Journal of the International Association of Providers of AIDS Care最新文献

Background: In people living with human immunodeficiency virus (PLHIV), hyperuricemia may result from antiretroviral therapy (ART)-induced metabolic changes, lifestyle behaviors, and individual host factors. However, there is a scarcity of data on the prevalence and determinants of hyperuricemia among PLHIV on ART in sub-Saharan Africa. Objective: This study aimed to assess the magnitude of hyperuricemia and its associated factors among PLHIV who enrolled in first-line ART in the Amhara Region, Ethiopia. Method: A multi-center, institution-based cross-sectional study was conducted from March 15 to June 15, 2024. Referral hospitals were selected through simple random sampling, and a total of 401 participants were enrolled from these hospitals using a systematic sampling approach. Data were collected using a structured questionnaire, patient chart review, physical measurements, and biochemical analysis. Hyperuricemia was defined as a serum uric acid level is >6 mg/dL for females and >7 mg/dL for males. Multivariable logistic regression was employed to identify the factors that are associated with hyperuricemia, and a statistical significance was decided at P ≤ .05. Result: The overall magnitude of hyperuricemia among PLHIV was 28.2% (95% confidence interval (CI): 23.7-32.5%). Male sex (AOR = 1.79, 95% CI: 1.07, 2.98), older age (AOR = 1.03; 95% CI: 1-1.06), obesity (AOR = 2.21; 95% CI: 1.04-4.73), and longer ART duration (AOR = 1.13; 95% CI: 1.01-1.27) were significantly associated with hyperuricemia. Conclusion: Our study found a relatively high prevalence of hyperuricemia (28.2%) among PLHIV on first-line ART. Significant associated factors included male sex, older age, obesity, and longer ART duration. Therefore, early screening, particularly in males, older adults, those with obesity, and long-term ART users, is essential to prevent complications.

BackgroundLong-distance truckers (LDTs) not only experience heightened risk of human immunodeficiency virus (HIV) infections due to risky sexual networks, but are also hard to reach with consistent risk reduction messages due to their often disruptive work schedules. Besides, evidence of the existing behavior change communication (BCC) strategies to enhance HIV/ acquired immunodeficiency syndrome (AIDS) risk reduction is limited. Thus, the study sought to explore the most effective and preferred BCC strategies for adoption among LDTs in Kenya.Methods and MethodologyNine key informants and 18 in-depth interviews were used to gather qualitative data from purposively sampled participants at Kenya's Busia and Namanga border points. A thematic analysis was conducted using a hybrid of inductive and deductive approaches, through the Qualitative Data Analysis Miner (QDA-Miner) software for QDA.ResultsAlmost half of the key informants (44%) were aged 25-34, whereas half of the in-depth interviewees were 35-44 years old. Media-based communication channels were the most common and accessible. Other BCC strategies included interpersonal communication and healthcare worker service-driven strategies, peer-led open discussions and shared experiences on HIV/AIDS risk reduction, outreach activities to reach more of the underserved LDTs, and non-governmental organization (NGO)-driven approaches to fill gaps left by the public healthcare systems.ConclusionMedia-based communication channels were the most common BCC strategies. However, a combination of interpersonal communication, peer-led services, outreach activities, and NGO-driven approaches played a key role in enhancing the HIV/AIDS risk reduction message reach to the LDTs.

BackgroundIn Cameroon, people living with HIV (PLHIV) receiving antiretroviral therapy (ART) have a high prevalence of hypertension (HTN) and an increased risk of cardiovascular mortality. Managing HTN in this population is a major challenge. This qualitative study, conducted at the Yaoundé Central Hospital, Cameroon, in 2024, explored the barriers and facilitators to hypertension management in PLHIV.MethodsThe study involved 15 participants, including 9 PLHIV diagnosed with hypertension, 03 healthcare providers, and 03 psychosocial agents. A quota sampling approach was used to recruit participants. Data was collected through 12 in-depth interviews and a focus group with 3 psychosocial agents. Data collection took place over a period of 5 months, from January to May 2024. A semistructured interview guide was used to explore participants' perceptions of hypertension management. Data analysis was based on the COM-B model to interpret the results, using NVivo software.ResultsIdentified barriers included a lack of knowledge about hypertension, difficulties in accessing medications due to high costs, and psychosocial issues such as family stress affecting treatment adherence. Additionally, cultural and religious beliefs, such as a preference for traditional treatments and miraculous healings, limited engagement with conventional medicine. However, facilitators included regular visits for ART follow-up, which allowed for hypertension screening, and financial support from families that facilitated access to treatment. The proactive involvement of healthcare providers and continuous communication also contributed to treatment adherence.ConclusionThe study highlights the need for interventions that address socio-economic, cultural, and medical barriers to improve hypertension management in PLHIV, particularly through enhancing access to care and raising awareness.

