Journal of AIDS and HIV research (Online)最新文献_第7页

Evaluating an enhanced adherence intervention among HIV positive adolescents failing atazanavir/ritonavir-based second line antiretroviral treatment at a public health clinic. 评估在一家公共卫生诊所接受阿扎那韦/利托那韦二线抗逆转录病毒治疗的艾滋病阳性青少年中采取的强化坚持干预措施。

Journal of AIDS and HIV research (Online)

Pub Date : 2017-01-01 Epub Date: 2017-01-31 DOI: 10.5897/JAHR2016.0406

Tariro Dianah Chawana, David Katzenstein, Kusum Nathoo, Bernard Ngara, Charles Fungai Brian Nhachi

Sustaining virological suppression among HIV-infected adolescents is challenging. We evaluated a home-based adherence intervention and characterized self-reported adherence, virological response and drug resistance among adolescents failing atazanavir/ritonavir (ATV/r)-based 2^nd line treatment.

Methods: HIV-positive adolescents (10-18 years) on ATV/r-based 2^nd line treatment with virological failure (viral load (VL) ≥1 000 copies/ml) were randomized to either standard care (SC) or SC with addition of modified directly administered antiretroviral therapy (mDAART) for 90 days. VL was measured and questionnaires were administered at study entry and at 3 months. Genotyping was done for participants with continued failure. Primary outcome was suppression to VL < 1 000 copies/ml.

Results: Fifty adolescents aged 10-18 years on 2^nd line treatment for >180 days were enrolled, 23(46%) were randomized to mDAART and 27(54%) to SC. Fifty-four percent were female; mean age was 15.8 years; mean baseline VL was 4.8(log₁₀) copies/ml; 40% reported adherence <80% in previous 1 month at baseline; 40% suppressed (VL <1 000 copies/ml) after follow-up. mDAART resulted in significantly increased self-reported adherence (RR= 0.1; 95% CI=0.02-0.8, p=0.023); closely following dosing schedule (RR= 4.8; 95% CI=1.6-13.8, p=0.004); VL decrease (p=0.031) and modest increase in virological suppression to <1 000 copies/ml (p=0.105). Genotyping in 28/30 participants with continued virological failure demonstrated high level atazanavir resistance (I50L, N88S and I84V) in 6(21%); 3(11%) of whom also had high level resistance to lopinavir and darunavir (V32I, I50L, I54V, 147V and V82A).

Discussion: The mDAART intervention modestly improved virological suppression among adolescents with ATV/r-based 2^nd line treatment failure, significantly increased self-reported adherence and decreased viral load. High level ATV/r resistance was demonstrated.

Conclusion: Targeting mDAART to adolescents who are virologically failing PI-based 2^nd line treatment decreases viral load and increases self-reported adherence. Early drug-resistance testing could reduce morbidity and mortality.

在感染艾滋病毒的青少年中维持病毒学抑制是一项挑战。我们评估了一种基于家庭的依从性干预措施，并描述了阿扎那韦/利托那韦（ATV/r）二线治疗失败的青少年自我报告的依从性、病毒学应答和耐药性。方法：对病毒学治疗失败（病毒载量（VL）≥1 000拷贝/毫升）、正在接受基于ATV/r的二线治疗的HIV阳性青少年（10-18岁）随机进行标准治疗（SC）或SC加改良直接给药抗逆转录病毒疗法（mDAART）治疗，为期90天。在研究开始时和 3 个月时测量 VL 并进行问卷调查。对持续失败的参与者进行基因分型。主要结果是VL抑制率小于1000拷贝/毫升：50名年龄在10-18岁、接受二线治疗超过180天的青少年参加了研究，其中23人（46%）被随机分配到mDAART，27人（54%）被随机分配到SC。54%为女性；平均年龄为15.8岁；平均基线VL为4.8(log10) 拷贝/毫升；40%报告了依从性讨论：mDAART 干预疗法适度改善了以 ATV/r 为基础的二线治疗失败青少年的病毒学抑制情况，显著提高了自我报告的依从性，并降低了病毒载量。ATV/r耐药率较高：结论：针对基于 PI 的二线治疗病毒学失败的青少年开展 mDAART，可降低病毒载量并提高自我报告的依从性。早期耐药性检测可降低发病率和死亡率。

