referent), and HIV-infected women with LSIL had 9-fold (P < .0001) greater risk. Conclusions. HIV-infected women with a normal Pap result who test HPV16 positive have high precancer risk (similar to those with LSIL), possibly warranting immediate colposcopy. Repeat screening in 1 year may be appropriate if non-16 oncHPV is detected. PMID:26187020

  6. Risk factors for HIV infection among women in Dodoma region, Tanzania

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To investigate the risk factors of HIV infection among women in the Dodoma region, Tanzania. Methods The protocol were assessed through a population-based cross sec-tional study. The participants were obtained by randomly selecting clusters of 10-households from Unga imited, Babati town and Matufa roadside village which are urban, semi-urban and rural communi-ties respectively. Informed verbal consent for participation in an interview and in HIV testing was sought from each respondent. Blood samples were collected from each consenting individual for HIV antibody testing using enzyme linked immunosorbent assay(ELISA) and all positive sera were con-firmed using repeated ELISA tests. Information on risk factors was obtained through the interview process using a structured questionnaire. Results Of 567 women who gave blood samples, 48 (8.5 % ) were HIV positive. The HIV seroprevalence rates among women in the urban area, the semi-ur-ban area and in the rural village were 14.4%, 6.9% and 2.3% respectively. Factors associated with significantly higher HIV seroprevalence were urban residence,history of having travelled out of Dodoma region within Tanzania, as well as having travelled abroad, having multiple sexual partners and having sexual intercourse under the influence of alcohol. Women who reported ever having used condoms had significantly higher probability of being infected with HIV than those who had never used condoms, suggesting that condom use may be a marker of high risk sexual behavior and that condom use was probably not adhered to in a way that consistently protects against HIV infection.Conclusions The results suggest the need for health education interventions aimed at increasing ap-propriate and consistent condom use and reduction of the number of sexual partners.

  7. Meta-analyses on behavioral interventions to reduce the risk of transmission of HIV.

    Science.gov (United States)

    Vergidis, Paschalis I; Falagas, Matthew E

    2009-06-01

    Different behavioral interventions have found to be efficacious in reducing high-risk sexual activity. Interventions have been evaluated in both original research and meta-analytic reviews. Most of the studies have shown that interventions are efficacious among different study populations. In adolescents, both in- and out-of-the classroom interventions showed a decrease in the risk of unprotected sex. In African Americans, greater efficacy was found for interventions including peer education. For Latinos, effect was larger in interventions with segmentation in the same gender. Geographic and social isolation are barriers in approaching MSM. For IDUs, interventions provided within a treatment program have an impact on risk reduction above that produced by drug treatment alone. Finally, people diagnosed with HIV tend to reduce their sexual risk behavior. However, adherence to safe sex practices for life can be challenging. Relentless efforts for implementation of behavioral interventions to decrease high-risk behavior are necessary to decrease HIV transmission.

  8. Addressing poverty as risk for disease: recommendations from CDC's consultation on microenterprise as HIV prevention.

    Science.gov (United States)

    Stratford, Dale; Mizuno, Yuko; Williams, Kim; Courtenay-Quirk, Cari; O'leary, Ann

    2008-01-01

    In March 2006, the Centers for Disease Control and Prevention (CDC) convened a consultation meeting to explore microenterprise as a potential human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention intervention. The impulse to link microenterprise with HIV/AIDS prevention was driven by the fact that poverty is a significant factor contributing to the risk for infection. Because increasingly high rates of HIV infection are occurring among women, particularly among poor African American women in the southern United States, we focused the consultation on microenterprise as an intervention among that population. In the international arena, income generated by microenterprise has contributed to improving family and community health outcomes. This article summarizes the contributions made to the consultation by participants from the diverse fields of microenterprise, microfinance, women's studies, and public health. The article ends with recommendations for HIV/AIDS prevention and, by implication, addressing other public health challenges, through the development of multifaceted intervention approaches.

  9. Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe

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    Zhou DT

    2015-05-01

    Full Text Available Danai Tavonga Zhou,1,2 Vitaris Kodogo,1 Kudzai Fortunate Vongai Chokuona,1 Exnevia Gomo,1 Olav Oektedalen,3 Babill Stray-Pedersen21Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe; 2Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway; 3Department of Infectious Diseases, Oslo University Hospital, Oslo, NorwayAbstract: The chronic inflammation induced by human immunodeficiency virus (HIV contributes to increased risk of coronary heart disease (CHD in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years. Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART- for total cholesterol (TC and high-density lipoprotein (HDL.Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings

  10. HIV risk-reduction counseling and testing on behavior change of MSM.

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    Xiping Huan

    Full Text Available HIV and AIDS incidence in China is high among men who have sex with men (MSM and ours was one of few studies in China to evaluate the role of HIV risk reduction counseling and testing. Respondent-driven sampling (RDS was used to recruit 430 MSM. Participants were followed up at 6, 12 and 18 months to evaluate behavioral changes after counseling to reduce risk behaviors. At baseline, HIV prevalence was 4.7%, whereas HIV incidence was 5.2 per 100 person-years. The incidence was 3.8 during six to 12 months, and 1.1 during 12 to 18 months. During the study period, the reported unprotected anal intercourse (UAI significantly decreased from 60.9% to 42.9%. The proportion of participants who had one or no partner significantly increased from 40.9% to 48.0%. The study also found that some risk behaviors decreased between baseline and 12 months, followed by a slight increase between 12 and 18 months. Reductions in UAI can be achieved through counseling and testing, but may wane over time. Future programs should consider HIV risk-reduction counseling and testing for interventions in MSM in China.

  11. Men's moralising discourses on gender and HIV risk in rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Mindry, Deborah L; Knight, Lucia; van Rooyen, Heidi

    2015-01-01

    Various interventions have resulted in increased rates of HIV testing. However, encouraging men to acknowledge their risk for HIV, to test and link to treatment remains a challenge. In this study, we examine men's perspectives on navigating HIV risk in rural KwaZulu-Natal, South Africa. Qualitative interviews were conducted at four intervals over a three-year time period with a baseline cohort of 126 men and women. We found that men navigated HIV risk in their sexual relationships mainly by monitoring their partner's behaviour. Men expressed concerns about female respectability, invoking discourses on hlonipha rooted in Zulu cultural ideals and Christian ideals about women staying close to home. In the post-apartheid era, these concerns were inflected by anxieties over changing gender norms and the high rates and risks of infection in the region. HIV prevention discourses on behaviour intersected with men's efforts to assert their masculinity through the monitoring and controlling of women's behaviour. The potential negative impacts of this should be addressed. Prevention efforts need to focus on men's vulnerability to infection in terms of their own behaviour as well as the contexts in which they live.

  12. Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study

    Science.gov (United States)

    Nyitray, Alan G.; Carvalho da Silva, Roberto J.; Chang, Mihyun; Baggio, Maria Luiza; Ingles, Donna J.; Abrahamsen, Martha; Papenfuss, Mary; Lin, Hui-Yi; Salmerón, Jorge; Quiterio, Manuel; Lazcano-Ponce, Eduardo; Villa, Luisa L.; Giuliano, Anna R.

    2016-01-01

    Background. Given high rates of anal disease, we investigated the natural history of high-risk anal human papillomavirus (HPV) among a multinational group of men who have sex with men (MSM) aged 18–64 years. Methods. Anal specimens from human immunodeficiency virus–negative men from Brazil, Mexico, and the United States were genotyped. Over 2 years, 406 MSM provided evaluable specimens every 6 months for ≥2 visits. These men were stratified into men who have sex only with men (MSOM, n = 70) and men who have sex with women and men (MSWM, n = 336). Persistence was defined as ≥12 months’ type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression. Results. Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log-rank P = .02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the 2 groups. Among men with prevalent high-risk infection (n = 106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n = 27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners. Conclusions. MSM with prevalent high-risk HPV infection should be considered at increased risk for nontransient infection. PMID:26962079

  13. A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers.

    Science.gov (United States)

    Kanamori, Mariano; De La Rosa, Mario; Diez, Stephanie; Weissman, Jessica; Trepka, Mary Jo; Sneij, Alicia; Schmidt, Peter; Rojas, Patria

    2016-12-30

    Throughout the past decade, HIV rates in Florida-particularly South Florida, where many Latina seasonal farmworkers reside and work-have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings.

  14. Heterosexual transmission of HIV and related risk factors among serodiscordant couples in Henan province, China

    Institute of Scientific and Technical Information of China (English)

    WANG Lan; WANG Lu; M.Kumi Smith; LI Li-ming; MING Shuai; L(U) Jun; CAO Wei-hua

    2013-01-01

    Background HIV transmission between discordant couples has become an important source of new infections in China.To describe the seroconversion rate among serodiscordant couples and to identify salient behavioral and clinical risk factors including ART that affect heterosexual HIV transmission risk among couples in rural China.Methods Longitudinal follow-up of an open cohort of HIV serodiscordant couples took place between 2007 and 2011 in Zhumadian,a city in southern Henan province in China,where blood plasma selling in 1990s led to a regional HIV epidemic.Annual follow-up included separate face-to-face interviews of husbands and wives,and HIV antibody testing for non-index partners.Cox proportional-hazard modeling was used to assess the relationship between HIV seroconversion and covariates of interest.Results By the end of 2011,4499 HIV serodiscordant couples had been enrolled in at least two follow-up interviews; 100 non-index partners seroconverted during the entire observation period for an incidence rate of 0.82 per 100 person-years (95% CI:0.66-0.99).The incidence rates by the end of 2008,2009,and 2010 were 2.14,1.51,and 0.90 per 100 personyears respectively.Always using condoms in the past year of sex,gender of the index partner,frequency of sex,and ART exposure were all significant predictors of HIV seroconversion in the negative spouse.ART was highly protective against seroconversion whether the index partner was actively receiving treatment at the last follow-up (RR=0.05,95% CI,0.01-0.16) or if the index partner had ever received ART (RR=0.01,95% CI,0.00,0.12).The risk of seroconversion in the nonindex spouse also decreased the longer the duration of the index partner's exposure to ART.Conclusions ART exposure and always using condom were highly protective against HIV semconversion in the negative spouse.HIV incidence in serodiscordant couples has been decreasing over time,associated with ART treatment time within 7 years in the index partner

  15. Living in rural New England amplifies the risk of depression in patients with HIV

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    Jensen Paul T

    2009-03-01

    Full Text Available Abstract Background The importance of depression as a complication of HIV infection is increasingly understood, and people living in rural areas are at increased risk for depression. However, it is not known whether living in rural areas amplifies the risk of depression in patients with HIV. Methods We compared the prevalence of depression between rural and metropolitan HIV patients seen at the Dartmouth-Hitchcock HIV Program in a retrospective cohort study. Using the validated Rural-Urban Commuting Area Score, we categorized patients as living in small town/rural areas, micropolitan or metropolitan towns. Then, using a multivariate logistic regression model to adjust for demographic factors that differed between rural and metropolitan patients, we estimated the impact of living in rural areas on the odds of depression. Results Among 646 patients with HIV (185 small town/rural, 145 micropolitan, 316 metropolitan, rural patients were older, white, male, and men who have sex with men (ANOVA, F-statistic Conclusion HIV-infected patients living in rural areas, particularly those on antiretroviral therapy, are highly vulnerable to depression.

  16. Self-Identified Sexual Orientation and Sexual Risk Behavior Among HIV-Infected Latino Males.

    Science.gov (United States)

    Champion, Jane Dimmitt; Szlachta, Alaina

    2016-01-01

    The HIV testing, disclosure, and sexual practices of ethnic minority men suggest that addressing sexual risk behavior and the underlying reasons for not receiving HIV testing or disclosing HIV-infection status-unique to differing populations-would improve public health interventions. Descriptive behaviors and underlying perspectives reported in our study suggest that public health interventions for HIV-infected Latino men who self-identify as heterosexual should explicitly identify substance use, needle sharing, and unprotected sex to current partners as behaviors placing both oneself and one's partners at high risk for contracting HIV. However, diversity of sexual behavior among gay, straight, and bisexual HIV-infected Latino men in our study ultimately suggested that clinicians should not rely on simplistic conceptions of sexuality in assessment of self-care needs. Care in presentation and discussion of self-identified sexual preference and sexual behavior is indicated, as these do not determine actual sexual orientation or behavior and vice versa. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  17. Sexual and reproductive health and HIV/AIDS risk perception in the Malawi tourism industry.

