High Rates Of HIV Infection Research Articles

Xu hướng nhiễm HIV và một số hành vi nguy cơ lây nhiễm HIV ở nam quan hệ tình dục đồng giới tại Cần Thơ, An Giang, giai đoạn 2017 – 2020

Objective: To describe the HIV infection tendencies and risk behaviors among men who have sex with men (MSM) in Can Tho and An Giang between 2017 and 2020. Method: Repeated cross-sectional study design based on the analysis of HIV sentinel surveillance (HSS) data collected in An Giang and Can Tho between 2017 and 2020. A trend analysis is applied to evaluate the changes in HIV infection and high-risk behaviors over time. Result: HIV prevalence is 16.3% of the MSM population, an increase from 14.4% to 19%, with a rising trend among those aged 25 and older. MSMs are increasingly more likely to have sex relationships at younger ages, engage in prostitution, group sexual activity, regularly have sex without using a condom, look for sexual partners online, use stimulants, and have syphilis. The percentage of MSM who receive free condoms, STIs testing and treatment is decreasing. Conclusion: The HIV transmission among MSM in the two middle provinces of the Cuu Long River Delta raises alarm, particularly with the current relatively high rate of HIV infection among young individuals. With the insufficient coverage of HIV preventive programs, several HIV-transmitted risk behaviors worsen. These two provinces should prioritize comprehensive HIV/AIDS prevention interventions with an emphasis on MSM. Key words: Trend analysis, HIV, MSM, risk behaviors, HSS

Characteristics and Trends in HIV Testing Among Medicaid Enrollees Diagnosed as Having Schizophrenia.

People with schizophrenia have more HIV risk factors and higher rates of HIV infection than the general U.S. population. The authors aimed to examine HIV testing patterns in this population nationally and by demographic characteristics and presence of high-risk comorbid conditions. This retrospective longitudinal study compared HIV testing between Medicaid-only enrollees with schizophrenia and without schizophrenia during 2002-2012 (N=6,849,351). Interrupted time series were used to analyze the impacts of the 2006 federal policy change recommending expanded HIV testing. Among enrollees with schizophrenia, multivariable logistic regression was used to estimate associations between testing and both demographic characteristics and comorbid conditions. Sensitivity analyses were also conducted. Enrollees diagnosed as having schizophrenia had consistently higher HIV testing rates than those without schizophrenia. When those with comorbid substance use disorders or sexually transmitted infections were excluded, testing was higher for individuals without schizophrenia (p<0.001). The federal policy change likely increased testing for both groups (p<0.001), but the net change was greater for those without schizophrenia (3.1 vs. 2.2 percentage points). Among enrollees with schizophrenia, testing rates doubled during 2002-2012 (3.9% to 7.2%), varied across states (range 17 percentage points), and tripled for those with at least one annual nonpsychiatric medical visit (vs. no visit; adjusted OR=3.10, 95% CI=2.99-3.22). Nationally, <10% of enrollees with schizophrenia had annual HIV testing. Increases appear to be driven by high-risk comorbid conditions and nonpsychiatric encounters, rather than by efforts to target people with schizophrenia. Psychiatric guidelines for schizophrenia care should consider HIV testing alongside annual metabolic screening.

Risk Factors for Human Papillomavirus-Associated Cancers Among People Living with HIV in Washington, District of Columbia.

District of Columbia (DC) has high rates of HIV infection and human papillomavirus (HPV)-associated cancers. People living with HIV (PLWH) are at risk for developing HPV-associated cancers. Previous studies identified factors that may further increase the risk of HPV-associated cancer among PLWH such as age, race/ethnicity, sex, risk factor for HIV transmission, stage of HIV infection, and age at HIV diagnosis. The extent to which PLWH in DC are affected by HPV-associated cancers has not previously been well described, and to our knowledge, the relationship between bacterial sexually transmitted infections (STIs) and subsequent development of HPV-associated cancer among PLWH in DC has not been explored. This was a retrospective case-control analysis of surveillance data on cancer, STIs, and HIV in Washington, DC from 1996 to 2015. There were 20,744 PLWH included in this study, of whom 335 (1.6%) had been diagnosed with an HPV-associated cancer. Among males living with HIV (MLWH), for every additional STI per 10 person-years, risk of developing an HPV-associated cancer increased by 11%. Exposure to STIs was not a significant risk factor for HPV-associated cancer among females. Ever being diagnosed with stage three HIV infection increased risk of HPV-associated cancers among males by 109% and females living with HIV by 111%. STI exposures were associated with HPV-associated cancers among MLWH in DC and ever being diagnosed with advanced HIV infection was associated with HPV-associated cancers among all PLWH. Clinicians treating MLWH should ensure their patients receive primary HPV infection prevention and HPV-associated cancer screenings.

