Heterosexual Mode Of Transmission Research Articles

Characteristics of newly reported HIV/AIDS cases with heterosexual mode of transmission in six districts of Chongqing city

Objective: To understand the routes of newly reported HIV/AIDS cases with heterosexual mode of transmission in six districts of Chongqing city, and to provide evidence for HIV/AIDS prevention and control programs regarding heterosexual mode of transmission on HIV. Methods: HIV/AIDS cases that were newly reported as with heterosexual mode of transmission in six districts of Chongqing from July 1st to October 1st in 2019, were recruited in the study. Information related to their sociodemographic characteristics and heterosexual behaviors was collected. A self-designed questionnaire was used in this face-to-face survey. Results: A total of 312 HIV/AIDS cases with heterosexual mode of transmission were recruited. Most of them were males (207, 66.3%), aged 50 years or over (210, 67.3%), having junior high school or lower education (252, 80.8%), married or cohabitating (200, 64.1%). 48.7% (152/312) of them were infected through commercial sexual contact while 40.4% (126/312) of them were infected by spouses or stabled partners. 10.9% (34/312) of them were infected by non-marital and non-commercial sexual contacts. Significant differences were noticed on the infection mode of heterosexual transmission in gender, age and occupation (P<0.05). Results from the multivariate logistic regression analysis revealed that: male (OR=822.34, 95%CI: 103.99-6 503.10), junior high school and lower education level (OR=3.02, 95%CI: 1.05-8.66), household chores and underemployed (OR=0.23, 95%CI: 0.07-0.76) were influencing factors on HIV infection that were through commercial sexual contacts. Male (OR=29.20, 95%CI: 9.40-90.75), junior high school and lower education level (OR=4.28, 95%CI: 1.24-14.81) were influencing factors on HIV infection, through non-marital and non-commercial sexual contacts. In addition to meeting sexual partners in offline places, some HIV/AIDS patients with heterosexual mode of transmission had developed sexual partnerships through online dating and with low-grade venue as the main place for sex engagement. Conclusions: Newly reported HIV/AIDS cases under heterosexual mode of transmission in Chongqing were mainly infected from offline low-grade venues, and caused by commercial sexual engagement. The routes of HIV infections that caused by heterosexual contact should be deeply understood in order to develop targeted intervention programs.

Injecting drug use among gay and bisexual men in New Zealand: Findings from national human immunodeficiency virus epidemiological and behavioural surveillance.

Gay and bisexual men (GBM) who inject drugs are disproportionately affected by human immunodeficiency virus (HIV) because of dual transmission risks. New Zealand has a progressive history of harm reduction and was the first country to publicly fund needle exchange programs in 1988 for people who inject drugs (PWID). We combine national HIV epidemiological and bio-behavioural surveillance data to understand HIV risk among this subpopulation. We examine trends in new HIV diagnoses 1996-2018 by mode of transmission, and compare HIV cases attributed to sex between men (MSM-only), MSM/injecting drug use (IDU) and IDU-only. IDU among GBM in a national HIV behavioural surveillance survey was also examined. We compare GBM by IDU status (never, 'recent', previous) and identified predictors of recent IDU. Of 1653 locally-acquired HIV diagnoses 1996-2018, 77.4% were MSM-only, 1.5% MSM/IDU, 1.4% IDU-only and 14.2% heterosexual mode of transmission. On average, just one HIV diagnosis attributed to MSM/IDU and IDU, respectively, occurred per annum. MSM/IDU cases were more likely than MSM-only cases to be indigenous Māori ethnicity. Of 3163 GBM survey participants, 5.4% reported lifetime IDU and 1.2% were recent IDU. Among GBM, HIV positivity was 20% among recent IDU and 5.3% among never injectors. Predictors of recent IDU were: age under 30; more than 20 male partners; female partner; condomless intercourse; HIV positivity. New Zealand has averted high endemic HIV rates seen among GBM and PWID in other countries and results have been sustained over 30 years.

