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  1. Surviving Sepsis in High HIV Prevalence Settings | Andrews ...

    No Abstract. Keywords: minimally invasive surgery, sclerotherapy, transfusion, HIV, occupational exposure. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

  2. Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study.

    Pepper, Dominique J; Schomaker, Michael; Wilkinson, Robert J; de Azevedo, Virginia; Maartens, Gary

    2015-01-01

    Identifying those at increased risk of death during TB treatment is a priority in resource-constrained settings. We performed this study to determine predictors of mortality during TB treatment. We performed a retrospective analysis of a TB surveillance population in a high HIV prevalence area that was recorded in ETR.net (Electronic Tuberculosis Register). Adult TB cases initiated TB treatment from 2007 through 2009 in Khayelitsha, South Africa. Cox proportional hazards models were used to identify risk factors for death (after multiple imputations for missing data). Model selection was performed using Akaike's Information Criterion to obtain the most relevant predictors of death. Of 16,209 adult TB cases, 851 (5.3 %) died during TB treatment. In all TB cases, advancing age, co-infection with HIV, a prior history of TB and the presence of both pulmonary and extra-pulmonary TB were independently associated with an increasing hazard of death. In HIV-infected TB cases, advancing age and female gender were independently associated with an increasing hazard of death. Increasing CD4 counts and antiretroviral treatment during TB treatment were protective against death. In HIV-uninfected TB cases, advancing age was independently associated with death, whereas smear-positive disease was protective. We identified several independent predictors of death during TB treatment in resource-constrained settings. Our findings inform resource-constrained settings about certain subgroups of TB patients that should be targeted to improve mortality during TB treatment.

  3. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence

    Keneuoe Hycianth Thinyane

    2015-01-01

    Full Text Available Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise data; association between variables was analysed using Fisher’s exact test. 56 patients were enrolled; the HIV coinfection rate was 79%. The most common presenting symptoms were altered mental status, neck stiffness, headache, and fever. TB meningitis was the most frequent diagnosis (39%, followed by bacterial (27%, viral (18%, and cryptococcal meningitis (16%. In-hospital mortality was 43% with case fatalities of 23%, 40%, 44%, and 90% for TB, bacterial, cryptococcal, and viral meningitis, respectively. Severe renal impairment was significantly associated with mortality. In conclusion, the causes of meningitis in this study reflect the high prevalence of HIV and TB in our setting. Strategies to reduce morbidity and mortality due to meningitis should include improving diagnostic services to facilitate early detection and treatment of meningitis and timely initiation of antiretroviral therapy in HIV-infected patients.

  4. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis.

    Lee, Hwa-Young; Yang, Bong-Min; Kang, Minah

    2015-11-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country.

  5. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases

    Meintjes Graeme

    2010-03-01

    Full Text Available Abstract Background The presentation and causes of adult meningitis in South Africa have changed substantially as a result of HIV. Knowledge of aetiology and laboratory findings in patients presenting with meningitis are important in guiding management. We performed a retrospective study to determine these findings in a setting of high HIV and TB prevalence in Cape Town. Methods Patients undergoing lumbar punctures between 1st January 2006 and 31st December 2008 at a public sector referral hospital were studied. Cases were classified by microbiological diagnosis, or in the absence of definitive microbiology as 1 normal CSF (neutrophils ≤ 1 × 106/L, lymphocytes ≤ 5 × 106/L, protein ≤ 0.5 g/dL, glucose ≥1.5 mmol/L, 2 minor abnormalities (neutrophils 2-5, lymphocytes 6-20, protein 0.51-1.0, glucose 1.0-1.49 or 3 markedly abnormal (neutrophils>5, lymphocytes>20, protein>1.0, glucose Results 5578 LPs were performed on 4549 patients, representing 4961 clinical episodes. Of these, 2293 had normal CSF and 931 had minor abnormalities and no aetiology identified. Of the remaining 1737, microbiological diagnoses were obtained in 820 (47%. Cryptococcus accounted for 63% (514 of microbiological diagnoses, TB for 28% (227, bacterial meningitis for 8% (68. Of the remaining 917 who had marked abnormalities, the majority (59% had a sterile lymphocytic CSF. Of note 16% (81 patients with confirmed Cryptococcus, 5% (12 with TB and 4% (3 with bacterial meningitis had normal CSF cell-counts and biochemistry. Conclusions Cryptococcal and tuberculous meningitis are now the commonest causes of adult meningitis in this setting. TB meningitis is probably underdiagnosed by laboratory investigation, as evidence by the large numbers presenting with sterile lymphocytic markedly abnormal CSFs.

  6. Evaluation of outpatients with suspected pulmonary tuberculosis in a high HIV prevalence setting in Ethiopia: clinical, diagnostic and epidemiological characteristics.

    Bruchfeld, Judith; Aderaye, Getachew; Palme, Ingela Berggren; Bjorvatn, Bjarne; Britton, Sven; Feleke, Yewenhareg; Källenius, Gunilla; Lindquist, Lars

    2002-01-01

    In a setting with a high prevalence of HIV we studied (i) the prevalence of pulmonary tuberculosis (PTB) and HIV; (ii) clinical and epidemiological characteristics of PTB; and (iii) the usefulness of standard procedures for diagnosing PTB. Of 509 consecutive outpatients evaluated on clinical suspicion of PTB in Addis Ababa, 33.0% were culture-verified as having PTB. PTB patients, non-TB patients and controls were HIV-1-positive in 57.1%, 38.5% and 8.3% of cases, respectively. Predictors for culture-verified PTB were age infection. Diagnosis of PTB based on clinical symptoms, sputum microscopy for acid-fast bacilli and chest radiography was sensitive (86.7%) but unspecific (64.1%). In HIV-positive patients both sensitivity and specificity were significantly lower (p infections are often misinterpreted as smear-negative PTB. HIV screening is therefore warranted not only in cases of verified TB but also as part of the diagnostic work-up in patients with respiratory symptoms suggestive of PTB. Also, increased awareness of, and improved diagnostic tools for, HIV-related pulmonary infections other than PTB are required, together with algorithms for patients with suspected PTB.

  7. What’s new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting1

    SALOOJEE, HAROON; DE MAAYER, TIM; GARENNE, MICHEL L.; KAHN, KATHLEEN

    2010-01-01

    Aim To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence. Design Case-control study. Setting Bushbuckridge District, Limpopo Province, South Africa. Participants 100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>−2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors. Results HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7–2091.3), poor weaning practices (OR 3.0, 95% CI 2.0–4.6), parental death (OR 38.0, 95% CI 3.8–385.3), male sex (OR 2.7, 95% CI 1.2–6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0–5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41–0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20–0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83–1.0), father smoking marijuana (OR 3.9, 95% CI 1.1–14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9–11.0). Conclusions Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS. PMID:17676510

  8. What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting.

    Saloojee, Haroon; De Maayer, Tim; Garenne, Michel L; Kahn, Kathleen

    2007-08-01

    To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence. Case-control study. Bushbuckridge District, Limpopo Province, South Africa. 100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>-2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors. HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7-2091.3), poor weaning practices (OR 3.0, 95% CI 2.0-4.6), parental death (OR 38.0, 95% CI 3.8-385.3), male sex (OR 2.7, 95% CI 1.2-6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0-5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41-0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20-0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83-1.0), father smoking marijuana (OR 3.9, 95% CI 1.1-14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9-11.0). Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS.

  9. Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting.

    Moyes, Jocelyn; Walaza, Sibongile; Pretorius, Marthi; Groome, Michelle; von Gottberg, Anne; Wolter, Nicole; Haffejee, Sumayya; Variava, Ebrahim; Cohen, Adam L; Tempia, Stefano; Kahn, Kathleen; Dawood, Halima; Venter, Marietjie; Cohen, Cheryl; Madhi, Shabir A

    2017-10-01

    There are limited data on the epidemiology of respiratory syncytial virus (RSV) illness in HIV-infected adults or the elderly in Africa. We studied the epidemiology of RSV-associated severe acute respiratory illness (SARI) hospitalizations in adults in South Africa from 2009 through 2013. Individuals admitted to sentinel surveillance hospitals were investigated by respiratory tract swabs for RSV, using a multiplex real-time polymerase chain reaction assay. The incidence of RSV-associated SARI was calculated for the one site with population denominators. Of 7796 participants investigated, 329 (4%) tested positive for RSV. On multivariable analysis, HIV-infected individuals with RSV-associated SARI had greater odds of being in the age groups 18-44 and 45-64 years (odd ratios (OR) 26.3; 95% confidence interval (CI) 6.2-112.1 and OR 11.4; 95% CI 2.6-50.0) compared with those ≥65 years and being female (OR 2.7; 95% CI 1.4-5.4). The relative risk of hospitalization with RSV-associated SARI was 12-18 times higher in HIV infected individual compared to that of HIV-uninfected. The incidence of RSV-associated SARI was higher in HIV-infected individuals and those aged 65 years and older. Further studies are warranted to describe the disease association of RSV detected in adults with SARI. Copyright © 2017 The British Infection Association. All rights reserved.

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

    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.

  11. Incidence of tuberculosis meningitis in a high HIV prevalence setting: time-series analysis from 2006 to 2011.

    Chaya, S; Dangor, Z; Solomon, F; Nzenze, S A; Izu, A; Madhi, S A

    2016-11-01

    This study was undertaken at a tertiary hospital in Soweto, a peri-urban low-middle income setting. Mycobacterium tuberculosis meningitis (TBM) is a severe manifestation of extra-pulmonary tuberculosis. To describe the incidence, mortality and clinical features of TBM in human immunodeficiency virus (HIV) infected and non-infected children in South Africa from 2006 to 2011. A retrospective, cross-sectional descriptive study. Electronic databases and individual patient records of all children with a discharge diagnosis of TBM were reviewed to yield incidence rate ratios (IRR) in HIV-infected and non-infected children. Clinical, laboratory and radiological characteristics were compared between HIV-infected and non-infected children with TBM. Overall TBM incidence per 100 000 population in 2006 was 6.9 (95%CI 4.4-10.3) and 9.8 (95%CI 6.9-13.6) in 2009, but had subsequently declined to 3.1 (95%CI 1.6-5.5) by 2011. There was a significant reduction in the IRR of TBM among HIV-infected children (IRR 0.916, P = 0.036). The overall case fatality ratio was 6.7%. Clinical features, cerebrospinal fluid and computed tomography brain findings were similar in HIV-infected and non-infected children. TBM incidence decreased over the study period from 2006 to 2011, and was temporally associated with an increase in the uptake of antiretroviral treatment in HIV-infected individuals.

  12. Hope Matters: Developing and Validating a Measure of Future Expectations Among Young Women in a High HIV Prevalence Setting in Rural South Africa (HPTN 068).

    Abler, Laurie; Hill, Lauren; Maman, Suzanne; DeVellis, Robert; Twine, Rhian; Kahn, Kathleen; MacPhail, Catherine; Pettifor, Audrey

    2017-07-01

    Hope is a future expectancy characterized by an individual's perception that a desirable future outcome can be achieved. Though scales exist to measure hope, they may have limited relevance in low resource, high HIV prevalence settings. We developed and validated a hope scale among young women living in rural South Africa. We conducted formative interviews to identify the key elements of hope. Using items developed from these interviews, we administered the hope scale to 2533 young women enrolled in an HIV-prevention trial. Women endorsed scale items highly and the scale proved to be unidimensional in the sample. Hope scores were significantly correlated with hypothesized psycholosocial correlates with the exception of life stressors. Overall, our hope measure was found to have excellent reliability and to show encouraging preliminary indications of validity in this population. This study presents a promising measure to assess hope among young women in South Africa.

  13. Mortality Associated With Seasonal and Pandemic Influenza Among Pregnant and Nonpregnant Women of Childbearing Age in a High-HIV-Prevalence Setting-South Africa, 1999-2009.

    Tempia, Stefano; Walaza, Sibongile; Cohen, Adam L; von Mollendorf, Claire; Moyes, Jocelyn; McAnerney, Johanna M; Cohen, Cheryl

    2015-10-01

    Information on the mortality burden associated with seasonal and pandemic influenza virus infection among pregnant women is scarce in most settings, particularly in sub-Saharan Africa where pregnancy and maternal mortality rates as well as human immunodeficiency virus (HIV) prevalence are elevated. We used an ecological study design to estimate the seasonal and A(H1N1)pdm09 influenza-associated mortality among pregnant and nonpregnant women of childbearing age (15-49 years) by HIV serostatus during 1999-2009 in South Africa. Mortality rates were expressed per 100 000 person-years. During 1999-2009, the estimated mean annual seasonal influenza-associated mortality rates were 12.6 (123 deaths) and 7.3 (914 deaths) among pregnant and nonpregnant women, respectively. Among pregnant women, the estimated mean annual seasonal influenza-associated mortality rates were 74.9 (109 deaths) among HIV-infected and 1.5 (14 deaths) among HIV-uninfected individuals. Among nonpregnant women, the estimated mean annual seasonal influenza-associated mortality rate was 41.2 (824 deaths) among HIV-infected and 0.9 (90 deaths) among HIV-uninfected individuals. Pregnant women experienced an increased risk of seasonal influenza-associated mortality compared with nonpregnant women (relative risk [RR], 2.8; 95% confidence interval [CI], 1.7-3.9). In 2009, the estimated influenza A(H1N1)pdm09-associated mortality rates were 19.3 (181 deaths) and 9.4 (1189 deaths) among pregnant and nonpregnant women, respectively (RR, 3.2; 95% CI, 2.3-4.1). Among women of childbearing age, the majority of estimated seasonal influenza-associated deaths occurred in HIV-infected individuals. Pregnant women experienced an increased risk of death associated with seasonal and A(H1N1)pdm09 influenza infection compared with nonpregnant women. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Cost-effectiveness of methadone maintenance therapy as HIV prevention in an Indonesian high-prevalence setting: a mathematical modeling study

    Wammes, J.J.G.; Siregar, A.Y.M.; Hidayat, T.; Raya, R.P.; van Crevel, R.; Ven, A.J.A.M. van der; Baltussen, R.M.

    2012-01-01

    BACKGROUND: Indonesia faces an HIV epidemic that is in rapid transition. Injecting drug users (IDUs) are among the most heavily affected risk populations, with estimated prevalence of HIV reaching 50% or more in most parts of the country. Although Indonesia started opening methadone clinics in 2003,

  15. Prevalence, risk factors, and pregnancy outcomes of cervical cell abnormalities in the puerperium in a hyperendemic HIV setting.

    Maise, Hopolang C; Moodley, Dhayendre; Sebitloane, Motshedisi; Maman, Suzanne; Sartorius, Benn

    2018-01-01

    To investigate the impact of cervical cell abnormalities detected in the puerperium in association with HIV-1 infection on pregnancy outcomes. The present study was a secondary data analysis of pregnancy outcomes, Pap smear results, HIV results, and participant demography from a behavioral intervention randomized controlled trial of 1480 pregnant women aged 18 years or more conducted at a periurban primary health clinic in South Africa during 2008-2010. The Pap smear was performed 14 weeks after delivery. In total, 564 (38.1%) women were HIV-1-positive and 78 (8.0%) of 973 women with a categorized Pap smear result tested positive for cervical cell abnormalities; 42 (4.2%) women had low-grade squamous intraepithelial lesions (LGSILs) and 7 (0.7%) had high-grade lesions (HGSILs). In an adjusted analysis, HIV infection was significantly more common among women with LGSILs (28/42 [66.7%]) or HGSILs (6/7 [85.7%]) when compared with the other Pap smear categories (P<0.001). The rates of premature birth, low birth weight, and non-live births were similar among HIV-infected and -uninfected women with abnormal cervical cytology. Pregnant women with HIV were more likely to be diagnosed with higher grades of squamous cell abnormalities than those without HIV. There was no association between squamous cell abnormalities/HIV comorbidity and adverse pregnancy outcomes. © 2017 International Federation of Gynecology and Obstetrics.

  16. Measuring Men's Gender Norms and Gender Role Conflict/Stress in a High HIV-Prevalence South African Setting.

    Gottert, Ann; Barrington, Clare; Pettifor, Audrey; McNaughton-Reyes, Heath Luz; Maman, Suzanne; MacPhail, Catherine; Kahn, Kathleen; Selin, Amanda; Twine, Rhian; Lippman, Sheri A

    2016-08-01

    Gender norms and gender role conflict/stress may influence HIV risk behaviors among men; however scales measuring these constructs need further development and evaluation in African settings. We conducted exploratory and confirmatory factor analyses to evaluate the Gender Equitable Men's Scale (GEMS) and the Gender Role Conflict/Stress (GRC/S) scale among 581 men in rural northeast South Africa. The final 17-item GEMS was unidimensional, with adequate model fit and reliability (alpha = 0.79). Factor loadings were low (0.2-0.3) for items related to violence and sexual relationships. The final 24-item GRC/S scale was multidimensional with four factors: Success, power, competition; Subordination to women; Restrictive emotionality; and Sexual prowess. The scale had adequate model fit and good reliability (alpha = 0.83). While GEMS is a good measure of inequitable gender norms, new or revised scale items may need to be explored in the South African context. Adding the GRC/S scale to capture men's strain related to gender roles could provide important insights into men's risk behaviors.

  17. Comparison of a Clinical Prediction Rule and a LAM Antigen-Detection Assay for the Rapid Diagnosis of TBM in a High HIV Prevalence Setting

    Patel, Vinod B.; Singh, Ravesh; Connolly, Cathy; Kasprowicz, Victoria; Zumla, Allimudin; Ndungu, Thumbi; Dheda, Keertan

    2010-01-01

    Background/Objective The diagnosis of tuberculous meningitis (TBM) in resource poor TB endemic environments is challenging. The accuracy of current tools for the rapid diagnosis of TBM is suboptimal. We sought to develop a clinical-prediction rule for the diagnosis of TBM in a high HIV prevalence setting, and to compare performance outcomes to conventional diagnostic modalities and a novel lipoarabinomannan (LAM) antigen detection test (Clearview-TB®) using cerebrospinal fluid (CSF). Methods Patients with suspected TBM were classified as definite-TBM (CSF culture or PCR positive), probable-TBM and non-TBM. Results Of the 150 patients, 84% were HIV-infected (median [IQR] CD4 count = 132 [54; 241] cells/µl). There were 39, 55 and 54 patients in the definite, probable and non-TBM groups, respectively. The LAM sensitivity and specificity (95%CI) was 31% (17;48) and 94% (85;99), respectively (cut-point ≥0.18). By contrast, smear-microscopy was 100% specific but detected none of the definite-TBM cases. LAM positivity was associated with HIV co-infection and low CD4 T cell count (CD4200 cells/µl; p = 0.03). The sensitivity and specificity in those with a CD4<100 cells/µl was 50% (27;73) and 95% (74;99), respectively. A clinical-prediction rule ≥6 derived from multivariate analysis had a sensitivity and specificity (95%CI) of 47% (31;64) and 98% (90;100), respectively. When LAM was combined with the clinical-prediction-rule, the sensitivity increased significantly (p<0.001) to 63% (47;68) and specificity remained high at 93% (82;98). Conclusions Despite its modest sensitivity the LAM ELISA is an accurate rapid rule-in test for TBM that has incremental value over smear-microscopy. The rule-in value of LAM can be further increased by combination with a clinical-prediction rule, thus enhancing the rapid diagnosis of TBM in HIV-infected persons with advanced immunosuppression. PMID:21203513

  18. 'Testing Together Challenges the Relationship': Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa.

    Hanani Tabana

    Full Text Available We conducted qualitative individual and combined interviews with couples to explore their experiences since the time of taking an HIV test and receiving the test result together, as part of a home-based HIV counselling and testing intervention.This study was conducted in October 2011 in rural KwaZulu-Natal, South Africa, about 2 years after couples tested and received results together. Fourteen couples were purposively sampled: discordant, concordant negative and concordant positive couples.Learning about each other's status together challenged relationships of the couples in different ways depending on HIV status and gender. The mutual information confirmed suspected infidelity that had not been discussed before. Negative women in discordant partnerships remained with their positive partner due to social pressure and struggled to maintain their HIV negative status. Most of the couple relationships were characterized by silence and mistrust. Knowledge of sero-status also led to loss of sexual intimacy in some couples especially the discordant. For most men in concordant negative couples, knowledge of status was an awakening of the importance of fidelity and an opportunity for behaviour change, while for concordant positive and discordant couples, it was seen as proof of infidelity. Although positive HIV status was perceived as confirmation of infidelity, couples continued their relationship and offered some support for each other, living and managing life together. Sexual life in these couples was characterized by conflict and sometimes violence. In the concordant negative couples, trust was enhanced and behaviour change was promised.Findings suggest that testing together as couples challenged relationships in both negative and positive ways. Further, knowledge of HIV status indicated potential to influence behaviour change especially among concordant negatives. In the discordant and concordant positive couples, traditional gender roles exposed

  19. Cost-effectiveness of methadone maintenance therapy as HIV prevention in an Indonesian high-prevalence setting: a mathematical modeling study.

    Wammes, Joost J G; Siregar, Adiatma Y; Hidayat, Teddy; Raya, Reynie P; van Crevel, Reinout; van der Ven, André J; Baltussen, Rob

    2012-09-01

    Indonesia faces an HIV epidemic that is in rapid transition. Injecting drug users (IDUs) are among the most heavily affected risk populations, with estimated prevalence of HIV reaching 50% or more in most parts of the country. Although Indonesia started opening methadone clinics in 2003, coverage remains low. We used the Asian Epidemic Model and Resource Needs Model to evaluate the long-term population-level preventive impact of expanding Methadone Maintenance Therapy (MMT) in West Java (43 million people). We compared intervention costs and the number of incident HIV cases in the intervention scenario with current practice to establish the cost per infection averted by expanding MMT. An extensive sensitivity analysis was performed on costs and epidemiological input, as well as on the cost-effectiveness calculation itself. Our analysis shows that expanding MMT from 5% coverage now to 40% coverage in 2019 would avert approximately 2400 HIV infections, at a cost of approximately US$7000 per HIV infection averted. Sensitivity analyses demonstrate that the use of alternative assumptions does not change the study conclusions. Our analyses suggest that expanding MMT is cost-effective, and support government policies to make MMT widely available as an integrated component of HIV/AIDS control in West Java. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Implementing universal HIV treatment in a high HIV prevalence and rural South African setting - Field experiences and recommendations of health care providers.

    Melanie Plazy

    Full Text Available We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP regarding the implementation of universal antiretroviral therapy (ART in rural KwaZulu-Natal, South Africa.In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April-July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants were conducted, audio-recorded, transcribed, and thematically analyzed.All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services.The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery.

  1. Implementing universal HIV treatment in a high HIV prevalence and rural South African setting – Field experiences and recommendations of health care providers

    Gumede, Dumile; Boyer, Sylvie; Pillay, Deenan; Dabis, François; Seeley, Janet; Orne-Gliemann, Joanna

    2017-01-01

    Background We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP) regarding the implementation of universal antiretroviral therapy (ART) in rural KwaZulu-Natal, South Africa. Methods In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH) is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria) was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April–July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants) were conducted, audio-recorded, transcribed, and thematically analyzed. Results All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services. Conclusions The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery. PMID:29155832

  2. The HIV/AIDS epidemic in Cuba: description and tentative explanation of its low HIV prevalence

    Clémençon Stéphan

    2007-11-01

    Full Text Available Abstract Background The Cuban HIV/AIDS epidemic has the lowest prevalence rate of the Caribbean region. The objective of this paper is to give an overview of the HIV/AIDS epidemic in Cuba and to explore the reasons for this low prevalence. Methods Data were obtained from the Cuban HIV/AIDS programme established in 1983. This programme has an extensive adult HIV testing policy, including testing of all pregnant women. HIV and AIDS cases have been recorded since 1986. Persons found to be HIV-positive are interviewed on their sexual behaviour and partners. Tracing and voluntary testing of these partners are organised. Epidemiological description of this epidemic was obtained from analysis of this data set. Using elementary mathematical analyses, we estimated the coverage of the detection system (percentage of HIV-positive adults detected and the average period between HIV infection and detection. Estimated HIV prevalence rates were corrected to account for the coverage. Results HIV prevalence has increased since 1996. In 2005, the prevalence among pregnant women was 1.2 per 10,000 (16/137000. Estimated HIV prevalence among 15- to 49-year-olds was 8.1 per 10,000 (4913/6065000; 95%CI: 7.9 per 10,000 – 8.3 per 10,000. Most (77% of the HIV-positive adults were men, most (85.1% of the detected HIV-positive men were reported as having sex with men (MSM, and most of the HIV-positive women reported having had sex with MSM. The average period between HIV infection and detection was estimated to be 2.1 years (IQR = 1.7 – 2.2 years. We estimated that, for the year 2005, 79.6% (IQR: 77.3 – 81.4% of the HIV-positive persons were detected. Conclusion MSM drive the HIV epidemic in Cuba. The extensive HIV testing policy may be an important factor in explaining the low HIV prevalence. To reduce the HIV epidemic in Cuba, the epidemic among MSM should be addressed. To understand this epidemic further, data on sexual behaviour should be collected. Now that

  3. Prevalence of HIV among people with physical disabilities in Rwanda.

    Munymana, J B; M'kumbuzi, V R P; Mapira, H T; Nzabanterura, I; Uwamariyai, I; Shema, E

    2014-01-01

    To determine the prevalence of HIV among persons with physical disabilities in Rwanda. Across-sectional HIV diagnostic study. A national referral rehabilitation centre in Rwanda. Persons aged 5 to 49 years with lower or upper limb impairments that were obtaining rehabilitation services at the centre. Blood samples were collected from the subjects who voluntarily accepted to participate in the study. Blood samples (4mls) were collected in vacutainer tubes and centrifuged to obtain serum which was analyzed using standard HIV rapid tests-determine HIV-1/2 Ab/Ag, SD-Bioline and UNI-Gold Recombigen HIV as a tie-breaker. The HIV status of participants--negative or positive. Descriptive statistics were computed to characterize the sample and proportions for the HIV test results. All one hundred and fifty-seven subjects, 59 (37.6%) male and 98 (62.4%) female, completed the study. The HIV prevalence obtained was 5.73%. All participants that tested positive were female and all tested positive for HIV-1. The prevalence obtained was higher than the population prevalence of 3.0% reported for Rwanda. Targeted HIV prevention is required for PWDs in Rwanda, with at least as much rigor as programs targeted towards the general population. Further, this should address the wide range of gender inequalities that make women particularly vulnerable to HIV. Further research needs to be conducted on a larger sample that draws participants from non-institutional settings and from other disability categories; as well as to study more specifically, the risk factors for HIV infection among PWDs in Rwanda.

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

    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.

  5. The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services.

    Spira, Thomas; Lindegren, Mary Lou; Ferris, Robert; Habiyambere, Vincent; Ellerbrock, Tedd

    2009-06-01

    The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms.

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

    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.

  7. HIV prevalence and trends among pregnant women in Abuja, Nigeria

    HIV prevalence and trends among pregnant women in Abuja, Nigeria: a 5-year ... trends in HIV prevalence to ascertain the current course of the HIV epidemic in ... Objective: The aim of this study was to determine the prevalence of HIV and its ...

  8. Prevalence of HIV infection among the patients with an avascular ...

    Objective: To study the prevalence of HIV infection among the risk factors associated with the avascular necrosis of the femoral head in Ouagadougou, Burkina Faso. Design: Multicenter retrospective study. Setting: Rheumatology consultations and Orthopedic-Traumatology Surgery Department Of The University Hospital ...

  9. Evaluation of the Architect HIV Ag/Ab Combo Assay in a low-prevalence setting: The role of samples with a low S/CO ratio.

    Alonso, Roberto; Pérez-García, Felipe; Gijón, Paloma; Collazos, Ana; Bouza, Emilio

    2018-06-01

    The Architect HIV Ag/Ab Combo Assay, a fourth-generation ELISA, has proven to be highly reliable for the diagnosis of HIV infection. However, its high sensitivity may lead to false-positive results. To evaluate the diagnostic performance of Architect in a low-prevalence population and to assess the role of the sample-to-cutoff ratio (S/CO) in reducing the frequency of false-positive results. We conducted a retrospective study of samples analyzed by Architect between January 2015 and June 2017. Positive samples were confirmed by immunoblot (RIBA) or nucleic acid amplification tests (NAATs). Different S/CO thresholds (1, 2.5, 10, 25, and 100) were analyzed to determine sensitivity, specificity, and negative and positive predictive values (NPV, PPV). ROC analysis was used to determine the optimal S/CO. A total of 69,471 samples were analyzed. 709 (1.02%) were positive by Architect. Of these, 63 (8.89%) were false-positive results. Most of them (93.65%) were in samples with S/CO < 100. However, most confirmations by NAATs (12 out of 19 cases) were also recorded for these samples. The optimal S/CO was 2.5, which provided the highest area under the ROC curve (0.9998) and no false-negative results. With this S/CO, sensitivity and specificity were 100.0%, and PPV and NPV were 95.8% and 100.0%, respectively. In addition, the frequency of false-positive results decreased significantly to 4.15%. Although Architect generates a relatively high number of false-positive results, raising the S/CO limit too much to increase specificity can lead to false-negative results, especially in newly infected individuals. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. [Prevalence and related factors of HIV/HBV coinfection among HIV/AIDS patients].

    Feng, D; Yao, T; Cheng, Y P; Pan, M H; Li, C X; Wang, J; Feng, Y L; Shi, J; Huang, H L; Lu, H Y; Lan, G H; Wang, S P; Zhang, Y W

    2017-12-10

    Objective: To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients. Methods: We conducted a cross-sectional study in two HIV clinics, affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional. A face-to-face interview, with questionnaire was conducted to collect information on socio-demographic characteristics, drug use, and sexual behavior. Blood samples were used to test HBsAg. χ (2) test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors. Results: The prevalence of HBV and HIV co-infection was 13.85% (113/816). Results from multivariate logistic regression analyses showed that age (25-45), family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection, with OR (95% CI ) as 1.738 (1.031-2.931), 2.898 (1.678-5.005) and 1.744 (1.052-2.892), respectively. Conclusion: The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population. HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV, while HepB vaccination was associated with the reduction of HIV/HBV coinfection. Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

  11. Prevalence of low bone mineral density among HIV patients on long-term suppressive antiretroviral therapy in resource limited setting of western India.

    Dravid, Ameet; Kulkarni, Milind; Borkar, Amit; Dhande, Sachin

    2014-01-01

    Bone mineral density (BMD) assessment in HIV patients is sparsely done in resource limited settings. We conducted a cross-sectional study of BMD amongst HIV patients following up in our clinic from 1 June to 1 December 2013 by performing dual-energy X-ray absorptiometry scan (Lunar Prodigy Advanced DXA System, GE Healthcare) of lumbar spine and hip. Patients on long term (≥12 months), virologically suppressive antiretroviral therapy (ART) were included. Patients who were ART naïve were included as control population. Virologic failures were excluded. Low BMD was defined by WHO T-score criteria (normal: T score ≥-1;osteopenia: T score between -1 and -2.5 SD; osteoporosis: T score ≤-2.5 SD). Baseline risk factors associated with low BMD like age, low BMI, lipoatrophy, diabetes mellitus, current smoking, current alcohol intake, steroid exposure and menopause were recorded. ART-related factors associated with low BMD like ART duration, exposure to tenofovir and exposure to protease inhibitors (PI) were studied. A total of 536 patients (66% males, 496 ART experienced and 40 ART naïve) were included in this analysis. Median age was 42 years, mean BMI 23.35 kg/m(2) and median CD4 count 146 cells/mm(3). All ART experienced patients had plasma viral loadpatients in our cohort is a matter of deep concern due to its association with pathological fractures. Bone mineral loss was seen irrespective of ART used. Association of low BMD with low baseline CD4 count strengthens the case for early ART.

  12. Risk perception and sex behaviour in pregnancy and breastfeeding in high HIV prevalence settings: Programmatic implications for PrEP delivery

    Farley, Elise; Towriss, Catriona; Gomba, Yolanda; Bekker, Linda-Gail; Gorbach, Pamina; Shoptaw, Steven; Coates, Thomas; Myer, Landon

    2018-01-01

    HIV acquisition during pregnancy and breastfeeding significantly contributes toward paediatric HIV infection; however, little is known about risk behaviours in HIV-uninfected pregnant and postpartum women. We conducted twenty-six in-depth-interviews between July and December 2016 using a semi-structured interview guide among HIV-uninfected pregnant and recently postpartum women at-risk of HIV acquisition (defined as reporting ≥1 of the following: partner’s serostatus unknown or HIV-infected, recent condomless sex in pregnancy, and/or alcohol use during pregnancy) who attended primary healthcare services. Our study contextualizes factors related to risky sexual behaviours during pregnancy and postpartum periods and assesses knowledge and hypothetical acceptability of pre-exposure prophylaxis (PrEP) in pregnancy. Translated and transcribed data were coded and analysed by three researchers using a thematic analysis approach. In interviews with HIV-uninfected pregnant/postpartum women at-risk of HIV acquisition, we identified common themes associated with sexual risk behaviours during pregnancy, including: lack of control over decisions in sex and condom use in pregnancy, low perceived risk (e.g. beliefs that their partner has the same HIV-negative serostatus), and socio-cultural beliefs around condom use during pregnancy (e.g. contact with sperm is essential for baby’s development). PrEP knowledge was low among HIV-uninfected pregnant and breastfeeding women, and potential acceptability was good, though primary concerns were around the potential impact on the infant. While mothers presented a clear desire to protect themselves from HIV acquisition once pregnant, they also reported lack of control, and socio-cultural beliefs, like sex is good for the baby, that increased their risk of seroconversion. Mothers had limited PrEP awareness but reported hypothetical willingness to use PrEP because of concerns over HIV acquisition and onward mother to child transmission

  13. Chronic diarrhoea in HIV patients: Prevalence of coccidian parasites

    Gupta S

    2008-01-01

    Full Text Available The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea ( P < 0.001. Isospora belli was found in 41.1% (14/34 of chronic diarrhoea and 6.3% (5/79 in non-diarrhoeal cases ( P < 0.001. Cryptosporidium was detected in 20.6% (7/34 of chronic diarrhoea and 2.5% (2/79 in non-diarrhoeal cases ( P < 0.01. Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%. CD4+ T-cell count was lower (180 cells/μl0 in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/μL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients.

  14. Gendered power dynamics and women’s negotiation of family planning in a high HIV prevalence setting: A qualitative study of couples in western Kenya

    Harrington, Elizabeth K.; Dworkin, Shari; Withers, Mellissa; Onono, Maricianah; Kwena, Zachary; Newmann, Sara J.

    2017-01-01

    In sub-Saharan Africa, high burdens of HIV and unmet need for contraception often coexist. Research emphasises the need to engage men and couples in reproductive health, yet couples’ negotiations around fertility and family planning in the context of HIV have been sparsely studied. This study examined the gendered power dynamics that frame women’s and couples’ negotiations of contraceptive use in western Kenya. We conducted 76 in-depth interviews with 38 couples, of whom 22 couples were concordant HIV-positive. Qualitative data were analysed using a grounded theory approach. Direct communication around contraception with men was often challenging due to perceived or expressed male resistance. A substantial minority of women avoided male reproductive decision-making authority through covert contraceptive use, with concern for severe consequences when contraceptive use was discovered. Many men assumed that family planning use signified female promiscuity and that infidelity motivated covert use. Men were more willing to use condoms to avoid HIV re-infection or at the recommendation of HIV care providers, which allowed some women leverage to insist on condom use. Our findings highlight the tension between male-dominated reproductive decision-making and women’s agency and point to the need for gender transformative approaches seeking to challenge masculinities that negatively impact health. PMID:26503879

  15. Gendered power dynamics and women's negotiation of family planning in a high HIV prevalence setting: a qualitative study of couples in western Kenya.

    Harrington, Elizabeth K; Dworkin, Shari; Withers, Mellissa; Onono, Maricianah; Kwena, Zachary; Newmann, Sara J

    2016-01-01

    In sub-Saharan Africa, high burdens of HIV and unmet need for contraception often coexist. Research emphasises the need to engage men and couples in reproductive health, yet couples' negotiations around fertility and family planning in the context of HIV have been sparsely studied. This study examined the gendered power dynamics that frame women's and couples' negotiations of contraceptive use in western Kenya. We conducted 76 in-depth interviews with 38 couples, of whom 22 couples were concordant HIV-positive. Qualitative data were analysed using a grounded theory approach. Direct communication around contraception with men was often challenging due to perceived or expressed male resistance. A substantial minority of women avoided male reproductive decision-making authority through covert contraceptive use, with concern for severe consequences when contraceptive use was discovered. Many men assumed that family planning use signified female promiscuity and that infidelity motivated covert use. Men were more willing to use condoms to avoid HIV re-infection or on the recommendation of HIV care providers, which allowed some women leverage to insist on condom use. Our findings highlight the tension between male dominated reproductive decision making and women's agency and point to the need for gender transformative approaches seeking to challenge masculinities that negatively impact health.

  16. Clinical Profile and HIV/AIDS Prevalence of Patients with ...

    Background: Clinical features of HIV/AIDS and various malignancies are similar. Clinical profiles and HIV/AIDS prevalence in Nigerian cancer patients have been poorly documented. Aim: To identify the patterns of clinical presentations in patients with malignancies and to determine the prevalence of HIV infection in cancer ...

  17. Voluntary Counseling and Testing and Prevalence of HIV Infection ...

    Voluntary Counseling and Testing and Prevalence of HIV Infection Amongst Patients Booked for Surgical Operations. ... The effectiveness (yield) of lay counseling in HIV testing by resident doctors who have not ... AJOL African Journals Online.

  18. HIV in Indian prisons: Risk behaviour, prevalence, prevention & treatment

    Dolan, Kate; Larney, Sarah

    2010-01-01

    Background & Objectives: HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Methods: Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered...

  19. Prevalence and characteristics of HIV/HBV and HIV/HCV coinfections in Tuscany

    Monia Puglia

    2016-07-01

    Conclusions: We have observed less advanced disease in HIV and HCV-HIV patients compared with HBV–HIV coinfected patients. Moreover, our results show a higher prevalence of HIV/HCV among drug addicts and in the age-group 35–59, corresponding to those born in years considered most at risk for addiction. This study also confirms the finding of a less advanced HIV disease in HIV/HCV coinfected patients.

  20. University students and HIV in Namibia: an HIV prevalence survey and a knowledge and attitude survey

    de Beer, Ingrid H.; Gelderblom, Huub C.; Schellekens, Onno; Gaeb, Esegiel; van Rooy, Gert; McNally, Alta; Wit, Ferdinand W.; Rinke de Wit, Tobias F.

    2012-01-01

    Background: With an overall adult HIV prevalence of 15.3%, Namibia is facing one of the largest HIV epidemics in Africa. Young people aged 20 to 34 years constitute one of the groups at highest risk of HIV infection in Namibia. However, little is known about the impact of HIV on this group and its

  1. Low Prevalence of Transmitted HIV Type 1 Drug Resistance Among Antiretroviral-Naive Adults in a Rural HIV Clinic in Kenya

    Hassan, Amin S.; Mwaringa, Shalton M.; Obonyo, Clare A.; Nabwera, Helen M.; Sanders, Eduard J.; Rinke de Wit, Tobias F.; Cane, Patricia A.; Berkley, James A.

    2013-01-01

    Low levels of HIV-1 transmitted drug resistance (TDR) have previously been reported from many parts of sub-Saharan Africa (sSA). However, recent data, mostly from urban settings, suggest an increase in the prevalence of HIV-1 TDR. Our objective was to determine the prevalence of TDR mutations among

  2. High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia

    Toussova, Olga V.; Verevochkin, Sergei V.; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P.

    2011-01-01

    The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting. PMID:18843531

  3. Prevalence of cervical cytology abnormalities among HIV infected ...

    Objectives: To establish the prevalence of cervical cytology abnormalities, determine the correlation between CD4+ cell count and abnormal Pap smear, determine the correlation between WHO-HIV staging and abnormal pap smear among HIV infected women attending HIV clinic at Rwanda Military Hospital. Design: ...

  4. Prevalence of HIV positive blood donors among screened ...

    hope&shola

    2006-04-03

    Apr 3, 2006 ... Department of Physiology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching. Hospital ... screening volunteer donors by initial criteria alone does not fully eliminate all HIV positive donors. The prevalence of HIV ... HIV test criteria alone to qualify for blood donation in the.

  5. Prevalence of HIV infection among premarital couples in southeast ...

    The Catholic Church in Nigeria offers premarital HIV screening to couples, yet instances of voluntary screening are rare in southeast Nigeria. This study examines the contribution of such tests to HIV detection, and evaluates the prevalence of HIV infection in southeast Nigeria among couples who are planning to marry.

  6. HIV in Indian prisons: risk behaviour, prevalence, prevention & treatment.

    Dolan, Kate; Larney, Sarah

    2010-12-01

    HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided.

  7. The prevalence of HIV infection among cannabis-abused psychiatric ...

    The prevalence of HIV infection among cannabis-abused psychiatric patients: the case of federal psychiatric hospital, Calabar. ... called “Prevalence of HIV infection and Cannabis-Abused Questionnaire” (P.H.I.C.Q.), while data obtained were subjected to statistical analysis using contingency chi-square (X2) technique.

  8. Refusal bias in the estimation of HIV prevalence

    Janssens, Wendy; van der Gaag, Jacques; Rinke de Wit, Tobias F.; Tanović, Zlata

    2014-01-01

    In 2007, UNAIDS corrected estimates of global HIV prevalence downward from 40 million to 33 million based on a methodological shift from sentinel surveillance to population-based surveys. Since then, population-based surveys are considered the gold standard for estimating HIV prevalence. However,

  9. Association of HIV prevalence and concurrency of sexual ...

    Association of HIV prevalence and concurrency of sexual partnerships in South Africa's language groups: An ecological analysis. C Kenyon. Abstract. Background. There is considerable variation in HIV prevalence between different language groups in South Africa (SA). Sexual partner concurrency has been linked to the ...

  10. Adherence to self-administered tuberculosis treatment in a high HIV-prevalence setting: a cross-sectional survey in Homa Bay, Kenya.

    Fabienne Nackers

    Full Text Available BACKGROUND: Good adherence to treatment is crucial to control tuberculosis (TB. Efficiency and feasibility of directly observed therapy (DOT under routine program conditions have been questioned. As an alternative, Médecins sans Frontières introduced self-administered therapy (SAT in several TB programs. We aimed to measure adherence to TB treatment among patients receiving TB chemotherapy with fixed dose combination (FDC under SAT at the Homa Bay district hospital (Kenya. A second objective was to compare the adherence agreement between different assessment tools. METHODS: We conducted a cross-sectional survey amongst a series of new TB patients receiving 6 months of standard TB chemotherapy with FDC under SAT. Adherence was assessed at home with urine testing for Isoniazid (INH, pill count, interviewer-administered questionnaire and visual analogue scale (VAS. RESULTS: In November 2008 and in June 2009, 212 of 279 eligible patients were assessed for adherence. Overall, 95.2% [95%CI: 91.3-97.7] of the patients reported not having missed a tablet in the last 4 days. On the VAS, complete adherence was estimated at 92.5% [95%CI: 88.0-95.6]. INH urine test was positive for 97.6% [95%CI: 94.6-99.2] of the patients. Pill count could be assessed among only 70% of the interviewed patients. Among them, it was complete for 82.3% [95%CI: 75.1-88.1]. Among the 212 surveyed patients, 193 (91.0% were successfully treated (cured or treatment completed. The data suggest a fair agreement between the questionnaire and the INH urine test (k = 0.43 and between the questionnaire and the VAS (k = 0.40. Agreement was poor between the other adherence tools. CONCLUSION: These results suggest that SAT, together with the FDC, allows achieving appropriate adherence to antituberculosis treatment in a high TB and HIV burden area. The use of a combination of a VAS and a questionnaire can be an adequate approach to monitor adherence to TB treatment in routine program

  11. The geography of HIV/AIDS prevalence rates in Botswana.

    Kandala, Ngianga-Bakwin; Campbell, Eugene K; Rakgoasi, Serai Dan; Madi-Segwagwe, Banyana C; Fako, Thabo T

    2012-01-01

    Botswana has the second-highest human immunodeficiency virus (HIV) infection rate in the world, with one in three adults infected. However, there is significant geographic variation at the district level and HIV prevalence is heterogeneous with the highest prevalence recorded in Selebi-Phikwe and North East. There is a lack of age-and location-adjusted prevalence maps that could be used for targeting HIV educational programs and efficient allocation of resources to higher risk groups. We used a nationally representative household survey to investigate and explain district level inequalities in HIV rates. A Bayesian geoadditive mixed model based on Markov Chain Monte Carlo techniques was applied to map the geographic distribution of HIV prevalence in the 26 districts, accounting simultaneously for individual, household, and area factors using the 2008 Botswana HIV Impact Survey. Overall, HIV prevalence was 17.6%, which was higher among females (20.4%) than males (14.3%). HIV prevalence was higher in cities and towns (20.3%) than in urban villages and rural areas (16.6% and 16.9%, respectively). We also observed an inverse U-shape association between age and prevalence of HIV, which had a different pattern in males and females. HIV prevalence was lowest among those aged 24 years or less and HIV affected over a third of those aged 25-35 years, before reaching a peak among the 36-49-year age group, after which the rate of HIV infection decreased by more than half among those aged 50 years and over. In a multivariate analysis, there was a statistically significant higher likelihood of HIV among females compared with males, and in clerical workers compared with professionals. The district-specific net spatial effects of HIV indicated a significantly higher HIV rate of 66% (posterior odds ratio of 1.66) in the northeast districts (Selebi-Phikwe, Sowa, and Francistown) and a reduced rate of 27% (posterior odds ratio of 0.73) in Kgalagadi North and Kweneng West districts

  12. HIV coreceptor phenotyping in the clinical setting.

    Low, Andrew J; Swenson, Luke C; Harrigan, P Richard

    2008-01-01

    The introduction of CCR5 antagonists increases the options available for constructing antiretroviral regimens. However, this option is coupled with the caveat that patients should be tested for HIV coreceptor tropism prior to initiating CCR5 antagonist-based therapy. Failure to screen for CXCR4 usage increases the risk of using an ineffective drug, thus reducing the likelihood of viral suppression and increasing their risk for developing antiretroviral resistance. This review discusses current and future methods of determining HIV tropism, with a focus on their utility in the clinical setting for screening purposes. Some of these methods include recombinant phenotypic tests, such as the Monogram Trofile assay, as well as genotype-based predictors, heteroduplex tracking assays, and flow cytometry based methods. Currently, the best evidence supports the use of phenotypic methods, although other methods of screening for HIV coreceptor usage prior to the administration of CCR5 antagonists may reduce costs and increase turnaround time over phenotypic methods. The presence of low levels of X4 virus is a challenge to all assay methods, resulting in reduced sensitivity in clinical, patient-derived samples when compared to clonally derived samples. Gaining a better understanding of the output of these assays and correlating them with clinical progression and therapy response will provide some indication on how both genotype-based, and phenotypic assays for determining HIV coreceptor usage can be improved. In addition, leveraging new technologies capable of detecting low-level minority species may provide the most significant advances in ensuring that individuals with low levels of dual/mixed tropic virus are not inadvertently prescribed CCR5 antagonists.

  13. The Prevalence of Disclosure of HIV Status to HIV-Infected Children in Western Kenya.

    Turissini, Matthew L; Nyandiko, Winstone M; Ayaya, Samuel O; Marete, Irene; Mwangi, Ann; Chemboi, Victor; Warui, Lucy; Vreeman, Rachel C

    2013-06-01

    As antiretroviral therapy (ART) allows the world's 2.3 million human immunodeficiency virus (HIV)-infected children to grow and thrive, these children need to be informed of their HIV status. Neither the prevalence of disclosure to children nor its impact has been evaluated in most resource-limited settings. We conducted a prospective assessment of a random sample of HIV-infected children ages 6-14 years enrolled in HIV care at a large referral clinic in Eldoret, Kenya. Clinicians administered questionnaires to children and caregivers independently at routine clinic visits to assess disclosure status, ART adherence, stigma, and depression. Children's demographic and clinical characteristics were extracted from chart review. We calculated descriptive statistics and performed logistic regression to assess the association between disclosure and other characteristics. Two hundred seventy children-caregiver dyads completed questionnaires. The mean child age was 9.3 years (standard deviation 2.6); 49% were male, and 42% were orphans. 11.1% of children had been informed of their HIV status (N = 30). Of those under 10 years, 3.3% knew their status, whereas 9.2% of 10- to 12-year-olds and 39.5% of 13- to 14-year-olds knew they had HIV. Only age was significantly associated with disclosure status in both bivariate analyses (P processes should be a key facet of long-term pediatric HIV management. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda

    Joseph K. B. Matovu

    2015-06-01

    Full Text Available Background: Studies show that uptake of couples’ HIV counseling and testing (couples’ HCT can be affected by individual, relationship, and socioeconomic factors. However, while couples’ HCT uptake can also be affected by background HIV prevalence and awareness of the existence of couples’ HCT services, this is yet to be documented. We explored the correlates of previous couples’ HCT uptake among married individuals in a rural Ugandan district with differing HIV prevalence levels. Design: This was a cross-sectional study conducted among 2,135 married individuals resident in the three HIV prevalence strata (low HIV prevalence: 9.7–11.2%; middle HIV prevalence: 11.4–16.4%; and high HIV prevalence: 20.5–43% in Rakai district, southwestern Uganda, between November 2013 and February 2014. Data were collected on sociodemographic and behavioral characteristics, including previous receipt of couples’ HCT. HIV testing data were obtained from the Rakai Community Cohort Study. We conducted multivariable logistic regression analysis to identify correlates that are independently associated with previous receipt of couples’ HCT. Data analysis was conducted using STATA (statistical software, version 11.2. Results: Of the 2,135 married individuals enrolled, the majority (n=1,783, 83.5% had been married for five or more years while (n=1,460, 66% were in the first-order of marriage. Ever receipt of HCT was almost universal (n=2,020, 95%; of those ever tested, (n=846, 41.9% reported that they had ever received couples’ HCT. There was no significant difference in previous receipt of couples’ HCT between low (n=309, 43.9%, middle (n=295, 41.7%, and high (n=242, 39.7% HIV prevalence settings (p=0.61. Marital order was not significantly associated with previous receipt of couples’ HCT. However, marital duration [five or more years vis-à-vis 1–2 years: adjusted odds ratio (aOR: 1.06; 95% confidence interval (95% CI: 1.04–1.08] and

  15. University students and HIV in Namibia: an HIV prevalence survey and a knowledge and attitude survey.

    de Beer, Ingrid H; Gelderblom, Huub C; Schellekens, Onno; Gaeb, Esegiel; van Rooy, Gert; McNally, Alta; Wit, Ferdinand W; Tobias, Rinke de Wit F

    2012-02-22

    With an overall adult HIV prevalence of 15.3%, Namibia is facing one of the largest HIV epidemics in Africa. Young people aged 20 to 34 years constitute one of the groups at highest risk of HIV infection in Namibia. However, little is known about the impact of HIV on this group and its access to healthcare. The purpose of this study was to estimate HIV prevalence, to assess the knowledge of and attitudes towards HIV/AIDS, and to assess access to healthcare among university students in Namibia. We assessed HIV/AIDS knowledge and attitudes, HIV prevalence and access to healthcare among students at the Polytechnic of Namibia and the University of Namibia. HIV prevalence was tested through anonymous oral fluid-based tests. Half (n = 2790/5568) of the university students and 45% (n = 2807/6302) of the Polytechnic students participated in the knowledge and attitudes surveys. HIV/AIDS knowledge was reasonable, except for misperceptions about transmission. Awareness of one's own HIV status and risks was low. In all, 55% (n = 3055/5568) of university students and 58% (n = 3680/6302) of Polytechnic students participated in the HIV prevalence survey; 54 (1.8%) university students and 103 (2.8%) Polytechnic students tested HIV positive. Campus clinics were not the major providers of healthcare to the students. Meaningful strategies addressing the gap between knowledge, attitude and young people's perception of risk of HIV acquisition should be implemented. HIV prevalence among Namibian university students appears relatively low. Voluntary counselling and testing should be stimulated. Efforts should be made to increase access to healthcare through the campus clinics.

  16. Barriers to access prevention of mother-to-child transmission for HIV positive women in a well-resourced setting in Vietnam

    Nguyen, T.A.; Oosterhoff, P.P.J.; Yen, P.N.; Wright, P.; Hardon, A.P.

    2008-01-01

    Background: According to Vietnamese policy, HIV-infected women should have access at least to HIV testing and Nevirapine prophylaxis, or where available, to adequate counselling, HIV infection staging, ARV prophylaxis, and infant formula. Many studies in high HIV prevalence settings have reported

  17. HIV Testing in Recent College Students: Prevalence and Correlates

    Caldeira, Kimberly M.; Singer, Barbara J.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

    2012-01-01

    Prevalence and correlates of HIV testing were examined in a sample of 957 unmarried recent college students in the United States. Participants were asked about HIV testing, past-six-months sexual activities, lifetime treatment for sexually transmitted infections (STI), past-year health service utilization, and DSM-IV criteria for alcohol and other…

  18. Prevalence of psychiatric disorders in HIV patients in the Central ...

    The statistical package for social sciences (SPSS) was used for the analysis. ... and mania) and anxiety disorders (General anxiety, agoraphobia, social phobia, ... Keywords: Prevalence, Psychiatric disorder, HIV infection, Mental challenges ...

  19. Brief communication: Low prevalence of HIV infection, and ...

    Brief communication: Low prevalence of HIV infection, and knowledge, ... History of sexually transmitted diseases was reported by 10.7% of the sexually active students. ... Continued health education is needed to bring behavioral changes.

  20. Decline in the prevalence HIV among pregnant women attending ...

    Decline in the prevalence HIV among pregnant women attending antenatal clinics in Tanzania, 2001-2011. ... Journal Home > Vol 19, No 2 (2017) > ... as age, marital status, parity, education level and duration of stay at present residence.

  1. Prevalence of HIV infection among trauma patients admitted to ...

    Prevalence of HIV infection among trauma patients admitted to Bugando Medical Centre, ... This was a descriptive cross sectional study involving trauma patients aged 11 years and ... A total of 250 trauma patients were recruited and studied.

  2. Determinants and prevalence of late HIV testing in Tijuana, Mexico.

    Carrizosa, Claudia M; Blumberg, Elaine J; Hovell, Melbourne F; Martinez-Donate, Ana P; Garcia-Gonzalez, Gregorio; Lozada, Remedios; Kelley, Norma J; Hofstetter, C Richard; Sipan, Carol L

    2010-05-01

    Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: "I preferred not to know I had HIV" (adjusted odds ratio [AOR] = 2.78, 1.46-5.31); clinic (AOR = 1.90, 1.06-3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02-1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47-0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45-0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.

  3. Trends in socioeconomic inequalities in HIV prevalence among young people in seven countries in eastern and southern Africa.

    Hargreaves, James R; Davey, Calum; Fearon, Elizabeth; Hensen, Bernadette; Krishnaratne, Shari

    2015-01-01

    In Eastern and Southern Africa, HIV prevalence was highest among higher socioeconomic groups during the 1990s. It has been suggested that this is changing, with HIV prevalence falling among higher-educated groups while stable among lower-educated groups. A multi-country analysis has not been undertaken. We analysed data on socio-demographic factors and HIV infection from 14 nationally representative surveys of adults aged 15-24 (seven countries, two surveys each, 4-8 years apart). Sample sizes ranged from 2,408-12,082 (72,135 total). We used logistic regression to assess gender-stratified associations between highest educational level attended and HIV status in each survey, adjusting for age and urban/rural setting. We tested for interactions with urban/rural setting and age. Our primary hypothesis was that higher education became less of a risk factor for HIV over time. We tested for interaction between survey-year and the education-HIV association in each country and all countries pooled. In Ethiopia and Malawi, HIV prevalence was higher in more educated women in both surveys. In Lesotho, Kenya and Zimbabwe, HIV prevalence was lower in higher educated women in both surveys. In Ethiopia, HIV prevalence fell among no and secondary educated women only (interaction pHIV changed over time (p=0·07). Pooled analysis found little evidence for an interaction between survey year and the education-HIV association among men (p=0·60) or women (p=0·37). The pattern of prevalent HIV infection among young adults by level of education in different sub-Saharan African countries was heterogeneous. There was little statistical evidence that this pattern changed between 2003-5 and 2008-12. Explanations for the social epidemiology of HIV in Africa will need to account for time-trends and inter-country differences.

  4. Expanding HIV testing efforts in concentrated epidemic settings: a population-based survey from rural Vietnam.

    Anastasia Pharris

    Full Text Available BACKGROUND: To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. METHODS: A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS. Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. RESULTS: The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01, higher economic status (aOR 3.4, 95% CI 2.21-5.22, and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66 were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. CONCLUSIONS: We found low testing uptake (6% among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider

  5. Expanding HIV testing efforts in concentrated epidemic settings: a population-based survey from rural Vietnam.

    Pharris, Anastasia; Nguyen, Thi Kim Chuc; Tishelman, Carol; Brugha, Ruairí; Nguyen, Phuong Hoa; Thorson, Anna

    2011-01-11

    To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS). Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01), higher economic status (aOR 3.4, 95% CI 2.21-5.22), and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66) were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. We found low testing uptake (6%) among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider-initiated testing of those who believe that they are at-risk of

  6. Testing initiatives increase rates of HIV diagnosis in primary care and community settings: an observational single-centre cohort study.

    Prini Mahendran

    Full Text Available The primary objective was to examine trends in new HIV diagnoses in a UK area of high HIV prevalence between 2000 and 2012 with respect to site of diagnosis and stage of HIV infection.Single-centre observational cohort study.An outpatient HIV department in a secondary care UK hospital.1359 HIV-infected adults.Demographic information (age, gender, ethnicity, and sexual orientation, site of initial HIV diagnosis (Routine settings such as HIV/GUM clinics versus Non-Routine settings such as primary care and community venues, stage of HIV infection, CD4 count and seroconversion symptoms were collated for each participant.There was a significant increase in the proportion of new HIV diagnoses made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001. Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001. Diagnosis of recent infection increased from 23.0% to 47.1% (p=0.001. Of those with recent infection, significantly more patients were likely to report symptoms consistent with a seroconversion illness over the 13 years (17.6% to 65.0%; p<0.001.This is the first study, we believe, to demonstrate significant improvements in HIV diagnosis and a shift in diagnosis of HIV from HIV/GUM settings to primary practice and community settings due to multiple initiatives.

  7. Prevalence of HIV associated neurocognitive deficit among HIV ...

    Background: HIV associated neurocognitive deficit impairs motor activity, neuropsychiatric functioning, daily activity and work activity usually due to the immune suppression effect of the virus. Sub-Saharan region including Ethiopia is the region with the highest burden of HIV. However, a few studies are found on this aspect ...

  8. Sero-prevalence of Human Immunodeficiency Virus (HIV) and ...

    Three hundred and seven (307) healthy blood donors aged 18 – 55 years were used to determine the sero-prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis B virus (HBV) in Yola, Nigeria. The association between donors' age, occupation and marital status and the prevalence of the infections among blood ...

  9. HIV / AIDS prevalence testing - merits, methodology and outcomes ...

    HIV / AIDS prevalence testing - merits, methodology and outcomes of a survey conducted at a large mining organisation in South Africa. ... These baseline prevalence data also provide an opportunity for monitoring of proposed interventions using cross-sectional surveys at designated intervals in the future. South African ...

  10. Typhoid Fever in South Africa in an Endemic HIV Setting.

    Keddy, Karen H; Sooka, Arvinda; Smith, Anthony M; Musekiwa, Alfred; Tau, Nomsa P; Klugman, Keith P; Angulo, Frederick J

    2016-01-01

    Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high. Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.

  11. HIV testing and treatment in the antenatal care setting.

    Coulter-Smith, S

    2010-01-01

    Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.

  12. HIV testing and treatment in the antenatal care setting.

    Coulter-Smith, S

    2012-02-01

    Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.