Addressing key issues in HIV self-test program implementation for Black and Latino sexual minority men in the Southern United States: a multiphase study protocol

BackgroundBlack and Latino sexual minority men in the Southern United States have the highest HIV infection rates in the country. Increased HIV testing can help decrease onward HIV transmission through detecting previously undiagnosed infections. HIV self-testing is an evidence-based strategy to increase HIV testing among sexual minority men, but the implementation of this intervention in the Southern United States is limited. One implementation barrier is the lack of knowledge of Black and Latino sexual minority men’s preferences for various HIV self-testing program characteristics and their willingness to pay for these preferences. In addition, little is known about facilitators and barriers to initiating HIV self-testing programs from the perspectives of HIV prevention implementation decision-makers in this region.MethodsWe will conduct an online discrete choice experiment among Black and Latino sexual minority men in the Southern United States (n = 300) to estimate this population’s preferences for the following HIV self-testing program characteristics: delivery strategy (home delivery, peer delivery, clinic pickup); delivery speed (same day, next day, 3 days, and 5 days); support (instructions only, during test, and 1 week after delivery); and price ($0, $20, $40, $50, $60). We will also use this choice data to generate willingness-to-pay estimates for each program characteristic. Guided by the Consolidated Framework for Implementation Research, we will then conduct semi-structured interviews (n = 30) with HIV prevention program decision-makers at various health organizations serving Black and Latino sexual minority men in the region to further understand facilitators and barriers to implementation of the most preferred HIV self-testing program design.DiscussionBy gaining perspectives on HIV self-testing implementation from patients and providers, this project will build a roadmap for the initiation of HIV self-testing programs to decrease HIV incidence among one of the most disproportionately impacted populations in the USA.

Parents resist sexuality education through digital activism

South Africa has high rates of HIV infection among its young population, high rates of unintended pregnancy among the youth, and extremely high rates of gender-based violence. Given all this, it is essential that young people be taught skills that will enable them to manage their sexuality. Schools have been shown to be best placed to provide accurate and relevant information on young people's sexualities. Through the Life Orientation (LO) curriculum, the Department of Basic Education (DBE) offers age-appropriate sexuality education as a response to these concerns. However, research in sexuality education shows that there is a lack of guidance and preparedness by educators, and this hampers how sexuality education is delivered in South African schools. A recent attempt by the DBE to upscale and strengthen the sexuality education curriculum in South African schools was met with resistance from parents and other lobby groups. This resistance was driven across many different media platforms, and particularly through an online hashtag #LeaveOurKidsAlone, largely on Facebook and Twitter. Through this resistance, we are introduced to parents/adult response to the teaching and learning of comprehensive sexuality education (CSE) in South African schools, a voice that has been missing to a great extent in this debate. Working within a broad feminist qualitative framework, I use critical discourse analysis to map out some of the key discourses emerging from the #LeaveOurKidsAlone resistance in an attempt to understand how parents/adults use social media to resist CSE in South Africa. I foreground critically adult voices and the implications of these for the teaching and learning of CSE in South African schools.

