Human Immunodeficiency Virus Prevention Research Articles

Common facts and fictions about HIV transmission, prevention and treatment among PLWHA attending a tertiary healthcare centre in North-Western Nigeria

Objectives:The transmission, prevention, and treatment of the human immunodeficiency virus (HIV) are greatly influenced by human behavioral practices. This makes knowledge of some truths (facts) and lies (fictions) about the disease extremely important in its prevention and control. Several studies on the assessment of knowledge about HIV infection have been undertaken among the general population, but only a few have involved people living with HIV/AIDS (PLWHA). This study was conducted to assess the level of knowledge and understanding on transmission, prevention, and treatment of HIV infection among PLWHA attending an adult anti- retroviral therapy (ART) clinic at Federal Medical Centre, Birnin Kebbi, North-western Nigeria.
 Method: The study was conducted as a hospital-based descriptive cross-sectional study using interviewer-administered questionnaires among 62 patients, selected by convenience sampling technique, attending adult ART-clinic over a period of 8 weeks. The data was analyzed using SPSS-16.
 Result: More than 70% of the respondents scored above 75% in the questions on modes of transmission of HIV infection. However, 73.4% of the respondents believed HIV infection was curable, and 40.6% believed there is commercially available vaccination against HIV infection. There were statistically significant associations between high mean scores (75% and above) in questions on modes of transmission and prevention of HIV, and being of Hausa ethnicity (p-value=0.013), having a senior secondary or higher level of education (p-value=0.014) and being a resident in an urban setting (pvalue=0.003)
 Conclusion: There is a fairly good basic knowledge about HIV transmission, prevention and treatment among the respondents; however, there is need for improvement in knowledge on certain lies/fictions regarding the disease.

HIV associated psychiatric comorbidity among attendees at a tertiary hospital, North-Eastern Nigeria.

There are a wide range of neuropsychiatric conditions associated with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). These mental disorders may be unrecognised yet their presence can significantly affect outcome. This study aimed to determine psychiatric comorbidity associated with HIV and AIDS. The HIV clinic of a tertiary hospital in North-Eastern Nigeria. A cross-sectional descriptive study consecutively recruiting 328 adult persons living with HIV. The Mini International Neuropsychiatric Interview and a sociodemographic questionnaire were administered to the participants. Two-thirds of the respondents were females. The mean age (±s.d.) was 42 years (±11.24). Majority of the participants had World Health Organization stage 1 HIV disease. The prevalence of psychiatry comorbidity among our respondents was 82.9%. Social phobia was the leading disorder (69.8%). Others were mixed depression anxiety disorder (49.4%) and post-traumatic stress disorder (36.6%). Current psychosis was 27.7%, while major depressive disorder was 12.2%. Psychiatric comorbidity was significantly associated with male gender, religion, ethnicity, marital status and being unemployed with p < 0.01. Human immunodeficiency virus stage was related to panic disorder with p < 0.01, while viral load was significantly associated with depressive disorder with p = 0.001. Majority of our HIV patients attending the clinic have undetected psychiatric morbidity. Clinicians need to be aware of the features of major psychiatric disorders and refer appropriately for improved overall outcome. This study contributes to the body of work on unrecognised psychiatric comorbidity in people living with HIV and AIDS, especially in North-Eastern Nigeria, identifying issues which are relevant to clinical practice and buttressing the need for integration of mental healthcare services into HIV treatment and prevention services.

