Rapid HIV Testing Research Articles

Novel DNA Biosensing Platform for Detecting HIV Integrase for Highly Sensitive and Quantitative HIV Detection, Diagnosis, and Therapeutic Monitoring.

Straightforward, sensitive, and specific human immunodeficiency virus (HIV) assays are urgently needed. The creation of a point-of-care (POC) device for decentralized diagnostics has the potential to significantly reduce the time to treatment, especially for infectious diseases. Notably, however, many POC solutions proposed to date fall short of meeting the ASSURED guidelines, which are crucial for effective deployment in the field. Herein, we developed a DNA biosensor platform for the specific and quantitative detection of HIV. The platform contains a rolling circle amplification (RCA)-based DNA biosensor and a portable fluorescence detector, in which HIV-encoded integrase (IN) enzyme activity is used as a biomarker to achieve HIV-specific detection. The cleavage and integration reaction of IN on the sensor surface and RCA are combined in this detection platform to perform detection signal cascade amplification, ultimately achieving a detection limit of 0.125 CFU/μL of HIV particles. Moreover, the DNA sensor system exhibited high sensitivity and accuracy for detecting HIV in clinical samples, suggesting that it has potential for application in clinical settings to detect retroviruses other than HIV. In addition, quantitative detection based on this biosensing platform was significantly correlated with the CD4+ lymphocytes count, which can provide guidance for antiretroviral therapy and which affects long-term death risk assessment in HIV patients. Therefore, this DNA biosensing platform based on IN activity is expected to be useful for rapid HIV testing, diagnosis, and treatment monitoring, enabling the development of new POC diagnostic tests and will thus be highly valuable for developing HIV prevention strategies and effective treatments.

Knowledge and attitudes of oral health care workers on HIV-associated oral lesions: A study at PHC facilities in Gauteng

Oral health care workers (OHCWs) are critical in providing holistic treatment and preventing the spread of HIV disease. They are uniquely placed to identify, diagnose, manage and treat HIV-related oral lesions.Aim To determine oral health clinicians’ knowledge and attitudes towards HIV-associated oral lesions. Methodology A descriptive cross-sectional survey was conducted at Gauteng’s primary health care (PHC) facilities. Data collection targeted the three categories of OHCWs – dentists, dental therapists and oral hygienists. ResultsThe response rate was 67.5% (n=110), majority of the participants, 76.4% (n=84), were female. Nearly all participants, 91.8% (n=100), agreed that oral lesions are common in people living with HIV and AIDS (PLWHA) and that early diagnosis of HIV/treatment increases PLHIV’s life expectancy. More than three-quarters (80%) reported that they had no problem treating patients diagnosed with HIV. Almost a third, 36.4% (n=40), listed necrotising periodontal conditions and oral candidiasis 34.5% (n=38) as the most common oral manifestations. Most respondents correctly identified oral candidiasis (92.7%), Kaposi sarcoma (84.5%) and necrotising ulcerative periodontal conditions (80.9%).ConclusionAlthough OHCWs had sound knowledge of oral manifestations of HIV, training programmes must be prioritised for knowledge transfer. Dental facilities can be used as a health-promoting platform and a viable location for provider-initiated testing and counselling (PICT) and client-initiated counselling and testing (CICT), also known as voluntary counselling and testing (VCT). The use of HIV rapid testing kits is an option to be explored in the dental facility by OHCWs.

Evidence-based prevalence of HIV infection and associated risk factors among female sex workers in Port Harcourt, Niger Delta, Nigeria

