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1

Brou et al. resubmission august 07 Disclosure of Women's HIV-Status to their Partner 1 When do HIV Infected Women Disclose their HIV Status to their Male Partner and  

E-print Network

07 Disclosure of Women's HIV-Status to their Partner 3 ABSTRACT Background: In Africa, women testedBrou et al. ­ resubmission august 07 Disclosure of Women's HIV-Status to their Partner 1 Full Title When do HIV Infected Women Disclose their HIV Status to their Male Partner and Why? Experience from

Paris-Sud XI, Université de

2

[Does post-test counseling support PLHIV in disclosing their HIV status? Practices and propositions by counselors in Burkina Faso].  

PubMed

Disclosure of HIV test results is discussed during post-test counseling, following norms. However, while barriers to disclosing a positive HIV result have been documented, the literature is sparse on the way guidelines are applied in the field. The aim of this article is to describe and analyze counseling practices regarding HIV disclosure to 'significant others' (partner, family members, friends) reported by clients and providers of HIV voluntary counseling and testing in Burkina Faso. A cross-sectional survey was conducted in urban and rural areas in 2008 . A questionnaire incorporating semi-open questions was used. A total of 542 people who completed the test in 2007 and 111 service providers of HIV counseling and testing were interviewed. The data were analyzed using SPSS 12. Only 29% of those tested stated that disclosure to partner or family members was discussed with them during post-test counseling. This result is explained by providers' uncertainties and concerns regarding how to disclose, risks related to disclosure and adverse consequences of disclosure. Strategies are developed by counseling providers to support people who have been diagnosed HIV positive in disclosing to significant others, but they recognize that these actions are insufficient. Providers' suggestions are to keep fighting against the stigmatization of PLHIV, to improve counseling providers' competence in this area, and to adopt legal texts to make mandatory disclosure of the HIV result to partners. The study identified several ways to improve counseling practices regarding clients' disclosure of their HIV status in Burkina Faso. These findings could have significance for Africa as a whole. PMID:23844802

Ky-Zerbo, Odette; Som, Jean-Franois; Simaga, Fod

2013-07-01

3

Social context of disclosing HIV test results in Tanzania.  

PubMed

This study sought to understand how individuals reveal their HIV test results to others and the ways in which social relations affect the disclosure process. The data were collected through open-ended interviews administered in Swahili to informants who had just been tested for HIV and to those who were living with HIV in Dar es Salaam and Iringa regions. Analysis shows that social relations influence the decisions individuals make about disclosure. Most people preferred to reveal their HIV status to close family members. Most also mentioned the fear of being rejected and discriminated against as major reasons for not disclosing their test results to others. PMID:21936654

Lugalla, Joe; Yoder, Stanley; Sigalla, Huruma; Madihi, Charles

2012-01-01

4

HIV/AIDS Case Managers and Client HIV Status Disclosure: Perceived Client Needs, Practices, and Services  

ERIC Educational Resources Information Center

People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/AIDS in New York State. The survey was conducted anonymously, and case

Kalichman, Seth C.; Klein, Susan J.; Kalichman, Moira O.; O'Connell, Daniel A.; Freedman, Jay A.; Eaton, Lisa; Cain, Demetria

2007-01-01

5

Comparing regret of disclosing HIV versus sexual orientation information by MSM  

Microsoft Academic Search

Very little research has been conducted focusing on regret associated with disclosing either HIV-positive serostatus or sexual orientation information. The purpose of this study was to investigate the prevalence of regret related to the disclosure of serostatus and sexual orientation to family members among HIV-positive men who have sex with men (MSM) and to further explore the participant, family member,

Julianne M. Serovich; Erika L. Grafsky; Sandra J. Reed

2010-01-01

6

Keeping and Disclosing a Secret among People with HIV in Israel  

ERIC Educational Resources Information Center

This study examined the association of key variables with the intention to disclose and actual disclosure to an additional significant other of being HIV-infected. Sixty-five participants were recruited from five AIDS/HIV centers in Israeli hospitals. Participants completed questionnaires at entry to the study. They were asked about the extent to

Landau, Gila; York, Alan S.

2004-01-01

7

Misleading sexual partners about HIV status among persons living with HIV/AIDS.  

PubMed

Most people living with HIV/AIDS (PLWHA) disclose their serostatus to their sexual partners and take steps to protect their partners from HIV. Prior research indicates that some PLWHA portray themselves to their sexual partners as HIV-negative or otherwise misrepresent their HIV status. The aim of this study was to document the prevalence of misleading sexual partners about HIV status and to identify factors associated with misleading. A sample of 310 PLWHA completed a self-administered questionnaire assessing demographic information, disclosure, HIV knowledge, HIV altruism, psychopathy, and sexual risk behavior. Participants were also asked "Since you were diagnosed as having HIV, have you ever misled a sexual partner about your HIV status?" Overall, 18.6% of participants indicated that they had misled a sexual partner. Those who had misled a partner at some point since their diagnosis reported more current HIV transmission risk behaviors, including unprotected anal or vaginal sex with a partner who was HIV-negative or whose HIV status was unknown. Participants who had misled a partner did not differ from those who had not in terms of demographic characteristics. Individuals who had misled a partner scored significantly lower on a measure of HIV knowledge than those who had not misled a partner. HIV altruism and psychopathy were associated with sexual risk behavior, but did not differ between those who had misled and those who had not. Disclosure of HIV status can reduce HIV transmission, but only if people are candid. Interventions aimed at increasing knowledge and accurate disclosure may reduce the spread of HIV. PMID:22183890

Benotsch, Eric G; Rodrguez, Vivian M; Hood, Kristina; Lance, Shannon Perschbacher; Green, Marisa; Martin, Aaron M; Thrun, Mark

2012-10-01

8

Legal Disclosure of HIV Status  

MedlinePLUS

... Hospitalization and Palliative Care Friends & Family Dating and Marriage Having Children Mixed-Status Couples Discrimination Legal Issues ... show ??good faith? efforts to notify the marriage partners of a patient with HIV/AIDS. Disclosure ...

9

Management of Conflicts Arising From Disclosure of HIV Status Among Married Women in Southwest Nigeria.  

PubMed

This study examined if disclosure to their spouses by married women living with HIV/AIDS resulted in conflicts. Fifty-seven women completed a questionnaire on conflict indicators. While 93% disclosed their status within 6 months of diagnosis, 12.3% did so through a third party. More than thirty-six percent (36.8%) confirmed that disclosure led to conflict. Although 19.3% had their conflicts resolved through a third party, 10% suffered separation. Marital status and fear of stigma significantly influence time to disclose (p <.01 and p <.05), while type of marriage strongly influences whether status will be disclosed (p <.01). Programs for women with HIV should consider conflicts that may arise from disclosure. PMID:23790020

Okareh, Oladapo T; Akpa, Onoja M; Okunlola, John O; Okoror, Titilayo A

2015-02-01

10

Disclosure of HIV status: Experiences of Patients Enrolled in an Integrated TB and HAART Pilot Programme in South Africa  

PubMed Central

The convergence between the tuberculosis (TB) and HIV epidemics has led to studies investigating strategies for integrated HIV and TB care. We present the experiences of a cohort of 17 patients enrolled in the first integrated TB and HIV treatment pilot programme, conducted in Durban, South Africa, as a precursor to a pivotal trial to answer the question of when to start antiretroviral treatment (ART) in patients co-infected with HIV and TB. Patients experiences with integrated TB and HIV care can provide insight about the problems or benefits of introducing HIV treatment into existing TB care in resource-constrained settings, where stigma and discrimination are often pervasive and determining factors influencing treatment uptake and coverage. Individual interviews, focus group discussions, and observations were used to understand patients experiences with integrated TB and HIV treatment. The patients described incorporating highly active antiretroviral therapy (HAART) into their daily routine as easy; however, the patients experienced difficulties with disclosing their HIV status. Non-disclosure to sexual partners may jeopardise safer-sex practices and enhance HIV transmission. Being on TB treatment created a safe space for all patients to conceal their HIV status from those to whom they did not wish to disclose. The data suggest that the context of directly observed therapy (DOT) for TB may have the added benefit of creating a safe space for introducing ART to patients who would benefit most from treatment initiation but who are not ready or prepared to disclose their HIV status to others. PMID:20411037

Gebrekristos, Hirut T; Lurie, Mark N; Mthethwa, Nkosinathi; Karim, Quarraisha Abdool

2010-01-01

11

Strategies and Outcomes of HIV Status Disclosure in HIV-Positive Young Women with Abuse Histories  

PubMed Central

Abstract Young women with HIV and histories of physical and/or sexual abuse in childhood may be vulnerable to difficulties with disclosure to sexual partners. Abuse in childhood is highly prevalent in HIV-positive women, and has been associated with poorer communication, low assertiveness, low self worth, and increased risk for sexual and other risk behaviors that increase the risk of secondary transmission of HIV. HIV disclosure may be an important link between abuse and sexual risk behaviors. Qualitative interviews with 40 HIV-positive young women with childhood physical and/or sexual abuse were conducted; some women had also experienced adult victimization. Results suggest that HIV-positive women with abuse histories use a host of strategies to deal with disclosure of HIV status, including delaying disclosure, assessing hypothetical responses of partners, and determining appropriate stages in a relationship to disclose. Stigma was an important theme related to disclosure. We discuss how these disclosure processes impact sexual behavior and relationships and discuss intervention opportunities based on our findings. PMID:23596649

Czaplicki, Lauren; Andrinopoulos, Katherine; Muessig, Kathryn; Hamvas, L.; Ellen, Jonathan M.

2013-01-01

12

HIV Status Disclosure to Sexual Partners, among People Living with HIV and AIDS on Antiretroviral Therapy at Sokod Regional Hospital, Togo  

PubMed Central

Background Many studies have reported factors associated with HIV status disclosure among People Living With HIV and AIDS (PLWHA) but very few were conducted among PLWHA receiving ART. In Togo, no study on HIV status disclosure to sexual partners has been conducted among PLWHA on ART yet. We sought to document factors associated with HIV status disclosure among PLWHA receiving ART at Sokod regional hospital in Togo. Method This was a cross-sectional study conducted from May to July 2013 at the regional hospital of Sokod among 291 PLWHA who had been on ART for at least three months. Results A total of 291 PLWHA on ART were enrolled in this study. Their mean age (SD) was 37.39.3 years and the sex ratio (Male/Female) was 0.4. Among them, 215 (74.6%) completed the questionnaire on HIV sero-status disclosure. We found that 131 PLWHA (60.9%) had disclosed their HIV sero-status to their sexual partners; 130 (60.5%) were aware of the HIV status of their sexual partners. In the multivariate analysis, the factors associated with HIV status disclosure to sexual partners were: adherence to ART (aOR = 4.89; 95%CI = [1.52; 15.78]), sexual partner awareness of HIV sero-status (aOR = 52.73; 95%CI = [14.76; 188.36]) and marital status of PLWHA (aOR = 6.10; 95%CI = [1.74; 21.37]). Conclusion This study allowed us to note that the disclosure of HIV status to sexual partners is relatively low and to document the associated factors such as adherence to ART, sexual partner awareness of HIV sero-status and marital status. PMID:25658105

Yaya, Issifou; Saka, Bayaki; Landoh, Dadja Essoya; Patchali, PNiw Massoubayo; Patassi, Akouda Akessiw; Aboubakari, Abdoul-samadou; Makawa, Makawa-Sy; NDri, Mathias Kouam; Senanou, Skand; Lamboni, Bassan; Idrissou, Daoudou; Salaka, Kao Tanang; Pitch, Palokinam

2015-01-01

13

Gender Perspective of Risk Factors Associated with Disclosure of HIV Status, a Cross-Sectional Study in Soweto, South Africa  

PubMed Central

Background Human Immunodeficiency Virus (HIV) status disclosure has been shown to provide several benefits, both at the individual and societal levels. Aim To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART) recipients in South Africa. Setting A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa. Methods We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other. Patients A total of 883 patients were interviewed. The majority were women (73%) with median age of 39 years. Results Employed patients were less likely to disclose than unemployed (odds ratio (OR) 0.36; 95% confidence interval (CI) 0.11.0; p?=?0.05)). Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.9011.7; p?=?0.07) than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.021.99; p?=?0.17) than men with lower income. Men were more likely than women to disclose to their partner (p<0.01), and to partner and family (p<0.01), women were more likely than men to disclose to child and family (p<0.01), to child, family and others (p?=?0.01). Conclusion Being employed imposed a risk factor for HIV status disclosure, additionally we found an interaction effect of gender and income on disclosure. Interventions designed to reduce workplace discrimination and gender-sensitive interventions promoting disclosure are strongly recommended. PMID:24743189

Longinetti, Elisa; Santacatterina, Michele; El-Khatib, Ziad

2014-01-01

14

Factors associated with HIV-status disclosure to HIV-infected children receiving care at Kilimanjaro Christian Medical Centre in Moshi, Tanzania  

PubMed Central

Introduction With the introduction of antiretroviral drugs HIV-infected children live longer. Disclosure of HIV diagnosis is increasingly an important and inevitable issue. Both healthcare providers and caregivers face challenges of disclosure to children. The objective of the study was to explore factors associated with HIV-status disclosure to HIV-infected children receiving care at Kilimanjaro Christian Medical Centre (KCMC). Methods A cross-sectional hospital-based study was conducted from October 2011 to April 2012. Study population included HIV-infected children aged 5 to 14 years, their caregivers and healthcare providers. Structured questionnaires were used to collect information. Children were asked the reason for hospital visits. Outcome of interest was HIV disclosure status. Data was processed and analysed using SPSS version 16.0. Multivariate logistic regression at 5% margin error was used to account for confounders. Results A total of 211 children were enrolled with mean age of 9.7 (SD 2.6; range 5-14) years. Only 47 (22.3%) children knew their HIV-status. The mean age of disclosure was 10.6 years. Most of disclosed children were aged above 10 years (p). Conclusion Most of children were not disclosed. Ages, self medication, getting other support and parents/caregivers prior discussion were strong predictors of disclosure status. PMID:25368739

Mumburi, Livin Peter; Hamel, Bernardus Carolus; Philemon, Rune Nathanael; Kapanda, Gibson Nsokolo; Msuya, Levina January

2014-01-01

15

Keepers of the secret: desires to conceal a family member's HIV-positive status in Namibia, Africa.  

PubMed

When people learn that they have tested positive for HIV, they may share their news with a family member; and this family listener may want them to keep their diagnosis a secret. This study extends privacy management research (e.g., Petronio, 2002) by investigating variables related to family members' desires to keep HIV-status secrets. Two studies, 2 years apart, included adult-respondents (N = 1,358) in northern Namibia, where HIV is prevalent. Two factors predicted potential co-owners' desires to keep a family member's HIV-positive status secret: (a) the sense of an environment inappropriate for disclosure, and (b) a lack of efficacy to oppose it. These findings suggest that many factors translated from disclosers to co-owners and from (primarily) Western studies of disclosure to southern Africa. From this investigation, one might consider the contexts that redistribute power so that confidants may limit discloser's rights to share his or her own information. PMID:19657828

Smith, Rachel A; Niedermyer, Angela J

2009-07-01

16

Men's Serostatus Disclosure to Parents: Associations Among Social Support, Ethnicity, and Disease Status in Men Living with HIV  

PubMed Central

Background Directly disclosing a positive HIV serostatus to family members can affect psychological and disease status. Perceptions that one is in a supportive family environment may moderate these effects; however, ethnic differences may exist in the support processes of families coping with HIV. Methods We examined the role of serostatus disclosure to parents, HIV-specific family support, and ethnicity (Latino versus non-Hispanic White) in explaining disease status (HIV Viral Load, CD4+ cell count) in a sample of men living with HIV (MLWH). Men (n = 120) reported whether they had disclosed their serostatus to their mothers and fathers, rated their perceptions of HIV-specific social support received from family members, and provided morning peripheral venous blood samples to assess immune function. We also collected psychosocial and urinary neuroendocrine indicators of stress/distress as possible mediator variables. Results A three-way interaction emerged between serostatus disclosure to mothers, HIV-specific family support, and ethnicity in explaining both viral load and CD4+ cell count. Non-Hispanic White men who had disclosed to mothers and were receiving high family support had a lower viral load and higher CD4+ cell count, but Latino men who had disclosed to mothers and were receiving low family support had a higher viral load. These associations were not accounted for by men's medication adherence, psychological distress, or neuroendocrine hormones. Disclosure to fathers was not related to disease status. Conclusions The effects of serostatus disclosure on disease status may depend, in part, on ethnic differences in the interpersonal processes of men's close family relationships. PMID:19486655

Fekete, Erin M.; Antoni, Michael H.; Lopez, Corina R.; Durn, Ron E.; Penedo, Frank J.; Bandiera, Frank C.; Fletcher, Mary Ann; Klimas, Nancy; Kumar, Mahendra; Schneiderman, Neil

2009-01-01

17

HIV status disclosure among infected men who have sex with men (MSM) in Buenos Aires, Argentina.  

PubMed

Five hundred men who have sex with men were recruited in Buenos Aires using respondent driven sampling. Of them, 46 respondents (24 of them not gay identified) who were HIV infected were asked questions on serodisclosure. The sample was characterized by indicators of low socioeconomic status. Most of the respondents reported being in good to excellent health despite 42% of them having been diagnosed with AIDS. Only 10% of respondents had not disclosed their serostatus to at least one person. Coworkers and lovers or main sexual partners were those most likely to know the respondents' serostatus. Reactions to disclosure were for the most part supportive. Those who had not disclosed anticipated less favorable reactions than those who had disclosed. No significant differences were observed between gay and non-gay identified respondents. The progressive social environment of Argentina that includes federal laws recognizing gay marriage may contribute to create a climate favorable for serostatus disclosure. PMID:24245593

Carballo-Diguez, Alex; Baln, Ivn C; Dolezal, Curtis; Ibitoye, Mobolaji; Pando, Mara A; Marone, Rubn; Barreda, Victoria; Avila, Mara Mercedes

2013-12-01

18

HIV Status Disclosure Among Infected Men Who Have Sex With Men (MSM) in Buenos Aires, Argentina  

PubMed Central

Five hundred men who have sex with men were recruited in Buenos Aires using respondent driven sampling. Of them, 46 respondents (24 of them not gay identified) who were HIV infected were asked questions on serodisclosure. The sample was characterized by indicators of low socioeconomic status. Most of the respondents reported being in good to excellent health despite 42% of them having been diagnosed with AIDS. Only 10% of respondents had not disclosed their serostatus to at least one person. Coworkers and lovers or main sexual partners were those most likely to know the respondents' serostatus. Reactions to disclosure were for the most part supportive. Those who had not disclosed anticipated less favorable reactions than those who had disclosed. No significant differences were observed between gay and non-gay identified respondents. The progressive social environment of Argentina that includes federal laws recognizing gay marriage may contribute to create a climate favorable for serostatus disclosure. PMID:24245593

Carballo-Diguez, Alex; Baln, Ivn C.; Dolezal, Curtis; Ibitoye, Mobolaji; Pando, Mara A.; Marone, Rubn; Barreda, Victoria; vila, Mara Mercedes

2013-01-01

19

HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda  

PubMed Central

Background Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. Methods Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. Results Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. Conclusions There is overwhelming support to individuals that disclose their HIV status, especially in the long term. Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure support strategies. PMID:24950958

2014-01-01

20

Counselling about HIV serological status disclosure: nursing practice or law enforcement? a Foucauldian reflection.  

PubMed

Recently, focus groups and qualitative interviews with nurses who provide frontline care for persons living with HIV highlighted the contentiousness surrounding the seemingly innocuous activity of counselling clients about HIV-status disclosure, hereafter disclosure counselling. These empirical studies highlighted that while some nurses felt they should instruct clients to disclose their HIV-positive status if HIV transmission were possible, other nurses were equally adamant that such counselling was outside the nursing scope of practice. A review of these opposing perceptions about disclosure counselling, including an examination of the empirical evidence which supports each point, revealed that the dichotomous arguments needed to be nuanced. The empirical evidence about serostatus disclosure neither supported nor refuted either of these assertions; rather, it substantiated parts of each. To create this understanding, both empirical and theoretical works are used. First, the results of empirical studies about serostatus disclosure, or lack thereof and HIV transmission is presented; as part of this, Marks and Crepaz's HIV disclosure and exposure framework is examined. Second, the work of Michel Foucault on disciplinary and pastoral power is drawn from. The outcome is a nuanced understanding about the interrelationships between disclosure counselling and nursing practice and a final interpretation about what this understanding means for public health practice. PMID:25053169

O'Byrne, Patrick; Holmes, Dave; Roy, Marie

2014-07-23

21

Factors associated with disclosure of HIV status among a cohort of individuals on antiretroviral therapy in British Columbia, Canada.  

PubMed

We sought to examine the prevalence and correlates of HIV-disclosure among treatment-experienced individuals in British Columbia, Canada. Study participants completed an interviewer-administered survey between July 2007 and January 2010. The primary outcome of interest was disclosing one's HIV-positive status to all new sexual partners within the last 6months. An exploratory logistic regression model was developed to identify variables independently associated with disclosure. Of the 657 participants included in this analysis, 73.4% disclosed their HIV-positive status to all of their sexual partners. Factors independently associated with non-disclosure included identifying as a woman (adjusted odds ratio [AOR] 1.92; 95% confidence interval [95% CI] 1.13-3.27) or as a gay or bisexual man (AOR 2.45; 95% CI 1.47-4.10). Behaviours that were independently associated with non-disclosure were having sex with a stranger (AOR 2.74; 95% CI 1.46-5.17), not being on treatment at the time of interview (AOR 2.67; 95% CI 1.40-5.11), and not always using a condom (AOR 1.78; 95% CI 1.09-2.90). Future preventative strategies should focus on environmental and social factors that may inhibit vulnerable HIV-positive populations, such as women and gay or bisexual men, from safely disclosing their positive status. PMID:24114265

Hirsch Allen, A J; Forrest, Jamie I; Kanters, Steve; O'Brien, Nadia; Salters, Kate A; McCandless, Lawrence; Montaner, Julio S G; Hogg, Robert S

2014-06-01

22

The Demand for, and Impact of, Learning HIV Status  

PubMed Central

This paper evaluates an experiment in which individuals in rural Malawi were randomly assigned monetary incentives to learn their HIV results after being tested. Distance to the HIV results centers was also randomly assigned. Without any incentive, 34 percent of the participants learned their HIV results. However, even the smallest incentive doubled that share. Using the randomly assigned incentives and distance from results centers as instruments for the knowledge of HIV status, sexually active HIV-positive individuals who learned their results are three times more likely to purchase condoms two months later than sexually active HIV-positive individuals who did not learn their results; however, HIV-positive individuals who learned their results purchase only two additional condoms than those who did not. There is no significant effect of learning HIV-negative status on the purchase of condoms. PMID:21687831

Thornton, Rebecca L.

2011-01-01

23

Poverty, Hunger, Education, and Residential Status Impact Survival in HIV  

Microsoft Academic Search

Despite combination antiretroviral therapy (ART), HIV infected people have higher mortality than non-infected. Lower socioeconomic\\u000a status (SES) predicts higher mortality in many chronic illnesses but data in people with HIV is limited. We evaluated 878\\u000a HIV infected individuals followed from 1995 to 2005. Cox proportional hazards for all-cause mortality were estimated for SES\\u000a measures and other factors. Mixed effects analyses

James McMahon; Christine Wanke; Norma Terrin; Sally Skinner; Tamsin Knox

24

Gender differences in health status and care among HIV-infected minority drug users  

Microsoft Academic Search

Gender differences were examined in health status and HIV care among HIV-infected minority drug users. More women than men reported having HIV-related symptoms and other health conditions, such as asthma and allergies. Hepatitis B or C was more often reported by men. As compared to men, women delayed HIV care and fewer attended HIV support groups. Delayed entry into HIV

Sung-Yeon Kang; Marjorie F. Goldstein; Sherry Deren

2008-01-01

25

HIV Status Disclosure to Perinatally-Infected Adolescents in Zimbabwe: A Qualitative Study of Adolescent and Healthcare Worker Perspectives  

PubMed Central

Introduction & Objectives Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. As these children grow and surpass the immediate threat of death, the issue of informing them of their HIV status arises. This study aimed to understand how perinatally-infected adolescents learn about their HIV-status as well as to examine their preferences for the disclosure process. Methods In-depth interviews were conducted with 31 (14 male, 17 female) perinatally-infected adolescents aged 1620 at an HIV clinic in Harare, Zimbabwe, and focused on adolescents' experiences of disclosure. In addition, 15 (1 male, 14 female) healthcare workers participated in two focus groups that were centred on healthcare workers' practices surrounding disclosure in the clinic. Purposive sampling was used to recruit participants. A coding frame was developed and major themes were extracted using grounded theory methods. Results Healthcare workers encouraged caregivers to initiate disclosure in the home environment. However, many adolescents preferred disclosure to take place in the presence of healthcare workers at the clinic because it gave them access to accurate information as well as an environment that made test results seem more credible. Adolescents learned more specific information about living with an HIV-positive status and the meaning of that status from shared experiences among peers at the clinic. Conclusions HIV-status disclosure to adolescents is distinct from disclosure to younger children and requires tailored, age-appropriate guidelines. Disclosure to this age group in a healthcare setting may help overcome some of the barriers associated with caregivers disclosing in the home environment and make the HIV status seem more credible to an adolescent. The study also highlights the value of peer support among adolescents, which could help reduce the burden of psychosocial care on caregivers and healthcare workers. PMID:24475271

Kidia, Khameer K.; Mupambireyi, Zivai; Cluver, Lucie; Ndhlovu, Chiratidzo E.; Borok, Margaret; Ferrand, Rashida A.

2014-01-01

26

Awareness of HIV Status, Prevention Knowledge and Condom Use among People Living with HIV in Mozambique  

PubMed Central

Objective To determine factors associated with HIV status unawareness and assess HIV prevention knowledge and condom use among people living with HIV/AIDS (PLHIV) in Mozambique. Design Cross-sectional household-based nationally representative AIDS Indicator Survey. Methods Analyses focused on HIV-infected adults and were weighted for the complex sampling design. We identified PLHIV who had never been tested for HIV or received their test results prior to this survey. Logistic regression was used to assess factors associated with HIV status unawareness. Results Of persons with positive HIV test results (N?=?1182), 61% (95% confidence interval [CI] 5765%) were unaware of their serostatus. Men had twice the odds of being unaware of their serostatus compared with women [adjusted odds ratio (aOR) 2.05, CI 1.402.98]. PLHIV in the poorest wealth quintile were most likely to be unaware of their serostatus (aOR 3.15, CI 1.099.12) compared to those in the middle wealth quintile. Most PLHIV (83%, CI 7987%) reported not using a condom during their last sexual intercourse, and PLHIV who reported not using a condom during their last sexual intercourse were more likely to be unaware of their serostatus (aOR 2.32, CI 1.573.43) than those who used a condom. Conclusions Knowledge of HIV-positive status is associated with more frequent condom use in Mozambique. However, most HIV-infected persons are unaware of their serostatus, with men and persons in the poorest wealth quintile being more likely to be unaware. These findings support calls for expanded HIV testing, especially among groups less likely to be aware of their HIV status and key populations at higher risk for infection. PMID:25222010

Dokubo, E. Kainne; Shiraishi, Ray W.; Young, Peter W.; Neal, Joyce J.; Aberle-Grasse, John; Honwana, Nely; Mbofana, Francisco

2014-01-01

27

Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men  

PubMed Central

Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS (PLWHA) endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a sample of HIV-positive BMSM (N = 156), the current study examined the effect of internalized stigma on HIV status disclosure to sexual partners, which can inform sexual decision-making in serodiscordant couples, and HIV status disclosure to family members, which can be beneficial in minimizing the psychological distress associated with HIV. Results revealed that greater internalized stigma was associated with less HIV status disclosure to participants last sexual partner and to family members. Findings from this study provide evidence that internalized negative beliefs about ones HIV status are linked to adverse interpersonal consequences. Implications of these findings are discussed with regard to prevention and intervention efforts to reduce HIV stigmatization. PMID:23006008

Overstreet, Nicole M.; Earnshaw, Valerie A.; Kalichman, Seth C.; Quinn, Diane M.

2014-01-01

28

TITLE: USES AND DISCLOSURES OF HIV/AIDS INFORMATION Columbia University Medical Center will use and disclose HIV/AIDS information in accordance  

E-print Network

patient, the patient's health care provider will obtain a written, informed consent from the patient to consent, the patient's health care provider will obtain a written informed consent from the person legally consent for the test has been received. b. The informed consent for an HIV-related test will include

Columbia University

29

HIV status, gender, and marriage dynamics among adults in Rural Malawi.  

PubMed

Awareness of and responses to HIV health risks stemming from relations between sexual partners have been well documented in sub-Saharan Africa, but few studies have estimated the effects of observed HIV status on marriage decisions and outcomes. We study marriage dissolution and remarriage in rural Malawi using longitudinal data with repeated HIV and marital status measurements. Results indicate that HIV-positive individuals face greater risks of union dissolution (via both widowhood and divorce) and lower remarriage rates. Modeling studies suggest that the exclusion of HIV-positive individuals from the marriage or partnership pools will reduce the spread of HIV. PMID:25469927

Anglewicz, Philip; Reniers, Georges

2014-12-01

30

HIV Risk Perception among HIV Negative or Status-Unknown Men Who Have Sex with Men in China  

PubMed Central

Objective. To evaluate HIV risk perception and its associated factors among Chinese MSM. Methods. A cross-sectional study was conducted among MSM with an HIV negative or unknown status in Beijing, China, between 2011 and 2012. A questionnaire interview was conducted and a blood sample was collected for HIV and syphilis testing. Results. Of 887 MSM who reported they were HIV negative or did not know their HIV status before recruitment, only 7.3% reported a high risk of HIV infection, 28.0% medium risk, 52.2% low risk, and 12.5% no risk. In multivariate logistic regression models using those who reported a medium self-perceived risk as a reference group, self-reported high risk of HIV perception was associated with minority ethnicity (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.038.19), self-reported history of sexually transmitted diseases (OR: 2.27; 95% CI: 1.254.10), and HIV testing times since the last HIV testing (OR: 0.47; 95% CI: 0.260.84); low self-perceived risk of HIV infection was related to full-time employment (OR: 1.58; 95% CI: 1.152.18) and illicit drug use (OR: 0.28; 95% CI: 0.100.75). Conclusions. The HIV/AIDS epidemic is rapidly rising among Beijing MSM, but more than half MSM did not perceive this risk. PMID:24795880

Fan, Wensheng; Yin, Lu; Li, Dongliang; Shao, Yiming; Vermund, Sten H.; Ruan, Yuhua; Zhang, Zheng

2014-01-01

31

Brain Microbial Populations in HIV/AIDS: ?-Proteobacteria Predominate Independent of Host Immune Status  

PubMed Central

The brain is assumed to be a sterile organ in the absence of disease although the impact of immune disruption is uncertain in terms of brain microbial diversity or quantity. To investigate microbial diversity and quantity in the brain, the profile of infectious agents was examined in pathologically normal and abnormal brains from persons with HIV/AIDS [HIV] (n?=?12), other disease controls [ODC] (n?=?14) and in cerebral surgical resections for epilepsy [SURG] (n?=?6). Deep sequencing of cerebral white matter-derived RNA from the HIV (n?=?4) and ODC (n?=?4) patients and SURG (n?=?2) groups revealed bacterially-encoded 16 s RNA sequences in all brain specimens with ?-proteobacteria representing over 70% of bacterial sequences while the other 30% of bacterial classes varied widely. Bacterial rRNA was detected in white matter glial cells by in situ hybridization and peptidoglycan immunoreactivity was also localized principally in glia in human brains. Analyses of amplified bacterial 16 s rRNA sequences disclosed that Proteobacteria was the principal bacterial phylum in all human brain samples with similar bacterial rRNA quantities in HIV and ODC groups despite increased host neuroimmune responses in the HIV group. Exogenous viruses including bacteriophage and human herpes viruses-4, -5 and -6 were detected variably in autopsied brains from both clinical groups. Brains from SIV- and SHIV-infected macaques displayed a profile of bacterial phyla also dominated by Proteobacteria but bacterial sequences were not detected in experimentally FIV-infected cat or RAG1?/? mouse brains. Intracerebral implantation of human brain homogenates into RAG1?/? mice revealed a preponderance of ?-proteobacteria 16 s RNA sequences in the brains of recipient mice at 7 weeks post-implantation, which was abrogated by prior heat-treatment of the brain homogenate. Thus, ?-proteobacteria represented the major bacterial component of the primate brains microbiome regardless of underlying immune status, which could be transferred into nave hosts leading to microbial persistence in the brain. PMID:23355888

Branton, William G.; Ellestad, Kristofor K.; Maingat, Ferdinand; Wheatley, B. Matt; Rud, Erling; Warren, Ren L.; Holt, Robert A.; Surette, Michael G.; Power, Christopher

2013-01-01

32

An Investigation of Irrational Beliefs and Death Anxiety as a Function of HIV Status  

Microsoft Academic Search

The present study investigated the relationship of irrational beliefs and death anxiety as a function of human immunodeficiency virus (HIV) status in homosexual and bisexual men. Recruited for this study were 101 HIV-seropositive participants (34 asymptomatic, 30 symptomatic, and 37 symptomatic and diagnosed with AIDS) and a contrast group (40 HIV-seronegative). In the primary analysis, HIV-negative participants in this study

Jeffrey W. Braunstein

2004-01-01

33

Combined effects of HIV-infection status and psychosocial vulnerability on mental health in homosexual men  

Microsoft Academic Search

The present study examines psychiatric symptomatology and syndromal depression among 174 HIV+ and 760 HIV? homosexual men\\u000a enrolled in the Pittsburgh site of the Multicenter AIDS Cohort Study (MACS). A central study goal was to determine whether\\u000a men's psychosocial status in the areas of demographics, social supports, and coping, in combination with their HIV-infection\\u000a status, was associated with mental health.

W. C. Dickey; M. A. Dew; J. T. Becker; L. Kingsley

1999-01-01

34

High-risk behaviours and associated factors among HIV-positive individuals in clinical care in southwest Ethiopia.  

PubMed

A hospital-based cross-sectional survey was conducted among 705 HIV-positive individuals. The result showed that 24% of the participants reported unprotected intercourse in their most recent sexual episode. Nine percent of these events were with partners perceived to be HIV-negative and 39% with those of unknown HIV status. Protected sex at recent episode was independently associated with knowing a partner's HIV status, disclosing HIV status to a partner, receipt of antiretroviral treatment and perceiving HIV as less stigmatizing. This highlights the need for interventions among HIV-positive individuals that will assist them in attaining and maintaining safer sex practices. PMID:18820197

Deribe, Kebede; Woldemichael, Kifle; Wondafrash, Mekitie; Haile, Amaha; Amberbir, Alemayehu

2008-10-01

35

Correlates of HIV infection and being unaware of HIV status among soon-to-be-released Ukrainian prisoners  

PubMed Central

Introduction Prisoners bear a disproportionate burden of Ukraine's volatile and transitional HIV epidemic, yet little is known in Eastern Europe about HIV testing, treatment and HIV-related risk among prisoners. Methods A nationally representative biobehavioural health survey linked with serological testing was conducted among soon-to-be released prisoners in 13 Ukrainian prisons from June to November 2011. Results Among 402 participants, 78 (19.4%) tested HIV seropositive of whom 38 (50.7%) were previously unaware of their HIV status. Independent correlates of HIV infection included drug injection (AOR=4.26; 95% CI: 2.238.15), female gender (AOR=2.00; 95% CI: 1.063.78), previous incarceration (AOR=1.99; 95% CI: 1.073.70) and being from Southern Ukraine (AOR=5.46; 95% CI: 2.2113.46). Those aware of being HIV-positive reported significantly more pre-incarceration sex- and drug-related HIV risk behaviours than those who were unaware. Conclusions Routine rather than risk-based HIV testing and expansion of opioid substitution and antiretroviral therapy among prisoners is urgently needed to reduce HIV transmission in volatile transitional HIV epidemics. PMID:25216073

Azbel, Lyuba; Wickersham, Jeffrey A; Grishaev, Yevgeny; Dvoryak, Sergey; Altice, Frederick L

2014-01-01

36

Conflicting Messages: How Criminal HIV Disclosure Laws Undermine Public Health Efforts to Control the Spread of HIV  

Microsoft Academic Search

Twenty-three U.S. states currently have laws that make it a crime for persons who have HIV to engage in various sexual behaviors without, in most cases, disclosing their HIV-positive status to prospective sex partners. As structural interventions aimed at reducing new HIV infections, the laws ideally should complement the HIV prevention efforts of public health professionals. Unfortunately, they do not.

Carol L. Galletly; Steven D. Pinkerton

2006-01-01

37

The status of HIV prevention efforts for women in correctional facilities.  

PubMed

In the United States, women are a significant proportion of the correctional population. Women also account for an increasing proportion of newly diagnosed human immunodeficiency virus (HIV) cases. When compared with white women, black women have higher incarceration rates and represent more of the newly diagnosed HIV cases. Correctional facilities offer an opportunity to provide women with HIV testing and prevention services so that they will know their status and receive HIV/sexually transmitted disease (STD) risk-reduction counseling and other preventive services. In this report, we describe incarcerated population statistics and HIV surveillance epidemiology for women. We also describe HIV prevention activities undertaken by the Centers for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Additional research, program development, and implementation are needed to improve HIV prevention efforts for high-risk women. PMID:24116966

Fleming, Eleanor B; LeBlanc, Tanya Telfair; Reid, Laurie C

2013-12-01

38

Weighing the Consequences: Self-Disclosure of HIV-Positive Status among African American Injection Drug Users  

ERIC Educational Resources Information Center

Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV

Valle, Maribel; Levy, Judith

2009-01-01

39

Brief research report: sociodemographic factors associated with HIV status among African American women in Washington, DC  

PubMed Central

Introduction African American women living in Washington, DC have one of the highest Human immunodeficiency virus (HIV) incidence rates in the US. However, this population has been understudied, especially as it relates to factors associated with HIV status. Methods This cross-sectional study examined sociodemographic factors that were associated with having a negative or positive HIV status among a sample of 115 African American women between the ages of 24 and 44 years. We assessed such factors as age, education, sexual orientation, household income, sources of income, number of children, length of residency tenure in Washington, DC, and level of HIV-prevention knowledge. Results Among the overall sample, 53 women self-identified as HIV-positive and 62 as HIV-negative. Compared to their HIV-negative counterparts, women who reported being HIV-positive were less educated, had lower household income, and had longer residency tenure in Washington, DC. There were no differences in HIV knowledge between HIV-positive and -negative study participants. Conclusion These findings may provide important directions for targeting specific subpopulations of African Americans for HIV-prevention/intervention programs. PMID:24082794

Perkins, Emory L; Voisin, Dexter R; Stennis, Kesslyn A Brade

2013-01-01

40

Vitamin D Status of HIV-Infected Women and Its Association with HIV Disease Progression, Anemia, and Mortality  

PubMed Central

Background Vitamin D has a potential role in slowing HIV disease progression and preventing mortality based on its extensive involvement in the immune system; however, this relationship has not been examined in large studies or in resource-limited settings. Methodology/Principal Findings Vitamin D levels were assessed in 884 HIV-infected pregnant women at enrollment in a trial of multivitamin supplementation (not including vitamin D) in Tanzania. Women were followed up for a median of 69.5 months, and information on hemoglobin levels, HIV disease progression, and mortality was recorded. Proportional hazard models and generalized estimating equations were used to assess the relationship of these outcomes with vitamin D status. Conclusions/Significance Low vitamin D status (serum 25-hydroxyvitamin D<32ng/mL) was significantly associated with progression to WHO HIV disease stage III or greater in multivariate models (incidence rate ratio [RR]: 1.25; 95% confidence intervals [CI]: 1.05, 1.50). No significant relationship was observed between vitamin D status and T-cell counts during follow-up. Women with low vitamin D status had 46% higher risk of developing severe anemia during follow-up, compared to women with adequate vitamin D levels (RR: 1.46; 95% CI: 1.09, 1.96). Women in the highest vitamin D quintile had a 42% lower risk of all-cause mortality, compared to the lowest quintile (RR: 0.58; 95% CI: 0.40, 0.84). Vitamin D status had a protective association with HIV disease progression, all-cause mortality, and development of anemia during follow-up in HIV-infected women. If confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to prolonging the time to initiation of antiretroviral therapy in HIV-infected patients, particularly in resource-limited settings. PMID:20098738

Mehta, Saurabh; Giovannucci, Edward; Mugusi, Ferdinand M.; Spiegelman, Donna; Aboud, Said; Hertzmark, Ellen; Msamanga, Gernard I.; Hunter, David; Fawzi, Wafaie W.

2010-01-01

41

Relationship between socioeconomic status and HIV infection in a rural tertiary health center  

PubMed Central

Background There is a scarcity of data in rural health centers in Nigeria regarding the relationship between socioeconomic status (SES) and HIV infection. We investigated this relationship using indicators of SES. Methods An analytical case-control study was conducted in the HIV clinic of a rural tertiary health center. Data collection included demographic variables, educational attainment, employment status, monthly income, marital status, and religion. HIV was diagnosed by conventional methods. Data were analyzed with the SPSS version 16 software. Results A total of 115 (48.5%) HIV-negative subjects with a mean age of 35.497.63 years (range: 1554 years), and 122 (51.5%) HIV-positive subjects with a mean age of 36.358.31 years (range: 1553 years) were involved in the study. Participants consisted of 47 (40.9%) men and 68 (59.1%) women who were HIV negative. Those who were HIV positive consisted of 35 (28.7%) men and 87 (71.3%) women. Attainment of secondary school levels of education, and all categories of monthly income showed statistically significant relationships with HIV infection (P=0.018 and P<0.05, respectively) after analysis using a logistic regression model. Employment status did not show any significant relationship with HIV infection. Conclusion Our findings suggested that some indicators of SES are differently related to HIV infection. Prevalent HIV infections are now concentrated among those with low incomes. Urgent measures to improve HIV prevention among low income earners are necessary. Further research in this area requires multiple measures in relation to partners SES (measured by education, employment, and income) to further define this relationship. PMID:24790469

Ogunmola, Olarinde Jeffrey; Oladosu, Yusuf Olatunji; Olamoyegun, Michael Adeyemi

2014-01-01

42

Hiv status and union dissolution in Sub-saharan Africa: The case of Rakai, Uganda  

Microsoft Academic Search

Little is known about the impact of HIV infection on the disruption of families through separation, divorce, and widowhood.\\u000a Using life tables and multinomial logistic regression, this research examined the influence of HIV status on the risk of separation\\u000a or divorce and widowhood among women in Rakai, Uganda. The multivariate results revealed that dissolution is more common among\\u000a HIV-infected women

Laura Porter; Lingxin Hao; David Bishai; David Serwadda; Maria J. Wawer; Thomas Lutalo; Ronald H. Gray

2004-01-01

43

Women's Disclosure of HIV Status: Experiences of Mistreatment and Violence in an Urban Setting  

Microsoft Academic Search

Women represent an increasing proportion of AIDS cases and anecdotal reports suggest some face substantial risks when others learn they are HIV-positive. The purpose of this paper is to describe women's fears and experiences regarding disclosure of their HIV status. Fifty HIV-positive women, ages 1645 from urban teaching hospital outpatient clinics, were interviewed using an in-depth, qualitative interview. Eighty-six percent

Andrea Carlson Gielen; Patricia OCampo; Ruth R. Faden; Agatha Eke

1997-01-01

44

The longitudinal and interactive effects of HIV status, stimulant use, and host genotype upon neurocognitive functioning.  

PubMed

Both human immunodeficiency virus (HIV)-1 infection and illicit stimulant use can adversely impact neurocognitive functioning, and these effects can be additive. However, significant variability exists such that as-of-yet unidentified exogenous and endogenous factors affect one's risk for neurocognitive impairment. Literature on both HIV and stimulant use indicates that host genetic variants in immunologic and dopamine-related genes are one such factor. In this study, the individual and interactive effects of HIV status, stimulant use, and genotype upon neurocognitive functioning were examined longitudinally over a 10-year period. Nine hundred fifty-two Caucasian HIV+ and HIV- cases from the Multicenter AIDS Cohort Study were included. All cases had at least two comprehensive neurocognitive evaluations between 1985 and 1995. Pre-highly active antiretroviral therapy (HAART) data were examined in order to avoid the confounding effect of variable drug regimens. Linear mixed models were used, with neurocognitive domain scores as the outcome variables. No four-way interactions were found, indicating that HIV and stimulant use do not interact over time to affect neurocognitive functioning as a function of genotype. Multiple three-way interactions were found that involved genotype and HIV status. All immunologically related genes found to interact with HIV status affected neurocognitive functioning in the expected direction; however, only C-C chemokine ligand 2 (CCL2) and CCL3 affected HIV+ individuals specifically. Dopamine-related genetic variants generally affected HIV-negative individuals only. Neurocognitive functioning among HIV+ individuals who also used stimulants was not significantly different from those who did not use stimulants. The findings support the role of immunologically related genetic differences in CCL2 and CCL3 in neurocognitive functioning among HIV+ individuals; however, their impact is minor. Being consistent with findings from another cohort, dopamine (DA)-related genetic differences do not appear to impact the longitudinal neurocognitive functioning of HIV+ individuals. PMID:24737013

Levine, Andrew J; Reynolds, Sandra; Cox, Christopher; Miller, Eric N; Sinsheimer, Janet S; Becker, James T; Martin, Eileen; Sacktor, Ned

2014-06-01

45

Cervical Dysplasia in HIV-Seropositive Women: Role of Human Papillomavirus Infection and Immune Status  

Microsoft Academic Search

Objective: In the present study we investigated the cytologic and colposcopic characteristics of a cohort of HIV-infected women, with the aim to determine a relationship between immunologic status and frequency and\\/or severity of cervical abnormalities. Materials and Methods: 21 women, who tested positive for the HIV antibody and who were admitted as outpatients because of various gynecologic complications or because

G. G. Garzetti; A. Ciavattini; L. Butini; A. Vecchi; M. Montroni

1995-01-01

46

Causes of hyperferritinaemia classified by HIV status in a tertiary-care setting in South Africa.  

PubMed

This study included all patients, with known HIV-1 status, admitted to hospital over a 5-year period with serum ferritin values exceeding 1500 ?g/l. Markedly elevated serum ferritin levels are associated with a host of causes which poses a diagnostic dilemma, as the aetiology is often highly dependent on local epidemiology. We evaluated patients' records retrospectively to determine underlying causes of possible hyperferritinaemia. Aetiologies associated with hyperferritinaemia varied significantly depending on HIV-1 status. In patients infected with the HIV-1 virus, infectious causes predominated with Mycobacterium tuberculosis accounting for more than 50% of the patient population with an odds ratio of 1798 (95% confidence interval 831-3888) in HIV-positive compared to HIV-negative patients. Of the HIV-1-negative patients, hereditary haemochromatosis accounted for less than 2% of patients and chronic renal failure was the most common diagnosis. The finding of hyperferritinaemia should prompt determination of HIV-1 status, as this impacts significantly on aetiological epidemiology. In HIV-1-positive patients, aggressive investigation for mycobacterial infection should be undertaken in cases of combined hyperferritinaemia and positive HIV-1 serology. PMID:22417736

Visser, A; Mostert, C

2013-01-01

47

Effects of HIV Infection on the Metabolic and Hormonal Status of Children with Severe Acute Malnutrition  

PubMed Central

Background HIV infection occurs in 30% of children with severe acute malnutrition in sub-Saharan Africa. Effects of HIV on the pathophysiology and recovery from malnutrition are poorly understood. Methods We conducted a prospective cohort study of 75 severely malnourished Ugandan children. HIV status/CD4 counts were assessed at baseline; auxologic data and blood samples were obtained at admission and after 14 days of inpatient treatment. We utilized metabolomic profiling to characterize effects of HIV infection on metabolic status and subsequent responses to nutritional therapy. Findings At admission, patients (mean age 16.3 mo) had growth failure (mean W/H z-score ?4.27 in non-edematous patients) that improved with formula feeding (mean increase 1.00). 24% (18/75) were HIV-infected. Nine children died within the first 14 days of hospitalization; mortality was higher for HIV-infected patients (33% v. 5%, OR?=?8.83). HIV-infected and HIV-negative children presented with elevated NEFA, ketones, and even-numbered acylcarnitines and reductions in albumin and amino acids. Leptin, adiponectin, insulin, and IGF-1 levels were low while growth hormone, cortisol, and ghrelin levels were high. At baseline, HIV-infected patients had higher triglycerides, ketones, and even-chain acylcarnitines and lower leptin and adiponectin levels than HIV-negative patients. Leptin levels rose in all patients following nutritional intervention, but adiponectin levels remained depressed in HIV-infected children. Baseline hypoleptinemia and hypoadiponectinemia were associated with increased mortality. Conclusions Our findings suggest a critical interplay between HIV infection and adipose tissue storage and function in the adaptation to malnutrition. Hypoleptinemia and hypoadiponectinemia may contribute to high mortality rates among malnourished, HIV-infected children. PMID:25050734

Hornik, Christoph P.; Kiyimba, Tonny; Bain, James; Muehlbauer, Michael; Kiboneka, Elizabeth; Stevens, Robert; St. Peter, John V.; Newgard, Christopher B.; Bartlett, John; Freemark, Michael

2014-01-01

48

Maternal Substance Use and HIV Status: Adolescent Risk and Resilience  

ERIC Educational Resources Information Center

We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in

Leonard, Noelle R.; Gwadz, Marya Viorst; Cleland, Charles M.; Vekaria, Pooja C.; Ferns, Bill

2008-01-01

49

Cardiovascular status of infants and children of women infected with HIV-1 (P2C2 HIV): a cohort study  

PubMed Central

Summary Background Data from cross-sectional and short-term longitudinal studies have suggested that children infected with HIV-1 might have cardiovascular abnormalities. We aimed to investigate this hypothesis in a long-term cohort study. Methods We measured cardiovascular function every 46 months for up to 5 years in a birth cohort of 600 infants born to women infected with HIV-1. We included 93 infants infected with HIV-1 and 463 uninfected infants (internal controls) from the same cohort. We also included a cross-sectionally measured comparison group of 195 healthy children born to mothers who were not infected with HIV-1 (external controls). Findings Children infected with HIV-1 had a significantly higher heart rate at all ages (mean difference 10 bpm, 95% CI 813) than internal controls. At birth, both cohort groups of children had similar low left ventricular (LV) fractional shortening. At 8 months, fractional shortening was similar in internal and external controls, whereas in children infected with HIV-1, fractional shortening remained significantly lower than in controls for the first 20 months of life (mean difference from internal controls at 8 months 37%, 2351). LV mass was similar at birth in both cohort groups, but became significantly higher in children with HIV-1 from 430 months (mean difference 24 g at 8 months, 0939). Conclusions Vertically-transmitted HIV-1 infection is associated with persistent cardiovascular abnormalities identifiable shortly after birth. Irrespective of their HIV-1 status, infants born to women infected with HIV-1 have significantly worse cardiac function than other infants, suggesting that the uterine environment has an important role in postnatal cardiovascular abnormalities. PMID:12241776

Lipshultz, Steven E; Easley, Kirk A; Orav, E John; Kaplan, Samuel; Starc, Thomas J; Bricker, J Timothy; Lai, Wyman W; Moodie, Douglas S; Sopko, George; Schluchter, Mark D; Colan, Steven D

2014-01-01

50

Depression in Caregivers of Status-Nave Pediatric HIV Patients Participating in a Status Disclosure Study in Haiti and the Dominican Republic: Preliminary Report.  

