HIV/acquired Immune Deficiency Syndrome Research Articles

Clinical and Biological Risk Factors Associated with Increased Mother-to-Child Transmission of HIV in Two South-East HIV-AIDS Regional Centers in Romania.

Background and Objectives: The occurrence of human immunodeficiency virus (HIV) infection in children in Romania has been reported since 1989. This retrospective study was aimed at assessing clinical and biological risk factors for mother-to-child transmission (MTCT) of HIV in two HIV-acquired immune deficiency syndrome (AIDS) Regional Centers (RCs), Constanta and Craiova in Romania. Materials and Methods: During the study period (2008–2019), 408 HIV-positive pregnant women, 244 from Constanta RC and 164 from Craiova RC who attended antenatal visits, were included. All HIV-positive pregnant women were under combined antiretroviral therapy (cART) during pregnancy and childbirth, being followedup with their infants up to 18 months after delivery. We investigated the clinical as well as biological risk factorsassociated with increased MTCT of HIV. Results: Comparing different variables of HIV-positive pregnant women from the two HIV-AIDS CRs, we find that there are significant differences between the mean value of hemoglobin, CD4 level, environmental area, marital and amniotic membranes status, and HIV patient stage in the last trimester of pregnancy (p < 0.05), but without any differences in mother’s mean age, education level, type of delivery, breastfeeding, the duration of cART administration, HIV viral load, and survival rate. Conclusions: In 408 HIV-positive pregnant women followed up at two HIV-AIDS RCs in Romania, the most important clinical and biological risk factors associated with increased MTCT of HIV are represented by anemia, CD4 level, and HIV patient stage.

Semiparametric regression analysis of doubly censored failure time data from cohort studies

Doubly censored failure time data occur when the failure time of interest represents the elapsed time between two events, an initial event and a subsequent event, and the observations on both events may suffer censoring. A well-known example of such data is given by the acquired immune deficiency syndrome (AIDS) cohort study in which the two events are HIV infection and AIDS diagnosis, and several inference methods have been developed in the literature for their regression analysis. However, all of them only apply to limited situations or focus on a single model. In this paper, we propose a marginal likelihood approach based on a general class of semiparametric transformation models, which can be applied to much more general situations. For the implementation, we develop a two-step procedure that makes use of both the multiple imputation technique and a novel EM algorithm. The asymptotic properties of the resulting estimators are established by using the modern empirical process theory, and the simulation study conducted suggests that the method works well in practical situations. An application is also provided.

Effectiveness of structured teaching programme on transmission and prevention of human immunodeficiency virus/acquired immune deficiency syndrome among adolescent girls in Lowry Memorial High School, Bengaluru.

Background:Adolescence is a critical stage in human development. Most young people become sexually active during adolescence and are more likely to have multipartner and unprotected sex with high-risk behavior that predisposes them to sexually transmitted infections such as human immunodeficiency virus (HIV).Objectives:The objective of the study was to evaluate the effectiveness of a structured teaching programme on transmission and prevention of HIV/acquired immune deficiency syndrome (HIV/AIDS) among adolescent girls.Methods:An evaluative research approach was adopted, in which a preexperimental, one group pre- and post-test research design was used to evaluate the effectiveness of the structured teaching programme on transmission and prevention of HIV/AIDS among adolescent girls studying at Lowry Memorial High School, Bengaluru. A self-administered structured questionnaire was used for data collection. Data were presented in frequency tables and statistical graphs (bar charts) and analyzed using descriptive statistics (mean, standard deviation) and inferential statistical methods (Chi-square and paired “t”-tests) using SPSS version 21.Results:The findings of the study revealed that the mean percentage difference in the pre- and post-test knowledge scores was statistically significant at 5% level (P < 0.05). The overall mean post-test knowledge score of adolescent girls on transmission and prevention of HIV/AIDS was 88.83%. It is apparently higher compared to the pretest knowledge score, which was 67.67% with enhancement of 21.16%. This implies that the structured teaching programme was effective in gaining knowledge of adolescent girls regarding transmission and prevention of HIV/AIDS.Conclusion:Our study suggests that structured teaching programme enhanced the knowledge of the adolescent girls on transmission and prevention of HIV/AIDS. We, therefore, recommend that structured teaching programmes on transmission and prevention of HIV/AIDS should be encouraged among adolescents and youths to reduce the spread of HIV infection.

