Human Immunodeficiency Virus Positive Women Research Articles

Prevalence of Human Cytomegalovirus Infection among Human Immunodeficiency Virus Positive Women Receiving Antiretroviral Treatment at Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria

Background: Cytomegalovirus has been identified as the major cause of morbidity and mortality among neonates. It commonly occurs in immunocompromised and immunodepressed individuals. Objectives: This study was conducted to determine the occurrence of CMV infection amongst HIV-positive women receiving antiretroviral treatment at Federal Teaching Hospital Abakaliki (FETHA). Socio-demographic factors associated with CMV and HIV were also examined. The population of volunteers present for the study was 124 Persons. Study Design: Blood samples were collected from the study subjects and recent infection of CMV was investigated using the Enzyme Linked Immunosorbent Assay ELISA), which detects Immunoglobulin M (IgM). Results: The result obtained indicated that 14 (11.3%) out of the 124 already confirmed HIV patients had recent/current CMV infection. Again, 18 of the patients were either pregnant or within two weeks of delivery, among which 3 (16.7%) were CMV positive. The study also showed that CMV and HIV co-infection predominates among the age group 26-30 years (15.6%), singles (13.9%), and unemployed (15.8%) of the tested population. The level of education had no effect on the rate of co-infection of CMV and HIV. Conclusion: This study shows the rate of infection and reactivation of CMV among HIV positive patients receiving antiretroviral treatment at Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria. CMV infection predominates among the Single HIV-positive individuals, within the age group 26-30 years, followed by Civil Servants and the unemployed. We therefore recommend that serious and aggressive campaign be carried out in this region and elsewhere where CMV and HIV co-infection is endemic or prevalent in order to curtail the transmission of the disease and thus reduce the possible menace posed by this virus.

Barriers of Condom Use among HIV Positive Women at Thika Level 5 Hospital, Kenya

Human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS) is the key public health concern particularly in sub-Saharan Africa including Kenya. Consistent condom use is crucial especially among HIV positive people to prevent HIV transmission as well as re-infection with different resistant virus strain. It is important to identify the obstacles of condom use among HIV positive individuals in order to constitute preventive measures. Thus, the study was conducted to explore barriers and challenges of condom use among women living with HIV attending Comprehensive Care Centre of Thika Level 5 Hospital, Kenya. We conducted qualitative method of data collection using three focus group discussions and ten key informant interviews. Purposive sampling was used to select participants. Descriptive quotes representing key themes were identified and then analysed thematically. The result indicated that the main barriers of condom use were inability to negotiate in condom use, fear of mistrust, nondisclosure of HIV positive status to partner, alcohol use, and reduced sexual pleasure. In addition, among the negative beliefs and misconceptions identified as barriers of condom use were feeling promiscuous for carrying condoms, religion (being Catholic) and perceived pores in condoms. HIV positive women face many challenges in using condoms and the specific areas of focus should include the barriers mentioned above.

Prevalence and predictors of placental malaria in human immunodeficiency virus-positive women in Nigeria.

Human immunodeficiency virus (HIV)-infected pregnant women have alterations in cellular and humoral immunity that increase the risks to placental malaria infection. This study aimed at determining the prevalence and predictors of placental malaria among HIV-positive women in Nigeria. It was a longitudinal cohort study of pregnant women receiving antenatal care at a tertiary hospital in Nigeria. Peripheral blood sample for packed cell volume estimation and placental blood sample for malaria parasite estimation were collected from each participant at a presentation in labor and upon delivery, respectively. The Prevalence of placenta malaria (68.6%) and anemia (66.7%) in HIV-positive women were significantly higher than the prevalence of placental malaria (35.3%) and anemia (44.1%) in HIV-negative control (P < 0.001 and P = 0.001 respectively). The employment status was the only sociodemographic factor significantly associated with the development of placental malaria in HIV-positive women (odds ratio: 21.60; 95% confidence interval: 7.1-66.2; P< 0.001). The prevalence of placental malaria is very high among HIV-positive women in Nigeria. Scaling up free distribution of insecticide treated nets in the short term and employment opportunities of HIV-positive women, in the long run, may reduce the prevalence of placental malaria in our population.