    Science.gov (United States)

    Bisika, Thomas

    2009-06-01

    Malawi has for a long time relied on agriculture for the generation of foreign exchange. Due to varied reasons like climate change, the Malawi government has, therefore, identified tourism as one way of boosting foreign exchange earnings and is already in the process of developing the sector especially in the area of ecotourism. However, tourism is associated with increasing prostitution, drug abuse and a whole range of other sexual and reproductive health (SRH) problems such as teenage pregnancies, HIV/AIDS and sexually transmitted infections (STIs). This paper examines the knowledge, attitudes, practices and behaviour as well as risk perceptions associated with HIV/AIDS, sexually transmitted infections and unwanted pregnancies among staff in the tourism industry and communities around tourist facilities in Malawi. The study was descriptive in nature and used both qualitative and quantitative research methods. The qualitative methods involved in-depth interviews and focus group discussions. The quantitative technique employed a survey of 205 purposively selected subjects from the tourism sector. The study concludes that people in the tourism sector are at high risk of HIV/AIDS, sexually transmitted infections and unwanted pregnancies and should be considered as a vulnerable group. The study further observes that this group of people has not adopted behaviours that can protect them from HIV/AIDS, sexually transmitted infections and unwanted pregnancies although there is high demand for voluntary counselling and testing (VCT) which offers a very good entry point for HIV prevention and treatment in the tourism sector. The study recommends that a comprehensive tourism policy covering tourists, employees and communities around tourist facilities is required. Such a policy should address the rights of HIV infected employees and the provision of prevention and treatment services for HIV/AIDS and STIs as well as a broad range of SRH and family planning services especially

  18. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    OpenAIRE

    Kiene, Susan M.; Fisher, William A.; Shuper, Paul A.; Cornman, Deborah H.; Christie, Sarah; MacDonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D.

    2013-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV tr...

  19. Identifying community risk factors for HIV among South African adolescents with mental health problems: a qualitative study of parental perceptions.

    Science.gov (United States)

    Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky

    2014-01-01

    High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.

  20. College Student Risk Behaviors: Implications for the HIV-AIDS Pandemic.

    Science.gov (United States)

    MacNair-Semands, Rebecca R.; Simono, R. B.

    1996-01-01

    Studied the link between specific sexual behaviors, HIV testing, levels of knowledge and personal vulnerability regarding HIV, and alcohol and condom use among college students. A significant portion (33.9%) of students stated that they were at risk for HIV and 25.4% reported that they had been tested for HIV. Includes a copy of the behavior…

  1. Epidemiological profile and risk factors of HIV and HBV/HCV co-infection in Fujian Province, southeastern China.

    Science.gov (United States)

    Wu, Shouli; Yan, Pingping; Yang, Tianfei; Wang, Zhenghua; Yan, Yansheng

    2017-03-01

    This study aimed to investigate the epidemiological features of HIV-infected subjects co-infected with HBV/HCV in Fujian Province, southeastern China, and identify the risk factors. Blood samples were collected from 2,028 HIV antibody-positive subjects in Fujian Province. Serum HBsAg and anti-HCV antibody were detected, and CD4(+) T cell count was measured. Of the 2,028 subjects, the prevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV co-infections was 16.22%, 3.7%, and 0.79%, respectively. Man (OR = 1.912, 95% CI: 1.371-2.667), key population (OR = 0.756, 95% CI: 0.57-0.976) and detainee (OR = 0.486, 95% CI: 0.259-0.909) were risk factors of HIV-HBV co-infection, and man (OR = 2.227, 95% CI: 1.096-4.525), minority (OR = 5.04, 95% CI: 1.696-14.98), junior high school or lower education (OR = 2.32, 95% CI: 1.071-5.025), intravenous drug use (OR = 38.46, 95% CI: 11.46-129.11) and detainee (OR = 5.687, 95% CI: 2.44-13.25) were risk factors of HIV-HCV co-infection. In addition, a lower mean CD4(+) T cell count was measured in HIV/HBV and HIV/HCV co-infected subjects than in HIV-infected subjects among the untreated individuals, while in the treated populations, a higher mean CD4(+) T cell count was detected in HIV/HBV and HIV/HCV co-infected subjects than in HIV-infected subjects. HIV co-infection with HBV or HCV, notably HIV-HBV co-infection, is widespread in southeastern China. Hepatitis virus screening should be included in monitoring of HIV infection, and HIV and hepatitis virus co-infection should be considered during the development of HIV antiretroviral therapy scheme. J. Med. Virol. 89:443-449, 2017. © 2016 Wiley Periodicals, Inc.

  2. Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study

    Directory of Open Access Journals (Sweden)

    Khodabakhsh Ahmadi

    2012-01-01

    Full Text Available Purpose. To assess the prevalence and associated factors of unprotected sex with injecting drug users (IDUs among a sample of female sex workers (FSWs in Iran. Methods. This cross-sectional study included 144 FSWs who were interviewed as a part of Unhide HIV Risk Study, a national behavioral survey focusing on various high-risk populations, including IDUs, FSWs, and Men who have Sex with Men (MSMs in 2009. The survey was conducted in eight provinces in Iran using respondent-driven sampling. Participants’ sociodemographic status, HIV knowledge, and HIV attitude were analyzed via logistic regression to determine the predictors of unprotected sex with IDU(s during the past month. Results. Nineteen percent of FSWs reported at least one occasion of unprotected sex with IDU(s in the month preceding the study. Higher educational level (OR=−0.653, 95%CI=-1.192 to −0.115, perceived HIV risk (OR=−1.047, 95%CI=-2.076 to −0.019, and perceived family intimacy during childhood (OR=−1.104, 95%CI=-1.957 to −0.251 were all independently associated with lower odds of having unprotected sex with IDU(s in the month preceding the study. Age, marital status, living condition, HIV knowledge, and perceived behavioral control did not affect the odds of FSWs having sex with IDUs. Conclusion. Perceived HIV risk, which is a modifiable factor, seems to be a promising target for harm reduction interventions amongst Iranian female sex workers. Data presented here may aid in reducing or eliminating the role of sex workers as a bridge for HIV transmission from IDUs to the general population in Iran.

  3. 宣化区男男性接触者艾滋病感染及高危行为状况调查研究%Survey of HIV infection status and high risk behaviors among MSM in Xuanhua district

    Institute of Scientific and Technical Information of China (English)

    段志才; 刘吉姝; 蔡斌郁

    2012-01-01

    目的 调查宣化区男男性接触者(men who have sex with men,MSM)艾滋病感染和高危行为现状,提出针对性防控工作策略.方法 在不同行业选定志愿者,以滚雪球方法 选取142名MSM为研究对象,采用一对一匿名问卷调查方式开展调查.结果 MSM高中以上文化程度占63%;38%未婚;肛交时安全套使用率低,口交时无人使用安全套,26%与女性发生过性行为;抗- HIV检测阳性8例,感染率为5.63%.结论 宣化区MSM艾滋病感染率较高;从多种行业中招募志愿者可作为扩大MSM人群高危行为干预和监测覆盖率的一种工作策略.%Objective To investigate the HIV infection status and high risk behaviors among MSM in Xuanhua, so as to provide scientific basis for proposing direction prevention and control direction strategies. Method Enlisting volunteers from different industries, selecting 142 MSMs as study objects by using rolling snowball method, adopting one - to - one a-nonymously questionnaire to carrying out investigation. Results By the investigation, 63% MSMs with high middle school education or higher. Low rate of condom used for anal sex and no one used condoms when oral sex, 26% of them had sexual behavior with women. Total of 8 cases were Ami - HIV positive, the infection rate was 5.63%. Conclusions The HIV infection rate among MSM was high in Xuanhua. Enlisting volunteers from different industries may be a strategy for expanding high risk behaviors intervention and monitoring coverage rate.

  4. CD26/dipeptidyl peptidase IV (CD26/DPPIV is highly expressed in peripheral blood of HIV-1 exposed uninfected Female sex workers

    Directory of Open Access Journals (Sweden)

    Meyers Adrienne FA

    2010-11-01

    Full Text Available Abstract Background Design of effective vaccines against the human immunodeficiency virus (HIV-1 continues to present formidable challenges. However, individuals who are exposed HIV-1 but do not get infected may reveal correlates of protection that may inform on effective vaccine design. A preliminary gene expression analysis of HIV resistant female sex workers (HIV-R suggested a high expression CD26/DPPIV gene. Previous studies have indicated an anti-HIV effect of high CD26/DPPIV expressing cells in vitro. Similarly, high CD26/DPPIV protein levels in vivo have been shown to be a risk factor for type 2 diabetes. We carried out a study to confirm if the high CD26/DPPIV gene expression among the HIV-R were concordant with high blood protein levels and its correlation with clinical type 2 diabetes and other perturbations in the insulin signaling pathway. Results A quantitative CD26/DPPIV plasma analysis from 100 HIV-R, 100 HIV infected (HIV + and 100 HIV negative controls (HIV Neg showed a significantly elevated CD26/DPPIV concentration among the HIV-R group (mean 1315 ng/ml than the HIV Neg (910 ng/ml and HIV + (870 ng/ml, p Conclusion HIV resistant sex workers have a high expression of CD26/DPPIV in tandem with lowered immune activation markers. This may suggest a novel role for CD26/DPPIV in protection against HIV infection in vivo.

  5. Comparison of HIV infection risk behaviors among injection drug users from East and West Coast US cities.

    Science.gov (United States)

    Garfein, Richard S; Monterroso, Edgar R; Tong, Tony C; Vlahov, David; Des Jarlais, Don C; Selwyn, Peter; Kerndt, Peter R; Word, Carl; Fernando, M Daniel; Ouellet, Lawrence J; Holmberg, Scott D

    2004-06-01

    This study assessed whether behavioral differences explained higher human immunodeficiency virus (HIV) seroprevalence among injection drug users (IDUs) in three East Coast versus two West Coast cities in the United States. Sociodemographic, sexual, and injecting information were collected during semiannual face-to-face interviews. Baseline data from New York City; Baltimore, Maryland; and New Haven, Connecticut, were compared with data from Los Angeles, California, and San Jose, California. Among 1,528 East Coast and 1,149 West Coast participants, HIV sero-prevalence was 21.5% and 2.3%, respectively (odds ratio [OR] 11.9; 95% confidence interval [CI] 7.9-17.8). HIV risk behaviors were common among IDUs on both coasts, and several were more common among West Coast participants. Adjusting for potential risk factors, East (vs. West) Coast of residence remained highly associated with HIV status (adjusted OR 12.14; 95% CI 7.36-20.00). Differences in HIV sero-prevalence between East and West Coast cities did not reflect self-reported injection or sexual risk behavior differences. This suggests that other factors must be considered, such as the probability of having HIV-infected injection or sexual partners. Prevention efforts are needed on the West Coast to decrease HIV-associated risk behaviors among IDUs, and further efforts are also needed to reduce HIV incidence on the East Coast.

  6. An assessment of health-care students' attitudes toward patients with or at high risk for HIV: implications for education and cultural competency.

    Science.gov (United States)

    Jin, Harry; Earnshaw, Valerie A; Wickersham, Jeffrey A; Kamarulzaman, Adeeba; Desai, Mayur M; John, Jacob; Altice, Frederick L

    2014-01-01

    Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p patients were significantly lower and significantly different between each group comparison. Within group differences, most notably religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia.

  7. HIV Risk and Perceptions of Masculinity among Young Black MSM

    Science.gov (United States)

    Fields, Errol L.; Bogart, Laura M.; Smith, Katherine C.; Malebranche, David J.; Ellen, Jonathan; Schuster, Mark A.

    2011-01-01

    Purpose Young Black men who have sex with men (MSM) have among the highest rates of HIV infection in the US. Although reported rates of unprotected anal intercourse are similar to MSM of other racial/ethnic backgrounds, young Black MSM (YBMSM) aged 15–22 are 5 times more likely than comparably aged white MSM to be HIV-infected. We explored contextual social-environmental factors that may influence how YBMSM assess risk, choose partners, and make decisions about condom use. Methods We analyzed semi-structured interviews with 35 YBMSM (18–24) in New York City, upstate NY, and Atlanta. We used structured analytic coding based on a theoretical scheme that emerged from the data. Results Perception of masculinity was the primary contextual factor influencing partner selection, risk assessment, and condom decision-making. Four primary themes emerged: 1) greater preference for partners perceived as masculine; 2) discomfort with allowing men perceived as feminine to be the insertive partner in anal intercourse; 3) a power dynamic such that partners perceived as more masculine made condom-use decisions within the dyad; and 4) use of potential partners’ perceived masculinity to assess HIV risk. Conclusions Perceived masculinity may play a significant role in HIV risk for YBMSM and may be an important concept to consider in prevention strategies directed towards this population. PMID:22325136

  8. Diabetes Risk May Be Higher for HIV-Positive Adults

    Science.gov (United States)

    ... Español You Are Here: Home → Latest Health News → Article URL of this page: https://medlineplus.gov/news/fullstory_163344.html Diabetes Risk May Be Higher for HIV-Positive Adults Longer survival with the virus might ...

