HIV Sentinel Surveillance Sites Research Articles

Changing trends in the types of drug used and infectious disease prevalence among drug users in jiangsu province, china

BackgroundIn recent years, a boom of synthetic drugs, especially methamphetamine has been documented in China, however, the situation in Jiangsu was unclear. The objective of this study was to evaluate the changing trends in types of drug used, examine the prevalence trends of HIV, syphilis and HCV over time and compare the demographic, drug and sexual behaviors among different types of people who use drugs (PWD) in Jiangsu Province, China. MethodsConsecutive cross-sectional studies were conducted from 2011 to 2015 in nine compulsory detoxification centers, which were HIV sentinel surveillance sites, in Jiangsu Province, China. A structured questionnaire was administered in a face-to-face interview with each participant to collect demographic, behavioral and laboratory information. Participants were classified into three types: opioids PWD (using heroin, opium, morphine and dolantin); stimulant PWD (using cocaine, methamphetamine, methylene dioxymetham-phetamine and Magu); poly-drug PWD (using opioids and stimulant drugs simultaneously). ResultsAmong a total of 16,164 PWD recruited from 2011 to 2015, the proportion of opioids PWD declined from 40.1% in 2011 to 11.8% in 2015, while the proportion of stimulant PWD increased from 53.6% to 84.3%. Overall HIV, syphilis, and HCV prevalence for the period was 0.3%, 9.6% and 31.6%, respectively. As types of drugs used shifted from opioids to stimulants, HIV prevalence increased (P = 0.031) while HCV decreased (P<0.001). HIV, syphilis and HCV prevalence trends varied across the three subgroups. Injection and needle-sharing behaviors differed between opioids and stimulant PWD, whereas unsafe sexual behaviors were similar. Poly-drug PWD might have higher risks for these infections due to combinations of unsafe sexual and injection behaviors. ConclusionAlthough the trend of drugs used have changed over time, HIV, syphilis and HCV infection risk behaviors among PWD still exist. Therefore, traditional intervention strategies should seek to address the challenge of increasing stimulant PWD. Access to convenient testing services, as well as pre- and post-exposure prophylaxis for HIV risk reduction should be improved among PWD. Antiviral treatment for HCV should be added to medical insurance coverage as soon as possible in Jiangsu Province.

HIV Risk profile and its socio-demographic correlates among long-distance truckers in West Bengal, India: Evidence from national HIV sentinel surveillance 2017.

Long-distance truckers (LDTs) belong to a special sentinel group with potentially high risk of acquisition of HIV owing to their high mobility, sociodemographic vulnerability, and high-risk behaviors. The objective is to estimate the prevalence of HIV and identifies its sociodemographic correlates among a representative population of LDTs in West Bengal, India. Between May and July 2017, HIV Sentinel Surveillance (HSS) was conducted in West Bengal by the National AIDS Control Organization. A total of 749 LDTs were recruited for the study, were interviewed, and tested for HIV. Descriptive and logistic regression analysis of socio-demographics, sexual risk behavior, and HIV serostatus were performed using SAS 9.3.2. The prevalence of HIV among LDT was 1.2% (95% confidence interval [CI] = 0.4-2.0). Mean age was 32.8 years (standard deviation 8.5), 77.1% were currently married, 89.9% were literate, 85.7% visited HSS site for collecting condoms or seeking medical care and treatment, 53.1% were rural residents, 86.7% had sex at least once with a female partner other than wife in the past 6 months, 2.7% had sex with a male partner and 1.7% injected drugs for recreational purpose. Higher age (odds ratio [OR] = 1.1 [95% CI = 1.0-1.1]), literate (OR = 0.3 [95% CI = 0.1-0.9]), visiting HSS sites for collecting condoms or seeking medical care and treatment (adjusted OR [AOR] = 0.2 [95% CI = 0.1-0.6]), rural residence (OR = 0.2 [95% CI = 0.1-0.3]) and duration of stay in home (AOR = 1.3 [95% CI = 1.1-1.5]) were found to be significant predictors of having sex with a female partner other than wife. High HIV burden calls for urgency in the implementation of targeted intervention to minimize HIV risk among LDTs in West Bengal to fight against HIV/AIDS.

Site preparedness and quality of HIV sentinel surveillance at antenatal care clinic sites in India, 2019.