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引用次数: 0

Mass incarceration, residential segregation and racial disparities in HIV 大规模监禁、居住隔离和艾滋病毒的种族差异

Journal of AIDS and HIV research (Online)

Pub Date : 2016-12-31 DOI: 10.5897/JAHR2016.0387

Loren Henderson

Using a “mass incarceration” framework and county-level national data, this paper examines the relationship between incarceration, ex-offender reentry locations, and HIV rates in counties with different racial compositions. A series of “race-of-county” stratified regression models estimate HIV prevalence rates with incarceration and ex-offender reentry locations when taking into consideration residential segregation (that is, Black isolation and White isolation), region, high school graduation rates, sex ratios, unemployment rates, median income, healthcare professional shortages, percentage of residents without insurance, population density, and income inequality. As predicted, HIV rates are higher in counties with high incarceration rates or with ex-offender reentry facilities. A race-of-county stratified analysis, however, reveals nuanced patterns: In White counties and the highest-percentage Black counties, HIV rates increase as incarceration rates increase. In integrated counties, they do not. In the highest-percentage Black counties, the presence of reentry locations is associated with higher rates of HIV, but this is not true in White and integrated counties. In integrated counties, higher levels of Black isolation are associated with high HIV rates. In counties of all racial compositions, higher levels of White isolation are associated with lower rates of HIV. Implications of these results are discussed. Key words: HIV, mass incarceration, residential segregation, racial disparities in HIV.

本文使用“大规模监禁”框架和县级国家数据，研究了不同种族构成的县的监禁、前罪犯再入地点和艾滋病毒感染率之间的关系。在考虑到居住隔离(即黑人隔离和白人隔离)、地区、高中毕业率、性别比例、失业率、收入中位数、保健专业人员短缺、无保险居民百分比、人口密度和收入不平等的情况下，一系列"县种族"分层回归模型估计了监禁地点和前罪犯再入场所的艾滋病毒流行率。正如预测的那样，艾滋病毒感染率在监禁率高的县或有前罪犯再入机构的县更高。然而，种族-县的分层分析揭示了微妙的模式:在白人县和黑人比例最高的县，艾滋病毒感染率随着监禁率的增加而增加。在一体化的县，他们没有。在黑人比例最高的县，重新安置地点的存在与较高的艾滋病毒感染率有关，但在白人和种族融合县并非如此。在一体化县，黑人隔离程度越高，艾滋病毒感染率就越高。在所有种族构成的县，较高的白人隔离水平与较低的艾滋病毒感染率相关。讨论了这些结果的意义。关键词:HIV;大规模监禁;居住隔离;

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引用次数: 6

Healthcare providers (HCPs) attitude towards older adults with HIV and AIDS in Botswana 博茨瓦纳医疗保健提供者(HCPs)对老年艾滋病毒和艾滋病患者的态度

Journal of AIDS and HIV research (Online)

Pub Date : 2016-11-30 DOI: 10.5897/JAHR2016.0389

N. Ama, S. Shaibu, D. Burnette

This study obtained the views of a random sample of 164 healthcare practitioners on their attitudes to older adults with HIV and AIDS. It shows that although the knowledge of protective measures to avoid HIV infection, mode of transmission and stigmatization are high among the healthcare providers (HCPs), yet the majority of them (76.2% of medical officers, 80.4% of nurses and 93.3% of others) are aware of discrimination against people living with HIV (PLHIV). Attitudes of HCPs to older adults with HIV with respect to quality of life, tolerance, education and training, support and treatment of PLHIV are positive, but they significantly differ on issues of blame and sexual attitude of the PLHIV. There is very little engagement between the HCPs and the older adults on their sexual characteristics which can be attributed to the low literacy of the PLHIV. The study recommends appropriate education and counselling, more awareness creation of HIV, its mode of infection, prevention and treatment among HCPs, to eliminate the fears associated with HIV and AIDS. Health facility policies and stringent laws against discrimination need to be put in place. Key words: People living with HIV (PLHIV), healthcare providers, attitude, older adults, HIV, AIDS