LC-MS/MS determination of antiretroviral drugs in influents and effluents from wastewater treatment plants in KwaZulu-Natal, South Africa

South Africa has the largest occurrence of the human immune deficiency virus (HIV) in the world but has also implemented the largest antiretroviral (ARV) treatment programme. It was therefore of interest to determine the presence and concentrations of commonly used antiretroviral drugs (ARVDs) and, also, to determine the capabilities of wastewater treatment plants (WWTPs) for removing ARVDs. To this end, a surrogate standard based LC-MS/MS method was optimized and applied for the detection of thirteen ARVDs used in the treatment and management of HIV/acquired immune deficiency syndrome (HIV/AIDS) in two major and one modular WWTP in the eThekwini Municipality in KwaZulu-Natal, South Africa. The method was validated and the detection limits fell within the range of 2–20 ng L−1. The analytical recoveries for the ARVDs were mainly greater than 50% with acceptable relative standard deviations. The concentration values ranged from <LOD – 53000 ng L−1 (influent), <LOD – 34000 ng L−1 (effluent) in a decentralized wastewater treatment facility (DEWATS); <LOD – 24000 ng L−1 (influent), <LOD – 33000 ng L−1 (effluent) in Northern WWTP and 61–34000 ng L−1 (influent), <LOD – 20000 ng L−1 (effluent) in Phoenix WWTP. Whilst abacavir, lamivudine and zidovudine were almost completely removed from the effluents, atazanavir, efavirenz, lopinavir and nevirapine persisted in the effluents from all three WWTPs. To estimate the ecotoxicological risks associated with the discharge of ARVDs, a countrywide survey focussing on the occurrence of ARVDs in WWTPs, surface and fresh water bodies, and aquatic organisms, is necessary.

Influence of Spousal Communication about Family Planning and HIV/AIDS-related Issues on Modern Contraceptive Use in Nigeria

Contraceptive use in Nigeria at 15 per cent is low, despite a high human immunodeficiency virus (HIV) prevalence of 3.4 per cent and fertility rate of 5.7 per cent. We assessed the levels of spousal communication on family planning and contraception (FPC) and HIV/acquired immune deficiency syndrome (HIV/AIDS), influence of demographic characteristics on this communication and association between this communication and the respondents’ health behaviours. We used a cross-sectional and nationally representative data on reproductive health and HIV/AIDS-related issues from randomly selected 30,752 men and women of reproductive age. Descriptive statistics, Pearson chi-square (c2) and logistic regression were used to analyze the data at 5 per cent significance level. About 61 per cent of the respondents were 25–49 years old and mostly from rural areas (65 per cent). Only 20 per cent of the respondents discussed HIV/AIDS with their spouses within 12 months preceding the survey while 15 per cent discussed FPC. A discussion of both HIV/AIDS and FPC among spouses was reported among 9 per cent compared to 26 per cent who reported discussing either. Respondents aged 35–39 years had higher odds of discussing HIV/AIDS (Odds Ratios [OR] = 7.06:6.16–8.09) than those aged 15–19 years. Urban dwellers also had higher odds (OR = 1.24:1.16–1.31) of HIV/AIDS discussions than rural respondents. Modern contraceptive use was 35 per cent and 23 per cent among respondents who discussed FPC and HIV/AIDS compared to 8 per cent and 9 per cent, respectively, among those who did not. Spousal communication on FP and HIV/AIDS was low and has influenced contraceptive use and HIV positivity in Nigeria. There is a need to encourage spousal discussion on FP and HIV/AIDS, especially among the rural dwellers and the poor and uneducated as a strategy for improving modern contraceptive use.

Haematological manifestations of human immune deficiency virus infection.