  13. HIV/AIDS in Russia: determinants of regional prevalence

    Jordaan Jacob A

    2007-06-01

    Full Text Available Abstract Background The motivation for this paper is to inform the selection of future policy directions for tackling HIV/AIDS in Russia. The Russian Federation has more people living with HIV/AIDS than any other country in Europe, and nearly 70% of the known infections in Eastern Europe and Central Asia. The epidemic is particularly young, with 80% of those infected aged less than thirty, and no Russian region has escaped the detection of infections. However, measures to address the epidemic in Russia have been hampered by late recognition of the scale of the problem, poor data on HIV prevalence, potentially counterproductive narcotics legislation, and competing health priorities. An additional complication has been the relative lack of research into the spatial heterogeneity of the Russian HIV/AIDS epidemic, investigating the variety of prevalence rates in the constituent regions and questioning assumptions about the links between the epidemic and the circumstances of post-Soviet transformation. In the light of these recent developments, this paper presents research into the determinants of regional HIV prevalence levels in Russia. Results Statistical empirical research on HIV and other infectious diseases has identified a variety of factors that influence the spread and development of these diseases. In our empirical analysis of determinants of HIV prevalence in Russia at the regional level, we identify factors that are statistically related to the level of HIV prevalence in Russian regions, and obtain some indication of the relative importance of these factors. We estimate an empirical model that includes factors which describe economic and socio-cultural characteristics. Conclusion Our analysis statistically identifies four main factors that influence HIV prevalence in Russian regions. Given the different nature of the factors that we identify to be of importance, we conclude that successful HIV intervention policies will need to be

  14. Prevalência da infecção pelo HIV em pacientes internados por tuberculose Prevalence of HIV infection in patients hospitalized due to tuberculosis

    GUILHERME FREIRE GARCIA

    2000-08-01

    Full Text Available Objetivos: Verificar a prevalência da co-infecção tuberculose (TBC/HIV e a capacidade da anamnese em detectar a infecção pelo HIV em pacientes internados por TBC. Local: Hospital Eduardo de Menezes, Belo Horizonte, MG, referência para TBC e SIDA. Material e métodos: Todos os pacientes internados com TBC na enfermaria de pneumologia foram avaliados prospectivamente no período de 1/1/1997 até 31/1/1998, com anamnese dirigida para fatores de risco para SIDA, TBC, tratamentos anteriores e abandonos de tratamento para TBC, e verificadas as formas clínicas de TBC. Foram excluídos pacientes com doenças marcadoras de SIDA com exceção da TBC, ou com sorologia anti-HIV realizada anteriormente. Foram realizadas sorologias anti-HIV (ELISA e, quando positivas, confirmadas pelo teste Western-Blot. Os testes do qui-quadrado e de Fisher foram usados para análise estatística. Resultados: Sessenta e cinco pacientes avaliados foram divididos em grupo I (sorologia positiva para HIV, n = 6 e grupo II (sorologia negativa para HIV, n = 59. Não houve diferença significativa entre os dois grupos quanto a fatores de risco para SIDA, TBC, abandonos de tratamento ou tratamentos anteriores para TBC ou formas clínicas de TBC. Conclusões: Devido à alta prevalência da infecção pelo HIV (9,2% no grupo estudado, estes achados reforçam as orientações do Consenso Brasileiro de Tuberculose no sentido de: 1 a anamnese não consegue detectar uma parcela significativa dos pacientes com co-infecção TBC/HIV; e: 2 a solicitação de sorologia anti-HIV deve ser feita de forma rotineira em todos os pacientes com TBC ativa.Objectives: To verify the prevalence of tuberculosis (TB/HIV co-infection and the ability of the clinical history to detect the HIV infection in TB inpatients. Setting: Eduardo de Menezes Hospital, reference for both TB and AIDS. Patients and methods: All patients admitted with TB in a pneumology ward were evaluated prospectively from 1

  15. Burkitt's lymphoma: The prevalence of HIV/AIDS and the outcome of treatment

    F Kouya

    2018-02-01

    Full Text Available The prevalence of HIV in Burkitt’s lymphoma (BL patients and the outcome of treatment in Cameroon were unknown. Records of all patients diagnosed with BL at three Cameroon Baptist Convention hospitals were reviewed to ascertain the recorded HIV status and outcome of treatment. Of 979 patients diagnosed with BL, 717 were tested for HIV and 11 (1.5% were HIV-positive. Three of eight patients treated with both cyclophosphamide (CPM-based chemotherapy and antiretrovirals were alive at 62, 96 and 111 months, respectively. The HIV rate was comparable to that of 1% for the general population of children aged <15 years. Low-cost high-frequency CPM was the only available treatment option for BL and was associated with 37.5% long-term survival in a resource-limited setting.

  16. National HIV prevalence estimates for sub-Saharan Africa: controlling selection bias with Heckman-type selection models

    Hogan, Daniel R; Salomon, Joshua A; Canning, David; Hammitt, James K; Zaslavsky, Alan M; Bärnighausen, Till

    2012-01-01

    Objectives Population-based HIV testing surveys have become central to deriving estimates of national HIV prevalence in sub-Saharan Africa. However, limited participation in these surveys can lead to selection bias. We control for selection bias in national HIV prevalence estimates using a novel approach, which unlike conventional imputation can account for selection on unobserved factors. Methods For 12 Demographic and Health Surveys conducted from 2001 to 2009 (N=138 300), we predict HIV status among those missing a valid HIV test with Heckman-type selection models, which allow for correlation between infection status and participation in survey HIV testing. We compare these estimates with conventional ones and introduce a simulation procedure that incorporates regression model parameter uncertainty into confidence intervals. Results Selection model point estimates of national HIV prevalence were greater than unadjusted estimates for 10 of 12 surveys for men and 11 of 12 surveys for women, and were also greater than the majority of estimates obtained from conventional imputation, with significantly higher HIV prevalence estimates for men in Cote d'Ivoire 2005, Mali 2006 and Zambia 2007. Accounting for selective non-participation yielded 95% confidence intervals around HIV prevalence estimates that are wider than those obtained with conventional imputation by an average factor of 4.5. Conclusions Our analysis indicates that national HIV prevalence estimates for many countries in sub-Saharan African are more uncertain than previously thought, and may be underestimated in several cases, underscoring the need for increasing participation in HIV surveys. Heckman-type selection models should be included in the set of tools used for routine estimation of HIV prevalence. PMID:23172342

  17. [Prevalence of HIV treatment in PHI].

    Wild, F; Finkenstädt, V

    2013-12-01

    The importance of HIV in PHI is examined on the basis of the "AIDS statistics" of the Association of PHI and pharmaceutical data from PHI. The observation period is from 2007 to 2011. We define a HIV case if a private insured person has submitted at least one HIV-related invoice (e.g., an antiretroviral drug) for reimbursement during the observation period. In 2011, 7,624 people in PHI received HIV therapy, that is 32% (+1888) more than in 2007. The number of new HIV cases in 2011 was 673, and thus 12% (-92) lower than in 2007. The proportion of people receiving antiretroviral therapy in PHI is higher than in the general population in Germany. HIV infections occur in all age groups, but peaks in the age group 41 to 50 years old. Men are affected more than women. In contrast, the number of HIV cases among 11- to 15-year-old girls is higher compared to boys of the same age.

  18. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia

    Weissman, Amy; Ngak, Song; Srean, Chhim; Sansothy, Neth; Mills, Stephen; Ferradini, Laurent

    2016-01-01

    Introduction Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia. Methods Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ?18 years, identi...

  19. Association of HIV prevalence and concurrency of sexual ...

    2013-03-03

    Mar 3, 2013 ... ... groups, increasing circumcision rates were correlated with lower HIV prevalence rates (R2=0.48; p=0.04). Table 1. P re v alence of HIV. [2] and v arious risk factors. [3] p er language group among S outh A fricans aged 16 - 55 years. L angu age. SABSSM III. [2]. N. CS 2009. [3]. N. Age median (IQ. R).

  20. Prevalence of Anaemia Among Human Immunodeficiency Virus (HIV)

    Background: Anaemia is the most commonly encountered haematological abnormality in human immunodeficiency virus (HIV) positive patients with estimates climbing as high as 95% depending on clinical settings. The twin effects of HIV infection and anaemia in pregnancy is associated with adverse maternal and ...

  1. Prevalence of HIV Infection Among Tuberculosis Patients in Bali, Indonesia

    Partha Muliawan

    2016-01-01

    Full Text Available Background: During 1998-2007, TB and HIV cases in Bali had shown a significant increase respectively. In general, both of these diseases are chronic diseases that need long term treatment, and together they could worsen the patients’ condition. To prevent the double burden of those patients, we need to know HIV infection prevalence among TB cases in Bali. Method: One thousands of TB cases diagnosed at TB health services unit (UPK at primary health centers (puskesmas and public hospitals in Bali, in September-November 2008, were given information and their blood samples were taken for HIV tests. Samples were chosen proportionally according to the number of TB cases registered in each UPK. Five milliliters of blood sample were taken from each eligible patient by laboratory staff or nurse at the UPK for HIV tests which were conducted at Bali Health Laboratory. HIV test used in this study were the two types of rapid test in accordance with WHO standard. Discussion: Thirty-nine out of 1,000 blood samples were found HIV positive. The highest HIV prevalence among TB cases was in the Buleleng District (11.5% and followed by Denpasar City (5.1%. This prevalence showed a different figure from the HIV/AIDS cases in VCT clinics registered at Bali Provincial Health Agency, where the highest prevalence found in Denpasar, followed by Buleleng and Badung. If we compare, the difference in figure between Badung and Buleleng, might be due to the difference in routes of HIV transmission. In Buleleng, most of the cases (90% were sexually transmitted, while in Badung 48% transmission were through injecting drug users. The IDUs seek health services at private health centers and rarely utilize public/government services such as puskesmas and hospitals. Conclusion: The HIV prevalence among TB patients in Bali was 3.9%. The characteristics of the patients showed that they are mostly male, aged between 31-40 years old, have junior high school-university education

  2. A network-level explanation for the differences in HIV prevalence in ...

    A network-level explanation for the differences in HIV prevalence in South Africa's ... or ethnic groups may help explain the differential spread of HIV in South Africa. ... Keywords: concurrency, epidemiology, ethnicity, HIV/AIDS, race, social ...

  3. Interaction between HIV awareness, knowledge, safe sex practice and HIV prevalence: evidence from Botswana.

    Ray, Ranjan; Sinha, Kompal

    2012-05-01

    This paper makes methodological and empirical contributions to the study of HIV in the context of Botswana, a country with high HIV prevalence. Comparable evidence is presented from India to put the Botswana results in perspective. The results point to the strong role played by affluence and education in increasing HIV knowledge, promoting safe sex and reducing HIV prevalence. The study presents African evidence on the role played by the empowerment of women in promoting safe sex practices such as condom use. The lack of significant association between HIV prevalence and safe sex practice points to the danger of HIV-infected individuals spreading the disease through multiple sex partners and unprotected sex. This danger is underlined by the finding that females with multiple sex partners are at higher risk of being infected with HIV. These results take on special policy significance in the context of Botswana, where the issue of multiple sex partners has not been adequately addressed in the programme to contain the spread of HIV.

  4. Prevalence and patterns of HIV transmitted drug resistance in Guatemala.

    Avila-Ríos, Santiago; Mejía-Villatoro, Carlos R; García-Morales, Claudia; Soto-Nava, Maribel; Escobar, Ingrid; Mendizabal, Ricardo; Girón, Amalia; García, Leticia; Reyes-Terán, Gustavo

    2011-12-01

    To assess human immunodeficiency virus (HIV) diversity and the prevalence of transmitted drug resistance (TDR) in Guatemala. One hundred forty-five antiretroviral treatment-naïve patients referred to the Roosevelt Hospital in Guatemala City were enrolled from October 2010 to March 2011. Plasma HIV pol sequences were obtained and TDR was assessed with the Stanford algorithm and the World Health Organization (WHO) TDR surveillance mutation list. HIV subtype B was highly prevalent in Guatemala (96.6%, 140/145), and a 2.8% (4/145) prevalence of BF1 recombinants and 0.7% (1/145) prevalence of subtype C viruses were found. TDR prevalence for the study period was 8.3% (12/145) with the Stanford database algorithm (score > 15) and the WHO TDR surveillance mutation list. Most TDR cases were associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) (83.3%, 10/12); a low prevalence of nucleoside reverse transcriptase inhibitors and protease inhibitors was observed in the cohort (Guatemala. TDR prevalence in Guatemala was at the intermediate level. Most TDR cases were associated with NNRTIs. Further and continuous TDR surveillance is necessary to gain more indepth knowledge about TDR spread and trends in Guatemala and to optimize treatment outcomes in the country.

  5. Prevalence of HIV associated neurocognitive deficit among HIV ...

    International HIV dementia scale, activity of daily living scale and Hospital Anxiety and Depression scale were used to assess neuro cognitive deficit, activity of daily living, anxiety and depression respectively. The data was analyzed by using SPSS window 20. Result: About 88% of the subjects were receiving highly active ...

  6. Pancreatitis in a high HIV prevalence environment

    In environments with low HIV infection rates, acute pancreatitis is ... The serum amylase level was used to confirm acute pancreatitis in 50 patients, with a ..... Mortier E, Gaba S, Mari I, Vinceneux P, Pouchot J. Acute pancreatitis during primary ...

  7. Psychiatric disorders, HIV infection and HIV/hepatitis co-infection in the correctional setting.

    Baillargeon, J G; Paar, D P; Wu, H; Giordano, T P; Murray, O; Raimer, B G; Avery, E N; Diamond, P M; Pulvino, J S

    2008-01-01

    Psychiatric disorders such as bipolar disorder, schizophrenia and depression have long been associated with risk behaviors for HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV). The US prison population is reported to have elevated rates of HIV, hepatitis and most psychiatric disorders. This study examined the association of six major psychiatric disorders with HIV mono-infection, HIV/HCV co-infection and HIV/HBV co-infection in one of the nation's largest prison populations. The study population consisted of 370,511 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 2003 and July 1, 2006. Information on medical conditions and sociodemographic factors was obtained from an institution-wide electronic medical information system. Offenders diagnosed with HIV mono-infection, HIV/HCV, HIV/HBV and all HIV combined exhibited elevated rates of major depression, bipolar disorder, schizophrenia, schizoaffective disorder, non-schizophrenic psychotic disorder and any psychiatric disorder. In comparison to offenders with HIV mono-infection, those with HIV/HCV co-infection had an elevated prevalence of any psychiatric disorder. This cross-sectional study's finding of positive associations between psychiatric disease and both HIV infection and hepatitis co-infection among Texas prison inmates holds both clinical and public health relevance. It will be important for future investigations to examine the extent to which psychiatric disorders serve as a barrier to medical care, communication with clinicians and adherence to prescribed medical regimens among both HIV-mono-infected and HIV/hepatitis-co-infected inmates.

  8. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates

    Thanh, D. H.; Sy, D. N.; Linh, N. D.; Hoan, T. M.; Dien, H. T.; Thuy, T. B.; Hoa, N. P.; Tung, L. B.; Cobelens, F.

    2010-01-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of

  9. Prevalence and determinants of HIV infection among maritime ...

    The close proximity of brothels and large sex-worker populations, as well as the fact that many seafarers are young, ... Methods: The study utilized a descriptive cross-sectional design. ... Prevalence of HIV in the studied population was 4.8%.

  10. 7 PREVALENCE OF Rh AND ABO BLOOD GROUPS IN HIV ...

    Bioline

    Summary: HIV status and blood groups determination (Rhesus and ABO groups) in 3691 pregnant ... quick test kits and tested for blood group types with anti-sera A,B,AB, and D. Overall, the prevalence of blood group .... Theory,Techniques,.

  11. Prevalence of cryptococcosis among HIV-infected patients in ...

    Objective: To investigate the prevalence of cryptococcosis among HIV infected patients in Yaounde. Methods: In a hospital-based surveillance study of cryptococcosis, the colonization of Cerebrospinal Fluid (CSF), urine and blood sample by C. neoformans was evaluated by direct microscopic examination and culture ...

  12. Pregnancy wastage among HIV infected women in a high HIV prevalence district of India.

    Halli, Shiva S; Khan, C G Hussain; Shah, Iqbal; Washington, Reynold; Isac, Shajy; Moses, Stephen; Blanchard, James F

    2015-07-02

    Bagalkot district in Karnataka state is one of the highest HIV prevalence districts in India. A large proportion of the girls also marry at early age in the district and negative pregnancy outcomes among the HIV positive women likely to have large pregnancy wastages. Therefore, this study examined the pregnancy wastages and the associated factors among HIV positive women in a high prevalent district in India. We used data from a cross-sectional survey conducted recently among randomly selected currently married HIV positive women, 15-29 years of age, in one of the high HIV prevalence districts in India. The study used the experience of reported pregnancy wastage as an outcome variable, and both bi-variate and multivariate logistic regression analyses were carried out to understand the factors associated with the pregnancy wastage among HIV infected women. Overall, 17% of the respondents reported pregnancy wastage, of which 81% were due to spontaneous abortions. Respondents who became pregnant since testing HIV positive reported significantly higher level of pregnancy wastage as compared to those were pregnant before they were tested for HIV. (AOR = 1.9; p = 0.00). While a positive association between duration of marriage and pregnancy wastage was noticed (AOR = 7.4; p = 0.01), there was a negative association between number of living children and pregnancy wastage (AOR = 0.24; p = 0.00). Living in a joint family was associated with increased reporting of pregnancy wastage as compared to those living in nuclear families (AOR = 1.7; p = 0.03). HIV prevention and care programs need to consider the reproductive health needs of HIV infected married women as a priority area since large proportion of these women reported negative pregnancy outcomes. There is also a need to explore ways to raise the age at marriage in order to stop women getting married before the legal age at marriage.

  13. Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis

    Prudden, Holly J.; Beattie, Tara S.; Bobrova, Natalia; Panovska-Griffiths, Jasmina; Mukandavire, Zindoga; Gorgens, Marelize; Wilson, David; Watts, Charlotte H.

    2015-01-01

    Background Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this. Methods National, urban and rural data on HIV prevalence, the percentage of younger (15–24) and older (25–49) women and men reporting multiple (2+) partners in the past year, HIV prevalence among female sex workers (FSWs), men who have bought sex in the past year (clients), and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other. Findings National population HIV prevalence varies between 0 4–2 9% for men and 0 4–5.6% for women. ART coverage ranges from 6–23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence. Interpretation In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners. PMID:26698854

  14. Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis.

    Holly J Prudden

    Full Text Available Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this.National, urban and rural data on HIV prevalence, the percentage of younger (15-24 and older (25-49 women and men reporting multiple (2+ partners in the past year, HIV prevalence among female sex workers (FSWs, men who have bought sex in the past year (clients, and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other.National population HIV prevalence varies between 0 4-2 9% for men and 0 4-5.6% for women. ART coverage ranges from 6-23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence.In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners.

  15. Correlates of Prevalent Disability Among HIV-Infected Elderly Patients.

    Ávila-Funes, José Alberto; Belaunzarán-Zamudio, Pablo Francisco; Tamez-Rivera, Oscar; Crabtree-Ramírez, Brenda; Navarrete-Reyes, Ana Patricia; Cuellar-Rodríguez, Jennifer; Sierra-Madero, Juan; Amieva, Hélène

    2016-02-01

    The growing elderly population of HIV-infected patients is leading to a significant epidemiological transition and HIV infection has been proposed as a premature and accelerated aging model rending the individual more susceptible to premature disability. However, the determinants of disability among this emergent population are still lacking. Therefore, the aim of this study is to determine the correlates of prevalent disability in adults ≥50 years with HIV infection. A cross-sectional study of 184 HIV-infected adults receiving ambulatory care in an HIV clinic of a tertiary care, university-affiliated hospital in Mexico City was conducted. Disability for instrumental (IADL) and basic activities of daily living (ADL) was established. Sociodemographic factors, clinical variables, current CD4(+) cell count, and HIV viral load (VL) were tested as potential determinants of disability. Multivariate logistic regression analyses were used to identify the correlates of both types of disability. The mean age was 59.3 years. All participants were receiving highly active antiretroviral therapy. Of participants 17.9% had disability for IADL and 26.1% for ADL. Multivariate logistic regression analyses indicated that being older; having a lower CD4(+) cell count, and having a detectable HIV VL were independently associated with both types of disability. In addition, educational level was also independently associated with ADL disability. Age, educational level, low CD4(+) cell count, and detectable HIV VL were independently associated with disability. Whether effective and timely antiretroviral therapy will reduce the risk of disability in HIV-infected elderly patients needs to be evaluated.

  16. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates.

    Thanh, D H; Sy, D N; Linh, N D; Hoan, T M; Dien, H T; Thuy, T B; Hoa, N P; Tung, L B; Cobelens, F

    2010-08-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of HIV infection among smear-positive TB patients in six provinces with relatively high HIV population prevalence in Vietnam. All patients who registered for treatment of smear-positive TB during the fourth quarter of 2005 were offered HIV testing. Of the 1217 TB patients included in the study, 100 (8.2%) tested HIV-positive. HIV prevalence varied between 2% and 17% in the provinces, and was strongly associated with age Vietnam, HIV infection is concentrated in drug users, as well as in specific geographic areas where it has considerable impact on TB notification rates among men aged 15-34 years.

  17. Prevalence of Trypanosoma cruzi/HIV coinfection in southern Brazil

    Dulce Stauffert

    2017-03-01

    Full Text Available Chagas disease reactivation has been a defining condition for acquired immune deficiency syndrome in Brazil for individuals coinfected with Trypanosoma cruzi and HIV since 2004. Although the first coinfection case was reported in the 1980s, its prevalence has not been firmly established. In order to know coinfection prevalence, a cross-sectional study of 200 HIV patients was performed between January and July 2013 in the city of Pelotas, in southern Rio Grande do Sul, an endemic area for Chagas disease. Ten subjects were found positive for T. cruzi infection by chemiluminescence microparticle immunoassay and indirect immunofluorescence. The survey showed 5% coinfection prevalence among HIV patients (95% CI: 2.0–8.0, which was 3.8 times as high as that estimated by the Ministry of Health of Brazil. Six individuals had a viral load higher than 100,000 copies per μL, a statistically significant difference for T. cruzi presence. These findings highlight the importance of screening HIV patients from Chagas disease endemic areas.

  18. Factors associated with HIV among female sex workers in a high HIV prevalent state of India.

    Medhi, Gajendra Kumar; Mahanta, Jagadish; Paranjape, Ramesh S; Adhikary, Rajatashuvra; Laskar, Nabjyoti; Ngully, P

    2012-01-01

    The study was carried out to assess the factors associated with HIV seropositivity among female sex workers (FSWs) in Dimapur, Nagaland, a high HIV prevalence state of India. A total of 426 FSWs were recruited into the study using respondent driven sampling (RDS). Data on demographic characteristics, sexual and injecting risk behaviours were collected from them and were tested for HIV, Syphilis, Neisseria gonorrhoeae and Chlamydia trachomatis. RDS-weighted univariate and multivariate logistic regression analysis was performed to assess the factors associated with HIV seropositivity. Consistent condom use with regular and occasional sexual clients was 9% and 16.4%, respectively. About 25% of the participants ever used and 5.7% ever injected illicit drugs. RDS adjusted HIV prevalence was 11.6%. In the univariate analysis, factors associated with HIV were initiating sexual intercourse before the age of 15 years, ≥2 years duration of sex work, serving clients at lodge/hotel, positive test result for one or more sexually transmitted infections (STIs), lifetime history of injecting drug use, lifetime history of consuming illicit drugs, ever having exchanged sex for drugs, having sexual partners who engaged in risky injecting practices and having been widowed or divorced. In multivariate analysis, factors found to be independently associated with HIV included lifetime injecting drug use, initiating sexual intercourse before the age of 15 years, positive test result for one or more STIs and having been widowed. Injecting drug use was found to be most potent independent risk factor for HIV (OR: 3.17, CI: 1.02-9.89). Because of lower consistent condom use among them, FSWs may act as bridge for HIV transmission to general population from injecting drug users (IDU) through their sexual clients. The informations from this study may be useful for enriching the HIV preventions effort for FSWs in this region.

  19. The association of neoplasms and HIV infection in the correctional setting.

    Baillargeon, Jacques; Pollock, Brad H; Leach, Charles T; Gao, Shou-Jiang

    2004-05-01

    HIV-associated immunosuppression has been linked to an increased risk of a number of cancers, including Kaposi sarcoma (KS), non-Hodgkin's lymphoma (NHL), and invasive cervical cancer. Because prison inmates constitute one of the highest HIV/AIDS prevalent populations in the US, understanding the link between HIV infection and cancer in the correctional setting holds particular public health relevance. The study population consisted of 336,668 Texas Department of Criminal Justice inmates who were incarcerated, for any duration, between 1 January 1999 and 31 December 2001. Inmates diagnosed with HIV infection exhibited elevated rates of KS, NHL, anal cancer, and Hodgkin's disease, after adjusting for age and race. The elevated rates of cancer among HIV-infected individuals, particularly prison inmates, may be mediated, in part, by high-risk behaviours. HIV-associated risk behaviours, including unsafe sexual practices, injection drug use, and prostitution may be associated with cancer-related risk behaviours, such as smoking, excessive alcohol consumption, and poor diet. It will be important for future investigators to examine the association between HIV infection and cancer risk with sufficiently large study cohorts and appropriate longitudinal designs.

  20. Prevalence of sexually transmitted infections among pregnant women with known HIV status in northern Tanzania

    Mbizvo Elizabeth M

    2009-02-01

    Full Text Available Abstract Objectives To determine the prevalence of sexually transmitted infections (STIs and other reproductive tract infections (RTIs among pregnant women in Moshi, Tanzania and to compare the occurrence of STIs/RTIs among human immunodeficiency virus (HIV-infected and uninfected women. Methods Pregnant women in their 3rd trimester (N = 2654 were recruited from two primary health care clinics between June 2002 and March 2004. They were interviewed, examined and genital and blood samples were collected for diagnosis of STIs/RTIs and HIV. Results The prevalence of HIV, active syphilis and herpes simplex virus – type 2 (HSV-2 were 6.9%, 0.9% and 33.6%, respectively, while 0.5% were positive for N gonorrhoeae, 5.0% for T vaginalis and 20.9% for bacterial vaginosis. Genital tract infections were more prevalent in HIV-seropositive than seronegative women, statistically significant for syphilis (3.3% vs 0.7%, HSV-2 (43.2% vs 32.0%, genital ulcers (4.4% vs 1.4% and bacterial vaginosis (37.2% vs 19.6%. In comparison with published data, a declining trend for curable STIs/RTIs (syphilis, trichomoniasis and bacterial vaginosis was noted. Conclusion Rates of STIs and RTIs are still high among pregnant women in Moshi. Where resources allow, routine screening and treatment of STIs/RTIs in the antenatal care setting should be offered. Higher STIs/RTIs in HIV-seropositive women supports the expansion of HIV-counseling and testing services to all centers offering antenatal care. After identification, STIs/RTIs need to be aggressively addressed in HIV-seropositive women, both at antenatal and antiretroviral therapy care clinics.

  1. HIV and STI prevalence and determinants among male migrant workers in India.

    Sangeeta S Dave

    Full Text Available Our objective was to estimate for the first time the prevalence and determinants of human immunodeficiency virus type 1 (HIV-1 and sexually transmitted infections (STIs among male migrants in India.We conducted a multi-stage stratified probability sample survey of migrant (defined as not born in Surat city men aged 18 to 49 years working in the diamond and textile industries in Surat city. Behavioural and biological data were collected. Biological data included laboratory diagnosed herpes simplex virus type 2 (HSV-2, syphilis, chlamydia, gonorrhoea, Trichomonas vaginalis (together defined as 'any STI' and HIV-1. Likely recently acquired STIs included chlamydia, gonorrhoea, T. vaginalis and syphilis with rapid plasma reagin ≥1:8. The response rate was 77% (845/1099. Among 841 participants, HIV-1 prevalence was 1.0%, 'any STI' prevalence was 9.5% and 38.9% of these STIs were likely to have been recently acquired. Being a diamond worker, Surat resident for 10+ years and recent antibiotic use were each associated with higher odds of 'any STI' (aORs 1.83 (95% CI 1.09-3.09, 1.98 (95% CI 1.22-3.22 and 2.57 (95% CI 1 .17-5.64, respectively after adjusting for the other two factors and age. The main study limitation was social desirability bias for self-reported sexual behaviour; STIs were diagnosed in some self-reported virgins.HIV and STI prevalence were lower than expected, but prevention interventions remain necessary in Surat since almost 40% of STIs among participants were probably recently acquired and sentinel surveillance HIV prevalence remains high. The participants had a similar HIV prevalence to Surat antenatal clinic attendees, a proxy for the general population. This suggests migrants are not always at higher risk of HIV compared to the general population in their migration destination. Our findings highlight the need to contextualise research findings from a specific setting with other local information to guide HIV/STI prevention

  2. No evidence of association between HIV-1 and malaria in populations with low HIV-1 prevalence.

    Diego F Cuadros

    Full Text Available The geographic overlap between HIV-1 and malaria has generated much interest in their potential interactions. A variety of studies have evidenced a complex HIV-malaria interaction within individuals and populations that may have dramatic effects, but the causes and implications of this co-infection at the population level are still unclear. In a previous publication, we showed that the prevalence of malaria caused by the parasite Plasmodium falciparum is associated with HIV infection in eastern sub-Saharan Africa. To complement our knowledge of the HIV-malaria co-infection, the objective of this work was to assess the relationship between malaria and HIV prevalence in the western region of sub-Saharan Africa.Population-based cross-sectional data were obtained from the HIV/AIDS Demographic and Health Surveys conducted in Burkina Faso, Ghana, Guinea, Mali, Liberia and Cameroon, and the malaria atlas project. Using generalized linear mixed models, we assessed the relationship between HIV-1 and Plasmodium falciparum parasite rate (PfPR adjusting for important socio-economic and biological cofactors. We found no evidence that individuals living in areas with stable malaria transmission (PfPR>0.46 have higher odds of being HIV-positive than individuals who live in areas with PfPR≤0.46 in western sub-Saharan Africa (estimated odds ratio 1.14, 95% confidence interval 0.86-1.50. In contrast, the results suggested that PfPR was associated with being infected with HIV in Cameroon (estimated odds ratio 1.56, 95% confidence interval 1.23-2.00.Contrary to our previous research on eastern sub-Saharan Africa, this study did not identify an association between PfPR and infection with HIV in western sub-Saharan Africa, which suggests that malaria might not play an important role in the spread of HIV in populations where the HIV prevalence is low. Our work highlights the importance of understanding the epidemiologic effect of co-infection and the relevant

  3. HIV risks and HIV prevention among female sex workers in two largest urban settings in Croatia, 2008-2014.

    Štulhofer, Aleksandar; Landripet, Ivan; Božić, Jasmina; Božičević, Ivana

    2015-01-01

    Harm reduction-based HIV prevention has been in place among female sex workers (FSWs) in Croatia for more than a decade. However, little is known about how well the existing programs meet the needs of FSWs in an environment where sex work remains criminalized and highly stigmatized. This study aims to assess changes in FSWs' vulnerability to HIV infection in the 2008-2014 period. Using convenience samples of FSWs in Croatia's two largest urban settings, behavioral data were collected in 2007-2008 and 2014. Outreach workers interviewed 154 FSWs in the first wave of the survey and 158 in the second. The period under observation was characterized by a stable prevalence of most HIV-relevant risk behaviors and experiences. Significant changes in client-based victimization and HIV knowledge were observed only among FSWs in the capital city. Substantial and mostly sustained levels of sexual and nonsexual victimization call for more research into the limits of the current behavior-based harm reduction approach to HIV prevention in the country.

  4. Prevalence of communication disorders in HIV-infected adults.

    Kallail, K James; Downs, David; Scherz, Julie; Sweet, Donna; Zackula, Rosalee E

    2014-01-01

    Few adult patients with HIV/AIDS are evaluated for communication disorders. A broad inventory of the communication disorders was obtained in a convenience sample of 82 adult HIV/AIDS patients who presented for medical appointments. Each participant underwent a head and neck exam and a communications skills evaluation. Speech, language, and cognition were assessed using a 10-item test battery. A 14-item hearing test battery was conducted in a separate session. The primary outcomes were the presence and degree of communication disorders. Head and neck exams revealed 40% with ear-related issues. Only 2 participants showed normal findings on all 24 communication skills assessments. Four demonstrated normal findings on all speech-language-cognitive assessments, whereas 8 had normal findings on the complete hearing test battery. A relatively high prevalence of cognitive and language deficits and central auditory disturbances were found. Clinicians must recognize the potential for communication deficits even in a relatively healthy patient with HIV.

  5. HIV and Pregnancy in Resource-Poor Settings

    Tang, Jennifer; Nour, Nawal M

    2010-01-01

    There are 33.4 million people living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome. Globally, HIV/AIDS is the leading cause of death among women of reproductive age. In the United States and other developed countries, aggressive efforts to treat HIV-positive pregnant women with highly active antiretroviral therapy have decreased the maternal-to-child transmission (MTCT) from over 20% to less than 2%. However, in resource-poor settings, access to antiretroviral therapy (ART) is not readily available, and perinatal transmission rates remain as high as 45%. Women are at greater risk of heterosexual transmission of HIV, which is compounded by lack of condom use, imbalance of social power, and the high fertility rate. Prevention programs are needed to empower and educate women and engender community awareness for condom use. Prenatal screening and treatment, intrapartum ART, and postpartum prophylaxis must be made available to all women and children to prevent MTCT. PMID:20842284

  6. Headache among patients with HIV disease: prevalence, characteristics, and associations.

    Kirkland, Kale E; Kirkland, Karl; Many, W J; Smitherman, Todd A

    2012-03-01

    Headache is one of the most common medical complaints reported by individuals suffering from human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), but limited and conflicting data exist regarding their prevalence, prototypical characteristics, and relationship to HIV disease variables in the current era of highly active antiretroviral therapy (HAART). The aims of the present cross-sectional study were to characterize headache symptoms among patients with HIV/AIDS and to assess relations between headache and HIV/AIDS disease variables. Two hundred HIV/AIDS patients (49% female; mean age = 43.22 ± 12.30 years; 74% African American) from an internal medicine clinic and an AIDS outreach clinic were administered a structured headache diagnostic interview to assess headache characteristics and features consistent with International Classification of Headache Disorders (ICHD)-II diagnostic semiologies. They also completed 2 measures of headache-related disability. Prescribed medications, most recent cluster of differentiation (CD4) cell count, date of HIV diagnosis, possible causes of secondary headache, and other relevant medical history were obtained via review of patient medical records. One hundred seven patients (53.5%) reported headache symptoms, the large majority of which were consistent with characteristics of primary headache disorders after excluding 4 cases attributable to secondary causes. Among those who met criteria for a primary headache disorder, 88 (85.44%) met criteria for migraine, most of which fulfilled ICHD-II appendix diagnostic criteria for chronic migraine. Fifteen patients (14.56%) met criteria for episodic or chronic tension-type headache. Severity of HIV (as indicated by CD4 cell counts), but not duration of HIV or number of prescribed antiretroviral medications, was strongly associated with headache severity, frequency, and disability and also distinguished migraine from TTH. Problematic headache is highly prevalent

  7. Low prevalence of primary HIV resistance in western Massachusetts.

    Iarikov, Dmitri E; Irizarry-Acosta, Melina; Martorell, Claudia; Hoffman, Robert P; Skiest, Daniel J

    2010-01-01

    Most studies of primary antiretroviral (ARV) resistance have been conducted in large metropolitan areas with reported rates of 8% to 25%. We collected data on 99 HIV-1-infected antiretroviral-naive patients from several sites in Springfield, MA, who underwent genotypic resistance assay between 2004 and 2008. Only major resistance mutations per International AIDS Society-USA (IAS-USA) drug resistance mutations list were considered. The prevalence of resistance was 5% (5 of 99). Three patients had one nonnucleoside reverse transcriptase inhibitor (NNRTI) mutation: 103N, 103N, and 190A, 1 patient had a protease inhibitor (PI) mutation: 90M; and 1 patient had 3-class resistance with NNRTI: 181C, 190A, PI: 90M, and nucleoside analogue reverse transcriptase inhibitor (NRTI): 41L, 210W. Mean time from HIV diagnosis to resistance testing was shorter in patients with resistance versus those without: 9 (range 0.3-42 months) versus 27 (range 0.1-418 months), P = .11. There was a trend to lower mean CD4 count in those with resistance, 170 versus 318 cells/mm(3), P = .06. No differences were noted in gender, age, HIV risk category, or HIV RNA level. The low prevalence of primary resistance may be explained by differences in demographic and risk factors or may reflect the time from infection to resistance testing. Our findings emphasize the importance of continued resistance surveillance.

  8. HIV-1 molecular epidemiology among newly diagnosed HIV-1 individuals in Hebei, a low HIV prevalence province in China.

    Xinli Lu

    Full Text Available New human immunodeficiency virus type 1 (HIV-1 diagnoses are increasing rapidly in Hebei. The aim of this study presents the most extensive HIV-1 molecular epidemiology investigation in Hebei province in China thus far. We have carried out the most extensive systematic cross-sectional study based on newly diagnosed HIV-1 positive individuals in 2013, and characterized the molecular epidemiology of HIV-1 based on full length gag-partial pol gene sequences in the whole of Hebei. Nine HIV-1 genotypes based on full length gag-partial pol gene sequence were identified among 610 newly diagnosed naïve individuals. The four main genotypes were circulating recombinant form (CRF01_AE (53.4%, CRF07_BC (23.4%, subtype B (15.9%, and unique recombinant forms URFs (4.9%. Within 1 year, three new genotypes (subtype A1, CRF55_01B, CRF65_cpx, unknown before in Hebei, were first found among men who have sex with men (MSM. All nine genotypes were identified in the sexually contracted HIV-1 population. Among 30 URFs, six recombinant patterns were revealed, including CRF01_AE/BC (40.0%, CRF01_AE/B (23.3%, B/C (16.7%, CRF01_AE/C (13.3%, CRF01_AE/B/A2 (3.3% and CRF01_AE/BC/A2 (3.3%, plus two potential CRFs. This study elucidated the complicated characteristics of HIV-1 molecular epidemiology in a low HIV-1 prevalence northern province of China and revealed the high level of HIV-1 genetic diversity. All nine HIV-1 genotypes circulating in Hebei have spread out of their initial risk groups into the general population through sexual contact, especially through MSM. This highlights the urgency of HIV prevention and control in China.

  9. HIV-1 molecular epidemiology among newly diagnosed HIV-1 individuals in Hebei, a low HIV prevalence province in China.

    Lu, Xinli; Kang, Xianjiang; Liu, Yongjian; Cui, Ze; Guo, Wei; Zhao, Cuiying; Li, Yan; Chen, Suliang; Li, Jingyun; Zhang, Yuqi; Zhao, Hongru

    2017-01-01

    New human immunodeficiency virus type 1 (HIV-1) diagnoses are increasing rapidly in Hebei. The aim of this study presents the most extensive HIV-1 molecular epidemiology investigation in Hebei province in China thus far. We have carried out the most extensive systematic cross-sectional study based on newly diagnosed HIV-1 positive individuals in 2013, and characterized the molecular epidemiology of HIV-1 based on full length gag-partial pol gene sequences in the whole of Hebei. Nine HIV-1 genotypes based on full length gag-partial pol gene sequence were identified among 610 newly diagnosed naïve individuals. The four main genotypes were circulating recombinant form (CRF)01_AE (53.4%), CRF07_BC (23.4%), subtype B (15.9%), and unique recombinant forms URFs (4.9%). Within 1 year, three new genotypes (subtype A1, CRF55_01B, CRF65_cpx), unknown before in Hebei, were first found among men who have sex with men (MSM). All nine genotypes were identified in the sexually contracted HIV-1 population. Among 30 URFs, six recombinant patterns were revealed, including CRF01_AE/BC (40.0%), CRF01_AE/B (23.3%), B/C (16.7%), CRF01_AE/C (13.3%), CRF01_AE/B/A2 (3.3%) and CRF01_AE/BC/A2 (3.3%), plus two potential CRFs. This study elucidated the complicated characteristics of HIV-1 molecular epidemiology in a low HIV-1 prevalence northern province of China and revealed the high level of HIV-1 genetic diversity. All nine HIV-1 genotypes circulating in Hebei have spread out of their initial risk groups into the general population through sexual contact, especially through MSM. This highlights the urgency of HIV prevention and control in China.

  10. Trends in socioeconomic inequalities in HIV prevalence among young people in seven countries in eastern and southern Africa.

    James R Hargreaves

    Full Text Available In Eastern and Southern Africa, HIV prevalence was highest among higher socioeconomic groups during the 1990s. It has been suggested that this is changing, with HIV prevalence falling among higher-educated groups while stable among lower-educated groups. A multi-country analysis has not been undertaken.We analysed data on socio-demographic factors and HIV infection from 14 nationally representative surveys of adults aged 15-24 (seven countries, two surveys each, 4-8 years apart. Sample sizes ranged from 2,408-12,082 (72,135 total. We used logistic regression to assess gender-stratified associations between highest educational level attended and HIV status in each survey, adjusting for age and urban/rural setting. We tested for interactions with urban/rural setting and age. Our primary hypothesis was that higher education became less of a risk factor for HIV over time. We tested for interaction between survey-year and the education-HIV association in each country and all countries pooled.In Ethiopia and Malawi, HIV prevalence was higher in more educated women in both surveys. In Lesotho, Kenya and Zimbabwe, HIV prevalence was lower in higher educated women in both surveys. In Ethiopia, HIV prevalence fell among no and secondary educated women only (interaction p<0·01. Only among young men in Tanzania there was some evidence that the association between education and HIV changed over time (p=0·07. Pooled analysis found little evidence for an interaction between survey year and the education-HIV association among men (p=0·60 or women (p=0·37.The pattern of prevalent HIV infection among young adults by level of education in different sub-Saharan African countries was heterogeneous. There was little statistical evidence that this pattern changed between 2003-5 and 2008-12. Explanations for the social epidemiology of HIV in Africa will need to account for time-trends and inter-country differences.

  11. Ecological association between HIV and concurrency point-prevalence in South Africa's ethnic groups.

    Kenyon, Chris

    2013-11-01

    HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the spread of HIV. Few studies have, however, investigated if differential concurrency rates could explain differential HIV spread within ethnic groups in South Africa. This ecological analysis, explores how much of the variation in HIV prevalence by ethnic group is explained by differential concurrency rates. Using a nationally representative survey (the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005) the HIV prevalence in each of eight major ethnic groups was calculated. Linear regression analysis was used to assess the association between an ethnic group's HIV prevalence and the point-prevalence of concurrency. Results showed that HIV prevalence rates varied considerably between South Africa's ethnic groups. This applied to both different racial groups and to different ethnic groups within the black group. The point-prevalence of concurrency by ethnic group was strongly associated with HIV prevalence (R(2) = 0.83; p = 0.001). Tackling the key drivers of high HIV transmission in this population may benefit from more emphasis on partner reduction interventions.

  12. Prevalence and associated factors of TB/HIV co-infection among HIV ...

    Abstract. Background: Tuberculosis is one of the world's most common causes of death in the era of Human immunodeficiency virus. The purpose of this study was to determine the prevalence and associated factors of TB/HIV co-infection. Methods: Hospital based retrospective studies were conducted among adult ...

  13. Screening Yield of HIV Antigen/Antibody Combination and Pooled HIV RNA Testing for Acute HIV Infection in a High-Prevalence Population.

    Peters, Philip J; Westheimer, Emily; Cohen, Stephanie; Hightow-Weidman, Lisa B; Moss, Nicholas; Tsoi, Benjamin; Hall, Laura; Fann, Charles; Daskalakis, Demetre C; Beagle, Steve; Patel, Pragna; Radix, Asa; Foust, Evelyn; Kohn, Robert P; Marmorino, Jenni; Pandori, Mark; Fu, Jie; Samandari, Taraz; Gay, Cynthia L

    2016-02-16

    established and acute HIV infections) by 10.4% (95% CI, 8.8%-12.2%) and pooled HIV RNA testing increased the relative HIV diagnostic yield by 12.4% (95% CI, 10.7%-14.3%). In a high-prevalence population, HIV screening using an HIV Ag/Ab combination assay following a negative rapid test detected 82% of acute HIV infections detectable by pooled HIV RNA testing, with a positive predictive value of 59%. Further research is needed to evaluate this strategy in lower-prevalence populations and in persons using preexposure prophylaxis for HIV prevention.

  14. Schistosoma mansoni and HIV infection in a Ugandan population with high HIV and helminth prevalence.

    Sanya, Richard E; Muhangi, Lawrence; Nampijja, Margaret; Nannozi, Victoria; Nakawungu, Prossy Kabuubi; Abayo, Elson; Webb, Emily L; Elliott, Alison M

    2015-09-01

    Recent reports suggest that Schistosoma infection may increase the risk of acquiring human immunodeficiency virus (HIV). We used data from a large cross-sectional study to investigate whether Schistosoma mansoni infection is associated with increased HIV prevalence. We conducted a household survey of residents in island fishing communities in Mukono district, Uganda, between October 2012 and July 2013. HIV status was assessed using rapid test kits. Kato-Katz (KK) stool tests and urine-circulating cathodic antigen (CCA) were used to test for Schistosoma infection. Multivariable logistic regression, allowing for the survey design, was used to investigate the association between S. mansoni infection and HIV infection. Data from 1412 participants aged 13 years and older were analysed (mean age 30.3 years, 45% female). The prevalence of HIV was 17.3%. Using the stool Kato-Katz technique on a single sample, S. mansoni infection was detected in 57.2% (719/1257) of participants; urine CCA was positive in 73.8% (478/650) of those tested. S. mansoni infection was not associated with HIV infection. [KK (aOR = 1.04; 95% CI: 0.74-1.47, P = 0.81), CCA (aOR = 1.53; 95% CI: 0.78-3.00, P = 0.19)]. The median S. mansoni egg count per gram was lower in the HIV-positive participants (P = 0.005). These results add to the evidence that S. mansoni has little effect on HIV transmission, but may influence egg excretion. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  15. Prevalence and risk factors for HIV among people aged 50 years ...

    JOHN

    reproductive and sexual health characteristics of the participants, knowledge on HIV ... Keywords: HIV, older adults, prevalence, knowledge, risk factors, Tanzania ... With increased availability of ART, people are living longer and age with HIV ...

  16. HIV/AIDS policy agenda setting in Iran

    Khodayari - Zarnaq, Rahim; Ravaghi, Hamid; Mohammad Mosaddeghrad, Ali; Sedaghat, Abbas; Mohraz, Minoo

    2016-01-01

    Background: HIV/AIDS control are one of the most important goals of the health systems. The aim of this study was to determine how HIV/AIDS control was initiated among policy makers’ agenda setting in Iran. Methods: A qualitative research (semi-structured interview) was conducted using Kingdon’s framework (problem, policy and politics streams, and policy windows and policy entrepreneurs) to analysis HIV/AIDS agenda setting in Iran. Thirty-two policy makers, managers, specialists, and researchers were interviewed. Also, 30 policy documents were analyzed. Framework analysis method was used for data analysis. Results: the increase of HIV among Injecting drug users (IDUs) and Female Sex Workers (FSWs), lack of control of their high-risk behaviors, and exceeding the HIV into concentrated phase were examples of problem stream. Policy stream was evidence-based solutions that highlighted the need for changing strategies for dealing with such a problem and finding technically feasible and acceptable solutions. Iran’s participation in United Nations General Assembly special sessions on HIV/AIDS (UNGASS), the establishment of National AIDS Committee; highlighting AIDS control in Iran’s five years development program and the support of the judiciary system of harm reduction policies were examples of politics stream. Policy entrepreneurs linking these streams put the HIV/AIDS on the national agenda (policy windows) and provide their solutions. Conclusion: There were mutual interactions among these three streams and sometimes, they weakened or reinforced each other. Future studies are recommended to understand the interactions between these streams’ parts and perhaps develop further Kingdon’s framework, especially in the health sector. PMID:27579283

  17. Community-level income inequality and HIV prevalence among persons who inject drugs in Thai Nguyen, Vietnam.

    Lim, Travis W; Frangakis, Constantine; Latkin, Carl; Ha, Tran Viet; Minh, Nguyen Le; Zelaya, Carla; Quan, Vu Minh; Go, Vivian F

    2014-01-01

    Socioeconomic status has a robust positive relationship with several health outcomes at the individual and population levels, but in the case of HIV prevalence, income inequality may be a better predictor than absolute level of income. Most studies showing a relationship between income inequality and HIV have used entire countries as the unit of analysis. In this study, we examine the association between income inequality at the community level and HIV prevalence in a sample of persons who inject drugs (PWID) in a concentrated epidemic setting. We recruited PWID and non-PWID community participants in Thai Nguyen, Vietnam, and administered a cross-sectional questionnaire; PWID were tested for HIV. We used ecologic regression to model HIV burden in our PWID study population on GINI indices of inequality calculated from total reported incomes of non-PWID community members in each commune. We also modeled HIV burden on interaction terms between GINI index and median commune income, and finally used a multi-level model to control for community level inequality and individual level income. HIV burden among PWID was significantly correlated with the commune GINI coefficient (r = 0.53, p = 0.002). HIV burden was also associated with GINI coefficient (β = 0.082, p = 0.008) and with median commune income (β = -0.018, p = 0.023) in ecological regression. In the multi-level model, higher GINI coefficient at the community level was associated with higher odds of individual HIV infection in PWID (OR = 1.46 per 0.01, p = 0.003) while higher personal income was associated with reduced odds of infection (OR = 0.98 per $10, p = 0.022). This study demonstrates a context where income inequality is associated with HIV prevalence at the community level in a concentrated epidemic. It further suggests that community level socioeconomic factors, both contextual and compositional, could be indirect determinants of HIV infection in PWID.

  18. Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil

    Paula Matos Oliveira

    Full Text Available CONTEXT AND OBJECTIVE: The human immunodeficiency virus (HIV is frequently associated with high-grade intraepithelial neoplasia. Immunosuppression and high HIV viral load are the main risk factors for cervical intraepithelial neoplasia (CIN. The aim of this study was to determine the prevalence of CIN in HIV-infected women in Salvador, Bahia, Brazil, and to describe the risk factors in comparison with non-infected women. DESIGN AND SETTING: Cross-sectional study at the AIDS Reference Center of Bahia and the Gynecological Outpatient Clinic of Fundação Bahiana para o Desenvolvimento da Ciência, in Salvador, Bahia, Brazil. METHODS: Sixty-four HIV-infected women and 76 uninfected women from Salvador were enrolled between May 2006 and May 2007. Associations between CIN and presence of HIV infection, HIV viral load, proportion of T CD4+ lymphocytes and risk factors were evaluated. The independence of the risk factors was investigated using logistic regression. RESULTS: CIN was more prevalent among HIV-infected women than in the control group (26.6% versus 6.6%; P = 0.01. The odds ratio for CIN among HIV-infected women was 3.7 (95% confidence interval, CI: 1.23-11; P = 0.01, after adjusting for the following variables: age at first sexual intercourse, number of partners, number of deliveries and previous history of sexually transmitted disease. CONCLUSION: The prevalence of CIN among HIV-infected women was significantly higher than among women without HIV infection. HIV infection was the most important risk factor associated with the development of cervical lesions.

  19. Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study.

    De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Parruti, Giustino; Pucci, Giacomo; Di Biagio, Antonio; Calza, Leonardo; Orofino, Giancarlo; Carenzi, Laura; Cecchini, Enisia; Madeddu, Giordano; Quirino, Tiziana; Schillaci, Giuseppe

    2014-02-01

    We aimed to assess the prevalence of hypertension in an unselected human immunodeficiency virus (HIV)-infected population and to identify factors associated with hypertension prevalence, treatment, and control. We used a multicenter, cross-sectional, nationwide study that sampled 1,182 unselected, consecutive, HIV-infected patients. Office blood pressure was accurately measured with standard procedures. Patients were 71% men and 92% white, with a median age of 47 years (range = 18-78); 6% were antiretroviral treatment naive. The overall prevalence of hypertension was 29.3%; high-normal pressure accounted for an additional 12.3%. Among hypertensive subjects, 64.9% were aware of their hypertensive condition, 52.9% were treated, and 33.0% were controlled (blood pressure < 140/90 mm Hg). Blood pressure-lowering medications were used in monotherapy in 54.3% of the subjects. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were the most frequently used drugs (76.1%: monotherapy = 39.1%, combination treatment = 37.0%). In multivariable regression models, hypertension was independently predicted by traditional risk factors, including age ≥50 years, male sex, family history of cardiovascular disease, body mass index ≥25 kg/m2, previous cardiovascular events, diabetes, central obesity, and metabolic syndrome, as well as by duration of HIV infection, duration of antiretroviral therapy, and nadir CD4+ T-cell count <200/μl. The choice of protease inhibitors vs. nonnucleoside reverse transcriptase inhibitors as a third antiretroviral drug was irrelevant. Hypertension affects nearly 30% of HIV adult outpatients in Italy. More than one-third of the hypertensive subjects are unaware of their condition, and more than two-thirds are uncontrolled. A higher level of attention to the diagnosis and treatment of hypertension is mandatory in this setting.

  20. Unexpected low prevalence of HIV among fertile women in Luanda, Angola. Does war prevent the spread of HIV?

    Strand, R T; Fernandes Dias, L; Bergström, S; Andersson, S

    2007-07-01

    We studied HIV prevalence and risk factors for HIV infection among fertile women in Luanda for the purposes of obtaining background data for planning of interventions as well as to look into the association of armed conflicts and HIV prevalence in sub-Saharan Africa. The HIV-1 prevalence was 1.7% in an antenatal care group (n = 517) and 1.9% in a family planning group (n = 518). Socioeconomic and sexual background factors did not significantly differ HIV-positive from HIV-negative women. Data on armed conflict factors were matched with HIV prevalence figures among pregnant women in sub-Saharan Africa. The level of armed conflicts was found to be inversely related to HIV prevalence. The low HIV seroprevalence in Luanda is in sharp contrast to the capitals of neighbouring countries. While the spread of HIV may have been hampered by the long armed conflict in the country, it is feared to increase rapidly with the return of soldiers and refugees in a post-war situation. The challenge for preventive actions is urgent. This example may be relevant to other areas with a recent end-of-war situation.

  1. Examining sex differentials in the uptake and process of HIV testing in three high prevalence districts of India.

    Joseph, Saju; Kielmann, Karina; Kudale, Abhay; Sheikh, Kabir; Shinde, Swati; Porter, John; Rangan, Sheela

    2010-03-01

    Sex differentials in the uptake of HIV testing have been reported in a range of settings, however, men's and women's testing patterns are not consistent across these settings, suggesting the need to set sex differentials against gender norms in patient testing behaviour and provider practices. A community-based, cross-sectional survey among 347 people living with HIV in three HIV high prevalence districts of India examined reasons for undergoing an HIV test, location of testing and conditions under which individuals were tested. HIV testing was almost always provider-initiated for men. Men were more likely to be advised to test by a private practitioner and to test in the private sector. Women were more likely to be advised to test by a family member, and to test in the public sector. Men were more likely to receive pre-test information than women, when tested in the private sector. Men were also more likely to receive direct disclosure of their HIV positive status by a health provider, regardless of the sector in which they tested. More women than men were repeatedly tested for HIV, regardless of sector. These sex differentials in the uptake and process of HIV testing are partially explained through differences in public and private sector testing practices. However, they also reflect women's lack of awareness and agency in HIV care seeking and differential treatment by providers. Examining gender dynamics that underpin sex differentials in HIV testing patterns and practices is essential for a realistic assessment of the challenges and implications of scaling-up HIV testing and mainstreaming gender in HIV/AIDS programmes.

  2. HIV Prevalence, Sexual Partners, Sexual Behavior and HIV Acquisition Risk Among Trans Men, San Francisco, 2014.

    McFarland, Willi; Wilson, Erin C; Raymond, Henry F

    2017-12-01

    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.

  3. Prevalence and determinants of unplanned pregnancy in HIV-positive and HIV-negative pregnant women in Cape Town, South Africa: a cross-sectional study.

    Iyun, Victoria; Brittain, Kirsty; Phillips, Tamsin K; le Roux, Stanzi; McIntyre, James A; Zerbe, Allison; Petro, Greg; Abrams, Elaine J; Myer, Landon

    2018-04-03

    Prevention of unplanned pregnancy is a crucial aspect of preventing mother-to-child HIV transmission. There are few data investigating how HIV status and use of antiretroviral therapy (ART) may influence pregnancy planning in high HIV burden settings. Our objective was to examine the prevalence and determinants of unplanned pregnancy among HIV-positive and HIV-negative women in Cape Town, South Africa. Cross-sectional analysis. Single primary-level antenatal care clinic in Cape Town, South Africa. HIV-positive and HIV-negative pregnant women, booking for antenatal care from March 2013 to August 2015, were included. Unplanned pregnancy was measured at the first antenatal care visit using the London Measure of Unplanned Pregnancy (LMUP). Analyses examined LMUP scores across four groups of participants defined by their HIV status, awareness of their HIV status prior to the current pregnancy and/or whether they were using antiretroviral therapy (ART) prior to the current pregnancy. Among 2105 pregnant women (1512 HIV positive; 593 HIV negative), median age was 28 years, 43% were married/cohabiting and 20% were nulliparous. Levels of unplanned pregnancy were significantly higher in HIV-positive versus HIV-negative women (50% vs 33%, p<0.001); and highest in women who were known HIV positive but not on ART (53%). After adjusting for age, parity and marital status, unplanned pregnancy was most common among women newly diagnosed and women who were known HIV positive but not on ART (compared with HIV-negative women, adjusted OR (aOR): 1.43; 95% CI 1.05 to 1.94 and aOR: 1.57; 95% CI 1.13 to 2.15, respectively). Increased parity and younger age (<24 years) were also associated with unplanned pregnancy (aOR: 1.42; 95% CI 1.25 to 1.60 and aOR: 1.83; 95% CI 1.23 to 2.74, respectively). We observed high levels of unplanned pregnancy among HIV-positive women, particularly among those not on ART, suggesting ongoing missed opportunities for improved family planning and

  4. HIV-Related discrimination in European health care settings.

    Nöstlinger, Christiana; Rojas Castro, Daniela; Platteau, Tom; Dias, Sonia; Le Gall, Jean

    2014-03-01

    This cross-sectional European study assessed self-reported HIV-related discrimination and its associated factors in health care settings. Socio-demographics, health status, support needs relating to sexual and reproductive health (SRH), and self-reported HIV-related discrimination were measured using an anonymous survey in a sample of 1549 people living with HIV from 14 countries. Thirty-two per cent of the participants had experienced HIV-related discrimination during the previous 3 years; almost half of them felt discriminated against by health care providers. For this type of discrimination, logistic regression analysis revealed significant associations with not being a migrant (OR: 2.0; IC 1.0-3.7; psex practices (OR: 1.8; IC 1.0-3.2; pgender had a protective effect (OR: 0.2; IC 0.0-0.9; pdiscrimination. Improving health care providers' communication skills, and fostering openness about SRH topics in HIV care could contribute to destigmatization of PLHIV.

  5. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015

    Wang, Haidong; Wolock, Tim M.; Carter, Austin; Nguyen, Grant; Kyu, Hmwe Hmwe; Gakidou, Emmanuela; Hay, Simon I.; Mills, Edward J.; Trickey, Adam; Msemburi, William; Coates, Matthew M.; Mooney, Meghan D.; Fraser, Maya S.; Sligar, Amber; Salomon, Joshua; Larson, Heidi J.; Friedman, Joseph; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M.; Abd El Razek, Mohamed Magdy; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adofo, Koranteng; Adou, Arsene Kouablan; Ajala, Oluremi N.; Akinyemiju, Tomi F.; Akseer, Nadia; Al Lami, Faris Hasan; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K. M.; Alasfoor, Deena; Aldhahri, Saleh Fahed S.; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V.; Alemu, Zewdie Aderaw; Alfonso-Cristancho, Rafael; Ali, Raghib; Amare, Azmeraw T.; Hoek, Hans W.

    Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral

  6. Prevalence of prenatal depression and associated factors among HIV-positive women in primary care in Mpumalanga province, South Africa.

    Peltzer, Karl; Rodriguez, Violeta J; Jones, Deborah

    2016-12-01

    This study aimed to assess the prevalence of depressed symptoms and associated factors in prenatal HIV-positive women in primary care facilities in rural South Africa. In a cross-sectional study, 663 HIV-positive prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited by systematic sampling (every consecutive patient after HIV post-test counselling). Results indicate that overall, 48.7% [95% CI: 44.8, 52.6] of women during the prenatal period reported depressed mood (scores of ≥ 13 on the Edinburgh Postnatal Depression Scale 10). In multivariate analysis, not being employed, unplanned pregnancy, not having an HIV-positive child, poor antiretroviral therapy adherence, non-condom use at last sex, and intimate partner violence were associated with depressive symptoms. Potential risk factors among HIV-infected prenatal women were identified which could be utilized in interventions. Routine screening for depression may be integrated into prenatal care settings.

  7. The cost-effectiveness of intervening in low and high HIV prevalence areas in South Africa

    Josue Mbonigaba

    2013-05-01

    Full Text Available This research compared the cost-effectiveness of a set of HIV/AIDS interventions in a low HIV prevalence area (LPA and in a high HIV prevalence area (HPA in South Africa. The rationale for this analysis was to assess the interaction dynamics between a specific HIV/AIDS intervention and an area of implementation and the effects of these dynamics on the cost-effectiveness of such an HIV/AIDS intervention. A pair of Markov models was evaluated for each intervention; one model for a HPA and another for an LPA and the cost-effectiveness of that intervention was compared across an LPA and a HPA. The baseline costs and health outcomes in each area were collected from the literature. To depict interaction dynamics between an HIV/AIDS intervention and an area of implementation, baseline health outcomes collected in each area, were adjusted over time based on the patterns of the projections observed in the AIDS model of the Actuarial Society of South Africa (ASSA2008. The study found that the VCT and treatment of STDs were equally cost-effective in an LPA and in a HPA while PMTCT and HAART were more cost-effective in an LPA than in a HPA. As a policy proposal, resources earmarked to non-ARV based interventions (VCT and treatment of STDs should  be equally shared across an LPA and a HPA while  more of the resources reserved for ARV-based interventions (PMTCT and HAART should go in an LPA in order to increase efficiency.

