High AIDS Prevalence Research Articles

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

Submicronic particulate matter (PM1), a “neglected killer” for HIV/AIDS patients in Hubei, China: Results from a cohort study from 2001 to 2020

BackgroundAlthough with the progress of antiretroviral therapy, the life expectancy of HIV/AIDS patients was still not equal to that of normal people. Submicronic particulate matter (PM1) might play a role in mortality among people living with HIV/AIDS, However, cohort evidence is extensively scarce. MethodsThis twenty-year open cohort study involved all individuals officially diagnosed with HIV/AIDS in Hubei Province from 2001 to 2020. Time-varying Cox proportional hazard models were applied to investigate the associations between long-term exposure to PM1 and mortality in HIV/AIDS patients. The concentration-response curves between PM1 and AIDS-related deaths/all-cause deaths were characterized by fitting restricted cubic spline models. These curves were then utilized to estimate the number of deaths attributed to PM1. ResultsLong-term exposure to PM1 was significantly associated with AIDS-related deaths and all-cause death among HIV/AIDS patients, with excess risks of 2.33 % [95 % confidence interval (CIs): 1.62, 3.15] and 0.69 % (0.22, 1.17) for each 1 μg/m3 increase in annual PM1. HIV-positive people with lower initial CD4+ cell count levels or aged over 65 years old were more susceptible to PM1 exposure. We estimated about 844 AIDS-related deaths and 1175 all-cause deaths can be attributable to ambient PM1 exposure, accounting for 41.7 % and 23.8 % of the total deaths from corresponding causes, respectively. ConclusionsLong-term exposure PM1 was a novel factor hindering the life spans of people living with HIV/AIDS. Early establishment of PM1 concentration standards and efforts to achieve them will bring substantial health benefits to people living with HIV/AIDS, especially in low- and middle-income countries facing the dual challenges of high air pollution and high AIDS prevalence.

Key challenges to voluntary medical male circumcision uptake in traditionally circumcising settings of Machinga district in Malawi

BackgroundVoluntary medical male circumcision (VMMC) is becoming more popular as an important HIV prevention strategy. Malawi, with a high HIV and AIDS prevalence rate of 8.8% and a low male circumcision prevalence rate of 28% in 2016, is one of the priority countries recommended for VMMC scale-up. This paper investigates the attitudes and key challenges to VMMC adoption in a traditionally circumcising community in Malawi where male circumcision is culturally significant.MethodsA mixed design study using quantitative and qualitative data collection methods was carried out to determine the attitudes of 262 randomly selected males towards VMMC in a culturally circumcising community in Malawi. Statistical Package for the Social Sciences (SPSS) version 20 was used to analyse the quantitative data. To identify predictors of VMMC uptake, we used logistic regression analysis. To identify the themes, qualitative data were analysed using content analysis.ResultsThe findings indicate that, while more males in this community prefer medical circumcision, traditional circumcision is still practised. Panic (63%) perceived surgical complications (31%), and cost (27%) in accessing VMMC services were some of the barriers to VMMC uptake. Age and culture were found to be statistically significant predictors of voluntary medical male circumcision in the logistic analysis. According to qualitative data analysis, the key challenges to VMMC uptake were the involvement of female health workers in the circumcision team and the incentives provided to traditional circumcisers.ConclusionAccording to the findings of this study, VMMC services should be provided in a culturally competent manner that respects and considers existing cultural beliefs and practices in the community. Coordination between local leaders and health workers should be encouraged so that VMMC services are provided in traditional settings, allowing for safe outcomes, and increasing VMMC uptake.

Incarceration, HIV Risk-Related Behaviors, and Partner Characteristics Among Heterosexual Men at Increased Risk of HIV Infection, 20 US Cities.

