HIV-infected Women Research Articles

Condom Use in Male Partners and Associated Factors Among HIV-positive Women Who Accessed PMTCT Services During Pregnancy in Jos, Nigeria

Despite being on antiretroviral therapy, during unprotected sex, a HIV-infected pregnant woman can transmit HIV not only to a HIV-negative sexual partner but also pose a risk for reinfection with new or resistant viral strains between her and a HIV-positive sexual partner, and ultimately to her baby. Condom use is a recognized strategy to reduce this risk if practiced consistently. This study set out to determine condom use and associated factors among a cohort of women who attended PMTCT clinic in Jos University Teaching hospital. Methods: Ninety-six enrolled women provided information about themselves and their male partners via a questionnaire, and other relevant information was obtained from their hospital records. Data obtained was analyzed using Epi info version 7 (CDC Atlanta, GA). The mean age of the women was 36.4±4.5 years. They were predominantly married (90.6%), Christians (75.0%), and educated above primary school level (88.6%). The mean age of the male partners was 45.3±6.1 years and over half of them (57.3%) were HIV-positive. The prevalence of consistent condom use in the participants was low (26.0%). Only 4.2% of male partners had ever received counselling in the PMTCT clinic. Factors significantly associated with condom use were younger age of male partner (mean ± SD=43.0±4.7 years), younger age of pregnant women (mean ± SD=34.2±3.3 years), Christian faith of the women, male partners having ever accompanied their pregnant woman for counselling in the PMTCT clinic and viral load of < 1000 copies/ml (P value=0.0290, 0.0035, 0.0440, 0.0227 and 0.0045 respectively). The practice of consistent condom use among male partners of HIV-positive pregnant women attending PMTCT clinic in JUTH was low, suggesting the need for improved strategies to optimize its usage. Involvement of male partners in PMTCT counselling is significantly associated with consistent condom use and should therefore be advocated to augment efforts towards fighting sexual and perinatal HIV transmission.

Non-governmental organization global, volunteerism local: An exploration of moral anthropology

This paper is an exploratory study of moral anthropology focused on the local practices of global non-governmental organizations. For more than 10 years, Ruili Women and Children Development Center (the Center) in the southwest border region of China has developed itself into a non-governmental organization that adopts transnational humanitarianism and fosters a spirit of grassroots volunteer dedication. In this paper, two anthropologists’ analytic framework of morality will be examined and my own views on morality/ethics will be discussed in three aspects: morality as norms, morality as doing good, and ethics as affect. The Center came into existence in response to the decline and uncertainty of local morality (morality as norms). Under such conditions, the Center allies itself with transnational humanitarianism to provide much-needed medical care for the sick in the region (morality as doing good). In the process, the Center, mainly consisting of female members, has created a “life-environment” that is in tune with global humanitarianism and an army of devoted volunteers, especially among local HIV-infected women, who have found “ joie” in life itself (ethics as affect). This study hopes to broaden our theoretical and experiential understanding of non-governmental organizations, and of how to improve quality of life in times of social change.

Determinants of repeated pregnancy among HIV-positive women on anti retroviral treatments at the public health facilities, in Gedeo zone, South Ethiopia: Unmatched case-control study

BackgroundThe desire of HIV-infected woman to have children in the future has significant implications for the transmission of HIV to sexual partners and newborn. This study aimed to determine the determinants of repeated Pregnancy among HIV-positive women on Anti retroviral Treatments, at the public health facility, in Gedeo Zone, South Ethiopia. MethodsAn unmatched case-control study was conducted from February 10 to April 27, 2020, among a total of 304 (76 cases and 228 controls) pregnant women. The participants were selected by randomly and data was collected using face-to-face interviewer-administered questionnaires, and entered using Epidata3.1 and analyzed by SPSS version 20. Bivariate logistic regression was used to select the candidate variables for the multivariable logistic regression with a p-value <0.25, and in the last multivariate logistic regression analysis was performed to assess determinant factors of repeated pregnancy in adjusted odds ratio with a p-value < 0.05, at 95% confidence level were declared statistically significant. ResultsA total of 304 pregnant mothers responded resulting in a response rate of 97.4%. Determinants which were found to be associated with repeated pregnancy were history of abortion, low educational attainment, 30–43years of age, being employed, and urban residence. ConclusionsThe results of the current study suggest that repeated pregnancies were more common among women who had a history of abortion and low educational attainment. Health practitioners of the Gedeo zone should give particular attention to prevent abortion and provide appropriate reproductive health services for those women.