Web-Based Harm Reduction Intervention for Chemsex in Men Who Have Sex With Men: Randomized Controlled Trial

Men who have sex with men (MSM) who practice chemsex have a higher likelihood of engaging in risky sexual behaviors and higher rates of HIV infection and other sexually transmitted infections (STIs) than those who do not. This trial aimed to evaluate the effectiveness of a web-based intervention in reducing the sexual harms of chemsex among MSM. The study was a 2-arm, assessor-blinded, randomized, parallel-group trial with a 3-month follow-up period. The study was conducted in the year 2021 in Hong Kong. Underpinned by the theory of planned behaviors and a harm reduction approach, the intervention consisted of interactive components and knowledge-based information about chemsex. Participants in the control group received brief information and content about sexual violence. The primary outcome was self-efficacy in refusing risky sexual behaviors and chemsex, as measured by the Condom Self-Efficacy Scale (CSES), Self-Efficacy for Sexual Safety (SESS) instrument, and Drug Avoidance Self-Efficacy Scale (DASES). The secondary outcomes included intentions to have chemsex, actual engagement in chemsex, HIV and other STI testing, and condom use in the last 3 months. All outcomes were self-reported. An online structured questionnaire was used to collect data. In total, 316 MSM enrolled in the study. The intervention group demonstrated a significantly larger improvement in condom-use self-efficacy (as measured by CSES scores; time-by-group interaction: β=4.52, 95% CI 2.03-7.02; P<.001), self-efficacy for sexual safety (as measured by SESS scores; time-by-group interaction: β=2.11, 95% CI 0.66-3.56; P=.004), and drug avoidance self-efficacy (as measured by DASES scores; time-by-group interaction: β=6.98, 95% CI 1.75-12.22; P=.009). Regarding the secondary outcomes, participants in the intervention group demonstrated a significantly larger reduction in the likelihood of having engaged in chemsex in the last 3 months (time-by-group interaction: odds ratio [OR]=0.23, 95% CI 0.10-0.53; P=.001) and likelihood of having had the intention to engage in chemsex in the last 3 months (time-by-group interaction: OR=0.37, 95% CI 0.18-0.78; P=.009). Participants in the intervention group also showed a significantly larger increase in the likelihood of having undergone HIV testing in the last 3 months (time-by-group interaction: OR=3.08, 95% CI 1.72-5.54; P<.001). This study suggests that a web-based intervention with a harm reduction approach can enhance the self-efficacy of MSM in refusing risky sexual behaviors and chemsex and improve the uptake of HIV testing. We also provide initial evidence that such interventions can reduce both the intention of MSM to engage in chemsex and their actual engagement in chemsex. ISRCTN Registry ISRCTN20134522; https://www.isrctn.com/ISRCTN20134522. RR2-10.1186/s12889-021-10742-8.

Factors associated with buying sex and the knowledge that condoms prevent HIV among long-distance truck drivers at Kazungula weighbridge terminal, Chobe District, Botswana

Background: Long-distance truck drivers (LDTDs) have a higher rate of HIV infection compared to the general population. This is due to their living and working conditions which predispose them to riskier sexual behaviours. Inadequate knowledge of HIV and AIDS, coupled with risky sexual behaviours such as unprotected sex with commercial sex workers (CSWs), predisposes LDTDs to contract and propagate HIV. This study aims to determine the factors associated with buying sex and the knowledge that condoms prevent HIV transmission among long-distance truck drivers at Kazungula weighbridge terminal in the Chobe District of Botswana. Methods: A cross-sectional descriptive survey was employed and 399 LDTDs participated. A questionnaire was used to collect sociodemographic data and information on knowledge of HIV and AIDS and the sexual behaviours of the LDTDs. Results: The results reveal that more than half of the LDTDs (56.9%; n = 227) had paid for sex with CSWs at some point in their travels, and 27.1% (n = 108) reported having had unprotected sex with CSWs. The LDTDs who preferred to have sex with CSWs without a condom had about five times the odds of buying sex with CSWs than those who preferred to use a condom (AOR 4.9; 95% CI 2.85–8.46). Disliking condom use was a factor contributing to less knowledge of condom use preventing HIV among the LDTDs (AOR 0.4; CI 0.17–0.97). Conclusion: It can be concluded from the results of this study that the LDTDs engage in considerable risky sexual behaviours, and associated factors were found to be multidimensional. This population remains of concern in HIV acquisition and transmission. Therefore, there is a need for a robust public health response to deal with the problem of both new infection and re-infection with HIV in this population.

Ethical HIV research with transgender and non-binary communities in the United States.