PubMed

A pilot study is underway to assess safety and acceptability of an intervention to disclose their HIV infection status to status-nave pediatric antiretroviral therapy patients in Hispaniola [the island shared by Haiti and the Dominican Republic (DR)]. Of 22 Haiti and 47 DR caregivers recruited to date, 68.2% Haiti and 34.0% DR caregivers had clinically significant depressive symptomatology at the time of enrollment (p = 0.008). Depressive symptom prevalence was higher in Haiti caregivers who were female (81.3% vs. 0 in males; p = 0.02) and in DR caregivers who were patients' mothers (50.0%) or grandmothers (66.7%; 56.0% combined) than others (9.1%), (p < 0.001). Internalized stigma was more commonly reported by Haiti (85.7%) than DR (53.2%; p = 0.01) caregivers; 56.4% of Haiti and DR caregivers reporting internalized stigma vs. 26.1% of caregivers denying it had depressive symptoms (p = 0.02). Depression is common in Hispaniola caregivers possibly affecting disclosure timing. Study participation presents opportunities for addressing caregiver depression. PMID:25389181

Beck-Sagu, Consuelo M; Dvieux, Jessy G; Pinzn-Iregui, Mara Claudia; Abreu-Prez, Rosa; Lerebours-Nadal, Leonel; Gaston, Stephanie; Dean, Andrew G; Halpern, Mina; Rouzier, Vanessa; Bertrand, Rachel; Rosenberg, Rhonda; Pape, Jean William; Nicholas, Stephen W; Blasini, Ileana

2015-02-01

51

Rethinking HIV/AID Disclosure Among Women Within the Context of Motherhood in South Africa  

PubMed Central

This qualitative study explored whether motherhood plays a role in influencing decisions to conceal or reveal knowledge of seropositive status among women living with HIV/AIDS in 2 South African communities: Gugulethu and Mitchell's Plain. Using the PEN-3 cultural model, we explored how HIV-positive women disclose their status to their mothers and how HIV-positive mothers make decisions about disclosure of their seropositive status. Our findings revealed 3 themes: the positive consequences of disclosing to mothers, how being a mother influences disclosure (existential role of motherhood), and the cost of disclosing to mothers (negative consequences). The findings highlight the importance of motherhood in shaping decisions to reveal or conceal knowledge of seropositive status. Implications for interventions on HIV/AIDS prevention, care, and support are discussed. PMID:20558809

Zungu, Nompumelelo; Airhihenbuwa, Collins O.

2010-01-01

52

Retrospective determination of HIV-1 status by a PCR method on paraffin wax embedded sections.  

PubMed Central

AIM--To develop a simple but reliable polymerase chain reaction (PCR) method to determine the HIV-1 status of patients on formalin fixed, paraffin wax embedded lymph node tissue. METHODS--Fifty lymph node specimens, 20 from HIV-1 seropositive and 30 from HIV-1 seronegative patients, were analysed. Lymph nodes with a variety of disease conditions were included in the study. Tissue sections were treated with a DNA extraction buffer containing proteinase K and the crude cell lysate was used in PCR analysis. Nested primers were used to amplify HIV-1 DNA sequences coding for gag, pol and env proteins. PCR products were demonstrated by polyacrylamide gel electrophoresis. Results were then compared with HIV-1 serology of the patients from whom the tissue was obtained. RESULTS--The PCR method yielded a specificity of 100%, a sensitivity of 95%, a positive predictive value of 100%, and a negative predictive value of 97% when compared with HIV-1 serology. The kappa statistic (0.958) showed an excellent agreement between the PCR method and serology. Furthermore, HIV-1 DNA was demonstrated in lymph node tissue from a serologically unconfirmed acquired immunodeficiency syndrome case necropsied in 1982. CONCLUSION--This PCR method is a simple and reliable means of retrospectively determining the HIV-1 status of patients using formalin fixed, paraffin wax embedded lymph node tissue. PMID:7560200

Slavik, T; Wolfaardt, M; van Zyl, H; Simson, I W

1995-01-01

53

Association between fertility and HIV status: what implications for HIV estimates?  

Microsoft Academic Search

BACKGROUND: Most estimates of HIV prevalence have been based on sentinel surveillance of pregnant women which may either under-estimate or over-estimate the actual prevalence in adult female population. One situation which can lead to either an underestimate or an overestimate of the actual HIV prevalence is where there is a significant difference in fertility rates between HIV-positive and HIV-negative women.

Eugene J Kongnyuy; Charles S Wiysonge

2008-01-01

54

Correlates of HIV Status Among Injection Drug Users in a Border Region of Southern China and Northern Vietnam  

Microsoft Academic Search

Summary: This article presents an analysis of the correlates of HIV status among samples of injection drug users (IDUs) in Lang Son Province, Vietnam (n = 348), and Ning Ming County, Guangxi Province, China (n = 294), who were interviewed and tested for HIV antibody just before the start of a peer-based HIV prevention intervention in this border region. Participants

Theodore M. Hammett; Patrick Johnston; Ryan Kling; Wei Liu; Doan Ngu; Nguyen Duy Tung; Kieu Thanh Binh; Ha Viet Dong; Tran Vu Hoang; Ly Kieu Van; Meng Donghua; Yi Chen; Don C Des Jarlais

2005-01-01

55

Knowledge of HIV antibody status and decisions to continue or terminate pregnancy among intravenous drug users.  

PubMed

We studied decisions to continue or terminate pregnancy among human immunodeficiency virus (HIV)-seropositive (+) and -seronegative (-) intravenous drug users informed of HIV antibody status before 24 weeks' gestation. Fourteen (50%) of 28 HIV+ vs 16 (44%) of 36 HIV- women chose to terminate their pregnancies. In retrospective interviews, HIV+ women were more likely to have perceived their risk of perinatal HIV transmission to be greater than or equal to 50% and, among those who terminated pregnancy, to cite this concern as an important factor in their decision. However, decisions to terminate pregnancy were predicted more readily by pregnancy-related variables such as prior elective abortion, a negative emotional reaction to pregnancy, and whether the pregnancy had been unplanned. Women who were HIV+ and chose to continue their pregnancies cited the desire for a child, religious beliefs, and family pressure as the most important factors in their decisions. Results indicate that while concerns about perinatal transmission of HIV may lead to decisions to terminate pregnancy in certain cases, there may be other determinants of pregnancy decisions in this population. Counseling of HIV-infected women must address not only perinatal transmission but also the sociocultural and behavioral context in which pregnancy decision making takes place. PMID:2724503

Selwyn, P A; Carter, R J; Schoenbaum, E E; Robertson, V J; Klein, R S; Rogers, M F

56

The Relationship between Housing Status and HIV Risk among Active Drug Users: A Qualitative Analysis  

PubMed Central

This paper examines the relationship between housing status and HIV risk using longitudinal, qualitative data collected in 2004-2005, from a purposeful sample of 65 active drug users in a variety of housed and homeless situations in Hartford, Connecticut. These data were supplemented with observations and in-depth interviews regarding drug use behavior collected in 2001-2005 to evaluate a peer-led HIV prevention intervention. Data reveal differences in social context within and among different housing statuses that affect HIV risky or protective behaviors including the ability to carry drug paraphernalia and HIV prevention materials, the amount of drugs in the immediate environment, access to subsidized and supportive housing, and relationships with others with whom drug users live. Policy implications of the findings, limitations to the data and future research are discussed. PMID:19142817

Dickson-Gomez, Julia; Hilario, Helena; Convey, Mark; Corbett, A. Michelle; Weeks, Margaret; Martinez, Maria

2009-01-01

57

Oral Health Status and Oromucosal Lesions in Patients Living with HIV/AIDS in India: A Comparative Study  

PubMed Central

Oral health status of HIV positive individuals is in poor condition which may be a sequela of variety of factors. This study was aimed at assessing and comparing the oral health status and oromucosal lesions between HIV positive and negative individuals in India. A total of 126 HIV positive and 532 HIV negative individuals were recruited for the study. Oral health status and oromucosal lesions were recorded using WHO oral health assessment form (1997). Data was analyzed using chi-square and independent sample student's t test. Majority (85.7%) of people suffering from HIV belonged to lower socioeconomic status. The mean for DMFT score was found to be significantly higher in HIV positive individuals (12.83 9.6) as compared to HIV negative individuals (8.34 7.6) (P value < 0.0001). Nearly 75% of HIV positive individuals showed oromucosal lesions with candidiasis (36%) being the most common. Nearly 50% of HIV positive individuals had community periodontal index (CPI) and loss of attachment (LOA) score >2. In conclusion HIV positive individuals have poor oral health status and poor periodontal status compared to control group. Effective policies need to be drafted to take care of the oral health of this high risk group. PMID:25215229

Mishra, Prashant; Warhekar, Shilpa; Airen, Bhuvnesh; Jain, Deepika; Godha, Shaijal

2014-01-01

58

Molecular Characterization of Ambiguous Mutations in HIV-1 Polymerase Gene: Implications for Monitoring HIV Infection Status and Drug Resistance  

PubMed Central

Detection of recent HIV infections is a prerequisite for reliable estimations of transmitted HIV drug resistance (t-HIVDR) and incidence. However, accurately identifying recent HIV infection is challenging due partially to the limitations of current serological tests. Ambiguous nucleotides are newly emerged mutations in quasispecies, and accumulate by time of viral infection. We utilized ambiguous mutations to establish a measurement for detecting recent HIV infection and monitoring early HIVDR development. Ambiguous nucleotides were extracted from HIV-1 pol-gene sequences in the datasets of recent (HIVDR threshold surveys [HIVDR-TS] in 7 countries; n=416) and established infections (1 HIVDR monitoring survey at baseline; n=271). An ambiguous mutation index of 2.0410-3 nts/site was detected in HIV-1 recent infections which is equivalent to the HIV-1 substitution rate (210-3 nts/site/year) reported before. However, significantly higher index (14.4110-3 nts/site) was revealed with established infections. Using this substitution rate, 75.2% subjects in HIVDR-TS with the exception of the Vietnam dataset and 3.3% those in HIVDR-baseline were classified as recent infection within one year. We also calculated mutation scores at amino acid level at HIVDR sites based on ambiguous or fitted mutations. The overall mutation scores caused by ambiguous mutations increased (0.5410-23.4810-2/DR-site) whereas those caused by fitted mutations remained stable (7.50-7.8910-2/DR-site) in both recent and established infections, indicating that t-HIVDR exists in drug-nave populations regardless of infection status in which new HIVDR continues to emerge. Our findings suggest that characterization of ambiguous mutations in HIV may serve as an additional tool to differentiate recent from established infections and to monitor HIVDR emergence. PMID:24147046

Zheng, Du-Ping; Rodrigues, Margarida; Bile, Ebi; Nguyen, Duc B.; Diallo, Karidia; DeVos, Joshua R.; Nkengasong, John N.; Yang, Chunfu

2013-01-01

59

Association of Toll-like receptor polymorphisms with HIV status in North Americans.  

PubMed

Single-nucleotide polymorphisms (SNPs) in Toll-like receptor (TLR) genes TLR2-4 and TLR7-9, but not in TLR1 and TLR6, have been previously evaluated regarding human immunodeficiency virus (HIV) acquisition and disease progression in various populations, most of which were European. In this study, we examined associations between a total of 41 SNPs in 8 TLR genes (TLR1-4, TLR6-9) and HIV status in North American subjects (total n=276 (Caucasian, n=102; African American, n=150; other, n=24)). Stratification of the data by self-identified race revealed that a total of nine SNPs in TLR1, TLR4, TLR6 and TLR8 in Caucasians, and two other SNPs, one each in TLR4 and TLR8, in African Americans were significantly associated with HIV status at P<0.05. Concordant with the odds ratios of these SNPs, significant differences were observed in the SNP allele frequencies between HIV+ and HIV- subjects. Finally, in Caucasians, certain haplotypes of single (TLR1 and TLR4) and heterodimer (TLR2_TLR6) genes may be inferred as 'susceptible' or 'protective'. Our study provides in-depth insight into the associations between TLR variants, particularly TLR1 and TLR6, and HIV status in North Americans, and suggests that these associations may be race specific. PMID:25253287

Willie, B; Hall, N B; Stein, C M; Jurevic, R J; Weinberg, A; Mehlotra, R K; Zimmerman, P A

2014-12-01

60

Matrix metalloproteinase levels in early HIV infection and relation to in vivo brain status  

PubMed Central

Background Matrix metalloproteinases (MMPs) have been implicated in HIV associated neurological injury; however, this relationship has not been studied early in infection. Methods Plasma levels of MMP-1, -2, -7, -9, and -10 measured using Luminex technology were compared in 52 HIV and 21 seronegative participants of the Chicago Early HIV Infection study. MMP levels were also examined in HIV subgroups defined by antibody reactivity, viremia, and antiretroviral status, as well as in available CSF samples (n=9). MMPs were evaluated for patterns of relationship to cognitive function and to quantitative magnetic resonance measurements of the brain derived in vivo. Results Plasma MMP-2 levels were significantly reduced in early HIV infection and correlated with altered white matter integrity and atrophic brain changes. MMP-9 levels were higher in the treated than nave HIV subgroup. Only MMP-2 and -9 were detected in CSF; CSF MMP-2 correlated with white matter integrity and with volumetric changes in basal ganglia. Relationships with cognitive function were also identified. Conclusions MMP-2 levels in plasma and in CSF correspond to early changes in brain structure and function. These findings establish a link between MMPs and neurological status previously unidentified in early HIV infection. PMID:23979706

Li, Suyang; Wu, Ying; Keating, Sheila M.; Du, Hongyan; Sammet, Christina L.; Zadikoff, Cindy; Mahadevia, Riti; Epstein, Leon G.; Ragin, Ann B.

2013-01-01

61

The Impact of Married Individuals Learning HIV Status in Malawi: Divorce, Number of Sexual Partners, and Condom Use With Spouses.  

PubMed

This article assesses how married individuals' knowledge of HIV status gained through HIV testing and counseling (HTC) affects divorce, the number of sexual partners, and the use of condoms within marriage. This study improves upon previous studies on this topic because the randomized incentives affecting the propensity to be tested for HIV permit control for selective testing. Instrumental variable probit and linear models are estimated, using a randomized experiment administered as part of the Malawi Longitudinal Study of Families and Health (MLSFH). The results indicate that knowledge of HIV status (1) does not affect chances of divorce for either HIV-negative or HIV-positive respondents; (2) reduces the number of reported sexual partners among HIV-positive respondents; and (3) increases reported condom use with spouses for both HIV-negative and HIV-positive respondents. These results imply that individuals actively respond to information about their HIV status that they learn during HTC, invoking protective behavior against future risk of HIV/AIDS for themselves and their actual and potential sexual partners. Some limitations of this study are a small sample size for those who are HIV-positive and dependence on self-reported sexual behaviors. PMID:25582891

Fedor, Theresa M; Kohler, Hans-Peter; Behrman, Jere R

2015-02-01

62

Depression Treatment in HIV-infected and Uninfected Veterans: Do Treatment Rates Vary by HIV Status?.  

E-print Network

??Background: Despite a higher prevalence of depression among HIV-infected veterans, previous research has shown that infectious disease (ID) providers report substantially less comfort with depression (more)

Sueoka, Kristen

63

HIV-1, human interaction database: current status and new features.  

PubMed

The 'Human Immunodeficiency Virus Type 1 (HIV-1), Human Interaction Database', available through the National Library of Medicine at http://www.ncbi.nlm.nih.gov/genome/viruses/retroviruses/hiv-1/interactions, serves the scientific community exploring the discovery of novel HIV vaccine candidates and therapeutic targets. Each HIV-1 human protein interaction can be retrieved without restriction by web-based downloads and ftp protocols and includes: Reference Sequence (RefSeq) protein accession numbers, National Center for Biotechnology Information Gene identification numbers, brief descriptions of the interactions, searchable keywords for interactions and PubMed identification numbers (PMIDs) of journal articles describing the interactions. In addition to specific HIV-1 protein-human protein interactions, included are interaction effects upon HIV-1 replication resulting when individual human gene expression is blocked using siRNA. A total of 3142 human genes are described participating in 12 786 protein-protein interactions, along with 1316 replication interactions described for each of 1250 human genes identified using small interfering RNA (siRNA). Together the data identifies 4006 human genes involved in 14 102 interactions. With the inclusion of siRNA interactions we introduce a redesigned web interface to enhance viewing, filtering and downloading of the combined data set. PMID:25378338

Ako-Adjei, Danso; Fu, William; Wallin, Craig; Katz, Kenneth S; Song, Guangfeng; Darji, Dakshesh; Brister, J Rodney; Ptak, Roger G; Pruitt, Kim D

2015-01-28

64

Intimate Partner Violence after Disclosure of HIV Test Results among Pregnant Women in Harare, Zimbabwe  

PubMed Central

Background HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women. Methods In this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV. Results Over 93% (1817) disclosed the HIV results to their partners (96.5% HIV? vs. 89.3% HIV+, p<0.0001). Overall HIV prevalence was 15.3%, (95%CI:13.716.9), 35.2% among non-disclosers and 14.3% among disclosers. Overall 32.8% reported IPV (40.5% HIV+; 31.5% HIV? women, p?=?0.004). HIV status was associated with IPV (partially adjusted 1.43: (95%CI:1.002.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.317.80). Factors associated with IPV were gender inequity, past IPV, risky sexual behaviours and living with relatives. IPV after HIV disclosure in pregnancy is high but lower than and is strongly related with IPV before pregnancy (adjusted OR 6.18, 95%CI: 3.849.93). Conclusion The study demonstrates the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. Health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened. PMID:25350001

Shamu, Simukai; Zarowsky, Christina; Shefer, Tamara; Temmerman, Marleen; Abrahams, Naeemah

2014-01-01

65

HIV/AIDS Disclosure and Unprotected Sex: A Critical Issue for Counselors and Other Mental Health Practitioners  

ERIC Educational Resources Information Center

This study found that African American males living with HIV/AIDS in rural southwest Alabama who did not disclose their HIV/AIDS seropositive status were more likely to engage in unprotected sex. Because much of the recent research is slanted to address homosexual behavior, which is still a taboo within the African American community, efforts to

Clark, Eddie, Jr.

2006-01-01

66

Don't ask, don't tell: patterns of HIV disclosure among HIV positive men who have sex with men with recent STI practising high risk behaviour in Los Angeles and Seattle  

PubMed Central

Objectives: A high incidence of HIV continues among men who have sex with men (MSM) in industrialised nations and research indicates many MSM do not disclose their HIV status to sex partners. Themes as to why MSM attending sexually transmitted infection (STI) clinics in Los Angeles and Seattle do and do not disclose their HIV status are identified. Methods: 55 HIV positive MSM (24 in Seattle, 31 in Los Angeles) reporting recent STI or unprotected anal intercourse with a serostatus negative or unknown partner from STI clinics underwent in-depth interviews about their disclosure practices that were tape recorded, transcribed verbatim, coded, and content analysed. Results: HIV disclosure themes fell into a continuum from unlikely to likely. Themes for "unlikely to disclose" were HIV is "nobody's business," being in denial, having a low viral load, fear of rejection, "it's just sex," using drugs, and sex in public places. Themes for "possible disclosure" were type of sex practised and partners asking/disclosing first. Themes for "likely to disclose" were feelings for partner, feeling responsible for partner's health, and fearing arrest. Many reported non-verbal disclosure methods. Some thought partners should ask for HIV status; many assumed if not asked then their partner must be positive. Conclusions: HIV positive MSM's decision to disclose their HIV status to sex partners is complex, and is influenced by a sense of responsibility to partners, acceptance of being HIV positive, the perceived transmission risk, and the context and meaning of sex. Efforts to promote disclosure will need to address these complex issues. PMID:15572626

Gorbach, P; Galea, J; Amani, B; Shin, A; Celum, C; Kerndt, P; Golden, M

2004-01-01

67

HIV serostatus disclosure among people living with HIV/AIDS in Mwanza, Tanzania  

PubMed Central

Background Disclosing HIV serostatus is important for HIV prevention and maintenance of health for people living with HIV their spouses and the community, it plays a role in the social relation which is critical in reducing HIV transmission. The process may have positive and negative effects to the HIV infected people who disclose their status. The present study was undertaken to describe HIV serostatus disclosure among HIV infected people attending care and treatment clinic at Sekou-Toure hospital in Mwanza, Tanzania. Methods A cross-sectional study was carried out on 270 HIV infected adults attending Care and Treatment Clinic (CTC) at Sekou-Toure hospital between September and October, 2010. A Swahili questionnaire was used to obtain demographic and HIV disclosure information. Results Hundred and ninety five (72.5%) of all recruited participants were females, 88.1% (238/270) were aged above 30 years and 44.1% (119/270) were married. The prevalence of serostatus disclosure was 93.3% (252/270) with participants aged above 30 years having significantly higher proportion of serostatus disclosure compared to those aged below 30 years (94.5% vs. 84.4%, p?disclosed their status, 69.3% reported closeness to the disclosed person as the reason for disclosure while 25.8% (65/252) disclosed because they needed help. Two hundred (79.4%) reported to have received emotional support following disclosure while 25.8% and 29.7% received financial support and freedom to use their anti-retroviral drugs around the person they disclosed their status respectively. Thirty four participants reported to have been discriminated following disclosure and 12 participants reported to have been divorced. Conclusions Rate of disclosure of HIV serostatus was noted to be high in this study. Delayed disclosure was also noted in small proportion of participants. Negative outcomes following disclosure of serostatus were reported by participants. Efforts need to be increased to promote disclosure of HIV serostatus in Tanzania through health education and awareness for both HIV infected individuals and the community. PMID:24450933

2014-01-01

68

Factors associated with inconsistent condom use in adolescents with negative or unknown HIV status in Northwest Cameroon.  

PubMed

The purpose of this study is to evaluate the association between utilization of HIV testing and condom use amongst Cameroonian youths/adolescents who are not known to be HIV-infected. Worldwide, HIV is spreading most quickly amongst youths/adolescents. Between 44% and 82% of sexually active youths in Cameroon report inconsistent condom use. Data regarding utilization of HIV testing and condom use are lacking. A cross-sectional survey was administered to 431 youths ages 12-26 years in Cameroon from September 2011 to December 2011. Data on sociodemographics, sexual risk behaviors, self-reported HIV status, and condom use were collected. We compared rates of inconsistent condom use between those with known HIV negative status who utilized testing (HIV-N) and those with unknown status due to unutilized testing (HIV-U). Inconsistent condom use was defined as responding "never," "sometimes," or "usually," while consistent condom use was defined as responding "always" to questions regarding frequency of condom use. Generalized estimating equations were applied to assess the association between HIV testing and inconsistent condom use, adjusting for other confounders. Of 414 eligible respondents, 205 were HIV-U and 209 were HIV-N. HIV-U subjects were younger (mean age = 16.4 vs. 17.9, p < 0.001) and more likely to report living in an urban area (p = 0.002) than HIV-N subjects. Seventy-two percent (137/191) of sexually active youths reported inconsistent condom use. After adjusting for potential confounders, HIV-U status (odds ratio [OR] = 3.97, 95% confidence interval [CI] = 1.68-6.01) was associated with inconsistent condom use. Similarly, female gender (OR = 3.2, 95% CI = 1.29-7.89) was associated with inconsistent condom use, while older age at sexual debut was associated with a decreased risk for inconsistent condom use (OR = 0.67, 95% CI = 0.56-0.81). Cameroonian adolescents report high rates of inconsistent condom use which we found to be associated with self-reported unknown HIV status due to unutilized HIV testing. Successful HIV prevention programs among African youths/adolescents may benefit from expanded HIV testing programs. PMID:24865769

Morris, Lee; Kouya, Francine; Kwalar, Rene; Pilapil, Mariecel; Saito, Kohta; Palmer, Nancy; Posada, Roberto; Tih, Pius Muffih; Welty, Thomas; Jao, Jennifer

2014-01-01

69

Controlling the HIV/AIDS epidemic: current status and global challenges  

PubMed Central

This review provides an overview of the current status of the global HIV pandemic and strategies to bring it under control. It updates numerous preventive approaches including behavioral interventions, male circumcision (MC), pre- and post-exposure prophylaxis (PREP and PEP), vaccines, and microbicides. The manuscript summarizes current anti-retroviral treatment options, their impact in the western world, and difficulties faced by emerging and resource-limited nations in providing and maintaining appropriate treatment regimens. Current clinical and pre-clinical approaches toward a cure for HIV are described, including new drug compounds that target viral reservoirs and gene therapy approaches aimed at altering susceptibility to HIV infection. Recent progress in vaccine development is summarized, including novel approaches and new discoveries. PMID:22912636

Demberg, Thorsten; Robert-Guroff, Marjorie

2012-01-01

70

Controlling the HIV/AIDS epidemic: current status and global challenges.  

PubMed

This review provides an overview of the current status of the global HIV pandemic and strategies to bring it under control. It updates numerous preventive approaches including behavioral interventions, male circumcision (MC), pre- and post-exposure prophylaxis (PREP and PEP), vaccines, and microbicides. The manuscript summarizes current anti-retroviral treatment options, their impact in the western world, and difficulties faced by emerging and resource-limited nations in providing and maintaining appropriate treatment regimens. Current clinical and pre-clinical approaches toward a cure for HIV are described, including new drug compounds that target viral reservoirs and gene therapy approaches aimed at altering susceptibility to HIV infection. Recent progress in vaccine development is summarized, including novel approaches and new discoveries. PMID:22912636

Demberg, Thorsten; Robert-Guroff, Marjorie

2012-01-01

71

Current status of substance abuse and HIV infection in Japan.  

PubMed

Japan has experienced an epidemic of methamphetamine (MAP) abuse three times: The first epidemic was from 1951 to 1957, the second epidemic was from 1970 to 1994, and the third epidemic started in 1995 and continues today. Fortunately, HIV infection is not as serious a problem in Japan as it is in other countries. The major route of HIV infection in Japan has been through male homosexual transmission. In cumulative number, homosexual transmission accounted for 63% of the 11,146 HIV-positive patients and 40% of 5,158 AIDS patients as of December 30, 2011. Intravenous drug use accounted for 0.3% and 0.4% of these cases, respectively. Drug abuse has changed during the past 20 years in Japan. The changes are summarized as follows: There has been (1) a remarkable decrease in solvent abuse, (2) a stabilization of MAP abuse, (3) a penetration of cannabis abuse, (4) an emergence of evasive drug abuse, and (5) a silent increase in medical drug dependence. This implies that (1) there has been a change from a "solvent dominant type" of use to a "cannabis dominant type," that is, from a "Japanese type" to a "Western type," (2) a shift to drugs which do not have a high potential to cause drug-induced psychosis, and (3) a shift from conduct that leads to arrest to conduct that does not lead to arrest. Regardless of whether the drug use is illicit or not, drug dependence is a mental disorder. Japan is urged to deal with drug abuse and dependence using not only the criminal model but also the medical model. PMID:25278734

Wada, Kiyoshi; Funada, Masahiko; Shimane, Takuya

2013-12-01

72

[Disclosure of infant HIV status: mothers' experiences and health workers' interpretations in Burkina Faso].  

PubMed

Disclosure of HIV status in infants is a special case which does not correspond to general recommendations for counseling as defined for adults, and few norms exist. Whereas preventing mother to child transmission (PMTCT) programs should result in 700,000 annual disclosures regarding infants born to HIV-positive mothers in Africa, the actual figures are much lower and the conditions for disclosure implementation and its social dimensions in the field are not precisely documented. The aims of this article are to describe and analyze the experience of HIV status disclosure for infants and children on the basis of interviews held with mothers and PMTCT teams in Burkina Faso. The method was based on repeated interviews with 37 mothers and with health workers. Their discourses show the complexity of disclosure in a context characterized by uncertainty. They show delays due to difficulties in venipuncture and in methods for laboratory diagnosis and information management in health services. HIV disclosure is implemented by PMTCT physicians and also other professionals, sometimes in other services. The mother plays a key role, sometimes by requesting disclosure; the father is generally informed only secondarily, in spite of his legal responsibility for the child. Interactions analysis reveals some ambiguities of disclosure, regarding information that doctors keep secret, reciprocal expectations of communication between doctors and mothers, mothers' interpretation of apparent signs regarding their child's health, and uncertain information being given. The information often contains guilt-inducing elements for mothers; communication about follow-up does not reduce this effect. These results encourage the elaboration of a model for specific counseling that should provide mothers with general information, and personalized interaction and support that they need in order to receive and manage disclosure of their child's HIV status. PMID:23844803

Desclaux, Alice; Alfieri, Chiara

2013-07-01

73

Orphan Status, HIV Risk Behavior, and Mental Health Among Adolescents in Rural Kenya  

PubMed Central

Objective?To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya.?Methods?Randomly selected adolescents aged 1018 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiverchild communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk.?Results?Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiveryouth communication were more strongly associated with lower sex-related self-efficacy for orphans.?Conclusions?Orphans are at higher risk for psychosocial problems. These problems may affect orphans self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans. PMID:22728899

Drabkin, Anya S.; Stashko, Allison L.; Broverman, Sherryl A.; Ogwang-Odhiambo, Rose A.; Sikkema, Kathleen J.

2012-01-01

74

Genomic architecture of HIV-1 infection: Current status & challenges  

PubMed Central

Studies on host genomics have revealed the existence of identifiable HIV-1 specific protective factors among infected individuals who remain naturally resistant viraemia controllers with little or no evidence of virus replication. These factors are broadly grouped into those that are immune associated (MHC, chemokines, cytokines, CTLs and others), linked to viral entry (chemokine co-receptors and ligands), act as post-entry restriction elements (TRIM5a, APOBEC3) and those associated with viral replication (cytokines and others). These features have been identified through multiple experimental approaches ranging from candidate gene approaches, genome wide association studies (GWAS), expression analysis in conjunction with functional assays in humans to primate based models. Several studies have highlighted the individual and population level gross differences both in the viral clade sequences as well as host determined genetic associations. This review collates current information on studies involving major histocompatibility complex (MHC) as well as non MHC genes in the context of HIV-1 infection and AIDS involving varied ethnic groups. Special focus of the review is on the genetic studies carried out on the Indian population. Further challenges with regard to therapeutic interventions based on current knowledge have been discussed along with discussion on documented cases of stem cell therapy and very early highly active antiretroviral therapy (HAART) interventions. PMID:24434320

Kaur, Gurvinder; Sharma, Gaurav; Kumar, Neeraj; Kaul, Mrinali H.; Bansal, Rhea A.; Vajpayee, Madhu; Wig, Naveet; Sharma, Surender K.; Mehra, Narinder K.

2013-01-01

75

Disclosure of Maternal HIV Status to Children: To Tell or Not To Tell That is the Question  

Microsoft Academic Search

HIV-infected mothers face the challenging decision of whether to disclose their serostatus to their children. From the perspective\\u000a of both mother and child, we explored the process of disclosure, providing descriptive information and examining the relationships\\u000a among disclosure, demographic variables, and child adjustment. Participants were 23 mothers and one of their noninfected children\\u000a (9 to 16 years of age). Sixty-one

Tanya L. Tompkins

2007-01-01

76

[Cerebral infarction disclosing neurocysticercosis].  

PubMed

An ischaemic stroke related to neurocysticercosis observed in the Paris neighbourhood is reported. A 32-year-old man originating from Cape Verde presented a left lacunar stroke. CT scan showed multiple areas of calcifications and a left capsulostriatal lucency. Gadolinium enhanced MRI disclosed significant abnormalities surrounding the left middle cerebral artery in the sylvian fissure. The titers of anticysticercian antibodies were highly positive in the serum and the CSF. The investigations in search of another cause of the stroke were negative. The outcome was good after a treatment associating albendazole and methylprednisolone. The increasingly recognized links between neurocysticercosis and stroke, especially in endemic areas are reviewed. Neurocysticercosis is an exceptional cause of ischaemic stroke in non endemic areas. In non-endemic areas, this cause of stroke has to be systematically suspected in patients coming from endemic areas. The diagnosis is based upon MRI, CT scanner and serologic tests. Treatment requires anti-parasitic drugs. The role of the corticosteroids is discussed. PMID:7481381

Sangla, S; De Broucker, T; Abgrall, S; Gauthier, N

1995-04-01

77

Patterns of HIV disclosure and condom use among HIV-infected young racial/ethnic minority men who have sex with men.  

PubMed

Recent findings highlight the continued rise in cases of HIV infection among racial/ethnic minority young men who have sex with men (YMSM). In adults, disclosure of HIV status has been associated with decreased sexual risk behaviors but this has not been explored among YMSM. In this study of 362 HIV-infected racial/ethnic minority YMSM, rates of disclosure were high, with almost all disclosing their status to at least one person at baseline. The majority had disclosed to a family member, with higher disclosure rates to female relatives compared with males. After adjustment for site, disclosure to sex partners and boyfriends was associated with an increase in condom use during both oral and anal sex. Future studies should consider skills training to assist youth in the disclosure process, facilitate how to determine who in their family and friend social network can be safely disclosed to and support family-based interventions. PMID:23054043

Hightow-Weidman, Lisa B; Phillips, Gregory; Outlaw, Angulique Y; Wohl, Amy R; Fields, Sheldon; Hildalgo, Julia; LeGrand, Sara

2013-01-01

78

Lack of Knowledge of HIV Status a Major Barrier to HIV Prevention, Care and Treatment Efforts in Kenya: Results from a Nationally Representative Study  

PubMed Central

Background We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007. Methods KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 1564 years. We used gender-specific multivariable regression models to identify factors independently associated with HIV testing in sexually active persons. Results Of 19,840 eligible persons, 80% consented to interviews and blood specimen collection. National HIV prevalence was 7.1% (95% CI 6.57.7). Among ever sexually active persons, 27.4% (95% CI 25.629.2) of men and 44.2% (95% CI 42.546.0) of women reported previous HIV testing. Among HIV-infected persons, 83.6% (95% CI 76.291.0) were unaware of their HIV infection. Among sexually active women aged 1549 years, 48.7% (95% CI 46.850.6) had their last HIV test during antenatal care (ANC). In multivariable analyses, the adjusted odds ratio (AOR) for ever HIV testing in women ?35 versus 1519 years was 0.2 (95% CI: 0.10.3; p<0.0001). Other independent associations with ever HIV testing included urban residence (AOR 1.6, 95% CI: 1.22.0; p?=?0.0005, women only), highest wealth index versus the four lower quintiles combined (AOR 1.8, 95% CI: 1.32.5; p?=?0.0006, men only), and an increasing testing trend with higher levels of education. Missed opportunities for testing were identified during general or pregnancy-specific contacts with health facilities; 89% of adults said they would participate in home-based HIV testing. Conclusions The vast majority of HIV-infected persons in Kenya are unaware of their HIV status, posing a major barrier to HIV prevention, care and treatment efforts. New approaches to HIV testing provision and education, including home-based testing, may increase coverage. Targeted interventions should involve sexually active men, sexually active women without access to ANC, and rural and disadvantaged populations. PMID:22574226

Cherutich, Peter; Kaiser, Reinhard; Galbraith, Jennifer; Williamson, John; Shiraishi, Ray W.; Ngare, Carol; Mermin, Jonathan; Marum, Elizabeth; Bunnell, Rebecca

2012-01-01

79

Contribution of Intestinal Barrier Damage, Microbial Translocation and HIV-1 Infection Status to an Inflammaging Signature  

PubMed Central

Background Systemic inflammation is a characteristic of both HIV-1 infection and aging (inflammaging). Intestinal epithelial barrier damage (IEBD) and microbial translocation (MT) contribute to HIV-associated inflammation, but their impact on inflammaging remains unclear. Methods Plasma biomarkers for IEBD (iFABP), MT (LPS, sCD14), T-cell activation (sCD27), and inflammation (hsCRP, IL-6) were measured in 88 HIV-1 uninfected (HIVneg) and 83 treated, HIV-1-infected (HIVpos) adults from 20100 years old. Results Age positively correlated with iFABP (r?=?0.284, p?=?0.008), sCD14 (r?=?0.646, p?=?<0.0001) and LPS (r?=?0.421, p?=?0.0002) levels in HIVneg but not HIVpos subjects. Age also correlated with sCD27, hsCRP, and IL-6 levels regardless of HIV status. Middle-aged HIVpos subjects had elevated plasma biomarker levels similar to or greater than those of elderly HIVneg subjects with the exception of sCD14. Clustering analysis described an inflammaging phenotype (IP) based on iFABP, sCD14, sCD27, and hsCRP levels in HIVneg subjects over 60 years of age. The IP in HIVneg subjects was used to develop a classification model that was applied to HIVpos subjects to determine whether HIVpos subjects under 60 years of age were IP+. HIVpos IP+ subjects were similar in age to IP- subjects but had a greater risk of cardiovascular disease (CVD) based on Framingham risk score (p?=? 0.01). Conclusions We describe a novel IP that incorporates biomarkers of IEBD, MT, immune activation as well as inflammation. Application of this novel IP in HIV-infected subjects identified a group at higher risk of CVD. PMID:24819230

Steele, Amanda K.; Lee, Eric J.; Vestal, Brian; Hecht, Daniel; Dong, Zachary; Rapaport, Eric; Koeppe, John; Campbell, Thomas B.; Wilson, Cara C.

2014-01-01

80

Vengeance, HIV Disclosure, and Perceived HIV Transmission to Others  

PubMed Central

Feelings of vengefulness result from being treated unfairly. However, some individuals are more sensitive to unfair treatment and more likely to demand restitution than others. Degrees of vengefulness may influence behavior in HIV-positive men who have sex with men (MSM), where highly vengeful men may seek limited retribution by placing others at risk, for example, by failing to disclose their HIV-status to sexual partners. This study examined the tendency towards vengefulness in HIV-positive MSM and its associations with disclosure and condom use behaviors. Results showed that greater certainty of from whom participants had contracted HIV was associated with lowered vengefulness over time. Though condom use did not vary by vengefulness, MSM reporting higher vengefulness concealed their HIV serostatus more than men reporting less vengefulness. Vengeance was not related to individuals perceptions that they had transmitted the disease to others. Overall, the data suggested identifying ones HIV transmitter was reconciliatory. Men reporting higher vengefulness might also derive a sense of justice from not disclosing their serostatus. PMID:18512142

Moskowitz, David A.; Roloff, Michael E.

2008-01-01

81

Effect of risedronate in osteoporotic HIV males, according to gonadal status: a pilot study.  

PubMed

The aim of the study was to evaluate the effect of risedronate on bone mineral density (BMD) and bone turnover markers in HIV-infected osteoporotic males, according to their gonadal status. HIV patients were followed up for 24 months and divided into two groups: patients with osteoporosis or osteopenia with fractures (group A, n = 20) and those without (group B, n = 21). Group A and B were further divided according to the presence of reduced androgenizations. Both groups were treated with cholecalciferol 800 I.U. and calcium (Ca) 1,000 mg orally every day for the first 12 months. Risedronate 75 mg for two consecutive days a month orally was then added in group A, for another 12 months. Group B continued treatment with Ca and vitamin D. Every 6 months each patient underwent biochemical evaluation, and BMD measurement. A significant increase in lumbar BMD was observed in HIV males with adequate androgenization after 12 months of risedronate treatment in group A together with a reduction of bone turnover markers. BMD remained stable with a concomitant significant slight reduction of bone turnover markers in group B. Risedronate increased BMD and reduced bone turnover markers to a greater extent in patients with adequate androgenization compared to osteoporotic HIV males with symptomatic hypoandrogenization. PMID:25104272

Pepe, J; Isidori, A M; Falciano, M; Iaiani, G; Salotti, A; Diacinti, D; Del Fiacco, R; Sbardella, E; Cipriani, C; Piemonte, S; Raimo, O; Biondi, P; Biamonte, F; Lenzi, A; Minisola, S

2014-11-01

82

Disclosure of HIV status between parents and children in Uganda in the context of greater access to treatment.  

PubMed

While disclosure of HIV sero-status is encouraged in the management of the HIV and AIDS epidemic, it remains a challenge, especially among family members. This article examines the moral dilemmas and pragmatic incentives surrounding disclosure of HIV status in contemporary Uganda. Our findings are based on 12 in-depth interviews, 2 focus-group discussions, 6 key informant interviews with AIDS activists, and open-ended responses derived from 148 HIV-positive persons in a quantitative survey. The study was conducted in 2008-2009 in Kampala, Mpigi, and Soroti districts in Uganda. We found both parents and adult children facing dilemmas in disclosure, whether it was parents revealing their own HIV status to their children or the status of their perinatally infected children, or young people infected through sexual intercourse telling their parents. For both groups, there is fear of blame, stigma, discrimination, and shame and guilt related to unsafe sex, while young people also fear loss of privileges. On the other hand, there are practical imperatives for disclosure in terms of gaining access to care, treatment, and material resources. Faced with these dilemmas, HIV-positive people and their families require professional counselling to help them work through the emotional challenges encountered and identify mechanisms of support and coping. PMID:23844801

Kyaddondo, David; Wanyenze, Rhoda K; Kinsman, John; Hardon, Anita

2013-07-01

83

Bloodborne Infections: Should They Be Disclosed? Is Differential Treatment Necessary?  

ERIC Educational Resources Information Center

There are students and staff in many schools with hepatitis B, hepatitis C, or HIV infections. Should parents or guardians be expected to disclose students' bloodborne infections to school officials? Can infected students play contact sports given the increased risk of blood spills? What type of response plan should schools develop in the event of

Kukka, Christine

2004-01-01

84

Review of policy and status of implementation of collaborative HIV-TB activities in 23 high-burden countries.  

PubMed

Issuance of national policy guidance is a critical step to ensure quality HIV-TB (human immunodeficiency virus-tuberculosis) coordination and programme implementation. From the database of the Joint United Nations Programme on HIV/AIDS (UNAIDS), we reviewed 62 national HIV and TB guidelines from 23 high-burden countries for recommendations on HIV testing for TB patients, criteria for initiating antiretroviral therapy (ART) and the Three I's for HIV/TB (isoniazid preventive treatment [IPT], intensified TB case finding and TB infection control). We used UNAIDS country-level programme data to determine the status of implementation of existing guidance. Of the 23 countries representing 89% of the global HIV-TB burden, Brazil recommends ART irrespective of CD4 count for all people living with HIV, and four (17%) countries recommend ART at the World Health Organization (WHO) 2013 guidelines level of CD4 count ?500 cells/mm(3) for asymptomatic persons. Nineteen (83%) countries are consistent with WHO 2013 guidelines and recommend ART for HIV-positive TB patients irrespective of CD4 count. IPT is recommended by 16 (70%) countries, representing 67% of the HIV-TB burden; 12 recommend symptom-based screening alone for IPT initiation. Guidelines from 15 (65%) countries with 79% of the world's HIV-TB burden include recommendations on HIV testing and counselling for TB patients. Although uptake of ART, HIV testing for TB patients, TB screening for people living with HIV and IPT have increased significantly, progress is still limited in many countries. There is considerable variance in the timing and content of national policies compared with WHO guidelines. Missed opportunities to implement new scientific evidence and delayed adaptation of existing WHO guidance remains a key challenge for many countries. PMID:25216827

Gupta, S; Granich, R; Date, A; Lepere, P; Hersh, B; Gouws, E; Samb, B

2014-10-01

85

Positive Tuberculosis Blood Test as a Predictor of Health Status Among HIV-Infected Persons.  

PubMed

This cross-sectional study explored tuberculosis (TB) knowledge, attitudes, practice, and TB interferon-gamma release assay (IGRA) results as the predictor of self-reported poor mental and physical health among HIV-infected persons attending a sexually transmitted diseases clinic (N = 111). The participants correctly responded to only 56.6% of the TB knowledge questions. Most had positive attitudes and would not be ashamed of TB diagnosis. The TB practice was suboptimal with only half having been tested for TB within the past 2 years. Eight percent of the participants had positive IGRA (n = 9). Simultaneous multiple regression models showed that positive IGRA, an indicator of latent TB infection, was the only significant predictor of both poor mental health (p = .006) and physical health days (p = .016). IGRA screening and treatment of latent TB infection in HIV-infected persons could potentially improve their mental and physical health status in addition to reducing the TB reactivation rate. PMID:25147333

Natad, Ashley; Moser, Kathleen; Maiden, Jeanne; Kim, Son Chae

2014-08-20

86

Effect of HIV status on fertility intention and contraceptive use among women in nine sub-Saharan African countries: evidence from Demographic and Health Surveys  

PubMed Central

Background Expanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals. Design Using multiple rounds of biomarker data from Demographic and Health Surveys (20042012) in nine sub-Saharan African countries, we compare patterns of associations between HIV status and fertility intention and between current use of modern contraception and HIV status in the context of expanding ART coverage. Results Generally, results show that knowledge of HIV status and proportion of women ever tested for HIV increased substantially between the two surveys for almost all countries. Whereas modern contraceptive use slightly increased, fertility intentions remained relatively stable, except for Rwanda, where they decreased. Results from the two surveys for the nine countries do however indicate that there is no clear consistent pattern of fertility intention and modern contraceptive use behavior by HIV status, with variations observed across countries. However, multivariate analyses show that for Rwanda and Zimbabwe women who were HIV positive, with knowledge of their status, had lower odds of wanting more children. Similarly only in Rwanda (both surveys) were HIV-positive women who knew their status more likely to be current users of contraception compared with women who were HIV negative. The reverse was observed for Zimbabwe. Conclusions Generally, the results point to the fact that the assumption that reproductive intention and behavior of HIV-positive women will differ compared with that of HIV-negative women may only hold true to the extent that women know their HIV status. Continuous expansion of voluntary counseling and testing services and integration of HIV treatment and care services with reproductive health services are thus warranted. PMID:25361729

Mumah, Joyce N.; Ziraba, Abdhalah K.; Sidze, Estelle M.

2014-01-01

87

Debunking common barriers to pediatric HIV disclosure.  

PubMed

As HIV-positive children continue to gain more access to antiretroviral therapy and survive into young adulthood, caregivers face the difficult process of disclosing a child's HIV status to that child. Although disclosure has many proven benefits for mental health, psychosocial development, caregiver well-being, treatment adherence and future planning, such a process is still often met with resistance. This article discusses the main reasons given for delaying or avoiding disclosure of a child's HIV status. Each barrier to disclosure is discussed and debunked as an insufficient reason to delay the positive benefits that the disclosure process has shown to produce. HIV disclosure is a critical and multifaceted issue in children. Such a process has been shown to best involve a multi-disciplinary support team that assists caregivers in continually adapting the disclosure discussion to meet the developmental needs and understanding of each individual child over time. PMID:20185559

Domek, Gretchen J

2010-12-01

88

Relationship between HIV Stigma and Self-Isolation among People Living with HIV in Tennessee  

PubMed Central

Introduction HIV stigma is a contributing factor to poor patient outcomes. Although HIV stigma has been documented, its impact on patient well-being in the southern US is not well understood. Methods Thirty-two adults participated in cognitive interviews after completing the Berger HIV or the Van Rie stigma scale. Participant responses were probed to ensure the scales accurately measured stigma and to assess the impact stigma had on behavior. Results Three main themes emerged regarding HIV stigma: (1) negative attitudes, fear of contagion, and misperceptions about transmission; (2) acts of discrimination by families, friends, health care providers, and within the workplace; and (3) participants use of self-isolation as a coping mechanism. Overwhelming reluctance to disclose a persons HIV status made identifying enacted stigma with a quantitative scale difficult. Discussion Fear of discrimination resulted in participants isolating themselves from friends or experiences to avoid disclosure. Participant unwillingness to disclose their HIV status to friends and family could lead to an underestimation of enacted HIV stigma in quantitative scales. PMID:23950897

Audet, Carolyn M.; McGowan, Catherine C.; Wallston, Kenneth A.; Kipp, Aaron M.

2013-01-01

89

Does Perceived Life Stress Mediate the Association between HIV Status and Alcohol Use? Evidence from Adults Living in Cape Town, South Africa  

PubMed Central

South Africa has the highest prevalence of HIV in the world. Because living with HIV is stressful and because alcohol consumption is often used to cope with stress, we examined whether stress mediates the association between HIV status and alcohol use among adults residing in South African townships. Field workers approached pedestrians or patrons of informal alcohol-serving venues (i.e., shebeens) and invited their participation in a survey. Of the 1,717 participants (98% Black, 34% women, mean age = 31), 82% were HIV-negative, 9% were HIV-positive, and 9% did not know their test result. Participants living with HIV reported greater perceived life stress compared to participants whose HIV status was negative or unknown. Perceived stress was associated with increased alcohol use (frequency of drinking days, frequency of intoxication, and frequency of drinking in shebeens/taverns). Subsequent analyses showed that stress mediated the association between HIV status and alcohol use. These findings indicate that greater frequency of drinking days, perceived intoxication, and drinking at shebeens was associated with elevated stress levels among participants who were HIV-positive. Perceived life stress mediates the association between HIV status and alcohol use. Programs to enhance stress management among HIV-positive South Africans may help to reduce alcohol consumption which may, in turn, lead to reduced rates of HIV transmission. PMID:23327560

Scott-Sheldon, Lori A. J.; Carey, Michael P.; Carey, Kate B.; Cain, Demetria; Vermaak, Redwaan; Mthembu, Jacqueline; Mehlomakhulu, Vuyelwa; Simbayi, Leickness C.; Kalichman, Seth C.

