Human Immunodeficiency Virus Burden Research Articles

Lessons Learnt from HIV and Noncommunicable Disease Healthcare Integration in Sub-Saharan Africa.

In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described. Case studies were categorized into three models: integrating NCD care into existing HIV care (n = 8), integrating HIV care into existing NCD care (n = 2), and simultaneous implementation of HIV and NCD services (n = 4). Facilitators include staff and patient education, while barriers encompass the lack of guidelines and inadequate infrastructure. Providers, patients, and policymakers support integrated care but note several challenges. Available health economics data suggest cost-effectiveness in the long run. Concluding, NCD and HIV healthcare integration in SSA was deemed feasible with models of service integration related to the implementation context.

The Global Burden of HIV and Progress toward the 2030 UNAIDS Targets: A Comprehensive Review

The Human Immunodeficiency Virus (HIV) epidemic, since its emergence in the early 1980s, claimed millions of lives and remained a significant global public health challenge. As of 2023, approximately 38.4 million people were living with HIV, with Sub-Saharan Africa and key populations disproportionately affected. In response, the international community had set ambitious targets to end the AIDS epidemic by 2030, encapsulated in the UNAIDS 95-95-95 goals. This comprehensive review, conducted through a synthesis of current literature and global data, assessed the global burden of HIV, the progress made toward achieving these targets, and the challenges that threatened this progress. The review also explored opportunities and innovations, including advances in HIV prevention, integration of services, community-led approaches, digital health technologies, and innovative financing models. Addressing the identified challenges and leveraging these innovations were crucial to achieving the 2030 targets. The article concluded that while substantial progress has been made, a renewed commitment to equity and human rights is essential for ending the AIDS epidemic as a public health threat by 2030. Keywords: HIV epidemic, UNAIDS 2030 targets, Global health, Antiretroviral therapy (ART), Prevention and innovation.

Feasibility of reaching populations at high risk for HIV in community pharmacies

BackgroundGrowing evidence has shown feasibility for human immunodeficiency virus (HIV) prevention service integration in pharmacies, including HIV testing and screening for pre-exposure prophylaxis (PrEP). Yet, further work is needed to determine whether pharmacies can effectively reach those at increased risk of HIV transmission. ObjectiveWe aimed to describe the HIV risk profiles and willingness to obtain HIV prevention services from a sample of pharmacy clients. MethodsThis was a cross-sectional pilot study aimed to develop a culturally appropriate pharmacy-based PrEP delivery model among Black men who have sex with men. Two pharmacies were recruited from low-income, underserved communities and participants were recruited within pharmacies for screener and social and behavioral surveys. Individuals were grouped by PrEP eligibility due to sexual risk, injection drug use risk, or both, and demographic and willingness measures were compared. ResultsAmong 460 pharmacy clients, 81 (17.6%) would have been eligible for PrEP due to sex or injection drug use risk. Most were eligible due to sexual risk (58.0%), while a substantial proportion were eligible due to injection drug use (27.2%) or a combination of sexual and injection drug use risk behaviors (42.0%). Of these eligible, the median age was 31 years (interquartile range = 28.32) and most had ≥1 female (75.3%) or male (96.3%) partner in the past 6 months. There was high willingness to receive a free HIV test in a pharmacy (90.1%). Most were willing to screen for PrEP in a pharmacy (95.1%) despite these services not being available in the state where this study was performed. There were no differences in willingness to obtain pharmacy-based HIV prevention services across risk groups. ConclusionThis study shows that pharmacies in disadvantaged areas can serve a key role in preventing and decreasing the transmission of HIV by reaching populations with high HIV burden and providing HIV prevention services.

Transmission Dynamics of Adolescent HIV is Very Different from Adults: A Longitudinal Study from India.

