Human Immunodeficiency Virus Risk Research Articles

Oropharyngeal Candidiasis, Candida Albicans Infections, and Oral Immune Mediators Associated with Oral Human Immunodeficiency Virus: A Literature Review

Introduction: While Candida albicans are usually commensal and present in low density in the oral cavity of healthy individuals, an immunocompromised immune system can lead to the overgrowth of this fungal species, leading to oral microbiome “dysbiosis” and activation of immune responses. In severe cases, C. albicans overgrowth can lead to an oral infection called oropharyngeal candidiasis (OPC), which is associated with inflammation, lesions, and sores of the oral cavity. While human immunodeficiency virus (HIV) infection has been linked to an increased risk of OPC, few studies have associated OPC and C. albicans infection with subsequent risk for oral HIV acquisition. Evidence on the oral microbiome and how it can alter HIV risk is also lacking. Methods: A literature search was performed on PubMed, Google Scholar, and the University of Alberta Library Database from inception to November 2023. Results and Discussion: The risk of oral HIV transmission is low. OPC and C. albicans fungal infection can increase HIV susceptibility by activating immune responses associated with the clearance of microbial pathogens, inducing inflammation and elevations in cytokines related to HIV risk including IL-17, IL-6 and IL-1ß. Persistent C. albicans infections also promote the recruitment of T-helper 17 cells, which is a common HIV target cell, and neutrophils, which releases neutrophil proteases upon inflammation and mediates the cleavage of tight junction proteins, ultimately disrupting the oral microbiome. Conclusion: Increased immune cell recruitment to the mucosa and increased epithelial breakdown may facilitate the diffusion and access of HIV virions across the epithelium to immune target cells, suggesting that OPC and C.albicans infections has the potential to increase risk for oral HIV acquisition. Limited evidence of the relationship between C. albicans density, OPC, and oral HIV risk, warrants high-quality cross-sectional studies in the future.

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.

Risky Behavior of Men who have Sex with Men (MSM) Increases the Risk of HIV and Syphilis Infection

The incidence of sexually transmitted infections in man who have sex with man (MSM) is increased among human immunodeficiency virus (HIV) patients. HIV and syphilis are two sexually transmitted diseases that frequently interact and modify the symptoms and signs of the disease. A case of a 27-year-old male with generalized multiple erythematous plaques including palms and soles since 4 days ago was reported. The patient has been diagnosed with HIV since 2017. The patient is sexually active with a male sex partner and rarely uses condoms. Diagnosis of syphilis is made based on anamnesis, physical examination, and laboratory tests. The treatment was benzathine penicillin G 2.4 million units in 3 doses. The combination of HIV and syphilis needs longer therapy and requires serological follow-up for up to 24 months.

Relationship Between High ACE Score, HIV Risk Behavior, and Previous HIV Testing in the South Carolina BRFSS [ID 2683384

INTRODUCTION: The incidence of human immunodeficiency virus (HIV) in the United States is stable among women. Due to stigma, 13% of persons with HIV are unaware of their diagnosis. Adverse childhood experiences (ACEs) describe negative events during childhood using a standardized questionnaire. Limited data exist on how ACEs affect HIV screening. Utilizing state-collected data from the Behavioral Risk Factor Surveillance System (BRFSS), we assessed the relationships between high ACE, gender, HIV risk behaviors, and previous HIV testing. METHODS: This is a retrospective observational cohort study of the BRFSS from 2014–2016 and 2019–2021. High ACE score was ≥ 4. Using bivariate analyses, we compared percentages of individuals with high versus low ACE scores. We used logistic regression to determine factors associated with HIV risk behaviors and previous HIV testing. RESULTS: Over 54,000 individuals were surveyed; 15% had high ACE scores. 4% reported HIV risk behaviors and 35% reported previous HIV testing. The mean ACE was 1.6 (SD 2.1). High ACE demonstrated increased risk of HIV risk behaviors (adjusted odds ratio [aOR] 2.652; 95% CI, 1.987–3.538) and previous HIV testing (aOR 2.340; 95% CI, 2.031–2.696). Female respondents were less likely to report HIV risk behavior (aOR 0.442; 95% CI, 0.336–0.581) and previous HIV testing (aOR 0.822; 95% CI, 0.736–0.919). CONCLUSION: Persons with high ACE scores were more likely to engage in HIV risk behaviors and have a history of HIV testing. Our findings suggest ACE scores may be useful for identifying persons at risk for HIV. The stable incidence of HIV and reduced perception of risk among women demonstrate the need for tailored HIV screening for women.

