HIV Cases Research Articles

Virological Outcome in Newly Adult HIV Cases on Rapid ART initiation in Thailand, A Retrospective Study

Background: Same day or rapid ART initiation was suitable for asymptomatic HIV stage. Studies have shown benefits in faster virological suppression and reduction of loss to follow up rate. Objective: To compare virological outcome at 24 and 72 weeks in adult HIV infection starting ART within two weeks as the rapid ART group, or more than two weeks as the standard care group. Materials and Methods: A retrospective cohort study was conducted at Chiangrai Prachanukroh Hospital, Chiangrai, Thailand. All new cases of patients diagnosed with HIV infection between October 1, 2012 and September 30, 2019 were included. The study included demographic data and virological outcome at 24 weeks and 72 weeks, status of loss to follow up or death. Results: One thousand seven new adult HIV cases were reviewed. Mean age was 34.03±11.27 years old. Male was predominant at 70.51%, mode of transmission was heterosexual at 87.49%. Median CD4 of cases was 268 cells/mm³. Of all the cases. 36.6% of cases were prescribed ART within 14 days with a median of eight days. NNRTI base regimen was given in 93.64% of the cases. Virological suppression less than 40 copies/mL at 24 weeks was 84.94% in rapid ART group compared with 82.92% in standard group. There was no statistical difference between the groups (p=0.747). Virological suppression less than 40 copies/mL at 72 weeks was 97.14% in rapid ART group compared with 93.84% in standard group, with no statistical difference (p=0.079). Retention to care was higher in rapid ART groups (p=0.012) and mortality rate was lower in rapid ART group (p=0.003). Loss to follow up rate was not different between the groups. Conclusion: There was no differences in virological outcome and loss to follow up between the rapid ART and standard groups, but there was better retention to care and lower mortality rate in the rapid ART group. Keywords: Adult; HIV; Rapid ART; Virological outcome; LTFU; Thailand

Modeling Syphilis and HIV Coinfection: A Case Study in the USA.

Syphilis and HIV infections form a dangerous combination. In this paper, we propose an epidemic model of HIV-syphilis coinfection. The model always has a unique disease-free equilibrium, which is stable when both reproduction numbers of syphilis and HIV are less than 1. If the reproduction number of syphilis (HIV) is greater than 1, there exists a unique boundary equilibrium of syphilis (HIV), which is locally stable if the invasion number of HIV (syphilis) is less than 1. Coexistence equilibrium exists and is stable when all reproduction numbers and invasion numbers are greater than 1. Using data of syphilis cases and HIV cases from the US, we estimated that both reproduction numbers for syphilis and HIV are slightly greater than 1, and the boundary equilibrium of syphilis is stable. In addition, we observed competition between the two diseases. Treatment for primary syphilis is more important in mitigating the transmission of syphilis. However, it might lead to increase of HIV cases. The results derived here could be adapted to other multi-disease scenarios in other regions.

RETROSPECTIVE ANALYSIS OF CLINICAL TRENDS OF SEXUALLY TRANSMITTED INFECTIONS IN PRE-COVID AND POST-COVID ERA AMONG ATTENDEES OF STI CLINIC IN TERTIARY CARE CENTRE IN SOUTH INDIA

Background The global COVID-19 pandemic was not only directly responsible for immeasurable COVID-related morbidity and mortality but also had an indirect impact on incidence and transmission prole of various Sexually Transmitted Infections (STIs) due to sexual distancing and service interruption. Long-term implications of these conicting factors on the STI epidemic have not yet been fully gauged. Aim of study To evaluate the prevalence and pattern of STIs in an earmarked population before, during and after the COVID pandemic. Methods A retrospective analysis of patients who reported to STI OPD of a tertiary care centre in South India over 5 years from 2018 to 2022 was performed and the varying clinical trends, prevalence and transmission dynamics of sexually transmitted infections were analyzed. Results The prevalence of STI in patients reported has been recorded at 12.83% (2018), 12.30% (2019), 13.01% (2020), 7.80% (2021) and 7.45 % (2022). The increased prevalence of STIs in 2020 may be due to the reduced overall census in STI Clinic. True to service interruption, HIV cases in year 2020 was recorded at an all-time low of 32 followed by an increase to 103 and 101 in 2021 and 2022 respectively. Bacterial STIs, especially Syphilis, have displayed a rising trend as evident by the prevalence of 11.05% in 2022. as opposed to the prevalence of 3.24% in 2018 Conclusion The shift in STI clinical trends could be partly attributed to the restrictive measures enforced by the Government during COVID and partly by psychosocial behavioural changes brought about by the post-COVID pandemic situation. The increasing trend of bacterial STIs in the post COVID years has to be curtailed with targeted interventions. Preventive and early treatment strategies among high-risk behaviour groups need to be strengthened to keep the STIs under control in post covid era

Effectiveness of Using Nucleic Acid Amplification Test to Screen Blood Donors for Hepatitis B, Hepatitis C, and HIV: A Tertiary Care Hospital Experience From Pakistan.

