HIV AIDS-Research and Palliative Care最新文献

Background: The primary cause of HIV transmission is a failure to deliver proper HIV/AIDS information, which is a major public health issue in low- and middle-income nations. While global health coverage continues, there is still little understanding of HIV/AIDS in Ethiopia, and there is a data gap. As a result, the aim of this study was to investigate the factors that influence comprehensive HIV/AIDS knowledge among HIV testing and counselling (HTC) service users in Gondar, northwest Ethiopia.

Methods: A facility-based cross-sectional study was conducted from June to July 2022. About 423 clients were included. Data on HIV/AIDS knowledge, attitude, and behavior were collected. Stata 17 was used to analyze. A pre-tested questionnaires were used. Using ordinal logistic regression model, variables having p values of 0.2 and <0.05 were chosen as a candidate variable in binary and final model.

Results: The total knowledge, favorable attitude, and good behaviors of HIV/AIDS were approximately 258 (61%), 220 (52%), and 210 (49.5%), respectively. Being male (AOR = 1.39, 95% CI = 1.28-3.01), age from 31 to 35 years (AOR = 2.13, 95% CI = 1.88-4.18), and above 36 years old (AOR = 2.21, 95% CI = 1.98-3.44), primary (AOR = 1.21, 95% CI = 1.67-3.20), and higher education (AOR = 1.19, 95% CI = 1.03-3.01), employed (AOR = 1.33, 95% CI = 1.09, 3.37), and media exposure (AOR = 2.02, 95% CI = 1.21, 3.61) were factors associated with comprehensive knowledge of HIV/AIDS, respectively.

Conclusion: The study participants' knowledge, attitudes, and behaviors regarding HIV/AIDS were rather low. Since HIV/AIDS is still a major public health issue, if the concerned body uses and designs media effectively, encouraging females to attend school, it will have a better chance of combating HIV/AIDS by increasing their knowledge.

Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is a single-tablet antiretroviral therapy regimen. B/F/TAF has become a popular treatment choice because of its small tablet size, high barrier to resistance, favorable tolerability, and limited drug-drug interaction profile. Continued research on B/F/TAF has revealed additional potential for this regimen. This review presents recent literature supporting the use of B/F/TAF as an option for consolidating therapy and maintaining virologic suppression in individuals despite M184V/I mutations. Additionally, children are a unique patient population with limited antiviral options. Standard dose B/F/TAF has demonstrated similar drug exposure in children and adolescents as adults, and low-dose B/F/TAF is approved for children living with HIV greater than two years of age and weighing at least 14 kg. Data supporting this recommendation is described in this review. Finally, despite a lack of prospective data, B/F/TAF may have a role in the future of pre- and post-exposure prophylaxis. This review discusses these discoveries and the continued exploration of the hidden potential of B/F/TAF.

Purpose: We evaluated the effect of multi-month dispensing (MMD) on viral suppression among newly enrolled adolescents and adults with HIV in 11 northern Nigerian states.

Patients and methods: We conducted a retrospective analysis of longitudinal data from 75 health facilities. We abstracted electronic medical records for patients ≥10 years, initiated on ART April 1, 2019 - June 30, 2021, and with a 6- or 12-month viral load (VL) result. We categorized participants in the MMD group to see if they received antiretroviral treatment (ART) for ≥84 days at any visit within 6 months of ART initiation. We consider cut-offs for viral suppression at 50 copies/mL. The period when the VL was performed was classified as pre-COVID-19 (before April 1, 2020) or during the COVID-19 pandemic. We estimated relative risks (RR) by comparing the unsuppressed proportion of those on MMD to those not on MMD, adjusted for age, gender, and COVID-19 period.

Results: Overall, 19,859 participant records were abstracted. Median age was 33 years, 64% were female, 91% were started on a dolutegravir (DTG)-based regimen, and 65% were on MMD. Overall, 15,259 (77%) participants were followed for ≥6 months, 4136 (27%) had a VL at 6 months and 3640 (24%) had a VL at 12 months after ART initiation. A slightly higher proportion of patients on MMD had undetectable VL levels at 6 months (65% vs 58%) and 12 months (66% vs 62%). In the adjusted analysis, we found no significant differences in undetectable VL at 6 months and 12 months between newly enrolled patients on MMD and those not on MMD. Those on Protease inhibitor-based regimen had 54% lower likelihood of undetectable VL compared to those on DTG-based regimen.

Conclusion: MMD does not result in poorer viral suppression among newly enrolled patients.

Introduction: Tuberculosis (TB) remains the leading cause of death among human immune deficiency virus (HIV) patients. Based on the 2020 global TB report, Ethiopia was among the 30 high TB and TB/HIV burden countries. This study filled gaps regarding IPT uptake in the study area and representative sample determination for assessing TB incidence and its predictors at public health facilities in Illubabor and Buno Bedelle zones, south-west Ethiopia.