Clinico-demographic profile of HIV patients at ART centre of a tertiary care referral hospital in North India

Background: According to the National AIDS Control Organization (NACO), HIV prevalence in India is 0.36% and people living with HIV are around 2.47 million. Although antiretroviral treatment (ART) does not cure HIV/AIDS, but effective ART regimens inhibit the efficient replication of the HIV virus, and reduce viremia to undetectable levels. Methods: HIV positive patients qualified to be enrolled in to the study were those who attended the infectious diseases clinic at least twice (one follow-up visit at least six months apart), between January 2009 to December 2011. The protocol was approved by the Ethical Committee of the IMS, BHU. History and detail of patients were recorded on a pre-designed performa which included the socio-demographic profile of the patients, mode of transmission, presenting symptoms, opportunistic infections and many others. Results: 5308 HIV positive patients were registered during three year of study period at the ART Centre of IMS, BHU. Of these 3379 (63.7%) were males and 1929 (36.3%) were females. Heterosexual mode of transmission was commonest in the study group and amounted to 70.5% of total HIV patients on ART. Pulmonary tuberculosis was most common opportunistic infection and was present in 1045(19.7%) of patients on ART. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusions: HIV infection is one of the major infectious diseases in this part of India, and being chronic and lifelong in nature, its impact is huge compared to other infectious diseases. People with high risk behavior and the spouse of the affected couple need to be educated for primary and secondary prevention of the disease.

Factors associated with late HIV diagnosis in North-East Scotland: a six-year retrospective study

ObjectivesLate HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland. Study designA population based retrospective database analysis. MethodsAll newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann–Whitney tests. ResultsCD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10–7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89–15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants. ConclusionHeterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.

Incidence of ocular manifestations in HIV infected patients: a study in a teaching hospital in Telangana

Introduction: Ocular manifestations of human immunodeficiency virus (HIV) infection are common. The aim of this study was to assess the prevalence of the ophthalmic manifestations observed in AIDS patients. Materials and Methods: 169 patients who were confirmed to be living with HIV were included into the study. Ophthalmic diagnoses were made based upon LogMAR and slit lamp biomicroscopic examination of the anterior segment (eyelids, conjunctiva, cornea, anterior chamber), and dilated indirect ophthalmoscopy to provide views of the central and peripheral retina. Results: Heterosexual mode of transmission was the most common with 91.1%. Most of them had the infection for less than 5 years and 106 of them were on ART. Ocular manifestations was seen in 96 (56.8%) of the patients. Cytomegaloviral retinitis was the most common cause of the ocular manifestation with 29 of the patients being affected. 16 of the patient s ha dcottony conjunctival growth, 11 had uveitis and 10 had a cutaneous lid. Conclusion: But since the incidence of ocular diseases is very high and most of the times asymptomatic it is essential to give a regular check up in patients with HIV. Keywords: Human Immunodeficiency virus, Ocular manifestations, AIDS, Cytomegaloviral retinitis, Incidence

Age-related - oral manifestations and co-morbidities in human immunodeficiency virus-infected/acquired immune deficiency syndrome adults in Hyderabad, India.

The objective of the study was to clinically evaluate age-related - oral manifestations and co-morbidities in different age groups of human immunodeficiency virus-infected/acquired immune deficiency syndrome adults. A cross-sectional study was conducted among 200 adult patients aged above 20 years at infectious diseases units, medical wards and ART centre of Gandhi Medical Hospital, Hyderabad. Oral manifestations were diagnosed according to the presumptive criteria of EC-Clearinghouse Classification, and clinical data were retrieved from patient's medical records. Chi-square test was used for statistical analysis. Men (72%) in the young age group of 21-30 years were commonly affected. Heterosexual mode of transmission was most common in all the age groups, and the overall distribution were statistically significant (P < 0.05). Most common oral findings seen in 21-30 years of age were depapillation (90%), hyperpigmentation (70% and 72%) in 31-40 and 41-50 years old and linear gingival erythema (68%) in above 50 years of age group. The various co-morbidities included the recurrent bacterial and skin infections (64% and 62% respectively) in the younger age group. Renal and cardiac diseases with pulmonary tuberculosis (74%) were commonly observed in middle-aged and elders. The underlying oral manifestations and co-morbidities could become very important variables that must be taken into account in determining treatment efficacy or health policy.

