Pub Date : 2018-01-01DOI: 10.4172/2155-6113.1000779
B. Dlamini, Nompumelelo Dlamini, Bonisile Nhalabatsi, M. Thwala-Tembe, S. Myeni, Lindiwe Malaza
Background: The need to link HIV/AIDS and Sexual Reproductive Health (SRH) response is important due to the interconnectedness of HIV and SRH. Swaziland is implementing the Primary Health Care strategy which involves integration of a number of health services. However, in the early years of the HIV/AIDS epidemic, its programming and funding was prioritized in a vertical manner due to the scale and scare of the epidemic. Over the years, the country recognized that addressing HIV/AIDS and Sexual Reproductive Health and Rights (SRHR) services as totally separate entities is counterproductive in achieving targets for both HIV and SRHR. This assessment was aimed at documenting the extent of SRH and HIV integration in Swaziland. Methods: A mixed-methods approach was used to document the extent of SRHR and HIV integration. The quantitative approach included secondary data analysis using national data and reports on SRHR and HIV integration indicators between 2009 and 2016. The qualitative approach included in-depth desk review of documents as well as key informant interviews. Results: RMNCAH and HIV integration is supported by enabling policy environment across all levels. In 2016, 94% accessed HIV services and 95% of those testing HIV positive were initiated within the RMNCAH platform, while 92% of clients attending FP services eligible for HIV testing were tested and 75% of those tested HIV positive linked to care and treatment. An observed increasing trend of HIV testing within TB clinics from 66% in 2012 to 92% in 2016. A significant p-value (pr>Chi2≤0.0001) indicating HIV testing in STI clinics. Conclusion: The bi-directional integration of RMNCAH and HIV provides a concrete ground for reaching the ambitious UNAIDS targets (90-90-90). This integration is not only logic to the health delivery system; it’s also beneficial to the clients. Having one strategy, one coordinating structure and one M&E system may significantly lead to attainment of the UN-SDGs. Recommendations: Programmers should outline a minimum package of integration is paramount in scaling up HIV and RMNCAH integration. Continuous capacity building including supportive supervision and mentorship is needed to integrate health services. Citation: Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S, et al. (2018) The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini. J AIDS Clin Res 9: 779. doi: 10.4172/2155-6113.1000779
背景:由于艾滋病毒和性健康与生殖健康相互关联,将艾滋病毒/艾滋病与性健康与生殖健康(SRH)应对措施联系起来的必要性非常重要。斯威士兰正在实施初级卫生保健战略,其中包括若干保健服务的整合。然而,在艾滋病毒/艾滋病流行的最初几年,由于该流行病的规模和可怕性,其方案编制和供资是以纵向方式优先考虑的。多年来,该国认识到,将艾滋病毒/艾滋病和性健康与生殖健康和权利服务作为完全独立的实体来处理,不利于实现艾滋病毒和性健康与生殖健康和权利的目标。该评估旨在记录斯威士兰性健康和生殖健康与艾滋病毒整合的程度。方法:采用混合方法来记录SRHR和HIV整合的程度。定量方法包括利用2009年至2016年期间的国家数据和关于SRHR和艾滋病毒整合指标的报告进行二次数据分析。定性方法包括对文件进行深入的案头审查以及对关键的线人进行面谈。结果:各级有利的政策环境支持RMNCAH和HIV整合。2016年,94%的人获得了艾滋病毒服务,95%的艾滋病毒检测呈阳性的人是在RMNCAH平台上开始的,而92%参加计划生育服务的客户有资格进行艾滋病毒检测,75%的艾滋病毒检测呈阳性的人接受了护理和治疗。观察到结核病诊所的艾滋病毒检测呈上升趋势,从2012年的66%上升到2016年的92%。显著的p值(pr>Chi2≤0.0001)表明在性病诊所进行HIV检测。结论:RMNCAH与HIV的双向整合为实现UNAIDS宏伟的目标(90-90-90)提供了坚实的基础。这种整合不仅符合卫生服务系统的逻辑;这对客户也是有利的。只有一个战略、一个协调结构和一个监测和评估系统,才能大大促进联合国可持续发展目标的实现。建议:程序员应该概述一个最小的集成包,这在扩展HIV和RMNCAH集成中是至关重要的。需要持续的能力建设,包括支持性监督和指导,以整合卫生服务。引用本文:Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S等。(2018)将艾滋病毒/艾滋病应对措施纳入生殖孕产妇新生儿和青少年健康平台:斯瓦蒂尼王国的经验。[J]艾滋病临床杂志,9:779。doi: 10.4172 / 2155 - 6113.1000779
