Early Detection Of HIV Research Articles

Exploring the Acceptability of HIV Testing in the UK Dental Setting: A Qualitative Study.

HIV point of care testing (POCT) is a common approach to expanding testing into non-specialised settings. Dental services have untapped potential to screen for health conditions including HIV. However, the perspectives of UK dental patients, dental professionals, and people with HIV are unknown. Ten focus groups were undertaken with dental patients, professionals, and people with HIV. The Framework method was used to analyse the qualitative data. Six themes were generated from the focus group data. The themes explored perceptions of HIV, the purpose, appropriateness, and acceptability of HIV testing in dental settings, and new processes that would need to be established in order to successfully implement point of care HIV testing in UK dental settings. Training needs were identified including communication skills and updates to current knowledge about HIV. HIV testing in dental settings is generally acceptable to dental patients, dental professionals, and PWH. However, of concern were logistical challenges and the risk of patients surprised at being offered an HIV test during a visit to the dentist. Nonetheless, the public health benefits of the intervention were well understood, i.e., early detection of HIV and initiation of treatment to improve health outcomes. Dental teams were able to generate novel solutions that could help to overcome contextual and logistical challenges to implementing HIV testing in dental settings.

Progress in Early Detection of HIV in Tajikistan.

HIV early detection (CD4 counts ≥350 cells/μL) is correlated with higher life expectancy among people living with HIV (PLHIV). Several factors, including physical, cultural, structural, and financial barriers, may limit early detection of HIV. This is a first-of-its-kind study on population-level differences in early detection of HIV across time within Tajikistan and any country in the Central Asia region. Utilizing the Tajikistan Ministry of Health's national HIV data (N = 10,700) spanning 2010 to 2023, we developed median regression models with the median CD4 cell count as the outcome and with the following predictors: time (years), region, age, gender, and area (urban/rural status). Individuals younger than 19 years old were detected early for HIV, whereas those older than 39 years were detected late. Females were detected earlier compared to their male counterparts regardless of region of residence. Rural populations were detected earlier in most years compared to their urban counterparts. The COVID-19 pandemic accelerated HIV early detection in 2021 but most regions have returned to near pre-pandemic levels of detection in 2022 and 2023. There were differences identified among different demographic and geographic groups which warrant further attention.

Factors Associated with Utilization Triple Elimination Examination by Pregnant Women In Indonesia: Scoping Review

Introduction: The prevalence of HIV, Syphilis and Hepatitis B infections among pregnant women in Indonesia has reached 0.3%, 1.7% and 2.5%, respectively. The risk of transmission from mother to child respectively 20%-45%, 69-80% and more than 90%. Transmission of these three diseases from pregnant women to babies during pregnancy, childbirth and breastfeeding cause disabilities in children and even death. The government stipulates that all pregnant women are required to HIV/AIDS, Syphilis and Hepatitis B screening (Triple elimination examination) at integrated antenatal services. The target set is that early detection of HIV, syphilis and hepatitis B in pregnant women must reach 100% through examinations at First Level Health Facilities and Referral Health Facilities by 2022. However, in 2021 the achievements were only 50.8%, 16.4% and 60.3% for HIV, syphilis and hepatitis B. Objective: This study aims to determine the factors associated with the utilization of triple elimination examinations by pregnant women. Method: This study uses a scoping review method. Article collected from online databases including scopus, science direct, proquest, EBSCO, PupMed and Google Scholar with keywords "Related" AND "Pregnant Women" OR "Pregnancy" AND "Triple Elimination Examination". Article selection conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Result: The results showed 8 articles that met the inclusion criteria. The research showed factors that associated with the utilization of the triple elimination examination are sources of information, the role of health workers, use of classes for pregnant women, family support, and age of pregnant women. Conclusion: This study concluded that the utilization of triple elimination examinations by pregnant women associated with external factors around pregnant women.

259 Eighty-six-fold increase in HIV diagnosis with “Opt-out” Screening: Frontlines of Communities in the U.S. (FOCUS) Program in the UHealth Tower (UHT) Emergency Department (ED) - path to eliminate HIV transmission in the U.S.

