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1

Asking and Telling: Communication About HIV Status Among Latino HIV-Positive Gay Men  

Microsoft Academic Search

Communication about HIV status—that is, asking about a sex partner's status as well as disclosing one's own status—was examined in a sample of 129 Latino HIV-positive gay men interviewed as part of a larger study conducted in New York, Miami, and Los Angeles. Asking and telling were strongly related to each other; however, participants were more likely to disclose their

María Cecilia Zea; Carol A. Reisen; Paul J. Poppen; Rafael M. Díaz

2003-01-01

2

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

PubMed

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

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

2014-06-01

3

Caregiver Perceptions and Motivation for Disclosing or Concealing the Diagnosis of HIV Infection to Children Receiving HIV Care in Mbarara, Uganda: A Qualitative Study  

PubMed Central

Background Disclosure of the diagnosis of HIV to HIV-infected children is challenging for caregivers. Despite current recommendations, data suggest that levels of disclosure of HIV status to HIV-infected children receiving care in resource-limited settings are very low. Few studies describe the disclosure process for children in these settings, particularly the motivators, antecedent goals, and immediate outcomes of disclosure to HIV-infected children. This study examined caregivers' perception of the disclosure concept prior to disclosure, their motivation towards or away from disclosure, and their short- and long-term intentions for disclosure to their HIV-infected children. Methods In-depth interviews were conducted with primary caregivers of 40 HIV-infected children (ages 5–15 years) who were receiving HIV care but did not know their HIV status. Results Caregivers of HIV-infected children mainly perceived disclosure as a single event rather than a process of gradual delivery of information about the child's illness. They viewed disclosure as potentially beneficial both to children and themselves, as well as an opportunity to explain the parents' role in the transmission of HIV to the children. Caregivers desired to personally conduct the disclosure; however, most reported being over-whelmed with fear of negative outcomes and revealed a lack of self-efficacy towards managing the disclosure process. Consequently, most cope by deception to avoid or delay disclosure until they perceive their own readiness to disclose. Conclusions Interventions for HIV disclosure should consider that caregivers may desire to be directly responsible for disclosure to children under their care. They, however, need to be empowered with practical skills to recognize opportunities to initiate the disclosure process early, as well as supported to manage it in a phased, developmentally appropriate manner. The potential role for peer counselors in the disclosure process deserves further study. PMID:24667407

Kiwanuka, Julius; Mulogo, Edgar; Haberer, Jessica E.

2014-01-01

4

HIV-1 evolution: frustrating therapies, but disclosing molecular mechanisms.  

PubMed

Replication of HIV-1 under selective pressure frequently results in the evolution of virus variants that replicate more efficiently under the applied conditions. For example, in patients on antiretroviral therapy, such evolution can result in variants that are resistant to the HIV-1 inhibitors, thus frustrating the therapy. On the other hand, virus evolution can help us to understand the molecular mechanisms that underlie HIV-1 replication. For example, evolution of a defective virus mutant can result in variants that overcome the introduced defect by restoration of the original sequence or by the introduction of additional mutations in the viral genome. Analysis of the evolution pathway can reveal the requirements of the element under study and help to understand its function. Analysis of the escape routes may generate new insight in the viral life cycle and result in the identification of unexpected biological mechanisms. We have developed in vitro HIV-1 evolution into a systematic research tool that allows the study of different aspects of the viral replication cycle. We will briefly review this method of forced virus evolution and provide several examples that illustrate the power of this approach. PMID:20478891

Das, Atze T; Berkhout, Ben

2010-06-27

5

Disclosure, knowledge of partner status, and condom use among HIV-positive patients attending clinical care in Tanzania, Kenya, and Namibia.  

PubMed

We describe the frequency of and factors associated with disclosure, knowledge of partner's HIV status, and consistent condom use among 3538 HIV-positive patients attending eighteen HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Overall, 42% of patients were male, and 64% were on antiretroviral treatment. The majority (80%) had disclosed their HIV status to their partners, 64% knew their partner's HIV status, and 77% reported consistent condom use. Of those who knew their partner's status, 18% reported their partner was HIV negative. Compared to men, women were significantly less likely to report disclosing their HIV status to their sex partner(s), to knowing their partner's HIV status, and to using condoms consistently with HIV-negative partners. Other factors negatively associated with consistent condom use include nondisclosure, alcohol use, reporting a casual sex partner, and desiring a pregnancy. Health care providers should target additional risk reduction counseling and support services to patients who report these characteristics. PMID:23829332

Bachanas, Pamela; Medley, Amy; Pals, Sherri; Kidder, Daniel; Antelman, Gretchen; Benech, Irene; DeLuca, Nicolas; Nuwagaba-Biribonwoha, Harriet; Muhenje, Odylia; Cherutich, Peter; Kariuki, Pauline; Katuta, Frieda; Bukuku, May

2013-07-01

6

The Effect of Partner Sex: Nondisclosure of HIV Status to Male and Female Partners Among Men who Have Sex with Men and Women (MSMW)  

Microsoft Academic Search

A common concern within HIV prevention is that HIV positive MSMW do not disclose their HIV status to female partners who are\\u000a thus at increased risk for HIV infection. The present study uses unique data to examine whether MSMW disclose more often to\\u000a male rather than female partners. Data were collected on most recent male and\\/or female primary partner and

Tara McKayMatt; Matt G. Mutchler

2011-01-01

7

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

PubMed Central

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

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

2013-01-01

8

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 • facing.aids.gov • providertools.aids.gov • HIV/AIDS Service Locator Locator Widgets • Instructions • API Find ...

9

Patterns of Disclosure of HIV- Status to Infected Children in a Sub-Saharan African Setting  

PubMed Central

Objective Adult caregivers provide children living with HIV with varying amounts and types of information about their health status that may affect their coping and health care behaviors. We aimed to describe patterns of information-sharing with children and thoughts around disclosure among caregivers in the Democratic Republic of the Congo. Methods 259 primary caregivers of children 5–17 years old in an HIV pediatric care and treatment program were screened; 8 adult caregivers (3%) had informed their child of the child’s HIV status. We conducted structured interviews with 201 caregivers whose children had not yet been told their HIV status. Results Nearly 50% of caregivers provided no information to their child about their health; 15% had given partial information without mentioning HIV, and 33% provided information that deflected attention from HIV, whether deliberately so or otherwise. Almost all caregivers said that the child should be told their status some day, and three-fourths reported having ever thought about what might lead them to tell. However, nearly one-third of caregivers saw no benefits to informing the child of her/his HIV status. A majority of caregivers felt that they themselves were the best to eventually disclose to the child, but some wanted support from health care providers. Conclusion HIV-infected children are given limited information about their health. Health care providers may serve as important sources of support to caregivers as they decide when and how to talk candidly with their children about their health. PMID:21317803

Vaz, Lara M. E.; Maman, Suzanne; Eng, Eugenia; Barbarin, Oscar A.; Tshikandu, Tomi; Behets, Frieda

2011-01-01

10

HIV status disclosure among HIV-positive African and Afro-Caribbean people in the Netherlands.  

PubMed

HIV status disclosure is often characterized as a dilemma. On the one hand, disclosure can promote health, social support, and psychological well-being. On the other, disclosure can lead to stigmatization, rejection, and other negative social interactions. Previous research has shown that HIV status disclosure is a reasoned process whereby the costs and benefits to oneself and to others are weighed. As such, understanding disclosure requires understanding the reasons for and against disclosure employed by people living with HIV (PLWH). In this study, disclosure among a population disproportionately affected by HIV in the Netherlands, namely African and Afro-Caribbean diaspora, was investigated. Reasons for nondisclosure were fear of stigmatization, previous negative experiences with disclosure, having observed the stigmatization of other PLWH, shame, the desire to protect others - particularly one's children and family - from stigmatization by association and/or worrying, and the belief that one's HIV status is a private matter. Participants reported disclosing because they were in a close and supportive relationship, disclosure led to emotional release, disclosure could lead to emotional or financial support, they felt a perceived duty to inform, and they had a desire to educate others about sexual risk-taking. The findings suggest that stigma plays an important role in disclosure decisions among these populations. They further point to a need for HIV-related stigma reduction interventions in African and Afro-Caribbean communities and culturally sensitive counseling for PLWH whereby caregivers do not automatically assume that disclosure is best but rather provide a safe environment in which the costs and benefits of disclosure can be weighed and strategies for disclosure can be developed, if perceived as beneficial by PLWH. PMID:21259132

Stutterheim, Sarah E; Shiripinda, Iris; Bos, Arjan E R; Pryor, John B; de Bruin, Marijn; Nellen, Jeannine F J B; Kok, Gerjo; Prins, Jan M; Schaalma, Herman P

2011-02-01

11

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

PubMed Central

Background Many studies have reported factors associated with HIV status disclosure among People Living With HIV and AIDS (PLWHA) but very few were conducted among PLWHA receiving ART. In Togo, no study on HIV status disclosure to sexual partners has been conducted among PLWHA on ART yet. We sought to document factors associated with HIV status disclosure among PLWHA receiving ART at Sokodé regional hospital in Togo. Method This was a cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months. Results A total of 291 PLWHA on ART were enrolled in this study. Their mean age (±SD) was 37.3±9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 215 (74.6%) completed the questionnaire on HIV sero-status disclosure. We found that 131 PLWHA (60.9%) had disclosed their HIV sero-status to their sexual partners; 130 (60.5%) were aware of the HIV status of their sexual partners. In the multivariate analysis, the factors associated with HIV status disclosure to sexual partners were: adherence to ART (aOR = 4.89; 95%CI = [1.52; 15.78]), sexual partner awareness of HIV sero-status (aOR = 52.73; 95%CI = [14.76; 188.36]) and marital status of PLWHA (aOR = 6.10; 95%CI = [1.74; 21.37]). Conclusion This study allowed us to note that the disclosure of HIV status to sexual partners is relatively low and to document the associated factors such as adherence to ART, sexual partner awareness of HIV sero-status and marital status. PMID:25658105

Yaya, Issifou; Saka, Bayaki; Landoh, Dadja Essoya; Patchali, P’Niwè Massoubayo; Patassi, Akouda Akessiwè; Aboubakari, Abdoul-samadou; Makawa, Makawa-Sy; N’Dri, Mathias Kouamé; Senanou, Sékandé; Lamboni, Bassan; Idrissou, Daoudou; Salaka, Kao Tanang; Pitché, Palokinam

2015-01-01

12

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

PubMed Central

Background Human Immunodeficiency Virus (HIV) status disclosure has been shown to provide several benefits, both at the individual and societal levels. Aim To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART) recipients in South Africa. Setting A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa. Methods We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other. Patients A total of 883 patients were interviewed. The majority were women (73%) with median age of 39 years. Results Employed patients were less likely to disclose than unemployed (odds ratio (OR) 0.36; 95% confidence interval (CI) 0.1–1.0; 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

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

2014-01-01

13

HIV Status Disclosure to Families for Social Support in South Africa (NIMH Project Accept/ HPTN 043)  

PubMed Central

Literature on HIV status disclosure among persons living with HIV/AIDS (PLWHA) is dominated by research on the rates, barriers and consequences of disclosure to sexual partners because of the assumed preventive health benefits of partner disclosure. Disclosure of HIV status can lead to an increase in social support and other positive psychosocial outcomes for PLWHA, but disclosure can also be associated with negative social outcomes including stigma, discrimination and violence. The purpose of this article is to describe the HIV status disclosure narratives of PLWHA living in South Africa. Thirty in-depth interviews were conducted with 13 PLWHA (11 women, 2 men) over a three year time period. We explored disclosure narratives of the PLWHA through questions about who they chose to disclose to, how they disclosed to these individuals, and how these individuals reacted. Narratives focused on disclosure to family members and contained relatively little discussion of disclosure to sexual partners. Participants often disclosed first to one trusted family member, and news of the diagnosis remained with this person for a long period of time, prior to sharing with others. This family member helped the PLWHA cope with the news of their diagnosis and prepared them to disclose to others. Disclosure to one’s partner was motivated primarily by a desire to encourage partners to test for HIV. Two participants described overtly negative reactions from a partner upon disclosure, and none of the PLWHA in this sample described very supportive relationships with their partners after disclosure. The critical role that family members played in the narratives of these PLWHA emphasizes the need for a greater focus on disclosure to families for social support in HIV counseling protocols. PMID:23875539

Maman, Suzanne; van Rooyen, Heidi; Groves, Allison K.

2014-01-01

14

Couples with Mixed HIV Status  

MedlinePLUS

... baby will be infected. Also, avoid breastfeeding a newborn. This can transmit HIV. Fact sheet 611 has more information on pregnancy for HIV-positive women. Back to Fact Sheet Categories The AIDS InfoNet is a project of the New Mexico ...

15

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

PubMed

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

Smith, Rachel A; Niedermyer, Angela J

2009-07-01

16

Discussing matters of sexual health with children: what issues relating to disclosure of parental HIV status reveal.  

PubMed

Little is published about the disclosure of parents' own HIV status to their children in Africa. Research shows that keeping family secrets from children, including those related to a parent's HIV status, can be detrimental to their psychological well-being and to the structure of the family. Further, children with HIV-positive parents have been shown to be more vulnerable to poorer reproductive health outcomes. This qualitative study in Botswana conducted in-depth interviews among 21 HIV-positive parents on antiretroviral therapy. The data revealed that parents found discussing the issue of HIV with children difficult, including disclosing their own HIV status to them. Reasons for disclosing included: children being HIV positive, the rest of the family knowing, or the parent becoming very sick. Reasons for not disclosing included: believing the child to be too young, not knowing how to address the issue of HIV, that it would be "too painful" for the child/ren. Concern that other people might find out about their status or fear of children experiencing stigmatising behaviour. Interviews elucidated the difficulty that parents have in discussing their own HIV status and more general sexual health issues with their children. Parents and other guardians require support in managing age-appropriate disclosure to their children. This may further enable access to forums that can help children cope with their fears about the future and develop life skills in preparation for dealing with relationships of a sexual nature and sexual health as children move into adulthood. In developing such support mechanisms, changing family roles in Botswana need to be taken into consideration and the role of other family members in the upbringing of children in Tswana society need to be recognised and utilised. PMID:19280415

Nam, Sara Liane; Fielding, Katherine; Avalos, Ava; Gaolathe, Tendani; Dickinson, Diana; Geissler, Paul Wenzel

2009-03-01

17

HIV Status Disclosure and Retention in Care in HIV-Infected Adolescents on Antiretroviral Therapy (ART) in West Africa  

PubMed Central

Objective We assessed the effect of HIV status disclosure on retention in care from initiation of antiretroviral therapy (ART) among HIV-infected children aged 10 years or more in Cote d'Ivoire, Mali and Sénégal. Methods Multi-centre cohort study within five paediatric clinics participating in the IeDEA West Africa collaboration. HIV-infected patients were included in this study if they met the following inclusion criteria: aged 10–21 years while on ART; having initiated ART?200 days before the closure date of the clinic database; followed ?15 days from ART initiation in clinics with ?10 adolescents enrolled. Routine follow-up data were merged with those collected through a standardized ad hoc questionnaire on awareness of HIV status. Probability of retention (no death or loss-to-follow-up) was estimated with Kaplan-Meier method. Cox proportional hazard model with date of ART initiation as origin and a delayed entry at date of 10th birthday was used to identify factors associated with death or loss-to-follow-up. Results 650 adolescents were available for this analysis. Characteristics at ART initiation were: median age of 10.4 years; median CD4 count of 224 cells/mm3 (47% with severe immunosuppression), 48% CDC stage C/WHO stage 3/4. The median follow-up on ART after the age of 10 was 23.3 months; 187 adolescents (28.8%) knew their HIV status. The overall probability of retention at 36 months after ART initiation was 74.6% (95% confidence interval [CI]: 70.5–79.0) and was higher for those disclosed compared to those not: adjusted hazard ratio for the risk of being death or loss-to-follow-up?=?0.23 (95% CI: 0.13–0.39). Conclusion About 2/3 of HIV-infected adolescents on ART were not aware of their HIV status in these ART clinics in West Africa but disclosed HIV status improved retention in care. The disclosure process should be thus systematically encouraged and organized in adolescent populations. PMID:22457782

Arrivé, Elise; Dicko, Fatoumata; Amghar, Hind; Aka, Addi Edmond; Dior, Hélène; Bouah, Belinda; Traoré, Mariam; Ogbo, Patricia; Dago-Akribi, Hortense Aka; Eboua, Tanoh Kassi F.; Kouakou, Kouadio; Sy, Haby Signate; Alioum, Ahmadou; Dabis, François; Ekouévi, Didier Koumavi; Leroy, Valériane

2012-01-01

18

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

PubMed

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

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

2013-12-01

19

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

PubMed Central

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

2014-01-01

20

The Demand for, and Impact of, Learning HIV Status  

PubMed Central

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

Thornton, Rebecca L.

2011-01-01

21

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

PubMed

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

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

2014-06-01

22

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

PubMed Central

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

2013-01-01

23

Micronutrient status during lactation in HIV-infected and HIV-uninfected South African women during the first 6 mo  

Microsoft Academic Search

Background:LittleinformationonthemicronutrientstatusofHIV- infected (HIV-positive) breastfeeding women is available. Objective: The objective was to compare the protein and micronu- trient status of South African breastfeeding women by HIV status. Design: Serum albumin, prealbumin, vitamin B-12, folate, retinol, -tocopherol, hemoglobin, ferritin, and zinc concentrations were compared between 92 HIV-positive and 52 HIV-uninfected (HIV- negative)mothers6,14,and24wkafterdelivery.C-reactiveprotein and 1-acid glycoprotein were used as proxy indicators of

Peggy C Papathakis; Nigel C Rollins; Caroline J Chantry; Michael L Bennish; Kenneth H Brown

24

Nutritional status and HIV in rural South African children  

Microsoft Academic Search

Background  Achieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability\\u000a of governments\\/policymakers to address nutritional status of children in general and those infected or affected by HIV\\/AIDS\\u000a in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of\\u000a nutritional status.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The study involved 671

Elizabeth W Kimani-Murage; Shane A Norris; John M Pettifor; Stephen M Tollman; Kerstin Klipstein-Grobusch; Xavier F Gómez-Olivé; David B Dunger; Kathleen Kahn

2011-01-01

25

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

E-print Network

; or 3. a person who the HIV/AIDS patient may have exposed to HIV under circumstances that present a risk sensitive nature, if HIV/AIDS information is improperly used or released, the patient's privacy, healthcare about a patient, including demographic information that may identify a patient, that relates

Columbia University

26

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

PubMed Central

Objective To determine factors associated with HIV status unawareness and assess HIV prevention knowledge and condom use among people living with HIV/AIDS (PLHIV) in Mozambique. Design Cross-sectional household-based nationally representative AIDS Indicator Survey. Methods Analyses focused on HIV-infected adults and were weighted for the complex sampling design. We identified PLHIV who had never been tested for HIV or received their test results prior to this survey. Logistic regression was used to assess factors associated with HIV status unawareness. Results Of persons with positive HIV test results (N?=?1182), 61% (95% confidence interval [CI] 57–65%) were unaware of their serostatus. Men had twice the odds of being unaware of their serostatus compared with women [adjusted odds ratio (aOR) 2.05, CI 1.40–2.98]. PLHIV in the poorest wealth quintile were most likely to be unaware of their serostatus (aOR 3.15, CI 1.09–9.12) compared to those in the middle wealth quintile. Most PLHIV (83%, CI 79–87%) reported not using a condom during their last sexual intercourse, and PLHIV who reported not using a condom during their last sexual intercourse were more likely to be unaware of their serostatus (aOR 2.32, CI 1.57–3.43) than those who used a condom. Conclusions Knowledge of HIV-positive status is associated with more frequent condom use in Mozambique. However, most HIV-infected persons are unaware of their serostatus, with men and persons in the poorest wealth quintile being more likely to be unaware. These findings support calls for expanded HIV testing, especially among groups less likely to be aware of their HIV status and key populations at higher risk for infection. PMID:25222010

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

2014-01-01

27

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

PubMed Central

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

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

2014-01-01

28

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

PubMed

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

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

2013-01-01

29

The relationship between substance use and HIV health status  

Microsoft Academic Search

This study investigated the relationship between past and current substance use and protected health status in people living with HIV. Past substance use variables were based upon diagnostic categories of use, abuse, dependence and severity derived from the SCID DSM-IV and used to generate a dysfunctional drug use factor for each drug class (alcohol, marijuana, cocaine, opioids, hallucinogens, stimulants, sedatives

Neal Andrew Baker

2003-01-01

30

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

PubMed

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

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

2015-12-01

31

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

PubMed Central

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

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

2015-01-01

32

Advancing methodology in the study of HIV status disclosure: the importance of considering disclosure target and intent.  

PubMed

Disclosure of HIV status has been the focus of three decades of research, which have revealed its complex relations to many behaviors involved in HIV prevention and treatment, and exposed its central role in managing the HIV epidemic. The causes and consequences of disclosure acts have recently been the subject of several theoretical models. Although it is acknowledged that individual disclosure events are part of a broader process of disclosing one's HIV status to an increasing number of people, this process has received less theoretical attention. In quantitative studies of disclosure, researchers have often implicitly assumed that disclosure is a single unidimensional process appropriately measured via the total number of one's disclosure acts. However, there is also evidence that disclosure may have different causes and consequences depending on the types of actors involved (e.g. family members, friends) and on the presence or absence of the discloser's intention, suggesting that the unidimensionality assumption may not hold. We quantitatively examined the dimensionality of voluntary and involuntary disclosure to different categories of actors, using data collected via structured interviews in the spring of 2010 from 158 people living with HIV in Kilimanjaro, Tanzania. For voluntary disclosure, nonparametric item response analyses identified two multi-category clusters, family and community, and two single-category dimensions, partner and children. Involuntary disclosure consisted of several single- or two-category dimensions. Correlation analyses between the resulting disclosure dimensions and stigma and social support revealed distinct relationships for each disclosure dimension. Our results suggest that treating disclosure as a unidimensional construct is a simplification of disclosure processes that may lead to incorrect conclusions about disclosure correlates. We therefore recommend examining disclosure acts jointly to identify sample-specific dimensions before examining causes and consequences of disclosure. We propose a methodology for investigating disclosure processes, and recommend its adoption in future disclosure studies. PMID:24641881

Dima, Alexandra L; Stutterheim, Sarah E; Lyimo, Ramsey; de Bruin, Marijn

2014-05-01

33

Murderer's HIV status irrelevant in trial of accomplice.  

PubMed

A three-judge panel of the Missouri State Court of Appeals affirmed a lower court's decision refusing a defendant charged with instigating a murder to question the hit man about his HIV status. The defendant, [name removed], claims that [name removed] had nothing to lose by implicating her in the murder-for-hire shooting death of her ex-husband because [name removed] was HIV-positive. [Name removed] confessed to shooting [name removed] at the request of Mrs. [Name removed] pleaded guilty to first-degree murder and agreed to a life sentence without the possibility of parole in exchange for testimony against [name removed]. The panel ruled that evidence that [name removed] is HIV-positive does not demonstrate a bias against the defendant's interests. PMID:11364079

1996-11-01

34

Nutritional status and HIV in rural South African children  

E-print Network

affecting the results is low. We did not use an elaborate food security status assessment as the tool did not include diverse dimensions of food security. This may have implications on our results, such as the observed lack of association of food security... persons [7]. Additionally, HIV/AIDS has enormous impact on food security of affected house- holds [8,9]. Other covariates of child malnutrition have been documented including child level factors such as age and birth weight; maternal level factors...

Kimani-Murage, Elizabeth W; Norris, Shane A; Pettifor, John M; Tollman, Stephen M; Klipstein-Grobusch, Kerstin; Gomez-Olive, Xavier F; Dunger, David B; Kahn, Kathleen

2011-03-25

35

HIV status and union dissolution in sub-Saharan Africa: the case of Rakai, Uganda.  

PubMed

Little is known about the impact of HIV infection on the disruption of families through separation, divorce, and widowhood. Using life tables and multinomial logistic regression, this research examined the influence of HIV status on the risk of separation or divorce and widowhood among women in Rakai, Uganda. The multivariate results revealed that dissolution is more common among HIV-infected women and that infected women in HIV-discordant couples are especially likely to face separation or divorce than women in other HIV-status couples. These results highlight women's vulnerability to the social impact of HIV infection and the importance of dyadic studies of the disruption of unions. PMID:15461010

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

2004-08-01

36

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

PubMed

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

Anglewicz, Philip; Reniers, Georges

2014-12-01

37

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

PubMed Central

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

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

2014-01-01

38

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

PubMed Central

Objective. To evaluate HIV risk perception and its associated factors among Chinese MSM. Methods. A cross-sectional study was conducted among MSM with an HIV negative or unknown status in Beijing, China, between 2011 and 2012. A questionnaire interview was conducted and a blood sample was collected for HIV and syphilis testing. Results. Of 887 MSM who reported they were HIV negative or did not know their HIV status before recruitment, only 7.3% reported a high risk of HIV infection, 28.0% medium risk, 52.2% low risk, and 12.5% no risk. In multivariate logistic regression models using those who reported a medium self-perceived risk as a reference group, self-reported high risk of HIV perception was associated with minority ethnicity (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.03–8.19), self-reported history of sexually transmitted diseases (OR: 2.27; 95% CI: 1.25–4.10), and HIV testing times since the last HIV testing (OR: 0.47; 95% CI: 0.26–0.84); low self-perceived risk of HIV infection was related to full-time employment (OR: 1.58; 95% CI: 1.15–2.18) and illicit drug use (OR: 0.28; 95% CI: 0.10–0.75). Conclusions. The HIV/AIDS epidemic is rapidly rising among Beijing MSM, but more than half MSM did not perceive this risk. PMID:24795880

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

2014-01-01

39

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

Microsoft Academic Search

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

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

2009-01-01

40

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

PubMed Central

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

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

2013-01-01

41

Profile and HIV diagnosis disclosure status of children enrolled in a pediatric antiretroviral program in Gauteng Province, South Africa.  

PubMed

A cross sectional survey was conducted with 121 caregivers of HIV-infected children aged 6-13 years enrolled in an antiretroviral treatment (ART) program at a tertiary hospital to determine the profile and HIV disclosure status of children on ART, as well as the socio-demographic profile of their caregivers. The majority of caregivers (n=104, 87.4%) were females, with a mean age of 39.6 years (range 21-76 years). Eighty-four (70.6%) caregivers had secondary education, 61 (51.3%) were single, 83 (69.8%) were unemployed, 73 (61.9%) depended on childcare grants, and 51 (42.9%) were biological mothers. The mean age of children was 9.4 years (range 1-13 years), 109 (90.8%) were schooling, and the mean diagnosis age was 5.2 years. Prevalence of disclosure was 40 (33.3%), mean disclosure age was 9.4 years (range 3-13 years), and mean diagnosis age was 5.2 years. Fifteen (37.5%) of the children were told their HIV diagnosis by biological mothers, 10 (25%) by healthcare providers, 7 (17.5%) by grandmothers, and 8 (20%) were told by other relatives and foster parents. The prevalence of diagnosis disclosure to HIV infected children was higher than previously reported rates in South Africa and could be attributed to the older mean age of diagnosis. Although biological mothers were the main caregivers, they disclosed the HIV diagnosis to only one-third of the children. There is a need for more research to profile HIV infected children accessing ART in public health facilities to inform interventions to manage this growing population of children. PMID:24450238

Madiba, Sphiwe; Mokwena, Kebogile

2013-11-01

42

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

PubMed Central

Introduction Prisoners bear a disproportionate burden of Ukraine's volatile and transitional HIV epidemic, yet little is known in Eastern Europe about HIV testing, treatment and HIV-related risk among prisoners. Methods A nationally representative biobehavioural health survey linked with serological testing was conducted among soon-to-be released prisoners in 13 Ukrainian prisons from June to November 2011. Results Among 402 participants, 78 (19.4%) tested HIV seropositive of whom 38 (50.7%) were previously unaware of their HIV status. Independent correlates of HIV infection included drug injection (AOR=4.26; 95% CI: 2.23–8.15), female gender (AOR=2.00; 95% CI: 1.06–3.78), previous incarceration (AOR=1.99; 95% CI: 1.07–3.70) and being from Southern Ukraine (AOR=5.46; 95% CI: 2.21–13.46). Those aware of being HIV-positive reported significantly more pre-incarceration sex- and drug-related HIV risk behaviours than those who were unaware. Conclusions Routine rather than risk-based HIV testing and expansion of opioid substitution and antiretroviral therapy among prisoners is urgently needed to reduce HIV transmission in volatile transitional HIV epidemics. PMID:25216073

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

2014-01-01

43

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

Microsoft Academic Search

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

Carol L. Galletly; Steven D. Pinkerton

2006-01-01

44

Age-associated predictors of medication adherence in HIV-positive adults: Health beliefs, self-efficacy, and neurocognitive status  

E-print Network

Medication adherence in HIV-infected adults: Effect of patient age, cognitive status, and substance abuse.Medication Adherence in HIV seropositive adults was associated with current drug abuse/abuse, length of HIV illness, or number of years on HIV medications.

2007-01-01

45

The Effect of a Model's HIV Status on Self-Perceptions: A Self-Protective Similarity Bias.  

ERIC Educational Resources Information Center

Examined how information about another person's HIV status influences self-perceptions and behavioral intentions. Individuals perceived their own personalities and behaviors as more dissimilar to anther's if that person's HIV status was believed positive compared with negative or unknown. Exposure to HIV-positive model produced greater intentions…

Gump, Brooks B.; Kulik, James A.