本研究随机抽取164名医护人员对老年人感染艾滋病毒和艾滋病的态度进行调查。它表明，尽管卫生保健提供者(HCPs)对避免艾滋病毒感染、传播方式和污名化的保护措施的了解程度很高，但他们中的大多数(76.2%的医务人员、80.4%的护士和93.3%的其他人)都意识到对艾滋病毒感染者(PLHIV)的歧视。医护人员对老年HIV感染者的生活质量、容忍、教育培训、支持和治疗等方面的态度均为阳性，但在对HIV感染者的指责和性态度方面存在显著差异。HCPs和老年人之间很少有关于他们的性特征的接触，这可以归因于对艾滋病毒的低识字率。该研究建议适当的教育和咨询，在医务人员中提高对艾滋病毒、其感染方式、预防和治疗的认识，以消除与艾滋病毒和艾滋病相关的恐惧。必须制定卫生设施政策和严格的反歧视法律。关键词:HIV感染者，医护人员，态度，老年人，HIV, AIDS

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引用次数: 0

Cytomegalovirus retinitis in HIV patients attending Eye/Uveitis clinic in Korle-Bu Teaching Hospital, Accra -Ghana 加纳阿克拉Korle-Bu教学医院眼科/葡萄膜炎诊所的HIV患者巨细胞病毒性视网膜炎

Journal of AIDS and HIV research (Online)

Pub Date : 2016-10-31 DOI: 10.5897/JAHR2016.0382

J. Ibrahim, A. Innocent, V. Orish, A. Stephene, F. Gladys, S. Makafiu, K. A. Kwashie, C. SagoeK.W., K. Amegan-Aho, K. T. Adiku

Cytomegalovirus (CMV) retinitis is an ocular manifestation of human immunodeficiency virus (HIV) infection especially in individual with low CD4 cells count. In Ghana, a country where CMV infection is hyperendemic, there is no data of CMV retinitis among HIV positive persons. This work was conducted to evaluate the prevalence of CMV retinitis among HIV positive persons attending eye clinic in Korle-Bu Teaching Hospital. Eye swab and vitreous samples were collected from HIV positive patients with retinal inflammation. The samples were assayed for DNA of Herpes Simplex Virus, Varicella Zoster, Cytomegalovirus and Epstein - Barr virus by using qualitative polymerase chain reaction (PCR) (multiplex PCR) to detect the presence or absence of herpes viruses. Sixty-two patients had retinal inflammation from ophthalmoscopy out of the total 404 that came into the clinic during the study period from July, 2010 to April, 2011. Forty six of these were HIV positive. Only 3 (6.5%) HIV positive patients had their swab or vitreous humour samples yielding DNA of CMV virus. These patients had their CD4 cell counts above 25 cells/µl. This is the first study to show the prevalence of CMV retinitis among HIV patients in Korle-Bu Teaching Hospital, Ghana. It is necessary for more comprehensive longitudinal study to evaluate incidence and cumulative risk of CMV retinitis among HIV positive individual. Key words: Cytomegalovirus, human immunodeficiency virus, Ghana, Korle-Bu, retinitis, CD4, ophthalmoscopy.