Behavioral risk factors in adolescents make them vulnerable to human immunodeficiency virus (HIV). Although it is dissimilar to adults, adolescent HIV is less studied. This study aimed to determine various socio-demographic attributes and transmission dynamics associated with adolescent HIV in order to comment on how they differ from the overall epidemiology of HIV. A record-based, comparative study was conducted using data from adolescents (ALHIV) and adults registered in all HIV centers across the Indian state of West Bengal over four years. The socio-demographic profile and modes of HIV transmission were studied. Transmission dynamics were compared between adolescent and non-adolescent beneficiaries, as well as male and female HIV-positive adolescents. The association of adolescent HIV burden with child marriage and adolescent pregnancy rates was also tested. More than 50% of AL-HIVs were students. While heterosexuality (87.17%) was the commonest route of HIV transmission in adults, parent-to-child transmission (PTCT) (51.69%) and blood transfusions (12.86%) were major routes in AL-HIVs; also, they were significantly more prone to get infected through these routes. PTCT was significantly lower, and transmission by needle syringes was higher in male adolescents than in their female counterparts. Districts with a higher prevalence of child marriage and adolescent pregnancy had a significantly higher burden of AL-HIV. The transmission dynamics of adolescent HIV are largely different from those of adults, with PTCT and sociocultural issues playing significant roles. It is, therefore, essential to design targeted interventions to tackle the unique challenges of HIV in adolescents for more effective and comprehensive campaigns against the pandemic.

Factors influencing adherence to antiretroviral therapy among young adults in Limpopo province.

South Africa is among the countries with the greatest burden of human immunodeficiency virus (HIV) in the world. The introduction of antiretroviral therapy (ART) has made HIV a manageable chronic health condition with a return to normal life expectancy. Adherence to ART is a prerequisite to realising these benefits. A qualitative study was conducted using individual semi-structured interviews to understand factors influencing adherence to ART among young adults. The study was conducted at three busy primary care clinics around Mankweng Hospital. Participants aged 18-35 years who had been on ART for more than a year were purposefully selected. Open-ended questions were used to explore factors that influence ART. Recorded interviews were transcribed verbatim and translated. The coded transcripts were thematically analysed. Eight major themes were identified to influence ART adherence among young adults: medication-related factors, healthcare system factors, attitudes of healthcare workers, economic factors, disclosure, acceptance, mobile phone reminders and family support. Adherence to ART is a major problem in our communities, and people living with HIV are still finding it challenging to optimally adhere to their ART medication because of the identified factors that influence ART adherence. Family support is a significant factor that was identified to positively influence ART as it leads to disclosure and acceptance of HIV-positive status, better emotional well-being and subsequently improved ART adherence.Contribution:This study underscores the importance of a family-oriented, patient-centred care approach in managing HIV and ART adherence.

Prevalence of extrapulmonary tuberculosis among people living with HIV/AIDS in Southeast Asia: a systematic review and meta-analysis.

The dual burden of human immunodeficiency virus (HIV) and tuberculosis (TB) impacts people living with HIV (PLHIV) coinfected with TB. Although some primary studies have been reported on the burden of extrapulmonary TB (EPTB) among PLHIV in Southeast Asia (SEA), there is no systematic review or meta-analysis that attempts to summarize the available literature. Therefore, this review aims to summarize the prevalence of EPTB/HIV co-infection in SEA using meta-analysis based on a systematic review of published articles and gray literature. A comprehensive 3-stage methodology was adopted to conduct a thorough literature search, encompassing both published and gray literature. Data sources such as MEDLINE and Web of Science were searched for articles reporting data from SEA between 2010 and 2022. Findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. The Joanna Briggs Institute prevalence studies checklist was employed for critical appraisal. The meta-analysis of proportions was carried out using the "metaprop" function in R software (version 4.3.1) to generate pooled estimates. Effects were summarized using random-effects models, and sources of heterogeneity were explored through I2, utilizing subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and pertinent statistical tests, including Egger's regression analysis. A total of 474 studies were initially identified in our search. After the removal of duplicates and a meticulous screening process of titles and abstracts, along with the application of exclusion criteria, 22 studies comprising 34,740 PLHIV were included in the final meta-analysis. The summary effect or pooled proportion estimate of EPTB among PLHIV was found to be 18% [95% confidence interval (CI): 15,22; heterogeneity: τ2=0.0056; degrees of freedom=21, p<0.001; I2=99%]. Our study showed that there was a diverse range of prevalence of EPTB among PLHIV in the SEA region, which ranged from 5% (95% CI: 4.0-7.0) in South Korea to 48% (95% CI: 41.0-55.0) in Thailand. Our systematic review and meta-analysis indicate a notably higher prevalence of EPTB among PLHIV. Early diagnosis of EPTB is crucial to mitigating associated morbidity and mortality. Therefore, a thorough medical history and comprehensive physical examination are imperative in assessing PLHIV, aiming to promptly identify and rule out EPTB. After a diligent evaluation, appropriate diagnostic measures and tailored management strategies should be promptly instituted.