Determination of the combined influence of alcohol abuse and hiv infection on the immunohistochemical indicators of the uterine tube receptors

In the practice of doctors of many specialties, immunohistochemical research methods are widely used. The aim of our work was to determine the combined effect of alcohol abuse and HIV infection on the immunohistochemical parameters of fallopian tube receptors. We have studied sectional material obtained from 100 women of reproductive age (from 20 to 40 years). The received materials were divided into 4 groups. The first group consisted of sectional material of 25 women who had confirmed HIV infection. The second group included sectional material of 25 women suffering from chronic alcoholism. The third group consisted of a sectional material of 25 women in whom HIV infection was combined with alcoholism. The fourth (control) group included sectional material of 25 women without HIV infection and alcoholism. The result of the study shows that the balance between the processes of apoptosis and anti-apoptosis is disturbed in all three studied groups, while the phenomena of apoptosis prevail in the group of people suffering from alcoholism. At the same time, the processes of anti-apoptosis are most suppressed in HIV-infected women. The processes of stress restructuring of the fallopian tube were most pronounced in the group of women who abused alcohol. We concluded that the combined effect of alcohol abuse and HIV infection leads to a significant change in the immunohistochemical parameters of the fallopian tube tissue receptors. Keywords: chronic alcoholism, HIV infection, fallopian tube.

English

BACKGROUND HIV/AIDS is a global pandemic with a national adult (15-49 yrs) prevalence of 0.22 % (NACO 2019) and females constituted around 44 % of the total estimated people living with HIV (PLHIV). HIV infection in women occurs mostly in their reproductive years which leads to transmission to the child thereby comprising the most common mode of acquiring HIV infection in children &lt; 15 yrs. Women account for more than 70 % of the caregivers of seropositive spouses or other family members. This study was conducted to explore the reasons behind increasing HIV prevalence among adult women in the region including their demographic profile, transmission dynamics and clinical profile of HIV/AIDS. METHODS This is a hospital-based observational study among 100 selected adult female patients with HIV/AIDS (as per NACO guidelines) who attended the Gauhati Medical College Hospital from 1st July 2016 to 30th June 2017. A detailed clinical history of the selected cases was obtained in the register of the institutional ICTC centre and was recorded in standard proforma. RESULTS Out of the 100 cases included in the study, 95 were married of which 74 had seropositive husbands while 21 were discordant couples. The mean age of the study population was 31.27 ± 9.7 yrs., with the majority of women being in the age group of 21 – 30 yrs. Among the study group, 13 were illiterates while 6 were graduates. Fever was the most common presenting feature with 59 % followed by weight loss (36 %) and diarrhoea (15 %) respectively. Bacterial respiratory tract infection and oral candidiasis were present in 12 % and 11 % of patients respectively as opportunistic infections. CONCLUSIONS The majority of cases in our study were housewives and the biggest risk was through heterosexual sex with their husbands or primary partners. Only a few attended colleges in the study group while the rest were either illiterates or school dropouts and the majority of them didn’t have comprehensive knowledge of HIV/AIDS. The large gender inequality in education and unemployment may be responsible for the spread of HIV/AIDS in women. KEY WORDS Clinical, HIV/AIDS, Women

The Frequency Detection of Opportunistic Sexually Transmitted Infections among HIV-Infected Women Planning Pregnancy