巨细胞病毒(CMV)视网膜炎是人类免疫缺陷病毒(HIV)感染的一种眼部表现，特别是在CD4细胞计数低的个体中。在加纳，一个巨细胞病毒感染高度流行的国家，在HIV阳性人群中没有巨细胞病毒视网膜炎的数据。本研究旨在评估在Korle-Bu教学医院眼科就诊的HIV阳性人群中巨细胞病毒性视网膜炎的患病率。收集HIV阳性视网膜炎症患者的眼拭子和玻璃体样本。采用定性聚合酶链式反应(PCR)检测单纯性疱疹病毒、水痘带状疱疹病毒、巨细胞病毒和eb病毒的DNA检测。2010年7月至2011年4月共就诊404例患者，其中62例因检眼镜引起视网膜炎症。其中46人是HIV阳性。只有3例(6.5%)HIV阳性患者的拭子或玻璃体样本含有巨细胞病毒DNA。这些患者CD4细胞计数大于25个细胞/µl。这是第一个显示加纳Korle-Bu教学医院HIV患者中巨细胞病毒性视网膜炎患病率的研究。对HIV阳性人群CMV视网膜炎的发病率和累积风险进行更全面的纵向研究是必要的。关键词:巨细胞病毒，人类免疫缺陷病毒，加纳，Korle-Bu，视网膜炎，CD4，验光

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引用次数: 0

Effect of the rebirth to seven wonders powder supplement for nutritional management in HIV-infected subjects on antiretroviral therapy 重生七神散补充营养管理对hiv感染者抗逆转录病毒治疗的影响

Journal of AIDS and HIV research (Online)

Pub Date : 2016-10-31 DOI: 10.5897/JAHR2016.0336

L. A. Atchibri, Ahou efa Nina-Laurette, D. J. Jacques, Serge Kouyo

The rebirth to seven wonders (R7M) powder supplement was used for nutritional management of HIV-infected patients. The powder is a multipurpose powder used as a food supplement in human foods because of its nutritional qualities. It has many uses such as in the fight against malnutrition in Cote d’Ivoire because of its nutritional qualities. The purpose of this study was to evaluate the effect of supplementation of the “R7M” powder consumption on the clinical evolution and the laboratory findings in people living with HIV/AIDS and on antiretroviral treatment. The present work is focused on biochemical analysis and monitoring of some anthropometric and laboratory parameters. The biochemical analysis of the powder showed that 100 g of powder contains 54.02 g of carbohydrate, 7.6 g of fat and 31.25 g of proteins. The same amount of powder contains minerals such as magnesium (149.25 mg), calcium (77.5 mg), zinc (3.25 mg) and iron (47.5 mg). After six months of using the “R7M” powder among both groups, anthropometric parameter (weigh) and biological parameters (creatine, hemoglobin and CD4 count) were measured. Nutritional recovery with the “R7M” powder showed an improvement in the main follow-up criteria, that is, weight, hemoglobin, creatine and CD4 count in both groups. This improvement was significantly increased in HIV group with antiretroviral (ARV) treatment. This study confirms the nutritional properties of the “R7M” powder which can be used as food supplement in the fight against protein-energy malnutrition and micronutrient deficiencies. Key words: Powder, rebirth to seven wonders, nutrition, HIV, food supplement.

将重生七奇迹(R7M)粉剂用于hiv感染者的营养管理。该粉末是一种多用途粉末，由于其营养品质，在人类食品中用作食品补充剂。由于它的营养品质，它有许多用途，例如在科特迪瓦与营养不良作斗争。本研究的目的是评估补充“R7M”粉末消费对艾滋病毒/艾滋病患者的临床演变和实验室结果以及抗逆转录病毒治疗的影响。目前的工作重点是生化分析和监测一些人体测量和实验室参数。经生化分析，100 g粉含碳水化合物54.02 g，脂肪7.6 g，蛋白质31.25 g。同样数量的粉末含有镁(149.25毫克)、钙(77.5毫克)、锌(3.25毫克)和铁(47.5毫克)等矿物质。两组小鼠在使用“R7M”粉6个月后，测量人体测量参数(体重)和生物学参数(肌酸、血红蛋白和CD4计数)。“R7M”粉营养恢复后，两组患者的主要随访指标，即体重、血红蛋白、肌酸和CD4计数均有改善。在接受抗逆转录病毒(ARV)治疗的艾滋病毒组中，这种改善显著增加。该研究证实了“R7M”粉的营养特性，可作为对抗蛋白质能量营养不良和微量营养素缺乏的食品补充剂。关键词:散，重生七大奇迹，营养，艾滋病，食物补充。