OBJECTIVES/GOALS: Early HIV detection and treatment are key to reducing patient morbidity and mortality, yet 40% of people living with HIV do not know their status. “OPT-OUT” approaches to hiv testing, in which patients #_MSOCOM_1 are informed that an HIV test will be conducted unless they decline, are being increasingly recognized as a means to increase HIV testing. METHODS/STUDY POPULATION: the ed at Uhealth tower (UHT) implemented #_MSOCOM_1 the focus program that integrates routine “opt-out” HIV screening into the existing electronic medical record workflow to increase the number of individuals who know their HIV status, optimize linkage to care, and reduce stigma associated with HIV. the emr facilitates the opt-out screening model and maximizes the use of information systems to seamlessly integrate screening as a routine practice in a high-volume ed. our partnership with the florida department of health in miami dade (FDOH) allows uht to verify whether cases are new or known /out-of-care, link individuals immediately to care, and increase efficiencies with real-time data reconciliation. RESULTS/ANTICIPATED RESULTS: since implementation#_MSOCOM_1, from October 2019 - Dec 2022, the UHT ED screened 34, 314 eligible patients for HIV, of which, 17, 850 were tested. 228 people with hiv were identified; 37 were newly diagnosed. of HIV+ Diagnoses, 54.67% of HIV+ individuals were black and 36.89% HISPANIC. HIV+ individuals were referred to the doh with linkage to care at 81%. comparatively, before the onset of focus, the ED ordered 38 HIV tests, with one positive from Oct 2018 TO Sept. 2019. DISCUSSION/SIGNIFICANCE: UHT ED’s focus “OPT-OUT” HIV testing is a valuable conduit for HIV detection, prevention, and care. OPT-OUT screening removes the stigma associated with hiv testing, fosters earlier diagnoses and treatment, reduces health disparities, and decreases the risk of transmission.

Nutritional status and treatment outcomes of tuberculosis in Mizan Tepi University Teaching Hospital, a five -year retrospective study.

Public health problems related to tuberculosis (TB) remain substantial globally, particularly in resource-limited countries. Determining TB treatment outcomes and identifying contributing factors are the basic components of the TB control strategy. In Ethiopia, different studies have been done on treatment outcomes and multiple associated factors, and there is also a little information on the effect of nutritional status on TB treatment outcomes. So there is a need for comprehensive research that examines the combined effects of multiple factors along with nutritional status. A five-year institution-based retrospective cross-sectional study was conducted at Mizan Tepi University Teaching Hospital, South West Ethiopia. This study included all tuberculosis patients who were documented in the TB registration and had known treatment outcomes at the treatment facility between January 1, 2016, and December 31, 2020. Data was collected through a pretested structured data extraction checklist. Data were entered into Epidata version 3.1 and analyzed through SPSS version 22. Multiple logistic regression was employed to assess the association between dependent and independent variables. A p-value of less than 0.05 was considered statistically significant. Of the total 625 TB patients, 283 (45.3%), 175 (28%), and 167 (26.7%) had smear-positive, extra-pulmonary, and smear-negative tuberculosis, respectively. The majority of study participants had normal weight (62.2%), were in the age group of 15-44 (67.4%), were new cases (73.8%), and were from urban areas (69.4%). About 32.2% of cases were HIV-positive. The overall unsuccessful treatment rate was 25%. From the total unsuccessful treatment rates, the highest proportion was a death rate of 90 (14.4%), followed by a treatment failure of 56 (9%). Being female (AOR = 1.7, 95% CI: 1.2-2.5), HIV positive (AOR = 2.7, 95% CI: 1.9-4.1), undernutrition (BMI<18.5kg/m2) (AOR = 1.9, 95% CI: 1.3-2.9), and smear-negative pulmonary TB (AOR = 1.6, 95% CI: 1-2.5) were independent predictors of unsuccessful treatment outcomes. The treatment success rate in the study area is very poor. Poor treatment outcomes were associated with undernutrition, female gender, HIV positivity and smear-negative pulmonary TB. So, continuous and serious supervision and monitoring of directly observed treatment short course (DOTS) program accomplishment, early detection of HIV and TB, prompt anti TB and antiretroviral treatment initiation and adherence, enhanced nutritional assessment, and counseling services need to be strengthened to improve treatment outcomes.