Late HIV diagnosis: Differences by rural/urban residence, Florida, 2007-2011.

The purpose of this retrospective cohort study was to identify individual-level demographic and community-level socioeconomic and health care resource factors associated with late diagnosis of HIV in rural and urban areas of Florida. Multilevel modeling was conducted with linked 2007-2011 Florida HIV surveillance, American Community Survey, Area Health Resource File, and state counseling and testing data. Late diagnosis (defined as AIDS diagnosis within 3 months of HIV diagnosis) was more common in rural than urban areas (35.8% vs. 27.4%) (p<0.0001). This difference persisted after controlling for age, sex, race/ethnicity, HIV transmission mode, country of birth, and diagnosis year (adjusted OR 1.39; 95% CI 1.17-1.66). In rural areas, older age and male sex were associated with late HIV diagnosis; zip code-level socioeconomic and county level health care resource variables were not associated with late diagnosis in rural areas. In urban areas only, Hispanic and non-Hispanic black race/ethnicity, foreign birth, and heterosexual mode of transmission were additionally associated with late HIV diagnosis. These findings suggest that, in rural areas, enhanced efforts are needed to target older individuals and men in screening programs and that studies of psychosocial and structural barriers to HIV testing in rural and urban areas be pursued.

English

BACKGROUND AND OBJECTIVES:To study the clinical presentation, spectrum of systemic involvement, opportunistic infections and the correlation between CD4 + cell count and TLC for monitoring disease progression in HIV patients. Previous studies have shown that TLC is an inexpensive and useful tool for monitoring HIV progression.METHODS: This was a 2 year prospective study in which cases were examined and according to theproforma, TLC and CD4+ counts were assessed in 50 HIV positive patients who attended Yenepoya Medical College Hospital, Mangalore between October 2005 and September 2007. Sensitivity and specificity of various TLC cut-off were computed for CD4 count <200 cells/mm3 and statistical indices computed. Pearson's correlation coefficient was used to find out the correlation between CD4+ count and TLC at baseline.RESULTS: 45 male and 5 female patients, having mean age of 38.08± 9.01 years (range 20 - 60 years) were studied. 70% were in 20-40 years age group. 34% were related to transport services. Heterosexual mode of transmission was seen in 64%, commonest presenting symptoms were fever and weight loss, oral candidiasis was present in 26% and lymphadenopathy in 46% of subjects. Tuberculosis was the most common opportunistic infection seen in 68% of subjects. One patient had AIDS dementia complex, one had HIV nephropathy and in 1 and a presumptive diagnosis of Kaposi's sarcoma was made. Tubercular meningitis was the most common neurological manifestation. The mean baseline CD4+ count in study group was 175 cells/mm3. The mean baseline TLC was 1338 cells/mm3. The scatter diagram shows, as the CD4 T cells rises, the TLC level also rises. The sensitivity and specificity of TLC < 1200 and CD4 count <200 was 91% and 53% respectively with a positive predictive value of 70% (p = 0.0001).CONCLUSION: Occupation was the important risk factor for HIV transmission and heterosexual contact is the commonest mode of spread. Among opportunistic infections, tuberculosis was most common. There was a definite correlation between the TLC and CD4 count in HIV positive patients before treatment. It is evident from this study that TLC can be used in place of CD4+ T cell counts in resource-limited settings to monitor the disease progression.

