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Sample records for unknown hiv status

  1. 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 ...

  2. An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study.

    Yang, Cui; Latkin, Carl; Tobin, Karin; Seal, David; Koblin, Beryl; Chander, Geetanjali; Siconolfi, Daniel; Flores, Stephen; Spikes, Pilgrim

    2018-05-19

    Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.

  3. HIV status and tuberculosis

    User

    Failure to perform mycobacterium culture bacterial blood culture and results of other causes of .... for Identification of Highly Infectious Tuberculosis in People Living with HIV in Southeast Asia. ... Indian Journal of Tuberculosis 58, 108-112.

  4. HIV Serosorting, Status Disclosure, and Strategic Positioning Among Highly Sexually Active Gay and Bisexual Men.

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

    2015-10-01

    Researchers have identified harm reduction strategies that gay, bisexual, and other men who have sex with men (GBMSM) use to reduce HIV transmission--including serosorting, status disclosure, and strategic positioning. We report on patterns of these behaviors among 376 highly sexually active (i.e., 9+partners, positioning; however, rates varied based on the participant's HIV status. HIV-positive and HIV-negative men both engaged in sex with men of similar status more often than they engaged in sex with men known to be a different HIV status (i.e., serosorting). However, HIV-negative men disclosed their HIV-status with about half of their partners, whereas HIV-positive participants disclosed with only about one-third. With regard to strategic positioning, HIV-positive participants were the receptive partner about half the time with their HIV-negative partners and with their HIV-positive partners. In contrast, strategic positioning was very common among HIV-negative participants-they rarely bottomed with HIV-positive partners, bottomed about one-third of the time with status-unknown partners, and 42% of the time (on average) with HIV-negative partners. Highly sexually active GBMSM are a critical population in which to both investigate HIV prevention strategies as well as develop effective intervention programs. Providers and clinicians might be well served to include a wide range of behavioral harm reduction strategies in addition to condom use and biomedical approaches to reduce onward HIV transmission.

  5. HIV Status Discordance: Associated Factors Among HIV Positive ...

    AJRH Managing Editor

    infection for a partner of a person with HIV is about 10%, with higher annual transmission rates ... We recommend the tracking of both men and women as index cases in other to reduce HIV .... HIV status was accepted as known only if backed.

  6. The Effect of a Model's HIV Status on Self-Perceptions: A Self-Protective Similarity Bias.

    Gump, Brooks B.; Kulik, James A.

    1995-01-01

    Examined how information about another person's HIV status influences self-perceptions and behavioral intentions. Individuals perceived their own personalities and behaviors as more dissimilar to anther's if that person's HIV status was believed positive compared with negative or unknown. Exposure to HIV-positive model produced greater intentions…

  7. Detection of viral sequence fragments of HIV-1 subfamilies yet unknown

    Stanke Mario

    2011-04-01

    Full Text Available Abstract Background Methods of determining whether or not any particular HIV-1 sequence stems - completely or in part - from some unknown HIV-1 subtype are important for the design of vaccines and molecular detection systems, as well as for epidemiological monitoring. Nevertheless, a single algorithm only, the Branching Index (BI, has been developed for this task so far. Moving along the genome of a query sequence in a sliding window, the BI computes a ratio quantifying how closely the query sequence clusters with a subtype clade. In its current version, however, the BI does not provide predicted boundaries of unknown fragments. Results We have developed Unknown Subtype Finder (USF, an algorithm based on a probabilistic model, which automatically determines which parts of an input sequence originate from a subtype yet unknown. The underlying model is based on a simple profile hidden Markov model (pHMM for each known subtype and an additional pHMM for an unknown subtype. The emission probabilities of the latter are estimated using the emission frequencies of the known subtypes by means of a (position-wise probabilistic model for the emergence of new subtypes. We have applied USF to SIV and HIV-1 sequences formerly classified as having emerged from an unknown subtype. Moreover, we have evaluated its performance on artificial HIV-1 recombinants and non-recombinant HIV-1 sequences. The results have been compared with the corresponding results of the BI. Conclusions Our results demonstrate that USF is suitable for detecting segments in HIV-1 sequences stemming from yet unknown subtypes. Comparing USF with the BI shows that our algorithm performs as good as the BI or better.

  8. HIV Status Discordance: Associated Factors Among HIV Positive ...

    AJRH Managing Editor

    HIV status Discordance among Pregnant Women in Lagos. African Journal ... Social marketing aimed at reducing concurrency should focus on both male and females, if we must .... This strategy is insufficient as available evidence shows that ...

  9. Couples coping with discordant HIV status.

    Beckerman, Nancy L

    2002-02-01

    As we start the third decade of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic, how does HIV/AIDS affect the emotional lives of couples of mixed HIV status? This is a case report based on the findings of an exploratory research study of serodiscordant couples in the New York City area. It focuses on the issues confronting a particular couple who represent the salient issues in the lives of serodiscordant couples. This case report discusses the findings of a study that attempted to ascertain the central emotional challenges facing couples of mixed HIV status and discusses one case in particular that illustrates how these issues might commonly manifest themselves. Fear of HIV transmission, coping with uncertainty of potential illness, shifts in emotional intimacy, and dilemmas regarding how HIV has impacted reproductive alternatives were identified as the most commonly experienced emotional issues for the serodiscordant couple.

  10. HIV Testing and Awareness of Partner's HIV Status Among Chinese Men Who Have Sex with Men in Main Partnerships.

    Wei, Chongyi; Yan, Hongjing; Raymond, H Fisher; Shi, Ling-En; Li, Jianjun; Yang, Haitao; McFarland, Willi

    2016-04-01

    Many men who have sex with men (MSM) do not use condoms with their main partners, especially if both parties are of the same HIV status. However, significant proportions of MSM have never tested or recently tested and are unaware of their main partners' HIV status. A cross-sectional survey was conducted among 524 MSM in Jiangsu, China in 2013-2014. Time-location sampling and online convenience sampling were used to recruit participants. We compared awareness of HIV status and recent HIV testing between participants who had main partners versus those who did not, and identified factors associated with recent HIV testing among men in main partnerships. Participants in main partnerships were significantly more likely to report recent HIV testing and being HIV-negative instead of HIV-unknown compared to participants in casual partnerships only. Overall, 74.5 % of participants were aware of their main partners' HIV status. Among participants in main partnerships, those who had 2-5 male anal sex partners in the past 6 months and those who reported that their partners were HIV-negative had 2.36 (95 % CI 1.12, 4.97) and 4.20 (95 % CI 2.03, 8.70) fold greater odds of being tested in the past year compared to those who had main partners only and those whose partners were HIV-positive/unknown, respectively. Chinese MSM in main partnerships might be practicing serosorting and may be at lower risk for HIV infection due to increased awareness of main partners' HIV status and higher uptake of recent testing.

  11. Predictors of HIV/AIDS confirmation and differences by guardian status in HIV+ adolescents in Jamaica.

    Pilgrim, N; Kershaw, T; Pierre, R B; Moore, J; Palmer, P; Davis, D; Christie, C D C

    2008-06-01

    Approximately 25% of the cumulative AIDS cases in Jamaica involve adolescents and young adults. However the lives of adolescents living with HIV within Jamaica and the Caribbean have been understudied. (1) To describe the sociodemographic characteristics of HIV+ Jamaican adolescents who have ever been a part of the Kingston Paediatric/Perinatal HIV Programme (KPAIDS) from September 1, 2002 to August 31, 2006 (2). To identify predictors of HIV/AIDS confirmation as well as factors associated or uniquely present in these adolescents by their guardian status. Seventy-two HIV+ adolescents, ages 10-19 years, were included. Factors studied included demographics as well as time to and time between HIV and AIDS confirmation. Data were analyzed by bivariate and multivariate statistics. The mean age of the adolescents was 12.6 +/- 2.8 years with slightly more males (52.8%) in the programme. There were equal proportions of adolescents living with HIV as with AIDS (43.1%). There were equal proportions who were lost to follow-up or deceased (8.3%). Twenty-two of them lived with parents, 25 with guardians and 18 in residential institutions. The primary mode of transmission was perinatal infection (68.1%), followed by sexual (20.8%), blood transfusion (2.9%) and unknown (8.3%). The mean time from HIV exposure to HIV confirmation and AIDS confirmation in mother-to-child transmission (MTCT) cases were 8.0 +/- 2.9 years and 9.6 +/- 3.3 years, respectively. In the multivariate analysis model, age and gender were significant in predicting time from HIV exposure to HIV confirmation. The majority of HIV-positive adolescents reside with parents and guardians and this might indicate support in spite of stigma and discrimination. However; the mean time to HIV confirmation in MTCT cases is quite long and must be reduced.

  12. Hepatitis B immunisation in persons not previously exposed to hepatitis B or with unknown exposure status

    Mathew, Joseph L; El Dib, Regina; Mathew, Preethy J

    2008-01-01

    The benefits and harms of hepatitis B vaccination in persons not previously exposed to hepatitis B infection or with unknown exposure status have not been established.......The benefits and harms of hepatitis B vaccination in persons not previously exposed to hepatitis B infection or with unknown exposure status have not been established....

  13. Disclosure of HIV Status in Rural Tanzania: Practices, Facilitators ...

    In Tanzania, HIV counselling and testing practices are now widely accepted as the cornerstone of HIV prevention programmes. Within HIV testing and counselling, emphasis is placed on the importance of individuals to disclose their HIV status. Despite increasing focus on disclosure of HIV status, relatively little is known ...

  14. Nutrition Status of HIV+ Children in Botswana

    Nnyepi, Maria; Bennink, Maurice R.; Jackson-Malete, Jose; Venkatesh, Sumathi; Malete, Leapetswe; Mokgatlhe, Lucky; Lyoka, Philemon; Anabwani, Gabriel M.; Makhanda, Jerry; Weatherspoon, Lorraine J.

    2015-01-01

    Purpose: Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the benefits of integrating nutrition (assessment and culturally acceptable food supplement intervention) in the treatment strategy for this target group.…

  15. Maternal HIV status and infant feeding practices among Ugandan ...

    Maternal HIV status and infant feeding practices among Ugandan women. ... SAHARA-J: Journal of Social Aspects of HIV/AIDS ... population in Uganda, and to assess the impact of maternal HIV status on these practices, a questionnaire was administered to women attending the follow-up clinics for child vaccination. Among ...

  16. Gender differences between predictors of HIV status among PWID in Ukraine.

    Corsi, K F; Dvoryak, S; Garver-Apgar, C; Davis, J M; Brewster, J T; Lisovska, O; Booth, R E

    2014-05-01

    The HIV epidemic in Ukraine is among the largest in Europe. While traditionally the epidemic has spread through injection risk behavior, sexual transmission is becoming more common. Previous research has found that women in Ukraine have higher rates of HIV and engage in more HIV risk behavior than men. This study extended that work by identifying risk factors that differentially predict men and women's HIV status among people who inject drugs (PWID) in Ukraine. From July 2010 to July 2013, 2480 sexually active PWID with unknown HIV status were recruited from three cities in Ukraine through street outreach. The average age was 31 years old. Women, who made up twenty-eight percent of the sample, had higher safe sex self-efficacy (pUkraine. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.

    Brown, J; McGowan, J A; Chouial, H; Capocci, S; Smith, C; Ivens, D; Johnson, M; Sathia, L; Shah, R; Lampe, F C; Rodger, A; Lipman, M

    2017-09-01

    We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

  18. Current status and prospects of HIV treatment.

    Cihlar, Tomas; Fordyce, Marshall

    2016-06-01

    Current antiviral treatments can reduce HIV-associated morbidity, prolong survival, and prevent HIV transmission. Combination antiretroviral therapy (cART) containing preferably three active drugs from two or more classes is required for durable virologic suppression. Regimen selection is based on virologic efficacy, potential for adverse effects, pill burden and dosing frequency, drug-drug interaction potential, resistance test results, comorbid conditions, social status, and cost. With prolonged virologic suppression, improved clinical outcomes, and longer survival, patients will be exposed to antiretroviral agents for decades. Therefore, maximizing the safety and tolerability of cART is a high priority. Emergence of resistance and/or lack of tolerability in individual patients require availability of a range of treatment options. Development of new drugs is focused on improving safety (e.g. tenofovir alafenamide) and/or resistance profile (e.g. doravirine) within the existing drug classes, combination therapies with improved adherence (e.g. single-tablet regimens), novel mechanisms of action (e.g. attachment inhibitors, maturation inhibitors, broadly neutralizing antibodies), and treatment simplification with infrequent dosing (e.g. long-acting injectables). In parallel with cART innovations, research and development efforts focused on agents that target persistent HIV reservoirs may lead to prolonged drug-free remission and HIV cure. Copyright © 2016 Gilead Sciences, Inc. Published by Elsevier B.V. All rights reserved.

  19. Household food security and HIV status in rural and urban ...

    Household food security and HIV status in rural and urban communities in the Free State ... SAHARA-J: Journal of Social Aspects of HIV/AIDS ... In all areas, a high percentage of HIV-infected respondents relied on a limited number of foods to ...

  20. Clients' experiences of HIV positive status disclosure to sexual ...

    The purpose of the study was to describe the experiences of HIV positive clients as they disclose their HIV positive status to their sexual partners. A qualitative descriptive and phenomenological design was used. Purposive sampling was used to select 15 HIV positive clients to participate in the study. Semi-structured ...

  1. Clinical and immunological status of a newly diagnosed HIV positive ...

    Objective: To evaluate the clinical and the immune status of newly HIV diagnosed patients, in Marrakech city and its neighboring area, in Morocco. Methods: We performed a retrospective study on 235 patients who have been previously confirmed for HIV infection, and underwent a CD4 T cells using flow cytometry ...

  2. Dental Caries Status of HIV Infected Children in Nigeria | Obileye ...

    Background: HIV positive children may be prone to developing Dental Caries due to prolonged and frequent use of sucrose containing medications and poor feeding practices. Objetive: To determine the caries status of primary and permanent dentition in HIV positive Nigerian children using dmft/DMFT indices. Methods: ...

  3. HIVThe influence of HIV status on prenatal genetic diagnosis choices

    HIVThe influence of HIV status on prenatal genetic diagnosis choices. JS Bee, M Glass, JGR Kromberg. Abstract. Background. At-risk women of advanced maternal age (AMA) can choose to have second-trimester invasive testing for a prenatal genetic diagnosis on the fetus. Being HIV-positive can complicate the ...

  4. Utilization Status of Electronic Information Sources (EIS) for HIV ...

    Tesfa

    HIV/AIDS Care and Treatment in Specialized Teaching Hospitals of. Ethiopia, 2016. Senait Samuel Bramo. 1. , Tesfamichael Alaro Agago. 2*. OPEN ACCESS. Citation: Senait Samuel Bramo,. Tesfamichael Alaro Agago. Utilization. Status of Electronic Information Sources. (EIS) for HIV/AIDS Care and Treatment.

  5. Enhancing HIV status disclosure and partners' testing through ...

    Background: In Tanzania HIV Testing and Counselling (HTC) is being implemented through voluntary counselling and testing (VCT), provider initiated counselling and testing (PITC) and work place counselling and testing (HTC). Within these programmes, HIV status disclosure is emphasized. However, among persons who ...

  6. HIV status disclosure and ARV adherence among patients attending ...

    HIV status disclosure and ARV adherence among patients attending Jomo Kenyatta University comprehensive care clinic. ... Failure to daily intake of Anti Retrovirals (ARV) not only prevents treatment failure but may also lead to viral development of resistance to the drugs. The fact that HIV is mainly sexually transmitted ...

  7. HIV status awareness, partnership dissolution and HIV transmission in generalized epidemics.

    Reniers, Georges; Armbruster, Benjamin

    2012-01-01

    HIV status aware couples with at least one HIV positive partner are characterized by high separation and divorce rates. This phenomenon is often described as a corollary of couples HIV Testing and Counseling (HTC) that ought to be minimized. In this contribution, we demonstrate the implications of partnership dissolution in serodiscordant couples for the propagation of HIV. We develop a compartmental model to study epidemic outcomes of elevated partnership dissolution rates in serodiscordant couples and parameterize it with estimates from population-based data (Rakai, Uganda). Via its effect on partnership dissolution, every percentage point increase in HIV status awareness reduces HIV incidence in monogamous populations by 0.27 percent for women and 0.63 percent for men. These effects are even larger when the assumption of monogamy can be relaxed, but are moderated by other behavior changes (e.g., increased condom use) in HIV status aware serodiscordant partnerships. When these behavior changes are taken into account, each percentage point increase in HIV status awareness reduces HIV incidence by 0.13 and 0.32 percent for women and men, respectively (assuming monogamy). The partnership dissolution effect exists because it decreases the fraction of serodiscordant couples in the population and prolongs the time that individuals spend outside partnerships. Our model predicts that elevated partnership dissolution rates in HIV status aware serodiscordant couples reduce the spread of HIV. As a consequence, the full impact of couples HTC for HIV prevention is probably larger than recognized to date. Particularly high partnership dissolution rates in female positive serodiscordant couples contribute to the gender imbalance in HIV infections.

  8. HIV status awareness, partnership dissolution and HIV transmission in generalized epidemics.

    Georges Reniers

    Full Text Available HIV status aware couples with at least one HIV positive partner are characterized by high separation and divorce rates. This phenomenon is often described as a corollary of couples HIV Testing and Counseling (HTC that ought to be minimized. In this contribution, we demonstrate the implications of partnership dissolution in serodiscordant couples for the propagation of HIV.We develop a compartmental model to study epidemic outcomes of elevated partnership dissolution rates in serodiscordant couples and parameterize it with estimates from population-based data (Rakai, Uganda.Via its effect on partnership dissolution, every percentage point increase in HIV status awareness reduces HIV incidence in monogamous populations by 0.27 percent for women and 0.63 percent for men. These effects are even larger when the assumption of monogamy can be relaxed, but are moderated by other behavior changes (e.g., increased condom use in HIV status aware serodiscordant partnerships. When these behavior changes are taken into account, each percentage point increase in HIV status awareness reduces HIV incidence by 0.13 and 0.32 percent for women and men, respectively (assuming monogamy. The partnership dissolution effect exists because it decreases the fraction of serodiscordant couples in the population and prolongs the time that individuals spend outside partnerships.Our model predicts that elevated partnership dissolution rates in HIV status aware serodiscordant couples reduce the spread of HIV. As a consequence, the full impact of couples HTC for HIV prevention is probably larger than recognized to date. Particularly high partnership dissolution rates in female positive serodiscordant couples contribute to the gender imbalance in HIV infections.

  9. UK: Welsh court reduces sentence, cites HIV status.

    Marceau, Emmanuelle

    2003-08-01

    A Welsh appeal court has reduced the sentence handed down to an offender because of his HIV status, despite his lengthy criminal record. The court reduced the sentence from five to three-and-a-half years' imprisonment.

  10. Determination of HIV Status in African Adults With Discordant HIV Rapid Tests.

    Fogel, Jessica M; Piwowar-Manning, Estelle; Donohue, Kelsey; Cummings, Vanessa; Marzinke, Mark A; Clarke, William; Breaud, Autumn; Fiamma, Agnès; Donnell, Deborah; Kulich, Michal; Mbwambo, Jessie K K; Richter, Linda; Gray, Glenda; Sweat, Michael; Coates, Thomas J; Eshleman, Susan H

    2015-08-01

    In resource-limited settings, HIV infection is often diagnosed using 2 rapid tests. If the results are discordant, a third tie-breaker test is often used to determine HIV status. This study characterized samples with discordant rapid tests and compared different testing strategies for determining HIV status in these cases. Samples were previously collected from 173 African adults in a population-based survey who had discordant rapid test results. Samples were classified as HIV positive or HIV negative using a rigorous testing algorithm that included two fourth-generation tests, a discriminatory test, and 2 HIV RNA tests. Tie-breaker tests were evaluated, including rapid tests (1 performed in-country), a third-generation enzyme immunoassay, and two fourth-generation tests. Selected samples were further characterized using additional assays. Twenty-nine samples (16.8%) were classified as HIV positive and 24 of those samples (82.8%) had undetectable HIV RNA. Antiretroviral drugs were detected in 1 sample. Sensitivity was 8.3%-43% for the rapid tests; 24.1% for the third-generation enzyme immunoassay; 95.8% and 96.6% for the fourth-generation tests. Specificity was lower for the fourth-generation tests than the other tests. Accuracy ranged from 79.5% to 91.3%. In this population-based survey, most HIV-infected adults with discordant rapid tests were virally suppressed without antiretroviral drugs. Use of individual assays as tie-breaker tests was not a reliable method for determining HIV status in these individuals. More extensive testing algorithms that use a fourth-generation screening test with a discriminatory test and HIV RNA test are preferable for determining HIV status in these cases.

  11. Occupational HIV Infection in a Research Laboratory With Unknown Mode of Transmission: A Case Report.

    Soria, Alessandro; Alteri, Claudia; Scarlatti, Gabriella; Bertoli, Ada; Tolazzi, Monica; Balestra, Emanuela; Bellocchi, Maria Concetta; Continenza, Fabio; Carioti, Luca; Biasin, Mara; Trabattoni, Daria; Bandera, Alessandra; Ceccherini-Silberstein, Francesca; Perno, Carlo Federico; Gori, Andrea

    2017-03-15

    A laboratory worker was infected with human immunodeficiency virus (HIV) type 1 in a biosafety level 2 containment facility, without any apparent breach. Through full-genome sequencing and phylogenetic analyses, we could identify the source of infection in a replication-competent clone that unknowingly contaminated a safe experiment. Mode of transmission remains unclear. Caution is warranted when handling HIV-derived constructs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  12. comparative analysis of micronutrients status of hiv infected and hiv ...

    USER

    2015-06-01

    Jun 1, 2015 ... Antiretroviral drugs are used to reduce the viral load, disease symptoms and ... amount of blue color produced read colorimetrically at 440nm using light ..... studies of HIV type 1 related cognitive changes. Arch. Neutral, 49 ...

  13. HIV status of partners of HIV positive pregnant women in different regions of Nigeria: matters arising.

    Sagay, A S; Onakewhor, J; Galadanci, H; Emuveyan, E E

    2006-12-01

    This study was conducted to determine the pattern of HIV sero-status of Partners of HIV Positive Pregnant Women in three different regions of Nigeria and to explore the implications for HIV prevention interventions. The Site Coordinators of PMTCT programs in three Nigerian cities obtained data of the HIV status of the partners of HIV positive pregnant women. The selection of Benin City, Jos and Kano was made after consideration of their ethnic, religious and cultural representation of Nigeria. Benin City represents a traditional southern Nigeria city, Kano a traditional northern city and Jos, a middle-belt, ethnically diverse cosmopolitan setting. The data were analyzed using frequencies. A total of 500 partners of HIV infected pregnant women were tested for HIV using Determine Abbott test kits. Positive results were confirmed using Western blot or a second rapid test kit. The city-by-city results showed that in Benin City (Southern Nigeria), 78.8% (104/132) of the partners were HIV negative (sero-discordant), Jos (Middle-Belt) had 48.4% (103/213) sero-discordance while Kano (Northern Nigeria) recorded a sero-discordance rate of only 7.7% (12/155). These results indicate that the dynamics of HIV transmission in marital settings in Nigeria are different in the various regions of the country. Socio-cultural and religious settings play a significant role in HIV transmission among couples. These findings should guide prevention interventions in order to achieve maximal impact.

  14. HIV and STD status among MSM and attitudes about Internet partner notification for STD exposure.

    Mimiaga, Matthew J; Tetu, Ashley M; Gortmaker, Steven; Koenen, Karestan C; Fair, Andrew D; Novak, David S; Vanderwarker, Rodney; Bertrand, Thomas; Adelson, Stephan; Mayer, Kenneth H

    2008-02-01

    This study assessed the acceptability and perceived utility of Internet-based partner notification (PN) of sexually transmitted disease (STD) exposure for men who have sex with men (MSM) by human immunodeficiency virus (HIV) serostatus. We recruited 1848 US MSM via a banner advertisement posted on an MSM website for meeting sexual partners between October and November 2005. Even though there was broad acceptance of a PN e-mail across HIV serostatus groups, HIV-infected men rated the importance of each component (e.g., information about where to get tested/treated, additional education regarding the STD exposed to, a mechanism for verifying the authenticity of the PN e-mail) lower than HIV-uninfected or status-unknown participants (all P's e-mail (if they were to receive an e-mail notifying them of possible STD exposure in the future), and were less likely to inform their partners of possible STD exposure via an Internet notification system in the future (all P's e-mail. If public health officials consider using Internet notification services, they may need to anticipate and address concerns of HIV-infected MSM, and will need to use a culturally-sensitive, social marketing campaign to ensure that those who may benefit from these services are willing to use this modality for PN. Internet PN should be considered as a tool to decrease rising STD and HIV rates among MSM who use the Internet to meet sexual partners.

  15. Health & nutritional status of HIV infected children in Hyderabad, India.

    Swetha, G Krishna; Hemalatha, R; Prasad, U V; Murali, Vasudev; Damayanti, K; Bhaskar, V

    2015-01-01

    Information on nutritional status of HIV infected children from India is lacking and is required before taking up nutritional supplementation trials. Thus, the aim of the present study was to assess the growth and morbidity status of HIV infected children over a period of one year in a city in southern India. This was an observational study carried out between July 2009 and February 2011, at two orphanages in Hyderabad, India. Seventy seven HIV-positive children aged between 1 and half and 15 years, both on and not on antiretroviral therapy (ART) were included. Nutritional status was assessed longitudinally for one year by weight gain, linear growth and body composition. Serum samples were analyzed for haemoglobin, micronutrients, CD4 and CD8 counts. Dietary intakes were assessed by institutional diet survey and morbidity data were recorded every day for 12 months. Mean energy intakes were less than recommended dietary allowance (RDA) in all age groups. Iron and folate intakes were less than 50 per cent of RDA; 46 (59.7%) children were stunted, 36 (46.8%) were underweight and 15 (19.5%) had low BMI for age. Anaemia was observed in 35 (45.5%) children. Micronutrient deficiencies such as vitamin D (40/77; 51.9%), vitamin A (11/77; 14.3%), folate (37/77; 48.1%), iron (38/77; 49.3%) were widely prevalent. HIV viral load was higher in children not on ART and those with morbidity. Respiratory (36.6%) and dermatological illnesses (18.8%) were the commonest presentations. Acute, chronic malnutrition and micronutrient deficiencies were common in HIV infected children, especially in those not on ART and having morbidity. With severe malnutrition being an alarming consequence of HIV, prophylactic nutritive care should be considered for integration into HIV care strategies besides initiation of ART to improve the nutritional status and quality of life of these children.

  16. Association between HIV status and psychological symptoms in perimenopausal women.

    Looby, Sara E; Psaros, Christina; Raggio, Greer; Rivard, Corinne; Smeaton, Laura; Shifren, Jan; Grinspoon, Steven; Joffe, Hadine

    2018-01-29

    HIV-infected women are burdened by depression and anxiety, which may impact adherence to antiretroviral therapy and overall quality of life. Yet, little is known about the scope of psychological symptoms in the growing number of HIV-infected women reaching menopause, when affective symptoms are more prevalent in the general population. We conducted a longitudinal study to compare affective symptoms between perimenopausal HIV-infected and non-HIV-infected women. The Center for Epidemiologic Studies Depression Scale (CES-D), and the Generalized Anxiety Disorder scale (GAD-7) were completed at baseline and 12 months among 33 HIV-infected and 33 non-HIV-infected perimenopausal women matched by race, age, menstrual patterns, and BMI. Linear regression models estimated the relationship of baseline GAD-7 and CES-D scores with clinical factors. All women were perimenopausal at baseline, and the vast majority remained perimenopausal throughout follow-up. HIV status was associated with higher baseline CES-D scores (median [interquartile range] 21 [12, 29] vs 10 [5, 14]; P = 0.03) and GAD-7 scores (7 [5, 15] vs 2 [1, 7]; P = 0.01), controlling for smoking, substance use, and antidepressant use. Depressive symptoms and anxiety remained significantly higher in the HIV-infected women at 12 months (P ≤ 0.01). Significant relationships of depressive symptoms (P = 0.048) and anxiety (P = 0.02) with hot flash severity were also observed. Perimenopausal HIV-infected women experienced a disproportionately high level of affective symptom burden over a 12-month observation period. Given the potential for these factors to influence adherence to HIV clinical care and quality of life, careful assessment and referral for treatment of these symptoms is essential.

  17. Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men

    Overstreet, Nicole M.; Earnshaw, Valerie A.; Kalichman, Seth C.; Quinn, Diane M.

    2012-01-01

    Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS (PLWHA) endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a s...

  18. HIV knowledge, stigma, and illness beliefs among pediatric caregivers in Ghana who have not disclosed their child's HIV status.

    Paintsil, Elijah; Renner, Lorna; Antwi, Sampson; Dame, Joycelyn; Enimil, Anthony; Ofori-Atta, Angela; Alhassan, Amina; Ofori, Irene Pokuaa; Cong, Xiangyu; Kyriakides, Tassos; Reynolds, Nancy R

    2015-01-01

    The majority of HIV-infected children in sub-Saharan Africa have not been informed of their HIV status. Caregivers are reluctant to disclose HIV status to their children because of concern about the child's ability to understand, parental sense of guilt, and fear of social rejection and isolation. We hypothesized that the low prevalence of pediatric HIV disclosure in Ghana is due to lack of accurate HIV information and high HIV stigma among caregivers. This is a preliminary analysis of baseline data of an HIV pediatric disclosure intervention study in Ghana ("Sankofa"). "Sankofa" - is a two-arm randomized controlled clinical trial comparing disclosure intervention plus usual care (intervention arm) vs usual care (control arm) at Korle-Bu Teaching Hospital (KBTH; control arm) and Komfo-Anokye Teaching Hospital (KATH; intervention arm). We enrolled HIV-infected children, ages 7-18 years who do not know their HIV status, and their caregivers. Baseline data of caregivers included demographic characteristics; Brief HIV Knowledge Questionnaire (HIV-KQ-18); Brief Illness Perception Questionnaire; and HIV Stigma Scale. Simple and multivariable linear regression analyses were used to assess the relationship between caregiver characteristics and HIV knowledge, stigma, and illness perception. Two hundred and ninety-eight caregivers were enrolled between January 2013 and July 2014 at the two study sites; KBTH (n = 167) and KATH (n = 131). The median age of caregivers was 41 years; 80.5% of them were female and about 60% of caregivers were HIV-positive. Seventy-eight percent of caregivers were self-employed with low household income. In both unadjusted and adjusted analyses, HIV negative status and lower level of education were associated with poor scores on HIV-KQ. HIV positive status remained significant for higher level of stigma in the adjusted analyses. None of the caregiver's characteristics predicted caregiver's illness perception. Intensification of HIV education in

  19. Determinants of nondisclosure of HIV status among women ...

    -2.90), caused divorce (OR=2.01, 95% CI: 1.25-3.22) and was unimportant (OR= 2.26, 95% CI: 1.33-3.87) were two times less likely to disclose their status. Respondents who received group HIV pre-test counselling were 2.4 times more likely ...

  20. Household food security and HIV status in rural and urban ...

    2017-10-11

    Oct 11, 2017 ... More than half of all participants reported feeling sad, blue or depressed ... and economic access to sufficient safe and nutritious food that meets their dietary .... select significant independent factors associated with HIV status. Variables with a ...... the disability grant: A South African dilemma? Journal of the ...

  1. Dual protection, contraceptive use, HIV status and risk among a ...

    The aim of this study was to investigate dual protection, contraceptive use, HIV status risk among a national sample of South African women. The final sample included only female participants (N=4675) who reported to have had sexual intercourse in the past 12 months aged 15 to 49 years. Results indicate that almost one ...

  2. Confidentiality concerning HIV/AIDS status - the implications of the ...

    The Appellate Division recently overturned a Supreme Court judgement concerning the disclosure of a patient's HIV status by his general practitioner to another general practitioner and a dentist. This article examines the content of both judgements with particular reference to its implication for the medical profession, and ...

  3. Nutrient Intake and Nutritional Status Profile of HIV-Positive ...

    The intake of sufficient nutrients is important for maintaining the functional compounds of the immune system. The main aim of this study was to assess the nutrient intake and nutritional status profile of HIV positive individuals. Home dietary recall and six days\\' food intake from the nutrition center was used to estimate the ...

  4. 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.

  5. Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men.

    Overstreet, Nicole M; Earnshaw, Valerie A; Kalichman, Seth C; Quinn, Diane M

    2013-01-01

    Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a sample of HIV-positive BMSM (N=156), the current study examined the effect of internalized stigma on HIV status disclosure to sexual partners, which can inform sexual decision-making in serodiscordant couples, and HIV status disclosure to family members, which can be beneficial in minimizing the psychological distress associated with HIV. Results revealed that greater internalized stigma was associated with less HIV status disclosure to participants' last sexual partner and to family members. Findings from this study provide evidence that internalized negative beliefs about one's HIV status are linked to adverse interpersonal consequences. Implications of these findings are discussed with regard to prevention and intervention efforts to reduce HIV stigmatization.

  6. The relationship between negative responses to HIV status disclosure and psychosocial outcomes among people living with HIV.

    Cama, Elena; Brener, Loren; Slavin, Sean; de Wit, John

    2017-07-01

    This report examines rates of HIV status disclosure and negative responses to disclosure among people living with HIV in Australia. Among 697 people living with HIV, most (>90%) had disclosed their status to friends, sexual partners and health providers. Almost a third had not disclosed to family, and half had not told any work colleagues. Negative responses to disclosure (e.g. blame, rejection) by all groups were associated with increased HIV-related stigma, psychological distress and diminished social support and health satisfaction. These results shed light on rates of disclosure among people living with HIV in Australia and the adverse health impacts of negative responses to disclosure.

  7. Disclosure of HIV status between parents and children in Uganda in ...

    While disclosure of HIV sero-status is encouraged in the management of the HIV and AIDS epidemic, it remains a challenge, especially among family members. This article examines the moral dilemmas and pragmatic incentives surrounding disclosure of HIV status in contemporary Uganda. Our findings are based on 12 ...

  8. HIV status disclosure among HIV-positive African and Afro-Caribbean people in the Netherlands

    Stutterheim, S.E.; Shiripinda, I.; Bos, A.E.R.; Pryor, J.B.; Bruin, de M.

    2011-01-01

    The disclosure of HIV status presents a dilemma; it can promote health, social support, and psychological well-being but it can also lead to negative social consequences such as stigmatisation and rejection. To understand disclosure it is necessary to understand the reasoning employed by people

  9. Self-disclosure of HIV status, disclosure counseling, and retention in HIV care in Cameroon.

    Breger, Tiffany L; Newman, Jamie E; Mfangam Molu, Brigitte; Akam, Wilfred; Balimba, Ashu; Atibu, Joseph; Kiumbu, Modeste; Azinyue, Innocent; Hemingway-Foday, Jennifer; Pence, Brian W

    2017-07-01

    Poor retention in care is common among HIV-positive adults in sub-Saharan Africa settings and remains a key barrier to HIV management. We quantify the associations of disclosure of HIV status and referral to disclosure counseling with successful retention in care using data from three Cameroon clinics participating in the Phase 1 International epidemiologic Databases to Evaluate AIDS Central Africa cohort. Of 1646 patients newly initiating antiretroviral therapy between January 2008 and January 2011, 43% were retained in care following treatment initiation. Self-disclosure of HIV status to at least one person prior to treatment initiation was associated with a minimal increase in the likelihood of being retained in care (risk ratio [RR] = 1.14; 95% confidence interval (CI): 0.94, 1.38). However, referral to disclosure counseling was associated with a moderate increase in retention (RR = 1.37; 95% CI: 1.21, 1.55) and was not significantly modified by prior disclosure status (p = .3). Our results suggest that while self-disclosure may not significantly improve retention among patients receiving care at these Cameroon sites, counseling services may play an important role regardless of prior disclosure status.

  10. Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana.

    Kenu, Ernest; Obo-Akwa, Adjoa; Nuamah, Gladys B; Brefo, Anita; Sam, Miriam; Lartey, Margaret

    2014-11-26

    In Ghana it is estimated that 1.2% of HIV infections occur in young people aged 15-24 but the representation in our clinics is small. Adherence to treatment, appointment keeping and knowledge of HIV status remains a challenge. Disclosure has been shown to result in better adherence to therapy, good clinical outcomes, psychological adjustment and reduction in the risk of HIV transmission when the young person becomes sexually active. A baseline study was conducted to ascertain if adolescents and young adults knew their HIV status and their knowledge on HIV. Informed consent and assent were obtained from willing participants. Self-administered questionnaires on general knowledge of HIV, HIV treatment and disclosure were collected and analyzed. Thirty-four young persons participated in the study. The mean age was 16.9±SD 2.5 and 62% (21/32) were female. All of them were still in school. Eighty-five percent were aware that young people their age could fall sick, 91% had heard of HIV, 70% knew someone with HIV and 45% thought that adolescents were not at risk of HIV. On modes of HIV transmission, 66.7% knew HIV was transmitted through sex and 63.6% knew about mother to child transmission. Fifty three percent (18/34) knew their HIV status, 50% (17/34) were on antiretroviral and 35% (6/17) of them admitted to missing ARV doses. One person who said he was HIV negative and another who did not know his status were both on ARVs. Disclosure of HIV status to adolescents and young people is dependent on a complex mix of factors and most practitioners recommend an age and developmentally appropriate disclosure. Thus it is highly individualized. The knowledge and awareness of HIV was 91% compared to 97% of adults in the most recent Ghana Demographic and Health Survey however only about two thirds had acceptable in depth knowledge on HIV. Only half knew their HIV status which was not the best considering their ages. There is the need to strengthen education to young persons with

  11. Pregnancy loss and role of infant HIV status on perinatal mortality among HIV-infected women

    Kim Hae-Young

    2012-08-01

    Full Text Available Abstract Background HIV-infected women, particularly those with advanced disease, may have higher rates of pregnancy loss (miscarriage and stillbirth and neonatal mortality than uninfected women. Here we examine risk factors for these adverse pregnancy outcomes in a cohort of HIV-infected women in Zambia considering the impact of infant HIV status. Methods A total of 1229 HIV-infected pregnant women were enrolled (2001–2004 in Lusaka, Zambia and followed to pregnancy outcome. Live-born infants were tested for HIV by PCR at birth, 1 week and 5 weeks. Obstetric and neonatal data were collected after delivery and the rates of neonatal ( Results The ratio of miscarriage and stillbirth per 100 live-births were 3.1 and 2.6, respectively. Higher maternal plasma viral load (adjusted odds ratio [AOR] for each log10 increase in HIV RNA copies/ml = 1.90; 95% confidence interval [CI] 1.10–3.27 and being symptomatic were associated with an increased risk of stillbirth (AOR = 3.19; 95% CI 1.46–6.97, and decreasing maternal CD4 count by 100 cells/mm3 with an increased risk of miscarriage (OR = 1.25; 95% CI 1.02–1.54. The neonatal mortality rate was 4.3 per 100 increasing to 6.3 by 70 days. Intrauterine HIV infection was not associated with neonatal morality but became associated with mortality through 70 days (adjusted hazard ratio = 2.76; 95% CI 1.25–6.08. Low birth weight and cessation of breastfeeding were significant risk factors for both neonatal and early mortality independent of infant HIV infection. Conclusions More advanced maternal HIV disease was associated with adverse pregnancy outcomes. Excess neonatal mortality in HIV-infected women was not primarily explained by infant HIV infection but was strongly associated with low birth weight and prematurity. Intrauterine HIV infection contributed to mortality as early as 70 days of infant age. Interventions to improve pregnancy outcomes for HIV-infected women are needed to

  12. Status of ANC-linked HIV counseling and testing as an intervention ...

    Status of ANC-linked HIV counseling and testing as an intervention for PMTCT in public health facilities in Addis Ababa: quality of HIV counseling given to pregnant women for PMTCT. ... AJOL African Journals Online. HOW TO USE AJOL.

  13. Nutritional status of HIV-infected adults on antiretroviral therapy and ...

    2010-05-04

    May 4, 2010 ... infections. HIV infection, nutritional status and immune function are ... dominant aspect in this relationship is the effect of HIV infection on nutritional .... as part of the medical treatment of the patient, and training and monitoring ...

  14. Pattern and predictors of partner disclosure of HIV status among HIV positive pregnant women in Nnewi Nigeria.

    Udigwe, G O; Mbachu, I I; Oguaka, V; Onyegbule, O A; Udegbunam, O; Umeononihu, O S

    2013-01-01

    Sub-Saharan Africa has continued to bear the greatest burden of HIV/AIDS epidemic in the world. Partner disclosure of status may create opportunities for support or rejection. This study evaluated the pattern of partner disclosure of HIV positive women, their partners' reaction and factors that affect disclosure of HIV status to partners. This was a descriptive cross-sectional study conducted among pregnant women in Nnamdi Azikiwe University Teaching Hospital Nnewi An interviewer-administered questionnaire was used to obtain relevant information from the subjects. Data was analysed using SPSS version 20 software. One hundred and twenty six women participated in this study. The mean age of the women was 30.4 years +/- 5 while the mean parity was 2.6 +/- 1. All the patients had at least primary education with 63.5% having secondary education as the highest educational attainment. One hundred and sixteen (92.1%) were in monogamous marriage. One hundred and fourteen 90.5%) had disclosed their HIV status to their partners. Eighty-three (66.7%) of the women did this by self. Partners initial reaction was supportive in 84 (66.7%) of the women. Partner's subsequent reaction showed that 103 (81.2%) were supportive, 7 (5.6%) were indifferent while 4 (3.2%) were abusive and violent. The partner's HIV status showed that 54 (42.9) tested positive to HIV antibodies while 52 (41.3%) tested negative to HIV antibodies and 20 (15.9%) do not know partner's HIV status. There was strong correlation between disclosure of HIV status with monogamous marriage and duration of illness. The partners' reaction to HIV status of their female partners was largely supportive. Disclosure of HIV status should be encouraged in view of the needed support of the partner in management of these women.

  15. Active methamphetamine use is associated with transmitted drug resistance to non-nucleoside reverse transcriptase inhibitors in individuals with HIV infection of unknown duration.

    Cachay, Edward R; Moini, Niousha; Kosakovsky Pond, Sergei L; Pesano, Rick; Lie, Yolanda S; Aiem, Heidi; Butler, David M; Letendre, Scott; Mathews, Wm Christopher; Smith, Davey M

    2007-01-01

    Frequent methamphetamine use among recently HIV infected individuals is associated with transmitted drug resistance (TDR) to non-nucleoside reverse transcriptase inhibitors (NNRTI); however, the reversion time of TDR to drug susceptible HIV may exceed 3 years. We assessed whether recreational substance use is associated with detectable TDR among individuals newly diagnosed with HIV infection of unknown duration. Cross-sectional analysis. Subjects were enrolled at the University California, San Diego Early Intervention Program. Demographic, clinical and substance use data were collected using structured interviews. Genotypic resistance testing was performed using GeneSeq, Monogram Biosciences. We analyzed the association between substance use and TDR using bivariate analyses and the corresponding transmission networks using phylogenetic models. Between April 2004 and July 2006, 115 individuals with genotype data were enrolled. The prevalence of alcohol, marijuana and methamphetamine use were 98%, 71% and 64% respectively. Only active methamphetamine use in the 30 days prior to HIV diagnosis was independently associated with TDR to NNRTI (OR: 6.6; p=0.002). Despite not knowing the duration of their HIV infection, individuals reporting active methamphetamine use in the 30 days prior to HIV diagnosis are at an increased risk of having HIV strains that are resistant to NNRTI.

  16. Active Methamphetamine Use is Associated with Transmitted Drug Resis-tance to Non-Nucleoside Reverse Transcriptase Inhibitors in Individuals with HIV Infection of Unknown Duration

    Cachay, Edward R; Moini, Niousha; Kosakovsky Pond, Sergei L; Pesano, Rick; Lie, Yolanda S; Aiem, Heidi; Butler, David M; Letendre, Scott; Mathews, Wm. Christopher; Smith, Davey M

    2007-01-01

    Background: Frequent methamphetamine use among recently HIV infected individuals is associated with transmitted drug resistance (TDR) to non-nucleoside reverse transcriptase inhibitors (NNRTI); however, the reversion time of TDR to drug susceptible HIV may exceed 3 years. We assessed whether recreational substance use is associated with detectable TDR among individuals newly diagnosed with HIV infection of unknown duration. Design: Cross-sectional analysis. Methods: Subjects were enrolled at the University California, San Diego Early Intervention Program. Demographic, clinical and substance use data were collected using structured interviews. Genotypic resistance testing was performed using GeneSeq™, Monogram Biosciences. We analyzed the association between substance use and TDR using bivariate analyses and the corresponding transmission networks using phylogenetic models. Results: Between April 2004 and July 2006, 115 individuals with genotype data were enrolled. The prevalence of alcohol, marijuana and methamphetamine use were 98%, 71% and 64% respectively. Only active methamphetamine use in the 30 days prior to HIV diagnosis was independently associated with TDR to NNRTI (OR: 6.6; p=0.002). Conclusion: Despite not knowing the duration of their HIV infection, individuals reporting active methamphetamine use in the 30 days prior to HIV diagnosis are at an increased risk of having HIV strains that are resistant to NNRTI. PMID:18923691

  17. Anthropometry of fetal growth in rural Malawi in relation to maternal malaria and HIV status

    Kalanda, B.F.; Buuren, S. van; Verhoeff, F.H.; Brabin, B.J.

    2005-01-01

    Objective: To describe fetal growth centiles in relation to maternal malaria and HIV status, using cross sectional measurements at birth. Design: A cross sectional study of pregnant women and their babies. Data on maternal socioeconomic status and current pregnancy, including HIV status and newborn

  18. Status Disclosure among People Living With HIV/AIDS in Ilorin ...

    Background: HIV/AIDS is a disease that is characterised by discrimination and stigmatisation particularly in Africa. Objective: To determine rate of disclosure of HIV status among People Living with HIV/AIDS (PLWHA) in Ilorin, Nigeria. Methods: A semi-structured, interviewer administered questionnaire containing 40 items ...

  19. Patient characteristics and perceived health status of individuals with HIV and tuberculosis coinfection in Guangxi, China.

    Zhu, Yujia; Wu, Jizhou; Feng, Xue; Chen, Huanhuan; Lu, Huaxiang; Chen, Li; Luo, Liuhong; Rui, Chao

    2017-04-01

    To explore demographics, clinical and medication profiles, patients' social support, and perceived health status in HIV/TB coinfected patients in Guangxi, China.We performed a cross-sectional study in the HIV clinic of the Guigang City People's Hospital (N = 150). Health professionals conducted face-to-face interviews and collected data from patients' electronic medical records regarding patients' demographic, clinical, and medication information, as well as their social support and perceived health status. We classified all HIV/AIDS patients into HIV monoinfected and TB coinfected, at a ratio of 2:1.Compared with the HIV monoinfected, patients with HIV/TB coinfection were more likely to be older, male, less educated, unemployed, carrying health insurance, having advanced stage of HIV infection, longer history with HIV, and other opportunistic infections. Patients coinfected with TB were also more likely to hold a negative belief that their HIV treatment could prevent exacerbations, and reported significantly worse emotional/informational support, social interaction, and perceived health status. Better social support and better self-efficacy to the HIV treatment adherence was significantly associated with better perceived health status among patients with HIV and TB coinfection.Having HIV/TB coinfection was associated with poorer perceived general well-being and mental health, particularly in those undergoing TB therapy. Our findings suggest the need for mental health referrals and medication management for coinfected individuals, as well as further efforts and policies to improve coordinated care.

  20. The relationships between HIV stigma, emotional status, and emotional regulation among HIV-affected children in rural China.

    Wei, Wei; Li, Xiaoming; Harrison, Sayward; Zhao, Junfeng; Zhao, Guoxiang

    2016-03-01

    Children affected by HIV/AIDS have unique psychosocial needs that often go unaddressed in traditional treatment approaches. They are more likely than unaffected peers to encounter stigma, including overt discriminatory behaviors, as well as stereotyped attitudes. In addition, HIV-affected children are at risk for experiencing negative affect, including sadness and depression. Previous studies have identified a link between HIV stigma and the subsequent emotional status of children affected by HIV/AIDS. However, limited data are available regarding protective psychological factors that can mitigate the effects of HIV stigma and thus promote resiliency for this vulnerable population. Utilizing data from 790 children aged 6-17 years affected by parental HIV in rural central China this study aims to examine the association between HIV stigma, including both enacted and perceived stigma, and emotional status among HIV-affected children, as well as to evaluate the mediating effects of emotional regulation on the relationship between HIV stigma and emotional status. In addition, the moderating role of age is tested. Multiple regression was conducted to test the mediation model. We found that the experience of HIV stigma had a direct positive effect on negative emotions among children affected by HIV. Emotional regulation offers a level of protection, as it mediated the impact of HIV stigma on negative emotions. Moreover, age was found to moderate the relationship between perceived stigma and negative emotions. A significant interaction between perceived stigma and age suggested that negative emotions increase with age among those who perceived a higher level of stigmatization. Results suggest that children affected by HIV may benefit from interventions designed to enhance their capacity to regulate emotions and that health professionals should be aware of the link between stigma and negative emotion in childhood and adolescence and use the knowledge to inform their

  1. Role and interpretation of fluorodeoxyglucose-positron emission tomography/computed tomography in HIV-infected patients with fever of unknown origin: a prospective study.

    Martin, C; Castaigne, C; Tondeur, M; Flamen, P; De Wit, S

    2013-09-01

    The aim of the study was to evaluate prospectively the usefulness of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in investigation of fever of unknown origin (FUO) in HIV-positive patients and to determine whether HIV viraemia impacts on FDG-PET/CT performance. The FDG-PET/CT results of 20 HIV-infected patients with FUO were analysed and compared with the FDG-PET/CT results of 10 HIV-infected viraemic patients without FUO. The performance of FDG-PET/CT for identifying the aetiology of FUO was assessed. Final diagnosis for FUO was based on histopathology, microbiological assays, or clinical and imaging follow-up. FDG-PET/CT contributed to the diagnosis or exclusion of a focal aetiology of the febrile state in 80% of patients with FUO. The presence of increased FDG uptake in the central lymph node has 100% specificity for focal aetiology of fever, even in viraemic patients. The absence of hypermetabolic central lymph nodes in FUO patients has 100% negative predictive value for focal disease. Lymph node biopsy in central hypermetabolic areas allowed, in 100% of cases, identification of underlying disease in patients with FUO. Biopsy of peripheral lymph nodes should be performed in lymph nodes with maximum standardized uptake value (SUVmax) ≥ 6-8 (sensitivity 62.5%; specificity 75%) and avoided in lymph nodes with SUVmax = 0-4 (specificity 0%). High HIV viraemia does not prevent correct interpretation of FDG-PET/CT. As in HIV-negative patients, we confirm the usefulness of FDG-PET/CT in investigation of FUO in HIV-positive patients even if they are viraemic. © 2013 British HIV Association.

  2. Oropharynx HPV status and its relation to HIV infection

    Leonora Maciel de Souza Vianna

    2018-03-01

    Full Text Available Background The number of oropharyngeal lesions caused by HPV (Human papillomavirus has been increasing worldwide in the past years. In spite of the clinical relevance of HPV infection in the anogenital tract of HIV-positive patients, the relevance of oropharynx HPV infection in these patients is not clear. The aim of the present study was to detect HPV infection, and clinical and cytological changes in the oropharynx of HIV-positive patients. Methods Samples collected from the oropharynx of 100 HIV-positive patients were subjected to hybrid capture (HC, conventional and liquid-based cytology. Clinical data were also collected to investigate the relation with HPV status. Results High and low-risk types of HPV were present in 8% and 16.7% of the total sample. The mean ± sd (maximum-minimum of the relative ratio light unit (RLU/cutoff (CO was 2.94 ± 2.58 (1.09–7.87 and 1.61 ± 0.65 (1.07–2.8 for high- and low-risk-HPV, respectively. By cytology, dysplasia was not detected, but atypical squamous cells of undetermined significance (ASC-US were diagnosed in two samples. No clinical change, suggestive of dysplasia/cancer, was detected. Conclusion Our study was able to detect and characterize HPV infection by hybrid capture, which may represent a good tool for screening and follow-up of HPV in the studied population. The frequency and viral load of HPV were low. Neither clinical nor cytological changes suggestive of dysplasia/neoplasia were observed in oropharynx of HIV-positive patients.

  3. Diarrhea in children less than two years of age with known HIV status in Kisumu, Kenya

    van Eijk, A.M.; Brooks, J.T.; Adcock, P.M.; Garrett, V.; Eberhard, M.; Rosen, D.H.; Ayisi, J.G.; Ochieng, J.B.; Kumar, L.; Gentsch, J.R.; Nahlen, B.L.; Mintz, E.D.; Slutsker, L.

    2010-01-01

    Objective: To compare the frequency and etiology of diarrhea in children aged less than 2 years with known HIV status. Methods: This was a nested cohort study, whereby children were followed during monthly routine and unscheduled visits. The HIV status of children was determined with PCR. A stool

  4. Brief research report: sociodemographic factors associated with HIV status among African American women in Washington, DC

    Perkins EL

    2013-09-01

    Full Text Available Emory L Perkins,1 Dexter R Voisin,2 Kesslyn A Brade Stennis1 1Department of Social Work, Bowie State University, Bowie, MD, USA; 2School of Social Service Administration, University of Chicago, Chicago, IL, USA Introduction: African American women living in Washington, DC have one of the highest Human immunodeficiency virus (HIV incidence rates in the US. However, this population has been understudied, especially as it relates to factors associated with HIV status. Methods: This cross-sectional study examined sociodemographic factors that were associated with having a negative or positive HIV status among a sample of 115 African American women between the ages of 24 and 44 years. We assessed such factors as age, education, sexual orientation, household income, sources of income, number of children, length of residency tenure in Washington, DC, and level of HIV-prevention knowledge. Results: Among the overall sample, 53 women self-identified as HIV-positive and 62 as HIV-negative. Compared to their HIV-negative counterparts, women who reported being HIV-positive were less educated, had lower household income, and had longer residency tenure in Washington, DC. There were no differences in HIV knowledge between HIV-positive and -negative study participants. Conclusion: These findings may provide important directions for targeting specific subpopulations of African Americans for HIV-prevention/intervention programs. Keywords: HIV status, African American women, sociodemographic factors

  5. The effect of HIV status on clinical outcomes of surgical sepsis in ...

    Background. KwaZulu-Natal Province, South Africa (SA), has long been the epicentre of the HIV epidemic, but the impact of HIV co-infection on the clinical outcomes of emergency surgical patients with sepsis remains largely unknown. Objective. To review our experience with the management of patients with HIV ...

  6. HIV positivity but not HPV/p16 status is associated with higher recurrence rate in anal cancer.

    Meyer, Joshua E; Panico, Vinicius J A; Marconato, Heloisa M F; Sherr, David L; Christos, Paul; Pirog, Edyta C

    2013-12-01

    Human papillomavirus (HPV) is a pathogenic factor of squamous cell carcinoma in various mucosal locations, including anal carcinoma (ACA). It is also known that patients positive for HIV are at high risk of ACA. The goal of this study was to examine clinical outcome in ACA in relation to HPV/p16 positivity, histologic tumor differentiation, and HIV status. Patients with oropharyngeal cancers that are positive for HPV and show overexpression of p16 as well as having non-keratinizing/basaloid histology have been reported to have better outcomes following chemoradiation (CRT). However, such relationships in ACA remain unknown. Forty-two patients with SCC of the anus treated with CRT between 1997 and 2009 were identified. The tumors were subclassified as either non-keratinizing (including basaloid) or keratinizing categories. HPV testing was performed using SPF10-PCR, and all cases were immunostained for p16. There were 23 men and 19 women; 43% of men and 11% of women were HIV-positive (p = 0.04). Fifty-five percent of patients had local disease (stages I and II) and 41% were stages III and IV, with 4% stage unknown. All tumors were positive for high-oncogenic risk HPVs, and all were positive with p16 immunostain. Sixty-four percent of tumors were non-keratinizing/basaloid and 36 % were keratinizing. The keratinizing tumors were more common in HIV-positive patients (67%), whereas non-keratinizing/basaloid tumors were more common in HIV-negative patients (77%) (p = 0.008). Thirty-one percent of patients had recurrence of disease, including 50% HIV-positive patients and 23% HIV-negative patients (p = 0.09). There was no difference in the recurrence rate between non-keratinizing and keratinizing tumor subtypes (p = 0.80). The 24-month recurrence-free survival for the cohort was 66% (95% CI = 46%, 81%), with HIV-positive patients having worse recurrence-free survival compared to HIV-negative patients (HR = 2.85, 95% CI = 0.95, 8.53; p = 0

  7. Symptom Status Predicts Patient Outcomes in Persons with HIV and Comorbid Liver Disease

    Wendy A. Henderson

    2012-01-01

    Full Text Available Persons living with human immunodeficiency virus (HIV are living longer; therefore, they are more likely to suffer significant morbidity due to potentially treatable liver diseases. Clinical evidence suggests that the growing number of individuals living with HIV and liver disease may have a poorer health-related quality of life (HRQOL than persons living with HIV who do not have comorbid liver disease. Thus, this study examined the multiple components of HRQOL by testing Wilson and Cleary’s model in a sample of 532 individuals (305 persons with HIV and 227 persons living with HIV and liver disease using structural equation modeling. The model components include biological/physiological factors (HIV viral load, CD4 counts, symptom status (Beck Depression Inventory II and the Medical Outcomes Study HIV Health Survey (MOS-HIV mental function, functional status (missed appointments and MOS-HIV physical function, general health perceptions (perceived burden visual analogue scale and MOS-HIV health transition, and overall quality of life (QOL (Satisfaction with Life Scale and MOS-HIV overall QOL. The Wilson and Cleary model was found to be useful in linking clinical indicators to patient-related outcomes. The findings provide the foundation for development and future testing of targeted biobehavioral nursing interventions to improve HRQOL in persons living with HIV and liver disease.

  8. Sequential treatment of icotinib after first-line pemetrexed in advanced lung adenocarcinoma with unknown EGFR gene status.

    Zheng, Yulong; Fang, Weijia; Deng, Jing; Zhao, Peng; Xu, Nong; Zhou, Jianying

    2014-07-01

    In non-small cell lung cancer (NSCLC), the well-developed epidermal growth factor receptor (EGFR) is an important therapeutic target. EGFR activating gene mutations have been proved strongly predictive of response to EGFR-tyrosine kinase inhibitors (TKI) in NSCLC. However, both in daily clinical practice and clinical trials, patients with unknown EGFR gene status (UN-EGFR-GS) are very common. In this study, we assessed efficacy and tolerability of sequential treatment of first-line pemetrexed followed by icotinib in Chinese advanced lung adenocarcinoma with UN-EGFR-GS. We analyzed 38 patients with advanced lung adenocarcinoma with UN-EGFR-GS treated with first-line pemetrexed-based chemotherapy followed by icotinib as maintenance or second-line therapy. The response rates to pemetrexed and icotinib were 21.1% and 42.1%, respectively. The median overall survival was 27.0 months (95% CI, 19.7-34.2 months). The 12-month overall survival probability was 68.4%. The most common toxicities observed in icotinib phase were rashes, diarrheas, and elevated aminotransferase. Subgroup analysis indicated that the overall survival is correlated with response to icotinib. The sequence of first-line pemetrexed-based chemotherapy followed by icotinib treatment is a promising option for advanced lung adenocarcinoma with UN-EGFR-GS in China.

  9. Differential relationships between social adversity and depressive symptoms by HIV status and racial/ethnic identity.

    Williamson, Timothy J; Mahmood, Zanjbeel; Kuhn, Taylor P; Thames, April D

    2017-02-01

    Historically marginalized groups are likely to be exposed to social adversity, which predicts important mental health outcomes (e.g., depression). Despite the well-established relationship between adversity and poor health, few studies have examined how adversity differentially predicts mental health among people living with multiple, co-occurring marginalized identities or statuses. The current study fills this gap by examining whether relationships between social adversity and depressive symptoms differed between those living with or without a stigmatized disease (i.e., HIV) and/or marginalized racial/ethnic identity (i.e., African American). A community sample of men and women (N = 149) completed questionnaires assessing demographics and depressive symptoms. Additionally, a composite index of social adversity was derived from measures of perceived discrimination, socioeconomic status, financial restriction to receiving medical care, and perceived neighborhood characteristics. Multiple regression was used to test whether relationships between adversity and depressive symptoms differed as a function of HIV status and racial/ethnic identity. A significant 3-way interaction between social adversity, HIV status, and racial/ethnic identity indicated that there was a direct relationship between adversity and depressive symptoms for HIV-positive (HIV+) African Americans but not for HIV-negative (HIV-) African Americans, HIV+ Caucasians, or HIV- Caucasians. Further, HIV+ African Americans evidenced a significantly greater relationship between adversity and depressive symptoms compared with HIV- African Americans, but not compared with other groups. The findings suggest that HIV+ African Americans may be at risk for higher depressive symptoms amid adversity, highlighting the importance of evaluating intersectional identities/statuses in the context of mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Association between HIV status and Positive Prostate Biopsy in a Study of U.S. Veterans

    Wayland Hsiao

    2009-01-01

    Full Text Available HIV infection is associated with increased incidence of malignancies, such as lymphomas and testicular cancers. We reviewed the relationship between HIV infection and prostate cancer in a contemporary series of prostate biopsy patients. The study is a retrospective analysis of consecutive prostate biopsies performed at a VA Medical Center. The indications for performing a prostate biopsy included an abnormal digital rectal examination and/or an elevated PSA. Patients were categorized according to their HIV status, biopsy results, and various demographic and clinical characteristics. Univariate and multivariate analyses compared distributions of HIV status, and various clinical and demographic characteristics. The adjusted measures of association between HIV status and positive biopsy were expressed as odds ratios (ORs and corresponding 95% confidence intervals (CI. The likelihood of positive biopsy was significantly higher among 18 HIV-positive patients compared to patients with negative HIV tests (adjusted OR = 3.9; 95% CI: 1.3–11.5. In analyses restricted to prostate cancer patients, HIV-positive patients were not different from the remaining group with respect to their prostate cancer stage, PSA level, PSA velocity, PSA density, or Gleason grade. There is an association between HIV infection and prostate biopsy positive for carcinoma in a population referred for urologic workup. Further confirmation of this association by prospective studies may impact the current screening practices in HIV patients.

