H. Ntalasha, J. Malungo, Sonja Merten, A. Phiri, S. Simona
Despite the roll out of free life prolonging HIV and AIDS drugs in many public clinics in Zambia and the well documented effects of Anti Retrovirals (ARVs) in reducing mortality among people living with HIV, some people living with HIV still abandon treatment. This study explores patient-related factors that influence adherence to the life prolonging drugs. It is hoped that such information would be useful in enhancing adherence so as to achieve the goal of ART. This information is critical considering irrefutable evidence that non-adherence to Anti-Retroviral Therapy (ART) can lead to drug resistance and consequently, transmission of drug resistant HIV. Drug resistant HIV is not only expensive to handle, but can lead to increased morbidity, mortality and increased incidence of HIV cases particularly, for a low income country like Zambia. Methods: This paper uses data from a large mixed method study which was conducted in a rural setting. The study explored how patient-related factors influence people living with HIV in continuing taking of medication. The paper, therefore, discusses the major reasons reported by HIV infected people on ART for either being able to consistently take their medication or failing to do so. Results: Both limiting and facilitating factors were identified as influencing adherence. Among the facilitators identified were one having a reminder, feeling better after being on ART, seeing someone on ART recover, desire to live longer and disclosure of one’s positive status. The limiting factors included forgetting to take medication, non-recovery while on treatment for some time and drug fatigue. A significant association was found between adherence treatment and one having a reminder, desire to live longer and seeing someone on ART get better. Conclusion: While facilitators enhanced adherence, the barriers prevented or discouraged people on ART from continuing taking AIDS medicines as prescribed by their health care providers. In order to avoid drug resistance and other public health implications, such as transmission of drug resistant HIV virus and deaths, there is need to address these patient-related barriers.
{"title":"Patient-Related Factors Influencing Adherence to ART, A Case of Chivuna, Southern Province of Zambia","authors":"H. Ntalasha, J. Malungo, Sonja Merten, A. Phiri, S. Simona","doi":"10.4236/WJA.2019.92005","DOIUrl":"https://doi.org/10.4236/WJA.2019.92005","url":null,"abstract":"Despite the roll out of free life prolonging HIV and AIDS drugs in many public clinics in Zambia and the well documented effects of Anti Retrovirals (ARVs) in reducing mortality among people living with HIV, some people living with HIV still abandon treatment. This study explores patient-related factors that influence adherence to the life prolonging drugs. It is hoped that such information would be useful in enhancing adherence so as to achieve the goal of ART. This information is critical considering irrefutable evidence that non-adherence to Anti-Retroviral Therapy (ART) can lead to drug resistance and consequently, transmission of drug resistant HIV. Drug resistant HIV is not only expensive to handle, but can lead to increased morbidity, mortality and increased incidence of HIV cases particularly, for a low income country like Zambia. Methods: This paper uses data from a large mixed method study which was conducted in a rural setting. The study explored how patient-related factors influence people living with HIV in continuing taking of medication. The paper, therefore, discusses the major reasons reported by HIV infected people on ART for either being able to consistently take their medication or failing to do so. Results: Both limiting and facilitating factors were identified as influencing adherence. Among the facilitators identified were one having a reminder, feeling better after being on ART, seeing someone on ART recover, desire to live longer and disclosure of one’s positive status. The limiting factors included forgetting to take medication, non-recovery while on treatment for some time and drug fatigue. A significant association was found between adherence treatment and one having a reminder, desire to live longer and seeing someone on ART get better. Conclusion: While facilitators enhanced adherence, the barriers prevented or discouraged people on ART from continuing taking AIDS medicines as prescribed by their health care providers. In order to avoid drug resistance and other public health implications, such as transmission of drug resistant HIV virus and deaths, there is need to address these patient-related barriers.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48723442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article addresses issues regarding the transmission of HIV; without the combination antiretroviral treatment (cART), HIV causes a fatal outcome of those infected in most cases. First, legal issues: For years, controversial discussions have dealt with the subject of the legal classification of HIV infection, such as “… criminalization of HIV exposure might limit access to and uptake of HIV prevention services…” Based on the rule of law of a constitutional state, we explain the legal principles that serve to protect the legal rights of its citizens. The state has to protect its citizens from harm by other people. The prosecution and conviction of a specific person for a proven HIV infection are legal. Therefore, general decriminalization of HIV infection would undermine the right of thereby harmed citizens to compensation. Second, HIV prevention strategies: Based on the Test and Treatment Strategy (TASP)1, controlled studies were undertaken to find out which framework conditions could improve their benefit. We outline concepts that can help to curb the still ongoing spread of HIV: By providing early HIV diagnosis and ongoing HIV care services as part of updated education and prevention campaigns. Also, concerted, comprehensive campaigns are required to demonstrate further impacts of HIV infection: Both on the quality of life of infected individuals due to the development of non-communicable diseases and the increasing burden to societies as a whole.