Incidence and risk factors of chronic renal disease in a cohort of Greek HIV‐1‐infected adults

Chronic kidney disease (CKD) in HIV‐infected patients is associated with both HIV and non‐HIV‐related factors. Initial renal dysfunction is silent and detectable only by laboratory tests such as the glomerular filtration rate (GFR) estimated by the Cockcroft‐Gault equation. Our objective was to assess possible risk factors for CKD in a cohort of Greek HIV‐1‐infected adults.MethodsPatients in the AMACS (Athens Multicenter AIDS Cohort Study) cohort with at least two available creatinine values were enrolled in the study. Renal dysfunction was defined as eGFR below 90 mL/min/1.73 m2. The Kaplan‐Meier estimator and the Cox proportional hazards model were used to analyze the occurrence and predictors of renal dysfunction.ResultsA total of 1073 patients were enrolled in the study; 255 (23.76%) had baseline eGFR below 90 mL/min/1.73 m2 and were excluded. Characteristics of the study population: men 88.4%, MSM 62.6%, median baseline age, CD4+count and viral load were 32.6 years, 413 cells/µL and 3.77 log10 copies/mL, respectively. 240 (29.3%) patients experienced an eGFR decrease below 90 mL/min/1.73 m2 during follow‐up period. Older age, female gender, heterosexual mode of transmission, lower baseline eGFR (all p&lt;0.001), lower baseline CD4+(p=0.001), stage C (p=0.023), administration of cART (p&lt;0.001) or other nephrotoxic agent (p=0.035) were the major risk factors in univariable analysis. Multivariable analysis identified older age [hazard ratio (HR) 1.289 per 10 years, p&lt;0.001] and female gender (HR vs male: 1.899, p&lt;0.001), as the major factors associated with increased hazard of developing CRD, whereas baseline eGFR &lt;110 (HR vs eGFR &lt;110: 0.245, p&lt;0.001) and current CD4+count ≥350 cells/µL (HR 0.564, p=0.003) were significant protective factors.ConclusionIn this large cohort of HIV‐infected Greek patients, almost one‐third (29.3%) experienced some degree of renal dysfunction during HIV infection. Older age and female gender were major predictors of CKD, whereas high current CD4+count and baseline eGFR were protective.

Protective Effect of CCR5-Δ32 Against HIV Infection by the Heterosexual Mode of Transmission in a Polish Population

Effects of chemokine receptor alleles (CCR5-Δ32 and CCR2-64I) on susceptibility to human immunodeficiency virus (HIV) infection were studied in a Polish population. The CCR5 and CCR2 genotypes were determined for 311 healthy, HIV-negative individuals (control group), 121 exposed to HIV infection but uninfected (EU group), and 470 HIV-positive patients. The frequency of the alleles in the control group was calculated as 0.12 for both CCR5-Δ32 and CCR2-64I. The logistic regression method was used to analyze the effects of the described factors. A protective effect was observed for the CCR5-Δ32 allele but only in the case of heterosexual exposure. Prevalence of the CCR5-Δ32/+ genotype in HIV(+) patients infected via the heterosexual route (n=61; 8.2%) was much lower than in the control group (n=311; 21.5%); in the heterosexually exposed uninfected group it was slightly higher (n=28; 25%). This suggested that in this mode of infection, the native CCR5 expression level was crucial for establishment of infection. Individuals with the CCR5-Δ32 allele have more than three times less chance of infection in the case of HIV heterosexual exposure (odds ratio, 3.37; 95% confidence interval, 1.055-10.76). However, a protective effect of the CCR5-Δ32/+ genotype was not observed in the case of intravenous drug users (IDUs). The rates of the genotype were similar in HIV-infected IDU individuals (n=356; 17.7%) and in exposed uninfected patients (n=84; 15.5%), not significantly different from control group. No effect of the CCR2 genotype was observed. The analysis revealed that the important factor increasing infection risk was, in particular, hepatitis C virus (HCV) infection (odds ratio, 12.9). Moreover, the effect of HCV infection was found to be age dependent. Susceptibility to HIV infection resulting from HCV positivity became weaker (6% per year) with increasing age.