Quality of HIV sentinel surveillance (HSS) depends on preparedness of the site and adherence to the standard operating procedures (SOPs) for HSS. A designated sentinel site is considered prepared for the round of sentinel surveillance based on the availability of infrastructure, human resource, and consumables. The study objectives were to describe the site level preparedness and adherence to SOP of antenatal care clinic (ANC) sites during the 16th round of HSS in India. This was a cross-sectional study based on the findings of the supervisory visits conducted by public health specialists in ANC sites during the 16th round of HSS from January to March 2019. Semi-structured checklists were used to assess site-preparedness and adherence to the SOP for HSS. All supervisors were expected to upload the filled pro forma to the HSS management information system (MIS). We present here a descriptive analysis of the uploaded visit reports. Of 870 HSS sites, 783 (90%) were visited, and 479 (61.2%) reports were uploaded to MIS. Preround HSS training was not attended by one-fifth (22.6%) of the site in-charges; 35.8% of them had never received any HSS training. SOP was followed at most (94%) of the sites. The most frequently reported problem at the sites was inadequate or delayed availability of consumables. The overall quality of site-level preparedness at antenatal clinic sites in India was good. Attention needs to be given to timely and adequate availability of consumables at sentinel sites along with proper administrative support and preround training of site in-charges.

Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

BackgroundYi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.MethodsXichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these areas, and the association between demographic and behavioral characteristics and risk of HIV infection.ResultsData on a total of 2797 pregnant women in Xichang and 3983 pregnant women in Zhaojue and Butuo was collected for the period 2009 to 2015. There was a fluctuating HIV prevalence among pregnant women of Xichang, with a rate of 0.75% in 2015 (χ2trend = 2.27, P = 0.13). HIV prevalence among pregnant women of Zhaojue and Butuo was consistently high, varying between 3.4% (9/267, 2011) and 10.3% (82/796, 2012) over the period of 2010 to 2015 (χ2trend = 0.12, P = 0.73). In Xichang, we found that Yi ethnicity (OR = 11.37, 95% CI = 2.92–44.25) and a husband who used drugs (OR = 32.13, 95% CI = 5.33–193.67) were significantly associated with HIV risk in pregnant women. For Zhaojue and Butuo, we observed that pregnant women had a higher risk of HIV infection when they were over 30 years old (OR = 1.72, 95% CI = 1.17–2.52), when they had a higher number of previous births, when their husbands had a history of migrating for work (OR = 1.56, 95% CI = 1.16–2.08), and when they had a history of other sexually transmitted infections (OR = 2.19, 95% CI = 1.16–2.08). Compared to those with a primary school education or below, pregnant women with a secondary or high school education level had a lower risk of HIV infection (OR = 0.28, 95% CI = 0.09–0.89).ConclusionOur results indicate that there is a serious HIV epidemic among pregnant Yi women, especially for those with less education, more past births, or a husband with a history of out-migrating for work or STD infection.

Hepatitis C virus and HIV co-infection among pregnant women in Rwanda

BackgroundHepatitis C virus (HCV) infection is a pandemic causing disease; more than 185 million people are infected worldwide. An HCV antibody (Ab) prevalence of 6.0% was estimated in Central African countries. The study aimed at providing HCV prevalence estimates among pregnant women in Rwanda.MethodsHCV surveillance through antibody screening test among pregnant women attending antenatal clinics was performed in 30 HIV sentinel surveillance sites in Rwanda.ResultsAmong 12,903 pregnant women tested at antenatal clinics, 335 (2.6% [95% Confidence Interval 2.32–2.87]) tested positive for HCV Ab. The prevalence of HCV Ab in women aged 25–49 years was 2.8% compared to 2.4% in women aged 15–24 years (aOR = 1.3; [1.05–1.59]); This proportion was 2.7% [2.37–2.94] in pregnant women in engaged in non-salaried employment compared to 1.2% [0.24–2.14] in those engaged in salaried employment (aOR = 3.2; [1.60–6.58]). The proportion of HCV Ab-positive co-infected with HIV was estimated at 3.9% (13 cases). Women in urban residence were more likely to be associated with HCV-infection (OR = 1.3; 95%CI [1.0–1.6]) compared to those living in rural setting.ConclusionHCV is a public health problem in pregnant women in Rwanda. Few pregnant women were co-infected with HCV and HIV. Living in urban setting was more likely to associate pregnant women with HCV infection.

P04.31 Study among injectable drugs users (idus)

Background Afghanistan is a country of low HIV prevalence but high risk factors for a number of reasons: There is no information on the prevalence rates of HIV amongst general population- there are neither HIV sentinel surveillance sites nor case reporting system. There have also been no general population household studies of Behavioural surveillance in general population. Methodology Rapid Assessment techniques comprising qualitative methods were used, in the first instance, to elicit salient key themes to inform questionnaire design for the quantitative component of the study. Key information interview were conducted in each five research sites with administrator and services provides who had knowledge of injecting drug use. Secondly, the free list technique was employed with information in all five research area to elicit responses to thematically- focused question on injecting drug use and lifestyle. Blood sample were drawn from each 250 participants to test HIV, HCV, HBS and Syphilis Study aims Describe the range of characteristics of IDUs in major cities of Afghanistan. Examine the injecting –related HIV risk behaviours of IDUs. Suggest necessary intervention to prevent HIV transmission among IDUs and their family and sex partners. Conclusion Study of characteristics and drug user pattern of IDUs conducted through in- depth interview with 250 IDUs in five area: Herat; Kabul; Bamyan; Jalalabad and Mazar-e-Sharif by the criteria of: demographics; ethnicity; place of birth; time spent outside Afghanistan during the past ten years; length of time of return to Afghanistan; education and literacy level; marital status; income; drug availability; drugs use and injection; condom use; sexual history and practices; knowledge and attitudes about HIV; services use and satisfaction. Disclosure of interest statement I would like to clear that I was the principle investigator of this study, I have approval letter from ministry of Public Health of Afghanistan.

