Sample records for disclosing hiv status

  1. A combined chemometric and quantitative NMR analysis of HIV/AIDS serum discloses metabolic alterations associated with disease status

    PubMed Central

    McKnight, Tracy R.; Yoshihara, Hikari A. I.; Sitole, Lungile J.; Martin, Jeffery N.; Steffens, Francois; Meyer, Debra

    2015-01-01

    Individuals infected with the human immunodeficiency virus (HIV) often suffer from concomitant metabolic complications. Treatment with antiretroviral therapy has also been shown to alter the metabolism of patients. Although chemometric analysis of nuclear magnetic resonance (NMR) spectra of human sera can distinguish normal sera (HIVneg) from HIV-infected sera (HIVpos) and sera from HIV-infected patients on antiretroviral therapy (ART), quantitative analysis of the discriminating metabolites and their relationship to disease status has yet to be determined. The objectives of the study were to analyze NMR spectra of HIVneg, HIVpos, and ART serum samples with a combination of chemometric and quantitative methods and to compare the NMR data with disease status as measured by viral load and CD4 count. High-resolution magic angle spinning (HRMAS) NMR spectroscopy was performed on HIVneg (N = 10), HIVpos (N = 10), and ART (N = 10) serum samples. Chemometric linear discriminant analysis classified the three groups of spectra with 100% accuracy. Concentrations of 12 metabolites were determined with a semi-parametric metabolite quantification method named high-resolution quantum estimation (HR-QUEST). CD4 count was directly associated with alanine (p = 0.008), and inversely correlated with both glutamine (p = 0.017) and glucose (p = 0.022) concentrations. A multivariate linear model using alanine, glutamine and glucose as covariates demonstrated an association with CD4 count (p = 0.038). The combined chemometric and quantitative analysis of the data disclosed previously unknown associations between specific metabolites and disease status. The observed associations with CD4 count are consistent with metabolic disorders that are commonly seen in HIV-infected patients. PMID:25105420

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  4. Keeping and Disclosing a Secret among People with HIV in Israel

    ERIC Educational Resources Information Center

    Landau, Gila; York, Alan S.

    2004-01-01

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

  5. 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

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

    2014-01-01

    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

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

    PubMed Central

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

    2010-01-01

    With the advent of highly active antiretroviral therapy (HAART) HIV-infected children are surviving into adulthood. Despite, emerging evidence of the benefits of disclosure, when and how to disclose the diagnosis of HIV to children remain a clinical dilemma. We investigated the prevalence and determinants of HIV disclosure in a cross-sectional study of 71 caregiver-child dyads from the Pediatric HIV/AIDS Care Program at Korle-Bu Teaching Hospital (Accra, Ghana). The children were from 8 to 14 years with median age of 10.39 years. The prevalence of disclosure was 21%. Age (p<0.01), the level of education (p<0.01), deceased biologic father (p=0.02), administration of own HIV medications (p=0.02), and longer duration on HIV medication (p=0.02) were significantly associated with disclosure. The low prevalence of disclosure underscores the need for a systematic and a staged approach in disclosing HIV status to infected children in resource limited countries. PMID:20607381

  7. Management of conflicts arising from disclosure of HIV status among married women in southwest Nigeria.

    PubMed

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

    2015-01-01

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

  8. HIV-related knowledge, stigma, and willingness to disclose: A mediation analysis

    Microsoft Academic Search

    H. Yang; X. Li; B. Stanton; X. Fang; D. Lin; S. Naar-King

    2006-01-01

    Increasing HIV knowledge is a focus of many HIV education and prevention efforts. While the bivariate relationship of HIV serostatus disclosure with HIV-related knowledge and stigma has been reported in the literature, little is known about the mediation effect of stigma on the relationship of HIV knowledge with HIV serostatus disclosure. Data from 4,208 rural-to-urban migrants in China were analyzed

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

    PubMed Central

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

    2013-01-01

    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

  10. HIV status disclosure, depressive symptoms, and sexual risk behavior among HIV-positive young men who have sex with men.

    PubMed

    Cook, Stephanie H; Valera, Pamela; Wilson, Patrick A

    2015-06-01

    The rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A particular focus is given to depressive symptoms and their potential role in explaining the association between HIV disclosure and sexual risk behavior. In a sample of 991 YMSM receiving care at 20 clinics across the United States, Univariate and multivariate analyses were conducted to explore these associations. Approximately one-half (52.4 %) of participants reported disclosing to their current sexual/romantic partner. Disclosure to family members was negatively associated with sexual risk behavior. Also, depressive symptoms were positively associated with sexual risk behavior. We discuss the implications of our findings for future research and intervention. PMID:25773478

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

    PubMed Central

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

    2011-01-01

    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

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

    PubMed Central

    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

    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

  13. Disclosure of HIV status to children in resource-limited settings: a systematic review

    PubMed Central

    Vreeman, Rachel C; Gramelspacher, Anna Maria; Gisore, Peter O; Scanlon, Michael L; Nyandiko, Winstone M

    2013-01-01

    Introduction Informing children of their own HIV status is an important aspect of long-term disease management, yet there is little evidence of how and when this type of disclosure takes place in resource-limited settings and its impact. Methods MEDLINE, EMBASE and Cochrane Databases were searched for the terms hiv AND disclos* AND (child* OR adolesc*). We reviewed 934 article citations and the references of relevant articles to find articles describing disclosure to children and adolescents in resource-limited settings. Data were extracted regarding prevalence of disclosure, factors influencing disclosure, process of disclosure and impact of disclosure on children and caregivers. Results Thirty-two articles met the inclusion criteria, with 16 reporting prevalence of disclosure. Of these 16 studies, proportions of disclosed children ranged from 0 to 69.2%. Important factors influencing disclosure included the child's age and perceived ability to understand the meaning of HIV infection and factors related to caregivers, such as education level, openness about their own HIV status and beliefs about children's capacities. Common barriers to disclosure were fear that the child would disclose HIV status to others, fear of stigma and concerns for children's emotional or physical health. Disclosure was mostly led by caregivers and conceptualized as a one-time event, while others described it as a gradual process. Few studies measured the impact of disclosure on children. Findings suggested adherence to antiretroviral therapy (ART) improved post-disclosure but the emotional and psychological effects of disclosure were variable. Conclusions Most studies show that a minority of HIV-infected children in resource-limited settings know his/her HIV status. While caregivers identify many factors that influence disclosure, studies suggest both positive and negative effects for children. More research is needed to implement age- and culture-appropriate disclosure in resource-limited settings. PMID:23714198

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

    PubMed Central

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

    2009-01-01

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

  15. Disclosure, Knowledge of Partner Status, and Condom Use Among HIV-Positive Patients Attending Clinical Care in Tanzania, Kenya, and Namibia

    PubMed Central

    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

    2013-01-01

    Abstract 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

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

    PubMed Central

    Gultie, Teklemariam; Genet, Minichil; Sebsibie, Girum

    2015-01-01

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

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

    PubMed

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

    2013-12-01

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

  18. HIV status disclosure to families for social support in South Africa (NIMH Project Accept/HPTN 043).

    PubMed

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

    2014-02-01

    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 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

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

    PubMed Central

    2013-01-01

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

  20. Iron status and the outcome of HIV infection: an overview

    Microsoft Academic Search

    Victor R. Gordeuk; Joris R. Delanghe; Michel R. Langlois; Johan R. Boelaert

    2001-01-01

    Background: Theoretical considerations and experiments in the laboratory suggest that excessive iron stores may have an adverse effect on immunity. If so, high iron stores might be especially a problem in patients with human immunodeficiency virus (HIV) infection. Objective and study design: Review published clinical studies that provide information regarding the effect of iron status on the outcome of HIV

  1. Antiretroviral Therapy as HIV Prevention: Status and Prospects

    PubMed Central

    Venkatesh, Kartik K.

    2010-01-01

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

  2. Maternal HIV status and infant feeding practices among Ugandan women

    Microsoft Academic Search

    Pius Okong; Praxedes Kituuka Namaganda; Luciana Bassani; Mary Mbidde Tabaro; Francesca Zanetto; Edith Birungi Mwebaze; Liliana Weimer; Lina Tomasoni; Francesco Castelli; Marina Giuliano

    2010-01-01

    To describe the infant feeding practices in the general population in Uganda, and to assess the impact of maternal HIV status on these practices, a questionnaire was administered to women attending the follow-up clinics for child vaccination. Among the mothers who were still breastfeeding at the time of interview (N=838), 61.4% of the HIV-infected women had planned to breastfeed for

  3. Health & nutritional status of HIV infected children in Hyderabad, India

    PubMed Central

    Swetha, G. Krishna; Hemalatha, R.; Prasad, U.V.; Murali, Vasudev; Damayanti, K.; Bhaskar, V.

    2015-01-01

    Background & objectives: Information on nutritional status of HIV infected children from India is lacking and is required before taking up nutritional supplementation trials. Thus, the aim of the present study was to assess the growth and morbidity status of HIV infected children over a period of one year in a city in southern India. Methods: This was an observational study carried out between July 2009 and February 2011, at two orphanages in Hyderabad, India. Seventy seven HIV-positive children aged between 1 and half and and 15 years, both on and not on antiretroviral therapy (ART) were included. Nutritional status was assessed longitudinally for one year by weight gain, linear growth and body composition. Serum samples were analyzed for haemoglobin, micronutrients, CD4 and CD8 counts. Dietary intakes were assessed by institutional diet survey and morbidity data were recorded every day for 12 months. Results: Mean energy intakes were less than recommended dietary allowance (RDA) in all age groups. Iron and folate intakes were less than 50 per cent of RDA; 46 (59.7%) children were stunted, 36 (46.8%) were underweight and 15 (19.5%) had low BMI for age. Anaemia was observed in 35 (45.5%) children. Micronutrient deficiencies such as vitamin D (40/77; 51.9%), vitamin A (11/77; 14.3%), folate (37/77; 48.1%), iron (38/77; 49.3%) were widely prevalent. HIV viral load was higher in children not on ART and those with morbidity. Respiratory (36.6%) and dermatological illnesses (18.8%) were the commonest presentations. Interpretation & conclusions: Acute, chronic malnutrition and micronutrient deficiencies were common in HIV infected children, especially in those not on ART and having morbidity. With severe malnutrition being an alarming consequence of HIV, prophylactic nutritive care should be considered for integration into HIV care strategies besides initiation of ART to improve the nutritional status and quality of life of these children. PMID:25857494

  4. The global HIV epidemic: current status and challenges.

    PubMed

    Abdool Karim, Quarraisha

    2013-06-01

    Three decades after the first reported cases of AIDS we have within our reach sufficient evidence to substantially alter the HIV epidemic at a country level regardless of mode of transmission of HIV. There are a growing number of countries demonstrating control of the epidemic. Human rights violations and/or legislation relating to sexual orientation, status of minors, injecting drug use and sex work together with stigma and discrimination remain key barriers to knowledge of HIV status and access to appropriate services. The use of anti-retrovirals prophylactically to reduce sexual and vertical transmission and systemically to treat infected infants and adults is central to the optimism in responses to the epidemic. In the current fiscal climate careful thought needs to be given to how to efficiently optimise combinations of what is available to have the biggest impact in the context of limited human and infrastructure resources. PMID:23568544

  5. Murderer's HIV status irrelevant in trial of accomplice.

    PubMed

    1996-11-01

    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

  6. Current Status of HIV/AIDS in South Asia

    PubMed Central

    Rodrigo, Chaturaka; Rajapakse, Senaka

    2009-01-01

    Background: According to the United Nations Joint Program on HIV/AIDS, 33.2 million adults and children are living with the infection worldwide. Of these, two to three million are estimated to be in South Asia. All countries of the region have a low prevalence of human immunodeficiency virus (HIV). However, it is important to review the current epidemiological data to identify the trends of infection as it would have implications on prevention. Materials and Methods: We performed a MEDLINE search using phrases ‘South Asia’ plus ‘HIV’, ‘AIDS’, and names of individual countries in South Asia (limits: articles published in last 10 years, in English language). Clinical trials, reviews, meta-analyses, letters, editorials, and practice guidelines were all considered. The following countries were included as belonging to South Asia; Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. Recent estimates and data on country status, and details of national control programs were obtained from websites of international agencies such as the World Bank and United Nations Joint Program on HIV/AIDS (UNAIDS). Results and Discussion: This review looks into many aspects of HIV infection in South Asia including country profiles with regard to infection, economic and psychological burden of illness and treatment issues in the South Asian context. PMID:20300398

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

    PubMed

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

    2004-08-01

    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

  8. Nutritional status assessment of HIV-positive drug addicts.

    PubMed

    Varela, P; Marcos, A; Ripoll, S; Requejo, A; Herrera, P; Casas, A

    1990-05-01

    Since human immunodeficiency virus (HIV) is known to lead to modifications of immune function and interrelationships among malnutrition, anergy and drug addiction have been shown, the aim of this work was to assess the nutritional status of 36 male heroin addicts under a period of detoxication (3 months). They were divided into two groups: (1) HIV negative (n = 20) and (2) HIV positive (n = 16); heights, weights and serum albumin concentration were measured and immune function was tested, using delayed hypersensitivity skin tests containing 7 antigens. No significant differences in anthropometric measurements were found between both groups, but anthropometric improvement was shown in every patient after the detoxication period. Serum albumin, often used as a classical index of malnutrition, remained within the normal values in both groups. The whole response to skin tests was depressed in both groups and no significant differences were shown between them. Therefore, these results might suggest that in spite of the apparent anthropometric recovery and the normal values of albumin, a subclinical malnutrition was indicated by the depressed immune function, which was more noticeable in the HIV-positive group. PMID:2387276

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

    PubMed Central

    Wanke, Christine; Terrin, Norma; Skinner, Sally; Knox, Tamsin

    2010-01-01

    Despite combination antiretroviral therapy (ART), HIV infected people have higher mortality than non-infected. Lower socioeconomic status (SES) predicts higher mortality in many chronic illnesses but data in people with HIV is limited. We evaluated 878 HIV infected individuals followed from 1995 to 2005. Cox proportional hazards for all-cause mortality were estimated for SES measures and other factors. Mixed effects analyses examined how SES impacts factors predicting death. The 200 who died were older, had lower CD4 counts, and higher viral loads (VL). Age, transmission category, education, albumin, CD4 counts, VL, hunger, and poverty predicted death in univariate analyses; age, CD4 counts, albumin, VL, and poverty in the multivariable model. Mixed models showed associations between (1) CD4 counts with education and hunger; (2) albumin with education, homelessness, and poverty; and (3) VL with education and hunger. SES contributes to mortality in HIV infected persons directly and indirectly, and should be a target of health policy in this population. PMID:20632079

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

    Microsoft Academic Search

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

    2012-01-01

    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

  11. Correlates of HIV-status awareness among adults in Nairobi slum areas.

    PubMed

    Ettarh, Remare Renner; Kimani, James; Kyobutungi, Catherine; Wekesah, Frederick

    2012-12-01

    The prevalence of HIV in the adult population in slum areas in Nairobi, Kenya, is higher than for residents in the city as a whole. This disparity suggests that the characteristics of slum areas may adversely influence the HIV-prevention strategies directed at reducing the national prevalence of HIV. The objective of the study was to identify some of the sociodemographic and behavioural correlates of HIV-status awareness among the adult population of two slums in Nairobi. In a household-based survey conducted by the African Population and Health Research Center (APHRC), 4 767 men and women aged between 15 and 54 years were randomly sampled from two slums (Korogocho and Viwandani) in Nairobi and data were collected on the social and health context of HIV and AIDS in these settlements. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with HIV-status awareness. The proportion of respondents that had ever been tested and knew their HIV status was 53%, with the women having greater awareness of their HIV status (62%) than the men (38%). Awareness of HIV status was significantly associated with age, sex, level of education, marital status and slum of residence. The lower level of HIV-status awareness among the men compared with the women in the slums suggests a poor uptake of HIV-testing services by males. Innovative strategies are needed to ensure greater access and uptake of HIV-testing services by the younger and less-educated residents of these slums if the barriers to HIV-status awareness are to be overcome. PMID:25860192

  12. Family Group Psychotherapy to Support the Disclosure of HIV Status to Children and Adolescents

    PubMed Central

    Nicastro, Emanuele; Continisio, Grazia Isabella; Storace, Cinzia; Bruzzese, Eugenia; Mango, Carmela; Liguoro, Ilaria; Officioso, Annunziata

    2013-01-01

    Abstract Disclosure of the HIV status to infected children is often delayed due to psychosocial problems in their families. We aimed at improving the quality of life in families of HIV-infected children, thus promoting disclosure of the HIV status to children by parents. Parents of 17 HIV-infected children (4.2–18 years) followed at our Center for pediatric HIV, unaware of their HIV status, were randomly assigned to the intervention group (8 monthly sessions of family group psychotherapy, FGP) or to the control group not receiving psychotherapy. Changes in the Psychological General Well-Being Index (PGWB-I) and in the Short-Form State-Trait Anxiety Inventory (Sf-STAI), as well as the HIV status disclosure to children by parents, were measured. Ten parents were assigned to the FGP group, while 7 parents to the controls. Psychological well-being increased in 70% of the FGP parents and none of the control group (p=0.017), while anxiety decreased in the FGP group but not in controls (60% vs. 0%, p=0.03). HIV disclosure took place for 6/10 children of the intervention group and for 1/7 of controls. Family group psychotherapy had a positive impact on the environment of HIV-infected children, promoting psychological well-being and the disclosure of the HIV status to children. PMID:23691925

  13. Gender differences between predictors of HIV status among PWID in Ukraine

    PubMed Central

    Corsi, K.F.; Dvoryak, S.; Garver-Apgar, C.; Davis, J.M.; Brewster, J.T.; Lisovska, O.; Booth, R.E.

    2014-01-01

    Background The HIV epidemic in Ukraine is among the largest in Europe. While traditionally the epidemic has spread through injection risk behavior, sexual transmission is becoming more common. Previous research has found that women in Ukraine have higher rates of HIV and engage in more HIV risk behavior than men. This study extended that work by identifying risk factors that differentially predict men and women’s HIV status among people who inject drugs (PWID) in Ukraine. Methods From July 2010 through July 2013, 2480 sexually active PWID with unknown HIV status were recruited from three cities in Ukraine through street outreach. The average age was 31 years old. Results Women, who made up twenty-eight percent of the sample, had higher safe sex self-efficacy (p<0.01) and HIV knowledge (p<0.001) than men, but scored higher on both the risky injection (p<0.001) and risky sex (p<0.001) composite scores than men. Risky sex behaviors were associated with women’s HIV status more than men’s. We also report results identifying predictors of risky injection and sex behaviors. Conclusions Gender-specific interventions could address problem of HIV risk among women who inject drugs in a country with a growing HIV epidemic. Our findings suggest specific ways in which intervention efforts might focus on groups and individuals who are at the highest risk of contracting HIV (or who are already HIV positive) to halt the spread of HIV in Ukraine. PMID:24613219

  14. The who and where of HIV in rural Malawi: Exploring the effects of person and place on individual HIV status.

    PubMed

    Feldacker, Caryl; Emch, Michael; Ennett, Susan

    2010-09-01

    Few spatial studies explore relationships between people and place in sub-Saharan Africa or in the context of human immunodeficiency virus (HIV). This paper uses individual-level demographic and behavioral data linked to area-level, spatially referenced socio-economic and access data to examine how the relationships between area- and individual-level risks and individual HIV status vary in rural Malawi. The political economy of health framework guides interpretation. Geographically weighted regression models show significant, local-level variation indicating that area-level factors drive patterns of HIV above individual-level contributions. In distinct locations, women who live further from health clinics, major roads, and major cities are less likely to be infected. For men, HIV status is strongly associated with migration patterns in specific areas. Local-level, gender-specific approaches to HIV prevention are necessary in high risk areas. PMID:20598623

  15. The who and where of HIV in rural Malawi: Exploring the effects of person and place on individual HIV status

    PubMed Central

    Feldacker, Caryl; Emch, Michael; Ennett, Susan

    2012-01-01

    Few spatial studies explore relationships between people and place in sub-Saharan Africa or in the context of Human Immunodeficiency Virus (HIV). This paper uses individual-level demographic and behavioral data linked to area-level, spatially-referenced socio-economic and access data to examine how the relationships between area- and individual-level risks and individual HIV status vary in rural Malawi. The Political Economy of Health framework guides interpretation. Geographically weighted regression models show significant, local-level variation indicating that area-level factors drive patterns of HIV above individual-level contributions. In distinct locations, women who live further from health clinics, major roads, and major cities are less likely to be infected. For men, HIV status is strongly associated with migration patterns in specific areas. Local-level, gender-specific approaches to HIV prevention are necessary in high risk areas. PMID:20598623

  16. Glutathione, glutathione peroxidase, and selenium status in HIV-positive and HIV-negative adolescents and young adults1-3

    Microsoft Academic Search

    Charles B Stephensen; Grace S Marquis; Steven D Douglas; Laurie A Kruzich; Craig M Wilson

    Background:Antioxidantnutrientdeficienciesmayhastenthepro- gression of HIV disease by impairing antioxidant defenses. Objective:TheobjectiveofthestudywastodeterminewhetherHIV infectionisassociatedwithpoorseleniumstatusandlowantioxidant protection by glutathione and glutathione peroxidase (GPX). Design: In a cross-sectional study of 365 HIV-positive and HIV- negative adolescents and young adults, we examined the relation of plasma selenium, whole-blood glutathione, and whole-blood GPX to HIV status, disease severity, immune activation, and oxidative damage. Results: Selenium deficiency (plasma selenium

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

    Microsoft Academic Search

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

    1997-01-01

    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

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

    PubMed Central

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

    2014-01-01

    Background Both HIV-1 infection and illicit stimulant use can adversely impact neurocognitive functioning, and these effects can be additive. However, significant variability exists such that as-of-yet unidentified exogenous and endogenous factors affect ones risk for neurocognitive impairment. Both HIV and stimulant literature indicates that host genetic variants in immunologic and dopamine-related genes are one such factor. In this study the individual and interactive effects of HIV status, stimulant use, and genotype upon neurocognitive functioning was examined longitudinally over a 10 year period. Methods 952 Caucasian HIV+ and HIV? cases from the Multicenter AIDS Cohort Study were included. All cases had at least two comprehensive neurocognitive evaluations between 1985 and 1995. Pre-HAART data was examined in order to avoid the confounding effect of variable drug regimens. Linear mixed models were used, with neurocognitive domain scores as the outcome variables. Results No 4-way interactions were found, indicating that HIV and stimulant use do not interact over time to affect neurocognitive functioning as a function of genotype. Multiple 3-way interactions were found that involved genotype and HIV status. All immunologic-related genes found to interact with HIV status affected neurocognitive functioning in the expected direction; however, only CCL2 and CCL3 affected HIV+ individuals specifically. Dopamine-related genetic variants generally affected HIV-negative individuals only. Neurocognitive functioning among HIV+ individuals who also used stimulants was not significantly different from those who did not use stimulants. Conclusion The findings support the role of immunologic-related genetic differences in CCL2 and CCL3 in neurocognitive functioning among HIV+ individuals; however their impact is minor. Consistent with findings from another cohort, DA-related genetic differences do not appear to impact the longitudinal neurocognitive functioning of HIV+ individuals. PMID:24737013

  19. Notification of HIV status disclosure and its related factors in HIV-infected adolescents in 2009 in the Aconda program (CePReF, CHU Yopougon) in Abidjan, Côte d'Ivoire, The PRADO-CI Study

    PubMed Central

    Meless, Guanga David; Aka-Dago-Akribi, Hortense; Cacou, Chantal; François Eboua, Tanoh; Edmond Aka, Addi; Maxime Oga, Aimé; Bouah, Belinda; Eugène, Messou; Moh, Corinne; Arrivé, Elise; Timité-Konan, Marguerite; Leroy, Valériane

    2013-01-01

    Introduction We studied the frequency of documentation of disclosure of HIV status in medical charts and its correlates among HIV-infected adolescents in 2009, in Abidjan, Côte d'Ivoire. Methods The PRADO-CI is a cross-sectional study aimed at studying HIV-infected adolescents’ social, psychological, and behavioural difficulties and their determinants in Abidjan, Côte d'Ivoire. In this study, we present specific analyses on disclosure. All HIV-infected adolescents aged 13–21 years and followed at least once in 2009 in two urban HIV-care centres in Abidjan (Cepref and Yopougon Teaching Hospital) were enrolled in the study. Standardized data were extracted from medical records to document if there was notification of disclosure of HIV status in the medical record. Frequency of notification of HIV disclosure was estimated with its 95% confidence interval (CI) and correlates were analyzed using logistic regression. Results In 2009, 229 adolescents were included: 126 (55%) males; 93% on antiretroviral therapy (ART), 61% on cotrimoxazole prophylaxis. Their median age was 15 years at the time of the study. Among the 193 patients for whom information on HIV status disclosure was documented (84%), only 63 (32.6%; 95% CI=26.0–39.3%) were informed of their status. The proportion of adolescents informed increased significantly with age: 19% for 13–15 years, 33% for 16–18 years and 86% for 19–21 years (p <0.0001). Adolescents on ART tended to be more likely to be informed of their HIV status (34.5%) than those not treated (13.3%) (p=0.11). Those on cotrimoxazole were significantly more likely to be informed (39.6%) than those not (21.9%) (p=0.01). Disclosure was significantly higher in adolescents with a history of ART regimen change (p=0.003) and in those followed in the Cepref (48.4%) compared to the Yopougon Teaching Hospital (24.8%), (p=0.001). In multivariate analyses, disclosed HIV status was significantly higher in those followed-up in the Cepref compared to the other centre: adjusted odds ratio (aOR)=3.5 (95% CI: 1.1–10.9), and among older adolescents compared to those aged 13–15 years: [16–18 years] aOR=4.2 (95% CI: 1.5–11.5) and [>18 years]: aOR=22.1 (95% CI: 5.2–93.5). Conclusions HIV disclosure rate was low among Ivoirian HIV adolescents and was site- and age-dependent. There is a need for practical interventions to support HIV disclosure to adolescents which provides age-appropriate information about the disease. PMID:23782475

  20. Iron status in HIV-1 infection: implications in disease pathology

    PubMed Central

    2012-01-01

    Background There had been conflicting reports with levels of markers of iron metabolism in HIV infection. This study was therefore aimed at investigating iron status and its possible mediation of severity of HIV- 1 infection and pathogenesis. Method Eighty (80) anti-retroviral naive HIV-1 positive and 50 sero-negative controls were recruited for the study. Concentrations of serum total iron, transferrin, total iron binding capacity (TIBC), CD4+ T -lymphocytes, vitamin C, zinc, selenium and transferrin saturation were estimated. Results The mean CD4+ T-lymphocyte cell counts, serum iron, TIBC, transferrin saturation for the tests and controls were 319 ± 22, 952 ± 57 cells/?l (P < 0.001), 35 ± 0.8, 11.8 ± 0.9??mol/l (P < 0.001), 58.5 ± 2.2, 45.2 ± 2.4??mol/l (P < 0.005) and 68.8 ± 3.3, 27.7 ± 2.2%, (P <0.001), respectively, while mean concentrations of vitamin C, zinc and selenium were 0.03 ± 0.01, 0.3 ± 0.04 (P < 0.001), 0.6 ± 0.05, 11.9 ± 0.26??mol/l (P < 0.001) and 0.1 ± 0.01, 1.2 ± 0.12??mol/l (P < 0.001) respectively. Furthermore, CD4+ T-lymphocyte cell count had a positive correlation with levels of vitamin C (r = 0.497, P < 0.001), zinc (r = 0.737, P < 0.001), selenium (r = 0.639, P < 0.001) and a negative correlation with serum iron levels (r = ?0.572, P < 0.001). Conclusion It could be inferred that derangement in iron metabolism, in addition to oxidative stress, might have contributed to the depletion of CD4+ T cell population in our subjects and this may result in poor prognosis of the disease. PMID:23245266

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

    PubMed Central

    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

    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

  2. HIV/AIDS in the courts--Canada. Argentinean couple living with HIV denied Convention refugee status.

    PubMed

    2005-08-01

    On 25 January 2005, the Federal Court of Canada upheld an Immigration and Refugee Board (IRB) decision refusing to grant refugee status to an HIV-positive man and his same-sex partner. Pablo Sergio Gonzalez and his partner, Nelson Horacio De-Robles, feared persecution by the government of Argentina because of Gonzalez's past political activity. PMID:16365980

  3. Disclosing Sexual Victimization

    ERIC Educational Resources Information Center

    Ciarlante, Mitru

    2007-01-01

    Exploring the process of disclosure for youth who have been sexually victimized, this article provides strategies for creating an environment where sexual violence is not accepted and where youth feel safe disclosing. It also provides strategies for working with youth who haven't yet disclosed. (Contains 1 footnote.)

  4. Cross Sectional Characterization of Factors Associated with Pediatric HIV Status Disclosure in Southern Ethiopia

    PubMed Central

    Tadesse, Birkneh Tilahun; Foster, Byron Alexander; Berhan, Yifru

    2015-01-01

    Background Disclosure of HIV positive status to children and adolescents is a complex process. However, disclosure has been found to be associated with improved outcomes. The objective of the current study was to identify the predictors that facilitate disclosure of HIV status to children and adolescents and to study the reasons for non-disclosure. Methods Interviews of caregivers and reviews of records were done to collect data on caregiver and child information and details regarding the disclosure status of children. Bivariate analysis was done to test the association between HIV status disclosure and different caregiver and child factors. To identify the independent predictors of disclosure, we did multivariable logistic regression. Results A total of 177 children attending an HIV clinic were included. The mean age of the participants was 10.1 years (SD = 2.8), and about half (50.8%) were female. Most caregivers, 137 (77.8%) stated that disclosure of HIV status to children is important and should be done. However, disclosure had only been made to 59 (33.3%) of the participants. Child age more than 10 years [AOR = 6.7; 95%CI: 1.73–26.01], duration of HIV diagnosis of 5 years or more [AOR = 4.4; 95%CI: 1.26–15.06] and taking a zidovudin (AZT) based regimen [AOR = 3.5; 95%CI: 1.31–9.53] predicted HIV positive status disclosure. Additionally, length of treatment of caregivers of more than 14 years [AOR = 3.9; 95%CI: 1.07–14.61], disclosure of caregiver’s HIV status to children and/or others [AOR = 4.7; 95%CI: 1.19–18.74], and the child’s inquiry about their condition [AOR = 4.5; 95%CI: 1.16–17.43] increased the odds of disclosure. Conclusion The rate of disclosure among HIV infected children in southern Ethiopia is low. Primarily time-based factors were associated with the probability of HIV positive status disclosure and a specific regimen which has not been found previously. Further qualitative research may elucidate more on these factors; educational strategies may address some of these determinants. PMID:26167687

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

    PubMed Central

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

    2009-01-01

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

  6. Perceptions of community and family level IDU and HIV related stigma, disclosure decisions and experiences with layered stigma among HIV positive injection drug users in Vietnam

    PubMed Central

    Rudolph, A.E.; Davis, W.W.; Quan, V.M.; Ha, T.V.; Minh, N.L.; Gregowski, A.; Salter, Megan; Celentano, D.D.; Go, V.

    2012-01-01

    This paper explores how perceived stigma and layered stigma related to injection drug use and being HIV positive influence the decision to disclose one’s HIV status to family and community and experiences with stigma following disclosure among a population of HIV positive male injection drug users (IDUs) in Thai Nguyen, Vietnam. In qualitative interviews conducted between 2007 and 2008, 25 HIV positive male IDUs described layered stigma in their community but an absence of layered stigma within their families. These findings suggest the importance of community level HIV prevention interventions that counter stigma and support families caring for HIV positive relatives. PMID:21777075

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

    PubMed Central

    Willie, B; Hall, NB; Stein, CM; Jurevic, RJ; Weinberg, A; Mehlotra, RK; Zimmerman, PA

    2014-01-01

    Single nucleotide polymorphisms (SNPs) in toll-like receptor (TLR) genes TLR2-4 and TLR7-9, but not in TLR1 and TLR6, have been previously evaluated regarding HIV acquisition and disease progression in various populations, most of which were European. In the present study, we examined associations between a total of 41 SNPs in 8 TLR genes (TLR1-4, TLR6-9) and HIV status in North American subjects (total n = 276 [Caucasian, n = 102; African American, n = 150; other, n = 24]). Stratification of the data by self-identified race revealed that a total of 9 SNPs in TLR1, TLR4, TLR6, and TLR8 in Caucasians, and 2 other SNPs, one each in TLR4 and TLR8, in African Americans were significantly associated with HIV status at P < 0.05. Concordant with the odds ratios of these SNPs, significant differences were observed in the SNP allele frequencies between HIV+ and HIV? subjects. Finally, in Caucasians, certain haplotypes of single (TLR1, TLR4) and heterodimer (TLR2_TLR6) genes may be inferred as “susceptible” or “protective”. Our study provides in-depth insight into the associations between TLR variants, particularly TLR1 and TLR6, and HIV status in North Americans, and suggests that these associations may be race-specific. PMID:25253287

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2015-02-01

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

  10. Housing status and HIV risk behaviors among transgender women in Los Angeles.

    PubMed

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

    2014-11-01

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

  11. Knowledge and Attitude about HIV/AIDS among HIV-Positive Individuals in Davangere.

    PubMed

    Mittal, Deepti; Babitha, G A; Prakash, Shobha; Kumar, Naveen; Prashant, G M

    2015-01-01

    A cross-sectional study was carried out on 100 HIV patients (55 male and 45 female) age 21 years and older registered at the Antiretroviral Therapy Centre of Chigateri General Hospital, Davangere, Karnataka, India, to evaluate their knowledge and attitude toward HIV. Overall, the source of knowledge about AIDS was through newspaper or television, 38% were aware of their AIDS status, 61% disclosed their status to family, 86% had incorrect knowledge about transmission, 57% experienced no moral support, 62% felt stigmatized, 52% discriminated against, 44% were denied treatment, 57% felt isolated, 54% experienced difficulty in carrying out daily activity, 52% of patients' social and personal life was affected, and 41% felt shy when disclosing their disease. This data reveals the need to consider the basic knowledge of the HIV patients about HIV/AIDS. PMID:26079940

  12. HIV and the Kidney: A status report after 20 years

    Microsoft Academic Search

    Monique E. Cho; Jeffrey B. Kopp

    2004-01-01

    The first association between HIV-1 infection and kidney disease was made in 1984 and much has been learned over the past\\u000a 20 years. In recent years, more effective therapies for HIV-1 infection and its associated opportunistic infections have led\\u000a to improved patient survival. However, with prolonged survival, morbidity associated with renal disease has also increased.\\u000a Among the multiple glomerulopathies that

  13. Prosthetic status and needs of HIV positive subjects

    Microsoft Academic Search

    Waszkiel D

    2006-01-01

    Purpose: The aim of this study is an evaluation of exist- ing dentition reconstructions in HIV-infected patients and definition of prosthetic needs of the examined population. Material and methods: We examined 49 HIV-infected subjects (19-52 years of age) and 49 non-infected patients as the control group. Dental services were evaluated using treatment structure. The analysis of teeth loss was per-

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

    PubMed Central

    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

    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

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

    PubMed Central

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

    2014-01-01

    Background HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women. Methods In this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV. Results Over 93% (1817) disclosed the HIV results to their partners (96.5% HIV? vs. 89.3% HIV+, p<0.0001). Overall HIV prevalence was 15.3%, (95%CI:13.7–16.9), 35.2% among non-disclosers and 14.3% among disclosers. Overall 32.8% reported IPV (40.5% HIV+; 31.5% HIV? women, p?=?0.004). HIV status was associated with IPV (partially adjusted 1.43: (95%CI:1.00–2.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.31–7.80). Factors associated with IPV were gender inequity, past IPV, risky sexual behaviours and living with relatives. IPV after HIV disclosure in pregnancy is high but lower than and is strongly related with IPV before pregnancy (adjusted OR 6.18, 95%CI: 3.84–9.93). Conclusion The study demonstrates the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. Health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened. PMID:25350001

  16. Supporting Healthy Alternatives through Patient Education: a theoretically driven HIV prevention intervention for persons living with HIV/AIDS.

    PubMed

    Estrada, Barbara D; Trujillo, Stephen; Estrada, Antonio L

    2007-09-01

    In the third decade of the HIV/AIDS epidemic, empirically based HIV transmission risk reduction interventions for HIV infected persons are still needed. As part of a Health Resources Services Administration/Special Projects of National Significance initiative to increase prevention services among HIV infected persons, we implemented SHAPE (Supporting Healthy Alternatives through Patient Education). SHAPE is a behavioral HIV prevention intervention delivered to HIV infected persons receiving primary medical care at El Rio Health Center in Tucson, Arizona. The SHAPE intervention is based on Kalichman's "Healthy Relationships for Men and Women Living with HIV-AIDS." The intervention is interactive and uses a video discussion intervention format where educational activities, movie clips, and discussions are used to provide participants with information and skills to increase their comfort in disclosing their HIV status and in reducing HIV transmission. This paper describes the intervention in sufficient detail to replicate it in other settings. PMID:17265144

  17. Disclosure of HIV Status to Perinatally Infected Adolescents in Urban Uganda: A Qualitative Study on Timing, Process, and Outcomes.