Methods: This retrospective cohort study was conducted among people living with HIV (PLHIV) who were on antiretroviral therapy (ART) at public health facilities in Illubabor and Buno Bedelle zones, south-west Ethiopia. Both isoniazid preventive therapy (IPT) exposed and unexposed PLHIV were followed from the date of ART initiation until the date of TB diagnosis of the most recent visit prior to the end of follow-up. The Cox proportional hazard model was employed to identify variables that predicted the incidence of TB at a P value of <0.05.

Results: Data were collected on 421 PLHIV, with a response rate of 97.4%. The median (interquartile range (IQR)) age of the study participants was 32 (28-40) year. The incidence rate of pulmonary TB was 3.1 per 1000 person-months (95% CI: 2.4-3.9). The incidence rate of TB among IPT-exposed PLHIV was 1.45 per 1000 person-months, but it was 6.2 per 1000 person-months in the unexposed group. Patient's residence, IPT exposure, baseline ART adherence, baseline hemoglobin level, baseline CD4+ cell, recent hemoglobin level, recent CD4+ cell, recent BMI, and recent WHO HIV clinical stage were independently associated with the incidence of TB.

Conclusion: Healthcare professionals working in ART clinics should routinely assess HIV-positive individuals for changes in clinical indicators and environmental exposures like living conditions, which will help HIV-positive individuals in reducing their risk for TB. Likewise, patients attending ART clinics should receive counseling on a regular basis.

Introduction: In Colombia, there are no studies that analyze the effect of socioeconomic vulnerability and belonging to the group of men who have sex with other men (MSM) on the prevalence of HIV in young people.

Objective: To compare the prevalence of HIV in three groups of young people from Medellín-Colombia: general population, socioeconomic vulnerability and MSM.

Methods: This cross-sectional analytical study included 2449 young people from the general population, 1736 from institutions that serve young people in situations of socioeconomic vulnerability, and 2269 MSM. The prevalence of infection in each group was determined, statistical differences were identified using Pearson's Chi-square and Trend's Chi-square, and crude and adjusted odds ratios were estimated using logistic regression with 95% confidence intervals. Analyses were performed in SPSS 29.0.

Results: HIV prevalence was 0.8% in the general population group, 1.3% in young people with socioeconomic vulnerability, and 5.6% in MSM. The groups with the highest HIV were as follows: (i) in MSM it was 4.1 compared to the general population, (ii) between 25-28 years of age it was 2.9 times compared to those under 20 years, (iii) in men it was 10 times that registered in women, (iv) in young people with primary, secondary, technical and university studies it was 7.1; 6.7; 11.0 and 14.5 times that found in those who did not register studies, (v) in affiliates of the subsidized health regime it was 2.2 times and in those without affiliation 2.4 times compared to the infection in affiliates of the contributory health regime.

Conclusion: HIV prevalence was high, and explained by socioeconomic vulnerability, having sex between men, gender, age, education, and health affiliation, demonstrating the intersectionality of determinants of the health system, socioeconomic status, and determinants individuals in the occurrence of HIV in young people in Medellín.

Introduction: People living with HIV (PLHIV) still have challenges in accessing HIV services in low- and middle-income countries (LMIC). In Uganda, community drug distribution points (CDDPs) are part of interventions to improve access to anti-retroviral medications. However, there is still low enrollment in CDDPs among PLHIV in south-western Uganda, particularly in Bushenyi district. This study explored the barriers and facilitators to the utilization of CDDPs among PLHIV.

Methods: This was a descriptive qualitative study utilizing a qualitative approach. We purposively recruited 24 PLHIV and 6 Primary healthcare providers as key informants. We conducted in-depth interviews with PLHIV and key informant interviews with Primary healthcare providers using an interview guide. The audio recordings were transcribed verbatim to Rukiga-Runyankore and then translated into English. Data were coded and analyzed using thematic analysis.

Results: Seven themes were developed describing drivers for the utilization of CDDPs. These were broadly categorized into facilitators and barriers. The main facilitators of the utilization of CDDPs were peer support, positive Primary healthcare providers' attitudes, satisfaction with HIV services, and accessibility of ART services. The main barriers were stigma, lack of physical infrastructure, and lack of comprehensive services.

Conclusion and recommendation: Utilization of CDDPs is facilitated by accessibility and Primary healthcare providers' attitude. Stigma is still a limitation to the utilization of HIV services. We recommend that Ministry of Health and other development partners should improve physical infrastructural facilities at the CDDP sites so that the privacy and confidentiality of the PLHIV are protected. Focus on interventions to eliminate stigma by Primary healthcare providers and other stakeholders at CDDP sites is urgently needed.