Hospital HIV Research Articles

Modern Family Planning Utilization and Associated Factors among Hiv Women of Reproductive Age Attending at Care and Treatment Clinics (CTC) in Mwanza City,tanzania

Background: In Sub-Saharan Africa HIV/AIDS prevalence remains high and makes it the world’s most severely affected region. The use of family planning helps to prevent unplanned pregnancies among HIV positive women of reproductive age. There is a dearth of evidence on the preferred methods, reasons for use and non-use and discontinuation of the use of family planning among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Therefore this study was conducted to determine family planning uptake, methods preferred and the reasons for discontinuation of the use of family planning among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Objective: To determine family planning uptake, methods preferred and reasons for discontinuation among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Methodology: This is a hospital based cross-sectional study involving 440 HIV positive reproductive age women (18 – 49 years) who were attending Bugando Medical Centre, Sekou Toure Regional Referral Hospital and Buzuruga Health Centre HIV Care and Treatment Clinics was carried out. A structured pre tested questionnaire was used to collect data on socio-demographic characteristics, information on current family planning use, health service related factors, family factors, disclosure and ART status, and factors associated with modern family planning use. Data analysis was done using STATA version 13 according to objectives. Results: A total of 440 participants were enrolled in the study and their median age was 36 [IQR 30 – 42] years. Majority, 246(56.2%) of the participants were aged 35 to 49 years. Majority 279 (63.4%) of women attained primary education. Factor associated with family planning discontinuation were not been counseled on FP(AOR 5.5; 95% CI 2.0 – 15.1; p-value 0.001), Partner has desire of children AOR 0.3; 95% CI 0.1 – 0.8;p-value=0.029), Advanced stage of HIV(AOR13.4; 95% CI 5.1 – 35.0; p-value<0.001 ), Divorced women(AOR 3.2; 95% CI 1.1 – 9.7; p-value=0.038) and women’s age ≥35 years(AOR 6.8; 95% CI 2.2-20.9 p-value=0.001). Conclusion: The overall uptake of modern family planning methods was low. Integration of modern family planning services within the CTCs was low too in all the facilities. Furthermore, the proportions of HIV positive women using dual family planning methods were very low. Factor associated with family planning discontinuation were not been counseled on FP, Partner has desire of children, Advanced stage of HIV, Divorced women and women’s age ≥35 years.

Assessment of Factors Associated with Adherence to Antiretroviral Therapy among HIV Patients at Kampala International University Teaching Hospital in Ishaka, Uganda

HIV has increasingly become a chronic, manageable disease due to the introduction of antiretroviral therapies (ARTs). For the effectiveness of antiretroviral therapy, a high level of adherence is required. This study therefore seeks to assess the adherence level and the influence of its determinants in HIV patients on antiretroviral therapy at the Kampala International University Teaching Hospital (KIUTH) HIV clinic in Ishaka, Uganda. Quantitative cross-section study approach was conducted to assess the factors associated with adherence to a-ntiretroviral therapy among HIV patients at KIUTH in Ishaka, Uganda. Data was collected using an interviewer-administered questionnaire in 150 respondents in this study. The qualitative data collected was statistically analysed and documented using Microsoft Excel and Word version 2019, which were then analyzed. The analysed data was presented in the form of tables and graphs, which formed the basis for discussion and conclusion. Of a total of 150 clients interviewed, equal proportions of 26% were in the age groups of 40–49 and 50–59 years, with a mean age of 46 years. The majority (65%) were female, with most (45%) being Anglicans, followed by Catholics (32%), Muslims (14%), and other religions (9%). Nearly half (45.1%) of the respondents were married. About 7% had tertiary education, while 37% had completed the ordinary level of high school. Nearly half (47%) knew the name of the ART they were taking, while 17% did not. Less than a third (26.7%) did not know the name of the ART drug they were taking. A large proportion (93%) stated that ART prevents mother-to-child transmission of infection, while 7% reported that they did not know. Nearly all (96%) respondents knew HIV could be controlled by ART. The majority (87%) stated that taking ART prevents disease progression, and 63% opined that missing ART drugs can lead to transmission of the disease. Overall, adherence to ART was 39% while non-adherence was 61%. In conclusion, the study discovered a high degree of awareness but a low level of adherence to ART among patients living with HIV. Forgetfulness, financial level, employment status, and knowledge of the benefits of the intervention are all important factors in nonadherence among some HIV patients. As a result, ART clinics should increase the level of education provided to customers to encourage patients to take complete responsibility for their health status. Keywords: Adherence, Antiretroviral Therapy, HIV, AIDS