Non-blood management of severe anaemia in pregnant human immunodeficiency virus positive Jehovah's Witness patients in the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Background: Blood transfusion is clinically used to treat severe anaemia, but some people refuse it for its adverse effects and religious reasons. Aim: To present two Jehovah's Witness pregnant human immunodeficiency virus (HIV) positive women who were managed successfully without blood at the University of Port Harcourt Teaching Hospital. Methods: Case series - The first case, a 27-year-old Jehovah's Witness woman was found to be retropositive with severe anaemia. She had a packed cell volume (PCV) of 14% in her second trimester in pregnancy. She was treated with oral haematinics, and the PCV rose to 34% before an elective caesarean section. The second case was a 29-year-old Jehovah's Witness woman who was admitted for chronic cough and fever in her second trimester. On further investigation, she was found to have pulmonary tuberculosis, septicaemia and severe anaemia with a PCV of 17%. She declined blood transfusion and was managed with parenteral iron and erythropoietin. Both cases had safe deliveries with good fetomaternal outcome. Conclusion: Pregnant patients who decline blood transfusion can be adequately managed if they register in the first trimester or the early second trimester and such cases need good team management and cooperation between the patient and the teams for a good outcome.

Analysis of HIV infection and its epidemic characteristics among pregnant women in Hunan from 2011 to 2015

Objective To investigate the prevalence of human immunodeficiency virus (HIV) infection and its characteristics among pregnant women in Hunan. Methods Data from information system of prevention of mother-to-child transmission of HIV management in Hunan 2011-2015 was analyzed in the study (3+ 1 mode by year statistics). Results The total HIV-positive infection rate was 0.19‰ among pregnant women from 2011 to 2015 in Hunan. The rate of HIV infection showed upward trend by years (P<0.05). The proportion of diagnosis of HIV positive cases intrapartum was 44.66%, showed declining trend by years (P<0.05). The 786 cases of HIV positive pregnant women were mainly the Han′s, the age distribution of 20 to 35 years old, 90.21% of them were farmers or unemployed. A percentage (76.84%) of them had junior high school education level or lower 37.91% of them were found in delivery or postpartum. A percentage (36.51%) of them accepted service in delivery or postpartum. A percentage (45.67%) of them was infected through sexual contact, 46.82% of them were infected by unknown ways. Conclusions The rate of HIV infection among pregnant women was increased by years in Hunan. It is suggested to strengthen health education among high-risk groups and high incidence areas, improve detection rate of early pregnant women, implement the Prevention of Mother to Child Transmission (PMTCT) measures to reduce the rate of mother to child transmission of Acquired Immune Deficiency Syndrome (AIDS). Key words: Acquired immunodeficiency syndrome/EP; Pregnant women; Parturition

Trichomonas vaginalis and Human Immunodeficiency Virus Coinfection Among Women Under Community Supervision: A Call for Expanded T. vaginalis Screening.

The United States has a large community supervision population, a growing number of whom are women. Trichomonas vaginalis infection is strongly associated with an increased risk of human immunodeficiency virus (HIV) acquisition and transmission, particularly among women, but there is a paucity of research on HIV and T. vaginalis co-infection among women under community supervision. This article examines the prevalence of T. vaginalis infection and T. vaginalis and HIV coinfection at baseline among women under community supervision in New York City. It also examines the 12-month outcomes of women treated for T. vaginalis. Women received biological tests for HIV and T. vaginalis at baseline and 12 months follow-up. Of the 333 women tested for sexually transmitted infections, 77 women (23.1%) tested positive for T. vaginalis at baseline and 44 (13.3%) were HIV positive. Human immunodeficiency virus-positive women had significantly higher rates of T. vaginalis infection than HIV-negative women (36.4% vs 21.3%, P ≤ 0.05). Sixteen women (4.8%) were coinfected with T. vaginalis and HIV. Of the 77 women who were positive for T. vaginalis infection at baseline, 58 (75.3%) received treatment by a health care provider. Of those who received treatment, 17 (29.3%) tested positive for T. vaginalis at the 12-month follow-up. Given the high prevalence of T. vaginalis among this sample of women, particularly among HIV-positive women, and high levels of reinfection or persistent infection, screening for T. vaginalis among women under community supervision may have a substantial impact on reducing HIV acquisition and transmission among this high-risk population.