  11. Association between HIV status and Positive Prostate Biopsy in a Study of U.S. Veterans

    Hsiao, Wayland; Anastasia, Katrina; Hall, John; Goodman, Michael; Rimland, David; Ritenour, Chad W. M.; Issa, Muta M.

    2009-01-01

    HIV infection is associated with increased incidence of malignancies, such as lymphomas and testicular cancers. We reviewed the relationship between HIV infection and prostate cancer in a contemporary series of prostate biopsy patients. The study is a retrospective analysis of consecutive prostate biopsies performed at a VA Medical Center. The indications for performing a prostate biopsy included an abnormal digital rectal examination and/or an elevated PSA. Patients were categorized according to their HIV status, biopsy results, and various demographic and clinical characteristics. Univariate and multivariate analyses compared distributions of HIV status, and various clinical and demographic characteristics. The adjusted measures of association between HIV status and positive biopsy were expressed as odds ratios (ORs) and corresponding 95% confidence intervals (CI). The likelihood of positive biopsy was significantly higher among 18 HIV-positive patients compared to patients with negative HIV tests (adjusted OR = 3.9; 95% CI: 1.3–11.5). In analyses restricted to prostate cancer patients, HIV-positive patients were not different from the remaining group with respect to their prostate cancer stage, PSA level, PSA velocity, PSA density, or Gleason grade. There is an association between HIV infection and prostate biopsy positive for carcinoma in a population referred for urologic workup. Further confirmation of this association by prospective studies may impact the current screening practices in HIV patients. PMID:19219374

  12. Caregivers' Attitudes towards HIV Testing and Disclosure of HIV Status to At-Risk Children in Rural Uganda.

    Rick Lorenz

    Full Text Available Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For a majority (96% of respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Other common themes identified included the existence of stigma in the caregivers' communities and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65% children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7. General provision of HIV information typically began at the same age as disclosure, and as many as two thirds (64% of the caregivers sought advice from an HIV counsellor prior to disclosure. How a caregiver chose to prepare themselves and the child did not affect the caregiver's perception of whether the disclosure experience was beneficial or not. These findings suggest that the HIV disclosure experience in Mbarara and Isingiro districts differs from current guidelines, especially with respect to age of disclosure, how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child's level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained

  13. Contribution of intestinal barrier damage, microbial translocation and HIV-1 infection status to an inflammaging signature.

    Amanda K Steele

    Full Text Available Systemic inflammation is a characteristic of both HIV-1 infection and aging ("inflammaging". Intestinal epithelial barrier damage (IEBD and microbial translocation (MT contribute to HIV-associated inflammation, but their impact on inflammaging remains unclear.Plasma biomarkers for IEBD (iFABP, MT (LPS, sCD14, T-cell activation (sCD27, and inflammation (hsCRP, IL-6 were measured in 88 HIV-1 uninfected (HIV(neg and 83 treated, HIV-1-infected (HIV(pos adults from 20-100 years old.Age positively correlated with iFABP (r = 0.284, p = 0.008, sCD14 (r = 0.646, p = <0.0001 and LPS (r = 0.421, p = 0.0002 levels in HIV(neg but not HIV(pos subjects. Age also correlated with sCD27, hsCRP, and IL-6 levels regardless of HIV status. Middle-aged HIV(pos subjects had elevated plasma biomarker levels similar to or greater than those of elderly HIV(neg subjects with the exception of sCD14. Clustering analysis described an inflammaging phenotype (IP based on iFABP, sCD14, sCD27, and hsCRP levels in HIV(neg subjects over 60 years of age. The IP in HIV(neg subjects was used to develop a classification model that was applied to HIV(pos subjects to determine whether HIV(pos subjects under 60 years of age were IP+. HIV(pos IP+ subjects were similar in age to IP- subjects but had a greater risk of cardiovascular disease (CVD based on Framingham risk score (p =  0.01.We describe a novel IP that incorporates biomarkers of IEBD, MT, immune activation as well as inflammation. Application of this novel IP in HIV-infected subjects identified a group at higher risk of CVD.

  14. Computed Tomography-Assisted Thoracoscopic Surgery: A Novel, Innovative Approach in Patients With Deep Intrapulmonary Lesions of Unknown Malignant Status.

    Kostrzewa, Michael; Kara, Kerim; Rathmann, Nils; Tsagogiorgas, Charalambos; Henzler, Thomas; Schoenberg, Stefan O; Hohenberger, Peter; Diehl, Steffen J; Roessner, Eric D

    2017-06-01

    Minimally invasive resection of small, deep intrapulmonary lesions can be challenging due to the difficulty of localizing them during video-assisted thoracoscopic surgery (VATS). We report our preliminary results evaluating the feasibility of an image-guided, minimally invasive, 1-stop-shop approach for the resection of small, deep intrapulmonary lesions in a hybrid operating room (OR). Fifteen patients (5 men, 10 women; mean age, 63 years) with a total of 16 solitary, deep intrapulmonary nodules of unknown malignant status were identified for intraoperative wire marking. Patients were placed on the operating table for resection by VATS. A marking wire was placed within the lesion under 3D laser and fluoroscopic guidance using a cone beam computed tomography system. Then, wedge resection by VATS was performed in the same setting without repositioning the patient. Complete resection with adequate safety margins was confirmed for all lesions. Marking wire placement facilitated resection in 15 of 16 lesions. Eleven lesions proved to be malignant, either primary or secondary; 5 were benign. Mean lesion size was 7.7 mm; mean distance to the pleural surface was 15.1 mm (mean lesion depth-diameter ratio, 2.2). Mean procedural time for marking wire placement was 35 minutes; mean VATS duration was 36 minutes. Computed tomography-assisted thoracoscopic surgery is a new, safe, and effective procedure for minimally invasive resection of small, deeply localized intrapulmonary lesions. The benefits of computed tomography-assisted thoracoscopic surgery are 1. One-stop-shop procedure, 2. Lower risk for the patient (no patient relocation, no marking wire loss), and 3. No need to coordinate scheduling between the CT room and OR.

  15. Breaking Binaries? Biomedicine and Serostatus Borderlands among Couples with Mixed HIV Status.

    Persson, Asha; Newman, Christy E; Ellard, Jeanne

    2017-01-01

    With recent breakthroughs in HIV treatment and prevention, the meanings of HIV-positivity and HIV-negativity are changing at biomedical and community levels. We explore how binary constructions of HIV serostatus identities are giving way to something more complex that brings both welcome possibilities and potential concerns. We draw on research with couples with mixed HIV status to argue that, in the context of lived experiences, serostatus identities have always been more ambiguous than allowed for in HIV discourse. However, their supposed dichotomous quality seems even more dubious now in view of contemporary biomedical technologies. Invoking the anthropological concept of "borderlands," we consider how biomedicine is generating more diverse serostatus identities, widening the options for how to live with HIV, and eroding the stigmatizing serostatus binary that has haunted the epidemic. But we also ask whether this emerging borderland, and its "normalizing" tendencies, is concomitantly giving rise to new and troubling binaries.

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

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

    2015-01-01

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

  17. HIV / AIDS And The Socio – Economic Status Of Victims In Oyo State ...

    Owing to the ferocious spread of HIV / AIDS and the soaring cases of ill – halth and impending death associated with the epidemic in Nigeria, this study assesses the impact of HIV / AIDS on the socio – economic status. Specifically, it examines the effects of the epidemic on the level of imcome, level of productivity, marital ...

  18. Periodontal status and dental care in HIV seropositive patients

    Maria Sueli Marques Soares

    2009-12-01

    Full Text Available Objective: The aim of the study was to evaluate the correlation between CD4+ cell count and viral load with periodontal and dental status in HIV seropositive patient. Methods: Forty HIV seropositive patients were selected from the dental clinic of the Clementino Fraga Hospital in João Pessoa, Paraíba, Brazil. The Community Periodontal Index, Simplified Oral Hygiene Index and Decayed, Missing or Filled Teeth Index were determined. The values of CD4+ lymphocyte count and viral load were collected from the medical records. Descriptive analysis was made and Spearman’s correlation test was applied, with values of p<0.05 being significant. Results: HIV seropositive patients were aged 33 to 47 years (mean = 40 years, 26 were men and 14 women. The mean CD4+ lymphocyte count was 507.82±306.4 cells/mm3, with 41% being a high, 38.5% a medium and 20.5% a low level. Sixty-five percent of the patients had undetectable viral load, 12.5% had a high, 5% a low and 5% a medium viral load. Most patients (87.5% presented with periodontal disease, calculus was the most frequent condition (40%. The mean Decayed, Missing or Filled Tooth Index was 19.7±6.8, with prevalence of the missing component. There was significant statistical correlation between the CD4+ count and the periodontal condition, p=0.046. There was no significant correlation between the CD4+ count and the Decayed, Missing or Filled Teeth Index (p=0.469 and the Simplified Oral Hygiene Index (p=0.189 indexes, and between viral load and Decayed, Missing or Filled Teeth Index (p=0.452, the Simplified Oral Hygiene Index (p=0.158 and Community Periodontal Index (p=0.216. Conclusion: The periodontal condition was influenced to a greater by the CD4+ cell count than the viral load, while there was no correlation between the decayed condition and the CD4+ cell count or the viral load condition.

  19. Factors Associated with Non-disclosure of HIV Status in a Cohort of Childbearing HIV-Positive Women in Ukraine.

    Ahn, Jane V; Bailey, Heather; Malyuta, Ruslan; Volokha, Alla; Thorne, Claire

    2016-01-01

    Ukraine has one of the largest populations of persons living with HIV in Europe. Data on 2019 HIV-positive married or cohabiting women enrolled in a postnatal cohort from 2007 to 2012 were analysed to investigate prevalence and factors associated with self-reported non-disclosure of HIV status. Median age at enrolment was 27.5 years, with two-thirds diagnosed during their most recent pregnancy. Almost all had received antenatal antiretroviral therapy and 24 % were taking it currently. One-tenth (n = 198) had not disclosed their HIV status to their partner and 1 in 20 (n = 93) had disclosed to no-one. Factors associated with non-disclosure were: unmarried status (AOR 2.99 (95 % CI 1.51-5.92), younger age at leaving full-time education (AOR 0.41 (95 % CI 0.19-0.88) for ≥19 years vs ≤16 years) and lack of knowledge of partner's HIV status (AOR 2.01 (95 % CI 1.09-3.66). Further work is needed to support disclosure in some groups and to explore relationships between disclosure and psychological factors in this setting, including depression, lack of support and perception of stigma.

  20. Discrimination based on HIV/AIDS status: A comparative analysis of ...

    Discrimination based on HIV/AIDS status: A comparative analysis of the Nigerian court's decision in Festus Odaife & Ors v Attorney General of the Federation & Ors with other Commonwealth jurisdictions.

  1. Occurrence of pregnancies among HIV infected Indian women: Does knowledge about HIV status make a difference?

    Darak, S.; Hutter, I.; Kulkarni, S.; Kulkarni, V.; Janssen, F.

    2015-01-01

    This is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India , were analysed. Directly

  2. Occurence of pregnancies among HIV infected Indian women : Does knowledge about HIV status make a difference?

    Darak, Shrinivas; Hutter, Inge; Kulkarni, Sanjeevani; Kulkarni, Vinay; Janssen, Fanny

    2015-01-01

    This is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India (N = 560), were analysed.

  3. Occurrence of Pregnancies among HIV Infected Indian Women : Does Knowledge about HIV Status Make a Difference?

    S. Darak (Shrinivas); I. Hutter (Inge); S. Kulkarni (Sanjeevani); V. Kulkarni (Vinay); F. Janssen (Fanny)

    2015-01-01

    textabstractThis is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India (N = 560), were

  4. Postnatal Depression Symptoms are Associated with Increased Diarrhea among Infants of HIV-Positive Ghanaian Mothers

    Okronipa, Harriet E.T.; Marquis, Grace S.; Lartey, Anna; Brakohiapa, Lucy; Perez-Escamilla, Rafael; Mazur, Robert E.

    2012-01-01

    HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place young infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n=492) were recruited from 3 antenatal clinics; mothers and infants ...

  5. Relationship of HIV Reservoir Characteristics with Immune Status and Viral Rebound Kinetics in an HIV Therapeutic Vaccine Study

    Li, Jonathan Z.; Heisey, Andrea; Ahmed, Hayat; Wang, Hongying; Zheng, Lu; Carrington, Mary; Wrin, Terri; Schooley, Robert T.; Lederman, Michael M.; Kuritzkes, Daniel R.

    2014-01-01

    Objectives To evaluate the impact of therapeutic HIV vaccination on the HIV reservoir, and assess the relationship of the viral reservoir with HIV-specific immune status and viral rebound kinetics. Design Retrospective analysis of ACTG A5197, a randomized, placebo-controlled trial of a therapeutic rAd5 HIV-1 gag vaccine. Methods Participants received vaccine/placebo at weeks 0, 4, and 26 prior to a 16-week analytic treatment interruption (ATI) at week 38. Cell-associated HIV-1 RNA and DNA (CA-RNA and CA-DNA) and HIV-1 residual viremia (RV) were quantified at weeks 0, 8, and 38. HIV-specific CD4+/CD8+ activity were assessed by an intracellular cytokine staining assay. Results At study entry, CA-RNA and CA-DNA levels were correlated inversely with the numbers of HIV-specific CD4+ interferon-γ-producing cells (CA-RNA: r = −0.23, P=0.03 and CA-DNA: r = −0.28, P<0.01, N=93). Therapeutic HIV vaccination induced HIV-specific CD4+ activity, but did not significantly affect levels of CA-RNA or CA-DNA. Vaccine recipients with undetectable RV at week 8 had higher frequencies of HIV-specific CD4+ and CD8+ interferon-γ-producing cells (undetectable versus detectable RV: 277 versus 161 CD4+ cells/106 lymphocytes, P=0.03 and 1326 versus 669 CD8+ cells/106 lymphocytes, P=0.04). Pre-ATI CA-RNA and CA-DNA were associated with post-ATI plasma HIV set point (CA-RNA: r = 0.51, P<0.01 and CA-DNA: r = 0.47, P<0.01). Conclusions Vaccine-induced T-cell responses were associated with a modest transient effect on RV, but more potent immune responses and/or combination treatment with latency-reversing agents are needed to reduce the HIV reservoir. HIV reservoir measures may act as biomarkers of post-ATI viral rebound kinetics. PMID:25254301

  6. Relationship between socioeconomic status and HIV infection in a rural tertiary health center

    Ogunmola OJ

    2014-04-01

    Full Text Available Olarinde Jeffrey Ogunmola,1 Yusuf Olatunji Oladosu,2 Michael Adeyemi Olamoyegun31Cardiac Care Centre, Department of Internal Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria, 2Department of Internal Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria, 3Endocrinology, Diabetes and Metabolism Unit, Department of Internal Medicine, Ladoke-Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: There is a scarcity of data in rural health centers in Nigeria regarding the relationship between socioeconomic status (SES and HIV infection. We investigated this relationship using indicators of SES.Methods: An analytical case-control study was conducted in the HIV clinic of a rural tertiary health center. Data collection included demographic variables, educational attainment, employment status, monthly income, marital status, and religion. HIV was diagnosed by conventional methods. Data were analyzed with the SPSS version 16 software.Results: A total of 115 (48.5% HIV-negative subjects with a mean age of 35.49±7.63 years (range: 15–54 years, and 122 (51.5% HIV-positive subjects with a mean age of 36.35±8.31 years (range: 15–53 years were involved in the study. Participants consisted of 47 (40.9% men and 68 (59.1% women who were HIV negative. Those who were HIV positive consisted of 35 (28.7% men and 87 (71.3% women. Attainment of secondary school levels of education, and all categories of monthly income showed statistically significant relationships with HIV infection (P=0.018 and P<0.05, respectively after analysis using a logistic regression model. Employment status did not show any significant relationship with HIV infection.Conclusion: Our findings suggested that some indicators of SES are differently related to HIV infection. Prevalent HIV infections are now concentrated among those with low incomes. Urgent measures to improve HIV prevention among low income earners are

  7. HIV Status Disclosure Among People Living with HIV in the Era of Combination Antiretroviral Therapy (cART).

    Madi, Deepak; Gupta, Parul; Achappa, Basavaprabhu; Bhaskaran, Unnikrishnan; Ramapuram, John T; Rao, Satish; Mahalingam, Soundarya

    2015-08-01

    As patients with HIV live longer due to Combination Anti-Retroviral Therapy (cART) serostatus disclosure becomes an important issue. Disclosure can have both positive and negative outcomes. Disclosure of HIV status has been associated with better adherence to medication and reduction in levels of psychological distress. Stigma and disruption of family relationships are barriers for disclosure. Most studies regarding disclosure status have been conducted in West. There are many cultural differences in Indian society when compared to west. There is a dearth of research in the field of disclosure of HIV infection in India. To determine the prevalence of HIV status disclosure among people living with HIV (PLHIV) in South India. This descriptive cross-sectional study was done in the hospital attached to Kasturba Medical College (KMC), Mangalore, India from May-June 2013. PLHIV of age more than 18 years were included. During the study period 111 consecutive patients who consented for the study were enrolled. Data was collected using a pre-tested interviewer administered semi structured questionnaire. Data collected was analysed using SPSS Version 11.5 statistical software. Descriptive statistics were done and the results are presented as proportions and mean. The mean age of the study population was 44.86 ± 10.8 years. Majority of the study subjects were men 76 (68.4%). Out of 111 study subjects, 102 (91.9%) had disclosed their HIV status to at least one person while 9 (8.1%) had not disclosed their HIV status to anyone. Disclosure on doctor's advice was the main reason for 56 (54.9%) participants to disclose their HIV status. The main reason for non-disclosure was fear of shame in family. Disclosure rate was high in our study in the era of cART. Society must stop discriminating against PLHIV so that they can disclose their serostatus and gain access to care and treatment services without any fear of stigma. In our study the main reason for disclosure was doctor

  8. Child Mortality Levels and Trends by HIV Status in Blantyre, Malawi: 1989-2009

    Taha, Taha E.; Dadabhai, Sufia S.; Sun, Jin; Rahman, M. Hafizur; Kumwenda, Johnstone; Kumwenda, Newton

    2012-01-01

    Introduction Continuous evaluation of child survival is needed in sub-Saharan Africa where HIV prevalence among women of reproductive age continues to be high. We examined mortality levels and trends over a period of ~20 years among HIV-unexposed and exposed children in Blantyre, Malawi. Methods Data from five prospective cohort studies conducted at a single research site from 1989-2009 were analyzed. In these studies, children born to HIV-infected and uninfected mothers were enrolled at birth and followed longitudinally for at least two years. Information on socio-demographic, HIV infection status, survival and associated risk factors was collected in all studies. Mortality rates were estimated using birth-cohort analyses stratified by maternal and infant HIV status. Multivariate Cox regression models were used to determine risk factors associated with mortality. Results The analysis included 8,286 children. From 1989-1995, overall mortality rates (per 100 person-years) in these clinic-based cohorts remained comparable among HIV-uninfected children born to HIV-uninfected mothers (range 3.3-6.9) or to HIV-infected mothers (range 2.5-7.5). From 1989-2009, overall mortality remained high among all children born to HIV-infected mothers (range 6.3-19.3), and among children who themselves became infected (range 15.6-57.4, 1994-2009). Only lower birth weight was consistently and significantly (P<0.05) associated with higher child mortality. Conclusions HIV infection among mothers and children contributed to high levels of child mortality in the African setting in the pre-treatment era. In addition to services that prevent mother-to-child transmission of HIV, other programs are needed to improve child survival by lowering HIV-unrelated mortality through innovative interventions that strengthen health infrastructure. PMID:22692091

  9. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa

    Gómez-Olivé, Francesc X.; Rohr, Julia K.; Houle, Brian C.; Kabudula, Chodziwadziwa W.; Wagner, Ryan G.; Salomon, Joshua A.; Kahn, Kathleen; Berkman, Lisa F.; Tollman, Stephen M.; Bärnighausen, Till

    2017-01-01

    Objective: To identify the unmet needs for HIV prevention among older adults in rural South Africa. Methods: We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age–sex standardization. Results: HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age–sex standardization. Conclusions: Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa. PMID:27926667

  10. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa.

    Rosenberg, Molly S; Gómez-Olivé, Francesc X; Rohr, Julia K; Houle, Brian C; Kabudula, Chodziwadziwa W; Wagner, Ryan G; Salomon, Joshua A; Kahn, Kathleen; Berkman, Lisa F; Tollman, Stephen M; Bärnighausen, Till

    2017-01-01

    To identify the unmet needs for HIV prevention among older adults in rural South Africa. We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age-sex standardization. HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age-sex standardization. Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa.

  11. Soybean ( Glycine max ) complementation and the zinc status of HIV ...

    The HIV and AIDS pandemic continues to ravage families and communities throughout the world particularly Sub-Saharan Africa. The scourge is associated with malnutrition specifically underweight, stunting and wasting among school children most of whom are orphaned by HIV. Subsequently, inadequate food supply at ...

  12. Documentation Status as a Contextual Determinant of HIV Risk Among Young Transgender Latinas.

    Palazzolo, Sarah L; Yamanis, Thespina J; De Jesus, Maria; Maguire-Marshall, Molly; Barker, Suyanna L

    2016-04-01

    The purpose of this study was to explore the contextual factors that determine or mitigate vulnerability to HIV among Latina transgender women. Documentation status (legal authorization to live in the United States) has been cited by other studies as a barrier to recruitment or engagement in HIV-related care among immigrant Latinos, but not explored as a determinant of HIV risk for transgender immigrant Latinas. We collaborated with a community-based organization to explore these contextual, including social and structural, factors. In-depth interviews in Spanish captured life histories of eight 18- to 29-year-old transgender Latinas, who collectively self-identify as chicas trans. Codes were assigned deductively from the interview guide, and emerging themes were identified throughout data collection. Most participants migrated to the United States from Central America after experiencing discrimination and violence in their countries of origin. Participants emphasized documentation status as a critical factor in three areas related to social and structural determinants of HIV risk: gender identity expression, access to services, and relationship power dynamics. Chicas trans who gained legal asylum reported greater control over sexual relationships, improved access to services, and less risky employment. Documentation status emerged as a key HIV risk factor for this population. For undocumented transgender Latinas, legal asylum appears to be a promising HIV-related protective factor. Further research could assess whether legal assistance combined with wraparound support services affects HIV prevention for this population.

  13. Oral mucosal lesions and immune status in HIV-infected Indian children.

    Subramaniam, Priya; Kumar, Krishna

    2015-04-01

    Pediatric HIV is growing at an alarming rate in developing countries. Due to their compromised immune status, children infected with HIV are prone to a number of opportunistic infections. Oral manifestations are the first signs of the disease in many of them. To assess the oral mucosal status of Indian children with HIV, based on their CD4 cell counts. Two hundred and twenty one HIV infected children aged 6-18 years from various HIV centers, were divided into three groups, based on their CD4 cell counts; Group 1: ≥500, Group 2: 201-499 and Group 3: ≤200 cells. The children in each group were further considered as 'prior to antiretroviral treatment (ART)' and 'on ART'. Oral mucosal examination was done based on presumptive criteria given by Ramos-Gomez for diagnosis of oro-facial lesions commonly associated with HIV infection in children. Data obtained was subjected to statistical analysis. Angular cheilitis and pseudomembranous candidiasis were the frequently seen oral lesions. Children with CD4 cell count ≥500 had significantly fewer oral lesions each. A high percentage of HIV-infected children were affected with oral mucosal lesions. There was a significant association between immune status and frequency of oral lesions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Assessment of antioxidants status and superoxide dismutase activity in HIV-infected children

    Camila Pugliese

    2014-09-01

    Conclusion: HIV-infected children have an inadequate selenium and copper nutritional status, which could influence the progression to AIDS. An adequate micronutrient status could improve the clinical conditions in these patients and minimize free radical production and cellular oxidative stress.

  15. Circumcision status and incident herpes simplex virus type 2 infection, genital ulcer disease, and HIV infection

    Mehta, Supriya D.; Moses, Stephen; Parker, Corette B.; Agot, Kawango; Maclean, Ian; Bailey, Robert C.

    2013-01-01

    Objective We assessed the protective effect of medical male circumcision (MMC) against HIV, herpes simplex virus type 2 (HSV-2), and genital ulcer disease (GUD) incidence. Design Two thousand, seven hundred and eighty-seven men aged 18–24 years living in Kisumu, Kenya were randomly assigned to circumcision (n=1391) or delayed circumcision (n =1393) and assessed by HIV and HSV-2 testing and medical examinations during follow-ups at 1, 3, 6, 12, 18, and 24 months. Methods Cox regression estimated the risk ratio of each outcome (incident HIV, GUD, HSV-2) for circumcision status and multivariable models estimated HIV risk associated with HSV-2, GUD, and circumcision status as time-varying covariates. Results HIV incidence was 1.42 per 100 person-years. Circumcision was 62% protective against HIV [risk ratio =0.38; 95% confidence interval (CI) 0.22–0.67] and did not change when controlling for HSV-2 and GUD (risk ratio =0.39; 95% CI 0.23–0.69). GUD incidence was halved among circumcised men (risk ratio =0.52; 95% CI 0.37–0.73). HSV-2 incidence did not differ by circumcision status (risk ratio =0.94; 95% CI 0.70–1.25). In the multivariable model, HIV seroconversions were tripled (risk ratio =3.44; 95% CI 1.52–7.80) among men with incident HSV-2 and seven times greater (risk ratio =6.98; 95% CI 3.50–13.9) for men with GUD. Conclusion Contrary to findings from the South African and Ugandan trials, the protective effect of MMC against HIV was independent of GUD and HSV-2, and MMC had no effect on HSV-2 incidence. Determining the causes of GUD is necessary to reduce associated HIV risk and to understand how circumcision confers protection against GUD and HIV PMID:22382150

  16. Current status and bioanalytical challenges in the detection of unknown anabolic androgenic steroids in doping control analysis.

    Pozo, Oscar J; De Brabanter, Nik; Fabregat, Andreu; Segura, Jordi; Ventura, Rosa; Van Eenoo, Peter; Deventer, Koen

    2013-11-01

    Androgenic anabolic steroids (AAS) are prohibited in sports due to their anabolic effects. Doping control laboratories usually face the screening of AAS misuse by target methods based on MS detection. Although these methods allow for the sensitive and specific detection of targeted compounds and metabolites, the rest remain undetectable. This fact opens a door for cheaters, since different AAS can be synthesized in order to evade doping control tests. This situation was evidenced in 2003 with the discovery of the designer steroid tetrahydrogestrinone. One decade after this discovery, the detection of unknown AAS still remains one of the main analytical challenges in the doping control field. In this manuscript, the current situation in the detection of unknown AAS is reviewed. Although important steps have been made in order to minimize this analytical problem and different analytical strategies have been proposed, there are still some drawbacks related to each approach.

  17. Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia

    Burke, Sara E.; Dovidio, John F.; Levina, Olga S.; Uusküla, Anneli; Niccolai, Linda M.; Heimer, Robert

    2016-01-01

    Marked overlap between the HIV and injection drug use epidemics in St. Petersburg, Russia, puts many people in need of health services at risk for stigmatization based on both characteristics simultaneously. The current study examined the independent and interactive effects of internalized HIV and drug stigmas on health status and health service utilization among 383 people with HIV who inject drugs in St. Petersburg. Participants self-reported internalized HIV stigma, internalized drug stigma, health status (subjective rating and symptom count), health service utilization (HIV care and drug treatment), sociodemographic characteristics, and health/behavioral history. For both forms of internalized stigma, greater stigma was correlated with poorer health and lower likelihood of service utilization. HIV and drug stigmas interacted to predict symptom count, HIV care, and drug treatment such that individuals internalizing high levels of both stigmas were at elevated risk for experiencing poor health and less likely to access health services. PMID:26050155

  18. Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs' Strategies for Disclosing HIV Status.

    Catona, Danielle; Greene, Kathryn; Magsamen-Conrad, Kate

    2015-01-01

    People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

  19. DISCLOSURE OF HIV STATUS BY PERSONS LIVING WITH HIV/AIDS IN THEIR WORKPLACES AND POST DISCLOSURE CONSEQUENCES ON THE PATIENTS

    2016-11-01

    Full Text Available HIV is currently a chronic disease; an increasing number of people living with HIV (PLHIV are actively working. Disclosure of HIV status in the workplace is influenced by many factors. To explore experiences of PLHIV in their workplaces concerning disclosure and attendant consequences. A pre-tested, semi-structured, self-administered questionnaire that contained information on demography and social aspects of work was used to assess 327 PLWHIV attending ARV clinics in health institutions in Enugu, Nigeria. Out of 327 respondents, 161 (49.2% were females. The modal age range was 31-40 years. Most, (60.2% were married, 71.9% were government employees. Ten (3.1% were forced by employer to do HIV test while 18.0% changed their jobs because of their status. One hundred and eleven (33.9% disclosed their HIV status to management. Reasons for not disclosing include fear of being sacked (84.3%. Post and ndash; disclosure consequences include: dismissal, 18 (5.5% and change in work schedule, 112 (34.3%. Over 80% of respondents claimed that relationship with management and co-workers have been affected by disclosing their HIV status. Many PL HIV do not disclose their HIV status at workplace for fear of discrimination. Full implementation of HIV workplace policy should be enforced.

  20. Patient characteristics and perceived health status of individuals with HIV and tuberculosis coinfection in Guangxi, China

    Zhu, Yujia; Wu, Jizhou; Feng, Xue; Chen, Huanhuan; Lu, Huaxiang; Chen, Li; Luo, Liuhong; Rui, Chao

    2017-01-01

    Abstract To explore demographics, clinical and medication profiles, patients? social support, and perceived health status in HIV/TB coinfected patients in Guangxi, China. We performed a cross-sectional study in the HIV clinic of the Guigang City People's Hospital (N?=?150). Health professionals conducted face-to-face interviews and collected data from patients? electronic medical records regarding patients? demographic, clinical, and medication information, as well as their social support and...

  1. Health and functional status among older people with HIV/AIDS in Uganda

    Scholten Francien

    2011-11-01

    Full Text Available Abstract Background In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1 HIV infected and on antiretroviral therapy (ART for at least 1 year; 2 HIV infected and not yet eligible for ART; 3 older people who had lost a child due to HIV/AIDS; 4 older people who have an adult child with HIV/AIDS; 5 older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion The systematic exploration of health and well being among older people, using eight self-reported and

  2. Determinants of subjective health status of HIV positive mothers in NAUTH Nnewi.

    Nwabueze, S A; Adogu, P O U; Adinma, E D; Ifeadike, C O; Nnebue, C C; Ilika, A L; Ikechebelu, J I

    2012-01-01

    Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support groups and stigma-free HIV services by providers may have good impact on the quality of life of HIV-positive mothers. This study was aimed at assessing the determinants of subjective health status of HIV-positive mothers accessing prevention-of-mother-to-child-transmission (PMTCT) of HIV services in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. This is a descriptive study in which 288 consenting HIV positive mothers were selected using the systematic sampling technique. Data on demographics, life style, social support, contraceptive use and subjective feeling about current health status were collected from the subjects using a pre-tested, structured, interviewer-administered questionnaire. The mean age of the respondents was 30.46 +/- 4.86 years. Majority (89.2%) of them were married while 55.2% were traders. A significantly higher proportion of the mothers on highly active anti retroviral therapy (HAART) (70.8%) than non users (29.2%) described their current health status as 'excellent' (p<0.001). Also a significantly higher proportion of condom users (99%) than pill users (1%) described their health status as 'excellent' (p<0.02). The same significantly higher proportions of 'excellent' response were given by subjects who engage in social support activities (p<0.001), who practice good feeding (p<0.01) andpersonal hygiene (p<0.01). Access to family planning services and HAART, participation in support group activities and positive lifestyle practices tend to improve subjective health status and should be comprehensively encouraged among the HIV positive mothers.

  3. Sexual Identity and HIV Status Influence the Relationship Between Internalized Stigma and Psychological Distress in Black Gay and Bisexual Men

    Boone, Melissa R.; Cook, Stephanie H.; Wilson, Patrick A.

    2016-01-01

    Experiences of internalized homophobia and HIV stigma in young Black gay and bisexual men (GBM) may lead to psychological distress, but levels of distress may be dependent upon their sexual identity or HIV status. In this study, we set out to explore the associations between psychological distress, sexual identity, and HIV status in young Black GBM. Participants were 228 young Black GBM who reported on their psychological distress, their HIV status, and their sexual identity. Results indicated that internalized homophobia was significantly related to psychological distress for gay men, but not for bisexual men. HIV stigma was related to psychological stress for HIV-positive men, but not for HIV-negative men. Results indicate a need for more nuanced examinations of the role of identity in the health and well-being of men who have sex with men. PMID:27017893

  4. Sexual identity and HIV status influence the relationship between internalized stigma and psychological distress in black gay and bisexual men.

    Boone, Melissa R; Cook, Stephanie H; Wilson, Patrick A

    2016-01-01

    Experiences of internalized homophobia and HIV stigma in young Black gay and bisexual men (GBM) may lead to psychological distress, but levels of distress may be dependent upon their sexual identity or HIV status. In this study, we set out to explore the associations between psychological distress, sexual identity, and HIV status in young Black GBM. Participants were 228 young Black GBM who reported on their psychological distress, their HIV status, and their sexual identity. Results indicated that internalized homophobia was significantly related to psychological distress for gay men, but not for bisexual men. HIV stigma was related to psychological stress for HIV-positive men, but not for HIV-negative men. Results indicate a need for more nuanced examinations of the role of identity in the health and well-being of men who have sex with men.

  5. "Managing identities" and parental disclosure of HIV sero-status in Zimbabwe.

    Muparamoto, Nelson; Chiweshe, Manase Kudzai

    2015-01-01

    Drawing from a small sample of HIV infected respondents, this paper examines parents' perceptions on the decision to disclose or not to disclose their HIV sero-status to their children. It explores how parents control the information in the interactional ritual with their children. The paper uses Goffman's concept of dramaturgy to analyse how parents manage and control disclosure within a context where HIV and AIDS is associated with stigma. Disclosure is a strategic encounter in which the interactants (parents) manage to create a desired identity or spoil an identity. Qualitative research incorporating focus group discussions and in-depth interviews was used to examine the perceptions of parents who are HIV positive on disclosure of their status to their children. Such a methodological approach allows for a nuanced understanding of the context in which decision to disclose status happens. The study findings show that in a social context involving parents and children as actors there are complex expectations which affect parental disclosure of HIV sero-status to their children. The desire to manage an expected identity militated or enabled disclosure in a parental relationship.

  6. 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.

  7. HIV Infection Status as a Predictor of Hepatitis C Virus RNA Testing in Primary Care

    Yartel, Anthony K.; Morgan, Rebecca L.; Rein, David B.; Brown, Kimberly Ann; Kil, Natalie B.; Massoud, Omar I.; Fallon, Michael B.; Smith, Bryce D.

    2015-01-01

    Introduction Receipt of hepatitis C virus (HCV) RNA testing following a positive HCV antibody (anti-HCV+) test result to establish current infection is a quality indicator for HCV-related care. This study examines HIV infection status as a predictor of HCV RNA test receipt after an anti-HCV+ result in the primary care setting. Methods Electronic medical records of anti-HCV+ patients from a multisite retrospective study of patients aged ≥18 years who utilized one or more primary care outpatient services during 2005–2010 were analyzed in 2014. A multivariable logistic regression model examined the independent relationships between patient characteristics and receipt of HCV RNA testing. Results Among 1,115 anti-HCV+ patients, 133 (11.9%) were also HIV-positive. Of these, 77.4% (n=103) underwent HCV RNA testing to determine current infection status. By contrast, 66.7% (n=654/980) of anti-HCV+ patients who were HIV-negative received HCV RNA testing. Following multivariable adjustment, the odds of receiving HCV RNA testing were higher among anti-HCV+ patients who were also HIV-positive (AOR=1.9, 95% CI=1.2, 3.0), compared with their HIV-negative counterparts. Elevated alanine aminotransferase level was also associated with receipt of HCV RNA testing (AOR=1.9, 95% CI=1.4, 2.4). Black race was associated with decreased odds of receiving HCV RNA testing (AOR=0.7, 95% CI=0.5, 1.0). Conclusions HIV infection status is independently associated with the likelihood of receiving HCV RNA testing following an anti-HCV+ result. One quarter of anti-HCV+ patients who were also HIV-positive and one third of their HIV-negative counterparts, respectively, did not receive testing to establish active HCV infection, which is imperative for appropriate care and treatment. PMID:25896194

  8. Conflicts in Rights of Disclosure of HIV Status in South Western Nigeria: the Health Care Provider's Perspective.

    Olalekan, Adebimpe Wasiu

    2012-01-01

    Close interaction between clients and health care workers as regards disclosure, refusal of treatment and right to know status has been a subject of debate in legal and medical quarters. The objective of this study was to assess perceived rights of health care workers towards disclosure of HIV status in Lagos State in Southwestern Nigeria. This was a descriptive cross sectional study carried out among 260 health care workers using multistage sampling technique. Research instruments were semi structured self administered and pre tested questionnaires. Data was analyzed using the SPSS softwares. Mean age of respondents was 39.3(+3.7) years. One hundred and eight four (70.8%) of the health workers studied said that it is the right of health care workers to know the HIV status of clients before commencement of treatments, and 36 (13.8%) agreed that health care workers have the right to refuse to treat or carry out procedure on known HIV positive clients. Twenty (7.7%) said that HIV positive health care workers should not be allowed to handle clients clinically, 72 (27.7%) believed that it is the right of HIV positive clients to know the HIV status of health care workers before attending to them, 36 (13.8%) of respondents has ever disclosed their HIV status to clients before carrying out procedures on them. Fifty six (21.5%) of respondents were willing to show their result results to a HIV positive clients who insist on knowing his or her HIV status, 84 (32.3%) believed that clients has the right to refuse a known HIV positive health care workers to treat or carry out some procedures. There was no statistically significant association between readiness to disclose HIV status and believing that health care workers have the right to know the status of clients before given them treatment ({Prights of health care workers and clients would assist in provision of quality services to HIV positive clients.

  9. Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study.

    Walcott, Melonie M; Hatcher, Abigail M; Kwena, Zachary; Turan, Janet M

    2013-12-02

    Women's ability to safely disclose their HIV-positive status to male partners is essential for uptake and continued use of prevention of mother-to-child transmission (PMTCT) services. However, little is known about the acceptability of potential approaches for facilitating partner disclosure. To lay the groundwork for developing an intervention, we conducted formative qualitative research to elicit feedback on three approaches for safe HIV disclosure for pregnant women and male partners in rural Kenya. This qualitative acceptability research included in-depth interviews with HIV-infected pregnant women (n = 20) and male partners of HIV-infected women (n = 20) as well as two focus groups with service providers (n = 16). The participants were recruited at health care facilities in two communities in rural Nyanza Province, Kenya, during the period June to November 2011. Data were managed in NVivo 9 and analyzed using a framework approach, drawing on grounded theory. We found that facilitating HIV disclosure is acceptable in this context, but that individual participants have varying expectations depending on their personal situation. Many participants displayed a strong preference for couples HIV counseling and testing (CHCT) with mutual disclosure facilitated by a trained health worker. Home-based approaches and programs in which pregnant women are asked to bring their partners to the healthcare facility were equally favored. Participants felt that home-based CHCT would be acceptable for this rural setting, but special attention must be paid to how this service is introduced in the community, training of the health workers who will conduct the home visits, and confidentiality. Pregnant couples should be given different options for assistance with HIV disclosure. Home-based CHCT could serve as an acceptable method to assist women and men with safe disclosure of HIV status. These findings can inform the design and implementation of programs geared at promoting HIV

  10. The Impact of Married Individuals Learning HIV Status in Malawi: Divorce, Number of Sexual Partners, and Condom Use With Spouses.

    Fedor, Theresa M; Kohler, Hans-Peter; Behrman, Jere R

    2015-02-01

    This article assesses how married individuals' knowledge of HIV status gained through HIV testing and counseling (HTC) affects divorce, the number of sexual partners, and the use of condoms within marriage. This study improves upon previous studies on this topic because the randomized incentives affecting the propensity to be tested for HIV permit control for selective testing. Instrumental variable probit and linear models are estimated, using a randomized experiment administered as part of the Malawi Longitudinal Study of Families and Health (MLSFH). The results indicate that knowledge of HIV status (1) does not affect chances of divorce for either HIV-negative or HIV-positive respondents; (2) reduces the number of reported sexual partners among HIV-positive respondents; and (3) increases reported condom use with spouses for both HIV-negative and HIV-positive respondents. These results imply that individuals actively respond to information about their HIV status that they learn during HTC, invoking protective behavior against future risk of HIV/AIDS for themselves and their actual and potential sexual partners. Some limitations of this study are a small sample size for those who are HIV-positive and dependence on self-reported sexual behaviors.

  11. BCG protects against tuberculosis irrespective of HIV status

    Faurholt-Jepsen, Daniel; Range, Nyagosya; PrayGod, George

    2013-01-01

    While BCG vaccine protects against severe tuberculosis (TB) in children, its effect against adult TB is questionable. Furthermore, it is not known if HIV co-infection modifies the effect of BCG. Among 352 pairs of Tanzanian TB cases and matched controls, the BCG scar was associated with a reduced...

  12. The intersection of abandonment, HIV-positive status and residential ...

    Although anti-retroviral treatments have significantly reduced the incidence of mother-to-child transmission of HIV and AIDS, there remains, for the foreseeable future, a group of adolescents who have been perinatally infected. Noting the paucity of information regarding the impact of paediatric AIDS and its intersection with ...

  13. HIV-positive status among surgeons - an ethical dilemma | Szabo ...

    HIV/AIDS is a manageable disease with a reasonable expectation that affected individuals might be able to experience both reduced mortality and morbidity. Within the socio-political context of the illness there has been a very strong emphasis on human rights issues, especially in relation to discrimination, which has ...

  14. Determinants of subjective health status of HIV positive mothers in ...

    BACKGROUND: Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support ...

  15. Issues around childhood disclosure of HIV status - findings from a qualitative study in West Bengal, India.

    Das, A; Detels, R; Javanbakht, M; Panda, S

    2016-07-01

    Informing the children living with HIV (CLH) about their disease (disclosure) is important from the perspective of disease treatment and overall psychosocial development. There are no published studies that qualitatively explored HIV disclosure-related issues among CLH in India. Our aim was to provide insights into the perceptions of informal caregivers of CLH regarding childhood disclosure. Children were defined as those aged maturity or was of marriageable age. Disclosure of HIV status to children is an emotional issue, both for the caregiver and the child. Like most low-or middle-income countries, no standardized, age-appropriate disclosure guidelines exist in India. Our findings advocate adoption of a multi-faceted approach, including increased availability of social and familial support, for childhood HIV disclosure. © 2016 John Wiley & Sons Ltd.

  16. Employment status in persons with and without HIV infection in Denmark

    Legarth, Rebecca; Omland, Lars Haukali; Kronborg, Gitte

    2014-01-01

    .v.) drug abuse as a route of HIV infection or diagnosed with hepatitis C infection (n = 2799) and 22,369 individually matched persons from the background population. Study inclusion was 1 January 1996 or HIV diagnosis, which ever came last. METHODS: Data on employment status and disability pension were......OBJECTIVE: To estimate annual employment rates and disability retirement rates (DRRs) among HIV-infected individuals and population controls during the period 1996-2011. DESIGN: A population-based cohort study including all HIV-infected individuals born in Denmark and not reporting intravenous (i...... extracted from Danish national registries. Employment rate and DRR were estimated in each calendar year after study inclusion for the cohorts included before 1996 (pre-1996), 1996-1999 and 2000-2011. RESULTS: Employment rate in the year of study inclusion increased from 54.8% [95% confidence interval (CI...

  17. Differences in risk behaviors, care utilization, and comorbidities in homeless persons based on HIV status.

    Parker, R David; Dykema, Shana

    2014-01-01

    This cross-sectional pilot project measured differences by HIV status in chronic health conditions, primary care and emergency department use, and high-risk behaviors of homeless persons through self-report. Using selective random sampling, 244 individuals were recruited from a homeless shelter. The reported HIV prevalence was 6.56% (n = 16), with the odds of HIV higher in persons reporting crack cocaine use. HIV-infected persons were more likely to report a source of regular medical care and less likely to use the emergency department than uninfected persons. Validation of findings through exploration of HIV and health care access in homeless persons is needed to confirm that HIV-infected homeless persons are more likely to have primary care. Distinctions between primary care and specialty HIV care also need to be explored in this context. If findings are consistent, providers who care for the homeless could learn more effective ways to engage homeless patients. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  18. Is Socio-Economic Status a Determinant of HIV-Related Stigma Attitudes in Zimbabwe? Findings from Project Accept.

    Mateveke, Kudzanai; Singh, Basant; Chingono, Alfred; Sibanda, E; Machingura, Ian

    2016-08-17

    HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept , which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIV-related stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants' ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR)=1.73, Pstigma and discrimination programs to be effective, they should take into account the socio-economic context of target population.

  19. Anti-retroviral therapy-induced status epilepticus in "pseudo-HIV serodeconversion".

    Etgen, Thorleif; Eberl, Bernhard; Freudenberger, Thomas

    2010-01-01

    Diligence in the interpretation of results is essential as information gained from the psychiatric patient's history might often be restricted. Nonobservance of established guidelines may lead to a wrong diagnosis, induce a false therapy and result in life-threatening situations. Communication errors between hospitals and doctors and uncritical acceptance of prior diagnoses add substantially to this problem. We present a patient with alcohol-related dementia who received anti-retroviral therapy that promoted a non-convulsive status epilepticus. HIV serodeconversion was considered after our laboratory result yielded a HIV-negative status. Critical review of previous diagnostic investigations revealed several errors in the diagnosis of HIV infection leading to a "pseudo-serodeconversion." Finally, anti-retroviral therapy could be discontinued. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi.

    Conroy, Amy A; Wong, Lauren H

    2015-11-01

    The majority of research on human immunodeficiency virus (HIV) disclosure utilizes the perspective from a single individual, which cannot be substantiated in the absence of supporting data such as from a primary partner. The objectives of this study were to evaluate: (1) the extent to which self-reported HIV disclosure was confirmed by a primary partner; (2) individual and relationship-level predictors of self-reported versus confirmed disclosure; and (3) whether confirmed disclosure was a stronger predictor of correctly assessing a partner's HIV status compared to self-reported disclosure. As part of an 8-wave longitudinal study from 2009 to 2011 in southern Malawi, 366 individuals (183 couples) were interviewed about their primary relationship (wave 3), individually tested for HIV (wave 4), and then asked whether they disclosed to their primary partner (wave 5). While 93% of respondents reported that they disclosed, only 64% of respondents had confirmed reports from their partner. Having communicated with partner about HIV was positively associated with self-reported disclosure; this association remained significant but became more precise in the models for confirmed disclosure. Confirmed disclosure, but not self-report, was a significant predictor of correctly assessing a partner's HIV status. Being male, having lower perceived partner infidelity, having higher relationship unity, and testing HIV-negative were positively and significantly associated with correct assessment. Dyadic data from two partners provide an improved measure of disclosure as compared to a single individual's self-report and could be used to identify behavioral and biomedical opportunities to prevent HIV transmission within couples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Fracture risk by HIV infection status in perinatally HIV-exposed children.

    Siberry, George K; Li, Hong; Jacobson, Denise

    2012-03-01

    The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate ratio was 1.1 (95% CI 0.2, 5.5). There was no evidence of a substantially increased risk of fracture in HIV-infected compared to HEU children.

  2. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    Kiene, Susan M.; Fisher, William A.; Shuper, Paul A.; Cornman, Deborah H.; Christie, Sarah; MacDonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D.

    2014-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV transmission risk behavior were assessed in a sample of 1,388 South Africans infected with HIV and receiving ART in 16 clinics in KwaZulu-Natal, South Africa. Results confirmed the assumptions of the IMB model and demonstrated that HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV transmission risk behavior in this population. Subanalyses confirmed these relationships for HIV transmission risk behavior overall and for HIV transmission risk behavior with partners perceived to be HIV-negative or HIV-status unknown. A consistent pattern of gender differences showed that for men, HIV prevention information and HIV prevention motivation may have direct links with HIV preventive behavior, while for women, the effects of HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV preventive behavior. These IMB model-based findings suggest directions for HIV prevention interventions with South African men and women living with HIV and on ART as an important component of overall strategies to contain South Africa’s generalized HIV epidemic. PMID:23477576

  3. Case of disclosure of HIV status helps to clarify privacy law in Ontario.

    Lang, Renée

    2008-07-01

    A judge in the Ontario Superior Court of Justice has dismissed a breach of privacy suit on the basis that the plaintiff failed to prove that the disclosure of his HIV status had caused him harm. The judgment set out guidelines for how future claims of breach of privacy should be addressed.

  4. Caries status and opinions of people living with HIV/AIDS on oral ...

    Aim The aim of this study was to investigate the dental caries status and opinions of the People Living with HIV/AIDS (PLHA) on how they should be handled by oral health care providers. Design: A cross sectional study. Study subjects and Methods The study was carried out among PLHA in Dar es Salaam, Tanzania.

  5. Iron status and anaemia of chronic disease in HIV-infected African ...

    2009-03-11

    Mar 11, 2009 ... status, more specifically to investigate the nutritional health of ... Respondents fasted overnight, abstained from exercise and avoided ... Nutrition is an important factor in the course of HIV infection1 and is ... activity, body perception and attitude toward weight control, ..... Krause's food, nutrition & diet therapy.

  6. To disclose or not to disclose: The moral complexities of HIV status ...

    AIDS and the associated stigma make it difficult for people, either suffering or suspected to be suffering from the opportunistic infections related with HIV, to go for testing and when they do to accept and disclose their status and seek the ...

  7. Marital status and risk of HIV infection in slum settlements of Nairobi ...

    This study examined the association between marital status and risk of HIV infection in urban slums of Nairobi. Data were derived from a cross-sectional population-based survey nested in an ongoing Demographic Surveillance System in two urban slums in Nairobi. Descriptive statistics and multivariate logistic regression ...

  8. Differential relationships between social adversity and depressive symptoms by HIV-status and racial/ethnic identity

    Williamson, Timothy J.; Mahmood, Zanjbeel; Kuhn, Taylor P.; Thames, April D.

    2016-01-01

    Objective Historically marginalized groups are likely to be exposed to social adversity, which predicts important mental health outcomes (e.g., depression). Despite the well-established relationship between adversity and poor health, few studies have examined how adversity differentially predicts mental health among people living with multiple, co-occurring marginalized identities or statuses. The current study fills this gap by examining whether relationships between social adversity and depressive symptoms differed between those living with or without a stigmatized disease (i.e., HIV) and/or marginalized racial/ethnic identity (i.e., African American). Method A community sample of men and women (n = 149) completed questionnaires assessing demographics and depressive symptoms. Additionally, a composite index of social adversity was derived from measures of perceived discrimination, socioeconomic status, financial restriction to receiving medical care, and perceived neighborhood characteristics. Multiple regression was used to test whether relationships between adversity and depressive symptoms differed as a function of HIV-status and racial/ethnic identity. Results A significant three-way interaction between social adversity, HIV-status, and racial/ethnic identity indicated that there was a direct relationship between adversity and depressive symptoms for HIV-positive (HIV+) African Americans but not for HIV-negative (HIV-) African Americans, HIV+ Caucasians, or HIV- Caucasians. Further, HIV+ African Americans evidenced a significantly greater relationship between adversity and depressive symptoms, as compared to HIV- African Americans but not as compared to other groups. Conclusions The findings suggest that HIV+ African Americans may be at risk for higher depressive symptoms amidst adversity, highlighting the importance of evaluating intersectional identities/statuses in the context of mental health. PMID:27929330

  9. Clinical and immunological status of a newly diagnosed HIV positive population, in Marrakech, Morocco.

    Admou, B; Elharti, E; Oumzil, H; Addebbous, A; Amine, M; Zahlane, K; Soraa, N; Zougaghi, L; Haouach, K; Tassi, N; Aajly, L; Chabaa, L; El Aouad, R

    2010-12-01

    To evaluate the clinical and the immune status of newly HIV diagnosed patients, in Marrakech city and its neighboring area, in Morocco. We performed a retrospective study on 235 patients who have been previously confirmed for HIV infection, and underwent a CD4 T cells using flow cytometry (FacsCount, Becton Dickinson®). The mean age of patients was 34,3 ± 8,4 years (range: 14-55), with a male predominance (sex-ratio M/F=1.4). On basis of clinical data of the patients, 62% (n=146) of them were categorized as "category C", 18.4% (n=43) as "category B", and 19.6% (n=46) as "category A" according to CDC (Center for Disease Control) HIV classification. Among all of them, 60.4% (n=142) had less than 200 CD4T cells, 26% (n=61) had between 200 and 499 CD4T cells, and only 13.6% (n=32) showed a number of CD4T cells less or equal to 500/mm(3). The results of this study reflect a significant delay in the diagnosis of HIV infected patients. Therefore, this delay may compromise timely management of HIV infected individuals and enhances propagation of the epidemic in our country. These data confirm the need for intensifying prevention efforts among high-risk population. Moreover, continuing education in HIV/AIDS among healthcare providers should be reinforced.

  10. Parental HIV/AIDS status and death, and children's psychological wellbeing

    Doku Paul

    2009-11-01

    Full Text Available Abstract Background Ghana has an estimated one million orphans, 250,000 are due to AIDS parental deaths. This is the first study that examined the impact of parental HIV/AIDS status and death on the mental health of children in Ghana. Methods In a cross-sectional survey, 4 groups of 200 children (children whose parents died of AIDS, children whose parents died of causes other than AIDS, children living with parents infected with HIV/AIDS, and non-orphaned children whose parents are not known to be infected with HIV/AIDS aged between 10 and 19 were interviewed on their hyperactivity, emotional, conduct, and peer problems using the Strengths and Difficulties Questionnaire. Results Children whose parents died of AIDS showed very high levels of peer problems [F (3,196 = 7.34, p Conclusion Orphans and children living with parents infected with HIV/AIDS are at heightened risks for emotional and behavioural disorders and that efforts to address problems in children affected by HIV/AIDS must focus on both groups of children. Parallel to this, researchers should see these findings as generated hypotheses (rather than conclusions calling for further exploration of specific causal linkages between HIV/AIDS and children's mental health, using more rigorous research tools and designs.

  11. Understanding HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy: an information--motivation--behavioral skills model analysis.

    Kiene, Susan M; Fisher, William A; Shuper, Paul A; Cornman, Deborah H; Christie, Sarah; Macdonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D

    2013-08-01

    The current study applied the Information-Motivation-Behavioral Skills (IMB) model (Fisher & Fisher, 1992; Fisher & Fisher, 1993) to identify factors associated with human immunodeficiency virus (HIV) transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa's generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV transmission risk behavior were assessed in a sample of 1,388 South Africans infected with HIV and receiving ART in 16 clinics in KwaZulu-Natal, South Africa. Findings confirmed the assumptions of the IMB model and demonstrated that HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV transmission risk behavior in this population. Subanalyses confirmed these relationships for HIV transmission risk behavior overall and for HIV transmission risk behavior with partners perceived to be HIV-negative or HIV-status unknown. A consistent pattern of gender differences showed that for men, HIV prevention information and HIV prevention motivation may have direct links with HIV preventive behavior, whereas for women, the effect of HIV prevention motivation works through HIV prevention behavioral skills to affect HIV preventive behavior. These IMB model-based findings suggest directions for HIV prevention interventions with South African men and women living with HIV and on ART as an important component of overall strategies to contain South Africa's generalized HIV epidemic. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  12. Where are we heading with HIV / AIDS in sub-Saharan Africa? The status and trends of HIV / AIDS / STD epidemics.

    Kerkhoven, R

    1998-02-01

    By the end of 1997, an estimated 20.8 million people in sub-Saharan Africa were infected with HIV, 68% of all HIV infections. At the Tenth Annual International Conference on STDs and AIDS in Africa held in Abidjan in 1997, the MAP network continued its series of pre-conference symposia on the shape and status of HIV/AIDS in the various continents. The outcome of the Abidjan symposium was then published in a provisional report made available to the main conference's participants. The main conclusions of the symposium with regard to the following areas and subjects are presented: West Africa, Central Africa, the Horn of Africa, Eastern Africa, Southern Africa, life expectancy, HIV/AIDS and STDs, data, determinants of the spread of HIV, the relative importance of determinants, poverty, understanding determinants, the national response, children and the spread of HIV, and the future.

  13. Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men

    Wagner, Glenn J.; Bogart, Laura M.; Klein, David J.; Green, Harold D.; Mutchler, Matt G.; McDavitt, Bryce; Hilliard, Charles

    2015-01-01

    We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assess...

  14. Zinc status in HIV infected Ugandan children aged 1-5 years: a cross sectional baseline survey

    Ndeezi, Grace; Tumwine, James K.; Bolann, Bjørn J.; Ndugwa, Christopher M.; Tylleskär, Thorkild

    2010-01-01

    Abstract Background Low concentrations of serum zinc have been reported in HIV infected adults and are associated with disease progression and an increased risk of death. Few studies have been conducted in HIV infected children in Africa. We determined serum zinc levels and factors associated with zinc deficiency in HIV infected Ugandan children. Methods We measured the baseline zinc status of 247 children aged 1-5 years enrolled in a randomised trial for multiple micronutrient supplementatio...

  15. Psychological and social correlates of HIV status disclosure: the significance of stigma visibility.

    Stutterheim, Sarah E; Bos, Arjan E R; Pryor, John B; Brands, Ronald; Liebregts, Maartje; Schaalma, Herman P

    2011-08-01

    HIV-related stigma, psychological distress, self-esteem, and social support were investigated in a sample comprising people who have concealed their HIV status to all but a selected few (limited disclosers), people who could conceal but chose to be open (full disclosers), and people who had visible symptoms that made concealing difficult (visibly stigmatized). The visibly stigmatized and full disclosers reported significantly more stigma experiences than limited disclosers, but only the visibly stigmatized reported more psychological distress, lower self-esteem, and less social support than limited disclosers. This suggests that having a visible stigma is more detrimental than having a concealable stigma. Differences in psychological distress and self-esteem between the visibly stigmatized and full disclosers were mediated by social support while differences between the visibly stigmatized and limited disclosers were mediated by both social support and stigma. These findings suggest that social support buffers psychological distress in people with HIV.

  16. Controlling the HIV/AIDS epidemic: current status and global challenges

    Thorsten eDemberg

    2012-08-01

    Full Text Available This review provides an overview of the current status of the global HIV pandemic and strategies to bring it under control. It updates numerous preventive approaches including behavioral interventions, male circumcision, pre- and post-exposure prophylaxis, vaccines, and microbicides. The manuscript summarizes current anti-retroviral treatment options, their impact in the western world, and difficulties faced by emerging and resource-limited nations in providing and maintaining appropriate treatment regimens. Current clinical and pre-clinical approaches towards a cure for HIV are described, including new drug compounds that target viral reservoirs and gene therapy approaches aimed at altering susceptibility to HIV infection. Recent progress in vaccine development is summarized, including novel approaches and new discoveries.

  17. Comparative characteristics of tuberculous pleurisy depending on HIV status

    E. V. Korzh

    2016-01-01

    Full Text Available Goal of the study: to study specific manifestations of tuberculous pleurisy in HIV patients, to evaluate the efficiency of video-assisted thoracoscopy when diagnosing tuberculous pleurisy in case of different HIV status of the patients.Materials and methods: 241 tuberculous pleurisy patients were examined. 88 – HIV positive (group 1, 153 – HIV negative (group 2. Average CD4 count in group 1 made 189 cells/mcl. The following parameters were compared in those groups: clinical and X-ray manifestations, microbiological, cytologic and biochemical rates in blood and effluent. 77 patients with isolated pleurisy (of them 33 HIV positive had video-assisted thoracoscopy with biopsy for diagnostic purposes. The data of histological examination of pleura, obtained through video-assisted thoracoscopy and autopsy have been presented.Results: tuberculous pleurisy with concurrent HIV infection is characterized by frequent occurrence of hemorrhagic effusion, scarce cellular sediment of effluent, expressed reduction of glucose level and increase of thymol test rates in effluent. Regardless of HIV status the frequency of tuberculous mycobacteria detection through microscopy and culture is low and does not exceed 10%. Histological testing of specimens obtained through video-assisted thoracoscopy allowed proving tuberculosis in all patients thus differentiating tuberculous changes from metastases. Thus video-assisted thoracoscopy can be recommended for diagnostics of difficult cases of tuberculous pleurisy regardless of HIV status.From morphological point of view tuberculous pleurisy was characterized by specific granulomas which were presented by lymphoid and epithelioid cells with Pirogov-Langhans cells with minor caseous necrosis in the center (9.1% or its complete absence (90.9%. 

  18. Dual Testing Algorithm of BED-CEIA and AxSYM Avidity Index Assays Performs Best in Identifying Recent HIV Infection in a Sample of Rwandan Sex Workers

    Braunstein, Sarah L.; Nash, Denis; Kim, Andrea A.; Ford, Ken; Mwambarangwe, Lambert; Ingabire, Chantal M.; Vyankandondera, Joseph; van de Wijgert, Janneke H. H. M.

    2011-01-01

    To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda. Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to

  19. At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

    Lewis, Ione R.