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引用次数: 0

Evaluation of HIV post-exposure prophylaxis (PEP) in a tertiary health institution in south-eastern Nigeria 尼日利亚东南部一家三级卫生机构对艾滋病毒暴露后预防(PEP)的评估

Journal of AIDS and HIV research (Online)

Pub Date : 2016-09-30 DOI: 10.5897/JAHR2016.0380

A. Isah, N. Igboeli, Maxwell Ugochukwu Adibe, C. Ukwe

This study aimed to evaluate the implementation of HIV post-exposure prophylaxis (PEP) guidelines and determine its clinical outcome in a PEPFAR (APIN-CDC) Clinic in south-eastern Nigeria from 2008 to 2012. It was a retrospective review of data of patients who accessed HIV PEP services from the clinic. Data on demographic and clinical characteristics of patients were retrieved from the database of the clinic and analyzed. Descriptive statistics and Chi-square test were applied to analyzed data at significance level of p<0.05. The result showed that thirty three (33) individuals were enrolled into PEP during the period. Thirty-one (31; 93.94%) were due to occupational exposure, while two (2; 6.06%) were due to non-occupational exposure. AZT+3TC 23 (69.70%), AZT+3TC+LPV/r 9 (27.27%) and AZT+3TC+ATV/r+RTV 1 (3.03%) were the ARVs used. The nature of exposure did not significantly determine the choice of the ARV. The study concludes that APIN/CDC Clinic, UNTH Enugu substantially followed recommendations of standard guidelines in HIV PEP management, but the absence of followup test results for majority of the enrollees was an impediment to any general statement on its clinical outcome.

本研究旨在评估2008年至2012年在尼日利亚东南部PEPFAR (APIN-CDC)诊所实施HIV暴露后预防(PEP)指南的情况，并确定其临床结果。这是对从诊所获得艾滋病毒PEP服务的患者数据的回顾性审查。从临床数据库中检索患者的人口学和临床特征数据并进行分析。分析资料采用描述性统计和卡方检验，p<0.05为显著性水平。结果表明，在此期间，共有33(33)人被纳入PEP。31 (31;93.94%)为职业暴露所致，2例(2;6.06%)为非职业暴露所致。使用的arv分别为AZT+3TC 23(69.70%)、AZT+3TC+LPV/r 9(27.27%)和AZT+3TC+ATV/r+RTV 1(3.03%)。暴露的性质并没有显著地决定抗逆转录病毒药物的选择。该研究的结论是，UNTH Enugu的APIN/CDC诊所基本上遵循了HIV PEP管理标准指南的建议，但大多数参与者缺乏随访测试结果，这阻碍了对其临床结果的任何一般性陈述。

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引用次数: 3

Evaluation of prevention of mother-to-child transmission (PMTCT) of HIV in a tertiary health institution in south-eastern Nigeria 对尼日利亚东南部一家三级卫生机构预防艾滋病毒母婴传播的评估

Journal of AIDS and HIV research (Online)