Trends in the burden and determinants of HIV in the Asia-Pacific region (1990-2019): An age-period-cohort analysis of the 2019 Global Burden of Disease Study.

Although the burden of the human immunodeficiency virus (HIV) in the Asia-Pacific region is increasingly severe, comprehensive evidence of the burden of HIV is scarce. We aimed to report the burden of HIV in people aged 15-79 years from 1990 to 2019 using data from the Global Burden of Disease Study (GBD) 2019. We analyzed rates of age-standardized disability-adjusted life years (ASDR), age-standardized mortality (ASMR), and age-standardized incidence (ASIR) in our age-period-cohort analysis by sociodemographic index (SDI). According to HIV reports in 2019 from 29 countries in the Asia-Pacific region, the low SDI group in Papua New Guinea had the highest ASDR, ASMR, and ASIR. From 1990 to 2019, the ASDR, ASIR, and ASMR of persons with acquired immune deficiency syndrome (AIDS) increased in 21 (72%) of the 29 countries in the Asia-Pacific region. During the same period, the disability-adjusted life years (DALYs) of AIDS patients in the low SDI group in the region grew the fastest, particularly in Nepal. The incidence of HIV among individuals aged 20-30 years in the low-middle SDI group was higher than that of those in the other age groups. In 2019, unsafe sex was the main cause of HIV-related ASDR in the region's 29 countries, followed by drug use. The severity of the burden of HIV/AIDS in the Asia-Pacific region is increasing, especially among low SDI groups. Specific public health policies should be formulated based on the socioeconomic development level of each country to alleviate the burden of HIV/AIDS.

The Global Impact of HIV: A Comprehensive Review

The Human Immunodeficiency Virus (HIV) has been a significant global health challenge since its discovery in the 1980s, leading to the devastating Acquired Immunodeficiency Syndrome (AIDS). Despite advancements in medical research and antiretroviral therapies, HIV/AIDS remains a pressing public health concern, particularly in resource-limited regions. This comprehensive review provides updated data and scientific insights on the global impact of HIV, shedding light on the current state of the epidemic and the challenges faced in combating it. The review highlights the resurgence of HIV cases in Eastern European countries, such as Ukraine, Estonia, and Latvia, with surprising increases in AIDS cases observed in East Asian countries. However, it is in sub-Saharan Africa that the burden of HIV remains most acute, with high prevalence rates and a significant number of affected individuals. The region requires continued attention and resources to address the complex challenges associated with HIV prevention, treatment, and care. The article delves into the classification and structure of HIV, emphasizing its belonging to the Lentivirinae subfamily, specifically HIV-1 and HIV-2. HIV-1, the predominant viral species globally, exhibits a distinct clinical latency phase, contributing to its persistence and infectivity. The high replication rate and genetic variability of HIV, driven by the error-prone reverse transcriptase enzyme, result in the emergence of diverse subtypes and strains across different regions. Furthermore, the article explores the structural components of HIV-1, including the envelope glycoproteins (gp120 and gp41), matrix protein, and various enzymes critical to the viral life cycle. Despite progress in medical research and access to antiretroviral therapies, HIV/AIDS continues to present challenges such as limited resources, drug resistance, and regional disparities.

Determinants of antiretroviral therapy adherence among transgender women in South Africa.