Human Immunodeficiency Virus (HIV) epidemic has remained a key public health issue for the sub-Saharan countries including Nigeria. Thus, sex workers in the region are top on the list of key populations with highest vulnerability. The prevalence of HIV among female sex workers is twice the prevalence found in the general population in Sub-Saharan countries. This study evaluated the prevalence of HIV among female sex workers in Port Harcourt, Rivers State, Nigeria. A respondent-oriented observational sampling technique which involved the use of questionnaire in addition to laboratory-based screening of HIV among female sex workers in Port Harcourt was used. The self-structured questionnaire comprehensively explored socio-demographic characteristics, and risk factors among the subjects. HIV rapid diagnostic test kit from Alere Determine was used to detect HIV infection. This cross sectional study findings recorded that, from a sample of 200 participants drawn, 171 were negative to HIV while 29 subjects were positive to HIV infection with an overall prevalence of 14.5% among female sex workers in Rivers State. Furthermore, the finding demonstrated null association (p>0.05) between HIV and the risk factors measured. The study implies that the risk of HIV among the study population, female sex workers, is not linked to the assumed risk factors measured in this study since the finding failed to establish association at p>0.05. HIV awareness campaigns should be intensified among female sex workers especially on the consistent and correct use of condoms, and possibly bringing HIV testing to the sex partners and clients as secondary prevention strategy to offset the trend in HIV prevalence among this key population. Also implementation of intervention such as HIV pre-exposure prophylaxis following crucial riskful accident; such as condom breakage is suggested among female sex workers.

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

Mycobacterium tuberculosis and human immunodeficiency virus co-infection and associated variables among presumptive pulmonary tuberculosis patients in Ethiopia; a health institution based cross-sectional study

BackgroundCo-infection of Mycobacterium tuberculosis (MTB) and the Human Immunodeficiency Virus (HIV) is a major global public health issue, particularly in border areas of resource-limited nations, including Ethiopia. ObjectiveTo explore the prevalence and associated variables of MTB/HIV co-infection among PTB presumptive patients in Northwest Ethiopia. MethodsFrom February to August 2021, a cross-sectional institutional investigation was conducted at the Metema and Abrehajira hospitals. Semi-structured questionnaires were used to collect socio-demographic and clinical data. The MTB/RIF Xpert assay was used to process sputum, and 3 ml of veins blood was collected for HIV rapid test (STAT-PAK, ABON, and SD BIOLINE HIV test algorithm) following the Ethiopian National HIV test algorithm. The Gene Xpert assay's sample processing control was checked to ensure data quality. Data entered into Epi-Data were exported to SPSS version 20 for analysis. Statistically significant variables (p-value ≤0.2) from bivariable analysis were included in multivariable analysis. A p-value ≤ 0.05 was judged statistically significant. ResultsThis study included 314 PTB presumptive patients with a median age of 35.0 years, of which 178 (56.69 %) were males. Among all patients, 40(12.7 %) and 51(16.2 %) were PTB, and HIV seropositivity, respectively. Of the PTB patients, 14/40 (35 %) (95 % CI: 24.4–45.6) were co-infected with HIV/AIDS. Married patients were 70 % less likely than unmarried individuals (AOR = 0.3 CI; 0.07–0.98) to have MTB/HIV co-infection. Patients who had contact history with MDR-TB patients (AOR = 5 CI; 1.37–18.00), and those who had a history of alcohol use (AOR = 12.2 CI; 2.56–57.8) were more likely to have MTB-HIV co-infection than their peers. ConclusionOur findings showed that MTB-HIV co-infection is one of the most important community health concerns in the study area. Therefore, MTB/HIV cooperation activities should be fully in place to prevent co-infection and its impact on the population.

Prevalence of pulmonary tuberculosis and HIV infections and risk factors associated to tuberculosis in detained persons in Antananarivo, Madagascar

The incidence rate of tuberculosis in prisons is estimated to be 8 times greater than that in the general population in Madagascar. Our objectives were to estimate the prevalence of pulmonary tuberculosis and HIV infection among prisoners and to identify risk factors associated with tuberculosis. We conducted a cross-sectional study at the central prison of Antananarivo from March to July 2021. Individual male and female inmates aged ≥ 13 years who had lived in the prison for at least three months prior to the study period were included as participants. Acid-fast bacilli detection by microscopy and/or culture, an intradermal tuberculin test, a chest X-ray, and a rapid diagnostic orientation test for HIV were performed. Among 748 participants, 4 (0.5%) were confirmed to have pulmonary tuberculosis. Overall, 14 (1.9%) patients had “confirmed” or “probable” tuberculosis [0.90–2.84, 95% CI]. The proportion of participants with latent tuberculosis infection was 69.6% (517/743) based on a positive tuberculin test without clinical symptoms or radiography images indicating tuberculosis. Out of 745 HIV screening tests, three showed reactive results (0.4%). Age (OR = 4.4, 95% CI [1.4–14.0]) and prior tuberculosis treatment (or episodes) were found to be associated with confirmed and probable tuberculosis.