Estimate of HIV prevalence and number of people living with HIV in India 2008–2009

ObjectivesTo update the estimation of the adult HIV prevalence and number of people living with HIV (PLHIV) in India for the year 2008−2009 with the combination of improved data and...

Advances and future directions in HIV surveillance in low- and middle-income countries

To present recent advances in HIV/AIDS surveillance methods in low- and middle-income countries. From 2001 to 2008, 30 low- and middle-income countries implemented national population-based surveys with HIV testing. Antenatal clinic HIV sentinel surveillance sites in sub-Saharan Africa increased from just over 1000 in 2003-2004 to almost 2500 in 2005-2006, becoming more representative of rural areas. Between 2003 and 2007, at least 122 behavioral surveys in low- and middle-income countries used respondent-driven sampling for surveillance among high-risk populations, although many countries with concentrated epidemics continue to have major sentinel surveillance gaps. Improvements have been made in modeling estimates of number of persons HIV infected, and systems are now in place to measure HIV drug resistance. However, the reliable monitoring of trends and the measuring of HIV incidence, morbidity, and mortality is still a challenge. In the past 5 years, there have been substantial improvements in the quantity and quality of HIV surveillance studies, especially in the countries with high prevalence. Further efforts should be made in countries that lack fully implemented surveillance systems to improve HIV incidence, morbidity, and mortality surveillance and to use data more effectively.

Differential of HIV prevalence in women and men who attended sexually transmitted disease clinics at HIV sentinel surveillance sites in Kenya, 1990–2001

Several studies in sub-Saharan Africa have reported that HIV prevalence in young women is higher than in young men. We used data from Kenya HIV sentinel surveillance conducted from 1990 to 2001 among sexually transmitted disease (STD) patients (15-49 years old) to investigate consistency of gender differentials over time and their risk factors. Of the 15,889 STD patients, the HIV prevalence ranged from 16.0% in 1990 to 41.8% in 1997. The odds ratios (ORs) of HIV infection for women compared to men decreased by age; women 15-24 years were nearly twice as likely as men of the same ages to be HIV infected (OR 1.7 [1.5-2.0]), but risk in those >44 years was almost equal (OR 0.8 [95% CI 0.7-1.2]). The odds of HIV infection for women compared to men were twice in unmarried patients (OR 2.1 [95% CI 1.8-2.3]). This association persisted after controlling for age groups or marital status, residence, level of education, and presence of STD syndromes. This pattern had been consistent over 12 years. Adolescent women with symptoms of STDs should be a focus for the HIV/STD intervention programmes because of their high risk for HIV.

How well do antenatal clinic (ANC) attendees represent the general population? A comparison of HIV prevalence from ANC sentinel surveillance sites with a population-based survey of women aged 15-49 in Cambodia

The purpose of this study was to evaluate whether HIV-1 prevalence among antenatal clinic (ANC) attendees in Cambodia provided a reasonable estimate of HIV-1 prevalence among all women 15-49 years. METHODS Antenatal clinic attendees in five HIV sentinel surveillance sites (five provinces) were selected by consecutive sampling (n = 1695). The population survey of females by household was carried out in the same five areas. Household females aged 15-49 years were selected using a three-stage cluster sampling design (n = 3066). Serum-based HIV ELISA testing was done for both ANC attendees and household females. The HIV prevalence for ANC attendees and household females were compared by age group and urban versus rural location. The overall prevalence of HIV-1 infection among ANC attendees (1.62%, 95% CI : 1.26-1.98) was similar to the overall prevalence obtained from the general population of household females (1.24%, 95% CI : 0.92-1.55) in the same catchment areas in Cambodia. In the rural areas, the overall HIV prevalence among ANC attendees (2.18%, 95% CI : 1.59-2.77) was significantly higher than among the household females (0.86%, 95% CI : 0.49-1.23) after adjustment for age distribution and education level. In the 15-24 age group in rural areas, the HIV prevalence of ANC women was 2.71% (95% CI : 0.96-4.46) compared with 0.77% (95% CI : 0.02-1.53) in household females. Although ANC data can be used to estimate trends over time, it should be realized that ANC data may overestimate the actual prevalence in the younger age group in rural areas in Cambodia.