  9. Risk factors of HIV-related oral lesions in adults

    Directory of Open Access Journals (Sweden)

    Maria Noel Marzano Rodrigues Petruzzi

    2013-02-01

    Full Text Available OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001, alcohol consumption (p = 0.011 and female gender (p = 0.031 were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029 a viral load above 5,000 copies/mm³ (p = 0.003 and smoking (p = 0.005. CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

  10. Factors associated with willingness to accept oral fluid HIV rapid testing among most-at-risk populations in China.

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    Huanmiao Xun

    Full Text Available BACKGROUND: The availability of oral fluid HIV rapid testing provides an approach that may have the potential to expand HIV testing in China, especially among most-a-risk populations. There are few investigations about the acceptability of oral fluid HIV testing among most-at-risk populations in China. METHOD: A cross-sectional study with men who have sex with men (MSM, female sex workers (FSW and voluntary counseling and testing (VCT clients was conducted in three cities of Shandong province, China from 2011 to 2012. Data were collected by face-to-face questionnaire. RESULTS: About 71% of participants were willing to accept the oral fluid HIV rapid testing, and home HIV testing was independently associated with acceptability of the new testing method among MSM, FSW and VCT clients (AOR of 4.46, 3.19 and 5.74, respectively. Independent predictors of oral fluid HIV rapid testing acceptability among MSM were having ever taken an oral fluid HIV rapid test (AOR= 15.25, having ever taken an HIV test (AOR= 2.07, and education level (AOR= 1.74. Engagement in HIV-related risk behaviors (AOR= 1.68 was an independent predictor of acceptability for FSW. Having taken an HIV test (AOR= 2.85 was an independent predictor of acceptability for VCT clients. The primary concern about the oral fluid HIV testing was accuracy. The median price they would pay for the testing ranged from 4.8 to 8.1 U.S. dollars. CONCLUSION: High acceptability of oral fluid HIV rapid testing was shown among most-at-risk populations. Findings provide support for oral rapid HIV testing as another HIV prevention tool, and provide a backdrop for the implementation of HIV home testing in the near future. Appropriate pricing and increased public education through awareness campaigns that address concerns about the accuracy and safety of the oral fluid HIV rapid testing may help increase acceptability and use among most-at-risk populations in China.

  11. Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review

    OpenAIRE

    Laisaar, Kaja-Triin; Raag, Mait; Rosenthal, Marika; Uusküla, Anneli

    2015-01-01

    Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-rand...

  12. Affect regulation and HIV risk among youth in therapeutic schools

    Science.gov (United States)

    Brown, Larry K.; Houck, Christopher; Lescano, Celia; Donenberg, Geri; Tolou-Shams, Marina; Mello, Justin

    2012-01-01

    The acquisition of affect regulation skills is often impaired or delayed in youth with mental health problems but the relationship between affect dysregulation and risk behaviors has not been well studied. Baseline data from adolescents (N =418; ages 13–19) recruited from therapeutic school settings examined the relationship between affect dysregulation, substance use, self-cutting, and sexual risk behavior. Analyses of covariance demonstrated that adolescents who did not use condoms at last sex, ever self-cut, attempted suicide, used alcohol and other drugs and reported less condom use self-efficacy when emotionally aroused were significantly more likely (p < .01) to report greater difficulty with affect regulation than peers who did not exhibit these behaviors. General patterns of difficulty with affect regulation may be linked to HIV risk behavior, including condom use at last sex. HIV prevention strategies for youth in mental health treatment should target affect regulation in relation to multiple risk behaviors. PMID:22669595

  13. Invasive cervical cancer risk among HIV-infected women: A North American multi-cohort collaboration prospective study

    Science.gov (United States)

    Abraham, Alison G; Strickler, Howard D; Jing, Yuezhou; Gange, Stephen J; Sterling, Timothy R; Silverberg, Michael; Saag, Michael; Rourke, Sean; Rachlis, Anita; Napravnik, Sonia; Moore, Richard D; Klein, Marina; Kitahata, Mari; Kirk, Greg; Hogg, Robert; Hessol, Nancy A; Goedert, James J; Gill, M John; Gebo, Kelly; Eron, Joseph J; Engels, Eric A; Dubrow, Robert; Crane, Heidi M; Brooks, John T; Bosch, Ronald; D’Souza, Gypsyamber

    2013-01-01

    Objective HIV infection and low CD4+ T-cell count are associated with an increased risk of persistent oncogenic HPV infection – the major risk factor for cervical cancer. Few reported prospective cohort studies have characterized the incidence of invasive cervical cancer (ICC) in HIV-infected women. Methods Data were obtained from HIV-infected and -uninfected female participants in the NA-ACCORD with no history of ICC at enrollment. Participants were followed from study entry or January, 1996 through ICC, loss-to follow-up or December, 2010. The relationship of HIV infection and CD4+ T-cell count with risk of ICC was assessed using age-adjusted Poisson regression models and standardized incidence ratios (SIR). All cases were confirmed by cancer registry records and/or pathology reports. Cervical cytology screening history was assessed through medical record abstraction. Results A total of 13,690 HIV-infected and 12,021 HIV-uninfected women contributed 66,249 and 70,815 person-years (pys) of observation, respectively. Incident ICC was diagnosed in 17 HIV-infected and 4 HIV-uninfected women (incidence rate of 26 and 6 per 100,000 pys, respectively). HIV-infected women with baseline CD4+ T-cells of ≥ 350, 200–349 and <200 cells/uL had a 2.3-times, 3.0-times and 7.7-times increase in ICC incidence, respectively, compared with HIV-uninfected women (Ptrend =0.001). Of the 17 HIV-infected cases, medical records for the 5 years prior to diagnosis showed that 6 had no documented screening, 5 had screening with low grade or normal results, and 6 had high-grade results. Conclusions This study found elevated incidence of ICC in HIV-infected compared to -uninfected women, and these rates increased with immunosuppression. PMID:23254153

  14. Prevalence and distribution of cervical high-risk human papillomavirus and cytological abnormalities in women living with HIV in Denmark - the SHADE

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Storgaard, Merete; Katzenstein, Terese L

    2016-01-01

    and cytological abnormalities in WLWH compared with WGP in Denmark. Predictors of HPV and cytological abnormalities were estimated in WLWH. METHODS: WLWH consecutively enrolled in the Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) in 2011 and were examined for cervical HPV...... and cytological abnormalities. WLWH were matched on age and prior cytological findings with WGP from an earlier study. HIV demographics were retrieved from the nationwide Danish HIV Cohort Study. Logistic regression was used to estimate predictors of hrHPV and cytological abnormalities. RESULTS: Of 334 included...... (adjusted OR 2.05 (95 % CI 1.03-4.10)) and CD4 Cytological abnormalities were prevalent in 10.4 % vs. 5.2 % (p = 0.0003) of WLWH and WGP. In WLWH with hrHPV, short duration of HAART predicted cervical dysplasia (adjusted OR per year 0.83 (95 % CI 0...

  15. HIV infection, risk factors, and preventive services utilization among female sex workers in the Mekong Delta Region of Vietnam.

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    Bach Xuan Tran

    Full Text Available BACKGROUND: Risk behaviors among female sex workers (FSW are considerable drivers of HIV infections in Vietnam, especially transmission between high-risk and low-risk groups. We assessed HIV prevalence and its correlates among FSWs, and the use of preventive services among this community in the Mekong Delta region, southern Vietnam. METHODS: A cross-sectional survey of 1,999 FSWs was carried out in five provinces including Ben Tre, Hau Giang, Kien Giang, Tien Giang, and Vinh Long between June, 2006 and June, 2007. We interviewed participants face-to-face in order to elicit information about their lives and potential risk factors, and we tested their sera to determine their HIV status. We then performed multivariate logistic regression analyses to investigate factors associated with HIV infection. RESULTS: Seventeen percent of the participating FSWs were street-based sex workers (SSWs and the rest (83% were entertainment establishment-based sex workers (ESWs. Unprotected sex with regular and casual clients in the past month was frequent among study participants (40.5% and 33.5% respectively. However, few respondents (1.3% had ever injected drugs. Only 2.1% (95% confidence interval (CI: 1.6%-2.8% of FSWs were found to be infected with HIV. HIV prevalence among SSWs was greater than among ESWs (3.8% vs. 1.8%, p = 0.02, respectively. Increased risk for HIV infection was significantly associated with the number of clients per month (adjusted odd ratio (aOR = 2.65, 95% CI: 1.26-5.59. CONCLUSIONS: Interventions to reduce unsafe sex and drug injection, and to increase uptake of HIV testing among FSWs are necessary. Differences in HIV prevalence and its correlates by type of sex work emphasize the importance of constrained contexts in shaping risk behaviors among FSWs; that should be considered in designing HIV prevention programs.

  16. HIV and risk of cardiovascular disease in sub-Saharan Africa: Rationale and design of the Ndlovu Cohort Study.

    Science.gov (United States)

    Vos, Alinda; Tempelman, Hugo; Devillé, Walter; Barth, Roos; Wensing, Annemarie; Kretzschmar, Mirjam; Klipstein-Grobusch, Kerstin; Hoepelman, Andy; Tesselaar, Kiki; Aitken, Sue; Madzivhandila, Mashudu; Uiterwaal, Cuno; Venter, Francois; Coutinho, Roel; Grobbee, Diederick E

    2017-07-01

    Background The largest proportion of people living with HIV resides in sub-Saharan Africa (SSA). Evidence from developed countries suggests that HIV infection increases the relative risk of cardiovascular disease (CVD) by up to 50%. Differences in lifestyle, gender distribution, routes of HIV transmission and HIV subtype preclude generalisation of data from Western countries to the SSA situation. The Ndlovu Cohort Study aims to provide insight into the burden of cardiovascular risk factors and disease, the mechanisms driving CVD risk and the contribution of HIV infection and its treatment to the development of CVD in a rural area of SSA. Design The Ndlovu Cohort Study is a prospective study in the Moutse area, Limpopo Province, South Africa. Methods A total of 1000 HIV-positive and 1000 HIV-negative participants aged 18 years and older with a male to female ratio of 1:1 will be recruited. Measurements of CVD risk factors and HIV-related characteristics will be performed at baseline, and participants will be followed-up over time at 6-month intervals. The burden of CVD will be assessed with repeated carotid intima-media thickness and pulse wave velocity measurements, as well as by recording clinical cardiovascular events that occur during the follow-up period. Conclusion This project will contribute to the understanding of the epidemiology and pathogenesis of CVD in the context of HIV infection in a rural area of SSA. The ultimate goal is to improve cardiovascular risk prediction and to indicate preventive approaches in the HIV-infected population and, potentially, for non-infected high-risk populations in a low-resource setting.

  17. Gender differences in the risk of HIV infection among persons reporting abstinence, monogamy, and multiple sexual partners in northern Tanzania.

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    Keren Z Landman

    Full Text Available BACKGROUND: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT in northern Tanzania. METHODOLOGY/ PRINCIPAL FINDINGS: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by number of lifetime sexual partners, and rates of seropositivity were reported by category. Factors associated with HIV seropositivity among monogamous males and females were identified by a multivariate logistic regression model. Of 6,549 clients, 3,607 (55% were female, and the median age was 30 years (IQR 24-40. 939 (25% females and 293 (10% males (p<0.0001 were HIV seropositive. Among 1,244 (34% monogamous females and 423 (14% monogamous males, the risk of HIV infection was 19% and 4%, respectively (p<0.0001. The risk increased monotonically with additional partners up to 45% (p<0.001 and 15% (p<0.001 for women and men, respectively with 5 or more partners. In multivariate analysis, HIV seropositivity among monogamous women was most strongly associated with age (p<0.0001, lower education (p<0.004, and reporting a partner with other partners (p = 0.015. Only age was a significant risk factor for monogamous men (p = 0.0004. INTERPRETATION: Among women presenting for VCT, the number of partners is strongly associated with rates of seropositivity; however, even women reporting lifetime monogamy have a high risk for HIV infection. Partner reduction should be coupled with efforts to place tools in the hands of sexually active women to reduce their risk

  18. High-risk motorcycle taxi drivers in the HIV/AIDS era: a respondent-driven sampling survey in Kampala, Uganda.

    Science.gov (United States)

    Lindan, Christina P; Anglemyer, Andrew; Hladik, Wolfgang; Barker, Joseph; Lubwama, George; Rutherford, George; Ssenkusu, John; Opio, Alex; Campbell, James