Progression of subclinical cardiovascular disease in patients with HIV.

Human immunodeficiency virus (HIV) infected patients are at increased risk of cardiovascular disease (CVD). Multidetector computed tomography (MDCT) stratifies cardiovascular risk in asymptomatic patients with subclinical atherosclerosis. The aim of this study was to determine the ability of MCTD and clinical and laboratory parameters to assess subclinical CVD progression in HIV patients. Prospective longitudinal cohort study of patients with at least 10 years of HIV infection and 5 years of antiretroviral therapy history, low cardiovascular risk and monitored for 6 years (2015-2021). All patients underwent clinical assessment, blood analysis, carotid ultrasound, and gated MDCT in 2015 and 2021. Sixty-three patients (63.5% male) with a mean age of 49.9 years (standard deviation [SD], 10.5) were included in 2015; 63 of them were followed until 2021. Comparing the results from 2015 with those from 2021, Systematic Coronary Risk Estimation-2 (SCORE2) was 2.9% (SD, 2.1) vs. 4.4% (SD,3.1); Multi-Ethnic Study of Atherosclerosis score (MESA risk) was 3.4 (SD 5.8) vs. 6.0 (SD 8.6); coronary artery calcification CAC) score >100 was 11.1% vs. 25.4% (P < 0.05); and 11% vs. 27% had carotid plaques (P = 0.03). After six years of follow-up, an increase in SCORE2, carotid plaques, CAC scoring and MESA risk was observed. MDCT findings, along with other clinical and laboratory parameters, could play an important role as a marker of CVD progression in the evaluation of patients with HIV and low cardiovascular risk.

Facilitators, Barriers, and Opportunities to Implementing Sexual History Screening and Human Immunodeficiency Virus Pre-Exposure Prophylaxis at a Federally Qualified Health Center.

Sexual history screening (SHS) is recommended to determine risk for acquisition of human immunodeficiency virus (HIV) and eligibility for pre-exposure prophylaxis (PrEP). SHS and PrEP are underutilized, sequential screening, and prevention practices. This study aimed to understand factors impacting the implementation of SHS and PrEP at a multi-site federally qualified health center (FQHC) in Connecticut. Guided by the Consolidated Framework for Implementation Research, semistructured interviews were conducted on Zoom with primary care providers (PCPs), medical assistants, clinical leadership, and PrEP navigators. Convenience and purposive sampling took place via email until thematic saturation was achieved. Thematic analysis was conducted. Twenty-two participants were interviewed for this study. PCPs lacked knowledge and reported limited or no use of SHS to determine patients' level of HIV risk, which may explain why most PCPs relied on patients to request PrEP. While PCPs perceived organizational support to prescribe PrEP, clinical staff were unaware of structural resources. Lastly, participants described a vertical trajectory of influence from external sources (policies and insurance) to time allocated to appointments that limits their ability to implement SHS and PrEP, further complicated by the electronic health record and disparities in structural resources across clinical sites. This study provides foundational evidence for future research on implementation strategies to improve HIV prevention through universal, comprehensive SHS to identify patients for PrEP. Overcoming barriers to SHS and PrEP, particularly in clinical settings such as FQHCs that care for vulnerable populations, may improve identification, prevention, and treatment of HIV and aid in ending the HIV epidemic.

Safe sex negotiation and HIV risk reduction among women: A cross-sectional analysis of Burkina Faso 2021 Demographic and Health Survey.

