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Sample records for disclosing hiv status

  1. HIV knowledge, stigma, and illness beliefs among pediatric caregivers in Ghana who have not disclosed their child's HIV status.

    PubMed

    Paintsil, Elijah; Renner, Lorna; Antwi, Sampson; Dame, Joycelyn; Enimil, Anthony; Ofori-Atta, Angela; Alhassan, Amina; Ofori, Irene Pokuaa; Cong, Xiangyu; Kyriakides, Tassos; Reynolds, Nancy R

    2015-12-01

    The majority of HIV-infected children in sub-Saharan Africa have not been informed of their HIV status. Caregivers are reluctant to disclose HIV status to their children because of concern about the child's ability to understand, parental sense of guilt, and fear of social rejection and isolation. We hypothesized that the low prevalence of pediatric HIV disclosure in Ghana is due to lack of accurate HIV information and high HIV stigma among caregivers. This is a preliminary analysis of baseline data of an HIV pediatric disclosure intervention study in Ghana ("Sankofa"). "Sankofa" - is a two-arm randomized controlled clinical trial comparing disclosure intervention plus usual care (intervention arm) vs usual care (control arm) at Korle-Bu Teaching Hospital (KBTH; control arm) and Komfo-Anokye Teaching Hospital (KATH; intervention arm). We enrolled HIV-infected children, ages 7-18 years who do not know their HIV status, and their caregivers. Baseline data of caregivers included demographic characteristics; Brief HIV Knowledge Questionnaire (HIV-KQ-18); Brief Illness Perception Questionnaire; and HIV Stigma Scale. Simple and multivariable linear regression analyses were used to assess the relationship between caregiver characteristics and HIV knowledge, stigma, and illness perception. Two hundred and ninety-eight caregivers were enrolled between January 2013 and July 2014 at the two study sites; KBTH (n = 167) and KATH (n = 131). The median age of caregivers was 41 years; 80.5% of them were female and about 60% of caregivers were HIV-positive. Seventy-eight percent of caregivers were self-employed with low household income. In both unadjusted and adjusted analyses, HIV negative status and lower level of education were associated with poor scores on HIV-KQ. HIV positive status remained significant for higher level of stigma in the adjusted analyses. None of the caregiver's characteristics predicted caregiver's illness perception. Intensification of HIV education in schools and targeted community campaigns are needed. PMID:26616122

  2. Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs' Strategies for Disclosing HIV Status.

    PubMed

    Catona, Danielle; Greene, Kathryn; Magsamen-Conrad, Kate

    2015-11-01

    People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making. PMID:26075594

  3. DISCLOSURE SPECIAL ISSUE: HIV Knowledge, Stigma and Illness Beliefs among Pediatric Caregivers’ in Ghana who have not Disclosed their Child's HIV Status

    PubMed Central

    Paintsil, Elijah; Renner, Lorna; Antwi, Sampson; Dame, Joycelyn; Enimil, Anthony; Ofori-Atta, Angela; Alhassan, Amina; Ofori, Irene Pokuaa; Cong, Xiangyu; Kyriakides, Tassos; Reynolds, Nancy R.

    2015-01-01

    The majority of HIV-infected children in sub-Saharan Africa have not been informed of their HIV status. Caregivers are reluctant to disclose HIV status to their children because of concern about the child's ability to understand, parental sense of guilt, and fear of social rejection and isolation. We hypothesized that the low prevalence of pediatric HIV disclosure in Ghana is due to lack of accurate HIV information and high HIV stigma among caregivers. This is a preliminary analysis of baseline data of an HIV pediatric disclosure intervention study in Ghana (“Sankofa”). “Sankofa” – is a two-arm randomized controlled clinical trial comparing disclosure intervention plus usual care (intervention arm) vs usual care (control arm) at Korle-Bu Teaching Hospital (KBTH; control arm) and Komfo-Anokye Teaching Hospital (KATH; intervention arm). We enrolled HIV-infected children, ages 7 to 18 years who do not know their HIV status, and their caregivers. Baseline data of caregivers included demographic characteristics; Brief HIV Knowledge Questionnaire (HIV-KQ-18); Brief Illness Perception Questionnaire (Brief IPQ); and HIV Stigma Scale. Simple and multivariable linear regression analyses were used to assess the relationship between caregiver characteristics and HIV knowledge, stigma, and illness perception. Two hundred and ninety-eight caregivers were enrolled between January 2013 and July 2014 at the two study sites; KBTH (n=167) and KATH (n=131). The median age of caregivers was 41 years; 80.5% of them were female and about 60% of caregivers were HIV-positive. Seventy-eight percent of caregivers were self-employed with low household income. In both unadjusted and adjusted analyses, HIV negative status and lower level of education were associated with poor scores on HIV Knowledge questionnaire. HIV positive status remained significant for higher level of stigma in the adjusted analyses. None of the caregiver's characteristics predicted caregiver's illness perception. Intensification of HIV education in schools and targeted community campaigns are needed. PMID:26616122

  4. Soldier imprisoned for failing to disclose HIV to sex partners.

    PubMed

    1999-02-01

    Pfc. [Name removed], a soldier at Aberdeen Proving Ground in Maryland, was sentenced to 3 years in a military prison for failing to disclose her HIV-positive status to her sexual partners. [Name removed]' commander had ordered her to use condoms and inform her sexual partners of her HIV status. She failed to inform eight of the nine men with whom she had sex and, she did not use a condom with four of them. So far, all nine men have tested negative for HIV. [Name removed] will be reduced to the rank of private, receive a bad conduct discharge, and forfeit all pay and benefits. PMID:11366267

  5. Guidelines for disclosing HIV-antibody test results to clients.

    PubMed

    Witt, R C; Silvestre, A J; Rinaldo, C R; Lyter, D W

    1992-01-01

    Because of new preventive therapies, HIV-antibody testing of asymptomatic individuals now has clear clinical benefits. Consequently, greater numbers of individuals are expected to seek testing. This article, based on the authors' experiences with disclosing HIV-antibody test results to a high-risk group of men, makes recommendations for how best to present HIV-antibody results. Disclosing HIV-antibody results provides an educational opportunity as well as a psychological challenge for clinicians. Some unusual client reactions are detailed in the case studies. PMID:1538838

  6. Caregivers' Intentions to Disclose HIV Diagnosis to Children Living with HIV in South Africa: A Theory-Based Approach

    PubMed Central

    Jemmott, John B.; Heeren, G. Anita; Sidloyi, Lulama; Marange, C. Show; Tyler, Joanne C.; Ngwane, Zolani

    2015-01-01

    When people know their HIV serostatus, they can take steps to manage their health and the risk of transmitting HIV to others. Mounting evidence indicates that caregivers often do not disclose to HIV-positive children that the children are living with HIV, but little is known about the modifiable determinants of pediatric HIV disclosure. The present study examined theory-of-planned-behavior predictors of the intention to disclose to children their HIV diagnosis. The participants were 100 caregivers of HIV-positive children in Eastern Cape Province, South Africa. Proportional-odds logistic regression analysis revealed that normative support for disclosure and caregiver-child communication predicted the intention to disclose, whereas behavioral beliefs regarding the consequences of disclosing and self-efficacy to disclose did not. The results suggest that interventions to increase pediatric HIV disclosure in South Africa should help caregivers enlist support for disclosure among important referents and improve communication with their HIV-infected children. PMID:24310931

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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…

  8. Caregivers' intentions to disclose HIV diagnosis to children living with HIV in South Africa: a theory-based approach.

    PubMed

    Jemmott, John B; Heeren, G Anita; Sidloyi, Lulama; Marange, C Show; Tyler, Joanne C; Ngwane, Zolani

    2014-06-01

    When children know their HIV serostatus, they are more likely to cooperate with steps to manage their health and the risk of transmitting HIV to others. Mounting evidence indicates that caregivers often do not disclose to HIV-positive children that the children are living with HIV, but little is known about the modifiable determinants of pediatric HIV disclosure. The present study examined theory-of-planned-behavior predictors of the intention to disclose to children their HIV diagnosis. The participants were 100 caregivers of HIV-positive children in Eastern Cape Province, South Africa. Proportional-odds logistic regression analysis revealed that normative support for disclosure and caregiver-child communication predicted the intention to disclose, whereas behavioral beliefs regarding the consequences of disclosing and self-efficacy to disclose did not. The results suggest that interventions to increase pediatric HIV disclosure in South Africa should help caregivers enlist support for disclosure among important referents and improve communication with their HIV-infected children. PMID:24310931

  9. Prevalence and pattern of disclosure of HIV status in HIV-infected children in Ghana.

    PubMed

    Kallem, Stacey; Renner, Lorna; Ghebremichael, Musie; Paintsil, Elijah

    2011-08-01

    With the advent of highly active antiretroviral therapy (HAART) HIV-infected children are surviving into adulthood. Despite emerging evidence of the benefits of disclosure, when and how to disclose the diagnosis of HIV to children remain a clinical dilemma. We investigated the prevalence and determinants of HIV disclosure in a cross-sectional study of 71 caregiver-child dyads from the Pediatric HIV/AIDS Care Program at Korle-Bu Teaching Hospital (Accra, Ghana). The children were between 8 and 14 years of age (median age, 10.39 years). The prevalence of disclosure was 21%. In the unadjusted analyses, the age of child, the level of education of child, deceased biologic father, administration of own HIV medications, and longer duration on HIV medication were significantly associated with disclosure. The low prevalence of disclosure underscores the need for a systematic and a staged approach in disclosing HIV status to infected children in resource limited countries. PMID:20607381

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

    PubMed

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

    2012-10-01

    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

  11. Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents.

    PubMed

    Toska, Elona; Cluver, Lucie D; Hodes, Rebecca; Kidia, Khameer K

    2015-12-01

    HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no study has explored the effects of (i) adolescent knowledge of one's HIV-status, (ii) knowledge of partner status and (iii) disclosure to partners, on safer sex behaviour. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. Eight fifty eight HIV-positive adolescents (10-19 years old, 52% female, 68.1% vertically infected) who had ever initiated antiretroviral treatment in 41 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers and their healthcare workers. N?=?128 (14.9%) of the total sample had ever had sex, while N?=?109 (85.1%) of sexually active adolescents had boy/girlfriend. In total, 68.1% of the sample knew their status, 41.5% of those who were sexually active and in relationships knew their partner's status, and 35.5% had disclosed to their partners. For adolescents, knowing one's status was associated with safer sex (OR?=?4.355, CI 1.085-17.474, p?=?.038). Neither knowing their partner's status, nor disclosing one's HIV-status to a partner, were associated with safer sex. HIV-positive adolescents feared rejection, stigma and public exposure if disclosing to sexual and romantic partners. Counselling by healthcare workers for HIV-positive adolescents focused on benefits of disclosure, but did not address the fears and risks associated with disclosure. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents, who may be ill-equipped to negotiate safer sex. There is a pressing need for effective interventions that mitigate the risks of disclosure and provide HIV-positive adolescents with skills to engage in safe sex. PMID:26616125

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

    E-print Network

    Columbia University

    TITLE: USES AND DISCLOSURES OF HIV/AIDS INFORMATION POLICY: Columbia University Medical Center will use and disclose HIV/AIDS information in accordance with its extremely confidential nature as required and Accountability Act of 1996 (HIPAA). PURPOSE : HIV/AIDS information is Protected Health Information (PHI) and

  13. HIV Status Discordance: Associated Factors Among HIV Positive Pregnant Women in Lagos, Southwest Nigeria.

    PubMed

    Uah, Innocent A O; Ezechi, Oliver C; Ohihoin, Aigbe Gregory

    2015-06-01

    The HIV negative partner in a HIV serodiscordant relationship is at high risk of becoming HIV infected. The annual risk of HIV infection for a partner of a person with HIV is about 10%, with higher annual transmission rates of 20-25% per year reported in Rwanda and Zambia. Although there is considerable variation across countries, recent studies in southern and east Africa countries with mature epidemics reported that up to two-thirds of infected persons in stable relationship are discordant. HIV serodiscordance is thus a recognized priority for HIV prevention intervention. In Nigeria only few studies have studied the burden of serodiscordance, making planning difficult. In this study HIV serodiscordance rate and associated factors among pregnant women were assessed in a large PMTCT clinic in Lagos Nigeria over a 9 years period. Information on HIV status disclosure, partners HIV status (confirmed by HIV test results), sociodemographic characteristics and reproductive information were obtained from the women after enrollment and entered into the case file. In the study, relevant information was managed with SPSS for windows version 19.0. The variables independently associated with HIV status discordance were determined in both univariate and multivariate analysis. P values and Odd ratio with their confidence intervals were calculated. Out of the 4435 women enrolled during the study period, 3712 (83.7%) had disclosed their status to their partner. Partner's HIV status among the women with confirmed HIV status was negative in 2065 (66.8%) women, thus a discordant rate of 66.8%. HIV status disclosure rate was 83.7%; with significantly higher disclosure rate in concordant couple (83.3%) compared to 76.8% among women in serodiscordant relationship (p = 0.00; OR: 1.5; 95% CI: 1.25-1.82). Discordant HIV status in a female positive relationship was found to be associated with history of at least two termination of pregnancy (OR: 3.05; 95% CI: 2.91-3.89) and five or more total life time sexual partnership (OR: 2.3; 95% CI: 1.27-3.21). The perception that men are the index cases is not supported by evidence from this study. We recommend the tracking of both men and women as index cases in other to reduce HIV transmission within stable relationship. Social marketing aimed at reducing concurrency should focus on both male and females, if we must reduce new HIV infection within stable relationships. PMID:26506663

  14. The need to know: HIV status disclosure expectations and practices among non-HIV-positive gay and bisexual men in Australia.

    PubMed

    Murphy, Dean A; de Wit, John B F; Donohoe, Simon; Adam, Philippe C G

    2015-12-01

    Although there is evidence of increasing overall rates of HIV status disclosure among gay and bisexual men, little is known about men's disclosure expectations and practices. In this study, we investigate the importance non-HIV-positive men in Australia vest in knowing the HIV status of their sexual partners, and the extent to which they restrict sex to partners of the same HIV status, and their HIV disclosure expectations. Data were collected through a national, online self-report survey. Of the 1044 men included in the study, 914 were HIV negative and 130 were untested. Participants completed the assessment of socio-demographic characteristics, HIV status preferences, and disclosure expectations and practices. Participants also completed reliable multi-item measures of perceived risk of HIV transmission, expressed HIV-related stigma, and engagement with the gay community and the community of people living with HIV. A quarter (25.9%) of participants wanted to know the HIV status of all sexual partners, and one-third (37.2%) restricted sex to partners of similar HIV status. Three quarters (76.3%) expected HIV-positive partners to disclosure their HIV status before sex, compared to 41.6% who expected HIV-negative men to disclose their HIV status. Less than half (41.7%) of participants reported that they consistently disclosed their HIV status to sexual partners. Multivariate linear regression analysis identified various covariates of disclosure expectations and practices, in particular of disclosure expectations regarding HIV-positive men. Men who expected HIV-positive partners to disclose their HIV status before sex more often lived outside capital cities, were less educated, were less likely to identify as gay, perceived more risk of HIV transmission from a range of sexual practices, were less engaged with the community of people living with HIV, and expressed more stigma towards HIV-positive people. These findings suggest that an HIV-status divide is emerging or already exists among gay men in Australia. HIV-negative and untested men who are most likely to sexually exclude HIV-positive men are less connected to the HIV epidemic and less educated about HIV risk and prevention. PMID:26616130

  15. The need to know: HIV status disclosure expectations and practices among non-HIV-positive gay and bisexual men in Australia

    PubMed Central

    Murphy, Dean A.; de Wit, John B.F.; Donohoe, Simon; Adam, Philippe C.G

    2015-01-01

    Although there is evidence of increasing overall rates of HIV status disclosure among gay and bisexual men, little is known about men's disclosure expectations and practices. In this study, we investigate the importance non-HIV-positive men in Australia vest in knowing the HIV status of their sexual partners, and the extent to which they restrict sex to partners of the same HIV status, and their HIV disclosure expectations. Data were collected through a national, online self-report survey. Of the 1044 men included in the study, 914 were HIV negative and 130 were untested. Participants completed the assessment of socio-demographic characteristics, HIV status preferences, and disclosure expectations and practices. Participants also completed reliable multi-item measures of perceived risk of HIV transmission, expressed HIV-related stigma, and engagement with the gay community and the community of people living with HIV. A quarter (25.9%) of participants wanted to know the HIV status of all sexual partners, and one-third (37.2%) restricted sex to partners of similar HIV status. Three quarters (76.3%) expected HIV-positive partners to disclosure their HIV status before sex, compared to 41.6% who expected HIV-negative men to disclose their HIV status. Less than half (41.7%) of participants reported that they consistently disclosed their HIV status to sexual partners. Multivariate linear regression analysis identified various covariates of disclosure expectations and practices, in particular of disclosure expectations regarding HIV-positive men. Men who expected HIV-positive partners to disclose their HIV status before sex more often lived outside capital cities, were less educated, were less likely to identify as gay, perceived more risk of HIV transmission from a range of sexual practices, were less engaged with the community of people living with HIV, and expressed more stigma towards HIV-positive people. These findings suggest that an HIV-status divide is emerging or already exists among gay men in Australia. HIV-negative and untested men who are most likely to sexually exclude HIV-positive men are less connected to the HIV epidemic and less educated about HIV risk and prevention. PMID:26616130

  16. HIV Serosorting, Status Disclosure, and Strategic Positioning Among Highly Sexually Active Gay and Bisexual Men.

    PubMed

    Grov, Christian; Rendina, H Jonathon; Moody, Raymond L; Ventuneac, Ana; Parsons, Jeffrey T

    2015-10-01

    Researchers have identified harm reduction strategies that gay, bisexual, and other men who have sex with men (GBMSM) use to reduce HIV transmission-including serosorting, status disclosure, and strategic positioning. We report on patterns of these behaviors among 376 highly sexually active (i.e., 9+partners, <90 days) GBMSM: mean age of 37, 49.5% men of color, 87.8% gay identified, 57.5% college educated. We found evidence that many men engaged in serosorting, status disclosure, and strategic positioning; however, rates varied based on the participant's HIV status. HIV-positive and HIV-negative men both engaged in sex with men of similar status more often than they engaged in sex with men known to be a different HIV status (i.e., serosorting). However, HIV-negative men disclosed their HIV-status with about half of their partners, whereas HIV-positive participants disclosed with only about one-third. With regard to strategic positioning, HIV-positive participants were the receptive partner about half the time with their HIV-negative partners and with their HIV-positive partners. In contrast, strategic positioning was very common among HIV-negative participants-they rarely bottomed with HIV-positive partners, bottomed about one-third of the time with status-unknown partners, and 42% of the time (on average) with HIV-negative partners. Highly sexually active GBMSM are a critical population in which to both investigate HIV prevention strategies as well as develop effective intervention programs. Providers and clinicians might be well served to include a wide range of behavioral harm reduction strategies in addition to condom use and biomedical approaches to reduce onward HIV transmission. PMID:26348322

  17. Legal Disclosure of HIV Status

    MedlinePLUS

    ... Legal Disclosure Translate Text Size Print Legal Disclosure HIV Disclosure Policies and Procedures If your HIV test ... aids.gov • locator.aids.gov • facing.aids.gov • HIV/AIDS Service Locator Locator Widgets • Instructions • API Find ...

  18. HIV Status Disclosure Among People Living with HIV in the Era of Combination Antiretroviral Therapy (cART)

    PubMed Central

    Madi, Deepak; Gupta, Parul; Bhaskaran, Unnikrishnan; Ramapuram, John T.; Rao, Satish; Mahalingam, Soundarya

    2015-01-01

    Introduction As patients with HIV live longer due to Combination Anti-Retroviral Therapy (cART) serostatus disclosure becomes an important issue. Disclosure can have both positive and negative outcomes. Disclosure of HIV status has been associated with better adherence to medication and reduction in levels of psychological distress. Stigma and disruption of family relationships are barriers for disclosure. Most studies regarding disclosure status have been conducted in West. There are many cultural differences in Indian society when compared to west. There is a dearth of research in the field of disclosure of HIV infection in India. Aim To determine the prevalence of HIV status disclosure among people living with HIV (PLHIV) in South India. Materials and Methods This descriptive cross-sectional study was done in the hospital attached to Kasturba Medical College (KMC), Mangalore, India from May–June 2013. PLHIV of age more than 18 years were included. During the study period 111 consecutive patients who consented for the study were enrolled. Statistical Analysis Data was collected using a pre-tested interviewer administered semi structured questionnaire. Data collected was analysed using SPSS Version 11.5 statistical software. Descriptive statistics were done and the results are presented as proportions and mean. Results The mean age of the study population was 44.86 ± 10.8 years. Majority of the study subjects were men 76 (68.4%). Out of 111 study subjects, 102 (91.9%) had disclosed their HIV status to at least one person while 9 (8.1%) had not disclosed their HIV status to anyone. Disclosure on doctor’s advice was the main reason for 56 (54.9%) participants to disclose their HIV status. The main reason for non-disclosure was fear of shame in family. Conclusion Disclosure rate was high in our study in the era of cART. Society must stop discriminating against PLHIV so that they can disclose their serostatus and gain access to care and treatment services without any fear of stigma. In our study the main reason for disclosure was doctor’s advice which clearly states the importance of the commitment of doctors in creating awareness among PLHIV about the need for voluntary disclosure. PMID:26435983

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

    PubMed Central

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

    2014-01-01

    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) 0.1–1.0; p?=?0.05)). Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.90–11.7; p?=?0.07) than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.02–1.99; 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

  20. Do support groups members disclose less to their partners? The dynamics of HIV disclosure in four African countries

    PubMed Central

    2013-01-01

    Background Recent efforts to curtail the HIV epidemic in Africa have emphasised preventing sexual transmission to partners through antiretroviral therapy. A component of current strategies is disclosure to partners, thus understanding its motivations will help maximise results. This study examines the rates, dynamics and consequences of partner disclosure in Burkina Faso, Kenya, Malawi and Uganda, with special attention to the role of support groups and stigma in disclosure. Methods The study employs mixed methods, including a cross-sectional client survey of counselling and testing services, focus groups, and in-depth interviews with HIV-positive individuals in stable partnerships in Burkina Faso, Kenya, Malawi and Uganda, recruited at healthcare facilities offering HIV testing. Results Rates of disclosure to partners varied between countries (32.7% – 92.7%). The lowest rate was reported in Malawi. Reasons for disclosure included preventing the transmission of HIV, the need for care, and upholding the integrity of the relationship. Fear of stigma was an important reason for non-disclosure. Women reported experiencing more negative reactions when disclosing to partners. Disclosure was positively associated with living in urban areas, higher education levels, and being male, while being negatively associated with membership to support groups. Conclusions Understanding of reasons for disclosure and recognition of the role of support groups in the process can help improve current prevention efforts, that increasingly focus on treatment as prevention as a way to halt new infections. Support groups can help spread secondary prevention messages, by explaining to their members that antiretroviral treatment has benefits for HIV positive individuals and their partners. Home-based testing can further facilitate partner disclosure, as couples can test together and be counselled jointly. PMID:23773542

  1. Nutrition Status of HIV+ Children in Botswana

    ERIC Educational Resources Information Center

    Nnyepi, Maria; Bennink, Maurice R.; Jackson-Malete, Jose; Venkatesh, Sumathi; Malete, Leapetswe; Mokgatlhe, Lucky; Lyoka, Philemon; Anabwani, Gabriel M.; Makhanda, Jerry; Weatherspoon, Lorraine J.

    2015-01-01

    Purpose: Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the benefits of integrating nutrition (assessment and culturally acceptable food supplement intervention) in the treatment strategy for this target group.…

  2. Disclosure of HIV-positive status to sexual partner and associated factors among ART users in Mekelle Hospital

    PubMed Central

    Gultie, Teklemariam; Genet, Minichil; Sebsibie, Girum

    2015-01-01

    Purpose The purpose of this study was to assess the disclosure of HIV-positive status and its associated factors to sexual partners among patients attending antiretroviral therapy (ART) clinic follow-up at Mekelle Hospital, Tigray, Ethiopia. Patients and methods An institution-based cross-sectional study was conducted at Mekelle hospital. Samples of 324 individuals were selected by using systematic random sampling techniques from July 1 until July 30, 2013. The data were collected by trained data collectors through a pretested semi-structured questionnaire. The collected data were cleaned, coded, entered, and analyzed using SPSS version 16.0 Windows program. Descriptive statistics and binary and multivariable regression analysis with 95% confidence interval was carried out and P-value less than 0.05 used to determine the significant association. Results A total of 324 people on ART care follow-up were interviewed with 100% response rate. The overall HIV status disclosure to sexual partner was 57.4%. Among those who disclosed their HIV status, 58% of them told their partner after 1 month after diagnosis. The study showed that there is significant association between knowing HIV status of sexual partner (adjusted odds ratio [AOR] =16.69, 95% CI: 5.4, 51.65), duration of HIV-related care follow-up (AOR =5.48, 95% CI =2.17, 13.80), and discussion before HIV testing (AOR =4.33, 95% CI =1.43, 13.08), with HIV-positive status disclosure to sexual partner. Conclusion An HIV-positive status disclosure to a sexual partner in this study was lower than what was reported in other studies in Ethiopia. The duration of HIV-related care follow-up, knowing partner’s HIV status, and prior discussion were the main factors that affected the practice of HIV-positive status disclosure to their sexual partners. PMID:26185470

  3. Disclosure of HIV status to medical providers: differences by gender, "race," and immune function.

    PubMed Central

    Jeffe, D B; Khan, S R; Meredith, K L; Schlesinger, M; Fraser, V J; Mundy, L M

    2000-01-01

    OBJECTIVE: The authors used data from a larger study to explore differences by gender, self-reported racial identification, and immune function in disclosure of HIV-positive serostatus to medical providers (dentists, family doctors, and emergency room [ER] and obstetrics-gynecology [ob/gyn] providers). METHOD: The authors analyzed interview responses from a convenience sample of African American and white men and women receiving HIV medical care at urban hospitals and clinics in St. Louis. Missouri. RESULTS: Of 179 respondents using at least one of three types of providers, 124 (69%) disclosed their HIV status to all applicable types of providers, 39 (22%) disclosed to only one or two types of providers, and 16 (9%) did not disclose to any of these types of providers. "Race" and CD4 count, but not gender, were independently associated with disclosure to dentists, family doctors, and ER providers in multivariate logistic regression analyses. CONCLUSIONS: Differences in disclosure rates, especially among patients who may be asymptomatic, suggest a need for public health education of both medical providers and patients with HIV. PMID:10968584

  4. 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

    2014-01-01

    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

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

    PubMed

    Carballo-Diéguez, Alex; Balán, Iván C; Dolezal, Curtis; Ibitoye, Mobolaji; Pando, María A; Marone, Rubén; Barreda, Victoria; Avila, María Mercedes

    2013-12-01

    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

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

    PubMed

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

    2015-06-01

    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

  7. Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study

    PubMed Central

    2013-01-01

    Background Women’s ability to safely disclose their HIV-positive status to male partners is essential for uptake and continued use of prevention of mother-to-child transmission (PMTCT) services. However, little is known about the acceptability of potential approaches for facilitating partner disclosure. To lay the groundwork for developing an intervention, we conducted formative qualitative research to elicit feedback on three approaches for safe HIV disclosure for pregnant women and male partners in rural Kenya. Methods This qualitative acceptability research included in-depth interviews with HIV-infected pregnant women (n?=?20) and male partners of HIV-infected women (n?=?20) as well as two focus groups with service providers (n?=?16). The participants were recruited at health care facilities in two communities in rural Nyanza Province, Kenya, during the period June to November 2011. Data were managed in NVivo 9 and analyzed using a framework approach, drawing on grounded theory. Results We found that facilitating HIV disclosure is acceptable in this context, but that individual participants have varying expectations depending on their personal situation. Many participants displayed a strong preference for couples HIV counseling and testing (CHCT) with mutual disclosure facilitated by a trained health worker. Home-based approaches and programs in which pregnant women are asked to bring their partners to the healthcare facility were equally favored. Participants felt that home-based CHCT would be acceptable for this rural setting, but special attention must be paid to how this service is introduced in the community, training of the health workers who will conduct the home visits, and confidentiality. Conclusion Pregnant couples should be given different options for assistance with HIV disclosure. Home-based CHCT could serve as an acceptable method to assist women and men with safe disclosure of HIV status. These findings can inform the design and implementation of programs geared at promoting HIV disclosure among pregnant women and partners, especially in the home-setting. PMID:24294994

  8. Correlates and Experiences of HIV Stigma in Prisoners Living With HIV in Indonesia: A Mixed-Method Analysis.

    PubMed

    Culbert, Gabriel J; Earnshaw, Valerie A; Wulanyani, Ni Made Swasti; Wegman, Martin P; Waluyo, Agung; Altice, Frederick L

    2015-01-01

    In Indonesia, the syndemic nature of HIV, drug use, and incarceration may influence experiences of stigma for HIV-infected prisoners. This mixed-method study explores HIV stigma in prisoners living with HIV in Indonesia. Randomly selected male HIV-infected prisoners (n = 102) from two large prisons in Jakarta completed in-depth interviews and a structured HIV stigma survey. Quantitative results found four groups of HIV-infected prisoners with significantly higher HIV stigma levels, including those: (a) with drug-related offenses, (b) seeking help to decrease drug use, (c) diagnosed with HIV before the current incarceration, and (d) who had not disclosed their HIV status to family members or friends. Qualitative results highlighted the prominent role of HIV stigma in decisions to disclose HIV status to family members, partners, and other prisoners. Interventions should address HIV stigma in HIV-infected prisoners in Indonesia to achieve HIV treatment as prevention goals. PMID:26304049

  9. Antiretroviral Therapy as HIV Prevention: Status and Prospects

    PubMed Central

    Venkatesh, Kartik K.

    2010-01-01

    As antiretroviral treatment of HIV infection has become increasingly accessible, attention has focused on whether these drugs can used for prevention because of increased tolerability of newer medications, decreased cost, and the limitations of other approaches. We review the status of antiretroviral HIV prevention, including chemoprophylaxis, as well as the effects of treatment of infected individuals on prevention. It is possible that the life-saving agents that have transformed the natural history of AIDS can be a critical component of HIV prevention efforts, but their ultimate role in affecting HIV transmission dynamics remains to be defined. PMID:20724682

  10. The impact of fear, secrecy, and stigma on parental disclosure of HIV status to children: a qualitative exploration with HIV positive parents attending an ART clinic in South Africa.

    PubMed

    Madiba, Sphiwe

    2013-03-01

    South Africa is one of the sub Saharan countries where considerable progress in providing antiretroviral treatment (ART) has been made. The increased access to ART contributes to improvements in the prognosis of HIV and parents are more likely to raise their children than ever before. The study examined the social context influencing disclosure of parental HIV status to children from the perspectives of fathers and mothers accessing ART from an academic hospital in South Africa. Three focus group interviews were conducted with 26 non-disclosed biological parents of children aged between 7 and 18 years. Their ages ranged between 20-60 years and they cared for a total of 60 children. Parental decision not to disclose their HIV status to children was influenced by the fear of death and dying, the influence of television and media, stigma and discrimination. Parents delayed disclosure of their HIV status to children because children believed that AIDS kills. Parents also feared that the child may not be able to keep the parent's HIV status secret and might result in the family being subjected to stigma, discrimination, and isolation. Fear of stigma and discrimination were also responsible for the continuous efforts by parents to protect their HIV status from their children, family and neighbour's. Parents also delayed disclosure to children because they lacked disclosure skills and needed support for disclosure from health care providers. Healthcare providers are in a unique position to provide such support and guidance and assist parents to disclose and children to cope with parental HIV infection. PMID:23445694

  11. Transient elastography discloses identical distribution of liver fibrosis in chronic hepatitis C between HIV-negative and HIV-positive patients on HAART

    PubMed Central

    2010-01-01

    Objective Progressive immunodeficiency associated with HIV-infection leads to a progressive course of liver disease in HIV/HCV-co-infected patients. Highly active antiretroviral therapy (HAART) efficiently restores and preserves immune functions and has recently been demonstrated to also result in reduced liver-related mortality in HIV/HCV-co-infected patients. Methods To analyse differences in current liver fibrosis as a possible effect of HAART on fibrosis progression we assessed hepatic fibrosis by transient elastography in a cross-sectional comparison between HCV-mono-infected and HIV/HCV-co-infected patients presenting at our outpatient department in 2007. Results Overall, we did not find any difference in the distribution of liver stiffness between mono- (n = 84) and double-infected (n = 57) patients (14.4 kPa (10.8 - 18.2) versus 12.4 kPa (9.1 - 16.1), mean (95%-CI)). However, in the 8 HIV+ patients with CD4 counts < 200/?l liver stiffness was markedly greater (18.4 kPa (0.8 - 36.0)) than in HIV+ patients with preserved immunity (11.5 kPa (8.4 - 15.0)). Conclusions These findings are in line with other data that show an improved prognosis of chronic hepatitis C in HIV+ patients under effective HAART, and may be a hint that fibrosis progression in well-treated HIV+ patients will no longer be different from that in HCV-mono-infected patients. PMID:20554494

  12. ‘We keep her status to ourselves’: Experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine

    PubMed Central

    Rispel, Laetitia C.; Cloete, Allanise; Metcalf, Carol A.

    2015-01-01

    Abstract In HIV-discordant relationships, the HIV-negative partner also carries the burden of a stigmatised disease. For this reason, couples often hide their HIV-discordant status from family, friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention, treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine. During 2008, HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire, while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited: 26 from South Africa, 10 from Tanzania, and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner, few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip, rumours and name-calling, and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system. PMID:25778765

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

    PubMed

    Anglewicz, Philip; Reniers, Georges

    2014-12-01

    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

  14. HIV status and sexual behaviour among gay men in Ottawa: considerations for public health

    PubMed Central

    O'Byrne, Patrick; Phillips, J Craig; Kitson, Cynthia; Bryan, Alyssa

    2014-01-01

    Objectives HIV prevention efforts, particularly among men who have sex with men (MSM), have not achieved maximum effectiveness. A survey of MSM in Ottawa, Canada was completed to ascertain whether there were differences in how the perceived HIV status of participants and their partners influenced sexual practices. Methods Self-directed surveys were administered to a convenience sample of 721 MSM in Ottawa, Canada from November 2011 through May 2012. Data collection occurred at 14 sites. The survey identified whether participants identified as HIV positive, negative or unsure of their HIV status. Results The findings indicated variation between HIV-negative MSM and those who are unsure of their HIV status. Men who were unsure of their HIV status were less likely to report that they asked sexual partners or have had their partners ask about HIV status. Conclusions The results of this study indicate that some MSM may base decisions about HIV prevention on discussion about HIV status with their partners, rather than condom use. These practices may increase, rather than decrease, HIV transmission. Survey findings and extant literature demonstrate a need to inform MSM about the limitations of serosorting as a prevention strategy, and to provide facilitated access to sexually transmitted infection testing and treatment to further reduce onward HIV transmission. PMID:25239290

  15. Reasons for disclosure of HIV status by people living with HIV/AIDS and in HIV care in Uganda: an exploratory study.

    PubMed

    Ssali, Sarah N; Atuyambe, Lynn; Tumwine, Christopher; Segujja, Eric; Nekesa, Nicolate; Nannungi, Annet; Ryan, Gery; Wagner, Glenn

    2010-10-01

    Most studies of HIV disclosure in Africa have focused on disclosure to spouses and sexual partners, and particularly among women. Few have examined disclosure to family, friends, and others. Understanding the reasons for disclosure and nondisclosure and how these reasons differ by disclosure target is needed for effective prevention interventions. Using a case study design and content analysis, this study explored whether the reasons for disclosure decisions differ by the nature of the relationship to the disclosure target. Semistructured interviews were conducted with 40 HIV clients in Kampala, with even stratification by gender and age. Most (95%) respondents reported disclosing to someone; among these, 84% disclosed to family members, 63% to friends, 21% to workplace colleagues, and 18% to others. Of the 24 participants who had a spouse, 13 (54%) reported disclosing to a spouse. The most common reasons for disclosure were to receive support (76%), associated with disclosure to family members; relationship ties (76%), associated with disclosure to all target types; explaining change in behavior or appearance (61%), associated with disclosing to family and friends; and HIV prevention (50%), associated with disclosure to spouse/partner and friends. The most common reasons for nondisclosure were: fear of abandonment, particularly among young women disclosing to spouse/partner; inaccessibility to the disclosure target; and not wanting to worry/upset the disclosure target. This exploratory analysis suggests that reasons for disclosure and nondisclosure differ depending on the targets of disclosure, highlighting the need for tailoring interventions for improving disclosure decisions making and outcomes. PMID:20863244

  16. HIV Status is An Independent Risk Factor for Reporting Lower Urinary Tract Symptoms

    PubMed Central

    Breyer, Benjamin N.; Van Den Eeden, Stephen K.; Horberg, Michael A.; Eisenberg, Michael L.; Deng, Donna Y.; Smith, James F.; Shindel, Alan W.

    2013-01-01

    Purpose HIV/AIDS is a worldwide epidemic. Limited evidence suggests that men infected with HIV/AIDS are at increased risk for lower urinary tract symptoms. We determined whether HIV/AIDS status is an independent risk factor for self-reported bothersome lower urinary tract symptoms in a large contemporary cohort. Materials and Methods We performed a cross-sectional, Internet based survey of urinary quality of life outcomes in adult HIV infected and HIV uninfected men who have sex with men. The main outcome measure was International Prostate Symptom Score. Results Of respondents with complete data 1,507 were HIV uninfected (median age 42 years, mean 43) and 323 HIV infected (median age 45 years, mean 45.1). Of the HIV infected respondents 148 were nonAIDS defining HIV infected and 175 were AIDS defining HIV infected. After adjusting for age and other comorbid conditions, nonAIDS defining HIV infected and AIDS defining HIV infected status increased the odds of severe lower urinary tract symptoms by 2.07 (95% CI 1.04–3.79) and 2.49 (95% CI 1.43–4.33), respectively. HIV infected men had a worse total International Prostate Symptom Score for all domains including quality of life compared to HIV uninfected men. Within the population of men with HIV, those with AIDS had worse mean total International Prostate Symptom Score and all individual International Prostate Symptom Score components relative to nonAIDS defining HIV infected men. Conclusions HIV status is an independent risk factor for bothersome lower urinary tract symptoms. The odds of severe lower urinary tract symptoms are greater in HIV infected men with a history of AIDS. PMID:21420120

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

    PubMed Central

    Anglewicz, Philip; Reniers, Georges

    2014-01-01

    Marriage and partnerships bring about non-negligible health risks in populations with generalized HIV epidemics, and concerns about the possible transmission of HIV thus often factor in the decision-making about partnership formation and dissolution. The awareness of and responses to HIV risk stemming from regular sexual partners have been well documented in African populations, but few studies have estimated the effects of observed HIV status on marriage decisions and outcomes. We study marriage dissolution and remarriage using longitudinal data with repeated HIV and marital status measurements from rural Malawi. Results indicate that HIV positive individuals face greater risks of union dissolution (both via widowhood and divorce) and lower remarriage rates. Modeling studies suggest that the exclusion of HIV positives from the marriage or partnerships market will decelerate the propagation of HIV. PMID:25469927

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

    PubMed

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

    2013-12-01

    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

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

    ERIC Educational Resources Information Center

    Valle, Maribel; Levy, Judith

    2009-01-01

    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

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

    PubMed Central

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

    2014-01-01

    Background Both 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 ones risk for neurocognitive impairment. Both HIV and stimulant literature 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 was examined longitudinally over a 10 year period. Methods 952 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-HAART data was 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. Results No 4-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 3-way interactions were found that involved genotype and HIV status. All immunologic-related genes found to interact with HIV status affected neurocognitive functioning in the expected direction; however, only 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. Conclusion The findings support the role of immunologic-related genetic differences in CCL2 and CCL3 in neurocognitive functioning among HIV+ individuals; however their impact is minor. Consistent with findings from another cohort, DA-related genetic differences do not appear to impact the longitudinal neurocognitive functioning of HIV+ individuals. PMID:24737013

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

    PubMed

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

    2014-06-01

    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

  2. AIDS Panic in the Twenty-First Century: The Tenuous Legal Status of HIV-Positive Persons in America.

    PubMed

    Cockerill, Richard; Wahlert, Lance

    2015-09-01

    Thirty-four states criminalize HIV in some way, whether by mandating disclosure of one's HIV status to all sexual partners or by deeming the saliva of HIV-positive persons a "deadly weapon." In this paper, we argue that HIV-specific criminal laws are rooted in historical prejudice against HIV-positive persons as a class. While purporting to promote public health goals, these laws instead legally sanction discrimination against a class of persons. PMID:26160604

  3. Maternal Substance Use and HIV Status: Adolescent Risk and Resilience

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

  4. Impact of HIV Infection Status on Interpretation of Quantitative PCR for Detection of Pneumocystis jirovecii.

    PubMed

    Louis, M; Guitard, J; Jodar, M; Ancelle, T; Magne, D; Lascols, O; Hennequin, C

    2015-12-01

    Quantitative PCR (qPCR) is now a key diagnostic tool for Pneumocystis pneumonia. However, cutoffs to distinguish between infected and colonized patients according to their HIV status have not yet been determined. According to clinical, radiological, and biological data, we retrospectively classified bronchoalveolar lavage (BAL) samples subjected to qPCR over a 3-year period into four categories, i.e., definite PCP, probable PCP, Pneumocystis colonization, and no infection. Fungal burden was then analyzed according to the HIV status of the patients. Among 1,212 episodes of pneumonia screened in immunocompromised patients, 52 and 27 HIV-positive patients were diagnosed with a definite and probable PCP, whereas 4 and 22 HIV-negative patients had definite and probable PCP, respectively. Among patients with definite or a probable PCP, HIV-negative patients had a significantly lower burden than HIV-positive patients (P < 10(-4)). In both groups, the median fungal burden was significantly higher in patients with definite PCP than in colonized patients. A single cutoff at 1.5 × 10(4) copies/ml allowed to differentiate colonized and infected HIV-positive patients with 100% sensitivity and specificity. In HIV-negative patients, cutoff values of 2.87 × 10(4) and 3.39 × 10(3) copies/ml resulted in 100% specificity and sensitivity, respectively. Using cutoffs determined for the whole population would have led us to set aside the diagnosis of PCP in 9 HIV-negative patients with definite or probable PCP. qPCR appeared to be the most sensitive test to detect Pneumocystis in BAL samples. However, because of lower inocula in HIV-negative patients, different cutoffs must be used according to the HIV status to differentiate between colonized and infected patients. PMID:26468505

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

    PubMed Central

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

    2009-01-01

    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

  6. Predictors of HIV serostatus disclosure to partners among HIV-positive pregnant women in Morogoro, Tanzania

    PubMed Central

    2013-01-01

    Background Prevention of mother to child transmission of HIV (PMTCT) has been scaled, to more than 90% of health facilities in Tanzania. Disclosure of HIV results to partners and their participation is encouraged in the program. This study aimed to determine the prevalence, patterns and predictors of HIV sero-status disclosure to partners among HIV positive pregnant women in Morogoro municipality, Tanzania. Methods A cross sectional study was conducted in March to May 2010 among HIV-positive pregnant women who were attending for routine antenatal care in primary health care facilities of the municipality and had been tested for HIV at least one month prior to the study. Questionnaires were used to collect information on possible predictors of HIV disclosure to partners. Results A total of 250 HIV-positive pregnant women were enrolled. Forty one percent (102) had disclosed their HIV sero-status to their partners. HIV-disclosure to partners was more likely among pregnant women who were?HIV status before the current pregnancy [AOR?=?3.7; 95% CI: 1.7–8.3], and discussed with their partner before testing [AOR?=?6.9; 95% CI: 2.4–20.1]. Dependency on the partner for food/rent/school fees, led to lower odds of disclosure to partners [AOR?=?0.4; 95% CI: 0.1–0.7]. Nine out of ten women reported to have been counseled on importance of disclosure and partner participation. Conclusions Six in ten HIV positive pregnant women in this setting had not disclosed their results of the HIV test to their partners. Empowering pregnant women to have an individualized HIV-disclosure plan, strengthening of the HIV provider initiated counseling and testing and addressing economic development, may be some of the strategies in improving HIV disclosure and partner involvement in this setting. PMID:23641927

  7. Communicating HIV Status in Sexual Interactions: Assessing Social Cognitive Constructs, Situational Factors, and Individual Characteristics Among South African MSM

    PubMed Central

    Reddy, Vasu; Kaighobadi, Farnaz; Nel, Dawie; Sandfort, Theo

    2012-01-01

    This study assessed whether social cognitive constructs, situational factors, and individual characteristics were associated with communicating HIV status and whether communication was related to sexual risk behavior. A quota-sampling method stratified by age, race, and township was used to recruit 300 men who have sex with men to participate in a community-based survey in Pretoria in 2008. Participants reported characteristics of their last sexual encounter involving anal sex, including whether they or their partner had communicated their HIV status. Fifty-nine percent of participants reported that they or their partner had communicated their HIV status. HIV communication self-efficacy (aOR = 1.2, 95 % CI: 1.04–1.68), being with a steady partner (aOR = 0.36, 95 % CI: 0.19–0.67), and being Black (versus White; aOR = 0.08, 95 % CI: 0.03–0.27) were independently associated with communicating HIV status. Communicating HIV status was not associated with unprotected anal intercourse. HIV communication self-efficacy increases men’s likelihood of communicating HIV status. Being with a steady partner and being Black reduces that likelihood. Communication about HIV status did not lead to safer sex. PMID:23065127

  8. Health and functional status among older people with HIV/AIDS in Uganda

    PubMed Central

    2011-01-01

    Background In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1) HIV infected and on antiretroviral therapy (ART) for at least 1 year; 2) HIV infected and not yet eligible for ART; 3) older people who had lost a child due to HIV/AIDS; 4) older people who have an adult child with HIV/AIDS; 5) older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion The systematic exploration of health and well being among older people, using eight self-reported and objective health indicators, showed that basic health problems are very common at older ages and poorly addressed by existing health services. HIV-infected older people, however, whether on ART or not yet on ART, had a similar health and functional status as other older people. PMID:22111659

  9. Housing Status and the Health of People Living with HIV/AIDS

    PubMed Central

    Milloy, M-J; Marshall, Brandon DL; Montaner, Julio; Wood, Evan

    2012-01-01

    Individuals who are homeless or living in marginal conditions have an elevated burden of infection with HIV. Existing research suggests the HIV/AIDS pandemic in resource-rich settings is increasingly concentrated among members of vulnerable and marginalized populations, including homeless/marginally-housed individuals, who have yet to benefit fully from recent advances in highly-active antiretroviral therapy (HAART). We reviewed the scientific evidence investigating the relationships between inferior housing and the health status, HAART access and adherence and HIV treatment outcomes of people living with HIV/AIDS (PLWHA.) Studies indicate being homeless/marginally-housed is common among PLWHA and associated with poorer levels of HAART access and sub-optimal treatment outcomes. Among homeless/marginally-housed PLWHA, determinants of poorer HAART access/adherence or treatment outcomes include depression, illicit drug use and medication insurance status. Future research should consider possible social- and structural-level determinants of HAART access and HV treatment outcomes that have been shown to increase vulnerability to HIV infection among homeless/marginally-housed individuals. As evidence indicates homeless/marginally-housed PLWHA with adequate levels of adherence can benefit from HAART at similar rates to housed PLWHA, and given the individual and community benefits of expanding HAART use, interventions to identify HIV-seropositive homeless/marginally-housed individuals and engage them in HIV care including comprehensive support for HAART adherence are urgently needed. PMID:22968432

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

    PubMed

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

    2015-02-01

    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

  11. Effect of Couples Counselling on Reported HIV Risk Behaviour among HIV Serodiscordant Couples by ART Use, HIV Status and Gender in Rural Uganda

    PubMed Central

    King, Rachel; Min, Jeong; Birungi, Josephine; Nyonyintono, Maureen; Muldoon, Katherine A.; Khanakwa, Sarah; Kaleebu, Pontiano; Moore, David M.