  8. Prevalence of genotypic HIV-1 drug resistance in Thailand, 2002

    Watitpun Chotip

    2003-03-01

    Full Text Available Abstract Background The prices of reverse transcriptase (RT inhibitors in Thailand have been reduced since December 1, 2001. It is expected that reduction in the price of these inhibitors may influence the drug resistance mutation pattern of HIV-1 among infected people. This study reports the frequency of HIV-1 genetic mutation associated with drug resistance in antiretroviral-treated patients from Thailand. Methods Genotypic resistance testing was performed on samples collected in 2002 from 88 HIV-1 infected individuals. Automated DNA sequencing was used to genotype the HIV-1 polymerase gene isolated from patients' plasma. Results Resistance to protease inhibitors, nucleoside and non-nucleoside reverse transcriptase inhibitors were found in 10 (12%, 42 (48% and 19 (21% patients, respectively. The most common drug resistance mutations in the protease gene were at codon 82 (8%, 90 (7% and 54 (6%, whereas resistant mutations at codon 215 (45%, 67 (40%, 41 (38% and 184 (27% were commonly found in the RT gene. This finding indicates that genotypic resistance to nucleoside reverse transcriptase inhibitors was prevalent in 2002. The frequency of resistant mutations corresponding to non-nucleoside reverse transcriptase inhibitors was three times higher-, while resistant mutation corresponding to protease inhibitors was two times lower than those frequencies determined in 2001. Conclusion This study shows that the frequencies of RT inhibitor resistance mutations have been increased after the reduction in the price of RT inhibitors since December 2001. We believe that this was an important factor that influenced the mutation patterns of HIV-1 protease and RT genes in Thailand.

  9. Determinants of prevalent HIV infection and late HIV diagnosis among young women with two or more sexual partners in Beira, Mozambique

    Zango, Arlinda; Dubé, Karine; Kelbert, Sílvia; Meque, Ivete; Cumbe, Fidelina; Chen, Pai Lien; Ferro, Josefo J.; Feldblum, Paul J.; van de Wijgert, Janneke

    2013-01-01

    The prevalence and determinants of HIV and late diagnosis of HIV in young women in Beira, Mozambique, were estimated in preparation for HIV prevention trials. An HIV prevalence survey was conducted between December 2009 and October 2012 among 1,018 women aged 18-35 with two or more sexual partners

  10. Routine HIV screening in two health-care settings--New York City and New Orleans, 2011-2013.

    Lin, Xia; Dietz, Patricia M; Rodriguez, Vanessa; Lester, Deborah; Hernandez, Paloma; Moreno-Walton, Lisa; Johnson, Grant; Van Handel, Michelle M; Skarbinski, Jacek; Mattson, Christine L; Stratford, Dale; Belcher, Lisa; Branson, Bernard M

    2014-06-27

    Approximately 16% of the estimated 1.1 million persons living with human immunodeficiency virus (HIV) in the United States are unaware of their infection and thus unable to benefit from effective treatment that improves health and reduces transmission risk. Since 2006, CDC has recommended that health-care providers screen for HIV all patients aged 13-64 years unless prevalence of undiagnosed HIV infection in their patients has been documented to be New York City and the Interim Louisiana Hospital (ILH) in New Orleans. Data were provided by the two programs. UHP screened a monthly average of 986 patients for HIV during January 2011-September 2013. Of the 32,534 patients screened, 148 (0.45%) tested HIV-positive, of whom 147 (99%) received their test result and 43 (29%) were newly diagnosed. None of the 148 patients with HIV infection were previously receiving medical care, and 120 (81%) were linked to HIV medical care. The ILH emergency department (ED) and the urgent-care center (UCC) screened a monthly average of 1,323 patients from mid-March to December 2013. Of the 12,568 patients screened, 102 (0.81%) tested HIV-positive, of whom 100 (98%) received their test result, 77 (75%) were newly diagnosed, and five (5%) had acute HIV infection. Linkage to HIV medical care was successful for 67 (74%) of 91 patients not already in care. Routine HIV screening identified patients with new and previously diagnosed HIV infection and facilitated their linkage to medical care. The two HIV screening programs highlighted in this report can serve as models that could be adapted by other health-care settings.

  11. Economic impact of HIV and antiretroviral therapy on education supply in high prevalence regions.

    Claire L Risley

    Full Text Available We set out to estimate, for the three geographical regions with the highest HIV prevalence, (sub-Saharan Africa [SSA], the Caribbean and the Greater Mekong sub-region of East Asia, the human resource and economic impact of HIV on the supply of education from 2008 to 2015, the target date for the achievement of Education For All (EFA, contrasting the continuation of access to care, support and Antiretroviral therapy (ART to the scenario of universal access.A costed mathematical model of the impact of HIV and ART on teacher recruitment, mortality and absenteeism (Ed-SIDA was run using best available data for 58 countries, and results aggregated by region. It was estimated that (1 The impact of HIV on teacher supply is sufficient to derail efforts to achieve EFA in several countries and universal access can mitigate this. (2 In SSA, the 2008 costs to education of HIV were about half of those estimated in 2002. Providing universal access for teachers in SSA is cost-effective on education returns alone and provides a return of $3.99 on the dollar. (3 The impacts on education in the hyperendemic countries in Southern Africa will continue to increase to 2015 from its 2008 level, already the highest in the world. (4 If treatment roll-out is successful, numbers of HIV positive teachers are set to increase in all the regions studied.The return on investing in care and support is also greater in those areas with highest impact. SSA requires increased investment in teacher support, testing and particularly ART if it is to achieve EFA. The situation for teachers in the Caribbean and East Asia is similar but on a smaller scale proportionate to the lower levels of infection and greater existing access to care and support.

  12. Recent HIV prevalence trends among pregnant women and all women in sub-Saharan Africa: implications for HIV estimates.

    Eaton, Jeffrey W; Rehle, Thomas M; Jooste, Sean; Nkambule, Rejoice; Kim, Andrea A; Mahy, Mary; Hallett, Timothy B

    2014-11-01

    National population-wide HIV prevalence and incidence trends in sub-Saharan Africa (SSA) are indirectly estimated using HIV prevalence measured among pregnant women attending antenatal clinics (ANC), among other data. We evaluated whether recent HIV prevalence trends among pregnant women are representative of general population trends. Serial population-based household surveys in 13 SSA countries. We calculated HIV prevalence trends among all women aged 15-49 years and currently pregnant women between surveys conducted from 2003 to 2008 (period 1) and 2009 to 2012 (period 2). Log-binomial regression was used to test for a difference in prevalence trend between the two groups. Prevalence among pregnant women was age-standardized to represent the age distribution of all women. Pooling data for all countries, HIV prevalence declined among pregnant women from 6.5 [95% confidence interval (CI) 5.3-7.9%] to 5.3% (95% CI 4.2-6.6%) between periods 1 and 2, whereas it remained unchanged among all women at 8.4% (95% CI 8.0-8.9%) in period 1 and 8.3% (95% CI 7.9-8.8%) in period 2. Prevalence declined by 18% (95% CI -9-38%) more in pregnant women than nonpregnant women. Estimates were similar in Western, Eastern, and Southern regions of SSA; none were statistically significant (P>0.05). HIV prevalence decreased significantly among women aged 15-24 years while increasing significantly among women 35-49 years, who represented 29% of women but only 15% of pregnant women. Age-standardization of prevalence in pregnant women did not reconcile the discrepant trends because at older ages prevalence was lower among pregnant women than nonpregnant women. As HIV prevalence in SSA has shifted toward older, less-fertile women, HIV prevalence among pregnant women has declined more rapidly than prevalence in women overall. Interpretation of ANC prevalence data to inform national HIV estimates should account for both age-specific fertility patterns and HIV-related sub-fertility.

  13. Prevalence of vaginitis, syphilis and HIV infection in women in the ...

    To determine the prevalence of vaginitis, syphilis and HIV infection in women in ... have a significant impact on infected people's health as well as on health care .... for both HIV-1 and H1V-2 antibodies using HIV 1/2 EIA. (Abbott Laboratories ...

  14. Maternal hiv positive sero-prevalence at delivery at a tertiary ...

    Background Key Words: Maternal HIV positive sero-prevalence, delivery, birth sex ratio,Orlu.: The duo of HIV/AIDS infection has become a Global public health problem. This study was conducted to determine the maternal HIV positive seroprevalence at delivery at the Imo State University Teaching Hospital, Orlu. Methods: ...

  15. Incident and prevalence of HIV/AIDS among patients attending a ...

    Young people, ages 15–24, account for approximately 40% of new HIV infections (among those 15 and over). Globally, young women are twice as likely to become infected with HIV than their male counterparts. As at 2012, UNAIDS revealed that the HIV/AIDS prevalence rate among adults of ages 15-49 in Nigeria was ...

  16. Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis

    Gupta, Ravindra K.; Jordan, Michael R.; Sultan, Binta J.; Hill, Andrew; Davis, Daniel H. J.; Gregson, John; Sawyer, Anthony W.; Hamers, Raph L.; Ndembi, Nicaise; Pillay, Deenan; Bertagnolio, Silvia

    2012-01-01

    Background The emergence and spread of high levels of HIV-1 drug resistance in resource-limited settings where combination antiretroviral treatment has been scaled up could compromise the effectiveness of national HIV treatment programmes. We aimed to estimate changes in the prevalence of HIV-1 drug

  17. Factors Associated with HIV Prevalence and HIV Testing in Sierra Leone: Findings from the 2008 Demographic Health Survey.

    Nataliya Brima

    Full Text Available The Sierra Leone Demographic Health Survey 2008 found an HIV prevalence of 1.5%. This study investigates associations with HIV infection and HIV testing.Households were selected using stratified multi-stage sampling. In all selected households women aged 15-49 were eligible. In every second household men aged 15-59 were also eligible. Participants were asked to consent for anonymous HIV testing. All participants interviewed and tested were analysed. Multiple logistic regression identified associations with HIV infection, undiagnosed infection and with ever having a voluntary HIV test among sexually active participants.Of 7495 invited 86% (6,475 agreed to an interview and HIV test. Among 96 HIV positive participants, 78% had never taken a voluntary HIV test so were unaware of their serostatus, and 86% were sexually active in the last 12 months among whom 96% did not use a condom at last intercourse. 11% of all participants had previously voluntarily tested. Among women who had tested, 60% did so in antenatal care. We found that those living in an urban area, and those previously married, were more likely to be HIV infected. Voluntary HIV testing was more common in those aged 25-44, living in an urban area, females, having secondary or higher education, having first sexual intercourse at age 17 years or older, and using condoms at last sex. Although 82% of men and 69% of women had heard of HIV, only 35% and 29% respectively had heard of antiretroviral therapy.The HIV prevalence in Sierra Leone has been stable. HIV testing, however, is uncommon and most infected individuals are unaware of their serostatus. This could allow the epidemic to escalate as individuals with undiagnosed infection are unlikely to change their behaviour or access treatment. Improving knowledge and increasing testing need to remain central to HIV prevention interventions in Sierra Leone.

  18. The prevalence of metabolic syndrome in Danish patients with HIV infection: the effect of antiretroviral therapy

    Hansen, B R; Petersen, J; Haugaard, S B

    2009-01-01

    OBJECTIVES: The prevalence of metabolic syndrome (MS) in HIV-infected patients on highly active antiretroviral therapy (HAART) is a subject of debate. We investigated the prevalence of MS in a cohort of Danish HIV-infected patients and estimated the effect of the various classes of antiretroviral...

  19. Increased prevalence of malaria in HIV-infected pregnant women and its implications for malaria control

    Verhoeff, F. H.; Brabin, B. J.; Hart, C. A.; Chimsuku, L.; Kazembe, P.; Broadhead, R. L.

    1999-01-01

    To examine in pregnant women the relationship between HIV infection and malaria prevalence and to determine, in relation to HIV infection, the effectiveness of sulphadoxine-pyrimethamine in clearing P. falciparum infection. Descriptive cross-sectional analysis of P. falciparum prevalence in pregnant

  20. Conflict and HIV: A framework for risk assessment to prevent HIV in conflict-affected settings in Africa.

    Mock, Nancy B; Duale, Sambe; Brown, Lisanne F; Mathys, Ellen; O'maonaigh, Heather C; Abul-Husn, Nina Kl; Elliott, Sterling

    2004-10-29

    In sub-Saharan Africa, HIV/AIDS and violent conflict interact to shape population health and development in dramatic ways. HIV/AIDS can create conditions conducive to conflict. Conflict can affect the epidemiology of HIV/AIDS. Conflict is generally understood to accelerate HIV transmission, but this view is simplistic and disregards complex interrelationships between factors that can inhibit and accelerate the spread of HIV in conflict and post conflict settings, respectively. This paper provides a framework for understanding these factors and discusses their implications for policy formulation and program planning in conflict-affected settings.

  1. Conflict and HIV: A framework for risk assessment to prevent HIV in conflict-affected settings in Africa

    Mock Nancy B

    2004-10-01

    Full Text Available Abstract In sub-Saharan Africa, HIV/AIDS and violent conflict interact to shape population health and development in dramatic ways. HIV/AIDS can create conditions conducive to conflict. Conflict can affect the epidemiology of HIV/AIDS. Conflict is generally understood to accelerate HIV transmission, but this view is simplistic and disregards complex interrelationships between factors that can inhibit and accelerate the spread of HIV in conflict and post conflict settings, respectively. This paper provides a framework for understanding these factors and discusses their implications for policy formulation and program planning in conflict-affected settings.

  2. Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa

    Mirkuzie Alemnesh H

    2012-12-01

    Full Text Available Abstract Background In the absence of reliable data, antenatal HIV surveillance has been used to monitor the HIV epidemic since the late 1980s. Currently, routine data from Prevention of Mother-to-child HIV transmission (PMTCT programmes are increasingly available. Evaluating whether the PMTCT programme reports provide comparable HIV prevalence estimates with the antenatal surveillance reports is important. In this study, we compared HIV prevalence estimates from routine PMTCT programme and antenatal surveillance in Addis Ababa with the aim to come up with evidence based recommendation. Methods Summary data were collected from PMTCT programmes and antenatal surveillance reports within the catchment of Addis Ababa. The PMTCT programme data were obtained from routine monthly reports from 2004 to 2009 and from published antenatal HIV surveillance reports from 2003 to 2009. Data were analysed using descriptive statistics. Results In Addis Ababa, PMTCT sites had increased from six in 2004 to 54 in 2009. The site expansion was accompanied by an increased number of women testing. There were marked increases in the rate of HIV testing following the introduction of routine opt-out HIV testing approach. Paralleling these increases, the HIV prevalence showed a steady decline from 10.0% in 2004 to 4.5% in 2009. There were five antenatal surveillance sites from 2003 to 2007 in Addis Ababa and they increased to seven by 2009. Four rounds of surveillance data from five sites showed a declining trend in HIV prevalence over the years. The overall antenatal surveillance data also showed that the HIV prevalence among antenatal attendees had declined from 12.4% in 2003 to 5.5% in 2009. The HIV prevalence estimates from PMTCT programme were 6.2% and 4.5% and from antenatal surveillance 6.1 and 5.5% in 2008 and 2009 respectively. Conclusions There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources

  3. Prevalence of HIV Among U.S. Female Sex Workers: Systematic Review and Meta-analysis.

    Paz-Bailey, Gabriela; Noble, Meredith; Salo, Kathryn; Tregear, Stephen J

    2016-10-01

    Although female sex workers are known to be vulnerable to HIV infection, little is known about the epidemiology of HIV infection among this high-risk population in the United States. We systematically identified and critically assessed published studies reporting HIV prevalence among female sex workers in the United States. We searched for and included original English-language articles reporting data on the prevalence of HIV as determined by testing at least 50 females who exchanged sexual practices for money or drugs. We did not apply any restrictions on date of publication. We included 14 studies from 1987 to 2013 that reported HIV prevalence for a total of 3975 adult female sex workers. Only two of the 14 studies were conducted in the last 10 years. The pooled estimate of HIV prevalence was 17.3 % (95 % CI 13.5-21.9 %); however, the prevalence of HIV across individual studies varied considerably (ranging from 0.3 to 32 %) and statistical heterogeneity was substantial (I(2) = 0.89, Q = 123; p HIV among female sex workers in the United States; however, the available evidence does suggest that HIV prevalence among this vulnerable population is high.

  4. Widespread rape does not directly appear to increase the overall HIV prevalence in conflict-affected countries: so now what?

    Mills Edward

    2008-07-01

    Full Text Available Abstract Background Sub-Saharan Africa (SSA is severely affected by HIV/AIDS and conflict. Sexual violence as a weapon of war has been associated with concerns about heightened HIV incidence among women. Widespread rape by combatants has been documented in Burundi, Sierra Leone, Rwanda, Democratic Republic of Congo, Liberia, Sudan and Uganda. To examine the assertion that widespread rape may not directly increase HIV prevalence at the population level, we built a model to determine the potential impact of varying scenarios of widespread rape on HIV prevalence in the above seven African countries. Discussion Our findings show that even in the most extreme situations, where 15% of the female population was raped, where HIV prevalence among assailants was 8 times the country population prevalence, and where the HIV transmission rate was highest at 4 times the average high rate, widespread rape increased the absolute HIV prevalence of these countries by only 0.023%. These projections support the finding that widespread rape in conflict-affected countries in SSA has not incurred a major direct population-level change in HIV prevalence. However, this must not be interpreted to say that widespread rape does not pose serious problems to women's acquisition of HIV on an individual basis or in specific settings. Furthermore, direct and indirect consequences of sexual violence, such as physical and psychosocial trauma, unwanted pregnancies, and stigma and discrimination cannot be understated. Summary The conclusions of this article do not significantly change current practices in the field from an operational perspective. Proper care and treatment must be provided to every survivor of rape regardless of the epidemiological effects of HIV transmission at the population level. Sexual violence must be treated as a protection issue and not solely a reproductive health and psychosocial issue. It is worth publishing data and conclusions that could be

  5. Prevalence of Vitamin B12 and folic acid deficiency in HIV-positive patients and its association with neuropsychiatric symptoms and immunological response.

    Adhikari, Prabha M R; Chowta, Mukta N; Ramapuram, John T; Rao, Satish; Udupa, Karthik; Acharya, Sahana Devdas

    2016-01-01

    Deficiency of micronutrients is prevalent even before the development of symptoms of HIV disease and is associated with accelerated HIV disease progression. This study evaluates the prevalence of folate and Vitamin B 12 deficiency in HIV-positive patients with or without tuberculosis (TB) and its association with neuropsychiatric symptoms and immunological response. Cross-sectional, observational study in an outpatient setting. Four groups of HIV-positive patients with TB (Group I), HIV-positive patients with neuropsychiatric symptoms (Group II), HIV-positive patients without neuropsychiatric symptoms or TB (Group III), and HIV-negative controls with neuropsychiatric symptoms (Group IV). Vitamin B 12 and folate estimation was done using carbonyl metallo-immunoassay method. ANOVA, Kruskal-Wallis and Mann-Whitney, Pearson's correlation. The prevalence of folic acid deficiency was 27.1% in the Group I, 31.9% in the Group II, 23.4% in the Group III, and 32% in the Group IV being higher in patients with neuropsychiatric symptoms in both HIV and non-HIV patients. The prevalence of Vitamin B 12 deficiency was 18.8% in Group I, 9.1% in Group II, 4.8% in Group III, and 16.7% in Group IV. The patients with folate deficiency had more severe depression and anxiety. Nearly, 30% of the HIV patients had a folic acid deficiency, and about 10% of the HIV patients had Vitamin B 12 deficiency. The folate deficiency was highest among neuropsychiatric patients with or without HIV infection and Vitamin B 12 deficiency was higher among HIV patients with TB.

  6. High HIV prevalence and associated risk factors among female sex workers in Rwanda.

    Mutagoma, Mwumvaneza; Samuel, Malamba S; Kayitesi, Catherine; Gasasira, Antoine R; Chitou, Bassirou; Boer, Kimberly; Hedt-Gauthier, Bethany; Gupta, Neil; Ntaganira, Joseph; Nsanzimana, Sabin

    2017-10-01

    Human immunodeficiency virus (HIV) prevalence is often high among female sex workers (FSWs) in sub-Saharan Africa. Understanding the dynamics of HIV infection in this key population is critical to developing appropriate prevention strategies. We aimed to describe the prevalence and associated risk factors among a sample of FSWs in Rwanda from a survey conducted in 2010. A cross-sectional biological and behavioral survey was conducted among FSWs in Rwanda. Time-location sampling was used for participant recruitment from 4 to 18 February 2010. HIV testing was done using HIV rapid diagnostic tests (RDT) as per Rwandan national guidelines at the time of the survey. Elisa tests were simultaneously done on all samples tested HIV-positive on RDT. Proportions were used for sample description; multivariable logistic regression model was performed to analyze factors associated with HIV infection. Of 1338 women included in the study, 1112 consented to HIV testing, and the overall HIV prevalence was 51.0%. Sixty percent had been engaged in sex work for less than five years and 80% were street based. In multivariable logistic regression, HIV prevalence was higher in FSWs 25 years or older (adjusted odds ratio [aOR] = 1.83, 95% [confidence interval (CI): 1.42-2.37]), FSWs with consistent condom use in the last 30 days (aOR = 1.39, [95% CI: 1.05-1.82]), and FSWs experiencing at least one STI symptom in the last 12 months (aOR = 1.74 [95% CI: 1.34-2.26]). There was an inverse relationship between HIV prevalence and comprehensive HIV knowledge (aOR = 0.65, [95% CI: 0.48-0.88]). HIV prevalence was high among a sample of FSWs in Rwanda, and successful prevention strategies should focus on HIV education, treatment of sexually transmitted infections, and proper and consistent condom use using an outreach approach.

  7. Epidemiology, Diagnosis, and Treatment of HIV-Associated Non-Hodgkin Lymphoma in Resource-Limited Settings

    Matthew Ulrickson

    2012-01-01

    Full Text Available Lymphoma was a common complication of HIV infection in the pre-antiretroviral era, and the incidence of HIV-associated lymphoma has dropped dramatically since the introduction of combination antiretroviral therapy (cART in resource-rich regions. Conversely, lymphoma is an increasingly common complication of HIV infection in resource-limited settings where the prevalence of HIV infection is high. Relatively little is known, however, about the true incidence and optimal treatment regimens for HIV-associated lymphoma in resource-poor regions. We review the epidemiology, diagnosis, and treatment of HIV-associated non-Hodgkin lymphoma in developing nations and highlight areas for further research that may benefit care in both settings. Examples include risk modification and dose modification of chemotherapy based on HIV risk factors, improving our understanding of the current burden of disease through national cancer registries, and developing cost-effective hematopathological diagnostic strategies to optimize care delivery and maximize use of available chemotherapy.

  8. G6PD Deficiency in an HIV Clinic Setting in the Dominican Republic

    Xu, Julia Z.; Francis, Richard O.; Lerebours Nadal, Leonel E.; Shirazi, Maryam; Jobanputra, Vaidehi; Hod, Eldad A.; Jhang, Jeffrey S.; Stotler, Brie A.; Spitalnik, Steven L.; Nicholas, Stephen W.

    2015-01-01

    Because human immunodeficiency virus (HIV)-infected patients receive prophylaxis with oxidative drugs, those with glucose-6-phosphate dehydrogenase (G6PD) deficiency may experience hemolysis. However, G6PD deficiency has not been studied in the Dominican Republic, where many individuals have African ancestry. Our objective was to determine the prevalence of G6PD deficiency in Dominican HIV-infected patients and to attempt to develop a cost-effective algorithm for identifying such individuals. To this end, histories, chart reviews, and G6PD testing were performed for 238 consecutive HIV-infected adult clinic patients. The overall prevalence of G6PD deficiency (8.8%) was similar in males (9.3%) and females (8.5%), and higher in Haitians (18%) than Dominicans (6.4%; P = 0.01). By logistic regression, three clinical variables predicted G6PD status: maternal country of birth (P = 0.01) and a history of hemolysis (P = 0.01) or severe anemia (P = 0.03). Using these criteria, an algorithm was developed, in which a patient subset was identified that would benefit most from G6PD screening, yielding a sensitivity of 94.7% and a specificity of 97.2%, increasing the pretest probability (8.8–15.1%), and halving the number of patients needing testing. This algorithm may provide a cost-effective strategy for improving care in resource-limited settings. PMID:26240158

  9. Stroke outcomes in Malawi, a country with high prevalence of HIV: a prospective follow-up study.

    Terttu Heikinheimo

    Full Text Available BACKGROUND: Stroke contributes significantly to disability and mortality in developing countries yet little is known about the determinants of stroke outcomes in such countries. 12% of Malawian adults have HIV/AIDS. It is not known whether having HIV-infection alters the outcome of stroke. The aim of this study was to document the functional outcome and mortality at 1 year of first-ever acute stroke in Malawi. Also to find out if the baseline variables, including HIV-infection, affect the outcome of stroke. METHODS AND FINDINGS: 147 adult patients with first-ever acute stroke were prospectively followed up for 12 months. Conventional risk factors and HIV-infection were assessed at baseline. Stroke severity was evaluated with modified National Institute of Health Stroke Scale (mNIHSS and functional outcome with modified Rankin scale (mRS. Fifty (34% of patients were HIV-seropositive. 53.4% of patients had a poor outcome (severe disability or death, mRS 4-6 at 1 year. Poor outcome was related to stroke severity and female gender but not to presence of HIV-infection. HIV-seropositive patients were younger and had less often common risk factors for stroke. They suffer more often ischemic stroke than HIV-seronegative patients. CONCLUSIONS: Mild stroke and male gender were associated with favourable outcome. HIV-infection is common in stroke patients in Malawi but does not worsen the outcome of stroke. However, it may be a risk factor for ischemic stroke for young people, who do not have the common stroke risk factors. Our results are significant, because stroke outcome in HIV-seropositive patients has not been studied before in a setting such as ours, with very limited resources and a high prevalence of HIV.

  10. Interventions to reduce risky sexual behaviour for preventing HIV infection in workers in occupational settings.

    Ojo, Olumuyiwa; Verbeek, Jos H; Rasanen, Kimmo; Heikkinen, Jarmo; Isotalo, Leena K; Mngoma, Nomusa; Ruotsalainen, Eija

    2011-12-07

    The workplace provides an important avenue to prevent HIV. To evaluate the effect of behavioral interventions for reducing HIV on high risk sexual behavior when delivered in an occupational setting. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO up until March 2011 and CINAHL, LILACS, DARE, OSH Update, and EPPI database up until October 2010. Randomised control trials (RCTs) in occupational settings or among workers at high risk for HIV that measured HIV, sexual transmitted diseases (STD), Voluntary Counseling and Testing (VCT), or risky sexual behaviour. Two reviewers independently selected studies for inclusion, extracted data and assessed risk of bias. We pooled studies that were similar. We found 8 RCTs with 11,164 participants but one study did not provide enough data. Studies compared VCT to no VCT and education to no intervention and to alternative education.VCT uptake increased to 51% when provided at the workplace compared to a voucher for VCT (RR=14.0 (95% CI 11.8 to16.7)). After VCT, self-reported STD decreased (RR = 0.10 (95% CI 0.01 to 0.73)) but HIV incidence (RR=1.4 (95% CI 0.7 to 2.7)) and unprotected sex (RR=0.71 (0.48 to 1.06)) did not decrease significantly. .Education reduced STDs (RR = 0.68 (95%CI 0.48 to 0.96)), unprotected sex (Standardised Mean Difference (SMD)= -0.17 (95% CI -0.29 to -0.05), sex with a commercial sex worker (RR = 0.88 (95% CI 0.81 to 0.96) but not multiple sexual partners (Mean Difference (MD) = -0.22 (95% CI -0.52 to 0.08) nor use of alcohol before sex (MD = -0.01 (95% CI of -0.11 to 0.08). Workplace interventions to prevent HIV are feasible. There is moderate quality evidence that VCT offered at the work site increases the uptake of testing. Even though this did no lower HIV-incidence, there was a decrease in self-reported sexual transmitted diseases and a decrease in risky sexual behaviour. There is low quality evidence that educational interventions decrease sexually

  11. No association between gender inequality and peak HIV prevalence in developing countries - an ecological study.

    Kenyon, Chris R; Buyze, Jozefien

    2015-01-01

    The prevalence of both gender inequality and HIV prevalence vary considerably both within all developing countries and within those in sub-Saharan Africa. We test the hypothesis that the extent of gender inequality is associated with national peak HIV prevalence. Linear regression was used to test the association between national peak HIV prevalence and three markers of gender equality - the gender-related development index (GDI), the gender empowerment measure (GEM), and the gender inequality index (GII). No evidence was found of a positive relationship between gender inequality and HIV prevalence, either in the analyses of all developing countries or those limited to Africa. In the bivariate analyses limited to Africa, there was a positive association between the two measures of gender "equality" and peak HIV prevalence (GDI: coefficient 28, 95% confidence interval (CI) 9.1-46.8; GEM: coefficient 54.8, 95% CI 20.5-89.1). There was also a negative association between the marker of gender "inequality" and peak HIV prevalence (GII: coefficient -66.9, 95% CI -112.8 to -21.0). These associations all disappeared on multivariate analyses. We could not find any evidence to support the hypothesis that variations in the extent of gender inequality explain variations in HIV prevalence in developing countries.

  12. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referr...

  13. HIV Prevalence and Risk Behaviors in Male to Female (MTF) Transgender Persons in Tijuana, Mexico.

    Salas-Espinoza, Kristian Jesús; Menchaca-Diaz, Rufino; Patterson, Thomas L; Urada, Lianne A; Smith, Davey; Strathdee, Steffanie A; Pitpitan, Eileen V

    2017-12-01

    Compared to HIV research on men who have sex with men, less is known about the risks and vulnerabilities for HIV among Male to Female (MTF) transgender persons, particularly in different geographic regions like Mexico. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, no precedent data exists on the MTF transgender population. Our aims were to estimate HIV prevalence and examine the behaviors and characteristics of the population. We conducted a cross-sectional study of 100 MTF transgender persons recruited through time location sampling in 2012. Participants underwent interviewer-administered (paper and pen) surveys and rapid tests for HIV. Descriptive univariate analyses were conducted on various factors, including sociodemographics, substance use, accessing social services (requested vs. received), stigma, and sex behaviors. A total of 22% tested positive for HIV, a prevalence higher than other key populations at risk for HIV in Tijuana.

  14. Strong association between in-migration and HIV prevalence in urban sub-Saharan Africa.

    Voeten, Hélène A C M; Vissers, Debby C J; Gregson, Simon; Zaba, Basia; White, Richard G; de Vlas, Sake J; Habbema, J Dik F

    2010-04-01

    Enormous variation exists in HIV prevalence between countries in sub-Saharan Africa. The contribution of migration to the spread of HIV has long been recognized, but its effect at the population level has never been assessed. In this ecological analysis, we explore how much variation in HIV prevalence in urban sub-Saharan Africa is explained by in-migration. We performed a linear regression to analyze the association between the proportion of recent in-migrants and HIV prevalence for men and women in urban areas, using 60 data points from 28 sub-Saharan African countries between 1987 and 2005. We found a strong association between recent in-migration and HIV prevalence for women (Pearson R = 57%, P Africa (R = 50%, P = 0.003). For both genders, the association was strongest between 1985 and 1994, slightly weaker between 1995 and 1999, and nonexistent as from 2000. The overall association for both men and women was not confounded by the developmental indicators GNI per capita, income inequalities, or adult literacy. Migration explains much of the variation in HIV spread in urban areas of sub-Saharan Africa, especially before the year 2000, after which HIV prevalences started to level off in many countries. Our findings suggest that migration is an important factor in the spread of HIV, especially in rapidly increasing epidemics. This may be of relevance to the current HIV epidemics in China and India.

  15. The impact of HIV prevalence, conflict, corruption, and GDP/capita on treatment cascades: data from 137 countries.

    Levi, Jacob; Pozniak, Anton; Heath, Katherine; Hill, Andrew

    2018-04-01

    In 2014, UNAIDS and partners set the 90-90-90 targets for the HIV treatment cascade. Multiple social, political and structural factors might influence progress towards these targets. We assessed how close countries and regions are to reaching these targets, and compared cascade outcomes with HIV prevalence, gross domestic product (GDP)/capita, conflict and corruption. Country-level HIV cascade data on diagnosis, ART coverage and viral suppression, from 2010 to 2016 were extracted from national reports, published papers and the www.AIDSinfoOnline database, and analysed. Weighted least-squares regression was used to assess predictors of cascade achievement: region, HIV prevalence, GDP/capita, the 2016 Corruption Perceptions Index (CPI), which is an international ranking system, and the 2016 Global Peace Index (GPI), which ranks all countries based on three main categories: societal safety, militarisation and conflict. Data were available for diagnosis for 84 countries, ART coverage for 137 countries, and viral suppression for 94 countries. Regions with the lowest ART coverage were South-east Asia and Pacific (36%), Eastern Europe and Central Asia (17%), and Middle East and North Africa (13%). Lower HIV prevalence was associated with poorer cascade results. Countries with higher GDP/capita achieved higher ART coverage ( P corruption had lower ART coverage ( P 2.5 all had ART coverage of corruption and conflict levels.

  16. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia.

    Amy Weissman

    Full Text Available Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia.Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ≥18 years, identified as male at birth and self-identified/expressed as a different gender, and reported having sex with at least one male partner in past year. From six major urban centers of Cambodia, 891 transgender individuals were recruited.The majority of the 891 participants self-identified as third gender or female (94.5%, were young (median age 23, IQR [20-27], had secondary education or higher (80.5%, not married (89.7%, and employed (90.2%. The majority had first sex before 18 years (66.8%, with a male (79.9%, 37.9% having been paid or paying for this first sex. The rate of HIV positivity among participants was found to be 4.15%. Consistent condom use with male and female partners was low with all partner types, but particularly low with male partners when paying for sex (20.3%. The majority of participants reported having experienced discrimination in their lifetime (54.8% and 30.3% had been assaulted. Multivariate analysis revealed that older age (adjusted OR = 14.73 [4.20, 51.67] for age 35-44 and adjusted OR = 7.63 [2.55, 22.81] for age 30-34, only having a primary school education or no schooling at all (adjusted OR = 2.62 [1.18, 5.80], being a resident of Siem Reap (adjusted OR = 7.44 [2.37, 23.29], receiving payment at first sex (adjusted OR = 2.26 [1.00, 5.11], having sex during/after using drugs (adjusted OR = 2.90 [1.09, 7.73], inconsistent condom use during last anal sex (adjusted OR = 3.84 [1.58, 9.33], and reporting low self-esteem (adjusted OR = 3.25 [1.35, 7.85] were

  17. Hepatitis C in HIV-infected individuals: a systematic review and meta-analysis of estimated prevalence in Africa.

    Azevedo, Tiago Castro Lopes; Zwahlen, Marcel; Rauch, Andri; Egger, Matthias; Wandeler, Gilles

    2016-01-01

    Although hepatitis C virus (HCV) screening is recommended for all HIV-infected patients initiating antiretroviral therapy, data on epidemiologic characteristics of HCV infection in resource-limited settings are scarce. We searched PubMed and EMBASE for studies assessing the prevalence of HCV infection among HIV-infected individuals in Africa and extracted data on laboratory methods used. Prevalence estimates from individual studies were combined for each country using random-effects meta-analysis. The importance of study design, population and setting as well as type of test (anti-HCV antibody tests and polymerase chain reactions) was examined with meta-regression. Three randomized controlled trials, 28 cohort studies and 121 cross-sectional analyses with 108,180 HIV-infected individuals from 35 countries were included. The majority of data came from outpatient populations (55%), followed by blood donors (15%) and pregnant women (14%). Based on estimates from 159 study populations, anti-HCV positivity prevalence ranged between 3.3% (95% confidence interval (CI) 1.8-4.7) in Southern Africa and 42.3% (95% CI 4.1-80.5) in North Africa. Study design, type of setting and age distribution did not influence this prevalence significantly. The prevalence of replicating HCV infection, estimated from data of 29 cohorts, was 2.0% (95% CI 1.5-2.6). Ten studies from nine countries reported the HCV genotype of 74 samples, 53% were genotype 1, 24% genotype 2, 14% genotype 4 and 9% genotypes 3, 5 or 6. The prevalence of anti-HCV antibodies is high in HIV-infected patients in Africa, but replicating HCV infection is rare and varies widely across countries.

  18. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008.

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother-to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Prevalence of HIV in pregnant women in Mumbai is decreasing.

  19. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    Ira Shah

    2017-01-01

    Full Text Available Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing.

  20. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing. PMID:29302524

  1. Prevalence of chronic kidney disease in Peruvian primary care setting.

    Herrera-Añazco, Percy; Taype-Rondan, Alvaro; Lazo-Porras, María; Alberto Quintanilla, E; Ortiz-Soriano, Victor Manuel; Hernandez, Adrian V

    2017-07-19

    Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting. We did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR 30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI). We evaluated 1211 patients (women [59%], mean age 65.8 years [SD: 12.7]). Prevalence of CKD was 18%. Using the estimated glomerular filtration rate (eGFR), the prevalence was 9.3% (95% CI 5.3 - 13.3) in patients without HTN or DM2; 20.2% (95% CI 17.6 - 22.8) in patients with HTN, and 23.9% (95% CI 19.4 - 28.4) in patients with DM2. The most common stages were 1 and 2 with 41.5% and 48%, respectively. Factors associated with CKD in the adjusted analysis were: age in years (PR = 1.03, 95% CI 1.01 - 1.04), DM2 (PR = 3.37, 95% CI 1.09 - 10.39), HTN plus DM2 (PR = 3.90, 95% CI 1.54 - 9.88), and uric acid from 5 to DM2, older age and hyperuricemia have higher prevalence of CKD.

  2. HIV prevalence, AIDS knowledge, and condom use among female sex workers in Santiago, Chile.

    Barrientos, Jaime E; Bozon, Michel; Ortiz, Edith; Arredondo, Anabella

    2007-08-01

    This paper describes HIV seroprevalence, knowledge of HIV transmission, and condom use among female sex workers (FSW) attending five specialized sexually transmitted disease (STD) clinics in Santiago, Chile. A short questionnaire with socio-demographic, AIDS knowledge, and condom-use variables was administered to 626 FSW. HIV seroprevalence was estimated with a blood test sent to the Chilean Public Health Institute. ELISA was used to confirm HIV in suspected cases. HIV prevalence was 0%. FSW showed adequate overall knowledge of HIV, even better than reported for the Chilean general population on some items. Condom use with clients was high ("always" = 93.4%), although regular use with steady partners was low ("always" = 9.9%). The zero HIV seroprevalence and consistent condom use with clients confirms the positive impact of intervention strategies for FSW, increasing both correct knowledge of AIDS and condom use with clients and helping decrease these women's HIV/AIDS vulnerability.

  3. HIV prevalence and behavioral studies in female sex workers in Togo: a decline in the prevalence between 2005 and 2011.

    Pitché, Palokinam; Gbetoglo, Komi; Saka, Bayaki; Akakpo, Séfako; Landoh, Dadja Essoya; d'Alméida, Stéphane; Banla, Abiba Kere; Sodji, Dométo; Deku, Kodzo

    2013-01-01

    We determined the sero-prevalence of HIV among female sex workers (FSWs) in Togo identified their sexual risk behaviors. We conducted a cross-sectional study from 17 to 27 December, 2011 on 1106 FSWs in Togo. Venous sample were collected to estimate HIV prevalence as per national algorithms. Behavior data were collected by interviewer-administered questionnaires. Of the 1106 FSWs (mean age = 27.6 years) surveyed, 17% and 63% had their first sexual intercourse before the age of 15 and 18 years respectively. Overall, 43.4% of the FSWs had more than seven clients per week. Most FSWs (95%) said they had sex using a condom in their lifetime while 8.8% had used a condom during their last sexual intercourse. About 79% of FSWs used a condom during their sexual encounters the previous week and 11.6% had used a condom during each of their sexual encounters the previous day. Most FSWs (62.2%) reported to have been tested for HIV. Of these, 145 (13.1%) were HIV positive. HIV sero-prevalence decreased from 19.4% in the south to 7.5% in the north of the country. Behaviors associated with FSW being HIV positive included: FSW having more than 7 clients per week (p sex in brothels (p HIV sero-prevalence among FSWs in 2011 to be 13.1% in Togo, significantly lower than a prevalence of 29.5% estimated previously in 2005. Inconsistent use of condoms was identified as associated with high risk factor for acquiring HIV.

  4. Prevalence and risk factors for HIV infection among men having sex with men in Metro Manila, Philippines.

    Gangcuangco, Louie Mar A; Tan, Maria Lourdes; Berba, Regina P

    2013-09-01

    HIV incidence in the Philippines is increasing at an alarming rate. We conducted this study to understand the factors catalyzing the HIV epidemic among men having sex with men (MSM) in Metro Manila. From November 2009 to January 2010, an HIV testing booth was set up adjacent to bars and restaurants in Metro Manila frequented by MSM at night. Participants aged > or =18 years were interviewed using a structured questionnaire. Rapid HIV antibody screening was performed using SD Bioline HIV 1/2 3.0 (Standard Diagnostics). Of 406 MSM included in the study, the mean age was 26.2 years [standard deviation (SD) 5.4]; 96% believed condoms reduced HIV risk but only 3% reported consistent use. The leading reasons for not using condoms were belief that the partner was HIV negative (34.4%), diminished pleasure (32%), and unavailability (23.4%). The HIV prevalence using the rapid test was 11.8% [95% confidence interval (CI): 8.7- 15.0]. All 40 cases who had a confirmatory Western blot test were positive, of whom 24 were business process outsourcing employees (BPOEs). On multivariate analysis, work as a BPOE [adjusted OR (aOR): 3.37; p=0.001], preference for receptive anal sex (aOR: 5.26; p=0.04), and sex while under the influence of excessive alcohol (aOR: 2.71; p=0.04) were independently associated with HIV. The proportion of BPOEs who consistently use condoms when having insertive anal sex with a stranger was significantly lower compared to non-BPOEs (24.5% versus 38.2%; p=0.02). Urgent interventions are needed to address the HIV epidemic in the Philippines.

  5. High prevalence of HIV p24 antigen among HIV antibody negative prospective blood donors in Ile-Ife, Nigeria.

    Japhet, Margaret Oluwatoyin; Adewumi, Moses Olubusuyi; Adesina, Olufisayo Adeyemi; Donbraye, Emmanuel

    2016-01-01

    Blood transfusion service centers in Nigeria screen donated blood for markers of HIV infection using antibody- (Ab) based rapid test and in some centers, positives are re-tested using Ab-based ELISA. Paucity of data exists on p24 antigen prevalence among HIV Ab-negative donors in Nigeria. This study aims at detecting HIV p24 antigen among prospective blood donors in Osun State, Nigeria. Prospective blood donors negative for HIV antibodies using Determine test kit were re-tested using BIORAD GENSCREEN Ultra Ag-Ab ELISA kit, a fourth-generation ELISA kit that detects HIV antibodies/p24 antigen. Of the 169 HIV Ab-negative prospective donors, 10 (5.9%) were positive for HIV p24 antigen and 70% (7/10) of them were in the age range 18-30 years. Results of this study show that blood transfusion is still one of the major routes of HIV transmission in Nigeria and a higher proportion is among youth. Inclusion of p24 antigen testing into the blood donor screening will help reduce transfusion associated HIV in Nigeria if Nucleic Acid Testing (NAT) of all blood donor samples is not affordable; also, HIV enlightenment programs tailored toward youth may help reduce this rate among donors since more young people donate blood in low/middle-income countries than in high-income countries.

  6. Prevalence of and risk factors for MRSA colonization in HIV-positive outpatients in Singapore

    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.

  7. Low prevalence of H. pylori Infection in HIV-Positive Patients in the Northeast of Brazil

    Silva Cícero IS

    2011-02-01

    Full Text Available Abstract Background This study conducted in Northeastern Brazil, evaluated the prevalence of H. pylori infection and the presence of gastritis in HIV-infected patients. Methods There were included 113 HIV-positive and 141 age-matched HIV-negative patients, who underwent upper gastrointestinal endoscopy for dyspeptic symptoms. H. pylori status was evaluated by urease test and histology. Results The prevalence of H. pylori infection was significantly lower (p H. pylori status and gender, age, HIV viral load, antiretroviral therapy and the use of antibiotics. A lower prevalence of H. pylori was observed among patients with T CD4 cell count below 200/mm3; however, it was not significant. Chronic active antral gastritis was observed in 87.6% of the HIV-infected patients and in 780.4% of the control group (p = 0.11. H. pylori infection was significantly associated with chronic active gastritis in the antrum in both groups, but it was not associated with corpus chronic active gastritis in the HIV-infected patients. Conclusion We demonstrated that the prevalence of H. pylori was significantly lower in HIV-positive patients compared with HIV-negative ones. However, corpus gastritis was frequently observed in the HIV-positive patients, pointing to different mechanisms than H. pylori infection in the genesis of the lesion.

  8. National South African HIV prevalence estimates robust despite substantial test non-participation

    Guy Harling

    2017-07-01

    Full Text Available Background. South African (SA national HIV seroprevalence estimates are of crucial policy relevance in the country, and for the worldwide HIV response. However, the most recent nationally representative HIV test survey in 2012 had 22% test non-participation, leaving the potential for substantial bias in current seroprevalence estimates, even after controlling for selection on observed factors. Objective. To re-estimate national HIV prevalence in SA, controlling for bias due to selection on both observed and unobserved factors in the 2012 SA National HIV Prevalence, Incidence and Behaviour Survey. Methods. We jointly estimated regression models for consent to test and HIV status in a Heckman-type bivariate probit framework. As selection variable, we used assigned interviewer identity, a variable known to predict consent but highly unlikely to be associated with interviewees’ HIV status. From these models, we estimated the HIV status of interviewed participants who did not test. Results. Of 26 710 interviewed participants who were invited to test for HIV, 21.3% of females and 24.3% of males declined. Interviewer identity was strongly correlated with consent to test for HIV; declining a test was weakly associated with HIV serostatus. Our HIV prevalence estimates were not significantly different from those using standard methods to control for bias due to selection on observed factors: 15.1% (95% confidence interval (CI 12.1 - 18.6 v. 14.5% (95% CI 12.8 - 16.3 for 15 - 49-year-old males; 23.3% (95% CI 21.7 - 25.8 v. 23.2% (95% CI 21.3 - 25.1 for 15 - 49-year-old females. Conclusion. The most recent SA HIV prevalence estimates are robust under the strongest available test for selection bias due to missing data. Our findings support the reliability of inferences drawn from such data.

  9. Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa

    Barnighausen Till

    2007-07-01

    Full Text Available Abstract Background To present and compare population-based and antenatal-care (ANC sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations, and with evidence of possible biases inherent to both surveillance systems, we explore differences between the two systems. There is particular emphasis on unrepresentative selection of ANC clinics and unrepresentative testing in the population. Methods HIV sero-prevalence amongst blood samples collected from women consenting to test during the 2005 annual longitudinal population-based serological survey was compared to anonymous unlinked HIV sero-prevalence amongst women attending antenatal care (ANC first visits in six clinics (January to May 2005. Both surveillance systems were conducted as part of the Africa Centre Demographic Information System. Results Population-based HIV prevalence estimates for all women (25.2% and pregnant women (23.7% were significantly lower than that for ANC attendees (37.7%. A large proportion of women attending urban or peri-urban clinics would be predicted to be resident within rural areas. Although overall estimates remained significantly different, presenting and standardising estimates by age and location (clinic for ANC-based estimates and individual-residence for population-based estimates made some group-specific estimates from the two surveillance systems more predictive of one another. Conclusion It is likely that where ANC coverage and contraceptive use is widespread and fertility is low, population-based surveillance under-estimates HIV prevalence due to unrepresentative testing by age, residence and also probably by HIV status, and that ANC sentinel surveillance over

  10. Towards 'reflexive epidemiology': Conflation of cisgender male and transgender women sex workers and implications for global understandings of HIV prevalence.

    Perez-Brumer, Amaya G; Oldenburg, Catherine E; Reisner, Sari L; Clark, Jesse L; Parker, Richard G

    2016-01-01

    The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. 'Male sex workers' have been identified as a 'key population' in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within this group. To assess these potential implications, this study employs self-critique and reflection to grapple with the empiric and conceptual implications of shifting understandings of sexuality and gender within the externally re-created etic category of 'MSM' and 'transgender women' in epidemiologic HIV research. We conducted a sensitivity analysis of our previously published meta-analysis which aimed to identify the scope of peer-reviewed articles assessing HIV prevalence among male sex workers globally between 2004 and 2013. The inclusion of four studies previously excluded due to non-differentiation of cisgender male from transgender women participants (studies from Spain, Thailand, India, and Brazil: 421 total participants) increased the overall estimate of global HIV prevalence among 'men' who engage in sex work from 10.5% (95% CI 9.4-11.5%) to 10.8% (95% CI 9.8-11.8%). The combination of social science critique with empiric epidemiologic analysis represents a first step in defining and operationalising 'reflexive epidemiology'. Grounded in the context of sex work and HIV prevention, this paper highlights the multiplicity of genders and sexualities across a range of social and cultural settings, limitations of existing categories (i.e. 'MSM', 'transgender'), and their global implications for epidemiologic estimates of HIV prevalence.

  11. Prevalence of Internalized HIV-Related Stigma Among HIV-Infected Adults in Care, United States, 2011-2013.

    Baugher, Amy R; Beer, Linda; Fagan, Jennifer L; Mattson, Christine L; Freedman, Mark; Skarbinski, Jacek; Shouse, R Luke

    2017-09-01

    HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown. We sought to determine HIV-related stigma prevalence among adults in care, describe which socio-demographic groups bear the greatest stigma burden, and assess the association between stigma and sustained HIV viral suppression. The Medical Monitoring Project measures characteristics of U.S. HIV-infected adults receiving care using a national probability sample. We used weighted data collected from June 2011 to May 2014 and assessed self-reported internalized stigma based on agreement with six statements. Overall, 79.1% endorsed ≥1 HIV-related stigma statements (n = 13,841). The average stigma score was 2.4 (out of a possible high score of six). White males had the lowest stigma scores while Hispanic/Latina females and transgender persons who were multiracial or other race had the highest. Although stigma was associated with viral suppression, it was no longer associated after adjusting for age. Stigma was common among HIV-infected adults in care. Results suggest individual and community stigma interventions may be needed, particularly among those who are Stigma was not independently associated with viral suppression; however, this sample was limited to adults in care. Examining HIV-infected persons not in care may elucidate stigma's association with viral suppression.

  12. Knowledge, attitudes and practices on HIV/AIDS and prevalence of HIV in the general population of Sucre, Bolivia.

    Terán Calderón, Carolina; Gorena Urizar, Dorian; González Blázquez, Cristina; Alejos Ferreras, Belén; Ramírez Rubio, Oriana; Bolumar Montrull, Francisco; Ortiz Rivera, Marta; del Amo Valero, Julia

    2015-01-01

    To analyse knowledge, attitudes and sexual practices on HIV/AIDS, and estimate HIV prevalence among residents of Sucre (Bolivia). Population-based survey of residents aged 15-49 randomly selected during 2008/2009. Blood samples were collected on Whatman-filter paper and tested with enzyme-linked immunosorbent assay. Knowledge on HIV/AIDS, sexual risk practices and discriminatory attitudes against people living with HIV/AIDS (PLWHA) were modelled with multiple logistic regression. Of 1499 subjects, 59% were women. All subjects were HIV-negative. Inadequate knowledge of HIV/AIDS transmission and prevention was observed in 67% and risk factors varied by gender (interaction p-value<0.05). Discriminatory attitudes were displayed by 85% subjects; associated factors were: rural residence, low educational level and low income. Unsafe sex was reported by 10%; risk factors varied by residence area (interaction p-value<0.05). In urban areas, risk factors were male sex, younger age and being in common-law union. Prevalence of HIV infection is very low and unsafe sex is relatively uncommon. Inadequate knowledge on HIV/AIDS and discriminatory attitudes towards PLWHA are extremely high and are associated to gender, ethnic and economic inequalities. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  13. Community-Level Income Inequality and HIV Prevalence among Persons Who Inject Drugs in Thai Nguyen, Vietnam

    Lim, Travis W.; Frangakis, Constantine; Latkin, Carl; Ha, Tran Viet; Minh, Nguyen Le; Zelaya, Carla; Quan, Vu Minh; Go, Vivian F.

    2014-01-01

    Socioeconomic status has a robust positive relationship with several health outcomes at the individual and population levels, but in the case of HIV prevalence, income inequality may be a better predictor than absolute level of income. Most studies showing a relationship between income inequality and HIV have used entire countries as the unit of analysis. In this study, we examine the association between income inequality at the community level and HIV prevalence in a sample of persons who inject drugs (PWID) in a concentrated epidemic setting. We recruited PWID and non-PWID community participants in Thai Nguyen, Vietnam, and administered a cross-sectional questionnaire; PWID were tested for HIV. We used ecologic regression to model HIV burden in our PWID study population on GINI indices of inequality calculated from total reported incomes of non-PWID community members in each commune. We also modeled HIV burden on interaction terms between GINI index and median commune income, and finally used a multi-level model to control for community level inequality and individual level income. HIV burden among PWID was significantly correlated with the commune GINI coefficient (r = 0.53, p = 0.002). HIV burden was also associated with GINI coefficient (β = 0.082, p = 0.008) and with median commune income (β = −0.018, p = 0.023) in ecological regression. In the multi-level model, higher GINI coefficient at the community level was associated with higher odds of individual HIV infection in PWID (OR = 1.46 per 0.01, p = 0.003) while higher personal income was associated with reduced odds of infection (OR = 0.98 per $10, p = 0.022). This study demonstrates a context where income inequality is associated with HIV prevalence at the community level in a concentrated epidemic. It further suggests that community level socioeconomic factors, both contextual and compositional, could be indirect determinants of HIV infection in PWID. PMID

  14. Prevalence and management of intestinal helminthiasis among HIV-infected patients at Muhimbili National Hospital.

    Mwambete, Kennedy D; Justin-Temu, Mary; Peter, Sharon

    2010-01-01

    A cross-sectional study was conducted at Muhimbili National Hospital (Tanzania) to determine prevalence of helminthiasis among in-patients with HIV/AIDS. After signing an informed consent form, participants answered a sociodemographic and risk factor questionnaire. Fecal specimens from patients with HIV-infected and uninfected patients were screened for intestinal helminthiasis (IHLs) using coprological methods. A total of 146 patients were recruited, of those 66 were HIV-negative while 80 were HIV-negative patients. Thirty-five patients (12 HIV/AIDS and 23 non-HIV/AIDS) had helminthic infections. Hookworms were the most frequently detected helminths among patients living with HIV/AIDS (13.6%) and HIV-negative patients (17.5%), followed by schistosomiasis (9%) detected among HIV-negative individuals only. Prevalence of helminthiases (HLs) was observed to be relatively lower among HIV-infected than uninfected patients, which is ascribable to prophylactic measures adopted for patients with HIV/AIDS. Thus, it is recommended that routine screening for HLs and prophylactic measures should be adopted for the improvement of patients' health status.

  15. HIV prevalence, attitudes and behaviour in clients of a confidential HIV testing and counselling centre in Uganda.

    Müller, O; Barugahare, L; Schwartländer, B; Byaruhanga, E; Kataaha, P; Kyeyune, D; Heckmann, W; Ankrah, M

    1992-08-01

    To describe clients, operation and impact of an African public HIV testing and counselling centre. Analysis of samples from clients attending the AIDS Information Centre (AIC) in Kampala, Uganda in early 1991. HIV-1-positive and HIV-negative consecutive clients (250 of each), 86 consecutive couples, and 200 consecutive clients who were HIV-negative in 1990 and were attending for their repeat test. HIV seroprevalence rates, attitudes, behaviour and behaviour change. HIV-1 prevalence was 28% overall, 24% in men and 35% in women. Reasons for taking the HIV test were a planned marriage or a new relationship (27%; 84% in couples), to plan for the future (35%), distrust of sexual partner (14%) and illness or disease/death (not HIV-specific) of partner (20%). The majority of the reported intentions in response to a positive or a negative HIV test result were positive, demonstrating the ability to cope with this information. Of repeat clients, two (1%) had become HIV-1-positive. The majority of repeat clients reported one sexual partner only (67%) or sexual abstinence (25%). Compared with pre-test information from AIC clients attending for the first time, repeat clients reported casual sexual contacts less often (6 versus 25%) and, of those, the majority used condoms. Our study demonstrates the demand for and the feasibility of confidential HIV testing and counseling services in Uganda, and illustrates the value of these services in achieving behaviour changes. Such services should be considered an additional approach for the reduction of HIV transmission in Africa, especially in areas with high HIV seroprevalence rates.

  16. HIV prevalence and risk behaviours among foreign migrant women residing in Cape Town, South Africa.

    Townsend, Loraine; Giorgio, Maggie; Zembe, Yanga; Cheyip, Mireille; Mathews, Catherine

    2014-10-01

    HIV prevalence and risk behaviour among foreign migrants in South Africa has not been explored. This paper describes the effectiveness of respondent-driven sampling (RDS) to recruit foreign migrant women residing in Cape Town, reports HIV prevalence, and describes key characteristics among them. We conducted a biological and behavioural surveillance survey using RDS. After written informed consent, participants completed an audio computer assisted self-interview and provided a dried blood sample for HIV analysis. HIV prevalence was estimated to be 7 % (CI 4.9-9.5) among 935 women. HIV sero-positivity was associated with older age (p = 0.001), country of origin (p used a condom at last sex with a main partner (p = 0.007). Few women reported early sexual debut, or multiple sexual partners. RDS was successful in recruiting foreign migrant women.

  17. High HIV sero-prevalence among students of institutions of higher education in Southeast Nigeria

    Ijeoma Emeka-Nwabunnia

    2014-04-01

    Full Text Available Objective: To investigate the prevalence and sexual behavioural dynamics of HIV infection in students of institutions of higher education (IHEs as a guide to the design of a tailor-made HIV intervention programmes. Methods: A total of 9 709 sexually matured students from five IHEs in Southeast Nigeria aged 1 9-24 years were recruited to obtain representative data from the institutionalised student population. HIV status was confirmed using enzyme based immuno-assay technique. Demographic and behavioural information were obtained through a structured questionnaire. Association of HIV infection with behavioural risk factors was done using multiple logistics regression model. Results: IHEs in Southeast Nigeria have a higher HIV prevalence of 3.69% against the national projected rate of 201 2. The age-specific prevalence among male students (2.91 % is nonsignificantly (P>0.1 lower than that of females (4.31 %. Female students had higher rate of infection, multiple sexual partner, transactional and forced sex, unusual genital discharge and low condom use when compared with their male counterparts. These risk factors were associated with increased HIV seropositivity. HIV prevalence and sexual risky behaviour were high among students of IHEs when compared with previous estimates of their non-institutionalised age brackets. Unprotected sexual activity have a 4.2 times higher chances of infecting the partner with HIV. Conclusions: The data showed a higher prevalence of HIV infection in students of IHEs in comparison with non-institutionalised persons of the same age bracket. Specifically, it could be inferred that appropriate HIV intervention measures was absent with higher incidence of the infection and risky behaviour found in female students. Therefore, a prioritised tailor-made policy for HIV control for students of IHEs should be considered.

  18. The prevalence of secondary diseases of the HIV patients in the Omsk region: cross sectional study

    Pasechnik, Oksana; Pitsenko, Natalia

    2014-01-01

    The prevalence of secondary diseases of the HIV infected patients who were under observation in medical organizations of Omsk region in 2013 has been studied. 16, 8% of HIV-infected patients had a wide spectrum of secondary diseases, mainly infectious etiology. In the structure of secondary infections the leading position was occupied by tuberculosis (32, 3%), candidiasis (24,4%), bacterial diseases (23,7%). The average risk of tuberculosis diseases is 24 cases for 1000 HIV-infected patients.

  19. 4. Prevalence and Factors Associated with Renal Dysfunction in HIV ...

    Esem

    -Saharan Africa has limited data on HIV related kidney disease with most available data coming from the developed countries. Kidney disease is a recognised complication in HIV infected patients presenting with acute renal failure (ARF) or ...

  20. Decline in the prevalence HIV among pregnant women attending ...

    ZoomUser

    The numbers of ANC sentinel sites and Regional coverage as well as ... revealed a decrease in the magnitude of HIV infection with variations by regions (THIS, 2005; ..... UNAIDS/WHO (1996) Working Group on Global HIV/AIDS and STI ...

  1. Perceptions about the acceptability and prevalence of HIV testing ...

    Yoliswa Ntsepe

    2014-07-25

    Jul 25, 2014 ... Keywords: HIV Counselling and Testing, perceptions, stigma, discrimination and confidentiality, ..... was very little self-initiated HIV testing in their communities. ..... women seek help much earlier as it a normalized behaviour,.

  2. Barriers to access prevention of mother-to-child transmission for HIV positive women in a well-resourced setting in Vietnam

    Wright Pamela

    2008-04-01

    Full Text Available Abstract Background According to Vietnamese policy, HIV-infected women should have access at least to HIV testing and Nevirapine prophylaxis, or where available, to adequate counselling, HIV infection staging, ARV prophylaxis, and infant formula. Many studies in high HIV prevalence settings have reported low coverage of PMTCT services, but there have been few reports from low HIV prevalence settings, such as Asian countries. We investigated the access of HIV-infected pregnant women to PMTCT services in the well-resourced setting of the capital city, Hanoi. Methods Fifty-two HIV positive women enrolled in a self-help group in Hanoi were consulted, through in-depth interviews and bi-weekly meetings, about their experiences in accessing PMTCT services. Results Only 44% and 20% of the women had received minimal and comprehensive PMTCT services, respectively. Nine women did not receive any services. Twenty-two women received no counselling. The women reported being limited by lack of knowledge and information due to poor counselling, gaps in PMTCT services, and fear of stigma and discrimination. HIV testing was done too late for optimal interventions and poor quality of care by health staff was frequently mentioned. Conclusion In a setting where PMTCT is available, HIV-infected women and children did not receive adequate care because of barriers to accessing those services. The results suggest key improvements would be improving quality of counselling and making PMTCT guidelines available to health services. Women should receive early HIV testing with adequate counselling, safe care and prophylaxis in a positive atmosphere towards HIV-infected women.