Women are biologically more susceptible to the Human Immunodeficiency Virus (HIV) and other sexually transmitted Infections (STIs) because receptive sex is riskier than insertive. Despite condom use being the staple preventive method for HIV infection (over 80% efficacy), in Sub-Saharan African countries like Burkina Faso, a high burden of HIV and the unmet need for condom use coexist. Moreover, even though women in SSA are disproportionately HIV positive, they are reportedly less capable of negotiating condom use for HIV risk reduction. Thus, using the Health Believe Model (HBM), this study explored the factors that influence condom use among women within the context of HIV prevention, with a key interest in condom use negotiation. Using the women's dataset of the 2021 Burkina Faso Demographic and Health Survey and applying logistic regression models, this study examined the factors associated with condom use for HIV risk reduction. Women who had confidence to negotiate condom use with their partners (OR = 1.57, P<0.001, 95%CI: 1.29, 1.91), those with secondary education (OR = 1.38, P<0.05, 95%CI: 1.07 1.77), from richest households (OR = 1.64, P<0.05, 95%CI: 1.08, 2.47), the employed (OR = 1.23, P<0.05, 95%CI: 1.02, 1.49), women with knowledge of sexually transmitted infections (OR = 1.58, P<0.001, 95%CI: 1.26, 1.97), those who have ever been tested for HIV (OR = 1.85, P<0.001, 95%CI: 1.52 2.24), as well as those who knew that a healthy-looking person can have HIV (OR = 2.64, P<0.001, 95%CI: 2.15, 3.24) were all significantly more likely to practice condom use for HIV risk reduction. Also, religion and geographical location of participants significantly predicted condom use for HIV risk reduction in the study context. The ability to negotiate condom use, knowledge of HIV and STIs, the socioeconomic status of women, as well as their geographical location, influence their practice of safer sex for HIV risk reduction in Burkina Faso.

The prevalence of Human Immunodeficiency Virus infection among voluntary blood donors in mainland China: A systematic review and meta-analysis.

Human immunodeficiency virus (HIV) infection through transfusion has been an imperative challenge for blood safety. Despite the implementation of screening strategies, there was still the residual risk of transfusion-transmitted HIV. Considering that the prevalence of HIV infection in blood donors is significant for evaluating blood safety and potential risks to the population, meta-analysis was applied to investigate the HIV prevalence among voluntary blood donors during the past 27 years to characterize the epidemiology and related risk factors of HIV in blood donors. The literature concerning the HIV screening reactive rate and prevalence in Chinese voluntary blood donors was collected through the systematic searching of four electronic databases. After integrating data, following the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines, data manipulation and statistical analyses were conducted by Stata 12.0. The results indicated that overall HIV prevalence was 0.0178% (95% confidence interval [CI], 0.0169%-0.0187%) with a remarkable rise, which varied from 2000 (0.0034%) to 2015 (0.027%). The HIV window period infection rate was 0.0475‱ (95%CI, 0.0304‱-0.0646‱). Importantly, subgroup analysis revealed the heterogeneity in gender, occupations, education and donation frequency. With the effective control of HIV transmission through blood, HIV prevalence declined in China to some extent in recent years, and the characteristics of HIV epidemic in some provinces have drastically changed. However, remaining relatively high HIV prevalence and overall increased trend of HIV prevalence since the 21th century demonstrates the potential residual risk of blood transfusion, and the whole society is supposed to pay close attention to HIV infection.

Self-Perception of Risk for HIV Acquisition and Calculated Risk for HIV Acquisition Among Active Duty Air Force Members With Newly Diagnosed HIV Infection.