Determinants of Late-Stage HIV Disease at Diagnosis in Singapore, 1996 to 2009

The delay in HIV diagnosis has been identified as a significant reason for late presentation to medical care. This research aims to elucidate the significant determinants of late-stage HIV infection in Singapore between 1996 and 2009, after the advent of highly active anti-retroviral therapies. We included 3735 patients infected via sexual mode of transmission from the National HIV Registry diagnosed between 1996 and 2009. Late-stage HIV infection is defined as CD4 count less than 200 mm(3) or AIDS-defining opportunistic infections at fi rst diagnosis or within one year of HIV diagnosis. We determined independent epidemiological risk factors for late-stage HIV infection at first diagnosis using multivariate logistic regression. Multivariate analysis showed that older age corresponded significantly with increasing odds of late-stage HIV infection. Compared to persons diagnosed at 15 to 24 years of age, those diagnosed at age 55 years and above were associated with 5-fold increased likelihood of late-stage infection (adjusted odds ratio (AOR): 5.17; 95% CI, 3.21 to 8.33). Chinese ethnicity, singlehood, and non-professional occupations were also significantly associated with late-stage HIV infection. Persons detected in the course of medical care had over 3.5 times the odds of late-stage infection (AOR: 3.55; 95% CI, 2.71 to 4.65). Heterosexual mode of transmission and having sex workers and social escorts as sexual partners, were the other epidemiological risk factors with significant associations. The findings of this study emphasises the need to increase HIV awareness and to encourage early and regular HIV testing among at-risk persons.

Epidemiological trends of HIV infection in Spain

Epidemiological trends of HIV infection in Spain

Report of the First Brazilian Symposium on Basic Research in HIV/AIDS.

HIV-1 from a seropositive Brazilian individual wasachieved in May 1987. During this time, a lot ofeffort was oriented towards solving emergent pub-lic health needs such as the development of easy,quick and cheap screening and confirmatory as-says for the serological diagnosis. The importanceof several institutions in financing reasearchprojects, e.g. Fundacao Banco do Brasil, NationalResearch Council (CNPq) and Petrobras waspointed out.Representing the Ministry of Health, DrEuclides A Castilho highlighted the trends of theHIV/AIDS epidemic in Brazil. He stated that inthe beginning of the epidemic, the epidemiologicprofile was similar to that observed in the USAand Western Europe. The homosexual/bisexualmode of transmission was the most important routein the propagation of infection in Brazil. Later, theepidemic profile began to change and currently theintravenous drug use and the heterosexual modeof transmission have assumed greater significance.He also summarized the present prevalence ofHIV/AIDS in Brazil: as of February of 1995, a to-tal of 71,111 AIDS cases were officially reportedto the Ministry of Health. The infection is dissemi-nated all over the country and the estimated preva-lence of infection in terms of incidence per 100,000inhabitants is 11.2 in the Northern, 13.0 in theNortheastern, 32.3 in the Middle-Western, 91.0 inthe Southeastern and 26.5 in the Southern regionsof Brazil. With respect to sexual preferences, since1980 a total of 45% of the cases of HIV/AIDSoccurred in homosexual/bisexual men and 17.7%in heterosexuals. The parenteral mode of transmis-sion accounts for 25.2% of cases due to blood orblood factors and 21% due to intravenous drug use.Dr Eduardo Martins, Vice-President of theFIOCRUZ, drew attention to the fact that theOswaldo Cruz Foundation, as the main research in-stitution of the Ministry of Health, recognizes theurgent need to establish ways to face the HIV-1 epi-demic in Brazil as well as other emergent or re-emergent infections. Therefore, the InstitutionalDuring the first decade of AIDS epidemic inBrazil very little basic research on HIV-1 was per-formed in this country. In fact, the efforts of Bra-zilian scientists and the government policy wereaimed to solve the immediate health problems cre-ated by the emergent HIV-1/AIDS epidemic. TheFirst Brazilian Symposium on Basic Research inHIV/AIDS was held in Angra dos Reis, Rio deJaneiro, from 13 to 16 of September 1995, in or-der to disseminate scientific information and en-hance national and international collaboration witha view of strengthening national research capabili-ties.Opportunity was taken to posthumously honorDr Marguerite (Peggy) Pereira and Dr Helio GelliPereira, two of the world’s most distinguished vi-rologists, whose life-work was presented by DrHerman Schatzmayr (FIOCRUZ, Rio de Janeiro).These scientists contributed a great deal to solvesome severe and important public health problemsin Brazil. Thanks to their contributions it has beenpossible to achieve significant success in control-ling the HIV/AIDS epidemic spread in blood do-nation centers in Brazil.Dr Bernardo Galvao-Castro (FIOCRUZ, Sal-vador) summarized the main historical aspects ofthe AIDS epidemic in Brazil. He recalled that thefirst AIDS cases reported in Brazil date back from1982, when six cases were reported in Sao Pauloand Rio de Janeiro. At that time, there was no offi-cial program to face this emergent epidemic. Infact, this program was established in 1985. Recog-nizing the severity of this new public health prob-lem, some groups of Brazilian researchers, mainlyin Sao Paulo and Rio de Janeiro, iniciated someactivities in clinic, immunology and epidemiol-ogy of HIV/AIDS.In July 1985 Drs Peggy and Helio Pereirakindly donated H9/HIV-1 infected cells to theOswaldo Cruz Foundation. This enabled FIOCRUZto promptly set up the HIV-1 screening routine inthe public Brazilian blood bank network, using theimmunofluorescence assay. The first isolation of