    PubMed

    Mutumba, Massy; Musiime, Victor; Tsai, Alexander C; Byaruhanga, Judith; Kiweewa, Francis; Bauermeister, José A; Snow, Rachel C

    2015-01-01

    Disclosure of HIV status to children and adolescents living with HIV remains a challenge in pediatric HIV care. Many of the current disclosure guidelines from national and international bodies recommend that perinatally infected children be informed of their HIV status prior to adolescence, but rates of disclosure in both high- and low-income countries remains low. The applicability of the recommendations to low-income countries remains largely unknown, as few studies have explored the disclosure process in these settings. Our purpose was to explore disclosure experiences of HIV-infected adolescents in Uganda. Disclosure was a largely one-time event conducted by health care providers. The average age at disclosure was 13 years. Disclosure elicited a diverse array of positive and negative reactions, including suicidal ideation; reactions were closely associated with participant age, gender, knowledge about HIV, and health status at time of disclosure. Interventions to promote locally effective, process-oriented approaches to early disclosure are needed. PMID:26066697

  18. HIV status and age at first marriage among women in Cameroon.

    PubMed

    Adair, Timothy

    2008-09-01

    Recent research has highlighted the risk of HIV infection for married teenage women compared with their unmarried counterparts (Clark, 2004). This study assesses whether a relationship exists, for women who have completed their adolescence (age 20-29 years), between HIV status with age at first marriage and the length of time between first sex and first marriage. Multivariate analysis utilizing the nationally representative 2004 Cameroon Demographic and Health Survey shows that late-marrying women and those with a longer period of pre-marital sex have the highest risk of HIV. Although women in urban areas overall marry later than their rural counterparts, the positive relationship between age at marriage and HIV risk is stronger in rural areas. The higher wealth status and greater number of lifetime sexual partners of late-marrying women contribute to their higher HIV risk. Given that the age at first marriage and the gap between first marriage and first sex have increased in recent years, focusing preventive efforts on late-marrying women will be of much importance in reducing HIV prevalence among females. PMID:17988430

  19. Management of stigma and disclosure of HIV\\/AIDS status in healthcare settings

    Microsoft Academic Search

    Victor Wong; Loretta Wong

    2006-01-01

    Purpose – This paper aims to examine the management strategies adopted by older people living with HIV\\/AIDS (PHAs) to conceal their positive status in healthcare settings, and their responses taken and means used to cope with the stigmatizing and exclusionary effects as a result of the disclosure of their status by\\/to healthcare workers. Design\\/methodology\\/approach – Under the auspices of a

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

    ERIC Educational Resources Information Center

    Clark, Eddie, Jr.

    2006-01-01

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

  1. Disclosure of HIV Status Is a Family Matter: Field Notes From China

    PubMed Central

    Li, Li; Sun, Stephanie; Wu, Sheng; Lin, Chunqing; Wu, Zunyou; Yan, Zhihua

    2009-01-01

    This study examines the role that family plays in disclosure of HIV–AIDS in China. In-depth semistructured interviews were conducted with 30 individuals living with HIV–AIDS infected through different routes. The vast majority of participants were between the ages of 20 and 39 years old (93.4%) and about a third (36.7%) were women. Two primary disclosure processes, involuntary and voluntary, are described. In both processes, family members other than the patient are usually the first to know HIV status. Positive impacts of disclosure include strengthening family relations and help with medical care and counseling, whereas negative impacts include fear, isolation, avoidance, and psychological burden. This study illustrates that family is an intricate part of the disclosure process in China and demonstrates the importance of including families in HIV–AIDS interventions. PMID:17605553

  2. Health status, sexual and drug risk, and psychosocial factors relevant to postrelease planning for HIV+ prisoners.

    PubMed

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

    2013-10-01

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

  3. Approaches to health status assessment in hiv disease overview of the conference

    Microsoft Academic Search

    Albert W. Wu; Haya R. Rubin

    1994-01-01

    Advances in health status assessment, and the evolution of HIV into a chronic disease managed with combinations of drugs, have resulted in increased interest and application of health-related quality of life measures for people with HIVIAIDS. This monograph reports on the proceedings of a conference convened to examine the state of the art of measurement approaches for health-related quality of

  4. Caregiving responsibilities and burden among older people by HIV status and other determinants in Uganda.

    PubMed

    Mugisha, Joseph; Scholten, Francien; Owilla, Sebastian; Naidoo, Nirmala; Seeley, Janet; Chatterji, Somnath; Kowal, Paul; Boerma, Ties

    2013-01-01

    Older caregivers have major caregiving responsibilities in countries severely affected by the HIV epidemic, but little is known about their own health and well-being. We conducted this study to assess the association of caregiving responsibilities and self-perceived burden with caregivers' health, HIV status, background characteristics and care-receiving among older people in South Western Uganda. Men and women aged 50 years and older were recruited from existing cohort studies and clinic registers and interviewed at home. Health was measured through a composite score of health in eight domains, anthropometry and handgrip strength. Summary measures of caregiving responsibilities and self-reported burden were used to analyse the main associations. There were 510 participants, including 198 living with HIV. Four fifths of women and 66% of men were caregivers. Older respondents with no care responsibility had poorer scores on all health indicators (self-reported health score, body mass index and grip strength). Having a caregiving responsibility was not associated with poorer health status or quality of life. Notably, HIV-infected people, whether on antiretroviral treatment (ART) or not, had similar caregiving responsibilities and health status as others. The self-reported burden associated with caregiving was significantly associated with a poorer health score. One third of female caregivers were the single adult in the household with larger caregiving responsibilities. Many of these women are in the poorest wealth quartile of the households in the study and are therefore more likely to need assistance. Physical and financial supports were received by 70% and 63%, respectively. Those with larger caregiving responsibilities more frequently received support. Caregiving responsibilities were associated with better health status, greater satisfaction and quality of life. Older HIV-infected people, whether on ART or not, had similar caregiving responsibilities and self-reported health status as other older people. PMID:23394785

  5. Click here for HIV status: Shifting templates of sexual negotiation

    Microsoft Academic Search

    Kane Race

    2010-01-01

    In the last decade, many aspects of gay social and sexual life have moved online. This article explores how the increasing use of the internet as a way of organizing gay sex is shaping sexual and risk subjectivities. It investigates how online cruising is mediating investments in, and tensions between, different HIV prevention ethics in Sydney, Australia – in particular,

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

    PubMed

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

    2015-06-01

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

  7. Housing status and health care service utilization among low-income persons with HIV\\/AIDS

    Microsoft Academic Search

    Meredith Y. Smith; Bruce D. Rapkin; Gary Winkel; Carolyn Springer; Rosy Chhabra; Ira S. Feldman

    2000-01-01

    OBJECTIVE: To examine the impact of housing status on health service utilization patterns in low-income HIV-infected adults.\\u000a \\u000a \\u000a DESIGN: A survey of 1,445 HIV-infected Medicaid recipients in New York State between April 1996 and March 1997.\\u000a \\u000a \\u000a \\u000a \\u000a MAIN RESULTS: Six percent of study participants were homeless, 24.5% were “doubled-up,” and 69.5% were stably housed. Compared with the\\u000a stably housed, doubled-up and homeless

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

    ERIC Educational Resources Information Center

    Lewis, Ione R.

    2012-01-01

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

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

    PubMed Central

    Demberg, Thorsten; Robert-Guroff, Marjorie

    2012-01-01

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

  10. Current status of substance abuse and HIV infection in Japan.

    PubMed

    Wada, Kiyoshi; Funada, Masahiko; Shimane, Takuya

    2013-12-01

    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

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

    PubMed Central

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

    2013-01-01

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

  12. The relationship between ART adherence and smoking status among HIV+ individuals.

    PubMed

    Moreno, Jose L; Catley, Delwyn; Lee, Hyoung S; Goggin, Kathy

    2015-04-01

    Smoking is highly prevalent among HIV+ individuals and studies indicate that it may be associated with poor ART adherence, though the relationship is poorly understood. In addition little is known about interest in quitting among HIV+ smokers who are having adherence difficulties. We examined smoking and ART adherence among 203 HIV+ individuals enrolled in a randomized trial of interventions to increase ART adherence. Prior analyses indicated there were no overall treatment group effects. Smoking status and motivation to quit was assessed at baseline and ART adherence was assessed at week 12, 24, 36, and 48. Longitudinal generalized estimating equation analysis that controlled for treatment group revealed that smoking status was not significantly related to adherence over time. Motivation to quit was high with 58 % intending to quit in the next 6 months and 25 % intending to quit in the next 30 days. Findings suggest that smoking is not associated with adherence among those with adherence difficulties. However it does not diminish importance of addressing both behaviors especially given HIV+ smokers substantial interest in changing smoking behavior. PMID:25572828

  13. Levels of childhood vaccination coverage and the impact of maternal HIV status on child vaccination status in rural KwaZulu-Natal, South Africa

    Microsoft Academic Search

    James Ndirangu; Till Bärnighausen; Frank Tanser; Khin Tint; Marie-Louise Newell

    2009-01-01

    Summary objectives To analyse coverage of childhood vaccinations in a rural South African population and investigate whether maternal HIV status is associated with children's vaccination status. methods 2 431 children with complete information, 12-23 months of age at some point during the period January 2005 through December 2006 and resident in the Africa Centre Demographic Surveil- lance Area at the

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

    PubMed Central

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

    2013-01-01

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

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

    Microsoft Academic Search

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

    2000-01-01

    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

  16. Emotion work: disclosing cancer

    PubMed Central

    Yoo, Grace J.; Aviv, Caryn; Levine, Ellen G.; Ewing, Cheryl; Au, Alfred

    2010-01-01

    Introduction Breast cancer remains one of the leading causes of morbidity and mortality for all women in the US. Current research has focused on the psychological relationship and not the sociological relationship between emotions and the experience of breast cancer survivors. This paper focuses on the emotion work involved in self-disclosing a breast cancer diagnosis in a racially or ethnically diverse population. Methods The participants (n=176) selected for this study were African American, Asian American, Latina, and Caucasian women who had been diagnosed with stages 0, I, or II breast cancer within the past 4 years. They completed an in-depth qualitative interview on self-disclosure and social support. Findings The results indicate self-disclosing was done at a time when important decisions about treatment needed to be made. Different strategies for disclosure were used, all of which entailed emotion work. Respondents talked about the various elements of emotion work in the disclosure process including: managing others' worry, protecting and soothing others, and educating and instructing others.. For many respondents, disclosure without calculating emotional management meant opening up to others which meant support and an increase in emotional resources. Conclusions The findings in this paper have implications for women with breast cancer and demonstrate the need for women to be involved in honest disclosure and less emotional management of others' feelings. There is also a need for education about the nature of the cancer experience among people who are not well educated about the treatment and consequences of cancer. This need may be even stronger among racial and ethnic minorities. PMID:19434430

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

    PubMed Central

    Moskowitz, David A.; Roloff, Michael E.

    2008-01-01

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

  18. Socio-economic status and HIV/AIDS stigma in Tanzania.

    PubMed

    Amuri, Mbaraka; Mitchell, Steve; Cockcroft, Anne; Andersson, Neil

    2011-03-01

    Tanzania has a generalised AIDS epidemic but the estimated adult HIV prevalence of 6% is much lower than in many countries in Southern Africa. HIV infection rates are reportedly higher in urban areas, among women and among those with more education. Stigma has been found to be more common in poorer, less-educated people, and those in rural areas. We examined associations between poverty and other variables and a stigmatising attitude (belief that HIV/AIDS is punishment for sinning). The variables we examined in a multivariate model included: food sufficiency (as an indicator of poverty), age, sex, marital status, education, experience of intimate partner violence, condom-related choice disability, discussion about HIV/AIDS, sources of information about HIV/AIDS and urban or rural residence. Of the 1,130 men and 1,803 women interviewed, more than half (58%) did not disagree that "HIV/AIDS is punishment for sinning". Taking other variables into account, people from the poorest households (without enough food in the last week) were more likely to believe HIV/AIDS is punishment for sinning (Odds Ratio [OR] 1.29, 95% confidence intervals [CI] 1.06-1.59). Others factors independently associated with this stigmatising attitude were: having less than primary education (OR 1.29, 95% CI 1.03-1.62); having experienced intimate partner violence in the last year (OR 1.40, 95% CI 1.12-1.75); being choice disabled for condom use (OR 1.36, 95% CI 1.08-1.71); and living in rural areas (OR 1.76, 95% CI 1.06-2.90). The level of HIV and AIDS stigma in Tanzania is high with independent associations with several disadvantages: poverty, less education and living in rural areas. Other vulnerable groups, such as survivors of intimate partner violence, are also more likely to have a stigmatising attitude. HIV prevention programmes should take account of stigma, especially among the disadvantaged, and take care not to increase it. PMID:21347901

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

    PubMed Central

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

    2014-01-01

    Background Expanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals. Design Using multiple rounds of biomarker data from Demographic and Health Surveys (2004–2012) in nine sub-Saharan African countries, we compare patterns of associations between HIV status and fertility intention and between current use of modern contraception and HIV status in the context of expanding ART coverage. Results Generally, results show that knowledge of HIV status and proportion of women ever tested for HIV increased substantially between the two surveys for almost all countries. Whereas modern contraceptive use slightly increased, fertility intentions remained relatively stable, except for Rwanda, where they decreased. Results from the two surveys for the nine countries do however indicate that there is no clear consistent pattern of fertility intention and modern contraceptive use behavior by HIV status, with variations observed across countries. However, multivariate analyses show that for Rwanda and Zimbabwe women who were HIV positive, with knowledge of their status, had lower odds of wanting more children. Similarly only in Rwanda (both surveys) were HIV-positive women who knew their status more likely to be current users of contraception compared with women who were HIV negative. The reverse was observed for Zimbabwe. Conclusions Generally, the results point to the fact that the assumption that reproductive intention and behavior of HIV-positive women will differ compared with that of HIV-negative women may only hold true to the extent that women know their HIV status. Continuous expansion of voluntary counseling and testing services and integration of HIV treatment and care services with reproductive health services are thus warranted. PMID:25361729

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

    ERIC Educational Resources Information Center

    Kukka, Christine

    2004-01-01

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

  1. Childbearing motivations and pregnancy desires among urban female youth: Does HIV-infection status make a difference?

    PubMed Central

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

    2015-01-01

    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 (OR 2.7, p=0.03) 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 (.09-.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

  2. Get Tested for HIV

    MedlinePLUS

    ... for HIV? Types of HIV tests Confidential versus anonymous testing Know your partner's HIV status Diagnosing AIDS ... acute HIV infection ). Return to top Confidential versus anonymous testing In some states, you can get tested ...

  3. Keepers of the Secret: Desires to Conceal a Family Member's HIV-Positive Status in Namibia, Africa

    Microsoft Academic Search

    Rachel A. Smith; Angela J. Niedermyer

    2009-01-01

    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

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

    Microsoft Academic Search

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

    2008-01-01

    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

  5. Masculinity and HIV disclosure among heterosexual South African men: implications for HIV/AIDS intervention.

    PubMed

    Dageid, Wenche; Govender, Kaymarlin; Gordon, Sarah F

    2012-01-01

    Relationships and constructions of masculinity are central to understanding the process of male HIV disclosure, which is an important step towards accessing HIV-related services. Data from in-depth interviews and focus-group discussions with 23 HIV-positive, self-identified heterosexual, Black South African men were used to explore the disclosure process and how this process was negotiated in the context of constructions of masculinity. Of these men, 20 had disclosed to one or more persons, with partners and siblings being the preferred confidants. Disclosure was dependent on the acceptance of HIV status, perceived support and healthy relationships with others, HIV counselling and participation in educational and training activities. Non-disclosure was explained as a result of stigma, fear of rejection, discrimination, a lack of healthy relationships with others and lack of access to suitable disclosure strategies. Negative perceptions of HIV and hegemonic conceptions of masculinity hindered men from disclosing and seeking health services. Many men, however, managed to renegotiate their masculine identities to become responsible, knowledgeable HIV-positive individuals, protecting their families and becoming community educators. Findings suggest the need to consider gendered, contextual, skills-building/income-generating and guided interventions to promote male HIV disclosure and service uptake. PMID:22943462

  6. Utilization of HIV and Tuberculosis Services by Health Care Workers in Uganda: Implications for Occupational Health Policies and Implementation

    PubMed Central

    Buregyeya, Esther; Nuwaha, Fred; Wanyenze, Rhoda K.; Mitchell, Ellen M. H.; Criel, Bart; Verver, Suzanne; Kasasa, Simon; Colebunders, Robert

    2012-01-01

    Background Access to HIV testing and subsequent care among health care workers (HCWs) form a critical component of TB infection control measures for HCWs. Challenges to and gaps in access to HIV services among HCWs may thus compromise TB infection control. This study assessed HCWs HIV and TB screening uptake and explored their preferences for provision of HIV and TB care. Methods A cross-sectional mixed-methods study involving 499 HCWs and 8 focus group discussions was conducted in Mukono and Wakiso districts in Uganda between October 2010 and February 2011. Results Overall, 5% of the HCWs reported a history of TB in the past five years. None reported routine screening for TB disease or infection, although 89% were willing to participate in a TB screening program, 77% at the workplace. By contrast, 95% had previously tested for HIV; 34% outside their workplace, and 27% self-tested. Nearly half (45%) would prefer to receive HIV care outside their workplace. Hypothetical willingness to disclose HIV positive status to supervisors was moderate (63%) compared to willingness to disclose to sexual partners (94%). Older workers were more willing to disclose to a supervisor (adjusted prevalence ratio [APR]?=?1.51, CI?=?1.16–1.95). Being female (APR?=?0.78, CI?=?0.68–0.91), and working in the private sector (APR?=?0.81, CI?=?0.65–1.00) were independent predictors of unwillingness to disclose a positive HIV status to a supervisor. HCWs preferred having integrated occupational services, versus stand-alone HIV care. Conclusions Discomfort with disclosure of HIV status to supervisors suggests that universal TB infection control measures that benefit all HCWs are more feasible than distinctions by HIVstatus, particularly for women, private sector, and younger HCWs. However, interventions to reduce stigma and ensuring confidentiality are also essential to ensure uptake of comprehensive HIV care including Isoniazid Preventive Therapy among HCWs. PMID:23071538

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

    PubMed Central

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

    2011-01-01

    Objective The Teaching, Raising, And Communicating with Kids (TRACK) program was a longitudinal pilot-trial intervention designed to assist mothers living with HIV (MLH) to disclose their serostatus to their young children (age 6 – 12 years). Method MLH and child dyads (N = 80 dyads) were recruited and randomized to intervention or control; the intervention group had three individual sessions and one follow-up phone call. The sessions focused on preparing MLH for disclosure through behavioral exercises utilizing Derlaga’s model of HIV-disclosure. Both MLH and their child were assessed across multiple time-points (baseline, 3-, 6-, and 9-months) regarding disclosure of HIV status, and specific outcome variables (i.e., relationship context, mother’s health, child’s mental health, and family outcomes). Results MLH in the intervention group were six times more likely to disclose their HIV status than those in the control group (O.R. 6.33, 95% C.I.: 1.64 – 24.45), with 33% disclosing in the intervention group compared to 7.3% in the control group. MLHs in the intervention group showed increases in disclosure self-efficacy across time, increased communication with their child, and improvement in emotional functioning. Children of MLHs in the intervention group exhibited reductions in depression and anxiety, and increases in happiness. Conclusions TRACK was found to be successful in helping MLH disclose their HIV status to their children, with positive outcomes noted for both MLH and their children. PMID:21355637

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

    PubMed Central

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

    2014-01-01

    Younger Black men who have sex with men (BMSM) ages 16–29 have the highest rates of HIV in the United States. Despite increased attention to social and sexual networks as a framework for biomedical intervention, the role of measured network positions, such as bridging and their relationship to HIV risk has received limited attention. A network sample (N=620) of BMSM respondents (n=154) and their MSM and transgendered person network members (n=466) was generated through respondent driven sampling of BMSM and elicitation of their personal networks. Bridging status of each network member was determined by a constraint measure and was used to assess the relationship between this bridging and unprotected anal intercourse (UAI), sex-drug use (SDU), group sex (GS) and HIV status within the network in South Chicago. Low, moderate and high bridging was observed in 411 (66.8%), 81 (13.2%) and 123 (20.0%) of the network. In addition to age and having sex with men only, moderate and high levels of bridging were associated with HIV status (AOR 3.19; 95% CI 1.58–6.45 and AOR 3.83; 95% CI 1.23–11.95, respectively). Risk behaviors observed including UAS, GS, and SDU were not associated with HIV status, however, they clustered together in their associations with one another. Bridging network position but not risk behavior was associated with HIV status in this network sample of younger BMSM. Socio-structural features such as position within the network may be important when implementing effective HIV prevention interventions in younger BMSM populations. PMID:24337699

  9. Marital status and risk of HIV infection in slum settlements of Nairobi, Kenya: results from a cross-sectional survey.

    PubMed

    Kimani, James K; Ettarh, Remare; Ziraba, Abdhalah K; Yatich, Nelly

    2013-03-01

    Kenya still faces major challenges due to the HIV/AIDS epidemic. This study examined the association between marital status and risk of HIV infection in urban slums of Nairobi. Data were derived from a cross-sectional population-based survey nested in an ongoing Demographic Surveillance System in two urban slums in Nairobi. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to assess the association between marital status and risk of HIV infection. HIV prevalence among married men and women was 10.4% and 11.1% and among divorced/separated/widowed men and women was 14.9% and 27.9%. Multivariate results showed the risk of acquiring HIV was significantly associated with being married, divorced/separated/widowed, being in the older age groups and the Luo ethnic group. There is urgent need for appropriate HIV prevention interventions targeted at the urban poor to address the high risk of HIV infections in this population. PMID:24069739

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

    ERIC Educational Resources Information Center

    Fesko, Shelia Lynch

    2001-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Reis, Janet S.; Weber, Kathleen M.

    2013-01-01

    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

  13. "It's my secret": fear of disclosure among sub-Saharan African migrant women living with HIV/AIDS in Belgium.

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2014-10-01

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

  15. Can women 'refuse' condoms? Dilemmas of condom negotiation among men living with HIV in South Africa.

    PubMed

    Mfecane, Sakhumzi

    2013-01-01

    This paper describes challenges that men living with HIV experience in negotiating condom use with sexual partners. After testing HIV-positive, the men in this study attended support groups of people living with HIV. Here they were taught to behave 'responsibly' by adopting safer sex measures. However, some men faced strong resistance from women concerning condom use, particularly from women with whom they had been sexually involved prior to testing HIV-positive. This paper explores the reasoning behind the rejection of condoms by women, focusing specifically on the nature of relationships, disclosure of HIV status and gender power dynamics. Analysis of the findings, which are taken from an ethnographic study conducted over 14 months, indicates that efforts to initiate condom use allowed women to challenge men's authority in sexual affairs and assert their own (limited) agency - albeit by demanding unprotected sex. However, women's rejection of condoms occurred in a knowledge vacuum about their own HIV risk because male partners had failed to disclose their HIV status prior to initiating condoms. Interventions need to encourage men to disclose their HIV status before they initiate condom use with their sexual partners. Furthermore men need to encourage their partners to be open about their sexual needs. PMID:23043556

  16. Sexual orientation disclosure and its relationship to psychological distress, immune, and physical health status variables in HIV-infection

    Microsoft Academic Search

    Marc Jay Zuckerman

    1998-01-01

    This study investigated the effects of sexual orientation disclosure on levels of psychological distress, immune, and physical health status variables within a sample (N = 43) of HIV-positive gay men. Cross-sectional findings indicated that four out of five measures of sexual orientation disclosure were associated with lower levels of psychological distress, as measured by avoidant cognitions and Beck Depression. In

  17. A Cross-Sectional Study of Disclosure of HIV Status to Children and Adolescents in Western Kenya

    PubMed Central

    Vreeman, Rachel C.; Scanlon, Michael L.; Mwangi, Ann; Turissini, Matthew; Ayaya, Samuel O.; Tenge, Constance; Nyandiko, Winstone M.

    2014-01-01

    Introduction Disclosure of HIV status to children is essential for disease management but is not well characterized in resource-limited settings. This study aimed to describe the prevalence of disclosure and associated factors among a cohort of HIV-infected children and adolescents in Kenya. Methods We conducted a cross-sectional study, randomly sampling HIV-infected children ages 6–14 years attending 4 HIV clinics in western Kenya. Data were collected from questionnaires administered by clinicians to children and their caregivers, supplemented with chart review. Descriptive statistics and disclosure prevalence were calculated. Univariate analyses and multivariate logistic regression were performed to assess the association between disclosure and key child-level demographic, clinical and psychosocial characteristics. Results Among 792 caregiver-child dyads, mean age of the children was 9.7 years (SD?=?2.6) and 51% were female. Prevalence of disclosure was 26% and varied significantly by age; while 62% of 14-year-olds knew their status, only 42% of 11-year-olds and 21% of 8-year-olds knew. In multivariate regression, older age (OR 1.49, 95%CI 1.35–1.63), taking antiretroviral drugs (OR 2.27, 95%CI 1.29–3.97), and caregiver-reported depression symptoms (OR 2.63, 95%CI 1.12–6.20) were significantly associated with knowing one’s status. Treatment site was associated with disclosure for children attending one of the rural clinics compared to the urban clinic (OR 3.44, 95%CI 1.75–6.76). Conclusions Few HIV-infected children in Kenya know their HIV status. The likelihood of disclosure is associated with clinical and psychosocial factors. More data are needed on the process of disclosure and its impact on children. PMID:24475159

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

    2012-01-01

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

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

    PubMed

    Chiu, ChingChe J; Young, Sean D

    2015-06-01

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

  1. 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

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

    2012-01-01

    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

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

    PubMed Central

    2009-01-01

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

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

    PubMed Central

    2014-01-01

    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

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

    PubMed Central

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

    2015-01-01

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

  5. Immunisation status and its predictors among children of HIV-infected people in Kolkata.

    PubMed

    Sensarma, Pinaki; Bhandari, Subhasis; Kutty, V Raman

    2012-11-01

    World Health Organization and United Nations International Children's Emergency Fund have strongly recommended a sustained coverage of universal immunisation among all children against tuberculosis, polio, diphtheria, pertussis, tetanus and measles. In India, these vaccines under the universal immunisation programme are made available absolutely free of cost to all children through the public health system. Information regarding immunisation coverage among HIV exposed children in India is still very limited. The objective of this study was to estimate the proportion of children of people living with HIV who had been completely immunised by the age of 12 months and to find predictors of complete immunisation. A community-based cross-sectional survey was conducted in the Kolkata Metropolitan Area between 15 June and 14 September 2009 using a pre-structured interview schedule. Data were analysed from 256 care-givers of children (85.5% response rate) whose parents were randomly selected from the Bengal Network of HIV-positive people. Multiple logistic regression was used to estimate and test associations of predictors with complete immunisation. The percentage of children of people living with HIV completely immunised at the age of 12 months was 73.0% (67.3% to 78.1%), which was not significantly different from that for all children at 12 months. Mothers having received antenatal care [OR (odds ratio): 7.29; 95% confidence intervals (CI): 2.39-22.25], mothers having postprimary education (OR: 3.37; 95% CI: 1.45-7.81), children of Hindu and Christian religion (OR: 3.74; 95% CI: 1.63-8.62), children not belonging to scheduled castes, tribes and 'other backward classes' (OR: 2.08; 95% CI: 1.02-4.25) were significant independent predictors of complete immunisation status of these children. This emphasises the imperative need for up-scaling of antenatal care among the pregnant mothers to ensure complete immunisation among their children. A special focus on girl child education should also be implemented to empower future mothers for a sustained improvement of child immunisation in the long-run. The current national immunisation programme should focus on the children from the Muslim community and those belonging to scheduled castes, tribes and other backward classes to improve coverage. PMID:22813078

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

    PubMed Central

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

    2014-01-01

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

  7. Risk and Protective Factors for HIV Self-disclosure among Poor African-American Women Living with HIV/AIDS.

    PubMed

    Polansky, Marcia; Teti, Michelle; Chengappa, Roshni; Aaron, Erika

    2015-03-01

    African-American women with HIV are among the fastest growing populations with HIV. The psychosocial factors and beliefs/attitudes associated with disclosure and other un-safe sex practices are not fully understood in this population. A total of 158 HIV-positive women receiving primary care in an HIV clinic in Philadelphia who enrolled in a safe-sex intervention, completed a baseline questionnaire on their sexual activities with male partners and psychosocial factors that were potential protective/risk factors for unsafe sex. Women who were emotionally close and monogamous with their partner were most likely to disclose their HIV status and least likely to worry they had infected their partner. Women who were non-monogamous and who did not have an emotional connection to any of their partners were least likely to self-disclose. Partners were more likely to know each other's status when the woman felt she had a responsibility to talk about the importance of staying HIV-negative. PMID:25897863

  8. The Effects of HIV Stigma on Health, Disclosure of HIV Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV

    Microsoft Academic Search

    Richard J. Wolitski; Sherri L. Pals; Daniel P. Kidder; Cari Courtenay-Quirk; David R. Holtgrave

    2009-01-01

    HIV-related stigma negatively affects the lives of persons living with HIV\\/AIDS (PLWHA). Homeless\\/unstably housed PLWHA experience\\u000a myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless\\/unstably housed PLWHA\\u000a from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical\\u000a utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    2015-01-01

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

  12. Relationship of Body Composition, Metabolic Status, Antiretroviral Use, and HIV Disease Factors to Endothelial Dysfunction in HIV-Infected Subjects

    PubMed Central

    Shen, Changyu; Mather, Kieren J.; Waltz, Jeff; Greenwald, Martha; Gupta, Samir K.

    2010-01-01

    Abstract Vascular endothelial dysfunction may contribute to the increase in cardiovascular events during HIV-1 infection and its treatment. Antiretroviral therapy (ART), metabolic factors, lipodystrophy, and HIV infection itself may be involved. Ninety-six HIV-infected subjects were evaluated for endothelial function by measurement of brachial artery flow-mediated dilation (FMD) by ultrasound, single-slice CT of the abdomen and mid-thigh, whole-body dual x-ray absorptiomety (DXA) scans, and metabolic evaluations in a cross-sectional study. The median age was 40 years; 28% were female, 38% black, 3% Hispanic, and 59% white. Forty-nine (51%) were receiving ART, which included a PI in 28 (57%) and was non-PI based in 21 (43%). FMD (±SD) in subjects not on ART was 5.5?±?4.3%, PI-ART 5.3?±?3.6%, and non-PI-ART 5.5?±?4.1% (p?=?0.9). Age, race, CD4?cell count, and HIV RNA did not correlate significantly with FMD. Among ART-treated subjects in the lowest tertile of thigh subcutaneous fat area (range 3–31?cm2), FMD was 4.4?±?3.5% and in the highest tertile (range 67–237?cm2) FMD was 6.8?±?3.6% (p?=?0.07, t-test). However, in multivariate analyses, no body composition measure showed a significant association with FMD for either the group as a whole or in ART-treated subjects. ART use, PI use, CD4?cell count, and HIV RNA levels were not associated with endothelial dysfunction by brachial FMD. A definitive association with measures of adiposity was not detected in multivariate analysis, suggesting that lipoatrophy may not be an important contributor to endothelial dysfunction in HIV-infected individuals on ART. PMID:20673142

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

    PubMed Central

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

    2011-01-01

    OBJECTIVE: To describe nutritional status, body composition and lipid profile in children and adolescents receiving protease inhibitors. METHODS: Fifty-nine patients, 23 treated with protease inhibitors (group 1) and 36 not using protease inhibitors (group 2). Their dietary intake, anthropometry, bioimpedance analysis and lipid profile variables were measured. RESULTS: There was no difference in nutritional status or body composition between groups at the beginning of the study. After 6 months of follow-up, there was an increase in weight and height in both groups, as well as in waist circumference and subscapular skinfold thickness. In group 2, body mass index and triceps skinfold thickness adequacy were significantly higher after 6 months of follow-up. The groups had similar energy and macronutrient intake at any time point. After 6 months, group 1 had a higher cholesterol intake and group 2 had a higher fiber intake. Triglyceride serum levels were significantly different between the groups, with higher values in G1, at any time point [G1: 153 mg/dl (30–344); 138 (58–378) versus G2: 76 mg/dl (29–378); 76 (29–378)]. After 6 months of follow-up, G1 had higher LDL-cholesterol than G2 [104 mg/dl (40–142) versus 82 (42–145)]. CONCLUSION: The use of protease inhibitors, per se, does not seem to significantly interfere with anthropometric measures, body composition and food intake of HIV-infected children and adolescents. However, this antiretroviral therapy was associated with a significant increase in triglyceride and LDL-cholesterol in our subjects. PMID:21808865

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

    PubMed Central

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

    2008-01-01

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

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

    PubMed

    George, Mathew Sunil; Lambert, Helen

    2015-09-01

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

  16. Importance of Women's Relative Socioeconomic Status within Sexual Relationships in Communication about Safer Sex and HIV/STI Prevention.

    PubMed

    Muchomba, Felix M; Chan, Christine; El-Bassel, Nabila

    2015-06-01

    The socioeconomic status (SES) of women is increasingly considered an important factor for HIV/STI risk. The HIV/STI literature has largely focused on women's absolute levels of SES, and therefore, the importance of their SES relative to their male sexual partners remains understudied. This paper examines the association between women's relative SES and frequency of safer sex communication among heterosexual couples. A convenience sample of 342 couples (N?=?684) recruited in New York City was asked about frequency of discussions with their partner about the need to use male condoms, about HIV prevention, and about STI prevention in the previous 90 days. Differences between partners in education, income, employment, housing, and incarceration history were combined using principal component analysis to form an index of women's relative SES. Negative binomial regression models assessed associations between woman's relative SES and communication frequency controlling for age, sex, race, ethnicity, education, and relationship type using a generalized estimating equation framework. On average, participants had 2.5, 4.2, and 4.8 discussions regarding the need to use male condoms, about HIV prevention, and about STI prevention, respectively. A one standard deviation increase in a woman's relative SES score was associated with increased frequency of discussions about male condom use (adjusted rate ratio [aRR], 1.15; 95 % confidence interval [CI], 1.03-1.29), about HIV prevention (aRR, 1.25; CI, 1.14-1.37), and about STI prevention (aRR, 1.29; CI, 1.18-1.41). Women's relative SES may be an important factor for sexual communication, and further research on its role in HIV/STI risk may uncover avenues for intervention. PMID:25665522

  17. 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

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

    2014-01-01

    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

  18. Personal journal bloggers: Profiles of disclosiveness

    Microsoft Academic Search

    Erin E. Hollenbaugh

    2010-01-01

    Personal journal blogs, which are primarily about bloggers’ selves and inner states, are often characterized by high amounts of self-disclosure. This study employed the uses and gratifications perspective to reveal the characteristics of disclosive personal journal bloggers. Path analyses of data from an online survey revealed that the most disclosive bloggers were women who were generally disclosive in their offline

  19. Food security status in households of people living with HIV/AIDS (PLWHA) in a Ugandan urban setting.

    PubMed

    Bukusuba, John; Kikafunda, Joyce K; Whitehead, Roger G

    2007-07-01

    Because HIV/AIDS negatively impacts on the food security status of households, it is crucial to identify how households respond to these impacts, in order to identify positive food security entry points and design strategies that can effectively alleviate food insecurity among the households of people living with HIV/AIDS (PLWHA). A cross-sectional study was thus undertaken to establish how HIV affected households in an urban Ugandan setting in terms of response to food shortages and the interrelations between the practice of agriculture by PLWHA households within and around town, food security, access to food aid and dietary diversity among these households. Data for this cross-sectional study were collected using quantitative methods from 144 randomly recruited households of PLWHA (aged 15-49 years) residing in Jinja town in Eastern Uganda. The study showed that the HIV/AIDS pandemic has increased the inability of affected households in the study area to put enough food on the table, possibly because of the continued decreased productivity in these households and the high expenditure on medical costs. Various coping mechanisms identified in the households of PLWHA may contribute to poor adherence to antiretroviral regimes and poor quality of life for all household members. However, the practice of agriculture by PLWHA households was one of the positive coping mechanisms to alleviate food insecurity. PMID:17381879

  20. HIV-positive mothers in Viet Nam: using their status to build support groups and access essential services.

    PubMed

    Oosterhoff, Pauline; Anh, Nguyen Thu; Yen, Pham Ngoc; Wright, Pamela; Hardon, Anita

    2008-11-01

    Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2004, and a sister group begun in 2005 in Thai Nguyen province. From April 2004 to early 2007, we carried out semi-structured interviews with 275 health care workers and 153 HIV-positive women and members of their families, as well as participant observation of group meetings and activities. Sunflowers have successfully organised themselves to access vital social, medical and economic support and services for themselves, their children and partners. They gained self-confidence, and learned to communicate with their peers and voice their needs to service providers. Based on personal development plans, they have accessed other state services, such as loans, job counselling and legal advice. They have also gained access to school and treatment for their children, who had previously been excluded. Although the women were vulnerable to HIV as wives and mothers, motherhood also provided them with social status and an identity they used to help build organisations and develop strategies to access the essential services that they and their families need. PMID:19027632

  1. Relationship between psychiatric status and frontal–subcortical systems in HIV-infected individuals

    PubMed Central

    COLE, MICHAEL A.; CASTELLON, STEVEN A.; PERKINS, ADAM C.; URENO, OSCAR S.; ROBINET, MARTA B.; REINHARD, MATTHEW J.; BARCLAY, TERRY R.; HINKIN, CHARLES H.