The purpose of our study was to determine the frequency of detection of opportunistic sexually transmitted infections (Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma spp, Human papillomavirus) in HIV-infected women planning pregnancy. Methods and Results: We examined 31 HIV-positive Caucasian women. They sought pregnancy planning advice at the Scientific Center for Family Health and Human Reproduction Problems in Irkutsk during 2014-2015. The average age of the women was 30.9±4.5 years (20-39 years). A clinical diagnosis of HIV was made at Irkutsk Regional AIDS Center. All HIV-infected women were tested for the presence of DNA of pathogens of bacterial and viral sexually transmitted infections in the epithelium of the cervical canal. Chlamydia trachomatis was detected in 1(3.2%) participant, Trichomonas vaginalis in 1(3.2%), Ureaplasma spp. in 14(45.2%), and HPV in 22(71%). Co-infection of HPV and Ureaplasma spp. was observed in 35.5% of HIV-positive women. Conclusion: the prevention and detection of sexually transmitted infections in HIV-infected individuals remain a public health priority and an integral component of HIV primary care.

Prevalence of Anaemia, Iron Deficiency, and Iron Deficiency Anaemia in Women of Reproductive Age and Children under 5 Years of Age in South Africa (1997-2021): A Systematic Review.

Using a systematic review method, the prevalence of anaemia, iron deficiency (ID), and iron deficiency anaemia (IDA) in women of reproductive age (WRA) and children under 5 years of age was obtained to inform priorities in health planning and policy in South Africa. We searched electronic databases for articles published between 1997 and 2021. A total of 713 articles were identified, of which 14 articles comprising 9649 WRA and 4085 children were included. Since most of the included studies were of low quality, we did not pool data in a meta-analysis due to heterogeneity (I2 > 75%). In WRA, anaemia prevalence ranged from 22.0% to 44.0%; ID from 7.7% and 19.0%; and IDA from 10.5% to 9.7%. The prevalence of anaemia in pregnancy was 29.0% to 42.7%; and 60.6% to 71.3% in HIV-infected pregnant women. Three national surveys reported anaemia in children at 28.9%, 10.7%, and 61.3%, respectively. Overall, among the children under 5 years old, anaemia was more prevalent in 1-year-olds (52.0%) compared to the other age groups. Between 2005 and 2012, ID increased by 3.8% and IDA decreased by 83.2% in children. Anaemia in WRA and children under 5 years in South Africa was a moderate public health concern. Therefore, interventions addressing anaemia should be intensified, and policies on iron supplementation and food fortification need to be revised and aligned to the WHO multiple micronutrient supplementation recommendations.

Participants\u2019 characteristics and motivations to screen for HIV vaccine and monoclonal antibody trials in KwaZulu-Natal, South Africa

BackgroundHIV is one of the greatest public health challenges in South Africa. Potential HIV vaccines and antibodies are thought to be cost-effective biomedical HIV prevention methods and are currently under investigation in phase I, II, and III trials. Consequently, current and future clinical trials need to ensure sufficient recruitment and retention. To achieve this goal, clinical trial staff need to understand the socio-demographic and behavioural characteristics of people volunteering to screen for these trials and their reasons for volunteering.MethodsWe conducted a secondary analysis of participant screening data across five vaccine and monoclonal antibody trials at four sites in KwaZulu-Natal, South Africa. Our study reviewed the demographic, behavioural, motivational, and health-related data from the case report forms and screening questionnaires. Descriptive statistics, chi-squared, and one-way ANOVA tests were used to analyse participants’ characteristics and motivation to participate in HIV vaccine and monoclonal antibody trials. Analyses were conducted using R version 3.5.2.ResultsScreening data from 1934 participants, including 79.2% of women, were obtained across all five trials (1034 enrolled, 900 screened out/declined). Screened participants predominately self-identified as black, heterosexual, cisgender women or men, many with lower educational backgrounds (43.9% did not complete secondary/high school), and several self-reported HIV-risk behaviours among themselves and their partners. 10.8% of the screened participants were living with HIV. Avoiding HIV risk was the main motivation to participate in clinical trials, followed by altruistic reasons such as a desire to help the community or helping to find a vaccine.DiscussionThe current recruitment approach of these trials attracts heterosexual participants who seek to reduce HIV risk and support their community. Hence, the data suggest the need for and potential acceptance of continued ongoing HIV prevention efforts. Current trials attract participants with lower educational levels, which may be driven by the site locations, current community mobilisation strategies and research site opening hours. The sites could consider more flexible working hours to accommodate working participants and find ways to connect participants to educational support and opportunities to upgrade education levels for the current clientele.Trial registrationHVTN 100: A Safety and Immune Response Study of 2 Experimental HIV Vaccines, NCT02404311. Registered on March 17, 2015.HVTN 111: Safety and Immune Response to a Clade C DNA HIV Vaccine, NCT02997969. Registered on December 16, 2016.HVTN 108: Evaluating the Safety and Immunogenicity of HIV Clade C DNA Vaccine and MF59- or AS01B-Adjuvanted Clade C Env Protein Vaccines in Various Combinations in Healthy, HIV-Uninfected Adults, NCT02915016. Registered on September 22, 2016.HVTN 702: Pivotal Phase 2b/3 ALVAC/Bivalent gp120/MF59 HIV Vaccine Prevention Safety and Efficacy Study in South Africa, NCT02968849. Registered on November 1, 2016.HVTN 703/HPTN 081: Evaluating the Safety and Efficacy of the VRC01 Antibody in Reducing Acquisition of HIV-1 Infection in Women, NCT02568215. Registered on October 1, 2015.