Background Ensuring blood safety is the primary goal of transfusion medicine. Despite extensive serological tests and strict safety measures, the risk of transfusion-transmitted infections (TTIs) still exists. As applied to blood screening, Nucleic Acid Amplification Test (NAT)offers much higher sensitivity for detecting viral infections. It is, however, currently available to a handful of centers due to the high cost. This study aims to establish the Effectiveness of NAT by assessing the NAT yield and residual risk of transmission of Hepatitis B virus (HBV), hepatitis C virus (HCV)and HIV with and without NAT testing. Material and method This prospective cross-sectional study recruited blood donors from January 2020 to November 2022. All donors underwent routine serologic screening. Only serologically negative donors were tested for HBV, HCV, and HIV by NAT. The NAT yield and residual risk (RR) per million donors were computed for viral infections in seronegative blood donors and calculated using the incidence/window period model. Result A total of 59708 donors were included during the study period. The overall prevalence of TTI's were: For HCV 1.7% (n = 1018), HBV 1.5% (n = 918), HIV 0.07% (n = 47), Syphilis 1.2% (n = 758) and malaria 0.3% (n = 218). Out of 57759 seronegative donors, thirty-four NAT-reactive samples were identified, with 3 cases of HCV, 31 cases of HBV, and Nil HIV cases. NAT yield of HBV was 1 in 1863 with an RR of 8.6 per million, followed by HCV with a NAT yield of 1 in 19253 and RR of 0.8 per million donations. NAT testing reduced RR for HBV by 48.9% and HCV by 94.5%. Conclusion Our study showed that NAT detected 34 out of 57759 cases initially missed by serological tests. The study suggests that the parallel use of serology and NAT screening of donated blood would be beneficial.

Adult HIV-1 incidence across 15 high-burden countries in sub-Saharan Africa from 2015 to 2019: a pooled analysis of nationally representative data

Harmonised population-based surveys with recent HIV-1 infection testing algorithms permit pooled cross-sectional estimation of HIV incidence across multiple countries. We aimed to estimate adult HIV-1 incidence rates and number of new infections by sex, age, and subregion in sub-Saharan Africa. We analysed data from 13 Population-Based HIV Impact Assessment (PHIA) surveys and two additional population-based surveys done between 2015 and 2019 in 15 sub-Saharan African countries. HIV-seropositive samples from adults aged 15-59 years were tested for recent HIV-1 infection by use of an algorithm consisting of the HIV-1 limiting antigen avidity enzyme immunoassay, HIV-1 viral load, and qualitative detection of antiretroviral agents. Data were pooled across countries; sampling weights were incorporated to represent all adults in the 15 national populations. Analyses accounted for the complex sample designs. HIV incidence rates, incidence rate differences, and number of new annual infections were estimated. Among 445 979 adults sampled, 382 had recent HIV-1 infection. The estimated HIV-1 incidence rate was 3·3 per 1000 person-years (95% CI 2·6-4·0) among women and 2·0 per 1000 person-years (1·2-2·7) among men (incidence rate difference 1·3 per 1000 person-years, 95% CI 0·3-2·3). Among adults aged 15-24 years, the incidence rate was higher for women (3·5 per 1000 person-years) than men (1·2 per 1000 person-years; difference 2·3, 95% CI 0·8-3·8), but infection rates were similar between sexes in all other age groups. The HIV-1 incidence rate was 7·4 per 1000 person-years (95% CI 5·0-9·7) in southern sub-Saharan Africa, 2·3 per 1000 person-years (1·7-2·9) in the eastern subregion, and 0·9 per 1000 person-years (0·6-1·2) in the western and central subregion. 689 000 (95% CI 546 000-833 000) new HIV cases were estimated annually among the 265 million susceptible adults (61·6% in women). HIV-1 incidence and number of new infections differed by age, sex, and subregion. Approaches for risk stratification are needed to guide comprehensive HIV-1 prevention. National Institutes of Health.