Transgender women bear a huge burden of human immunodeficiency virus (HIV) in South Africa. However, they are not fully engaged in healthcare across the HIV continuum of care. In addition, transgender women face multiple facets of stigma and discrimination as well as socio-economic inequalities, which all have a negative impact on antiretroviral therapy (ART) adherence. The study aimed at exploring and describing the experiences of ART adherence of transgender women living with HIV in the Buffalo City Metro Municipality. The study employed an interpretative phenomenological analysis (IPA) design. Twelve participants were enrolled using a snowballing sampling technique. Data were collected using semi-structured interviews and analysed using an IPA framework. While exploring determinants to ART adherence among transgender women living with HIV in Buffalo City Metro, two superordinate themes emerged: enablers to ART adherence and psychosocial factors promoting adherence. The study found that factors such as differentiated ART service delivery, ARV medicines-related factors, motivators for taking treatment and support systems facilitated ART adherence. Emerging from this study is the need to scale up differentiated, person-centred ART service deliveries that will enhance access and adherence to treatment for transgender women.Contribution:This study provides unique insights on factors enhancing ART adherence among transgender women. There is a paucity of literature on access to HIV care services for key and vulnerable populations, and these findings will be shared in the country and in the region.

Spatial distribution and determinants of HIV high burden in the Southern African sub-region.

Spatial analysis at different levels can help understand spatial variation of human immunodeficiency virus (HIV) infection, disease drivers, and targeted interventions. Combining spatial analysis and the evaluation of the determinants of the HIV burden in Southern African countries is essential for a better understanding of the disease dynamics in high-burden settings. The study countries were selected based on the availability of demographic and health surveys (DHS) and corresponding geographic coordinates. We used multivariable regression to evaluate the determinants of HIV burden and assessed the presence and nature of HIV spatial autocorrelation in six Southern African countries. The overall prevalence of HIV for each country varied between 11.3% in Zambia and 22.4% in South Africa. The HIV prevalence rate was higher among female respondents in all six countries. There were reductions in prevalence estimates in most countries yearly from 2011 to 2020. The hotspot cluster findings show that the major cities in each country are the key sites of high HIV burden. Compared with female respondents, the odds of being HIV positive were lesser among the male respondents. The probability of HIV infection was higher among those who had sexually transmitted infections (STI) in the last 12 months, divorced and widowed individuals, and women aged 25 years and older. Our research findings show that analysis of survey data could provide reasonable estimates of the wide-ranging spatial structure of the HIV epidemic in Southern African countries. Key determinants such as individuals who are divorced, middle-aged women, and people who recently treated STIs, should be the focus of HIV prevention and control interventions. The spatial distribution of high-burden areas for HIV in the selected countries was more pronounced in the major cities. Interventions should also be focused on locations identified as hotspot clusters.

Safe sex negotiation and HIV risk reduction among women: A cross-sectional analysis of Burkina Faso 2021 Demographic and Health Survey.

Women are biologically more susceptible to the Human Immunodeficiency Virus (HIV) and other sexually transmitted Infections (STIs) because receptive sex is riskier than insertive. Despite condom use being the staple preventive method for HIV infection (over 80% efficacy), in Sub-Saharan African countries like Burkina Faso, a high burden of HIV and the unmet need for condom use coexist. Moreover, even though women in SSA are disproportionately HIV positive, they are reportedly less capable of negotiating condom use for HIV risk reduction. Thus, using the Health Believe Model (HBM), this study explored the factors that influence condom use among women within the context of HIV prevention, with a key interest in condom use negotiation. Using the women's dataset of the 2021 Burkina Faso Demographic and Health Survey and applying logistic regression models, this study examined the factors associated with condom use for HIV risk reduction. Women who had confidence to negotiate condom use with their partners (OR = 1.57, P<0.001, 95%CI: 1.29, 1.91), those with secondary education (OR = 1.38, P<0.05, 95%CI: 1.07 1.77), from richest households (OR = 1.64, P<0.05, 95%CI: 1.08, 2.47), the employed (OR = 1.23, P<0.05, 95%CI: 1.02, 1.49), women with knowledge of sexually transmitted infections (OR = 1.58, P<0.001, 95%CI: 1.26, 1.97), those who have ever been tested for HIV (OR = 1.85, P<0.001, 95%CI: 1.52 2.24), as well as those who knew that a healthy-looking person can have HIV (OR = 2.64, P<0.001, 95%CI: 2.15, 3.24) were all significantly more likely to practice condom use for HIV risk reduction. Also, religion and geographical location of participants significantly predicted condom use for HIV risk reduction in the study context. The ability to negotiate condom use, knowledge of HIV and STIs, the socioeconomic status of women, as well as their geographical location, influence their practice of safer sex for HIV risk reduction in Burkina Faso.