Educational technology for pregnant women on rapid HIV testing: validation study

Objective: To describe the process of validating a booklet for pregnant women on the rapid test for the Human Immunodeficiency Virus. Method: Methodological research with a quantitative approach, with an emphasis on content and appearance validation. Data collection took place between January and August 2020, with the application of two online questionnaires, one for 14 health judges and the other for four judges from other areas. Descriptive statistics were used to obtain the Content Validity Index (minimum 0.7) and the Suitability Assessment of Materials score (minimum ten points). Results: The Content Validity Index was 0.8 and the SAM score was 25.25. Conclusion: The booklet was considered adequate in terms of content and appearance, and can mediate educational actions with pregnant women on rapid HIV testing.

Acceptability of venue-based HIV testing and prevention interventions for men who have sex with transgender women and transgender women in Lima, Perú: a formative, qualitative study

Background Despite being at elevated risk for HIV, men who have sex with transgender women (MSTW) are an overlooked population in the global HIV response. Venue-based HIV interventions have previously had success reaching other HIV priority populations, including transgender women (TW). Similar approaches could be applied for MSTW. Objective To evaluate the prospective acceptability of venue-based HIV testing and prevention interventions for MSTW and TW in Lima, Peru. Methods In this exploratory qualitative study, we conducted in-depth interviews (IDI) and focus group discussions (FGD) with three types of participants: MSTW (7 IDIs, 1 FGD), TW (1 FGD), and owners of social venues frequented by MSTW/TW in Lima (2 IDIs). We elicited participants’ attitudes and perceptions related to the following four hypothetical interventions delivered at social venues in Lima: rapid HIV testing; HIV self-test distribution; condom/lubricant distribution; and enrolment in a mobile app supporting HIV prevention. We performed a mixed deductive-inductive thematic analysis using the framework method, then applied the Theoretical Framework of Acceptability to classify the overall acceptability of each intervention. Results Condom/lubricant distribution and app-based HIV prevention information were highly acceptable among all participant types. The two HIV testing interventions had relatively lower acceptability; however, participants suggested this could be overcome if such interventions focused on ensuring discretion, providing access to healthcare professionals, and offering appropriate incentives. Conclusions Overall, MSTW and TW shared similar favourable attitudes towards venue-based HIV interventions. Venue-based outreach warrants further exploration as a strategy for engaging MSTW and TW in HIV prevention activities.

The current state and outlook of HIV infection and AIDS in South Korea

Background: Over the past decade, approximately 1,100 newly diagnosed cases of human immunodeficiency virus (HIV) infection have been reported annually in South Korea, with 1,066 newly diagnosed cases reported in 2022. A decrease in HIV infection rate can be achieved only through coordinated prevention, diagnosis, and treatment. South Korea is lagging in the worldwide decreasing trend of HIV infection, and a brief review of this situation may suggest improvements necessary for progress.Current Concepts: In South Korea, the proportion of patients with CD4 cell count below 200 cells/mm<sup>3</sup> at initial diagnosis of HIV infection remains high, suggesting that a significant population is diagnosed at the late stage of the disease. Since 2019, the Korean National Health Insurance Service began to cover the cost of preexposure prophylaxis for sexual partners of patients living with HIV, but few have started the regimen due to several barriers. Insurance criteria for a prophylaxis regimen should be modified, and accessibility to the regimen should be made available through multiple pathways. Proactive use of rapid HIV testing kits in community health centers and clinics should be expanded. Legal and administrative environments encouraging voluntary testing, early diagnosis, and treatment should be fostered. Medical personnel must be able to offer medical care without discrimination regardless of HIV infection status.Discussion and Conclusion: The HIV epidemic in South Korea has not yet decreased. To end it, efforts should be required across broad areas, including voluntary HIV testing, early diagnosis, active pre-exposure prophylaxis, a stigma- and discrimination-free social environment, and changes in legal and medical environments.

Assessment of a screening tool to aid home-based identification of adolescents (aged 10-14) living with HIV in Zambia and South Africa: HPTN 071 (PopART) study.