{"title":"The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini","authors":"B. Dlamini, Nompumelelo Dlamini, Bonisile Nhalabatsi, M. Thwala-Tembe, S. Myeni, Lindiwe Malaza","doi":"10.4172/2155-6113.1000779","DOIUrl":"https://doi.org/10.4172/2155-6113.1000779","url":null,"abstract":"Background: The need to link HIV/AIDS and Sexual Reproductive Health (SRH) response is important due to the interconnectedness of HIV and SRH. Swaziland is implementing the Primary Health Care strategy which involves integration of a number of health services. However, in the early years of the HIV/AIDS epidemic, its programming and funding was prioritized in a vertical manner due to the scale and scare of the epidemic. Over the years, the country recognized that addressing HIV/AIDS and Sexual Reproductive Health and Rights (SRHR) services as totally separate entities is counterproductive in achieving targets for both HIV and SRHR. This assessment was aimed at documenting the extent of SRH and HIV integration in Swaziland. Methods: A mixed-methods approach was used to document the extent of SRHR and HIV integration. The quantitative approach included secondary data analysis using national data and reports on SRHR and HIV integration indicators between 2009 and 2016. The qualitative approach included in-depth desk review of documents as well as key informant interviews. Results: RMNCAH and HIV integration is supported by enabling policy environment across all levels. In 2016, 94% accessed HIV services and 95% of those testing HIV positive were initiated within the RMNCAH platform, while 92% of clients attending FP services eligible for HIV testing were tested and 75% of those tested HIV positive linked to care and treatment. An observed increasing trend of HIV testing within TB clinics from 66% in 2012 to 92% in 2016. A significant p-value (pr>Chi2≤0.0001) indicating HIV testing in STI clinics. Conclusion: The bi-directional integration of RMNCAH and HIV provides a concrete ground for reaching the ambitious UNAIDS targets (90-90-90). This integration is not only logic to the health delivery system; it’s also beneficial to the clients. Having one strategy, one coordinating structure and one M&E system may significantly lead to attainment of the UN-SDGs. Recommendations: Programmers should outline a minimum package of integration is paramount in scaling up HIV and RMNCAH integration. Continuous capacity building including supportive supervision and mentorship is needed to integrate health services. Citation: Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S, et al. (2018) The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini. J AIDS Clin Res 9: 779. doi: 10.4172/2155-6113.1000779","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6113.1000779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70272205","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}
Pub Date : 2018-01-01DOI: 10.4172/2155-6113.1000782
G. Morsica, L. Peano, S. Bagaglio, A. Poli, H. Hasson, E. Messina, C. Uberti-Foppa
Background and Aim: Hepatitis Delta Virus (HDV) infection has been mainly studied in HIV negative patients, while data on HIV-1 positive patients are limited. We investigated the virological pattern as well as biochemical and clinical features of liver disease and immune status in HIV-1 positive patients with delta hepatitis. Their clinical characteristics were compared with those of anti-HDV negative, hepatitis B surface antigen (HBsAg) positive/HIV+ patients. Methods: This retrospective study included HBsAg positive subjects with anti-HDV serology available, during the period 2010-2017. Biochemical and virological parameters were obtained at last visit in 2017 for each patient. Potential determinants for HDV positivity were examined by applying multivariate regression model. Results: Of 78 HBsAg positive patients 19 (24.4%) were found anti-HDV+. Anti-HDV+ patients were more frequently intra venous drug users, anti-HCV positive and HBV e antigen (HBeAg) negative. Additionally, the patients had more severe liver disease and necro inflammatory activity (assessed by transient elastography and transaminases levels, repectively) than the counterpart of anti-HDV- patients. A suppressive effect of HDV over HCV was also revealed in anti-HDV+ subjects. By multivariate analysis, years of ART (OR 1.22; CI 0.986-1.43, p=0.014) and sexual exposure vs. IVDU (OR 0.08; CI 0.556-0.986, p=0.004) were independently associated with anti-HDV positivity. Conclusion: Our data underlines the need for continuing prevention program that includes HBV vaccination, screening and monitoring in population at high risk, as well as development of an alternative treatment option for HDV.