    2015-04-01

    We evaluated motorcycle taxi ('boda-boda') drivers in Kampala for the prevalence of HIV/sexually transmitted infections. We used respondent-driven sampling to recruit a cross-sectional sample of boda-boda drivers. We collected data through audio computer-assisted self-administered interviews. Men were tested for HIV, syphilis serology using Rapid Plasma Reagin and enzyme immunoassay, and Chlamydia and gonorrhoea using urine polymerase chain reaction. We recruited 683 men. Median age was 26 years; 59.4% were single. The prevalence of HIV was 7.5% (95% CI 5.2-10.0), of positive syphilis serology was 6.1% (95% CI 4.3-8.1), of Chlamydia was 1.1% (95% CI 0.4-2.0), and of gonorrhoea was 1.2% (95% CI 0.1-1.2). Many men (67.8%) had both casual and regular partners, sex with other men (8.7%), and commercial sex (33.1%). Factors associated with having HIV included reporting a genital ulcer (odds ratio [OR] =2.4, 95% CI 1.4-4.4), drinking alcohol during last sex (OR 2.0, 95% CI 1.1-3.7), having 4-6 lifetime partners (OR 2.2, 95% CI 1.0-4.8), and having one's last female partner be >24 years of age (OR 2.8, 95% CI 1.2-6.6). Independent predictors of HIV included age ≥31 (adjusted OR (aOR) 5.8, 95% CI 1.5-48.5), having 4-6 partners (aOR 2.2, 95%CI 1.0-5.1), and self-report of a genital ulcer (OR 2.3, 95% CI 1.2-4.1). Only 39.2% of men were circumcised, and 36.9% had been HIV tested in the past. Male boda-boda drivers have a higher prevalence of HIV than the general population, and low frequency of preventive behaviours, such as circumcision and HIV testing. Targeted and intensified interventions for this group are warranted. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. Risk of Myocardial Infarction in Parents of HIV-infected Individuals:a population-based Cohort Study

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    Kronborg Gitte

    2010-06-01

    Full Text Available Abstract Background Previous studies have indicated an increased risk of myocardial infarction (MI in HIV infected individuals especially after start of highly active antiretroviral therapy (HAART. It is however controversial whether the increased risk of atherosclerotic disease is exclusively associated with the HIV disease and HAART or whether life-style related or genetic factors also increase the risk in this population. To establish whether the increased risk of myocardial infarction in HIV patients partly reflects an increased risk of MI in their families, we estimated the relative risk of MI in parents of HIV-infected individuals. Methods From the Danish HIV Cohort Study and the Danish Civil Registration System we identified the parents of all HIV-infected patients born in Denmark after 1952 in whom a Danish born mother was identifiable. For each HIV patient, 4 matched population controls and their parents were identified. Cumulative incidence functions were constructed to illustrate time to first MI of the parents as registered in the Danish National Hospital Registry. Incidence rate ratios (IRR were estimated by Cox's regression analyses. Due to the confidential type of the analysed data the study was approved by the Danish Data Protection Agency. Results 2,269 mothers and 2,022 fathers of HIV patients as well as 9,076 mothers and 8,460 fathers of control subjects were identified. We observed an increased risk of MI in mothers of HIV patients (adjusted IRR, 1.31; 95% CI: 1.08-1.60. The strongest association was seen in case the offspring was infected heterosexually (adjusted IRR, 1.59; 95% CI: 1.07-2.35 or by IV drug abuse (IVD (adjusted IRR, 1.63; 95% CI: 1.02-2.60. In fathers of HIV patients the risk of MI was only increased if the offspring was infected by IVD (adjusted IRR, 1.42; 95% CI: 1.01-2.00. Conclusion Mothers of HIV-infected patients have an increased risk of MI. We presume that this stems from family related life style risk

  20. High risk pregnancy

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    Bernardita Donoso Bernales

    2012-06-01

    Full Text Available It is estimated that roughly 20% of pregnancies fall into the high risk category, which in turn are responsible for over 80% of perinatal adverse outcome. Modern obstetrics has been very successful in reducing maternal morbidity and mortality. It has focused mainly on fetal and neonatal aspects, and on identifying the subgroup of pregnant women that need greater surveillance and care because of clearly identifiable risk factors. The article describes the preconceptional advice, its components and recommendations for its implementation, as well as its role in maternal and perinatal risk assessment. These interventions attempt to reduce the rates of maternal and perinatal mortality.

  1. Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior.

    Science.gov (United States)

    Meade, Christina S; Kershaw, Trace S; Hansen, Nathan B; Sikkema, Kathleen J

    2009-04-01

    The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.

  2. Acute risk for hepatitis E virus infection among HIV-1-positive pregnant women in central Africa

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    Caron Mélanie

    2012-10-01

    Full Text Available Abstract Background Hepatitis E virus (HEV, an enterically transmitted pathogen, is highly endemic in several African countries. Pregnant women are at particularly high risk for acute or severe hepatitis E. In Gabon, a central African country, the prevalence of antibodies to HEV among pregnant women is 14.1%. Recent studies have demonstrated unusual patterns of hepatitis E (chronic hepatitis, cirrhosis among immunodeficient patients. Findings We investigated the prevalence of antibodies to HEV among pregnant women infected with HIV-1 or HTLV-1 in Gabon. Of 243 samples collected, 183 were positive for HIV-1 and 60 for HTLV-1; 16 women (6.6% had IgG antibodies to HEV. The seroprevalence was higher among HIV-1-infected women (7.1% than HTLV-1-infected women (5.0%. Moreover, the HIV-1 viral load was significantly increased (p ≤ 0.02 among women with past-HEV exposure (1.3E+05 vs 5.7E+04 copies per ml, whereas no difference was found in HTLV-1 proviral load (9.0E+01 vs 1.1E+03 copies per ml. Conclusions These data provide evidence that HIV-1-infected women are at risk for acute or severe infection if they are exposed to HEV during pregnancy, with an increased viral load.

  3. Combining social and genetic networks to study HIV transmission in mixing risk groups

    NARCIS (Netherlands)

    Zarrabi, N.; Prosperi, M.C.F.; Belleman, R.G.; Di Giambenedetto, S.; Fabbiani, M.; De Luca, A.; Sloot, P.M.A.

    2013-01-01

    Reconstruction of HIV transmission networks is important for understanding and preventing the spread of the virus and drug resistant variants. Mixing risk groups is important in network analysis of HIV in order to assess the role of transmission between risk groups in the HIV epidemic. Most of the r

  4. HIV prevalence and sexual risk behaviors associated with awareness of HIV status among men who have sex with men in Paris, France.

    Science.gov (United States)

    Velter, Annie; Barin, Francis; Bouyssou, Alice; Guinard, Jérôme; Léon, Lucie; Le Vu, Stéphane; Pillonel, Josiane; Spire, Bruno; Semaille, Caroline

    2013-05-01

    A cross-sectional survey, using self-sampled finger-prick blood on blotting paper and anonymous behavioral self-administrated questionnaires was conducted in Paris in 2009 among MSM attending gay venues. Paired biological results and questionnaires were available for 886 participants. HIV seroprevalence was 17.7 % (95 % CI: 15.3-20.4). Four groups were identified according to their knowledge of their HIV biological status. Among the 157 found to be seropositive, 31 (19.7 %) were unaware of their status and reported high levels of sexual risk behaviors and frequent HIV testing in the previous 12 months. Among the 729 MSM diagnosed HIV-negative, 183 were no longer sure whether they were still HIV-negative, or had never been tested despite the fact that they engaged in at-risk sexual behaviors. This study provides the first estimate of HIV seroprevalence among MSM in Paris and underlines the specific need for combined prevention of HIV infection in this MSM population.

  5. Professional risk, knowledge, attitudes and practice of health care personnel in Serbia with regard to HIV and AIDS.

    Science.gov (United States)

    Kocić, Biljana; Petrović, Branislav; Bogdanović, Dragan; Jovanović, Jovica; Nikić, Dragana; Nikolić, Maja

    2008-09-01

    The aim of our investigation was to assess HIV/AIDS-related professional risk, knowledge, attitude and practice of health care workers in Nis. A cross-sectional study of health personnel from Primary Health Centre, Clinical Medical Centre and Dental Clinic in Nis was performed. The data were collected by an anonymous questionnaire. Mantel-Haenszel X2 testing and multiple logistic regression analysis were applied. Results show that 89% of health personnel perceived high professional risk of acquiring HIV infection. The risk perception of acquiring HIV infections was higher among those who were frequently exposed to patients' blood and other body fluids (OR = 10.1 95% CI = 3.1-32.5), and those who had treated HIV-positive patients (OR = 3.0 95% CI = 1.0-8.8). The majority of respondents had insufficient knowledge about the modes of HIV transmission. Nearly two thirds of health personnel agreed that every hospitalized patient should be tested for HIV, and more than four fifths of them agreed that their personal protection was more important than the confidentiality of patient's HIV/AIDS status. Twenty nine percent of health personnel use adequate protection during their daily work with patients. These findings indicated a need for urgent educational and training initiatives of HIV and AIDS for all categories of health care workers.

  6. Risk Behaviors and STI Prevalence Among People with HIV in El Salvador

    Science.gov (United States)

    Paz-Bailey, G; Shah, N; Creswell, J; Guardado, ME; Nieto, AI; Estrada, MC; Cedillos, R; Pascale, JM; Monterroso, E

    2012-01-01

    To date, there are no studies from El Salvador among people with HIV to inform prevention programs. We conducted a study in El Salvador in 2008 among people with HIV using audio computer-assisted interviews on risk behaviors and access to health care. Blood was tested for syphilis and herpes simplex type 2 (HSV-2). Active syphilis was defined as RPR titer ≥1:8. Genital specimens were tested for other sexually transmitted infections (STI) by PCR. We evaluated factors associated with unprotected sex with last stable partner of HIV-negative or unknown status among those reporting a stable partner. A total of 811 HIV-positive individuals participated: 413 men and 398 women. Prevalence of Chlamydia and gonorrhea was low (≤1%), while prevalence of other STI was high: Mycoplasma genitalium (14%), syphilis (15% seropositivity, active syphilis 3%) and HSV-2 (85%). In multivariate analysis, disclosing HIV status to partner (OR 0.2, 95% CI: 0.1-0.3, pEl Salvador should focus on increasing condom access, promoting HIV disclosure and couples testing and reducing the number of partners. The positive role of support groups should be used to enhance behavioral change. PMID:23049671

  7. HIV, STI prevalence and risk behaviours among women selling sex in Lahore, Pakistan

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    Zaman Shakila

    2011-05-01

    Full Text Available Abstract Background More than 340 million cases of curable sexually transmitted infections (STIs were estimated to have occurred worldwide in 1995. Previous studies have shown that the presence of other concomitant STIs increases the likelihood of HIV transmission. The first national study of STIs conducted in Pakistan in 2004 revealed a high burden of STIs among women selling sex. The HIV epidemic in Pakistan has thus far followed the "Asian epidemic model". Earlier studies among women selling sex have shown a low prevalence of HIV coupled with a low level of knowledge about AIDS. The aim of our study was to estimate the prevalence of HIV and STIs, and assess knowledge and risk behaviours related to HIV/STI, among women selling sex in Lahore, Pakistan. Methods A total of 730 participants were recruited through respondent-driven sampling. The participants were women selling sex in three areas (referred to as "A", "B", and "C" of Lahore. A structured questionnaire addressing demographic information, sexual life history, sexual contacts, and knowledge and practices related to HIV/STI prevention was administered by face-to-face interview. Biological samples were obtained from all participants and tested for HIV, Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. Pearson's chi-square and multivariable logistic regression analysis were performed to test associations between potential risk factors and specified diagnosed infections. Results The prevalence of HIV infection was 0.7%, T pallidum 4.5%, N gonorrhoeae 7.5%, C trachomatis 7.7% and T vaginalis 5.1%. The participants had been selling sex for a median period of seven years and had a median of three clients per day. Sixty five percent of the participants reported that they "Always use condom". The median fee per sexual contact was Rs. 250 (3 Euro. Compared to Areas A and C, women selling sex in Area B had a significantly higher risk of chlamydial

  8. Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya.