The effect of incarceration on HIV risk-related behaviors among at-risk heterosexual men is understudied. The objective of our study was to examine the association between incarceration and HIV risk-related behaviors among a sample of predominantly non-Hispanic black and Hispanic heterosexual men residing in urban areas in the United States with a high prevalence of AIDS. We analyzed data from the 2013 National HIV Behavioral Surveillance system on 5321 at-risk heterosexual men using log-linked Poisson regression models, adjusted for demographic characteristics and clustered on city. Of 5321 men, 1417 (26.6%) had recently been incarcerated (in the past 12 months), 2781 (52.3%) had ever been incarcerated but not in the past 12 months, and 1123 (21.1%) had never been incarcerated. Recent incarceration was associated with multiple casual female sexual partners (adjusted prevalence ratio [aPR] = 1.23; 95% confidence interval [CI], 1.05-1.44), condomless sex with multiple female sexual partners (aPR = 1.32; 95% CI, 1.06-1.66), injection drug use (aPR = 3.75; 95% CI, 2.64-5.32), and having sexual partners who were more likely to have ever injected drugs (aPR = 1.84; 95% CI, 1.48-2.28), been incarcerated (aPR = 2.28; 95% CI, 2.01-2.59), or had a concurrent sexual partner (aPR = 1.08; 95% CI, 1.05-1.11), as compared with never-incarcerated men. Incarceration history was associated with HIV risk-related behaviors among heterosexual men from urban areas in the United States. Correctional rehabilitation initiatives are needed to promote strategies that mitigate HIV risk-related behaviors and promote healthy reentry into communities among heterosexual men at high risk for HIV.

Analysis of spatial-temporal distribution and influencing factors of pulmonary tuberculosis in China, during 2008-2015.

At present, the number of people with tuberculosis in China is second only to India and ranks second in the world. Under such a severe case of tuberculosis in China, prevention and control of pulmonary tuberculosis are urgently needed. This study aimed to study the temporal and geographical relevance of the pathogenesis of pulmonary tuberculosis and the factors affecting the incidence of tuberculosis. Spatial autocorrelation model was used to study the spatial distribution characteristics of pulmonary tuberculosis from a quantitative level. The research results showed that the overall incidence of pulmonary tuberculosis (IPT) in China was low in the east, high in the west and had certain seasonal characteristics. We use Spatial Lag Model to explore influencing factors of pulmonary tuberculosis. It indicates that the IPT is high in areas with underdeveloped economics, poor social services and low average smoking ages. Additionally, the IPT is high in areas with high AIDS prevalence. Also, compared with Classical Regression Model and Spatial Error Model, our model has smaller values of Akaike information criterion and Schwarz criterion. Besides, our model has bigger values of coefficient of determination (R2) and log-likelihood (log L) than the other two models. Apart from that, it is more significant than Spatial Error Models in the spatial dependence test for the IPT.

Fears for the future: the incommensurability of securitisation and in/securities among southern African youth

Over the past two decades, southern Africa has experienced both exceptionally high AIDS prevalence and recurrent food shortages. International institutions have responded to these challenges by framing them as security concerns that demand urgent intervention. Young people are implicated in both crises and drawn into the securitisation discourse as agents (of risk and protection) and as (potential) victims. However, the concepts of security deployed by global institutions and translated into national policy do not reflect the ways in/security is experienced ‘on the ground’ as a subjective and embodied orientation to the future. This paper brings work on youth temporalities to bear on social and cultural geographies of in/security and securitisation. It reports on research that explored insecurities among young people in Lesotho and Malawi. It concludes that, by focusing on ‘threats’ in isolation, and seeking to protect ‘society’ as an abstract aggregate of people, global securitisation discourses fail either to engage with the complex contextualised ways in which marginalised people experience insecurity or to proffer the political responses that are needed if those felt insecurities are to be addressed. However, while securitisation is problematic, in/security is nonetheless an important element in young people’s orientation to the future.

Fluoroquinolone, Macrolide, and Ketolide Resistance in Haemophilus parainfluenzae from South Africa.