  3. High prevalence of the metabolic syndrome in HIV-infected patients

    Worm, Signe Westring; Friis-Møller, Nina; Bruyand, Mathias

    2010-01-01

    This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time....

  4. The Prevalence of HIV/AIDS Epidemic in Anambra State, Nigeria ...

    In 2012 AVERT'S HIV/AIDS statistics records Nigeria as the second largest number ... state, Nigeria with 8.7% above the national prevalence average rate of 4.5 per cent. ... Results revealed among others that: biological issues, poverty, female ... false religious assurances against HIV/AIDS, and traditional birth practices are ...

  5. The prevalence of HIV among patients admitted with stroke at the ...

    lmboera

    The respective proportions were 44% vs 24.7%; 26.7% vs 7.6%; 20.0% vs 2.9%; 13.3% vs 1.2%; ... Key words: HIV, stroke, prevalence, hospital, Tanzania ..... The clinical picture of patients with stroke and HIV infection is of importance. As.

  6. HIV-Sero- prevalence trend among blood donors in North East ...

    2017-09-03

    Sep 3, 2017 ... On the other hand, significantly declining fashion of. HIV seroprevalence were observed in the studies done in blood banks of Jimma University Specialized Hos- pital and Gonder University hospital7,8 and NorthWest. Ethiopia.9 The Federal Ministry of Health reported the. National HIV prevalence as 3.5% ...

  7. Prevalence and predictors of late presentation for HIV care in South ...

    2 Division of Global HIV/AIDS and Tuberculosis, Centers for Disease Control and ..... HIV care tended to be more prevalent among males, older people, ..... Newell M-L, McGrath N. Factors associated with pre-ART loss-to-follow up in adults.

  8. Prevalence and risk factors for HIV among people aged 50 years ...

    Background: It is estimated that over ten percent of the 36.7 million people living with HIV (PLWHIV) globally, are those aged ≥50 years. The objective of this study was to determine the prevalence and risk factors for HIV among adult aged 50 years and above in Rombo district, northern Tanzania. Methods: This cross ...

  9. Low sero-prevalence of hepatitis delta antibodies in HIV/ hepatitis B ...

    /198, 3.2% (95% CI 1.14-6.92%), associated with male gender and a duration of more than 5 years since HIV diagnosis. Conclusions: The sero-prevalence of HDV antibodies among the HIV/HBV co-infected patients is low in a Ugandan urban ...

  10. The prevalence and clinical significance of intestinal parasites in HIV-infected patients in Denmark

    Stensvold, Christen Rune; Nielsen, Susanne Dam; Badsberg, Jens Henrik

    2011-01-01

    To investigate the prevalence and clinical significance of intestinal parasites in human immunodeficiency virus (HIV)-infected patients, faecal specimens from 96 HIV-infected patients were submitted to microbiological analyses, including microscopy and polymerase chain reaction for protozoa and e...

  11. HIV-Sero- prevalence trend among blood donors in North East ...

    Background: Although blood transfusion is one of the known therapeutic interventions that cuts across a number of clinical disciplines. It is necessary to test all intending blood donors for HIV infection before donation. The aim of this study was to determine the prevalence of HIV among blood donors at Dessie Blood Bank, ...

  12. HIV prevalence, sexual risk behaviour and sexual mixing patterns among migrants in Amsterdam, The Netherlands

    Gras, M. J.; Weide, J. F.; Langendam, M. W.; Coutinho, R. A.; van den Hoek, A.

    1999-01-01

    To study (1) HIV prevalence; (2) sexual risk behaviour; (3) sexual mixing patterns; (4) determinants of disassortative (between-group) mixing among migrant groups in Amsterdam, the Netherlands and to gain insight into the potential for heterosexual spread of HIV/sexually transmitted diseases.

  13. Prevalence and associated factors of late HIV diagnosis in north ...

    Information regarding age, sex, WHO stage, type of opportunistic condition, HIV testing service and on diagnosis CD4 counts were all collected. On diagnosis CD4 counts <200cells/µl was coded as Late HIV diagnosis. The proportion of with Late HIV diagnosis was calculated and logistic regression modal was used to ...

  14. Prevalence and Factors Associated with Renal Dysfunction in HIV ...

    Background: Despite having the highest disease burden of HIV, Sub-Saharan Africa has limited data on HIV related kidney disease with most available data coming from the developed countries. Kidney disease is a recognised complication in HIV infected patients presenting with acute renal failure (ARF) or chronic kidney ...

  15. Messages about dual contraception in areas of high HIV prevalence ...

    Background. Dual protection is recommended for prevention of unwanted pregnancies and protection against sexually transmitted infections, including HIV. It is critical for HIV-negative women to prevent seroconversion and HIV transmission to their infants during pregnancy and breastfeeding. Methods. Women were ...

  16. Perceptions about the acceptability and prevalence of HIV testing ...

    HIV counselling and testing (HCT) is considered important because it is an entry point to a comprehensive continuum of care for HIV/AIDS. The South African Department of Health launched an HCT campaign in April 2010, and this reached 13,269,746 people by June 2011, of which 16% tested HIV positive and 400,000 of ...

  17. HIV Risk, Prevalence, and Access to Care Among Men Who Have Sex with Men in Lebanon.

    Heimer, Robert; Barbour, Russell; Khouri, Danielle; Crawford, Forrest W; Shebl, Fatma; Aaraj, Elie; Khoshnood, Kaveh

    2017-11-01

    Little is known about HIV prevalence and risk among men who have sex with men (MSM) in much of the Middle East, including Lebanon. Recent national-level surveillance has suggested an increase in HIV prevalence concentrated among men in Lebanon. We undertook a biobehavioral study to provide direct evidence for the spread of HIV. MSM were recruited by respondent-driven sampling, interviewed, and offered HIV testing anonymously at sites located in Beirut, Lebanon, from October 2014 through February 2015. The interview questionnaire was designed to obtain information on participants' sociodemographic situation, sexual behaviors, alcohol and drug use, health, HIV testing and care, and experiences of stigma and discrimination. Individuals not reporting an HIV diagnosis were offered optional, anonymous HIV testing. Among the 292 MSM recruited, we identified 36 cases of HIV (12.3%). A quarter of the MSM were born in Syria and recently arrived in Lebanon. Condom use was uncommon; 65% reported condomless sex with other men. Group sex encounters were reported by 22% of participants. Among the 32 individuals already aware of their infection, 30 were in treatment and receiving antiretroviral therapy. HIV prevalence was substantially increased over past estimates. Efforts to control future increases will have to focus on reducing specific risk behaviors and experience of stigma and abuse, especially among Syrian refugees.

  18. Motivators of couple HIV counseling and testing (CHCT uptake in a rural setting in Uganda

    Victoria Nannozi

    2017-01-01

    Full Text Available Abstract Background Couple HIV Counseling and Testing (CHCT is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. Methods The study was conducted in two sub-counties in a rural district (Mukono district about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. Results The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53 and 49% (26/53 of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC attendance and preparation for marriage. Conclusion The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater

  19. Motivators of couple HIV counseling and testing (CHCT) uptake in a rural setting in Uganda.

    Nannozi, Victoria; Wobudeya, Eric; Matsiko, Nicholas; Gahagan, Jacqueline

    2017-01-23

    Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. The study was conducted in two sub-counties in a rural district (Mukono district) about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT) members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53) and 49% (26/53) of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC) attendance and preparation for marriage. The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater attention to enhancers of CHCT programming is needed in trying to

  20. HIV, HBV and HCV Coinfection Prevalence in Iran--A Systematic Review and Meta-Analysis.

    Fahimeh Bagheri Amiri

    Full Text Available worldwide, hepatitis C and B virus infections (HCV and HCV, are the two most common coinfections with human immunodeficiency virus (HIV and has become a major threat to the survival of HIV-infected persons. The review aimed to estimate the prevalence of HIV, HBV, HCV, HIV/HCV and HIV/HBV and triple coinfections in different subpopulations in Iran.Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports on prevalence of HIV, HBV, HCV and HIV coinfections in different subpopulations in Iran. We systematically reviewed the literature to identify eligible studies from January 1996 to March 2012 in English or Persian/Farsi databases. We extracted the prevalence of HIV antibodies (diagnosed by Elisa confirmed with Western Blot test, HCV antibodies and HBsAg (with confirmatory laboratory test as the main primary outcome. We reported the prevalence of the three infections and coinfections as point and 95% confidence intervals.HIV prevalence varied from %0.00 (95% CI: 0.00-0.003 in the general population to %17.25 (95% CI: 2.94-31.57 in people who inject drugs (PWID. HBV prevalence ranged from % 0.00 (95% CI: 0.00-7.87 in health care workers to % 30.9 (95% CI: 27.88-33.92 in PWID. HCV prevalence ranged from %0.19 (95% CI: 0.00-0.66 in health care workers to %51.46 (95% CI: 34.30-68.62 in PWID. The coinfection of HIV/HBV and also HIV/HCV in the general population and in health care workers was zero, while the most common coinfections were HIV/HCV (10.95%, HIV/HBV (1.88% and triple infections (1.25% in PWID.We found that PWID are severely and disproportionately affected by HIV and the other two infections, HCV and HBV. Screenings of such coinfections need to be reinforced to prevent new infections and also reduce further transmission in their community and to others.

  1. Intestinal Parasitic Infections in HIV Infected and Non-Infected Patients in a Low HIV Prevalence Region, West-Cameroon

    Nkenfou, Céline Nguefeu; Nana, Christelle Tafou; Payne, Vincent Khan

    2013-01-01

    The magnitude of intestinal parasitic infection in acquired immunodeficiency syndrome patients requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several tropical diseases. However, there have been very few studies addressing this issue in Cameroon. This study was conducted to determine the prevalence of intestinal parasitosis in HIV/AIDS patients in Dschang -Cameroon. Stool and blood specimens from HIV/AIDS patients and control group were screened respectively for intestinal parasites and for HIV antibodies. Intestinal parasites were identified using direct microscopy, formalin-ether concentration and Ziehl Neelsen methods. Out of 396 participants recruited among patients consulting at hospital, 42 (10.6%) were HIV positive, thirty of them treatment naïve. The overall prevalence of intestinal parasites was 14.64%. Out of 42 HIV/AIDS patients, 59.5% (25/42) were infected with intestinal parasites, while only 9.32% (33/354) of the HIV negative patients were infected with intestinal parasites. The parasites detected in our study population included Crystosporidium parvum (2.53%), Entamoeba histolytica (7.52%), Entamoeba coli (4.04%), Giardia lamblia (0.25%), Trichuris trichura (0.25%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%). In the HIV infected group, Crystosporidium parvum (19.04%), Entamoeba histolytica (19.04%), Entamoeba coli (21.42%), Giardia lamblia (2.38%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%) were found. Crystosporidium parvum was found to be significantly higher in HIV/AIDS patients than in controls (Pintestinal parasitosis. Routine examinations of stool samples for parasites would significantly benefit the HIV patients by contributing in reducing morbidity and improving the efficiency of antiretroviral treatment. Even after the introduction of free anti-retroviral drugs, opportunistic intestinal infections are still a threat. HIV patients should be screened

  2. Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania

    Kumogola Yusufu

    2010-09-01

    Full Text Available Abstract Background Sentinel surveillance for HIV in ante-natal clinics (ANC remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania. HIV prevalence from ANC surveys in 2000 and 2002 was 10.5% and 10.8% respectively. In previous rounds urban residence, residential mobility, the length of time sexually active before marriage, time since marriage and age of the partner were associated with HIV infection. Methods A third round of HIV sentinel surveillance was conducted at ante-natal clinics in Mwanza region, Tanzania during 2006. We interviewed women attending 27 ante-natal clinics. In 15 clinics we also anonymously tested women for syphilis and HIV infection and linked these results to the questionnaire data. Results HIV prevalence was 7.6% overall in 2006 and 7.4% at the 11 clinics used in previous rounds. Geographical variations in HIV prevalence, apparent in previous rounds, have largely disappeared but syphilis prevalence is still higher in rural clinics. HIV prevalence has declined in urban clinics and is stable in rural clinics. The correlates of HIV infection have changed over time. In this round older age, lower gravidity, remarriage, duration of marriage, sexual activity before marriage, long interval between last birth and pregnancy and child death were all associated with infection. Conclusions HIV prevalence trends concur with results from a community-based cohort in the region. Correlates of HIV infection have also changed and more proximate, individual level factors are now more important, in line with the changing epidemiology of infection in this population.

  3. National HIV/AIDS mortality, prevalence, and incidence rates are associated with the Human Development Index.

    Lou, Li-Xia; Chen, Yi; Yu, Chao-Hui; Li, You-Ming; Ye, Juan

    2014-10-01

    HIV/AIDS is a worldwide threat to human health with mortality, prevalence, and incidence rates varying widely. We evaluated the association between the global HIV/AIDS epidemic and national socioeconomic development. We obtained global age-standardized HIV/AIDS mortality, prevalence, and incidence rates from World Health Statistics Report of the World Health Organization. The human development indexes (HDIs) of 141 countries were obtained from a Human Development Report. Countries were divided into 4 groups according to the HDI distribution. We explored the association between HIV/AIDS epidemic and HDI information using Spearman correlation analysis, regression analysis, and the Kruskal-Wallis test. HIV/AIDS mortality, prevalence, and incidence rates were inversely correlated with national HDI (r = -0.675, -0.519, and -0.398, respectively; P birth, mean years of schooling, expected years of schooling, and gross national income per capita). Low HDI countries had higher HIV/AIDS mortality, prevalence, and incidence rates than that of medium, high, and very high HDI countries. Quantile regression results indicated that HDI had a greater negative effect on the HIV/AIDS epidemic in countries with more severe HIV/AIDS epidemic. Less-developed countries are likely to have more severe HIV/AIDS epidemic. There is a need to pay more attention to HIV/AIDS control in less-developed countries, where lower socioeconomic status might have accelerated the HIV/AIDS epidemic more rapidly. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Longitudinal Trends in the Prevalence of Detectable HIV Viremia: Population-Based Evidence From Rural KwaZulu-Natal, South Africa.

    Vandormael, Alain; Bärnighausen, Till; Herbeck, Joshua; Tomita, Andrew; Phillips, Andrew; Pillay, Deenan; de Oliveira, Tulio; Tanser, Frank

    2018-04-03

    The prevalence of detectable viremia has previously been used to infer the potential for ongoing human immunodeficiency virus (HIV) transmission. To date, no study has evaluated the longitudinal change in the prevalence of detectable viremia within the HIV-positive community (PDV+) and the entire population (PDVP) using data from a sub-Saharan African setting. In 2011, 2013, and 2014, we obtained 6752 HIV-positive and 15415 HIV-negative test results from a population-based surveillance system in the KwaZulu-Natal province of South Africa. We quantified the PDV+ as the proportion of the 6752 HIV-positive results with a viral load >1550 copies/mL and the PDVP as the proportion of the 6752 HIV-positive and 15415 HIV-negative results with a viral load >1550 copies/mL. Between 2011 and 2014, the PDV+ decreased by 16.5 percentage points (pp) for women (from 71.8% to 55.3%) and 10.6 pp for men (from 77.8% to 67.2%). However, a steady rise in the overall HIV prevalence, from 26.7% to 32.4%, offset the declines in the PDV+ for both sexes. For women, the PDVP decreased by only 2.1 pp, from 21.3% to 19.2%, but for men, the PDVP actually increased by 1.6 pp, from 14.6% to 16.2%, over the survey period. The PDV+, which is currently being tracked under the UNAIDS 90-90-90 targets, may not be an accurate indicator of the potential for ongoing HIV transmission. There is a critical need for countries to monitor and report the prevalence of detectable viremia among all adults, irrespective of HIV status.

  5. Opening the Door to Zero New HIV Infections in Closed Settings

    Torriente, Anna; Tadion, Alexander; Hsu, Lee-Nah

    2016-01-01

    Abstract Prisons and other closed settings are high-risk environments for HIV and tuberculosis (TB) transmission. Prisoners often experience overcrowded living conditions and violence?including sexual assault?increasing their vulnerability to HIV and TB. However, high infection rates in prisons affect both prisoners and prison employees. Both groups, in interacting with their families and their communities, represent a potential risk of HIV transmission outside the prison setting. National HI...

  6. Contextualizing gender differences and methamphetamine use with HIV prevalence within a South African community.

    Wechsberg, Wendee M; Doherty, Irene A; Myers, Bronwyn; Morgan-Lopez, Antonio A; Emanuel, Andrea; Carney, Tara; Kline, Tracy L; Zule, William A

    2014-05-01

    This study was conducted in a large Black African township outside of Cape Town, South Africa, where HIV infection has been endemic at extremely high levels for years. Problems associated with high HIV prevalence are compounded by gender inequality and high rates of gender-based violence exacerbated by heavy alcohol use and increasing methamphetamine use. Informal drinking establishments (known as shebeens) were geocoded and mapped. Based on visual examination, we identified 36 neighbourhoods, each of which contained between three to seven drinking venues clustered together. Neighbourhoods were separated from each other by at least 200m. We randomly selected 30 of the 36 neighbourhoods. Outreach workers screened males in shebeens and screened their female partners. This analysis includes 580 study participants recruited from 30 neighbourhoods between 2010 and 2012. All participants completed a baseline questionnaire that included individual-level, couple-level, and neighbourhood-level measures of alcohol and other drug use, HIV infection, and HIV risk behaviours. Multilevel fixed effects regression analyses stratified by gender were conducted to examine correlates of HIV infection. Women were twice as likely as men to be HIV infected, yet they reported fewer sex partners. Neighbourhood prevalence of HIV was correlated with greater likelihood of HIV infection among women, but not men. Neighbourhood methamphetamine use was marginally associated with HIV among women but not among men. At the individual level, heavy alcohol use was marginally associated with HIV infection among men but not among women. Having an HIV positive partner was the strongest correlate of being HIV positive among both men and women. Findings from this study underscore the need for policy makers to direct scarce resources to the communities, places within communities, and populations, especially vulnerable women, where the impact on HIV prevention and onward transmission will be greatest

  7. Prevalence and mortality of cancer among HIV-infected inpatients in Beijing, China.

    Yang, Jun; Su, Shu; Zhao, Hongxin; Wang, Dennis; Wang, Jiali; Zhang, Fujie; Zhao, Yan

    2016-02-16

    Cancer is responsible for elevated HIV-related morbidity and mortality. Research on HIV-infected patients with concurrent cancer is rare in China. The purpose of our study was to investigate the prevalence and risk factors associated with cancer among HIV-infected inpatients in Beijing, and to investigate the mortality and risk factors among HIV-infected inpatients with cancer. Hospital records from a total of 1946 HIV-infected patients were collected from the Beijing Ditan Hospital. The data, from 2008 to 2013, were collected retrospectively. The cancer diagnoses included AIDS-defining cancers (ADC) and non-AIDS defining cancers (NADC). Logistic regression was used to identify risk factors predicting the concurrence of cancer with HIV. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models. 7.7 % (149 cases) of all HIV-infected inpatients had concurrent cancer at their first hospital admission; of those, 33.6 % (50 cases) had ADCs, and 66.4 % (99 cases) had NADCs. The most prevalent NADCs were Hodgkin's lymphoma, gastrointestinal cancer, liver cancer, and lung cancer. Patients who did not accept antiretroviral therapy (ART) were more likely to suffer from cancer [AOR = 2.07 (1.42-3.01), p = 0.001]. Kaplan-Meier curves indicated that the survival probability of HIV-positive cancer patients was significantly lower than that of HIV-positive cancer-free patients (log-rank test, p cancer, the mortality was also higher among those who did not receive ART [AHR = 2.19 (1.84-2.61), p cancer concurrence among hospitalized HIV-infected patients was 7.7 %. Concurrent cancer also increased mortality among HIV-infected patients. ART was protective against concurrent cancer as well as mortality among HIV-infected cancer patients. These results highlight the importance of promoting cancer screening and early ART initiation among HIV-infected patients.

  8. Opening the Door to Zero New HIV Infections in Closed Settings.

    Torriente, Anna; Tadion, Alexander; Hsu, Lee-Nah

    2016-06-01

    Prisons and other closed settings are high-risk environments for HIV and tuberculosis (TB) transmission. Prisoners often experience overcrowded living conditions and violence-including sexual assault-increasing their vulnerability to HIV and TB. However, high infection rates in prisons affect both prisoners and prison employees. Both groups, in interacting with their families and their communities, represent a potential risk of HIV transmission outside the prison setting. National HIV and TB strategies should therefore include measures to prevent transmission and increase access to HIV-related services in prisons. Courts have progressively recognized the human rights of prisoners, including the right to health and access to HIV-related services. A number of national and regional court decisions have affirmed that prison authorities have a duty of care to prisoners and an obligation to ensure that prisoners have access to HIV prevention measures and treatment. Policies and programs on HIV, AIDS, and TB for prison workplaces that are aligned with the ILO's international labor standards can benefit both prisoners and prison employees. In particular, the ILO's HIV and AIDS Recommendation, 2010 (No. 200) affirms the principle of universal access to HIV services and provides guidance for the HIV/TB response in prison settings.

  9. Prevalence of Dyslipidemia Among Antiretroviral-Naive HIV-Infected Individuals in China

    Shen, Yinzhong; Wang, Jiangrong; Wang, Zhenyan; Qi, Tangkai; Song, Wei; Tang, Yang; Liu, Li; Zhang, Renfang; Lu, Hongzhou

    2015-01-01

    Abstract Little is known about the epidemiological features of dyslipidemia among antiretroviral-naive HIV-infected individuals in China. We used a cross-sectional study design to estimate the prevalence of dyslipidemia in this population, and to identify risk factors associated with the presence of dyslipidemia. One thousand five hundred and eighteen antiretroviral-naive HIV-infected individuals and 347 HIV-negative subjects in China were enrolled during 2009 to 2010. Demographics and medical histories were recorded. After an overnight fast, serum samples were collected to measure lipid levels. Factors associated with the presence of dyslipidemia were analyzed by logistic regression. Mean total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL) levels were lower in HIV-positive than HIV-negative subjects, but mean triglyceride (TG) was higher in HIV-positive subjects. The overall prevalence of dyslipidemia in HIV-positive and HIV-negative groups did not differ (75.6% vs. 73.7%, P = 0.580). However, the prevalence of high TC (8.4% vs. 28.2%, P dyslipidemia characterized by high TG and low HDL, which was associated with lower CD4 counts. These data support the assessment of lipid profiles before and after initiation of antiretroviral therapy regardless of age. PMID:26632908

  10. Prevalence and significance of Mycoplasma genitalium in women living with HIV in Denmark

    Madsen, Anne Marie Rosendahl; Thorsteinsson, Kristina; Lebech, Anne-Mette

    2017-01-01

    has been suggested as part of HIV prevention strategies. The objective of this study was to determine the prevalence of M. genitalium in women living with HIV (WLWH) in Denmark, and to compare the result with data on symptoms from the lower abdomen, sexual habits and immune status. 234 women......, recruited from Danish HIV centres as part of a larger observational study on aspects of living with HIV as a woman (the SHADE study), were included. RESULTS: We tested cervical samples for M. genitalium by specific PCR. We found three samples positive (1.3%). The women were between 30 and 50 years old, all...... were of Asian origin, sexually active, and on antiretroviral treatment with supressed HIV RNA and CD4 count >350 cells/µL. None reported symptoms from the lower abdomen. The prevalence of M. genitalium infection in WLWH in Denmark is low, thus systematic screening for M. genitalium in this group does...

  11. Future-oriented tweets predict lower county-level HIV prevalence in the United States.

    Ireland, Molly E; Schwartz, H Andrew; Chen, Qijia; Ungar, Lyle H; Albarracín, Dolores

    2015-12-01

    Future orientation promotes health and well-being at the individual level. Computerized text analysis of a dataset encompassing billions of words used across the United States on Twitter tested whether community-level rates of future-oriented messages correlated with lower human immunodeficiency virus (HIV) rates and moderated the association between behavioral risk indicators and HIV. Over 150 million tweets mapped to U.S. counties were analyzed using 2 methods of text analysis. First, county-level HIV rates (cases per 100,000) were regressed on aggregate usage of future-oriented language (e.g., will, gonna). A second data-driven method regressed HIV rates on individual words and phrases. Results showed that counties with higher rates of future tense on Twitter had fewer HIV cases, independent of strong structural predictors of HIV such as population density. Future-oriented messages also appeared to buffer health risk: Sexually transmitted infection rates and references to risky behavior on Twitter were associated with higher HIV prevalence in all counties except those with high rates of future orientation. Data-driven analyses likewise showed that words and phrases referencing the future (e.g., tomorrow, would be) correlated with lower HIV prevalence. Integrating big data approaches to text analysis and epidemiology with psychological theory may provide an inexpensive, real-time method of anticipating outbreaks of HIV and etiologically similar diseases. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  12. Association of HIV prevalence and concurrency of sexual partnerships in South Africa’s language groups: An ecological analysis

    Chris Kenyon

    2013-01-01

    Background. There is considerable variation in HIV prevalence between different language groups in South Africa (SA). Sexual partner concurrency has been linked to the spread of HIV, but its effect on differential HIV transmission within SA’s language groups has not been investigated quantitatively. Objective. This ecological analysis was intended to explore the degree to which the variation in HIV prevalence according to language group can be explained by differential concurrency rates. ...

  13. High HIV prevalence and the internet as a source of HIV-related service information at a community-based organization in Peru: a cross-sectional study of men who have sex with men.

    Passaro, R Colby; Haley, Connie A; Sanchez, Hugo; Vermund, Sten H; Kipp, Aaron M

    2016-08-24

    The HIV prevalence among men who have sex with men (MSM) in Peru (12.4 %) is 30 times higher than in the general adult population (0.4 %). It is critical for community-based organizations to understand how to provide HIV services to MSM while maximizing limited resources. This study describes the HIV prevalence and risk profiles of MSM seeking HIV services at a community-based organization in Lima, Peru. It then compares HIV prevalence between those who found out about the HIV services through different sources. A cross-sectional study of MSM seeking HIV services at Epicentro Salud in Lima, Peru for the first time between April 2012 and October 2013. We compared HIV prevalence among MSM who found out about Epicentro via online sources of information (N = 419), those using in-person sources (friends, partners) (N = 907), and sex workers (N = 140) using multivariable logistic regression models. HIV prevalence was 18.3 % overall: 23.2 % among MSM using online sources, 19.3 % among sex workers, and 15.9 % among MSM using in-person sources. However, when compared to the in-person group, sexual risk behaviors were not statistically higher among MSM using online sources. For the sex worker group, some behaviors were more common, while others were less. After adjusting for confounders, the odds of having HIV was higher for the online group (Odds Ratio = 1.61; 95 % Confidence Interval: 1.19-2.18), but not for the sex worker group (OR = 1.12; 95 % CI: 0.68-1.86), compared to the in-person group. Internet-based promotion appears to successfully reach MSM at high risk of HIV in Peru. Outreach via this medium can facilitate HIV diagnosis, which is the critical first step in getting infected individuals into HIV care. For community-based organizations working in resource-limited settings, this may be an effective strategy for engaging a subset of high-risk persons in HIV care.

  14. High HIV prevalence and the internet as a source of HIV-related service information at a community-based organization in Peru: a cross-sectional study of men who have sex with men

    R. Colby Passaro

    2016-08-01

    Full Text Available Abstract Background The HIV prevalence among men who have sex with men (MSM in Peru (12.4 % is 30 times higher than in the general adult population (0.4 %. It is critical for community-based organizations to understand how to provide HIV services to MSM while maximizing limited resources. This study describes the HIV prevalence and risk profiles of MSM seeking HIV services at a community-based organization in Lima, Peru. It then compares HIV prevalence between those who found out about the HIV services through different sources. Methods A cross-sectional study of MSM seeking HIV services at Epicentro Salud in Lima, Peru for the first time between April 2012 and October 2013. We compared HIV prevalence among MSM who found out about Epicentro via online sources of information (N = 419, those using in-person sources (friends, partners (N = 907, and sex workers (N = 140 using multivariable logistic regression models. Results HIV prevalence was 18.3 % overall: 23.2 % among MSM using online sources, 19.3 % among sex workers, and 15.9 % among MSM using in-person sources. However, when compared to the in-person group, sexual risk behaviors were not statistically higher among MSM using online sources. For the sex worker group, some behaviors were more common, while others were less. After adjusting for confounders, the odds of having HIV was higher for the online group (Odds Ratio = 1.61; 95 % Confidence Interval: 1.19–2.18, but not for the sex worker group (OR = 1.12; 95 % CI: 0.68–1.86, compared to the in-person group. Conclusion Internet-based promotion appears to successfully reach MSM at high risk of HIV in Peru. Outreach via this medium can facilitate HIV diagnosis, which is the critical first step in getting infected individuals into HIV care. For community-based organizations working in resource-limited settings, this may be an effective strategy for engaging a subset of high-risk persons in HIV care.

  15. Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria

    Frederick Olusegun Akinbo

    2010-10-01

    Full Text Available This study was carried out to determine the presence of intestinal parasites and their correlation with CD4+ T-cell counts and demographics among human immunodeficiency virus (HIV-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals were examined for ova, cysts, or parasites, using standard procedures. In addition, patient's blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIV-positive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (P<0.0001 risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count <200cell/µl, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIV-positive patients. The level of education, occupation, and source of water among HIV patients significantly (P<0.0001 affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count <200 cells/µl was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated.

  16. Increasing adolescent HIV prevalence in Eastern Zimbabwe--evidence of long-term survivors of mother-to-child transmission?

    Jeffrey W Eaton

    Full Text Available Recent data from the Manicaland HIV/STD Prevention Project, a general-population open HIV cohort study, suggested that between 2004 and 2007 HIV prevalence amongst males aged 15-17 years in eastern Zimbabwe increased from 1.20% to 2.23%, and in females remained unchanged at 2.23% to 2.39%, while prevalence continued to decline in the rest of the adult population. We assess whether the more likely source of the increase in adolescent HIV prevalence is recent sexual HIV acquisition, or the aging of long-term survivors of perinatal HIV acquisition that occurred during the early growth of the epidemic. Using data collected between August 2006 and November 2008, we investigated associations between adolescent HIV and (1 maternal orphanhood and maternal HIV status, (2 reported sexual behaviour, and (3 reporting recurring sickness or chronic illness, suggesting infected adolescents might be in a late stage of HIV infection. HIV-infected adolescent males were more likely to be maternal orphans (RR = 2.97, p<0.001 and both HIV-infected adolescent males and females were more likely to be maternal orphans or have an HIV-infected mother (male RR = 1.83, p<0.001; female RR = 16.6, p<0.001. None of 22 HIV-infected adolescent males and only three of 23 HIV-infected females reported ever having had sex. HIV-infected adolescents were 60% more likely to report illness than HIV-infected young adults. Taken together, all three hypotheses suggest that recent increases in adolescent HIV prevalence in eastern Zimbabwe are more likely attributable to long-term survival of mother-to-child transmission rather than increases in risky sexual behaviour. HIV prevalence in adolescents and young adults cannot be used as a surrogate for recent HIV incidence, and health systems should prepare for increasing numbers of long-term infected adolescents.

  17. Retrospective analysis of the prevalence of and factors associated with condom use among young HIV-infected women in Cameroon

    Mariecel Pilapil

    2016-01-01

    policy in resource-limited settings with high HIV prevalence.

  18. A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities.

    Renata Viebrantz Enne Sgarbi

    Full Text Available Prior studies have reported higher HIV prevalence among prisoners than the general population in Brazil, but data have been derived from single prisons. The aim of this study was to evaluate HIV testing practices, prevalence and linkage to care among inmates in a network of 12 prisons.We administered a questionnaire to a population-based sample of inmates from 12 prisons in Central-West Brazil and collected sera for HIV and syphilis testing from January to December 2013. We evaluated factors associated with HIV testing and infection using multivariable logistic regression models. Six months after HIV testing, we assessed whether each HIV-infected prisoner was engaged in clinical care and whether they had started antiretroviral therapy.We recruited 3,362 inmates, of whom 2,843 (85% were men from 8 prisons, and 519 (15% were women from 4 prisons. Forty-five percent of participants reported never having been tested for HIV previously. In multivariable analysis, the variables associated with previous HIV testing were lack of a stable partner (adjusted odds ratio [AOR]: 1.38; 95% CI: 1.18-1.60, completed more than four years of schooling (AOR 1.40; 95% CI: 1.20-1.64, history of previous incarceration (AOR: 1.68; 95% CI: 1.43-1.98, history of mental illness (AOR 1.52; 95% CI: 1.31-1.78 and previous surgery (AOR 1.31; 95% CI: 1.12-1.52. Fifty-four (1.6% of all participants tested positive for HIV; this included 44 (1.54% men and 10 (1.92% women. Among male inmates, HIV infection was associated with homosexuality (AOR 6.20, 95% CI: 1.73-22.22, self-report of mental illness (AOR 2.18, 95% CI: 1.13-4.18, history of sexually transmitted infections (AOR 3.28, 95% CI: 1.64-6.56, and syphilis sero-positivity (AOR 2.54, 95% CI: 1.20-5.39. Among HIV-infected individuals, 34 (63% were unaware of their HIV status; only 23 of these 34 (68% newly diagnosed participants could be reached at six month follow-up, and 21 of 23 (91% were engaged in HIV care.HIV testing

  19. Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions

    Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

    2013-01-01

    Introduction HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. Methods This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. Results High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs “got what they deserved” (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable

  20. Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions.

    Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

    2013-11-13

    HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs "got what they deserved" (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable drivers, which are consistent with

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

    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.

  2. Prevalence of human immunodeficiency virus (HIV) infection among ...

    AJB SERVER

    2007-02-05

    Feb 5, 2007 ... associated virus (LAV, now HIV1.). In the same year,. Robert Gallo and colleagues, working at the National. Cancer Institute (NCI), USA made a similar discovery while in their quest to find cancer-causing viruses. In. 1986 a second closely related virus, termed HIV 2 was isolated from a patient from West ...

  3. Prevalence of intestinal parasitic infections among HIV patients in ...

    2010-10-29

    Oct 29, 2010 ... Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in. HIV-positive patients is advocated. Keywords: intestinal parasites; HIV; CD4 count; Demographics; Benin City. Received: 2 August 2010; Revised: 25 September 2010; ...

  4. Prevalence of HIV infection among trauma patients admitted to ...

    Tanzania Journal of Health Research Volume 12, Number 4, October 2010 ... Thus, all trauma health care workers in this region need to practice universal barrier ... of HIV in trauma patients is vital for education and post-exposure prophylaxis. ... of HIV among trauma patients admitted at Bugando Medical Centre in Mwanza, ...

  5. Prevalence of HIV positive blood donors among screened ...

    Two thousand five hundred and thirty two (2,532) males, aged 25 – 50 years potential blood donors were randomly selected from the total number of volunteer blood donors who satisfied the initial screening criteria for donating blood, and were screened for HIV using Immunocomb II (HIV 1 and 2 Bispot) and Recombigen ...

  6. Prevalence and associated factors of late HIV diagnosis in north ...

    User

    Moreover, there is still a lack of studies addressing the risk factors ..... Jiang, H., Yin, J., Fan, Y., Liu, J., Zhang, Z, Liu, L. & Nie, S. (2015) Gender difference in advanced HIV disease ... Incidence of HIV-associated tuberculosis among individuals taking combination antiretroviral therapy: a systematic review and meta-analysis.

  7. Anal and penile high-risk human papillomavirus prevalence in HIV-negative and HIV-infected MSM

    van Aar, Fleur; Mooij, Sofie H.; van der Sande, Marianne A. B.; Speksnijder, Arjen G. C. L.; Stolte, Ineke G.; Meijer, Chris J. L. M.; Verhagen, Dominique W. M.; King, Audrey J.; de Vries, Henry J. C.; Schim van der Loeff, Maarten F.

    2013-01-01

    Anal and penile high-risk human papillomavirus (HPV) infection is associated with anogenital cancer, which is especially common in HIV-infected MSM. We assessed HPV prevalence and determinants in MSM. Analysis of baseline data from a prospective cohort study. MSM aged 18 years or older were

  8. Estimates of global HIV/AIDS mortality, prevalence and incidence rates, and their association with the Human Development Index

    Kamyar Mansori; Erfan Ayubi; Fatemeh Khosravi Shadmani; Shiva Mansouri Hanis; Somayeh Khazaei; Mohadeseh Sani; Yousef Moradi; Salman Khazaei; Abolfazl Mohammadbeigi

    2017-01-01

    Background: HIV/AIDS is one of greatest global public health concerns today due to the high incidence, prevalence and mortality rates. The aim of this research was investigate and estimate the global HIV/AIDS mortality, prevalence and incidence rates, and explore their associations with the Human Development Index. Methods: The global age-standardized rates of mortality, prevalence and incidence of HIV/AIDS were obtained from the UNAIDS for different countries in 2015. The human developm...

  9. Prevalence of HIV infection among former commercial plasma donors in rural eastern China.

    Wu, Z; Rou, K; Detels, R

    2001-03-01

    Sporadic reports of HIV-1 infection among commercial plasma donors in China between 1994 and 1995. (1) To determine the prevalence of HIV infection among repeat plasma donors; (2) to identify factors associated with HIV infection; and (3) to describe characteristics associated with secondary transmission. Plasma/blood donors who had a history of donating plasma/blood before March 1, 1995, their spouses, and their children under 5 years were recruited for a cross-sectional study. A questionnaire and an HIV test were collected anonymously. Information collected included demographic characteristics, sexual behaviour, recreational drug use and history of medical care and blood/plasma donation. HIV antibody was identified by the Hema-Strip rapid test and confirmed by Western blot. The prevalence of HIV infection was calculated and risk factors associated with infection determined by univariate analyses followed by multivariate modelling. A total of 1517 individuals were interviewed and tested, of whom 1043 adults admitted to donating plasma. The prevalence of HIV infection among plasma donors was 12.5% and among their non-donor spouses was 2.1%. Prevalence was inversely related to educational level and was higher in married participants, but was not associated with medical care, drug abuse or multiple sexual partners. A higher frequency of plasma donation was directly associated with a higher risk of HIV infection. Multivariate analyses demonstrated that being HIV-positive was associated with being 30 to 49 years old [odds ratio (OR) = 1.9], donating both plasma and blood (OR = 2.5), and the frequency of plasma donation (OR = 14 for >10 donations per month). The study demonstrated that the prevalence of HIV infection in the commercial plasma donor population was alarmingly high. Many married individuals and those getting married in the future will transmit the virus to their spouses and future children. Plasma donors need to be alerted to the risk of being infected with

  10. KHOMANANI: AN HIV AND AIDS COMMUNITY MOBILISATION PROGRAMME FOR RESOURCE-CONSTRAINED SETTINGS

    Shilubane, Tlangelani

    2013-05-01

    Full Text Available An overview of HIV and AIDS statistics indicates that there were 31.6 million people living with HIV in 2010, and that 68% of those people were from Sub-Saharan Africa (UNAIDS, 2011:07. In South Africa, one of the countries in Sub-Saharan Africa, HIV prevalence among people between the ages of 15 and 49 has stabilised at 17.8%, with the absolute number of people living with HIV (PLHIV showing a steep increase of approximately 100 000 additional PLHIV each year. The number of people aged 15 and older living with HIV is estimated to be 5 300 000. These figures actually mean that one out of every six people with HIV in the world lives in South Africa (UNAIDS, 2011:21. The authors therefore postulate that these statistics encapsulate the devastation that HIV and AIDS is causing, particularly in South Africa, which arguably carries the heaviest HIV and AIDS burden in the world. Initially South Africa’s efforts to mitigate the impact of HIV and AIDS were characterised by programme designs which followed an inflexible biomedical approach that did not focus on the influence of socio-economic and structural factors in addressing the pandemic. This situation, among others, contributed to raise the country’s HIV infection growth rate to among the highest in the world (Kahn, 2006:4.

  11. HIV prevalence and characteristics of sex work among female sex workers in Hargeisa, Somaliland, Somalia.

    Kriitmaa, Kelsi; Testa, Adrienne; Osman, Mohamed; Bozicevic, Ivana; Riedner, Gabriele; Malungu, Jacqueline; Irving, Greg; Abdalla, Ismail

    2010-07-01

    To measure prevalence of HIV and syphilis and describe characteristics of sex work among female sex workers (FSWs) in Hargeisa, Somaliland, Somalia. A cross-sectional survey recruited 237 FSWs using respondent-driven sampling (RDS). A face-to-face, structured interview using handheld-assisted personal interviewing (HAPI) on personal digital assistants (PDAs) was completed and blood collected for serological testing. FSWs 15-19 years old accounted for 6.9% of the population; 20-24 year-old constituted an additional 18.0%. The majority (86.6%) never attended school. International (59.0%) and interzonal (10.7%) migration was common. Most (95.7%) reported no other source of income; 13.8% had five or more clients in the last 7 days. A minority (38.4%) had heard of STIs, even fewer (6.9%) held no misconceptions about HIV. Only 24% of FSW reported using a condom at last transactional sex, and 4% reported ever been tested for HIV. HIV prevalence was 5.2% and syphilis prevalence was 3.1%. Sex work in Hargeisa, Somaliland, Somalia, is characterized by high numbers of sexual acts and extremely low knowledge of HIV. This study illustrates the need for targeted HIV prevention interventions focusing on HIV testing, risk-reduction awareness raising, and review of condom availability and distribution mechanisms among FSWs and males engaging with FSWs.

  12. HIV AND HCV COINFECTION: PREVALENCE, ASSOCIATED FACTORS AND GENOTYPE CHARACTERIZATION IN THE MIDWEST REGION OF BRAZIL

    Solange Zacalusni Freitas

    2014-12-01

    Full Text Available A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6. In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection, a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3% and 3 (41.7%. The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

  13. HIV and HCV coinfection: prevalence, associated factors and genotype characterization in the Midwest Region of Brazil.

    Freitas, Solange Zacalusni; Teles, Sheila Araújo; Lorenzo, Paulo Cesar; Puga, Marco Antonio Moreira; Tanaka, Tayana Serpa Ortiz; Thomaz, Danilo Yamamoto; Martins, Regina Maria Bringel; Druzian, Angelita Fernandes; Lindenberg, Andréa Siqueira Campos; Torres, Marina Sawada; Pereira, Sérgio A; Villar, Livia Melo; Lampe, Elisabete; Motta-Castro, Ana Rita Coimbra

    2014-01-01

    A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6). In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection), a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3%) and 3 (41.7%). The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

  14. High prevalence of radiological vertebral fractures in HIV-infected males.

    Torti, Carlo; Mazziotti, Gherardo; Soldini, Pier Antonio; Focà, Emanuele; Maroldi, Roberto; Gotti, Daria; Carosi, Giampiero; Giustina, Andrea

    2012-06-01

    Age-related co-morbidities including osteoporosis are relevant in patients responding to combination antiretroviral therapy (cART). Vertebral fractures are common osteoporotic fractures and their diagnosis is useful for managing at-risk individuals. However, there are few data from HIV-infected patients. Therefore, the aim of this study was to determine the prevalence of and factors associated with vertebral fractures in a population of HIV-infected males. A cross-sectional study of 160 HIV-infected patients with available chest X-rays was conducted from 1998 to 2010. One hundred and sixty-three males with comparable age and with no history of HIV infection were recruited as controls. Semi-quantitative evaluation of vertebral heights in lateral chest X-rays and quantitative morphometry assessment of centrally digitized images using dedicated morphometry software were utilized to detect prevalent vertebral fractures. The result showed that the vertebral fractures were detected in 43/160 (26.9%) HIV-infected patients and in 21/163 (12.9%) controls (P = 0.002). In HIV-infected patients with fractures, 27 had two or more fractures and ten patients had severe fractures. The prevalence of any fractures and multiple fractures in HIV-infected patients receiving cART (29.6 and 20.0%) was slightly higher than in HIV-infected patients not exposed to cART (17.1 and 5.7%), but significantly higher than control subjects (12.9 and 3.7%). At multivariable analyses, body mass index and diabetes mellitus were independently correlated with vertebral fractures in HIV-infected patients. We concluded that a significant proportion of HIV-infected males receiving cART showed vertebral fractures. Furthermore, proactive diagnosis of vertebral fragility fractures is particularly relevant in patients who are overweight or suffer from diabetes.

  15. HIV prevalence and sexual risk behaviour among non-injection drug users in Tijuana, Mexico.

    Deiss, Robert G; Lozada, Remedios M; Burgos, Jose Luis; Strathdee, Steffanie A; Gallardo, Manuel; Cuevas, Jazmine; Garfein, Richard S

    2012-01-01

    Prior studies estimate HIV prevalence of 4% among injection drug users (IDUs), compared with 0.8% in the general population of Tijuana, Mexico. However, data on HIV prevalence and correlates among non-injecting drug users (NIDUs) are sparse. Individuals were recruited through street outreach for HIV testing and behavioural risk assessment interviews to estimate HIV prevalence and identify associated sexual risk behaviours among NIDUs in Tijuana. Descriptive statistics were used to characterise 'low-risk' NIDUs (drug users who were not commercial sex workers or men who have sex with men). Results showed that HIV prevalence was 3.7% among low-risk NIDUs. During the prior six months, 52% of NIDUs reported having >1 casual partner; 35% reported always using condoms with a casual partner; and 13% and 15%, respectively, reported giving or receiving something in exchange for sex. Women were significantly more likely than men to have unprotected sex with an IDU (pTijuana. Broad interventions including HIV testing, condom promotion and sexual risk reduction should be offered to all drug users in Tijuana.

  16. Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: rural and urban experience in a resource limited setting.

    Christine Mugasha

    Full Text Available INTRODUCTION: Linkage of HIV-infected pregnant women to HIV care remains critical for improvement of maternal and child outcomes through prevention of maternal-to-child transmission of HIV (PMTCT and subsequent chronic HIV care. This study determined proportions and factors associated with intra-facility linkage to HIV care and Early Infant Diagnosis care (EID to inform strategic scale up of PMTCT programs. METHODS: A cross-sectional review of records was done at 2 urban and 3 rural public health care facilities supported by the Infectious Diseases Institute (IDI. HIV-infected pregnant mothers, identified through routine antenatal care (ANC and HIV-exposed babies were evaluated for enrollment in HIV clinics by 6 weeks post-delivery. RESULTS: Overall, 1,025 HIV-infected pregnant mothers were identified during ANC between January and June, 2012; 267/1,025 (26% in rural and 743/1,025 (74% in urban facilities. Of these 375/1,025 (37% were linked to HIV clinics [67/267(25% rural and 308/758(41% urban]. Of 636 HIV-exposed babies, 193 (30% were linked to EID. Linkage of mother-baby pairs to HIV chronic care and EID was 16% (101/636; 8/179 (4.5%] in rural and 93/457(20.3% in urban health facilities. Within rural facilities, ANC registration <28 weeks-of-gestation was associated with mothers' linkage to HIV chronic care [AoR, 2.0 95% CI, 1.1-3.7, p = 0.019] and mothers' multi-parity was associated with baby's linkage to EID; AoR 4.4 (1.3-15.1, p = 0.023. Stigma, long distance to health facilities and vertical PMTCT services affected linkage in rural facilities, while peer mothers, infant feeding services, long patient queues and limited privacy hindered linkage to HIV care in urban settings. CONCLUSION: Post-natal linkage of HIV-infected mothers to chronic HIV care and HIV-exposed babies to EID programs was low. Barriers to linkage to HIV care vary in urban and rural settings. We recommend targeted interventions to rapidly improve linkage to

  17. HIV-1 subtypes D and F are prevalent in Guinea Conakry.

    Freimanis, G L; Loua, A; Allain, J P

    2012-04-01

    Limited data is available upon the distribution of different HIV-1/2 genotypes in the blood donor population from Guinea Conakry. To investigate the prevalence of HIV-1/2 subtypes in asymptomatic blood donors in Guinea Conakry, in order to update knowledge of HIV-1/2 epidemiology within this country. Samples from 104 blood donors seropositive for HIV-1/2 were tested for HIV-1 by real-time RT-PCR. Those negative for HIV-1 were tested with HIV-2 nested RT-PCR. Positive samples were further amplified in the HIV-1 gag and pol regions and sequenced. Subtypes were determined by phylogenetic analysis on amplicon sequences. 61 samples were positive by HIV-1 real-time RT-PCR. Of the 43 negative, 2 (4.6%) were positive for HIV-2. 52/61 (85.3%) samples were positive by nested RT-PCR. Of the 52, 43 (70.5%) and 31(59.6%) sequences were obtained in the gag and pol regions, respectively; 23 for both regions. HIV-1 subtype distribution was 1 B (2.1%), 8 F (17%), 8 D (17%) and 28 CRF02_AG (59.6%) with 2 unclassified recombinants (4.3%). Unique clusters for subtype D and F distinguished Guinea from HIV-1 subtype distribution in neighboring countries. Subtype F and subtype D strains, uncommon in West Africa, are a substantial part of HIV-1 epidemiology in Guinea. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Prevalence of HIV in pregnant women identified with a risk factor at a tertiary care hospital.

    Mahmud, Ghazala; Abbas, Shazra

    2009-01-01

    HIV is an epidemic quite unlike any other, combining the problems of a lifelong medical disease with immense social, psychological, economic and public health consequences. Since we are living in a global village where human interactions has become fast and frequent, diseases like HIV are no more alien to us. HIV/AIDS in Pakistan is slowly gaining recognition as a public health issue of great importance. Objectives of this study were to determine the prevalence of HIV in pregnant women identified with a high risk factor/behaviour at a tertiary care hospital. It is a Descriptive study. All pregnant women attending antenatal booking clinic were assessed via a pre-designed 'Risk assessment questionnaire'. Women identified with a risk factor were offered HIV Rapid screening test (Capillus HIV1/2). Positive (reactive) results on screening test were confirmed with ELISA. During the study period (March 2007-May 2008), out of 5263 antenatal bookings 785 (14%) women were identified with a risk factor. HIV screening test was done in 779 (99%), and 6 women refused testing. Three women (0.3%) were found positive (reactive) on screening. Two out of 3 women were confirmed positive (0.2%) on ELISA. Husbands of both women were tested and one found positive (migrant from Dubai). Second women had history of blood transfusion. Her husband was HIV negative. During the study period, in addition to 2 pregnant women diagnosed as HIV positive through ANC risk screening, 6 confirmed HIV positive women, found pregnant were referred from 'HIV Treatment Centre', Pakistan Institute of Medical Sciences (PIMS) to Prevention of Parent to Child Transmission (PPTCT) centre for obstetric care. Spouses of 5 out of 6 had history of working abroad and extramarital sexual relationships. All positive (8) women were referred to PPTCT centre for further management. A simple 'Risk Assessment Questionnaire' can help us in identifying women who need HIV screening. Sexual transmission still remains the

  19. Computer-facilitated rapid HIV testing in emergency care settings: provider and patient usability and acceptability.

    Spielberg, Freya; Kurth, Ann E; Severynen, Anneleen; Hsieh, Yu-Hsiang; Moring-Parris, Daniel; Mackenzie, Sara; Rothman, Richard

    2011-06-01

    Providers in emergency care settings (ECSs) often face barriers to expanded HIV testing. We undertook formative research to understand the potential utility of a computer tool, "CARE," to facilitate rapid HIV testing in ECSs. Computer tool usability and acceptability were assessed among 35 adult patients, and provider focus groups were held, in two ECSs in Washington State and Maryland. The computer tool was usable by patients of varying computer literacy. Patients appreciated the tool's privacy and lack of judgment and their ability to reflect on HIV risks and create risk reduction plans. Staff voiced concerns regarding ECS-based HIV testing generally, including resources for follow-up of newly diagnosed people. Computer-delivered HIV testing support was acceptable and usable among low-literacy populations in two ECSs. Such tools may help circumvent some practical barriers associated with routine HIV testing in busy settings though linkages to care will still be needed.

  20. Creating an African HIV clinical research and prevention trials network: HIV prevalence, incidence and transmission.

    Anatoli Kamali

    Full Text Available HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner.

  1. Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission

    Kamali, Anatoli; Price, Matt A.; Lakhi, Shabir; Karita, Etienne; Inambao, Mubiana; Sanders, Eduard J.; Anzala, Omu; Latka, Mary H.; Bekker, Linda-Gail; Kaleebu, Pontiano; Asiki, Gershim; Ssetaala, Ali; Ruzagira, Eugene; Allen, Susan; Farmer, Paul; Hunter, Eric; Mutua, Gaudensia; Makkan, Heeran; Tichacek, Amanda; Brill, Ilene K.; Fast, Pat; Stevens, Gwynn; Chetty, Paramesh; Amornkul, Pauli N.; Gilmour, Jill

    2015-01-01

    HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner. PMID:25602351

  2. Prevalence of Helicobacter pylori prevalence and upper gastrointestinal endoscopy in HIV/AIDS patients with gastrointestinal symptoms in the University Teaching Hospitals in Cameroon.

    Andoulo, F A; Kowo, M; Ngatcha, G; Ndam, A N; Awouoyiegnigni, B; Sida, M B; Tzeuton, C; Ndjitoyap Ndam, E C

    2016-08-01

    To determine the prevalence of Helicobacter pylori (H. pylori) infection and of various upper gastrointestinal (GI) lesions in HIV + patients with GI symptoms and the relation of H. pylori infection to CD4 cell counts. In all, 56 HIV + patients and 56 age- and sex-matched HIV - controls, all with upper GI symptoms, were evaluated by an upper endoscopy examination and gastric biopsy. H. pylori status was assessed with a urease test and histology. HIV was diagnosed with the rapid test and enzyme-linked immunosorbent assay (ELISA). The prevalence of H. pylori was 50% (28/56 [95%CI 36.3-63.7]) in HIV + subjects and 55% (31/56 [95%CI 41.5-68.7]) in HIV - controls (p = 0.57). H. pylori infection rates did not differ significantly in HIV + patients between those with a CD4 count ≥200/mm 3 (52%) and those with a CD4 count HIV + patients and controls were compared: esophageal candidiasis (61%, 34/56 vs. 7%; pHIV + and HIV - subjects. Prevalence of H. pylori was also lower, although not significantly, among HIV + patients with CD4 T-cell counts below 200/mm 3 . On endoscopy, esophageal candidiasis was the most common finding in HIV + patients, discovered by dysphagia.

  3. Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

    Rentz, Michael F; Ruffner, Andrew H; Ancona, Rachel M; Hart, Kimberly W; Kues, John R; Barczak, Christopher M; Lindsell, Christopher J; Fichtenbaum, Carl J; Lyons, Michael S

    2017-11-23

    Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT. The study aimed to evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting. Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became the next-generation index cases in a snowball recruitment strategy. The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported that they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years. TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Prevalence, severity, and related factors of anemia in HIV/AIDS patients

    Mohsen Meidani

    2012-01-01

    Full Text Available Objective: The prevalence of anemia in HIV infected patients has not been well characterized in Iran. This study aimed to describe the prevalence of anemia and related factors in HIV positive patients. Materials and Methods: In a cross-sectional study, anemia prevalence and risk factors of 212 HIV positive patients were assessed, at the behavioral disease consulting center in Isfahan. The relationship between anemia, demographic variables, and clinical histories were analyzed. Mild to moderate anemia was defined as hemoglobin 8-13 g/dL for men and 8-12 g/dL for women. Severe anemia was defined as hemoglobin, 8 g/dL. Results: A total of 212 HIV positive patients with a mean±SD age of 36.1 ± 9.1 years were assessed. We found that hemoglobin levels were between 4.7 and 16.5 gr/dL. In this study, the overall prevalence of anemia was 71%, with the majority of patients having mild to moderate anemia. Mild to moderate anemia and severe anemia occurred in 67% and 4% of patients, respectively. The mean absolute CD4 count was 348 ± 267.8 cells/cubic mm. Sixty one of 212 patients were at late stage of HIV infection (males=51 and female=10. Of the 212 HIV positive patients enrolled, 17 (8% had a positive history of tuberculosis. We found a strong association between anemia and death. Conclusion: Normocytic anemia with decreased reticulocyte count was the most common type of anemia in overall. Prevalence of anemia in this study is relatively higher than other similar studies. Such a high prevalence of anemia needs close monitoring of patients on a zidovudine-based regimen. Better screening for anemia and infectious diseases, and modified harm reduction strategy (HRS for injection drug users are primary needs in HIV seropositive patients.

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

    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

    2015-01-01

    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 condu...

  6. An association between neighbourhood wealth inequality and HIV prevalence in sub-Saharan Africa.

    Brodish, Paul Henry

    2015-05-01

    This paper investigates whether community-level wealth inequality predicts HIV serostatus using DHS household survey and HIV biomarker data for men and women ages 15-59 pooled from six sub-Saharan African countries with HIV prevalence rates exceeding 5%. The analysis relates the binary dependent variable HIV-positive serostatus and two weighted aggregate predictors generated from the DHS Wealth Index: the Gini coefficient, and the ratio of the wealth of households in the top 20% wealth quintile to that of those in the bottom 20%. In separate multilevel logistic regression models, wealth inequality is used to predict HIV prevalence within each statistical enumeration area, controlling for known individual-level demographic predictors of HIV serostatus. Potential individual-level sexual behaviour mediating variables are added to assess attenuation, and ordered logit models investigate whether the effect is mediated through extramarital sexual partnerships. Both the cluster-level wealth Gini coefficient and wealth ratio significantly predict positive HIV serostatus: a 1 point increase in the cluster-level Gini coefficient and in the cluster-level wealth ratio is associated with a 2.35 and 1.3 times increased likelihood of being HIV positive, respectively, controlling for individual-level demographic predictors, and associations are stronger in models including only males. Adding sexual behaviour variables attenuates the effects of both inequality measures. Reporting eleven plus lifetime sexual partners increases the odds of being HIV positive over five-fold. The likelihood of having more extramarital partners is significantly higher in clusters with greater wealth inequality measured by the wealth ratio. Disaggregating logit models by sex indicates important risk behaviour differences. Household wealth inequality within DHS clusters predicts HIV serostatus, and the relationship is partially mediated by more extramarital partners. These results emphasize the importance

  7. The prevalence of HIV among blood donors at Juba Teaching Hospital Blood Bank, South Sudan

    Kenneth L L Sube

    2014-11-01

    Full Text Available Objectives The aim of this study is to determine the prevalence of HIV among blood donors in Juba Teaching Hospital Blood Bank, South Sudan in 2013. Method and Materials This is a retrospective study that involved the abstraction of data from registers at the blood bank. Data were collected onto data sheets and entered into a computer database. Statistical analysis was performed using SPSS Version 20 Software. A p value of <0.05 was considered statistically significant. Results Out of 1095 blood donors, 1074 (98.1% were males and 21 (1.9% were females. The mean age and the range for the whole group was 29+7.16 (15-69 yrs. The prevalence of HIV was higher among males than females 85 (7.9% vs 1 (4.8% respectively but this was not statistical significant (p=0.6. The 20 to 29 year age group had the highest prevalence of 49 (57% with no statistical significance (p=0.3.The prevalence of HIV was 7.0 % (86 and there were co-infections between HIV and HBV, HCV and syphilis of 14 (50%, 5 (18%, 9 (32% with p=0.7, p=0.1, p=0.8 respectively. Blood group O positive had the highest percentage 58.1 % (n=50 and was the commonest group. Conclusion In this study, HIV prevalence is very high among blood donors at the Juba Teaching Hospital blood bank.

  8. Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention

    Kalysha Closson

    2016-11-01

    Full Text Available Abstract Background Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Methods Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS, prevalence of “ever” experiencing a traumatic event among adolescents (aged 14–19 was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C scale (19 items, study alpha = 0.63. We assessed self-reported number of potentially traumatic events (PTEs experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of ‘high PTE score’ (≥7 PTEs. Results Overall, 767/830 (92% participants were included (58% adolescent women. Nearly all (99.7% reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19. Adolescent men reported more violent PTEs (e.g., “seen an act of violence in the community” whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., “family member or someone close died of HIV/AIDS”. High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively. For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63; and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76. Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03, and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37. Conclusion Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with

  9. Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention.

    Closson, Kalysha; Dietrich, Janan Janine; Nkala, Busi; Musuku, Addy; Cui, Zishan; Chia, Jason; Gray, Glenda; Lachowsky, Nathan J; Hogg, Robert S; Miller, Cari L; Kaida, Angela

    2016-11-25

    Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV

  10. Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region, West-Cameroon.