    2012-01-01

    Child sexual abuse in Papua New Guinea is a human rights issue as well as an indicator of HIV risk in women. This study aimed to develop knowledge about the link between violence experienced by women and their HIV status. The study used a mixed method approach to collect quantitative and qualitative data through structured interviews with a sample…

  20. Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study

    2013-01-01

    Background Women’s ability to safely disclose their HIV-positive status to male partners is essential for uptake and continued use of prevention of mother-to-child transmission (PMTCT) services. However, little is known about the acceptability of potential approaches for facilitating partner disclosure. To lay the groundwork for developing an intervention, we conducted formative qualitative research to elicit feedback on three approaches for safe HIV disclosure for pregnant women and male partners in rural Kenya. Methods This qualitative acceptability research included in-depth interviews with HIV-infected pregnant women (n = 20) and male partners of HIV-infected women (n = 20) as well as two focus groups with service providers (n = 16). The participants were recruited at health care facilities in two communities in rural Nyanza Province, Kenya, during the period June to November 2011. Data were managed in NVivo 9 and analyzed using a framework approach, drawing on grounded theory. Results We found that facilitating HIV disclosure is acceptable in this context, but that individual participants have varying expectations depending on their personal situation. Many participants displayed a strong preference for couples HIV counseling and testing (CHCT) with mutual disclosure facilitated by a trained health worker. Home-based approaches and programs in which pregnant women are asked to bring their partners to the healthcare facility were equally favored. Participants felt that home-based CHCT would be acceptable for this rural setting, but special attention must be paid to how this service is introduced in the community, training of the health workers who will conduct the home visits, and confidentiality. Conclusion Pregnant couples should be given different options for assistance with HIV disclosure. Home-based CHCT could serve as an acceptable method to assist women and men with safe disclosure of HIV status. These findings can inform the design and

  1. Differences in Gay Male Couples' Use of Drugs and Alcohol With Sex by Relationship HIV Status.

    Mitchell, Jason W

    2016-07-01

    Prior studies with men who have sex with men have documented a strong association between substance use with sex and risk for acquisition of HIV. However, few studies have been conducted about gay male couples' use of substances with sex, despite the fact that between one third and two thirds of men who have sex with men acquire HIV from their relationship partners. The present study sought to (1) describe whether one or both partners in the male couple uses substances with sex-by substance type-within and/or outside of their relationship, and (2) assess whether differences exist in those who use substances with sex within and outside the relationship by the couples' HIV status. Dyadic data for this analysis were collected in the United States from a nation-wide cross-sectional Internet study about male couples' relationships and behaviors. Couple-level descriptive and comparative analyses were employed with 361 male couples. Except for alcohol, most couples did not use substances with sex. Of those who did, rates of who used it with sex and substance type within the relationship varied; most couples only had one partner who used substances with sex outside the relationship. Significantly higher proportions of concordantly HIV-negative and HIV-positive couples had both partners who used substances (all types) with sex within their relationship over discordant couples. Most couples had one partner who used outside the relationship; only marijuana and erectile dysfunction medication use with sex significantly differed by couples' HIV status. Findings indicate the need to conduct additional research for prevention development. © The Author(s) 2014.

  2. Bacteria isolated from the airways of paediatric patients with bronchiectasis according to HIV status

    Charl Verwey

    2017-05-01

    Full Text Available Background. Knowledge of which bacteria are found in the airways of paediatric patients with bronchiectasis unrelated to cystic fibrosis (CF is important in defining empirical antibiotic guidelines for the treatment of acute infective exacerbations. Objective. To describe the bacteria isolated from the airways of children with non-CF bronchiectasis according to their HIV status. Methods. Records of children with non-CF bronchiectasis who attended the paediatric pulmonology clinic at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, from April 2011 to March 2013, or were admitted to the hospital during that period, were reviewed. Data collected included patient demographics, HIV status, and characteristics of the airway samples and types of bacteria isolated. Results. There were 66 patients with non-CF bronchiectasis over the 2-year study period. The median age was 9.1 years (interquartile range 7.2 - 12.1. The majority of patients (78.8% were HIV-infected. A total of 134 samples was collected (median 1.5 per patient, range 1 - 7, of which 81.3% were expectorated or induced sputum samples. Most bacteria were Gram negatives (72.1%. Haemophilus influenzae was the most common bacterium identified (36.0%, followed by Streptococcus pneumoniae (12.6%, Moraxella catarrhalis (11.1% and Staphylococcus aureus (10.6%. There were no differences between HIV-infected and uninfected patients in prevalence or type of pathogens isolated. Conclusion. Bacterial isolates from the airways of children with non-CF bronchiectasis were similar to those in other paediatric populations and were not affected by HIV status.

  3. HIV status: the prima facie right not to know the result.

    Chan, Tak Kwong

    2016-02-01

    When a patient regains consciousness from Cryptococcus meningitis, the clinician may offer an HIV test (in case it has not already been done) (scenario 1) or offer to tell the patient his HIV status (in case the test has already been performed with a positive result while the patient was unconscious) (scenario 2). Youngs and Simmonds proposed that the patient has the prima facie right to refuse an HIV test in scenario 1 but not the prima facie right not to be told the HIV status in scenario 2. I submit that the claims to the right of refusal in both scenarios are similarly strong as they should both be grounded in privacy, self determination or dignity. But a conscientious agent should bear in mind that members of the public also have the right not to be harmed. When the circumstance allows, a proper balance of the potential benefits and harm for all the competing parties should guide the clinical decision as to whose right should finally prevail. Where a full ethical analysis is not possible, the presumption should favour respecting the patient's right of refusal in both scenarios. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. The relationship between ART adherence and smoking status among HIV+ individuals.

    Moreno, Jose L; Catley, Delwyn; Lee, Hyoung S; Goggin, Kathy

    2015-04-01

    Smoking is highly prevalent among HIV+ individuals and studies indicate that it may be associated with poor ART adherence, though the relationship is poorly understood. In addition little is known about interest in quitting among HIV+ smokers who are having adherence difficulties. We examined smoking and ART adherence among 203 HIV+ individuals enrolled in a randomized trial of interventions to increase ART adherence. Prior analyses indicated there were no overall treatment group effects. Smoking status and motivation to quit was assessed at baseline and ART adherence was assessed at week 12, 24, 36, and 48. Longitudinal generalized estimating equation analysis that controlled for treatment group revealed that smoking status was not significantly related to adherence over time. Motivation to quit was high with 58 % intending to quit in the next 6 months and 25 % intending to quit in the next 30 days. Findings suggest that smoking is not associated with adherence among those with adherence difficulties. However it does not diminish importance of addressing both behaviors especially given HIV+ smokers substantial interest in changing smoking behavior.

  5. Perceptions and Experiences about Self-Disclosure of HIV Status among Adolescents with Perinatal Acquired HIV in Poor-Resourced Communities in South Africa.

    Madiba, Sphiwe; Mokgatle, Mathildah

    2016-01-01

    Background. There is limited research on the disclosure experiences of adolescents with perinatal acquired HIV (PAH). The study explores how adolescents with PAH experience living with HIV and examined their perceptions and experiences regarding disclosure and onward self-disclosure to friends and sexual partners. Methods. Thematic analysis was used to analyze in-depth interviews conducted with 37 adolescents. Findings. Adolescents received disclosure about their status at mean age of 12 years. They perceived disclosure as necessary and appreciated the truthful communication they received. Adolescents have learned to accept and live with HIV, and they desired to be healthy and normal like other people. After receiving disclosure, they found their treatment meaningful, and they adhered to medication. However, they also expressed a strong message that their HIV status was truly their secret and that self-disclosure to others will take the feeling of being normal away from them because they will be treated differently. Conclusion. Adolescents maintained secrecy in order to be accepted by their peers but also to protect themselves from stigma and isolation. Given that adolescents want to be informed of their HIV status but desire controlling self-disclosure of their HIV status, these should form the basis for development of disclosure interventions.

  6. Perceptions and Experiences about Self-Disclosure of HIV Status among Adolescents with Perinatal Acquired HIV in Poor-Resourced Communities in South Africa

    Sphiwe Madiba

    2016-01-01

    Full Text Available Background. There is limited research on the disclosure experiences of adolescents with perinatal acquired HIV (PAH. The study explores how adolescents with PAH experience living with HIV and examined their perceptions and experiences regarding disclosure and onward self-disclosure to friends and sexual partners. Methods. Thematic analysis was used to analyze in-depth interviews conducted with 37 adolescents. Findings. Adolescents received disclosure about their status at mean age of 12 years. They perceived disclosure as necessary and appreciated the truthful communication they received. Adolescents have learned to accept and live with HIV, and they desired to be healthy and normal like other people. After receiving disclosure, they found their treatment meaningful, and they adhered to medication. However, they also expressed a strong message that their HIV status was truly their secret and that self-disclosure to others will take the feeling of being normal away from them because they will be treated differently. Conclusion. Adolescents maintained secrecy in order to be accepted by their peers but also to protect themselves from stigma and isolation. Given that adolescents want to be informed of their HIV status but desire controlling self-disclosure of their HIV status, these should form the basis for development of disclosure interventions.

  7. Disparities in lymphoma on the basis of race, gender, HIV status, and sexual orientation.

    Becnel, Melody; Flowers, Christopher R; Nastoupil, Loretta J

    2017-11-01

    Lymphoid malignancies account for the sixth leading cause of death in the US, and, although survival is improving overall, this trend is not applicable to all patients. In this review, we describe disparities in the initial presentation, treatment, and outcomes across a diverse group of lymphoma patients on the basis of gender, race, HIV status, and sexual orientation. Identifying these disparities will hopefully lead to improved outcomes in these groups of lymphoma patients in the future.

  8. Missed opportunities for HIV control: Gaps in HIV testing for partners of people living with HIV in Lima, Peru.

    Ana L Vasquez

    Full Text Available Based on the hypothesis that HIV programs struggle to deliver health services that harmonize necessities of treatment and prevention, we described the outcomes of routinely provided HIV testing to partners of people living with HIV (PLWH through a secondary analysis of routine data collected at a public hospital in Lima, Peru.Among PLWH enrolled in the study center's HIV program between 2005 and 2014, we identified index cases (IC: PLWH who reported a unique partner not previously enrolled. We grouped partners according to their HIV status as reported by IC and collected data on HIV testing, clinical characteristics and admissions. The main outcome was the frequency of HIV testing among partners with reported unknown/seronegative HIV status.Out of 1586 PLWH who reported a unique partner at enrollment, 171 had a previously enrolled partner, leaving 1415 (89% IC. HIV status of the partner was reported as unknown in 571 (40%, seronegative in 325 (23% and seropositive in 519 (37%. Out of 896 partners in the unknown/seronegative group, 72 (8% had HIV testing, 42/72 (58% tested within three months of IC enrollment. Among the 49/72 (68% who tested positive for HIV, 33 (67% were enrolled in the HIV program. The proportion in WHO clinical stage IV was lower in enrolled partners compared to IC (37% vs 9%, p = 0.04. Non-tested partners (824 were likely reachable by the hospital, as 297/824 (36% of their IC were admitted in the study center at least once, 51/243 (21% female IC had received pregnancy care at the study center, and 401/692 (64% of IC on antiretroviral therapy had achieved viral suppression, implying frequent visits to the hospital for pill pick-up.In this setting, HIV testing of partners of PLWH was suboptimal, illustrating missed opportunities for HIV control. Integration of HIV strategies in primarily clinical-oriented services is a challenging need.

  9. Relationships between neighbourhood characteristics and current STI status among HIV-infected and HIV-uninfected women living in the Southern USA: a cross-sectional multilevel analysis.

    Haley, Danielle F; Kramer, Michael R; Adimora, Adaora A; Haardörfer, Regine; Wingood, Gina M; Ludema, Christina; Rubtsova, Anna; Hickson, DeMarc A; Ross, Zev; Golub, Elizabeth; Bolivar, Hector; Cooper, Hannah Lf

    2017-12-01

    Neighbourhood characteristics (eg, high poverty rates) are associated with STIs among HIV-uninfected women in the USA. However, no multilevel analyses investigating the associations between neighbourhood exposures and STIs have explored these relationships among women living with HIV infection. The objectives of this study were to: (1) examine relationships between neighbourhood characteristics and current STI status and (2) investigate whether the magnitudes and directions of these relationships varied by HIV status in a predominantly HIV-infected cohort of women living in the Southern USA. This cross-sectional multilevel analysis tests relationships between census tract characteristics and current STI status using data from 737 women enrolled at the Women's Interagency HIV Study's southern sites (530 HIV-infected and 207 HIV-uninfected women). Administrative data (eg, US Census) described the census tract-level social disorder (eg, violent crime rate) and social disadvantage (eg, alcohol outlet density) where women lived. Participant-level data were gathered via survey. Testing positive for a current STI was defined as a laboratory-confirmed diagnosis of chlamydia, gonorrhoea, trichomoniasis or syphilis. Hierarchical generalised linear models were used to determine relationships between tract-level characteristics and current STI status, and to test whether these relationships varied by HIV status. Eleven per cent of participants tested positive for at least one current STI. Greater tract-level social disorder (OR=1.34, 95% CI 0.99 to 1.87) and social disadvantage (OR=1.34, 95% CI 0.96 to 1.86) were associated with having a current STI. There was no evidence of additive or multiplicative interaction between tract-level characteristics and HIV status. Findings suggest that neighbourhood characteristics may be associated with current STIs among women living in the South, and that relationships do not vary by HIV status. Future research should establish the

  10. Ramifications of ostracism as a consequence of revelation of HIV positive status: its effect o individuals and families in Botswana

    Tabitha T. Langeni

    2003-12-01

    the structure and composition of the family in Botswana. The study showed that the highest proportion of respondents who would abandon an HIV positive partner (58.4% occurs among young people aged 15 to 19 years; and that the propensity to abandon an HIV positive partner diminishes with advancement in age. In-depth inquiries on why HIV positive partners would be abandoned produced responses that revolved around fear of exposure, vulnerability and association with an HIV positive individual. The study showed that the highest proportion of respondents who would not reveal their HIV positive status occurs among those who have lost a relative or a friend to AIDS. Fear of being isolated, rejected, stigmatized and unwanted featured among the top reasons why respondents would not reveal their HIV positive status. Society’s reaction towards HIV positive individuals and families with HIV/AIDS patients appeared strong enough to drive individuals to hide their positive status and to go ahead and take the risk of onward transmission of the virus.

  11. HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

    Ubesie, A C; Iloh, K K; Emodi, I J; Ibeziako, N S; Obumneme-Anyim, I N; Iloh, O N; Ayuk, A C; Anikene, C J; Enemuo, J E

    2016-12-01

    To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

  12. Has the employment status of people living with HIV changed since the early 2000s?

    Annequin, Margot; Lert, France; Spire, Bruno; Dray-Spira, Rosemary

    2015-07-31

    In a context marked by major changes in the field of HIV and in the general socioeconomic context, this study aimed at investigating changes in the employment situation of people living with HIV (PLWHIV) in France since the early 2000s. Repeated cross-sectional survey among two nationally representative samples of PLWHIV followed at hospital in France in 2003 (N = 2932) and 2011 (N = 3022). Differences between 2003 and 2011 in (1) rates of employment, unemployment, and inactivity and (2) rates of work cessation and access to work following HIV diagnosis were measured using two-step multivariate Poisson regression models adjusted for individual sociodemographic determinants of position on the labor market, and then additionally for health status characteristics. Overall, among working-age PLWHIV 60.9% in 2003 and 59.6% in 2011 were employed; 12.6 and 15.8%, respectively, were unemployed; and 26.5 and 24.6%, respectively, were inactive. Adjusting for sociodemographic determinants of position on the labor market, while employment rate was not different in 2011 compared with 2003, inactivity rate significantly decreased (adjusted prevalence rate ratio: 0.83, 95% confidence interval: [0.72-0.96]) and unemployment rate significantly increased (1.28 [1.04-1.57]). After additional adjustment for health status characteristics, the difference was no longer significant for inactivity (0.89 [0.77-1.03]) but remained significant for unemployment (1.55 [1.24-1.93]). Compared with 2003, in 2011 transitions to unemployment following HIV diagnosis tended to be more frequent (1.58 [0.92-2.68]) and access to work was significantly less frequent (0.57 [0.33-0.99]). Improvements in HIV care have not translated into improvements in PLWHIV's situation regarding employment.

  13. Determination of HIV status of infants born to HIV-infected mothers: A review of the diagnostic methods with special focus on the applicability of p24 antigen testing in developing countries

    Wessman, Maria J; Theilgaard, Zahra Persson; Katzenstein, Terese L

    2012-01-01

    Abstract In 2009, 2.5 million children under the age of 15 y were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); 370,000 were diagnosed with HIV and 260,000 died due to AIDS. More than 90% of the children infected with HIV live in sub-Saharan Africa. Most...... children infected with HIV contract the infection in utero, during delivery, or via breast milk. This review outlines the current diagnostic methods to determine the HIV status of infants born to HIV-infected mothers. The HIV DNA and RNA polymerase chain reaction (PCR) tests are highly accurate...

  14. Knowledge of HIV and hepatitis B and C status among people living in extreme poverty in France, in 2012.

    Chappuis, M; Pauti, M-D; Tomasino, A; Fahet, G; Cayla, F; Corty, J-F

    2015-03-01

    "Médecins du Monde" healthcare centers receive individuals living in extremely precarious conditions for primary health care; 94% of these are foreigners. These medical consultations are an opportunity to discuss their serological status and to offer them screening tests. Two standardized questionnaires were implemented in all healthcare centers in 2000. The medical record covers knowledge of HIV and hepatitis B and C status. 41,033 consultations were given in 2012 in the 20 healthcare centers, for 23,181 patients. Only 29% of the patients knew their hepatitis status and 35% their HIV status. 42% of French patients were unaware of their HIV status compared to 67% of foreign patients. The lack of knowledge of foreign patients' HIV status was more frequent among men and in age classes60 years of age. Patients from non-EU Europe, the Middle East, and Asia were significantly more likely to be unaware of their HIV status compared to people from Sub-Saharan Africa and Oceania/America. The rate of foreigners not having undergone screening remained stable, regardless of the duration of residence in France. These results highlight the need to develop specific prevention projects among immigrant populations in precarious situations. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Discussing matters of sexual health with children: what issues relating to disclosure of parental HIV status reveal.

    Nam, Sara Liane; Fielding, Katherine; Avalos, Ava; Gaolathe, Tendani; Dickinson, Diana; Geissler, Paul Wenzel

    2009-03-01

    Little is published about the disclosure of parents' own HIV status to their children in Africa. Research shows that keeping family secrets from children, including those related to a parent's HIV status, can be detrimental to their psychological well-being and to the structure of the family. Further, children with HIV-positive parents have been shown to be more vulnerable to poorer reproductive health outcomes. This qualitative study in Botswana conducted in-depth interviews among 21 HIV-positive parents on antiretroviral therapy. The data revealed that parents found discussing the issue of HIV with children difficult, including disclosing their own HIV status to them. Reasons for disclosing included: children being HIV positive, the rest of the family knowing, or the parent becoming very sick. Reasons for not disclosing included: believing the child to be too young, not knowing how to address the issue of HIV, that it would be "too painful" for the child/ren. Concern that other people might find out about their status or fear of children experiencing stigmatising behaviour. Interviews elucidated the difficulty that parents have in discussing their own HIV status and more general sexual health issues with their children. Parents and other guardians require support in managing age-appropriate disclosure to their children. This may further enable access to forums that can help children cope with their fears about the future and develop life skills in preparation for dealing with relationships of a sexual nature and sexual health as children move into adulthood. In developing such support mechanisms, changing family roles in Botswana need to be taken into consideration and the role of other family members in the upbringing of children in Tswana society need to be recognised and utilised.

  16. Lack of knowledge of HIV status a major barrier to HIV prevention, care and treatment efforts in Kenya: results from a nationally representative study.

    Peter Cherutich

    Full Text Available BACKGROUND: We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS 2007. METHODS: KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 15-64 years. We used gender-specific multivariable regression models to identify factors independently associated with HIV testing in sexually active persons. RESULTS: Of 19,840 eligible persons, 80% consented to interviews and blood specimen collection. National HIV prevalence was 7.1% (95% CI 6.5-7.7. Among ever sexually active persons, 27.4% (95% CI 25.6-29.2 of men and 44.2% (95% CI 42.5-46.0 of women reported previous HIV testing. Among HIV-infected persons, 83.6% (95% CI 76.2-91.0 were unaware of their HIV infection. Among sexually active women aged 15-49 years, 48.7% (95% CI 46.8-50.6 had their last HIV test during antenatal care (ANC. In multivariable analyses, the adjusted odds ratio (AOR for ever HIV testing in women ≥35 versus 15-19 years was 0.2 (95% CI: 0.1-0.3; p<0.0001. Other independent associations with ever HIV testing included urban residence (AOR 1.6, 95% CI: 1.2-2.0; p = 0.0005, women only, highest wealth index versus the four lower quintiles combined (AOR 1.8, 95% CI: 1.3-2.5; p = 0.0006, men only, and an increasing testing trend with higher levels of education. Missed opportunities for testing were identified during general or pregnancy-specific contacts with health facilities; 89% of adults said they would participate in home-based HIV testing. CONCLUSIONS: The vast majority of HIV-infected persons in Kenya are unaware of their HIV status, posing a major barrier to HIV prevention, care and treatment efforts. New approaches to HIV testing provision and education, including home-based testing, may increase coverage. Targeted interventions should involve sexually active men, sexually

  17. Testing and testing positive: childhood adversities and later life HIV status among Kenyan women and their partners.

    Goodman, Michael L; Raimer-Goodman, Lauren; Chen, Catherine X; Grouls, Astrid; Gitari, Stanley; Keiser, Philip H

    2017-12-01

    Adverse childhood experiences are a critical feature of lifelong health. No research assesses whether childhood adversities predict HIV-testing behaviors, and little research analyzes childhood adversities and later life HIV status in sub-Saharan Africa. We use regression models with cross-sectional data from a representative sample (n = 1974) to analyze whether adverse childhood experiences, separately or as cumulative exposures, predict reports of later life HIV testing and testing HIV+ among semi-rural Kenyan women and their partners. No significant correlation was observed between thirteen cumulative childhood adversities and reporting prior HIV testing for respondent or partner. Separately, childhood sexual abuse and emotional neglect predicted lower odds of reporting having previously been tested for HIV. Witnessing household violence during one's childhood predicted significantly higher odds of reporting HIV+. Sexual abuse predicted higher odds of reporting a partner tested HIV+. Preventing sexual abuse and household violence may improve HIV testing and test outcomes among Kenyan women. More research is required to understand pathways between adverse childhood experiences and partner selection within Kenya and sub-Saharan Africa, and data presented here suggest understanding pathways may help improve HIV outcomes. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Trends in contraceptive use according to HIV status among privately insured women in the United States.

    Haddad, Lisa B; Monsour, Michael; Tepper, Naomi K; Whiteman, Maura K; Kourtis, Athena P; Jamieson, Denise J

    2017-12-01

    There is limited information on the patterns and trends of contraceptive use among women living with HIV, compared with noninfected women in the United States. Further, little is known about whether antiretroviral therapy correlates with contraceptive use. Such information is needed to help identify potential gaps in care and to enhance unintended pregnancy prevention efforts. We sought to compare contraceptive method use among HIV-infected and noninfected privately insured women in the United States, and to evaluate the association between antiretroviral therapy use and contraceptive method use. We used a large US nationwide health care claims database to identify girls and women ages 15-44 years with prescription drug coverage. We used diagnosis, procedure, and National Drug Codes to assess female sterilization and reversible prescription contraception use in 2008 and 2014 among women continuously enrolled in the database during 2003 through 2008 or 2009 through 2014, respectively. Women with no codes were classified as using no method; these may have included women using nonprescription methods, such as condoms. We calculated prevalence of contraceptive use by HIV infection status, and by use of antiretroviral therapy among those with HIV. We used multivariable polytomous logistic regression to calculate unadjusted and adjusted odds ratios and 95% confidence intervals for female sterilization, long-acting reversible contraception, and short-acting hormonal contraception compared to no method. While contraceptive use increased among HIV-infected and noninfected women from 2008 through 2014, in both years, a lower proportion of HIV-infected women used prescription contraceptive methods (2008: 17.5%; 2014: 28.9%, compared with noninfected women (2008: 28.8%; 2014: 39.8%, P contraception (adjusted odds ratio, 0.67; 95% confidence interval, 0.52-0.86 compared to no method) or short-acting hormonal contraception method (adjusted odds ratio, 0.59; 95% confidence

  19. Buddhism, the status of women and the spread of HIV/AIDS in Thailand.

    Klunklin, Areewan; Greenwood, Jennifer

    2005-01-01

    The common-sense construction of Buddhism is that of a general power for good; the less positive aspects of Buddhism's power, especially when reinforced by folklore and ancient superstition, is infrequently recognised. In this article we make explicit Buddhism's less positive power, particularly as it relates to the status of women and, by implication, its role in the human immunodeficiency (HIV)/acquired immune deficiency syndrome (AIDS) epidemic in Thailand. The Buddhist, folklore, and superstitious bases of Thai misogyny are explored, together with its expression in the differential gender roles of women and men. In addition, the attitudes of both women and men to commercial sex workers (CSWs) and condom use is discussed. The implications of these attitudinal analyses to the epidemiology of HIV/AIDS in Thailand is outlined. We argue that the current spread of HIV/AIDS in Thailand is primarily a function of the inferior status of women, which, in turn, is a function of Buddhism and Thai cultural beliefs. In light of this, some realistic strategies to address the problem also are discussed.

  20. [Status of marriage and HIV transmission between couples in newly reported HIV cases before diagnosis was made, among men who have sex with men in China, 2014].

    Li, J; Han, J; Xu, J; Tang, H L; Mao, Y R

    2017-06-10

    Objective: To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made, among men who have sex with men (MSM) in China. Methods: Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System. Infected MSM who were older than 22 years of age were included in this study. HIV cases were divided into sero-concordant or sero-discordant group, according to the HIV status of the couple who were tested 180 days post-diagnosis. Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made. Results: A total of 5 081 (22.7 % ) of the HIV infected MSM who had couples, were included in this study. A total of 3 715 cases had their couples tested 180 days after the diagnosis was made. 7.6 % (282) had positive couples. Results from the multivariate logistic regression analysis showed that factors as: older than 60 ( OR =2.64, 95 % CI : 1.50-4.65) years of age, being minorities ( OR =1.93, 95 % CI : 1.13-3.29), having CD(4)(+)T cells less than 500 cells/μl (<200: OR =2.91, 95 %CI : 1.82-4.65; 200-349: OR =1.98, 95 %CI : 1.22-3.23; 350-500: OR =1.69, 95 %CI : 1.00-2.86), with self-reported unsafe behaviors ( OR =1.92, 95 % CI : 1.44-2.58) etc. , were more likely to transmit HIV to their couples before the diagnosis was made. Conclusion: Behavior interventions and early HIV testing should be promoted, especially among those MSM who had couples, to avoid inter-spousal transmission.

  1. Feeding practices and nutritional status of HIV-exposed and HIV ...

    Background: Optimal infant- and young child–feeding practices are crucial for nutritional status, growth, development, health and, ultimately, survival. Human breast milk is optimal nutrition for all infants. Complementary food introduced at the correct age is part of optimal feeding practices. In South Africa, widespread access ...

  2. Serodiscordance and disclosure among HIV-positive pregnant women in the Southwestern United States.

    Nacius, Lori A; Levison, Judy; Minard, Charles G; Fasser, Carl; Davila, Jessica A

    2013-04-01

    The prevalence of HIV-positive pregnant women in relationships with HIV-negative men in the United States is unclear. The purpose of this study was to calculate the prevalence of HIV-positive pregnant women with a serodiscordant (HIV-negative) partner within a single clinic population, assess disclosure of their HIV status, and examine factors associated with disclosure. All HIV-positive pregnant women who received prenatal care at the Harris County Hospital District Women's Program at Northwest Health Center in Houston TX between 1/1/2006 and 4/1/2011 were identified. Data were obtained from electronic medical records. Prevalence of serodiscordance and disclosure was calculated, and predictors of disclosure were evaluated. We identified 212 HIV-positive pregnant women. About 40% had a serodiscordant partner, and 34% had a partner with an unknown HIV status. Disclosure occurred in over 90% of women with a serodiscordant partner and in 68% of women with partners whose HIV status was unknown. Among pregnant women who knew their HIV status prior to the current pregnancy and had a serodiscordant partner, 92% reported disclosing their status prior to conception. Our data indicated that serodiscordant relationships are common in our clinic population. Suboptimal disclosure rates were observed, especially among women who have a partner with an unknown HIV status. Further research is needed to evaluate the prevalence of serodiscordance and disclosure in other United States populations.

  3. Correlation between national income, HIV/AIDS and political status and mortalities in African countries.

    Andoh, S Y; Umezaki, M; Nakamura, K; Kizuki, M; Takano, T

    2006-07-01

    To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education. We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants. Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR. National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

  4. HIV status disclosure to perinatally-infected adolescents in Zimbabwe: a qualitative study of adolescent and healthcare worker perspectives.

    Khameer K Kidia

    Full Text Available Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. As these children grow and surpass the immediate threat of death, the issue of informing them of their HIV status arises. This study aimed to understand how perinatally-infected adolescents learn about their HIV-status as well as to examine their preferences for the disclosure process.In-depth interviews were conducted with 31 (14 male, 17 female perinatally-infected adolescents aged 16-20 at an HIV clinic in Harare, Zimbabwe, and focused on adolescents' experiences of disclosure. In addition, 15 (1 male, 14 female healthcare workers participated in two focus groups that were centred on healthcare workers' practices surrounding disclosure in the clinic. Purposive sampling was used to recruit participants. A coding frame was developed and major themes were extracted using grounded theory methods.Healthcare workers encouraged caregivers to initiate disclosure in the home environment. However, many adolescents preferred disclosure to take place in the presence of healthcare workers at the clinic because it gave them access to accurate information as well as an environment that made test results seem more credible. Adolescents learned more specific information about living with an HIV-positive status and the meaning of that status from shared experiences among peers at the clinic.HIV-status disclosure to adolescents is distinct from disclosure to younger children and requires tailored, age-appropriate guidelines. Disclosure to this age group in a healthcare setting may help overcome some of the barriers associated with caregivers disclosing in the home environment and make the HIV status seem more credible to an adolescent. The study also highlights the value of peer support among adolescents, which could help reduce the burden of psychosocial care on caregivers and healthcare workers.

  5. Association between HIV infection and socio-economic status: evidence from a semirural area of southern Mozambique.

    Pons-Duran, Clara; González, Raquel; Quintó, Llorenç; Munguambe, Khatia; Tallada, Joan; Naniche, Denise; Sacoor, Charfudin; Sicuri, Elisa

    2016-12-01

    To analyse the association between socio-economic status (SES) and HIV in Manhiça, a district of Southern Mozambique with one of the highest HIV prevalences in the world. Data were gathered from two cross-sectional surveys performed in 2010 and 2012 among 1511 adults and from the household census of the district's population. Fractional polynomial logit models were used to analyse the association between HIV and SES, controlling for age and sex and taking into account the nonlinearity of covariates. The inequality of the distribution of HIV infection with regard to SES was computed through a concentration index. Fourth and fifth wealth quintiles, the least poor, were associated with a reduced probability of HIV infection compared to the first quintile (OR = 0.595, P-value = 0.009 and OR = 0.474, P-value < 0.001, respectively). Probability of HIV infection peaked at 36 years and then fell, and was always higher for women regardless of age and SES. HIV infection was unequally distributed across the SES strata. Despite the high HIV prevalence across the entire population of Manhiça, the poorest are at greatest risk of being HIV infected. While women have a higher probability of being HIV positive than men, both sexes showed the same infection reduction at higher levels of SES. HIV interventions in the area should particularly focus on the poorest and on women without neglecting anyone else, as the HIV risk is high for everyone. © 2016 John Wiley & Sons Ltd.

  6. Change in subjective social status following HIV diagnosis and associated effects on mental and physical health among HIV-positive gay men in Australia.

    Heywood, Wendy; Lyons, Anthony

    2017-07-01

    This study investigates the impact of HIV diagnosis on subjective social status and if changes are linked to health outcomes. Two measures of subjective social status, socio-economic and standing in the community were examined in 342 Australian HIV-positive gay men in 2014. Participants recalled ratings at diagnosis were compared with current ratings. Self-reported mental (psychological distress, self-esteem, positive mental health and satisfaction with life) and physical health (self-rated health, CD4 count, viral load). Half of the participants reported improvements in subjective socio-economic status (59%) or standing in the community (52%) since diagnosis, yet one quarter reported socio-economic status (25%) or standing in the community had decreased (23%). Increases in either measure of subjective social status were linked to higher self-esteem, positive mental health, satisfaction with life and better self-rated health. Decreases in subjective social status, however, were strongly linked to poorer outcomes on all mental health measures. Decreases in standing in the community were also associated with poorer physical self-rated health. Most participants reported their subjective social status were the same or better since diagnosis. Changes in subjective social status following diagnosis were strongly linked to mental health outcomes. Those who reported a decrease in subjective social status were particularly vulnerable to mental health problems.

  7. Types and predictors of partner reactions to HIV status disclosure among HIV-infected adult Nigerians in a tertiary hospital in the Niger Delta

    Ogoina, Dimie; Ikuabe, Peter; Ebuenyi, Ikenna; Harry, Tubonye; Inatimi, Otonyo; Chukwueke, Ogechi

    BACKGROUND AND OBJECTIVE: Our aim was to describe the types and determinants of partner reactions to HIV-status disclosure among adults attending an antiretroviral therapy-(ART) clinic in the Bayelsa State, Nigeria. METHODS: A cross-sectional study was undertaken between January and March 2013 among

  8. Determinants of nondisclosure of HIV status among women attending the prevention of mother to child transmission programme, Makonde district, Zimbabwe, 2009.

    Mucheto, Pride; Chadambuka, Addmore; Shambira, Gerald; Tshimanga, Mufuta; Gombe, Notion; Nyamayaro, Wenceslas

    2011-01-01

    The 2007 United Nations General Assembly Report on HIV/AIDS in Zimbabwe reported nondisclosure of HIV status as a challenge in the PMTCT programme. Preliminary investigations on nondisclosure among 21 women tested for HIV at Chinhoyi Hospital showed that only six had disclosed their HIV status. We investigated the determinants of nondisclosure of HIV status. A cross sectional analytic study was conducted at six health facilities in Makonde district. The Theory of Planned Behaviour was adapted to guide socio-cultural variables assessed. Antenatal and postnatal women tested for HIV in the PMTCT program who consented to participate were interviewed. We enrolled 334 women. Thirty four percent (114) did not disclose their HIV status. Among HIV positive respondents, 43% (25) did not disclose their status. Women who believed disclosure caused physical abuse (OR=1.81, 95% CI: 1.17-2.90), caused divorce (OR=2.01, 95% CI: 1.25-3.22) and was unimportant (OR= 2.26, 95% CI: 1.33-3.87) were two times less likely to disclose their status. Respondents who received group HIV pre-test counselling were 2.4 times more likely not to disclose. Receiving ANC HIV education at least twice and referral for psychosocial support were significantly protective [OR 0.54 (95% CI 0.24-0.63) and 0.16 (95% CI: 0.06-0.41) respectively. Independent determinants of nondisclosure among HIV positive women were perception that disclosure would cause divorce (AOR=7.82, p=0.03), living with an extended family (AOR=10.3, p=0.01) and needing spousal approval of HIV testing (AOR=0.11, pcauses divorce, abuse or is unimportant contributes to nondisclosure. Identifying women with social challenges and strengthening their referral for psychosocial support can improve disclosure of HIV status and reduce mother to child transmission of HIV.

  9. Is socio-economic status a determinant of HIV-related stigma attitudes in Zimbabwe? Findings from Project Accept

    Kudzanai Mateveke

    2016-08-01

    Full Text Available HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIVrelated stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants’ ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR=1.73, P<0.01] and low SES (OR=1.97, P<0.01, indicating more stigmatizing attitudes by participants belonging to medium and low SES in comparison to high SES. For HIV related stigma and discrimination programs to be effective, they should take into account the socio-economic context of target population.

  10. HIV and risk behaviors of persons of low socio-economic status, Popayan-Colombia (2008-2009)

    Pinzón, María Virgínia; Tello, Ines Constanza; Rincón-Hoyos, Hernan Gilberto; Galindo, Jaime

    2013-01-01

    Abstract Objetive: To determine HIV presence and risk behaviors of persons of low socio-economic status in the city of Popayan-Colombia. Methods: Cross-sectional study; between 2008 and 2009, 363 participants of Popayan signed informed consent and received pre and post HIV test counseling. Socio-demographic characteristics and history of STDs, risk behaviors and previous HIV testing were assessed. Descriptive statistics, correlations and multivariate logistic regression were calculated. Results: Mean age 33.5±10,2; 66 %women. Frequency of HIV-positive patients was 3.86 % (95% CI:1.87-5.85), greater in men (7.38%; p= 0.013). Greater frequency of HIV-positive patients was observed in people age 29-37, those without a stable partner, and those with history of risky alcohol consumption (more than five drinks in 2 h). Conclusions: HIV-positive patients frequency in this population was greater than national estimate for general population, aged 15-49 in Colombia, with even greater frequency in men. This study suggests that characteristics associated with low socioeconomic status, in economically active population, without a stable partner and with risky alcohol use, can potentially increase risk of HIV infection. PMID:24892315

  11. Contextual, experiential, and behavioral risk factors associated with HIV status: a descriptive analysis of transgender women residing in Atlanta, Georgia.

    Salazar, Laura F; Crosby, Richard A; Jones, Jamal; Kota, Krishna; Hill, Brandon; Masyn, Katherine E

    2017-10-01

    This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P transgender women also experienced less trans-related discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.

  12. [Impact of maternal HIV status on family constructions and the infant's relational environment during the perinatal period].

    Trocmé, N; Courcoux, M-F; Tabone, M-D; Leverger, G; Dollfus, C

    2013-01-01

    To assess whether maternal HIV-positive status negatively affects family construction and the child's psychological environment. Could this be responsible for behavioral problems observed in children infected with or affected by HIV? Interviews were conducted with 60 HIV+ mothers and their infants during the perinatal period, within 3 months of delivery, collected at the time of a pediatric outpatient visit within a PMTCT program. Half of the 60 mothers did not live with the infant's father, 56% of multiparous mothers were separated from their previous children. Sixty-five percent of the fathers were informed of the mother's HIV-positive status, although 90% of fathers who lived with the mothers were informed. During pregnancy, 80% of mothers reported psychological stress; after delivery, 72% of mothers suffered from not being allowed to breastfeed their infants, 43.5% expressed a fear of transmitting the infection to the child, and 40% avoided contacts with the infant. The impact of the mother's psychological stress and anxiety related to the risk of HIV transmission through breastfeeding and casual contacts were already noticeable in the first mother-child interrelations. Although the risk of MTC transmission in now very small, psychological troubles related to maternal HIV status may negatively affect the children's well-being and behavior, psychological support should be provided for mothers and children as part of comprehensive services. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  13. Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya

    Agatha Christine Onyango

    2012-01-01

    Full Text Available Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT and mean corpuscular volume (MCV. Results. Among the 497 patients recruited (M : F sex ratio: 1.4, mean age: 39 years ± 10.5 y, Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49 ± 3.49 mg. All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4 ± 2.60 male and 11.2 ± 4.25 female. Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life.

  14. Structural bridging network position is associated with HIV status in a younger Black men who have sex with men epidemic.

    Shah, Nirav S; Iveniuk, James; Muth, Stephen Q; Michaels, Stuart; Jose, Jo-Anne; Laumann, Edward O; Schneider, John A

    2014-02-01

    Younger Black men who have sex with men (BMSM) ages 16-29 have the highest rates of HIV in the United States. Despite increased attention to social and sexual networks as a framework for biomedical intervention, the role of measured network positions, such as bridging and their relationship to HIV risk has received limited attention. A network sample (N = 620) of BMSM respondents (N = 154) and their MSM and transgendered person network members (N = 466) was generated through respondent driven sampling of BMSM and elicitation of their personal networks. Bridging status of each network member was determined by a constraint measure and was used to assess the relationship between this bridging and unprotected anal intercourse (UAI), sex-drug use (SDU), group sex (GS) and HIV status within the network in South Chicago. Low, moderate and high bridging was observed in 411 (66.8 %), 81 (13.2 %) and 123 (20.0 %) of the network. In addition to age and having sex with men only, moderate and high levels of bridging were associated with HIV status (aOR 3.19; 95 % CI 1.58-6.45 and aOR 3.83; 95 % CI 1.23-11.95, respectively). Risk behaviors observed including UAS, GS, and SDU were not associated with HIV status, however, they clustered together in their associations with one another. Bridging network position but not risk behavior was associated with HIV status in this network sample of younger BMSM. Socio-structural features such as position within the network may be important when implementing effective HIV prevention interventions in younger BMSM populations.

  15. "Know Your Status": results from a novel, student-run HIV testing initiative on college campuses.

    Milligan, Caitlin; Cuneo, C Nicholas; Rutstein, Sarah E; Hicks, Charles

    2014-08-01

    Know Your Status (KYS), a novel, student-run program offered free HIV-testing at a private university (PU) and community college (CC). Following completion of surveys of risk behaviors/reasons for seeking testing, students were provided with rapid, oral HIV-testing. We investigated testing history, risk behaviors, and HIV prevalence among students tested during the first three years of KYS. In total, 1408 tests were conducted, 5 were positive: 4/408 CC, 1/1000 PU (1% vs. 0.1%, p=0.01). Three positives were new diagnoses, all black men-who-have-sex-with-men (MSM). Over 50% of students were tested for the first time and 59% reported risk behaviors. CC students were less likely to have used condoms at last sex (a surrogate for risk behavior) compared to PU (OR 0.73, CI [0.54, 0.98]). Race, sexual identity, and sex were not associated with condom use. These results demonstrate that KYS successfully recruited large numbers of previously untested, at-risk students, highlighting the feasibility and importance of testing college populations.

  16. Household food security and HIV status in rural and urban communities in the Free State province, South Africa.

    Pienaar, Michélle; van Rooyen, Francois C; Walsh, Corinna M

    2017-12-01

    Higher socioeconomic status impacts profoundly on quality of life. Life-event stressors, such as loss of employment, marital separation/divorce, death of a spouse and food insecurity, have been found to accelerate disease progression among people with human immunodeficiency virus (HIV). The objective of this study was to determine significant independent sociodemographic and food security factors associated with HIV status in people from rural and urban communities in the Assuring Health for All study, which was undertaken in rural Trompsburg, Philippolis and Springfontein and urban Mangaung, in the Free State Province of South Africa. Sociodemographic and food security factors associated with HIV status were determined in 886 households. Logistic regression with forward selection (p rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. A relatively high percentage of respondents had never attended school, while very few participants in all areas had a tertiary education. The unemployment rate of HIV-infected adults was higher than that of HIV-uninfected adults. A high percentage of respondents in all areas reported running out of money to buy food, with this tendency occurring significantly more among urban HIV-infected than HIV-uninfected respondents. In all areas, a high percentage of HIV-infected respondents relied on a limited number of foods to feed their children, with significantly more HIV-infected urban respondents compared to their uninfected counterparts reporting this. Most participants in all areas had to cut the size of meals, or ate less because there was not enough food in the house or not enough money to buy food. During periods of food shortage, more than 50% of respondents in all areas asked family, relatives or neighbours for assistance with money and/or food, which occurred at a higher percentage of HIV-infected rural participants compared to HIV-uninfected rural participants. More than half of all

  17. Microbicides in the prevention of HIV infection: current status and future directions.

    Nuttall, Jeremy

    2010-07-09

    More than 28 years since the first cases of HIV/AIDS, there is still no cure or vaccine. The worst affected region is sub-Saharan Africa and, increasingly, it is young women who are bearing the brunt of the epidemic. Consequently, there is an urgent need for HIV prevention options for women in developing countries. Microbicides are topical products that can be used vaginally by women to impede sexual transmission of HIV and thus represent one of the most promising prevention strategies. Efficacy trials with early nonspecific microbicide gels have so far been unsuccessful, but the field has now switched its focus to products containing highly potent and highly specific antiretroviral drugs that are easier to use, and can be formulated in a variety of dosage forms to suit individual and regional preferences. However, these products have their own challenges, with a greater likelihood of absorption, and the potential for systemic toxicities or the development of resistance in infected individuals who are unaware of their HIV status. The conduct of clinical trials is complex for all microbicides, with limited availability of trial sites, difficulties in dose selection and safety monitoring, and a lack of a truly objective measure of adherence. Once a microbicide has been shown to be safe and effective, there will need to be a clear pathway to regulatory approval, and the successful launch of a product will depend on having in place appropriate methods for distribution to the women who need it, along with a strategy for ensuring that they use it correctly. This will require substantial effort in terms of education and community engagement, and these activities need to be initiated well in advance of microbicide rollout.

  18. Resources to cope with stigma related to HIV status, gender identity, and sexual orientation in gay men and transgender women.

    Arístegui, Inés; Radusky, Pablo D; Zalazar, Virginia; Lucas, Mar; Sued, Omar

    2018-02-01

    The stigma related to HIV status, gender identity, and sexual orientation has negative implications for the quality of life of individuals. A qualitative study was conducted to explore the resources that these stigmatized groups recognize as tools to cope with stigma and maintain their psychological well-being. Four focus groups were conducted with gay men and transgender women divided by HIV status. A thematic analysis revealed that individual, interpersonal, and institutional resources are commonly recognized as coping resources. This article discusses the importance of enhancing self-acceptance, social support, and a legal framework that legitimizes these groups as right holders.

  19. Evaluation of HBsAg and anti-HBc assays in saliva and dried blood spot samples according HIV status.

    Flores, Geane Lopes; Cruz, Helena Medina; Potsch, Denise Vigo; May, Silvia Beatriz; Brandão-Mello, Carlos Eduardo; Pires, Marcia Maria Amendola; Pilotto, Jose Henrique; Lewis-Ximenez, Lia Laura; Lampe, Elisabeth; Villar, Livia Melo

    2017-09-01

    Influence of HIV status in HBV markers detection in saliva and dried blood spots (DBS) was not well established. This study aims to evaluate the performance of optimized commercial immunoassay for identifying HBsAg and anti-HBc in saliva and DBS according HIV status. A sum of 535 individuals grouped as HIV + , HBV + , HIV/HBV + and HIV/HBV- were recruited where 347 and 188 were included for HBsAg and anti-HBc evaluation, respectively. Serum, DBS collected in Whatman 903 paper and saliva obtained using salivette device were analyzed using EIA. Increased sample volume and ROC curve analysis for cut off determination were used for DBS and saliva testing. HBsAg detection in saliva and DBS exhibited sensitivities of 80.9% and 85.6% and specificities of 86.8% and 96.3%. Sensitivity of anti-HBc in saliva and DBS were 82.4% and 76.9% and specificities in saliva and DBS were 96.9% and 91.7%. Low sensitivities were observed for HBsAg (62%) and anti-HBc (47%) detection in saliva of HIV/HBV+ individuals. OD values were also lower for HBsAg detection in DBS and saliva of HIV/HBV+ individuals compared to their serum samples. Statistical significance was found for sensitivities in HBsAg detection between saliva and DBS demonstrating high sensitivity for DBS specimens. In conclusion, HIV status or antiretroviral treatment appears to interfere in the performance of HBsAg and anti-HBc detection in DBS and saliva samples using the adapted commercial EIA. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Men's serostatus disclosure to parents: associations among social support, ethnicity, and disease status in men living with HIV.

    Fekete, Erin M; Antoni, Michael H; Lopez, Corina R; Durán, Ron E; Penedo, Frank J; Bandiera, Frank C; Fletcher, Mary Ann; Klimas, Nancy; Kumar, Mahendra; Schneiderman, Neil

    2009-07-01

    Directly disclosing a positive HIV serostatus to family members can affect psychological and disease status. Perceptions that one is in a supportive family environment may moderate these effects; however, ethnic differences may exist in the support processes of families coping with HIV. We examined the role of serostatus disclosure to parents, HIV-specific family support, and ethnicity (Latino versus non-Hispanic White) in explaining disease status (HIV Viral Load, CD4+ cell count) in a sample of men living with HIV (MLWH). Men (n=120) reported whether they had disclosed their serostatus to their mothers and fathers, rated their perceptions of HIV-specific social support received from family members, and provided morning peripheral venous blood samples to assess immune function. We also collected psychosocial and urinary neuroendocrine indicators of stress/distress as possible mediator variables. A three-way interaction emerged between serostatus disclosure to mothers, HIV-specific family support, and ethnicity in explaining both viral load and CD4+ cell count. Non-Hispanic White men who had disclosed to mothers and were receiving high family support had a lower viral load and higher CD4+ cell count, but Latino men who had disclosed to mothers and were receiving low family support had a higher viral load. These associations were not accounted for by men's medication adherence, psychological distress, or neuroendocrine hormones. Disclosure to fathers was not related to disease status. The effects of serostatus disclosure on disease status may depend, in part, on ethnic differences in the interpersonal processes of men's close family relationships.

  1. Employment status is associated with both physical and mental health quality of life in people living with HIV.

    Rueda, Sergio; Raboud, Janet; Mustard, Cameron; Bayoumi, Ahmed; Lavis, John N; Rourke, Sean B

    2011-04-01

    To evaluate the relationship between employment status and health-related quality of life (HRQOL) in HIV/AIDS. A total of 361 participants provided baseline data in the context of an ongoing cohort study examining the natural history of neurobehavioral functioning and its effects on HRQOL. We administered tests and collected laboratory data to determine demographic status, HIV disease markers, psychosocial symptom burden, neurocognitive function and HRQOL (MOS-HIV). We performed regression analyses to evaluate the contribution of employment status to the physical and mental health components of quality of life (QOL). Multivariate analyses showed that employment status was strongly related to better physical and mental health QOL after controlling for potential confounders. We found, however, that employment status had a greater impact on physical health than mental health QOL [physical health (β = 6.8, 95% CI 4.6 to 9.1) and mental health QOL (β = 3.3, 95% CI 0.93 to 5.7)]. The effect of employment for physical health QOL was stronger than that observed for ethnicity, social support, or having an AIDS diagnosis and was comparable to that observed with having many HIV-related symptoms. This cross-sectional study suggests that there may be physical and mental health benefits associated with obtaining or keeping employment, or more likely that both selection and causation mechanisms comprise an interactional and reinforcing process.

  2. The Association of Fat and Lean Tissue With Whole Body and Spine Bone Mineral Density Is Modified by HIV Status and Sex in Children and Youth.

    Jacobson, Denise L; Lindsey, Jane C; Coull, Brent A; Mulligan, Kathleen; Bhagwat, Priya; Aldrovandi, Grace M

    2018-01-01

    HIV-infected (HIV-pos) male children/youth showed lower bone mineral density at sexual maturity than HIV-uninfected (HIV-neg) females. It is not known whether complications of HIV disease, including abnormal body fat distribution, contribute to lower bone accrual in male HIV-pos adolescents. In a cross-sectional study, we evaluated the relationship between body composition (fat and lean mass) and bone mass in HIV-pos and HIV-neg children/youth and determined if it is modified by HIV status and sex. We used generalized estimating equations to simultaneously model the effect of fat/lean mass on multiple bone outcomes, including total body bone mineral density and bone mineral content and spine bone mineral density. We evaluated effect modification by HIV and sex. The analysis cohort consisted of 143 HIV-neg and 236 HIV-pos, of whom 55% were black non-Hispanic and 53% were male. Ages ranged from 7 to children/youth were at Tanner stage 1 and 20% at Tanner 5. Fat mass was more strongly positively correlated with bone mass in HIV-neg than HIV-pos children/youth and these relationships were more evident for total body bone than spine outcomes. Within HIV strata, fat mass and bone were more correlated in female than male children/youth. The relationship between lean mass and bone varied by sex, but not by HIV status. HIV disease diminishes the positive relationship of greater fat mass on bone mass in children/youth. Disruptions in body fat distribution, which are common in HIV disease, may have an impact on bone accretion during pubertal development.

  3. Serum selenium status of HIV-infected children on care and ...

    Although the use of HAART has revolutionised the management of. HIV infection ... prevent the replication of HIV and retard the development of AIDS in newly infected ..... Effect of multiple ... Nutrition, HIV, and drug abuse: The molecular basis ...

  4. Gender perspective of risk factors associated with disclosure of HIV status, a cross-sectional study in Soweto, South Africa.

    Longinetti, Elisa; Santacatterina, Michele; El-Khatib, Ziad

    2014-01-01

    Human Immunodeficiency Virus (HIV) status disclosure has been shown to provide several benefits, both at the individual and societal levels. To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART) recipients in South Africa. A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa. We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other. A total of 883 patients were interviewed. The majority were women (73%) with median age of 39 years. Employed patients were less likely to disclose than unemployed (odds ratio (OR) 0.36; 95% confidence interval (CI) 0.1-1.0; p = 0.05)). Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.90-11.7; p = 0.07) than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.02-1.99; p = 0.17) than men with lower income. Men were more likely than women to disclose to their partner (pwomen were more likely than men to disclose to child and family (pgender and income on disclosure. Interventions designed to reduce workplace discrimination and gender-sensitive interventions promoting disclosure are strongly recommended.

  5. Zinc status in HIV infected Ugandan children aged 1-5 years: a cross sectional baseline survey

    Ndugwa Christopher M

    2010-09-01

    Full Text Available Abstract Background Low concentrations of serum zinc have been reported in HIV infected adults and are associated with disease progression and an increased risk of death. Few studies have been conducted in HIV infected children in Africa. We determined serum zinc levels and factors associated with zinc deficiency in HIV infected Ugandan children. Methods We measured the baseline zinc status of 247 children aged 1-5 years enrolled in a randomised trial for multiple micronutrient supplementation at paediatric HIV clinics in Uganda (http://ClinicalTrials.gov NCT00122941. Zinc status was determined using inductively coupled atomic emission spectrophotometry (ICP-AES. Clinical and laboratory characteristics were compared among zinc deficient (zinc Results Of the 247 children, 134 (54.3% had low serum zinc ( Conclusion Almost two thirds of HAART naïve and a third of HAART treated HIV infected children were zinc deficient. Increased access to HAART among HIV infected children living in Uganda might reduce the prevalence of zinc deficiency.

  6. Socio-economic and demographic factors related to HIV status in urban informal settlements in the Eastern Cape, South Africa.

    Steenkamp, Liana; Venter, Danie; Walsh, Corinna; Dana, Pelisa

    2014-09-01

    The prevalence of HIV&AIDS is embedded in social and economic inequity and the relationship between social determinants and HIV incidence is well established. The aim of this study was to determine which socio-economic and demographic factors are related to HIV status in the age group 18 to 49 years in informal settlements in the Eastern Cape, South Africa. This cross-sectional study was conducted in 3 informal settlements (n = 752) during March 2013 within the Nelson Mandela Bay and Buffalo City districts. A proportional cluster sample was selected and stratified by area and formal plot/squatter households in open areas. Respondents who volunteered to participate had to provide informed written consent before trained, bilingual peer educators interviewed them and completed the structured questionnaire. HIV status was determined and information on demographic and socio-economic variables was included in the bivariate analysis. The prevalence of HIV was higher, at 17.3%, than the 2011 estimated national prevalence among the general population in South Africa. The level of education (χ(2) = 5.50, df = 1, p < 0.05), geographical site (χ(2) = 7.41, df = 2, p < 0.05), gender (χ(2) = 33.10, df = 1, p < 0.0005), household food insecurity (χ(2) = 4.77, df = 1, p < 0.05), cooking with cast iron pots (χ(2) = 15.0, df = 3, p < 0.05) and availability of perceived 'wealth' indicators like mobile telephones and refrigerators (χ(2) = 9.67, df = 2, p < 0.05) were significantly associated with HIV-status. No significant associations could be demonstrated between household income, the number of people living in the household and the availability of electricity/water and HIV status. As the observed levels of HIV prevalence underlined gender bias and failure to graduate from high school, future interventions should focus on HIV prevention in female schoolchildren. However, HIV infection is also prevalent among wealthier individuals in informal settlements, which indicates that

  7. Sexual minority status and violence among HIV infected and at-risk women.

    Pyra, Maria; Weber, Kathleen; Wilson, Tracey E; Cohen, Jennifer; Murchison, Lynn; Goparaju, Lakshmi; Cohen, Mardge H

    2014-08-01

    Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence. To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV. Longitudinal study of 1,235 HIV infected and 508 uninfected women of the Women's Interagency HIV Study (WIHS) cohort, from New York City, NY, Chicago, IL, Washington D.C., and San Francisco, CA, 1994-2012. Primary exposures are sexual identity (heterosexual, bisexual, lesbian/gay) and sexual behavior (male, female, or male & female partners). Primary outcomes are sexual abuse, intimate partner violence (IPV) and physical violence; high-risk sex and substance use were examined as mediators. Bisexual women were at increased odds for sexual abuse [aOR 1.56 (1.00, 2.44)], IPV [aOR 1.50 (1.08, 2.09)], and physical violence [aOR 1.77 (1.33, 2.37)] compared to heterosexual women. In a separate analysis, women who reported sex with men and women (WSMW) had increased odds for sexual abuse [aOR 1.65 (0.99, 2.77], IPV [aOR 1.50 (1.09, 2.06)] and physical violence [aOR 2.24 (1.69, 2.98)] compared to women having sex only with men (WSM). Using indirect effects, multiple sex partners, cocaine and marijuana were significant mediators for most forms of abuse. Transactional sex was only a mediator for bisexual women. Women who reported sex only with women (WSW) had lower odds of sexual abuse [aOR 0.23 (0.06, 0.89)] and physical violence [aOR 0.42 (0.21, 0.85)] compared to WSM. Women who identify as bisexual or report both male and female sex partners are most vulnerable to violence; multiple recent sex partners, transactional sex and some types of substance use mediate this relationship. Acknowledging sexual identity and behavior, while addressing substance use and high-risk sex in clinical and psychosocial settings, may help reduce violence exposure among women with and at-risk for HIV.

  8. Brain microbial populations in HIV/AIDS: α-proteobacteria predominate independent of host immune status.

    William G Branton

    Full Text Available The brain is assumed to be a sterile organ in the absence of disease although the impact of immune disruption is uncertain in terms of brain microbial diversity or quantity. To investigate microbial diversity and quantity in the brain, the profile of infectious agents was examined in pathologically normal and abnormal brains from persons with HIV/AIDS [HIV] (n = 12, other disease controls [ODC] (n = 14 and in cerebral surgical resections for epilepsy [SURG] (n = 6. Deep sequencing of cerebral white matter-derived RNA from the HIV (n = 4 and ODC (n = 4 patients and SURG (n = 2 groups revealed bacterially-encoded 16 s RNA sequences in all brain specimens with α-proteobacteria representing over 70% of bacterial sequences while the other 30% of bacterial classes varied widely. Bacterial rRNA was detected in white matter glial cells by in situ hybridization and peptidoglycan immunoreactivity was also localized principally in glia in human brains. Analyses of amplified bacterial 16 s rRNA sequences disclosed that Proteobacteria was the principal bacterial phylum in all human brain samples with similar bacterial rRNA quantities in HIV and ODC groups despite increased host neuroimmune responses in the HIV group. Exogenous viruses including bacteriophage and human herpes viruses-4, -5 and -6 were detected variably in autopsied brains from both clinical groups. Brains from SIV- and SHIV-infected macaques displayed a profile of bacterial phyla also dominated by Proteobacteria but bacterial sequences were not detected in experimentally FIV-infected cat or RAG1⁻/⁻ mouse brains. Intracerebral implantation of human brain homogenates into RAG1⁻/⁻ mice revealed a preponderance of α-proteobacteria 16 s RNA sequences in the brains of recipient mice at 7 weeks post-implantation, which was abrogated by prior heat-treatment of the brain homogenate. Thus, α-proteobacteria represented the major bacterial component of the primate brain

  9. The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis.

    Kim, Hae-Young; Hanrahan, Colleen F; Dowdy, David W; Martinson, Neil; Golub, Jonathan; Bridges, John F P

    2018-03-29

    Antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are important to reduce morbidity and mortality among people newly diagnosed of HIV. The successful uptake of ART and IPT requires a comprehensive understanding of patients' motivation to take such therapies. Partners also play an important role in the decision to be initiated and retained in care. We quantified patients' motivation to take preventive therapies (ART and IPT) and compared by partner HIV status among people newly diagnosed of HIV. We enrolled and surveyed adults (≥18 years) with a recent HIV diagnosis (ART and 334 (79%) had a partner or spouse. Keeping themselves healthy for their family was the most important motivator to take preventive therapies (p motivation for ART and IPT initiation and adherence compared to individual health benefits. These messages should be emphasized to provide effective patient-centered care and counseling.

  10. Association of serum ferritin levels with immunological status and clinical staging of HIV patients: a retrospective study

    Saragih, R. H.; Mardia, A. I.; Purba, G. C. F.; Syahrini, H.

    2018-03-01

    Serum ferritin has long known as an acute phase reactant during inflammation. It works as an oxidative stress marker beside its role in the storage of intracellular iron. The increase of serum ferritin levels (SFL) has been reported found in HIV patients. It remains unclear though whether it causes, or is the cause, to the progressivity of the disease. The purpose of this study was to find the association between the SFL and the progressivity of the HIV disease. A retrospective study of 91 patients was carried out at the Haji Adam Malik Central General Hospital. All of the study population were HIV positive inpatients admitted from January to December 2016. The data needed to be all obtained from the patient’s medical records. The WHO Clinical Staging System was used to assess the HIV clinical staging. An inverse relationship was found between the SFL with the immunological status of the HIV patients (r=-0.213) based on their CD4+ count. There was no association found between the SFL with the clinical staging of the HIV patients (p=0.953). The elevated SFL is a feature found in HIV-diagnosed patients with the low CD4+ count, and it affects the progressivity of the disease.