1995-01-01

46

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

PubMed Central

Background There is a scarcity of data in rural health centers in Nigeria regarding the relationship between socioeconomic status (SES) and HIV infection. We investigated this relationship using indicators of SES. Methods An analytical case-control study was conducted in the HIV clinic of a rural tertiary health center. Data collection included demographic variables, educational attainment, employment status, monthly income, marital status, and religion. HIV was diagnosed by conventional methods. Data were analyzed with the SPSS version 16 software. Results A total of 115 (48.5%) HIV-negative subjects with a mean age of 35.49±7.63 years (range: 15–54 years), and 122 (51.5%) HIV-positive subjects with a mean age of 36.35±8.31 years (range: 15–53 years) were involved in the study. Participants consisted of 47 (40.9%) men and 68 (59.1%) women who were HIV negative. Those who were HIV positive consisted of 35 (28.7%) men and 87 (71.3%) women. Attainment of secondary school levels of education, and all categories of monthly income showed statistically significant relationships with HIV infection (P=0.018 and P<0.05, respectively) after analysis using a logistic regression model. Employment status did not show any significant relationship with HIV infection. Conclusion Our findings suggested that some indicators of SES are differently related to HIV infection. Prevalent HIV infections are now concentrated among those with low incomes. Urgent measures to improve HIV prevention among low income earners are necessary. Further research in this area requires multiple measures in relation to partners’ SES (measured by education, employment, and income) to further define this relationship. PMID:24790469

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

2014-01-01

47

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

Microsoft Academic Search

Women represent an increasing proportion of AIDS cases and anecdotal reports suggest some face substantial risks when others learn they are HIV-positive. The purpose of this paper is to describe women's fears and experiences regarding disclosure of their HIV status. Fifty HIV-positive women, ages 16–45 from urban teaching hospital outpatient clinics, were interviewed using an in-depth, qualitative interview. Eighty-six percent

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

1997-01-01

48

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

PubMed

This study included all patients, with known HIV-1 status, admitted to hospital over a 5-year period with serum ferritin values exceeding 1500 ?g/l. Markedly elevated serum ferritin levels are associated with a host of causes which poses a diagnostic dilemma, as the aetiology is often highly dependent on local epidemiology. We evaluated patients' records retrospectively to determine underlying causes of possible hyperferritinaemia. Aetiologies associated with hyperferritinaemia varied significantly depending on HIV-1 status. In patients infected with the HIV-1 virus, infectious causes predominated with Mycobacterium tuberculosis accounting for more than 50% of the patient population with an odds ratio of 17·98 (95% confidence interval 8·31-38·88) in HIV-positive compared to HIV-negative patients. Of the HIV-1-negative patients, hereditary haemochromatosis accounted for less than 2% of patients and chronic renal failure was the most common diagnosis. The finding of hyperferritinaemia should prompt determination of HIV-1 status, as this impacts significantly on aetiological epidemiology. In HIV-1-positive patients, aggressive investigation for mycobacterial infection should be undertaken in cases of combined hyperferritinaemia and positive HIV-1 serology. PMID:22417736

Visser, A; Mostert, C

2013-01-01

49

Urban Crack Users: Gender Differences in Drug Use, HIV Risk and Health Status  

Microsoft Academic Search

This study assessed gender differences in drug use, HIV risk, and health status in a sample of urban crack users. Using targeted sampling, 1434 crack users (66% male and primarily African-American and Puerto Rican), were recruited from the streets of East Harlem, New York City. A standardized, structured interview was administered, drug use was validated by urinalysis, and HIV testing

Stephanie Tortu; Marjorie Goldstein; Sherry Deren; Mark Beardsley; Rahul Hamid; Kristine Ziek

1998-01-01

50

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

Microsoft Academic Search

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

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

1995-01-01

51

HIV testing and self-reported HIV status in South African MSM: Results from a community-based survey  

PubMed Central

Objective To investigate the characteristics of South African men who have sex with men (MSM) who (1) have been tested for HIV and (2) are HIV-positive. Methods Data were collected among 1045 MSM in community surveys using questionnaires which were administered either face-to-face, mail, or on the internet. The mean age of the men was 29.9 years. The racial distribution was as follows: 35.3% black, 17.0% coloured, 5.3% Indian, and 41.1% white. Results The proportion of MSM that were HIV-tested was 69.7%; having been tested was independently associated with being older, being more open about one's homosexuality, and being homosexually instead of bisexually attracted; black MSM, students, and MSM living in KwaZulu-Natal were less likely to have been tested. Of the 728 MSM who had ever been tested, 14.1% (n=103) reported to be HIV-positive (9.9% of the total sample). Being HIV-positive is independently associated with two factors: men who were positive were more likely to have a lower level of education and to know other persons who were living with HIV/AIDS; race was not independently associated with HIV status among those who had been tested. Conclusions The likelihood of having been tested for HIV seems to decrease with increasing social vulnerability. Racially, the distribution of HIV among MSM seems to differ from that of the general South African population, suggesting that while intertwined with the heterosexual epidemic, there is also an epidemic among South African MSM with specific dynamics. These findings suggest that in-depth research is urgently needed to address the lack of understanding of HIV testing practices and HIV prevalence in South African MSM. PMID:19028940

Sandfort, Theo G. M.; Nel, Juan; Rich, Eileen; Reddy, Vasu; Yi, Huso

2009-01-01

52

Should psychiatrists self disclose?  

PubMed

The extent to which psychiatrists disclose personal information about their feelings, their pasts, and themselves to their patients has always been an important ethical and clinical question. In the past, psychiatrists tended to believe they should not self disclose personal information to their patients, mainly to help patients by exploring their transference. More recent work has suggested that self disclosing by the psychiatrist may benefit some patients and cause harm to other patients. This article presents the author's present understanding of some of the core pros and cons of self disclosing by the psychiatrist, as well as some specific contexts in which self disclosure is indicated or should be avoided. PMID:22247813

Howe, Edmund

2011-12-01

53

Determinants of benzodiazepine use in a representative population of HIV-infected individuals: the role of HIV status disclosure (ANRS-EN12-VESPA study)  

Microsoft Academic Search

HIV infection may result in stressful situations such as disclosure to others and could be a mediator between seropositivity status and psychiatric illness, depression, or anxiety. Several results have shown that anxiolytic use (mainly benzodiazepines [BDZ]) is highly prevalent in HIV-infected individuals, but few studies have highlighted to what extent this use could be associated with HIV disclosure. A national

Perrine Roux; Lionel Fugon; Laurent Michel; France Lert; Yolande Obadia; Bruno Spire; Maria Patrizia Carrieri

2011-01-01

54

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

PubMed Central

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

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

2014-01-01

55

HIV disclosure and its effect on treatment outcomes in perinatal HIV-infected Thai children.  

PubMed

The World Health Organization guideline recommends informing children of their HIV status between the ages of 6-12 years. Primary caregivers of perinatal HIV-infected Thai children ?6 years were interviewed in order to assess the HIV status disclosure rate. In addition, pill counts of antiretroviral therapy (ART) were performed every three months. CD4 and HIV-RNA were performed every six months. Of the 260 children/adolescents included, the median age of disclosure was 14.8 years. The disclosure rate among those from 6 to 12 years was 21% and for those greater than 12 years of age was 84%. When comparing children aged 6-12 years whose HIV status had been disclosed to them, to children whose HIV had yet to be disclosed, no difference was noted in median ART adherence by pill count, CD4 count, or proportion of HIV-RNA <50 copies/ml (p > 0.05). Factors associated with HIV disclosure were an age of ?12 years (OR 17.8, 95% CI 8.86-35.79) and a current CD4 ? 30% (OR 2.09, 95% CI 1.20-3.62). In conclusion, although the majority of adolescents ?12 years were aware of their HIV status only one-fifth of children aged 6-12 years were aware. Moreover, the child's/adolescent's disclosure status had no bearing on ART adherence by pill count or immunological and virological outcomes. PMID:24625136

Sirikum, Chompoonoot; Sophonphan, Jiratchaya; Chuanjaroen, Thongsuai; Lakonphon, Sudrak; Srimuan, Amornrat; Chusut, Patcharaporn; Do, Tanya C; Prasitsuebsai, Wasana; Puthanakit, Thanyawee; Ananworanich, Jintanat; Bunupuradah, Torsak

2014-01-01

56

Rethinking HIV/AID disclosure among women within the context of motherhood in South Africa.  

PubMed

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

Iwelunmor, Juliet; Zungu, Nompumelelo; Airhihenbuwa, Collins O

2010-08-01

57

Effects of HIV infection, perceived health and clinical status on a cohort at risk for aids  

Microsoft Academic Search

Data from a general population sample of 621 healthy homosexual men are used to evaluate the social and emotional effects of HIV antibody status, clinical signs detected by medical examination, and subjectively perceived symptoms. Participants are unaware of their serologic status at the time of data collection, thus allowing the effects of the virus to be separated from reactions to

Ronald C. Kessler; Kerth OBrien; Jill G. Joseph; David G. Ostrow; John P. Phair; Joan S. Chmiel; Camille B. Wortman; Carol-Ann Emmons

1988-01-01

58

HIV Status and Gender: A Brief Report from Heterosexual Couples in Thailand  

PubMed Central

Although the impact of HIV falls on both partners of a married couple, the burden of stress may not be necessarily shared evenly. This study examined the relations among HIV status, gender and depressive symptoms among 152 married or cohabitating couples living with HIV in the Northern and Northeastern regions of Thailand. Depressive symptoms were assessed using a 15-item depressive symptom screening test that was developed and used previously in Thailand. Among the 152 couples, 59% were couples in which both members were people living with HIV (PLH) (seroconcordant; both PLH couples), 28% had only female members with HIV (serodiscordant; female PLH couples), and 13% had only male members with HIV (serodiscordant; male PLH couples). The prevalence of depressive symptoms between seroconcordant and serodiscordant groups was similar. However, female PLH reported significantly higher levels of depressive symptoms, regardless of their partners’ HIV status. Future prevention programs focusing on serodiscordant couples should be planned to target HIV risk, as well as emphasis on mental health, with a particular focus on women’s increased susceptibility to negative mental health outcomes. PMID:22747184

Li, Li; Liang, Li-Jung; Lee, Sung-Jae; Farmer, Shu C.

2012-01-01

59

Criminal Law and Public Health Practice: Are the Canadian HIV Disclosure Laws an Effective HIV Prevention Strategy?  

Microsoft Academic Search

Over the last few years, the number of people living with HIV who have been convicted for not disclosing their HIV status\\u000a to sexual partners in Canada has been steadily increasing. Whilst these laws are criminal in nature, and not public health-based,\\u000a it is important to examine their effect on public health HIV prevention efforts. To undertake such an analysis,

Patrick O’Byrne

60

The Relationship between Vitamin D Status and HIV-Related Complications in HIV-infected Children and Young Adults  

PubMed Central

Background In HIV-infected adults, we and others have shown that vitamin D deficiency is independently associated with increased carotid intima-media thickness (cIMT), a surrogate marker for cardiovascular disease (CVD). This study explored for the first time the relationship between vitamin D and CVD risk in HIV-infected youth. Methods This is a cross-sectional assessment of cIMT, inflammation, metabolic markers and vitamin D status in HIV-infected youth and healthy controls. We measured serum 25-hydroxyvitamin D (25(OH)D), fasting lipids, insulin, glucose, inflammatory markers, and cIMT. Results 30 HIV–infected subjects and 31 controls were included. Among HIV-infected subjects, median age was 11 years (37% males; 73% black; similar to controls). HIV-infected subjects’ mean (standard deviation) serum 25(OH)D was 24 (35) ng/mL; 70% had 25(OH)D <20 ng/mL (deficient), 23% between 20–30 ng/mL (insufficient), and 7% >30 ng/mL (sufficient); proportions were similar to controls (P=0.17). After adjusting for season, sex and race, there was no difference in serum 25(OH)D between groups (P=0.11). Serum 25(OH)D was not significantly correlated with cIMT, inflammatory markers, or lipids. Serum 25(OH)D was negatively correlated with body mass index, insulin resistance, HIV duration, and cumulative use of antiretroviral therapy, non- and nucleoside reverse transcriptase inhibitors. Conclusions Most HIV-infected youth have vitamin D deficiency or insufficiency. Despite no direct association between serum 25(OH)D and cIMT, there were notable associations with some CVD risk factors, particularly inverse correlation with insulin resistance. Studies are needed to determine whether CVD risk, including insulin resistance, could be improved with vitamin D supplementation. PMID:23360833

Eckard, Allison Ross; Tangpricha, Vin; Seydafkan, Shabnam; O’Riordan, Mary Ann; Storer, Norma; Labbato, Danielle; McComsey, Grace A.

2013-01-01

61

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

PubMed Central

Detection of recent HIV infections is a prerequisite for reliable estimations of transmitted HIV drug resistance (t-HIVDR) and incidence. However, accurately identifying recent HIV infection is challenging due partially to the limitations of current serological tests. Ambiguous nucleotides are newly emerged mutations in quasispecies, and accumulate by time of viral infection. We utilized ambiguous mutations to establish a measurement for detecting recent HIV infection and monitoring early HIVDR development. Ambiguous nucleotides were extracted from HIV-1 pol-gene sequences in the datasets of recent (HIVDR threshold surveys [HIVDR-TS] in 7 countries; n=416) and established infections (1 HIVDR monitoring survey at baseline; n=271). An ambiguous mutation index of 2.04×10-3 nts/site was detected in HIV-1 recent infections which is equivalent to the HIV-1 substitution rate (2×10-3 nts/site/year) reported before. However, significantly higher index (14.41×10-3 nts/site) was revealed with established infections. Using this substitution rate, 75.2% subjects in HIVDR-TS with the exception of the Vietnam dataset and 3.3% those in HIVDR-baseline were classified as recent infection within one year. We also calculated mutation scores at amino acid level at HIVDR sites based on ambiguous or fitted mutations. The overall mutation scores caused by ambiguous mutations increased (0.54×10-23.48×10-2/DR-site) whereas those caused by fitted mutations remained stable (7.50-7.89×10-2/DR-site) in both recent and established infections, indicating that t-HIVDR exists in drug-naïve populations regardless of infection status in which new HIVDR continues to emerge. Our findings suggest that characterization of ambiguous mutations in HIV may serve as an additional tool to differentiate recent from established infections and to monitor HIVDR emergence. PMID:24147046

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

2013-01-01

62

Prevalence of oral lesions in Mexican children with perinatally acquired HIV: association with immunologic status, viral load, and gender.  

PubMed

It has been proposed that HIV-related oral lesions (HIV-ROL) have a significant diagnostic and prognostic value for human immunodeficiency virus (HIV) infection in adult patients. However, in HIV-infected children, the relation between HIV-ROL and immune and virologic status is not well established. The principal objective of this paper is to assess the prevalence of HIV-related oral lesions (HIV-ROL) in Mexican HIV-infected children in relation to their immunologic status, viral load, and gender. Forty-eight HIV-infected children from Immunodeficiency Clinic, Child's Hospital of México, México City, were examined for oral pathology. The data obtained from medical records were: name, gender, age, route of infection, CD4 lymphocytes cells count/mL, HIV-1-RNA level of copies/mL (viral load), and type and time of treatment. The prevalence of HIV-ROL was 29.2%. Oral candidosis was the most prevalent oral lesion (20.8%) followed by periodontal and gingival disease (4.2%), herpes simplex (2.1%), and parotid enlargement (2.1%). There was no association between the prevalence of HIV-ROL and gender, immunological status, or viral load. The most frequent clinical form of oral candidosis was erythematous candidosis (12.5%, N = 6). Our results do not suggest a direct relationship between prevalence of HIV-ROL, severe immunodepression, and/or viral load > 100000 copies in this population. PMID:12015869

Gaitán-Cepeda, Luis; Cashat-Cruz, Miguel; Morales-Aguirre, Jose Juan; Sánchez-Vargas, Luis; Aquino-Garcia, Sandra; Fragoso-Ríos, Rodolfo; Cuairán-Ruidiaz, Vicente; Avila-Figueroa, Carlos; Morales, Juan; Figueroa, Carlos Avila

2002-04-01

63

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

PubMed Central

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

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

2012-01-01

64

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

PubMed Central

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

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

2012-01-01

65

Prevalence, perceptions, and correlates of pediatric HIV disclosure in an HIV treatment program in Kenya.  

PubMed

Disclosure to HIV-infected children regarding their diagnosis is important as expanding numbers of HIV-infected children attain adolescence and may become sexually active. In order to define correlates of pediatric disclosure and facilitate development of models for disclosure, we conducted a cross-sectional survey of primary caregivers of HIV-1 infected children aged 6-16 years attending a pediatric HIV treatment program in Nairobi, Kenya. We conducted focus group discussions with a subset of caregivers to further refine perceptions of disclosure. Among 271 caregiver/child dyads in the cross-sectional survey, median child age was 9 years (interquartile range: 7-12 years). Although 79% of caregivers believed children should know their HIV status, the prevalence of disclosure to the child was only 19%. Disclosure had been done primarily by health workers (52%) and caregivers (33%). Caregivers reported that 5 of the 52 (10%) who knew their status were accidentally disclosed to. Caregivers of older children (13 vs. 8 years; p<0.001), who were HIV-infected and had disclosed their own HIV status to the child (36% vs. 4%; p=0.003), or who traveled frequently (29% vs. 16%, p=0.03) were more likely to have disclosed. Children who had been recently hospitalized (25% vs. 44%, p=0.03) were less likely to know their status, and caregivers with HIV were less likely to have disclosed (p=0.03). Reasons for disclosure included medication adherence, curiosity or illness while reasons for nondisclosure included age and fear of inadvertent disclosure. Our study found that disclosure rates in this Kenyan setting are lower than observed rates in the USA and Europe but consistent with rates from other resource-limited settings. Given these low rates of disclosure and the potential benefits of disclosure, strategies promoting health worker trainings and caregiver support systems for disclosure may benefit children with HIV. PMID:23256520

John-Stewart, Grace C; Wariua, Grace; Beima-Sofie, Kristin M; Richardson, Barbra A; Farquhar, Carey; Maleche-Obimbo, Elizabeth; Mbori-Ngacha, Dorothy; Wamalwa, Dalton

2013-01-01

66

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

PubMed

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

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

2015-02-01

67

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

PubMed

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

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

2015-01-01

68

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

PubMed Central

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

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

2015-01-01

69

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

PubMed Central

Background HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women. Methods In this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV. Results Over 93% (1817) disclosed the HIV results to their partners (96.5% HIV? vs. 89.3% HIV+, p<0.0001). Overall HIV prevalence was 15.3%, (95%CI:13.7–16.9), 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

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

2014-01-01

70

Determinants of HIV serostatus disclosure to sexual partner among HIV-positive alcohol users in Haiti.  

PubMed

This study examined the relationship between antiretroviral therapy use, participants' knowledge of partner's HIV serostatus, number of sex partners, perceived infectivity and HIV disclosure to a main sexual partner among 258 HIV-positive Haitian alcohol users. Only 38.6 % had disclosed their HIV serostatus to sexual partners. Logistic regression analyses revealed that participants who self-reported having an HIV-negative partner (OR = 0.36, 95 % CI 0.13-0.97) or a partner of unknown HIV status (OR = 0.09, 95 % CI 0.04-0.22) were less likely to disclose their HIV serostatus than participants who self-reported having an HIV-positive partner. Participants who had more than one sexual partner in the past 3 months (OR = 0.41, 95 % CI 0.19-0.90) were also less likely to disclose than participants who had one partner. These findings suggest the need for couples-based programs to assist people living with HIV (PLWH) with the disclosure process, especially among PLWH who have more than one sexual partner and/or are in serodiscordant relationships. PMID:24385230

Conserve, Donaldson F; King, Gary; Dévieux, Jessy G; Jean-Gilles, Michèle; Malow, Robert

2014-06-01

71

Provider-initiated symptom screening for tuberculosis in Zimbabwe: diagnostic value and the effect of HIV status  

PubMed Central

Abstract Objective To assess the diagnostic value of provider-initiated symptom screening for tuberculosis (TB) and how HIV status affects it. Methods We performed a secondary analysis of randomly selected participants in a community-based TB–HIV prevalence survey in Harare, Zimbabwe. All completed a five-symptom questionnaire and underwent sputum TB culture and HIV testing. We calculated the sensitivity, specificity, and positive and negative predictive values of various symptoms and used regression analysis to investigate the relationship between symptoms and TB disease. Findings We found one or more symptoms of TB in 21.2% of 1858 HIV-positive (HIV+) and 9.9% of 7121 HIV-negative (HIV?) participants (P < 0.001). TB was subsequently diagnosed in 48 HIV+ and 31 HIV? participants. TB was asymptomatic in 18 culture-positive individuals, 8 of whom (4 in each HIV status group) had positive sputum smears. Cough of any duration, weight loss and, for HIV+ participants only, drenching night sweats were independent predictors of TB. In HIV+ participants, cough of ? 2 weeks’ duration, any symptom and a positive sputum culture had sensitivities of 48%, 81% and 65%, respectively; in HIV? participants, the sensitivities were 45%, 71% and 74%, respectively. Symptoms had a similar sensitivity and specificity in HIV+ and HIV? participants, but in HIV+ participants they had a higher positive and a lower negative predictive value. Conclusion Even smear-positive TB may be missed by provider-initiated symptom screening, especially in HIV+ individuals. Symptom screening is useful for ruling out TB, but better TB diagnostics are urgently needed for resource-poor settings. PMID:20428349

Zezai, Abbas; Cheung, Yin Bun; Bandason, Tsitsi; Dauya, Ethel; Munyati, Shungu S; Butterworth, Anthony E; Rusikaniko, Simba; Churchyard, Gavin J; Mungofa, Stanley; Hayes, Richard J; Mason, Peter R

2010-01-01

72

Tuberculosis transmission attributable to close contacts and HIV status, Malawi.  

PubMed

We conducted the first molecular study of tuberculosis (TB) to estimate the role of household contact and transmission from HIV-positive putative source contacts (PSCs) in a high HIV-prevalence area. TB patients in a long-term population-based study in Malawi were asked about past contact with TB. DNA fingerprinting was used to define clusters of cases with identical strains. Among 143 epidemiologically defined PSC-case pairs, fingerprinting confirmed transmission for 44% of household and family contacts and 18% of other contacts. Transmission was less likely to be confirmed if the PSC were HIV positive than if he or she was HIV negative (odds ratio 0.32, 95% confidence interval [CI] 0.14-0.74). Overall, epidemiologic links were found for 11% of 754 fingerprint-clustered cases. We estimate that 9%-13% of TB cases were attributable to recent transmission from identifiable close contacts and that nearly half of the TB cases arising from recent infection had acquired the infection from HIV-positive patients. PMID:16704828

Crampin, Amelia C; Glynn, Judith R; Traore, Hamidou; Yates, Malcolm D; Mwaungulu, Lorren; Mwenebabu, Michael; Chaguluka, Steven D; Floyd, Sian; Drobniewski, Francis; Fine, Paul E M

2006-05-01

73

Anti-retroviral therapy-induced status epilepticus in "pseudo-HIV serodeconversion".  

PubMed

Diligence in the interpretation of results is essential as information gained from the psychiatric patient's history might often be restricted. Nonobservance of established guidelines may lead to a wrong diagnosis, induce a false therapy and result in life-threatening situations. Communication errors between hospitals and doctors and uncritical acceptance of prior diagnoses add substantially to this problem. We present a patient with alcohol-related dementia who received anti-retroviral therapy that promoted a non-convulsive status epilepticus. HIV serodeconversion was considered after our laboratory result yielded a HIV-negative status. Critical review of previous diagnostic investigations revealed several errors in the diagnosis of HIV infection leading to a "pseudo-serodeconversion." Finally, anti-retroviral therapy could be discontinued. PMID:20851280

Etgen, Thorleif; Eberl, Bernhard; Freudenberger, Thomas

2010-01-01

74

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

PubMed Central

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

Abati, Paulo Afonso Martins; Segurado, Aluisio Cotrim

2015-01-01

75

Adult Trauma and HIV Status Among Latinas: Effects Upon Psychological Adjustment and Substance Use  

Microsoft Academic Search

Latinas have unique cultural factors that can contribute to their health, including recent immigration, documentation status, and language barriers. Additional stressors and experiencing traumatic events can further compromise their psychological adjustment and substance use. This study tests the differential contribution of adult trauma and other life stressors to psychological adjustment and substance use among Latinas who differ in their HIV

Michael D. Newcomb; Jennifer Vargas Carmona

2004-01-01

76

Buddhism, The Status of Women and The Spread of HIV\\/AIDS in Thailand  

Microsoft Academic Search

The common-sense construction of Buddhism is that of a general power for good; the less positive aspects of Buddhism's power, especially when reinforced by folklore and ancient superstition, is infrequently recognised. In this article we make explicit Buddhism's less positive power, particularly as it relates to the status of women and, by implication, its role in the human immunodeficiency (HIV)\\/acquired

AREEWAN KLUNKLIN; JENNIFER GREENWOOD

2005-01-01

77

Maternal substance use and HIV status: adolescent risk and resilience.  

PubMed

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 background characteristics, mental health issues and current substance use risk behaviors. In addition to maternal substance abuse, youth in both groups experienced similar risk factors including early foster care placement and high levels of maltreatment. Current patterns of emerging risk behaviors were evident among youth in both groups as well as signs of resiliency including high levels of school attendance. These results underscore the importance of interventions for youth of substance abusing mothers, particularly those living in urban poverty. PMID:17707902

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

2008-06-01

78

Division of HIV/AIDS PreventionThe Status of HIV Prevention  

E-print Network

In the United States, prevention has already averted more than 350,000 * HIV infections. 1 Now, we have the potential to go much further. The nation’s HIV prevention efforts are guided by a single, ambitious strategy for combating the epidemic: the National HIV/AIDS Strategy (NHAS). 2 Recent scientific breakthroughs have equipped us with an unprecedented number of effective tools to prevent infection. 3-6 And in many of the communities hardest hit by HIV, there is growing leadership and momentum for change. Yet the challenges remain daunting. By CDC’s latest estimates, approximately 50,000 Americans become infected with HIV annually, and 16,000 people with AIDS died in 2008. 7,8 As a result, the number of people living with HIV in the United States, now at nearly 1.2 million, continues to grow by tens of thousands each year, creating more opportunities for HIV transmission. 9 And a range of social, economic, and demographic factors affect some Americans ’ risk for HIV, such as stigma, discrimination, income, education, and geographic region. While current prevention efforts have helped to keep the number of new infections stable in recent years, continued growth in the population living with HIV will ultimately lead to more new infections if prevention, care, and treatment efforts are not intensified. 10 To address these challenges, CDC and its partners are pursuing a High-Impact Prevention approach to reducing new HIV infections. 11 By using combinations of scientifically proven, cost-effective, and scalable interventions targeted to the right populations in the right geographic areas, this approach promises to increase the impact of HIV prevention efforts – an essential step in achieving the goals of NHAS. This approach is designed to maximize the impact of prevention efforts for all Americans at risk for HIV infection, including gay and bisexual men, communities of color, women, injection drug users, transgender women and men and youth. *A conservative estimate examining the period 1991 to 2006.

In The United States

79

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

PubMed

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

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

2014-01-01

80

Disclosure of their HIV status to infected children: a review of the literature.  

PubMed

Since the introduction of highly active antiretroviral therapy (ART) in 1996, HIV-infected children often survive beyond adolescence. To assess worldwide trends in disclosure since ART was introduced, we reviewed articles that refer to disclosure of their status to HIV-infected children, and which described patient, health care provider and/or caregiver opinions about disclosure and/or reported the proportion of children who knew their diagnosis. Most studies (17 [55%]) were performed in low- or middle-income (LMI) countries. In the 21 articles that included information on whether the children knew their status, the proportion who knew ranged from 1.2 to 75.0% and was lower in LMI (median = 20.4%) than industrialized countries (43%; p = 0.04). LMI country study participants who knew their status tended to have learned it at older ages (median = 9.6 years) than industrialized country participants (median = 8.3 years; p = 0.09). The most commonly reported anticipated risks (i.e. emotional trauma to child and child divulging status to others) and benefits (i.e. improved ART adherence) of disclosure did not vary by the country's economic development. Only one article described and evaluated a disclosure process. Despite recommendations, most HIV-infected children worldwide do not know their status. Disclosure strategies addressing caregiver concerns are urgently needed. PMID:23070738

Pinzón-Iregui, María C; Beck-Sagué, Consuelo M; Malow, Robert M

2013-04-01

81

Disclosure of Their HIV Status to Infected Children: A Review of the Literature  

PubMed Central

Since the introduction of highly active antiretroviral therapy (ART) in 1996, HIV-infected children often survive beyond adolescence. To assess worldwide trends in disclosure since ART was introduced, we reviewed articles that refer to disclosure of their status to HIV-infected children, and which described patient, health care provider and/or caregiver opinions about disclosure and/or reported the proportion of children who knew their diagnosis. Most studies (17 [55%]) were performed in low- or middle-income (LMI) countries. In the 21 articles that included information on whether the children knew their status, the proportion who knew ranged from 1.2 to 75.0% and was lower in LMI (median = 20.4%) than industrialized countries (43%; p = 0.04). LMI country study participants who knew their status tended to have learned it at older ages (median = 9.6 years) than industrialized country participants (median = 8.3 years; p = 0.09). The most commonly reported anticipated risks (i.e. emotional trauma to child and child divulging status to others) and benefits (i.e. improved ART adherence) of disclosure did not vary by the country’s economic development. Only one article described and evaluated a disclosure process. Despite recommendations, most HIV-infected children worldwide do not know their status. Disclosure strategies addressing caregiver concerns are urgently needed. PMID:23070738

Pinzón-Iregui, María C.; Malow, Robert M.

2013-01-01

82

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

PubMed

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.OBJETIVO Analisar as características clínicas e laboratoriais de indivíduos infectados pelo HIV na admissão em serviço de referência em saúde. MÉTODOS Estudo transversal realizado entre 1999 e 2010, com 527 indivíduos com diagnóstico sorológico confirmado de infecção pelo HIV, matriculados em serviço de saúde ambulatorial, em Santarém, PA, Brasil. Foram coletadas informações de prontuários referentes à população estudada sobre o motivo de realização da testagem anti-HIV, estadio clínico e número de linfócitos T CD4+ periféricos, no ato da matrícula. Os dados foram distribuídos em três grupos, segundo ano de admissão do paciente: 1999 a 2002 (P1), 2003 a 2006 (P2) e 2007 a 2010 (P3), para a análise comparativa das variáveis de interesse. RESULTADOS Do total estudado, 62,0% dos pacientes foram admitidos no grupo P3. O motivo de realização da testagem anti-HIV diferiu entre os sexos. Houve preponderância da realização do teste por presença de sintomas sugestivos da infecção na população masculina e pelo conhecimento da soropositividade do parceiro entre as mulheres nos grupos P1 e P2. A maior proporção de mulheres testadas por apresentarem sintomas de infecção pelo HIV/aids fez desaparecer essa diferença entre os gêneros no período mais recente. Observou-se maior participação de matriculados em fase mais avançada da doença no grupo P3. CONCLUSÕES Apesar do maior reconhecimento de casos de HIV/aids, os pacientes seguem descobrindo seu status sorológico tardiamente e apresentando-se à admissão no serviço de saúde com doença em atividade. A epidemia de HIV/aids no Pará apresenta especificidades em evolução que compõem o complexo mosaico da epidemia na região Norte e no Brasil. PMID:25741647

Abati, Paulo Afonso Martins; Segurado, Aluisio Cotrim

2015-01-01

83

Impact of prison status on HIV-related risk behaviors.  

PubMed

Baseline data were collected to evaluate the effectiveness of interventions on completion of the hepatitis A and B vaccine series among 664 sheltered and street-based homeless adults who were: (a) homeless; (b) recently (<1 year) discharged from prison; (c) discharged 1 year or more; and (d) never incarcerated. Group differences at baseline were assessed for socio-demographic characteristics, drug and alcohol use, sexual activity, mental health and public assistance. More than one-third of homeless persons (38%) reported prison time and 16% of the sample had been recently discharged from prison. Almost half of persons who were discharged from prison at least 1 year ago reported daily use of drugs and alcohol over the past 6 months compared to about 1 in 5 among those who were recently released from prison. As risk for HCV and HIV co-infection continues among homeless ex-offenders, HIV/HCV prevention efforts are needed for this population. PMID:19455412

Hudson, Angela L; Nyamathi, Adeline; Bhattacharya, Debika; Marlow, Elizabeth; Shoptaw, Steven; Marfisee, Mary; Leake, Barbara

2011-02-01

84

Impact of Prison Status on HIV-Related Risk Behaviors  

PubMed Central

Baseline data were collected to evaluate the effectiveness of interventions on completion of the hepatitis A and B vaccine series among 664 sheltered and street-based homeless adults who were: (a) homeless; (b) recently (<1 year) discharged from prison; (c) discharged 1 year or more; and (d) never incarcerated. Group differences at baseline were assessed for socio–demographic characteristics, drug and alcohol use, sexual activity, mental health and public assistance. More than one-third of homeless persons (38%) reported prison time and 16% of the sample had been recently discharged from prison. Almost half of persons who were discharged from prison at least 1 year ago reported daily use of drugs and alcohol over the past 6 months compared to about 1 in 5 among those who were recently released from prison. As risk for HCV and HIV co-infection continues among homeless ex-offenders, HIV/HCV prevention efforts are needed for this population. PMID:19455412

Hudson, Angela L.; Bhattacharya, Debika; Marlow, Elizabeth; Shoptaw, Steven; Marfisee, Mary; Leake, Barbara

2009-01-01

85

Current status of HIV-1 diversity and drug resistance monitoring in the former USSR.  

PubMed

This review summarizes the available data on the molecular epidemiology of HIV and the transmission of HIV drug resistance in the former USSR (FSU) in recent decades. The data presented here were obtained from publications or personal communication with colleagues in these countries as well as from studies the author was involved in. The molecular epidemiology data demonstrate the preservation of a relatively low diversity of HIV-1 in FSU countries, where infections are predominantly caused by subtype A, IDU-A variant. Subtype B was the second most common variant, followed by CRF03_AB and CRF02_AG, with CRF02_AG spreading rapidly in Central Asian countries and the Asian part of Russia. Mosaic variants formed from CRF02_AG and IDU-A were found elsewhere, as were subtypes C, G, and CRF01_AE. The status of HIV drug resistance monitoring in FSU countries is cause for serious concern because, so far, no regular action has been undertaken. HIV genotyping has been available in Russia for several years and is becoming accessible to patients in Belarus, Ukraine, Kazakhstan, and Uzbekistan. Nevertheless, this subject has not been systematically studied, and no data have been presented to the scientific community. Several recent studies suggest a low level of HIV drug resistance transmission in the FSU (3-7%); however, problems with irregular drug supply and possible low adherence may lead to the rapid growth of these figures. These findings support the urgent need to develop a shared HIV drug resistance monitoring system for FSU countries to better control the HIV epidemic in the region. PMID:24192601

Bobkova, Marina

2013-01-01

86

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

ERIC Educational Resources Information Center

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…

Lewis, Ione R.