Factors associated with normal or abnormal Papanicolaou smear among HIV-infected women at a national hospital in Lima, Peru, 2012–2015

ABSTRACT HIV-infected women are at a risk of developing abnormal lesions of the uterine cervix. The objective of this study was to determine factors associated with normal or abnormal Papanicolaou (Pap) smear among HIV-infected women. A case–control study was conducted; case and control were defined as HIV-infected women ≥18 years with an abnormal and normal Pap smear, respectively. A logistic regression analysis was performed, and the Odds Ratio (OR) was calculated with its 95% Confidence Interval (CI). We included 368 patients, and the mean age was 36.83 years (SD ± 9.81), similar between cases and controls. Regarding cases, 30.50% (n = 43) had an alcohol consumption (AC), 75.18% (n = 106) were on antiretroviral therapy (ART) and 37.74% (n = 40) were in virologic failure (VF). About controls, 18.02% (n = 41) had AC, 85.02% (n = 193) were on ART, and 23.12% (n = 40) were in VF. In multivariate analysis, AC [OR: 1.77 (1.06–2.95)], VF [OR: 2.41 (1.55–3.74)], and ART [OR: 0.07 (0.02–0.23)] were significant factors. The risk factors associated with an abnormal Pap smear were AC and VF. ART was a protective factor. Therefore, besides scheduled Pap smear, human papillomavirus screening/immunization, VF, and ART should be strictly reinforced, and AC should be mitigated.

Unmet need for family planning and factors associated among women living with HIV in Oromia regional state, Ethiopia

ObjectivesThe purpose of this study was to determine the prevalence of the unmet need and identifying factors associated with the unmet need among women of reproductive age living with HIV in Oromia regional state, Ethiopia. One critical component of both a full range of contraceptives and satisfying demand for family planning with HIV services all women living with HIV is the appropriate model for HIV therapy, HIV prevention, and care with family planning services in a resource-limiting area like Ethiopia.MethodsHealth facility-based cross-sectional study design was conducted among women living with HIV attending ART clinics in the special zone of, Oromia regional state, by simple random sampling was used to select 654 respondents. Both bivariate and multivariable logistic regressions analysis was used to identify at adjusted odds ratio (AOR) with 95% CI in the final model.ResultThe study assessed the magnitude of demand for family planning among HIV-infected women and established that the demand was 630 (96.3%), of which 100 (16%) of women of reproductive age living with HIV had unmet needs for family planning while attending monthly ART clinic drug refilling and follow up. This study identified that factors found to be associated with met needs for family planning among women of reproductive age living with HIV attending ART/PMTC were discussions with healthcare providers (AOR = 4.33, 95% CI 2.56–7.32), previous pregnancy (AOR = 3.07, 95% CI 1.84–5.12); future fertility desire (AOR = 2.15, 95% CI 1.31–3.51); having sexual partners (AOR = 5.26, 95% CI 1.79–15.5) and the number of the sexual partner (one) (AOR = 7.24, 95% CI 1.82–28.74) were identified independent predictors of met needs for family planning.ConclusionThe overall demand for family planning was 96% among the women living with HIV, and that 16% of women had an unmet need for family planning. The authors conducted a logistic regression and find various dependent variables that are associated with the met need for family planning services, such as having discussions with healthcare providers, having a partner and previous pregnancy; future fertility desire, the last pregnancy being intended. These results are interpreted to suggest that clear policy implications of family planning must be better integrated into ART clinics.