Missed opportunities for integrated testing: An Evaluation of the implementation of TB and HIV EID Testing on the GeneXpert platform in Lesotho

Introduction: Integrated testing of TB and HIV can improve health outcomes and save costs. The GeneXpert (GX) instrument, a multi-disease testing platform, can allow for simultaneous HIV and TB testing. However, utilization of the platform for integrated testing remains suboptimal, and there are operational barriers to implementing integrated TB and HIV testing.&#x0D; Methods: We evaluated the implementation of TB and HIV testing on the GX instrument for early infant detection (EID) of HIV and tuberculosis (TB) testing in thirteen health facilities in Lesotho. The data collection process used a survey questionnaire, semi-structured interviews, and a review of records at each health facility. Data was collected for the period 2017 and 2019.&#x0D; Results: All thirteen health facilities had at least one GX instrument for TB or EID testing. In 2017, the average utilization rate for the GX instrument for TB and EID testing was 63% and 24%, while in 2019, the average utilization rate was 61% for TB testing and 27% for EID. However, none of the health facilities included testing for TB and HIV on the same GX instrument simultaneously. In general, utilization rates were sufficiently low that all the HIV and TB tests undertaken in 2017 and 2019 could have been performed using only the instruments currently dedicated to TB testing. All except for three sites (Scott, Motebang and Maluti) where the testing rates were high. &#x0D; Conclusion and Policy Implications: Much progress has been made in integrating TB and HIV activities in Africa. However, there is a missed opportunity for the integration of testing for TB and HIV on the GX instrument, which could save costs.&#x0D; This evaluation highlights areas that need more focus and more detailed diagnostic network optimization exercises to improve service delivery and allocate stocks, staff, equipment, and training. Better coordination of donor support or increased flexibility in reporting of use will be important to maximize the use of resources, where integration may be more effective than purchasing new equipment. Monitoring and evaluation should be a routine part of the implementation and should be budgeted and demanded by policymakers and donors. Health facilities may require additional resources and technical support to improve data collection, analysis, and dissemination.&#x0D; In conclusion, areas highlighted in this evaluation merit further exploration, such as the need to understand integrated testing models, including what works, why, and for which target groups. This will allow for effective targeted interventions to improve testing coverage across several diseases especially taking advantage of the multi-disease testing platforms.&#x0D; &#x0D;

Sensitive Blood-Based Detection of HIV-1 and Mycobacterium tuberculosis Peptides for Disease Diagnosis by Immuno-Affinity Liquid Chromatography-Tandem Mass Spectrometry: A Method Development and Proof-of-Concept Study.

Novel approaches that allow early diagnosis and treatment monitoring of both human immunodeficiency virus-1 (HIV-1) and tuberculosis disease (TB) are essential to improve patient outcomes. We developed and validated an immuno-affinity liquid chromatography-tandem mass spectrometry (ILM) assay that simultaneously quantifies single peptides derived from HIV-1 p24 and Mycobacterium tuberculosis (Mtb) 10-kDa culture filtrate protein (CFP10) in trypsin-digested serum derived from cryopreserved serum archives of cohorts of adults and children with/without HIV and TB. ILM p24 and CFP10 results demonstrated good intra-laboratory precision and accuracy, with recovery values of 96.7% to 104.6% and 88.2% to 111.0%, total within-laboratory precision (CV) values of 5.68% to 13.25% and 10.36% to 14.92%, and good linearity (r2 > 0.99) from 1.0 to 256.0 pmol/L and 0.016 to 16.000 pmol/L, respectively. In cohorts of adults (n = 34) and children (n = 17) with HIV and/or TB, ILM detected p24 and CFP10 demonstrated 85.7% to 88.9% and 88.9% to 100.0% diagnostic sensitivity for HIV-1 and TB, with 100% specificity for both, and detected HIV-1 infection earlier than 3 commercial p24 antigen/antibody immunoassays. Finally, p24 and CFP10 values measured in longitudinal serum samples from children with HIV-1 and TB distinguished individuals who responded to TB treatment from those who failed to respond or were untreated, and who developed TB immune reconstitution inflammatory syndrome. Simultaneous ILM evaluation of p24 and CFP10 results may allow for early TB and HIV detection and provide valuable information on treatment response to facilitate integration of TB and HIV diagnosis and management.