Analysis of the Prevalence of HTLV-1 Proviral DNA in Cervical Smears and Carcinomas from HIV Positive and Negative Kenyan Women

The oncogenic retrovirus human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in some countries although its prevalence and relationship with other sexually transmitted infections in Sub-Saharan Africa is largely unknown. A novel endpoint PCR method was used to analyse the prevalence of HTLV-1 proviral DNA in genomic DNA extracted from liquid based cytology (LBC) cervical smears and invasive cervical carcinomas (ICCs) obtained from human immunodeficiency virus-positive (HIV+ve) and HIV-negative (HIV−ve) Kenyan women. Patient sociodemographic details were recorded by structured questionnaire and these data analysed with respect to HIV status, human papillomavirus (HPV) type (Papilocheck®) and cytology. This showed 22/113 (19.5%) of LBC’s from HIV+ve patients were positive for HTLV-1 compared to 4/111 (3.6%) of those from HIV−ve women (p = 0.0002; odds ratio (OR) = 6.42 (2.07–26.56)). Only 1/37 (2.7%) of HIV+ve and none of the 44 HIV−ve ICC samples were positive for HTLV-1. There was also a significant correlation between HTLV-1 infection, numbers of sexual partners (p < 0.05) and smoking (p < 0.01). Using this unique method, these data suggest an unexpectedly high prevalence of HTLV-1 DNA in HIV+ve women in this geographical location. However, the low level of HTLV-1 detected in HIV+ve ICC samples was unexpected and the reasons for this are unclear.

English

Mother-to-child transmission is the largest source of human immunodeficiency virus (HIV) infection in children. About one third of children are believed to be infected vertically through breast-feeding. Infant feeding in the context of HIV is complex. HIV positive women are confused about feeding methods and mixed feeding continued to be widespread. However, there are few studies on the practice of HIV positive mothers and counseling message of health workers in Ethiopia (Maru and Haidar, 2009). Objective: The objective of this study was to assess magnitude and factors associated with infant and young child feeding practice of HIV positive mothers in selected hospitals of Southern Nations Nationalities and Peoples of Region, 2011. An institution based cross sectional study was conducted using both quantitative and qualitative methods. A total of 201 HIV positive mothers with children less than two years of age were purposively selected at morning time in order of arrival. Health workers working on anti -retroviral therapy and prevention of mother to child transmission clinics were taken for in-depth interview in Hawassa, Yirgalem and Dilla Hospitals. Of all respondent, 87 (47.5%) HIV positive mothers had children with the age of less than 6 months, among 87 (47.5%) HIV positive mothers, 56.3% had experience of exclusive breast feeding, 13 (35.6%) of the mothers mix fed their babies while 8.1% exclusive replacement feeding. Regarding issues discussed during counseling time by health workers, from total of 183 HIV positive mothers, 78.7% mothers received counseling on different feeding options. Most, 96.2 and 76.0% of mothers received counseling on advantages and disadvantages of breast feeding respectively, and 67.8 and 71% disadvantages of replacement and mixed feeding respectively. Mother‘s who had antenatal follow up and favorable attitude towards feeding options were more likely to practice exclusive breast feeding and less likely to practice mixed feeding. More than half of the mothers practiced exclusive breast feeding and very small proportion of HIV positive mothers chose replacement feeding, but still greater than one third of HIV positive mothers practiced mixed feeding. In general, infant and young child feeding practices observed in this study fall short of the World Health Organization (WHO) recommendations, so it is recommended that all HIV positive mothers should be provided with adequate information to enable them to select the best feeding option for their babies, and to successfully carry out their infant feeding decisions. Key words: Infant and young child, feeding practice, HIV.