There have been nearly 1,600 new diagnoses of Human Immunodeficiency Virus (HIV) across the US Armed Forces between 2017 and 2022. While treatment has improved overall survival, self-perception of acquiring HIV may not align with actual risk of acquiring HIV, thus slowing diagnosis and treatment. We aim to evaluate self-perceived risk (SPR) versus calculated risk (CR) of HIV infection in US Air Force (USAF) members with incident HIV diagnosis. All USAF members with new HIV diagnosis evaluated at a specialty care military medical center between January 2015 and March 2020 with case report forms were included (n = 142). SPR was compared to CR using the Denver HIV Risk Score (DHRS). The study was approved by the Army Public Health Center's Public Health Review Board (#14-311) and the Walter Reed Army Institute of Research Human Subjects Protection Branch (#1861E). Patients were predominantly male (98%), with a median age of 26 (IQR 22-30) years, and the majority (85%) reported same-sex partners. Most patients reported a low SPR (n = 78; 55%). A higher proportion of low SPR patients were married or partnered than high SPR patients (29% versus 14%; P = 0.04). Both groups had median DHRS scores in the highest risk category with similar results by reason for HIV screening. The majority of USAF members with incident HIV infection reported a low SPR despite risk factors and CRs identical to high SPR patients. In order to inform HIV prevention strategies in the military, further efforts are needed to educate the military population and providers about HIV risk perception.

Determination of multipurpose prevention technology choice for contraception and HIV/STI prevention: A survey of sexually active women in Nigeria

Objectives: Interest in human immunodeficiency virus (HIV) prophylaxis in the context of multiple sexual and reproductive health risks women face suggests a place for multipurpose prevention techniques (MPTs), which act by combining contraception and pre-exposure prophylaxis against HIV into one unified delivery method. At present, condoms are a readily available form of MPTs. The study aims to determine the sexual characteristics of women in Nigeria and assess factors associated with MPT acceptance in the identified population. Materials and Methods: An online cross-sectional survey was conducted using the data collection tool Google Forms®. The survey was distributed to the prospective respondents using the snowballing technique through an instant messaging application to ensure proper circulation among the geopolitical zones in Nigeria. Interest in MPT’s was evaluated using descriptive analysis. Specifically, personal and product attributes were evaluated descriptively (frequency and response rating) and with inferential statistics (logistic regression and model validation). Results: More than one-half (57%) of the participants were sexually active in the past three months. Most of the subjects reported at least one HIV risk behavior such as engaging in sexual intercourse with a male partner without a condom (50%). Factors associated with acceptance of MPTs included perceived safety, long-lasting action, and effectiveness of the formulation. Formulation types preferred by respondents include daily pills (21%), vaginal gels (12%), and inserts (8%). Personal characteristics supporting MPT use include age (30–39) and (40–49) years, married, formally educated, being a housewife, and having not had sexual intercourse with an HIV-positive male partner and having had an unintended pregnancy. Conclusion: Most of the respondents were interested in MPTs as a daily pill. Safety, long-lasting activity, and effectiveness are the top three criteria predicting acceptance. A variety of MPTs are required to be developed to suit the varying needs of different populations. The MPT preferences must be considered during product development to promote future acceptance among women in Nigeria.

“We mostly focus on preventing pregnancy, we don’t really focus on preventing HIV … ”: Young people’s perceptions and priorities when preventing unplanned pregnancy and HIV

In South Africa, the high rate of human immunodeficiency virus (HIV) infection among young people and unplanned pregnancies remains a concern. Using a qualitative approach, this study aimed to explore how young people between 18 and 24 years old perceive the risk of unplanned pregnancy and HIV, and how they give priority to and act to prevent both concerns. Fifty-four young people were recruited from three provinces in South Africa: KwaZulu-Natal, Eastern Cape, and Gauteng. Data collection took place between May and June in 2016. All data collection was carried out in person using a standardised discussion guide and a semi-structured interview guide in English. We conducted eight focus group discussions with young people and three in-depth interviews with young people who had become parents in their teens. We utilised thematic analysis grounded in a social constructionist framework to assess patterns and associations in the data. Respondents reported unplanned pregnancy and HIV as prevalent among their peers, but prioritised both concerns differently. Preventing pregnancy was a greater priority and threat than HIV. Respondents were less concerned about being infected with HIV which was perceived as invisible and not a death sentence because of the efficacy and ease of use of treatment. HIV was considered comparatively more manageable and less burdensome than other chronic illnesses and unplanned pregnancy. Our study suggests unplanned pregnancy and HIV prevention interventions should prioritise responding to young people’s primary desire to control their fertility, but also encourage them to have holistic sexual and reproductive health goals that include HIV prevention. Our findings suggest a pressing need for biomedical therapies that offer combined HIV and pregnancy prevention for young people. Future programmes need to be agile and innovative in addressing young people’s tendency to prioritise HIV and pregnancy differently, and they need to revive the sense of urgency to prevent HIV.