2014-01-01

90

Structural bridging network position is associated with HIV status in a younger Black men who have sex with men epidemic  

PubMed Central

Younger Black men who have sex with men (BMSM) ages 1629 have the highest rates of HIV in the United States. Despite increased attention to social and sexual networks as a framework for biomedical intervention, the role of measured network positions, such as bridging and their relationship to HIV risk has received limited attention. A network sample (N=620) of BMSM respondents (n=154) and their MSM and transgendered person network members (n=466) was generated through respondent driven sampling of BMSM and elicitation of their personal networks. Bridging status of each network member was determined by a constraint measure and was used to assess the relationship between this bridging and unprotected anal intercourse (UAI), sex-drug use (SDU), group sex (GS) and HIV status within the network in South Chicago. Low, moderate and high bridging was observed in 411 (66.8%), 81 (13.2%) and 123 (20.0%) of the network. In addition to age and having sex with men only, moderate and high levels of bridging were associated with HIV status (AOR 3.19; 95% CI 1.586.45 and AOR 3.83; 95% CI 1.2311.95, respectively). Risk behaviors observed including UAS, GS, and SDU were not associated with HIV status, however, they clustered together in their associations with one another. Bridging network position but not risk behavior was associated with HIV status in this network sample of younger BMSM. Socio-structural features such as position within the network may be important when implementing effective HIV prevention interventions in younger BMSM populations. PMID:24337699

Shah, Nirav S.; Iveniuk, James; Muth, Stephen Q.; Michaels, Stuart; Jose, Jo-Anne; Laumann, Edward O.; Schneider, John A.

2014-01-01

91

Effect of HIV status on fertility desire and knowledge of long-acting reversible contraception of postpartum Malawian women.  

PubMed

The objectives of this study were to describe the most recent pregnancy intentions and family planning preferences of HIV-infected and HIV-uninfected postpartum Malawian women, and to assess whether HIV status is associated with fertility desire and knowledge of intrauterine contraception (IUC) and the subdermal contraceptive implant. We conducted a cross-sectional analysis of the baseline characteristics of Malawian women enrolled in a prospective cohort study assessing postpartum contraceptive uptake and continuation. Women at a government hospital completed a baseline survey assessing reproductive history, family planning preferences, and knowledge of IUC and the implant. We used Pearson's chi-square tests to compare these parameters between HIV-infected and HIV-uninfected women. Modified Poisson regression was performed to assess the association between HIV status and fertility desire and knowledge about IUC and the implant. Of 634 postpartum women surveyed, HIV-infected women were more likely to report their most recent pregnancy was unintended (49% vs. 37%, p = 0.004). Nearly all women (97%) did not want a child in the next 2 years, but HIV-infected women were more likely to desire no more children (adjusted prevalence ratio [PR]: 1.59; 95% confidence interval [CI]: 1.33, 1.89). HIV-infected women were also less likely to know that IUC (adjusted PR: 0.72; 95% CI: 0.61, 0.84) and the implant (adjusted PR: 0.83; 95% CI: 0.75, 0.92) are safe during breast-feeding. Postpartum women strongly desire family spacing and many HIV-infected postpartum women desire no more children, suggesting an important role for these long-acting methods. Education about the efficacy and safety of IUC and the implant particularly during breast-feeding may facilitate postpartum use. PMID:25367269

O'Shea, Michele S; Rosenberg, Nora E; Hosseinipour, Mina C; Stuart, Gretchen S; Miller, William C; Kaliti, Stephen M; Mwale, Mwawi; Bonongwe, Phylos P; Tang, Jennifer H

2015-04-01

92

Disclosure experience and associated factors among HIV positive men and women clinical service users in southwest Ethiopia  

PubMed Central

Background Disclosing HIV test results to one's sexual partner allows the partner to engage in preventive behaviors as well as the access of necessary support for coping with serostatus or illness. It may motivate partners to seek testing or change behavior, and ultimately decrease the transmission of HIV. The present study was undertaken to determine the rate, outcomes and factors associated with HIV positive status disclosure in Southwest Ethiopia among HIV positive service users. Methods A cross-sectional study was carried out from January 15, 2007 to March 15, 2007 in Jimma University Specialized Hospital. Data were collected using a pre-tested interviewer-administered structured questionnaire. Results A total of 705 people (353 women and 352 men), participated in the study of which 71.6% were taking ART. The vast majority (94.5%) disclosed their result to at least one person and 90.8% disclosed to their current main partner. However, 14.2% of disclosure was delayed and 20.6% did not know their partner's HIV status. Among those who did not disclose, 54% stated their reason as fear of negative reaction from their partner. Among those disclosures however, only 5% reported any negative reaction from the partner. Most (80.3%) reported that their partners reacted supportively to disclosure of HIV status. Disclosure of HIV results to a sexual partner was associated with knowing the partner's HIV status, advanced disease stage, low negative self-image, residing in the same house with partner, and discussion about HIV testing prior to seeking services. Conclusion Although the majority of participants disclosed their test results, lack of disclosure by a minority resulted in a limited ability to engage in preventive behaviors and to access support. In addition, a considerable proportion of the participants did not know their partner's HIV status. Programmatic and counseling efforts should focus on mutual disclosure of HIV test results, by encouraging individuals to ask their partner's HIV status in addition to disclosing their own. PMID:18312653

Deribe, Kebede; Woldemichael, Kifle; Wondafrash, Mekitie; Haile, Amaha; Amberbir, Alemayehu

2008-01-01

93

Workplace Experiences of Individuals Who Are HIV+ and Individuals with Cancer.  

ERIC Educational Resources Information Center

Reviews the workplace experiences of 18 individuals who are HIV+ and 14 people who have cancer. Questions in the study addressed the following issues: the impact of the illness on their work life; whether they disclosed their health status and, if so, the reactions of co-workers and supervisors; and what accommodations, if any, they received.

Fesko, Shelia Lynch

2001-01-01

94

Facilitators and Barriers to Discussing HIV Prevention With Adolescents: Perspectives of HIV-Infected Parents  

PubMed Central

Objectives. We examined HIV-infected parents conversations about HIV prevention with their uninfected children, including what facilitated or hindered communication. Methods. Parents with HIV/AIDS (n?=?90) who had children aged 10 to 18 years were recruited for a mixed method study from 2009 to 2010. Interviews assessed facilitators and barriers to discussing HIV prevention. A questionnaire identified the frequency and content of conversations, parental confidence level, and perceived importance of discussing preventive topics. Results. Eighty-one percent of parents reported sometimes or often communicating about HIV prevention. A subset of parents found these conversations difficult; 44% indicated their desire for support. Facilitators to communication included utilizing support, focusing on the benefits of talking, and having a previous relationship with ones child. Barriers to discussions included fear of negative consequences, living in denial, and lacking a parental role model who discussed safer sex. Parents varied as to how they believed their HIV status affected communication. Those who did not disclose their HIV status to their children reported less frequent communication; self-efficacy partially mediated this relationship. Conclusions. Findings highlighted the need for communication skills training that support HIV-infected parents in their efforts to discuss HIV-related information with adolescents. PMID:23763390

Reis, Janet S.; Weber, Kathleen M.

2013-01-01

95

[Analysis on HIV infection status of voluntary blood donors in Chinese Nanjing area from 2003 to 2013].  

PubMed

This study was purposed to analyze HIV infections status among the unpaid blood donation population in Chinese Nanjing area from 2003 to 2013, to understand the HIV antibody positive and/or HIV-RNA positive population characteristics in order to provide evidence for recruiting strategy of blood donation without compensation. The whole blood samples of unpaid donors and the platelet donors were tested by ELISA, from June 2010 the NAT test was added for the samples that were ELISA test with unilateral negative. Every HIV reactive sample (HIV-antibody and/or HIV-RNA) was sent to confirm in the Centers for Disease Control and Prevention in Nanjing, including 1 case of enzyme bilateral positive and HIV-RNA reactivity has been sentenced as indeterminacy; another 1 case of enzyme bilateral negative and HIV-RNA reactive was sent to the Centers for Disease Control and Prevention in Jiangsu Province to test nucleic acid quantification to be positive; The unpaid donor HIV screening results from 2003 to 2013 in Chinese Nanjing area were analysed statistically. The results showed that from 2003 to 2013 years 641401 unpaid blood donors were tested,out of them 57 cases were contirmed to be HIV antibody positive (HIV-1),the total positive rate was 8.89/100 000. Since 2010 years, the HIV antibody positive rate increased significantly (P < 0.01), then it was stable until to 2012 years, the HIV antibody positive rate was 15.43/100 000. In the 2013 year, the HIV antibody positive rate was 10.03/100 000. The HIV antiboby positive rates in male and female were 13.25: 1. The years of male cases were 18-30 that accounted for 56.14%, and the years of male cases were 31-40 that accounted for 31.58%. The men who first time donated blood were 46 cases and accounted for 80.70%. The men who donated blood again were 11 cases and accounted for 19.30%. The men who donated blood on streets of blood donation accounted for 80.70% and their HIV antibody positive rate was 11.88/100 000. The men who donated blood in the plan organization of donators were 8.78%, and their HIV antibody possitive rate was 2.33/100 000. The HIV antibody positive rate were different in the different times and different donation types, and were statistical significance (P < 0.01). It is concluded that based on the present status of HIV antibldy positive rate in Chinese Nanjing area, the HIV antibody possitive donors are more observed in the first blood donation population, especially in the higher educated young men. This situation or tendency indicates that the voluntary blood donors should be organized or selected from low risk population, and should popularize the knowlege of unpaid blood donation, especiatly the knowlege of AIDS, strengthen cosulting work on the mobile donation points in streets before donating blood, and should establish the cyber-database to ensure blood safety. PMID:25338600

Cai, Li-Na; Zhu, Shao-Wen; Zhou, Chun; Chen, Bao-An; Sun, Jun

2014-10-01

96

Socio-economic and demographic factors related to HIV status in urban informal settlements in the Eastern Cape, South Africa.  

PubMed

The prevalence of HIV&AIDS is embedded in social and economic inequity and the relationship between social determinants and HIV incidence is well established. The aim of this study was to determine which socio-economic and demographic factors are related to HIV status in the age group 18 to 49 years in informal settlements in the Eastern Cape, South Africa. This cross-sectional study was conducted in 3 informal settlements (n = 752) during March 2013 within the Nelson Mandela Bay and Buffalo City districts. A proportional cluster sample was selected and stratified by area and formal plot/squatter households in open areas. Respondents who volunteered to participate had to provide informed written consent before trained, bilingual peer educators interviewed them and completed the structured questionnaire. HIV status was determined and information on demographic and socio-economic variables was included in the bivariate analysis. The prevalence of HIV was higher, at 17.3%, than the 2011 estimated national prevalence among the general population in South Africa. The level of education (?(2) = 5.50, df = 1, p < 0.05), geographical site (?(2) = 7.41, df = 2, p < 0.05), gender (?(2) = 33.10, df = 1, p < 0.0005), household food insecurity (?(2) = 4.77, df = 1, p < 0.05), cooking with cast iron pots (?(2) = 15.0, df = 3, p < 0.05) and availability of perceived 'wealth' indicators like mobile telephones and refrigerators (?(2) = 9.67, df = 2, p < 0.05) were significantly associated with HIV-status. No significant associations could be demonstrated between household income, the number of people living in the household and the availability of electricity/water and HIV status. As the observed levels of HIV prevalence underlined gender bias and failure to graduate from high school, future interventions should focus on HIV prevention in female schoolchildren. However, HIV infection is also prevalent among wealthier individuals in informal settlements, which indicates that renewed efforts should be made to improve sexual risk behaviour within this group. PMID:25388981

Steenkamp, Liana; Venter, Danie; Walsh, Corinna; Dana, Pelisa

2014-09-01

97

Health Status, Sexual and Drug Risk, and Psychosocial Factors Relevant to Post-release Planning for HIV+ Prisoners  

PubMed Central

The prevalence of HIV infection among male prison inmates is significantly higher than the United States population. Adequate planning to ensure continued medication adherence and continuity of care after release is important for this population. This study describes the pre-release characteristics of 162 incarcerated HIV-positive men (40 from jails and 122 from prisons). The results include a demographic description of the sample and their sexual risk behaviors, substance use, health status and HIV medication adherence, health care utilization, mental health, and family and social support. The results highlight a potentially high level of need for services and low levels of support and social connectedness. Post-release planning should include support for improving HIV medication adherence as well as reducing both sexual and IDU-related transmission risk for these individuals. PMID:24078623

Feaster, Daniel J.; Reznick, Olga Grinstead; Zack, Barry; McCartney, Kathleen; Gregorich, Steven; Brincks, Ahnalee M.

2014-01-01

98

Mediation and Moderation: Testing Relationships between Symptom Status, Functional Health, and Quality of Life in HIV Patients  

ERIC Educational Resources Information Center

We extended Wilson and Cleary's (1995) health-related quality of life model to examine the relationships among symptom status (Symptoms), functional health (Disability), and quality of life (QOL). Using a community sample (N = 956) of male HIV positive patients, we tested a mediation model in which the relationship between Symptoms and QOL is

Ryu, Ehri; West, Stephen G.; Sousa, Karen H.

2009-01-01

99

HIV Disclosure and Sexual Transmission Behaviors among an Internet Sample of HIV-positive Men Who Have Sex with Men in Asia: Implications for Prevention with Positives  

PubMed Central

The relationship between HIV disclosure and sexual transmission behaviors, and factors that influence disclosure are unknown among HIV-positive men who have sex with men (MSM) in Asia. We describe disclosure practices and sexual transmission behaviors, and correlates of disclosure among this group of MSM in Asia. A cross-sectional multi-country online survey was conducted among 416 HIV-positive MSM. Data on disclosure status, HIV-related risk behaviors, disease status, and other characteristics were collected. Multivariable logistic regression was used to identify significant correlates of disclosure. Only 7.0% reported having disclosed their HIV status to all partners while 67.3% did not disclose to any. The majority (86.5%) of non-disclosing participants had multiple partners and unprotected insertive or receptive anal intercourse with their partners (67.5%). Non-disclosure was significantly associated with non-disclosure from partners (AOR = 37.13, 95% CI: 17.22, 80.07), having casual partners only (AOR = 1.91, 95% CI: 1.03, 3.53), drug use before sex on a weekly basis (AOR: 6.48, 95% CI: 0.99, 42.50), being diagnosed with HIV between 15 years ago (AOR = 2.23, 95% CI: 1.05, 4.74), and not knowing ones viral load (AOR = 2.80, 95% CI: 1.00, 7.83). Given the high HIV prevalence and incidence among MSM in Asia, it is imperative to include Prevention with Positives for MSM. Interventions on disclosure should not solely focus on HIV-positive men but also need to include their sexual partners and HIV-negative men. PMID:22198313

Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E.; Koe, Stuart

2012-01-01

100

The role of disclosure in relation to assent to participate in HIV-related research among HIV-infected youth: a formative study  

PubMed Central

Background The objective of this study was to develop a culturally appropriate approach for obtaining assent from children aged eight to 17 years to participate in paediatric HIV-related operational research in Kinshasa, Democratic Republic of Congo (DRC). Included within this objective was to determine whether or not HIV disclosure should be included as part of the assent process prior to research participation, a component of research participation, or not incorporated in any aspect of the child's involvement in the research. Factors that influence parents' and caregivers' decisions to disclose HIV status to children in non-research contexts were also explored. Methods A qualitative formative study was conducted. Semi-structured interviews were conducted with 19 youth living with HIV, 36 parents and caregivers of youth living with HIV, and 17 health professionals who provide care and support to youth living with HIV and their families. Participants were purposefully selected from three HIV care, treatment and/or psychosocial support programmes in Kinshasa, DRC. Results Most youth interviewed believed minors participating in HIV-related research should be informed of their HIV-positive status. Parents and caregivers and health professionals had varied perspectives on if and when HIV status should be disclosed to minors during research participation. The age of the youth influenced parents and caregivers' responses, and disclosure to adolescents was more frequently supported than disclosure to children. Several parents and caregivers, as well as some health professionals, suggested that minors should never be told their HIV-positive status when participating in HIV-related research, regardless of their age. Within the context of treatment programmes, disclosure of HIV status to minors was supported by youth, parents and caregivers, and health professionals as a means to improve adherence to medication. Conclusion In settings where most minors are unaware of their HIV infection, researchers should consider excluding the term, "HIV", when explaining HIV-related research to minors, and omitting it from assent forms or informational sheets related to research participation. However, an individualized disclosure plan should be initiated with parents and caregivers at the time of enrolment in HIV-related research, particularly in research that involves treatment. PMID:19712468

2009-01-01

101

Ascertaining Partner HIV Status and its Association with Sexual Risk Behavior Among Internet-Using Men Who Have Sex with Men  

Microsoft Academic Search

The aims of this study were to understand strategies and consistency of strategy used by HIV-negative and HIV-positive men\\u000a who have sex with men (MSM) to ascertain the HIV status of their male sexual partners and their associations with unprotected\\u000a anal intercourse (UAI) and serodiscordant UAI (SDUAI) in the past 3months. Participants (n=640) completed an online survey in December 2007.

Keith J. Horvath; Kate Nygaard; B. R. Simon Rosser

2010-01-01

102

Growth patterns and anaemia status of HIV-infected children living in an institutional facility in India  

PubMed Central

Objective To understand the health status of HIV orphans in a well-structured institutional facility in India. Method Prospective longitudinal analysis of growth and anaemia prevalence among these children, between June 2008 and May 2011. Results A total of 85 HIV-infected orphan children residing at Sneha Care Home, Bangalore, for at least 1 year, were included in the analysis. Prevalence of anaemia at entry into the home was 40%, with the cumulative incidence of anaemia during the study period being 85%. At baseline, 79% were underweight and 72% were stunted. All children, irrespective of their antiretroviral therapy (ART) status, showed an improvement in nutritional status over time as demonstrated by a significant increase in weight (median weight-for-age Z-score: ?2.75 to ?1.74, P < 0.001) and height Z-scores (median height-for-age Z-score: ?2.69 to ?1.63, P < 0.001). Conclusion These findings suggest that good nutrition even in the absence of ART can bring about improvement in growth. The Sneha Care Home model indicates that the holistic approach used in the Home may have been helpful in combating HIV and poor nutritional status in severely malnourished orphaned children. PMID:22686454

Kapavarapu, Prasanna K.; Bari, Omar; Perumpil, Mathew; Duggan, Christopher; Dinakar, Chitra; Krishnamurthy, Shubha; Arumugam, Karthika; Shet, Anita

2013-01-01

103

Dating, Marriage, and Parenthood for HIV-Positive Heterosexual Puerto Rican Men: Normalizing Perspectives on Everyday Life With HIV.  

PubMed

HIV-positive men are living long and healthier lives while managing HIV as a chronic illness. Although research has extensively documented the experiences of illness of people living with HIV, dating, marriage, and fatherhood among heterosexual Latino men has not been examined. To address this gap, this study used a qualitative study design to examine patterns and strategies for dating, marriage, and parenthood among 24 HIV-positive heterosexual Puerto Rican men living in Boston. The findings in our study indicate that an HIV diagnosis does not necessarily deter men from having an active sexual life, marrying, or having children. In fact, for some of the men, engaging in these social and life-changing events is part of moving on and normalizing life with HIV; these men planned for, achieved, and interpreted these events in the context of establishing normalcy with HIV. Although the HIV diagnosis discouraged some men from engaging in sexual relations, getting married, or having children, others fulfilled these desires with strategies aimed to reconciling their HIV status in their personal life, including dating or marrying HIV-positive women only. Additional important themes identified in this study include the decision to disclose HIV status to new sexual partners as well as the decision to accept the risk of HIV transmission to a child or partner in order to fulfill desires of fatherhood. Understanding the personal struggles, decision-making patterns, and needs of HIV-positive heterosexual men can aid in designing interventions that support healthy living with HIV. PMID:24794822

Sastre, Francisco; Sheehan, Diana M; Gonzalez, Arnaldo

2015-03-01

104

Choice-Disability and HIV Infection: A Cross Sectional Study of HIV Status in Botswana, Namibia and Swaziland  

Microsoft Academic Search

Interpersonal power gradients may prevent people implementing HIV prevention decisions. Among 7,464 youth aged 1529years\\u000a in Botswana, Namibia and Swaziland we documented indicators of choice-disability (low education, educational disparity with\\u000a partner, experience of sexual violence, experience of intimate partner violence (IPV), poverty, partner income disparity,\\u000a willingness to have sex without a condom despite believing partner at risk of HIV), and

Neil Andersson; Anne Cockcroft

105

HTLV-1/-2 and HIV-1 co-infections: retroviral interference on host immune status  

PubMed Central

The human retroviruses HIV-1 and HTLV-1/HTLV-2 share similar routes of transmission but cause significantly different diseases. In this review we have outlined the immune mediated mechanisms by which HTLVs affect HIV-1 disease in co-infected hosts. During co-infection with HIV-1, HTLV-2 modulates the cellular microenvironment favoring its own viability and inhibiting HIV-1 progression. This is achieved when the HTLV-2 proviral load is higher than that of HIV-1, and thanks to the ability of HTLV-2 to: (i) up-regulate viral suppressive CCL3L1 chemokine expression; (ii) overcome HIV-1 capacity to activate the JAK/STAT pathway; (iii) reduce the activation of T and NK cells; (iv) modulate the host miRNA profiles. These alterations of immune functions have been mainly attributed to the effects of the HTLV-2 regulatory protein Tax and suggest that HTLV-2 exerts a protective role against HIV-1 infection. Contrary to HIV-1/HTLV-2, the effect of HIV-1/HTLV-1 co-infection on immunological and pathological conditions is still controversial. There is evidence that indicates a worsening of HIV-1 infection, while other evidence does not show clinically relevant effects in HIV-positive people. Possible differences on innate immune mechanisms and a particularly impact on NK cells are becoming evident. The differences between the two HIV-1/HTLV-1 and HIV-1/HTLV-2 co-infections are highlighted and further discussed. PMID:24391628

Pilotti, Elisabetta; Bianchi, Maria V.; De Maria, Andrea; Bozzano, Federica; Romanelli, Maria G.; Bertazzoni, Umberto; Casoli, Claudio

2013-01-01

106

HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.  

PubMed Central

OBJECTIVES: This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. METHODS: We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. RESULTS: HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. CONCLUSIONS: High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services. PMID:11392934

Clements-Nolle, K; Marx, R; Guzman, R; Katz, M

2001-01-01

107

HIV Positivity but not HPV/p16 Status is Associated with Higher Recurrence Rate in Anal Cancer  

PubMed Central

Aim Human papillomavirus (HPV) is a pathogenic factor of squamous cell carcinoma in various mucosal locations, including anal carcinoma (ACA). It is also known that patients positive for HIV are at high risk of ACA. The goal of this study was to examine clinical outcome in ACA in relation to HPV/p16 positivity, histologic tumor differentiation, and HIV status. Patients with oropharyngeal cancers that are positive for HPV and show overexpression of p16 as well as having non-keratinizing/basaloid histology have been reported to have better outcomes following chemoradiation (CRT). However, such relationships in ACA remain unknown. Methods Forty-two patients with SCC of the anus treated with CRT between 1997 and 2009 were identified. The tumors were subclassified as either non-keratinizing (including basaloid) or keratinizing categories. HPV testing was performed using SPF10-PCR, and all cases were immunostained for p16. Results There were 23 men and 19 women; 43 % of men and 11 % of women were HIV-positive (p =0.04). Fifty-five percent of patients had local disease (stages I and II) and 41 % were stages III and IV, with 4 % stage unknown. All tumors were positive for high-oncogenic risk HPVs, and all were positive with p16 immunostain. Sixty-four percent of tumors were non-keratinizing/basaloid and 36 % were keratinizing. The keratinizing tumors were more common in HIV-positive patients (67 %), whereas non-keratinizing/basaloid tumors were more common in HIV-negative patients (77 %) (p =0.008). Thirty-one percent of patients had recurrence of disease, including 50 % HIV-positive patients and 23 % HIV-negative patients (p =0.09). There was no difference in the recurrence rate between non-keratinizing and keratinizing tumor subtypes (p =0.80). The 24-month recurrence-free survival for the cohort was 66 % (95 % CI=46 %, 81 %), with HIV-positive patients having worse recurrence-free survival compared to HIV-negative patients (HR=2.85, 95 % CI= 0.95, 8.53; p =0.06). Conclusion The regional and distant failure rate was not related to HPV/p16 positivity or histologic differentiation of ACA; however, HIV positivity appeared to be associated with a higher recurrence rate and worse recurrence-free survival. PMID:24014082

Meyer, Joshua E.; Panico, Vinicius J. A.; Marconato, Heloisa M. F.; Sherr, David L.; Christos, Paul

2014-01-01

108

Prevention Needs of HIV-Positive Men and Women Awaiting Release from Prison  

PubMed Central

Greater understanding of barriers to risk reduction among incarcerated HIV+ persons reentering the community is needed to inform culturally tailored interventions. This qualitative study elicited HIV prevention-related information, motivation and behavioral skills (IMB) needs of 30 incarcerated HIV+ men and women awaiting release from state prison. Unmet information needs included risk questions about viral loads, positive sexual partners, and transmission through casual contact. Social motivational barriers to risk reduction included partner perceptions that prison release increases sexual desirability, partners negative condom attitudes, and HIV disclosure-related fears of rejection. Personal motivational barriers included depression and strong desires for sex or substance use upon release. Behavioral skills needs included initiating safer behaviors with partners with whom condoms had not been used prior to incarceration, disclosing HIV status, and acquiring clean needles or condoms upon release. Stigma and privacy concerns were prominent prison context barriers to delivering HIV prevention services during incarceration. PMID:21553252

Thibodeau, Laura; BlueSpruce, June; Yard, Samantha S.; Seal, David W.; Amico, K. Rivet; Bogart, Laura M.; Mahoney, Christine; Balderson, Benjamin H. K.; Sosman, James M.

2011-01-01

109

Nutritional status and lipid profile of HIV-positive children and adolescents using antiretroviral therapy  

PubMed Central

OBJECTIVE: To describe nutritional status, body composition and lipid profile in children and adolescents receiving protease inhibitors. METHODS: Fifty-nine patients, 23 treated with protease inhibitors (group 1) and 36 not using protease inhibitors (group 2). Their dietary intake, anthropometry, bioimpedance analysis and lipid profile variables were measured. RESULTS: There was no difference in nutritional status or body composition between groups at the beginning of the study. After 6 months of follow-up, there was an increase in weight and height in both groups, as well as in waist circumference and subscapular skinfold thickness. In group 2, body mass index and triceps skinfold thickness adequacy were significantly higher after 6 months of follow-up. The groups had similar energy and macronutrient intake at any time point. After 6 months, group 1 had a higher cholesterol intake and group 2 had a higher fiber intake. Triglyceride serum levels were significantly different between the groups, with higher values in G1, at any time point [G1: 153mg/dl (30344); 138 (58378) versus G2: 76mg/dl (29378); 76 (29378)]. After 6 months of follow-up, G1 had higher LDL-cholesterol than G2 [104mg/dl (40142) versus 82 (42145)]. CONCLUSION: The use of protease inhibitors, per se, does not seem to significantly interfere with anthropometric measures, body composition and food intake of HIV-infected children and adolescents. However, this antiretroviral therapy was associated with a significant increase in triglyceride and LDL-cholesterol in our subjects. PMID:21808865

Contri, Patricia Vigan; Berchielli, rica Miranda; Tremeschin, Marina Hjertquist; de Moura Negrini, Bento Vidal; Salomo, Roberta Garcia; Monteiro, Jacqueline Pontes

2011-01-01

110

A pilot study of immigration status, homosexual self-acceptance, social support, and HIV reduction in high risk Asian and Pacific Islander men.  

PubMed

This article reports the results of a cross-sectional study that was conducted to describe the sexual behavior and HIV risk reduction behaviors of homosexual and bisexual Asian and Pacific Islander men and to relate immigration status, self-acceptance as a homosexual, and levels of social support to the adoption of safe sexual behaviors in this population. Thirty-one gay and bisexual Asian and Pacific Islander men in San Diego County, California, participated. Generally high levels of knowledge about HIV and transmission risks as well as self-acceptance and social support were found. While most (84%) reported some attempts to increase condom use in the previous 6 months, 42% reported engaging in unprotected intercourse during that same time period. An inverse relationship between self-acceptance and utilization of risk reduction strategies was found. No association was found between immigration status or self-reported HIV status and level of HIV knowledge, level of HIV risk behavior, or level of HIV risk reduction efforts. The findings are discussed within the context of other social network studies and HIV prevention programs for gay and bisexual Asian and Pacific Islander men. PMID:16228708

Lloyd, L S; Faust, M; Roque, J S; Loue, S

1999-04-01

111

Health care utilization and access to human immunodeficiency virus (HIV) testing and care and treatment services in a rural area with high HIV prevalence, Nyanza Province, Kenya, 2007.  

PubMed

We present health and demographic surveillance system data to assess associations with health care utilization and human immunodeficiency virus (HIV) service receipt in a high HIV prevalence area of western Kenya. Eighty-six percent of 15,302 residents indicated a facility/clinician for routine medical services; 60% reported active (within the past year) attendance. Only 34% reported a previous HIV test, and self-reported HIV prevalence was 6%. Active attendees lived only slightly closer to their reported service site (2.8 versus 3.1 km; P < 0.001) compared with inactive attendees. Multivariate analysis showed that younger respondents (< 30 years of age) and active and inactive attendees were more likely to report an HIV test compared with non-attendees; men were less likely to report HIV testing. Despite traveling farther for HIV services (median distance = 4.4 km), 77% of those disclosing HIV infection reported HIV care enrollment. Men and younger respondents were less likely to enroll in HIV care. Socioeconomic status was not associated with HIV service use. Distance did not appear to be the major barrier to service receipt. The health and demographic surveillance system data identified patterns of service use that are useful for future program planning. PMID:24323517

Ackers, Marta-Louise; Hightower, Allen; Obor, David; Ofware, Peter; Ngere, Lilian; Kubaje, Adazu; Laserson, Kayla F

2014-02-01

112

Spiritual Well-Being, Depressive Symptoms, and Immune Status Among Women Living with HIV\\/AIDS  

Microsoft Academic Search

Spirituality is a resource some HIV-positive women use to cope with HIV, and it also may have positive impact on physical health. This cross-sectional study examined associations of spiritual well-being, with depressive symptoms, and CD4 cell count and percentages among a non-random sample of 129 predominantly African-American HIV-positive women. Significant inverse associations were observed between depressive symptoms and spiritual well-being

Safiya George Dalmida; Marcia McDonnell Holstad; Colleen Diiorio; Gary Laderman

2009-01-01

113

Revisiting Pneumonia and Exposure Status in Infants Born to HIV-Infected Mothers  

PubMed Central

HIV-exposed uninfected infants are an increasing population. Past analyses have often categorized these infants as uninfected leading to inaccurate conclusions. We present a HIV exposure, rather than infection, based reanalysis of treatment failure among children with pneumonia to show that failure odds among HIV-exposed uninfected infants are intermediate between their unexposed and infected counterparts. Additional prospective studies aimed at better understanding this population are needed. PMID:24352190

Izadnegahdar, Rasa; Fox, Matthew P.; Jeena, Prakash; Qazi, Shamim A.; Thea, Donald M.

2013-01-01

114

HIV Screening in the Health Care Setting: Status, Barriers, and Potential Solutions  

PubMed Central

Thirty years into the human immunodeficiency virus (HIV) epidemic in the United States, an estimated 50,000 persons become infected each year: highest rates are in black and Hispanic populations and in men who have sex with men. Testing for HIV has become more widespread over time, with the highest rates of HIV testing in populations most affected by HIV. However, approximately 55% of adults in the United States have never received an HIV test. Because of the individual and community benefits of treatment for HIV, in 2006 the Centers for Disease Control and Prevention recommended routine screening for HIV infection in clinical settings. The adoption of this recommendation has been gradual owing to a variety of issues: lack of awareness and misconceptions related to HIV screening by physicians and patients, barriers at the facility and legislative levels, costs associated with testing, and conflicting recommendations concerning the value of routine screening. Reducing or eliminating these barriers is needed to increase the implementation of routine screening in clinical settings so that more people with unrecognized infection can be identified, linked to care, and provided treatment to improve their health and prevent new cases of HIV infection in the United States. PMID:22958996

Rizza, Stacey A.; MacGowan, Robin J.; Purcell, David W.; Branson, Bernard M.; Temesgen, Zelalem

2012-01-01

115

Do the factors associated with female HIV infection vary by socioeconomic status in Cameroon?  

PubMed

One of the most consistent findings in social epidemiology is an inverse relationship between indicators of SES and most types of illness. However, a growing body of research on HIV in sub-Saharan Africa suggests an intriguing reversal of this pattern, particularly with respect to HIV among women. In Cameroon, specifically, high-SES women have higher rates of HIV infection compared with low-SES women. Using data from the 2004 Cameroon DHS, this study explored the relationships between SES and HIV and tested a multivariate model designed to highlight the distinctive factors associated with increased risk of HIV among women in different SES classes. The results revealed that high-SES women who reported engaging in riskier sexual behaviour had the highest levels of HIV infection. Surprisingly, among this group increased knowledge of HIV, more domestic decision-making authority and access to health care did not reduce vulnerability. Meanwhile, among low-SES women relative gender inequality was significantly related to HIV risk. Specifically, among this group of women, having a partner with higher education was strongly associated with greater HIV risk. The results suggest that different approaches targeting each sub-group are needed to effectively combat the disease. PMID:24871428

Mumah, Joyce N; Jackson-Smith, Douglas

2014-07-01

116

Essential Trace Elements and Antioxidant Status in Relation to Severity of HIV in Nigerian Patients  

Microsoft Academic Search

Objectives: This study was designed to determine the plasma levels of some antioxidants and trace elements in three severity groups of HIV patients compared with non-HIV-infected controls. Methods: The plasma levels of antioxidants (total antioxidant, albumin, bilirubin and uric acid) and trace elements (Mg, Fe, Zn, Mn, Cu, Cr, Cd and Se) were estimated spectrophotometrically in controls and patients with

J. A. Olaniyi; O. G. Arinola

2007-01-01

117

Current status of HIV/AIDS in Cameroon: how effective are control strategies?  

PubMed

Nearly three decades after its discovery, HIV infection remains the number one killer disease in Sub- Saharan Africa where up to 67% of the world's 33 million infected people live. In Cameroon, based on a Demographic Health Survey carried out in 2004, the national HIV prevalence is estimated at 5.5% with women and youths being predominantly infected. Orphans and vulnerable children (OVC) from the HIV and AIDS pandemic have increased steadily over the years; hospital occupancy is estimated at about 30%, hence stretching the health system; co-infections like HIV/tuberculosis have been reported to reach 40-50% of infected cases and 95% of teachers are said not to be productive on several counts. Thus, the impact is multi-sectorial. Furthermore, the HIV epidemic in Cameroon is peculiar because of the wide HIV-1 genetic diversity of HIV-1 Group M observed with several subtypes reported (A, B, C, D, F, G, H, J, K), predominantly subtype A. There are also circulating recombinant forms, mainly CRF02_AG. In addition, HIV-1 Groups O and N have all been noted in Cameroon. These findings have great implications not only for HIV diagnosis, but also for responsiveness to therapy as well as for vaccine development. In 1986, the initial response of the Cameroon government to the increasing trends in the HIV/AIDS infection was to create a National AIDS Control Committee to coordinate a national AIDS programme. By 2000, the first National Strategic Plan was drawn for 2000-2005. The second National Strategic Plan for 2006-2010 is currently being implemented and covers various axes. Some results obtained show that there has been significantly positive outcomes noted in the various arms of intervention by the Cameroon government. PMID:19151432

Mbanya, Dora; Sama, Martyn; Tchounwou, Paul

2008-12-01

118

Lowering the Risk of Secondary HIV Transmission: Insights From HIV-Positive Youth and Health Care Providers  

PubMed Central

CONTEXT Both perinatally and behaviorally infected HIV-positive youth engage in sexually risky behaviors, and a better understanding of the perceptions of these youth and of health care providers regarding disclosure of HIV status and risk reduction would aid in the development of behavioral interventions for such youth. METHODS In spring 2007, some 20 HIV-positive inner-city youth (aged 1324) and 15 health care providers who work with HIV-infected youth participated in in-depth, semistructured interviews. Youth were recruited at an HIV clinic, AIDS clinics and an AIDS service organization, and had received care from participating providers. Detailed contextual and thematic discourse analysis was performed on interview transcriptions. RESULTS Eighteen of the 20 youth had disclosed their HIV status to another individual at least once. Eleven reported being sexually active, and three of these had been perinatally infected. Qualitative analysis revealed four subthemes related to disclosure: stigma and emotions, trust issues, reasons for disclosing and strategies for addressing disclosure. Five subthemes were identifi ed related to sexual risk reduction: dating challenges, attitudes toward condom use, self-effi cacy for condom use negotiation, pregnancy attitudes and sexual risk reduction strategies. Providers reported that access to more engaging and interactive educational tools within the clinic setting could enhance their risk reduction counseling with HIV-positive youth. CONCLUSIONS HIV-positive youth experience multiple challenges regarding disclosure and sexual risk reduction, and health care providers need innovative tools that can be used in clinic settings to improve adolescents skills in reducing risky sexual behavior. PMID:20618750

Markham, Christine M.; Bui, Thanh; Shegog, Ross; Paul, Mary E.

2011-01-01

119

HIV among Latinos  

MedlinePLUS

... testing, counseling, or treatment if infected because of immigration status, stigma, or fear of discrimination. Traditional gender ... testing, and treatment. Because of fear of disclosing immigration status and possible deportation, undocumented Hispanic/Latino immigrants ...

120

Geographically Structured Populations of Cryptococcus neoformans Variety grubii in Asia Correlate with HIV Status and Show a Clonal Population Structure  

PubMed Central

Cryptococcosis is an important fungal disease in Asia with an estimated 140,000 new infections annually the majority of which occurs in patients suffering from HIV/AIDS. Cryptococcus neoformans variety grubii (serotype A) is the major causative agent of this disease. In the present study, multilocus sequence typing (MLST) using the ISHAM MLST consensus scheme for the C. neoformans/C. gattii species complex was used to analyse nucleotide polymorphisms among 476 isolates of this pathogen obtained from 8 Asian countries. Population genetic analysis showed that the Asian C. neoformans var. grubii population shows limited genetic diversity and demonstrates a largely clonal mode of reproduction when compared with the global MLST dataset. HIV-status, sequence types and geography were found to be confounded. However, a correlation between sequence types and isolates from HIV-negative patients was observed among the Asian isolates. Observations of high gene flow between the Middle Eastern and the Southeastern Asian populations suggest that immigrant workers in the Middle East were originally infected in Southeastern Asia. PMID:24019866

Simwami, Sitali; Fisher, Matthew C.; Wahyuningsih, Retno; Chakrabarti, Arunaloke; Chowdhary, Anuradha; Ikeda, Reiko; Taj-Aldeen, Saad J.; Khan, Ziauddin; Ip, Margaret; Imran, Darma; Sjam, Ridhawati; Sriburee, Pojana; Liao, Wanqing; Chaicumpar, Kunyaluk; Vuddhakul, Varaporn; Meyer, Wieland; Trilles, Luciana; van Iersel, Leo J. J.; Meis, Jacques F.; Klaassen, Corn H. W.; Boekhout, Teun

2013-01-01

121

MY MOTHER TOLD ME I MUST NOT COOK ANYMOREFOOD, CULTURE, AND THE CONTEXT OF HIV- AND AIDS-RELATED STIGMA IN THREE COMMUNITIES IN SOUTH AFRICA*  

PubMed Central

The purpose of this study was to examine the role of food as an instrument in expressing and experiencing HIV/AIDS stigma by HIV-positive women and their families, with the goal of reducing discrimination. It goes beyond willingness to share utensils, which has been identified in HIV/AIDS research. As part of an ongoing capacity-building HIV/AIDS stigma project in South Africa, 25 focus groups and 15 key informant interviews were conducted among 195 women and 54 men in three Black communities. Participants were asked to discuss how they were treated in the family as women living with HIV and AIDS, and data was organized using the PEN-3 model. Findings highlight both the positive and negative experiences HIV-positive women encounter. Women would not disclose their HIV status to avoid being isolated from participating in the socio-cultural aspects of food preparation, while others that have disclosed their status have experienced alienation. The symbolic meanings of food should be a major consideration when addressing the elimination of HIV/AIDS stigma in South Africa. PMID:19095587

OKOROR, T. A.; AIRHIHENBUWA, C. O.; ZUNGU, M.; MAKOFANI, D.; BROWN, D. C.; IWELUNMOR, J.

2012-01-01

122

Today's HIV/AIDS Epidemic  

MedlinePLUS

... spread of HIV. Language barriers and concerns about immigration status present additional prevention challenges. While the impact ... 2 CDC. Estimated HIV incidence among adults and adolescents in the United States, 20072010. HIV Surveillance ...

123

Disclosure of Their Status to Youth with Human Immunodeficiency Virus Infection in the Dominican Republic: A Mixed-Methods Study.  

PubMed

A mixed-methods study was conducted to determine the proportion of HIV-infected children who knew their status, identify characteristics associated with children's knowledge of their status, and describe caregivers' and adolescents' experiences relevant to disclosure in the Dominican Republic (DR). Of 327 patients aged 6-18years treated in the principal DR pediatric HIV facilities, 74 (22.6%) knew their status. Patients aged 13years or older and/or who had participated in non-clinical activities for HIV-infected children were more likely to know their status. Caregivers who had disclosed cited healthcare providers' advice, children's desire to know and concerns that children might initiate sexual activity before knowing or discover their status by accidental or malicious disclosure. Non-disclosing caregivers worried that children would be traumatized by disclosure and/or stigmatized if they revealed it to others. Adolescents supported disclosure by 10-12years of age, considered withholding of children's HIV diagnosis ill-advised, and recommended a disclosure process focused initially on promoting non-stigmatizing attitudes about HIV. PMID:25186784

Beck-Sagu, Consuelo; Pinzn-Iregui, Maria Claudia; Abreu-Prez, Rosa; Lerebours-Nadal, Leonel; Navarro, Christi M; Ibanez, Gladys; Soto, Solange; Halpern, Mina; Nicholas, Stephen W; Malow, Robert; Dvieux, Jessy G

2014-09-01

124

Nondisclosure of HIV Status in a Clinical Trial Setting: Antiretroviral Drug Screening Can Help Distinguish Between Newly Diagnosed and Previously Diagnosed HIV Infection  

PubMed Central

In The HIV Prevention Trials Network 061 study, 155 human immunodeficiency virus (HIV)infected men reported no prior HIV diagnosis; 83 of those men had HIV RNA levels of <1000 copies/mL at enrollment. Antiretroviral drug testing revealed that 65 of the 83 (78.3%) men were on antiretroviral treatment. Antiretroviral drug testing can help distinguish between newly diagnosed and previously diagnosed HIV infection. PMID:24092804

Marzinke, Mark A.; Clarke, William; Wang, Lei; Cummings, Vanessa; Liu, Ting-Yuan; Piwowar-Manning, Estelle; Breaud, Autumn; Griffith, Sam; Buchbinder, Susan; Shoptaw, Steven; del Rio, Carlos; Magnus, Manya; Mannheimer, Sharon; Fields, Sheldon D.; Mayer, Kenneth H.; Wheeler, Darrell P.; Koblin, Beryl A.; Eshleman, Susan H.; Fogel, Jessica M.

2014-01-01

125

Dipeptidyl Peptidase IV Inhibition Does Not Adversely Affect Immune or Virological Status in HIV Infected Men And Women: A Pilot Safety Study  

PubMed Central

Context: People infected with HIV have a higher risk for developing insulin resistance, diabetes, and cardiovascular disease than the general population. Dipeptidyl peptidase IV (DPP4) inhibitors are glucose-lowering medications with pleiotropic actions that may particularly benefit people with HIV, but the immune and virological safety of DPP4 inhibition in HIV is unknown. Objective: DPP4 inhibition will not reduce CD4+ T lymphocyte number or increase HIV viremia in HIV-positive adults. Design: This was a randomized, placebo-controlled, double-blind safety trial of sitagliptin in HIV-positive adults. Setting: The study was conducted at an academic medical center. Participants: Twenty nondiabetic HIV-positive men and women (9.8 5.5 years of known HIV) taking antiretroviral therapy and with stable immune (625 134 CD4+ T cells per microliter) and virological (<48 copies HIV RNA per milliliter) status. Intervention: The intervention included sitagliptin (100 mg/d) vs matching placebo for up to 24 weeks. Main Outcome Measures: CD4+ T cell number and plasma HIV RNA were measured every 4 weeks; fasting serum regulated upon activation normal T-cell expressed and secreted (RANTES), stromal derived factor (SDF)-1?, Soluble TNF receptor II, and oral glucose tolerance were measured at baseline, week 8, and the end of study. ANOVA was used for between-group comparisons; P < .05 was considered significant. Results: Compared with placebo, sitagliptin did not reduce CD4+ T cell count, plasma HIV RNA remained less than 48 copies/mL, RANTES and soluble TNF receptor II concentrations did not increase. SDF1? concentrations declined (P < .0002) in the sitagliptin group. The oral glucose tolerance levels improved in the sitagliptin group at week 8. Conclusions: Despite lowering SDF1? levels, sitagliptin did not adversely affect immune or virological status, or increase immune activation, but did improve glycemia in healthy, nondiabetic HIV-positive adults. These safety data allow future efficacy studies of sitagliptin in HIV-positive people with cardiometabolic complications. PMID:23264399

Goodwin, Scott R.; Reeds, Dominic N.; Royal, Michael; Struthers, Heidi; Laciny, Erin

2013-01-01

126

Healthcare provider intervention on smoking and quit attempts among HIV-positive versus HIV-negative MSM smokers in Chengdu, China  

PubMed Central

Given the implications for smoking among HIV-positive individuals and high smoking and HIV rates among men who have sex with men (MSM) in China, we examined sociodemographic, smoking-related, psychosocial, and substance use factors in relation to HIV status; receiving some sort of healthcare provider intervention regarding smoking; and having made a quit attempt in the past year in a sample of MSM smokers in Chengdu. We conducted a cross-sectional survey of 381 MSM smokers recruited by a nongovernmental organization in Chengdu in 20122013. Of these, 350 disclosed their HIV status and 344 (188 HIV-positive and 156 HIV-negative) provided completed data. Half (50.0%) reported at least one quit attempt in their lifetime; 30.5% reported a quit attempt in the past year. The majority (59.4%) reported that a healthcare provider had intervened in some way (assessed smoking, advised quitting, provided assistance), most commonly by assessing smoking status (50.0%). HIV-positive individuals were more likely to report a healthcare provider intervening on their smoking (p < .001). Those who received provider intervention were more likely to have attempted to quit ever (p = .009) and in the past year (p < .001). Those HIV-positive were more likely to have attempted to quit since diagnosis if a provider had intervened (p = .001). Multivariate regression documented that being HIV-positive (p < .001), greater cigarette consumption (p = .02), less frequent drinking (p = .03), and greater depressive symptoms (p = .003) were significant correlates of healthcare provider intervention. Multivariate regression also found that healthcare provider intervention (p = .003), older age (p = .01), and higher autonomous motivation (p = .007) were significant correlates of attempting to quit in the past year. Given the impact of healthcare provider intervention regarding smoking on quit attempts among MSM, greater training and support is needed to promote consistent intervention on smoking in the clinical setting among HIV-positive and HIV-negative MSM smokers. PMID:24601710

Berg, Carla J.; Nehl, Eric J.; Wang, Xiaodong; Ding, Yingying; He, Na; Johnson, Brent A.; Wong, Frank Y.

2015-01-01

127

A Community-Based Study of Barriers to HIV Care Initiation  

PubMed Central

Abstract Timely treatment of HIV infection is a public health priority, yet many HIV-positive persons delay treatment initiation. We conducted a community-based study comparing HIV-positive persons who received an HIV diagnosis at least 3 months ago but had not initiated care (n=100) with a reference population of HIV-positive persons currently in care (n=115) to identify potential barriers to treatment initiation. Study participants were mostly male (78.0%), and persons of color (54.9% Latino, 26.3% black), with median age 37.8 years. Median time since HIV diagnosis was 3.7 years. Univariate analysis revealed that those never in care differed substantially from those currently in care with regard to sociodemographics; HIV testing and counseling experiences; perceived barriers to care; and knowledge, attitudes, and beliefs regarding HIV. Factors independently associated with never initiating HIV care were younger age (adjusted odds ratio [AOR]=0.93; 95% confidence interval [CI]: 0.88, 0.99), shorter time since diagnosis (AOR=0.87; 95% CI: 0.77, 0.98), lacking insurance (AOR=0.11; 95% CI: 0.03, 0.35), not knowing someone with HIV/AIDS (AOR=0.09; 95% CI: 0.03, 0.30) not disclosing HIV status (AOR=0.13; 95% CI: 0.02, 0.70), not receiving help making an HIV care appointment after diagnosis (AOR=0.04; 95% CI: 0.01, 0.14), and not wanting to think about being HIV positive (AOR=3.57; 95% CI: 1.22, 10.46). Our findings suggest that isolation and stigma remain significant barriers to initiating HIV care in populations consisting primarily of persons of color, and that direct linkages to HIV care at the time of diagnosis are critical to promoting timely care initiation in these populations. PMID:21955175

Pollini, Robin A.; Blanco, Estela; Crump, Carol

2011-01-01

128

HIV-positive parents, HIV-positive children, and HIV-negative childrens perspectives on disclosure of a parents and childs illness in Kenya  

PubMed Central

HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at five years with full disclosure delivered at 10 years when the child was capable of understanding the illness, or by 14 years when the child was mature enough to receive the news if full disclosure had not been conducted earlier. Important considerations at the time of full disclosure included the parents and/or childs health statuses, number of infected family members illnesses to be disclosed to the child, childs maturity and understanding level, and the person best suited to deliver full disclosure to the child. The results also revealed it was important to address important life events such as taking a national school examination during disclosure planning and delivery. Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs in resource-poor nations with high HIV prevalence. PMID:25071999

Burkholder, Gary J.; Ferraro, Aimee

2014-01-01

129

What Should Be Disclosed to Research Participants?  