{"title":"Clinical and Virologic Characteristics of HIV-1 Positive Patients with Delta Hepatitis","authors":"G. Morsica, L. Peano, S. Bagaglio, A. Poli, H. Hasson, E. Messina, C. Uberti-Foppa","doi":"10.4172/2155-6113.1000782","DOIUrl":"https://doi.org/10.4172/2155-6113.1000782","url":null,"abstract":"Background and Aim: Hepatitis Delta Virus (HDV) infection has been mainly studied in HIV negative patients, while data on HIV-1 positive patients are limited. We investigated the virological pattern as well as biochemical and clinical features of liver disease and immune status in HIV-1 positive patients with delta hepatitis. Their clinical characteristics were compared with those of anti-HDV negative, hepatitis B surface antigen (HBsAg) positive/HIV+ patients. Methods: This retrospective study included HBsAg positive subjects with anti-HDV serology available, during the period 2010-2017. Biochemical and virological parameters were obtained at last visit in 2017 for each patient. Potential determinants for HDV positivity were examined by applying multivariate regression model. Results: Of 78 HBsAg positive patients 19 (24.4%) were found anti-HDV+. Anti-HDV+ patients were more frequently intra venous drug users, anti-HCV positive and HBV e antigen (HBeAg) negative. Additionally, the patients had more severe liver disease and necro inflammatory activity (assessed by transient elastography and transaminases levels, repectively) than the counterpart of anti-HDV- patients. A suppressive effect of HDV over HCV was also revealed in anti-HDV+ subjects. By multivariate analysis, years of ART (OR 1.22; CI 0.986-1.43, p=0.014) and sexual exposure vs. IVDU (OR 0.08; CI 0.556-0.986, p=0.004) were independently associated with anti-HDV positivity. Conclusion: Our data underlines the need for continuing prevention program that includes HBV vaccination, screening and monitoring in population at high risk, as well as development of an alternative treatment option for HDV.","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":"9 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70296183","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}
Pub Date : 2018-01-01DOI: 10.4172/2155-6113.1000773
J. PerezStachowski, Gonzalez Domenech Cm, C. GarciaVallecillos, I. PérezCamacho, D. VinuesaGarcia, M. Omar, J. Olalla, R. Palacios, A. delArco, C. HidalgoTenorio, Jesús Santos, J. L. Prada, J. Delatorre
Aims: In recent years, increasing numbers of studies have been made of the durability of antiretroviral treatments (ART) and reasons for changing this medication, but few have evaluated the most recent therapeutic approaches. In this paper, we analyse the durability of the first-line ART regimen currently employed for patients infected with human immunodeficiency virus (HIV), and examine the reasons for treatment modification. Method: A retrospective multicentre observational study was conducted of patients with HIV infection who started first-line ART between January 2012 and December 2013 in the provinces of Málaga, Granada, Jaén and Almería (Spain). The main study variable is the durability of the first-line ART regimen until its modification, the reasons for which are described. Survival analysis was performed using Kaplan-Meier curves to evaluate durability, and a Cox multiple regression model was constructed to identify associated factors. Results: A total of 664 patients started first-line ART. The average durability was 20 months (95% CI: 17-22); at one year, 29% had abandoned this regimen, while 57% maintained it until the end of follow-up. The greatest durability was achieved with regimens based on rilpivirine (RPV), darunavir (DRV) and raltegravir (RAL). The main reason for change was toxicity (20%), mainly gastrointestinal, associated with the use of protease inhibitors (PI), and neuropsychiatric, associated with the use of efavirenz (EFV). HCV coinfection, AIDS diagnosis and type of ART regimen were all associated with reduced durability. Conclusion: With the regimens currently applied, the durability of first-line ART is 20 months. At one year of treatment, this first-line regimen had been modified for 29% of patients, with toxicity being the main reason for change. Regimens based on RPV, DRV and RAL present greater durability, mainly due to their lower toxicity. Citation: Perez Stachowski J, Gonzalez-Domenech CM, García Vallecillos C, Perez-Camacho I, Vinuesa Garcia D, et al. (2018) Durability of FirstLine Antiretroviral Treatment Regimens in a Cohort of HIV-Infected Patients. J AIDS Clin Res 9: 773. doi: 10.4172/2155-6113.1000773
目的:近年来,越来越多的研究对抗逆转录病毒治疗(ART)的持久性和改变这种药物的原因进行了研究,但很少有研究对最新的治疗方法进行评估。在本文中,我们分析了目前用于人类免疫缺陷病毒(HIV)感染者的一线抗逆转录病毒治疗方案的持久性,并检查了治疗修改的原因。方法:对2012年1月至2013年12月在Málaga、格拉纳达、贾文森和Almería(西班牙)等省接受一线抗逆转录病毒治疗的HIV感染者进行回顾性多中心观察研究。主要的研究变量是一线抗逆转录病毒治疗方案的持久性,直到其修改,其原因被描述。生存分析采用Kaplan-Meier曲线评估耐久度,构建Cox多元回归模型确定相关因素。结果:664例患者开始一线抗逆转录病毒治疗。平均持续时间为20个月(95% CI: 17-22);一年后,29%的患者放弃了该方案,57%的患者坚持到随访结束。以利匹韦林(RPV)、达那韦(DRV)和雷替格拉韦(RAL)为基础的方案获得了最大的持久性。改变的主要原因是毒性(20%),主要是胃肠道毒性,与蛋白酶抑制剂(PI)的使用有关,以及神经精神毒性,与依非韦伦(EFV)的使用有关。丙型肝炎病毒合并感染、艾滋病诊断和抗逆转录病毒治疗方案类型均与持久性降低有关。结论:按照目前的方案,一线抗逆转录病毒治疗的持续时间为20个月。治疗一年后,29%的患者改变了一线治疗方案,毒性是改变的主要原因。基于RPV, DRV和RAL的方案具有更大的持久性,主要是由于它们的毒性较低。引用本文:Perez Stachowski J, Gonzalez-Domenech CM, García Vallecillos C, Perez- camacho I, Vinuesa Garcia D,等(2018)一线抗逆转录病毒治疗方案在hiv感染者队列中的持久性。[J]艾滋病临床杂志,9:773。doi: 10.4172 / 2155 - 6113.1000773