The prevalence of HTLV-1 co-infection among people living with HIV in a tertiary care hospital in Tehran: a cross-sectional study

The prevalence of HTLV-1 co-infection among people living with HIV in a tertiary care hospital in Tehran: a cross-sectional study

Reasons, Efficacy and Safety of Switching to Dolutegravir-Based Regimens Among Virologically Suppressed PLWH: A Retrospective Cohort Study of 96 Weeks.

The study aimed to explore the reasons, efficacy, and safety of switching to dolutegravir (DTG) based regimens in virologically suppressed people living with HIV (PLWH) in tertiary hospitals in China. Therefore, the study could provide a valuable reference for the rational clinical use of DTG. PLWH's basic information, treatment details, and reasons for switching were collected, through the electrical clinical medical record system and telephone follow-up. Data included the proportion of PLWH with HIV RNA <50 copies/mL, changes in immunological indicators, and metabolic metrics at week 48 and week 96. 319 PLWH were included in the analysis. The three major reasons for switching were neurological toxicity (16.30%), simplification (13.79%), and renal toxicity (11.29%). Our study showed high rates of virologic suppression in the per-protocol analysis (week 48: 99.69%; week 96: 99.29%) after switching to DTG-based regimens. The median CD4+ T cell count increased from 579 cells/μL (IQR 420.5-758) to 642 cells/μL (IQR 466.5-854) at week 96 (p<0.0001). An improvement was observed in liver function (ALT: p<0.0001; AST: p<0.0001) and fasting glucose (p<0.0001). However, there was an elevation in creatinine (Cr) (p<0.0001) and a slight decrease in the estimated glomerular filtration rate (eGFR) (p<0.0001). Regarding lipid profile, triglyceride (TG) levels declined, while total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels increased. Further analysis revealed that the increase in TC and LDL-C was associated with the withdrawal of tenofovir disoproxil fumarate (TDF). This observed increase in lipid parameters only concerned the PLWH who switched from a TDF-containing regimen to a non-TDF regimen. This study confirmed the virologic efficacy of switching to DTG-based regimens in virologically suppressed PLWH over a 96-week period. The findings also expanded the evidence of immune reconstitution and metabolic safety associated with this switch.

Assessing high-risk sexual practices associated with human immunodeficiency virus infection among young female sex workers in Lubumbashi, Democratic Republic of the Congo: a cross-sectional study

IntroductionYoung female sex workers (YFSWs) face a higher risk of HIV infection compared to older workers, but there is a lack of comprehensive data on their sexual practices and HIV infection risks, which may present unique challenges and vulnerabilities. The study aimed to identify high-risk sexual practices associated with HIV infection among YFSWs in Lubumbashi.MethodsWe conducted an analytical cross-sectional study and used a comprehensive sample of all YFSWs who presented to the HIV/Sexually Transmitted Infections Screening and Treatment Center in Lubumbashi between April 2016 and December 2017. We collected data on socio-demographic characteristics and behavioral risk factors of female sex workers were collected using a structured questionnaire. Using STATA version 16, multivariate logistic regression was fitted and the results were presented as adjusted odds ratios (aORs) with their 95% confidence intervals (95% CIs).ResultsA total of 572 YFSWs were included in the study, 19 of whom were HIV-positive (3.3%; 95% CI: 2.1–5.1%). Participants who were forced to have sex (aOR = 12.2; 95% CI: 3.2–46.4; p < 0.0001), those who did not use condoms systematically (aOR = 4.1; 95% CI: 1.3–13.0; p = 0.018), and those who had anal sex (aOR = 23.8; 95% CI: 6.9–82.4; p < 0.0001) were more likely to be HIV-positive.ConclusionThe study reveals a concerning trend of higher hospital HIV prevalence among YFSWs compared to the general Congolese population. It also highlights a significant link between high-risk sexual practices and HIV infection, highlighting the need for urgent interventions.