  11. HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil

    Paulo Afonso Martins Abati

    2015-01-01

    Full Text Available OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center. METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient’s year of admission – P1 (1999-2002, P2 (2003-2006, and P3 (2007-2010 – for comparative analysis of the variables of interest. RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner’s seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3. CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country.

  12. HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil.

    Abati, Paulo Afonso Martins; Segurado, Aluisio Cotrim

    2015-01-01

    OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center. METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient's year of admission - P1 (1999-2002), P2 (2003-2006), and P3 (2007-2010) - for comparative analysis of the variables of interest. RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner's seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3. CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country.

  13. HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda.

    Atuyambe, Lynn Muhimbuura; Ssegujja, Eric; Ssali, Sarah; Tumwine, Christopher; Nekesa, Nicolate; Nannungi, Annette; Ryan, Gery; Wagner, Glenn

    2014-06-21

    Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. There is overwhelming support to individuals that disclose their HIV status

  14. Mediation and Moderation: Testing Relationships between Symptom Status, Functional Health, and Quality of Life in HIV Patients

    Ryu, Ehri; West, Stephen G.; Sousa, Karen H.

    2009-01-01

    We extended Wilson and Cleary's (1995) health-related quality of life model to examine the relationships among symptom status (Symptoms), functional health (Disability), and quality of life (QOL). Using a community sample (N = 956) of male HIV positive patients, we tested a mediation model in which the relationship between Symptoms and QOL is…

  15. A cross-sectional study of disclosure of HIV status to children and adolescents in western Kenya.

    Rachel C Vreeman

    Full Text Available Disclosure of HIV status to children is essential for disease management but is not well characterized in resource-limited settings. This study aimed to describe the prevalence of disclosure and associated factors among a cohort of HIV-infected children and adolescents in Kenya.We conducted a cross-sectional study, randomly sampling HIV-infected children ages 6-14 years attending 4 HIV clinics in western Kenya. Data were collected from questionnaires administered by clinicians to children and their caregivers, supplemented with chart review. Descriptive statistics and disclosure prevalence were calculated. Univariate analyses and multivariate logistic regression were performed to assess the association between disclosure and key child-level demographic, clinical and psychosocial characteristics.Among 792 caregiver-child dyads, mean age of the children was 9.7 years (SD = 2.6 and 51% were female. Prevalence of disclosure was 26% and varied significantly by age; while 62% of 14-year-olds knew their status, only 42% of 11-year-olds and 21% of 8-year-olds knew. In multivariate regression, older age (OR 1.49, 95%CI 1.35-1.63, taking antiretroviral drugs (OR 2.27, 95%CI 1.29-3.97, and caregiver-reported depression symptoms (OR 2.63, 95%CI 1.12-6.20 were significantly associated with knowing one's status. Treatment site was associated with disclosure for children attending one of the rural clinics compared to the urban clinic (OR 3.44, 95%CI 1.75-6.76.Few HIV-infected children in Kenya know their HIV status. The likelihood of disclosure is associated with clinical and psychosocial factors. More data are needed on the process of disclosure and its impact on children.

  16. Performance evaluation of the Bio-Rad Laboratories GS HIV Combo Ag/Ab EIA, a 4th generation HIV assay for the simultaneous detection of HIV p24 antigen and antibodies to HIV-1 (groups M and O) and HIV-2 in human serum or plasma.

    Bentsen, Christopher; McLaughlin, Lisa; Mitchell, Elizabeth; Ferrera, Carol; Liska, Sally; Myers, Robert; Peel, Sheila; Swenson, Paul; Gadelle, Stephane; Shriver, M Kathleen

    2011-12-01

    A multi-center study was conducted to evaluate the Bio-Rad GS HIV Combo Ag/Ab EIA, a 4th generation HIV-1/HIV-2 assay for the simultaneous detection of HIV p24 antigen and antibodies to HIV-1 (groups M and O) and HIV-2 in human serum or plasma in adult and pediatric populations. The objectives of the study were to assess assay performance for the detection of acute HIV infections; sensitivity in known HIV positive samples; percent agreement with HIV status; specificity in low and high risk individuals of unknown HIV status; and to compare assay performance to a 3rd generation HIV assay. The evaluation included testing 9150 samples at four U.S. clinical trial sites, using three kit lots. Unlinked samples were from routine testing, repositories or purchased from vendors. GS HIV Combo Ag/Ab EIA detection in samples from individuals in two separate populations with acute HIV infection was 95.2% (20/21) and 86.4% (38/44). Sensitivity was 100% (1603/1603) in known antibody positive [HIV-1 Groups M and O, and HIV-2] samples. HIV p24 antigen detection was 100% (53/53) in HIV-1 culture supernatants. HIV-1 seroconversion panel detection improved by a range of 0-20 days compared to a 3rd generation HIV test. Specificity was 99.9% (5989/5996) in low risk, 99.9% (959/960) in high risk and 100% (100/100) in pediatric populations. The GS HIV Combo Ag/Ab EIA significantly reduced the diagnostic window when compared to the 3rd generation screening assay, enabling earlier diagnosis of HIV infection. The performance parameters of the Bio-Rad GS HIV Combo Ag/Ab EIA are well suited for use in HIV diagnostic settings. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS.

    Zeng, Chengbo; Li, Linghua; Hong, Yan Alicia; Zhang, Hanxi; Babbitt, Andrew Walker; Liu, Cong; Li, Lixia; Qiao, Jiaying; Guo, Yan; Cai, Weiping

    2018-01-15

    Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People's Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. Our findings suggest that PIS is associated

  18. Types and predictors of partner reactions to HIV status disclosure among HIV-infected adult Nigerians in a tertiary hospital in the Niger Delta.

    Ogoina, Dimie; Ikuabe, Peter; Ebuenyi, Ikenna; Harry, Tubonye; Inatimi, Otonyo; Chukwueke, Ogechi

    2015-03-01

    Our aim was to describe the types and determinants of partner reactions to HIV-status disclosure among adults attending an antiretroviral therapy-(ART) clinic in the Bayelsa State, Nigeria. A cross-sectional study was undertaken between January and March 2013 among consecutive adult patients who had disclosed their HIV-status to their current sexual partner. Sociodemograhic data and types of initial and subsequent partner reactions to disclosure were obtained using interviewer-administered standardized-questionnaire. Independent determinants of reactions to disclosure were ascertained by unconditional logistic regression. Out of 123 study participants, 57.7% were females, 92% were receiving ART and 86.1% were currently married. Majority of the participants reported predominant positive or supportive initial (72.4%) and subsequent (89.5%) partner reactions to disclosure, with significant increase in positive reactions over time. Positive initial partner reactions were independently associated with prior post-test counselling-(Odds ratio [OR]-6.5, 95% Confidence interval [CI]-1.3-31.6-p=0.02), age>35 years-(OR-5.8, 95% CI-1.6-20.9-p=0.008) and being healthy at time of disclosure-(OR-7.8, 95% CI-1.7-35.4-p=0.008). Subsequent positive partner reactions were significantly associated with receiving antiretroviral therapy and having only one lifetime sexual partner. Our results indicate that partner reactions to HIV-status disclosure are predominantly supportive. Disclosure counselling and early initiation of ART may be effective in improving HIV-status disclosure in Nigeria.

  19. The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA): Data on mortality, by HIV status and stage on the HIV care continuum, among the general population in seven longitudinal studies between 1989 and 2014.

    Slaymaker, Emma; McLean, Estelle; Wringe, Alison; Calvert, Clara; Marston, Milly; Reniers, Georges; Kabudula, Chodziwadziwa Whiteson; Crampin, Amelia; Price, Alison; Michael, Denna; Urassa, Mark; Kwaro, Daniel; Sewe, Maquins; Eaton, Jeffrey W; Rhead, Rebecca; Nakiyingi-Miiro, Jessica; Lutalo, Tom; Nabukalu, Dorean; Herbst, Kobus; Hosegood, Victoria; Zaba, Basia

    2017-11-06

    Timely progression of people living with HIV (PLHIV) from the point of infection through the pathway from diagnosis to treatment is important in ensuring effective care and treatment of HIV and preventing HIV-related deaths and onwards transmission of infection.  Reliable, population-based estimates of new infections are difficult to obtain for the generalised epidemics in sub-Saharan Africa.  Mortality data indicate disease burden and, if disaggregated along the continuum from diagnosis to treatment, can also reflect the coverage and quality of different HIV services.  Neither routine statistics nor observational clinical studies can estimate mortality prior to linkage to care nor following disengagement from care.  For this, population-based data are required. The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa brings together studies in Kenya, Malawi, South Africa, Tanzania, Uganda, and Zimbabwe.  Eight studies have the necessary data to estimate mortality by HIV status, and seven can estimate mortality at different stages of the HIV care continuum.  This data note describes a harmonised dataset containing anonymised individual-level information on survival by HIV status for adults aged 15 and above. Among PLHIV, the dataset provides information on survival during different periods: prior to diagnosis of infection; following diagnosis but before linkage to care; in pre-antiretroviral treatment (ART) care; in the first six months after ART initiation; among people continuously on ART for 6+ months; and among people who have ever interrupted ART.

  20. Gender perspective of risk factors associated with disclosure of HIV status, a cross-sectional study in Soweto, South Africa.

    Elisa Longinetti

    Full Text Available BACKGROUND: Human Immunodeficiency Virus (HIV status disclosure has been shown to provide several benefits, both at the individual and societal levels. AIM: To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART recipients in South Africa. SETTING: A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa. METHODS: We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other. PATIENTS: A total of 883 patients were interviewed. The majority were women (73% with median age of 39 years. RESULTS: Employed patients were less likely to disclose than unemployed (odds ratio (OR 0.36; 95% confidence interval (CI 0.1-1.0; p = 0.05. Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.90-11.7; p = 0.07 than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.02-1.99; p = 0.17 than men with lower income. Men were more likely than women to disclose to their partner (p<0.01, and to partner and family (p<0.01, women were more likely than men to disclose to child and family (p<0.01, to child, family and others (p = 0.01. CONCLUSION: Being employed imposed a risk factor for HIV status disclosure, additionally we found an interaction effect of gender and income on disclosure. Interventions designed to reduce workplace discrimination and gender-sensitive interventions promoting disclosure are strongly recommended.

  1. Relation between HIV status, risky sexual behavior, and mental health in an MSM sample from three Chilean cities

    Fabiola Gómez

    2017-04-01

    Full Text Available ABSTRACT Objective To explore the association among HIV status; negative psychological symptoms (anxiety, depression, and hostility; and risky sexual behaviors (multiple sexual partners and unprotected sexual intercourse in a Chilean sample of men who have sex with men (MSM. Methods This study had a cross-sectional design and a sample of 325 MSM whose ages ranged from 18 to 64 years (mean: 30.8; standard deviation: 9.8. Association tests (chi-squared and group mean comparisons (Student’s t-tests and F-tests were performed. Results No statistically significant differences were found for condom use or for the number of sexual partners between HIV-positive men and those who are not infected. In both groups, about 50% reported sexual encounters without condom use in the past six months. There were statistically significant differences in symptoms associated with depression between the two groups. Conclusions These results reveal the need to strengthen messages about the importance of condom use, as the only way to prevent HIV, and as a means of preventing HIV infection and reinfection, in national prevention and self-care programs for sexually active subjects. More studies are needed in Latin America to advance HIV prevention efforts for the MSM population. The data generated by this study can be used to inform the development of HIV prevention programming strategies and interventions targeting the MSM population in Latin America.

  2. HIV status disclosure to families for social support in South Africa (NIMH Project Accept/HPTN 043).

    Maman, Suzanne; van Rooyen, Heidi; Groves, Allison K

    2014-02-01

    Literature on HIV status disclosure among persons living with HIV/AIDS (PLWHA) is dominated by research on the rates, barriers and consequences of disclosure to sexual partners, because of the assumed preventive health benefits of partner disclosure. Disclosure of HIV status can lead to an increase in social support and other positive psychosocial outcomes for PLWHA, but disclosure can also be associated with negative social outcomes including stigma, discrimination, and violence. The purpose of this article is to describe the HIV status disclosure narratives of PLWHA living in South Africa. Thirty in-depth interviews were conducted with 13 PLWHA (11 women, 2 men) over a three-year period. We explored disclosure narratives of the PLWHA through questions about who they chose to disclose to, how they disclosed to these individuals, and how these individuals reacted. Narratives focused on disclosure to family members and contained relatively little discussion of disclosure to sexual partners. Participants often disclosed first to one trusted family member, and news of the diagnosis remained with this person for a long period of time, prior to sharing with others. This family member helped the PLWHA cope with the news of their diagnosis and prepared them to disclose to others. Disclosure to one's partner was motivated primarily by a desire to encourage partners to test for HIV. Two participants described overtly negative reactions from a partner upon disclosure, and none of the PLWHA in this sample described very supportive relationships with their partners after disclosure. The critical role that family members played in the narratives of these PLWHA emphasizes the need for a greater focus on disclosure to families for social support in HIV counseling protocols.

  3. Maternal Nutritional Status Predicts Adverse Birth Outcomes among HIV-Infected Rural Ugandan Women Receiving Combination Antiretroviral Therapy

    Young, Sera; Murray, Katherine; Mwesigwa, Julia; Natureeba, Paul; Osterbauer, Beth; Achan, Jane; Arinaitwe, Emmanuel; Clark, Tamara; Ades, Veronica; Plenty, Albert; Charlebois, Edwin; Ruel, Theodore; Kamya, Moses; Havlir, Diane; Cohan, Deborah

    2012-01-01

    Objective Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Design Prospective cohort. Methods HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Results Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women. Trial Registration Clinicaltrials.gov NCT00993031 PMID:22879899

  4. [Association between intracellular zinc levels and nutritional status in HIV-infected and uninfected children exposed to the virus].

    Gómez G, Erika María; Maldonado C, María Elena; Rojas L, Mauricio; Posada J, Gladys

    2015-01-01

    Malnutrition, growth retardation and opportunistic infections outlast the metabolic, immune and gastrointestinal disorders produced by HIV. Zinc deficiency has been associated with deteriorating nutritional status, growth failure, and risk of infection. The aim of this study is to determine the association between zinc levels in peripheral blood mononuclear cells (PBMC) and the nutritional status of HIV-infected and uninfected children exposed to the virus. An analytical, observational, cross-sectional study was conducted on 17 infected and 17 exposed children, aged 2-10 years. Anthropometric measurements, clinical and nutritional history, 24h recall, measurement of physical activity, and zinc in PBMC by flow cytometry analysis were recorded. Height according to age, energy consumption and adequacy of energy, protein and dietary zinc were significantly higher in children exposed to the virus compared to those infected with HIV (P .05). However, the median levels of zinc in monocytes of infected patients was higher (218.6) compared to the control group (217.0). No association was found between zinc intake and levels of intracellular zinc. The deterioration of nutritional status and growth retardation in children were associated with HIV, but not with the levels of intracellular zinc. The dietary intake of this nutrient was not associated with levels of zinc in monocytes or CD4 + and CD4- lymphocytes. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  5. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review.

    Aidala, Angela A; Wilson, Michael G; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K; Caban, Maria; Rourke, Sean B

    2016-01-01

    Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking "upstream" economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual's control that affect housing and residential environments and the health resources or risk exposures such contexts provide. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in high-income countries. We defined housing status to include

  6. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

    Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

    2016-01-01

    Background. Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking “upstream” economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual’s control that affect housing and residential environments and the health resources or risk exposures such contexts provide. Objectives. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. Search methods. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. Selection criteria. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in

  7. The Relationship Between Online Social Network Use, Sexual Risk Behaviors, and HIV Sero-Status Among a Sample of Predominately African American and Latino Men Who have Sex with Men (MSM) Social Media Users.

    Chiu, ChingChe J; Young, Sean D

    2015-06-01

    Social networking technologies have emerged as potential platforms to reach HIV(+) MSM in HIV interventions. This study sought to compare use of online social networking sites (SNSs) and sexual risk behaviors between HIV(+) and HIV(-) individuals among a sample of predominately African American and Latino SNS-using MSM. A total of 112 MSM Facebook users were recruited online and offline and completed an online survey. We performed regression models to assess the association between HIV status, SNS use, and sexual risk behaviors. After adjusting for age, race, and employment status, being HIV positive was significantly associated with a greater number of sexual partners (ARR = 2.84, p = 0.0017) and lower comfort levels of discussing HIV/STI status on SNSs (AOR: 0.23, p = 0.011). Findings suggest that HIV status is associated with sexual risk behaviors and SNS use among SNS-using MSM. We discuss the implications for online HIV prevention.

  8. The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV.

    Wolitski, Richard J; Pals, Sherri L; Kidder, Daniel P; Courtenay-Quirk, Cari; Holtgrave, David R

    2009-12-01

    HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

  9. prevalence and immune status of hiv/hbv co-infected pregnant women

    boaz

    occurrence of HBV antibodies in HIV-1 positive pregnant women and the relationship to Ante-retroviral therapy (ART) and other demographic ... the potential benefits of interferon use during ... infection and does not influence HIV suppression.

  10. Prevalence, barriers and factors associated with parental disclosure of their HIV positive status to children: a cross-sectional study in an urban clinic in Kampala, Uganda

    Charles Peter Osingada

    2016-07-01

    Full Text Available Abstract Background Disclosure of parental HIV status is associated with a number of positive outcomes such as improved adherence to clinic appointments, lower levels of parental anxiety and depression, and mutual emotional support between parents and their children. Very few studies in low-resource settings have addressed the issues of parental disclosure of their HIV status to their children. Methods A cross-sectional study was conducted among adult parents attending HIV/AIDS prevention, care and treatment clinic at Makerere University Infectious Diseases Institute (IDI, Kampala, Uganda. Participants were interviewed using the Parent Disclosure Interview (PDI questionnaire which is a standard tool developed specifically for HIV infected parents. Data were analyzed using STATA version 13.1. Results Of 344 participants, only 37 % had told at least one of their children that they were HIV positive. Barriers to disclosure were fear that children may tell other people about the parent’s HIV status, desire not to worry or upset children and perceptions that children may not understand. Age of the parent, religion and having someone committed to care of the children were positively associated with parental disclosure of their HIV positives status. Attainment of tertiary level of education was negatively associated with parental disclosure of their HIV status. Conclusions Parental disclosure of a positive HIVstatus to their children is still low in urban Kampala. There is therefore need to develop locally relevant interventions so as to increase rates of parental disclosure of a positive HIV status to their children and thus promote open and honest discussions about HIV/AIDS at family level.

  11. Prevalence, barriers and factors associated with parental disclosure of their HIV positive status to children: a cross-sectional study in an urban clinic in Kampala, Uganda.

    Osingada, Charles Peter; Okuga, Monica; Nabirye, Rose Chalo; Sewankambo, Nelson Kaulukusi; Nakanjako, Damalie

    2016-07-11

    Disclosure of parental HIV status is associated with a number of positive outcomes such as improved adherence to clinic appointments, lower levels of parental anxiety and depression, and mutual emotional support between parents and their children. Very few studies in low-resource settings have addressed the issues of parental disclosure of their HIV status to their children. A cross-sectional study was conducted among adult parents attending HIV/AIDS prevention, care and treatment clinic at Makerere University Infectious Diseases Institute (IDI), Kampala, Uganda. Participants were interviewed using the Parent Disclosure Interview (PDI) questionnaire which is a standard tool developed specifically for HIV infected parents. Data were analyzed using STATA version 13.1. Of 344 participants, only 37 % had told at least one of their children that they were HIV positive. Barriers to disclosure were fear that children may tell other people about the parent's HIV status, desire not to worry or upset children and perceptions that children may not understand. Age of the parent, religion and having someone committed to care of the children were positively associated with parental disclosure of their HIV positives status. Attainment of tertiary level of education was negatively associated with parental disclosure of their HIV status. Parental disclosure of a positive HIVstatus to their children is still low in urban Kampala. There is therefore need to develop locally relevant interventions so as to increase rates of parental disclosure of a positive HIV status to their children and thus promote open and honest discussions about HIV/AIDS at family level.

  12. Salivary human beta defensins affected by oral Candida status in Chinese HIV/AIDS patients undergoing ART.

    Liu, Zhenmin; Yong, Xiangzhi; Jiang, Lanlan; Zhang, Linlin; Lin, Xuefang; Liu, Wei; Peng, Yuanyuan; Tao, Renchuan

    2018-03-02

    To observe relationships between oral Candida status and salivary human beta defensin-2 and -3 (hBD-2 and hBD-3) levels in HIV/AIDS patients of Guangxi, China during the first year of antiretroviral therapy (ART) dynamically, and to understand the influence of ART on oral Candida status and salivary hBDs expressions. A prospective self-controlled study was carried to observe the dynamic changes of CD4 + T cell counts, oral Candida carriages and salivary hBD-2,3 expressions in HIV/AIDS patients during the first year of ART. A total of 90 HIV/AIDS patients were enrolled, and were examined at the baseline, 3rd, 6th, 12th month of ART. Thirty healthy individuals were enrolled as control. Peripheral blood, oral rinse sample and unstimulated whole saliva were collected to test CD4 + T cell counts, oral Candida carriages and hBD-2,3 expressions. In the first year of ART, CD4 + T cell counts increased significantly. However, oral Candida carriages and oral candidiasis decreased significantly, and salivary hBD-2 expressions in HIV/AIDS patients decreased gradually, salivary hBD-3 levels were highly variable. Salivary hBD-2 concentrations were positively related to oral Candida carriages. The incidence of oral candidiasis among HIV/AIDS patients gradually decreased due to the immune reconstruction of ART. Salivary defensins might play an important role in Candida-host interaction in HIV/AIDS patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Marital status and risk of HIV infection in slum settlements of Nairobi

    AJRH Managing Editor

    HIV prevalence among married men and women was 10.4% and 11.1% and among ... (a 27% increase). Sub-Saharan Africa continues to be disproportionately affected by the HIV epidemic, accounting for 68% of the global HIV burden1. In Kenya, according to ... fact that use of condoms suggested infidelity, lack of trust, or a ...

  14. Correlates of HIV-status awareness among adults in Nairobi slum ...

    The prevalence of HIV in the adult population in slum areas in Nairobi, Kenya, is higher than for residents in the city as a whole. This disparity suggests that the characteristics of slum areas may adversely influence the HIV-prevention strategies directed at reducing the national prevalence of HIV. The objective of the study ...

  15. Clinical and laboratory peculiarities of cryptococcal meningoencephalitis in patients with hiv-negative status

    Елена Леонидовна Панасюк

    2015-09-01

    Full Text Available Aim of research: to study the clinical, ummunologic, pathomorphologic peculiarities of cryptococcal meningoencephalitis in patients with HIV-negative status. Materials and methods: there were examined and treated 9 patients (5 women and 5 men 23-65 years old with cryptococcal meningoencephalitis (CME with HIV-negative status. In this group of patients in 3 (33,3 % mycotic injure of nervous system developed on the background of pathology of ENT-organs (2 – larynx cancer, 1 – nasopharynx tumour, in 2 (22,2 % – endocrinopathy (decompensated diabetes mellitus type 11, chronic suprarenal insufficiency, in 1 case tuberculous meningoencephalitis, chronic suprarenal insufficiency connected with chronic pyelonephritis, polypous cystitis, hemolytic anemia, colloid cyst of the 111 ventricle of brain. Among persons with pathology of ENT-organs three patients entered into intensive care department (ICD after operative treatment and repeated courses of chemo- and radial therapy, 1 – after palliative operative treatment. Results: Primary clinical manifestations of cryptococcal menongoencephalitis depended on premorbid background and character of previous medical manipulations. Typical gradual development of CME was noticed only in patients with decompensated somatic pathology. In single cases initial manifestations of CME can flow acutely, violently imitating an image of an acute disorder of brain blood circulation or feebly, inertly on the background of already present neuroinfection. It was set the separate group of patients whose development of CME had a temporal connection with previous operative interventions. Most patients were transferred to IEID (Public Institution “Institute of Epidemiology and infectious diseases L.V. Gromashevsky National Academy of Medical sciences of Ukraine’ at the mean on 18±2,1 day of disease in the grave condition, in all cases the late diagnostics of disease was observed. At admission in 8 cases were

  16. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.

    Sera Young

    Full Text Available Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART. We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG, and hemoglobin concentration (Hb among 166 women initiating cART in rural Uganda.Prospective cohort.HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis.Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW (19.6%, preterm delivery (17.7%, fetal death (3.9%, stunting (21.1%, small-for-gestational age (15.1%, and head-sparing growth restriction (26%. No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%.In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women.Clinicaltrials.gov NCT00993031.

  17. Therapeutic patient education and disclosure of status of HIV infected children in Yaounde, Cameroon Achievements and competence.

    Njom Nlend, A E; Lyeb, A S; Moyo, S; Nsangou, D

    2016-08-01

    Psychosocial support and therapeutic patient education are recommended practices that are poorly reported. Our objective was to describe the main achievements after a patient therapeutic education program conducted for pre-adolescents and adolescents with HIV infection. This qualitative study of 37 children with a mean age of 11 years assessed the outcome of an educational program of 8 sessions that ended by the disclosure of their HIV status. Semistructured interviews that took place 8 weeks after the last session and lasted 20 minutes evaluated the following areas: knowledge of the disease, its treatment, its prevention, and their skills in managing their treatment and the secret. The level of knowledge was acceptable except about HIV transmission, and specifically, how they had acquired the disease. In all, 33/37 (89%) of the children were able to cite or write the name of their disease; 29/37 (78%) had acquired knowledge of their treatment (name of the drugs, objective, and daily treatment times); they were able to manage treatment intake away from home; and secrecy was the standard for all. However, many were unable to explain how they had acquired the virus. Therapeutic patient education for HIV status disclosure enables adolescents to acquire knowledge about their disease and the ability to manage it. The poor results observed for knowledge of transmission needs to be improved after disclosure in support groups.

  18. Gaps along the HIV care continuum: findings among a population seeking sexual health care services in New York City.

    Pathela, Preeti; Jamison, Kelly; Braunstein, Sarah L; Schillinger, Julia A; Tymejczyk, Olga; Nash, Denis

    2018-03-02

    Linkage/re-linkage to HIV care for virally unsuppressed persons with new sexually transmitted infections is critical for ending the HIV epidemic. We quantified HIV care continuum gaps, and viral suppression, among HIV-positive patients attending New York City (NYC) sexual health clinics (SHC). 1,649 HIV-positive patients and a 10% sample of 11,954 patients with unknown HIV status on clinic visit date (DOV) were matched against the NYC HIV registry. Using registry diagnosis dates, we categorized matched HIV-positive patients as "new-positives" (newly diagnosed on DOV), "recent-positives (diagnosed ≤90 days before DOV), "prevalent-positives" (diagnosed >90 days before DOV), and "unknown-positives" (previously diagnosed, but status unknown to clinic on DOV). We assessed HIV care continuum outcomes before and after DOV for new-positives, prevalent-positives, and unknown-positives using registry laboratory data. In addition to 1,626 known HIV-positive patients, 5% of the unknown sample (63/1,196) matched to the registry, signifying that about 630 additional HIV-positive patients attended SHCs. Of new-positives, 65% were linked to care after DOV. Of prevalent-positives, 66% were in care on DOV; 43% of the out-of-care were re-linked after DOV. Of unknown-positives, 40% were in care on DOV; 21% of the out-of-care re-linked after DOV. Viral suppression was achieved by: 88% of in-care unknown-positives, 76% in-care prevalent-positives, 50% new-positives, 42% out-of-care prevalent-positives, and 16% out-of-care unknown-positives. Many HIV-positive persons, including those with uncontrolled HIV infection, attend SHCs and potentially contribute to HIV spread. However, HIV status often is not known to staff, resulting in missed linkage/re-linkage to care opportunities. Better outcomes could be facilitated by real-time ascertainment of HIV status and HIV care status.

  19. Dried Blood Spot Test for HIV Exposed Infants and Children and Their Anti-Retro Viral Treatment Status in Selected Hospitals in Ethiopia.

    Wondafrash, Beyene; Hiko, Desta

    2016-01-01

    Infants and children living with HIV receive antiretroviral treatment often late, are exposed to opportunistic infection and quickly develop AIDS. Few hospitals are providing ART service after Dried Blood Spot (DBS)test.The objective of this study is to assess the status of infants and children linked to ART. Descriptive cross-sectional study was conducted in hospitals. Data of 138 infants and children exposed to HIV were collected from registration books and data bases from 2009 to 2011. Data were analyzed using SPSS version 16. Chi-squared test and p-value were computed. In-depth interviews were conducted with key informants. Ninety-eight (71%) infants and children exposed to HIV were diagnosed for HIV infection of which 68(69.4%) initiated ART. Twenty four (35.3%) initiated ART one month after HIV screening results. Thirty-three (50.0%) and 23(35.3%) infants and children dropped from and adhered to ART respectively. Eleven (16.2%) of them who initiated ART died within the study period. HIV infection status (p-value=0.003), dropping from ART (p-value=0.002) and death after ART initiation (p-value=0.010) showed significance with mothers' PMTCT service status. Seven in ten HIV-exposed infants and children were diagnosed with HIV, and almost all of them initiated ART. The overall turnaround time was 10 days. Based up on mothers' PMTCT service status, there was a significant difference among HIV-exposed infants and children in acquiring HIV infection from mothers during pregnancy (p-value=0.003) and dropping from ART (p-value=0.010). There were challenges in sample collection and transportation. Early HIV screening during pregnancy and PMTCT service should be strengthened.

  20. Status of HIV Epidemic Control Among Adolescent Girls and Young Women Aged 15-24 Years - Seven African Countries, 2015-2017.

    Brown, Kristin; Williams, Daniel B; Kinchen, Steve; Saito, Suzue; Radin, Elizabeth; Patel, Hetal; Low, Andrea; Delgado, Stephen; Mugurungi, Owen; Musuka, Godfrey; Tippett Barr, Beth A; Nwankwo-Igomu, E Amaka; Ruangtragool, Leala; Hakim, Avi J; Kalua, Thokozani; Nyirenda, Rose; Chipungu, Gertrude; Auld, Andrew; Kim, Evelyn; Payne, Danielle; Wadonda-Kabondo, Nellie; West, Christine; Brennan, Elizabeth; Deutsch, Beth; Worku, Anteneh; Jonnalagadda, Sasi; Mulenga, Lloyd B; Dzekedzeke, Kumbutso; Barradas, Danielle T; Cai, Haotian; Gupta, Sundeep; Kamocha, Stanley; Riggs, Margaret A; Sachathep, Karampreet; Kirungi, Wilford; Musinguzi, Joshua; Opio, Alex; Biraro, Sam; Bancroft, Elizabeth; Galbraith, Jennifer; Kiyingi, Herbert; Farahani, Mansoor; Hladik, Wolfgang; Nyangoma, Edith; Ginindza, Choice; Masangane, Zandile; Mhlanga, Fortune; Mnisi, Zandile; Munyaradzi, Pasipamire; Zwane, Amos; Burke, Sean; Kayigamba, Felix B; Nuwagaba-Biribonwoha, Harriet; Sahabo, Ruben; Ao, Trong T; Draghi, Chiara; Ryan, Caroline; Philip, Neena M; Mosha, Fausta; Mulokozi, Aroldia; Ntigiti, Phausta; Ramadhani, Angela A; Somi, Geoffrey R; Makafu, Cecilia; Mugisha, Veronicah; Zelothe, Julius; Lavilla, Kayla; Lowrance, David W; Mdodo, Rennatus; Gummerson, Elizabeth; Stupp, Paul; Thin, Kyaw; Frederix, Koen; Davia, Stefania; Schwitters, Amee M; McCracken, Stephen D; Duong, Yen T; Hoos, David; Parekh, Bharat; Justman, Jessica E; Voetsch, Andrew C

    2018-01-12

    In 2016, an estimated 1.5 million females aged 15-24 years were living with human immunodeficiency virus (HIV) infection in Eastern and Southern Africa, where the prevalence of HIV infection among adolescent girls and young women (3.4%) is more than double that for males in the same age range (1.6%) (1). Progress was assessed toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 2020 targets for adolescent girls and young women in sub-Saharan Africa (90% of those with HIV infection aware of their status, 90% of HIV-infected persons aware of their status on antiretroviral treatment [ART], and 90% of those on treatment virally suppressed [HIV viral load girls and young women aged 15-24 years, the percentage who were aware of their status, and among those persons who were aware, the percentage who had achieved viral suppression were calculated. The target for viral suppression among all persons with HIV infection is 73% (the product of 90% x 90% x 90%). Among all seven countries, the prevalence of HIV infection among adolescent girls and young women was 3.6%; among those in this group, 46.3% reported being aware of their HIV-positive status, and 45.0% were virally suppressed. Sustained efforts by national HIV and public health programs to diagnose HIV infection in adolescent girls and young women as early as possible to ensure rapid initiation of ART should help achieve epidemic control among adolescent girls and young women.

  1. Psychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia.

    Desrosiers, Alethea; Blokhina, Elena; Krupitsky, Evgeny; Zvartau, Edwin; Schottenfeld, Richard; Chawarski, Marek

    2017-03-01

    The Russian Federation is experiencing a very high rate of HIV infection among people who inject drugs (PWID). However, few studies have explored characteristics of people with co-occurring opioid use disorders and HIV, including psychiatric symptom presentations and how these symptoms might relate to quality of life. The current study therefore explored a.) differences in baseline psychiatric symptoms among HIV+ and HIV- individuals with opioid use disorder seeking naltrexone treatment at two treatment centers in Saint Petersburg, Russia and b.) associations between psychiatric symptom constellations and quality of life. Participants were 328 adults enrolling in a randomized clinical trial evaluating outpatient treatments combining naltrexone with different drug counseling models. Psychiatric symptoms and quality of life were assessed using the Brief Symptom Inventory and The World Health Organization Quality of Life-BREF, respectively. Approximately 60% of participants were HIV+. Those who were HIV+ scored significantly higher on BSI anxiety, depression, psychoticism, somatization, paranoid ideation, phobic anxiety, obsessive-compulsive, and GSI indexes (all pHIV-. A K-means cluster analysis identified three distinct psychiatric symptom profiles; the proportion of HIV+ was significantly greater and quality of life indicators were significantly lower in the cluster with the highest psychiatric symptom levels. Higher levels of psychiatric symptoms and lower quality of life indicators among HIV+ (compared to HIV-) individuals injecting drugs support the potential importance of combining interventions that target improving psychiatric symptoms with drug treatment, particularly for HIV+ patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era

    Montoto, Silvia; Shaw, Kate; Okosun, Jessica; Gandhi, Shreyans; Fields, Paul; Wilson, Andrew; Shanyinde, Milensu; Cwynarski, Kate; Marcus, Robert; de Vos, Johannes; Young, Anna Marie; Tenant-Flowers, Melinda; Orkin, Chloe; Johnson, Margaret; Chilton, Daniella; Gribben, John G.; Bower, Mark

    2012-01-01

    Purpose The prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in the HAART era according to HIV serostatus to establish whether this also holds true for HL. Patients and Methods From 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS ≥ 3: 68% v 26%, respectively; P < .001). Forty-seven HIV-positive patients had a CD4 count less than 200/μL, and 92 patients received HAART during chemotherapy. Results The complete response rate was 74% for HIV-positive patients and 79% for HIV-negative patients (P = not significant). After a median follow-up of 60 months (range, 8 to 174 months), 23 patients (16 HIV-negative and seven HIV-positive patients) have experienced relapse at a median time of 6 months (range, 1 to 106 months). Five-year event-free survival (EFS) was 59% (95% CI, 47% to 70%) for HIV-positive patients and 66% (95% CI, 57% to 74%) for HIV-negative patients (P = not significant). Five-year overall survival (OS) was 81% (95% CI, 69% to 89%) and 88% (95% CI, 80% to 93%) for HIV-positive and HIV-negative patients, respectively (P = not significant). HIV status did not predict OS or EFS on multivariate analysis including IPS and HIV status. Conclusion This mature study demonstrates that HIV-positive patients with HL have more extensive disease with more adverse prognostic factors than HIV-negative patients, but when treated with ABVD, HIV infection does not adversely affect OS or EFS. PMID:23045581

  3. 'We keep her status to ourselves': experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine.

    Rispel, Laetitia C; Cloete, Allanise; Metcalf, Carol A

    2015-01-01

    In HIV-discordant relationships, the HIV-negative partner also carries the burden of a stigmatised disease. For this reason, couples often hide their HIV-discordant status from family, friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention, treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine. During 2008, HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire, while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited: 26 from South Africa, 10 from Tanzania, and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner, few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip, rumours and name-calling, and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system.

  4. Periodontal status of HIV infected patients with special reference to CD4 cell count in West Bengal, India

    Shallu Rozra

    2012-12-01

    Full Text Available Objective: To evaluate the periodontal status of HIV seropositive patients and to find out if any correlation exists between the severity of periodontal disease and the CD4 cell count in HIV patients. Methods: One hundred and thirty patients attending the Viral Diseases OPD, Calcutta School of Tropical Medicine, Kolkata were examined. They were grouped according to the CD4 cell count as Group A - Subjects with CD4 Cell count < 200/ 毺 L and Group B - Subjects with CD4 Cell count 曒 200/ 毺 L. Their community periodontal index of treatment needs (CPITN score were recorded. Results: It was found that most of the patients in each group were having score ‘2’ (i.e. presence of supra or subgingival calculus, as their highest score. A statistically significant association was found between immune status as depicted by CD4 cell count and periodontal status as shown by highest CPITN score in the present study. Conclusions: The present study confirms the effect of immunosuppression on periodontal diseases in HIV infected patients.

  5. Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy

    Ana Celia Oliveira dos Santos

    2013-12-01

    Full Text Available Introduction Even with current highly active antiretroviral therapy, individuals with AIDS continue to exhibit important nutritional deficits and reduced levels of albumin and hemoglobin, which may be directly related to their cluster of differentiation 4 (CD4 cell counts. The aim of this study was to characterize the nutritional status of individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS and relate the findings to the albumin level, hemoglobin level and CD4 cell count. Methods Patients over 20 years of age with AIDS who were hospitalized in a university hospital and were receiving antiretroviral therapy were studied with regard to clinical, anthropometric, biochemical and sociodemographic characteristics. Body mass index, percentage of weight loss, arm circumference, triceps skinfold and arm muscle circumference were analyzed. Data on albumin, hemoglobin, hematocrit and CD4 cell count were obtained from patient charts. Statistical analysis was performed using Fisher's exact test, Student's t-test for independent variables and the Mann-Whitney U-test. The level of significance was set to 0.05 (α = 5%. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS 17.0 software for Windows. Results Of the 50 patients evaluated, 70% were male. The prevalence of malnutrition was higher when the definition was based on arm circumference and triceps skinfold measurement. The concentrations of all biochemical variables were significantly lower among patients with a body mass index of less than 18.5kg/m2. The CD4 cell count, albumin, hemoglobin and hematocrit anthropometric measures were directly related to each other. Conclusions These findings underscore the importance of nutritional follow-up for underweight patients with AIDS, as nutritional status proved to be related to important biochemical alterations.

  6. “Experiences with disclosure of HIV-positive status to the infected child”: Perspectives of healthcare providers in Dar es Salaam, Tanzania

    Adellah Sariah

    2016-10-01

    Full Text Available Abstract Background The specific age to which an HIV infected child can be disclosed to is stipulated to begin between ages 4 and 6 years. It has also been documented that before disclosure of HIV positive status to the infected child. Health care providers should consider children’s cognitive-developmental ability. However, observation and situation analysis show that, health care providers still feel uncomfortable disclosing the HIV positive status to the infected child. The aim of the study was to explore healthcare providers’ experiences in disclosure of HIV-positive status to the infected child. Methods A qualitative study involving 20 health care providers who attend HIV-positive children was conducted in September, 2014 in Dar es Salaam, Tanzania. Participants were selected from ten HIV care and treatment clinics (CTC by purposive sampling. An interview guide, translated into participants’ national language (Kiswahili was used during in-depth interviews. Sampling followed the principle of data saturation. The interviews focused on perspectives of health-care providers regarding their experience with paediatric HIV disclosure. Data from in-depth interviews were transcribed into text; data analysis followed qualitative content analysis. Results The results show how complex the process of disclosure to children living with HIV can be to healthcare providers. Confusion was noted among healthcare providers about their role and responsibility in the process of disclosing to the HIV infected child. This was reported to be largely due to unclear guidelines and lack of standardized training in paediatric HIV disclosure. Furthermore, healthcare providers were concerned about parental hesitancy to disclose early to the child due to lack of disclosure skills and fear of stigma. In order to improve the disclosure process in HIV infected children, healthcare providers recommended further standardized training on paediatric HIV disclosure with

  7. Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.

    Morenike Oluwatoyin Folayan

    Full Text Available Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status.We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies.Eighty-one adolescents (18.6% reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87, and transactional sex (OR: 2.80; 95% CI: 1.56-4.95. Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11 and loss and grief (OR: 1.34; 95% CI: 0.73-2.65, but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18. They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50 than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64 to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03 and loss and grief (p = 0.009. Adolescents reporting forced sexual initiation and HIV

  8. Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria

    Folayan, Morenike Oluwatoyin

    2016-01-01

    Objectives Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. Methods We analyzed data from 436 sexually active 10–19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman’s conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Results Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14–11.87), and transactional sex (OR: 2.80; 95% CI: 1.56–4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96–1.11) and loss and grief (OR: 1.34; 95% CI: 0.73–2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34–1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62–3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49–1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced

  9. Mutual HIV status disclosure is associated with consistent condom use in public sector ART clients in Free State province, South Africa: a short report.

    Booysen, Frederik le Roux; Wouters, Edwin; de Walque, Damien; Over, Mead

    2017-11-01

    Risky sexual behaviour in PLWHA on antiretroviral therapy threatens both prevention and treatment efforts, but disclosure promises to support safer sexual practices. This paper investigates the association between HIV self-disclosure and consistent condom use in a cohort of public sector patients on antiretroviral (ARV) treatment. Using data from the FEATS cohort study, logistic regression analysis shows that knowledge of your partner's HIV status is positively associated with consistent condom use (OR 2.73, 95% CI 1.37-5.43, p = 0.004) and so too mutual HIV disclosure (OR 3.38, 95% CI 1.60-7.18, p = 0.001). Prevention and treatment programmes, through couple HIV counselling and testing (CHCT) and other assistance programmes, should focus on supporting the mutual disclosure of HIV status among PLWHA on ARV treatment.

  10. Increasing rates of obesity among HIV-infected persons during the HIV epidemic.

    Nancy Crum-Cianflone

    2010-04-01

    Full Text Available The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV-infected persons are unknown.We evaluated prospective data from a U.S. Military HIV Natural History Study (1985-2004 consisting of early diagnosed patients. Statistics included multivariate linear regression and longitudinal linear mixed effects models.Of 1682 patients, 2% were underweight, 37% were overweight, and 9% were obese at HIV diagnosis. Multivariate predictors of a higher body mass index (BMI at diagnosis included more recent year of HIV diagnosis, older age, African American race, and earlier HIV stage (all p<0.05. The majority of patients (62% gained weight during HIV infection. Multivariate factors associated with a greater increase in BMI during HIV infection included more recent year of diagnosis, lower BMI at diagnosis, higher CD4 count, lower HIV RNA level, lack of AIDS diagnosis, and longer HIV duration (all p<0.05. Nucleoside agents were associated with less weight gain; other drug classes had no significant impact on weight change in the HAART era.HIV-infected patients are increasingly overweight/obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general population. Weight management programs may be important components of HIV care.

  11. Effects of Aerobic Exercise on the Pulmonary Functions, Respiratory Symptoms and Psychological Status of People Living With HIV.

    Aweto, Happiness Anulika; Aiyegbusi, Ayoola Ibifubara; Ugonabo, Adaora Justina; Adeyemo, Titilope Adenike

    2016-01-01

    Pulmonary complications, respiratory symptoms and depression are common occurrences which contribute to the morbidity and mortality seen in individuals living with HIV/AIDS. This study investigated the effect of aerobic exercise on the pulmonary functions, respiratory symptoms and psychological status of people living with HIV. This study was conducted in Lagos, Nigeria from October 2014 to May 2015. Forty eligible individuals with HIV aged 18 yr and above participated, of which 33 cooperated to the end. They were recruited from the HIV/AIDS Prevention and Intervention Initiative (APIN) Clinic, Lagos University Teaching Hospital, Nigeria and were randomly assigned to either the study or the control group. The study group received aerobic exercise training three times a week for six weeks and counselling while the control group received only counselling. Pulmonary functions, respiratory symptoms and psychological status were evaluated at baseline and at six weeks. Inferential statistics of paired and independent t-test were used to analyse the data. Comparison of mean changes in the pulmonary variables of the study group with those of the control group showed significant differences in all but in the respiratory rate (RR) - [Forced Expiratory Volume in one second: P=0.001, Forced Vital Capacity: P=0.001, Peak Expiratory Flow: P=0.001]. There were also significant differences between the mean changes in respiratory symptoms (P=0.001) and depressive symptoms (P=0.001) of study group and those of the control group. Aerobic exercise training significantly improved pulmonary functions as well as significantly reduced respiratory and depressive symptoms in people living with HIV.

  12. Deworming and the immune status of HIV positive pre-antiretroviral therapy individuals in Arba Minch, Chencha and Gidole hospitals, Southern Ethiopia.

    Abossie, Ashenafi; Petros, Beyene

    2015-09-28

    Helminths/HIV co-infections are very common in developing countries, especially in Africa. The effect of overlapping distribution of HIV and helminths becomes important because concomitant infection may exacerbate disease outcome of HIV infection. The study aimed at determining the effect of deworming on the immune status of helminth/HIV coinfected Pre-ART HIV patients attending three health institutions in Southern Ethiopia. 97 HIV-positive Pre-ART individuals were observed into 2 groups on the basis of helminth co-infection and no infection. Out of these, 66 study participants were helminths/HIV co-infected and the remaining 31 study participants were helminths (-)/HIV (+) control. Helminth/HIV co-infected participants CD4+ T-cell count was done at baseline, after 15 weeks and 6 months after antihelminthics treatment. Data were analyzed using SPSS version 16. Ascaris lumbricoides was the highest prevalent soil transmitted helminths in Pre-ART individuals in this study. CD4+ T-cell count in the Ascaris lumricoides/HIV co-infected was significantly higher (P = 0.05) and (P intestinal helminth parasites detected in the study. In conclusion, this finding on Ascaris lumbricoides-specific nature of immune interaction in helminth/HIV co-infection may partly explain the inconsistent reports on the role of intestinal helminths on progression of HIV infection to AIDS. Therefore, a well-designed longitudinal study on helminth species-specific HIV/helminth co-infection will be needed to fully establish the possible benefits of deworming in intestinal helminth/HIV co-infection.

  13. Fluctuations in Blood Marginal Zone B-Cell Frequencies May Reflect Migratory Patterns Associated with HIV-1 Disease Progression Status.

    Gauvin, Julie; Chagnon-Choquet, Josiane; Poudrier, Johanne; Roger, Michel

    2016-01-01

    We have previously shown that overexpression of BLyS/BAFF was associated with increased relative frequencies of innate "precursor" marginal zone (MZ)-like B-cells in the blood of HIV-1-infected rapid and classic progressors. However, along with relatively normal BLyS/BAFF expression levels, these cells remain unaltered in elite-controllers (EC), rather, percentages of more mature MZ-like B-cells are decreased in the blood of these individuals. Fluctuations in frequencies of blood MZ-like B-cell populations may reflect migratory patterns associated with disease progression status, suggesting an important role for these cells in HIV-1 pathogenesis. We have therefore longitudinally measured plasma levels of B-tropic chemokines by ELISA-based technology as well as their ligands by flow-cytometry on blood B-cell populations of HIV-1-infected individuals with different rates of disease progression and uninfected controls. Migration potential of B-cell populations from these individuals were determined by chemotaxis assays. We found important modulations of CXCL13-CXCR5, CXCL12-CXCR4/CXCR7, CCL20-CCR6 and CCL25-CCR9 chemokine-axes and increased cell migration patterns in HIV progressors. Interestingly, frequencies of CCR6 expressing cells were significantly elevated within the precursor MZ-like population, consistent with increased migration in response to CCL20. Although we found little modulation of chemokine-axes in EC, cell migration was greater than that observed for uninfected controls, especially for MZ-like B-cells. Overall the immune response against HIV-1 may involve recruitment of MZ-like B-cells to peripheral sites. Moreover, our findings suggest that "regulated" attraction of these cells in a preserved BLyS/BAFF non-inflammatory environment, such as encountered in EC could be beneficial to the battle and even control of HIV.

  14. Importance of Women's Relative Socioeconomic Status within Sexual Relationships in Communication about Safer Sex and HIV/STI Prevention.

    Muchomba, Felix M; Chan, Christine; El-Bassel, Nabila

    2015-06-01

    The socioeconomic status (SES) of women is increasingly considered an important factor for HIV/STI risk. The HIV/STI literature has largely focused on women's absolute levels of SES, and therefore, the importance of their SES relative to their male sexual partners remains understudied. This paper examines the association between women's relative SES and frequency of safer sex communication among heterosexual couples. A convenience sample of 342 couples (N = 684) recruited in New York City was asked about frequency of discussions with their partner about the need to use male condoms, about HIV prevention, and about STI prevention in the previous 90 days. Differences between partners in education, income, employment, housing, and incarceration history were combined using principal component analysis to form an index of women's relative SES. Negative binomial regression models assessed associations between woman's relative SES and communication frequency controlling for age, sex, race, ethnicity, education, and relationship type using a generalized estimating equation framework. On average, participants had 2.5, 4.2, and 4.8 discussions regarding the need to use male condoms, about HIV prevention, and about STI prevention, respectively. A one standard deviation increase in a woman's relative SES score was associated with increased frequency of discussions about male condom use (adjusted rate ratio [aRR], 1.15; 95% confidence interval [CI], 1.03-1.29), about HIV prevention (aRR, 1.25; CI, 1.14-1.37), and about STI prevention (aRR, 1.29; CI, 1.18-1.41). Women's relative SES may be an important factor for sexual communication, and further research on its role in HIV/STI risk may uncover avenues for intervention.

  15. HIV status, breastfeeding modality at 5 months and postpartum maternal weight changes over 24 months in rural South Africa.

    Chetty, Terusha; Carter, Rosalind J; Bland, Ruth M; Newell, Marie-Louise

    2014-07-01

    To determine the effect of infant feeding practices on postpartum weight change among HIV-infected and -uninfected women in South Africa. In a non-randomised intervention cohort study of antiretroviral therapy-naïve women in South Africa, infants were classified as exclusive (EBF), mixed (MF) or non-breastfed (NBF) at each visit. We analysed infant feeding cumulatively from birth to 5 months using 24-hour feeding history (collected weekly for each of the preceding 7 days). Using generalised estimating equation mixed models, allowing for repeated measures, we compared postpartum weight change (kg) from the first maternal postpartum weight within the first 6 weeks (baseline weight) to each subsequent visit through 24 months among 2340 HIV-infected and -uninfected women with live births and at least two postpartum weight measurements. HIV-infected (-0.2 kg CI: -1.7 to 1.3 kg; P = 0.81) and -uninfected women (-0.5 kg; 95% CI: -2.1 to 1.2 kg; P = 0.58) had marginal non-significant weight loss from baseline to 24 months postpartum. Adjusting for HIV status, socio-demographic, pregnancy-related and infant factors, 5-month feeding modality was not significantly associated with postpartum weight change: weight change by 24 months postpartum, compared to the change in the reference EBF group, was 0.03 kg in NBF (95% CI: -2.5 to +2.5 kg; P = 0.90) and 0.1 kg in MF (95% CI: -3.0 to +3.2 kg; P = 0.78). HIV-infected and -uninfected women experienced similar weight loss over 24 months. Weight change postpartum was not associated with 5-month breastfeeding modality among HIV-infected and -uninfected women. © 2014 John Wiley & Sons Ltd.

  16. Child, Caregiver, and Health Care Provider Perspectives and Experiences Regarding Disclosure of HIV Status to Perinatally Infected Children in Lima, Peru.

    Baker, Amira Noori; Bayer, Angela Marie; Kolevic, Lenka; Najarro, Lizzete; Viani, Rolando Mario; Deville, Jaime Gerardo

    2018-01-01

    Despite recommendations for disclosure of HIV status to children living with HIV (CLHIV), fewer than half of CLHIV at the Instituto Nacional de Salud del Niño (INSN) in Lima, Peru, have had disclosure. How and when the disclosure process for CLHIV should take place in Peru has not been studied. We conducted a qualitative study at INSN to explore perceptions and experiences of 6 health care providers (HCPs), 14 disclosed and nondisclosed CLHIV (8-17 years), and their 14 caregivers regarding knowledge of illness, disclosure of HIV status, and appropriate disclosure approaches. Disclosed children wanted to be told their diagnosis earlier. Nondisclosed children expressed frustration taking medications. Caregivers and HCPs discussed motivations to disclose, including educating, honesty, improving medication adherence, and preventing secondary transmission. Culturally appropriate guidelines and training for HCPs and caregivers are needed to support disclosure of children's HIV status and ongoing support for CLHIV.

  17. Do the factors associated with female HIV infection vary by socioeconomic status in Cameroon?

    Mumah, Joyce N; Jackson-Smith, Douglas

    2014-07-01

    One of the most consistent findings in social epidemiology is an inverse relationship between indicators of SES and most types of illness. However, a growing body of research on HIV in sub-Saharan Africa suggests an intriguing reversal of this pattern, particularly with respect to HIV among women. In Cameroon, specifically, high-SES women have higher rates of HIV infection compared with low-SES women. Using data from the 2004 Cameroon DHS, this study explored the relationships between SES and HIV and tested a multivariate model designed to highlight the distinctive factors associated with increased risk of HIV among women in different SES classes. The results revealed that high-SES women who reported engaging in riskier sexual behaviour had the highest levels of HIV infection. Surprisingly, among this group increased knowledge of HIV, more domestic decision-making authority and access to health care did not reduce vulnerability. Meanwhile, among low-SES women relative gender inequality was significantly related to HIV risk. Specifically, among this group of women, having a partner with higher education was strongly associated with greater HIV risk. The results suggest that different approaches targeting each sub-group are needed to effectively combat the disease.

  18. Known knowns, known unknowns and unknown unknowns in prokaryotic transposition.

    Siguier, Patricia; Gourbeyre, Edith; Chandler, Michael

    2017-08-01

    Although the phenomenon of transposition has been known for over 60 years, its overarching importance in modifying and streamlining genomes took some time to recognize. In spite of a robust understanding of transposition of some TE, there remain a number of important TE groups with potential high genome impact and unknown transposition mechanisms and yet others, only recently identified by bioinformatics, yet to be formally confirmed as mobile. Here, we point to some areas of limited understanding concerning well established important TE groups with DDE Tpases, to address central gaps in our knowledge of characterised Tn with other types of Tpases and finally, to highlight new potentially mobile DNA species. It is not exhaustive. Examples have been chosen to provide encouragement in the continued exploration of the considerable prokaryotic mobilome especially in light of the current threat to public health posed by the spread of multiple Ab R . Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Nutritional status of people living with HIV/AIDS in the Ratoma community medical center (Republic of Guinea).

    Sidibé, S; Magassouba, A S; Delamou, A; Magaboussa, F B; Sandouno, S D; Kra, K É; Conte, N

    2017-02-01

    The nutritional status of people living with HIV/AIDS (PLHIV) has a direct impact on their health. The aim of this study was to describe the nutritional status of PLWHA receiving care at the Ratoma community medical center in Conakry, Guinea. This quantitative cross-sectional study assessed the nutritional status of 184 people PLHIV receiving antiretroviral treatment. The sample comprised 184 PLHIV selected by a systematic random sampling from the complete list of PLHIV. The data were collected by individual questionnaires. Two groups were defined according to their nutritional status, based on their body mass index (BMI): a malnourished group (BMI < 18,5kg/m2) and a well-nourished group (BMI ≥ 18,5kg/m2). CD4 lymphocyte counts were also collected. Of the 184 PLVIH, 19.6% were malnourished (95%CI: 14.1-25.0). The mean BMI was 22.2 ± 4.3 kg/m2). The mean CD4 count differed significantly between the groups (328.7±237.7 CD4 cells/mm3 for the malnourished group and 432.9±256.9 for the well-nourished, p <0.017). Malnutrition was significantly associated with a low CD4 count. To improve survival and quality of life among PLHIV, this high frequency of malnutrition calls for sustained attention to the prevention and early detection and treatment of malnutrition in the early stages of HIV.

  20. The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia.

    Nabila El-Bassel

    Full Text Available We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex.We used Respondent Driven Sampling (RDS to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics.Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants.Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population.

  1. The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia.

    El-Bassel, Nabila; Gilbert, Louisa; Shaw, Stacey A; Mergenova, Gaukhar; Terlikbayeva, Assel; Primbetova, Sholpan; Ma, Xin; Chang, Mingway; Ismayilova, Leyla; Hunt, Tim; West, Brooke; Wu, Elwin; Beyrer, Chris

    2016-01-01

    We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex). We used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics. Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants. Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population.

  2. The immunological response to syphilis differs by HIV status; a prospective observational cohort study.

    Kenyon, Chris; Osbak, Kara Krista; Crucitti, Tania; Kestens, Luc

    2017-01-31

    It is not known if there is a difference in the immune response to syphilis between HIV-infected and uninfected individuals. We prospectively recruited all patients with a new diagnosis of syphilis and tested their plasma for IFNα, IFNγ, IL-1β, IL-12p40, IL-12p70, IP-10, MCP-1, MIP-1α, MIP-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10 and IL-17A at baseline pre-treatment and 6 months following therapy. A total of 79 HIV-infected [44 primary/secondary syphilis (PSS) and 35 latent syphilis (LS)] and 12 HIV-uninfected (10 PSS and 2 LS) cases of syphilis and 30 HIV-infected controls were included in the study. At the baseline visit, compared to the control group, concentrations of IL-10 were significantly elevated in the HIV-infected and uninfected groups. The level of IL-10 was significantly higher in the HIV-infected compared to the HIV-uninfected PSS group (25.3 pg/mL (IQR, 4.56-41.76) vs 2.73 pg/mL (IQR, 1.55-9.02), P = 0.0192). In the HIV-infected PSS group (but not the HIV-infected LS or HIV-uninfected PSS groups) the IP-10, MIP-1b, IL-6 and IL-8 were raised compared to the controls. IL-10 levels decreased but did not return to control baseline values by 6 months in HIV infected PSS and LS and HIV uninfected PSS. PSS and LS in HIV-infected individuals is characterized by an increase in inflammatory and anti-inflammatory cytokines such as IL-10. The increase of IL-10 is greater in HIV-infected than uninfected individuals. Further work is required to ascertain if this is part of an immunological profile that correlates with adverse outcomes such as serofast syphilis and neurosyphilis, in HIV-infected individuals.

  3. HIV/AIDS in sub-Saharan Africa: Current status, challenges and prospects

    Nweze Justus Amuche

    2017-04-01

    Full Text Available The problem of HIV/AIDS was sort of a fairy tale and mere information till the immunological disorder was scientifically confirmed. Today, HIV/AIDS has continued to be a serious international health concern, and sub-Saharan Africa remains the most affected region. Over 25.6 million persons are currently living with HIV in sub-Saharan Africa. This accounts for two-thirds of the recent overall world HIV infections and more than 70 percent of all AIDSrelated deaths. In 2015, Eastern and Southern Africa had about 7.1% adult HIV prevalence rate (about 19 million HIV patients, while Western and Central Africa accounted for about 2.2% (about 6.5 million HIV patients. Few countries now boast of numerous signs of gradual to moderate declines in HIV occurrence. However, HIV prevalence rate has continued to increase in countries like Lesotho (22.7%, Botswana (22.2% and South Africa (19.2%. The nature, procedure and result of the scourge in this region have been fashioned by a mind-boggling interaction of traditional, behavioural, social and material factors. Even if there are notably strong prevention, treatment and care programmes, too many sexual partners are engaging in risky sexual practices. The aim of this article is to discuss the current trends of HIV/AIDS in sub-Saharan Africa, the factors that might have contributed to high prevalence of the virus in the region, the effect of the HIV/AIDS scourge, the prevention programmes and the way forward.