INCREASING KNOWLEDGE IN PREGNANT WOMEN ABOUT ANEMIA SCREENING AND TRIPLE ELIMINATION THROUGH PREGNANT WOMEN CLASSES

According to the World Health Organization, the number of new HIV cases worldwide will approach 1.5 million by 2020. Africa is registered as the region with the highest number of new HIV cases with 880,000 cases. According to UNAIDS, around 50% of people living with HIV are women and 2.1 million are children under 15 years of age. Based on Indonesia's health status in 2018, 69.95% of pregnant women were tested for HIV and hepatitis B. Of these tests, 0.28% of pregnant women were HIV positive. The effect that HIV-infected pregnant women can transmit HIV to your child during pregnancy, childbirth or breastfeeding. In addition to the triple elimination test, anemia examination is also recommended for pregnant women, because it is one of the steps to prevent anemia in pregnant women. The purpose of this study was to increase pregnant women' s knowledge about anemia screening and determine triple elimination through pregnant women courses. The research method uses Quasy experimental design with a group pretest design. The sample in this study were all pregnant women in the Kampung Bojong Jaya area as many as 40 people, the sampling technique was a comprehensive sample. The results of the research are the knowledge of pregnant women about anemia screening and triple elimination before counseling, most pregnant women have sufficient knowledge and then have good knowledge. Pregnant women received the most information about anemia screening and three times the elimination in the pregnant women category (p-value 0.000). The research method uses Quasy experimental design with a group pretest design. The sample in this study were all pregnant women in the Kampung Bojong Jaya area as many as 40 people, the sampling technique was a comprehensive sample. The results of the research are the knowledge of pregnant women about anemia screening and triple elimination before counseling, most pregnant women have sufficient knowledge and then have good knowledge. Pregnant women received the most information about anemia screening and three times the elimination in the pregnant women category (p-value 0.000). The research method uses Quasy experimental design with a group pretest design. The sample in this study were all pregnant women in the Kampung Bojong Jaya area as many as 40 people, the sampling technique was a comprehensive sample. The results of the research are the knowledge of pregnant women about anemia screening and triple elimination before counseling, most pregnant women have sufficient knowledge and then have good knowledge. Pregnant women received the most information about anemia screening and three times the elimination in the pregnant women category (p-value 0.000). The results of the research are the knowledge of pregnant women about anemia screening and triple elimination before counseling, most pregnant women have sufficient knowledge and then have good knowledge. Pregnant women received the most information about anemia screening and three times the elimination in the pregnant women category (p-value 0.000). The results of the research are the knowledge of pregnant women about anemia screening and triple elimination before counseling, most pregnant women have sufficient knowledge and then have good knowledge. Pregnant women received the most information about anemia screening and three times the elimination in the pregnant women category (p-value 0.000).

Qualitative Study on HIV/AIDS Prevention in Jombang City


 
 
 
 Background: 2022 will see an increase in the number of HIV/AIDS cases in Jombang City, ranking it second in East Java with 1388 PLWHA, 20 cases of mother-to-child HIV transmission during childbirth, 12 HIV (+) cases, 8 AIDS cases, and 100 fatalities. The Independent Practice Midwife (BPM) is the linchpin of a healthcare organization that has the potential to grow into a network of expectant mothers. Midwives are qualified to serve as health educators for expectant women who exhibit habits that increase their risk of contracting HIV/AIDS. In a qualitative study in Jombang City, the aim of this study was to determine the program to develop midwives' ability as health educators for expectant mothers in an effort to prevent HIV/AIDS transmission.
 Method: This study is qualitative and employs an in-depth interviewing methodology. Up to 8 stakeholders served as primary informants, while 2 NGOs and 10 BPM employees served as secondary informants. analysis of data using the content analysis approach.
 Results: Because national guidelines for preventing HIV transmission from mother to newborn have been popularized, stakeholders have implemented a policy that uses standard technical programs for midwifery practice. Midwives have received training in APN, PI, and STIs, but due to funding restrictions, they have never received training in HIV/AIDS counseling. There is no such thing as BPM; only the central IBI does monitoring and assessment, which is done only through monthly reports. The coordination of NGOs, KPAD Regional Child Protection Commission, Public Health Office, The Indonesian Midwives Association, and BPM in the execution of monitoring and evaluation is insufficient, and only IBI is carried out, unplanned, carried out at any moment if it is going to prolong the practice permit. BPM has not yet received special supervision. Coordination amongst stakeholders during the implementation of supervision is insufficient. In an effort to stop the spread of HIV/AIDS, health education facilities for pregnant women in BPM have been provided with posters, flipcharts, and MCH handbooks. There are four VCT clinics and three PMTCT clinics.
 Conclusion: Program to improve midwives' abilities as health educators for expectant mothers in an effort to stop the spread of HIV/AIDS at BPM (independent practice midwives) Jombang City. In order to improve coordination between stakeholders (KPAD Regional Child Protection Commission, Public Health Office, and IBI The Indonesian Midwives Association with BPM in monitoring and supervision, train counselors for BPM (independent practice midwives), and have midwives become more motivated to provide IEC and continue to improve professionalism in providing midwifery services, advocacy is required to the Regional/ Legislative Council
 