Pub Date : 2016-09-30 DOI: 10.5897/JAHR2016.0375

A. Isah, N. Igboeli, M. Adibe, C. Ukwe

Mother-to-child transmission is the highest mode of acquisition of HIV infection in children, with a 1545% risk of an infant acquiring HIV from an infected mother without any medical intervention. The objectives of this study were to evaluate the implementation of prevention of mother-to-child transmission (PMTCT) guidelines and determine its clinical outcome in a PEPFAR Clinic in Nigeria from 2008 to 2012. A retrospective review of data of patients who accessed PMTCT from the Clinic in the University of Nigeria Teaching Hospital (UNTH), Enugu was conducted. Data were retrieved from the clinic’s database and analyzed. The result showed that three hundred and seventy-three (373) pregnant women (aged 30.22±4.88) and three hundred and sixty-seven (367) children from the pregnancies were enrolled into PMTCT. Ten (10) regimens were used for the mothers: AZT/3TC/NVP, TDF/3TC+NVP and AZT/3TC+EFV accounting for 80.00, 11.00 and 2.65%, respectively. AZT (15.80%) and NVP (84.20%) were used for the infants, 8 (2.18%) of whom tested positive for HIV. The study concluded that PEPFAR Clinic, UNTH Enugu substantially followed the guidelines in its PMTCT programme which was found to drastically reduce the transmission of HIV from mother to child.

母婴传播是儿童感染艾滋病毒的最高方式，婴儿在没有任何医疗干预的情况下从感染艾滋病毒的母亲处感染艾滋病毒的风险为1545%。本研究的目的是评估2008年至2012年在尼日利亚PEPFAR诊所预防母婴传播(PMTCT)指南的实施情况，并确定其临床结果。对从埃努古尼日利亚大学教学医院(UNTH)诊所接受预防母婴传播治疗的患者数据进行了回顾性审查。从诊所的数据库中检索数据并进行分析。结果显示，共有373名(373)名孕妇(年龄30.22±4.88岁)和367名(367)名儿童参与了预防母婴传播。母亲采用AZT/3TC/NVP、TDF/3TC+NVP和AZT/3TC+EFV共10种方案，分别占80.00、11.00和2.65%。婴儿使用AZT(15.80%)和NVP(84.20%)，其中HIV阳性8例(2.18%)。该研究的结论是，UNTH Enugu的PEPFAR诊所基本上遵循了其PMTCT项目的指导方针，该项目被发现大大减少了艾滋病毒母婴传播。

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引用次数: 2

Disclosure of HIV diagnosis to infected children receiving care in University of Uyo Teaching Hospital, Uyo, Nigeria 向尼日利亚尤约大学教学医院接受治疗的感染儿童披露艾滋病毒诊断

Journal of AIDS and HIV research (Online)

Pub Date : 2016-08-31 DOI: 10.5897/JAHR2016.0374

Emmanuel Ikpeme Enobong, Tony Dixon Umo Ofonime

Disclosure of human immunodeficiency virus (HIV) diagnosis to infected children is still a challenge despite proven evidences that it has numerous social and medical benefits for the child and family. The aim of this study was to document the disclosure rate of HIV diagnosis to children in Uyo, Nigeria and determine the factors influencing disclosure or non-disclosure to these children. This was a descriptive cross-sectional study. A pre-tested and validated semi-structured questionnaire was administered to consenting parents/caregivers of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) infected children aged 6 to 17 years in care at the Paediatric Infectious Diseases Unit of the University of Uyo Teaching Hospital, Uyo (UUTH) from January to June, 2015. One hundred and twenty-two caregivers (26 males and 96 females), giving a male to female ratio of 1:3.7, aged 20 to 60 years, were interviewed. Sixty-eight (55.8%) of them had post secondary education. Twenty (16.4%) of the children aged 9 to 17 years (13.3±2.4 years) had been disclosed to. Age of the children, gender, orphan status, their level of schooling and their socio-economic class positively affected disclosure. Also, caregivers between ages 30 and 49 years who were more educated were more likely to disclose the HIV status of their children. Commonest reason for non-disclosure was child being sad (29.5%). Others were blaming the parents (18.0%), not understanding the import of the diagnosis (9.8%) and 6.6% feared child disclosing to others. Forty-four (37.7%) did not give reasons for non-disclosure. Sixty-seven (54.9%) of the caregivers who did not disclose said they would do so after 10 years of age. A national protocol for paediatric HIV disclosure is desirable. Key words: Disclosure, diagnosis, children, human immunodeficiency virus (HIV), Nigeria.