    Céline Nguefeu Nkenfou

    Full Text Available The magnitude of intestinal parasitic infection in acquired immunodeficiency syndrome patients requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several tropical diseases. However, there have been very few studies addressing this issue in Cameroon. This study was conducted to determine the prevalence of intestinal parasitosis in HIV/AIDS patients in Dschang -Cameroon. Stool and blood specimens from HIV/AIDS patients and control group were screened respectively for intestinal parasites and for HIV antibodies. Intestinal parasites were identified using direct microscopy, formalin-ether concentration and Ziehl Neelsen methods. Out of 396 participants recruited among patients consulting at hospital, 42 (10.6% were HIV positive, thirty of them treatment naïve. The overall prevalence of intestinal parasites was 14.64%. Out of 42 HIV/AIDS patients, 59.5% (25/42 were infected with intestinal parasites, while only 9.32% (33/354 of the HIV negative patients were infected with intestinal parasites. The parasites detected in our study population included Crystosporidium parvum (2.53%, Entamoeba histolytica (7.52%, Entamoeba coli (4.04%, Giardia lamblia (0.25%, Trichuris trichura (0.25%, Strongyloides stercoralis (0.25% and Taenia spp. (0.25%. In the HIV infected group, Crystosporidium parvum (19.04%, Entamoeba histolytica (19.04%, Entamoeba coli (21.42%, Giardia lamblia (2.38%, Strongyloides stercoralis (0.25% and Taenia spp. (0.25% were found. Crystosporidium parvum was found to be significantly higher in HIV/AIDS patients than in controls (P<0.05. Multivariate analysis showed that the HIV status and the quality of water were the major risk factors for intestinal parasitosis. Routine examinations of stool samples for parasites would significantly benefit the HIV patients by contributing in reducing morbidity and improving the efficiency of antiretroviral treatment. Even after the introduction

  11. Cost, affordability and cost-effectiveness of strategies to control tuberculosis in countries with high HIV prevalence

    Williams Brian G

    2005-12-01

    Full Text Available Abstract Background The HIV epidemic has caused a dramatic increase in tuberculosis (TB in East and southern Africa. Several strategies have the potential to reduce the burden of TB in high HIV prevalence settings, and cost and cost-effectiveness analyses can help to prioritize them when budget constraints exist. However, published cost and cost-effectiveness studies are limited. Methods Our objective was to compare the cost, affordability and cost-effectiveness of seven strategies for reducing the burden of TB in countries with high HIV prevalence. A compartmental difference equation model of TB and HIV and recent cost data were used to assess the costs (year 2003 US$ prices and effects (TB cases averted, deaths averted, DALYs gained of these strategies in Kenya during the period 2004–2023. Results The three lowest cost and most cost-effective strategies were improving TB cure rates, improving TB case detection rates, and improving both together. The incremental cost of combined improvements to case detection and cure was below US$15 million per year (7.5% of year 2000 government health expenditure; the mean cost per DALY gained of these three strategies ranged from US$18 to US$34. Antiretroviral therapy (ART had the highest incremental costs, which by 2007 could be as large as total government health expenditures in year 2000. ART could also gain more DALYs than the other strategies, at a cost per DALY gained of around US$260 to US$530. Both the costs and effects of treatment for latent tuberculosis infection (TLTI for HIV+ individuals were low; the cost per DALY gained ranged from about US$85 to US$370. Averting one HIV infection for less than US$250 would be as cost-effective as improving TB case detection and cure rates to WHO target levels. Conclusion To reduce the burden of TB in high HIV prevalence settings, the immediate goal should be to increase TB case detection rates and, to the extent possible, improve TB cure rates, preferably

  12. Prevalence and significance of Mycoplasma genitalium in women living with HIV in Denmark

    Madsen, Anne Marie Rosendahl; Thorsteinsson, Kristina; Lebech, Anne-Mette

    2017-01-01

    has been suggested as part of HIV prevention strategies. The objective of this study was to determine the prevalence of M. genitalium in women living with HIV (WLWH) in Denmark, and to compare the result with data on symptoms from the lower abdomen, sexual habits and immune status. 234 women...... were of Asian origin, sexually active, and on antiretroviral treatment with supressed HIV RNA and CD4 count >350 cells/µL. None reported symptoms from the lower abdomen. The prevalence of M. genitalium infection in WLWH in Denmark is low, thus systematic screening for M. genitalium in this group does......OBJECTIVE: Mycoplasma genitalium (M. genitalium) is a sexually transmitted pathogen associated with urethritis, cervicitis, and pelvic inflammatory disease. Previous studies have shown a strong association between M. genitalium and HIV infection, therefore screening and treatment for M. genitalium...

  13. Birth prevalence of congenital cytomegalovirus among infants of HIV-infected women on prenatal antiretroviral prophylaxis in South Africa.

    Manicklal, S; van Niekerk, A M; Kroon, S M; Hutto, C; Novak, Z; Pati, S K; Chowdhury, N; Hsiao, N Y; Boppana, S B

    2014-05-01

    A high rate of congenital cytomegalovirus (CMV) has been documented in human immunodeficiency virus (HIV)-exposed infants in industrialized settings, both in the pre- and post-highly active antiretroviral therapy (HAART) era. Only limited data on the birth prevalence of congenital CMV among infants of HIV-infected women on prenatal antiretroviral (ARV) prophylaxis are available from sub-Saharan Africa, despite a high prevalence of both infections. We evaluated the prevalence of congenital CMV in HIV-exposed infants in the Western Cape, South Africa. HIV-infected mothers were recruited in the immediate postnatal period at a referral maternity hospital between April and October 2012. Maternal and infant clinical data and newborn saliva swabs were collected. Saliva swabs were assayed by real-time polymerase chain reaction for CMV. Data were analyzed using univariate and multivariate logistic regression analyses to determine specific demographic, maternal, and newborn characteristics associated with congenital CMV. CMV was detected in 22 of 748 newborn saliva swabs (2.9%; 95% confidence interval [CI], 1.9%-4.4%). Overall, 96% of mothers used prenatal ARV prophylaxis (prenatal zidovudine, 43.9%; HAART, 52.1%). Maternal age, gestational age, prematurity (CMV-infected and -uninfected infants. Maternal CD4 count CMV (adjusted odds ratio, 2.9; 95% CI, 1.2-7.3). A negative correlation between CMV load in saliva and maternal CD4 count was observed (r = -0.495, n = 22, P = .019). The birth prevalence of congenital CMV was high despite prenatal ARV prophylaxis, and was associated with advanced maternal immunosuppression.

  14. A behavioral and serological survey on HIV prevalence among prisoners in Benin

    S. Hessou

    2017-08-01

    Full Text Available Cases of HIV are common in Benin, with infection rates varying according to socioeconomic and cultural factors, and by region. Certain segments of the population, such as prison inmates, sex worker clients and truck drivers are at high risk for HIV/AIDS. The aim of this study is to identify which behavioral and serological indicators contribute to the spread of HIV among prisoners. A total of 496 inmates from prisons located in all major cities in Benin were surveyed. Data was collected through interview sessions carried out using a questionnaire and through blood samples. The results show that most inmates are Beninese (83.5%, and the average age is 33 years (range: 14-80 years. No prisoner reported using a condom the last time they engaged in sexual intercourse. Blood exposure was found in 14.6% of inmates and HIV was detected in 1.4% of cases. Our analysis indicates that the length of detention and gender are factors that influence HIV status. However, age, education, nationality and HIV awareness had no significant effect on HIV prevalence among inmates. The results highlight the need to raise awareness in prisons about HIV. This can be achieved by strengthening communication strategies and by organizing HIV and sexually transmitted diseases information sessions for both prison officers and inmates.

  15. National South African HIV prevalence estimates robust despite ...

    Approximately 18% of all people living with HIV in 2013 were estimated to live in South Africa (SA),[1] which ... 1 Research Department of Infection and Population Health, Institute for Global Health, University College London, UK.

  16. An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India.

    Phukan, Sanjib Kumar; Medhi, Gajendra Kumar; Mahanta, Jagadish; Adhikary, Rajatashuvra; Thongamba, Gay; Paranjape, Ramesh S; Akoijam, Brogen S

    2017-07-03

    Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur. A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes. The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors. Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users

  17. Augmented Cross-Sectional Prevalence Testing for Estimating HIV Incidence

    Wang, R.; Lagakos, S. W.

    2010-01-01

    Estimation of an HIV incidence rate based on a cross-sectional sample of individuals evaluated with both a sensitive and less-sensitive diagnostic test offers important advantages to incidence estimation based on a longitudinal cohort study. However, the reliability of the cross-sectional approach has been called into question because of two major concerns. One is the difficulty in obtaining a reliable external approximation for the mean “window period” between detectability of HIV infection ...

  18. Screening, prevalence, and risk factors for cervical lesions among HIV positive and HIV negative women in Swaziland

    Pauline E. Jolly

    2017-02-01

    Full Text Available Abstract Background Cervical Cancer (CC is the number one cancer among women in sub-Saharan Africa. Although CC is preventable, most women in developing countries do not have access to screening. Methods This cross-sectional study was conducted to determine the prevalence and risk factors for cervical lesions using visual inspection with acetic acid (VIA among 112 HIV positive and 161 negative women aged 18–69 years. Results The presence of cervical lesions was greater among HIV positive (22.9% than HIV negative women (5.7%; p < 0.0001. In logistic models, the risk of cervical lesions among HIV positive women was 5.24 times higher when adjusted by age (OR 5.24, CI 2.31–11.88, and 4.06 times higher in a full model (OR 4.06, CI 1.61–10.25, than among HIV negative women. In the age-adjusted model women who had ≥2 lifetime sexual partners were 3 times more likely (OR 3.00, CI 1.02–8.85 to have cervical lesions compared to women with one lifetime partner and the odds of cervical lesions among women with a history of STIs were 2.16 greater (OR 2.16, CI 1.04–4.50 than among women with no previous STI. In the fully adjusted model women who had a previous cervical exam were 2.5 times more likely (OR 2.53, CI 1.06–6.05 to have cervical lesions than women who had not. Conclusions The high prevalence of HIV infection and the strong association between HIV and cervical lesions highlight the need for substantial scale-up of cervical screening to decrease the rate of CC in Swaziland.

  19. HBV and HIV co-infection: Prevalence and clinical outcomes in tertiary care hospital Malaysia.

    Akhtar, Ali; Khan, Amer Hayat; Sulaiman, Syed Azhar Syed; Soo, Chow Ting; Khan, Kashifullah

    2016-03-01

    According to WHO, Malaysia has been classified as a concentrated epidemic country due to progression of HIV infection in the population of injecting drug users. The main objectives of current study are to determine the prevalence of HBV among HIV-positive individuals in a tertiary care hospital of Malaysia and to assess the predictors involved in the outcomes of HIV-HBV co-infected patients. A retrospective, cross-sectional study is conducted at Hospital Palau Pinang, Malaysia. The collection of socio-demographic data as well as clinical data is done with the help of data collection form. Data were analyzed after putting the collected values of required data by using statistical software SPSS version 20.0 and P > 0.05 is considered as significant. Results show that the overall prevalence of HBV was 86 (13%) including 495 (74.5%) males and 169 (25.5%) females among a total of 664 HIV-infected patients. It was observed that there is a high prevalence of HIV-HBV co-infection in males 76 (11.4%) as compared to females 10 (1.5%) (P = 0.002). The median age of the study population was 39 years. The statistical significant risk factors involved in the outcomes of HIV-HBV co-infected patients were observed in the variables of gender, age groups, and injecting drug users. The findings of the present study shows that the prevalence of HBV infection among HIV-positive patients was 13% and the risk factors involved in the outcomes of HIV-HBV co-infected patients were gender, age, and intravenous drug users. © 2015 Wiley Periodicals, Inc.

  20. The Prevalence of HIV Risk Behaviors among Felony Drug Court Participants.

    Festinger, David S; Dugosh, Karen L; Metzger, David S; Marlowe, Douglas B

    2012-01-01

    A small percentage of participants in a large metropolitan felony Drug Court engaged in high-risk injection drug use, but a large percentage engaged in high-risk sexual behaviors. HIV risk behaviors were associated with being male, African-American, and younger. A large proportion of Drug Court participants resided in areas of the city with a high prevalence of persons living with HIV/AIDS, thus heightening the probability of exposure to the virus.

  1. High HIV infection prevalence in a group of men who have sex with men

    Raquel Maria Cardoso Torres

    2017-11-01

    Full Text Available Brazil is characterized by a concentrated AIDS epidemic, it has a prevalence of less than 1% in the general population. However, there are higher rates in specific populations, especially in men who have sex with men. The study's aim was to analyze the association between sociodemographic characteristics, sexual practices, sexual behaviors and the HIV infection in a group of men who have sex with men. Secondary data was collected between June 2014 and September 2015 in a research of cross-sectional design in the city of Rio de Janeiro, Brazil. Volunteers answered an online computerized questionnaire and took HIV test. Chi-squared distribution and multiple logistic regression was used. There were 341 participants. Most of them were racially mixed, single, average age of 30.6 years and with a higher education level. The HIV prevalence was 13.9%. Two logistic models were fit (insertive or receptive anal intercourse. Both models showed an association with HIV among those who had a HIV positive sexual partner (Odds Ratio ≈ 2.5 and a high self-perception of acquiring HIV (Model 1: Odds Ratio ≈ 7/Model 2: Odds Ratio ≈ 10. Low condom usage in receptive anal intercourse with casual partners had a direct association with HIV seropositivity, whereas insertive anal intercourse with casual partners with or without condoms were inversely related. The study identified a high prevalence of HIV infections among a group of men who sex with men with a high self-perception risk of acquiring HIV. The findings also showed a relation with sociodemographic and sexual behavior variables.

  2. The prevalence and pathogenesis of diabetes mellitus in treated HIV-infection.

    Paik, Il Joon; Kotler, Donald P

    2011-06-01

    HIV-associated morbidity and mortality have declined significantly since the introduction of highly active antiretroviral therapy (HAART). These developments have allowed an increased focus on associated adverse metabolic effects, such as dyslipidemia, diabetes mellitus, and insulin resistance, which are risk factors for cardiovascular disease and other adverse outcomes. The pathophysiologic mechanisms underlying the metabolic changes are complicated and not yet fully elucidated due to the difficulty of separating the effects of HIV infection from those of HAART, co-morbidities, or individual patient vulnerabilities. This article reviews studies concerning the prevalence and incidence of diabetes mellitus and HIV, HIV-specific effects on diabetes mellitus complications, and HIV-specific diabetes mellitus treatment considerations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. High Prevalence of Hypertension in Ethiopian and Non-Ethiopian HIV-Infected Adults

    Maya Korem

    2018-01-01

    Full Text Available Objectives. Prevalence of hypertension has not been studied in the Ethiopian HIV-infected population, which represents 60% of the patients in our AIDS unit. Our aim was to identify risk factors and characterize the prevalence of hypertension in the population monitored at our unit. Methods. A retrospective chart review categorized subjects according to their blood pressure levels. Hypertension prevalence was determined and stratified according to variables perceived to contribute to elevated blood pressure. Results. The prevalence of hypertension in our study population was significantly higher compared to the general population (53% versus 20%, P<0.0001 and was associated with known risk factors and not with patients’ viral load and CD4 levels. Ethiopian HIV-infected adults had a prominently higher rate of blood pressure rise over time as compared to non-Ethiopians (P=0.016. Conclusions. The high prevalence of hypertension in this cohort and the rapid increase in blood pressure in Ethiopians are alarming. We could not attribute high prevalence to HIV-related factors and we presume it is part of the metabolic syndrome. The lifelong cardiovascular risk associated with HIV infection mandates hypertension screening and close monitoring in this population.

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

    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....

  5. Prevalence and management of helminthiasis among underfives living with HIV/AIDS at Amana Hospital, Tanzania.

    Mwambete, Kennedy D; Tunzo, Jones; Justin-Temu, Mary

    2013-01-01

    This was a cross-sectional study intended to assess the prevalence and management of helminthiasis (HL) among underfives living with HIV/AIDS (ULHA). Clinical histories of ULHA were scrutinized for HIV/AIDS status, antiretroviral therapy (ART), HL prevalence, and their management. About 364 ULHA were studied, 213 (58.5%) were girls and 151 (41.5%) were boys. Of the 364 ULHA, 171 (47.5%) had HL and 64.3% were treated with albendazole (ABZ). Trichuriasis was ascribed to 23.6% of HL. Majority (72.5%) of ULHA had a CD4 count below 200 cells/mm³. Direct association was observed between CD4 counts and HL. About 55% ULHA were on lamivudine (3TC)-stavudine (d4T)-nevirapine (NVP; LSN) combination therapy. The ABZ-LSN combination was frequently used for HIV/AIDS and HL management. High prevalence of HL and vivid correlation between HIV status and HL were observed. The LSN-ABZ combination was frequently employed for management of HIV/AIDS and HL. We recommended prompt diagnosis of HL to avoid acceleration of HIV infection to AIDS.

  6. Trends in HIV Prevalence in Pregnant Women in Rural South Africa.

    Kharsany, Ayesha B M; Frohlich, Janet A; Yende-Zuma, Nonhlanhla; Mahlase, Gethwana; Samsunder, Natasha; Dellar, Rachael C; Zuma-Mkhonza, May; Abdool Karim, Salim S; Abdool Karim, Quarraisha

    2015-11-01

    Despite substantial progress in the delivery of HIV prevention programs, some communities continue to experience high rates of HIV infection. We report on temporal trends in HIV prevalence in pregnant women in a community in rural KwaZulu-Natal in South Africa. Annual, anonymous cross-sectional HIV sero-prevalence surveys were conducted between 2001 and 2013 among first visit prenatal clinic attendees. The time periods 2001 to 2003 were defined as pre-antiretroviral therapy (ART), 2004 to 2008 as early ART, and 2009 to 2013 as contemporary ART roll-out, to correspond with the substantial scale-up of ART program. Overall, HIV prevalence rose from 35.3% [95% confidence interval (CI): 32.3 to 38.3] pre-ART (2001-2003) to 39.0% (95% CI: 36.8 to 41.1) in the early ART (2004-2008) to 39.3% (95% CI: 37.2 to 41.4) in the contemporary ART (2009-2013) roll-out periods. In teenage women (age 20-24 and ≥ 25 years had a 1.7-fold (95% CI: 1.3-2.4; P = 0.001) and 3-fold (95% CI: 2.1 to 4.3; P age-disparate relationships, are needed to impact this HIV epidemic trajectory.

  7. A "Mindful Rational Living" Approach for Addressing HIV in the School Setting

    Chenneville, Tiffany; St. John Walsh, Audra

    2016-01-01

    This paper describes a "mindful rational living" approach, which incorporates mindfulness techniques with rational emotive behavioral therapy strategies for addressing HIV in the school setting. The utility of this approach for attending to the physical, mental, and psychosocial aspects of school-based HIV prevention and treatment will…

  8. Prevalence and correlates of HIV among men who have sex with men in Tijuana, Mexico.

    Pitpitan, Eileen V; Goodman-Meza, David; Burgos, Jose Luis; Abramovitz, Daniela; Chavarin, Claudia V; Torres, Karla; Strathdee, Steffanie A; Patterson, Thomas L

    2015-01-01

    Men who have sex with men (MSM) in developing countries such as Mexico have received relatively little research attention. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, data on MSM are over a decade old. Our aims were to estimate the prevalence and examine correlates of HIV infection among MSM in this city. We conducted a cross-sectional study of 191 MSM recruited through respondent-driven sampling (RDS) in 2012. Biological males over the age of 18 who resided in Tijuana and reported sex with a male in the past year were included. Participants underwent interviewer-administered surveys and rapid tests for HIV and syphilis with confirmation. A total of 33 MSM tested positive for HIV, yielding an RDS-adjusted estimated 20% prevalence. Of those who tested positive, 89% were previously unaware of their HIV status. An estimated 36% (95% CI: 26.4-46.5) had been tested for HIV in the past year, and 30% (95% CI: 19.0-40.0) were estimated to have ever used methamphetamine. Independent correlates of being infected with HIV were methamphetamine use (odds ratio [OR] = 2.24, p = 0.045, 95% CI: 1.02, 4.92) and active syphilis infection (OR = 4.33, p = 0.01, 95% CI: 1.42, 13.19). Our data indicate that MSM are a key sub-population in Tijuana at higher risk for HIV. Tijuana would also appear to have the highest proportion among upper-middle-income countries of HIV-positive MSM who are unknowingly infected. More HIV prevention research on MSM is urgently needed in Tijuana.

  9. An update on the prevalence of HIV/AIDS in Bangladesh.

    Islam, M M; Karim, E; Mian, M A; Kristensen, S; Chowdhury, M R; Vermund, S H

    1999-06-01

    The National AIDS Committee was formed in 1985 to develop and support policies that prevent transmission of human immunodeficiency virus (HIV). In 1990, the Institute of Epidemiology, Disease Control and Research in the Ministry of Health began sero-surveillance for AIDS/HIV infection. Convenience sampling was conducted among prisoners, sailors, truckers, antenatal attendees, repatriated Bangladeshi workers, and brothel-based prostitutes in Dhaka. In 1994, commercial sex workers in other high-risk areas were included in surveillance activities. Among over 75,700 HIV tests through 1998, 119 have been confirmed positive for HIV. While the cumulative HIV prevalence rate was only 1.5/1,000 tests, it was significantly higher among men (p women. The rates among men were as high as 28/1,000 tests in 1996 and 21/1,000 tests in 1997. Almost 50% of the reported HIV cases are from cities on the border of India and Myanmar. It is anticipated that HIV transmission will increase further given the high prevalence of risk behaviors, core high-risk groups, and extreme poverty.

  10. Prevalence and predictors of major depression in HIV-infected patients on antiretroviral therapy in Bamenda, a semi-urban center in Cameroon.

    Bradley N Gaynes

    Full Text Available Recent blue-ribbon panel reports have concluded that HIV treatment programs in less wealthy countries must integrate mental health identification and treatment into normal HIV clinical care and that research on mental health and HIV in these settings should be a high priority. We assessed the epidemiology of depression in HIV patients on antiretroviral therapy in a small urban setting in Cameroon by administering a structured interview for depression to 400 patients consecutively attending the Bamenda Regional Hospital AIDS Treatment Center. One in five participants met lifetime criteria for MDD, and 7% had MDD within the prior year. Only 33% had ever spoken with a health professional about depression, and 12% reported ever having received depression treatment that was helpful or effective. Over 2/3 with past-year MDD had severe or very severe episodes. The number of prior depressive episodes and the number of HIV symptoms were the strongest predictors of past-year MDD. The prevalence of MDD in Cameroon is as high as that of other HIV-associated conditions, such as tuberculosis and Hepatitis B virus, whose care is incorporated into World Health Organization guidelines. The management of depression needs to be incorporated in HIV-care guidelines in Cameroon and other similar settings.

  11. HIV prevalence by ethnic group covaries with prevalence of herpes simplex virus-2 and high-risk sex in Uganda: An ecological study.

    Kenyon, Chris R

    2018-01-01

    HIV prevalence varies from 1.7% to 14.8% between ethnic groups in Uganda. Understanding the factors responsible for this heterogeneity in HIV spread may guide prevention efforts. We evaluated the relationship between HIV prevalence by ethnic group and a range of risk factors as well as the prevalence of herpes simplex virus-2 (HSV-2), syphilis and symptomatic STIs in the 2004/2005 Uganda HIV/AIDS Sero-Behavioural Survey-a two stage, nationally representative, population based survey of 15-59-year-olds. Spearman's correlation was used to assess the relationship between HIV prevalence and each variable. There was a positive association between HIV prevalence and HSV-2, symptomatic STIs and high-risk sex (sex with a non-cohabiting, non-marital partner) for women. Non-significant positive associations were present between HIV and high-risk sex for men and lifetime number of partners for men and women. Variation in sexual behavior may contribute to the variations in HIV, HSV-2 and other STI prevalence by ethnic group in Uganda. Further work is necessary to delineate which combinations of risk factors determine differential STI spread in Uganda.

  12. Prevalence of Metabolic Syndrome in Patients with HIV in the Era of Highly Active Antiretroviral Therapy.

    Lombo, Bernardo; Alkhalil, Imran; Golden, Marjorie P; Fotjadhi, Irma; Ravi, Sreedhar; Virata, Michael; Lievano, Marta; Diez, Jose; Ghantous, Andre; Donohue, Thomas

    2015-05-01

    Since the introduction of combination antiretroviral therapy (cART) as the standard of care for HIV disease, there has been a precipitous decline in the death rate due to HIV/ AIDS. The purpose of this study was to report the prevalence of metabolic syndrome in HIV infected patients. Retrospective, cross-sectional, observational study of 259 patients with HIV infection treated with cART from an urban community hospital. Metabolic syndrome prevalence was defined using the International Diabetes Federation (IDF) and the U.S. National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Study patients were included regardless of the duration of cART. The prevalence of metabolic syndrome was 27% using IDF criteria and 26% using ATP III criteria. Logistic regression analysis found an association between treatment with the protease inhibitor darunavir and metabolic syndrome. (OR 3.32 with 95% confidence interval between 1.54 and 7.15). There is a high prevalence of metabolic syndrome and obesity in HIV patients treated with cART, especially those taking the protease inhibitor darunavir.

  13. Association of HIV prevalence and concurrency of sexual partnerships in South Africa’s language groups: An ecological analysis

    Chris Kenyon

    2013-02-01

    Full Text Available Background. There is considerable variation in HIV prevalence between different language groups in South Africa (SA. Sexual partner concurrency has been linked to the spread of HIV, but its effect on differential HIV transmission within SA’s language groups has not been investigated quantitatively. Objective. This ecological analysis was intended to explore the degree to which the variation in HIV prevalence according to language group can be explained by differential concurrency rates. Method. Linear regression was used to assess the association between each language group’s HIV prevalence and four risk factors: the prevalence of concurrency, multiple sexual partners in the preceding year, circumcision, and condom utilisation. Results. In multivariate analysis, only the point prevalence of concurrency remained associated with HIV prevalence. Conclusion. There is evidence of a high prevalence of point concurrency in sexual partnerships in SA’s most HIV-affected language groups. Together with evidence that relatively small decreases in concurrency can lead to large declines in HIV incidence, this provides impetus for interventions to promote having only one sexual partner at a time. S Afr J HIV Med 2013;14(1:25-28. DOI:10.7196/SAJHIVMED.884

  14. Intimate partner sexual and physical violence among women in Togo, West Africa: Prevalence, associated factors, and the specific role of HIV infection

    Juan Burgos-Soto

    2014-05-01

    attitudes. Discussion and conclusions: The prevalence rates of both lifetime physical and sexual violence were very high among HIV-uninfected women and even higher among HIV-infected women recruited in health facilities in this West African country. Screening for intimate partner violence should be systematic in health-care settings, and specifically within HIV care services. At a time of increased investments in couple-oriented HIV prevention interventions, further longitudinal research to better understanding of HIV-serodiscordant couple dynamics in terms of intimate partner violence is needed.

  15. Economic Costs of Patients Attending the Prevention of Mother-to- Child Transmission of HIV/AIDS (PMTCT Services in Ethiopia: Urban-Rural Settings

    Elias Asfaw Zegeye

    2016-08-01

    Full Text Available Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT. This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence and rural (low-HIV prevalence settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory and direct non-medical (food, transportation and accommodation. The mean direct medical expense per patient per year was Ethiopian birr (ETB 746 (US$ 38 in the urban settings, as compared to ETB 368 (US$ 19 in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327 and ETB 2,154 (US$ 110 per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132 and ETB 2,919 (US$ 148.39 in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.

  16. Prevalence of clinical oral manifestations and symptoms of HIV/AIDS ...

    Type of study: Cross-sectional study. Population: HIV/AIDS individuals attended at Sikonge hospital. Setting: ... However, the distribution and relative frequency of the different lesions is variable from that from other studies. There is need for ...

  17. Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

    Yang, Shujuan; Yang, Chao; Liao, Qiang; Zhai, Wenwen; Yu, Gang; Xiao, Lin; Wang, Qixing; Gong, Yuhan; Zhang, Suhua; Yao, Yongna; Wang, Ke; Wang, Ju; Bian, Shaochao; Liu, Qian

    2017-01-01

    Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015. Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these areas, and the association between demographic and behavioral characteristics and risk of HIV infection. Data on a total of 2797 pregnant women in Xichang and 3983 pregnant women in Zhaojue and Butuo was collected for the period 2009 to 2015. There was a fluctuating HIV prevalence among pregnant women of Xichang, with a rate of 0.75% in 2015 (χ2trend = 2.27, P = 0.13). HIV prevalence among pregnant women of Zhaojue and Butuo was consistently high, varying between 3.4% (9/267, 2011) and 10.3% (82/796, 2012) over the period of 2010 to 2015 (χ2trend = 0.12, P = 0.73). In Xichang, we found that Yi ethnicity (OR = 11.37, 95% CI = 2.92-44.25) and a husband who used drugs (OR = 32.13, 95% CI = 5.33-193.67) were significantly associated with HIV risk in pregnant women. For Zhaojue and Butuo, we observed that pregnant women had a higher risk of HIV infection when they were over 30 years old (OR = 1.72, 95% CI = 1.17-2.52), when they had a higher number of previous births, when their husbands had a history of migrating for work (OR = 1.56, 95% CI = 1.16-2.08), and when they had a history of other sexually transmitted infections (OR = 2.19, 95% CI = 1.16-2.08). Compared to those with a primary school education or below, pregnant women with a secondary or high school education level had a lower risk of HIV infection (OR = 0.28, 95% CI = 0.09-0.89). Our results indicate that there is a serious HIV epidemic among pregnant Yi women, especially for those with less education, more past births, or a husband with a history of

  18. Prevalence and predictors of severe menopause symptoms among HIV-positive and -negative Nigerian women.

    Agaba, Patricia A; Meloni, Seema T; Sule, Halima M; Ocheke, Amaka N; Agaba, Emmanuel I; Idoko, John A; Kanki, Phyllis J

    2017-11-01

    We compared the prevalence of menopause symptoms between women living with HIV to their HIV-negative peers and determined predictors of severe menopause symptoms in Jos, Nigeria. This descriptive cross-sectional study included 714 women aged 40-80 years. We compared prevalence and severity of menopause symptoms using the menopause rating scale (MRS). Logistic regression analysis was used to determine the predictors of severe symptoms. Six-hundred and seven (85.0%) were HIV-positive, with a mean duration of infection of 5.6 ± 2.7 years. The mean age of the cohort was 46 ± 5 years. The most prevalent menopause symptoms were hot flushes (67.2%), joint and muscle discomfort (66.2%), physical/mental exhaustion (65.3%), heart discomfort (60.4%), and anxiety (56.4%). The median MRS score was higher for HIV-positive compared to HIV-negative women (p = 0.01). Factors associated with severe menopause symptoms included HIV-positive status (aOR: 3.01, 95% CI: 1.20-7.54) and history of cigarette smoking (aOR: 4.18, 95% CI: 1.31-13.26). Being married (aOR: 0.49, 95% CI: 0.32-0.77), premenopausal (aOR: 0.60, 95% CI: 0.39-0.94), and self-reporting good quality of life (aOR: 0.62. 95% CI: 0.39-0.98) were protective against severe menopause symptoms. We found HIV infection, cigarette smoking, quality of life, and stage of the menopause transition to be associated with severe menopause symptoms. As HIV-positive populations are aging, additional attention should be given to the reproductive health of these women.

  19. Estimating incidence from prevalence in generalised HIV epidemics: methods and validation.

    Timothy B Hallett

    2008-04-01

    Full Text Available HIV surveillance of generalised epidemics in Africa primarily relies on prevalence at antenatal clinics, but estimates of incidence in the general population would be more useful. Repeated cross-sectional measures of HIV prevalence are now becoming available for general populations in many countries, and we aim to develop and validate methods that use these data to estimate HIV incidence.Two methods were developed that decompose observed changes in prevalence between two serosurveys into the contributions of new infections and mortality. Method 1 uses cohort mortality rates, and method 2 uses information on survival after infection. The performance of these two methods was assessed using simulated data from a mathematical model and actual data from three community-based cohort studies in Africa. Comparison with simulated data indicated that these methods can accurately estimates incidence rates and changes in incidence in a variety of epidemic conditions. Method 1 is simple to implement but relies on locally appropriate mortality data, whilst method 2 can make use of the same survival distribution in a wide range of scenarios. The estimates from both methods are within the 95% confidence intervals of almost all actual measurements of HIV incidence in adults and young people, and the patterns of incidence over age are correctly captured.It is possible to estimate incidence from cross-sectional prevalence data with sufficient accuracy to monitor the HIV epidemic. Although these methods will theoretically work in any context, we have able to test them only in southern and eastern Africa, where HIV epidemics are mature and generalised. The choice of method will depend on the local availability of HIV mortality data.

  20. HIV prevalence and demographic determinants of condomless receptive anal intercourse among trans feminine individuals in Beirut, Lebanon

    Rachel L Kaplan; Justine McGowan; Glenn J Wagner

    2016-01-01

    Introduction: Growing evidence suggests increased HIV incidence in the Middle East and North Africa among “key populations.” To date, epidemiological data have not accurately included and measured HIV prevalence and risk among trans feminine individuals in the region. Through the lens of the Gender Affirmation Framework, we assessed demographic correlates of risk behaviour and the prevalence of HIV among trans feminine individuals in Lebanon. Methods: Long-chain referral sampling was used to ...

  1. High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal, West Africa

    Benzekri, Noelle A.; Sambou, Jacques; Diaw, Binetou; Sall, El Hadji Ibrahima; Sall, Fatima; Niang, Alassane; Ba, Selly; Ngom Gu?ye, Nd?ye Fatou; Diallo, Mouhamadou Ba?la; Hawes, Stephen E.; Seydi, Moussa; Gottlieb, Geoffrey S.

    2015-01-01

    Background Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HI...

  2. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil

    Saffier, I. P.; Kawa, H.; Harling, G.

    2017-01-01

    Background Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. Methods We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published stud...

  3. Prevalence and predictors of unknown HIV status among women ...

    MTCT rates to less than 2% in non-breastfeeding popu- lations2. Even in ... women in sub Saharan Africa received HIV testing. In ac- cordance with the WHO ..... Health Services Research (COHRE) Training Program at the Joint Clinical and ...

  4. Prevalence and clinical presentation of HIV positive female ...

    Nine of the 19 HIV positive patients (47%) had a pre-existing primary psychiatric diagnosis, most commonly Bipolar Disorder, recent episode mania with psychotic symptoms. The most common psychotic symptoms were grandiose delusions followed by auditory hallucinations, paranoid delusions and visual hallucinations.

  5. Incidence of HIV-1 infection and changes in prevalence of ...

    Sexual risk behaviours and RTIs may have contributed to HIV-1 transmission in this community. The data collected may help to inform the future design and evaluation of various intervention measures. Keywords: Africa, bacterial vaginosis, candidiasis, chlamydia, epidemiological synergy, gonorrhoea, incidence, sequelae

  6. Prevalence of hematological abnormalities and malnutrition in HIV ...

    Their hemoglobin level, neutrophil, and platelet counts were the hematological profiles evaluated using the WHO case definitions in HIV clinical staging. The weight-for-height z-score index was used to assess the nutritional status of subjects using the WHO reference ranges. The t-test, Chi-square, and Pearson correlation ...

  7. HIV sero.prevalence among adult with newly diagnosed pulmonary ...

    Materials and Methods: New patients registered with the DOTS clinic meeting TB case definition, diagnosed based on findings suggestive of pulmonary tuberculosis (PTB) on clinical and radiological examination (chest X.ray), and sputum testing for AFB (acid fast bacilli) were offered provider initiated HIV counseling and ...

  8. Gender asymmetry in concurrent partnerships and HIV prevalence

    Leung, Ka Yin; Powers, Kimberly A.; Kretzschmar, Mirjam

    The structure of the sexual network of a population plays an essential role in the transmission of HIV. Concurrent partnerships, i.e. partnerships that overlap in time, are important in determining this network structure. Men and women may differ in their concurrent behavior, e.g. in the case of

  9. Gender asymmetry in concurrent partnerships and HIV prevalence

    Leung, Ka Yin; Powers, Kimberly A.; Kretzschmar, Mirjam

    2017-01-01

    The structure of the sexual network of a population plays an essential role in the transmission of HIV. Concurrent partnerships, i.e. partnerships that overlap in time, are important in determining this network structure. Men and women may differ in their concurrent behavior, e.g. in the case of

  10. Prevalence of intestinal parasitic infestation in HIV seropositive and ...

    opportunistic parasites such as Cryptosporidium,. Cyclospora and Isospora species. It is also important to note that this report will be the first documentation on HIV/AIDS and intestinal parasites from this center. And it aims to determine the frequency and pattern of intestinal parasitic infestation, including protozoan species ...

  11. Prevalence of hematological abnormalities and malnutrition in HIV ...

    2013-10-11

    Oct 11, 2013 ... case definitions) and malnutrition in HIV‑infected children receiving care at the University of Nigeria Teaching. Hospital, Enugu. ... on highly active antiretroviral therapy treatment and had advanced HIV disease (clinical stage 3). Children who were ..... iron, vitamin B complex, and folic acid deficiencies are.

  12. The Prevalence of HIV Infection among Pregnant Women at ...

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... Log in or Register to get access to full text downloads. ... The HIV infection has been a threat to mothers and their babies since many years in ... But persistent vigilance is needed to prevent the Mother to Child transmission.

  13. Prevalence of human immunodeficiency virus (HIV) infection among ...

    AJB SERVER

    2007-02-05

    Feb 5, 2007 ... ... virus (HIV) was disco- vered in 1983 (two years after the diseases AIDS was ... de this lipid bilayer is a matrix (MA) protein (p17). Below the matrix is ... conformational changes in the viral envelope to permit virus-cell fusion.

  14. Prevalence of HIV among blood donors at Juba Teaching Hospital ...

    Male. 85. (99%). 193. (99%). 34. (100%). 102. (97%). 414. Female. 1(1%). 2(1%). 0. 3(3%). 6. Total. 86. 195. 34. 105. 420. Figure 1. Distribution (percent) of HIV, HBV, HCV and syphilis among blood donors. Table 3. Distribution of blood groups among blood donors. Blood group. Frequency. Percentage (%). A+ve. 270. 24.7.

  15. the prevalence and risk factors associated with anaemia among hiv ...

    associated with the development of anaemia among HIV patients attending the special ... Methods: This was a cross – sectional study conducted over a period of 6 months from June ..... reflected in other studies (Mukund B.K. et al 2015, Alem.

  16. Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia

    Shaboltas Alla V

    2009-07-01

    Full Text Available Abstract Background The HIV epidemic in Russia has been driven by the unsafe injection of drugs, predominantly heroin and the ephedrine derived psychostimulants. Understanding differences in HIV risk behaviors among injectors associated with different substances has important implications for prevention programs. Methods We examined behaviors associated with HIV risk among 900 IDUs who inject heroin, psychostimulants, or multiple substances in 2002. Study participants completed screening questionnaires that provided data on sociodemographics, drug use, place of residence and injection- and sex-related HIV risk behaviors. HIV testing was performed and prevalence was modeled using general estimating equation (GEE analysis. Individuals were clustered by neighborhood and disaggregated into three drug use categories: Heroin Only Users, Stimulant Only Users, and Mixed Drug Users. Results Among Heroin Only Users, younger age, front/backloading of syringes, sharing cotton and cookers were all significant predictors of HIV infection. In contrast, sharing needles and rinse water were significant among the Stimulant Only Users. The Mixed Drug Use group was similar to the Heroin Only Users with age, front/back loading, and sharing cotton significantly associated with HIV infection. These differences became apparent only when neighborhood of residence was included in models run using GEE. Conclusion The type of drug injected was associated with distinct behavioral risks. Risks specific to Stimulant Only Users appeared related to direct syringe sharing. The risks specific to the other two groups are common to the process of sharing drugs in preparation to injecting. Across the board, IDUs could profit from prevention education that emphasizes both access to clean syringes and preparing and apportioning drug with these clean syringes. However, attention to neighborhood differences might improve the intervention impact for injectors who favor different drugs.

  17. IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS.

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-01-01

    This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia. Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences. Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders' preferences for the importance of criteria are similar. Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

  18. Prevalence and predictors of food insecurity among people living with HIV affiliated with AIDS service organizations in Ontario, Canada.

    Bekele, Tsegaye; Globerman, Jason; Watson, James; Jose-Boebridge, Murray; Kennedy, Richard; Hambly, Keith; Anema, Aranka; Hogg, Robert S; Rourke, Sean B

    2018-05-01

    Up to half of people living with HIV in resource-rich settings experience moderate to severe food insecurity. Food insecurity, in turn, has been linked to adverse health outcomes including poor antiretroviral adherence, poor HIV viral suppression, frailty, and mortality. We estimated the prevalence of food insecurity among 649 adults living with HIV and recruited from community-based AIDS service organizations in Ontario, Canada. Food security was assessed using the Canadian Household Food Security module. We used logistic regression modeling to identify demographic, socioeconomic, and psychosocial factors independently associated with food insecurity. Almost three-fourths of participants (70.3%) were food insecure and a third (31%) reported experiencing hunger. The prevalence of food insecurity in this sample is approximately six times higher than that of the general population. Factors independently associated with food insecurity were: having dependent children at home, residing in large urban areas, low annual household income (<$40,000), difficulty meeting housing-related expenses, cigarette smoking, harmful drug use, and depression. Broad, multisector interventions that address income, housing affordability, substance use and mental health issues are needed and could offset future public health expenditures.

  19. HIV testing uptake and prevalence among adolescents and adults in a large home-based HIV testing program in Western Kenya.

    Wachira, Juddy; Ndege, Samson; Koech, Julius; Vreeman, Rachel C; Ayuo, Paul; Braitstein, Paula

    2014-02-01

    To describe HIV testing uptake and prevalence among adolescents and adults in a home-based HIV counseling and testing program in western Kenya. Since 2007, the Academic Model Providing Access to Healthcare program has implemented home-based HIV counseling and testing on a large scale. All individuals aged ≥13 years were eligible for testing. Data from 5 of 8 catchments were included in this analysis. We used descriptive statistics and multivariate logistic regression to examine testing uptake and HIV prevalence among adolescents (13-18 years), younger adults (19-24 years), and older adults (≥25 years). There were 154,463 individuals eligible for analyses as follows: 22% adolescents, 19% younger adults, and 59% older adults. Overall mean age was 32.8 years and 56% were female. HIV testing was high (96%) across the following 3 groups: 99% in adolescents, 98% in younger adults, and 94% in older adults (P < 0.001). HIV prevalence was higher (11.0%) among older adults compared with younger adults (4.8%) and adolescents (0.8%) (P < 0.001). Those who had ever previously tested for HIV were less likely to accept HIV testing (adjusted odds ratio: 0.06, 95% confidence interval: 0.05 to 0.07) but more likely to newly test HIV positive (adjusted odds ratio: 1.30, 95% confidence interval: 1.21 to 1.40). Age group differences were evident in the sociodemographic and socioeconomic factors associated with testing uptake and HIV prevalence, particularly, gender, relationship status, and HIV testing history. Sociodemographic and socioeconomic factors were independently associated with HIV testing and prevalence among the age groups. Community-based treatment and prevention strategies will need to consider these factors.

  20. Prevalence of human cytomegalovirus (HCMV antibodies among patients HIV/AIDS in Kurdistan province, 2015

    Arezo Omati

    2016-12-01

    Full Text Available Background : Cytomegalovirus (CMV infection is one of the most common causes of death in people with immune deficiency diseases such as: organ or tissue recipients, patients with HIV/AIDS and newborn infants. The aim of this study was to determine the prevalence of anti-CMV antibodies in patients with HIV/AIDS in the Kurdistan province. Materials and Methods: This cross-sectional study carried out on 151 patients with HIV/AIDS covered by behavioral health counseling centers in Kurdistan province, 2015. For all patients the values of CMV antibodies, include IgG and IgM, were determined by ELISA technique and Diagnostic Kits (EIA WELL, Rome, Italy. Data analyses were done by use of t-test and multiple linear regression tests in stata software, version 13. Results: 116 (76.8% and 35 (23.2% of the patients were male and female, respectively. Mean (SD age of the patients were 39.3 (9.1 years. All studied patients were found positive for CMV-IgG (prevalence=100%, whereas only one case (0.7% was found positive for CMV-IgM. The relationship between age and CMV-IgG levels was statistically significant. Conclusion: The results showed that high prevalence of CMV in patients with HIV/AIDS, so in addition to paying more attention to the issue of HIV and CMV co-infection, about value of early antiretroviral treatment conducting further studies seems necessary.

  1. Non-governmental organizations, democracy, and HIV prevalence: a cross-national analysis.

    Shircliff, Eric J; Shandra, John M

    2011-01-01

    Despite the scale, reach, and global impact of the human immunodeficiency virus (HIV), its study has remained largely at the purview of various micro-level analyses (e.g., Gutmann 2007; Levi and Vitória 2002). However, differences in prevalence rates at the national level suggest that other forces might be at work. Following the work of McIntosh and Thomas (2004), the only cross-national study of HIV/AIDS published to our knowledge, we conduct a cross-national analysis that examines world polity ideas that higher levels of health and women’s non-governmental organizations (NGOs) should be associated with lower levels of HIV prevalence. Initially, we find no support for these hypotheses. However, we respecify our models to test a political opportunity structure hypothesis that democracy enhances the ability of health and women’s NGOs to deal with HIV. We test this line of reasoning by including an interaction term between democracy and the health and women’s NGO variables. In doing so, we find that health and women’s NGOs are associated with lower levels of HIV prevalence in democratic rather than repressive nations.

  2. [Aids in Madagascar. II. Intervention policy for maintaining low HIV infection prevalence].

    Ravaoarimalala, C; Andriamahenina, R; Ravelojaona, B; Rabeson, D; Andriamiadana, J; May, J F; Behets, F; Rasamindrakotroka, A

    1998-01-01

    The HIV seroprevalence per 100,000 adults Malagasy rose from 20 in 1989, to 30 in 1992, and to 70 in 1995. In that year, the total number of HIV infected people in the Big Island was estimated at 5,000, the number of people sick with AIDS at 130, and the people at risk at more than 1,000,000. The latter are the persons infected with other STDs and individuals (or their partners) with risky sexual behaviour (e.g. numerous sexual partners, occasional sexual partners, and/or sexual contacts with commercial sex workers). The HIV prevalence rate is low as compared with those of other countries. Nevertheless, the spread of the HIV infection is alarming in some parts of the country and the risk factors are also present, namely: the high prevalence of STDs, numerous sexual partners, the low use of condoms in all groups, the development of tourism, the development of prostitution associated with social and economical problems, and internal and international migrations (with risky sexual contacts). Therefore, the still low but rising HIV prevalence in 1995 does not warrant complacency. To estimate the trend of HIV prevalence within the population, it is useful to know two different assumptions, as follows: firstly, a controlled evolution of the epidemic (low epidemic) and secondly, a very fast spread of the epidemic (high epidemic). If we consider the 5,000 individuals seropositive in July 1995, the Aids Impact Model (AIM) projection model shows that HIV seroprevalence rates among adults in 2015 might be between 3% (when the progression course of HIV epidemic is low) and 15% (when the progression course of HIV epidemic is high). By 2015 AIDS could have severe demographic, social, and economic impacts. Then, it is necessary to take measures to prevent contamination. Five major interventions are required: public information about AIDS, HIV transmission mechanism, and its prevention, communities education via the respected people and the notabilities to promote moral values

  3. HIV, STI prevalence and risk behaviours among women selling sex in Lahore, Pakistan

    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

  4. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil.

    Saffier, Igor Pedrosa; Kawa, Hélia; Harling, Guy

    2017-10-11

    Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors. Forty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status. Few published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in

  5. Oncogenic Viral Prevalence in Invasive Vulvar Cancer Specimens from HIV Positive and Negative Women in Botswana

    Tesfalul, Martha; Simbiri, Kenneth; Wheat, Chikoti M.; Motsepe, Didintle; Goldbach, Hayley; Armstrong, Kathleen; Hudson, Kathryn; Kayembe, Mukendi K.; Robertson, Erle; Kovarik, Carrie

    2014-01-01

    Objective The primary aim of this study is to describe the prevalence of select oncogenic viruses within vulvar squamous cell carcinoma (VSCC) and their association with Human Immunodeficiency Virus (HIV) status in women in Botswana, where the national HIV prevalence is the third highest in the world. Methods/materials A cross-sectional study of biopsy-confirmed VSCC specimens and corresponding clinical data was conducted in Gaborone, Botswana. Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC) viral testing were done for Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV) strains, and Kaposi's Sarcoma Herpesvirus (KSHV), and PCR viral testing alone was done for John Cunningham Virus (JCV). Results HPV prevalence by PCR was 100% (39/39 35/35) among tested samples. HPV16 was the most prevalent HPV strain (82.9% by PCR, 94.7% by either PCR or IHC). KSHV prevalence by PCR had a significant association with HIV status (p = 0.013), but not by IHC (p = 0.650). Conclusions The high burden of HPV, specifically HPV16, in VSCC in Botswana suggests a distinct HPV profile that differs from other studied populations, which provides increased motivation for HPV vaccination efforts. Oncogenic viruses KSHV and EBV were also more prevalent in our study population though their potential role in VSCC pathology is unclear. PMID:24651632

  6. Prevalence and determinants of glucose intolerance among HIV ...

    ±SD age of 38±15 years were HAARTtreated; while 200 (61 males and 139 females) with mean±SD age of 33±17 years were HAART-naive. Overall, the prevalence of GI was 40.4% (IFG) 19.5%, IGT 11.5% and DM 9.4%. The prevalence of ...

  7. Changing drug use and HIV prevalence among injecting drug users in Ukraine: evidence from biobehavioral surveys

    Dumchev, Kostyantyn

    2012-07-01

    Full Text Available BACKGROUND: Integrated biobehavioral surveys (IBBS have been used to evaluate the impact of HIV prevention efforts among most-at-risk groups in Ukraine since 2007. Harm reduction program coverage among injecting-drug users (IDUs increased substantially from 96,000 in 2008 to 170,000 in 2010 with support from the Global Fund, and IBBS have shown declining HIV prevalence. Aim of the study was to examine the changes in HIV prevalence, drug use patterns and risky behaviors in IDUs on national and city level.METHODS: For this analysis, three IDU-IBBS datasets were combined – 2008 (N=3711, 2009 (N=3962, and 2011 (N=9069. The analysis included 25 cities that participated in either 2008 or 2009, and 2011. Changes in HIV prevalence, drug use, and risk behaviors were compared between 2008/9 and 2011.RESULTS: The surveyed IDU population in 2011 was older than in 2008/9 (31.0 vs. 32.8 years; p<.0001, and included more females (23.5% vs. 25.5%; p=.0038, with substantial variation across cities.Overall HIV prevalence in the sample declined slightly (22.9% to 21.6%; p=.05. In eight cities, HIV prevalence decreased significantly (-5% to -18%, while significant increases were seen in five cities (8% to 15%. Prevalence among IDUs younger than 25 years declined (9.9% to 7.2%; p=.0078.The combined dataset showed no difference in opioid or stimulant past-30-day use, with variation at city level. Clean needle/syringe use during last injection increased significantly (88.8% to 97.0%; p<.0001, with no opposing trend in any city. Three cities had an increase in past-30-day needle/syringe sharing; nine – in container sharing; twelve – in use of preloaded syringes. Changes in condom use were not significant (54.1% to 54.9%, p=.32.CONCLUSIONS: IDUs in Ukraine are ageing and HIV seroprevalence among IDUs continues to decline, especially among young IDUs. However, prevention programming needs to respond to significant regional variations in risk behaviors and HIV

  8. [Prevalences of HIV, hepatitis B and hepatitis C in blood donors in the Republic of Djibouti].

    Dray, X; Dray-Spira, R; Bronstein, J A; Mattera, D

    2005-01-01

    Screening for hepatitis B (HBV) surface antigen (Ag HBs) and for antibodies to hepatitis C (HCV) and human: immunodeficiency virus (HIV) was carried out in 9006 volunteer blood donors at the National Blood Bank in the Republic of Djibouti from 1998 to 2000. Results demonstrated the presence of Ag HBs in 934 patients (10.4%), antibodies to HCV in 21 patients (0.3%), and antibodies to HIV in 175 patients (1.9%). In comparison with neighboring countries the prevalence of HBV, HCV, and HIV infection in Djibouti was low. These findings should be used to guide preventive action against these viral infections in the Republic of Djibouti. Estimations of HIV infection (11.7%) based on modeling by the World Health Organization should be reviewed.

  9. HIV and Syphilis Prevalence and Associated Risks in the Cameroonian Armed Forces.

    Grillo, Michael; Tran, Bonnie Robin; Tamoufe, Ubald; Djoko, Cyrille F; Saylors, Karen; Woodland, Kelly; Wangmene, L T C; Macera, Caroline

    2017-01-01

    Continued surveillance of the HIV epidemic is critical to monitor changes in trends and risk behaviors. A 2005 study in the Cameroonian Armed Forces (CAF) found an HIV prevalence of 11.3% among male and female service members. The purpose of the current study is to determine the 5-year change in the HIV prevalence, estimate the prevalence of syphilis, and examine factors associated with infection in the CAF. Participants were male and female service members 18 years of age or older who were stationed at one of the 10 military garrisons selected for participation. The military garrisons included in this study were proportionally representative of the CAF by geographic region. Military companies and individuals within the selected garrisons were randomly chosen to participate in the study. Demographic and behavioral risk data were collected from September-November 2011 using personal interviews. Blood was collected for HIV and syphilis testing. Of 2,523 participants tested, 6.0% screened positive for HIV [includes 5.3% who screened positive for HIV only and 0.7% who screened positive for both HIV and syphilis], and 3.1% screened positive for syphilis only. Analyses examining risk factors associated with HIV/syphilis infection (i.e., infected with HIV, infected with syphilis, or co-infected with both HIV and syphilis) were restricted to 2,255 men who reported ever having sex. In a multivariate logistic regression model, the odds of testing positive for HIV/syphilis were higher among men who were separated, divorced, or widowed (adjusted odds ratio [AOR]=3.13, 95% confidence interval [CI]: 1.24-7.89), had sex with sex workers (AOR=1.64, 95% CI: 1.19-2.27), and reported a genital sore/ulcer in the past 12 months preceeding the survey (AOR=1.73, 95% CI: 1.05-2.86). Higher HIV knowledge was protective against HIV/syphilis infection (AOR=0.73, 95% CI: 0.54-0.99). While the overall HIV prevalence in this sample of military personnel was lower than previously reported (6

  10. Hepatitis C prevalence among HIV-infected patients in Guinea-Bissau

    Hønge, Bo Langhoff; Jespersen, Sanne; Medina, Candida

    2014-01-01

    Objectives: To estimate the prevalence and determine the clinical presentation of risk factors of hepatitis C virus (HCV) among HIV-infected patients in Bissau, Guinea-Bissau. Methods: In this cross-sectional study, we included individuals who had a routine blood analysis performed during...... the period April 28 to September 30, 2011. Patient samples were tested for HCV antibodies (anti-HCV) with a chemiluminescence test (Architect, Abbott, USA) and INNO-LIA HCV Score (Innogenetics, Belgium). HCV viral load and genotype were analyzed using an in-house real-time PCR method. Results: In total, 576...... patients were included (417 HIV-1, 104 HIV-2, and 55 HIV-1/2). Ten (1.7%) patients were anti-HCV-positive and eight (1.4%) patients had detectable HCV RNA; all were genotype 2. In a multivariable logistic regression analysis, age >50 years was associated with anti-HCV reactivity (p

  11. Determinants of Selenium Intake in a High HIV Prevalence Fishing Community in Bondo District, Kenya

    Samwel Boaz Otieno; Fred Were; Ephantus Kabiru; Kaunda Waza

    2016-01-01

    A study was done to establish determinants of selenium intake in a high HIV prevalence fishing community in the Pala Bondo district, Kenya. It was established that most of the respondents (61%) were small holder Farmers and Fishermen {χ2 (1, N=386) p

  12. Prevalence and Incidence of Toxoplasmosis in HIV-Positive Patients in the Czech Republic

    Kodym, P.; Hrdá, Š.; Machala, L.; Rozsypal, H.; Staňková, M.; Malý, Marek

    2006-01-01

    Roč. 53, Suppl. 1 (2006), s. 160-161 ISSN 1066-5234 Source of funding: V - iné verejné zdroje Keywords : toxoplasmosis * HIV infection * prevalence Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.288, year: 2006

  13. The prevalence of HIV and AIDS and average demographic data in ...

    HIV infection and AIDS are non-notifiable conditions with a serious effect on forestry contracting businesses due to the effect on human resource productivity. The condition affects households as it burdens the household income, affects breadwinners and the family. With information available concerning the prevalence rate ...

  14. Declining HIV prevalence among women attending antenatal care in Pune, India

    Kulkarni, Vinay; Joshi, Smita; Gupte, Nikhil; Parchure, Ritu; Darak, Shrinivas; Kulkarni, Sanjeevani

    A declining prevalence of HIV among young women has been reported by the public sector implementing prevention of mother-to-child transmission (PMTCT) programmes, sentinel surveillance sites and research institutions ill India. However, there are no reports evaluating such trends from the private

  15. Prevalence and Risk Factors for HIV/AIDS among Male Inmates in ...

    It was only one (0.4%) of the prisoners that practiced homosexuality in prison. The age 26-45 years were mostly affected constituting 56%. Seroprevalence among the prisoners (7%) was higher than the National median prevalence of HIV infection among pregnant women in year 2006 survey. This suggests the possibility of ...

  16. Prevalence and significance of Mycoplasma genitalium in women living with HIV in Denmark

    Madsen, Anne Marie Rosendahl; Thorsteinsson, Kristina; Lebech, Anne-Mette

    2017-01-01

    were of Asian origin, sexually active, and on antiretroviral treatment with supressed HIV RNA and CD4 count >350 cells/µL. None reported symptoms from the lower abdomen. The prevalence of M. genitalium infection in WLWH in Denmark is low, thus systematic screening for M. genitalium in this group does...

  17. Prevalence of HIV and syphilis in pregnant women in Leon, Nicaragua

    Hoekstra, Carlijn E L; Riedijk, Martiene; Matute, Armando J; Hak, Eelko; Delgado, Edgar; Alonso, Rosa E; Benavides, Maria D; van Loon, Anton M; Hoepelman, Ilja M

    The objective of this study was to determine the prevalence of HIV and syphilis and to identify risk factors among pregnant women visiting antenatal clinics in León, Nicaragua. During February to April 2004, blood samples from pregnant women were collected after written consent had been obtained.

  18. The HIV prevalence among pregnant women in the Amsterdam region (1988-1991)

    Bindels, P. J.; Mulder-Folkerts, D. K.; Boer, K.; Schutte, M. F.; van der Velde, W. j; Wong, F. J.; van den Hoek, A. J.; van Doornum, G. J.; Coutinho, R. A.

    1994-01-01

    The objective of the study was to monitor the HIV prevalence in the years 1988-1991 among pregnant women in the Amsterdam region, visitors to an abortion clinic and 3 outpatient infertility clinics. All women attending these clinics were asked to participate in the study on a voluntary basis and

  19. Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

    Haddow, Lewis J; Laverick, Rosanna; Daskalopoulou, Marina

    2018-01-01

    We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z scor...

  20. Prevalence and Determinants of Chronic periodontitis in HIV positive patients in Nigeria

    Kehinde Adesola Umeizudike

    2014-08-01

    Full Text Available Objective: To determine the prevalence and determinants of chronic periodontitis in HIV positive patients. Methods: A total of 120 HIV positive patients attending the dedicated HIV outpatient clinic of the Lagos University Teaching Hospital, Nigeria were recruited for the study. Their periodontal status was assessed using the community periodontal index of treatment needs. Their CD4+ cell count was determined using the flow-cytometer method. The risk factors for periodontitis including age, gender, education, smoking, CD4+ cell counts, bleeding on probing (BOP were determined. Results: Prevalence of periodontitis was high (63.3% in the HIV positive patients. In a bivariate analysis, significant associations were observed between severity of periodontitis and age ≥35 years (P=0.021, male gender (P=0.005, smoking (P=0.040 and ≥3 community periodontal index of treatment needs sextants exhibiting BOP (P=0.004. In a binary logistic regression, independent predictors of periodontitis were ≥3 sextants exhibiting BOP (odds ratio 1.738, 95% CI 1.339 to 2.256, P=0.000 and age ≥35 years (odds ratio 1.057, 95% CI 1.005 to 1.111, P=0.030. The CD4+ cell counts were not associated with periodontitis in the HIV positive patients (P=0.988. Conclusions: A high prevalence of periodontitis was found among the HIV positive Nigerian patients in this study. Older age ≥35 years and BOP were the determinants of periodontitis. There is therefore a need for close periodontal monitoring of HIV positive Nigerian patients with emphasis on preventive, professional oral prophylaxis.