{"title":"The HIV Infection: Clarification of Its Legal Classification of Transmission and Measures to Protect Societies from Burdening Caused by Social and Medical Care Services for the Coming Decades","authors":"R. Dennin, Arndt Sinn","doi":"10.4236/WJA.2019.92004","DOIUrl":"https://doi.org/10.4236/WJA.2019.92004","url":null,"abstract":"This article addresses issues regarding the transmission of HIV; without the combination antiretroviral treatment (cART), HIV causes a fatal outcome of those infected in most cases. First, legal issues: For years, controversial discussions have dealt with the subject of the legal classification of HIV infection, such as “… criminalization of HIV exposure might limit access to and uptake of HIV prevention services…” Based on the rule of law of a constitutional state, we explain the legal principles that serve to protect the legal rights of its citizens. The state has to protect its citizens from harm by other people. The prosecution and conviction of a specific person for a proven HIV infection are legal. Therefore, general decriminalization of HIV infection would undermine the right of thereby harmed citizens to compensation. Second, HIV prevention strategies: Based on the Test and Treatment Strategy (TASP)1, controlled studies were undertaken to find out which framework conditions could improve their benefit. We outline concepts that can help to curb the still ongoing spread of HIV: By providing early HIV diagnosis and ongoing HIV care services as part of updated education and prevention campaigns. Also, concerted, comprehensive campaigns are required to demonstrate further impacts of HIV infection: Both on the quality of life of infected individuals due to the development of non-communicable diseases and the increasing burden to societies as a whole.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48259727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women; median age was 38 years; 67% were married; 89 (78%) had heterosexual sex as HIV risk; 40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%); 12 (10%) unskilled labourers; 27 (23%) housewives; 26 (22%) pro-fessionals/blue collar job; 1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P
{"title":"Improvement in Socio-Economic Productivity of HIV Positive Individuals on Antiretroviral Treatment in a Private Setting in South India","authors":"F. Visnegarwala, Glory Alexander, R. Babu","doi":"10.4236/WJA.2019.91003","DOIUrl":"https://doi.org/10.4236/WJA.2019.91003","url":null,"abstract":"PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women; median age was 38 years; 67% were married; 89 (78%) had heterosexual sex as HIV risk; 40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%); 12 (10%) unskilled labourers; 27 (23%) housewives; 26 (22%) pro-fessionals/blue collar job; 1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45585096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard Bahizire Riziki, Sylvie Mutonda Mwangaza, Théo Mitima Kashosi, Bienfait Mitima Misuka, Freud Muciza Bayunvanye, Tharcisse Mateso Kakulibo, Jean Paul N’Sibula Bisimwa, Jean Lambert Mandjo Aholoma, Philippe Bianga Katchunga
Background: It has been well-established that a program to fight HIV can accomplish the same results with noncommunicable diseases (NCDs). Such a strategy has not yet been the subject of a trial in the Democratic Republic of the Congo (DRC). The aim of this study was to test the feasibility of HIV concurrent and respectively other chronic infectious and NCDs in the general population of South Kivu. Methods: Between 1 December 2016 and 15 January 2017, HIV, hepatitis B, high blood pressure (HBP) and diabetes mellitus (DM) were tested in the general adult population ≥ 15 years, respectively, in the towns of Bukavu and Uvira, and the rural areas Nyangezi and Walungu, on World AIDS Day 2016. Previous screening of these diseases has been sought, but the association between them was modeled in a multiple logistic regression. Results: Among the three thousand eight hundred and sixty-three (3863) adult subjects > 15 years (52.1% of men) tested voluntarily, the previous screening and prevalence were 33.8% and 1.2% respectively for HIV, 1.3% and 8.3% for hepatitis B, 18.2% and 25.1% for HBP and 9.5% and 4.8% for DM. The acceptance rate for current screening was significantly higher (p < 0.0001) for HIV (97.5%) than for HBP (84.6%) as well as DM (64.6%). Finally, age ≥ 60 years (adjusted OR = 1.74; p = 0.01), HBP (adjusted OR = 1.82; p = 0.004) and above all HIV (adjusted OR = 3.94; p = 0.008) showed an independent effect on the likelihood of DM. Conclusion: This study did more HIV testing than screens for other diseases. Finally, these problems can be managed (at a reasonable cost) with a view similar to the objectives of the World Health Organization (WHO).