Implementation Triple Elimination Screening to Midwifes Knowledge About Risk Factors, Modes of Transmission and Impact of HIV, Syphilis, and Hepatitis B Type

Triple Elimination program that aims to early detection of HIV, syphilis and Hepatitis B infection in pregnant women and is very important for all pregnant women because it can save the lives of mothers and children. This type of research is observational research, namely by distributing questionnaires to determine the effect of the implementation of triple elimination on the knowledge of midwives in Palembang City. The results showed that of the 50 respondents who were old, around 19 people with a percentage (38.0%). While the young ones only reached 31 people (62.0%). The results showed that of the 50 respondents, the majority had a D3 education with a total of 36 people or (72.0%). While in S1 education reached 7 people (14.0%). And 7 people or (14.0%) professional education. The results of the analysis using the Chi Squre test, obtained a p-value of 0.000 on midwife knowledge, at age obtained a p-value of 0.285 and at education obtained a p-value of 0.0.019, which means greater than&gt; 0.05, it can be interpreted that H0 is accepted and Ha is rejected. The conclusion is that there is a significant relationship between age, education and midwife knowledge in implementing triple elimination

HIV infection and engagement in the care continuum among migrants and refugees from Venezuela in Colombia: a cross-sectional, biobehavioural survey

Venezuela has experienced substantial human displacement since 2015. To inform HIV programmes and treatment distribution, we aimed to estimate HIV prevalence and associated indicators among migrants and refugees from Venezuela residing in Colombia, the largest receiving country. We conducted a biobehavioural, cross-sectional survey using respondent-driven sampling among Venezuelan people aged 18 years or older who had arrived in Colombia since 2015 and resided in four cities (ie, Bogotá, Soacha, Soledad, and Barranquilla). Participants completed sociobehavioural questionnaires and rapid HIV and syphilis screening with laboratory-based confirmatory testing, CD4 cell counts, and viral load quantification. Policies related to migration status affect access to insurance and HIV services in Colombia, as in many receiving countries, so we provided legal assistance and navigation support to participants with HIV for sustained access to treatment. Population-based estimates were weighted for the complex sampling design. Penalised multivariable logistic regression analysis was used to identify correlates of viral suppression (HIV-1 RNA <1000 copies per mL). Between July 30, 2021, and Feb 5, 2022, 6506 participants were recruited through respondent-driven sampling, of whom 6221 were enrolled. 4046 (65·1%) of 6217 were cisgender women, 2124 (34·2%) of 6217 were cisgender men, and 47 (0·8%) of 6217 were transgender or non-binary people. 71 (1·1%) of all 6221 participants had laboratory-confirmed HIV infection, resulting in a weighted population HIV prevalence of 0·9% (95% CI 0·6-1·4). Among participants living with HIV, 34 (47·9%) of 71 had been previously diagnosed with HIV and 25 (35·7%) of 70 had viral suppression. Individuals with irregular migration status compared with individuals with regular migration status (adjusted odds ratio 0·3, 95% CI 0·1-0·9) and with a most recent HIV test in Colombia compared with a most recent test in Venezuela (0·2, 0·1-0·8) were less likely to have suppressed viral loads. HIV prevalence among migrants and refugees from Venezuela in Colombia suggests the HIV epidemic is close to being generalised, which could be addressed by the inclusion of migrants and refugees from Venezuela in local HIV services, improved access to and navigation support for HIV testing and care, and coordination with humanitarian programmes. There is an association between migration status and viral suppression, conferring both clinical and epidemiological implications. Therefore, legal support and access to insurance might lead to early detection of HIV and timely treatment for people with irregular migration status. US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention. For the Spanish translation of the abstract see Supplementary Materials section.

Early infant diagnosistesting for HIV in a hard-to-reach fishing community in Uganda.