{"title":"Durability of First-Line Antiretroviral Treatment Regimens in a Cohort of HIV-Infected Patients","authors":"J. PerezStachowski, Gonzalez Domenech Cm, C. GarciaVallecillos, I. PérezCamacho, D. VinuesaGarcia, M. Omar, J. Olalla, R. Palacios, A. delArco, C. HidalgoTenorio, Jesús Santos, J. L. Prada, J. Delatorre","doi":"10.4172/2155-6113.1000773","DOIUrl":"https://doi.org/10.4172/2155-6113.1000773","url":null,"abstract":"Aims: In recent years, increasing numbers of studies have been made of the durability of antiretroviral treatments (ART) and reasons for changing this medication, but few have evaluated the most recent therapeutic approaches. In this paper, we analyse the durability of the first-line ART regimen currently employed for patients infected with human immunodeficiency virus (HIV), and examine the reasons for treatment modification. Method: A retrospective multicentre observational study was conducted of patients with HIV infection who started first-line ART between January 2012 and December 2013 in the provinces of Málaga, Granada, Jaén and Almería (Spain). The main study variable is the durability of the first-line ART regimen until its modification, the reasons for which are described. Survival analysis was performed using Kaplan-Meier curves to evaluate durability, and a Cox multiple regression model was constructed to identify associated factors. Results: A total of 664 patients started first-line ART. The average durability was 20 months (95% CI: 17-22); at one year, 29% had abandoned this regimen, while 57% maintained it until the end of follow-up. The greatest durability was achieved with regimens based on rilpivirine (RPV), darunavir (DRV) and raltegravir (RAL). The main reason for change was toxicity (20%), mainly gastrointestinal, associated with the use of protease inhibitors (PI), and neuropsychiatric, associated with the use of efavirenz (EFV). HCV coinfection, AIDS diagnosis and type of ART regimen were all associated with reduced durability. Conclusion: With the regimens currently applied, the durability of first-line ART is 20 months. At one year of treatment, this first-line regimen had been modified for 29% of patients, with toxicity being the main reason for change. Regimens based on RPV, DRV and RAL present greater durability, mainly due to their lower toxicity. Citation: Perez Stachowski J, Gonzalez-Domenech CM, García Vallecillos C, Perez-Camacho I, Vinuesa Garcia D, et al. (2018) Durability of FirstLine Antiretroviral Treatment Regimens in a Cohort of HIV-Infected Patients. J AIDS Clin Res 9: 773. doi: 10.4172/2155-6113.1000773","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":"09 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70271345","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}
Pub Date : 2018-01-01Epub Date: 2018-02-22DOI: 10.4172/2155-6113.1000757
Christina J Sun, Erin Sutfin, Laura H Bachmann, Jason Stowers, Scott D Rhodes
Objective: Researchers and public health professionals have increased their attention to GPS-based social and sexual networking applications (apps) tailored to gay, bisexual, other men who have sex with men (MSM) and transgender women. These populations continue to be disproportionately affected by HIV in the United States, therefore these apps, in particular Grindr, have become an important sampling venue for the recruitment of HIV-related research participants. As such, it is essential to identify differences among app users to avoid potential sampling bias. This paper seeks to identify differences in MSM and transgender women who use Grindr and those who use other similar apps.
Methods: A community-based participatory research (CBPR) approach was used to recruit participants online who then completed a 25-item anonymous survey. Five domains were assessed: sociodemographics, HIV testing, sexual risk, substance abuse, and use of GPS-based social and sexual networking apps.
Results: 457 participants completed surveys. There were significant differences in the sociodemographic characteristics by app use, including age, race/ethnicity, sexual orientation, and outness. After adjusting for the sociodemographic characteristics associated with app use, there were significant differences in HIV risk and substance use between the groups.
Conclusion: This paper is the first to report on findings that compare MSM and transgender women who report using Grindr to MSM and transgender women who report using other similar apps. GPS-based social and sexual networking apps may offer a valuable recruitment tool for future HIV research seeking to recruit populations at increased risk for HIV or those living with HIV for therapeutic trials. Because of the differences identified across users of different apps, these findings suggest that if researchers recruited participants from just one app, they could end up with a sample quite different than if they had recruited MSM and transgender women from other apps.