{"title":"Screening for Human Immunodeficiency Virus, Hepatitis B, High Blood Pressure, and Diabetes Mellitus in the General Population of South Kivu—Results of World AIDS Day 2016","authors":"Richard Bahizire Riziki, Sylvie Mutonda Mwangaza, Théo Mitima Kashosi, Bienfait Mitima Misuka, Freud Muciza Bayunvanye, Tharcisse Mateso Kakulibo, Jean Paul N’Sibula Bisimwa, Jean Lambert Mandjo Aholoma, Philippe Bianga Katchunga","doi":"10.4236/WJA.2019.91002","DOIUrl":"https://doi.org/10.4236/WJA.2019.91002","url":null,"abstract":"Background: It has been well-established that a program to fight HIV can accomplish the same results with noncommunicable diseases (NCDs). Such a strategy has not yet been the subject of a trial in the Democratic Republic of the Congo (DRC). The aim of this study was to test the feasibility of HIV concurrent and respectively other chronic infectious and NCDs in the general population of South Kivu. Methods: Between 1 December 2016 and 15 January 2017, HIV, hepatitis B, high blood pressure (HBP) and diabetes mellitus (DM) were tested in the general adult population ≥ 15 years, respectively, in the towns of Bukavu and Uvira, and the rural areas Nyangezi and Walungu, on World AIDS Day 2016. Previous screening of these diseases has been sought, but the association between them was modeled in a multiple logistic regression. Results: Among the three thousand eight hundred and sixty-three (3863) adult subjects > 15 years (52.1% of men) tested voluntarily, the previous screening and prevalence were 33.8% and 1.2% respectively for HIV, 1.3% and 8.3% for hepatitis B, 18.2% and 25.1% for HBP and 9.5% and 4.8% for DM. The acceptance rate for current screening was significantly higher (p < 0.0001) for HIV (97.5%) than for HBP (84.6%) as well as DM (64.6%). Finally, age ≥ 60 years (adjusted OR = 1.74; p = 0.01), HBP (adjusted OR = 1.82; p = 0.004) and above all HIV (adjusted OR = 3.94; p = 0.008) showed an independent effect on the likelihood of DM. Conclusion: This study did more HIV testing than screens for other diseases. Finally, these problems can be managed (at a reasonable cost) with a view similar to the objectives of the World Health Organization (WHO).","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42241678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Mirambo, B. Kidenya, Vitus Silago, E. Mkumbo, Awadh Mujuni, Kennedy J. Mmanga, Japhet J. Mwihambi, Shimba Henerico, Carolyne A. Minja, S. Mshana
Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections have been a major public health problem. HIV patients with HBV and HCV infection are at high risk of liver diseases which is associated with increased mortality. This study aims at determining the prevalence of hepatitis B surface antigen (HBsAg), HCV antibodies and HBV antibodies (anti-HBsAg) among HIV seropositive adults attending care and treatment clinic at Sengerema district hospital in Mwanza, Tanzania. A cross-sectional hospital based study was conducted between February and March 2017 among 243 HIV adult patients at Sengerema designated district hospital, Mwanza, Tanzania. Socio-demographic and other relevant information were collected using pre-tested questionnaires. Detection of HBsAg and HCV antibodies was done by commercial rapid immunochromatographic test while the detection of anti-HBsAg was done using enzyme linked immunosorbent assay. Data were analyzed by using STATA version 13. The median age of the study participants was 43, interquartile range (IQR): 37 - 51 years. The majority 172 (70.8) of study participants were female and the majority (88%) of participants had CD4 count of greater than 200 counts/μl. The prevalence of HBsAg, HCV antibodies and anti-HBsAg were 26/243 (10.7%, 95% confidence interval [CI]: 7 - 14), 20/243 (8.2%, 95% CI: 4.7 - 11.6) and (100/243) 41.2%, 95% CI: 35 - 47, respectively. Co-infection with HCV (OR: 4.45, 95% CI: 1.51 - 13.21, P = 0.007) was independenlty found to predict HbsAg positivity. History of blood transfusion (OR: 2.34, 95% CI: 1.08 - 5.06, P = 0.028) was significantly associated with anti-HBsAg among HIV infected individuals while, the rate of anti-HBsAg was found to decrease by 2.02 IU/L in a year increase in age. About one tenth of HIV infected individuals are co-infected with HCV and HBV with more than one third being positive for anti-HBsAg. There is a paramount need to emphasize the need for regular screening and proper management of these patients to reduce associated complications in resource limited countries where these infections are common.