Safeguarding strategies and current HIV treatment in the UK

Objectives: This study aims to illuminate contemporary strategies and treatment approaches employed in the United Kingdom (UK) to safeguard against Human Immunodeficiency Virus (HIV) transmission and enhance the well-being of those grappling with Acquired Immune Deficiency Syndrome (AIDS). The review contributes to a comprehensive understanding of the nation's ongoing efforts in managing the impact of HIV on public health. Material and Methods: Research, reports, guidelines, and official websites from 2005 to 2024 were searched from the Pubmed database and Bournemouth University's database. English resources were searched using keywords related to HIV risk measures, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and anti-retroviral therapy (ART). Results: HIV prevention efforts in the UK emphasize education, widespread testing, and targeted interventions. Strategies include promoting safe sex practices, regular testing, and condom use. HIV testing, PrEP, PEP and ART play crucial roles in prevention and treatment, with initiatives focusing on high-risk populations such as men who have sex with men (MSM) and transgender individuals. Challenges include regional variations, financial constraints, and social stigma. Conclusions: A holistic and adaptable approach is essential in HIV prevention and treatment in the UK. Education, widespread testing, and tailored interventions for diverse populations are key components. Challenges such as financial constraints and social stigma require sustained efforts and global collaboration. Advancements in PrEP, PEP, and ART offer promising avenues for mitigating the impact of HIV, emphasizing the importance of accessibility and adherence.

Sexually Transmitted Infection Prevalence, Partner Notification, and Human Immunodeficiency Virus Risk Perception in a Cohort of Women Completing Sexually Transmitted Infection Screening as Part of a Safer Conception Study.

Integrating sexually transmitted infection (STI) and preexposure prophylaxis (PrEP) care may optimize sexual and reproductive health. We nested an STI substudy within a human immunodeficiency virus (HIV) prevention cohort (parent study) of 18- to 35-year-old women from South Africa, planning pregnancy with a partner with HIV or of unknown serostatus. Parent-study women completed annual surveys regarding HIV-risk perceptions and were offered oral PrEP. Preexposure prophylaxis initiators completed quarterly plasma tenofovir (TFV) testing. Substudy women completed STI screening at enrollment, 6 months, onset of pregnancy, and in the third trimester via examination, vaginal swabs tested via PCR for Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma genitalium , and blood tested for Treponema pallidum . Follow-up was 6 months. Women with STIs were treated, offered partner notification (PN) cards, and surveyed regarding PN practices. We describe STI prevalence and incidence, and model factors associated with prevalent infection. Sexually transmitted infection substudy and parent study-only participants were matched on age and number of days on study to assess HIV-risk perception scores between the 2 groups and the proportion with detectable TFV. Among 50 substudy participants, 15 (30%) had prevalent STI. All 13 completing follow-up reported PN. Most did not prefer assisted PN. Mean HIV risk perception scores and proportion with detected plasma TFV were similar across groups. High STI prevalence supports the importance of laboratory screening to optimize sexual health for women planning pregnancy. Rates of self-reported PN are reassuring; low interest in assisted PN suggests the need for alternative approaches. Enhanced STI care did not affect HIV-risk perception or PrEP adherence, however both were relatively high in this cohort.