{"title":"Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: Implications for recruitment and health promotion.","authors":"Christina J Sun, Erin Sutfin, Laura H Bachmann, Jason Stowers, Scott D Rhodes","doi":"10.4172/2155-6113.1000757","DOIUrl":"https://doi.org/10.4172/2155-6113.1000757","url":null,"abstract":"<p><strong>Objective: </strong>Researchers and public health professionals have increased their attention to GPS-based social and sexual networking applications (apps) tailored to gay, bisexual, other men who have sex with men (MSM) and transgender women. These populations continue to be disproportionately affected by HIV in the United States, therefore these apps, in particular Grindr, have become an important sampling venue for the recruitment of HIV-related research participants. As such, it is essential to identify differences among app users to avoid potential sampling bias. This paper seeks to identify differences in MSM and transgender women who use Grindr and those who use other similar apps.</p><p><strong>Methods: </strong>A community-based participatory research (CBPR) approach was used to recruit participants online who then completed a 25-item anonymous survey. Five domains were assessed: sociodemographics, HIV testing, sexual risk, substance abuse, and use of GPS-based social and sexual networking apps.</p><p><strong>Results: </strong>457 participants completed surveys. There were significant differences in the sociodemographic characteristics by app use, including age, race/ethnicity, sexual orientation, and outness. After adjusting for the sociodemographic characteristics associated with app use, there were significant differences in HIV risk and substance use between the groups.</p><p><strong>Conclusion: </strong>This paper is the first to report on findings that compare MSM and transgender women who report using Grindr to MSM and transgender women who report using other similar apps. GPS-based social and sexual networking apps may offer a valuable recruitment tool for future HIV research seeking to recruit populations at increased risk for HIV or those living with HIV for therapeutic trials. Because of the differences identified across users of different apps, these findings suggest that if researchers recruited participants from just one app, they could end up with a sample quite different than if they had recruited MSM and transgender women from other apps.</p>","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6113.1000757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35959478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2155-6113.1000781
Alexander Kwakye
Psychosocial disorders such as depression, anxiety and stress are more prevalent among HIV/AIDS patients compared to the general population. These psychosocial disorders impact negatively on HIV AIDS patients on highly active anti-retroviral therapy (HAART). This study determined how these psychosocial disorders impact CD4+ cell counts of HIV/AIDS patients receiving HAART in a peri-urban hospital in Kumasi, Ghana. This cross-sectional study included randomly selected 138 HIV/AIDS patients receiving HAART. DASS-21 questionnaire was used to determine the depression, anxiety and stress levels of participants. Venous blood sample was collected from each participant for the estimation of CD4+ cell counts. The mean age of the study sample was 45.2 ± 10 years, with about 79% of them being females. The prevalence of depression, anxiety and stress among the participants were 87%, 78.3%, 71% respectively. The median (Inter-quartile range, IQR) CD4+ count of participants with depression compared to nondepressed [340.8 (261, 713) cells/μL vs. 418 (242, 481.2) cells/μL; p ≤ 0.0001], anxiety compared to non-anxious [318 (124, 540) μL vs. 438 (267, 487) μL; p ≤ 0.0001] and stress disorders compared to non-stressed [370 (251, 467) μL vs. 484 (424.5, 752.3) μL; p ≤ 0.0001] were significantly lower. Depression and anxiety correlated negatively with CD4+ cell count of participants [Depression; (r=-0.13, p=0.556), Stress; (r=-0.2, p=0.359)]. This study shows that depression, anxiety and stress have negative impact on CD4+ cell counts of HIV/AIDS patients receiving HAART. Citation: Kwakye A (2018) Prevalence and Impact of Depression, Anxiety and Stress on CD4+ Cell Counts of HIV/AIDS Patients Receiving HAART in Ghana. J AIDS Clin Res 9: 781. doi: 10.4172/2155-6113.1000781
{"title":"Prevalence and Impact of Depression, Anxiety and Stress on CD4+ Cell Counts of HIV/AIDS Patients Receiving HAART in Ghana","authors":"Alexander Kwakye","doi":"10.4172/2155-6113.1000781","DOIUrl":"https://doi.org/10.4172/2155-6113.1000781","url":null,"abstract":"Psychosocial disorders such as depression, anxiety and stress are more prevalent among HIV/AIDS patients compared to the general population. These psychosocial disorders impact negatively on HIV AIDS patients on highly active anti-retroviral therapy (HAART). This study determined how these psychosocial disorders impact CD4+ cell counts of HIV/AIDS patients receiving HAART in a peri-urban hospital in Kumasi, Ghana. This cross-sectional study included randomly selected 138 HIV/AIDS patients receiving HAART. DASS-21 questionnaire was used to determine the depression, anxiety and stress levels of participants. Venous blood sample was collected from each participant for the estimation of CD4+ cell counts. The mean age of the study sample was 45.2 ± 10 years, with about 79% of them being females. The prevalence of depression, anxiety and stress among the participants were 87%, 78.3%, 71% respectively. The median (Inter-quartile range, IQR) CD4+ count of participants with depression compared to nondepressed [340.8 (261, 713) cells/μL vs. 418 (242, 481.2) cells/μL; p ≤ 0.0001], anxiety compared to non-anxious [318 (124, 540) μL vs. 438 (267, 487) μL; p ≤ 0.0001] and stress disorders compared to non-stressed [370 (251, 467) μL vs. 484 (424.5, 752.3) μL; p ≤ 0.0001] were significantly lower. Depression and anxiety correlated negatively with CD4+ cell count of participants [Depression; (r=-0.13, p=0.556), Stress; (r=-0.2, p=0.359)]. This study shows that depression, anxiety and stress have negative impact on CD4+ cell counts of HIV/AIDS patients receiving HAART. Citation: Kwakye A (2018) Prevalence and Impact of Depression, Anxiety and Stress on CD4+ Cell Counts of HIV/AIDS Patients Receiving HAART in Ghana. J AIDS Clin Res 9: 781. doi: 10.4172/2155-6113.1000781","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70272320","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}
Pub Date : 2017-12-27DOI: 10.24966/ACRS-7370/100012
Karl Norwald, Charlotta Holmström, L. Plantin
The aim of this study has been to investigate the potential effects on women’s experiences of their sexuality and their sexual relations after being diagnosed with HIV. The result of the qualitativ ...