向受感染儿童披露人类免疫缺陷病毒(艾滋病毒)诊断结果仍然是一项挑战，尽管有确凿证据表明，这对儿童和家庭有许多社会和医疗益处。本研究的目的是记录尼日利亚尤约儿童艾滋病毒诊断的披露率，并确定影响向这些儿童披露或不披露的因素。这是一项描述性横断面研究。2015年1月至6月，在尤尤大学教学医院儿科传染病科，对6至17岁感染人类免疫缺陷病毒/获得性免疫缺陷综合症(HIV/艾滋病)的儿童的同意父母/照顾者进行了预测试和验证的半结构化问卷调查。调查对象为122名年龄在20 ~ 60岁的护理人员(男26名，女96名)，男女比例为1:37。其中68人(55.8%)受过专上教育。9 ~ 17岁(13.3±2.4岁)患儿中有20例(16.4%)被披露。儿童的年龄、性别、孤儿状况、受教育程度和社会经济阶层对信息披露有积极影响。此外，年龄在30至49岁之间、受教育程度较高的看护人更有可能披露其子女的艾滋病毒状况。最常见的隐瞒原因是孩子伤心(29.5%)。其余依次为责怪父母(18.0%)、不理解诊断的重要性(9.8%)、担心孩子向他人透露(6.6%)。44位(37.7%)没有给出不披露的原因。67名(54.9%)没有透露的照顾者表示，他们会在10岁后这样做。制定一项儿童艾滋病毒信息披露的国家方案是可取的。关键词:披露，诊断，儿童，人类免疫缺陷病毒，尼日利亚

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引用次数: 5

Outcome of infants born to HIV-positive women through the aspects of prevention of mother to child transmission in Lom (Togo, West Africa) from 2008 to 2010 2008年至2010年在洛美(西非多哥)预防母婴传播方面艾滋病毒阳性妇女所生婴儿的结局

Journal of AIDS and HIV research (Online)

Pub Date : 2016-08-31 DOI: 10.5897/JAHR2015.0350

A. B. Adama-Hondegla, A. Djeha, K. Lawson-Evi, D. Y. Atakouma

Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) infection in children under 15 years is mostly due to mother to child transmission. The purpose of this study was to assess the outcome of infants born to HIV-positive women through the prevention of mother to child transmission (PMTCT) aspects at Sylvanus Olympio’s Teaching Hospital of Lome. This retrospective study of 24 months (from September 1, 2008 to September 1, 2010) was performed in 232 recorded files of infants delivered in the centre and monitored in the pediatrics department. From 230 women who had given birth to 232 infants, 224 (97.4%) knew their positive HIV status before delivery and 6 (2.6%) tested positive after child birth. Low birth weight was observed in 21.5% of newborns and 12.3% were born preterm. Two hundred seven (55.0%) infants were exclusively breastfed, with abrupt weaning at 4 months in 40.2% (39). Polymerase chain reaction (PCR) test was performed at 17 and 19 weeks in the 232 infants and 13 positive cases were found (5.6% transmission rate). An assessment of the centre in 2010 identified a mother-child transmission rate of HIV that was still high. There was need to strengthen screening strategies, counselling during antenatal care, and access to ART for all pregnant women. Key words: Prevention of mother to child transmission (PMTCT), human immunodeficiency virus (HIV) pregnant women, antiretroviral treatment, Togo, West Africa.