The HPTN071 (PopART) for Youth (P-ART-Y) study evaluated the acceptability and uptake of a community-level combination HIV prevention package including universal testing and treatment (UTT) among young people in Zambia and South Africa. We determined whether a four-question primary care level screening tool, validated for use in clinical settings, could enhance community (door-to-door) identification of undiagnosed HIV-positive younger adolescents (aged 10-14) who are frequently left out of HIV interventions. Community HIV-care Providers (CHiPs) contacted and consented adolescents in their homes and offered them participation in the PopART intervention. CHiPs used a four question-screening tool, which included: history of hospital admission; recurring skin problems; poor health in last 3 months; and death of at least one parent. A "yes" response to one or more questions was classified as being "at risk" of being HIV-positive. Rapid HIV tests were offered to all children. Data were captured through an electronic data capture device from August 2016 to December 2017. The sensitivity, specificity, positive predictive value and negative predictive value were estimated for the screening tool, using the rapid HIV test result as the gold standard. In our 14 study sites, 33,710 adolescents aged 10-14 in Zambia and 8,610 in South Africa participated in the study. About 1.3% (427/33,710) and 1.2% (106/8,610) self-reported to be HIV positive. Excluding the self-reported HIV-positive, we classified 11.3% (3,746/33,283) of adolescents in Zambia and 17.5% (1,491/8,504) in South Africa as "at risk". In Zambia the estimated sensitivity was 35.3% (95% CI 27.3%-44.2%) and estimated specificity was 88.9% (88.5%-89.2%). In South Africa the sensitivity was 72.3% (26.8%-94.9%) and specificity was 82.5% (81.6-83.4%). The sensitivity of the screening tool in a community setting in Zambia was low, so this tool should not be considered a substitute for universal testing where that is possible. In South Africa the sensitivity was higher, but with a wide confidence interval. Where universal testing is not possible the tool may help direct resources to adolescents more likely to be living with undiagnosed HIV. Clinical Trial Number: NCT01900977.

HIV screening of migrants in the autonomous Province of Trento (North-Eastern Italy).

Migrants have accounted for more than 40% of new HIV diagnoses in Europe in 2022. Among the population of asylum seekers currently present in the Trento Province, screening for HIV infection is poorly carried out for various reasons. Here we report our experience about screening for HIV infection in asylum seekers present in that area using rapid self HIV-testing.

Sexual Practices and HIV Risk Perception Among Men Who Have Sex with Men in Brazil.

Objectives: To investigate sexual practices and HIV risk perception among MSM, identifying associated risk factors and determinants. Methods: A cross-sectional epidemiological study was conducted with 144 MSM in Teresina, Piauí, Brazil, using the snowball sampling technique. Participants were recruited via snowball sampling and underwent rapid HIV testing, in addition to completing questionnaires on sexual practices, risk perception, and illicit drug use. Results: The majority of participants showed an unsatisfactory perception of HIV risk. Factors associated with this perception include non-penetrative sex as an HIV preventive measure, which increased the chances of having an unsatisfactory risk perception by 1.45 times (P = .04), engaging with known HIV-positive individuals without knowledge of their viral load (ORa = 2.70; P = .043), and using illicit drugs before/during sex (ORa = 0.29; P = .048). Conclusions: The results indicate a high prevalence of risky sexual practices and an unsatisfactory HIV risk perception among the MSM studied.

The effect of daily oral PrEP use during pregnancy on bone mineral density among adolescent girls and young women in Uganda.