 
 

Sexually Transmitted Diseases and Associated Risk Factors Among Transgenders in Peshawar

Background: Transgenders, male to female, are exceptionally predominant in India-Pakistan, dreaded to be alarming for sexually transmitted diseases. The objective of this study was to determine the frequency of sexually transmitted diseases and their associated risk factors among transgenders.
 Methodology: This cross-sectional study was conducted amongst transgenders at Institute of Paramedical Sciences (IPMS), Khyber Medical University Peshawar from January to July,2021. About two ml of venous blood was collected in a gel tube under aseptic conditions among 100 individuals to check for HBsAg, anti-HCV, HIV and syphilis by ICT rapid strip method. Positive samples of HBsAg and anti-HCV were confirmed by Polymerase Chain Reaction (PCR), while positive cases of syphilis were confirmed by Treponema Pallidum Hemagglutination (TPHA). Chi-square test was applied to determine the association between sexually transmitted disease and associated risk factors.
 Results: Out of 100, seven (7%) samples were positive for HBsAg, five (5%) for anti-HCV and nine (9%) were positive for syphilis while there were no positive cases of HIV. HBV infection was significantly associated with blood transfusion, a drug injection history and some surgical procedure (p<0.05). For syphilis, the data were significantly associated with a history of blood transfusion and drug injection (p<0.05).
 Conclusion: Frequency of HBV, HCV and syphilis infections are high in transgenders with common associated risk factors to be sexual activities, drug injection, unsafe blood transfusion and surgical procedures.
 Keywords: Chromatography, Hepatitis B surface antigen, Hepatitis C Antibodies, HIV, Syphilis, Transgenders

Regression-based Model Deciphers Progression on Health Management for Two Long-standing and Unresolved Infectious Diseases in Indonesia: Integration of Outpatient Data by the National Universal Health Care (BPJS) and Fluctuation of Registered HIV and Malaria Cases

Although the COVID-19 outbreak was recently declared overcome COVID-19 is not the sole life-threatening infectious disease for which we direct our all resources. HIV and malaria are, on the other hand, two long-standing national health issues that are yet to find a proper solution. We query how these two infectious diseases load volume on National Burden as represented by the claims National Health Resilience and how far our efforts paid thus far affect the progression on optimally putting the cases in a break. We approach these mathematically as we hardly found integrated reports on this matter. Hence, we employed regression linear to model the Health Resilience of Indonesia based on the dynamics of outpatients and inpatients across facility categories (class) provided by National Universal Health Care (BPJS) in the context of HIV and malaria infection cases respectively. The estimation of the two regression parameters was done via the ordinary least square (OLS) method. We used pandas 1.3.5 for performing the data analysis, seaborn 0.11.2 and matplotlib 3.5.1 for the data visualization, and scipy 1.7.3 and statmats 0.31.2 for the statistical analysis. Our results show that the number of outpatients declines as the number of HIV and malaria cases increase. Furthermore, we obtained significant associations between the increased HIV rate and decreased number of outpatients in class 2 (P=0.030), class 3 (P=0.002), and the total outpatients (P=0.0019). These patterns are not observed for malaria cases. Meanwhile, the increase in HIV cases was found to be associated with the decreased number of registered BPJS in class 1 (P=4e-4), class 3 (P=1.5e-6), and total participants in all classes (P=3.6e-6). Less strong associations were found between the malaria cases with decreased number of participants in BPJS class 1 (P=0.010), class 3 (P=0.042), and the total registered to BPJS (P=0.045). Our data suggest that the higher the HIV incidence rate the lesser likelihood of the affected patients being treated as outpatients using facility classes 2 and 3 since this may lose the transmission control intervention. Intriguingly, in the sense of the BPJS facility category where an increased HIV rate is seen to be strongly associated with a decreased registration number for class 1 and class 3, the monthly dues and the adequateness of expected facility items may be the most abductive reasoning. Despite our understanding that these require validation cohort, taken altogether our data hint the threat of HIV is steady and demands a new approach to strategizing for the sake of limiting the transmission as well as maintaining the quality of life of the affected patients.