Turkish Translation and Cross-Cultural Validity of WHOQOL-HIV Bref Tool.

The assessment of health-related quality of life among people living with HIV (PLWH) has gained increasing importance as it assesses their overall well-being, guides treatment decisions, and addresses psychosocial challenges, improving their quality of life. This study focuses on adapting and validating the Turkish version of the WHOQOL-HIV Bref, a tool developed by the World Health Organization (WHO) to measure health-related quality of life in PLWH. This adaptation is based on the generic WHOQOL-Bref Turkish and WHOQOL-HIV Bref inventory. In line with WHO guidelines, the tool was translated and tested on 189 PLWH from İstanbul Şişli Hamidiye Etfal Training and Research Hospital's HIV outpatient clinic. A variety of statistical methods were employed to assess content, construct, concurrent, and known-group validity, as well as internal consistency and reliability. Participants' median age was 35 years (IQR: 14), with 178(94%) being male. The Turkish WHOQOL-HIV Bref showed overall satisfactory psychometric properties. Despite limitations in the spirituality domain, it demonstrated good internal consistency (alpha coefficient: 0.93) and strong validity across several metrics, including test-retest reliability (ICC: 0.79). The WHOQOL-HIV BREF in Turkish is a reliable and valid instrument for assessing the quality of life in Turkish PLWH.

Profile of registered cases of occupational exposure to HIV in a referral hospital

A Workplace Accident involving Biological Material (WBA) is one in which the worker comes into contact with potentially contaminated blood and organic fluids. The aim was to determine the profile of cases of occupational exposure to the HIV virus in a referral hospital. This is a retrospective documentary study with a quantitative approach, carried out at the Clementino Fraga Hospital Complex. The population universe of 270 occupational accident records in 2018 indicated this number of cases that were treated at the Hospital Complex, resulting in a sample of 159 medical records. The proposed instrument was a form containing objective questions that addressed socioeconomic data and the objectives of the study. Data collection took place in March and April 2019. It was approved by the Research Ethics Committee. The documents collected showed that the profile of the sample investigated was predominantly female (86%), aged between 20 and 40 (73%), brown (91%) and nursing technician (47%). Considering the object of the study, it was found that in 53% of cases exposure was reported within 12 hours, in 87% the type of exposure was percutaneous, in 59% the organic material involved was blood, in 58% a needle with a lumen was the agent and in 25% improper disposal of sharp material was the most common circumstance. Turning to the preventive aspect, gloves were the PPE most used by professionals in their work (32%). However, a worrying fact was the almost proportional percentage of professionals who reported not using any type of PPE (30%). In addition, 79% of the workers had complete vaccination status, 42% of the cases did not know the source patient and, among the sample of the source patient variable, 52% had an unknown serological result. With regard to the outcome of the accident, 43% of the documents indicated the need for ART, 50% of the sample abandoned the treatment outlined by the doctor and 35% were discharged due to the negative serology of the source patient. Based on the main findings, we would like to draw attention to the need to start prophylaxis in the first two hours after the accident, the need to be careful when disposing of materials perforated during work activities, the need to be vigilant when using mandatory PPE in care practices, the need to know the source patient when carrying out the protocol and the need to actively seek out accident victims who abandon the recommended care.