15岁以下儿童感染人体免疫机能丧失病毒/后天免疫机能丧失综合症(艾滋病毒/艾滋病)的主要原因是母婴传播。本研究的目的是通过预防母婴传播(PMTCT)方面评估艾滋病病毒阳性妇女所生婴儿在洛美希尔瓦努斯·奥林匹奥教学医院的结局。本回顾性研究从2008年9月1日至2010年9月1日共24个月，对在该中心分娩并在儿科监测的232例患儿进行了回顾性研究。在生下232名婴儿的230名妇女中，224名(97.4%)在分娩前知道自己的艾滋病毒阳性状况，6名(2.6%)在分娩后检测呈阳性。21.5%的新生儿低出生体重，12.3%为早产。277例(55.0%)婴儿为纯母乳喂养，40.2%(39%)婴儿在4个月时突然断奶。对232例新生儿在17周和19周进行聚合酶链反应(PCR)检测，发现13例阳性(传播率5.6%)。2010年对该中心的一项评估发现，艾滋病毒母婴传播率仍然很高。有必要加强筛查战略，产前保健期间的咨询，并为所有孕妇提供抗逆转录病毒治疗。关键词:预防母婴传播，HIV孕妇，抗逆转录病毒治疗，多哥，西非

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引用次数: 2

Barriers to the practice of exclusive breastfeeding among HIV-positive mothers in sub-Saharan Africa: A scoping review of counselling, socioeconomic and cultural factors 撒哈拉以南非洲艾滋病毒阳性母亲纯母乳喂养的障碍:咨询、社会经济和文化因素的范围审查

Journal of AIDS and HIV research (Online)

Pub Date : 2016-07-31 DOI: 10.5897/JAHR2015.0353

M. Al-Mujtaba, N. Sam-Agudu, R. Khatri

The World Health Organization (WHO) recommends exclusive breast-feeding (EBF) for HIV exposed infants for six months; this is considered best practice for reducing mother-to-child transmission of HIV in the postpartum period. This is a scoping review of the barriers affecting women's decision-making and choice to sustain the practice of EBF in sub-Saharan Africa (SSA). An online literature search via PubMed, Science Direct, Google Scholar, WHO and Joint United Nations programme on HIV and AIDS (UNAIDS) websites identified research studies and reports that explored socio-economic, cultural and infant feeding counselling-related barriers to EBF among HIV-positive mothers in SSA. A total of 341 relevant articles were identified only 35 (23 qualitative, 3 quantitative and 9 mixed methods) met the inclusion criteria. Findings reveal that key barriers to choice and sustained practice of EBF are healthcare workers’ personal biases, inadequate counselling skills and guideline knowledge, a culture of mixed feeding norms, and maternal lack of decision-making power and fear of vertical transmission. Transmission of HIV programs in countries where major challenges persist should evaluate and address the identified healthcare worker and community-level factors impeding EBF.

世界卫生组织(世卫组织)建议对接触艾滋病毒的婴儿进行6个月的纯母乳喂养;这被认为是减少产后艾滋病毒母婴传播的最佳做法。这是对撒哈拉以南非洲(SSA)影响妇女决策和选择维持EBF做法的障碍的范围审查。通过PubMed、Science Direct、b谷歌Scholar、世卫组织和联合国艾滋病毒和艾滋病联合规划(UNAIDS)网站进行的在线文献检索发现了一些研究和报告，这些研究和报告探讨了SSA艾滋病毒阳性母亲中与EBF相关的社会经济、文化和婴儿喂养咨询障碍。341篇相关文献中，仅有35篇(定性23篇，定量3篇，混合9篇)符合纳入标准。研究结果表明，选择和持续实施EBF的主要障碍是卫生保健工作者的个人偏见、咨询技能和指南知识不足、混合喂养规范的文化、母亲缺乏决策权和对垂直传播的恐惧。在主要挑战持续存在的国家，艾滋病毒传播项目应该评估和解决确定的卫生保健工作者和社区层面阻碍EBF的因素。

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引用次数: 23