Trends in Sexually Transmitted Infection Cases in HIV Populations in Indonesia: Need Firm Roadmaps and Actions

Human immunodeficiency virus (HIV) infection and sexually transmitted infections (STIs) remain a public health problem and extend to social, economic, and cultural issues. HIV cases in the Southeast Asia region account for 10% of the total global HIV burden. In Indonesia, there are five provinces with the highest number of HIV cases as of December 2021, including DKI Jakarta (73,442), East Java (68,112), West Java (49,435), Central Java (42,012), and Papua (40,277). In Indonesia in 2021, the number of people living with HIV (ODHIV) reported was 36,902 and in 2022 up to the third quarter (July - September 2022) there were 34,213 people. New HIV infections in Indonesia continue to decline, in line with the global decline in new HIV infections. However, this decline has not been as large as expected.

Sociodemographic predictors of beliefs about getting HIV infection by witchcraft or supernatural means: a population-based study of 15335 Senegalese women.

To provide more insights about beliefs of witchcraft and supernatural means as causes of human immunodeficiency virus (HIV) among women in Senegal. We included eligible women from the demographic and health survey conducted in Senegal during the year 2017. We included 15335 women, of those 620 (4%) thought that they can get HIV through witchcraft or supernatural means. After the adjustment of all available covariates, old age, receiving primary or secondary education, higher wealth index, more frequency of listening to radio, watching television for less than once a week and reading newspaper or magazine for at least once a week were significantly associated with a reduction in the witchcraft and supernatural means beliefs (p < 0.05). Moreover, rural residence was associated with an increase in the wrong HIV beliefs (p < 0.05). We demonstrated many predictors of the wrong beliefs about getting HIV infection by witchcraft or supernatural means in the Senegalese women. Policymakers should initiate health educational programs in parallel with increasing the socioeconomic status to limit the HIV transmission. In addition, continuous monitoring of the HIV knowledge in the endemic countries is crucial to decrease HIV burden.

Hematological Complications of Human Immunodeficiency Virus (HIV) Infection: An Update From an HIV-Endemic Setting.

Medical professionals, particularly in regions with a high burden of human immunodeficiency virus (HIV), should be alert to the hematological complications of HIV, which may include cytopenias, malignancy, and coagulation disturbances. Patients may present with these conditions as the first manifestation of HIV infection. Hematological abnormalities are often multifactorial with opportunistic infections, drugs, malignancy, and HIV infection itself contributing to the clinical presentation, and the diagnosis should consider all these factors. Life-threatening hematological complications requiring urgent diagnosis and management include thrombotic thrombocytopenic purpura, superior mediastinal syndrome, spinal cord compression, and tumor lysis syndrome due to aggressive lymphoma. Antiretroviral therapy is the therapeutic backbone, including for patients with advanced HIV, in addition to specific therapy for the complication. This article reviews the impact of HIV on the hematological system and provides a clinical and diagnostic approach, including the role of a bone marrow biopsy, focusing on perspectives from sub-Saharan Africa.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review.

Targeted interventions for key populations remain critical for realisation of epidemic control for human immunodeficiency virus (HIV) infection because of the causal relationship between HIV infection in the general population and among key population groups. To consolidate evidence on the fast-track interventions towards achieving HIV epidemic control among key populations. A rapid scoping review was conducted using the methodological framework by Arksey and O' Malley. The Population, Intervention, Context and Outcome (PICO) framework was used to identify relevant studies using key words with Boolean operators in electronic data bases, namely CINHAL, Web of Science, Psych Info and Sabinet. Studies were extracted using a modified data extraction tool, and results were presented narratively. A total of 19 articles were included in this review. Most articles were primary studies (n = 17), while another involved the review of existing literature and policies (n = 2) and routinely collected data (n = 1). Most studies were conducted in the United States of America (n = 6), while another were conducted in China, Kenya, Botswana, South Africa and Mozambique. All studies revealed findings on tested interventions to achieve HIV epidemic control among key populations. Effective interventions for HIV epidemic control were stand-alone behavioural preventive interventions, stand-alone biomedical preventive strategies and combination prevention approaches. Furthermore, the findings suggest that effective activities to achieve HIV epidemic control among key populations should be centred around prevention.Contribution: The findings of this study have policy and practice implications for high HIV burden settings such as South Africa in terms of interventions to facilitate realisation of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets, thereby contributing to HIV epidemic control.