  4. Access to housing subsidies, housing status, drug use and HIV risk among low-income U.S. urban residents

    Dickson-Gomez Julia

    2011-11-01

    Full Text Available Abstract Background Much research has shown an association between homelessness and unstable housing and HIV risk but most has relied on relatively narrow definitions of housing status that preclude a deeper understanding of this relationship. Fewer studies have examined access to housing subsidies and supportive housing programs among low-income populations with different personal characteristics. This paper explores personal characteristics associated with access to housing subsidies and supportive housing, the relationship between personal characteristics and housing status, and the relationship between housing status and sexual risk behaviors among low-income urban residents. Methods Surveys were conducted with 392 low-income residents from Hartford and East Harford, Connecticut through a targeted sampling plan. We measured personal characteristics (income, education, use of crack, heroin, or cocaine in the last 6 months, receipt of welfare benefits, mental illness diagnosis, arrest, criminal conviction, longest prison term served, and self-reported HIV diagnosis; access to housing subsidies or supportive housing programs; current housing status; and sexual risk behaviors. To answer the aims above, we performed univariate analyses using Chi-square or 2-sided ANOVA's. Those with significance levels above (0.10 were included in multivariate analyses. We performed 2 separate multiple regressions to determine the effects of personal characteristics on access to housing subsidies and access to supportive housing respectively. We used multinomial main effects logistic regression to determine the effects of housing status on sexual risk behavior. Results Being HIV positive or having a mental illness predicted access to housing subsidies and supportive housing, while having a criminal conviction was not related to access to either housing subsidies or supportive housing. Drug use was associated with poorer housing statuses such as living on the

  5. Status and methodology of publicly available national HIV care continua and 90-90-90 targets: A systematic review.

    Reuben Granich

    2017-04-01

    Full Text Available In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS issued treatment goals for human immunodeficiency virus (HIV. The 90-90-90 target specifies that by 2020, 90% of individuals living with HIV will know their HIV status, 90% of people with diagnosed HIV infection will receive antiretroviral treatment (ART, and 90% of those taking ART will be virally suppressed. Consistent methods and routine reporting in the public domain will be necessary for tracking progress towards the 90-90-90 target.For the period 2010-2016, we searched PubMed, UNAIDS country progress reports, World Health Organization (WHO, UNAIDS reports, national surveillance and program reports, United States President's Emergency Plan for AIDS Relief (PEPFAR Country Operational Plans, and conference presentations and/or abstracts for the latest available national HIV care continuum in the public domain. Continua of care included the number and proportion of people living with HIV (PLHIV who are diagnosed, on ART, and virally suppressed out of the estimated number of PLHIV. We ranked the described methods for indicators to derive high-, medium-, and low-quality continuum. For 2010-2016, we identified 53 national care continua with viral suppression estimates representing 19.7 million (54% of the 2015 global estimate of PLHIV. Of the 53, 6 (with 2% of global burden were high quality, using standard surveillance methods to derive an overall denominator and program data from national cohorts for estimating steps in the continuum. Only nine countries in sub-Saharan Africa had care continua with viral suppression estimates. Of the 53 countries, the average proportion of the aggregate of PLHIV from all countries on ART was 48%, and the proportion of PLHIV who were virally suppressed was 40%. Seven countries (Sweden, Cambodia, United Kingdom, Switzerland, Denmark, Rwanda, and Namibia were within 12% and 10% of achieving the 90-90-90 target for "on ART" and for "viral suppression

  6. Marital status and HIV prevalence among women in Nigeria: Ingredients for evidence-based programming

    Adeniyi Francis Fagbamigbe

    2016-07-01

    Conclusion: Being formerly married, under 15 years of age at first sex, and having engaged in transactional sex were found to be the strongest HIV risk factors among women. Besides empowering formerly married women and providing better social security, these women should be targeted in HIV programming and policies.

  7. Data-protection standards and confidentiality of HIV/AIDS status in ...

    Also, the article presents a preliminary assessment of the possible impact of professionalisation (and outsourcing) of workplace HIV/AIDS management on ... the development of law governing data protection and HIV/AIDS confidentiality in South Africa) and interviews conducted with workplace health managers and trade ...

  8. The status of HIV-1 resistance to antiretroviral drugs in sub-Saharan Africa

    Hamers, Raph L.; Derdelinckx, Inge; van Vugt, Michèle; Stevens, Wendy; Rinke de Wit, Tobias F.; Schuurman, Rob

    2008-01-01

    Access to highly active antiretroviral therapy (HAART) for persons infected with HIV in sub-Saharan Africa has greatly improved over the past few years. However, data on long-term clinical outcomes of Africans receiving HAART, patterns of HIV resistance to antiretroviral drugs and implications of

  9. Effect of Knowledge of Patients' HIV Positive Status on the Attitude of ...

    Sitwala

    ABSTRACT. Background: Zambia, Southern Africa, has one of the world's most devastating HIV and AIDS epidemics. More than one in every seven adults in the country is living with HIV1 and this disease is the leading cause for patient work load in all health institutions putting a strain on the depleted work force. Fear of ...

  10. Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM

    Frye, Victoria; Nandi, Vijay; Egan, James; Cerda, Magdalena; Greene, Emily; Van Tieu, Hong; Ompad, Danielle C.; Hoover, Donald R.; Lucy, Debbie; Baez, Eduardo; Koblin, Beryl A.

    2014-01-01

    Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner (“HIV transmission risk”). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner (“HIV acquisition risk”). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts. PMID:25381561

  11. Sexual orientation- and race-based discrimination and sexual HIV risk behavior among urban MSM.

    Frye, Victoria; Nandi, Vijay; Egan, James; Cerda, Magdalena; Greene, Emily; Van Tieu, Hong; Ompad, Danielle C; Hoover, Donald R; Lucy, Debbie; Baez, Eduardo; Koblin, Beryl A

    2015-02-01

    Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner ("HIV transmission risk"). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner ("HIV acquisition risk"). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts.

  12. HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study.

    Ayieko, James; Ti, Angeline; Hagey, Jill; Akama, Eliud; Bukusi, Elizabeth A; Cohen, Craig R; Patel, Rena C

    2017-08-08

    Factors influencing fertility desires among HIV-infected individuals remain poorly understood. With new recommendations for universal HIV treatment and increasing antiretroviral therapy (ART) access, we sought to evaluate how access to early ART influences fertility desires among HIV-infected ART-naïve women. Semi-structured in-depth interviews were conducted with a select subgroup of 20 HIV-infected ART-naïve women attending one of 13 HIV facilities in western Kenya between July and August 2014 who would soon newly become eligible to initiate ART based on the latest national policy recommendations. The interviews covered four major themes: 1) definitions of family and children's role in community; 2) personal, interpersonal, institutional, and societal factors influencing fertility desires; 3) influence of HIV-positive status on fertility desires; and 4) influence of future ART initiation on fertility desires. An iterative process of reading transcripts, applying inductive codes, and comparing and contrasting codes was used to identify convergent and divergent themes. The women indicated their HIV-positive status did influence-largely negatively-their fertility desires. Furthermore, initiating ART and anticipating improved health status did not necessarily translate to increased fertility desires. Instead, individual factors, such as age, parity, current health status, financial resources and number of surviving or HIV-infected children, played a crucial role in decisions about future fertility. In addition, societal influences, such as community norms and health providers' expectations of their fertility desires, played an equally important role in determining fertility desires. Initiating ART may not be the leading factor influencing fertility desires among previously ART-naïve HIV-infected women. Instead, individual and societal factors appear to be the major determinants of fertility desires among these women.

  13. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities.

    Kharsany, Ayesha B M; Karim, Quarraisha A

    2016-01-01

    Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included.

  14. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities

    Kharsany, Ayesha B.M.; Karim, Quarraisha A.

    2016-01-01

    Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included. PMID:27347270

  15. Relations between circumcision status, sexually transmitted infection history, and HIV serostatus among a national sample of men who have sex with men in the United States.

    Jozkowski, Kristen; Rosenberger, Joshua G; Schick, Vanessa; Herbenick, Debby; Novak, David S; Reece, Michael

    2010-08-01

    Circumcision's potential link to HIV/sexually transmitted infections (STI) has been at the center of recent global public health debates. However, data related to circumcision and sexual health remain limited, with most research focused on heterosexual men. This study sought to assess behavioral differences among a large sample of circumcised and noncircumcised men who have sex with men (MSM) in the United States. Data were collected from 26,257 U.S. MSM through an online survey. Measures included circumcision status, health indicators, HIV/STI screening and diagnosis, sexual behaviors, and condom use. Bivariate and regression analyses were conducted to determine differences between HIV/STI status, sexual behaviors, and condom use among circumcised and noncircumcised men. Circumcision status did not significantly predict HIV testing (p > 0.05), or HIV serostatus (p > 0.05), and there were no significant differences based on circumcision status for most STI diagnosis [syphilis, gonorrhea, chlamydia, human papilloma virus (HPV)]. Being noncircumcised was predictive of herpes-2 diagnosis, however, condom use mediated this relationship. These data provide one of the first large national assessments of circumcision among MSM. While being noncircumcised did not increase the likelihood of HIV and most STI infections, results indicated that circumcision was associated with higher rates of condom use, suggesting that those who promote condoms among MSM may need to better understand condom-related behaviors and attitudes among noncircumcised men to enhance the extent to which they are willing to use condoms consistently.

  16. [Epidemiology of bacillary pulmonary tuberculosis according to HIV status of patients followed in the department of infectious diseases Conakry (Guinea)].

    Traoré, F A; Sako, F B; Sylla, D; Bangoura, M; Kpamy, D O; Traoré, M; Doumbouya, M; Sangare, I

    2014-12-01

    Despite many efforts of prevention and the availability of free treatment, TB/HIV co-infection is still rampant in Guinea. The objective of this study was to describe the epidemiology of smear positive pulmonary tuberculosis according to HIV status among patients hospitalized in the infectious diseases department of Conakry University Hospital. This was a descriptive and analytical retrospective study of patient records admitted for pulmonary tuberculosis from January 2003 to December 2012. During this period, 1953 cases of tuberculosis were collected of which 346 (17.7%) were smear positive. There was a marked male predominance (59.7%). The average age was 38 ± 11 years. The majority of patients originated from the suburbs of Conakry and its surrounding prefectures (76.7%). People without profession were most represented (40.7%). A level of primary education was the most frequently reported (39.7%). Out of 325 patients tested for HIV, the serology was positive in 185 patients (56.9%). A contact with a TB patient was reported in 21.4% of HIV negative patients, and in 6.5% of the HIV-positive group (p = 0.0006). There was no difference between the two groups regarding clinical signs and symptoms. The mean CD4 count was comparable in both groups (p = 0.05). Lethality was higher among co-infected patients (30.4% against 15.56%; p = 0.00037). Strengthening the prevention of TB among PLWHA by the administration of isoniazide seems necessary and warrants further study on this subject in Guinea.

  17. Caries Experience and Periodontal Status during Pregnancy in a Group of Pregnant Women with HIV+ Infections from Puerto Rico.

    López, Lydia M; Guerra, María Elena

    2015-03-01

    The aim of this study was to determine the caries rate and periodontal status in a sample of pregnant women with HIV+ infections from Puerto Rico. A pilot study was conducted on a cross sectional convenience sample of 25 pregnant women with HIV+ infections from Puerto Rico who visit the CEMI clinic (Centro de Estudios Materno Infantil) at the University of Puerto Rico. The women subjects were evaluated for caries, DMFT (D: Decay tooth; M: Missing tooth due to caries; F: Filled tooth) index, oral lesions associated with HIV+/AIDS and periodontal disease parameters, with a Florida probe by a calibrated dentist on periodontal indexes such as as bleeding on probing, CEJ (cemento-enamel junction) and pocket depth. Periodontal disease was classified as having 4 sites with pocket depth greater than 4 mm and caries were identified following the Radike criteria. Data was statistically analyzed using the SSPS Program (Statistical Software Program for Social Sciences) and descriptive statistics were calculated. Mean DT (decayed teeth), MT (missing teeth due to caries), FT (filled teeth) and DMFT (decay, missing and filled teeth) were 4.8, 1.86, 5.3 and 12, respectively; mean sites of bleeding on probing=12.06; mean sites with pocket depth>4 mm=6.95 and mean sites with loss of attachment greater than 4 mm=7.66. [Almost 50% of the patients had generalized chronic periodontitis. A 72% prevalence of periodontal disease was found. No oral lesions related to HIV+/AIDS were reported. CD4 and viral load was statistically associated with bleeding on probing and severe signs of periodontal disease. High levels of dental disease were found in pregnant women with HIV+/AIDS infections from Puerto Rico, and these women were in need of substantial dental services.

  18. Sociodemographic factors and prejudice toward HIV and hepatitis B/C status in a working-age population: results from a national, cross-sectional study in Japan.

    Eguchi, Hisashi; Wada, Koji; Smith, Derek R

    2014-01-01

    In many countries, HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) infected individuals may face discrimination and mistreatment from coworkers. Effective interventions to reduce workplace discrimination are therefore needed to protect these vulnerable populations. The current study investigated potential associations between sociodemographic factors and prejudice toward HIV and HBV/HCV infected colleagues within a Japanese working population. An online anonymous, nationwide internet survey was administered to a cross-section of approximately 3,000 individuals in Japan. The survey comprised 14 questions focusing on demographics (five items), basic HIV or HBV/HCV knowledge (eight items), and potential prejudice toward HIV or HBV/HCV infected colleagues (one item). The sociodemographic characteristics evaluated were sex, age, educational level, employment status, and individual income; with multiple logistic regression used for the analysis. In total, 3,055 individuals were recruited for the HIV related survey and 3,129 for the HBV/HCV related survey. Older age was significantly and positively associated with prejudice toward HIV infected colleagues (pprejudice toward HBV/HCV infected colleagues (pprejudice toward HIV and HBV/HCV infected coworkers. Overall, this study suggests that age may be associated with prejudice toward HIV and HBV/HCV infected colleagues among the working age population of Japan. As such, policy makers should consider the age of participants when formulating efforts to reduce prejudice toward HIV and HBV/HCV infected workers.

  19. Education and nutritional status of orphans and children of HIV-infected parents in Kenya.

    Mishra, Vinod; Arnold, Fred; Otieno, Fredrick; Cross, Anne; Hong, Rathavuth

    2007-10-01

    We examined whether orphaned and fostered children and children of HIV-infected parents are disadvantaged in schooling, nutrition, and health care. We analyzed data on 2,756 children aged 0-4 years and 4,172 children aged 6-14 years included in the 2003 Kenya Demographic and Health Survey, with linked anonymous HIV testing, using multivariate logistic regression. Results indicate that orphans, fostered children, and children of HIV-infected parents are significantly less likely to attend school than non-orphaned/non-fostered children of HIV-negative parents. Children of HIV-infected parents are more likely to be underweight and wasted, and less likely to receive medical care for ARI and diarrhea. Children of HIV-negative single mothers are also disadvantaged on most indicators. The findings highlight the need to expand child welfare programs to include not only orphans but also fostered children, children of single mothers, and children of HIV-infected parents, who tend to be equally, if not more, disadvantaged.

  20. Epidemiological and clinical features of hepatitis delta in HBsAg-positive patients by HIV status.

    Nicolini, Laura A; Taramasso, Lucia; Schiavetti, Irene; Giannini, Edoardo G; Beltrame, Andrea; Feasi, Marcello; Cassola, Giovanni; Grasso, Alessandro; Bartolacci, Valentina; Sticchi, Laura; Picciotto, Antonino; Viscoli, Claudio

    2015-01-01

    The epidemiology of HBV-associated hepatitis has changed in recent years, especially after the introduction of anti-HBV vaccination, with a consequent decrease in the incidence of HDV-associated hepatitis. However, HDV remains of concern in non-vaccinated people and in immigrants. The aim of this retrospective survey has been to assess prevalence and clinical characteristics of HDV infection in Liguria, a region in Northern Italy, in both HIV-positive and negative patients. During the year 2010, 641 patients chronically infected with HBV entered an observational study of HBV infection conducted in eight tertiary care centres belonging to the 'Ligurian HBV Study Group'. Of 641 patients, 454 (70.8%) were evaluated for HDV serology and 26 (5.7%) were found positive. Among them, 16 were also HIV-positive and 10 were not. Of the 428 HDV-negative patients, only 313 were tested for HIV and 33 (10.5%) were positive. At the time point of study entry there was no age difference between HIV-positive or negative patients, but HIV-positive patients were 10 years younger than HIV-negative (mean age 34.25 ±6.16 versus 41.50 ±8.89 years; P=0.021) at the time point of their first visit in each centre and they were also more frequently intravenous drug users (P=0.009). Despite a similar rate of cirrhosis in the two groups, no HIV-positive patient received an HDV-active therapy (that is, interferon), versus 4 of 10 HIV-negative patients (P=0.014). HDV infection is still a problem in patients not covered by HBV vaccination. Both HDV and HIV testing were frequently overlooked in our setting.

  1. Uptake of health care services and health status of HIV-infected women diagnosed through antenatal HIV screening in Barbados, 1996-2004 Utilización de los servicios de atención sanitaria y estado de salud de las mujeres seropositivas al VIH diagnosticadas mediante el tamizaje prenatal para el VIH en Barbados, 1996-2004

    Alok Kumar; Krishna R. Kilaru; Sheila Forde; Ira Waterman

    2007-01-01

    OBJECTIVES: To study utilization of HIV-related health care services and to describe the health status of HIV-infected women diagnosed through antenatal voluntary counseling and testing (VCT) for HIV infection in Barbados. METHODS: This is a descriptive study. The study population includes all HIV-infected women in Barbados diagnosed as HIV-infected through VCT for HIV infection during 1996-2004. RESULTS: The median duration of HIV infection from time of diagnosis to the time of this report f...

  2. Vaccination status of people living with HIV/AIDS in outpatient care in Fortaleza, Ceará, Brazil

    Gilmara Holanda da Cunha

    2016-09-01

    Full Text Available Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA. The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria. Data were collected for interviews using forms to characterize sociodemographic, clinical and vaccination situations. Only 14 patients had complete vaccination schedules. The most used vaccines were hepatitis B, influenza vaccine and 23-valent pneumococcal. There was no difference between men and women regarding the proportion of PLWHA with full vaccination schedule or between sex, skin color, marital status, sexual orientation, religion or occupational status. There was no difference between having or not having a complete vaccination schedule and age, years of education, family income or number of hospitalizations. CD4+ T-cells count of patients with incomplete immunization was lower than patients with complete immunization. Health education strategies can be done individually or in groups to explain the importance of vaccination and to remind about doses to be administered. Most patients did not have proper adherence to vaccination schedules, especially due to lack of guidance. Results implied that education in health is important for vaccination adhesion, knowledge of adverse events and continuation of schemes.

  3. A cross-sectional study of the magnitude, barriers, and outcomes of HIV status disclosure among women participating in a perinatal HIV transmission study, "the Nevirapine Repeat Pregnancy study".

    Kiweewa, Flavia M; Bakaki, Paul M; McConnell, Michelle S; Musisi, Maria; Namirembe, Constance; Nakayiwa, Frances; Kusasira, Fiona; Nakintu, Dorothy; Mubiru, Michael C; Musoke, Philippa; Fowler, Mary Glenn

    2015-09-29

    HIV status disclosure is a difficult emotional task for HIV-infected persons and may create the opportunity for both social support and rejection. In this study, we evaluated the proportions, patterns, barriers and outcomes of HIV- 1 status disclosure among a group of women in Uganda. An exit interview was conducted one year post-partum for 85 HIV-infected women who participated in a study of HIV-1 transmission rates among NVP-experienced compared with NVP-naïve women in "The Nevirapine Repeat Pregnancy (NVP-RP) Study" at the Makerere University-Johns Hopkins University Research Collaboration, Kampala-Uganda, between June 2004 and June 2006. Of the 85 women interviewed, 99 % had disclosed their HIV status to at least one other person. Disclosure proportions ranged between 1 % to employer(s) and 69 % to a relative other than a parent. Only 38 % of the women had disclosed to their sex partners. Women with an HIV-infected baby were more likely than those with an uninfected baby to disclose to their sex partner, OR 4.9 (95 % CI, 2.0 -11.2), and women were less likely to disclose to a partner if they had previously disclosed to another relative than if they had not, OR 0.19 (95 % CI, 0.14-0.52). The most common reasons for non-disclosure included fear of separation from the partner and subsequent loss of financial support 34 %, and not living with the partner (not having opportunities to disclose) 26 %. While most women (67 %) reported getting social support following disclosure, 22 % reported negative outcomes (neglect, separation from their partners, and loss of financial support). Following disclosure of HIV status, 9 % of women reported that their partner (s) decided to have an HIV test. Results from this study show high overall HIV disclosure proportions and how this disclosure of HIV status can foster social support. However, proportions of disclosure specifically to male sex partners were low, which suggests the need for interventions aimed at increasing male

  4. The impact of fear, secrecy, and stigma on parental disclosure of HIV status to children: a qualitative exploration with HIV positive parents attending an ART clinic in South Africa.

    Madiba, Sphiwe

    2012-11-28

    South Africa is one of the sub Saharan countries where considerable progress in providing antiretroviral treatment (ART) has been made. The increased access to ART contributes to improvements in the prognosis of HIV and parents are more likely to raise their children than ever before. The study examined the social context influencing disclosure of parental HIV status to children from the perspectives of fathers and mothers accessing ART from an academic hospital in South Africa. Three focus group interviews were conducted with 26 non-disclosed biological parents of children aged between 7 and 18 years. Their ages ranged between 20-60 years and they cared for a total of 60 children. Parental decision not to disclose their HIV status to children was influenced by the fear of death and dying, the influence of television and media, stigma and discrimination. Parents delayed disclosure of their HIV status to children because children believed that AIDS kills. Parents also feared that the child may not be able to keep the parent's HIV status secret and might result in the family being subjected to stigma, discrimination, and isolation. Fear of stigma and discrimination were also responsible for the continuous efforts by parents to protect their HIV status from their children, family and neighbour's. Parents also delayed disclosure to children because they lacked disclosure skills and needed support for disclosure from health care providers. Healthcare providers are in a unique position to provide such support and guidance and assist parents to disclose and children to cope with parental HIV infection.

  5. HIV Status Disclosure in the Workplace: Positive and Stigmatizing Experiences of Health Care Workers Living with HIV.

    Stutterheim, Sarah E; Brands, Ronald; Baas, Ineke; Lechner, Lilian; Kok, Gerjo; Bos, Arjan E R

    We explored workplace experiences of 10 health care providers with HIV in the Netherlands. We used semi-structured interviews to discuss motivations for disclosure and concealment, reactions to disclosures, the impact of reactions, and coping with negative reactions. Reasons for disclosure were wanting to share the secret, expecting positive responses, observing positive reactions to others, wanting to prevent negative reactions, and being advised to disclose. Reasons for concealment included fearing negative reactions, observing negative reactions, previous negative experiences, having been advised to conceal, and considering disclosure unnecessary. Positive reactions included seeing HIV as a nonissue; showing interest, support, and empathy; and maintaining confidentiality. Negative reactions included management wanting to inform employees, work restrictions, hiring difficulties, gossip, and hurtful comments, resulting in participants being upset, taken aback, angry, depressed, or feeling resignation. Participants coped by providing information, standing above the experience, attributing reactions to ignorance, seeking social support, or leaving their jobs. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  6. The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda: Universal Primary Education as a natural experiment.

    Behrman, Julia Andrea

    2015-02-01

    This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  7. The risks of partner violence following HIV status disclosure, and health service responses: narratives of women attending reproductive health services in Kenya.

    Colombini, Manuela; James, Courtney; Ndwiga, Charity; Mayhew, Susannah H

    2016-01-01

    For many women living with HIV (WLWH), the disclosure of positive status can lead to either an extension of former violence or new conflict specifically associated with HIV status disclosure. This study aims to explore the following about WLWH: 1. the women's experiences of intimate partner violence (IPV) risks following disclosure to their partners; 2. an analysis of the women's views on the role of health providers in preventing and addressing IPV, especially following HIV disclosure. Thirty qualitative interviews were conducted with purposively selected WLWH attending clinics in Kenya. Data were coded using NVivo 9 and analyzed thematically. Nearly one third of the respondents reported experiencing physical and/or emotional violence inflicted by their partners following the sero-disclosure, suggesting that HIV status disclosure can be a period of heightened risk for partner stigma and abuse, and financial withdrawal, and thus should be handled with caution. Sero-concordance was protective for emotional and verbal abuse once the partner knew his positive status, or knew the woman knew his status. Our results show acceptance of the role of the health services in helping prevent and reduce anticipated fear of partner stigma and violence as barriers to HIV disclosure. Some of the approaches suggested by our respondents included couple counselling, separate counselling sessions for men, and facilitated disclosure. The women's narratives illustrate the importance of integrating discussions on risks for partner violence and fear of disclosure into HIV counselling and testing, helping women develop communication skills in how to disclose their status, and reducing fear about marital separation and break-up. Women in our study also confirmed the key role of preventive health services in reducing blame for HIV transmission and raising awareness on HIV as a chronic disease. However, several women reported receiving no counselling on safe disclosure of HIV status

  8. Nutritional status and metabolic risk in HIV-infected university students

    L Steenkamp

    Open Access article distributed under the terms of the. Creative Commons ... dCampus Health Service, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa ..... Equally, denial due to fear of the HIV infection lends itself to non-.

  9. Status of ANC-linked HIV counseling and testing as an intervention ...

    Bernt Lindtjorn

    Results: A total of 66 (31 pre- and 35 post test) counselling sessions were observed. The mean duration of ... Conclusions: The communication skill of the counselors was generally 'satisfactory'. ... to make an informed decision on HIV testing.

  10. Iron status and anaemia of chronic disease in HIV-infected African ...

    2009-03-11

    Mar 11, 2009 ... A large percentage of women had anaemia of chronic disease, with HIV-infected ... subjects were recruited per week over a 25-week period (March 2000 ..... Washington DC: Academy for Educational Development; 1993.

  11. Current status of HIV treatment in Asia and the Pacific region.

    Phuphuakrat, Angsana; Kiertiburanakul, Sasisopin; Sungkanuparph, Somnuek

    2014-07-01

    Asia and the Pacific represent a diverse group of nations facing HIV epidemic profiles of differing severity. Compared to other parts of the world, the burden of HIV disease is high in this region because of its large populations. At the end of 2011, 5million people were living with HIV in Asia and the Pacific. This accounted for 15% of people living with HIV worldwide. The prevalence of people living with HIV, as well as access to HIV treatment and care, varies widely between countries. Differences between high-income economies and the rest of the continent are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens. Middle- and low-income countries have rapid ART scale-up and are dependent on international funding. This may compromise the sustainability of ART availability. In addition, lack of access to second- and third-line therapy remains a problem in many countries. The global goal of achieving universal access to ART by 2015 requires mainly low- and middle-income countries to be targeted. Regional policy should be developed in order to identify new infections in key populations, to start earlier treatment, to retain patients in care and to maintain funding.

  12. 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...

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

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

    2011-04-01

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

  14. 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.

  15. Clinical characteristics and risk behavior as a function of HIV status among heroin users enrolled in methadone treatment in northern Taiwan

    Shih Chien-Yu

    2011-04-01

    Full Text Available Abstract Background Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program in response to the human immunodeficiency virus (HIV, which is endemic among Taiwanese heroin users. The present study was aimed at examining the clinical and behavioral characteristics of methadone patients in northern Taiwan according to their HIV status. Methods The study was conducted at four methadone clinics. Participants were patients who had undergone methadone treatment at the clinics and who voluntarily signed a consent form. Between August and November 2008, each participant completed a face-to-face interview that included questions on demographics, risk behavior, quality of life, and psychiatric symptoms. Data on HIV and hepatitis C virus (HCV infections, methadone dosage, and morphine in the urine were retrieved from patient files on the clinical premises, with permission of the participants. Results Of 576 participants, 71 were HIV positive, and 514 had hepatitis C. There were significant differences between the HIV-positive and HIV-negative groups on source of treatment payment, HCV infection, urine test results, methadone dosage, and treatment duration. The results indicate that HIV-negative heroin users were more likely to have sexual intercourse and not use condoms during the 6 months prior to the study. A substantial percent of the sample reported anxiety (21.0%, depression (27.2%, memory loss (32.7%, attempted suicide (32.7%, and administration of psychiatric medications (16.1%. There were no significant differences between the HIV-positive and HIV-negative patients on psychiatric symptoms or quality of life. Conclusions HIV-positive IDUs were comorbid with HCV, indicating the need to refer both HIV- and HCV-infected individuals for treatment in methadone clinics. Currently, there is a gap between psychiatric/psychosocial services and patient symptoms, and more integrated medical services should be provided to heroin

  16. SAMHD1 controls cell cycle status, apoptosis and HIV-1 infection in monocytic THP-1 cells

    Bonifati, Serena; Daly, Michele B.; St Gelais, Corine; Kim, Sun Hee; Hollenbaugh, Joseph A.; Shepard, Caitlin; Kennedy, Edward M.; Kim, Dong-Hyun; Schinazi, Raymond F.; Kim, Baek; Wu, Li

    2016-01-01

    SAMHD1 limits HIV-1 infection in non-dividing myeloid cells by decreasing intracellular dNTP pools. HIV-1 restriction by SAMHD1 in these cells likely prevents activation of antiviral immune responses and modulates viral pathogenesis, thus highlighting a critical role of SAMHD1 in HIV-1 physiopathology. Here, we explored the function of SAMHD1 in regulating cell proliferation, cell cycle progression and apoptosis in monocytic THP-1 cells. Using the CRISPR/Cas9 technology, we generated THP-1 cells with stable SAMHD1 knockout. We found that silencing of SAMHD1 in cycling cells stimulates cell proliferation, redistributes cell cycle population in the G_1/G_0 phase and reduces apoptosis. These alterations correlated with increased dNTP levels and more efficient HIV-1 infection in dividing SAMHD1 knockout cells relative to control. Our results suggest that SAMHD1, through its dNTPase activity, affects cell proliferation, cell cycle distribution and apoptosis, and emphasize a key role of SAMHD1 in the interplay between cell cycle regulation and HIV-1 infection.

  17. SAMHD1 controls cell cycle status, apoptosis and HIV-1 infection in monocytic THP-1 cells

    Bonifati, Serena [Center for Retrovirus Research, Department of Veterinary Biosciences, The Ohio State University, Columbus, OH (United States); Daly, Michele B. [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); St Gelais, Corine; Kim, Sun Hee [Center for Retrovirus Research, Department of Veterinary Biosciences, The Ohio State University, Columbus, OH (United States); Hollenbaugh, Joseph A.; Shepard, Caitlin [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); Kennedy, Edward M. [Department of Molecular Genetics and Microbiology, Duke University, Durham, NC (United States); Kim, Dong-Hyun [Department of Pharmacy, School of Pharmacy, Kyung-Hee University, Seoul (Korea, Republic of); Schinazi, Raymond F. [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); Kim, Baek, E-mail: baek.kim@emory.edu [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); Department of Pharmacy, School of Pharmacy, Kyung-Hee University, Seoul (Korea, Republic of); Wu, Li, E-mail: wu.840@osu.edu [Center for Retrovirus Research, Department of Veterinary Biosciences, The Ohio State University, Columbus, OH (United States)

    2016-08-15

    SAMHD1 limits HIV-1 infection in non-dividing myeloid cells by decreasing intracellular dNTP pools. HIV-1 restriction by SAMHD1 in these cells likely prevents activation of antiviral immune responses and modulates viral pathogenesis, thus highlighting a critical role of SAMHD1 in HIV-1 physiopathology. Here, we explored the function of SAMHD1 in regulating cell proliferation, cell cycle progression and apoptosis in monocytic THP-1 cells. Using the CRISPR/Cas9 technology, we generated THP-1 cells with stable SAMHD1 knockout. We found that silencing of SAMHD1 in cycling cells stimulates cell proliferation, redistributes cell cycle population in the G{sub 1}/G{sub 0} phase and reduces apoptosis. These alterations correlated with increased dNTP levels and more efficient HIV-1 infection in dividing SAMHD1 knockout cells relative to control. Our results suggest that SAMHD1, through its dNTPase activity, affects cell proliferation, cell cycle distribution and apoptosis, and emphasize a key role of SAMHD1 in the interplay between cell cycle regulation and HIV-1 infection.

  18. Negotiating cultures: disclosure of HIV-positive status among people from minority ethnic communities in Sydney.

    Körner, Henrike

    2007-01-01

    Because of the multiple stigma attached to HIV/AIDS, disclosure of HIV-positive serostatus is a considerable social risk for those who disclose. While HIV/AIDS-related stigma affects all HIV-positive people, for people from minority cultures additional cultural factors may play a significant role in self-disclosure. This paper draws on data from semi-structured, in-depth interviews with HIV-positive people from minority cultures in Sydney. Disclosure decisions were influenced by gender, sexual orientation, as well as cultural background. Gay men drew on both collectivist and individualist notions of interdependence and self-reliance in different socio-cultural contexts. This enabled them to accommodate the imperative to maintain harmony with the family and meet their individual needs for support. Heterosexual men who had disclosed voluntarily or involuntarily experienced discrimination and avoidance, and interdependence with family and ethnic community was disrupted. Heterosexual women disclosed to no one outside the health care system and were anxious to avoid any disclosure in the future. For all participants, voluntary and involuntary disclosure caused potential and actual disruption of relationships with their families and ethnic communities. The paper concludes by arguing for an ecological perspective of health in which decisions are not located in rational decision making alone but in the broader context of family and community.

  19. Designing towards the unknown

    Wilde, Danielle; Underwood, Jenny

    2018-01-01

    the research potential to far-ranging possibilities. In this article we unpack the motivations driving the PKI project. We present our mixed-methodology, which entangles textile crafts, design interactions and materiality to shape an embodied enquiry. Our research outcomes are procedural and methodological......New materials with new capabilities demand new ways of approaching design. Destabilising existing methods is crucial to develop new methods. Yet, radical destabilisation—where outcomes remain unknown long enough that new discoveries become possible—is not easy in technology design where complex......, to design towards unknown outcomes, using unknown materials. The impossibility of this task is proving as useful as it is disruptive. At its most potent, it is destabilising expectations, aesthetics and processes. Keeping the researchers, collaborators and participants in a state of unknowing, is opening...

  20. Sexual risk behaviors among HIV-infected South African men and women with their partners in a primary care program: implications for couples-based prevention.

    Venkatesh, Kartik K; de Bruyn, Guy; Lurie, Mark N; Modisenyane, Tebogo; Triche, Elizabeth W; Gray, Glenda E; Welte, Alex; Martinson, Neil A

    2012-01-01

    We studied 1163 sexually-active HIV-infected South African men and women in an urban primary care program to understand patterns of sexual behaviors and whether these behaviors differed by partner HIV status. Overall, 40% reported a HIV-positive partner and 60% a HIV-negative or status unknown partner; and 17.5% reported >2 sex acts in the last 2 weeks, 16.4% unprotected sex in the last 6 months, and 3.7% >1 sex partner in the last 6 months. Antiretroviral therapy (ART) was consistently associated with decreased sexual risk behaviors, as well as with reporting a HIV-negative or status unknown partner. The odds of sexual risk behaviors differed by sex; and were generally higher among participants reporting a HIV-positive partner, but continued among those with a HIV-negative or status unknown partner. These data support ART as a means of HIV prevention. Engaging in sexual risk behaviors primarily with HIV-positive partners was not widely practiced in this setting, emphasizing the need for couples-based prevention.

  1. Food security and nutritional status of children under-five in households affected by HIV and AIDS in Kiandutu informal settlement, Kiambu County, Kenya.

    Chege, Peter M; Ndungu, Zipporah W; Gitonga, Betty M

    2016-07-22

    HIV and AIDS affect most the productive people, leading to reduced capacity to either produce food or generate income. Children under-fives are the most vulnerable group in the affected households. There exists minimal information on food security status and its effect on nutritional status of children under-fives in households affected by HIV and AIDS. The aim of this study was to assess food security and nutritional status of children under-five in households affected by HIV and AIDS in Kiandutu informal settlement, Kiambu County. A cross-sectional analytical design was used. A formula by Fisher was used to calculate the desired sample size of 286. Systematic random sampling was used to select the children from a list of identified households affected by HIV. A questionnaire was used to collect data. Focus group discussion (FGD) guides were used to collect qualitative data. Nutri-survey software was used for analysis of nutrient intake while ENA for SMART software for nutritional status. Data were analyzed using SPSS computer software for frequency and means. Qualitative data was coded and summarized to capture the emerging themes Results show that HIV affected the occupation of people with majority being casual laborers (37.3 %), thus affecting the engagement in high income generating activities. Pearson correlation coefficient showed a significant relationship between dietary diversity score and energy intake (r = 0.54 p = 0.044) and intake of vitamin A, iron, and zinc (p poor nutritional status noted by a prevalence of 9.9 % in wasting. Stunting and underweight was 17.5 and 5.5 %, respectively. Qualitative data shows that the stigma due to HIV affected the occupation and ability to earn income. The research recommends a food-based intervention program among the already malnourished children.

  2. HIV Testing and Cross Border Migrant Vulnerability: Social Integration and Legal/Economic Status Among Cross Border Migrant Workers in Thailand.

    Ford, Kathleen; Holumyong, Charamporn

    2016-04-01

    The objective of this paper was to identify factors related to the use of HIV testing among cross border migrants in Thailand. Two measures of vulnerability (social integration and legal/economic status) as well as HIV knowledge, risk behaviour, and demographic factors were tested for association with HIV testing. Data were drawn from a survey of 2600 sexually active migrants age 15-59 in multiple provinces of Thailand. The measures of social integration (AOR = 1.14(95 % CI 1.09, 1.20) female; AOR = 1.12 (95 %CI 1.05, 1.19) male) and legal-income status (AOR = 1.12 (95 % CI 1.07, 1.18) female; AOR = 1.31 (95 %CI 1.20, 1.42) male) were positively related to the odds of reporting an HIV test for both male and female migrants. Exposure to AIDS programming including attending an AIDS meeting and possessing AIDS knowledge was also related to an increase in HIV testing. In addition, reproductive health factors including sexual risk behavior and childbirth increased the rate of HIV testing.

  3. Colorectal Cancer Screening at the Nexus of HIV, Minority Statuses, and Cultural Safety

    Ka'opua, Lana Sue I.; Diaz, Tressa P.; Park, Soon H.; Bowen, Talita; Patrick, Kevin; Tamang, Suresh; Braun, Kathryn L.

    2014-01-01

    Background: The incidence of non-AIDS-defining cancers has increased significantly among persons living with HIV (PLHIV). Screening education is recommended. Purpose: Social learning, minority stress, and cultural safety theories informed this pilot to assess the feasibility of a colorectal cancer screening intervention targeted to PLHIV, with…

  4. A pilot study to compare HIV status, cervical and penile pathology ...

    Abstract. Background: Cancer of the cervix is the most common malignancy in women of childbearing age in Zambia. It is known to be associated with HIV infection and oncogenic strains of HPV. However, there are few studies of penile lesions as a predictor of malignant and premalignant cervical lesions in female partners.

  5. Changes in immunological status among newly-diagnosed HIV-infected in Denmark 1995-2005

    Hoegh, S.; Lohse, N.; Hansen, A.B.

    2008-01-01

    INTRODUCTION: The incidence of new HIV diagnoses in Denmark has remained stable since 1991, but it has increased among the subgroup of homosexual men in recent years. This may reflect an actual increase in newly infected, e.g. as a result of increased risk behaviour, or it may reflect increased HIV....... MATERIALS AND METHODS: Observational study based on the Danish HIV Cohort Study, which includes all adults seen at Danish HIV clinics since 1995. RESULTS: From 2000 to 2004 the number of newly-infected homosexual men increased (from 69 to 123), particularly in persons under 30 years (from 5 to 42......). The median CD4 cell count at the time of diagnosis increased in this group (median 19.1 cells/microL per year [95% CI: 3.7-11.3]), while it remained stable among heterosexually infected. The number of newly-diagnosed homosexually infected under 30 years with a CD4 cell count over 400 cells/microL increased...

  6. Nutrition and health status of HIV-infected adults on ARVs at AMREF ...

    A descriptive case study design was used to sample 120 HIV-infected patients using systematic sampling procedure. These patients sought health care from an urban slum, Kibera AMREF clinic. Data were collected by anthropometric measurements, bio-chemical analysis, semi-structured questionnaire and secondary data.

  7. Optimism and education buffer the effects of syndemic conditions on HIV status among African American men who have sex with men.

    O'Leary, Ann; Jemmott, John B; Stevens, Robin; Rutledge, Scott Edward; Icard, Larry D

    2014-11-01

    The present study sought to replicate effects of the number of syndemic psychosocial health conditions on sexual risk behavior and HIV infection among a sample of high-risk African American men who have sex with men (MSM) and to identify resilience factors that may buffer these effects. We used baseline data from an HIV risk-reduction trial to examine whether a higher number of syndemic conditions was associated with higher rates of self-reported sexual risk behavior and HIV infection. Using logistic regression models, we tested for interactions between number of syndemic conditions and several potential resilience factors to identify buffering effects. Replicating previous studies, we found significant associations between numbers of syndemic conditions and higher rates of sexual risk behavior and HIV infection. Surprisingly, we also replicated a previous finding (Stall et al., Am J Public Health, 93(6):939-942, 2003) that the effects of syndemic burden on HIV status fell off at the highest levels of syndemic conditions. Among a variety of potential resilience factors, two-optimism and education-buffered the syndemic effect on HIV prevalence. This is, to our knowledge, the first paper to identify resilience factors buffering against syndemic effects among MSM. It also constitutes a significant contribution to the literature regarding prevention among black MSM. These results point to the need to identify HIV-positive black MSM and provide effective treatment for them and to develop interventions addressing both syndemic and resilience factors.

  8. Talking to children about their HIV status: a review of available resources, tools, and models for improving and promoting pediatric disclosure.

    Wright, S; Amzel, A; Ikoro, N; Srivastava, M; Leclerc-Madlala, S; Bowsky, S; Miller, H; Phelps, B R

    2017-08-01

    As children living with HIV (CLHIV) grow into adolescence and adulthood, caregivers and healthcare providers are faced with the sensitive challenge of when to disclose to a CLHIV his or her HIV status. Despite WHO recommendations for CLHIV to know their status, in countries most affected by HIV, effective resources are often limited, and national guidance on disclosure is often lacking. To address the need for effective resources, gray and scientific literature was searched to identify existing tools and resources that can aid in the disclosure process. From peer-reviewed literature, seven disclosure models from six different countries were identified. From the gray literature, 23 resources were identified including children's books (15), job aides to assist healthcare providers (5), and videos (3). While these existing resources can be tailored to reflect local norms and used to aid in the disclosure process, careful consideration must be taken in order to avoid damaging disclosure practices.

  9. Periradicular lesions in HIV-infected patients attending the faculty of dentistry : Clinical findings, sociodemographics status, habits and laboratory data - Seeking an association

    Fontes, Tatiana Vasconcellos; Ferreira, Sonia Maria Soares; Silva-Júnior, Arley; dos Santos Marotta, Patrícia; Noce, Cesar Werneck; de Carvalho Ferreira, Dennis; Gonçalves, Lucio Souza

    2014-01-01

    Objective: The purpose of this study was to estimate the prevalence of periradicular lesions in HIV-infected Brazilian patients and to assess the correlation of several factors with the periradicular status. Method: One hundred full-mouth periapical radiographs were evaluated. A total of 2,214 teeth

  10. Sociodemographic factors and prejudice toward HIV and hepatitis B/C status in a working-age population: results from a national, cross-sectional study in Japan.

    Hisashi Eguchi

    Full Text Available BACKGROUND: In many countries, HIV, hepatitis B virus (HBV, and hepatitis C virus (HCV infected individuals may face discrimination and mistreatment from coworkers. Effective interventions to reduce workplace discrimination are therefore needed to protect these vulnerable populations. The current study investigated potential associations between sociodemographic factors and prejudice toward HIV and HBV/HCV infected colleagues within a Japanese working population. METHODS: An online anonymous, nationwide internet survey was administered to a cross-section of approximately 3,000 individuals in Japan. The survey comprised 14 questions focusing on demographics (five items, basic HIV or HBV/HCV knowledge (eight items, and potential prejudice toward HIV or HBV/HCV infected colleagues (one item. The sociodemographic characteristics evaluated were sex, age, educational level, employment status, and individual income; with multiple logistic regression used for the analysis. RESULTS: In total, 3,055 individuals were recruited for the HIV related survey and 3,129 for the HBV/HCV related survey. Older age was significantly and positively associated with prejudice toward HIV infected colleagues (p<0.01 and negatively associated with prejudice toward HBV/HCV infected colleagues (p<0.01. Statistically significant associations were not observed between other sociodemographic characteristics and potential prejudice toward HIV and HBV/HCV infected coworkers. CONCLUSION: Overall, this study suggests that age may be associated with prejudice toward HIV and HBV/HCV infected colleagues among the working age population of Japan. As such, policy makers should consider the age of participants when formulating efforts to reduce prejudice toward HIV and HBV/HCV infected workers.

  11. Factors associated with HIV status disclosure to one's steady sexual partner in PLHIV in Morocco.

    Loukid, Mohamed; Abadie, Alise; Henry, Emilie; Hilali, Mohamed Kamal; Fugon, Lionel; Rafif, Nadia; Mellouk, Othoman; Lahoucine, Ouarsas; Otis, Joanne; Préau, Marie

    2014-02-01

    The objective of the present study was to determine the factors independently associated with disclosure of seropositivity to one's steady sexual partner in people living with HIV (PLHIV) who are recipients of services provided by Association de Lutte Contre le Sida, a Moroccan community-based organization (CBO) working on AIDS response. Between May and October 2011, 300 PLHIV were interviewed about their sociodemographic and economic characteristics, their sexual life and disclosure of their serostatus to their friends, family and to their steady sexual partner. A weighted logistic regression was used to study factors associated with serostatus disclosure to one's steady sexual partner. We restricted the analysis to people who declared they had a steady sexual partner (n = 124). Median age was 36 years old, 56 % were men and 62 % declared that they had disclosed their serostatus to their steady sexual partner. The following factors were independently associated with disclosure: living with one's steady sexual partner [OR 95 % CI: 9.85 (2.86-33.98)], having a higher living-standard index [2.06 (1.14-3.72)], regularly discussing HIV with friends [6.54 (1.07-39.77)] and CBO members [4.44 (1.27-15.53)], and having a higher social exclusion score [1.24 (1.07-1.44)]. Unemployment (as opposed to being a housewife) was negatively associated with disclosure [0.12 (0.02-0.87)]. Despite the potential positive effects for the prevention of HIV transmission and for adherence to HIV treatment, many PLHIV had not disclosed their serostatus to their steady sexual partner. Some factors shown here to be significantly associated with such disclosure will help in the development of future support interventions.

  12. Provider-initiated HIV testing & counselling in incident tuberculosis cases under National TB Programme conditions at a tertiary care teaching hospital in Tirupati, south India

    Alladi Mohan

    2017-01-01

    >Interpretation & conclusions: The findings of this study showed that a higher proportion of TB patients underwent HIV testing (75% compared to the national figure of 63 per cent in 2013-2014. HIV seropositivity (4.6% in TB patients who underwent HIV testing was similar to the five per cent figure observed at national level during 2013-2014. The HIV status of 25 per cent of patients with incident TB still remained unknown, suggesting a need for better integration and co-ordination for effective management of HIV-TB co-infection.

  13. Differences in knowledge, attitudes and behaviors of Israeli HIV-uninfected gay men in HIV-discordant vs. concordant steady relationships.

    Tairy, Daniel; Levy, Itzchak; Turner, Dan; Livnat, Yuval; Mor, Zohar

    2018-06-01

    HIV-discordant gay male couples may play an important role in HIV-transmissions. This cross-sectional study compared the knowledge, attitudes and sexual behaviors of HIV-uninfected gay men, between those in HIV-discordant and those in HIV-concordant steady relationships. Anonymous questionnaires were distributed electronically in designated gay-related internet sites and in AIDS-clinics in 2015. The dependent variable was defined as a steady relationship of an HIV-uninfected man with an HIV-infected partner. Risky sexual behavior was defined as unprotected anal intercourse (UAI) with a sex partner whose HIV-status was either positive or unknown. Of 2,319 responders, 460 (20%) were HIV-uninfected gay men in steady relationships, of whom 72 were in HIV-discordant relationships and 388 were in HIV-concordant relationships. Those in HIV-discordant relationships presented better established knowledge regarding HIV-transmission, more lenient attitudes regarding UAI, and reported being involved in riskier sexual behavior, both within and outside their steady relationship compared to men in HIV-concordant relationships. UAI was performed by 48% of the HIV-discordant couples and was associated with the use of sero-positioning strategy and with achieving undetectable viral-load. These findings reflect the complexity of constant use of condoms during long-term sero-discordant relationships. Targeted interventions for HIV-prevention in HIV-discordant couples should be employed for balancing the partners' desire for intimacy and sexual pleasure in the relationship, while reducing the risk for acquiring HIV. ART: Antiretroviral therapy; PEP: Post exposure prophylaxis; PrEP: Pre exposure prophylaxis; STI: Sexually transmitted infections; UAI: Unprotected anal intercourse.

  14. National HIV Testing Day

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses National HIV Testing Day, an annual observance which raises awareness of the importance of knowing one's HIV status and encourages at-risk individuals to get an HIV test.

  15. The dimensionality of disclosure of HIV status amongst post-partum ...

    Disclosure was commonplace in the sample, ranging from widely disclosing status (rare); to disclosing to some family, friends and partners; to tacit disclosure, where participants took medication in front of others without explicitly discussing their status. Women described reasons for non-disclosure in terms of not being ready ...

  16. Fever of unknown origin

    Misaki, Takashi; Matsui, Akira; Tanaka, Fumiko; Okuno, Yoshishige; Mitsumori, Michihide; Torizuka, Tatsurou; Dokoh, Shigeharu; Hayakawa, Katsumi; Shimbo, Shin-ichirou

    1990-01-01

    Gallium-67 scintigraphy is a commonly performed imaging modality in deteting pyrogenic lesions in cases of long-standing inexplainable fever. To re-evaluate the significance of gallium imaging in such cases, a retrospective review was made of 56 scans performed in febrile patients in whom sufficient clinical and laboratory findings were obtained. Gallium scans were true positive in 30 patients, false positive in 3, true negative in 19, and false negative in 4. In the group of true positive, local inflammatory lesions were detected in 23 patients with a final diagnosis of lung tuberculosis, urinary tract infection, and inflammatory joint disease. Abnormal gallium accumulation, as shown in the other 7 patients, provided clues to the diagnosis of generalized disorders, such as hematological malignancies (n=3), systemic autoimmune diseases (n=3), and severe infectious mononucleosis (n=one). In the group of false positive, gallium imaging revealed intestinal excretion of gallium in 2 patients and physiological pulmonary hilar accumulation in one. In the true negative group of 19 patients, fever of unknown origin was resolved spontaneously in 12 patients, and with antibiotics and corticosteroids in 2 and 5 patients, respectively. Four patients having false negative scans were finally diagnosed as having urinary tract infection (n=2), bacterial meningitis (n=one), and polyarteritis (n=one). Gallium imaging would remain the technique of choice in searching for origin of unknown fever. It may also be useful for early diagnosis of systemic disease, as well as focal inflammation. (N.K.)

  17. The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors.

    Gard, Tracy L; Hoover, Donald R; Shi, Qiuhu; Cohen, Mardge H; Mutimura, Eugene; Adedimeji, Adebola A; Anastos, Kathryn

    2013-10-01

    We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics. Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.

  18. Social, structural and behavioral determinants of overall health status in a cohort of homeless and unstably housed HIV-infected men.

    Elise D Riley

    Full Text Available Previous studies indicate multiple influences on the overall health of HIV-infected persons; however, few assess and rank longitudinal changes in social and structural barriers that are disproportionately found in impoverished populations. We empirically ranked factors that longitudinally impact the overall health status of HIV-infected homeless and unstably housed men.Between 2002 and 2008, a cohort of 288 HIV+ homeless and unstably housed men was recruited and followed over time. The population was 60% non-Caucasian and the median age was 41 years; 67% of study participants reported recent drug use and 20% reported recent homelessness. At baseline, the median CD4 cell count was 349 cells/µl and 18% of eligible persons (CD490% ranked 5th for its positive influence on mental health, and viral load ranked 4th for its negative influence on physical health.The inability to meet food, hygiene, and housing needs was the most powerful predictor of poor physical and mental health among homeless and unstably housed HIV-infected men in an urban setting. Impoverished persons will not fully benefit from progress in HIV medicine until these barriers are overcome, a situation that is likely to continue fueling the US HIV epidemic.

  19. Current status of herpesvirus identification in the oral cavity of HIV-infected children

    Raquel dos Santos Pinheiro

    2013-01-01

    Full Text Available INTRODUCTION: Some viruses of the Herpesviridae family are frequently the etiologic agents of oral lesions associated with HIV. The aim of this study was to identify the presence of herpes simplex virus types 1 and 2 (HSV-1, HSV-2, Varicella Zoster virus (VZV, Epstein-Barr virus (EBV, human cytomegalovirus (HCMV, human herpesvirus type 6, type 7 and type 8 (HHV-6, HHV-7 and HHV-8 in the oral cavity of HIV-infected children/adolescents and verify the association between viral subtypes and clinical factors. METHODS: The cells of oral mucosa were collected from 50 HIV infected children/adolescents, 3-13 years old (mean age 8.66. The majority (66% of selected were girls, and they were all outpatients at the pediatric AIDS clinic of a public hospital in Rio de Janeiro. Nested-PCR was used to identify the viral types. RESULTS: Absence of immunosuppression was observed in 66% of the children. Highly active antiretroviral therapy (HAART was used by 72.1% of selected and moderate viral load was observed in 56% of the children/adolescents. Viral types were found in 86% of the children and the subtypes were: HSV-1 (4%, HSV-2 (2%, VZV (4%, EBV (0%, HCMV (24%, HHV6 (18%, HHV-7 (68%, HHV8 (0%. CONCLUSIONS: The use of HAART has helped to reduce oral lesions, especially with herpes virus infections. The health professionals who work with these patients should be aware of such lesions because of their predictive value and the herpes virus can be found circulating in the oral cavity without causing lesions.

  20. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs.

    Zulu, Rodah M; Byrne, Nuala M; Munthali, Grace K; Chipeta, James; Handema, Ray; Musonda, Mofu; Hills, Andrew P

    2011-09-21

    Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Pan African Clinical Trial Registry PACTR201108000303396.

  1. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

    Musonda Mofu

    2011-09-01

    Full Text Available Abstract Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW and derive fat-free mass (FFM and fat mass (FM. Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI, body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396.

  2. Beyond Condoms: Risk Reduction Strategies Among Gay, Bisexual, and Other Men Who Have Sex With Men Receiving Rapid HIV Testing in Montreal, Canada.

    Otis, Joanne; McFadyen, Amélie; Haig, Thomas; Blais, Martin; Cox, Joseph; Brenner, Bluma; Rousseau, Robert; Émond, Gilbert; Roger, Michel; Wainberg, Mark

    2016-12-01

    Gay, bisexual, and other men who have sex with men (MSM) have adapted their sexual practices over the course of the HIV/AIDS epidemic based on available data and knowledge about HIV. This study sought to identify and compare patterns in condom use among gay, bisexual, and other MSM who were tested for HIV at a community-based testing site in Montreal, Canada. Results showed that while study participants use condoms to a certain extent with HIV-positive partners and partners of unknown HIV status, they also make use of various other strategies such as adjusting to a partner's presumed or known HIV status and viral load, avoiding certain types of partners, taking PEP, and getting tested for HIV. These findings suggest that MSM who use condoms less systematically are not necessarily taking fewer precautions but may instead be combining or replacing condom use with other approaches to risk reduction.

  3. [Badminton--unknown sport].

    Zekan-Petrinović, Lidija

    2007-01-01

    For a long time, badminton was considered to be only a slow and light game for children, a game that is played outdoors and is structurally undemanding.Today, it is not an unknown and unrecognised sport, especially after it was included into the Olympics Games in 1992. Badminton is one of the oldest sports in the world. It is suitable for all ages (for children and elderly equally), women and men and even handicapped persons. Beginners can start playing badminton matches early because the basics are learned quickly. As a recreational activity, badminton is very popular in Zagreb. In the last 10 years, a number of halls specialized for badminton or offering badminton as one of available sports activities have been opened in Zagreb. At present, there are over 70 professional playgrounds for training of top contestants but also for the citizens who can play recreational badminton.

  4. Factors Associated With Forensic Nurses Offering HIV nPEP Status Post Sexual Assault.

    Draughon, Jessica E; Hauda, William E; Price, Bonnie; Rotolo, Sue; Austin, Kim Wieczorek; Sheridan, Daniel J

    2015-09-01

    Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making. © The Author(s) 2014.

  5. Erysipelothrix rhusiopathiae and Mycoplasma hyopneumoniae: the sensitivities of enzyme-linked immunosorbent assays for detecting vaccinated sows of unknown disease status using serum and colostrum, and the correlation of the results for sow serum, colostrum, and piglet serum.

    Jenvey, Caitlin J; Reichel, Michael P; Cockcroft, Peter D

    2015-03-01

    Due to relatively high concentrations of immunoglobulins, colostrum has the potential to improve the sensitivity of diagnostic tests for diseases in pigs when compared with serum. It is possible that colostrum could improve the sensitivity of the antibody enzyme-linked immunosorbent assay (ELISA) compared with serum. Colostrum is also essential for piglets, providing protection against infections in the first few weeks and months of life. The sensitivity of 2 commercially available ELISAs, one for the detection of Erysipelothrix rhusiopathiae and the second for Mycoplasma hyopneumoniae antibodies, when used with sow colostrum in comparison with serum was investigated. The correlation of maternal E. rhusiopathiae- and M. hyopneumoniae-specific antibody levels with specific-antibody serum levels in the piglet was also determined. The sensitivity was defined as the proportion of vaccinated sows that were correctly identified as vaccinated at a given cutoff point. The true disease status of the sows with regard to the 2 infections was unknown. Blood and colostrum samples were collected from 20 sows, 10 primiparous and 10 multiparous, and blood samples were also collected from the piglets of each sow, 48-72 hr post-farrowing. The sensitivities of both ELISAs were significantly improved when using colostrum compared with serum. Sow serum and colostrum optical density (OD) values were significantly correlated. The mean sow OD values for serum for E. rhusiopathiae and M. hyopneumoniae and colostrum for E. rhusiopathiae were significantly correlated with piglet serum OD levels. If the improved sensitivity of colostrum can be demonstrated in infected animals, this will increase the ability of the test to identify infected animals using both individual and pooled colostrum. Testing serum and/or colostrum using ELISA can be useful predictors of piglet disease-specific OD values. © 2015 The Author(s).

  6. Doing battle with "the monster:" how high-risk heterosexuals experience and successfully manage HIV stigma as a barrier to HIV testing.

    Gwadz, Marya; Leonard, Noelle R; Honig, Sylvie; Freeman, Robert; Kutnick, Alexandra; Ritchie, Amanda S

    2018-04-20

    Annual HIV testing is recommended for populations at-risk for HIV in the United States, including heterosexuals geographically connected to urban high-risk areas (HRA) with elevated rates of HIV prevalence and poverty, who are primarily African American/Black or Hispanic. Yet this subpopulation of "individuals residing in HRA" (IR-HRA) evidence low rates of regular HIV testing. HIV stigma is a recognized primary barrier to testing, in part due to its interaction with other stigmatized social identities. Guided by social-cognitive and intersectionality theories, this qualitative descriptive study explored stigma as a barrier to HIV testing and identified ways IR-HRA manage stigma. In 2012-2014, we conducted in-depth qualitative interviews with 31 adult IR-HRA (74% male, 84% African American/Black) with unknown or negative HIV status, purposively sampled from a larger study for maximum variation on HIV testing experiences. Interviews were audio-recorded and professionally transcribed verbatim. Data were analyzed using a systematic content analysis approach that was both theory-driven and inductive. Stigma was a primary barrier to HIV testing among IR-HRA. In the context of an under-resourced community, HIV stigma was experienced as emerging from, and being perpetuated by, health care organizations and educational institutions, as well as community members. Participants noted it was "better not to know" one's HIV status, to avoid experiencing HIV-related stigma, which could interact with other stigmatized social identities and threaten vital social relationships, life chances, and resources. Yet most had tested for HIV previously. Factors facilitating testing included health education to boost knowledge of effective treatments for HIV; understanding HIV does not necessitate ending social relationships; and tapping into altruism. In the context of economic and social inequality, HIV stigma operates on multiple, intersecting layers. IR-HRA struggle with an aversion to

  7. "You just can't trust everybody": the impact of sexual risk, partner type and perceived partner trustworthiness on HIV-status disclosure decisions among HIV-positive black gay and bisexual men.

    Bird, Jason D P; Eversman, Michael; Voisin, Dexter R

    2017-08-01

    HIV remains an intractable public health concern in the USA, with infection rates notably concentrated among Black gay and bisexual men. Status disclosure by HIV-positive individuals can be an important aspect of risk reduction but doing so poses dilemmas concerning privacy, stigma and self-protection, especially among populations subjected to multiple types of stigmatisation. Understanding the factors related to the disclosure process can help to inform prevention efforts. Using exploratory in-depth interviews, this qualitative study examines the disclosure process among a sample of twenty HIV-positive Black gay and bisexual men (mean age = 40) recruited through a non-profit health centre in a mid-western city in the USA. Data were analysed using a thematic analysis approach with HIV-disclosure as an a priori sensitising concept. Fears of stigma and secondary disclosure within social networks were critical barriers to talking about HIV with sexual partners and disclosure decisions involved a complex process centred on three primary themes: degree of sexual risk, partner type and perceived partner trustworthiness. The unique combinations of these contextual factors resulted in increased or decreased likelihood of disclosure. A conceptual model explicating a potential process by which these contextual factors influence disclosure decisions is presented.

  8. Evaluating the utility of provider-recorded clinical status in the medical records of HIV-positive adults in a limited-resource setting

    Stonbraker, Samantha; Befus, Montina; Nadal, Leonel Lerebours; Halpern, Mina; Larson, Elaine

    2016-01-01

    Provider-reported summaries of clinical status may assist with clinical management of HIV in resource poor settings if they reflect underlying biological processes associated with HIV disease progression. However, their ability to do so is rarely evaluated. Therefore, we aimed to assess the relationship between a provider-recorded summary of clinical status and indicators of HIV progression. Data were abstracted from 201 randomly selected medical records at a large HIV clinic in the Dominican Republic. Multivariable logistic regressions were used to examine the relationship between provider-assigned clinical status and demographic (gender, age, nationality, education) and clinical factors (reported medication adherence, CD4 cell count, viral load). The mean age of patients was 41.2 (SD = ±10.9) years and most were female (n = 115, 57%). None of the examined characteristics were significantly associated with provider-recorded clinical status. Higher CD4 cell counts were more likely for females (OR = 2.2 CI: 1.12–4.31) and less likely for those with higher viral loads (OR = 0.33 CI: 0.15–0.72). Poorer adherence and lower CD4 cell counts were significantly associated with higher viral loads (OR = 4.46 CI: 1.11–20.29 and 6.84 CI: 1.47–37.23, respectively). Clinics using provider-reported summaries of clinical status should evaluate the performance of these assessments to ensure they are associated with biologic indicators of disease progression. PMID:27495146

  9. [Evolution of the nutritional status of patients with HIV-AIDS. Effects of socioeconomic situation and dietetic counseling].