Hospitalization and mortality outcomes among adult persons living with HIV in a tertiary hospital in South-western Nigeria: A cross-sectional study.

HIV infection continues to be a major public health issue, with significant morbidity and mortality especially in resource poor areas. Infection with HIV results in an increased risk of opportunistic infections and other complications, which may lead to hospital admission and death. Morbidity and mortality patterns among hospitalized persons living with HIV (PLHIV) have been well documented in high income countries, but there is paucity of such data in Nigeria. We investigated the reasons for hospitalization and predictors of death among adult PLHIV at the Federal Medical Center (FMC) Abeokuta, Nigeria. This was a hospital based cross-sectional study carried out over a 15-month period between January 2018 and March 2019. All consenting hospitalized adult PLHIV who met the inclusion criteria were enrolled into the study. Causes of hospitalization and death were obtained and analyzed. Over the study period, 193 hospitalizations of PLHIV were studied. Although a number of clinical syndromes were documented, Sepsis and Tuberculosis were the commonest causes of hospitalization and mortality. Mortality rate was 37(19.2%) for outcomes on day 30, with anaemia [OR 3.00 (95% C.I: 1.04-8.67)], poor adherence with Cotrimoxazole [OR 4.07 (95% C.I: 1.79-9.28)], poor adherence with cART [OR 13.40 (95% C.I: 3.92-45.44)], and a longer duration of fever [OR 3.34 (95% C.I: 1.10-9.99)] being predictors of mortality. Part of the study's limitation was resource-constraint of some of the indigent patient which affected their ability to access some diagnostic investigations and get optimal care thereby impacting on their outcome. Despite the upscaling of cART, opportunistic infections and sepsis remain common causes of hospitalization and death in adult PLHIV. More attention should therefore be placed on early diagnosis, prevention of immunosuppression and sepsis through timely administration and adherence to cART and other prophylactic measures.

Knowledge and attitudes in the prevention of vertical transmission of HIV in referral hospitals.

Prevention of HIV vertical transmission programmes (VTPs) in South Africa has decreased paediatric HIV. These programmes require integration in referral hospitals. To determine knowledge of and attitudes to the national VTP guidelines in staff from Obstetric and Paediatric disciplines at two referral hospitals. Using a cross-sectional design, a questionnaire to assess knowledge of the guidelines and attitudes (awareness, ease-of-use and non-silo practice, measuring integrated practice) was developed and validated locally. Using standard statistical analyses, data from these questionnaires were used to draw comparisons and determine factors associated with knowledge and attitudes. Of the 249 participants, 138 (55.4%) were in obstetrics, 125 (50.2%) were nurses, and 168 (67.5%) self-identified as junior staff. Knowledge scores were good, median score (Q1-Q3) was 91.7% (79.1-95.8), and higher in those who had discipline-specific training (P = 0.003). Junior staff (P = 0.002) had higher knowledge levels than senior staff. Most (80%) found the guidelines easy to use and had good awareness, which correlated with knowledge and training. Gaps included understanding of antenatal testing of HIV-negative women and timelines for neonatal HIV testing. Staff scored poorly on integrated practice; the median score (Q1-Q3) was 50% (33.3-58.3), which was inversely correlated with knowledge (r= -0.146, n = 249, P = 0.022). Staff in referral hospitals appear to be practising within silos when implementing VTPs, and this may result in failures to ensure integrated practice. Regularised interdisciplinary and interprofessional training may be important to ensure the integrated implementation of VTPs in referral hospitals.

Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors

Major depression is the most common neuropsychiatric disorder among people living with HIV (PLWH) and is predictive of high morbidity and mortality among them. This study estimated the prevalence and explored factors associated with depression among PLWH in two rural secondary health facilities providing anti-retroviral therapy (ART) services in Southwestern Nigeria between September and December 2020. The Patient Health Questionnaire-9 (PHQ-9) was used to screen and identify PLWH aged 18 years or older with depression. Descriptive statistics, bivariate and multivariate analyses were performed with SPSS version 23. A total of 172 respondents were screened. The prevalence of depression was 16.3% (95% CI 11.1%, 22.7%). Mild, moderate, and moderately severe depression was identified in 17 (9.9%), 8(4.7%) and 3(1.7%) of the participants, respectively. One (0.6%) respondent had suicidal ideation. Of PLWH with any depression, 20/28(71.4%) were within the 40–59 years of age range. None of the participants was on antidepressants. The factor most associated with depression was hypertension, with adjusted odd ratios of 9.8(95% CI 3.5–27.3, p < 0.0001). The study highlights the importance of screening for the severity of depression among PLWH in rural hospitals providing ART services in Africa. PLWH with comorbid hypertension were more likely to suffer from some form of depression.

HIV viral load suppression among people with mental disorders at two urban HIV clinics in Uganda: a parallel convergent mixed methods study using the social ecological model

BackgroundUganda adopted and implemented the Universal Test and Treat (UTT) guidelines in 2017, which require HIV-infected persons to be initiated on antiretroviral therapy (ART) at any CD4 + cell count, and to be routinely monitored for viral load to assess response to ART. However, there is paucity of data on viral load suppression (VLS) among people living with HIV (PLHIV) with mental disorders. We conducted a parallel convergent mixed methods study to determine HIV VLS among people with a mental disorder and explored the socio-cultural determinants of VLS at Butabika hospital and Mulago (ISS) HIV Clinics in Uganda.MethodsWe conducted a retrospective medical records review; seven key informant interviews (KII) among purposively selected healthcare providers and 12 in-depth interviews (IDI) among clinically stable PLHIV with a mental disorder. Data was collected on demographics, mental disorder, ART, viral load status, social support, stigma, and disclosure of HIV status. Quantitative data was analysed using descriptive statistics and modified Poisson regression, while Inductive thematic analysis was used for the qualitative data.ResultsOf the 240 PLHIV with a mental disorder who were enrolled, 161 (67.1%) were female with mean age 38.9 (± 11.2) years. Overall, 88.8% (95% Cl: 84.0 – 92.2%) achieved VLS. Age (aPR = 1.00, 95%Cl = 1.00–1.00), male gender (aPR = 0.90, 95%Cl = 0.82–0.98), divorced (aPR = 0.88, 95%Cl = 0.82–0.94), widowed (aPR = 0.84, 95%Cl = 0.83–0.86), baseline CD4 count < 200 (aPR = 0.89, 95%Cl = 0.85–0.94), psychotic mental disorders (aPR = 1.11; 95%CI = 1.08–1.13) and fair (85–94%) ART adherence level (aPR = 0.69, 95%Cl = 0.55–0.87) and TDF/3TC/DTG (aPR = 0.92; 95%CI = 0.91–0.94) were associated with HIV VLS. Social support from family members, knowledge of impact of negative thoughts on VLS, fear of breaking up with partners and compassionate healthcare providers positively influenced VLS. Stigma and discrimination from the community, self-perceived stigma hindering social relations, socio-economic challenges and psychiatric drug stock-outs negatively affected VLS.Conclusion and recommendationsHIV VLS among PLHIV with mental disorders at institutions that provide integrated HIV and mental health care is still below the UNAIDS 95% target. Health promotion messaging focusing on benefits of VLS and countering stigma to create a safe environment; and active involvement of family members in care could improve HIV treatment outcomes for PLHIV with mental disorders.

The Effect on Theatre Nurses for Rendering Perioperative Care to Patients Living with HIV in a South African Tertiary Hospital.