    2010-01-01

    Human immunodeficiency virus (HIV)-infected adults frequently evidence both neurocognitive and psychiatric dysfunction. It was hypothesized that apathy and irritability, but not anxiety and depression, are related to HIV effects on frontal–subcortical systems. This hypothesis was evaluated by determining the degree to which these psychiatric features are associated with neurocognitive functioning that is dependent upon frontal–subcortical circuitry and, therefore, thought to be sensitive to the central nervous system effects of HIV. Rating scales assessing irritability, apathy, depression, and anxiety and a dual-task paradigm were administered to 189 HIV-seropositive (HIV+) and 53 HIV-seronegative participants. Deficits in dual-task performance and greater anxiety, depression, apathy, and irritability were observed in HIV+ participants. Simultaneous multivariate regression and communality analyses revealed that only apathy and irritability were associated with dual-task performance in HIV+ participants. Thus, these findings suggest that apathy and irritability, but not depression and anxiety, are likely associated with the effects of HIV on frontal–subcortical circuitry. PMID:17445305

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

    PubMed

    Mumah, Joyce N; Jackson-Smith, Douglas

    2014-07-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    2014-01-01

    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

  5. Street Youth in Toronto, Canada: An Investigation of Demographic Predictors of HIV Status Among Street Youth Who Access Preventive Health and Social Services

    Microsoft Academic Search

    Anthony B. Linton; Mina D. Singh; David Turbow; Timothy J. Legg

    2009-01-01

    Street youth are increasingly at risk for HIV infection due to high-risk sexual behaviors and injection drug use. The purpose of this study was to assess the extent to which demographic characteristics of street youth in Toronto were predictive of HIV status. Age, gender, and ethnicity, education, length of time street-involved, and income were measured among a cross-sectional sample of

  6. Religious participation and HIV-disclosure rationales among people living with HIV/AIDS in rural Swaziland.

    PubMed

    Root, Robin

    2009-09-01

    Despite the cultural salience of Christianity in many parts of Africa and the expansion of antiretroviral treatment, few studies have examined experiences of religious participation among HIV-positive individuals. Correspondingly, most studies of HIV self-disclosure in sub-Saharan Africa focus primarily on disclosure to sexual partners. Addressing both concerns, the central concern of this article is HIV self-disclosure in church settings, where disclosure rationales functioned as a key heuristic to explore experience of HIV-positivity, religiosity, and church participation. Given 39.2% antenatal HIV prevalence in Swaziland-the highest in the world-and an estimated 6 500 local congregations, this article draws on a medical anthropological project in Swaziland to investigate experiences of church participation among HIV-positive individuals. The data were derived from semi-structured interviews with 28 HIV-positive individuals across three domains: 1) pre- and post-diagnosis religiosity; 2) HIV stigma and support in church settings; and 3) decisions around HIV disclosure. Field research and open-ended interviews with individuals close to people living with HIV, health personnel, and pastors provided important contextual data. A grounded theory analysis showed that HIV disclosure in church settings is a highly reflexive process, mediated by subjective religiosity, the social dynamics of church networks, and broader structural vulnerabilities. Church participation often entailed significant stigma, which negatively affected self-disclosure and help-seeking practices; however, a rhetoric of 'courage' emerged to describe individuals who voluntarily disclosed their HIV-positive status. Pastors and pastors' wives were key protagonists in disclosure strategies. A church-based defense of the meaning of personhood for people living with HIV was among the most important findings. Given that congregations in much of Africa are predominantly female, and because women comprised the majority of the sample, the study productively problematised church settings as sites of analysis where gender, poverty, and religion intersect disease epidemiology in ways that may have untapped programmatic implications. PMID:25864545

  7. Disclosure of HIV positive result to a sexual partner among adult clinical service users in Kemissie district, northeast Ethiopia.

    PubMed

    Seid, Mohammed; Wasie, Belaynew; Admassu, Mengesha

    2012-03-01

    HIV Status disclosure is vital for HIV prevention efforts and the couple's health in the context of accelerated highly active antiretroviral therapy. This study aimed to identify factors associated with disclosure of HIV Status to a sexual partner and its outcomes. A facility based cross-sectional study was conducted at Kemissie Health center on 360 HIV positive individuals selected by systematic random sampling. Data were collected using a structured, interviewer administered questionnaire. The level of disclosure to a sexual partner was 93.1%. Among those who disclosed, 74.5% were accepted, 10.8% minor challenges or suspicion of result and the last 7.8% faced physical abuse and blame. The main reasons for not disclosing were fear of divorce [32%], fear of stigma and discrimination [32%] and fear of physical abuse [16%]. Prior discussion, disclosure to family, smooth relationship and knowing partner status were significantly associated with disclosure. HIV prevention programs and counseling efforts should focus on mutual disclosure of HIV test results, by encouraging discussion, reduction of stigma, for better disclosure and continuing care. PMID:22783673

  8. Racial/Ethnic Differences in Sexual Network Mixing: A Log-Linear Analysis of HIV Status by Partnership and Sexual Behavior Among Most at-Risk MSM.

    PubMed

    Fujimoto, Kayo; Williams, Mark L

    2015-06-01

    Mixing patterns within sexual networks have been shown to have an effect on HIV transmission, both within and across groups. This study examined sexual mixing patterns involving HIV-unknown status and risky sexual behavior conditioned on assortative/dissortative mixing by race/ethnicity. The sample used for this study consisted of drug-using male sex workers and their male sex partners. A log-linear analysis of 257 most at-risk MSM and 3,072 sex partners was conducted. The analysis found two significant patterns. HIV-positive most at-risk Black MSM had a strong tendency to have HIV-unknown Black partners (relative risk, RR = 2.91, p < 0.001) and to engage in risky sexual behavior (RR = 2.22, p < 0.001). White most at-risk MSM with unknown HIV status also had a tendency to engage in risky sexual behavior with Whites (RR = 1.72, p < 0.001). The results suggest that interventions that target the most at-risk MSM and their sex partners should account for specific sexual network mixing patterns by HIV status. PMID:25081598

  9. Effective methods for disclosing breast cancer diagnosis

    Microsoft Academic Search

    Michelle C. Azu; Stephanie Jean; Jean-Marie Piotrowski; Brian O’Hea

    2007-01-01

    BackgroundThe current study sought to determine effective methods for disclosing breast cancer diagnosis and to identify epidemiologic patterns in patient preference for method of information disclosure.

  10. Geographically structured populations of Cryptococcus neoformans Variety grubii in Asia correlate with HIV status and show a clonal population structure.

    PubMed

    Khayhan, Kantarawee; Hagen, Ferry; Pan, Weihua; 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

    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

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

    PubMed Central

    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

    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

  12. Disclosure of their status to youth with human immunodeficiency virus infection in the Dominican Republic: a mixed-methods study.

    PubMed

    Beck-Sagué, Consuelo; Pinzón-Iregui, Maria Claudia; Abreu-Pérez, Rosa; Lerebours-Nadal, Leonel; Navarro, Christi M; Ibanez, Gladys; Soto, Solange; Halpern, Mina; Nicholas, Stephen W; Malow, Robert; Dévieux, Jessy G

    2015-02-01

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

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

    PubMed Central

    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

    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

  14. Prevalence of anemia and nutritional status among HIV-positive children receiving antiretroviral therapy in Harar, eastern Ethiopa

    PubMed Central

    Teklemariam, Zelalem; Mitiku, Habtamu; Mesfin, Firehiwot

    2015-01-01

    Purpose Anemia and growth retardation are common manifestations of HIV-positive children, which threaten their lives. Therefore, this study tried to assess the burden of anemia and the nutritional status of HIV-positive children receiving antiretroviral therapy (ART) in eastern Ethiopa. Patients and methods A total of 108 records of children on ART followed up in Hiwot Fana Specialized University Hospital from 2007 to 2010 were retrospectively reviewed from November 1 to November 30, 2011. Results Approximately 54.4% of the children had been anemic before the initiation of their ART (at baseline): 7.8% were severely anemic and 44.7% were moderately anemic. These percentages were higher in preschool children than in school children (adjusted odds ratio [AOR]: 4.80 [95% confidence interval {CI}: 1.96, 11.75]), and were higher in males than in females (AOR: 2.61 [95% CI: 1.06, 6.45]). The prevalence of anemia was reduced to 39.2% 1 year after initiation of ART. The increasing of hemoglobin values was highly significant for both zidovudine (AZT)- and stavudine (d4T)-based ART (P<0.05). At baseline, 51.6% of the study subjects were underweight (weight-for-age Z score less than ?2 standard deviation [SD]); 49.1% were stunted (height-for-age Z score less than ?2 SD); and 31.5% were wasted (body mass index less than ?2 SD), which, after a year on ART, declined to 8.9%, 15.9%, and 9.8%, respectively. Conclusion There was high prevalence of anemia and growth failure among HIV-infected children in the study area. However, there was a decline after initiation of ART. Therefore, adherence counseling to strengthen the uptake of ART is recommended. Moreover, large-scale, prospective studies should be done to understand the magnitude and etiology of the problems with HIV-negative control groups.

  15. HIV and identity: the experience of AIDS support group members who unexpectedly tested HIV negative in Uganda.

    PubMed

    Seeley, Janet; Mbonye, Martin; Ogunde, Nelly; Kalanzi, Isaiah; Wolff, Brent; Coutinho, Alex

    2012-03-01

    Living with HIV, for many of those infected, has meant adjusting to life with a stigmatised condition and, until recently, the threat of looming death. We explore the adjustment of a group of long-term former clients of The AIDS Support Organisation (TASO) in Uganda who, when tested for HIV during the rollout of antiretroviral therapy in 2004, were found to be HIV negative. In-depth semi-structured interviews with 34 former TASO clients were conducted between 2005 and 2007. Their narratives reveal a great deal about the biographical disruption they have faced, and the biographical work that they have undertaken in both the personal and the social dimensions of their lives in order to manage their new-found HIV-uninfected status. After the negative test result, as they were no longer HIV-infected, they had to leave TASO and that support was sorely missed, as was the friendship of TASO members to whom they often felt reluctant to disclose their new status. The identity 'reversal' or change was often handled privately. Compared with their transition to an HIV-positive identity, they now lacked a social dimension to their identity transformation as they managed their new identity in the face of self- and public doubt. PMID:21707665

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    2014-01-01

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

  18. How Trauma, Recent Stressful Events, and PTSD Affect Functional Health Status and Health Utilization in HIV-Infected Patients in the South

    Microsoft Academic Search

    JANE LESERMAN; KATHRYN WHETTEN; KRISTIN LOWE; DALENE STANGL; MARVIN S. SWARTZ; NATHAN M. THIELMAN

    2005-01-01

    and utilization of health care may also be important indicators of health status in HIV-infected patients. There is insufficient understanding of the psychosocial predictors of health-related physical functioning and use of health services among those with this chronic disease. Therefore, the current study examines how trauma, severe stressful events, posttraumatic stress disorder (PTSD), and depressive symptoms are related to physical

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

    PubMed Central

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

    2014-01-01

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

  20. HIV Testing & Risky Sexual Behavior September 2010

    E-print Network

    Silver, Whendee

    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

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

    PubMed Central

    Fahey, J L; Schooley, R

    1992-01-01

    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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  4. What Should Be Disclosed to Research Participants?

    PubMed Central

    Wendler, David

    2014-01-01

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

  5. Knowledge of pregnant women on transmission of HIV infection through breast feeding.

    PubMed

    Kasinga, F; Mogotlane, S M; van Rensburg, G H

    2008-09-01

    Although breast-feeding is nature's way of providing nutrition to the baby, in HIV positive mothers this has been identified as one of the means through which HIV infection is transmitted from the mother to the child. In Africa where children under the age of 5 are killed by preventable diseases like diarrhoea, the issue of HIV transmission through breast feeding poses an added huge problem. Research has, however shown that exclusive infant feeding, be it breast or formula, reduces the risk substantially. It is imperative that mothers be informed about safer methods of infant feeding so that HIV infection is kept to a minimum. The objective of the study was to explore and describe the knowledge that pregnant women had about mother to child transmission of HIV infection through breast-feeding. A non-experimental quantitative exploratory and descriptive research design was used to explore the knowledge women had on mother to child transmission of HIV infection through breast-feeding. From the data collected, it showed that although women were aware of the susceptibility of children to HIV infection if fed on breast and formula feeds simultaneously by HIV positive mothers, exclusive feeding was a problem as people associated the practise with a positive HIV status. Women who had not disclosed their HIV status and were HIV positive, found it difficult to comply with the requirement to exclusively feed their infants. These either continued with complementary feeds or did not collect the free formula milk supply preferring instead to buy the formula feeds privately. In this study it was recommended that information on transmission of HIV infection from mother to child through breast -feeding including the benefits of exclusive infant feeding, be it breast or formula, for the first three to six months be provided to the community so that relatives can support the mother on infant feeding method of choice. PMID:19177967

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Chenneville, Tiffany

    2007-01-01

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

  8. A meta-analysis of disclosure of one's HIV-positive status, stigma and social support

    Microsoft Academic Search

    Rachel Smith; Kelly Rossetto; Brittany L. Peterson

    2008-01-01

    This study provides an analysis of the relationships among perceived stigma, reported disclosure and perceived social support for those living with HIV. The meta-analytic summary of 21 studies (4104 participants) showed, as predicted, a positive, heterogeneous correlation between disclosure and social support (?=.159), a negative, heterogeneous correlation between stigma and social support (?=?.344) and a negative, homogenous correlation between stigma

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

    PubMed Central

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

    2015-01-01

    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

  10. Improving Access to Mental Health Services for Racialized Immigrants, Refugees, and Non-Status People Living with HIV/AIDS.

    PubMed

    Chen, Y Y Brandon; Li, Alan Tai; Fung, Kenneth Po; Wong, Josephine Pui

    2015-05-01

    The demographic characteristics of people living with HIV/AIDS (PHAs) in Canada are increasingly diverse. Despite literature suggesting a potentially heightened mental health burden borne by racialized immigrant, refugee, and non-status PHAs (IRN-PHAs), researchers have hitherto paid insufficient attention to whether existing services adequately address this need and how services might be improved. Employing community-based research methodology involving PHAs from five ethnoracial groups in Toronto, Ontario, this study explored IRN-PHAs' mental health service-seeking behaviors, service utilization experiences, and suggestions for service improvements. Results showed that while most IRN-PHAs were proactive in improving their mental health, their attempts to obtain support were commonly undermined by service provider mistreatment, unavailability of appropriate services, and multiple access barriers. A three-pronged approach involving IRN-PHA empowerment, anti-stigma and cultural competence promotion, and greater service integration is proposed for improving IRN-PHAs' mental health service experience. PMID:25913347

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

    PubMed

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

    2013-07-01

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

  12. Social network predictors of disclosure of MSM behavior and HIV-positive serostatus among African American MSM in Baltimore, Maryland.

    PubMed

    Latkin, Carl; Yang, Cui; Tobin, Karin; Roebuck, Geoffrey; Spikes, Pilgrim; Patterson, Jocelyn

    2012-04-01

    This study examined correlates of disclosure of MSM behavior and seropositive HIV status to social network members among 187 African American MSM in Baltimore, MD. 49.7% of participants were HIV-positive, 64% of their social network members (excluding male sex partners) were aware of their MSM behavior, and 71.3% were aware of their HIV-positive status. Disclosure of MSM behavior to network members was more frequent among participants who were younger, had a higher level of education, and were HIV-positive. Attributes of the social network members associated with MSM disclosure included the network member being HIV-positive, providing emotional support, socializing with the participant, and not being a female sex partner. Participants who were younger were more likely to disclose their positive HIV status. Attributes of social network members associated with disclosure of positive serostatus included the network member being older, HIV-positive, providing emotional support, loaning money, and not being a male sex partner. PMID:21811844

  13. Social network predictors of disclosure of MSM behavior and HIV-positive serostatus among African American MSM in Baltimore, Maryland

    PubMed Central

    Latkin, Carl; Yang, Cui; Tobin, Karin; Roebuck, Geoffrey; Spikes, Pilgrim; Patterson, Jocelyn

    2012-01-01

    This study examined correlates of disclosure of MSM behavior and seropositive HIV status to social network members among 187 African American MSM in Baltimore, MD. 49.7% of participants were HIV-positive, 64% of their social network members (excluding male sex partners) were aware of their MSM behavior, and 71.3% were aware of their HIV-positive status. Disclosure of MSM behavior to network members was more frequent among participants who were younger, had a higher level of education, and were HIV-positive. Attributes of the social network members associated with MSM disclosure included the network member being HIV-positive, providing emotional support, socializing with the participant, and not being a female sex partner. Participants who were younger were more likely to disclose their positive HIV status. Attributes of social network members associated with disclosure of positive serostatus included the network member being older, HIV-positive, providing emotional support, loaning money, and not being a male sex partner. PMID:21811844

  14. 75 FR 15635 - Delegations of Authority To Disclose Confidential Information

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-30

    ...CFR Parts 38 and 140 RIN 3038--AC68 Delegations of Authority To Disclose Confidential...proposing to amend its regulations governing delegations of authority to disclose confidential...gov. Reference should be made to ``Delegations of Authority to Disclose...

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

    PubMed Central

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

    2014-01-01

    Background HIV-related stigma has negative consequences for infected people's lives and is a barrier to HIV prevention. Therefore valid and reliable instruments to measure stigma are needed to enable mapping of HIV stigma. This study aimed to evaluate the psychometric properties of the HIV stigma scale in a Swedish context with regard to construct validity, data quality, and reliability. Methods The HIV stigma scale, developed by Berger, Ferrans, and Lashley (2001), was distributed to a cross-sectional sample of people living with HIV in Sweden (n?=?194). The psychometric evaluation included exploratory factor analysis together with an analysis of the distribution of scores, convergent validity by correlations between the HIV stigma scale and measures of emotional well-being, and an analysis of missing items and floor and ceiling effects. Reliability was assessed using Cronbach's ?. Results The exploratory factor analysis suggested a four-factor solution, similar to the original scale, with the dimensions personalised stigma, disclosure concerns, negative self-image, and concerns with public attitudes. One item had unacceptably low loadings and was excluded. Correlations between stigma dimensions and emotional well-being were all in the expected direction and ranged between ?0.494 and ?0.210. The instrument generated data of acceptable quality except for participants who had not disclosed their HIV status to anybody. In line with the original scale, all subscales demonstrated acceptable internal consistency with Cronbach's ? 0.87–0.96. Conclusion A 39-item version of the HIV stigma scale used in a Swedish context showed satisfactory construct validity and reliability. Response alternatives are suggested to be slightly revised for items assuming the disclosure of diagnosis to another person. We recommend that people that have not disclosed should skip all questions belonging to the dimension personalised stigma. Our analysis confirmed construct validity of the instrument even without this dimension. PMID:25522127

  16. Nondisclosure of HIV Infection to Sex Partners and Alcohol’s Role: A Russian Experience

    PubMed Central

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

    2013-01-01

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

  17. 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

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

    2015-04-01

    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

  18. Impact of HIV-Related Stigma on Health Behaviors and Psychological Adjustment Among HIV-Positive Men and Women

    PubMed Central

    Vanable, Peter A.; Carey, Michael P.; Blair, Donald C.; Littlewood, Rae A.

    2008-01-01

    HIV-related stigmatization remains a potent stressor for HIV-positive people. This study examined the relationships among stigma-related experiences and depression, medication adherence, serostatus disclosure, and sexual risk among 221 HIV-positive men and women. In bivariate analyses that controlled for background characteristics, stigma was associated with depressive symptoms, receiving recent psychiatric care, and greater HIV-related symptoms. Stigma was also associated with poorer adherence and more frequent serostatus disclosure to people other than sexual partners, but showed no association to sexual risk behavior. In a multivariate analysis that controlled for all correlates, depression, poor adherence, and serostatus disclosure remained as independent correlates of stigma-related experiences. Findings confirm that stigma is associated with psychological adjustment and adherence difficulties and is experienced more commonly among people who disclose their HIV status to a broad range of social contacts. Stigma should be addressed in stress management, health promotion, and medication adherence interventions for HIV-positive people. PMID:16604295

  19. Factors Associated With Forensic Nurses Offering HIV nPEP Status Post Sexual Assault.

    PubMed

    Draughon, Jessica E; Hauda, William E; Price, Bonnie; Rotolo, Sue; Austin, Kim Wieczorek; Sheridan, Daniel J

    2014-04-14

    Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making. PMID:24733232

  20. Cerebrospinal fluid neopterin levels in 159 neurologically asymptomatic persons infected with the human immunodeficiency virus (HIV-1): relationship to immune status.

    PubMed

    Lucey, D R; McGuire, S A; Abbadessa, S; Hall, K; Woolford, B; Valtier, S; Butzin, C A; Melcher, G P; Hendrix, C W

    1993-01-01

    Monocytes and brain macrophage-microglial cells are thought to play a crucial role in the neurologic dysfunction associated with HIV-1 disease. Since neopterin is produced by monocytes-macrophages, we asked whether cerebrospinal fluid (CSF) neopterin levels increase before the onset of HIV-1 neurologic disease and whether they correlate with other CSF and peripheral blood immunologic parameters. In this study, CSF neopterin levels from 159 neurologically asymptomatic HIV-positive persons were found to increase as the blood CD4+ T-cell count decreased and as CSF IgG, IgG synthesis, IgG index, and beta 2-microglobulin increased. Neopterin levels in the CSF exceeded those in the serum in 32% of patients, while 25% had CSF levels > 13.5 nmol/liter. CSF neopterin levels vary with immune status, may reflect intrathecal production, and can be elevated in asymptomatic HIV-positive patients with normal neurologic examinations. Long-term follow-up of this patient population should be able to define the clinical correlation between CSF neopterin levels during the asymptomatic phase of HIV-1 disease and the risk of subsequent neurologic disease. PMID:7909441

  1. Prospective associations between lateralised brain function and immune status in HIV infection: Analysis of EEG, cognition and mood over 30 months

    Microsoft Academic Search

    John Gruzelier; Adrian Burgess; Torsten Baldeweg; Massimo Riccio; David Hawkins; Janet Stygall; Susan Catt; Gillian Irving; José Catalan

    1996-01-01

    Prospective relations between individual differences in both lateralised neuro-psychophysiological functions and mood ratings with immune status (CD4 and CD8 counts) were examined in asymptomatic HIV-positive men (n = 27) over thirty months. They participated in a controlled study of zidovudine versus placebo (results published elsewhere). Measures included EEG spectra, neuropsychological tests and mood ratings. A model of reciprocal lateralised influences

  2. Survivor Seeks to Disclose to a

    E-print Network

    Snider, Barry B.

    are Discussed with Survivor Police Charges Are Filed by the Survivor No Police Charges are Filed A Community either or BOTH to local police and the Department of Student Rights and Community Standards. #12;#12;Incident Occurs Survivor Seeks to Disclose to a Brandeis Community Member Protocols and Resources

  3. Children's Expressed Emotions when Disclosing Maltreatment

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  4. Male circumcision and HIV status among Latino immigrant MSM in New York City.

    PubMed

    Reisen, Carol A; Zea, Maria Cecilia; Poppen, Paul J; Bianchi, Fernanda T

    2007-01-01

    This study investigated protective effects of circumcision in a sample of immigrant Latino men who have sex with men (MSM). A survey in Portuguese, Spanish, or English was administered with computer-assisted self-interview technology with audio enhancement (A-CASI) to 482 MSM from Brazil (n=146), Colombia (n=169), and the Dominican Republic (n=167), living in the New York metropolitan area. Logistic regression revealed that after controlling for age, income, education, having had syphilis, having done sex work, and preferring the receptive role in anal intercourse, uncircumcised men were almost twice as likely to be HIV-positive as circumcised men. Follow-up analyses revealed, however, that the protective effects occurred only among the group of Colombian men. PMID:19002268

  5. Imipramine induced elevation of prolactin levels in patients with HIV/AIDS improved their immune status.

    PubMed

    Orlander, H; Peter, S; Jarvis, M; Ricketts-Hall, L

    2009-06-01

    Prolactin is known to have significant immunomodulatory properties. Imipramine, a monoamine oxidase inhibitor stimulates prolactin production because it decreases dopamine which inhibits secretion of prolactin. The study objective was to determine if use of imipramine can result in immunological benefits for HIV-positive patients by restoration and preservation of immunological function. A cohort of 19 retroviral positive patients was identified for the prospective study which continued for a 28-week period. Three patients dropped out before the study began. Inclusion criteria accepted only patients on the same highly active antiretroviral therapy (HAART) regimen for a nine-month period and who had reached a plateau with respect to the CD4 cell count and also had no prior history of antidepressant use for a 12-month period. This study had a "before and after" design, patients serving as their own control. The study drug imipramine was prescribed for a 12-week period up to visit 4, and then discontinued for 4-weeks (washout period) at which time blood investigations were done at visit 5. Finally, patients were prescribed the study drug for a further 12-week period to the end of the trial (visit 7). At the 95 per cent probability level, significant differences in average prolactin and CD4 levels from visit 4 to the end of the trial period were recorded. Results showed a trend of prolactin levels decreasing after washout (p = 0.015) and increasing by the end of the trial period once imipramine dispensation had recommenced (p = 0.006). With respect to the CD4 cell count, there was a significant increase after wash-out (p = 0.022). These results indicate a trend to immune boosting in HIV-positive patients who had obtained the maximum response from HAART. PMID:20043526

  6. Experiences of HIV-positive gay, bisexual and other men who have sex with men residing in relatively rural areas.

    PubMed

    Hubach, Randolph D; Dodge, Brian; Schick, Vanessa; Ramos, William D; Herbenick, Debby; Li, Michael J; Cola, Thea; Reece, Michael

    2015-08-01

    Most previous studies of the sexual behaviour of gay, bisexual and other men who have sex with men living with HIV are based on samples of men recruited within relatively urban and suburban areas of the USA. The aim of the present study was to explore the potential challenges associated with HIV-related stigma and residing in a relatively rural area. We conducted a qualitative study based in south-central Indiana, a relatively rural area of the USA. Twenty-three HIV-positive gay, bisexual and other men who have sex with men, aged 21-48 years, were interviewed on topics regarding community engagement, perceived HIV-related stigma, relationship formation, sexual behaviour and HIV status disclosure. Findings indicate HIV-related stigma is commonly reported at the interpersonal and community levels. Because of this, men face complex situations on how and when to disclose their HIV status to members of their social and sexual networks. Although many participants reported many challenges associated with relationship formation, all expressed a desire for romantic and/or sexual connections with other men and/or women. Results suggest that new programmatic approaches are necessary to inform the work of social service and medical providers on mechanisms to intervene and combat stigma and discrimination inherent in communities, programmes and policies. PMID:25608847

  7. HIV knowledge, disclosure and sexual risk among pregnant women and their partners in rural South Africa

    PubMed Central

    Shikwane, Molatelo Elisa; Villar-Loubet, Olga M.; Weiss, Stephen M.; Peltzer, Karl; Jones, Deborah L.

    2014-01-01

    Partner involvement has been deemed fundamental for the prevention of mother-to-child transmission (PMTCT) of HIV, although it remains difficult to achieve. This study aimed to explore the attitudes and behaviours of pregnant women and their partners who participated in a behavioural risk reduction intervention in six community health centres in the Mpumalanga province of South Africa. Qualitative methods only were used in this study. Women and their partners took part in four gender-concordant groups that addressed HIV, PMTCT, disclosure of HIV status and safer sex practices. The results indicate that men value and understand the importance of being involved in women's reproductive health, although some components of the PMTCT programme such as condom use were still met with some resistance. Participants demonstrated high levels of HIV- and sexually transmitted infection-related knowledge. Men lacked knowledge about PMTCT but were interested in acquiring information so that they could support their partners. All groups highlighted the emotional and physical benefits of disclosing one's HIV status. The involvement of men in antenatal care has the potential to prevent women from becoming infected with HIV both during pregnancy and post-partum when they are more vulnerable to infection and have a high risk of transmission to the infant. There is a need for interventions that focus on both increasing male involvement and promoting condom use during pregnancy. PMID:24405286

  8. Circumcision Status and Risk of HIV Acquisition during Heterosexual Intercourse for Both Males and Females: A Meta-Analysis.

    PubMed

    Lei, Jun Hao; Liu, Liang Ren; Wei, Qiang; Yan, Shi Bing; Yang, Lu; Song, Tu Run; Yuan, Hai Chao; Lv, Xiao; Han, Ping

    2015-01-01

    In this study, we evaluated if male circumcision was associated with lower HIV acquisition for HIV (-) males and HIV (-) females during normal sexual behavior. We performed a systematic literature search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify studies that compared HIV acquisition for the circumcised and uncircumcised groups. The reference lists of the included and excluded studies were also screened. Fifteen studies (4 RCTs and 11 prospective cohort studies) were included, and the related data were extracted and analyzed in a meta-analysis. Our study revealed strong evidence that male circumcision was associated with reduced HIV acquisition for HIV(-) males during sexual intercourse with females [pooled adjusted risk ratio (RR): 0.30, 95% CI 0.24 0.38, P < 0.00001] and provided a 70% protective effect. In contrast, no difference was detected in HIV acquisition for HIV (-) females between the circumcised and uncircumcised groups (pooled adjusted RR after sensitivity analysis: 0.68, 95%CI 0.40-1.15, P = 0.15). In conclusion, male circumcision could significantly protect males but not females from HIV acquisition at the population level. Male circumcision may serve as an additional approach toward HIV control, in conjunction with other strategies such as HIV counseling and testing, condom promotion, and so on. PMID:25942703

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

    PubMed

    Winchester, M S; McGrath, J W; Kaawa-Mafigiri, D; Namutiibwa, F; Ssendegye, G; Nalwoga, A; Kyarikunda, E; Birungi, J; Kisakye, S; Ayebazibwe, N; Walakira, E; Rwabukwali, C B

    2013-01-01

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

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

    PubMed

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

    2014-07-01

    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

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

    PubMed Central

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

    1994-01-01

    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. HIV serostatus could be verified in 738 (68.7%) of these. MEASUREMENTS AND MAIN RESULTS--Crude and adjusted odds ratios and their 95% confidence intervals were estimated to assess the association between HIV serostatus and behavioural changes. In their daily interactions with other members of the same household, seropositive subjects more frequently used preventive methods aimed at avoiding transmission than seronegative patients. Treatment for abuse or dependency before the current regimen had a greater impact in HIV positive than HIV negative subjects in terms of abstaining from risk behaviours. There was a significant trend toward lower drug consumption in HIV positive subjects, and the number of seropositive and seronegative IVDUs who stopped injecting their drugs was significantly higher among the former. Seropositive subjects were also more likely to stop sharing drug injecting equipment and to change their sexual habits; they reported an increased consistent use of condoms. CONCLUSIONS--HIV positive IVDUs were more likely to change their risk behaviours than their HIV negative counterparts. PMID:7964355

  12. Domestic violence among women living with HIV/AIDS in Kano, Northern Nigeria.

    PubMed

    Iliyasu, Zubairu; Abubakar, Isa S; Babashani, Musa; Galadanci, Hadiza S

    2011-09-01

    Despite the increased risk of domestic violence among women living with HIV/AIDS, its burden has not been adequately explored in many developing countries including Nigeria. Using interviewer administered questionnaires we assessed the prevalence and risk factors for domestic violence among 300 HIV seropositive women attending a teaching hospital in northern Nigeria. Participants have been diagnosed HIV positive for an average of 6.7 years; 66.3% were seroconcordant with their intimate partners while 16.3% were serodiscordant, the rest 17.4% did not know the partner's status; 67.1% had disclosed their status to their partners; and 64(22.1%) [95% CI (17.5% to 27.4%)] had experienced domestic violence following HIV diagnosis. Specifically, 30.0% (n = 19) experienced physical violence (slapping, kicking and punching), 59.3% (n = 38) reported verbal violence (insults, threats) and 10.7% (n = 7) endured emotional violence. None was sexually assaulted. Predictors of domestic violence were the woman's age, marital status, disclosure and partner's educational status. This calls for urgent steps and strategies for prevention, protection and post-test counseling on disclosure to avert this human right infringement. PMID:22574491

  13. "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

    2010-01-01

    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

  14. Disclosure and Nondisclosure Among People Newly Diagnosed with HIV: An Analysis from a Stress and Coping Perspective

    PubMed Central

    Wrubel, Judith; Bränström, Richard; Acree, Michael; Moskowitz, Judith Tedlie

    2012-01-01

    Abstract Disclosing HIV status to friends, family, and sex partners is often stressful. However, HIV disclosure has been associated with improved physical health, psychological well-being, and improved health behaviors. The aim of this study was to address some of the gaps in the literature regarding the disclosure process by conducting a mixed-methods study of disclosure in people newly diagnosed with HIV and the relationship of disclosure to stigma and social support. The CHAI (Coping, HIV, and Affect Interview) Study was a longitudinal cohort study that followed individuals who were newly diagnosed with HIV. The study took place from October 2004 to June 2008 in the San Francisco Bay Area. This sample includes data from 50 participants who were interviewed 1, 3, and 9 months following diagnosis with HIV. We identified four main approaches to HIV disclosure that revealed distinct differences in how participants appraised disclosure, whether disclosure was experienced as stressful, and whether disclosure or nondisclosure functioned as a way of coping with an HIV diagnosis. Implications of these findings for disclosure counseling are discussed. PMID:22256856

  15. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

    PubMed

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

    2015-01-01

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

  16. 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

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

    2015-01-01

    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

  17. 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

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

    2014-01-01

    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

  18. Spontaneous Regression of Refractory Diffuse Large B-Cell Lymphoma with Improvement in Immune Status with ART in a Patient with HIV: A Case Report and Literature Review

    PubMed Central

    K.C., Birendra; Afzal, Muhammad Zubair; Wentland, Katherine A.; Hashmi, Hamza; Singh, Sudhir; Ivan, Elena; Lakhani, Nehal

    2015-01-01

    Patient: Male, 55 Final Diagnosis: Diffuse large B-cell lymphoma • HIV Symptoms: Fatigue • weight loss Medication: — Clinical Procedure: Renal biopsy Specialty: Oncology Objective: Unusual or unexpected effect of treatment Background: Diffuse large B-cell lymphoma accounts for the large majority of AIDS-related non-Hodgkin lymphoma. Traditionally, this lymphoma has been treated with CHOP-like regimens with the recent addition of rituximab. We report a unique case where an HIV-infected patient with diffuse large B-cell lymphoma had complete regression of the lymphoma with continued antiretroviral therapy (ART) after chemotherapy was stopped. Case Report: A 55-year-old man who presented with fatigue and weight loss had initial CT findings of bilateral renal masses during his workup. Biopsy revealed diffuse large B-cell lymphoma and subsequently he was also diagnosed with HIV. He completed 6 cycles of CHOP-like (4 cycles of EPOCH-R and 2 cycles of R-CHOP) first-line therapy with significant dose delays and dose reductions due to severe adverse effects. Chemotherapy was stopped due to physical deconditioning and intolerable adverse effects. He had a FDG-PET/CT showing progression of his disease 8 weeks after completing chemotherapy. He was maintained only on ART after finishing 6 cycles of chemotherapy. With this therapy alone and with improvement in his immune status, his lymphoma regressed completely. Conclusions: There are very few reported cases in which lymphoma has regressed with treatment of HIV alone, as is regression of diffuse large B-cell lymphoma. This case emphasizes that ART can lead to immune reconstitution of HIV-infected patients and can establish the anti-tumor effect, causing regression of the lymphoma. PMID:26046822

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

    Microsoft Academic Search

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

    2007-01-01

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

  20. Sex Position, Marital Status, and HIV Risk Among Indian Men Who Have Sex with Men: Clues to Optimizing Prevention Approaches

    PubMed Central

    Hemmige, Vagish; Snyder, Hannah; Liao, Chuanhong; Mayer, Kenneth; Lakshmi, Vemu; Gandham, Sabitha R.; Orunganti, Ganesh

    2011-01-01

    Abstract A divide exists between categories of men who have sex with men (MSM) in India based on their sex position, which has consequences for the design of novel HIV prevention interventions. We examine the interaction between sex position and other attributes on existing HIV risk including previous HIV testing, unprotected anal intercourse (UAI), and HIV serostatus among MSM recruited from drop-in centers and public cruising areas in the twin cities of Hyderabad and Secunderabad, India. A survey was administered by trained research assistants and minimally invasive HIV testing was performed by finger-stick or oral testing. HIV seropositive MSM underwent CD4+ lymphocyte count measurement. In our sample (n=676), 32.6% of men were married to women, 22.2% of receptive only participants were married, and 21.9% of men were HIV seropositive. In bivariate analysis, sex position was associated with previous HIV testing, UAI, HIV serostatus, and CD4+ lymphocyte count at diagnosis. In multivariate analysis with interaction terms, dual unmarried men were more likely to have undergone an HIV test than insertive unmarried men (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.2–6.5), a relationship that did not hold among married men. Conversely, dual married men were less likely than insertive married men to engage in UAI (OR 0.3; 95% CI 0.1–0.6), a relationship that did not hold among unmarried men. Further implementation research is warranted in order to best direct novel biologic and behavioral prevention interventions towards specific risk behaviors in this and other similar contexts. PMID:21682588

  1. 47 CFR 1.1206 - Permit-but-disclose proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Permit-but-disclose proceedings. 1.1206 Section 1.1206 Telecommunication...Parte Communications Non-Restricted Proceedings § 1.1206 Permit-but-disclose proceedings. (a) Unless otherwise provided...

  2. 47 CFR 1.1206 - Permit-but-disclose proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Permit-but-disclose proceedings. 1.1206 Section 1.1206 Telecommunication...Parte Communications Non-Restricted Proceedings § 1.1206 Permit-but-disclose proceedings. (a) Unless otherwise provided...

  3. 47 CFR 1.1206 - Permit-but-disclose proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Permit-but-disclose proceedings. 1.1206 Section 1.1206 Telecommunication...Parte Communications Non-Restricted Proceedings § 1.1206 Permit-but-disclose proceedings. (a) Unless otherwise provided...

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  6. Low-Density Lipoprotein Cholesterol Levels and Statin Treatment by HIV Status Among Multicenter AIDS Cohort Study Men.