2012-01-01

87

Disclosing a dyslexic identity.  

PubMed

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

Evans, William

2015-04-01

88

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

PubMed Central

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

Demberg, Thorsten; Robert-Guroff, Marjorie

2012-01-01

89

Current status of substance abuse and HIV infection in Japan  

PubMed Central

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

Wada, Kiyoshi; Funada, Masahiko; Shimane, Takuya

2014-01-01

90

Maternal HIV disclosure to HIV-uninfected children in rural South Africa: a pilot study of a family-based intervention  

PubMed Central

Background As access to treatment increases, large numbers of HIV-positive parents are raising HIV-negative children. Maternal HIV disclosure has been shown to have benefits for mothers and children, however, disclosure rates remain low with between 30-45% of mothers reporting HIV disclosure to their children in both observational and intervention studies. Disclosure of HIV status by parent to an HIV-uninfected child is a complex and challenging psychological and social process. No intervention studies have been designed and tested in Southern Africa to support HIV-positive parents to disclose their status, despite this region being one of the most heavily affected by the HIV epidemic. Method This paper describes the development of a family-centred, structured intervention to support mothers to disclose their HIV status to their HIV-negative school-aged children in rural South Africa, an area with high HIV prevalence. The intervention package includes printed materials, therapeutic tools and child-friendly activities and games to support age-appropriate maternal HIV disclosure, and has three main aims: (1) to benefit family relationships by increasing maternal HIV disclosure; (2) to increase children’s knowledge about HIV and health; (3) to improve the quality of custody planning for children with HIV-positive mothers. We provide the theoretical framework for the intervention design and report the results of a small pilot study undertaken to test its acceptability in the local context. Results The intervention was piloted with 24 Zulu families, all mothers were HIV-positive and had an HIV-negative child aged 6–9 years. Lay counsellors delivered the six session intervention over a six to eight week period. Qualitative data were collected on the acceptability, feasibility and the effectiveness of the intervention in increasing disclosure, health promotion and custody planning. All mothers disclosed something to their children: 11/24 disclosed fully using the words "HIV" while 13/24 disclosed partially using the word "virus". Conclusion The pilot study found the intervention was feasible and acceptable to mothers and counsellors, and provides preliminary evidence that participation in the intervention encouraged disclosure and health promotion. The pilot methodology and small sample size has limitations and further research is required to test the potential of this intervention. A larger demonstration project with 300 families is currently underway. PMID:23418933

2013-01-01

91

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

PubMed

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

Desclaux, Alice; Alfieri, Chiara

2013-07-01

92

Does HIV status influence the outcome of patients admitted to a surgical intensive care unit? A prospective double blind study.  

PubMed Central

OBJECTIVES: (a) To assess the impact of HIV status (HIV negative, HIV positive, AIDS) on the outcome of patients admitted to intensive care units for diseases unrelated to HIV; (b) to decide whether a positive test result for HIV should be a criterion for excluding patients from intensive care for diseases unrelated to HIV. DESIGN: A prospective double blind study of all admissions over six months. HIV status was determined in all patients by enzyme linked immunosorbent assay (ELISA), immunofluorescence assay, western blotting, and flow cytometry. The ethics committee considered the clinical implications of the study important enough to waive patients' right to informed consent. Staff and patients were blinded to HIV results. On discharge patients could be advised of their HIV status if they wished. SETTING: A 16 bed surgical intensive care unit. SUBJECTS: All 267 men and 135 women admitted to the unit during the study period. INTERVENTIONS: None. MAIN OUTCOME MEASURES: APACHE II score (acute physiological, age, and chronic health evaluation), organ failure, septic shock, durations of intensive care unit and hospital stay, and intensive care unit and hospital mortality. RESULTS: No patient had AIDS. 52 patients were tested positive for HIV and 350 patients were tested negative. The two groups were similar in sex distribution but differed significantly in age, incidence of organ failure (37 (71%) v 171 (49%) patients), and incidence of septic shock (20 (38%) v 54 (15%)). After adjustment for age there were no differences in intensive care unit or hospital mortality or in the durations of stay in the intensive care unit or hospital. CONCLUSIONS: Morbidity was higher in HIV positive patients but there was no difference in mortality. In this patient population a positive HIV test result should not be a criterion for excluding a patient from intensive care. PMID:9133887

Bhagwanjee, S.; Muckart, D. J.; Jeena, P. M.; Moodley, P.

1997-01-01

93

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

PubMed

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

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

2014-11-01

94

Optimism, distress, and immunologic status in HIV-infected gay men following hurricane andrew  

Microsoft Academic Search

This study investigated how dispositional optimism relates to psychological and immunologic status in 40 HIV-infected gay\\u000a men residing in areas of South Florida hard hit by Hurricane Andrew. In the months following the storm, participants’ levels\\u000a of psychological distress (hurricane-related and overall distress) and antibody titers to several herpesviruses (Herpes Simplex\\u000a Virus-2, Epstein-Barr Virus [EBV], Cytomegalovirus, and Human Herpes Virus-6

Stacy Cruess; Michael Antoni; Kristin Kilbourn; Gail Ironson; Nancy Klimas; Mary Ann Fletcher; Andy Baum; Neil Schneiderman

2000-01-01

95

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

PubMed Central

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

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

2009-01-01

96

Sociocultural Factors Influencing HIV Disclosure Among Men in South Africa.  

PubMed

In South Africa, more than 2 million people living with HIV are men aged 15 years and older, and heterosexual intercourse remains the predominant mode of HIV transmission. Knowledge of the sociocultural factors that influence men's decisions about whether, when, or how to disclose seropositive status remains incompletely understood. Using the PEN-3 cultural model as a guide, this study explored the sociocultural factors influencing HIV disclosure among men in South Africa. Four focus group discussions with 27 participants were used to determine the perceptions, enabling and nurturing factors that influence how men chose to reveal or conceal knowledge of their seropositive status. The results revealed that notions of male identity in the South African context, family, and community factors contribute to disclosure and nondisclosure of seropositive status among men living with HIV/AIDS. Future interventions should work to address these factors, as they are necessary with supporting disclosure among men living with HIV. PMID:24871161

Iwelunmor, Juliet; Sofolahan-Oladeinde, Yewande; Airhihenbuwa, Collins O

2015-05-01

97

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

PubMed

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

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

2013-01-01

98

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

PubMed Central

Background We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007. Methods KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 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

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

2012-01-01

99

Vengeance, HIV disclosure, and perceived HIV transmission to others.  

PubMed

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

Moskowitz, David A; Roloff, Michael E

2008-09-01

100

To Disclose or Not To Disclose: That Is the Question.  

ERIC Educational Resources Information Center

This paper focuses on the issue of whether the individual with a disability should disclose this information to a current or potential employer. It notes that, under the Americans with Disabilities Act (ADA), it is the individual's responsibility to disclose his/her disability and initiate a request for accommodation. The employer cannot inquire…

Hughes, Cathy; Graham, Jill Williams

1994-01-01

101

Depression and its Relationship to Work Status and Income Among HIV Clients in Uganda  

PubMed Central

Purpose Despite high levels of depression among persons living with HIV (PLWHIV), little research has investigated the relationship of depression to work status and income in PLWHIV in sub-Saharan Africa, which was the focus of this analysis. Methods Baseline data from a prospective longitudinal cohort of 798 HIV patients starting antiretroviral therapy in Kampala, Uganda were examined. In separate multivariate analyses, we examined whether depressive severity and symptom type [as measured by the Patient Health Questionnaire (PHQ-9)] and major depression [diagnosed with the Mini International Neuropsychiatric Interview (MINI)] were associated with work status and income, controlling for demographics, physical health functioning, work self-efficacy, social support and internalized HIV stigma. Results 14% of the sample had Major Depression and 66% were currently working. Each measure of depression (PHQ-9 total score, somatic and cognitive subscales; Major Depression diagnosis) was associated with not working and lower average weekly income in bivariate analysis. However, none of the depression measures remained associated with work and income in multivariate analyses that controlled for other variables associated with these economic outcomes. Conclusions These findings suggest that while depression is related to work and income, its influence may only be indirect through its relationship to other factors such as work self-efficacy and physical health functioning. PMID:24653946

Wagner, Glenn J.; Ghosh-Dastidar, Bonnie; Dickens, Akena; Nakasujja, Noeline; Okello, Elialilia; Luyirika, Emmanuel; Musisi, Seggane

2014-01-01

102

“Telling my husband I have HIV is too heavy to come out of my mouth”: pregnant women's disclosure experiences and support needs following antenatal HIV testing in eastern Uganda  

PubMed Central

Introduction Disclosure of HIV serostatus by women to their sexual partners is critical for the success of the prevention of mother-to-child transmission of HIV (PMTCT) programme as an integrated service in antenatal care. We explored pregnant HIV-positive and HIV-negative women's partner disclosure experiences and support needs in eastern Uganda. Methods This was a qualitative study conducted at Mbale Regional Referral Hospital in eastern Uganda between January and May 2010. Data collection was through in-depth interviews with 15 HIV-positive and 15 HIV-negative pregnant women attending a follow up antenatal clinic (ANC) at Mbale Hospital, and six key informant interviews with health workers at the clinic. Data management was done using NVivo version 9, and a content thematic approach was used for analysis. Results All HIV-negative women had disclosed their HIV status to their sexual partners but expressed need for support to convince their partners to also undergo HIV testing. Women reported that their partners often assumed that they were equally HIV-negative and generally perceived HIV testing in the ANC as a preserve for women. Most of the HIV-positive women had not disclosed their HIV status to sexual partners for fear of abandonment, violence and accusation of bringing HIV infection into the family. Most HIV-positive women deferred disclosure and requested health workers’ support in disclosure. Those who disclosed their positive status generally experienced positive responses from their partners. Conclusions Within the context of routine HIV testing as part of the PMTCT programme, most women who test HIV-positive find disclosure of their status to partners extremely difficult. Their fear of disclosure was influenced by the intersection of gender norms, economic dependency, women's roles as mothers and young age. Pregnant HIV-negative women and their unborn babies remained at risk of HIV infection owing to the resistance of their partners to go for HIV testing. These findings depict a glaring need to strengthen support for both HIV-positive and HIV-negative women to maximize opportunities for HIV prevention. PMID:22905360

Rujumba, Joseph; Neema, Stella; Byamugisha, Robert; Tylleskär, Thorkild; Tumwine, James K; Heggenhougen, Harald K

2012-01-01

103

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

PubMed

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

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

2014-10-01

104

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

ERIC Educational Resources Information Center

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

Kukka, Christine

2004-01-01

105

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

PubMed Central

Introduction HIV stigma is a contributing factor to poor patient outcomes. Although HIV stigma has been documented, its impact on patient well-being in the southern US is not well understood. Methods Thirty-two adults participated in cognitive interviews after completing the Berger HIV or the Van Rie stigma scale. Participant responses were probed to ensure the scales accurately measured stigma and to assess the impact stigma had on behavior. Results Three main themes emerged regarding HIV stigma: (1) negative attitudes, fear of contagion, and misperceptions about transmission; (2) acts of discrimination by families, friends, health care providers, and within the workplace; and (3) participants’ use of self-isolation as a coping mechanism. Overwhelming reluctance to disclose a 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

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

2013-01-01

106

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

PubMed Central

Background Expanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals. Design Using multiple rounds of biomarker data from Demographic and Health Surveys (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

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

2014-01-01

107

Family, cultural and gender role aspects in the context of HIV risk among African American women of unidentified HIV status: An exploratory qualitative study  

Microsoft Academic Search

This was an exploratory, qualitative study of contextual cultural and social realities of the sexual interactions of a representative sample of African American women of unidentified HIV status. The study expanded our understanding of family and gender role variables by exploring influences of family of origin and idealistic perceptions of roles on sexual relationships. Data was collected on 51 African

S. L. Jarama; F. Z. Belgrave; J. Bradford; M. Young; J. A. Honnold

2007-01-01

108

HIV-related stigma, service utilization, and status disclosure among truck drivers crossing the Southern borders in Brazil  

Microsoft Academic Search

HIV-related stigma and discrimination (S&D) have been shown to impede prevention, care and treatment. Yet, few quantitative studies have tested the associations between stigma, service utilization and status disclosure, especially in countries with concentrated HIV epidemics. Surveys, administered to a random sample of 1,775 truck drivers crossing Southern borders in Brazil, included items on multiple conceptual domains of S&D, such

J. Pulerwitz; A. P. Michaelis; S. A. Lippman; M. Chinaglia; J. Díaz

2008-01-01

109

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

PubMed

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 and SDUAI partners, as was using an inconsistent strategy. Ascertaining HIV status before having sex was associated with fewer SDUAI partners. Prevention should target MSM who guess the HIV status of their sex partners and emphasize explicit safer sex agreements. PMID:19921419

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

2010-12-01

110

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

PubMed

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

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

2015-04-01

111

Influence of HIV Status and Age on Cognitive Representations of Others  

PubMed Central

In 2 studies the postulate that the perception of time left in life influences the ways that people conceptualize social relationships was explored. It was hypothesized that when time is limited, emotional aspects of relationships are highly salient. In Study 1, a card-sort paradigm involving similarity judgments demonstrated, for a sample of persons 18 to 88 years old, that the prominence of affect in the mental representations of prospective social partners is positively associated with age. In Study 2, the same experimental approach was applied to a sample of young gay men similar to one another in age, but notably different in their health status (that is, HIV negative; HIV positive, asymptomatic; and HIV positive, symptomatic). It was found that, with age held constant, increasing closeness to the end of life is also associated with an increasing prominence of affect in the mental representations of social partners. The results suggest that the perception of limited time, rather than chronological age, is the critical variable influencing mental representations of social partners. PMID:9848799

Carstensen, Laura L.; Fredrickson, Barbara L.

2011-01-01

112

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

PubMed Central

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

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

2015-01-01

113

Disclosure of HIV-positive status to Latino gay men's social networks.  

PubMed

This study explored disclosure of serostatus in a sample of 155 HIV-positive Latino gay men from New York City and Washington, DC. We examined rates of disclosure to different members of the social network: mothers, fathers, close friends, and primary sexual partners. There were high rates of disclosure of HIV-positive serostatus to main partners and closest friends and lower rates to fathers and mothers. We examined the role of 3 contextual target-dependent factors (emotional closeness to target, anticipated reactions from target, and target's knowledge of sexual orientation), as well as acculturation and time since diagnosis. Three separate logistic regression models were performed to predict disclosure of HIV-positive status to 3 targets: mothers, fathers, and closest friends. We found that disclosure was not a generalized tendency, but rather different factors were influential depending on the target. Whether the target was aware of participant's sexual orientation was associated with disclosure in all 3 models. Greater emotional closeness also predicted disclosure to mother and father; greater U.S. acculturation was associated with disclosure to father and marginally to mother. A longer time since diagnosis was associated with disclosure to the closest friend. These findings highlight the importance of taking into account roles and relationships, and their effect on disclosure. PMID:15055758

Zea, María Cecilia; Reisen, Carol A; Poppen, Paul J; Echeverry, John J; Bianchi, Fernanda T

2004-03-01

114

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

PubMed Central

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

Reis, Janet S.; Weber, Kathleen M.

2013-01-01

115

Serological Response to Treatment of Syphilis According to Disease Stage and HIV Status  

PubMed Central

Background.?Serology is the mainstay for syphilis diagnosis and treatment monitoring. We investigated serological response to treatment of syphilis according to disease stage and HIV status. Methods.?A retrospective cohort study of 264 patients with syphilis was conducted, including 90 primary, 133 secondary, 33 latent, and 8 tertiary syphilis cases. Response to treatment as measured by the Venereal Disease Research Laboratory (VDRL) test and a specific IgM (immunoglobulin M) capture enzyme-linked immunosorbent assay (ELISA; Pathozyme-IgM) was assessed by Cox regression analysis. Results.?Forty-two percent of primary syphilis patients had a negative VDRL test at their diagnosis. Three months after treatment, 85%–100% of primary syphilis patients had reached the VDRL endpoint, compared with 76%–89% of patients with secondary syphilis and 44%–79% with latent syphilis. In the overall multivariate Cox regression analysis, serological response to treatment was not influenced by human immunodeficiency virus (HIV) infection and reinfection. However, within primary syphilis, HIV patients with a CD4 count of <500 cells/?L had a slower treatment response (P = .012). Compared with primary syphilis, secondary and latent syphilis showed a slower serological response of VDRL (P = .092 and P < .001) and Pathozyme-IgM tests (P < .001 and P = .012). Conclusions.?The VDRL should not be recommended as a screening test owing to lack of sensitivity. The syphilis disease stage significantly influences treatment response whereas HIV coinfection only within primary syphilis has an impact. VDRL test titers should decline at least 4-fold within 3–6 months after therapy for primary or secondary syphilis, and within 12–24 months for latent syphilis. IgM ELISA might be a supplement for diagnosis and treatment monitoring. PMID:22955437

Knaute, Damaris Fröhlich; Graf, Nicole; Lautenschlager, Stephan; Weber, Rainer; Bosshard, Philipp P.

2012-01-01

116

Under-two child mortality according to maternal HIV status in Rwanda: assessing outcomes within the National PMTCT Program  

PubMed Central

Introduction We sought to compare risk of death among children aged under-2 years born to HIV positive mother (HIV-exposed) and to HIV negative mother (HIV non-exposed), and identify determinants of under-2 mortality among the two groups in Rwanda. Methods In a stratified, two-stage cluster sampling design, we selected mother-child pairs using national Antenatal Care (ANC) registers. Household interview with each mother was conducted to capture socio-demographic data and information related to pregnancy, delivery and post-partum. Data were censored at the date of child death. Using Cox proportional hazard model, we compared the hazard of death among HIV-exposed children and HIV non-exposed children. Results Of 1,455 HIV-exposed children, 29 (2.0%; 95% CI: 1.3%-2.7%) died by 6 months compared to 18 children of the 1,565 HIV non-exposed children (1.2%; 95% CI: 0.6%-1.7%). By 9 months, cumulative risks of death were 3.0% (95%; CI: 2.2%-3.9%) and 1.3% (96%; CI: 0.7%-1.8%) among HIV-exposed and HIV non-exposed children, respectively. By 2 years, the hazard of death among HIV-exposed children was more than 3 times higher (aHR:3.5; 95% CI: 1.8-6.9) among HIV-exposed versus non-exposed children. Risk of death by 9-24 months of age was 50% lower among mothers who attended 4 or more antenatal care (ANC) visits (aHR: 0.5, 95% CI: 0.3-0.9), and 26% lower among families who had more assets (aHR: 0.7, 95% CI: 0.5-1.0). Conclusion Infant mortality was independent of perinatal HIV exposure among children by 6 months of age. However, HIV-exposed children were 3.5 times more likely to die by 2 years. Fewer antenatal visits, lower household assets and maternal HIV seropositive status were associated with increased mortality by 9-24 months. PMID:22145068

Mugwaneza, Placidie; Umutoni, Nadine Wa Shema; Ruton, Hinda; Rukundo, Alphonse; Lyambabaje, Alexandre; Bizimana, Jean de Dieu; Tsague, Landry; Wagner, Claire M; Nyankesha, Elévanie; Muita, Jane; Mutabazi, Vincent; Nyemazi, Jean Pierre; Nsanzimana, Sabin; Karema, Corine; Binagwaho, Agnes

2011-01-01

117

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

PubMed

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

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

2014-09-01

118

HIV+ women’s narratives of non-disclosure: resisting the label of immorality  

PubMed Central

Increasing partner disclosure rates among HIV positive individuals is widely seen as an important public health strategy to reduce HIV transmission. One approach for encouraging disclosure is to emphasize individuals’ moral responsibility to disclose their status to their partners. We use South Africa as a case study to draw attention to two problems with labeling non-disclosure as immoral. First, we argue that because women are tested for HIV at much higher rates than men, any approach that involves blaming HIV positive individuals for not disclosing their status will disproportionately burden women. Second, through the narratives of six HIV positive women, we highlight how a focus on morality undervalues the complexity of sexual partnerships. Specifically, women describe how their perceived obligation to disclose is directly influenced by communication with their sexual partners. Women also discuss how the onset of different life events might alter the meaning of HIV and change obligations regarding disclosure within the partnership. The differences in testing rates across gender combined with the complexity of sexual partnerships leads us to suggest that labeling non-disclosure as immoral does little to advance HIV prevention. There is an urgent need to identify alternative interventions that support women through the disclosure process. PMID:22594880

Groves, Allison K; Maman, Suzanne; Moodley, Dhayendre

2014-01-01

119

Women's choices regarding HIV testing, disclosure and partner involvement in infant feeding and care in a rural district of Malawi with high HIV prevalence.  

PubMed

The influence of HIV-related stigma on women's choices with regard to HIV testing, disclosure and partner involvement in infant feeding and care is not well understood in rural Malawi but may influence the risk of vertical HIV transmission and infant health. In a study of HIV-infected and -uninfected women in 20 rural locations in Zomba District, Malawi, mothers were questioned at 18-20 months post-partum about these issues. Ten per cent of women claimed unknown HIV status in labour so HIV testing should be routinely offered in Labour & Delivery wards. HIV-infected women were somewhat less likely to disclose to their partners than HIV-uninfected women (89 and 97%, respectively; p = 0.007) or to be cohabiting with partners during pregnancy (74 and 86%, respectively; p = 0.03). Partners of women were less inclined to disclose their HIV testing or HIV status (49 and 66% of partners of HIV-infected and -uninfected women, respectively). Greater partner testing and disclosure may improve prevention of mother to child transmission of HIV (PMTCT) in this population. A majority of women were inclined to make feeding decisions on their own, whereas most felt that other health-related decisions should also involve the father. Most mothers believe that exclusive breast feeding (EBF) is the best infant feeding method (for the first six months) but it was actually practiced by a minority of women (20% of HIV-infected and 5% of HIV-uninfected mothers; p = 0.01). EBF needs systematic support in order to be practised. PMID:24090356

Bedell, Richard A; van Lettow, Monique; Landes, Megan

2014-04-01

120

Xpert MTB/RIF as a Measure of Sputum Bacillary Burden. Variation by HIV Status and Immunosuppression  

PubMed Central

Rationale: Xpert MTB/RIF cycle threshold values are a measure of sputum mycobacterial burden. Data on the impact of HIV infection and immunosuppression on this measure are limited. Objectives: Examine the impact of HIV status and level of immunosuppression on the distribution of mean cycle threshold values, and the correlation of cycle threshold values and smear microscopy grade with time to culture positivity. Methods: Paired sputum samples from 2,406 individuals with suspected pulmonary tuberculosis in South Africa were tested by Xpert MTB/RIF, concentrated smear microscopy, and liquid culture to quantify bacterial burden using cycle threshold values, smear grading, and time to culture positivity. Measurements and Main Results: Cycle threshold values were lower in HIV-uninfected versus HIV-infected individuals (22.9 vs. 26.6; P < 0.001). Among HIV-infected, CD4 count was an independent predictor of cycle threshold value, with an average increase of 1.50 cycles for CD4 count greater than or equal to 200 (P 0.071) and 3.66 cycles for CD4 count less than 200 (P < 0.001) compared with HIV-uninfected individuals. Correlation between cycle threshold value and time to culture positivity was similar to that between smear status and time to culture positivity (both Spearman ? 0.58). The strength of correlation between measures decreased as the level of immunosuppression increased. A cycle threshold value cutoff of 28 had good predictive value for smear positivity. Conclusions: We observed decreasing bacillary burden with increasing level of immunosuppression as measured by Xpert MTB/RIF cycle threshold values. A cycle threshold value of 28 can be used as a measure of bacterial burden and smear status in a high HIV burden setting. PMID:24786895

Theron, Grant; Bassett, Jean; Dheda, Keertan; Scott, Lesley; Stevens, Wendy; Sanne, Ian; Van Rie, Annelies

2014-01-01

121

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

Microsoft Academic Search

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

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

2009-01-01

122

Oral health status and its impact on the quality of life of children and adolescents living with HIV-1  

PubMed Central

Background Oral health problems can generate considerable negative effects on the quality of life of individuals living with HIV. The aim of this study was investigate the oral health status and its impact on the quality of life of 1 to 18 years-old living with HIV-1 under follow-up at referral centers in Southern Brazil. Methods A cross-sectional study involving individuals under follow-up (n?=?36) was carried out. The individuals living with HIV-1 and their guardians underwent individual interviews using validated questionnaires for assessing oral health-related quality of life according to age group. Clinical oral examinations were performed to establish oral health status, in terms of caries and treatment need, HIV-1-related gingival as well as stomatological changes. Medical records were reviewed searching for clinical history of the infection and the presence of HIV-1-related diseases. Association studies between frequent/very frequent oral health-related impact on quality of life and independent variables were performed using Fisher’s exact test. Results The prevalence of frequent/very frequent oral health-related impact on quality of life was 69.0%. The prevalence of caries was 75.9%. Gingival changes were present in 20.7% of the individuals. Dental treatment was needed in 72.4% of the patients. HIV-1-related disease was present in 55.2%. The variables significantly associated with the prevalence of frequent/very frequent impact on oral health-related quality of life were dental treatment need (p?=?0.037) and being more than 12 years of age (p?=?0.041). Conclusions Individuals living with HIV-1 with need for dental treatment and those over 12-years of age reported a statistically higher frequency of frequent/very frequent oral health-related impact on quality of life. PMID:25069518

2014-01-01

123

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

PubMed Central

The relationship between HIV disclosure and sexual transmission behaviors, and factors that influence disclosure are unknown among HIV-positive men who have sex with men (MSM) in Asia. We describe disclosure practices and sexual transmission behaviors, and correlates of disclosure among this group of MSM in Asia. A cross-sectional multi-country online survey was conducted among 416 HIV-positive MSM. Data on disclosure status, HIV-related risk behaviors, disease status, and other characteristics were collected. Multivariable logistic regression was used to identify significant correlates of disclosure. Only 7.0% reported having disclosed their HIV status to all partners while 67.3% did not disclose to any. The majority (86.5%) of non-disclosing participants had multiple partners and unprotected insertive or receptive anal intercourse with their partners (67.5%). Non-disclosure was significantly associated with non-disclosure from partners (AOR = 37.13, 95% CI: 17.22, 80.07), having casual partners only (AOR = 1.91, 95% CI: 1.03, 3.53), drug use before sex on a weekly basis (AOR: 6.48, 95% CI: 0.99, 42.50), being diagnosed with HIV between 1–5 years ago (AOR = 2.23, 95% CI: 1.05, 4.74), and not knowing one’s viral load (AOR = 2.80, 95% CI: 1.00, 7.83). Given the high HIV prevalence and incidence among MSM in Asia, it is imperative to include Prevention with Positives for MSM. Interventions on disclosure should not solely focus on HIV-positive men but also need to include their sexual partners and HIV-negative men. PMID:22198313

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

2012-01-01

124

Sexual behaviour among HIV-infected new mothers in South Africa 3-12 months after delivery.  

PubMed

The aim of this study was to assess sexual activity, condom use and disclosure of HIV infection status among HIV-infected women 3-12 months after delivery and to identify factors associated with unsafe sex. A cross-sectional study was carried out on 480 HIV-positive sexually active new mothers in 48 primary health care clinics in Nkangala District. Post-natal women were recruited by systematic sampling (every consecutive patient over a period of 2 months) and responded to a questionnaire. Overall, 31.9% reported unsafe sex with an HIV-uninfected of unknown-status partner. In multivariate regression analysis, not having disclosed their HIV status, having experienced physical partner violence, lack of male involvement and not having attended a support group were associated with unsafe sex. Several risk factors for unsafe sex post-natally have been identified and can be utilised in post-partum sexual health education programmes. PMID:23724951

Peltzer, Karl

2014-02-01

125

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

PubMed Central

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

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

2015-01-01

126

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

PubMed Central

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

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

2014-01-01

127

Dating, marriage, and parenthood for HIV-positive heterosexual Puerto Rican men: normalizing perspectives on everyday life with HIV.  

PubMed

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

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

2015-03-01

128

HIV  

PubMed Central

Getting to zero: zero new HIV infections, zero deaths from AIDS-related illness, zero discrimination is the theme of World AIDS Day 2012. Given the spread of the epidemic today, getting to zero may sound difficult, but significant progress is underway. The total annual loss for the entire country due to HIV is 7% of GDP, which exceeds India’s annual health expenditure in 2004. The additional loss due to loss of labor income and increased medical expenditure as measured by the external transfers, account for 5% of the country’s health expenditure and 0.23% of GDP. Given that the HIV incidence rate is only 0.27% in India, these losses are quite staggering. Despite the remarkable achievements in development of anti-retroviral therapies against HIV and the recent advances in new prevention technologies, the rate of new HIV infections continue to outpace efforts on HIV prevention and control. Thus, the development of a safe and effective vaccine for prevention and control of AIDS remains a global public health priority and the greatest opportunity to eventually end the AIDS pandemic. PMID:24056755

Chawla, Sumit; Sahoo, Soumya Swaroop; Jain, Rambilas; Khanna, Pardeep; Mehta, Bharti; Singh, Inderjeet

2014-01-01

129

Factors associated with HIV sero-status in young rural South African women: connections between intimate partner violence and HIV  

Microsoft Academic Search

Results About 12.4% of women had HIV and 26.6% had experienced more than one episode of physical or sexual IPV. After adjusting for age, HIV infection was associated with having three or more past year partners (odds ratio (OR) 2.39; 95% confidence interval (95% CI) 1.48-3.85), sex in past 3 months (OR 3.33; 95% CI 1.87-5.94), a partner three or

R Jewkes; K Dunkle; M Nduna; J Levin; N Jama; N Khuzwayo; M Koss; A Puren; N Duvvury

2006-01-01

130

Dietary intake and nutritional status of HIV-1-infected children and adolescents in Florianopolis, Brazil.  