{"title":"Hepatitis B and Hepatitis C among Human Immunodeficiency Virus Infected Patients at a District Hospital in Mwanza, Tanzania","authors":"M. Mirambo, B. Kidenya, Vitus Silago, E. Mkumbo, Awadh Mujuni, Kennedy J. Mmanga, Japhet J. Mwihambi, Shimba Henerico, Carolyne A. Minja, S. Mshana","doi":"10.4236/WJA.2019.91001","DOIUrl":"https://doi.org/10.4236/WJA.2019.91001","url":null,"abstract":"Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections have been a major public health problem. HIV patients with HBV and HCV infection are at high risk of liver diseases which is associated with increased mortality. This study aims at determining the prevalence of hepatitis B surface antigen (HBsAg), HCV antibodies and HBV antibodies (anti-HBsAg) among HIV seropositive adults attending care and treatment clinic at Sengerema district hospital in Mwanza, Tanzania. A cross-sectional hospital based study was conducted between February and March 2017 among 243 HIV adult patients at Sengerema designated district hospital, Mwanza, Tanzania. Socio-demographic and other relevant information were collected using pre-tested questionnaires. Detection of HBsAg and HCV antibodies was done by commercial rapid immunochromatographic test while the detection of anti-HBsAg was done using enzyme linked immunosorbent assay. Data were analyzed by using STATA version 13. The median age of the study participants was 43, interquartile range (IQR): 37 - 51 years. The majority 172 (70.8) of study participants were female and the majority (88%) of participants had CD4 count of greater than 200 counts/μl. The prevalence of HBsAg, HCV antibodies and anti-HBsAg were 26/243 (10.7%, 95% confidence interval [CI]: 7 - 14), 20/243 (8.2%, 95% CI: 4.7 - 11.6) and (100/243) 41.2%, 95% CI: 35 - 47, respectively. Co-infection with HCV (OR: 4.45, 95% CI: 1.51 - 13.21, P = 0.007) was independenlty found to predict HbsAg positivity. History of blood transfusion (OR: 2.34, 95% CI: 1.08 - 5.06, P = 0.028) was significantly associated with anti-HBsAg among HIV infected individuals while, the rate of anti-HBsAg was found to decrease by 2.02 IU/L in a year increase in age. About one tenth of HIV infected individuals are co-infected with HCV and HBV with more than one third being positive for anti-HBsAg. There is a paramount need to emphasize the need for regular screening and proper management of these patients to reduce associated complications in resource limited countries where these infections are common.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42803583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Okpokoro, S. Osawe, Stephen Umaru, Lincoln Egbo, F. Okolo, P. Datong, A. Abimiku
Background: Retention in clinical trials is critical for the accumulation of data over time and retaining enough power for comprehensive analysis. We document for the first time the retention rates and factors associated with retention among a cohort of HIV exposed seronegative (HESN) person in a discordant relationship. Understanding these factors will provide valuable cues for maintaining high retention rates in future HIV biomedical prevention studies in this cohort. Aim: We aimed to document retention rates and associated factors relevant in conducting future HIV prevention studies using a cohort of HIV exposed sero-negative individuals. Method: We conducted a prospective cohort study to enroll HESN persons in discordant relationship based on established inclusion criteria that includes: Established sero-discordance with at least 3 months in the relationship; above 18 years and willingness to be followed up. Relevant ethical approvals were obtained. Following informed consent at enrollment, standardized questionnaires on risk behavior and factors that may affect retention were administered at enrollment and during the 2 years follow-up. This was spread over 10 follow-up visits to mimic phase a 2b HIV vaccine clinical trial follow up and duration. In addition, clinical examinations were done and samples collected for safety lab during the follow up visits. Estimation of CD4 and viral load was also done for the HIV+ partners of HESN study participants. Results: Six hundred and sixty HESN persons were screened and 534 (81%) enrolled (i.e. month 0) and followed up. There was a decline in retention from 96% at month 1 (visit 1) to 78% at month 24 (Visit 10). Sharpest drop out from the study occurred at month 1 (20%) and month 15 (14%) follow-up visits. Inability to reach study participants, unwillingness of study participants to continue study, and mortality of the