Fluoroquinolones and ketolides are among the drugs of choice for the treatment of Haemophilus parainfluenzae infections. There has been a report of an emerging fluoroquinolone and telithromycin resistance in H. parainfluenzae isolates from the private sector of KwaZulu-Natal Province of South Africa that necessitates molecular investigation. The aim of this study is to characterize these resistance delineating mutations in genes commonly associated with reduced susceptibility. Ten H. parainfluenzae isolates retrieved from the sputum of 10 patients with H. parainfluenzae pneumonia were subjected to sensitivity testing by the disc diffusion and CLSI broth microdilution methods, polymerase chain reaction (PCR) and DNA sequencing of selected genes associated with resistance were carried out, while repetitive extragenic palindromic PCR (REP-PCR) was used to ascertain clonality. Fluoroquinolone resistance was attributed to the following amino acid substitutions: S84F, D88Y in GyrA, and S84Y/L, S138T, and M198 L change in ParC of the isolates. The plasmid-mediated quinolone resistance gene aac-(6')-Ib-cr was detected for the first time in four isolates of H. parainfluenzae and D420 N change was observed in ParE in one isolate. Macrolide and ketolide resistance were ascribed to the resistance genes mef (A), msr (D), and erm (B) detected in the isolates. REP-PCR analysis showed that the isolates were not clonal. All the observed resistance mechanisms are first reports in Africa. There is an emerging fluoroquinolone and macrolide resistance in H. parainfluenzae in South Africa that is attributable to known/novel resistance mechanisms, necessitating the monitoring of this pathogen as a potential opportunistic pathogen in a country with a high HIV and AIDS prevalence.

Combating HIV and/or AIDS: A challenge to Millennium Development Goals for disaster managers in the Southern African Development Community.

Disaster management is a process of planning and implementation of measures involving multiple disciplines and sectors; hence Millennium Development Goals (MDGs) cannot go unnoticed. Approximately 189 member states agreed to endeavour to achieve MDGs which should be accomplished by 2015. The purpose of this research was to establish the primary involvement of the disaster management fraternity within the Southern African Development Community (SADC) region in this agreement. SADC countries are the countries with a high prevalence of HIV and AIDS and they feature on the disaster manager’s priority list of hazards, hence the focus on MDG 6 for this study. Various data gathering tools were employed and included making use of indicators developed by the United Nations to review disaster management statutes or civil protection statutes and scholarly documents on the progress of MDG 6. Structured interviews were carried out with heads of disaster management centres of SADC countries through the guidance of MDG 6 indicators. The main findings were that most statutes do acknowledge the fight against epidemics and most disaster managers are aware of MDG 6 and are involved in its achievement. It was recommended that disaster managers should be part of the Post 2015 MDG delegation.

Evaluation Framework for HIV Prevention and Care Activities in the Enhanced Comprehensive HIV Prevention Planning Project, 2010-2013.

The Enhanced Comprehensive HIV Prevention Planning (ECHPP) project was a demonstration project implemented by 12 U.S. health departments (2010-2013) to enhance HIV program planning in cities with high AIDS prevalence, in support of National HIV/AIDS Strategy goals. Grantees were required to improve their planning and implementation of HIV prevention and care programs to increase their impact on local HIV epidemics. A multilevel evaluation using multiple data sources, spanning multiple years (2008-2015), will be conducted to assess the effect of ECHPP on client outcomes (e.g., HIV risk behaviors) and impact indicators (e.g., new HIV diagnoses). We designed an evaluation approach that includes a broad assessment of program planning and implementation, a detailed examination of HIV prevention and care activities across funding sources, and an analysis of environmental and contextual factors that may affect services. A data triangulation approach was incorporated to integrate findings across all indicators and data sources to determine the extent to which ECHPP contributed to trends in indicators. To date, data have been collected for 2008-2009 (pre-ECHPP implementation) and 2010-2013 (ECHPP period). Initial analysis of process data indicate the ECHPP grantees increased their provision of HIV testing, condom distribution, and partner services programs and expanded their delivery of prevention programs for people diagnosed with HIV. The ECHPP evaluation (2008-2015) will assess whether ECHPP programmatic activities in 12 areas with high AIDS prevalence contributed to changes in client outcomes, and whether these changes were associated with changes in longer-term, community-level impact.