这项研究的目的是调查女性在被诊断感染艾滋病毒后,对她们的性经历和性关系的潜在影响。定性的结果是……
{"title":"HIV and Sexuality : Perceptions and Experiences of Sexuality among Women Who Live with HIV in Sweden","authors":"Karl Norwald, Charlotta Holmström, L. Plantin","doi":"10.24966/ACRS-7370/100012","DOIUrl":"https://doi.org/10.24966/ACRS-7370/100012","url":null,"abstract":"The aim of this study has been to investigate the potential effects on women’s experiences of their sexuality and their sexual relations after being diagnosed with HIV. The result of the qualitativ ...","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48866507","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}
Background: Sexually transmitted infections (STIs) are a major global cause of acute illness, infertility, long-term disability and death with serious medical and psychological consequences of millions of men, women and infants. Due to their high prevalence, particularly in developing settings, STIs result in substantial productivity losses for individuals and communities, particularly where the majority of the population is less than 40 years of age. Objective: To assess knowledge, attitude and preventive practices of Arsi Negelle preparatory students towards STIs. Methodology: Institutional based cross-sectional study design and quantitative method of data collection were employed. A Proportionate Stratified random sampling technique was used and finally, a total of 303 respondents were selected by systematic random sampling method. A standardized self-administered questionnaire was used to collect information from respondents. Results: Half of the respondents (50.8%) had good knowledge about STIs and 54.5% of respondents were identified to have positive attitude towards STIs and 38.6% of respondents had good preventive practice despite the fact that the rest 61.4% had poor preventive practice towards STIs. Conclusion: Most of respondents had heard about STIs in one or another way however nearly half of respondent's have good knowledge regarding STIs. This study had called for continued and strengthened health education.
{"title":"Knowledge, Attitude and Preventive Practices towards Sexually Transmitted Infection among Preparatory School Students of Arsi Negelle Town","authors":"Nega Degefa Megersa, S. Ahmed, Befikadu Tariku Gutema, Girum Sebsibie Teshome, Zeleke Aschalew Melketsedik, Eshetu Zerihun Tariku","doi":"10.4172/2155-6113.1000748","DOIUrl":"https://doi.org/10.4172/2155-6113.1000748","url":null,"abstract":"Background: Sexually transmitted infections (STIs) are a major global cause of acute illness, infertility, long-term disability and death with serious medical and psychological consequences of millions of men, women and infants. Due to their high prevalence, particularly in developing settings, STIs result in substantial productivity losses for individuals and communities, particularly where the majority of the population is less than 40 years of age. \u0000Objective: To assess knowledge, attitude and preventive practices of Arsi Negelle preparatory students towards STIs. \u0000Methodology: Institutional based cross-sectional study design and quantitative method of data collection were employed. A Proportionate Stratified random sampling technique was used and finally, a total of 303 respondents were selected by systematic random sampling method. A standardized self-administered questionnaire was used to collect information from respondents. \u0000Results: Half of the respondents (50.8%) had good knowledge about STIs and 54.5% of respondents were identified to have positive attitude towards STIs and 38.6% of respondents had good preventive practice despite the fact that the rest 61.4% had poor preventive practice towards STIs. \u0000Conclusion: Most of respondents had heard about STIs in one or another way however nearly half of respondent's have good knowledge regarding STIs. This study had called for continued and strengthened health education.","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6113.1000748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45783894","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}
Pub Date : 2017-12-26DOI: 10.4172/2155-6113.1000751
Devika Mehra, T. Khanna, Jagannnath Behera, S. Mehra
Background: Globally, Young key populations (age 10-24) (YKPs) are more at risk to HIV infection and are disproportionately infected by HIV. There is a pressing need evidence on how best to implement effective interventions for young key populations. Objective: The overall aim was to conduct a systematic review of interventions to summarize the data on effectiveness of interventions in low and middle income countries among young key populations. Method: We conducted a review of the evidence on interventions designed to increase adolescents and young people's access to services for reducing their HIV risk. We focused specifically on the young key populations from low to middle income countries. We searched PubMed, Medline and Cochrane databases using MesH terms to identify peer-reviewed articles. We included studies with designs such as randomized control trails (RCT), clustered randomized trails, quasi experimental, prospective observational and studies that measured outcomes pre and post an intervention. We identified a total of 10 studies that were included in the review based on certain inclusion and exclusion criteria's. Results: Among the interventions designed for young people, community based interventions driven by peer led approach and mobile based interventions were effective in engaging with these hard to reach populations. Structural interventions focusing on stigma and psychosocial component can positively impact important HIV-related outcomes. Also, HIV screening needs to be integrated in programs and policy with intimate partner violence. The evidence on PreP is mixed and needs more systematic investigation. Conclusion: A combination prevention packages that include behavioural, structural and biological interventions are needed for young key populations to prevent new HIV infections. These interventions with proven effectiveness should be included in all HIV prevention programming for young people.
