AIDS Research and Treatment最新文献

Background: Globally, over 2 billion people are affected by food insecurity linked to HIV/AIDS. In Africa, there are about 28.5 million people of all ages living with HIV/AIDS, of whom 2.2 million died of AIDS due to multiple factors that overlap, severe household food insecurity including inadequate food diversity, food intake less than three times a day, body mass index (BMI) of less than 18 kg per square meter, and inadequate food intake. Good nutrition is important for people with HIV because it helps strengthen the immune system and keeps people with HIV healthy and helps absorb HIV medicines. In sub-Saharan Africa, including Ethiopia, the high prevalence of starvation or famine exacerbated HIV/AIDS patients' mortality rates. National data from Ethiopia show that nearly 90% of HIV/AIDS-infected people are affected by food insecurity. The current study aimed to assess the magnitude, determinant factors, and coping strategies of food insecurity among adult people living with HIV/AIDS. Methods: An institutional-based cross-sectional study was conducted on 421 adult HIV positives who were attending antiretroviral treatment at public health facilities in both rural and semiurban areas. The study subjects were selected by a simple random sampling technique. A pretested, semistructured questionnaire was used. A bivariate and multivariate logistic regression model was fitted to identify the independent factors associated with food insecurity. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to measure the strength of the association. Results: Food insecurity was prevalent among 80.3% of HIV/AIDS patients in the study population. Living in a rural area, the presence of another family member with HIV, inadequate dietary diversity, low frequency of meals, and current high viral load in the last 12 months were some of the factors that significantly affect food insecurity among AIDS patients. Eating less preferred foods and reducing the number of meals were among common coping strategies. Conclusion: This study analyzed the overall magnitude of food insecurity among HIV/AIDS patients and found it to be higher, which may end up in a shortening of life expectancy. A national health policymaker needs to integrate long-term food and nutrition interventions for marginalized groups, specifically PLWHA to tackle factors negatively affecting food insecurity and highly erosive coping strategies among AIDS patients.

Background: Disclosing HIV serostatus to a partner is essential for HIV prevention and care. It encourages safer sexual practices, lowers the risk of transmission, and helps individual's access to treatment and support. However, the choice to share one's HIV status can be affected by a range of personal and societal influences. Ethiopia has a diverse population where traditional norms and health challenges intersect which might negatively influence HIV disclosure. Therefore, this study aims to explore HIV disclosure patterns to sexual partners and associated factors among HIV-positive adults in Sheger City, Ethiopia. Methods: An institution-based cross-sectional study was conducted among 393 people living with HIV attending the ART clinic in Sheger City from August 1 to September 30, 2023. Study participants were selected using a systematic sampling technique. Data were collected through a pretested, interviewer-administered structured questionnaire. Multicollinearity was assessed using the variance inflation factor (VIF). To evaluate the goodness of fit of the logistic regression model, we calculated the pseudo-R ² values and the area under the receiver-operating characteristic (ROC) curve. Binary and multivariable logistic regression analyses were performed to identify factors independently associated with HIV disclosure status. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and statistical significance was determined at a p-value of < 0.05. Results: The overall prevalence of HIV serostatus disclosure to sexual partners was 67.9% (95% CI: 63.5%, 72.5%). Factors significantly associated with HIV disclosure included pretest counseling (AOR = 7.86; 95% CI: 3.61, 17.08), marital status (AOR = 9.32; 95% CI: 2.62, 33.19), presence of initiating factors (AOR = 7.18; 95% CI: 3.41, 15.01), type of testing (AOR = 6.44; 95% CI: 2.43, 17.07), perception of HIV-related stigma (AOR = 0.21; 95% CI: 0.09, 0.47), and having clinical symptoms at the time of HIV testing (AOR = 22.12; 95% CI: 8.74, 56.20). Conclusion: This study found that 67.9% of people living with HIV disclosed their serostatus to their sexual partners. Pretest counseling, being married, the presence of initiating factors, self-initiated testing, and experiencing clinical symptoms during testing were found to be positively associated with HIV status disclosure. In contrast to this, the perception of HIV-related stigma was associated with lower rate of disclosure. Thus, enhancing pretest counseling, launching community-based initiatives and offering extra support for symptomatic individuals are essential strategies to increase disclosure rates.

Background: Aging among people living with HIV (PLWH) presents multifaceted challenges influenced by antiretroviral therapy (ART), chronic inflammation, viral coinfections, stigma, multimorbidity, and immunosuppression. Methods: This review synthesizes recent research findings to outline factors contributing to aging with HIV. A comprehensive literature search was done using electronic databases including PubMed, Web of Science, Google Scholar, and CINAHL with keywords "HIV," "Aging," "Elderly," "Geriatrics," "Older Adults," "HIV Infections," and "HIV/AIDS. Results: Addressing age-related comorbidities, cognitive impairment, and non-AIDS events is imperative as older PLWH face increased morbidity and mortality rates compounded by coinfections such as HCV, HPV, TB, HSV, and bacterial infections. While ART is vital for viral suppression, it introduces challenges such as mitochondrial toxicity, metabolic disorders, and decreased CD4 cell counts, accelerating the aging process. Lifestyle factors, including smoking, substance abuse, malnutrition, sedentary behavior, and mental health conditions, further exacerbate aging in PLWH. Conclusions: This study emphasizes the necessity of holistic approaches to meet the unique healthcare needs of older PLWH, with insights into immunosenescence, coinfections, disease progression, ART exposure, and lifestyle factors. Understanding these dynamics is crucial for improving health outcomes and quality of life in aging PLWH.