IntroductionBecause transgender individuals experience disproportionately high rates of HIV infection, this population is an increasing focus of epidemiological and implementation science research to combat the epidemic. However, study participants, providers and other advocates have become increasingly concerned about research practices that may alienate, objectify, exploit or even re‐traumatize the communities they are designed to benefit. This commentary explores the common pitfalls of HIV research with transgender communities and provides a potential framework for ethical, community‐engaged research practice.DiscussionWe review some of the critical challenges to HIV research with transgender and non‐binary communities that limit the potential for such studies to improve practice. For example, scales that measure stigma perceptions/experiences often include activating language, while the consistent focus in research on risk and trauma can often feel judgemental and redundant. Because of limited employment opportunities, some participants may feel undue influence by research stipends; others may perceive their participation as fuelling the larger research economy without providing research jobs to community members. Questions remain regarding optimal strategies for authentic research partnership beyond community advisory boards or focus groups. Transgender and non‐binary researchers are under‐represented and may be tokenized. Many demonstration projects provide much‐needed services that disappear when the research funding is over, and community‐based dissemination efforts are often perceived as “too little, too late” to effect change.ConclusionsBased on this review and input from study participants across the United States, we detail six recommendations for ethical HIV research with transgender and non‐binary communities, including (1) equitable budgeting with community‐based programme partners; (2) representation in the development of both research agenda and methods; (3) integration of research activities into the ongoing work of any clinical or service site, so that individuals’ needs as “clients” can continue to be prioritized over their role as “participants;” (4) mindfully considered compensation that values the contributions of community members, but avoids undue influence; (5) transparent, community‐focused and timely communication at every stage of the study, including research purpose, data usage, preliminary findings and full‐scale results; and (6) planning for sustainability of any programme or services beyond the life of the research project.

Lessons from +LOVE, Improving HIV Care for Black Men Who Have Sex with Men in New Orleans Using an Integrated Behavioral Health Crisis Support Model of Care.

Black men who have sex with men (BMSM) experience higher rates of HIV infection than other groups. They also face disparities in linkage and retention to HIV care, as well as in viral suppression. To address the needs of the BMSM population living with HIV, we developed a novel intervention program (+LOVE), which integrated case management with behavioral health/crisis support. The intervention consisted of (1) a dedicated therapist; (2) an SMS (text message)-based engagement program, CareSignal that provided medication reminders and administered routine ecological momentary assessments (EMAs); (3) a triage crisis coordinator to respond to alerts generated by the EMA responses; and (4) a case manager. This study assessed the additional impact of the first three components of the intervention (a dedicated therapist, text messaging application, along with a triage crisis coordinator), compared with the fourth component alone, the current standard of care (a case manager) on access to HIV care, antiretroviral therapy (ART) adherence, and viral suppression. Analyzing electronic medical record data, survey data, and EMA response data extracted from CareSignal, we found that those who engaged in the behavioral health therapy had higher odds of remaining in HIV care than those who only engaged with the case manager. We also found that increased engagement with CareSignal led to an increased probability of achieving positive HIV-related health outcomes. Our results suggest that an integrated behavioral health/crisis support model of intervention integrated with case managementincreased positive outcomes over case management alone.

“That makes me feel human”: a qualitative evaluation of the acceptability of an HIV differentiated care intervention for formerly incarcerated people re-entering community settings in South Africa