Health Department HIV Prevention Programs That Support the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010-2013.

The Enhanced Comprehensive HIV Prevention Planning project was the first initiative of the Centers for Disease Control and Prevention (CDC) to address the goals of the National HIV/AIDS Strategy (NHAS). Health departments in 12 U.S. cities with a high prevalence of AIDS conducted comprehensive program planning and implemented cost-effective, scalable HIV prevention interventions that targeted high-risk populations. We examined trends in health department HIV prevention programs in these cities during the project. We analyzed the number of people who received partner services, condoms distributed, and people tested for HIV, as well as funding allocations for selected HIV prevention programs by year and by site from October 2010 through September 2013. We assessed trends in the proportional change in services and allocations during the project period using generalized estimating equations. We also conducted thematic coding of program activities that targeted people living with HIV infection (PLWH). We found significant increases in funding allocations for HIV testing and condom distribution. All HIV partner services indicators, condom distribution, and HIV testing of African American and Hispanic/Latino populations significantly increased. HIV tests associated with a new diagnosis increased significantly among those self-identifying as Hispanic/Latino but significantly decreased among African Americans. For programs targeting PLWH, health department activities included implementing new program models, improving local data use, and building local capacity to enhance linkage to HIV medical care, retention in care, and treatment adherence. Overall, these findings indicate that health departments in areas with a high burden of AIDS successfully shifted their HIV prevention resources to scale up important HIV programs and make progress toward NHAS goals.

HIV Risk Behaviors Are Common Among Heterosexuals in the U.S.

The National HIV Behavioral Surveillance System (NHBS) collects data on HIV prevalence and risk behaviors from three populations — men who have sex with men, injection-drug users, and heterosexuals at increased risk for HIV infection — in selected U.S. metropolitan statistical areas with high AIDS prevalence. Because the initial (2006–2007) NHBS data-collection cycle among heterosexuals suggested that low socioeconomic status (SES) was an accurate marker of HIV acquisition risk in this group, researchers …

Psychosocial Support and Girls Infected or Affected by HIV and AIDS Education in Maseno Division, Western Kenya

There wide gender disparities in education in places with high HIV and AIDS prevalence despite the support of many stakeholders. The study was to identify the psychosocial support in the area under study and establish areas of inadequacies’. The objective of the study was to establish the influence psychosocial support on education of girls’ infected or affected by HIV and AIDS. The study was conducted between June 2011 and February

Correlates of HIV Infection Among African American Women from 20 Cities in the United States

Little research has been conducted to investigate multiple levels of HIV risk-individual risk factors, sex partner characteristics, and socioeconomic factors-among African American women, who, in 2010, comprised 64 % of the estimated 9,500 new infections in women. Respondent-driven sampling was used to recruit and interview women in 20 cities with high AIDS prevalence in the United States through the National HIV Behavioral Surveillance System. We assessed individual risk factors, sex partner characteristics, and socioeconomic characteristics associated with being HIV-positive but unaware of the infection among African American women. Among 3,868 women with no previous diagnosis of HIV, 68 % had high school education or more and 84 % lived at or below the poverty line. In multivariable analysis, women who were 35 years or older, homeless, received Medicaid, whose last sex partner ever used crack cocaine or was an exchange sex partner were more likely to be HIV-positive-unaware. Developing and implementing strategies that address socioeconomic factors, such as homelessness and living in poverty, as well as individual risk factors, can help to maximize the effectiveness of the public health response to the HIV epidemic.