PubMed

This cross-sectional study aimed to investigate the nutritional status and dietary intake of HIV-infected children and adolescents and the relationship between nutritional status and dietary intake and CD4(+) T-cell count and viral load. The sample was composed of 49 subjects aged 7-17 years and living in Florianópolis, Brazil. Nutritional status was assessed by height-for-age and body mass index-for-age. Dietary intake was assessed by a food frequency questionnaire. Spearman correlations and multiple linear regressions were used to determine the relationship between energy, nutrient intake and body mass index-for-age and CD4(+) T-cell count and viral load. The mean body mass index-for-age and height-for-age values were -0.26?±?0.86 and -0.56?±?0.92, respectively. The energy intake was 50.8% above the estimated energy requirement and inadequate intake of polyunsaturated fat, cholesterol, fibre, calcium and vitamin C was present in 100%, 57.1%, 40.8%, 61.2% and 26.5% of the sample, respectively. Multiple linear regression analyses revealed that energy intake was correlated with CD4+ T-cell count (r?=?0.33; p?=?0.028) and viral load (r?=?-0.35; p?=?0.019). These data showed low body mass index-for-age and height-for-age z-scores, high energy intake and inadequate intake of important nutrients for immune function, growth and control of chronic diseases. A lower energy intake was correlated with viral suppression and immune preservation. PMID:24352121

Hillesheim, Elaine; Lima, Luiz R A; Silva, Rosane C R; Trindade, Erasmo B S M

2014-05-01

131

Maternal Nutritional Status Predicts Adverse Birth Outcomes among HIV-Infected Rural Ugandan Women Receiving Combination Antiretroviral Therapy  

PubMed Central

Objective Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Design Prospective cohort. Methods HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Results Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%. Conclusions In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women. Trial Registration Clinicaltrials.gov NCT00993031 PMID:22879899

Young, Sera; Murray, Katherine; Mwesigwa, Julia; Natureeba, Paul; Osterbauer, Beth; Achan, Jane; Arinaitwe, Emmanuel; Clark, Tamara; Ades, Veronica; Plenty, Albert; Charlebois, Edwin; Ruel, Theodore; Kamya, Moses; Havlir, Diane; Cohan, Deborah

2012-01-01

132

The potential for bridging: HIV status awareness and risky sexual behaviour of injection drug users who have non-injecting permanent partners in Ukraine  

PubMed Central

Objective To quantify potential bridging of HIV transmission between the injection drug using subpopulation to the non-injection drug using population through unprotected heterosexual sex. Design Secondary analysis of cross-sectional data. Methods A sub-sample of participants who reported having a permanent partner who are not injection drug users and have not injected drugs in the past (N=1379) was selected from a survey implemented in 26 Ukrainian cities in 2011. This study evaluates the association between consistent condom use and awareness of HIV status as measured by rapid testing during the study (known/unknown HIV+, known/unknown HIV? and undetermined) among a sub-sample of male injection drug users (IDUs) who have a non-injecting permanent partner. Poisson regression, with robust variance estimates, was utilized to identify associations while adjusting for other factors. Results Reported consistent condom use varied between 15.5% (unknown HIV?) and 37.5% (known HIV+); average use was 19.3%. In multivariate analysis, males who were aware of their HIV+ status were more likely to report recent consistent condom use compared to those who were unaware of their HIV+ status. This association remains after adjustment for age, region, education level, years of injection, alcohol use, self-reported primary drug use and being an NGO client (prevalence ratio=1.65; 95% CI 1.03–2.64). No such association was found for those who were HIV?. Conclusions Our results regarding HIV-positive male IDUs reinforce previous findings that HIV testing and counselling may be an effective means of secondary prevention. Further research is needed to understand how to effectively promote safer sex behaviours for IDUs who are currently HIV?. PMID:24560341

Mazhnaya, Alyona; Andreeva, Tatiana I; Samuels, Steve; DeHovitz, Jack; Salyuk, Tetyana; McNutt, Louise-Anne

2014-01-01

133

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

PubMed Central

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

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

2013-01-01

134

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

PubMed Central

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

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

2001-01-01

135

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

PubMed Central

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

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

2011-01-01

136

Impact of HIV/AIDS on mothers in southern India: a qualitative study.  

PubMed

The purpose of this study is to explore the perceptions and needs of mothers living with HIV to gain greater insights into the challenges they face in relation to their health seeking behavior, fears around disclosure, and issues related to stigma and discrimination. This qualitative study utilized focus groups consisting of a sample of 60 HIV-infected mothers recruited from a large maternity hospital and STD clinic in Chennai, India. Discrimination by physicians and other health care workers has been a major impediment expressed by mothers living with HIV in accessing quality health care. Mothers living with HIV are increasingly concerned about how and when to disclose their HIV status to their children and the repercussions which could result from disclosure. The findings of this study call for urgent intervention strategies taking into consideration these various concerns and needs of mothers living with HIV and their children. PMID:18941883

Thomas, Beena; Nyamathi, Adeline; Swaminathan, Soumya

2009-10-01

137

Perceived HIV status is a key determinant of unprotected anal intercourse within partnerships of men who have sex with men in Amsterdam.  

PubMed

The practice of unprotected anal intercourse (UAI) involves at least two partners. We examined the associations between insertive or receptive UAI and perceived HIV seroconcordance and partnership type in self-perceived HIV-negative and self-perceived HIV-positive men who have sex with men (MSM). MSM (age ? 18 years) were recruited for a cross-sectional survey at the sexually transmitted infections clinic in Amsterdam, the Netherlands, in 2008-2009. Participants completed a questionnaire concerning partnerships in the preceding 6 months. Associations were quantified via multinomial logistic regression models using generalized estimating equations. The outcomes were 'no, or safe anal intercourse', 'insertive UAI', and 'receptive UAI'. We included 5,456 partnerships from 1,890 self-perceived HIV-negative men and 1,861 partnerships from 558 self-perceived HIV-positive men. Within the partnerships, perceived HIV status of the partner was an important determinant of UAI (p < 0.001). Among HIV-negative men, perceived HIV discordance was negatively associated with receptive UAI compared with no or safe UAI (OR 0.57; 95 % CI 0.36-0.92); when the partners were more familiar with each other, the risk of receptive UAI was increased relative to no or safe anal intercourse. Among HIV-positive men, perceived HIV discordance was negatively associated with insertive UAI (OR 0.05; 95 % CI 0.03-0.08). Within partnerships, perceived HIV status of the partner was one of the strongest determinants of UAI among self-perceived HIV-negative and HIV-positive MSM, and discordant serostatus was negatively associated with UAI. The findings suggest that serosorting is one of the main strategies when engaging in UAI. PMID:24920343

Matser, Amy; Heijman, Titia; Geskus, Ronald; de Vries, Henry; Kretzschmar, Mirjam; Speksnijder, Arjen; Xiridou, Maria; Fennema, Han; Schim van der Loeff, Maarten

2014-12-01

138

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

PubMed

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

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

2015-01-01

139

It's not just who you are but where you live: an exploration of community influences on individual HIV status in rural Malawi.  

PubMed

Approximately 1 million people are infected with Human Immunodeficiency Virus (HIV) in Malawi. Despite efforts aimed at changing individual risk behaviors, HIV prevalence continues to rise among rural populations. Both previous research and the Political Economy of Health framework suggest that community-based socio-economic factors and accessibility may influence HIV transmission; however, these community factors have received little empirical investigation. To fill this gap, this research uses data from a nationally representative probability sample of rural Malawians combined with small area estimates of community socio-economic and accessibility data in logistic regression models to: 1) reveal relationships between community factors and individual HIV status; 2) determine whether these relationships operate through individual HIV risk behaviors; and 3) explore whether these associations vary by gender. Community socio-economic factors include relative and absolute poverty; community accessibility factors include distance to roads, cities, and public health facilities. Individual HIV risk behaviors include reported condom use, sexually transmitted infections, multiple partnerships, and paid sex. Results show that higher community income inequality, community proximity to a major road, and community proximity to a public health clinic are associated with increased odds of HIV for women. For men, community proximity to a major road and community proximity to a public health clinic are associated with increased odds of HIV infection. These direct relationships between community factors and individual HIV status are not mediated by individual HIV risk behaviors. The Political Economy of Health frames the discussion. This study provides evidence for expanding HIV prevention efforts beyond individual risk behaviors to consideration of community factors that may drive the HIV epidemic in rural Malawi. PMID:21316134

Feldacker, Caryl; Ennett, Susan T; Speizer, Ilene

2011-03-01

140

Health Care Utilization and Access to Human Immunodeficiency Virus (HIV) Testing and Care and Treatment Services in a Rural Area with High HIV Prevalence, Nyanza Province, Kenya, 2007  

PubMed Central

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

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

2014-01-01

141

Access to housing subsidies, housing status, drug use and HIV risk among low-income U.S. urban residents  

PubMed Central

Background Much research has shown an association between homelessness and unstable housing and HIV risk but most has relied on relatively narrow definitions of housing status that preclude a deeper understanding of this relationship. Fewer studies have examined access to housing subsidies and supportive housing programs among low-income populations with different personal characteristics. This paper explores personal characteristics associated with access to housing subsidies and supportive housing, the relationship between personal characteristics and housing status, and the relationship between housing status and sexual risk behaviors among low-income urban residents. Methods Surveys were conducted with 392 low-income residents from Hartford and East Harford, Connecticut through a targeted sampling plan. We measured personal characteristics (income, education, use of crack, heroin, or cocaine in the last 6 months, receipt of welfare benefits, mental illness diagnosis, arrest, criminal conviction, longest prison term served, and self-reported HIV diagnosis); access to housing subsidies or supportive housing programs; current housing status; and sexual risk behaviors. To answer the aims above, we performed univariate analyses using Chi-square or 2-sided ANOVA's. Those with significance levels above (0.10) were included in multivariate analyses. We performed 2 separate multiple regressions to determine the effects of personal characteristics on access to housing subsidies and access to supportive housing respectively. We used multinomial main effects logistic regression to determine the effects of housing status on sexual risk behavior. Results Being HIV positive or having a mental illness predicted access to housing subsidies and supportive housing, while having a criminal conviction was not related to access to either housing subsidies or supportive housing. Drug use was associated with poorer housing statuses such as living on the street or in a shelter, or temporarily doubling up with friends, acquaintances or sex partners. Living with friends, acquaintances or sex partners was associated with greater sexual risk than those living on the street or in other stable housing situations. Conclusions Results suggest that providing low-income and supportive housing may be an effective structural HIV prevention intervention, but that the availability and accessibility of these programs must be increased. PMID:22112385

2011-01-01

142

To disclose, or not to disclose? Context matters  

PubMed Central

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

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

2015-01-01

143

To disclose, or not to disclose? Context matters.  

PubMed

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

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

2015-03-01

144

Low socioeconomic status and risk for infection with human herpesvirus 8 among HIV-1 negative, South African black cancer patients.  

PubMed Central

Between January 1994 and October 1997, we interviewed 2576 black in-patients with newly diagnosed cancer in Johannesburg and Soweto, South Africa. Blood was tested for HIV-1 and HHV-8 antibodies and the study was restricted to 2191 HIV-1 antibody-negative patients. We examined the relationship between infection with HHV-8 and sociodemographic and behavioural factors using unconditional logistic regression models. Of the 2191 HIV-1 negative patients who did not have Kaposi's sarcoma, 854 (39.1%) were positive for antibodies against the latent nuclear antigen of HHV-8 encoded by orf73 in a immunofluorescence assay. Infection with HHV-8 was independently associated with increasing age (P trend = 0.02). For females, independent risk factors also included working in a paid domestic capacity (OR 1.63, 95% CI 1.09-2.44, P = 0.02), defining occupational status as economically non-active unemployed (OR 1.70, 95% CI 1.06-2.72, P = 0.03), having a state pension or being on a disability grant (OR 1.49, 95% CI 1.05-2.11, P = 0.02), using oral contraceptives (OR 1.43, 95% CI 1.03-1.99, P = 0.03) and having a delayed age at menarche (P trend = 0.04). The relationship between these variables and HHV-8 antibody status requires further, prospective study. PMID:15635980

Wojcicki, J. M.; Newton, R.; Urban, Mi; Stein, L.; Hale, M.; Patel, M.; Ruff, P.; Sur, R.; Bourboulia, D.; Sitas, F.

2004-01-01

145

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

PubMed

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

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

2008-01-01

146

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

PubMed Central

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

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

2013-01-01

147

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

Microsoft Academic Search

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

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

2009-01-01

148

Disclosure of HIV-Positive Status to Latino Gay Men's Social Networks  

Microsoft Academic Search

This study explored disclosure of serostatus in a sample of 155 HIV-positive Latino gay men from New York City and Washington, DC. We examined rates of disclosure to different members of the social network: mothers, fathers, close friends, and primary sexual partners. There were high rates of disclosure of HIV-positive serostatus to main partners and closest friends and lower rates

María Cecilia Zea; Carol A. Reisen; Paul J. Poppen; John J. Echeverry; Fernanda T. Bianchi

2004-01-01

149

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

Microsoft Academic Search

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

J. A. Olaniyi; O. G. Arinola

2007-01-01

150

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

ERIC Educational Resources Information Center

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…

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

2007-01-01

151

Current status of gene therapy strategies to treat HIV\\/AIDS  

Microsoft Academic Search

Progress in developing effective gene transfer approaches to treat HIV-1 infection has been steady. Many different transgenes have been reported to inhibit HIV-1 in vitro. However, effective translation of such results to clinical practice, or even to animal models of AIDS, has been challenging. Among the reasons for this failure are uncertainty as to the most effective cell population(s) to

David S. Strayer; Ramesh Akkina; Bruce A. Bunnell; Boro Dropulic; Vicente Planelles; Roger J. Pomerantz; John J. Rossi; John A. Zaia

2005-01-01

152

Association between nutritional status and the immune response in HIV?+?patients under HAART: protocol for a systematic review  

PubMed Central

Background Over 850 million people worldwide and 200 million adults in Sub-Saharan Africa suffer from malnutrition. Countries most affected by HIV are also stricken by elevated rates of food insecurity and malnutrition. HIV infection and insufficient nutritional intake are part of a vicious cycle that contributes to immunodeficiency and negative health outcomes. However, the effect of the overlap between HIV infection and undernutrition on the immune response following antiretroviral initiation remains unclear. A possible explanation could be the lack of consensus concerning the definition and assessment of nutritional status. Our objectives are to investigate the existence of an association between undernutrition and immune response at antiretroviral treatment initiation and the following year in low- and middle-income countries where malnutrition is most prevalent. Methods/design Our systematic review will identify studies originating from low- and middle-income countries (LMICs) published from 1996 onwards, through searches in MEDLINE (PubMed interface), EMBASE (OVID interface), Cochrane Central (OVID interface) and grey literature. No language restrictions will be applied. We will seek out studies of any design investigating the association between the nutritional status (for example, undernourished versus well nourished) and the immune response, either in terms of CD4 count or immune failure, in seropositive patients initiating antiretroviral therapy or in their first year of treatment. Two reviewers will independently screen articles, extract data and assess scientific quality using standardized forms and published quality assessment tools tailored for each study design. Where feasible, pooled measures of association will be obtained through meta-analyses. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. This protocol has been registered in the PROSPERO database (registration number: CRD42014005961). Conclusion Undernutrition and weight loss are prevalent amongst highly active antiretroviral therapy (HAART)-treated patients in LMICs and contribute to excess early mortality. A possible intermediate pathway could be poor immune reconstitution secondary to deficient nutritional status. In the face of limited access to second line treatments, raising HIV resistance and cut backs to HIV programs, it is crucial to identify the factors associated with suboptimal response and therapeutic failure in order to better customize the care strategies employed in LMICs. PMID:24513015

2014-01-01

153

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

PubMed Central

CONTEXT Both perinatally and behaviorally infected HIV-positive youth engage in sexually risky behaviors, and a better understanding of the perceptions of these youth and of health care providers regarding disclosure of HIV status and risk reduction would aid in the development of behavioral interventions for such youth. METHODS In spring 2007, some 20 HIV-positive inner-city youth (aged 13–24) and 15 health care providers who work with HIV-infected youth participated in in-depth, semistructured interviews. Youth were recruited at an HIV clinic, AIDS clinics and an AIDS service organization, and had received care from participating providers. Detailed contextual and thematic discourse analysis was performed on interview transcriptions. RESULTS Eighteen of the 20 youth had disclosed their HIV status to another individual at least once. Eleven reported being sexually active, and three of these had been perinatally infected. Qualitative analysis revealed four subthemes related to disclosure: stigma and emotions, trust issues, reasons for disclosing and strategies for addressing disclosure. Five subthemes were identifi ed related to sexual risk reduction: dating challenges, attitudes toward condom use, self-effi cacy for condom use negotiation, pregnancy attitudes and sexual risk reduction strategies. Providers reported that access to more engaging and interactive educational tools within the clinic setting could enhance their risk reduction counseling with HIV-positive youth. CONCLUSIONS HIV-positive youth experience multiple challenges regarding disclosure and sexual risk reduction, and health care providers need innovative tools that can be used in clinic settings to improve adolescents’ skills in reducing risky sexual behavior. PMID:20618750

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

2011-01-01

154

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

PubMed

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

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

2015-04-01

155

Disclosure of maternal HIV-infection in South Africa: description and relationship to child functioning.  

PubMed

South Africa has one of the highest HIV-infection rates in the world, yet few studies have examined disclosure of maternal HIV status and its influence on children. This study provides descriptive information about HIV disclosure among South African mothers and explores whether family context variables interact with maternal HIV disclosure to affect children's functioning. A total of 103 mothers, who self-identified as living with HIV and who were the primary caregivers of a child between the ages of 11 and 16, were interviewed. A total of 44% of mothers had disclosed, and those who had most typically perceived children's reactions to disclosure to be sadness and worry. Widows and married mothers were more likely than single mothers to disclose their HIV status. Disclosure to children significantly predicted externalizing, but not internalizing, behaviors. Family variables had direct but not interactive effects on child functioning. This study highlights the complexity of disclosure-related decisions and the importance of addressing the family context. PMID:18770026

Palin, Frances L; Armistead, Lisa; Clayton, Alana; Ketchen, Bethany; Lindner, Gretchen; Kokot-Louw, Penny; Pauw, Analie

2009-12-01

156

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

PubMed Central

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

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

2012-01-01

157

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

PubMed Central

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

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

2013-01-01

158

High HIV Prevalence among MSM in Jamaica is associated with Social Vulnerability and other Sexually Transmitted Infections  

PubMed Central

Background HIV prevalence among men who have sex with men (MSM) is thought to be high in Jamaica. The objective of this study was to estimate HIV prevalence and identify risk factors in order to improve prevention approaches. Methods With the help of influential MSM, an experienced research nurse approached MSM in four parishes to participate in a cross-sectional survey in 2007. MSM were interviewed and blood taken for HIV and syphilis tests, and urine taken for gonorrhoea, Chlamydia and Trichomonas testing using transcription-mediated amplification assays. A structured questionnaire was administered by the nurse. Results One third (65 of 201; 32%, 95% Confidence Interval (CI) 25.2% – 47.9%) of MSM were HIV positive. Prevalence of other sexually transmitted infections (STI) was: Chlamydia 11%, syphilis 6%, gonorrhea 3.5% and Trichomonas 0%. One third (34%) of MSM identified themselves as being homosexual, 64% as bisexual and 1.5% as heterosexual. HIV positive MSM were significantly more likely to have ever been told by a doctor that they had a STI (48% vs. 27%, OR 2.48 CI 1.21 – 5.04, p=0.01) and to be the receptive sexual partner at last sex (41% vs. 23%, OR 2.41 CI 1.21 – 4.71, p=0.008). MSM who were of low socio-economic status, ever homeless and victims of physical violence were twice as likely to be HIV positive. The majority (60%) of HIV positive MSM had not disclosed their status to their partner and over 50% were not comfortable disclosing their status to anyone. Conclusions The high HIV prevalence among MSM is an important factor driving the HIV epidemic in Jamaica. More effective ways need to be found to reduce the high prevalence of HIV among MSM including measures to reduce their social vulnerability, combat stigma and discrimination and empower them to practice safe sex. PMID:24756602

Figueroa, JP; Weir, SS; Jones-Cooper, C; Byfield, L; Hobbs, MM; McKnight, I; Cummings, S

2013-01-01

159

Sex, Drugs, Violence, and HIV Status Among Male-to-Female Transgender Persons in Houston, Texas  

Microsoft Academic Search

To inform the Community Planning Group (Houston, Texas) in setting HIV-prevention priorities, risk behavior surveys were completed by 67 male-to-female (MtF) transgender persons. By self-identification, 58% were preoperative and 48% were self-described heterosexual women. We found this small sample of male-to-female transgender individuals to have high rates of HIV infection, and high prevalence of risky behaviors, intimate partner violence, and

Jan M. H. Risser; Andrea Shelton; Sheryl McCurdy; John Atkinson; Paige Padgett; Bernardo Useche; Brenda Thomas; Mark Williams

2005-01-01

160

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression  

PubMed Central

Abstract Anemia is common in HIV-infected children and iron deficiency is thought to be a common cause. This study investigates the prevalence of anemia, thalassemia, and underlying iron status in Thai and Cambodian children without advanced HIV disease to determine the necessity of routine iron supplementation. Antiretroviral (ARV)-naive HIV-infected Asian children aged 1–12 years, with CD4 15–24%, CDC A or B, and hemoglobin (Hb) ?7.5?g/dl were eligible for the study. Iron studies, serum ferritin, Hb typing, and C-reactive protein were assessed. Anemia was defined as Hb <11.0?g/dl in children <5 years of age or <11.5?g/dl in children 5–12 years. We enrolled 299 children; 57.9% were female and the mean (SD) age was 6.3 (2.9) years. The mean (SD) CD4% and HIV-RNA were 20% (4.6) and 4.6 (0.6) log10 copies/ml, respectively. The mean (SD) Hb and serum ferritin were 11.2 (1.1) g/dl and 78.3 (76.4) ?g/liter, respectively. The overall iron deficiency anemia (IDA) prevalence was 2.7%. One hundred and forty-eight (50%) children had anemia, mostly of a mild degree. Of these, 69 (46.6%) had the thalassemia trait, 62 (41.8%) had anemia of chronic disease (ACD), 9 (6.1%) had thalassemia diseases, 3 (2.0%) had iron deficiency anemia, and 5 (3.4%) had IDA and the thalassemia trait. The thalassemia trait was not associated with increased serum ferritin levels. Mild anemia is common in ARV-naïve Thai and Cambodian children without advanced HIV. However, IDA prevalence is low; with the majority of cases caused by ACD. A routine prescription of iron supplement in anemic HIV-infected children without laboratory confirmation of IDA should be discouraged, especially in regions with a high prevalence of thalassemia and low prevalence of IDA. PMID:22734817

Bunupuradah, Torsak; Vonthanak, Saphonn; Wiangnon, Surapon; Hansudewechakul, Rawiwan; Vibol, Ung; Kanjanavanit, Suparat; Ngampiyaskul, Chaiwat; Wongsawat, Jurai; Luesomboon, Wicharn; Lumbiganon, Pagakrong; Sopa, Bunruan; Apornpong, Tanakorn; Chuenyam, Theshinee; Cooper, David A.; Ruxrungtham, Kiat; Ananworanich, Jintanat; Puthanakit, Thanyawee

2012-01-01

161

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

PubMed

Given the implications for smoking among HIV-positive individuals and high smoking and HIV rates among men who have sex with men (MSM) in China, we examined sociodemographic, smoking-related, psychosocial, and substance use factors in relation to HIV status; receiving some sort of healthcare provider intervention regarding smoking; and having made a quit attempt in the past year in a sample of MSM smokers in Chengdu. We conducted a cross-sectional survey of 381 MSM smokers recruited by a nongovernmental organization in Chengdu in 2012-2013. Of these, 350 disclosed their HIV status and 344 (188 HIV-positive and 156 HIV-negative) provided completed data. Half (50.0%) reported at least one quit attempt in their lifetime; 30.5% reported a quit attempt in the past year. The majority (59.4%) reported that a healthcare provider had intervened in some way (assessed smoking, advised quitting, provided assistance), most commonly by assessing smoking status (50.0%). HIV-positive individuals were more likely to report a healthcare provider intervening on their smoking (p < .001). Those who received provider intervention were more likely to have attempted to quit ever (p = .009) and in the past year (p < .001). Those HIV-positive were more likely to have attempted to quit since diagnosis if a provider had intervened (p = .001). Multivariate regression documented that being HIV-positive (p < .001), greater cigarette consumption (p = .02), less frequent drinking (p = .03), and greater depressive symptoms (p = .003) were significant correlates of healthcare provider intervention. Multivariate regression also found that healthcare provider intervention (p = .003), older age (p = .01), and higher autonomous motivation (p = .007) were significant correlates of attempting to quit in the past year. Given the impact of healthcare provider intervention regarding smoking on quit attempts among MSM, greater training and support is needed to promote consistent intervention on smoking in the clinical setting among HIV-positive and HIV-negative MSM smokers. PMID:24601710

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

2014-01-01

162

HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya  

PubMed Central

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

Burkholder, Gary J.; Ferraro, Aimee

2014-01-01

163

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

PubMed Central

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

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

2014-01-01

164

Stress Management, Depression and Immune Status in Lower Income Racial/Ethnic Minority Women Co-infected with HIV and HPV  

PubMed Central

The stress of co-infection with HIV and Human Papillomavirus (HPV), in race/ethnic minority women, may increase depression and immune decrements. Compromised immunity in HIV+ HPV+ women may increase the odds of cervical dysplasia. Thus we tested the efficacy of a 10-wk cognitive behavioral stress management (CBSM) group intervention and hypothesized that CBSM would decrease depression and improve immune status (CD4+ T-cells, natural killer [NK] cells). HIV+HPV+ women (n=71) completed the Beck Depression Inventory (BDI) and provided blood samples, were randomized to CBSM or a control condition, and were re-assessed post-intervention. Women in CBSM revealed less depression, greater NK cells, and marginally greater CD4+ T-cells post-intervention vs. controls. Stress management may improve mood and immunity in HIV+HPV+ lower income minority women. PMID:23526866

Lopez, Corina R.; Antoni, Michael H.; Pereira, Deirdre; Seay, Julia; Whitehead, Nicole; Potter, Jonelle; O'Sullivan, MaryJo; Fletcher, Mary Ann

2013-01-01

165

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

ERIC Educational Resources Information Center

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

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

2013-01-01

166

Status of immune-based therapies in HIV infection and AIDS.  

PubMed Central

As our understanding of HIV disease pathogenesis progresses, approaches to immune-based therapy are evolving. Initial therapies aiming to alter immune function in patients with HIV infection have had mixed results. Clinical benefit in the trials so far has not been dramatic, although the studies are still at an early stage, and the correct protocols for the various agents or combinations of agents have yet to be established. As might be expected, where apparent benefit has occurred, it has been more obvious in those patients whose immune system was still intact. PMID:1563093

Fahey, J L; Schooley, R

1992-01-01

167

HIV Testing & Risky Sexual Behavior September 2010  

E-print Network

HIV Testing & Risky Sexual Behavior Erick Gong September 2010 Abstract A puzzle in HIV prevention is that while HIV tests provide important information about a person's health status, it has little eect about their HIV status. Using data from a study that randomly assigns oers of HIV testing in two urban

Silver, Whendee

168

Vitamin D Status of HIV-positive Patients with Advanced Liver Disease Enrolled in the Solid Organ Transplantation in HIV Multi-site Study  

PubMed Central

Optimal vitamin D status may benefit liver transplant (LT) patients. Higher levels of 25-hydroxyvitamin D [25(OH)D] mitigate steroid-induced bone loss post-LT, correlate with better HCV treatment responses, and increase graft survival. This study investigated 25(OH)D levels and assessed strategies for vitamin D deficiency prevention in HIV-positive patients with advanced liver disease enrolled in the Solid Organ Transplantation Multi-site Study. 25(OH)D was measured in banked specimens of 154 LT candidates/recipients using the Diasorin assay; deficiency was defined as 25(OH)D < 20 ng/mL. Information about vitamin D supplement use post-LT was obtained from medication logs and via survey. Logistic regression, Cox regression and linear repeated measures analyses were performed in SAS. We found that none of the 17 academic medical centers in the United States routinely recommended vitamin D supplements prior to LT, and only a minority (4/17) recommended vitamin D supplements to all patients after LT. Among 139 patients with pre-LT values, 71% had vitamin D deficiency, which was significantly associated with cirrhosis (p=0.01) and no other variable. Vitamin D status improved modestly after LT; however, 40% were deficient one year post-LT. In a multivariable linear repeated measures model, higher pre-LT 25(OH)D (p<.0001), summer season for specimen collection (p=0.0003), a routine vitamin D supplementation strategy post-LT (p=0.0004) and time elapsed post-LT (p=0.01) were significantly associated with an increase in the post-LT 25(OH)D level; black race was associated with a decreased level (p=0.02). In conclusion, the majority of patients awaiting LT were vitamin D deficient, and about half were vitamin D deficient post-LT. More extensive use of vitamin D supplements and/or more sun exposure are needed to prevent deficiency in HIV-positive LT candidates and recipients. PMID:24338934

Branch, Andrea D.; Barin, Burc; Rahman, Adeeb; Stock, Peter; Schiano, Thomas D.

2014-01-01

169

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

ERIC Educational Resources Information Center

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

Chenneville, Tiffany

2007-01-01

170

The effects of immune status and race on health service use among people with HIV disease.  

PubMed Central

OBJECTIVES. The purpose of this study was to examine the relationship between CD4 lymphocyte count and health service use, and to determine whether differences in the rates of service use between Whites and people of color could be identified. METHODS. Medical records for 571 HIV-infected individuals were analyzed. Incidence rates and relative rates across CD4 strata (defined by cell counts) were calculated for inpatient and outpatient events. Rate ratios comparing people of color with Whites were estimated within strata, adjusting for confounding factors using a Mantel-Haenszel pooling procedure. RESULTS. Both inpatient and outpatient service use increased over progressively lower levels of CD4 counts. Within each CD4 stratum and controlling for other factors, White participants had more HIV clinic visits and fewer admissions than people of color. Among participants with fewer than 51 CD4 cells per cubic millimeter, people of color were admitted 20% more often, had 35% more inpatient days per person-year, and had only 74% as many HIV clinic visits as their White counterparts. CONCLUSIONS. These results indicate that CD4 lymphocyte count is strongly associated with increased usage of health services. People of color with HIV disease are more likely than similar Whites to be admitted to the hospital and less likely to use outpatient care. PMID:8096368

Piette, J D; Mor, V; Mayer, K; Zierler, S; Wachtel, T

1993-01-01

171

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

ERIC Educational Resources Information Center

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

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

2014-01-01

172

Prevalence of sexually transmitted infections among pregnant women with known HIV status in northern Tanzania  

Microsoft Academic Search

OBJECTIVES: To determine the prevalence of sexually transmitted infections (STIs) and other reproductive tract infections (RTIs) among pregnant women in Moshi, Tanzania and to compare the occurrence of STIs\\/RTIs among human immunodeficiency virus (HIV)-infected and uninfected women. METHODS: Pregnant women in their 3rd trimester (N = 2654) were recruited from two primary health care clinics between June 2002 and March

Sia E Msuya; Jacqueline Uriyo; Akhtar Hussain; Elizabeth M Mbizvo; Stig Jeansson; Noel E Sam; Babill Stray-Pedersen

2009-01-01

173

Childbearing motivations, pregnancy desires, and perceived partner response to a pregnancy among urban female youth: does HIV-infection status make a difference?  

PubMed

Despite a growing literature assessing pregnancy desires among HIV-infected women enrolled in clinical care, little attention has been paid to HIV-infected youth for whom pregnancy is a very relevant issue. In urban areas with high rates of teen pregnancy and HIV infection, further understanding of childbearing motivations and relationship dynamics influencing pregnancy desires among female youth is needed. This study compares the childbearing motivations, pregnancy desires, and perceived partner desire for a pregnancy among predominately African-American HIV-infected (n=46) and HIV-uninfected (n=355) female youth (15-24 years). An HIV-infected status was not significantly associated with childbearing motivations or the desire for a future pregnancy, p>0.10. HIV-infection was, however, associated with an increased likelihood to perceive that one's partner would have a positive response to a pregnancy (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.2-10.4, p=0.02) compared to uninfected peers. While race was not associated with participants' own desire for a child, white youth were significantly less likely to perceive a positive partner response to becoming pregnant than their African-American peers (aOR 0.23, 95% CI 0.09-0.56, p=0.001). These data suggest that the desire for childbearing is not diminished by HIV infection among urban female youth, highlighting the need for routine, provider-initiated discussions about childbearing with urban youth to minimized unintended pregnancies and HIV transmission. PMID:21777077

Finocchario-Kessler, Sarah; Sweat, Michael D; Dariotis, Jacinda K; Anderson, Jean R; Jennings, Jacky M; Keller, Jean M; Vyas, Amita A; Trent, Maria E

2012-01-01

174

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

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

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

2014-01-01

175

Does knowledge about antiretroviral therapy and mother-to-child transmission affect the relationships between HIV status and fertility preferences and contraceptive use? New evidence from Nigeria and Zambia.  