Infants born to HIV-infected mothers are at a high risk of acquiring the infection. The World Health Organization recommends early diagnosis of HIV-exposed infants (HEIs) through deoxyribonucleic acid polymerase chain reaction (DNA PCR) and rapid HIV testing. Early detection of paediatric HIV is critical for access to antiretroviral therapy (ART) and child survival. However, there is limited evidence of the factors associated with receiving early infant diagnosis (EID) tests of the HIV testing protocol among HEIs in fishing communities in Uganda. This study established the factors associated with receiving EID tests of the HIV testing protocol among HEIs in a hard-to-reach fishing community in Uganda. A cross-sectional study was conducted among HEIs in selected healthcare facilities in Buvuma islands, Buvuma district. We obtained secondary data from mother-infant pair files enrolled in the EID program using a data extraction tool. Data were analysed using STATA Version 14. A modified Poisson regression analysis was used to determine the factors associated with not receiving the 1st DNA PCR test among HEIs enrolled in care. None of the HEIs had received all the EID tests prescribed by the HIV testing protocol within the recommended time frame for the period of January 2014-December 2016. The proportion of infants that had received the 1st and 2nd DNA PCR, and rapid HIV tests was 39.5%, 6.1%, and 81.0% respectively. Being under the care of a single mother (PR = 1.11, 95% CI: 1.01-1.23, p = 0.023) and cessation of breastfeeding (PR = 0.90, 95% CI: 0.83-0.98, p = 0.025) were significantly associated with not receiving the 1st DNA PCR. Our study revealed that none of the HEIs had received all the EID tests of the HIV diagnosis testing protocol. Receiving the 1st DNA PCR was positively associated with being an infant born to a single mother, and exclusive breastfeeding. Our findings highlight the need for the creation of an enabling environment for mothers and caregivers in order to increase the uptake of early diagnosis services for HEIs. Awareness-raising on the importance of EID should be scaled up in fishing communities. Demographic characteristics such as marital and breastfeeding status should be used as an entry point to increase the proportion of HEIs who receive EID tests.

Acceptance and associated factors of HIV testing among college students in China: A systematic review and meta-analysis.

Although HIV testing is helpful for early detection and treatment of HIV, its utilization rate is low among college students in China. Understanding the acceptance and associated factors of HIV testing is the key to improve the detection rate. The purpose of the systematic review was to examine the acceptance and associated factors of HIV testing (including HIV self-testing and HIV counseling and testing services) among college students in China. This systematic review was reported following PRISMA guidelines 2020. Electronic sources such as PubMed, Embase, Web of Science, CNKI, CBM, Wanfang Database and VIP Database were searched for relevant studies published before September 2022. The tool by Agency for Healthcare Research and Quality (AHRQ) was used to assess quality for cross-sectional studies. The random-effects and fixed-effect model were employed to estimate the pooled proportions and associated factor of HIV testing acceptance. The Cochrane's Q statistic and I2 test were used to examine heterogeneity. All the quantitative meta analyses were conducted using STATA version 12 software. A total of 21 eligible studies with 100, 821 participants were included in the systematic review. The pooled acceptance rate of HIV testing was 68% (95% CI = 60, 76), and varies between regions in China. Male, heterosexual and urban college students had higher HIV testing acceptance. Gender, medical specialty, sexual education, sexual behavior, HIV/AIDS knowledge, perception HIV risk, and previous HIV testing were the factors associated with HIV testing acceptance. The review revealed that most of the college students intend to accept HIV detection, and the proportion of acceptance influenced by different factors. Therefore, the government and universities should implement targeted measures, improve HIV testing services, and promote HIV testing behavior. PROSPERO CRD42022367976.

Molecular immunological techniques to support the differential microbiological diagnosis of acute HIV infection

This research sought to identify HIV confirmatory molecular immunological methods for the early diagnosis of acute infections, complementing the differential microbiological diagnosis. A descriptive study of a clinical case was carried out using molecular immunological analyses. The results showed that molecular immunological methods range from third generation techniques, capable of diagnosing the infection in the acute phase, to fourth generation techniques that detect the infection from the third week of infection. Confirmatory tests, such as Western Blot and LIA, presented high sensitivity and specificity. Revised molecular techniques, such as p24 detection or Polymerase Chain Reaction (PCR), reduced diagnosis time. In conclusion, molecular immunological methods allow early detection of HIV with high precision, providing diagnostic and confirmation results from the third week of infection.

HIV Screening among Patients with Newly Diagnosed Solid and Hematologic Malignancies in a Tertiary Hospital in the Philippines.