Inhibition of miR-155 Promotes TGF-β Mediated Suppression of HIV Release in the Cervical Epithelial Cells.

TGF-β has been shown to play a differential role in either restricting or aiding HIV infection in different cell types, however its role in the cervical cells is hitherto undefined. Among females, more than 80% of infections occur through heterosexual contact where cervicovaginal mucosa plays a critical role, however the early events during the establishment of infection at female genital mucosa are poorly understood. We earlier showed that increased TGF-β level has been associated with cervical viral shedding in the HIV infected women, however a causal relationship could not be examined. Therefore, here we first established an in vitro cell-associated model of HIV infection in the cervical epithelial cells (ME-180) and demonstrated that TGF-β plays an important role as a negative regulator of HIV release in the infected cervical epithelial cells. Inhibition of miR-155 upregulated TGF-β signaling and mRNA expression of host restriction factors such as APOBEC-3G, IFI-16 and IFITM-3, while decreased the HIV release in ME-180 cells. To conclude, this is the first study to decipher the complex interplay between TGF-β, miR-155 and HIV release in the cervical epithelial cells. Collectively, our data suggest the plausible role of TGF-β in promoting HIV latency in cervical epithelial cells which needs further investigations.

Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study

BackgroundHome delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and risk factors for home delivery among women living with HIV in Lira, Northern Uganda.MethodsThis prospective cohort study was conducted between August 2018 and January 2020 in Lira district, Northern Uganda. A total of 505 HIV infected women receiving antenatal care at Lira regional referral hospital were enrolled consecutively and followed up at delivery. We used a structured questionnaire to obtain data on exposures which included: socio-demographic, reproductive-related and HIV-related characteristics. Data was analysed using Stata version 14.0 (StataCorp, College Station, Texas, U.S.A.). We estimated adjusted risk ratios using Poisson regression models to ascertain risk factors for the outcome of interest which was home delivery (which is delivering an infant outside a health facility setting under the supervision of a non-health worker).ResultsThe incidence of home delivery among women living with HIV was 6.9% (95%CI: 4.9–9.5%). Single women were more likely to deliver at home (adjusted risk ratio = 4.27, 95%CI: 1.66–11). Women whose labour started in the night (night time onset of labour ARR = 0.39, 95%CI: 0.18–0.86) and those that were adherent to their ART (ARR = 0.33, 95%CI: 0.13–0.86) were less likely to deliver at home.ConclusionHome delivery remains high among women living with HIV especially those that do not have a partner. We recommend intensified counselling on birth planning and preparedness in the context of HIV and PMTCT especially for women who are: separated, divorced, widowed or never married and those that are not adherent to their ART.

Mortality and Loss to Follow-Up Among HIV-Exposed Infants After Option B+ Guideline Implementation in Amhara Regional State Referral Hospitals, Ethiopia