Assessment of Knowledge on HIV Screening Among Students in Girls' Secondary School Abayi, Aba, Abia State, Nigeria

Background: Voluntary counseling and testing is a vital element of Human Immunodeficiency Virus (HIV) prevention and care strategies worldwide. It is a test carried out to determine the HIV status of a person. HIV screening enables early detection and initiation of treatment which improves the quality, and life expectancy of a HIV positive individual. Adolescents are among the vulnerable groups with an increased risk of exposure to HIV/AIDS and need to embrace HIV/AIDS testing and counseling. Objective: To assess the knowledge on HIV screening amongst adolescents in Girls’ Secondary School Abayi with a view to enlighten them on the importance of HIV screening. Materials and Methods: It was a descriptive cross-sectional study and semi-structured questionnaire was used for data collection. Students within the ages of 10-19 years were selected by systematic sampling methods and 424 students were presented using tables. Association was tested at p-value of 0.05%. Results: There was a non-response rate of 20 (4.7%). Two-hundred and thirty-four (57.9%) of the students had good knowledge of HIV/AIDS screening and 282 (69.8%) knew that HIV screening is a test to determine individual HIV status. Uptake of HIV screening was 57(14.1%) and 178 (44.1%) students believed that the reason for poor HIV screening was lack of proper awareness. Benefits of HIV screening included helping to start early treatment as accepted by 191 (47.3%) students and 332 (82.2%) respondents agreed that the test provided opportunity for proper advice on knowledge of HIV. Association of class of the respondents and knowledge HCT was found to be statistically significant with p-values of 0.006. Conclusion: There was a good knowledge of HIV screening among the students. The major reason for poor screening uptake were lack of awareness on HIV screening and inadequate provision of screening opportunities. HIV screening awareness was recommended.

A semiparametric Cox-Aalen transformation model with censored data.

We propose a broad class of so-called Cox-Aalen transformation models that incorporate both multiplicative and additive covariate effects on the baseline hazard function within a transformation. The proposed models provide a highly flexible and versatile class of semiparametric models that include the transformation models and the Cox-Aalen model as special cases. Specifically, it extends the transformation models by allowing potentially time-dependent covariates to work additively on the baseline hazard and extends the Cox-Aalen model through a predetermined transformation function. We propose an estimating equationapproach and devise an expectation-solving (ES) algorithm that involves fast and robust calculations. The resulting estimator is shown to be consistent and asymptotically normal via modern empirical process techniques. The ES algorithm yields a computationally simple method for estimating the variance of both parametric and nonparametric estimators. Finally, we demonstrate the performance of our procedures through extensive simulation studies and applications in two randomized, placebo-controlled human immunodeficiency virus (HIV) prevention efficacy trials. The data example shows the utility of the proposed Cox-Aalen transformation models in enhancing statistical power for discovering covariateeffects.

Virtual avatars as a new tool for human immunodeficiency virus prevention among men who have sex with men: a narrative review.

Human immunodeficiency virus (HIV) continues to affect sexual and gender minorities, predominantly men who have sex with men (MSM). Stigma, medical mistrust, and apprehension towards discussing sexual health with one's medical provider are significant barriers in seeking or accessing preventive services. Those obstacles could be surpassed through novel digital and electronic health interventions, specifically with virtual avatar technology. Avatars are digital self-representative agents that are controlled with an interactive electronic device. Avatars allow for virtual self-immersion within infinitely customizable environments to practice skill building, fostering relationships and more, through an optional incognito approach. The objective of this narrative review is to examine recent uses of and developments in avatar technology, highlight the personalization attribute of this technology, and evaluate its strengths and limitations as a tool for HIV prevention among MSM. We reviewed recent scientific literature generated by PubMed that use virtual avatar technology in HIV prevention and treatment among populations put at risk. Articles that met the inclusion criteria were then categorized on how the avatar technology was used. We identified eleven studies that met inclusion criteria. Avatar technology was found to create a comfortable environment for participants to address and discuss their sexual behaviors with less hesitation. Avatars can build rapport with populations put at high risk, creating an opportunity for reevaluation of their sexual behavior while assisting them in being able seek information, preventive services, or treatment for HIV or other sexually transmitted infections (STIs). Given the increased use of digital technology in health and prevention, avatars might be useful in sexual health education and HIV prevention among populations put at risk. The benefits and potential in utilizing this technology for HIV prevention are highlighted.

Assessing HIV transmission knowledge in psychiatric patients in Johannesburg, South Africa.