PubMed Central

Debate surrounding the SUPPORT study highlights the absence of consensus regarding what information should be disclosed to potential research participants. Some commentators endorse the view that clinical research should be subject to high disclosure standards, even when it is testing standard-of-care interventions. Others argue that trials assessing standard-of-care interventions need to disclose only the information that is disclosed in the clinical care setting. To resolve this debate, it is important to identify the ethical concerns raised by clinical research and determine what consent process is needed to address them. PMID:24256522

Wendler, David

2014-01-01

130

Optimism and education buffer the effects of syndemic conditions on HIV status among African American men who have sex with men.  

PubMed

The present study sought to replicate effects of the number of syndemic psychosocial health conditions on sexual risk behavior and HIV infection among a sample of high-risk African American men who have sex with men (MSM) and to identify resilience factors that may buffer these effects. We used baseline data from an HIV risk-reduction trial to examine whether a higher number of syndemic conditions was associated with higher rates of self-reported sexual risk behavior and HIV infection. Using logistic regression models, we tested for interactions between number of syndemic conditions and several potential resilience factors to identify buffering effects. Replicating previous studies, we found significant associations between numbers of syndemic conditions and higher rates of sexual risk behavior and HIV infection. Surprisingly, we also replicated a previous finding (Stall et al., Am J Public Health, 93(6):939-942, 2003) that the effects of syndemic burden on HIV status fell off at the highest levels of syndemic conditions. Among a variety of potential resilience factors, two-optimism and education-buffered the syndemic effect on HIV prevalence. This is, to our knowledge, the first paper to identify resilience factors buffering against syndemic effects among MSM. It also constitutes a significant contribution to the literature regarding prevention among black MSM. These results point to the need to identify HIV-positive black MSM and provide effective treatment for them and to develop interventions addressing both syndemic and resilience factors. PMID:24705710

O'Leary, Ann; Jemmott, John B; Stevens, Robin; Rutledge, Scott Edward; Icard, Larry D

2014-11-01

131

Relationship Between Health Literacy, Knowledge of Health Status, and Beliefs about HIV/AIDS Transmission among Ryan White Clients in Miami  

ERIC Educational Resources Information Center

Objective: The aim of this study was to examine the relationships between health literacy, knowledge of health status, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) transmission beliefs among recipients of Ryan White care. Design: Quota and convenience sampled, quantitative analysis captured with closed and

Mooss, Angela; Brock-Getz, Petra; Ladner, Robert; Fiano, Theresa

2013-01-01

132

CD127 Expression, Exhaustion Status and Antigen Specific Proliferation Predict Sustained Virologic Response to IFN in HCV/HIV Co-Infected Individuals  

PubMed Central

Hepatitis C virus (HCV) infection is a major cause of morbidity and mortality in the HIV co-infected population. Interferon-alpha (IFN-?) remains a major component of anti-HCV therapy despite its deleterious effects on the immune system. Furthermore, IFN-? was recently shown to diminish the size of the latent HIV reservoir. The objectives of this study were to monitor the impact of IFN-? on T cell phenotype and proliferation of HIV and HCV-specific T cells during IFN therapy, and to identify immune markers that can predict the response to IFN in HICV/HIV co-infected patients. We performed longitudinal analyses of T cell numbers, phenotype and function in co-infected patients undergoing IFN-? therapy with different outcomes including IFN-? non-responders (NR) (n?=?9) and patients who achieved sustained virologic response (SVR) (n?=?19). We examined the expression of activation (CD38, HLA-DR), functional (CD127) and exhaustion markers (PD1, Tim-3, CD160 and CD244) on total CD4 and CD8 T cells before, during and after therapy. In addition, we examined the HIV- and HCV-specific proliferative responses against HIV-p24 and HCV-NS3 proteins. Frequencies of CD127+ CD4 T cells were higher in SVR than in NR patients at baseline. An increase in CD127 expression on CD8 T cells was observed after IFN-? therapy in all patients. In addition, CD8 T cells from NR patients expressed a higher exhaustion status at baseline. Finally, SVR patients exhibited higher proliferative response against both HIV and HCV antigens at baseline. Altogether, SVR correlated with higher expression of CD127, lower T cell exhaustion status and better HIV and HCV proliferative responses at baseline. Such factors might be used as non-invasive methods to predict the success of IFNbased therapies in co-infected individuals. PMID:25007250

Kared, Hassen; Saeed, Sahar; Klein, Marina B.; Shoukry, Naglaa H.

2014-01-01

133

Get Tested for HIV  

MedlinePLUS

... tested at least once to find out your HIV status. Ask your doctor or nurse if and when you need the test again. All pregnant women should be tested for HIV. All other women should be tested at least ...

134

Alternative medicine use in HIV-positive men and women: Demographics, utilization patterns and health status  

Microsoft Academic Search

Between 1995 and 1997, 1,675 HIV-positive men and women using complementary and alternative medicine (CAM) were enrolled into the Bastyr University AIDS Research Center's Alternative Medicine Care Outcomes in AIDS (AMCOA) study. Funded by the National Institutes of Health (NIH) Office of Alternative Medicine (OAM) and National Institute of Allergy and Infectious Diseases (NIAID), the AMCOA study collected information on

L. J. Standish; K. B. Greene; S. Bain; C. Reeves; F. Sanders; R. C. M. Wines; P. Turet; J. G. Kim; C. Calabrese

2001-01-01

135

Colorectal Cancer Screening at the Nexus of HIV, Minority Statuses, and Cultural Safety  

ERIC Educational Resources Information Center

Background: The incidence of non-AIDS-defining cancers has increased significantly among persons living with HIV (PLHIV). Screening education is recommended. Purpose: Social learning, minority stress, and cultural safety theories informed this pilot to assess the feasibility of a colorectal cancer screening intervention targeted to PLHIV, with

Ka'opua, Lana Sue I.; Diaz, Tressa P.; Park, Soon H.; Bowen, Talita; Patrick, Kevin; Tamang, Suresh; Braun, Kathryn L.

2014-01-01

136

Results from an Empirical Study of School Principals' Decisions about Disclosure of HIV Status  

ERIC Educational Resources Information Center

Elementary school principals' decisions about disclosure of school age children's confidential medical information was empirically studied. Participants included a stratified sample of 339 elementary school principals from the seven largest school districts in Florida. Each participant received one of six vignettes describing a student with HIV,

Chenneville, Tiffany

2007-01-01

137

Self-compassion and reactions to serious illness: the case of HIV.  

PubMed

To test the hypothesis that self-compassion buffers people against the emotional impact of illness and is associated with medical adherence, 187 HIV-infected individuals completed a measure of self-compassion and answered questions about their emotional and behavioral reactions to living with HIV. Self-compassion was related to better adjustment, including lower stress, anxiety, and shame. Participants higher in self-compassion were more likely to disclose their HIV status to others and indicated that shame had less of an effect on their willingness to practice safe sex and seek medical care. In general, self-compassion was associated with notably more adaptive reactions to having HIV. PMID:23300046

Brion, John M; Leary, Mark R; Drabkin, Anya S

2014-02-01

138

A comparative evaluation of quantitative neuroimaging measurements of brain status in HIV infection.  

PubMed

Diffusion tensor imaging (DTI), magnetization transfer imaging (MT) and automated brain volumetry were used to summarize brain involvement in human immunodeficiency virus (HIV) infection. A multiparametric neuroimaging protocol was implemented at 1.5 T in 10 HIV+ and 24 controls. Various summary parameters were calculated based on DTI, MT, and automated brain volumetry. The magnitude of the difference, as well as the between-group discrimination, was determined for each measure. Bivariate correlations were computed and redundancy among imaging parameters was examined by principal factor analysis. Significant or nearly significant differences were found for most measures. Large Cohen's d effect sizes were indicated for mean diffusivity (MD), fractional anisotropy (FA), magnetization transfer ratio (MTR) and gray matter volume fraction (GM). Between-group discrimination was excellent for FA and MTR and acceptable for MD. Correlations among all imaging parameters could be explained by three factors, possibly reflecting general atrophy, neuronal loss, and alterations. This investigation supports the utility of summary measurements of brain involvement in HIV infection. The findings also support assumptions concerning the enhanced sensitivity of DTI and MT to atrophic as well as alterations in the brain. These findings are broadly generalizable to brain imaging studies of physiological and pathological processes. PMID:22892348

Du, Hongyan; Wu, Ying; Ochs, Renee; Edelman, Robert R; Epstein, Leon G; McArthur, Justin; Ragin, Ann B

2012-07-30

139

Foreign Born Status and HIV\\/AIDS: A Comparative Analysis of HIV\\/AIDS Characteristics Among Foreign and U.S. Born Individuals  

Microsoft Academic Search

The purpose of this study was to observe differences in HIV characteristics between the foreign and U.S. born HIV population.\\u000a The study sample consisted of individuals, ?13years of age, who have been diagnosed with HIV and are patients of the Lexington\\u000a Bluegrass Care Clinic. For the comparison analysis, the sample was divided into two groups (n=1070), foreign born and U.S.

Tim Crawford; Glyn Caldwell; Heather M. Bush; Steve Browning; Alice Thornton

140

Immigration Status and HIV-risk Related Behaviors among Female Sex Workers in South America  

Microsoft Academic Search

This study compares immigrant (i.e., foreigner) with non-immigrant (i.e., local\\/native) HIV-related risk behaviors among female\\u000a sex workers (FSW) in South America. A total of 1,845 FSW were enrolled in Argentina, Bolivia, Ecuador, and Uruguay. According\\u000a to their nationality, 10.1% of participants were immigrant FSW. Immigrant FSW were more likely to be younger in Argentina;\\u000a to work in a disco\\/bar in

Christian T. Bautista; Carlos Mosquera; Margarita Serra; Alberto Gianella; Maria M. Avila; Victor Laguna-Torres; Jean K. Carr; Silvia M. Montano; Jos L. Sanchez

2008-01-01

141

The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda: Universal Primary Education as a natural experiment.  

PubMed

This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p<0.01) in Malawi and by 0.03 (p<0.05) in Uganda. These results are robust to a variety of model specifications. In a series of supplementary analyses a number of potential pathways through which such effects may occur are explored. Findings indicate increased primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. PMID:24985789

Behrman, Julia Andrea

2015-02-01

142

Periradicular lesions in HIV-infected patients attending the faculty of dentistry: clinical findings, socio-demographics status, habits and laboratory data - seeking an association  

PubMed Central

OBJECTIVE: The purpose of this study was to estimate the prevalence of periradicular lesions in HIV-infected Brazilian patients and to assess the correlation of several factors with the periradicular status. METHOD: One hundred full-mouth periapical radiographs were evaluated. A total of 2,214 teeth were evaluated for the presence of periradicular lesions, caries lesions, coronal restorations, pulp cavity exposure and endodontic treatment. RESULTS: The prevalence of periradicular lesions was 46%. There were no significant differences between individuals with or without periradicular lesions with respect to their socio-demographic status, habits, laboratory data and route of HIV infection. However, the presence of a periradicular lesion was statistically correlated with the number of teeth with endodontic treatment (p?=?0.018), inadequate endodontic treatment (p?=?0.025), images suggesting pulp cavity exposure (p?=?0.002) and caries lesions (p?=?0.001). CONCLUSIONS: The prevalence of periradicular lesions in HIV-infected individuals was 46% and was not related to HIV infection. PMID:25318095

Fontes, Tatiana Vasconcellos; Ferreira, Sonia Maria Soares; Silva-Jnior, Arley; dos Santos Marotta, Patrcia; Noce, Cesar Werneck; de Carvalho Ferreira, Dennis; Gonalves, Lucio Souza

2014-01-01

143

Association between lipid genetic and immunological status in chronically HIV-infected patients  

PubMed Central

Introduction Polymorphisms in some host genes have a significant impact on susceptibility to HIV-1 infection and rate of disease progression [1, 2]. The purpose of the current sub-study was to find out the relationship between polymorphisms in genes involved in the lipid metabolism and the CD4/CD8 T-cell counts. Methods Sub-study of a cross-sectional, observational study conducted in 468 patients with HIV infection attended at the outpatient clinic to investigate individual genetic predisposition to atherogenic dyslipidemia (AD). All patients were genetically characterized and all polymorphisms were in HardyWeinberg equilibrium. Thirteen polymorphisms were selected from nine genes: APOA5 (rs662799 and rs3135506); APOC3 (rs5128 and rs4520); LPL (rs328 and rs268); CETP (rs708272); HL (rs1800588); MTP (rs1800591); APOE (rs7412 and rs429358); LRP5 (rs7116604); and VLDLR (rs1454626). Lipid and lipoprotein parameters, CD4 and CD8 T-cell counts and plasma HIV-RNA were determinate. The statistical analysis was performed using SPSS statistical software version 19 (SPSS Inc., Chicago, IL, USA). Results We studied 468 HIV-infected patients (men, 77%), with a mean (SD) age of 45.9 (19.7) years. The mean CD4 T-cell count and nadir CD4 was 547 (459) and 193 (159) cells/L, respectively; 78.7% of participants were virologically suppressed. Patients carrying rs3135506 in the APOA5 gene presented a 9% increase in circulating TG levels (p=0.002) and 10% decrease in HDLc levels (p=0.005). Such association of APOA5 towards dyslipidemia was accompanied by a 21% decrease of the CD4 T-cell count (p=0.024) and a 19% increase in CD8 T-cell count (p=0.002) in carriers of the rare allele in the APOA5 rs662799 polymorphism adjusted by age and gender. Patients carrying the rare allele in rs5128 (APOC3) had a 16% decrease in circulating CD4 T cells (p=0.029); patients carrying rs1800591 (MTP) had a 29% decrease in CD4 T cells and 14% decrease in CD8 T cells (p=0.018 and p=0.008, respectively); patients carrying the rare allele rs1800588 in HL had a 11% increase in CD4 T cells (p=0.043); and carriers of the rs145626 in the VLDLR gene had 10% decrease in CD4 circulating T cells (p=0.013). Conclusion Variants in genes involved in the development of AD may also influence the immunological hostvirus equilibrium in chronically HIV-infected subjects [2, 3]. PMID:25394062

Echeverra, Patricia; Guardiola, Montse; Gonzlez, Marta; Carles Vallv, Joan; Puig, Jordi; Bonjoch, Anna; Clotet, Bonaventura; Ribalta, Josep; Negredo, Eugenia

2014-01-01

144

Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context  

PubMed Central

Background HIV-related stigma has negative consequences for infected people's lives and is a barrier to HIV prevention. Therefore valid and reliable instruments to measure stigma are needed to enable mapping of HIV stigma. This study aimed to evaluate the psychometric properties of the HIV stigma scale in a Swedish context with regard to construct validity, data quality, and reliability. Methods The HIV stigma scale, developed by Berger, Ferrans, and Lashley (2001), was distributed to a cross-sectional sample of people living with HIV in Sweden (n?=?194). The psychometric evaluation included exploratory factor analysis together with an analysis of the distribution of scores, convergent validity by correlations between the HIV stigma scale and measures of emotional well-being, and an analysis of missing items and floor and ceiling effects. Reliability was assessed using Cronbach's ?. Results The exploratory factor analysis suggested a four-factor solution, similar to the original scale, with the dimensions personalised stigma, disclosure concerns, negative self-image, and concerns with public attitudes. One item had unacceptably low loadings and was excluded. Correlations between stigma dimensions and emotional well-being were all in the expected direction and ranged between ?0.494 and ?0.210. The instrument generated data of acceptable quality except for participants who had not disclosed their HIV status to anybody. In line with the original scale, all subscales demonstrated acceptable internal consistency with Cronbach's ? 0.870.96. Conclusion A 39-item version of the HIV stigma scale used in a Swedish context showed satisfactory construct validity and reliability. Response alternatives are suggested to be slightly revised for items assuming the disclosure of diagnosis to another person. We recommend that people that have not disclosed should skip all questions belonging to the dimension personalised stigma. Our analysis confirmed construct validity of the instrument even without this dimension. PMID:25522127

Lindberg, Maria H.; Wettergren, Lena; Wiklander, Maria; Svedhem-Johansson, Veronica; Eriksson, Lars E.

2014-01-01

145

Emotional Writing in an HIV+ Population: Assessing Two Scoring Methods of Emotional\\/Cognitive Processing and Their Effects on Health Status, Physical Symptoms and Psychological Well-being  

Microsoft Academic Search

Objective: The purpose of the present study is to examine whether level of written emotional expression (EE) and emotional\\/cognitive processing (ECP) for traumatic events predict health status (CD4 and VL), Category B symptoms, depression and anxiety in an HIV+ population over four years. Specifically, two different scoring methods of two variables within ECP (cognitive appraisal and self-esteem) will be compared

Lindsay M. Bira

2011-01-01

146

Nondisclosure of HIV Infection to Sex Partners and Alcohols Role: A Russian Experience  

PubMed Central

Nondisclosure of ones HIV infection to sexual partners obviates safer sex negotiations and thus jeopardizes HIV transmission prevention. The role of alcohol use in the disclosure decision process is largely unexplored. This study assessed the association between alcohol use and recent nondisclosure of HIV serostatus to sex partners by HIV-infected risky drinkers in St. Petersburg, Russia. Approximately half (317/605; 52.4 %) reported not having disclosed their HIV serostatus to all partners since awareness of infection. Using three separate GEE logistic regression models, we found no significant association between alcohol dependence, risky alcohol use (past 30 days), or alcohol use at time of sex (past 30 days) with recent (past 3 months) nondisclosure (AOR [95 %CI] 0.81 [0.55, 1.20], 1.31 [0.79, 2.17], 0.75 [0.54, 1.05], respectively). Alcohol use at time of sex was associated with decreased odds of recent nondisclosure among seroconcordant partners and among casual partners. Factors associated with nondisclosure were relationship with a casual partner, a serodiscordant partner, multiple sex partners, awareness of HIV diagnosis less than 1 year, and a lifetime history of sexually transmitted disease. Nondisclosure of HIV status to sex partners is common among HIV-infected Russians, however alcohol does not appear to be a predictor of recent disclosure. PMID:22677972

Cheng, Debbie M.; Quinn, Emily; Krupitsky, Evgeny; Raj, Anita; Walley, Alexander Y.; Bridden, Carly; Chaisson, Christine; Lioznov, Dmitry; Blokhina, Elena; Samet, Jeffrey H.

2013-01-01

147

HIV disclosure and unsafe sex among HIV-infected women in Cameroon: Results from the ANRS-EVAL study  

Microsoft Academic Search

Encouraging seropositive people to voluntarily disclose their serostatus has been promoted as a key component of HIV prevention. Among other reasons, HIV disclosure to one's main partner is believed to be an incentive for serodiscordant couples to practice safe sex. The present article investigated this issue by conducting a cross-sectional survey of a large sample of HIV-infected women attending HIV

Sandrine Loubiere; Patrick Peretti-Watel; Sylvie Boyer; Jrme Blanche; Sverin-Ccile Abega; Bruno Spire

2009-01-01

148

Hazardous and harmful use of alcohol and/or other drugs and health status among South African patients attending HIV clinics.  

PubMed

There is growing recognition of the influence of substance use, particularly alcohol use, on HIV disease progression. This study investigated how hazardous/harmful use of alcohol and drugs impacts the health status of 1503 patients attending HIV clinics. Of the sample, 37 % indicated hazardous/harmful drinking and 13 % indicated a drug problem. Hazardous/harmful use of alcohol and drugs was significantly related to health status, with participants using substances more likely to have TB-positive status (?(2) = 4.30, p < 0.05), less likely to be on ARVs (?(2) = 9.87, p < 0.05) and having lower CD4 counts (t = 4.01, p < 0.05). Structural equation modelling confirmed the centrality of hazardous/harmful use of alcohol as a direct and indirect determinant of disease progression. Based on these findings it is recommended that patients attending HIV clinics be routinely screened for problematic alcohol and/or drug use, with strong emphasis on ensuring ARV adherence in those with problematic alcohol use. PMID:23921585

Kader, R; Seedat, S; Govender, R; Koch, J R; Parry, C D

2014-03-01

149

Effect of Early Antiretroviral Therapy on Sexual Behaviors and HIV-1 Transmission Risk Among Adults With Diverse Heterosexual Partnership Statuses in Cte d'Ivoire  

PubMed Central

Background.?The effect of early initiation of antiretroviral therapy (ART; ie, at CD4+ T-cell counts >350 cells/mm3) on sexual behaviors and human immunodeficiency virus type 1 (HIV) transmission risk has not been documented in populations other than HIV-serodiscordant couples in stable relationships. Methods.?On the basis of data from a behavioral study nested in a randomized, controlled trial (Temprano-ANRS12136) of early ART, we compared proportions of risky sex (ie, unprotected sex with a partner of negative/unknown HIV status) reported 12 months after inclusion between participants randomly assigned to initiate ART immediately (hereafter, early ART) or according to ongoing World Health Organization criteria. Group-specific HIV transmission rates were estimated on the basis of sexual behaviors and viral loadspecific per-act HIV transmission probabilities. The ratio of transmission rates was computed to estimate the protective effect of early ART. Results.?Among 957 participants (baseline median CD4+ T-cell count, 478 cells/mm3), 46.0% reported sexual activity in the past month; of these 46.0%, sexual activity for 41.5% involved noncohabiting partners. The proportion of subjects who engaged in risky sex was 10.0% in the early ART group, compared with 12.8% in the standard ART group (P = .17). After accounting for sexual behaviors and viral load, we estimated that the protective effect of early ART was 90% (95% confidence interval, 81%95%). Conclusion.?Twelve months after inclusion, patients in the early and standard ART groups reported similar sexual behaviors. Early ART decreased the estimated risk of HIV transmission by 90%, suggesting a major prevention benefit among seronegative sex partners in stable or casual relationships with seropositive individuals. PMID:23990567

Jean, Kvin; Gabillard, Delphine; Moh, Raoul; Danel, Christine; Fassassi, Rami; Desgres-du-Lo, Annabel; Eholi, Serge; Lert, France; Anglaret, Xavier; Dray-Spira, Rosemary

2014-01-01

150

Prevalence of unsafe sex with one's steady partner either HIV-negative or of unknown HIV status and associated determinants in Cameroon (EVAL ANRS12-116 survey)  

Microsoft Academic Search

ObjectiveOur study aimed at estimating the prevalence of inconsistent condom use and at identifying its determinants in steady partnerships among people living with HIV\\/AIDS (PLWHA) in Cameroon.MethodsAnalyses were based on data collected during the national cross-sectional multicentre survey EVAL (ANRS 12-116), which was conducted in Cameroon between September 2006 and March 2007 among 3151 adult PLWHA diagnosed HIV-positive for at

Assata Dia; Fabienne Marcellin; Rene-Ccile Bonono; Sylvie Boyer; Anne-Dborah Bouhnik; Camelia Protopopescu; Sinata Koulla-Shiro; Maria Patrizia Carrieri; Claude Ab; Bruno Spire

2010-01-01

151

Early HIV disclosure and nondisclosure among men and women on antiretroviral treatment in Uganda  

PubMed Central

Efforts to expand access to HIV care and treatment often stress the importance of disclosure of HIV status to aid adherence, social support, and continued resource mobilization. We argue that an examination of disclosure processes early in the process of seeking testing and treatment can illuminate individual decisions and motivations, offering insight into potentially improving engagement in care and adherence. We report on baseline data of early HIV disclosure and non-disclosure, including reasons for and responses to disclosure from a cohort of men and women (n=949) currently accessing antiretroviral treatment in two regions of Uganda. We found early disclosures at the time of suspicion or testing positive for HIV by men and women to be largely for the purposes of emotional support and friendship. Responses to these selected disclosures were overwhelmingly positive and supportive, including assistance in accessing treatment. Nonetheless, some negative responses of worry, fear, or social ostracism did occur. Individuals deliberately chose to not disclose their status to partners, relatives, and others in their network, for reasons of privacy or not wanting to cause worry from the other person. These data demonstrate the strategic choices that individuals make early in the course of suspicion, testing, and treatment for HIV to mobilize resources and gain emotional or material support, and similarly their decisions and ability to maintain privacy regarding their status. PMID:23356654

Winchester, MS; McGrath, JW; Kaawa-Mafigiri, D; Namutibwa, F; Ssendegye, G; Nalwoga, A; Kyarikunda, E; Birungi, J; Kisakye, S; Ayebazibwe, N; Walakira, E; Rwabukwali, CB

2013-01-01

152

Acceptability of intrapartum HIV counselling and testing in Cameroon  

Microsoft Academic Search

BACKGROUND: To assess the acceptability of intrapartum HIV testing and determine the prevalence of HIV among labouring women with unknown HIV status in Cameroon. METHOD: The study was conducted in four hospitals (two referral and two districts hospitals) in Cameroon. Labouring women with unknown HIV status were counselled and those who accepted were tested for HIV. RESULTS: A total of

Eugene J Kongnyuy; Enow R Mbu; Francois X Mbopi-Keou; Nelson Fomulu; Philip N Nana; Pierre M Tebeu; Rebecca N Tonye; Robert JI Leke

2009-01-01

153

Missed opportunities for religious organizations to support people living with HIV/AIDS: findings from Tanzania.  

PubMed

Religious beliefs play an important role in the lives of Tanzanians, but little is known about the influence of religion for people living with HIV/AIDS (PLWHA). This study shares perspectives of PLWHA and identifies opportunities for religious organizations to support the psychological well-being of this group. Data were collected in 2006 and 2007 through semistructured interviews with 36 clients (8 Muslims and 28 Christians) receiving free antiretrovirals (ARVs) in Arusha, Tanzania. Swahili-speaking interviewers asked about participation in religion, change in religious engagement since HIV diagnosis, and what role faith plays in living with HIV and taking ARVs. Interviews were audiotaped, transcribed, translated, and analyzed using Atlas t.i. The findings revealed that patients' personal faith positively influenced their experiences living with HIV, but that religious organizations had neutral or negative influences. On the positive side, prayer gave hope to live with HIV, and religious faith increased after diagnosis. Some respondents said that prayer supported their adherence to medications. On the other hand, few disclosed their HIV status in their religious communities, expressing fear of stigma. Most had heard that prayer can cure HIV, and two expected to be cured. While it was common to hear messages about HIV prevention from churches or mosques, few had heard messages about living with HIV. The findings point to missed opportunities by religious organizations to support PLWHA, particularly the need to ensure that messages about HIV are not stigmatizing; share information about HIV treatment; introduce role models of PLWHA; and emphasize that prayers and medical care go hand-in-hand. PMID:19335171

Watt, Melissa H; Maman, Suzanne; Jacobson, Mark; Laiser, John; John, Muze

2009-05-01

154

Terms Used for People Living With HIV in the Democratic Republic of the Congo  

PubMed Central

For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directed at PLWH through anchoring or objectification. Being labeled sometimes made these youth suffer in silence, afraid to disclose their status, or avoid performing actions in public, preferring to let others do them. YLWH need psychosocial support to mitigate the harmful effects of these labels and strengthen their coping skills, whereas community, institutional, and national efforts are needed for stigma reduction. PMID:24463633

Mupenda, Bavon; Duvall, Sandra; Maman, Suzanne; Pettifor, Audrey; Holub, Christina; Taylor, Eboni; Rennie, Stuart; Kashosi, Mujalambo; Lema, Mamie; Behets, Frieda

2015-01-01

155

Terms used for people living with HIV in the Democratic Republic of the Congo.  

PubMed

For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directed at PLWH through anchoring or objectification. Being labeled sometimes made these youth suffer in silence, afraid to disclose their status, or avoid performing actions in public, preferring to let others do them. YLWH need psychosocial support to mitigate the harmful effects of these labels and strengthen their coping skills, whereas community, institutional, and national efforts are needed for stigma reduction. PMID:24463633

Mupenda, Bavon; Duvall, Sandra; Maman, Suzanne; Pettifor, Audrey; Holub, Christina; Taylor, Eboni; Rennie, Stuart; Kashosi, Mujalambo; Lema, Mamie; Behets, Frieda

2014-02-01

156

Serostatus disclosure among adults with HIV in the era of HIV therapy.  

PubMed

Serostatus disclosure is an important component of secondary HIV prevention with potential benefits for both the individual by experiencing increased social support and society by reducing HIV transmission risk behaviors. This cross-sectional study assessed disclosure patterns to sex partners, family members, and friends by sociodemographic and HIV-related factors among an urban, Midwestern U.S. HIV clinic population (n = 809); a majority of whom were African American and male with a mean age of 41 years. Almost three quarters (n = 596) of the sample was currently receiving HIV therapy, with 68% (n = 404) successfully suppressing their HIV viral loads. Among sexually activity individuals, 97% reported disclosing their serostatus to sex partners. This high rate of disclosure to sex partners suggests that social desirability may play a role in this self-reported measure. Approximately half of the sample (n = 359) disclosed to at least one family member and 60% (n = 474) disclosed to at least one friend. Disclosing to family members occurred more often among participants who were unemployed and endorsed depressive disorder symptoms (p < 0.05 for all). Disclosing to friends occurred more frequently among women, Caucasians and those who completed higher levels of education (p < 0.001 for all). HIV disclosure and disease severity were unassociated. Given the chronic nature of HIV care, additional research is needed to develop interventions to facilitate timely disclosure of HIV serostatus. PMID:22107039

Shacham, Enbal; Small, Eusebius; Onen, Nur; Stamm, Kate; Overton, E Turner

2012-01-01

157

Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training  

PubMed Central

Undernutrition among HIV-positive children can be ameliorated if they are given adequate foods in the right frequency and diversity. Food insecurity is known to undermine such efforts, but even in food rich areas, people have undernutrition. As yet no study has examined feeding practices and their associations with nutrition status among as HIV-positive children in regions with high food production. We therefore examined the magnitude of undernutrition and its association with feeding practices among HIV-positive children in a high food production region in Tanzania. Methods We conducted this mixed-method study among 748 children aged 6 months-14 years attending 9 of a total of 32 care and treatment centers in Tanga region, Tanzania. We collected quantitative data using a standard questionnaire and qualitative data through seven focus group discussions (FGDs). Results HIV-positive children had high magnitudes of undernutrition. Stunting, underweight, wasting, and thinness were prevalent among 61.9%, 38.7%, 26.0%, and 21.1% of HIV-positive children, respectively. They also had poor feeding practices: 88.1% were fed at a frequency below the recommendations, and 62.3% had a low level of dietary diversity. Lower feeding frequency was associated with stunting (??=?0.11, p?=?0.016); underweight (??=?0.12, p?=?0.029); and thinness (??=?0.11, p?=?0.026). Lower feeding frequency was associated with low wealth index (??=?0.06, p<0.001), food insecurity (??=??0.05, p<0.001), and caregiver's education. In the FGDs, participants discussed the causal relationships among the key associations; undernutrition was mainly due to low feeding frequency and dietary diversity. Such poor feeding practices resulted from poor nutrition knowledge, food insecurity, low income, and poverty. Conclusion Feeding practices and nutrition status were poor among HIV-positive children even in food rich areas. Improving feeding frequency may help to ameliorate undernutrition. To improve it, tailored interventions should target children of poor households, the food insecure, and caregivers who have received only a low level of education. PMID:24846016

Sunguya, Bruno F.; Poudel, Krishna C.; Mlunde, Linda B.; Urassa, David P.; Yasuoka, Junko; Jimba, Masamine

2014-01-01

158

HIV status, trust in health care providers, and distrust in the health care system among Bronx women  

Microsoft Academic Search

Trust in health care providers and the health care system are essential. This study examined factors associated with trust in providers and distrust in the health care system among minority HIV-positive and -negative women.Interviews were conducted and laboratory tests performed with 102 women from the Women's Interagency HIV Study Bronx site. Interviews collected information about trust in providers, distrust in

C. O. Cunningham; N. L. Sohler; L. Korin; W. Gao; K. Anastos

2007-01-01

159

An Expressive Therapy Group Disclosure Intervention for Women Living With HIV Improves Social Support, Self-efficacy, and the Safety and Quality of Relationships: A Qualitative Analysis.  

PubMed

Women living with HIV (WLHIV) face high rates of morbidity and mortality. HIV disclosure interventions have been identified as a promising but under-evaluated approach for WLHIV to improve their health and well-being. The Medea Project is an expressive therapy group intervention that was first developed to help incarcerated women develop the confidence and skills to tell their stories publicly in theatrical performances. The intervention was subsequently adapted as a community-based disclosure intervention for WLHIV. Our study describes an analysis of the impact of the Medea Project on the lives of the WLHIV who participated. All participating WLHIV publicly disclosed their HIV status during the performances. Five impact themes emerged from the data: sisterhood, catharsis, self-acceptance, safer and healthier relationships, and gaining a voice. Our study identifies a voluntary, effective, and broadly beneficial disclosure intervention for women living with HIV. PMID:25027284

Machtinger, Edward L; Lavin, Sonja M; Hilliard, Starr; Jones, Rhodessa; Haberer, Jessica E; Capito, Kristen; Dawson-Rose, Carol

2015-01-01

160

Experiences of HIV Positive Mothers From Rural South India during Intra-Natal Period  

PubMed Central

Context: Tamil Nadu comes under group I high prevalence state, with less than 1% prevalence of HIV infection in antenatal women but above 5% prevalence in high risk group. One of the ways to control HIV/AIDS in India is through Prevention of Parent to Child Transmission (PPTCT), the success of which lies in identifying pregnant women with HIV infection. But due to the stigma against HIV/AIDS among health care providers, HIV positive patients face discrimination in the health sector. Aims: To explore the difficulties faced by rural HIV positive mothers during the intra-natal period. Methods: A descriptive qualitative study was conducted among HIV positive mothers, in Gingee block of Villupuram district, Tamil Nadu, India. All the mothers who tested positive between June 2006 and May 2010 were interviewed in-depth using an interview guide. Results: There were 21 HIV positive mothers during this period, 19 of whom gave consent. Majority of the mothers were <30 years of age from families belonging to lower socio-economic class. The discriminations faced from the health staff was avoidance of physical examination, rude behaviour like throwing of records on the face, discriminatory comments, unnecessary referrals and even refusal to provide intra-partum services. The negative attitude of the staff made a few mothers to deliver in some other institution without disclosing their HIV status. Conclusion: Stigma among health care providers towards HIV positive pregnant women acts as a barrier for improving access to PPTCT services in India and it poses high risk to the mothers, babies and also the health care providers. There is a pressing need to improve access to quality PPTCT services especially during the intranatal period. PMID:24298476

Subramaniyan, Anbarasi; Sarkar, Sonali; Roy, Gautam; Lakshminarayanan, Subitha

2013-01-01

161

Genitourinary Medicine trainees' experience and training needs in the management of patients disclosing sexual violence.  

PubMed

The British Association for Sexual Health and HIV (BASHH) Sexual Violence group assessed the level of confidence of Genitourinary Medicine (GUM) trainees in managing patients disclosing sexual violence using an online survey. Twenty-eight percent of current UK GUM trainees responded. The results demonstrated wide variation in trainees' experience and confidence in managing these patients, which was dependent on the patient type, as well as the gender of the trainee and the number of years' experience the trainee had in the specialty. There were also differences in the reported availability of training in this specialist area. Regular accessible training in identification and management of patients disclosing sexual violence is recommended for GUM trainees. PMID:24100285

Sacks, Rachel; Emerson, Carol

2014-04-01

162

Status of the HIV/AIDS epidemic and methods to monitor it in the Latin America and Caribbean region.  

PubMed

The paper presented is a review of the available epidemiological data on the situation in the Latin America and Caribbean (LAC) region, and looks at HIV prevalence in specific population groups. At the end of 2001, HIV remains an important health issue in the LAC region. Twelve countries in the region have an estimated prevalence of 1% or higher among pregnant women. Most of the LAC countries with generalized epidemics are located in the Caribbean basin. In the past decade there has been a slow but continuous increase in HIV prevalence rates among the general population and vulnerable groups, although information in some countries is limited. In many countries, the highest HIV prevalence among vulnerable groups is found among men who have sex with men. HIV infections related to injecting drug use are concentrated in the countries of the Southern Cone and Brazil. HIV is well anchored in the region, concentrated in vulnerable groups in most countries, but with an increasing presence in some countries in the general population. There is a need to improve data collection and introduce new tools to monitor behavior trends and the impact of interventions. PMID:12685919

Calleja, Jesus M Garcia; Walker, Neff; Cuchi, Paloma; Lazzari, Stefano; Ghys, Peter D; Zacarias, Fernando

2002-12-01

163

Risk behaviors and STI prevalence among people with HIV in El Salvador.  

PubMed

To date, there are no studies from El Salvador among people with HIV to inform prevention programs. We conducted a study in El Salvador in 2008 among people with HIV using audio computer-assisted interviews on risk behaviors and access to health care. Blood was tested for syphilis and herpes simplex type 2 (HSV-2). Active syphilis was defined as RPR titer ?1:8. Genital specimens were tested for other sexually transmitted infections (STI) by PCR. We evaluated factors associated with unprotected sex with last stable partner of HIV-negative or unknown status among those reporting a stable partner. A total of 811 HIV-positive individuals participated: 413 men and 398 women. Prevalence of Chlamydia and gonorrhea was low (?1%), while prevalence of other STI was high: Mycoplasma genitalium (14%), syphilis (15% seropositivity, active syphilis 3%) and HSV-2 (85%). In multivariate analysis, disclosing HIV status to partner (OR 0.2, 95% CI: 0.1-0.3, p<0.001), participation in HIV support groups (OR 0.3, 95% CI: 0.1-0.8, p=0.01), easy access to condoms (OR 0.4, 95% CI: 0.2-0.9, p=0.04) were protective factors for unprotected sex. Reporting a casual partner in the last 12 months (OR 3.6, 95% CI: 1.5-8.5, p=0.004). and having an STI (OR 2.6, 95% CI:1.3-5.5, p=0.02) were associated with an increased odds of unprotected sex. Prevention interventions among HIV-positives in El Salvador should focus on increasing condom access, promoting HIV disclosure and couples testing and reducing the number of partners. The positive role of support groups should be used to enhance behavioral change. PMID:23049671

Paz-Bailey, G; Shah, N; Creswell, J; Guardado, M E; Nieto, A I; Estrada, M C; Cedillos, R; Pascale, J M; Monterroso, E

2012-01-01

164

Mixed-Status Couples  

MedlinePLUS

... Hospitalization and Palliative Care Friends & Family Dating and Marriage Having Children Mixed-Status Couples Discrimination Legal Issues ... safe sex and HIV. Friends and Family Dating & Marriage Having Children Mixed-Status Couples Related Topics on ...

165

Details for Manuscript Number SSM-D-07-01631R1 HIV-Related Stigma: Adapting a Theoretical Framework for Use in India  

PubMed Central

Stigma complicates the treatment of HIV worldwide. We examined whether a multi-component framework, initially consisting of enacted, felt normative, and internalized forms of individual stigma experiences, could be used to understand HIV-related stigma in Southern India. In Study 1, qualitative interviews with a convenience sample of 16 people living with HIV revealed instances of all three types of stigma. Experiences of discrimination (enacted stigma) were reported relatively infrequently. Rather, perceptions of high levels of stigma (felt normative stigma) motivated people to avoid disclosing their HIV status. These perceptions often were shaped by stories of discrimination against others HIV-infected individuals, which we adapted as an additional component of our framework (vicarious stigma). Participants also varied in their acceptance of HIV stigma as legitimate (internalized stigma). In Study 2, newly-developed measures of the stigma components were administered in a survey to 229 people living with HIV. Findings suggested that enacted and vicarious stigma influenced felt normative stigma; that enacted, felt normative, and internalized stigma were associated with higher levels of depression; and that the associations of depression with felt normative and internalized forms of stigma were mediated by the use of coping strategies designed to avoid disclosure of one's HIV serostatus. PMID:18599171

Herek, Gregory M; Ramakrishna, Jayashree; Bharat, Shalini; Chandy, Sara; Wrubel, Judith; Ekstrand, Maria L

2008-01-01

166

Fertility desire among HIV-positive women in Tigray region, Ethiopia: implications for the provision of reproductive health and prevention of mother-to-child HIV transmission services.  

PubMed

BackgroundThere is growing recognition of the difficult reproductive decisions faced by HIV-positive women. Studies in both resource-constrained and developed countries have suggested that many HIV-positive women continue to desire children in spite of their understanding of the possible risks that HIV poses. This study investigates the factors associated with fertility desire among HIV-positive women in Tigray region, Ethiopia.MethodsA cross-sectional survey was conducted among 964 HIV-positive women receiving HIV care in 12 health centers of Tigray region. In each health center, the number of study participants was allocated proportionally to the load of HIV-positive women in the chronic care clinics. A descriptive summary of the data and a logistic regression model were used to identify factors associated with fertility desire using odds ratios with a 95% confidence interval and P-value of 0.05.ResultsFour hundred and thirty nine (45.5%) of the participants reported a desire to have children in the future. Eighty six percent of the women had given birth to at least one live baby at the time of study, with the median number of live births being 2 (Inter quartile range=1,3). Women in the age group of 1524 years [AOR=2.64(95% CI: 1.44, 4.83)] and 2534 years [AOR=2.37(95% CI: 1.60, 2.4 3.50)] had higher fertility desire as compared to women in the age group of 3549 years. Having no children [AOR=25.76(95% CI: 13.66, 48.56)], having one to two children [AOR=5.14 (95%CI: 3.37, 7.84)] and disclosing HIV status to husband/sexual partner [AOR=1.74(95% CI: 1.11, 2.72)] were all independently associated with fertility desire.ConclusionsAge, HIV disclosure status to husband/sexual partner, and relatively few live children were all found to influence HIV-positive womens fertility desire. Programmers and policy makers should consider the effects of these factors for HIV-positive women as they develop HIV/AIDS interventions. PMID:25407330

Melaku, Yohannes; Zeleke, Ejigu; Kinsman, John; Abraha, Akberet

2014-11-19

167

Incidence and Predictors of Pregnancy among a Cohort of HIV-Positive Women Initiating Antiretroviral Therapy in Mbarara, Uganda  

PubMed Central

Objective Many people living with HIV in sub-Saharan Africa desire biological children. Implementation of HIV prevention strategies that support the reproductive goals of people living with HIV while minimizing HIV transmission risk to sexual partners and future children requires a comprehensive understanding of pregnancy in this population. We analyzed prospective cohort data to determine pregnancy incidence and predictors among HIV-positive women initiating antiretroviral therapy (ART) in a setting with high HIV prevalence and fertility. Methods Participants were enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO) cohort of HIV-positive individuals initiating ART in Mbarara. Bloodwork (including CD4 cells/mm3, HIV viral load) and questionnaires (including socio-demographics, health status, sexual behavior, partner dynamics, HIV history, and self-reported pregnancy) were completed at baseline and quarterly. Our analysis includes 351 HIV-positive women (1849 years) who enrolled between 20052011. We measured pregnancy incidence by proximal and distal time relative to ART initiation and used multivariable Cox proportional hazards regression analysis (with repeated events) to identify baseline and time-dependent predictors of pregnancy post-ART initiation. Results At baseline (pre-ART initiation), median age was 33 years [IQR: 2737] and median prior livebirths was four [IQR: 26]. 38% were married with 61% reporting HIV-positive spouses. 73% of women had disclosed HIV status to a primary sexual partner. Median baseline CD4 was 137 cells/mm3 [IQR: 81207]. At enrolment, 9.1% (31/342) reported current pregnancy. After ART initiation, 84 women experienced 105 pregnancies over 3.8 median years of follow-up, yielding a pregnancy incidence of 9.40 per 100 WYs. Three years post-ART initiation, cumulative probability of at least one pregnancy was 28% and independently associated with younger age (Adjusted Hazard Ratio (AHR): 0.89/year increase; 95%CI: 0.860.92) and HIV serostatus disclosure to primary sexual partner (AHR: 2.45; 95%CI: 1.294.63). Conclusions Nearly one-third of women became pregnant within three years of initiating ART, highlighting the need for integrated services to prevent unintended pregnancies and reduce periconception-related risks for HIV-infected women choosing to conceive. Association with younger age and disclosure suggests a role for early and couples-based safer conception counselling. PMID:23704906

Kaida, Angela; Matthews, Lynn T.; Kanters, Steve; Kabakyenga, Jerome; Muzoora, Conrad; Mocello, A. Rain; Martin, Jeffrey N.; Hunt, Peter; Haberer, Jessica; Hogg, Robert S.; Bangsberg, David R.

2013-01-01

168

Relationships Among Neurocognitive Status, Medication Adherence Measured by Pharmacy Refill Records, and Virologic Suppression in HIV-infected Persons  

PubMed Central

Background Optimal antiretroviral therapy (ART) effectiveness depends upon medication adherence, which is a complex behavior with many contributing factors including neurocognitive function. Pharmacy refill records offer a promising and practical tool to assess adherence. Methods A substudy of the CHARTER (CNS HIV Anti-Retroviral Therapy Effects Research) study was conducted at the Johns Hopkins University (JHU) and the University of Washington (UW). Pharmacy refill records were the primary method to measure ART adherence, indexed to a sentinel drug with the highest central nervous system penetration effectiveness score. Standardized neuromedical, neuropsychological, psychiatric and substance use assessments were performed at enrollment and at 6 months. Regression models were used to determine factors associated with adherence and the relationships between adherence and change in plasma and cerebrospinal fluid HIV RNA concentrations between visits. Results Among 80 (33 JHU, 47 UW) participants, the mean adherence score was 86.4% with no difference by site. In the final multivariable model, better neurocognitive function was associated with better adherence, especially among participants who were at JHU, male, and HIV-infected for a longer time-period. Worse performance on working memory tests was associated with worse adherence. Better adherence predicted greater decreases in cerebrospinal fluid HIV RNA between visits. Conclusion Poorer global neurocognitive functioning and deficits in working memory were associated with lower adherence defined by a pharmacy refill record measure, suggesting that assessments of cognitive function, and working memory in particular, may identify patients at risk for poor ART adherence who would benefit from adherence support. PMID:23202813

Andrade, Adriana S.A.; Deutsch, Reena; Celano, Shivaun; Duarte, Nichole A.; Marcotte, Thomas D.; Umlauf, Anya; Atkinson, J. Hampton; McCutchan, J. Allen; Franklin, Donald; Alexander, Terry J.; McArthur, Justin; Marra, Christina; Grant, Igor; Collier, Ann C

2013-01-01

169

Health Status of HIV-Infected Women Entering Care: Baseline Medical Findings from the Women of Color Initiative.  

PubMed

Abstract The WOC Initiative is a prospective study of 921 women of color (WOC) entering HIV care at nine (three rural, six urban) sites across the US. A baseline interview was performed that included self-reported limitation(s) in activity, health conditions, and the CDC's health-related quality of life measures (Healthy Days). One-third of the WOC reported limiting an activity because of illness or a health condition and those with an activity limitation reported 13 physically and 14 mentally unhealthy days/month, compared with 5 physically and 9 mentally unhealthy days/month in the absence of an activity limitation. Age was associated with a three- to fourfold increased risk of an activity limitation but only for WOC in the urban sites. Diabetes was associated with a threefold increased risk of a limitation among women at rural sites. Cardiac disease was associated with a six- to sevenfold increased risk of an activity limitation for both urban and rural WOC. HIV+ WOC reported more physically and mentally unhealthy days than the general US female population even without an activity limitation. Prevention and treatment of diabetes and cardiovascular disease will need to be a standard part of HIV care to promote the long-term health and HRQOL for HIV-infected WOC. PMID:25561306

Quinlivan, E Byrd; Fletcher, Jason; Eastwood, Elizabeth A; Blank, Arthur E; Verdecias, Niko; Roytburd, Katya

2015-01-01

170

Disclosing information about the self is intrinsically rewarding  

E-print Network

Disclosing information about the self is intrinsically rewarding Diana I. Tamir1 and Jason P- port for this hypothesis. Self-disclosure was strongly associated with increased activation in brain area. Moreover, individuals were willing to forgo money to disclose about the self. Two additional

Mitchell, Jason

171

Association between polymorphisms in genes involved in lipid metabolism and immunological status in chronically HIV-infected patients.  

PubMed

Several studies have reported associations between lipid parameters and clinical progression of HIV infection. We performed a cross-sectional study including 468 antiretroviral-treated HIV-infected patients to investigate the impact of 13 polymorphisms of 9 genes affecting lipid metabolism and CD4 and CD8-T cell levels. Polymorphisms were identified in genes selected for their role in the development of atherogenic dyslipidemia, defined as triglycerides ?1.7mmol/L and high-density lipoprotein cholesterol (HDLc) <1.02 in women or 1.28mmol/L in men. Lipid and lipoprotein parameters were determined in all participants, as well as CD4 and CD8 T-cell counts. ANOVA was performed to compare the mean values of lipid and CD4 and CD8 T-cell count data. A Bonferroni correction for multiple comparisons was applied. 468 patients were included, 148 of them had a diagnosis of atherogenic dyslipidemia. The polymorphism rs3135506 in APOA5 was associated with a 9% increase in triglycerides (p=0.002), 10% and 21% decrease in HDLc (p=0.005), and CD4 T-cell count (p=0.024), respectively. APOA5 rs662799, was associated with a 19% increase in CD8 T-cell count (p=0.002). Carriers of LPL rs328 in the dyslipidemic group presented 11% higher levels of HDLc (p=0.015) and 14% higher levels of CD4 cells (p=0.038). In conclusion, polymorphisms in genes associated to the development of atherogenic dyslipidemia, especially variants in APOA5 gene (rs3135506 and rs662799), can influence the circulating CD4 T-cell levels in chronically HIV-infected patients. These data support previous reports on the effect of lipid metabolism on immunologic parameters in HIV+ individuals on antiretroviral therapy. PMID:25500319

Echeverria, Patricia; Guardiola, Montse; Gonzlez, Marta; Vallv, Joan Carles; Bonjoch, Anna; Puig, Jordi; Clotet, Bonaventura; Ribalta, Josep; Negredo, Eugnia

2015-02-01

172

Sexual risk behaviors, circumcision status and pre-existing immunity to adenovirus type 5 among men who have sex with men participating in a randomized HIV-1 vaccine efficacy trial: Step Study  

PubMed Central

Background The Step Study found that men who had sex with men (MSM) who received an adenovirus type 5 (Ad5) vector-based vaccine and were uncircumcised or had prior Ad5 immunity had a higher HIV incidence than MSM who received placebo. We investigated whether differences in HIV exposure, measured by reported sexual risk behaviors, may explain the increased risk. Methods Among 1,764 MSM in the trial, 724 were uncircumcised, 994 had prior Ad5 immunity and 560 were both uncircumcised and had prior Ad5 immunity. Analyses compared sexual risk behaviors and perceived treatment assignment among vaccine and placebo recipients, determined risk factors for HIV acquisition and examined the role of insertive anal intercourse in HIV risk among uncircumcised men. Findings Few sexual risk behaviors were significantly higher in vaccine vs. placebo recipients at baseline or during follow-up. Among uncircumcised men, vaccine recipients at baseline were more likely to report unprotected insertive anal intercourse with HIV negative partners (25.0% vs. 18.1%; p=0.03). Among uncircumcised men who had prior Ad5 immunity, vaccine recipients were more likely to report unprotected insertive anal intercourse with partners of unknown HIV status (46.0% vs. 37.5%; p=0.05). Vaccine recipients remained at higher risk of HIV infection compared to placebo recipients (HR =2.8; 95% CI:1.7, 6.8) controlling for potential confounders. Interpretation These analyses do not support a behavioral explanation for the increased HIV infection rates observed among uncircumcised men in the Step Study. Identifying biologic mechanisms to explain the increased risk is a priority. This study is registered with ClinicalTrials.gov, number NCT00095576. PMID:22421748

Koblin, Beryl A.; Mayer, Kenneth H.; Noonan, Elizabeth; Wang, Ching-Yun; Marmor, Michael; Sanchez, Jorge; Brown, Stephen J.; Robertson, Michael N.; Buchbinder, Susan P.