    2015-01-01

    Background We examined several measures of self-reported HIV risk behaviour in mutually disclosed sero-discordant couples over time to see if a couples counselling intervention was associated with changes in these behaviors. Methods We analysed data from a prospective cohort study of HIV sero-discordant couples in Jinja, Uganda collected between June 2009 and December 2011. Participants received couples counselling, at 3-monthly intervals. We examined trends in reported condom-use, number of concurrent sexual partners, knowledge of HIV serostatus of concurrent partners and condom use of concurrent partners using Generalized Estimating Equation models, comparing responses at study enrollment with responses at six, 12 18 and 24 months of follow-up. Results A total of 586 couples were enrolled and the female member was HIV positive in 255 (44%) of them. The median age for female participants was 35 years and 42 years for men. Reported condom use at last sex with spouse increased over time (p<0.001) with the largest increases found among couples where the positive participant never received ART during the study(an increase from 68.8% at enrollment to 97.1% at 24 months). Male participants reported reductions in the number of concurrent sexual partners (p<0.001), increase in the knowledge of the HIV serostatus of these partners (p = 0.001) and a trend towards improved condom-use among non-primary partners (p = 0.070). Reported reduced risky behaviors did not wane over the study period. Conclusion Couples counselling resulted in increased condom use among all participants and among men the intervention resulted in reductions in risk behaviour with concurrent sexual partners. Routine counselling for serodiscordant couples should be integrated in routine ART care programs. PMID:26384103

  12. Living with HIV, disclosure patterns and partnerships a decade after the introduction of HIV programmes in rural South Africa.

    PubMed

    Mkwanazi, Ntombizodumo B; Rochat, Tamsen J; Bland, Ruth M

    2015-12-01

    Prevention of mother-to-child Transmission and HIV Treatment programmes were scaled-up in resource-constrained settings over a decade ago, but there is still much to be understood about women's experiences of living with HIV and their HIV disclosure patterns. This qualitative study explored women's experiences of living with HIV, 6-10 years after being diagnosed during pregnancy. The area has high HIV prevalence, and an established HIV treatment programme. Participants were enrolled in a larger intervention, "Amagugu", that supported women (n = 281) to disclose their HIV status to their children. Post-intervention we conducted individual in-depth interviews with 20 randomly selected women, stratified by clinic catchment area, from the total sample. Interviews were entered into ATLAS.ti computer software for coding. Most women were living with their current sexual partner and half were still in a relationship with the child's biological father. Household exposure to HIV was high with the majority of women knowing at least one other HIV-infected adult in their household. Eighteen women had disclosed their HIV status to another person; nine had disclosed to their current partner first. Two main themes were identified in the analyses: living with HIV and the normalisation of HIV treatment at a family level; and the complexity of love relationships, in particular in long-term partnerships. A decade on, most women were living positively with HIV, accessing care, and reported experiencing little stigma. However, as HIV became normalised new challenges arose including concerns about access to quality care, and the need for family-centred care. Women's sexual choices and relationships were intertwined with feelings of love, loyalty and trust and the important supportive role played by partners and families was acknowledged, however, some aspects of living with HIV presented challenges including continuing to practise safe sex several years after HIV diagnosis. PMID:26616127

  13. Living with HIV, disclosure patterns and partnerships a decade after the introduction of HIV programmes in rural South Africa

    PubMed Central

    Mkwanazi, Ntombizodumo B.; Rochat, Tamsen J.; Bland, Ruth M.

    2015-01-01

    Prevention of mother-to-child Transmission and HIV Treatment programmes were scaled-up in resource-constrained settings over a decade ago, but there is still much to be understood about women's experiences of living with HIV and their HIV disclosure patterns. This qualitative study explored women's experiences of living with HIV, 6–10 years after being diagnosed during pregnancy. The area has high HIV prevalence, and an established HIV treatment programme. Participants were enrolled in a larger intervention, “Amagugu”, that supported women (n = 281) to disclose their HIV status to their children. Post-intervention we conducted individual in-depth interviews with 20 randomly selected women, stratified by clinic catchment area, from the total sample. Interviews were entered into ATLAS.ti computer software for coding. Most women were living with their current sexual partner and half were still in a relationship with the child's biological father. Household exposure to HIV was high with the majority of women knowing at least one other HIV-infected adult in their household. Eighteen women had disclosed their HIV status to another person; nine had disclosed to their current partner first. Two main themes were identified in the analyses: living with HIV and the normalisation of HIV treatment at a family level; and the complexity of love relationships, in particular in long-term partnerships. A decade on, most women were living positively with HIV, accessing care, and reported experiencing little stigma. However, as HIV became normalised new challenges arose including concerns about access to quality care, and the need for family-centred care. Women's sexual choices and relationships were intertwined with feelings of love, loyalty and trust and the important supportive role played by partners and families was acknowledged, however, some aspects of living with HIV presented challenges including continuing to practise safe sex several years after HIV diagnosis. PMID:26616127

  14. Housing Status and HIV Risk Behaviors among Transgender Women in Los Angeles

    PubMed Central

    Fletcher, Jesse B.; Kisler, Kimberly A.; Reback, Cathy J.

    2014-01-01

    Due to social stigma, lack of social support, and minimal legal employment opportunities, transgender women (transwomen) face elevated rates of unstable housing. This study examined the association between housing status and HIV risk behaviors among 517 transwomen encountered through street outreach. Seven variables (including sociodemographics, HIV status, housing status, and sexual partner type) were used to estimate partial associations during multivariable analyses; housing status was coded trichotomously (housed, marginally housed, and homeless) for these analyses. Results demonstrated that homeless and marginally housed transwomen engaged in significantly higher rates of illicit drug use than housed transwomen; however, marginally housed and housed transwomen engaged in significantly higher rates of illegal hormone injections than homeless transwomen. Rates of sex work were high in the sample as a whole, though sex with an exchange partner was most common among the marginally housed transwomen. Multivariate logistic regression revealed that unstable housing moderated the association between HIV status and engagement in unprotected serodiscordant anal intercourse. The marginally housed transwomen exhibited the greatest risk profile for HIV acquisition or transmission. PMID:25190499

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

    PubMed Central

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

    2014-01-01

    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:13.7–16.9), 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:1.00–2.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.31–7.80). 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: 3.84–9.93). 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

  16. HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil

    PubMed Central

    Abati, Paulo Afonso Martins; Segurado, Aluisio Cotrim

    2015-01-01

    OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center. METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient’s year of admission – P1 (1999-2002), P2 (2003-2006), and P3 (2007-2010) – for comparative analysis of the variables of interest. RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner’s seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3. CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country. PMID:25741647

  17. Self-Efficacy for Sexual Risk Reduction and Partner HIV Status as Correlates of Sexual Risk Behavior Among HIV-Positive Adolescent Girls and Women.

    PubMed

    Boone, Melissa R; Cherenack, Emily M; Wilson, Patrick A

    2015-06-01

    Little is known about the correlates of sexual risk behavior among HIV-positive adolescent girls and women in the United States. This study investigates two potential factors related to unprotected vaginal and anal intercourse (UVAI) that have yet to be thoroughly studied in this group: self-efficacy for sexual risk reduction and partner HIV status. Data was analyzed from 331 HIV-positive adolescent girls and women between 12 and 24 years old who reported vaginal and/or anal intercourse with a male partner in the past 3 months at fifteen sites across the United States. Results show that overall self-efficacy (B=-0.15, p=0.01), self-efficacy to discuss safe sex with one's partner (B=-0.14, p=0.01), and self-efficacy to refuse unsafe sex (B=-0.21, p=0.01) are related to UVAI episodes. Participants with only HIV-positive partners or with both HIV-positive and HIV-negative partners showed a trend towards higher percentages of UVAI episodes compared to participants with only HIV-negative partners (F(2, 319)=2.80, p=0.06). These findings point to the importance of including self-efficacy and partner HIV status in risk-reduction research and interventions developed for HIV-positive adolescent girls and young women. PMID:25856632

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

    ERIC Educational Resources Information Center

    Clark, Eddie, Jr.

    2006-01-01

    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…

  19. Substance-related coping, HIV-related factors, and mental health among an HIV-positive sexual minority community sample.

    PubMed

    Cramer, Robert J; Colbourn, Scholar L; Gemberling, Tess M; Graham, James; Stroud, Caroline H

    2015-09-01

    HIV-positive status poses a unique set of social stressors, especially among lesbian, gay, and bisexual (LGB) persons. Among these difficulties are the internalization of HIV-related stigma and poor mental health. Unfortunately, substance use as a coping mechanism is also common, dependent on other demographic factors, among HIV-positive and LGB samples. The present study integrates these bodies of literature by examining main and interactive effects of HIV-related experiences (i.e., disclosure of HIV-positive status, fear of disclosure, HIV-related victimization, and internalized HIV-related stigma) and substance-related coping with discrimination as they impact mental health (i.e., stress, anxiety, depressive symptoms, and suicide and self-injury proneness). Participants were 216 HIV-positive LGB community members from an urban community medical clinic. Prominent results included: (1) robust negative effects of internalized HIV-related stigma on all mental health indicators when controlling for other HIV-related experiences and (2) a significant interaction in which substance-related coping significantly increases suicide proneness, only for those who have disclosed HIV-positive status to family or friends. Results are discussed with respect to theoretical perspectives of internalized stigma, implications for clinical work with LGB persons of HIV-positive status, and future research. PMID:25801497

  20. Managing identity impacts associated with disclosure of HIV status: a qualitative investigation

    PubMed Central

    Frye, Victoria; Fortin, Princess; MacKenzie, Sonja; Purcell, David; Edwards, Lorece V.; Mitchell, Shannon Gwin; Valverde, Eduardo; Garfein, R.; Metsch, Lisa; Latka, Mary H

    2011-01-01

    Disclosure of HIV status to potential and current sex partners by HIV-positive people (HIVPP) is a complex issue that has received a significant amount of attention. Research has found that disclosure depends upon the evaluation by HIVPP of potential benefits and risks, especially of the risks stemming from the profound social stigma of HIV and AIDS. Drawing on concepts from Goffman’s classic stigma theory and Anderson’s more recently developed cultural-identity theory of drug abuse, we analyzed data from in-depth, post-intervention qualitative interviews with 116 heterosexually active, HIV-positive injection drug users enrolled in a randomized trial of a behavioral intervention to prevent HIV transmission. We explored how disclosure experiences lead to “identity impacts” defined as: (1) identity challenges (i.e. interactions that challenge an individual’s self-concept as a “normal” or non-deviant individual); and (2) identity transformations (i.e. processes whereby an individual comes to embrace a new identity and reject behaviors and values of an old one, resulting in the conscious adoption of a social and/or public identity as an HIV-positive individual). Participants engaged in several strategies to manage the identity impacts associated with disclosure. Implications of these findings for research and prevention programming are discussed. PMID:20024764

  1. Factors Associated with Inconsistent Condom Use in Adolescents with Negative or Unknown HIV status in Northwest Cameroon

    PubMed Central

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

    2014-01-01

    Objective To evaluate the association between utilization of HIV testing and condom use amongst Cameroonian youth/adolescents who are not known to be HIV-infected. Background Worldwide, HIV is spreading most quickly amongst youth/adolescents. Between 44% and 82% of sexually active youth in Cameroon report inconsistent condom use. Data regarding utilization of HIV testing and condom use is lacking. Methods A cross-sectional survey was administered to 431 youth ages 12-26 years in Cameroon from September to December 2011. Data on socio-demographics, sexual risk behaviors, self-reported HIV status, and condom use were collected. We compared rates of inconsistent condom use between those known HIV negative who utilized testing (HIV-N) versus 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. Results Of 414 eligible respondents, 205 were HIV-U and 209 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 youth 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). Conclusion 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

  2. At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

    ERIC Educational Resources Information Center

    Lewis, Ione R.

    2012-01-01

    Child sexual abuse in Papua New Guinea is a human rights issue as well as an indicator of HIV risk in women. This study aimed to develop knowledge about the link between violence experienced by women and their HIV status. The study used a mixed method approach to collect quantitative and qualitative data through structured interviews with a sample…

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

    PubMed Central

    Demberg, Thorsten; Robert-Guroff, Marjorie

    2012-01-01

    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

  4. Multivitamin supplementation improves haematologic status in children born to HIV-positive women in Tanzania

    PubMed Central

    Liu, Enju; Duggan, Christopher; Manji, Karim P; Kupka, Roland; Aboud, Said; Bosch, Ronald J; Kisenge, Rodrick R; Okuma, James; Fawzi, Wafaie W

    2013-01-01

    Introduction Anaemia is prevalent among children born to HIV-positive women, and it is associated with adverse effects on cognitive and motor development, growth, and increased risks of morbidity and mortality. Objective To examine the effect of daily multivitamin supplementation on haematologic status and mother-to-child transmission (MTCT) of HIV through breastfeeding. Methods A total of 2387 infants born to HIV-positive women from Dar es Salaam, Tanzania were enrolled in a randomized, double-blind, placebo-controlled trial, and provided a daily oral supplement of multivitamins (vitamin B complex, C and E) or placebo at age 6 weeks for 24 months. Among them, 2008 infants provided blood samples and had haemoglobin concentrations measured at baseline and during a follow-up period. Anaemia was defined as haemoglobin concentrations<11 g/dL and severe anaemia<8.5 g/dL. Results Haemoglobin concentrations among children in the treatment group were significantly higher than those in the placebo group at 12 (9.77 vs. 9.64 g/dL, p=0.03), 18 (9.76 vs. 9.57 g/dL, p=0.004), and 24 months (9.93 vs. 9.75 g/dL, p=0.02) of follow-up. Compared to those in the placebo group, children in the treatment group had a 12% lower risk of anaemia (hazard ratio (HR): 0.88; 95% CI: 0.79–0.99; p=0.03). The treatment was associated with a 28% reduced risk of severe anaemia among children born to women without anaemia (HR: 0.72; 95% CI: 0.56–0.92; p=0.008), but not among those born to women with anaemia (HR: 1.10; 95% CI: 0.79–1.54; p=0.57; p for interaction=0.007). One thousand seven hundred fifty three infants who tested HIV-negative at baseline and had HIV testing during follow-up were included in the analysis for MTCT of HIV. No association was found between multivitamin supplements and MTCT of HIV. Conclusions Multivitamin supplements improve haematologic status among children born to HIV-positive women. Further trials focusing on anaemia among HIV-exposed children are warranted in the context of antiretroviral therapy. PMID:23948440

  5. Percentages, Process, and Patterns of HIV Disclosure Among the Spouses of HIV-Infected Men in South India.

    PubMed

    Suhadev, Mohanarani; Mahadevan, Udaya; Dilip, Meenalochani; Suryanarayanan, Devaraj; Sikhamani, Rajasekaran; Thomas, Beena

    2011-01-01

    Most studies have described the outcome of HIV status disclosure rather than the process of disclosure. Hence, a study was conducted among 201 women who accompanied their spouses and children to 3 hospitals at Chennai and Vellore, Tamil Nadu, India, during January to June 2007. Majority of the respondents were sero-positive (69%) and marriage was the only risk factor for them. Of 201 women, 49% did not know the reason for their husbands' HIV infection. Confidentiality of the patient was often breached during disclosure as family members were drawn into the process without consulting the patient. Only for 117 (50%) respondents, HIV diagnosis was disclosed directly by the health providers. There was a considerable delay for men in disclosing their HIV status to their spouses. Apart from the spouses, 122 (61%) shared their diagnosis with other family members. Disgrace to self and family (54%), fear of discrimination (27%), and fear of rejection (9%) were reported for nondisclosure. PMID:21266322

  6. Association of maternal depression and infant nutritional status among women living with HIV in Tanzania.

    PubMed

    Kaaya, Sylvia; Garcia, Maria E; Li, Nan; Lienert, Jeffrey; Twayigize, William; Spiegelman, Donna; Smith Fawzi, Mary C

    2014-11-01

    Antenatal and post-natal depression has demonstrated a significant burden in sub-Saharan Africa, with rates ranging from 10% to 35%. However, perinatal women living with HIV in Tanzania have reported an even greater prevalence of depression (43-45%). The primary goal of this study was to examine the relationship between maternal depression and infant malnutrition among women living with HIV. The design was a retrospective cohort study within the context of a randomised controlled trial among women living with HIV and their infants. Within this trial, 699 mother-child pairs were analysed for the present study. Although antenatal depression was not associated with infant malnutrition and post-natal depression was negatively associated [relative risk (RR?=?0.80, P?=?0.04], cumulative depression demonstrated a positive association with infant wasting (RR?=?1.08, P?status was observed for episodic vs. chronic depression. These findings suggest that providing evidence-based services for persistent depression among women living with HIV may have an effect on infant malnutrition. In addition, other positive outcomes may be related to infant cognitive development as well as HIV disease prognosis and survival among women. PMID:25382710

  7. Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes

    PubMed Central

    Zou, James; Yamanaka, Yvonne; John, Muze; Watt, Melissa; Ostermann, Jan; Thielman, Nathan

    2009-01-01

    Background Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment. Methods A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001). Most participants (84.2%) said that they would disclose their HIV status to their pastor or congregation if they became infected. Although the majority of respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said that they would begin ARV treatment if they became HIV-infected. The multivariate analysis found that respondents' hypothetical willingness to begin ARV treatme was not significantly associated with the belief that prayer could cure HIV or with other religious factors. Refusal of ARV treatment was instead correlated with lack of secondary schooling and lack of knowledge about ARVs. Conclusion The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups. PMID:19261186

  8. 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

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

    2012-01-01

    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 15–64 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 6.5–7.7). Among ever sexually active persons, 27.4% (95% CI 25.6–29.2) of men and 44.2% (95% CI 42.5–46.0) of women reported previous HIV testing. Among HIV-infected persons, 83.6% (95% CI 76.2–91.0) were unaware of their HIV infection. Among sexually active women aged 15–49 years, 48.7% (95% CI 46.8–50.6) 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 15–19 years was 0.2 (95% CI: 0.1–0.3; p<0.0001). Other independent associations with ever HIV testing included urban residence (AOR 1.6, 95% CI: 1.2–2.0; p?=?0.0005, women only), highest wealth index versus the four lower quintiles combined (AOR 1.8, 95% CI: 1.3–2.5; 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

  9. Vengeance, HIV Disclosure, and Perceived HIV Transmission to Others

    PubMed Central

    Moskowitz, David A.; Roloff, Michael E.

    2008-01-01

    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 one’s HIV transmitter was reconciliatory. Men reporting higher vengefulness might also derive a sense of justice from not disclosing their serostatus. PMID:18512142

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

    PubMed

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

    2013-07-01

    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

  11. Disclosing a dyslexic identity.

    PubMed

    Evans, William

    Potential difficulties experienced by nursing students diagnosed with dyslexia can be minimised with the introduction of appropriate policies and guidance around reasonable adjustment and support. In order to access all relevant services, however, a student must actively decide to disclose their dyslexic identity to relevant faculty personnel. Disclosure of such personal information is a complex matter and, critically, requires a receptive environment where diversity and disability are embraced in a positive and meaningful way. The act of disclosure for the most part has previously been described in simplistic terms, with the focus being solely on the behaviour itself and not on the individual's own positioning of their dyslexia or the social context associated with the act. There is an onus on all students with dyslexia to self-monitor how this aspect of their identity interacts with their professional duty of care. PMID:25849235

  12. 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

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

    2014-01-01

    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 (2004–2012) 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

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

    PubMed Central

    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

    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

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

    PubMed

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

    2016-02-01

    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

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

    PubMed Central

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

    2013-01-01

    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 person’s 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

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

    PubMed

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

    2014-02-01

    Younger Black men who have sex with men (BMSM) ages 16-29 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 1.58-6.45 and aOR 3.83; 95 % CI 1.23-11.95, 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

  17. Neuropsychiatric aspects of HIV-1 infection in gay men: controlled investigation of psychiatric, neuropsychological and neurological status.

    PubMed

    Riccio, M; Pugh, K; Jadresic, D; Burgess, A; Thompson, C; Wilson, B; Lovett, E; Baldeweg, T; Hawkins, D A; Catalan, J

    1993-12-01

    The aim of this study was to determine whether HIV infection is associated with psychiatric morbidity or neuropsychological impairment in asymptomatic and early symptomatic stages of disease in gay men. The subjects were 100 gay men (68 HIV-ve, 32 HIV+ve, 6 being CDC IV). All subjects were recruited at the time of requesting their first HIV test and the assessment was double-blind to HIV serostatus. There were no differences in psychiatric status or neuropsychological performance between the HIV-ve and HIV+ve groups. Multiple regression analysis and logistic regression were used to identify factors associated with psychiatric morbidity, neuropsychological impairment and subjective reporting of memory problems and physical symptoms for all 100 subjects. Previous psychiatric history and current illegal (non-dependent) drug use were associated with psychiatric morbidity, poor education was associated with neuropsychological impairment and psychiatric status (score on HAD and PSE) was associated with subjective reporting of memory problems and physical symptoms. PMID:8301622

  18. HIV/AIDS-related stigma in South African alcohol-serving venues and its potential impact on HIV disclosure, testing and treatment-seeking behaviours.

    PubMed

    Velloza, Jennifer; Watt, Melissa H; Choi, Karmel W; Abler, Laurie; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree; Sikkema, Kathleen J

    2015-10-01

    Alcohol-serving venues in South Africa are sites for high-risk behaviours that may lead to HIV transmission. Prevention and treatment interventions are sorely needed in these settings, but HIV-related stigma may limit their effectiveness. This study explored expressions of stigma among alcohol-serving venue patrons in Cape Town and examined the potential impact of stigma on HIV disclosure, testing and treatment-seeking behaviours. A total of 92 in-depth interviews with male and female, black and coloured patrons were conducted. Transcripts were analysed via memo-writing and diagramming techniques. Many participants mentioned knowing other patrons living with HIV/AIDS (PLWH), and this visibility of HIV impacted expressions of HIV-related stigma. Participants discussed four forms of HIV-related stigma in the venues: fearing PLWH, fearing HIV acquisition, blaming others for spreading HIV and isolating PLWH. HIV visibility and expressions of HIV-related stigma, particularly fear of isolation, influenced participants' willingness to disclose their status. HIV-related stigma in the venues also appeared to indirectly influence testing and treatment-seeking behaviour outside the venue. Results suggest that efforts to change norms and reduce expressions of HIV-related stigma in alcohol-serving venues are necessary to successfully deliver tailored HIV prevention interventions and increase uptake of HIV testing and care in this important social setting. PMID:25630531

  19. Knowledge and perceptions of sexual and reproductive health and HIV among perinatally HIV-infected adolescents in rural China.

    PubMed

    Mu, Weiwei; Zhao, Yan; Khoshnood, Kaveh; Cheng, Yuewu; Sun, Xin; Liu, Xia; Xu, Wenqing; Wang, Shuiwang; Ma, Ye; Zhang, Fujie

    2015-09-01

    Due to the success of highly active antiretroviral therapy, more children infected with HIV perinatally are living to adolescence. This brings new challenges on sexual and reproductive health (SRH) needs and psychosocial support specific to adolescents. To improve such efforts on long-term care of this vulnerable population, we assessed SRH and HIV knowledge and perceptions among perinatally HIV-infected adolescents (PHIVA). This descriptive cross-sectional study was conducted between July and September 2013 in a rural HIV clinic. A structured questionnaire focusing on SRH and HIV was administered to 124 PHIVA attending quarterly medical visit. Multivariable logistic regression was used to detect associated factors with knowledge acquisition. Among participants, 79% had never discussed puberty development or sexuality with parents. Over 50% had never heard of condoms and 20% reported not having any informational source of SRH and HIV knowledge. Only 5% correctly answered all questions regarding HIV knowledge and pregnancy, with 18% correctly answered questions regarding contraception. Adolescents older than age of 15 and who had been disclosed of HIV status were more likely to acquire correct knowledge of SRH and HIV. Most PHIVA did not report having access to comprehensive information on SRH and HIV, in part because of the early death of caretakers or unfavorable family status. Further integration of SRH services with HIV treatment programs is needed to provide comprehensive care for adolescents and prepare them for the transition to adult care. PMID:25894204

  20. To tell or not to tell: South African women’s disclosure of HIV status during pregnancy

    PubMed Central

    Visser, Maretha J.; Neufeld, Sharon; de Villiers, Annelize; Makin, Jennifer D.; Forsyth, Brian W.C.

    2014-01-01

    HIV-positive pregnant women often do not disclose their serostatus to their partners, family and friends, creating potential barriers to preventing sexual transmission to partners and mother-to-child transmission through breastfeeding. This research explores recently diagnosed HIV-positive pregnant women’s reasons for disclosure and non-disclosure of serostatus to various members of their social networks, as well as the consequences of their disclosure. Data were collected through open-ended questions as part of a semi-structured interview with 293 recently diagnosed HIV-positive pregnant women recruited from antenatal clinics in two townships in Tshwane, South Africa. A content analysis of responses showed that women weighed fear of abandonment and discrimination against their desire to raise risk awareness and their need for support. Partners most often responded to disclosure with disbelief and shock, whereas parents frequently exhibited emotional distress, but were still supportive, as were other relatives and friends. The women subsequently experienced low levels of adverse consequences after disclosure. The results can assist health care providers in understanding the complexity of pregnant women’s decisions to disclose to various members of their social networks and emphasize the need for continued counselling and support. PMID:18825520

  1. “KNOW YOUR STATUS”: RESULTS FROM A NOVEL, STUDENT-RUN HIV TESTING INITIATIVE ON COLLEGE CAMPUSES

    PubMed Central

    Milligan, Caitlin; Cuneo, C. Nicholas; Rutstein, Sarah E.; Hicks, Charles

    2015-01-01

    Know Your Status (KYS), a novel, student-run program offered free HIV-testing at a private university (PU) and community college (CC). Following completion of surveys of risk behaviors/reasons for seeking testing, students were provided with rapid, oral HIV-testing. We investigated testing history, risk behaviors, and HIV prevalence among students tested during the first three years of KYS. In total, 1408 tests were conducted, 5 were positive: 4/408 CC, 1/1000 PU (1% vs. 0.1%, p = 0.01). Three positives were new diagnoses, all black men-who-have-sex-with-men (MSM). Over 50% of students were tested for the first time and 59% reported risk behaviors. CC students were less likely to have used condoms at last sex (a surrogate for risk behavior) compared to PU (OR 0.73, CI [0.54, 0.98]). Race, sexual identity, and sex were not associated with condom use. These results demonstrate that KYS successfully recruited large numbers of previously untested, at-risk students, highlighting the feasibility and importance of testing college populations. PMID:25068179

  2. "Know Your Status": results from a novel, student-run HIV testing initiative on college campuses.

    PubMed

    Milligan, Caitlin; Cuneo, C Nicholas; Rutstein, Sarah E; Hicks, Charles

    2014-08-01

    Know Your Status (KYS), a novel, student-run program offered free HIV-testing at a private university (PU) and community college (CC). Following completion of surveys of risk behaviors/reasons for seeking testing, students were provided with rapid, oral HIV-testing. We investigated testing history, risk behaviors, and HIV prevalence among students tested during the first three years of KYS. In total, 1408 tests were conducted, 5 were positive: 4/408 CC, 1/1000 PU (1% vs. 0.1%, p=0.01). Three positives were new diagnoses, all black men-who-have-sex-with-men (MSM). Over 50% of students were tested for the first time and 59% reported risk behaviors. CC students were less likely to have used condoms at last sex (a surrogate for risk behavior) compared to PU (OR 0.73, CI [0.54, 0.98]). Race, sexual identity, and sex were not associated with condom use. These results demonstrate that KYS successfully recruited large numbers of previously untested, at-risk students, highlighting the feasibility and importance of testing college populations. PMID:25068179

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

    ERIC Educational Resources Information Center

    Kukka, Christine

    2004-01-01

    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…

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

    PubMed Central

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

    2011-01-01

    Objective The Teaching, Raising, And Communicating with Kids (TRACK) program was a longitudinal pilot-trial intervention designed to assist mothers living with HIV (MLH) 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 control; the intervention group had three individual sessions and one follow-up phone call. The sessions focused on preparing MLH for disclosure through behavioral exercises utilizing Derlaga’s model of HIV-disclosure. Both MLH and their child were assessed across multiple time-points (baseline, 3-, 6-, and 9-months) regarding disclosure of HIV status, and specific outcome variables (i.e., relationship context, mother’s health, child’s mental health, and family outcomes). Results MLH in the intervention group were six times more likely to disclose their HIV status than those in the control group (O.R. 6.33, 95% C.I.: 1.64 – 24.45), with 33% disclosing in the intervention group compared to 7.3% in the control group. MLHs in the intervention group showed increases in disclosure self-efficacy across time, increased communication with their child, and improvement in emotional functioning. Children of MLHs in the intervention group exhibited reductions in depression and anxiety, and increases in happiness. Conclusions TRACK was found to be successful in helping MLH disclose their HIV status to their children, with positive outcomes noted for both MLH and their children. PMID:21355637

  5. [HIV disclosure in polygamous settings in Senegal].

    PubMed

    Sow, Khoudia

    2013-07-01

    In Senegal, where HIV prevalence is less than 1% and stigma remains important, 40% of marriages are polygamic. The purpose of this article is to describe and analyze the motivations, benefits and constraints related to HIV disclosure, and to explore specific situations related to polygamy. Data were collected through qualitative research based on in-depth repeated interviews on the experience of antiretroviral therapy and its social effects, conducted over a period of 10 years with people on antiretroviral treatment and their caregivers. Health professionals encourage people to disclose their HIV status, especially in certain circumstances such as preventing mother-to-child transmission of HIV. Nevertheless they are aware of the social risks for some patients, particularly women. Some health workers insist on disclosure, while others do not interfere with women who do not disclose to their partner, while highlighting their ethical dilemma. Interviews trace the changing attitudes of caregivers regarding disclosure. The majority of married women begin by sharing their HIV status with their mother, waiting for her to confirm that the contamination is not due to immoral behavior and to participate in implementing a strategy to maintain secrecy. In polygamous households, women try to disclose to their partner, keeping the secret beyond the couple. Some women fear disclosure by their husbands to co-spouses, whose attitudes can be very diverse: some stories relate collective rejection from the household; sometimes disclosure is made in a progressive way following the hierarchy of positions of each person in the household; another person reported the solidarity shown by her co-spouses who kept her HIV status a secret outside the household. The article shows the diversity of situations and their dynamics regarding both disclosure practices and their social effects. PMID:23844800

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

    PubMed Central

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

    2014-01-01

    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

  7. Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa

    PubMed Central

    Nöstlinger, Christiana; Bakeera-Kitaka, Sabrina; Buyze, Jozefien; Loos, Jasna; Buvé, Anne

    2015-01-01

    Adolescents living with HIV (ALHIV) face many psychosocial challenges, including HIV disclosure to others. Given the importance of socialization during the adolescent transition process, this study investigated the psychological and social factors influencing self-disclosure of own HIV status to peers. We examined social HIV self-disclosure to peers, and its relationship to perceived HIV-related stigma, self-efficacy to disclose, self-esteem, and social support among a sample of n = 582 ALHIV aged 13–17 years in Kampala, Uganda, and Western Kenya. Data were collected between February and April 2011. Among them, 39% were double orphans. We conducted a secondary data analysis to assess the degree of social disclosure, reactions received, and influencing factors. Interviewer-administered questionnaires assessed medical, socio-demographic, and psychological variables (Rosenberg self-esteem scale; self-efficacy to disclose to peers), HIV-related stigma (10-item stigma scale), and social support (family–life and friends). Descriptive, bivariate, and logistic regression analyses were performed with social self-disclosure to peers with gender as covariates. Almost half of ALHIV had told nobody (except health-care providers) about their HIV status, and about 18% had disclosed to either one of their friends, schoolmates, or a boy- or girlfriend. Logistic regression models revealed that having disclosed to peers was significantly related to being older, being a paternal orphan, contributing to family income, regular visits to the HIV clinic, and greater social support through peers. Low self-efficacy to disclose was negatively associated to the outcome variable. While social self-disclosure was linked to individual factors such as self-efficacy, factors relating to the social context and adolescents’ access to psychosocial resources play an important role. ALHIV need safe environments to practice disclosure skills. Interventions should enable them to make optimal use of available psychosocial resources even under constraining conditions such as disruptive family structures. PMID:26616124

  8. Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa.

    PubMed

    Nöstlinger, Christiana; Bakeera-Kitaka, Sabrina; Buyze, Jozefien; Loos, Jasna; Buvé, Anne

    2015-12-01

    Adolescents living with HIV (ALHIV) face many psychosocial challenges, including HIV disclosure to others. Given the importance of socialization during the adolescent transition process, this study investigated the psychological and social factors influencing self-disclosure of own HIV status to peers. We examined social HIV self-disclosure to peers, and its relationship to perceived HIV-related stigma, self-efficacy to disclose, self-esteem, and social support among a sample of n = 582 ALHIV aged 13-17 years in Kampala, Uganda, and Western Kenya. Data were collected between February and April 2011. Among them, 39% were double orphans. We conducted a secondary data analysis to assess the degree of social disclosure, reactions received, and influencing factors. Interviewer-administered questionnaires assessed medical, socio-demographic, and psychological variables (Rosenberg self-esteem scale; self-efficacy to disclose to peers), HIV-related stigma (10-item stigma scale), and social support (family-life and friends). Descriptive, bivariate, and logistic regression analyses were performed with social self-disclosure to peers with gender as covariates. Almost half of ALHIV had told nobody (except health-care providers) about their HIV status, and about 18% had disclosed to either one of their friends, schoolmates, or a boy- or girlfriend. Logistic regression models revealed that having disclosed to peers was significantly related to being older, being a paternal orphan, contributing to family income, regular visits to the HIV clinic, and greater social support through peers. Low self-efficacy to disclose was negatively associated to the outcome variable. While social self-disclosure was linked to individual factors such as self-efficacy, factors relating to the social context and adolescents' access to psychosocial resources play an important role. ALHIV need safe environments to practice disclosure skills. Interventions should enable them to make optimal use of available psychosocial resources even under constraining conditions such as disruptive family structures. PMID:26616124

  9. Burden of HIV among primary school children and feasibility of primary school-linked HIV testing in Harare, Zimbabwe: a mixed methods study.

    PubMed

    Bandason, Tsitsi; Langhaug, Lisa F; Makamba, Memory; Laver, Sue; Hatzold, Karin; Mahere, Stephen; Munyati, Shungu; Mungofa, Stanley; Corbett, Elizabeth L; Ferrand, Rashida A

    2013-01-01

    Population-based surveys in Southern Africa suggest a substantial burden of undiagnosed HIV-infected long-term survivors of mother-to-child transmission. We conducted an HIV prevalence survey of primary school pupils in Harare, Zimbabwe, and evaluated school-linked HIV counselling and testing (HCT) for pupils, their families and schoolteachers. Population-weighted cluster sampling was used to select six primary schools. Randomly selected class-grade pupils underwent anonymous HIV testing, with concurrent school-linked family HCT offered during the survey. Focus group discussions and interviews were conducted with pupils, parents/guardians, counsellors, and schoolteachers. About 4386 (73%) pupils provided specimens for anonymous HIV testing. Median age was 9 years (IQR 8-11), and 54% were female. HIV prevalence was 2.7% (95% CI: 2.2-3.1) with no difference by gender. HIV infection was significantly associated with orphanhood, stunting, wasting, and being one or more class grades behind in school due to illness (p<0.001). After adjusting for covariates, orphanhood and stunting remained significantly associated with being HIV positive (p<0.001). Uptake of diagnostic HIV testing by pupils was low with only 47/4386 (1%) pupils undergoing HCT. The HIV prevalence among children under 15 years who underwent HIV testing was 6.8%. The main barrier to HIV testing was parents' fear of their children experiencing stigma and of unmasking their own HIV status should the child test HIV positive. Most guardians believed that a child's HIV-positive result should not be disclosed and the child could take HIV treatment without knowing the reason. Increased recognition of the high burden of undiagnosed HIV infection in children is needed. Despite awareness of the benefits of HIV testing, HIV-related stigma still dominates parents/guardians' psychological landscape. There is need for comprehensive information and support for families to engage with HIV testing services. PMID:23528004

  10. Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

    PubMed Central

    2012-01-01

    Background Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed. Methods A cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART) in Abidjan, Côte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model. Results The frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0) in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1) in the 1,047 HIV-negative ones (p < 10-4). In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23)] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08)]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (p < 10-4). Conclusion The higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure. PMID:22443255

  11. The Relationship Between Online Social Network Use, Sexual Risk Behaviors, and HIV Sero-Status Among a Sample of Predominately African American and Latino Men Who have Sex with Men (MSM) Social Media Users.

    PubMed

    Chiu, ChingChe J; Young, Sean D

    2015-06-01

    Social networking technologies have emerged as potential platforms to reach HIV(+) MSM in HIV interventions. This study sought to compare use of online social networking sites (SNSs) and sexual risk behaviors between HIV(+) and HIV(-) individuals among a sample of predominately African American and Latino SNS-using MSM. A total of 112 MSM Facebook users were recruited online and offline and completed an online survey. We performed regression models to assess the association between HIV status, SNS use, and sexual risk behaviors. After adjusting for age, race, and employment status, being HIV positive was significantly associated with a greater number of sexual partners (ARR = 2.84, p = 0.0017) and lower comfort levels of discussing HIV/STI status on SNSs (AOR: 0.23, p = 0.011). Findings suggest that HIV status is associated with sexual risk behaviors and SNS use among SNS-using MSM. We discuss the implications for online HIV prevention. PMID:25572831

  12. Evaluation of Cervical Cancer Screening Programs in Côte d’Ivoire, Guyana, and Tanzania: Effect of HIV Status

    PubMed Central

    Estep, Deb; Besana, Giulia; Kibwana, Sharon; Varallo, John; Sun, Kai; Lu, Enriquito

    2015-01-01

    Background HIV infection increases a woman’s risk for cervical cancer, and cervical cancer incidence and mortality rates are higher in countries with high HIV prevalence and limited resources for screening. Visual inspection with acetic acid (VIA) allows screening and treatment of cervical lesions in a single-visit approach (SVA), but data on its performance in HIV-infected women are limited. This study’s objective was to examine cervical cancer screening using VIA/SVA in programs serving HIV-infected women. Methods A VIA/SVA program with cryotherapy for VIA-positive lesions was implemented in Côte d’Ivoire, Guyana, and Tanzania from 2009 to 2012. The effect of HIV status on VIA positivity and on presence of cryotherapy-eligible lesions was examined using a cross-sectional study design, with Chi-square tests for comparisons and constructed multivariate logistic regression models. A P-value of < 0.05 was significant. Findings VIA was performed on 34,921 women, 10% (3,580) were VIA positive; 2,508 (85%) eligible women received cryotherapy during the same visit; only 234 (52%) of those who postponed returned for treatment; 622 (17%) VIA-positive women had lesions too large to be treated with cryotherapy and were referred for excisional treatment. In multivariate analysis—controlling for HIV status, location of the screening clinic, facility location, facility type, and country—compared to HIV-uninfected/unknown women, HIV-infected women had higher odds of being VIA positive (OR 1.95, 95% CI 1.76, 2.16, P<0.0001) and of having large lesions requiring referral (OR 1.93, 95% CI 1.49, 2.51, P< 0.0001). Minor treatment complications occurred in 19 of 3,032 (0.63%) women; none required further intervention. Conclusions This study found that compared to HIV-uninfected/unknown women, HIV-infected women had nearly twice the odds of being VIA-positive and to require referral for large lesions. SVA was safe and resulted in significant reductions in loss to follow-up. There is increased need for excisional treatment in countries with high HIV prevalence. PMID:26405784

  13. Payer Status, Race/Ethnicity, and Acceptance of Free Routine Opt-Out Rapid HIV Screening Among Emergency Department Patients

    PubMed Central

    Hopkins, Emily; Sasson, Comilla; Al-Tayyib, Alia; Bender, Brooke; Haukoos, Jason S.

    2012-01-01

    Objectives. We estimated associations between payer status, race/ethnicity, and acceptance of nontargeted opt-out rapid HIV screening in the emergency department (ED). Methods. We analyzed data from a prospective clinical trial between 2007 and 2009 at Denver Health. Patients in the ED were offered free HIV testing. Patient demographics and payer status were collected, and we used multivariable logistic regression to estimate associations with HIV testing acceptance. Results. A total of 31?525 patients made 44?765 unique visits: 40% were White, 37% Hispanic, 14% Black, 1% Asian, and 7% unknown race/ethnicity. Of all visits, 10?237 (23%) agreed to HIV testing; 27% were self-pay, 23% state-sponsored, 18% Medicaid, 13% commercial insurance, 12% Medicare, and 8% another payer source. Compared with commercial insurance patients, self-pay patients (odds ratio [OR]?=?1.63; 95% confidence interval [CI]?=?1.51, 1.75), state-sponsored patients (OR?=?1.64; 95% CI?=?1.52, 1.77), and Medicaid patients (OR?=?1.24; 95% CI?=?1.14, 1.34) had increased odds of accepting testing. Compared with White patients, Black (OR?=?1.29; 95% CI?=?1.21, 1.38) and Hispanic (OR?=?1.17; 95% CI?=?1.11, 1.23) patients had increased odds of accepting testing. Conclusions. Many ED patients are uninsured or subsidized through government programs and are more likely to consent to free rapid HIV testing. PMID:22420816

  14. FRAILTY, FOOD INSECURITY, AND NUTRITIONAL STATUS IN PEOPLE LIVING WITH HIV

    PubMed Central

    SMIT, E.; WANKE, C.; DONG, K.; GROTHEER, A.; HANSEN, S.; SKINNER, S.; TANG, A.M.

    2015-01-01

    Background Nutritional status and food insecurity are associated with frailty in the general U.S. population, yet little is known about this in the aging population of people living with HIV (PLWH). Objectives Given the potential importance of nutrition and the amenability to intervention, we examined the association between nutritional status, food insecurity, and frailty in PLWH. Design Cross sectional study. Setting Boston, Massachusetts, U.S.A. Participants 50 PLWH, age ?45 years, recruited from a cohort study examining risk factors for cardiovascular disease. Measurements Frailty, duration of HIV, use of antiretroviral therapy, disease history, food insecurity, physical function, and physical activity were assessed by questionnaire. Dietary intake was assessed using 3-day food records. Blood was drawn for CD4+ cell count, hemoglobin, hematocrit, and lipid levels. Physical measurements included height, weight, and skinfold thickness. Results The prevalence of frailty was 16% (n=8), 44% were pre-frail (n=22) and 40% were not frail (n=20). The number of reported difficulties with 20 activities of daily living was highest in frail (mean 10.4±3.9 SD), followed by pre-frail (6.5±4.6), and lowest in not frail participants (2.0±2.3). Seven (88%) of the frail PLWH lost weight with an average weight loss of 22.9 pounds; 6 (75%) reported unintentional weight loss, and all 6 of these met the frailty criteria for weight loss of 10 or more pounds. Nine (45%) of the not frail PLWH reported losing weight with an average weight loss of 6.2 pounds; 5 (23%) reported unintentional weight loss of <10 pounds. Frail PLWH were more likely to report being food insecure than not frail PLWH (63% vs. 10%, p=0.02), and tended to have lower energy intake than not frail PLWH. Conclusion Research is needed on targeted interventions to improve food security and activities of daily living in PLWH for both the prevention and improvement of frailty. PMID:26689809

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  17. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

    PubMed Central

    Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

    2016-01-01

    Background. Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking “upstream” economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual’s control that affect housing and residential environments and the health resources or risk exposures such contexts provide. Objectives. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. Search methods. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. Selection criteria. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in high-income countries. We defined housing status to include consideration of material or social dimensions of housing adequacy, stability, and security of tenure. Data collection and analysis. Two independent reviewers performed data extraction and quality appraisal. We used the Cochrane Risk of Bias Tool for randomized controlled trials and a modified version of the Newcastle Ottawa Quality Appraisal Tool for nonintervention studies. In our quality appraisal, we focused on issues of quality for observational studies: appropriate methods for determining exposure and measuring outcomes and methods to control confounding. Results. Searches yielded 5528 references from which we included 152 studies, representing 139?757 HIV-positive participants. Most studies were conducted in the United States and Canada. Studies examined access and utilization of HIV medical care, adherence to antiretroviral medications, HIV clinical outcomes, other health outcomes, emergency department and inpatient utilization, and sex and drug risk behaviors. With rare exceptions, across studies in all domains, worse housing status was independently associated with worse outcomes, controlling for a range of individual patient and care system characteristics. Conclusions. Lack of stable, secure, adequate housing is a significant barrier to consistent and appropriate HIV medical care, access and adherence to antiretroviral medications, sustained viral suppression, and risk of forward transmission. Studies that examined the history of homelessness or problematic housing years before outcome assessment were least likely to find negative outcomes, homelessness being a potentially modifiable contextual factor. Randomized controlled trials and observational studies indicate an independent effect of housing assistance on improved outcomes for formerly homeless or inadequately housed people with HIV. Housing challenges result from complex interactions between individual vulnerabilities and broader economic, political, and legal structural determinants of health. The broad structur

  18. “It’s My Secret”: Fear of Disclosure among Sub-Saharan African Migrant Women Living with HIV/AIDS in Belgium

    PubMed Central

    Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald

    2015-01-01

    Patients with HIV not only have to deal with the challenges of living with an incurable disease but also with the dilemma of whether or not to disclose their status to their partners, families and friends. This study explores the extent to which sub-Saharan African (SSA) migrant women in Belgium disclose their HIV positive status, reasons for disclosure/non-disclosure and how they deal with HIV disclosure. A qualitative study consisting of interviews with twenty-eight SSA women with HIV/AIDS was conducted. Thematic content analysis was employed to identify themes as they emerged. Our study reveals that these women usually only disclose their status to healthcare professionals because of the treatment and care they need. This selective disclosure is mainly due to the taboo of HIV disease in SSA culture. Stigma, notably self-stigma, greatly impedes HIV disclosure. Techniques to systematically incorporate HIV disclosure into post-test counseling and primary care services are highly recommended. PMID:25781906

  19. Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review

    PubMed Central

    Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

    2015-01-01

    Introduction Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. Methods We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. Results Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. Conclusions The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe disclosure outcomes is needed to guide programme planners and policy makers. PMID:26643462

  20. Exploring risk of experiencing intimate partner violence after HIV infection: a qualitative study among women with HIV attending postnatal services in Swaziland

    PubMed Central

    Mulrenan, Claire; Colombini, Manuela; Kikuvi, Joshua; Mayhew, Susannah H

    2015-01-01

    Objective To explore risks of experiencing intimate partner violence (IPV) after HIV infection among women with HIV in a postnatal care setting in Swaziland. Design A qualitative semistructured in-depth interview study, using thematic analysis with deductive and inductive coding, of IPV experiences after HIV infection extracted from service-integration interview transcripts. Setting Swaziland. Participants 19 women with HIV, aged 18–44, were purposively sampled for an in-depth interview about their experiences of services, HIV and IPV from a quantitative postnatal cohort participating in an evaluation of HIV and reproductive health services integration in Swaziland. Results Results indicated that women were at risk of experiencing IPV after HIV infection, with 9 of 19 disclosing experiences of physical violence and/or coercive control post-HIV. IPV was initiated through two key pathways: (1) acute interpersonal triggers (eg, status disclosure, mother-to-child transmission of HIV) and (2) chronic normative tensions (eg, fertility intentions, initiating contraceptives). Conclusions The results highlight a need to mitigate the risk of IPV for women with HIV in shorter and longer terms in Swaziland. While broader changes are needed to resolve gender disparities, practical steps can be institutionalised within health facilities to reduce, or avoid increasing, IPV pathways for women with HIV. These might include mutual disclosure between partners, greater engagement of Swazi males with HIV services, and promoting positive masculinities that support and protect women. Trial registration number NCT01694862. PMID:25976760

  1. Racial differences in the accuracy of perceived partner HIV status among men who have sex with men (MSM) in Atlanta, Georgia.