The bidirectional relationship between human immunodeficiency virus (HIV) and psychiatric illnesses is well documented. Misinformation about HIV transmission and prevention is associated with high rates of HIV-related risky behaviours, and therefore, HIV infection risk. To assess basic HIV transmission knowledge in psychiatric patients. Outpatient psychiatric clinic at Tara Psychiatric Hospital, Johannesburg, South Africa. A cross-sectional, quantitative study was conducted employing a self-administered HIV knowledge questionnaire, the 18- item HIV knowledge questionnaire (HIV-KQ18). Consent, demographic, and clinical profile information were obtained from participants meeting the selection criteria. This study indicated a mean knowledge score of 12.6 (69.7%) out of 18, and therefore good knowledge. The highest HIV-KQ18 mean scores were found in patients with personality disorders (78.9%), anxiety disorders (75.6%) and bipolar and related disorders (71.1%). Participants with schizophrenia, depressive disorders and substance use disorders had scores ranging between 66.1% and 69.4%. Statistically significant differences in knowledge were evident based on age, marital status, level of education and employment status. Interestingly, participants who used substances had higher average basic HIV transmission knowledge scores compared to those who did not use substances. Good overall HIV transmission knowledge was found in this population, albeit lower than in the general population. Statistically, correlates were found between psychiatric diagnosis, substance use, age, marital status, level of education, and employment status and basic level of HIV knowledge. HIV knowledge remains lower in psychiatric patients than in the general population, with correlates between demographic and clinical factors, calling for psychoeducation efforts to take all these into consideration.

Evaluation of adherence to antiretroviral medications in a supermarket‐based community pharmacy

AbstractIntroductionA critical aspect of human immunodeficiency virus (HIV) infection management and prevention is adherence to antiretroviral (ARV) medications. There are limited recent studies focused on the impact of community pharmacy interventions on ARV adherence; previous studies were conducted between 2004 and 2012 with more complicated regimens.ObjectivesThe primary objective was to compare the adherence rates for ARV medications for both HIV treatment and prevention in patients using HIV‐focused (HIV‐F) pharmacies compared with traditional (non‐HIV focused) pharmacies in a supermarket‐based community pharmacy. The secondary objectives were to determine which factors impact adherence rates as well as the demographic information of patients using HIV‐F pharmacies.MethodsThis was a retrospective study of de‐identified pharmacy dispensing data for patients filling ARV medications from October 2018 to July 2021 at a Safeway pharmacy in the Washington D.C., Maryland, and Virginia (DMV) area. Patients 18 years and older who had fill records at a Safeway pharmacy in the DMV area of at least two 30‐day supplies of ARV medication were included. For all eligible patients, medication adherence was measured by assessing the proportion of days covered (PDC).ResultsOf the 1496 patients who met the inclusion criteria, 971 patients used an HIV‐F pharmacy. Overall, patients were predominantly male (78.9%) with a median age of 44 years. The median PDC score of HIV‐F pharmacies was higher than traditional pharmacies, but the difference was not statistically significant (97.1% vs. 96.6%, respectively, p = 0.2).ConclusionPatients using this regional division supermarket‐based community pharmacy have a high PDC score regardless of pharmacy type. Use of newer ARV agents may have facilitated patients' adherence and diminished the potential benefit of utilizing HIV‐F pharmacies. Pharmacies currently providing specialized patient care for ARV medications may need to re‐evaluate how best to promote medication adherence.

Demonstration project of oral TDF-containing PrEP, administered, once-daily orally to men having sex with men (MSM) and transgender women (TGW) in India: Study protocol.