FACTORS AFFECTING THE AVAILABILITY OF THE PREVENTION OF MOTHERTO- CHILD TRANSMISSION OF HIV PROGRAMME AT RURAL HEALTH CARE FACILITIES OF MADIBENG SUB-DISTRICT

ABSTRACTThe study determined the experiences of the Human Immunodeficiency Virus (HIV) positive pregnant women regarding the availability of the prevention of mother-to-child transmission (PMTCT) programme. A qualitative, explorative and descriptive research was conducted. Non-probability purposive sampling technique was utilized to identify research participants. Data were collected through semi-structured individual interviews. Data were analyzed using Tesch’s steps. Emerging theme from data analysis was lack of and shortage of resources. Results revealed that HIV positive pregnant women experienced PMTCT programme services which were poor and of low standard. Recommendations were developed for HIV positive pregnant women to have available PMTCT programme services through filling of vacant health care workers posts, increasing number of health care facilities and extension of working hours.

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

Human papillomavirus is a virus that is distributed worldwide, and persistent infection with high-risk genotypes (HR-HPV) is considered the most important factor for the development of squamous cell cervical carcinoma (SCC). However, by itself, it is not sufficient, and other factors may contribute to the onset and progression of lesions. For example, infection with other sexually transmitted diseases such as human immunodeficiency virus (HIV) may be a factor. Previous studies have shown the relationship between HPV infection and SCC development among HIV-infected women in many regions of the world, with great emphasis on low- and middle- income countries (LMICs). Brazil is considered a LMIC and has great disparities across different regions. The purpose of this review was to highlight the current knowledge about HPV infection and cervical abnormalities in HIV+ women in Brazil because this country is an ideal setting to evaluate HIV impact on SCC development and serves as model of LMICs and low-resource settings.

Human Papilloma Virus Awareness and Uptake of HPV Vaccination among Human Immunodeficiency Virus Positive Women in Nigeria

Human Papilloma Virus Awareness and Uptake of HPV Vaccination among Human Immunodeficiency Virus Positive Women in Nigeria

High Risk Human Papilloma Virus Genotyping and Cervical Cytology as Screening Tests for Cervical Cancer in Human Immunodeficiency Virus Positive Women in Nigeria

Introduction : The integration of high risk oncogenic strains of human papillomavirus into the genome of cells in the cervix results in specific cytopathic changes. The propensity for dysplastic changes is worst in the presence of depressed immunity. Aim: To compare screening methods by the identification of oncogenic strains of human papillomavirus (hrHPV) in cervical smears and the cytopathic changes among human immunodeficiency virus (HIV) positive patients. Study Design: Prospective cross-sectional study

Prevalence of preeclampsia among human immunodeficiency virus-positive pregnant women as compared to human immunodeficiency virus-negative women in Ibadan

Introduction: Preeclampsia is a common complication of pregnancy and a major cause of maternal morbidity. Pathogenetic explanations for preeclampsia include: Maladaptation of the immune system to paternal antigens and exaggerated maternal inflammatory response to trophoblastic tissue. Immune deficiency, induced by human immunodeficiency virus (HIV) or any other cause, could, therefore, inhibit a tendency to immune hyper-reactivity and thus theoretically prevent the development of preeclampsia. The study aims to explore the role of the immune theory of preeclampsia by comparing the prevalence of preeclampsia among HIV-positive and HIV-negative pregnant women. Materials and Methods: The study was a cross-sectional survey of pregnant women, beyond 28 weeks gestation, who delivered at the University College Hospital, Ibadan between 1st October 2011 and 31st December 2011. Data was collected using a prespecified proforma. The analysis was performed using SPSS version 17.0 and P value was set at <0.05. Results: A total of 766 women who gave birth during the study met the inclusion criteria. Among the cohort, HIV prevalence rate was 7.2% whereas preeclampsia was 10.7%. None of the HIV-positive women had preeclampsia. Conclusion: This study suggested that the prevalence and perhaps, risk of developing preeclampsia is reduced among HIV positive women. This is similar to other studies done in various countries in the world. There is a need for further study as it may prove valuable in the management and prevention of preeclampsia.