Aims: This study aims to assess the correlation between risky behaviors (unprotected sexual intercourse with multiple partners, men who have sex with men (MSM), and injectable drug users) and HIV infection among patients. The study focus on evaluating risk behaviors associated with HIV transmission among HIV-positive individuals. Background: HIV is an RNA virus that primarily attacks the immune system. Currently, there are 39 million people infected with HIV. Methodology: This study is a cross-sectional analysis involving 67 HIV patients admitted to the Pakistan Institute of Medical Sciences (PIMS) during the years 2023-2024. All patients were interviewed regarding their HIV infection, and various questions concerning risk factors were posed to them. Results: Our research demonstrates a significant prevalence of HIV among unmarried individuals, with a statistical significance of p < 0.01. Furthermore, engaging in the high-risk behavior of sharing syringes and needles (standard beta = 0.73) and associating with drug users (standard beta = 0.061) might be considered forms of unsafe practices. There is a strong positive correlation (r = 0.867^∗∗) between drug users and the practice of sharing syringes and needles, which is highly statistically significant (p < 0.01). The results indicate a substantial association between drug users, the sharing of needles and syringes, and HIV infection. Conclusion: Drug users often share needles and syringes with other users, which significantly contributes to the outbreak of HIV in society. Unmarried men exhibit a higher prevalence of HIV compared to married men. Increasing public awareness and implementing robust government policies could help reduce the rate of HIV infections.

Introduction: We aimed to evaluate the clinical presentation and diagnosis process of all newly diagnosed human immunodeficiency virus (HIV) patients and conduct a 'look back' for barriers to care to aid a greater understanding of interventions to reduce late presentation. Methods: We evaluated 102 patients with newly diagnosed HIV who were referred to Melaka Hospital's infectious disease (ID) team from January 2021 to December 2022 via retrospective case record review. They were categorised into late presenters (LPs) and nonlate presenters (NLPs). LP is defined as persons presenting for care with a cluster of differentiation 4 (CD4) count below 350 cells/μL or presenting with an acquired immunodeficiency syndrome (AIDS) defining event, regardless of the CD4 cell count. Demographic characteristics, individual and healthcare system barriers and treatment outcomes were evaluated. Results: There were 89.2% of LPs, with 56.9% presenting with opportunistic infection (OI). Median CD4 for LPs upon diagnosis was 53 cells/μL. Pneumocystis jirovecii pneumonia was the most common presenting OI. Most were men who had sex with men (MSM) with more university graduates among the NLPs compared to LPs (36.4% vs. 8.8%, p 0.02). 9.9% of LPs experienced pitfalls during healthcare consultation, leading to late presentation, which was labelled as adverse events. LP's median time from diagnosis to first ID consultation was 7 days, and all patients' median duration of antiretroviral therapy (ART) initiation was 24 days. 82.4% of the patients were still on follow-up, with 69.6% achieving virological suppression at 6 months of ART. The mortality rate was 5.9%, all of which were LPs, and most were MSM. Conclusions: Late presentation remains challenging, with 9.9% of potent preventable adverse events. Morbidity meetings are crucial for immediate feedback to involved healthcare providers. Community-based organisations also play an essential role in identifying and providing linkage of high-risk groups to early HIV screening and diagnosis.

Background: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) continues to be a major public health issue, particularly among women of reproductive age. This study was conducted to examine the factors that influence HIV awareness and knowledge among women in Somaliland. Methods: The data used in this study were obtained from the Somaliland Demographic and Health Survey conducted between 2019 and 2020, which included a representative sample of women aged 15-49 years. Descriptive statistics and multivariable binary logistic regression analyses were performed to investigate the connections between various sociodemographic factors and HIV awareness and knowledge among the women. Results: The investigation uncovered that the level of HIV awareness and knowledge among women in Somaliland was inadequate, with only a small percentage possessing accurate information about HIV transmission and prevention. The multivariate logistic regression analysis showed that the education level (AOR = 1.58, 95% CI: 1.23-2.03), age (AOR = 0.82, 95% CI: 0.71-0.94), marital status (AOR = 1.32, 95% CI: 1.09-1.61), and media exposure (AOR = 1.49, 95% CI: 1.19-1.87) were significantly linked to higher levels of HIV awareness and knowledge among women. Conclusions: The research findings highlight the need for tailored interventions aimed at increasing HIV awareness and knowledge among women in Somaliland. To achieve this, it is essential to improve educational opportunities, conduct media campaigns, and eliminate cultural and socioeconomic obstacles that hinder the dissemination of precise information about HIV/AIDS. Collaboration between healthcare professionals, community leaders, and policymakers is vital for the development and implementation of successful interventions aimed at improving HIV awareness and knowledge among women in Somaliland.