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    Gerald S Bloomfield

    Full Text Available There is increased risk of cardiovascular disease among HIV seropositive individuals. The prevalence of HIV is highest in sub-Saharan Africa; however, HIV-related cardiovascular risk research is largely derived from developed country settings. Herein, we describe the prevalence of hypertension and obesity in a large HIV treatment program in Kenya.We performed a retrospective analysis of the electronic medical records of a large HIV treatment program in Western Kenya between 2006 and 2009. We calculated the prevalence of hypertension and obesity among HIV+ adults as well as utilized multiple logistic regression analyses to examine the relationship between clinical characteristics, HIV-related characteristics, and hypertension.Our final sample size was 12,194. The median systolic/diastolic blood pressures were similar for both sexes (male: 110/70 mmHg, female: 110/70 mmHg. The prevalence of hypertension among men and women were 11.2% and 7.4%, respectively. Eleven percent of men and 22.6% of women were overweight/obese (body mass index ≥25 kg/m(2. Ordinal logistic regression analyses showed that overweight/obesity was more strongly associated with hypertension among HIV+ men (OR 2.41, 95% CI 1.88-3.09 than a higher successive age category (OR 1.62, 95% CI 1.40-1.87 comparing 16-35, 36-45 and >45 years categories. Among women, higher age category and overweight/obesity were most strongly associated with hypertension (age category: OR 2.21, 95% CI 1.95-2.50, overweight/obesity: OR 1.80, 95% CI 1.50-2.16. Length of time on protease inhibitors was not found to be related to hypertension for men (OR 1.62, 95% CI 0.42-6.20 or women (OR 1.17, 95% CI 0.37-2.65 after adjustment for CD4 count, age and BMI.In Western Kenya, there is a high prevalence of hypertension and overweight/obesity among HIV+ patients with differences observed between men and women. The care of HIV+ patients in sub-Saharan Africa should also include both identification and

  9. Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men

    Science.gov (United States)

    Sharma, Akshay; Goodreau, Steven M.; Rosenberg, Eli S.; Weiss, Kevin M.; Hoover, Karen W.; Smith, Dawn K.; Sullivan, Patrick

    2017-01-01

    Objectives Risk compensation (RC) could reduce or offset the biological prevention benefits of HIV preexposure prophylaxis (PrEP) among those at substantial risk of infection, including men who have sex with men (MSM). We investigated the potential extent and causal mechanisms through which RC could impact HIV transmission at the population and individual levels. Methods Using a stochastic network-based mathematical model of HIV transmission dynamics among MSM in the United States, we simulated RC as a reduction in the probability of condom use after initiating PrEP, with heterogeneity by PrEP adherence profiles and partnership type in which RC occurred. Outcomes were changes to population-level HIV incidence and individual-level acquisition risk. Results When RC was limited to MSM highly/moderately adherent to PrEP, 100% RC (full replacement of condoms) resulted in a 2% relative decline in incidence compared to no RC, but an 8% relative increase in infection risk for MSM on PrEP. This resulted from confounding by indication: RC increased the number of MSM indicated for PrEP as a function of more condomless anal intercourse among men otherwise not indicated for PrEP; this led to an increased PrEP uptake and subsequent decline in incidence. Conclusions RC is unlikely to decrease the prevention impact of PrEP, and in some cases RC may be counterintuitively beneficial at the population level. This depended on PrEP uptake scaling with behavioral indications. Due to the increased acquisition risk associated with RC, however, clinicians should continue to support PrEP as a supplement rather than replacement of condoms. PMID:28060881

  10. Heterosexual risk of HIV infection in China: systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    ZANG Chun-peng; JIA Zhong-wei; Katherine Brown; Kathleen Heather Reilly; WANG Jun-jie; WANG Ning

    2011-01-01

    Background Heterosexual sex has become the dominant transmission route in China. Recently studies reported high heterogeneity in heterosexual transmission risk in resource-limited countries. The aim of this study was to summarize the risk of HIV transmission among Chinese serodiscordant couples.Methods A systematic review and meta-analysis of observational studies of heterosexual HIV transmission among serodiscordant couples in China was conducted. Two reviewers conducted a literature search using the China National Knowledge Infrastructure (CNKI), Chinese Medical Current Contents (CMCC), and Medline databases. Pooled transmission estimates per 100 person-years (PY) were calculated using a random-effects model. Meta-regression analysis and subgroup analysis stratified by study design, transmission direction and period of antiretroviral therapy (ART) availability were conducted to assess the factors associated with transmission.Results Eleven eligible studies were identified reporting on 11 984 couples and 405 HIV transmission events. HIV transmission risk from HIV-positive individuals to heterosexual partners was 1.68 (95% CI 0.74-2.62) per 100 PY. Study design did not reach statistical significance in meta-regression analysis. The pooled female-to-male transmission estimate was 1.11 (95% CI 0.09-2.14) per 100 PY and male-to-female transmission estimate was 1.43 (95% CI 0.19-2.68) per 100 PY. The pooled estimate for those before the availability of the Chinese National Free Antiretroviral Therapy Program (2.13 (95% CI 0.00-4.63) per 100 PY) was higher than that for those after the implementation of this program (1.44 (95% C/0.62-2.26) per 100 PY).Conclusions Transmission estimates in China were lower than other developing countries, but higher than developed countries. Research that better defines HIV secondary transmission rates and the associated behavioral, treatment adherence, and health-related risk factors among heterosexual serodiscordant couples in China is

  11. Venues for Meeting Sex Partners and Partner HIV Risk Characteristics: HIV Prevention Trials Network (HPTN064) Women's HIV Seroincidence Study (ISIS)

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    Golin, C.; Wang, J.; Hughes, J.; Justman, J.; Haley, D.; Kuo, I.; Adimora, A.; Chege, W.; Hodder, S.

    2016-01-01

    Identifying venues where women meet sexual partners, particular partners who increase women's risk of acquiring HIV, could inform prevention efforts. We categorized venues where women enrolled in HPTN 064 reported meeting their last three sex partners as: (1) Formal, (2) Public, (3) Private, and (4) Virtual spaces. We used multinomial logistic regression to assess the association between these venues and women's individual characteristics and reports of their partners' HIV risk characteristics. The 2099 women reported meeting 3991 partners, 51 % at Public, 30 % Private, 17 % Formal and 3 % at Virtual venues. Women meeting partners at Formal venues reported more education and condom use than women meeting partners at other venues. Fewer partners met through Formal venues had “high” risk characteristics for HIV than through other venues and hence may pose less risk of HIV transmission. HIV prevention interventions can help women choose partners with fewer risk characteristics across all venue types. PMID:25863466

  12. Porn video shows, local brew, and transactional sex: HIV risk among youth in Kisumu, Kenya

    OpenAIRE

    Njue, C.; Voeten, H.A.C.M.; Remes, P.

    2011-01-01

    Background: Kisumu has shown a rising HIV prevalence over the past sentinel surveillance surveys, and most new infections are occurring among youth. We conducted a qualitative study to explore risk situations that can explain the high HIV prevalence among youth in Kisumu town, Kenya\\ud \\ud Methods: We conducted in-depth interviews with 150 adolescents aged 15 to 20, held 4 focus group discussions, and made 48 observations at places where youth spend their free time.\\ud \\ud Results: Porn video...

  13. Sex and HIV serostatus differences in decision making under risk among substance dependent individuals

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    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M.; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV− substance dependent men and women. HIV+ participants made significantly poorer decisions compared with HIV− participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ SDIs. Potential factors for the HIV+ women’s relatively greater impairment are discussed. PMID:26882176

  14. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  15. HIV sexual transmission risks in the context of clinical care: a prospective study of behavioural correlates of HIV suppression in a community sample, Atlanta, GA, USA

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    Seth C Kalichman

    2015-08-01

    Full Text Available Introduction: Antiretroviral therapy (ART improves the health of people living with HIV and has the potential to reduce HIV infectiousness, thereby preventing HIV transmission. However, the success of ART for HIV prevention hinges on sustained ART adherence and avoiding sexually transmitted infections (STI. Objectives: To determine the sexual behaviours and HIV transmission risks of individuals with suppressed and unsuppressed HIV replication (i.e., viral load. Methods: Assessed HIV sexual transmission risks among individuals with clinically determined suppressed and unsuppressed HIV. Participants were 760 men and 280 women living with HIV in Atlanta, GA, USA, who completed behavioural assessments, 28-daily prospective sexual behaviour diaries, one-month prospective unannounced pill counts for ART adherence, urine screening for illicit drug use and medical record chart abstraction for HIV viral load. Results: Individuals with unsuppressed HIV demonstrated a constellation of behavioural risks for transmitting HIV to uninfected sex partners that included symptoms of STI and substance use. In addition, 15% of participants with suppressed HIV had recent STI symptoms/diagnoses, indicating significant risks for sexual infectiousness despite their HIV suppression in blood plasma. Overall, 38% of participants were at risk for elevated sexual infectiousness and just as many engaged in unprotected sexual intercourse with non-HIV-infected partners. Conclusions: Implementation strategies for using HIV treatments as HIV prevention requires enhanced behavioural interventions that extend beyond ART to address substance use and sexual health that will otherwise undermine the potential preventive impact of early ART.

  16. State of the evidence: intimate partner violence and HIV/STI risk among adolescents.

    Science.gov (United States)

    Seth, Puja; DiClemente, Ralph J; Lovvorn, Amy E

    2013-10-01

    This paper provides a critical narrative review of the scientific literature on intimate partner violence (IPV) and risky sexual behavior as well as sexually transmitted infections (STIs) among adolescents, aged 14-24 years. Intimate partner violence has been associated with a number of high risk sexual behavior, including inconsistent condom use, multiple sexual partners, earlier sexual debut, consuming substances while engaging in sexual behavior, and sexually transmitted infections among adolescents. An electronic search of the literature was performed using PubMed/MEDLINE, PsycINFO, and Web of Science and articles from January 2000 - June 2013 were reviewed. Search terms included a combination of keywords for IPV, HIV/STI risk, and adolescents. The findings from the review indicated that IPV was associated with inconsistent condom use, STIs, early sexual debut, multiple sexual partners, and other HIV/STI-associated risk factors among adolescents. HIV/STI interventions for female adolescents often focus on increasing behavioral and cognitive skills, specifically condom negotiation. However, within the context of an abusive relationship, it becomes challenging for adolescents to enact these skills, where this behavior could potentially place them at greater risk. Components that address violence are necessary within HIV prevention programming. Additionally, integration of IPV screening within healthcare settings is important along with a combined approach that merges resources from healthcare, social, and community-level settings.

  17. Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti.

    Science.gov (United States)

    Li, Michelle; Betancourt, Theresa; Eustache, Eddy; Oswald, Catherine; Louis, Ermaze; Mukherjee, Joia; Surkan, Pamela J; Smith Fawzi, Mary C

    2015-01-01

    The present study aims to: (1) estimate the levels of internalizing symptoms and externalizing behaviors among youth affected by HIV in central Haiti; and (2) examine the risk and protective factors associated with these outcomes to identify potential areas of intervention for HIV-affected youth. Baseline data for 492 youth affected by HIV (ages 10-17) and their 330 caregivers were collected for a pilot study of a psychosocial support intervention. Participants were recruited from a list of HIV-positive patients receiving care at Partners In Health/Zanmi Lasante clinic sites. Internalizing and externalizing behaviors were assessed using the Strengths and Difficulties Questionnaire. Demographic, economic, and social indicators were collected using a structured questionnaire administered by trained social workers. Youth affected by HIV in central Haiti displayed high levels of internalizing and, to a lesser degree, externalizing symptoms. Multivariate regression analysis demonstrated risk factors most strongly associated with internalizing symptoms (socioeconomic status, parental depressive symptoms) and externalizing behaviors (household living arrangements, such as living with a stepparent). Social support had a protective effect on externalizing behaviors for both caregiver (β=-0.03, p=0.01) and self-report (β=-0.05, pHaiti and similar resource-limited settings.

  18. Prevalence of and risk factors for MRSA colonization in HIV-positive outpatients in Singapore

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    Kyaw Win

    2012-11-01

    Full Text Available Abstract Background Whilst there have been studies on the risks and outcomes of MRSA colonization and infections in HIV-positive patients, local data is limited on the risk factors for MRSA colonization among these patients. We undertook this study in a tertiary HIV care centre to document the risk factors for colonization and to determine the prevalence of MRSA colonization among HIV-positive outpatients in Singapore. Methods This was a cross-sectional study in which factors associated with MRSA positivity among patients with HIV infection were evaluated. A set of standardized questionnaire and data collection forms were available to interview all recruited patients. Following the interview, trained nurses collected swabs from the anterior nares/axilla/groin (NAG, throat and peri-anal regions. Information on demographics, clinical history, laboratory results and hospitalization history were retrieved from medical records. Results MRSA was detected in swab cultures from at least 1 site in 15 patients (5.1%. Inclusion of throat and/or peri-anal swabs increased the sensitivity of NAG screening by 20%. Predictors for MRSA colonization among HIV-positive patients were age, history of pneumonia, lymphoma, presence of a percutaneous device within the past 12 months, history of household members hospitalized more than two times within the past 12 months, and a most recent CD4 count less than 200. Conclusions This study highlights that a proportion of MRSA carriers would have been undetected without multiple-site screening cultures. This study could shed insight into identifying patients at risk of MRSA colonization upon hospital visit and this may suggest that a risk factor-based approach for MRSA surveillance focusing on high risk populations could be considered.