This preliminary study determined the prevalence of HIV infection among patients with newly diagnosed solid and hematologic malignancies at the Philippine General Hospital - Cancer Institute. Adult Filipinos aged 19 years and above with biopsy- or imaging-confirmed malignancy and for chemotherapy, seen at the adult medical oncology and hematology clinic from January to September 2021 were included. Demographic and clinical data were obtained using a questionnaire. Rapid HIV screening was performed using blood extracted via finger prick. Pre- and post-test counselling were conducted. Of the 124 patients included in our study, majority were female (91, 73.4%), and 45 years old and above with a median age of 49 (20 - 74). Majority had solid tumors (121, 97.6%) with breast cancer being the most common (67, 54.0%) followed by colorectal (18, 14.5%), and head and neck cancer (14, 11.3%). Among those with hematologic malignancies, two had acute myelogenous leukemia and one had multiple myeloma. Six patients had AIDS-defining malignancies (NHL, cervical cancer). HIV risk factors and associated conditions were present in 18 patients (14.5%). Ten patients reported prior HIV testing. None of the patients tested positive for HIV. The absence of HIV cases detected in our cohort may be due to the low prevalence of HIV risk factors and associated conditions. At this time, there is insufficient evidence to routinely recommend HIV testing among newly-diagnosed cancer patients. However, physicians are encouraged to offer HIV testing to cancer patients, especially to those with HIV risk factors, given the benefits of early detection and management of HIV.

2067. Missed Opportunities for Confirmatory HIV Testing at a Midwestern Medical Center

Abstract Background The currently recommended HIV testing algorithm begins with a 4th generation antigen/antibody (Ag/Ab) combination immunoassay, which allows for early detection of HIV. However, this assay’s high sensitivity can result in false positives that must be distinguished from acute infections via an HIV nucleic acid test (NAT). At our medical center, HIV NATs are recommended in the lab report for anyone with a positive p24Ag component on the screening assay, but they are not done reflexively by the lab as it requires a different blood tube. Thus, difficulties arise in obtaining the NAT, such as providers failing to order the test or patients failing to return for another blood draw, jeopardizing the diagnosis of early HIV. Methods We conducted a retrospective chart review of adult patients at a Midwest academic medical center with a positive p24Ag on the HIV-1/2 Ag/Ab combination assay between Jan. 1, 2017 and Feb. 21, 2021. We assessed if appropriate confirmatory testing was performed, identified barriers to missed opportunities for confirmatory testing, and used t-tests and Fisher’s exact tests to evaluate differences between those who did and did not receive confirmatory testing. Results Of 37 people with a positive p24Ag on the HIV Ag/Ab immunoassay, 6 (17%) did not have an HIV NAT performed within 30 days of their positive screening test. Of these 6 cases, the ordering provider did not acknowledge the need for a confirmatory test in 3 cases, the patient did not return for the test in 1 case, and other factors prevented follow-up in 2 cases. Of those who had an HIV NAT ordered, 7 (23%) had a positive HIV NAT. Younger age was significantly associated with completion of appropriate confirmatory testing (p=0.05), but other factors including sex, race, insurance status, having a primary care provider, specialty of ordering provider, encounter location, and test indication were not. Conclusion Our review identified multiple missed opportunities for confirmatory HIV testing following a positive p24Ag component on the HIV screening test. Provider lack of knowledge/awareness of the need for appropriate testing was the most common barrier. A quality improvement initiative will be undertaken to minimize future risk of missed opportunities for confirmatory testing. Disclosures Paul D. Fey, PhD, BioFire: Advisor/Consultant|BioFire: Grant/Research Support|Merck: Grant/Research Support Sara H. Bares, MD, Gilead Sciences: Expert Testimony|GSK ViiV Healthcare: Grant/Research Support|Janssen: Grant/Research Support.

Peramalan Jumlah Kasus Baru HIV Menurut Provinsi Menggunakan Machine Learning dengan Teknik Levenberg-Marquardt

Early detection of HIV is a crucial step to reducing transmission and increasing the success of HIV treatment. The sooner HIV is detected, the sooner treatment can be carried out so that this infection can be controlled and does not develop into AIDS. Therefore, the purpose of this study is to forecast the Number of New HIV Cases in Indonesia based on 34 Provinces so that the government can obtain information early on to determine the right policy to suppress the increasing number of new HIV cases in Indonesia. This research proposes forecasting using a Machine Learning algorithm with the Levenberg-Marquardt technique. The research data is data on the number of new HIV cases by province obtained from the 2021 Indonesian Health Profile book issued by the Ministry of Health of the Republic of Indonesia. This research will be analyzed using three network architecture models, 3-15-1, 3-20-1 and 3-25-1. Based on the analysis of the three models used, the results show that the 3-15-1 model is the best because it produces a higher accuracy level than the other two models, which is 88%. It can be concluded that the Levenberg-Marquardt technique with the 3-15-1 model is quite suitable for forecasting new cases of HIV in Indonesia. Based on the prediction results, the number of new HIV cases by the province in Indonesia at the end of 2022 decreased significantly compared to 2021, which was 24668 compared to 36902 or reduced by around 12 thousand cases.