Background: Prevention of mother-to-child transmission of HIV program (PMTCT) is a comprehensive approach that aimed for the wellbeing of all HIV-infected women, to prevent new HIV infection among infants born to HIV-positive mothers, and providing management for HIV-positive women and infants. Nevertheless, there was considerably high attrition within the prevention of mother-to-child transmission programs that was merely because of loss to follow-up (LTFU) followed by mortality. In resource-limited countries, one-third of infected children die before 1 year, and more than half of them die before 2 years. The aim of this study was to assess the prevalence or incidence of mortality and LTFU among infants born from HIV-positive mothers in the Amhara regional state referral hospitals, Ethiopia.Methods: This study was conducted in five Amhara regional state referral hospitals' prevention of mother-to-child transmission departments. A simple random sampling technique with proportional allocation was used to assess the outcomes of 221 exposed infants. A retrospective cohort design was used in selecting the 221 exposed infants' document from the referral hospitals of the region, Amhara. The exposed infants' profiles were documented between January 1, 2014 and May 30, 2017.Results: This study described attritions (death and loss-to-follow-up) of exposed babies in PMTCT departments of Amhara regional state referral hospitals in Ethiopia. In this study, low LTFU with zero death was reported. Residence, immunization status of babies, and place of delivery were independent factors of LTFU.Conclusions: The cumulative incidence of mortality in this study was zero. This assured that the recommended option is substantial for the elimination of HIV-caused death in 2030 as per WHO plan. However, the cumulative incidence of LTFU was not zero.

Maternal and fetal outcomes of pregnancies complicated by acute hepatitis E and the impact of HIV status: A cross-sectional study in Namibia.

Background & AimsNamibia has been suffering from an outbreak of hepatitis E genotype 2 since 2017. As nearly half of hepatitis E‐related deaths were among pregnant and postpartum women, we analysed maternal and fetal outcomes of pregnancies complicated by acute hepatitis E and assessed whether HIV‐status impacted on outcome.MethodsA retrospective cross‐sectional study was performed at Windhoek Hospital Complex. Pregnant and postpartum women, admitted between 13 October 2017 and 31 May 2019 with reactive IgM for Hepatitis E, were included. Outcomes were acute liver failure (ALF), maternal death, miscarriage, intra‐uterine fetal death and neonatal death. Odds ratios (OR) and 95% confidence interval (CI) were calculated.ResultsSeventy women were included. ALF occurred in 28 (40.0%) of whom 13 died amounting to a case fatality rate of 18.6%. Sixteen women (22.9%) were HIV infected, compared to 16.8% among the general pregnant population (OR 1.47, 95% CI 0.84‐2.57, P = .17). ALF occurred in 4/5 (80%) HIV infected women not adherent to antiretroviral therapy compared to 1/8 (12.5%) women adherent to antiretroviral therapy (OR 28.0, 95% CI 1.4‐580.6). There were 10 miscarriages (14.3%), five intra‐uterine fetal deaths (7.1%) and four neonatal deaths (5.7%).ConclusionsOne in five pregnant women with Hepatitis E genotype 2 died, which is comparable to genotype 1 outbreaks. Despite small numbers, HIV infected women receiving antiretroviral therapy appear to be less likely to develop ALF in contrast with HIV infected women not on treatment. As there is currently no curative treatment, this phenomenon needs to be assessed in larger cohorts.

HIV care continuum among cisgender and transgender women sex workers in Greater Kuala Lumpur, Malaysia

ABSTRACT An estimated 37,000 cisgender and transgender women work as sex workers in Malaysia, a population that has been disproportionately affected by the HIV epidemic. Although Malaysia provides no-cost antiretroviral therapy (ART) to people with HIV, little is known about sex workers’ engagement in the HIV care continuum. We analyzed data from 57 HIV-infected cisgender women (n = 33) and transgender women (n = 24) sex workers from a respondent-driven sampling study on HIV prevalence among sex workers in Kuala Lumpur, Malaysia. We examined the proportion of women who were newly diagnosed with HIV, had a baseline CD-4 count test, were initiated and retained on antiretroviral treatment (ART). Overall, only 26.3% had ever been HIV tested and almost 60% were newly diagnosed. Only a small proportion of cisgender (15.2%) and transgender (12.5%) women were currently taking ART. Interventions to enhance sex workers’ engagement in the HIV care continuum are urgently needed. Deployment of evidence-based strategies to improve linkage and retention in HIV care should be adapted to address the unique needs of this important key population.