Cost-Effectiveness of Universal Repeat Screening for HIV in the Third Trimester of Pregnancy

Screening all pregnant individuals for HIV in the first trimester in pregnancy has long been the standard of care in the United States, with only select populations deemed at higher risk receiving repeat screening in the third trimester. However, HIV acquisition during pregnancy significantly increases the risk of mother-to-child transmission (MTCT), and questions remain as to whether broadening third trimester screening would be effective in reducing MTCT in a cost-effective manner. A decision-analytic model was constructed to compare two strategies: screening for HIV in the first trimester alone vs addition of repeat screening in the third trimester. Probabilities, costs, and utilities were derived from the literature and varied in sensitivity analyses. The assumed incidence of HIV in pregnancy was 0.029%. Outcomes included costs (in 2022 USD), maternal and neonatal quality-adjusted life years (QALYs), and cases of neonatal HIV. Our theoretical cohort contained 3.8 million pregnant individuals, the approximate number of births in the US in 2020. The willingness to pay threshold was set at $100,000/QALY. We performed tornado analysis and univariable sensitivity analyses to determine inputs that most impacted the model. Universal third trimester screening prevented 209 cases of neonatal HIV in this theoretical cohort. Universal third trimester screening led to an increased cost of $600.7 million and 6,118 increased QALYs, with an incremental cost-effectiveness ratio (ICER) of $98,188.82/QALY, less than the WTP threshold. In a univariate sensitivity analysis, third trimester screening remained cost-effective with variation of HIV incidence in pregnancy to as low as 0.027%. In a theoretical US-based cohort of pregnant individuals, universal repeat screening for HIV in the third trimester was found to be both cost-effective and to reduce vertical transmission of HIV. These results merit consideration of a broader HIV screening program in the third trimester.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Epidemiologia do HIV em gestantes e sua relação com o período da pandemia de COVID-19

To analyze, in the light of the Social Ecological Theory, the progression of reported cases of HIV during pregnancy in a Brazilian state and their relationship with the onset of the COVID-19 pandemic. Retrospective study, with a sample consisting of all reports of gestational HIV in the state of Ceará - Brazil from 2017 to 2021, on the IntegraSUS platform. Data collection was carried out in January 2022. The analyzed variables were organized according to the theoretical levels: macrosystem, exosystem, mesosystem, and microsystem. A total of 1,173 cases of HIV in pregnant women were recorded. When comparing the pre- and post-pandemic period, a reduction in the disease detection rate (from 231 to 122.67 pregnant women) was observed, as well as 1.82 times more chances of women not using antiretrovirals during childbirth after the start of the pandemic. There was a 55% reduction in vaginal births and 39% in cesarean sections among women diagnosed with HIV after the start of the pandemic. The COVID-19 pandemic had an epidemiological and care impact, leading to a reduction in the number of notifications and in the detection rate of pregnant women living with HIV in the state of Ceará. Therefore, the need to ensure health care coverage is emphasized, with early diagnosis actions, guaranteed treatment, and quality prenatal care.

ВНЕДРЕНИЕ ВИЧ УСЛУГ В УЧРЕЖДЕНИЯ ПЕРВИЧНОЙ МЕДИКО-САНИТАРНОЙ ПОМОЩИ ТАДЖИКИСТАНА НА ПРИМЕРЕ Г. ДУШАНБЕ: ТЕКУЩИЕ РЕЗУЛЬТАТЫ И ПЕРСПЕКТИВЫ ДАЛЬНЕЙШЕГО РАЗВИТИЯ

Objective: To assess the current results of the integration of HIV services into primary health care (PHC) facilities in Tajikistan in the example of Dushanbe Methods: A comparative analysis of the official statistical data on human immunodeficiency virus infection (HIV) of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan (MHSP RT) was carried out in dynamics. The data of electronic records of people living with HIV (PLHIV) in the system of electronic tracking of HIV cases, including patients receiving integrated HIV services in PHC facilities, were analyzed. The materials of local and foreign scientific medical journals were studied. The method of descriptive statistics was used in the work. Results: In 2021, 922 new cases of HIV were detected in Tajikistan, including 1) people with sexual transmission – 83.7%; 2) labor migrants (LM) and those tested for clinical indications – 49.2%; 3) people over 50 years of age – 12.3%. The share of LM during HIV testing was 3% of the total population tested for HIV in 2021. The number of PLHIV in the country as of December 31, 2021, was 10,077; 8740 of them (86.7%) received antiretroviral therapy (ART), of which 14.2% were above 50 years of age. As of December 31, 2021, 1,155 (11.5% of all PLHIV in the country) received HIV service at the PHC facilities, 21.2% of them were children (<18 years old), and 78.8% – were adults (18+). Among adult patients, 34.7% were from key population groups (KPs); 1146 (99.2%) PLHIV received ART, of which 97.6% showed viral load (VL) suppression. Coverage of PLHIV with ART in the regions of the country varied from 81.8% to 90.1%. Conclusion: According to the research data, the HIV epidemic continues in the country with increasing infection circulation in the general population and “aging” of HIV. So far, the integration of HIV services into PHC facilities of the country was carried out only in the City Health Centers (CHCs) of Dushanbe, where every third adult PLHIV was from KPs. Almost all PLHIV received ART at the CHCs, and VL suppression was observed in most of them. In the CHCs, it is necessary to expand HIV testing at the initiative of health workers. It is recommended to start implementing the integration of HIV services in the CHCs of other large cities of the country. Keywords: HIV infection, people living with HIV, antiretroviral therapy, viral load suppression, integration of HIV services, primary health care.

Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis.

Syphilis remains a global health problem with recent reports of resurgence from various parts of the world. We undertook this study to analyze the current epidemiological and clinical trends of syphilis in our part of the country. To analyze the changing trends in clinical presentation of syphilis and the current status of HIV/AIDS-syphilis co-infection in our area. This is a hospital-based retrospective analysis of records of sexually transmitted disease (STD) patients enrolled in "Suraksha clinic" in the department of Skin and VD at a Tertiary Care Hospital in North India. Patient records were analyzed from January 2018 to December 2021. The demographic, clinical, and serological profiles of patients were assessed to study the percentage of syphilis patients attending the STD clinic and their clinical presentations. A total of 7153 patients were enrolled in the"Suraksha clinic" from January 2018 to December 2021, these included the venereal disease patients (3137) and nonvenereal disease patients (4016) who were registered for HIV and venereal disease research laboratory (VDRL) screening from the dermatology outpatient department. Out of 3137 sexually transmitted infection (STI) patients, 139 patients tested positive for VDRL. Treponema pallidum hemagglutination was found positive in 137 patients and negative in two patients. Hence, 137 patients were confirmed syphilis cases, constituting 4.36% of total STD cases in our STI clinic in 4 years. Out of 137 patients, 2 (1.45%) presented with primary chancre, 6 (4.37%) with lesions of secondary syphilis and 129 (94.16%) were found serologically reactive without any symptoms or clinical signs, i.e., in latent syphilis. Our records also showed 14 (10.21%) cases of HIV and syphilis co-infection. In our study, a remarkable rise in the number of patients in the latent syphilis stage is observed over primary and secondary syphilis stage. This signifies the persistence of syphilis in subclinical phase in the community and unfortunately, it goes unnoticed. These could be "warning signs" for changing disease pattern of syphilis in India and points toward hidden resurgence of syphilis as being reported in various parts of the world. To actively look for these "hidden cases," there is a need to strengthen "Suraksha clinics." VDRL testing should be mandatory along with routine testing in all patients visiting the hospital irrespective of their disease. We also propose for the central registration of syphilis patients on lines of HIV-infected patients' registry.

Factors That Influence Of Individual Hypocritical Action On Condoms In The Dynamic Of Social Relation (Sociology Study of Health in Society in the Capital of South Sulawesi Province)

In the last four years cases of HIV and AIDS in South Sulawesi Province continue to increase. So far, the use of condoms is quite effective for HIV and AIDS prevention but hypocritical actions against condoms are still found in the people of South Sulawesi. This study aims to determine the factors that influence hypocritical action on condom use in social transitions, the dimensions of each factor both partially and simultaneously, and the expected alternative solutions. This study used an analytical method with a multistage sampling technique, carried out in the Capital of South Sulawesi Province with a total sample of 400 people. The conclusions from the research on individual hypocritical actions toward condoms are caused by religious values, cultural norms, and previous experiences in condom use and have a simultaneous positive influence on one variable.

Elevada prevalência de doenças infecciosas entre trabalhadores da saúde indica a necessidade de melhorar a vigilância

Abstract Objective: to estimate the seroprevalence of arboviruses, syphilis, HIV, and hepatitis B (HBV) in Healthcare Workers (HCW). Methods: a survey among HCW among was randomly selected in a city in Bahia-Brazil. The research used a structured questionnaire, which collected sociodemographic, occupational, and health information in 2019. Rapid immunochromatographic tests were used to track infections. Thus, positive results for arboviruses, syphilis, HIV, and HBV indicated seropositivity for the respective infection. In addition, simultaneous detection of antibodies for zika (ZIKV) and dengue (DENV) viruses indicated seropositivity for flavivirus infection. Results: a total of 453 HCW were included, 82.8% were women. Most HCW (55.1%) reported contact with biological material; 5.2% reported injuries with biological material. The seroprevalence was 34.7% (95%CI:30.1-39.4) for dengue, 1.7% (95%CI:0.7-3.4) for zika, 9.9% (95%CI:7.2-13.2) for chikungunya, and 39.9% (95%CI:35.2-44.7) for flavivirus (ZIKV+DENV); with 21.9% (95%CI:18.1-26.2) being negative to all arboviruses. Seropositivity to arboviruses increased with age and was higher among endemic disease control agents. Three HCW tested positive for HBV (HBsAg); no HIV cases were detected. Conclusion: a high percentage of HCW was exposed to infectious agents (contact with biological material and/or exposure to arboviruses). Among the necessary conditions for preventing infections in the work environment, the following stand out: monitoring of infectious diseases among HCW, surveillance of work environments, and measures to control occupational exposures, such as the availability of repellents.