PubMed

The increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009-2010 community-based surveys in Nigeria and Zambia, this study explores whether women's knowledge about ART and PMTCT influences the relationship between HIV status and fertility preferences and contraceptive behaviour. The findings show that women living with HIV are more likely to want more children in Nigeria and to want to limit childbearing in Zambia compared with HIV-negative women. While there is no significant difference in contraceptive use by women's HIV status in the two countries, women who did not know their HIV status are less likely to use contraceptives relative to women who are HIV-negative. Knowledge about ART reduces the childbearing desires of HIV-positive women in Nigeria and knowledge about PMTCT increases desire for more children among HIV-positive women in Zambia, as well as contraceptive use among women who do not know their HIV status. The findings indicate that knowledge about HIV prevention and treatment services changes how living with HIV affects childbearing desires and, at least in Zambia, pregnancy prevention, and highlight the importance of access to accurate knowledge about ART and PMTCT services to assist women and men to make informed childbearing decisions. Knowledge about ART and PMTCT should be promoted not only through HIV treatment and maternal and newborn care facilities but also through family planning centres and the mass media. PMID:24331375

Bankole, Akinrinola; Biddlecom, Ann E; Dzekedzeke, Kumbutso; Akinyemi, Joshua O; Awolude, Olutosin; Adewole, Isaac F

2014-09-01

176

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

PubMed Central

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

2011-01-01

177

A prospective, cross-sectional study of anaemia and peripheral iron status in antiretroviral naïve, HIV-1 infected children in Cape Town, South Africa  

PubMed Central

Background Anaemia is a common manifestation of paediatric HIV infection. Although there are many causes, anaemia of chronic diseases is the most frequent type. In poor countries iron deficiency is widespread. It is probable that many HIV-infected children in these countries are also iron deficient. This study describes the relationship between paediatric HIV infection and anaemia, and documents the peripheral iron status of antiretroviral naive, HIV-infected children. Methods Sixty children were evaluated prospectively. Investigations included CD4+ count, haemoglobin concentration (Hb), red blood cell (RBC) morphology, and iron studies. Results Anaemia was present in 73% of children. Compared to mild HIV infection, median Hb was lower in children with moderate clinical infection (104 g/L v 112 g/L, p = 0.04) and severe clinical infection (96 g/L v 112 g/L, p = 0.006), and more children with severe infection were anaemic (92% v 58%, 0.04). There was a significant relationship between immunological status and Hb. 68% had abnormal RBC morphology. Significantly more children with moderate and severe disease, and severe immunosuppression had abnormal RBC morphology. 52% were iron-depleted, 20% had iron-deficient erythropoiesis and 18% iron deficiency anaemia (IDA). 16% (7/44) of anaemic children had microcytosis and hypochromia. Median soluble transferrin receptor concentration was significantly higher in those with microcytic hypochromic anaemia (42.0 nmol/L v 30.0 nmol/L, p = 0.008). Conclusions Both the proportion of anaemic children and the median Hb were associated with disease status. Iron depletion and IDA are major problems in HIV-infected children in South Africa. PMID:11866864

Eley, Brian S; Sive, Alan A; Shuttleworth, Margaret; Hussey, Gregory D

2002-01-01

178

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

PubMed Central

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

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

2015-01-01

179

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

PubMed

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

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

2014-02-01

180

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

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

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

2013-01-01

181

Children of injection drug users: Impact of parental HIV status, AIDS, and depression  

Microsoft Academic Search

We investigated the association between parental factors (including infection with human immunodeficiency virus [HIV], acquired\\u000a immunodeficiency syndrome [AIDS] diagnosis, parental medical illness, and depression) and children's behavioral and emotional\\u000a problems among children of injection drug users (IDUs). IDUs were recruited through community outreach. The sample included\\u000a 73 parents of 73 children, aged 4 to 12 years. Parental depression (odds ratio

Daniel J. Pilowsky; Amy R. Knowlton; Carl A. Latkin; Donald R. Hoover; Shang-en Chung; David D. Celentano

2001-01-01

182

Current status of targets and assays for anti-HIV drug screening  

Microsoft Academic Search

HIV\\/AIDS is one of the most serious public health challenges globally. Despite the great efforts that are being devoted to\\u000a prevent, treat and to better understand the disease, it is one of the main causes of morbidity and mortality worldwide. Currently,\\u000a there are 30 drugs or combinations of drugs approved by FDA. Because of the side-effects, price and drug resistance,

Ren-rong Tian; Qing-jiao Liao; Xu-lin Chen

2007-01-01

183

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

PubMed

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

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

2013-07-01

184

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

PubMed

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

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

2012-07-30

185

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

Microsoft Academic Search

BackgroundWe analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007.MethodsKAIS 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

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

2012-01-01

186

75 FR 15635 - Delegations of Authority To Disclose Confidential Information  

Federal Register 2010, 2011, 2012, 2013, 2014

...Delegations of Authority To Disclose Confidential Information AGENCY: Commodity Futures...delegations of authority to disclose confidential information to permit CFTC staff to provide confidential information to ``registered...

2010-03-30

187

Social, Structural and Behavioral Determinants of Overall Health Status in a Cohort of Homeless and Unstably Housed HIV-Infected Men  

PubMed Central

Background Previous studies indicate multiple influences on the overall health of HIV-infected persons; however, few assess and rank longitudinal changes in social and structural barriers that are disproportionately found in impoverished populations. We empirically ranked factors that longitudinally impact the overall health status of HIV-infected homeless and unstably housed men. Methods and Findings Between 2002 and 2008, a cohort of 288 HIV+ homeless and unstably housed men was recruited and followed over time. The population was 60% non-Caucasian and the median age was 41 years; 67% of study participants reported recent drug use and 20% reported recent homelessness. At baseline, the median CD4 cell count was 349 cells/µl and 18% of eligible persons (CD4<350) took antiretroviral therapy (ART). Marginal structural models were used to estimate the population-level effects of behavioral, social, and structural factors on overall physical and mental health status (measured by the SF-36), and targeted variable importance (tVIM) was used to empirically rank factors by their influence. After adjusting for confounding, and in order of their influence, the three factors with the strongest negative effects on physical health were unmet subsistence needs, Caucasian race, and no reported source of instrumental support. The three factors with the strongest negative effects on mental health were unmet subsistence needs, not having a close friend/confidant, and drug use. ART adherence >90% ranked 5th for its positive influence on mental health, and viral load ranked 4th for its negative influence on physical health. Conclusions The inability to meet food, hygiene, and housing needs was the most powerful predictor of poor physical and mental health among homeless and unstably housed HIV-infected men in an urban setting. Impoverished persons will not fully benefit from progress in HIV medicine until these barriers are overcome, a situation that is likely to continue fueling the US HIV epidemic. PMID:22558128

Riley, Elise D.; Neilands, Torsten B.; Moore, Kelly; Cohen, Jennifer; Bangsberg, David R.; Havlir, Diane

2012-01-01

188

Coping with HIV/AIDS Stigma in Five African Countries  

PubMed Central

People living with HIV (PLWH) and their families are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. This paper examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive, qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. Forty-three focus groups were conducted with 251 participants (114 nurses, 111 PLWHs and 26 volunteers). In describing incidents of stigma, respondents reported strategies used or observed to cope with those incidents of stigma. Nurse reports of coping strategies that they used as well as coping strategies they observed as used by HIV-infected patients were coded. Coping strategies used by PLWH in dealing with HIV-related stigma were coded. Seventeen different self-care strategies were identified: restructuring, seeing oneself as OK, letting go, turning to God, hoping, changing behavior, keeping oneself active, using humor, joining a support or social group, disclosing one’s HIV status, speaking to others with same problem, getting counseling, helping others to cope with the illness, educating others, learning from others, acquiring knowledge and understanding about the disease, and getting help from others. Coping appears to be self-taught and only modestly helpful in managing perceived stigma. PMID:18328964

Makoae, Lucia N.; Greeff, Minrie; Phetlhu, René D.; Uys, Leana R.; Naidoo, Joanne R.; Kohi, Thecla W.; Dlamini, Priscilla S.; Chirwa, Maureen L.; Holzemer, William L.

2008-01-01

189

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

PubMed Central

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

Fontes, Tatiana Vasconcellos; Ferreira, Sonia Maria Soares; Silva-Júnior, Arley; dos Santos Marotta, Patrícia; Noce, Cesar Werneck; de Carvalho Ferreira, Dennis; Gonçalves, Lucio Souza

2014-01-01

190

Short Communication: The Veterans Aging Cohort Study Index Is an Effective Tool to Assess Baseline Frailty Status in a Contemporary Cohort of HIV-Infected Persons.  

PubMed

The Veterans Aging Cohort Study (VACS) Index has previously been used to identify frail HIV-infected persons. However, data demonstrating the independent association between the VACS Index and baseline frailty status is lacking. Furthermore, the ability of the VACS Index to also reflect transitions in frailty status over time is unknown. We used data from the Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN Study) to determine independent association of baseline frailty status with the VACS Index. We also evaluated VACS Index changes with frailty status transitions over time. We included 303 participants (median age 48 years, 76% men, 57% non-Hispanic white, 91% with plasma HIV RNA <400 copies/ml, and median CD4(+) cell count 595 cells/ml) with baseline and follow-up frailty assessments and used the Fried's criteria to define frailty status. There were 184 (61%) nonfrail, 112 (37%) prefrail, and seven (2%) frail participants at baseline. Prefrail/frail participants had significantly higher median VACS Index scores compared with nonfrail participants (18 versus 10, p<0.001). In multivariable analysis, prefrailty/frailty was independently associated with a higher VACS Index score (odds ratio 1.025, p=0.019). After a median follow-up of 12 months, participants who remained prefrail/frail compared to those who remained nonfrail continued to have higher median VACS Index scores. The VACS Index score did not significantly change with transitions in frailty status over time. Our study highlights the potential utility of the VACS Index in frailty assessment within the clinical setting. PMID:25495766

Escota, Gerome V; Patel, Pragna; Brooks, John T; Bush, Tim; Conley, Lois; Baker, Jason; Kojic, Erna Milunka; Hammer, John; Önen, Nur F

2015-03-01

191

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

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

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

2013-01-01

192

Status of immunity against PVB19 in HIV-infected patients according to CD4+ cell count, and antiretroviral therapy regimen groups  

PubMed Central

Background: Human Parvovirus B19 (PVB19) is among the aetiology of aplastic crisis in human immunodeficiency virus (HIV)-infected patients. Several studies have indicated the importance of an infection agent in bringing about complications in immuno-compromised patients. The current study aims to determine the seroprevalence of IgM and IgG antibodies to PVB19 among HIV-positive patients and its association with clinical and epidemiological factors. Materials and Methods: In a case control study, 90 HIV-positive patients were compared with 90 sex and age matched healthy controls in terms of anti-PVB19 IgG and IgM along with other primary clinical and laboratory features. Results: The overall prevalence of positive anti-PVB19 IgG among HIV patients and controls were 81.1% and 28.9%, respectively (P < 0.001). None of the subjects showed positive results for anti-PVB19 IgM. Patients with CD4+ cell count <200 showed higher seroprevalence of positive anti-PVB19 IgG which did not reach statistically significant. However, anti-PVB19 IgG seropositivity differed significantly between HIV patients on different regimens of antiretroviral therapy (ART) (P < 0.05). Conclusion: Immunity against PVB19 is more prevalent among HIV-positive patients compared to healthy controls. However, positive HIV status is not associated with acute PVB19 infection. The presence of anti-PVB19 IgG does not necessarily protect the body from further complications like anaemia. Given the results of the study, AIDS patients are recommended to undergo screening for parvovirus antibody in order to prevent complications like aplastic anaemia. PMID:24970964

Abdollahi, Alireza; Shoar, Saeed; Sheikhbahaei, Sara; Mahdaviani, Behnaz; Rasoulinejad, Mehrnaz

2014-01-01

193

Care burden and self-reported health status of informal women caregivers of HIV/AIDS patients in Kinshasa, Democratic Republic of Congo.  

PubMed

We conducted a cross-sectional study on women who were caregivers of HIV/AIDS-affected spouses in Bumbu in Kinshasa, Democratic Republic of Congo. The sample consisted of 80 women randomly selected from a client visitation list of the home-based care program for AIDS patients. A semi-structured questionnaire was applied. A self-reported health status was calculated with five items from the questionnaire. The self-reported health status score of participants indicated poor health. The study highlights the great burden on caregivers in sub-Saharan Africa. PMID:16971277

Kipp, Walter; Matukala Nkosi, Thomas; Laing, Lory; Jhangri, Gian S

2006-10-01

194

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

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

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

2015-01-01

195

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

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

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

2015-12-01

196

Food insecurity, socioeconomic status, and HIV-related risk behavior among women in farming households in Tanzania.  

PubMed

Food insecurity (FI) is associated with higher-risk sexual behavior in some studies. However, the overlap between FI and socioeconomic status (SES) has been poorly described. The study objectives were to: (1) determine the relationship between household FI and four dimensions of SES among sexually active Tanzanian women in farming households: expenditures, assets, flooring material of the home, and land ownership; and (2) determine whether FI is associated with higher-risk sexual behavior and relationship power. In male-headed households, FI was associated with assets, flooring material, and land ownership but not expenditures. There was no association between FI and the four dimensions of SES in female-headed households. Among women in male-headed households, but not female household heads themselves, severe FI was associated with a non-significant increase in the likelihood of being in a relationship because of material goods [adjusted prevalence ratio (PRa) = 1.76, 95 % confidence interval (CI) 0.81, 3.81] and was inversely associated with being able to ask partners to use condoms (PRa = 0.47, 95 % CI 0.25, 0.88). There was not a strong association between food security and relationship power. Our findings suggest that the association between FI and HIV risk behavior may differ depending on the type of household. PMID:24097335

McCoy, Sandra I; Ralph, Lauren J; Njau, Prosper F; Msolla, Mbette Mshindo; Padian, Nancy S

2014-07-01

197

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

PubMed Central

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

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

2014-01-01

198

Perceived mental health status of drug users with HIV: concordance between caregivers and care recipient reports and associations with caregiving burden and reciprocity.  

PubMed

Because caregivers' monitoring of care recipients' mental health status likely facilitates provision of needed forms of assistance, the current study examines relationship factors associated with agreement in caregiver- and recipient self-reports of recipients' mental health status. Participants were former or current injection drug using persons with HIV/AIDS and their main caregivers (N = 258 dyads). Care recipients completed the Center for Epidemiologic Studies Depression scale and caregivers responded to a single item rating their recipients' mental health. Nearly two-thirds (64.7 %) of dyads agreed on care recipients' mental health status (? = .26, p < .001). More secondary stressors of care, less reciprocity, and care recipients' greater physical limitations, substance use, and younger age predicted greater agreement on recipients' having poorer mental health. Greater secondary stressors and lower income were associated with less agreement on care recipients' mental health. Findings, which suggest that promoting reciprocity and alleviating secondary stressors of caregiving may help facilitate these caregivers' improved assessment of their care recipients' mental health status, have implications to dyadic approaches to promote drug users' HIV health outcomes. PMID:24385229

Mitchell, Mary M; Robinson, Allysha C; Wolff, Jennifer L; Knowlton, Amy R

2014-06-01

199

Missed Opportunities for Religious Organizations to Support People Living with HIV/AIDS: Findings from Tanzania  

PubMed Central

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

Maman, Suzanne; Jacobson, Mark; Laiser, John; John, Muze

2009-01-01

200

HIV Discrimination and the Health of Women Living with HIV  

Microsoft Academic Search

Women living with HIV are especially vulnerable to discrimination because of the stigma associated with the disease, as well as their race, gender and class status. To investigate the association between self-reported HIV discrimination and health outcomes among African-American and white women living with HIV, 366 women living with HIV were recruited from HIV\\/AIDS clinics in Georgia and Alabama. In

Gina M. Wingood; Ralph J. DiClemente; Isis Mikhail; Donna Hubbard McCree; Susan L. Davies; James W. Hardin; Shani Harris Peterson; Edward W. Hook; Mike Saag

2007-01-01

201

"I will not let my HIV status stand in the way." Decisions on motherhood among women on ART in a slum in Kenya- a qualitative study  

PubMed Central

Background The African Medical Research Foundation antiretroviral therapy program at the community health centre in Kibera counsels women to wait with pregnancy until they reach the acceptable level of 350 cells/ml CD4 count and to discuss their pregnancy intentions with their health care providers. A 2007 internal assessment showed that women were becoming pregnant before attaining the 350 cells/ml CD4 count and without consulting health care providers. This qualitative study explored experiences of intentionally becoming pregnant among women receiving highly active antiretroviral therapy (HAART). Methods Nine pregnant women, six newly delivered mothers and five women wanting to get pregnant were purposefully selected for in-depth interviews. Content analysis was used to organize and interpret the women's experiences of becoming pregnant. Results Women's choices for pregnancy could be categorized into one overarching theme 'strive for motherhood' consisting of three sub-themes. A child is thought of as a prerequisite for a fulfilled and happy life. The women accepted that good health was required to bear a pregnancy and thought that feeling well, taking their antiretroviral treatment and eating nutritious food was enough. Consulting health care providers was perceived as interfering with the women's decisions to get pregnant. Becoming pregnant as an HIV-infected woman was, however, complicated by the dilemmas related to disclosing HIV infection and discussing pregnancy intentions with their partners. Conclusions Motherhood is important to women on antiretroviral treatment. But they seemed to lack understanding of the relationship between a high CD4 cell count and a low chance of transmission of HIV to offspring. Better education about the relationship of perceived good physical health, low CD4 cell count and the risk of mother to child transmission is required. Women want to control the domain of childbearing but need enough information to make healthy choices without risking transmission. PMID:20423528

2010-01-01

202

Intestinal parasitic infections in relation to HIV\\/AIDS status, diarrhea and CD4 T-cell count  

Microsoft Academic Search

BACKGROUND: HIV infection has been modifying both the epidemiology and outcome of parasitic infections. Hence, this study was undertaken to determine the prevalence of intestinal parasitic infection among people with and without HIV infection and its association with diarrhea and CD4 T-cell count. METHODS: A cross-sectional study was conducted at Hawassa Teaching and Referral Hospital focusing on HIV positive individuals,

Shimelis Assefa; Berhanu Erko; Girmay Medhin; Zelalem Assefa; Techalew Shimelis

2009-01-01

203

IV drug users: changes in risk behaviour according to HIV status in a national survey in Spain  

Microsoft Academic Search

STUDY OBJECTIVE--To determine whether HIV positive intravenous drug users (IVDUs) who were receiving outpatient treatment for opiate and cocaine abuse or dependence used practices aimed at reducing the spread of HIV. DESIGN--Cross sectional study of behaviour and HIV serostatus in IVDUs. SETTING--A nationwide sample, from 83 health centres for outpatient treatment, stratified by autonomous regions. PARTICIPANTS--Altogether 1074 IVDUs were recruited.

M Delgado-Rodríguez; L dé lá Fuente; M J Bravo; P Lardelli; G Barrio

1994-01-01

204

One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans  

PubMed Central

The pathways through which stigma is associated with psychological distress remains understudied in Africa. This study evaluates stigma among 277 Mozambicans who were on an antiretroviral therapy (ART) regimens for a full year. Using bivariate and multiple regression analyses, we examine psychosocial factors (disclosure decisions, perceived social support, and depression) associated with stigma, at ART initiation and one year later. We found one year after initiating ART, participants reported no change in stigma, a decreased in perceived social support, and an increase in depressive symptomology. Disclosing HIV status to friends (vs. family or partner) was associated with lower levels of stigma. These findings suggest that HIV care in comparable settings should include counselling, support groups, and peer support, that includes stigma and disclosure concerns prior to and during the first year following diagnosis. Most importantly, assessment and treatment of depression should be incorporated into ongoing HIV care. PMID:19639405

Pearson, C. R.; Micek, M. A.; Pfeiffer, J.; Montoya, P.; Matediane, E.; Jonasse, T.; Cunguara, A.; Rao, D.; Gloyd, S. S.

2010-01-01

205

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

PubMed Central

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

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

2015-01-01

206

Serostatus Disclosure Among Adults with HIV in the Era of HIV Therapy  

PubMed Central

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

Small, Eusebius; Onen, Nur; Stamm, Kate; Overton, E. Turner

2012-01-01

207

Home-based HIV counseling and testing: Client experiences and perceptions in Eastern Uganda  

PubMed Central

Background Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues. Methods We conducted 395 individual interviews in Kumi district, Uganda, where teams providing HBHCT had visited 6–12 months prior to the interviews. Semi-structured questionnaires elicited information on clients’ experiences, from initial community mobilization up to receipt of results and access to HIV services post-test. Results We found that 95% of our respondents had ever tested (average for Uganda was 38%). Among those who were approached by HBHCT providers, 98% were informed of their right to decline HIV testing. Most respondents were counseled individually, but 69% of the married/cohabiting were counseled as couples. The majority of respondents (94%) were satisfied with the information given to them and the interaction with the HBHCT providers. Most respondents considered their own homes as more private than health facilities. Twelve respondents reported that they tested positive, 11 were referred for follow-up care, seven actually went for care, and only 5 knew their CD4 counts. All HIV infected individuals who were married or cohabiting had disclosed their status to their partners. Conclusion These findings show a very high uptake of HIV testing and satisfaction with HBHCT, a large proportion of married respondents tested as couples, and high disclosure rates. HBHCT can play a major role in expanding access to testing and overcoming disclosure challenges. However, access to HIV services post-test may require attention. PMID:23146071

2012-01-01

208

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

PubMed Central

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

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

2015-01-01

209

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

PubMed

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

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

2015-01-01

210

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

PubMed Central

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

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

2014-01-01

211

Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam  

PubMed Central

Introduction HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. Methods A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. Results There was little urban–rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (p<0.05). For individuals, higher education was significantly associated with lower stigma (HIV and drug related) reported by both PWID and community members. Part-time employed PWID reported more experiences and perceptions of drug-related stigma, while conversely unemployed community members reported enacting lower drug-related stigma. Multi-level analysis revealed that the relationship between education inequality and HIV-related stigma is superseded by the effect of individual-level education. Conclusions The results of the study confirm that socioeconomic factors at both the individual level and community level affect different types of stigma in different ways. Attention should be paid to these differences when planning structural or educational interventions to reduce stigma, and additional research should investigate the mechanisms with which SES and inequality affect social relationships and, in turn, stigma. PMID:24242257

Lim, Travis; Zelaya, Carla; Latkin, Carl; Quan, Vu Minh; Frangakis, Constantine; Ha, Tran Viet; Minh, Nguyen Le; Go, Vivian

2013-01-01

212

Simulating the Use of Disclosed Items in Computerized Adaptive Testing.  

ERIC Educational Resources Information Center

Explored, using simulations, the use of disclosed items on continuous testing conditions under a worse-case scenario that assumes that disclosed items are always answered correctly. Some item pool and test designs were identified in which the use of disclosed items produces effects on test scores that may be viewed as negligible. (Author/MAK)

Stocking, Martha L.; Ward, William C.; Potenza, Maria T.

1998-01-01

213

Embryo research: is disclosing commercial intent enough?  

PubMed

This article critically reviews legislative and ethical frameworks that regulate embryo research. Australian legislation for embryo research is currently being reviewed. It is a legal mandate that scientists disclose to embryo donors any intent to pursue commercial gain from altruistic donation. But scientists are also required to inform donors that, as donors, they too must not benefit financially. In the same political context, public subsidy for IVF treatment is under review. There is contradiction in values and indication of inequity in the Australian social context. IVF is undervalued, yet products derived from IVF embryos are imbued with public hope. Rather than regulate to balance this inequity, assumptions of altruism and attention to autonomy in legislative framework give it further scope. This article proposes that justice be addressed by acknowledging reproductive effort, and thereby embryo research be considered in terms of reciprocity. It further proposes regulation of commercial profit and the imposition of a redirected tax levy. PMID:16571639

de Lacey, Sheryl

2006-07-01

214

"I have grown up controlling myself a lot." Fear and misconceptions about sex among adolescents vertically-infected with HIV in Tanzania.  

PubMed

With increased access to HIV treatment throughout Africa, a generation of HIV positive children is now transitioning to adulthood while living with a chronic condition requiring lifelong medication, which can amplify the anxieties of adolescence. This qualitative study explored how adolescents in Tanzania with HIV experience their nascent sexuality, as part of an evaluation of a home-based care programme. We interviewed 14 adolescents aged 15-19 who had acquired HIV perinatally, 10 of their parents or other primary caregivers, and 12 volunteer home-based care providers who provided support, practical advice, and referrals to clinical services. Adolescents expressed unease about their sexuality, fearing that sex and relationships were inappropriate and hazardous, given their HIV status. They worried about having to disclose their status to partners, the risks of infecting others and for their own health. Thus, many anticipated postponing or avoiding sex indefinitely. Caregivers and home-based care providers reinforced negative views of sexual activity, partly due to prevailing misconceptions about the harmful effects of sex with HIV. The adolescents had restricted access to accurate information, appropriate guidance, or comprehensive reproductive health services and were likely to experience significant unmet need as they initiated sexual relationships. Care programmes could help to reduce this gap by facilitating open communication about sexuality between adolescents and their caregivers, providers, and HIV-positive peers. PMID:23684191

Busza, Joanna; Besana, Giulia V R; Mapunda, Pasiens; Oliveras, Elizabeth

2013-05-01

215

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

PubMed

[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

1995-12-01

216

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

PubMed Central

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

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

217

"Don't tell him you have HIV unless he's 'the one'": romantic relationships among adolescents and young adults with perinatal HIV infection.  

PubMed

Individuals with perinatally-acquired HIV (PHIV) are surviving into young adulthood. Previous literature has explored the sexual behavior of those with PHIV. However, their perspectives on navigating romantic relationships are not well understood. Semi-structured interviews were conducted with 35 young adults living with PHIV recruited from two pediatric infectious disease clinics in the southeast United States. The majority of participants were African American (n=27, 77.2%), female (n=23, 65.7%), and the mean age was 20.7 (range 15-30) years. Questions focused on experiences with dating and romantic relationships as well as relationship advice for others living with HIV. Transcribed interviews were coded for emergent themes. Qualitative analyses revealed that the majority of participants have dated and struggled with their HIV status in their intimate relationships. The majority of those who disclosed their HIV status to past partners had experienced some form of rejection. However, several participants reported receiving support upon disclosure. Some individuals had never disclosed to a romantic partner, but carefully managed intimacy by delaying dating, terminating relationships, and "taking it slow." Advice fell into two broad categories: "be safe" which referred to the physical protection of self and partners, as well as emotional protection from possible rejection. The second advice category was basic encouragement which stressed the importance for young adults living with HIV to have hope that they would find a supportive partner and to be patient. The focus of education must include not only transmission risk factors, but also developing and maintaining healthy relationships in the context of a highly stigmatized illness. PMID:23199192

Fair, Cynthia; Albright, Jamie

2012-12-01

218

Disclosure amongst adult HIV patients on antiretroviral therapy in Port Harcourt, Nigeria.  

PubMed

HIV transmission is still a public health concern in sub-Saharan Africa; disclosure is an effective tool for its prevention, contact tracing and treatment. We aimed to evaluate the disclosure-behaviours of adult HIV-positive patients receiving HAART in University of Port Harcourt Teaching Hospital, identify major challenges to disclosure in a bid to develop ways to improve this practice in the environment. Patients receiving HAART in this centre were interviewed using an interviewer-administered questionnaire. A total of 250 clients were interviewed over three months following informed consent. Majority of the patients were tested on account of ill health 143 (57.2%). They commenced the HAART within 8?±?15.4 SD months of presentation. The mean period before disclosure was 4.75?±?12.8 SD months of diagnosis. Thirty-six (14.4%) of the respondents had not disclosed their HIV status; the major barrier to disclosure was stigmatisation in 19 (36%). Disclosure of HIV status is imperative in HIV prevention. PMID:25249594

Omunakwe, Hannah E; Okoye, Helen; Efobi, Chilota; Onodingene, Maryanne; Chinenye, Sunny; Nwauche, Chijioke A

2014-09-22

219

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

PubMed

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

Sacks, Rachel; Emerson, Carol

2014-04-01

220

Evaluation of the nutritional status of infants from mothers tested positive to HIV/AIDS in the health district of Dschang, Cameroon  

PubMed Central

Introduction Poor infant feeding practices are common in Africa, resulting in physical and intellectual developmental impairments. Good feeding practices are crucial, especially in the first year of growth. HIV/AIDS has worsened the clinical and nutritional status of both mothers and their children, exacerbating high rates of malnutrition. The aim of this study was to assess by participative approach, the nutritional status of infants from mothers tested positive to HIV in the health district of Dschang. Methods This is a cross sectional study with a period of recruitment of 2 years (2010-2012). Data Collection was done by the aim of a personal slip followed by training to strengthen the nutritional and hygienic capacity of targeted parents. Height and weight of infants were measured and body mass index (BMI) calculated. Results Significant difference (p ? 0.05) was noticed in height-for-age z-score (HAZ) of girls aged between 1 to 2 years compared to 1-year old girls as well as to boys of all ages, defining them as stunted. Furthermore, the weight-for-age z-score (WAZ) results indicate that both girls and boys of all age are in moderate state of malnutrition. The results of BMI thinness classified according to gender and age groups, indicates that most infants (68/130, 52.3%) showed grade 2 thinness predominantly in 2-years old both boys and girls. However, no participants fall within the normal category for age and sex, as well as overweight and obesity categories. Conclusion Undernutrition exists among infants from mothers tested positive to HIV residing in Dschang, as most of the infants are underweight, and malnourished. PMID:25400858

Sobze, Martin Sanou; Wadoum, Raoul Guetiya; Temgoua, Edith; Donfack, Jean-Hubert; Ercoli, Lucia; Buonomo, Ersilia; Fokam, Joseph; Dongho, Bruna Djeunang; Onohiol, James-Francis; Zefack, Yannick; Zambou, François Ngoufack; Cresci, Alberto; Russo, Gianluca; Colizzi, Vittorio

2014-01-01

221

Disclose or not disclose: determinants of social reporting for STOXX Europe 600 firms  

Microsoft Academic Search

Building on prior literature, determinants of disclosing a social report are examined. As such, reports prepared with the\\u000a help of the guidelines developed by the Global Reporting Initiative (GRI) are used in this paper. The sample consists of STOXX\\u000a Europe 600 firms. Thus, we are able to analyse country specific effects based on a broad sample of companies. The analysis

Carsten Albers; Thomas Günther

2010-01-01

222

Japan discloses 16,520 "eugenic" sterilizations.  

PubMed

In Japan, the government has reported that the Eugenic Protection Law led to sterilization of 16,520 people from 1949 to 1994. The Eugenic Protection Law was replaced in 1996 with a Maternal Protection Law. Both laws provide legal loopholes that allow women to have abortions despite the 1907 Criminal Abortion Law. The disclosure was sparked when Sweden announced that approximately 60,000 of its people were sterilized between 1935 and 1976 for eugenic reasons. It was then disclosed that Denmark had sterilized approximately 11,000 people from 1929 to 1967, Finland sterilized 11,000 people and performed 4000 involuntary abortions from 1945 to 1970, and Norway had 2000 sterilizations. A consortium of 17 Japanese groups and individuals representing women and the disabled requested that the Japanese Minister of Health and Welfare issue an apology and provide compensation to victims of coercive sterilization. The group is calling for research into coercive sterilizations to be conducted in ways that respect the privacy of the victims. The government response has been that no apologies or compensation would be forthcoming because the sterilizations were legal under existing law and (it claims) were not coercive. PMID:12321235

1997-11-01

223

Murders and HIV.  

PubMed

Investigators have dismissed the previously reported HIV diagnosis links in two prominent homicide cases. Serial murderer [name removed], who shot renowned fashion designer Gianni Versace and four other men, was thought to have killed out of rage because his own life was doomed by HIV. Tests conducted during [name removed]'s autopsy revealed that he was not HIV-positive. [Name removed], who was HIV-positive, had unprotected sex with more than 100 women and girls and did not inform them of his HIV-status. [Name removed] infected at least 30 women with HIV through unprotected sex. When [name removed] was found murdered in St. Louis, MO, police suspected that the motive was revenge for intentional HIV transmission. It was later determined that [name removed] was the victim of a street robbery. PMID:11364597

1997-08-22

224

HIV-disclosure in the context of vertical transmission: HIV-positive mothers in Johannesburg, South Africa.  