    PubMed

    Monroe, Anne K; Fu, Wei; Zikusoka, Michelle N; Jacobson, Lisa P; Witt, Mallory D; Palella, Frank J; Kingsley, Lawrence A; Post, Wendy S; Brown, Todd T

    2015-06-01

    Treating cardiovascular disease (CVD) risk factors, including dyslipidemia, is important in HIV care. Low-density lipoprotein cholesterol (LDL-c) target achievement is a readily available benchmark for dyslipidemia control, although use of this target is not uniformly endorsed by professional societies. We examined whether HIV serostatus is associated with not achieving LDL-c target. Among Multicenter AIDS Cohort Study (MACS) participants completing visit 56 (10/1/2011-3/31/2012), we categorized each man as on or off statin therapy and used NCEP ATP III guidelines to determine if each man was at LDL-c target or not at target. We compared proportions of men not at target and determined predictors using multivariate logistic regression. Sixty of 543 (11.1%) HIV-infected men and 87 of 585 (14.9%) HIV-uninfected men not receiving statin therapy were not at target (p=0.07), while 31 of 230 (13.5%) HIV-infected and 29 of 204 (14.2%) HIV-uninfected men receiving statin therapy were not at target (p=0.82). Factors associated with not being at target (among men not receiving statin therapy) included current smoking (OR=2.31, 95% CI 1.31, 4.06) and a diagnosis of hypertension (OR=4.69, 95% CI 2.68, 8.21). Factors associated with not being at target (among men receiving statin therapy) included current smoking (OR=2.72, 95% CI 1.30, 5.67) and diabetes (OR=5.31, 95% CI 2.47, 11.42). HIV-infected and HIV-uninfected men receiving statin therapy demonstrated similar nonachievement of LDL-c targets. Comorbidities (e.g., diabetes) lowered targets and may explain why goals were less likely to be met. PMID:25664922

  7. Assessment of Nutritional, Clinical, and Immunologic Status of HIV-Infected, Inner-City Patients with Multiple Risk Factors

    Microsoft Academic Search

    ELISABETH LUDER; EMILIE GODFREY; JAMES GODBOLD; DAVID M SIMPSON

    1995-01-01

    Objective To evaluate the nutritional, clinical, and immunologic factors associated with human immunodeficiency virus (HIV)-infected, inner-city patients with multiple risk factors.Design Prospective cross-sectional nutrition evaluation of patients with HIV infection.Setting Patients were interviewed at the outpatient clinic at Mt Sinai Medical Center, New York City, NY.Subjects Our subjects were men and women older than 18 years of age and at

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

    PubMed

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

    2002-12-01

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

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

    PubMed Central

    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

    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

  10. Spontaneous Regression of Refractory Diffuse Large B-Cell Lymphoma with Improvement in Immune Status with ART in a Patient with HIV: A Case Report and Literature Review.

    PubMed

    K C, Birendra; Afzal, Muhammad Zubair; Wentland, Katherine A; Hashmi, Hamza; Singh, Sudhir; Ivan, Elena; Lakhani, Nehal

    2015-01-01

    BACKGROUND Diffuse large B-cell lymphoma accounts for the large majority of AIDS-related non-Hodgkin lymphoma. Traditionally, this lymphoma has been treated with CHOP-like regimens with the recent addition of rituximab. We report a unique case where an HIV-infected patient with diffuse large B-cell lymphoma had complete regression of the lymphoma with continued antiretroviral therapy (ART) after chemotherapy was stopped. CASE REPORT A 55-year-old man who presented with fatigue and weight loss had initial CT findings of bilateral renal masses during his workup. Biopsy revealed diffuse large B-cell lymphoma and subsequently he was also diagnosed with HIV. He completed 6 cycles of CHOP-like (4 cycles of EPOCH-R and 2 cycles of R-CHOP) first-line therapy with significant dose delays and dose reductions due to severe adverse effects. Chemotherapy was stopped due to physical deconditioning and intolerable adverse effects. He had a FDG-PET/CT showing progression of his disease 8 weeks after completing chemotherapy. He was maintained only on ART after finishing 6 cycles of chemotherapy. With this therapy alone and with improvement in his immune status, his lymphoma regressed completely. CONCLUSIONS There are very few reported cases in which lymphoma has regressed with treatment of HIV alone, as is regression of diffuse large B-cell lymphoma. This case emphasizes that ART can lead to immune reconstitution of HIV-infected patients and can establish the anti-tumor effect, causing regression of the lymphoma. PMID:26046822

  11. The status of middle level HIV/STD education as assessed by state and local education agencies.

    PubMed

    Wolff, W J; Schoeberlein, D R

    1999-08-01

    During spring 1998 RAD Educational Programs, in cooperation with the National Middle School Association, conducted a needs assessment of middle level HIV/STD prevention programs from the perspective of representatives from state education agencies (SEA) and local education agencies (LEA). Data were collected from 84% of states (SEAs) and 88% of cities (LEAs) funded by CDC to conduct HIV/STD prevention activities. A range of activities are occurring in school-based HIV/STD prevention for early adolescents in grades 5-8. However, a prevailing characteristic among states was the high degree to which local control and local decision making affects programming in schools. Needs of SEAs and LEAs are similar as reflected by the need for continued improvement of middle level HIV/STD prevention education. A concrete result was the multitude of requests for effective HIV/STD curricula for middle level students. In addition, administrators shared similar needs for an increase in time allotment for health instruction. Most SEAs (65%) and LEAs (77%) believed that time for health education in the classroom would increase if a nation-wide mandate existed resulting in appropriate standards and assessments for all middle level and high school students. PMID:10461283

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

    Microsoft Academic Search

    Carsten Albers; Thomas Günther

    2010-01-01

    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

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

    PubMed Central

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

    2013-01-01

    Objective Many people living with HIV in sub-Saharan Africa desire biological children. Implementation of HIV prevention strategies that support the reproductive goals of people living with HIV while minimizing HIV transmission risk to sexual partners and future children requires a comprehensive understanding of pregnancy in this population. We analyzed prospective cohort data to determine pregnancy incidence and predictors among HIV-positive women initiating antiretroviral therapy (ART) in a setting with high HIV prevalence and fertility. Methods Participants were enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO) cohort of HIV-positive individuals initiating ART in Mbarara. Bloodwork (including CD4 cells/mm3, HIV viral load) and questionnaires (including socio-demographics, health status, sexual behavior, partner dynamics, HIV history, and self-reported pregnancy) were completed at baseline and quarterly. Our analysis includes 351 HIV-positive women (18–49 years) who enrolled between 2005–2011. We measured pregnancy incidence by proximal and distal time relative to ART initiation and used multivariable Cox proportional hazards regression analysis (with repeated events) to identify baseline and time-dependent predictors of pregnancy post-ART initiation. Results At baseline (pre-ART initiation), median age was 33 years [IQR: 27–37] and median prior livebirths was four [IQR: 2–6]. 38% were married with 61% reporting HIV-positive spouses. 73% of women had disclosed HIV status to a primary sexual partner. Median baseline CD4 was 137 cells/mm3 [IQR: 81–207]. At enrolment, 9.1% (31/342) reported current pregnancy. After ART initiation, 84 women experienced 105 pregnancies over 3.8 median years of follow-up, yielding a pregnancy incidence of 9.40 per 100 WYs. Three years post-ART initiation, cumulative probability of at least one pregnancy was 28% and independently associated with younger age (Adjusted Hazard Ratio (AHR): 0.89/year increase; 95%CI: 0.86–0.92) and HIV serostatus disclosure to primary sexual partner (AHR: 2.45; 95%CI: 1.29–4.63). Conclusions Nearly one-third of women became pregnant within three years of initiating ART, highlighting the need for integrated services to prevent unintended pregnancies and reduce periconception-related risks for HIV-infected women choosing to conceive. Association with younger age and disclosure suggests a role for early and couples-based safer conception counselling. PMID:23704906

  14. On the road to HIV/AIDS competence in the household: building a health-enabling environment for people living with HIV/AIDS.

    PubMed

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

    2015-03-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    Microsoft Academic Search

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

    2008-01-01

    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

  17. Health status of HIV-infected women entering care: baseline medical findings from the women of color initiative.

    PubMed

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

    2015-01-01

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

  18. HIV UPDATE: AGING & HIV

    E-print Network

    Bushman, Frederic

    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

  19. HIV UPDATE: BOTSWANA HIV

    E-print Network

    Bushman, Frederic

    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

  20. Adolescent experiences of discrimination, harassment, connectedness to community and comfort with sexual orientation reported by adult men who have sex with men as a predictor of adult HIV status.

    PubMed

    Raymond, H Fisher; Chen, Yea-Hung; Stall, Ron D; McFarland, Willi

    2011-04-01

    Using data from a probability based sample of adult men who have sex with men (MSM) we examined the association of negative life factors during adolescence and adult HIV status. 521 MSM reported on experiences of connectedness to community, comfort with sexuality, harassment and discrimination due to their sexual orientation at ages 12-18 years. HIV status was determined by serological testing. Overall, men reported moderate levels of being harassed, being discriminated against and high levels of feeling disconnected from gay communities while reporting high levels of being uncomfortable with their sexuality at those ages. However, in analyses of scores on these factors, higher experiences of harassment, higher levels of discrimination and more discomfort with sexuality at these ages are associated with HIV-negative status as adults. This study suggests that the relationship between negative adolescent experiences among MSM and adult HIV infection may not be straightforward, but may also dependent upon aspects of the intensity of the negative experiences, the relationship of the victim and the perpertrator(s), the sexual identity of the victim at the time and/or the number of these experiences or the length of time over which they occurred. Studies investigating specific multiple stressors in adolescent gay development and their effect on adult health outcomes are needed. PMID:19915973

  1. Dis closive Ethics and Information Technology: Disclosing Facial Recognition Systems

    Microsoft Academic Search

    Lucas D. Introna

    2005-01-01

    This paper is an attempt to present disclosive ethics as a framework for computer and information ethics – in line with the suggestions by Brey, but also in quite a different manner. The potential of such an approach is demonstrated through a disclosive analysis of facial recognition systems. The paper argues that the politics of information technology is a particularly

  2. Recruiting substance-using men who have sex with men into HIV prevention research: current status and future directions.

    PubMed

    Jenkins, Richard A

    2012-08-01

    Research investigators have identified increasing challenges to the recruitment of men who have sex with men (MSM) for observational and intervention HIV/AIDS studies. To address these issues, program staff from the National Institute on Drug Abuse convened a meeting on April 28th to 29th, 2009 to discuss issues in MSM recruitment. The panel indicated that there was decreased community identification with HIV research, although altruistic, community-oriented motives continued to be important. Substance use adds to recruitment challenges, particularly recruitment of MSM who use stigmatized substances. Relatively new recruitment methods such as respondent driven sampling, venue-data-time sampling, and internet sampling have helped advance knowledge about the recruitment process; however, they have not mitigated the challenges to MSM recruitment. Recruitment of youth and members of racial/ethnic minority populations present additional considerations. This report summarizes the meeting's proceedings, key points of discussion, and areas for further research consideration. PMID:22016329

  3. Drug Use and HIV Infection Status of Detainees in Re-Education through Labour Camps in Guangxi Province, China

    PubMed Central

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

    2015-01-01

    This study describes HIV disease burden and patterns of drug use before and during incarceration among detainees in Re-education-Through-Labour-Camps (RTLCs) in China. A cross-sectional survey of 576 men and 179 women from three RTLCs was conducted in Guangxi Province, China. Over three-quarters of study participants were detained due to drug-related offences. Over half of the women (n = 313, 54.3%) and two-thirds of men (n = 119, 66.5%) had been previously been incarcerated in a compulsory detoxification treatment centre (CDTC), and around one-third (men n = 159, 27.6%; women n = 50, 27.9%) in a RTLC. Of those surveyed, 49 men (8.5%) and one (0.6%) woman reported ever using drugs while in a CDTC and/or RTLC. Previous incarceration in CDTCs and RTLCs were associated with HIV infection among both male (OR = 2.15 [1.11–4.15]) and female (OR = 3.87 [1.86–9.04]) detainees. Being married/cohabiting with a partner (OR = 0.53, [0.30–0.93]) and being employed (OR = 0.46, [0.22–0.95]) were associated with a reduced odds of HIV infection among male detainees. A significant proportion of RTLC detainees had a history of drug use and a limited number of inmates had used illegal substances whilst in custody. Repeat incarcerations in CDTCs/RTLCs were associated with higher risks of HIV infection. PMID:25915836

  4. Brief Report: A Qualitative Analysis of Discussions about HIV in Families of Parents with HIV

    PubMed Central

    Cowgill, Burton O.; Bogart, Laura M.; Parra, Michelle T.; Ryan, Gery; Elliott, Marc N.; Park, Susan K.; Patch, Jennifer; Schuster, Mark A.

    2009-01-01

    Objective?To explore communication about HIV prevention, risk behaviors, and transmission in families affected by HIV.?Methods?Semi-structured interviews were conducted with 33 parents with HIV, 27 children (9- to 17-years old), and 19 adult children (?18-years old) across the U.S. Coders reviewed transcripts, identified themes, and coded transcripts.?Results?Youth felt uncomfortable discussing HIV with their parent who has HIV because they worried about upsetting and reminding the parent of his/her illness. Adult children reported learning about HIV prevention by watching how the illness affected their parents. Few siblings reported talking with one another about HIV because they worried about upsetting their brother/sister and about their sibling unintentionally disclosing the parent's illness to others.?Conclusions?Discussions between youth and their parent with HIV and their siblings vary, highlighting the need for further research in this area. PMID:19028715

  5. HIV stigma experienced by young men who have sex with men (MSM) living with HIV infection.

    PubMed

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

    2015-02-01

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

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

    PubMed Central

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

    2007-01-01

    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

  7. 22 CFR 1304.6 - Records not disclosed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...disclose the identity of a confidential source, including a State, local, or foreign agency or authority, any private institution, or a Bank, which furnished information on a confidential basis, and, in the case of a record compiled by...

  8. 22 CFR 1304.6 - Records not disclosed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...disclose the identity of a confidential source, including a State, local, or foreign agency or authority, any private institution, or a Bank, which furnished information on a confidential basis, and, in the case of a record compiled by...

  9. 22 CFR 1304.6 - Records not disclosed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...disclose the identity of a confidential source, including a State, local, or foreign agency or authority, any private institution, or a Bank, which furnished information on a confidential basis, and, in the case of a record compiled by...

  10. 22 CFR 1304.6 - Records not disclosed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...disclose the identity of a confidential source, including a State, local, or foreign agency or authority, any private institution, or a Bank, which furnished information on a confidential basis, and, in the case of a record compiled by...

  11. HIV UPDATE: cancer & HIV

    E-print Network

    Bushman, Frederic

    HIV UPDATE: cancer & HIV NOVEMBER 2012, Issue 11 This month's Taleletso provides an introduction to the topic of HIV and Cancer. This month we would also like to raise your awareness of a global cancer initiative, MOVEMBER, which is committed to raise money to diagnose and treat cancers in men. As part

  12. If, when and how to tell: a qualitative study of HIV disclosure among young women in Zimbabwe.

    PubMed

    Zamudio-Haas, Sophia; Mudekunye-Mahaka, Imelda; Lambdin, Barrot H; Dunbar, Megan S

    2012-12-01

    In the Shona culture of Zimbabwe, a high regard for childbearing contributes to strong pressures on women to have children. For young women living with HIV, consequently, disclosure of HIV status can be a central strategy to garner support for controlling fertility. This paper reports findings from qualitative interviews with 28 young women aged 16-20 living with HIV in urban Zimbabwe and discusses how these findings can contribute to better policies and programs for this population. Regardless of their current relationship status, interview participants described disclosure as a turning point in romantic partnerships, recounting stressful experiences with major ramifications such as abuse and abandonment on the one hand, and support and love on the other. All but one participant had been in a committed relationship, and most had disclosed to a previous or current partner, with about half of disclosure experiences resulting in adverse reactions. Findings suggest that sexual and reproductive health services must do more to help young women living with HIV negotiate the complexities of disclosure in the context of achieving desired fertility. PMID:23177677

  13. CBERS - Disclosing a Successful International Space Cooperation

    NASA Astrophysics Data System (ADS)

    Loureiro, G.

    2002-01-01

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

  14. Lowest ever CD4 lymphocyte count (CD4 nadir) as a predictor of current cognitive and neurological status in human immunodeficiency virus type 1 infection—The Hawaii Aging with HIV Cohort

    Microsoft Academic Search

    Victor Valcour; Priscilla Yee; Andrew E. Williams; Bruce Shiramizu; Michael Watters; Ola Selnes; Robert Paul; Cecilia Shikuma; Ned Sacktor

    2006-01-01

    Low CD4 lymphocyte count was a marker for neurological disease in human immunodeficiency virus type 1 (HIV-1); but is now\\u000a less common among patients with access to highly active antiretroviral therapy. In this study, the authors determine the reliability\\u000a of self-reported CD4 nadir and its predictive value for neurological status. The authors identify a high degree of reliability\\u000a (r =

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

    PubMed

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

    2013-01-01

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

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

    PubMed

    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

    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

  17. Women, Social Networks, and HIV

    Microsoft Academic Search

    Wassie Kebede

    2012-01-01

    HIV\\/AIDS has been a growing problem since the 1980s. The purpose of this study is to understand the relationship between social networks of women and their HIV\\/AIDS status in Debre Zeit, Ethiopia. In-depth interviews were conducted to collect data from 24 women, 14 of whom were HIV positive. A content analysis technique was applied and UCINET software was used to

  18. HIV charge dropped.

    PubMed

    1997-07-25

    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

  19. 63 FR 27628 - Human Immunodeficiency Virus (HIV) Prevention Projects and HIV Prevention Community Planning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1998-05-19

    ...status, geographic area, sexual orientation, risk for HIV infection...race/ethnicity, gender, sexual orientation, geographic distribution...4. Provide a thorough orientation for all new members, as...

  20. 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.

  1. Disclosing ambiguous gene aliases by automatic literature profiling

    PubMed Central

    2010-01-01

    Background Retrieving pertinent information from biological scientific literature requires cutting-edge text mining methods which may be able to recognize the meaning of the very ambiguous names of biological entities. Aliases of a gene share a common vocabulary in their respective collections of PubMed abstracts. This may be true even when these aliases are not associated with the same subset of documents. This gene-specific vocabulary defines a unique fingerprint that can be used to disclose ambiguous aliases. The present work describes an original method for automatically assessing the ambiguity levels of gene aliases in large gene terminologies based exclusively in the content of their associated literature. The method can deal with the two major problems restricting the usage of current text mining tools: 1) different names associated with the same gene; and 2) one name associated with multiple genes, or even with non-gene entities. Important, this method does not require training examples. Results Aliases were considered “ambiguous” when their Jaccard distance to the respective official gene symbol was equal or greater than the smallest distance between the official gene symbol and one of the three internal controls (randomly picked unrelated official gene symbols). Otherwise, they were assigned the status of “synonyms”. We evaluated the coherence of the results by comparing the frequencies of the official gene symbols in the text corpora retrieved with their respective “synonyms” or “ambiguous” aliases. Official gene symbols were mentioned in the abstract collections of 42 % (70/165) of their respective synonyms. No official gene symbol occurred in the abstract collections of any of their respective ambiguous aliases. In overall, querying PubMed with official gene symbols and “synonym” aliases allowed a 3.6-fold increase in the number of unique documents retrieved. Conclusions These results confirm that this method is able to distinguish between synonyms and ambiguous gene aliases based exclusively on their vocabulary fingerprint. The approach we describe could be used to enhance the retrieval of relevant literature related to a gene. PMID:21210969

  2. Use of food colourants as plaque disclosing agents.

    PubMed

    Kieser, J B; Wade, A B

    1976-11-01

    The effectiveness of plaque disclosure by several liquid food colourants and disclosing agents was compared in a group of eight subjects. The subjects refrained from all forms of oral hygiene for a 48-hour period prior to rinsing with 5 ml of each dye in turn at weekly intervals. Kodachrome film records were taken and projected for the assessment at weekly intervals. Kodachrome film records were taken and projected for the assessment of plaque staining efficacy by a panel of 38 assessors. Acceptability with respect to taste, extent and duration of mucosal staining and any side effects was also evaluated. The food colourants were as effective as the disclosing agents. Ability to stain plaque appears to be related not only to the constituents of each dye, but also to their concentrations and relative proportions. Other desirable properties of an ideal disclosing agent tended to be fulfilled to a level equivalent to, or better than, that reached by the proprietery disclosing agents. Difficulty in obtaining proprietary disclosing agents should not act as a handicap to achieving better levels of oral cleanliness as inexpensive food colourants of equal effectiveness to the best proprietary agent are readily available. PMID:62762

  3. 34 CFR 99.37 - What conditions apply to disclosing directory information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  4. 34 CFR 99.37 - What conditions apply to disclosing directory information?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...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...

  5. 34 CFR 99.37 - What conditions apply to disclosing directory information?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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...

  6. 34 CFR 99.37 - What conditions apply to disclosing directory information?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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...

  7. 34 CFR 99.37 - What conditions apply to disclosing directory information?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...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...

  8. 78 FR 45246 - Office of Clinical and Preventive Services National HIV Program: Enhanced HIV/AIDS Screening and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ...reduce the incidence of HIV/AIDS and improve quality of life for People Living with HIV/AIDS (PLWHA). The main goals...of his/her HIV status; and, improve engagement and...related services, reduce stigma, make HIV testing...

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

    PubMed Central

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

    2015-01-01

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

  10. HIV Vertical Transmission Rate Determinations Are Subject to Differing Definitions and Therefore Different Rates

    Microsoft Academic Search

    Jane Pitt; Johanna Goldfarb; Mark Schluchter; Andrea Kovacs; Ellen Cooper; David Hodes; Kenneth McIntosh; Hannah Peavy; William Shearer

    1998-01-01

    The HIV infection status of a cohort of 600 prospectively followed children born to HIV infected mothers was determined using HIV peripheral blood culture tests at 0, 3, and 6 months of age, HIV serology at ?15 months, and CDC AIDS criteria. We estimated transmission rates using five methods which differed in how HIV indeterminates are handled. These methods were

  11. The Impact of Utilizing HIV-Positive Speakers in AIDS Education

    Microsoft Academic Search

    Susan Paxton

    2002-01-01

    A longitudinal matched control study was conducted to evaluate the effects on young people (n=1280) of talks by HIV-positive speakers who disclose their personal perspective of living with HIV. Focus group discussions with students (n=117) were used to elucidate the impact. Meeting HIV-positive people decreased fear and prejudice, reinforced messages about protective behaviour and increased the belief that HIV is

  12. 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 ...

  13. Characteristics of Women Enrolled into a Randomized Clinical Trial of Dapivirine Vaginal Ring for HIV-1 Prevention

    PubMed Central

    Palanee-Phillips, Thesla; Schwartz, Katie; Brown, Elizabeth R.; Govender, Vaneshree; Mgodi, Nyaradzo; Kiweewa, Flavia Matovu; Nair, Gonasagrie; Mhlanga, Felix; Siva, Samantha; Bekker, Linda-Gail; Jeenarain, Nitesha; Gaffoor, Zakir; Martinson, Francis; Makanani, Bonus; Naidoo, Sarita; Pather, Arendevi; Phillip, Jessica; Husnik, Marla J.; van der Straten, Ariane; Soto-Torres, Lydia; Baeten, Jared

    2015-01-01

    Introduction Women in sub-Saharan Africa are a priority population for evaluation of new biomedical HIV-1 prevention strategies. Antiretroviral pre-exposure prophylaxis is a promising prevention approach; however, clinical trials among young women using daily or coitally-dependent products have found low adherence. Antiretroviral-containing vaginal microbicide rings, which release medication over a month or longer, may reduce these adherence challenges. Methods ASPIRE (A Study to Prevent Infection with a Ring for Extended Use) is a phase III, randomized, double-blind, placebo-controlled trial testing the safety and effectiveness of a vaginal ring containing the non-nucleoside reverse transcriptase inhibitor dapivirine for prevention of HIV-1 infection. We describe the baseline characteristics of African women enrolled in the ASPIRE trial. Results Between August 2012 and June 2014, 5516 women were screened and 2629 HIV-1 seronegative women between 18–45 years of age were enrolled from 15 research sites in Malawi, South Africa, Uganda, and Zimbabwe. The median age was 26 years (IQR 22–31) and the majority (59%) were unmarried. Nearly 100% of participants reported having a primary sex partner in the prior three months but 43% did not know the HIV-1 status of their primary partner; 17% reported additional concurrent partners. Nearly two-thirds (64%) reported having disclosed to primary partners about planned vaginal ring use in the trial. Sexually transmitted infections were prevalent: 12% had Chlamydia trachomatis, 7% Trichomonas vaginalis, 4% Neisseria gonorrhoeae, and 1% syphilis. Conclusions African HIV-1 seronegative women at risk of HIV -1 infection were successfully enrolled into a phase III trial of dapivirine vaginal ring for HIV-1 prevention. PMID:26061040

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

    PubMed Central

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

    2015-01-01

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

  15. Factors associated with access to antiretroviral therapy among people living with hiv in vientiane capital, lao pdr.

    PubMed

    Chanvilay, Thammachak; Yoshida, Yoshitoku; Reyer, Joshua A; Hamajima, Nobuyuki

    2015-02-01

    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/mm(3) at the first screening, or those who presented with advanced AIDS-related symptoms. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by a logistic model. After adjustment, young people (OR=2.17; 95% CI: 1.00-4.68; p=0.049), low education (OR=0.23; 95% CI: 0.10-0.55; p=0.001) and duration between risk behavior and HIV test (OR=3.83; 95% CI: 1.22-12.00; p=0.021) were significantly associated with delayed access to ART. Low perception of high risk behaviors was one of the obstacles leading to delayed testing and inability to access ART. Almost all reported feeling self-stigma, and only 30.5% of men and 23.7% of women disclosed the HIV status to his/her partner/spouse. In conclusion, delayed access to ART was associated with individual factors and exposure to health care facility. In order to improve early detection HIV infection following access to ART, an improvement in perceptional knowledge of HIV, as well as reduction of HIV/AIDS-related stigma, might be needed. PMID:25797968

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

    ERIC Educational Resources Information Center

    Kelderman, Eric

    2008-01-01

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

  17. Between a Rock and a Hard Place: Disclosing Medical Errors

    Microsoft Academic Search

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

    2006-01-01

    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

  18. HIV Life Cycle

    MedlinePLUS

    ... HIV life cycle. What is the connection between HIV medicines and the HIV life cycle? Without treatment, HIV infection gradually destroys ... the risk of HIV drug resistance . What is HIV drug resistance? Drug resistance is when HIV is ...

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

    Sun, Yang; Lu, Hongzhou

    2014-06-01

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

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

    PubMed

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

    2015-07-01

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

  2. Impact of earlier HAART initiation on the immune status and clinical course of treated patients on the basis of cohort data of the German Competence Network for HIV\\/AIDS

    Microsoft Academic Search

    A. Plettenberg; N. H. Brockmeyer; B. Haastert; C. Michalik; S. Dupke; K. Schewe; M. Rausch; M. Hower; A. Ulmer; E. Wolf; T. Lorenzen; G. Arendt; K. Jansen

    2011-01-01

    Purpose  Hitherto, studies on highly active antiretroviral therapy (HAART) initiation have shown partly inconsistent results. Our study\\u000a investigated the clinical course and course of immune status after HAART initiation at CD4-cell-count\\/?l of treated patients\\u000a between 250 and 349 (group 1), compared to 350–449 (group 2), on the basis of the cohort of the Competence Network for HIV\\/AIDS\\u000a (KompNet cohort).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients had

  3. 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

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

    2013-01-01

    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

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

    PubMed Central

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

    2009-01-01

    We examined relationships between client-perpetrated emotional, physical, and sexual abuse, injection drug use, and HIV-serostatus among 924 female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-US border cities. We hypothesized that FSWs’ injection drug use would mediate the relationship between client-perpetrated abuse and HIV-seropositivity. The prevalence of client-perpetrated emotional, physical, and sexual abuse in the past 6 months was 26, 18, and 10% respectively; prevalence of current injection drug use and HIV was 12 and 6%, respectively. Logistic regression analyses revealed that client-perpetrated sexual abuse was significantly associated with HIV-seropositivity and injection drug use, and that injection drug use was positively associated with HIV-seropositivity. Injection drug use partially mediated the relationship between client-perpetrated sexual abuse and HIV-seropositivity. Results suggest the need to address client-perpetrated violence and injection drug use when assessing HIV risk among FSWs. PMID:19636697

  5. Impact of HIV comprehensive care and treatment on serostatus disclosure among Cameroonian patients in rural district hospitals.

    PubMed

    Suzan-Monti, Marie; Kouanfack, Charles; Boyer, Sylvie; Blanche, Jérôme; Bonono, Renée-Cécile; Delaporte, Eric; Carrieri, Patrizia M; Moatti, Jean-Paul; Laurent, Christian; Spire, Bruno

    2013-01-01

    This work aimed to analyze the rate of disclosure to relatives and friends over time and to identify factors affecting disclosure among seropositive adults initiating antiretroviral therapy (ART) in rural district hospitals in the context of decentralized, integrated HIV care and task-shifting to nurses in Cameroon. Stratall was a 24-month, randomized, open-label trial comparing the effectiveness of clinical monitoring alone with laboratory plus clinical monitoring on treatment outcomes. It enrolled 459 HIV-infected ART-naive adults in 9 rural district hospitals in Cameroon. Participants in both groups were sometimes visited by nurses instead of physicians. Patients with complete data both at enrolment (M0) and at least at one follow-up visit were included in the present analysis. A mixed Poisson regression was used to estimate predictors of the evolution of disclosure index over 24 months (M24).The study population included 385 patients, accounting for 1733 face-to-face interviews at follow-up visits from M0 to M24. The median [IQR] number of categories of relatives and friends to whom patients had disclosed was 2 [1]-[3] and 3 [2]-[5] at M0 and M24 (p-trend<0.001), respectively. After multiple adjustments, factors associated with disclosure to a higher number of categories of relatives and friends were as follows: having revealed one's status to one's main partner, time on ART, HIV diagnosis during hospitalization, knowledge on ART and positive ratio of follow-up nurse-led to physician-led visits measuring task-shifting. ART delivered in the context of decentralized, integrated HIV care including task-shifting was associated with increased HIV serological status disclosure. PMID:23383117

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

    PubMed

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

    2013-08-01

    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

  7. Psychological morbidity and HIV in Kenya.

    PubMed

    Carson, A J; Sandler, R; Owino, F N; Matete, F O; Johnstone, E C

    1998-04-01

    This paper describes a cross-sectional study with subjects and raters blind to HIV status to assess psychiatric morbidity associated with HIV in a sample of working adults in Western Kenya. Subjects were recruited from an occupational health clinic for statutory annual health checks of workers in the food industry. Psychiatric interviews and neuropsychological tests were conducted. Of 230 subjects, 34% were HIV positive. Women had a higher rate than men, and those who worked as bargirls or were divorced, widowed or separated were particularly at risk. There were no substantial differences in psychiatric morbidity or neuropsychological functioning between the HIV-positive and HIV-negative subjects. PMID:9570486

  8. When masculinity interferes with women's treatment of HIV infection: a qualitative study about adherence to antiretroviral therapy in Zimbabwe

    PubMed Central

    2011-01-01

    Background Social constructions of masculinity have been shown to serve as an obstacle to men's access and adherence to antiretroviral therapies (ART). In the light of women's relative lack of power in many aspects of interpersonal relationships with men in many African settings, our objective is to explore how male denial of HIV/AIDS impacts on their female partners' ability to access and adhere to ART. Methods We conducted a qualitative case study involving thematic analysis of 37 individual interviews and five focus groups with a total of 53 male and female antiretroviral drug users and 25 healthcare providers in rural eastern Zimbabwe. Results Rooted in hegemonic notions of masculinity, men saw HIV/AIDS as a threat to their manhood and dignity and exhibited a profound fear of the disease. In the process of denying and avoiding their association with AIDS, many men undermine their wives' efforts to access and adhere to ART. Many women felt unable to disclose their HIV status to their husbands, forcing them to take their medication in secret, and act without a supportive treatment partner, which is widely accepted to be vitally important for adherence success. Some husbands, when discovering that their wives are on ART, deny them permission to take the drugs, or indeed steal the drugs for their own treatment. Men's avoidance of HIV also leave many HIV-positive women feeling vulnerable to re-infection as their husbands, in an attempt to demonstrate their manhood, are believed to continue engaging in HIV-risky behaviours. Conclusions Hegemonic notions of masculinity can interfere with women's adherence to ART. It is important that those concerned with promoting effective treatment services recognise the gender and household dynamics that may prevent some women from successfully adhering to ART, and explore ways to work with both women and men to identify couples-based strategies to increase adherence to ART PMID:21658260

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

    PubMed Central

    2012-01-01

    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

  10. HIV-positive status and preservation of privacy: a recent decision from the Italian Data Protection Authority on the procedure of gathering personal patient data in the dental office.

    PubMed

    Conti, Adelaide; Delbon, Paola; Laffranchi, Laura; Paganelli, Corrado; De Ferrari, Francesco

    2012-06-01

    The processing of sensitive information in the health field is subject to rigorous standards that guarantee the protection of information confidentiality. Recently, the Italian Data Protection Authority (Garante per la Protezione dei Dati Personali) stated their formal opinion on a standard procedure in dental offices involving the submission of a questionnaire that includes the patient's health status. HIV infection status is included on the form. The Authority has stated that all health data collection must be in accordance with the current Italian normative framework for personal data protection and respect the patient's freedom. This freedom allows the patient to decide, in a conscious and responsible way, whether to share health information with health personnel without experiencing any prejudice in the provision of healthcare requested. Moreover, data collection must be relevant and cannot exceed the principles of treatment goals with reference to the specific care of the concerned person. However, the need for recording information regarding HIV infection at the first appointment, regardless of the clinical intervention or therapeutic plan that needs to be conducted, should not alter the standard protection measures of the healthcare staff. In fact, these measures are adopted for every patient. PMID:22313663

  11. HIV in Europe.

    PubMed

    Põder, Airi; Haldre, Madli

    2014-01-01

    In 2011, the estimated number of people living with HIV in Europe and Central Asia was 2.3 million. This is more than twice the 2001 figure. At the same time, approximately 50% of the infected people may not know their HIV status. The Europe/Central Asia region is one of only two regions in which HIV infections continue to increase. The estimated prevalence rate in the west and center of the region, however, has remained stable at 0.2%. The HIV epidemics in Eastern Europe and Central Asia are typically driven by unsafe drug injection and by onward transmission to the sexual partners of people who inject drugs. In the western part of the region, the epidemic remains concentrated among men who have sex with men and migrants from countries with generalized epidemics. Means of preventing and fighting HIV should, first and foremost, be directed to those parts of the population that are most exposed to the risk of the infection. Proceeding from the data presented, recommendations are given for ways of decreasing HIV prevalence in the region, such as promoting dialogue and awareness among multistakeholders, including policy makers, donors, and population groups most exposed to the infection. PMID:24559564

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

    PubMed

    Johnson, Ofonime E

    2012-01-01

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

  13. HIV/AIDS Basics

    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/ ...

  14. [Mixed cryoglobulinemia-associated membranoproliferative glomerulonephritis, disclosing gastric MALT lymphoma].

    PubMed

    Buob, David; Copin, Marie-Christine

    2006-09-01

    We report a case of a mixed cryoglobulinemia-associated membranoproliferative glomerulonephritis, disclosing gastric lymphoma of MALT-type. In the reported case, glomerulonephritis was associated with joint and skin symptoms related to type II mixed cryoglobulinemia. MALT lymphoma diagnosis was made by gastric biopsy. Renal pathological examination showed relatively uncommon findings, ie mesangioproliferative glomerulonephritis lacking usual intraluminal thrombi. Although classical, renal manifestations of malignant lymphomas are uncommon, and rarely allow lymphoma diagnosis. The renal biological function improves as the lymphoma regresses with appropriated treatment. This case underlines the benefit of gastroscopy in cryoglobulinemia etiological research. PMID:17128153

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

    PubMed Central

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

    2013-01-01

    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

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

    E-print Network

    2009-01-01

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

  17. Outcome of HIV Exposed Infants: Experience of a Regional Pediatric Center for HIV in North India

    Microsoft Academic Search

    Anju Seth; Jagdish Chandra; Rohini Gupta; Praveen Kumar; Varun Aggarwal; Ashok Dutta

    Objective  To study the outcome of HIV exposed infants in terms of mortality, morbidity, nutritional status and HIV infection status.\\u000a \\u000a \\u000a \\u000a Methods  Retrospective analysis of data on 162 HIV exposed infants registered at Regional Pediatric Center for HIV, Delhi and meeting\\u000a the inclusion criteria, was done.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Median age at presentation was 6 wk. 17.4% mothers were on ART while 44.1% received NVP prophylaxis. 61.7%

  18. 48 CFR 14.407-3 - Other mistakes disclosed before award.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...false Other mistakes disclosed before award. 14.407-3 Section 14.407-3... SEALED BIDDING Opening of Bids and Award of Contract 14.407-3 Other mistakes disclosed before award. In order to minimize delays in...

  19. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  20. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  1. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  2. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  3. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  4. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  5. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  6. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  7. 78 FR 13158 - Proposed Information Collection (Authorization To Disclose Personal Beneficiary/Claimant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-26

    ...Collection (Authorization To Disclose Personal Beneficiary/Claimant Information to...information needed to allow VA to share personal beneficiary or claims information to...technology. Title: Authorization to Disclose Personal Beneficiary/Claimant Information...

  8. 20 CFR 603.9 - What safeguards and security requirements apply to disclosed information?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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...

  9. 18 CFR 401.114 - Data and information previously disclosed to the public.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...information previously disclosed to the public. 401.114 Section 401.114...RULES OF PRACTICE AND PROCEDURE Public Access to Records and Information § 401...information previously disclosed to the public. Any Commission record that...

  10. 18 CFR 401.114 - Data and information previously disclosed to the public.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...information previously disclosed to the public. 401.114 Section 401.114...RULES OF PRACTICE AND PROCEDURE Public Access to Records and Information § 401...information previously disclosed to the public. Any Commission record that...

  11. 18 CFR 401.114 - Data and information previously disclosed to the public.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...information previously disclosed to the public. 401.114 Section 401.114...RULES OF PRACTICE AND PROCEDURE Public Access to Records and Information § 401...information previously disclosed to the public. Any Commission record that...

  12. 18 CFR 401.114 - Data and information previously disclosed to the public.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...information previously disclosed to the public. 401.114 Section 401.114...RULES OF PRACTICE AND PROCEDURE Public Access to Records and Information § 401...information previously disclosed to the public. Any Commission record that...

  13. 18 CFR 401.114 - Data and information previously disclosed to the public.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...information previously disclosed to the public. 401.114 Section 401.114...RULES OF PRACTICE AND PROCEDURE Public Access to Records and Information § 401...information previously disclosed to the public. Any Commission record that...