    PubMed

    Grey, Jeremy A; Rothenberg, Richard; Sullivan, Patrick S; Rosenberg, Eli S

    2015-01-01

    We compared perceptions of partner HIV status to HIV test results in a cross-sectional study of sexual networks of men who have sex with men (MSM) in Atlanta. We then examined differences between black and white MSM in the predictive value of perceived partner status. We recruited men ("seeds") using time-space venue sampling. These seeds then referred up to three partners, who could also refer partners. All participants reported sexual behavior and HIV status for recent partners and received HIV tests. For partners who enrolled, we compared laboratory diagnoses to their partner's perception of their status. Black MSM who perceived themselves to be HIV negative were more likely than perceived-negative white MSM to have a positive partner among those they perceived to be HIV negative or whose status was unknown to them (OR=6.6). Furthermore, although frequency of unprotected anal intercourse (UAI) was similar by race, black men were more likely to have had UAI with an unknown-positive partner (OR=9.3). PMID:25348797

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

    PubMed Central

    Contri, Patricia Viganó; Berchielli, Érica Miranda; Tremeschin, Marina Hjertquist; de Moura Negrini, Bento Vidal; Salomão, Roberta Garcia; Monteiro, Jacqueline Pontes

    2011-01-01

    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: 153 mg/dl (30–344); 138 (58–378) versus G2: 76 mg/dl (29–378); 76 (29–378)]. After 6 months of follow-up, G1 had higher LDL-cholesterol than G2 [104 mg/dl (40–142) versus 82 (42–145)]. 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

  3. Sexual Negotiation and HIV Serodisclosure among Men who Have Sex with Men with Their Online and Offline Partners

    PubMed Central

    Oakes, J. Michael; Rosser, B. R.Simon

    2008-01-01

    The aim of this study was to examine online profile and in-person communication patterns and their associations with unprotected anal intercourse (UAI) in online and offline partnerships between men who have sex with men (MSM) who have never tested for HIV (“Never Tested”), had been tested at least once for HIV (“Tested”), and had tested positive for HIV. Between September and November 2005, 2,716 MSM participated in a one-time online survey. Although 75% and 72% of the Tested and Never Tested groups disclosed a HIV-negative status in all of their online profiles, 17% of HIV-positive participants did so. Exchanging HIV status information was highest among the Tested group, while HIV-positive men were most likely to negotiate UAI. Serodisclosure was not an independent predictor of UAI, although making an explicit agreement to engage in UAI was. Sexual communication and risk-taking patterns differed by testing status. Explicit agreements to avoid UAI were associated with reduced sexual risk-taking. Misrepresentation of HIV status is an identified challenge for HIV prevention. PMID:18649141

  4. Ascertaining partner HIV status and its association with sexual risk behavior among Internet-using men who have sex with men

    PubMed Central

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

    2012-01-01

    The aims of this study were to understand strategies and consistency of strategy used by HIV-negative and HIV-positive men who have sex with men (MSM) to ascertain the HIV status of their male sexual partners and their associations with unprotected anal intercourse (UAI) and serodiscordant UAI (SDUAI) in the past 3 months. Participants (n=640) completed an online survey in December 2007. The most commonly reported strategy was checking online profiles (85%), followed by talking before sex (82%), talking after sex (42%), and guessing (29%). Adjusting for demographic and behavioral factors, guessing the HIV status of sex partners was associated with greater UAI (IRR=1.18) and SDUAI (IRR =2.651) partners, as was using an inconsistent strategy (UAI: IRR=1.36; SDUAI: IRR=1.94). Ascertaining HIV status before having sex was associated with fewer SDUAI partners (IRR=0.32). Prevention should target MSM who guess the HIV status of their sex partners and emphasize explicit safer sex agreements. PMID:19921419

  5. HIV testing in re-education through labour camps in Guangxi Autonomous Region, China (a cross-sectional survey)

    PubMed Central

    Yap, Lorraine; Reekie, Joanne; Liu, Wei; Chen, Yi; Wu, Zunyou; Li, Jianghong; Zhang, Lei; Wand, Handan; Donovan, Basil; Butler, Tony

    2015-01-01

    Objective HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studies have reported on the process. Methods The survey response rate was 100% although 29 detainees were excluded because they were under 18 years of age. A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, located in the south-western region of China. Results Of the 755 detainees surveyed, 725 (96%) reported having a blood test in the labour camps of whom 493 (68%) thought this included an HIV test. 61 detainees self-reported they were HIV infected, their status confirmed by medical records, if available. Of these, 53 (87%) recalled receiving post-test HIV education, and 15 (25%) were currently receiving HIV antiretroviral therapy. Pretest education on HIV was provided to 233/725 (32%) detainees. The study further reports on detainees’ reactions and feelings towards non-disclosure and disclosure of their HIV test results in the labour camps. Conclusions Mandatory testing is almost universal in the labour camps although a proportion of detainees were unaware that this included an HIV test. HIV test results should be disclosed to all labour camp detainees to reduce their distress of not knowing and prevent misconceptions about their HIV status. Labour camps provide another opportunity to implement universal treatment (‘Test and Treat’) to prevent the spread of HIV. PMID:25739879

  6. 'I am doing fine only because I have not told anyone': the necessity of concealment in the lives of people living with HIV in India.

    PubMed

    George, Mathew Sunil; Lambert, Helen

    2015-01-01

    In HIV prevention and care programmes, disclosure of status by HIV-positive individuals is generally encouraged to contain the infection and provide adequate support to the person concerned. Lack of disclosure is generally framed as a barrier to preventive behaviours and accessing support. The assumption that disclosure is beneficial is also reflected in studies that aim to identify determinants of disclosure and recommend individual-level measures to promote disclosure. However, in contexts where HIV infection is stigmatised and there is fear of rejection and discrimination among those living with HIV, concealment of status becomes a way to try and regain as much as possible the life that was disrupted by the discovery of HIV infection. In this study of HIV-positive women and children in India, concealment was considered essential by individuals and families of those living with HIV to re-establish and maintain their normal lives in an environment where stigma and discrimination were prevalent. This paper describes why women and care givers of children felt the need to conceal HIV status, the various ways in which people tried to do so and the implications for treatment of people living with HIV. We found that while women were generally willing to disclose their status to their husband or partner, they were very keen to conceal their status from all others, including family members. Parents and carers with an HIV-positive child were not willing to disclose this status to the child or to others. Understanding the different rationales for concealment would help policy makers and programme managers to develop more appropriate care management strategies and train care providers to assist clients in accessing care and support without disrupting their lives. PMID:25706959

  7. Barriers and Facilitators of HIV Disclosure: Perspectives from HIV-Infected Men Who Have Sex with Men

    PubMed Central

    Driskell, Jeffrey R.; Salomon, Elizabeth; Mayer, Kenneth; Capistrant, Benjamin; Safren, Steven

    2013-01-01

    HIV disclosure among sexually active HIV-infected men who have sex with men (MSM) is a complex phenomenon. To better understand factors that impact the decision-making process regarding HIV disclosure among HIV-infected MSM, the present study analyzed content from previously conducted counseling sessions where HIV disclosure was selected as the primary focus of the session. The counselor/participant dialogue was audio-recorded, transcribed, and analyzed qualitatively using content analysis. Factors identified as barriers that deter HIV-infected MSM from disclosing include rejection, issues of confidentiality, possible missed sexual opportunities, partner’s HIV status, deferred responsibility, sexual partner type, and public sex environments. Participants identified ethical obligation, the potential for a dating relationship, timing of disclosure, and bidirectional communication as facilitators of disclosure. Findings can be used for policy development as well as to guide social workers and other healthcare providers’ assessment and development of clinical interventions addressing sexual health among HIV-infected MSM as it relates to HIV disclosure. PMID:23671405

  8. Women’s HIV Disclosure to Immediate Family

    PubMed Central

    SEROVICH, JULIANNE M.; CRAFT, SHONDA M.; YOON, HAE-JIN

    2007-01-01

    Previous researchers have comprehensively documented rates of HIV disclosure to family at discrete time periods yet none have taken a dynamic approach to this phenomenon. The purpose of this study is to address the trajectory of HIV serostatus disclosure to family members over time. Time to disclosure was analyzed from data provided by 125 primarily single (48.8%), HIV-positive African American (68%) adult women. Data collection occurred between 2001 and 2006. Results indicated that women were most likely to disclose their HIV status within the first seven years after diagnosis, and mothers and sisters were most likely to be told. Rates of disclosure were not significantly impacted by indicators of disease progression, frequency of contact, physical proximity, or relationship satisfaction. The results of this study are discussed in comparison to previous disclosure research, and clinical implications are provided. PMID:18154493

  9. Tracking working status of HIV/AIDS-trained service providers by means of a training information monitoring system in Ethiopia

    PubMed Central

    McNabb, Marion E; Hiner, Cynthia A; Pfitzer, Anne; Abduljewad, Yassir; Nadew, Mesrak; Faltamo, Petros; Anderson, Jean

    2009-01-01

    Background The Federal Ministry of Health of Ethiopia is implementing an ambitious and rapid scale-up of health care services for the prevention, care and treatment of HIV/AIDS in public facilities. With support from the United States President's Emergency Plan for AIDS Relief, 38 830 service providers were trained, from early 2005 until December 2007, in HIV-related topics. Anecdotal evidence suggested high attrition rates of providers, but reliable quantitative data have been limited. Methods With that funding, Jhpiego supports a Training Information Monitoring System, which stores training information for all HIV/AIDS training events supported by the same funding source. Data forms were developed to capture information on providers' working status and were given to eight partners who collected data during routine site visits on individual providers about working status; if not working at the facility, date of and reason for leaving; and source of information. Results Data were collected on 1744 providers (59% males) in 53 hospitals and 45 health centres in 10 regional and administrative states. The project found that 32.6% of the providers were no longer at the site, 57.6% are still working on HIV/AIDS services at the same facility where they were trained and 10.4% are at the facility, but not providing HIV/AIDS services. Of the providers not at the facility, the two largest groups were those who had left for further study (27.6%) and those who had gone to another public facility (17.6%). Of all physicians trained, 49.2% had left the facility. Regional and cadre variation was found, for example Gambella had the highest percent of providers no longer at the site (53.7%) while Harari had the highest percentage of providers still working on HIV/AIDS (71.6%). Conclusion Overall, the project found that the information in the Training Information Monitoring System can be used to track the working status of trained providers. Data generated from the project are being shared with key stakeholders and used for planning and monitoring the workforce, and partners have agreed to continue collecting data. The attrition rates found in this project imply an increased need to continue to conduct in-service training for HIV/AIDS in the short term. For long-term solutions, retention strategies should be developed and implemented, and opportunities to accelerate the incorporation of HIV/AIDS training in pre-service institutions should be explored. Further study on reasons why providers leave sites and why providers are not working on HIV at the sites where they were trained, in addition to our project findings, can provide valuable data for development of national and regional strategies and retention schemes. Project findings suggest that the development of national and region-specific human resources for health strategy and policies could address important human resources issues found in the project. PMID:19338670

  10. Ending overly broad HIV criminalization: Canadian scientists and clinicians stand for justice.

    PubMed

    Kazatchkine, Cécile; Bernard, Edwin; Eba, Patrick

    2015-01-01

    In Canada, people living with HIV who do not disclose their HIV status prior to sexual acts risk prosecution for aggravated sexual assault even if they have sex with a condom or while having a low (or undetectable) viral load, they had no intent to transmit HIV, and no transmission occurred. In 2013, six distinguished Canadian HIV scientists and clinicians took ground-breaking action to advance justice by co-authoring the "Canadian consensus statement on HIV and its transmission in the context of the criminal law." This effort was born out of the belief that the application of criminal law to HIV non-disclosure was being driven by a poor appreciation of the science of HIV. More than 75 HIV scientists and clinicians Canada-wide have now endorsed the statement, agreeing that "[they] have a professional and ethical responsibility to assist those in the criminal justice system to understand and interpret current medical and scientific evidence regarding HIV." As some 61 countries have adopted laws that specifically allow for HIV criminalization, and prosecutions for HIV non-disclosure, exposure and transmission have been reported in at least 49 countries, the authors hope that others around the world will take similar action. PMID:26194348

  11. Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya.

    PubMed

    Vreeman, Rachel C; Scanlon, Michael L; Marete, Irene; Mwangi, Ann; Inui, Thomas S; McAteer, Carole I; Nyandiko, Winstone M

    2015-12-01

    Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, children's mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child's knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. PMID:26616121

  12. Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

    PubMed Central

    Vreeman, Rachel C.; Scanlon, Michael L.; Marete, Irene; Mwangi, Ann; Inui, Thomas S.; McAteer, Carole I.; Nyandiko, Winstone M.

    2015-01-01

    Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver–child dyads enrolled in the study, children’s mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child’s knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5–2.1), better WHO disease stage (OR 2.5, 95% CI 1.4–4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1–3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. PMID:26616121

  13. [Epidemiology of bacillary pulmonary tuberculosis according to HIV status of patients followed in the department of infectious diseases Conakry (Guinea)].

    PubMed

    Traoré, F A; Sako, F B; Sylla, D; Bangoura, M; Kpamy, D O; Traoré, M; Doumbouya, M; Sangare, I

    2014-12-01

    Despite many efforts of prevention and the availability of free treatment, TB/HIV co-infection is still rampant in Guinea. The objective of this study was to describe the epidemiology of smear positive pulmonary tuberculosis according to HIV status among patients hospitalized in the infectious diseases department of Conakry University Hospital. This was a descriptive and analytical retrospective study of patient records admitted for pulmonary tuberculosis from January 2003 to December 2012. During this period, 1953 cases of tuberculosis were collected of which 346 (17.7%) were smear positive. There was a marked male predominance (59.7%). The average age was 38 ± 11 years. The majority of patients originated from the suburbs of Conakry and its surrounding prefectures (76.7%). People without profession were most represented (40.7%). A level of primary education was the most frequently reported (39.7%). Out of 325 patients tested for HIV, the serology was positive in 185 patients (56.9%). A contact with a TB patient was reported in 21.4% of HIV negative patients, and in 6.5% of the HIV-positive group (p = 0.0006). There was no difference between the two groups regarding clinical signs and symptoms. The mean CD4 count was comparable in both groups (p = 0.05). Lethality was higher among co-infected patients (30.4% against 15.56%; p = 0.00037). Strengthening the prevention of TB among PLWHA by the administration of isoniazide seems necessary and warrants further study on this subject in Guinea. PMID:25256251

  14. Education and Nutritional Status of Orphans and Children of HIV-Infected Parents in Kenya

    ERIC Educational Resources Information Center

    Mishra, Vinod; Arnold, Fred; Otieno, Fredrick; Cross, Anne; Hong, Rathavuth

    2007-01-01

    We examined whether orphaned and fostered children and children of HIV-infected parents are disadvantaged in schooling, nutrition, and health care. We analyzed data on 2,756 children aged 0-4 years and 4,172 children aged 6-14 years included in the 2003 Kenya Demographic and Health Survey, with linked anonymous HIV testing, using multivariate…

  15. 31 CFR 1010.717 - Disclosing information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Disclosing information. 1010.717... § 1010.717 Disclosing information. (a) Any part of any administrative ruling, including names, addresses, or information related to the business transactions of private parties, may be disclosed pursuant...

  16. 31 CFR 1010.717 - Disclosing information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Disclosing information. 1010.717... § 1010.717 Disclosing information. (a) Any part of any administrative ruling, including names, addresses, or information related to the business transactions of private parties, may be disclosed pursuant...

  17. Disclosure of HIV serostatus among pregnant and postpartum women in sub-Saharan Africa: a systematic review.

    PubMed

    Tam, Melanie; Amzel, Anouk; Phelps, B Ryan

    2015-01-01

    Disclosure of one's HIV status can help to improve uptake and retention in prevention of mother-to-child transmission of HIV services; yet, it remains a challenge for many women. This systematic review evaluates disclosure rates among pregnant and postpartum women in sub-Saharan Africa, timing of disclosure, and factors affecting decisions to disclose. PubMed and EMBASE databases were searched to identify relevant studies published between January 2000 and April 2014. Rates of HIV serostatus disclosure to any person ranged from 5.0% to 96.7% (pooled estimate: 67.0%, 95% CI: 55.7%-78.3%). Women who chose to disclose their status did so more often to their partners (pooled estimate: 63.9%; 95% CI: 56.7%-71.1%) than to family members (pooled estimate: 40.1; 95% CI: 26.2%-54.0%), friends (pooled estimate: 6.4%; 95% CI: 3.0%-9.8%), or religious leaders (pooled estimate: 7.1%; 95% CI: 4.3%-9.8%). Most women disclosed prior to delivery. Decisions to disclose were associated with factors related to the woman herself (younger age, first pregnancies, knowing someone with HIV, lower levels of internalized stigma, and lower levels of avoidant coping), the partner (prior history of HIV testing and higher levels of educational attainment), their partnership (no history of domestic violence and financial independence), and the household (higher quality of housing and residing without co-spouses or extended family members). Interventions to encourage and support women in safely disclosing their status are needed. PMID:25636060

  18. HIV disclosure as practice and public policy

    PubMed Central

    Adam, Barry D.; Corriveau, Patrice; Elliott, Richard; Globerman, Jason; English, Ken; Rourke, Sean

    2015-01-01

    Responses to the largest surveys of HIV-positive people in Ontario show that most either disclose to or do not have partners who are HIV-negative or of unknown status. Non-disclosure strategies and assumptions are reported by relatively small sets of people with some variation according to employment status, sexual orientation, gender, ethnicity, and having had a casual partner. Interviews with 122 people living with HIV show that disclosure is an undertaking fraught with emotional pitfalls complicated by personal histories of having misread cues or having felt deceived leading up to their own sero-conversion, then having to negotiate a stigmatized status with new people. In gay communities, constructions of the self as individual actors in a marketplace of risk co-exist with the sexual etiquette developed throughout the AIDS era of care of the self and other through safer sex. Among heterosexual populations, notions of responsibility show some divergence by gender. The findings of this study suggest that the heightened pressure of criminal sanction on decision-making about disclosure in personal interactions does not address difficulties in HIV transmission and is unlikely to result in enhanced prevention. PMID:26339127

  19. Determination of HIV status of infants born to HIV-infected mothers: a review of the diagnostic methods with special focus on the applicability of p24 antigen testing in developing countries.

    PubMed

    Wessman, Maria J; Theilgaard, Zahra; Katzenstein, Terese L

    2012-03-01

    In 2009, 2.5 million children under the age of 15 y were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); 370,000 were diagnosed with HIV and 260,000 died due to AIDS. More than 90% of the children infected with HIV live in sub-Saharan Africa. Most children infected with HIV contract the infection in utero, during delivery, or via breast milk. This review outlines the current diagnostic methods to determine the HIV status of infants born to HIV-infected mothers. The HIV DNA and RNA polymerase chain reaction (PCR) tests are highly accurate and are recommended as the first-choice diagnostic methods. However, they are expensive and require complex laboratory procedures. Consequently, a search for less costly and complicated methods has led to the testing of p24 antigen analyses as an alternative to the gold-standard PCR tests, with encouraging results. The p24 antigen Perkin Elmer assay currently most often used has a sensitivity of 98.8% and a specificity of 100% (infants 6 weeks of age). Larger-scale studies should be performed in resource-limited settings to confirm these findings. PMID:22074445

  20. To disclose, or not to disclose? Context matters.

    PubMed

    Rahimzadeh, Vasiliki; Avard, Denise; Sénécal, Karine; Knoppers, Bartha Maria; Sinnett, Daniel

    2015-03-01

    Progress in understanding childhood disease using next-generation sequencing (NGS) portends vast improvements in the nature and quality of patient care. However, ethical questions surrounding the disclosure of incidental findings (IFs) persist, as NGS and other novel genomic technologies become the preferred tool for clinical genetic testing. Thus, the need for comprehensive management plans and multidisciplinary discussion on the return of IFs in pediatric research has never been more immediate. The aim of this study is to explore the views of investigators concerning the return of IFs in the pediatric oncology research context. Our findings reveal at least four contextual themes underlying the ethics of when, and how, IFs could be disclosed to participants and their families: clinical significance of the result, respect for individual, scope of professional responsibilities, and implications for the healthcare/research system. Moreover, the study proposes two action items toward anticipatory governance of IF in genetic research with children. The need to recognize the multiplicity of contextual factors in determining IF disclosure practices, particularly as NGS increasingly becomes a centerpiece in genetic research broadly, is heightened when children are involved. Sober thought should be given to the possibility of discovering IF, and to proactive discussions about disclosure considering the realities of young participants, their families, and the investigators who recruit them. PMID:24916647

  1. To disclose, or not to disclose? Context matters

    PubMed Central

    Rahimzadeh, Vasiliki; Avard, Denise; Sénécal, Karine; Knoppers, Bartha Maria; Sinnett, Daniel

    2015-01-01

    Progress in understanding childhood disease using next-generation sequencing (NGS) portends vast improvements in the nature and quality of patient care. However, ethical questions surrounding the disclosure of incidental findings (IFs) persist, as NGS and other novel genomic technologies become the preferred tool for clinical genetic testing. Thus, the need for comprehensive management plans and multidisciplinary discussion on the return of IFs in pediatric research has never been more immediate. The aim of this study is to explore the views of investigators concerning the return of IFs in the pediatric oncology research context. Our findings reveal at least four contextual themes underlying the ethics of when, and how, IFs could be disclosed to participants and their families: clinical significance of the result, respect for individual, scope of professional responsibilities, and implications for the healthcare/research system. Moreover, the study proposes two action items toward anticipatory governance of IF in genetic research with children. The need to recognize the multiplicity of contextual factors in determining IF disclosure practices, particularly as NGS increasingly becomes a centerpiece in genetic research broadly, is heightened when children are involved. Sober thought should be given to the possibility of discovering IF, and to proactive discussions about disclosure considering the realities of young participants, their families, and the investigators who recruit them. PMID:24916647

  2. Newcomer Status as a Protective Factor among Hispanic Migrant Workers for HIV Risk

    PubMed Central

    McCoy, H. Virginia; Shehadeh, Nancy; Rubens, Muni; Navarro, Christi M.

    2014-01-01

    The HIV rate among U.S. migrant workers is 10 times that of the national rate. The highly unstable lifestyle of migrant workers places them at heightened vulnerability to sexually transmitted infections; hence, there is a need to investigate the attitudes and sexual risk factors that may play a protective role in the transmission of HIV in this population. This study examines the association between attitudes and HIV risk behaviors among Hispanic male and female migrant workers (n?=?255) and their length of stay (shorter length of stay as a protective factor) in Immokalee, FL, USA. Pearson’s correlation and regression analyses were utilized to analyze the relationship between HIV risk behaviors (intention to use condoms and alcohol use) with length of stay in Immokalee. Longer length of stay positively correlated with number of drinks (p?HIV risk behaviors and having more favorable attitudes toward risk reduction than long-timers. This study might provide important new evidence on the drivers of multiple concurrent and potential protective factors against risky sexual behaviors among Hispanic migrant workers. PMID:25426480

  3. Optimism and Education Buffer the Effects of Syndemic Conditions on HIV Status among African American Men who Have Sex with Men

    PubMed Central

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

    2014-01-01

    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., 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

  4. Household food insecurity, maternal nutritional status, and infant feeding practices among HIV-infected Ugandan women receiving combination antiretroviral therapy

    PubMed Central

    YOUNG, Sera L.; PLENTY, Albert H. J.; LUWEDDE, Flavia A.; NATAMBA, Barnabas K.; NATUREEBA, Paul; ACHAN, Jane; MWESIGWA, Julia; RUEL, Theodore D.; ADES, Veronica; OSTERBAUER, Beth; CLARK, Tamara D.; DORSEY, Grant; CHARLEBOIS, Edwin D.; KAMYA, Moses; HAVLIR, Diane V.; COHAN, Deborah L.

    2015-01-01

    Objectives Household food insecurity may be a barrier to both optimal maternal nutritional status and infant feeding practices, but few studies have tested this relationship quantitatively, and never among HIV-infected individuals. We therefore explored if greater household food insecurity was associated with poorer maternal nutritional status, shorter duration of exclusive breastfeeding (EBF) and fewer animal-source complementary foods. Methods We assessed these outcomes among 180 HIV-infected pregnant and breastfeeding (BF) women receiving combination antiretroviral therapy in the PROMOTE trial (NCT00993031), a prospective, longitudinal cohort study in Tororo, Uganda. Results Household food insecurity was common; the prevalence of severe, moderate, and little to no household hunger was 7.3%, 40.5%, and 52.2%, respectively. Poor maternal nutritional status was common and women in households experiencing moderate to severe household hunger (MSHH) had statistically significantly lower BMIs at enrollment (21.3 vs 22.5, p<0.01) and prior to delivery (22.6 vs. 23.8, p<0.01). However, MSHH was not associated with maternal BMI or gestational weight gain in multivariate models. The prevalence (95% CI) of EBF at 6 months was 66.4% (59.0%-72.8%), and the proportion of women breastfeeding at 12 months was 80.0% (73.0%-85.3%).MSHH was not associated with EBF at 6 months or breastfeeding at 12 months. However, among those women still EBF at 4 months (81.0% of population), those experiencing MSHH were significantly more likely to cease EBF between 4 and 6 months (aHR: 2.52, 95% CI 1.03-6.19). Conclusions Interventions addressing household food insecurity, maternal malnutrition and suboptimal breastfeeding practices are urgently needed. PMID:24585398

  5. Perceptions Towards Condom Use, Sexual Activity, and HIV Disclosure among HIV-Positive African American Men Who Have Sex with Men: Implications for Heterosexual Transmission

    PubMed Central

    Harawa, Nina T.; Ramamurthi, Hema Codathi; Bingham, Trista A.

    2006-01-01

    Disproportionately high HIV/AIDS rates and frequent non-gay identification (NGI) among African American men who have sex with men or with both men and women (MSM/W) highlight the importance of understanding how HIV-positive African American MSM/W perceive safer sex, experience living with HIV, and decide to disclose their HIV status. Thirty predominately seropositive and non-gay identifying African American MSM/W in Los Angeles participated in three semi-structured focus group interviews, and a constant comparison method was used to analyze responses regarding condom use, sexual activity after an HIV diagnosis, and HIV serostatus disclosure. Condom use themes included its protective role against disease and pregnancy, acceptability concerns pertaining to aesthetic factors and effectiveness, and situational influences such as exchange sex, substance use, and suspicions from female partners. Themes regarding the impact of HIV on sexual activity included rejection, decreased partner seeking, and isolation. Serostatus disclosure themes included disclosure to selective partners and personal responsibility. Comprehensive HIV risk-reduction strategies that build social support networks, condom self-efficacy, communication skills, and a sense of collective responsibility among NGI African American MSM/W while addressing HIV stigma in the African American community as a whole are suggested. PMID:16736115

  6. 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

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

    2013-01-01

    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…

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

    PubMed Central

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

    2014-01-01

    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 IFN–based therapies in co-infected individuals. PMID:25007250

  8. The Reproductive Health Behaviors of HIV-Infected Young Women in the United States: A Literature Review

    PubMed Central

    Kraft, Joan M.; Hatfield-Timajchy, Kendra; Snead, Margaret C.; Ozeryansky, Larisa; Fasula, Amy M.; Koenig, Linda; Kourtis, Athena P.

    2013-01-01

    Abstract HIV-infected young women in the United States have important reproductive health needs that are made more complex by their HIV status. We searched Pubmed and relevant bibliographies to identify 32 articles published from 2001 to July 2012 that described the prevalence, correlates, and characteristics of the sexual activity, relationships, pregnancy intentions, HIV status disclosure, and contraceptive and condom use among US HIV-infected adolescents and young women. Our synthesis of those articles found that, like youth not infected with HIV, substantial proportions of HIV-infected youth were sexually active, and most sought romantic or sexual relationships, though their serostatus may have affected the pace of physical and emotional intimacy. Disclosure was difficult, and large proportions of HIV-infected youth had not disclosed their serostatus to recent partners. A few studies suggest that most HIV-infected young women hoped to have children in the future, but many wanted to avoid pregnancy until later. Only one study described contraceptive use among this population in detail and found that condoms were a primary method of contraception. The results point to substantial gaps in published research, particularly in the areas of pregnancy intentions and contraceptive use. Much more needs to be done in research and health services to better understand and meet the complex health needs of HIV-infected young women. PMID:24320012

  9. Disclosure of parental HIV infection to children and psychosocial impact on children in China: a qualitative study.

    PubMed

    Zhang, Liying; Li, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang; Kaljee, Linda; Stanton, Bonita

    2013-01-01

    This qualitative study aims to investigate parental HIV disclosure and psychological impact from the perspectives of their children. In-depth individual interviews with 47 children who had lost one or both parents to AIDS were conducted in China. All transcripts were coded using the software ATLAS.ti 5. Results showed that few of children knew of parental HIV status before the death of their parents. The main disclosers were the children's current caregivers. Some children knew about their parent's HIV infection based on their own observations or through overheard conversation, or their interactions with villagers. Both positive and negative psychological outcomes related to parental HIV disclosure were reported. Psychological counseling is needed for both parents and children to dealing with the parental HIV infection. PMID:24761258

  10. Sociodemographic Factors and Prejudice toward HIV and Hepatitis B/C Status in a Working-Age Population: Results from a National, Cross-Sectional Study in Japan

    PubMed Central

    Eguchi, Hisashi; Wada, Koji; Smith, Derek R.

    2014-01-01

    Background In many countries, HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) infected individuals may face discrimination and mistreatment from coworkers. Effective interventions to reduce workplace discrimination are therefore needed to protect these vulnerable populations. The current study investigated potential associations between sociodemographic factors and prejudice toward HIV and HBV/HCV infected colleagues within a Japanese working population. Methods An online anonymous, nationwide internet survey was administered to a cross-section of approximately 3,000 individuals in Japan. The survey comprised 14 questions focusing on demographics (five items), basic HIV or HBV/HCV knowledge (eight items), and potential prejudice toward HIV or HBV/HCV infected colleagues (one item). The sociodemographic characteristics evaluated were sex, age, educational level, employment status, and individual income; with multiple logistic regression used for the analysis. Results In total, 3,055 individuals were recruited for the HIV related survey and 3,129 for the HBV/HCV related survey. Older age was significantly and positively associated with prejudice toward HIV infected colleagues (p<0.01) and negatively associated with prejudice toward HBV/HCV infected colleagues (p<0.01). Statistically significant associations were not observed between other sociodemographic characteristics and potential prejudice toward HIV and HBV/HCV infected coworkers. Conclusion Overall, this study suggests that age may be associated with prejudice toward HIV and HBV/HCV infected colleagues among the working age population of Japan. As such, policy makers should consider the age of participants when formulating efforts to reduce prejudice toward HIV and HBV/HCV infected workers. PMID:24792095

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

    ERIC Educational Resources Information Center

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

    2014-01-01

    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…

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

    ERIC Educational Resources Information Center

    Chenneville, Tiffany

    2007-01-01

    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,…

  13. Social Support, Stigma and Disclosure: Examining the Relationship with HIV Medication Adherence among Ryan White Program Clients in the Mid-South USA

    PubMed Central

    Pichon, Latrice C.; Rossi, Kristen R.; Ogg, Siri A.; Krull, Lisa J.; Griffin, Dorcas Young

    2015-01-01

    Social support from friends and family is positively related to better health outcomes among adults living with HIV. An extension of these networks such as religious communities may be an untapped source of social support for promoting HIV medical adherence. This paper explores the association of HIV medication adherence to satisfaction with support from family, friends and church members, as well as HIV-related stigma, and HIV disclosure. In partnership with the Shelby County Health Department, the Memphis Ryan White Part A Program, and the University of Memphis School of Public Health, a total of 286 interviewer-administered surveys were conducted with Ryan White clients. Seventy-six percent (n = 216) of participants reported being prescribed antiretroviral medication (ARVs). Nearly all participants (n = 202, 94%) prescribed ARVs reported disclosing their HIV status to someone. Almost 20% (n = 40) of those prescribed ARVs reported not being satisfied with support received from his/her church. Interestingly, participants reported rarely experiencing stigma as a result of their HIV status. The extent to which satisfaction with support from personal networks and institutional settings like the church affect medication adherence is yet to be understood. The complexity of HIV disclosure and HIV stigma in relation to these supports warrants further investigation to understand how best to improve HIV health outcomes. PMID:26103592

  14. Longitudinal evaluation of prostaglandin E2 (PGE2) and periodontal status in HIV+ patients.

    PubMed

    Alpagot, Tamer; Remien, John; Bhattacharyya, Mouchumi; Konopka, Krystyna; Lundergan, William; Duzgune?, Nejat

    2007-11-01

    The study aim was to determine whether prostaglandin E(2) (PGE(2)) in gingival crevicular fluid (GCF) could serve as a risk factor for periodontitis in human immunodeficiency virus-positive (HIV(+)) patients. Clinical measurements, including gingival index (GI), plaque index, bleeding index, probing depth (PD), attachment loss (AL) and GCF samples were taken from two healthy sites (including sites with gingival recession, GI=0; PD< or =3 mm; AL< or =2 mm), three gingivitis sites (GI>0; PD< or =3 mm; AL=0) and three periodontitis sites (GI>0; PD> or =5 mm; AL> or =3 mm) of each of the 30 patients at baseline and 6-month visits. GCF samples were also taken by means of paper strips. GCF PGE(2) levels were determined by a sandwich ELISA. The progressing site was defined as a site which had 2 mm or more attachment loss during the 6-month study period. The mean amounts of PGE(2) were significantly higher in gingivitis and periodontitis sites than in healthy sites (p<0.0001). GCF levels of PGE(2) were significantly correlated with probing depth, attachment loss, CD4(+) cells, viral load, age and smoking pack-years at baseline and 6-month visits (0.0001HIV(+) patients. It is well known that the activated inflammatory cells produce inflammatory mediators which stimulate the production of PGE(2). Longitudinal evaluation of GCF PGE(2) with respect to the progression of untreated periodontitis sites in HIV(+) subjects will contribute to the understanding of the pathogenesis of periodontitis in HIV(+) patients. These data indicate that sites with high GCF levels of PGE(2) in HIV(+) patients are at significantly greater risk for progression of periodontitis. PMID:17586460

  15. 31 CFR 1010.717 - Disclosing information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Disclosing information. 1010.717 Section 1010.717 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FINANCIAL CRIMES ENFORCEMENT NETWORK, DEPARTMENT OF THE TREASURY GENERAL PROVISIONS Administrative Rulings § 1010.717 Disclosing information. (a) Any...

  16. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

    PubMed Central

    2011-01-01

    Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396. PMID:21936938

  17. A Systematic Review of Effects of Concurrent Strength and Endurance Training on the Health-Related Quality of Life and Cardiopulmonary Status in Patients with HIV/AIDS

    PubMed Central

    Ogalha, Cecília; Andrade, Antônio Marcos; Brites, Carlos

    2013-01-01

    Purpose. To determine the effects of concurrent strength and endurance training (concurrent training) on the Health-Related Quality of Life (HRQOL) and cardiopulmonary status among HIV-infected patients, using a systematic search strategy of randomized, controlled trials (RCTs). Methods. A systematic review was performed by two independent reviewers using Cochrane Collaboration protocol. The sources used in this review were Cochrane Library, EMBASE, LILACS, MEDLINE, PEDro and Web of Science from 1950 to August 2012. The PEDro score was used to evaluate methodological quality. Result. Individual studies suggested that concurrent training contributed to improved HRQOL and cardiovascular status. Concurrent training appears to be safe and may be beneficial for medically stable adults living with HIV. The rates of nonadherence were of 16%. Conclusion. Concurrent training improves the HRQOL and cardiopulmonary status. It may be an important intervention in the care and treatment of adults living with HIV. Further research is needed to determine the minimal and optimal duration, frequency, and intensity of exercise needed to produce beneficial changes in the HIV-infected population subgroups. PMID:23691497

  18. Feasibility of using an iPod touch device and acceptability of a stigma reduction intervention with HIV-infected women in the Deep South.

    PubMed

    Relf, Michael V; Silva, Susan G; Williams, Megan Scull; Moore, Elizabeth; Arscott, Joyell; Caiola, Courtney; Barroso, Julie

    2015-10-01

    As with many infectious diseases throughout history, stigma is a part of the trajectory of the HIV disease process. HIV-related stigma impedes women from being tested for HIV. Once infected, HIV-related stigma hinders women from disclosing their HIV status to sexual partners and health care providers, engaging in medical care, effectively self-managing the disease after infection, and adhering to anti-retroviral therapy. After three decades of the HIV epidemic, no evidenced-based, culturally relevant, gender-specific interventions exist to help women infected with HIV manage the stigma associated with HIV infection. This manuscript reports the feasibility of using an iPod touch device and acceptability of a stigma reduction intervention with HIV-infected women in the Deep South in a mixed-method, randomized clinical trial. Results from the study demonstrate that it is feasible to utilize an iPod touch device to deliver an HIV-related stigma intervention to women. Further, women report that the HIV-related stigma intervention is acceptable and meaningful. PMID:25761644

  19. The impact of criminalization of HIV non-disclosure on the healthcare engagement of women living with HIV in Canada: a comprehensive review of the evidence

    PubMed Central

    Patterson, Sophie E; Milloy, M-J; Ogilvie, Gina; Greene, Saara; Nicholson, Valerie; Vonn, Micheal; Hogg, Robert; Kaida, Angela

    2015-01-01

    Introduction In 2012, the Supreme Court of Canada ruled that people living with HIV (PLWH) must disclose their HIV status to sexual partners prior to sexual activity that poses a “realistic possibility” of HIV transmission for consent to sex to be valid. The Supreme Court deemed that the duty to disclose could be averted if a person living with HIV both uses a condom and has a low plasma HIV-1 RNA viral load during vaginal sex. This is one of the strictest legal standards criminalizing HIV non-disclosure worldwide and has resulted in a high rate of prosecutions of PLWH in Canada. Public health advocates argue that the overly broad use of the criminal law against PLWH undermines efforts to engage individuals in healthcare and complicates gendered barriers to linkage and retention in care experienced by women living with HIV (WLWH). Methods We conducted a comprehensive review of peer-reviewed and non-peer-reviewed evidence published between 1998 and 2015 evaluating the impact of the criminalization of HIV non-disclosure on healthcare engagement of WLWH in Canada across key stages of the cascade of HIV care, specifically: HIV testing and diagnosis, linkage and retention in care, and adherence to antiretroviral therapy. Where available, evidence pertaining specifically to women was examined. Where these data were lacking, evidence relating to all PLWH in Canada or other international jurisdictions were included. Results and discussion Evidence suggests that criminalization of HIV non-disclosure may create barriers to engagement and retention within the cascade of HIV care for PLWH in Canada, discouraging access to HIV testing for some people due to fears of legal implications following a positive diagnosis, and compromising linkage and retention in healthcare through concerns of exposure of confidential medical information. There is a lack of published empirical evidence focused specifically on women, which is a concern given the growing population of WLWH in Canada, among whom marginalized and vulnerable women are overrepresented. Conclusions The threat of HIV non-disclosure prosecution combined with a heightened perception of surveillance may alter the environment within which women engage with healthcare services. Fully exploring the extent to which HIV criminalization represents a barrier to the healthcare engagement of WLWH is a public health priority. PMID:26701080

  20. Using communication privacy management theory to examine HIV disclosure to sexual partners/spouses among PLHIV in Guangxi.

    PubMed

    Xiao, Zhiwen; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2015-12-01

    The current study employed Communication Privacy Management (CPM) theory to examine the factors associated with disclosure of HIV infection to sexual partners or spouses as well as gender differences in these associations among a sample of people living with HIV (PLHIV) in China. A total of 1254 PLHIV who had 5-16 years old children were invited to answer the questions related to disclosure of HIV infection to sexual partners/spouses. Prevalence of HIV disclosure was reported. Key variables related to CPM theory (such as motivations for disclosure and nondisclosure, HIV-related stigma, and relational factors) were compared between females and males. Logistic regression was employed to determine the factors of influencing whether or not the participants disclosed their HIV status to spouses/partners for the male, the female and the combined samples. Fear of rejection was a significant predictor of HIV nondisclosure for the male, the female and the combined samples. Concern about privacy was a significant factor in not disclosing to sexual partners/spouses only in the male sample. The endorsement of duty to inform/educate was the only motivation factor that was significantly related to HIV disclosure for the three samples. The motivation to establish a close/supportive relationship with intimate partners/spouses was found to be associated with HIV disclosure for the combined and male samples. The current study confirmed the utilities of CPM in studying HIV disclosure to sexual partners/spouse. The findings have theoretical and practical implications for HIV disclosure interventions among PLHIV in Guangxi. PMID:26616128

  1. Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV

    PubMed Central

    Amin, Avni

    2015-01-01

    Introduction Globally, women constitute 50% of all persons living with HIV. Gender inequalities are a key driver of women's vulnerabilities to HIV. This paper looks at how these structural factors shape specific behaviours and outcomes related to the sexual and reproductive health of women living with HIV. Discussion There are several pathways by which gender inequalities shape the sexual and reproductive health and wellbeing of women living with HIV. First, gender norms that privilege men's control over women and violence against women inhibit women's ability to practice safer sex, make reproductive decisions based on their own fertility preferences and disclose their HIV status. Second, women's lack of property and inheritance rights and limited access to formal employment makes them disproportionately vulnerable to food insecurity and its consequences. This includes compromising their adherence to antiretroviral therapy and increasing their vulnerability to transactional sex. Third, with respect to stigma and discrimination, women are more likely to be blamed for bringing HIV into the family, as they are often tested before men. In several settings, healthcare providers violate the reproductive rights of women living with HIV in relation to family planning and in denying them care. Lastly, a number of countries have laws that criminalize HIV transmission, which specifically impact women living with HIV who may be reluctant to disclose because of fears of violence and other negative consequences. Conclusions Addressing gender inequalities is central to improving the sexual and reproductive health outcomes and more broadly the wellbeing of women living with HIV. Programmes that go beyond a narrow biomedical/clinical approach and address the social and structural context of women's lives can also maximize the benefits of HIV prevention, treatment, care and support. PMID:26643464

  2. Parental HIV disclosure in Burkina Faso: experiences and challenges in the era of HAART.

    PubMed

    Tiendrebeogo, Georges; Hejoaka, Fabienne; Belem, Edwige Mireille; Compaoré, Pascal Louis Germain; Wolmarans, Liezel; Soubeiga, André; Ouangraoua, Nathalie

    2013-07-01

    Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However, limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex, parent's older age, parent's marital history and number of children. After adjustment, it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases, children suspected, and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However, parents who disclosed to their children did not experience blame nor was their secret revealed. Rather, children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However, whether aware or not of their parents' HIV-positive status, children contribute positively to the care of parents living with HIV. Perceptions about children's vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally, without institutional counselling support, disclosure to children remains a challenge for both parents and children, which suggests a need for rethinking of current counselling practices. PMID:23808393

  3. Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context

    PubMed Central

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

    2014-01-01

    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 ? 0.87–0.96. 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

  4. Navigating condom use and HIV status disclosure with partners met online: A qualitative pilot study with gay and bisexual men from Craigslist.org

    PubMed Central

    Grov, Christian; Agyemang, Linda; Ventuneac, Ana; Breslow, Aaron S.

    2013-01-01

    We conducted face-to-face semi-structured interviews with 50 men recruited off the New York City men-seeking-men section of Craigslist.org. Participants discussed their favorite venues for meeting sex partners (n = 28 said the Internet), and we focused on these men’s responses to probes regarding decisions around condom use and HIV status disclosure with online partners. A majority indicated they set a priori rules for themselves to always use condoms, and cited the Internet as their favorite venue in part because it helped them sort for like-minded partners. Participants indicated that having in-person conversations around condom use and HIV was often difficult, and that the Internet was a convenient medium to facilitate the process. Notable differences were observed in how HIV-positive and HIV-negative men navigated serostatus disclosure—HIV-negative men were less subtle in starting the conversation. Finally, participants described a common narrative around distrust with online partners, which is one reason why they consistently use condoms. These data suggest that features which allow men to easily indicate, and filter for, condom use preferences should be built into (or maintained on) profile-based sexual networking sites and sexual bulletin board sites. PMID:23387953

  5. Experiences of social stigma and implications for healthcare among a diverse population of HIV positive adults.

    PubMed

    Sayles, Jennifer N; Ryan, Gery W; Silver, Junell S; Sarkisian, Catherine A; Cunningham, William E

    2007-11-01

    Stigma profoundly affects the lives of people with HIV/AIDS. Fear of being identified as having HIV or AIDS may discourage a person from getting tested, from accessing medical services and medications, and from disclosing their HIV status to family and friends. In the present study, we use focus groups to identify the most salient domains of stigma and the coping strategies that may be common to a group of diverse, low-income women and men living with HIV in Los Angeles, CA (n = 48). We also explore the impact of stigma on health and healthcare among HIV positive persons in our sample. Results indicate that the most salient domains of stigma include: blame and stereotypes of HIV, fear of contagion, disclosure of a stigmatized role, and renegotiating social contracts. We use the analysis to develop a framework where stigma is viewed as a social process composed of the struggle for both internal change (self-acceptance) and reintegration into the community. We discuss implications of HIV-related stigma for the mental and physical health of HIV-positive women and men and suggestions for possible interventions to address stigma in the healthcare setting. PMID:17786561

  6. Smoking, HIV status, and HIV risk behaviors in a respondent-driven sample of injection drug users in Baltimore, Maryland: The BeSure Study.