Oral pre-exposure prophylaxis (PrEP) is recommended during pregnancy for at-risk cisgender women. Pregnancy is known to impede bone growth and tenofovir-based PrEP may also yield detrimental changes to bone health. Thus, we evaluated the effect of PrEP use during pregnancy on bone mineral density (BMD). We used data from a cohort of women who were sexually active, HIV-negative, ages 16-25 years, initiating DMPA or choosing condoms for contraception and enrolled in the Kampala Women's Bone Study. Women were followed quarterly with rapid testing for HIV and pregnancy, PrEP dispensation, and adherence counseling. Those who became pregnant were counseled on PrEP use during pregnancy per national guidelines. BMD of the neck of the hip, total hip, and lumbar spine was measured using dual-energy x-ray absorptiometry at baseline and annually. We compared the mean percent change in BMD from baseline to month 24. Among 499 women enrolled in the study, 105 pregnancies occurred in 90 women. At enrollment, the median age was 20 years (IQR: 19-21) and 89% initiated PrEP. During pregnancy, 67% of women continued using PrEP and PrEP was dispensed in 64% of visits. BMD declined significantly in women using PrEP during pregnancy compared to women who were not pregnant nor used PrEP: relative BMD change was -2.26% (95% CI: -4.63 to 0.11, p = 0.06) in the femoral neck, -2.57% (95% CI: -4.48 to -0.66, p = 0.01) in total hip, -3.06% (95% CI: -5.49 to -0.63, p = 0.001) lumbar spine. There was no significant difference in BMD loss when comparing PrEP-exposed pregnant women to pregnant women who never used PrEP. Women who became pregnant were less likely to continue PrEP at subsequent study visits than women who did not become pregnant (adjOR: 0.25, 95% CI: 0.16-0.37, p < 0.001). Based on pill counts, there was a 62% reduction in the odds of high PrEP adherence during pregnancy (adjOR = 0.38, 95% CI: 0.27-0.58, p < 0.001). Women who used PrEP during pregnancy experienced a similar reduction in BMD as pregnant women with no PrEP exposure, indicating that BMD loss in PrEP-using pregnant women is largely driven by pregnancy and not PrEP.

Longitudinal patterns in indeterminate HIV rapid antibody test results: a population-based, prospective cohort study.

Rapid HIV tests are critical to HIV surveillance and universal testing and treatment programs. We assessed longitudinal patterns in indeterminate HIV rapid test results in an African population-based cohort. Prospective HIV rapid antibody test results, defined by two parallel rapid tests, among participants aged 15-49 years from three survey rounds of the Rakai Community Cohort Study, Uganda, from 2013 to 2018, were assessed. An indeterminate result was defined as any weak positive result or when one test was negative and the other was positive. A total of 31,405 participants contributed 54,459 person-visits, with 15,713 participants contributing multiple visits and 7,351 participants contributing 3 visits. The prevalence of indeterminate results was 2.7% (1,490/54,469). Of the participants with multiple visits who initially tested indeterminate (n = 591), 40.4% were negative, 18.6% were positive, and 41.0% were indeterminate at the subsequent visit. Of the participants with two consecutive indeterminate results who had a third visit (n = 67), 20.9% were negative, 9.0% were positive, and 70.2% remained indeterminate. Compared to a prior negative result, a prior indeterminate result was strongly associated with a subsequent indeterminate result [adjusted prevalence ratio, 23.0 (95% CI = 20.0-26.5)]. Compared to men, women were more likely to test indeterminate than negative [adjusted odds ratio, 2.3 (95% CI = 2.0-2.6)]. Indeterminate rapid HIV test results are highly correlated within an individual and 0.6% of the population persistently tested indeterminate over the study period. A substantial fraction of people with an indeterminate result subsequently tested HIV positive at the next visit, underscoring the importance of follow-up HIV testing protocols.IMPORTANCERapid HIV tests are a critical tool for expanding HIV testing and treatment to end the HIV epidemic. The interpretation and management of indeterminate rapid HIV test results pose a unique challenge for connecting all people living with HIV to the necessary care and treatment. Indeterminate rapid HIV test results are characterized by any weak positive result or discordant results (when one test is negative and the other is positive). We systematically tested all participants of a Ugandan population-based, longitudinal cohort study regardless of prior test results or HIV status to quantify longitudinal patterns in rapid HIV test results. We found that a substantial fraction (>15%) of participants with indeterminate rapid test results subsequently tested positive upon follow-up testing at the next visit. Our findings demonstrate the importance of follow-up HIV testing protocols for indeterminate rapid HIV test results.

Recent HIV infections and estimated HIV incidence among adolescents from key populations.