  14. 48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  15. 48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    PubMed

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

    2013-06-01

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

  17. Profiles of Malawian adolescents at risk for HIV infections: Implications for targeted prevention, policy, and practices

    Microsoft Academic Search

    Eusebius Small; Bridget E. Weller

    2012-01-01

    Young people are at the center of the HIV epidemic. In fact, HIV has been referred to as a “youth-driven disease” worldwide. This cross-sectional study identified a typology of risk for HIV among Malawian adolescents, examined the distribution of HIV status within each group in the typology, and tested the association between class membership and changes in sexual behaviors to

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  19. Depression, death anxiety, and hope among female caregivers of children with HIV\\/AIDS

    Microsoft Academic Search

    Enrique Gular

    1995-01-01

    This study examined depression, death anxiety and hope among pediatric HIV caregivers. One hundred and seven female caregivers of children with HIV\\/AIDS were interviewed in a pediatric clinic at a large metropolitan hospital.^ Caregivers were given the Beck Depression Inventory, Templer's Death Anxiety Scale, Herth Hope Index, and a demographic questionnaire. Anonymous HIV testing was offered, and HIV status was

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

    ERIC Educational Resources Information Center

    Cederbaum, Julie A.

    2012-01-01

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

  1. 77 FR 36550 - Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ...reduce the incidence of HIV/AIDS and improve quality of life for People Living with HIV/AIDS (PLWHA). The main goals...of his/her HIV status; and, improve engagement and...related services, reduce stigma, make HIV testing...

  2. Death sentence affirmed despite defendant's HIV infection.

    PubMed

    1999-05-14

    A defense attorney's decision not to focus on a defendant's HIV status during a murder trial was not an error, according to the Florida Supreme Court. The HIV-positive status of [name removed], who fatally shot a police officer while escaping from prison, was not raised during the trial and was only addressed in a passing remark during the penalty phase of the trial. The justices agreed that the decision not to focus on [name removed]' HIV-positive status was well within range of professional assistance. The court also stated that the fear and stigma associated with AIDS at the time of the trial could have outweighed the sympathy that focusing on his HIV status may have evoked. [Name removed] was convicted for murder in the first-degree for the July 1988 shooting. PMID:11366956

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

    Microsoft Academic Search

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

    1995-01-01

    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,

  4. HIV Prevention

    MedlinePLUS

    ... your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral ... your partner to get and stay on treatment. ART reduces the amount of HIV virus (viral load) ...

  5. HIV Transmission

    MedlinePLUS

    ... whether the partner with HIV is using antiretroviral therapy (ART) consistently and correctly and whether the partner who ... if the partner with HIV is taking antiretroviral therapy (ART) consistently and correctly, and if the partner who ...

  6. HIV virus

    NSDL National Science Digital Library

    Carl Henderson (National Institutes of Health; )

    2005-12-09

    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.

  7. 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

    Mokgatle, Mathildah

    2015-01-01

    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. PMID:25893147

  8. The impact of integrating food supplementation, nutritional education and HAART (Highly Active Antiretroviral Therapy) on the nutritional status of patients living with HIV/AIDS in Mozambique: results from the DREAM Programme.

    PubMed

    Scarcella, P; Buonomo, E; Zimba, I; Doro Altan, A M; Germano, P; Palombi, L; Marazzi, M C

    2011-01-01

    DREAM (Drug Resources Enhancement against AIDS and Malnutrition) is a multiregional health program active in Mozambique since 2002 and provides free of charge an integrating package of care consisting of peer to peer nutritional and health education, food supplementation, voluntary counseling and testing, immunological, virological, clinical assessment and HAART (Highly Active AntiRetroviral Treatment). The main goals of this paper are to describe the state of health and nutrition and the adequacy of the diet of a sample of HIV/AIDS patients in Mozambique on HAART and not. A single-arm retrospective cohort study was conducted. 106 HIV/AIDS adult patients (84 in HAART), all receiving food supplementation and peer-to-peer nutritional education, were randomly recruited in Mozambique in two public health centres where DREAM is running. The programme is characterized by: provision of HAART, clinical and laboratory monitoring, peer to peer health and nutritional education and food supplementation. We measured BMI, haemoglobin, viral load, CD4 count at baseline (T0) and after at least 1 year (T1). Dietary intake was estimated using 24h food recall and dietary diversity was assessed by using the Dietary Diversity Score (DDS) at T1. Overall, the patients'diet appeared to be quite balanced in nutrients. In the cohort not in HAART the mean BMI values showed an increases but not significant (initial value: 21.9 ± 2.9; final value: 22.5 ± 3.3 ) and the mean haemoglobin values (g/dl) showed a significant increases (initial value: 10.5+ 2.1; final value: 11.5 ± 1.7 p< 0.024) . In the cohort in HAART, both the mean of BMI value (initial value: 20.7 ± 3.9; final value: 21.9 ± 3.3 p< 0.001) and of haemoglobin (initial value: 9.9 ± 2.2; final value: 10.8 ± 1.7 p< 0.001) showed a higher significant increase. The increase in BMI was statistically associated with the DDS in HAART patients. In conclusion nutritional status improvement was observed in both cohorts. The improvement in BMI was significant and substantially higher in HAART patients because of the impact of HAART on nutritional status of AIDS patients. Subjects on HAART and with a DDS > 5, showed a substantial BMI gain. This association showed an additional expression of the synergic effect of integrating food supplementation, nutritional education and HAART on the nutritional status of African AIDS patients and also highlights the complementary role of an adequate and diversified diet in persons living with HIV/AIDS in resources limited settings. PMID:21468153

  9. Women, Migration, Conflict and Risk for HIV

    Microsoft Academic Search

    Anita Raj; Jhumka Gupta; Jay G. Silverman

    \\u000a Women now constitute the majority of those living with HIV\\/AIDS globally, even if only by a small margin (UNAIDS, 2007). While\\u000a the lower status of women has been recognized as increasing their HIV risk, issues of migration and conflict combined with\\u000a this lower status are believed to propel women’s risk for infection further, particularly in high infection areas such as

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

    Denis, Philippe

    2014-04-01

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

  12. Impact of house-hold food insecurity on nutritional status of HIV-infected children attending an ART centre in Tamil Nadu.

    PubMed

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

    2015-03-01

    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

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

    PubMed Central

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

    2014-01-01

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

  14. Low HIV?testing rates among younger high?risk homosexual men in Amsterdam

    PubMed Central

    Stolte, Ineke G; de Wit, John B F; Kolader, Marion E; Fennema, Han S A; Coutinho, Roel A; Dukers, Nicole H T M

    2007-01-01

    Objective To investigate HIV?testing behaviour and HIV prevalence among homosexual visitors of a sexually transmitted infection (STI) outpatient clinic, and to investigate determinants of unknown HIV status, and of HIV testing separately for men with unknown and negative HIV status. Design Cross?sectional survey conducted from March 2002 to December 2003 among homosexual men with negative or unknown HIV status visiting the Amsterdam STI clinic. Methods A convenience sample of 1201 men with negative or unknown HIV status answered a written questionnaire about history of HIV testing, sexual risk behaviour and behavioural determinants (non?response, 35%). Information was matched to the STI registration system. Associations were determined using logistic regression. Results 817 men reported a negative HIV status, and 384 reported an unknown HIV status. The overall HIV prevalence among the 523 men who tested at new STI consultation was 2.8%. The proportion of men with unknown HIV status was relatively high among those diagnosed with infectious syphilis and those reporting unprotected anal intercourse with a casual partner. Their testing rates at new STI clinic visit were lower. Among men with an unknown HIV status, those aged <30?years and reporting risky sexual behaviour tested the least (OR 0.13, 95% CI 0.03 to 0.61). Conclusion Although HIV testing rates have increased, they are still lower than in other industrialised countries. Moreover, some men still undertake high?risk sex without knowing their own HIV status, which might pose a risk for ongoing HIV transmission. Therefore, more active testing promotion is needed. PMID:17314129

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Adeyemi, Ezekiel Oluwagbemiga

    2011-01-01

    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

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

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

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

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

    SciTech Connect

    Johnston, R. G. (Nuclear Engineering Division)

    2009-01-01

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

  19. 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.

  20. Genomewide Association Study for Determinants of HIV-1 Acquisition and Viral Set Point in HIV-1 Serodiscordant Couples with Quantified Virus Exposure

    PubMed Central

    Kahle, Erin; Fellay, Jacques; Shianna, Kevin; McElrath, M. Juliana; Thomas, Katherine K.; Baeten, Jared M.; Celum, Connie; Wald, Anna; de Bruyn, Guy; Mullins, James I.; Nakku-Joloba, Edith; Farquhar, Carey; Essex, Max; Donnell, Deborah; Kiarie, James; Haynes, Bart; Goldstein, David

    2011-01-01

    Background Host genetic factors may be important determinants of HIV-1 sexual acquisition. We performed a genome-wide association study (GWAS) for host genetic variants modifying HIV-1 acquisition and viral control in the context of a cohort of African HIV-1 serodiscordant heterosexual couples. To minimize misclassification of HIV-1 risk, we quantified HIV-1 exposure, using data including plasma HIV-1 concentrations, gender, and condom use. Methods We matched couples without HIV-1 seroconversion to those with seroconversion by quantified HIV-1 exposure risk. Logistic regression of single nucleotide polymorphisms (SNPs) for 798 samples from 496 HIV-1 infected and 302 HIV-1 exposed, uninfected individuals was performed to identify factors associated with HIV-1 acquisition. In addition, a linear regression analysis was performed using SNP data from a subset (n?=?403) of HIV-1 infected individuals to identify factors predicting plasma HIV-1 concentrations. Results After correcting for multiple comparisons, no SNPs were significantly associated with HIV-1 infection status or plasma HIV-1 concentrations. Conclusion This GWAS controlling for HIV-1 exposure did not identify common host genotypes influencing HIV-1 acquisition. Alternative strategies, such as large-scale sequencing to identify low frequency variation, should be considered for identifying novel host genetic predictors of HIV-1 acquisition. PMID:22174851

  1. Posttraumatic Growth and HIV Disease Progression

    ERIC Educational Resources Information Center

    Milam, Joel

    2006-01-01

    The relationship between posttraumatic growth (PTG; perceiving positive changes since diagnosis) and disease status, determined by changes in viral load and CD4 count over time, was examined among 412 people living with HIV. In controlled multiple regression models, PTG was not associated with disease status over time for the entire sample.…

  2. Posttraumatic Growth and HIV Disease Progression

    Microsoft Academic Search

    Joel Milam

    2006-01-01

    The relationship between posttraumatic growth (PTG; perceiving positive changes since diagnosis) and disease status, determined by changes in viral load and CD4 count over time, was examined among 412 people living with HIV. In controlled multiple regression models, PTG was not associated with disease status over time for the entire sample. However, there were significant associations for certain subgroups. PTG

  3. Colorectal Cancer Cases and Relatives of Cases Indicate Similar Willingness to Receive and Disclose Genetic Information

    PubMed Central

    Ceballos, Rachel M.; Newcomb, Polly A.; Beasley, Jeannette M.; Peterson, Scot; Templeton, Allyson; Hunt, Julie R.

    2009-01-01

    Context Recent developments in genetic testing allow us to detect individuals with inherited susceptibility to some cancers. Genetic testing to identify carriers of cancer-related mutations may help lower risk by encouraging preventive behaviors and surveillance. This study assessed willingness of colon cancer cases and relatives to receive genetic information that may indicate an increased risk for cancer, to whom they would disclose genetic information, and whether receiving genetic test results may influence future prevention behaviors among individuals enrolled in the Seattle Colorectal Cancer Family Registry. Methods Incident invasive colorectal cancer cases were identified from the Puget Sound Surveillance Epidemiology and End Results (SEER) registry. In 2007, a sequential sample of cases and relatives (n = 147) were asked to respond to a questionnaire addressing study aims. The questionnaire was administered during a baseline or 5-year follow-up interview. Results Patterns of response to each statement were similar between colorectal cancer cases and relatives. Both colorectal cases (95%) and relatives (95%) reported willingness to receive genetic information. Nearly all participants would tell their doctor the results of a genetic test (99% of cases; 98% of relatives), and all married participants would tell their spouses. Cases (96%) anticipated being slightly more likely than relatives (90%) to change their cancer screening behavior, but this difference was not statistically significant (p = 0.33). Conclusions A high percentage of both colorectal cancer cases and relatives sampled from the Seattle Colorectal Cancer Family Registry are interested in identifying their genetic status, discussing their genetic status with their family and doctor, and adopting behavioral changes that may reduce cancer risk. PMID:18752450

  4. Stigma and HIV disclosure in the Cape Metropolitan area, South Africa.

    PubMed

    Klopper, Ceridwyn; Stellenberg, Ethelwynn; van der Merwe, Anita

    2014-01-01

    Disclosure rates of HIV-positive status remain low and are considered to be related to stigmatisation. Determining the factors that influence a person's decision to disclose a positive status is essential to understanding the process of and ways to improve disclosure rates. This study investigated the factors that influence the disclosure of a person's HIV-positive status and focused on socio-demographic factors, stigma and discrimination, religion, culture, fear of abandonment and rejection as well as knowledge of the disease that may all influence disclosure rates. A facility based descriptive cross-sectional research design with a quantitative approach was applied using convenience sampling. The sample comprised 150 individuals which was 12.5% of the study population. A self-administered questionnaire comprising mainly closed-ended questions, with a limited number of open ended questions was designed, tested and utilised. Statistical associations were determined between the demographic factors and responses to the questions. The open ended questions were analysed thematically by means of content analysis to extract meaning. The results revealed that fear of stigmatisation, especially among the male participants, was a major reason for delayed or non-disclosure. The results of the total study sample also showed that the level of education influenced the fear of stigmatisation; those with secondary school level education were most afraid of this (29%). There was a statistically significant association between fear of blame or discrimination and disclosure to the sexual partner. This fear was most often cited by the participants who had never married (19%). The participants who feared blame or discrimination the most reported having no income (23%). The findings of this study indicate that numerous factors influence HIV disclosure. Stigma of individuals who are HIV-positive remains a barrier to disclosure as well as fear of blame and discrimination. Recommendations were made to facilitate and increase disclosure rates. This should include community based support groups and advocating partners to attend voluntary counselling and testing together to minimise the fear of blame. PMID:25174514

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

    Unprotected anal intercourse (UAI) remains a main risk factor for HIV among men who have sex with men (MSM) and this is of particular concern for partners of HIV serodiscordant status. However, HIV transmission risk has been demonstrated to vary by the sexual position adopted among partners. Guided by interdependence theory, this study examined how relational factors were differentially associated with risk taking (HIV-positive/insertive and HIV-negative/receptive) and strategic positioning (HIV-positive/receptive and HIV-negative/insertive) UAI 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

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

    PubMed

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

    2014-09-01

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

  8. Maternal HIV Serostatus, Mother–Daughter Sexual Risk Communication and Adolescent HIV Risk Beliefs and Intentions

    PubMed Central

    Hutchinson, M. Katherine; Duan, Lei; Jemmott, Loretta S.

    2012-01-01

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

  9. 16 CFR 1101.23 - Providing less than 15 days notice before disclosing information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...2012-01-01 2012-01-01 false Providing less than 15 days notice before disclosing information...6(b)(1) § 1101.23 Providing less than 15 days notice before disclosing information...subject to section 6(b)(1) in a time less than 15 days after providing notice...

  10. 16 CFR 1101.23 - Providing less than 15 days notice before disclosing information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...2011-01-01 2011-01-01 false Providing less than 15 days notice before disclosing information...6(b)(1) § 1101.23 Providing less than 15 days notice before disclosing information...subject to section 6(b)(1) in a time less than 15 days after providing notice...

  11. 16 CFR 1101.23 - Providing less than 15 days notice before disclosing information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...2014-01-01 2014-01-01 false Providing less than 15 days notice before disclosing information...6(b)(1) § 1101.23 Providing less than 15 days notice before disclosing information...subject to section 6(b)(1) in a time less than 15 days after providing notice...

  12. 16 CFR 1101.23 - Providing less than 15 days notice before disclosing information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false Providing less than 15 days notice before disclosing information...6(b)(1) § 1101.23 Providing less than 15 days notice before disclosing information...subject to section 6(b)(1) in a time less than 15 days after providing notice...

  13. 16 CFR 1101.23 - Providing less than 15 days notice before disclosing information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...2013-01-01 2013-01-01 false Providing less than 15 days notice before disclosing information...6(b)(1) § 1101.23 Providing less than 15 days notice before disclosing information...subject to section 6(b)(1) in a time less than 15 days after providing notice...

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

    ERIC Educational Resources Information Center

    Kogan, Steven M.

    2004-01-01

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

  15. 24 CFR 30.65 - Failure to disclose lead-based paint hazards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  16. Prognosis in HIV-infected patients with non-small cell lung cancer

    PubMed Central

    Sigel, K; Crothers, K; Dubrow, R; Krauskopf, K; Jao, J; Sigel, C; Moskowitz, A; Wisnivesky, J

    2013-01-01

    Background: We conducted a population-based study to evaluate whether non-small cell lung cancer (NSCLC) prognosis was worse in HIV-infected compared with HIV-uninfected patients. Methods: Using the Surveillance, Epidemiology and End Results (SEER) registry linked to Medicare claims, we identified 267 HIV-infected patients and 1428 similar controls with no evidence of HIV diagnosed with NSCLC between 1996 and 2007. We used conditional probability function (CPF) analyses to compare survival by HIV status accounting for an increased risk of non-lung cancer death (competing risks) in HIV-infected patients. We used multivariable CPF regression to evaluate lung cancer prognosis by HIV status adjusted for confounders. Results: Stage at presentation and use of stage-appropriate lung cancer treatment did not differ by HIV status. Median survival was 6 months (95% confidence interval (CI): 5–8 months) among HIV-infected NSCLC patients compared with 20 months (95% CI: 17–23 months) in patients without evidence of HIV. Multivariable CPF regression showed that HIV was associated with a greater risk of lung cancer-specific death after controlling for confounders and competing risks. Conclusion: NSCLC patients with HIV have a poorer prognosis than patients without evidence of HIV. NSCLC may exhibit more aggressive behaviour in the setting of HIV. PMID:24022194

  17. 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...

  18. 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 ...

  19. HIV Transmission

    PubMed Central

    Shaw, George M.; Hunter, Eric

    2012-01-01

    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

  20. Anolunula in Fingernails among Patients Infected with HIV

    PubMed Central

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

    2014-01-01

    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

  1. Sexual health for people living with HIV.

    PubMed

    Shapiro, Kathy; Ray, Sunanda

    2007-05-01

    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

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

    PubMed

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

    2015-01-01

    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

  3. The epidemiology of HIV infection in Zambia

    Microsoft Academic Search

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

    2008-01-01

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

  4. HIV risk among currently married couples in rural Malawi: what do spouses know about each other?

    PubMed

    Anglewicz, Philip A; Bignami-Van Assche, Simona; Clark, Shelley; Mkandawire, James

    2010-02-01

    In countries with generalized HIV/AIDS epidemics, married couples have a shared risk of acquiring HIV/AIDS. Yet very little research has adopted a couple-level perspective to investigate perceived risk of HIV infection. In this paper, we used population-based data from 768 married monogamous couples in the 2004 Malawi Diffusion and Ideational Change Project (MDICP) to compare respondents' perceptions about their spouses' HIV status to their spouses' actual HIV status. Using chi-squared and Kappa coefficient statistics, we evaluated how accurately respondents assess their spouse's HIV status, and compared the assessment of their spouse's HIV status with their assessment of their own serostatus. We found that individuals tend to overestimate their spouse's as well as their own risk of having HIV. Husbands were generally more accurate in assessing their own risk of HIV infection than that of their wives, but wives were more accurate in assessing the HIV status of their spouses. In our multivariate logistic regression results, we found that marital infidelity is the most important correlate of overestimating individual and spousal HIV risk. PMID:19051003

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    Microsoft Academic Search

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

    2011-01-01

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

  7. Age and HIV Sexual Risk among Women in Methadone Treatment

    Microsoft Academic Search

    Malitta Engstrom; Tazuko Shibusawa; Nabila El-Bassel; Louisa Gilbert

    2011-01-01

    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

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

    PubMed Central

    Mutumba, Massy; Resnicow, Kenneth; Mugyenyi, Godfrey

    2013-01-01

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

  9. Isolated and bilateral simultaneous facial palsy disclosing early human immunodeficiency virus infection

    PubMed Central

    Sathirapanya, Pornchai

    2015-01-01

    Bilateral lower motor neuron type facial palsy is an unusual neurological disorder. There are few reports that associate it with the human immunodeficiency virus (HIV) infection on initial presentation. A 51-year-old married woman, who was previously healthy and had no risk of HIV infection, presented solely with bilateral simultaneous facial palsy. A positive HIV serology test was confirmed by an enzyme-linked immunosorbent assay test. Following a short course of oral prednisolone, the patient recovered completely from facial palsy in three months, even though an antiretroviral treatment was suspended. Exclusion of HIV infection in patients with bilateral facial palsy is essential for early diagnosis and management of HIV.

  10. Urinary Proteomic Analysis for Assessment of HIV Clinical Mary Pacold

    E-print Network

    Gleeson, Joseph G.

    Urinary Proteomic Analysis for Assessment of HIV Clinical Status Mary Pacold Med-into-Grad Research in utilizing this biologic sample for analysis. High concentrations of albumin, globulins, and interfering for diagnostic or therapeutic monitoring purposes. Renal disease is a relatively common complication of HIV

  11. Methadone Maintenance and HIV Prevention: A Cost-Effectiveness Analysis

    Microsoft Academic Search

    Gregory S. Zaric; Margaret L. Brandeau; Paul G. Barnett

    2000-01-01

    We assess the cost-effectiveness of maintenance treatment for heroin addiction, with emphasis on its role in preventing HIV infection. The analysis is based on a dynamic compartmental model of the HIV epidemic among a population of adults, ages 18 to 44. The population is divided into nine compartments according to infection status and risk group. The model takes into account

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

    ERIC Educational Resources Information Center

    Emlet, Charles A.

    2006-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  14. Current Trends of HIV Recombination Worldwide

    PubMed Central

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

    2013-01-01

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

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

    E-print Network

    Aalberts, Daniel P.

    Request for Accounting of PHI Disclosed by Williams College I request an accounting of all PHI) _______________________________________________ pursuant to the requirements of the HIPAA Privacy Rule. I understand that this accounting will not include of disclosure. The period of time I am requesting the accounting for is from

  16. 48 CFR 914.407-3 - Other mistakes disclosed before award.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...mistakes disclosed before award. 914.407-3 Section 914.407-3 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 914.407-3 Other...

  17. Perceptions of Behavioral Norms Related to HIV Transmission by People with HIV and by Residents of Their Communities

    PubMed Central

    Miller, Carol T.; Bunn, Janice Y.; Grover, Kristin W.; Solomon, Sondra E.

    2015-01-01

    We examined how people with HIV are both part of and apart from the communities in which they live. We compared perceptions of behavioral norms of 203 people with HIV living in 33 different communities with community-level normative perceptions assessed by surveys of 2,444 randomly selected residents of these communities. Participants with HIV perceived behavior that risks the transmission of HIV as injunctively and descriptively more normative than did other community residents. Participants with HIV living in communities in which community residents perceived relatively widespread approval of condom use to prevent HIV and other sexually transmitted diseases also perceived these behaviors as injunctively normative, and they perceived relatively low levels of HIV stigmatization. Discussion focuses on how perceptions about “deviant” behaviors may affect the experiences of people whose stigmatized status is assumed to be the result of such behavior.

  18. Experience and Covariates of Depressive Symptoms Among a Cohort of HIV Infected Women

    Microsoft Academic Search

    Jean Richardson; Susan Barkan; Mardge Cohen; Sara Back; Gordon Fitzgerald; Joseph Feldman; Mary Young; Herminia Palacio

    2001-01-01

    Objectives: The objectives of this study are to assess (a) the level of depressive symptoms among a cohort of HIV infected women and comparable controls and (b) the relationship with covariates including socioeconomic status, substance use, social relations, disease status.Methods: Participants were enrolled in the Women's Interagency HIV Study (WIHS). Depressive symptoms were measured using the Center for Epidemiological Studies

  19. The health effects of disclosing traumatic events: examining behavioral inhibition theory

    E-print Network

    Jacks, Stephen Daniel

    1990-01-01

    THE HEALTH EFFECTS OF DISCLOSING TRAUMATIC EVENTS: EXAMINING BEHAVIORAL INHIBITION THEORY A Thesis by STEPHEN DANIEL JACKS Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements... for the degree of MASTER OF SCIENCE August 1990 Major Subject: Psychology THE HEALTH EFFECTS OF DISCLOSING TRAUMATIC EVENTS; EXAMINING BEHAVIORAL INHIBITION THEORY A Thesis by STEPHEN DANIEL JACKS Approved as to style and content by: Karl G. Hursey...

  20. 12 CFR 792.29 - If I send NCUA confidential commercial information, can it be disclosed under FOIA?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...confidential commercial information, can it be disclosed under FOIA? 792.29 Section...confidential commercial information, can it be disclosed under FOIA? (a) If you...confidential commercial information to NCUA, it may be disclosed in response to a FOIA...

  1. 12 CFR 792.29 - If I send NCUA confidential commercial information, can it be disclosed under FOIA?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...confidential commercial information, can it be disclosed under FOIA? 792.29 Section...confidential commercial information, can it be disclosed under FOIA? (a) If you...confidential commercial information to NCUA, it may be disclosed in response to a FOIA...

  2. 41 CFR 105-64.502 - How do I find out if my record has been disclosed?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... false How do I find out if my record has been disclosed? 105-64.502 Section...105-64.502 How do I find out if my record has been disclosed? You may request an accounting...the persons or agencies to whom your record has been disclosed, including the date and...

  3. Living with HIV/AIDS

    MedlinePLUS

    ... Finding your HIV care team Mental health and HIV/AIDS Pregnancy and HIV/AIDS Parenting a child with HIV ... Finding your HIV care team Mental health and HIV/AIDS Pregnancy and HIV/AIDS Parenting a child with HIV ...

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  6. Understanding HIV testing behaviors of minority adolescents: a health behavior model analysis.

    PubMed

    Schnall, Rebecca; Rojas, Marlene; Travers, Jasmine

    2015-01-01

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

  7. Chemoprophylaxis for HIV Prevention: New Opportunities and New Questions

    PubMed Central

    Mayer, Kenneth H.; Venkatesh, Kartik K.

    2010-01-01

    Growing data suggest that antiretrovirals can be used as an effective means of HIV prevention. This paper reviews the current status and future clinical prospects of utilizing antiretroviral chemoprophylaxis before and after high-risk HIV exposure to prevent HIV transmission. The discussion about using antiretrovirals as a means of primary HIV prevention has moved to the forefront of public health discourse because of a growing evidence base, the increased tolerability of the medications, the decreased cost, the ever expanding formulary, and the limitations of other approaches. PMID:21406981

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  9. Both HIV-infected and HIV-exposed uninfected children living in Brazil, Argentina and Mexico have similar rates of low concentrations of retinol, ?-carotene and vitamin E

    PubMed Central

    Monteiro, Jacqueline P.; Freimanis-Hance, Laura; Faria, Lidiane B.; Mussi-Pinhata, Marisa M; Korelitz, James; Vannucchi, Hélio; Queiroz, Wladimir; Succi, Regina CM; Hazra, Rohan

    2009-01-01

    Our objective was to describe the prevalence of low concentrations of retinol, ?-carotene, and vitamin E in a group of HIV-infected Latin American children and a comparison group of HIV-exposed, uninfected children. Our hypothesis was that the rates of low concentrations of these micronutrients would be higher in the HIV-infected group than those in the HIV-exposed, uninfected group. This was a cross-sectional substudy of a larger cohort study at clinical pediatric HIV centers in Latin America. Serum levels of micronutrients were measured in the first stored sample obtained after each child’s first birthday by high-performance liquid chromatography. Low concentrations of retinol, ?-carotene and vitamin E were defined as serum levels below 0.70 ?mol/L, 0.35 ?mol/L and 18.0 ?mol/L, respectively. The population for this analysis was 336 children (124 HIV-infected, 212 HIV-exposed, uninfected) aged ? 1 to < 4 years of age. Rates of low concentrations were 74% for retinol, 27% for ?-carotene, and 89% for vitamin E. These rates were not affected by HIV status. Among the HIV-infected children those treated with antiretrovirals were less likely to have retinol deficiency, but no other HIV-related factors correlated with micronutrient low serum levels. Low concentrations of retinol, ?-carotene and vitamin E are very common in children exposed to HIV living in Brazil, Argentina and Mexico, regardless of HIV-infection status. PMID:19917451

  10. Impact of tuberculosis on the body composition of HIV-infected men in Brazil.

    PubMed

    Paton, N I; Castello-Branco, L R; Jennings, G; Ortigao-de-Sampaio, M B; Elia, M; Costa, S; Griffin, G E

    1999-03-01

    This paper examines the impact of tuberculosis (TB) on the body composition of HIV-positive men with treatment for active TB (HIV/TB+) and HIV-infected men without TB (HIV/TB-) in Brazil. Total body water (TBW) and extracellular water (ECW) were measured by giving oral doses of deuterium oxide and sodium bromide, respectively, and determining the enrichment in plasma after 4 hours. Calculated from these parameters are the intracellular water (ICW), body cell mass (BCM), lean body mass (LBM) and fat mass. Age, height, CD4 count and HIV risk factors were similar among HIV/TB+ (n = 11) and HIV/TB- (n = 12). HIV/TB+ patients had significantly lower mean ICW (13.2 vs. 16.6 kg) and BCM (18.4 vs. 23 kg), a relative expansion of ECW (35 vs. 30 l/kg body weight, nonsignificant reductions in TBW (58 vs. 62.1 kg), LBM (45.5 vs. 47.7 kg) and fat mass (12.5 vs. 14.4 kg) compared with HIV/TB- men. Nutritional status was found to be significantly worse among HIV+ patients. Malnutrition was also severe in HIV/TB+ patients, which contributed to a decreased life span. Hypermetabolism appears to play a role in the wasting process of patients with HIV and TB. To improve physical function, quality of life, and survival among HIV-infected patients with TB, optimization of nutritional status should be at the core of treatment. PMID:10077175

  11. Preventing HIV with Medicine

    MedlinePLUS

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

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

    PubMed Central

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

    2013-01-01

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

  13. Benefits of leptin therapy in HIV patients

    PubMed Central

    Sinha, Uma; Sinharay, Keshab; Sengupta, Nilanjan; Mukhopadhyay, Prasanta

    2012-01-01

    Leptin therapy in human recombinant form has recently been used in HIV-associated lipodystrophy syndrome on experimental basis in some small short-term clinical trials. It has shown its beneficial effects only in hypoleptinemic HIV-infected patients by causing definite improvement in their insulin sensitivity, glucose tolerance, lipid status, and truncal obesity. Leptin prevents lipotoxicity and activates insulin signaling pathways through several postulated mechanisms. Central leptin insufficiency with peripheral hyperleptinemia has come out to be a significant contributor to the development of obesity and metabolic syndrome. In this article, we will review the basis of leptin therapy in HIV patients, with its promises. However, further larger clinical trials are needed to prove its long-term efficacy in the control of metabolic complications related to HIV therapy. PMID:23565500

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

    E-print Network

    Bashir, Rashid

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

  15. Women with onset of epilepsy prior to marriage: disclose or conceal?

    PubMed

    Santosh, Deetha; Kumar, T Santosh; Sarma, P Sankara; Radhakrishnan, Kurupath

    2007-05-01

    We inquired reasons for concealment/disclosure of the history of epilepsy during marriage negotiations and marriage outcomes of 82 consecutive women attending a tertiary referral center based epilepsy clinic in Kerala, southern India. At the time of marriage, 55% concealed and 45% disclosed the history of epilepsy. Majority of those who concealed admitted that they did so fearing breakup of marriage negotiations, and majority of those who disclosed did so to forestall the consequences after marriage of concealing. Compared to those who disclosed, the prevalence of divorce, separation and disturbed marriages were significantly higher among those who concealed. Honest prospective communication during marriage negotiations about epilepsy is important for preserving subsequent married life. PMID:17386055

  16. Psychiatric Diagnoses among an HIV-Infected Outpatient Clinic Population.

    PubMed

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

    2014-10-27

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

  17. How Radiation Oncologists Would Disclose Errors: Results of a Survey of Radiation Oncologists and Trainees

    SciTech Connect

    Evans, Suzanne B., E-mail: Suzannne.evans@yale.edu [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Yu, James B. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States)] [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Chagpar, Anees [Department of Surgery, Yale University School of Medicine, New Haven, Connecticut (United States)] [Department of Surgery, Yale University School of Medicine, New Haven, Connecticut (United States)

    2012-10-01

    Purpose: To analyze error disclosure attitudes of radiation oncologists and to correlate error disclosure beliefs with survey-assessed disclosure behavior. Methods and Materials: With institutional review board exemption, an anonymous online survey was devised. An email invitation was sent to radiation oncologists (American Society for Radiation Oncology [ASTRO] gold medal winners, program directors and chair persons of academic institutions, and former ASTRO lecturers) and residents. A disclosure score was calculated based on the number or full, partial, or no disclosure responses chosen to the vignette-based questions, and correlation was attempted with attitudes toward error disclosure. Results: The survey received 176 responses: 94.8% of respondents considered themselves more likely to disclose in the setting of a serious medical error; 72.7% of respondents did not feel it mattered who was responsible for the error in deciding to disclose, and 3.9% felt more likely to disclose if someone else was responsible; 38.0% of respondents felt that disclosure increased the likelihood of a lawsuit, and 32.4% felt disclosure decreased the likelihood of lawsuit; 71.6% of respondents felt near misses should not be disclosed; 51.7% thought that minor errors should not be disclosed; 64.7% viewed disclosure as an opportunity for forgiveness from the patient; and 44.6% considered the patient's level of confidence in them to be a factor in disclosure. For a scenario that could be considerable, a non-harmful error, 78.9% of respondents would not contact the family. Respondents with high disclosure scores were more likely to feel that disclosure was an opportunity for forgiveness (P=.003) and to have never seen major medical errors (P=.004). Conclusions: The surveyed radiation oncologists chose to respond with full disclosure at a high rate, although ideal disclosure practices were not uniformly adhered to beyond the initial decision to disclose the occurrence of the error.

  18. Highly active antiretroviral treatment for the prevention of HIV transmission

    PubMed Central

    2010-01-01

    In 2007 an estimated 33 million people were living with HIV; 67% resided in sub-Saharan Africa, with 35% in eight countries alone. In 2007, there were about 1.4 million HIV-positive tuberculosis cases. Globally, approximately 4 million people had been given highly active antiretroviral therapy (HAART) by the end of 2008, but in 2007, an estimated 6.7 million were still in need of HAART and 2.7 million more became infected with HIV. Although there has been unprecedented investment in confronting HIV/AIDS - the Joint United Nations Programme on HIV/AIDS estimates $13.8 billion was spent in 2008 - a key challenge is how to address the HIV/AIDS epidemic given limited and potentially shrinking resources. Economic disparities may further exacerbate human rights issues and widen the increasingly divergent approaches to HIV prevention, care and treatment. HIV transmission only occurs from people with HIV, and viral load is the single greatest risk factor for all modes of transmission. HAART can lower viral load to nearly undetectable levels. Prevention of mother to child transmission offers proof of the concept of HAART interrupting transmission, and observational studies and previous modelling work support using HAART for prevention. Although knowing one's HIV status is key for prevention efforts, it is not known with certainty when to start HAART. Building on previous modelling work, we used an HIV/AIDS epidemic of South African intensity to explore the impact of testing all adults annually and starting persons on HAART immediately after they are diagnosed as HIV positive. This theoretical strategy would reduce annual HIV incidence and mortality to less than one case per 1000 people within 10 years and it would reduce the prevalence of HIV to less than 1% within 50 years. To explore HAART as a prevention strategy, we recommend further discussions to explore human rights and ethical considerations, clarify research priorities and review feasibility and acceptability issues. PMID:20205768

  19. HIV Acquisition Among Women From Selected Areas of the United States

    PubMed Central

    Hodder, Sally L.; Justman, Jessica; Hughes, James P.; Wang, Jing; Haley, Danielle F.; Adimora, Adaora A.; Del Rio, Carlos; Golin, Carol E.; Kuo, Irene; Rompalo, Anne; Soto-Torres, Lydia; Mannheimer, Sharon B.; Johnson-Lewis, LeTanya; Eshleman, Susan H.; El-Sadr, Wafaa M.

    2014-01-01

    Background Women account for 23% of newly diagnosed HIV infections in the United States, but there are few recent, well-characterized cohorts of U.S. women in whom behavior characteristics and HIV acquisition have been well-described. Objective To evaluate HIV incidence and describe behaviors among U.S. women residing in areas of high HIV prevalence. Design Multisite, longitudinal cohort of women who had HIV rapid testing and audio computer-assisted self-interviews at baseline and every 6 months for up to 12 months. (ClinicalTrials.gov: NCT00995176) Setting 10 urban and periurban communities with high HIV prevalence and poverty rates, located in the northeastern and southeastern United States. Patients Venue-based sampling was used to recruit women aged 18 to 44 years who recently had unprotected sex and had 1 or more additional personal or partner risk factors and no self-reported previous HIV diagnosis. Measurements HIV prevalence and incidence, frequency of HIV risk behaviors, and health status perceptions. Results Among 2099 high-risk women (85.9% black and 11.7% of Hispanic ethnicity), 32 (1.5%) were diagnosed with HIV infection at enrollment. Annual HIV incidence was 0.32% (95% CI, 0.14% to 0.74%). Older age, substance use, and knowing a partner had HIV were associated with HIV prevalence. Ten women died during the study (0.61% per year). Limitations Longitudinal assessment of risk behaviors was limited to a maximum of 12 months. There were few incident HIV infections, precluding identification of characteristics predictive of HIV acquisition. Conclusion This study enrolled a cohort of women with HIV incidence substantially higher than the Centers for Disease Control and Prevention national estimate in the general population of U.S. black women. Concerted efforts to improve preventive health care strategies for HIV and overall health status are needed for similar populations. PMID:23277896

  20. A group approach to psychosocial issues faced by HIV-positive women.

    PubMed

    Chung, J Y; Magraw, M M

    1992-09-01

    Women now constitute the fastest-growing population of persons with AIDS in the U.S. The psychosocial problems of women with AIDS and HIV infection are underrecognized, and economic, personal, and social resources to meet their needs are often inadequate. The authors describe development of a group for HIV-infected women and discuss issues raised by group members. HIV-infected women often feel isolated and experience stigma and shame. Their roles as caregivers and as wives and mothers are often changed or lost, and they experience anxiety and confusion about options for sexual activity. They sometimes fear transmitting HIV to family members through non-sexual contact. Physicians may discount their symptoms and may need to be educated about gynecological problems associated with HIV. Other issues involve coping with being both ill and a mother, disclosing information to children about the illness, and loss of reproductive choice. PMID:1427696

  1. FACT SHEETS HIV and Pregnancy

    E-print Network

    Levin, Judith G.