    Sánchez Alvarez, M C; Gómez Ramos, M J; Cano Sánchez, A; Pacheco Guevara, R; Nicolás Hernández, M; García Alberola, A

    1998-12-01

    To know HIV-AIDS patient's nutritional status in different infection's condition and their relation with the socioeconomic situation and, in that case, the nutritional condition improvement through the dietetic advice appropriated for each patient. Prospective study of 79 patients with HIV-AIDS diagnostic in any illness's condition and recopilation of anthropometrics and biochemical variables. At the beginning of the study we got data about socioeconomic situation of patient with a scale of 1 to 5 points each variable and an score top of 35. In the survivors we checked, after dietetic advice, the variables at 6 and 12 months by sanitary personal (physician and nurse) who weren't implicated in direct assistance. The study was analyzed by Student "T" for matched data and the simple correlation test. We have objectivated a lost of initial weight over their habitual's with a progressive impairment in different stage of evolution that weren't modified by dietetic advice. We didn't observed significant variations in the biochemical variables included in advances states and in parameters which are usually affected in malnutrition. In the analysis of relation between nutritional condition and socioeconomic factors, it was estimated a lesser score, that was statistically significative, in patients who had a work, family situation and an affective upset positive. The results obtained induce to think that the nutritional advices appropriated for each patient are not related, in our series, with progressive deterioration of anthropometrics variables, neither biochemical parameters fluctuations at 6, 12 months of follow-up. The patient's socioeconomic situation is not influenced by nutritional condition except for the work, affectivity and family environment.

  10. Changing Patterns of lung, liver, and head and neck non-AIDS-defining cancers relative to HIV status in Tanzania between 2002-2014

    Julee A. Campbell

    2016-11-01

    Full Text Available Abstract Background Tanzania, like other low-income countries, has an increasing cancer burden that remains underestimated. Infection-associated malignancies, particularly HIV-infection, represent a great proportion of cancer burden in Tanzania and throughout Africa. Availability of HIV treatment and improved survival of HIV patients are suggested factors related to increasing prevalence of non-AIDS-defining cancers (NADCs. This study examined patterns of NADCs and proportions of HIV-positivity at the Ocean Road Cancer Institute (ORCI. Methods We reviewed logbooks of all ORCI patients diagnosed and/or treated for lung, liver, and head and neck cancers during 2002–2014. The number of total cancers diagnosed at ORCI during this period was used to calculate proportions of NADCs. We abstracted medical records to obtain demographic and clinical profiles and HIV status information for 1127 patients diagnosed or treated during 2010–2014. Trends in numbers and proportions of NADCs were analyzed using Joinpoint regression. Characteristics of NADC patients were analyzed using multinomial logistic regression. Results NADCs diagnosed at ORCI increased by 33.8% from 2002 to 2014 while the proportion of NADCs relative to all cancers significantly decreased from 6.8% in 2002 to 5.6% in 2014 (APC = -2.74%. Numbers and proportions of lung and liver cancers increased compared to all cancer diagnoses from 2002 to 2014. The number of head and neck cancers increased while decreasing proportionally compared to all cancer diagnoses from 2002 to 2014. Among patients with pathologically confirmed NADCs between 2010 and 2014, HIV prevalence showed a non-statistically significant decrease from 8.1 to 7.1% (APC = -3.77%. Conclusions Absolute numbers of lung, liver, and head and neck cancers increased at ORCI by 1/3 since 2002. Improving survivorship of HIV patients and varying immunodeficiency status may have contributed to the increasing number of NADCs. Total

  11. Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era.

    Zlotorzynska, Maria; Spaulding, Anne C; Messina, Lauren C; Coker, Daniella; Ward, Kevin; Easley, Kirk; Baillargeon, Jacques; Mink, Pamela J; Simard, Edgar P

    2016-04-11

    Non-AIDS-defining cancers (NADCs) have emerged as significant contributors to cancer mortality and morbidity among persons living with HIV (PLWH). Because NADCs are also associated with many social and behavioural risk factors that underlie HIV, determining the extent to which each of these factors contributes to NADC risk is difficult. We examined cancer incidence and mortality among persons with a history of incarceration, because distributions of other cancer risk factors are likely similar between prisoners living with HIV and non-infected prisoners. Registry-based retrospective cohort study. Cohort of 22,422 persons incarcerated in Georgia, USA, prisons on 30 June 1991, and still alive in 1998. Cancer incidence and mortality were assessed between 1998 and 2009, using cancer and death registry data matched to prison administrative records. Age, race and sex-adjusted standardised mortality and incidence ratios, relative to the general population, were calculated for AIDS-defining cancers, viral-associated NADCs and non-infection-associated NADCs, stratified by HIV status. There were no significant differences in cancer mortality relative to the general population in the cohort, regardless of HIV status. In contrast, cancer incidence was elevated among the PLWH. Furthermore, incidence of viral-associated NADCs was significantly higher among PLWH versus those without HIV infection (standardised incidence ratio=6.1, 95% CI 3.0 to 11.7, pcancer incidence was elevated relative to the general population, likely related to increased prevalence of oncogenic viral co-infections. Cancer prevention and screening programmes within prisons may help to reduce the cancer burden in this high-risk population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Social, structural and behavioral determinants of overall health status in a cohort of homeless and unstably housed HIV-infected men.

    Riley, Elise D; Neilands, Torsten B; Moore, Kelly; Cohen, Jennifer; Bangsberg, David R; Havlir, Diane

    2012-01-01

    Previous studies indicate multiple influences on the overall health of HIV-infected persons; however, few assess and rank longitudinal changes in social and structural barriers that are disproportionately found in impoverished populations. We empirically ranked factors that longitudinally impact the overall health status of HIV-infected homeless and unstably housed men. Between 2002 and 2008, a cohort of 288 HIV+ homeless and unstably housed men was recruited and followed over time. The population was 60% non-Caucasian and the median age was 41 years; 67% of study participants reported recent drug use and 20% reported recent homelessness. At baseline, the median CD4 cell count was 349 cells/µl and 18% of eligible persons (CD4effects of behavioral, social, and structural factors on overall physical and mental health status (measured by the SF-36), and targeted variable importance (tVIM) was used to empirically rank factors by their influence. After adjusting for confounding, and in order of their influence, the three factors with the strongest negative effects on physical health were unmet subsistence needs, Caucasian race, and no reported source of instrumental support. The three factors with the strongest negative effects on mental health were unmet subsistence needs, not having a close friend/confidant, and drug use. ART adherence >90% ranked 5th for its positive influence on mental health, and viral load ranked 4th for its negative influence on physical health. The inability to meet food, hygiene, and housing needs was the most powerful predictor of poor physical and mental health among homeless and unstably housed HIV-infected men in an urban setting. Impoverished persons will not fully benefit from progress in HIV medicine until these barriers are overcome, a situation that is likely to continue fueling the US HIV epidemic.

  13. National HIV Testing Day

    2011-06-09

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses National HIV Testing Day, an annual observance which raises awareness of the importance of knowing one's HIV status and encourages at-risk individuals to get an HIV test.  Created: 6/9/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 6/9/2011.

  14. Stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia: a longitudinal study.

    Haile, Demewoz; Belachew, Tefera; Berhanu, Getenesh; Setegn, Tesfaye; Biadgilign, Sibhatu

    2014-12-01

    Even though many studies showed that infant and child feeding index has a statistically significant association with nutritional status, there is paucity of studies on stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants. This study aimed to investigate the stability of infant and child feeding index over time that is developed based on the current recommendations and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia. A panel study design was conducted in health institutions in Sidama Zone from February to July, 2012. Three repeated measurements of data were collected from each HIV exposed infant aged 6-17 months over the 6 month follow-up period approximately per 2 month interval. The cross-sectional index was found stable overtime with the repeatability coefficient of 0.802 which differed significantly from zero (95% CI: 0.75-0.85). A longitudinal infant and child feeding index (L-ICFI) has a statistically significant association with length for age Z scores (LAZ) and weight for age Z scores (WAZ) at visit three (β=0.262, p=0.007; β=0.226, p=0.017), respectively. But the longitudinal index has no statistically significant association with WLZ score (p=0.552). There was no significant difference in change of LAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. The index is stable overtime at individual level even though one third of the index components were not stable. The L-CFI was associated with LAZ and WAZ but not with WLZ. However there was no significant difference in change of HAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Nutritional status is the major factor affecting grip strength of African HIV patients before and during antiretroviral treatment

    Filteau, Suzanne; PrayGod, G; Woodd, Susannah L

    2017-01-01

    OBJECTIVES: Low grip strength is a marker of frailty and a risk factor for mortality among HIV patients and other populations. We investigated factors associated with grip strength in malnourished HIV patients at referral to ART, and at 12 weeks and 2-3 years after starting ART. METHODS: The study...... involved HIV-infected Zambian and Tanzanian participants recruited to the NUSTART trial when malnourished (body mass index .... CONCLUSIONS: In this population of originally malnourished HIV patients, poor grip strength was more strongly and independently associated with nutritional than with infection and inflammation variables. Programmes to improve health and survival of HIV patients should incorporate nutritional assessment...

  16. 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.

  17. Importance of vitamin and mineral supplementation in HIV/AIDS patients to improve their nutritional and immunological status

    Oguntibeju, O.O.; Schalkwyk, F.V; Heever, WMJ. V.den.; Veldman, F.J.

    2003-01-01

    Nutrition intervention aimed at preventing or reversing weight loss and wasting in HIV infection may help to improve quality of life and prolong survival. Micronutrient supplementation may help to strengthen the immune system and reduce the severity and impact of opportunistic infections in people living with HIV / AIDS. HIV contributes to malnutrition for physiological reasons related to the infection itself. HIV /AIDS, being a disease of the immune system, new strategies, including specific dietary nutrients (nutrient supplementation) to improve immune functions, quality of life and prolong survival in infected individuals, could provide additional/alternative approaches for therapeutic treatment in HIV infected subjects. Several vitamins and minerals are important in fighting HIV infection and its resultant effects, hence nutritional supplementation has been advocated. This review focuses on the importance of vitamin/mineral supplementation in HIV / AIDS subjects. (author)

  18. Coping strategies, mental health and HIV status: Predictors of suicidal behaviour among PWIDs

    Akram, B.; Ilyas, M.

    2017-01-01

    To understand suicidal behaviour among people who inject drugs. Methods: This correlational, cross-sectional study was conducted in two Pakistani cities of Gujrat and Jhelum from October 2015 to March 2016, and comprised male injecting-drug users aged18-60 years. Multistage systematic random sampling method was used. Urdu-translated versions of the brief cope inventory, mental health status scale and suicidal behaviour questionnaire (revised) were administered. SPSS 16 was used for data analysis. Results: Of the 200 participants, 83(41.5%) were aged 26-32 years. The prevalence of human immunodeficiency virus was in 94(47%) cases. Suicidal behaviour was positively associated with psychological distress and human immunodeficiency virus status (p<0.05), whereas it was negatively associated with mental health, psychological well-being and coping strategies (p<0.05). Regression analysis showed mental health index and psychological well-being were negative predictors, whereas psychological distress and human immunodeficiency virus status were positive predictors of suicidal behaviour among the participants (p<0.05). Conclusion: The level of stress led people who inject drugs towards suicidal behaviour. However, the level of stress varied according to the severity of human immunodeficiency virus and poor mental health. (author)

  19. In-Country Migration and Risk Factors for HIV Acquisition among Pregnant Women in Tijuana, Mexico.

    Viani, Rolando M; Araneta, Maria R; Spector, Stephen A

    2016-05-01

    To compare HIV prevalence and HIV acquisition risk behaviors between pregnant women residents and migrants. A cross-sectional study of pregnant women of unknown HIV status seeking care at Tijuana General Hospital, Mexico. Pregnant women attending the labor and delivery unit or the prenatal clinic had a rapid HIV test drawn, with positive results confirmed by Western blot. Migrants were defined as women who had resided in Tijuana for less than 5 years. Between 2007 and 2008, a total of 3331 pregnant women consented to participate. The HIV seroprevalence did not differ between Tijuana residents (18 of 2502, 0.72%) and migrants (3 of 829, 0.36%, P = .32). In multivariate regression analyses, HIV acquisition risk behaviors included methamphetamine use (adjusted odds ratio [OR]: 6.03, 95% confidence interval [CI]: 2.3-15.8, P Tijuana residents and migrants. © The Author(s) 2014.

  20. Recension: Mao - The Unknown Story

    Clausen, Søren

    2005-01-01

    Anmeldelse - kritisk! - til Sveriges førende Kinatidsskrift af Jung Chang & Jon Halliday's sensationelle "Mao - the Unknown Story".......Anmeldelse - kritisk! - til Sveriges førende Kinatidsskrift af Jung Chang & Jon Halliday's sensationelle "Mao - the Unknown Story"....

  1. Mediation and moderation: Testing relationships between symptom status, functional health, and quality of life in HIV patients

    Ryu, Ehri; West, Stephen G.; Sousa, Karen H.

    2010-01-01

    We extended Wilson and Cleary's (1995) health-related quality of life model to examine the relationships among symptoms status (Symptoms), functional health (Disability), and quality of life (QOL). Using a community sample (N = 956) of male HIV positive patients, we tested a mediation model in which the relationship between Symptoms and QOL is partially mediated by Disability. Common and unique ideas from three approaches to examining moderation of effects in mediational models (Edwards & Lambert, 2007; Preacher, Rucker, & Hayes, 2007; MacKinnon, 2008) were used to test whether (a) the direct relationship of Symptoms to QOL and (b) the relationship of Disability to QOL are moderated by age. In the mediation model, both the direct and the indirect (mediated) effects were significant. The direct relationship of Symptoms to QOL was significantly moderated by age, but the relationship of Disability to QOL was not. High Symptoms were associated with lower QOL at all ages, but that this relationship became stronger at older ages. We compare the three approaches and consider their advantages over traditional approaches to combining mediation and moderation. PMID:20706561

  2. AN ASSESSMENT OF THE STATUS OF HIV COUNSELLING AND TESTING FACILITY IN GOVERNMENT HOSPITALS OF DISTRICT JHANSI UTTAR PRADESH

    Atul Kumar Singh

    2010-06-01

    Full Text Available Background: Counseling is the face to face communication by which counselor can help the person” client to make decisions and act on them, Effective Counseling and Testing programs can help patients identify and limit- behaviors that increase the risk of’ HIV infection or transmission. Objective: ToAssess the status of HlV Counseling and Testing facilities in Government Hospitals of District Jhansi. Study design: Cross-sectional study. Settings: Four Government Hospitals namely Mèdical College, District Hospital, Railway Hospital and Military Hospital of district Jhansi. Study Period: Two months (l5th August to 15’ October 2008. StatisticalAnalysis: Percentages Results: In most (87.5% of the sessions of all the centers only signature of the patients was taken instead of filling the full consent form whereas rapport with the patients by the counselor was maintained only in 37.5% sessions. In 80% of the sessions the patients were not been told about ‘window period” by the counselors. In 75% of the sessions counselors were not fully attentive towards patient’s concerns. Only in 5% sessions patients were correctly informed about HI V/AIDS. In all the centers, there was no provision for group- session and usually the test results of HlV infection (positive or negative was not provided on the very same day, due to heavy patient load.

  3. Self-Reported HIV-Positive Status But Subsequent HIV-Negative Test Result Using Rapid Diagnostic Testing Algorithms Among Seven Sub-Saharan African Military Populations

    2017-07-07

    analysis, data interpretation, or writing of the report. Leidos provided support in the form of salaries for JH, BRT, AGT, MBJ and JM but did not have any...have data on a QA process. The survey used for all seven partner mili- taries was based on a standardized modular survey, which assessed HIV risk... Technical considerations Technical limitations have been shown to increase false-positive HIV test results in voluntary counseling and testing centers

  4. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  5. Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam.

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

    2013-11-13

    HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. There was little urban-rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (pinequality and HIV-related stigma is superseded by the effect of individual-level education. The results of the study confirm that socioeconomic factors at both the individual level and community level affect different types of stigma in different ways. Attention should be paid to these

  6. Changes in Bone Mineral Density, Body Composition, Vitamin D Status, and Mineral Metabolism in Urban HIV-Positive South African Women Over 12 Months.

    Hamill, Matthew M; Pettifor, John M; Ward, Kate A; Norris, Shane A; Prentice, Ann

    2017-08-01

    Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are associated with bone loss and poor vitamin D status in white populations, though their relative roles are not known. No previous studies have examined longitudinal changes in areal bone mineral density (aBMD), measured by dual-energy X-ray absorptiometry (DXA), or in vitamin D status in HIV-positive African women. Of 247 premenopausal, urban, black African women from Soweto, South Africa, initially recruited, 187 underwent anthropometry, DXA scanning and blood and urine collections at both baseline and 12 months. Of these, 67 were HIV-negative throughout (Nref), 60 were HIV-positive with preserved CD4 counts at baseline (Ppres), and 60 were HIV-positive with low CD4 counts at baseline, eligible for ART by South African standards of care at the time (Plow). No participant had been exposed to ART at baseline. By 12 months, 51 Plow women had initiated ART, >85% of whom took combined tenofovir disoproxil fumarate (TDF), lamivudine, and efavirenz. By 12 months, Plow and Nref, but not Ppres, increased in body weight and fat mass (group-by-timepoint p ≤ 0.001, p = 0.002, respectively). Plow had significant decreases in aBMD of 2% to 3%, before and after size adjustment, at the femoral neck (p ≤ 0.002) and lumbar spine (p ≤ 0.001), despite significant weight gain. These decreases were associated with increased bone turnover but there were no significant differences or changes over time in vitamin D status, serum phosphate concentrations, or renal phosphate handling. Excluding data from nine Plow women unexposed to ART and 11 Ppres women who had initiated ART accentuated these findings, suggesting the bone loss in Plow was related to ART exposure. This is the first study describing DXA-defined bone loss in HIV-positive Sub-Saharan African women in association with ART. Further work is required to establish if bone loss continues with ongoing ART and, if so, whether this

  7. Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men.

    Wagner, Glenn J; Bogart, Laura M; Klein, David J; Green, Harold D; Mutchler, Matt G; McDavitt, Bryce; Hilliard, Charles

    2016-08-01

    We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions.

  8. Sex position, marital status, and HIV risk among Indian men who have sex with men: clues to optimizing prevention approaches.

    Hemmige, Vagish; Snyder, Hannah; Liao, Chuanhong; Mayer, Kenneth; Lakshmi, Vemu; Gandham, Sabitha R; Orunganti, Ganesh; Schneider, John

    2011-12-01

    A divide exists between categories of men who have sex with men (MSM) in India based on their sex position, which has consequences for the design of novel HIV prevention interventions. We examine the interaction between sex position and other attributes on existing HIV risk including previous HIV testing, unprotected anal intercourse (UAI), and HIV serostatus among MSM recruited from drop-in centers and public cruising areas in the twin cities of Hyderabad and Secunderabad, India. A survey was administered by trained research assistants and minimally invasive HIV testing was performed by finger-stick or oral testing. HIV seropositive MSM underwent CD4+ lymphocyte count measurement. In our sample (n = 676), 32.6% of men were married to women, 22.2% of receptive only participants were married, and 21.9% of men were HIV seropositive. In bivariate analysis, sex position was associated with previous HIV testing, UAI, HIV serostatus, and CD4+ lymphocyte count at diagnosis. In multivariate analysis with interaction terms, dual unmarried men were more likely to have undergone an HIV test than insertive unmarried men (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.2-6.5), a relationship that did not hold among married men. Conversely, dual married men were less likely than insertive married men to engage in UAI (OR 0.3; 95% CI 0.1-0.6), a relationship that did not hold among unmarried men. Further implementation research is warranted in order to best direct novel biologic and behavioral prevention interventions towards specific risk behaviors in this and other similar contexts.

  9. HIV Testing and Counselling in Colombia: Local Experience on Two Different Recruitment Strategies to Better Reach Low Socioeconomic Status Communities

    Jaime Galindo-Quintero

    2014-01-01

    Full Text Available HIV testing rates remain very low in Colombia, with only 20% of individuals at risk ever tested. In order to tackle this issue, the Corporacion de Lucha Contra el Sida (CLS has implemented a multidisciplinary, provider-initiated, population-based HIV testing/counselling strategy named BAFI. In this report, we describe the experience of CLS at reaching populations from low socioeconomic backgrounds in 2008-2009. Two different approaches were used: one led by CLS and local health care providers (BAFI-1 and the other by CLS and community leaders (BAFI-2. Both approaches included the following: consented HIV screening test, a demographic questionnaire, self-reported HIV knowledge and behaviour questionnaires, pre- and posttest counselling, confirmatory HIV tests, clinical follow-up, access to comprehensive care and antiretroviral treatment. A total of 2085 individuals were enrolled in BAFI-1 and 363 in BAFI-2. The effectiveness indicators for BAFI-1 and BAFI-2, respectively, were HIV positive-confirmed prevalence = 0.29% and 3.86%, return rate for confirmatory results = 62.5% and 93.7%, return rate for comprehensive care = 83.3% and 92.8%, and ART initiation rate = 20% and 76.9%. Although more people were reached with BAFI-1, the community-led BAFI-2 was more effective at reaching individuals with a higher prevalence of behavioural risk factors for HIV infection.

  10. HIV Testing and Counselling in Colombia: Local Experience on Two Different Recruitment Strategies to Better Reach Low Socioeconomic Status Communities

    Galindo-Quintero, Jaime; Mueses-Marin, Hector Fabio; Montaño-Agudelo, David; Pinzón-Fernández, María Virginia; Tello-Bolívar, Inés Constanza; Alvarado-Llano, Beatriz Eugenia; Martinez-Cajas, Jorge Luis

    2014-01-01

    HIV testing rates remain very low in Colombia, with only 20% of individuals at risk ever tested. In order to tackle this issue, the Corporacion de Lucha Contra el Sida (CLS) has implemented a multidisciplinary, provider-initiated, population-based HIV testing/counselling strategy named BAFI. In this report, we describe the experience of CLS at reaching populations from low socioeconomic backgrounds in 2008-2009. Two different approaches were used: one led by CLS and local health care providers (BAFI-1) and the other by CLS and community leaders (BAFI-2). Both approaches included the following: consented HIV screening test, a demographic questionnaire, self-reported HIV knowledge and behaviour questionnaires, pre- and posttest counselling, confirmatory HIV tests, clinical follow-up, access to comprehensive care and antiretroviral treatment. A total of 2085 individuals were enrolled in BAFI-1 and 363 in BAFI-2. The effectiveness indicators for BAFI-1 and BAFI-2, respectively, were HIV positive-confirmed prevalence = 0.29% and 3.86%, return rate for confirmatory results = 62.5% and 93.7%, return rate for comprehensive care = 83.3% and 92.8%, and ART initiation rate = 20% and 76.9%. Although more people were reached with BAFI-1, the community-led BAFI-2 was more effective at reaching individuals with a higher prevalence of behavioural risk factors for HIV infection. PMID:24592330

  11. The Impact of Homophobia and HIV Stigma on HIV Testing Uptake Among Chinese Men Who Have Sex With Men: a Mediation Analysis.

    Wei, Chongyi; Cheung, Doug H; Yan, Hongjing; Li, Jianjun; Shi, Ling-en; Raymond, Henry F

    2016-01-01

    Gay and HIV-related stigma and discrimination are major barriers to accessing HIV prevention services among Men Who Have Sex with Men (MSM) worldwide. We aimed to identify modifiable factors that mediate the relationships between gay and HIV-related stigma and discrimination and HIV testing uptake among Chinese MSM. We conducted a cross-sectional survey study of 523 HIV-uninfected or unknown HIV status MSM in Jiangsu Province, China between November 2013 and January 2014. Multivariable analyses were conducted to examine the associations among experienced homophobia, HIV stigma, and recent HIV testing. Causal mediation parametric analyses were conducted to assess whether depression and social norms mediated hypothesized associations. Stronger subjective norms toward testing was associated with higher odds of recent HIV testing (adjusted odds ratio [AOR]: 1.10, 95% confidence interval [CI]: 1.01 to 1.21), whereas increasing levels of depression and HIV stigma were both associated with lower odds of recent testing (AOR: 0.96, 95% CI: 0.92 to 0.99; and AOR: 0.91, 95% CI: 0.84 to 0.99, respectively). There was an indirect relationship (natural indirect effect [NIE]) of experienced homophobia on recent testing (ORNIE: 0.96, 95% CI: 0.93 to 0.98) mediated (35.0%) through depression. Furthermore, there was an indirect relationship of HIV stigma on recent testing (ORNIE: 0.98, 95% CI: 0.95 to 0.99) mediated (19.2%) through subjective norms. Depression and social norms are important mediators of HIV testing uptake among stigmatized Chinese MSM. Therefore, in addition to advocacy efforts and policies that address social-level stigma and discrimination, HIV prevention programs should also address mental health issues and incorporate community-based approaches to changing social norms toward HIV testing.

  12. Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam

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

    2013-01-01

    Introduction HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. Methods A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. Results There was little urban–rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (pstigma (HIV and drug related) reported by both PWID and community members. Part-time employed PWID reported more experiences and perceptions of drug-related stigma, while conversely unemployed community members reported enacting lower drug-related stigma

  13. Data-protection standards and confidentiality of HIV/AIDS status in the workplace - a South African case study.

    Muskat-Gorska, Zuzanna

    2008-11-01

    The article contextualises an emerging new regime for information privacy in South Africa (i.e. the draft Protection of Personal Information Bill). Subsequently, it discusses the possibility of successful implementation of international data-protection standards in an environment where there is an urgent need to balance HIV/AIDS confidentiality rights with public health requirements. Also, the article presents a preliminary assessment of the possible impact of professionalisation (and outsourcing) of workplace HIV/AIDS management on workplace data-protection practices, and it identifies some spaces for social dialogue on HIV/AIDS-data treatment in South Africa. The study methods comprise an analysis of legal documents (concerning international data-protection standards and the development of law governing data protection and HIV/AIDS confidentiality in South Africa) and interviews conducted with workplace health managers and trade union representatives, in Johannesburg, in 2007.

  14. HIV risk sexual behaviors among teachers in Uganda

    Lillian Ayebale

    2014-03-01

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

  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. Pediatric HIV in Kano, Nigeria

    2013-02-15

    Feb 15, 2013 ... HIV‑infected children were enrolled into HIV care and followed up for 6 months. ..... the HIV infection, particularly from diarrhoea and anorexia resulting from ... improved socio‑economic status, and improved nutrition should be ...

  17. [Status and influencing factors of rush poppers use and HIV infection among men who have sex with men in Changsha].

    Lei, Yunxiao; Wang, Honghong; Xiao, Xueling; Chen, Jia; Li, Xianhong

    2016-02-01

    To explore the relationship between use of rush poppers and HIV infection, and associated factors among men who have sex with men in Changsha. A cross-sectional study was conducted in Changsha from April to December, 2014. Men who have sex with men who came for HIV counseling and testing services were invited to fill out a survey. A total of 608 MSM were finally recruited. The survey included socio-demographic characteristics, sexual roles, sexual behaviors in last 6 months and rush poppers use, HIV infection among MSM. After finishing the questionnaire, 5 ml blood was also drawn for HIV testing. Chi-square test or Fisher probabilities was used to compare usage of rush poppers and HIV antibody positive rate among MSM who had different characteristics and sexual behaviors. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use and HIV infection of MSM. Among 608 MSM, 29.8% (181) said they ever used rush poppers, and 13.3% (81 cases) were HIV positive. Among MSM who ever used rush poppers, 18.8% (34/181) were HIV positive; While among those who never used rush poppers, 10.5% (45/427) were HIV positive (χ(2)=7.65,P=0.006). Compared with MSM who had no For One Night sex in the last 6 months,OR (95% CI) value of MSM who had 6-10 times For One Night sexes in last 6 months to use rush poppers was 4.32 (1.77-10.57). Compared with MSM who self-identified as top,OR (95% CI) value of MSM who self-identified as bottom or versatile using rush poppers were 2.99 (1.53-5.86), or 3.60 (2.13-6.09). Compared with MSM who self-identified as top, OR (95% CI) value of MSM who self-identified as bottom or versatile to infect HIV were 3.19 (1.35-7.58), or 2.33 (1.12-4.85). Compared with MSM who used condoms at every anal sex,OR (95% CI) value of MSM who used condoms sometimes or never used to infect HIV were 1.93 (1.12-3.35) or 1.87 (0.64-5.50). Compared with MSM who never used rush poppers,OR (95% CI) value of MSM who ever used

  18. Unknown foundation determination for scour.

    2012-04-01

    Unknown foundations affect about 9,000 bridges in Texas. For bridges over rivers, this creates a problem : regarding scour decisions as the calculated scour depth cannot be compared to the foundation depth, and a : very conservative costly approach m...

  19. HIV/AIDS-related knowledge and its association with socioeconomic status among women: results of Lebanese Survey for Family Health (PAPFAM) 2004.

    Kobeissi, Loulou; El Kak, Faysal H; Khawaja, Marwan; Khoshnood, Kaveh

    2015-03-01

    This article assesses the association of women's HIV/AIDS knowledge of transmission and prevention with socioeconomic status (SES). Data from the 2004 Lebanese PAPFAM (Pan-Arab Project for Family Health) survey were used. The survey was based on a representative household sample (n = 5532 households; n = 3315 women) of ever-married women aged 15 to 55 years. Adjusted analysis revolved around multivariate logistic regression models. 18% of women were knowledgeable of HIV/AIDS transmission methods and 21% of prevention methods. Income and education were significantly related to women's transmission and prevention knowledge. Significant differences were also found by region and media exposure. Women in the richest income quintile were 4 times (95% confidence interval [CI] = 2.43-6.42) more likely to be knowledgeable than those in the poorest. Women with the highest education were 2.57 times more likely (95% CI = 1.98-3.34) to be knowledgeable than those with elementary education or less. These results suggest the need for incorporating contextual regional and population differences for more effective HIV/AIDS awareness campaigns in Lebanon. © 2011 APJPH.

  20. HIV/AIDS and Associated Conditions among HIV-Infected Refugees in Minnesota, 2000–2007

    Lowther, Sara A.; Johnson, Glenise; Hendel-Paterson, Brett; Nelson, Kailey; Mamo, Blain; Krohn, Kristina; Pessoa-Brandão, Luisa; O’Fallon, Ann; Stauffer, William

    2012-01-01

    In 2010, the requirement for human immunodeficiency virus (HIV) testing of adult refugees prior to US resettlement was removed, thus leading to a potential for missed diagnosis. We reviewed refugee health assessment data and medical charts to evaluate the health status of HIV-infected refugees who arrived in Minnesota during 2000–2007, prior to this 2010 policy change. Among 19,292 resettled adults, 174 were HIV-infected; 169 (97%) were African (median age 26.4 (range: 17–76) years). Charts were abstracted for 157 (124 (79%) with ≥1 year of follow-up). At initial presentation, two of 74 (3%) women were pregnant; 27% became pregnant during follow-up. HIV clinical stage varied (59%, asymptomatic; 11%, mild symptoms; 10%, advanced symptoms; 3%, severe symptoms; 17%, unknown); coinfections were common (51 tuberculosis, 13 hepatitis B, 13 parasites, four syphilis). Prior to arrival 4% had received antiretrovirals. Opportunistic infections were diagnosed among 13%; 2% died from AIDS-related causes. Arrival screening may be needed to identify these HIV-infected refugees and prevent HIV-related morbidity and mortality. PMID:23202841

  1. Status of the structure, process and outcoms of pharmaceutical care to HIV patient in Spain. Origen study

    R. Morillo-Verdugo

    2014-03-01

    Full Text Available Objectives: To describe the structure, process and outcomes with which hospital pharmacist performs health care activity, teaching and research about Pharmaceutical Care (PC in HIV patients in Spain. Methods: Observational, cross-sectional and multicenter study carried out between November 2011-February 2012 in spanish hospitals. The inclusion criteria were: hospitals pharmacy services that dispensed antiretroviral medication to HIV patients. The questionnaire had 41 questions structured in 9 groups: hospital type and person conducting the survey, structure and resources, health care activities, interventions, communication with the rest of the multidisciplinary team, adherence, and quality records, management and pharmacoeconomy and teaching and research. Descriptive analysis was performed. To analyze the existence of statistically significant relationships, we applied fisher test, chi-square or logistic regression Results: 86 hospitals completed the survey. In 93%, PC consultation was not classified by pathologies. 27.9% provided continuing PC to all patients. Adherence was determined regularly or when pharmacist suspected poor adherence (57.5 %. 20% of hospital s teaching had a program that allowed a high level of training in PC to HIV patient. 52,3% of participating centers had published scientific articles related to HIV. Conclusions: Pharmaceutical care to HIV patients in Spain need to adapt to a new situation. For this, hospital pharmacists have to consider several issues such as chronicity, comorbidity, incorporation of new technologies and the stratification of patients in order to make it more efficient.

  2. Tuberculosis and hepatic steatosis are prevalent liver pathology findings among HIV-infected patients in South Africa.

    Christopher J Hoffmann

    Full Text Available Liver disease epidemiology in sub-Saharan Africa has shifted as a result of HIV and the increased use of antiretroviral therapy leading to a need for updated data on common causes of liver disease. We retrospectively reviewed records from all hospitalized patients who had liver biopsy at a single hospital in South Africa from 2001 to 2009 and compared diagnosis by HIV status. During the period of study 262 patients had liver biopsy, 108 (41% were HIV-infected, 25 (10% were HIV-sero-negative, and 129 (49% had unknown or unrecorded HIV status. Overall 81% of biopsies provided additional diagnostic data. Malignancy was the most common finding reported on 56 (21% biopsies followed by granuloma or TB, hepatic steatosis, and fibrosis or cirrhosis. HIV-infected patients were more likely to have granulomas and steatosis. Half of patients with granulomas were already on TB treatment, suggesting paradoxical reactions or drug induced liver injury may have been important causes of liver inflammation among these patients. We note that TB, paradoxical reactions during TB treatment, possible drug induced liver injury, and hepatic steatosis are important causes of liver pathology among HIV-infected hospitalized patients with unclear etiology of liver disease after initial assessment. Among HIV sero-negative patients, malignancy was the major cause of liver disease. Our findings re-enforce the importance of TB as a diagnosis among HIV-infected individuals.

  3. Correlates of lending needles/syringes among HIV-seropositive injection drug users.

    Metsch, Lisa R; Pereyra, Margaret; Purcell, David W; Latkin, Carl A; Malow, Robert; Gómez, Cynthia A; Latka, Mary H

    2007-11-01

    Among HIV-positive injection drug users (IDUs), we examined the correlates of lending needles/syringes with HIV-negative and unknown status injection partners. HIV-positive IDUs (N=738) from 4 cities in the United States who reported injection drug use with other IDUs in the past 3 months participated in an audio computer-assisted self-administered interview. Eighteen percent of study participants self-reported having lent their needles to HIV-negative or unknown status injection partners. Multivariate analyses showed that 6 variables were significantly associated with this high-risk injecting practice. Older IDUs, high school graduates, and those reporting more supportive peer norms for safer drug use were less likely to lend needles/syringes. Admission to a hospital for drug treatment in the past 6 months, having injected with >1 person in the past 3 months, and having more psychiatric symptoms were all associated with more risk. These findings underscore the need for a continued prevention focus on HIV-positive IDUs that recognizes the combination of drug use, mental health factors, and social factors that might affect this high-risk injecting practice, which could be associated with HIV and hepatitis C transmission.

  4. Mortality in HIV-infected injection drug users with active vs cleared hepatitis C virus-infection: a population-based cohort study

    Omland, L H; Jepsen, P; Weis, N

    2010-01-01

    Acute hepatitis C virus (HCV) infection may lead to chronic HCV-infection with detectable HCV RNA or to spontaneous clearance with no HCV RNA, but detectable HCV antibodies. It is unknown whether HCV RNA status is associated with mortality in HIV-infected injection drug users (IDUs). We conducted...

  5. ORIGINAL ARTICLE: Blood Donor’s Status of HIV, HBV, HCV and Syphilis in this Region of Marathwada, India

    Rangrao H. Deshpande

    2012-07-01

    Full Text Available Aims & Objectives: Blood transfusion can cause the transmission of infections to recipients. This is an important mode of infection. The aim of study was to assess the prevalence of such type of infections among blood donors and to compare the seroprevalence of transfusion transmitted diseases in voluntary donors and replacement donors. Retrospective study of five years from Jan. 2007 to Dec. 2011 was done. This study was conducted at Blood bank, MIMSR Medical College Latur, Govt. Medical College, Latur and Bhalchandra Blood bank, Latur. Material & Methods: Total 10, 4925 donors were tested. Donors were screened for seroprevalence of HIV, HBC, HCV and Syphilis. Screening of HIV, HBV & HCV was done by ELISA method & Syphilis was screened by RPR type. Results: The comparison of seroprevalence of HIV, HBV, HCV & Syphilis in voluntary donors and replacement donors showed significant difference only for HIV in the years 2007, 2010, and 2011. Conclusion: The seroprevalence of transfusion transmitted diseases in the study is very low or negligible in voluntary donors as compared to replacement donors. There was a declining trend of seroprevalence for all the disease screened. But in our study the difference is not significant, which indicates that the selection of donors is of low quality. The selection of high quality voluntary donors should be achieved by creation of awareness by education of the prospective donor populations.

  6. Prevalence and Type Distribution of Human Papillomavirus Among 1813 Men in Tanzania and the Relationship to HIV Status

    Olesen, Tina Bech; Iftner, Thomas; Mwaiselage, Julius

    2013-01-01

    Infection with high-risk (HR) human papillomavirus (HPV) is associated with penile cancer in men, cervical cancer in women, and anal cancer and certain types of head and neck cancers in both sexes. Few studies have assessed the prevalence and type distribution of HPV among men in sub-Saharan Africa......, where the rates of HIV and penile and cervical cancer are high....

  7. Weighing the Consequences: Self-Disclosure of HIV-Positive Status among African American Injection Drug Users

    Valle, Maribel; Levy, Judith

    2009-01-01

    Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV…

  8. Nutritional status is the major factor affecting grip strength of African HIV patients before and during antiretroviral treatment.

    Filteau, S; PrayGod, G; Woodd, S L; Friis, H; Heimburger, D C; Koethe, J R; Kelly, P; Kasonka, L; Rehman, A M

    2017-10-01

    Low grip strength is a marker of frailty and a risk factor for mortality among HIV patients and other populations. We investigated factors associated with grip strength in malnourished HIV patients at referral to ART, and at 12 weeks and 2-3 years after starting ART. The study involved HIV-infected Zambian and Tanzanian participants recruited to the NUSTART trial when malnourished (body mass index <18.5 kg/m 2 ) and requiring ART. The relationship of grip strength to nutritional, infectious and demographic factors was assessed by multivariable linear regression at referral for ART (n = 1742) and after 12 weeks (n = 778) and 2-3 years of ART (n = 273). In analyses controlled only for sex, age and height, most nutrition and infection-related variables were associated with grip strength. However, in multivariable analyses, consistent associations were seen for fat-free mass index, mid-upper arm circumference, haemoglobin and systolic blood pressure, and a variable association with fat mass index in men. C-reactive protein and CD4 count had limited independent effects on grip strength, while receiving tuberculosis treatment was associated with weaker grip strength. In this population of originally malnourished HIV patients, poor grip strength was more strongly and independently associated with nutritional than with infection and inflammation variables. Programmes to improve health and survival of HIV patients should incorporate nutritional assessment and management and could use grip strength as a functional indicator of improving nutrition. © 2017 John Wiley & Sons Ltd.

  9. Allocating monitoring effort in the face of unknown unknowns

    Wintle, B.A.; Runge, M.C.; Bekessy, S.A.

    2010-01-01

    There is a growing view that to make efficient use of resources, ecological monitoring should be hypothesis-driven and targeted to address specific management questions. 'Targeted' monitoring has been contrasted with other approaches in which a range of quantities are monitored in case they exhibit an alarming trend or provide ad hoc ecological insights. The second form of monitoring, described as surveillance, has been criticized because it does not usually aim to discern between competing hypotheses, and its benefits are harder to identify a priori. The alternative view is that the existence of surveillance data may enable rapid corroboration of emerging hypotheses or help to detect important 'unknown unknowns' that, if undetected, could lead to catastrophic outcomes or missed opportunities. We derive a model to evaluate and compare the efficiency of investments in surveillance and targeted monitoring. We find that a decision to invest in surveillance monitoring may be defensible if: (1) the surveillance design is more likely to discover or corroborate previously unknown phenomena than a targeted design and (2) the expected benefits (or avoided costs) arising from discovery are substantially higher than those arising from a well-planned targeted design. Our examination highlights the importance of being explicit about the objectives, costs and expected benefits of monitoring in a decision analytic framework. ?? 2010 Blackwell Publishing Ltd/CNRS.

  10. Inpatient mortality rates during an era of increased access to HIV testing and ART: A prospective observational study in Lilongwe, Malawi.

    Matoga, Mitch M; Rosenberg, Nora E; Stanley, Christopher C; LaCourse, Sylvia; Munthali, Charles K; Nsona, Dominic P; Haac, Bryce; Hoffman, Irving; Hosseinipour, Mina C

    2018-01-01

    In the era of increased access to HIV testing and antiretroviral treatment (ART), the impact of HIV and ART status on inpatient mortality in Malawi is unknown. We prospectively followed adult inpatients at Kamuzu Central Hospital medical wards in Lilongwe, Malawi, between 2011 and 2012, to evaluate causes of mortality, and the impact of HIV and ART status on mortality. We divided the study population into five categories: HIV-negative, new HIV-positive, ART-naïve patients, new ART-initiators, and ART-experienced. We used multivariate binomial regression models to compare risk of death between categories. Among 2911 admitted patients the mean age was 38.5 years, and 50% were women. Eighty-one percent (81%) of patients had a known HIV status at the time of discharge or death. Mortality was 19.4% and varied between 13.9% (HIV-negative patients) and 32.9% (HIV-positive patients on ART ≤1 year). In multivariable analyses adjusted for age, sex and leading causes of mortality, being new HIV-positive (RR = 1.64 95% CI: 1.16-2.32), ART-naive (RR = 2.28 95% CI: 1.66-2.32) or being a new ART-initiator (RR = 2.41 95% CI: 1.85-3.14) were associated with elevated risk of mortality compared to HIV-negative patients. ART-experienced patients had comparable mortality (RR = 1.33 95% CI: 0.94-1.88) to HIV-negative patients. HIV related mortality remains high among medical inpatients, especially among HIV-positive patients who recently initiated ART or have not started ART yet.

  11. Function analysis of unknown genes

    Rogowska-Wrzesinska, A.

    2002-01-01

      This thesis entitled "Function analysis of unknown genes" presents the use of proteome analysis for the characterisation of yeast (Saccharomyces cerevisiae) genes and their products (proteins especially those of unknown function). This study illustrates that proteome analysis can be used...... to describe different aspects of molecular biology of the cell, to study changes that occur in the cell due to overexpression or deletion of a gene and to identify various protein modifications. The biological questions and the results of the described studies show the diversity of the information that can...... genes and proteins. It reports the first global proteome database collecting 36 yeast single gene deletion mutants and selecting over 650 differences between analysed mutants and the wild type strain. The obtained results show that two-dimensional gel electrophoresis and mass spectrometry based proteome...

  12. DEPIVIH 2: Use of three HIV testing methods in French primary care settings - ELISA laboratory screening versus two rapid point-of-care HIV tests.

    Papadima, D; Gauthier, R; Prévoteau du Clary, F; Bouée, S; Conort, G; Livrozet, J-M; Taulera, O; Wajsbrot, A; Majerholc, C; Peter, J-M; Aubert, J-P

    2018-03-01

    The primary endpoint was to evaluate the use of HIV testing methods by French primary care providers: Elisa laboratory screening, instant result HIV diagnostic test and rapid result HIV diagnostic test. The secondary endpoints were the population screening rate of unknown HIV status consulting during the study period, reasons for screening and for choosing the specific screening method, the investigators' satisfaction with the rapid diagnostic test (RDT) and problems encountered. National prospective interventional study with French family physicians (FP) from December 2013 to December 2014. FPs enrolled all consenting adults consulting for an HIV screening test during a 6-month period: the choice was an Elisa laboratory test or one of the two RDTs. During the study period, 43 FPs included 981 patients. HIV screening was performed for the first time for 31.6% of patients; 767 (78.2%) Elisa laboratory test prescriptions and 214 (21.8%) RDTs were performed, leading to a screening rate of 1.3%. For 120 (15.7%) of the Elisa laboratory tests, the result was not reported and six RDTs were not valid. Nine patients were diagnosed as HIV-infected (0.9%): five with Elisa laboratory test and four with RDT. Almost 90% of FPs were willing to keep on using RDTs in their daily practice. In general practice, RDTs may be an important additional tool to traditional HIV screening. They could account for one in five tests prescribed in this context. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. The role of the family in HIV status disclosure among women in Vietnam: Familial dependence and independence.

    Dinh, H T; White, J L; Hipwell, M; Nguyen, C T K; Pharris, A

    2018-04-01

    Insights into disclosure by people living with HIV and AIDS (PLWHA) can inform strategies for treatment and support, yet Vietnamese women's self-disclosure patterns are poorly understood. We conducted interviews with 12 HIV-positive women, identifying three principal factors influencing disclosure to family members: patrilocal residence, desire to protect own family, and the need for financial support. Women's decision-making about disclosure was significantly affected by dependence on or independence of parents-in-law and their own parents. We believe that our findings reveal the complex interplay of stigma and disclosure within Vietnamese families, highlighting the need for specific social measures that promote self-disclosure combined with family support for female PLWHA.

  14. Disclosure of HIV status and its impact on the loss in the follow-up of HIV-infected patients on potent anti-retroviral therapy programs in a (post- conflict setting: A retrospective cohort study from Goma, Democratic Republic of Congo.

    Pierre Zalagile Akilimali

    Full Text Available The study aimed to identify the impact of non-disclosure of HIV status on the loss to follow-up (LTFU of patients receiving anti-retroviral therapy.A historic cohort of HIV patients from 2 major hospitals in Goma, Democratic Republic of Congo was followed from 2004 to 2012. LTFU was defined as not taking an ART refill for a period of 3 months or longer since the last attendance, and had not yet been classified as 'dead' or 'transferred-out'. Kaplan-Meier plots were used to determine the probability of LTFU as a function of time as inclusive of the cohort. The log-rank test was used to compare survival curves based on determinants. Cox proportional hazard modeling was used to measure predictors of LTFU from the time of treatment induction until December 15th, 2012 (the end-point.The median follow-up time was 3.99 years (IQR = 2.33 to 5.59. Seventy percent of patients had shared their HIV status with others (95% CI: 66.3-73.1. The proportion of LTFU was 12% (95%CI: 9.6-14.4. Patients who did not share their HIV status (Adjusted HR 2.28, 95% CI 1.46-2.29, patients who did not live in the city of Goma (Adjusted HR 1.97, 95% CI 1.02-3.77, and those who attained secondary or higher education level (Adjusted HR 1.60, 95% CI 1.02-2.53 had a higher hazard of being LTFU.This study shows the relationship between the non-disclosure HIV status and LTFU. Healthcare workers in similar settings should pay more attention to clients who have not disclosed their HIV status, and to those living far from health settings where they receive medication.

  15. The role of the family in HIV status disclosure amongst women in Vietnam: Familial dependence and independence

    Dinh, D.; White, J.; Hipwell, M.; Nguyen, T.; Pharris, A.

    2017-01-01

    Insights into disclosure by PLWHA can inform strategies for treatment and support, yet Vietnamese women's self-disclosure patterns are poorly understood. We conducted interviews with 12 HIV-positive women, identifying three principal factors influencing disclosure to family members: patrilocal residence, desire to protect own family, and the need for financial support. Women's decision-making about disclosure was significantly affected by dependence on or independence of parents-in-law and th...

  16. Community vulnerability and stratified risk: Hegemonic masculinity, socioeconomic status, and HIV/AIDS in a sex work community in Kampala, Uganda.

    Schmidt-Sane, Megan M

    2018-01-29

    This article examines the social patterning of health, economic uncertainty, hegemonic masculinity, and vulnerability among men who live and work in a low-income sex work community in Kampala, Uganda. This problematises the notion that vulnerable communities are homogenous, in demographics, economic status, and risk. This article draws on ethnographic data collected in 2016, including semi-structured interviews and participant observation. This article uses a stratified risk framework to describe the central finding of this study, which is that men's experience in Kataba is characterised by a struggle to fulfil the provider role that constitutes a core aspect of their socially ascribed gender role. In a context of economic scarcity, men's lives are fraught with strain and this intersects with other forms of risk. Finally, by focusing on community vulnerability rather than individual risk, this work contributes to theories of gender and sex work, and informs HIV/AIDS praxis.

  17. Characteristics of clients accessing HIV counseling and testing ...

    Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in ... Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. ... AJOL African Journals Online.

  18. Financial Development and Economic Growth: Known Knowns, Known Unknowns, and Unknown Unknowns

    Ugo Panizza

    2014-01-01

    This paper summarizes the main findings of the literature on the relationship between financial and economic development (the known knowns), points to directions for future research (the known unknowns), and then speculates on the third Rumsfeldian category. The known knowns section organizes the empirical literature on finance and growth into three strands: (i) the traditional literature which established the link between finance and growth; (ii) the new literature which qualified some of th...

  19. An Adaptive Approach to Locating Mobile HIV Testing Services.

    Gonsalves, Gregg S; Crawford, Forrest W; Cleary, Paul D; Kaplan, Edward H; Paltiel, A David

    2018-02-01

    Public health agencies suggest targeting "hotspots" to identify individuals with undetected HIV infection. However, definitions of hotspots vary. Little is known about how best to target mobile HIV testing resources. We conducted a computer-based tournament to compare the yield of 4 algorithms for mobile HIV testing. Over 180 rounds of play, the algorithms selected 1 of 3 hypothetical zones, each with unknown prevalence of undiagnosed HIV, in which to conduct a fixed number of HIV tests. The algorithms were: 1) Thompson Sampling, an adaptive Bayesian search strategy; 2) Explore-then-Exploit, a strategy that initially draws comparable samples from all zones and then devotes all remaining rounds of play to HIV testing in whichever zone produced the highest observed yield; 3) Retrospection, a strategy using only base prevalence information; and; 4) Clairvoyance, a benchmarking strategy that employs perfect information about HIV prevalence in each zone. Over 250 tournament runs, Thompson Sampling outperformed Explore-then-Exploit 66% of the time, identifying 15% more cases. Thompson Sampling's superiority persisted in a variety of circumstances examined in the sensitivity analysis. Case detection rates using Thompson Sampling were, on average, within 90% of the benchmark established by Clairvoyance. Retrospection was consistently the poorest performer. We did not consider either selection bias (i.e., the correlation between infection status and the decision to obtain an HIV test) or the costs of relocation to another zone from one round of play to the next. Adaptive methods like Thompson Sampling for mobile HIV testing are practical and effective, and may have advantages over other commonly used strategies.

  20. Acceleration of Age-Associated Methylation Patterns in HIV-1-Infected Adults

    Sehl, Mary; Sinsheimer, Janet S.; Hultin, Patricia M.; Hultin, Lance E.; Quach, Austin; Martínez-Maza, Otoniel; Horvath, Steve; Vilain, Eric; Jamieson, Beth D.

    2015-01-01

    Patients with treated HIV-1-infection experience earlier occurrence of aging-associated diseases, raising speculation that HIV-1-infection, or antiretroviral treatment, may accelerate aging. We recently described an age-related co-methylation module comprised of hundreds of CpGs; however, it is unknown whether aging and HIV-1-infection exert negative health effects through similar, or disparate, mechanisms. We investigated whether HIV-1-infection would induce age-associated methylation changes. We evaluated DNA methylation levels at >450,000 CpG sites in peripheral blood mononuclear cells (PBMC) of young (20-35) and older (36-56) adults in two separate groups of participants. Each age group for each data set consisted of 12 HIV-1-infected and 12 age-matched HIV-1-uninfected samples for a total of 96 samples. The effects of age and HIV-1 infection on methylation at each CpG revealed a strong correlation of 0.49, pmodules; module 3 (ME3) was significantly correlated with age (cor=0.70) and HIV-1 status (cor=0.31). Older HIV-1+ individuals had a greater number of hypermethylated CpGs across ME3 (p=0.015). In a multivariate model, ME3 was significantly associated with age and HIV status (Data set 1: βage= 0.007088, p=2.08 x 10-9; βHIV= 0.099574, p=0.0011; Data set 2: βage= 0.008762, p=1.27x 10-5; βHIV= 0.128649, p= 0.0001). Using this model, we estimate that HIV-1 infection accelerates age-related methylation by approximately 13.7 years in data set 1 and 14.7 years in data set 2. The genes related to CpGs in ME3 are enriched for polycomb group target genes known to be involved in cell renewal and aging. The overlap between ME3 and an aging methylation module found in solid tissues is also highly significant (Fisher-exact p=5.6 x 10-6, odds ratio=1.91). These data demonstrate that HIV-1 infection is associated with methylation patterns that are similar to age-associated patterns and suggest that general aging and HIV-1 related aging work through some common cellular

  1. Intraabdominal abscessus of unknown etiology

    Čolović Radoje

    2012-01-01

    Full Text Available Introduction. Intraabdominal abscesses are in 98-99% cases the result of secondary and only in 1-2% of primary peritonitis. They are easy and successfully diagnosed. Abdominal abscesses of unknown cause are extremely rare. Case Outline. The authors present a 68-year-old man, without significant data in past history, who suddenly developed epigastric pain, nausea, vomiting and leukocytosis which was treated with antibiotics resulting in the alleviation of complaints and reduction of white blood cells count. After five days ultrasonography showed incapsulated collection of dense fluid in the epigastrium confirmed by CT scan two days later. Upper endoscopy excluded ulcer and/or perforation of the stomach and duodenum. Under local anesthesia, through the upper part of the left rectal muscle, puncture followed by incision was done, and about 50 ml of dense pus was removed. Finger exploration of the cavity showed no foreign body within the cavity. Using drainage, the recovery was quick and uneventful. By preoperative and postoperative abdominal investigations no cause of the abscess was found. Two and a half years after surgery the patient remained symptom-free with normal clinical, laboratory and ultrasonographic findings. Conclusion. The authors presented an intraabdominal abscess of unknown cause that was successfully treated with antibiotics, percutaneous puncture and drainage under local anaesthesia. In spite of all diagnostic methods the cause of the abscess could not be found. Thus, such a possibility, although being rare, should be taken into account.

  2. Ocular surface squamous neoplasia in HIV-positive and HIV-negative patients and response to 5-fluorouracil in Angola

    Nutt RJ

    2014-12-01

    Full Text Available Robert J Nutt,1 John L Clements,2 William H Dean3 1Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK; 2Boa Vista Eye Clinic, Benguela, Angola; 3Bristol Eye Hospital, Bristol, UK Background: Ocular surface squamous neoplasia (OSSN is becoming increasingly prevalent and aggressive in Sub-Saharan Africa. It is a phenomenon linked with human immunodeficiency virus (HIV infection, although association rates in Angola are currently unknown. A topical treatment that is effective in HIV-positive and HIV-negative individuals may be preferable to surgery in some contexts. We aimed to estimate the proportion of OSSN associated with HIV in Angola and to report on the success of topical 5-fluorouracil as a primary treatment in HIV-positive and HIV-negative patients.Methods: Photographs of OSSNs taken at presentation and following treatment with 5-fluorouracil in patients presenting to Boa Vista Eye Clinic, Angola, between October 2011 and July 2013 were grouped into HIV-positive and HIV-negative groups and analyzed to compare presenting features and treatment response. Eighty-one OSSNs were analyzed for clinical features and 24 met the inclusion criteria for analysis of treatment response.Results: Eighty-two patients presented with OSSN between October 2011 and July 2013. Twenty-one (26% were HIV-positive and typically had OSSNs that exhibited more pathological features than those in HIV-negative patients. Twenty-four (29% patients met the inclusion criteria for analysis of treatment response; of these, 26 (91% OSSNs in both groups displayed at least partial resolution after one treatment course. In the HIV-positive group, five of eight patients displayed complete resolution, two showed partial resolution, and one failed. In the HIV-negative group, five of 16 showed complete resolution, ten of 16 had partial resolution, and one failed.Conclusion: Individuals presenting with OSSN in Angola are more likely to have HIV infection compared

  3. Adolescent experiences of discrimination, harassment, connectedness to community and comfort with sexual orientation reported by adult men who have sex with men as a predictor of adult HIV status.

    Raymond, H Fisher; Chen, Yea-Hung; Stall, Ron D; McFarland, Willi

    2011-04-01

    Using data from a probability based sample of adult men who have sex with men (MSM) we examined the association of negative life factors during adolescence and adult HIV status. 521 MSM reported on experiences of connectedness to community, comfort with sexuality, harassment and discrimination due to their sexual orientation at ages 12-18 years. HIV status was determined by serological testing. Overall, men reported moderate levels of being harassed, being discriminated against and high levels of feeling disconnected from gay communities while reporting high levels of being uncomfortable with their sexuality at those ages. However, in analyses of scores on these factors, higher experiences of harassment, higher levels of discrimination and more discomfort with sexuality at these ages are associated with HIV-negative status as adults. This study suggests that the relationship between negative adolescent experiences among MSM and adult HIV infection may not be straightforward, but may also dependent upon aspects of the intensity of the negative experiences, the relationship of the victim and the perpertrator(s), the sexual identity of the victim at the time and/or the number of these experiences or the length of time over which they occurred. Studies investigating specific multiple stressors in adolescent gay development and their effect on adult health outcomes are needed.

  4. Morphologic changes in the placentas of HIV-positive women and their association with degree of immune suppression.

    Vermaak, Anine; Theron, Gerhard B; Schubert, Pawel T; Kidd, Martin; Rabie, Ursula; Adjiba, Benedict M; Wright, Colleen A

    2012-12-01

    To provide baseline information regarding a possible association between specific histopathologic features of the placentas of HIV-positive women and the degree of immune suppression. A prospective single-blinded laboratory-based pilot study was conducted at Tygerberg Hospital, South Africa. The macroscopic and microscopic features of placentas from HIV-positive (n=91) and HIV-negative women (n=89) were compared and recorded using a standard template. Investigators were blinded to the participants' HIV status and CD4-positive cell count. Placentas from the HIV-positive group were characterized by decreased weight and increased number of marginal infarcts relative to the HIV-negative group. The most important microscopic finding was the increased presence of villitis of unknown etiology (VUE) among the group of untreated HIV-positive women with CD4 cell counts of 200 cells/mm(3) or below. Both macroscopic and microscopic differences relating to the degree of immune suppression were identified, which seemingly contradicts previous reports. Larger studies are warranted to define the function of antiretroviral therapy and VUE in the mechanism of mother-to-fetus transmission of HIV. Furthermore, the potential role of VUE in the pathophysiology of the compromised immune response observed among HIV-exposed but uninfected infants should be investigated. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men.

    Cook, Robert L; McGinnis, Kathleen A; Samet, Jeffrey H; Fiellin, David A; Rodriguez-Barradas, Maria C; Rodriquez-Barradas, Maria C; Kraemer, Kevin L; Gibert, Cynthia L; Braithwaite, R Scott; Goulet, Joseph L; Mattocks, Kristin; Crystal, Stephen; Gordon, Adam J; Oursler, Krisann K; Justice, Amy C

    2010-02-01

    Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior. To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. Cross-sectional study. Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data. EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P sexual behavior (11% vs. 10%, p = 0.9) and STDs (7% vs 7%, p = 0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men. EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIV-infected men, indicating ongoing need for prevention interventions.

  6. Sexual practices and condom usage in a cohort of homosexual men in relation to human immunodeficiency virus status.

    Tindall, B; Swanson, C; Donovan, B; Cooper, D A

    1989-09-18

    Between January 1, and October 31, 1987, 420 homosexual men who participated in a cohort study of infection with the human immunodeficiency virus (HIV) completed a questionnaire that examined their sexual practices during the previous six months. Of the subjects, 205 (48.8%) men were HIV-seropositive and 215 (51.2%) men were HIV-seronegative. Although there was an appreciable level of condom usage in both groups, 13.5% of the HIV-seronegative men had engaged in unprotected receptive anal intercourse and 6.3% of the HIV-seropositive men had engaged in unprotected insertive anal intercourse. Condom breakage was reported on approximately 6% of occasions by a minority of subjects. Among subjects who were in a relationship with a regular male sexual partner, the most commonly reported sexual practices were deep kissing, mutual masturbation and receptive oral intercourse without ejaculation. No HIV-seronegative man engaged in unprotected receptive and/or insertive anal intercourse, receptive oral intercourse with ejaculation or receptive and/or insertive "fisting" with a regular partner who was HIV-seropositive. No HIV-seropositive man engaged in unprotected insertive anal intercourse to ejaculation with an HIV-seronegative partner, although they did so with partners who were HIV-seropositive or of unknown status. On multivariate analyses the subject's antibody status was found to be associated with receptive anal intercourse with a condom (P = 0.007) and mutual masturbation (P = 0.001), with HIV-seronegative men being more likely to practise either; no significant independent effect was associated with the partner's antibody status. These findings provide important information on the types and levels of sexual practices in a group of homosexual men after the recognition of the acquired immunodeficiency syndrome in this country.

  7. [Focal myositis: An unknown disease].

    Gallay, L; Streichenberger, N; Benveniste, O; Allenbach, Y

    2017-10-01

    Focal myositis are inflammatory muscle diseases of unknown origin. At the opposite from the other idiopathic inflammatory myopathies, they are restricted to a single muscle or to a muscle group. They are not associated with extramuscular manifestations, and they have a good prognosis without any treatment. They are characterized by a localized swelling affecting mostly lower limbs. The pseudo-tumor can be painful, but is not associated with a muscle weakness. Creatine kinase level is normal. Muscle MRI shows an inflammation restricted to a muscle or a muscle group. Muscle biopsy and pathological analysis remain necessary for the diagnosis, showing inflammatory infiltrates composed by macrophages and lymphocytes without any specific distribution within the muscle. Focal overexpression of HLA-1 by the muscle fibers is frequently observed. The muscle biopsy permits to rule out differential diagnosis such a malignancy (sarcoma). Spontaneous remission occurs within weeks or months after the first symptoms, relapse is unusual. Copyright © 2017. Published by Elsevier SAS.