Unmet need for contraception among human immunodeficiency virus-positive women in Jos, Nigeria: A call to integrate family planning and human immunodeficiency virus services

PURPOSE: In the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), contraception is one of the four strategies proposed by the World Health Organization. Closing the gaps of unmet need for contraception among people living with HIV (PLHIVs) is critical, especially for Nigeria which contributes about 30% of global PMTCT burden. We assessed contraceptive utilization and needs, partner support, and planning of pregnancies among female PLHIVs receiving care at the HIV Treatment Centre of Jos University Teaching Hospital (JUTH). MATERIALS AND METHODS: Structured questionnaires were administered to 350 postpartum women attending the PMTCT Unit of HIV Clinic of the JUTH in 2009 using a convenience sampling method. This was to access their knowledge and utilization of contraception. All were receiving PMTCT follow-up and were within 18 months postpartum. The data were analyzed with the Epi Info Statistical Package version 3.3. RESULTS: The participants' ages ranged 19–44 years and 81.4% were Christians. Most (36.1%) were homemakers and 87.1% were married. About 44.1% were discovered to be HIV positive during antenatal care, and 47.6% of husbands were HIV positive. The previous pregnancies had been planned in 38%, thus 62% of preceding pregnancies were unplanned, while 33.8% did not desire more children. Contraception awareness was high (84.5%) but 87.1% of the participants used no form of female contraception and 81.4% admitted regular sexual activity. Among those who did not desire more pregnancies, only 48.4% used modern female contraception. Majority (80.7%) of the respondents indicated that family planning (FP) would be easily accessed in the HIV clinic while male partners (49.4%) encouraged contraception. CONCLUSION: Among PLHIVs in northern Nigeria, there is a high rate of unintended pregnancy, and high contraceptive awareness did not translate into usage. Integration of HIV and reproductive health services holds potential to improve FP access and usage by PLHIVs.

Anal Cytology and Human Papillomavirus Genotyping in Women With a History of Lower Genital Tract Neoplasia Compared With Low-Risk Women.

To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia. A cross-sectional cohort study was performed from December 2012 to February 2014. Women were recruited from outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal cytology, dysplasia, or cancer were considered the high-risk group. Women with no history of high-grade anogenital dysplasia or cancer were considered the low-risk group. Human immunodeficiency virus-positive women were excluded. Anal cytology and HPV genotyping were performed. Women with abnormal anal cytology were referred for high-resolution anoscopy. There were 190 women in the high-risk group and 83 in the low-risk group. The high-risk group was slightly older: 57 years compared with 47 years (P=.045); 21.7% of low-risk women had abnormal anal cytology compared with 41.2% of high-risk women (P=.006). High-risk HPV was detected in the anal canal of 1.2% of the low-risk group compared with 20.8% of the high-risk group (P<.001). Among women who underwent anoscopy, no anal dysplasia was detected in the low-risk group, whereas 13.4% in the high-risk group had anal dysplasia with 4.2% having anal intraepithelial neoplasia 2 or greater (P<.001). Human immunodeficiency virus-negative women with a history of lower genital tract neoplasia are more likely to have positive anal cytology, anal high-risk HPV, and anal intraepithelial neoplasia. Anal cancer screening should be considered for these high-risk women. II.