Preferences for PrEP modalities among gay, bisexual, and other men who have sex with men from Brazil, Mexico, and Peru: a cross-sectional study.

Pre-exposure prophylaxis (PrEP) scale-up is urgent to reduce new HIV cases among gay, bisexual, and other men who have sex with men (MSM) in Latin America. Different PrEP modalities may increase PrEP uptake and adherence, especially among young MSM. To assess preferences for PrEP modalities among MSM from Brazil, Mexico, and Peru. Cross-sectional web-based study (March-May 2018) targeting MSM through advertisements on Grindr, Hornet, and Facebook. We included MSM aged ⩾ 18 years and who reported HIV-negative status. We assessed preferences for PrEP modalities with the following question: 'Considering that all following PrEP modalities were available, which one would you prefer considering a scale from 1 to 3 (1 = most preferred): daily oral PrEP, event-driven PrEP (ED-PrEP), and long-acting injectable PrEP'. We assessed factors associated with each most preferred PrEP modality per country using multivariable logistic regression models. A total of 19,457 MSM completed the questionnaire (Brazil: 58%; Mexico: 31%; Peru: 11%); median age was 28 years [interquartile range (IQR): 24-34]. Overall, injectable PrEP was the most preferred modality [42%; 95% confidence interval (CI): 41-43], followed by daily PrEP (35%; 95% CI: 34-35), and ED-PrEP (23%; 95% CI: 23-24). In multivariable models, preferring injectable PrEP was associated with PrEP awareness in all three countries, while PrEP eligibility only in Brazil. Preferring daily PrEP was associated with younger age and lower income in Brazil and Mexico, and lower education only in Brazil. The odds of preferring ED-PrEP were lower among MSM aware and eligible for PrEP in Brazil and Mexico. Long-acting injectable PrEP was the preferred PrEP modality among MSM in Brazil, Mexico, and Peru, especially those aware and eligible for PrEP. Public health interventions to increase PrEP modalities literacy and availability in Latin America are urgent especially among MSM of young age, lower income, and lower education.

Assessment of levels and trends of HIV infections among different subgroup populations of Gujarat State - Prioritization of the districts.

In India, HIV prevalence varies by region and high-risk groups. General population rates have decreased in high prevalence states through HIV Sentinel Surveillance among pregnant women, while low-moderate prevalence states show variable trends. Gujarat, in western India, has mixed HIV prevalence according to 2017 Sentinel Surveillance data. To study the level and trend of HIV positivity among pregnant women and high-risk groups (HRGs) across different districts of the state of Gujarat from year 2012-13 to 2016-17. To review the possible determinants of the HIV epidemic across the selected districts in the state of Gujarat. Data from the National AIDS Control Organization (NACO) spanning 2012-17 was analyzed for HIV trends in Gujarat. This included combined HIV testing data from pregnant women at Integrated and Counseling Testing Centers, blood unit testing data from selected districts, and HIV testing among high-risk populations through Targeted Intervention sites. HIV cases in Kheda district declined post-2013-14 among pregnant women (0.38% to 0.21% in 2016-17), and in general ICTC clients (5.53% to 0.264% in 2017-18). MSM seropositivity dropped from 1.15% (2014-15) to 0.74% (2016-17), FSWs from 0.7% (2014-15) to 0.29% (2015-16). Contrastingly, blood donors exhibited an increasing trend, rising from 0.15% (2012-13) to 0.24% (2016-17). In Mehsana, ANC mother seropositivity rose to 0.6% (2013-14), fell to 0.32% (2015-16), and rose again to 0.48% (2016-17). General ICTC clients declined from 1.2% (2012-13) to 0.53% (2016-17). FSWs had 0.25% seropositivity (2015-16), while MSM saw a drop from 0.44% (2014-15) to 0.23% (2016-17). Blood donors' trend was inconsistent. Sabarkantha's pregnant women seropositivity dipped from 0.59% (2012-13) to 0.20% (2014-15), rising to 0.25% (2017-18). General ICTC client seropositivity decreased from 5.34% (2012-13) to 1.17% (2017-18). While declines in HIV prevalence are evident among certain groups such as pregnant women and general ICTC clients, there are fluctuations in seropositivity among high-risk populations like MSM, FSWs, and blood donors. These insights emphasize the need for targeted interventions and ongoing monitoring to effectively address the evolving HIV landscape in these districts.