  8. Previously unknown species of Aspergillus.

    Gautier, M; Normand, A-C; Ranque, S

    2016-08-01

    The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care. Copyright © 2016 European Society of Clinical Microbiology and

  9. High and persistent HIV seroincidence in men who have sex with men across 47 U.S. cities.

    Marta-Louise Ackers

    Full Text Available OBJECTIVE: To provide HIV seroincidence data among men who have sex with men (MSM in the United States and to identify predictive factors for seroconversion. METHODS: From 1998-2002, 4684 high-risk MSM, age 18-60 years, participated in a randomized, placebo-controlled HIV vaccine efficacy trial at 56 U.S. clinical trial sites. Demographics, behavioral data, and HIV status were assessed at baseline and 6 month intervals. Since no overall vaccine efficacy was detected, data were combined from both trial arms to calculate HIV incidence based on person-years (py of follow-up. Predictors of seroconversion, adjusted hazards ratio (aHR, were evaluated using a Cox proportional hazard model with time-varying covariates. RESULTS: Overall, HIV incidence was 2.7/100 py and was relatively uniform across study sites and study years. HIV incidence was highest among young men and men reporting unprotected sex, recreational drug use, and a history of a sexually transmitted infection. Independent predictors of HIV seroconversion included: age 18-30 years (aHR = 2.4; 95% CI 1.4,4.0, having >10 partners (aHR = 2.4; 95% CI 1.7,3.3, having a known HIV-positive male sex partner (aHR = 1.6; 95% CI 1.2, 2.0, unprotected anal intercourse with HIV positive/unknown male partners (aHR = 1.7; 95% CI 1.3, 2.3, and amphetamine (aHR = 1.6; 95% CI 1.1, 2.1 and popper (aHR = 1.7; 95% CI 1.3, 2.2 use. CONCLUSIONS: HIV seroincidence was high among MSM despite repeated HIV counseling and reported declines in sexual risk behaviors. Continuing development of new HIV prevention strategies and intensification of existing efforts will be necessary to reduce the rate of new HIV infections, especially among young men.

  10. It's Never Just HIV: Exposure to an HIV Prevention Media Campaign and Behavior Change Among Men Who Have Sex with Men Participating in the National HIV Behavioral Surveillance System in New York City.

    Reilly, Kathleen H; Neaigus, Alan; Shepard, Colin W; Cutler, Blayne H; Sweeney, Monica M; Rucinski, Katherine B; Jenness, Samuel M; Wendel, Travis; Marshall, David M; Hagan, Holly

    2016-08-01

    The aim of this study was to assess the exposure to and impact of the It's Never Just HIV mass media campaign aimed at HIV negative men who have sex with men (MSM) in New York City. Questions about the campaign were included in the local questionnaire of the Centers for Disease Control and Prevention (CDC)-sponsored National HIV Behavioral Surveillance (NHBS) study of MSM in NYC conducted in 2011. Participants in this cross-sectional study were recruited using venue-based sampling. Among 447 NYC National HIV Behavioral Surveillance study participants who self-reported HIV negative or unknown status and answered questions about the NYC Department of Health and Mental Hygiene's It's Never Just HIV campaign, more than one-third (n = 173, 38.7%) reported having seen the campaign. Latinos (34.8%) and blacks (34.4%) were less likely to report seeing the campaign compared to whites (47.7%). Most of those who reported seeing the campaign saw it on the subway (80.1%). Only 9.4% of those who saw the campaign reported having changed their sexual or health behaviors in response to the campaign. These data suggest that thousands of HIV-uninfected MSM in NYC have been reached by the campaign and recalled its message.

  11. HIV diagnosis, linkage to HIV care, and HIV risk behaviors among newly diagnosed HIV-positive female sex workers in Kigali, Rwanda

    Braunstein, Sarah L.; Umulisa, Marie-Michèle; Veldhuijzen, Nienke J.; Kestelyn, Evelyne; Ingabire, Chantal M.; Nyinawabega, Jeanine; van de Wijgert, Janneke H. H. M.; Nash, Denis

    2011-01-01

    To evaluate linkage-to-care, sexual behavior change, and psychosocial experiences among newly HIV-diagnosed female sex workers (FSWs) in Rwanda. FSWs (n = 800) with unknown serostatus were screened for HIV during 2007/2008. Women testing HIV positive (n = 192) were referred to care and asked to

  12. Preliminary findings of an adapted evidence-based woman-focused HIV intervention on condom use and negotiation among at-risk women in Pretoria, South Africa.

    Wechsberg, Wendee M; Luseno, Winnie K; Kline, Tracy L; Browne, Felicia A; Zule, William A

    2010-01-01

    This article presents the results of a randomized trial in South Africa of an adapted evidence-based Woman-Focused intervention on condom use with primary sex partners. The preliminary findings show that regardless of HIV status, condom negotiation was significantly associated with condom use at the 3- and 6-month follow-ups. By intervention group, significant intervention effects were found at 6-month follow-up for HIV-positive and HIV-unknown status women in the Woman-Focused intervention who were more likely than women in the Standard intervention to report condom use with a primary male partner. Among HIV-positive women, those in the Woman-Focused group and those with greater sexual control were more likely to report condom use at the 6-month follow-up. The findings indicate that gender-based interventions for women may result in increased condom negotiation skills.

  13. Contraceptive Choice and Use of Dual Protection Among Women Living with HIV in Canada: Priorities for Integrated Care.

    Kaida, Angela; Patterson, Sophie; Carter, Allison; Loutfy, Mona; Ding, Erin; Sereda, Paul; Webster, Kath; Pick, Neora; Kestler, Mary; de Pokomandy, Alexandra

    2017-12-01

    Preventing unintended pregnancy and HIV transmission is important for women with HIV, but little is known about their contraceptive use, particularly under current antiretroviral therapy (ART) recommendations for treatment and prevention. The prevalence of contraceptive use and of dual protection was examined among 453 sexually active women with HIV aged 16-49 and enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study in 2013-2015; multivariable logistic regression was used to identify correlates of use. Two definitions of dual protection were assessed: the World Health Organization (WHO) definition (consistent condom use alongside another effective method) and an expanded definition (consistent condom use or a suppressed HIV viral load alongside an effective method). Overall, 73% of women used effective contraceptives, primarily male condoms (45%) or tubal ligation (19%). Eighteen percent practiced WHO-defined dual protection, and 40% practiced dual protection according to the expanded definition. Characteristics positively associated with contraceptive use were younger age, having been pregnant, being heterosexual, being unaware of ART's HIV prevention benefits and having had partners of unknown HIV status (odds ratios, 1.1-6.7). Younger age and perceived inability to become pregnant were positively associated with both definitions of dual protection (1.04-3.3); additionally, WHO-defined dual protection was associated with perceiving HIV care to be women-centered and having had partners of unknown HIV status (2.0-4.1), and dual protection under the expanded definition was related to having been pregnant (2.7). Future research should explore how sustained ART and broader contraceptive options can support women's sexual and reproductive health care needs. Copyright © 2017 by the Guttmacher Institute.

  14. The Danish PEP registry: experience with the use of postexposure prophylaxis (PEP) following sexual exposure to HIV from 1998 to 2006

    Lunding, Suzanne; Katzenstein, Terese L; Kronborg, Gitte

    2010-01-01

    BACKGROUND: Studies indicate that antiretroviral postexposure prophylaxis (PEP) after sexual exposure to HIV reduce the risk of infection considerably. Since 1998 PEP after sexual HIV exposure within the preceding 24 hours, has been available in Denmark. PEP can only be prescribed at clinical...... centers with specialists experienced in HIV treatment. The objective of this study is to describe the use of PEP after sexual exposure from 1998 to 2006. METHODS: The Danish PEP registry collects data from all cases of PEP use in Denmark after exposure to HIV through a structured questionnaire. RESULTS......: There were 374 cases of PEP use after sexual exposure. The incidence increased from 5 cases in 1997 to 87 in 2006. PEP was used by heterosexuals (40%) as well as men who have sex with men (57%). The HIV-status of the source was unknown in 41% of the cases of which 90% involved a source belonging to a high...

  15. Age, sex, and nutritional status modify the CD4+ T-cell recovery rate in HIV-tuberculosis co-infected patients on combination antiretroviral therapy.

    Ezeamama, Amara E; Mupere, Ezekiel; Oloya, James; Martinez, Leonardo; Kakaire, Robert; Yin, Xiaoping; Sekandi, Juliet N; Whalen, Christopher C

    2015-06-01

    Baseline age and combination antiretroviral therapy (cART) were examined as determinants of CD4+ T-cell recovery during 6 months of tuberculosis (TB) therapy with/without cART. It was determined whether this association was modified by patient sex and nutritional status. This longitudinal analysis included 208 immune-competent, non-pregnant, ART-naive HIV-positive patients from Uganda with a first episode of pulmonary TB. CD4+ T-cell counts were measured using flow cytometry. Age was defined as ≤24, 25-29, 30-34, and 35-39 vs. ≥40 years. Nutritional status was defined as normal (>18.5kg/m(2)) vs. underweight (≤18.5kg/m(2)) using the body mass index (BMI). Multivariate random effects linear mixed models were fitted to estimate differences in CD4+ T-cell recovery in relation to specified determinants. cART was associated with a monthly rise of 15.7 cells/μl (precovery during TB therapy (p = 0.655). However, among patients on cART, the age-associated CD4+ T-cell recovery rate varied by sex and nutritional status, such that age recovery among females (p=0.006) and among patients with a BMI ≥18.5kg/m(2) (p18.5kg/m(2) or they are female. These patients may benefit from increased monitoring and nutritional support during cART. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Any condomless anal intercourse is no longer an accurate measure of HIV sexual risk behaviour in gay and other men who have sex with men

    Fengyi eJin

    2015-02-01

    Full Text Available Background: Condomless anal intercourse (CLAI has long been recognised as the primary mode of sexual transmission of HIV in gay and other men who have sex with men (MSM. A variety of measures of CLAI have been commonly used in behavioural surveillance for HIV risk and to forecast trends in HIV infection. However, gay and other MSM’s sexual practices changed as the understanding of disease and treatment options advance. In the present paper, we argue that summary measures such as any CLAI do not accurately measure HIV sexual risk behaviour. Methods: Participants were 1,427 HIV-negative men from the Health in Men cohort study run from 2001 to 2007 in Sydney, Australia, with six-monthly interviews. At each interview, detailed quantitative data on the number of episodes of insertive and receptive CLAI in the last six months were collected, separated by partner type (regular vs. casual and partners’ HIV status (negative, positive, and HIV status unknown.Results: A total of 228,064 episodes of CLAI were reported during the study period with a mean of 44 episodes per year per participant (median: 14. The great majority of CLAI episodes were with a regular partner (92.6%, most of them with HIV-negative regular partners (84.8%. Participants were more likely to engage in insertive CLAI with casual than with regular partners (66.7% vs. 55.3% of all acts of CLAI with each partner type, p<0.001. Men were more likely to report CLAI in the receptive position with HIV-negative and HIV status unknown partners than with HIV-positive partners (p<0.001 for both regular and casual partners. Conclusion: Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behaviour. As HIV prevention enters the era of antiretroviral-based biomedical approach, using all forms of CLAI indiscriminately as a measure of HIV behavioural risk is not helpful in understanding the current drivers of HIV transmission in the community.

  17. Food Insecurity, Nutritional Status, and Factors Associated with Malnutrition among People Living with HIV/AIDS Attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia.

    Gebremichael, Delelegn Yilma; Hadush, Kokeb Tesfamariam; Kebede, Ermiyas Mulu; Zegeye, Robel Tezera

    2018-01-01

    In resource limited settings, HIV/AIDS patients lack access to sufficient nutritious foods, which poses challenges to the success of antiretroviral therapy. HIV/AIDS and malnutrition are still major public health problems in Ethiopia. Though measuring nutritional status is an essential part of ART program, little evidence exists on food insecurity and nutritional status of HIV/AIDS patients in Ethiopia. Hence, the study aimed to determine food insecurity and nutritional status and contextual determinants of malnutrition among HIV/AIDS patients in West Shewa Zone, Ethiopia. Institution-based cross-sectional study was conducted among HIV/ADIS patients who have been attending antiretroviral therapy at public health facilities in West Shewa Zone from April to May 2016, Ethiopia. The sample size was 512 and study participants were selected from each facilities using systematic random sampling method. Data were collected using pretested questionnaire by trained data collectors. Data were entered to Epi-Info 3.5.1 for Windows and analyzed using SPSS version 22. Logistic regression analyses were conducted to determine independent factors associated with malnutrition. Prevalence of malnutrition was 23.6% (95% CI: 19.7%-27.4%) and prevalence of household food insecurity was 35.2% (95% CI: 31.1%-39.0%). Factors significantly associated with malnutrition among HIV/AIDS patients were unemployment (AOR = 3.4; 95% CI: 1.8-5.3), WHO clinical stages III/IV (AOR = 3.3; 95% CI: 1.8-6.5), CD4 count less than 350 cells/ μ l (AOR = 2.0; 95% CI: 1.8-4.2), tuberculosis (AOR = 2.3; 95% CI: 1.3-4.9), duration on antiretroviral therapy (AOR = 1.8; 95% CI: 1.2-2.9), and household food insecurity (AOR = 5.3; 95% CI: 2.5-8.3). The findings revealed high prevalence of malnutrition and household food insecurity among HIV/AIDS patients attended ART. The negative interactive effects of undernutrition, inadequate food consumption, and HIV infection demand effective cross-sectorial integrated

  18. Food Insecurity, Nutritional Status, and Factors Associated with Malnutrition among People Living with HIV/AIDS Attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia

    Delelegn Yilma Gebremichael

    2018-01-01

    Full Text Available Background. In resource limited settings, HIV/AIDS patients lack access to sufficient nutritious foods, which poses challenges to the success of antiretroviral therapy. HIV/AIDS and malnutrition are still major public health problems in Ethiopia. Though measuring nutritional status is an essential part of ART program, little evidence exists on food insecurity and nutritional status of HIV/AIDS patients in Ethiopia. Hence, the study aimed to determine food insecurity and nutritional status and contextual determinants of malnutrition among HIV/AIDS patients in West Shewa Zone, Ethiopia. Methods. Institution-based cross-sectional study was conducted among HIV/ADIS patients who have been attending antiretroviral therapy at public health facilities in West Shewa Zone from April to May 2016, Ethiopia. The sample size was 512 and study participants were selected from each facilities using systematic random sampling method. Data were collected using pretested questionnaire by trained data collectors. Data were entered to Epi-Info 3.5.1 for Windows and analyzed using SPSS version 22. Logistic regression analyses were conducted to determine independent factors associated with malnutrition. Results. Prevalence of malnutrition was 23.6% (95% CI: 19.7%–27.4% and prevalence of household food insecurity was 35.2% (95% CI: 31.1%–39.0%. Factors significantly associated with malnutrition among HIV/AIDS patients were unemployment (AOR = 3.4; 95% CI: 1.8–5.3, WHO clinical stages III/IV (AOR = 3.3; 95% CI: 1.8–6.5, CD4 count less than 350 cells/μl (AOR = 2.0; 95% CI: 1.8–4.2, tuberculosis (AOR = 2.3; 95% CI: 1.3–4.9, duration on antiretroviral therapy (AOR = 1.8; 95% CI: 1.2–2.9, and household food insecurity (AOR = 5.3; 95% CI: 2.5–8.3. Conclusions. The findings revealed high prevalence of malnutrition and household food insecurity among HIV/AIDS patients attended ART. The negative interactive effects of undernutrition, inadequate food

  19. Estrus resynchronization in ewes with unknown pregnancy status.

    Miranda, Vladinis O; Oliveira, Fernando C; Dias, Jenniffer H; Vargas Júnior, Sergio F; Goularte, Karina L; Sá Filho, Manoel F; Sá Filho, Ocilon G de; Baldassarre, Hernan; Vieira, Arnaldo D; Lucia, Thomaz; Gasperin, Bernardo G

    2018-01-15

    Although fixed-time artificial insemination (FTAI) protocols are available for sheep, estrus resynchronization has not been previously reported. The objectives of this study were to evaluate the effect of estrus resynchronization with exogenous progestogen on endogenous progesterone levels and to compare pregnancy rates after two consecutive estrus synchronizations in ewes. In Experiment 1, ewes (n = 20) received an intravaginal device (IVD) containing 60 mg medroxyprogesterone acetate (MPA) for 10 days. At the IVD withdrawal (D0), ewes received 250 IU eCG and were allocated into two treatments: either no further treatment (Control; n = 10) or estrus resynchronization (Resynch; n = 10) from D12 to D19. Serum progesterone (P4) levels did not differ at D12 and D19 (P > 0.05), but were greater at D15 for the Control compared with the Resynch group (P ewes (n = 250) were submitted to a first synchronization protocol followed by estrus detection and either artificial insemination (AI) or natural mating (NM). Subsequently, ewes were divided into two groups: Control (n = 104): which received no further treatment and were bred by NM; and Resynch (n = 146): which were submitted to a second synchronization starting on D14 (first IVD withdrawal = D0) and to NM after second IVD withdrawal (D20). Cumulative pregnancy rates did not differ between the Control (67.3%, 70/104) and Resynch (62.3%, 91/146) groups. In a third experiment, ewes (n = 83) were bred by two consecutive FTAI within a 20-day interval. Pregnancy rates after the first (30.1%, 25/83) and the second FTAI (36.2%, 21/58) did not differ (P > 0.05). In conclusion, although exogenous progestogen supplementation reduced circulating levels of P4, pregnancy maintenance was unaffected. Estrus resynchronization in ewes is feasible, resulting in similar fertility after the first and the second services. The use of resynchronization coupled with artificial insemination using semen from genetically superior rams may potentially accelerate genetic improvement in sheep herds by allowing a higher differential selection compared with natural breeding. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Travelling with HIV

    Nielsen, Ulla S; Jensen-Fangel, Søren; Pedersen, Gitte

    2014-01-01

    BACKGROUND: We aimed to describe travel patterns, extent of professional pre-travel advice and health problems encountered during travel among HIV-infected individuals. METHODS: During a six-month period a questionnaire was handed out to 2821 adult HIV-infected individuals attending any...... of the eight Danish medical HIV care centers. RESULTS: A total of 763 individuals responded. During the previous two years 49% had travelled outside Europe; 18% had travelled less and 30% were more cautious when choosing travel destination than before the HIV diagnosis. Pre-travel advice was sought by only 38......%, and travel insurance was taken out by 86%. However, 29%/74% did not inform the advisor/the insurance company about their HIV status. Nearly all patients on highly active antiretroviral therapy (HAART) were adherent, but 58% worried about carrying HIV-medicine and 19% tried to hide it. Only 19% experienced...

  1. Dificuldades enfrentadas pelos parceiros sorodiscordantes ao HIV na manutençao do sexo seguro Dificultades enfrentadas por las parejas serodiscordantes para el HIV en el mantenimiento del sexo seguro Difficulties faced by HIV mixed status couples in maintaining safe sex

    Renata Karina Reis

    2005-02-01

    ón específica de los servicios de salud, y las estrategias preventivas deben contemplar los aspectos cultural y psicosocial que se constituyen en aspectos importantes de la vulnerabilidad de las parejas serodiscordantes.This study aimed to identify the factors that interfere in maintaining safe sex. Data were collected through individual interviews with 11 HIV/aids patients living with HIV-negative partners, under clinical treatment at a specialized aids clinic. Analysis was based on Prose analysis by André (1983. The concept of vulnerability was used as a theoretical reference framework. The sexual prevention of HIV/aids for the non infected partner constitutes one of the largest challenges for the serodiscordant couples, because men and women accept condoms differently. The greater motivation towards condom use among serodiscordant couples does not eliminate the difficulties to use them for maintaining safe sex. The serodiscordant couples deserve specific assistance, and the preventive strategies should contemplate the cultural and psychosocial aspects that constitute important aspects of mixed-status partner vulnerability.

  2. HIV-infected Children in Malawi Have Decreased Performance on the 6-minute Walk Test With Preserved Cardiac Mechanics Regardless of Antiretroviral Treatment Status.

    Sims Sanyahumbi, Amy E; Hosseinipour, Mina C; Guffey, Danielle; Hoffman, Irving; Kazembe, Peter N; McCrary, Madeline; Minard, Charles G; van der Horst, Charles; Sable, Craig A

    2017-07-01

    The aims of this study were to 1) determine if cardiac disease can be detected in HIV-infected children by strain imaging and 2) to evaluate differences in exercise performance between HIV-infected children on antiretroviral therapy (ART) and HIV-infected children not yet on ART and in HIV-uninfected children by 6-minute walk tests (6MWTs). This cross-sectional study evaluated cardiac function by echocardiogram and exercise performance by 6MWT in HIV-infected and HIV-uninfected children 4-18 years of age in Lilongwe, Malawi. Analyses compared HIV uninfected, HIV infected not yet on ART, and HIV infected on ART. Comparisons used χ test, t test, analysis of variance and multiple linear regression. No differences were found in ejection fraction, shortening fraction or strain in 73 children not yet on ART, 149 on ART and 77 HIV-uninfected controls. As viral load increased, children had worse circumferential strain. In addition, children receiving ART had better circumferential strain than those not yet on ART. Increased CD4 percentage was associated with better longitudinal strain and farther 6MWT distance. As longitudinal strain worsened, the 6MWT distance decreased. HIV-infected children not yet on ART walked a mean of 25.8 m less than HIV-uninfected children, and HIV-infected children on ART walked 25.9 m less (P = 0.015 comparing 3 groups). HIV-uninfected children performed better on the 6MWT than HIV-infected children. Lower viral load, being on ART, and higher CD4 percentage were associated with better strain measures. Better longitudinal strain was associated with a farther 6MWT distance. Overall, ejection fraction, shortening fraction and strain measures between groups were similar, so cardiac strain did not detect cardiac dysfunction in this young population.

  3. Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV-positive and HIV-negative women in Rwanda.

    Mukanyangezi, M F; Sengpiel, V; Manzi, O; Tobin, G; Rulisa, S; Bienvenu, E; Giglio, D

    2018-02-01

    Cervical cancer is the major cause of death from cancer in Africa. We wanted to assess the prevalence of human papillomavirus (HPV) infections and associated risk factors and to determine whether HPV testing could serve as a screening method for squamous intraepithelial lesions (SILs) in Rwanda. We also wanted to obtain a broader understanding of the underlying risk factors for the establishment of HPV infection in Rwanda. A total of 206 HIV-positive women, 172 HIV-negative women and 22 women with unknown HIV status were recruited at the University Teaching Hospitals of Kigali (UTHK) and of Butare (UTHB) in Rwanda. Participants underwent an interview, cervical sampling for a Thinprep Pap test and a screening test analysing 37 HPV strains. Only 27% of HIV-positive women and 7% of HIV-negative women had been screened for cervical cancer before. HPV16 and HPV52 were the most common HPV strains. HIV-positive women were more commonly infected with high-risk (HR) HPV and multitype HPV than HIV-negative women. The sensitivity was 78% and the specificity 87% to detect high-grade SIL (HSIL) with HPV screening. Among HIV-negative women, being divorced was positively associated with HR-HPV infection, while hepatitis B, Trichomonas vaginalis infection and HR-HPV infection were factors positively associated with SILs. Ever having had gonorrhoea was positively associated with HR-HPV infection among HIV-positive women. HR-HPV infection and the number of live births were positively associated with SILs. The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high-risk patients. © 2017 British HIV Association.

  4. Factors associated with conception among a sample of HIV-positive ...

    positive status, the variables were compared for women in two groups: those who conceived while knowing their HIV-positive status and those who discovered their HIV status during pregnancy. Bivariate and logistic regression analyses were ...

  5. Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia.

    Heemelaar, Steffie; Habets, Nicole; Makukula, Ziche; van Roosmalen, Jos; van den Akker, Thomas

    2015-03-01

    To assess coverage of repeat HIV testing among women who delivered in a Zambian hospital. HIV testing of pregnant women and repeat testing every 3 months during pregnancy and breastfeeding is the recommended policy in areas of high HIV prevalence. A prospective implementation study in a second-level hospital in rural Zambia. Included were all pregnant women who delivered in hospital during May and June 2012. Data regarding antenatal visits and HIV testing were collected by two investigators using a standardised form. Of 401 women who delivered in hospital, sufficient antenatal data could be retrieved for 322 (80.3%) women. Of these 322 women, 301 (93.5%) had attended antenatal care (ANC) at least once. At the time of discharge after delivery in hospital, 171 (53.1%) had an unclear HIV status because their negative test result was more than 3 months ago or of an unknown date, or because they had not been tested at all during pregnancy or delivery. An updated HIV status was present for 151 (46.9%) women: 25 (7.8%) were HIV positive and 126 (39.1%) had tested negative within the last 3 months. In this last group, 79 (24.5%) had been tested twice or more during pregnancy. During the study period, none of the women was tested during admission for delivery. Despite high ANC coverage, opportunities for repeat HIV testing were missed in almost half of all women who delivered in this hospital in a high-prevalence HIV setting. © 2014 John Wiley & Sons Ltd.

  6. Actual sexual risk and perceived risk of HIV acquisition among HIV-negative men who have sex with men in Toronto, Canada

    Maya A. Kesler

    2016-03-01

    Full Text Available Abstract Background Theory suggests that perceived human immunodeficiency virus (HIV risk and actual HIV risk behaviour are cyclical whereby engaging in high risk behaviour can increase perceived risk, which initiates precautionary behaviour that reduces actual risk, and with time reduces perceived risk. While current perceived risk may impact future actual risk, it is less clear how previous actual risk shapes current perceived risk. If individuals do not base their current perceived risk on past behaviour, they lose the protective effect of perceived risk motivating precautionary behaviour. Our goal was to determine the impact of actual risk on perceived risk. Methods Sexually active men who have sex with men (MSM were recruited at the Maple Leaf Medical Clinic in downtown Toronto from September 2010 to June 2012. Participants completed a socio-behavioural questionnaire using an Audio Computer Assisted Self-Interview (ACASI. Actual HIV risk (primary predictor was constructed by applying principal component analysis (PCA to eight sexual risk survey questions and comprised three components which reflected sex with casual partners, sex with HIV-positive regular partners and sex with HIV unknown status regular partners. Perceived HIV risk (outcome was measured by asking participants what the chances were that they would ever get HIV. Multivariable logistic regression was used to measure the association between actual and perceived HIV risk. Results One hundred and fifty HIV-negative MSM were recruited (median age 44.5 years [IQR 37–50 years]. Twenty percent of MSM perceived their HIV risk to be high. The odds of having a high perceived risk was significantly higher in those with high actual HIV risk indicated by low condom use with an HIV-positive regular partner compared to those with low actual HIV risk indicated by high condom use with an HIV-positive regular partner (Odds Ratio (OR 18.33, 95 % confidence interval (CI 1.65–203.45. Older

  7. The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda.

    Rawat, Rahul; Faust, Elizabeth; Maluccio, John A; Kadiyala, Suneetha

    2014-05-01

    Although the last decade has seen increased access to antiretroviral therapy across the developing world, widespread food insecurity and undernutrition continue to compromise an effective response to the AIDS epidemic. Limited evidence exists on the potential benefit of food security and nutrition interventions to people living with HIV (PLHIV). We capitalized on an existing intervention to PLHIV in Uganda and conducted a prospective quasi-experimental study evaluating the impact of a monthly household food basket, provided to food insecure antiretroviral therapy-naive PLHIVs for 12 months. The outcomes of interest measured at baseline and follow-up were nutritional status [body mass index; mid-upper arm circumference and hemoglobin (Hb) concentrations], disease severity (CD4 count), and 2 measures of food security: diet quality (Individual Dietary Diversity Score) and food access (Household Food Insecurity Access Scale). We used difference-in-difference propensity score matching to examine the impact of food assistance. Over 12 months, food assistance significantly increased body mass index by 0.6 kg/m (P Insecurity Access Scale, by 2.1 points (P insecurity.

  8. [Comparison of human papilloma virus infection status between men who have sex with men recruited from gay bathhouses and HIV voluntary counseling and testing clinics respectively in Urumqi].

    Tian, T; Cai, A J; Huang, B X; Abidan, Ainiwaer; Wang, H; Dai, J H

    2017-01-10

    Objective: To understand the human papilloma virus (HPV) infection status in men who have sex with men (MSM) recruited from gay bathhouses and HIV voluntary counseling and testing (VCT) clinics in Urumqi, Xinjiang Uygur autonomous region, and identify the associated risk factors. Methods: A total of 200 MSM aged ≥18 years were recruited by using the " snowballing" sampling method from gay bathhouses and VCT clinics in Urumqi during March-May, 2016. The MSM recruited completed questionnaires after filling in the informed consent form. The information about their demographic characteristics and sexual behaviors were collected, and anal swabs were collected from them for HPV genotyping. Results: The overall HPV infection rate was 54.0 % . The HPV infection rate was 66.7 % (74/111) in MSM from gay bathhouses and 38.2 % (34/89) in MSM from VCT clinics and the high risk type HPV infection rate was 39.6 % (44/111) in MSM from gay bathhouses and 14.6 % (13/89) in MSM from VCT clinics, the differences were significant ( χ (2)=16.112, P prevalence of HPV in MSM from gay bathhouses was higher than that in MSM from VCT clinics, indicating that close attention should be paid to the behavior intervention in MSM.

  9. To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status.

    Johnson, Cheryl C; Fonner, Virginia; Sands, Anita; Ford, Nathan; Obermeyer, Carla Mahklouf; Tsui, Sharon; Wong, Vincent; Baggaley, Rachel

    2017-08-29

    In accordance with global testing and treatment targets, many countries are seeking ways to reach the "90-90-90" goals, starting with diagnosing 90% of all people with HIV. Quality HIV testing services are needed to enable people with HIV to be diagnosed and linked to treatment as early as possible. It is essential that opportunities to reach people with undiagnosed HIV are not missed, diagnoses are correct and HIV-negative individuals are not inadvertently initiated on life-long treatment. We conducted this systematic review to assess the magnitude of misdiagnosis and to describe poor HIV testing practices using rapid diagnostic tests. We systematically searched peer-reviewed articles, abstracts and grey literature published from 1 January 1990 to 19 April 2017. Studies were included if they used at least two rapid diagnostic tests and reported on HIV misdiagnosis, factors related to potential misdiagnosis or described quality issues and errors related to HIV testing. Sixty-four studies were included in this review. A small proportion of false positive (median 3.1%, interquartile range (IQR): 0.4-5.2%) and false negative (median: 0.4%, IQR: 0-3.9%) diagnoses were identified. Suboptimal testing strategies were the most common factor in studies reporting misdiagnoses, particularly false positive diagnoses due to using a "tiebreaker" test to resolve discrepant test results. A substantial proportion of false negative diagnoses were related to retesting among people on antiretroviral therapy. Conclusions HIV testing errors and poor practices, particularly those resulting in false positive or false negative diagnoses, do occur but are preventable. Efforts to accelerate HIV diagnosis and linkage to treatment should be complemented by efforts to improve the quality of HIV testing services and strengthen the quality management systems, particularly the use of validated testing algorithms and strategies, retesting people diagnosed with HIV before initiating treatment and

  10. The Effect of HIV and the Modifying Effect of Anti-Retroviral Therapy (ART on Body Mass Index (BMI and Blood Pressure Levels in Rural South Africa.

    Andrea B Feigl

    Full Text Available High BMI and blood pressure are leading chronic disease risk factors in South Africa. Longterm effects of HIV and ART on adiposity and blood pressure are poorly understood, and direct comparisons of risk factor trajectories in HIV- versus HIV+ populations are rare.In 2003 and 2010, height, weight, and blood pressure were recorded in a study population (n = 505 in KwaZulu-Natal, South Africa (30% adult HIV prevalence. We modeled change in BMI and BP longitudinally in HIV- individuals (n = 315, seroconverters (n = 32, HIV+ patients not on ART (HIV+ART-; n = 52, HIV+ patients on ART for 0-<2 years as of 2010 (HIV+ART0-<2 yrs; n = 18, patients on ART for 2-5 years (HIV+ART2-5yrs; n = 44, and a subgroup with unknown HIV status (n = 44. Difference-in-differences were assessed in reference to the HIV- population.Between 2003 and 2010, BMI increased significantly in the HIV- group, by 0.874 (95% CI 0.339, 1.41; p = 0.001, to 30.4. BMI drop was significantly greater in HIV+ART0-<2yrs than in HIV+ART2-5yrs (p = 0.005. DID in BMI in HIV+ART0-<2yrs versus the reference was -5.21 (95% CI -7.53, -2.90; p = 0.001, and DID in HIV+ART2-5yrs versus reference was -1.35 (95% CI -2.89, 0.189; p = 0.086. DID in SBP in HIV+ART-vs HIV- DID was -7.55 mmHg (95% CI -13.2 to -1.90; p = 0.009.Short-term ART (0-<2 years was associated with larger weight loss than either no ART or long-term ART. Once on ART for 2+ years, individuals 'caught up' on weight gain with the HIV- population. Our results showcase the importance of health system readiness to address the burgeoning double burden of disease in South Africa.

  11. The energy equation with three unknowns

    Schifano, Fabio; Moriconi, Daniele

    2008-01-01

    This article discusses the alarming situation of energy in Italy as this country depends at 82 per cent on its imports (oil, natural gas and electricity), a dependence which could even increase. The authors first propose overviews of the situation regarding oil, natural gas and electric power (origins of imports, role of Italian companies, status of infrastructures), and also briefly of renewable energies. They recall the history of the use of nuclear energy: Italy has been one of the first country to use nuclear energy to produce electric power, but a referendum organised after Chernobyl resulted in phasing out nuclear. Then, the authors discuss perspectives associated with three main strategic unknowns: an increase of energy dependence with respect to hydrocarbons and to foreign nuclear power, a supply insecurity due to a dependence concentrated on a small number of countries (notably as far as natural gas is concerned), and an increasing interdependence between economic growth and sustainable development (the reduction of greenhouse emissions is a prevailing parameter for future energetic choices)

  12. A HIV stigma reduction intervention for people living with HIV and ...

    Johanna Beatrix Pretorius

    stigma as conceptualised by Alonzo and Reynolds (1995) is used for this ... to access healthcare as it inhibits HIV testing and disclosure of. HIV status ... 2007; Rao et al., 2012) indicates that few effective pro- ..... stress-related mental illness.

  13. Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients

    Fleming, M. F.; Krupitsky, E.; Tsoy, M.; Zvartau, E.; Brazhenko, N.; Jakubowiak, W.; E. McCaul, M.

    2006-01-01

    SUMMARY SETTING: Alcohol use, tuberculosis (TB) drug resistance and human immunodeficiency virus (HIV) risk behavior are of increasing concern in Russian TB patients. DESIGN: A prevalence study of alcohol use and HIV risk behavior was conducted in a sample of 200 adult men and women admitted to TB hospitals in St Petersburg and Ivanovo, Russia. RESULTS: Of the subjects, 72% were men. The mean age was 41. Active TB was diagnosed using a combination of chest X-ray, sputum smears and sputum cultures. Sixty-two per cent met DSM-IV criteria for current alcohol abuse or dependence. Drug use was uncommon, with only two patients reporting recent intravenous heroin use. There was one case of HIV infection. The mean total risk assessment battery score was 3.4. Depression was present in 60% of the sample, with 17% severely depressed. Alcohol abuse/dependence was associated with an eight-fold increase in drug resistance (OR 8.58; 95% CI 2.09-35.32). Patients with relapsing or chronic TB were more likely to meet the criteria for alcohol abuse/dependence (OR 2.56; 95% CI 1.0-6.54). CONCLUSION: Alcohol use disorders are common in patients being treated for active TB, and are associated with significant morbidity. Additional surveys are needed to examine the relationship between alcohol use disorders and anti-tuberculosis drug resistance. CONTEXTE: Chezles patients tuberculeux russes, l’utilisation d’alcool, la résistance aux médicaments antituberculeux et un comportement à risque pour le virus de l’immunodéficience humaine (VIH) sont des sujets croissants d’inquiétude. SCHÉMA: Une étude: de prévalence de l’utilisation d’alcool et du comportement à risque pour le VIH a été menée sur un échantillon de 200 hommes et femmes adultes, admis dans des hôpitaux pour la tuberculose (TB) de Saint-Pétersbourg et d’Ivanovo en Russie. RÉSULTATS: Il y avait 72% d’hommes dans l’échantillon. L’âge moyen est de 41 ans. On a diagnostiqué la TB active par l

  14. Daily consumption of ready to use peanut based therapeutic food increased fat free mass, improved anemic status but has no impact on the zinc status of people living with HIV/AIDS: a randomized controlled trial

    Diouf, Adama; Badiane, Abdou; Idohou-Dossou, Nicole; Wade, Salimata; Manga, Noel Magloire; Sow, Papa Salif

    2016-01-01

    Background: Food insecurity in sub-Saharan Africa and malnutrition constitute the main obstacles for successful treatment of people living with HIV/AIDS (PLWH). The aim of this study was to assess the effect of consuming daily 100 g RUTF (ready-to-use therapeutic food) as supplement, on body composition, anemia and zinc status of hospitalized PLWH in Senegal. Methods: A Controlled clinical trial was conducted in 65 PLWH randomly allocated to receive either standard hospital diet alone (Control group: n=33), or the standard diet supplemented with 100 g RUTF/day (RUTF group: n=32). Supplementation was continued at home during 9 weeks. Individual dietary intakes were measured and compared to the Recommended Dietary Allowances. Body composition was determined using Bio-Impedance Analysis. Hemoglobin was measured by HemoCue and plasma zinc (PZ) concentration by atomic absorption spectrometry. PZ was adjusted to infection (CRP and -+a1-AGP). All measures were conducted on admission, discharge and after 9 weeks home-based follow up. Results: 34 and 24 % of the patients in RUTF and Control groups were suffering from severe malnutrition (BMI 16 kg/m2), respectively. In both groups, more than 90 % were anemic and zinc deficiency affected over 50 % of the patients. Food consumed by the Control group represented 75, 14 and 55 % of their daily recommended intake (DRI) of energy, iron and zinc, respectively. When 100 g of RUTF was consumed with the standard diet, the DRI of energy and zinc were 100 % covered (2147 kcal, 10.4 mg, respectively), but not iron (2.9 mg). After 9 weeks of supplementation, body weight, and fat-free mass increased significantly by +11 % (p= 0.033), and +11.8 % (p= 0.033) in the RUTF group, but not in the Control group, while percentage body fat was comparable between groups (p=0.888). In the RUTF group, fat free mass gain is higher in the patients on ART (+11.7 %, n=14; p=0.0001) than in those without ART (+6.2 %, n= 6; p=0.032). Anemia decreased

  15. Uptake of health care services and health status of HIV-infected women diagnosed through antenatal HIV screening in Barbados, 1996-2004 Utilización de los servicios de atención sanitaria y estado de salud de las mujeres seropositivas al VIH diagnosticadas mediante el tamizaje prenatal para el VIH en Barbados, 1996-2004

    Alok Kumar

    2007-12-01

    Full Text Available OBJECTIVES: To study utilization of HIV-related health care services and to describe the health status of HIV-infected women diagnosed through antenatal voluntary counseling and testing (VCT for HIV infection in Barbados. METHODS: This is a descriptive study. The study population includes all HIV-infected women in Barbados diagnosed as HIV-infected through VCT for HIV infection during 1996-2004. RESULTS: The median duration of HIV infection from time of diagnosis to the time of this report for the 163 women diagnosed during the study period was 72 months (low range, 9 months; high range, 117 months. Of the 163 women, 102 (62.6% had attended the centralized HIV/AIDS clinic for follow-up (care, treatment, and monitoring, whereas 61 (37.4% had never attended the clinic. The median time lag between diagnosis of HIV infection and first presentation to the HIV/AIDS clinic was 36 months (low range, 1 month; high range, 114 months. Of the HIV-infected women who attended the HIV/AIDS clinic, more than one-fourth had severe immunodeficiency at the time of their first follow-up visit. Of the 53 women undergoing highly active anti-retroviral therapy (HAART at the time of the study, 23 (43.4% began the therapy within three months of their first follow-up visit. CONCLUSIONS: Early HIV diagnosis through antenatal VCT is not enough to ensure that women with HIV will get adequate and timely HIV-related health care. These women suffer significant premature mortality, largely related to inadequate follow-up.OBJETIVOS: Estudiar la utilización de los servicios de atención sanitaria relacionados con el VIH y describir el estado de salud de las mujeres infectadas con este virus, diagnosticadas mediante el asesoramiento y la prueba de detección del VIH de carácter voluntario (APDV durante el período prenatal en Barbados. MÉTODOS: Este es un estudio descriptivo. La población de estudio abarcó a todas las mujeres infectadas por el VIH, diagnosticadas en Barbados

  16. Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review

    Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

    2015-01-01

    Introduction: Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. Methods: We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violenc...

  17. Risk Factors for HIV Transmission and Barriers to HIV Disclosure: Metropolitan Atlanta Youth Perspectives.

    Camacho-Gonzalez, Andres F; Wallins, Amy; Toledo, Lauren; Murray, Ashley; Gaul, Zaneta; Sutton, Madeline Y; Gillespie, Scott; Leong, Traci; Graves, Chanda; Chakraborty, Rana

    2016-01-01

    Youth carry the highest incidence of HIV infection in the United States. Understanding adolescent and young adult (AYA) perspectives on HIV transmission risk is important for targeted HIV prevention. We conducted a mixed methods study with HIV-infected and uninfected youth, ages 18-24 years, from Atlanta, GA. We provided self-administered surveys to HIV-infected and HIV-uninfected AYAs to identify risk factors for HIV acquisition. By means of computer-assisted thematic analyses, we examined transcribed focus group responses on HIV education, contributors to HIV transmission, and pre-sex HIV status disclosure. The 68 participants had the following characteristics: mean age 21.5 years (standard deviation: 1.8 years), 85% male, 90% black, 68% HIV-infected. HIV risk behaviors included the perception of condomless sex (Likert scale mean: 8.0) and transactional sex (88% of participants); no differences were noted by HIV status. Qualitative analyses revealed two main themes: (1) HIV risk factors among AYAs, and (2) barriers to discussing HIV status before sex. Participants felt the use of social media, need for immediate gratification, and lack of concern about HIV disease were risk factors for AYAs. Discussing HIV status with sex partners was uncommon. Key reasons included: fear of rejection, lack of confidentiality, discussion was unnecessary in temporary relationships, and disclosure negatively affecting the mood. HIV prevention strategies for AYAs should include improving condom use frequency and HIV disclosure skills, responsible utilization of social media, and education addressing HIV prevention including the risks of transactional sex.

  18. The uptake of integrated perinatal prevention of mother-to-child HIV transmission programs in low- and middle-income countries: a systematic review.

    Lorainne Tudor Car

    Full Text Available BACKGROUND: The objective of this review was to assess the uptake of WHO recommended integrated perinatal prevention of mother-to-child transmission (PMTCT of HIV interventions in low- and middle-income countries. METHODS AND FINDINGS: We searched 21 databases for observational studies presenting uptake of integrated PMTCT programs in low- and middle-income countries. Forty-one studies on programs implemented between 1997 and 2006, met inclusion criteria. The proportion of women attending antenatal care who were counseled and who were tested was high; 96% (range 30-100% and 81% (range 26-100%, respectively. However, the overall median proportion of HIV positive women provided with antiretroviral prophylaxis in antenatal care and attending labor ward was 55% (range 22-99% and 60% (range 19-100%, respectively. The proportion of women with unknown HIV status, tested for HIV at labor ward was 70%. Overall, 79% (range 44-100% of infants were tested for HIV and 11% (range 3-18% of them were HIV positive. We designed two PMTCT cascades using studies with outcomes for all perinatal PMTCT interventions which showed that an estimated 22% of all HIV positive women attending antenatal care and 11% of all HIV positive women delivering at labor ward were not notified about their HIV status and did not participate in PMTCT program. Only 17% of HIV positive antenatal care attendees and their infants are known to have taken antiretroviral prophylaxis. CONCLUSION: The existing evidence provides information only about the initial PMTCT programs which were based on the old WHO PMTCT guidelines. The uptake of counseling and HIV testing among pregnant women attending antenatal care was high, but their retention in PMTCT programs was low. The majority of women in the included studies did not receive ARV prophylaxis in antenatal care; nor did they attend labor ward. More studies evaluating the uptake in current PMTCT programs are urgently needed.

  19. The uptake of integrated perinatal prevention of mother-to-child HIV transmission programs in low- and middle-income countries: a systematic review.

    Tudor Car, Lorainne; Brusamento, Serena; Elmoniry, Hoda; van Velthoven, Michelle H M M T; Pape, Utz J; Welch, Vivian; Tugwell, Peter; Majeed, Azeem; Rudan, Igor; Car, Josip; Atun, Rifat

    2013-01-01

    The objective of this review was to assess the uptake of WHO recommended integrated perinatal prevention of mother-to-child transmission (PMTCT) of HIV interventions in low- and middle-income countries. We searched 21 databases for observational studies presenting uptake of integrated PMTCT programs in low- and middle-income countries. Forty-one studies on programs implemented between 1997 and 2006, met inclusion criteria. The proportion of women attending antenatal care who were counseled and who were tested was high; 96% (range 30-100%) and 81% (range 26-100%), respectively. However, the overall median proportion of HIV positive women provided with antiretroviral prophylaxis in antenatal care and attending labor ward was 55% (range 22-99%) and 60% (range 19-100%), respectively. The proportion of women with unknown HIV status, tested for HIV at labor ward was 70%. Overall, 79% (range 44-100%) of infants were tested for HIV and 11% (range 3-18%) of them were HIV positive. We designed two PMTCT cascades using studies with outcomes for all perinatal PMTCT interventions which showed that an estimated 22% of all HIV positive women attending antenatal care and 11% of all HIV positive women delivering at labor ward were not notified about their HIV status and did not participate in PMTCT program. Only 17% of HIV positive antenatal care attendees and their infants are known to have taken antiretroviral prophylaxis. The existing evidence provides information only about the initial PMTCT programs which were based on the old WHO PMTCT guidelines. The uptake of counseling and HIV testing among pregnant women attending antenatal care was high, but their retention in PMTCT programs was low. The majority of women in the included studies did not receive ARV prophylaxis in antenatal care; nor did they attend labor ward. More studies evaluating the uptake in current PMTCT programs are urgently needed.

  20. Partner testing, linkage to care, and HIV-free survival in a program to prevent parent-to-child transmission of HIV in the Highlands of Papua New Guinea

    Carmone, Andy; Bomai, Korai; Bongi, Wayaki; Frank, Tarua Dale; Dalepa, Huleve; Loifa, Betty; Kiromat, Mobumo; Das, Sarthak; Franke, Molly F.

    2014-01-01

    Background To eliminate new pediatric HIV infections, interventions that facilitate adherence, including those that minimize stigma, enhance social support, and mitigate the influence of poverty, will likely be required in addition to combination antiretroviral therapy (ART). We examined the relationship between partner testing and infant outcome in a prevention of parent-to-child transmission of HIV program, which included a family-centered case management approach and a supportive environment for partner disclosure and testing. Design We analyzed routinely collected data for women and infants who enrolled in the parent-to-child transmission of HIV program at Goroka Family Clinic, Eastern Highlands Provincial Hospital, Papua New Guinea, from 2007 through 2011. Results Two hundred and sixty five women were included for analysis. Of these, 226 (85%) had a partner, 127 (56%) of whom had a documented HIV test. Of the 102 HIV-infected partners, 81 (79%) had been linked to care. In adjusted analyses, we found a significantly higher risk of infant death, infant HIV infection, or loss to follow-up among mother–infant pairs in which the mother reported having no partner or a partner who was not tested or had an unknown testing status. In a second multivariable analysis, infants born to women with more time on ART or who enrolled in the program in later years experienced greater HIV-free survival. Conclusions In a program with a patient-oriented and family-centered approach to prevent vertical HIV transmission, the majority of women's partners had a documented HIV test and, if positive, linkage to care. Having a tested partner was associated with program retention and HIV-free survival for infants. Programs aiming to facilitate diagnosis disclosure, partner testing, and linkage to care may contribute importantly to the elimination of pediatric HIV. PMID:25172429

  1. Cancer treatment disparities in HIV-infected individuals in the United States.

    Suneja, Gita; Shiels, Meredith S; Angulo, Rory; Copeland, Glenn E; Gonsalves, Lou; Hakenewerth, Anne M; Macomber, Kathryn E; Melville, Sharon K; Engels, Eric A

    2014-08-01

    HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this. We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer. We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non-small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage. HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates. © 2014 by American Society of Clinical

  2. Association between HIV status and depressive symptoms among children and adolescents in the Southern Highlands Zone, Tanzania: A case-control study.

    Lwidiko, Abraham; Kibusi, Stephen Matthew; Nyundo, Azan; Mpondo, Bonaventura C T

    2018-01-01

    Children and adolescents continue to have HIV/AIDS in southern Saharan Africa. Scaling up of HIV services has significantly improved access to ARV and consequently improved on morbidity and mortality related to HIV/AIDS including opportunistic infection. Despite the above efforts, non-communicable conditions including mental disorders such as depression have been observed to contribute to the burden of disabilities about which little is documented. This study, therefore, aimed to determine the magnitude of depressive symptoms and the associated factors among HIV-infected children and adolescents. The study was a matched case-control design involving 300 cases of HIV-infected children matched by age and sex against 600 uninfected controls. Systematic sampling technique was used to select the cases while multistage sampling technique was employed to identify villages/ streets purposive and sampling technique was employed to obtain participants from households. The overall prevalence of depressive symptoms among the cohort of 900 participants was found to be 12.9%, with 27% of HIV-infected and 5.8% of HIV-uninfected children and adolescents screened positive for depressive symptoms. Multiple logistic regression revealed that being HIV-infected (AOR 1.96(1.11-3.45)), residing in a rural setting (AOR 0.61(0.39-0.96)) and history of childhood deprivation (AOR 4.76 (2.79-8.13)) were significantly associated with depressive symptoms. HIV infected adolescents are more affected by depression compared to non-infected counterparts. Childhood deprivation was significantly associated with presence of depressive symptoms. Integration of mental health evaluation and treatment into the HIV care provided for adolescents can be beneficial. More studies to delineate factors associated with depressed adolescents with HIV may add value to the body of knowledge and overall improvement of care.

  3. Factors Associated with HIV Testing Among Participants from Substance Use Disorder Treatment Programs in the US: A Machine Learning Approach.

    Pan, Yue; Liu, Hongmei; Metsch, Lisa R; Feaster, Daniel J

    2017-02-01

    HIV testing is the foundation for consolidated HIV treatment and prevention. In this study, we aim to discover the most relevant variables for predicting HIV testing uptake among substance users in substance use disorder treatment programs by applying random forest (RF), a robust multivariate statistical learning method. We also provide a descriptive introduction to this method for those who are unfamiliar with it. We used data from the National Institute on Drug Abuse Clinical Trials Network HIV testing and counseling study (CTN-0032). A total of 1281 HIV-negative or status unknown participants from 12 US community-based substance use disorder treatment programs were included and were randomized into three HIV testing and counseling treatment groups. The a priori primary outcome was self-reported receipt of HIV test results. Classification accuracy of RF was compared to logistic regression, a standard statistical approach for binary outcomes. Variable importance measures for the RF model were used to select the most relevant variables. RF based models produced much higher classification accuracy than those based on logistic regression. Treatment group is the most important predictor among all covariates, with a variable importance index of 12.9%. RF variable importance revealed that several types of condomless sex behaviors, condom use self-efficacy and attitudes towards condom use, and level of depression are the most important predictors of receipt of HIV testing results. There is a non-linear negative relationship between count of condomless sex acts and the receipt of HIV testing. In conclusion, RF seems promising in discovering important factors related to HIV testing uptake among large numbers of predictors and should be encouraged in future HIV prevention and treatment research and intervention program evaluations.

  4. Opportunistic and non-opportunistic intestinal parasites in HIV/ AIDS patients in relation to their clinical and epidemiological status in a specialized medical service in Goiás, Brazil.

    Barcelos, Natane Barbosa; Silva, Lorena de Freitas E; Dias, Regyane Ferreira Guimarães; Menezes Filho, Hélio Ranes de; Rodrigues, Rosângela Maria

    2018-03-08

    Patients infected with the Human Immunodeficiency Virus (HIV) often have opportunistic infections, among which strongyloidiasis and coccidiosis are the most common parasitic infections that aggravate their health status. This study examined the prevalence of intestinal parasites, particularly of Strongyloides stercoralis and intestinal coccidia in patients with the Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) who were treated at the Specialized Assistance Service (SAE) of Jataí, State of Goiás, Brazil, and analyzed its correlation with clinical, laboratory, and socio-epidemiological parameters. A total of 270 stool samples were analyzed by the Lutz technique, Rugai's method, Agar Plate Culture, Ritchie's method and specific staining, Ziehl-Neelsen modified technique, Kinyoun's method and the rapid safranin method. The prevalence of intestinal parasites was 28.88% including 3.8% of S. stercoralis, Cryptosporidium sp. and Cystoisospora belli. There was a significant positive correlation between intestinal parasites and the clinical status and the use of antiretroviral therapy (ART), smoking, CD4+ lymphocyte counts and sexual orientation. In conclusion, the widespread use of antiretroviral therapy and health assistance contributed to the low prevalence of S. stercoralis and coccidiosis in patients with HIV/ AIDS who were followed up at the SAE.

  5. Nutrition and HIV

    Friis, Henrik; Olsen, Mette Frahm; Filteau, Suzanne

    2017-01-01

    , which is mainly synergistic and operating at different levels. HIV infection increases energy and nutrient requirements, yet it reduces food security. The result is nutritional deficiencies, which increase progression of HIV infection. Both undernutrition and food insecurity may also lead to increased...... risk of transmission. Nutritional intake and status may affect metabolism of antiretroviral drugs, some of which may affect body composition, and increase risk of the metabolic syndrome. In addition, HIV is transmitted through breastfeeding, causing a serious infant feeding dilemma for which...

  6. HLA-DQBl*0402 alleles polymorphisms detected in Javanese HIV patients with positive anti-Toxoplasma gondii IgM

    Sari, Yulia; Haryati, Sri; Prasetyo, Afiono Agung; Hartono, Adnan, Zainal Arifin

    2017-02-01

    The human leukocyte antigen (HLA)-DQB1 gene polymorphisms may associated with the infection risk of Toxoplasma gondii in HIV patients. The HLA-DQB1*0402 in HIV-1-positive patients could be considered risk factors for developing neurological opportunistic infections, mainly Toxoplasma encephalitis. However, the HLA-DQB1*0402 gene polymorphisms status in the Javanese HIV patients is unknown. This study evaluated the prevalence of HLA-DQB*0402 alleles polymorphisms in Javanese HIV patients with positive anti-Toxoplasma gondii IgM status. Since 2009 our research group performing a molecular epidemiology of blood borne viruses in Central Java Indonesia, by collecting the epidemiological and clinical data from the high risk communities. All blood samples were screened for blood borne pathogens by serological and molecular assays including for HIV and Toxoplasma gondii. The genomic DNA was isolated from the whole blood samples. Genetic polymorphisms of HLA-DQB1*0402 alleles were detected with polymerase chain reaction-sequence-specific primers (PCR-SSPs) technique. The genotypes were defined according to generated fragment patterns in the agarose gel electrophoresis analysis of PCR products. All of the samples were tested at least in duplicate. HLA-DQB1*0402 alleles were detected in 20.8% (16/77) patients and not detected in all HIV positive samples with negative anti-Toxoplasma gondii IgM status (n= 200). The HLA-DQB1*0402 alleles polymorphisms were detected in Javanese HIV patients with positive anti-Toxoplasma gondii IgM. The polymorphisms found may have association with the infection risk of Toxoplasma gondii in HIV patients.

  7. The metabolic profiles of HIV-infected and non-infected women in ...

    infected and HIV-uninfected women. Conclusions: The results indicate a possible impact of HIV infection on serum protein and serum albumin, which may adversely affect biochemical nutritional status and the course of HIV progression.

  8. Oral rapid test: an alternative to traditional HIV screening in Chile

    Lisette Paola Irarrazábal

    2013-06-01

    Full Text Available OBJECTIVE: To compare the sensitivity and specificity of an Oral Rapid Test (ORT to that of the Enzyme-Linked Immunosorbent Assay (ELISA for HIV testing in Santiago, Chile; to track the number of study participants returning for ELISA testing results; and to analyze the participants' perceptions of the ORT compared to the ELISA. METHODS: A total of 497 people were recruited in Santiago, Chile: 153 had previously tested positive for HIV, and 344 were of unknown status. Participants were tested for HIV using both the ELISA and the ORT to examine and compare specificity and sensitivity. Qualitative data were collected from 22 participants to compare perceptions of the testing experience with ORT versus ELISA. RESULTS: The ELISA reported 184 (37% of the 497 participants as being "positive" for HIV antibodies; the ORT showed 181 (36.4% as being "reactive" for HIV. The ORT showed a sensitivity of 98.4% (95.7%-99.9%, 95% Confidence Interval and specificity of 100%. The Kappa test produced K = 0.983 (P < 0.0001. Of the 344 participants whose HIV status was unknown at the start of the study, 55 failed to return for their ELISA results. Participants positively perceived ORT as having reduced both waiting time and anxiety over obtaining their test results. ORT oral swabbing appeared more practical and less invasive than drawing blood for the ELISA. CONCLUSIONS: The ORT and ELISA were statistically equal in specificity and sensitivity. ORT provides quicker results, potentially ensuring that more people receive them, and does not require handling of or exposure to potentially hazardous blood products. Trial number: ClinicalTrials.gov identifier: NCT01733927.

  9. Characteristics of Black Men Who Have Sex With Men in Baltimore, Philadelphia, and Washington, D.C.: Geographic Diversity in Socio-Demographics and HIV Transmission Risk.

    German, Danielle; Brady, Kathleen; Kuo, Irene; Opoku, Jenevieve; Flynn, Colin; Patrick, Rudy; Park, Ju Nyeong; Adams, Joella; Carroll, Makeda; Simmons, Ron; Smith, Carlton R; Davis, Wendy W

    2017-07-01

    Baltimore, Philadelphia, and Washington, DC are geographically proximate cities with high HIV prevalence, including among black men who have sex with men (BMSM). Using data collected among BMSM in CDC's National HIV Behavioral Surveillance project, we compared socio-demographic characteristics, HIV risk behaviors, and service utilization to explore similarities and differences that could inform local and regional HIV intervention approaches. BMSM were recruited through venue time location sampling, June-December, 2011. Participants completed identical socio-behavioral surveys and voluntary HIV testing. Analyses were conducted among the full sample and those aged 18-24. Participants included 159 (DC), 364 (Baltimore), and 331 (Philadelphia) eligible BMSM. HIV prevalence was 23.1% (DC), 48.0% (Baltimore), 14.6% (Philadelphia) with 30.6%, 69.0%, 33.3% unrecognized HIV infection, respectively. Among BMSM 18-24, HIV prevalence was 11.1% (DC), 38.9% (Baltimore), 9.6% (Philadelphia) with unrecognized HIV infection 0.0%, 73.8%, 60.0% respectively. Compared with the other 2 cities, Baltimore participants were less likely to identify as gay/homosexual; more likely to report unemployment, incarceration, homelessness, sex exchange; and least likely to use the internet for partners. DC participants were more likely to have a college degree and employment. Philadelphia participants were more likely to report gay/homosexual identity, receptive condomless anal sex, having only main partners, and bars/clubs as partner meeting places. Sexually transmitted disease testing was universally low. Analyses showed especially high HIV prevalence among BMSM in Baltimore including among young BMSM. Socio-demographic characteristics and HIV infection correlates differed across cities but unrecognized HIV infection and unknown partner status were universally high.

  10. Evolution of the health sector response to HIV in Myanmar: progress, challenges and the way forward.

    Oo, Htun Nyunt; Hone, San; Fujita, Masami; Maw-Naing, Amaya; Boonto, Krittayawan; Jacobs, Marjolein; Phyu, Sabe; Bollen, Phavady; Cheung, Jacquie; Aung, Htin; Aung Sang, May Thu; Myat Soe, Aye; Pendse, Razia; Murphy, Eamonn

    2016-11-28

    Critical building blocks for the response to HIV were made until 2012 despite a series of political, social and financial challenges. A rapid increase of HIV service coverage was observed from 2012 to 2015 through collaborative efforts of government and non-governmental organisations (NGOs). Government facilities, in particular, demonstrated their capacity to expand services for antiretroviral therapy (ART), prevention of mother-to-child transmission (PMTCT) of HIV, tuberculosis and HIV co-infection and methadone-maintenance therapy (MMT). After nearly three decades into the response to HIV, Myanmar has adopted strategies to provide the right interventions to the right people in the right places to maximise impact and cost efficiency. In particular, the country is now using strategic information to classify areas into high-, medium- and low-HIV burden and risk of new infections for geographical prioritisation - as HIV remains concentrated among key population (KP) groups in specific geographical areas. Ways forward include: •Addressing structural barriers for KP to access services, and identifying and targeting KPs at higher risk;•Strengthening the network of public facilities, NGOs and general practitioners and introducing a case management approach to assist KPs and other clients with unknown HIV status, HIV-negative clients and newly diagnosed clients to access the health services across the continuum to increase the number of people testing for HIV and to reduce loss to follow-up in both prevention and treatment;•Increasing the availability of HIV testing and counselling services for KPs, clients of female sex workers (FSW), and other populations at risk, and raising the demand for timely testing including expansion of outreach and client-initiated voluntary counselling and testing (VCT) services;•Monitoring and maximising retention from HIV diagnosis to ART initiation and expanding quality HIV laboratory services, especially viral load

  11. Beyond HIV-serodiscordance: Partnership communication dynamics that affect engagement in safer conception care.

    Lynn T Matthews

    Full Text Available We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda.We recruited HIV-positive men and women on antiretroviral therapy (ART ('index' from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner ('partner', HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision. Translated and transcribed data were analyzed using thematic analysis.11/20 index participants were women, median age of 32.5 years, median of 2 living children, and 80% had HIV-RNA <400 copies/mL. Awareness of HIV prevention strategies beyond condoms and abstinence was limited and precluded opportunity to explore or validly assess acceptability or feasibility of safer conception methods. Four key partnership communication challenges emerged as primary barriers to engagement in safer conception care, including: (1 HIV-serostatus disclosure: Although disclosure was an inclusion criterion, partners commonly reported not knowing the index partner's HIV status. Similarly, the partner's HIV-serostatus, as reported by the index, was frequently inaccurate. (2 Childbearing intention: Many couples had divergent childbearing intentions and made incorrect assumptions about their partner's desires. (3 HIV risk perception: Participants had disparate understandings of HIV transmission and disagreed on the acceptable level of HIV risk to meet reproductive goals. (4 Partnership commitment: Participants revealed significant discord in perceptions of partnership commitment. All four types of partnership

  12. Differences in HIV natural history among African and non-African seroconverters in Europe and seroconverters in sub-Saharan Africa

    Pantazis, Nikos; Morrison, Charles; Amornkul, Pauli N

    2012-01-01

    It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations.......It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations....