  19. HIV-related risk perception among female sex workers in Nigeria

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    Ankomah A

    2011-07-01

    Full Text Available Augustine Ankomah1, Godpower Omoregie1, Zacch Akinyemi2, Jennifer Anyanti1, Olaronke Ladipo1, Samson Adebayo11Society for Family Health, Abuja, Nigeria; 2Population Services International, Kigali, RwandaBackground: Over one-third of sex workers in Nigeria are infected with human immunodeficiency virus (HIV, yet there is a lack of understanding of sex workers’ own perception of sexual risk-taking. Applying the theory of cognitive dissonance, this paper examined the personal HIV risk perception of brothel-based sex workers.Methods: The study is based on 24 focus group discussions held among brothel-based sex workers in four geographically and culturally dispersed cities in Nigeria.Results: It was found that sex workers underestimated their risk of infection and rationalized, defended, or justified their behaviors, a typical psychological response to worry, threat, and anxiety arising from the apparent discrepancies between beliefs and behaviors. To reduce dissonance, many sex workers had a strong belief in fatalism, predestination, and faith-based invulnerability to HIV infection. Many believed that one will not die of acquired immune deficiency syndrome if it is not ordained by God. The sex workers also had a high level of HIV-related stigma.Conclusion: From these findings, most sex workers considered risk reduction and in particular condom use as far beyond their control or even unnecessary, as a result of their strong beliefs in fatalism and predestination. Therefore, one critical area of intervention is the need to assist sex workers to develop accurate means of assessing their personal vulnerability and self-appraisal of HIV-related risk.Keywords: female sex workers, cognitive dissonance, risk perception, risky behavior, focus group discussions, Nigeria

  20. Racial discrimination, social support, and sexual HIV risk among Black heterosexual men.

    Science.gov (United States)

    Bowleg, Lisa; Burkholder, Gary J; Massie, Jenné S; Wahome, Rahab; Teti, Michelle; Malebranche, David J; Tschann, Jeanne M

    2013-01-01

    Numerous studies document the adverse impact of racial discrimination on African Americans' health outcomes, but few have focused on HIV risk. We examined the relationship between racial discrimination and sexual risk in a sample of 526 Black heterosexual men and tested the hypothesis that social support would moderate this relationship. Participants in the predominantly low-income urban sample ranged in age from 18 to 45. High social support had a buffering impact on the relationship between racial discrimination and sexual risk. Among men reporting high racial discrimination, those with more social support reported less sexual risk than men with low social support. Men who reported high racial discrimination and low social support reported more sexual risk than men in any of the other groups. The study highlights social support as an important but understudied protective factor that may reduce sexual risk for Black heterosexual men who report high levels of racial discrimination.

  1. Risk behaviors and STI prevalence among people with HIV in El Salvador.

    Science.gov (United States)

    Paz-Bailey, G; Shah, N; Creswell, J; Guardado, M E; Nieto, A I; Estrada, M C; Cedillos, R; Pascale, J M; Monterroso, E

    2012-01-01

    To date, there are no studies from El Salvador among people with HIV to inform prevention programs. We conducted a study in El Salvador in 2008 among people with HIV using audio computer-assisted interviews on risk behaviors and access to health care. Blood was tested for syphilis and herpes simplex type 2 (HSV-2). Active syphilis was defined as RPR titer ≥1:8. Genital specimens were tested for other sexually transmitted infections (STI) by PCR. We evaluated factors associated with unprotected sex with last stable partner of HIV-negative or unknown status among those reporting a stable partner. A total of 811 HIV-positive individuals participated: 413 men and 398 women. Prevalence of Chlamydia and gonorrhea was low (≤1%), while prevalence of other STI was high: Mycoplasma genitalium (14%), syphilis (15% seropositivity, active syphilis 3%) and HSV-2 (85%). In multivariate analysis, disclosing HIV status to partner (OR 0.2, 95% CI: 0.1-0.3, p<0.001), participation in HIV support groups (OR 0.3, 95% CI: 0.1-0.8, p=0.01), easy access to condoms (OR 0.4, 95% CI: 0.2-0.9, p=0.04) were protective factors for unprotected sex. Reporting a casual partner in the last 12 months (OR 3.6, 95% CI: 1.5-8.5, p=0.004). and having an STI (OR 2.6, 95% CI:1.3-5.5, p=0.02) were associated with an increased odds of unprotected sex. Prevention interventions among HIV-positives in El Salvador should focus on increasing condom access, promoting HIV disclosure and couples testing and reducing the number of partners. The positive role of support groups should be used to enhance behavioral change.

  2. Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons

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    Koosha Paydary

    2016-01-01

    Full Text Available Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker and former (abstinent heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART, Iowa Gambling Task (IGT, Barratt Impulsiveness Scale (BIS, and Zuckerman Sensation Seeking Scale (SSS. Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS, experience seeking (ES, disinhibition (DIS, and boredom susceptibility (BS, there was a borderline difference in DIS (P=0.08 as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB. In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI (P=0.03 and nonplanning impulsivity (NPI (P=0.05 in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P=0.015. IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people.

  3. Barriers to Condom Use: Results for Men and Women Enrolled in HIV Risk Reduction Trials in Outpatient Drug Treatment.

    Science.gov (United States)

    Campbell, Aimee N C; Brooks, Audrey J; Pavlicova, Martina; Hu, Mei-Chen; Hatch-Maillette, Mary A; Calsyn, Donald A; Tross, Susan

    2016-01-01

    HIV transmission often occurs through heterosexual high-risk sex. Even in the era of HIV combination prevention, promoting condom use, and understanding condom barriers, remain priorities, especially among substance-dependent individuals. Men and women (N=729) in outpatient drug treatment participated in a five-session gender-specific risk reduction group or one-session HIV Education group. Condom barriers (Motivation, Partner-related, Access/Availability, Sexual experience) were assessed at baseline and 6-month follow-up. Completing either intervention was associated with fewer motivation and partner-related barriers. Among women, reductions in motivation and sexual experience barriers were associated with less sexual risk with primary partners. Condom barriers are important to gender-specific HIV prevention; given limited resources, brief interventions maximizing active components are needed.

  4. Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practises of female sex workers, prison inmates and people who inject drugs.

    Science.gov (United States)

    Khajehkazemi, Razieh; Haghdoost, AliAkbar; Navadeh, Soodabeh; Setayesh, Hamidreza; Sajadi, Leily; Osooli, Mehdi; Mostafavi, Ehsan

    2014-12-01

    Background In this study data of three national surveys conducted among female sex workers (FSW), prison inmates and people who inject drugs (PWID) were presented and compared in relation to knowledge, attitude, and practises. The surveys were conducted in 2009 and 2010 and included 2546 PWID, 872 FSW and 5530 prison inmates. Knowledge, attitude and practises towards HIV were measured through similar questions for each category. Over 90% of all participants had ever heard of HIV/AIDS, although only approximately half of them perceived themselves at risk of contracting HIV. More than 80% were able to correctly identify the ways of preventing the sexual transmission of HIV; while more than two-thirds did not use condom in their last sexual contact. Approximately 20% of prisoners and FSW had a history of injecting drugs. Among all participants who have injected drugs, prisoners had the highest unsafe injecting behaviour at the last injection (61%), followed by FSW (11%) and PWID (3%). Despite major efforts to control the HIV epidemic in Iran, the level of risk and vulnerability among prisoners, FSW and PWID is still high. The level of comprehensive knowledge about HIV/AIDS is relatively good; however, their risk perception of contracting HIV is low and high-risk behaviours are prevalent. Therefore, HIV prevention programs should be redesigned in a more comprehensive way to identify the best venues to reach the largest number of people at a higher risk of contracting HIV and decrease their risk overlaps and vulnerability factors.

  5. Effects of Disengagement Coping with HIV Risk on Unprotected Sex among HIV-Negative Gay Men in New York City

    Science.gov (United States)

    Yi, Huso; Sandfort, Theo G. M.; Shidlo, Ariel

    2009-01-01

    Objective This study examined how disengagement coping with HIV risk mediated the association between internalized homophobia and unprotected anal intercourse (UAI) and how sexual encounters in public venues (public sex) and drug use moderated the association between disengagement coping and UAI among HIV-negative gay men. Disengagement coping included fatalistic beliefs about maintaining HIV-negative seronegative serostatus (fatalism), optimistic attitudes toward medical seriousness of HIV infection and reduced concern about HIV risk due to HAART (optimism), and negative affective states associated with sexual risk (anxiety). Design A survey was conducted among 285 HIV-negative gay men at an HIV prevention counseling program in New York City. Main Outcome Measures Sexual risk was defined as having had UAI with non-primary partners in the past six months. Results In addition to the positive association between internalized homophobia, disengagement coping, and UAI, fatalism mediated the association between internalized homophobia and UAI; and optimism mediated the association between anxiety and UAI. A significant moderation effect of public sex was found between fatalism and UAI. Conclusions The findings highlight the importance of understanding disengagement coping as it affects sexual risk practices among HIV-negative gay men in the continuing epidemic. PMID:20230094

  6. Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review.

    Science.gov (United States)

    Laisaar, Kaja-Triin; Raag, Mait; Rosenthal, Marika; Uusküla, Anneli

    2015-05-01

    Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ≥18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV.

  7. Menthol cigarettes and the cardiovascular risks of people living with HIV.

    Science.gov (United States)

    Míguez-Burbano, María José; Vargas, Mayra; Quiros, Clery; Lewis, John E; Espinoza, Luis; Deshratan, Asthana

    2014-01-01

    The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored cigarettes heightens CVD risk factors. Our study aims to assess traditional (10-year risk using the Framingham Risk Model) and nontraditional CVD risk factors and to contrast the effects of menthol-flavored versus non-menthol-flavored cigarettes on these risk factors. Compared to controls, menthol smokers were twice as likely to have hypertension. Users of menthol-flavored cigarettes had higher body mass index values, and increased risk of abdominal obesity. Multivariate analyses indicated that menthol smokers doubled the odds of having moderate to high CVD risk. This finding is highly significant given the widespread use of menthol-flavored cigarettes, particularly among women, minorities, and PLWH.

  8. 深圳市2011年MSM高危行为特征及梅毒/HIV感染调查%Characteristics of high risk behavior and syphilis/HIV infection among MSM in Shenzhen in 2011

    Institute of Scientific and Technical Information of China (English)

    赖永珲; 蔡于茂; 宋亚娟; 郑霞; 洪福昌

    2013-01-01

    Objective To understand the characteristics of high risk behavior and syphilis/HIV prevalence among men who have sex with men (MSM)in Shenzhen and to provide scientific evidence for effective intervention. Methods With informed consent,questionnaires were conducted and blood samples were taken among MSM in Shenzhen in 2011. Results A total of 762 MSM were enrolled and received voluntary counseling and testing. The infection rates of syphilis, HIV,and syphilis/HIV co-infection among them were 17.8% ,7.1% and 3.8% ,respectively. As to the role in homosexual behavior,45.8% were predominantly inserted partners,23.8% were receptive partners,29.5% were both inserted and receptive partners and only 0.9% had seldom anal sex or had always oral sex. In the past 6 months,70.8% had more than one sex partners for anal sex,64.4% had more than one sex partners for oral sex. In the past 6 months,37.1% had used condoms for every act of anal sex,4.0% had used condoms for every act of oral sex and 27.1% had used condoms for every act of vaginal sex with female sex partners. Conclusions Unprotected sexual behaviors were universal among MSM in Shenzhen and they served as bridge people in transmitting syphilis/HIV from high risk population to general population.%目的 了解深圳市男男性行为者高危行为特征及梅毒/HIV感染情况,为今后有针对性地实施有效干预措施提供科学依据. 方法 知情同意原则下,2011年对深圳市MSM进行问卷调查及抽血检测. 结果 共762例接受自愿咨询检测,梅毒感染率为17.8%,HIV感染率为7.1%,梅毒合并HIV感染率为3.8%;45.8%性角色以主动为主,23.8%以被动为主,29.5%二者兼有,0.9%很少肛交或多口交;半年内70.8%肛交性伴数≥2个,64.4%口交性伴数≥2个;37.1%半年内肛交时每次使用安全套,4.0%半年内口交时每次使用安全套,27.1%半年内与女性性交时每次使用安全套. 结论 深圳市MSM人群不安全性行为

  9. Hepatitis B virus prevalence, risk factors and genotype distribution in HIV infected patients from West Java, Indonesia.