PubMed

HIV-disclosure among childbearing women remains poorly understood, particularly in sub-Saharan Africa. This paper chronicles disclosure experiences of 31 women attending prevention of mother-to-child HIV transmission services in Johannesburg. Data collection entailed repeat in-depth interviews over a nine-month period. Virtually all women (93.5%) had told at least one person (usually a partner), most voluntarily and within a week of the test result. Secondary disclosure was most likely with female family members, through indirect means and involuntary. Confidentiality breach by primary targets likely contributed to the observed high rates of involuntary secondary disclosure and negative secondary disclosure experiences. For most mothers, voluntary disclosure was driven by the desire to ensure adequate infant care and avoid vertical HIV transmission. The impact of disclosure was not always clear-cut. While most primary disclosure experiences were ultimately constructive, secondary disclosure more likely led to rejection, stigmatization and the withholding of financial support. Our data illustrate the influence of social contextual factors on disclosure patterns and impact. For these mothers, socio-cultural norms, the current media and political environment surrounding HIV/AIDS, household composition and social networks and childbearing status shaped disclosure experiences; sometimes constraining disclosure circumstances and sometimes creating a safe space to disclose. Programmatic implications are also discussed. PMID:17012085

Varga, C A; Sherman, G G; Jones, S A

2006-11-01

225

Sexual Behaviors of Non-gay Identified Non-disclosing Men Who Have Sex with Men and Women  

Microsoft Academic Search

The sexual behaviors of non-gay identified men who have sex with men and women (MSMW) who do not disclose their same-sex behavior\\u000a to their female partners (referred to by some as men “on the down low”) were examined, including the potential for these men\\u000a to serve as a “bisexual bridge” for HIV and STD acquisition and transmission. Self-reported sexual behavior

Karolynn Siegel; Eric W. Schrimshaw; Helen-Maria Lekas; Jeffrey T. Parsons

2008-01-01

226

Residential Status as a Risk Factor for Drug Use and HIV Risk Among Young Men Who Have Sex with Men  

PubMed Central

There is growing behavioral and epidemiological evidence to suggest that young men who have sex with men (YMSM) are at high risk for becoming HIV-infected. Unfortunately, relatively little research has been conducted to examine the range of individual, social, and community-level factors that put these young men at increased risk. To address existing gaps in the literature, the Healthy Young Men’s (HYM) Study was launched in Los Angeles to examine the range of factors associated with HIV risk and protective behaviors within an ethnically diverse sample of 526 YMSM recruited using a venue-based stratified probability sampling design. In this paper we present findings that demonstrate that YMSM who experience residential instability, who have been forced to leave their home because of their sexuality, and/or who are precariously housed are at significantly greater risk for drug use and involvement in HIV risk-related behaviors. PMID:17265143

Kipke, Michele D.; Weiss, George; Wong, Carolyn F.

2010-01-01

227

Disclosing the origin and diversity of Omani cattle.  

PubMed

Among all livestock species, cattle have a prominent status as they have contributed greatly to the economy, nutrition and culture from the beginning of farming societies until the present time. The origins and diversity of local cattle breeds have been widely assessed. However, there are still some regions for which very little of their local genetic resources is known. The present work aimed to estimate the genetic diversity and the origins of Omani cattle. Located in the south-eastern corner of the Arabian Peninsula, close to the Near East, East Africa and the Indian subcontinent, the Sultanate of Oman occupies a key position, which may enable understanding cattle dispersal around the Indian Ocean. To disclose the origin of this cattle population, we used a set of 11 polymorphic microsatellites and 113 samples representing the European, African and Indian ancestry to compare with cattle from Oman. This study found a very heterogenic population with a markedly Bos indicus ancestry and with some degree of admixture with Bos taurus of African and Near East origin. PMID:22957920

Mahgoub, Osman; Babiker, Hamza A; Kadim, I T; Al-Kindi, Mohammed; Hassan, Salwa; Al-Marzooqi, W; Eltahir, Yasmin E; Al-Abri, M A; Al-Khayat, Aisha; Al-Sinani, Kareema R; Hilal Al-Khanjari, Homoud; Costa, Vânia; Chen, Shanyuan; Beja-Pereira, Albano

2013-06-01

228

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

PubMed

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

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

2015-01-01

229

HIV-related stigma and physical symptoms have a persistent influence on health-related quality of life in Australians with HIV infection  

PubMed Central

Background The health-related quality of life (HRQL) of people living with HIV infection is an important consideration in HIV management. The PROQOL-HIV psychometric instrument was recently developed internationally as a contemporary, discriminating HIV-HRQL measure incorporating influential emotional dimensions such as stigma. Here we present the first within-country results of PROQOL-HIV using qualitative and quantitative data collected from a West Australian cohort who participated in the development and validation of PROQOL-HIV, and provide a comprehensive picture of HRQL in our setting. Methods We carried out a secondary analysis of data from Australian patients who participated in the international study: 15 in-depth interviews were conducted and 102 HRQL surveys using the PROQOL-HIV instrument and a symptom questionnaire were administered. We employed qualitative methods to extract description from the interview data and linear regression for exploration of the composite and sub-scale scores derived from the survey. Results Interviews revealed the long-standing difficulties of living with HIV, particularly in the domains of intimate relationships, perceived stigma, and chronic ill health. The novel PROQOL-HIV instrument discriminated impact of treatment via symptomatology, pill burden and treatment duration. Patients demonstrated lower HRQL if they were: newly diagnosed (p=0.001); naive to anti-retroviral treatment (p=0.009); reporting depression, unemployment or a high frequency of adverse symptoms, (all p<0.001). Total HRQL was notably reduced by perceived stigma with a third of surveyed patients reporting persistent fears of both disclosing their HIV status and infecting others. Conclusions The analysis showed that psychological distress was a major influence on HRQL in our cohort. This was compounded in people with poor physical health which in turn was associated with unemployment and depression. People with HIV infection are living longer and residual side effects of the earlier regimens complicate current clinical management and affect their quality of life. However, even for the newly diagnosed exposed to less toxic regimens, HIV-related stigma exerts negative social and psychological effects. It is evident that context-specific interventions are required to address persistent distress related to stigma, reframe personal and public perceptions of HIV infection and ameliorate its disabling social and psychological effects. PMID:23566318

2013-01-01

230

Recurrent major depressive disorder among human immunodeficiency virus (HIV)-positive and HIV-negative intravenous drug users: Findings of a 3-year longitudinal study  

Microsoft Academic Search

A longitudinal study was conducted to investigate the association between human immunodeficiency virus (HIV) infection, history of major depressive disorder (MDD), and persistent or recurrent MDD among intravenous drug users. Psychiatric disorders were assessed in a sample of HIV-positive (HIV+) and HIV-negative (HIV?) intravenous drug users every 6 months for 3 years. Results indicated that HIV status and baseline MDD

Jeffrey G Johnson; Judith G Rabkin; Joshua D Lipsitz; Janet B. W Williams; Robert H Remien

1999-01-01

231

HIV UPDATE: AGING & HIV  

E-print Network

HIV UPDATE: AGING & HIV SEPTEMBER 2012, Issue 9 Tlaleletso is a monthly publication produced-friendly format. This month's Taleletso provides an introduction to the topic of HIV and Aging. For a more is an invaluable resource for doctors managing HIV patients. Next month Tlaleletso will discuss the Management

Bushman, Frederic

232

HIV UPDATE: BOTSWANA HIV  

E-print Network

HIV UPDATE: BOTSWANA HIV CONFERENCE OCTOBER 2012, Issue 10 Tlaleletso is a monthly publication presentations from the Botswana HIV conference, which was held in Gaborone from September 19th to 22nd, 2012. Next month's Tlaleletso will discuss HIV and Cancer. If there are other topics you would like

Bushman, Frederic

233

The association of HIV\\/AIDS treatment side effects with health status, work productivity, and resource use  

Microsoft Academic Search

Due to stable incidence and improved survival rates, there are an increasing number of patients living with HIV\\/AIDS in the USA. Although highly effective, current antiretroviral therapies are associated with a variety of side effects. The role side effects play on health outcomes has not been fully examined. The current study assessed the association of medication side effects with (1)

Marco daCosta DiBonaventura; Shaloo Gupta; Michelle Cho; Joseph Mrus

2012-01-01

234

Analysis of HIV Early Infant Diagnosis Data to Estimate Rates of Perinatal HIV Transmission in Zambia  

PubMed Central

Background Mother-to-child transmission of HIV (MTCT) remains the most prevalent source of pediatric HIV infection. Most PMTCT (prevention of mother-to-child transmission of HIV) programs have concentrated monitoring and evaluation efforts on process rather than on outcome indicators. In this paper, we review service data from 28,320 children born to HIV-positive mothers to estimate MTCT rates. Method This study analyzed DNA PCR results and PMTCT data from perinatally exposed children zero to 12 months of age from five Zambian provinces between September 2007 and July 2010. Results The majority of children (58.6%) had a PCR test conducted between age six weeks and six months. Exclusive breastfeeding (56.8%) was the most frequent feeding method. An estimated 45.9% of mothers were below 30 years old and 93.3% had disclosed their HIV status. In terms of ARV regimen for PMTCT, 32.7% received AZT+single dose NVP (sdNVP), 30.9% received highly active antiretroviral treatment (HAART), 19.6% received sdNVP only and 12.9% received no ARVs. Transmission rates at six weeks when ARVs were received by both mother and baby, mother only, baby only, and none were 5.8%, 10.5%, 15.8% and 21.8% respectively. Transmission rates at six weeks where mother received HAART, AZT+sd NVP, sdNVP, and no intervention were 4.2%, 6.8%, 8.7% and 20.1% respectively. Based on adjusted analysis including ARV exposures and non ARV-related parameters, lower rates of positive PCR results were associated with 1) both mother and infant receiving prophylaxis, 2) children never breastfed and 3) mother being 30 years old or greater. Overall between September 2007 and July 2010, 12.2% of PCR results were HIV positive. Between September 2007 and January 2009, then between February 2009 and July 2010, proportions of positive PCR results were 15.1% and 11% respectively, a significant difference. Conclusion The use of ARV drugs reduces vertical transmission of HIV in a program setting. Non-chemoprophylactic factors also play a significant role in HIV transmission. The overall change in the proportions of positive PCR results over time is more likely an indication of better PMTCT implementation. Determination of the outcomes of PMTCT in program settings is feasible but requires accurate documentation and analysis. PMID:22912752

Torpey, Kwasi; Mandala, Justin; Kasonde, Prisca; Bryan-Mofya, Gail; Bweupe, Maximillian; Mukundu, Jonathan; Zimba, Chilunje; Mwale, Catherine; Lumano, Hilary; Welsh, Michael

2012-01-01

235

Stigma is Associated with Delays in Seeking Care Among HIV-Infected People in India  

PubMed Central

Background Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others. Purpose To examine whether four stigma manifestations—enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma’s prevalence) and internalized (personal endorsement of stigma beliefs)—were linked with delays in seeking care among HIV-infected people in India. Methods A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru. Results Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV-positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care seeking delays. Conclusions It is vital to develop stigma reduction interventions to ensure timely receipt of care. PMID:22282878

Steward, Wayne T.; Bharat, Shalini; Ramakrishna, Jayashree; Heylen, Elsa; Ekstrand, Maria L.

2012-01-01

236

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

PubMed

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

Echeverria, Patricia; Guardiola, Montse; González, Marta; Vallvé, Joan Carles; Bonjoch, Anna; Puig, Jordi; Clotet, Bonaventura; Ribalta, Josep; Negredo, Eugènia

2015-02-01

237

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

PubMed

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

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

2014-09-17

238

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

PubMed Central

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

Roberts, J Scott; Tersegno, Sarah M

2010-01-01

239

Streamlining HIV testing for HIV preexposure prophylaxis.  

PubMed

HIV-testing algorithms for preexposure prophylaxis (PrEP) should be optimized to minimize the risk of drug resistance, the time off PrEP required to evaluate false-positive screening results, and costs and to expedite the start of therapy for those confirmed to be infected. HIV rapid tests (RTs) for anti-HIV antibodies provide results in less than 1 h and can be conducted by nonlicensed staff at the point of care. In many regions, Western blot (WB) testing is required to confirm reactive RT results. WB testing, however, causes delays in diagnosis and adds expense. The iPrEx study evaluated the safety and efficacy of daily oral emtricitabine-tenofovir disoproxil fumarate among HIV-seronegative men and transgender women who have sex with men: HIV infection was assessed with two RTs plus WB confirmation, followed by HIV-1 plasma viral load testing. During the iPrEx study, there were 51,260 HIV status evaluations among 2,499 volunteers using RTs: 142 (0.28%) had concordant positive results (100% were eventually confirmed) and 19 (0.04%) had discordant results among 14 participants; 11 were eventually determined to be HIV infected. A streamlined approach using only one RT to screen and a second RT to confirm (without WB) would have had nearly the same accuracy. Discrepant RT results are best evaluated with nucleic acid testing, which would also increase sensitivity. PMID:25378570

Guanira, Juan V; Leigler, Teri; Kallas, Esper; Schechter, Mauro; Sharma, Usha; Glidden, David; Grant, Robert M

2015-01-01

240

22 CFR 1304.6 - Records not disclosed.  

Code of Federal Regulations, 2010 CFR

...Except as otherwise provided in this part, MCC shall not disclose records that are: ...Executive order. (2) Related solely to the MCC's internal personnel rules and practices...other than an agency in litigation with MCC. (6) Personnel, medical, or...

2010-04-01

241

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

PubMed Central

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

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

2012-01-01

242

Factors correlated with disclosure of HIV infection in the French Antilles and French Guiana: results from the ANRS-EN13-VESPA-DFA Study  

PubMed Central

OBJECTIVES To determine the rate, patterns and predictors of HIV disclosure in a predominantly heterosexual population in the Caribbean region. METHODS A cross-sectional survey was carried out among a 15% random sample (n= 398) of the hospital caseload in all 9 hospitals providing HIV care in French Antilles and French Guiana. Information was obtained from a face-to-face questionnaire and from medical records. Determinants of disclosure to 1) steady partner and 2) other members of the social network were analysed using logistic regression. RESULTS From the time of diagnosis, 84.6% of those in a couple (n=173) disclosed their HIV+ status to their steady partner/spouse, 55.6% disclosed to other close relatives and friends and 30.3% did not tell their status to anyone. Disclosure within steady partnership was less likely among non-French individuals (Haitians: aOR 0.11 [95%CI 0.02–0.72], other nationalities: aOR 0.13 [0.02–0.68]), and among patients diagnosed since 1997 (aOR 0.21 [0.05–0.86]). Determinants of disclosure to the family, friend or religious network were found to be gender (women: aOR 2.04 [1.24–3.36]), age at diagnosis (>=50 years vs <30 years: aOR 0.42 [0.19–0.90]), nationality (Haitians vs French: aOR 0.39 [0.19–0.77]), transmission route (non-sexual vs sexual: aOR 3.38 [1.12–10.23]) and hospital inpatients (hospitalised vs non-hospitalised patients: aOR 1.98 [1.17–3.37]). A marginally significant association was found between eduction and disclosure: less educated people disclosed less often both to steady partner and to their social network. After disclosing, most persons living with HIV/AIDS received social and emotional support from their confidants. Discriminatory attitudes were infrequent. CONCLUSIONS In this study, almost one third of persons living with HIV/AIDS had not told anyone that they were HIV positive. Interventions targeting the general population and social institutions, and support of PLWHA by healthcare staff are needed to improve the situation. PMID:17159594

Bouillon, Kim; Lert, France; Sitta, Rémi; Schmaus, Annie; Spire, Bruno; Dray-Spira, Rosemary

2007-01-01

243

Hepatitis B virus and hepatitis C virus infection among HIV-1-infected injection drug users in Dali, China: prevalence and infection status in a cross-sectional study.  

PubMed

To assess the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and to investigate their mutual influences on infection status among human immunodeficiency virus type 1 (HIV-1)-seropositive injection drug users (IDUs). A cross-sectional study was conducted among HIV infected IDUs in Dali, China. The participants were tested for serological markers of HBV and HCV infection, alanine transaminase (ALT) activity and CD4(+) T cell count. HCV genotype was determined by sequencing. Of 529 patients, 498 (94.1 %) HIV infected IDUs agreed to participate. The overall prevalence of HCV infection (anti-HCV antibody positive) and spontaneous HCV clearance were 90.8 % (452/498) and 21.5 % (97/452), respectively. Of 411 subjects who had not received HBV vaccine, 296 (72.0 %) were positive for antibody against HBV core antigen (HBcAb), while 274 (66.7 %) were positive for both HCV antibody and HBcAb. HBV antigens were detected in 52 of the HBV-infected subjects (17.6 %). HCV clearance was associated with HBV antigenemia (p = 0.0002) and higher CD4(+) T cell count (p = 0.0294). Resolved HBV infection was associated with HCV genotype 3 (p = 0.0365). HBV and HCV infection are highly prevalent and mutually influence infection status in HIV-1 infected IDUs in Dali, China. PMID:25616842

Dong, Yuan; Qiu, Chao; Xia, Xueshan; Wang, Jing; Zhang, Haiyan; Zhang, Xiaoyan; Xu, Jianqing

2015-04-01

244

Cochlear Function among HIV-Seropositive and HIV-Seronegative Men and Women  

PubMed Central

Objectives There is limited research about cochlear function in adults who are human immunodeficiency virus (HIV) positive (+). The aim of the present study was to collect measures of cochlear function in a large sample of adults with, or at risk for, HIV infection, to evaluate associations between HIV status, HIV treatment, and cochlear function. Design Distortion product otoacoustic emissions (DPOAEs) were used to evaluate cochlear function in 506 participants; 329 men, 150 of whom were HIV+, and 177 women, 136 of whom were HIV+. DPOAEs were measured at frequencies 1000, 2000, 3000, 4000, and 6000 Hz. A DPOAE nonresponse (NR) was defined as an absolute DPOAE level less than ?15 dB SPL or a difference between the absolute DPOAE level and the background noise level less than 6 dB. The total number of NRs was calculated for each ear. The associations of demographic variables, HIV status, and HIV treatment with number of NRs were evaluated with univariate and multivariate ordinal regression models. Results There was a statistically significant increase in the odds of higher numbers of NRs with age, being male, and being non-Black, but not with HIV status. Among HIV+ participants, there were no statistically significant associations of the HIV disease status or treatment variables with higher number of NRs. Conclusion The authors found no evidence of impaired cochlear function by HIV disease status or highly active antiretroviral therapy–treated HIV infection in this cross-sectional study. PMID:24080949

Torre, Peter; Hoffman, Howard J.; Springer, Gayle; Cox, Christopher; Young, Mary; Margolick, Joseph B.; Plankey, Michael

2013-01-01

245

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

PubMed Central

Objective To report on risk factors for severe events (hospitalisation or infant death) within the first half of infancy amongst HIV-unexposed infants in South Africa. Methods South African data from the multisite community-based cluster-randomised trial PROMISE EBF promoting exclusive breastfeeding in three sub-Saharan countries from 2006 to 2008 were used. The South African sites were Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal. This analysis included 964 HIV-negative mother–infant pairs. Data on severe events and infant feeding practices were collected at 3, 6, 12 and 24 weeks post-partum. We used a stratified extended Cox model to examine the association between the time to the severe event and covariates including birthweight, with breastfeeding status as a time-dependent covariate. Results Seventy infants (7%) experienced a severe event. The median age at first hospitalisation was 8 weeks, and the two main reasons for hospitalisation were cough and difficult breathing followed by diarrhoea. Stopping breastfeeding before 6 months (HR 2.4; 95% CI 1.2–5.1) and low birthweight (HR 2.4; 95% CI 1.3–4.3) were found to increase the risk of a severe event, whilst maternal completion of high school education was protective (HR 0.3; 95% CI 0.1–0.7). Conclusions A strengthened primary healthcare system incorporating promotion of breastfeeding and appropriate caring practices for low birthweight infants (such as kangaroo mother care) are critical. Given the leading reasons for hospitalisation, early administration of oral rehydration therapy and treatment of suspected pneumonia are key interventions needed to prevent hospitalisation in young infants. PMID:25053420

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

2014-01-01

246

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

PubMed

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

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

2014-10-01

247

Correlates of risk patterns and race/ethnicity among HIV-positive men who have sex with men.  

PubMed

Behaviors related to HIV infection vary by race, with African American and Latino men who have sex with men (MSM) more likely to report sex with women than are European-American MSM. The epidemic among African Americans, in particular, is growing rapidly among both men and women. Some have hypothesized that bisexually active men may be contributing to the epidemic among women. However, little is known about risk patterns among men of different races who are already infected. In this study of 456 HIV-seropositive MSM we found that, like HIV-negative MSM, African American MSM who are HIV-positive were less likely than European American men to identify as gay, more likely to report sex with women, and less comfortable discussing their MSM behavior with close friends and acquaintances. African American participants also exhibited higher levels of internalized homophobia, as well as lower self-efficacy for disclosing their HIV status to sex partners. Implications for interventions for this population are discussed. PMID:17295071

O'Leary, Ann; Fisher, Holly H; Purcell, David W; Spikes, Pilgrim S; Gomez, Cynthia A

2007-09-01

248

HIV-testing behavior and associated factors among MSM in Chongqing, China: results of 2 consecutive cross-sectional surveys from 2009 to 2010.  

PubMed

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

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

2014-12-01

249

HIV charge dropped.  

PubMed

Guilford County Superior Court Judge James Webb ruled there was not enough evidence to convict HIV-positive [name removed] on charges of attempted murder and assault with a deadly weapon in connection with the rape of a 12-year-old girl. Prosecutors argued [name removed] knew he was HIV-positive when the rape occurred and defense attorney Randy Jones argued that there was no medical proof of [name removed]'s HIV status at the time of the attack. The judge dismissed the two charges against [name removed]. A jury later convicted [name removed] of statutory rape and taking indecent liberties with a minor. PMID:11364510

1997-07-25

250

HIV/AIDS Surveillance Report  

NSDL National Science Digital Library

The Centers for Disease Control and Prevention (CDC) have been releasing data on US AIDS and HIV cases since 1982. This semi-annual report provides tables and graphics for by state, metropolitan area, mode of exposure to HIV, gender, race/ ethnicity, age group, vital status, and more.

251

HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection.  

PubMed

Selecting sex partners of the same HIV status or serosorting is a sexual risk reduction strategy used by many men who have sex with men. However, the effectiveness of serosorting for protection against HIV is potentially limited. We sought to examine how men perceive the protective benefits of factors related to serosorting including beliefs about engaging in serosorting, sexual communication, and perceptions of risk for HIV. Participants were 94 HIV negative seroconcordant (same HIV status) couples, 20 HIV serodiscordant (discrepant HIV status) couples, and 13 HIV positive seroconcordant (same HIV status) couples recruited from a large gay pride festival in the southeastern US. To account for nonindependence found in the couple-level data, we used multilevel modeling which includes dyad in the analysis. Findings demonstrated that participants in seroconcordant relationships were more likely to believe that serosorting reduces concerns for condom use. HIV negative participants in seroconcordant relationships viewed themselves at relatively low risk for HIV transmission even though monogamy within relationships and HIV testing were infrequent. Dyadic analyses demonstrated that partners have a substantial effect on an individual's beliefs and number of unprotected sex partners. We conclude that relationship partners are an important source of influence and, thus, intervening with partners is necessary to reduce HIV transmission risks. PMID:18953645

Eaton, Lisa A; West, Tessa V; Kenny, David A; Kalichman, Seth C

2009-04-01

252

"HIV isn't me…": HIV+ adolescents' experiences in a positive context of support and treatment.  

PubMed

We describe the experiences of a sample of Canadian HIV+ youth whose intact adolescent identities contrast sharply with the expected identity challenges of persons living with a serious, chronic disease. We first showcase the positive HIV+ identities emerging from the successful management of HIV+ status through long-term HIV-related medical care and established pharmaceutical regimes. Second, we describe the medical, familial, and broader social context of support in which these adolescents' are negotiating HIV. Finally, we highlight the youth's expectations of future, specific identity and role challenges regarding intimacy and sexuality-related to disclosure of their private HIV+ identities and their embodied HIV+ status. Continued social and medical supports will be key to their emergence into adulthood as healthy HIV+ persons; with such supports, these youths' experiences highlight the capacity for living optimally with HIV. PMID:21390880

Di Risio, Michelle; Ballantyne, Peri J; Read, Stanley E; Bendayan, Reina

2011-06-01

253

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

PubMed Central

Introduction Children living with HIV experience particular challenges in accessing HIV care. Children usually rely on adult caregivers for access to care, including timely diagnosis, initiation of treatment and sustained engagement with HIV services. The aim of this study was to inform the design of a community-based intervention to support caregivers of HIV-positive children to increase children's retention in care as part of a programme introducing decentralized HIV care in primary health facilities. Methods Using an existing conceptual framework, we conducted formative research to identify key local contextual factors affecting children's linkages to HIV care in Harare, Zimbabwe. We conducted semi-structured interviews with 15 primary caregivers of HIV-positive children aged 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

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

2014-01-01

254

Assessing Targeted Screening and Low Rates of HIV Testing  

PubMed Central

Objectives. We assessed rates of HIV testing based on targeting patients with identified risk factors at the Veterans Affairs Medical Center in Washington, DC (VAMC-DC), where written informed consent along with pretest and posttest counseling had, until recently, been required by federal law. Methods. A cumulative retrospective review of the period 2000 through 2007 was conducted to assess the number of patients who were provided medical care at VAMC-DC, tested for HIV, and underwent confirmatory testing. Data on demographic characteristics and risks for HIV acquisition were also collected. Results. At VAMC-DC, 3.8% to 4.9% (mean = 4.25%) of patients in care without known HIV infection underwent HIV screening annually. On average, HIV was confirmed at a yearly rate of 3.4% among those tested. During the study period, HIV prevalence ranged from 2.1% to 2.5%. Among patients receiving HIV care, 41.5% disclosed no risk factors for HIV acquisition. Conclusions. Given that the HIV prevalence observed in this study was above 2% and that 41.5% of patients in care did not disclose any acquisition risks, targeted HIV screening has not been sufficient. HIV testing must be broadened and offered as part of routine medical care. PMID:20634454

Kennedy, Leigh A.; Gordin, Fred M.

2010-01-01

255

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

Code of Federal Regulations, 2010 CFR

...2010-07-01 false Disclosing the medical records of minors. 806b.48 Section... § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their...

2010-07-01

256

34 CFR 99.37 - What conditions apply to disclosing directory information?  

Code of Federal Regulations, 2010 CFR

...What conditions apply to disclosing directory information? 99.37 Section...What conditions apply to disclosing directory information? (a) An educational agency or institution may disclose directory information if it has given...

2010-07-01

257

34 CFR 99.37 - What conditions apply to disclosing directory information?  

Code of Federal Regulations, 2012 CFR

...What conditions apply to disclosing directory information? 99.37 Section...What conditions apply to disclosing directory information? (a) An educational agency or institution may disclose directory information if it has given...

2012-07-01

258

34 CFR 99.37 - What conditions apply to disclosing directory information?  

Code of Federal Regulations, 2011 CFR

...What conditions apply to disclosing directory information? 99.37 Section...What conditions apply to disclosing directory information? (a) An educational agency or institution may disclose directory information if it has given...

2011-07-01

259

34 CFR 99.37 - What conditions apply to disclosing directory information?  

Code of Federal Regulations, 2014 CFR

...What conditions apply to disclosing directory information? 99.37 Section...What conditions apply to disclosing directory information? (a) An educational agency or institution may disclose directory information if it has given...

2014-07-01

260

34 CFR 99.37 - What conditions apply to disclosing directory information?  

Code of Federal Regulations, 2013 CFR

...What conditions apply to disclosing directory information? 99.37 Section...What conditions apply to disclosing directory information? (a) An educational agency or institution may disclose directory information if it has given...

2013-07-01

261

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

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Disclosing the medical records of minors. 806b.48 Section... § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their...

2013-07-01

262

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

Code of Federal Regulations, 2012 CFR

...2012-07-01 false Disclosing the medical records of minors. 806b.48 Section... § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their...

2012-07-01

263

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

PubMed

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

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

2015-01-01

264

Why HIV positive patients on antiretroviral treatment and/or cotrimoxazole prophylaxis use traditional medicine: perceptions of health workers, traditional healers and patients: a study in two provinces of South Africa.  

PubMed

The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%'respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions -one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient's rationale for THP use. This study revealed a need to better understand factors involved in patients' choosing to use THP concurrently with ART. PMID:23983385

Puoane, T R; Hughes, G D; Uwimana, J; Johnson, Q; Folk, W R

2012-01-01

265

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 ...

266

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

PubMed

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

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

2015-04-01

267

Intimate partner sexual and physical violence among women in Togo, West Africa: Prevalence, associated factors, and the specific role of HIV infection  

PubMed Central

Background A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence. Methods A cross-sectional survey was conducted between May and July 2011 within Sylvanus Olympio University Hospital in Lomé. HIV-infected women attending HIV care and uninfected women attending postnatal care and/or children immunization visits were interviewed. Intimate partner physical and sexual violence and controlling behaviors were assessed using an adapted version of the WHO Multi-country study on Women’s Health and Life Events questionnaire. Results Overall, 150 HIV-uninfected and 304 HIV-infected women accepted to be interviewed. The prevalence rates of lifetime physical and sexual violence among HIV-infected women were significantly higher than among uninfected women (63.1 vs. 39.3%, p<0.01 and 69.7 vs. 35.3%, p<0.01, respectively). Forty-two percent of the women reported having ever had physical injuries as a consequence of intimate partner violence. Among injured women, only one-third had ever disclosed real causes of injuries to medical staff and none of them had been referred to local organizations to receive appropriate psychological support. Regardless of HIV status and after adjustment on potential confounders, the risk of intimate partner physical and sexual violence was strongly and significantly associated with male partner multi-partnership and early start of sexual life. Among uninfected women, physical violence was significantly associated with gender submissive attitudes. Discussion and conclusions The prevalence rates of both lifetime physical and sexual violence were very high among HIV-uninfected women and even higher among HIV-infected women recruited in health facilities in this West African country. Screening for intimate partner violence should be systematic in health-care settings, and specifically within HIV care services. At a time of increased investments in couple-oriented HIV prevention interventions, further longitudinal research to better understanding of HIV-serodiscordant couple dynamics in terms of intimate partner violence is needed. PMID:24866864

Burgos-Soto, Juan; Orne-Gliemann, Joanna; Encrenaz, Gaëlle; Patassi, Akouda; Woronowski, Aurore; Kariyiare, Benjamin; Lawson-Evi, Annette K.; Leroy, Valériane; Dabis, François; Ekouevi, Didier K.

2014-01-01

268

Facilitators and barriers to cotrimoxazole and nevirapine prophylaxis among HIV exposed babies: a qualitative study from Harare, Zimbabwe  

PubMed Central

Implementation of cotrimoxazole prophylaxis (CTX-p) among HIV-exposed children is poor in southern Africa. We conducted a multi-methods study to investigate the barriers to delivery of CTX-p to HIV exposed infants in Zimbabwe at each step of the care cascade. Here we report findings of the qualitative component designed to investigate issues related to adherence conducted among women identified as HIV positive whose babies were started on CTX-p postnatally. Between Feb–Dec 2011, the first 19 HIV infected mothers identified were invited for in-depth interview 4–5 months postnatally. Interviews were recorded, transcribed, translated and analysed thematically. Of note, Zimbabwe also provides nevirapine prophylaxis for HIV-exposed babies, so the majority were giving nevirapine and CTX-p to their babies. All women desired their baby's health above all else, and were determined to do all they could to ensure their wellbeing. They did not report problems remembering to give drugs. The baby's apparent good health was a huge motivator for continued adherence. Testimonies from women whose babies had tested HIV negative strengthened the resolve to adhere. However, most women reported that their husbands were less engaged in HIV care, refusing to be HIV tested and in some cases stealing drugs prescribed for their wives for themselves. In two instances the man stopped the woman from giving CTX-p to the baby either because of fear of side effects or not appreciating its importance: “he said if I kept giving CTX-p he would take the baby away from me and give him to his mother.” Stigma continues to be an important issue. Mothers reported being reluctant to disclose their HIV status to other people so found it difficult to collect prescription refills from the HIV clinic for fear of being seen by friends/relatives. Some women reported that it was hard to administer the drugs if there were people around at home. Other challenges faced were stock-outs of CTX-p at the clinic, which occurred four times during the study. The baby would then go without CTX-p if the woman could not afford buying at a private pharmacy. The study highlights that adherence knowledge and desire alone is insufficient to overcome the familial and structural barriers to maintaining CTX-p. Improving adherence to CTX-p among HIV exposed infants will require interventions to improve male involvement, reduce HIV stigma at facilities and ensure adequate supply of drugs.