    PubMed

    Villanti, Andrea; German, Danielle; Sifakis, Frangiscos; Flynn, Colin; Holtgrave, David

    2012-04-01

    Tobacco use is the largest preventable cause of death in the United States. Associations between cigarette smoking and HIV risk behaviors were examined among 669 injection drug users (IDU) in the 2006 wave of the National HIV Behavioral Surveillance System in Baltimore, Maryland, using respondent-driven sampling. The adjusted prevalence of smoking among IDU was 92.1%, with 32.7% smoking < 1 pack of cigarettes per day (light smoking) and 59.3% smoking ? 1 packs per day (heavy smoking). Self-reported HIV prevalence decreased as smoking frequency increased (p = 0.001). In multivariate analysis, heavy smokers were more likely to report painkiller use and binge drinking and less likely to report anal sex or health care use in the past year than light smokers. Results suggest that health care use mediates the relationship between heavy smoking and self-reported HIV. Integrating smoking cessation with HIV prevention services could address unmet health needs in IDU. PMID:22468974

  7. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: Results of a qualitative study

    PubMed Central

    Jaiantilal, Prafulta; Gutin, Sarah A.; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Abstract Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as gender inequalities, stigma and discrimination which hinder the full impact of PP interventions in this context. PMID:25778860

  8. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: results of a qualitative study.

    PubMed

    Jaiantilal, Prafulta; Gutin, Sarah A; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as gender inequalities, stigma and discrimination which hinder the full impact of PP interventions in this context. PMID:25778860

  9. ‘Wamepotea’ (They have become lost): Outcomes of HIV-positive and HIV-exposed children lost to follow-up from a large HIV treatment program in western Kenya

    PubMed Central

    Braitstein, P.; Songok, J.; Vreeman, R.; Wools-Kaloustian, K.; Koskei, P.; Walusuna, L.; Ayaya, S.; Nyandiko, W.; Yiannoutsos, C.

    2011-01-01

    Objective The objective of this study was to identify the vital status and reasons for children becoming LTFU from a large program in western Kenya. Methods This was a prospective evaluation of a random sample of 30% of HIV-exposed and positive children LTFU from either an urban or rural HIV (AMPATH) clinic. LTFU is defined as absence from clinic for >6 months if on cART, and >12 months if not. Experienced Community Health Workers were engaged to locate them. Results There were 97 children sampled (78 urban, 19 rural). Of these, 82% were located (78% urban, 100% rural). Among the HIV-positive, 16%of the children were deceased, and 16% had not returned to clinic because of disclosure issues/discrimination in the family or community. Among the HIV-exposed, 30% never returned to care because their guardians either had not disclosed their own HIV status or were afraid of family/community stigma related to their HIV status or that of the child. Among children whose HIV status was unknown, 29% of those found had actually died, and disclosure/discrimination accounted for 14% of the reasons for becoming LTFU. Other reasons included believing the child was healed by faith or through the use of traditional medicine (7%), transport costs (6%), and transferring care to other programs or clinics (8%). Conclusion After locating > 80% of the children in our sample, we identified that mortality and disclosure issues including fear of family or community discrimination were the most important reasons why these children became LTFU. PMID:21407085

  10. Anal human papillomavirus genotype distribution in HIV-infected men who have sex with men by geographical origin, age, and cytological status in a Spanish cohort.

    PubMed

    Torres, Montserrat; González, Cristina; del Romero, Jorge; Viciana, Pompeyo; Ocampo, Antonio; Rodríguez-Fortúnez, Patricia; Masiá, Mar; Blanco, José Ramón; Portilla, Joaquín; Rodríguez, Carmen; Hernández-Novoa, Beatriz; del Amo, Julia; Ortiz, Marta

    2013-11-01

    Knowledge of human papillomavirus (HPV) type distribution in populations at risk for anal cancer is needed. Here, we describe the anal HPV genotype distribution in a large Spanish cohort (Cohort of the Spanish HIV Research Network HPV [CoRIS-HPV]) of HIV-positive men who have sex with men (MSM) according to geographical origin, age, and cytological status. A cross-sectional analysis of baseline data from 1,439 HIV-infected MSM (2007 to 2012) was performed. Anal HPV genotyping was performed using the Linear Array HPV genotyping test. Descriptive analyses of subject characteristics, prevalences, and 95% confidence intervals (CI) were performed. The global prevalences of HPV, high-risk HPV (HR-HPV), and low-risk HPV (LR-HPV) types were 95.8%, 83.0%, and 72.7%, respectively. Among the HR-HPV types, HPV16 was the most common, followed by HPV59, -39, -51, -18, and -52. The prevalence of multiple HR-HPV infections was 58.5%. There were no differences in the crude analyses between Spanish and Latin-American MSM for most HPV types, and a peak in prevalence for most HPV types was seen in patients in their late thirties. Globally and by specific HPV groups, men with abnormal anal cytologies had a higher prevalence of infection than those with normal cytologies. This study has the largest number of HIV-positive MSM with HPV genotype data analyzed according to cytological status as far as we know. The information gained from this study can help with the design of anal cancer prevention strategies in HIV-positive patients. PMID:23966501

  11. Anal Human Papillomavirus Genotype Distribution in HIV-Infected Men Who Have Sex with Men by Geographical Origin, Age, and Cytological Status in a Spanish Cohort

    PubMed Central

    Torres, Montserrat; González, Cristina; del Romero, Jorge; Viciana, Pompeyo; Ocampo, Antonio; Rodríguez-Fortúnez, Patricia; Masiá, Mar; Blanco, José Ramón; Portilla, Joaquín; Rodríguez, Carmen; Hernández-Novoa, Beatriz; del Amo, Julia

    2013-01-01

    Knowledge of human papillomavirus (HPV) type distribution in populations at risk for anal cancer is needed. Here, we describe the anal HPV genotype distribution in a large Spanish cohort (Cohort of the Spanish HIV Research Network HPV [CoRIS-HPV]) of HIV-positive men who have sex with men (MSM) according to geographical origin, age, and cytological status. A cross-sectional analysis of baseline data from 1,439 HIV-infected MSM (2007 to 2012) was performed. Anal HPV genotyping was performed using the Linear Array HPV genotyping test. Descriptive analyses of subject characteristics, prevalences, and 95% confidence intervals (CI) were performed. The global prevalences of HPV, high-risk HPV (HR-HPV), and low-risk HPV (LR-HPV) types were 95.8%, 83.0%, and 72.7%, respectively. Among the HR-HPV types, HPV16 was the most common, followed by HPV59, -39, -51, -18, and -52. The prevalence of multiple HR-HPV infections was 58.5%. There were no differences in the crude analyses between Spanish and Latin-American MSM for most HPV types, and a peak in prevalence for most HPV types was seen in patients in their late thirties. Globally and by specific HPV groups, men with abnormal anal cytologies had a higher prevalence of infection than those with normal cytologies. This study has the largest number of HIV-positive MSM with HPV genotype data analyzed according to cytological status as far as we know. The information gained from this study can help with the design of anal cancer prevention strategies in HIV-positive patients. PMID:23966501

  12. Sexual risk behaviour, marriage and ART: a study of HIV-positive people in Papua New Guinea

    PubMed Central

    2013-01-01

    Background The prevention of intimate partner transmission of HIV remains an important component of comprehensive HIV prevention strategies. In this paper we examine the sexual practices of people living with HIV on antiretroviral therapy (ART) in Papua New Guinea (PNG). Method In 2008, a total of 374 HIV-positive people over the age of 16 and on ART for more than two weeks were recruited using a non-probability, convenience sampling methodology. This accounted for around 18% of adults on ART at the time. A further 36 people participated in semi-structured interviews. All interviews were thematically analysed using NVivo qualitative data analysis software. Results Less than forty per cent (38%) of participants reported having had sexual intercourse in the six months prior to the survey. Marital status was by far the most important factor in determining sexual activity, but consistent condom use during vaginal intercourse with a regular partner was low. Only 46% reported consistent condom use during vaginal intercourse with a regular partner in the last six months, despite 77% of all participants reporting that consistent condom use can prevent HIV transmission. Consistent condom use was lowest amongst married couples and those in seroconcordant relationships. The vast majority (91.8%) of all participants with a regular heterosexual partner had disclosed their status to their partner. Qualitative data reinforced low rates of sexual activity and provided important insights into sexual abstinence and condom use. Conclusions Considering the importance of intimate partner transmission of HIV, these results on the sexual practices of people with HIV on ART in PNG suggest that one-dimensional HIV prevention messages focussing solely on condom use fail to account for the current practices and needs of HIV-positive people, especially those who are married and know their partners’ HIV status. PMID:23805823

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

    PubMed Central

    Jean, Kévin; Gabillard, Delphine; Moh, Raoul; Danel, Christine; Fassassi, Raïmi; Desgrées-du-Loû, Annabel; Eholié, Serge; Lert, France; Anglaret, Xavier; Dray-Spira, Rosemary

    2014-01-01

    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 load–specific 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

  14. REASONS FOR HIV DISCLOSURE OR NONDISCLOSURE TO CASUAL SEXUAL PARTNERS

    PubMed Central

    Mosack, Katie E.

    2005-01-01

    The purpose of this study was to investigate reasons HIV-positive gay men give for disclosing or not disclosing their serostatus to their casual sexual partners. Participants were 78 HIV-positive gay men who were part of a larger HIV and disclosure project. A clear factor structure for disclosure emerged which suggests that issues of responsibility dominated men's decisions to disclose. No clear factor structure for nondisclosure emerged. Reasons for disclosure or nondisclosure to casual sexual partners were varied and this data could provide new insights for secondary prevention efforts. More research needs to be conducted to better understand salient issues in considering whether to disclose. PMID:12627744

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

    PubMed Central

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

    2014-01-01

    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 additional tailoring for relevance to Native Hawaiians, a group with low participation in cancer screening. Method The targeted education included behavioral modeling and barriers counseling in a culturally safe environment. Using a 2-group, pre/posttest design, AIDS service organizations were randomized to culturally responsive or standard education. AIDS service organizations consumers recruited through venue-based promotions were the unit of analysis. Knowledge–attitudes–practices, fecal occult blood test screening completion, and intervention feasibility were measured. Results Treatment arm participants, regardless of ethnicity, adhered to fecal occult blood test instructions and achieved increases in screening knowledge, attitudes, and practices. Relevance and acceptability of the educational intervention were endorsed. Discussion The culturally responsive intervention was successful in this group of PLHIV. Additional tailoring may be needed to reach PLHIV who do not participate in organizational activities. Conclusion/Translation to Health Education Practice This culturally responsive intervention shows promise for efficacy testing in a broader PLHIV population. Constituent-involving strategies were central to its development and delivery. PMID:24653993

  16. Polymerase chain reaction in detecting HIV infection among seropositive infants: relation to clinical status and age and to results of other assays.

    PubMed

    Comeau, A M; Harris, J A; McIntosh, K; Weiblen, B J; Hoff, R; Grady, G F

    1992-01-01

    The polymerase chain reaction (PCR) for human immunodeficiency virus (HIV) was evaluated using coded blood specimens from infants whose clinical status is now known. A micromethod for the efficient isolation of mononuclear cells from small volumes of blood, and definitions of PCR positivity that took into account the number and purity of these mononuclear cells, were established in an attempt to define parameters for quality assurance. Results of HIV culture, p-24 antigen, and HIV-specific IgA obtained on the same specimens were compared to PCR results. PCR had a specificity of 100% among 83 specimens from 50 babies known to be uninfected. Sensitivity among 26 HIV-infected infants older than 3 months was 98% (44 of 45 specimens); the one negative specimen, which had also been culture negative, gave a positive PCR result on the remaining aliquot when tested after decoding. Among infected infants less than 3 months old, which is an age when diagnosis by other assays is most problematic, PCR identified 10 of 10 patients (10 of 11 specimens) including two younger than one month. Viral culture showed the best concordance with PCR; however, in three infants, positive PCR results were observed several months before positive results were observed by viral culture. PMID:1740753

  17. Children's Expressed Emotions when Disclosing Maltreatment

    ERIC Educational Resources Information Center

    Sayfan, Liat; Mitchell, Emilie B.; Goodman, Gail S.; Eisen, Mitchell L.; Qin, Jianjian

    2008-01-01

    Objective: Our goal was to examine children's expressed emotions when they disclose maltreatment. Little scientific research exists on this topic, and yet children's emotional expressions at disclosure may inform psychological theory and play a crucial role in legal determinations. Method: One hundred and twenty-four videotaped forensic interviews…

  18. [The social relegation of widows living with HIV in the time of ART in Senegal].

    PubMed

    Desclaux, A; Boye, S; Taverne, B

    2014-10-01

    While prolonged widowhood is unusual in Senegalese society, some women living with HIV receiving antiretroviral therapy for ten years remained widows. Are they maintained in this situation for refusing or being unable to remarry? To understand the conditions and the reasons for this lack of "matrimonial normalization", a qualitative interview study was conducted in Dakar with 31 widows. Their living conditions are mostly marked by economic difficulties, dependence on host families, and responsibilities visà-vis their children. They refuse to remarry, regret not being able to, or wish to without success, despite the existence locally of social forms of marital union that would respond to their situation. The refusal to disclose their HIV status combined with self-stigma prevent them from improving their condition. This form of social vulnerability that remains beyond the restoration of health is ignored by public policy and HIV/AIDS community based organizations claims. It should be acknowledged and considered for defending PLWAs' rights. PMID:24563114

  19. The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-Natal, South Africa

    PubMed Central

    Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala

    2015-01-01

    Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner’s HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95–26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality. PMID:25853870

  20. The current status and challenges in the development of fusion inhibitors as therapeutics for HIV-1 infection.

    PubMed

    Tan, Jian Jun; Ma, Xue Ting; Liu, Chang; Zhang, Xiao Yi; Wang, Cun Xin

    2013-01-01

    HIV-1 membrane fusion as a part of the process of viral entry in the target cells is facilitated by gp41 and gp120, which are encoded by Env gene of HIV-1. Based on the structure and the mechanism researches, new treatment options targeting HIV-1 entry process have been proposed. Enfuvirtide, which mimics amino acid sequences of viral envelope glycoprotein gp41, is the first HIV-1 fusion inhibitor approved by FDA. Although it fulfills vital functions by binding to gp41 and abolishing the membrane fusion reaction when used in combination, it could induce drug resistant virus variants. Currently, a number of design and modification schemes have been presented, a large number of prospective fusion peptides have emerged. For these fusion inhibitors, multiple mutations in gp41 have been associated with the loss of susceptibility to agents. This review reported the current developments and innovative designs of HIV-1 membrane fusion inhibitors. PMID:23092283

  1. HIV Prevention

    MedlinePLUS

    ... you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | Subscribe ... Get Email Updates on HIV Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV/ ...

  2. HIV Testing and Counselling in Colombia: Local Experience on Two Different Recruitment Strategies to Better Reach Low Socioeconomic Status Communities

    PubMed Central

    Galindo-Quintero, Jaime; Mueses-Marin, Hector Fabio; Montaño-Agudelo, David; Pinzón-Fernández, María Virginia; Tello-Bolívar, Inés Constanza; Alvarado-Llano, Beatriz Eugenia; Martinez-Cajas, Jorge Luis

    2014-01-01

    HIV testing rates remain very low in Colombia, with only 20% of individuals at risk ever tested. In order to tackle this issue, the Corporacion de Lucha Contra el Sida (CLS) has implemented a multidisciplinary, provider-initiated, population-based HIV testing/counselling strategy named BAFI. In this report, we describe the experience of CLS at reaching populations from low socioeconomic backgrounds in 2008-2009. Two different approaches were used: one led by CLS and local health care providers (BAFI-1) and the other by CLS and community leaders (BAFI-2). Both approaches included the following: consented HIV screening test, a demographic questionnaire, self-reported HIV knowledge and behaviour questionnaires, pre- and posttest counselling, confirmatory HIV tests, clinical follow-up, access to comprehensive care and antiretroviral treatment. A total of 2085 individuals were enrolled in BAFI-1 and 363 in BAFI-2. The effectiveness indicators for BAFI-1 and BAFI-2, respectively, were HIV positive-confirmed prevalence = 0.29% and 3.86%, return rate for confirmatory results = 62.5% and 93.7%, return rate for comprehensive care = 83.3% and 92.8%, and ART initiation rate = 20% and 76.9%. Although more people were reached with BAFI-1, the community-led BAFI-2 was more effective at reaching individuals with a higher prevalence of behavioural risk factors for HIV infection. PMID:24592330

  3. Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV-infected patients in St. Luke and Tulubolo Hospital, Oromia Region, Ethiopia

    PubMed Central

    Bayou, Bekelech; Sisay, Abay; Kumie, Abera

    2015-01-01

    Introduction The use of antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. However, cost and resistance to ART are major obstacles for access to treatment especially in resource-limited settings. In this study, we aimed to assess the magnitude and associated factors of Immunological failure among adult and adolescent HIV infected Patients (with age ‘15yrs) on Highly Active Antiretroviral Therapy (HAART) in St. Luke and Tulu Bolo Hospitals, Oromia Region, Ethiopia. Methods A retrospective follow-up study was conducted among HIV-infected patients initiated 1st line ART at St. Luke and Tulu Bolo Hospitals, South West Shoa Zone, Oromia, Ethiopia. Results A total of 828 patient charts were reviewed. 477(57.6%) were female and the median age was 32 years. The median baseline CD4 count was 148cells/mm3. The most common prescribed ART was TDF based (36.7%). Out of 828 patients chart reviewed 6.8% (56) were developed immunological failure. Out of them only 20 (2.4%) were detected and put on second line regimen. The incidence of immunological failure was 1.8 cases per 100 person years of follow-up. Patients who had not disclosed their HIV status to any one had high risk of immunological failure compared with patients those who had disclosed their HIV status (AHR, 0.429; 95% CI 0.206 - 0.893; P-value=0.024). Conclusion Non disclosures of HIV status and with ambulatory of baseline functional status were found to be predictors of immunological failure. Most of the immunological failure cases were not detected early and not switched to second line ARV regimen. So patients with the above risk factors should be considered for a timely switch to second line HAART. PMID:26587140

  4. HIV/AIDS-related knowledge and its association with socioeconomic status among women: results of Lebanese Survey for Family Health (PAPFAM) 2004.

    PubMed

    Kobeissi, Loulou; El Kak, Faysal H; Khawaja, Marwan; Khoshnood, Kaveh

    2015-03-01

    This article assesses the association of women's HIV/AIDS knowledge of transmission and prevention with socioeconomic status (SES). Data from the 2004 Lebanese PAPFAM (Pan-Arab Project for Family Health) survey were used. The survey was based on a representative household sample (n = 5532 households; n = 3315 women) of ever-married women aged 15 to 55 years. Adjusted analysis revolved around multivariate logistic regression models. 18% of women were knowledgeable of HIV/AIDS transmission methods and 21% of prevention methods. Income and education were significantly related to women's transmission and prevention knowledge. Significant differences were also found by region and media exposure. Women in the richest income quintile were 4 times (95% confidence interval [CI] = 2.43-6.42) more likely to be knowledgeable than those in the poorest. Women with the highest education were 2.57 times more likely (95% CI = 1.98-3.34) to be knowledgeable than those with elementary education or less. These results suggest the need for incorporating contextual regional and population differences for more effective HIV/AIDS awareness campaigns in Lebanon. PMID:22186399

  5. Restaurant to pay $25,000 to settle bartender's HIV firing.

    PubMed

    1995-12-01

    [Name removed], an HIV-positive bartender, will receive $25,000 in damages from his former employer, The Pub, in Evansville, IL. The Federal Court ruled that [name removed] was terminated because he disclosed his HIV status to an emergency room nurse following a workplace-based accident. Upon hearing the news, restaurant owner [name removed] relieved [name removed] of his position. [Name removed]'s attorneys claimed that The Pub violated the Americans with Disabilities Act (ADA), which prohibits disability-based employment discrimination. The suit was filed on behalf of the Equal Employment Opportunity Commission (EEOC), which also charged that [name removed]'s privacy had been violated. During pretrial discovery proceedings, the key issue was whether [name removed]'s case could be heard because of the small size of The Pub's operation. Before the issue could be resolved, The Pub offered to settle out of court. Under the terms of the settlement, The Pub will institute a confidentiality policy for all employees' medical information. [Name removed] has filed suit against St. Mary's Hospital for disclosing his HIV status to his employer. That case is in the discovery phase. PMID:11362947

  6. Lung and Heart Diseases Are Better Predicted by Pack-Years than by Smoking Status or Duration of Smoking Cessation in HIV Patients

    PubMed Central

    Guaraldi, Giovanni; Raggi, Paolo; Gomes, André; Zona, Stefano; Marchi, Enrico; Santoro, Antonella; Besutti, Giulia; Scaglioni, Riccardo; Ligabue, Guido; Leipsic, Jonathon; Man, Paul; Sin, Don

    2015-01-01

    Background The objective of this study was to assess the relationship of pack-years smoking and time since smoking cessation with risk of lung and heart disease. Methods We investigated the history of lung and heart disease in 903 HIV-infected patients who had undergone thoracic computed tomography (CT) imaging stratified by smoking history. Multimorbidity lung and heart disease (MLHD) was defined as the presence of ? 2 clinical or subclinical lung abnormalities and at least one heart abnormality. Results Among 903 patients, 23.7% had never smoked, 28.7% were former smokers and 47.6% were current smokers. Spirometry indicated chronic obstructive pulmonary disease in 11.4% of patients and MLHD was present in 53.6%. Age, male sex, greater pack-years smoking history and smoking cessation less than 5 years earlier vs. more than 10 years earlier (OR 2.59, 95% CI 1.27–5.29, p = 0.009) were independently associated with CT detected subclinical lung and heart disease. Pack-years smoking history was more strongly associated with MLHD than smoking status (p<0.001). Conclusions MLHD is common even among HIV-infected patients who never smoked and pack- years smoking history is a stronger predictor than current smoking status of MLHD. A detailed pack-years smoking history should be routinely obtained and smoking cessation strategies implemented. PMID:26650682

  7. HIV-Testing Behavior and Associated Factors Among MSM in Chongqing, China

    PubMed Central

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

    2014-01-01

    Abstract 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

  8. On the Road to HIV/AIDS Competence in the Household: Building a Health-Enabling Environment for People Living with HIV/AIDS

    PubMed Central

    Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian

    2015-01-01

    When aiming to provide chronic disease care within the context of human resource shortages, we should not only consider the responsibility of the individual person living with HIV/AIDS (PLWHA) but also the capacity of the social environment to actively encourage a lifestyle that fosters health. In this social environment, extensive efforts are thus required to increase HIV/AIDS knowledge, reduce stigma, stimulate HIV testing, improve health care-seeking behavior, and encourage safe sexual practices—described in the literature as the need for AIDS competence. In accordance with socio-ecological theory, one cannot restrict the research focus to communities, as AIDS competence studies should also incorporate the intermediate household level. In responding to this research need, the aim of this article is to conceptualize an “HIV/AIDS competent household” based on qualitative interviews and focus group discussions conducted in a township on the outskirts of Cape Town, South Africa. Our results show that a household’s supportive response to disclosure allows a patient to live openly as HIV positive in the household concerned. This may mark the start of the road to HIV/AIDS competence in the household, meaning the PLWHA receives sustainable support throughout the care continuum and positive living becomes the norm for the PLWHA and his or her household. A feedback loop might also be created in which other household members are encouraged to be tested and to disclose their status, which is an important step towards a sustainable response to HIV/AIDS-related challenges. Despite the fact that this road to HIV/AIDS competence at the household level is fragile and prone to various barriers, this article shows that the household has the potential to be a health-enabling environment for PLWHA. PMID:25794189

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

    PubMed Central

    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

    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

  10. Sexual Behavior and STI/HIV Status Among Adolescents in Rural Malawi: An Evaluation of the Effect of Interview Mode on Reporting

    PubMed Central

    Mensch, Barbara S.; Hewett, Paul C.; Gregory, Richard; Helleringer, Stephane

    2008-01-01

    This study investigates the reporting of premarital sex in rural southern Malawi. It summarizes the results of an interview-mode experiment conducted with unmarried young women aged 15–21 in which respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. In addition, biomarkers were collected for HIV and three STIs: gonorrhea, chlamydia, and trichomoniasis. Prior to collecting the biomarkers, nurses conducted a short face-to-face interview in which they repeated questions about sexual behavior. The study builds on earlier research among adolescents in Kenya where we first investigated the feasibility and effectiveness of ACASI. In both Malawi and Kenya, the mode of interviewing and questions about types of sexual partners affect the reporting of sexual activity. Yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode. When we ask about other partners as well as multiple lifetime partners, however, the reporting is consistently higher with ACASI, in many cases significantly so. The FTF mode produced more consistent reporting of sexual activity between the main interview and a subsequent interview. The association between infection status and reporting of sexual behavior is stronger in the FTF mode, although in both modes a number of young women who denied ever having sex test positive for STIs/HIV. PMID:19248718

  11. The relationship of HIV status, type of coagulation disorder, and school absenteeism to cognition, educational performance, mood, and behavior of boys with hemophilia.

    PubMed

    Mayes, S D; Handford, H A; Schaefer, J H; Scogno, C A; Neagley, S R; Michael-Good, L; Pelco, L E

    1996-06-01

    Psychological and educational data were analyzed for all school-aged males with hemophilia at the Hemophilia Center of Central Pennsylvania (N = 66). Mean IQ (113.5) was higher than normal, and 2.4 times as many boys with hemophilia were enrolled in gifted programming than is the state average for boys. However, there was a disproportionately high prevalence of attention-deficit/hyperactivity disorder (ADHD; 28.3%), learning disability (LD; 15.8%), and graphomotor weakness. These were not significantly associated with HIV status or type and severity of coagulation disorder. School absenteeism was high but was not significantly related to academic achievement, IQ/achievement discrepancy, need for educational intervention, or diagnosis of ADHD or LD. PMID:8656201

  12. HIV/AIDS treatment adherence in economically better off women in Colombia.

    PubMed

    Arrivillaga, Marcela; Springer, Andrew E; Lopera, Monica; Correa, Diego; Useche, Bernardo; Ross, Michael W

    2012-01-01

    Studies on HIV/AIDS treatment adherence have been carried out in a limited number of geographic settings, but few studies have explored it in people of higher socioeconomic status in Latin America. This qualitative study explored and compared determinants of adherence behaviors among 52 HIV-positive Colombian women in medium and high socioeconomic positions (SPs). Findings indicated that the two SP groups reported high adherence behaviors related to taking medication, following a diet, and executing lifestyle changes in line with healthcare providers' recommendations. Nevertheless, differences were observed between the two groups. While women with a medium SP disclosed their diagnosis, were empowered, and had acceptable access to economic resources that resulted in favorable adherence, their better off counterparts tended to hide their status and made a conscious effort to keep their adherence behaviors in secret due to HIV-related stigma. More studies on adherence of people living with HIV/AIDS from high SPs should be conducted to better understand how psychosocial support can be provided and to advance the knowledge of how and why adherence practices in these groups are undertaken. PMID:22273077

  13. Strategic information is everyone's business: perspectives from an international stakeholder meeting to enhance strategic information data along the HIV Cascade for people who inject drugs.

    PubMed

    Pierce, Richard D; Hegle, Jennifer; Sabin, Keith; Agustian, Edo; Johnston, Lisa G; Mills, Stephen; Todd, Catherine S

    2015-01-01

    People who inject drugs (PWID) are at increased HIV transmission risk because of unsafe injecting practices and a host of other individual, network, and structural factors. Thus, PWID have a great need for services within the Cascade of HIV prevention, diagnosis, care, and treatment (HIV Cascade). Yet the systems that monitor their progress through the Cascade are often lacking. Subsequently, fewer reliable data are available to guide programs targeting this key population (KP). Programmatic data, which are helpful in tracking PWID through the Cascade, also are limited because not all countries have harm reduction programming from which to estimate Cascade indicators. Also, due to stigma and the illegal nature of drug use, PWID may not disclose their drug use behavior or HIV status when accessing services. Consequently, PWID appear to have low HIV testing rates and, for those living with HIV, lower access to health services and lower viral suppression rates than do other KP groups. This commentary, based on outcomes from an international stakeholder meeting, identifies data gaps and proposes solutions to strengthen strategic information (SI), the systematic collection, analysis, and dissemination of information, to optimize HIV prevention, care, and treatment programming for PWID. PMID:26471018

  14. To tell or not to tell: negotiating disclosure for people living with HIV on antiretroviral treatment in a South African setting.

    PubMed

    Linda, Pride

    2013-07-01

    Disclosure of HIV status occurs for a variety of reasons and in various contexts, such as to sexual partners to enable safer sexual choices, to health-care workers to access treatment and care services and to family and community members to gain various forms of support. The reasons for disclosure or non-disclosure are shaped by the relationships, needs and circumstances of people living with HIV (PLHIV) at the time of disclosure. The purpose of this study was to investigate and describe the act and experience of disclosure in order to understand how these experiences of disclosure impact on the lives of PLHIV on antiretroviral (ARV) treatment and influence adherence to treatment. Using a qualitative research design, I conducted an ethnographic study at and through the referral clinic at the Tygerberg Hospital in Cape Town, South Africa. Ninety-three adult patients (75 women) participated in the study, 32 of whom were visited at home to conduct semi-structured in-depth interviews, and 61 of them participated in a cross-sectional study at the referral clinic using researcher-administered questionnaires. A general inductive approach was used to analyse the data. Participants in both arms of the study disclosed mainly to family members, then partners and then to friends and other persons; only five had not disclosed to anyone at all. In deciding to disclose or not, the author began to see how patients negotiated their disclosure. From weighing up other people's reactions, to being concerned about the effect of their disclosure on their disclosure targets, to concealing one's status to evade untoward negative reactions towards themselves. Further, negotiating one's disclosure is not only about to whom or how to disclose, it also means finding good opportunities to disclose or conceiving ways of hiding one's status and/or medication from others in order to enhance access and adherence to their ARV treatment. Perceived rather than actual stigma played an important role in decisions not to disclose. Nonetheless, HIV remains a highly stigmatising disease. The author suggests that both the gains in support and the evasion of negative reactions from the disclosure will continue to drive negotiation of disclosure of one's status in order for patients to access and remain adherent to their treatment. Thus, areas of disclosure and concealment as they influence one's adherence to treatment need to be investigated further to facilitate adherence to treatment. PMID:23844799

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

    PubMed

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

    2015-10-01

    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

  16. Factors Affecting Disclosure in South African HIV-Positive Pregnant Women

    PubMed Central

    Forsyth, Brian W.C.; Visser, Maretha J; Sikkema, Kathleen J.; Neufeld, Sharon; Jeffery, Bridget

    2008-01-01

    Abstract To provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery. At enrollment, 59% had disclosed to their partners and 42% to others. This rose to 67% and 59%, respectively, by follow-up. Logistic regression analysis identified being married (adjusted odds Ratio [AOR] 2.32; 95% confidence interval [CI] 1.20–4.47), prior discussion about testing (AOR 4.19; CI 2.34–7.49), having a partner with tertiary education (AOR 2.76; CI 1.29–5.88) and less experience of violence (AOR 0.48; CI 0.24–0.97) as factors associated with having disclosed to partners prior to enrollment. Better housing (AOR 1.26; CI 1.06–1.49), less financial dependence on partners (AOR 0.46; CI 0.25–0.85), and knowing someone with HIV (AOR 2.13; CI 1.20–3.76) were associated with prior disclosure to others. Increased levels of stigma at baseline decreased the likelihood of disclosure to partners postenrollment (AOR 0.91; CI 0.84–0.98) and increased levels of avoidant coping decreased subsequent disclosure to others (AOR 0.84; CI 0.72–0.97). These results provide understanding of disclosure for women diagnosed as HIV positive in pregnancy, and identify variables that could be used to screen for women who require help. PMID:19025485

  17. Maximizing the impact of HIV prevention efforts: Interventions for couples

    PubMed Central

    Medley, Amy; Baggaley, Rachel; Bachanas, Pamela; Cohen, Myron; Shaffer, Nathan; Lo, Ying-Ru

    2015-01-01

    Despite efforts to increase access to HIV testing and counseling services, population coverage remains low. As a result, many people in sub-Saharan Africa do not know their own HIV status or the status of their sex partner(s). Recent evidence, however, indicates that as many as half of HIV-positive individuals in ongoing sexual relationships have an HIV-negative partner and that a significant proportion of new HIV infections in generalized epidemics occur within serodiscordant couples. Integrating couples HIV testing and counseling (CHTC) into routine clinic- and community-based services can significantly increase the number of couples where the status of both partners is known. Offering couples a set of evidence-based interventions once their HIV status has been determined can significantly reduce HIV incidence within couples and if implemented with sufficient scale and coverage, potentially reduce population-level HIV incidence as well. This article describes these interventions and their potential benefits. PMID:23656251

  18. Maximizing the impact of HIV prevention efforts: interventions for couples.

    PubMed

    Medley, Amy; Baggaley, Rachel; Bachanas, Pamela; Cohen, Myron; Shaffer, Nathan; Lo, Ying-Ru

    2013-01-01

    Despite efforts to increase access to HIV testing and counseling services, population coverage remains low. As a result, many people in sub-Saharan Africa do not know their own HIV status or the status of their sex partner(s). Recent evidence, however, indicates that as many as half of HIV-positive individuals in ongoing sexual relationships have an HIV-negative partner and that a significant proportion of new HIV infections in generalized epidemics occur within serodiscordant couples. Integrating couples HIV testing and counseling (CHTC) into routine clinic- and community-based services can significantly increase the number of couples where the status of both partners is known. Offering couples a set of evidence-based interventions once their HIV status has been determined can significantly reduce HIV incidence within couples and if implemented with sufficient scale and coverage, potentially reduce population-level HIV incidence as well. This article describes these interventions and their potential benefits. PMID:23656251

  19. Wounds in patients with HIV.

    PubMed

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

    2014-09-01

    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

  20. Estimating and disclosing the risk of developing Alzheimer’s disease: challenges, controversies and future directions

    PubMed Central

    Roberts, J Scott; Tersegno, Sarah M

    2010-01-01

    With Alzheimer’s disease increasing in prevalence and public awareness, more people are becoming interested in learning their chances of developing this condition. Disclosing Alzheimer’s disease risk has been discouraged because of the limited predictive value of available tests, lack of prevention and treatment options, and concerns regarding potential psychological and social harms. However, challenges to this status quo include the availability of direct-to-consumer health risk information (e.g., genetic susceptibility tests), as well as a growing literature suggesting that people seeking risk information for Alzheimer’s disease through formal education and counseling protocols generally find it useful and do not experience adverse effects. This paper reviews current and potential methods of risk assessment for Alzheimer’s disease, discusses the process and impact of disclosing risk to interested patients and consumers, and considers the practical and ethical challenges in this emerging area. Anticipated future directions are addressed. PMID:20856693

  1. Using Health Provider Insights to Inform Pediatric HIV Disclosure: A Qualitative Study and Practice Framework from Kenya

    PubMed Central

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

    2014-01-01

    Abstract 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

  2. Heterosexual Partnerships and the Need for HIV Prevention and Testing for Men Who Have Sex With Men and Women in China: A Qualitative Study.

    PubMed

    Wang, Sijia; Song, Dandan; Huang, Wen; He, Huan; Wang, Min; Manning, David; Zaller, Nickolas; Zhang, Hongbo; Operario, Don

    2015-04-01

    Previous studies have reported that approximately 30% of men who have sex with men (MSM) in China have concurrent female partners. Men who have sex with men and women (MSMW) might "bridge" HIV transmission to their female sex partners. This study aimed to explore (a) motivations for why MSMW in China engage in relationships and sexual behaviors with female partners; (b) patterns of sexual behaviors and condom use between MSMW and their female partners; and (c) barriers to and strategies for encouraging MSMW and their female partners to undergo HIV testing. The authors conducted in-depth interviews with 30 MSMW in two urban cities in China, Guangzhou and Chengdu, and used thematic analysis methods to code and interpret the data. MSMW described family, social, and workplace pressures to have a female partner, and expressed futility about their ability to form stable same-sex relationships. Although participants reported concern about the risk of personally acquiring and transmitting HIV or other sexually transmitted infections (STIs) to their female partners, they described the challenges to using condoms with female partners. HIV-positive participants described how stigma restricted their ability to disclose their HIV status to female partners, and HIV-negative participants displayed less immediate concern about the need for female partners to undergo HIV testing. Participants described a range of possible strategies to encourage HIV testing among female partners. These findings highlight the urgent need for HIV risk reduction and testing interventions for Chinese MSMW in the context of heterosexual partnerships, and they also underscore the additional need for privacy and cultural sensitivity when designing future studies. PMID:25915698

  3. “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

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

    2014-01-01

    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 6–15 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

  4. HIV Symptoms

    MedlinePLUS

    ... Submit Home > HIV/AIDS > What is HIV/AIDS? HIV/AIDS This information in Spanish ( en español ) HIV symptoms Photo courtesy of AIDS.gov Facing AIDS ... and brain Return to top More information on HIV symptoms Explore other publications and websites Basic Information ...

  5. ‘Are We Not Human?’ Stories of Stigma, Disability and HIV from Lusaka, Zambia and Their Implications for Access to Health Services

    PubMed Central

    Parsons, Janet A.; Bond, Virginia A.; Nixon, Stephanie A.

    2015-01-01

    Background The advent of anti-retroviral therapy (ART) in Southern Africa holds the promise of shifting the experience of HIV toward that of a manageable chronic condition. However, this potential can only be realized when persons living with HIV are able to access services without barriers, which can include stigma. Our qualitative study explored experiences of persons living with disabilities (PWD) in Lusaka, Zambia who became HIV-positive (PWD/HIV+). Methods and Findings We conducted interviews with 32 participants (21 PWD/HIV+ and 11 key informants working in the fields of HIV and/or disability). Inductive thematic analysis of interview transcripts was informed by narrative theory. Participants’ accounts highlighted the central role of stigma experienced by PWD/HIV+, with stigmatizing attitudes closely linked to prevailing societal assumptions that PWD are asexual. Seeking diagnostic and treatment services for HIV was perceived as evidence of PWD being sexually active. Participants recounted that for PWD/HIV+, stigma was enacted in a variety of settings, including the queue for health services, their interactions with healthcare providers, and within their communities. Stigmatizing accounts told about PWD/HIV+ were described as having important consequences. Not only did participants recount stories of internalized stigma (with its damaging effects on self-perception), but also that negative experiences resulted in some PWD preferring to “die quietly at home” rather than being subjected to the stigmatizing gaze of others when attempting to access life-preserving ART. Participants recounted how experiences of stigma also affected their willingness to continue ART, their willingness to disclose their HIV status to others, as well as their social relations. However, participants also offered counter-stories, actively resisting stigmatizing accounts and portraying themselves as resilient and resourceful social actors. Conclusions The study highlights a significant barrier to healthcare experienced by PWD/HIV+, with important implications for the future design and equitable delivery of HIV services in Zambia. Stigma importantly affects the abilities of PWD/HIV+ to manage their health conditions. PMID:26039666

  6. Cryptococcus neoformans and Streptococcus pneumoniae co-infection in post-traumatic meningitis in a patient with unknown HIV status.

    PubMed

    Saleem, Faryal; Fasih, Naima; Zafar, Afia

    2015-10-01

    Meningitis is a serious disease associated with considerable morbidity and mortality. Mixed meningeal infections due to bacteria and fungi are exceptionally rare. Here we report a case of meningeal co-infection with cryptococcus neoformans and streptococcus pneumoniae in a patient with unknown human immunodeficiency virus status. Because of the rarity of such cases, stringent screening of every cerebrospinal fluid specimen to exclude the presence of multiple pathogens is imperative. Assessment of patients for immunodeficiencies in case of isolation of an opportunistic organism like cryptococcus is also needed. PMID:26440847

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

    PubMed

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

    2015-01-01

    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

  8. Stages of HIV Infection

    MedlinePLUS

    ... HIV Infection Translate Text Size Print Stages of HIV Infection How Does HIV Progress In Your Body? Without treatment, HIV advances ... are the three stages of HIV infection: Acute HIV Infection Stage Within 2-4 weeks after HIV ...

  9. FACTORS ASSOCIATED WITH ACCESS TO ANTIRETROVIRAL THERAPY AMONG PEOPLE LIVING WITH HIV IN VIENTIANE CAPITAL, LAO PDR

    PubMed Central

    CHANVILAY, THAMMACHAK; YOSHIDA, YOSHITOKU; REYER, JOSHUA A; HAMAJIMA, NOBUYUKI

    2015-01-01

    ABSTRACT Since 2001, antiretroviral therapy (ART) has been available for people living with HIV (PLHIV) in Lao People’s Democratic Republic (PDR). Over 10 years of the ART program many HIV patients were found with advanced-stage AIDS in health care service facilities. This study aimed to examine factors associated with delayed access to ART among PLHIV in the capital of Vientiane. A cross-sectional study was conducted with 283 respondents (131 males and 152 females) aged 15 years or over. In this study, delayed access to ART was defined by a CD4 cell count of less than 350 cells/mm3 at the first screening, or those who presented with advanced AIDS-related symptoms. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by a logistic model. After adjustment, young people (OR=2.17; 95% CI: 1.00–4.68; p=0.049), low education (OR=0.23; 95% CI: 0.10–0.55; p=0.001) and duration between risk behavior and HIV test (OR=3.83; 95% CI: 1.22–12.00; p=0.021) were significantly associated with delayed access to ART. Low perception of high risk behaviors was one of the obstacles leading to delayed testing and inability to access ART. Almost all reported feeling self-stigma, and only 30.5% of men and 23.7% of women disclosed the HIV status to his/her partner/spouse. In conclusion, delayed access to ART was associated with individual factors and exposure to health care facility. In order to improve early detection HIV infection following access to ART, an improvement in perceptional knowledge of HIV, as well as reduction of HIV/AIDS-related stigma, might be needed. PMID:25797968

  10. "You Must Do the Test to Know Your Status": Attitudes to HIV Voluntary Counseling and Testing for Adolescents among South African Youth and Parents

    ERIC Educational Resources Information Center

    MacPhail, Catherine Lorne; Pettifor, Audrey; Coates, Tom; Rees, Helen

    2008-01-01

    Reduced HIV risk behavior and increased use of care and support services have been demonstrated among adults accessing HIV voluntary counseling and testing (VCT). The impact of VCT on adolescents is, however, not known. Focus group discussions were held with adolescents and parents in two South African townships to establish the perceptions of and…

  11. 34 CFR 99.31 - Under what conditions is prior consent not required to disclose information?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...prior consent not required to disclose information? 99.31 Section 99.31 Education...Institution Disclose Personally Identifiable Information From Education Records? § 99.31...prior consent not required to disclose information? (a) An educational agency...

  12. Vitamin D status in Well-Controlled Caucasian HIV Patients in Relation to Inflammatory and Metabolic Markers – A Cross-Sectional Cohort Study in Sweden

    PubMed Central

    Missailidis, C; Höijer, J; Johansson, M; Ekström, L; Bratt, G; Hejdeman, B; Bergman, P

    2015-01-01

    To study vitamin D (25OH D3) in relation to (i) microbial translocation (ii) systemic inflammation and (iii) blood lipid markers, in Caucasian, well-controlled HIV patients and healthy controls, plasma and serum samples from n = 97 male, HIV patients on HAART with immeasurable viral load (<20 copies/ml) since median 6.5 years and no concurrent inflammatory or infectious disease and n = 30 healthy controls were analysed for (i) LPS; (ii) sCD14, hsCRP, IL-4, IL-6, IL-10, IL-17, MCP-1 and IFN-?; as well as (iii) blood lipids. Vitamin D levels were similarly distributed and equally low in both HIV patients and controls. There was no association between vitamin D levels and markers of microbial translocation, systemic inflammation or dyslipidemia. LPS levels were similar in both groups but HIV patients expressed higher levels of sCD14 and hsCRP, with HIV as an independent risk factor. HIV patients had higher cholesterol and Apo B levels. Notably, more HIV patients smoked and smoking was associated with lower vitamin D levels. In conclusion; these well-treated Caucasian HIV patients had similar vitamin D levels as healthy controls. However, despite perfect virological control, they exhibited slightly increased inflammatory markers and disturbed blood lipids. However, neither of these parameters were associated with low vitamin D levels but appeared to be linked to the HIV-disease per se. Thus, the rationale for vitamin D substitution as a way to improve microbial translocation and systemic inflammation is not fully supported in this HIV population. PMID:25833795

  13. How are important life events disclosed on facebook? Relationships with likelihood of sharing and privacy.

    PubMed

    Bevan, Jennifer L; Cummings, Megan B; Kubiniec, Ashley; Mogannam, Megan; Price, Madison; Todd, Rachel

    2015-01-01

    This study examined an aspect of Facebook disclosure that has as yet gone unexplored: whether a user prefers to share information directly, for example, through status updates, or indirectly, via photos with no caption or relationship status changes without context or explanation. The focus was on the sharing of important positive and negative life events related to romantic relationships, health, and work/school in relation to likelihood of sharing this type of information on Facebook and general attitudes toward privacy. An online survey of 599 adult Facebook users found that when positive life events were shared, users preferred to do so indirectly, whereas negative life events were more likely to be disclosed directly. Privacy shared little association with how information was shared. Implications for understanding the finer nuances of how news is shared on Facebook are discussed. PMID:25584725

  14. “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 Central

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

    2014-01-01

    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) 50 years of age and older (range 50–79) 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

  15. Exclusive breastfeeding and HIV/AIDS: a crossectional survey of mothers attending prevention of mother-to-child transmission of HIV clinics in southwestern Nigeria

    PubMed Central

    Aishat, Usman; David, Dairo; Olufunmilayo, Fawole

    2015-01-01

    Introduction Prevention of Mother-To-Child-Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) guideline recommends replacement feeding where it is acceptable, feasible, affordable, sustainable and safe. Where this is un-achievable, exclusive breastfeeding (EBF) is recommended during the first six months of life. Methods A hospital-based cross-sectional study was conducted among 600 HIV-positive using a two-stage sampling technique. Data on socio-demographics, infant feeding choice and factors influencing these choices were collected using semi-structured questionnaires. Results Majority of the mothers (86.0%) were married and aged 31.0 ± 5.7years. Slightly above half (53.0%) had?2 children and more than two-third had disclosed their HIV status to their spouses. About two-third (61.0%) were traders with 75.0% earning monthly income ?N5,000.00k. Half of the mothers had ?4 antenatal care visits and 85.0% had infant feeding counselling. Infant feeding choices among the mothers were EBF (61.0%), ERF (26.0%) and MF (13.0%). The choice of EBF was influenced by spouse influence (84.0%), family influence (81.0%) and fear of stigmatisation (53.0%). Predictors of EBF were; monthly income (AOR = 2.6, C.I. =1.4-4.5), infant feeding counselling (AOR = 2.7, C.I. = 1.6-6.9) and fear of stigmatisation (AOR = 7. 2, C.I. = 2.1-23.6). Conclusion HIV positive mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. More extensive and comprehensive approach of infant feeding counseling with emphasis on behavioural change programmes in the context of HIV/AIDS within communities is advocated. PMID:26587157

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

    PubMed

    Sun, Yang; Lu, Hongzhou

    2014-06-01

    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

  17. Disclosure outcomes, coping strategies, and life changes among women living with HIV in Uganda.

    PubMed

    Medley, Amy M; Kennedy, Caitlin E; Lunyolo, Stella; Sweat, Michael D

    2009-12-01

    An HIV diagnosis is a life-changing event. Disclosure of HIV test results might be related to developing effective coping strategies. We conducted qualitative, in-depth interviews with 30 HIV-infected women in Uganda to explore links between HIV disclosure and coping strategies. Many women experienced an evolution in their ability to cope from initial shame to eventual acceptance. Factors that facilitated adaptive coping included being healthy, feeling responsible for children, support group participation, forming supportive relationships, and low perceived stigma and discrimination. HIV disclosure was often the first step in this coping process. Overall, 80% of the women had disclosed, with most reporting positive outcomes. Development of adaptive coping strategies and HIV serostatus disclosure are closely related, as they allow women to develop support networks and begin coming to terms with their diagnosis. Strategies are needed to safely support women who want to disclose their HIV test results. PMID:19949223

  18. IRS Releases Tax Questionnaire that Asks Colleges to Disclose More

    ERIC Educational Resources Information Center

    Kelderman, Eric

    2008-01-01

    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…

  19. 5 CFR 2502.16 - Information to be disclosed.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...RECORDS Production or Disclosure of Records Under the Freedom of Information Act, 5 U.S.C. 552 Charges for Search and Reproduction § 2502.16 Information to be disclosed. (a) In general, all records of the Office of Administration are...