2012-01-01

173

Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda.  

PubMed

The rapid scale-up of human immunodeficiency virus (HIV) testing, counselling and treatment throughout sub-Saharan Africa has raised questions about how to protect patients' rights to consent, confidentiality, counselling and care in resource-constrained settings. The Multi-country African Testing and Counselling for HIV (MATCH) study investigated client and provider experiences with different modes of testing in sub-Saharan Africa. One component of that study was a survey of 275 HIV service providers in Burkina Faso, Kenya and Uganda that gathered quantifiable indicators and qualitative descriptions using a standardized instrument. This article presents provider perspectives on the challenges of obtaining consent, protecting confidentiality, providing counselling and helping clients manage disclosure. It also explores health workers' fear of infection within the workplace and their reports on discrimination against HIV clients within health facilities. HIV care providers in Burkina Faso, Kenya and Uganda experienced substantial rewards from their work, including satisfaction from saving lives and gaining professional skills. They also faced serious resource constraints, including staff shortages, high workloads, lack of supplies and inadequate infrastructure, and they expressed concerns about accidental exposure. Health workers described heavy emotional demands from observing clients suffer emotional, social and health consequences of being diagnosed with HIV, and also from difficult ethical dilemmas related to clients who do not disclose their HIV status to those around them, including partners. These findings suggest that providers of HIV testing and counselling need more resources and support, including better protections against HIV exposure in the workplace. The findings also suggest that health facilities could improve care by increasing attention to consent, privacy and confidentiality and that health policy makers and ethicists need to address some unresolved ethical dilemmas related to confidentiality and non-disclosure, and translate those discussions into better guidance for health workers. PMID:25237134

Bott, Sarah; Neuman, Melissa; Helleringer, Stephane; Desclaux, Alice; Asmar, Khalil El; Obermeyer, Carla Makhlouf

2014-09-17

174

CBERS - Disclosing a Successful International Space Cooperation  

NASA Astrophysics Data System (ADS)

On 14th October, 1999 the first satellite developed, assembled, integrated and tested by two emergent countries, Brazil and China, was successfully launched by a Long March series type rocket, from the Chinese launch base of Taiyuan, and its designed 2 years long life has already been extended by one year more. Since then, the China Brazil Earth Resources Satellite - Flight Model # 1 (CBERS-FM1) satellite is providing imaging services for both countries and also offering a competitive commercial products in the international market. Following the cooperation, FM1 orbit control has been conducted by both countries during different periods. For the orbit operation, both countries conduct the control once the satellite is passing inside each ground station window. The experience accumulated during the FM1 Assembly, Integration and Test (AIT), at Chinese laboratories, and its flight operation, provided important clues to implement some modification in the second satellite in order to enhance its operational performance. Succeeding these significant marks, the second satellite has already accomplished its AIT sequence at Brazilian Integration and Test Laboratory (LIT). In order to get the FM2 satellite ready to replace FM1 on time, the AIT schedule became critical, taking into account the several effects of the aspects intrinsic to this joint cooperation program. Since the AIT should be conducted in Brazil, and the later launching in China, the satellite preparation gained additional constraints for its logistic, management, follow up, technical progression, product assurance, and so on. The substantial feedback gained by both countries from their own CBERS FM1 remote sensing imagery capability, and now from the FM2 maturation, are leading the expansion of the program toward its second generation. The purpose of this paper is to present an overview of the program progresses, the FM1satellite flight operational status, the conduction and realization of the FM2 satellite AIT at LIT, and compare the AIT approaches used during FM1/China and FM2/Brazil. The significance of the ongoing success and the program continuing certainly represent a new experience for the international space community.

Loureiro, G.

2002-01-01

175

HIV Stigma Experienced by Young Men Who Have Sex With Men (MSM) Living With HIV Infection.  

PubMed

Stigma can compromise the health of persons living with HIV. Although HIV is increasingly affecting young men who have sex with men (MSM), little is known about their experiences with HIV stigma. We used narrative data to examine HIV stigma experienced by young MSM living with HIV. Data came from 28 qualitative interviews with young MSM. We used inductive content analysis to identify themes across these interviews. Participants commonly discussed negative perceptions and treatment of persons living with HIV. Stigma could result in nondisclosure of HIV status, internalized stigma, and avoidance of HIV-related things. Some men discussed strategies that might combat stigma. Findings suggest that HIV stigma might challenge young MSM's health by undermining health-conducive resources (e.g., social support) and contributing to HIV vulnerability. Interventions that counteract HIV stigma may help to create environments that promote well-being among young MSM living with HIV. PMID:25646730

Jeffries, William L; Townsend, Ebony Symone; Gelaude, Deborah J; Torrone, Elizabeth A; Gasiorowicz, Mari; Bertolli, Jeanne

2015-02-01

176

Reaching and Engaging Non-Gay Identified, Non-Disclosing Black Men who have Sex with both Men and Women  

PubMed Central

Non-gay identified (NGI) Black men who have sex with both men and women (MSMW) and use substances are at risk of acquiring and transmitting HIV to their partners. Homophobic community norms can discourage such men from disclosing their risk behaviour to female partners and others, including service providers. It is important to understand the dynamics of risk in this vulnerable population, but research is challenged by the mens need for secrecy. In this paper we report on successful efforts to recruit 33 non-disclosing, NGI Black MSMW for in-depth interviews concerning substance use, HIV risk and attitudes toward disclosing their risk behaviour. We employed targeted and referral sampling, with initial contacts and/or key informants drawn from several types of settings in New York City including known gay venues, community organisations, neighbourhood networks and the Internet. Key informant gatekeepers and the ability to establish rapport proved central to success. Perceived stigma is a source of social isolation, but men are willing to discuss their risk behaviour when they trust interviewers to protect their privacy and engage with them in a non-judgemental manner. Findings imply that the most effective prevention approaches for this population may be those that target risk behaviours without focusing on disclosure of sexual identities. PMID:22937767

Benoit, Ellen; Pass, Michael; Randolph, Doris; Murray, Deborah; Downing, Martin J.

2012-01-01

177

Vitamin D Status and Incidence of Pulmonary Tuberculosis, Opportunistic Infections, and Wasting Among HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy  

PubMed Central

Background.?Maintaining vitamin D sufficiency may decrease the incidence of pulmonary tuberculosis and other infectious diseases. We present the first prospective study of vitamin D among human immunodeficiency virus (HIV)infected adults receiving antiretrovirals in sub-Saharan Africa. Methods.?Serum 25-hydroxyvitamin D (25(OH)D) level was assessed at antiretroviral therapy (ART) initiation for 1103 HIV-infected adults enrolled in a trial of multivitamins (not including vitamin D) in Tanzania. Participants were prospectively followed at monthly visits at which trained physicians performed a clinical examination and nurses took anthropometric measurements and assessed self-reported symptoms. Cox proportional hazards models estimated hazard ratios (HRs) of morbidity outcomes. Results.?After multivariate adjustment, vitamin D deficiency (defined as a concentration of <20 ng/mL) had a significantly greater association with incident pulmonary tuberculosis, compared with vitamin D sufficiency (HR, 2.89; 95% confidence interval [CI], 1.317.41; P = .027), but no association was found for vitamin D insufficiency (defined as a concentration of 2030 ng/mL; P = .687). Deficiency was also significantly associated with incident oral thrush (HR, 1.96; 95% CI, 1.013.81; P = .046), wasting (HR, 3.10; 95% CI, 1.337.24; P = .009), and >10% weight loss (HR, 2.10; 95% CI, 1.133.91; P = .019). Wasting results were robust to exclusion of individuals experiencing pulmonary tuberculosis. Vitamin D status was not associated with incident malaria, pneumonia, or anemia. Conclusions.?Vitamin D supplementation trials for adults receiving ART appear to be warranted. PMID:23162137

Sudfeld, Christopher R.; Giovannucci, Edward L.; Isanaka, Sheila; Aboud, Said; Mugusi, Ferdinand M.; Wang, Molin; Chalamilla, Guerino; Fawzi, Wafaie W.

2013-01-01

178

Severe events in the first 6 months of life in a cohort of HIV-unexposed infants from South Africa: effects of low birthweight and breastfeeding status  

PubMed Central

Objective To report on risk factors for severe events (hospitalisation or infant death) within the first half of infancy amongst HIV-unexposed infants in South Africa. Methods South African data from the multisite community-based cluster-randomised trial PROMISE EBF promoting exclusive breastfeeding in three sub-Saharan countries from 2006 to 2008 were used. The South African sites were Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal. This analysis included 964 HIV-negative motherinfant pairs. Data on severe events and infant feeding practices were collected at 3, 6, 12 and 24 weeks post-partum. We used a stratified extended Cox model to examine the association between the time to the severe event and covariates including birthweight, with breastfeeding status as a time-dependent covariate. Results Seventy infants (7%) experienced a severe event. The median age at first hospitalisation was 8 weeks, and the two main reasons for hospitalisation were cough and difficult breathing followed by diarrhoea. Stopping breastfeeding before 6 months (HR 2.4; 95% CI 1.25.1) and low birthweight (HR 2.4; 95% CI 1.34.3) were found to increase the risk of a severe event, whilst maternal completion of high school education was protective (HR 0.3; 95% CI 0.10.7). Conclusions A strengthened primary healthcare system incorporating promotion of breastfeeding and appropriate caring practices for low birthweight infants (such as kangaroo mother care) are critical. Given the leading reasons for hospitalisation, early administration of oral rehydration therapy and treatment of suspected pneumonia are key interventions needed to prevent hospitalisation in young infants. PMID:25053420

Doherty, Tanya; Jackson, Debra; Swanevelder, Sonja; Lombard, Carl; Engebretsen, Ingunn M S; Tylleskr, Thorkild; Goga, Ameena; Ekstrm, Eva-Charlotte; Sanders, David; Promise EBF study group

2014-01-01

179

Impact of Disclosure of HIV Infection on Health-Related Quality of Life Among Children and Adolescents With HIV Infection  

PubMed Central

Background Little is known concerning the impact of HIV status disclosure on quality of life, leaving clinicians and families to rely on research of children with other terminal illnesses. Objectives The purpose of this work was to examine the impact of HIV disclosure on pediatric quality of life and to describe the distribution of age at disclosure in a perinatally infected pediatric population. Methods A longitudinal analysis was conducted of perinatally HIV-infected youth ?5 years of age enrolled in a prospective cohort study, Pediatric AIDS Clinical Trials Group 219C, with ?1 study visit before and after HIV disclosure. Age-specific quality-of-life instruments were completed by primary caregivers at routine study visits. The distribution of age at disclosure was summarized. Six quality-of-life domains were assessed, including general health perception, symptom distress, psychological status, health care utilization, physical functioning, and social/role functioning. For each domain, mixed-effects models were fit to estimate the effect of disclosure on quality of life. Results A total of 395 children with 2423 study visits were analyzed (1317 predisclosure visits and 1106 postdisclosure visits). The median age at disclosure was estimated to be 11 years. Older age at disclosure was associated with earlier year of birth. Mean domain scores were not significantly different at the last undisclosed visit compared with the first disclosed visit, with the exception of general health perception. When all of the visits were considered, 5 of 6 mean domain scores were lower after disclosure, although the differences were not significant. In mixed-effects models, disclosure did not significantly impact quality of life for any domain. Conclusions Age at disclosure decreased significantly over time. There were no statistically significant differences between predisclosure and postdisclosure quality of life; therefore, disclosure should be encouraged at an appropriate time. PMID:19255023

Butler, Anne M.; Williams, Paige L.; Howland, Lois C.; Storm, Deborah; Hutton, Nancy; Seage, George R.

2009-01-01

180

The impact of stressful life events, symptom status, and adherence concerns on quality of life in people living with HIV.  

PubMed

Studies concerning persons living with HIV (PLWH) report that stressful life events (SLEs) contribute to an exacerbation of symptoms and reduced antiretroviral (ARV) adherence and quality of life (QOL). Little is known about whether these findings are site-specific. Our study's aims were to characterize the type and frequency of SLEs for PLWH in Puerto Rico, South Africa, and the United States, and to assess the impact of SLEs by national site, symptoms, and ARV adherence concerns on QOL. The sample consisted of 704 participants. The total number of SLEs correlated significantly with the total number of symptoms, adherence concerns, and QOL (p?.001). Overall, 27.2% of the variance in QOL was explained by the aforementioned variables. Although SLEs were of concern to PLWH, worries about ARV adherence were of even greater concern. Routine assessment of ARV concerns and SLEs can promote ongoing ARV adherence and improved QOL. PMID:23473660

Corless, Inge B; Voss, Joachim; Guarino, A J; Wantland, Dean; Holzemer, William; Jane Hamilton, Mary; Sefcik, Elizabeth; Willard, Suzanne; Kirksey, Kenn; Portillo, Carmen; Rivero Mendez, Marta; Rosa, Maria E; Nicholas, Patrice K; Human, Sarie; Maryland, Mary; Moezzi, Shahnaz; Robinson, Linda; Cuca, Yvette

2013-01-01

181

Using health provider insights to inform pediatric HIV disclosure: a qualitative study and practice framework from Kenya.  

PubMed

Optimal pediatric HIV disclosure impacts illness and developmental experiences while improving access to timely treatment. However, disclosure rates in high HIV prevalence countries remain low and there are limited data on best practices. We conducted a qualitative study of disclosure practices and interviewed healthcare providers from five pediatric HIV clinics in Kenya. We identified themes central to disclosure practices, rationale for approaches, barriers to implementing disclosure, and creative strategies to overcome challenges. We used these insights to develop a practice-based framework for disclosure that is sensitive to practical challenges. Overall, providers had limited training but extensive experience in disclosure, endorsed individualized disclosure practices, invested substantial time on disclosure despite clinical burden, and noted adverse outcomes associated with unplanned or abrupt disclosure. Providers advocated for an approach to disclosure that is child-centered but respects caregiver fears and values. Caregiver support was provided to enable caregivers to be the person who ultimately disclosed HIV status to children. Unplanned or abrupt disclosure to children was reported to have severe and persistent adverse impact and was a stimulus to accelerate disclosure in scenarios when providers believed children may be suspecting their diagnosis. Based on these expert insights, the framework we developed incorporates concurrent evaluation of child and caregiver readiness, identifies cues to prompt disclosure discussions, includes caregiver education and support, and utilizes a gradual approach of unveiling HIV diagnosis to the child. PMID:25216105

Beima-Sofie, Kristin; John-Stewart, Grace; Shah, Brandi; Wamalwa, Dalton; Maleche-Obimbo, Elizabeth; Kelley, Maureen

2014-10-01

182

HIV-Testing Behavior and Associated Factors Among MSM in Chongqing, China: Results of 2 Consecutive Cross-Sectional Surveys From 2009 to 2010.  

PubMed

The high and climbing human immunodeficiency virus (HIV) rates among Chinese men who have sex with men (MSM) bring huge pressure and challenge to acquired immune deficiency syndrome response work in China. This study examined HIV-testing behavior and describes the characteristics of recently tested MSM in Chongqing to address targeting HIV prevention interventions.Two consecutive cross-sectional surveys were conducted among Chongqing MSM using respondent-driven sampling in 2009 and 2010. Information was collected regarding details on demographic characteristics, sexual practices with male and female partners, and HIV-testing experiences. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with recent HIV testing.The final sample size included in our analyses was 992. The overall HIV prevalence was 13.4%, and HIV prevalence increased significantly from 11.6% in 2009 to 15.4% in 2010 (P?=?0.08). The overall rate of HIV testing in the past 12 months was 44.6%, and the self-reported rates decreased significantly from 47.8% in 2009 to 41.1% in 2010 (P?=?0.03). Factors independently associated with recent HIV testing included living in Chongqing >1 year (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI] 1.1-2.9), the age of most recent male partner ?25 (AOR 1.5, 95% CI 1.1-2.1), not having unprotected insertive anal sex with most recent male partner in the past 6 months (AOR 1.5, 95% CI 1.1-2.0), disclosing HIV status to most recent male partner (AOR 2.8, 95% CI 2.0-3.8), and holding lower level of HIV-related stigma (AOR 1.1 per scale point, 95% CI 1.0-1.1).The extremely high HIV prevalence and low annual testing level put MSM at high risk of HIV infection and transmission, and it is a priority to promote regular HIV testing among this group in order to control the spread of HIV in Chongqing, China. PMID:25501047

Li, Xuefeng; Wu, Guohui; Lu, Rongrong; Feng, Liangui; Fan, Wensheng; Xiao, Yan; Sun, Zheya; Zhang, Heng; Xing, Hui; Shao, Yiming; Ruan, Yuhua

2014-12-01

183

Telling Others You Are HIV Positive  

MedlinePLUS

... and discuss the schools policy and attitude on HIV. Meet with the nurse and your childs teacher. Be sure to talk about your childs legal right to confidentiality. GETTING HELP You can get help with telling others about your HIV status from the counselors at the HIV anonymous ...

184

Wounds in patients with HIV.  

PubMed

Highly active antiretroviral therapy has dramatically reduced morbidity and mortality among patients who are HIV-positive. A retrospective review of the authors' data separated subjects into cohorts based on HIV status and matched them for age and gender. The authors' data reveal a higher fraction of venous ulcers compared with a lower fraction of pressure ulcers in the seropositive population. PMID:25133341

McMeeking, Alexander; Kim, In; Ross, Frank; Ayello, Elizabeth A; Brem, Harold; Linton, Patrick; O'Neill, Daniel K

2014-09-01

185

I don't want financial support but verbal support. How do caregivers manage children's access to and retention in HIV care in urban Zimbabwe?  

PubMed Central

Introduction Children living with HIV experience particular challenges in accessing HIV care. Children usually rely on adult caregivers for access to care, including timely diagnosis, initiation of treatment and sustained engagement with HIV services. The aim of this study was to inform the design of a community-based intervention to support caregivers of HIV-positive children to increase children's retention in care as part of a programme introducing decentralized HIV care in primary health facilities. Methods Using an existing conceptual framework, we conducted formative research to identify key local contextual factors affecting children's linkages to HIV care in Harare, Zimbabwe. We conducted semi-structured interviews with 15 primary caregivers of HIV-positive children aged 615 years enrolled at a hospital clinic for at least six months, followed by interviews with nine key informants from five community-based organizations providing adherence support or related services. Results We identified a range of facilitators and barriers that caregivers experience. Distance to the hospital, cost of transportation, fear of disclosing HIV status to the child or others, unstable family structure and institutional factors such as drug stock-outs, healthcare worker absenteeism and unsympathetic school environments proved the most salient limiting factors. Facilitators included openness within the family, availability of practical assistance and psychosocial support from community members. Conclusions The proposed decentralization of HIV care will mitigate concerns about distance and transport costs but is likely to be insufficient to ensure children's sustained retention. Following this study, we developed a package of structured home visits by voluntary lay workers to proactively address other determinants such as disclosure within families, access to available services and support through caregivers social networks. A randomized controlled trial is underway to assess impact on children's retention in care over two years. PMID:24815595

Busza, Joanna; Dauya, Ethel; Bandason, Tsitsi; Mujuru, Hilda; Ferrand, Rashida A

2014-01-01

186

Issues surrounding reproductive choice for women lying with HIV in Abidjan, Cte d'ivoire  

Microsoft Academic Search

The vast majority of women living with HIV in Africa are unaware of their HIV status and are usually first tested for HIV in the course of a pregnancy. This paper analyses the reproductive choices made by women attending an antenatal clinic in Abidjan, Cte d'Ivoire who learned their HIV-positive status during their last pregnancy. It documents the ways in

H. Aka-Dago-Akribi; A. Desgres Du Lo; Philippe Msellati; R. Dossou; C. Welffens-Ekra

1999-01-01

187

Weighing the Risks: A Child's Decision to Disclose Peer Victimization  

ERIC Educational Resources Information Center

It is disturbingly common for victims of peer victimization, also referred to as bullying, to withhold disclosure of their experience. This is so despite the implementation of numerous programs to increase the ability and willingness of victims to disclose and to improve the capacity of others to intervene. Disclosure is a complex matter that may

Mishna, Faye; Alaggia, Ramona

2005-01-01

188

Eye Movements Disclose Decisions in Set Joost Broekens a  

E-print Network

Eye Movements Disclose Decisions in Set Joost Broekens a Walter A. Kosters b Timo de Vries b a Section Man-Machine Interaction, Delft University of Technology, The Netherlands joost.broekens@gmail.com b Leiden Institute of Advanced Computer Science, Leiden University, The Netherlands kosters

Kosters, Walter

189

The Duty to Disclose Adverse Clinical Trial Results  

Microsoft Academic Search

Participants in some clinical trials are at risk of being harmed and sometimes are seriously harmed as a result of not being provided with available, relevant risk information. We argue that this situation is unacceptable and that there is a moral duty to disclose all adverse clinical trial results to participants in clinical trials. This duty is grounded in the

S. Matthew Liao; Mark Sheehan; Steve Clarke

2009-01-01

190

IRS Releases Tax Questionnaire that Asks Colleges to Disclose More  

ERIC Educational Resources Information Center

Nearly 400 colleges across the United States are about to be asked to disclose intimate financial details of their operations to the Internal Revenue Service. This article reports on a highly detailed financial questionnaire designed by the IRS for the first phase of its Colleges and Universities Compliance Project, which is part of a continuing

Kelderman, Eric

2008-01-01

191

Parental HIV disclosure: from perspectives of children affected by HIV in Henan, China.  

PubMed

Culturally and developmentally appropriate parental HIV disclosure (i.e., parents disclose their HIV infection to children) has been shown to be closely related with the well-being of both HIV-infected parents and their children. However, current practices and effects of parental HIV disclosure remain poorly understood in low- and middle-income countries including China. Quantitative data from 626 children affected by parental HIV (orphans and vulnerable children) in Henan, China, were collected in 2011 to examine children's perceptions and knowledge regarding their parents' HIV disclosure practices and to assess the associations of these practices with children's demographic and psychosocial factors. The data in the current study revealed that only a small proportion of children learned parental HIV infection from their parents (direct disclosure), and many of these disclosure seemed being unplanned. Among the children who were not told by their parents, at least 95% of them either knew parental illness from others (indirect disclosure) or from their own observations or suspicions. The children reported similar disclosure practices by fathers and mothers. There were minimum differences between disclosed and nondisclosed children on a number of psychosocial measures. The findings support the notion that parental HIV disclosure is a complex process and can only be beneficial if it is carefully planned. The data in the current study suggest the needs for the culturally and developmentally appropriate approach in parental HIV disclosure in order to maximize both short- and long-term benefits to children, parents, and family functioning. PMID:25465533

Zhao, Junfeng; Li, Xiaoming; Qiao, Shan; Zhao, Guoxiang; Zhang, Liying; Stanton, Bonita

2015-04-01

192

Coping with HIV in a Culture of Silence: Results of a Body-Mapping Workshop.  

PubMed

Abstract The image shows a body map created by a young HIV-positive African woman living in Belgium. It was created as part of a body-mapping workshop with 10 sub-Saharan African migrants living with HIV. The short text provided with the image describes experiences and results of this workshop. The participants experienced body-mapping as a valuable tool in coping with HIV and it supported them in disclosing HIV to others. PMID:25581617

Nstlinger, Christiana; Loos, Jasna; Verhoest, Xavier

2015-01-01

193

HIV, poverty and women.  

PubMed

This review examines the interactions of financial status and HIV and its implications for women. MEDLINE and Google scholar were searched using the keywords 'women', 'poverty' and 'HIV' in any field of the article. The search was limited to articles published in English over the last 10 years. The first section of the article tries to establish whether poverty or wealth is a risk factor for HIV. There is credible evidence for both arguments. While wealth shows an increased risk for both sexes, poverty places women at a special disadvantage. The second section explains how the financial status interacts with other 'non biological' factors to put women at increased risk. While discrimination based on these factors disadvantage women, there are some paradoxical observations that do not fit with the traditional line of explanation (e.g. paradoxical impact of wealth and education on HIV). The final section assesses the impact of HIV in driving poverty and the role of women in interventional programmes. The specific impact of poverty on females in families living with HIV is less explored. Though microfinance initiatives to empower women are a good idea in theory, the actual outcome of such a programme is less convincing. PMID:24037044

Rodrigo, Chaturaka; Rajapakse, Senaka

2010-03-01

194

Comparative chromosome painting discloses homologous segments in distantly related mammals  

Microsoft Academic Search

Comparative chromosome painting, termed ZOO-FISH, using DNA libraries from flow sorted human chromosomes 1,16,17 and X, and mouse chromosome 11 discloses the presence of syntenic groups in distantly related mammalian Orders ranging from primates (Homo sapiens), rodents (Mus musculus), even-toed ungulates (Muntiacus muntjak vaginalis and Muntiacus reevesi) and whales (Balaenoptera physalus). These mammalian Orders have evolved separately for 55-80 million

Harry Scherthan; Thomas Cremer; Ulfur Arnason; Heinz-Ulrich Weier; Antonio Lima-de-Faria; Lutz Frnicke

1994-01-01

195

"I Should Know Better": The Roles of Relationships, Spirituality, Disclosure, Stigma, and Shame for Older Women Living With HIV Seeking Support in the South.  

PubMed

The population of older people living with HIV in the United States is growing. Little is known about specific challenges older HIV-infected women face in coping with the disease and its attendant stressors. To understand these issues for older women, we conducted semi-structured in-depth interviews with 15 women (13 African American, 2 Caucasian) 50years of age and older (range 50-79years) in HIV care in the southeastern United States, and coded transcripts for salient themes. Many women felt isolated and inhibited from seeking social connection due to reluctance to disclose their HIV status, which they viewed as more shameful at their older ages. Those receiving social support did so mainly through relationships with family and friends, rather than romantic relationships. Spirituality provided great support for all participants, although fear of disclosure led several to restrict connections with a church community. Community-level stigma-reduction programs may help older HIV-infected women receive support. PMID:24630627

Grodensky, Catherine A; Golin, Carol E; Jones, Chaunetta; Mamo, Meheret; Dennis, Alexis C; Abernethy, Melinda G; Patterson, Kristine B

2015-01-01

196

Why are some HIV/AIDS patients reluctant to receive antiviral therapy as soon as possible in China?  

PubMed

In more than 20 years of medical practice, a surprising phenomenon has often occurred: some patients with acquired immunodeficiency syndrome (AIDS) decide not to go to the hospital and they do not let others know that they are suffering from the disease unless they believe that they are dieing. Zhang Shan (a pseudonym) is one such patient with human immunodeficiency virus (HIV)/AIDS who was reluctant to receive antiviral therapy as soon as possible, and this paper shares Zhang's story as he related it. Clearly, there are numerous views as to why patients in China behave as Zhang did. Presented here are several reasons, including society, history, morality and ideology, family, and education. Although all of these reasons do play a role, the patient's mindset and behavior is the most significant reason for a patient's reluctance to seek treatment or disclose his/her status. If the individual patient's mindset and behavior are not dealt with effectively, then HIV/AIDS can continue to spread and threaten additional lives and even the fabric of society. This paper analyzes the reasons why patients are hesitant to receive antiviral therapy, but this paper also suggests steps healthcare personnel can take to encourage patients to seek treatment. Such steps can save the lives of current patients with HIV/AIDS. In addition, sound public health measures and a rational approach to treatment are important to helping potential patients with HIV/AIDS. PMID:25030855

Sun, Yang; Lu, Hongzhou

2014-06-01

197

HIV risk behaviours and determinants among people living with HIV/AIDS in Vietnam.  

PubMed

There is a potentially high risk of HIV spreading from people living with HIV/AIDS. We conducted a cross-sectional study to examine HIV risk behaviours and their determinants among people living with HIV/AIDS. Eighty-two percent had been sexually active. Sex with multiple partners was reported by 20% and consistent condom use by about one third. More than half of the participants (52%) reported having injected drugs during the previous month, and 35% of those had shared needles and syringes. Voluntary HIV testing and having received condoms or injection equipment from the local HIV prevention program, were found to be significantly associated with fewer HIV risk behaviours. Having learned recently about personal HIV status, multiple sex partners, low educational attainment and young age were found to be associated with higher HIV risk behaviours. Giving high priority to targeted preventive and support programmes is likely to be a highly cost-effective strategy. PMID:18787940

Thanh, Duong Cong; Hien, Nguyen Tran; Tuan, Nguyen Anh; Thang, Bui Duc; Long, Nguyen Thanh; Fylkesnes, Knut

2009-12-01

198

Neurotoxic Profiles of HIV, Psychostimulant Drugs of Abuse, and their Concerted Effect on the Brain: Current Status of Dopamine System Vulnerability in NeuroAIDS  

PubMed Central

There are roughly 30 to 40 million HIV infected individuals in the world as of December 2007, and drug abuse directly contributes to one-third of all HIV-infections in the United States. Antiretroviral therapy has increased the lifespan of HIV-seropositives, but CNS function often remains diminished, effectively decreasing quality of life. A modest proportion may develop HIV-associated dementia, the severity and progression of which is increased with drug abuse. HIV and drugs of abuse in the CNS target subcortical brain structures and DA systems in particular. This toxicity is mediated by a number of neurotoxic mechanisms, including but not limited to, aberrant immune response and oxidative stress. Therefore, novel therapeutic strategies must be developed that can address a wide variety of disparate neurotoxic mechanisms and apoptotic cascades. This paper reviews the research pertaining to the where, what, and how of HIV and cocaine/methamphetamine toxicity in the CNS. Specifically, where these toxins most affect the brain, what aspects of the virus are neurotoxic, and how these toxins mediate neurotoxicity. PMID:18430470

Ferris, Mark J.; Mactutus, Charles F.; Booze, Rosemarie M.

2008-01-01

199

How HIV diagnosis and disclosure affect sexual behavior and relationships in Ugandan fishing communities.  

PubMed

In this article we examine how members of fishing communities on the shores of Lake Victoria in Uganda respond to HIV diagnosis in terms of disclosure to sexual partners. We then explore the subsequent changes in sexual behavior and relationships. To access this information, we collected life history data from 78 HIV-positive individuals in five fishing communities. We found that the strength of the sexual relationships shaped how and why individuals disclosed to partners, and that these relationships tended to be stronger when partners shared familial responsibility. Those who perceived their current sexual partnership to be weak sought to conceal their status by maintaining prediagnosis patterns of sexual behavior. The majority of the study's participants rarely changed their sexual behavior following HIV diagnosis, regardless of their relationship's strength. These findings elucidate barriers to disclosure and behavior change, and suggest that a life-course approach might enhance individual-level counseling so that counselors can provide tailored support to individuals regarding disclosure decisions and outcomes. PMID:23774629

McArthur, Moriah; Birdthistle, Isolde; Seeley, Janet; Mpendo, Juliet; Asiki, Gershim

2013-08-01

200

Vulnerability and non-adherence to antiretroviral therapy among HIV patients, Minas Gerais State, Brazil.  

PubMed

The aim of the present study was to describe vulnerability profiles and to verify their association with non-adherence to antiretroviral therapy (ART) among 295 HIV-patients receiving their first prescription in two public-referral centers in Minas Gerais States, Brazil. The cumulative incidence of non-adherence was 36.9%. Three pure vulnerability profiles (lower, medium and higher) were identified based on the Grade of Membership method (GoM). Pure type patients of the "higher vulnerability" profile had, when compared to the overall sample, an increased probability of being younger, not understanding the need of ART, having a personal reason to be HIV-tested, not disclosing their HIV status, having more than one (non-regular) sexual partner, reporting use of alcohol, tobacco and illicit drugs, and having sex among men. Non-adherence to ART was statistically associated (p < 0.001) with this profile. Also, the heterogeneity of the sample was found to be high, since over 40% were mixed type. The implications are that health staff should be trained to develop strategies for incorporating risk-reduction interventions, bearing in mind the three dimensions of vulnerability and the diversity of those patients initiating antiretroviral therapy. PMID:19009140

Bonolo, Palmira de Ftima; Machado, Carla Jorge; Csar, Cibele Comini; Ceccato, Maria das Graas Braga; Guimares, Mark Drew Crosland

2008-11-01

201

Barriers to Acceptance of Personal Digital Assistants for HIV/AIDS Data Collection in Angola  

PubMed Central

Purpose Handheld computers have potential to improve HIV/AIDS programs in healthcare settings in low-resource countries, by improving the speed and accuracy of collecting data. However, the acceptability of the technology (i.e., user attitude and reaction) is critical for its successful implementation. Acceptability is particularly critical for HIV/AIDS behavioral data, as it depends on respondents giving accurate information about a highly sensitive topic sexual behavior. Methods To explore the acceptability of handheld computers for HIV/AIDS data collection and to identify potential barriers to acceptance, five focus groups of 810 participants each were conducted in Luanda, Angola. Facilitators presented Palm Tungsten E handhelds to the focus groups, probed participants perceptions of the handheld computer, and asked how they felt about disclosing intimate sexual behavior to an interviewer using a handheld computer. Discussions were conducted in Portuguese, the official language of Angola, and audio-taped. They were then transcribed and translated into English for analysis. Results In total, 49 people participated in the focus groups. PDAs were understood through the lens of social and cultural beliefs. Themes that emerged were suspicion of outsiders, concern with longevity, views on progress and development, and concern about social status. Conclusions The findings from this study suggest that personal and cultural beliefs influence participant acceptance of PDAs in Angola. While PDAs provide great advantages in terms of speed and efficiency of data collection, these barriers, if left unaddressed, may lead to biased reporting of HIV/AIDS risk data. An understanding of the barriers and why they are relevant in Angola may help researchers and practitioners to reduce the impact of these barriers on HIV/AIDS data collection. PMID:21622022

Cheng, Karen G.; Ernesto, Francisco; Ovalle-Bahamn, Ricardo E.; Truong, Khai N.

2011-01-01

202

Sexual Risk Behavior Among Youth With Perinatal HIV Infection in the United States: Predictors and Implications for Intervention Development  

PubMed Central

Background.?Factors associated with initiation of sexual activity among perinatally human immunodeficiency virus (HIV)infected (PHIV+) youth, and the attendant potential for sexual transmission of antiretroviral (ARV) drug-resistant HIV, remain poorly understood. Methods.?We conducted cross-sectional and longitudinal analyses of PHIV+ youth aged 1018 years (mean, 13.5 years) enrolled in the US-based Pediatric HIV/AIDS Cohort Study between 2007 and 2009. Audio computer-assisted self-interviews (ACASI) were used to collect sexual behavior information. Results.?Twenty-eight percent (95% confidence interval [CI], 23%33%) (92/330) of PHIV+ youth reported sexual intercourse (SI) (median initiation age, 14 years). Sixty-two percent (57/92) of sexually active youth reported unprotected SI. Among youth who did not report history of SI at baseline, ARV nonadherence was associated with sexual initiation during follow-up (adjusted hazard ratio, 2.87; 95% CI, 1.326.25). Youth living with a relative other than their biological mother had higher odds of engaging in unprotected SI than those living with a nonrelative. Thirty-three percent of youth disclosed their HIV status to their first sexual partner. Thirty-nine of 92 (42%) sexually active youth had HIV RNA ?5000 copies/mL after sexual initiation. Viral drug resistance testing, available for 37 of these 39 youth, identified resistance to nucleoside reverse transcriptase inhibitors in 62%, nonnucleoside reverse transcriptase inhibitors in 57%, protease inhibitors in 38%, and all 3 ARV classes in 22%. Conclusions.?As PHIV+ youth become sexually active, many engage in behaviors that place their partners at risk for HIV infection, including infection with drug-resistant virus. Effective interventions to facilitate youth adherence, safe sex practices, and disclosure are urgently needed. PMID:23139252

Tassiopoulos, Katherine; Moscicki, Anna-Barbara; Mellins, Claude; Kacanek, Deborah; Malee, Kathleen; Allison, Susannah; Hazra, Rohan; Siberry, George K.; Smith, Renee; Paul, Mary; Van Dyke, Russell B.; Seage, George R.

2013-01-01

203

Disclosing Medical Mistakes: A Communication Management Plan for Physicians  

PubMed Central

Introduction: There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate, but such disclosures are made difficult by medical traditions of concern about medical malpractice suits and by physicians own emotional reactions. Because the physician may have compelling reasons both to keep the information private and to disclose it to the patient or family, these situations can be conceptualized as privacy dilemmas. These dilemmas may create barriers to effectively addressing the mistake and its consequences. Although a number of interventions exist to address privacy dilemmas that physicians face, current evidence suggests that physicians tend to be slow to adopt the practice of disclosing medical mistakes. Methods: This discussion proposes a theoretically based, streamlined, two-step plan that physicians can use as an initial guide for conversations with patients about medical mistakes. The mistake disclosure management plan uses the communication privacy management theory. Results: The steps are 1) physician preparation, such as talking about the physicians emotions and seeking information about the mistake, and 2) use of mistake disclosure strategies that protect the physician-patient relationship. These include the optimal timing, context of disclosure delivery, content of mistake messages, sequencing, and apology. A case study highlighted the disclosure process. Conclusion: This Mistake Disclosure Management Plan may help physicians in the early stages after mistake discovery to prepare for the initial disclosure of a medical mistakes. The next step is testing implementation of the procedures suggested. PMID:23704848

Petronio, Sandra; Torke, Alexia; Bosslet, Gabriel; Isenberg, Steven; Wocial, Lucia; Helft, Paul R

2013-01-01

204

48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.  

Code of Federal Regulations, 2011 CFR

...changes to disclosed or established cost accounting practices. 30.604 Section 30...GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration...changes to disclosed or established cost accounting practices. (a) Scope....

2011-10-01

205

48 CFR 30.603 - Changes to disclosed or established cost accounting practices.  

Code of Federal Regulations, 2011 CFR

...Changes to disclosed or established cost accounting practices. 30.603 Section 30...GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration...Changes to disclosed or established cost accounting...

2011-10-01

206

48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.  

Code of Federal Regulations, 2010 CFR

...changes to disclosed or established cost accounting practices. 30.604 Section 30...GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration...changes to disclosed or established cost accounting practices. (a) Scope....

2010-10-01

207

48 CFR 30.603 - Changes to disclosed or established cost accounting practices.  

Code of Federal Regulations, 2010 CFR

...Changes to disclosed or established cost accounting practices. 30.603 Section 30...GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration...Changes to disclosed or established cost accounting...

2010-10-01

208

45 CFR 1159.13 - In what other situations will the Endowment disclose its records?  

Code of Federal Regulations, 2011 CFR

...false In what other situations will the Endowment disclose its records? 1159.13 ...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS IMPLEMENTATION OF THE...13 In what other situations will the Endowment disclose its records? (a)...

2011-10-01

209

45 CFR 1159.13 - In what other situations will the Endowment disclose its records?  

Code of Federal Regulations, 2013 CFR

...false In what other situations will the Endowment disclose its records? 1159.13 ...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS IMPLEMENTATION OF THE...13 In what other situations will the Endowment disclose its records? (a)...

2013-10-01

210

45 CFR 1159.13 - In what other situations will the Endowment disclose its records?  

Code of Federal Regulations, 2012 CFR

...false In what other situations will the Endowment disclose its records? 1159.13 ...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS IMPLEMENTATION OF THE...13 In what other situations will the Endowment disclose its records? (a)...

2012-10-01

211

45 CFR 1159.13 - In what other situations will the Endowment disclose its records?  

...false In what other situations will the Endowment disclose its records? 1159.13 ...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS IMPLEMENTATION OF THE...13 In what other situations will the Endowment disclose its records? (a)...

2014-10-01

212

75 FR 54802 - Requirement of a Statement Disclosing Uncertain Tax Positions  

Federal Register 2010, 2011, 2012, 2013

...Statement Disclosing Uncertain Tax Positions AGENCY: Internal...schedule disclosing uncertain tax positions related to the tax...hearing. Drafting Information The principal author of these regulations...Subjects in 26 CFR Part 1 Income taxes, Reporting and...

2010-09-09

213

HIV Life Cycle  

MedlinePLUS

... the connection between HIV medicines and the HIV life cycle? Without treatment, HIV infection gradually destroys the ... HIV. What are the stages of the HIV life cycle? To understand the HIV life cycle, it ...

214

JABOYA VS. JAKAMBI: STATUS, NEGOTIATION, AND HIV RISKS AMONG FEMALE MIGRANTS IN THE SEX FOR FISH ECONOMY IN NYANZA PROVINCE, KENYA  

PubMed Central

In Nyanza Province, Kenya, HIV incidence is highest (26.2%) in the beach communities along Lake Victoria. Prior research documented high mobility and HIV risks among fishermen; mobility patterns and HIV risks faced by women in fishing communities are less well researched. This study aimed to characterize forms of mobility among women in the fish trade in Nyanza; describe the spatial and social features of beaches; and assess characteristics of the sex-for-fish economy and its implications for HIV prevention. We used qualitative methods, including participant observation in 6 beach villages and other key destinations in the Kisumu area of Nyanza that attract female migrants, and we recruited individuals for in-depth semi-structured interviews at those destinations. We interviewed 40 women, of whom 18 were fish traders, and 15 men, of whom 7 were fishermen. Data were analyzed using Atlas.ti software. We found that female fish traders are often migrants to beaches; they are also highly mobile. They are at high risk of HIV acquisition and transmission via their exchange of sex for fish with jaboya fishermen. PMID:23631716

Camlin, Carol S.; Kwena, Zachary A.; Dworkin, Shari L.

2013-01-01

215

Jaboya vs. jakambi: Status, negotiation, and HIV risks among female migrants in the "sex for fish" economy in Nyanza Province, Kenya.  

PubMed

In Nyanza Province, Kenya, HIV incidence is highest (26.2%) in the beach communities along Lake Victoria. Prior research documented high mobility and HIV risks among fishermen; mobility patterns and HIV risks faced by women in fishing communities are less well researched. This study aimed to characterize forms of mobility among women in the fish trade in Nyanza; describe the spatial and social features of beaches; and assess characteristics of the "sex-for-fish" economy and its implications for HIV prevention. We used qualitative methods, including participant observation in 6 beach villages and other key destinations in the Kisumu area of Nyanza that attract female migrants, and we recruited individuals for in-depth semi-structured interviews at those destinations. We interviewed 40 women, of whom 18 were fish traders, and 15 men, of whom 7 were fishermen. Data were analyzed using Atlas.ti software. We found that female fish traders are often migrants to beaches; they are also highly mobile. They are at high risk of HIV acquisition and transmission via their exchange of sex for fish with jaboya fishermen. PMID:23631716

Camlin, Carol S; Kwena, Zachary A; Dworkin, Shari L

2013-06-01

216

Creating Genetic Resistance to HIV  

PubMed Central

HIV/AIDS remains a chronic and incurable disease, in spite of the notable successes of highly active antiretroviral therapy. Gene therapy offers the prospect of creating genetic resistance to HIV that supplants the need for antiviral drugs. In sight of this goal, a variety of anti-HIV genes have reached clinical testing, including gene-editing enzymes, protein-based inhibitors, and RNA-based therapeutics. Combinations of therapeutic genes against viral and host targets are designed to improve the overall antiviral potency and reduce the likelihood of viral resistance. In cell-based therapies, therapeutic genes are expressed in gene modified T lymphocytes or in hematopoietic stem cells that generate an HIV-resistant immune system. Such strategies must promote the selective proliferation of the transplanted cells and the prolonged expression of therapeutic genes. This review focuses on the current advances and limitations in genetic therapies against HIV, including the status of several recent and ongoing clinical studies. PMID:22985479

Burnett, John C.; Zaia, John A.; Rossi, John J.

2012-01-01

217

The contribution of spatial analysis to understanding HIV/TB mortality in children: a structural equation modelling approach  

PubMed Central

Background South Africa accounts for more than a sixth of the global population of people infected with HIV and TB, ranking her highest in HIV/TB co-infection worldwide. Remote areas often bear the greatest burden of morbidity and mortality, yet there are spatial differences within rural settings. Objectives The primary aim was to investigate HIV/TB mortality determinants and their spatial distribution in the rural Agincourt sub-district for children aged 15 years in 2004. Our secondary aim was to model how the associated factors were interrelated as either underlying or proximate factors of child mortality using pathway analysis based on a Mosley-Chen conceptual framework. Methods We conducted a secondary data analysis based on cross-sectional data collected in 2004 from the Agincourt sub-district in rural northeast South Africa. Child HIV/TB death was the outcome measure derived from physician assessed verbal autopsy. Modelling used multiple logit regression models with and without spatial household random effects. Structural equation models were used in modelling the complex relationships between multiple exposures and the outcome (child HIV/TB mortality) as relayed on a conceptual framework. Results Fifty-four of 6,692 children aged 15 years died of HIV/TB, from a total of 5,084 households. Maternal death had the greatest effect on child HIV/TB mortality (adjusted odds ratio=4.00; 95% confidence interval=1.0115.80). A protective effect was found in households with better socio-economic status and when the child was older. Spatial models disclosed that the areas which experienced the greatest child HIV/TB mortality were those without any health facility. Conclusion Low socio-economic status and maternal deaths impacted indirectly and directly on child mortality, respectively. These factors are major concerns locally and should be used in formulating interventions to reduce child mortality. Spatial prediction maps can guide policy makers to target interventions where they are most needed. PMID:23364095

Musenge, Eustasius; Vounatsou, Penelope; Collinson, Mark; Tollman, Stephen; Kahn, Kathleen

2013-01-01

218

Pulmonary manifestations in HIV seropositivity and malnutrition in Zimbabwe  

Microsoft Academic Search

Over a 10 month period 184 children, aged 5 years or less, who died at home had their nutritional status and HIV serostatus established; necropsies were also carried out. The HIV antibody test was positive in 122\\/184 (66%). Of the HIV seropositive childrenPneumocystis carinii pneumonia was present in 19 (16%), cytomegalovirus pneumonia in nine (7%), and lymphoid interstitial pneumonitis in

Michael O Ikeogu; Bart Wolf; Stanford Mathe

1997-01-01

219

Disclosing information about the self is intrinsically rewarding  

PubMed Central

Humans devote 3040% of speech output solely to informing others of their own subjective experiences. What drives this propensity for disclosure? Here, we test recent theories that individuals place high subjective value on opportunities to communicate their thoughts and feelings to others and that doing so engages neural and cognitive mechanisms associated with reward. Five studies provided support for this hypothesis. Self-disclosure was strongly associated with increased activation in brain regions that form the mesolimbic dopamine system, including the nucleus accumbens and ventral tegmental area. Moreover, individuals were willing to forgo money to disclose about the self. Two additional studies demonstrated that these effects stemmed from the independent value that individuals placed on self-referential thought and on simply sharing information with others. Together, these findings suggest that the human tendency to convey information about personal experience may arise from the intrinsic value associated with self-disclosure. PMID:22566617

Tamir, Diana I.; Mitchell, Jason P.

2012-01-01

220

Metabolic peculiarities of Aspergillus niger disclosed by comparative metabolic genomics  

PubMed Central

Background Aspergillus niger is an important industrial microorganism for the production of both metabolites, such as citric acid, and proteins, such as fungal enzymes or heterologous proteins. Despite its extensive industrial applications, the genetic inventory of this fungus is only partially understood. The recently released genome sequence opens a new horizon for both scientific studies and biotechnological applications. Results Here, we present the first genome-scale metabolic network for A. niger and an in-depth genomic comparison of this species to seven other fungi to disclose its metabolic peculiarities. The raw genomic sequences of A. niger ATCC 9029 were first annotated. The reconstructed metabolic network is based on the annotation of two A. niger genomes, CBS 513.88 and ATCC 9029, including enzymes with 988 unique EC numbers, 2,443 reactions and 2,349 metabolites. More than 1,100 enzyme-coding genes are unique to A. niger in comparison to the other seven fungi. For example, we identified additional copies of genes such as those encoding alternative mitochondrial oxidoreductase and citrate synthase in A. niger, which might contribute to the high citric acid production efficiency of this species. Moreover, nine genes were identified as encoding enzymes with EC numbers exclusively found in A. niger, mostly involved in the biosynthesis of complex secondary metabolites and degradation of aromatic compounds. Conclusion The genome-level reconstruction of the metabolic network and genome-based metabolic comparison disclose peculiarities of A. niger highly relevant to its biotechnological applications and should contribute to future rational metabolic design and systems biology studies of this black mold and related species. PMID:17784953

Sun, Jibin; Lu, Xin; Rinas, Ursula; Zeng, An Ping

2007-01-01

221

Perceived HIV stigma among children in a high HIV-prevalence area in central China: beyond the parental HIV-related illness and death  

Microsoft Academic Search

Objectives. (1) Examine the psychometric properties of two parallel measures of HIV-related stigma (i.e., perceived public stigma and children's personal stigma against people living with HIV\\/AIDS [PLWHA]) among children affected by HIV\\/AIDS. (2) Examine whether expressions of stigma measures differ by child's sex, developmental stage, family socioeconomic status (SES), or orphanhood status (i.e., AIDS orphans, vulnerable children, and comparison children).