The study aimed to gain an in-depth understanding of how theatre nurses are being affected when they render perioperative care to patients living with HIV in a South African tertiary hospital. There is a scarcity of studies that focus solely on the wellbeing of theatre nurses who render perioperative care to HIV patient due to the ramifications of the nurses' fear of contracting HIV. Patients living with HIV often receive substandard care. To establish how theatre nurses are being impacted when rendering perioperative care to patient living with HIV, the study followed a qualitative approach using an interpretative phenomenological analysis design. Data were collected through in-depth individual interviews from ten theatre nurses who were purposively selected according to specific criteria. They voluntarily agreed to participate. An interpretive phenomenological analysis framework was used to analyse the data. Two main themes emerged from the data analysis, namely, the negative effect on nurses' wellbeing and the impact that it had on them professionally. The study revealed that the perioperative care of patients living with HIV had a negative impact on physical, mental, and social wellbeing of theatre nurses. Their compromised wellbeing in turn led to poor patient care, which put nurses at risk of losing their jobs and even potentially having to face litigation. The study further indicated that nurses did not receive psychological support from the management which further affected their health and professional performance. The study proposes that theatre nurses rendering perioperative care to people living with HIV should receive proper training and support; staff shortages should also be addressed. There is also an urgent need for appropriate and sufficient protective equipment. Such changes will be essential in order to mitigate the negative impact that their jobs have on their wellbeing and on them in their professional capacity.

The prevalence of HBV, HCV, and HIV among hemodialysis patients in a tertiary care hospital in Mashhad, Iran.

Hepatitis and acquired immunodeficiency are major health concerns in high-risk patients with renal failure undergoing hemodialysis. This might be due to the number of blood transfusions, age, and dialysis duration. We aimed to investigate the prevalence of HBV, HCV, and HIV in hemodialysis patients to determine the effectiveness of preventive measures already in place and the possible correlation between various risk factors and viral infection in the Hemodialysis Center in Mashhad, Iran. Sixty-five patients were included in a retrospective cross-sectional study. The demographic information was collected. Hepatitis-B surface antigens, anti-HCV, and anti-HIV antibodies were screened using ELISA. Out of 65 patients, 34 (52.3%) were male, and 31 (47.7%) were female. Mean duration of dialysis was 30.68 ± 26.39 months, and the mean age was 64.95 ± 14.09 years. We found 9 (13.8%) patients that were HBV positive (HbsAg-positive), and 3 (4.6%) patients were HCV positive. Sex and the number of blood transfusions were found to be risk factors for HBV infection and had statistical significance (p = 0.02 and p = 0.01, respectively). No statistical significance was found between HBV- and HCV- positivity and the mean age of patients (p = 0.84 and p = 0.76, respectively). All patients were HIV-negative. Prevalence of HBV was high and significant. More preventive measures need to be developed, and further studies should be conducted to examine the effectiveness of these measures. Moreover, evaluating the prevalence rates of HBV, HCV, and HIV in other hospitals and dialysis centers in Mashhad is recommended to minimize viral infections. Initial HBV vaccination for patients that require hemodialysis is crucial.

Characterisation and variables associated with mortality in a population with HIV and central nervous system opportunistic infections in a Colombian public hospital in Bogotá

IntroductionHIV-associated mortality after a central nervous system opportunistic infection can reach up to 78%. In populations with limited economic resources, few studies have evaluated the clinical outcomes of these infections in patients with HIV. MethodsWe performed an observational analytical study using our hospital's database. Sociodemographic, clinical, and paraclinical data were gathered from patients with HIV-associated opportunistic neurological infections attended between January 2019 and January 2021. The aim of the study was to describe the in-hospital mortality rate and to establish associations with sociodemographic, clinical, and paraclinical variables. ResultsSeventy-five patients were included, with a mean age of 38.7 years. Fourteen (31.8%) were receiving antiretroviral therapy at the time of admission. The most frequent neurological infections were cerebral toxoplasmosis (37.3%, n = 28), meningeal cryptococcosis (20%, n = 15), and neurosyphilis (20%, n = 15). The in-hospital mortality rate was 25.3% (n = 19). The variables associated with increased mortality risk were diagnosis of meningeal cryptococcosis, admission to the ICU, and presence of fever. The variables associated with decreased mortality risk were CSF/blood glucose ratio > 0.5 and normal body mass index (18–25). ConclusionsIn a population of patients with HIV-associated opportunistic neurological infections, in-hospital mortality was 25.3%. The diagnosis of meningeal cryptococcosis, admission to the ICU, and the presence of fever are associated with higher mortality risk. To the contrary, CSF/blood glucose ratio > 0.5 and normal body mass index are associated with lower mortality risk.