  20. 42 CFR 1001.1101 - Failure to disclose certain information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Failure to disclose certain information. 1001.1101 Section 1001.1101 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN... considered neutral); (4) Any other facts that bear on the nature or seriousness of the conduct; (5)...

  1. Convincing Users to Disclose Personal Data Alfred Kobsa

    E-print Network

    Kobsa, Alfred

    Convincing Users to Disclose Personal Data Alfred Kobsa Department of Informatics University of California, Irvine +1 949 485-5020 kobsa@uci.edu Max Teltzrow International Computer Science Institute, personalized systems need considerable amounts of personal data. Users are however often reluctant to divulge

  2. 12 CFR 343.40 - What you must disclose.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... 6103(a). (4) Electronic form of disclosures. (i) Subject to the requirements of section 101(c) of the Electronic Signatures in Global and National Commerce Act (12 U.S.C. 7001(c)), you may provide the written... CONSUMER PROTECTION IN SALES OF INSURANCE § 343.40 What you must disclose. (a) Insurance disclosures....

  3. 12 CFR 343.40 - What you must disclose.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... 6103(a). (4) Electronic form of disclosures. (i) Subject to the requirements of section 101(c) of the Electronic Signatures in Global and National Commerce Act (12 U.S.C. 7001(c)), you may provide the written... CONSUMER PROTECTION IN SALES OF INSURANCE § 343.40 What you must disclose. (a) Insurance disclosures....

  4. 12 CFR 343.40 - What you must disclose.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... 6103(a). (4) Electronic form of disclosures. (i) Subject to the requirements of section 101(c) of the Electronic Signatures in Global and National Commerce Act (12 U.S.C. 7001(c)), you may provide the written... CONSUMER PROTECTION IN SALES OF INSURANCE § 343.40 What you must disclose. (a) Insurance disclosures....

  5. 12 CFR 343.40 - What you must disclose.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... 6103(a). (4) Electronic form of disclosures. (i) Subject to the requirements of section 101(c) of the Electronic Signatures in Global and National Commerce Act (12 U.S.C. 7001(c)), you may provide the written... CONSUMER PROTECTION IN SALES OF INSURANCE § 343.40 What you must disclose. (a) Insurance disclosures....

  6. 12 CFR 343.40 - What you must disclose.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... 6103(a). (4) Electronic form of disclosures. (i) Subject to the requirements of section 101(c) of the Electronic Signatures in Global and National Commerce Act (12 U.S.C. 7001(c)), you may provide the written... CONSUMER PROTECTION IN SALES OF INSURANCE § 343.40 What you must disclose. (a) Insurance disclosures....

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

    ERIC Educational Resources Information Center

    Mishna, Faye; Alaggia, Ramona

    2005-01-01

    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…

  8. HIV among Women

    MedlinePLUS

    ... you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | Subscribe ... Get Email Updates on HIV Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV ...

  9. Non-Verbal Behavior of Children Who Disclose or Do Not Disclose Child Abuse in Investigative Interviews

    ERIC Educational Resources Information Center

    Katz, Carmit; Hershkowitz, Irit; Malloy, Lindsay C.; Lamb, Michael E.; Atabaki, Armita; Spindler, Sabine

    2012-01-01

    Objective: The study focused on children's nonverbal behavior in investigative interviews exploring suspicions of child abuse. The key aims were to determine whether non-verbal behavior in the pre-substantive phases of the interview predicted whether or not children would disclose the alleged abuse later in the interview and to identify…

  10. HIV infection and HIV-associated behaviors among injecting drug users - 20 cities, United States, 2009.

    PubMed

    2012-03-01

    Despite a recent reduction in the number of human immunodeficiency virus (HIV) infections attributed to injecting drug use in the United States, 9% of new U.S. HIV infections in 2009 occurred among injecting drug users (IDUs). To monitor HIV-associated behaviors and HIV prevalence among IDUs, CDC's National HIV Behavioral Surveillance System (NHBS) conducts interviews and HIV testing in selected metropolitan statistical areas (MSAs). This report summarizes data from 10,073 IDUs interviewed and tested in 20 MSAs in 2009. Of IDUs tested, 9% had a positive HIV test result, and 45% of those testing positive were unaware of their infection. Among the 9,565 IDUs with HIV negative or unknown HIV status before the survey, 69% reported having unprotected vaginal sex, 34% reported sharing syringes, and 23% reported having unprotected heterosexual anal sex during the 12 previous months. Although these risk behavior prevalences appear to warrant increased access to HIV testing and prevention services, for the previous 12-month period, only 49% of the IDUs at risk for acquiring HIV infection reported having been tested for HIV, and 19% reported participating in a behavioral intervention. Increased HIV prevention and testing efforts are needed to further reduce HIV infections among IDUs. PMID:22377843

  11. Ethnic differences in HIV testing.

    PubMed

    Otiniano, M E; Shahjahan, M

    1999-09-01

    Testing plays an important role in the early detection of human immunodeficiency virus (HIV) infection and in the formulation of an appropriate management plan for patients who are infected with the virus. Statistical data from the City of Houston Health Department were reviewed for persons who were screened for HIV during 1996 to determine their demographic characteristics, counseling status after testing positive, and availability of medical insurance. Records of 29,085 persons were reviewed in Houston during 1996. Eight hundred eleven cases (3%) tested positive for HIV. Seventy-three percent of the HIV-positive persons received post-test counseling, and 82% of the HIV-positive persons had no health insurance. Of the total number of positive tests, 53% were African American; 28%, white; and 17%, Hispanic. Counseling after a positive test can be an important preventive measure for persons known to be at high risk for the disease. PMID:10518441

  12. 32 CFR 806b.48 - Disclosing the medical records of minors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Disclosing the medical records of minors. 806b... ADMINISTRATION PRIVACY ACT PROGRAM Disclosing Records to Third Parties § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their parents or...

  13. 32 CFR 806b.48 - Disclosing the medical records of minors.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Disclosing the medical records of minors. 806b... ADMINISTRATION PRIVACY ACT PROGRAM Disclosing Records to Third Parties § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their parents or...

  14. 32 CFR 806b.48 - Disclosing the medical records of minors.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Disclosing the medical records of minors. 806b... ADMINISTRATION PRIVACY ACT PROGRAM Disclosing Records to Third Parties § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their parents or...

  15. 32 CFR 806b.48 - Disclosing the medical records of minors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Disclosing the medical records of minors. 806b... ADMINISTRATION PRIVACY ACT PROGRAM Disclosing Records to Third Parties § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their parents or...

  16. 32 CFR 806b.48 - Disclosing the medical records of minors.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Disclosing the medical records of minors. 806b... ADMINISTRATION PRIVACY ACT PROGRAM Disclosing Records to Third Parties § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their parents or...

  17. Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

    E-print Network

    2009-01-01

    reduce depression and stigma among new HIV? parents may beto stigma, as many mothers ?rst learn of their HIV statusHIV-positive mother) Clinical response to ART in children was an important factor in reducing stigma.

  18. An Ecological Community-Based Participatory Research Study of Late Diagnosed HIV/AIDS in Oakland, California: Investigating influential factors in racial/ ethnic health inequities

    E-print Network

    Chopel, Alison Marie

    2014-01-01

    regard to immigration policies around HIV status. 19 Taylorrace US immigra- tion policies re: HIV infection Females andand policy developments must be designed in order to halt the increasing inequities in late diagnosed HIV and

  19. HIV Transmission

    MedlinePLUS

    ... HIV-negative partner. HIV is not spread through saliva. Learn more about how to protect yourself and ... not spread by Mosquitoes, ticks, or other insects. Saliva, tears, or sweat that is not mixed with ...

  20. HIV-Associated Neurocognitive Disorders: The Relationship of HIV Infection with Physical and Social Comorbidities

    PubMed Central

    Tedaldi, Ellen M.; Minniti, Nancy L.; Fischer, Tracy

    2015-01-01

    The prevalence of HIV (human immunodeficiency virus) associated neurocognitive disorders (HAND) will undoubtedly increase with the improved longevity of HIV-infected persons. HIV infection, itself, as well as multiple physiologic and psychosocial factors can contribute to cognitive impairment and neurologic complications. These comorbidities confound the diagnosis, assessment, and interventions for neurocognitive disorders. In this review, we discuss the role of several key comorbid factors that may contribute significantly to the development and progression of HIV-related neurocognitive impairment, as well as the current status of diagnostic strategies aimed at identifying HIV-infected individuals with impaired cognition and future research priorities and challenges. PMID:25815329

  1. Truth-telling to the patient, family, and the sexual partner: a rights approach to the role of healthcare providers in adult HIV disclosure in China

    PubMed Central

    Nie, Jing-Bao; Walker, Simon Thomas; Qiao, Shan; Li, Xiaoming; Tucker, Joseph D

    2015-01-01

    Patients’ rights are central in today’s legislation and social policies related to health care, including HIV care, in not only Western countries but around the world. However, given obvious socio-cultural differences it is often asked how or to what extent patients’ rights should be respected in non-Western societies such as China. In this paper, it is argued that the patients’ rights framework is compatible with Chinese culture, and that from the perspective of contemporary patient rights healthcare providers have a duty to disclose truthfully the diagnosis and prognosis to their patients, that the Chinese cultural practice of involving families in care should – with consent from the patient – be promoted out of respect for patients’ rights and well-being, and that healthcare providers should be prepared to address the issue of disclosing a patient’s HIV status to sexual partner(s). Legally, the provider should be permitted to disclose without consent from the patient but not obliged to in all cases. The decision to do this should be taken with trained sensitivity to a range of ethically relevant considerations. Post-disclosure counseling or psychological support should be in place to address the concerns of potentially adverse consequences of provider-initiated disclosure and to maximize the psychosocial and medical benefits of the disclosure. There is an urgent need for healthcare providers to receive training in ethics and disclosure skills. This paper concludes also with some suggestions for improving the centerpiece Chinese legislation, State Council’s “Regulations on AIDS Prevention and Control” (2006), to further safeguard the rights and well-being of HIV patients. PMID:26616129

  2. Truth-telling to the patient, family, and the sexual partner: a rights approach to the role of healthcare providers in adult HIV disclosure in China.

    PubMed

    Nie, Jing-Bao; Walker, Simon Thomas; Qiao, Shan; Li, Xiaoming; Tucker, Joseph D

    2015-12-01

    Patients' rights are central in today's legislation and social policies related to health care, including HIV care, in not only Western countries but around the world. However, given obvious socio-cultural differences it is often asked how or to what extent patients' rights should be respected in non-Western societies such as China. In this paper, it is argued that the patients' rights framework is compatible with Chinese culture, and that from the perspective of contemporary patient rights healthcare providers have a duty to disclose truthfully the diagnosis and prognosis to their patients, that the Chinese cultural practice of involving families in care should - with consent from the patient - be promoted out of respect for patients' rights and well-being, and that healthcare providers should be prepared to address the issue of disclosing a patient's HIV status to sexual partner(s). Legally, the provider should be permitted to disclose without consent from the patient but not obliged to in all cases. The decision to do this should be taken with trained sensitivity to a range of ethically relevant considerations. Post-disclosure counseling or psychological support should be in place to address the concerns of potentially adverse consequences of provider-initiated disclosure and to maximize the psychosocial and medical benefits of the disclosure. There is an urgent need for healthcare providers to receive training in ethics and disclosure skills. This paper concludes also with some suggestions for improving the centerpiece Chinese legislation, State Council's "Regulations on AIDS Prevention and Control" (2006), to further safeguard the rights and well-being of HIV patients. PMID:26616129

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    2013-06-01

    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

  5. Thoughts, Attitudes, and Feelings of HIV-Positive MSM Associated with High Transmission-Risk Sex

    ERIC Educational Resources Information Center

    Skinta, Matthew D.; Murphy, Jessie L.; Paul, Jay P.; Schwarcz, Sandra K.; Dilley, James W.

    2012-01-01

    This study presents survey data collected from a sample of HIV-positive men (N = 182) who had high transmission-risk sex, defined as unprotected anal intercourse with a man whose HIV-status was negative or unknown, in the previous 6 months. Despite the tremendous changes in HIV treatment and their impact on people living with HIV, little recent…

  6. The Experience of Sexual Risk Communication in African American Families Living with HIV

    ERIC Educational Resources Information Center

    Cederbaum, Julie A.

    2012-01-01

    Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV

  7. Opportunities for HIV Combination Prevention to Reduce Racial and Ethnic Health Disparities

    ERIC Educational Resources Information Center

    Grossman, Cynthia I.; Purcell, David W.; Rotheram-Borus, Mary Jane; Veniegas, Rosemary

    2013-01-01

    Despite advances in HIV prevention and care, African Americans and Latino Americans remain at much higher risk of acquiring HIV, are more likely to be unaware of their HIV-positive status, are less likely to be linked to and retained in care, and are less likely to have suppressed viral load than are Whites. The first National HIV/AIDS Strategy…

  8. Living Situation Affects Adherence to Combination Antiretroviral Therapy in HIV-Infected Adolescents in Rwanda: A Qualitative Study

    PubMed Central

    Mutwa, Philippe R.; Van Nuil, Jennifer Ilo; Asiimwe-Kateera, Brenda; Kestelyn, Evelyne; Vyankandondera, Joseph; Pool, Robert; Ruhirimbura, John; Kanakuze, Chantal; Reiss, Peter; Geelen, Sibyl; van de Wijgert, Janneke; Boer, Kimberly R.

    2013-01-01

    Introduction Adherence to combination antiretroviral therapy (cART) is vital for HIV-infected adolescents for survival and quality of life. However, this age group faces many challenges to remain adherent. We used multiple data sources (role-play, focus group discussions (FGD), and in-depth interviews (IDI)) to better understand adherence barriers for Rwandan adolescents. Forty-two HIV positive adolescents (ages 12–21) and a selection of their primary caregivers were interviewed. All were perinatally-infected and received (cART) for ?12 months. Topics discussed during FGDs and IDIs included learning HIV status, disclosure and stigma, care and treatment issues, cART adherence barriers. Results Median age was 17 years, 45% female, 45% orphaned, and 48% in boarding schools. We identified three overarching but inter-related themes that appeared to influence adherence. Stigma, perceived and experienced, and inadvertent disclosure of HIV status hampered adolescents from obtaining and taking their drugs, attending clinic visits, carrying their cARTs with them in public. The second major theme was the need for better support, in particular for adolescents with different living situations, (orphanages, foster-care, and boarding schools). Lack of privacy to keep and take medication came out as major barrier for adolescents living in congested households, as well the institutionalization of boarding schools where privacy is almost non-existent. The third important theme was the desire to be ‘normal’ and not be recognized as an HIV-infected individual, and to have a normal life not perturbed by taking a regimen of medications or being forced to disclose where others would treat them differently. Conclusions We propose better management of HIV-infected adolescents integrated into boarding school, orphanages, and foster care; training of school-faculty on how to support students and allow them privacy for taking their medications. To provide better care and support, HIV programs should stimulate caregivers of HIV-infected adolescents to join them for their clinic visits. PMID:23573232

  9. Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria.

    PubMed

    Johnson, Ofonime E

    2012-01-01

    People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA, to describe the level and patterns of stigma and discrimination, if any, experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends, family members, health workers, colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital, Uyo, Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire, which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority, 256 (77.3%), of the respondents were within the age range of 25-44 years. A total of 121 (36.6%) PLWHA were single and 151 (46.6%) were married, while the rest were widowed, divorced or separated. A majority, 129 (85.4%), of the married respondents disclosed their status to their spouses and 65 (50.4%) were supportive. Apart from spouses, disclosure to mothers (39.9%) was highest. Most clients (57.7%) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4%) of the respondents working for others did not disclose their status to their employers. Among those whose status was known, discrimination was reported to be highest among friends (23.2%) and at the workplace (20.2%). Attitudes such as hostility (14.5%), withdrawal (11.7%) and neglect (6.8%) were reported from the private hospitals. Apart from disclosure to spouses, the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility, neglect and withdrawal from friends, colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society. PMID:23237039

  10. The role of enacted stigma in parental HIV disclosure among HIV-infected parents in China

    PubMed Central

    Qiao, Shan; Li, Xiaoming; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu; Stanton, Bonita

    2015-01-01

    Existing studies have delineated that HIV-infected parents face numerous challenges in disclosing their HIV infection to the children (“parental HIV disclosure”), and practices of parental HIV disclosure vary with individual characteristics, family contexts, and social environment. Using cross-sectional data from 1254 HIV-infected parents who had children aged 5–16 years in southwest China, the current study examined the association of parental HIV disclosure with mental health and medication adherence among parents and explored the possible effect of enacted stigma on such association. Multivariate analysis of variance revealed that parents who had experienced disclosure to children reported higher level enacted stigma, worse mental health conditions, and poorer medication adherence. Enacted stigma partially mediated the associations between disclosure and both mental health and medication adherence after controlling basic background characteristics. Our findings highlight the importance of providing appropriate disclosure-related training and counseling service among HIV-infected parents. In a social setting where HIV-related stigma is still persistent, disclosure intervention should address and reduce stigma and discrimination in the practice of parental HIV disclosure. PMID:26616123

  11. The role of enacted stigma in parental HIV disclosure among HIV-infected parents in China.

    PubMed

    Qiao, Shan; Li, Xiaoming; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu; Stanton, Bonita

    2015-12-01

    Existing studies have delineated that HIV-infected parents face numerous challenges in disclosing their HIV infection to the children ("parental HIV disclosure"), and practices of parental HIV disclosure vary with individual characteristics, family contexts, and social environment. Using cross-sectional data from 1254 HIV-infected parents who had children aged 5-16 years in southwest China, the current study examined the association of parental HIV disclosure with mental health and medication adherence among parents and explored the possible effect of enacted stigma on such association. Multivariate analysis of variance revealed that parents who had experienced disclosure to children reported higher level enacted stigma, worse mental health conditions, and poorer medication adherence. Enacted stigma partially mediated the associations between disclosure and both mental health and medication adherence after controlling basic background characteristics. Our findings highlight the importance of providing appropriate disclosure-related training and counseling service among HIV-infected parents. In a social setting where HIV-related stigma is still persistent, disclosure intervention should address and reduce stigma and discrimination in the practice of parental HIV disclosure. PMID:26616123

  12. Serial knife stabbings with HIV exposure--implications for post-exposure prophylaxis.

    PubMed

    Jorgensen, Pernille; Marcus, Ulrich; Albrecht, Helmut; Suttorp, Norbert; Schürmann, Dirk

    2010-01-01

    Thirty-three persons became victims of a serial knife stabbing incident. One of the first victims one day later disclosed that he was HIV-infected. Thereafter thirty-one victims initiated HIV post-exposure prophylaxis (PEP), one exposed patient declined. None of the victims evaluated had seroconverted six months later. In most such incidents HIV exposure will be difficult to rule out as reliable information on the HIV serostatus of all serial victims will be lacking. It appears prudent, however, to inform serial stab victims about the potential risk of HIV transmission and to at least consider PEP in such scenarios. PMID:19840818

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

    PubMed

    Murphy, Patrick J; Hevey, David; O'Dea, Siobhán; Ní Rathaille, Neans; Mulcahy, Fiona

    2015-01-01

    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

  14. High-Risk Enteric Pathogens Associated with HIV-Infection and HIV-Exposure in Kenyan Children with Acute Diarrhea

    PubMed Central

    PAVLINAC, PB; JOHN-STEWART, GC; NAULIKHA, JM; ONCHIRI, FM; DENNO, DM; ODUNDO, EA; SINGA, BO; RICHARDSON, BA; WALSON, JL

    2015-01-01

    Objective HIV-infection is an established risk for diarrheal severity, less is known about specific enteric pathogens associated with HIV status. We determined associations of selected enteric pathogens with HIV-infection and HIV-exposure among Kenyan children. Design Cross-sectional study among 6 months to 15 year olds presenting to two Western Kenya District hospitals with acute diarrhea between 2011–2013. Methods Stool was tested using standard bacterial culture and microscopy for ova and parasites. HIV testing was obtained on children and mothers. Enteric pathogen prevalence was compared between HIV-infected and HIV-uninfected children and between HIV-exposed uninfected (HEU) and HIV-unexposed. Unadjusted and adjusted prevalence ratios (PR) for selected pathogens by HIV-status were estimated using relative risk (RR) regression and P-values. Age, site, income, household crowding, water source/treatment, anthropometrics, cotrimoxazole use, and breastfeeding history were accounted for in multivariable models. Results Among 1,076 children, median age was 22 months (interquartile range: 11–42), 56 (5.2%) were HIV-infected, and 10.3%(105/1020) of HIV-uninfected children were HIV-exposed. The following organisms were most frequently isolated from stool: enteroaggregative Escherichia coli (13.3%), Giardia spp. (11.1%) Campylobacter (6.3%), enteropathogenic Escherichia coli (EPEC) (6.1%) and Cryptosporidium spp. (3.7%). Accounting for age, HIV-infection was associated with EPEC infection (PR: 3.70, P=0.002) while HIV-exposure was associated with Cryptosporidium among HIV-uninfected children (PR: 2.81, P=0.005). Conclusion EPEC and Cryptosporidium infections were more common in HIV-infected and HIV-exposed children, respectively. This could explain the increased mortality attributed to these pathogens in other studies. Interventions targeting EPEC and Cryptosporidium may reduce morbidity and mortality in high HIV-prevalence settings. PMID:25028987

  15. HIV and Atherosclerosis

    MedlinePLUS

    ... Pressure High Blood Pressure Tools & Resources Stroke More HIV and Atherosclerosis Updated:Jan 22,2014 Featured Video ... improve your cholesterol ratios, with or without HIV. HIV and Your Heart • Home • About HIVHIV and ...

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

    PubMed Central

    Denis, Philippe

    2014-01-01

    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 government’s 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

  17. HIV testing in black Africans living in England.

    PubMed

    Rice, B; Delpech, V; Sadler, K E; Yin, Z; Elford, J

    2013-08-01

    We examined the uptake of HIV testing in black Africans living in England before the introduction of national testing guidelines. Analyses were conducted using data from an anonymous self-completed questionnaire linked to oral fluid samples to establish HIV status in black Africans attending community venues in England in 2004. Of 946 participants, 44% had ever been tested for HIV and 29% had been tested in the previous 24 months. Of those with undiagnosed HIV, 45% had previously had a negative HIV test. Almost a third of people tested in the UK had been at general practice. Uptake of HIV testing was not associated with perceived risk of HIV. These findings highlight the need for the implementation of national HIV testing guidelines in the UK, including the promotion of testing in general practice. Regular testing in black Africans living in the UK should be promoted regardless of their HIV test history. PMID:23040613

  18. HIV serostatus disclosure in the treatment cascade: evidence from Northern Tanzania.

    PubMed

    Ostermann, Jan; Pence, Brian; Whetten, Kathryn; Yao, Jia; Itemba, Dafrosa; Maro, Venance; Reddy, Elizabeth; Thielman, Nathan

    2015-12-01

    HIV serostatus disclosure plays an important role in HIV transmission risk reduction and is positively associated with HIV medication adherence and treatment outcomes. However, to date, no study has quantified the role of disclosure across the HIV treatment cascade, particularly in Sub-Saharan Africa. We used data from a cohort of HIV-infected adults in Northern Tanzania to describe associations between disclosure and engagement and retention in the HIV treatment cascade. Between 2008 and 2009, the Coping with HIV/AIDS in Tanzania (CHAT) study enrolled 260 clients newly diagnosed with HIV and 492 HIV-infected patients in established HIV care in two large HIV care and treatment centers in Northern Tanzania. Participants aged 18 and older completed annual clinical assessments and twice-annual in-person interviews for 3.5 years. Using logistic regression models, we assessed sociodemographic correlates of HIV serostatus disclosure to at least one household member, and associations between this disclosure measure and linkage to care, evaluation for antiretroviral therapy (ART) eligibility, ART coverage, and rates of undetectable HIV RNA levels during the follow-up period. Married individuals and those diagnosed earlier were more likely to have disclosed their HIV infection to at least one household member. During follow-up, HIV serostatus disclosure was associated with higher rates of linkage to care, evaluation for ART eligibility, and ART coverage. No significant association was observed with rates of undetectable viral loads. Marginal effects estimates suggest that a 10 percentage-point lower probability of linkage to care for those who did not disclose their HIV serostatus (86% vs. 96%; p?=?0.035) was compounded by an 18 percentage-point lower probability of ever receiving a CD4 count (62% vs. 80%; p?=?.039), and a 20 percentage-point lower probability of ever receiving ART (55% vs. 75%; p?=?.029). If causal, these findings suggest an important role for disclosure assistance efforts across the HIV treatment cascade. PMID:26616126

  19. HIV serostatus disclosure in the treatment cascade: evidence from Northern Tanzania

    PubMed Central

    Ostermann, Jan; Pence, Brian; Whetten, Kathryn; Yao, Jia; Itemba, Dafrosa; Maro, Venance; Reddy, Elizabeth; Thielman, Nathan

    2015-01-01

    ABSTRACT HIV serostatus disclosure plays an important role in HIV transmission risk reduction and is positively associated with HIV medication adherence and treatment outcomes. However, to date, no study has quantified the role of disclosure across the HIV treatment cascade, particularly in Sub-Saharan Africa. We used data from a cohort of HIV-infected adults in Northern Tanzania to describe associations between disclosure and engagement and retention in the HIV treatment cascade. Between 2008 and 2009, the Coping with HIV/AIDS in Tanzania (CHAT) study enrolled 260 clients newly diagnosed with HIV and 492 HIV-infected patients in established HIV care in two large HIV care and treatment centers in Northern Tanzania. Participants aged 18 and older completed annual clinical assessments and twice-annual in-person interviews for 3.5 years. Using logistic regression models, we assessed sociodemographic correlates of HIV serostatus disclosure to at least one household member, and associations between this disclosure measure and linkage to care, evaluation for antiretroviral therapy (ART) eligibility, ART coverage, and rates of undetectable HIV RNA levels during the follow-up period. Married individuals and those diagnosed earlier were more likely to have disclosed their HIV infection to at least one household member. During follow-up, HIV serostatus disclosure was associated with higher rates of linkage to care, evaluation for ART eligibility, and ART coverage. No significant association was observed with rates of undetectable viral loads. Marginal effects estimates suggest that a 10 percentage-point lower probability of linkage to care for those who did not disclose their HIV serostatus (86% vs. 96%; p?=?0.035) was compounded by an 18 percentage-point lower probability of ever receiving a CD4 count (62% vs. 80%; p?=?.039), and a 20 percentage-point lower probability of ever receiving ART (55% vs. 75%; p?=?.029). If causal, these findings suggest an important role for disclosure assistance efforts across the HIV treatment cascade. PMID:26616126

  20. Exploring Social Networking Technologies as Tools for HIV Prevention for Men Who Have Sex With Men.

    PubMed

    Ramallo, Jorge; Kidder, Thomas; Albritton, Tashuna; Blick, Gary; Pachankis, John; Grandeleski, Valen; Kershaw, Trace

    2015-08-01

    Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social etiquettes and rules that may increase HIV risk by discouraging HIV status disclosure. Overall, successful interventions for MSM using social networking technologies must consider aspects of privacy, stigma, and social norms in order to enact HIV reduction among MSM. PMID:26241381

  1. Right to know and the duty to disclose hazard information

    SciTech Connect

    Baram, M.S.

    1984-04-01

    Since 1970, OSHA has used its authority to regulate various health and safety hazards in private workplaces. Two types of OSHA regulations establish rights to know and duties to disclose: rules dealing with specific substances, and generic access to information rules. OSHA rules for specific hazards such as coke oven emissions, asbestos, arsenic, acrylonitrile, cotton dust, noise, and lead each contain separate requirements for record compilation, reporting, and worker access. Generic rights of access and duties to disclose are afforded by three OSHA rules: the rule on inspections under the general duty clause of the enabling statute, the access to medical and exposure records rule, and the new hazard communication rule. Under the general duty clause and OSHA regulation, workers have the right to request OSHA inspection, and to be notified of any imminent dangers of death or serious physical harm discovered by the inspector. The effectiveness of this rule is dependent on worker initiative, OSHA inspection, and the extent to which proprietary claims limit disclosures. It is usually invoked after some exposure has occurred, and thus has a somewhat limited role in risk prevention. Legal and historical aspects of these regulations are discussed in detail in this review. 38 references

  2. Increasing Rates of Obesity among HIV-Infected Persons during the HIV Epidemic

    PubMed Central

    Crum-Cianflone, Nancy; Roediger, Mollie Poehlman; Eberly, Lynn; Headd, Maryam; Marconi, Vincent; Ganesan, Anuradha; Weintrob, Amy; Barthel, R. Vincent; Fraser, Susan; Agan, Brian K.

    2010-01-01

    Background The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV)-infected persons are unknown. Methods We evaluated prospective data from a U.S. Military HIV Natural History Study (1985–2004) consisting of early diagnosed patients. Statistics included multivariate linear regression and longitudinal linear mixed effects models. Results Of 1682 patients, 2% were underweight, 37% were overweight, and 9% were obese at HIV diagnosis. Multivariate predictors of a higher body mass index (BMI) at diagnosis included more recent year of HIV diagnosis, older age, African American race, and earlier HIV stage (all p<0.05). The majority of patients (62%) gained weight during HIV infection. Multivariate factors associated with a greater increase in BMI during HIV infection included more recent year of diagnosis, lower BMI at diagnosis, higher CD4 count, lower HIV RNA level, lack of AIDS diagnosis, and longer HIV duration (all p<0.05). Nucleoside agents were associated with less weight gain; other drug classes had no significant impact on weight change in the HAART era. Conclusions HIV-infected patients are increasingly overweight/obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general population. Weight management programs may be important components of HIV care. PMID:20419086

  3. Understanding Treatment Refusal Among Adults Presenting for HIV-Testing in Soweto, South Africa: A Qualitative Study

    PubMed Central

    Dietrich, Janan; Tshabalala, Gugu; Essien, Thandekile; Rough, Kathryn; Wright, Alexi A.; Bangsberg, David R.; Gray, Glenda E.; Ware, Norma C.

    2014-01-01

    HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described feeling “too healthy” to start treatment, despite often having a diagnosis of AIDS. This subjective view of wellness was framed within the context of treatment being reserved for the sick. Taking ART could also lead to unintended disclosure and social isolation. These data provide a novel explanatory model of treatment refusal, recognizing perceived risks and social costs incurred when disclosing one’s status through treatment initiation. Our findings suggest that improving engagement in care for people living with HIV in South Africa will require optimizing social integration and connectivity for those who test positive. PMID:25304330

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

    PubMed

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

    2016-02-01

    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

  5. HIV transmission risk behavior among HIV-positive patients receiving antiretroviral therapy in KwaZulu-Natal, South Africa.

    PubMed

    Shuper, Paul A; Kiene, Susan M; Mahlase, Gethwana; MacDonald, Susan; Christie, Sarah; Cornman, Deborah H; Fisher, William A; Greener, Ross; Lalloo, Umesh G; Pillay, Sandy; van Loggerenberg, Francois; Fisher, Jeffrey D

    2014-08-01

    The aim of this investigation was to identify factors associated with HIV transmission risk behavior among HIV-positive women and men receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa. Across 16 clinics, 1,890 HIV+ patients on ART completed a risk-focused audio computer-assisted self-interview upon enrolling in a prevention-with-positives intervention trial. Results demonstrated that 62 % of HIV-positive patients' recent unprotected sexual acts involved HIV-negative or HIV status unknown partners. For HIV-positive women, multivariable correlates of unprotected sex with HIV-negative or HIV status unknown partners were indicative of poor HIV prevention-related information and of sexual partnership-associated behavioral skills barriers. For HIV-positive men, multivariable correlates represented motivational barriers, characterized by negative condom attitudes and the experience of depressive symptomatology, as well as possible underlying information deficits. Findings suggest that interventions addressing gender-specific and culturally-relevant information, motivation, and behavioral skills barriers could help reduce HIV transmission risk behavior among HIV-positive South Africans. PMID:24158486

  6. 46 CFR 502.201 - Duty to disclose; general provisions governing discovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...disclose; general provisions governing discovery. 502.201 Section 502.201...PRACTICE AND PROCEDURE Disclosures and Discovery § 502.201 Duty to disclose; general provisions governing discovery. (a) Applicability....

  7. 46 CFR 502.201 - Duty to disclose; general provisions governing discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...disclose; general provisions governing discovery. 502.201 Section 502.201...PRACTICE AND PROCEDURE Disclosures and Discovery § 502.201 Duty to disclose; general provisions governing discovery. (a) Applicability....

  8. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...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....

  9. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...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...

  10. 20 CFR 603.9 - What safeguards and security requirements apply to disclosed information?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...security requirements apply to disclosed information? 603.9 Section 603.9 Employees...CONFIDENTIALITY AND DISCLOSURE OF STATE UC INFORMATION Confidentiality and Disclosure Requirements...security requirements apply to disclosed information? (a) In general . For...

  11. 75 FR 54802 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ...1545-BJ54 Requirement of a Statement Disclosing Uncertain Tax Positions AGENCY: Internal Revenue Service (IRS...corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the IRS. This document...

  12. 75 FR 78160 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ...1545-BJ54 Requirement of a Statement Disclosing Uncertain Tax Positions AGENCY: Internal Revenue Service (IRS...corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the IRS. DATES:...

  13. 48 CFR 2014.407-3 - Other mistakes disclosed before award.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... true Other mistakes disclosed before award. 2014.407-3 Section 2014.407-3 Federal Acquisition Regulations System...BIDDING Opening of Bids and Award of Contract 2014.407-3 Other mistakes disclosed before...

  14. 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 Failure to disclose lead-based paint hazards. (a) General. ...the Office of Healthy Homes and Lead Hazard Control, or his...

  15. 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 Failure to disclose lead-based paint hazards. (a) General. ...the Office of Healthy Homes and Lead Hazard Control, or his...

  16. 48 CFR 514.407-3 - Other mistakes disclosed before award.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... false Other mistakes disclosed before award. 514.407-3 Section 514.407-3 Federal Acquisition Regulations System...SEALED BIDDING Opening of Bids and Award of Contract 514.407-3 Other mistakes disclosed before...

  17. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...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....

  18. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...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...

  19. From Space to the Patient: A New Cytokine Release Assay to Monitor the Immune Status of HIV Infected Patients and Sepsis Patients

    NASA Technical Reports Server (NTRS)

    Kaufmann, I.; Draenert, R.; Gruber, M.; Feuerecker, M.; Crucian, B. E.; Mehta, S. L.; Roider, J.; Pierson, D. L.; Briegel, J. M.; Schelling, G.; Sams, C. F.; Chouker, A.

    2013-01-01

    Monitoring of humans either in the healthy men under extreme environmental stress like space flight, in human immunodeficiency virus (HIV) infected patients or in sepsis is of critical importance with regard to the timing of adequate therapeutic (counter-)measures. The in vivo skin delayed-type hypersensitivity test (DTH) served for many years as a tool to evaluate cell mediated immunity. However, this standardised in vivo test was removed from the market in 2002 due to the risk of antigen stabilization. To the best of our knowledge an alternative test as monitoring tool to determine cell mediated immunity is not available so far. For this purpose we tested a new alternative assay using elements of the skin DTH which is based on an ex vivo cytokine release from whole blood and asked if it is suitable and applicable to monitor immune changes in HIV infected patients and in patients with septic shock.

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

    PubMed Central

    2012-01-01

    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-naïve 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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

    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…

  2. 43 CFR 3862.2-3 - Trustee to disclose nature of trust.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Trustee to disclose nature of trust. 3862... Lode Mining Claim Patent Applications § 3862.2-3 Trustee to disclose nature of trust. Any party applying for patent as trustee must disclose fully the nature of the trust and the name of the cestui...

  3. 43 CFR 3862.2-3 - Trustee to disclose nature of trust.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Trustee to disclose nature of trust. 3862... Lode Mining Claim Patent Applications § 3862.2-3 Trustee to disclose nature of trust. Any party applying for patent as trustee must disclose fully the nature of the trust and the name of the cestui...

  4. 43 CFR 3862.2-3 - Trustee to disclose nature of trust.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Trustee to disclose nature of trust. 3862... Lode Mining Claim Patent Applications § 3862.2-3 Trustee to disclose nature of trust. Any party applying for patent as trustee must disclose fully the nature of the trust and the name of the cestui...

  5. 43 CFR 3862.2-3 - Trustee to disclose nature of trust.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Trustee to disclose nature of trust. 3862... Lode Mining Claim Patent Applications § 3862.2-3 Trustee to disclose nature of trust. Any party applying for patent as trustee must disclose fully the nature of the trust and the name of the cestui...

  6. 43 CFR 3862.2-3 - Trustee to disclose nature of trust.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Trustee to disclose nature of trust. 3862.2-3 Section 3862... § 3862.2-3 Trustee to disclose nature of trust. Any party applying for patent as trustee must disclose fully the nature of the trust and the name of the...

  7. Get Tested for HIV

    MedlinePLUS

    ... Submit Home > HIV/AIDS > Get tested for HIV HIV/AIDS This information in Spanish ( en español ) Get tested for HIV When should I get tested for HIV? Types ... to top More information on Get tested for HIV Explore other publications and websites HIV Anonymous Testing, ...

  8. "Manejar la Situacion": Partner Notification, Partner Management, and Conceptual Frameworks for HIV/STI Control Among MSM in Peru.

    PubMed

    Clark, Jesse L; Perez-Brumer, Amaya; Salazar, Ximena

    2015-12-01

    Previous analyses of partner notification (PN) have addressed individual, interpersonal, social, and structural issues influencing PN outcomes but have paid less attention to the conceptual framework of PN itself. We conducted 18 individual interviews and 8 group discussions, in a two-stage qualitative research process, to explore the meanings and contexts of PN for sexually transmitted infections (STI) among men who have sex with men (MSM) and men who have sex with men and women (MSMW) in Lima, Peru. Participants described PN as the open disclosure of private, potentially stigmatizing information that could strengthen or disrupt a partnership, structured by the tension between concealment and revelation. In addition to informing partners of an STI diagnosis, the act of PN was believed to reveal other potentially stigmatizing information related to sexual identity and practices such as homosexuality, promiscuity, and HIV co-infection. In this context, the potential development of visible, biological STI symptoms represented a risk for disruption of the boundary between secrecy and disclosure that could result in involuntary disclosure of STI status. To address the conflict between concealment and disclosure, participants cited efforts to "manejar la situacion" (manage the situation) by controlling the biological risks of STI exposure without openly disclosing STI status. We use this concept of "managing the situation" as a practical and theoretical framework for comprehensive Partner Management for HIV/STI control systems among MSM in Latin America. PMID:25821149

  9. Impact of cocaine abuse on HIV pathogenesis

    PubMed Central

    Dash, Sabyasachi; Balasubramaniam, Muthukumar; Villalta, Fernando; Dash, Chandravanu; Pandhare, Jui

    2015-01-01

    Over 1.2 million people in the United States are infected with the human immunodeficiency virus type 1 (HIV-1). Tremendous progress has been made over the past three decades on many fronts in the prevention and treatment of HIV-1 disease. However, HIV-1 infection is incurable and antiretroviral drugs continue to remain the only effective treatment option for HIV infected patients. Unfortunately, only three out of ten HIV-1 infected individuals in the US have the virus under control. Thus, majority of HIV-1 infected individuals in the US are either unaware of their infection status or not connected/retained to care or are non-adherent to antiretroviral therapy (ART). This national public health crisis, as well as the ongoing global HIV/AIDS pandemic, is further exacerbated by substance abuse, which serves as a powerful cofactor at every stage of HIV/AIDS including transmission, diagnosis, pathogenesis, and treatment. Clinical studies indicate that substance abuse may increase viral load, accelerate disease progression and worsen AIDS-related mortality even among ART-adherent patients. However, confirming a direct causal link between substance abuse and HIV/AIDS in human patients remains a highly challenging endeavor. In this review we will discuss the recent and past developments in clinical and basic science research on the effects of cocaine abuse on HIV-1 pathogenesis. PMID:26539167

  10. Relationship characteristics and HIV transmission risk in same-sex male couples in HIV serodiscordant relationships.

    PubMed

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

    2014-01-01

    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 within serodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (n couples = 91; n individuals = 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 strategic positioning unprotected anal sex. Results of multinomial logistic regression indicated that HIV-negative partners' levels of relationship commitment were positively associated with the odds of engaging in strategic positioning sexual behaviors. For HIV-negative partners, reports of relationship intimacy, and sexual satisfaction were negatively associated with odds of reporting risk taking behavior. In contrast, HIV-positive partners' reported 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 of discussions of HIV risk reduction strategies, enhancing communication between partners, and support for general relationship functioning in HIV care. PMID:24243004

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

    PubMed Central

    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

    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

  12. Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results

    PubMed Central

    Beck-Sagué, Consuelo M.; Dévieux, Jessy; Pinzón-Iregui, Maria Claudia; Lerebours-Nadal, Leonel; Abreu-Pérez, Rosa; Bertrand, Rachel; Rouzier, Vanessa; Gaston, Stephanie; Ibanez, Gladys; Halpern, Mina; Pape, Jean W.; Dorceus, Patricia; Preston, Sharice M.; Dean, Andrew G.; Nicholas, Stephen W.; Blasini, Ileana

    2015-01-01

    Objectives To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic. Design A quasi-experimental trial was conducted comparing caregiver–youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth. Methods Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0–17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation. Results To date, 65 Dominican Republic and 27 Haiti caregiver–youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM. Conclusion Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM. PMID:26049543

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

    PubMed

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

    2014-12-01

    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

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

    PubMed

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

    2013-09-01

    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

  15. Sexual orientation- and race-based discrimination and sexual HIV risk behavior among urban MSM.

    PubMed

    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

    2015-02-01

    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 32 years; 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-negative status (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

  16. Hepatitis B and HIV

    MedlinePLUS

    ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ... of Opportunistic Infections in HIV-Infected Adults and Adolescents , HRSA’s Clinical Guide for HIV/AIDS Care , and ...

  17. Testing for HIV

    MedlinePLUS

    ... Vaccines, Blood & Biologics Safety & Availability (Biologics) HIV Home Test Kits Testing for HIV Share Tweet Linkedin Pin it ... for HIV? A complete list of the HIV test kits approved in the U.S. is available on our ...

  18. HIV and Your Heart

    MedlinePLUS

    ... Pressure High Blood Pressure Tools & Resources Stroke More HIV and Your Heart Banner 1 - HIV and Your ... Commercial support for this program was provided by HIV Wellness Checklist People living with HIV have even ...

  19. HIV Medication Adherence

    MedlinePLUS

    HIV Treatment HIV Medication Adherence (Last updated 4/29/2015; last reviewed 4/29/2015) Key Points Medication adherence means sticking ... exactly as prescribed. Why is adherence to an HIV regimen important? Adherence to an HIV regimen gives ...

  20. 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 ...

  1. Basic HIV/AIDS Statistics

    MedlinePLUS

    ... you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | Subscribe ... Get Email Updates on HIV Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV/ ...

  2. The question of disclosing the diagnosis to terminally ill patients.

    PubMed

    Hartwich, P

    1979-07-01

    The question of disclosing the diagnosis to terminally ill patients was investigated by means of a semi-standardized interview of 56 subjects who had been 'told the truth' about their condition. The effects and interdependence of the factors of age, personality structure (EPI neuroticism scale), duration of knowledge, social contact, and religiousness, on the patient's ability to cope with the information were examined. The process of adjustment was assessed according to the stages proposed by Kübler-Ross (1969). Using the statistical model of path analysis, it was possible to evaluate these individual factors and present linearly their interrelationships. These results can offer medical staff the following guidelines: Three factors (a) advanced years, (b) good social contact, and (c) optimally unneurotic personality structure, provide the optimum conditions for a positive adjustment to the disclosure of a diagnosis of fatal illness. If, however, only one or two of these factors are involved, or if they are evident only to a slight degree, then conditions for telling the truth are less positive. On the other hand, in the case of (a) youth, (b) restricted social contact, and (c) a more markedly neurotic person, particular caution is recommended, since the danger of a negative reaction, and indeed even of suicide, must be reckoned with. PMID:496613

  3. A model for how to disclose physical security vulnerabilities.

    SciTech Connect

    Johnston, R. G.