    Science.gov (United States)

    Fibriani, Azzania; Wisaksana, Rudi; Alisjahbana, Bachti; Indrati, Agnes; Schutten, Martin; van Crevel, Reinout; van der Ven, Andre; Boucher, Charles A B

    2014-04-01

    Indonesia currently faces both an increasing HIV incidence and a high hepatitis B virus (HBV) burden. The objective of our study is to examine the prevalence, risk factors, and genotypic distribution of HBV infection among HIV infected patients in West Java, Indonesia. A cross sectional study was conducted among a cohort of HIV infected patients in 2008. Demographic and disease related variables were compared between HBV negative and positive patients. Logistic regression was applied to determine risk factors for HBV co-infection. HBV and HIV genotyping was performed in co-infected patients. Of 636 HIV-infected patients, the rate of HBV co-infection was 7%. The proportion of males was higher in HBV/HIV co-infected patients than in HIV mono-infected patients (93% vs. 72%, P=0.001). A history of injecting drug use (IDU), but not tattooing, was associated with HBV co-infection [P=0.035 OR 2.41 (95% CI 1.06-5.47)]. In the HIV and HBV treatment naive patients, CD4 cells counts Java. However, an increased prevalence was observed in men with a history of IDU, underlining the need for routine HBV screening and monitoring. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. HIV and STI knowledge, testing, and risk among adult crack users in Mexico city: baseline findings from a feasibility study.

    Science.gov (United States)

    Cepeda, Alice; Frankeberger, Jessica; Bailey, Jennifer L; Nowotny, Kathryn M; Natera-Rey, Guillermina; Valdez, Avelardo

    2017-03-01

    Recent research has documented crack cocaine's increasing spread in Mexico, which is likely to contribute to the rapid transmission of HIV and other sexually transmitted infections (STIs). In Mexico, crack use is increasing most rapidly in vulnerable, hard-to-reach populations, where little is known about risk behaviors. This report aims to present baseline data regarding HIV and STI knowledge and testing prevalence from an innovative projection mapping HIV intervention, in which 3-D illusions, animation, and visual text graphics and sound are projected onto buildings with health messages that were designed to disrupt everyday life and connect with the target population. Fifty-eight men and women who used crack in the past month without receiving drug treatment were recruited and interviewed before the projection mapping intervention took place. Testing instruments included a sociodemographic assessment, drug use and treatment profile, HIV and STI knowledge questionnaires, and a sex and drug risk assessment. The mean scores for respondents on the HIV Knowledge Questionnaire (10.5 out of 18, 58.3%) and STD Knowledge Questionnaire (9.5 out of 27, 35.2%) were both low. Respondents also reported high rates of sexual risk behaviors, with 73% reporting never using a condom and 64% never being tested for HIV. This report provides a portrait of STI and HIV risk among a vulnerable population in Mexico City and the need for urgent interventions to prevent the spread of STIs and HIV. The associated projection mapping intervention will seek to increase HIV and STI knowledge and reduce risk in this hard-to-reach population.

  11. Early life emotional neglect and HIV risk taking among men using the Internet to find other men for unprotected sex.

    Science.gov (United States)

    Klein, Hugh

    2014-03-01

    Using a Syndemics Theory conceptual model, this study examines the relationship between emotional neglect experiences during childhood and/or adolescence and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. Emotional neglect was highly prevalent among the men participating in this study. Emotional neglect experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. Childhood experiences with emotional neglect are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, emotional neglect appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Adapting an evidence-based intervention for HIV to avail access to testing and risk-reduction counseling for female victims of sexual violence in post-earthquake Haiti.

    Science.gov (United States)

    Rahill, Guitele J; Joshi, Manisha; Hernandez, Anthony

    2016-01-01

    Haiti has the highest prevalence of HIV/AIDS in the Caribbean. Before the 2010 earthquake, Haitian women bore a disproportionate burden of HIV/AIDS, had lower HIV knowledge, less capacity to negotiate for safer sex, and limited access to HIV testing and risk-reduction (RR) counseling. Since 2010, there has been an increase in sexual violence against women, characterized by deliberate vaginal injuries by non-intimate partners, increasing victims' risk of sexually transmitted infections including HIV/AIDS. Needed is an adaptation of evidence-based interventions for HIV that include HIV testing and counseling for this stigmatized population. We reviewed several features of Centers for Disease Control and Prevention's 103 evidence-based interventions for HIV (e.g., measures used, participant risk characteristics, theoretical framework, outcome variables, and evidence tier) in an attempt to seek a feasibly adaptable evidence-based intervention for HIV that could be used for victims of sexual violence (VOSV). RESPECT, one of the reviewed evidence-based HIV interventions, comprises of one-on-one, client-focused HIV prevention/RR counseling, and RAPID HIV testing. Adapting RESPECT can enhance access to testing for Haitian VOSV and can influence their perceptions of HIV risk, and establishment of RR goals for future consensual intimate relations. Adapting and implementing RESPECT can increase uptake of evidence-based HIV interventions among Haitians and positively affect a region with high HIV prevalence and increased rates of sexual violence.

  13. Sustained High HIV Incidence in Young Women in Southern Africa: Social, Behavioral, and Structural Factors and Emerging Intervention Approaches.

    Science.gov (United States)

    Harrison, Abigail; Colvin, Christopher J; Kuo, Caroline; Swartz, Alison; Lurie, Mark

    2015-06-01

    Young women in southern Africa experience some of the highest incidence rates of HIV infection in the world. Across southern Africa, HIV prevalence among women increases rapidly between the teenage years and young adulthood. Adult HIV prevalence is 16.8 % in South Africa, 23 % in Botswana, 23 % in Lesotho, and 26.5 % in Swaziland. Existing research has illuminated some of the key social, behavioral, and structural factors associated with young women's disproportionate HIV risk, including gendered social norms that advantage male power in sexual relationships and age disparities in relationships between younger women and older male partners. Important structural factors include the region's history of labor migration and legacy of family disruption, and entrenched social and economic inequalities. New interventions are emerging to address these high levels of HIV risk in the key population of young women, including structural interventions, biomedical prevention such as PrEP, and combined HIV prevention approaches.

  14. Homelessness and Other Risk Factors for HIV Infection in the Current Outbreak Among Injection Drug Users in Athens, Greece.

    Science.gov (United States)

    Sypsa, Vana; Paraskevis, Dimitrios; Malliori, Meni; Nikolopoulos, Georgios K; Panopoulos, Anastasios; Kantzanou, Maria; Katsoulidou, Antigoni; Psichogiou, Mina; Fotiou, Anastasios; Pharris, Anastasia; Van De Laar, Marita; Wiessing, Lucas; Jarlais, Don Des; Friedman, Samuel R; Hatzakis, Angelos

    2015-01-01

    Objectives. We examined HIV prevalence and risk factors among injection drug users (IDUs) in Athens, Greece, during an HIV outbreak. Methods. We used respondent-driven sampling (RDS) to recruit 1404 IDUs to the Aristotle intervention in August to October 2012. We interviewed participants and tested for HIV. We performed bivariate and multivariate analyses. Results. Estimated HIV prevalence was 19.8% (RDS-weighted prevalence = 14.8%). Odds of infection were 2.3 times as high in homeless as in housed IDUs and 2.1 times as high among IDUs who injected at least once per day as among less frequent injectors (both, P homelessness as well as scaling up prevention services, such as needle and syringe distribution and other risk reduction interventions.

  15. Telephone consultation for improving health of people living with or at risk of HIV: a systematic review.

    Directory of Open Access Journals (Sweden)

    Michelle H M M T van Velthoven

    Full Text Available BACKGROUND: Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care. METHODS: We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis. RESULTS: The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial and for delivering behavioural interventions aimed at improving mental health (four trials, reducing sexual transmission risk (one trial, improving medication adherence (two trials and smoking cessation (one trial. Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone. CONCLUSIONS: We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation

  16. Identification of HIV-1 specific T lymphocyte responses in highly exposed persistently seronegative Chinese

    Institute of Scientific and Technical Information of China (English)

    LIU Hong-wei; SHAO Yi-ming; HONG Kun-xue; MA Jun; YUAN Lin; LIU Sha; CHEN Jian-ping; ZHANG Yuan-zhi; RUAN Yu-hua; XU Jian-qing

    2006-01-01

    Background Studies of highly exposed persistently seronegative (HEPS) individuals may provide valuable information on mechanisms of protection and on vaccine design. Cellular immune responses play a critical role in containing human immunodeficiency virus. However, the cellular immune responses in HEPS individuals have not been thoroughly assessed at the entire viral genome level.Methods Ten HEPS Chinese with a history of frequent penetrative vaginal intercourse (mean frequency, at least once a week), with some unprotected sexual contact occurring in the weeks or days immediately before enrollment, 25 HIV-1 seropositive individuals, 10 HIV-1-seronegative healthy individuals with low-risk sexual behavior and no history suggestive of exposure to HIV-1 infection were enrolled. HIV-1-specific T cell responses were comprehensively analyzed by an interferon- γ Elispot assay against 770 overlapping peptides spanning all HIV-1 proteins.Results HIV-1-specific T-cell responses of interferon- γ secretion were identified in 3 (30%) out of 10 HEPS individuals; the specific cytotoxic T lymphocytes were targeted at Pol (2/10), Env (2/10), and Tat (1/10).HIV-1-specific T-cell responses of interferon- γ secretion were identified in 20 (80%) out of 25 seropositive intravenous drug users (IDUs), revealing that all HIV-1 proteins and protein subunits could serve as targets for HIV-1-specific CD8+ T cell responses with 85% recognizing Gag, 80% recognizing Nef, 75% recognizing Pol,60% recognizing Env, 55% recognizing Vpu, 45% recognizing Vpr, 20% recognizing Vif, 20% recognizing Tat and 15% recognizing Rev in these seropositive individuals. None of the seronegative healthy individuals gave the positive T-cell responses.Conclusions About 30% of HEPS Chinese mounted HIV-1 specific T cell immune responses. Cell-mediated immunity against HIV-1 may be developed through non-productive infections.

  17. Sexuality, HIV risk and potential acceptability of involving adolescent girls in microbicide research in Kisumu, Kenya.

    Science.gov (United States)

    Montandon, Michele; Sahin-Hodoglugil, Nuriye Nalan; Bukusi, Elizabeth; Agot, Kawango; Boland, Brigid; Cohen, Craig R

    2008-12-01

    Current microbicide clinical trials primarily enroll adult participants; however, females under the age of 18, because of their high rates of HIV acquisition, represent an important population for future microbicide clinical research. We sought to understand the individual, family and community-level factors that may influence the acceptability of microbicide use and research involving adolescent girls. We conducted 30 interviews with adolescent girls aged 14-17 and nine focus group discussions with adolescent girls, parents and community leaders in Kisumu, Kenya. Participants discussed adolescent sexuality, HIV prevention methods, perceptions about microbicide use and views about microbicide research involving adolescent girls. Adolescent sexual activity is stigmatised yet acknowledged to be a natural part of the 'adolescent stage.' Desperation to stop the spread of HIV among youth and support for female-initiated HIV prevention methods led to enthusiasm about microbicides and future microbicide research. Yet concerns about microbicides were numerous and included: difficulty using it in a timely manner due to the rushed, unplanned nature of adolescent sex; a fear of trying experimental products; concerns about microbicide efficacy; and parental worry that supporting microbicide use in youth would defy societal pressures that denounce adolescent sexual activity. Microbicide acceptability for youth in sub-Saharan Africa may be bolstered by desperation for new methods to stop the spread of HIV, yet hindered by misgivings about experimental HIV prevention methods for youth. Understanding and addressing the microbicide's perceived benefits and shortcomings, as well as the broader context of adolescent sexuality and HIV prevention, may facilitate future research and promotion of microbicides in this high-risk group.

  18. Educational attainment and risk of HIV infection, response to antiretroviral treatment, and mortality in HIV-infected patients

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Omland, Lars H; Kronborg, Gitte

    2014-01-01

    OBJECTIVE: To estimate association between educational attainment and risk of HIV diagnosis, response to HAART, all-cause, and cause-specific mortality in Denmark in 1998-2009. DESIGN: Prospective, population-based cohort study including 1277 incident HIV-infected patients without hepatitis C vir...

  19. Drug and sexual HIV risk behaviours related to knowledge of HIV serostatus among injection drug users in Houston, Texas.

    Science.gov (United States)

    Noor, Syed W B; Ross, Michael W; Lai, Dejian; Risser, Jan M

    2014-02-01

    This study examines the association between drug and sexual HIV risk behaviours and knowledge of HIV serostatus among a sample of injection drug users, recruited into the 2009 National HIV Behavioral Surveillance project. We calculated prevalence ratios and associated 95% confidence intervals of reporting a given risk behaviour comparing injection drug users unaware of their serostatus and HIV-negative to HIV-positive injection drug users. Of 523 participants, 21% were unaware of their HIV serostatus. The three groups were not different from each other in terms of drug-use behaviours; however, injection drug users unaware of their HIV serostatus were 33% more likely to report having more than three sexual partners in the past 12 months and 45% more likely to report having unprotected sex compared to HIV-positive injection drug users. We observed markedly higher prevalence of sexual risk behaviours among injection drug users unaware of their serostatus, but drug-use risk behaviours were similar across the groups.