Engagement in HIV Care Among HIV-Positive Men Who Have Sex with Men From 21 Cities in the United States

We assessed factors associated with HIV care among HIV-infected men who have sex with men (MSM). We used 2008 data on MSM from the National HIV Behavioral Surveillance System (NHBS). Venue-based, time-space sampling was used to recruit and interview men in 21 U.S. cities with high AIDS prevalence. Among self-reported HIV-positive MSM, we used generalized estimating equations (clustered on city of interview) to evaluate factors associated with delayed linkage to care (care entry >3months after diagnosis), not currently receiving care (no visit for HIV care during the 6months before the study interview), and not being on antiretroviral therapy (ART). Among 8,153 MSM, 882 (11%) were self-reported HIV-positive. 25% had delayed linkage, 12% were not currently receiving care and among those with at least one heath care visit 30% were not on ART. In multivariate analysis, lower income and testing positive at their first HIV test were associated with delayed linkage. Age 18-29years, and not having health insurance were associated with not currently receiving care. Among those with at least one health care visit, being age 18-39years, having private or no health insurance, and stimulant use were associated with not being on ART. These findings can inform efforts to improve engagement in care.

Parents’ perceptions of HIV counselling and testing in schools: Ethical, legal and social implications

In view of the high prevalence of HIV and AIDS in South Africa, particularly among adolescents, the Departments of Health and Education have proposed a school-based HIV counselling and testing (HCT) campaign to reduce HIV infections and sexual risk behaviour. Through the use of semi-structured interviews, our qualitative study explored perceptions of parents regarding the ethico-legal and social implications of the proposed campaign. Despite some concerns, parents were generally in favour of the HCT campaign. However, they were not aware of their parental limitations in terms of the Children's Act. Their views suggest that the HCT campaign has the potential to make a positive contribution to the fight against HIV and AIDS, but needs to be well planned. To ensure the campaign's success, there is a need to enhance awareness of the programme. All stakeholders, including parents, need to engage in the programme as equal partners.

Economic Decline, Health Worker Migration and its Impact on Female Workload in Zimbabwe

This paper explores the implications of Home Based Care on women’s workload in the context of high HIV and AIDS prevalence rates in Zimbabwe as the country has experienced serious health worker migration since 2000. Health worker migration in Zimbabwe as a result of the weak performance of the economy over the years has inadvertently increased women’s workload as more and more people adopt Home Based Care for their terminally ill family members suffering from HIV and AIDS. Home-based care has been one of the most effective community care strategies in Zimbabwe for people living with HIV and AIDS. To explore this state of affairs the paper adopted the theory of reflexive modernity which argues that the progressive freeing of the agency from structure has the effect of releasing people from the inherent constrains of the socio-structural tradition of modernity. The conclusion is that in the Zimbabwean context were women are viewed as the ‘natural’ care givers reflexive modernity may fail to apply as increased health worker migration is increasing women’s workload as more women are involved in Home Based Care in the context of high HIV and AIDS prevalence rates.

Impact of HIV and AIDS on food security in Rufiji District, Tanzania

Relatively high prevalence of HIV and AIDS and food insecurity in Rufiji District whilst the linkage between the two problems was not known was the basis of this study. Data were collected amongst 225 households between November 2005 and October 2006 through participatory rural appraisal (PRA), household income and expenditure survey (HIES) and structured interviews. Binary logistic regression was used for analysis in which case the dependent variable was food security in terms of food insecure (0) and food secure (1) based on kilocalories consumed per adult equivalent per day. The independent variables included having been affected by HIV and AIDS in terms of not affected (0) and affected (1). The results reveal that the odds for households affected by HIV and AIDS to be food secure were 0.705 times as high as the odds for households not affected by HIV and AIDS to be food secure. This means that households affected by HIV and AIDS were less likely to be food secure as opposed to those not affected by HIV and AIDS. The B statistic for having been affected by HIV and AIDS was negative (B = -0.350) meaning that being affected by HIV and AIDS had negative impact on food security. However, the Wald statistic which shows the magnitude of impact was small (0.251) and not significant (p = 0.617). This shows that HIV and AIDS had little impact on food security. Based on these findings, it is concluded that although being affected by HIV and AIDS has negative impact on food security, it does not automatically make households food insecure, especially in a short run, and that some non-HIV and AIDS factors like high dependency ratio and low ability to buy food have bigger negative impact than that of HIV and AIDS on food security. On the basis of the conclusion, it is recommended that efforts to improve food security amongst households affected by HIV and AIDS should consider both HIV and AIDS and non-HIV and AIDS factors.