  13. HIV Testing

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... All Collapse All Should I get tested for HIV? CDC recommends that everyone between the ages of ...

  14. HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection.

    Eaton, Lisa A; West, Tessa V; Kenny, David A; Kalichman, Seth C

    2009-04-01

    Selecting sex partners of the same HIV status or serosorting is a sexual risk reduction strategy used by many men who have sex with men. However, the effectiveness of serosorting for protection against HIV is potentially limited. We sought to examine how men perceive the protective benefits of factors related to serosorting including beliefs about engaging in serosorting, sexual communication, and perceptions of risk for HIV. Participants were 94 HIV negative seroconcordant (same HIV status) couples, 20 HIV serodiscordant (discrepant HIV status) couples, and 13 HIV positive seroconcordant (same HIV status) couples recruited from a large gay pride festival in the southeastern US. To account for nonindependence found in the couple-level data, we used multilevel modeling which includes dyad in the analysis. Findings demonstrated that participants in seroconcordant relationships were more likely to believe that serosorting reduces concerns for condom use. HIV negative participants in seroconcordant relationships viewed themselves at relatively low risk for HIV transmission even though monogamy within relationships and HIV testing were infrequent. Dyadic analyses demonstrated that partners have a substantial effect on an individual's beliefs and number of unprotected sex partners. We conclude that relationship partners are an important source of influence and, thus, intervening with partners is necessary to reduce HIV transmission risks.

  15. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India

    M Dash

    2013-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV counseling and testing (HCT conducted at integrated counseling and testing centers (ICTCs is an entry point, cost-effective intervention in preventing transmission of HIV. Objectives: To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. Materials and Methods: It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. Results: A total of 1732 (7.5% out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7% were males, while 594 (34.3% were females. Majority (88.3% of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1% was more seropositive compared to provider-initiated (2.9%. Among discordant couples, majority (95.5% were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001. Risk factors included heterosexual promiscuous (89.3%, parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%. Conclusions: There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  16. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India.

    Dash, M; Padhi, S; Sahu, S; Mohanty, I; Panda, P; Parida, B; Sahoo, M K

    2013-01-01

    Human immunodeficiency virus (HIV) counseling and testing (HCT) conducted at integrated counseling and testing centers (ICTCs) is an entry point, cost-effective intervention in preventing transmission of HIV. To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. A total of 1732 (7.5%) out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7%) were males, while 594 (34.3%) were females. Majority (88.3%) of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1%) was more seropositive compared to provider-initiated (2.9%). Among discordant couples, majority (95.5%) were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001). Risk factors included heterosexual promiscuous (89.3%), parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%). There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  17. Experiences of HIV stigma: the role of visible symptoms, HIV centrality and community attachment for people living with HIV.

    Brener, Loren; Callander, Denton; Slavin, Sean; de Wit, John

    2013-01-01

    For many people living with HIV (PLHIV), disclosure or concealment of their HIV status may be under their personal control; however, for PLHIV with visible symptoms of their illness, disclosure may no longer be a choice. Previous research suggests that those with visible HIV symptoms have poorer mental and physical health than those without visible HIV symptoms. This study aimed to extend these findings and assess the role of perceived centrality of HIV in the lives of PLHIV as well as the role of attachment to an HIV-positive community in understanding the negative effects on health and well-being for PLHIV with visible HIV symptoms. Participants were 697 PLHIV who completed an online survey that assessed symptom visibility, HIV-status disclosure, perceived stigma, health and well-being, how central HIV was to identity and HIV community attachment. Results indicate that those with visible symptoms experienced more HIV-related stigma and had poorer outcomes on a range of psychological and mental health measures than those who were able to conceal their stigma. These effects remained after controlling for length of time since diagnosis, time on HIV treatment, perceived health satisfaction and age. PLHIV with visible symptoms also reported that HIV was more central to their identity and reported greater attachment to an HIV-positive community. Furthermore, findings suggest that while HIV centrality appears to increase the negative effects of having visible symptoms associated with HIV, greater community attachment seems to ameliorate these effects. This suggests the need for a nuanced understanding of the implications of visible HIV symptoms for PLHIV. The study also highlights the potential benefits of HIV-positive community attachment in buffering PLHIV from the negative effect of visible HIV symptoms on their health and well-being.

  18. The experience of African American women living with HIV: creating a prevention film for teens.

    Norris, Anne E; DeMarco, Rosanna

    2005-01-01

    The personal and social costs of HIV are well documented. What remains unknown is the effect of public disclosure of HIV status on the individual who is doing the disclosing. This study describes the experience of four African American women living with HIV who participated in the development of an intergenerational education intervention for African American adolescent girls. These women suggested that they be filmed discussing the "dark side" of HIV in an effort to create an intergenerational education intervention that would alter the risk-taking behavior that they observed in young women in their community. After a rough cut of the film was completed, these women viewed the film and participated in a focus group during which they discussed what it was like to reveal and revisit their own painful experiences associated with becoming infected and then living with HIV. Findings from content analysis of transcribed dialogue included the following positive themes: (a) self-acceptance by telling one's own story and hearing the stories of the other women, (b) a sense of liberation by disclosing publicly one's image and message and letting go of others' judgments, (c) feeling supported by meeting other women who share the same experience, (d) value of using the film to impact or save young people from the pain one has experienced. A negative theme emerged related to personal pain in reliving the individual's history with HIV.

  19. Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

    Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

    2013-10-01

    Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

  20. Pharmacokinetics and pharmacodynamics in HIV prevention; current status and future directions: a summary of the DAIDS and BMGF sponsored think tank on pharmacokinetics (PK)/pharmacodynamics (PD) in HIV prevention.

    Romano, Joseph; Kashuba, Angela; Becker, Stephen; Cummins, James; Turpin, Jim; Veronese, Fulvia

    2013-11-01

    Thirty years after its beginning, the HIV/AIDS epidemic is still raging around the world. According to UNAIDS, in 2011 alone 1.7M deaths were attributable to AIDS, and 2.5M people were newly infected by the virus. Despite the success in treating HIV-infected people with potent antiretroviral drugs, preventing HIV infection is the key to ending the epidemic. Recently, the efficacy of topical and systemic antiviral chemoprophylaxis (i.e., preexposure prophylaxis or "PrEP"), using the same drugs used for HIV treatment, has been demonstrated in a number of clinical trials. However, results from other trials have been inconsistent, especially those evaluating PrEP in women. These inconsistencies may result from our incomplete understanding of pharmacokinetics (PK)/pharmacodynamics (PD) at the mucosal sites of sexual transmission: the male and female gastrointestinal and reproductive tracts. The drug concentrations used in these trials were derived from those used for treatment; however, we still do not know the relationship between the therapeutic and the preventive dose. This article presents the first comprehensive review of the available data in the HIV pharmacology field from animal models to human studies, and outlines gaps, challenges, and future directions. Addressing these pharmacological gaps and challenges will be critical in selecting and advancing future PrEP candidates and strategies with the greatest impact on the HIV epidemic.

  1. Accessibility of Early Infant Diagnostic Services by Under-5 Years and HIV Exposed Children in Muheza District, North-East Tanzania

    Veneranda M. Bwana

    2018-05-01

    Full Text Available Introduction: Early infant diagnosis (EID of Human Immunodeficiency Virus (HIV provides an opportunity for follow up of HIV exposed children for early detection of infection and timely access to antiretroviral treatment. We assessed predictors for accessing HIV diagnostic services among under-five children exposed to HIV infection in Muheza district, Tanzania.Methods: A cross sectional facility-based study among mother/guardian-child pairs of HIV exposed children was conducted from June 2015 to June 2016. Using a structured questionnaire, we collected information on HIV status, socio-demographic characteristics and other relevant data. Multiple regression analyses were used to investigate associations of potential predictors of accessing EID services.Results: A total of 576 children with their respective mothers/guardians were recruited. Of the 576 mothers/guardians, 549 (95.3% were the biological mothers with a median age of 34 years (inter-quartile range: 30–38 years. The median age of the 576 children was 15 months (inter- quartile range: 8.5–38.0 months. A total of 251 (43.6% children were born to mothers with unknown HIV status at conception. Only 329 (57.1% children accessed EID between 4 and 6 weeks of age. Children born to mothers with unknown HIV status at conception (AOR = 0.6, 95% CI 0.4–0.8 and those with ages 13–59 months (AOR = 0.4, 95% CI 0.2–0.6 were the significant predictors of missed opportunity to access EID. Children living with the head of household with at least a high education level had higher chances of accessing EID (AOR = 1.8, 95% CI 1.1–3.3. Their chances of accessing EID services was three-fold higher among mothers/guardians with good knowledge of HIV infection prevention of mother to child transmission (AOR = 3.2, 95% CI 2.0–5.2 than those with poor knowledge. Mothers/guardians living in rural areas had poorer knowledge of HIV infection prevention of mother to child transmission (AOR = 0.6, 95% CI 0

  2. [HIV Stigma and Spiritual Care in People Living With HIV].

    Yu, Chia-Hui; Chiu, Yi-Chi; Cheng, Su-Fen; Ko, Nai-Ying

    2018-06-01

    HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self. Nursing professionals provide holistic care for all people living with HIV and value their lives in order to achieve the harmony of body, mind, and spirit. This article describes the stigma that is currently associated with HIV and how stigma-related discrimination affects the spiritual health of PLWH and then proposes how to reduce discrimination and stigma in order to improve the spiritual health of PLWH through appropriate spiritual care. Reducing HIV stigma and promoting spiritual well-being will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Programme on HIV/AIDS for ending the AIDS epidemic in 2030.

  3. Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa.

    Oketch, Jecinter Akinyi; Paterson, Marie; Maunder, Eleni Winfred; Rollins, Nigel Campbell

    2011-03-01

    Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults. In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups. Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush. Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Stigma gets in my way: Factors affecting client-provider communication regarding childbearing among people living with HIV in Uganda.

    Jolly Beyeza-Kashesya

    Full Text Available Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.75% of the sample was female; 61% were on antiretroviral therapy; and 61% had HIV-negative or unknown status partners. Nearly all (98% reported the desire to discuss childbearing intentions with their HIV provider; however, only 44% reported such discussions, the minority (28% of which was initiated by the provider. Issues discussed with HIV providers included: HIV transmission risk to partner (30%, HIV transmission risk to child (30%, and how to prevent transmission to the child (27%; only 8% discussed safer conception methods. Regression analysis showed that those who had communicated with providers about childbearing were more likely to have been diagnosed with HIV for a longer period [OR (95% CI = 1.09 (1.03, 1.15], while greater internalized childbearing stigma was associated with lower odds of this communication [OR (95% CI = 0.70 (0.49, 0.99], after controlling for all bivariate correlates and basic demographics.Communication between HIV clients and providers about childbearing needs is poor and associated with stigma. Innovations to mitigate stigma among clients as well as training to improve health worker communication and skills related to safer conception counseling is needed.

  5. HIV Testing by Transgender Status at Centers for Disease Control and Prevention–Funded Sites in the United States, Puerto Rico, and US Virgin Islands, 2009–2011

    Wang, Guoshen; Mulatu, Mesfin S.; Larish, Nili

    2015-01-01

    Objectives. We examined HIV testing services, seropositivity, and the characteristics associated with newly identified, confirmed HIV-positive tests among transgender individuals. Methods. We analyzed data (2009–2011) using bivariate and multivariable logistic regression to examine the relationships between HIV positivity and sociodemographic and risk characteristics among male-to-female transgender individuals. Results. Most of the testing was conducted in females (51.1%), followed by males (48.7%) and transgender individuals (0.17%). Tests in male-to-female transgender individuals had the highest, newly identified confirmed HIV positivity (2.7%), followed by males (0.9%), female-to-male transgender individuals (0.5%), and females (0.2%). The associated characteristics with an HIV-positive test among male-to-female transgender individuals included ages 20 to 29 and 40 to 49 years (adjusted odds ratio [AOR] = 2.8; 95% confidence interval [CI] = 1.4, 5.6 and AOR = 2.8; 95% CI = 1.3, 5.9, respectively), African American (AOR = 4.6; 95% CI = 2.7, 7.9) or Hispanic/Latino (AOR = 2.6; 95% CI = 1.5, 4.5) race/ethnicity, and reporting sex without condom within the past year (AOR = 1.9; 95% CI = 1.3, 2.6), sex with an HIV-positive person (AOR = 1.5; 95% CI = 1.1, 2.0), or injection drug use (AOR = 2.0; 95% CI = 1.3, 3.0). Conclusions. High levels of HIV positivity among transgender individuals, particularly male-to-female transgender individuals, underscore the necessity for targeted HIV prevention services that are responsive to the needs of this population. PMID:26180964

  6. Emotional adjustment of children and adolescents with haemophilia in relation to the HIV threat

    Boswerger, M. G.; Fijnvandraat, K.; van Veldhuizen, A. M.; Rosendaal, F. R.; Peters, M.

    1997-01-01

    A Dutch nation-wide study on young haemophilia patients, whose former treatment placed them at risk for HIV infection, was done to examine the effect of HIV testing, HIV status, disclosure of HIV status and the child's experiences with disease-related information on emotional adjustment. In the

  7. The socio-economic impact of HIV/AIDS on infected individuals in ...

    The findings revealed that there are different sources of income of HIV-positive people, living conditions of HIV-positive people which are not acceptable, consequences related to HIV and AIDS disease progression, the support and care to HIV-positive people and disclosure versus non-disclosure of HIV-positive status.

  8. HIV Care in the Swedish-Danish HIV Cohort 1995-2010

    Helleberg, Marie; Häggblom, Amanda; Sönnerborg, Anders

    2013-01-01

    Successful treatment reduces morbidity, mortality and transmission of HIV. We evaluated trends in the treatment status of HIV infected individuals enrolled in care in Sweden and Denmark during the years 1995-2010. Our aim was to assess the proportion of HIV-infected individuals who received...

  9. HIV status and hearing loss among children between 6 and 12 years of age at a large urban health facility in south western Uganda.

    Nakku, Doreen; Nyaiteera, Victoria; Llowet, Evelyn; Nanseera, Dennis; Nakalema, Gladys; Westerberg, Brian; Bajunirwe, Francis

    2017-10-01

    Pediatric HIV infection and treatment may increase the risk for hearing loss (HL), both sensorineural (SNHL) and conductive hearing loss (CHL). There is limited data on this subject, especially from sub Saharan Africa. The aim of this study was therefore to compare the prevalence of hearing loss among HIV positive and negative children, to determine the types of hearing loss and whether Nevirapine (NVP) based antiretroviral therapy (ART) is associated with HL. We conducted a cross sectional study at two tertiary health facilities in south western Uganda. We consecutively enrolled 79 HIV negative and 148 HIV positive children aged between 6 and 12 years. Inclusion criteria were completion of written consent, ability to follow instructions to perform an audiogram and absence of congenital HL. We conducted hearing screening using the iPad Shoebox ® audiometer, and confirmatory assessments were conducted using pure tone audiometry. Hearing was classified as either normal hearing, CHL, SNHL or mixed. Of the 227 children enrolled, 115 (50.7%) were female. The mean age was 9.2 years (median = 9). Based on self-report, frequency of HL among HIV positive children was 6.8% and 20.3% among HIV negative children (p=children was 8.8% compared to 10.1% among the HIV negative children (p = 0.74). CHL was generally more frequent than SNHL but SNHL occurred more frequently among HIV positive (7.4%) compared to HIV negative children (3.8%). No association was found between NVP based ART and HL (p = 0.41). Logistic regression showed that older age of the child (p = 0.01), previous ear infection (p=children. Older age of the child, previous ear infection, use of TB drugs and long duration on ART among the HIV positive children increase the odds of having hearing loss among children. However, use of NVP was not associated with HL. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Quantum circuits cannot control unknown operations

    Araújo, Mateus; Feix, Adrien; Costa, Fabio; Brukner, Časlav

    2014-01-01

    One of the essential building blocks of classical computer programs is the ‘if’ clause, which executes a subroutine depending on the value of a control variable. Similarly, several quantum algorithms rely on applying a unitary operation conditioned on the state of a control system. Here we show that this control cannot be performed by a quantum circuit if the unitary is completely unknown. The task remains impossible even if we allow the control to be done modulo a global phase. However, this no-go theorem does not prevent implementing quantum control of unknown unitaries in practice, as any physical implementation of an unknown unitary provides additional information that makes the control possible. We then argue that one should extend the quantum circuit formalism to capture this possibility in a straightforward way. This is done by allowing unknown unitaries to be applied to subspaces and not only to subsystems. (paper)

  11. Multifocal, chronic osteomyelitis of unknown etiology

    Kozlowski, K.; Beluffi, G.; Feltham, C.; James, M.; Nespoli, L.; Tamaela, L.; Pavia Univ.; Municipal Hospital, Nelson; Medical School, Jakarta

    1985-01-01

    Four cases of multifocal osteomyelitis of unknown origin in childhood are reported. The variable clinical and radiographic appearances of the disease are illustrated and the diagnostic difficulties in the early stages of the disease are stressed. (orig.) [de

  12. Respiratory viruses in young South African children with acute lower respiratory infections and interactions with HIV.

    Annamalay, Alicia A; Abbott, Salome; Sikazwe, Chisha; Khoo, Siew-Kim; Bizzintino, Joelene; Zhang, Guicheng; Laing, Ingrid; Chidlow, Glenys R; Smith, David W; Gern, James; Goldblatt, Jack; Lehmann, Deborah; Green, Robin J; Le Souëf, Peter N

    2016-08-01

    Human rhinovirus (RV) is the most common respiratory virus and has been associated with frequent and severe acute lower respiratory infections (ALRI). The prevalence of RV species among HIV-infected children in South Africa is unknown. To describe the prevalence of respiratory viruses, including RV species, associated with HIV status and other clinical symptoms in children less than two years of age with and without ALRI in Pretoria, South Africa. Nasopharyngeal aspirates were collected from 105 hospitalized ALRI cases and 53 non-ALRI controls less than two years of age. HIV status was determined. Common respiratory viruses were identified by PCR, and RV species and genotypes were identified by semi-nested PCR, sequencing and phylogenetic tree analyses. Respiratory viruses were more common among ALRI cases than controls (83.8% vs. 69.2%; p=0.041). RV was the most commonly identified virus in cases with pneumonia (45.6%) or bronchiolitis (52.1%), regardless of HIV status, as well as in controls (39.6%). RV-A was identified in 26.7% of cases and 15.1% of controls while RV-C was identified in 21.0% of cases and 18.9% of controls. HIV-infected children were more likely to be diagnosed with pneumonia than bronchiolitis (pinfected cases (n=15) compared with 30.6% of HIV-uninfected cases (n=85, p=0.013), and was identified more frequently in bronchiolitis than in pneumonia cases (43.8% vs. 12.3%; pinfection may be protective against RSV and bronchiolitis. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. realising equality in access to hiv treatment for vulnerable

    UOVS

    been recognised that equality is tantamount to non-discrimination. .... HIV/AIDS), sexual orientation, and civil, political, social or other status which has ... ensuring equal HIV treatment for children, sex workers and men who have sex with.

  14. Known Unknowns in Judgment and Choice

    Walters, Daniel

    2017-01-01

    This dissertation investigates how people make inferences about missing information. Whereas most prior literature focuses on how people process known information, I show that the extent to which people make inferences about missing information impacts judgments and choices. Specifically, I investigate how (1) awareness of known unknowns affects overconfidence in judgment in Chapter 1, (2) beliefs about the knowability of unknowns impacts investment strategies in Chapter 2, and (3) inferences...

  15. Mobile assistant for unknown caller identification

    Hribernik, Andraž

    2012-01-01

    The main motivation of this diploma thesis is a development of Android application, which helps user of application to find out who is the owner of unknown phone number. Data source for finding unknown phone number are free available web sources. Through the development of prototype, data from different web sources were integrated. Result of this integration is shown in Android application. Data integration includes access to semi-structured data on web portal of Phone Directory of Slovenia, ...

  16. HIV risk associated with gay bathhouses and sex clubs: findings from 2 seattle surveys of factors related to HIV and sexually transmitted infections.

    Reidy, William J; Spielberg, Freya; Wood, Robert; Binson, Diane; Woods, William J; Goldbaum, Gary M

    2009-04-01

    We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington. We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time-venue cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify patron characteristics and predictors of risk behaviors and compared the 2 survey populations. Fourteen percent of respondents reported a previous HIV-positive test, 14% reported unprotected anal intercourse, and 9% reported unprotected anal intercourse with a partner of unknown or discordant HIV status during the current commercial sex venue visit. By logistic regression, recent unprotected anal intercourse outside of a commercial sex venue was independently associated with unprotected anal intercourse. Sex venue site and patron drug use were strongly associated with unprotected anal intercourse at the crude level. The 2004 and 2006 survey populations did not differ significantly in demographics or behaviors. Patron and venue-specific characteristics factors may each influence the frequency of HIV risk behaviors in commercial sex venues. Future research should evaluate the effect of structural and individual-level interventions on HIV transmission.

  17. HIV Risk Associated With Gay Bathhouses and Sex Clubs: Findings From 2 Seattle Surveys of Factors Related to HIV and Sexually Transmitted Infections

    Spielberg, Freya; Wood, Robert; Binson, Diane; Woods, William J.; Goldbaum, Gary M.

    2009-01-01

    Objectives. We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington. Methods. We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time–venue cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify patron characteristics and predictors of risk behaviors and compared the 2 survey populations. Results. Fourteen percent of respondents reported a previous HIV-positive test, 14% reported unprotected anal intercourse, and 9% reported unprotected anal intercourse with a partner of unknown or discordant HIV status during the current commercial sex venue visit. By logistic regression, recent unprotected anal intercourse outside of a commercial sex venue was independently associated with unprotected anal intercourse. Sex venue site and patron drug use were strongly associated with unprotected anal intercourse at the crude level. The 2004 and 2006 survey populations did not differ significantly in demographics or behaviors. Conclusions. Patron and venue-specific characteristics factors may each influence the frequency of HIV risk behaviors in commercial sex venues. Future research should evaluate the effect of structural and individual-level interventions on HIV transmission. PMID:19218174

  18. Executive summary of the Consensus Statement on monitoring HIV: pregnancy, birth, and prevention of mother-to-child transmission.

    Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernandez, Antonio; Peres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, M Carmen; González Tomé, María Isabel

    2014-05-01

    The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. If the serological status is unknown at the time of delivery, or in the immediate postpartum, HIV serology testing has to be performed as soon as possible. In this document, recommendations are made regarding the health of the mother and from the perspective of minimizing mother-to-child transmission. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi.

    Price, Joan T; Rosenberg, Nora E; Vansia, Dhrutika; Phanga, Twambilile; Bhushan, Nivedita L; Maseko, Bertha; Brar, Savvy K; Hosseinipour, Mina C; Tang, Jennifer H; Bekker, Linda-Gail; Pettifor, Audrey

    2018-01-01

    Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV prevalence and incidence. We sought to understand which HIV risk factors individually and in combination contribute to risk, and whether these factors are associated with HIV worry and risk perception. This study is ongoing at 4 public health centers in Lilongwe, Malawi (2016-2017). AGYW of 15-24 years old were recruited to participate in a study assessing 4 models of service delivery. At each health center, participants completed a baseline survey assessing socioeconomic, behavioral, biomedical, and partnership characteristics; self-reported HIV status; and, if HIV-uninfected, HIV risk perception (high versus low or none) and HIV worry (any versus none). We analyzed associations between baseline characteristics and HIV prevalence, risk perception, and worry. Among 1000 AGYW, median age was 19 years (IQR: 17-21). Thirty-three participants reported being HIV-infected. Fifteen characteristics were associated with HIV infection. Having more risk factors was associated with higher HIV prevalence (≤4 factors, 0.5%; 5-8 factors, 6%; >8 factors, 21%). Having more risk factors was also associated with higher risk perception (P risk factors, 52% did not consider themselves to be at high risk and 21% did not report any HIV worry. Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.

  20. 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.

  1. "Inside These Fences Is Our Own Little World": Prison-Based HIV Testing and HIV-Related Stigma Among Incarcerated Men and Women.

    Muessig, Kathryn E; Rosen, David L; Farel, Claire E; White, Becky L; Filene, Eliza J; Wohl, David A

    2016-04-01

    Correctional facilities offer opportunities to provide comprehensive HIV services including education, testing, treatment, and coordination of post- release care. However, these services may be undermined by unaddressed HIV stigma. As part of a prison-based HIV testing study, we interviewed 76 incarcerated men and women from the North Carolina State prison system. The sample was 72% men, median age 31.5 years (range: 19 to 60). Thematic analysis revealed high levels of HIV-related fear and stigma, homophobia, incomplete HIV transmission knowledge, beliefs that HIV is highly contagious within prisons ("HIV miasma"), and the View of HIV testing as protective. Interviewees described social distancing behaviors and coping mechanisms they perceived to be protective, including knowing their HIV status and avoiding contact with others and shared objects. Interviewees endorsed universal testing, public HIV status disclosure, and segregation of HIV-positive inmates. Intensified education and counseling efforts are needed to ameliorate entrenched HIV-transmission fears and stigmatizing beliefs.

  2. An Evaluation of Phylogenetic Methods for Reconstructing Transmitted HIV Variants using Longitudinal Clonal HIV Sequence Data

    McCloskey, Rosemary M.; Liang, Richard H.; Harrigan, P. Richard; Brumme, Zabrina L.

    2014-01-01

    ABSTRACT A population of human immunodeficiency virus (HIV) within a host often descends from a single transmitted/founder virus. The high mutation rate of HIV, coupled with long delays between infection and diagnosis, make isolating and characterizing this strain a challenge. In theory, ancestral reconstruction could be used to recover this strain from sequences sampled in chronic infection; however, the accuracy of phylogenetic techniques in this context is unknown. To evaluate the accuracy of these methods, we applied ancestral reconstruction to a large panel of published longitudinal clonal and/or single-genome-amplification HIV sequence data sets with at least one intrapatient sequence set sampled within 6 months of infection or seroconversion (n = 19,486 sequences, median [interquartile range] = 49 [20 to 86] sequences/set). The consensus of the earliest sequences was used as the best possible estimate of the transmitted/founder. These sequences were compared to ancestral reconstructions from sequences sampled at later time points using both phylogenetic and phylogeny-naive methods. Overall, phylogenetic methods conferred a 16% improvement in reproducing the consensus of early sequences, compared to phylogeny-naive methods. This relative advantage increased with intrapatient sequence diversity (P reconstructing ancestral indel variation, especially within indel-rich regions of the HIV genome. Although further improvements are needed, our results indicate that phylogenetic methods for ancestral reconstruction significantly outperform phylogeny-naive alternatives, and we identify experimental conditions and study designs that can enhance accuracy of transmitted/founder virus reconstruction. IMPORTANCE When HIV is transmitted into a new host, most of the viruses fail to infect host cells. Consequently, an HIV infection tends to be descended from a single “founder” virus. A priority target for the vaccine research, these transmitted/founder viruses are

  3. The role of HIV-related stigma in utilization of skilled childbirth services in rural Kenya: a prospective mixed-methods study.

    Janet M Turan

    Full Text Available Childbirth with a skilled attendant is crucial for preventing maternal mortality and is an important opportunity for prevention of mother-to-child transmission of HIV. The Maternity in Migori and AIDS Stigma Study (MAMAS Study is a prospective mixed-methods investigation conducted in a high HIV prevalence area in rural Kenya, in which we examined the role of women's perceptions of HIV-related stigma during pregnancy in their subsequent utilization of maternity services.From 2007-2009, 1,777 pregnant women with unknown HIV status completed an interviewer-administered questionnaire assessing their perceptions of HIV-related stigma before being offered HIV testing during their first antenatal care visit. After the visit, a sub-sample of women was selected for follow-up (all women who tested HIV-positive or were not tested for HIV, and a random sample of HIV-negative women, n = 598; 411 (69% were located and completed another questionnaire postpartum. Additional qualitative in-depth interviews with community health workers, childbearing women, and family members (n = 48 aided our interpretation of the quantitative findings and highlighted ways in which HIV-related stigma may influence birth decisions. Qualitative data revealed that health facility birth is commonly viewed as most appropriate for women with pregnancy complications, such as HIV. Thus, women delivering at health facilities face the risk of being labeled as HIV-positive in the community. Our quantitative data revealed that women with higher perceptions of HIV-related stigma (specifically those who held negative attitudes about persons living with HIV at baseline were subsequently less likely to deliver in a health facility with a skilled attendant, even after adjusting for other known predictors of health facility delivery (adjusted odds ratio = 0.44, 95% CI 0.22-0.88.Our findings point to the urgent need for interventions to reduce HIV-related stigma, not only for improving quality of

  4. The role of HIV-related stigma in utilization of skilled childbirth services in rural Kenya: a prospective mixed-methods study.

    Turan, Janet M; Hatcher, Abigail H; Medema-Wijnveen, José; Onono, Maricianah; Miller, Suellen; Bukusi, Elizabeth A; Turan, Bulent; Cohen, Craig R

    2012-01-01

    Childbirth with a skilled attendant is crucial for preventing maternal mortality and is an important opportunity for prevention of mother-to-child transmission of HIV. The Maternity in Migori and AIDS Stigma Study (MAMAS Study) is a prospective mixed-methods investigation conducted in a high HIV prevalence area in rural Kenya, in which we examined the role of women's perceptions of HIV-related stigma during pregnancy in their subsequent utilization of maternity services. From 2007-2009, 1,777 pregnant women with unknown HIV status completed an interviewer-administered questionnaire assessing their perceptions of HIV-related stigma before being offered HIV testing during their first antenatal care visit. After the visit, a sub-sample of women was selected for follow-up (all women who tested HIV-positive or were not tested for HIV, and a random sample of HIV-negative women, n = 598); 411 (69%) were located and completed another questionnaire postpartum. Additional qualitative in-depth interviews with community health workers, childbearing women, and family members (n = 48) aided our interpretation of the quantitative findings and highlighted ways in which HIV-related stigma may influence birth decisions. Qualitative data revealed that health facility birth is commonly viewed as most appropriate for women with pregnancy complications, such as HIV. Thus, women delivering at health facilities face the risk of being labeled as HIV-positive in the community. Our quantitative data revealed that women with higher perceptions of HIV-related stigma (specifically those who held negative attitudes about persons living with HIV) at baseline were subsequently less likely to deliver in a health facility with a skilled attendant, even after adjusting for other known predictors of health facility delivery (adjusted odds ratio = 0.44, 95% CI 0.22-0.88). Our findings point to the urgent need for interventions to reduce HIV-related stigma, not only for improving quality of life among

  5. Evolving treatment implementation among HIV-infected pregnant women and their partners: results from a national surveillance study in Italy, 2001-2015.

    Floridia, Marco; Frisina, Valentina; Ravizza, Marina; Marconi, Anna Maria; Pinnetti, Carmela; Cetin, Irene; Sansone, Matilde; Molinari, Atim; Cervi, Francesca; Meloni, Alessandra; Luzi, Kety; Masuelli, Giulia; Tamburrini, Enrica

    2017-06-01

    The current global and national indications for antiretroviral treatment (ART, usually triple combination therapy) in adolescent and adults, including pregnant women, recommend early ART before immunologic decline, pre-exposure chemoprophylaxis (PrEP), and treatment of HIV-negative partners in serodiscordant couples. There is limited information on the implementation of these recommendations among pregnant women with HIV and their partners. The present analysis was performed in 2016, using data from clinical records of pregnant women with HIV, followed between 2001 and 2015 at hospital or university clinics within a large, nationally representative Italian cohort study. The study period was divided in three intervals of five years each (2001-2005, 2006-2010, 2011-2015), and the analysis evaluated temporal trends in rates of HIV diagnosis in pregnancy, maternal antiretroviral treatment at conception, prevalence of HIV infection among partners of pregnant women with HIV, and proportion of seronegative and seropositive male partners receiving antiretroviral treatment. The analysis included 2755 pregnancies in women with HIV. During the three time intervals considered the rate of HIV diagnosis in pregnancy (overall 23.3%), and the distribution of HIV status among male partners (overall 48.7% HIV-negative, 28.6% HIV-positive and 22.8% unknown) remained substantially unchanged. Significant increases were observed in the proportion of women with HIV diagnosed before pregnancy who were on antiretroviral treatment at conception (from 62.0% in 2001-2005 to 81.3% in 2011-2015, P  HIV-positive partners on antiretroviral treatment (from 73.3% in 2001-2005 to 95.8% in 2011-2015, P  = 0.002). Antiretroviral treatment was administered in 99.1% of the pregnancies that did not end early because of miscarriage, termination, or intrauterine death, and in 75.3% of those not ending in a live birth. No implementation of antiretroviral treatment was introduced among male HIV

  6. Migration and risk of HIV acquisition in Rakai, Uganda: a population-based cohort study.

    Olawore, Oluwasolape; Tobian, Aaron A R; Kagaayi, Joseph; Bazaale, Jeremiah M; Nantume, Betty; Kigozi, Grace; Nankinga, Justine; Nalugoda, Fred; Nakigozi, Gertrude; Kigozi, Godfrey; Gray, Ronald H; Wawer, Maria J; Ssekubugu, Robert; Santelli, John S; Reynolds, Steven J; Chang, Larry W; Serwadda, David; Grabowski, Mary K

    2018-04-01

    In sub-Saharan Africa, migrants typically have higher HIV prevalence than non-migrants; however, whether HIV acquisition typically precedes or follows migration is unknown. We aimed to investigate the risk of HIV after migration in Rakai District, Uganda. In a prospective population-based cohort of HIV-negative participants aged 15-49 years in Rakai, Uganda, between April 6, 1999, and Jan 30, 2015, we assessed the association between migration and HIV acquisition. Individuals were classified as recent in-migrants (≤2 years in community), non-recent in-migrants (>2 years in community), or permanent residents with no migration history. The primary outcome was incident HIV infection. We used Poisson regression to estimate incidence rate ratios (IRRs) of HIV associated with residence status with adjustment for demographics, sexual behaviours, and time. Data were also stratified and analysed within three periods (1999-2004, 2005-11, and 2011-15) in relation to the introduction of combination HIV prevention (CHP; pre-CHP, early CHP, and late CHP). Among 26 995 HIV-negative people who participated in the Rakai Community Cohort Study survey, 15 187 (56%) contributed one or more follow-up visits (89 292 person-years of follow-up) and were included in our final analysis. 4451 (29%) were ever in-migrants and 10 736 (71%) were permanent residents. 841 incident HIV events occurred, including 243 (29%) among in-migrants. HIV incidence per 100 person-years was significantly increased among recent in-migrants compared with permanent residents, for both women (1·92, 95% CI 1·52-2·43 vs 0·93, 0·84-1·04; IRR adjusted for demographics 1·75, 95% CI 1·33-2·33) and men (1·52, 0·99-2·33 vs 0·84, 0·74-0·94; 1·74, 1·12-2·71), but not among non-recent in-migrants (IRR adjusted for demographics 0·94, 95% CI 0·74-1·19 for women and 1·28, 0·94-1·74 for men). Between the pre-CHP and late-CHP periods, HIV incidence declined among permanent resident men (p

  7. Protocol for counterfactually transporting an unknown qubit

    Hatim eSalih

    2016-01-01

    Full Text Available Quantum teleportation circumvents the uncertainty principle using dual channels: a quantum one consisting of previously-shared entanglement, and a classical one, together allowing the disembodied transport of an unknown quantum state over distance. It has recently been shown that a classical bit can be counterfactually communicated between two parties in empty space, Alice and Bob. Here, by using our dual version of the chained quantum Zeno effect to achieve a counterfactual CNOT gate, we propose a protocol for transporting an unknown qubit counterfactually, that is without any physical particles travelling between Alice and Bob—no classical channel and no previously-shared entanglement.

  8. EFFECT OF HIV PREVENTION AND TREATMENT PROGRAM ON HIV AND HCV TRANSMISSION AND HIV MORTALITY AT AN INDONESIAN NARCOTIC PRISON.

    Nelwan, Erni J; Indrati, Agnes K; Isa, Ahmad; Triani, Nurlita; Alam, Nisaa Nur; Herlan, Maria S; Husen, Wahid; Pohan, Herdiman T; Alisjahbana, Bachti; Meheus, Andre; Van Crevel, Reinout; van der Ven, Andre Jam

    2015-09-01

    Validated data regarding HIV-transmission in prisons in developing countries is scarce. We examined sexual and injecting drug use behavior and HIV and HCV transmission in an Indonesian narcotic prison during the implementation of an HIV prevention and treatment program during 2004-2007 when the Banceuy Narcotic Prison in Indonesia conducted an HIV transmission prevention program to provide 1) HIV education, 2) voluntary HIV testing and counseling, 3) condom supply, 4) prevention of rape and sexual violence, 5) antiretroviral treatment for HIV-positive prisoners and 6) methadone maintenance treatment. During a first survey that was conducted between 2007 and 2009, new prisoners entered Banceuy Narcotics Prison were voluntary tested for HIV and HCV-infection after written informed consent was obtained. Information regarding sexual and injecting risk behavior and physical status were also recorded at admission to the prison. Participants who tested negative for both HIV and HCV during the first survey were included in a second survey conducted during 2008-2011. During both surveys, data on mortality among HIV-seropositive patients were also recorded. All HIV-seropositive participants receive treatment for HIV. HIV/ AIDS-related deaths decreased: 43% in 2006, 18% in 2007, 9% in 2008 and 0% in 2009. No HIV and HCV seroconversion inside Banceuy Narcotic Prison were found after a median of 23 months imprisonment (maximum follow-up: 38 months). Total of 484.8 person-years observation was done. Participants reported HIV transmission risk-behavior in Banceuy Prison during the second survey was low. After implementation of HIV prevention and treatment program, no new HIV or HCV cases were detected and HIV-related mortality decreased.

  9. Risk Perception and sexual risk behaviors among HIV-positive men on antiretroviral therapy.

    Remien, Robert H; Halkitis, Perry N; O'Leary, Ann; Wolitski, Richard J; Gómez, Cynthia A

    2005-06-01

    There are reports of increased sexual risk behavior among people on highly active antiretroviral therapy (HAART) due to beliefs about risk of HIV transmission when on HAART. In a cross-sectional study (Seropositive Urban Men's Study), we examined the relationship between risk perception and sexual risk behavior among sexually active, culturally diverse HIV positive men who have sex with men (N = 456). Less than twenty-five percent engaged in unprotected anal sex (either with an HIV negative, or unknown-status partner, or an HIV positive partner) within the past 3 months. Most men believed there was significant health risk (to partner or self) associated with unprotected sex when on HAART. There was no increased risk behavior associated with being on HAART, although the perception of negative health consequences, including HIV transmission, when on HAART was significantly lower for the relatively small subset of men who reported unprotected sex. Prevention strategies need to be tailored to address risk perception associated with HAART.

  10. Socio-economic status and time trends associated with early ART initiation following primary HIV infection in Montreal, Canada: 1996 to 2015.

    Mehraj, Vikram; Cox, Joseph; Lebouché, Bertrand; Costiniuk, Cecilia; Cao, Wei; Li, Taisheng; Ponte, Rosalie; Thomas, Réjean; Szabo, Jason; Baril, Jean-Guy; Trottier, Benoit; Côté, Pierre; LeBlanc, Roger; Bruneau, Julie; Tremblay, Cécile; Routy, Jean-Pierre

    2018-02-01

    Guidelines regarding antiretroviral therapy (ART) initiation in HIV infection have varied over time, with the 2015 World Health Organization recommendation suggesting ART initiation at the time of diagnosis regardless of CD4 T-cell counts. Herein, we investigated the influence of socio-demographic and clinical factors in addition to time trends on early ART initiation among participants of the Montreal Primary HIV Infection Study. The Montreal Primary HIV Infection Study is a prospective cohort established in three community medical centres (CMCs) and two university medical centres (UMCs). Recently diagnosed HIV-infected adults were categorized as receiving early (vs. delayed) ART if ART was initiated within 180 days of the baseline visit. Associations between early ART initiation and socio-demographic, socio-economic and behavioural information were examined. Independent associations of factors linked with early ART initiation were determined using multivariable binary logistic regression analysis. A total of 348 participants had a documented date of HIV acquisition of age of participants was 35 (28; 42) years and the majority were male (96%), having paid employment (63%), men who have sex with men (MSM) (78%) and one to four sexual partners in the last three months (70%). Participants presented with a median IQR HIV plasma viral load of 4.6 (3.7; 5.3) log 10 copies/ml, CD4 count of 510 (387; 660) cells/μl and were recruited in CMCs (52%) or UMCs (48%). Early ART initiation was observed in 47% of the participants and the trend followed a V-shaped curve with peaks in 1996 to 1997 (89%) and 2013 to 2015 (88%) with a dip in 2007 to 2009 (22%). Multivariable analyses showed that having a paid employment adjusted odds ratio (aOR: 2.43; 95% CI: 1.19, 4.95), lower CD4 count (aOR per 50 cell increase: 0.93; 95% CI: 0.87, 0.99) and care at UMCs (aOR: 2.03; 95% CI: 1.06 to 3.90) were independently associated with early ART initiation. Early ART initiation during primary

  11. Women and HIV

    ... Consumer Information by Audience For Women Women and HIV: Get the Facts on HIV Testing, Prevention, and Treatment Share Tweet Linkedin Pin ... How can you lower your chance of HIV? HIV Quick Facts What is HIV? HIV is the ...

  12. Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire.

    Becquet, Renaud; Leroy, Valériane; Ekouevi, Didier K; Viho, Ida; Castetbon, Katia; Fassinou, Patricia; Dabis, François; Timite-Konan, Marguerite

    2006-04-01

    In high HIV prevalence resource-constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. A prospective cohort study in Abidjan, Côte d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly

  13. Ethnic Comparisons in HIV Testing Attitudes, HIV Testing, and Predictors of HIV Testing Among Black and White College Students.

    Moore, Melanie P; Javier, Sarah J; Abrams, Jasmine A; McGann, Amanda Wattenmaker; Belgrave, Faye Z

    2017-08-01

    This study's primary aim was to examine ethnic differences in predictors of HIV testing among Black and White college students. We also examined ethnic differences in sexual risk behaviors and attitudes toward the importance of HIV testing. An analytic sample of 126 Black and 617 White undergraduatestudents aged 18-24 were analyzed for a subset of responses on the American College Health Association-National College Health Assessment II (ACHA-NCHA II) (2012) pertaining to HIV testing, attitudes about the importance of HIV testing, and sexual risk behaviors. Predictors of HIV testing behavior were analyzed using logistic regression. t tests and chi-square tests were performed to access differences in HIV test history, testing attitudes, and sexual risk behaviors. Black students had more positive attitudes toward testing and were more likely to have been tested for HIV compared to White students. A greater number of sexual partners and more positive HIV testing attitudes were significant predictors of HIV testing among White students, whereas relationship status predicted testing among Black students. Older age and history of ever having sex were significant predictors of HIV testing for both groups. There were no significant differences between groups in number of sexual partners or self-reports in history of sexual experience (oral, vaginal, or anal). Factors that influence HIV testing may differ across racial/ethnic groups. Findings support the need to consider racial/ethnic differences in predictors of HIV testing during the development and tailoring of HIV testing prevention initiatives targeting college students.

  14. Multifocal chronic osteomyelitis of unknown etiology

    Kozlowski, K.; Masel, J.; Harbison, S.; Yu, J.; Royal Brisbane Children Hospital; Regional Hospital Bowral

    1983-01-01

    Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. (orig.)

  15. Disclosure of HIV Serostatus and Sexual Orientation Among HIV-Positive Men Who Have Sex with Men in China.

    Lin, Xiuyun; Chi, Peilian; Zhang, Liying; Zhang, Yan; Fang, Xiaoyi; Qiao, Shan; Li, Xiaoming

    2016-05-01

    This study addressed the issue of disclosing HIV status and sexual orientation, and explored the consequences of such disclosures among HIV-positive men who have sex with men (MSM) in China. In-depth individual interviews were conducted with 37 HIV-positive MSM. Of these participants, 3 (8.1%) disclosed neither their HIV status nor their sexual orientation to anyone; 24 (64.9%) voluntarily disclosed both their HIV-positive status and their sexual orientation; 7 (18.9%) voluntarily disclosed their HIV status only, and 3 (8.1%) involuntarily disclosed their HIV status and sexual orientation. Parents, partners, siblings and close friends were the most common disclosure targets. HIV-positive MSM were less likely to disclose their sexual orientation than their HIV status. The positive consequences of disclosure included receiving support, acquiring family care, reducing stress, improving mood and developing more positive values and beliefs. The negative consequences included the participants' perception of rejection and stigma toward themselves and their families. However, the stigma mainly comes from "outsiders" rather than family members and close friends. We did not find any differences with respect to consequences between participants who disclosed their HIV status only and those who disclosed both their HIV status and sexual orientation. In conclusion, partners, siblings and friends were main disclosure targets, and HIV positive MSM preferred to disclose their HIV serostatus than their sexual orientation. Voluntarily disclosing one's HIV status to significant others resulted in more positive consequences than negative consequences. Theses results were informative for developing mental health and coping interventions.

  16. Young Transgender Women's Attitudes Toward HIV Pre-exposure Prophylaxis.

    Wood, Sarah M; Lee, Susan; Barg, Frances K; Castillo, Marne; Dowshen, Nadia

    2017-05-01

    Our primary aim was to explore themes regarding attitudes toward HIV pre-exposure prophylaxis (PrEP) among young transgender women (YTW), in order to develop a theoretical model of PrEP uptake in this population disproportionally affected by HIV. Qualitative study nested within a mixed-method study characterizing barriers and facilitators to health services for YTW. Participants completed an in-depth interview exploring awareness of and attitudes toward PrEP. Key themes were identified using a grounded theory approach. Participants (n = 25) had a mean age of 21.2 years (standard deviation 2.2, range 17-24) and were predominately multiracial (36%) and of HIV-negative or unknown status (68%). Most participants (64%) reported prior knowledge of PrEP, and 28% reported current use or intent to use PrEP. Three major content themes that emerged were variability of PrEP awareness, barriers and facilitators to PrEP uptake, and emotional benefits of PrEP. Among participants without prior PrEP knowledge, participants reported frustration that PrEP information has not been widely disseminated to YTW, particularly by health care providers. Attitudes toward PrEP were overwhelmingly positive; however, concerns were raised regarding barriers including cost, stigma, and adherence challenges. Both HIV-positive and negative participants discussed emotional and relationship benefits of PrEP, which were felt to extend beyond HIV prevention alone. A high proportion of YTW in this study had prior knowledge of PrEP, and attitudes toward PrEP were positive among participants. Our findings suggest several domains to be further explored in PrEP implementation research, including methods of facilitating PrEP dissemination and emotional motivation for PrEP uptake. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Cancer Incidence following Expansion of HIV Treatment in Botswana.

    Dryden-Peterson, Scott; Medhin, Heluf; Kebabonye-Pusoentsi, Malebogo; Seage, George R; Suneja, Gita; Kayembe, Mukendi K A; Mmalane, Mompati; Rebbeck, Timothy; Rider, Jennifer R; Essex, Myron; Lockman, Shahin

    2015-01-01

    The expansion of combination antiretroviral treatment (ART) in southern Africa has dramatically reduced mortality due to AIDS-related infections, but the impact of ART on cancer incidence in the region is unknown. We sought to describe trends in cancer incidence in Botswana during implementation of the first public ART program in Africa. We included 8479 incident cases from the Botswana National Cancer Registry during a period of significant ART expansion in Botswana, 2003-2008, when ART coverage increased from 7.3% to 82.3%. We fit Poisson models of age-adjusted cancer incidence and counts in the total population, and in an inverse probability weighted population with known HIV status, over time and estimated ART coverage. During this period 61.6% of cancers were diagnosed in HIV-infected individuals and 45.4% of all cancers in men and 36.4% of all cancers in women were attributable to HIV. Age-adjusted cancer incidence decreased in the HIV infected population by 8.3% per year (95% CI -14.1 to -2.1%). However, with a progressively larger and older HIV population the annual number of cancers diagnosed remained constant (0.0% annually, 95% CI -4.3 to +4.6%). In the overall population, incidence of Kaposi's sarcoma decreased (4.6% annually, 95% CI -6.9 to -2.2), but incidence of non-Hodgkin lymphoma (+11.5% annually, 95% CI +6.3 to +17.0%) and HPV-associated cancers increased (+3.9% annually, 95% CI +1.4 to +6.5%). Age-adjusted cancer incidence among individuals without HIV increased 7.5% per year (95% CI +1.4 to +15.2%). Expansion of ART in Botswana was associated with decreased age-specific cancer risk. However, an expanding and aging population contributed to continued high numbers of incident cancers in the HIV population. Increased capacity for early detection and treatment of HIV-associated cancer needs to be a new priority for programs in Africa.

  18. Prevalência de HIV em gestantes e transmissão vertical segundo perfil socioeconômico, Vitória, ES Factores asociados a recidiva en hanseníasis en Mato Grosso, Centro-oeste de Brasil HIV prevalence in pregnant women and vertical transmission in according to socioeconomic status, Southeastern Brazil

    Anne Caroline Barbosa Cerqueira Vieira

    2011-08-01

    ón de Agravios de Notificación, Prontuarios y entrevistas. Se utilizó regresión logística condicional y abordaje jerárquico. RESULTADOS: Posterior al análisis ajustado, se mostraron asociados a la ocurrencia de recidiva: individuos residentes en casas alquiladas (OR=4,1; IC95%:1,43;12,04, en domicilio de madera/tapia (OR=3,2; IC 95%:1,16;8,76, que moraban con más de cinco personas (OR=2,1; IC95%:1,03;4,36, con trastorno por uso de alcohol (OR=2,8;IC95%:1,17;6,79, irregularidad del tratamiento (OR= 3,8; IC95%: 1,44;10,02, sin esclarecimiento sobre la enfermedad/tratamiento (OR= 2,6; IC95%:1,09,6,13, que usaban transporte colectivo para el acceso a la unidad de salud (OR=5,5; IC95%: 2,36;12,63, forma clínica de la enfermedad (OR= 7,1;IC95%: 2,48;20,52 y esquema terapéutico (OR= 3,7; IC95%:1,49;9,11. CONCLUSIONES: Los factores predictivos de recidiva se relacionan con condiciones de vivienda, hábitos de vida, organización de los servicios de salud, formas clínicas y esquemas terapéuticos. Compete a los servicios de salud ofrecer orientaciones adecuadas a los pacientes, así como garantizar la regularidad del tratamiento.OBJECTIVE: To describe HIV prevalence in pregnant women and the rate of vertical transmission according to socioeconomic status of residential neighborhoods. METHODS: Ecological exploratory study, which used the Information System of Notifiable Diseases database on HIV-positive pregnant women and AIDS in children, reported from 2000 to 2006, in Vitória, Southeastern Brazil. For analysis of socioeconomic data the Urban Quality Index was utilized The HIV prevalence rate in pregnant women and vertical transmission rate were calculated. Spatial distribution was carried out by Terraview 3.2.0. To verify the association between urban quality and HIV prevalence in pregnant women, Poisson regression was used. RESULTS: A total of 137 HIV-positive women and 14 children infected by vertical transmission was reported. Seven children matched to HIV

  19. Melanoma of unknown origin: a case series.

    Kelly, J

    2010-12-01

    The natural history of metastatic melanoma involving lymph nodes, in the absence of a known primary site (cutaneous, ocular or mucosal) has, to date, been poorly defined; and the optimal management of this rare subtype of disease is therefore unclear. Melanomas of unknown primary site (MUP) are estimated to comprise between 3.7 and 6% of all melanomas (Anbari et al. in Cancer 79:1861-1821, 1997).

  20. Autonomous Flight in Unknown Indoor Environments

    Bachrach, Abraham Galton; He, Ruijie; Roy, Nicholas

    2009-01-01

    This paper presents our solution for enabling a quadrotor helicopter, equipped with a laser rangefinder sensor, to autonomously explore and map unstructured and unknown indoor environments. While these capabilities are already commodities on ground vehicles, air vehicles seeking the same performance face unique challenges. In this paper, we describe the difficulties in achieving fully autonomous helicopter flight, highlighting the differences between ground and helicopter robots that make it ...

  1. Multidimensional procurement auctions with unknown weights

    Greve, Thomas

    This paper studies the consequences of holding a procurement auction when the principal chooses not to show its preferences. My paper extends the procurement auction model of Che (1993) to a situation where both the principal and the agents have private information. Thus, unknown parameters of bo...... gives rise to an analysis of a principal that can not fully commit to the outcome induced by the scoring rule. Therefore, my result apply to contract theory and it’s problems with imperfect commitment....

  2. Factors associated with the quality of life of people living with HIV in Finland.

    Nobre, Nuno; Pereira, Marco; Roine, Risto P; Sintonen, Harri; Sutinen, Jussi

    2017-08-01

    In recent years, the concept of quality of life (QoL) has received significant attention in the HIV/AIDS literature. In Finland, however, the factors associated with the QoL of people living with HIV/AIDS (PLWHA) still remain unknown. The aim of this study was to identify the sociodemographic and HIV-related factors associated with the different domains of QoL of PLWHA in Finland. The sample of this cross-sectional study consisted of 453 HIV-infected patients (Mean age = 46.5 years; 76.5% male) followed at the Infectious Disease Clinic of Helsinki University Hospital. Participants completed a self-reported questionnaire covering sociodemographic and HIV-related information, and the Finnish version of the WHOQOL-HIV-Bref questionnaire. Participants reported rather high scores in the six QoL domains, which ranged between 68.48 (Social relationships) and 78.05 (Environment) on a 0-100 scale. Multiple regression analyses revealed that male gender, being married or living in a partnered relationship, being employed, having fewer financial concerns, and not having depression and other medical comorbidities were the main factors positively and consistently associated with higher scores in the different domains of the QoL. HIV-related variables were not significantly associated with QoL ratings. Sociodemographic factors were independently associated with the QoL of PLWHA in Finland. Psychosocial support should reflect these factors in order to improve the health status and well-being of PLWHA.

  3. Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions

    Lord, E; Stockdale, A J; Malek, R

    2017-01-01

    OBJECTIVES: European guidelines recommend HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs). The extent to which non-HIV specialty guidelines recommend HIV testing in ICs and ADCs is unknown. Our aim was to pilot a methodology in the UK...... are piloting methods to engage with guideline development groups to ensure that patients diagnosed with ICs/ADCs are tested for HIV. We then plan to apply our methodology in other European settings as part of the Optimising Testing and Linkage to Care for HIV across Europe (OptTEST) project....... to review specialty guidelines and ascertain if HIV was discussed and testing recommended. METHODS: UK and European HIV testing guidelines were reviewed to produce a list of 25 ADCs and 49 ICs. UK guidelines for these conditions were identified from searches of the websites of specialist societies...

  4. HIV and schistosomiasis in rural Zimbabwe

    Kotzé, Sebastian Ranzi; Zinyama-Gutsire, Rutendo; Kallestrup, Per

    2015-01-01

    BACKGROUND: Vitamin A has widespread effects on immune function and is therefore interesting in HIV-infection. Retinol-binding protein (RBP or RBP4) is a negative acute-phase protein and a marker of vitamin A status. Our aim was to investigate the association of RBP with HIV progression, infection...... with schistosomiasis, inflammatory cytokines, and mortality. METHODS: The study included 192 HIV-infected and 177 HIV-uninfected individuals from Mupfure in rural Zimbabwe. Of these, 208 were infected with Schistosoma haematobium, 27 with S. mansoni and 48 with both. Plasma RBP, HIV-RNA, CD4 cell count, haemoglobin......, cytokines, clinical staging (CDC category), self-reported level of function (Karnoffsky Performance Score, KPS) and schistosomiasis status were assessed at baseline. Participants were followed up for survival 3-4 years post-enrolment. RESULTS: RBP levels were lower in HIV-infected individuals(p

  5. Acceleration of age-associated methylation patterns in HIV-1-infected adults.

    Tammy M Rickabaugh

    Full Text Available Patients with treated HIV-1-infection experience earlier occurrence of aging-associated diseases, raising speculation that HIV-1-infection, or antiretroviral treatment, may accelerate aging. We recently described an age-related co-methylation module comprised of hundreds of CpGs; however, it is unknown whether aging and HIV-1-infection exert negative health effects through similar, or disparate, mechanisms. We investigated whether HIV-1-infection would induce age-associated methylation changes. We evaluated DNA methylation levels at >450,000 CpG sites in peripheral blood mononuclear cells (PBMC of young (20-35 and older (36-56 adults in two separate groups of participants. Each age group for each data set consisted of 12 HIV-1-infected and 12 age-matched HIV-1-uninfected samples for a total of 96 samples. The effects of age and HIV-1 infection on methylation at each CpG revealed a strong correlation of 0.49, p<1 x 10(-200 and 0.47, p<1 x 10(-200. Weighted gene correlation network analysis (WGCNA identified 17 co-methylation modules; module 3 (ME3 was significantly correlated with age (cor=0.70 and HIV-1 status (cor=0.31. Older HIV-1+ individuals had a greater number of hypermethylated CpGs across ME3 (p=0.015. In a multivariate model, ME3 was significantly associated with age and HIV status (Data set 1: βage=0.007088, p=2.08 x 10(-9; βHIV=0.099574, p=0.0011; Data set 2: βage=0.008762, p=1.27 x 10(-5; βHIV=0.128649, p=0.0001. Using this model, we estimate that HIV-1 infection accelerates age-related methylation by approximately 13.7 years in data set 1 and 14.7 years in data set 2. The genes related to CpGs in ME3 are enriched for polycomb group target genes known to be involved in cell renewal and aging. The overlap between ME3 and an aging methylation module found in solid tissues is also highly significant (Fisher-exact p=5.6 x 10(-6, odds ratio=1.91. These data demonstrate that HIV-1 infection is associated with methylation patterns that

  6. Pregnancy incidence and correlates during the HVTN 503 Phambili HIV vaccine trial conducted among South African women.

    Mary H Latka

    Full Text Available HIV prevention trials are increasingly being conducted in sub-Saharan Africa. Women at risk for HIV are also at risk of pregnancy. To maximize safety, women agree to avoid pregnancy during trials, yet pregnancies occur. Using data from the HVTN 503/"Phambili" vaccine trial, we report pregnancy incidence during and after the vaccination period and identify factors, measured at screening, associated with incident pregnancy.To enrol in the trial, women agreed and were supported to avoid pregnancy until 1 month after their third and final vaccination ("vaccination period", corresponding to the first 7 months of follow-up. Unsterilized women, pooled across study arms, were analyzed. Poisson regression compared pregnancy rates during and after the vaccination period. Cox proportional hazards regression identified associations with first pregnancy.Among 352 women (median age 23 yrs; median follow-up 1.5 yrs, pregnancy incidence was 9.6/100 women-years overall and 6.8/100 w-yrs and 11.3/100 w-yrs during and after the vaccination period, respectively [Rate Ratio = 0.60 (0.32-1.14, p = 0.10]. In multivariable analysis, pregnancy was reduced among women who: enrolled at sites providing contraception on-site [HR = 0.43, 95% CI (0.22-0.86]; entered the trial as injectable contraceptive users [HR = 0.37 (0.21-0.67] or as consistent condom users (trend [HR = 0.54 (0.28-1.04]. Compared with women with a single partner of HIV-unknown status, pregnancy rates were increased among women with: a single partner whose status was HIV-negative [HR = 2.34(1.16-4.73] and; 2 partners both of HIV-unknown status [HR = 4.42(1.59-12.29]. Women with 2 more of these risk factors: marijuana use, heavy drinking, or use of either during sex, had increased pregnancy incidence [HR = 2.66 (1.24-5.72].It is possible to screen South African women for pregnancy risk at trial entry. Providing injectable contraception for free on-site and supporting consistent condom use may reduce

  7. Pregnancy Incidence and Correlates during the HVTN 503 Phambili HIV Vaccine Trial Conducted among South African Women

    Latka, Mary H.; Fielding, Katherine; Gray, Glenda E.; Bekker, Linda-Gail; Nchabeleng, Maphoshane; Mlisana, Koleka; Nielson, Tanya; Roux, Surita; Mkhize, Baningi; Mathebula, Matsontso; Naicker, Nivashnee; de Bruyn, Guy; Kublin, James; Churchyard, Gavin J.

    2012-01-01

    Background HIV prevention trials are increasingly being conducted in sub-Saharan Africa. Women at