Sibanda, E; Weller, I; Bernays, S; Hakim, J; Cowan, F

2012-01-01

269

5 CFR 2502.16 - Information to be disclosed.  

Code of Federal Regulations, 2010 CFR

...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...

2010-01-01

270

Transgender Marriage and the Legal Obligation to Disclose Gender History  

Microsoft Academic Search

Section 12 of the Matrimonial Causes Act 1973 as amended by the Gender Recognition Act 2004 requires transgender people to disclose their ‘gender history’ to the other party to a marriage prior to the marriage ceremony. Failure to do so enables the other party to exit the relationship through nullity proceedings. This article argues that this provision is discriminatory and

Alex Sharpe

2012-01-01

271

27 CFR 46.119 - Errors disclosed by taxpayers.  

Code of Federal Regulations, 2010 CFR

...Special (Occupational) Tax Special Tax Stamps § 46.119 Errors disclosed by taxpayers. On receipt of a special tax stamp, the taxpayer must examine it to ensure...if not, the taxpayer must return the stamp to the TTB officer who issued it,...

2010-04-01

272

Between a Rock and a Hard Place: Disclosing Medical Errors  

Microsoft Academic Search

Background: Healthcare-related errors cause patient morbidity and mortality. Despite fear of reprimand, laboratory personnel have a professional obligation to rapidly report major medical errors when they are identified. Well-defined protocols regarding how and when to disclose a suspected error by a colleague do not exist. Patient: We describe a woman with a well documented allergy to sulfamethoxazole who was treated

Kimberley G. Crone; Michele B. Muraski; Joy D. Skeel; Latisha Love-Gregory; Jack H. Ladenson; Ann M. Gronowski

2006-01-01

273

IRS Releases Tax Questionnaire that Asks Colleges to Disclose More  

ERIC Educational Resources Information Center

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

Kelderman, Eric

2008-01-01

274

Relative foster parents of HIV-affected children.  

PubMed

The HIV epidemic is one of the reasons for an increase in relative foster care. Most children of HIV-infected parents are not infected, but both the children and their caregivers are affected by the parent's illness. Twenty-eight caregivers participated in an exploratory, qualitative study of the permanency planning needs of HIV-affected relative foster parents. Of the caregivers, 17 disclosed that the foster child's parent was HIV-infected; 11 caregivers did not report HIV infection in the immediate family. HIV-affected caregivers' greatest need was a more adequate response from social workers and therapy services for the children; nonaffected caregivers needed financial assistance most. More HIV-affected caregivers were considering permanency than nonaffected caregivers. Child welfare workers and relative foster parents need training on HIV's effect on the families so that appropriate services can be accessed as early as possible. PMID:12109600

Mason, Sally; Linsk, Nathan

2002-01-01

275

HIV / AIDS  

MedlinePLUS

... on. Read more information on enabling JavaScript. HIV/AIDS Skip Content Marketing Share this: Main Content Area ... are being affected by HIV/AIDS. Understanding HIV/AIDS Overview Cause Transmission Symptoms Testing and Diagnosis Treatment ...

276

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

PubMed Central

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.

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

2015-01-01

277

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

278

Switching from an EFV-based STR to a RPV-based STR is effective, safe and improves HIV patients health status  

PubMed Central

Introduction TDF/FTC/RPV has been shown effective in both naïve and PI-pre-treated patients. Less is known about a switch strategy in subjects receiving EFV. Materials and Methods We evaluated viro-immunologic outcomes, Quality of Life (QoL) and costs of an unselected cohort of patients switching from a TDF/FTC/EFV STR (?6 months duration) to a TDF/FTC/RPV STR. The considered outcome measures were quality-adjusted life years (QALYs) as measured with the EQ5D questionnaire and the overall direct health costs. 64 patients with a baseline viral load<50 copies/mL were randomized to immediately switch therapy or to continue TDF/FTC/EFV for four months and then switch to TDF/FTC/RPV. Six patients in the deferred switch group did not actually change cART. Results Patients were mostly males (73.4%) with a mean age of 46 years, a baseline mean HIV-RNA of 6.4 copies/mL and a mean baseline CD4 count of 588 cells/µL. For the considered follow-up period, the mean cost per patient resulted 2,563 for TDF/FTC/RPV and 2,572 for TDF/FTC/EFV. Viremia remained undetectable and CD4 stable in all patients. Over time the mean QoL increased in the RPV arm ad slightly decreased in the EFV arm, after four months the mean per patient QALYs was 0.849 for RPV and 0.841 for EFV, respectively (Figure 1). A sharp increment of QoL was observed in the deferred-switch arm after switch, too. VAS analysis of health status perception also increased overall from 82.78 to 83.79 due to the improvement in the RPV arm. Mean cholesterol levels improved in the RPV arm from 203 to 170 mg/dL, while an increment from 190 to 207 mg/dL was observed in the EFV arm. HDL levels lowered from 49 to 45 and rose from 53 to 54 mg/dL in the RPV and EFV arms, respectively. Triglycerides levels improved both in the RPV arm (from 138 to 112 mg/dL) and in the EFV arm (from 110 to 103 mg/dL). Conclusions Switching from TDF/FTC/EFV to TDF/FTC/RPV is a safe, well tolerated strategy that improves the overall health status of HIV-treated patients. The switch does not expose patients to a risk of virologic failure due to possible PK interactions of the drugs. RPV compared to EFV proved to be cost-effective showing lower cost and higher outcome measure values. PMID:25397542

Maggiolo, Franco; Di Matteo, Sergio; Bruno, Giacomo; Astuti, Noemi; Di Filippo, Elisa; Valenti, Daniela; Colombo, Giorgio

2014-01-01

279

"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

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…

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

2008-01-01

280

Comparative chromosome painting discloses homologous segments in distantly related mammals  

Microsoft Academic Search

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

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

1994-01-01

281

Pharmacokinetics and Pharmacodynamics in HIV Prevention; Current Status and Future Directions: A Summary of the DAIDS and BMGF Sponsored Think Tank on Pharmacokinetics (PK)/Pharmacodynamics (PD) in HIV Prevention  

PubMed Central

Abstract Thirty years after its beginning, the HIV/AIDS epidemic is still raging around the world. According to UNAIDS, in 2011 alone 1.7M deaths were attributable to AIDS, and 2.5M people were newly infected by the virus. Despite the success in treating HIV-infected people with potent antiretroviral drugs, preventing HIV infection is the key to ending the epidemic. Recently, the efficacy of topical and systemic antiviral chemoprophylaxis (i.e., preexposure prophylaxis or “PrEP”), using the same drugs used for HIV treatment, has been demonstrated in a number of clinical trials. However, results from other trials have been inconsistent, especially those evaluating PrEP in women. These inconsistencies may result from our incomplete understanding of pharmacokinetics (PK)/pharmacodynamics (PD) at the mucosal sites of sexual transmission: the male and female gastrointestinal and reproductive tracts. The drug concentrations used in these trials were derived from those used for treatment; however, we still do not know the relationship between the therapeutic and the preventive dose. This article presents the first comprehensive review of the available data in the HIV pharmacology field from animal models to human studies, and outlines gaps, challenges, and future directions. Addressing these pharmacological gaps and challenges will be critical in selecting and advancing future PrEP candidates and strategies with the greatest impact on the HIV epidemic. PMID:23614610

Romano, Joseph; Kashuba, Angela; Becker, Stephen; Cummins, James; Turpin, Jim

2013-01-01

282

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

PubMed

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

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

2013-08-01

283

Clinical and serologic baseline and follow-up features of syphilis according to HIV status in the post-HAART era.  

PubMed

There is a lack of large studies appraising the effect of the human immunodeficiency virus (HIV) on the course of syphilis since the advent of highly active antiretroviral therapy (HAART). We aimed to appraise the effect of HIV on clinical and serologic features of syphilis at baseline and during follow-up in the post-HAART era.We designed a retrospective cohort study of consecutive syphilis cases, diagnosed between 2000 and 2007, in an academic venereal disease center. Data were collected using standardized medical forms. Patients were treated according to the European guidelines. Serologic failure was defined as either a 4-fold rise in Venereal Disease Research Laboratory (VDRL) titers 30-400 days posttreatment or a lack of 4-fold drop in VDRL titers at 270-400 days posttreatment.Among 279 syphilis cases with informative baseline clinical and serologic data, HIV infection was significantly associated with men having sex with men, French origin, multiple partners, lesser usage of condom, history of sexually transmitted disease, early syphilis, anal primary chancre, and cutaneous eruption. Median baseline titer from the Treponema pallidum hemagglutination assay (TPHA) was higher in HIV-infected patients (p = 0.02).Among 144 informative syphilis cases, there was a nonsignificant trend for a lower rate of serologic response among HIV-positive patients (91.8% vs. 98.3%, p = 0.14). Serologic failure was significantly associated with a history of previous syphilis (p < 0.05). The median delay to serologic response was similar in HIV-positive (117 d) and in HIV-negative (123 d) patients (p = 0.44).We conclude that for patients under HAART treatment, the effect of HIV on serologic response to syphilis treatment is likely minimal or absent. PMID:19910747

Farhi, David; Benhaddou, Nadjet; Grange, Philippe; Zizi, Nada; Deleuze, Jean; Morini, Jean-Pierre; Gerhardt, Philippe; Krivine, Anne; Avril, Marie-Françoise; Dupin, Nicolas

2009-11-01

284

Impact of HIV1 status on the radiological presentation and clinical outcome of children with WHO defined community-acquired severe pneumonia  

Microsoft Academic Search

Aims:We compared the radiological features and outcome of WHO defined severe pneumonia among HIV infected and exposed uninfected children randomised to receive penicillin or oral amoxicillin in Durban, South Africa.Methods:Of 425 children aged between 3 and 59 months with WHO defined severe pneumonia, 366 had anonymous HIV testing performed. Outcome was assessed by failure to improve at 48 h after

P M Jeena; A K Minkara; P Corr; F Bassa; L M McNally; H M Coovadia; M Fox; D H Hamer; D Thea

2007-01-01

285

Supreme Court says Air Force may dismiss HIV-positive major.  

PubMed

The U.S. Supreme Court decided unanimously that the Air Force has a right to dismiss an officer convicted by a court-martial for having unprotected sex with two women without disclosing his HIV-positive status. The court overturned a decision by a military appeals court to grant the defendant extraordinary relief under the All Writs Act. The defendant appealed his administrative dismissal, fearing he would lose medication access, and asserting that his removal was an unconstitutional violation of the "ex post facto" and double jeopardy clauses. The defendant had already served time in military confinement and lost salary following his court-martial. The justices stated that other statutory relief was available, and that the officer's dismissal was purely administrative, and unrelated to his court-martial. PMID:11367141

1999-05-28

286

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

PubMed Central

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

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

2008-01-01

287

Desgres du Lo et al, SSM-D-07-02046R2 1 From prenatal HIV testing of the mother to prevention of sexual HIV transmission  

E-print Network

Desgrées du Loû et al, SSM-D-07-02046R2 1 From prenatal HIV testing of the mother to prevention for many women to learn their own HIV status. This prenatal HIV testing is not only the entry point the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women

Boyer, Edmond

288

HIV Viral Load  

MedlinePLUS

... that an HIV viral load test detects HIV RNA. What is an HIV DNA test? The HIV ... HIV-1-Infected Adults and Adolescents, Plasma HIV RNA Testing. AIDSinfo On-line information]. Available online through ...

289

HIV and Atherosclerosis  

MedlinePLUS

HIV and Atherosclerosis Updated:Jan 22,2014 Featured Video How is HIV Related to Atherosclerosis? Length: 2: ... improve your cholesterol ratios, with or without HIV. HIV and Your Heart • Home • About HIVHIV and ...

290

Treatment for HIV  

MedlinePLUS

... and Public Home » Treatment » Treatment Decisions and HIV HIV/AIDS HIV/AIDS HIV/AIDS Home For Veterans ... here Enter ZIP code here Treatment Decisions and HIV for Veterans and the Public Treatment for HIV: ...

291

HIV Testing Frequency  

MedlinePLUS

... Testing : HIV Testing Frequency Translate Text Size Print HIV Testing Frequency Testing Frequency How often should you ... local health department for proper care and information. HIV Testing HIV Test Locations HIV Test Types HIV ...

292

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

PubMed Central

Background.?Factors associated with initiation of sexual activity among perinatally human immunodeficiency virus (HIV)–infected (PHIV+) youth, and the attendant potential for sexual transmission of antiretroviral (ARV) drug-resistant HIV, remain poorly understood. Methods.?We conducted cross-sectional and longitudinal analyses of PHIV+ youth aged 10–18 years (mean, 13.5 years) enrolled in the US-based Pediatric HIV/AIDS Cohort Study between 2007 and 2009. Audio computer-assisted self-interviews (ACASI) were used to collect sexual behavior information. Results.?Twenty-eight percent (95% confidence interval [CI], 23%–33%) (92/330) of PHIV+ youth reported sexual intercourse (SI) (median initiation age, 14 years). Sixty-two percent (57/92) of sexually active youth reported unprotected SI. Among youth who did not report history of SI at baseline, ARV nonadherence was associated with sexual initiation during follow-up (adjusted hazard ratio, 2.87; 95% CI, 1.32–6.25). Youth living with a relative other than their biological mother had higher odds of engaging in unprotected SI than those living with a nonrelative. Thirty-three percent of youth disclosed their HIV status to their first sexual partner. Thirty-nine of 92 (42%) sexually active youth had HIV RNA ?5000 copies/mL after sexual initiation. Viral drug resistance testing, available for 37 of these 39 youth, identified resistance to nucleoside reverse transcriptase inhibitors in 62%, nonnucleoside reverse transcriptase inhibitors in 57%, protease inhibitors in 38%, and all 3 ARV classes in 22%. Conclusions.?As PHIV+ youth become sexually active, many engage in behaviors that place their partners at risk for HIV infection, including infection with drug-resistant virus. Effective interventions to facilitate youth adherence, safe sex practices, and disclosure are urgently needed. PMID:23139252

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

2013-01-01

293

Disclosure experience in a convenience sample of quebec-born women living with HIV: a phenomenological study  

PubMed Central

Background In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV). Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women. Methods We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12). They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience. Results Seven themes were identified to understand the experience of disclosure in women: 1) Respecting for self and confidants; 2) Feeling apprehension; 3) Exercising control to ensure protection; 4) Deliberately engaging in a process of disclosure/non-disclosure; 5) Exposing oneself to stigma and social exclusion; 6) Suffering internally; and 7) Benefitting from the positive effects of one’s decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained. Conclusions Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter-organizational and intersectoral levels. Mobilization of actors from different sectors would facilitate the implementation of pertinent and opportune interventions. PMID:23078352

2012-01-01

294

“That Pregnancy Can Bring Noise into the Family”: Exploring Intimate Partner Sexual Violence during Pregnancy in the Context of HIV in Zimbabwe  

PubMed Central

Background Globally, studies report a high prevalence of intimate partner sexual violence (IPSV) and an association with HIV infection. Despite the criminalisation of IPSV and deliberate sexual HIV infection in Zimbabwe, IPSV remains common. This study explored women's and health workers' perspectives and experiences of sexuality and sexual violence in pregnancy, including in relation to HIV testing. Methods This qualitative study was part of a larger study of the dynamics of intimate partner violence and HIV in pregnancy in Zimbabwe. Key informant interviews were conducted with health workers and focus group discussions were held with 64 pregnant or nursing mothers attending antenatal and postnatal care clinics in low-income neighbourhoods of Harare, covering the major thematic areas of validated sexual violence research instruments. Thematic content analysis of audio-recorded and transcribed data was conducted. Results While women reported some positive experiences of sex in pregnancy, most participants commonly experienced coercive sexual practices. They reported that men failed to understand, or refused to accept, pregnancy and its associated emotional changes, and often forced painful and degrading sexual acts on them, usually while the men were under the influence of alcohol or illicit drugs. Men often refused or delayed HIV testing, and participants reported accounts of HIV-positive men not disclosing their status to their partners and deliberately infecting or attempting to infect them. Women's passive acceptance of sexual violence was influenced by advice they received from other females to subordinate to their partners and to not deprive men of their conjugal sexual rights. Conclusions Cultural and societal factors, unequal gender norms and practices, women's economic vulnerability, and men's failure to understand pregnancy and emotional changes, influence men to perpetrate IPSV, leading to high risk of HIV infection. PMID:22937018

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

2012-01-01

295

HIV Testing, Subjective Beliefs and Economic Behavior  

PubMed Central

This paper examines the effects of learning HIV status on economic behavior among rural Malawians. According to economic life-cycle models, if learning HIV results is informative about additional years of life, being diagnosed HIV-positive or negative should predict changes in consumption, investment and savings behavior with important micro and macro-economic implications. Using an experiment that randomly assigned incentives to learn HIV results, I find that while learning HIV results had short term effects on subjective belief of HIV infection, these differences did not persist after two years. Consistent with this, there were relatively few differences two years later in savings, income, expenditures, and employment between those who learned and did not learn their status. PMID:24369439

Thornton, Rebecca L.

2013-01-01

296

HIV Testing, Subjective Beliefs and Economic Behavior.  

PubMed

This paper examines the effects of learning HIV status on economic behavior among rural Malawians. According to economic life-cycle models, if learning HIV results is informative about additional years of life, being diagnosed HIV-positive or negative should predict changes in consumption, investment and savings behavior with important micro and macro-economic implications. Using an experiment that randomly assigned incentives to learn HIV results, I find that while learning HIV results had short term effects on subjective belief of HIV infection, these differences did not persist after two years. Consistent with this, there were relatively few differences two years later in savings, income, expenditures, and employment between those who learned and did not learn their status. PMID:24369439

Thornton, Rebecca L

2012-11-01

297

Mandatory Testing of Pregnant Women and Newborns: HIV, Drug Use, and Welfare Policy  

Microsoft Academic Search

In this Introduction, the author discusses how the collection of essays provide insightful analysis of biological, legal, and public health issues surrounding mandatory testing of pregnant women and infants for HIV. As background, beginning February 1, 1997, New York ordered that every newborn in the state be tested for HIV-antibodies. In addition, the results are disclosed to the delivering mother,

Elizabeth B. Cooper

1997-01-01

298

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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...

2010-09-09

299

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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:...

2010-12-15

300

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

Code of Federal Regulations, 2012 CFR

...What safeguards and security requirements apply to disclosed information? 603.9 Section...DISCLOSURE OF STATE UC INFORMATION Confidentiality...What safeguards and security requirements apply to disclosed information? (a) In...

2012-04-01

301

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

Code of Federal Regulations, 2013 CFR

...What safeguards and security requirements apply to disclosed information? 603.9 Section...DISCLOSURE OF STATE UC INFORMATION Confidentiality...What safeguards and security requirements apply to disclosed information? (a) In...

2013-04-01

302

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

Code of Federal Regulations, 2011 CFR

...What safeguards and security requirements apply to disclosed information? 603.9 Section...DISCLOSURE OF STATE UC INFORMATION Confidentiality...What safeguards and security requirements apply to disclosed information? (a) In...

2011-04-01

303

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

Code of Federal Regulations, 2014 CFR

...What safeguards and security requirements apply to disclosed information? 603.9 Section...DISCLOSURE OF STATE UC INFORMATION Confidentiality...What safeguards and security requirements apply to disclosed information? (a) In...

2014-04-01

304

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

Code of Federal Regulations, 2010 CFR

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

2010-10-01

305

78 FR 21522 - Delegation of Authority To Disclose Confidential Information to a Contract Market, Registered...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Part 140 RIN 3038-AE04 Delegation of Authority To Disclose Confidential Information to a Contract Market, Registered Futures Association...employees of the Commission with the authority to disclose confidential information only to any contract market, registered...

2013-04-11

306

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

Code of Federal Regulations, 2011 CFR

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

2011-10-01

307

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

Code of Federal Regulations, 2010 CFR

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

2010-10-01

308

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

Code of Federal Regulations, 2011 CFR

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

2011-10-01

309

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

Code of Federal Regulations, 2014 CFR

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

2014-10-01

310

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

Code of Federal Regulations, 2012 CFR

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

2012-10-01

311

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

Code of Federal Regulations, 2013 CFR

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

2013-10-01

312

75 FR 60371 - Requirements of a Statement Disclosing Uncertain Tax Positions; Correction  

Federal Register 2010, 2011, 2012, 2013, 2014

...1545-BJ54 Requirements of a Statement Disclosing Uncertain Tax Positions; Correction AGENCY: Internal Revenue Service (IRS), Treasury...require corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the IRS. FOR...

2010-09-30

313

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

PubMed

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

Johnson, Ofonime E

2012-01-01

314

Internalized Stigma Among People Living with HIV-AIDS  

Microsoft Academic Search

HIV is recognized as a highly stigmatized disease; however, there has been a lack of research on the internalization of this stigma by seropositive people. This study examined internalized stigma among HIV-positive men and women (N = 268) in Milwaukee and Madison, Wisconsin, and New York City. The majority of the sample experienced internalized stigma related to their HIV status.

Rachel S. Lee; Arlene Kochman; Kathleen J. Sikkema

2002-01-01

315

Pulmonary manifestations in HIV seropositivity and malnutrition in Zimbabwe  

Microsoft Academic Search

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

Michael O Ikeogu; Bart Wolf; Stanford Mathe

1997-01-01

316

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

PubMed

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

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

2013-06-01

317

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

PubMed Central

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

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

2013-01-01

318

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

PubMed Central

Background South Africa accounts for more than a sixth of the global population of people infected with HIV and TB, ranking her highest in HIV/TB co-infection worldwide. Remote areas often bear the greatest burden of morbidity and mortality, yet there are spatial differences within rural settings. Objectives The primary aim was to investigate HIV/TB mortality determinants and their spatial distribution in the rural Agincourt sub-district for children aged 1–5 years in 2004. Our secondary aim was to model how the associated factors were interrelated as either underlying or proximate factors of child mortality using pathway analysis based on a Mosley-Chen conceptual framework. Methods We conducted a secondary data analysis based on cross-sectional data collected in 2004 from the Agincourt sub-district in rural northeast South Africa. Child HIV/TB death was the outcome measure derived from physician assessed verbal autopsy. Modelling used multiple logit regression models with and without spatial household random effects. Structural equation models were used in modelling the complex relationships between multiple exposures and the outcome (child HIV/TB mortality) as relayed on a conceptual framework. Results Fifty-four of 6,692 children aged 1–5 years died of HIV/TB, from a total of 5,084 households. Maternal death had the greatest effect on child HIV/TB mortality (adjusted odds ratio=4.00; 95% confidence interval=1.01–15.80). A protective effect was found in households with better socio-economic status and when the child was older. Spatial models disclosed that the areas which experienced the greatest child HIV/TB mortality were those without any health facility. Conclusion Low socio-economic status and maternal deaths impacted indirectly and directly on child mortality, respectively. These factors are major concerns locally and should be used in formulating interventions to reduce child mortality. Spatial prediction maps can guide policy makers to target interventions where they are most needed. PMID:23364095

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

2013-01-01

319

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

PubMed Central

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

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

320

HIV UPDATE: cancer & HIV  

E-print Network

management of cancer and HIV treatment can be complex, with important drug-drug interactions and overlapping 40% of all cancers in men1 . Pathogenesis KS is a spindle-cell tumor thought to derive from endothelial cell lineage. This condition carries a variable clinical course ranging from minimal mucocutaneous

Bushman, Frederic

321

HIV Transmission  

MedlinePLUS

... kissing Toilet seats. Can I get HIV from anal sex? Yes. In fact, having anal sex is the riskiest type of sex for ... may allow HIV to enter the body during anal sex, but the top is also at risk ...

322

HIV Prevention  

MedlinePLUS

... post-exposure prophylaxis. How can I prevent getting HIV from anal or vaginal sex? Choose less risky ... consistently and correctly. How can I prevent getting HIV from oral sex? Avoid having your partner ejaculate ...

323

HIV virus  

NSDL National Science Digital Library

HIV is a virus that can be transmitted through fluids exchanged in sexual activity. HIV eventually causes AIDS. AIDS patients have compromised immune systems and they eventually die from diseases that healthy humans would normally fight off very easily.

Carl Henderson (National Institutes of Health; )

2005-12-09

324

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

E-print Network

THE UNIVERSITY OF MONTANA - MISSOULA CONSENT TO DISCLOSE STUDENT EDUCATION RECORDS (Form consent to disclose those records to other persons. However, disclosure of non-directory information may request to the Registrar's Office to change or rescind this consent to disclose my education records. NAME

Vonessen, Nikolaus

325

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

Code of Federal Regulations, 2013 CFR

...2013-10-01 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...

2013-10-01

326

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

Code of Federal Regulations, 2011 CFR

...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...

2011-10-01

327

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

Code of Federal Regulations, 2012 CFR

...2012-10-01 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...

2012-10-01

328

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

Code of Federal Regulations, 2014 CFR

...2014-10-01 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...

2014-10-01

329

Foreskin T cell subsets differ substantially from blood with respect to HIV co-receptor expression, inflammatory profile and memory status  

PubMed Central

The foreskin is the main site of heterosexual HIV acquisition in uncircumcised men, but functional data regarding T cells subsets present at this site are lacking. Foreskin tissue and blood were obtained from Ugandan men undergoing elective adult circumcision. Tissue was treated by mechanical and enzymatic digestion followed by T cell subset identification and assessment of cytokine production using flow cytometery. Foreskin CD4+ T cells were predominantly an effector memory phenotype, and compared to blood they displayed a higher frequency of CCR5 expression (42.0% vs. 9.9%) and IL-17 production. There was no difference in T regulatory cell frequency, but IFN? and TNF? production were increased in foreskin CD8+ T cells. These novel techniques demonstrate that the foreskin represents a pro-inflammatory milieu that is enriched for HIV-susceptible T cell subsets. Further characterization of foreskin T cell subsets may help to define the correlates of HIV susceptibility in the foreskin. PMID:22089029

Prodger, J.L.; Gray, R.; Kigozi, G.; Nalugoda, F.; Galiwango, R.; Hirbod, T.; Wawer, M.; Hofer, S.O.P.; Sewankambo, N.; Serwadda, D.; Kaul, R.

2011-01-01

330

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

PubMed Central

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.

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

2015-01-01

331

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

ERIC Educational Resources Information Center

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

Cederbaum, Julie A.

2012-01-01

332

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

333

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

ERIC Educational Resources Information Center

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…

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

2013-01-01

334

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

PubMed

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

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

2015-01-01

335

Injection Drug Use as a Mediator Between Client-perpetrated Abuse and HIV Status Among Female Sex Workers in Two Mexico-US Border Cities  

Microsoft Academic Search

We examined relationships between client-perpetrated emotional, physical, and sexual abuse, injection drug use, and HIV-serostatus\\u000a among 924 female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-US border cities. We hypothesized that\\u000a FSWs’ injection drug use would mediate the relationship between client-perpetrated abuse and HIV-seropositivity. The prevalence\\u000a of client-perpetrated emotional, physical, and sexual abuse in the past 6 months

Monica D. Ulibarri; Steffanie A. Strathdee; Emilio C. Ulloa; Remedios Lozada; Miguel A. Fraga; Carlos Magis-Rodríguez; Adela De La Torre; Hortensia Amaro; Patricia O’Campo; Thomas L. Patterson

2011-01-01

336

Women’s Self-Disclosure of HIV Infection: Rates, Reasons, and Reactions  

Microsoft Academic Search

A survey of 65 ethnically diverse women at 2 outpatient HIV clinics revealed relatively low rates of disclosure of HIV-positive serostatus to extended family members, somewhat higher rates for immediate family members, and highest rates for lovers and friends. Spanish-speaking Latinas were less likely to disclose their serostatus or to discuss HIV-related worries with others than English-speaking Latinas, African Americans,

Jane M. Simoni; Hyacinth R. C. Mason; Gary Marks; Monica S. Ruiz; Deborah Reed; Jean L. Richardson

1995-01-01

337

The glucocorticoid antagonist RU-486 suppresses HIV infectivity and replication.  

PubMed

The effects of RU-486, a glucocorticoid antagonist, on HIV infection and replication in depressed and nondepressed women were studied using ex vivo models of HIV infection. RU-486 treatment of cells decreased HIV reverse transcriptase activity of monocyte-derived macrophages in a model of acute infectivity. RU-486 also decreased HIV viral replication in the chronically-infected T-cell line ACH-2, but not in the promonocyte cell line U1. No differences were associated with depression status. Thus, glucocorticoid antagonism may suppress HIV infectivity and replication ex vivo. Studies to determine the role of glucocorticoid antagonists in the host defense against HIV should be performed. PMID:23487193

Benton, Tami D; Lynch, Kevin G; Dubé, Benoit; Gettes, David R; Tustin, Nancy B; Metzger, David S; Blume, Joshua; Douglas, Steven D; Evans, Dwight L

2013-01-01

338

Health care workers’ perspectives about disclosure to HIV-infected children; cross-sectional survey of health facilities in Gauteng and Mpumalanga provinces, South Africa  

PubMed Central

The perspectives and practices of health care workers (HCWs) regarding disclosure to HIV-infected children have not been adequately investigated ten years after the roll-out of pediatrics antiretroviral therapy (ART). The aim of the study was to examine the opinions of HCWs about disclosure to HIV-infected children and determine their role in disclosure to children accessing ART in health centers in South Africa. This was a cross-sectional survey using a semi-structured questionnaire among HCWs in ART centers at three hospitals and 48 primary health facilities in two provinces in South Africa. Of the 206 HCWs, 140 (68.2%) were nurses, 44 (21.5%) were lay counsellors, and 4 (2%) were doctors. The majority (n = 183, 89.3%) felt that disclosure benefits children and they should be told about their HIV status. Over half (n = 93, 51.4%) recommended 11–18 years as the appropriate age to disclose. Half (n = 99, 48.5%) said that caregivers should take the lead to disclose, 87 (42.7%) said that disclosure is a shared responsibility of caregivers and HCWs, and 18 (8.8%) said HCWs should lead disclosure. HCWs perceived their role as that of preparing the caregiver for disclosure and the child to understand the disease. However, the lack of guidelines and training on disclosure counselling for children affects their ability to fully participate in disclosure to children. There is a need to adopt the World Health Organizations’ disclosure guidelines for children and adapt them to the local cultural and community contexts and train HCWs to guide, support, and assist caregivers in their disclosure to HIV-infected children.

Mokgatle, Mathildah

2015-01-01

339

New patterns of disclosure: how HIV-positive support group members from KwaZulu-Natal speak of their status in oral narratives.  

PubMed

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

Denis, Philippe

2014-04-01

340

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

PubMed Central

This paper examines the representations and emotions associated with disclosure and stigma in Pietermaritzburg, KwaZulu-Natal, seven years after the start of the South African 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

Denis, Philippe

2014-01-01

341

Impact of House-hold Food Insecurity on Nutritional Status of HIV-infected Children Attending an ART Centre in Tamil Nadu.  