Investigation of in vitro Anti-trichomoniasis Effect of Helianthemum ledifolium L. (Mill.) Varieties against Trichomonas vaginalis

Aim: Trichomonas vaginalis is a flagellated protozoan that is sexually transmitted and causes trichomonosis. It is one of the public health problems caused by sexually transmitted diseases. However, for a long time it received less attention than other parasitic and sexually transmitted diseases. Recently, the parasite has been associated with increased cases of HIV, miscarriages, infertility, pelvic inflammatory diseases and cervical and prostate cancers. Given the increasing resistance to the nitroimidazole class of drugs used in its treatment, new alternatives are needed. New drugs are increasingly being derived from natural products containing a large number of active compounds. In addition, different synthetic products or derivatives from old drugs are also used as an alternative for the treatment of trichomonosis. In this study, it was investigated whether Helianthemum ledifolium variates growing naturally in Turkey [H. ledifolium (L.) Miller var. ledifolium (L.) Miller; H. ledifolium (L.) Miller var. microcarpum Willk.; H. ledifolium (L.) Miller var. lasiacarpum (Willk.) Bornm.] aqueous and methanol extracts prepared by maceration method from the above-ground parts were evaluated for their in vitro anti-trichomoniasis activity against Trichomonas vaginalis. Materials and Methods: The extracts prepared from H. ledifolium variates were added to the parasite grown in culture and checked at regular intervals to check for viability. each measurement was performed twice and averaged. Descriptive statistics of the data set are expressed as mean ± standard deviation (SD). The values of lethal doses were determined using probit analysis for certain periods of time depending on specific concentrations (LD50 and LD90). Results: Extracts prepared from H. ledifolium variates inhibited the growth of T. vaginalis in a dose-dependent manner starting from the 4th hour. The 4th hour LD50 values were 2.39 mg for ledifolium water extract, 6.63 mg for ledifolium methanol, 2.39 mg for lasiocarpium water, 1.99 mg for lasiocarpium methanol, 5.77 mg for microcarpium water, 8.76 mg for microcarpium methanol. Conclusion: The study concluded that Helianthemum ledifolium varieties can be used for the treatment of the parasite. It was suggested that invitro studies could be carried out for the use of the plant in treatment.

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

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

Accelerating HIV epidemic control in Benue state, Nigeria, 2019-2021: the APIN program experience.

As at 2019, Nigeria was ranked the fourth highest HIV burden in the world. There is varied geographical HIV prevalence in Nigeria. The progress made is inequitable across geographical locations and sub-populations (18). Benue state has the second highest HIV prevalence in Nigeria. In 2018, about 35,623 people living with HIV (PLHIV) were yet to commence antiretroviral treatment (ART) in the state, accounting for an estimated ART coverage gap of 11% out of the combined gap of 320,921 in the country. To close this gap, the Benue ART surge (BAS) was implemented. The aim of this study was to describe the BAS strategic approaches and demonstrate progress in expanding ART access for PLHIV in Benue State, Nigeria. BAS was implemented in 252 health facilities from May 2019 to September 2021. Data were collected and reported using an Excel-based dashboard and electronic medical records. The trend of HIV case identification, ART initiation, viral load suppression rate, and rate of interruption in treatment during the BAS period was then described and analyzed. Out of 893,462 clients reached, 6.7% (n = 60,297) were diagnosed with HIV and 99.8% (n = 60,236) were initiated on ART. HIV case identification per month increased by 467% from 650 at baseline to a peak of 3685 in August 2020, and then declined by 35% to 2380 in September 2021. All new HIV-infected patients (100%) were linked to ART. Viral load testing coverage and viral load suppression rate increased from 30% (43,185/126,004) and 84% (n = 36,165/43,185) at baseline to 95% (n = 193,890/204,095) and 96% (185,785/193,890), respectively. Implementation of the BAS improved access to comprehensive HIV services in Benue State. The increase in HIV case identification and ART initiation significantly reduced the HIV treatment gap in the state. To fast track the attainment of UNAIDS 95-95-95 goals, lessons learnt from the BAS should be adapted and scaled up in the national HIV program in Nigeria.