    2009-01-01

    When security vulnerabilities are discovered, it is often unclear how much public disclosure of the vulnerabilities is prudent. This is especially true for physical security vis a vis cyber security. We never want to help the 'bad guys' more than the 'good guys', but if the good guys aren't made aware of the problems, they are unlikely to fix them. This paper presents a unique semi-quantitative tool, called the 'Vulnerability Disclosure Index' (VDI), to help determine how much disclosure of vulnerabilities is warranted and in what forum. The VDI certainly does not represent the final, definitive answer to this complex issue. It does, however, provide a starting point for thinking about some of the factors that must go into making such a decision. Moreover, anyone using the VDI tool can at least claim to have shown some degree of responsibility in contemplating disclosure issues. The purpose of this paper is to provide a tool to help decide if and how security vulnerabilities should be disclosed. This tool, called the Vulnerability Disclosure Index (VDI), is not presented here as the ultimate, authoritative method for dealing with this complex issue. It is offered instead as a first step, and as a vehicle for thinking about and discussing some of the factors that need to be pondered when vulnerability disclosures are being considered.

  4. [Cerebral thrombophlebitis disclosing Behçet disease. Value of high resolution MRI].

    PubMed

    Sulimovic, H; Flaisler, F; Teissier, J M; Lopez, F M; Combe, B

    1993-01-01

    A 21-year-old male of Moroccan descent was admitted for inflammatory polyarthralgia and monoarthritis of the left knee. The patient reported a history of recurrent isolated aphthous ulcerations of the oral cavity. He was found to be positive for the HLA B5 antigen. The other investigations for Behçet's disease were negative. During hospitalization, headache responsible for insomnia developed. Neurologic evaluation was normal, as well as funduscopy and spinal tap findings. CT scan images were suggestive of cerebral thrombophlebitis. Magnetic resonance imaging (MRI) disclosed an old thrombosis of the right transverse sinus. Time-of-flight MRI (MRI with sequences adapted to the study of vessels) evidenced recent thrombophlebitis of the left transverse sinus. Cerebral angiography fully confirmed MRI findings. Treatment with a corticosteroid and an anticoagulant was successful. Final diagnosis was Behçet's disease. Subsequently, the patient developed additional features of the disease, including hypersensitivity to pinprick, retinal vasculitis, and erythema nodosum. This case is interesting for two reasons: cerebral thrombophlebitis in Behçet's disease can manifest as localized headache. It occurs in 6 to 13% of patients. Early diagnosis and treatment are essential; MRI features of cerebral thrombophlebitis were confirmed by the cerebral angiogram. MRI established that the thrombophlebitis was of recent onset. MRI may be appropriate as the initial investigation in patients with suspected cerebral thrombophlebitis. PMID:8242030

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

    PubMed

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

    2013-01-01

    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

  6. 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...

  7. HIV / AIDS

    MedlinePLUS

    ... Marketing Share this: Main Content Area Understanding HIV/AIDS AIDS was first reported in the United States in ... and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or ...

  8. 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 Central

    Noor, Syed WB; Rampalli, Krystal; Rosser, B.R. Simon

    2014-01-01

    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=3309) from an online survey conducted across 16 US 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 90 days) 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

  9. 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

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

    2014-09-01

    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 90 days) 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

  10. HIV-associated dementia: A diagnostic dilemma

    PubMed Central

    Saldanha, Daniel; Beniwal, Sumit; Bhattacharya, Labanya; Srivastava, Kalpana

    2011-01-01

    Background: Considerable clinical research has been conducted to increase our knowledge in understanding the underlying neuropathological significance of HIV viral infection. Aim: To find the incidence of HIV Associated Dementia in a suburban part of India. Materials and Methods: 6135 prospective cases from January 2008 to August 2010 were subjected to pretest counseling. Those willing were tested for HIV status using western blot test. Results: 5688 (92.71%) underwent for detection of HIV.273 (4.8%) were tested positive. 246 out of these (90.10%) were put on ART. 1 (0.37%) was detected to have HAD stage II.38 cases (18.92%) had varied psychiatric symptoms. Conclusion: HAART has considerably reduced morbidity in HIV infection. PMID:23271867

  11. HIV and Child Mental Health: A Case-Control Study in Rwanda

    PubMed Central

    Scorza, Pamela; Kanyanganzi, Frederick; Fawzi, Mary C. Smith; Sezibera, Vincent; Cyamatare, Felix; Beardslee, William; Stulac, Sara; Bizimana, Justin I.; Stevenson, Anne; Kayiteshonga, Yvonne

    2014-01-01

    BACKGROUND: The global HIV/AIDS response has advanced in addressing the health and well-being of HIV-positive children. Although attention has been paid to children orphaned by parental AIDS, children who live with HIV-positive caregivers have received less attention. This study compares mental health problems and risk and protective factors in HIV-positive, HIV-affected (due to caregiver HIV), and HIV-unaffected children in Rwanda. METHODS: A case-control design assessed mental health, risk, and protective factors among 683 children aged 10 to 17 years at different levels of HIV exposure. A stratified random sampling strategy based on electronic medical records identified all known HIV-positive children in this age range in 2 districts in Rwanda. Lists of all same-age children in villages with an HIV-positive child were then collected and split by HIV status (HIV-positive, HIV-affected, and HIV-unaffected). One child was randomly sampled from the latter 2 groups to compare with each HIV-positive child per village. RESULTS: HIV-affected and HIV-positive children demonstrated higher levels of depression, anxiety, conduct problems, and functional impairment compared with HIV-unaffected children. HIV-affected children had significantly higher odds of depression (1.68: 95% confidence interval [CI] 1.15–2.44), anxiety (1.77: 95% CI 1.14–2.75), and conduct problems (1.59: 95% CI 1.04–2.45) compared with HIV-unaffected children, and rates of these mental health conditions were similar to HIV-positive children. These results remained significant after controlling for contextual variables. CONCLUSIONS: The mental health of HIV-affected children requires policy and programmatic responses comparable to HIV-positive children. PMID:25049342

  12. 77 FR 37415 - Office of Urban Indian Health Programs; Title V HIV/AIDS Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-21

    ...of Urban Indian Health Programs; Title V HIV/AIDS Program Announcement Type: New Limited...of Urban Indian Health Programs Title V HIV/AIDS program. This program is authorized...Title V grants to increase awareness of HIV/AIDS status among urban American...

  13. Developing a Measure of Stigma by Association with African American Adolescents Whose Mothers Have HIV

    ERIC Educational Resources Information Center

    Mason, Sally; Berger, Barbara; Ferrans, Carol Estwing; Sultzman, Vickey; Fendrich, Michael

    2010-01-01

    Objectives: African American urban adolescents are one of the fastest growing groups of children affected by their mother's HIV status. These children experience HIV stigma by association with their HIV-positive mothers. Stigma may contribute to adverse outcomes for these teens. Methods: The authors describe a multistage process of scale…

  14. Unreported Male Sex Partners Among Men with Newly Diagnosed HIV Infection - North Carolina, 2011-2013.

    PubMed

    Wu, Hsiu; Hightow-Weidman, Lisa B; Gay, Cynthia L; Zhang, Xinjian; Beagle, Steve; Hall, Laura; Jackson, Tonyka; Marmorino, Jenni; Do, Ann N; Peters, Philip J

    2015-09-25

    Human immunodeficiency virus (HIV) prevention interventions, such as preexposure prophylaxis (PrEP), are often targeted to men who have sex with men (MSM) who self-report high-risk behaviors. Data from a prospective study evaluating methods to detect acute HIV infection among a primarily young (aged <25 years) and black or African American (African American) population from North Carolina were analyzed. In the study, participants were asked about risk behaviors during pretest counseling (at the time of testing) and then during a partner services interview (at HIV diagnosis). Participants whose disclosure of sexual risk behaviors during pretest counseling was different from their disclosure of sexual risk behaviors during their partner services interview were identified, and factors associated with these discordant responses were examined. Among 113 HIV-infected men, 26 (23.0%) did not disclose male sex partners at pretest counseling, but subsequently did disclose this information during their partner services interview. When compared with men who disclosed having male partners at pretest counseling, these 26 MSM who did not disclose male partners during pretest counseling were found to have a similar number of male partners during contact tracing, but were more likely to have a female partner (30.8% versus 6.9%). In addition, the proportions of MSM found to have at least one HIV-infected partner were similar for both groups (MSM who disclosed having male partners during pretest counseling and those who did not). To better customize HIV prevention interventions for MSM, HIV prevention programs might consider using novel strategies to accurately assess risk in this population. PMID:26401589

  15. Relationship of vitamin D, HIV, HIV treatment and lipid levels in the Women’s Interagency HIV study (WIHS) of HIV-infected and un-infected women in the US

    PubMed Central

    Schwartz, Janice B.; Moore, Kelly L.; Yin, Michael; Sharma, Anjali; Merenstein, Dan; Islam, Talat; Golub, Elizabeth T.; Tien, Phyllis C.; Adeyemi, Oluwatoyin M.

    2014-01-01

    Relationships between vitamin D, lipids, HIV infection, and HIV treatment (±ART) were investigated with Women’s Interagency HIV Study data (n=1758 middle-aged women) using multivariable regression. 63 % had vitamin D deficiency. Median 25-OH vitamin D was highest in HIV-infected +ART-treated women (17 ng/mL, p<0.001), but the same in HIV-uninfected or HIV-infected without ART (14 ng/mL). Vitamin D levels were lower if ART included efavirenz (15 vs 19 ng/mL, p<0.001). The most common lipid abnormality was high triglycerides (?200 mg/dL) in HIV-infected +ART, (13%, vs 7% of HIV-infected without ART and 5% of HIV-uninfected (p<0.001) with a positive relationship between 25-OH-D and triglycerides (95% confidence interval 0.32 to 1.69, p<.01). No relationships between 25-OH-D and cholesterol were detected. Vitamin D deficiency is common irrespective of HIV status but influenced by HIV treatment. Similarly, vitamin D levels were positively related to triglycerides only in ART treated HIV infected, and unrelated to cholesterol. PMID:24668135

  16. Behavioral and Psychological Responses to HIV Antibody Testing.

    ERIC Educational Resources Information Center

    Jacobsen, Paul B.; And Others

    1990-01-01

    Considers effects of informing individuals of their antibody status as determined by human immunodeficiency virus (HIV) antibody testing. Reviews research examining changes in psychological distress and in behaviors associated with HIV infections among individuals who have undergone antibody testing. Identifies methodological issues in studying…

  17. "You're Awfully Old to Have This Disease": Experiences of Stigma and Ageism in Adults 50 Years and Older Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Emlet, Charles A.

    2006-01-01

    Purpose: Older adults living with HIV infection may be doubly stigmatized, as they are branded by both age as well as HIV status. Through semistructured interviews, this study sought to examine whether older adults with HIV/AIDS experience both ageism and HIV stigma and how those experiences manifest in their lives. Design and Methods: This was a…

  18. Adaptation of the HIV Stigma Scale in Spaniards with HIV.

    PubMed

    Fuster-RuizdeApodaca, Maria José; Molero, Fernando; Holgado, Francisco Pablo; Ubillos, Silvia

    2015-01-01

    The primary goal of this study was to adapt Berger, Ferrans, & Lahley (2001) HIV Stigma Scale in Spain, using Bunn, Solomon, Miller, & Forehand (2007) version. A second goal assessed whether the four-factor structure of the adapted scale could be explained by two higher-order dimensions, perceived external stigma and internalized stigma. A first qualitative study (N = 40 people with HIV, aged 28-59) was used to adapt the items and test content validity. A second quantitative study analyzed construct and criterion validity. In this study participants were 557 people with HIV, aged 18-76. The adapted HIV Stigma Scale for use in Spain (HSSS) showed a good internal consistency (? = .88) and good construct validity. Confirmatory Factor Analyses yielded a first-order, four-factor structure and a higher-order, bidimensional structure with the two expected factors (RMSEA = .051, 90% CI [.046, .056]; RMR = .073; GFI = .96; AGFI = .96; CFI = .98). Negative relations were found between stigma and quality of life (r = -.39; p < .01), self-efficacy to cope with stigma (r = -.50; p < .01) and the degree of HIV status disclosure (r = -.35; p < .01). Moreover, the people who had suffered AIDS-related opportunistic infections had a higher score in the Perceived External Stigma dimension than those who had not suffered them, t (493) = 3.02, p = .003, d = 0.26. PMID:26369905

  19. 37 CFR 5.5 - Permit to disclose or modification of secrecy order.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Permit to disclose or modification of secrecy order. 5.5 Section 5.5 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... FILE APPLICATIONS IN FOREIGN COUNTRIES Secrecy Orders § 5.5 Permit to disclose or modification...

  20. 45 CFR 1159.13 - In what other situations will the Endowment disclose its records?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...other situations will the Endowment disclose its records? 1159.13 Section 1159.13...other situations will the Endowment disclose its records? (a) The Endowment shall...sufficient historical or other value to warrant its continued preservation by the United...

  1. TITLE: AUTHORIZATION TO DISCLOSE PATIENT INFORMATION PATIENT ACCESS USE AND DISCLOSURE OF MEDICAL

    E-print Network

    Columbia University

    to disclose their medical information to another physician, hospital, or medical facility, an attorney information must be reviewed before protected health information is disclosed: A patient or other designated information to a physician, hospital, or medical facility upon receipt of the required authorization

  2. 24 CFR 30.65 - Failure to disclose lead-based paint hazards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Failure to disclose lead-based... to disclose lead-based paint hazards. (a) General. The Director of the Office of Healthy Homes and Lead Hazard Control, or his or her designee, may initiate a civil money penalty action against...

  3. 24 CFR 30.65 - Failure to disclose lead-based paint hazards.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Failure to disclose lead-based... to disclose lead-based paint hazards. (a) General. The Director of the Office of Healthy Homes and Lead Hazard Control, or his or her designee, may initiate a civil money penalty action against...

  4. 24 CFR 30.65 - Failure to disclose lead-based paint hazards.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Failure to disclose lead-based... to disclose lead-based paint hazards. (a) General. The Director of the Office of Healthy Homes and Lead Hazard Control, or his or her designee, may initiate a civil money penalty action against...

  5. 24 CFR 30.65 - Failure to disclose lead-based paint hazards.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Failure to disclose lead-based... to disclose lead-based paint hazards. (a) General. The Director of the Office of Healthy Homes and Lead Hazard Control, or his or her designee, may initiate a civil money penalty action against...

  6. 24 CFR 30.65 - Failure to disclose lead-based paint hazards.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Failure to disclose lead-based... to disclose lead-based paint hazards. (a) General. The Director of the Office of Healthy Homes and Lead Hazard Control, or his or her designee, may initiate a civil money penalty action against...

  7. 49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 9 2013-10-01 2013-10-01 false SSI disclosed by TSA or the Coast Guard. 1520.15... PROTECTION OF SENSITIVE SECURITY INFORMATION § 1520.15 SSI disclosed by TSA or the Coast Guard. (a) In... available for public inspection or copying, nor does TSA or the Coast Guard release such records to...

  8. 49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 9 2014-10-01 2014-10-01 false SSI disclosed by TSA or the Coast Guard. 1520.15... PROTECTION OF SENSITIVE SECURITY INFORMATION § 1520.15 SSI disclosed by TSA or the Coast Guard. (a) In... available for public inspection or copying, nor does TSA or the Coast Guard release such records to...

  9. 49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 9 2011-10-01 2011-10-01 false SSI disclosed by TSA or the Coast Guard. 1520.15... PROTECTION OF SENSITIVE SECURITY INFORMATION § 1520.15 SSI disclosed by TSA or the Coast Guard. (a) In... available for public inspection or copying, nor does TSA or the Coast Guard release such records to...

  10. 49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 9 2012-10-01 2012-10-01 false SSI disclosed by TSA or the Coast Guard. 1520.15... PROTECTION OF SENSITIVE SECURITY INFORMATION § 1520.15 SSI disclosed by TSA or the Coast Guard. (a) In... available for public inspection or copying, nor does TSA or the Coast Guard release such records to...

  11. 49 CFR 1520.15 - SSI disclosed by TSA or the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false SSI disclosed by TSA or the Coast Guard. 1520.15... PROTECTION OF SENSITIVE SECURITY INFORMATION § 1520.15 SSI disclosed by TSA or the Coast Guard. (a) In... available for public inspection or copying, nor does TSA or the Coast Guard release such records to...

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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,…

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

    ERIC Educational Resources Information Center

    Kogan, Steven M.

    2004-01-01

    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

  14. 34 CFR 99.31 - Under what conditions is prior consent not required to disclose information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... EDUCATIONAL RIGHTS AND PRIVACY May an Educational Agency or Institution Disclose Personally Identifiable... information? (a) An educational agency or institution may disclose personally identifiable information from an... educational interests. (B) A contractor, consultant, volunteer, or other party to whom an agency...

  15. 34 CFR 99.31 - Under what conditions is prior consent not required to disclose information?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... EDUCATIONAL RIGHTS AND PRIVACY May an Educational Agency or Institution Disclose Personally Identifiable... information? (a) An educational agency or institution may disclose personally identifiable information from an... educational interests. (B) A contractor, consultant, volunteer, or other party to whom an agency...

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  17. HIV Life Cycle

    MedlinePLUS

    HIV Overview The HIV Life Cycle (Last updated 9/22/2015; last reviewed 9/22/2015) Key Points HIV gradually destroys the immune ... life cycle. What is the connection between the HIV life cycle and HIV medicines? Antiretroviral therapy (ART) ...

  18. Ongoing HIV Transmission and the HIV Care Continuum in North Carolina

    PubMed Central

    Cope, Anna B.; Powers, Kimberly A.; Kuruc, JoAnn D.; Leone, Peter A.; Anderson, Jeffrey A.; Ping, Li-Hua; Kincer, Laura P.; Swanstrom, Ronald; Mobley, Victoria L.; Foust, Evelyn; Gay, Cynthia L.; Eron, Joseph J.; Cohen, Myron S.; Miller, William C.

    2015-01-01

    Objective HIV transmission is influenced by status awareness and receipt of care and treatment. We analyzed these attributes of named partners of persons with acute HIV infection (index AHI cases) to characterize the transmission landscape in North Carolina (NC). Design Secondary analysis of programmatic data. Methods We used data from the NC Screening and Tracing of Active Transmission Program (2002–2013) to determine HIV status (uninfected, AHI, or chronic HIV infection [CHI]), diagnosis status (new or previously-diagnosed), and care and treatment status (not in care, in care and not on treatment, in care and on treatment) of index AHI cases' named partners. We developed an algorithm identifying the most likely transmission source among known HIV-infected partners to estimate the proportion of transmissions arising from contact with persons at different HIV continuum stages. We conducted a complementary analysis among a subset of index AHI cases and partners with phylogenetically-linked viruses. Results Overall, 358 index AHI cases named 932 partners, of which 218 were found to be HIV-infected (162 (74.3%) previously-diagnosed, 11 (5.0%) new AHI, 45 (20.6%) new CHI). Most transmission events appeared attributable to previously-diagnosed partners (77.4%, 95% confidence interval 69.4–85.3%). Among these previously-diagnosed partners, 23.2% (14.0–32.3%) were reported as in care and on treatment near the index AHI case diagnosis date. In the subset study of 33 phylogenetically-linked cases and partners, 60.6% of partners were previously diagnosed (43.9–77.3%). Conclusions A substantial proportion of HIV transmission in this setting appears attributable to contact with previously-diagnosed partners, reinforcing the need for improved engagement in care after diagnosis. PMID:26042804

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

    PubMed

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

    2014-12-01

    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

  20. Mitigating HIV Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution

    PubMed Central

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

    2014-01-01

    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

  1. Contemplating abortion: HIV-positive women's decision to terminate pregnancy.

    PubMed

    Maccarthy, Sarah; Rasanathan, Jennifer J K; Crawford-Roberts, Ann; Dourado, Ines; Gruskin, Sofia

    2014-01-01

    Research on pregnancy termination largely assumes HIV status is the only reason why HIV-positive women contemplate abortion. As antiretroviral treatment (ART) becomes increasingly available and women are living longer, healthier lives, the time has come to consider the influence of other factors on HIV-positive women's reproductive decision-making. Because ART has been free and universally available to Brazilians for more than two decades, Brazil provides a unique context in which to explore these issues. A total of 25 semi-structured interviews exploring women's pregnancy termination decision-making were conducted with women receiving care at the Reference Centre for HIV/AIDS in Salvador, Brazil. Interviews were transcribed, translated into English and coded for analysis. HIV played different roles in women's decision-making. In all, 13 HIV-positive women did not consider terminating their pregnancy. Influential factors described by those who did consider terminating their pregnancy included fear of HIV transmission, fear of HIV-related stigma, family size, economic constraints, partner and provider influence, as well as lack of access to pregnancy termination services and abortifacients. For some HIV-positive women in Brazil, HIV can be the only reason to consider terminating a pregnancy, but other factors are significant. A thorough understanding of all variables affecting reproductive decision-making is necessary for enhancing services and policies and better meeting the needs and rights of HIV-positive women. PMID:24387297

  2. 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 ...

  3. Travelers' Health: HIV Infection

    MedlinePLUS

    ... AGENT HIV, a single-stranded, positive-sense, enveloped RNA virus in the genus Lentivirus. TRANSMISSION HIV can ... be diagnosed is approximately 9 days, when HIV RNA becomes detectable in blood; however, tests needed to ...

  4. Women and HIV

    MedlinePLUS

    ... Many women think AIDS is a disease of gay men. But women get HIV from heterosexual sex ... Sheets 111. Optimizing the HIV Care Environment 115. Adolescents and the HIV Care Continuum 114. Increasing retention ...

  5. Children and HIV

    MedlinePLUS

    ... Children Translate Text Size Print Children Children and HIV Most HIV-positive children under the age of ... Frequently Asked Questions How long do children with HIV typically live? Because effective treatments are relatively new ...

  6. HIV Antibody Test

    MedlinePLUS

    ... limited. Home Visit Global Sites Search Help? HIV Antibody Share this page: Was this page helpful? Also ... Screen; HIV Serology Formal name: Human Immunodeficiency Virus Antibody Test Related tests: p24 Antigen ; HIV Antigen/Antibody ...

  7. Preventing HIV with Medicine

    MedlinePLUS

    ... information in Spanish ( en español ) 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 ...

  8. How HIV Causes AIDS

    MedlinePLUS

    ... Share this: Main Content Area How HIV Causes AIDS HIV destroys CD4 positive (CD4+) T cells, which ... and disease, ultimately resulting in the development of AIDS. Most people who are infected with HIV can ...

  9. HIV and AIDS

    MedlinePLUS

    ... How the Body Works Main Page HIV and AIDS KidsHealth > Kids > Health Problems > Infections > HIV and AIDS ... serious infection. Continue How Many People Have HIV/AIDS? Since the discovery of the virus almost 30 ...

  10. HIV/AIDS Basics

    MedlinePLUS

    ... Enter ZIP code or city Follow Act Against AIDS Act Against AIDS @talkHIV Act Against AIDS Get Email Updates on AAA Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV/ ...

  11. HIV-AIDS Connection

    MedlinePLUS

    ... Marketing Share this: Main Content Area The HIV-AIDS Connection AIDS was first recognized in 1981 and ... is there overwhelming scientific consensus that HIV causes AIDS? Before HIV infection became widespread in the human ...

  12. 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...

  13. Management of HIV/AIDS in older patients–drug/drug interactions and adherence to antiretroviral therapy

    PubMed Central

    Burgess, Mary J; Zeuli, John D; Kasten, Mary J

    2015-01-01

    Patients with human immunodeficiency virus (HIV) are living longer with their disease, as HIV has become a chronic illness managed with combination antiretroviral therapy (cART). This has led to an increasing number of patients greater than 50 years old living successfully with HIV. As the number of older adults with HIV has increased, there are special considerations for the management of HIV. Older adults with HIV must be monitored for drug side effects and toxicities. Their other non-HIV comorbidities should also be considered when choosing a cART regimen. Older adults with HIV have unique issues related to medication compliance. They are more likely than the younger HIV patients to have vision loss, cognitive impairment, and polypharmacy. They may have lower expectations of their overall health status. Depression and financial concerns, especially if they are on a fixed income, may also contribute to noncompliance in the aging HIV population. PMID:26604826

  14. Seroincidence of 2009 H1N1 infection in HIV-infected and HIV-uninfected women prior to vaccine availability.

    PubMed

    Althoff, Keri N; Eichelberger, Maryna; Gange, Stephen J; Sharp, Gerald B; Gao, Jin; Glesby, Marshall J; Young, Mary; Greenblatt, Ruth M; French, Audrey L; Villacres, Maria C; Minkoff, Howard

    2011-06-01

    The 2009 H1N1 pandemic was a unique opportunity to investigate differences in influenza infection using serology by HIV status. Using serial serum specimens collected from 1 April to 30 September 2009 and the prior 2 years from Women's Interagency HIV study participants, there was no difference in serologic evidence of 2009 H1N1 infection among HIV-infected women with a CD4 cell count at least 350 cells/?l compared with HIV-uninfected women. Owing to evidence showing a greater risk of influenza-related complications, HIV-infected individuals should continue to be a priority group for vaccination. PMID:21505313

  15. Cervical Cytopathology in a Population of HIV-Positive and HIV-Negative Women

    PubMed Central

    de Lemos, Patrícia Abreu Pinheiro; García-Zapata, Marco Túlio Antonio; Tavares, Suelene Brito do Nascimento

    2012-01-01

    The association between abnormal cervical cytology and HIV infection status in women was evaluated to correlate with CD4 cell count and viral load in HIV-positive patients with the presence of low-grade (LSIL) and high-grade squamous intraepithelial lesion (HSIL). Cervical samples were collected at the Tropical Disease Hospital, Maternal and Child Healthcare Hospital and at the Nascer Cidadão Maternity Hospital in Goiânia, Goiás, Brazil. An Ayre's spatula was used to collect samples from the ectocervix and a cytology brush to collect samples from the endocervix. Of a total of 237 women, 125 were HIV positive and 112 were HIV negative. Abnormal cytology (n = 21; 8.9%) was more common in the HIV positive group (n = 15; 12.1%) compared to the HIV-negative group (n = 6; 5.4%) (P = 0.05). Cytological abnormalities were not found to be associated with immunosuppression, defined as CD4 count < 200 cells/mm3. A higher frequency was found between higher viral loads (>10,000/mm3) and the presence of abnormal cytology. Pregnant women, irrespective of whether they were HIV positive or negative, were less likely to have lesions compared to the nonpregnant women in the same groups. The higher frequency of abnormal findings in Papanicolaou cytology in HIV-positive women with higher viral loads suggests the association between preinvasive cervical lesions and human immunodeficiency. PMID:22888358

  16. Missed opportunities for HIV testing in health care settings among young African American men who have sex with men: implications for the HIV epidemic.

    PubMed

    Dorell, Christina G; Sutton, Madeline Y; Oster, Alexandra M; Hardnett, Felicia; Thomas, Peter E; Gaul, Zaneta J; Mena, Leandro A; Heffelfinger, James D

    2011-11-01

    Limited health care access and missed opportunities for HIV and other sexually transmitted infection (STI) education and testing in health care settings may contribute to risk of HIV infection. In 2008, we conducted a case-control study of African American men who have sex with men (MSM) in a southeastern city (Jackson, Mississippi) with an increase in numbers of newly reported HIV cases. Our aims were to evaluate associations between health care and HIV infection and to identify missed opportunities for HIV/STI testing. We queried 40 potential HIV-infected cases and 936 potential HIV-uninfected controls for participation in this study. Study enrollees included HIV-infected cases (n=30) and HIV-uninfected controls (n=95) who consented to participate and responded to a self-administered computerized survey about sexual risk behaviors and health care utilization. We used bivariate analysis and logistic regression to test for associations between potential risk factors and HIV infection. Cases were more likely than controls to lack health insurance (odds ratio [OR]=2.5; 95% confidence interval [CI]=1.1-5.7), lack a primary care provider (OR=6.3; CI=2.3-16.8), and to not have received advice about HIV or STI testing or prevention (OR=5.4; CI=1.3-21.5) or disclose their sexual identity (OR=7.0; CI=1.6-29.2) to a health care provider. In multivariate analysis, lacking a primary health care provider (adjusted odds ratio [AOR]=4.5; CI=1.4-14.7) and not disclosing sexual identity to a health care provider (AOR=8.6; CI=1.8-40.0) were independent risk factors for HIV infection among African American MSM. HIV prevention interventions for African American MSM should address access to primary health care providers for HIV/STI prevention and testing services and the need for increased discussions about sexual health, sexual identity, and sexual behaviors between providers and patients in an effort to reduce HIV incidence and HIV-related health disparities. PMID:21923415

  17. 77 FR 36557 - Office of Urban Indian Health Programs Funding Opportunity: Title V HIV/AIDS Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ...Health Programs Funding Opportunity: Title V HIV/AIDS Program Announcement Type: New Limited...of Urban Indian Health Programs Title V HIV/AIDS program. This program is authorized...Title V grants to increase awareness of HIV/AIDS status among urban American...

  18. IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 60, NO. 3, MARCH 2013 715 Micro-and Nanotechnology for HIV/AIDS

    E-print Network

    Bashir, Rashid

    - and Nanotechnology for HIV/AIDS Diagnostics in Resource-Limited Settings Gregory L. Damhorst, Nicholas N. Watkins, and Rashid Bashir , Fellow, IEEE Abstract--Thirty-four million people are living with HIV world- wide caused by HIV, requires regular monitoring of both the status of the host's immune system and levels

  19. Silent oophoritis due to cytomegalovirus in a patient with advanced HIV disease.

    PubMed

    Manfredi, R; Alampi, G; Talò, S; Calza, L; Tadolini, M; Martinelli, G N; Chiodo, F

    2000-06-01

    A case of isolated necrotizing cytomegalovirus (CMV) oophoritis disclosed only by necropsy studies in a patient with AIDS, is described. This unusual case report is discussed with a review of the literature dealing with CMV involvement of genital organs in the immunocompromised host, and in patients with HIV infection and AIDS. PMID:10872916

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  2. 24 CFR 2002.3 - OIG's overall policy concerning discloseable records and requests for OIG records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...discloseable records and requests for OIG records. 2002.3 Section 2002.3 Housing and Urban Development Regulations...DEVELOPMENT AVAILABILITY OF INFORMATION TO THE PUBLIC § 2002.3 OIG's overall policy concerning...

  3. 24 CFR 2002.3 - OIG's overall policy concerning discloseable records and requests for OIG records.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...discloseable records and requests for OIG records. 2002.3 Section 2002.3 Housing and Urban Development Regulations...DEVELOPMENT AVAILABILITY OF INFORMATION TO THE PUBLIC § 2002.3 OIG's overall policy concerning...

  4. 24 CFR 2002.3 - OIG's overall policy concerning discloseable records and requests for OIG records.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...discloseable records and requests for OIG records. 2002.3 Section 2002.3 Housing and Urban Development Regulations...DEVELOPMENT AVAILABILITY OF INFORMATION TO THE PUBLIC § 2002.3 OIG's overall policy concerning...

  5. 24 CFR 2002.3 - OIG's overall policy concerning discloseable records and requests for OIG records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...discloseable records and requests for OIG records. 2002.3 Section 2002.3 Housing and Urban Development Regulations...DEVELOPMENT AVAILABILITY OF INFORMATION TO THE PUBLIC § 2002.3 OIG's overall policy concerning...

  6. 24 CFR 2002.3 - OIG's overall policy concerning discloseable records and requests for OIG records.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...discloseable records and requests for OIG records. 2002.3 Section 2002.3 Housing and Urban Development Regulations...DEVELOPMENT AVAILABILITY OF INFORMATION TO THE PUBLIC § 2002.3 OIG's overall policy concerning...

  7. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    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...

  8. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    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...

  9. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    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...

  10. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    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...

  11. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    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...

  12. 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

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

    2013-01-01

    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

  13. Adjusting HIV prevalence estimates for non-participation: an application to demographic surveillance

    PubMed Central

    McGovern, Mark E.; Marra, Giampiero; Radice, Rosalba; Canning, David; Newell, Marie-Louise; Bärnighausen, Till

    2015-01-01

    Introduction HIV testing is a cornerstone of efforts to combat the HIV epidemic, and testing conducted as part of surveillance provides invaluable data on the spread of infection and the effectiveness of campaigns to reduce the transmission of HIV. However, participation in HIV testing can be low, and if respondents systematically select not to be tested because they know or suspect they are HIV positive (and fear disclosure), standard approaches to deal with missing data will fail to remove selection bias. We implemented Heckman-type selection models, which can be used to adjust for missing data that are not missing at random, and established the extent of selection bias in a population-based HIV survey in an HIV hyperendemic community in rural South Africa. Methods We used data from a population-based HIV survey carried out in 2009 in rural KwaZulu-Natal, South Africa. In this survey, 5565 women (35%) and 2567 men (27%) provided blood for an HIV test. We accounted for missing data using interviewer identity as a selection variable which predicted consent to HIV testing but was unlikely to be independently associated with HIV status. Our approach involved using this selection variable to examine the HIV status of residents who would ordinarily refuse to test, except that they were allocated a persuasive interviewer. Our copula model allows for flexibility when modelling the dependence structure between HIV survey participation and HIV status. Results For women, our selection model generated an HIV prevalence estimate of 33% (95% CI 27–40) for all people eligible to consent to HIV testing in the survey. This estimate is higher than the estimate of 24% generated when only information from respondents who participated in testing is used in the analysis, and the estimate of 27% when imputation analysis is used to predict missing data on HIV status. For men, we found an HIV prevalence of 25% (95% CI 15–35) using the selection model, compared to 16% among those who participated in testing, and 18% estimated with imputation. We provide new confidence intervals that correct for the fact that the relationship between testing and HIV status is unknown and requires estimation. Conclusions We confirm the feasibility and value of adopting selection models to account for missing data in population-based HIV surveys and surveillance systems. Elements of survey design, such as interviewer identity, present the opportunity to adopt this approach in routine applications. Where non-participation is high, true confidence intervals are much wider than those generated by standard approaches to dealing with missing data suggest. PMID:26613900

  14. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000-2009.

    PubMed

    Holt, Martin; Lee, Evelyn; Prestage, Garrett P; Zablotska, Iryna; de Wit, John; Mao, Limin

    2013-01-01

    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

  15. 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

    ...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. 2.62 Section 2.62 Public...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. A court order under...

  16. 38 CFR 1.492 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. 1.492 Section 1.492...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. A court order...

  17. 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

    ...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. 2.62 Section 2.62 Public...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. A court order under...

  18. 38 CFR 1.492 - Order not applicable to records disclosed without consent to researchers, auditors and evaluators.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. 1.492 Section 1.492...Order not applicable to records disclosed without consent to researchers, auditors and evaluators. A court order...

  19. HIV-Prevalence in Tuberculosis Patients in Germany, 2002–2009: An Estimation Based on HIV and Tuberculosis Surveillance Data

    PubMed Central

    Fiebig, Lena; Kollan, Christian; Hauer, Barbara; Gunsenheimer-Bartmeyer, Barbara; an der Heiden, Matthias; Hamouda, Osamah; Haas, Walter

    2012-01-01

    Tuberculosis (TB) and HIV comorbidity is a major challenge in TB prevention and control but difficult to assess in Germany as in other countries, where data confidentiality precludes notifying the HIV status of TB patients. We aimed to estimate the HIV-prevalence in TB patients in Germany, 2002–2009, and to characterize the HIV/TB patients demographically. Data from the long-term observational open multicentre cohort ClinSurv HIV were used to identify incident TB in HIV-positive individuals. We assessed the cohort’s coverage for the nationwide HIV-positive population by contrasting ClinSurv HIV patients under antiretroviral therapy (ART) with national HIV patient numbers derived from ART prescriptions (data by Insight Health; available for 2006–2009). The HIV-prevalence in TB patients was calculated as the number of HIV/TB cases projected for Germany over all culture-positive TB notifications. From 2002 to 2009, 298 of 15,531 HIV-positive patients enrolled in the ClinSurv HIV cohort were diagnosed with TB. A 21% cohort coverage was determined. The annual estimates of the HIV-prevalence in TB patients were on average 4.5% and ranged from 3.5% (95%CI 2.3–5.1%) in 2007 to 6.6% (95%CI 5.0–8.5%) in 2005. The most recent estimate for 2009 was 4.0% (95%CI 2.6–5.9%). The 298 HIV/TB patients were characterized by a male-to-female ratio of 2.1, by a median age of 38 years at TB diagnosis, and by 59% of the patients having a foreign origin, mainly from Subsahara Africa. We provide, to our knowledge, the first estimate of the HIV-prevalence in TB patients for Germany by joint evaluation of anonymous HIV and TB surveillance data sources. The identified level of HIV in TB patients approximates available surveillance data from neighbouring countries and indicates a non-negligible HIV/TB burden in Germany. Our estimation approach is valuable for epidemiological monitoring of HIV/TB within the current legal frameworks. PMID:23145087

  20. HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana

    PubMed Central

    2013-01-01

    Background HIV Counselling and Testing (VCT) and knowledge about HIV are some key strategies in the prevention and control of HIV/AIDS in Ghana. However, HIV knowledge and utilization of VCT services among university students is low. The main objective was to determine the level of HIV/AIDS knowledge and to explore factors associated with the use HIV counselling and testing among private university students in Accra, Ghana. Materials and methods A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a privately owned tertiary institution in Accra, Ghana. Results The respondents consisted of 56.2% males and 43.8% females aged 17 – 37 years. The mean HIV/AIDS knowledge score of was 7.70. There was a significant difference in knowledge of HIV/AIDS by gender where female students had more knowledge about HIV/AIDS than males [t (322)?=?2.40, p?=?0.017]. The ANOVA results showed that there was a significant difference in HIV/AIDS knowledge according to the age groups [F (3, 321)?=?6.26, p?=?0. 0001] and marital status [F (3, 321)?=?4.86, p?=?0. 008] of the sample. Over half of the participants had not tested for HIV, although over 95% of them knew where to access counseling and testing services. The study also revealed a significant association between demographic variables, testing for HIV and intention to test in the future. Participants who were never married (single), aged 17 – 20 years and had knowledge of two routes of HIV transmission were more likely to have taken an HIV test. Males were more likely to take an HIV test in the future than females. Majority of the students receive HIV/AIDS information from both print and electronic media, but few of them received such information from parents. Conclusion The students HIV knowledge was very good, yet HIV testing were low. Health education and HIV intervention programmes must not only provide accurate information, but must be made to help to equip private university students, especially females to test for HIV consistently. PMID:23537116

  1. Knowing is not enough: a qualitative report on HIV testing among heterosexual African-American men

    PubMed Central

    Bond, Keosha T.; Frye, Victoria; Taylor, Raekiela; Williams, Kim; Bonner, Sebastian; Lucy, Debbie; Cupid, Malik; Weiss, Linda; Koblin, Beryl A.

    2015-01-01

    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

  2. Psychometric Properties of a New HIV/AIDS Knowledge Measure for Adults.

    PubMed

    Prati, Gabriele; Zani, Bruna; Pietrantoni, Luca; Scudiero, Diego; Perone, Patrizia; Cosmaro, Lella; Cerioli, Alessandra; Oldrini, Massimo

    2016-01-01

    The aim of this study was to develop a new 29-item HIV/AIDS knowledge measure and to examine its psychometric properties for three samples of adults: non-HIV-positive heterosexual people, non-HIV-positive men who have sex with men (MSM), and people living with HIV/AIDS (PLWHA). The authors collected data using an online questionnaire. A total of 9,349 Italian individuals agreed to participate in the study: 694 individuals (7.4%) were PLWHA, 5,232 (56.0%) were HIV negative, and the remaining 3,423 (36.6%) were MSM. Using two-parameter item response theory analysis, a bifactor model was found to be better fitting than a one-factor model or a 12 correlated first-order factor model. Differential item functioning showed evidence of measurement nonequivalence of the instrument for the three samples of adults. The reliability of HIV/AIDS knowledge scale among PLWHA was satisfactory. Criterion-related validity was only achieved among non-HIV-positive heterosexual people, non-HIV-positive MSM, as the HIV/AIDS knowledge scale was related with attitudes toward condom use, condom use with casual partners, unknown HIV status of partner, and HIV stigma. Among non-HIV-positive heterosexual people, the HIV/AIDS knowledge scale adds to the prediction of condom use above that of attitudes toward condom use scale. The HIV/AIDS knowledge scale is especially discriminating at low to medium levels of knowledge. PMID:26674412

  3. Association of Chronic Hepatitis C Infection with T-Cell Phenotypes in HIV-Negative and HIV-Positive Women

    PubMed Central

    Kuniholm, Mark H.; Xie, Xianhong; Anastos, Kathryn; Kaplan, Robert C.; Xue, Xiaonan; Kovacs, Andrea; Peters, Marion G.; Seaberg, Eric C.; French, Audrey L.; Young, Mary A.; Augenbraun, Michael; Martinson, Jeffrey A.; Bush, Kristin A.; Landay, Alan L.; Strickler, Howard D.

    2014-01-01

    Background Hepatitis C virus (HCV) viremia is thought to have broad, systemic effects on the cellular immune system that go beyond its impact on just those T-cells that are HCV-specific. However, prior studies of chronic HCV and circulating T-cell subsets (activation and differentiation phenotypes) in HIV-negatives used general population controls, rather than a risk-appropriate comparison group. Studies in HIV-positives did not address overall immune status (total CD4+ count). Methods We used fresh blood from HIV-positive and at-risk HIV-negative women, with and without chronic HCV, to measure percentages of activated CD4+ and CD8+ T-cells, Tregs, and T-cell differentiation phenotypes (naïve, central memory (CM), effector memory (EM), and terminally differentiated effector). This included 158 HIV-negatives and 464 HIV-positives, of whom 18 and 63, respectively, were HCV viremic. Results In multivariate models of HIV-negatives, HCV viremia was associated with 25% fewer naïve CD4+ (P=0.03), 33% more EM CD4+ (P=0.0002) and 37% fewer CM CD8+ (P=0.02) T-cells. Among HIV-positives we observed only one of these three relationships: higher percentage of EM CD4+ among HCV viremic women. Further, the association with EM CD4+ among HIV-positives was limited to individuals with diminished immune status (total CD4+ count ?500 cells/?L), as were associations of HCV viremia with higher percentages of activated CD4+ and Tregs. Among HIV-positives with high CD4+ count, no significant associations were observed. Conclusions These data suggest that HCV viremia in HIV-negatives is associated with accelerated T-cell differentiation, but among HIV-positives the impact of HCV viremia is less straightforward and varies by total CD4+ count. PMID:25314250

  4. Syphilis and HIV co-infection.

    PubMed

    Salado-Rasmussen, Kirsten

    2015-12-01

    The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten per cent of Danish men with syphilis acquired HIV infection within five years after they were diagnosed with syphilis during an 11-year study period. Interestingly, the risk of HIV declined during the later part of the period. Moreover, HIV-infected men had a substantial increased risk of re-infection with syphilis compared to HIV-uninfected men. As one third of the HIV-infected patients had viral loads >1,000 copies/ml, our conclusion supported the initiation of cART in more HIV-infected MSM to reduce HIV transmission. During a five-year study period, including the majority of HIV-infected patients from the Copenhagen area, we observed that syphilis was diagnosed in the primary, secondary, early and late latent stage. These patients were treated with either doxycycline or penicillin and the rate of treatment failure was similar in the two groups, indicating that doxycycline can be used as a treatment alternative - at least in an HIV-infected population. During a four-year study period, the T. pallidum strain type distribution was investigated among patients diagnosed by PCR testing of material from genital lesions. In total, 22 strain types were identified. HIV-infected patients were diagnosed with nine different strains types and a difference by HIV status was not observed indicating that HIV-infected patients did not belong to separate sexual networks. In conclusion, concurrent HIV remains common in patients diagnosed with syphilis in Denmark, both in those diagnosed by serological testing and PCR testing. Although the rate of syphilis has stabilized in recent years, a spread to low-risk groups is of concern, especially due to the complex symptomatology of syphilis. However, given the efficient treatment options and the targeted screening of pregnant women and persons at higher risk of syphilis, control of the infection seems within reach. Avoiding new HIV infections is the major challenge and here cART may play a prominent role. PMID:26621404

  5. A qualitative assessment of perspectives on the inclusion of adolescents in HIV vaccine trials in South Africa

    PubMed Central

    Jaspan, H B; Soka, N F; Mathews, C; Flisher, A J; Mark, D; Middelkoop, K; Wood, R; Bekker, L-G

    2013-01-01

    Summary Adolescents are at high risk for HIV acquisition, and thus need to be included in HIV vaccine trials. In preparation for inclusion of adolescents in HIV vaccine trials in an urban community in Cape Town with a high antenatal HIV prevalence, the study assessed the attitudes towards the inclusion of adolescents in HIV vaccine trials. A total of 18 focus group discussions were conducted using a semistructured interview guide. The participants (n = 200) were adolescents, young adults, parents and other key informants. Participants from all groups welcomed the inclusion of adolescents in HIV vaccine trials due to their high-risk status. There were, however, concerns about sexual disinhibition, fear of side-effects, fear of HIV testing and disclosure of HIV status, mistrust of nurses and clinics. The study highlighted a number of ethical and social issues that need to be addressed before the trials. PMID:20215620

  6. HIV Structural Database

    National Institute of Standards and Technology Data Gateway

    SRD 102 HIV Structural Database (Web, free access)   The HIV Protease Structural Database is an archive of experimentally determined 3-D structures of Human Immunodeficiency Virus 1 (HIV-1), Human Immunodeficiency Virus 2 (HIV-2) and Simian Immunodeficiency Virus (SIV) Proteases and their complexes with inhibitors or products of substrate cleavage.

  7. HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviors among HIV Patients in Kenya, Namibia, and Tanzania

    PubMed Central

    Kidder, Daniel P.; Bachanas, Pam; Medley, Amy; Pals, Sherri; Nuwagaba-Biribonwoha, Harriet; Ackers, Marta; Howard, Andrea; DeLuca, Nick; Mbatia, Redempta; Sheriff, Muhsin; Arthur, Gilly; Katuta, Frieda; Cherutich, Peter; Somi, Geoffrey

    2013-01-01

    HIV care and treatment settings provide an opportunity to reach people living with HIV/AIDS (PLHIV) with prevention messages and services. Population-based surveys in sub-Saharan Africa have identified HIV risk behaviors among PLHIV, yet data are limited regarding HIV risk behaviors of PLHIV in clinical care. This paper describes the baseline sociodemographic, HIV transmission risk behaviors, and clinical data of a study evaluating an HIV prevention intervention package for HIV care and treatment clinics in Africa. The study was a longitudinal group-randomized trial in 9 intervention clinics and 9 comparison clinics in Kenya, Namibia, and Tanzania (N?=?3538). Baseline participants were mostly female, married, had less than a primary education, and were relatively recently diagnosed with HIV. Fifty-two percent of participants had a partner of negative or unknown status, 24% were not using condoms consistently, and 11% reported STI symptoms in the last 6 months. There were differences in demographic and HIV transmission risk variables by country, indicating the need to consider local context in designing studies and using caution when generalizing findings across African countries. Baseline data from this study indicate that participants were often engaging in HIV transmission risk behaviors, which supports the need for prevention with PLHIV (PwP). Trial Registration ClinicalTrials.gov NCT01256463 PMID:23459196

  8. 12 CFR 792.29 - If I send NCUA confidential commercial information, can it be disclosed under FOIA?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...confidential commercial information, can it be disclosed under FOIA? 792.29 Section...confidential commercial information, can it be disclosed under FOIA? (a) If you...confidential commercial information to NCUA, it may be disclosed in response to a FOIA...