India has successfully reduced Human Immuno-deficiency Virus (HIV) incidence, with a 66% decline since the year 2000 has been seen; however, control among Men having sex with Men (MSM) and transgender women (TGW) remains a critical challenge. Oral Pre-Exposure Prophylaxis (PrEP) may help close a critical HIV prevention gap for MSM and TGW in India; however, no studies to date have evaluated the feasibility of oral PrEP among MSM and TGW in India. The proposed study aims at understanding the implementation of the provision of daily oral-Tenofovir (TDF) containing PrEP among MSM and TGW through the clinic and community-based delivery models in Pune, Maharashtra, and Jalandhar, Punjab respectively in India. The study aims at estimating PrEP adherence, facilitators, and barriers to PrEP use, retention, acceptability, and willingness to pay for PrEP. After the screening, eligible participants (n = 600) will receive PrEP medicines and will be monitored quarterly for HIV, STIs, and renal and liver toxicity for 12 months as per the schedule of events. The primary outcomes of interest are PrEP acceptability, PrEP adherence, retention rate, adverse medical events, and sexual behavioural changes with PrEP use and breakthrough infections while on PrEP. The study will assess the feasibility of two service delivery models; however, the data from the two service delivery models will be analyzed independently and will not be compared for feasibility and other outcome indicators. The study has been initiated after obtaining appropriate regulatory approvals. PrEP is efficacious in preventing HIV among high-risk population however there are scarce data on providing PrEP to MSM and TGW. The study will provide critical evidence to programs and policymakers on the implementation of PrEP in a "real world" setting, among MSM and TGW in India including identifying populations that can benefit most from this additional HIV prevention intervention along with acceptable delivery strategies and means of support for adherence. Not applicable being a demonstration project. Efficacy is already proven.

A Qualitative Study of Barriers and Facilitators to Integrating Medications for Opioid Use Disorder and HIV Preexposure Prophylaxis for Adolescents and Young Adults.

The syndemic of substance use and human immunodeficiency virus (HIV) is a well-recognized global phenomenon that threatens to undermine the priorities outlined by the National Institutes of Health "Ending the HIV Epidemic" initiative. There are few published studies on preexposure prophylaxis (PrEP) for adolescents and young adults (AYAs) with opioid use disorder (OUD) despite increasing availability of biomedical prevention options and Centers for Disease Control and Prevention recommendations to offer PrEP to this group. Healthcare providers who previously prescribed medications for OUD (MOUDs) and/or PrEP for AYA were purposively sampled. Audio-recorded in-depth individual interviews were conducted using chart-stimulated recall to explore barriers and facilitators to integrated MOUD and HIV prevention services. Interviews were double-coded, and qualitative analysis was performed using a modified grounded theory. Of 19 providers sampled, most were physicians (63%). All recommended HIV screening at varying intervals; however, few counseled on (19%) or prescribed (11%) PrEP to patients on MOUD. Barriers to PrEP prescriptions included patient-level (ie, stigma surrounding PrEP use, adherence challenges, and competing social or mental healthcare needs), provider (perception of low risk, lack of training/experience), and system-level factors (including restricted visit types). Facilitators of PrEP prescriptions included patient-initiated requests, electronic health record system reminders, and the availability of consistent support staff (ie, navigators, certified recovery specialists). Our study confirms that discussions about HIV prevention and PrEP prescriptions may be rare for AYA patients receiving MOUD. Further research is needed to develop interventions that increase the integration of PrEP delivery within the context of OUD care among this key AYA population.

Inclusion of a Parental Component in a Sports-Based HIV Prevention Program for Dominican Youth.

Underprivileged youth in the Dominican Republic (DR) are at high risk of acquiring the human immunodeficiency virus (HIV). Protective parenting practices may inhibit sexual risk-taking. We investigated whether parental involvement in a sports-based HIV prevention program increased self-efficacy to prevent HIV and safe sex behavior among Dominican youth. The study had a quasi-experimental design with repeated measures. N = 90 participants between 13 and 24 years of age participated in the program through two different trainings, UNICA and A Ganar, both of which had an experimental (i.e., program with parental component) and a control (i.e., program without parental component) condition. Self-efficacy to prevent HIV significantly increased among participants in the experimental condition of UNICA. Self-efficacy for safe sex increased among sexually active participants in the experimental condition of A Ganar. Implications for Impact: These findings are important to meet the United Nations' Sustainable Development Goal of good health and wellbeing, as they suggest that parental involvement in sports-based HIV prevention programs can enhance their positive effects for increasing youth's self-efficacy to practice HIV-preventive behaviors. Randomized control trials and longitudinal studies are needed.