{"title":"Review of HIV Interventions among Young and Adolescent Key Populations in Low to Middle Income Countries","authors":"Devika Mehra, T. Khanna, Jagannnath Behera, S. Mehra","doi":"10.4172/2155-6113.1000751","DOIUrl":"https://doi.org/10.4172/2155-6113.1000751","url":null,"abstract":"Background: Globally, Young key populations (age 10-24) (YKPs) are more at risk to HIV infection and are disproportionately infected by HIV. There is a pressing need evidence on how best to implement effective interventions for young key populations. \u0000Objective: The overall aim was to conduct a systematic review of interventions to summarize the data on effectiveness of interventions in low and middle income countries among young key populations. \u0000Method: We conducted a review of the evidence on interventions designed to increase adolescents and young people's access to services for reducing their HIV risk. We focused specifically on the young key populations from low to middle income countries. We searched PubMed, Medline and Cochrane databases using MesH terms to identify peer-reviewed articles. We included studies with designs such as randomized control trails (RCT), clustered randomized trails, quasi experimental, prospective observational and studies that measured outcomes pre and post an intervention. We identified a total of 10 studies that were included in the review based on certain inclusion and exclusion criteria's. \u0000Results: Among the interventions designed for young people, community based interventions driven by peer led approach and mobile based interventions were effective in engaging with these hard to reach populations. Structural interventions focusing on stigma and psychosocial component can positively impact important HIV-related outcomes. Also, HIV screening needs to be integrated in programs and policy with intimate partner violence. The evidence on PreP is mixed and needs more systematic investigation. \u0000Conclusion: A combination prevention packages that include behavioural, structural and biological interventions are needed for young key populations to prevent new HIV infections. These interventions with proven effectiveness should be included in all HIV prevention programming for young people.","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6113.1000751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43943797","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}
Pub Date : 2017-11-30DOI: 10.4172/2155-6113.1000747
T. Endo, H. Goto, N. Miyashita, Takahide Ara, Kohei Kasahara, K. Okada, S. Shiratori, J. Sugita, M. Onozawa, D. Hashimoto, M. Nakagawa, K. Kahata, K. Fujimoto, T. Kondo, S. Hashino, K. Houkin, T. Teshima
Objective: Several studies have shown that rates of cerebrovascular events in HIV-infected patients are increased in comparison to uninfected individuals. In addition, cerebral bleeding represents a serious complication in hemophilia patients. Recently, asymptomatic cerebral microbleeds (CMBs), which can be detected by highly sensitive techniques such as T2*-weighted magnetic resonance imaging (MRI), have emerged as an important marker for predicting symptomatic cerebral bleeding. The aim of the present study was to investigate the prevalence of CMBs in HIVinfected hemophilia patients and to evaluate the association between HIV infection and cerebral bleeding. Methods: All HIV-infected hemophilia patients (HIV+ HemPts) who visited our hospital from January 2015 to December 2016 were enrolled in this study. In addition, all HIV-uninfected hemophilia patients (HIV- HemPts) who visited our hospital in the same period were enrolled as controls. CMBs were assessed using T2*-weighted MRI. The relationship between cerebral bleeding and the patients’ clinical factors was examined. Results: Two HIV+ HemPts had symptomatic cerebral bleedings during the study period. Twenty-one asymptomatic HIV+ HemPts and 13 HIV- HemPts underwent T2*-weighted MRI. CMBs were observed in 7 HIV+ HemPts (30.4%) and 1 HIV- HemPts (7.7%). In the multivariate logistic regression analysis, HIV infection was the factor most closely related to cerebral bleeding (odds ratio: 9.78, p-value: 0.08). Conclusion: This is the first report to investigate the prevalence of CMBs in HIV-infected patients. The prevalence of CMBs or symptomatic cerebral bleeding in HIV+ HemPts was high in comparison to that in HIV- HemPts. The brain screening test by T2*-weighted MRI seems to be meaningful for HIV+ HemPts.