HIV+ partners of HESN participants were the commonest reasons for participant study termination. Furthermore, no or low level of formal education, (AOR 2.79; 95% CI 1.29 - 6.02, p = 0.06), being unemployed (AOR 1.96; 95% CI 1.18 - 3.29, p < 0.01) and inconsistent use of condoms (AOR 1.83; 95% CI 1.16 - 2.91, p < 0.01) were predictors of non-completion of the study. Conclusion: Retention rates decline especially during month 1 (visit 1) and month 15 (visit 7) mainly due to participants’ inability to locate study participants and death of HIV+ partners of HESN enrollees. One unexpected finding from our study is that those who were more consistent in their use of condom were more likely to stay in the study. This is a possible indication of commitment or an incentive for giving free condoms at study visits. This is encouraging for combined biomedical prevention strategies where consistent condoms use is desired. On the other hand, factors such as unemployment, poor formal education and never/occasional condom use were predictors of study drop out. Retention strategies should consider these
{"title":"Strategies for Good Retention Rates in HIV Exposed Sero-Negatives (HESN) Individuals: Important Consideration for HIV Biomedical Prevention Trials in Nigeria","authors":"E. Okpokoro, S. Osawe, Stephen Umaru, Lincoln Egbo, F. Okolo, P. Datong, A. Abimiku","doi":"10.4236/wja.2018.84012","DOIUrl":"https://doi.org/10.4236/wja.2018.84012","url":null,"abstract":"Background: Retention in clinical trials is critical for the accumulation of data over time and retaining enough power for comprehensive analysis. We document for the first time the retention rates and factors associated with retention among a cohort of HIV exposed seronegative (HESN) person in a discordant relationship. Understanding these factors will provide valuable cues for maintaining high retention rates in future HIV biomedical prevention studies in this cohort. Aim: We aimed to document retention rates and associated factors relevant in conducting future HIV prevention studies using a cohort of HIV exposed sero-negative individuals. Method: We conducted a prospective cohort study to enroll HESN persons in discordant relationship based on established inclusion criteria that includes: Established sero-discordance with at least 3 months in the relationship; above 18 years and willingness to be followed up. Relevant ethical approvals were obtained. Following informed consent at enrollment, standardized questionnaires on risk behavior and factors that may affect retention were administered at enrollment and during the 2 years follow-up. This was spread over 10 follow-up visits to mimic phase a 2b HIV vaccine clinical trial follow up and duration. In addition, clinical examinations were done and samples collected for safety lab during the follow up visits. Estimation of CD4 and viral load was also done for the HIV+ partners of HESN study participants. Results: Six hundred and sixty HESN persons were screened and 534 (81%) enrolled (i.e. month 0) and followed up. There was a decline in retention from 96% at month 1 (visit 1) to 78% at month 24 (Visit 10). Sharpest drop out from the study occurred at month 1 (20%) and month 15 (14%) follow-up visits. Inability to reach study participants, unwillingness of study participants to continue study, and mortality of the HIV+ partners of HESN participants were the commonest reasons for participant study termination. Furthermore, no or low level of formal education, (AOR 2.79; 95% CI 1.29 - 6.02, p = 0.06), being unemployed (AOR 1.96; 95% CI 1.18 - 3.29, p < 0.01) and inconsistent use of condoms (AOR 1.83; 95% CI 1.16 - 2.91, p < 0.01) were predictors of non-completion of the study. Conclusion: Retention rates decline especially during month 1 (visit 1) and month 15 (visit 7) mainly due to participants’ inability to locate study participants and death of HIV+ partners of HESN enrollees. One unexpected finding from our study is that those who were more consistent in their use of condom were more likely to stay in the study. This is a possible indication of commitment or an incentive for giving free condoms at study visits. This is encouraging for combined biomedical prevention strategies where consistent condoms use is desired. On the other hand, factors such as unemployment, poor formal education and never/occasional condom use were predictors of study drop out. Retention strategies should consider these","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"160-176"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46256065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper introduces the online Sociometrics Social, Behavioral, and Health Sciences Library, an exciting new science-based resource for HIV/AIDS researchers, health educators, and clinicians. The over 400 products in the Sociometrics Library supplement the online publications—journal articles, books, reports, monographs—that have been the focus of scientific research libraries and publishers to date, both printed and online. Examples of the innovative science-based products that serve as the library’s content include: Evidence-based interventions and programs (EBIs/EBPs) that evaluation research has shown to be effective in preventing HIV or its risky social and behavioral antecedents; primary research data and survey instruments; and interactive, multimedia training tools and courses to build HIV professionals’ capacity to implement EBPs with fidelity and to cooperate with evaluators in the assessment of their effectiveness. A Scientist Expert Panel has guided and will continue to guide product selection and acquisition, ensuring the collection’s continuing technical merit, research utility, and relevance for practice and policy. The Sociometrics Library aims to become the dominant online source of behavioral and social science-based HIV research by-products, operationally sustainable and able to stay up-to-date both from a technological and scientific perspective.
{"title":"An Online Library of Science-Based HIV Prevention Resources","authors":"J. Card, L. Baden","doi":"10.4236/WJA.2018.84010","DOIUrl":"https://doi.org/10.4236/WJA.2018.84010","url":null,"abstract":"This paper introduces the online Sociometrics Social, Behavioral, and Health Sciences Library, an exciting new science-based resource for HIV/AIDS researchers, health educators, and clinicians. The over 400 products in the Sociometrics Library supplement the online publications—journal articles, books, reports, monographs—that have been the focus of scientific research libraries and publishers to date, both printed and online. Examples of the innovative science-based products that serve as the library’s content include: Evidence-based interventions and programs (EBIs/EBPs) that evaluation research has shown to be effective in preventing HIV or its risky social and behavioral antecedents; primary research data and survey instruments; and interactive, multimedia training tools and courses to build HIV professionals’ capacity to implement EBPs with fidelity and to cooperate with evaluators in the assessment of their effectiveness. A Scientist Expert Panel has guided and will continue to guide product selection and acquisition, ensuring the collection’s continuing technical merit, research utility, and relevance for practice and policy. The Sociometrics Library aims to become the dominant online source of behavioral and social science-based HIV research by-products, operationally sustainable and able to stay up-to-date both from a technological and scientific perspective.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"119-136"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48596654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ongoing spread of HIV after sobering news about the goal “End of AIDS” is not encouraging, apart from regional differences. We focus on the consequences of the two essentially failed HIV prevention strategies in certain countries. The first failed because the correct messages concerning preventive behavior did not reach the required levels of target populations to interrupt HIV infection chains. There was a lack of appropriate framework conditions for the target populations to engage in the required scale. The additional biomedical strategy “Treatment as Prevention” didn’t achieve the breakthrough as was hoped. The consequences thereof affect the financial burden on societies, which can take several decades. We draw attention to the unbalanced principles of proportionality to which governments are committed, but which are practiced in favor of those vulnerable people; these people abuse their autonomy and contribute to the further spread of HIV at the expense of financial burdens, social and medical care systems; this behavior is tolerated, although the transmission of HIV is mostly preventable. We point to extreme tendencies, such as the chem-sex settings, whose unswayable participants engage in indirect violence against the societies. Another possible consequence of the still uncontrolled spread of HIV is the potential for HIV to increase its virulence.