English

The interaction between human papilloma virus (HPV) and human immunodeficiency virus (HIV), both sexually transmitted infections appears to be related to the alteration in cell-mediated immunity in HIV infected persons. Linkage studies of HIV/AIDs and cancer registries have indicated a 2 to 22 fold increase in cervical cancer in HIV positive women compared to HIV negative women. Data on the prevalence of HPV types in invasive cervical carcinoma (ICC) suggest that the proportion of infection with types HPV16/18 (responsible for over 70% of all cervical cancers) is similar in HIV negative and HIV positive women. The biological interaction between HIV and HPV needs further elucidation, although there is some evidence that the presence of HPV infection may be associated with increased HIV transmission. Adolescents perinatally infected by HIV are known to have higher rates of HPV infection and also have been shown to seroconvert in response to HPV vaccination with the quadrivalent vaccine, albeit to lower titers than HIV negative individuals. Anal cancer incidence is greatly increased in HIV positive individuals, particularly in HIV positive men who have sex with men. Screening for anal cancer precursors is feasible and effective; however, the impact on reduction of anal cancer remains to be demonstrated. There are ongoing studies on the safety, immunogenicity, and efficacy of current HPV vaccines in HIV positive individuals and mature data are awaited. &nbsp; Key words: human immunodeficiency virus (HIV), human papilloma virus (HPV), cervicovaginal cancer.

The impact of HIV-related stigma on the lives of HIV-positive women: an integrated literature review.

To critically explore how Human Immunodeficiency Virus-related stigma impacts on the lives of Human Immunodeficiency Virus-positive women through an integrative review of the literature. Throughout history Human Immunodeficiency Virus infection has been associated with sex trade, injecting drug use and other deviant behaviours within society. These historical associations can lead to the generation of negative perceptions of Human Immunodeficiency Virus-positive women. As such, women who contract Human Immunodeficiency Virus infection can be susceptible to societal stigma. An integrative literature review. To identify the publications on the impact of Human Immunodeficiency Virus-related stigma among women, a search was performed using the following databases: CINAHL, Medline, PsycINFO, EMBASE, and Applied Social Sciences Index and Abstract covering the period from 2000-2014. The following key words were included in the search: 'women', 'Human Immunodeficiency Virus', and 'stigma'. Twenty-six articles were retrieved and reviewed. From the results, four key themes merged in relation to the impact of Human Immunodeficiency Virus-related stigma on Human Immunodeficiency Virus-positive women's lives: the individual, relationships, work and the community. Despite great advances in the management and treatment of those who are Human Immunodeficiency Virus positive, it appears the lives of many women living with Human Immunodeficiency Virus remain greatly affected by their Human Immunodeficiency Virus infection with gender-specific stigma and stereotypes. Having a holistic understanding of this impact offers the potential for those responsible for the funding and draws the attention of researchers and policy makers on promoting medical services specifically for Human Immunodeficiency Virus-positive women, minimising social stigmatisation towards this client group, and optimising their health outcomes. In an attempt to amplify Human Immunodeficiency Virus-positive women's ability to resist social injustice, obtain support and optimise their health outcomes, nurses should expand their roles and work with professionals from different sectors to ensure the provision of comprehensive care to women with Human Immunodeficiency Virus infection.

Willingness and acceptability of cervical cancer screening among women living with HIV/AIDS in Addis Ababa, Ethiopia: a cross sectional study

BackgroundIn Ethiopia, cervical cancer (CC) ranks the 2nd most frequent cancer and the country had 27.19 million women at risk of developing the disease though only 0.6 % women age 18-69 years was screened every 3 years. Nearly a quarter (22.1 %) of southern Ethiopia HIV (Human Immunodeficiency Virus) infected Women were positive for precancerous cervical cancer. Doing regular screening can prevent the disease by around half (45 %) of the cases in age of 30s and three quarter (75 %) cases in 50s and 60s.In the presence of high risk for acquiring cervical cancer among HIV patients, willingness and acceptance of the screening is low in Addis Ababa, Ethiopia thus the current study was aimed to assess willingness and acceptability of cervical cancer screening and its determinants among women living with HIV/AIDS in Addis Ababa, Ethiopia.MethodA facility based cross sectional study was conducted among HIV positive women attending HIV treatment centers in Addis Ababa. The respondents were identified using systematic random sampling method. Data was collected using pretested questionnaire and were entered in to Epi-info version 3.5.1 software and exported in to SPSS version 20 statistical package for analysis. The criterias for entering independent variables into multivariate analysis were having p-value 0.05 or less at bivariate analysis and not co-linear.ResultOne third (34.2 %) of participants knew cervical cancer and two third (62.7 %) were willing for the test though only a quarter (24.8 %) were accepted the test. The independent variables significantly associated with acceptance of screening were educational level, source of information, awareness for the test and preventability of the disease.ConclusionIn current study willingness and acceptance of CC (cervical cancer) were low thus organizations working on cancer and HIV/AIDS should establish cervical cancer screening program and further enhance awareness creation.