Xiuyun Lin; Guoxiang Zhao; Xiaoming Li; Bonita Stanton; Liying Zhang; Yan Hong; Junfeng Zhao; Xiaoyi Fang

2010-01-01

222

Optimism, community attachment and serostatus disclosure among HIV-positive men who have sex with men.  

PubMed

This study investigated the relationship between HIV health optimism (HHO) (the belief that health will remain good after HIV infection due to treatment efficacy), HIV-positive community attachment (HCA), gay community attachment (GCA) and serostatus disclosure to casual sex partners by HIV-positive men who have sex with men (MSM). Cross-sectional questionnaire data were gathered from 97 HIV-positive MSM attending an HIV treatment clinic in Dublin, Ireland. Based on self-reported disclosure to casual partners, participants were classified according to their pattern of disclosure (consistent, inconsistent or non-disclosers). Multinomial logistic regression was used to assess HHO, HCA and GCA as predictors of participants' pattern of disclosure. Classification as a non-discloser (compared to a consistent discloser) was associated with higher HHO, less HCA and greater GCA. Classification as an inconsistent discloser (compared to a consistent discloser) was associated with higher GCA. The study provided novel quantitative evidence for associations between the constructs of interest. The results suggest that (1) HHO is associated with reduced disclosure, suggesting optimism may preclude individuals reaping the benefits of serostatus disclosure and (2) HCA and GCA represent competing attachments with conflicting effects on disclosure behaviour. Limitations and areas for future research are discussed. PMID:25495615

Murphy, Patrick J; Hevey, David; O'Dea, Siobhn; N Rathaille, Neans; Mulcahy, Fiona

2015-04-01

223

Request for Accounting of PHI Disclosed by Williams College I request an accounting of all PHI disclosed by Williams College's (fill in name of department or  

E-print Network

Request for Accounting of PHI Disclosed by Williams College I request an accounting of all PHI disclosed by Williams College's (fill in name of department or office permitted to be made by Williams College; 6. made to discuss my healthcare with a family member or other

Aalberts, Daniel P.

224

HIV / AIDS  

MedlinePLUS

... major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or HIV. By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight ...

225

HIV Incidence  

MedlinePLUS

... HIV infections was attributed to heterosexual contact (84%). Sex Among females, the estimated number of new HIV ... male-to-male sexual contact. Men Who Have Sex with Men Among MSM, the estimated number of ...

226

A Descriptive Analysis of HIV Prevalence, HIV Service Uptake, and HIV-Related Risk Behaviour among Patients Attending a Mental Health Clinic in Rural Malawi  

PubMed Central

Background Human immunodeficiency virus (HIV) and mental illness are interlinked health problems; mental illness may pose a risk for contracting HIV and HIV-positive individuals are at higher risk of mental illness. However, in countries with high HIV prevalence, the main focus of HIV-related health programmes is usually on prevention and treatment of somatic complications of HIV, and mental illness is not given high priority. We examined HIV prevalence, uptake of HIV services, and HIV-related risk behaviour among people attending a mental health clinic in rural Malawi. Methodology Semi-structured interviews were performed with patients capable to consent (94%), and with those accompanied by a capable caregiver who consented. HIV counselling and testing was offered to participants. Findings Among 174 participants, we collected 162 HIV test results (91%). HIV prevalence was 14.8%. Women were three times as likely to be HIV-positive compared to men. Two-thirds of participants reported having been tested for HIV prior to this study. The uptake of HIV-services among HIV-positive patients was low: 35% did not use recommended prophylactic therapy and 44% of patients not receiving antiretroviral treatment (ART) had never been assessed for ART eligibility. The reported rate of sexual activity was 61%, and 9% of sexually active participants had multiple partners. Inconsistent condom use with stable (89%) and occasional (79%) sexual partners, and absence of knowledge of the HIV status of those partners (53%, 63%) indicate high levels of sexual risk behaviour. Conclusions HIV-prevalence among persons attending the clinic, particularly men, was lower than among the general population in a population survey. The rate of HIV testing was high, but there was low uptake of preventive measures and ART. This illustrates that HIV-positive individuals with mental illness or epilepsy constitute a vulnerable population. HIV programmes should include those with neuropsychiatric illness. PMID:24015216

Lommerse, Kinke; Stewart, Robert C.; Chilimba, Queen; van den Akker, Thomas; Lund, Crick

2013-01-01

227

New Patterns of Disclosure: How HIV-Positive Support Group Members from KwaZulu-Natal Speak of their Status in Oral Narratives  

PubMed Central

This paper examines the representations and emotions associated with disclosure and stigma in Pietermaritzburg, KwaZulu-Natal, seven years after the start of the South African governments ARV roll-out programme on the basis of in-depth oral history interviews of HIV-positive support group members. It argues that the wider availability of ARV treatment, the ensuing reduced fatality rate and the increased number of people, including men, who receive counselling and testing, may mean that HIV/AIDS is less stigmatised and that disclosure has become easier. This does not mean that stigma has disappeared and that the confusion created by competing world-views and belief systems has dissipated. Yet the situation of extreme denial and ideological confusion observed, for example, by Deborah Posel and her colleagues in 2003 and 2004 in the Mpumalanga province seems to have lessened. The interviews hint at the possibility that people living with HIV may have, more than a decade before, a language to express the emotions and feelings associated with HIV/AIDS. They were also found to be more assertive in matters of gender relations. These new attitudes would make disclosure easier and stigma more likely to recede. PMID:24775433

Denis, Philippe

2014-01-01

228

Experience of stigma and discrimination and the implications for healthcare seeking behavior among people living with HIV/AIDS in resource-limited setting  

PubMed Central

Background Stigma and discrimination can limit access to care and treatment services. Stigma hides HIV from the public, resulting in reduced pressure for behavioral change. For effective behavior change, empirically grounded and theory-based behavioral change approaches are fundamental as a prevention interventions directed on decreasing stigma and discrimination. The objective of the study was to assess the experience of stigma and discrimination on the psychosocial and health care seeking behavior of people living with HIV/AIDS (PLHIV) in Arba Minch, Ethiopia. Methods This study uses qualitative methods involving focus-group discussions and in-depth interviews conducted in Arba Minch town and nearby Kebeles. Our sample consisted of PLHIV and other key informants who were purposively selected. Data were analyzed manually using thematic content analysis framework. Results It appears that the magnitude of stigma and discrimination in the area has decreased to a considerably lower level, however, the problem's severity is still being influenced by various factors including: current residence, disclosure status and level of community's awareness about HIV/AIDS. Care and support services provided to PLHIV were well accepted by the respondents and the majority of them were willing to make use of any service available. Health information messages that have been disseminated to the public through mass media since the start of the epidemic in 1984 and AIDS cases in 1986 have played a significant role regarding the current prevailing problem of stigma and discrimination of PLHIV. Conclusion Stigma and discrimination have come to a level that can be tolerated by most PLHIV that live in this region, especially those who have disclosed their HIV status and were living in urban areas. This calls for a strategy that improves the rates of serostatus disclosure after HIV counseling and testing and strengthens and integrates activities in the task of expanding care and support activities. PMID:23721543

Alemu, Taddese; Biadgilign, Sibhatu; Deribe, Kebede; Escudero, Horacio Ruiseor

2013-01-01

229

Gender inequities in sexually transmitted infections: implications for HIV infection and control in Lagos State, Nigeria  

PubMed Central

Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multistage random sampling procedure was employed in administration of 1358 questionnaires. For qualitative data, four focus group discussions (FGD) were conducted to collect information from stakeholders within the study population, while In-depth interview was employed to collect information from 188 people living with HIV/AIDS through support groups in the State. The data collected were subjected to basic demographic analytical techniques. Combination of univariate, bivariate, and multivariate analysis were employed. Information from focus group discussions and in-depth interviews were transcribed and organized under broad headings that depict different aspects of the discussions. Majority of the respondents interviewed did not inform their partners about their infection in the study area. It was also discovered that stigmatization did not allow some women to disclose their status to their sexual partners. Some of the HIV-positive patients interviewed agreed that they did not attend the health facilities to treat the STIs before they were finally confirmed positive. The study hypothesis revealed that communication between partners about STIs was associated with an increase in risk reduction behaviour. The paper concluded that there is need for more information and education on communication about STIs between the sexual partners; to reduce the spread of sexually transmitted diseases within the nation. PMID:24470905

Adeyemi, Ezekiel Oluwagbemiga

2011-01-01

230

Young Children's Reactions to Mothers' Disclosure of Maternal HIV+ Serostatus  

ERIC Educational Resources Information Center

Little is known about the impact of maternal disclosure of HIV-positive serostatus on young children. The objective of this study was to explore this topic, utilizing in-depth qualitative interviews. Qualitative interviews were conducted with 47 mothers who had disclosed to their young, well child, and with the children. The most prevalent child

Murphy, Debra A.; Roberts, Kathleen J.; Hoffman, Dannie

2006-01-01

231

Synbiotic therapy decreases microbial translocation and inflammation and improves immunological status in HIV-infected patients: a double-blind randomized controlled pilot trial  

PubMed Central

Background HIV-infection results in damage and dysfunction of the gastrointestinal system. HIV enteropathy includes pronounced CD4+ T-cell loss, increased intestinal permeability, and microbial translocation that promotes systemic immune activation, which is implicated in disease progression. A synbiotic is the combination of probiotics and prebiotics that could improve gut barrier function. Our study goal was to determine whether the use of a synbiotic, probiotics or a prebiotic can recover immunological parameters in HIV-infected subjects through of a reduction of microbial translocation and pro-inflammatory cytokine production. Methods A randomized, double-blind controlled study was performed; twenty Antiretroviral treatment-nave HIV-infected subjects were subgrouped and assigned to receive a synbiotic, probiotics, a prebiotic, or a placebo throughout 16?weeks. Results We had no reports of serious adverse-events. From baseline to week 16, the synbiotic group showed a reduction in bacterial DNA concentrations in plasma (p?=?0.048). Moreover, the probiotic and synbiotic groups demonstrated a decrease in total bacterial load in feces (p?=?0.05). The probiotic group exhibited a significant increment of beneficial bacteria load (such as Bifidobacterium; p?=?0.05) and a decrease in harmful bacteria load (such as Clostridium; p?=?0.063). In the synbiotic group, the CD4+ T-cells count increased (median: +102 cells/?L; p?=?0.05) and the level of Interleukin 6 cytokine decreased significantly (p?=?0.016). Conclusions Our study showed a significant increase in CD4+ T lymphocyte levels in the synbiotic group, which could delay the initiation of antiretroviral therapy and decrease costs in countries with limited resources. PMID:23101545

2012-01-01

232

Vitamin D deficiency in HIV-infected postmenopausal Hispanic and African-American women  

Microsoft Academic Search

SummaryWe evaluated vitamin D status in HIV+ and HIV? postmenopausal African-American (AA) and Hispanic women. Most women (74-78%)\\u000a had insufficient 25-hydroxyvitamin D (25OHD) levels, regardless of HIV status. 25OHD was lower in AA women and women lacking\\u000a supplement use, providing support for screening and supplementation. Among HIV+ women, 25OHD was associated with current CD4\\u000a but not type of antiretroviral therapy.

E. M. Stein; M. T. Yin; D. J. McMahon; A. Shu; C. A. Zhang; D. C. Ferris; I. Colon; J. F. Dobkin; S. M. Hammer; E. Shane

2011-01-01

233

Determinants of Intimate Partner Violence Among HIV-Positive and HIV-Negative Women in India.  

PubMed

To reduce the many adverse health outcomes associated with intimate partner violence (IPV), high-risk groups need to be specifically targeted in the fight against domestic violence in India. This study aims to examine the prevalence and correlates of IPV in HIV-positive and HIV-negative women from India. A convenience sample of HIV-positive and HIV-negative women responded to questionnaires to assess their experience and perception of violence. Multivariate logistic regression analysis was used to model the association between IPV and age, education, employment status, contraception use, age at first marriage, and HIV status. Although adjusting for age, education, employment status, contraception use, age at first marriage, and HIV status, women who are employed were 3.5 times more likely to suffer IPV (confidence interval [CI] = [1.5, 8.5]), women aged 18 or above at first marriage are 0.3 times less likely to face IPV (CI = [0.1, 0.6]), and women who use contraception are 7 times more likely to suffer IPV (CI = [1.4, 30.2]). Also, HIV-positive women are 3 times more likely to face sexual violence compared with HIV-negative women (CI = [1.1, 7.6]). PMID:25381267

Chakraborty, Hrishikesh; Patted, Shobhana; Gan, Anita; Islam, Farahnaz; Revankar, Amit

2014-11-01

234

Adolescent HIV disclosure in Zambia: barriers, facilitators and outcomes  

PubMed Central

Introduction As adolescents living with HIV gain autonomy over their self-care and begin to engage in sexual relationships, their experiences of being informed about their HIV status and of telling others about their HIV status may affect their ability to cope with having the disease. Methods In 2010, we conducted a qualitative study among adolescents aged 1019 living with HIV in Zambia, and with their parents and health care providers. Through interviews and focus group discussions, we explored the disclosure of HIV status to adolescents living with HIV; adolescents disclosure of their status to others; and the impact of both forms of disclosure on adolescents. Results Our study identified three main barriers to disclosure of HIV status: local norms that deter parents from communicating with their children about sexuality; fear of HIV stigma; and an underlying presumption that adolescents would not understand the consequences of a HIV diagnosis on their lives and relationships. With regard to adolescents disclosure of their HIV status to their sexual partners, our study identified fear of rejection as a common barrier. In rare cases, open family conversations about HIV helped adolescents come to terms with a HIV diagnosis. Findings indicated that disclosure had various outcomes at the individual and interpersonal levels. At the individual level, some adolescents described being anxious, depressed and blaming themselves after being told they had HIV. At the interpersonal level, disclosure created opportunities for adolescents to access adherence support and other forms of psychosocial support from family members and peers. At the same time, it occasionally strained adolescents sexual relationships, although it did not always lead to rejection. Conclusions There is a need for public health interventions that guide adolescents living with HIV, their parents and families through the disclosure process. Such interventions should help parents to assess and understand the evolving cognitive capacity and maturity of their adolescents in order to determine the appropriate time to inform them of their HIV-positive status. Such interventions should also mitigate the risk of HIV stigma, as well as local norms that may prevent discussions of sexuality within families. Adolescents who have been informed of their HIV status should be provided with on-going support to prevent disclosure from negatively affecting their psychological and sexual wellbeing. Further research is needed to explore the potential role of trusted family members in contributing to the disclosure process. PMID:24629845

Mburu, Gitau; Hodgson, Ian; Kalibala, Sam; Haamujompa, Choolwe; Cataldo, Fabian; Lowenthal, Elizabeth D; Ross, David

2014-01-01

235

HIV risk behavior and access to services: what predicts HIV testing among heterosexually active homeless men?  

PubMed

HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV testing behavior of homeless men. This study examined the association between individual (HIV risk) and structural (service access) factors and past year HIV testing. Participants were a representative sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Logistic regression examined the association between past year HIV testing and demographic characteristics, HIV risk behavior, and access to other services in the Skid Row area in the past 30 days. Despite high rates of past year HIV testing, study participants also reported high rates of HIV risk behavior, suggesting there is still significant unmet need for HIV prevention among homeless men. Having recently used medical/dental services in the Skid Row area (OR: 1.91; CI: 1.09, 3.35), and being a military veteran (OR: 2.10; CI: 1.01-4.37) were significantly associated with HIV testing service utilization. HIV testing was not associated with HIV risk behavior, but rather with access to services and veteran status, the latter of which prior research has linked to increased service access. We suggest that programs encouraging general medical service access may be important for disseminating HIV testing services to this high-risk, vulnerable population. PMID:22676465

Wenzel, Suzanne L; Rhoades, Harmony; Tucker, Joan S; Golinelli, Daniela; Kennedy, David P; Zhou, Annie; Ewing, Brett

2012-06-01

236

HIV chemotherapy  

NASA Astrophysics Data System (ADS)

The use of chemotherapy to suppress replication of the human immunodeficiency virus (HIV) has transformed the face of AIDS in the developed world. Pronounced reductions in illness and death have been achieved and healthcare utilization has diminished. HIV therapy has also provided many new insights into the pathogenesis and the viral and cellular dynamics of HIV infection. But challenges remain. Treatment does not suppress HIV replication in all patients, and the emergence of drug-resistant virus hinders subsequent treatment. Chronic therapy can also result in toxicity. These challenges prompt the search for new drugs and new therapeutic strategies to control chronic viral replication.

Richman, Douglas D.

2001-04-01

237

Immunologic status and virologic outcomes in repeat pregnancies to HIV-positive women not on antiretroviral therapy at conception: a case for lifelong antiretroviral therapy?  

PubMed

During their second pregnancy with diagnosed HIV (n = 1177), two-fifths of women in the UK/Ireland not on antiretroviral therapy (ART) at conception had an immunological indication for treatment (CD4(+) <350 cells/?l), of whom nearly half had CD4(+) at least 350 cells/?l in their previous pregnancy. Those initiating ART during pregnancy had a 4.3-fold increased odds of detectable viral load at delivery compared with those conceiving on treatment, suggesting that continuation of ART after pregnancy may be beneficial for many women. PMID:24685820

French, Clare E; Thorne, Claire; Tariq, Shema; Cortina-Borja, Mario; Tookey, Pat A

2014-06-01

238

Disclosure and impact of maternal HIV+ serostatus on mothers and children in rural Haiti.  

PubMed

Mothers living with HIV (MLWHs) in the United States have reported that one of their main challenges is the decision to disclose their HIV serostatus to their children and the potential consequences of their disclosure. Little is known about the experiences of MLWHs regarding disclosing their HIV serostatus to their children and the impact of maternal HIV serostatus disclosure in the island nations of the Caribbean. Study objectives were to identify the factors influencing maternal HIV serostatus disclosure, examine the breadth of maternal HIV serostatus, and understand the impact of disclosure on mothers and the children. Baseline interviews were conducted between 2006 and 2007 with 25 HIV-positive mothers and 26 children ages 10-17 participating in a pilot psychosocial support intervention for HIV-affected youth and their caregivers in Haiti. Interviews were transcribed verbatim and coded for topical themes by two investigators. Analysis of the interviews yielded several themes relevant to reasons for disclosure, including children's experience of HIV stigma in the community, social support and encouragement from psychosocial intervention workers. The main themes related to breadth of disclosure were brief disclosure and explicit disclosure with some mothers sharing information about how they learned about their illness diagnosis and their medication. Themes related to impacts of disclosure included emotional reactions of children and mothers, and children's desire to assist mothers with illness and become involved. These findings suggest the need to provide more psychosocial support to HIV-affected families in the Caribbean region. PMID:24158504

Conserve, Donaldson F; Eustache, Eddy; Oswald, Catherine M; Louis, Ermaze; King, Gary; Scanlan, Fiona; Mukherjee, Joia S; Surkan, Pamela J

2014-12-01

239

Shading the Truth: The Patterning of Adolescents' Decisions to Avoid Issues, Disclose, or Lie to Parents  

ERIC Educational Resources Information Center

Latent Class Analysis (LCA) was used to examine the patterning of adolescents' strategy choice when discussing issues with parents in a sample of 1678 Chilean 11-19 year olds (mean age = 14.9). Adolescents reported whether they fully disclosed, partially disclosed, avoided the issue, or lied for six core areas that bridged personal autonomy and

Cumsille, Patricio; Darling, Nancy; Martinez, M. Loreto

2010-01-01

240

Helping Counts: Predicting Children's Intentions to Disclose Being Bullied to Teachers from Prior Social Support Experiences  

ERIC Educational Resources Information Center

Despite possible negative effects, many children do not tell their teachers when they have been bullied. This study examined junior school pupils' ("N"=294) reports of instrumental, emotional and validation social support received after disclosing being bullied to teachers, and associations with intentions to disclose in the future. Overall,

Boulton, Michael J.; Murphy, Debborah; Lloyd, Julie; Besling, Sabine; Coote, Jennifer; Lewis, Jennifer; Perrin, Roxanne; Walsh, Linda

2013-01-01

241

24 CFR 30.65 - Failure to disclose lead-based paint hazards.  

Code of Federal Regulations, 2012 CFR

... 2012-04-01 false Failure to disclose lead-based paint hazards. 30.65 Section 30.65 Housing and Urban Development... Violations 30.65 Failure to disclose lead-based paint hazards. (a) General. The Director of the...

2012-04-01

242

24 CFR 30.65 - Failure to disclose lead-based paint hazards.  

... 2014-04-01 false Failure to disclose lead-based paint hazards. 30.65 Section 30.65 Housing and Urban Development... Violations 30.65 Failure to disclose lead-based paint hazards. (a) General. The Director of the...

2014-04-01

243

24 CFR 30.65 - Failure to disclose lead-based paint hazards.  

Code of Federal Regulations, 2010 CFR

... 2010-04-01 false Failure to disclose lead-based paint hazards. 30.65 Section 30.65 Housing and Urban Development... Violations 30.65 Failure to disclose lead-based paint hazards. (a) General. The Director of the...

2010-04-01

244

24 CFR 30.65 - Failure to disclose lead-based paint hazards.  

Code of Federal Regulations, 2011 CFR

... 2011-04-01 false Failure to disclose lead-based paint hazards. 30.65 Section 30.65 Housing and Urban Development... Violations 30.65 Failure to disclose lead-based paint hazards. (a) General. The Director of the...

2011-04-01

245

24 CFR 30.65 - Failure to disclose lead-based paint hazards.  

Code of Federal Regulations, 2013 CFR

... 2013-04-01 false Failure to disclose lead-based paint hazards. 30.65 Section 30.65 Housing and Urban Development... Violations 30.65 Failure to disclose lead-based paint hazards. (a) General. The Director of the...

2013-04-01

246

Disclosing Unwanted Sexual Experiences: Results from a National Sample of Adolescent Women  

ERIC Educational Resources Information Center

Objective: The aims of this study are to identify factors that influence the disclosures made by female survivors of unwanted sexual experiences (USE) in childhood and adolescence. The predictors of both the timing of disclosure (short delay, long delay, non-disclosure) and the recipient of the disclosure (disclosing ever to an adult, disclosing

Kogan, Steven M.

2004-01-01

247

49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.  

Code of Federal Regulations, 2010 CFR

...false SSI disclosed by TSA or the Coast Guard. 1520.15 Section 1520...15 SSI disclosed by TSA or the Coast Guard. (a) In general. Except...inspection or copying, nor does TSA or the Coast Guard release such records to...

2010-10-01

248

49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.  

Code of Federal Regulations, 2013 CFR

...false SSI disclosed by TSA or the Coast Guard. 1520.15 Section 1520...15 SSI disclosed by TSA or the Coast Guard. (a) In general. Except...inspection or copying, nor does TSA or the Coast Guard release such records to...

2013-10-01

249

49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.  

...false SSI disclosed by TSA or the Coast Guard. 1520.15 Section 1520...15 SSI disclosed by TSA or the Coast Guard. (a) In general. Except...inspection or copying, nor does TSA or the Coast Guard release such records to...

2014-10-01

250

49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.  

Code of Federal Regulations, 2012 CFR

...false SSI disclosed by TSA or the Coast Guard. 1520.15 Section 1520...15 SSI disclosed by TSA or the Coast Guard. (a) In general. Except...inspection or copying, nor does TSA or the Coast Guard release such records to...

2012-10-01

251

49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.  

Code of Federal Regulations, 2011 CFR

...false SSI disclosed by TSA or the Coast Guard. 1520.15 Section 1520...15 SSI disclosed by TSA or the Coast Guard. (a) In general. Except...inspection or copying, nor does TSA or the Coast Guard release such records to...

2011-10-01

252

Missed Opportunities for Early HIV diagnosis: Critical Insights from Stories of Kenyan Women Living with HIV  

PubMed Central

Early HIV testing is critical to prevention and timely treatment. Missed opportunities for HIV diagnosis can result in unnecessary deaths at a time when access to antiretroviral treatment proves life saving. While HIV prevention and treatment research has increased, less research exists on women's experiences with HIV diagnosis, despite the fact that women are most affected. Insights from local women are critical in designing culturally meaningful interventions that thwart missed opportunities for early HIV diagnosis. The purpose of our study was to uncover steps women took to know their HIV diagnosis. Using narrative inquiry methodology informed by post-colonial feminism, we interviewed 40 HIV- positive women in Kenya. Five themes emerged related to uptake of HIV testing for women: (a) spouse's critical illness or death; (b) years of suffering from HIV-related symptoms; (c) sick children; (d) prenatal testing; and (e) personal desire to know one's HIV status. These findings centered on women experiences provide an important basis for health promotion interventions related to HIV prevention, earlier detection, and treatment. PMID:24273455

Kako, Peninnah M.; Stevens, Patricia E.; Mkandawire-Valhmu, Lucy; Kibicho, Jennifer; Karani, Anna K.; Dressel, Anne

2013-01-01

253

HIV/AIDS-related stigmatizing and discriminatory attitudes and recent HIV testing among Beijing men who have sex with men  

PubMed Central

The study was to assess the correlates for recent HIV testing and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Beijing, China. A cross-sectional study probed demographics, sexual and drug use behaviors, HIV testing, and prevention services. Of 500 participants, 39.3% recently received a test for HIV. Recent testing was independently associated with expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes, more male sex partners, no female sexual partners and knowing HIV status of their last male partner. Expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with recent testing, younger age, and knowing HIV status of their last male partner. This study revealed that HIV/AIDS-related stigmatizing and discriminatory attitudes were common and inversely associated with recent HIV testing. Low levels of testing highlighted the urgent needs to reduce HIV/AIDS-related stigma and discrimination and expand HIV testing among Beijing MSM. PMID:22350831

Ma, Xiaoyan; Sun, Yanming; He, Xiong; Li, Chunmei; Raymond, H. F.; McFarland, Willi; Sun, Jiangping; Pan, Stephen W.; Shao, Yiming; Vermund, Sten H.; Xiao, Yan; Ruan, Yuhua; Jia, Yujiang

2014-01-01

254

HIV Testing Behaviors and Perceptions of Risk of HIV Infection Among MSM with Main Partners.  

PubMed

Male couples represent a high priority group for HIV prevention interventions because primary partners have been identified as the source of one-third to two-thirds of HIV infections among men who have sex with men (MSM). HIV testing is an important component of the U.S. National AIDS Strategy. In previous research rates of HIV testing among partnered MSM have been found to be lower compared to other MSM. In this paper, we use a sample of 906 MSM recruited through internet advertisements to contrast HIV testing behavior, perceived risk of HIV infection and confidence in remaining HIV sero-negative between single MSM and MSM who report having a main partner. We also examine associations between sexual agreements and HIV testing and perceived risk among partnered MSM. Although results were marginally significant, men with a main partner had significantly higher odds of perceiving zero risk of HIV infection, higher odds of being very confident they will remain HIV-negative, and lower odds of testing for HIV in the past 6months. Partnered men who reported they were in an open relationship had higher odds of recent HIV testing, lower odds of perceiving zero risk, and lower odds of being very confident in remaining HIV-negative, relative to those who reported monogamy. The results point to the need for dyadic interventions to tackle the underestimation of potential risk associated low HIV testing among partnered MSM. Couples HIV Testing and Counseling-CHTC-affords male couples the opportunity to learn their sero-status together and discuss the realities of their agreement and relationship and should be considered a priority intervention for male couples in the U.S. PMID:25081599

Stephenson, Rob; White, Darcy; Darbes, Lynae; Hoff, Colleen; Sullivan, Patrick

2014-08-01

255

Relationship Characteristics and HIV Transmission Risk in Same-sex Male Couples in HIV Serodiscordant Relationships  

PubMed Central

Unprotected anal intercourse (UAI) remains a main risk factor for HIV among men who have sex with men (MSM) and this is of particular concern for partners of HIV serodiscordant status. However, HIV transmission risk has been demonstrated to vary by the sexual position adopted among partners. Guided by interdependence theory, this study examined how relational factors were differentially associated with risk taking (HIV-positive/insertive and HIV-negative/receptive) and strategic positioning (HIV-positive/receptive and HIV-negative/insertive) UAI withinserodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (ncouples=91; nindividuals=182) simultaneously but independently completed computerized questionnaires and HIV-positive men had blood drawn for viral load.A minority of couples (30%) engaged in risk taking and/or strategicpositioning unprotected anal sex. Results of multinomial logistic regressionindicated that HIV-negative partners levels of relationship commitment were positively associated with the odds of engaging in both risk taking and strategic positioning sexual behaviors. For HIV-negative partners, reports of relationship intimacy, autonomy, and sexual satisfaction were negatively associated with odds of reporting risk taking behavior. In contrast, HIV-positive partnersreported sexual satisfaction was positively associated with odds of engaging in risk taking behavior. Findings suggested that aspects of relational quality may be differentially associated with sexual decision making for same-sex male couples in serodiscordant relationships. Study findings lend support for the incorporation ofdiscussions of HIV risk reduction strategies, enhancing communication between partners, and support for general relationship functioning in HIV care. PMID:24243004

Starks, Tyrel J.; Gamarel, Kristi E.; Johnson, Mallory O.

2014-01-01

256

HIV-1 prevalence in selected Tijuana sub-populations.  

PubMed Central

To assess the prevalence of HIV-1 (human immunodeficiency virus) infection among high-risk populations in Tijuana, Mexico, HIV-1 antibody status was determined and information on risk behavior was obtained from 1,069 individuals in three high-risk groups. The prevalence of HIV-1 among 415 prostitutes was 0.5 percent; 410 prisoners, 1.2 percent; 233 homosexual/bisexual men, 11.6 percent; and 106 intravenous drug abusers, 1.9 percent. The potential for spread of HIV-1 exists in Tijuana despite the current relatively low seroprevalence of HIV-1. PMID:2014864

Gerea-Burgueo, F; Benenson, A S; Seplveda-Amor, J

1991-01-01

257

Maternal HIV serostatus, mother-daughter sexual risk communication and adolescent HIV risk beliefs and intentions.  

PubMed

Daughters of HIV-positive women are often exposed to the same factors that placed their mothers at risk. This cross-sectional study (N = 176 dyads) examined HIV status, parent-teen sexual risk communication (PTSRC), and daughters' abstinence and condom use beliefs and intentions. Maternal HIV status was not associated with PTSRC. Path analyses show that maternal depression was associated with PTSRC behavioral and normative beliefs; relationship satisfaction was associated with PTSRC normative and control beliefs. Control beliefs were solely predictive of maternal PTSRC intention. PTSRC was associated with adolescent behavioral and normative beliefs. Abstinence beliefs were associated with abstinence intentions; condom beliefs were associated with condom use intentions. Relationship satisfaction was associated with adolescent control beliefs about both abstinence and condom use. There is a need for interventions that help HIV-positive mothers recognize their daughter's HIV risk and provide them with relationship building and parent process skills to help reduce these risks. PMID:22677973

Cederbaum, Julie A; Hutchinson, M Katherine; Duan, Lei; Jemmott, Loretta S

2013-09-01

258

Factors influencing HIV serodisclosure among men who have sex with men in the US: an examination of online versus offline meeting environments and risk behaviors.  

PubMed

One key component in HIV prevention is serostatus disclosure. Until recently, many studies have focused on interpersonal factors and minimally considered meeting venues as they pertain to disclosure. Using data (N=3,309) from an online survey conducted across 16 U.S. metropolitan statistical areas, we examined whether HIV serodisclosure varies by online/offline meeting venues in both protected and unprotected anal intercourse encounters. Most of the sample (76.9%) reported meeting men for sex (last 90days) both online and offline, versus 12.7% offline only and 10.4% online only. After controlling for other variables, we found that the men who meet partners in both online and offline were 20~30% more likely to report disclosing their HIV status prior to sex than men who met their partners exclusively either offline or online. While previous studies have identified the Internet as a risk environment, our findings suggest bi-environmental partner seeking may also have beneficial effects. PMID:24743960

Noor, Syed W B; Rampalli, Krystal; Rosser, B R Simon

2014-09-01

259

Plasma and breastmilk selenium in HIV-infected Malawian mothers is positively associated with infant selenium status at 2 or 6 and 24 weeks post-partum but is not associated with supplementation  

Technology Transfer Automated Retrieval System (TEKTRAN)

Selenium (Se) levels are typically low in HIV-infected individuals, but have been increased by supplementation in previous studies. In HIV-infected populations, the effect of Se supplementation on breastmilk Se and, consequently, plasma Se levels in exclusively breastfed infants is unknown. HIV-inf...

260

Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM.  

PubMed

Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32years; 32% were white; 32% Latino/Hispanic; 25% African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7% (N=27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner ("HIV transmission risk"). Of MSM who self-reported HIV-negativestatus (992), 11% (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner ("HIV acquisition risk"). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts. PMID:25381561

Frye, Victoria; Nandi, Vijay; Egan, James; Cerda, Magdalena; Greene, Emily; Van Tieu, Hong; Ompad, Danielle C; Hoover, Donald R; Lucy, Debbie; Baez, Eduardo; Koblin, Beryl A

2014-11-01

261

Early uptake of HIV clinical care after testing HIV-positive during home-based testing and counseling in western Kenya.  

PubMed

Home-based HIV testing and counseling (HBTC) has the potential to increase access to HIV testing. However, the extent to which HBTC programs successfully link HIV-positive individuals into clinical care remains unclear. To determine factors associated with early enrollment in HIV clinical care, adult residents (aged ?13 years) in the Health and Demographic Surveillance System in Kisumu, Kenya were offered HBTC. All HIV-positive residents were referred to nearby HIV clinical care centers. Two to four months after HBTC, peer educators conducted home visits to consenting HIV-positive residents. Overall, 9,895 (82 %) of 12,035 residents accepted HBTC; 1,087 (11 %) were HIV-positive; and 737 (68 %) received home visits. Of those receiving home visits, 42 % reported HIV care attendance. Factors associated with care attendance included: having disclosed, living with someone attending HIV care, and wanting to seek care after diagnosis. Residents who reported their current health as excellent or who doubted their HBTC result were less likely to report care attendance. While findings indicate that HBTC was well-received in this setting, less than half of HIV-positive individuals reported current care attendance. Identification of effective strategies to increase early enrollment and retention in HIV clinical care is critical and will require coordination between testing and treatment program staff and systems. PMID:23076720

Medley, Amy; Ackers, Marta; Amolloh, Manase; Owuor, Patrick; Muttai, Helen; Audi, Beryl; Sewe, Manquins; Laserson, Kayla

2013-01-01

262

Determinants of HIV testing among Nigerian couples: a multilevel modelling approach.  

PubMed

In this article we analyse the determinants of HIV testing among Nigerian couples using Demographic and Health Survey data set (2008). This study is motivated by the fact that although there is a strong willingness from the Nigerian Government to examine new HIV preventions approaches such as Pre-Exposure Prophylaxis for HIV (PrEP) and Treatment as Prevention (TasP) for HIV serodiscordant couples, the implementation of such policies would require the HIV status of each partner in the couple to be known. This is far to be achieved in the Nigerian context since in Nigeria only 6% of couples know their HIV status. In order to identify potential policies that are needed to increase HIV testing uptake, we use a three-level random intercept logistic model to separately explore the determinants of knowing HIV status among female and male partners. The use of the multilevel modelling allows including the unobserved heterogeneity at the village and state level that may affect HIV testing behaviours. Our results indicate that education, wealth, stigma, HIV knowledge and perceived risk are predictors of HIV testing among both partners while routine provider initiated testing appears to be very effective to increase HIV testing among women. The introduction of financial incentives as well as an increase in routine testing and home-based testing may be needed for large scale increase in HIV testing prior to the implementation of new HIV prevention technologies among discordant couples. PMID:24906362

Lpine, Aurlia; Terris-Prestholt, Fern; Vickerman, Peter

2014-06-01

263

HIV Surveillance in a Large, Community-Based Study: Results from the Pilot Study of Project Accept (HIV Prevention Trials Network 043)  

PubMed Central

Background Project Accept is a community randomized, controlled trial to evaluate the efficacy of community mobilization, mobile testing, same-day results, and post-test support for the prevention of HIV infection in Thailand, Tanzania, Zimbabwe, and South Africa. We evaluated the accuracy of in-country HIV rapid testing and determined HIV prevalence in the Project Accept pilot study. Methods Two HIV rapid tests were performed in parallel in local laboratories. If the first two rapid tests were discordant (one reactive, one non-reactive), a third HIV rapid test or enzyme immunoassay was performed. Samples were designated HIV NEG if the first two tests were non-reactive, HIV DISC if the first two tests were discordant, and HIV POS if the first two tests were reactive. Samples were re-analyzed in the United States using a panel of laboratory tests. Results HIV infection status was correctly determined based on-in country testing for 2,236 (99.5%) of 2,247 participants [7 (0.37%) of 1,907 HIV NEG samples were HIV-positive; 2 (0.63%) of 317 HIV POS samples were HIV-negative; 2 (8.3%) of 24 HIV DISC samples were incorrectly identified as HIV-positive based on the in-country tie-breaker test]. HIV prevalence was: Thailand: 0.6%, Tanzania: 5.0%, Zimbabwe 14.7%, Soweto South Africa: 19.4%, Vulindlela, South Africa: 24.4%, (overall prevalence: 14.4%). Conclusions In-country testing based on two HIV rapid tests correctly identified the HIV infection status for 99.5% of study participants; most participants with discordant HIV rapid tests were not infected. HIV prevalence varied considerably across the study sites (range: 0.6% to 24.4%). Trial Registration ClinicalTrials.gov registry number NCT00203749. PMID:21943026

2011-01-01

264

HIV and Cardiovascular Disease  

MedlinePLUS

... Select a Language: Fact Sheet 652 HIV and Cardiovascular Disease HIV AND CARDIOVASCULAR DISEASE WHY SHOULD PEOPLE WITH HIV CARE ABOUT CVD? ... OF CVD? WHAT ABOUT CHANGING MEDICATIONS? HIV AND CARDIOVASCULAR DISEASE Cardiovascular disease (CVD) includes a group of problems ...

265

HIV Testing and Pregnancy  

MedlinePLUS

... effective ways to protect her health and prevent mother-to- child transmission of HIV . She can also ... with HIV take anti-HIV medications to prevent mother-to-child transmission of HIV and, if needed, ...

266

Stages of HIV Infection  

MedlinePLUS

... Care Act and HIV/AIDS Community Engagement Incarceration Immigration HIV/AIDS Care Continuum Funding Opportunities How To ... of ART in HIV-1-Infected Adults and Adolescents: Acute and Recent (Early) HIV infection . clinical latency ...

267

Anolunula in Fingernails among Patients Infected with HIV  

PubMed Central

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection. PMID:24701356

Mishra, Nitin; Chauhan, Sandhya; Ali, Mir Mubashir; Rastogi, Madhur Kant; Thakur, Richa

2014-01-01

268

Undiagnosed HIV among people who inject drugs in Manipur, India.  

PubMed

Manipur is a geographically isolated state of India characterised by a high HIV prevalence among people who inject drugs (PWID). A low-to-moderate lifetime rate of HIV testing has been documented amongst PWID in Manipur. Little is known about the extent of undiagnosed HIV in this setting and whether uptake of HIV testing (and knowledge of a positive diagnosis) leads HIV-positive PWID to change their risk behaviours. The cross-sectional data (n = 821) analysed for this paper were collected in 2009 for the Integrated Behavioural and Biological Assessment (IBBA) using interviewer-administered questionnaires and the collection of de-linked blood and urine samples. Almost one-third (30.7%) of the participants tested HIV positive. The majority knew where to obtain a confidential HIV test (80.7%), however, half of the HIV-positive participants had either never had an HIV test (37.7%), or had undertaken a test without collecting the result (12.7%). Almost one-quarter (23.4%) of the HIV-positive participants and 17.4% of the HIV-negative participants had shared a needle/syringe with at least one other injector during the preceding month. Encouragingly, HIV-positive participants were significantly more likely than HIV-negative participants to use condoms with their regular sexual partners, however, there was still a high proportion of HIV-positive participants who did not use a condom at last sex with their regular (47.2%) or casual (48.0%) partners. Having taken an HIV test and collected the result was associated with a reduction in HIV-risk behaviours among HIV-positive participants, but not among HIV-negative participants. In conclusion, we found that a substantial proportion of the HIV-positive PWID in Manipur were not aware of their positive status, and risky injecting and sexual practices were commonplace. However, HIV-positive PWID appear to reduce their high-risk behaviours when they become aware of their HIV status highlighting the importance of taking HIV testing coverage to scale. PMID:25345544

Armstrong, Gregory; Medhi, Gajendra K; Mahanta, Jagadish; Paranjape, R S; Kermode, Michelle

2015-03-01

269

The epidemiology of HIV infection in Zambia  

Microsoft Academic Search

Population surveys of health and fertility are an important source of information about demographic trends and their likely impact on the HIV\\/AIDS epidemic. In contrast to groups sampled at health facilities they can provide nationally and regionally representative estimates of a range of variables. Data on HIV-sero-status were collected in the 2001 Zambia Demographic and Health Survey (ZDHS) and made

N. B. Kandala; C. Ji; P. F. Cappuccio; R. W. Stones

2008-01-01

270

HIV Transmission  

MedlinePLUS

... HIV. Oral sex involves giving or receiving oral stimulation to the penis (fellatio), the vagina (cunnilingus), or ... from food? Except for rare cases in which children consumed food that was pre-chewed by an ...

271

[Breastfeeding and HIV. Risks and advantages].  

PubMed

HIV can be transmitted from the mother to the baby during pregnancy, birth, or breast feeding. Around 66% of infants born to HIV-infected mothers are not infected with HIV. Most infants breast fed by their HIV-infected mothers do not become infected with HIV via breast milk, even though HIV has been detected in breast milk. Breast feeding when the mother is HIV infected does increase the risks of HIV infection for the infant but the degree of risk is not yet known. It is not easy to know if an infant is HIV positive until 12-18 months. Certain factors do increase the risk of HIV transmission during breast feeding: recent maternal HIV infection and presence of AIDS-related infections. Medical experts are so preoccupied by the risks that women receive bad advice and decide not to breast feed out of fear of transmitting HIV to their newborn. Breast feeding is an important way for mothers to assure good health for their newborns. Infants not breast fed are 14 times more likely to suffer childhood diseases than exclusively breast fed infants. Health workers must continue to support breast feeding, especially in areas where infectious diseases and malnutrition are the main causes of death, where poor hygienic conditions prevail, and where limited financial resources do not allow viable infant feeding alternatives. In such scenarios, the risk of transmitting HIV via breast milk is less than the risk of death if an infant is not breast fed. Health workers need to counsel pregnant women on breast feeding and to encourage them to consider their risk status, regardless of HIV status, so the women can make a more informed decision whether or not to breast feed. They often must provide this counseling under conditions where neither HIV testing nor infant feeding alternatives are available. Infant feeding decisions affect the whole family. Health workers should address counseling services for other family members also. Regardless of the mothers' decision on breast feeding, they need support and counseling on caring for their infant and themselves under the best conditions. PMID:12291924

Kaijage, T

1995-10-01

272

Risk Behaviors Among HIV-Positive Gay and Bisexual Men at Party-Oriented Vacations  

PubMed Central

Objective: This study examined substance use (intended and actual), unprotected sex, and HIV disclosure practices (disclosure and questioning) among HIV-positive men who have sex with men (MSM) at two party-oriented vacations, where substance use and sexual risk may be heightened. Method: A random sample of 489 MSM attending one of two party-oriented vacations participated in PartyIntents, a short-term longitudinal survey. Nearly half (47%) completed a follow-up assessment at the event or online for up to 2 weeks after the event. We examined rates of baseline intentions to use substances, actual substance use, and unprotected intercourse among HIV-positive men in attendance.Rates among HIV-negative men were estimated for comparison. Multiple logistic regression was used to assess the impact of illegal drug use and HIV status on unprotected anal intercourse (UAI). Results: HIV-positive attendees (17%) were significantly more likely than HIV-negative attendees to use nitrite inhalants (or poppers) (24.3% vs. 10.7%). HIV-positive attendees were also significantly more likely to have insertive UAI (64.3% vs. 34.1%) and receptive UAI (68.8% vs. 22.2%). Multivariate models showed associations between HIV status and illegal drug use with UAI (for HIV status, odds ratio [OR] = 4.5, p = .001; for any illegal drug use, OR = 16.4, p < .001). There was no evidence that the influence of drug use moderated risk by HIV status. Rates of HIV disclosure and questioning did not differ by HIV status. Conclusions: HIV-positive men attending these events engaged in higher rates of illegal drug use and sexual risk than HIV-negative men. Prevention campaigns targeting MSM at high-risk events should include messages geared toward HIV-positive men. PMID:23200162

Fisher, Michael P.; Ramchand, Rajeev; Bana, Sarah; Iguchi, Martin Y.

2013-01-01

273

43 CFR 3503.41 - Will BLM disclose information I submit under these regulations?  

Code of Federal Regulations, 2013 CFR

...MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) LEASING OF SOLID MINERALS OTHER THAN COAL AND OIL SHALE Areas Available for Leasing Filing Applications 3503.41 Will BLM disclose information I submit under...

2013-10-01

274

42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.  

Code of Federal Regulations, 2011 CFR

42 Public Health 1 2011-10-01 2011-10-01 false Disclosing information obtained from a provider of mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH...

2011-10-01

275

42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.  

Code of Federal Regulations, 2012 CFR

42 Public Health 1 2012-10-01 2012-10-01 false Disclosing information obtained from a provider of mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH...

2012-10-01

276

42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.  

Code of Federal Regulations, 2010 CFR

42 Public Health 1 2010-10-01 2010-10-01 false Disclosing information obtained from a provider of mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH...

2010-10-01

277

42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.  

42 Public Health 1 2014-10-01 2014-10-01 false Disclosing information obtained from a provider of mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH...

2014-10-01

278

42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.  

Code of Federal Regulations, 2013 CFR

42 Public Health 1 2013-10-01 2013-10-01 false Disclosing information obtained from a provider of mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH...

2013-10-01

279

48 CFR 1314.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 5 2010-10-01 2010-10-01...Other mistakes disclosed before award. 1314.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF COMMERCE ...BIDDING Opening of Bids and Awards of Contracts...

2010-10-01

280

48 CFR 2014.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 6 2010-10-01 2010-10-01...Other mistakes disclosed before award. 2014.407-3 Section...Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION...BIDDING Opening of Bids and Award of Contract...

2010-10-01

281

48 CFR 414.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 4 2010-10-01 2010-10-01...Other mistakes disclosed before award. 414.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE...BIDDING Opening of Bids and Award of Contract...

2010-10-01

282

48 CFR 514.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 4 2010-10-01 2010-10-01...Other mistakes disclosed before award. 514.407-3 Section...Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION...BIDDING Opening of Bids and Award of Contract...

2010-10-01

283

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Patient/Employee Name: ___________________________ Date of Birth: ___________Medical Record #: __________________  

E-print Network

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Patient/Employee Name: ___________________________ Date of Birth: ___________Medical Record #: __________________ I hereby authorize the following. Disclosure authorized to: __Employee Occupational Health Services Clinic University of New Mexico

New Mexico, University of

284

What do we know about older adults and HIV? a review of social and behavioral literature  

Microsoft Academic Search

The fastest growing segment of the United States HIV population is people aged 50 and older. This heterogeneous group includes people with diverse pathways into HIV positive status in later life, including aging with the disease as well as later life-acquired infections. As people with HIV live into older ages, solving problems of successful secondary prevention and ongoing treatment requires

Andrea Sankar; Andrea Nevedal; Stewart Neufeld; Rico Berry; Mark Luborsky

2011-01-01

285

Is Knowledge Enough? Considering HIV/AIDS Risk Behaviors and HIV/AIDS Knowledge with African American Women  

PubMed Central

Background: This quantitative explanatory study was designed to explain the relationship between HIV/AIDS risk-taking behaviors among African American women and their knowledge surrounding HIV/AIDS. More specifically, the research considers whether knowledge alone was sufficient to alter African-American womens risk-taking behaviors regarding HIV/AIDS. Objectives: This study was designed to investigate knowledge surrounding sexual risk-taking behaviors including 1) heterosexual transmission; 2) low and sporadic condom usage; 3) illicit drug use; and 4) multiple sex partners associated with HIV positive and negative status among African-American women. Patients and Methods: Participants in this study were African-American women who ranged in age between 24 and 44 years. This sample of African-American women was divided into two groups according to their HIV status: 53 women who were HIV positive and 62 women who were HIV negative women. The data for this investigation were obtained through self-administered questionnaires. The t-test was used to analyze the data through the use of the windows version of the statistical package for social sciences (19.0). Results: Findings suggest that knowledge of HIV was not found to be significantly different for the HIV positive and negative groups, and thus, suggest that knowing about the consequences of risk-taking behaviors is not sufficient to alter ones behavior among African American women. The findings from this investigation will contribute new empirical knowledge to the existing social work database on HIV/AIDS and knowledge specifically relative to African-American women. Conclusions: It was anticipated that knowledge of HIV would have been significantly higher in the HIV negative group than in the HIV positive group. However, the hypothesis was not supported by data. The HIV positive women and negative women were equally knowledgeable about HIV/AIDS.

Perkins, Emory L; Stennis, Kesslyn Brade; Taylor Spriggs, Velva; Kwegyir-Afful, Emma Aya; Prather, Aaron

2014-01-01

286

The Social Legacy of AIDS: Fertility Aspirations Among HIV-Affected Women in Uganda  

PubMed Central

Objectives. We investigated the impact of HIV status on fertility desires in Uganda. Methods. We surveyed 1594 women aged 18 to 49 years visiting outpatient services at Mbarara Regional Hospital, from May through August 2010. Of these, 59.7% were HIV-positive; 96.4% of HIV-positive women were using antiretroviral therapy (ART). We used logistic regression models to examine relationships between HIV status and fertility desires, marital status, household structure, educational attainment, and household income. Results. Among married women, HIV-positive status was significantly associated with a lower likelihood of desiring more children (27.7% vs 56.4% of HIV-negative women; ?2?=?39.97; P?HIV-positive women were more likely to be poor, unmarried, single heads of household, in second marriages (if married), living with an HIV-positive spouse, and supporting foster children. Conclusions. We found a strong association between positive HIV status and lower fertility aspirations among married women in Uganda, irrespective of ART status. Although the increasing availability of ART is a tremendous public health achievement, women affected by HIV have numerous continuing social needs. PMID:23237166

Mutumba, Massy; Resnicow, Kenneth; Mugyenyi, Godfrey

2013-01-01

287

49 CFR 385.321 - What failures of safety management practices disclosed by the safety audit will result in a...  

Code of Federal Regulations, 2010 CFR

... What failures of safety management practices disclosed by the...SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety... What failures of safety management practices disclosed by the... The failures of safety management practices consist of a...