New diagnosis of mother-to-child transmission of HIV in 8 Latin-American countries during 2018

BackgroundImportant prevention efforts have led to a reduction in mother-to-child transmission of HIV (MTCT) globally. However, new cases of paediatric HIV infections still occur. Early diagnosis of new HIV infections is essential to start an appropriate antiretroviral treatment to avoid childhood morbidity and mortality related to infection. The aim of this study was to describe the new cases of MTCT in Latin-American referral hospitals.MethodsA retrospective, multicentre and descriptive study of the new cases of MTCT diagnosed during 2018 in 13 referral hospitals from 8 Latin-American countries (Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama) belonging to PLANTAIDS (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children), was conducted. PLANTAIDS is included in CYTED (Ibero-American Programme of Science and Technology for Development).ResultsEighty-one children (40.7% males) were included, median age at diagnosis of 2.33 years (IQR:0.7–4.7). Less than 3% of women knew their HIV diagnosis before pregnancy. More than 80% of them were diagnosed after delivery, 8.7% during pregnancy, and 2.9% at delivery. Only one patient underwent antiretroviral therapy (ART) prior to pregnancy. At diagnosis, 50.0% of the children presented with an advanced stage of disease (stage C following the current CDC classification for HIV infection), and 34.4% had less than 15% CD4+ cells/mm3. The time elapsed between delivery and the maternal diagnosis was correlated with the age of children at diagnosis, ρ = 0.760, p < 0.001. Younger age at diagnosis (p = 0.03), a smaller number of previous hospitalizations (p < 0.01), and better immunovirological status (p < 0.01) were found in children whose mothers knew their HIV status at delivery, compared to mothers who were not aware of it.ConclusionsAlthough MTCT in Latin America has declined in recent years, our series shows there are still cases that indicate some failures in prevention, being a critical point to improve an earlier diagnosis of pregnant women. Half of the children were diagnosed in an advanced stage of disease and the delay in maternal diagnosis entailed a worse clinical and immunological child’ prognosis.

The prevalence of people who inject drugs among those with HIV late presentation: a meta-analysis

BackgroundOne of the most important routes of HIV transmission is through injections of drugs, and this group, due to unawareness of their infection, causes the spread of HIV. The coexistence of other opportunistic infections and diseases with HIV among people who inject drugs (PWID) imposes healthcare costs and is associated with high morbidity/mortality rates. Early detection of HIV among PWID is essential to prevent and control the spread of the disease.ObjectivesThis study aimed to determine the prevalence of PWID among those with late presentation (LP).MethodsThree electronic databases of PubMed, Scopus, and Web of science were searched using appropriate keywords. Besides the prevalence data reported for PWID among LP, the other outcomes of interest were LP defined as having CD4 count < 350 cells/μL or HIV or advanced disease defined with CD4 count < 200 cells/μL or HIV at the time of diagnosis.ResultsOf the 160 studies found, only eight met the inclusion criteria. Among those presented late, 36.5% were PWID (95% CI = 24.88–48.17). Compared with men who have sex with men (MSM), HIV-infected PWID had a higher risk of LP [OR = 1.51; 95% CI = 0.96–2.06].ConclusionThe results of this study show that HIV is diagnosed late in the majority of PWID when CD4 is less than 350 cells/μL. Targeted interventions/strategies are highly required to reduce LP among HIV-infected PWID.