Influence of systemic inflammation predictors on the premature labor of hiv-infected women living in Subarctic region

The goal is to conduct a comparative analysis of the characteristics of blood counts of pregnant women with HIV living in the subarctic climatic zone of the Khanty-Mansiysk District, as predictors of a systemic inflammatory reaction on the background of infection and pregnancy complicated by preterm delivery.Material and methods. A retrospective analysis of 78 stories of pregnant women with HIV (main group II) was carried out, in 2016–2018. observed in one antenatal clinic in the city of Surgut. Control group (I) comprised 20 histories of pregnant women without HIV. Clinical-anamnestic and blood parameters were compared, including indicators of T-helpers, T-suppressors and viral load, leukocyte intoxication indices, hemoglobin, erythrocytes and platelets by trimesters of pregnancy. The material was processed using the Statistica-10 software system. The critical level of statistical significance was taken at p&lt;0,05.Results. A comparative analysis of blood counts of pregnant women living in the subarctic region showed a relationship between the preterm labor of patients with HIV with a progressive decrease in the T-cell level of immunity, an increase in the level of lymphocytes and leukocyte blood indices, a decrease of hemoglobin, erythrocytes, platelets, against the background of persisting viral load for the remainder of pregnancy. A decrease of T-lymphocyte counts indicates the development of a systemic inflammatory response on the background of HIV infection, depletion of the immune defense organs and the progression of the disease, while a low level of CD4 lymphocytes stimulates the activation of granulocytes in the blood and indicates further depletion of T-lymphocytes. Activation of a systemic inflammatory response that promotes the release of inflammatory mediators and prostaglandins and, with a high probability, underlies the mechanisms of rejection of the fetus and placenta and the spontaneous preterm labor. The comorbid background of pregnant women with HIV and preterm labor is associated with low adherence to HAART therapy and high detectable viral load throughout gestation.

Zidovudine inhibits telomere elongation, increases the transposable element LINE-1 copy number and compromises mouse embryo development.

Millions of pregnant, HIV-infected women take reverse transcriptase inhibitors, such as zidovudine (azidothymidine or AZT), during pregnancy. Reverse transcription plays important roles in early development, including regulation of telomere length (TL) and activity of transposable elements (TE). So we evaluated the effects of AZT on embryo development, TL, and copy number of an active TE, Long Interspersed Nuclear Element 1 (LINE-1), during early development in a murine model. Experimental study. In vivo fertilized mouse zygotes from B6C3F1/B6D2F1 mice were cultured for 48h in KSOM with no AZT (n = 45), AZT 1μM (n = 46) or AZT 10μM (n = 48). TL was measured by single-cell quantitative PCR (SC-pqPCR) and LINE-1 copy number by qPCR. The percentage of morulas at 48h, TL and LINE-1 copy number were compared among groups. Exposure to AZT 1μM or 10μM significantly impairs early embryo development. TL elongates from oocyte to control embryos. TL in AZT 1μM embryos is shorter than in control embryos. LINE-1 copy number is significantly lower in oocytes than control embryos. AZT 1μM increases LINE-1 copy number compared to oocytes controls, and AZT 10μM embryos. AZT at concentrations approaching those used to prevent perinatal HIV transmission compromises mouse embryo development, prevents telomere elongation and increases LINE-1 copy number after 48h treatment. The impact of these effects on the trajectory of aging of children exposed to AZT early during development deserves further investigation.

Seroprevalence of Listeria monocytogenes in HIV infected pregnant women from Brazil

ObjectiveTo describe the prevalence and factors associated with serologic response to Listeria monocytogenes in HIV infected and uninfected pregnant women in Brazil. MethodsCross-sectional study, pregnant women after 14 weeks of gestational age were enrolled. Positive serologic test for L. monocytogenes was defined as titers >1:80 (agglutination test). Comparisons were performed using logistic regression. ResultsA total of 213 women were enrolled, 73 (34%) were HIV infected. 55 women were seroreactive for L. monocytogenes, 27 (37%) HIV-infected and 28 (20%) HIV-uninfected (p < 0.01). Considering the diet record, white cheese consumption was associated with seroreactivity (p < 0.01). In the group of pregnant women living with HIV, the variables associated with L. monocytogenes positive serology were: lower CD4+ cells count at study entry OR=4.8 (95%CI=1.1–19.8) and having neonates admitted to the intensive care unit OR=5.9 (95%CI=1.01–34.9). ConclusionPositive serology for Listeria monocytogenes was associated with HIV infection. Brazilian women should avoid white cheese during pregnancy.