Ambiguous diagnosis, futile treatments and temporary recovery: Meanings of medical treatment among HIV/AIDS family caregivers providing care without ARVs

The capacity of countries with high HIV and AIDS prevalence to provide antiretroviral treatment and care for all people who need support remains a public health challenge. In Lesotho, there are improvements in this area but the high proportion of people who need ART yet they do not receive treatment suggests that many HIV-infected people continue to depend on medicines that treat opportunistic infections. The objective of the article is to explore caregivers' experiences with diagnostic procedures and outcomes, prescriptions and treatment outcomes when ARVs were unavailable. A phenomenological design using in-depth face-to-face interviews was used to obtain the experiences of 21 family caregivers about caregiving, including access to and use of medical treatments. Caregivers' experiences indicate that most of the consulted health professionals provided vague and inconsistent diagnoses while the medication they prescribed failed to treat most of the symptoms. Unavailability of medicines that control pain and symptoms effectively continues to be a prominent feature of HIV and AIDS home-based caregiving in Lesotho. It is recommended that health professionals should facilitate disclosure of HIV diagnosis to family caregivers to assist them to understand unstable treatment outcomes; and policy makers should strengthen home-based care by developing policies that integrate palliative care into HIV and AIDS care.

Private healthcare sector doctors and HIV testing practices in the eThekwini Metro of KwaZulu-Natal

Background: Human immunodeficiency virus (HIV) testing has many logistic and ethical challenges. The UNAIDS/WHO policy statement states that the testing of individuals must be confidential, be accompanied by counselling, and be conducted with informed consent. HIV testing is integral to the management of the epidemic, and since KwaZulu-Natal (KZN) has the highest prevalence of AIDS in South Africa, it is vital that doctors in this province are knowledgeable about HIV testing practices. This study was undertaken in view of the lack of data on private sector doctors’ HIV testing practices in KwaZulu-Natal. Method: A descriptive cross-sectional study was conducted among private sector doctors who manage HIV and AIDS patients in the eThekwini Metro of KZN. One hundred private practitioners were randomly selected from a sample of 175 consenting private sector doctors. These doctors were asked to fill in an anonymous questionnaire. The questionnaires were collected and analysed using SPSS® version 15. Results: A response rate of 60% was obtained, with 57 (95%) indicating that they do HIV testing after obtaining patients’ consent. Over 96% of the doctors carried out pre-test counselling, while over 98% did post-test counselling. Eighty-one per cent did a confirmatory test if the patient tested positive, while 49% performed a confirmatory test if the patient tested negative; over 50% did the test after three months. Forty-seven per cent did not know or failed to indicate what confirmatory test they used. The majority did not disclose patient status or do counselling in the presence of others. However, if it was done, it was done with the consent of the patient or the parents in cases where the patient was a minor. The majority stated that they follow the guidelines when testing. Conclusion: The HIV testing practices of private sector doctors who participated in the study are compliant with the UNAIDS/WHO policy statement regarding confidentiality, informed consent and counselling. However, doctors’ knowledge of confirmatory test appears to be inadequate. Keywords: HIV, AIDS, private healthcare sector doctors, HIV testing

S13.4 Use of respondent-driven sampling for monitoring HIV behaviours among injecting drug users in the United States

BackgroundApproximately 1.1 million persons in the United States are living with HIV and for 18.5% their infections are attributable to injection drug use. In 2009 there were an estimated 5063...