Comparative study of preinvasive and invasive lesions of the cervix in HIV-positive and HIV-negative women

Background: Evidence suggests that Human Immunodeficiency Virus (HIV) infection is a risk factor for preinvasive and invasive lesions of cervix but confusion regarding pathogenesis and progression of cervical neoplasia in HIV-positive women still prevails. Aims : To find the incidence of cervical neoplasia in HIV positive and HIV-negative women and to study the impact of CD4 counts, duration of HIV infection, and treatment with highly active antiretroviral therapy (HAART) on the incidence of cervical lesions in HIV positive women. Materials and Methods : It was an observational case control study carried over a period of one year at the Department of Obstetrics and Gynaecology and Department of Medicine, King George Medical University, Lucknow. Cases were HIV-positive women and controls were HIV negative women. Those with previous diagnosis or treatment for cervical neoplasia, history of total hysterectomy or coexistent immunosuppressive conditions were excluded. All subjects had cervical screening by Pap smear. Colposcopy and cervical biopsy were done if indicated. Statistical Analysis Used : Chi square test, univariate, and multivariate analysis. Results: The incidence of cervical lesions in HIV-positive women (159.66 per 1000 screened women) was higher compared to HIV-negative women (15.15 per 1000 screened women) ( P 3 were associated with an increased incidence of cervical neoplasia ( P P Conclusions: Seropositivity is associated with an increased incidence of cervical lesions. This risk is further enhanced by CD4 counts less than 500/mm 3 and duration of HIV infection of more than two years.

Consistent Condom Use among HIV Positive Women Attending Comprehensive Care Centre of Thika Level 5 Hospital, Kenya

Background: Condoms offer protection against human immunodeficiency virus (HIV) transmission when used correctly and consistently. Many HIV infected people do not use condom regularly, thus leading to new HIV infections and reinfections. In Kenya, condom use is considered to be low and HIV prevalence is high among women aged 15 - 49 years where utilization of condoms among HIV positive women has not been studied. Objectives: The study aimed at determining the prevalence of consistent condom use among HIV positive women aged 18 - 49 years and to investigate the variables associated with it. Methods: A mixed method of study design (qualitative and quantitative approaches) was employed. A total of 422 participants were selected randomly and interviewed using a pretested structured questionnaire. Three (3) focus group discussions with 8 participants in each group were conducted. Chi-square test (p < 0.05) and odds ratio with corresponding 95% confidence interval were computed to establish the association between consistent condom use and independent variables. Binary logistic regression model was used to identify variables independently associated with consistent condom use. Qualitative data were transcribed and coded and then analysed thematically. Results: Consistent condom use among sexually active HIV positive women was found to be 57.4% (95%CI: 52.7% - 62.1%). The stepwise logistic regression revealed that attending tertiary education [aOR = 2.54; 95%CI = 1.30 - 4.95; P = 0.006], disclosing HIV status [aOR = 2.27; 95%CI = 1.27 - 4.06; P = 0.005], having an HIV negative partner [aOR = 4.23; 95%CI = 1.99 - 8.98; P < 0.001], not taking alcohol [aOR = 1.72; 95%CI = 1.10 - 2.69; P = 0.017], never encountered resistance to use condom by partners [aOR = 1.87; 95%CI = 1.15 - 3.03; P = 0.011] and perceived risk of contracting STIs [aOR = 2.11; 95%CI = 1.12 - 3.97; P = 0.021] as factors independently associated with consistent condom use. Conclusion: This study shows that there is still low prevalence of consistent condom use among HIV positive women. More education, campaigning and sensitization should be tailored among HIV positive women during counseling so as to avoid re-infection and transmission of infections.