High proportion of HIV-2 and HIV-1/2 double-reactive sera in two Indian states, Maharashtra and Goa: First appearance of an HIV-2 epidemic along with an HIV-1 Epidemic outside of Africa

The seroprevalence of HIV-1 and HIV-2 infections was determined in selected groups of patients from an STD clinic and in female prostitutes from two different states of India. A total of 809 sera from Maharashtra and of 61 sera from Goa were analyzed. Of the unscreened sera from Bombay, 39% were positive as were 15% of the sera from Goa. Among the HIV-positive sera from Bombay, 79% were positive for HIV-1, 4% were positive for HIV-2 and 17% were positive for HIV-1 and 2. In the Goa group, 67% of the infected sera were HIV-1-positive and 33% were HIV-2 positive. Due to the nearly even distribution of infections between men and women, a mainly heterosexual mode of transmission is evident. HIV-2 infections were first detected in India in 1990 (Rübsamen et al., Lancet, 1991). Before that time, Asia was believed to be free HIV-2. The present study represents the first documentation of a large proportion of these infections, alone and in combination with HIV-1, in the Asian continent. An HIV-2 epidemic running parallel to an HIV-1 epidemic so far has never been observed outside of Africa. This would indicate that a further spread of HIV-2 worldwide is to be expected and that HIV-2 should be included in programs of vaccine development for humans.

Women with HIV presenting at three London clinics between 1985-1992.

To determine the changing patterns of HIV infection in women in three units in London. Three hundred and fifty seven HIV seropositive women who have attended outpatient clinics between 1984 and 1992. A retrospective review of data obtained from a computerised database and supplemented by direct inspection of the notes. The number of newly identified women with HIV has risen steadily over the period of study with a significant shift towards a heterosexual mode of transmission. This is a reflection of increasing numbers of women from Sub-Saharan Africa rather than a rise in the incidence of HIV in women born in the UK. The increase in women infected by HIV remains predominantly restricted to women in "high risk" groups. Although encouraging, our data should be interpreted with caution since it suffers from the inherent bias of selective testing. Safer sex education and epidemiological surveillance should continue despite the apparent low risk to women born in the UK.