Listening to the Voices of Gay and Bisexual Men and Other Men Who Have Sex with Men in Kenya: Recommendations for Improved HIV Prevention Programming.

Young gay and bisexual men and other men who have sex with men (GBMSM) are a key population at high risk for new human immunodeficiency virus (HIV) infections in Kenya; thus, increased efforts are necessary to reduce their health risks. This qualitative study describes recommendations offered by young GBMSM in Kenya regarding the development and delivery of culturally appropriate HIV prevention services. Both young GBMSM Community Members and Peer Educators recommend that future HIV prevention efforts enhance economic empowerment, provide mental health and substance use services, and incorporate arts-based health promotion strategies. In addition, participants recommended that public health professionals increase the ease of access to HIV prevention services for GBMSM and that researchers disseminate findings from HIV prevention research back to the community.

PrEP Access as HIV Prevention for LGBTQ+ College Students: An Exploration of Current Barriers to Access

Background: Although tremendous strides have been made in Human Immunodeficiency Virus (HIV) prevention, detection, and treatment, HIV remains a public health issue in the United States. Sexual and gender diverse individuals and the 18-24 age group are considered vulnerable populations at risk for contracting the virus. Pre-exposure prophylaxis (PrEP) is a medication that has proven effective in reducing the risk of HIV transmission. Aim: This article aims to justify the necessity of PrEP medication on college campuses, especially for gender and sexual diverse students. Methods: This article provides information on the state of PrEP education, availability, and access on college campuses in the United States. This article also addresses barriers that college students face with accessing PrEP medication through college health services. Results: Limited research has found that most colleges in the United States lack PrEP availability for college students. Other factors, including insurance, privacy concerns, and stigma, may deter students from seeking and taking PrEP medication. Conclusions: This article supports widespread PrEP availability and access on college campuses and acknowledges the need to address barriers that keep students from utilizing PrEP.

Frequency of HIV serodifferent couples within TB-affected households in a setting with a high burden of HIV-associated TB

IntroductionStrong epidemiological links between human immunodeficiency virus (HIV) and tuberculosis (TB) may make household TB contact investigation an efficient strategy for HIV screening and finding individuals in serodifferent partnerships at risk of HIV and linking them to HIV prevention services. We aimed to compare the proportions of HIV serodifferent couples in TB-affected households and in the general population of Kampala, Uganda.MethodsWe included data from a cross-sectional trial of HIV counselling and testing (HCT) in the context of home-based TB evaluation in Kampala, Uganda in 2016–2017. After obtaining consent, community health workers visited the homes of participants with TB to screen contacts for TB and offer HCT to household members ≥ 15 years. We defined index participants and their spouses or parents as couples. Couples were classified as serodifferent if confirmed by self-reported HIV status or by HIV testing results. We used a two-sample test of proportions to compare the frequency of HIV serodifference among couples in the study to its prevalence among couples in Kampala in the 2011 Uganda AIDS Indicator Survey (UAIS).ResultsWe included 323 index TB participants and 507 household contacts aged ≥ 18 years. Most index participants (55%) were male, while most (68%) adult contacts were female. There was ≥ 1 couple in 115/323 (35.6%) households, with most couples (98/115, 85.2%) including the index participant and spouse. The proportion of households with HIV-serodifferent couples was 18/323 (5.6%), giving a number-needed-to-screen of 18 households. The proportion of HIV serodifference among couples identified in the trial was significantly higher than among couples in the UAIS (15.7% vs. 8%, p = 0.039). The 18 serodifferent couples included 14 (77.8%) where the index participant was living with HIV and the spouse was HIV-negative, and 4 (22.2%) where the index partner was HIV-negative, while the spouse was living with HIV.ConclusionsThe frequency of HIV serodifference among couples identified in TB-affected households was higher than in the general population. TB household contact investigation may be an efficient strategy for identifying people with substantial exposure to HIV and linking them to HIV prevention services.