How Taiwan has responded to COVID-19 and how COVID-19 has affected Taiwan, 2020-2022.

From January 2020 to December 2022, there was a total of 8,872,955 confirmed COVID-19 cases in Taiwan. In addition, a total of 15,253 COVID-19 related deaths were reported. During these three years, the government and health authority did many efforts to response this pandemic. In the early pandemic, Taiwan Central Epidemic Command Center was established in the early 2020 to organize associated resource, develop effective policy and implement strict intervention. In response to COVID-19 pandemic, many infection control policy and interventions, including universal mask wearing with increasing production of face mask, hand hygiene, border control, introduce of digital technology incorporating big data, quarantine of COVID-19 cases, travel and gathering restriction, were implemented. In the meanwhile, two COVID-19 vaccines, namely MVC-COV1901 and UB-612, have been developed under the support of government. Furthermore, MVC-COV1901 was taken into clinical practice after received emergency use approval. In addition, two traditional Chinese medicines, including NRICM101 and NRICM102 showed their promising effect against SARS-CoV-2 infection and were recommended as potential therapeutic options for COVID-19. During the pandemic, the nonpharmacologic intervention help reduce many infectious diseases, especially for airborne/droplet-transmitted diseases. However, COVID-19 exhibited some adverse impacts on the healthcare systems, such as emergency medical service on out of hospital cardiac arrest, cancer screening, HIV screening and prevention services, and public health, namely the psychosocial status of healthcare workers. Although the outbreak of SARS-CoV-2 infections may gradually subsided, we should keep monitoring its associated impact and appropriately response to this pandemic.

An audit of adherence to cervical cancer screening guidelines in a tertiary-level HIV clinic.

Cervical cancer is the most common malignancy affecting South African women aged 15-44 years, with a higher prevalence among women living with HIV (WLWH). Despite recommendations for a screening target of 70%, the reported rate of cervical cancer screening in South Africa is 19.3%. To investigate the adherence of healthcare workers to cervical cancer screening guidelines in a tertiary-level HIV clinic. A retrospective cross-sectional record audit of women attending the Charlotte Maxeke Johannesburg Academic Hospital HIV Clinic over a 1-month period. Out of 403 WLWH who attended the clinic, 180 (44.7%) were screened for cervical cancer in the 3 years prior to the index consultation. Only 115 (51.6%) of those women with no record of prior screening were subsequently referred for screening. Women who had undergone screening in the previous 3 years were significantly older (47 years vs 44 years, P = 0.046) and had a longer time since diagnosis of their HIV (12 years vs 10 years, P = 0.001) compared to women who had not undergone screening. There was no significant difference in CD4 count or viral suppression between women who had and had not undergone screening. The rate of cervical cancer screening in our institution is below that recommended by the World Health Organization and the South African National Department of Health.