Outcome and barriers to cervical cancer screening amongst human immunodeficiency virus-positive women attending Aminu Kano Teaching Hospital, Kano State, Nigeria

Sub-Saharan Africa carries the overwhelming share of the global burden of human immunodeficiency virus (HIV) infection and of HIV-associated cervical cancer. Screening is an effective strategy for the prevention, early diagnosis and prompt management of cervical precancerous lesions among HIV-positive women. This study assessed the outcome and barriers to cervical cancer screening among HIV-positive women attending Aminu Kano Teaching Hospital, Kano. Using a cross sectional study design, a pro forma was used to collect data and screen 740 HIV-positive women. Screening was done using visual inspection with acetic acid and Lugol’s iodine and the data were analysed using SPSS version 24.0. The age of the patients ranged from 25 to 49 years with a mean age of 30.7 ± 2.4 years. Majority (n=698; 94.3%) were  30 years and married (n=592; 80.0%). Almost half (n=362; 48.9%) had secondary level of education and many (n=520; 70.3%) were unemployed. A few (n=42; 5.7%) had positive results on visual inspection with acetic acid and a lesser proportion (n=26; 3.5%) had positive screening results on visual inspection with Lugol’s iodine. Lack of awareness of screening services for cervical cancer was found to be a barrier to cervical cancer screening and treatment among two-thirds (n=565; 76.4%) of the patients while a substantial proportion (n=592; 80.0%) reported that their personal belief which was strengthened by their religion prevented them from accessing cervical cancer screening services. Also, two-thirds (n=493; 66.6%) agreed that their culture which considers cervical screening a taboo was a barrier to screening. There is a need for targeted and enhanced education with counselling to optimize the uptake of screening for cervical cancer among HIV-positive women in HIV treatment centers. The generated data can guide in the provision of evidence-based policy and decision-making.

Health Screening Strategies for Artisanal and Small-Scale Miners for Tuberculosis, Human Immunodeficiency Virus and Silicosis: A Case of the USAID-Supported Kunda Nqob'iTB Project in Zimbabwe.

Artisanal and small-scale mining is characterized by excessive exposure to physical, chemical, ergonomic, psychosocial and biological hazards. There is a high burden of tuberculosis (TB), human immunodeficiency virus (HIV) infections and silicosis among artisanal and small-scale miners (ASMs). The aim of this project report is to describe lessons learned from strategies implemented to reach ASMs with screening services for TB, HIV and silicosis in Zimbabwe through the Kunda-Nqob'i TB (KNTB) project supported by the United States Agency for International Development (USAID). The intervention package for screening ASMs for TB, HIV and silicosis included service provision through two occupational health clinics at two provincial hospitals and a mobile workplace-based screening (WBS) facility at the mining sites. From 1 October 2020 to 30 September 2023, 10,668 ASMs were screened, with a high number of cases of silicosis (21%) and TB (7.4%). There was a high burden of HIV (30%) in ASMs attending the occupational health clinics. The two occupational health clinics screened 3453 ASMs, while the mobile WBS activities screened 7215 ASMs during the period. A total of 370 healthcare workers (doctors/clinical officers, nurses, environmental health technicians and district tuberculosis and Leprosy control officers) were trained on TB and the fundamental diagnostic principles of silicosis. The KNTB project has been successful in reaching out to many ASMs operating in remote and hard-to-reach mining areas. The KNTB project has brought to light the positive health-seeking behavior of ASMs operating in remote areas. The project has brought to the fore the effectiveness of multi-stakeholder engagement and collaboration in reaching out to ASMs in remote areas with health screening services. There is a high burden of TB, HIV and silicosis in ASMs. Screening for TB, HIV and silicosis using workplace-based screening and occupational health clinics is an effective strategy and should be rolled out to all areas with high artisanal and small-scale mining activity.