    FACT SHEETS HIV and Pregnancy HIV Testing and Pregnancy Mother-to-Child Transmission of HIV Anti-HIV Medications for Use in Pregnancy Safety of Anti-HIV Medications During Pregnancy Preventing Transmission and Pregnancy These fact sheets on HIV and pregnancy are intended for women infected with HIV who are pregnant

  2. Lack of Awareness of Human Immunodeficiency Virus (HIV) Infection: Problems and Solutions With Self-reported HIV Serostatus of Men Who Have Sex With Men

    PubMed Central

    Sanchez, Travis H.; Kelley, Colleen F.; Rosenberg, Eli; Luisi, Nicole; O'Hara, Brandon; Lambert, Rodriques; Coleman, Raphael; Frew, Paula; Salazar, Laura F.; Tao, Sijia; Clarke, William; del Rio, Carlos; Sullivan, Patrick S.

    2014-01-01

    Background ?Lack of human immunodeficiency virus (HIV) infection awareness may be a driver of racial disparities in HIV infection among men who have sex with men (MSM). Lack of awareness is typically measured by comparing HIV test result to self-reported HIV status. This measure may be subject to reporting bias and alternatives are needed. Methods ?The InvolveMENt study examined HIV disparities between black and white MSM from Atlanta. Among HIV-positive participants who did not report knowing they were positive, we examined other measures of awareness: HIV viral load (VL) <1000 copies/mL (low VL), antiretroviral (ARV) drugs in blood, and previous HIV case surveillance report. Results ?Using self-report only, 32% (62 of 192) of black and 16% (7 of 45) of white MSM were not aware of their HIV infection (P = .03). Using self-report and low VL, 25% (48 of 192) black and 16% (7 of 45) white MSM lacked awareness (P = .18). Using self-report and ARVs, 26% (50 of 192) black and 16% (7 of 45) white MSM lacked awareness (P = .14). Using self-report and surveillance report, 15% (28 of 192) black and 13% (6 of 45) white MSM lacked awareness (P = .83). Conclusions ?Self-report only may overestimate true lack of awareness of HIV status for black MSM. If, as our data suggest, black MSM are not less likely to be aware of their HIV infection than are white MSM, then this factor is not a substantial driver of HIV disparity. Future HIV research that depends on accurate measurement of HIV status awareness should consider including additional laboratory and case surveillance data. PMID:25734150

  3. Ocular surface squamous neoplasia in HIV-positive and HIV-negative patients and response to 5-fluorouracil in Angola

    PubMed Central

    Nutt, Robert J; Clements, John L; Dean, William H

    2014-01-01

    Background Ocular surface squamous neoplasia (OSSN) is becoming increasingly prevalent and aggressive in Sub-Saharan Africa. It is a phenomenon linked with human immunodeficiency virus (HIV) infection, although association rates in Angola are currently unknown. A topical treatment that is effective in HIV-positive and HIV-negative individuals may be preferable to surgery in some contexts. We aimed to estimate the proportion of OSSN associated with HIV in Angola and to report on the success of topical 5-fluorouracil as a primary treatment in HIV-positive and HIV-negative patients. Methods Photographs of OSSNs taken at presentation and following treatment with 5-fluorouracil in patients presenting to Boa Vista Eye Clinic, Angola, between October 2011 and July 2013 were grouped into HIV-positive and HIV-negative groups and analyzed to compare presenting features and treatment response. Eighty-one OSSNs were analyzed for clinical features and 24 met the inclusion criteria for analysis of treatment response. Results Eighty-two patients presented with OSSN between October 2011 and July 2013. Twenty-one (26%) were HIV-positive and typically had OSSNs that exhibited more pathological features than those in HIV-negative patients. Twenty-four (29%) patients met the inclusion criteria for analysis of treatment response; of these, 26 (91%) OSSNs in both groups displayed at least partial resolution after one treatment course. In the HIV-positive group, five of eight patients displayed complete resolution, two showed partial resolution, and one failed. In the HIV-negative group, five of 16 showed complete resolution, ten of 16 had partial resolution, and one failed. Conclusion Individuals presenting with OSSN in Angola are more likely to have HIV infection compared with the general population. Regardless of HIV status, 5-fluorouracil drops can be an effective strategy for management of OSSN without incurring the costs and risks of surgery in the developing world setting. PMID:25506205

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

    PubMed Central

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

    2015-01-01

    Despite having higher rates of HIV testing than all other racial groups, African-Americans continue to be disproportionately affected by the HIV epidemic in the United States. Knowing one’s status is the key step to maintaining behavioral changes that could stop the spread of the virus, yet little is known about the individual- and socio-structural-level barriers associated with HIV testing and communication among heterosexual African-American men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African-American men, we conducted computerized, structured interviews with 61 men, focus group interviews with 25 men in 5 different groups, and in-depth qualitative interviews with 30 men living in high HIV prevalence neighborhoods in New York City. Results revealed that HIV testing was frequent among the participants. Even with high rates of testing, the men in the study had low levels of HIV knowledge; perceived little risk of HIV; and misused HIV testing as a prevention method. Factors affecting HIV testing, included stigma, relationship dynamics and communication, and societal influences, suggesting that fear, low perception of risk, and HIV stigma may be the biggest barriers to HIV testing. These results also suggest that interventions directed toward African-American heterosexual men must address the use of “testing as prevention” as well as correct misunderstandings of the window period and the meaning of HIV test results, and interventions should focus on communicating about HIV. PMID:25298014

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

    PubMed

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

    2015-01-01

    Despite having higher rates of HIV testing than all other racial groups, African-Americans continue to be disproportionately affected by the HIV epidemic in the United States. Knowing one's status is the key step to maintaining behavioral changes that could stop the spread of the virus, yet little is known about the individual- and socio-structural-level barriers associated with HIV testing and communication among heterosexual African-American men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African-American men, we conducted computerized, structured interviews with 61 men, focus group interviews with 25 men in 5 different groups, and in-depth qualitative interviews with 30 men living in high HIV prevalence neighborhoods in New York City. Results revealed that HIV testing was frequent among the participants. Even with high rates of testing, the men in the study had low levels of HIV knowledge; perceived little risk of HIV; and misused HIV testing as a prevention method. Factors affecting HIV testing, included stigma, relationship dynamics and communication, and societal influences, suggesting that fear, low perception of risk, and HIV stigma may be the biggest barriers to HIV testing. These results also suggest that interventions directed toward African-American heterosexual men must address the use of "testing as prevention" as well as correct misunderstandings of the window period and the meaning of HIV test results, and interventions should focus on communicating about HIV. PMID:25298014

  6. Allowing HIV-Positive Organ Donation: Ethical, Legal and Operational Considerations

    PubMed Central

    Mgbako, O; Glazier, A; Blumberg, E; Reese, PP

    2013-01-01

    Case reports of kidney transplantation using HIV-positive (HIV+) donors in South Africa and advances in the clinical care of HIV+ transplant recipients have drawn attention to the legal prohibition of transplanting organs from HIV+ donors in the US. For HIV+ transplant candidates, who face high barriers to transplant access, this prohibition violates beneficence by placing an unjustified limitation on the organ supply. However, transplanting HIV+ organs raises non-maleficence concerns given limited data on recipient outcomes. Informed consent and careful monitoring of outcome data should mitigate these concerns, even in the rare circumstance when an HIV+ organ is intentionally transplanted into an HIV-negative recipient. For potential donors, the federal ban on transplanting HIV+ organs raises justice concerns. While in practice there are a number of medical criteria that preclude organ donation, only HIV+ status is singled out as a mandated exclusion to donation under the National Organ Transplant Act (NOTA). Operational objections could be addressed by adapting existing approaches used for organ donors with hepatitis. Center-specific outcomes should be adjusted for HIV donor and recipient status. In summary, transplant professionals should advocate for eliminating the ban on HIV+ organ donation and funding studies to determine outcomes after transplantation of these organs. PMID:23758835

  7. Resilience among asylum seekers living with HIV

    PubMed Central

    2012-01-01

    Background A small body of evidence demonstrates the challenges faced by migrant communities living with HIV but has yet to consider in-depth the experience of asylum seekers whose residency status is undetermined. The overall aim of our study was to explore the experiences of those who are both living with HIV and seeking asylum. This paper focuses on the stressors precipitated by the HIV diagnosis and by going through the asylum system; as well as participants’ resilience in responding to these stressors and the consequences for their health and wellbeing. Methods We conducted an ethnographic study. Fieldwork took place in the UK between 2008–2009 and included: 350 hours of observation at voluntary services providing support to black and minority ethnic groups living with HIV; 29 interviews and four focus group discussions with those who were seeking asylum and living with HIV; and 15 interviews with their health and social care providers. Data were analysed using the constant comparative method. Results There were three main stressors that threatened participants’ resilience. First, migration caused them to leave behind many resources (including social support). Second, stigmatising attitudes led their HIV diagnosis to be a taboo subject furthering their isolation. Third, they found themselves trapped in the asylum system, unable to influence the outcome of their case and reliant on HIV treatment to stay alive. Participants were, however, very resourceful in dealing with these experiences. Resilience processes included: staying busy, drawing on personal faith, and the support received through HIV care providers and voluntary organisations. Even so, their isolated existence meant participants had limited access to social resources, and their treatment in the asylum system had a profound impact on perceived health and wellbeing. Conclusions Asylum seekers living with HIV in the UK show immense resilience. However, their isolation means they are often unable to deal with their treatment in the asylum system, with negative consequences for their perceived health and wellbeing. PMID:23110402

  8. 48 CFR 714.406-3 - Other mistakes disclosed before award.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    48 ? Federal Acquisition Regulations System ? 5 ? 2010-10-01 ? 2010-10-01 ? false ? Other mistakes disclosed before award. ? 714.406-3 ? Section 714.406-3 ? Federal Acquisition Regulations System ? AGENCY FOR INTERNATIONAL DEVELOPMENT ? CONTRACTING METHODS AND CONTRACT TYPES ? SEALED BIDDING...

  9. TITLE: MARKETING Columbia University Medical Center will not use or disclose a patient's Protected Health

    E-print Network

    Columbia University

    TITLE: MARKETING POLICY: Columbia University Medical Center will not use or disclose a patient's Protected Health Information (PHI) for marketing purposes without the patient's written authorization or disclosure of a patient's PHI for marketing purposes unless the marketing communication is directly related

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

    E-print Network

    Vonessen, Nikolaus

    THE UNIVERSITY OF MONTANA - MISSOULA CONSENT TO DISCLOSE STUDENT EDUCATION RECORDS (Form. The University of Montana has designated certain parts of a student's education record as "Directory Information records. "A university or college shall release a student's academic record only when requested

  11. Disclosing arbuscular mycorrhizal fungal biodiversity in soil through a land-use gradient using a

    E-print Network

    Bruns, Tom

    Disclosing arbuscular mycorrhizal fungal biodiversity in soil through a land-use gradient using 25, 10125, Italy. Summary The biodiversity of arbuscular mycorrhizal fungi (AMF) communities present-oak formation because other mycorrhizal fungal species, more likely associ- ated to trees and shrubs, were

  12. Factors Associated with Behavioral Intention to Disclose Personal Information on Geosocial Networking Applications

    ERIC Educational Resources Information Center

    Cox, Trissa

    2012-01-01

    Information privacy is a major concern for consumers adopting emerging technologies dependent on location-based services. This study sought to determine whether a relationship exists among factors of personalization, locatability, perceived playfulness, privacy concern and behavioral intention to disclose personal information for individuals using…

  13. Confidentiality Issues when Minor Children Disclose Family Secrets in Family Counseling

    ERIC Educational Resources Information Center

    McCurdy, Kenneth G.; Murray, Kenneth C.

    2003-01-01

    The literature addressing ethical issues involved in the disclosure of family secrets in counseling has typically focused on secrets disclosed by adults, ignoring the ethical issues surrounding individual disclosure by minor children and confidentiality within the family counseling context. This article explores family secrets, confidentiality…

  14. Willingness to Self-Disclose among Late Adolescent Female Survivors of Childhood Sexual Abuse

    Microsoft Academic Search

    Nancy E. Nereo; Barry A. Farber; Veronica J. Hinton

    2002-01-01

    The primary aim of this study was to compare the willingness of sexually abused (n = 22) and non–sexually abused (n = 36) late adolescent women to self-disclose both general and sexual information to strangers and intimate partners. Results, based on a sample of college women, indicate that those who were sexually abused in childhood are less likely than nonabused

  15. Remember: UCIT will never ask you to disclose your password. Email Phishing, Scams & Hoaxes

    E-print Network

    Habib, Ayman

    Remember: UCIT will never ask you to disclose your password. Email Phishing, Scams & Hoaxes and phishing scams. What is phishing? In a computing context, phishing is an impersonation of a corporation. Phishing is typically done using e-mail or an instant messaging program. The attempt of the message

  16. The Role of Disclosing Child Sexual Abuse on Adolescent Adjustment and Revictimization

    ERIC Educational Resources Information Center

    Kogan, Steven M.

    2005-01-01

    The role of disclosing child sexual abuse on adolescent survivors' symptomology and the presence of additional unwanted sexual experiences was investigated in a subsample of 111 adolescents from the National Survey of Adolescents who reported child sexual abuse. Results indicated that prompt disclosure of sexual abuse to an adult moderated the…

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

    E-print Network

    Columbia University

    ; or as authorized by the patient or other legally authorized individual / or entity. Protected Health Information information must be reviewed before protected health information is disclosed: A patient or other designated for such information. Refer to the ColumbiaDoctors' Legal Health Record and the Designated Record Set Policy (AD.3

  18. 46 CFR 502.201 - Duty to disclose; general provisions governing discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...paid for the study and testimony...testify. (4) Time to disclose...testimony. The time for disclosure...or cost. On motion to compel...expert's study or testimony...may at any time order the...order. The motion must...

  19. 46 CFR 502.201 - Duty to disclose; general provisions governing discovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...paid for the study and testimony...testify. (4) Time to disclose...testimony. The time for disclosure...or cost. On motion to compel...expert's study or testimony...may at any time order the...order. The motion must...

  20. Negative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men.

    PubMed

    Reed, G M; Kemeny, M E; Taylor, S E; Visscher, B R

    1999-07-01

    This study examined negative HIV-related expectancies, AIDS-related bereavement, and the interaction of expectancies and bereavement as predictors of the onset of significant HIV-related symptoms among previously asymptomatic HIV-positive gay men. From a longitudinal psychobiological investigation, 72 men were selected who had been HIV-positive and asymptomatic from study entry (approximately 3 years). Participants were followed for an additional 2 1/2 to 3 1/2 years after psychosocial assessment, with symptom status assessed every 6 months. The interaction of negative HIV-specific expectancies and bereavement was a significant predictor of symptom onset. Negative HIV-specific expectancies predicted the subsequent development of symptoms among bereaved men, controlling for immunological status, use of zidovudine, high-risk sexual behavior, substance use, and depression. PMID:10431936

  1. HIV Structural Database

    National Institute of Standards and Technology Data Gateway

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

  2. HIV Treatment: The Basics

    MedlinePLUS

    Key Points Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines ( ... and treatment failure. What is antiretroviral therapy? Antiretroviral therapy (ART) is the use of HIV medicines to treat ...

  3. Detection of Acute HIV-1 Infection by RT-LAMP

    PubMed Central

    2015-01-01

    A rapid, cost-effective diagnostic test for the detection of acute HIV-1 infection is highly desired. Isothermal amplification techniques, such as reverse-transcription loop-mediated isothermal amplification (RT-LAMP), exhibit characteristics that are ideal for the development of a rapid nucleic acid amplification test (NAAT) because they are quick, easy to perform and do not require complex, dedicated equipment and laboratory space. In this study, we assessed the ability of the HIV-1 RT-LAMP assay to detect acute HIV infection as compared to a representative rapid antibody test and several FDA-approved laboratory-based assays. The HIV-1 RT-LAMP assay detected seroconverting individuals one to three weeks earlier than a rapid HIV antibody test and up to two weeks earlier than a lab-based antigen/antibody (Ag/Ab) combo enzyme immunoassay (EIA). RT-LAMP was not as sensitive as a lab-based qualitative RNA assay, which could be attributed to the significantly smaller nucleic acid input volume. To our knowledge, this is the first demonstration of detecting acute HIV infection using the RT-LAMP assay. The availability of a rapid NAAT, such as the HIV-1 RT-LAMP assay, at the point of care (POC) or in laboratories that do not have access to large platform NAAT could increase the percentage of individuals who receive an acute HIV infection status or confirmation of their HIV status, while immediately linking them to counseling and medical care. In addition, early knowledge of HIV status could lead to reduced high-risk behavior at a time when individuals are at a higher risk for transmitting the virus. PMID:25993381

  4. The Efficacy of Serostatus Disclosure for HIV Transmission Risk Reduction

    PubMed Central

    O’Connell, Ann A.; Serovich, Julianne A.

    2015-01-01

    Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698–705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed. PMID:25164375

  5. What Are the Reasons for Poor Uptake of HIV Testing among Patients with TB in an Eastern India District?

    PubMed Central

    Bishnu, Bipra; Bhaduri, Sudipto; Kumar, Ajay M. V.; Click, Eleanor S.; Chadha, Vineet Kumar; Satyanarayana, Srinath; Nair, Sreenivas Achutan; Gupta, Devesh; Ahmed, Quazi T.; Sarkar, Silajit; Paul, Durba; Dewan, Puneet

    2013-01-01

    Background National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors associated with low uptake of HIV testing among patients with TB. Methods We reviewed TB and HIV program records to assess the HIV testing status of patients registered for anti-TB treatment from July-September 2010 in South-24-Parganas district, West Bengal, assessed availability of HIV testing kits and interviewed a random sample of patients with TB and providers. Results Among 1633 patients with TB with unknown HIV status at the time of diagnosis, 435 (26%) were tested for HIV within the intensive phase of TB treatment. Patients diagnosed with and treated for TB at facilities with co-located HIV testing services were more likely to get tested for HIV than at facilities without [RR?=?1.27, (95% CI 1.20–3.35)]. Among 169 patients interviewed, 67 reported they were referred for HIV testing, among whom 47 were tested. During interviews, providers attributed the low proportion of patients with TB being referred and tested for HIV to inadequate knowledge among providers about the national policy, belief that patients will not test for HIV even if they are referred, shortage of HIV testing kits, and inadequate supervision by both programs. Discussion In West Bengal, poor uptake of HIV testing among patients with TB was associated with absence of HIV testing services at sites providing TB care services and to poor referral practices among providers. Comprehensive strategies to change providers’ beliefs and practices, decentralization of HIV testing to all TB care centers, and improved HIV test kit supply chain management may increase the proportion of patients with TB who are tested for HIV. PMID:23469163

  6. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection

    PubMed Central

    Goldberg, Brittany E.; Mongodin, Emmanuel F.; Jones, Cheron E.; Chung, Michelle; Fraser, Claire M.; Tate, Anupama; Zeichner, Steven L.

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi’s sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better characterize the oral microbiome in children and those with poorly-controlled HIV infections. PMID:26146997

  7. HIV stigma and disclosure experiences of people living with HIV in an urban and a rural setting.

    PubMed

    French, Heleen; Greeff, Minrie; Watson, Martha J; Doak, Colleen M

    2015-08-01

    Human immunodeficiency virus (HIV) remains a highly stigmatised condition for people living with HIV (PLWH) and people living close to them (PLC) globally. The research objectives for this study were to explore and describe how HIV stigma and disclosure experiences impact the lives of PLWH and to explore whether there are differences between experiences in urban and rural settings. A qualitative approach was followed and participants were selected through purposive voluntary sampling. Data collection took place using in-depth interviews with 23 PLWH, 11 of whom resided in an urban setting in North-West, South Africa, and 12 resided in a rural setting in the same province. The data were manually analysed through open coding. The HIV stigma experiences expressed by PLWH depicted negative behavioural patterns and attitudes towards them, fear from the community of being infected by PLWH and lastly negative self-judgement by PLWH themselves. During disclosure, PLWH were unsure and they described it as a stressful event. They cautiously considered to whom to disclose their condition and what benefits disclosure will hold. They further had to handle forced disclosure due to being identifiable in health-care settings. HIV stigma and related disclosure practices remained a problem, which detrimentally affected treatment and support efforts. Recommendations focused on HIV stigma reduction in the community that needed to involve PLWH and PLC. PMID:25790237

  8. Occurrence of HBV/HIV coinfection by laboratory values in Roma, Lesotho

    PubMed Central

    Mugomeri, Eltony; Senauoane, Mamakoli Blandina; Ruhanya, Vurayai; Chin'ombe, Nyasha; Nyandoro, George

    2015-01-01

    Objective This study was an assessment of the coinfection status of patients with human immunode?ciency virus (HIV) and hepatitis B virus (HBV) in Lesotho, and this has been rarely reported. Methods This was a retrospective study, in a laboratory setting, on HBV/HIV coinfection among 304 HIV-positive patients who were screened for HBsAg in St Joseph's Hospital records between March 2011 and December 2013. Demographic characteristics, HIV status, indications for HBsAg screening, HBsAg results and liver function test results including alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase were reviewed from the patient and laboratory registers. Results In this study 10.5% of 304 HIV-positive patients had HBV/HIV coinfection. With respect to gender, males had a significantly higher (p=0.048) rate of HBV/HIV coinfection in this study. Increased levels of ALT (p=0.013) and AST (p=0.014) were significantly associated with HBV/HIV coinfection status. Conclusion Gender and liver function tests are important predictors for HBV/HIV coinfection. Screening for HBV coinfection in HIV-positive patients is recommended. PMID:25763362

  9. Syphilis Treatment and HIV Infection in a Population-Based Study of Persons at High Risk for Sexually Transmitted Disease\\/HIV Infection in Lima, Peru

    Microsoft Academic Search

    Corey M. Long; Jeffrey D. Klausner; Segundo Leon; Franca R. Jones; Maziel Giron; Julio Cuadros; Jose Pajuelo; Carlos Caceres; Thomas J. Coates

    2006-01-01

    Objectives: The objective of this study was to characterize syphilis epidemiology and the relationship of HIV status and initial rapid plasma reagin (RPR) titer to syphilis treatment in Lima, Peru. Study Design: We screened 1,261 individuals at high risk for sexually transmitted diseases for syphilis and HIV infection. Syphilis was treated with penicillin injection or doxycycline; treatment was repeated in

  10. Internalized heterosexism among HIV-positive, gay-identified men: implications for HIV prevention and care.

    PubMed

    Johnson, Mallory O; Carrico, Adam W; Chesney, Margaret A; Morin, Stephen F

    2008-10-01

    Internalized heterosexism (IH), or the internalization of societal antihomosexual attitudes, has been consistently linked to depression and low self-esteem among gay men, and it has been inconclusively associated with substance use and sexual risk in gay and bisexual men. Using structural equation modeling, the authors tested a model framed in social action theory (C. K. Ewart, 1991, 2004) in which IH is associated with HIV transmission risk and poor adherence to HIV antiretroviral therapy (ART) through the mechanisms of negative affect and stimulant use. Data from a sample of 465 gay-identified men interviewed as part of an HIV risk reduction behavioral trial were used to test the fit of the model. Results support the hypothesized model in which IH was associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, and with ART nonadherence indirectly via increased negative affect and more regular stimulant use. The model accounted for 15% of the variance in unprotected receptive anal intercourse and 17% of the variance in ART nonadherence. Findings support the potential utility of addressing IH in HIV prevention and treatment with HIV-positive gay men. PMID:18837600

  11. HIV Medicines and Side Effects

    MedlinePLUS

    ... depend on a person’s individual needs. Can HIV medicines cause side effects? HIV medicines help people with ... are common short-term side effects from HIV medicines? When starting an HIV medicine for the first ...

  12. Disrespect and Abuse During Childbirth in Tanzania: Are Women Living With HIV More Vulnerable?

    PubMed Central

    Sando, David; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

    2014-01-01

    Introduction: HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Methods: Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Results: Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. Conclusions: In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on ensuring respectful maternity care for all women. PMID:25436822

  13. High Rates of HIV Seroconversion in Pregnant Women and Low Reported Levels of HIV Testing among Male Partners in Southern Mozambique: Results from a Mixed Methods Study

    PubMed Central

    De Schacht, Caroline; Hoffman, Heather J.; Mabunda, Nédio; Lucas, Carlota; Alons, Catharina L.; Madonela, Ana; Vubil, Adolfo; Ferreira, Orlando C.; Calú, Nurbai; Santos, Iolanda S.; Jani, Ilesh V.; Guay, Laura

    2014-01-01

    Introduction Prevention of acute HIV infections in pregnancy is required to achieve elimination of pediatric HIV. Identification and support for HIV negative pregnant women and their partners, particularly serodiscordant couples, are critical. A mixed method study done in Southern Mozambique estimated HIV incidence during pregnancy, associated risk factors and factors influencing partner's HIV testing. Methods Between April 2008 and November 2011, a prospective cohort of 1230 HIV negative pregnant women was followed during pregnancy. A structured questionnaire, HIV testing, and collection of dried blood spots were done at 2–3 scheduled visits. HIV incidence rates were calculated by repeat HIV testing and risk factors assessed by Poisson regression. A qualitative study including 37 individual interviews with men, women, and nurses and 11 focus group discussions (n?=?94) with men, women and grandmothers explored motivators and barriers to uptake of male HIV testing. Results HIV incidence rate was estimated at 4.28/100 women-years (95%CI: 2.33–7.16). Significant risk factors for HIV acquisition were early sexual debut (RR 3.79, 95%CI: 1.04–13.78, p?=?0.04) and living in Maputo Province (RR 4.35, 95%CI: 0.97–19.45, p?=?0.05). Nineteen percent of women reported that their partner had tested for HIV (93% knew the result with 8/213 indicating an HIV positive partner), 56% said their partner had not tested and 19% did not know their partner test status. Of the 14 seroconversions, only one reported being in a serodiscordant relationship. Fear of discrimination or stigma was reported as a key barrier to male HIV testing, while knowing the importance of getting tested and receiving care was the main motivator. Conclusions HIV incidence during pregnancy is high in Southern Mozambique, but knowledge of partners' HIV status remains low. Knowledge of both partners' HIV status is critical for maximal effectiveness of prevention and treatment services to reach elimination of pediatric HIV/AIDS. PMID:25542035

  14. Design, synthesis, and X-ray crystallographic analysis of a novel class of HIV-1 protease inhibitors.

    PubMed

    Ganguly, Ashit K; Alluri, Sesha S; Caroccia, Danielle; Biswas, Dipshikha; Wang, Chih-Hung; Kang, Eunhee; Zhang, Yong; McPhail, Andrew T; Carroll, Steven S; Burlein, Christine; Munshi, Vandna; Orth, Peter; Strickland, Corey

    2011-10-27

    In the present paper, design, synthesis, X-ray crystallographic analysis, and HIV-1 protease inhibitory activities of a novel class of compounds are disclosed. Compounds 28-30, 32, 35, and 40 were synthesized and found to be inhibitors of the HIV-1 protease. The crucial step in their synthesis involved an unusual endo radical cyclization process. Absolute stereochemistry of the three asymmetric centers in the above compounds have been established to be (4S,2'R,3'S) for optimal potency. X-ray crystallographic analysis has been used to determine the binding mode of the inhibitors to the HIV-1 protease. PMID:21916489

  15. Review of HIV Testing Efforts in Historically Black Churches.

    PubMed

    Pichon, Latrice Crystal; Powell, Terrinieka Williams

    2015-01-01

    This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one's HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care. PMID:26030470

  16. Prepulse Inhibition in HIV-Associated Neurocognitive Disorders

    PubMed Central

    Minassian, Arpi; Henry, Brook L.; Woods, Steven Paul; Vaida, Florin; Grant, Igor; Geyer, Mark A.; Perry, William

    2013-01-01

    Sensorimotor inhibition, or the ability to filter out excessive or irrelevant information, theoretically supports a variety of higher-level cognitive functions. Impaired inhibition may be associated with increased impulsive and risky behavior in everyday life. Individuals infected with HIV frequently show impairment on tests of neurocognitive function, but sensorimotor inhibition in this population has not been studied and may be a contributor to the profile of HIV-associated Neurocognitive Disorders (HAND). 37 HIV-infected individuals (15 with HAND) and 48 non-infected comparison subjects were assessed for prepulse inhibition (PPI), an eyeblink startle paradigm measuring sensorimotor gating. Although HIV status alone was not associated with PPI deficits, HIV-positive participants meeting criteria for HAND showed impaired PPI compared to cognitively intact HIV-positive subjects. In HIV-positive subjects, PPI was correlated with working memory but was not associated with antiretroviral therapy or illness factors. In conclusion, sensorimotor disinhibition in HIV accompanies deficits in higher-order cognitive functions, though the causal direction of this relationship requires investigation. Subsequent research on the role of sensorimotor gating on decision-making and risk behaviors in HIV may be indicated. PMID:23552464

  17. Review of HIV Testing Efforts in Historically Black Churches

    PubMed Central

    Pichon, Latrice Crystal; Powell, Terrinieka Williams

    2015-01-01

    This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one’s HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care. PMID:26030470

  18. Macronutrient Supplementation and Food Prices in HIV Treatment12

    PubMed Central

    Sztam, Kevin A.; Fawzi, Wafaie W.; Duggan, Christopher

    2010-01-01

    Infection caused by HIV and malnutrition have a complex interaction and often coexist geographically. Malnutrition has synergistic immune effects and HIV affects nutritional status. HIV care and treatment programs are compelled to confront this dual burden to optimize HIV outcomes. In this article, we review the published literature concerning intervention studies in adults and children and the effect of food prices on HIV treatment programs. While the evidence base is relatively incomplete for specific macronutrient interventions in the context of HIV treatment, it is clear that a new standard of care is needed, guided by experience, rationale, and existing data, in which malnourished patients may easily access nutritional therapies within HIV treatment. From this clinical foundation, we may both treat patients and evaluate novel therapies. Some HIV care and treatment programs provide food-based supplements; however, rising food costs and economic instability may jeopardize the success of these programs. HIV treatment programs may struggle to meet the needs of patients with potential increased rates of malnutrition and food insecurity in the setting of high food prices. PMID:19939991

  19. Effect of HIV Infection on Body Composition and Fat Distribution in Rwandan Women

    PubMed Central

    Mutimura, Eugene; Anastos, Kathryn; Lin, Zheng; Cohen, Mardge; Binagwaho, Agnes; Kotler, Donald P.

    2015-01-01

    Objective To assess the association of HIV infection with body weight and composition in Rwandan women. Design Body weight and composition, the latter determined by bioelectrical impedance analysis (BIA) and by anthropometry, were compared in 620 HIV-positive and 211 HIV-negative participants. Associations of HIV with body composition were assessed, and t tests compared the groups. Results HIV-positive women were younger (?7.0 years, P < .001) and shorter (? 2.1 cm, P < .001). Mean body weight, body mass index (BMI), total body fat, and waist-to-hip ratio (WHR) were similar. Mean fat-free mass was 2.5% greater in HIV-negative participants, and 19% of HIV-positive group had BMI <18.5 kg/m2 versus 26% of the HIV-negative group (P < .05). CD4 counts and body composition were not associated. Conclusions Malnutrition was common in this cohort of Rwandan women. However, HIV infection was not associated with nutritional status. Factors other than malnutrition may influence quality-of-life outcomes in HIV-infected Rwandan women. Initiatives to improve nutritional status should be population-wide and not restricted to the HIV-infected population. PMID:20530472

  20. A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.

    PubMed

    Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan

    2014-03-01

    To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs. PMID:23970652

  1. The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City

    PubMed Central

    Ross, Michael W.

    2014-01-01

    Objectives Stigma connected with HIV/AIDS has decreased considerably since the early epidemic yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill this evidence gap by examining how HIV stigma is perceived and experienced by gay men who have become HIV-infected and how they respond to this stigma. Methods Thematic analysis of 19 gay men's narratives identified six main themes. Results Encountering HIV stigmatization was common and was linked to the physical stigmata identifying respondents as HIV-positive. Overwhelmingly, they found stigmatization to be most intensely felt within gay communities. One profound theme was internalized HIV stigma, referring to respondents' internalized negative feelings about their HIV status. A related theme was the closeted nature of HIV. Lastly, regarding how the men dealt with the HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. Conclusions Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that in a climate in which HIV has become increasingly invisible and closeted and in which infections are on the rise, gay and bisexual men will be increasingly affected and infected by HIV. PMID:25170366

  2. HIV Prevalence and Impact on Renutrition in Children Hospitalised for Severe Malnutrition in Niger: An Argument for More Systematic Screening

    PubMed Central

    Madec, Yoann; Germanaud, David; Moya-Alvarez, Violeta; Alkassoum, Wafa; Issa, Aichatou; Amadou, Morou; Tchiombiano, Stephanie; Pizzocolo, Cecilia; Huber, Florence; Diallo, Sanata; Abdoulaye-Mamadou, Roubanatou

    2011-01-01

    Background In developing countries, malnutrition is a contributing factor in over 50% of child deaths. Mortality rates are higher in underweight children, and HIV-infection is known to increase underweight. Our goals were to evaluate the prevalence of HIV among children hospitalised for severe malnutrition (SM) at the Niamey national hospital (Niger), and to compare renutrition and mortality by HIV-status. Methods Retrospective study based on all children <5 years hospitalised for SM between January 1st 2008 and July 1st 2009. HIV-prevalence was the ratio of HIV+ children on the number of children tested. Duration of renutrition and mortality were described using survival curves. Results During the study period, 477 children were hospitalised for SM. HIV testing was accepted in 470 (98.5%), of which 40 were HIV+ (HIV prevalence (95% confidence interval) of 8.6% (6.2–11.5)). Duration of renutrition was longer in HIV+ than HIV? children (mean: 22 vs. 15 days; p?=?0.003). During renutrition, 8 (20%) and 61 (14%) HIV+ and HIV? children died, respectively (p?=?0.81). Conclusion Around 9% of children hospitalised for severe malnutrition were HIV infected, while in Niger HIV prevalence in adults is estimated at 0.8%. This pleads for wider access to HIV testing in this population. PMID:21829514

  3. Risk analysis. HIV / AIDS country profile: Senegal.

    PubMed

    1996-12-01

    Since the first acquired immunodeficiency syndrome (AIDS) case was confirmed in 1986, Senegal has conducted an aggressive prevention campaign. Senegal's National AIDS Committee has noted the contributions of poverty and migration to the spread of AIDS. By June 1994, 1297 AIDS cases had been reported and an estimated 500,000 people (1.4% of the population) were infected with human immunodeficiency virus (HIV)-1 and 2. The highest rate of HIV infection (14%) exists among commercial sex workers. At present, HIV/AIDS cases are concentrated in Dakar, Kaolack, the Matam region, and Ziguinchor; however, the growing importance of inter-regional trading is expected to spread HIV to the smaller towns and rural areas. Also salient is the recent devaluation by 50% of the CFA franc, which has reduced the public sector workforce and led many poor urban residents into commercial sex work. CFA devaluation has made Senegal attractive to tourists and business visitors--another factor responsible for growth of the legalized commercial sex industry. Although sex workers are instructed in condom use and tested annually for HIV, only 850 of the 2000 registered sex workers have reported for check-ups, and the majority of prostitutes are unregistered. Senegal's AIDS Plan for 1994-98 focuses on care of AIDS patients, pressures placed on family structures by HIV, and AIDS-related erosions in the status of women. Each health service region has its own local plan for AIDS/HIV and sexually transmitted diseases, supervised by a regional committee. Public education has involved outreach to religious leaders, promotion of affordable condoms, and distribution of over 75,000 leaflets to key target populations. About US $16 million of the $25,688,875-budget HIV/AIDS program for 1994-98 was pledged by external donors. PMID:12320531

  4. 10 CFR 1044.09 - What do you do if you plan to disclose classified or unclassified controlled nuclear information...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    You must describe in detail to the Inspector General what information you wish to disclose. The Inspector General may require that the information to be disclosed be put in writing in order to ensure the Inspector General obtains and provides accurate...

  5. 10 CFR 1044.09 - What do you do if you plan to disclose classified or unclassified controlled nuclear information...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...What do you do if you plan to disclose classified or unclassified controlled nuclear...What do you do if you plan to disclose classified or unclassified controlled nuclear...General, as to whether the information is classified or controlled and any steps needed...

  6. 10 CFR 1044.09 - What do you do if you plan to disclose classified or unclassified controlled nuclear information...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...What do you do if you plan to disclose classified or unclassified controlled nuclear...What do you do if you plan to disclose classified or unclassified controlled nuclear...General, as to whether the information is classified or controlled and any steps needed...