  1. Transactional sex among young women in rural South Africa: prevalence, mediators and association with HIV infection

    Ranganathan, Meghna; Heise, Lori; Pettifor, Audrey; Silverwood, Richard J; Selin, Amanda; MacPhail, Catherine; Delany-Moretlwe, Sinead; Kahn, Kathleen; Gómez-Olivé, F Xavier; Hughes, James P; Piwowar-Manning, Estelle; Laeyendecker, Oliver; Watts, Charlotte

    2016-01-01

    Introduction Young adolescent women in sub-Saharan Africa are three to four times more likely to be HIV-positive than boys or men. One of the relationship dynamics that is likely to be associated with young women's increased vulnerability to HIV is transactional sex. There are a range of HIV-related risk behaviours that may drive this vulnerability. However, to date, limited epidemiological data exist on the role of transactional sex in increasing HIV acquisition, especially among young women in sub-Saharan Africa. Our paper presents data on the prevalence of self-reported engagement in transactional sex and explores whether transactional sex is associated with increased risk of HIV infection among a cohort of young, rural, sexually active South African women. We also explore whether this relationship is mediated through certain HIV-related risk behaviours. Methods We analyzed baseline data from a phase III trial of conditional cash transfers for HIV prevention of 693 sexually active, school-going young women aged 13–20 years in rural South Africa. We examined the association between young women's engagement in transactional sex and HIV infection. Transactional sex is defined as a non-commercial, non-marital sexual relationship whereby sex is exchanged for money and/or gifts. We explored whether this relationship is mediated by certain HIV-related risk behaviours. We used logistic and multinomial regression and report unadjusted and adjusted odds ratios with 95% CI. Results Overall, 14% (n=97) of sexually active young women reported engaging in transactional sex. Engagement in transactional sex was associated with an increased risk of being HIV-positive (aOR: 2.5, CI: 95% 1.19–5.25, p=0.01). The effect size of this association remained nearly unchanged when adjusted for certain other dimensions of HIV risk that might help explain the underlying pathways for this relationship. Conclusions This study provides quantitative support demonstrating that transactional

  2. Prevalence and Correlates of HIV Infection among Street Boys in Kisumu, Kenya.

    Goldblatt, Ariella; Kwena, Zachary; Lahiff, Maureen; Agot, Kawango; Minnis, Alexandra; Prata, Ndola; Lin, Jessica; Bukusi, Elizabeth A; Auerswald, Colette L

    2015-01-01

    Despite their perceived vulnerability to HIV, East African street youth have been neglected in HIV prevention research. We examined HIV seroprevalence and correlates of HIV infection in a sample of male street youth in Kisumu, Kenya. We enrolled a street-recruited sample of 13-21 year old street youth. Participants completed a survey followed by voluntary HIV counseling and testing. Survey items included demographics, homelessness history, survival activities, sexual behavior and substance use. We examined the relationship between predictor variables, markers of coercion and marginalization and HIV. The sample included 296 males. Survival activities included garbage picking (55%), helping market vendors (55%), begging (17%), and working as porters (46%) or domestic workers (4%). Forty-nine percent of participants reported at least weekly use of alcohol and 32% marijuana. Forty-six percent of participants reported lifetime inhalation of glue and 8% fuel. Seventy-nine percent of participants reported lifetime vaginal sex, 6% reported lifetime insertive anal sex and 8% reported lifetime receptive anal sex. Twelve (4.1%; 95% CI: 2.3-7.0) participants tested positive for HIV. Of those, all had been on the street for at least one year and all had engaged in vaginal sex. Occupations placing youth at particular risk of coercion by adults, including helping market vendors (prevalence ratio (PR) = 8.8; 95% CI: 1.2-67.5) and working as domestic workers (PR = 4.6; 95% CI: 1.1-19.0), were associated with HIV infection. Both insertive anal sex (PR = 10.2; 95% CI: 3.6-29.4) and receptive anal sex (PR = 3.9; 95% CI: 1.1-13.4) were associated with HIV infection. Drug use, begging, and garbage picking were not associated with HIV infection. Although HIV prevalence in our sample of street youth is comparable to that of similarly-aged male youth in Nyanza Province, our findings highlight behavioral factors associated with HIV infection that offer opportunities for targeted prevention

  3. Prevalence and Correlates of HIV Infection among Street Boys in Kisumu, Kenya.

    Ariella Goldblatt

    Full Text Available Despite their perceived vulnerability to HIV, East African street youth have been neglected in HIV prevention research. We examined HIV seroprevalence and correlates of HIV infection in a sample of male street youth in Kisumu, Kenya.We enrolled a street-recruited sample of 13-21 year old street youth. Participants completed a survey followed by voluntary HIV counseling and testing. Survey items included demographics, homelessness history, survival activities, sexual behavior and substance use. We examined the relationship between predictor variables, markers of coercion and marginalization and HIV.The sample included 296 males. Survival activities included garbage picking (55%, helping market vendors (55%, begging (17%, and working as porters (46% or domestic workers (4%. Forty-nine percent of participants reported at least weekly use of alcohol and 32% marijuana. Forty-six percent of participants reported lifetime inhalation of glue and 8% fuel. Seventy-nine percent of participants reported lifetime vaginal sex, 6% reported lifetime insertive anal sex and 8% reported lifetime receptive anal sex. Twelve (4.1%; 95% CI: 2.3-7.0 participants tested positive for HIV. Of those, all had been on the street for at least one year and all had engaged in vaginal sex. Occupations placing youth at particular risk of coercion by adults, including helping market vendors (prevalence ratio (PR = 8.8; 95% CI: 1.2-67.5 and working as domestic workers (PR = 4.6; 95% CI: 1.1-19.0, were associated with HIV infection. Both insertive anal sex (PR = 10.2; 95% CI: 3.6-29.4 and receptive anal sex (PR = 3.9; 95% CI: 1.1-13.4 were associated with HIV infection. Drug use, begging, and garbage picking were not associated with HIV infection.Although HIV prevalence in our sample of street youth is comparable to that of similarly-aged male youth in Nyanza Province, our findings highlight behavioral factors associated with HIV infection that offer opportunities for targeted

  4. Prevalence and Correlates of HIV Infection among Street Boys in Kisumu, Kenya

    Goldblatt, Ariella; Kwena, Zachary; Lahiff, Maureen; Agot, Kawango; Minnis, Alexandra; Prata, Ndola; Lin, Jessica; Bukusi, Elizabeth A.; Auerswald, Colette L.

    2015-01-01

    Introduction Despite their perceived vulnerability to HIV, East African street youth have been neglected in HIV prevention research. We examined HIV seroprevalence and correlates of HIV infection in a sample of male street youth in Kisumu, Kenya. Methods We enrolled a street-recruited sample of 13–21 year old street youth. Participants completed a survey followed by voluntary HIV counseling and testing. Survey items included demographics, homelessness history, survival activities, sexual behavior and substance use. We examined the relationship between predictor variables, markers of coercion and marginalization and HIV. Results The sample included 296 males. Survival activities included garbage picking (55%), helping market vendors (55%), begging (17%), and working as porters (46%) or domestic workers (4%). Forty-nine percent of participants reported at least weekly use of alcohol and 32% marijuana. Forty-six percent of participants reported lifetime inhalation of glue and 8% fuel. Seventy-nine percent of participants reported lifetime vaginal sex, 6% reported lifetime insertive anal sex and 8% reported lifetime receptive anal sex. Twelve (4.1%; 95% CI: 2.3–7.0) participants tested positive for HIV. Of those, all had been on the street for at least one year and all had engaged in vaginal sex. Occupations placing youth at particular risk of coercion by adults, including helping market vendors (prevalence ratio (PR) = 8.8; 95% CI: 1.2–67.5) and working as domestic workers (PR = 4.6; 95% CI: 1.1–19.0), were associated with HIV infection. Both insertive anal sex (PR = 10.2; 95% CI: 3.6–29.4) and receptive anal sex (PR = 3.9; 95% CI: 1.1–13.4) were associated with HIV infection. Drug use, begging, and garbage picking were not associated with HIV infection. Conclusions Although HIV prevalence in our sample of street youth is comparable to that of similarly-aged male youth in Nyanza Province, our findings highlight behavioral factors associated with HIV

  5. HIV and HCV prevalence among entrants to methadone maintenance treatment clinics in China: a systematic review and meta-analysis

    Zhuang Xun

    2012-06-01

    Full Text Available Abstract Background Methadone maintenance treatment (MMT was implemented in China since 2004. It was initiated in 8 pilot clinics and subsequently expanded to 738 clinics by the end of 2011. Numerous individual research studies have been conducted to estimate HIV and HCV prevalence among MMT clients but an overview of the epidemics in relations to MMT remains unclear. The aim of this study is to estimate the magnitude and changing trends of HIV, HCV and HIV-HCV co-infections among entry clients to MMT clinics in China during 2004-2010. Methods Chinese and English databases of literature were searched for studies reporting HIV, HCV and co-infection prevalence among MMT clients in China from 2004 to 2010. The prevalence estimates were summarized through a systematic review and meta-analysis of published literatures. Results Ninety eligible articles were selected in this review (2 in English and 88 in Chinese. Nationally, pooled prevalence of HIV-HCV and HIV-HCV co-infection among MMT clients was 6.0% (95%CI: 4.7%-7.7%, 60.1% (95%CI: 52.8%-67.0% and 4.6% (95%CI: 2.9%-7.2%, respectively. No significant temporal trend was found in pooled prevalence estimates. Study location is the major contributor of heterogeneities of both HIV and HCV prevalence among drug users in MMT. Conclusions There was no significant temporal trend in HIV and HCV prevalence among clients in MMT during 2004–2010. Prevalence of HCV is markedly higher than prevalence of HIV among MMT clients. It is recommended that health educational programs in China promote the earlier initiation and wider coverage of MMT among injecting drug users (IDUs, especially HIV-infected IDUs.

  6. High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam.

    Nadol, Patrick; Hoang, Tran Vu; Le, Linh-Vi; Nguyen, Tuan Anh; Kaldor, John; Law, Matthew

    2017-08-01

    In Vietnam's concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a 'bridge' of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam's largest cities, in 2013-2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0-27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2-47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across 'bridging' categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87-7.56), current opioid use (OR 2.55; 95% CI 1.02-6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46-19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These

  7. Prevalence of postnatal depression and associated factors among HIV-positive women in primary care in Nkangala district, South Africa

    K Peltzer

    2011-12-01

    Full Text Available Background. The prevalence of postpartum depression in South Africa is high, but there is lack of prevalence data on postnatal depression among HIV-infected women. Aim. The aim of this study was to determine the prevalence of depressed mood and associated factors in postnatal HIV-positive women in primary care facilities in Nkangala district, Mpumalanga, South Africa. Methods. This cross-sectional study was carried out on 607 HIV-positive postnatal women in 48 primary health care clinics and community health centres in Nkangala district. Postnatal women were recruited by systematic sampling (every consecutive patient over a period of 2 months. Demographic and other data were obtained from all the women who responded to a questionnaire in the local language on male involvement, HIV test disclosure, delivery and infant profile, infant HIV diagnosis, stigma, discrimination, postnatal depression, attendance of support groups and social support. Results. Overall, 45.1% of women reported a depressed mood in the postnatal period. Depressed mood in a multivariable analysis was significantly associated with internalised stigma (odds ratio (OR 1.12, 95% confidence interval (CI 1.05 - 1.19; p=0.000, discrimination experiences (OR 1.22, CI 1.03 - 1.46; p=0.023, lack of social support (OR 0.86, CI 0.74 - 0.99; p=0.037 and having had an STI in the past 12 months (OR 2.22, CI 1.21 - 4.04; p=0.010. There were no statistically significant correlations between the Edinburgh Postnatal Depression Scale (EPDS scores of the women and age, marital status, level of education, employment status and number of own children. Conclusion. Depressed mood is common among HIV-positive postpartum women. This is significantly associated with lack of social support, stigma and discrimination. Routine screening to identify those currently depressed or at risk of depression should be integrated into postnatal care settings to target those most needing intervention.

  8. HIV prevalence and correlates of unprotected anal intercourse among men who have sex with men, Jinan, China.

    Ruan, Shiman; Yang, Hui; Zhu, Yanwen; Ma, Yanhui; Li, Jinxing; Zhao, Jinkou; McFarland, Willi; Raymond, H Fisher

    2008-05-01

    China's HIV epidemic may be shifting towards predominantly sexual transmission and emerging data point to potential increases in HIV prevalence among men who have sex with men (MSM). There is particular need to assess the extent of risk behavior among MSM outside of China's most cosmopolitan cities. We conducted a respondent-driven sampling survey (N = 428) to measure HIV seroprevalence and risk behavior among MSM in Jinan, China, the provincial capital of Shandong. HIV prevalence was 0.5% (95% confidence interval [CI] 0.1-1.0). Unprotected anal intercourse (UAI) in the last 6 months (reported by 61.4%) was associated with buying or selling sex to a man in the last 6 months, syphilis infection, multiple partners in the last month, low HIV knowledge and migrant status. No participant had previously tested for HIV. Risk for HIV transmission is widespread among MSM throughout China; basic prevention programs are urgently needed.

  9. Impact of intimate partner violence on clinic attendance, viral suppression and CD4 cell count of women living with HIV in an urban clinic setting.

    Anderson, Jocelyn C; Campbell, Jacquelyn C; Glass, Nancy E; Decker, Michele R; Perrin, Nancy; Farley, Jason

    2018-04-01

    The substance abuse, violence and HIV/AIDS (SAVA) syndemic represents a complex set of social determinants of health that impacts the lives of women. Specifically, there is growing evidence that intimate partner violence (IPV) places women at risk for both HIV acquisition and poorer HIV-related outcomes. This study assessed prevalence of IPV in an HIV clinic setting, as well as the associations between IPV, symptoms of depression and PTSD on three HIV-related outcomes-CD4 count, viral load, and missed clinic visits. In total, 239 adult women attending an HIV-specialty clinic were included. Fifty-one percent (95% CI: 45%-58%) reported past year psychological, physical, or sexual intimate partner abuse. In unadjusted models, IPV was associated with having a CD4 count 33% of past year all type clinic visits (OR: 1.535, 95% CI: 0.920-2.560, p = 0.101) or HIV specialty clinic visits (OR: 1.251, 95% CI: 0.732-2.140). In multivariable regression, controlling for substance use, mental health symptoms and demographic covariates, IPV remained associated with CD4 count suppression. The association between IPV and lower CD4 counts, but not adherence markers such as viral suppression and missed visits, indicates a need to examine potential physiologic impacts of trauma that may alter the immune functioning of women living with HIV. Incorporating trauma-informed approaches into current HIV care settings is one opportunity that begins to address IPV in this patient population.

  10. Pterygium: prevalence and severity in an Amazonian ophthalmic setting, Brazil

    Sophie Joanna Coutts

    2012-12-01

    Full Text Available OBJECTIVE: This is a cross sectional ophthalmic clinic-based study to estimate the prevalence and severity of pterygium in a selected population in the Amazon Basin, Brazil. METHODS: The study included 225 subjects above 20 years age from three different places of residence of Manaus city (group 1, n=89, river based communities (group 2, n= 116 and indigenous rainforest inhabitants (group 3, n=20. Pterygia was graded 1-4 by torch examination and gender, age and occupation determined. RESULTS: were assessed to have pterygia (grades 2-4 117 people; 52% against 108 control subjects with bilateral disease in 43% of subjects. Prevalence of grades 2-4 increased from 36% in group 1 to 62.5 % in group 2 and 75% in group 3. Of these subjects the percentage with outdoor professions increased across the groups from 31.2% to 67.1 % and 70% respectively. Also subjects of group 2 who worked largely outdoors, showed increasing pterygia severity, from grades 2 at 57% (p=0.0002, grade 3 at 93.3% (p,0.0001 to grade 4 at 100% (p=0.0004 CONCLUSION: Amazonian communities have a high prevalence of pterygia, which correlates to greater outdoor occupation and sun exposure. This study agrees with previous worldwide reports and it is the first study to compare the prevalence of pterygium in rural and urban living in Amazonian in Brazil. This study highlights the public health significance and gross need for intervention studies.

  11. Prevalence and correlates of knowledge of male partner HIV testing and serostatus among African-American women living in high poverty, high HIV prevalence communities (HPTN 064)

    Jennings, Larissa; Rompalo, Anne M.; Wang, Jing; Hughes, James; Adimora, Adaora A.; Hodder, Sally; Soto-Torres, Lydia E.; Frew, Paula M.; Haley, Danielle F.

    2014-01-01

    Knowledge of sexual partners' HIV infection can reduce risky sexual behaviors. Yet, there are no published studies to-date examining prevalence and characteristics associated with knowledge among African-American women living in high poverty communities disproportionately affected by HIV. Using the HIV Prevention Trial Network's (HPTN) 064 Study data, multivariable logistic regression was used to examine individual, partner, and partnership-level determinants of women's knowledge (n=1,768 women). Results showed that women's demographic characteristics alone did not account for the variation in serostatus awareness. Rather, lower knowledge of partner serostatus was associated with having two or more sex partners (OR=0.49, 95%CI: 0.37-0.65), food insecurity (OR=0.68, 95%CI: 0.49-0.94), partner age>35 (OR=0.68, 95%CI: 0.49-0.94), and partner concurrency (OR=0.63, 95%CI: 0.49-0.83). Access to financial support (OR=1.42, 95%CI: 1.05-1.92) and coresidence (OR=1.43, 95%CI: 1.05-1.95) were associated with higher knowledge of partner serostatus. HIV prevention efforts addressing African-American women's vulnerabilities should employ integrated behavioral, economic, and empowerment approaches. PMID:25160901

  12. High prevalence of HIV-1 CRF01_AE viruses among female commercial sex workers residing in Surabaya, Indonesia.

    Kotaki, Tomohiro; Khairunisa, Siti Qamariyah; Sukartiningrum, Septhia Dwi; Arfijanto, M Vitanata; Utsumi, Takako; Normalina, Irine; Handajani, Retno; Widiyanti, Prihartini; Rusli, Musofa; Rahayu, Retno Pudji; Lusida, Maria Inge; Hayashi, Yoshitake; Nasronudin; Kameoka, Masanori

    2013-01-01

    Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cause serious health problems and have an impact on the Indonesian economy. In addition, the rapid epidemic growth of HIV is continuing in Indonesia. Commercial sex plays a significant role in the spread of HIV; therefore, in order to reveal the current HIV prevalence rate among commercial sex workers (CSWs), we conducted an epidemiological study on HIV infection among CSWs residing in Surabaya, the capital of East Java province of Indonesia with large communities of CSWs. The prevalence of HIV infection among 200 CSWs was studied. In addition, the subtype of HIV type 1 (HIV-1) and the prevalence of other blood-borne viruses, hepatitis B virus (HBV), hepatitis C virus (HCV) and GB virus C (GBV-C), were studied. The prevalence rates of HIV, hepatitis B core antibody, hepatitis B surface antigen, anti-HCV antibodies and anti-GBV-C antibodies were 11%, 64%, 4%, 0.5% and 0% among CSWs involved in this study, respectively. HIV-1 CRF01_AE viral gene fragments were detected in most HIV-positive samples. In addition, most CSWs showed low awareness of sexually transmitted diseases and had unprotected sex with their clients. The HIV prevalence rate among CSWs was significantly higher than that among the general population in Indonesia (0.2-0.4%). In addition, CSWs were at a high risk of exposure to HBV, although chronic HBV infection was less frequently established. Our results suggest the necessity of efficient prevention programs for HIV and other blood-borne viral infections among CSWs in Surabaya, Indonesia.

  13. High prevalence of HIV-1 CRF01_AE viruses among female commercial sex workers residing in Surabaya, Indonesia.

    Tomohiro Kotaki

    Full Text Available Human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS cause serious health problems and have an impact on the Indonesian economy. In addition, the rapid epidemic growth of HIV is continuing in Indonesia. Commercial sex plays a significant role in the spread of HIV; therefore, in order to reveal the current HIV prevalence rate among commercial sex workers (CSWs, we conducted an epidemiological study on HIV infection among CSWs residing in Surabaya, the capital of East Java province of Indonesia with large communities of CSWs.The prevalence of HIV infection among 200 CSWs was studied. In addition, the subtype of HIV type 1 (HIV-1 and the prevalence of other blood-borne viruses, hepatitis B virus (HBV, hepatitis C virus (HCV and GB virus C (GBV-C, were studied. The prevalence rates of HIV, hepatitis B core antibody, hepatitis B surface antigen, anti-HCV antibodies and anti-GBV-C antibodies were 11%, 64%, 4%, 0.5% and 0% among CSWs involved in this study, respectively. HIV-1 CRF01_AE viral gene fragments were detected in most HIV-positive samples. In addition, most CSWs showed low awareness of sexually transmitted diseases and had unprotected sex with their clients.The HIV prevalence rate among CSWs was significantly higher than that among the general population in Indonesia (0.2-0.4%. In addition, CSWs were at a high risk of exposure to HBV, although chronic HBV infection was less frequently established. Our results suggest the necessity of efficient prevention programs for HIV and other blood-borne viral infections among CSWs in Surabaya, Indonesia.

  14. ORIGINAL ARTICLES HIV/AIDS prevalence testing – merits ...

    2006-01-18

    Jan 18, 2006 ... individuals.2 The annual national antenatal surveillance survey in 20033 ... groups, the antenatal survey prevalence figures do not reflect the lower overall ... employees with antiretroviral therapy. .... versus the sample taken.

  15. Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia.

    Kayeyi, Nkomba; Sandøy, Ingvild F; Fylkesnes, Knut

    2009-08-25

    Investigations of the association between socio-economic position indicators and HIV in East, Central and Southern Africa have chiefly focused on factors that pertain to individual-level characteristics. This study investigated the effect of neighbourhood educational attainment on HIV prevalence among young women in selected urban and rural areas in Zambia. This study re-analysed data from a cross-sectional population survey conducted in Zambia in 2003. The analyses were restricted to women aged 15-24 years (n = 1295). Stratified random cluster sampling was used to select 10 urban and 10 rural clusters. A measure for neighbourhood-level educational attainment was constructed by aggregating individual-level years-in-school. Multi-level mixed effects regression models were run to examine the neighbourhood-level educational effect on HIV prevalence after adjusting for individual-level underlying variables (education, currently a student, marital status) and selected proximate determinants (ever given birth, sexual activity, lifetime sexual partners). HIV prevalence among young women aged 15-24 years was 12.5% in the urban and 6.8% in the rural clusters. Neighbourhood educational attainment was found to be a strong determinant of HIV infection in both urban and rural population, i.e. HIV prevalence decreased substantially by increasing level of neighbourhood education. The likelihood of infection in low vs. high educational attainment of neighbourhoods was 3.4 times among rural women and 1.8 times higher among the urban women after adjusting for age and other individual-level underlying variables, including education. However, the association was not significant for urban young women after this adjustment. After adjusting for level of education in the neighbourhood, the effect of the individual-level education differed by residence, i.e. a strong protective effect among urban women whereas tending to be a risk factor among rural women. The findings suggested structural

  16. Does marital status matter in an HIV hyperendemic country? Findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey.

    Shisana, Olive; Risher, Kathryn; Celentano, David D; Zungu, Nompumelelo; Rehle, Thomas; Ngcaweni, Busani; Evans, Meredith G B

    2016-01-01

    South Africa has experienced declining marriage rates and the increasing practice of cohabitation without marriage. This study aims to improve the understanding of the relationship between marital status and HIV in South Africa, an HIV hyperendemic country, through an analysis of findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The nationally representative population-based cross-sectional survey collected data on HIV and socio-demographic and behavioural determinants in South Africa. This analysis considered respondents aged 16 years and older who consented to participate in the survey and provided dried blood spot specimens for HIV testing (N = 17,356). After controlling for age, race, having multiple sexual partners, condom use at last sex, urban/rural dwelling and level of household income, those who were married living with their spouse had significantly reduced odds of being HIV-positive compared to all other marital spouses groups. HIV incidence was 0.27% among respondents who were married living with their spouses; the highest HIV incidence was found in the cohabiting group (2.91%). Later marriage (after age 24) was associated with increased odds of HIV prevalence. Our analysis suggests an association between marital status and HIV prevalence and incidence in contemporary South Africa, where odds of being HIV-positive were found to be lower among married individuals who lived with their spouses compared to all other marital status groups. HIV prevention messages therefore need to be targeted to unmarried populations, especially cohabitating populations. As low socio-economic status, low social cohesion and the resulting destabilization of sexual relationships may explain the increased risk of HIV among unmarried populations, it is necessary to address structural issues including poverty that create an environment unfavourable to stable sexual relationships.

  17. HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China.

    Zhu, Jing; Yuan, Rui; Hu, Dan; Zhu, Zhibin; Wang, Ning; Wang, Bei

    2018-04-01

    Female sex workers (FSWs) and their male clients are vulnerable to HIV infection and serve as a bridge in HIV transmission from the high-risk population to the general, low-risk population. To examine the factors of FSWs and male clients that correlate with the prevalence of HIV infection in the Chinese-Vietnamese border region, a cross-sectional survey was conducted in 2014 in the Hekou county of the Yunnan province of China. We performed a questionnaire survey to collect data on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections and drug use. We found that the prevalence of HIV infection among FSWs was 2.74%, and 15 male clients (2.62%) were HIV-positive. Multivariate logistic regression analysis revealed that herpes simplex virus type 2 infection was a risk factor for HIV infection in FSWs and male clients, suggesting the increased role of sexual transmission in the HIV epidemic in the Chinese-Vietnamese border region. Positive urinalysis result for amphetamine-type stimulants was observed in FSWs with HIV infection. History of drug use was correlated with HIV infection, which increased the HIV infection risk of male clients, confirming that drug use is an important target in future interventions for HIV prevention.

  18. Continued high prevalence of HIV, HBV and HCV among injecting and noninjecting drug users in Italy

    Laura Camoni

    2010-03-01

    Full Text Available We estimated the prevalence of HIV, HBV and HCV infections among injecting and non-injecting drug users treated within public drug-treatment centres in Italy to determine the correlates of infection. In the sample of 1330 drug users, the prevalence of HIV was 14.4% among drug injectors and 1.6% among non-injectors; the prevalence of HBV was 70.4% among injecting drug users and 22.8% among non-injectors and of HCV was 83.2% among injecting drug users and 22.0% among non-injectors. Old age, unemployment, and intravenous drug use were significantly correlated with each of the infections, as well as a longer history of injecting drug use. The results indicate that these infections continue to circulate among drug users, highlighting the need for monitoring of this group in Italy.

  19. Salmonella prevalence among reptiles in a Zoo education setting

    Hydeskov, H. B.; Guardabassi, Luca; Aalbæk, Bent

    2013-01-01

    Clinically healthy reptiles may shed Salmonella and therefore act as a potential zoonotic threat. Most people in Northern European countries are rarely exposed to reptiles, but many zoos have education departments where children have direct contact with this group of animals. The objectives...... of this study were to determine the prevalence and serotype distribution of Salmonella among reptiles in the Education Department (n = 55) at Copenhagen Zoo and compare it to the Zoo's main reptile collection (n = 145) to evaluate the zoonotic risk. Salmonella was isolated from cloacal swabs by selective...... enrichment, and a single isolate from each positive sample was further identified by biochemical tests and serotyped. The overall prevalence was 35% (69/200) with significant difference between the Education Department (64%, 35/55) and the main reptile collection (23%, 34/145). A total of 28 serotypes were...

  20. HIV/AIDS, Drug Abuse Treatment, and the Correctional System.

    Lipton, Douglas S.

    1997-01-01

    Discusses in-prison prevalence and transmission of Human Immunodeficiency Virus (HIV). Focuses on epidemiology in prison settings, the role of ethnicity and gender in transmission, screening for HIV, segregating the HIV-positive inmate, condom distribution, medical treatment for HIV-positive inmates, HIV education and prevention, and tuberculosis…

  1. Determinants of Human Immunodeficiency Virus (HIV prevalence in homosexual and bisexual men screened for admission to a cohort study of HIV negatives in Belo Horizonte, Brazil: Project Horizonte

    Carneiro Mariângela

    2003-01-01

    Full Text Available Project Horizonte, an open cohort of homosexual and bisexual human immunodeficiency virus (HIV-1 negative men, is a component of the AIDS Vaccine Program, in Belo Horizonte, Minas Gerais, Brazil. The objective of this study was to compare volunteers testing HIV positive at cohort entry with a sample of those who tested HIV negative in order to identify risk factors for prevalent HIV infection, in a population being screened for enrollment at Project Horizonte. A nested case-control study was conducted. HIV positive volunteers at entry (cases were matched by age and admission date to three HIV negative controls each. Selected variables used for the current analysis included demographic factors, sexual behavior and other risk factors for HIV infection. During the study period (1994-2001, among the 621 volunteers screened, 61 tested positive for HIV. Cases were matched to 183 HIV negative control subjects. After adjustments, the main risk factors associated with HIV infection were unprotected sex with an occasional partners, OR = 3.7 (CI 95% 1.3-10.6, receptive anal intercourse with an occasional partner, OR = 2.8 (95% CI 0.9-8.9 and belonging to the negro racial group, OR = 3.4 (CI 95% 1.1-11.9. These variables were associated with an increase in the risk of HIV infection among men who have sex with men at the screening for admission to an open HIV negative cohort.

  2. HIV-related social intolerance and risky sexual behavior in a high HIV prevalence environment.

    Delavande, Adeline; Sampaio, Mafalda; Sood, Neeraj

    2014-06-01

    Although most countries state that fighting social intolerance against persons with HIV is part of their national HIV strategy, the impact of reducing intolerance on risky sexual behavior is largely unknown. In this paper, we estimate the effect of social intolerance against HIV+ persons on risky sexual behavior in rural Malawi using data from roughly 2000 respondents from the 2004 and 2006 waves of the Malawi Longitudinal Study of Families and Health (MLSFH). The effect of social intolerance on risky behavior is a priori ambiguous. On the one hand, higher social intolerance or stigma can lead people to disassociate from the stigmatized group and hence promote risky behavior. On the other hand, intolerance can be viewed as a social tax on being HIV+ and thus higher intolerance may reduce risky behavior. We find that a decrease in social intolerance is associated with a decrease in risky behavior, including fewer partners and a lower likelihood of having extra-marital relations. This effect is mainly driven by the impact of social intolerance on men. Overall the results suggests that reducing social intolerance might not only benefit the HIV positive but might also forestall the spread of HIV. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Salmonella prevalence among reptiles in a zoo education setting.

    Hydeskov, H B; Guardabassi, L; Aalbaek, B; Olsen, K E P; Nielsen, S S; Bertelsen, M F

    2013-06-01

    Clinically healthy reptiles may shed Salmonella and therefore act as a potential zoonotic threat. Most people in Northern European countries are rarely exposed to reptiles, but many zoos have education departments where children have direct contact with this group of animals. The objectives of this study were to determine the prevalence and serotype distribution of Salmonella among reptiles in the Education Department (n = 55) at Copenhagen Zoo and compare it to the Zoo's main reptile collection (n = 145) to evaluate the zoonotic risk. Salmonella was isolated from cloacal swabs by selective enrichment, and a single isolate from each positive sample was further identified by biochemical tests and serotyped. The overall prevalence was 35% (69/200) with significant difference between the Education Department (64%, 35/55) and the main reptile collection (23%, 34/145). A total of 28 serotypes were detected. Ten serotypes were isolated from more than one specimen and four from more than one species. Salmonella enterica subsp. enterica serovar Eastbourne was the predominant serotype (32%, 22/69) and was also the serotype isolated from most reptile species (n = 7). Transmission of serotypes from one department to another was very limited indicated by the serotype distribution. Despite the relative high prevalence observed among the reptiles in the Zoo's Education Department compared to the reptiles in the Zoo's main reptile collection, no Salmonella cases have been linked to the Zoo, and Salmonella ser. Eastbourne is very rarely isolated from humans in Denmark. Simple hygienic procedures such as hand washing which is consistently carried out following handling of reptiles at the Education Department may reduce the risk and therefore contribute to this low prevalence. © 2012 Blackwell Verlag GmbH.

  4. Smoking in Correctional Settings Worldwide: Prevalence, Bans, and Interventions.

    Spaulding, Anne C; Eldridge, Gloria D; Chico, Cynthia E; Morisseau, Nancy; Drobeniuc, Ana; Fils-Aime, Rebecca; Day, Carolyn; Hopkins, Robyn; Jin, Xingzhong; Chen, Junyu; Dolan, Kate A

    2018-06-01

    Smoking tobacco contributes to 11.5% of deaths worldwide and, in some countries, more hospitalizations than alcohol and drugs combined. Globally in 2015, 25% of men and 5% of women smoked. In the United States, a higher proportion of people in prison smoke than do community-dwelling individuals. To determine smoking prevalence in prisons worldwide, we systematically reviewed the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; we also examined whether prisons banned smoking or treated smokers. We searched databases for articles published between 2012 and 2016 and located 85 relevant articles with data representing 73.5% of all incarcerated persons from 50 countries. In 35 of 36 nations (97%) with published prevalence data, smoking for the incarcerated exceeded community rates 1.04- to 62.6-fold. Taking a conservative estimate of a 2-fold increase, we estimated that, globally, 14.5 million male and 26,000 female smokers pass through prisons annually. Prison authorities' responses include permitting, prohibiting, or treating tobacco use. Bans may temporarily improve health and reduce in-prison health care costs but have negligible effect after prison release. Evidence-based interventions for smoking cessation effective outside prisons are effective inside; effects persist after release. Because smoking prevalence is heightened in prisons, offering evidence-based interventions to nearly 15 million smokers passing through yearly would improve global health.

  5. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts. Published by Elsevier Inc.

  6. HIV infection among foreign transsexual sex workers in Rome: prevalence, behavior patterns, and seroconversion rates.

    Spizzichino, L; Zaccarelli, M; Rezza, G; Ippolito, G; Antinori, A; Gattari, P

    2001-07-01

    The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people. To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center. A cross-sectional, follow-up study was conducted. Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion. The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.

  7. Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women

    Nara Chartuni Pereira Teixeira

    Full Text Available OBJECTIVES: To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN among HIV-infected women. METHODS: Cross-sectional study of 494 HIV-infected women in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors. RESULTS: CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1. Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm³ (OR 5.0, 95% CI 2.5-10.1, with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5, and with age < 34 years old (OR 1.5, 95% CI 1.0-2.4. HIV viral load and antiretroviral use were not independent risk factors for CIN. CONCLUSIONS: Severity of immunosupression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.

  8. Prevalence of Periodontal Diseases in a Multicenter Cohort of Perinatally HIV-Infected and HIV-exposed and Uninfected Youth

    Ryder, Mark I.; Yao, Tzy-Jyun; Russell, Jonathan S.; Moscicki, Anna-Barbara; Shiboski, Caroline H.

    2016-01-01

    Aims To compare the prevalence and severity of periodontal diseases between 180 perinatally HIV-infected (PHIV) and 118 perinatally HIV-exposed and uninfected (PHEU) youth in a cross-sectional study conducted at 11 clinical sites in the United States and Puerto Rico from the Adolescent Master Protocol (AMP) study of the Pediatric HIV/AIDS cohort study (PHACS) network. Methods Several analyses were conducted, employing the current CDC/AAP classification for periodontitis and incorporating a definition of gingivitis based on a bleeding on probing threshold, and analyses based on more detailed whole mouth, intraoral regionally, site-based, and tooth-based criteria of bleeding on probing, plaque levels, pockets depths and clinical attachment levels. Results After adjusting for plaque control habits, and behavioral and sociodemographic factors, there were no significant differences in periodontal diseases between the PHIV and PHEU youth using any of these criteria. For PHIV youth, there was no significant association between parameters of periodontal disease and current HIV status. Conclusions While no significant differences in periodontal parameters were noted between the PHIV and PHEU youth, the influence of antiretroviral therapy on merits further exploration in this cohort in a longitudinal study. PMID:27801947

  9. The Impact of Quality Assurance Initiatives and Workplace Policies and Procedures on HIV/AIDS-Related Stigma Experienced by Patients and Nurses in Regions with High Prevalence of HIV/AIDS.

    Hewko, Sarah J; Cummings, Greta G; Pietrosanu, Matthew; Edwards, Nancy

    2018-02-23

    Stigma is commonly experienced by people living with HIV/AIDS and by those providing care to HIV/AIDS patients. Few intervention studies have explored the impact of workplace policies and/or quality improvement on stigma. We examine the contribution of health care workplace policies, procedures and quality assurance initiatives, and self- and peer-assessed individual nurse practices, to nurse-reported HIV/AIDS-stigma practices toward patients living with HIV/AIDS and nurses in health care settings. Our sample of survey respondents (n = 1157) included managers (n = 392) and registered/enrolled nurses (n = 765) from 29 facilities in 4 countries (South Africa, Uganda, Jamaica, Kenya). This is one of the first studies in LMIC countries to use hierarchical linear modeling to examine the contributions of organizational and individual factors to HIV/AIDS stigma. Based on our results, we argue that organizational interventions explicitly targeting HIV/AIDS stigma are required to reduce the incidence, prevalence and morbidity of HIV/AIDS.

  10. Prevalence of HIV Infection and Risk Factors Among Female Sex Workers in a Southeast Province of Vietnam.

    Nguyen, Tri; Stewart, Donald Edwin; Lee, Chiao Tzu Patricia; Dang, Thi Nhu Hang

    2017-08-01

    Female sex workers (FSWs) are at heightened risk of HIV infection. This research aims to determine the prevalence of HIV and relevant risk factors and related behavior among FSWs in Ba Ria - Vung Tau, a southeast province of Vietnam. 420 FSWs were interviewed using a structured questionnaire and biological samples tested for HIV. 2.6 % were found to be HIV positive. HIV infection was significantly higher in FSWs who had low income (≤AUD 200 per month), have had anal sex, have had sex with injecting drug users, and had a low level of HIV/AIDS-related knowledge. Improved employment opportunities and income are important to reduce the pressure for young women to engage in sex work for income purposes, but in public health terms, existing HIV treatment, prevention and intervention programs needs better targeting and improvements to reduce the risk of HIV infection.

  11. Research Priorities for the Intersection of Alcohol and HIV/AIDS in Low and Middle Income Countries: A Priority Setting Exercise.

    Gordon, Sara; Rotheram-Borus, Mary Jane; Skeen, Sarah; Perry, Charles; Bryant, Kendall; Tomlinson, Mark

    2017-11-01

    The harmful use of alcohol is a component cause for more than 200 diseases. The association between alcohol consumption, risk taking behavior and a range of infectious diseases such as HIV/AIDS is well established. The prevalence of HIV/AIDS as well as harmful alcohol use in low and middle income countries is high. Alcohol has been identified as a modifiable risk factor in the prevention and treatment of HIV/AIDS. The objective of this paper is to define research priorities for the interaction of alcohol and HIV/AIDS in low and middle income countries. The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities of the interaction of alcohol and HIV/AIDS. A group of 171 global and local experts in the field of alcohol and or HIV/AIDS related research were identified and invited to generate research questions. This resulted in 205 research questions which have been categorized and refined by senior researchers into 48 research questions to be evaluated using five criteria: answerability, effectiveness, feasibility, applicability and impact, as well as equity. A total of 59 experts participated independently in the voluntary scoring exercise (a 34% response rate). There was substantial consensus among experts on priorities for research on alcohol and HIV. These tended to break down into two categories, those focusing on better understanding the nexus between alcohol and HIV and those directed towards informing practical interventions to reduce the impact of alcohol use on HIV treatment outcomes, which replicates what Bryant (Subst Use Misuse 41:1465-1507, 2006) and Parry et al. (Addiction 108:1-2, 2012) found. Responses from experts were stratified by location in order to determine any differences between groups. On average experts in the LMIC gave higher scores than the HIC experts. Recent research has shown the causal link between alcohol consumption and the incidence of HIV

  12. HAART impact on prevalence of chronic otitis media in Brazilian HIV-infected children.

    Weber, Raimar; Pinheiro Neto, Carlos Diógenes; Miziara, Ivan Dieb; Araújo Filho, Bernardo Cunha

    2006-01-01

    The advent of new antiretroviral drugs such as protease inhibitors has generated sensible changes in morbity and mortality in HIV-infected patients. To evaluate the impact of Highly Active Antiretroviral Therapy (HAART) on the prevalence of chronic otitis media in HIV-infected pediatric population. We analyzed medical charts of 471 children aged zero to 12 years and 11 months with HIV infection from an Ambulatory of ENT and AIDS. Children were divided according to the age: 0 to 5 years and 11 months and 6 to 12 years and 11 months and classified as having chronic otitis media based on history, physical examination, audiologic and tympanometric data. Prevalence of chronic otitis media, as well as CD4+ lymphocyte count were compared between groups in use of HAART and the group without HAART. Out of 459 children, 65 (14.2%) had chronic otitis media. We observed that in children aged 0 to 5 years and 11 months who were taking HAART there was significant lower prevalence of chronic otitis media (p=0.02). The use of HAART was associated to higher mean CD4+ lymphocyte count (pmedia in HIV infected children, probably due to increase in mean CD4+ lymphocyte count.

  13. HIV transmission in the dental setting and the HIV-infected oral health care professional: workshop 1C.

    Flint, S R

    2011-04-01

    This workshop addressed two important issues: first, the global evidence of HIV transmission from health care provider to patient and from patient to health care provider in the general health care environment and the dental practice setting; second, in the era of highly active antiretroviral therapy, whether oral health care professionals living with HIV pose a risk of transmission to their patients and whether standard infection control is adequate to protect both the patient and the oral health care professional in dental practice. The workshop culminated in a general discussion and the formulation of a consensus statement from the participating delegates, representing more than 30 countries, on the criteria under which an HIV-infected oral health care professional might practice dentistry without putting patients at risk. This consensus statement, the Beijing Declaration, was agreed nem con.

  14. Prevalence of HIV and other sexually transmitted infections among female sex workers in Kisumu, Western Kenya, 1997 and 2008.

    Hilde M Vandenhoudt

    Full Text Available In 1997, a survey in Kisumu found a prevalence of HIV infection among female sex workers (FSW of 75%. Only 50% reported using a condom with the last client. In 2008, we conducted another survey to collect data to inform an intervention targeting FSW in Kisumu.In 2008 FSW were recruited by respondent-driven sampling. Women completed a questionnaire and were tested for HIV and other sexually transmitted infections (STIs. Multiple logistic regression analysis was done to explore factors associated with HIV-infection, and with condom use. Prevalence of HIV infection was compared in the two surveys from 1997 and 2008. Multivariate analysis was used to assess whether a change in HIV prevalence between the two surveys could be explained by changes in socio-demographic characteristics and/or behavioral factors.481 FSW participated in the 2008 study. HIV prevalence was 56.5% (95% CI 52.0-61.6. Factors independently associated with HIV were age older than 29 years; being a widow; STI treatment in the past year; herpes simplex virus Type-2 infection; bacterial vaginosis; and trichomoniasis. Condom use with last client was reported by 75.0% (95% CI 70.9-78.9. Predictors of condom use with the last client were age older than 29 years; higher price paid by last client; ever having been tested for HIV. Predictors of unprotected sex were being drunk during last sex act; usually having sex during menses; and STI treatment in the past year. The odds ratio of HIV infection associated with year of survey was 0.49 (95% CI 0.33-0.75 after adjusting for socio-demographic and behavioral factors.The prevalence of HIV among FSW in Kisumu was found to be lower in 2008 than in 1997, while reported condom use was higher. However, access to HIV/STI prevention and care services needs to improve to further decrease HIV transmission between FSW and their clients.

  15. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

    Moesgaard Iburg, Kim

    2016-01-01

    and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all......Summary Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage......-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software...

  16. HIV Prevalence and Antenatal Care Attendance among Pregnant Women in a Large Home-Based HIV Counseling and Testing Program in Western Kenya.

    Ndege, Samson; Washington, Sierra; Kaaria, Alice; Prudhomme-O'Meara, Wendy; Were, Edwin; Nyambura, Monica; Keter, Alfred K; Wachira, Juddy; Braitstein, Paula

    2016-01-01

    To describe the uptake of and factors associated with HIV prevalence among pregnant women in a large-scale home-based HIV counseling and testing (HBCT) program in western Kenya. In 2007, the Academic Model Providing Access to Healthcare Program (AMPATH) initiated HBCT to all individuals aged ≥13 years and high-risk children HIV prevalence. There were 119,678 women eligible for analysis; median age 25 (interquartile range, IQR: 18-34) years. Of these, 7,396 (6.2%) were pregnant at the time of HBCT; 4,599 (62%) had ever previously tested for HIV and 2,995 (40.5%) had not yet attended ANC for their current pregnancy. Testing uptake among pregnant women was high (97%). HBCT newly identified 241 (3.3%) pregnant HIV-positive women and overall HIV prevalence among all pregnant women was 6.9%. HIV prevalence among those who had attended ANC in this pregnancy was 5.4% compared to 9.0% among those who had not. Pregnant women were more likely to newly test HIV-positive in HBCT if they had not attended ANC in the current pregnancy (AOR: 6.85, 95% CI: 4.49-10.44). Pregnant women who had never attended ANC were about 6 times more likely to newly test HIV-positive compared to those who had attended ANC, suggesting that the cascade of services for prevention of mother-to-child HIV transmission should optimally begin at the home and village level if elimination of perinatal HIV transmission is to be achieved.

  17. Prevalence of malnutrition in various political, economic, and geographic settings.

    Klek, Stanislaw; Krznaric, Zeljko; Gundogdu, Riza Haldun; Chourdakis, Michael; Kekstas, Gintautas; Jakobson, Triin; Paluszkiewicz, Piotr; Vranesic Bender, Darija; Uyar, Mehmet; Demirag, Kubilay; Poulia, Kalliopi Anna; Klimasauskas, Andrius; Starkopf, Joel; Galas, Aleksander

    2015-02-01

    Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European countries. The aim of this study was to put the problem into perspective by comparing the prevalence of malnutrition in countries from opposite parts of the continent. Six countries-Croatia, Estonia, Greece, Lithuania, Poland, and Turkey-participated in the study. A short questionnaire was used to assess DRM: its prevalence, the current situation in hospitals, regulations for reimbursement, and general healthcare circumstances. Data from ESPEN's NutritionDay 2006 were used to broaden the perspective. At admission in October 2012, 4068 patients were assessed. The study was performed in 160 hospitals and 225 units with 9143 beds. The highest proportions of patients with 3 or more points on the Nutritional Risk Screening 2002 were observed in Estonia (80.4%) and Turkey (39.4%), whereas the lowest were in Lithuania (14.2%). The provision of nutrition support was best in Turkey (39.4% required intervention, 34.4% received intervention) and Poland (21.9% and 27.8%, respectively). Nutrition support teams (NSTs) are active in some countries, whereas in others they virtually do not exist. The prevalence of malnutrition was quite high in some countries, and the nutrition approach differed among them. It could be the result of the lack of reimbursement, inactive or nonexistent NSTs, and low nutrition awareness. Those facts confirmed that the continuation of FAM activities is necessary. © 2013 American Society for Parenteral and Enteral Nutrition.

  18. A Meta-Analysis of the Metabolic Syndrome Prevalence in the Global HIV-Infected Population.

    Kim A Nguyen

    Full Text Available Cardio-metabolic risk factors are of increasing concern in HIV-infected individuals, particularly with the advent of antiretroviral therapy (ART and the subsequent rise in longevity. However, the prevalence of cardio-metabolic abnormalities in this population and the differential contribution, if any, of HIV specific factors to their distribution, are poorly understood. Therefore, we conducted a systematic review and meta-analysis to estimate the global prevalence of metabolic syndrome (MS in HIV-infected populations, its variation by the different diagnostic criteria, severity of HIV infection, ART used and other major predictive characteristics.We performed a comprehensive search on major databases for original research articles published between 1998 and 2015. The pooled overall prevalence as well as by specific groups and subgroups were computed using random effects models.A total of 65 studies across five continents comprising 55094 HIV-infected participants aged 17-73 years (median age 41 years were included in the final meta-analysis. The overall prevalence of MS according to the following criteria were: ATPIII-2001:16.7% (95%CI: 14.6-18.8, IDF-2005: 18% (95%CI: 14.0-22.4, ATPIII-2004-2005: 24.6% (95%CI: 20.6-28.8, Modified ATPIII-2005: 27.9% (95%CI: 6.7-56.5, JIS-2009: 29.6% (95%CI: 22.9-36.8, and EGIR: 31.3% (95%CI: 26.8-36.0. By some MS criteria, the prevalence was significantly higher in women than in men (IDF-2005: 23.2% vs. 13.4, p = 0.030, in ART compared to non-ART users (ATPIII-2001: 18.4% vs. 11.8%, p = 0.001, and varied significantly by participant age, duration of HIV diagnosis, severity of infection, non-nucleoside reverse transcriptase inhibitors (NNRTIs use and date of study publication. Across criteria, there were significant differences in MS prevalence by sub-groups such as in men, the Americas, older publications, regional studies, younger adults, smokers, ART-naïve participants, NNRTIs users, participants with shorter

  19. HIV prevalence in South Sudan: data from the ANC sentinel ...

    data, triangulated with data from other sources that will achieve informed consensus about population prevalence. Methodology selection of sample. Sentinel surveillance was conducted among pregnant women aged 15-49 attending ANC. Pregnant women were selected as a proxy for the general population and because ...

  20. Prevalence and multiplicity of HPV in HIV women in Minas Gerais, Brazil Prevalência e multiplicidade do HPV em mulheres infectadas pelo HIV em Minas Gerais

    Christine Miranda Corrêa

    2011-08-01

    Full Text Available OBJECTIVE: To detect the frequency and subtypes of HPV in the uterine cervix of HIV-infected women. METHODS: Sample consisted of 288 HIV-infected women, recruited from the public health system of five cities of Minas Gerais, Brazil. Women were seen from August 2003 to August 2008. Cervical samples were collected for cytological analysis and for HPV DNA detection, using polymerase chain reaction (PCR. HPV DNA was classified according to its oncogenic potential in low risk (types 6, 11 and high risk (types 16, 18, 31, 33, 35. Colposcopy was performed, followed by cervical biopsy when necessary. Categorical variables were compared using the Chi-squared test, with a significance level established at the 5% level. RESULTS: HPV prevalence was 78.8%. Most frequent genotypes were HPV-6 (63.9% and HPV-16 (48.5%. High-risk HPV were observed in 70.5% of the women; low-risk in 71.4%; both high and low-risk HPV were detected in 55.1% of the patients. Multiple HPV genotypes were detected in 64.8% of the patients; two genotypes in 23.8%, and three in 18.9%. CONCLUSION: HPV prevalence was high among HIV-infected women. Multiple HPV genotypes were common in samples from the uterine cervix of HIV-infected womenOBJETIVO: Detectar a frequência e os subtipos do HPV na cérvice uterina de mulheres infectadas pelo HIV. MÉTODOS: A amostra era composta por 288 mulheres infectadas pelo HIV, recrutadas do sistema público de saúde de cinco cidades de Minas Gerais, Brasil. As mulheres foram avaliadas de agosto de 2003 a agosto de 2008. Amostras cervicais foram coletadas para análise citológica e para detecção do HPV DNA, usando a reação em cadeia de polimerase (PCR. O HPV DNA foi classificado de acordo com seu potencial oncogênico em baixo risco (tipos 6,11 e alto risco (tipos 16, 18, 31, 33, 35. Foi realizada colposcopia, seguida de biópsia cervical, quando indicada. Variáveis categóricas foram comparadas usando o teste do quiquadrado, com nível de signific

  1. HBV or HCV Coinfection in HIV-1-Infected Pregnant Women in France: Prevalence and Pregnancy Outcomes.

    Benhammou, Valérie; Tubiana, Roland; Matheron, Sophie; Sellier, Pierre; Mandelbrot, Laurent; Chenadec, Jérôme Le; Marel, Emmanuelle; Khoshnood, Babak; Warszawski, Josiane

    2018-04-15

    Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is frequent in HIV-infected persons but their impact on pregnant HIV-infected women is understudied. We explored whether these coinfections are associated with adverse pregnancy outcomes and lower response to antiretroviral therapy (ART). Pregnancies in HIV-1-infected women included in the ANRS French Perinatal Cohort between 2005 and 2013 were analyzed if HBV and HCV infection statuses were available. Among 4236 women, the prevalence of HBV (HBs Ag+) and HCV (RNA+) were 6.2% (95% confidence interval: 5.4 to 6.8) and 1.7% (1.3 to 2.1), respectively. HCV coinfection was strongly associated with a history of drug use; HBV coinfection was 6 times more frequent in women born in Sub-Saharan Africa than in European France. Baseline HIV viral load, CD4 count, and HIV care during pregnancy were similar in coinfected and monoinfected HIV mothers, except that 90% of HBV/HIV women were receiving tenofovir and/or lamivudine or emtricitabine. HCV coinfection was significantly associated with cholestasis [adjusted odds ratio: 4.1 (1.5-10.8), P = 0.005], preterm delivery [3.0 (1.6-5.7), P HIV-infected women, chronic HBV infection, mostly treated using targeted ART, had no major impact on the course of pregnancy. By contrast, chronic HCV infection was associated with a higher risk of obstetrical complications and a poorer immune-virological response to ART. It is yet unknown whether cure of HCV infection before conception can limit these adverse outcomes.

  2. Sharply rising prevalence of HIV infection in Bali: a critical assessment of the surveillance data.

    Januraga, P P; Wulandari, L P L; Muliawan, P; Sawitri, S; Causer, L; Wirawan, D N; Kaldor, J M

    2013-08-01

    This study critically examines serological survey data for HIV infection in selected populations in Bali, Indonesia. Sero-survey data reported by the Bali Health Office between 2000 and 2010 were collated, and provincial health staff were interviewed to gain a detailed understanding of survey methods. Analysis of time series restricted to districts that have used the same sampling methods and sites each year indicates that there has been a steady decline in HIV prevalence among prisoners, from 18.7% in 2000 to 4.3% in 2010. In contrast, HIV prevalence among women engaged in sex work increased sharply: from 0.62% in 2000 to 20.2% in 2010 (brothel based), and from 0% in 2000 to 7.2% in 2010 (non-brothel based). The highest prevalence was recorded among people who injected drugs. Recent surveys of gay men and transvestites also found high prevalences, at 18.7% and 40.9%, respectively. Review of the methodology used in the surveys identified inconsistencies in the sampling technique, sample numbers and sites over time, and incomplete recording of individual information about survey participants. Attention to methodological aspects and incorporation of additional information on behavioural factors will ensure that the surveillance system is in the best position to support prevention activities.

  3. Perceptions of HIV and Safe Male Circumcision in High HIV Prevalence Fishing Communities on Lake Victoria, Uganda.

    Paul E Nevin

    Full Text Available In 2010, the Uganda Ministry of Health introduced its Safe Male Circumcision (SMC strategy for HIV prevention with the goal of providing 4.2 million voluntary medical male circumcisions by 2015. Fishing communities, where HIV prevalence is approximately 3-5 times higher than the national average, have been identified as a key population needing targeted HIV prevention services by the National HIV Prevention Strategy. This study aimed to understand perceptions of HIV and identify potential barriers and facilitators to SMC in fishing communities along Lake Victoria.We conducted 8 focus group discussions, stratified by sex and age, with 67 purposefully sampled participants in 4 communities in Kalangala District, Uganda.There was universal knowledge of the availability of SMC services, but males reported high uptake in the community while females indicated that it is low. Improved hygiene, disease prevention, and improved sexual performance and desirability were reported facilitators. Barriers included a perceived increase in SMC recipients' physiological libido, post-surgical abstinence, lost income during convalescence, and lengthier recovery due to occupational hazards. Both males and females reported concerns about spousal fidelity during post-SMC abstinence. Reported misconceptions and community-held cultural beliefs include fear that foreskins are sold after their removal, the belief that a SMC recipient's first sexual partner after the procedure should not be his spouse, and the belief that vaginal fluids aid circumcision wound healing.Previous outreach efforts have effectively reached these remote communities, where availability and health benefits of SMC are widely understood. However, community-specific intervention strategies are needed to address the barriers identified in this study. We recommend the development of targeted counseling, outreach, and communication strategies to address barriers, misconceptions, and community-held beliefs

  4. National Prevalence and Trends of HIV Transmitted Drug Resistance in Mexico

    Avila-Ríos, Santiago; García-Morales, Claudia; Garrido-Rodríguez, Daniela; Ormsby, Christopher E.; Hernández-Juan, Ramón; Andrade-Villanueva, Jaime; González-Hernández, Luz A.; Torres-Escobar, Indiana; Navarro-Álvarez, Samuel; Reyes-Terán, Gustavo

    2011-01-01

    Background Transmitted drug resistance (TDR) remains an important concern for the management of HIV infection, especially in countries that have recently scaled-up antiretroviral treatment (ART) access. Methodology/Principal Findings We designed a study to assess HIV diversity and transmitted drug resistance (TDR) prevalence and trends in Mexico. 1655 ART-naïve patients from 12 Mexican states were enrolled from 2005 to 2010. TDR was assessed from plasma HIV pol sequences using Stanford scores and the WHO TDR surveillance mutation list. TDR prevalence fluctuations over back-projected dates of infection were tested. HIV subtype B was highly prevalent in Mexico (99.9%). TDR prevalence (Stanford score>15) in the country for the study period was 7.4% (95% CI, 6.2∶8.8) and 6.8% (95% CI, 5.7∶8.2) based on the WHO TDR surveillance mutation list. NRTI TDR was the highest (4.2%), followed by NNRTI (2.5%) and PI (1.7%) TDR. Increasing trends for NNRTI (p = 0.0456) and PI (p = 0.0061) major TDR mutations were observed at the national level. Clustering of viruses containing minor TDR mutations was observed with some apparent transmission pairs and geographical effects. Conclusions TDR prevalence in Mexico remains at the intermediate level and is slightly lower than that observed in industrialized countries. Whether regional variations in TDR trends are associated with differences in antiretroviral drug usage/ART efficacy or with local features of viral evolution remains to be further addressed. PMID:22110765

  5. Peripheral neuropathy in HIV: prevalence and risk factors

    Evans, Scott R.; Ellis, Ronald J.; Chen, Huichao; Yeh, Tzu-min; Lee, Anthony J.; Schifitto, Giovanni; Wu, Kunling; Bosch, Ronald J.; McArthur, Justin C.; Simpson, David M.; Clifford, David B.

    2011-01-01

    Objectives To estimate neuropathic sign/symptom rates with initiation of combination antiretroviral therapy (cART) in HIV-infected ART-naive patients, and to investigate risk factors for: peripheral neuropathy and symptomatic peripheral neuropathy (SPN), recovery from peripheral neuropathy/SPN after neurotoxic ART (nART) discontinuation, and the absence of peripheral neuropathy/SPN while on nART. Design AIDS Clinical Trials Group (ACTG) Longitudinal Linked Randomized Trial participants who initiated cART in randomized trials for ART-naive patients were annually screened for symptoms/signs of peripheral neuropathy. ART use and disease characteristics were collected longitudinally. Methods Peripheral neuropathy was defined as at least mild loss of vibration sensation in both great toes or absent/hypoactive ankle reflexes bilaterally. SPN was defined as peripheral neuropathy and bilateral symptoms. Generalized estimating equation logistic regression was used to estimate associations. Results Two thousand, one hundred and forty-one participants were followed from January 2000 to June 2007. Rates of peripheral neuropathy/SPN at 3 years were 32.1/8.6% despite 87.1% with HIV-1RNA 400 copies/ml or less and 70.3% with CD4 greater than 350 cells/µl. Associations with higher odds of peripheral neuropathy included older patient age and current nART use. Associations with higher odds of SPN included older patient age, nART use, and history of diabetes mellitus. Associations with lower odds of recovery after nART discontinuation included older patient age. Associations with higher odds of peripheral neuropathy while on nART included older patient age and current protease inhibitor use. Associations with higher odds of SPN while on nART included older patient age, history of diabetes, taller height, and protease inhibitor use. Conclusion Signs of peripheral neuropathy remain despite virologic/immunologic control but frequently occurs without symptoms. Aging is a risk factor for

  6. Low prevalence of peripheral arterial disease in a cross-sectional study of Danish HIV-infected patients

    Knudsen, Andreas; Malmberg, Catarina Anna Evelina; Kjær, Andreas

    2015-01-01

    . However, controversies exist on the prevalence of PAD among HIV-infected patients. In this study we aimed to measure the prevalence of PAD among HIV-infected patients and compare the ABI with carotid intima-media thickness (cIMT) and other known CVD risk predictors. METHODS: We prospectively included HIV......BACKGROUND: Patients infected with human immunodeficiency virus (HIV) appear to be at increased risk of cardiovascular disease (CVD). The ankle-brachial index (ABI) is a well-established screening tool for peripheral arterial disease (PAD) and future cardiovascular events in the general population....... In contrast, a strong correlation was found between cIMT and traditional risk factors. Values of post-exercise ABI and cIMT were not correlated. The current ART did not influence ABI values. CONCLUSIONS: We found a low prevalence of PAD in HIV-infected patients. ABI did not correlate with CVD risk factors...