{"title":"The Prevalence of Cerebral Microbleeds in HIV-Infected Hemophilia Patients","authors":"T. Endo, H. Goto, N. Miyashita, Takahide Ara, Kohei Kasahara, K. Okada, S. Shiratori, J. Sugita, M. Onozawa, D. Hashimoto, M. Nakagawa, K. Kahata, K. Fujimoto, T. Kondo, S. Hashino, K. Houkin, T. Teshima","doi":"10.4172/2155-6113.1000747","DOIUrl":"https://doi.org/10.4172/2155-6113.1000747","url":null,"abstract":"Objective: Several studies have shown that rates of cerebrovascular events in HIV-infected patients are increased in comparison to uninfected individuals. In addition, cerebral bleeding represents a serious complication in hemophilia patients. Recently, asymptomatic cerebral microbleeds (CMBs), which can be detected by highly sensitive techniques such as T2*-weighted magnetic resonance imaging (MRI), have emerged as an important marker for predicting symptomatic cerebral bleeding. The aim of the present study was to investigate the prevalence of CMBs in HIVinfected hemophilia patients and to evaluate the association between HIV infection and cerebral bleeding. Methods: All HIV-infected hemophilia patients (HIV+ HemPts) who visited our hospital from January 2015 to December 2016 were enrolled in this study. In addition, all HIV-uninfected hemophilia patients (HIV- HemPts) who visited our hospital in the same period were enrolled as controls. CMBs were assessed using T2*-weighted MRI. The relationship between cerebral bleeding and the patients’ clinical factors was examined. Results: Two HIV+ HemPts had symptomatic cerebral bleedings during the study period. Twenty-one asymptomatic HIV+ HemPts and 13 HIV- HemPts underwent T2*-weighted MRI. CMBs were observed in 7 HIV+ HemPts (30.4%) and 1 HIV- HemPts (7.7%). In the multivariate logistic regression analysis, HIV infection was the factor most closely related to cerebral bleeding (odds ratio: 9.78, p-value: 0.08). Conclusion: This is the first report to investigate the prevalence of CMBs in HIV-infected patients. The prevalence of CMBs or symptomatic cerebral bleeding in HIV+ HemPts was high in comparison to that in HIV- HemPts. The brain screening test by T2*-weighted MRI seems to be meaningful for HIV+ HemPts.","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46260068","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}
Pub Date : 2017-11-28DOI: 10.4172/2155-6113.1000740
Kajimb P, M. O, Kakisingi C, M. M., Ngwej D, Ngoie B, Tshikuluila B, Mwamba C, A. F, Kipenge R, Situakibanza H, Numbi E, Isango Y
Objective: Evaluate PMTCT services in the Lubumbashi Health Zone. Methods: This is a cross-sectional study carried out in the maternity wards of all 18 maternities in the Lubumbashi Health Zone from 1 January 2015 to 31 December 2015; one of the 27 health zones in the province of Haut-Katanga (DR Congo). Included were all women who received prenatal, perinatal and postnatal consultations during the study period. Results: Of 12496 women admitted to ANC, 6291 (50.1%) were counseled for HIV testing; 6170 (98.5%) were screened and an incidence of 2.4% was observed. Regarding male partners of women diagnosed during ANC consultations, 120 (1.9%) were counseled, 100 (83.3%) of those who were counseled were screened for HIV and an incidence of 20% to HIV was reported. Concerning management of women screened HIV positive during ANC, 106 (89.1%) among them were placed on ART according to Option B+. One hundred and sixteen live-born infants were born from HIV positive mothers and all were placed on nevirapine prophylaxis. Forty-six (39.7%) were tested with DBS at six weeks giving an incidence of 4.3% Conclusion: These results show that there are still challenges to be faced in preventing mother-to-child transmission of HIV in the Lubumbashi Health Zone. The integration of PMTCT activities with Option B+ in all maternity units in this health zone would reduce the vertical transmission of HIV.
{"title":"Uptake of Services for Prevention for Mother-to-Child Transmission of HIV in Lubumbashi (D.R. of Congo)","authors":"Kajimb P, M. O, Kakisingi C, M. M., Ngwej D, Ngoie B, Tshikuluila B, Mwamba C, A. F, Kipenge R, Situakibanza H, Numbi E, Isango Y","doi":"10.4172/2155-6113.1000740","DOIUrl":"https://doi.org/10.4172/2155-6113.1000740","url":null,"abstract":"Objective: Evaluate PMTCT services in the Lubumbashi Health Zone. Methods: This is a cross-sectional study carried out in the maternity wards of all 18 maternities in the Lubumbashi Health Zone from 1 January 2015 to 31 December 2015; one of the 27 health zones in the province of Haut-Katanga (DR Congo). Included were all women who received prenatal, perinatal and postnatal consultations during the study period. \u0000Results: Of 12496 women admitted to ANC, 6291 (50.1%) were counseled for HIV testing; 6170 (98.5%) were screened and an incidence of 2.4% was observed. Regarding male partners of women diagnosed during ANC consultations, 120 (1.9%) were counseled, 100 (83.3%) of those who were counseled were screened for HIV and an incidence of 20% to HIV was reported. Concerning management of women screened HIV positive during ANC, 106 (89.1%) among them were placed on ART according to Option B+. One hundred and sixteen live-born infants were born from HIV positive mothers and all were placed on nevirapine prophylaxis. Forty-six (39.7%) were tested with DBS at six weeks giving an incidence of 4.3% \u0000Conclusion: These results show that there are still challenges to be faced in preventing mother-to-child transmission of HIV in the Lubumbashi Health Zone. The integration of PMTCT activities with Option B+ in all maternity units in this health zone would reduce the vertical transmission of HIV.","PeriodicalId":89166,"journal":{"name":"Journal of AIDS & clinical research","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48514263","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}