Development of dissolving microneedles for intradermal delivery of the long-acting antiretroviral drug bictegravir

Oral administration and intramuscular (IM) injection are commonly recommended options for human immunodeficiency virus (HIV) treatment. However, poor patient compliance due to daily oral dosing, pain at injection sites and the demand for trained healthcare staff for injections limit the success of these administration routes, especially in low-resource settings. To overcome these limitations, for the first time, we propose novel bilayer dissolving microneedles (MNs) for the intradermal delivery of long-acting nanosuspensions of the antiretroviral (ARV) drug bictegravir (BIC) for potential HIV treatment and prevention. The BIC nanosuspensions were prepared using a wet media milling technique on a laboratory scale with a particle size of 358.99 ± 18.53 nm. The drug loading of nanosuspension-loaded MNs and BIC powder-loaded MNs were 1.87 mg/0.5 cm2 and 2.16 mg/0.5 cm2, respectively. Both dissolving MNs exhibited favorable mechanical and insertion ability in the human skin simulant Parafilm® M and excised neonatal porcine skin. Importantly, the pharmacokinetic profiles of Sprague Dawley rats demonstrated that dissolving MNs were able to intradermally deliver 31% of drug loading from nanosuspension-loaded MNs in the form of drug depots. After a single application, both coarse BIC and BIC nanosuspensions achieved sustained release, maintaining plasma concentrations above human therapeutic levels (162 ng/mL) in rats for 4 weeks. These minimally invasive and potentially self-administered MNs could improve patient compliance, providing a promising platform for the delivery of nanoformulated ARVs and resulting in prolonged drug release, particularly for patients in low-resource settings.

Spatiotemporally Comparative Analysis of HIV, Pulmonary Tuberculosis, HIV-Pulmonary Tuberculosis Coinfection in Jiangsu Province, China.

Pulmonary tuberculosis (PTB) is a severe chronic communicable disease that causes a heavy disease burden in China. Human Immunodeficiency Virus (HIV) and PTB coinfection dramatically increases the risk of death. This study analyzes the spatiotemporal dynamics of HIV, PTB and HIV-PTB coinfection in Jiangsu Province, China, and explores the impact of socioeconomic determinants. The data on all notified HIV, PTB and HIV-PTB coinfection cases were extracted from Jiangsu Provincial Center for Disease Control and Prevention. We applied the seasonal index to identify high-risk periods of the disease. Time trend, spatial autocorrelation and SaTScan were used to analyze temporal trends, hotspots and spatiotemporal clusters of diseases. The Bayesian space-time model was conducted to examine the socioeconomic determinants. The case notification rate (CNR) of PTB decreased from 2011 to 2019 in Jiangsu Province, but the CNR of HIV and HIV-PTB coinfection had an upward trend. The seasonal index of PTB was the highest in March, and its hotspots were mainly distributed in the central and northern parts, such as Xuzhou, Suqian, Lianyungang and Taizhou. HIV had the highest seasonal index in July and HIV-PTB coinfection had the highest seasonal index in June, with their hotspots mainly distributed in southern Jiangsu, involving Nanjing, Suzhou, Wuxi and Changzhou. The Bayesian space-time interaction model showed that socioeconomic factor and population density were negatively correlated with the CNR of PTB, and positively associated with the CNR of HIV and HIV-PTB coinfection. The spatial heterogeneity andspatiotemporal clusters of PTB, HIV and HIV-PTB coinfection are exhibited obviously in Jiangsu. More comprehensive interventions should be applied to target TB in the northern part. While in southern Jiangsu, where the economic level is well-developed and the population density is high, we should strengthen the prevention and control of HIV and HIV-PTB coinfection.

Pilot study of an arts- and theatre-based HIV prevention intervention for men who have sex with men and transgender women migrants in South Africa: acceptability, feasibility and preliminary efficacy.