PubMed

We studied the level of food insecurity among households with HIV-infected children and its relationship with childhood nutritional indicators. Among the 147 children assessed, food insecurity was present in 59% of households. Majority of children with stunting belonged to-food insecure families. Stunting and Underweight were more prevalent among children >5 years of age. PMID:25849010

Suresh, E; Srinivasan, R; Valan, A S; Klinton, Joel S; Padmapriyadarsini, C

2015-03-01

342

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

PubMed Central

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

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

2013-01-01

343

Disclosure and Experienced Social Support are not Related to Anxiety or Depression in a German HIV Patient Cohort  

PubMed Central

Background It is unclear to which extent the rate of disclosure of the diagnosis "HIV" to the social environment and the nature of experienced responses are correlated with the current mental health status of HIV-infected patients living in Germany. Materials and Methods Eighty consecutive patients of two German HIV outpatient clinics were enrolled. Patients performed the Hospital Anxiety and Depression Scale (HADS) in its German version. Disclosure behaviour and the experienced responses after disclosing as perceived by the participants were assessed using a questionnaire. In addition, patients were asked to state whether they felt guilty for the infection on a 1-4 point Likert scale. Results Pathological results on the anxiety scale were reached by 40% of male and 73% of female patients, and on the depression scale by 30% of male and 47% of female patients, thus significantly exceeding recently assessed values in the German general population, except for depression in males. None of the HADS scale results was interrelated either with the rate of disclosure or the experienced responses. 36% of patients reported to feel guilty for the infection, which was positively correlated with results from the HADS. Limitation: The time since the single disclosure events was not assessed, and the subgroup of women was comparably small. Conclusions Despite substantial improvement in treatment, HIV-infected patients in Germany still suffer from an elevated level of anxiety and, in part, depression. However, mental health status was neither related with disclosure behaviour nor with experienced responses. We hypothesize that internal beliefs may play a more important role. PMID:25024869

Brokamp, Felix; Thomaidis, Thomas; Schmidt, Reinhold E.; Wiltink, Jörg; Galle, Peter R.

2014-01-01

344

Declining Relative Risk for Myocardial Infarction Among HIV-Positive Compared With HIV-Negative Individuals With Access to Care.  

PubMed

Concerns remain for an increased myocardial infarction (MI) risk among individuals infected with human immunodeficiency virus (HIV). We conducted a cohort study evaluating MI risk from 1996 to 2011 by HIV status. The adjusted MI rate ratio for HIV status declined over time, reaching 1.0 (95% confidence interval, .7-1.4) in 2010-2011, the most recent study period. PMID:25595743

Klein, Daniel B; Leyden, Wendy A; Xu, Lanfang; Chao, Chun R; Horberg, Michael A; Towner, William J; Hurley, Leo B; Marcus, Julia L; Quesenberry, Charles P; Silverberg, Michael J

2015-04-15

345

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

PubMed Central

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

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

2015-01-01

346

Leukocyte Telomere Length in HIV-Infected and HIV-Exposed Uninfected Children: Shorter Telomeres with Uncontrolled HIV Viremia  

PubMed Central

Objectives Nucleoside reverse transcriptase inhibitors (NRTIs) used in HIV antiretroviral therapy can inhibit human telomerase reverse transcriptase. We therefore investigated whether in utero or childhood exposure to NRTIs affects leukocyte telomere length (LTL), a marker of cellular aging. Methods In this cross-sectional CARMA cohort study, we investigated factors associated with LTL in HIV -1-infected (HIV+) children (n?=?94), HIV-1-exposed uninfected (HEU) children who were exposed to antiretroviral therapy (ART) perinatally (n?=?177), and HIV-unexposed uninfected (HIV?) control children (n?=?104) aged 0–19 years. Univariate followed by multivariate linear regression models were used to examine relationships of explanatory variables with LTL for: a) all subjects, b) HIV+/HEU children only, and c) HIV+ children only. Results After adjusting for age and gender, there was no difference in LTL between the 3 groups, when considering children of all ages together. In multivariate models, older age and male gender were associated with shorter LTL. For the HIV+ group alone, having a detectable HIV viral load was also strongly associated with shorter LTL (p?=?0.007). Conclusions In this large study, group rates of LTL attrition were similar for HIV+, HEU and HIV? children. No associations between children’s LTL and their perinatal ART exposure or HIV status were seen in linear regression models. However, the association between having a detectable HIV viral load and shorter LTL suggests that uncontrolled HIV viremia rather than duration of ART exposure may be associated with acceleration of blood telomere attrition. PMID:22815702

Côté, Hélène C. F.; Soudeyns, Hugo; Thorne, Anona; Alimenti, Ariane; Lamarre, Valérie; Maan, Evelyn J.; Sattha, Beheroze; Singer, Joel; Lapointe, Normand; Money, Deborah M.; Forbes, John

2012-01-01

347

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

PubMed Central

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

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

2014-01-01

348

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

PubMed

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

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

2015-04-01

349

HIV Wellness Numbers  

MedlinePLUS Videos and Cool Tools

HIV Wellness Numbers Updated:Mar 22,2012 Featured Video The Basics of HIV Management Length: 2:37 ... Learn more about your important heart-health numbers . HIV and Your Heart • Home • About HIVHIV and ...

350

The Combination of Phylogenetic Analysis with Epidemiological and Serological Data to Track HIV-1 Transmission in a Sexual Transmission Case  

PubMed Central

Objective To investigate the linkage of HIV transmission from a man to a woman through unprotected sexual contact without disclosing his HIV-positive status. Methods Combined with epidemiological information and serological tests, phylogenetic analysis was used to test the a priori hypothesis of HIV transmission from the man to the woman. Control subjects, infected with HIV through heterosexual intercourse, from the same location were also sampled. Phylogenetic analyses were performed using the consensus gag, pol and env sequences obtained from blood samples of the man, the woman and the local control subjects. The env quasispecies of the man, the woman, and two controls were also obtained using single genome amplification and sequencing (SGA/S) to explore the paraphyletic relationship by phylogenetic analysis. Results Epidemiological information and serological tests indicated that the man was infected with HIV-1 earlier than the woman. Phylogenetic analyses of the consensus sequences showed a monophyletic cluster for the man and woman in all three genomic regions. Furthermore, gag sequences of the man and woman shared a unique recombination pattern from subtype B and C, which was different from those of CRF07_BC or CRF08_BC observed in the local samples. These indicated that the viral sequences from the two subjects display a high level of similarity. Further, viral quasispecies from the man exhibited a paraphyletic relationship with those from the woman in the Bayesian and maximum-likelihood (ML) phylogenetic trees of the env region, which supported the transmission direction from the man to the woman. Conclusions In the context of epidemiological and serological evidence, the results of phylogenetic analyses support the transmission from the man to the woman. PMID:25807147

Chen, Min; Ma, Yanling; Yang, Chaojun; Yang, Li; Chen, Huichao; Dong, Lijuan; Dai, Jie; Jia, Manhong; Lu, Lin

2015-01-01

351

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

PubMed Central

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

Adeyemi, Ezekiel Oluwagbemiga

2011-01-01

352

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)

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.

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

353

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

Microsoft Academic Search

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

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

2011-01-01

354

A candidate anti-HIV reservoir compound, auranofin, exerts a selective ‘anti-memory' effect by exploiting the baseline oxidative status of lymphocytes  

PubMed Central

Central memory (TCM) and transitional memory (TTM) CD4+ T cells are known to be the major cellular reservoirs for HIV, as these cells can harbor a transcriptionally silent form of viral DNA that is not targeted by either the immune system or current antiretroviral drug regimens. In the present study, we explored the molecular bases of the anti-HIV reservoir effects of auranofin (AF), a pro-oxidant gold-based drug and a candidate compound for a cure of AIDS. We here show that TCM and TTM lymphocytes have lower baseline antioxidant defenses as compared with their naive counterpart. These differences are mirrored by the effects exerted by AF on T-lymphocytes: AF was able to exert a pro-differentiating and pro-apoptotic effect, which was more pronounced in the memory subsets. AF induced an early activation of the p38 mitogen-activated protein kinase (p38 MAPK) followed by mitochondrial depolarization and a final burst in intracellular peroxides. The pro-differentiating effect was characterized by a downregulation of the CD27 marker expression. Interestingly, AF-induced apoptosis was inhibited by pyruvate, a well-known peroxide scavenger, but pyruvate did not inhibit the pro-differentiating effect of AF, indicating that the pro-apoptotic and pro-differentiating effects involve different pathways. In conclusion, our results demonstrate that AF selectively targets the TCM/TTM lymphocyte subsets, which encompass the HIV reservoir, by affecting redox-sensitive cell death pathways. PMID:24309931

Chirullo, B; Sgarbanti, R; Limongi, D; Shytaj, I L; Alvarez, D; Das, B; Boe, A; DaFonseca, S; Chomont, N; Liotta, L; III Petricoin, E; Norelli, S; Pelosi, E; Garaci, E; Savarino, A; Palamara, A T

2013-01-01

355

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

Microsoft Academic Search

BACKGROUND: Disclosing HIV test results to one's sexual partner allows the partner to engage in preventive behaviors as well as the access of necessary support for coping with serostatus or illness. It may motivate partners to seek testing or change behavior, and ultimately decrease the transmission of HIV. The present study was undertaken to determine the rate, outcomes and factors

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

2008-01-01

356

HIV Medicine  

NSDL National Science Digital Library

From Flying Publisher, _HIV Medicine 2005_ is a free, online "medical textbook that provides a comprehensive and up-to-date overview of the treatment of HIV Infection." This edition is an update of the 2003 version of the textbook (reported on in the June 13, 2003 NSDL Scout Report for Life Sciences). Chapter titles in the textbook include HIV Testing, HIV and Pulmonary Diseases, Mitochondrial Toxicity, HIV and HBV Coinfections, and Traveling with HIV, to name a few. The textbook is available in both German and English. Please note that while certain sections of the 2005 edition are currently available, many sections are still in the process of being published on the site. Sections from the 2003 edition are standing in for some of the forthcoming 2005 sections. The entire 352-page 2003 edition is available for download at this site as well.

357

Developing HIV / AIDS and STD workplace policies.  

PubMed

Employers and/or community leaders carry the primary responsibility for setting up workplace HIV/AIDS and STD (sexually transmitted disease) policies. They should include workers from the beginning to help identify policy objectives and content. Major objectives of a workplace policy include ensuring the health and rights of workers, reducing the effects of poor health on workplace productivity, and contributing to the general welfare of the community. Clearly stated principles of workplace policy may encompass freedom from mandatory HIV testing for job applicants and workers, ensuring a safe working environment, supporting treatment of HIV/STD-related illnesses, assuring confidentiality of HIV status, establishing a climate in which HIV-positive workers feel they can tell their employers about their status, and ensuring freedom from discrimination. HIV/AIDS and STD workplace policies are likely to include management and employee training, education and support services, and observance of employee rights. Examples of heeding employee rights are application and promotion procedures that do not require HIV testing, opportunities for HIV-positive workers to do work other than their usual work when their physical condition deteriorates, establishment of and adherence to disciplinary and grievance procedures if confidentiality of HIV status is violated, and treatment for STDs and other illnesses. A few persons should be responsible for monitoring implementation of HIV/AIDS and STD workplace policy. Monitoring may consist of regular meetings to reassess and, if needed, adapt the policy; a system of feedback from employees; assessment of use of support services; and conversations with HIV-positive workers to learn of the success of the workplace program in tending to their concerns and needs. PMID:12289838

1995-01-01

358

Hepatocellular carcinoma in HIV positive patients.  

PubMed

Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV-1-infected patients leading to increased survival and a better quality of life. Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are common among HIV-1-infected subjects and represent the most important risk factors for hepatocellular carcinoma (HCC). Whether HIV plays a direct role in hepatocellular carcinoma (HCC) pathogenesis remains to be established.HCC clinical course depends on stage of cancer disease, performance status and comorbidities. Therapeutic options include liver transplantation, local antiblastic chemotherapy and biological drugs. In the HIV setting few data are available about treatment options. The increased longevity of patients with HIV imposes new strategies for prevention and therapeutic management of patients. The aim of this article is to provide an up-to-date review of HIV-related HCC in the HAART era. PMID:23047511

Nunnari, G; Berretta, M; Pinzone, M R; Di Rosa, M; Berretta, S; Cunsolo, G; Malaguarnera, M; Cosentino, S; De Paoli, P; Schnell, J M; Cacopardo, B

2012-09-01

359

Adolescent HIV disclosure in Zambia: barriers, facilitators and outcomes  

PubMed Central

Introduction As adolescents living with HIV gain autonomy over their self-care and begin to engage in sexual relationships, their experiences of being informed about their HIV status and of telling others about their HIV status may affect their ability to cope with having the disease. Methods In 2010, we conducted a qualitative study among adolescents aged 10–19 living with HIV in Zambia, and with their parents and health care providers. Through interviews and focus group discussions, we explored the disclosure of HIV status to adolescents living with HIV; adolescents’ disclosure of their status to others; and the impact of both forms of disclosure on adolescents. Results Our study identified three main barriers to disclosure of HIV status: local norms that deter parents from communicating with their children about sexuality; fear of HIV stigma; and an underlying presumption that adolescents would not understand the consequences of a HIV diagnosis on their lives and relationships. With regard to adolescents’ disclosure of their HIV status to their sexual partners, our study identified fear of rejection as a common barrier. In rare cases, open family conversations about HIV helped adolescents come to terms with a HIV diagnosis. Findings indicated that disclosure had various outcomes at the individual and interpersonal levels. At the individual level, some adolescents described being anxious, depressed and blaming themselves after being told they had HIV. At the interpersonal level, disclosure created opportunities for adolescents to access adherence support and other forms of psychosocial support from family members and peers. At the same time, it occasionally strained adolescents’ sexual relationships, although it did not always lead to rejection. Conclusions There is a need for public health interventions that guide adolescents living with HIV, their parents and families through the disclosure process. Such interventions should help parents to assess and understand the evolving cognitive capacity and maturity of their adolescents in order to determine the appropriate time to inform them of their HIV-positive status. Such interventions should also mitigate the risk of HIV stigma, as well as local norms that may prevent discussions of sexuality within families. Adolescents who have been informed of their HIV status should be provided with on-going support to prevent disclosure from negatively affecting their psychological and sexual wellbeing. Further research is needed to explore the potential role of trusted family members in contributing to the disclosure process. PMID:24629845

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

2014-01-01

360

HIV chemotherapy  

NASA Astrophysics Data System (ADS)

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

Richman, Douglas D.

2001-04-01

361

Women and HIV  

MedlinePLUS

... is called HIV positive (HIV+). HIV makes it hard for your body to fight off sickness. How do you get HIV? HIV is spread through body fluids like blood, semen, or breast milk. You can get HIV when you : Have sex with a person who is HIV+ and do ...

362

Non-culpable ignorance and HIV criminalisation.  

PubMed

In this essay, I argue that any legal framework that addresses sexual transmission of HIV should be sensitive to the way that culpability can be mitigated by moral and factual ignorance. Though it is wrong to transmit HIV, public officials should be wary of criminalising transmission because people with HIV may be excused if they suffer from blameless moral or factual ignorance. I begin with the widely shared premise that blameless ignorance about one's HIV status is an excuse for sexual transmission of infections. I then extend this premise to other kinds of non-moral ignorance about HIV. Next, I argue that blameless moral ignorance also excuses transmission of HIV. There is some evidence of significant blameless non-moral and moral ignorance about HIV transmission. In these cases, transmission is excused. In light of the presence of moral and non-moral ignorance about HIV, I conclude that public health officials should encourage moral deliberation about HIV transmission and also that criminal penalties for HIV transmission are unwarranted even in some cases of knowing or intentional transmission. PMID:25190732

Flanigan, Jessica

2014-12-01

363

Decrease of vitamin D concentration in patients with HIV infection on a non nucleoside reverse transcriptase inhibitor-containing regimen  

Microsoft Academic Search

BACKGROUND: Vitamin D is an important determinant of bone health and also plays a major role in the regulation of the immune system. Interestingly, vitamin D status before the start of highly active antiretroviral therapy (HAART) has been recently associated with HIV disease progression and overall mortality in HIV-positive pregnant women. We prospectively studied vitamin D status in HIV individuals

Anali Conesa-Botella; Eric Florence; Lutgarde Lynen; Robert Colebunders; Joris Menten; Rodrigo Moreno-Reyes

2010-01-01

364

Comparison of Trends in Tuberculosis Incidence among Adults Living with HIV and Adults without HIV – Kenya, 1998–2012  

PubMed Central

Background In Kenya, the comparative incidences of tuberculosis among persons with and without HIV have not been described, and the differential impact of public health interventions on tuberculosis incidence in the two groups is unknown. Methods We estimated annual tuberculosis incidence stratified by HIV status during 2006–2012 based on the numbers of reported tuberculosis patients with and without HIV infection, the prevalence of HIV infection in the general population, and the total population. We also made crude estimates of annual tuberculosis incidence stratified by HIV status during 1998–2012 by assuming a constant ratio of HIV prevalence among tuberculosis patients compared to the general population. Results Tuberculosis incidence among both adults with HIV and adults without HIV increased during 1998–2004 then remained relatively stable until 2007. During 2007–2012, tuberculosis incidence declined by 28–44% among adults with HIV and by 11–26% among adults without HIV, concurrent with an increase in antiretroviral therapy uptake. In 2012, tuberculosis incidence among adults with HIV (1,839–1,936 cases/100,000 population) was still eight times as high as among adults without HIV (231–238 cases/100,000 population), and approximately one third of tuberculosis cases were attributable to HIV. Conclusions Although tuberculosis incidence has declined among adults with and without HIV, the persistent high incidence of tuberculosis among those with HIV and the disparity between the two groups are concerning. Early diagnosis of HIV, early initiation of antiretroviral therapy, regular screening for tuberculosis, and isoniazid preventive therapy among persons with HIV, as well as tuberculosis control in the general population, are required to address these issues. PMID:24937804

Yuen, Courtney M.; Weyenga, Herman O.; Kim, Andrea A.; Malika, Timothy; Muttai, Hellen; Katana, Abraham; Nganga, Lucy; Cain, Kevin P.; De Cock, Kevin M.

2014-01-01

365

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

PubMed

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

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

2014-12-01

366

Disclosing conflicts of interest in patient decision aids  

PubMed Central

Background In 2005, the International Patient Decisions Aid Standards (IPDAS) Collaboration developed quality criteria for patient decisions aids; one of the quality dimensions dealt with disclosure of conflicts of interest (COIs). The purposes of this paper are to review newer evidence on dealing with COI in the development of patient decision aids and to readdress the theoretical justification and definition for this quality dimension. Methods The committee conducted a primary systematic literature review to seek published research addressing the question, "What is the evidence that disclosure of COIs in patient decision aids reduces biased decision making?" A secondary literature review included a systematic search for recent meta-analyses addressing COIs in other spheres of health care, including research and publication, medical education, and clinical care. Results No direct evidence was found addressing this quality dimension in the primary literature review. The secondary review yielded a comprehensive Institute of Medicine report, as well as four relevant meta-analyses addressing disclosure of COIs in health care. They revealed a broad consensus that disclosure of COIs is desirable in such areas as research publication, guideline development, medical education, and clinical care. Conclusions The committee recommends the criteria that are currently used to operationally define the quality dimension “disclosing conflicts of interest” be changed as follows (changes in italics): Does the patient decision aid: • report prominently and in plain language the source of funding to develop or exclusively distribute the patient decision aid? • report prominently and in plain language whether funders, authors, or their affiliations, stand to gain or lose by choices patients make after using the patient decision aid? Furthermore, based on a consensus that simple disclosure is insufficient to protect users from potentially biased information, the committee recommends that the IPDAS Collaboration consider adding the following criterion when the IPDAS consensus process is next conducted: “Does the patient decision aid: • report that no funding to develop or exclusively distribute the patient decision aid has been received from commercial, for-profit entities that sell tests or treatments included as options in the patient decision aid?” PMID:24625114

2013-01-01

367

HIV Incidence  

MedlinePLUS

... 4.2 times that of females (7.3). Blacks/African Americans Blacks/African Americans continue to be disproportionately affected by HIV infection. The estimated rate of new HIV infections among blacks/African Americans (68.9) was 7.9 times ...

368

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

PubMed Central

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

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

2013-01-01

369

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

PubMed

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

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

2013-05-01

370

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

PubMed Central

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

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

2014-01-01

371

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

PubMed

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

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

2015-03-01

372

Distribution of Human Papillomavirus Genotypes among HIV-Positive and HIV-Negative Women in Cape Town, South Africa  

PubMed Central

Objective: HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). Methods: We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17–65?years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid Capture 2) with positive samples tested to determine the specific genotype (Line Blot). CIN status was determined based on colposcopy and biopsy. Results: The HPV prevalence was higher among HIV-positive women (52.4%) than among HIV-negative women (20.8%) overall and in all age groups. Younger women, aged 17–19?years, had the highest HPV prevalence regardless of HIV status. HIV-positive women were more likely to have CIN 2 or 3 than HIV-negative women. HPV 16, 35, and 58 were the most common high-risk HPV types with no major differences in the type distribution by HIV status. HPV 18 was more common in older HIV-positive women (40–65?years) with no or low grade disease, but less common in younger women (17–29?years) with CIN 2 or 3 compared to HIV-negative counterparts (p?HIV-positive than HIV-negative women, controlling for age and cervical disease status. Conclusion: HIV-positive women were more likely to have high-risk HPV than HIV-negative women; but, among those with HPV, the distribution of HPV types was similar by HIV status. Screening strategies incorporating HPV genotyping and vaccination should be effective in preventing cervical cancer in both HIV-positive and -negative women living in sub-Saharan Africa. PMID:24672770

McDonald, Alicia C.; Tergas, Ana I.; Kuhn, Louise; Denny, Lynette; Wright, Thomas C.

2014-01-01

373

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

E-print Network

Information (PHI) may only be accessed / used or (disclosed), as follows: to those directly involved a patient for physical therapy. According to New York State Law "...a subject over the age of 12 mayTITLE: AUTHORIZATION TO DISCLOSE PATIENT INFORMATION PATIENT ACCESS ­ USE AND DISCLOSURE OF MEDICAL

Columbia University

374

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

ERIC Educational Resources Information Center

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

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

2013-01-01

375

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

ERIC Educational Resources Information Center

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

Kogan, Steven M.

2004-01-01

376

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

Code of Federal Regulations, 2013 CFR

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

2013-04-01

377

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

Code of Federal Regulations, 2010 CFR

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

2010-04-01

378

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

Code of Federal Regulations, 2011 CFR

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

2011-04-01

379

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

Code of Federal Regulations, 2012 CFR

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

2012-04-01

380

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

Code of Federal Regulations, 2014 CFR

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

2014-04-01

381

Pretreatment loss-to-follow-up after HIV diagnosis from 27 counseling and testing centers across India: findings from a cohort study.  

PubMed

Individuals testing HIV positive were interviewed at testing centers, followed prospectively and interviewed again when they registered at referral antiretroviral therapy (ART) centers (ARTCs). Those who did not register at ARTCs were traced and interviewed in the community. A total of 1057 newly diagnosed people living with HIV (PLHIV; 52% women; mean age, 34.7 years) were recruited. A total of 73.5% of PLHIV registered at referral ARTCs within 60 days, 17.9% did not register and were interviewed in the community, and 8.6% were not interviewed. The 2 main reasons cited for not registering were a perception of good health (30%) and work/family engagements (22%). Single clients (adjusted relative risk [ARR]: 1.54; 95% confidence interval [CI]: 1.02-2.34), participants who had not disclosed their HIV status (ARR: 2.32; 95%CI: 1.77-3.05), participants who knew a PLHIV (ARR: 1.89; 95% CI: 1.41-2.53), and participants from laborer households (ARR: 2.66; 95%CI:1.15-6.15) were more likely to not register. In conclusion, the majority of newly diagnosed PLHIV do reach ARTCs. Disclosure concerns and a perception of good health prevent PLHIV from accessing services. PMID:23418205

Sarna, Avina; Sebastian, Mary; Bachani, Damodar; Sogarwal, Ruchi; Battala, Madhusudana

2014-01-01

382

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

PubMed

One key component in HIV prevention is serostatus disclosure. Until recently, many studies have focused on interpersonal factors and minimally considered meeting venues as they pertain to disclosure. Using data (N = 3,309) from an online survey conducted across 16 U.S. metropolitan statistical areas, we examined whether HIV serodisclosure varies by online/offline meeting venues in both protected and unprotected anal intercourse encounters. Most of the sample (76.9 %) reported meeting men for sex (last 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

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

2014-09-01

383

HIV and Rheumatic Disease  

MedlinePLUS

... Patient Resources > Diseases & Conditions Back to Diseases & Conditions HIV and Rheumatic Disease PRINT Download PDF HIV infection ... treatment and HIV infection all overlap. What are HIV-associated rheumatic diseases? Some diseases of the joints ...

384

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 ...

385

HIV Treatment: The Basics  

MedlinePLUS

... with HIV live longer, healthier lives. How do HIV medicines work? HIV attacks and destroys the infection- ... to sexual partners. What are risks of taking HIV medicines? Potential risks of ART include side effects ...

386

HIV Transmission  

PubMed Central

HIV-1 is transmitted by sexual contact across mucosal surfaces, by maternal-infant exposure, and by percutaneous inoculation. For reasons that are still incompletely understood, CCR5-tropic viruses (R5 viruses) are preferentially transmitted by all routes. Transmission is followed by an orderly appearance of viral and host markers of infection in the blood plasma. In the acute phase of infection, HIV-1 replicates exponentially and diversifies randomly, allowing for an unambiguous molecular identification of transmitted/founder virus genomes and a precise characterization of the population bottleneck to virus transmission. Sexual transmission of HIV-1 most often results in productive clinical infection arising from a single virus, highlighting the extreme bottleneck and inherent inefficiency in virus transmission. It remains to be determined if HIV-1 transmission is largely a stochastic process whereby any reasonably fit R5 virus can be transmitted or if there are features of transmitted/founder viruses that facilitate their transmission in a biologically meaningful way. Human tissue explant models of HIV-1 infection and animal models of SIV/SHIV/HIV-1 transmission, coupled with new challenge virus strains that more closely reflect transmitted/founder viruses, have the potential to elucidate fundamental mechanisms in HIV-1 transmission relevant to vaccine design and other prevention strategies. PMID:23043157

Shaw, George M.; Hunter, Eric

2012-01-01

387

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...

388

HIV disclosure and discussions about grief with Shona children: a comparison between health care workers and community members in Eastern Zimbabwe.  

PubMed

Research in HIV-related counseling for African children has concentrated on urban tertiary hospitals, but most children have their first health care encounter at a rural primary health care center. This study investigated perceptions about the acceptability of disclosing the parents' or child's HIV status to a child and talking about grief with children, as well as the preferred time, type and setting for HIV disclosure. An anonymous survey was taken from 64 primary health care workers and 131 community members from rural Eastern Zimbabwe. The results expressed a high need and desire for such communications and should be interpreted against a background of high perceived confidence to talk about grief with adults and a high degree of familiarity with child bereavement and foster care. The participants preferred that partial disclosure occurs from the age of 10.8 (+/-4.2) years and full disclosure from the age of 14.4 (+/-4.5) years. Compared to community members, health care workers were significantly more open to full disclosure and disclosure at a younger age but were slightly less open to discussing grief. The different preferred combinations of persons to initiate such communications included a health care worker in up to 56% of the responses and a family member in up to 52%. The most commonly preferred family members were father's sister (up to 37%) and grandmother (up to 40%) rather than the partner (up to 15%). Southern African family dynamics may hinder a mother initiating HIV disclosure and discussions about grief, even though she is traditionally present during HIV diagnosis, counseling and health education. A more culturally adapted approach than the standard Western 'couple approach' may thus be required. Consequently, counseling training models may need to be adapted. Further research into empowering mothers to involve significant members from the extended family may be highly beneficial. PMID:17928117

De Baets, Anniek J; Sifovo, Sibongile; Parsons, Ross; Pazvakavambwa, Isidore E

2008-01-01

389

Anolunula in Fingernails among Patients Infected with HIV  

PubMed Central

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

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

2014-01-01

390

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/ ...

391

Sexual health for people living with HIV.  

PubMed

Sexual health is defined in terms of well-being, but is challenged by the social, cultural and economic realities faced by women and men with HIV. A sexual rights approach puts women and men with HIV in charge of their sexual health. Accurate, accessible information to make informed choices and safe, pleasurable sexual relationships possible is best delivered through peer education and health professionals trained in empathetic approaches to sensitive issues. Young people with HIV especially need appropriate sex education and support for dealing with sexuality and self-identity with HIV. Women and men with HIV need condoms, appropriate services for sexually transmitted infections, sexual dysfunction and management of cervical and anogenital cancers. Interventions based on positive prevention, that combine protection of personal health with avoiding HIV/STI transmission to partners, are recommended. HIV counselling following a positive test has increased condom use and decreased coercive sex and outside sexual contacts among discordant couples. HIV treatment and care have reduced stigma and increased uptake of HIV testing and disclosure of positive status to partners. High adherence to antiretroviral therapy and safer sexual behaviour must go hand-in-hand. Sexual health services have worked with peer educators and volunteer groups to reach those at higher risk, such as sex workers. Technological advances in diagnosis of STIs, microbicide development and screening and vaccination for human papillomavirus must be available in developing countries and for those with the highest need globally. PMID:17531749

Shapiro, Kathy; Ray, Sunanda

2007-05-01

392

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

PubMed

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

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

2015-03-01

393

Parent and adolescent intentions to disclose and links to positive social behavior.  

PubMed

Children's disclosure to parents as a buffer against antisocial behavior, and its parenting antecedents, have been extensively studied in recent years. The influence of parents' own disclosure on children's disclosure and positive social behavior has received little attention, however. We assessed mothers' (n = 149), fathers' (n= 105), and 12- to 14-year-old early adolescents' (n = 127) intentions to disclose about distress-related events and rule transgressions, their reasons for disclosing, and links to positive social behavior (assessed by mothers' ratings of willing compliance and by teachers' [n = 114] ratings of prosocial behavior). Parents reported that they disclosed to teach lessons or to encourage their children to disclose, whereas adolescents said they disclosed for comfort and advice. Child intention to disclose about distressing events mediated between mother (but not father) intention to disclose about these same issues and children's willing compliance, but not prosocial behavior in the classroom. Parent and child disclosure about rule transgressions were not related. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25495640

Chaparro, Maria Paula; Grusec, Joan E

2015-02-01

394

What factors are associated with patient self-reported health status among HIV outpatients? A multi-centre UK study of biomedical and psychosocial factors  

Microsoft Academic Search

Patient self-reported outcomes are increasingly important in measuring disease, treatment and care outcomes. It is unclear what constitutes well-being using a combined biomedical and psychosocial approach for patients with antiretroviral therapy (ART) access. This study aimed to determine the variance within the visual analogue scale (VAS) measure of health status using the existing five dimensions of the EuroQOL-5D, to identify

Richard Harding; Claudine Clucas; Fiona C. Lampe; Heather Leake Date; Martin Fisher; Margaret Johnson; Simon Edwards; Jane Anderson; Lorraine Sherr

2012-01-01

395

Prevalence of HIV Antibodies in Pregnant Women With Increased Risk for AIDS  

Microsoft Academic Search

The prevalence of Human immunodeficiency virus (HIV) antibodies in pregnant women varies widely between industrialized and developing countries. There is a lack of information about the status of HIV-infected pregnant women with increased risk for AIDS. Our objective was to determine the prevalence of HIV antibodies in pregnant women with increased risk at the Hospital of Obstetrics and Gynecology of

Gustavo Romero-Gutiérrez; Fátima Rocío De Luna-Ortega; Alejandra Horna-López; Ana Lilia Ponce-Ponce De León

2009-01-01

396

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

ERIC Educational Resources Information Center

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…

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

2010-01-01

397

Age and HIV Sexual Risk among Women in Methadone Treatment  

Microsoft Academic Search

This study examines the relationship between age and HIV sexual risk behaviors among a random sample of 372 women in methadone\\u000a treatment in New York City. Logistic regression results indicate that women of all ages are at risk for HIV through inconsistent\\u000a condom use. Exposure to intimate partner violence (IPV), alcohol use, and HIV-negative status are associated with inconsistent\\u000a condom

Malitta Engstrom; Tazuko Shibusawa; Nabila El-Bassel; Louisa Gilbert

2011-01-01

398