Introduction: In recent decades, AIDS-related illnesses have declined due to the widespread use of highly active antiretroviral therapy (HAART). Despite the numerous benefits that HAART provides, it causes significant challenges for users in the form of adverse drug reactions (ADRs). Therefore, this systematic review and meta-analysis was conducted to explore the pooled incidence of antiretroviral therapy-related adverse drugs in Ethiopia. Methods: A systematic review and meta-analysis was conducted on cohort studies conducted among HIV patients living in Ethiopia. The study was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A random-effects meta-analysis was used to determine the pooled incidence of ADR. Heterogeneity was assessed, and the source of variation was analyzed using subgroup and sensitivity analyses. Funnel plots and Egger's regression tests were used to investigate publication bias. Results: Based on the random effects model from 10 extracted studies, the pooled incidence rate of adverse effects of ART drugs was 5.09 (95% CI: 3.86-6.71) per 100 person-years, with significant heterogeneity (I ² = 96.4%, p < 0.0001). It was also observed to be higher in subgroups from multicenter study areas, studies employing both prospective and retrospective designs, and among children. Discussion: The findings of this systematic review and meta-analysis revealed disparities in ADR incidence rates. In addition, the findings of this review showed that the occurrence of ART-related ADR in people living with HIV is common in the healthcare system. Conclusion: This systematic review and meta-analysis highlighted the significant incidence of adverse effects among individuals diagnosed with HIV in ART clinics in Ethiopia. A comprehensive strategy and coordinated collaboration among health planners, policymakers, and the community are essential to address this issue and integrate pharmacovigilance into service provision.

Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria. Methods: In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed-effect meta-analysis with the meta package on R Studio Version 4.2.0. Results: We included six of the 91 articles across the four databases. Most studies (n = 5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01-1.43). Similarly, PLWH in the South-South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01-1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South-East region. Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence.

Background: Globally, an estimated 1.7 million people were newly infected with human immunodeficiency virus (HIV), and approximately 37.9 million people were living with the virus. The prevalence of HIV remains high in sub-Saharan African countries, including Ethiopia. Consequently, enhancing the awareness of HIV risk is crucial for prevention efforts, as studies have shown that increased risk perception is strongly linked to condom utilization among youths. Objective: This study aimed to assess HIV risk perception and condom utilization among youths and associated factors in Gashena town, Northeast Ethiopia. Method: Community-based cross-sectional study involving 422 youths (15-24 years old) was conducted from June 01 to 30, 2022. Participants were selected using a systematic random sampling technique, and data analysis was conducted using Statistical Package for the Social Sciences (SPSS) Version 25 software. Logistic regression analysis was employed to determine the odds ratios for variable associations, with statistical significance set at p < 0.05. Result: The present study revealed that 50% (95% CI: 42.7-57.3) of youths utilized condoms, while 19.4% (95% CI: 15.8-23.5) had a perception of being at risk for HIV. Factors significantly associated with both condom utilization and HIV risk perception included being 18 years old or older (AOR: 95% CI: 0.2 [0.10-0.40]), having completed primary education or higher (AOR: 95% CI: 6.23 [3.44-11.29]), and being employed (AOR: 95% CI: 1.96 [1.09-3.53]). Conclusion: This study found a low prevalence of condom utilization and HIV risk perception among youths. Being 18 years old or older, having completed primary education or higher, and being employed were factors significantly linked to both condom use and HIV risk perception. Therefore, raising awareness about the implications of unprotected sexual intercourse and HIV risk perception among youths of varying ages, educational status, and occupational statuses could potentially enhance condom utilization among this demographic group.

The effects of ignoring survey designs during the analysis of complex survey data may lead to biased estimates. This has been a common practice for most researchers. It is more critical for public health data which involve the clinical decisions that decide the fate of people's lives. This analysis compares the estimates of factors of viral load suppression (VLS) with and without including survey designs using the Tanzania HIV Impact Survey (THIS). This survey reveals factors associated with VLS among Tanzanians living with HIV/AIDS. The correlates of VLS were examined using multivariable logistic regression models in both cases with and without including survey design. The study unveils significant correlates such as age, middle wealth quintile, CD4, adherence, and antiretroviral (ARV) detection status of a patient. Furthermore, the study emphasizes the essence of properly accounting for CSD. Failure to do so may result in biased parameter estimates and incorrect variances; hence, incorrect inferences. Thus, the study's findings on VLS determinants have significant practical implications that allow government agencies and stakeholders to establish targeted and successful HIV/AIDS prevention and treatment initiatives. Consequently, this study suggests a complex design as an approach for obtaining unbiased estimates on the national representative surveys.