  9. 12 CFR 792.29 - If I send NCUA confidential commercial information, can it be disclosed under FOIA?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...confidential commercial information, can it be disclosed under FOIA? 792.29 Section...confidential commercial information, can it be disclosed under FOIA? (a) If you...confidential commercial information to NCUA, it may be disclosed in response to a FOIA...

  10. Sexual Dysfunction, HIV, and AIDS in Men Who Have Sex with Men

    PubMed Central

    Shindel, Alan W.; Horberg, Michael A.; Smith, James F.

    2011-01-01

    Abstract HIV infection is associated with sexual dysfunction. Using validated instruments, we investigated the relationship between HIV/AIDS and sexual function in a contemporary cohort of men who have sex with men (MSM). An anonymous Internet-based survey was disseminated to MSM via organizations and social networking sites that cater to this population. Information on ethnodemographic variables, health status (including HIV status, disease stage, and other health conditions), and sexual behavior was collected. Men were categorized as HIV-negative, HIV-positive/AIDS-negative, or HIV-positive /AIDS-positive. A modified validated version of the International Index of Erectile Function (IIEF) for use in MSM and the Premature Ejaculation Diagnostic Tool (PEDT) were used to stratify risk of sexual dysfunction. The study cohort included 1361 men (236 of whom were HIV-positive) who provided complete data on HIV status, IIEF, and PEDT. There was a significant trend toward greater prevalence of erectile dysfunction (ED) in men with progressive HIV infection 40–59 years of age relative to age matched HIV-negative men (p=0.02). In a logistic regression model controlling for other variables, HIV infection without AIDS was not associated with greater odds of ED; however, HIV infection with AIDS was associated with greater odds of ED (p=0.006). In a separate logistic regression model, HIV infection with or without AIDS was not significantly associated with greater odds of premature ejaculation (p>0.05). Use of phosphodiesterase 5 (PDE5) inhibitor drugs was much more common in HIV-infected men. HIV infection is a risk factor for poorer sexual function primarily due to higher risk of erectile dysfunction in men with AIDS. PMID:21501095

  11. Social, Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon

    PubMed Central

    Wagner, Glenn J.; Hoover, Matthew; Green, Harold; Tohme, Johnny; Mokhbat, Jacques

    2014-01-01

    Social, relational and network determinants of condom use and HIV testing were examined among 213 men who have sex with men (MSM) in Beirut. 64% reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% had HIV-tested. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Multi-level social factors influence sexual health in MSM. PMID:26535073

  12. Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak

    PubMed Central

    2011-01-01

    Background Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to understand the privacy barriers which could potentially influence family physicians' reporting of patient-level surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak. Methods Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009. They also completed a survey about the data they were willing to disclose to public health units. Descriptive statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based on grounded theory. Results The family doctors were reluctant to disclose patient data to public health units. This was due to concerns about the extent to which public health agencies are dependable to protect health information (trusting beliefs), and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that public health units can take which would affect these beliefs, and potentially increase the willingness to disclose patient information for public health purposes. Conclusions The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable reporting during future outbreaks. PMID:21658256

  13. Subcortical shape and volume abnormalities in an elderly HIV+ cohort

    NASA Astrophysics Data System (ADS)

    Wade, Benjamin S. C.; Valcour, Victor; Busovaca, Edgar; Esmaeili-Firidouni, Pardis; Joshi, Shantanu H.; Wang, Yalin; Thompson, Paul M.

    2015-03-01

    Over 50% of HIV+ individuals show significant impairment in psychomotor functioning, processing speed, working memory and attention [1, 2]. Patients receiving combination antiretroviral therapy may still have subcortical atrophy, but the profile of HIV-associated brain changes is poorly understood. With parametric surface-based shape analyses, we mapped the 3D profile of subcortical morphometry in 63 elderly HIV+ subjects (4 female; age=65.35 ± 2.21) and 31 uninfected elderly controls (2 female; age=64.68 ± 4.57) scanned with MRI as part of a San Francisco Bay Area study of elderly people with HIV. We also investigated whether morphometry was associated with nadir CD4+ (T-cell) counts, viral load and illness duration among HIV+ participants. FreeSurfer was used to segment the thalamus, caudate, putamen, pallidum, hippocampus, amygdala, accumbens, brainstem, callosum and ventricles from brain MRI scans. To study subcortical shape, we analyzed: (1) the Jacobian determinant (JD) indexed over structures' surface coordinates and (2) radial distances (RD) of structure surfaces from a medial curve. A JD less than 1 reflects regional tissue atrophy and greater than 1 reflects expansion. The volumes of several subcortical regions were found to be associated with HIV status. No regional volumes showed detectable associations with CD4 counts, viral load or illness duration. The shapes of numerous subcortical regions were significantly linked to HIV status, detectability of viral RNA and illness duration. Our results show subcortical brain differences in HIV+ subjects in both shape and volumetric domains.

  14. Relationship between inflammatory mediator patterns and anemia in HIV-1 positive and exposed children with Plasmodium falciparum malaria.

    PubMed

    Davenport, Gregory C; Hittner, James B; Were, Tom; Ong'echa, John M; Perkins, Douglas J

    2012-07-01

    Anemia is the primary hematological manifestation of both Plasmodium falciparum malaria and HIV-1 in pediatric populations in sub-Saharan Africa. We have previously shown that HIV-1 positive and exposed children have greater risk of developing severe anemia (hemoglobin, Hb <6.0 g dL?¹) during acute malaria. However, enhanced severity of anemia was unrelated to either erythropoietic suppression or parasite-driven red blood cell hemolysis. To further explore mechanisms of anemia, circulating inflammatory mediators (IMs) were determined using a 25-plex bead array in P. falciparum-infected (Pf[+]) children (3-36 month, n = 194) stratified into three groups: HIV-1 negative (HIV-1[-]/Pf[+]); HIV-1 exposed (HIV-1[exp]/Pf[+]); and HIV-1 infected (HIV-1[+]/Pf[+]). IL-12, MIG/CXCL9, eotaxin/CCL11, and GM-CSF differed significantly and progressively increased across the groups (HIV-1[-]?HIV-1[exp]?HIV-1[+]). To further explore the relationship between the inflammatory milieu (i.e., cytokines, chemokines, and growth factors) and HIV-1 status, the large panel of IMs was reduced into discrete groups by principal component factor analysis. Of the six principal components that emerged, three components were significantly higher in the HIV-1 [+]/pf[+] and HIV[exp]/Pf[+] groups, demonstrating that inflammatory profiles differ according to HIV-1 status. Additional analyses exploring the relationship between the components and anemia revealed significant positive correlations between Hb and Component 3 (IL-1Ra, IL-7, IL-17, IFN-?, IFN-?, MIG/CXCL9) in the HIV-1[-]/Pf[+] group, and Component 4 (IL-4, IL-5, IL-12, Eotaxin/CCL11) in HIV-1[+]/Pf[+] children. Further analyses of the HIV-1[+]/Pf[+] group revealed that IL-12 had the strongest association with anemia. Results presented here demonstrate that there are unique relationships between the inflammatory environment and anemia in HIV-1 positive and exposed children with malaria. PMID:22570198

  15. Why mandatory HIV antibody screening cannot work.

    PubMed

    Wilson, R J

    1989-06-01

    In 1985 this country introduced the first serologic screening test [enzyme immunoassays (EIAs)] designed to detect antibodies to the human immunodeficiency virus (HIV), the pathogen of acquired immunodeficiency syndrome (AIDS). Some people now suggest use of this test to identify people within the general population who are infected with the virus. This article will review technical and administrative problems pertaining to the use of EIAs to screen the general population for antibodies to HIV, and will explain why optometrists can provide safe and comprehensive care to all patients without knowledge of a patient's HIV antibody status. Prior knowledge by the optometrist of the patient's serological status is unnecessary if the practitioner 1) adheres to established guidelines pertaining to infection control, and 2) is aware of the various ocular manifestations of HIV disease. It concludes that mandatory HIV screening programs should not be adopted until the benefits to society have been more clearly elucidated and associated technical, administrative, and ethical problems have been resolved. PMID:2671108

  16. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection

    PubMed Central

    Goldberg, Brittany E.; Mongodin, Emmanuel F.; Jones, Cheron E.; Chung, Michelle; Fraser, Claire M.; Tate, Anupama; Zeichner, Steven L.

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi’s sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better characterize the oral microbiome in children and those with poorly-controlled HIV infections. PMID:26146997

  17. Prevalence and Factors Associated with Sexually Transmitted Infections among HIV Positive Women Opting for Intrauterine Contraception

    PubMed Central

    2015-01-01

    Background Women living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD). Methods Three hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted. Results Participants’ mean age was 29.4 ± 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69%) had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants’ spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4) and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85) having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78) and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78). Conclusion STI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI. PMID:25859659

  18. HIV-Helicobacter pylori Co-Infection: Antibiotic Resistance, Prevalence, and Risk Factors

    PubMed Central

    Nkuize, Marcel; De Wit, Stéphane; Muls, Vinciane; Delforge, Marc; Miendje Deyi, Véronique Y.; Cadière, Guy B.; Buset, Michel

    2015-01-01

    Background Patients infected with human immunodeficiency virus (HIV) are living longer due to the availability of more potent treatments. However, prescription of antibiotics to treat or prevent infections in these patients may increase the likelihood of co-infection with antibiotic-resistant species. Aim To compare antimicrobial susceptibility of Helicobacter pylori (H. pylori) in HIV-positive and HIV-negative patients and assess risk-factors for resistance. Methods We prospectively collected data from consecutive HIV-positive and HIV-negative patients undergoing upper gastrointestinal endoscopy. Patients with H. pylori-positive gastric biopsies who had never received H. pylori treatment were included. Results Of the 353 patients included, 93 were HIV-positive and 260 HIV-negative. Among the HIV-positive patients, 56 (60%) had been infected for <10 years, the median CD4+ count was 493 cells/?l and median viral load was 61 copies/mL; 66 (71%) were receiving antiretroviral therapy. HIV-positive patients were more often male (p = 0.009), had a lower body mass index (p<0.0001), and had less frequently received antibiotics during the 12-months prior to the endoscopy (p<0.0001) than HIV-negative patients. HIV-positive patients were more likely to have H. pylori resistant to levofloxacin (p = 0.0004), metronidazole (p = 0.01), or multiple antibiotics (p = 0.006). HIV-positive Black Africans were more likely to have resistant strains than were HIV-negative Black Africans (p = 0.04). Ethnicity and HIV status were independent risk factors for H. pylori resistance in all patients and acquired immune deficiency syndrome (AIDS) and sex were risk factors in HIV-positive patients. Conclusions There was a higher prevalence of primary H. pylori-resistant strains in HIV-positive than in HIV-negative patients. AIDS and sex were predictors of H. pylori resistance in HIV-positive patients. PMID:26691198

  19. HIV/AIDS Clinical Trials

    MedlinePLUS

    ... APIs Widgets Order Publications Skip Nav HIV/AIDS Clinical Trials Home > Clinical Trials Español Text Size Use ... Vaccine Research HIV Preventive Vaccines HIV Therapeutic Vaccines Clinical Trial News Wednesday, December 23, 2015 HIV Antibody ...

  20. HIV Medicines and Side Effects

    MedlinePLUS

    ... depend on a person’s individual needs. Can HIV medicines cause side effects? HIV medicines help people with ... are common short-term side effects from HIV medicines? When starting an HIV medicine for the first ...

  1. Side Effects of HIV Medicines: HIV and Osteoporosis

    MedlinePLUS

    Side Effects of HIV Medicines HIV and Osteoporosis (Last updated 7/31/2015; last reviewed 12/9/2014) Key Points Osteoporosis is a disease that ... HIV include HIV infection itself and some HIV medicines (for example, tenofovir [brand name: Viread]). Also, HIV ...

  2. Perceived HIV stigma in AIDS caregiving dyads.

    PubMed

    Wight, Richard G; Aneshensel, Carol S; Murphy, Debra A; Miller-Martinez, Dana; Beals, Kristin P

    2006-01-01

    This study examines perceived HIV stigma in AIDS caregiving dyads in the United States, assessing the measurement of and correlates of personal stigma (among care-recipients living with HIV), courtesy stigma (among caregivers), and dyadic stigma. Survey data from 135 dyads in which the caregiver is a midlife or older mother or wife, and the care-recipient is her HIV-infected adult son or husband, are analyzed with individual-level and multilevel regression models. Results indicate that: (1) perceived stigma can be reliably measured among both persons living with HIV (PLH) and caregivers; (2) personal stigma can be distinguished from courtesy stigma; (3) perceived stigma is relatively low in this sample, and is higher among PLH than caregivers, higher among caregiving wives than mothers, and similar between PLH who are husbands and sons; (4) dyadic stigma is influenced by the caregiver's HIV status, the ethnic composition of the dyad, caregiving duration, and household income; (5) stigma discrepancy within dyads is a function of health discrepancy within dyads; and (6) differences in multivariate correlates of perceived stigma at the individual-level, in comparison to the dyad-level, suggest that dyadic stigma is a unique construct. A recognition that perceived stigma bears its own unique influence on the caregiving dyad is important for understanding how best to allocate resources aimed at alleviating stigma among individuals and families impacted by HIV. PMID:16039763

  3. Adolescent HIV/AIDS: Issues and challenges

    PubMed Central

    Naswa, Smriti; Marfatia, Y. S.

    2010-01-01

    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

  4. The Efficacy of Serostatus Disclosure for HIV Transmission Risk Reduction

    PubMed Central

    O’Connell, Ann A.; Serovich, Julianne A.

    2015-01-01

    Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698–705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed. PMID:25164375

  5. HIV among Gay and Bisexual Men

    MedlinePLUS

    ... you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | Subscribe ... Get Email Updates on HIV Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV ...

  6. 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

    De Schacht, Caroline; Hoffman, Heather J.; Mabunda, Nédio; Lucas, Carlota; Alons, Catharina L.; Madonela, Ana; Vubil, Adolfo; Ferreira, Orlando C.; Calú, Nurbai; Santos, Iolanda S.; Jani, Ilesh V.; Guay, Laura

    2014-01-01

    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 2–3 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: 2.33–7.16). Significant risk factors for HIV acquisition were early sexual debut (RR 3.79, 95%CI: 1.04–13.78, p?=?0.04) and living in Maputo Province (RR 4.35, 95%CI: 0.97–19.45, 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

  7. Disrespect and Abuse During Childbirth in Tanzania: Are Women Living With HIV More Vulnerable?

    PubMed Central

    Sando, David; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

    2014-01-01

    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

  8. The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City

    PubMed Central

    Ross, Michael W.

    2014-01-01

    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

  9. How Radiation Oncologists Would Disclose Errors: Results of a Survey of Radiation Oncologists and Trainees

    SciTech Connect

    Evans, Suzanne B.; Yu, James B.; Chagpar, Anees

    2012-10-01

    Purpose: To analyze error disclosure attitudes of radiation oncologists and to correlate error disclosure beliefs with survey-assessed disclosure behavior. Methods and Materials: With institutional review board exemption, an anonymous online survey was devised. An email invitation was sent to radiation oncologists (American Society for Radiation Oncology [ASTRO] gold medal winners, program directors and chair persons of academic institutions, and former ASTRO lecturers) and residents. A disclosure score was calculated based on the number or full, partial, or no disclosure responses chosen to the vignette-based questions, and correlation was attempted with attitudes toward error disclosure. Results: The survey received 176 responses: 94.8% of respondents considered themselves more likely to disclose in the setting of a serious medical error; 72.7% of respondents did not feel it mattered who was responsible for the error in deciding to disclose, and 3.9% felt more likely to disclose if someone else was responsible; 38.0% of respondents felt that disclosure increased the likelihood of a lawsuit, and 32.4% felt disclosure decreased the likelihood of lawsuit; 71.6% of respondents felt near misses should not be disclosed; 51.7% thought that minor errors should not be disclosed; 64.7% viewed disclosure as an opportunity for forgiveness from the patient; and 44.6% considered the patient's level of confidence in them to be a factor in disclosure. For a scenario that could be considerable, a non-harmful error, 78.9% of respondents would not contact the family. Respondents with high disclosure scores were more likely to feel that disclosure was an opportunity for forgiveness (P=.003) and to have never seen major medical errors (P=.004). Conclusions: The surveyed radiation oncologists chose to respond with full disclosure at a high rate, although ideal disclosure practices were not uniformly adhered to beyond the initial decision to disclose the occurrence of the error.

  10. Risk analysis. HIV / AIDS country profile: Senegal.

    PubMed

    1996-12-01

    Since the first acquired immunodeficiency syndrome (AIDS) case was confirmed in 1986, Senegal has conducted an aggressive prevention campaign. Senegal's National AIDS Committee has noted the contributions of poverty and migration to the spread of AIDS. By June 1994, 1297 AIDS cases had been reported and an estimated 500,000 people (1.4% of the population) were infected with human immunodeficiency virus (HIV)-1 and 2. The highest rate of HIV infection (14%) exists among commercial sex workers. At present, HIV/AIDS cases are concentrated in Dakar, Kaolack, the Matam region, and Ziguinchor; however, the growing importance of inter-regional trading is expected to spread HIV to the smaller towns and rural areas. Also salient is the recent devaluation by 50% of the CFA franc, which has reduced the public sector workforce and led many poor urban residents into commercial sex work. CFA devaluation has made Senegal attractive to tourists and business visitors--another factor responsible for growth of the legalized commercial sex industry. Although sex workers are instructed in condom use and tested annually for HIV, only 850 of the 2000 registered sex workers have reported for check-ups, and the majority of prostitutes are unregistered. Senegal's AIDS Plan for 1994-98 focuses on care of AIDS patients, pressures placed on family structures by HIV, and AIDS-related erosions in the status of women. Each health service region has its own local plan for AIDS/HIV and sexually transmitted diseases, supervised by a regional committee. Public education has involved outreach to religious leaders, promotion of affordable condoms, and distribution of over 75,000 leaflets to key target populations. About US $16 million of the $25,688,875-budget HIV/AIDS program for 1994-98 was pledged by external donors. PMID:12320531

  11. RELATIONSHIP BETWEEN INFLAMMATORY MEDIATOR PATTERNS AND ANEMIA IN HIV-1 POSITIVE AND EXPOSED CHILDREN WITH PLASMODIUM FALCIPARUM MALARIA

    PubMed Central

    DAVENPORT, Gregory C.; HITTNER, James B.; WERE, Tom; ONG'ECHA, John M.; PERKINS, Douglas J.

    2015-01-01

    Anemia is the primary hematological manifestation of both Plasmodium falciparum malaria and HIV-1 in pediatric populations in sub-Saharan Africa. We have previously shown that HIV-1 positive and exposed children have greater risk of developing severe anemia (hemoglobin, Hb<6.0 g/dL) during acute malaria. However, enhanced severity of anemia was unrelated to either erythropoietic suppression or parasite-driven red blood cell hemolysis. To further explore mechanisms of anemia, circulating inflammatory mediators (IMs) were determined using a 25-plex bead array in P. falciparum-infected (Pf[+]) children (3-36 mos., n=194) stratified into three groups: HIV-1 negative (HIV-1[?]/Pf[+]); HIV-1 exposed (HIV-1[exp]/Pf[+]); and HIV-1 infected (HIV-1[+]/Pf[+]). IL-12, MIG/CXCL9, eotaxin/CCL11, and GM-CSF differed significantly and progressively increased across the groups (HIV-1[?]?HIV-1[exp]?HIV-1[+]). To further explore the relationship between the inflammatory milieu (i.e., cytokines, chemokines, and growth factors) and HIV-1 status, the large panel of IMs was reduced into discrete groups by principal component factor analysis. Of the six principal components that emerged, three components were significantly higher in the HIV-1 positive and exposed groups, demonstrating that inflammatory profiles differ according to HIV-1 status. Additional analyses exploring the relationship between the components and anemia revealed significant positive correlations between Hb and component 3 (IL-1Ra, IL-7, IL-17, IFN-?, IFN-?, MIG/CXCL9) in the (HIV-1[?]/Pf[+]) group, and component 4 (IL-4, IL-5, IL-12, Eotaxin/CCL11) in HIV-1[+]/Pf[+] children. Further analyses of the HIV-1[+]/Pf[+] group revealed that IL-12 had the strongest association with anemia. Results presented here demonstrate that there are unique relationships between the inflammatory environment and anemia in HIV-1 positive and exposed children with malaria. PMID:22570198

  12. 28 CFR 541.68 - Release from controlled housing status.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.68 Release from controlled housing status. (a) Only the...

  13. 28 CFR 541.68 - Release from controlled housing status.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.68 Release from controlled housing status. (a) Only the...

  14. 28 CFR 541.67 - Review of controlled housing status.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.67 Review of controlled housing status. (a) Staff...

  15. 28 CFR 541.68 - Release from controlled housing status.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.68 Release from controlled housing status. (a) Only the...

  16. 28 CFR 541.68 - Release from controlled housing status.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.68 Release from controlled housing status. (a) Only the...

  17. 28 CFR 541.67 - Review of controlled housing status.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.67 Review of controlled housing status. (a) Staff...

  18. 28 CFR 541.68 - Release from controlled housing status.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.68 Release from controlled housing status. (a) Only the...

  19. 28 CFR 541.67 - Review of controlled housing status.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.67 Review of controlled housing status. (a) Staff...

  20. 28 CFR 541.67 - Review of controlled housing status.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.67 Review of controlled housing status. (a) Staff...

  1. 28 CFR 541.67 - Review of controlled housing status.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Procedures for Handling of HIV Positive Inmates Who Pose Danger to Others § 541.67 Review of controlled housing status. (a) Staff...

  2. Conversation about Serostatus decreases risk of acquiring HIV: results from a case control study comparing MSM with recent HIV infection and HIV negative controls

    PubMed Central

    2014-01-01

    Background Data on knowledge, attitudes, behaviour and practices (KABP) of persons with recent HIV infection compared to controls with negative HIV test result provide information on current risk patterns and can help to re-focus HIV prevention strategies. Methods From March 2008 through May 2010, persons newly diagnosed with HIV (cases) and HIV-negative controls were recruited by physicians in Germany. To distinguish recent (?5 months) infection, dried blood spots from people newly diagnosed with HIV were tested with the BED IgG-capture ELISA. Cases and controls completed a KABP-questionnaire. We compared cases with recent infection and controls among men having sex with men (MSM) regarding reported risk behaviour in the previous 6 months. To detect differences, unadjusted Odds Ratios (OR) were calculated and multivariate analysis was performed. Results Cases and controls did not differ in terms of knowledge on transmission risks, HIV testing frequency, partnership status, or regarding the frequency of any unprotected sex with partners known to be HIV-positive or assumed to be HIV-negative. Cases more often reported a shorter duration of partnership (HIV-serostatus was more often indicated by cases than controls (OR?=?3.0; p?=?0.003). Having a conversation about HIV serostatus before having sex was associated with a lower risk of infection (OR?=?0.2; p?=?0.01). In multivariate analysis “being always safe” (always using a condom when having sex in different situations outside of a relationship) and talking about serostatus before sex (OR?=?0.23; p?=?0.004; OR?=?0.14; p?=?0.014) were negatively associated with HIV- infection. Conclusions There were no significant differences regarding knowledge about HIV-transmission risks among cases and controls. Differences in risk behaviour were observed regarding unprotected sex with partners of unknown HIV-serostatus and duration of primary partnership at the time of diagnosis, suggesting some HIV-transmissions occurring in newly formed partnerships. The practice of discussing serostatus with prospective sex partners before engaging in sex seems to be protective for HIV-transmission. PMID:24885694

  3. Brief Report: HIV Testing Among Pregnant Women Who Attend Antenatal Care in Malawi.

    PubMed

    Tenthani, Lyson; Haas, Andreas D; Egger, Matthias; Van Oosterhout, Joep J; Jahn, Andreas; Chimbwandira, Frank; Tal, Kali; Myer, Landon; Estill, Janne; Keiser, Olivia

    2015-08-15

    Malawi adopted the Option B+ strategy in 2011. Its success in reducing mother-to-child transmission depends on coverage and timing of HIV testing. We assessed HIV status ascertainment and its predictors during pregnancy. HIV status ascertainment was 82.3% (95% confidence interval: 80.2 to 85.9) in the pre-Option B+ period and 85.7% (95% confidence interval: 83.4 to 88.0) in the Option B+ period. Higher HIV ascertainment was independently associated with higher age, attending antenatal care more than once, and registration in 2010. The observed high variability of HIV ascertainment between sites (50.6%-97.7%) and over time suggests that HIV test kit shortages and insufficient numbers of staff posed major barriers to reducing mother-to-child transmission. PMID:25950205

  4. Knowing Kids Dying of HIV: A Traumatic Event for AIDS Orphans

    PubMed Central

    Zhao, Qun; Li, Xiaoming; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Zhao, Junfeng

    2009-01-01

    Data from 755 AIDS orphans living in a rural area of China with high rates of HIV infection were used to examine the association between a child’s trauma symptoms and knowing a peer with HIV infection or one who had died of HIV. Trauma symptoms were measured by the Traumatic Symptoms Checklist for Children-Chinese Version (TSCC-CV). About 47% of participants reported they knew a child with HIV or one who had died of HIV. More orphans living in family-based care reported such knowledge, and trauma symptoms were significantly higher in children who reported such knowledge. Multivariate analysis revealed that such knowledge was significantly associated with traumatic symptoms, controlling for gender, age, family socioeconomic status, orphan status (double vs. single), and care arrangement (family-based vs. institutional care). The findings underscored the importance of psychosocial support and counseling to orphans in communities with high levels of HIV-related mortality. PMID:19576544

  5. Knowing kids dying of HIV: a traumatic event for AIDS orphans.

    PubMed

    Zhao, Qun; Li, Xiaoming; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Zhao, Junfeng

    2009-01-01

    Data from 755 AIDS orphans living in a rural area of China with high rates of HIV infection were used to examine the association between a child's trauma symptoms and knowing a peer with HIV infection or one who had died of HIV. Trauma symptoms were measured by the Traumatic Symptoms Checklist for Children-Chinese Version (TSCC-CV). About 47% of participants reported they knew a child with HIV or one who had died of HIV. More orphans living in family-based care reported such knowledge, and trauma symptoms were significantly higher in children who reported such knowledge. Multivariate analysis showed that such knowledge was significantly associated with traumatic symptoms, controlling for gender, age, family socioeconomic status, orphan status (double vs. single), and care arrangement (family-based vs. institutional care). The results underscored the importance of psychosocial support and counseling to orphans in communities with high levels of HIV-related mortality. PMID:19576544

  6. Disturbed Amino Acid Metabolism in HIV: Association with Neuropsychiatric Symptoms

    PubMed Central

    Gostner, Johanna M.; Becker, Kathrin; Kurz, Katharina; Fuchs, Dietmar

    2015-01-01

    Blood levels of the amino acid phenylalanine, as well as of the tryptophan breakdown product kynurenine, are found to be elevated in human immunodeficiency virus type 1 (HIV-1)-infected patients. Both essential amino acids, tryptophan and phenylalanine, are important precursor molecules for neurotransmitter biosynthesis. Thus, dysregulated amino acid metabolism may be related to disease-associated neuropsychiatric symptoms, such as development of depression, fatigue, and cognitive impairment. Increased phenylalanine/tyrosine and kynurenine/tryptophan ratios are associated with immune activation in patients with HIV-1 infection and decrease upon effective antiretroviral therapy. Recent large-scale metabolic studies have confirmed the crucial involvement of tryptophan and phenylalanine metabolism in HIV-associated disease. Herein, we summarize the current status of the role of tryptophan and phenylalanine metabolism in HIV disease and discuss how inflammatory stress-associated dysregulation of amino acid metabolism may be part of the pathophysiology of common HIV-associated neuropsychiatric conditions. PMID:26236243

  7. HIV/AIDS, Reproductive and Sexual Health, and the Law

    PubMed Central

    Gostin, Lawrence O.; Hodge, James G.

    2008-01-01

    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

  8. Disturbed Amino Acid Metabolism in HIV: Association with Neuropsychiatric Symptoms.

    PubMed

    Gostner, Johanna M; Becker, Kathrin; Kurz, Katharina; Fuchs, Dietmar

    2015-01-01

    Blood levels of the amino acid phenylalanine, as well as of the tryptophan breakdown product kynurenine, are found to be elevated in human immunodeficiency virus type 1 (HIV-1)-infected patients. Both essential amino acids, tryptophan and phenylalanine, are important precursor molecules for neurotransmitter biosynthesis. Thus, dysregulated amino acid metabolism may be related to disease-associated neuropsychiatric symptoms, such as development of depression, fatigue, and cognitive impairment. Increased phenylalanine/tyrosine and kynurenine/tryptophan ratios are associated with immune activation in patients with HIV-1 infection and decrease upon effective antiretroviral therapy. Recent large-scale metabolic studies have confirmed the crucial involvement of tryptophan and phenylalanine metabolism in HIV-associated disease. Herein, we summarize the current status of the role of tryptophan and phenylalanine metabolism in HIV disease and discuss how inflammatory stress-associated dysregulation of amino acid metabolism may be part of the pathophysiology of common HIV-associated neuropsychiatric conditions. PMID:26236243

  9. HIV-1 Prevention for HIV-1 Serodiscordant Couples

    PubMed Central

    Curran, Kathryn; Baeten, Jared M.; Coates, Thomas J.; Kurth, Ann; Mugo, Nelly R.

    2013-01-01

    A substantial proportion of HIV-1-infected individuals in sub-Saharan Africa are in stable relationships with HIV-1-uninfected partners, and HIV-1 serodiscordant couples thus represent an important target population for HIV-1 prevention. Couple-based HIV-1 testing and counseling facilitates identification of HIV-1 serodiscordant couples, counseling about risk reduction, and referrals to HIV-1 treatment, reproductive health services, and support services. Maximizing HIV-1 prevention for HIV-1 serodiscordant couples requires a combination of strategies, including counseling about condoms, sexual risk, fertility, contraception, and the clinical and prevention benefits of antiretroviral therapy (ART) for the HIV-1-infected partner; provision of clinical care and ART for the HIV-1-infected partner; antenatal care and services to prevent mother to child transmission for HIV-1- infected pregnant women; male circumcision for HIV-1-uninfected men; and, pending guidelines and demonstration projects, oral pre-exposure prophylaxis (PrEP) for HIV-1-uninfected partners. PMID:22415473

  10. Translational spatial task and its relationship to HIV-associated neurocognitive disorders and apolipoprotein E in HIV-seropositive women.

    PubMed

    Morales, Diana; Acevedo, Summer F; Skolasky, Richard L; Hechavarria, Rosa; Santiago, Sharon; De La Torre, Tania; Maldonado, Elizabeth; Wojna, Valerie

    2012-12-01

    HIV-associated neurocognitive disorders (HAND) continue to be a neurological complication of HIV infection in the era of combined antiretroviral therapy. 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 cerebral spinal fluid (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 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 noncarriers: NP tests showed effects of the ?4 allele in HIV-seronegative women but not HIV-seropositive ones, whereas 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

  11. 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

    Kasirye, Ibrahim; Hisali, Eria

    2010-01-01

    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…

  12. Widow Inheritance and HIV Prevalence in Bondo District, Kenya: Baseline Results from a Prospective Cohort Study

    PubMed Central

    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

    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 1.49–2.86); widows who were inherited by relatives for sexual ritual also had elevated odds of HIV infection (OR?=?1.34; 95%CI?=?1.07–1.70). 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 0.63–1.14). 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

  13. Tobacco Use and Nicotine Dependence among HIV-Infected and Uninfected Injection Drug Users

    PubMed Central

    Marshall, Mariah M.; Kirk, Gregory D.; Caporaso, Neil E.; McCormack, Meredith C.; Merlo, Christian A.; Hague, John C.; Mehta, Shruti H.; Engels, Eric A.

    2010-01-01

    Introduction Urban U.S. populations are burdened by intersecting epidemics of HIV-infection, injection drug use, and cigarette smoking. Given the substantial morbidity attributable to tobacco in these populations, we characterized smoking behaviors, nicotine addiction, and tobacco exposure among HIV-infected and HIV-uninfected injection drug users (IDUs) in Baltimore, Maryland. Methods Smoking behaviors among participants in the ALIVE Study were assessed using interviewer-administered questionnaires. Smoking history and nicotine dependence (Fagerstrom Index scores) were compared by HIV and drug injecting status. Serum cotinine (a nicotine metabolite) was measured for a sample of participants by enzyme immunoassay. Results Among 1,052 participants (29.7% HIV-infected, 39.8% active injectors), 85.2% were current smokers and 9.3% former smokers. Smoking prevalence, age at smoking initiation, and cumulative tobacco exposure were similar by HIV status. Median Fagerstrom scores of 4 for HIV-infected and HIV-uninfected smokers indicated moderate nicotine dependence. Daily cigarette consumption was identical by HIV status (median 10 cigarettes), although HIV-infected participants were less likely to smoke 1+ pack daily compared to HIV-uninfected participants (18.0% vs. 26.9%, p=0.001). Compared to former injectors, active injectors had higher smoking prevalence (90.5% vs. 81.7%, p=0.0001), greater daily cigarette consumption (30.7% vs. 19.6% smoked 1+ pack daily, p=0.0001), and slightly higher Fagerstrom scores (median 5 vs. 4). Cotinine levels paralleled self-reported cigarette consumption. Discussion Tobacco use is extremely common among inner city IDUs. Smoking behavior and nicotine dependence did not materially differ by HIV status but were associated with active drug injection. Cessation efforts should target the dual dependence of cigarettes and drugs experienced among this population. PMID:20875704

  14. Women's HIV Disclosure to Family and Friends

    PubMed Central

    Craft, Shonda M.; Reed, Sandra J.

    2012-01-01

    Abstract Previous researchers have documented rates of HIV disclosure to family at discrete time periods, yet none have taken a dynamic approach to this phenomenon. The purpose of this study is to take the next step and provide a retrospective comparison of rates of women's HIV disclosure to family and friends over a 15-year time span. Of particular interest are the possible influences of social network and relationship characteristics on the time-to-disclosure of serostatus. Time-to-disclosure was analyzed from data provided by 125 HIV-positive women. Participants were primarily married or dating (42%), unemployed (79.2%), African American (68%) women with a high school diploma or less (54.4%). Length of time since diagnosis ranged from 1 month to over 19 years (M=7.1 years). Results pointed to statistically significant differences in time-to-disclosure between family, friends, and sexual partners. Additionally, females and persons with whom the participant had more frequent contact were more likely to be disclosed to, regardless of the type of relationship. The results of this study underscore possible challenges with existing studies which have employed point prevalence designs, and point to new methods which could be helpful in family research. PMID:22313348

  15. HIV Treatment: The Basics

    MedlinePLUS

    ... of HIV transmission. When is it time to start treatment with HIV medicines? When to start ART depends on a person’s individual needs. Factors that influence the decision to start ART include: The overall health of the person ...

  16. Treatment of HIV Infection

    MedlinePLUS

    ... Marketing Share this: Main Content Area Treatment of HIV Infection Photo of a variety of different drug ... drugs in order to maintain their health quality. HIV/AIDS Treatment Research NIAID is focused on finding ...

  17. HIV and AIDS

    MedlinePLUS

    ... High School How Can I Stop Cutting? Scoliosis HIV and AIDS KidsHealth > Teens > Sexual Health > STDs & Other ... can begin treatment if necessary. Continue How Does HIV Affect the Body? A healthy body has CD4 ...

  18. HIV and Pulmonary Hypertension

    MedlinePLUS

    HIV Pulmonary & PH Hypertension Did you know that if you are HIV-positive, you are at risk for pulmonary hypertension? www.PHAssociation.org About Pulmonary Hypertension PULMONARY HYPERTENSION, OR PH, is complex and often misunderstood. PH means high ...

  19. HIV/AIDS

    MedlinePLUS

    ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ... cancers. When that happens, the illness is called AIDS. Once a person has the virus, it stays ...

  20. HIV/AIDS

    MedlinePLUS

    ... Fact sheets Features Commentaries 2014 Multimedia Contacts HIV/AIDS Fact sheet N°360 Updated November 2015 Key ... 2015, new HIV infections have fallen by 35%, AIDS-related deaths have fallen by 24% with some ...

  1. Children and HIV

    MedlinePLUS

    ... available. Children have a very high rate of metabolism. This gradually slows as they mature. The liver ... Newest Fact Sheets 111. Optimizing the HIV Care Environment 115. Adolescents and the HIV Care Continuum 114. ...

  2. 18 CFR 401.114 - Data and information previously disclosed to the public.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Data and information previously disclosed to the public. 401.114 Section 401.114 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Public Access...

  3. 10 CFR 1044.11 - How do you protect the information that you want to disclose?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... information disclosed as required in 10 CFR part 710, after verifying any special authorizations or accesses... the generation of classified documents; (c) Mark documents as required by 10 CFR part 1045 (classified information), 10 CFR Part 1017 (unclassified controlled nuclear information), or as required by the Office...

  4. 10 CFR 1044.11 - How do you protect the information that you want to disclose?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... information disclosed as required in 10 CFR part 710, after verifying any special authorizations or accesses... the generation of classified documents; (c) Mark documents as required by 10 CFR part 1045 (classified information), 10 CFR Part 1017 (unclassified controlled nuclear information), or as required by the Office...

  5. 46 CFR 502.201 - Duty to disclose; general provisions governing discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... which the estimate is based, including materials bearing on the nature and extent of injuries suffered... that is relevant to any party's claim or defense—including the existence, description, nature, custody... secret or other confidential research, development, or commercial information not be disclosed or...

  6. Differential Effects of Self-Disclosing versus Self-Involving Counselor Statements.

    ERIC Educational Resources Information Center

    McCarthy, Patricia R.; Betz, Nancy E.

    1978-01-01

    Female undergraduates listened to audiotaped recordings of a counseling interview between an experienced male counselor and a female client. Subjects rated counselor's expertness, attractiveness, and trustworthiness, and generated written responses to self-disclosing or self-involving counselor statements. The self-involving counselor was rated as…

  7. TITLE: MARKETING Columbia University Medical Center will not use or disclose a patient's Protected Health

    E-print Network

    Columbia University

    TITLE: MARKETING POLICY: Columbia University Medical Center will not use or disclose a patient's Protected Health Information (PHI) for marketing purposes without the patient's written authorization or disclosure of a patient's PHI for marketing purposes unless the marketing communication is directly related

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  9. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities and Individuals § 51.46 Disclosing information obtained...

  10. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities and Individuals § 51.46 Disclosing information obtained...

  11. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities and Individuals § 51.46 Disclosing information obtained...

  12. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities and Individuals § 51.46 Disclosing information obtained...

  13. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities and Individuals § 51.46 Disclosing information obtained...

  14. Factors Associated with Behavioral Intention to Disclose Personal Information on Geosocial Networking Applications

    ERIC Educational Resources Information Center

    Cox, Trissa

    2012-01-01

    Information privacy is a major concern for consumers adopting emerging technologies dependent on location-based services. This study sought to determine whether a relationship exists among factors of personalization, locatability, perceived playfulness, privacy concern and behavioral intention to disclose personal information for individuals using…

  15. 12 CFR 14.40 - What a covered person must disclose.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... paragraph (a) and (b) of this section through electronic media instead of on paper, if the consumer... consumer when required. (iii) With respect to those disclosures made through electronic media for which... PROTECTION IN SALES OF INSURANCE § 14.40 What a covered person must disclose. (a) Insurance disclosures....

  16. 12 CFR 14.40 - What a covered person must disclose.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... paragraph (a) and (b) of this section through electronic media instead of on paper, if the consumer... consumer when required. (iii) With respect to those disclosures made through electronic media for which... PROTECTION IN SALES OF INSURANCE § 14.40 What a covered person must disclose. (a) Insurance disclosures....

  17. 12 CFR 14.40 - What a covered person must disclose.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... paragraph (a) and (b) of this section through electronic media instead of on paper, if the consumer... consumer when required. (iii) With respect to those disclosures made through electronic media for which... PROTECTION IN SALES OF INSURANCE § 14.40 What a covered person must disclose. (a) Insurance disclosures....

  18. 12 CFR 14.40 - What a covered person must disclose.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... paragraph (a) and (b) of this section through electronic media instead of on paper, if the consumer... consumer when required. (iii) With respect to those disclosures made through electronic media for which... PROTECTION IN SALES OF INSURANCE § 14.40 What a covered person must disclose. (a) Insurance disclosures....

  19. 12 CFR 14.40 - What a covered person must disclose.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... paragraph (a) and (b) of this section through electronic media instead of on paper, if the consumer... consumer when required. (iii) With respect to those disclosures made through electronic media for which... PROTECTION IN SALES OF INSURANCE § 14.40 What a covered person must disclose. (a) Insurance disclosures....

  20. 75 FR 54802 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Positions AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed rulemaking and notice... corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the... announced it was developing a schedule requiring certain taxpayers to report uncertain tax positions...

  1. 75 FR 78160 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ... Statement Disclosing Uncertain Tax Positions, 75 FR 54802 (proposed Sept. 9, 2010). The IRS received one... Positions AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulation. SUMMARY: This document... tax positions related to the tax return as required by the IRS. DATES: Effective date: This...

  2. Confidentiality Issues when Minor Children Disclose Family Secrets in Family Counseling

    ERIC Educational Resources Information Center

    McCurdy, Kenneth G.; Murray, Kenneth C.

    2003-01-01

    The literature addressing ethical issues involved in the disclosure of family secrets in counseling has typically focused on secrets disclosed by adults, ignoring the ethical issues surrounding individual disclosure by minor children and confidentiality within the family counseling context. This article explores family secrets, confidentiality…

  3. 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

  4. 37 CFR 1.56 - Duty to disclose information material to patentability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... material to patentability. 1.56 Section 1.56 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... Provisions The Application § 1.56 Duty to disclose information material to patentability. (a) A patent by its very nature is affected with a public interest. The public interest is best served, and the...

  5. 37 CFR 1.56 - Duty to disclose information material to patentability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... material to patentability. 1.56 Section 1.56 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... Provisions The Application § 1.56 Duty to disclose information material to patentability. (a) A patent by its very nature is affected with a public interest. The public interest is best served, and the...

  6. 37 CFR 1.56 - Duty to disclose information material to patentability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... material to patentability. 1.56 Section 1.56 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... Provisions The Application § 1.56 Duty to disclose information material to patentability. (a) A patent by its very nature is affected with a public interest. The public interest is best served, and the...

  7. 37 CFR 1.56 - Duty to disclose information material to patentability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... material to patentability. 1.56 Section 1.56 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... Provisions The Application § 1.56 Duty to disclose information material to patentability. (a) A patent by its very nature is affected with a public interest. The public interest is best served, and the...

  8. 37 CFR 1.56 - Duty to disclose information material to patentability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... material to patentability. 1.56 Section 1.56 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... Provisions The Application § 1.56 Duty to disclose information material to patentability. (a) A patent by its very nature is affected with a public interest. The public interest is best served, and the...

  9. 48 CFR 214.407-3 - Other mistakes disclosed before award.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Other mistakes disclosed before award. 214.407-3 Section 214.407-3 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening...

  10. Sexual mixing patterns among social networks of HIV-positive and HIV-negative Beijing men who have sex with men: a multilevel comparison using roundtable network mapping.

    PubMed

    Ruan, Yuhua; Pan, Stephen W; Chamot, Eric; Qian, Han-Zhu; Li, Dongliang; Li, Qing-Chun; Liang, Hong-Yuan; Spittal, Patricia; Shao, Yiming; Kristensen, Sibylle

    2011-08-01

    Men who have sex with men (MSM) are of immediate concern in China's HIV epidemic. In 2008, approximately 2.5-6.5% of China's eight million MSM were HIV positive, while MSM represented 11% of all new HIV cases. Two factors that will in-part determine HIV-transmission dynamics among MSM, are sexual mixing patterns and the social networks which shape them. Sexual mixing patterns and social networks of Chinese MSM, however, remain poorly understood with little refined data available. One reason is that stigma discourages disclosure of names and identifiers to researchers. Using an alternative network-mapping approach, matched case-control design, and snowball sampling, this pilot study sought to compare characteristics of social networks of HIV-positive and HIV-negative Beijing MSM at the individual, dyad, and network levels. First, HIV-negative MSM controls were matched to HIV-positive MSM cases based on age, education, residency, and ethnicity. Then, each case or control and their MSM social network convened at a specific time and location with study investigators. Venues included health clinics, karaoke clubs, brothels, and community centers. Then, using arbitrarily assigned numbers in lieu of actual names, all participants simultaneously completed self-administered surveys regarding their sexual relationships with other participants of the same social network. These new findings indicate that cross-generational sex (anal or oral sex between men with ?10 years age difference) was more prevalent among social networks of HIV-positive MSM, and was due to older age structure of the social network, rather than behavioral differences in sex-partner selection. Members of social networks of HIV-positive MSM were also less likely to have ever disclosed their MSM identity to non-MSM. Future studies should partner with MSM advocacy groups to explore behavioral and structural interventions as possible means of reducing the cross-generational sex and sexual identity-development issues elevating HIV risk for young Chinese MSM. PMID:21400315

  11. The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women.

    PubMed

    Rubin, Leah H; Cook, Judith A; Weber, Kathleen M; Cohen, Mardge H; Martin, Eileen; Valcour, Victor; Milam, Joel; Anastos, Kathryn; Young, Mary A; Alden, Christine; Gustafson, Deborah R; Maki, Pauline M

    2015-08-01

    In contrast to findings from cohorts comprised primarily of HIV-infected men, verbal memory deficits are the largest cognitive deficit found in HIV-infected women from the Women's Interagency HIV Study (WIHS), and this deficit is not explained by depressive symptoms or substance abuse. HIV-infected women may be at greater risk for verbal memory deficits due to a higher prevalence of cognitive risk factors such as high psychosocial stress and lower socioeconomic status. Here, we investigate the association between perceived stress using the Perceived Stress Scale (PSS-10) and verbal memory performance using the Hopkins Verbal Learning Test (HVLT) in 1009 HIV-infected and 496 at-risk HIV-uninfected WIHS participants. Participants completed a comprehensive neuropsychological test battery which yielded seven cognitive domain scores, including a primary outcome of verbal memory. HIV infection was not associated with a higher prevalence of high perceived stress (i.e., PSS-10 score in the top tertile) but was associated with worse performance on verbal learning (p?HIV status, high stress was associated with poorer performance in those cognitive domains (p's?HIV by stress interaction was found only for the verbal memory domain (p?=?0.02); among HIV-infected women only, high stress was associated with lower performance (p's?