  20. A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men

    DEFF Research Database (Denmark)

    May, Margaret; Sterne, Jonathan A C; Shipley, Martin;

    2007-01-01

    Many HIV-infected patients on highly active antiretroviral therapy (HAART) experience metabolic complications including dyslipidaemia and insulin resistance, which may increase their coronary heart disease (CHD) risk. We developed a prognostic model for CHD tailored to the changes in risk factors...

  1. Risky sexual behaviors: The role of ethnic identity in HIV risk in migrant workers.

    Science.gov (United States)

    Shehadeh, Nancy; McCoy, H Virginia

    2014-01-01

    Migrant workers have been shown to be at a heightened level of risk for HIV, and ethnic identity has been posited to have an impact on engagement in risky sexual behaviors. Our longitudinal study examined associations between baseline and short-term changes in ethnic identity and high-risk sexual behaviors. Baseline (n = 431) and 6-month assessment (n = 270) data were obtained from a larger HIV prevention study conducted among African American and Hispanic migrant workers. Repeated-measures multivariate analysis of covariance and multiple linear regressions were used. Ethnic identity explore, a subscale of ethnic identity, was a significant predictor of overall sexual risk [F(8, 422) = 6.953, p < .001] and unprotected vaginal acts [F(8, 422) = 8.444, p < .001] at baseline. However, ethnic identity had no bearing on changes in risky sexual behaviors. Ethnic identity explore was associated with safer sexual behaviors.

  2. Property rights violations as a structural driver of women's HIV risks: a qualitative study in Nyanza and Western Provinces, Kenya.

    Science.gov (United States)

    Dworkin, Shari L; Grabe, Shelly; Lu, Tiffany; Hatcher, Abigail M; Hatcher, Abbey; Kwena, Zachary; Bukusi, Elizabeth; Mwaura-Muiru, Esther

    2013-07-01

    While access to and control over assets can minimize women's HIV risk, little is known about the processes through which property rights violations increase the sexual transmission of HIV. The current study focused on two rural areas in Nyanza and Western Province, Kenya where HIV prevalence was high (23.8-33 %) and property rights violations were common. The current work drew on in-depth interview data collected from 50 individuals involved in the development and implementation of a community-led land and property rights program. The program was designed to respond to property rights violations, prevent disinheritance and asset stripping, and reduce HIV risk among women. In our findings, we detailed the social and economic mechanisms through which a loss of property rights was perceived to influence primary and secondary prevention of HIV. These included: loss of income, loss of livelihood and shelter, and migration to slums, markets, or beaches where the exchange of sex for food, money, shelter, clothing, or other goods was common. We also examined the perceived influence of cultural practices, such as wife inheritance, on HIV risk. In the conclusions, we made recommendations for future research in the science-base focused on the development of property ownership as a structural HIV prevention and treatment intervention.

  3. HIV Prevalence, Sexual Partners, Sexual Behavior and HIV Acquisition Risk Among Trans Men, San Francisco, 2014.

    Science.gov (United States)

    McFarland, Willi; Wilson, Erin C; Raymond, Henry F

    2017-02-24

    We surveyed 122 trans men using a hybrid sampling method that included randomly selected physical and online venues and peer referral to measure HIV prevalence and risk behaviors. HIV prevalence was 0% (one-sided 97.5% confidence interval 0-3.3%). Of 366 partnerships described, 44.8% were with cisgender women, 23.8% with cisgender men, 20.8% with trans men, and 10.7% with trans women. Condomless receptive anal and front hole/vaginal sex averaged one to three episodes per six months. HIV prevalence in trans men is likely closer to heterosexual cisgender men and women in San Francisco than trans women or MSM. Prevention prioritizing trans women and MSM, coupled with individualized and relevant sexual health education for trans men with partners from these populations, may best address the HIV prevention needs of trans men. Systematic collection of transgender status in Census and health data is needed to understand other health disparities among trans men.

  4. HIV and syphilis infection and high-risk behaviors among men who have sex with men in Shenzhen city%深圳市男男性行为者HIV和梅毒感染及行为调查

    Institute of Scientific and Technical Information of China (English)

    刘少础; 陈琳; 蔡文德; 赵锦; 石向东; 资芸芸; 尹平; 程锦泉

    2011-01-01

    目的 了解广东省深圳市男男性行为者(MSM)人类免疫缺陷病毒(HIV)和梅毒感染状况及高危行为,为今后针对该人群进行有效的干预工作提供经验和依据.方法 通过招募MSM志愿者,采用"滚雪球"的方法,对深圳市450名近6个月有过男男性行为的MSM进行匿名自填问卷调查并抽血检测.结果 6个月深圳市MSM男性性伴数平均为(5.02±1.23)个,18.67%的人有过异性性行为,5.35%和7.26%的人分别有向男性购买和贩卖性行为;46.21%的人在与男性发生肛交性行为能坚持每次使用安全套,4种不同性伴性行为安全套使用频率比较,差异有统计学意义(x2=34.1484,P<0.0001);HIV和梅毒感染率分别为5.56%和18.44%;经多因素Logistic回归分析表明,月收入越低(OR=1.415,P=0.0039),感染HIV的危险越大;年龄越高(OR=1.713,P=0.0073),月收入越低(OR=1.185,P=0.0419),感染梅毒的危险越大.结论 深圳市MSM安全套使用频率较低,大多存在多性伴和异性性行为,HIV和梅毒感染率较高,应加大该人群的干预力度,以有效控制艾滋病性病的传播和流行.%Objective To understand HIV and syphilis infection and high-risk behaviors among men who have sex with men(MSM) in Shenzhen, and to provide basis for effective intervention in the population. Methods By recruiting MSM volunteers, a self-administered anonymous questionnaire and blood test were conducted among 450 MSM with sexual behavior with men in the previous 6 months using snowballing sampling. Results The average number of male partners of the MSM was 5.02 ± 1.23 ,and 18. 67% of the MSM had sex with female. Among the MSM,5.35% bought sex from male and 7.26% sold sex to male. Totally 46. 21% of the MSM could persist in using condom when having anal sex with male.There was a significant difference in the frequency of condom use among four different kinds of sex partners among the MSM ( x2 = 34. 1484, P < 0. 0001 ). The infection rate of HIV and

  5. Risk of Human Immunodeficiency Virus (HIV) Seroconversion in U.S. Navy Personnel Following Visits to Foreign Ports

    Science.gov (United States)

    1991-03-25

    Islands 3 475. La Napoule, France 2 426. Nagasaki, Japan 3 476. Langkawi , Malaysia 2 427. Nice, France 3 477. Larnaca, Cyprus 2 428. Oran, Algeria 3...continents and many islands of the world. HIV (human immunodeficiency virus-I) rates vary widely worldwide, and are high in many areas visited by the Navy...career histories and ship movement information to examine the relationship of visits to foreign ports with risk of HIV seropositivity and

  6. Incidence and Risk Factors for Invasive Pneumococcal Disease in HIV-infected and non-HIV infected Individuals Before and After the Introduction of Combination Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Harboe, Zitta Barrella; Larsen, Mette Vang; Ladelund, Steen;

    2014-01-01

    Danish HIV-treatment centers during 1995-2012. Nineteen population-matched controls per HIV-infected individual were retrieved. The risk of IPD (RR, [95% CI]) was assessed using Poisson regression. RESULTS:  The incidence of IPD was 304.7 cases/100,000 PYFU in HIV-infected and 12.8/100,000 PYFU in HIV...

  7. Immunodeficiency, AIDS-related pneumonia, and risk of lung cancer among HIV-infected individuals.

    Science.gov (United States)

    Marcus, Julia L; Leyden, Wendy A; Chao, Chun R; Horberg, Michael A; Klein, Daniel B; Quesenberry, Charles P; Towner, William J; Silverberg, Michael J

    2017-04-24

    The objective is to clarify the role of immunodeficiency and pneumonia in elevated lung cancer risk among HIV-infected individuals. Cohort study of HIV-infected and HIV-uninfected adults in a large integrated healthcare system in California during 1996-2011. We used Poisson models to obtain rate ratios for lung cancer associated with HIV infection, overall and stratified by recent CD4 cells/μl (HIV-uninfected as reference group), with χ tests for trends across CD4 strata. Fully adjusted models included demographics, cancer risk factors (smoking, drug/alcohol abuse, overweight/obesity), and prior pneumonia. Among 24 768 HIV-infected and 257 600 HIV-uninfected individuals, the lung cancer rate per 100 000 person-years was 66 (n = 80 events) for HIV-infected and 33 (n = 506 events) for HIV-uninfected individuals [rate ratio 2.0, 95% confidence interval (CI): 1.7-2.2]. Overall, HIV-infected individuals were at increased risk of lung cancer after adjustment for demographics and cancer risk factors (rate ratio 1.4, 95% CI: 1.1-1.7), but not after additional adjustment for pneumonia (rate ratio 1.2, 95% CI: 0.9-1.6). Lower CD4 cell counts were associated with higher risk of lung cancer in unadjusted and demographics-adjusted models (P cancer risk factors and pneumonia. Compared with HIV-uninfected individuals, HIV-infected individuals with CD4 less than 200 cells/μl were not at increased risk of lung cancer in fully adjusted models. The increased lung cancer risk among HIV patients is attributable to differences in demographics, risk factors such as smoking, and history of pneumonia. Immunodeficiency does not appear to have an independent effect on lung cancer risk.

  8. Plasma lipidomic profiling of treated HIV-positive individuals and the implications for cardiovascular risk prediction.

    Science.gov (United States)

    Wong, Gerard; Trevillyan, Janine M; Fatou, Benoit; Cinel, Michelle; Weir, Jacquelyn M; Hoy, Jennifer F; Meikle, Peter J

    2014-01-01

    The increased risk of coronary artery disease in human immunodeficiency virus (HIV) positive patients is collectively contributed to by the human immunodeficiency virus and antiretroviral-associated dyslipidaemia. In this study, we investigate the characterisation of the plasma lipid profiles of treated HIV patients and the relationship of 316 plasma lipid species across multiple lipid classes with the risk of future cardiovascular events in HIV-positive patients. In a retrospective case-control study, we analysed plasma lipid profiles of 113 subjects. Cases (n = 23) were HIV-positive individuals with a stored blood sample available 12 months prior to their diagnosis of coronary artery disease (CAD). They were age and sex matched to HIV-positive individuals without a diagnosis of CAD (n = 45) and with healthy HIV-negative volunteers (n = 45). Association of plasma lipid species and classes with HIV infection and cardiovascular risk in HIV were determined. In multiple logistic regression, we identified 83 lipids species and 7 lipid classes significantly associated with HIV infection and a further identified 74 lipid species and 8 lipid classes significantly associated with future cardiovascular events in HIV-positive subjects. Risk prediction models incorporating lipid species attained an area under the receiver operator characteristic curve (AUC) of 0.78 (0.775, 0.785)) and outperformed all other tested markers and risk scores in the identification of HIV-positive subjects with increased risk of cardiovascular events. Our results demonstrate that HIV-positive patients have significant differences in their plasma lipid profiles compared with healthy HIV-negative controls and that numerous lipid species were significantly associated with elevated cardiovascular risk. This suggests a potential novel application for plasma lipids in cardiovascular risk screening of HIV-positive patients.

  9. Male Circumcision and HIV/AIDS Risk – Analysis of the Scientific ...

    African Journals Online (AJOL)

    ra

    thesis that male circumcision reduces the risk of HIV infection and ... 1999 to 2008, using the terms “male circumcision”, “HIV infection” and “sexually transmitted .... trials of male circumcision to prevent HIV infection in three African countries.

  10. The Experience of Sexual Risk Communication in African American Families Living with HIV

    Science.gov (United States)

    Cederbaum, Julie A.

    2012-01-01

    Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV…

  11. An increase in rates of obstetric haemorrhage in a setting of high HIV seroprevalence

    Directory of Open Access Journals (Sweden)

    E Shabalala

    2017-07-01

    Full Text Available Background. Obstetric haemorrhage (OH is the leading cause of maternal mortality worldwide, although, indirectly, HIV is also a leading cause of maternal mortality in some settings with a high HIV seroprevalence. Objective. To determine the possible association between increasing rates of OH and HIV or its treatment. Methods. We conducted a retrospective chart review of women with OH at King Edward VIII Hospital, Durban, South Africa, over a 3-year period (2009 - 2011, during which the drug regimen for the prevention of mother-to-child transmission was evolving from single-dose nevirapine to antenatal zidovudine combined with intrapartum nevirapine (also referred to as dual therapy, and finally to a combination or highly active antiretroviral therapy (cART or HAART. Cases of OH (including abruptio placentae, placenta praevia, unspecified antepartum haemorrhage (APH, and postpartum haemorrhage (PPH were identified from maternity delivery records, and the relevant data extracted. Results. We analysed the records of 448 women diagnosed with OH. Even though the incidence of OH was low, the study found an increasing number of cases during the 3-year period. PPH – not APH – was associa