Factors Associated With Precancerous Cervical Lesions in Human Immunodeficiency Virus-Infected Women: A Cross-Sectional Survey in Togo.

The burden of human immunodeficiency virus (HIV) in cervical cancer remains a major public health challenge in developing countries, like Togo. Precancerous lesions include all cellular abnormalities that have malignant potential that can develop into cancer. The objective of this study was to determine the prevalence and factors associated with precancerous cervical lesions in HIV-infected women in our context. A cross-sectional descriptive study was carried out from November 31, 2022, to January 31, 2023, in an HIV care center in Lomé (Non-Governmental Organization Espoir Vie Togo [NGO EVT] Grand-Lomé-Togo). A total of 271 women were included with a mean age of 47.0 years and a standard deviation of 10.0 years, among whom 20.7% do not have any scholar education. Only 6.7% of them had previously performed cervical smear examinations. The prevalence of precancerous cervical lesions observed in people living with human immunodeficiency virus (PLHIV) was 11.4% with a 95% confidence interval (CI) of 5.0 to 15.4. Cytological abnormalities were marked by low-grade squamous intraepithelial lesion (LSIL) (5.1%), followed by the presence of atypical squamous cells of undetermined significance (ASCUS) (3.5%). A statistically significant association was found between parity and the presence of precancerous lesions (P = .014). In this study, more than 1 out of 10 women living with HIV had precancerous cervical lesions, and parity was the factor associated. The implementation of a systematic screening program for precancerous cervical lesions and human papillomavirus (HPV) infection integrated into HIV care is necessary for early treatment.

A Mixed Method Assessment of the Fertility Preferences of Clients Using Antiretroviral Therapy in Ilorin, Nigeria - A Descriptive Cross-sectional Survey.

The burden of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome in Nigeria remains one of the highest in the world, with the country having the highest number of people living with the infection in the West African subregion. Recent estimates put the HIV prevalence rate in Nigeria at 1.9%. In the early years of the HIV epidemic, attention on the reproductive preferences of people living with HIV was not really considered because of the high risk of mortality and few options to reduce mother-to-child transmission. A descriptive cross-sectional study was carried out in November 2018 using quantitative and qualitative methods. A total of 400 participants were recruited for the quantitative part of the study and 10 respondents for each of the focus group discussion (FGD) sessions. Data were collected using an interviewer-administered questionnaire and a FGD guide. Frequencies and percentages were determined using descriptive analysis. Univariate analysis was used to explore the association between the outcome variables and the independent variables. The independent variables which showed a significant association in the univariate analysis were further subjected to multivariate analysis. The desire to have children since their HIV diagnosis had been mooted by 255 (63.8%) respondents in the past and 64.5% of the respondents admitted to wanting to have children at some point in the future. More than half of the respondents (61%) currently wanted more children while a significant proportion of the respondents who wanted children (68.4%) wanted more than one child. The study observed that the desire to have children had largely not been affected by the HIV infection as respondents still had a fairly strong desire to continue to have more children in spite of the risks of transmission involved. The study recommended that government and HIV policymakers need to ensure that HIV prevention messages and programmes adopt cultural and socio-economic considerations when designing and planning HIV prevention programmes.

HIV Infection and Associated Factors Among Out-of-School MSM Aged 16-24 Years - 6 Cities and Tianjin Municipality, China, 2022-2023.

Approximately 80% of newly diagnosed human immunodeficiency virus (HIV) cases among individuals aged 15-24 years in China are attributed to out-of-school youth. This study presents findings on HIV prevalence and comprehensive insights into HIV service utilization, risky behaviors, and prevention knowledge among young out-of-school men who have sex with men (MSM) aged 16-24 years in China. This population exhibits a disproportionately high burden of HIV, with only 51.6% of HIV cases previously diagnosed. HIV services should be expanded to include these key populations. Tailored interventions are needed to remove barriers to regular HIV services faced by young key populations.