  7. Brief Report: HIV Testing Among Pregnant Women Who Attend Antenatal Care in Malawi.

    PubMed

    Tenthani, Lyson; Haas, Andreas D; Egger, Matthias; Oosterhout, Joep J Van; Jahn, Andreas; Chimbwandira, Frank; Tal, Kali; Myer, Landon; Estill, Janne; Keiser, Olivia

    2015-08-15

    Malawi adopted the Option B+ strategy in 2011. Its success in reducing mother-to-child transmission depends on coverage and timing of HIV testing. We assessed HIV status ascertainment and its predictors during pregnancy. HIV status ascertainment was 82.3% (95% confidence interval: 80.2 to 85.9) in the pre-Option B+ period and 85.7% (95% confidence interval: 83.4 to 88.0) in the Option B+ period. Higher HIV ascertainment was independently associated with higher age, attending antenatal care more than once, and registration in 2010. The observed high variability of HIV ascertainment between sites (50.6%-97.7%) and over time suggests that HIV test kit shortages and insufficient numbers of staff posed major barriers to reducing mother-to-child transmission. PMID:25950205

  8. Women's HIV disclosure to family and friends.

    PubMed

    Serovich, Julianne Maria; Craft, Shonda M; Reed, Sandra J

    2012-04-01

    Previous researchers have documented rates of HIV disclosure to family at discrete time periods, yet none have taken a dynamic approach to this phenomenon. The purpose of this study is to take the next step and provide a retrospective comparison of rates of women's HIV disclosure to family and friends over a 15-year time span. Of particular interest are the possible influences of social network and relationship characteristics on the time-to-disclosure of serostatus. Time-to-disclosure was analyzed from data provided by 125 HIV-positive women. Participants were primarily married or dating (42%), unemployed (79.2%), African American (68%) women with a high school diploma or less (54.4%). Length of time since diagnosis ranged from 1 month to over 19 years (M=7.1 years). Results pointed to statistically significant differences in time-to-disclosure between family, friends, and sexual partners. Additionally, females and persons with whom the participant had more frequent contact were more likely to be disclosed to, regardless of the type of relationship. The results of this study underscore possible challenges with existing studies which have employed point prevalence designs, and point to new methods which could be helpful in family research. PMID:22313348

  9. Girls Who Disclose Sexual Abuse: Urogenital Symptoms and Signs After Genital Contact

    Microsoft Academic Search

    Cynthia DeLago; Esther Deblinger; Christine Schroeder; Martin A. Finkel

    BACKGROUND.Little information is available about idiosyncratic historical details pro- vided by sexually abused girls, yet this information can help medical professionals diagnose sexual abuse. OBJECTIVES.Our goals were to describe types and frequencies of urogenital symptoms\\/ signs reported by girls who disclosed direct genital contact and to explore factors associated with this reporting. METHODS.We reviewed 161 medical charts of 3- to

  10. Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak

    Microsoft Academic Search

    Khaled El Emam; Jay Mercer; Katherine Moreau; Inese Grava-Gubins; David Buckeridge; Elizabeth Jonker

    2011-01-01

    Background  Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the\\u000a case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good\\u000a should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they\\u000a are diluted

  11. HIV/AIDS, reproductive and sexual health, and the law.

    PubMed

    Gable, Lance; Gostin, Lawrence O; Hodge, James G

    2008-10-01

    The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health. PMID:18703431

  12. Adolescents' information management: comparing ideas about why adolescents disclose to or keep secrets from their parents.

    PubMed

    Tilton-Weaver, Lauree

    2014-05-01

    Recognizing that adolescents providing or withholding information about their activities is a strong predictor of parental knowledge, this article compares several ideas about what prompts adolescents to disclose information or keep secrets from their parents. Using a sample of 874 Northern European adolescents (aged 12-16 years; 49.8 % were girls), modified cross-lagged models examined parental monitoring (solicitation and monitoring rules), adolescent delinquency, and perceived parental support as predictors and consequences of adolescents disclosing to parents or keeping secrets, with adolescents' acceptance of parental authority as a moderator. Results suggest that, when adolescents view their parents as supportive, they subsequently disclose more and keep fewer secrets. Engaging in delinquent behavior was related reciprocally to keeping secrets. By comparison, the results generally did not support the idea that adolescents who are monitored provide information to parents, even when they accept parental authority. These results suggest that relationship dynamics and adolescents' delinquent behaviors play an important role in adolescents' information management. PMID:24002679

  13. The Socioeconomic Impact of HIV/AIDS on Education Outcomes in Uganda: School Enrolment and the Schooling Gap in 2002/2003

    ERIC Educational Resources Information Center

    Kasirye, Ibrahim; Hisali, Eria

    2010-01-01

    Due to high prime-age mortality--a result of the HIV/AIDS scourge, the number of orphans in Uganda continues to rise. Using the 2002/2003 Uganda National Household Survey, this paper investigates how HIV/AIDS orphan status affects schooling enrolment and grade progression. Our results show that HIV/AIDS orphans are not significantly less likely to…

  14. Acceptability of Carraguard, a candidate microbicide and methyl cellulose placebo vaginal gels among HIV-positive women and men in Durban, South Africa

    Microsoft Academic Search

    Gita Ramjee; Neetha S Morar; Sarah Braunstein; Barbara Friedland; Heidi Jones; Janneke van de Wijgert

    2007-01-01

    BACKGROUND AND METHODS: When on the market, microbicides are likely to be used by individuals who do not know their HIV status. Hence, assessment of safety and acceptability among HIV positive men and women is important. Acceptability of Carraguard, the Population Council's lead microbicide candidate was assessed in a Phase I safety study among healthy HIV-positive sexually abstinent women and

  15. Sexual mixing patterns among social networks of HIV-positive and HIV-negative Beijing men who have sex with men: a multilevel comparison using roundtable network mapping.

    PubMed

    Ruan, Yuhua; Pan, Stephen W; Chamot, Eric; Qian, Han-Zhu; Li, Dongliang; Li, Qing-Chun; Liang, Hong-Yuan; Spittal, Patricia; Shao, Yiming; Kristensen, Sibylle

    2011-08-01

    Men who have sex with men (MSM) are of immediate concern in China's HIV epidemic. In 2008, approximately 2.5-6.5% of China's eight million MSM were HIV positive, while MSM represented 11% of all new HIV cases. Two factors that will in-part determine HIV-transmission dynamics among MSM, are sexual mixing patterns and the social networks which shape them. Sexual mixing patterns and social networks of Chinese MSM, however, remain poorly understood with little refined data available. One reason is that stigma discourages disclosure of names and identifiers to researchers. Using an alternative network-mapping approach, matched case-control design, and snowball sampling, this pilot study sought to compare characteristics of social networks of HIV-positive and HIV-negative Beijing MSM at the individual, dyad, and network levels. First, HIV-negative MSM controls were matched to HIV-positive MSM cases based on age, education, residency, and ethnicity. Then, each case or control and their MSM social network convened at a specific time and location with study investigators. Venues included health clinics, karaoke clubs, brothels, and community centers. Then, using arbitrarily assigned numbers in lieu of actual names, all participants simultaneously completed self-administered surveys regarding their sexual relationships with other participants of the same social network. These new findings indicate that cross-generational sex (anal or oral sex between men with ?10 years age difference) was more prevalent among social networks of HIV-positive MSM, and was due to older age structure of the social network, rather than behavioral differences in sex-partner selection. Members of social networks of HIV-positive MSM were also less likely to have ever disclosed their MSM identity to non-MSM. Future studies should partner with MSM advocacy groups to explore behavioral and structural interventions as possible means of reducing the cross-generational sex and sexual identity-development issues elevating HIV risk for young Chinese MSM. PMID:21400315

  16. Evolutionary origin on HIV zThe closest relatives of HIV-1 and HIV-2

    E-print Network

    Moehlis, Jeff

    Evolutionary origin on HIV zThe closest relatives of HIV-1 and HIV-2 are simian immunodeficiency viruses (SIV). zThere is evidence for multiple transmissions from SIV into humans. zHIV-1 is very closely of virulence. #12;HIV is a quasispecies zViral replication is error prone. zHIV reverse transcriptase and RNA

  17. HIV and Its Treatment Changing an HIV Treatment Regimen Changing an HIV Treatment Regimen

    E-print Network

    Levin, Judith G.

    HIV and Its Treatment ­ Changing an HIV Treatment Regimen Changing an HIV Treatment Regimen Will my HIV treatment regimen ever change? At some point, you may need to adjust or change your regimen an HIV treatment regimen? There are several reasons why a person may switch to another HIV regimen

  18. Stress Biomarkers as Outcomes for HIV+ Prevention: Participation, Feasibility and Findings Among HIV+ Latina and African American Mothers

    Microsoft Academic Search

    Dorie A. Glover; Elena F. Garcia-Aracena; Patricia Lester; Eric Rice; Mary Jane Rothram-Borus

    2010-01-01

    Mothers living with HIV (MLH) are at high risk for acute and chronic stress, given challenges related to their HIV status,\\u000a ethnicity, economic and urban living conditions. Biomarkers combined into a composite index show promise in quantifying psychosocial\\u000a stress in healthy people, but have not yet been examined among MLH. According, we examined potential biomarker correlates\\u000a of stress [cortisol and

  19. Moving from Fact to Policy: Housing is HIV Prevention and Health Care

    Microsoft Academic Search

    Virginia Shubert; Nancy Bernstine

    2007-01-01

    A growing body of empirical evidence shows strong correlations between improved housing status and reduced HIV risk behaviors,\\u000a improved access to health care for persons living with HIV\\/AIDS, and better health outcomes. These findings support the provision\\u000a of housing assistance for low-income persons living with HIV\\/AIDS: as a basic human right; as a necessary component of systems\\u000a to enable individuals

  20. HIV multidisciplinary teams work: support services improve access to and retention in HIV primary care.

    PubMed

    Sherer, R; Stieglitz, K; Narra, J; Jasek, J; Green, L; Moore, B; Shott, S; Cohen, M

    2002-08-01

    The multidisciplinary team model of HIV care evolved out of necessity due to the diverse characteristics and needs of people living with HIV disease. Though it is now accepted as the international standard of care, it represents a significant departure from methods of care for other infectious diseases, and debate continues regarding the effectiveness of its interventions. The debate has been largely uninformed by data; for example, little is known about the relationship between ancillary support services and primary care outcomes. We hypothesized that support services increase access to and retention in HIV primary care in an inner city public hospital clinic. We conducted a retrospective analysis of clinical data sets on 2,647 patients at the CORE Center, Chicago from 1997-1998 to investigate the relationship between four support services-case management (CM), transportation (TRANS), mental health (MH) and chemical dependency (CD)-and access to and retention in HIV primary care. We found that patients who received each of these services were significantly more likely to receive any care, regular care and had more visits than patients with no service, and retention increased by 15-18%. Female gender, younger age, self-pay status and IDU predicted less regular care. Need for all services was substantial and significantly greater in women. Outcomes improved to the greatest extent among patients who needed and received each service. We conclude that support services significantly increased access to and retention in HIV primary care. Our findings validate the multidisciplinary team model of HIV care, and suggest that health services that are tailored to the express needs of patients lead to better care and improved health outcomes. Further testing of changes in health care delivery to meet the rapidly changing needs of people living with HIV disease and respond to the constantly changing practice of HIV medicine is urgently needed to maintain and extend the advances in HIV care outcomes of the past decade. PMID:12204140

  1. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran

    PubMed Central

    2010-01-01

    Background People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. Methods In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. Results and discussion Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. Conclusions While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context. PMID:20649967

  2. The Burgeoning HIV/HCV Syndemic in the Urban Northeast: HCV, HIV, and HIV/HCV Coinfection in an Urban Setting

    PubMed Central

    Morano, Jamie P.; Gibson, Britton A.; Altice, Frederick L.

    2013-01-01

    Introduction Despite recommendations for generation-based HCV and once lifetime HIV screening, thousands of individuals in the U.S. still remain untested and undiagnosed. This cross-sectional study examines the correlates of HCV and HIV monoinfection and HIV/HCV coinfection in an urban Northeast setting. Methods Utilizing an electronic database from a mobile medical clinic in New Haven, CT from January 2003 to July 2011, 8,311 individuals underwent structured health assessment and screening for HIV and HCV. Results HIV [N?=?601 (8.0%)] and HCV [N?=?753 (10.1%)] infection were identified, and 197 (26.1%) of the 753 with HCV were coinfected with HIV. Both monoinfection and coinfection status were independently correlated with crack cocaine use and increasing age. HIV/HCV coinfection was correlated with men having sex with men (MSM) (AOR?=?38.53, p<0.0080), shooting gallery use (AOR?=?3.06, p<0.0070), and not completing high school (AOR?=?2.51, p<0.0370). HCV monoinfection correlated with health insurance (AOR?=?2.16, p<0.0020), domestic violence (AOR?=?1.99, p<0.0070), and being Hispanic (AOR?=?2.63, p<0.0001), while HIV monoinfection correlated with having had syphilis (AOR?=?2.66, p<0.0001) and being Black (AOR?=?1.73, p?=?0.0010). Conclusions Though HIV and HCV share common transmission risk behaviors, independent correlates with viral infection status in an urban Northeast setting are distinct and have important implications for surveillance, healthcare delivery, disease prevention, and clinical care. PMID:23691197

  3. The Effect of Marriage and HIV Risks on Condom Use Acceptability in Rural Malawi

    PubMed Central

    Anglewicz, Philip; Clark, Shelley

    2013-01-01

    A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent’s HIV status, HIV perceptions, and risk behaviors, and (3) spouse’s HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. PMID:24161086

  4. The effect of marriage and HIV risks on condom use acceptability in rural Malawi.

    PubMed

    Anglewicz, Philip; Clark, Shelley

    2013-11-01

    A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent's HIV status, HIV perceptions, and risk behaviors, and (3) spouse's HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. PMID:24161086

  5. Estimating the HIV Vertical Transmission Rate and the Pediatric AIDS Incubation Period from Prospective Data

    Microsoft Academic Search

    D. T. Dunn; A. E. Ades

    1996-01-01

    This article considers the estimation of the rate of vertical human immunodeficiency virus (HIV) transmission and the pediatric acquired immune deficiency syndrome (AIDS) incubation period using data from birth cohort studies. Standard methods of analysis, which ignore children whose infection status is not established, may lead to biased estimates. Methods based on modeling the disappearance of HIV antibody or appearance

  6. Risk Acts, Health Care, and Medical Adherence Among HIV+ Youths in Care over Time

    Microsoft Academic Search

    Mary Jane Rotheram-Borus; Debra A. Murphy; Christy L. Coleman; Michael Kennedy; Helen M. Reid; Timothy R. Cline; Jeffrey M. Birnbaum; Donna Futterman; Linda Levin; Arlene Schneir; Brenda Chabon; Zane O'Keefe; Michelle Kipke

    1997-01-01

    The level and consistency of HIV-related sexual and substance-use risk acts, health status, and medical adherence were examined among 102 HIV+ youths aged 14 to 23 years (27% African American, 33% Latino). Over their lifetime, youths engaged in unprotected sexual acts with multiple partners (M = 284; Median = 44; consistent condom protection, 5%) and substance use (21% injecting drug

  7. Perspective Transformation over Time: A 2-Year Follow-up Study of HIV-Positive Adults.

    ERIC Educational Resources Information Center

    Courtenay, Bradley C.; Merriam, Sharan; Reeves, Patricia; Baumgartner, Lisa

    2000-01-01

    A follow-up study of 14 of 18 HIV-positive adults showed that their perspective transformation had been maintained 2 years later. Their meaning schemes changed to include a future-oriented perspective, greater attention to self-care, and integration of their HIV-positive status into their self-definition. (SK)

  8. Death Anxiety in Persons with HIV/AIDS: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Miller, Audrey K.; Lee, Brittany L.; Henderson, Craig E.

    2012-01-01

    One of the most commonly cited psychological sequelae of HIV/AIDS is anxiety regarding death due to the illness (i.e., death anxiety; DA). However, extant research is inconclusive on several empirical issues, such as DA's relation to HIV/AIDS diagnostic status, the impact of illness-related symptoms on DA, and factors that may protect against DA.…

  9. IMMUNOBIOLOGY Impaired function of circulating HIV-specific CD8 T cells in chronic human

    E-print Network

    Lieberman, Judy

    in chronically infected subjects was evaluated. By flow cytometry, only 5 of 7 subjects had detectable CD8IMMUNOBIOLOGY Impaired function of circulating HIV-specific CD8 T cells in chronic human, and Judy Lieberman The functional status of circulating hu- man immunodeficiency (HIV)-specific CD8 T cells

  10. Working It Out: Workplace Experiences of Individuals with HIV and Individuals with Cancer.

    ERIC Educational Resources Information Center

    Fesko, Sheila Lynch

    1999-01-01

    Thirty-two individuals with cancer or HIV (human immunodeficiency virus) were interviewed concerning their employment related experiences and concerns. Findings indicated that the decision to tell their supervisor and/or co-workers about their health status varied substantially between individuals with HIV and those with cancer. All study…

  11. Demographic predictors of HIV serostatus among HIV counseling and testing clients in rural Nigeria.

    PubMed

    Akinwande, Oluyemisi A; Ele, Prince U; Gebi, Usman I; Igboelina, Donald O; Dakum, Patrick S; Alkan, Michael L

    2012-01-01

    Nnewi is a rural Nigerian town with a human immunodeficiency virus (HIV) counseling and testing center which tests about 120 clients/d. The objective of this study is to determine the factors predicting positive HIV status at Nnewi. Review of records was done with age, gender, marital status, and occupation as variables. Logistic regression analysis was used to identify factors linked to a positive HIV test. Overall HIV prevalence was 31.14%. Drivers and married clients had a high risk of being HIV+ (odds ratio [OR], 3.59; 95% confidence interval [CI], 2.17-5.96 and OR, 2.78; 95% CI, 2.42-3.19). Housewives were 2 times more likely to be positive (OR, 2.11; 95% CI, 1.35-3.29). After adjustment, females had 22% higher risk (OR, 1.22; 95% CI, 1.03-1.45) with the highest chance found in married females (OR, 6.70; 95% CI, 4.45-10.09). The study succeeded in panning out an unexpected risk group: married women. Drivers have been known to be a risk group. Preventive methods must be tailored to and acceptable by each risk group. PMID:22875580

  12. Modeling HIV transmission risk among Mozambicans prior to their initiating highly active antiretroviral therapy.

    PubMed

    Pearson, C R; Kurth, A E; Cassels, S; Martin, D P; Simoni, J M; Hoff, P; Matediana, E; Gloyd, S

    2007-05-01

    Understanding sexual behavior and assessing transmission risk among people living with HIV-1 is crucial for effective HIV-1 prevention. We describe sexual behavior among HIV-positive persons initiating highly active antiretroviral therapy (HAART) in Beira, Mozambique. We present a Bernoulli process model (tool available online) to estimate the number of sexual partners who would acquire HIV-1 as a consequence of sexual contact with study participants within the prior three months. Baseline data were collected on 350 HAART-naive individuals 18-70 years of age from October 2004 to February 2005. In the three months prior to initiating HAART, 45% (n = 157) of participants had sexual relationships with 191 partners. Unprotected sex occurred in 70% of partnerships, with evidence suggesting unprotected sex was less likely with partners believed to be HIV-negative. Only 26% of the participants disclosed their serostatus to partners with a negative or unknown serostatus. Women were less likely to report concurrent relationships than were men (21 versus 66%; OR 0.13; 95%CI: 0.06, 0.26). Given baseline behaviors, the model estimated 23.2 infections/1,000 HIV-positive persons per year. The model demonstrated HAART along with syphilis and herpes simplex virus type 2 (HSV-2) treatment combined could reduce HIV-1 transmission by 87%; increasing condom use could reduce HIV-1 transmission by 67%. PMID:17505919

  13. Bridging HIV-1 cellular latency and clinical long-term non-progressor: an interactomic view.

    PubMed

    Yang, Jin; Yang, Zongxing; Lv, Hangjun; Lou, Yi; Wang, Juan; Wu, Nanping

    2013-01-01

    Development of an effective HIV management is enticed by the fact that long-term non-progressors (LTNP) restrict viral replication spontaneously, but is hindered by HIV-1 latency. Given that the most overlapping characteristics found between HIV-1 LTNP and latency, detailed analysis of the difference would disclose the essentials of latency. In this study, microarray data from our previous study was combined with HIV-1 latency and LTNP data obtained from NCBI GEO database. Principal variance component analysis and hierarchical clustering verified the removal of batch effect across platform. The analysis revealed a total of 456 differential expressed genes with >2-fold change and B-statistic >0. Bayesian inference was used to reconstitute the transcriptional network of HIV-1 latency or LTNP, respectively. Gene regulation was reprogrammed under different disease condition. By network interference, KPNA2 and ATP5G3 were identified as the hubs in latency network which mediate nuclear export and RNA processing. These data offer comparative insights into HIV-1 latency, which will facilitate the understanding of the genetic basis of HIV-1 latency in vivo and serve as a clue for future treatment dealing with key targets in HIV-1 latency. PMID:23451031

  14. Paying for HIV Care

    MedlinePLUS

    ... and Co-Payment Programs (Copyright © AIDS Treatment Data Network) - This online resource offers information on government and drug company-sponsored programs that help pay for HIV medicines. Social Security for People Living With HIV/AIDS - If you ...

  15. HIV Wellness Numbers

    MedlinePLUS Videos and Cool Tools

    ... viral load Once your HIV is diagnosed, your immune system health will depend on two important indicators: Your ... cells in a normal healthy range. When your immune system is strong, it keeps the HIV virus from ...

  16. HIV and AIDS

    MedlinePLUS

    ... that causes the disease AIDS. HIV Hurts the Immune System People who are HIV positive have been tested ... to everyone in the world. When the person's immune system has weakened and more of the blood's T ...

  17. Stages of HIV Infection

    MedlinePLUS

    ... thereâ??s good news: when used consistently, antiretroviral therapy (ART) prevents the HIV virus from multiplying and from ... AIDS. In addition, research has shown that taking ART can help prevent the spread of HIV to ...

  18. Beyond Anal Sex: Sexual Practices Associated with HIV Risk Reduction among Men Who Have Sex with Men in Boston, Massachusetts

    PubMed Central

    Reisner, Sari L.; Skeer, Margie; Mayer, Kenneth H.

    2009-01-01

    Abstract Men who have sex with men (MSM) continue to bear a disproportionate HIV and sexually transmitted disease (STD) burden. The current study examined the frequency and associations of sexual risk reduction behaviors among a sample of MSM in the greater Boston, Massachusetts area. One hundred eighty-nine MSM completed a one-time behavioral and psychosocial assessment between March 2006 and May 2007. Logistic regression procedures examined the association of demographic, psychosocial, and behavioral factors with risk reduction practices. Twenty percent of the sample reported rimming, mutual masturbation, digital penetration, using sex toys, or 100% condom use as a means to reduce their risk of acquiring or transmitting HIV in the prior 12 months. In bivariate analyses, risk reducers were more likely to disclose their MSM status (i.e., be “out”; odds ratio [OR]?=?3.64; p?

  19. [Pathogenesis of HIV-1].

    PubMed

    Metzner, Karin J

    2014-08-01

    The human immunodeficiency virus type 1 (HIV-1) establishes a chronic, lifelong infection finally leading to the acquired immunodeficiency syndrome (AIDS), which is characterized by the onset of opportunistic infections and tumors. The natural course of HIV-1 infections is very variable and depends on the virus and its replication competence as well as the host. This review summarizes our current knowledge on HIV-1 and host factors influencing the pathogenesis of HIV-1. PMID:25093308

  20. HIV among men who have sex with men in Malawi: elucidating HIV prevalence and correlates of infection to inform HIV prevention

    PubMed Central

    Wirtz, Andrea L; Jumbe, Vincent; Trapence, Gift; Kamba, Dunker; Umar, Eric; Ketende, Sosthenes; Berry, Mark; Strömdahl, Susanne; Beyrer, Chris; Baral, Stefan D

    2013-01-01

    Introduction There are limited data characterizing the burden of HIV among men who have sex with men (MSM) in Malawi. Epidemiologic research and access to HIV prevention, treatment and care services have been traditionally limited in Malawi by criminalization and stigmatization of same-sex practices. To inform the development of a comprehensive HIV prevention intervention for Malawian MSM, we conducted a community-led assessment of HIV prevalence and correlates of infection. Methods From April 2011 to March 2012, 338 MSM were enrolled in a cross-sectional study in Blantyre, Malawi. Participants were recruited by respondent-driven sampling methods (RDS), reaching 19 waves. Trained staff administered the socio-behavioural survey and HIV and syphilis voluntary counselling and testing. Results Crude HIV and syphilis prevalence estimates were 15.4% (RDS-weighted 12.5%, 95% confidence interval (CI): 7.3–17.8) and 5.3% (RDS-weighted 4.4%, 95% CI: 3.1–7.6), respectively. Ninety per cent (90.4%, unweighted) of HIV infections were reported as being previously undiagnosed. Participants were predominantly gay-identified (60.8%) or bisexually identified (36.3%); 50.7% reported recent concurrent relationships. Approximately half reported consistent condom use (always or almost always) with casual male partners, and proportions were relatively uniform across partner types and genders. The prevalence of perceived and experienced stigma exceeded 20% for almost all variables, 11.4% ever experienced physical violence and 7% were ever raped. Current age >25 years (RDS-weighted adjusted odds ratio (AOR) 3.9, 95% CI: 1.2–12.7), single marital status (RDS-weighted AOR: 0.3; 95% CI: 0.1–0.8) and age of first sex with a man <16 years (RDS-weighted AOR: 4.3, 95% CI: 1.2–15.0) were independently associated with HIV infection. Conclusions Results demonstrate that MSM represent an underserved, at-risk population for HIV services in Malawi and merit comprehensive HIV prevention services. Results provide a number of priorities for research and prevention programmes for MSM, including providing access to and encouraging regular confidential HIV testing and counselling, and risk reduction counselling related to anal intercourse. Other targets include the provision of condoms and compatible lubricants, HIV prevention information, and HIV and sexually transmitted infection treatment and adherence support. Addressing multiple levels of HIV risk, including structural factors, may help to ensure that programmes have sufficient coverage to impact this HIV epidemic among MSM. PMID:24321110

  1. Experiences with HIV Testing, Entry, and Engagement in Care by HIV-Infected Women of Color, and the Need for Autonomy, Competency, and Relatedness

    PubMed Central

    Messer, Lynne C.; Adimora, Adaora A.; Roytburd, Katya; Bowditch, Natasha; Parnell, Heather; Seay, Julia; Bell, Lynda; Pierce, Jonah K.

    2013-01-01

    Abstract Self-determination theory examines the needs of people adopting new behaviors but has not been applied to the adoption of HIV healthcare behaviors. The current study applied self-determination theory to descriptions of healthcare behaviors adopted by ethnic minority women after an HIV diagnosis. Women of color were asked to describe their experiences with HIV testing, entry, and engagement-in-care in qualitative interviews and focus groups. Participants were mostly African-American (88%), over 40 years old (70%), had been diagnosed for more than 6 years (87%) and had disclosed their HIV infection to more than 3 people (73%). Women described unmet self-determination needs at different time points along the HIV Continuum of Care. Women experienced a significant loss of autonomy at the time of HIV diagnosis. Meeting competency and relatedness needs assisted women in entry and engagement-in-care. However, re-establishing autonomy was a key element for long-term engagement-in-care. Interventions that satisfy these needs at the optimal time point in care could improve diagnosis, entry-to-care, and retention-in-care for women living with HIV. PMID:23829331

  2. Women and HIV

    MedlinePLUS

    ... studies that track women with HIV who take HIV medicines during pregnancy. To Learn More AIDS.gov National Library of ... Women's Health Topics Mammography Women and Diabetes HPV, HIV, Birth Control Heart Health for Women Pregnancy Menopause More Women's Health Topics Resources for You ...

  3. HIV and adolescents

    Microsoft Academic Search

    Mary Jane Rotheram-Borus; Cheryl Koopman

    1991-01-01

    Seroprevalence studies and documented sex and drug use risk behaviors indicate the importance of primary prevention programs for HIV among adolescents. Females and minority adolescents are at particular risk. Prevention workers must decide which strategies to advocate: abstinence, monogamy, HIV testing, screening partners, or explicit instruction of safer acts. Youths must be helped to personalize knowledge of HIV, acquire coping

  4. HIV-Associated Cancers

    Cancer.gov

    Published on Office of Cancer Genomics (http://ocg.cancer.gov) Home > HIV-Associated Cancers HIV-Associated Cancers [1] The Office of Cancer Genomics (OCG)Opens in a New Tab [2], along with the Office of HIV and AIDS Malignancies (OHAM)Opens in a New

  5. HIV-Associated Cancers

    Cancer.gov

    Published on Office of Cancer Genomics (https://ocg.cancer.gov) Home > HIV-Associated Cancers HIV-Associated Cancers [1] The Office of Cancer Genomics (OCG)Opens in a New Tab [2], along with the Office of HIV and AIDS Malignancies (OHAM)Opens in a New

  6. A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya

    PubMed Central

    2015-01-01

    There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak with for social support. When feeling overwhelmed by their circumstances, the children self-withdrew and performed positive activities (e.g., praying, watching TV, listening to the radio, singing, dancing) to help themselves feel better. Many HIV-affected families have a combination of HIV-positive and negative siblings within the household. Pending further studies conducted with larger sample sizes, the results of this study should assist healthcare professionals to better facilitate disclosure between HIV-positive parents and their children of mixed HIV statuses. PMID:26082868

  7. [HIV infection, gonorrhea and syphilis from Thailand to Norway].

    PubMed

    Aavitsland, P; Nilsen, O

    1999-10-30

    Thailand, a popular tourist destination for Norwegians, is experiencing an increasing epidemic of HIV infection. We used the Norwegian surveillance system for communicable diseases to assess the connections between the Norwegian and Thai epidemics. Before 1999, 1,869 cases of HIV-infection had been reported in Norway. From 1993 to 1998, 1,334 cases of gonorrhoea and 62 cases of syphilis were reported. We studied cases with a Thai patient or source partner and cases acquired in Thailand. 56 (3%) of HIV-infection cases, 64 (5%) of gonorrhoea cases and two (3%) of syphilis cases were connected to Thailand. All the Norwegians who acquired HIV in Thailand were males, with a median age of 39. Eight of them were diagnosed in 1998 as compared to 16 during the previous ten-year period. 21 Thai women and seven males were diagnosed with HIV infection in Norway, eight in 1998 and 20 in the previous ten-year period. The Norwegian HIV epidemic is influenced by the Thai epidemic. Norwegian men are infected in Thailand during holidays. Thai women come with their Norwegian partner to Norway and later discover their HIV status. We recommend raising the awareness of the Thai epidemic among Norwegian tourists. Immigrants to Norway from highly endemic countries should be offered HIV counselling and testing. PMID:10592752

  8. HIV prevention at the grass roots level.

    PubMed

    Sadler, J W

    1992-01-01

    In Washington, D.C. adolescents are infected with about 1/3 of all sexually transmitted diseases, and the incidence of congenital syphilis is mounting. The District of Columbia had a reported AIDS infection rate of 132.5/100,000 residents between July 1991 and June 1992 compared with 44.8 in New York. A total of 6613 cases were reported of which 6523 afflicted adults and adolescents. Only San Francisco had more cases with 12,402 cases of adults and adolescents reported. The District of Columbia's 1991 Youth Risk Behavior Survey disclosed that 78.8% of the 1275 adolescents in grades 9 and 10 had experienced sexual intercourse, and 38.8% of these were 13 years old or younger at 1st coitus. 33% of responders had had sex with 6 or more people. .53% of adolescent military recruits from the District had HIV infection, the highest rate in the nation. The District of Columbia Public Schools (DCPS) started an AIDS education program in 1987 for grades 4-12 with support from the Centers for Disease Control. During 1987-92 a 5-year HIV/AIDS Education program's activities involved formal training for all teachers; awareness seminars for school counselors and instructors; evaluation of teachers trained; student assessment of classroom training; DCPS Advisory Board with medical specialists, AIDS educators, and AIDS victims; coalition building with more than 20 organizations in the city; and distribution of literature to the 174 schools in the system. The program resulted in significant improvement in HIV/AIDS awareness at all 3 school levels, although it was more effective with elementary students and it made the least impact on senior high school students, especially on boys. Girls in junior high school showed improvement in knowledge, attitudes, and behavior concerning HIV/AIDS than boys. Future educational efforts should concentrate more on boys both in junior and senior high school. PMID:12286191

  9. Early and Prolonged Antiretroviral Therapy Is Associated with an HIV1Specific T-Cell Profile Comparable to That of Long-Term Non-Progressors

    Microsoft Academic Search

    Cristina Cellerai; Alexandre Harari; Hans Stauss; Sabine Yerly; Anna-Maria Geretti; Anne Carroll; Thynn Yee; Jonathan Ainsworth; Ian Williams; John Sweeney; Andrew Freedman; Margaret Johnson; Giuseppe Pantaleo; Sabine Kinloch-De Loes; Mathias Lichterfeld

    2011-01-01

    BackgroundIntervention with antiretroviral treatment (ART) and control of viral replication at the time of HIV-1 seroconversion may curtail cumulative immunological damage. We have therefore hypothesized that ART maintenance over a very prolonged period in HIV-1 seroconverters could induce an immuno-virological status similar to that of HIV-1 long-term non-progressors (LTNPs).Methodology\\/Principal FindingsWe have investigated a cohort of 20 HIV-1 seroconverters on long-term

  10. Apolipoprotein E4 Genotype Does Not Increase Risk of HIV-associated Neurocognitive Disorders

    PubMed Central

    Morgan, E.E.; Woods, S.P.; Letendre, S.L.; Franklin, D.R.; Bloss, C.; Goate, A.; Heaton, R.K.; Collier, A.C.; Marra, C.M.; Gelman, B.B.; McArthur, J.C.; Morgello, S.; Simpson, D.M.; McCutchan, J.A.; Ellis, R.J.; Abramson, I.; Gamst, A.; Fennema-Notestine, C.; Smith, D.M.; Grant, I.; Vaida, F.; Clifford, D.B.

    2013-01-01

    This is a cross-sectional, observational study to evaluate the hypothesis that HIV-seropositive (HIV+) apolipoprotein E4 (APOE4) carriers are at increased risk for HIV-associated Neurocognitive Disorders (HAND) compared to APOE4 noncarriers with HIV in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Group sample. APOE genotype was determined in 466 CHARTER participants with varying disease stages and histories of antiretroviral treatment who did not have severe psychiatric or medical comorbid conditions that preclude diagnosis of HAND. HAND diagnoses were based on results of comprehensive neurobehavioral evaluation and use of current neuroAIDS diagnostic criteria. HAND status consisting of two levels: neuropsychologically normal status (i.e., no HAND) and any HAND diagnosis (i.e., asymptomatic neurocognitive impairment, minor neurocognitive disorder, HIV-associated dementia). Logistic regression analyses revealed no association between APOE4 carrier status and HAND, and there were no interactions between APOE4 carrier status and ethnicity, age, substance use disorders, duration of infection, or nadir CD4. Results did not differ when analysis was restricted to symptomatic HAND, and no APOE4 gene dose-dependent relationship to HAND emerged. APOE4 status was not associated with concurrent HAND in this large, well-characterized sample. This does not preclude emergence of an association between APOE4 status and HAND as this population ages. Prospective, longitudinal studies are needed to examine APOE4 as a risk factor for neurocognitive decline, incident HAND at older ages, and potential associations with CSF amyloid. PMID:23408335

  11. Anthropometric measures and cognition in middle-aged HIV-infected and uninfected women. The Women's Interagency HIV Study.

    PubMed

    Gustafson, Deborah R; Mielke, Michelle M; Tien, Phyllis C; Valcour, Victor; Cohen, Mardge; Anastos, Kathryn; Liu, Chenglong; Pearce, Leigh; Golub, Elizabeth T; Minkoff, Howard; Crystal, Howard A

    2013-12-01

    This study aimed to explore the relationship of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with cognition in women with (HIV+) and without HIV (HIV-) infection. One thousand six hundred ninety participants (1,196 HIV+, 494 HIV-) in the Women's Interagency HIV Study (WIHS) with data available on anthropometric measures comprise the analytical sample. Cross-sectional analyses using linear regression models estimated the relationship between anthropometric variables and Trails A, Trails B, Stroop interference time, Stroop word recall, Stroop color naming and reading, and Symbol Digit Modalities Test (SDMT) with consideration for age, HIV infection status, Wide Range Achievement Test score, CD4 count, insulin resistance, drug use, and race/ethnicity. Among HIV+ women, BMI?HIV- women, an obese BMI was related to worse performance on the Stroop color naming test. Few and inconsistent associations were observed between WC, WHR, and cognition. Among women at mid-life with chronic (at least 10 years) HIV infection, common anthropometric measures, primarily BMI, were differentially related to cognitive test performance by cognitive domain. Higher levels of BMI were associated with better cognitive function. In this era of antiretroviral therapies, restoration of health evidenced as higher BMI due to effective antiretroviral therapies, may improve cognitive function in middle-aged HIV-infected women. PMID:24338243

  12. 'Triply cursed': racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men.

    PubMed

    Arnold, Emily A; Rebchook, Gregory M; Kegeles, Susan M

    2014-06-01

    In the USA, young Black gay men are disproportionately impacted upon by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and nine service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and non-disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community and from friends within the Black gay community, which otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with alienation and rejection. PMID:24784224

  13. “Triply cursed”: Racism, homophobia, and HIV-related stigma are barriers to regular HIV testing, treatment adherence, and disclosure among young Black gay men

    PubMed Central

    Arnold, Emily A.; Rebchook, Gregory M.; Kegeles, Susan M.