  7. Prevalence of HIV/AIDS and psychiatric disorders and their related risk factors among adults in Epworth, Zimbabwe.

    Sebit, M B; Tombe, M; Siziya, S; Balus, S; Nkomo, S D A; Maramba, P

    2003-10-01

    To examine the prevalence of HIV infection, neuropsychiatric disorders, psychiatric symptoms/signs, alcohol use/misuse, CD4 cell counts and risk factors in adult patients. Cross-sectional study. Epworth, which is about 15 km on the southeastern part of Harare, Zimbabwe. Two hundred subjects were included in the study out of which six were excluded beacause of HIV-1 indeterminate results. A convenience sample of 200 subjects recruited in a cross-sectional study in Epworth, Zimbabwe. Six subjects had indeterminate HIV-1 antibody results and were excluded from the study. The remaining 194 subjects of whom 101 (52.1%) knew about their sero-status and were consecutively recruited, whereas, 93 (47.9%) did not know about their sero-status and were recruited by a systematic random sampling method (1-in-3). They were then interviewed about neuropsychiatric disorders using BPRS, MADRS, AUDIT and MINI Mental State Test, including the risk factors related to HIV infection. After ELISA tests' results, the two groups were combined and then categorised into HIV positive (n=115) and HIV negative (n=79) subjects. Prevalence, neuropsychiatric disorders, increased CD4 cell counts and risk factors associated with HIV infection. The findings were that the overall point prevalence of the HIV infection was 59.3% (115/194). Comparative analyses between seropositive and seronegative HIV/AIDS subjects showed: over two thirds (71.3%) of the HIV positive subjects suffered from psychiatric disorders, more than those with HIV negative 44.3% (OR=3.12, 95% CI=1.64-5.95, P=0.0002), and subjects aged 35 years and less were mostly HIV seronegatives (n=77.2%, OR=2.34, 95% CI=1.18-4.75, P=0.014). The overall prevalence of alcohol use/misuse was 41 (21.1%), with higher prevalence rate among HIV positive subjects, 28 (24.3%) than those who were HIV negative, 13 (16.5%). The commonest psychiatric symptoms/signs (P<0.05) were emotional withdrawal, depressed mood, suspiciousness, apparent sadness, reduced

  8. HIV prevalence by race co-varies closely with concurrency and number of sex partners in South Africa.

    Chris Kenyon

    Full Text Available BACKGROUND: HIV prevalence differs by more than an order of magnitude between South Africa's racial groups. Comparing the sexual behaviors and other risk factors for HIV transmission between the different races may shed light on the determinants of South Africa's generalized HIV epidemic. METHODS: Five nationally representative and one city-representative population-based surveys of sexual behavior were used to assess the extent to which various risk factors co-varied with HIV prevalence by race in South Africa. RESULTS: In 2004, the prevalence of HIV was 0.5%, 1%, 3.2% and 19.9% in 15-49 year old whites, Indians, coloureds and blacks respectively. The risk factors which co-varied with HIV prevalence by race in the six surveys were age of sexual debut (in five out of five surveys for men and three out of six surveys for women, age gap (zero surveys in men and three in women, mean number of sex partners in the previous year (five surveys in men and three in women and concurrent partnerships (five surveys in men and one in women. Condom usage and circumcision were both more prevalent in the high HIV prevalence groups. The reported prevalence of concurrency was 6 to 17 times higher in the black as opposed to the white men in the five surveys. CONCLUSIONS: The differences in sexual behavior in general, and the prevalence of concurrency and the number of sexual partners in particular, offer a plausible and parsimonious cause to explain a part of the differing prevalences of HIV between South Africa's racial groups.

  9. Prevalence and Risk Factors for Human Immunodeficiency Virus (HIV) and Syphilis Infections Among Military Personnel in Sierra Leone

    2017-03-01

    sponses (n=10). 3.5. Factors Associated with Syphilis Status Syphilis seropositivity was increased by older age , HIV in- fection and the...multiple sexual partnerships in the same week and HIV testing outside of military facilities (pɘ.05). Increasing age , positive HIV status and rural...population (15-49 years of age ) of Sierra Leone, and the estimated syphilis prevalence ranged from 1.5% to 5.2% based on regional studies. We examined the

  10. The association of psychiatric disorders and HIV infection in the correctional setting.

    Baillargeon, Jacques; Ducate, Suzanne; Pulvino, John; Bradshaw, Patrick; Murray, Owen; Olvera, Rene

    2003-10-01

    Psychiatric disorders, such as bipolar disorder, schizophrenia, and depression, have been associated with both HIV-associated risk behaviors and HIV infection. While the US prison population is reported to exhibit elevated rates of HIV/AIDS and most psychiatric disorders, scarce information currently exists on the association of these conditions in the prison setting. The present study examined the association of six major psychiatric disorders with HIV infection in one of the nation's largest prison populations. The study population consisted of 336,668 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 1999 and December 31, 2001. Information on medical conditions and sociodemographic factors was obtained from an institution-wide medical information system. Inmates diagnosed with HIV infection exhibited elevated rates of major depression, dysthymia, bipolar disorder, schizophrenia, schizoaffective disorder, and non-schizophrenic psychotic disorder. These rates persisted in stratified analyses and in a multivariate analysis that statistically adjusted for gender, race, and age category. The present cross-sectional study's finding of a positive association between HIV infection and psychiatric diagnoses among inmates holds both clinical and public health relevance. It will be important for future investigations to prospectively assess the underlying mechanisms of these associations in the correctional setting.

  11. Sero-prevalence of latent Toxoplasma gondii infection among HIV-infected and HIV-uninfected people in Addis Ababa, Ethiopia: A comparative cross-sectional study

    Tegbaru Belete

    2009-10-01

    Full Text Available Abstract Background Toxoplasmosis in immuno-compromised hosts manifests primarily as a life threatening condition, toxoplasmic encephalitis. However, there is scarce information about the magnitude of Toxoplasma gondii infection among HIV-infected people in Ethiopia. This study was, therefore, conducted to determine the sero-prevalence of T. gondii infection among HIV-infected and HIV-uninfected subjects. Findings Sera were collected from people with and without HIV infection for the purpose of studying hepatitis B virus (HBV at St. Paul Hospital, Addis Ababa, Ethiopia from 24 January 2007 to 15 February 2007. Among these sera, the first 330 consecutive sera, 165 from each HIV sero-group, were selected and tested for anti-T. gondii IgG antibodies using Enzyme Linked Immunosorbent Assay. The seroprevalence of Toxoplasma infection was assessed against socio-demographic characteristics, HIV and HBV serostatus and HBV-related risk factors. The overall sero-prevalence of latent T. gondii infection among the study subjects was 90.0%. Toxoplasma infection was observed with respective prevalence of 93.3% and 86.7% among HIV-infected and HIV-uninfected people. Though Toxoplasma infection seems to be influenced by age, gender and HIV serostatus, only HBV serostatus was significantly associated (OR 2.71, CI 1.12 to 6.57 in multivariate logistic regression analysis. Conclusion The seroprevalence of latent T. gondii infection is high and similar by HIV status. Educating people to prevent acquisition of new Toxoplasma infection and minimizing the risk of disease manifestations among HIV-Toxoplasma co-infected individuals is important.

  12. Prevalence and associated factors of TB/HIV co-infection among HIV ...

    of ART, patients whose marital status was single were significant predictors for ..... Table 1 Summary result of TB/HIV co-infection vs. socio-demographic, economic and clinical, and risk .... persons are younger than married persons and have a.

  13. Association between Perceived Discrimination in Healthcare Settings and HIV Medication Adherence: Mediating Psychosocial Mechanisms.

    Turan, Bulent; Rogers, Anna Joy; Rice, Whitney S; Atkins, Ghislaine C; Cohen, Mardge H; Wilson, Tracey E; Adimora, Adaora A; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L; Ofotokun, Igho; Metsch, Lisa; Tien, Phyllis C; Johnson, Mallory O; Turan, Janet M; Weiser, Sheri D

    2017-12-01

    There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of 1356 diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study. Indirect effects analysis with bootstrapping was used to examine the potential mediating roles of internalized stigma and depressive symptoms in the association between perceived discrimination in healthcare settings and ART adherence. Perceived discrimination in healthcare settings was negatively associated with optimal (95% or better) ART adherence (adjusted odds ratio (AOR) = 0.81, p = 0.02, 95% confidence interval (CI) [0.68, 0.97]). Furthermore, internalization of stigma and depressive symptoms mediated the perceived discrimination-adherence association: Serial mediation analyses revealed a significant indirect effect of perceived discrimination in healthcare settings on ART adherence, first through internalized HIV stigma, and then through depressive symptoms (B = - 0.08, SE = 0.02, 95% CI [- 0.12, - 0.04]). Perceiving discrimination in healthcare settings may contribute to internalization of HIV-related stigma, which in turn may lead to depressive symptoms, with downstream adverse effects on ART adherence among women. These findings can guide the design of interventions to reduce discrimination in healthcare settings, as well as interventions targeting psychosocial mechanisms that may impact the ability of women living with HIV to adhere to ART regimens.

  14. PREVALENCE OF HYPERTENSION, ANEMIA, ASYMPTOMATIC URINARY TRACT INFECTION, SYPHILIS, HIV AND HEPATITIS B VIRUS INFECTION

    Deme, Chala; Edao, Beyene; Jaya, Gemedi; Tisiano, Gebre; Fano, Hayi; Alegria, Iñaki; Reyes, Francisco; Gorgolas, Miguel; Ramos, José M

    2016-09-01

    Antenatal care (ANC) is provided to prevent, diagnose early and treat pregnant women for a variety of diseases. The objective of this study was to determine the seroprevalences of syphilis, human immunodeficiency virus (HIV) and hepatitis B virus (HVB) and asymptomatic urinary tract infections and the prevalence of hypertension and anemia among pregnant women attending the antenatal clinic at Gambo Rural Hospital in southern Ethiopia. The following tests were conducted among study subjects: hemoglobin (Hgb) level, rapid plasma reagin (RPR) for syphilis, anti-HIV antibodies, hepatitis B surface antigen (HBsAg) and urine analysis. A total of 574 pregnant women were included in this study. The mean age of the participants was 25.7 (SD: 4.8) years old; 88.2% were living in urban areas and 11.8% in rural areas. Sixty-seven point two percent of participants began their attended care during the second trimester of their pregnancy. Overall, anemia (Hgb urinary tract infection (having ≥10 white blood cells /high power field in the urine) was present in 12.7% of participants (95% CI: 10.0-15.5). The RPR test was positive in two patients (0.3%; 95% CI: 0.1-1.3). The prevalences of positive test for HBsAg and HIV-1 were 2.3% (95% CI: 1.3-3.8) and 0.2% (95% CI: 0.03-0.9), respectively. No HIV-2 cases were detected. Our data show relatively low prevalences of anemia, hypertension, urinary tract infection, syphilis, HIV, and hepatitis B virus infections among study subjects at a rural antenatal clinic in southern Ethiopia.

  15. Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam.

    Levintow, Sara N; Pence, Brian W; Ha, Tran Viet; Minh, Nguyen Le; Sripaipan, Teerada; Latkin, Carl A; Vu, Pham The; Quan, Vu Minh; Frangakis, Constantine; Go, Vivian F

    2018-01-01

    HIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam. We used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009-2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D≥23) with prevalence odds ratios (POR) and 95% confidence intervals (CI). The prevalence of severe depressive symptoms (CES-D≥23) was 44%. 25% of participants had mild to moderate depressive symptoms (16≤CES-D<23), and 31% experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95% CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95% CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95% CI = 1.40, 3.47). Severe depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.

  16. Short Communication: Prevalence of HIV Type 1 Transmitted Drug Resistance in Slovenia: 2005–2010

    Lunar, Maja M.; Židovec Lepej, Snježana; Abecasis, Ana B.; Tomažič, Janez; Vidmar, Ludvik; Karner, Primož; Vovko, Tomaž D.; Pečavar, Blaž; Maver, Polona J.; Seme, Katja

    2013-01-01

    Abstract Slovenia is a small European country with a total of 547 HIV-infected individuals cumulatively reported by the end of 2011. However, the estimated incidence rate of HIV infections increased from 7.0 per million in 2003 to 26.8 per million in 2011. In this study, we assessed the prevalence of transmitted drug resistance (TDR) in the past 6 years (2005–2010) and analyzed the time trend of the proportion of men having sex with men (MSM) and HIV-1 subtype B among newly diagnosed individuals in a 15-year period (1996–2010) in Slovenia. Among 150 patients included in the study, representing 63% of HIV-1 newly diagnosed patients in 2005–2010, TDR was found in seven patients (4.7%). The prevalence of TDR to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors was 2% (3/150), 2% (3/150), and 0.7% (1/150), respectively. The majority of patients were infected with subtype B (134/150, 89%), while subtype A was detected in 6.0% (9/150), subtype D in 1.3% (2/150), and subtype G and CRF02_AG in 0.7% (one patient each). Three of 150 sequences could not be typed. Infection with subtype B was found to be significantly associated with male gender, Slovenia being reported as the country of the patient's nationality and origin of the virus, CDC class A, mode of transmission with homosexual/bisexual contact, sex with an anonymous person, and a higher CD4+ count. Among patients carrying the subtype B virus, an MSM transmission route was reported in 87% of patients. Although the prevalence of TDR in Slovenia is still below the European average, active surveillance should be continued, especially among MSM, the most vulnerable population for HIV-1 infection in this part of Europe. PMID:22860694

  17. Short communication: prevalence of HIV type 1 transmitted drug resistance in Slovenia: 2005-2010.

    Lunar, Maja M; Židovec Lepej, Snježana; Abecasis, Ana B; Tomažič, Janez; Vidmar, Ludvik; Karner, Primož; Vovko, Tomaž D; Pečavar, Blaž; Maver, Polona J; Seme, Katja; Poljak, Mario

    2013-02-01

    Slovenia is a small European country with a total of 547 HIV-infected individuals cumulatively reported by the end of 2011. However, the estimated incidence rate of HIV infections increased from 7.0 per million in 2003 to 26.8 per million in 2011. In this study, we assessed the prevalence of transmitted drug resistance (TDR) in the past 6 years (2005-2010) and analyzed the time trend of the proportion of men having sex with men (MSM) and HIV-1 subtype B among newly diagnosed individuals in a 15-year period (1996-2010) in Slovenia. Among 150 patients included in the study, representing 63% of HIV-1 newly diagnosed patients in 2005-2010, TDR was found in seven patients (4.7%). The prevalence of TDR to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors was 2% (3/150), 2% (3/150), and 0.7% (1/150), respectively. The majority of patients were infected with subtype B (134/150, 89%), while subtype A was detected in 6.0% (9/150), subtype D in 1.3% (2/150), and subtype G and CRF02_AG in 0.7% (one patient each). Three of 150 sequences could not be typed. Infection with subtype B was found to be significantly associated with male gender, Slovenia being reported as the country of the patient's nationality and origin of the virus, CDC class A, mode of transmission with homosexual/bisexual contact, sex with an anonymous person, and a higher CD4(+) count. Among patients carrying the subtype B virus, an MSM transmission route was reported in 87% of patients. Although the prevalence of TDR in Slovenia is still below the European average, active surveillance should be continued, especially among MSM, the most vulnerable population for HIV-1 infection in this part of Europe.

  18. High prevalence of the metabolic syndrome in HIV-infected patients : impact of different definitions of the metabolic syndrome

    Worm, Signe W; Friis-Møller, Nina; Bruyand, Mathias; D'Arminio Monforte, Antonella; Rickenbach, Martin; Reiss, Peter; El-Sadr, Wafaa; Phillips, Andrew; Lundgren, Jens; Sabin, Caroline; Schölvinck, Elisabeth H.

    2010-01-01

    INTRODUCTION: This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time.

  19. High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome

    Worm, Signe H.Westring; Friis-Møller, Nina; Bruyand, Mathias

    2010-01-01

    This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time....

  20. Prevalence of oral candidiasis in HIV/AIDS children in highly active antiretroviral therapy era. A literature analysis.

    Gaitán-Cepeda, Luis Alberto; Sánchez-Vargas, Octavio; Castillo, Nydia

    2015-08-01

    SummaryHighly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy. © The Author(s) 2014.

  1. High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome

    Worm, Signe W.; Friis-Møller, Nina; Bruyand, Mathias; D'Arminio Monforte, Antonella; Rickenbach, Martin; Reiss, Peter; El-Sadr, Wafaa; Phillips, Andrew; Lundgren, Jens; Sabin, Caroline; de Wolf, F.; Zaheri, S.; Gras, L.; Bronsveld, W.; Hillebrand-Haverkort, M. E.; Prins, J. M.; Bos, J. C.; Eeftinck Schattenkerk, J. K. M.; Geerlings, S. E.; Godfried, M. H.; Lange, J. M. A.; van Leth, F. C.; Lowe, S. H.; van der Meer, J. T. M.; Nellen, F. J. B.; Pogány, K.; van der Poll, T.; Ruys, Th A.; Steingrover, R.; van Twillert, G.; van der Valk, M.; van Vonderen, M. G. A.; Vrouenraets, S. M. E.; van Vugt, M.; Wit, F. W. M. N.; van Eeden, A.; ten Veen, J. H.; van Dam, P. S.; Roos, J. C.; Brinkman, K.; Frissen, P. H. J.; Weigel, H. M.; Mulder, J. W.; van Gorp, E. C. M.; Meenhorst, P. L.; Mairuhu, A. T. A.; Veenstra, J.; Danner, S. A.; van Agtmael, M. A.; Claessen, F. A. P.

    2010-01-01

    INTRODUCTION: This study describes the characteristics of the metabolic syndrome in HIV-positive patients in the Data Collection on Adverse Events of Anti-HIV Drugs study and discusses the impact of different methodological approaches on estimates of the prevalence of metabolic syndrome over time.

  2. Prevalence and Knowledge Assessment of HIV and Non-Communicable Disease Risk Factors among Formal Sector Employees in Namibia

    Guariguata, Leonor; de Beer, Ingrid; Hough, Rina; Mulongeni, Pancho; Feeley, Frank G.; Rinke de Wit, Tobias F.

    2015-01-01

    The burden of non-communicable diseases (NCDs) is growing in sub-Saharan Africa combined with an already high prevalence of infectious disease, like HIV. Engaging the formal employment sector may present a viable strategy for addressing both HIV and NCDs in people of working age. This study assesses

  3. Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women.

    Cohen, Mardge H; Fabri, Mary; Cai, Xiaotao; Shi, Qiuhu; Hoover, Donald R; Binagwaho, Agnes; Culhane, Melissa A; Mukanyonga, Henriette; Karegeya, Davis Ksahaka; Anastos, Kathryn

    2009-11-01

    During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean > 2) and depressive symptoms (CES-D > or = 16) for 850 women (658 HIV-positive and 192 HIV-negative). PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p = 0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p depressive symptoms. Independent predictors for increased depressive symptoms were making rape, and having more PTSD symptoms. The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts depression and PTSD may reduce morbidity and mortality among women in postconflict countries.

  4. The Prevalence of Common Mental Disorders Among South Africans Seeking HIV Testing.

    Kagee, Ashraf; Saal, Wylene; De Villiers, Laing; Sefatsa, Mpho; Bantjes, Jason

    2017-06-01

    We administered the Structured Clinical Interview for the DSM to 485 persons seeking HIV testing at five community testing centres in South Africa to determine the prevalence of common mental disorders among this population. The prevalence estimates for the various disorders were as follows: major depressive disorder: 14.2 % (95 % CI [11.1, 17.3]); generalised anxiety disorder 5.0 % (95 % CI [3.07, 6.93]); posttraumatic stress disorder 4.9 % (95 % CI [2.98, 6.82]); and alcohol use disorder 19.8 % (95 % CI [16.26, 23.34]). Our findings imply the need to research the integration of screening and referral trajectories in the context of voluntary HIV counselling and testing.

  5. Timing is everything: international variations in historical sexual partnership concurrency and HIV prevalence.

    Martina Morris

    Full Text Available BACKGROUND: Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance of overlap duration and coital exposure are examined here. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comparison of data from three studies of sexual behavior carried out in the early 1990s in Uganda, Thailand and the US. Using cumulative concurrency measures, the three countries appeared somewhat similar. Over 50% of both Thai and Ugandan men reported a concurrency within the last three partnerships and over 20% reported a concurrency in the last year, the corresponding rates among US men were nearly 20% for Blacks and Hispanics, and about 10% for other racial/ethnic groups. Concurrency measures that were more sensitive to overlap duration, however, showed large differences. The point prevalence of concurrency on the day of interview was over 10% among Ugandan men compared to 1% for Thai men. Ugandan concurrencies were much longer duration - a median of about two years - than either the Thai (1 day or US concurrencies (4-9 months across all groups, and involved 5-10 times more coital risk exposure with the less frequent partner. In the US, Blacks and Hispanics reported higher prevalence, longer duration and greater coital exposure than Whites, but were lower than Ugandans on nearly every measure. Together, the differences in the prevalence, duration and coital exposure of concurrent partnerships observed align with the HIV prevalence differentials seen in these populations at the time the data were collected. CONCLUSIONS/SIGNIFICANCE: There were substantial variations in the patterns of concurrent partnerships within and between populations. More long-term overlapping partnerships, with regular coital exposure, were found in populations with

  6. HIV prevalence and factors associated with HIV infection among transgender women in Cambodia: results from a national Integrated Biological and Behavioral Survey.

    Chhim, Srean; Ngin, Chanrith; Chhoun, Pheak; Tuot, Sovannary; Ly, Cheaty; Mun, Phalkun; Pal, Khondyla; Macom, John; Dousset, Jean-Philippe; Mburu, Gitau; Yi, Siyan

    2017-08-11

    To examine factors associated with HIV infection among transgender women in Cambodia. Cross-sectional study. HIV high-burden sites including the capital city and 12 provinces. This study included 1375 sexually active transgender women with a mean age of 25.9 years (SD 7.1), recruited by using respondent-driven sampling for structured questionnaire interviews and rapid finger-prick HIV testing. HIV infection detected by using Determine antibody test. HIV prevalence among this population was 5.9%. After adjustment for other covariates, participants living in urban areas were twice as likely to be HIV infected as those living in rural areas. Participants with primary education were 1.7 times as likely to be infected compared with those with high school education. HIV infection increased with age; compared with those aged 18-24 years, the odds of being HIV infected were twice as high among transgender women aged 25-34 years and 2.8 times higher among those aged ≥35 years. Self-injection of gender affirming hormones was associated with a fourfold increase in the odds of HIV infection. A history of genital sores over the previous 12 months increased the odds of HIV infection by threefold. Transgender women with stronger feminine identity, dressing as a woman all the time, were twice as likely to be HIV infected compared with those who did not dress as a woman all the time. Having never used online services developed for transgender women in the past six months was also associated with higher odds of being HIV infected. Transgender women in Cambodia are at high risk of HIV. To achieve the goal of eliminating HIV in Cambodia, effective combination prevention strategies addressing the above risk factors among transgender women should be strengthened. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Multilevel Analysis of the Predictors of HIV Prevalence among Pregnant Women Enrolled in Annual HIV Sentinel Surveillance in Four States in Southern India.

    Thamattoor, Usha; Thomas, Tinku; Banandur, Pradeep; Rajaram, S; Duchesne, Thierry; Abdous, Belkacem; Washington, Reynold; Ramesh, B M; Moses, Stephen; Alary, Michel

    2015-01-01

    Heterogeneity of the HIV epidemic across districts of south India is reflected in HIV positivity among antenatal clinic (ANC) attendees. Along with individual factors, contextual factors also need consideration for effective HIV interventions. Thus, identifying district and individual level factors that influence ANC HIV positivity assumes importance to intervene effectively. Data on HIV sentinel surveillance among the ANC population were obtained from the National AIDS Control Organization (NACO) between years 2004 and 2007. Data from serial cross-sectional studies among female sex workers (FSWs) conducted during this time period in 24 districts were used to generate district level variables corresponding to parameters concerning this high risk population. Other district level data were obtained from various official/governmental agencies. Multilevel logistic regression was used to identify individual and district level factors associated with ANC-HIV positivity. The average ANC-HIV prevalence from 2004 to 2007 in the 24 integrated biological and behavioural assessments (IBBA) districts ranged from 0.25 to 3.25%. HIV positivity was significantly higher among ANC women with age ≥ 25 years [adjusted odds ratio (AOR):1.49; 95% confidence interval (95%CI):1.27 to 1.76] compared to those with ageIlliteracy of the woman, higher HIV prevalence among FSWs and early marriage were associated with HIV positivity among pregnant women in southern India. In addition to targeted HIV preventive interventions among FSWs, studying and changing the behavior of FSW clients and addressing structural drivers of the epidemic might indirectly help reduce HIV infection among women in southern India.

  8. Alta prevalência de sedentarismo em adolescentes que vivem com HIV/Aids

    Luana Fiengo Tanaka

    2015-09-01

    Full Text Available ResumoObjetivo:Verificar a prevalência de sedentarismo entre adolescentes com HIV/Aids e seus fatores associados.Métodos:Foram entrevistados 91 adolescentes de 10 a 19 anos, com HIV/Aids, em acompanhamento em uma unidade de infectologia universitária. Foram coletados dados antropométricos (peso, altura e circunferência da cintura em duplicata, informações clínicas foram obtidas nos prontuários médicos e a prática de atividade física habitual foi medida por meio do questionário proposto por Florindo et al. O ponto de corte para sedentarismo foi de 300 minutos/semana.Resultados:As prevalências de altura inadequada para idade, desnutrição e sobrepeso/obesidade foram de 15,4%, 9,9% e 12,1%, respectivamente. As atividades físicas mais citadas foram: futebol (44,4%, voleibol (14,4% e andar de bicicleta (7,8%. Os tempos medianos dispendidos com a prática de atividade física e caminhando/andando de bicicleta até a escola foram de 141 minutos e 39 minutos, respectivamente. A maioria dos adolescentes (71,4% era sedentária, proporção maior entre as meninas (p=0,046.Conclusões:Foi observada alta prevalência de sedentarismo entre adolescentes com HIV/Aids, prevalência essa semelhante àquela observada na população geral. Promover a prática de atividade física entre adolescentes - especialmente entre meninas - com HIV/Aids, assim como monitorá-la, deve fazer parte da rotina de acompanhamento desses pacientes.

  9. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?

    Gisslén, Magnus; Price, Richard W; Nilsson, Staffan

    2011-01-01

    Abstract Background A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART). This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI). Discussion ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without as...

  10. Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes

    Katerndahl, David A.; Bell, Iris R.; Palmer, Raymond F.; Miller, Claudia S.

    2012-01-01

    PURPOSE This study extends previous community-based studies on the prevalence and clinical characteristics of chemical intolerance in a sample of primary care clinic patients. We evaluated comorbid medical and psychiatric disorders, functional status, and rates of health care use. METHODS A total of 400 patients were recruited from 2 family medicine clinic waiting rooms in San Antonio, Texas. Patients completed the validated Quick Environmental Exposure and Sensitivity Inventory (QEESI) to assess chemical intolerance; the Primary Care Evaluation of Mental Disorders (PRIME-MD) screen for possible psychiatric disorders; the Dartmouth–Northern New England Primary Care Cooperative Information Project (Dartmouth COOP) charts for functional status; and the Healthcare Utilization Questionnaire. RESULTS Overall, 20.3% of the sample met criteria for chemical intolerance. The chemically intolerant group reported significantly higher rates of comorbid allergies and more often met screening criteria for possible major depressive disorder, panic disorder, generalized anxiety disorder, and alcohol abuse disorder, as well as somatization disorder. The total number of possible mental disorders was correlated with chemical intolerance scores (P intolerance were significantly more likely to have poorer functional status, with trends toward increased medical service use when compared with non–chemically intolerant patients. After controlling for comorbid psychiatric conditions, the groups differed significantly only regarding limitations of social activities. CONCLUSIONS Chemical intolerance occurs in 1 of 5 primary care patients yet is rarely diagnosed by busy practitioners. Psychiatric comorbidities contribute to functional limitations and increased health care use. Chemical intolerance offers an etiologic explanation. Symptoms may resolve or improve with the avoidance of salient chemical, dietary (including caffeine and alcohol), and drug triggers. Given greater medication

  11. The prevalence of anal human papillomavirus among young HIV negative men who have sex with men

    Zou Huachun

    2012-12-01

    Full Text Available Abstract Men who have sex with men (MSM especially those who are HIV positive are at risk for HPV-associated anal cancer. We systematically reviewed studies with data on the prevalence of vaccine preventable anal HPV among men who have sex with men aged 25 or younger and identified 6 studies. None of these studies were specifically designed to determine the prevalence of HPV in this population. Available data, albeit limited, suggest many young MSM may not already be HPV infected. Further studies using representative sampling focused on teenage MSM are required to confirm this.

  12. Prevalence of HIV/AIDS and prediction of future trends in north-west region of India: A six-year ICTC-based study

    Vyas Nitya

    2009-01-01

    Full Text Available Background: The study was conducted to analyze previous six-year prevalence data of HIV infection in the Northwest region of India and predict future trends for a couple of years. Objectives: The study was conducted to aid SACS and NACO to plan and arrange resources for the future scenario. Materials and Methods: All the attendees of ICTC, Jaipur, from January 2002 to December 2007 were included and variables like age, sex, marital status, occupation, place of residence, pattern of risk behavior and HIV serostatus were studied. As per the strategy and policy prescribed by NACO, tests (E/R/S were performed on the serum samples. Data was collected; compiled and analyzed using standard statistical methods. Future trends of HIV-prevalence in north-west India were anticipated. Results: The overall positivity rates among attendees of ICTC, were found to be 12.2% (386/3161, 11.8% (519/4381, 11.1% (649/5867, 13% (908/6983, 14% (1385/9911 and 17.34% (1756/10133 in the years 2002, 2003, 2004, 2005, 2006 and 2007 respectively. Future trends for the next couple of years depict further increase in prevalence without any plateau. Conclusion: Epidemiological studies should be carried out in various settings to understand the role and complex relations of innumerable behavioral, social and demographic factors, which will help, interrupt and control the transmission of HIV/ AIDS.

  13. Implementation of evidence-based HIV interventions for young adult African American women in church settings.

    Stewart, Jennifer M

    2014-01-01

    To assess the barriers and facilitators to using African American churches as sites for implementation of evidence-based HIV interventions among young African American women. Mixed methods cross-sectional design. African American churches in Philadelphia, PA. 142 African American pastors, church leaders, and young adult women ages 18 to 25. Mixed methods convergent parallel design. The majority of young adult women reported engaging in high-risk HIV-related behaviors. Although church leaders reported willingness to implement HIV risk-reduction interventions, they were unsure of how to initiate this process. Key facilitators to the implementation of evidence-based interventions included the perception of the leadership and church members that HIV interventions were needed and that the church was a promising venue for them. A primary barrier to implementation in this setting is the perception that discussions of sexuality should be private. Implementation of evidence-based HIV interventions for young adult African American women in church settings is feasible and needed. Building a level of comfort in discussing matters of sexuality and adapting existing evidence-based interventions to meet the needs of young women in church settings is a viable approach for successful implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  14. High HIV prevalence and associated factors in a remote community in the Rwenzori region of Western Uganda

    John Rubaihayo

    2010-10-01

    Full Text Available In Uganda, previous studies have shown a tremendous decline in HIV prevalence over the past two decades due to changes in sexual behavior with a greater awareness of the risks involved. However, studies in Fort-Portal municipality, a rural town in Western Uganda, continued to show a persistent high HIV prevalence despite the various interventions in place. We conducted a study to establish the current magnitude of HIV prevalence and the factors associated with HIV prevalence in this community. This cross-sectional study was conducted between July and November 2008. Participants were residents of Fort-Portal municipality aged 15-49 years. A population-based HIV sero-survey and a clinical review of prevention of mother to child HIV transmission (PMTCT and voluntary counseling and HIV Testing (VCT records were used to collect quantitative data. An inteviewer administered structured questionnaire was used to collect qualitative data on social deographics, risk behaviour and community perceptions. Focus group discussions (FGDs and in-depth interviews provided supplementary data on community perceptions. Logistic regression was used in the analysis. The overall HIV prevalence in the general population was 16.1% [95% CI; 12.5-20.6]. Prevalence was lower among women (14.5%; 95% CI; 10.0-19.7 but not significantly different from that among men (18.7%; 95% CI; 12.5-26.3 (c2=0.76, P=0.38. Having more than 2 sexual partners increased the odds of HIV by almost 2.5 times. None or low education and age over 35 years were independently associated with HIV prevalence (P<0.05. Most participants attributed the high HIV prevalence to promiscuity/multiple sexual partners (32.5%, followed by prostitution (13.6%, alcoholism (10.1%, carelessness (10.1%, poverty (9.7%, ignorance (9.5%, rape (4.7%, drug abuse (3.6% and others (malice/malevolence, laziness, etc. (6.2%. Although there was a slight decline compared to previous reports, the results from this study confirm

  15. HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People's Democratic Republic, 2007.

    Sheridan, Sarah; Phimphachanh, Chansy; Chanlivong, Niramonh; Manivong, Sisavath; Khamsyvolsvong, Sod; Lattanavong, Phonesay; Sisouk, Thongchanh; Toledo, Carlos; Scherzer, Martha; Toole, Mike; van Griensven, Frits

    2009-01-28

    Men who have sex with men are at high risk for HIV infection. Here we report the results of the first assessment of HIV prevalence and risk behaviour in this group in Vientiane, Lao People's Democratic Republic. Between August and September 2007, 540 men were enrolled from venues around Vientiane, using venue-day-time sampling. Men of Lao nationality, 15 years and over, reporting oral or anal sex with a man in the previous 6 months were eligible for participation. Demographic and socio-behavioural information was self-collected using hand-held computers. Oral fluid was tested for HIV infection. Logistic regression was used to evaluate risk factors for prevalent HIV infection. The median age of participants was 21 years; the HIV prevalence was 5.6%. Of participants, 39.6% reported exclusive attraction to men and 57.6% reported sex with women. Of those who reported having regular and nonregular sexual partner(s) in the past 3 months, consistent condom use with these partners was 14.4 and 24.2%, respectively. A total of 42.2% self-reported any sexually transmitted infection symptoms and 6.3% had previously been tested for HIV. Suicidal ideation was reported by 17.0%, which was the only variable significantly and independently associated with HIV infection in multivariate analysis. Although the HIV prevalence is low compared with neighbouring countries in the region, men who have sex with men in Lao People's Democratic Republic are at high behavioural risk for HIV infection. To prevent a larger HIV epidemic occurrence and transmission into the broader community, higher coverage of HIV prevention interventions is required.

  16. Scale-up, retention and HIV/STI prevalence trends among female sex workers attending VICITS clinics in Guatemala.

    Sonia Morales-Miranda

    Full Text Available Since 2007, Guatemala integrated STI clinical service with an HIV prevention model into four existing public health clinics to prevent HIV infection, known as the VICITS strategy. We present the first assessment of VICITS scale-up, retention, HIV and STI prevalence trends, and risk factors associated with HIV infection among Female Sex Workers (FSW attending VICITS clinics in Guatemala.Demographic, behavioral and clinical data were collected using a standardized form. Data was analyzed by year and health center. HIV and STI prevalence were estimated from routine visits. Retention was estimated as the percent of new users attending VICITS clinics who returned for at least one follow-up visit to any VICITS clinic within 12 months. Separate multivariate logistic regression models were conducted to investigate factors associated with HIV infection and program retention.During 2007-2011 5,682 FSW visited a VICITS clinic for the first-time. HIV prevalence varied from 0.4% to 5.8%, and chlamydia prevalence from 0% to 14.3%, across sites. Attending the Puerto Barrios clinic, having a current syphilis infection, working primarily on the street, and using the telephone or internet to contact clients were associated with HIV infection. The number of FSW accessing VICITS annually increased from 556 to 2,557 (361% during the period. In 2011 retention varied across locations from 7.7% to 42.7%. Factors negatively impacting retention included current HIV diagnosis, having practiced sex work in another country, being born in Honduras, and attending Marco Antonio Foundation or Quetzaltenango clinic sites. Systematic time trends did not emerge, however 2008 and 2010 were characterized by reduced retention.Our data show local differences in HIV prevalence and clinic attendance that can be used to prioritize prevention activities targeting FSW in Guatemala. VICITS achieved rapid scale-up; however, a better understanding of the causes of low return rates is urgently

  17. Scale-up, retention and HIV/STI prevalence trends among female sex workers attending VICITS clinics in Guatemala.

    Morales-Miranda, Sonia; Jacobson, Jerry O; Loya-Montiel, Itzel; Mendizabal-Burastero, Ricardo; Galindo-Arandi, César; Flores, Carlos; Chen, Sanny Y

    2014-01-01

    Since 2007, Guatemala integrated STI clinical service with an HIV prevention model into four existing public health clinics to prevent HIV infection, known as the VICITS strategy. We present the first assessment of VICITS scale-up, retention, HIV and STI prevalence trends, and risk factors associated with HIV infection among Female Sex Workers (FSW) attending VICITS clinics in Guatemala. Demographic, behavioral and clinical data were collected using a standardized form. Data was analyzed by year and health center. HIV and STI prevalence were estimated from routine visits. Retention was estimated as the percent of new users attending VICITS clinics who returned for at least one follow-up visit to any VICITS clinic within 12 months. Separate multivariate logistic regression models were conducted to investigate factors associated with HIV infection and program retention. During 2007-2011 5,682 FSW visited a VICITS clinic for the first-time. HIV prevalence varied from 0.4% to 5.8%, and chlamydia prevalence from 0% to 14.3%, across sites. Attending the Puerto Barrios clinic, having a current syphilis infection, working primarily on the street, and using the telephone or internet to contact clients were associated with HIV infection. The number of FSW accessing VICITS annually increased from 556 to 2,557 (361%) during the period. In 2011 retention varied across locations from 7.7% to 42.7%. Factors negatively impacting retention included current HIV diagnosis, having practiced sex work in another country, being born in Honduras, and attending Marco Antonio Foundation or Quetzaltenango clinic sites. Systematic time trends did not emerge, however 2008 and 2010 were characterized by reduced retention. Our data show local differences in HIV prevalence and clinic attendance that can be used to prioritize prevention activities targeting FSW in Guatemala. VICITS achieved rapid scale-up; however, a better understanding of the causes of low return rates is urgently needed.

  18. Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya.

    Madise, Nyovani J; Ziraba, Abdhalah K; Inungu, Joseph; Khamadi, Samoel A; Ezeh, Alex; Zulu, Eliya M; Kebaso, John; Okoth, Vincent; Mwau, Matilu

    2012-09-01

    In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. HIV-1 transmitting couples have similar viral load set-points in Rakai, Uganda.

    T Déirdre Hollingsworth

    2010-05-01

    Full Text Available It has been hypothesized that HIV-1 viral load set-point is a surrogate measure of HIV-1 viral virulence, and that it may be subject to natural selection in the human host population. A key test of this hypothesis is whether viral load set-points are correlated between transmitting individuals and those acquiring infection. We retrospectively identified 112 heterosexual HIV-discordant couples enrolled in a cohort in Rakai, Uganda, in which HIV transmission was suspected and viral load set-point was established. In addition, sequence data was available to establish transmission by genetic linkage for 57 of these couples. Sex, age, viral subtype, index partner, and self-reported genital ulcer disease status (GUD were known. Using ANOVA, we estimated the proportion of variance in viral load set-points which was explained by the similarity within couples (the 'couple effect'. Individuals with suspected intra-couple transmission (97 couples had similar viral load set-points (p = 0.054 single factor model, p = 0.0057 adjusted and the couple effect explained 16% of variance in viral loads (23% adjusted. The analysis was repeated for a subset of 29 couples with strong genetic support for transmission. The couple effect was the major determinant of viral load set-point (p = 0.067 single factor, and p = 0.036 adjusted and the size of the effect was 27% (37% adjusted. Individuals within epidemiologically linked couples with genetic support for transmission had similar viral load set-points. The most parsimonious explanation is that this is due to shared characteristics of the transmitted virus, a finding which sheds light on both the role of viral factors in HIV-1 pathogenesis and on the evolution of the virus.

  20. High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal, West Africa.

    Benzekri, Noelle A; Sambou, Jacques; Diaw, Binetou; Sall, El Hadji Ibrahima; Sall, Fatima; Niang, Alassane; Ba, Selly; Ngom Guèye, Ndèye Fatou; Diallo, Mouhamadou Baïla; Hawes, Stephen E; Seydi, Moussa; Gottlieb, Geoffrey S

    2015-01-01

    Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes. We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review. One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01). Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population.

  1. High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal, West Africa.

    Noelle A Benzekri

    Full Text Available Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes.We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review.One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5 was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01 and not taking antiretroviral therapy due to hunger (p = 0.02. Malnutrition was associated with lower CD4 cell counts (p = 0.01.Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population.

  2. Prevalence of human Papilloma Virus in HIV-positive and HIV-negative patients in the State of Bahia: a pilot study

    Conceição Queiroz

    Full Text Available Human Papilloma Virus (HPV plays a central role in the development of cervical cancer. However, other coexisting factors, such as HIV infection, must be present for this to occur. We evaluated the prevalence of HPV in HIV-positive and HIV-negative patients in the city of Salvador , Bahia, Brazil, and determined the most prevalent types of HPV in these patients. Fifty-five cases were selected from among patients attending three institutions providing cervical pathology services in the city of Salvador. HIV testing (Elisa/WB, HPV-DNA testing by PCR, colposcopy, cytology and biopsy were carried out in all patients. The histopathological results were classified as follows: 11 cases were normal/negative for neoplasia, 15 were diagnosed as cervical intraepithelial neoplasia grade 1 (CIN 1, 10 were CIN 2, 15 cases were CIN 3 and there were four cases of invasive squamous cell carcinoma. Among the 55 patients studied, 43 tested positive for HPV-DNA and 20 for HIV. All HIV-positive patients were positive for HPV-DNA. The most prevalent types of HPV were HPV 16, 52, 58, 53, 54, 33 and 51, and there was little difference between the groups of HIV-positive and HIV-negative patients with respect to the type of HPV encountered. The HIV-positive patients were found to be infected with a greater number of types of HPV than the HIV-negative patients. This study corroborates the existence of regional variations in the distribution of certain types of HPV, which is probably due to the particular ethnic constitution found in this region of Brazil.

  3. Hypertension and obesity in adults living in a high HIV prevalence rural area in South Africa.

    Abraham Malaza

    Full Text Available Hypertension and excess body weight are major risk factors of cardiovascular morbidity and mortality in developing countries. In countries with a high HIV prevalence, it is unknown how increased antiretroviral treatment and care (ART coverage has affected the prevalence of overweight, obesity, and hypertension. We conducted a health survey in 2010 based on the WHO STEPwise approach in 14,198 adult resident participants of a demographic surveillance area in rural South Africa to investigate factors associated with hypertension and excess weight including HIV infection and ART status. Women had a significantly higher median body mass index (BMI than men (26.4 vs. 21.2 kg/m(2, p<0.001. The prevalence of obesity (BMI ≥ 30 kg/m(2 in women (31.3%, 95% confidence interval (CI 30.2-32.4 was 6.5 times higher than in men (4.9%, 95% CI 4.1-5.7, whereas prevalence of hypertension (systolic or diastolic blood pressure ≥ 140 or 90 mm Hg, respectively was 1.4 times higher in women than in men (28.5% vs 20.8%, p<0.001. In multivariable regression analysis, both hypertension and obesity were significantly associated with sex, age, HIV and ART status. The BMI of women and men on ART was on average 3.8 (95% CI 3.2-3.8 and 1.7 (95% CI 0.9-2.5 kg/m(2 lower than of HIV-negative women and men, respectively. The BMI of HIV-infected women and men not on ART was on average 1.2 (95% CI 0.8-1.6 and 0.4 (95% CI -0.1-0.9 kg/m(2 lower than of HIV-negative women and men, respectively. Obesity was a bigger risk factor for hypertension in men (adjusted odds ratio (aOR 2.99, 95% CI 2.00-4.48 than in women (aOR 1.64, 95% CI 1.39-1.92 and overweight (25 ≤ BMI<30 was a significant risk factor for men only (aOR 1.53 95% CI 1.14-2.06. Our study suggests that, cardiovascular risk factors of hypertension and obesity differ substantially between women and men in rural South Africa.

  4. Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

    2011-01-01

    Background Cervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition. Methods To determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+) among this group of patients. Results The prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times), and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count ASCUS+ (P = 0.043). There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level. Conclusion There are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening. PMID:21211065

  5. Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

    Thamkhantho Manopchai

    2011-01-01

    Full Text Available Abstract Background Cervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition. Methods To determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+ among this group of patients. Results The prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times, and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count P = 0.043. There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level. Conclusion There are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening.

  6. An increase in rates of obstetric haemorrhage in a setting of high HIV seroprevalence

    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 associated with HIV seropositivity (odds ratio 1.84, 95% confi­dence interval 1.14 - 2.95. cART was not associated with an increased risk of haemorrhage. Conclusion. HIV was associated with a high risk of PPH, and its possible association with HIV treatment needs further research.

  7. Validity of measures of pain and symptoms in HIV/AIDS infected households in resources poor settings: results from the Dominican Republic and Cambodia

    Morineau Guy

    2006-03-01

    Full Text Available Abstract Background HIV/AIDS treatment programs are currently being mounted in many developing nations that include palliative care services. While measures of palliative care have been developed and validated for resource rich settings, very little work exists to support an understanding of measurement for Africa, Latin America or Asia. Methods This study investigates the construct validity of measures of reported pain, pain control, symptoms and symptom control in areas with high HIV-infected prevalence in Dominican Republic and Cambodia Measures were adapted from the POS (Palliative Outcome Scale. Households were selected through purposive sampling from networks of people living with HIV/AIDS. Consistencies in patterns in the data were tested used Chi Square and Mantel Haenszel tests. Results The sample persons who reported chronic illness were much more likely to report pain and symptoms compared to those not chronically ill. When controlling for the degrees of pain, pain control did not differ between the chronically ill and non-chronically ill using a Mantel Haenszel test in both countries. Similar results were found for reported symptoms and symptom control for the Dominican Republic. These findings broadly support the construct validity of an adapted version of the POS in these two less developed countries. Conclusion The results of the study suggest that the selected measures can usefully be incorporated into population-based surveys and evaluation tools needed to monitor palliative care and used in settings with high HIV/AIDS prevalence.

  8. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil

    Saffier, Igor Pedrosa; Kawa, Hélia; Harling, Guy

    2017-01-01

    Background Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. Methods We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any...

  9. Prevalence, risk factors and genotypes of hepatitis B infection among HIV-infected patients in the State of MS, Central Brazil

    Solange Zacalusni Freitas

    2014-09-01

    Conclusion: This study demonstrates the low prevalence of HIV-HBV infection and also highlights the need for early vaccination against HBV as well as testing for HBV, HCV and HDV in all HIV-infected individuals.

  10. Size estimation, HIV prevalence and risk behaviours of female sex workers in Pakistan

    Altaf, A.; Aga, A.; McKinizie, M.H.; Abbas, Q.; Jafri, S.B.

    2012-01-01

    Objective: To provide size estimation and to determine risky behaviours and HIV prevalence among female sex workers in Pakistan, which has progressed from a low to concentrated level of HIV epidemic. Methods: A cross-sectional study (geographic mapping and integrated behavioural and biological survey-IBBS) was conducted between August 2005 to January 2006 in Karachi, Hyderabad and Sukkur. A detailed questionnaire and dry blood spot (DBS) specimen for HIV testing were collected by trained interviewers after informed consent. The study was ethically approved by review boards in Canada and Pakistan. Results: About 14,900 female sex workers were estimated to be functional in Sindh. A total of 1158 of them were interviewed for the study. Average age of sex workers was 27.4+- 6.7 years, and the majority 787 (67.9%) were married, and uneducated 764 (65.9%). Sindhi (26.4%) was the predominant ethnicity. Mean number of paid clients was 2.1+-1.2. Three workers were confirmed HIV positive (0.75%, 95 percent CI 0.2-2.2%) from Karachi. Condom use at last sexual act was highest (68%) among brothel-based workers from Karachi, and the lowest in Sukkur where only 1.3% street-based workers reported using a condom at last sexual act. Overall use of illicit drugs through injections was negligible. Conclusion: HIV prevalence among female sex workers in Sindh, Pakistan is low but risky behaviours are present. Well organised service delivery programmes can help promoting safer practices. (author)

  11. Potential future impact of a partially effective HIV vaccine in a southern African setting

    Phillips, Andrew N; Cambiano, Valentina; Nakagawa, Fumiyo

    2014-01-01

    of a realistic future implementation scenario in resource limited settings. METHODS: An individual level model of HIV transmission, progression and the effect of antiretroviral therapy was used to predict the outcome to 2060 of introduction in 2025 of a partially effective vaccine with various combinations...

  12. Provider-initiated HIV testing in health care settings: Should it ...

    centered counselling? ... SAHARA-J: Journal of Social Aspects of HIV/AIDS ... To address the resource limitations of the PITC setting, WHO and CDC suggest that patient-provider interactions during PITC may need to focus on providing information ...

  13. Human immunodeficiency virus, hepatitis B and hepatitis C in an Indonesian prison: prevalence, risk factors and implications of HIV screening.

    Nelwan, Erni J; Van Crevel, Reinout; Alisjahbana, Bachti; Indrati, Agnes K; Dwiyana, Reiva F; Nuralam, Nisaa; Pohan, Herdiman T; Jaya, Ilham; Meheus, Andre; Van Der Ven, Andre

    2010-12-01

    To determine the prevalence and behavioural correlates of HIV, HBV and HCV infections among Indonesian prisoners and to examine the impact of voluntary counselling and testing for all incoming prisoners on access to antiretroviral treatment (ART). In a non-anonymous survey in an Indonesian prison for drug-related offences, all incoming prisoners and symptomatic resident prisoners were counselled and offered testing for HIV, hepatitis B and C. Screening was performed in 679 incoming prisoners, of whom 639 (94.1%) agreed to be tested, revealing a seroprevalence of 7.2% (95% CI 5.2-9.2) for HIV, 5.8% (95% CI 3.9-7.6) for HBsAg and 18.6% (95% CI 15.5-21.6) for HCV. Of 57 resident prisoners tested, 29.8% were HIV-positive. HIV infection was strongly associated with injecting drug use (IDU; P prisoners was responsible for diagnosing and treating HIV in 73.0%, respectively, and 68.0% of HIV-positive individuals. HIV and HCV are highly prevalent among incoming Indonesian prisoners and almost entirely explained by IDU. Our study is the first to show that voluntary HIV counselling and testing during the intake process in prison may greatly improve access to ART in a developing country. © 2010 Blackwell Publishing Ltd.

  14. Prevalence of HIV and Associated Risks of Sex Work among Youth in the Slums of Kampala.

    Swahn, Monica H; Culbreth, Rachel; Salazar, Laura F; Kasirye, Rogers; Seeley, Janet

    2016-01-01

    Purpose. The purpose of this study is to examine the prevalence of and risk factors for engaging in sex work among youth living in Kampala, Uganda. Methods. Analyses are based on a cross-sectional study (N = 1,134) of youth aged 12-18 years, living in the slums of Kampala, conducted in Spring of 2014. The analytic sample consisted of only sexually active youth (n = 590). Youth who reported engaging in sex work were compared to youth who did not report sex work. Multivariable analyses were conducted to examine factors associated with sex work. Results. Among the youth who had ever had sexual intercourse (n = 590), 13.7% (n = 81) reported engaging in sex work. Self-reported HIV prevalence was 13.9% among the total sample (n = 81) and 22.5% (n = 18) among youth engaged in sex work. Engaging in sex work was associated with being female (AOR 10.4; 95% CI: 3.9, 27.4), being an orphan (AOR 3.8; 95% CI: 1.7, 8.4), ever drinking alcohol (AOR 8.3; 95% CI 3.7, 19.0), and experiencing any rape (AOR 5.3; 95% CI: 2.9, 9.5). Discussion. The reported prevalence of sex work is high among youth in the slums of Kampala and is associated with high HIV prevalence, ever drinking alcohol, previously being raped, and being an orphan.

  15. Prevalence of HIV and Associated Risks of Sex Work among Youth in the Slums of Kampala

    Monica H. Swahn

    2016-01-01

    Full Text Available Purpose. The purpose of this study is to examine the prevalence of and risk factors for engaging in sex work among youth living in Kampala, Uganda. Methods. Analyses are based on a cross-sectional study (N = 1,134 of youth aged 12-18 years, living in the slums of Kampala, conducted in Spring of 2014. The analytic sample consisted of only sexually active youth (n = 590. Youth who reported engaging in sex work were compared to youth who did not report sex work. Multivariable analyses were conducted to examine factors associated with sex work. Results. Among the youth who had ever had sexual intercourse (n = 590, 13.7% (n = 81 reported engaging in sex work. Self-reported HIV prevalence was 13.9% among the total sample (n = 81 and 22.5% (n = 18 among youth engaged in sex work. Engaging in sex work was associated with being female (AOR 10.4; 95% CI: 3.9, 27.4, being an orphan (AOR 3.8; 95% CI: 1.7, 8.4, ever drinking alcohol (AOR 8.3; 95% CI 3.7, 19.0, and experiencing any rape (AOR 5.3; 95% CI: 2.9, 9.5. Discussion. The reported prevalence of sex work is high among youth in the slums of Kampala and is associated with high HIV prevalence, ever drinking alcohol, previously being raped, and being an orphan.

  16. Multilevel Analysis of the Predictors of HIV Prevalence among Pregnant Women Enrolled in Annual HIV Sentinel Surveillance in Four States in Southern India.

    Usha Thamattoor

    Full Text Available Heterogeneity of the HIV epidemic across districts of south India is reflected in HIV positivity among antenatal clinic (ANC attendees. Along with individual factors, contextual factors also need consideration for effective HIV interventions. Thus, identifying district and individual level factors that influence ANC HIV positivity assumes importance to intervene effectively.Data on HIV sentinel surveillance among the ANC population were obtained from the National AIDS Control Organization (NACO between years 2004 and 2007. Data from serial cross-sectional studies among female sex workers (FSWs conducted during this time period in 24 districts were used to generate district level variables corresponding to parameters concerning this high risk population. Other district level data were obtained from various official/governmental agencies. Multilevel logistic regression was used to identify individual and district level factors associated with ANC-HIV positivity.The average ANC-HIV prevalence from 2004 to 2007 in the 24 integrated biological and behavioural assessments (IBBA districts ranged from 0.25 to 3.25%. HIV positivity was significantly higher among ANC women with age ≥ 25 years [adjusted odds ratio (AOR:1.49; 95% confidence interval (95%CI:1.27 to 1.76] compared to those with age<25 years; illiterate (AOR:1.62; 95%CI:1.03 to 2.54 compared to literate; employed in agriculture (AOR:1.34; 95%CI:1.11 to 1.62 or with occupations like driver/helper/industry/factory workers/hotel staff (AOR:1.59; 95%CI:1.26 to 2.01 compared to unemployed. District level HIV prevalence among FSWs (AOR:1.03; 95%CI:1.0 to 1.05 and percentage women marrying under 18 years were significantly associated with ANC-HIV positivity (AOR:1.02; 95%CI:1.00 to 1.04.Illiteracy of the woman, higher HIV prevalence among FSWs and early marriage were associated with HIV positivity among pregnant women in southern India. In addition to targeted HIV preventive interventions among

  17. Prevalence of parasitic infections in HIV-positive patients in southern Ethiopia: a cross-sectional study.

    Fekadu, Sintayehu; Taye, Kefyalew; Teshome, Wondu; Asnake, Solomon

    2013-11-15

    Intestinal parasitic infections are a major public health burden in tropical countries. Although all HIV/AIDS patients are susceptible to parasitic infections, those having lower immune status are at greater risk. The aim of this study was to determine the prevalence of intestinal parasitic infections in patients living with HIV/AIDS. This was a facility-based cross-sectional study. A total of 343 consecutively sampled HIV/AIDS patients from the HIV care clinic of Hawassa University Referral Hospital were included. Subjects were interviewed for demographic variables and diarrheal symptoms using structured questionnaires. Stool examinations and CD4 cells counts were also performed. The prevalence of intestinal parasitic infection was 47.8% among HIV/AIDS patients; single helminthic infection prevalence (22.7%) was higher than that the prevalence of protozoal infections (14.6%). About 54% of study participants had chronic diarrhea while 3.4% had acute diarrhea. The prevalence of intestinal parasites in patients with chronic diarrhea was significantly higher than in acute diarrhea (p intestinal parasite infections such as Ascaris lumbricoides, Taenia spp., and hookworm were commonly found, regardless of immune status or diarrheal symptoms. Opportunistic and non-opportunistic intestinal parasitic infection were more frequent in patients with a CD4 count of Intestinal parasitic infections should be suspected in HIV/AIDS-infected patients with advanced disease presenting with chronic diarrhea. Patients with low CD4 counts should be examined critically for intestinal parasites, regardless of diarrheal status.

  18. A Cross Section Study to Determine the Prevalence of Antibodies against HIV Infection among Hepatitis B and C Infected Individuals

    Geane L. Flores

    2016-03-01

    Full Text Available (1 Background: There are limited data regarding human immunodeficiency virus (HIV prevalence among hepatitis B virus (HBV or hepatitis C virus (HCV infected individuals. The aim of this cross-sectional study is to determine the prevalence of HBV and HCV infection among HIV individuals; (2 Methods: A total of 409 patients (126 HBV+ and 283 HCV+ referred to the Brazilian Reference Laboratory for Viral Hepatitis from 2010 to 2013 donated serum samples. Anti-HIV, HBsAg, anti-HBc, anti-HBs, anti-HBcIgM, anti-HBe, HBeAg, and anti-HCV antibodies were measured, and anti-HCV positive samples were tested for viral RNA and genotype; (3 Results: The anti-HIV antibody prevalence was 10.31% and 4.59% among HBV+ and HCV+ patients, respectively. The HCV mean (SD viral load was log 5.14 ± 1.64 IU/mL, and genotype I was most prevalent (163/283. Anti-HBs and anti-HBc were detected in 40% and 26% of HCV+ individuals, respectively. Among the HBV+ population, the presence of anti-HIV antibodies was associated with male gender, marital status (married, tattoo, sexual orientation, sexual practices (oral sex and anal sex, history of sexually transmitted diseases (STDs, history of viral hepatitis treatment, and a sexual partner with hepatitis or HIV. For the HCV+ group, the presence of anti-HIV antibodies was associated with female gender, marital status (married, anal intercourse, previous history of STDs, and number of sexual partners; (4 Conclusion: A high prevalence of anti-HIV antibodies was found among individuals with HBV and HCV, showing the importance of education programmes towards HIV infection among HBV- and HCV-infected individuals.

  19. Sexual agreements and perception of HIV prevalence among an online sample of partnered men who have sex with men.

    Stephenson, Rob; White, Darcy; Mitchell, Jason W

    2015-10-01

    Stemming from recent evidence that between one- and two-thirds of new HIV transmissions among men who have sex with men (MSM) occur within main partnerships, research and programmatic efforts have begun to recognize the role of the male-male dyad in shaping HIV risk. Central to this new focus has been studies detailing the presence of sexual agreements, which provide guidelines governing permissions around sex with partners outside of the relationship. Using a Facebook-recruited sample of US-partnered MSM (n = 454), this study examines the associations between reporting of sexual agreements and perceptions of HIV prevalence among male sex partners, friends, and local and national MSM populations. Men who perceived that 10-20 % (OR 6.18, 95 % CI 1.28-29.77) and >20 % of their male sex partners were HIV positive (OR 2.68, 95 % CI 1.02-7.08) had significantly higher odds of reporting having an open agreement with their current main partner than men who perceived that less than 10 % of their male sex partners were HIV positive. Partnered men with open sexual agreements may have more sexual partners than those who report monogamy, possibly leading to heightened perceptions of HIV risk, which may result in reporting of perceptions of greater local HIV prevalence. Additionally, men who have made agreements with their partners may have done so due to concerns about HIV risks, and may also be more aware of increased risks of HIV infection, or may have greater knowledge of HIV prevalence through discussions of serostatus with sex partners. Attention is needed to develop prevention efforts, such as toolkits and resources that enable men to form sexual agreements that are based on comprehensive knowledge of the potential risks for acquisition of HIV.

  20. Evaluation of Performance of Two Rapid Tests for Detection of HIV-1 and -2 in High- and Low-Prevalence Populations in Nigeria.

    Manak, Mark M; Njoku, Ogbonnaya S; Shutt, Ashley; Malia, Jennifer; Jagodzinski, Linda L; Milazzo, Mark; Suleiman, Aminu; Ogundeji, Amos A; Nelson, Robert; Ayemoba, Ojor R; O'Connell, Robert J; Singer, Darrell E; Michael, Nelson L; Peel, Sheila A

    2015-11-01

    The availability of reliable human immunodeficiency virus types 1 and 2 (HIV-1/2) rapid tests in resource-limited settings represents an important advancement in the accurate diagnosis of HIV infection and presents opportunities for implementation of effective prevention and treatment interventions among vulnerable populations. A study of the potential target populations for future HIV vaccine studies examined the prevalence of HIV infections at six selected sites in Nigeria and evaluated the use of two rapid diagnostic tests (RDTs) for HIV. The populations included market workers at sites adjacent to military installations and workers at highway settlements (truck stops) who may have a heightened risk of HIV exposure. Samples from 3,187 individuals who provided informed consent were tested in parallel using the Determine (DT) and Stat-Pak (SP) RDTs; discordant results were subjected to the Uni-Gold (UG) RDT as a tiebreaker. The results were compared to those of a third-generation enzyme immunoassay screen with confirmation of repeat reactive samples by HIV-1 Western blotting. One participant was HIV-2 infected, yielding positive results on both RDTs. Using the laboratory algorithm as a gold standard, we calculated sensitivities of 98.5% (confidence interval [CI], 97.1 to 99.8%) for DT and 98.1% (CI, 96.7 to 99.6%) for SP and specificities of 98.7% (CI, 98.3 -99.1%) for DT and 99.8% (CI, 99.6 to 100%) for SP. Similar results were obtained when the sites were stratified into those of higher HIV prevalence (9.4% to 22.8%) versus those of lower prevalence (3.2% to 7.3%). A parallel two-test algorithm requiring both DT and SP to be positive resulted in the highest sensitivity (98.1%; CI, 96.7 to 99.6%) and specificity (99.97%; CI, 99.9 to 100%) relative to those for the reference laboratory algorithm. Copyright © 2015, Manak et al.

  1. [Prevalence of congenital and perinatal infection in HIV positive pregnant in Belo Horizonte metropolitan region].