The Determinants of Behavior of HIV Testing in Pregnant Mothers

HIV infection in Indonesia is one of the health problems and infectious diseases that can affect maternal and child mortality. More than 90% of HIV-infected infants are infected by HIV-positive mothers. Transmission can occur during pregnancy, during delivery and during breastfeeding. Early detection of HIV is important so that antiretroviral virus (ARV) drug therapy is carried out more quickly to reduce the rate of HIV transmission from mother to baby. The research, which was conducted at the Balongan Subdistrict Health Center, Indramayu Regency, was conducted to determine the determinants associated with HIV testing behavior during pregnancy. This type of research is quantitative with a cross-sectional study design using the total population. The results of the univariate analysis showed that 71.1% of mothers did not take an HIV test during pregnancy. and education about HIV/AIDS, because the husband is the closest person to the mother so that the husband makes a big contribution to providing support to the mother

HIV Education, Empathy, and Empowerment (HIVE3): A Peer Support Intervention for Reducing Intersectional Stigma as a Barrier to HIV Testing among Men Who Have Sex with Men in Ghana.

Men who have sex with men (MSM) in Ghana remain at heightened risk of HIV infection, and face challenges in accessing HIV prevention and care services. Previous research in Ghana shows that MSM face intersectional stigma across ecological levels (family, peers, healthcare settings, and community level) and the criminalization of same-gender sexual behaviors in the country. To protect their wellbeing from exposure to stigma, many MSM avoid interactions with healthcare systems and services, which inadvertently inhibits their opportunities for early detection and treatment of HIV. Consequently, MSM in Ghana carry a disproportionate burden of HIV prevalence (18%) compared to the general population (2%), highlighting the need for culturally relevant processes in HIV/STI prevention, and care communication to optimize sexual health and wellness among MSM in Ghana. To this effect, we collaborated with community partners to use the Assessment, Decision, Adaptation, Production, Topical Experts, Training, Testing (ADAPT-ITT) model to modify a theory-driven smartphone-based peer support intervention to enhance its focus on intersectional stigma reduction, and improve HIV health-seeking behaviors among MSM, including HIV testing and linkage to care. We used the Dennis Peer Support Model to develop the peer support components (emotional, informational, and appraisal support) to increase peer social support, decrease social isolation, and minimize intersectional stigma effects on HIV-related healthcare-seeking behaviors. This paper shows the preliminary acceptability and effectiveness of employing culturally relevant techniques and communication strategies to provide secure peer support to improve HIV prevention and care among key populations in highly stigmatized environments.

Time to initial highly active antiretroviral therapy discontinuation and its predictors among HIV patients in Felege Hiwot comprehensive specialized hospital: a retrospective cohort study

BackgroundAnti-retroviral therapy regimen discontinuations become a big challenge and cause diminishing the clinical and immunological benefit of treatment in Ethiopia. It reduces both the duration and the chance of viral control due to cross-resistance between different alternative drugs and overlapping toxicity between and within a class of antiretroviral drugs in Ethiopia. However, information’s on the time of initial regimen discontinuation and its predictors are not well studied.ObjectiveThis study aimed to assess the time to initial highly active antiretroviral therapy discontinuation and its predictors among HIV patients in Felege Hiwot comprehensive specialized hospital, North West Ethiopia.MethodInstitution-based retrospective cohort study was conducted among 418 HIV patients who started HAART from January 1, 2014, to December 31, 2019. Data were collected from the patient chart using a data extraction tool. The Kaplan–Meier curve was employed to compare survival rates. Multivariable Cox proportional hazard regression was applied to identify independent predictors of time to initial regimen discontinuation.ResultA total of 418 patients on anti-retroviral therapy were followed. Incidence of initial HAART discontinuation was 16.7/100 person year. The median survival time was 3.5 years. Predictors showed association for time to initial HAART discontinuation were taking > 1 ART pills/day (AHR = 4.1, 95% CI 3.0–6.5), baseline CD4 count < 100 cells/mm3 (AHR = 2.6, 95% CI 1.5–4.7), 100–199 cells/mm3 (AHR = 2.2, 95% CI 1.2–4.0), baseline WHO clinical stage IV (AHR = 2.68, 95% CI 1.6–4.3) and stage III (AHR = 2.6, 95% CI 1.4–4.3) and TB infection (AHR = 2.3, 95% CI 1.6–3.5).ConclusionMost of the discontinuation occurred after 1 year of initiation of HAART. Baseline WHO clinical stage, TB infection, baseline CD4 count, and taking > 1 ART pill/day were found predictors of initial HAART regimen discontinuation. Work on early detection of HIV before the disease is advanced and initiation of one ART regimen daily is vital for survival on the initial regimen.