  12. The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women

    PubMed Central

    Cook, Judith A.; Weber, Kathleen M.; Cohen, Mardge H.; Martin, Eileen; Valcour, Victor; Milam, Joel; Anastos, Kathryn; Young, Mary A.; Alden, Christine; Gustafson, Deborah R.; Maki, Pauline M.

    2015-01-01

    In contrast to findings from cohorts comprised primarily of HIV-infected men, verbal memory deficits are the largest cognitive deficit found in HIV-infected women from the Women’s Interagency HIV Study (WIHS), and this deficit is not explained by depressive symptoms or substance abuse. HIV-infected women may be at greater risk for verbal memory deficits due to a higher prevalence of cognitive risk factors such as high psychosocial stress and lower socioeconomic status. Here, we investigate the association between perceived stress using the Perceived Stress Scale (PSS-10) and verbal memory performance using the Hopkins Verbal Learning Test (HVLT) in 1009 HIV-infected and 496 at-risk HIV-uninfected WIHS participants. Participants completed a comprehensive neuropsychological test battery which yielded seven cognitive domain scores, including a primary outcome of verbal memory. HIV infection was not associated with a higher prevalence of high perceived stress (i.e., PSS-10 score in the top tertile) but was associated with worse performance on verbal learning (p<0.01) and memory (p<0.001), as well as attention (p=0.02). Regardless of HIV status, high stress was associated with poorer performance in those cognitive domains (p’s< 0.05) as well as processing speed (p=0.01) and executive function (p<0.01). A significant HIV by stress interaction was found only for the verbal memory domain (p=0.02); among HIV-infected women only, high stress was associated with lower performance (p’s<0.001). That association was driven by the delayed verbal memory measure in particular. These findings suggest that high levels of perceived stress contribute to the deficits in verbal memory observed in WIHS women. PMID:25791344

  13. Addressing Anal Health in the HIV Primary Care Setting: A Disappointing Reality

    PubMed Central

    Cardenas, Gabriel A.; Dickinson, Gordon; Metsch, Lisa R.

    2010-01-01

    Abstract The increased risk of anal cancer among individuals living with HIV suggests that anal health (e.g., anal symptoms, anal practices, examination of the anus) should be an issue of priority for HIV care providers to discuss with their HIV-infected patients. We investigated the prevalence of HIV-infected individuals discussing anal health with their HIV primary care provider and factors associated with this discussion. We surveyed 518 adult patients from 5 HIV primary care clinics in Miami, Florida, from May 2004 to May 2005. Overall, only 22% of women, 32% of heterosexual men, and 54% of men who have sex with men (MSM) reported discussing anal health with their HIV providers in the prior 12 months. In a multivariable logistic regression, when adjusting for other factors, heterosexual men and MSM were 2.31 and 5.56 times, respectively, more likely to discuss anal health with their HIV providers compared to their women counterparts. Other factors associated with anal health discussion were the patients' better perception of engagement with HIV providers and having had a sexually transmitted disease exam in the past 12 months. Reporting of unprotected sex with HIV-negative or unknown HIV status was inversely related to discussion of anal health with primary care providers (odds ratio [OR]?=?0.53). Efforts are greatly needed to increase the focus on anal health in the HIV primary care setting for both men and women. PMID:20731611

  14. HIV testing and sexually transmitted infection care among sexually active youth in the Balkans.

    PubMed

    Delva, Wim; Wuillaume, Françoise; Vansteelandt, Stijn; Claeys, Patricia; Verstraelen, Hans; Broeck, Davy Vanden; Temmerman, Marleen

    2008-10-01

    In light of the imminent threat of a growing HIV epidemic in east and southeast Europe, optimal accessibility of primary and secondary HIV preventative interventions, including HIV testing and sexually transmitted infection (STI) care, are fast becoming public health priorities. We surveyed 2150 high school students in Bosnia and Herzegovina, FYR of Macedonia, Serbia, and Montenegro to examine the uptake of HIV testing and associated predictors. Among sexually active youth (n = 651), 5.9% had already been tested for HIV. In marginal logistic regression, country of origin, type of high school, knowing a friend or relative with HIV, poor self-assessed health status, suspicion of having had an STI, and not having used a condom at first sex were independently associated with HIV testing. Fear of the diagnosis, fear of violation of confidentiality, and not knowing where to go for HIV testing were reported as barriers to HIV testing. Of sexually active adolescents who thought they might have contracted an STI, only 42% had subsequently visited a doctor or health facility. The main reasons for not doing so were spontaneous disappearance of the complaints, fear of the diagnosis and being ashamed of discussing the problem. In conclusion, the uptake of HIV testing among this population of sexually active, urban high school students was found to be low, although a higher prevalence of HIV testing history was observed among students showing evidence of risky sexual behavior. Practical and psychological factors seem to challenge the accessibility of facilities for HIV testing and STI care. PMID:18847388

  15. HIV-Infected African Parents Living in Stockholm, Sweden: Disclosure and Planning for Their Children's Future

    ERIC Educational Resources Information Center

    Asander, Ann-Sofie; Bjorkman, Anders; Belfrage, Erik; Faxelid, Elisabeth

    2009-01-01

    In Sweden, most HIV-infected parents are of African origin. The present study explored the frequency of HIV-infected African parents' disclosure of their status to their children and custody planning for their children's future to identify support needs among these families. Semistructured interviews were conducted with 47 parents (41 families).…

  16. Russia: European Court of Human Rights rules HIV-positive foreign national suffered discrimination.

    PubMed

    Weiss, Rémi

    2011-10-01

    On 10 March 2011, the European Court of Human Rights (ECHR) held that refusing a residence permit to a foreign national solely on the basis of his HIV-positive status amounted to unlawful discrimination. This case is a significant boost to the rights of persons living with HIV/AIDS (PLHIV) in Europe and beyond. PMID:22165275

  17. Death Anxiety in Persons with HIV/AIDS: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Miller, Audrey K.; Lee, Brittany L.; Henderson, Craig E.

    2012-01-01

    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.…

  18. Women and HIV

    MedlinePLUS

    ... HIV who take HIV medicines during pregnancy. To Learn More AIDS.gov National Library of Medicine- AIDS/HIV More in For Women Medication Safety for Women ¡Nunca Más! Novelas An Invitation to Collaborate Free Publications English Publications Spanish Publications Publications in Other Languages Take ...

  19. HIV and Immunizations

    MedlinePLUS

    HIV Treatment HIV and Immunizations (Last updated 4/29/2015; last reviewed 4/29/2015) Key Points Vaccines are products that protect people from diseases ... taking HIV medicines before getting immunizations. What are vaccines? Vaccines are products that protect people from diseases ...

  20. HIV-Associated Cancers

    Cancer.gov

    Published on Office of Cancer Genomics (http://ocg.cancer.gov) Home > HIV-Associated Cancers HIV-Associated Cancers [1] The Office of Cancer Genomics (OCG)Opens in a New Tab [2], along with the Office of HIV and AIDS Malignancies (OHAM)Opens in a New

  1. HIV-Associated Cancers

    Cancer.gov

    Published on Office of Cancer Genomics (https://ocg.cancer.gov) Home > HIV-Associated Cancers HIV-Associated Cancers [1] The Office of Cancer Genomics (OCG)Opens in a New Tab [2], along with the Office of HIV and AIDS Malignancies (OHAM)Opens in a New

  2. Stigma and discrimination experiences of HIV-positive men who have sex with men in Cape Town, South Africa.

    PubMed

    Cloete, A; Simbayi, L C; Kalichman, S C; Strebel, A; Henda, N

    2008-10-01

    Since the primary mode of HIV transmission in sub-Saharan Africa is heterosexual, research focusing on the sexual behaviour of men who have sex with men (MSM) is scant. Currently it is unknown how many people living with HIV in South Africa are MSM and there is even less known about the stigmatisation and discrimination of HIV-positive MSM. The current study examined the stigma and discrimination experiences of MSM living with HIV/AIDS in South Africa. Anonymous venue-based surveys were collected from 92 HIV-positive MSM and 330 HIV-positive men who only reported sex with women (MSW). Internalised stigma was high among all HIV-positive men who took part in the survey, with 56% of men reporting that they concealed their HIV status from others. HIV-positive MSM reported experiencing greater social isolation and discrimination resulting from being HIV-positive, including loss of housing or employment due to their HIV status, however these differences were not significant. Mental health interventions, as well as structural changes for protection against discrimination, are needed for HIV-positive South African MSM. PMID:18608067

  3. A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya

    PubMed Central

    2015-01-01

    There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak with for social support. When feeling overwhelmed by their circumstances, the children self-withdrew and performed positive activities (e.g., praying, watching TV, listening to the radio, singing, dancing) to help themselves feel better. Many HIV-affected families have a combination of HIV-positive and negative siblings within the household. Pending further studies conducted with larger sample sizes, the results of this study should assist healthcare professionals to better facilitate disclosure between HIV-positive parents and their children of mixed HIV statuses. PMID:26082868

  4. Sexual Serosorting among Women with or at Risk of HIV Infection

    PubMed Central

    Liu, Chenglong; Hu, Haihong; Goparaju, Lakshmi; Plankey, Michael; Bacchetti, Peter; Weber, Kathleen; Correa, Nereida; Nowicki, Marek; Wilson, Tracey E.

    2010-01-01

    Serosorting, the practice of selectively engaging in unprotected sex with partners of the same HIV serostatus, has been proposed as a strategy for reducing HIV transmission risk among men who have sex with men (MSM). However, there is a paucity of scientific evidence regarding whether women engage in serosorting. We analyzed longitudinal data on women’s sexual behavior with male partners collected in the Women’s Interagency HIV Study from 2001 to 2005. Serosorting was defined as an increasing trend of unprotected anal or vaginal sex (UAVI) within seroconcordant partnerships over time, more frequent UAVI within seroconcordant partnerships compared to non-concordant partnerships, or having UAVI only with seroconcordant partners. Repeated measures Poisson regression models were used to examine the associations between serostatus partnerships and UAVI among HIV-infected and HIV-uninfected women. The study sample consisted of 1,602 HIV-infected and 664 HIV-uninfected women. Over the follow-up period, the frequency of seroconcordant partnerships increased for HIV-uninfected women but the prevalence of UAVI within seroconcordant partnerships remained stable. UAVI was reported more frequently within HIV seroconcordant partnerships than among serodiscordant or unknown serostatus partnerships, regardless of the participant’s HIV status or types of partners. Among women with both HIV-infected and HIV-uninfected partners, 41% (63 HIV-infected and 9 HIV-uninfected) were having UAVI only with seroconcordant partners. Our analyses suggest that serosorting is occurring among both HIV-infected and HIV-uninfected women in this cohort. PMID:20490909

  5. HIV-related discrimination reported by people living with HIV in London, UK.

    PubMed

    Elford, Jonathan; Ibrahim, Fowzia; Bukutu, Cecilia; Anderson, Jane

    2008-03-01

    The objective was to examine the extent to which people living with HIV in London reported being discriminated against because of their infection. In 2004-2005, people living with HIV attending NHS outpatient HIV clinics in north east London were asked: "Have you ever been treated unfairly or differently because of your HIV status-in other words discriminated against?". Of the 1,687 people who returned a questionnaire (73% response rate), data from 1,385 respondents were included in this analysis; 448 heterosexual women and 210 heterosexual men of black African origin, 727 gay/bisexual men (621 white, 106 ethnic minority). Overall, nearly one-third of respondents (29.9%, 414/1,385) said they had been discriminated against because of their HIV infection. Of those who reported experiencing HIV-related discrimination, almost a half (49.6%, 200/403) said this had involved a health care worker including their dentist (n = 102, 25.3%) or primary care physician (n = 70, 17.4%). PMID:18080829

  6. Mapping abnormal subcortical brain morphometry in an elderly HIV + cohort

    PubMed Central

    Wade, Benjamin S.C.; Valcour, Victor G.; Wendelken-Riegelhaupt, Lauren; Esmaeili-Firidouni, Pardis; Joshi, Shantanu H.; Gutman, Boris A.; Thompson, Paul M.

    2015-01-01

    Over 50% of HIV + individuals exhibit neurocognitive impairment and subcortical atrophy, but the profile of brain abnormalities associated with HIV is still poorly understood. Using surface-based shape analyses, we mapped the 3D profile of subcortical morphometry in 63 elderly HIV + participants and 31 uninfected controls. The thalamus, caudate, putamen, pallidum, hippocampus, amygdala, brainstem, accumbens, callosum and ventricles were segmented from high-resolution MRIs. To investigate shape-based morphometry, we analyzed the Jacobian determinant (JD) and radial distances (RD) defined on each region's surfaces. We also investigated effects of nadir CD4 + T-cell counts, viral load, time since diagnosis (TSD) and cognition on subcortical morphology. Lastly, we explored whether HIV + participants were distinguishable from unaffected controls in a machine learning context. All shape and volume features were included in a random forest (RF) model. The model was validated with 2-fold cross-validation. Volumes of HIV + participants' bilateral thalamus, left pallidum, left putamen and callosum were significantly reduced while ventricular spaces were enlarged. Significant shape variation was associated with HIV status, TSD and the Wechsler adult intelligence scale. HIV + people had diffuse atrophy, particularly in the caudate, putamen, hippocampus and thalamus. Unexpectedly, extended TSD was associated with increased thickness of the anterior right pallidum. In the classification of HIV + participants vs. controls, our RF model attained an area under the curve of 72%.

  7. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran

    PubMed Central

    2010-01-01

    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

  8. STI/HIV test result disclosure between female sex workers and their primary, noncommercial male partners in two Mexico-U.S. border cities

    PubMed Central

    Pines, Heather A.; Patterson, Thomas L.; Rangel, Gudelia; Martinez, Gustavo; Robertson, Angela M.; Ulibarri, Monica D.; Syvertsen, Jennifer L.; Martin, Natasha K.; Strathdee, Steffanie A.

    2015-01-01

    Objectives Disclosure of STI/HIV results to sexual partners in Mexico is left to the individual as public health guidelines do not mandate disclosure. To assess the feasibility of couples-based STI/HIV testing with facilitated disclosure as a risk reduction strategy within female sex workers’ (FSWs) primary partnerships, we examined current STI/HIV test result disclosure patterns between FSWs and their primary, non-commercial male partners in Tijuana and Ciudad Juárez, two Mexico-U.S. border cities. Methods In a cohort study (2010–2013), 330 participants (178 FSWs and 152 primary male partners) were followed for 24 months. At semi-annual visits, participants were tested for STIs/HIV and reported on their disclosure of test results from the prior visit. Multilevel logistic regression for dyadic data was used to identify individual- and partnership-level predictors of cumulative STI/HIV test result disclosure within couples during follow-up (disclosed all results vs. did not disclose ?1 result). Results Eighty-seven percent of participants reported disclosing all STI/HIV test results to their primary partners. Non-disclosure of ?1 STI/HIV test result was more common among participants who reported an STI/HIV diagnosis as part of the study (adjusted odds ratio [AOR]=3.54, 95% confidence interval [CI]: 1.18–10.60), those in longer-duration partnerships (AOR=1.11 per year, 95% CI: 1.01–1.21), and those who used drugs before/during sex within partnerships (AOR=3.71, 95% CI: 1.16–11.86). Non-disclosure was less common among participants who injected drugs (AOR=0.27, 95% CI: 0.09–0.80). Conclusions STI/HIV test result disclosure was highly prevalent within FSWs’ primary partnerships, suggesting couples-based STI/HIV testing with facilitated disclosure may be feasible for these and potentially other socially-marginalized couples. PMID:25298381

  9. Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review.

    PubMed

    Laisaar, Kaja-Triin; Raag, Mait; Rosenthal, Marika; Uusküla, Anneli

    2015-05-01

    Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ?18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV. PMID:25844941

  10. Indices to Measure Risk of HIV Acquisition in Rakai, Uganda

    PubMed Central

    Kagaayi, Joseph; Gray, Ronald H.; Whalen, Christopher; Fu, Pingfu; Neuhauser, Duncan; McGrath, Janet W.; Sewankambo, Nelson K.; Serwadda, David; Kigozi, Godfrey; Nalugoda, Fred; Reynolds, Steven J.; Wawer, Maria J.; Singer, Mendel E.

    2014-01-01

    Introduction Targeting most-at-risk individuals with HIV preventive interventions is cost-effective. We developed gender-specific indices to measure risk of HIV among sexually active individuals in Rakai, Uganda. Methods We used multivariable Cox proportional hazards models to estimate time-to-HIV infection associated with candidate predictors. Reduced models were determined using backward selection procedures with Akaike's information criterion (AIC) as the stopping rule. Model discrimination was determined using Harrell's concordance index (c index). Model calibration was determined graphically. Nomograms were used to present the final prediction models. Results We used samples of 7,497 women and 5,783 men. 342 new infections occurred among females (incidence 1.11/100 person years,) and 225 among the males (incidence 1.00/100 person years). The final model for men included age, education, circumcision status, number of sexual partners, genital ulcer disease symptoms, alcohol use before sex, partner in high risk employment, community type, being unaware of a partner's HIV status and community HIV prevalence. The Model's optimism-corrected c index was 69.1 percent (95% CI?=?0.66, 0.73). The final women's model included age, marital status, education, number of sex partners, new sex partner, alcohol consumption by self or partner before sex, concurrent sexual partners, being employed in a high-risk occupation, having genital ulcer disease symptoms, community HIV prevalence, and perceiving oneself or partner to be exposed to HIV. The models optimism-corrected c index was 0.67 (95% CI?=?0.64, 0.70). Both models were well calibrated. Conclusion These indices were discriminative and well calibrated. This provides proof-of-concept that population-based HIV risk indices can be developed. Further research to validate these indices for other populations is needed. PMID:24704778

  11. Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era.

    PubMed

    Mutchler, Matt G; McDavitt, Bryce; Ghani, Mansur A; Nogg, Kelsey; Winder, Terrell J A; Soto, Juliana K

    2015-09-01

    Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options. PMID:26121564

  12. Anthropometric measures and cognition in middle-aged HIV-infected and uninfected women. The Women's Interagency HIV Study

    PubMed Central

    Gustafson, Deborah R.; Mielke, Michelle M.; Tien, Phyllis C.; Valcour, Victor; Cohen, Mardge; Anastos, Kathryn; Liu, Chenglong; Pearce, Leigh; Golub, Elizabeth T.; Minkoff, Howard; Crystal, Howard A.

    2014-01-01

    Objective To explore the relationship of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with cognition in women with (HIV+) and without HIV (HIV-) infection. Design/Methods 1690 participants (1196 HIV+, 494 HIV-) in the Women's Interagency HIV Study (WIHS) with data available on anthropometric measures comprise the analytical sample. Cross-sectional analyses using linear regression models estimated the relationship between anthropometric variables and Trails A, Trails B, Stroop interference time, Stroop word recall, Stroop color naming and reading, and Symbol Digit Modalities Test (SDMT) with consideration for age, HIV infection status, Wide Range Achievement Test score, CD4 count, insulin resistance, drug use, and race/ethnicity. Results Among HIV+ women, BMI < 18.5 kg/m2 was associated with poorer cognitive performance evidenced by longer Trails A and Trails B and shorter SDMT completion times. An obese BMI (30 kg/m2 or higher) was related to better performance on Trails B and worse performance on the Stroop Interference test. Among HIV- women, an obese BMI was related to worse performance on the Stroop – Color naming test. Few and inconsistent associations were observed between WC, WHR and cognition. Conclusion Among women at mid-life with chronic (at least 10 years) HIV infection, common anthropometric measures, primarily BMI, were differentially related to cognitive test performance by cognitive domain. Higher levels of BMI were associated with better cognitive function. In this era of antiretroviral therapies, restoration of health evidenced as higher BMI due to effective antiretroviral therapies, may improve cognitive function in middle-aged HIV infected women. PMID:24338243

  13. Anthropometric measures and cognition in middle-aged HIV-infected and uninfected women. The Women's Interagency HIV Study.

    PubMed

    Gustafson, Deborah R; Mielke, Michelle M; Tien, Phyllis C; Valcour, Victor; Cohen, Mardge; Anastos, Kathryn; Liu, Chenglong; Pearce, Leigh; Golub, Elizabeth T; Minkoff, Howard; Crystal, Howard A

    2013-12-01

    This study aimed to explore the relationship of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with cognition in women with (HIV+) and without HIV (HIV-) infection. One thousand six hundred ninety participants (1,196 HIV+, 494 HIV-) in the Women's Interagency HIV Study (WIHS) with data available on anthropometric measures comprise the analytical sample. Cross-sectional analyses using linear regression models estimated the relationship between anthropometric variables and Trails A, Trails B, Stroop interference time, Stroop word recall, Stroop color naming and reading, and Symbol Digit Modalities Test (SDMT) with consideration for age, HIV infection status, Wide Range Achievement Test score, CD4 count, insulin resistance, drug use, and race/ethnicity. Among HIV+ women, BMI?HIV- women, an obese BMI was related to worse performance on the Stroop color naming test. Few and inconsistent associations were observed between WC, WHR, and cognition. Among women at mid-life with chronic (at least 10 years) HIV infection, common anthropometric measures, primarily BMI, were differentially related to cognitive test performance by cognitive domain. Higher levels of BMI were associated with better cognitive function. In this era of antiretroviral therapies, restoration of health evidenced as higher BMI due to effective antiretroviral therapies, may improve cognitive function in middle-aged HIV-infected women. PMID:24338243

  14. Experiences with HIV Testing, Entry, and Engagement in Care by HIV-Infected Women of Color, and the Need for Autonomy, Competency, and Relatedness

    PubMed Central

    Messer, Lynne C.; Adimora, Adaora A.; Roytburd, Katya; Bowditch, Natasha; Parnell, Heather; Seay, Julia; Bell, Lynda; Pierce, Jonah K.

    2013-01-01

    Abstract Self-determination theory examines the needs of people adopting new behaviors but has not been applied to the adoption of HIV healthcare behaviors. The current study applied self-determination theory to descriptions of healthcare behaviors adopted by ethnic minority women after an HIV diagnosis. Women of color were asked to describe their experiences with HIV testing, entry, and engagement-in-care in qualitative interviews and focus groups. Participants were mostly African-American (88%), over 40 years old (70%), had been diagnosed for more than 6 years (87%) and had disclosed their HIV infection to more than 3 people (73%). Women described unmet self-determination needs at different time points along the HIV Continuum of Care. Women experienced a significant loss of autonomy at the time of HIV diagnosis. Meeting competency and relatedness needs assisted women in entry and engagement-in-care. However, re-establishing autonomy was a key element for long-term engagement-in-care. Interventions that satisfy these needs at the optimal time point in care could improve diagnosis, entry-to-care, and retention-in-care for women living with HIV. PMID:23829331

  15. Identification of psychobiological stressors among HIV-positive women. HIV Neurobehavioral Research Center (HNRC) Group.

    PubMed

    Semple, S J; Patterson, T L; Temoshok, L R; McCutchan, J A; Straits-Tröster, K A; Chandler, J L; Grant, I

    1993-01-01

    This research describes major stressors in the lives of women who have been infected with the human immunodeficiency virus (HIV). Thirty-one HIV antibody positive (HIV+) women infected primarily through heterosexual contact participated in a two hour semi-structured interview detailing the circumstances, context, and consequences of all stressful life events and difficulties experienced within the preceding six months. Qualitative methods of data analyses were utilized (Miles & Huberman, 1984). HIV-related life events and difficulties were classified into primary and secondary stressors based on the stress process model (Pearlin et al., 1981). Problems arising directly from one's seropositivity were defined as primary stressors. Stressful life events and difficulties occurring in other role areas were defined as secondary stressors. Six categories of HIV-related stressors were identified and quantified. Primary stressors were health-related, and included both gynecological problems (e.g., amenorrhea) and general symptoms of HIV infection (e.g., fatigue). Secondary stressors related to child and family (e.g., future guardianship of children), marital/partner relations (e.g., disclosure of HIV+ status), occupation (e.g., arranging time-off for medical appointments), economic problems (e.g., insurance "hassles"), and social network events (e.g., death of friends from AIDS). This research indicates that HIV-positive women are exposed to multiple stressors; some may be viewed as unique to women, whereas others may be considered common to both sexes. Identification of stressors has implications for the design of medical and psychiatric interventions for women. PMID:8171874

  16. Schistosoma mansoni and HIV infection in a Ugandan population with high HIV and helminth prevalence

    PubMed Central

    Nampijja, Margaret; Nannozi, Victoria; Nakawungu, Prossy Kabuubi; Abayo, Elson; Webb, Emily L.; Elliott, Alison M.

    2015-01-01

    OBJECTIVES Recent reports suggest that Schistosoma infection may increase the risk of acquiring human immunodeficiency virus (HIV). We used data from a large cross-sectional study to investigate whether Schistosoma mansoni infection is associated with increased HIV prevalence. METHODS We conducted a household survey of residents in island fishing communities in Mukono district, Uganda, between October 2012 and July 2013. HIV status was assessed using rapid test kits. Kato-Katz (KK) stool tests and urine-circulating cathodic antigen (CCA) were used to test for Schistosoma infection. Multivariable logistic regression, allowing for the survey design, was used to investigate the association between S. mansoni infection and HIV infection. RESULTS Data from 1412 participants aged 13 years and older were analysed (mean age 30.3 years, 45% female). The prevalence of HIV was 17.3%. Using the stool Kato-Katz technique on a single sample, S. mansoni infection was detected in 57.2% (719/1257) of participants; urine CCA was positive in 73.8% (478/650) of those tested. S. mansoni infection was not associated with HIV infection. [KK (aOR = 1.04; 95% CI: 0.74–1.47, P = 0.81), CCA (aOR = 1.53; 95% CI: 0.78–3.00, P = 0.19)]. The median S. mansoni egg count per gram was lower in the HIV-positive participants (P = 0.005). CONCLUSIONS These results add to the evidence that S. mansoni has little effect on HIV transmission, but may influence egg excretion. PMID:25976017

  17. Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda.

    PubMed

    Shuaib, Faisal M B; Ehiri, John E; Jolly, Pauline; Zhang, Qionghui; Emusu, Donath; Ngu, Julius; Foushee, Herman; Katongole, Drake; Kirby, Russell; Wabwire-Mangen, Fred

    2012-01-01

    HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in negative concordant unions. Multivariable logistic regression was used to assess the association between participants' serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1±11.1 years, range: 19-65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2±9.0 years, range: 18-56 years), or HIV negative women in concordant relationships (32.3±11.0 years, range: 18-62), (p=0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95% CI 1.27-4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples' HIV serostatus was not significant related to incident sexual violence after controlling for potential confounding covariates. Nevertheless, the results were able to elucidate the sexual violence risk factor profile of participants based on couples' HIV serostatus. Couple counseling protocols at HIV voluntary counseling and testing centers in Uganda should identify those at risk for sexual violence and develop interventions to reduce its incidence. PMID:22909921

  18. “Triply cursed”: Racism, homophobia, and HIV-related stigma are barriers to regular HIV testing, treatment adherence, and disclosure among young Black gay men

    PubMed Central

    Arnold, Emily A.; Rebchook, Gregory M.; Kegeles, Susan M.

    2014-01-01

    In the USA, young Black gay men are disproportionately impacted by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and 9 service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community, and from friends within the Black gay community, that otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with their alienation and rejection. PMID:24784224

  19. Beyond Anal Sex: Sexual Practices Associated with HIV Risk Reduction among Men Who Have Sex with Men in Boston, Massachusetts

    PubMed Central

    Reisner, Sari L.; Skeer, Margie; Mayer, Kenneth H.

    2009-01-01

    Abstract Men who have sex with men (MSM) continue to bear a disproportionate HIV and sexually transmitted disease (STD) burden. The current study examined the frequency and associations of sexual risk reduction behaviors among a sample of MSM in the greater Boston, Massachusetts area. One hundred eighty-nine MSM completed a one-time behavioral and psychosocial assessment between March 2006 and May 2007. Logistic regression procedures examined the association of demographic, psychosocial, and behavioral factors with risk reduction practices. Twenty percent of the sample reported rimming, mutual masturbation, digital penetration, using sex toys, or 100% condom use as a means to reduce their risk of acquiring or transmitting HIV in the prior 12 months. In bivariate analyses, risk reducers were more likely to disclose their MSM status (i.e., be “out”; odds ratio [OR]?=?3.64; p?

  20. Types of HIV/AIDS Antiretroviral Drugs

    MedlinePLUS

    ... reverse transcriptase (RT) from converting single-stranded HIV RNA into double-stranded HIV DNA?a process called ... RT, interfering with its ability to convert HIV RNA into HIV DNA Integrase Inhibitors block the HIV ...

  1. How Do You Get HIV or AIDS?

    MedlinePLUS

    ... Translate Text Size Print How Do You Get HIV or AIDS? How Is HIV Spread? HIV is spread from an infected person ... to find a testing site near you. Ways HIV Is Transmitted In the United States, HIV is ...

  2. HIV transmission law in the age of treatment-as-prevention.

    PubMed

    Haire, Bridget; Kaldor, John

    2015-12-01

    Evidence that treating people with HIV early in infection prevents transmission to sexual partners has reframed HIV prevention paradigms. The resulting emphasis on HIV testing as part of prevention strategies has rekindled the debate as to whether laws that criminalise HIV transmission are counterproductive to the human rights-based public health response. It also raises normative questions about what constitutes 'safe(r) sex' if a person with HIV has undetectable viral load, which has significant implications for sexual practice and health promotion. This paper discusses a recent high-profile Australian case where HIV transmission or exposure has been prosecuted, and considers how the interpretation of law in these instances impacts on HIV prevention paradigms. In addition, we consider the implications of an evolving medical understanding of HIV transmission, and particularly the ability to determine infectiousness through viral load tests, for laws that relate to HIV exposure (as distinct from transmission) offences. We conclude that defensible laws must relate to appreciable risk. Given the evidence that the transmissibility of HIV is reduced to negligible level where viral load is suppressed, this needs to be recognised in the framing, implementation and enforcement of the law. In addition, normative concepts of 'safe(r) sex' need to be expanded to include sex that is 'protected' by means of the positive person being virally suppressed. In jurisdictions where use of a condom has previously mitigated the duty of the person with HIV to disclose to a partner, this might logically also apply to sex that is 'protected' by undetectable viral load. PMID:26420071

  3. 17 CFR 275.206(4)-4 - Financial and disciplinary information that investment advisers must disclose to clients.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... written disclosure statement to clients under Rule 204-3 (17 CFR 275.204-3); Provided, That the delivery... information that investment advisers must disclose to clients. 275.206(4)-4 Section 275.206(4)-4 Commodity and... disclose to clients. (a) It shall constitute a fraudulent, deceptive, or manipulative act, practice,...

  4. 41 CFR 105-64.502 - How do I find out if my record has been disclosed?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  5. 41 CFR 105-64.502 - How do I find out if my record has been disclosed?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...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...

  6. An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa

    PubMed Central

    2012-01-01

    Background Despite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people’s health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. Methods Data were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score. Results Median age of the sample was 60 years (range 50–94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08–0.29) and HIV-affected (aOR 0.20, 95% CI 0.08–0.50), were significantly less likely than men to be in good functional ability. Women’s adjusted odds of being in good overall health state were similarly lower than men’s; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants. Discussion and conclusions The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system. PMID:22471743

  7. Disclosing Adult Wrongdoing: Maltreated and Non-Maltreated Children’s Expectations and Preferences

    PubMed Central

    Malloy, Lindsay C.; Quas, Jodi A.; Lyon, Thomas D.; Ahern, Elizabeth C.

    2014-01-01

    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 children’s evaluations of disclosing adult wrongdoing by focusing on children’s 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 parent’s or stranger’s transgression. Older children preferred caregiver over police officer recipients when disclosing a parent’s, but not a stranger’s, transgression. Maltreated children’s 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 child’s 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 children’s development and highlight the developmental, experiential, and socio-contextual factors underlying children’s disclosure patterns. PMID:24769356

  8. "You're an open target to be abused": a qualitative study of stigma and HIV self-disclosure among Black men who have sex with men.

    PubMed

    Bird, Jason D P; Voisin, Dexter R

    2013-12-01

    The HIV/AIDS epidemic is a health crisis among Black men who have sex with men (MSM). HIV-related stigma presents a primary barrier to sexual communication and effective HIV prevention. Using in-depth, qualitative interviews conducted with 20 HIV-positive Black MSM between 2007 and 2008 in Chicago, Illinois, we explored the themes related to HIV-related stigma and the underlying messages HIV-positive Black MSM receive regarding their status. Stigmatizing messages stem from family, churches, and the gay community and from negative, internalized, beliefs HIV-positive Black MSM held about infected individuals before their own infection. HIV stigma influences sexual silence around HIV disclosure, especially to sexual partners. PMID:24134345

  9. “You’re an Open Target to Be Abused”: A Qualitative Study of Stigma and HIV Self-Disclosure Among Black Men Who Have Sex With Men

    PubMed Central

    Voisin, Dexter R.

    2013-01-01

    The HIV/AIDS epidemic is a health crisis among Black men who have sex with men (MSM). HIV-related stigma presents a primary barrier to sexual communication and effective HIV prevention. Using in-depth, qualitative interviews conducted with 20 HIV-positive Black MSM between 2007 and 2008 in Chicago, Illinois, we explored the themes related to HIV-related stigma and the underlying messages HIV-positive Black MSM receive regarding their status. Stigmatizing messages stem from family, churches, and the gay community and from negative, internalized, beliefs HIV-positive Black MSM held about infected individuals before their own infection. HIV stigma influences sexual silence around HIV disclosure, especially to sexual partners. PMID:24134345

  10. Predictors of Self-Efficacy for HIV Prevention Among Hispanic Women in South Florida

    PubMed Central

    Villegas, Natalia; Cianelli, Rosina; Gonzalez-Guarda, Rosa; Kaelber, Lorena; Ferrer, Lilian; Peragallo, Nilda

    2012-01-01

    Self-efficacy is a critical element for HIV prevention, however little is known about the predictors of self-efficacy for HIV prevention among Hispanic women. In this cross-sectional study we assessed if age, living with a partner, employment status, HIV knowledge, self-esteem, and intimate partner violence (IPV) predicted self-efficacy for HIV prevention in 548 Hispanic women in South Florida who participated in a randomized controlled trial (SEPA). The majority of Hispanic women reported high levels of self-efficacy for HIV prevention. Women who were older, living with a partner, with less HIV knowledge, and a history of IPV reported significantly lower levels of self-efficacy for HIV prevention. HIV knowledge was the most important predictor of self-efficacy for HIV prevention. Employment was not a significant predictor of self-efficacy for HIV prevention. Predictors identified in the study can be used to identify high-risk Hispanic women who are in need of HIV prevention interventions. PMID:22795758

  11. Contemplating abortion: HIV-positive women’s decision to terminate pregnancy

    PubMed Central

    Rasanathan, Jennifer J. K.; Crawford-Roberts, Ann; Dourado, Ines; Gruskin, Sofia

    2015-01-01

    Research on pregnancy termination (PT) largely assumes HIV status is the only reason why HIV-positive women contemplate abortion. As antiretroviral treatment (ART) becomes increasingly available and women are living longer, healthier lives, the time has come to consider the influence of other factors on HIV-positive women’s reproductive decision-making. Because ART has been free and universally available to Brazilians for more than two decades, Brazil provides a unique context in which to explore these issues. Twenty-five semi-structured interviews exploring women’s PT decision-making were conducted with women receiving care at the Reference Centre for HIV/AIDS in Salvador, Brazil. Interviews were transcribed, translated into English, and coded for analysis. HIV played different roles in women’s decision-making. 13 HIV-positive women did not consider PT. Influential factors described by those who did consider PT included fear of HIV transmission, fear of HIV-related stigma, family size, economic constraints, partner and provider influence, as well as lack of access to such services as PT and abortifacients. For some HIV-positive women in Brazil, HIV can be the only reason to consider PT, but other factors are significant. A thorough understanding of all variables affecting reproductive decision-making is necessary for enhancing services and policies and better meeting the needs and rights of HIV-positive women. PMID:24387297

  12. Male involvement in antenatal HIV counseling and testing: exploring men's perceptions in rural Malawi.

    PubMed

    Aarnio, Pauliina; Olsson, Pia; Chimbiri, Agnes; Kulmala, Teija

    2009-12-01

    Antenatal care can act as an excellent tool to improve access to HIV counseling and testing services. This paper investigates an issue that may weaken its potential, namely lack of male involvement. We explored married men's perceptions of HIV in pregnancy and male involvement in antenatal HIV testing and counseling in Southern Malawi through 11 focus group discussions and a cross-sectional survey (n=388). The main findings were that men were largely unaware of available antenatal HIV testing and counseling services, and perceived it overall problematic to attend female-oriented health care. Most men supported provision of antenatal HIV testing. They perceived husbands to participate in the process indirectly through spousal communication, being faithful during pregnancy, and supporting the wife if found HIV-positive. Involvement of husbands was compromised by men's reluctance to learn their HIV status and the threat that HIV poses on marriage. Men stressed the importance of prior spousal agreement of antenatal HIV testing and considered HIV testing without their consent a valid reason for divorce. We suggest that male involvement in antenatal HIV testing requires refocusing of information and health services to include men. To avoid negative social outcomes for women, comprehensive and early involvement of men is essential. PMID:20024733

  13. High HIV prevalence among children presenting for general consultation in rural Cameroon.

    PubMed

    Zoufaly, A; Hammerl, R; Sunjoh, F; Jochum, J; Nassimi, N; Awasom, C; Tayong, G; Sauter, F; Schmiedel, S; van Lunzen, J; Burchard, G; Feldt, T

    2014-09-01

    Data on the HIV-prevalence children presenting to health care facilities in sub-Saharan Africa are scant in general, and the debate about opportunities for paediatric HIV screening is ongoing. Nine hundred and eighty-one children with unknown HIV-status presenting to a large general paediatric outpatient department in rural Cameroon were tested using the Determine HIV-1/2 rapid test (Abbott), and positive results were confirmed with the Hexagon HIV rapid test (Human Diagnostics). In children younger than 18 months, HIV infection was confirmed by PCR testing. Median age was 1.3 years and 52.8% were of male gender. In 514 children below 18 months of age, 16 (3.1%) tested positive. Of those, HIV-1 PCR was available for 11 children, of whom 6 had a positive PCR result. HIV prevalence was highest in the age group 5-9 years, being 8.8%. Malnutrition (33.3 vs 5.2%, p?HIV infection. Our study results indicate that HIV testing should be offered to all children at possible entry points to medical care, irrespective of symptoms, in order to reduce HIV-associated mortality through timely initiation of antiretroviral therapy. PMID:24469969

  14. Acceptance of HIV testing among African-American college students at a historically black university in the south.

    PubMed Central

    Payne, Nanetta S.; Beckwith, Curt G.; Davis, Melvin; Flanigan, Timothy; Simmons, Emma M.; Crockett, Kathy; Ratcliff, Tanya M.; Brown, Larry K.; Sly, Kaye F.

    2006-01-01

    PURPOSE: Routine HIV testing on college campuses has the potential to increase students' awareness of their HIV status. Testing targeted only at persons reporting HIV risk behaviors will not identify infected persons who may deny or be unaware of their risk. Thus, this study sought to investigate the acceptability of rapid HIV testing among African-American college students in a nontraditional setting on a historically black college/university (HBCU) campus. METHODS: A cross-sectional survey on risk behaviors, barriers to testing, and HIV testing history was administered to 161 African-American college students at an HBCU. All approached students (both those participating and not) were offered free HIV rapid testing. RESULTS: Eighty-one African-American college students consented to be tested for HIV and all tested negative. Results of the questionnaire indicated that African-American college students engage in risky sexual behaviors (such as unprotected sex) yet perceive themselves as at little or no risk. College students who reported past HIV testing often did so in conjunction with routine exams, such as annual pap smears, rather than specifically seeking HIV testing. CONCLUSIONS: Routine HIV testing on college campuses may be an important public health initiative in reducing the spread of HIV. Specifically, this strategy may provide a model for student access to HIV testing, particularly males and other students who may be less likely to seek HIV testing at traditional medical settings. These data supports expansion of routine testing programs directed at African-American college students. PMID:17225833

  15. Identifying New Positives and Linkage to HIV Medical Care--23 Testing Site Types, United States, 2013.

    PubMed

    Seth, Puja; Wang, Guoshen; Collins, Nicoline T; Belcher, Lisa

    2015-06-26

    Among the estimated 1.2 million persons living with human immunodeficiency virus (HIV) infection in the United States, approximately 14% have not had their HIV diagnosed. Certain populations, such as African Americans/blacks (in this report referred to as blacks), men who have sex with men (MSM), and Hispanics/Latinos (in this report referred to as Hispanics), are disproportionately affected by HIV. In areas where HIV prevalence is ?0.1%, CDC recommends routine HIV screening in health care settings for persons aged 13-64 years. Implementation of HIV screening as part of routine care can increase the number of HIV diagnoses, destigmatize HIV testing, and improve access to care for persons with new HIV infections. Additionally, targeted testing in non-health care settings might facilitate access to persons in at-risk populations (e.g., MSM, blacks, and Hispanics) who are unaware of their status and do not routinely seek care. CDC analyzed data for 23 testing site types submitted by 61 health departments and 151 CDC-funded community-based organizations to determine 1) the number of HIV tests conducted, 2) the percentage of persons with new diagnoses of HIV infection (in this report referred to as new positives), and 3) the percentage of persons who were linked to HIV medical care within 90 days after receiving diagnoses at specific site types within health care and non-health care settings. The results indicated that, in health care settings, primary care and sexually transmitted disease (STD) clinics accounted for substantially more HIV tests than did other sites, and STD clinics identified more new positives. In non-health care settings, HIV counseling and testing sites accounted for the most tests and identified the highest number of new positives. Examining program data by site type shows which sites performed better in diagnosing new positives and informs decisions about program planning and allocation of CDC HIV testing resources among and within settings. PMID:26110836

  16. Opportunities for HIV Combination Prevention to Reduce Racial and Ethnic Health Disparities

    PubMed Central

    Grossman, Cynthia I.; Purcell, David W.; Rotheram-Borus, Mary Jane; Veniegas, Rose

    2013-01-01

    Despite advances in HIV prevention and care, African American and Latino Americans remain at much higher risk of acquiring HIV, are more likely to be unaware of their HIV-positive status, are less likely to be linked to and retained in care, or to have suppressed viral load than are Whites. The first National HIV/AIDS Strategy (NHAS) has reducing these disparities as one of its three goals by encouraging the implementation of combination high impact HIV intervention strategies. Federal agencies have expanded their collaborations in order to decrease HIV-related disparities by: better implementation of data-driven decision-making; integration and consolidation of the continuum of HIV care; and the reorganization of relationships among public health agencies, researchers, community-based organizations (CBO), and HIV advocates. Combination Prevention, the integration of evidence-based and impactful behavioral, biomedical, and structural intervention strategies to reduce HIV incidence, provides the tools to address the HIV epidemic. Unfortunately, health disparities exist at every step along the HIV testing-to-care continuum. This provides an opportunity and a challenge to everyone involved in HIV prevention and care to understand and address health disparities as integral to ending the HIV epidemic in the U.S. To further reduce health disparities, successful implementation of NHAS and combination prevention strategies will require multi-disciplinary teams, including psychologists with diverse cultural backgrounds and experiences, to successfully engage groups at highest risk for HIV and those already HIV-infected. In order to utilize the comprehensive care continuum, psychologists and behavioral scientists have a role to play in re-conceptualizing the continuum of care, conducting research to address health disparities, and creating community mobilization strategies. PMID:23688091

  17. HIV Prevalence and Demographic Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon

    PubMed Central

    Wagner, Glenn J.; Tohme, Johnny; Hoover, Matthew; Frost, Simon; Ober, Allison; Khouri, Danielle; Iguchi, Martin; Mokhbat, Jacques

    2014-01-01

    The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47%) were under age 25 years and 67% self-identified as gay. Nearly two-thirds (64%) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23% who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5% of 198 participants tested) were HIV-positive; 62% had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33% vs. 71%). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM. PMID:24752791

  18. HIV TREATMENT OPTIMISM AND UNSAFE ANAL INTERCOURSE AMONG HIV-POSITIVE MEN WHO HAVE SEX WITH MEN: FINDINGS FROM THE POSITIVE CONNECTIONS STUDY

    PubMed Central

    Brennan, David J.; Welles, Seth L.; Miner, Michael H.; Ross, Michael W.; Rosser, B. R. Simon

    2013-01-01

    This study was designed to examine the impact of HIV treatment optimism on sexual risk among a racially diverse sample of HIV-positive MSM. Survey data were collected from 346 racially diverse HIV-positive MSM. Inclusion criteria: 18 years of age, male, at least one incident of unprotected anal intercourse (UAI) in the last year, currently on treatment. Other variables included demographics, sexual risk, depression, internalized homonegativity, HIV treatment history, alcohol/drug use and beliefs about HIV treatments (Susceptibility to transmit HIV, Severity of HIV infection and Condom Motivation). Those with lower income were more likely to report that HIV was less transmissible. A self-reported decrease in condom motivation was associated with being White, well-educated and increased alcoho/drug use. A decrease in Severity of HIV was associated with better mental health, being non-White and undetectable viral load. Sexual risk appears related to beliefs about how treatment affects the transmissibility of HIV. Race, socioeconomic status, alcoho/drug use, mental health and viral load were also associated with treatment beliefs. PMID:20387983

  19. Behavior and psychological functioning of young children of HIV-positive mothers in South Africa.

    PubMed

    Sipsma, Heather; Eloff, Irma; Makin, Jennifer; Finestone, Michelle; Ebersohn, Liesel; Visser, Maretha J; Sikkema, Kathleen J; Allen, Charmayne A Boeving; Ferreira, Ronél; Forsyth, Brian

    2013-01-01

    Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects. We, thus, aimed to compare the behavior and psychological functioning of young children (aged 6-10 years) of HIV-positive and HIV-negative mothers. We also aimed to examine the association between HIV status disclosure and child outcomes. This study uses cross-sectional data from the baseline assessment of a randomized controlled trial conducted in Tshwane, South Africa. Participants (n=509) and their children were recruited from area health clinics. Among the 395 mothers with HIV, 42% reported symptoms of HIV disease. Multivariate linear regression models suggested that after adjusting for socio-demographic characteristics, children of HIV-positive mothers had significantly greater externalizing behaviors than children of HIV-negative mothers. Importantly, children whose mothers were symptomatic had greater internalizing and externalizing behaviors compared with children of HIV-negative mothers, but this was not true for children of asymptomatic mothers. Additionally, among children of HIV-positive mothers, those who had been told their mothers were sick compared with children who had been told nothing had less internalizing and externalizing behaviors and improved daily living skills. This study, therefore, provides evidence that maternal HIV disease can affect the behaviors of young children in South Africa but, importantly, only when the mothers are symptomatic from their disease. Furthermore, results suggest that disclosure of maternal illness but not HIV status was associated with improved behavior and psychological functioning among young children. PMID:23514366

  20. HIV/AIDS in Women

    MedlinePLUS

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