    Maia, Marcelle Marie Martins; Lage, Eura Martins; Moreira, Bárbara Cecília Borges; Deus, Elayne Alayne Braga de; Faria, Joanna Gonçalves; Pinto, Jorge Andrade; Melo, Victor Hugo

    2015-09-01

    To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors. A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs. Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis. The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.

  2. HIV prevalence and uptake of HIV/AIDS services among youths (15–24 Years in fishing and neighboring communities of Kasensero, Rakai District, South Western Uganda

    Richardson Mafigiri

    2017-03-01

    Full Text Available Abstract Background Although fishing communities have a significantly higher HIV prevalence than the general population, there is paucity of data on the burden of HIV and service utilization, particularly among the youth. We assessed the HIV prevalence and utilization of HIV prevention and treatment services among youth in Kasensero fishing community and the neighboring communities. Method Data were derived from the Rakai Community Cohort Study (RCCS surveys conducted between 2013 and 2014. The RCCS is a population-based household survey that collects data annually from individuals aged 15–49 years, resident in 48 communities in Rakai and neighboring districts in Uganda. For this analysis, socio-demographic, behavioral and HIV-related data were obtained for 792 individuals aged 15–24 years. We used logistic regression to conduct bivariate and multivariable analysis to determine the factors that are independently associated with HIV-positive status and their corresponding 95% confidence intervals. Data were analyzed using STATA version 13. Results Overall HIV prevalence was 19.7% (n = 155; higher in Kasensero (n = 141; 25.1% and Gwanda (n = 8; 11% than in Kyebe (n = 6; 3.9%, p < 0.001 and among females (n = 112; 26.0% than males (n = 43; 12.0%, p < 0.001. Uptake of HIV testing was high in both HIV-positive (n = 136; 89.5% and HIV-negative youth (n = 435; 92%. Consistent condom use was virtually non-existent in HIV-positive youth (n = 1; 0.6% compared to HIV-negative youth (n = 20; 4.2%. Only 22.4% (n = 34 of the HIV-positive youth were receiving antiretroviral therapy (ART in 2013–2014; higher in the HIV-positive females (n = 31; 28.4% than HIV-positive males (n = 03; 6.7%. Slightly more than half of males (n = 134; 53.8% reported that they were circumcised; the proportion of circumcised youth was higher among HIV-negative males (n = 122; 58% than HIV-positive males (n

  3. Prevalence and risk factors for osteopenia/osteoporosis in an HIV-infected male population.

    Tomazic, Janez; Ul, Katja; Volcansek, Gabriele; Gorensek, Samo; Pfeifer, Misa; Karner, Primoz; Prezelj, Janez; Vidmar, Gaj; Vidmar, Ludvik

    2007-01-01

    The objective of our investigation was to estimate the prevalence of osteopenia/osteoporosis in men with HIV/AIDS and evaluate the role of antiretroviral treatment (ART), HIV and other risk factors in reducing bone mineral density (BMD). All known Slovenian HIV-infected ART-naïve and treated males (infected or treated > 12 months) were invited to participate in a cross-sectional study. Data were collected on age, BMI, waist-hip ratio, family history of hip fracture, duration of infection, duration of ART, smoking, alcohol, exercise, viral load and CD4+ cells. BMD was measured using dual X-ray absorptiometry. A total of 96 patients (out of 133 who fulfilled the inclusion criteria) were assessed and allocated into three groups: group A (n = 24), ART-naïve; group B1 (n = 37), treated with non-protease-inhibitor (PI) containing ART; and group B2 (n = 35), treated with PI-containing ART. The prevalence of osteopenia/osteoporosis was 57/96 (59%): osteopenia 45/96 (47%) and osteoporosis 12/96 (12%). Significantly lower BMD was detected in group A (P = 0.020). Multiple logistic regression analysis showed ART to be an independent negative predictor for reduced BMD (P = 0.037; OR = 0.29, 95%CI 0.09-0.93). Vitamin D(3) deficiency was detected in 79 (82%) of the patients. The study group represented 72% of the national HIV-infected male population; this proportion being higher than in any other study reported to date. The prevalence of reduced BMD was notably higher than the national prevalence among men of comparable age. There was no association between reduced BMD and any specific ART. According to our results, absence of ART was confirmed as an independent predictor of osteopenia/osteoporosis. Targeted screening and early treatment present a reasonable strategy for preventing reduced BMD in HIV-infected patients, but correcting vitamin D(3) levels could also be an important component.

  4. Analysis of the prevalence of dyslipidemia in individuals with HIV and its association with antiretroviral therapy

    Talita Gabriela de Limas

    2014-10-01

    Full Text Available Introduction Antiretroviral therapy (ART has been used to treat large numbers of patients living with human immunodeficiency virus (HIV infection. Lipid disorders are often observed in these patients, and include elevations in total cholesterol (TC and triglycerides (TG. Methods A cross-sectional study was performed using 333 patient records from the Regional Hospital of São José Doutor Homero de Miranda Gomes (HRSJHMG. The study population consisted of patients with HIV who were under medical follow up, either on or off drug treatment. The data were entered into Excel and exported to SPSS 16.0 for analysis using chi-square testing. We used prevalence ratios as the measure of association. Results Lipid abnormalities were observed in 78.9% of individuals who received ART. Of the 308 subjects on ART, 59.1%, 41.9%, and 33.1% had TG, TC and low-density lipoprotein (LDL abnormalities, respectively. The prevalence of LDL changes was 2.57-fold higher in individuals who had been using ART for more than 12 months, compared to those using ART for 6 to 12 months. Conclusions HIV patients showed a significant increase in the association between TC and TG levels and the use of ART. In particular, changes in TC, LDL and TG were greater in individuals who had received ART for over more than 12 months.

  5. HIV decline associated with changes in risk behaviours among young key populations in Nepal: analysis of population-based HIV prevalence surveys between 2001 and 2012.

    Deuba, Keshab; Ekström, Anna Mia; Tomson, Göran; Shrestha, Rachana; Marrone, Gaetano

    2017-08-01

    We assessed changes in HIV prevalence and risk behaviours among young key populations in Nepal. A total of 7505 participants (aged 16-24 years) from key populations who were at increased risk of HIV infection (2767 people who inject drugs (PWID); 852 men who have sex with men/transgender (MSM/TG); 2851 female sex workers (FSW) and 1035 male labour migrants) were recruited randomly over a 12-year period, 2001-2012. Local epidemic zones of Nepal (Kathmandu valley, Pokhara valley, Terai Highway and West to Far West hills) were analysed separately. We found a very strong and consistent decline in HIV prevalence over the past decade in different epidemic zones among PWID and MSM/TG in Kathmandu, the capital city, most likely due to a parallel increase in safe needle and syringe use and increased condom use. A decrease in HIV prevalence in 22 Terai highway districts, sharing an open border with India, was also consistent with increased condom use among FSW. Among male labour migrants, HIV prevalence was low throughout the period in the West to Far West hilly regions. Condom use by migrant workers involved with FSW abroad increased while their condom use with Nepalese FSW declined. Other risk determinants such as mean age at starting first injection, injection frequency, place of commercial sex solicitation, their mean age when leaving to work abroad did not change consistently across epidemic zones among the young key populations under study. In Nepal, the decline in HIV prevalence over the past decade was remarkably significant and consistent with an increase in condom use and safer use of clean needles and syringes. However, diverging trends in risk behaviours across local epidemic zones of Nepal suggest a varying degree of implementation of national HIV prevention policies. This calls for continued preventive efforts as well as surveillance to sustain the observed downward trend.

  6. Prevalence of sexually transmitted infections among HIV-infected women in Brazil

    Ana Gabriela Álvares Travassos

    Full Text Available This study aimed to evaluate the prevalence of sexually transmitted infections (STIs and associated risk factors in HIV-infected pregnant women followed for prenatal care in Salvador, Bahia. This was a cross-sectional study of 63 women seeking prenatal care at a reference center. Participants were interviewed regarding socio-epidemiological and clinical history, and were tested for HBsAg, anti-HCV, anti HTLV I/II, VDRL, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, CD4 count, and HIV plasma viral load. The main outcome variable was the presence of any STI. The mean age of patients was 28.2 years (16-40 years. 23 (36.5% were diagnosed with at least one STI. The frequency of diagnoses was: HBV, 3.2%; HCV, 8.1%; HTLV I/II, 3.4%; syphilis, 9.5%; Chlamydia trachomatis, 11.1%; HPV, 15.0%; Mycoplasma hominis, 2.1%, and Ureaplasma urealyticum, 2.1%. No case of Neisseria gonorrhoeae was identified. No association was found between socio-epidemiological variables and the presence of an STI. CD4 T lymphocyte 1,000 copies (p = 0.027 were associated with the presence of sti. stis are frequent in pregnant women infected with hiv, and all hiv-infected pregnant women should be screened to decrease transmission of these pathogens and to protect their own health.

  7. Prevalencia de trombocitopenia en niños con HIV/sida Prevalence of thrombocytopenia in HIV infected children

    Graciela Barboni

    2010-10-01

    Full Text Available La trombocitopenia es una de las múltiples alteraciones hematológicas presentes en pacientes infectados con el virus de la inmunodeficiencia humana (HIV. Puede ser de curso crónico, en la cual la destrucción inmune, el secuestro esplénico o el daño en la producción son los mecanismos primariamente involucrados, o aguda, acompañando a otra intercurrencia. En este trabajo se evaluó la prevalencia de trombocitopenia en un lapso de 14 años, en una población pediátrica con HIV/sida, analizando las características clínicas y la relación con el estado inmuno-virológico. La prevalencia de trombocitopenia fue de 8.5%, (29 de los 339 niños en seguimiento. En 22 fue de curso crónico y en 7 aguda. Los pacientes evaluados presentaron niveles porcentuales de TCD4+ variables y la presencia de trombocitopenia no estuvo en relación con el compromiso inmunitario. Los pacientes trombocitopénicos tuvieron niveles de carga viral significativamente mayores que los que no la presentaron. En 10 de los 29 niños con recuentos plaquetarios disminuidos, la trombocitopenia fue la manifestación inicial de la infección por HIV. Las manifestaciones hemorrágicas de las trombocitopenias crónicas fueron leves, presentes en el 23% de los niños y no se asociaron al deterioro inmunológico, mientras que en las agudas fueron más graves y condicionadas a la evolución de la enfermedad coexistente. El desarrollo de trombocitopenias se ve favorecido por la continua actividad viral y la falla en la implementación del tratamiento antirretroviral adecuado.Thrombocytopenia is a common hematologic finding in patients infected with the human immunodeficiency virus. Multiple mechanisms may contribute to the development of chronic thrombocytopenia as immune-mediated platelet destruction, enhanced platelet splenic sequestration and impaired platelet production. Acute thrombocytopenia is frequently associated with coexisting disorders. In this study, the prevalence of

  8. Actual and undiagnosed HIV prevalence in a community sample of men who have sex with men in Auckland, New Zealand

    Saxton Peter JW

    2012-02-01

    Full Text Available Abstract Background The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand. Methods The study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%, 1049 provided a matched specimen (provision rate 80.4%. Results HIV prevalence was 6.5% (95% CI: 5.1-8.1. After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9% of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection. Conclusions This is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics

  9. Actual and undiagnosed HIV prevalence in a community sample of men who have sex with men in Auckland, New Zealand.

    Saxton, Peter J W; Dickson, Nigel P; Griffiths, Richard; Hughes, Anthony J; Rowden, John

    2012-02-01

    The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM) in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand. The study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%), 1049 provided a matched specimen (provision rate 80.4%). HIV prevalence was 6.5% (95% CI: 5.1-8.1). After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9%) of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection. This is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics, HIV prevalence was elevated in subgroups of MSM based on

  10. Actual and undiagnosed HIV prevalence in a community sample of men who have sex with men in Auckland, New Zealand

    2012-01-01

    Background The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM) in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand. Methods The study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%), 1049 provided a matched specimen (provision rate 80.4%). Results HIV prevalence was 6.5% (95% CI: 5.1-8.1). After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9%) of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection. Conclusions This is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics, HIV prevalence was

  11. Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis.

    Chris Richard Kenyon

    Full Text Available HIV prevalence varies between 0.8 and 20.2% in Kenya's various ethnic groups. The reasons underlying these variations have not been evaluated before.We used data from seven national surveys spanning the period 1989 to 2008 to compare the prevalence of a range of risk factors in Kenya's ethnic groups. Spearman's and linear regression were used to assess the relationship between HIV prevalence and each variable by ethnic group.The ethnic groups exhibited significant differences in a number of HIV related risk factors. Although the highest HIV prevalence group (the Luo had the highest rates of HIV testing (Men 2008 survey: 56.8%, 95% CI 51.0-62.5% and condom usage at last sex (Men 2008∶28.6%, 95% CI 19.6-37.6%, they had the lowest prevalence of circumcision (20.9%, 95% CI 15.9-26.0 the highest prevalence of sex with a non-married, non-cohabiting partner (Men: 40.2%, 95% CI 33.2-47.1% and pre-marital sex (Men 2008∶73.9%, 95% CI 67.5-80.3% and the youngest mean age of debut for women (1989 SURVEY: 15.7 years old, 95% CI 15.2-16.2. At a provincial level there was an association between the prevalence of HIV and male concurrency (Spearman's rho = 0.79, P = 0.04. Ethnic groups with higher HIV prevalence were more likely to report condom use (Men 2008 survey: R2 = 0.62, P = 0.01 and having been for HIV testing (Men 2008 survey: R2 = 0.47, P = 0.04.In addition to differences in male circumcision prevalence, variation in sexual behavior may contribute to the large variations in HIV prevalence in Kenya's ethnic groups. To complement the prevention benefits of the medical male circumcision roll-out in several parts of Kenya, interventions to reduce risky sexual behavior should continue to be promoted.

  12. Access and management of HIV-related diseases in resource-constrained settings: a workshop report.

    Dimba, Eao; Yengopal, V; Joshua, E; Thavarajah, R; Balasundaram, S

    2016-04-01

    With advancement of medical interventions, the lifespan of people living with HIV has increased globally. However, low- and middle-income countries (LMICs) which bear the greatest burden of the HIV pandemic face a constant challenge in addressing the treatment needs of immune-suppressed patients. An analysis of the current management protocols and access to medication in resource-poor settings was conducted at this workshop, with emphasis on the situation in resource-poor settings. The participants developed a consensus document based on the need to respond to the constantly changing HIV pandemic. Provision of oral health care must be guided by interconnecting principles based on population based strategies that address upstream determinants of health. Basic oral health coverage in developing countries can only be realized with a strong foundation at the primary health level. Early diagnosis of HIV-related comorbidities including the adverse effects of ARVs is essential for the improvement of treatment outcomes. Standardization of oral health care delivery mechanisms will facilitate evaluation at national and regional levels. Oral health care workers have a moral obligation to participate in sustained campaigns to reduce the social stigma associated with HIV/AIDS in their work places at every stage of the referral chain. Future research also needs to realign itself towards prevention using the common risk factor approach, which has a broader impact on non-communicable diseases, which are increasingly affecting patients with HIV/AIDS as their life expectancies increase. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Improving outcomes in infants of HIV-infected women in a developing country setting.

    Noel, Francine; Mehta, Sapna; Zhu, Yuwei; Rouzier, Patricia De Matteis; Marcelin, Abdias; Shi, Jian R; Nolte, Claudine; Severe, Linda; Deschamps, Marie Marcelle; Fitzgerald, Daniel W; Johnson, Warren D; Wright, Peter F; Pape, Jean W

    2008-01-01

    Since 1999 GHESKIO, a large voluntary counseling and HIV testing center in Port-au-Prince, Haiti, has had an ongoing collaboration with the Haitian Ministry of Health to reduce the rate of mother to child HIV transmission. There are limited data on the ability to administer complex regimens for reducing mother to child transmission and on risk factors for continued transmission and infant mortality within programmatic settings in developing countries. We analyzed data from 551 infants born to HIV-infected mothers seen at GHESKIO, between 1999 and 2005. HIV-infected mothers and their infants were given "short-course" monotherapy with antiretrovirals for prophylaxis; and, since 2003, highly active antiretroviral therapy (HAART) when clinical or laboratory indications were met. Infected women seen in the pre-treatment era had 27% transmission rates, falling to 10% in this cohort of 551 infants, and to only 1.9% in infants of women on HAART. Mortality rate after HAART introduction (0.12 per year of follow-up [0.08-0.16]) was significantly lower than the period before the availability of such therapy (0.23 [0.16-0.30], Pbirth weight on mortality and transmission were determined using univariate and multivariate analysis. Infant HIV-1 infection and low birth weight were associated with infant mortality in less than 15 month olds in multivariate analysis. Our findings demonstrate success in prevention of mother-to-child HIV transmission and mortality in a highly resource constrained setting. Elements contributing to programmatic success include provision of HAART in the context of a comprehensive program with pre and postnatal care for both mother and infant.

  14. Improving outcomes in infants of HIV-infected women in a developing country setting.

    Francine Noel

    Full Text Available Since 1999 GHESKIO, a large voluntary counseling and HIV testing center in Port-au-Prince, Haiti, has had an ongoing collaboration with the Haitian Ministry of Health to reduce the rate of mother to child HIV transmission. There are limited data on the ability to administer complex regimens for reducing mother to child transmission and on risk factors for continued transmission and infant mortality within programmatic settings in developing countries.We analyzed data from 551 infants born to HIV-infected mothers seen at GHESKIO, between 1999 and 2005. HIV-infected mothers and their infants were given "short-course" monotherapy with antiretrovirals for prophylaxis; and, since 2003, highly active antiretroviral therapy (HAART when clinical or laboratory indications were met. Infected women seen in the pre-treatment era had 27% transmission rates, falling to 10% in this cohort of 551 infants, and to only 1.9% in infants of women on HAART. Mortality rate after HAART introduction (0.12 per year of follow-up [0.08-0.16] was significantly lower than the period before the availability of such therapy (0.23 [0.16-0.30], P<0.0001. The effects of maternal health, infant feeding, completeness of prophylaxis, and birth weight on mortality and transmission were determined using univariate and multivariate analysis. Infant HIV-1 infection and low birth weight were associated with infant mortality in less than 15 month olds in multivariate analysis.Our findings demonstrate success in prevention of mother-to-child HIV transmission and mortality in a highly resource constrained setting. Elements contributing to programmatic success include provision of HAART in the context of a comprehensive program with pre and postnatal care for both mother and infant.

  15. A small set of succinct signature patterns distinguishes Chinese and non-Chinese HIV-1 genomes.

    Yan Wang

    Full Text Available The epidemiology of HIV-1 in China has unique features that may have led to unique viral strains. We therefore tested the hypothesis that it is possible to find distinctive patterns in HIV-1 genomes sampled in China. Using a rule inference algorithm we could indeed extract from sequences of the third variable loop (V3 of HIV-1 gp120 a set of 14 signature patterns that with 89% accuracy distinguished Chinese from non-Chinese sequences. These patterns were found to be specific to HIV-1 subtype, i.e. sequences complying with pattern 1 were of subtype B, pattern 2 almost exclusively covered sequences of subtype 01_AE, etc. We then analyzed the first of these signature patterns in depth, namely that L and W at two V3 positions are specifically occurring in Chinese sequences of subtype B/B' (3% false positives. This pattern was found to be in agreement with the phylogeny of HIV-1 of subtype B inside and outside of China. We could neither reject nor convincingly confirm that the pattern is stabilized by immune escape. For further interpretation of the signature pattern we used the recently developed measure of Direct Information, and in this way discovered evidence for physical interactions between V2 and V3. We conclude by a discussion of limitations of signature patterns, and the applicability of the approach to other genomic regions and other countries.

  16. Human Papillomavirus prevalence, viral load and cervical intraepithelial neoplasia in HIV-infected women

    José E. Levi

    Full Text Available HIV-infected women from São Paulo city were enrolled in a cross-sectional study on Human Papillomavirus (HPV and cervical intraepithelial neoplasia (CIN prevalence and their association with laboratory markers of AIDS, namely HIV viral load and CD4+ cell counts. A cervical specimen was collected and submitted to Hybrid Capture, a test for HPV viral load determination. HPV-DNA was detected in 173 of 265 women (64.5%. Twenty (7.5% women were infected by one or more low-risk viruses, 89 (33% by one or more high-risk viruses, and 64 (24% harbored at least one HPV type from each risk group. Abnormal smears were observed in 19% of the patients, though there were no invasive carcinomas. Severely immunosuppressed patients (CD4/µL <100 were at the greatest risk of having a cytological abnormality and a high high-risk HPV viral load.

  17. Human Papillomavirus prevalence, viral load and cervical intraepithelial neoplasia in HIV-infected women

    Levi José E.

    2002-01-01

    Full Text Available HIV-infected women from São Paulo city were enrolled in a cross-sectional study on Human Papillomavirus (HPV and cervical intraepithelial neoplasia (CIN prevalence and their association with laboratory markers of AIDS, namely HIV viral load and CD4+ cell counts. A cervical specimen was collected and submitted to Hybrid Capture, a test for HPV viral load determination. HPV-DNA was detected in 173 of 265 women (64.5%. Twenty (7.5% women were infected by one or more low-risk viruses, 89 (33% by one or more high-risk viruses, and 64 (24% harbored at least one HPV type from each risk group. Abnormal smears were observed in 19% of the patients, though there were no invasive carcinomas. Severely immunosuppressed patients (CD4/µL <100 were at the greatest risk of having a cytological abnormality and a high high-risk HPV viral load.

  18. Lower HIV prevalence among Asian/Pacific Islander men who have sex with men: a critical review for possible reasons.

    Wei, Chongyi; Raymond, H Fisher; Wong, Frank Y; Silvestre, Anthony J; Friedman, Mark S; Documét, Patricia; McFarland, Willi; Stall, Ron

    2011-04-01

    We conducted a critical literature review for possible reasons that may explain the lower HIV prevalence observed among API MSM compared to MSM of other races/ethnicities. Trends emerging from the literature suggest that traditional individual-level factors-unprotected anal intercourse, substance use, STD prevalence, rates and frequency of HIV testing, and utilization of HIV prevention services-do not appear to be related to the lower HIV prevalence among API MSM. Some evidence suggests that socio-cultural and structural factors might be the more critical forces in determining racial/ethnic disparities of HIV among MSM. For API MSM, these factors include structures of sexual networks, access to and reception of medical care and treatment among HIV-positive MSM, and influences of different levels and types of acculturation. Moreover, emerging risk reduction strategies, such as seroadaptive behaviors, could play a role. Future research should address these factors in intervention design. In addition, better theories of resilience and measurement of strengths and protective factors are needed to enhance the efficacy of HIV interventions.

  19. Impact of Extended Combination Antiretroviral Therapy on the Decline of HIV Prevalence in Pregnant Women in Malawi.

    Liotta, Giuseppe; Chimbwandira, Frank; Wouters, Kristien; Nielsen-Saines, Karin; Jere, Haswell; Mancinelli, Sandro; Ceffa, Susanna; Erba, Fulvio; Palombi, Leonardo; Marazzi, Maria Cristina

    2016-01-01

    Combination antiretroviral therapy has been shown to reduce HIV transmission and incident infections. In recent years, Malawi has significantly increased the number of individuals on combination antiretroviral drugs through more inclusive treatment policies. Using a retrospective observational cohort design, records with HIV test results were reviewed for pregnant women attending a referral hospital in Malawi over a 5-year period, with viral load measurements recorded. HIV prevalence over time was determined, and results correlated with population viral load. A total of 11 052 women were included in this analysis, with 440 (4.1%) HIV infections identified. HIV prevalence rates in pregnant women in Malawi halved from 6.4% to 3.0% over 5 years. Mean viral loads of adult patients decreased from 120 000 copies/mL to less than 20 000 copies/mL. Results suggest that community viral load has an effect on HIV incidence rates in the population, which in turn correlates with reduced HIV prevalence rates in pregnant women. © The Author(s) 2015.

  20. Human papillomavirus prevalence and type distribution in 3603 HIV-positive and HIV-negative women in the general population of Tanzania

    Dartell, Myassa Arkam; Rasch, Vibeke; Kahesa, Crispin

    2012-01-01

    The aim of the Prevention of Cervical Cancer in Tanzania (PROTECT) study is to assess the prevalence of oncogenic human papillomavirus (HPV) and to determine the type distribution among women in the general population according to human immunodeficiency virus (HIV) status, in preparation for a po......The aim of the Prevention of Cervical Cancer in Tanzania (PROTECT) study is to assess the prevalence of oncogenic human papillomavirus (HPV) and to determine the type distribution among women in the general population according to human immunodeficiency virus (HIV) status, in preparation...

  1. High prevalence of diarrhoegenic intestinal parasite infections among non-ART HIV patients in Fitche Hospital, Ethiopia.

    Adamu, Haileeyesus; Wegayehu, Teklu; Petros, Beyene

    2013-01-01

    HIV infection has been modifying both the epidemiology and outcome of parasite infections. Hence, this study was undertaken to determine the prevalence of Cryptosporidium and other intestinal parasite infections among HIV positives with and without Antiretroviral Treatment(ART) and its association with CD4+ T-cell count. A cross-sectional study was conducted at Fitche hospital focusing on HIV positives who came to hospital for follow-ups. A total of 378 HIV positive persons with and without ART participated in the study. Data on socio-demographic factors and diarrhoea status were obtained by interviewing all 214 with ART and 164 without ART. Stool samples were collected from all patients and examined for intestinal parasites using direct, formol-ether and modified acid-fast staining techniques. The prevalence of intestinal parasite infections in this study was significantly higher among HIV positive persons not on ART. Specifically, the rate of infection with Cryptosporidium species, Blastocystis spp., Giardia lamblia, and Entamoeba histolytica/E. dispar were higher, particularly in those with CD4+ T-cell counts less than 200 cells/µL. Fifty seven percent of the study participants were on ART. Out of these 164/378 (43%) of the non-ART study participants were infected with at least one intestinal parasite species. Significant association was observed between lower CD4+ T-cell count (parasites were significantly more prevalent in HIV positive non-ART patients. HIV infection increased the risk of having Cryptosporidium and other intestinal parasites and diarrhoea. Therefore, raising HIV positive's immune status and screening for intestinal parasites is important. This study showed that patients who are taking ART had a lower prevalence of diarrhoea causing parasites and Cryptosporidium suggesting that ART through improvement of immune status of the patients may have contributed to controlling diarrhoea-causing parasites in HIV positive patients.

  2. Prevalence of neurocognitive disorders and depression in a Brazilian HIV population

    Flávio Trentin Troncoso

    2015-08-01

    Full Text Available AbstractINTRODUCTION:Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND, which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17, compare the IHDS performance with the performances on the Timed Gait Test (TGT, the Digit Symbol Coding Test (DS and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL, and evaluate the association between the IHDS performance and clinical-demographic variables.METHODS:One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses.RESULTS:According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4 levels were significantly and independently associated with neurocognitive impairment.CONCLUSIONS:The prevalence of neurocognitive impairment according to the IHDS is high and associated with female gender, education level, and low CD4 levels.

  3. Human immunodeficiency virus type-1 (HIV-1) genetic diversity and ...

    PROGMANAGER

    2013-04-24

    Apr 24, 2013 ... objective of this study was to determine the genetic diversity of HIV-1 and the prevalence of antiretroviral (ARV) ... individuals in resource limited settings. Key words: ... management of HIV infection even as antiretroviral (ARV).

  4. Hepatitis B virus prevalence, risk factors and genotype distribution in HIV infected patients from West Java, Indonesia.

    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.

  5. Effect of misclassification of antiretroviral treatment status on the prevalence of transmitted HIV-1 drug resistance

    Castro Hannah

    2012-03-01

    Full Text Available Abstract Background Estimates of the prevalence of transmitted HIV drug resistance (TDR in a population are derived from resistance tests performed on samples from patients thought to be naïve to antiretroviral treatment (ART. Much of the debate over reliability of estimates of the prevalence of TDR has focused on whether the sample population is representative. However estimates of the prevalence of TDR will also be distorted if some ART-experienced patients are misclassified as ART-naïve. Methods The impact of misclassification bias on the rate of TDR was examined. We developed methods to obtain adjusted estimates of the prevalence of TDR for different misclassification rates, and conducted sensitivity analyses of trends in the prevalence of TDR over time using data from the UK HIV Drug Resistance Database. Logistic regression was used to examine trends in the prevalence of TDR over time. Results The observed rate of TDR was higher than true TDR when misclassification was present and increased as the proportion of misclassification increased. As the number of naïve patients with a resistance test relative to the number of experienced patients with a test increased, the difference between true and observed TDR decreased. The observed prevalence of TDR in the UK reached a peak of 11.3% in 2002 (odds of TDR increased by 1.10 (95% CI 1.02, 1.19, p(linear trend = 0.02 per year 1997-2002 before decreasing to 7.0% in 2007 (odds of TDR decreased by 0.90 (95% CI 0.87, 0.94, p(linear trend Conclusion The effect of misclassification of ART on estimates of the prevalence of TDR may be appreciable, and depends on the number of naïve tests relative to the number of experienced tests. Researchers can examine the effect of ART misclassification on their estimates of the prevalence of TDR if such a bias is suspected.

  6. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India

    Jaya Chakravarty

    2016-01-01

    Full Text Available Background & objectives: India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART Centre in a tertiary care hospital in eastern India. Methods: We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Results: Of the 216 HIV-positive women screened, 58 (26.85% were HPV-positive; 56 (25.9% were of high-risk (HR HPV type. The most prevalent HPV type was HPV-16 (7.9%; non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR, 2.56 (1.26-5.19], illiteracy [OR, 2.30 (1.19-4.46], rural residence [OR, 3.99 (1.27-12.56] and CD4 ≤350/µl [OR, 2.46 (1.26-4.83] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33% patients had normal/ negative for intraepithelial lesions (NILM cytology, three (1.60% had atypical squamous cells of undetermined significance (ASCUS, 32 (17.11% had low-grade squamous intraepithelial lesions (LSIL, 10 (5.35% had high-grade squamous intraepithelial lesions (HSIL and three (1.60% had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49] and CD4 ≤350/µl [OR, 2.84 (1.30-6.20] were risk factors for abnormal cytology. Interpretation &conclusions: Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  7. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India.

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤ 350/µl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤ 350/µl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  8. Colpocytological abnormalities in HIV infected and uninfected pregnant women: prevalence, persistence and progression.

    Carriero, Carmine; Fascilla, Fabiana Divina; Cramarossa, Paola; Lepera, Achiropita; Bettocchi, Stefano; Vimercati, Antonella

    2018-02-01

    In this retrospective case-control study, we analyse data of 48 HIV-positive pregnant patients, versus a control group of 99 HIV-negative pregnant women, followed as outpatients by our department from 2009 to 2014. The aims of the study were to investigate the prevalence, persistence and progression of cervical squamous intraepithelial lesions (SIL) in each group and to correlate colpo-cytological lesions to the socio-demographic and clinical-laboratory findings in the HIV + pregnant women. In our study we observed that immunosuppression, HPV infection and vaginal coinfections were predictive of cervical lesions. Pap smear and colposcopy should be part of routine care for HIV-infected pregnant women because these lesions behave aggressively in these patients. Success of prevention depends on massive access of patients to screening. HAART reduces viral load and maintains CD4 count and can affect progression of SIL. Multidisciplinary services on the same site appear to be one promising strategy to improve compliance in patients. Impact Statement What is already known on this subject: Our study provided novel information on a highly vulnerable population of young HIV + pregnant women. What the results of this study add: We observed that immunosuppression, HPV infection and vaginal coinfections were predictive of cervical lesions remarkable with colposcopy. We could consider these important risk factors to evaluate to establish an appropriate strategy of management for these patients. What the implications are of these findings for clinical practice and/or further research: Association of the risk between SIL presence and HIV and HPV infection also deserves additional investigation. We believe that Pap smears and colposcopies should be part of the routine care for HIV-infected women because these lesions behave particularly aggressively in these patients.

  9. Prevalence of prior HIV testing and associated factors among MSM in Zhejiang Province, China: a cross-sectional study

    Runhua Li

    2016-11-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become one of high-risk population for human immunodeficiency virus (HIV infection, due to their multiple sex partners and unprotected anal intercourse. Promoting HIV testing is an effective strategy for the prevention and control of HIV infection. We assessed the factors associated with a prior HIV testing history, which could provide guidance for implementation of future HIV intervention programs. Methods A cross-sectional study was conducted in three cities of Zhejiang Province, namely, Hangzhou, Ningbo and Wenzhou, using respondent-driven sampling, between December 2013 and June 2014. A face-to-face questionnaire survey was employed to collect relevant information about HIV testing. Univariate and multivariate logistic regression analyses were used to identify the factors associated with a prior HIV testing history. Results The adjusted rate of prior HIV testing among MSM in Zhejiang Province was 55.9 %. The adjusted rates of HIV and syphilis infections among MSM in Zhejiang Province were 14.0 % and 11.4 %, respectively. A weighted multivariate analysis showed that MSM of older age were more likely to be tested, as were MSM with higher level of education, self-reported homosexuality and a higher frequency of receiving AIDS/sexually transmitted infections educational intervention in the past year. MSM with suicidal inclination and self-perceived lower possibility of HIV infection were less likely to report ever having undergone an HIV test. Conclusions The prevalence of prior HIV testing among MSM in Zhejiang Province, China is low. Effective and more frequent interventional measures should be adopted to improve risk awareness and psychosocial support for younger, less educated MSM, and to encourage more MSM to undergo HIV testing.

  10. Prevalence and factors associated with sexually transmitted infections among HIV positive women opting for intrauterine contraception.

    Othman Kakaire

    Full Text Available Women living with HIV/AIDS (WLHA are a high risk group for sexually transmitted infections (STIs. However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD.Three hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG, Trichomonas vaginalis (TV and Chlamydia trachomatis (CT infections conducted.Participants' mean age was 29.4 ± 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69% had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants' spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4 and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85 having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78 and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78.STI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI.

  11. Prevalence of hepatitis B and C infection in persons living with HIV enrolled in care in Rwanda.

    Umutesi, Justine; Simmons, Bryony; Makuza, Jean D; Dushimiyimana, Donatha; Mbituyumuremyi, Aimable; Uwimana, Jean Marie; Ford, Nathan; Mills, Edward J; Nsanzimana, Sabin

    2017-05-02

    Hepatitis B (HBV) and C (HCV) are important causes of morbidity and mortality in people living with human immunodeficiency virus (HIV). The burden of these co-infections in sub-Saharan Africa is still unclear. We estimated the prevalence of the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV-infected individuals in Rwanda and identified factors associated with infection. Between January 2016 and June 2016, we performed systematic screening for HBsAg and HCVAb among HIV-positive individuals enrolled at public and private HIV facilities across Rwanda. Results were analyzed to determine marker prevalence and variability by demographic factors. Overall, among 117,258 individuals tested, the prevalence of HBsAg and HCVAb was 4.3% (95% confidence interval [CI] (4.2-4.4) and 4.6% (95% CI 4.5-4.7) respectively; 182 (0.2%) HIV+ individuals were co-infected with HBsAg and HCVAb. Prevalence was higher in males (HBsAg, 5.4% [5.1-5.6] vs. 3.7% [3.5-3.8]; HCVAb, 5.0% [4.8-5.2] vs. 4.4% [4.3-4.6]) and increased with age; HCVAb prevalence was significantly higher in people aged ≥65 years (17.8% [16.4-19.2]). Prevalence varied geographically. HBV and HCV co-infections are common among HIV-infected individuals in Rwanda. It is important that viral hepatitis prevention and treatment activities are scaled-up to control further transmission and reduce the burden in this population. Particular efforts should be made to conduct targeted screening of males and the older population. Further assessment is required to determine rates of HBV and HCV chronicity among HIV-infected individuals and identify effective strategies to link individuals to care and treatment.

  12. HIV prevalence among the female sex workers in major cities in Myanmar and the risk behaviors associated with it

    Swe LA

    2013-08-01

    Full Text Available Lin Aung Swe,1 Abdul Rashid2 1Beneficial Partner Group, Bahan Township, Myanmar; 2Department of Public Health Medicine, Penang Medical College, Georgetown, Malaysia Background: Myanmar is one of the countries hardest hit by the human immunodeficiency virus (HIV epidemic in Asia. Aim: The objective of the study was to determine HIV prevalence among the female sex workers in major cities in Myanmar and the risk behaviors associated with it. Methods: This cross-sectional study was conducted among female sex workers in major cities in Myanmar. Interviews were conducted by trained research assistants, in private, using a questionnaire. The HIV status of the respondents was asked and confirmed by the blood test reports from the laboratories of the Myanmar National AIDS Programme sexually transmitted infections (STI/acquired immunodeficiency syndrome (AIDS Teams and nongovernmental organizations (NGOs. Results: There were 200 respondents in this study. Out of the 136 participants who were tested for HIV, 25 (18.4% were HIV-positive. Respondents of other ethnic groups than Myanmars and other religions than Buddhist were about six times (odds ratio [OR] 5.9 and five times (OR 4.6, respectively, at higher odds of being HIV-positive. Those who were earning an income of less than 200,000 kyats were almost three times (OR 2.9 at higher odds of being HIV-positive. The difference in the age group was found to be statistically significant (P = 0.001. Respondents who did not have HIV counseling (OR 7.3, who did not use condoms (OR 1.3, and with regular partners who refused the use of condoms (OR 6.0 were at higher odds of being HIV-positive. Conclusion: HIV prevention services should include socioeconomic support programs, and the clients and regular partners of sex workers should also be targeted for behavior-change messages, to reduce condom resistance. Keywords: HIV prevalence, risk factors, Myanmar, sex workers, condom

  13. The Prevalence of HIV by Ethnic Group Is Correlated with HSV-2 and Syphilis Prevalence in Kenya, South Africa, the United Kingdom, and the United States

    Chris Richard Kenyon

    2014-01-01

    Full Text Available Background. This paper investigates two issues: do ethnic/racial groups with high HIV prevalences also have higher prevalences of other STIs? and is HIV prevalence by ethnic group correlated with the prevalence of circumcision, concurrency, or having more than one partner in the preceding year? Methods. We used Spearman’s correlation to estimate the association between the prevalence of HIV per ethnic/racial group and HSV-2, syphilis, symptoms of an STI, having more than one partner in the past year, concurrency, and circumcision in Kenya, South Africa, the United Kingdom, and the United States. Results. We found that in each country HSV-2, syphilis, and symptomatic STIs were positively correlated with HIV prevalence (HSV-2: Kenya rho = 0.50, P = 0.207; South Africa rho-1, P = 0.000; USA rho-1, P = 0.000, Syphilis: Kenya rho = 0.33, P = 0.420; South Africa rho-1, P = 0.000; USA rho-1, P = 0.000, and STI symptoms: Kenya rho = 0.92, P = 0.001; South Africa rho-1, P = 0.000; UK rho = 0.87, P = 0.058; USA rho-1, P = 0.000. The prevalence of circumcision was only negatively associated with HIV prevalence in Kenya. Both having more than one partner in the previous year and concurrency were positively associated with HIV prevalence in all countries (concurrency: Kenya rho = 0.79, P = 0.036; South Africa rho-1, P = 0.000; UK 0.87, P = 0.058; USA rho-1, P = 0.000 and multiple partners: Kenya rho = 0.82, P = 0.023; South Africa rho-1, P = 0.000; UK rho = 0.87, P = 0.058; USA rho-1, P = 0.000. Not all associations were statistically significant. Conclusion. Further attention needs to be directed to what determines higher rates of partner change and concurrency in communities with high STI prevalence.

  14. Interactive "Video doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings

    Gilbert, P; Ciccarone, D; Gansky, SA; Bangsberg, DR; Clanon, K; McPhee, SJ; Calderón, SH; Bogetz, A; Gerbert, B

    2008-01-01

    Background Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide “prevention with positives” in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based...

  15. Prevalence and risk factors for HIV-1 infection in rural Kilimanjaro region of Tanzania: Implications for prevention and treatment

    Leyna Germana H

    2007-04-01

    Full Text Available Abstract Background Variability in stages of the HIV-1 epidemic and hence HIV-1 prevalence exists in different areas in sub-Saharan Africa. The purpose of this study was to investigate the magnitude of HIV-1 infection and identify HIV-1 risk factors that may help to develop preventive strategies in rural Kilimanjaro, Tanzania. Methods A cross-sectional study was conducted between March and May of 2005 involving all individuals aged between 15–44 years having an address in Oria Village. All eligible individuals were registered and invited to participate. Participants were interviewed regarding their demographic characteristics, sexual behaviors, and medical history. Following a pre-test counseling, participants were offered an HIV test. Results Of the 2 093 eligible individuals, 1 528 (73.0% participated. The overall age and sex adjusted HIV-1 prevalence was 5.6%. Women had 2.5 times higher prevalence (8.0% vs. 3.2% as compared to men. The age group 25–44 years, marriage, separation and low education were associated with higher risk of HIV-1 infection for both sexes. HIV-1 infection was significantly associated with >2 sexual partners in the past 12 months (women: Adjusted odds ratio [AOR], 2.5 (95%CI: 1.3–4.7, and past 5 years, [(men: AOR, 2.2 (95%CI:1.2–5.6; women: AOR, 2.5 (95%CI: 1.4–4.0], unprotected casual sex (men: AOR,1.8 95%CI: 1.2–5.8, bottled alcohol (Men: AOR, 5.9 (95%CI:1.7–20.1 and local brew (men: AOR, 3.7 (95%CI: 1.5–9.2. Other factors included treatment for genital ulcers and genital discharge in the past 1 month. Health-related complaints were more common among HIV-1 seropositive as compared to seronegative participants and predicted the presence of HIV-1 infection. Conclusion HIV-1 infection was highly prevalent in this population. As compared to our previous findings, a shift of the epidemic from a younger to an older age group and from educated to uneducated individuals was observed. Women and married or

  16. Prevalence and risk factors for HIV-1 infection in rural Kilimanjaro region of Tanzania: implications for prevention and treatment.

    Mmbaga, Elia J; Hussain, Akhtar; Leyna, Germana H; Mnyika, Kagoma S; Sam, Noel E; Klepp, Knut-Inge

    2007-04-19

    Variability in stages of the HIV-1 epidemic and hence HIV-1 prevalence exists in different areas in sub-Saharan Africa. The purpose of this study was to investigate the magnitude of HIV-1 infection and identify HIV-1 risk factors that may help to develop preventive strategies in rural Kilimanjaro, Tanzania. A cross-sectional study was conducted between March and May of 2005 involving all individuals aged between 15-44 years having an address in Oria Village. All eligible individuals were registered and invited to participate. Participants were interviewed regarding their demographic characteristics, sexual behaviors, and medical history. Following a pre-test counseling, participants were offered an HIV test. Of the 2 093 eligible individuals, 1 528 (73.0%) participated. The overall age and sex adjusted HIV-1 prevalence was 5.6%. Women had 2.5 times higher prevalence (8.0% vs. 3.2%) as compared to men. The age group 25-44 years, marriage, separation and low education were associated with higher risk of HIV-1 infection for both sexes. HIV-1 infection was significantly associated with >2 sexual partners in the past 12 months (women: Adjusted odds ratio [AOR], 2.5 (95%CI: 1.3-4.7), and past 5 years, [(men: AOR, 2.2 (95%CI:1.2-5.6); women: AOR, 2.5 (95%CI: 1.4-4.0)], unprotected casual sex (men: AOR,1.8 95%CI: 1.2-5.8), bottled alcohol (Men: AOR, 5.9 (95%CI:1.7-20.1) and local brew (men: AOR, 3.7 (95%CI: 1.5-9.2). Other factors included treatment for genital ulcers and genital discharge in the past 1 month. Health-related complaints were more common among HIV-1 seropositive as compared to seronegative participants and predicted the presence of HIV-1 infection. HIV-1 infection was highly prevalent in this population. As compared to our previous findings, a shift of the epidemic from a younger to an older age group and from educated to uneducated individuals was observed. Women and married or separated individuals remained at higher risk of infection. To prevent further

  17. Prevalence, Incidence, and Residual Risks for Transfusion Transmitted HIV-1/2 Infection among Chinese Blood Donors

    Wang, Jingxing; Liu, Jing; Yao, Fuzhu; Wen, Guoxin; Li, Julin; Huang, Yi; Lv, Yunlai; Wen, Xiuqiong; Wright, David; Yu, Qilu; Guo, Nan; Ness, Paul; Shan, Hua

    2012-01-01

    Background There is little data on HIV prevalence, incidence or residual risks for transfusion transmitted HIV infection among Chinese blood donors. Methods Donations from five Chinese blood centers in 2008–2010 were screened using two rounds of ELISA testing for anti-HIV-1/2. A reactive result in either or both rounds led to Western Blot confirmatory testing. HIV prevalence and demographic correlates among first time donors, incidence rate and demographic correlates among repeat donors were examined. Weighted multivariable logistic regression analysis examined correlates of HIV confirmatory status among first time donors. Residual risks for transfusion transmitted HIV infection were evaluated based on incidence among repeat donors. Results Among 821,320 donations, 40% came from repeat donors.1,837 (0.34%) first time and 577 (0.17%) repeat donations screened reactive for anti-HIV-1/2, among which 1,310 and 419 were tested by Western Blot. 233 (17.7%) first time and 44 (10.5%) repeat donations were confirmed positive. Estimated prevalence was 66 infections per 100,000 (95% CI: 59–74) first time donors. Estimated incidence was 9/100,000 (95% CI: 7–12) person-years among repeat donors. Weighted multivariable logistic regression analysis indicate that first time donors 26–45 years old were 1.6–1.8 times likely to be HIV positive than those 25 years and younger. Donors with some college or above education were less likely to be HIV positive than those with middle school education, ORs ranging from 0.35 to 0.60. Minority were 1.6 times likely to be HIV positive than Han majority donors (OR: 1.6; CI: 1.2–2.1). No difference in prevalence was found between gender. Current HIV TTI residual risk was 5.4 (1.2–12.5) infections per million whole blood donations. Conclusion Despite the declining HIV epidemic China, estimated residual risks for transfusion transmitted HIV infection are still high, highlighting the potential blood safety yield of NAT implementation

  18. Socioeconomic inequalities in HIV/AIDS prevalence in sub-Saharan African countries: evidence from the Demographic Health Surveys

    2014-01-01

    Introduction Extant studies universally document a positive gradient between socioeconomic status (SES) and health. A notable exception is the apparent concentration of HIV/AIDS among wealthier individuals. This paper uses data from the Demographic Health Surveys and AIDS Indicator Surveys to examine socioeconomic inequalities in HIV/AIDS prevalence in 24 sub-Saharan African (SSA) countries, the region that accounts for two-thirds of the global HIV/AIDS burden. Methods The relative and generalized concentration indices (RC and GC) were used to quantify wealth-based socioeconomic inequalities in HIV/AIDS prevalence for the total adult population (aged 15-49), for men and women, and in urban and rural areas in each country. Further, we decomposed the RC and GC indices to identify the determinants of socioeconomic inequalities in HIV/AIDS prevalence in each country. Results Our findings demonstrated that HIV/AIDS was concentrated among higher SES individuals in the majority of SSA countries. Swaziland and Senegal were the only countries in the region where HIV/AIDS was concentrated among individuals living in poorer households. Stratified analyses by gender showed HIV/AIDS was generally concentrated among wealthier men and women. In some countries, including Kenya, Lesotho Uganda, and Zambia, HIV/AIDS was concentrated among the poor in urban areas but among wealthier adults in rural areas. Decomposition analyses indicated that, besides wealth itself (median = 49%, interquartile range [IQR] = 90%), urban residence (median = 54%, IQR = 81%) was the most important factor contributing to the concentration of HIV/AIDS among wealthier participants in SSA countries. Conclusions Further work is needed to understand the mechanisms explaining the concentration of HIV/AIDS among wealthier individuals and urban residents in SSA. Higher prevalence of HIV/AIDS could be indicative of better care and survival among wealthier individuals and urban adults, or reflect

  19. Estimating prevalence of accumulated HIV-1 drug resistance in a cohort of patients on antiretroviral therapy

    Bannister, Wendy P; Cozzi-Lepri, Alessandro; Kjær, Jesper

    2011-01-01

    Estimating the prevalence of accumulated HIV drug resistance in patients receiving antiretroviral therapy (ART) is difficult due to lack of resistance testing at all occasions of virological failure and in patients with undetectable viral load. A method to estimate this for 6498 EuroSIDA patients...... who were under follow-up on ART at 1 July 2008 was therefore developed by imputing data on patients with no prior resistance test results, based on the probability of detecting resistance in tested patients with similar profiles....

  20. Mexican patients with HIV have a high prevalence of vertebral fractures

    José Antonio Mata-Marín

    2018-04-01

    Full Text Available Low bone mineral density (BMD and fragility fractures are common in individuals infected with HIV, who are undergoing antiretroviral therapy (ART. In high-income countries, dual energy X-ray absorptiometrry is typically used to evaluate osteopenia or osteoporosis in HIV infected individuals. However, this technology is unavailable in low and-middle income countries, so a different approach is needed. The aim of this study was to use X-ray scans of the spine to determine the prevalence of and associated risk factors for vertebral fractures in HIV-infected patients in a tertiary-care hospital in Mexico. We conducted a cross-sectional study of outpatients who were >40 years old and receiving ART at the Hospital de Infectología, La Raza National Medical Center in Mexico City, Mexico. We used semi-quantitative morphometric analysis of centrally digitized X-ray images to assess vertebral deformities in the spine. Anterior, middle and posterior vertebral heights were measured, and height ratios were calculated. For each vertebral body, fractures were graded on the basis of height ratio reductions, and a spine deformity index’ (SDI value was calculated by summing the grades of the vertebral deformities: An SDI>1 was indicative of a vertebral fracture. We included 104 patients, 87% of whom were men. The median age was 49 years [interquartile range (IQR 42-52]. Themost common stage of HIV infection, as defined by the Centers for Disease Control,was B2 in 40 (39% of patients. Forty seven (45% patients were on ART regimens that included protease inhibitors (PIs and 100 (96% being treated with tenofovir. The median time of ART was 6.5 years (IQR1.6-9.0. Of the 104 patients in our study, 83 (80% had undetectable viral load, as assessed by HIV-1 RNA levels, 32 (31% showed evidence of a previous fracture, 4 (4% were co-infected with hepatitis C virus, and 57 (55% had a history of corticosteroid treatment. The prevalence of vertebral fractures was 25%, 95

  1. Within-Gender Changes in HIV Prevalence among Adults between 2005/6 and 2010/11 in Zimbabwe.

    Elizabeth Gonese

    Full Text Available Zimbabwe has reported significant declines in HIV prevalence between 2005/06 and 2010/11 Demography and Health Surveys; a within-gender analysis to identify the magnitude and factors associated with this change, which can be masked, is critical for targeting interventions.We analyzed change in HIV prevalence for 6,947 women and 5,848 men in the 2005/06 survey and 7,313 women and 6,250 men in 2010/11 surveys using 2005/06 as referent. The data was analyzed taking into consideration the survey design and therefore the svy, mean command in Stata was used in both linear and logistic regression.There were similar proportional declines in prevalence at national level for males (15% p=0.011 and females (16%,p=0.008. However, there were variations in decline by provincial setting, demographic variables of age, educational level and some sexual risk behaviours. In logistic regression analysis, statistically significant declines were observed among men in Manicaland, Mashonaland East and Harare (p<0.01 and for women in Manicaland, Mashonaland Central and Harare (p<0.01. Although not statistically significant, numerical increases were observed among men in Matebeleland North, Matebeleland South, Midlands and for both men and women in Bulawayo. Young women in the age range 15-34 experienced a decline in prevalence (p<0.01 while older men 30-44 had a statistically significant decline (p<0.01. Having a secondary and above education, regardless of employment status for both men and women recorded a significant decline. For sexual risk behaviours, currently in union for men and women and not in union for women there was a significant decline in prevalence.Zimbabwe has reported a significant decline among both men and women but there are important differentials across provinces, demographic characteristics and sexual risk behaviours that suggest that the epidemic in Zimbabwe is heterogeneous and therefore interventions must be targeted in order to achieve

  2. Syphilis and HIV prevalence and associated factors to their co-infection, hepatitis B and hepatitis C viruses prevalence among female sex workers in Rwanda.

    Mutagoma, Mwumvaneza; Nyirazinyoye, Laetitia; Sebuhoro, Dieudonné; Riedel, David J; Ntaganira, Joseph

    2017-07-28

    Human Immunodeficiency Virus (HIV), syphilis, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are sexually transmitted infections (STIs) and share modes of transmission. These infections are generally more prevalent among female sex workers (FSWs). This is a cross-sectional study conducted among female sex workers (FSWs) in Rwanda in 2015. Venue-Day-Time (VDT) sampling method was used in recruiting participants. HIV, syphilis, HBV, and HCV testing were performed. Descriptive analyses and logistic regression models were computed. In total, 1978 FSWs were recruited. The majority (58.5%) was aged between 20 and 29 years old. Up to 63.9% of FSWs were single, 62.3% attained primary school, and 68.0% had no additional occupation beside sex work. Almost all FSWs (81.2%) had children. The majority of FSWs (68.4%) were venue-based, and most (53.5%) had spent less than five years in sex work. The overall prevalence of syphilis was 51.1%; it was 2.5% for HBV, 1.4% for HCV, 42.9% for HIV and 27.4% for syphilis/HIV co-infection. The prevalence of syphilis, HIV, and syphilis + HIV co-infection was increasing with age and decreasing with the level of education. A positive association with syphilis/HIV co-infection was found in: 25 years and older (aOR = 1.82 [95% CI:1.33-2.50]), having had a genital sore in the last 12 months (aOR = 1.34 [95% CI:1.05-1.71]), and having HBsAg-positive test (aOR = 2.09 [1.08-4.08]). The prevalence of HIV and syphilis infections and HIV/syphilis co-infection are very high among FSWs in Rwanda. A strong, specific prevention program for FSWs and to avert HIV infection and other STIs transmission to their clients is needed.

  3. The impact of HIV and ART on recurrent tuberculosis in a sub-Saharan setting.

    Houben, Rein M G J; Glynn, Judith R; Mboma, Sebastian; Mzemba, Themba; Mwaungulu, Nimrod J; Mwaungulu, Lorren; Mwenibabu, Michael; Mpunga, James; French, Neil; Crampin, Amelia C

    2012-11-13

    To estimate the impact of antiretroviral therapy (ART) on the incidence of recurrent tuberculosis (TB) in an African population. A long-term population cohort in Karonga District, northern Malawi. Patients who had completed treatment for laboratory-confirmed TB diagnosed since 1996 were visited annually to record vital status, ART use and screen for TB. Survival analysis estimated the effect of HIV/ART status at completion of treatment on mortality and recurrence. Analyses were stratified by time since treatment completion to estimate the effects on relapse (predominates during first year) and reinfection disease (predominates later). Among 1133 index TB cases contributing 4353 person-years of follow-up, there were 307 deaths and 103 laboratory-confirmed recurrences (recurrence rate 4.6 per 100 person-years). Half the recurrences occurred in the first year since completing treatment. HIV infection increased the recurrence rate [rate ratio adjusted for age, sex, period and TB type 2.69, 95% confidence interval (CI) 1.69-4.26], but with less effect in the first year (adjusted rate ratio 1.71, 95% CI 0.87-3.35) than subsequently (adjusted rate ratio 4.2, 95% CI 2.16-8.15). Recurrence rates on ART were intermediate between those of HIV-negative individuals and HIV-positive individuals without ART. Compared with HIV-positive individuals without ART, the adjusted rate ratio was 0.74 (95% CI 0.27-2.06) in the first year, and 0.43 (95% CI 0.11-1.73) later. The increased incidence of TB recurrence observed in HIV-positive patients appeared to be reduced by ART. The effects are mostly on later (likely reinfection) disease so the impact of ART on reducing recurrence will be highest in high TB incidence settings.

  4. Generational sex work and HIV risk among Indigenous women in a street-based urban Canadian setting.

    Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio; Shannon, Kate

    2014-01-01

    In Canada, Indigenous women are over-represented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women's HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal women. In multivariate logistic regression model, Aboriginal women remained three times more likely to experience generational sex work (AOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (AOR = 3.01, 95%CI: 1.67-4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and three-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV-prevention initiatives are required for Indigenous sex workers.

  5. Prevalence of orofacial manifestations in HIV-positive South Indian children and the co-relation with CD4 counts

    Rachna Kaul

    2009-01-01

    Full Text Available Objectives : Orofacial manifestations (OFMs are seen early in the course of HIV disease in children and can also act as indicators for the presence of the disease. The objective of the study were to find the prevalence of OFMs of HIV in infected children, co-relate them with their CD4 counts and establish whether OFMs could be used as markers for disease progression. Materials and Methods : Using the diagnostic criteria recommended by the European Collaborative Clearinghouse (ECC on oral problems related to HIV infection and WHO Collaborating Centre on oral manifestations of the HIV, 48 HIV-infected children were examined at the baseline and their CD4 counts were obtained. A follow-up was conducted 6 months later. Chi-Square test was used to analyse the data obtained. Results : OFM showed a high prevalence in HIV-infected children. The degree of immunosuppression was found to co-relate with the presence of OFMs. But, it could not be established that the presence of OFMs could be a marker for HIV disease progression. Conclusion : The results of our study indicated a high prevalence of OFMs in HIV-infected South Indian children. A decline in CD4 counts was found to be associated with more number of OFMs. However, we were unable to establish OFMs as markers for HIV disease progression. The sample size in our study being about 48 patients and the variability in the initiation and duration of HAART therapy, use of other drugs not being considered, may have an influence on the result of our study. Larger population groups, with parameters such as nutritional status and HAART initiation included, can probably give a more conclusive result..

  6. Ethical considerations in HIV prevention and vaccine research in resource-limited settings.

    Garner, Samual A; Anude, Chuka J; Adams, Elizabeth; Dawson, Liza

    2014-09-01

    HIV prevention research has been facing increasing ethical and operational challenges. Factors influencing the design and conduct of HIV prevention trials include a rapidly changing evidence base, new biomedical prevention methods and modalities being tested, a large diversity of countries, sites and populations affected by HIV and participating in trials, and challenges of developing and making available products that will be feasible and affordable for at-risk populations. To discuss these challenges, a meeting, Ethical considerations around novel combination prevention modalities in HIV prevention and vaccine trials in resource-limited settings, was convened by NIH/NIAID/Division of AIDS on April 22-23, 2013. Several themes emerged from the meeting: (1) because of both trial design and ethical complexities, choosing prevention packages and designing combination prevention research trials will need to be evaluated on a case by case basis in different clinical trials, countries, and health systems; (2) multilevel stakeholder engagement from the beginning is vital to a fair and transparent process and also to designing ethical and relevant trials; (3) research should generally be responsive to a host country's needs, and sponsors and stakeholders should work together to address potential barriers to future access; and finally, (4) another meeting including a broader group of stakeholders is needed to address many of the outstanding ethical issues raised by this meeting. We offer an overview of the meeting and the key discussion points and recommendations to help guide the design and conduct of future HIV prevention and vaccine research in resource-limited settings.

  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

    Meque, Ivete; Dubé, Karine; Feldblum, Paul J.; Clements, Archie C. A.; Zango, Arlinda; Cumbe, Fidelina; Chen, Pai Lien; Ferro, Josefo J.; van de Wijgert, Janneke H.

    2014-01-01

    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. Between 2009 and 2012, 411 women aged 18-35 years at higher risk of HIV

  8. High prevalence of oral colonization by Candida dubliniensis in HIV-positive patients in Argentina.

    Binolfi, Andrés; Biasoli, Marisa S; Luque, Alicia G; Tosello, María E; Magaró, Hortensia M

    2005-08-01

    Candida dubliniensis is a recently described yeast species, closely related to Candida albicans. This work represents the first general survey of the carriage of C. dubliniensis in the oral cavities of HIV-positive patients in Argentina. We studied 133 strains isolated from 162 HIV-positive patients, using the following identification tests: chlamydospore production on corn meal agar with Tween 80; colony color on CHROMagar Candida media; differential growth at 45 degrees C on potato dextrose agar; D-xylose assimilation; chlamydospore formation on sunflower seed agar (SSA); carbohydrate assimilation profiles using the API 20 C Aux commercial kit and PCR using primers that hybridize to the class IV intron of the ACT1 gene. Out of the 133 strains, 21 were identified as C. dubliniensis, representing approximately 13% of the 162 patients in this study. From these data, we conclude that although the PCR assay is the most reliable method, clamydospore formation on SSA is an easier and less expensive test for the screening of C. dubliniensis in the routine laboratory. Our results show that C. dubliniensis has a high prevalence among HIV-positive patients in Argentina.

  9. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea).

    Traore, Bangaly; Bah, Thierno Souleymane; Traore, Fode Amara; Sow, Mamadou Saliou; Diane, Solomana; Keita, Mamady; Cisse, Mohamed; Koulibaly, Moussa; Camara, Naby Daouda

    2015-01-01

    Aim. To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea). Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education) and immune status (HIV type, CD4 count) were reviewed. Results. Out of 2598 cancer patients, 54 (2.1%) tested positive for HIV. There were 11 (20.4%) defining AIDS and 43 (79.6%) nondefining AIDS cancers. The most frequent cancers were breast (14) (26.0%), non-Hodgkin lymphoma (6) (11.1%), liver (6) (11.1%), eye and annexes (6) (11.1%), and cervical cancer (5) (9.3%). These patients were female in 34 (63.0%) and had a median age of 39 years and body mass in