1301 OUTCOMES FROM A PILOT PROJECT OFFERING FRAIL OLDER ADULTS LIVING WITH HIV A VIRTUAL MDT COMPREHENSIVE GERIATRIC ASSESSMENT

Abstract Introduction Advancements in HIV treatment has resulted in an ageing population in people living with HIV (PLWH). Increasing prevalence of frailty in older PLWH has been demonstrated, giving rise to multi-morbidities, polypharmacy and consequently, complex medical and social needs. Approximately 5650 people are living with HIV across Greater Manchester. With increasing patient complexity, a pathway was developed to help provide holistic care and improve quality of life for older adults living with HIV. Methods A pilot involving multi-disciplinary professionals from the hospital frailty, HIV and community teams was established. Patients were screened using the Clinical Frailty Scale and patients with a CFS ≥ 4 were referred for completion of a comprehensive geriatric assessment (CGA). Patients would then be discussed at the Frailty MDT meeting, where action plans were devised. Results 47 patients were assessed between October 2020 to December 2021, with 30 eligible for review in the frailty clinic. Commonly reported issues were mobility n=26 (86.6%), pain n=23 (76.6%), low mood n= 14 (46.6%), memory issues n=3 (43.3%) and falls n=12 (40%). Following MDT recommendations, 8 (26.6%) referrals were completed for social care, 1 (3%) referral for safeguarding and 9 (30%) referrals for active case management community teams for co-ordination of care in the community. Deprescribing recommendations were suggested for 16 (53.3%) patients and new medicine recommendations made for 24 (80%) patients. Conclusion A collaborative MDT approach to managing older PLWH can facilitate formulation of action plans to address patients physical, psychological and social needs.

Medication adherence and adverse drug reactions of isoniazid preventive therapy for tuberculosis in people living with HIV (PLHIV) in a tertiary care teaching hospital, Kakinada

Medication adherence and adverse drug reactions of isoniazid preventive therapy for tuberculosis in people living with HIV (PLHIV) in a tertiary care teaching hospital, Kakinada

Living with HIV during COVID-19: knowledge and worry about COVID-19, adherence to COVID-19-related precautions, and HIV health outcomes

ABSTRACT The COVID-19 pandemic has been profound impacts on mental and physical health of individuals with chronic diseases. Thus, it is important to understand the effects of the COVID-19 pandemic on people living with HIV. We aimed to assess the association between COVID-19-related knowledge and worry, HIV-related health practices and outcomes, and adherence to precautions related to COVID-19, and possible associations of these factors with HIV treatment outcomes (ART adherence and viral load). A cross-sectional survey was conducted between October 2020 and February 2021 among 291 PLWH at two large university hospital HIV clinics in Izmir, Turkey. Additionally, the most recent HIV-RNA load, CD4 count was recorded using medical records. Logistic regression analyses were performed to determine predictors of self-reported adherence to COVID-19-related precautions, ART adherence and undetectable viral load. COVID-19-related worry, COVID-19-related knowledge, and ART adherence were significant predictors of adherence to COVID-19-related precautions. Furthermore, adherence to COVID-19-related precautions was a significant predictor of both ART adherence and undetectable viral load. Findings provide a unique aspect of the interrelations of COVID and living with HIV. Since health behaviors and outcomes for COVID-19 and HIV seem to be interrelated, treatment practices and interventions that address these simultaneously may enhance their efficacy.

Health systems responsiveness towards the Mentor Mother Program for preventing mother-to-child transmission of HIV in military hospitals.

This study explored health systems responsiveness towards the Mentor Mother Program for PMTCT in the Nigeria Department of Defence hospitals. Factors affecting quality service were also highlighted, which gave helpful insights into the strategies employed by stakeholders to ensure that health systems responsiveness was propagated responsibly. An exploratory qualitative interview study. Six semistructured interviews were conducted with six key informants (three doctors and three nurses) and one focus group session with six Mentor Mothers. Open coding of data was done to formulate themes and subthemes. Thematic analysis was adopted for analysis. Four themes emerged-Service Quality, Basic Amenities, Patient-oriented Strategies and Factors affecting service Quality. These showcased the nonmedical components of health systems responsiveness and accentuated how well they were utilized to achieve health systems responsiveness.