BackgroundCorrectional settings in South Africa have disproportionately high rates of HIV infection; a large number of inmates living with HIV return to the community each year. The transition community adherence club (TCAC) intervention was a differentiated care delivery approach with structural and peer components designed to increase antiretroviral therapy (ART) adherence and HIV care engagement following release from incarceration. The objective of this study was to assess the acceptability of the TCAC intervention among HIV-infected community re-entrants to inform program revisions and future intervention designs.MethodsThis was a qualitative study set within a randomized controlled trial (RCT) of the TCAC intervention in South Africa. We conducted semi-structured, in-depth interviews with 16 re-entrants living with HIV and assigned to the intervention arm. All interviews were audio-recorded, transcribed, translated, and de-identified. Transcripts were coded and analyzed using content analysis, and acceptability was assessed using the Theoretical Framework of Acceptability (TFA).ResultsOverall, study participants reported that the TCAC intervention was acceptable. Development of supportive relationships between participants, non-judgmental attitudes from peer-facilitators, and perceived effectiveness of the intervention to support ART adherence and HIV care were noted as the most valued components. An altruistic desire to help other participants facing similar post-incarceration and HIV-related challenges was a key motivator for TCAC attendance. A lack of access to reliable transportation to intervention sites and clinic-based medication collection were described as burdens to program participation. Illicit drug use by other group members and negative social influences were also identified as potential barriers to optimal program engagement.ConclusionThe TCAC was a well-accepted model of differentiated care delivery among re-entrants living with HIV in South Africa. To further enhance intervention acceptability for future scale-ups, program revisions should address logistical barriers related to reaching TCAC sites and implementing ART distribution at TCAC group sessions.

Acceptability and Appropriateness of Digital PrEP Interventions for Black and Latina Cisgender Women: Perspectives From Service Providers in Los Angeles County.

Black and Latina cisgender women (BLCW) experience disproportionately high rates of HIV infection compared with White women. BLCW also experience disparities in uptake of pre-exposure prophylaxis (PrEP), a highly effective HIV prevention strategy. Digital technology interventions may help to improve PrEP accessibility among BLCW and address barriers to receiving PrEP services in clinical settings. We conducted a formative implementation research project with service providers to explore the use of digital technology interventions to improve PrEP care continuum outcomes among priority populations in Los Angeles County. A thematic analysis approach was then used to assess the perceived acceptability and appropriateness of digital PrEP interventions for BLCW. Of the five technology products presented, service providers viewed the stand-alone telemedicine platforms as the most acceptable intervention type for BLCW. Service providers also noted perceived benefits and barriers that BLCW may experience in using stand-alone telemedicine platforms, and offered recommendations for tailoring the products to meet the individual needs of BLCW. Digital PrEP interventions may help address barriers BLCW experience in accessing PrEP in clinical settings. We offer suggestions of implementation strategies to optimize the use of digital PrEP interventions among BLCW.

A Descriptive Analysis of Cancer Screening Health Literacy Among Black Women Living with HIV in Baltimore, Maryland.

Background:Black women living with HIV (WLH) have the highest HIV infection rate, cervical cancer mortality, and the lowest cancer screening use compared to other groups. However, there is a gap in knowledge about cancer screening health literacy in the Black WLH population.Objective:The purpose of this study was to assess the level of cancer screening health literacy, and to identify factors associated with health literacy among Black WLH.Methods:This study used baseline data from a community-based randomized controlled trial for a health literacy intervention called CHECC-uP (community-based health literacy intervention for cancer control). We recruited a convenience sample of Black WLH (N = 123) who understand English and had no Pap testing in the prior 12 months. The outcome was cancer screening health literacy measured with a validated health literacy tool—Assessment of Health Literacy in Cancer Screening. Predictors included age, marital status, education, income, and insurance type. The association between cancer screening health literacy and predictors was assessed with multivariate logistic regression.Key Results:Almost one-half (49.6%) of study participants had a reading level at or below sixth grade. Older age (adjusted odds ratio [aOR] 1.05) and higher educational levels (aOR 5.13) were significantly associated with higher cancer screening health literacy among our sample of Black WLH in bivariate and multivariate analyses.Conclusions:Educational materials and other approaches to empower patients should be tested with patients who have low health literacy to ensure efficacy. [HLRP: Health Literacy Research and Practice. 2022;6(3):e175–e181.]Plain Language Summary:Using a cancer screening health literacy tool, we found that about one-half of the Black WLH in the study had a reading level at or below sixth grade. Age and education level were related to their reading levels among the women. Researcher and clinicians need to test educational materials and other approaches with patients who have low health literacy to make sure they work.