To identify recent HIV-1 infection and estimate HIV incidence among adolescent men who have sex with men (AMSM) and transgender women (ATGW) in Brazil. From January to December 2020, a cross-sectional analysis was conducted with baseline data from the PrEP1519 study, an HIV pre-exposure prophylaxis (PrEP) demonstration cohort in Brazil among sexually active AMSM/ATGW aged 15-19. For enrollment, participants were screened with a fourth-generation HIV rapid test. The recent infection testing algorithm (RITA) included a recency assay in blood specimens, viral load, and CD4 cell count prior to antiretroviral treatment use. Among these participants, RITA-based HIV incidence was estimated using a mean duration of recency infection of 214 days and a false-recent rate of 0.02. Out of the 494 participants screened, 21 tested positive for HIV. Following RITA, five adolescents had a recent HIV infection, 14 had long-term infections, and two did not have blood specimens available. We classified these two participants as long-term infection cases due to CD4 cell counts and previous use of antiretroviral treatment. Among those who tested positive, all but one were AMSM (94.7%), 73.6% were aged 18-19, and 76.2% were non-White. The HIV prevalence was 4.2%, and the estimated HIV incidence was 1.7%. The estimated incidence highlights the need for targeted HIV prevention interventions, such as PrEP, for sexual minority adolescents. Integrating RITA into routine HIV testing services for this population provides valuable information on the current HIV epidemic. This strategy can aid in monitoring the effectiveness of prevention efforts and improving early entry to HIV care.

Mapping projects for expanding rapid HIV testing in key populations, Brazil, 2004-2021.

The HIV/AIDS epidemic remains a persistent and real issue, especially in key populations such as men who have sex with men (MSM), travestis and transgender persons. Projects for expanding rapid HIV testing are strategic initiatives aimed at the earliest possible identification of individuals' serological status and thus early treatment, screening of sex partners, and upscaling of preventive actions to interrupt the transmission chain. This study thus maps, describes, and systematizes the projects for expanding rapid HIV testing implemented from 2004 to 2021 in Brazil, highlighting the on-going contribution of civil society organizations and discussing the interoperability and cooperation resulting from public governance processes. We selected 67 documents for analysis, including 30 scientific publications retrieved from electronic databases and 37 documents produced by government institutions and nongovernmental organizations (NGOs). Find Out (Fique Sabendo), I Want to Get Tested (Quero Fazer), The Time is Now (A Hora É Agora), Live Better Knowing (Viva Melhor Sabendo), and Live Better Knowing Young (Viva Melhor Sabendo Jovem) were the projects mapped. Results show that the projects have used strategies adapted to the key population, such as mobile testing units, peer education, and innovative community engagement approaches. Such actions were enabled by effective cooperation and interoperability between participating stakeholders, especially NGOs.

Factors associated with university students' knowledge about HIV and preand post-exposure prophylaxis.

to analyze the factors associated with university students' knowledge about HIV and preand post-exposure prophylaxis. a cross-sectional study was conducted with 503 university students from a southern state in Brazil; data were collected using a characterization tool and a questionnaire containing 16 statements about the topic; descriptive measures and Poisson regression models with robust variance were used for analysis. the prevalence of adequate knowledge (i.e., scoring more than 12 correct answers) was 27.83%; students older than 24 years, enrolled in health-related courses, who had not engaged in sexual relations in the last quarter, with a history of rapid HIV testing, and who knew or had heard about the prophylaxes showed a higher likelihood of scoring more than 12 correct answers. generally, the knowledge of young people about HIV and its prophylaxes was found to be inadequate and influenced by sociodemographic, educational, and behavioral factors.

Prevalence of HIV P24 Antigen; A Sensitive Marker among Seronegative Antibody Blood Donors in Some Hospitals Within Kaduna Metropolis, Nigeria

Detecting and monitoring HIV infection is crucial for effective disease management. The p24 antigen serves as an early viral marker in HIV diagnosis. Despite advancements in diagnosis and monitoring, there is a need for a comprehensive assessment of p24 antigen prevalence in HIV cases. Therefore, this study aims to ascertain the prevalence of p24 antigen among a diverse population of blood donors in Kaduna metropolis. The study recruited 261 blood donors aged between 18 and 55 from various blood bank units in the metropolis. Initial HIV status determination utilized the Immune-Chromatographic Determine® HIV rapid test kit, followed by re-screening with UnigoldRecombigen HIV 1 and 2, boasting 99.70% specificity and 100% sensitivity. HIGHTOP (HIV) ELISA test kit was employed to screen HIV antibodynegative blood donors for HIV p24 antigen. Additionally, demographic factors like gender, residency, age, and marital status were taken into account. Results indicated p24 antigen detection in 9 out of 261 blood samples, yielding a prevalence of 3.5%. Conversely, 252 samples tested negative for the antigen, resulting in a prevalence of 96.5%. The study's findings support the assertion that HIV p24 antigen serves as a sensitive marker, advocating for its integration into routine blood donor screening within Kaduna metropolis to enhance HIV infection detection rates.