Innovative approaches addressing the elevated human immunodeficiency virus (HIV) risk among men who have sex with men (MSM) or transgender women (TGW) migrants in South Africa are urgently needed. We sought to present the acceptability, feasibility and preliminary efficacy of 'Externalize and Mobilize!', a multi-session arts- and theatre-based HIV prevention group intervention for MSM and TGW migrants in South Africa. Fourteen participants-MSM (n = 7; 50%), genderqueer/nonbinary persons (n = 4; 29%) and TGW (n = 3; 21%)-in Cape Town were recruited and enrolled in the intervention and administered pre- and post-intervention assessments of HIV knowledge, HIV risk-reduction self-efficacy, stigma and resilience. The intervention, delivered over 4 days, was completed by all 14 participants. Scores on HIV knowledge and HIV risk-reduction self-efficacy were statistically significantly higher at post-intervention compared with pre-intervention. Additionally, participants responded affirmatively (i.e. 'Agree' or 'Strongly agree') on all items assessing intervention acceptability. Findings demonstrate the high acceptability, feasibility and preliminary efficacy of an arts- and theatre-based intervention for increasing HIV knowledge and HIV risk-reduction self-efficacy among MSM and TGW migrants in South Africa. This study provides further support for the use of creative and innovative interventions to address entrenched HIV disparities in South Africa.

Long-term trends of HIV/AIDS incidence in India: an application of joinpoint and age-period-cohort analyses: a gendered perspective.

Monitoring the transmission patterns of human immunodeficiency virus (HIV) in a population is fundamental for identifying the key population and designing prevention interventions. In the present study, we aimed to estimate the gender disparities in HIV incidence and the age, period, and cohort effects on the incidence of HIV in India for identifying the predictors that might have led to changes in the last three decades. This study utilizes data from the Global Burden of Disease Study for the period 1990-2019. The joinpoint regression analysis was employed to identify the magnitude of the changes in age-standardized incidence rates (ASIRs) of HIV. The average annual percentage changes in the incidence were computed, and the age-period-cohort analysis was performed. A decreasing trend in the overall estimates of age-standardized HIV incidence rates were observed in the period 1990-2019. The joinpoint regression analysis showed that the age-standardized incidence significantly declined from its peak in 1997 to 2019 (38.0 and 27.6 among males and females per 100,000 in 1997 to 5.4 and 4.6, respectively, in 2019). The APC was estimated to be 2.12 among males and 1.24 among females for the period 1990-2019. In recent years, although the gender gap in HIV incidence has reduced, females were observed to bear a proportionately higher burden of HIV incidence. Age effect showed a decline in HIV incidence by 91.1 and 70.1% among males and females aged between 15-19 years and 75-79 years. During the entire period from 1990-1994 to 2015-2019, the RR of HIV incidence decreased by 36.2 and 33.7% among males and females, respectively. India is experiencing a decline in new HIV infections in recent years. However, the decline is steeper for males than for females. Findings highlight the necessity of providing older women and young women at risk with effective HIV prevention. This study emphasizes the need for large-scale HIV primary prevention efforts for teenage girls and young women.

The roles of churches in HIV prevention among youth at Nqutu in KwaZulu-Natal South Africa.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a crisis of massive economic, social, spiritual, as well as political magnitudes. Joint United Nations Programme on HIV/AIDS (UNAIDS) revealed that in 2018, there were 37.9 million individuals across the globe who lived with HIV and/or AIDS. The religion is an essential tool used by the pastors to help people living with HIV to come to terms with the illness. Therefore, it is imperative that religious leaders should be actively involved in the prevention of HIV epidemic among the youth. The study objective was to explore and describe the roles of churches in HIV prevention among youth at Nqutu in KwaZulu-Natal. A qualitative descriptive phenomenology design was employed. Data were collected from 18 to 35 years old participants who were purposefully sampled. Unstructured interviews were conducted to collect data, which was determined by saturation and analysed using Colaizzi's method of data analysis. The study revealed five major themes, which consisted of churches' contribution to HIV prevention; health awareness; churches' involvement in sexual education; churches' partnership with stakeholders, human and financial resources. It became evident that churches' contribution to HIV and/or AIDS prevention is beneficial to the youth. The study's findings revealed that churches play a significant role in HIV prevention among youths. Programmes available in churches play an important role among the youth in curbing the HIV epidemic.Contribution:The Department of Health should consider collaborating with church leaders to promote and prevent HIV and/or AIDS among youth.

Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia.

Voluntary medical male circumcision (VMMC) is a strategy used to try to limit new human immunodeficiency virus (HIV) infections, as it has the potential to reduce HIV and/or AIDS transmission from women to men by up to 60%. However, in spite of efforts by the Ministry of Health and Social Services, only a few men in Namibia have been circumcised. The objective of this study was to explore and describe the facilitators of, and barriers to, medical male circumcision for HIV prevention in Kavango East, Namibia. A qualitative, explorative, descriptive and contextual design was employed. The accessible population in this study comprised 18 health professionals who were selected for the study using a purposive sampling technique. Participants reported numerous barriers to VMMC in Namibia. Barriers to VMMC included 'myths' and misconceptions attached to VMMC, age limitations, fear of pain and stigma associated with HIV, small VMMC team and long distances from health facilities. Facilitators to VMMC included family support, having experienced genital sores and genital warts or phimosis and paraphimosis. The study revealed that a number of barriers must be overcome before VMMC before the desired number of men take advantage of VMMC. Multiple factors act as constraints to VMMC, including fear, myths and misconceptions, small VMMC teams and the long distance between clients' homes and VMMC services.Contribution:The study's findings can be used to develop targeted interventions and strategies that can be used by VMMC providers to address the identified barriers.

Interprofessional student team development of an annual wellness visit for human immunodeficiency virus (HIV) prevention and care

People living with human immunodeficiency virus (HIV) experience a variety of pathophysiological events and adverse psychosocial consequences, contributing to considerable morbidity even as mortality due to acquired immunodeficiency syndrome (AIDS) continues to decline in the era of anti-retroviral therapy. The prevention and management of newly diagnosed HIV cases requires a highly integrated, team-based approach across a variety of health professions. To prepare the next generation of providers, interprofessional education (IPE) represents a rapidly expanding global initiative where current and future health professionals learn with, from, and about each other to improve health care outcomes. Louisiana State University Health Sciences Center in New Orleans has established Team Up, a two-year longitudinal IPE curriculum integrated across all six professional schools. At the end of the second year, diverse student teams develop plans for a comprehensive and patient-centered interprofessional wellness visit, strategy for implementation, and poster presentation focused on primary or secondary prevention specific to an age or medical condition. Here, we describe designs for an interprofessional annual wellness visit centered around HIV prevention and care from two consecutive student teams (2020-21 and 2021-22 cohorts). Factors of time and cost (including billing codes and fees) for the screening were considered, and an informational resource list for HIV management and prevention was also included. The 2020-21 team (Team 1, n=12) was comprised of audiology, clinical laboratory sciences, dental, medical, nursing, and physical therapy students. The 2021-22 team (Team 52, n=10) was comprised of clinical laboratory sciences, dental, dental hygiene, medical, nursing, physical therapy, physician assistant, and speech language pathology students. For this cohort, students were also asked to consider a female patient in the “most disadvantaged” category according to Area Health Education Center (AHEC) guidelines. Students from both cohorts recommended additional local and national resources from an interprofessional lens that would be valuable for HIV prevention and care. Teams communicated the benefits of an interprofessional assessment from the patient/community perspective as well as from the provider’s perspective. Challenges to implementation as well as solutions were also provided. At the end of each year, cohorts presented their posters in virtual format to their fellow classmates and faculty facilitators and reflected on IPE core competencies developed by the Interprofessional Education Collaborative (IPEC). We believe that these efforts represent an effective educational tool to equip future health providers with interprofessional team-based experiences to improve future prevention and management of HIV and related co-morbidities. NIAAA P60AA009803 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.