2010-10-01

288

The precarious visibility politics of self?stigmatization: The case of HIV\\/AIDS tattoos  

Microsoft Academic Search

One of the ethical issues that emerges in discussions about HIV and AIDS is disclosure of serostatus?who should know if an individual is HIV?antibody positive, when, and by what means? For seropositive individuals, day?to?day existence is characterized by strategies of concealment and reveal?ment about their seropositivity. Some seropositive individuals have chosen to disclose their serostatus rather indiscriminately by non?verbal, rather

Dan Brouwer

1998-01-01

289

Relationships among HIV infection, metabolic risk factors, and left ventricular structure and function.  

PubMed

Our objective was to determine if the presence of metabolic complications (MC) conveyed an additional risk for left ventricular (LV) dysfunction in people with HIV. HIV? and HIV? men and women were categorized into four groups: (1) HIV? with MC (437 years, n=64), (2) HIV? without MC (427 years, n=59), (3) HIV? with MC (448 years, n=37), or (4) HIV? controls without MC (428 years, n=41). All participants underwent two-dimensional (2-D), Doppler, and tissue Doppler echocardiography. Overall, the prevalence of systolic dysfunction (15 vs. 4%, p=0.02) and LV hypertrophy (9 vs. 1%, p=0.03) was greater in HIV? than in HIV? participants. Participants with MC had a greater prevalence of LV hypertrophy (10% vs. 1%). Early mitral annular velocity during diastole was significantly (p<0.005) lower in groups with MC (HIV?/MC?: 11.62.3, HIV?/MC?: 12.02.3 vs. HIV?/MC?: 12.42.3, HIV?/MC?: 13.12.4 cm/s) and tended to be lower in groups with HIV (p=0.10). However, there was no interaction effect of HIV and MC for any systolic or diastolic variable. Regardless of HIV status, participants with MC had reduced LV diastolic function. Although both the presence of MC and HIV infection were associated with lower diastolic function, there was no additive negative effect of HIV on diastolic function beyond the effect of MC. Also, HIV was independently associated with lower systolic function. Clinical monitoring of LV function in individuals with metabolic risk factors, regardless of HIV status, is warranted. PMID:23574474

Cade, William Todd; Overton, Edgar Turner; Mondy, Kristin; de las Fuentes, Lisa; Davila-Roman, Victor G; Waggoner, Alan D; Reeds, Dominic N; Lassa-Claxton, Sherry; Krauss, Melissa J; Peterson, Linda R; Yarasheski, Kevin E

2013-08-01

290

Current Trends of HIV Recombination Worldwide  

PubMed Central

One of the major characteristics of HIV-1 is its high genetic variability and extensive heterogeneity. This characteristic is due to its molecular traits, which in turn allows it to vary, recombine, and diversify at a high frequency. As such, it generates complex molecular forms, termed recombinants, which evade the human immune system and so survive. There is no sequence constraint to the recombination pattern as it appears to occur at inter-group (between groups M and O), as well as interand intra-subtype within group M. Rapid emergence and active global transmission of HIV-1 recombinants, known as circulating recombinant forms (CRFs) and unique recombinant forms (URFs), requires urgent attention. To date, 55 CRFs have been reported around the world. The first CRF01_AE originated from Central Africa but spread widely in Asia. The most recent CRF; CRF55_01B is a recombinant form of CRF01_AE and subtype B, although its origin is yet to be publicly disclosed. HIV-1 recombination is an ongoing event and plays an indispensable role in HIV epidemics in different regions. Africa, Asia and South America are identified as recombination hot-spots. They are affected by continual emergence and cocirculation of newly emerging CRFs and URFs, which are now responsible for almost 20% of HIV-1 infections worldwide. Better understanding of recombinants is necessary to determine their biological and molecular attributes. PMID:24470968

Lau, Katherine A.; Wong, Justin J.L.

2013-01-01

291

Reducing HIV Transmission Risk by Increasing Serostatus Disclosure: A Mathematical Modeling Analysis  

PubMed Central

Persons living with HIV infection are encouraged to disclose their HIV-positive serostatus to prospective sex partners to decrease the likelihood of unsafe sex and HIV transmission. However, the effectiveness of serostatus disclosure as a preventive measure is not known. We developed a mathematical framework for assessing the HIV transmission risk reduction effectiveness of serostatus disclosure, examined how increasing the disclosure rate affects the transmission risk reduction effectiveness of disclosure, and explored the interaction between condom use and disclosure effectiveness. Under base-case assumptions, serostatus disclosure reduced the risk of HIV transmission by between 17.9% and 40.6% relative to no disclosure. Increasing the disclosure rate from the base-case value of 51.975.7% produced a 26.259.2% reduction in risk. The findings of this modeling study strongly support intervention efforts to increase both serostatus disclosure and condom use by persons living with HIV. PMID:17082982

Pinkerton, Steven D.; Galletly, Carol L.

2008-01-01

292

Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia  

PubMed Central

Background Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART). Design An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS). A cutoff score ?19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. Results The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS?19). Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.2720.81), low social support (OR=10.17, 95% CI 2.8536.29), number of negative life events of six and above (OR=3.99, 95% CI 1.778.99), not disclosing HIV status (OR=5.24, 95% CI 1.3320.62), and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.450.83) and 200499 cells/mm3 (OR=3.53, 95% CI 1.627.73). Conclusions This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health services with HIV/AIDS care and support program. PMID:24852246

Tesfaye, Solomon H.; Bune, Girma T.

2014-01-01

293

Duty to disclose what? Querying the putative obligation to return research results to participants.  

PubMed

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of "research results," specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. PMID:18316466

Miller, F A; Christensen, R; Giacomini, M; Robert, J S

2008-03-01

294

Plasma and breastmilk selenium in HIV-infected Malawian mothers are positively associated with infant selenium status but are not associated with maternal supplementations: Breastfeeding, Antiretrovirals, and Nutrition Study  

Technology Transfer Automated Retrieval System (TEKTRAN)

Background: Low dietary selenium (Se) intake coupled with low plasma Se concentrations in HIV infection could result in inadequate breastmilk Se intake by exclusively breastfed infants of HIV-infected women. Objective: To test the effect of lipid-based nutrient supplements (LNS) containing 1.3 R...

295

Complementary Feeding Adequacy in Relation to Nutritional Status Among Early Weaned Breastfed Children Who Are Born to HIV-Infected Mothers: ANRS 1201\\/1202 Ditrame Plus, Abidjan, Cote d'Ivoire  

Microsoft Academic Search

OBJECTIVE. In high HIV prevalence resource- constrained settings, exclusive breast- feeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has poten- tial adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature

Renaud Becquet; Valeriane Leroy; Didier K. Ekouevi; Ida Viho; Katia Castetbon; Patricia Fassinou

296

Relationship satisfaction of HIV-positive Ugandan individuals with HIV-negative partners.  

PubMed

Challenges of relational coping are well documented in the literature on couples and chronic illnesses, but there is significantly less research on the psychological aspects of couple relationships and HIV, particularly in international contexts. Coping with the uncertainty of illness progression, family planning, disclosure to friends and family, social isolation and stigma, fear of transmission, sexual intimacy, changes to social and physical functioning, and receiving and providing care pose special challenges for couples with discordant HIV statuses. This study examined the correlates of relationship satisfaction in Ugandan HIV-positive individuals seeking treatment at a community clinic. Relationship satisfaction of HIV-positive individuals was uniquely predicted by their couple identity and depression, underscoring the importance of mental and relational health in HIV/AIDS. PMID:25483813

Pasipanodya, Elizabeth C; Heatherington, Laurie

2014-12-01

297

Examining the Impact of Parental Disclosure of HIV on Children: A Meta-Analysis  

ERIC Educational Resources Information Center

This meta-analysis examined the impact of a mother's decision to disclose her HIV positive serostatus to her children. Results indicated that disclosure to a child improves the parent-child relationship (average r = + 0.171). There was a corresponding increase in internalized negative emotions (average r = + 0.108) and negative externalized

Tenzek, Kelly E.; Herrman, Anna R.; May, Amy R.; Feiner, Benjamin; Allen, Mike

2013-01-01

298

Pilot Trial of a Disclosure Intervention for HIV+ Mothers: The TRACK Program  

ERIC Educational Resources Information Center

Objective: The "T"eaching, "R"aising, "A"nd "C"ommunicating with "K"ids (TRACK) program was a longitudinal pilot-trial intervention designed to assist mothers living with HIV (MLHs) to disclose their serostatus to their young children (age 6-12 years). Method: MLH and child dyads (N = 80 dyads) were recruited and randomized to intervention or

Murphy, Debra A.; Armistead, Lisa; Marelich, William D.; Payne, Diana L.; Herbeck, Diane M.

2011-01-01

299

Mitigating HIV health disparities: the promise of mobile health for a patient-initiated solution.  

PubMed

The HIV epidemic is an ongoing public health problem fueled, in part, by undertesting for HIV. When HIV-infected people learn their status, many of them decrease risky behaviors and begin therapy to decrease viral load, both of which prevent ongoing spread of HIV in the community. Some physicians face barriers to testing their patients for HIV and would rather their patients ask them for the HIV test. A campaign prompting patients to ask their physicians about HIV testing could increase testing. A mobile health (mHealth) campaign would be a low-cost, accessible solution to activate patients to take greater control of their health, especially populations at risk for HIV. This campaign could achieve Healthy People 2020 objectives: improve patient-physician communication, improve HIV testing, and increase use of mHealth. PMID:25322292

Arya, Monisha; Kumar, Disha; Patel, Sajani; Street, Richard L; Giordano, Thomas Peter; Viswanath, Kasisomayajula

2014-12-01

300

Understanding HIV Testing Behaviors of Minority Adolescents: A Health Behavior Model Analysis.  

PubMed

Adolescents and young adults are the fastest-growing age group of people living with HIV infection in the United States. Yet many adolescents and young adults with high-risk behaviors for HIV are unaware of their HIV status and have never had an HIV test. The purpose of our work was to understand minority adolescents' beliefs, attitudes, and behaviors related to HIV testing. We conducted focus group sessions with 41 minority adolescents to assess their perceptions about HIV testing. We triangulated the findings from our focus group data with data from a 125-question survey. Analysis of focus group data demonstrated that Perceived Susceptibility, Perceived Severity, Perceived Benefits, Perceived Barriers, and Cues to Action influenced adolescents' decisions to get tested for HIV. Findings support the need to design interventions that address adolescents' perceived barriers to HIV testing and increase access to and knowledge about HIV testing. PMID:25283353

Schnall, Rebecca; Rojas, Marlene; Travers, Jasmine

2014-08-22

301

FACTORS RELATED TO HIV TESTING AMONG AN AFRICAN AMERICAN CHURCH-AFFILIATED POPULATION  

PubMed Central

HIV continues to disproportionately impact communities of color, and more calls are being extended to African American churches to assist in HIV education and screening efforts. However, no studies have reported on the HIV testing practices of African American church-affiliated persons. This study examines demographic, social, and behavioral factors associated with ever receiving an HIV test and last 12-month HIV testing. Findings indicated not having insurance and condom use were predictors of ever receiving an HIV test. Predictors of HIV testing in the last 12 months included marital status (i.e., single, divorced, separated, or widowed) and intentions to get tested for HIV in the near future. These predictors should be considered when designing HIV education and screening interventions for African American church settings. PMID:22468975

Berkley-Patton, Jannette; Moore, Erin W.; Hawes, Starlyn M.; Thompson, Carole Bowe; Bohn, Alexandria

2014-01-01

302

Alcohol Abuse and HIV Infection: Role of DRD2  

PubMed Central

According to a survey from the HIV Cost and Services Utilization Study (HCSUS), approximately 53% of HIV-infected patients reported drinking alcohol and 8% were classified as heavy drinkers. The role of alcohol as a risk factor for HIV infection has been widely studied and recent research has found a significant association between heavy alcohol consumption and lower levels of CD4 T cells among HIV-infected alcoholics. Although there is evidence on the role of alcohol as a risk factor for HIV transmission and disease progression, there is a need for population studies to determine the genetic mechanisms that affect alcohols role in HIV disease progression. One of the mechanisms of interest is the dopaminergic system. To date, the effects of dopamine on HIV neuroimmune pathogenesis are not well understood; however, dopaminergic neural degeneration due to HIV is known to occur by viral invasion into the brain via immune cells, and modulation of dopamine in the CNS may be a common mechanism by which different types of substances of abuse impact HIV disease progression. Although previous studies have shown an association of D(2) dopamine receptor (DRD2) polymorphisms with severity of alcohol dependence, the expression of this allele risk on HIV patients with alcohol dependence has not been systematically explored. In the current study, DRD2 Taq1A and C957T SNP genotyping analyses were performed in 165 HIV-infected alcohol abusers and the results were examined with immune status and CD4 counts. PMID:25053368

Agudelo, Marisela; Khatavkar, Pradnya; Yndart, Adriana; Yoo, Changwon; Rosenberg, Rhonda; Dvieux, Jessy G.; Malow, Robert M.; Nair, Madhavan

2015-01-01

303

Are They Really Lost? True Status and Reasons for Treatment Discontinuation among HIV Infected Patients on Antiretroviral Therapy Considered Lost to Follow Up in Urban Malawi  

PubMed Central

Introduction Patients who are lost to follow-up (LTFU) while on antiretroviral therapy (ART) pose challenges to the long-term success of ART programs. We describe the extent to which patients considered LTFU are misclassified as true disengagement from care when they are still alive on ART and explain reasons for ART discontinuation using our active tracing program to further improve ART retention programs and policies. Methods We identified adult ART patients who missed clinic appointment by more than 3 weeks between January 2006 and December 2010, assuming that such patients would miss their doses of antiretroviral drugs. Patients considered LTFU who consented during ART registration were traced by phone or home visits; true ART status after tracing was documented. Reasons for ART discontinuation were also recorded for those who stopped ART. Results Of the 4,560 suspected LTFU cases, 1,384 (30%) could not be traced. Of the 3,176 successfully traced patients, 952 (30%) were dead and 2,224 (70%) were alive, of which 2,183 (99.5%) started ART according to phone-based self-reports or physical verification during in-person interviews. Of those who started ART, 957 (44%) stopped ART and 1,226 (56%) reported still taking ART at the time of interview by sourcing drugs from another clinic, using alternative ART sources or making brief ART interruptions. Among 940 cases with reasons for ART discontinuations, failure to remember (17%), too weak/sick (12%), travel (46%), and lack of transport to the clinic (16%) were frequently cited; reasons differed by gender. Conclusion The LTFU category comprises sizeable proportions of patients still taking ART that may potentially bias retention estimates and misdirect resources at the clinic and national levels if not properly accounted for. Clinics should consider further decentralization efforts, increasing drug allocations for frequent travels, and improving communication on patient transfers between clinics to increase retention and adherence. PMID:24086627

Tweya, Hannock; Feldacker, Caryl; Estill, Janne; Jahn, Andreas; Ngambi, Wingston; Ben-Smith, Anne; Keiser, Olivia; Bokosi, Mphatso; Egger, Matthias; Speight, Colin; Gumulira, Joe; Phiri, Sam

2013-01-01

304

Vitamin D deficiency in HIV-infected postmenopausal Hispanic and African-American women  

PubMed Central

Summary We evaluated vitamin D status in HIV+ and HIV? postmenopausal African-American (AA) and Hispanic women. Most women (7478%) had insufficient 25-hydroxyvitamin D (25OHD) levels, regardless of HIV status. 25OHD was lower in AA women and women lacking supplement use, providing support for screening and supplementation. Among HIV+ women, 25OHD was associated with current CD4 but not type of antiretroviral therapy. Introduction To evaluate vitamin D status and factors associated with vitamin D deficiency and insufficiency in HIV-infected (HIV+) postmenopausal minority women. Methods In this cross-sectional study, 89 HIV+ and 95 HIV? postmenopausal women (33% AA and 67% Hispanic) underwent assessment of 25OHD, 1,25-dihydroxyvitamin D, parathyroid hormone, markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry. Results The prevalence of low 25OHD did not differ by HIV status; the majority of both HIV+ and HIV? women (7478%) had insufficient levels (<30 ng/ml). Regardless of HIV status, 25OHD was significantly lower in AA subjects, and higher in subjects who used both calcium and multi-vitamins. In HIV+ women on antiretroviral therapy (ART), 25OHD was directly associated with current CD4 count (r= 0.32; p<0.01) independent of age, ethnicity, BMI, or history of AIDS-defining illness. No association was observed between 1,25(OH)2D and CD4 count or between serum 25OHD, 1,25(OH)2D or PTH and type of ART. Conclusions In postmenopausal minority women, vitamin D deficiency was highly prevalent and associated with AA race and lack of supplement use, as well as lower current CD4 cell count. These results provide support for screening and repletion of vitamin D in HIV+ patients. PMID:20585939

Stein, E. M.; McMahon, D. J.; Shu, A.; Zhang, C. A.; Ferris, D. C.; Colon, I.; Dobkin, J. F.; Hammer, S. M.; Shane, E.

2011-01-01

305

Disclosure of HIV infection among Israeli men who have sex with men.  

PubMed

A descriptive, cross-sectional study was conducted to explore disclosure decisions regarding potential HIV infection by men who have sex with men (MSM). The sample consisted of 104 Israeli MSM. A questionnaire based on the theory of reasoned action was used for data determination. The questionnaire deals with beliefs, attitudes, and disclosure intentions. Results showed that only 30% of respondents intended to disclose potential HIV infection. A total of 70% of those who intended to disclose would choose to disclose the information to their brother/sister, two thirds to their mother, and only about 50% to their father. All components of the theory have an effect on MSM intentions of disclosure to others. In addition, behavioral beliefs, that is, MSM beliefs of the consequences of disclosure, were found to be the most significant predictor of behavioral intention. Research recommendations include the promotion of positive behavioral attitudes toward disclosure, leading to an increase in behavioral intentions of disclosure. PMID:21191035

Ben Natan, Merav; Zeltzer, Ira; Melnikov, Katia

2011-01-01

306

Facilitating HIV Disclosure Across Diverse Settings: A Review  

PubMed Central

HIV status disclosure is central to debates about HIV because of its potential for HIV prevention and its links to privacy and confidentiality as human-rights issues. Our review of the HIV-disclosure literature found that few people keep their status completely secret; disclosure tends to be iterative and to be higher in high-income countries; gender shapes disclosure motivations and reactions; involuntary disclosure and low levels of partner disclosure highlight the difficulties faced by health workers; the meaning and process of disclosure differ across settings; stigmatization increases fears of disclosure; and the ethical dilemmas resulting from competing values concerning confidentiality influence the extent to which disclosure can be facilitated. Our results suggest that structural changes, including making more services available, could facilitate HIV disclosure as much as individual approaches and counseling do. PMID:21493947

Baijal, Parijat; Pegurri, Elisabetta

2011-01-01

307

Secrets and lies: the dilemma of disclosing the diagnosis to an adult with dementia.  

PubMed

Guidelines state that doctors should reveal the diagnosis to the carer and the person with dementia. Carers may, however, not wish the diagnosis to be disclosed. We investigated carer and patient characteristics associated with the wish for disclosure. Fifty-four per cent of 100 carers wished the diagnosis to be revealed. The only significant predictor of wish for diagnosis to be hidden was a lower Mini Mental State Examination <17. Clinicians should strive for earlier diagnosis and to address carer concerns, disclose the diagnosis and thus avoid the need for secrets and lies. PMID:12851190

Fahy, Martin; Wald, Claudia; Walker, Zuzana; Livingston, Gill

2003-07-01

308

Preventing HIV with Medicine  

MedlinePLUS

... information in Spanish ( en espaol ) Preventing HIV with medicine Get medicine right after you are exposed to ... to top More information on Preventing HIV with medicine Explore other publications and websites National HIV and ...

309

HIV and AIDS  

MedlinePLUS

... Teens > Sexual Health > STDs & Other Infections > HIV and AIDS Print A A A Text Size What's in ... in human history. HIV causes a condition called acquired immunodeficiency syndrome better known as AIDS . HIV destroys a type ...

310

HIV/AIDS  

MedlinePLUS

HIV stands for human immunodeficiency virus. It kills or damages the body's immune system cells. AIDS stands for acquired immunodeficiency syndrome. It is the most advanced stage of infection with HIV. HIV most ...

311

Children and HIV  

MedlinePLUS

... Care Act and HIV/AIDS Community Engagement Incarceration Immigration HIV/AIDS Care Continuum Funding Opportunities How To ... reach developmental milestones. Many children with HIV reach adolescence without issue, and maintain relatively intact immune systems. ...

312

Older People and HIV  

MedlinePLUS

... they had a partner they may have ignored HIV prevention messages Very little HIV prevention education is targeted at older people Many older people believe that HIV only affects younger people Most older people get ...

313

Effects of Aging and Smoking on Carotid Intima Media Thickness in HIV-infection  

PubMed Central

Objectives To investigate the effects of aging and smoking on carotid intima-media thickness (cIMT) among patients with and without HIV. Methods Data from a community sample of HIV-infected and HIV-uninfected participants were analyzed. Carotid intima-media thickness was measured via carotid ultrasound and smoking history was obtained via patient interview. Results Data on 166male and female participants with stable HIV-infection and 152 healthy HIV-uninfected participants were analyzed. Among the HIV-infected and HIV-uninfected participants, a significant association was observed between age and cIMT [r=0.51, P<0.0001 (HIV), r=0.39, P<0.0001, (non-HIV)], and between smoking burden and cIMT [r=0.42, P<0.0001 (HIV), r=0.24, P=0.003 (non-HIV)]. In multivariate regression modeling among all participants (HIV and non-HIV), a significant three-way interaction was observed between age, smoking burden, and HIV status with respect to cIMT (P<0.010), controlling for gender, race and traditional cardiovascular disease (CVD) risk factors, such that increased cIMT was associated with increased smoking burden and age to a greater degree among HIV-infected vs. HIV-uninfected participants. Among HIV-infected participants a significant interaction between smoking burden and age with respect to cIMT was seen (P=0.027), controlling for race, gender, CVD risk factors, immunological function and antiretroviral therapy use. Conclusion A significant interaction between HIV, age and smoking on cIMT was observed, suggesting that HIV-infection modifies the relationship of age and smoking on cIMT in this population. These findings emphasize the need to encourage smoking cessation in this population, due to its deleterious effect on subclinical atherosclerosis in older HIV-infected patients. PMID:22874518

FITCH, Kathleen V.; LOOBY, Sara E.; ROPE, Alison; ENEH, Peace; HEMPHILL, Linda; LEE, Hang; GRINSPOON, Steven K.

2013-01-01

314

Infant feeding practice of HIV positive mothers and its determinants in selected health institutions of Addis Ababa, Ethiopia  

Microsoft Academic Search

Background: Avoidance of all breast-feeding by HIV infected mothers is recommended when replacement feeding is acceptable, feasible, affordable, sustainable, and safe. Whereas for women whose HIV status is unknown or negative, exclusive breastfeeding for the first six months is the single infant feeding option recommended. Objective: To assess the infant feeding practice of HIV positive mothers and its determinants. Methods:

Yetayesh Maru; Jemal Haidar

315

Psychiatric Diagnoses among an HIV-Infected Outpatient Clinic Population.  

PubMed

As individuals with HIV infection are living longer, the management of psychiatric disorders has increasingly been incorporated into comprehensive care. Individuals were recruited from an outpatient HIV clinic to assess the prevalence and related associations of current psychiatric disorders and biomarkers. Of the 201 participants who completed the interviews, the median age was 43.5 years, and the majority was male and African American. Most were receiving HIV therapy and 78% of those had achieved virologic suppression. Prevalent psychiatric diagnoses included major depressive disorder, generalized anxiety, and agoraphobia. Alcohol and cocaine/crack abuse and dependence were common substance use disorders. Current receipt of HIV therapy was less common among those diagnosed with generalized anxiety disorder. Agoraphobia was the only disorder associated with unsuppressed viral load. Psychiatric and substance use disorders are highly prevalent among an urban HIV clinic population, although we identified few associations between psychiatric diagnoses and HIV diseases status. PMID:25348798

Shacham, Enbal; Onen, Nur F; Donovan, Michael F; Rosenburg, Neal; Overton, E Turner

2014-10-27

316

HIV Screening among TB Patients and Co-Trimoxazole Preventive Therapy for TB/HIV Patients in Addis Ababa: Facility Based Descriptive Study  

PubMed Central

Background Collaborative TB/HIV management is essential to ensure that HIV positive TB patients are identified and treated appropriately, and to prevent tuberculosis (TB) in HIV positive patients. The purpose of this study was to assess HIV case finding among TB patients and Co-trimoxazole Preventive Therapy (CPT) for HIV/TB patients in Addis Ababa. Methods A descriptive cross-sectional, facility-based survey was conducted between June and July 2011. Data was collected by interviewing 834 TB patients from ten health facilities in Addis Ababa. Both descriptive and inferential statistics were used to summarize and analyze findings. Results The proportion of TB patients who (self reported) were offered for HIV test, tested for HIV and tested HIV positive during their anti-TB treatment follow-up were; 87.4%, 69.4% and 20.2%; respectively. Eighty seven HIV positive patients were identified, who knew their status before diagnosed for the current TB disease, bringing the cumulative prevalence of HIV among TB patients to 24.5%. Hence, the proportion of TB patients who knew their HIV status becomes 79.9%. The study revealed that 43.6% of those newly identified HIV positives during anti-TB treatment follow-up were actually treated with CPT. However, the commutative proportion of HIV positive TB patients who were ever treated with CPT was 54.4%; both those treated before the current TB disease and during anti-TB treatment follow-up. Conclusions HIV case finding among TB patients and provision of CPT for TB/HIV co-infected patients needs boosting. Hence, routine offering of HIV test and provision of CPT for PLHIV should be strengthened in-line with the national guidelines. PMID:24498278

Denegetu, Amenu Wesen; Dolamo, Bethabile Lovely

2014-01-01

317

THE UNIVERSITY OF MONTANA -MISSOULA CONSENT TO DISCLOSE STUDENT EDUCATION RECORDS  

E-print Network

THE UNIVERSITY OF MONTANA - MISSOULA CONSENT TO DISCLOSE STUDENT EDUCATION RECORDS (Form records as maintained by The University of Montana, complete this form and return it to the Griz Central. The University of Montana has designated certain parts of a student's education record as "Directory Information

Vonessen, Nikolaus

318

What is a meaningful result? Disclosing the results of genomic research in autism to research participants  

Microsoft Academic Search

Developments in genomics research have been accompanied by a controversial ethical injunction: that researchers disclose individually relevant research results to research participants. With the explosion of genomic research on complex psychiatric conditions such as autism, researchers must increasingly contend with whether and which results to report. We conducted a qualitative study with researchers and participants involved in autism

Fiona Alice Miller; Robin Zoe Hayeems; Jessica Peace Bytautas; FA Miller

2010-01-01

319

Why Adolescents Don't Disclose Incidents of Bullying and Harassment  

Microsoft Academic Search

Bullying among students is a recalcitrant problem in U.S. schools. Victimized students are more likely to experience feelings of sadness, hopelessness, loneliness, insomnia, and suicidal ideation. Research indicates that many students do not disclose bullying they experience or witness despite repeated efforts on the part of adults. The preponderance of research tends to neither include the perceptions of students nor

Ellen W. deLara

2012-01-01

320

Impaired respiration discloses the physiological significance of state transitions in Chlamydomonas  

E-print Network

Impaired respiration discloses the physiological significance of state transitions in Chlamydomonas- sitions and/or mitochondrial respiration, we show that photosyn- thetic growth, and therefore biomass cannot be provided by respiration, enhanced photosystem I turnover elicited by transition to state 2

321

Adolescents' Self-Disclosure to Parents across Cultures: Who Discloses and Why  

ERIC Educational Resources Information Center

Much attention has been given to self-disclosure as an important component of parent-adolescent relationships. The authors address gaps in the current literature via a multimethod, multicultural design, interviewing 120 adolescents in Costa Rica, Thailand, and South Africa about their reasons for disclosing to parents, and then constructing items

Hunter, Sally B.; Barber, Brian K.; Olsen, Joseph A.; McNeely, Clea A.; Bose, Krishna

2011-01-01

322

48 CFR 1414.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 5 2010-10-01 2010-10-01...Other mistakes disclosed before award. 1414.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR...BIDDING Opening of Bids and Award of Contract...

2010-10-01

323

48 CFR 2414.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 6 2010-10-01 2010-10-01...Other mistakes disclosed before award. 2414.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND...BIDDING Opening of Bids and Award of Contracts...

2010-10-01

324

48 CFR 914.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 5 2010-10-01 2010-10-01...Other mistakes disclosed before award. 914.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING...BIDDING Opening of Bids and Award of Contract...

2010-10-01

325

48 CFR 714.406-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 5 2010-10-01 2010-10-01...Other mistakes disclosed before award. 714.406-3 Section...Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT...BIDDING Opening of Bids and Award of Contract...

2010-10-01

326

48 CFR 3414.406-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 7 2010-10-01 2010-10-01...Other mistakes disclosed before award. 3414.406-3 Section...Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION...BIDDING Opening of Bids and Award of Contract...

2010-10-01

327

48 CFR 614.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 4 2010-10-01 2010-10-01...Other mistakes disclosed before award. 614.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACTING...BIDDING Opening of Bids and Award of Contract...

2010-10-01

328

48 CFR 2814.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 6 2010-10-01 2010-10-01...Other mistakes disclosed before award. 2814.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF JUSTICE Contracting...BIDDING Opening of Bids and Award of Contract...

2010-10-01

329

48 CFR 2914.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 7 2010-10-01 2010-10-01...Other mistakes disclosed before award. 2914.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF LABOR CONTRACTING...BIDDING Opening of Bids and Award of Contract...

2010-10-01

330

48 CFR 814.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 5 2010-10-01 2010-10-01...Other mistakes disclosed before award. 814.407-3 Section...Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS...BIDDING Opening of Bids and Award of Contract...

2010-10-01

331

48 CFR 314.407-3 - Other mistakes disclosed before award.  

Code of Federal Regulations, 2010 CFR

...Federal Acquisition Regulations System 4 2010-10-01 2010-10-01...Other mistakes disclosed before award. 314.407-3 Section...Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES...BIDDING Opening of Bids and Award of Contract...

2010-10-01

332

AUTHORIZATION TO USE AND DISCLOSE PROTECTED HEALTH INFORMATION FOR RESEARCH PURPOSES  

E-print Network

AUTHORIZATION TO USE AND DISCLOSE PROTECTED HEALTH INFORMATION FOR RESEARCH PURPOSES The privacy health information (protected health information). The privacy law requires me to sign an authorization for research purposes in the study entitled [insert title of study/protocol/project] . I authorize [name

Karsai, Istvan

333

TITLE: AUTHORIZATION TO DISCLOSE PATIENT INFORMATION PATIENT ACCESS USE AND DISCLOSURE OF MEDICAL  

E-print Network

TITLE: AUTHORIZATION TO DISCLOSE PATIENT INFORMATION PATIENT ACCESS ­ USE AND DISCLOSURE OF MEDICAL, an insurance company, to the patient or any other party as authorized by the patient. Protected Health to a patient; to researchers as authorized by the patient or an IRB approval; as required by law

Columbia University

334

Disclosing arbuscular mycorrhizal fungal biodiversity in soil through a land-use gradient using a  

E-print Network

25, 10125, Italy. Summary The biodiversity of arbuscular mycorrhizal fungi (AMF) communities presentDisclosing arbuscular mycorrhizal fungal biodiversity in soil through a land-use gradient using. The environments with low inputs (pasture and covered vineyard) showed a higher AMF biodiversity than those

Bruns, Tom

335

Hepatitis C virus replication in Caucasian HIV controllers.  

PubMed

Whether HIV controllers, patients who spontaneously control HIV viraemia, are able to control hepatitis C virus (HCV) infection, in terms of spontaneous clearance or lower HCV replication, is not well understood. To assess to what extent Caucasian HIV controllers are able to control HCV replication and potential associated factors, plasma HIV-1 and HCV RNA levels, anti-HCV antibodies, HCV genotype and human leucocyte antigens (HLA) typing were determined in samples from 75 HIV controllers (33 viraemic controllers, <1000 HIV-1 RNA?copies/mL, and 42 elite controllers, <40 HIV-1 RNA?copies/mL) and compared with 261 HIV-infected noncontrollers. We did not find differences in the HCV spontaneous clearance rates between groups. However, we interestingly found a lower HCV viral load in HIV controllers, alongside a different distribution of HCV genotypes in relation to the comparison group. In addition, HLA-B57 was associated with a lower HCV viral load in the control group and HIV controllers, and conversely, HLA-B35 with higher HCV viral load in HIV controllers. The subrepresentation of HCV genotype 1 and the overrepresentation of HLA-B57 only partly explained the lower HCV viral load found in HIV controllers. In fact, HIV controller status was independently associated with lower HCV viral load, together with HCV genotype non-1, the presence of HLA-B57 and absence of HLA-B35. Caucasian HIV controllers are able to better control HCV replication, in terms of lower HCV viral load levels. These findings support the idea that some common host mechanisms are involved in the defence against these two persistent infections. PMID:21692947

Ruiz-Mateos, E; Machmach, K; Romero-Sanchez, M C; Ferrando-Martinez, S; Viciana, P; Del Val, M; Muoz-Fernandez, M A; Genebat, M; Leal, M

2011-07-01

336

The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000-2009.  

PubMed

To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000-2001 to 2008-2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000-2001 and 11,083 in 2008-2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men. PMID:22639958

Holt, Martin; Lee, Evelyn; Prestage, Garrett P; Zablotska, Iryna; de Wit, John; Mao, Limin

2013-01-01

337

HIV Acquisition Among Women From Selected Areas of the United States  

PubMed Central

Background Women account for 23% of newly diagnosed HIV infections in the United States, but there are few recent, well-characterized cohorts of U.S. women in whom behavior characteristics and HIV acquisition have been well-described. Objective To evaluate HIV incidence and describe behaviors among U.S. women residing in areas of high HIV prevalence. Design Multisite, longitudinal cohort of women who had HIV rapid testing and audio computer-assisted self-interviews at baseline and every 6 months for up to 12 months. (ClinicalTrials.gov: NCT00995176) Setting 10 urban and periurban communities with high HIV prevalence and poverty rates, located in the northeastern and southeastern United States. Patients Venue-based sampling was used to recruit women aged 18 to 44 years who recently had unprotected sex and had 1 or more additional personal or partner risk factors and no self-reported previous HIV diagnosis. Measurements HIV prevalence and incidence, frequency of HIV risk behaviors, and health status perceptions. Results Among 2099 high-risk women (85.9% black and 11.7% of Hispanic ethnicity), 32 (1.5%) were diagnosed with HIV infection at enrollment. Annual HIV incidence was 0.32% (95% CI, 0.14% to 0.74%). Older age, substance use, and knowing a partner had HIV were associated with HIV prevalence. Ten women died during the study (0.61% per year). Limitations Longitudinal assessment of risk behaviors was limited to a maximum of 12 months. There were few incident HIV infections, precluding identification of characteristics predictive of HIV acquisition. Conclusion This study enrolled a cohort of women with HIV incidence substantially higher than the Centers for Disease Control and Prevention national estimate in the general population of U.S. black women. Concerted efforts to improve preventive health care strategies for HIV and overall health status are needed for similar populations. PMID:23277896

Hodder, Sally L.; Justman, Jessica; Hughes, James P.; Wang, Jing; Haley, Danielle F.; Adimora, Adaora A.; Del Rio, Carlos; Golin, Carol E.; Kuo, Irene; Rompalo, Anne; Soto-Torres, Lydia; Mannheimer, Sharon B.; Johnson-Lewis, LeTanya; Eshleman, Susan H.; El-Sadr, Wafaa M.

2014-01-01

338

Reproductive decision-making among HIV-Infected women.  

PubMed Central

OBJECTIVE: To describe factors related to reproductive decision-making among HIV-infected women. MATERIALS AND METHODS: A sample of HIV-infected women (N=104) who received care at an HIV clinic in the southern United States were interviewed about their reproductive decision-making. Women who became pregnant subsequent to HIV diagnosis were compared to women who did not become pregnant, and women who underwent a sterilization procedure subsequent to HIV diagnosis were compared to women who did not get sterilized. RESULTS: Compared to women who did not get pregnant after receiving an HIV diagnosis, women who became pregnant were more likely to be young, single, diagnosed earlier in the epidemic and to have more recently used a noninjecting drug. Among women who did not get pregnant, 63% reported their diagnosis greatly affected that decision. Having a partner who wants more children was not associated with pregnancy. Compared to women who did not get sterilized after learning their HIV status, women who did get sterilized tended to be Baptist and already had a prior live birth. Neither a woman's desire nor her partner's desire for more children was associated with sterilization. CONCLUSIONS: HIV is an important influence on HIV-infected women's reproductive choices, regardless of the decision being made. Reproductive counseling by HIV care providers needs to be sensitive to all the issues faced by these women. PMID:16353661

Bedimo-Rung, Ariane Lisann; Clark, A. Rebecca; Dumestre, Jeanne; Rice, Janet; Kissinger, Patricia

2005-01-01

339

Advocating prevention over punishment: the risks of HIV criminalization in Burkina Faso.  

PubMed

In 2004, parliamentarians from 12 countries in West and Central Africa created a template for legislation aimed at protecting the rights of people with HIV and stemming rising HIV infection rates by criminalizing HIV transmission. Since then, the template has been adopted as national law in 15 African countries, including Burkina Faso in 2008. The Burkina Faso law offers a number of protections for people with HIV, such as confidentiality of HIV test results, and holds the government accountable for providing health services for people with HIV and education about HIV in schools. However, other articles in the law, which criminalize HIV transmission and mandate disclosure of HIV status, may contribute to violations of the human rights of women and men with HIV. This article reviews the two cases brought in Burkina Faso under the 2008 HIV law to date, both against women, and explores the implications of specific elements of the legislation. It recommends that Burkina Faso use guidance provided by UNAIDS and the Southern Africa Development Community to repeal harmful articles in the HIV-specific legislation and implement the positive provisions. Prioritizing HIV prevention over punishment is the best way to respect the rights of people living with HIV and AIDS. PMID:19962648

Sanon, Patrice; Kabor, Simon; Wilen, Jennifer; Smith, Susanna J; Galvo, Jane

2009-11-01

340

Knowing is not enough: a qualitative report on HIV testing among heterosexual African-American men.  

PubMed

Despite having higher rates of HIV testing than all other racial groups, African-Americans continue to be disproportionately affected by the HIV epidemic in the United States. Knowing one's status is the key step to maintaining behavioral changes that could stop the spread of the virus, yet little is known about the individual- and socio-structural-level barriers associated with HIV testing and communication among heterosexual African-American men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African-American men, we conducted computerized, structured interviews with 61 men, focus group interviews with 25 men in 5 different groups, and in-depth qualitative interviews with 30 men living in high HIV prevalence neighborhoods in New York City. Results revealed that HIV testing was frequent among the participants. Even with high rates of testing, the men in the study had low levels of HIV knowledge; perceived little risk of HIV; and misused HIV testing as a prevention method. Factors affecting HIV testing, included stigma, relationship dynamics and communication, and societal influences, suggesting that fear, low perception of risk, and HIV stigma may be the biggest barriers to HIV testing. These results also suggest that interventions directed toward African-American heterosexual men must address the use of "testing as prevention" as well as correct misunderstandings of the window period and the meaning of HIV test results, and interventions should focus on communicating about HIV. PMID:25298014

Bond, Keosha T; Frye, Victoria; Taylor, Raekiela; Williams, Kim; Bonner, Sebastian; Lucy, Debbie; Cupid, Malik; Weiss, Linda; Koblin, Beryl A

2015-02-01

341

Small alveolar macrophages are infected preferentially by HIV and exhibit impaired phagocytic function  

PubMed Central

HIV-1-infected persons are at higher risk of lower respiratory tract infections than HIV-1-uninfected individuals. This suggests strongly that HIV-infected persons have specific impairment of pulmonary immune responses, but current understanding of how HIV alters pulmonary immunity is incomplete. Alveolar macrophages (AMs), comprising small and large macrophages, are major effectors of innate immunity in the lung. We postulated that HIV-1 impairs pulmonary innate immunity through impairment of AM physiological functions. AMs were obtained by bronchoalveolar lavage from healthy, asymptomatic, antiretroviral therapy-naive HIV-1-infected and HIV-1-uninfected adults. We used novel assays to detect in vivo HIV-infected AMs and to assess AM functions based on the HIV infection status of individual cells. We show that HIV has differential effects on key AM physiological functions, whereby small AMs are infected preferentially by the virus, resulting in selective impairment of phagocytic function. In contrast, HIV has a more generalized effect on AM proteolysis, which does not require direct viral infection. These findings provide new insights into how HIV alters pulmonary innate immunity and the phenotype of AMs that harbors the virus. They underscore the need to clear this HIV reservoir to improve pulmonary immunity and reduce the high incidence of lower respiratory tract infections in HIV-1-infected individuals. PMID:24472847

Jambo, K C; Banda, D H; Kankwatira, A M; Sukumar, N; Allain, T J; Heyderman, R S; Russell, D G; Mwandumba, H C

2014-01-01

342

Allowing HIV-Positive Organ Donation: Ethical, Legal and Operational Considerations  

PubMed Central

Case reports of kidney transplantation using HIV-positive (HIV+) donors in South Africa and advances in the clinical care of HIV+ transplant recipients have drawn attention to the legal prohibition of transplanting organs from HIV+ donors in the US. For HIV+ transplant candidates, who face high barriers to transplant access, this prohibition violates beneficence by placing an unjustified limitation on the organ supply. However, transplanting HIV+ organs raises non-maleficence concerns given limited data on recipient outcomes. Informed consent and careful monitoring of outcome data should mitigate these concerns, even in the rare circumstance when an HIV+ organ is intentionally transplanted into an HIV-negative recipient. For potential donors, the federal ban on transplanting HIV+ organs raises justice concerns. While in practice there are a number of medical criteria that preclude organ donation, only HIV+ status is singled out as a mandated exclusion to donation under the National Organ Transplant Act (NOTA). Operational objections could be addressed by adapting existing approaches used for organ donors with hepatitis. Center-specific outcomes should be adjusted for HIV donor and recipient status. In summary, transplant professionals should advocate for eliminating the ban on HIV+ organ donation and funding studies to determine outcomes after transplantation of these organs. PMID:23758835

Mgbako, O; Glazier, A; Blumberg, E; Reese, PP

2013-01-01

343

Resilience among asylum seekers living with HIV  

PubMed Central

Background A small body of evidence demonstrates the challenges faced by migrant communities living with HIV but has yet to consider in-depth the experience of asylum seekers whose residency status is undetermined. The overall aim of our study was to explore the experiences of those who are both living with HIV and seeking asylum. This paper focuses on the stressors precipitated by the HIV diagnosis and by going through the asylum system; as well as participants resilience in responding to these stressors and the consequences for their health and wellbeing. Methods We conducted an ethnographic study. Fieldwork took place in the UK between 20082009 and included: 350 hours of observation at voluntary services providing support to black and minority ethnic groups living with HIV; 29 interviews and four focus group discussions with those who were seeking asylum and living with HIV; and 15 interviews with their health and social care providers. Data were analysed using the constant comparative method. Results There were three main stressors that threatened participants resilience. First, migration caused them to leave behind many resources (including social support). Second, stigmatising attitudes led their HIV diagnosis to be a taboo subject furthering their isolation. Third, they found themselves trapped in the asylum system, unable to influence the outcome of their case and reliant on HIV treatment to stay alive. Participants were, however, very resourceful in dealing with these experiences. Resilience processes included: staying busy, drawing on personal faith, and the support received through HIV care providers and voluntary organisations. Even so, their isolated existence meant participants had limited access to social resources, and their treatment in the asylum system had a profound impact on perceived health and wellbeing. Conclusions Asylum seekers living with HIV in the UK show immense resilience. However, their isolation means they are often unable to deal with their treatment in the asylum system, with negative consequences for their perceived health and wellbeing. PMID:23110402

2012-01-01

344

Regional differences in HIV prevalence among drug users in China: potential for future spread of HIV?  

PubMed Central

Background Drug use and in particular injecting drug use has been at the forefront of the explosive spread of HIV in general populations in many countries in Asia. There is concern that also in China increased HIV incidence in drug users might spark off a generalized epidemic in the wider population. Close monitoring of HIV incidence and risk factors in drug users is therefore important to be able to target interventions effectively. Second generation surveillance was launched to assess HIV prevalence and risk behaviours jointly with the purpose of describing trends and predicting future developments. To assess whether these goals were fulfilled among drug users in China we provide an analysis of risk factors for HIV infection and of regional differences in HIV prevalence. Methods We analysed data collected in 2005 in 21 drug user second generation surveillance sentinel sites from 14 provinces in China. We used random effects logistic regression to test for risk factors for HIV infection and regional differences. Results The overall HIV-1 antibody prevalence was 5.4% (279/5128); 4.9% among injecting drug users (IDU) not sharing needles and 3.7% among non-injecting drug users. We found substantial heterogeneity among the surveillance sites with prevalence rates ranging between 0% and 54%. HIV status was strongly affected by the regional prevalence of HIV. Risk behaviours were highly prevalent in regions where HIV prevalence is still low. The distribution of duration of drug use in different sites indicated different stages of the drug use epidemics. Conclusion ]Regional differences in HIV prevalence in China reflect different stages of the drug use and HIV epidemics rather than differences in risk behaviours. Therefore, outbreaks of HIV among drug users in regions where prevalence is still low can be expected in the future. However, methodological limitations of surveillance embedded into routine systems limit the usability of existing data. More standardized approaches to data collection in secondary generation HIV surveillance are necessary to better understand regional differences in risk behaviour and prevalence and to design targeted intervention for those regions at risk of experiencing outbreaks. PMID:18680587

Kretzschmar, Mirjam; Zhang, Weidong; Mikolajczyk, Rafael T; Wang, Lan; Sun, Xinhua; Kraemer, Alexander; Lv, Fan

2008-01-01

345

CYTOMEGALOVIRUS INFECTION AND HIV-1 DISEASE PROGRESSION IN INFANTS BORN TO HIV-1INFECTED WOMEN  

PubMed Central

Background and Methods Cytomegalovirus (CMV) has been implicated as a cofactor in the progression of human immunodeficiency virus type 1 (HIV-1) disease. We assessed 440 infants (75 of whom were HIV-1infected and 365 of whom were not) whose CMV status was known, who were born to HIV-1infected women, and who were followed prospectively. HIV-1 disease progression was defined as the presence of class C symptoms (according to the criteria of the Centers for Disease Control and Prevention [CDC]) or CD4 counts of less than 750 cells per cubic millimeter by 1 year of age and less than 500 cells per cubic millimeter by 18 months of age. Results At birth the frequency of CMV infection was similar in the HIV-1infected and HIV-1uninfected infants (4.3 percent and 4.5 percent, respectively), but the HIV-1infected infants had a higher rate of CMV infection at six months of age (39.9 percent vs. 15.3 percent, P=0.001) and continued to have a higher rate of CMV infection through four years of age (P=0.04). By 18 months of age, the infants with both infections had higher rates of HIV-1 disease progression (70.0 percent vs. 30.4 percent, P=0.001), CDC class C symptoms or death (52.5 percent vs. 21.7 percent, P=0.008), and impaired brain growth or progressive motor deficits (35.6 percent vs. 8.7 percent, P=0.005) than infants infected only with HIV-1. In a Cox regression analysis, CMV infection was associated with an increased risk of HIV-1 disease progression (relative risk, 2.59; 95 percent confidence interval, 1.13 to 5.95). Among children infected with HIV-1 alone, but not among those infected with both viruses, children with rapid progression of HIV-1 disease had higher mean levels of HIV-1 RNA than those with slower or no progression of disease. Conclusions HIV-1infected infants who acquire CMV infection in the first 18 months of life have a significantly higher rate of disease progression and central nervous system disease than those infected with HIV-1 alone. PMID:10395631

Kovacs, Andrea; Schluchter, Mark; Easley, Kirk; Demmler, Gail; Shearer, William; La Russa, Philip; Pitt, Jane; Cooper, Ellen; Goldfarb, Johanna; Hodes, David; Kattan, Meyer; McIntosh, Kenneth

2014-01-01

346

A Case of Cerebellar Ataxia Associated with HIV Infection.  

PubMed

Cerebellar complications of HIV infection primarily manifested in ataxia, usually arise as the result of cerebellar lesions due to opportunistic infections, vasculitis or neoplastic processes. A 28 year old female known to have HIV infection for last four years, presented to our hospital with progressive unsteadiness in walking, slurring of speech and intention tremors for the last two months. There was no family history of similar complaints, and she was on Anti retroviral treatment for last one and a half years. The results of examination were notable for severe dysarthria, slow saccades, a conspicuous dysmetria and dysdiadokokinesia. She had no cognitive, sensory or motor deficits. MRI revealed diffuse cerebellar atrophy. Extensive laboratory work up failed to disclose a cause for subacute ataxia. Isolated cerebellar degeneration in an HIV patient is rare and should prompt a diagnostic work up. PMID:24759449

Anand, Kuljeet Singh; Wadhwa, Ankur; Garg, Jyoti

2014-09-01

347

HIV Treatment Failure  

MedlinePLUS

... HIV medications for at least 3 months). Drug resistance: HIV can mutate (change form). The altered HIV can multiply even in the presence of anti-HIV medications that would normally kill the virus. One or more ... Drug resistance testing: laboratory testing to determine if ...