Knowledge and utilization of prevention of mother-to-child transmission of HIV services among pregnant women in Tanzania

Background: Human Immunodeficiency Virus (HIV) infection among children is mainly vectored through mother-to-child transmission. Prevention of mother-to-child-transmission strategy is highly effective; however, its accessibility and utilization is affected by the lack of knowledge among other factors.&#x0D; Methods: A cross-sectional study was conducted among antenatal care attendees in two districts in Tanzania to determine their knowledge and utilization of the prevention of MTCT services.&#x0D; Results: We interviewed 160 antenatal care attendees aged 18-45 years with a mean (SD) age of 30.4 (6.3) years; 74 (46.2 %) were HIV-infected. HIV-infected women demonstrated significantly correct knowledge of HIV (p=0.001) and AIDS (p=0.014) than uninfected individuals. HIV-infected women also significantly demonstrated correct knowledge of mother-to-child transmission during pregnancy than HIV-uninfected women (p=0.016) and during delivery (p=0.005). A significant proportion of HIV-positive women compared to HIV-negative women were aware that correct use of antiretroviral during pregnancy can reduce the risk of mother-to-child-transmission of HIV (p&lt;0.039), but only 6 (3.75%) of all women were aware that correct use of antiretroviral during delivery can significantly reduce the risk of mother-to-child-transmission. HIV-infected women had significant comprehensive knowledge of HIV/AIDS (p=0.001) and prevention of mother-to-child transmission of HIV (p=0.006) than HIV-negative women. Comprehensive knowledge prevention of mother-to-child transmission of HIV was low among the study participants. Male partners’ involvement in maternal antenatal care was significantly higher among HIV-infected women than males from the HIV-infected women group (p&lt;0.006).&#x0D; Conclusion: The study demonstrated inadequate knowledge of PMTCT among women who made ANC visits. HIV uninfected women had poorer knowledge compared to the HIV-infected ones. Routine HIV counseling and testing services were highly accepted among these women.

Fertility Desires and Family Size Preferences of HIV Positive Women Accessing Care in the University of Port Harcourt Teaching Hospital

Introduction: Women living with HIV may or may not intend to bear children. They may also have different preferences in terms of family sizes. The desire of HIV positive women to bear children and their family size preferences has significant implication for horizontal and vertical transmission of this incurable disease. This study, therefore, aims to determine fertility preferences and their predictors among HIV positive women accessing care at UPTH, Port Harcourt, Rivers State.&#x0D; Methods: The study was a descriptive cross-sectional study among 402 women within the reproductive age (15-49 years) who were on Antiretroviral Therapy (ART). Participants were recruited using systematic sampling method and were interviewed with an interviewer-administered questionnaire. A semi-structured, self-administered questionnaire was used to obtain participant’s socio-demographic characteristics, desire for children, use, demand and choice of contraception and reproductive characteristics. With SPSS version 20, data was summarised as descriptive statistics and Chi-square test was used to test for association.&#x0D; Results: The study showed that 81.8% of respondents desire to have children out of which 96 (29.3%) desired one to two children, 169 (51.5%) desired three to four children, and 18 (5.5%) wanted five or more children. Factors such as age, marital status, and disclosure of Sero-status to partner were found to be associated with family size preferences (p&lt;0.05).&#x0D; Conclusion: HIV positive women in Port Harcourt have high fertility desires and moderate family sizes preferences; thus, indicating the need for more support and involvement of the government and relevant stake holders in ensuring better access to ART services in the country. More resources should be channelled towards provision of effective preventive medications and services, people who live with HIV (PLHIVs) should be continuously and adequately sensitised with the necessary knowledge on how to make healthy reproductive decisions, as well as on available practicable reproductive options for HIV-infected women should be made efficient, and easily accessible.