{"title":"The Disregarded HIV Prevention Strategies—Their Potential to Uphold the Pandemic, and the Challenges Facing Societies","authors":"R. Dennin, Arndt Sinn, Z. Du","doi":"10.4236/WJA.2018.84011","DOIUrl":"https://doi.org/10.4236/WJA.2018.84011","url":null,"abstract":"The ongoing spread of HIV after sobering news about the goal “End of AIDS” is not encouraging, apart from regional differences. We focus on the consequences of the two essentially failed HIV prevention strategies in certain countries. The first failed because the correct messages concerning preventive behavior did not reach the required levels of target populations to interrupt HIV infection chains. There was a lack of appropriate framework conditions for the target populations to engage in the required scale. The additional biomedical strategy “Treatment as Prevention” didn’t achieve the breakthrough as was hoped. The consequences thereof affect the financial burden on societies, which can take several decades. We draw attention to the unbalanced principles of proportionality to which governments are committed, but which are practiced in favor of those vulnerable people; these people abuse their autonomy and contribute to the further spread of HIV at the expense of financial burdens, social and medical care systems; this behavior is tolerated, although the transmission of HIV is mostly preventable. We point to extreme tendencies, such as the chem-sex settings, whose unswayable participants engage in indirect violence against the societies. Another possible consequence of the still uncontrolled spread of HIV is the potential for HIV to increase its virulence.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"8 1","pages":"137-159"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42108558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed at assessing satisfaction with life among elderly HIV patients attending Mulago HIV Clinic. Methodology: A cross-sectional study design carried out among elderly people (>50 years old) attending Mulago HIV clinic, as stated by the WHO standard age cut-off of >50 years. A random selection of 353 elderly HIV patients was made. The study collected quantitative data to assess patient satisfaction with life, Illness related to discrimination, Barriers to healthcare and social services, and Physical wellbeing, social support and coping using quantitative data collection techniques. Interview discussions were harnessed to obtain patients’ opinions and perceptions and then results grouped into themes. EPIDATA and STATA 14.2 statistical softwares were used for statistical analysis. Results: The study showed that only variables that were significantly associated at multivariate level are, disagreeing that other patients are seen before you when you are first to arrive, which had an odds ratio of 2.87, disagreeing that your employer can never promote you which had an odds ratio of 6.87 compared to agreeing, not being sure whether friend or family member cannot share room/uten-sil/clothes with you reduced the odds of being satisfied by 95% when compared to agreeing and disagreeing that friend or nician and give them priority, provide more work-related support awareness programs; Put more efforts towards counselling care takers or family members who help them to adhere or socialize with them.
{"title":"Assessment of Satisfaction with Life among Elderly Patients Receiving HIV Care and Treatment in Mulago HIV Clinic: A Chronic Illness Quality of Life Model","authors":"Kalule, Kizito","doi":"10.4236/wja.2021.114012","DOIUrl":"https://doi.org/10.4236/wja.2021.114012","url":null,"abstract":"Objective: This study aimed at assessing satisfaction with life among elderly HIV patients attending Mulago HIV Clinic. Methodology: A cross-sectional study design carried out among elderly people (>50 years old) attending Mulago HIV clinic, as stated by the WHO standard age cut-off of >50 years. A random selection of 353 elderly HIV patients was made. The study collected quantitative data to assess patient satisfaction with life, Illness related to discrimination, Barriers to healthcare and social services, and Physical wellbeing, social support and coping using quantitative data collection techniques. Interview discussions were harnessed to obtain patients’ opinions and perceptions and then results grouped into themes. EPIDATA and STATA 14.2 statistical softwares were used for statistical analysis. Results: The study showed that only variables that were significantly associated at multivariate level are, disagreeing that other patients are seen before you when you are first to arrive, which had an odds ratio of 2.87, disagreeing that your employer can never promote you which had an odds ratio of 6.87 compared to agreeing, not being sure whether friend or family member cannot share room/uten-sil/clothes with you reduced the odds of being satisfied by 95% when compared to agreeing and disagreeing that friend or nician and give them priority, provide more work-related support awareness programs; Put more efforts towards counselling care takers or family members who help them to adhere or socialize with them.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43205465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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