BackgroundThis study assessed the acceptability, among caregivers, of a mental health chatbot designed for adolescents living with HIV aged 10 to 19 years.MethodsFifteen caregivers interacted with the mental health chatbot. Pre-post assessments and semistructured interviews evaluated acceptability. Data were analyzed using a Framework Analysis approach.ResultsCaregivers aged 31 to 70 years found the chatbot acceptable on individual, interpersonal, and environmental levels. They appreciated the educational content and self-help tools, feeling the chatbot would benefit them personally. Caregivers also saw potential in the chatbot to improve communication with their children, particularly during critical periods like HIV diagnosis. Despite concerns about data costs or internet access, most viewed the chatbot as an accessible supplement to traditional mental health services.ConclusionThis study suggests that a mental health chatbot for Peruvian adolescents living with HIV was acceptable to their caregivers, potentially benefiting caregivers' mental health, enhancing caregiver-adolescent interactions, and fostering better communication.

BackgroundHuman immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome Acquired immunodeficiency syndrome can affect any age group, and it is the major cause of pediatric morbidity and mortality worldwide; challenges persist in identifying and linking all HIV-exposed infants to early infant diagnosis and care.MethodsA cross-sectional study was done using secondary data extracted from the medical records of 244 HIV-exposed children from HIV-infected mothers who were on follow-up from January 2018 to December 2023 and enrolled in four public hospitals. Data were collected and imported into Epi-Data and exported to SPSS version 26.0 for analysis. A binary logistic regression model was used to fit each variable.ResultsAmong 244 HIV-exposed infants, 10 (4.1%) were diagnosed as HIV positive. Children who received cotrimoxazole preventive therapy {AOR 0.89 = 95% CI (0.02-0.79)} and children born at a health facility 91.2% {AOR 0.088 = 95% CI (0.01-0.58)} were associated with positive HIV sero-status.ConclusionThe level of HIV infection among infants was relatively high compared with the global goal of less than 2% for 2030.

People with a previous HIV diagnosis (PWHDx) who are out of care (OOC) (PWHDx OOC) represent a significant but often overlooked population in the United States, accounting for nearly half of new HIV transmissions annually. Emergency departments (EDs), frequently accessed by PWHDx OOC for unscheduled care, are uniquely positioned to identify and re-engage these individuals in HIV care. While ED-based HIV efforts have traditionally focused on diagnosing new infections, this paper reviews and evaluates 3 models EDs can implement to identify PWHDx OOC: routine HIV screening, health information exchange, and electronic health record alerts. We describe each model using examples from the literature, assessing their feasibility, scalability, and effectiveness in identifying patients and determining care status. By synthesizing current approaches, this paper highlights practical and policy-relevant pathways for expanding ED-based HIV services beyond diagnosis, offering concrete guidance for healthcare systems aiming to meet the national "Ending the HIV Epidemic" goals.

ObjectiveAlthough incarcerated individuals are at disproportionately higher HIV risk compared to the general US population, few jails offer linkage to preexposure prophylaxis (PrEP). We explored stakeholder perspectives about barriers and facilitators to PrEP for justice-involved individuals.MethodsSemi-structured interviews were conducted with three stakeholder groups in Dallas County, Texas: justice-involved individuals (n = 8), County Jail staff (n = 9), and employees of local community organizations that provide PrEP services (n = 9). Transcripts were analyzed using a combined deductive and inductive approach.ResultsBarriers to PrEP linkage included: limited provider knowledge of and capacity for PrEP care, stigma around incarceration and PrEP, and mistrust in healthcare and criminal justice systems among justice-involved individuals. Perceived facilitators included addressing competing priorities, partnering with community organizations, and providers' cultural competency training.ConclusionFuture research should focus on adapting successful implementation strategies to the needs of justice-involved populations to improve HIV prevention and health outcomes in high-burden regions like the Southern USA.

Background: The incidence of sexually transmitted infections (STIs) remains high among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) (PWH). This study determined the prevalence of asymptomatic STIs in MSM PWH attending an HIV clinic in Mexico City.

Methods: This cross-sectional study (May 2022-November 2023) included self-questionnaires on STI-related behaviors and symptoms, urethral samples for multiplex polymerase chain reaction (PCR), and serological tests for syphilis, HBV, and HCV.

Results: Among 261 patients, 56.7% were receiving antiretroviral therapy, 41.8% had suppressed HIV-1 viral load, and 26.1% tested positive for at least one STI in urethral PCR. The most prevalent microorganisms were Ureaplasma urealyticum (14.9%), Mycoplasma hominis (6.9%), Mycoplasma genitalium (4.2%), and Chlamydia trachomatis (3.1%). Multiple infections were identified in 5.3% of cases. Seroprevalence rates for syphilis, HBV, and HCV were 17.6%, 6.5%, and 3.1%, respectively. Current smoking and insertive anal sex were the only statistically significant associated factors.

Conclusions: This study underscores the high frequency of asymptomatic STIs and the importance of regular screening.