Secondary Syphilis Reinfection with Suspected Asymptomatic Neurosyphilis

Syphilis, a sexually transmitted disease caused by Treponema pallidum, poses a significant global health threat, with an annual incidence of around 12 million cases, predominantly affecting individuals aged 15-49. Reinfection occurs in 11 out of 120 patients, underscoring the importance of effective management. If untreated, 4-9% of cases may progress to early neurosyphilis, often presenting asymptomatically. We present the case of a 22-year-old male with reddish-brown patches on the face, palms, and soles, along with erythematous papules on the genital region, following a history of recent promiscuity. Physical examination revealed distinctive manifestations, including nickels and dimes on the face, syphilitic roseola, Biett's collarette on the palmoplantar region, and erythematous papules-plaques on the scrotal and penile areas. The VDRL test indicated a titer of 1:32, TPHA test &gt;1:5120, and a non-reactive HIV rapid test. Initiating treatment with a single intramuscular injection of benzyl benzathine penicillin G (2.4 million IU) resulted in successful symptom resolution, accompanied by a four-fold decrease in VDRL titer to 1:8 by the third month. However, a subsequent increase to 1:32, following sexual intercourse in the sixth month, indicated reinfection and raised suspicions of asymptomatic neurosyphilis. The patient received oral doxycycline (100 mg twice daily) for 30 days. Unfortunately, treatment success could not be determined as the patient was lost to follow-up. This case report highlights that elevated VDRL titers signify reinfection, treatment failure, or neurosyphilis. Asymptomatic reinfection is common due to lead-time bias and partial immunity, especially with multiple episodes of syphilis. Early neurosyphilis may coexist with primary or secondary syphilis and is frequently asymptomatic. Continued efforts in monitoring and treatment adherence are crucial for effective syphilis management on a global scale.

Prevalence of Tuberculosis in HIV- or Tuberculosis-exposed neonates at the University Teaching Hospital in Lusaka over a period of six months

Background: Tuberculosis (TB) is the leading cause of mortality globally and represents a major health problem. The burden of TB in Zambia is among the highest in the African region with a national prevalence estimated at 455/100 000 for all age groups. A large proportion of people with TB are in the reproductive age group as such may either be pregnant or have young children. As at 2014 the prevalence of TB among women attending antenatal care in Zambia was estimated to be 1.5% in HIV infected women and 1.4% in uninfected women. There is a close association between maternal TB and HIV infection and postpartum infant morbidity and mortality. TB in neonates is very rare but a tenfold increase in the risk of acquiring TB in infants born to HIV infected mothers has been documented. Methods: A cross sectional study was conducted to establish the prevalence of tuberculosis in neonates exposed to either HIV or TB, or to both TB and HIV. The study included neonates aged 28 days and below that were admitted to the intensive care unit (NICU) and nurseries on general pediatric wards at the University teaching hospital. Mothers to neonates that had a positive rapid HIV test were approached, made aware of the study and invited to participate by giving consent to have their baby included in the study. When consent was granted, basic demographic details and medical information were collected. One gastric lavage sample was collected before the first feed of the day and analysed using Xpert MTB- RIF test. Results: One hundred forty-nine consecutive neonates that met the inclusion criteria were enrolled in the study. The average age of the neonates was nine days, 49 % had mean birth weight of 2.50kg (0.85 SD), 86 full term delivery and 73 (49%) were male. One hundred, ten (110) were born to multiparous (74%) vs 38 primiparous (26%) mothers. All the neonates enrolled in the study were HIV exposed and only one neonate was exposed to both TB and HIV. Mycobacterium tuberculosis was detected in 2 out 149 samples analysed using the Xpert MTB-RIF test. None were positive for rifampicin resistance Conclusion: The prevalence of TB using Xpert MTB-RIF test performed on gastric aspirates of HIV exposed neonates admitted to the University teaching hospital is 1.3 %.