The Kasaba Quartet: The Impact of Card Games on Knowledge and Self-Efficacy HIV/AIDS Prevention

BACKGROUND: The rate of HIV/AIDS infection is increasing every year. The highest rates of HIV infection are among adolescents aged 15–24 years. Therefore, appropriate action is needed to prevent HIV transmission through risky behavior in adolescents. AIM: The purpose of this study was to determine the effect of Kasaba Quartet card game on HIV/AIDS knowledge and self-efficacy in preventing HIV/AIDS-related risk behavior in adolescents. METHODS: The study used a quasi-experiment with an equivalent time-series design. The intervention in this study was a card game using the Kasaba Quartet. The card game was held 3 times with a 1-day break. Adolescents’ HIV/AIDS knowledge and self-efficacy were measured at the end of each card game. Sampling used purposive sampling with criteria including adolescents aged 12–16 years and domiciled in Bandung. A total of 30 people were involved in this study. RESULTS: After playing the Kasaba Quartet card game, the results showed that adolescents’ knowledge of HIV/AIDS in the excellent category increased significantly, with average scores from 66.04 ± 16.219 to 97.40 ± 2.776. Likewise, adolescents’ self-efficacy with the high sort was raised, from 77.83 ± 8.67 to 97.60 ± 3.45. The results of statistical tests using the Friedman test showed the significance level of 0.001 (Sig. &lt;0.05). In other words, there was an effect of the Kasaba quartet card game on HIV knowledge and self-efficacy in preventing HIV risk behavior. CONCLUSIONS: Thus, the Kasaba Quartet card game effectively increases knowledge of HIV/AIDS and self-efficacy in preventing risky behavior in adolescents. The study results can be used as an alternative strategy to increase knowledge and confidence in adolescents to avoid the spread of HIV/AIDS cases.

Increased condom use among key populations using oral PrEP in Kenya: results from large scale programmatic surveillance

BackgroundFemale sex workers (FSW) and men having sex with men (MSM) in Kenya have high rates of HIV infection. Following a 2015 WHO recommendation, Kenya initiated national scale-up of pre-exposure prophylaxis (PrEP) for all persons at high-risk. Concerns have been raised about PrEP users' potential changes in sexual behaviors such adopting condomless sex and multiple partners as a result of perceived reduction in HIV risk, a phenomenon known as risk compensation. Increased condomless sex may lead to unintended pregnancies and sexually transmitted infections and has been described in research contexts but not in the programmatic setting. This study looks at changes in condom use among FSW and MSM on PrEP through a national a scale-up program.MethodsRoutine program data collected between February 2017 and December 2019 were used to assess changes in condom use during the first three months of PrEP in 80 health facilities supported by a scale-up project, Jilinde. The primary outcome was self-reported condom use. Analyses were conducted separately for FSW and for MSM. Log-Binomial Regression with Generalized Estimating Equations was used to compare the incidence proportion (“risk”) of consistent condom use at the month 1, and month 3 visits relative to the initiation visit.ResultsAt initiation, 69% of FSW and 65% of MSM reported consistent condom use. At month 3, this rose to 87% for FSW and 91% for MSM. MSM were 24% more likely to report consistent condom use at month 1 (Relative Risk [RR], 1.24, 95% Confidence Interval [CI], 1.18–1.30) and 40% more likely at month 3 (RR, 1.40, 95% CI, 1.33–1.47) compared to at initiation. FSW were 15% more likely to report consistent condom use at the month one visit (RR, 1.15, 95% CI, 1.13–1.17) and 27% more likely to report condom use on the month 3 visit (RR 1.27, 95% CI, 1.24–1.29).ConclusionCondom use increased substantially among both FSW and MSM. This may be because oral PrEP was provided as part of a combination prevention strategy that included counseling and condoms but could also be due to the low retention rates among those who initiated.

How HIV advocacy can be used to ensure quality transgender health care: lessons from South Africa

Based on rights entrenched in the 1996 Constitution for transgender people, South Africa has made substantial progress in advancing transgender health (appendix). We present some insights from the experience in South Africa of how HIV funding augmented the trajectory of transgender health care in South Africa. A 2018–19 survey conducted with transgender women showed high rates of HIV infection, ranging from 45·5% to 63·3%, in Cape Town, Johannesburg, and Buffalo City; this finding shows the vulnerability of these women.