348

Marked ethnic differences in HIV prevalence and risk behaviors among injection drug users in Dushanbe, Tajikistan, 2004  

Microsoft Academic Search

Objective: To examine differences by ethnicity of HIV prevalence and correlates among injection drug users (IDUs) in Dushanbe, Tajikistan.Methods: The researchers enrolled 489 active adult IDUs in a cross-sectional risk factor study of HIV infection. Participants were provided HIV pre-and posttest counseling and risk reduction counseling and answered an interviewer-administered questionnaire. HIV-1 status was determined with rapid tests and confirmed

Julie A. Stachowiak; Farida K. Tishkova; Steffanie A. Strathdee; Mark A. Stibich; Alisher Latypov; Vladimir Mogilnii; Chris Beyrer

2006-01-01

349

What Are the Reasons for Poor Uptake of HIV Testing among Patients with TB in an Eastern India District?  

PubMed Central

Background National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors associated with low uptake of HIV testing among patients with TB. Methods We reviewed TB and HIV program records to assess the HIV testing status of patients registered for anti-TB treatment from July-September 2010 in South-24-Parganas district, West Bengal, assessed availability of HIV testing kits and interviewed a random sample of patients with TB and providers. Results Among 1633 patients with TB with unknown HIV status at the time of diagnosis, 435 (26%) were tested for HIV within the intensive phase of TB treatment. Patients diagnosed with and treated for TB at facilities with co-located HIV testing services were more likely to get tested for HIV than at facilities without [RR?=?1.27, (95% CI 1.203.35)]. Among 169 patients interviewed, 67 reported they were referred for HIV testing, among whom 47 were tested. During interviews, providers attributed the low proportion of patients with TB being referred and tested for HIV to inadequate knowledge among providers about the national policy, belief that patients will not test for HIV even if they are referred, shortage of HIV testing kits, and inadequate supervision by both programs. Discussion In West Bengal, poor uptake of HIV testing among patients with TB was associated with absence of HIV testing services at sites providing TB care services and to poor referral practices among providers. Comprehensive strategies to change providers beliefs and practices, decentralization of HIV testing to all TB care centers, and improved HIV test kit supply chain management may increase the proportion of patients with TB who are tested for HIV. PMID:23469163

Bishnu, Bipra; Bhaduri, Sudipto; Kumar, Ajay M. V.; Click, Eleanor S.; Chadha, Vineet Kumar; Satyanarayana, Srinath; Nair, Sreenivas Achutan; Gupta, Devesh; Ahmed, Quazi T.; Sarkar, Silajit; Paul, Durba; Dewan, Puneet

2013-01-01

350

HIV transmission risk behavior among men and women living with HIV in 4 cities in the United States.  

PubMed

Determining rates of HIV transmission risk behavior among HIV-positive individuals is a public health priority, especially as infected persons live longer because of improved medical treatments. Few studies have assessed the potential for transmission to the partners of HIV-positive persons who engage in high-risk activities. A total of 3723 HIV-infected persons (1918 men who have sex with men [MSM], 978 women, and 827 heterosexual men) were interviewed in clinics and community-based agencies in Los Angeles, Milwaukee, New York City, and San Francisco from June 2000 to January 2002 regarding sexual and drug use behaviors that confer risk for transmitting HIV. Less than one quarter of women and heterosexual men had 2 or more sexual partners, whereas 59% of MSM reported having multiple partners. Most unprotected vaginal and anal sexual activity took place in the context of relationships with other HIV-positive individuals. Approximately 19% of women, 15.6% of MSM, and 13.1% of heterosexual men engaged in unprotected vaginal or anal intercourse with partners who were HIV-negative or whose serostatus was unknown. The majority of sexually active participants disclosed their serostatus to all partners with whom they engaged in unprotected intercourse. An estimated 30.4 new infections (79.7% as a result of sexual interactions with MSM) would be expected among the sex partners of study participants during the 3-month reporting period. Eighteen percent of 304 participants who injected drugs in the past 3 months reported lending their used injection equipment to others. In addition to the more traditional approaches of HIV test counseling and of focusing on persons not infected, intensive prevention programs for persons with HIV infection are needed to stem the future spread of the virus. PMID:15247559

Weinhardt, Lance S; Kelly, Jeffrey A; Brondino, Michael J; Rotheram-Borus, Mary Jane; Kirshenbaum, Sheri B; Chesney, Margaret A; Remien, Robert H; Morin, Stephen F; Lightfoot, Marguerita; Ehrhardt, Anke A; Johnson, Mallory O; Catz, Sheryl L; Pinkerton, Steven D; Benotsch, Eric G; Hong, Daniel; Gore-Felton, Cheryl

2004-08-15

351

43 CFR 2.8 - Can you ask for records to be disclosed in a particular form or format?  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Can you ask for records to be disclosed in...TESTIMONY How To Make a Request 2.8 Can you ask for records to be disclosed in...the requested form or format if the bureau can readily reproduce the record in that...

2013-10-01

352

41 CFR 105-64.502 - How do I find out if my record has been disclosed?  

Code of Federal Regulations, 2011 CFR

...Management 3 2011-01-01 2011-01-01 false How do I find out if my record has been disclosed? 105-64.502 Section... 64.5-Disclosure of Records 105-64.502 How do I find out if my record has been disclosed? You may request an...

2011-01-01

353

41 CFR 105-64.502 - How do I find out if my record has been disclosed?  

Code of Federal Regulations, 2010 CFR

...Management 3 2010-07-01 2010-07-01 false How do I find out if my record has been disclosed? 105-64.502 Section... 64.5-Disclosure of Records 105-64.502 How do I find out if my record has been disclosed? You may request an...

2010-07-01

354

41 CFR 105-64.502 - How do I find out if my record has been disclosed?  

...Management 3 2014-01-01 2014-01-01 false How do I find out if my record has been disclosed? 105-64.502 Section... 64.5-Disclosure of Records 105-64.502 How do I find out if my record has been disclosed? You may request an...

2014-01-01

355

41 CFR 105-64.502 - How do I find out if my record has been disclosed?  

Code of Federal Regulations, 2012 CFR

...Management 3 2012-01-01 2012-01-01 false How do I find out if my record has been disclosed? 105-64.502 Section... 64.5-Disclosure of Records 105-64.502 How do I find out if my record has been disclosed? You may request an...

2012-01-01

356

41 CFR 105-64.502 - How do I find out if my record has been disclosed?  

Code of Federal Regulations, 2013 CFR

...Management 3 2013-07-01 2013-07-01 false How do I find out if my record has been disclosed? 105-64.502 Section... 64.5-Disclosure of Records 105-64.502 How do I find out if my record has been disclosed? You may request an...

2013-07-01

357

Helping counts: predicting childrens intentions to disclose being bullied to teachers from prior social support experiences  

Microsoft Academic Search

Despite possible negative effects, many children do not tell their teachers when they have been bullied. This study examined junior school pupils (N = 294) reports of instrumental, emotional and validation social support received after disclosing being bullied to teachers, and associations with intentions to disclose in the future. Overall, participants reported receiving modest to high levels of social support.

Michael J. Boulton; Debborah Murphy; Julie Lloyd; Sabine Besling; Jennifer Coote; Jennifer Lewis; Roxanne Perrin; Linda Walsh

2011-01-01

358

The health effects of disclosing traumatic events: examining behavioral inhibition theory  

E-print Network

for the degree of MASTER OF SCIENCE August 1990 Major Subject: Psychology THE HEALTH EFFECTS OF DISCLOSING TRAUMATIC EVENTS; EXAMINING BEHAVIORAL INHIBITION THEORY A Thesis by STEPHEN DANIEL JACKS Approved as to style and content by: Karl G. Hursey...; Pennebaker, Hughes, & O'Heeron, 1987; Pennebaker, Kiecolt-Glaser & Glaser, 1988) developed a theory he termed "behavioral inhibition. " According to this theory, the failure to confide traumatic events is stressful and associated with health problems...

Jacks, Stephen Daniel

2012-06-07

359

Sustained favourable HIV viral load response in South African patients during concomitant HAART and cancer therapy.  

PubMed

HIV infection has led to an increase of both AIDS defining and non-AIDS defining cancers. Immunosuppressive cancer therapy had been noted for increased HIV viral load in cancer patients infected with HIV before the advent of highly active antiretroviral therapy (HAART). Assessing the outcome of concomitant HAART and cancer treatment in regions endemic for HIV is thus important. From a cohort of 34 cancer patients infected with HIV, 10 (six underwent radiotherapy and four chemotherapy) had at least three serial samples collected before, during and after treatment. From each sample, HIV viral load, CD4?+? and CD8?+? cell count was investigated. HIV genotypic drug resistance was assessed for six patients with a detectable HIV viral load at baseline. Of the 10 patients; one was HIV positive only, three were HIV and HBV co-infected and six were HIV, HBV and HCV triple infected. Four patients were HAART experienced at recruitment, while six were HAART naive with detectable HIV viral loads. A significant HIV viral load decrease (P?=?0.0128) was observed in all six patients with detectable baseline HIV viral loads. The four patients on HAART at recruitment maintained lower than detectable HIV viral load status throughout cancer therapy. A positive correlation between the rise in CD4?+? cell count and attaining a lower than detectable HIV viral load was also observed (P?=?0.0439). This pilot study supports concomitant treatment of HIV/AIDS and cancer in HIV endemic regions irrespective of the type of cancer diagnosed, prescribed cancer therapy or other viral (HBV, HCV or both) co-infections. J. Med. Virol. 87:192-198, 2015. 2014 Wiley Periodicals, Inc. PMID:25156795

Musyoki, Andrew M; Msibi, Thembeni L; Motswaledi, Mojakgomo H; Selabe, Selokela G; Mphahlele, M Jeffrey

2015-02-01

360

HIV infection among partners of HIV-infected black men who have sex with Men - North Carolina, 2011-2013.  

PubMed

The incidence of human immunodeficiency virus (HIV) infection has significantly increased among black men who have sex with men (MSM) in the United States, and young black MSM have been disproportionately affected. HIVinfected black MSM are also less likely to engage in HIV care and achieve viral suppression than MSM of other races/ethnicities. Engaging in care and achieving viral suppression is a multistep process that starts with diagnosis. Diagnosing persons unaware of their HIV status traditionally has been a critical component of HIV partner services, but partner services also provide an important opportunity to reengage HIVinfected partners in medical care. One approach for partner services involves contacting partners of persons with newly diagnosed HIV infection and using sexual and social network and molecular phylogenetic data to improve the continuum of HIV care among black MSM. To evaluate the effectiveness of that approach, results from a prospective partner services study conducted in North Carolina were examined, and one of the partner networks identified through this study was evaluated in depth. Overall, partner services were provided to 30 black, HIV-infected MSM who named 95 sex partners and social contacts, of whom 39 (41%) previously had been diagnosed with HIV infection. The partner network evaluation demonstrated that HIV-infected and HIV-negative partners were frequently in the same network, and that the majority of HIV-infected partners were already aware of their diagnosis but had not achieved viral suppression. Using partner services to ensure that HIV-infected partners are linked to care and treatment might reduce HIV transmission and might improve outcomes along the continuum of care. PMID:24500287

Peters, Philip J; Gay, Cindy; Beagle, Steve; Shankar, Anupama; Switzer, William M; Hightow-Weidman, Lisa B

2014-02-01

361

Adolescents' information management: comparing ideas about why adolescents disclose to or keep secrets from their parents.  

PubMed

Recognizing that adolescents providing or withholding information about their activities is a strong predictor of parental knowledge, this article compares several ideas about what prompts adolescents to disclose information or keep secrets from their parents. Using a sample of 874 Northern European adolescents (aged 12-16 years; 49.8 % were girls), modified cross-lagged models examined parental monitoring (solicitation and monitoring rules), adolescent delinquency, and perceived parental support as predictors and consequences of adolescents disclosing to parents or keeping secrets, with adolescents' acceptance of parental authority as a moderator. Results suggest that, when adolescents view their parents as supportive, they subsequently disclose more and keep fewer secrets. Engaging in delinquent behavior was related reciprocally to keeping secrets. By comparison, the results generally did not support the idea that adolescents who are monitored provide information to parents, even when they accept parental authority. These results suggest that relationship dynamics and adolescents' delinquent behaviors play an important role in adolescents' information management. PMID:24002679

Tilton-Weaver, Lauree

2014-05-01

362

Please Tell! Barriers to Disclosing Sexual Victimization and Subsequent Social Support Perceived by Children and Adolescents.  

PubMed

The present study examines barriers to disclosing sexual victimization and perceived social support after disclosure from the perspective of children and adolescents. Forty-two children and adolescents aged 6 to 17 years participated in semistructured interviews about their history of sexual victimization, the delay of disclosure, barriers to disclosure, informal and formal recipients of disclosure, as well as abuse-specific social support as perceived by the recipients. The participants disclosed their victimization with a delay of approximately 17 months, ranging from immediate reporting to 10 years of nondisclosure. The most frequent reasons to withhold the information were feelings of shame and threats by the perpetrator. A majority felt that people believed and supported them after disclosing, but a considerable proportion of study participants reported a lack of perceived protection against recurring victimization. The results underline the importance of educating children and adolescents about sexual victimization and of encouraging the immediate reporting of critical incidents. Possibilities to address the barriers identified in this study are discussed. PMID:25381281

Mnzer, Annika; Fegert, Jrg M; Ganser, Helene G; Loos, Sabine; Witt, Andreas; Goldbeck, Lutz

2014-11-01

363

Disclosing Adult Wrongdoing: Maltreated and Non-Maltreated Childrens Expectations and Preferences  

PubMed Central

Little is known about the process by which children disclose adult wrongdoing, a topic of considerable debate and controversy. In the present study, we investigated childrens evaluations of disclosing adult wrongdoing by focusing on childrens preferences for particular disclosure recipients and perceptions of the consequences of disclosure in hypothetical vignettes. We tested whether children thought disclosure recipients would believe a story child as a truth-teller and what actions the recipients would take against the instigator who committed the transgression. Maltreated and non-maltreated 4- to 9-year-olds (N = 235) responded to questions about vignettes that described a parents or strangers transgression. Older children preferred caregiver over police officer recipients when disclosing a parents, but not a strangers, transgression. Maltreated childrens preference for caregiver over police recipients developed more gradually than that of non-maltreated children. Older children expected disclosure recipients to be more skeptical of the story childs account, and older children and maltreated children expected disclosure recipients to intervene formally less often when a parent rather than stranger was the instigator. Results contribute to understanding vulnerable childrens development and highlight the developmental, experiential, and socio-contextual factors underlying childrens disclosure patterns. PMID:24769356

Malloy, Lindsay C.; Quas, Jodi A.; Lyon, Thomas D.; Ahern, Elizabeth C.

2014-01-01

364

Adolescent HIV/AIDS: Issues and challenges  

PubMed Central

Adolescence (10-19 years) is a phase of physical growth and development accompanied by sexual maturation, often leading to intimate relationships. Adolescent HIV/AIDS is a separate epidemic and needs to be handled and managed separately from adult HIV. The adolescents can be subdivided into student, slum and street youth; street adolescents being most vulnerable to HIV/AIDS. Among various risk factors and situations for adolescents contracting HIV virus are adolescent sex workers, child trafficking, child labor, migrant population, childhood sexual abuse, coercive sex with an older person and biologic (immature reproductive tract) as well as psychological vulnerability. The most common mode of transmission is heterosexual, yet increasing number of perinatally infected children are entering adolescence. This is due to bimodal progression (rapid and slow progressors) among the vertically infected children. Clinically, the HIV infected adolescents present as physically stunted individuals, with delayed puberty and adrenarche. Mental illness and substance abuse are important co-morbidities. The disclosure and declaration of HIV status to self and family is challenging and guilt in sexually infected adolescents and tendency to blame parents if vertically affected need special consideration and proper counseling. Serodiscordance of the twins and difference in disease progression of seroconcordant twins are added causes of emotional trauma. Treatment related issues revolve around the when and what of initiation of ART; the choice of antiretrovirals and their dosages; issues related to long term ADRs; sense of disinhibition following ART commencement; adherence and resistance. PMID:21808429

Naswa, Smriti; Marfatia, Y. S.

2010-01-01

365

Infectiousness of HIV between male homosexual partners.  

PubMed

To estimate the risk of transmission of HIV per receptive anal sexual contact, 329 homosexually-active men, representing 155 sexual partnerships, were enrolled into a study. Information on HIV infection status and sexual behavior within and outside the primary relationship was collected. Of these 329 men, 24 had AIDS and 31 had ARC. Of the 155 couples, 35 consisted of partners that were both HIV +; 62 of partners that were both HIV-; and 58 were discordant. A binomial model was fit to data obtained in the first visit to estimate per contact risk of HIV transmission. Assuming a constant risk of transmission per sexual contact between infected and uninfected partners, the estimated risk is about 5 to 30 per 1000 receptive anal exposures to ejaculate. Although the average risk of HIV transmission per sexual contact appears to be low, there appears to be great variability in infectivity. To model this variability over time and across individuals, more complex models must be fit to longitudinal studies of sexual partners. PMID:2789269

DeGruttola, V; Seage, G R; Mayer, K H; Horsburgh, C R

1989-01-01

366

Insulin resistance in HIV-related lipodystrophy.  

PubMed

Lipodystrophy (LD) associated with HIV infection is a syndrome of abnormal fat distribution observed in HIV-infected patients treated with various antiretroviral agents. In addition, insulin resistance and dyslipidemia can occur in HIV-infected patients with or without LD. The demonstration of the latter metabolic disorders in normal subjects using protease inhibitors suggests that these agents could play a causative role in their development independently of HIV status. Possible mechanisms whereby protease inhibitors can hinder insulin actions include inhibition of glucose transporter isoform Glut 4, and altered expression of leptin and tumor necrosis factor-a in adipose tissue. The presence of insulin resistance and dyslipidemia can potentially increase the risk of diabetes, cardiovascular disease, and death. However, short-term data in this regard are inconsistent. Treatment of HIV-related LD with metformin may ameliorate insulin resistance, but its impact on fat redistribution requires additional studies. Temporary cessation of antiretroviral therapy does not appear to reverse body fat changes or insulin resistance, but may partially improve the lipid profile. Further investigations are urgently needed to define the mechanisms and cardiovascular consequences of insulin resistance in HIV-related LD, and to find an effective treatment for this complex syndrome. PMID:12642010

Mikhail, Nasser

2003-04-01

367

Disrespect and Abuse During Childbirth in Tanzania: Are Women Living With HIV More Vulnerable?  

PubMed Central

Introduction: HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Methods: Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Results: Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. Conclusions: In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on ensuring respectful maternity care for all women. PMID:25436822

Sando, David; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

2014-01-01

368

High Rates of HIV Seroconversion in Pregnant Women and Low Reported Levels of HIV Testing among Male Partners in Southern Mozambique: Results from a Mixed Methods Study  

PubMed Central

Introduction Prevention of acute HIV infections in pregnancy is required to achieve elimination of pediatric HIV. Identification and support for HIV negative pregnant women and their partners, particularly serodiscordant couples, are critical. A mixed method study done in Southern Mozambique estimated HIV incidence during pregnancy, associated risk factors and factors influencing partner's HIV testing. Methods Between April 2008 and November 2011, a prospective cohort of 1230 HIV negative pregnant women was followed during pregnancy. A structured questionnaire, HIV testing, and collection of dried blood spots were done at 23 scheduled visits. HIV incidence rates were calculated by repeat HIV testing and risk factors assessed by Poisson regression. A qualitative study including 37 individual interviews with men, women, and nurses and 11 focus group discussions (n?=?94) with men, women and grandmothers explored motivators and barriers to uptake of male HIV testing. Results HIV incidence rate was estimated at 4.28/100 women-years (95%CI: 2.337.16). Significant risk factors for HIV acquisition were early sexual debut (RR 3.79, 95%CI: 1.0413.78, p?=?0.04) and living in Maputo Province (RR 4.35, 95%CI: 0.9719.45, p?=?0.05). Nineteen percent of women reported that their partner had tested for HIV (93% knew the result with 8/213 indicating an HIV positive partner), 56% said their partner had not tested and 19% did not know their partner test status. Of the 14 seroconversions, only one reported being in a serodiscordant relationship. Fear of discrimination or stigma was reported as a key barrier to male HIV testing, while knowing the importance of getting tested and receiving care was the main motivator. Conclusions HIV incidence during pregnancy is high in Southern Mozambique, but knowledge of partners' HIV status remains low. Knowledge of both partners' HIV status is critical for maximal effectiveness of prevention and treatment services to reach elimination of pediatric HIV/AIDS. PMID:25542035

De Schacht, Caroline; Hoffman, Heather J.; Mabunda, Ndio; Lucas, Carlota; Alons, Catharina L.; Madonela, Ana; Vubil, Adolfo; Ferreira, Orlando C.; Cal, Nurbai; Santos, Iolanda S.; Jani, Ilesh V.; Guay, Laura

2014-01-01

369

The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City  

PubMed Central

Objectives Stigma connected with HIV/AIDS has decreased considerably since the early epidemic yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill this evidence gap by examining how HIV stigma is perceived and experienced by gay men who have become HIV-infected and how they respond to this stigma. Methods Thematic analysis of 19 gay men's narratives identified six main themes. Results Encountering HIV stigmatization was common and was linked to the physical stigmata identifying respondents as HIV-positive. Overwhelmingly, they found stigmatization to be most intensely felt within gay communities. One profound theme was internalized HIV stigma, referring to respondents' internalized negative feelings about their HIV status. A related theme was the closeted nature of HIV. Lastly, regarding how the men dealt with the HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. Conclusions Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that in a climate in which HIV has become increasingly invisible and closeted and in which infections are on the rise, gay and bisexual men will be increasingly affected and infected by HIV. PMID:25170366

Ross, Michael W.

2014-01-01

370

A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.  

PubMed

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs. PMID:23970652

Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan

2014-03-01

371

Evaluation of integrated registers for tuberculosis and HIV surveillance in children, Ethiopia, 2007-2009.  

PubMed

In 2008, Ethiopia implemented tuberculosis (TB) treatment registers that included columns for recording human immunodeficiency virus (HIV) test results (integrated registers) to replace the previous system of separate TB and HIV registers (pre-integration registers). We compared the proportion of children with documented HIV rapid test results at eight hospitals before and after adopting the integrated registers. HIV status was more consistently documented in the integrated registers; however, HIV status for infants aged <18 months could not be assessed, as the registers did not capture results from polymerase chain reaction-based testing. Recording procedures should be revised to document age-appropriate HIV diagnostic results and ensure referral for appropriate care. PMID:22417732

Click, E S; Feleke, B; Pevzner, E; Fantu, R; Gadisa, T; Assefa, D; Melaku, Z; Cain, K; Menzies, H

2012-05-01

372

Pregnancy outcome in women with ?-thalassemia major and HIV infection  

Microsoft Academic Search

Objectives. To conduct a study of maternal and foetal outcome in pregnant transfusion-dependent ?-thalassemia major (?-TM) women with HIV-1 disease.Study design. The course and outcome of pregnancy was studied prospectively in 123 women with transfusion-dependent ?-thalassemia major, of which 81 were HIV-1 positive, at Sanjay Gandhi hospital Manipur, India, from January 1990 to January 1997. The clinical and immunological status

Rachana M Kumar; Ashok Khuranna

1998-01-01

373

HIV/AIDS, reproductive and sexual health, and the law.  

PubMed

The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health. PMID:18703431

Gable, Lance; Gostin, Lawrence O; Hodge, James G

2008-10-01

374

HIV/AIDS, Reproductive and Sexual Health, and the Law  

PubMed Central

The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health. PMID:18703431

Gostin, Lawrence O.; Hodge, James G.

2008-01-01

375

The Socioeconomic Impact of HIV/AIDS on Education Outcomes in Uganda: School Enrolment and the Schooling Gap in 2002/2003  

ERIC Educational Resources Information Center

Due to high prime-age mortality--a result of the HIV/AIDS scourge, the number of orphans in Uganda continues to rise. Using the 2002/2003 Uganda National Household Survey, this paper investigates how HIV/AIDS orphan status affects schooling enrolment and grade progression. Our results show that HIV/AIDS orphans are not significantly less likely to

Kasirye, Ibrahim; Hisali, Eria

2010-01-01

376

Prevalence of orphans among HIV infected children--a preliminary study from a pediatric HIV centre in Western India.  

PubMed

The aim of this study was to determine the prevalence of orphaned HIV-infected children in Mumbai, India and analyze whether orphanhood affects care of these children. This study is a retrospective analysis of prospectively collected data of 147 HIV-infected children referred to our pediatric HIV clinic at B. J. Wadia Hospital for Children (Mumbai, India). All children underwent a detailed history and clinical examination. Transmission of HIV was determined by parental HIV status, history of blood transfusion or sexual exposure. Orphan status was determined by verbal autopsy of parent death (either mother or father or both). Factors affected by orphan status such as follow up, caregiver, antiretroviral treatment and age of the child when orphaned was determined. Fifty nine (40%) HIV-infected children were orphans. In 28 children (19%), father had died; in 20 children (13.6%), mother had died; in 11 children (7.5%) both parents had died and in 2 children (1.4%), parents death status was not known. Cause of death was AIDS in 19 parents (38%) and TB in 21 parents (42%). The mean age of the child when mother had died was 5.6 +/- 2.2 years; when father had died was 7.08 +/- 3.5 years and when both parents had died was 10.9 +/- 2.4 years (p < 0.0001). There was no statistical difference in follow up (p = 0.48) or initiation of antiretroviral therapy (p = 0.04) in orphaned and nonorphaned children. In orphaned children, grandparents (5.4%) and aunts (4.8%) took responsibility of taking care of the children. Only two children (1.4%) were put in orphanages. Prevalence of HIV-infected orphans is high (40%). However, there is no difference in HIV care between orphans and nonorphans. PMID:18267963

Shah, Ira

2008-08-01

377

Widow Inheritance and HIV Prevalence in Bondo District, Kenya: Baseline Results from a Prospective Cohort Study  

PubMed Central

Background Widow Inheritance is a widespread cultural practice in sub-Saharan Africa that has been postulated as contributing to risk of HIV transmission. We present baseline results from a study designed to investigate the association between widow inheritance and HIV acquisition. Methods and Findings We performed a cross-sectional analysis of baseline data from a prospective cohort study to investigate if widow inheritance is a risk practice for HIV infection. Study participants were 1,987 widows who were interviewed regarding their inheritance status and sexual behavior profile and tested for HIV. Of these widows, 56.3% were inherited. HIV prevalence, at 63%, was similar among non-inherited and inherited widows. We stratified exposure status by the relationship of the widow to the inheritor and the reason for inheritance, and reexamined the HIV status of four subgroups of inherited women relative to the HIV status of non-inherited women. When adjusting for age and level of formal education, widows who were inherited by non-relatives for sexual ritual were significantly more likely to be infected than widows who were not inherited (OR?=?2.07; 95%CI 1.492.86); widows who were inherited by relatives for sexual ritual also had elevated odds of HIV infection (OR?=?1.34; 95%CI?=?1.071.70). Widows who were inherited by relatives for companionship were less likely than women who were not inherited to be infected with HIV (OR?=?0.85; 95%CI 0.631.14). Conclusions HIV prevalence among inherited widows varied depending upon why and by whom they were inherited. The cohort study will determine the risk for HIV acquisition among the HIV seronegative widows in this sample. PMID:21103347

Agot, Kawango E.; Vander Stoep, Ann; Tracy, Melissa; Obare, Billy A.; Bukusi, Elizabeth A.; Ndinya-Achola, Jeckoniah O.; Moses, Stephen; Weiss, Noel S.

2010-01-01

378

HIV Infection and Travel: Pretravel Recommendations and Health-Related Risks  

Microsoft Academic Search

In the current era of globalization and ease of air travel combined with the increased survival attained since the advent of potent antiretroviral therapy, HIV-infected individuals are traveling to remote and resource-limited areas of the world. Travel-related health risks in a patient with HIV depend on the patient's immune status, destination, travel itinerary, and type of travel. HIV-infected patients with

Carlos Franco-Paredes; Alicia Hidron; Ildefonso Tellez; Jeffrey Lesesne; Carlos del Rio

379

Translational Spatial Task and its Relationship to HIV-Associated Neurocognitive Disorders and Apolipoprotein E in HIV-Seropositive Women  

PubMed Central

HIV-associated neurocognitive disorders (HAND) continue to be a neurological complication of HIV infection in the era of combined antiretroviral therapy (cART). Hippocampal neurodegeneration and dysfunction occurs as a result of HIV infection, but few studies to date have assesses spatial learning and memory function in patients with HAND. We used the Memory Island (MI) Test to study the effects of HIV infection, Apolipoprotein E (ApoE) allele status, and CSF ApoE protein levels on spatial learning and memory in our cohort of Hispanic women. The MI Test is a virtual reality-based computer program that tests spatial learning and memory, and was designed to resemble the Morris Water Maze (MWM) test of hippocampal function widely used in rodent studies. In the current study, HIV-seropositive women (n=20) and controls (n=16) were evaluated with neuropsychological (NP) tests, the MI Test, ApoE, and CSF ApoE assays. On the MI, the HIV-seropositive group showed significant reduced learning and delayed memory performance compared with HIV-seronegative controls. When stratified by cognitive performance on NP tests, the HIV-seropositive, cognitively impaired group performed worse than HIV-seronegative controls in ability to learn and in the delayed memory trial. Interestingly, differences were observed in the results obtained by the NP tests and the MI Test for ?4 carriers and non-carriers: NP tests showed effects of the ?4 allele in HIV-seronegative women but not HIV-seropositive ones, whereas as the converse was true for the MI Test. Our findings suggest that the MI test is sensitive in detecting spatial deficits in HIV-seropositive women, and that these deficits may arise relatively early in the course of HAND. PMID:22972599

Morales, Diana; Acevedo, Summer F.; Skolasky, Richard L.; Hechavarria, Rosa; Santiago, Sharon; De La Torre, Tania; Maldonado, Elizabeth; Wojna, Valerie

2012-01-01

380

Evidence for the Long-Term Stability of HIV Transmission-Associated Sexual Behavior Following HIV Diagnosis  

PubMed Central

Background Most persons diagnosed with HIV alter their sexual behavior in a way that reduces the risk of HIV transmission, but the durability of such behavior change is unknown. Methods We conducted annual anonymous cross-sectional surveys in randomly selected patients with appointments at a large, public hospital HIV Clinic in Seattle, Washington from 2005 to 2009. We used logistic regression to assess the association between time since HIV diagnosis and self-report of unprotected anal or vaginal intercourse (UAVI) with partners of negative or unknown HIV status (nonconcordant UAVI), and quantile regression to evaluate the association between time since HIV diagnosis and number of anal or vaginal sex partners. Results We analyzed 845 surveys collected over 5 years. MSM had been diagnosed with HIV a mean of 12 (SD 7) years and non-MSM a mean of 11 (SD 6) years. Among 597 MSM, longer time since HIV diagnosis was associated with lower age-adjusted odds of reporting nonconcordant UAVI [(OR 0.96 (95% CI: 0.92 0.99)] and a lower age-adjusted number of sex partners (? coefficient ?0.03, p=0.007). Among 248 women and heterosexual men, time since HIV diagnosis was not significantly associated with age-adjusted odds of nonconcordant UAVI [OR 0.99 (95% CI: 0.93 1.04)] or number of sex partners (? coefficient ?0.01, p=0.48). Conclusions These results indicate that HIV transmission-associated behavior is relatively stable following the first year after HIV diagnosis. Our findings suggest that behavior change in the first year after HIV diagnosis, reported in other studies, is durable. PMID:23254116

Dombrowski, Julia C.; Harrington, Robert D.; Golden, Matthew R.

2014-01-01

381

The right to know and the duty to disclose hazard information.  

PubMed

In late 1983, the Occupational Safety and Health Administration (OSHA) promulgated its final rule on "hazard communication," establishing the right of workers in manufacturing industries to information about chemical hazards, and the duty of importers and manufacturers to disclose such information. Baram reviews areas where the new, limited OSHA regulation conflicts with existing local, state, and federal laws, many of which are more stringent and more protective of worker and community health. He suggests steps that could be taken to avoid the extensive litigation that might result from the potential preemptive effect of the new OSHA rule. PMID:6703171

Baram, M S

1984-04-01

382

Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran  

PubMed Central

Background People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. Methods In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. Results and discussion Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. Conclusions While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context. PMID:20649967

2010-01-01

383

Death Anxiety in Persons with HIV/AIDS: A Systematic Review and Meta-Analysis  

ERIC Educational Resources Information Center

One of the most commonly cited psychological sequelae of HIV/AIDS is anxiety regarding death due to the illness (i.e., death anxiety; DA). However, extant research is inconclusive on several empirical issues, such as DA's relation to HIV/AIDS diagnostic status, the impact of illness-related symptoms on DA, and factors that may protect against DA.

Miller, Audrey K.; Lee, Brittany L.; Henderson, Craig E.

2012-01-01

384

Mother-to-child HIV transmission despite antiretroviral therapy in the ANRS French Perinatal Cohort  

E-print Network

therapy. Design: The French Perinatal Cohort (EPF), a multicenter prospective cohort of HIV infectedTITLE Mother-to-child HIV transmission despite antiretroviral therapy in the ANRS French Perinatal status as dependant variable, were conducted among 5271 mothers who received antiretroviral therapy

Boyer, Edmond

385

Development of structured support groups for HIV-positive women in South Africa  

Microsoft Academic Search

Women living with HIV in a stigmatising community need support to cope with their HIV status. In a process of action research, a structured support group programme was designed to meet the needs of women to cope with their diagnosis and interpersonal relationships. The emphasis was on identifying their needs and developing programme material to address those needs through group

Maretha Visser; Jonathan Mundell; Annelize de Villiers; Kathleen Sikkema; Bridget Jeffery

2005-01-01

386

The Effect of Marriage and HIV Risks on Condom Use Acceptability in Rural Malawi  

PubMed Central

A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondents HIV status, HIV perceptions, and risk behaviors, and (3) spouses HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. PMID:24161086

Anglewicz, Philip; Clark, Shelley

2013-01-01

387

HIV Treatment: The Basics  

MedlinePLUS

... for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents From the Department of Veterans Affairs: Treatment Decisions From the National Institute of Allergy and Infectious Diseases: Treatment of HIV Infection

388

HIV/AIDS  

MedlinePLUS

... infected with HIV in 2013 globally. Sub-Saharan Africa is the most affected region, with 24.7 [ ... living with HIV in 2013. Also sub-Saharan Africa accounts for almost 70% of the global total ...

389

HIV and AIDS  

MedlinePLUS

... that causes the disease AIDS. HIV Hurts the Immune System People who are HIV positive have been tested ... to everyone in the world. When the person's immune system has weakened and more of the blood's T ...

390

HIV/AIDS  

MedlinePLUS

Human immunodeficiency virus (HIV) causes HIV infection and AIDS. The virus attacks the immune system. As the immune system weakens, the body is at risk of getting life-threatening infections and cancers. Once a person has the virus, ...

391

Women and HIV  

MedlinePLUS

... in the vagina, persistent yeast infections, and severe pelvic inflammatory disease (PID) can be signs of HIV. Hormone changes, birth ... Women with HIV get vaginal infections, genital ulcers, pelvic inflammatory disease, and genital warts more often and more severely ...

392

HIV Medication Adherence  

MedlinePLUS

... that previously prevented the virus from multiplying. Drug resistance can develop as HIV multiplies in the body. When HIV multiplies, the virus sometimes mutates (changes form) and makes variations of itself. Variations of ...

393

Testing for HIV  

MedlinePLUS

... Food and Drug Administration Protecting and Promoting Your Health A to Z Index Follow FDA En ... Availability (Biologics) HIV Home Test Kits Testing for HIV Resources for You Consumers (Biologics) Healthcare ...

394

Soluble CD163 is associated with shortened telomere length in HIV-infected patients.  

PubMed

Telomere length (TL) and immune activation markers were measured in a cohort of HIV-infected (n = 102) and age-matched non-HIV-infected (n = 41) men. TL was significantly shorter in HIV-infected compared with non-HIV-infected subjects (P = 0.04). Univariate analysis revealed a strong inverse relationship of TL to sCD163, and thus, monocyte/macrophage activation, among the HIV group (? = -0.30, P = 0.003). In multivariate modeling among the whole group, HIV-positive serostatus (P = 0.06) and sCD163 (P = 0.05) remained predictors of TL controlling for age and smoking status. Our data demonstrate that increased immune activation relates to shorter TL in HIV. PMID:25197827

Srinivasa, Suman; Fitch, Kathleen V; Petrow, Eva; Burdo, Tricia H; Williams, Kenneth C; Lo, Janet; Ct, Hlne C F; Grinspoon, Steven K

2014-12-01

395

Membranoproliferative Glomerulonephritis due to Visceral Leishmaniasis in an HIV Patient.  

PubMed

Background Visceral leishmaniasis is an important opportunistic disease in HIV-positive patients. The information available on the effects of such co-infection in the kidney is limited. We describe a patient with HIV/leishmania coinfection who developed nephrotic syndrome and membranoproliferative glomerulonephritis. As far as we know, only 2 cases of this nephropathy in HIV/leishmania coinfection have been reported. Case Report A 47-year-old man developed nephrotic syndrome. He had been diagnosed with HIV infection and visceral leishmaniasis and was treated with antiretroviral therapy, antimonial compounds, liposomal amphotericin B and miltefosine, but the leishmania followed a relapsing course. Renal biopsy disclosed membranoproliferative glomerulonephritis and leishmania amastigotes were seen within glomerular capillary lumens. He was given miltefosine and liposomal amphotericin B but the leishmaniasis persisted. Stage 3B chronic renal disease and nephrotic range proteinuria tend to become stable by 15-month follow-up. Conclusions Our case illustrated some aspects of leishmaniasis in HIV patients: its relapsing course, the difficulties in therapy, and the renal involvement. PMID:25575099

Enrquez, Ricardo; Sirvent, Ana Esther; Padilla, Sergio; Toro, Paula; Snchez, Mara; Milln, Isabel

2015-01-01

396

Membranoproliferative Glomerulonephritis due to Visceral Leishmaniasis in an HIV Patient  

PubMed Central

Patient: Male, 47 Final Diagnosis: Membranoproliferative glomerulonephritis Symptoms: Nephrotic syndrome Medication: Clinical Procedure: Renal biopsy Specialty: Nephrology Objective: Rare disease Background: Visceral leishmaniasis is an important opportunistic disease in HIV-positive patients. The information available on the effects of such co-infection in the kidney is limited. We describe a patient with HIV/leishmania coinfection who developed nephrotic syndrome and membranoproliferative glomerulonephritis. As far as we know, only 2 cases of this nephropathy in HIV/leishmania coinfection have been reported. Case Report: A 47-year-old man developed nephrotic syndrome. He had been diagnosed with HIV infection and visceral leishmaniasis and was treated with antiretroviral therapy, antimonial compounds, liposomal amphotericin B and miltefosine, but the leishmania followed a relapsing course. Renal biopsy disclosed membranoproliferative glomerulonephritis and leishmania amastigotes were seen within glomerular capillary lumens. He was given miltefosine and liposomal amphotericin B but the leishmaniasis persisted. Stage 3B chronic renal disease and nephrotic range proteinuria tend to become stable by 15-month follow-up. Conclusions: Our case illustrated some aspects of leishmaniasis in HIV patients: its relapsing course, the difficulties in therapy, and the renal involvement. PMID:25575099

Enrquez, Ricardo; Sirvent, Ana Esther; Padilla, Sergio; Toro, Paula; Snchez, Mara; Milln, Isabel

2015-01-01

397

Internalized stigma, social distance, and disclosure of HIV seropositivity in rural Uganda  

PubMed Central

Background HIV is highly stigmatized, compromising both treatment and prevention in resource-limited settings. Purpose To study the relationship between internalized HIV-related stigma and serostatus disclosure and to determine the extent to which this association varies with the degree of social distance. Methods We fit multivariable Poisson regression models, with cluster-correlated robust estimates of variance, to data from 259 persons with HIV enrolled in an ongoing cohort study in rural Uganda. Results Persons with more internalized stigma were less likely to disclose their seropositivity. The magnitude of association increased with social distance such that the largest association was observed for public disclosures and the smallest association was observed for disclosures to sexual partners. Conclusions Among persons with HIV in rural Uganda, internalized stigma was negatively associated with serostatus disclosure. The inhibiting effect of stigma was greatest for the most socially distant ties. PMID:23690283

Tsai, Alexander C.; Bangsberg, David R.; Kegeles, Susan M.; Katz, Ingrid T.; Haberer, Jessica E.; Muzoora, Conrad; Kumbakumba, Elias; Hunt, Peter W.; Martin, Jeffrey N.; Weiser, Sheri D.

2013-01-01

398

Knowledge of HIV/AIDS and use of mandatory premarital HIV testing as a prerequisite for marriages among religious leaders in Sokoto, North Western Nigeria  

PubMed Central

Background In Sub-Saharan Africa, an estimated 1.8 million became infected with the HIV in 2009 and Nigeria currently has about 3.4 million people living with HIV. Measures put in place by religious organizations to combat HIV/AIDS in Nigeria include mandatory premarital HIV testing. The knowledge of HIV/AIDS amongst religious leaders in Nigeria has not been sufficiently explored . In this study, we assessed the knowledge of HIV/AIDS amongst religious leaders in Sokoto and if they routinely demand for mandatory premarital HIV testing for all intending couples. Methods This was a descriptive cross-sectional study involving 158 religious leaders (30 Christians and 128 Muslims) who officiate or assist during marriages. Data was collected using interviewer and self administered questionnaire which sought such information as biodata, knowledge of HIV/AIDS , speaking to congregation about AIDS and using Premarital HIV status as a pre-requisite for contracting marriages. Data was entered into and analysed using Epi-info computer soft ware program. Level of statistical significance was put at P=0.05. Results The ages of the respondents ranged from 35 to 78 years with a mean age of 26.3 20.3years. Forty nine percent of the respondents had adequate knowledge of HIV/AIDS with more Christian clerics compared to Muslim Clerics having better knowledge of HIV/AIDS (P<0.0001). All the Christian clerics opined that they would insist on mandatory premarital HIV testing for their subjects before joining them in marriages. Conclusion The results of the study have shown that most of the religious leaders lacked adequate knowledge of HIV/AIDS and the use of mandatory premarital HIV testing is yet to be adopted by the Muslim clerics. Awareness campaigns should be intensified for the religious leaders to improve their knowledge of HIV/AIDS. PMID:22514761

Umar, Sambo Adamu; Oche, Oche Mansur

2012-01-01

399

HIV among men who have sex with men in Malawi: elucidating HIV prevalence and correlates of infection to inform HIV prevention  

PubMed Central

Introduction There are limited data characterizing the burden of HIV among men who have sex with men (MSM) in Malawi. Epidemiologic research and access to HIV prevention, treatment and care services have been traditionally limited in Malawi by criminalization and stigmatization of same-sex practices. To inform the development of a comprehensive HIV prevention intervention for Malawian MSM, we conducted a community-led assessment of HIV prevalence and correlates of infection. Methods From April 2011 to March 2012, 338 MSM were enrolled in a cross-sectional study in Blantyre, Malawi. Participants were recruited by respondent-driven sampling methods (RDS), reaching 19 waves. Trained staff administered the socio-behavioural survey and HIV and syphilis voluntary counselling and testing. Results Crude HIV and syphilis prevalence estimates were 15.4% (RDS-weighted 12.5%, 95% confidence interval (CI): 7.317.8) and 5.3% (RDS-weighted 4.4%, 95% CI: 3.17.6), respectively. Ninety per cent (90.4%, unweighted) of HIV infections were reported as being previously undiagnosed. Participants were predominantly gay-identified (60.8%) or bisexually identified (36.3%); 50.7% reported recent concurrent relationships. Approximately half reported consistent condom use (always or almost always) with casual male partners, and proportions were relatively uniform across partner types and genders. The prevalence of perceived and experienced stigma exceeded 20% for almost all variables, 11.4% ever experienced physical violence and 7% were ever raped. Current age >25 years (RDS-weighted adjusted odds ratio (AOR) 3.9, 95% CI: 1.212.7), single marital status (RDS-weighted AOR: 0.3; 95% CI: 0.10.8) and age of first sex with a man <16 years (RDS-weighted AOR: 4.3, 95% CI: 1.215.0) were independently associated with HIV infection. Conclusions Results demonstrate that MSM represent an underserved, at-risk population for HIV services in Malawi and merit comprehensive HIV prevention services. Results provide a number of priorities for research and prevention programmes for MSM, including providing access to and encouraging regular confidential HIV testing and counselling, and risk reduction counselling related to anal intercourse. Other targets include the provision of condoms and compatible lubricants, HIV prevention information, and HIV and sexually transmitted infection treatment and adherence support. Addressing multiple levels of HIV risk, including structural factors, may help to ensure that programmes have sufficient coverage to impact this HIV epidemic among MSM. PMID:24321110

Wirtz, Andrea L; Jumbe, Vincent; Trapence, Gift; Kamba, Dunker; Umar, Eric; Ketende, Sosthenes; Berry, Mark; Strmdahl, Susanne; Beyrer, Chris; Baral, Stefan D

2013-01-01

400

HIV and the menopause.  

PubMed

Dramatic improvement in the survival of the HIV population has occurred with the ascendance of highly active antiretroviral therapy (HAART). In the foreseeable future, HIV-infected women who acquired disease during the peak years of the epidemic are expected to survive to experience menopause and even years beyond. The HIV epidemic may be viewed as 'mature', as its earlier victims become part of the geriatric population. Research about the process of menopause in HIV-infected women and, conversely, about HIV infection in women undergoing menopause is currently limited. Existing research suggests that the process of menopause is affected by HIV infection, inasmuch as infected women appear to experience menopause at an earlier age, with greater symptomatology, and with different reproductive hormone profiles compared with HIV-uninfected women. HIV infection also appears to affect bone mineral density, cardiovascular disease and cognition, with some age-related interactions. Lifestyle and demographic factors have pervasive importance for both HIV infection and the menopause in women. This article reviews the current state of knowledge about the menopausal process in HIV-infected women, and the common conditions in postmenopausal women that are likely to be affected by HIV infection. Clinicians should appreciate the potential role of HIV infection in caring for menopause-aged women. PMID:19037065

Fan, Maria D; Maslow, Bat-Sheva; Santoro, Nanette; Schoenbaum, Ellie

2008-12-01

401

National HIV Testing Day  

E-print Network

of testing in detecting, treating, and preventing human immunodeficiency virus (HIV) infection. HIV testing is the essential entry point to a continuum of prevention, healthcare, and social services that improve the quality of life and the length of survival for persons with HIV (1). Persons with HIV who receive appropriate treatment, monitoring, and health care also reduce their chances of transmitting HIV to others. CDC recommends that all persons aged 1364 years be screened for HIV in health-care settings located in areas where the prevalence of undiagnosed HIV infection is>0.1%, and that persons with increased risk for HIV be retested at least annually (2). In April 2013, the U.S. Preventive Services Task Force updated its 2005 guidelines on HIV screening, to recommend that clinicians screen all persons aged 1565 years for HIV infection at least once, regardless of their risk; that younger adolescents and older adults with increased risk also be screened; and that persons with increased risk be screened more frequently (3). These updated recommendations are based on increasing evidence of the benefits of early antiretroviral therapy for HIV-infected persons and its effectiveness in preventing HIV transmission. Additional information is available at

unknown authors

2013-01-01

402

Determinants of Recent HIV Infection Among Seattle-Area Men Who Have Sex with Men  

PubMed Central

Objectives. We sought to identify HIV-infection risk factors related to partner selection and sexual behaviors with those partners among men who have sex with men (MSM) in King County, Washington. Methods. Participants were recruited from HIV testing sites in the Seattle area. Recent HIV infection status was determined by the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) or a self-reported previous HIV-negative test. Data on behaviors with 3 male partners were collected via computer-based self-interviews. Generalized estimating equation models identified partnership factors associated with recent infection. Results. We analyzed data from 32 HIV-positive MSM (58 partners) and 110 HIV-negative MSM (213 partners). In multivariate analysis, recent HIV infection was associated with meeting partners at bathhouses or sex clubs, bars or dance clubs, or online; methamphetamine use during unprotected anal intercourse; and unprotected anal intercourse, except with HIV-negative primary partners. Conclusions. There is a need to improve efforts to promote condom use with casual partners, regardless of their partner's HIV status. New strategies to control methamphetamine use in MSM and to reduce risk behaviors related to meeting partners at high-risk venues are needed. PMID:18445808

Jenkins, Richard A.; Carey, James W.; Hutcheson, Rebecca; Thomas, Katherine K.; Stall, Ronald D.; White, Edward; Allen, Iris; Mejia, Roberto; Golden, Matthew R.

2009-01-01

403

24 CFR 5.218 - Penalties for failing to disclose and verify Social Security and Employer Identification Numbers.  

Code of Federal Regulations, 2010 CFR

...Penalties for failing to disclose and verify Social Security and Employer Identification Numbers...WAIVERS Disclosure and Verification of Social Security Numbers and Employer Identification...Information Disclosure and Verification of Social Security Numbers and Employer...

2010-04-01

404

24 CFR 5.218 - Penalties for failing to disclose and verify Social Security and Employer Identification Numbers.  

Code of Federal Regulations, 2011 CFR

...Penalties for failing to disclose and verify Social Security and Employer Identification Numbers...WAIVERS Disclosure and Verification of Social Security Numbers and Employer Identification...Information Disclosure and Verification of Social Security Numbers and Employer...

2011-04-01

405

12 CFR 792.31 - Can exempt records be disclosed to credit unions, financial institutions and state or federal...  

Code of Federal Regulations, 2010 CFR

...Can exempt records be disclosed to credit unions, financial institutions and state or federal...31 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR...

2010-01-01

406

42 CFR 2.62 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.  

...2014-10-01 2014-10-01 false Order not applicable to records disclosed...PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use 2.62 Order not applicable to records...

2014-10-01

407

42 CFR 2.62 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Order not applicable to records disclosed...PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use 2.62 Order not applicable to records...

2013-10-01

408

42 CFR 2.62 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Order not applicable to records disclosed...PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use 2.62 Order not applicable to records...

2010-10-01

409

42 CFR 2.62 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 2012-10-01 false Order not applicable to records disclosed...PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use 2.62 Order not applicable to records...

2012-10-01

410

42 CFR 2.62 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 2011-10-01 false Order not applicable to records disclosed...PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use 2.62