    2014-01-01

    In the USA, young Black gay men are disproportionately impacted by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and 9 service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community, and from friends within the Black gay community, that otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with their alienation and rejection. PMID:24784224

  14. Pharmacist counseling in a cohort of women with HIV and women at risk for HIV

    PubMed Central

    Cocohoba, Jennifer M; Althoff, Keri N; Cohen, Mardge; Hu, Haihong; Cunningham, Chinazo O; Sharma, Anjali; Greenblatt, Ruth M

    2012-01-01

    Background and methods Achieving high adherence to antiretroviral therapy for human immunodeficiency virus (HIV) is challenging due to various system-related, medication-related, and patient-related factors. Community pharmacists can help patients resolve many medication-related issues that lead to poor adherence. The purpose of this cross-sectional survey nested within the Women’s Interagency HIV Study was to describe characteristics of women who had received pharmacist medication counseling within the previous 6 months. The secondary objective was to determine whether HIV-positive women who received pharmacist counseling had better treatment outcomes, including self-reported adherence, CD4+ cell counts, and HIV-1 viral loads. Results Of the 783 eligible participants in the Women’s Interagency HIV Study who completed the survey, only 30% of participants reported receiving pharmacist counseling within the last 6 months. Factors independently associated with counseling included increased age (odds ratio [OR] 1.28; 95% confidence interval [CI] 1.07–1.55), depression (OR 1.75; 95% CI 1.25–2.45), and use of multiple pharmacies (OR 1.65; 95% CI 1.15–2.37). Patients with higher educational attainment were less likely to report pharmacist counseling (OR 0.68; 95% CI 0.48–0.98), while HIV status did not play a statistically significant role. HIV-positive participants who received pharmacist counseling were more likely to have optimal adherence (OR 1.23; 95% CI 0.70–2.18) and increased CD4+ cell counts (+43 cells/mm3, 95% CI 17.7–104.3) compared with those who had not received counseling, though these estimates did not achieve statistical significance. Conclusion Pharmacist medication counseling rates are suboptimal in HIV-positive and at-risk women. Pharmacist counseling is an underutilized resource which may contribute to improved adherence and CD4+ counts, though prospective studies should be conducted to explore this effect further. PMID:22791983

  15. 12 CFR 792.31 - Can exempt records be disclosed to credit unions, financial institutions and state or federal...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...Can exempt records be disclosed to credit unions, financial institutions and state or federal...31 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR...

  16. 12 CFR 792.31 - Can exempt records be disclosed to credit unions, financial institutions and state or federal...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...Can exempt records be disclosed to credit unions, financial institutions and state or federal...31 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR...

  17. 12 CFR 792.31 - Can exempt records be disclosed to credit unions, financial institutions and state or federal...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...Can exempt records be disclosed to credit unions, financial institutions and state or federal...31 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR...

  18. 12 CFR 792.31 - Can exempt records be disclosed to credit unions, financial institutions and state or federal...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...Can exempt records be disclosed to credit unions, financial institutions and state or federal...31 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR...

  19. 12 CFR 792.31 - Can exempt records be disclosed to credit unions, financial institutions and state or federal...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...Can exempt records be disclosed to credit unions, financial institutions and state or federal...31 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR...

  20. 17 CFR 140.72 - Delegation of authority to disclose confidential information to a contract market, registered...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...futures association or self-regulatory organization. ...the Office of International Affairs, and the Deputy Director of the Office of International Affairs, the authority to disclose...futures association, or self-regulatory organization as...

  1. 49 CFR 40.111 - When and how must a laboratory disclose statistical summaries and other information it maintains?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...laboratory disclose statistical summaries and other...transmit an aggregate statistical summary, by employer, of the data listed in Appendix...transmit an aggregate statistical summary of the data listed in...

  2. 49 CFR 40.111 - When and how must a laboratory disclose statistical summaries and other information it maintains?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...laboratory disclose statistical summaries and other...transmit an aggregate statistical summary, by employer, of the data listed in Appendix...transmit an aggregate statistical summary of the data listed in...

  3. 49 CFR 40.111 - When and how must a laboratory disclose statistical summaries and other information it maintains?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...laboratory disclose statistical summaries and other...transmit an aggregate statistical summary, by employer, of the data listed in Appendix...transmit an aggregate statistical summary of the data listed in...

  4. [HIV-associated neuropathies].

    PubMed

    Hahn, K; Husstedt, I W

    2010-04-01

    Human immunodeficiency virus (HIV)-associated polyneuropathy has become the most common neurological complication of HIV infection and is one of the main risk factors for development of a neuropathy worldwide. Therefore HIV should always be considered as an underlying cause in patients with neuropathy. Many types of peripheral neuropathies are seen in HIV infection depending on the stage of infection. The inflammatory demyelinating neuropathies both acute (Guillain-Barré syndrome, GBS) and chronic (chronic inflammatory demyelinating neuropathy, CIDP) occur mainly at the time of seroconversion or early in the course of the disease while syndromes associated with opportunistic infections like CMV (i.e. polyradiculoneuropathy) occur in the late phase of HIV infection and are related to the loss of immune function. Distal symmetrical polyneuropathy (DSP) is the most common neuropathy in HIV-infected patients. We review the clinical manifestations, epidemiology, clinical diagnostics, pathophysiology and management strategies for HIV-associated polyneuropathies. PMID:20195565

  5. My body, my life, my choice: practices and meanings of complementary and alternative medicine among a sample of Australian people living with HIV\\/AIDS and their practitioners

    Microsoft Academic Search

    Karalyn McDonald; Sean Slavin

    2010-01-01

    In this study we examine the sociocultural meaning and use of complementary and alternative medicine (CAM) by nine people living with HIV\\/AIDS (PLWHA) and four CAM practitioners. Analysis revealed five themes: focus on health not illness; resistance to antiretroviral therapy and adherence; allopathic medicine as narrow; difficulty disclosing to doctors; and a continuum of CAM that sometimes included conventional medicine

  6. 30 CFR 285.113 - How will data and information obtained by MMS under this part be disclosed to the public?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... How will data and information obtained by MMS under this part be disclosed to the public... How will data and information obtained by MMS under this part be disclosed to the public? (a) The MMS will make data and information...

  7. 30 CFR 285.113 - How will data and information obtained by MMS under this part be disclosed to the public?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... How will data and information obtained by MMS under this part be disclosed to the public... How will data and information obtained by MMS under this part be disclosed to the public? (a) The MMS will make data and information...

  8. DisClose: Discovering Colossal Closed Itemsets via a Memory Efficient Compact Row-Tree

    SciTech Connect

    Zulkurnain, Nurul F.; Keane, John A.; Haglin, David J.

    2013-02-01

    Itemset mining has recently focused on discovery of frequent itemsets from high-dimensional datasets with relatively few rows and a larger number of items. With exponentially in-creasing running time as average row length increases, mining such datasets renders most conventional algorithms impracti-cal. Unfortunately, large cardinality closed itemsets are likely to be more informative than small cardinality closed itemsets in this type of dataset. This paper proposes an approach, called DisClose, to extract large cardinality (colossal) closed itemsets from high-dimensional datasets. The approach relies on a memory-efficient Compact Row-Tree data structure to represent itemsets during the search process. The search strategy explores the transposed representation of the dataset. Large cardinality itemsets are enumerated first followed by smaller ones. In addition, we utilize a minimum cardinality threshold to further reduce the search space. Experimental result shows that DisClose can complete the extraction of colossal closed itemsets in the considered dataset, even for low support thresholds. The algorithm immediately discovers closed itemsets without needing to check if each new closed itemset has previously been found.

  9. A secure protocol for protecting the identity of providers when disclosing data for disease surveillance

    PubMed Central

    Hu, Jun; Mercer, Jay; Peyton, Liam; Kantarcioglu, Murat; Malin, Bradley; Buckeridge, David; Samet, Saeed; Earle, Craig

    2011-01-01

    Background Providers have been reluctant to disclose patient data for public-health purposes. Even if patient privacy is ensured, the desire to protect provider confidentiality has been an important driver of this reluctance. Methods Six requirements for a surveillance protocol were defined that satisfy the confidentiality needs of providers and ensure utility to public health. The authors developed a secure multi-party computation protocol using the Paillier cryptosystem to allow the disclosure of stratified case counts and denominators to meet these requirements. The authors evaluated the protocol in a simulated environment on its computation performance and ability to detect disease outbreak clusters. Results Theoretical and empirical assessments demonstrate that all requirements are met by the protocol. A system implementing the protocol scales linearly in terms of computation time as the number of providers is increased. The absolute time to perform the computations was 12.5?s for data from 3000 practices. This is acceptable performance, given that the reporting would normally be done at 24?h intervals. The accuracy of detection disease outbreak cluster was unchanged compared with a non-secure distributed surveillance protocol, with an F-score higher than 0.92 for outbreaks involving 500 or more cases. Conclusion The protocol and associated software provide a practical method for providers to disclose patient data for sentinel, syndromic or other indicator-based surveillance while protecting patient privacy and the identity of individual providers. PMID:21486880

  10. Side Effects of HIV Medicines: HIV and Hepatotoxicity

    MedlinePLUS

    ... away without stopping the HIV medicine. What is hepatotoxicity? Hepatotoxicity means damage to the liver caused by ... be life threatening. What HIV medicines can cause hepatotoxicity? HIV medicines in the following drug classes can ...

  11. Side Effects of HIV Medicines: HIV and Hyperlipidemia

    MedlinePLUS

    ... levels: All HIV medicines in the protease inhibitor (PI) drug class . (HIV medicines are grouped into drug ... for all HIV medicines, including those in the PI drug class. Efavirenz (brand name: Sustiva), which belongs ...

  12. Predictors of self-efficacy for HIV prevention among Hispanic women in South Florida.

    PubMed

    Villegas, Natalia; Cianelli, Rosina; Gonzalez-Guarda, Rosa; Kaelber, Lorena; Ferrer, Lilian; Peragallo, Nilda

    2013-01-01

    Self-efficacy is a critical element for HIV prevention, however little is known about the predictors of self-efficacy for HIV prevention among Hispanic women. In this cross-sectional study we assessed if age, living with a partner, employment status, HIV knowledge, self-esteem, and intimate partner violence (IPV) predicted self-efficacy for HIV prevention in 548 Hispanic women in South Florida who participated in a randomized controlled trial (SEPA). The majority of Hispanic women reported high levels of self-efficacy for HIV prevention. Women who were older, living with a partner, had less HIV knowledge, and had a history of IPV reported significantly lower levels of self-efficacy for HIV prevention. HIV knowledge was the most important predictor of self-efficacy for HIV prevention. Employment was not a significant predictor of self-efficacy for HIV prevention. Predictors identified in the study can be used to identify high-risk Hispanic women who are in need of HIV prevention interventions. PMID:22795758

  13. Sexual risk behavior among HIV-positive patients at an urban clinic in Santiago, Dominican Republic.

    PubMed

    Sears, David; Cabrera, Claudia; Ortiz, Francisco; Anderson, Bradley; Stein, Michael

    2011-12-01

    More than 1% of adults in the Dominican Republic are HIV-infected and most infections are acquired sexually. We studied sexual risk behaviors in a group of HIV-positive patients treated in Santiago, Dominican Republic. Interviews were conducted with 129 participants seen in May 2006 at one of the country's largest public hospital HIV clinics. Questions included demographics, sexual history, condom use, and focused on patients' last sexual encounter. Most patients (72.4%) had been sexually active since their HIV diagnosis. Following their diagnosis, 72.8% of sexually active patients used condoms more frequently, 21.7% used condoms with the same frequency, and 5.4% used condoms less often. The most common reason cited for not using a condom after HIV diagnosis differed by gender; men cited decreased sexual pleasure (70.0%) and women reported that their partner had refused to use a condom (71.8%). Sexually active patients who believed that their partner did not have HIV were much more likely to report using a condom at their last sexual encounter than those who did not know their partner's HIV status (odds ratio [OR] = 16.9). HIV-positive patients reported using condoms more frequently following their HIV diagnosis and were more likely to use a condom if they believed their partner did not have HIV. Increased HIV testing may lead to reduced sexual risk behavior in the Dominican Republic. PMID:21732896

  14. Contemplating abortion: HIV-positive women’s decision to terminate pregnancy

    PubMed Central

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

    2015-01-01

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

  15. Long-term incidence of cervical cancer in women with HIV

    PubMed Central

    Massad, L. Stewart; Seaberg, Eric C.; Watts, D. Heather; Minkoff, Howard; Levine, Alexandra M.; Henry, Donna; Colie, Christine; Darragh, Teresa M.; Hessol, Nancy A.

    2009-01-01

    Objective To estimate the incidence of invasive cervical cancer (ICC) in women with human immunodeficiency virus (HIV) and compare it to that in HIV-uninfected women. Methods In a cohort study of HIV infected and uninfected women who had Pap tests obtained every six months, pathology reports were retrieved for women with biopsy or self-report of ICC. Histology was reviewed when reports confirmed ICC. Incidence rates were calculated and compared to those in HIV-negative women. Results After a median follow-up of 10.3 years, three ICCs were confirmed in HIV seropositive women, none in seronegative women. The ICC incidence rate was not significantly associated with HIV status (HIV negative: 0/100,000 person-years vs. HIV positive: 21.4/100,000 person-years; p=0.59). A calculated incidence rate ratio standardized to expected results from the Surveillance Epidemiology and End Results database restricted to the HIV-infected WIHS participants was 1.32 (95% CI: 0.27, 3.85; p=0.80). Conclusion Among women with HIV in a prospective study incorporating cervical cancer prevention measures, ICC incidence was not significantly higher than in a comparison group of HIV-negative women. PMID:19127538

  16. Male involvement in antenatal HIV counseling and testing: exploring men's perceptions in rural Malawi.

    PubMed

    Aarnio, Pauliina; Olsson, Pia; Chimbiri, Agnes; Kulmala, Teija

    2009-12-01

    Antenatal care can act as an excellent tool to improve access to HIV counseling and testing services. This paper investigates an issue that may weaken its potential, namely lack of male involvement. We explored married men's perceptions of HIV in pregnancy and male involvement in antenatal HIV testing and counseling in Southern Malawi through 11 focus group discussions and a cross-sectional survey (n=388). The main findings were that men were largely unaware of available antenatal HIV testing and counseling services, and perceived it overall problematic to attend female-oriented health care. Most men supported provision of antenatal HIV testing. They perceived husbands to participate in the process indirectly through spousal communication, being faithful during pregnancy, and supporting the wife if found HIV-positive. Involvement of husbands was compromised by men's reluctance to learn their HIV status and the threat that HIV poses on marriage. Men stressed the importance of prior spousal agreement of antenatal HIV testing and considered HIV testing without their consent a valid reason for divorce. We suggest that male involvement in antenatal HIV testing requires refocusing of information and health services to include men. To avoid negative social outcomes for women, comprehensive and early involvement of men is essential. PMID:20024733

  17. Identifying New Positives and Linkage to HIV Medical Care - 23 Testing Site Types, United States, 2013.

    PubMed

    Seth, Puja; Wang, Guoshen; Collins, Nicoline T; Belcher, Lisa

    2015-06-26

    Among the estimated 1.2 million persons living with human immunodeficiency virus (HIV) infection in the United States, approximately 14% have not had their HIV diagnosed. Certain populations, such as African Americans/blacks (in this report referred to as blacks), men who have sex with men (MSM), and Hispanics/Latinos (in this report referred to as Hispanics), are disproportionately affected by HIV. In areas where HIV prevalence is ?0.1%, CDC recommends routine HIV screening in health care settings for persons aged 13-64 years. Implementation of HIV screening as part of routine care can increase the number of HIV diagnoses, destigmatize HIV testing, and improve access to care for persons with new HIV infections. Additionally, targeted testing in non-health care settings might facilitate access to persons in at-risk populations (e.g., MSM, blacks, and Hispanics) who are unaware of their status and do not routinely seek care. CDC analyzed data for 23 testing site types submitted by 61 health departments and 151 CDC-funded community-based organizations to determine 1) the number of HIV tests conducted, 2) the percentage of persons with new diagnoses of HIV infection (in this report referred to as new positives), and 3) the percentage of persons who were linked to HIV medical care within 90 days after receiving diagnoses at specific site types within health care and non-health care settings. The results indicated that, in health care settings, primary care and sexually transmitted disease (STD) clinics accounted for substantially more HIV tests than did other sites, and STD clinics identified more new positives. In non-health care settings, HIV counseling and testing sites accounted for the most tests and identified the highest number of new positives. Examining program data by site type shows which sites performed better in diagnosing new positives and informs decisions about program planning and allocation of CDC HIV testing resources among and within settings. PMID:26110836

  18. Routine HIV Testing among Hospitalized Patients in Argentina. Is It Time for a Policy Change?

    PubMed Central

    Socías, María Eugenia; Hermida, Laura; Singman, Mariana; Kulgis, Gisela; Díaz Armas, Andrés; Cando, Osvaldo; Sued, Omar; Pérez, Héctor; Hermes, Ricardo; Presas, José Luis; Cahn, Pedro

    2013-01-01

    Introduction The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. Objective We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. Methods Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. Results Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39%) reported prior HIV testing. One hundred and ninety (76%) patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05) was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%); none belonged to a most-at-risk population. Conclusions Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy. PMID:23936034

  19. Molecular mechanisms of HIV-1 mother-to-child transmission and infection in neonatal target cells

    PubMed Central

    Ahmad, Nafees

    2010-01-01

    HIV-1 mother-to-child transmission (MTCT) occurs mainly at three stages, including prepartum, intrapartum and postpartum. Several maternal factors, including low CD4+ lymphocyte counts, high viral load, immune response, advanced disease status, smoking and abusing drugs have been implicated in an increased risk of HIV-1 MTCT. While use of antiretroviral therapy (ART) during pregnancy has significantly reduced the rate of MTCT, selective transmission of ART resistant mutants has been reported. Based on HIV-1 sequence comparison, the maternal HIV-1 minor genotypes with R5 phenotypes are predominantly transmitted to their infants and initially maintained in the infants with the same properties. Several HIV-1 structural, regulatory and accessory genes were highly conserved following MTCT. In addition, HIV-1 sequences from non-transmitting mothers are less heterogeneous compared with transmitting mothers, suggesting that a higher level of viral heterogeneity influences MTCT. Analysis of the immunologically relevant epitopes showed that variants evolved to escape the immune response that influenced HIV-1 MTCT. Several cytotoxic T lymphocyte (CTL) epitopes were identified in various HIV-1 genes that were conserved in HIV-1 mother-infant sequences, suggesting a role in MTCT. We have shown that HIV-1 replicates more efficiently in neonatal T-lymphocytes and monocytes/macrophages compared with adult cells, and this differential replication is influenced at the level of HIV-1 gene expression, which was due to differential expression of host factors, including transcriptional activators, signal transducers and cytokines in neonatal than adult cells. In addition, HIV-1 integration occurs in more actively transcribed genes in neonatal compared with adult cells, which may influence HIV-1 gene expression. The increased HIV-1 gene expression and replication in neonatal target cells contribute to a higher viral load and more rapid disease progression in neonates/infants than adults. These findings may identify targets, viral and host, for developing strategies for HIV-1 prevention and treatment. PMID:20888841

  20. HIV prevalence and demographic determinants of unprotected anal sex and HIV testing among men who have sex with men in Beirut, Lebanon.

    PubMed

    Wagner, Glenn J; Tohme, Johnny; Hoover, Matthew; Frost, Simon; Ober, Allison; Khouri, Danielle; Iguchi, Martin; Mokhbat, Jacques

    2014-05-01

    The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47 %) were under age 25 years and 67 % self-identified as gay. Nearly two-thirds (64 %) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23 % who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5 % of 198 participants tested) were HIV-positive; 62 % had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33 % vs. 71 %). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM. PMID:24752791

  1. HIV TREATMENT OPTIMISM AND UNSAFE ANAL INTERCOURSE AMONG HIV-POSITIVE MEN WHO HAVE SEX WITH MEN: FINDINGS FROM THE POSITIVE CONNECTIONS STUDY

    PubMed Central

    Brennan, David J.; Welles, Seth L.; Miner, Michael H.; Ross, Michael W.; Rosser, B. R. Simon

    2013-01-01

    This study was designed to examine the impact of HIV treatment optimism on sexual risk among a racially diverse sample of HIV-positive MSM. Survey data were collected from 346 racially diverse HIV-positive MSM. Inclusion criteria: 18 years of age, male, at least one incident of unprotected anal intercourse (UAI) in the last year, currently on treatment. Other variables included demographics, sexual risk, depression, internalized homonegativity, HIV treatment history, alcohol/drug use and beliefs about HIV treatments (Susceptibility to transmit HIV, Severity of HIV infection and Condom Motivation). Those with lower income were more likely to report that HIV was less transmissible. A self-reported decrease in condom motivation was associated with being White, well-educated and increased alcoho/drug use. A decrease in Severity of HIV was associated with better mental health, being non-White and undetectable viral load. Sexual risk appears related to beliefs about how treatment affects the transmissibility of HIV. Race, socioeconomic status, alcoho/drug use, mental health and viral load were also associated with treatment beliefs. PMID:20387983

  2. HIV Prevalence and Demographic Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut, Lebanon

    PubMed Central

    Wagner, Glenn J.; Tohme, Johnny; Hoover, Matthew; Frost, Simon; Ober, Allison; Khouri, Danielle; Iguchi, Martin; Mokhbat, Jacques

    2014-01-01

    The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47%) were under age 25 years and 67% self-identified as gay. Nearly two-thirds (64%) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23% who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5% of 198 participants tested) were HIV-positive; 62% had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33% vs. 71%). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM. PMID:24752791

  3. Circumcision as a primary HIV preventive: Extrapolating from the available data.

    PubMed

    Van Howe, Robert S

    2015-01-01

    Billions of dollars to circumcise millions of African males as an HIV infection prevention have been sought, yet the effectiveness of circumcision has not been demonstrated. Data from 109 populations comparing HIV prevalence and incidence in men based on circumcision status were evaluated using meta-regression. The impact on the association between circumcision and HIV incidence/prevalence of the HIV risk profile of the population, the circumcision rates within the population and whether the population was in Africa were assessed. No significant difference in the risk of HIV infection based on the circumcision status was seen in general populations. Studies of high-risk populations and populations with a higher prevalence of male circumcision reported significantly greater odds ratios (odds of intact man having HIV) (p < .0001). When adjusted for the impact of a high-risk population and the circumcision rate of the population, the baseline odds ratio was 0.78 (95% CI = 0.56-1.09). No consistent association between presence of HIV infection and circumcision status of adult males in general populations was found. When adjusted for other factors, having a foreskin was not a significant risk factor. This undermines the justification for using circumcision as a primary preventive for HIV infection. PMID:25760456

  4. Increase in HIV sexual risk behaviour in homosexual men in Scotland, 1996–2002: prevention failure?

    PubMed Central

    Hart, G; Williamson, L

    2005-01-01

    Objective: To investigate trends in homosexual men's sexual risk behaviour for HIV infection in Scotland. Methods: Cross sectional surveys in 1996, 1999, and 2002 were carried out in "gay" bars in Glasgow and Edinburgh, Scotland. 6508 men—2276 (79% response rate) in 1996, 2498 (78%) in 1999, and 1734 (62%) in 2002. Results: In 1996, 10.7% of men surveyed and in 1999, 11.2% reported unprotected anal intercourse (UAI) with casual partners, compared with 18.6% in 2002 (p<0.001). There was also a significant increase in men reporting that they "knew" their casual partners' HIV status, despite no increase in HIV testing among men who reported UAI with casual partners. In 2002, increases in UAI with more than one partner, in UAI with casual partners and in reporting seroconcordance remained significant after adjusting for confounding factors including HIV testing status and demographic characteristics. Conclusions: High risk sexual behaviour among homosexual men in Scotland increased between 1999 and 2002. Men showed increased confidence of shared antibody status, despite no increase in HIV testing, or evidence of discussion of HIV status. Explanations for this must include consideration of a cultural shift in the perception of HIV and "prevention failure" on the part of governments and health agencies. PMID:16199733

  5. African American women’s perspectives on “Down Low/DL” men: Implications for HIV Prevention

    PubMed Central

    Goparaju, Lakshmi; Warren-Jeanpiere, Lari

    2012-01-01

    African American women are disproportionately affected by HIV. Some research has explored if non-disclosing men who have sex with men and women (MSMW) contribute to women’s HIV risk. Popular media discourse tends to refer to these men as “Down Low” or “DL”. Six focus groups were conducted with 36 African American women in Washington D.C. to examine their knowledge, attitudes, beliefs, and behaviours regarding “Down Low/DL” men. Three of the focus groups were composed of HIV positive women and three groups were composed of HIV negative women. Data analysis reveals six central subcategories related to women’s perspectives on the “DL”: awareness; suspicion; coping with partner infidelity: male vs. female; sexual health communication; empathy; and religion. No major differences were identified between the HIV positive and HIV negative focus groups. Findings from this study provide insight into African American women’s perceptions of African American male sexuality and how these perceptions serve to influence interpersonal relationship factors and women’s exposure to HIV risk. PMID:22804686

  6. HIV, AIDS, and the Future

    MedlinePLUS

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV, AIDS, and the Future Past Issues / Summer 2009 Table ... and your loved ones from HIV/AIDS. The AIDS Memorial Quilt In 1987, a total of 1, ...

  7. Research Report: HIV/AIDS

    MedlinePLUS

    ... Home » HIV/AIDS » Letter from the Director HIV/AIDS Email Facebook Twitter Letter from the Director Human immunodeficiency virus (HIV) — the virus that causes acquired immune deficiency syndrome (AIDS) — has been with us for three decades now. ...

  8. HIV/AIDS and Alcohol

    MedlinePLUS

    ... Psychiatric Disorders Other Substance Abuse HIV/AIDS HIV/AIDS Human immunodeficiency virus (HIV) targets the body’s immune ... and often leads to acquired immune deficiency syndrome (AIDS). Each year in the United States, between 55, ...

  9. HIV/AIDS Statistics Overview

    MedlinePLUS

    ... expenditure data from the Kaiser Family Foundation. International Statistics HIV disease continues to be a serious health ... impact. Other resources for international HIV and AIDS statistics: For information on international HIV infection and AIDS ...

  10. HIV sexual risk behavior following bereavement in gay men.

    PubMed

    Mayne, T J; Acree, M; Chesney, M A; Folkman, S

    1998-09-01

    The present study followed a group of 100 gay men up to 1 year before and 1 year after losing a partner to AIDS (University of California, San Francisco Coping Project). Following bereavement, participants were at increased risk for engaging in unprotected anal intercourse: at 4 to 6 months for HIV-negative men and at 8 to 12 months for HIV-positive men. Sociodemographic variables, HIV serostatus, substance use, depression, prebereavement relationship quality, and social support did not explain sexual risk-taking in this sample. However, men who engaged in unprotected anal intercourse were twice as likely to be involved in a new primary relationship as those who did not. The authors concluded that risk varies over time by HIV status and may involve engagement in new relationships. PMID:9775998

  11. Knowledge of HIV testing and attitudes towards blood donation at three blood centres in Brazil

    PubMed Central

    Miranda, C.; Moreno, E.; Bruhn, R.; Larsen, N. M.; Wright, D. J.; Oliveira, C. D. L.; Carneiro-Proietti, A. B. F.; Loureiro, P.; de Almeida-Neto, C.; Custer, B.; Sabino, E. C.; Gonçalez, T. T.

    2015-01-01

    Background Reducing risk of HIV window period transmission requires understanding of donor knowledge and attitudes related to HIV and risk factors. Study Design and Methods We conducted a survey of 7635 presenting blood donors at three Brazilian blood centres from 15 October through 20 November 2009. Participants completed a questionnaire on HIV knowledge and attitudes about blood donation. Six questions about blood testing and HIV were evaluated using maximum likelihood chi-square and logistic regression. Test seeking was classified in non-overlapping categories according to answers to one direct and two indirect questions. Results Overall, respondents were male (64%) repeat donors (67%) between 18 and 49 years old (91%). Nearly 60% believed blood centres use better HIV tests than other places; however, 42% were unaware of the HIV window period. Approximately 50% believed it was appropriate to donate to be tested for HIV, but 67% said it was not acceptable to donate with risk factors even if blood is tested. Logistic regression found that less education, Hemope-Recife blood centre, replacement, potential and self-disclosed test-seeking were associated with less HIV knowledge. Conclusion HIV knowledge related to blood safety remains low among Brazilian blood donors. A subset finds it appropriate to be tested at blood centres and may be unaware of the HIV window period. These donations may impose a significant risk to the safety of the blood supply. Decreasing test-seeking and changing beliefs about the appropriateness of individuals with behavioural risk factors donating blood could reduce the risk of transfusing an infectious unit. PMID:24313562

  12. Time of HIV Diagnosis and Engagement in Prenatal Care Impact Virologic Outcomes of Pregnant Women with HIV

    PubMed Central

    Momplaisir, Florence M.; Brady, Kathleen A.; Fekete, Thomas; Thompson, Dana R.; Diez Roux, Ana; Yehia, Baligh R.

    2015-01-01

    Background HIV suppression at parturition is beneficial for maternal, fetal and public health. To eliminate mother-to-child transmission of HIV, an understanding of missed opportunities for antiretroviral therapy (ART) use during pregnancy and HIV suppression at delivery is required. Methodology We performed a retrospective analysis of 836 mother-to-child pairs involving 656 HIV-infected women in Philadelphia, 2005-2013. Multivariable regression examined associations between patient (age, race/ethnicity, insurance status, drug use) and clinical factors such as adequacy of prenatal care measured by the Kessner index which classifies prenatal care as inadequate, intermediate, or adequate prenatal care; timing of HIV diagnosis; and the outcomes: receipt of ART during pregnancy and viral suppression at delivery. Results Overall, 25% of the sample was diagnosed with HIV during pregnancy; 39%, 38%, and 23% were adequately, intermediately, and inadequately engaged in prenatal care. Eight-five percent of mother-to-child pairs received ART during pregnancy but only 52% achieved suppression at delivery. Adjusting for patient factors, pairs diagnosed with HIV during pregnancy were less likely to receive ART (AOR 0.39, 95% CI 0.25-0.61) and achieve viral suppression (AOR 0.70, 95% CI 0.49-1.00) than those diagnosed before pregnancy. Similarly, women with inadequate prenatal care were less likely to receive ART (AOR 0.06, 95% CI 0.03-0.11) and achieve viral suppression (AOR 0.31, 95% CI 0.20-0.47) than those with adequate prenatal care. Conclusions Targeted interventions to diagnose HIV prior to pregnancy and engage HIV-infected women in prenatal care have the potential to improve HIV related outcomes in the perinatal period. PMID:26132142

  13. Dyspareunia in HIV-positive and HIV-negative middle-aged women: a cross-sectional study

    PubMed Central

    Valadares, Ana L R; Pinto-Neto, Aarão M; Gomes, Debora de C; D'Avanzo, Walquíria C; Moura, Alexandre S; Costa-Paiva, Lúcia; de Sousa, Maria Helena

    2014-01-01

    Objectives To evaluate whether dyspareunia is associated with HIV status in menopausal women and also to assess which factors are associated with dyspareunia in a group of HIV-positive menopausal women. Methods A cross-sectional study was conducted with 178 HIV-negative and 128 HIV-positive women aged 40–60?years. The Short Personal Experiences Questionnaire (SPEQ) was used to collect data. Sociodemographic, clinical, behavioural and reproductive factors were evaluated, as well as factors related to the HIV infection. Dyspareunia was defined as pain during intercourse. A bivariate analysis and Poisson multiple regression analysis were performed. Results Overall, 41.4% of the HIV-positive women reported dyspareunia compared with 34.8% of the HIV-negative women (p=0.242). In the HIV-positive women, bivariate analysis revealed an association between dyspareunia and having a steady partner (p=0.047); the woman’s partner having undergone HIV testing (p=0.020); vaginal dryness (p<0.001); muscle/joint pain (p=0.021); physical/emotional violence (p=0.049); urinary incontinence (p=0.004); and the use of lamivudine/zidovudine (p=0.048). The Poisson multiple regression analysis found an association between dyspareunia and vaginal dryness (prevalence ratio (PR)=1.96, 95% CI 1.10 to 3.50, p=0.023) and urinary incontinence (PR=1.86, 95% CI 1.06 to 3.27, p=0.031). Conclusions Dyspareunia was common in this group of HIV-positive women and was associated principally with vaginal dryness and urinary incontinence. The importance of treating dyspareunia within the context of sexual health in this group of women should be emphasised and appropriate management of this issue may reduce the likelihood of lesions on the vaginal wall, which may act as a portal of entry for other infections. PMID:25421335

  14. HIV-1 sexual transmission: early events of HIV-1 infection of human cervico-vaginal tissue in an optimized ex vivo model.

    PubMed

    Saba, E; Grivel, J-C; Vanpouille, C; Brichacek, B; Fitzgerald, W; Margolis, L; Lisco, A

    2010-05-01

    Infection and dissemination of human immunodeficiency virus (HIV)-1 through the female body after vaginal intercourse depends on the activation/differentiation status of mucosal CD4 T cells. In this study, we investigated this status and the susceptibility to HIV-1 infection of human cervico-vaginal tissue ex vivo. We found that virtually all T cells are of the effector memory phenotype with broad CC chemokine receptor 5 (CCR5) expression. As it does in vivo, human cervico-vaginal tissue ex vivo preferentially supports the productive infection of R5 HIV-1 rather than that of X4 HIV-1 in spite of the broad expression of CXC chemokine receptor 4 (CXCR4). X4 HIV-1 replicated only in the few tissues that were enriched in CD27(+)CD28(+) effector memory CD4 T cells. Productive infection of R5 HIV-1 occurred preferentially in activated CD38(+)CD4 T cells and was followed by a similar activation of HIV-1-uninfected (bystander) CD4 T cells that may amplify viral infection. These results provide new insights into the dependence of HIV-1 infection and dissemination on the activation/differentiation of cervico-vaginal lymphocytes. PMID:20147895

  15. Moral Status

    E-print Network

    Harman, Elizabeth, 1975-

    2003-01-01

    Chapters One through Three present the following view: (i) I explain moral status as follows: something has moral status just in case we have reasons not to cause harms to it simply in virtue of the badness of the harms ...

  16. Mothers Affected by HIV & AIDS: The "Kgolo Mmogo" Project

    ERIC Educational Resources Information Center

    Eloff, Irma

    2008-01-01

    In this short report, I discuss the way in which an assumption at the outset of a longitudinal study on HIV-positive mothers has been challenged three years into the study. The assumption concerns the employment status of the participants. The "Kgolo Mmogo" project is investigating the resilience factors in mothers (n = 440) and children (n = 440)…

  17. The Role of HIV Serostatus Disclosure on Sexual Risk Behaviours among People Living with HIV in Steady Partnerships in Rio de Janeiro, Brazil

    PubMed Central

    Lee, Lana; Bastos, Francisco I.; Bertoni, Neilane; Malta, Monica; Kerrigan, Deanna

    2015-01-01

    Understanding partnership dynamics is a crucial step in the process of HIV serostatus disclosure to partners. This study examines the relational characteristics associated with HIV serostatus disclosure and the role of disclosure on sexual behaviours within steady partnerships among people living with HIV (PLHIV) in Rio de Janeiro, Brazil. Study participants from 6 large public health facilities were surveyed to investigate psychosocial and relational factors associated with sexual health and well-being. Among 489 individuals in steady partnerships, 86% reported HIV serostatus disclosure to steady partners. After adjusting for demographic variables, attitudes towards disclosure, having an HIV-positive partner, living with partner, and longer relationships were significantly associated with reported disclosure using multivariable logistic regression analysis. Living with partner was negatively associated with partner concurrency. However, having an HIV-positive partner, sex under the influence of drugs or alcohol, and experiencing physical aggression by a steady partner were negatively associated with consistent condom use. Interventions supporting PLHIV to safely and voluntarily disclose to partners may be an effective prevention approach between steady partners, however addressing partner violence and substance use are important considerations for future work. PMID:25223980

  18. AIDS fatigue and university students' talk about HIV risk.

    PubMed

    Shefer, Tamara; Strebel, Anna; Jacobs, Joachim

    2012-06-01

    Drawing on a qualitative study that included 20 focus group discussions with male and female students at an urban-based university in South Africa, this article reports on perceptions, attitudes and reported behaviour with respect to HIV and AIDS and safer sex in the campus setting, with an aim to better understand how young people are responding to the challenges of HIV and AIDS in contemporary South Africa. The findings demonstrate the gap between reported HIV-prevention knowledge and safer-sex practices among a group of young and educated South Africans. Although the participants reported that students were knowledgeable about HIV and had easy access to condoms on campus, a range of factors mediated their capacity to apply this knowledge to safer-sex practices. Besides the usual set of complex social-cultural dynamics, including normative gender roles and power inequalities between men and women, socioeconomic challenges, and differences in age and status between sexual partners, the findings reveal substantial denial, stigma and HIV/AIDS 'fatigue.' The findings point to the importance of seeking creative ways to impart HIV-prevention and safer-sex messages that are not explicitly referent to HIV but link rather with broader issues concerning relationships, lifestyle and identity, and hence are responsive to the particular cultural context of university campuses. PMID:25859914

  19. Suicidal ideation, bereavement, HIV serostatus and psychosocial variables in partners of men with AIDS.

    PubMed

    Rosengard, C; Folkman, S

    1997-08-01

    This prospective 2-year study examines suicidal ideation in 86 HIV-positive and 167 HIV-negative caregiving partners of men with AIDS. One hundred and fifty-six of the caregivers became bereaved during the course of the study. The study focuses on the relationship between suicidal ideation and bereavement status (bereaved vs non-bereaved), HIV serostatus (HIV-positive vs HIV-negative), and psycho-social factors (caregiving burdens, social support, coping, and optimism). Bereavement was related to suicidal ideation, but HIV serostatus was not. High suicidal ideators were characterized by feeling burdened by caregiving, perceiving low levels of social support and subjective social integration, and the use of behavioural escape-avoidance coping. Those who reported never having suicidal ideation were characterized by higher levels of optimism. Clinical implications are discussed. PMID:9337882

  20. Reference ranges and sources of variability of CD4 counts in HIV-seronegative women and men

    Microsoft Academic Search

    M K Maini; R J Gilson; N Chavda; S Gill; A Fakoya; E J Ross; A N Phillips; I V Weller

    1996-01-01

    BACKGROUND: CD4 lymphocyte counts are used to monitor immune status in HIV disease. An understanding of the variability of CD4 counts which occurs in the absence of HIV infection is essential to their interpretation. The sources and degree of such variability have not been extensively studied. OBJECTIVES: To establish reference ranges for CD4 counts in HIV-seronegative women and heterosexual men