Early in the human immunodeficiency virus (HIV) epidemic, infected patients presented to medical attention with striking abnormalities in each of the major blood cell lineages. The reasons for these derangements remain complex and multifactorial. HIV infects multipotent haematopoietic progenitor cells and establish latent cellular reservoirs, disturbs the bone marrow microenvironment and also causes immune dysregulation. These events lead to cytokine imbalances and disruption of other factors required for normal haematopoiesis. Activation of the reticulo-endothelial system can also result in increased blood cell destruction. The deleterious effects of medications, including first and second generation anti-retroviral agents, on haematopoiesis were well documented in the early years of HIV care; in the current era of HIV-care, the advent of newer and less toxic anti-retroviral drugs have had a more beneficial impact on haematopoiesis. Due to impaired regulation of the immune system and potential side effects of one or more anti-retroviral agents, there is also an increase in coagulation abnormalities such as thromboembolism, and less frequently, acquired disorders of coagulation including thrombotic thrombocytopenic purpura, immune thrombocytopenic purpura and acquired inhibitors of coagulation. In this article we review the epidemiology and aetiology of select non-oncological haematological disorders commonly seen in people living with HIV-acquired immune deficiency syndrome.

Community perception on biomedical research: A case study of malariometric survey in Korogwe District, Tanga Region, Tanzania.

BackgroundCommunity perception in biomedical research remains critical in Africa with many participants being driven by different motives. The objective of this study was to explore the perceived motives for women or females guardians to volunteer for their children to participate in biomedical research and to explore experiences and challenges faced by Community Owned Resource Persons (CORPs) when mobilizing community members to participate in biomedical research.MethodsThis cross sectional study was conducted in Korogwe district, in north-eastern Tanzania. Qualitative methods combining random and purposive sampling techniques were used for data collection. A randomly selected sample using random table method from the existing list of households in the ward office was used to select participants for Focus Group Discussions (FGDs). A purposive sampling technique was used for In-Depth Interviews (IDIs) with CORPs. Thematic framework analysis was used to analyze the data.ResultsNeed for better health services, availability of qualified clinicians, and better access to services provided at the research points were reported as main motives for community members to participate in biomedical research. With regard to experience and challenges faced by CORPs, the main reasons for mothers and guardians not participating in biomedical research were linked to misconception of the malariometric surveys, negative perception of the validity and sensitivity of rapid diagnostic tests, fear of knowing Human Immunodeficiency Virus Infection (HIV)/Acquired Immune Deficiency Syndrome (HIV/AIDS) sero status, and lack of trust for the medical information provided by the CORPs. Challenges reported by CORPs included lack ofawareness of malariometric surveys among participants, time consumption in mobilization of the community, difficulties in identifying individual results, and family responsibilities.ConclusionThis study has shown that majority of community members had positive perceptions of the about malariometric surveys services provided. The availability of free health services was the major determining factor for community members’ participation in malariometric surveys. CORPs are instrumental in mobilizing community members participation during malariometric surveys, despite their experiences and the challenges they face.

Epidemiology of HIV Infection in the United States: Implications for Linkage to Care

The epidemiology of human immunodeficiency virus (HIV) infection in the United States has changed significantly over the past 30 years. HIV/acquired immune deficiency syndrome (HIV/AIDS) is currently a disease of greater demographic diversity, affecting all ages, sexes, and races, and involving multiple transmission risk behaviors. At least 50,000 new HIV infections will continue to be added each year; however, one-fifth of persons with new infections may not know they are infected, and a substantial proportion of those who know they are infected are not engaged in HIV care. Barriers to early engagement in care may be specific to a demographic group. In this paper, the current epidemiology of HIV/AIDS in the United States is reviewed in order to understand the challenges, successes, and best practices for removing the barriers to effective diagnosis and receipt of HIV care within specific demographic groups.

Confidentiality and the acquired immune deficiency syndrome (AIDS): an analysis of the legal and professional issues.

Confidentiality is one of the most significant concepts in health care and nursing practice, particularly in the arena of HIV infection and AIDS. The implications for individuals of deliberate or accidental disclosure of their HIV status can and does have far reaching effects. This paper will explore the concept of confidentiality by discussing the legal and professional issue of confidentiality and AIDS. The nature of the law and guidance by professional bodies allow exceptions to the respect of confidentiality in certain situations. AIDS and the need for confidentiality often is in conflict when public health considerations are deemed to be involved. The law is poorly developed in this area and often professional guidance is less than clear.