Cango Lyec (Healing the Elephant): Probable post-traumatic stress disorder (PTSD) and depression in Northern Uganda five years after a violent conflict

BackgroundFrom 1986 to 2006, Northern Uganda experienced an atrocious civil war between the Lord's Resistance Army (LRA) and the Ugandan government. Acholi people living in the region continue to be impacted by trauma sequelae of the war and a wide range of daily stressors including poverty, hunger, and high rates of HIV infection. To date, there is a dearth of gender-differentiated mental health research in this post-conflict setting. The current study aimed to estimate the prevalence of probable post-traumatic stress disorder (PTSD) and depression in three districts most affected by the Northern Ugandan conflict and examine socio-structural, war-related, and sexual vulnerability factors associated with mental health. MethodsCango Lyec (Healing the Elephant) is an open cohort study involving participants from eight randomly selected communities in Amuru, Gulu, and Nwoya districts of Northern Uganda. Between November 2011 and July 2012, the baseline cohort (N = 2,458) completed the Harvard Trauma Questionnaire (HTQ) and Hopkins Symptom Checklist-25 (HSCL-25) for screening PTSD and depression, in addition to a detailed questionnaire assessing socio-demographic-behavioral characteristics. Baseline categorical variables were compared between males and females using Fisher's exact test. Multivariate logistic regression was used to model correlates of probable PTSD and depression. All analyses were stratified by gender. ResultsThe overall prevalence of probable PTSD and depression was 11.7% and 15.2% respectively. Among former abductees, the prevalence was 23.2% for probable PTSD and 26.6% for probable depression. Women were significantly more likely to experience mental distress than men. Factors associated with mental distress included wartime trauma (adjusted odds ratios ranging from 2.80 to 7.19), experiences of abduction (adjusted odds ratios ranging from 1.97 to 3.03), and lack of housing stability and safety (adjusted odds ratios ranging from 1.95 to 4.59). Additional risk factors for women included HIV infection (AOR=1.90; 95% CI: 1.29–2.80), sexual abuse in the context of war (AOR=1.58; 95% CI: 1.02–2.45), and intimate partner violence (AOR=2.45; 95% CI: 1.07–5.63). ConclusionCango Lyec participants displayed lower than previously reported yet significant levels of probable PTSD and depression. Based on findings from this study, providing trauma-informed care, ensuring food and housing security, eliminating gender-based violence, and reintegrating former abductees remain important tasks to facilitate post-conflict rehabilitation in Northern Uganda.

Tailored motivational interviewing (TMI): Translating basic science in skills acquisition into a behavioral intervention to improve community health worker motivational interviewing competence for youth living with HIV.

Objective: Interventions to promote evidence-based practices are particularly needed for paraprofessional staff working with minority youth with HIV who have higher rates of HIV infection but lower rates of linkage and retention in care compared to older adults. Utilizing the ORBIT model for behavioral intervention development, we defined and refined a behavioral intervention for providers, Tailored Motivational Interviewing (TMI), to improve provider competence in previous studies (Phase 1a and 1b). The current study focuses on ORBIT Phase 2a-proof of concept. We hypothesized that TMI would be acceptable and feasible and would show a signal of efficacy of improving and maintaining community health worker (CHW) MI competence scores using an innovative statistical method for small N proof-of-concept studies. Method: Longitudinal data were collected from 19 CHWs at 16 youth HIV agencies. CHWs from 8 sites were assigned to the TMI group per the cofunders request. The remaining 8 sites were randomly assigned to TMI or services as usual. MI competence was assessed at baseline and up to 15 times over 2 years. Random coefficient models were utilized to examine time trajectories of competence scores and the impact of the intervention on competence trajectories. Semistructured interviews were conducted to determine barriers and facilitators of TMI. Results: Competence scores in the TMI group significantly increased while the scores of the control group significantly decreased. Further analysis of the intervention group demonstrated that scores significantly increased during the first 3 months after initial workshop and was sustained through the end of the study. Qualitative findings revealed insufficient time and competing priorities as perceived barriers whereas integrating MI into routine agency practices and ongoing training might facilitate implementation. Conclusions: Following a successful proof-of-concept, the next step is a fully randomized pilot study of TMI relative to a control condition in preparation for a stepped-wedge cluster randomized full scale trial. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Seroprevalence and characterisation of herpes simplex virus from human immunodeficiency virus in samples collected from two provinces in South Africa: a retrospective study.

Background:Herpes simplex virus (HSV) is a widely distributed human pathogen that is known for its ulcerative lesions at the infection site. HSV can cause persistent infection in the host that is often followed by a period of latency within the neurons. Considering the high rate of HIV infection in South Africa, it is important to assess the seroprevalence of HSV with a focus to determine the epidemiological association between HSV-DNA and HIV-1 in the population. Methods:A total of 44 sera samples were screened for HSV and HIV-1 using the highly sensitive enzyme-linked immunosorbent assay (ELISA). The ELISA positive samples were characterized using polymerase chain reaction (PCR) to confirm the positivity of both viruses and to further differentiate HSV into HSV-1 and -2. Thereafter, the samples were analysed for relatedness using phylogenetic analysis. Results:Of the 44 samples, 36 (81.8%) were positive for HIV-1, while 35 (79.5%) were positive for HSV when screened with ELISA kits. The PCR results, with the use of type specific primers, showed that 4/35 (11.4%) samples were specific for HSV-1 while 30/35 (85.7%) were specific for HSV-2. Statistical analysis performed using the chi-squared goodness-of-fit test showed that there is a significant relationship between HSV-2 and HIV-1 transmission. Conclusions:There is a significant positive association between HSV-2 and HIV-1 in the study population. Our study shows that some of the HSV-2 isolates are not related to the clinical isolate SD90e from South Africa, suggesting diversity in HSV-2 viral transmission.

Antiretroviral therapy experience, satisfaction, and preferences among a diverse sample of young adults living with HIV

ABSTRACT Youth and young adults living with HIV (YLWH) have a high HIV infection rate and suboptimal oral medication adherence. Biomedical researchers hope that long-acting antiretroviral therapy (LAART) modalities can help those who struggle with daily oral adherence. While adults living with HIV have expressed interest in LAART, little research has explored perspectives of YLWH. This study explores ART experiences and perspectives on LAART through qualitative interviews with twenty diverse YLWH (18–29) in the United States. Data were analyzed using framework analysis. Most participants were satisfied with their current ART yet had experienced side effects or had struggled with daily adherence. Preferences for improving daily oral ART included making pills smaller and reformulating ART into flavored chewable gummies. Most expressed enthusiasm for LAART, although needle aversion and previous injection drug use were potential barriers for some. Approximately half were interested in an ART patch, though its visibility and fear of stigmatization was concerning. Few expressed interest in implantable ART, calling it unappealing. Although younger people are most likely to benefit from these advancements in HIV treatment, additional research is needed to identify gaps in uptake and to further explore perspectives of YLWH to improve the success of new treatment modalities.

A systematic review of comprehensive sexuality education for South African adolescents

Comprehensive sexuality education (CSE) was implemented in South African schools in the year 2000 as part of the subject Life Orientation, with the aim of contributing positively to adolescent sexual health in a holistic manner. Continued high rate of teenage pregnancy and HIV infection is an indication; however, that the programme is not entirely successful. To establish why the aims of the programme and the consequences of learners’ sexual behaviour do not correspond, this systematic review aimed to determine how the programme contributes to the sexual health of adolescents and to make recommendations for its improvement. Nine databases were searched, after which two reviewers independently evaluated the methodological quality of the identified studies using an appraisal tool. The 22 articles that met the criteria for final inclusion were qualitative in nature and included cross-sectional and cohort studies. Results indicate that the contribution of the CSE programme is reflected in teachers, learners and the curriculum. Teachers are in need of expert training and learners are neither actively involved in the learning process nor the development of the programme as they need and would like to be. Recommendations include the development of context-specific training curricula for pre- and in-service teachers as developed collaboratively by various experts and stakeholders. Learners’ voices, active involvement, cultural context and needs are fundamental to the development and delivery of CSE. The teaching method and content of sexuality education should meet the contemporary needs of the 21st century adolescent to ensure optimal sexual health.