Model-Informed Targeted Network Interventions on Social Networks Among Men Who Have Sex With Men in Zhuhai, China

Men who have sex with men (MSM) are at disproportionally high risk for human immunodeficiency virus (HIV) infection in China. The increasing HIV prevalence among MSM highlights the urgent need for effective prevention interventions among MSM. Interventions targeted at individuals who are highly vulnerable to HIV infection have been proven effective in reducing incidence rates. However, existing targeted interventions are limited to small-scale programs. To investigate the effectiveness of large-scale targeted network interventions in real-world settings, we build a stochastic agent-based network model informed by the comprehensive online social networking and dating behavior data and epidemiological data among MSM in Zhuhai, China. With the proposed model, we simulate HIV transmissions and compare the efficacy of different targeted intervention programs. We propose a new method, namely, RiskRank, to prioritize nodes for targeted interventions by incorporating: 1) their topological features on the online social network; 2) the underlying epidemic dynamics; and 3) the position of identified HIV-infected individuals on the sexual network. Results show that the targeted interventions are more effective than random interventions in large-scale HIV epidemic control. The proposed RiskRank method consistently outperforms state-of-the-art baselines in various intervention scenarios.

“You get HIV because there is no hope” a rapid qualitative assessment of the HIV vulnerabilities of transgender women in three South African metros

Introduction Epidemiological data show that transgender women are disproportionately affected by Human Immunodeficiency Virus (HIV). Data in South Africa on the HIV vulnerabilities of transgender women are sparse. This paper qualitatively explores the structural, personal, and economic factors that contribute to making South African transgender women vulnerable to HIV and other sexually transmitted infections (STIs). Methods We conducted a rapid qualitative assessment in the Cape Town, Johannesburg, and Buffalo City metropolitan municipalities to frame the HIV risk vulnerabilities of transgender women. Purposive sampling was used to recruit study participants. We conducted 25 key informant interviews, five focus group discussions, and 26 in-depth interviews with transgender women. Atlas.ti.8 was used to facilitate qualitative data analysis. Study findings These data illustrate a pervasive theme of social rejection, discrimination, and everyday victimization among transgender women. The ubiquitous presence of stigma and rejection leads to internalized stigmatization, which affects the social and mental well-being of transgender women, who often turn to alcohol and illicit drug use to alleviate negative emotions. We found that transgender women may engage in high-risk sexual activities like sex work where they can express and affirm their gender identity. In this context, transgender women engaging in high-risk sexual activities found it challenging to access pre-exposure prophylaxis (PrEP). Stigma also leads to reluctance to use public healthcare services. Despite experiencing stigma and discrimination, qualitative data highlights the resilience of transgender women in the study. Conclusions Qualitative data demonstrate that HIV risk for transgender women is complex. Multi-level community-led interventions grounded in empowerment are also required to address interpersonal, biological, structural, and community risk. Successful interventions should address stigma and draw upon the resilience of transgender women. Peer-driven interventions may motivate personal responsibility to use high-impact HIV prevention and treatment services.

HIV knowledge, self-perception of HIV risk, and sexual risk behaviors among male Tajik labor migrants who inject drugs in Moscow

BackgroundThe interplay of human immunodeficiency virus (HIV) knowledge and self-perception of risk for HIV among people who inject drugs is complex and understudied, especially among temporary migrant workers who inject drugs (MWID) while in a host country. In Russia, Tajik migrants make up the largest proportion of Moscow’s foreign labor. Yet, HIV knowledge and self-perceived risk in association with sexual risk behavior among male Tajik MWID in Moscow remains unknown.ObjectiveThis research examines knowledge about HIV transmission, self-perception of HIV risk, and key psychosocial factors that possibly contribute to sexual risk behaviors among male Tajik labor MWID living in Moscow.MethodsStructured interviews were conducted with 420 male Tajik labor MWID. Modified Poisson regression models investigated possible associations between major risk factors and HIV sexual risk behavior.ResultsOf the 420 MWID, 255 men (61%) reported sexual activity in the last 30 days. Level of HIV knowledge was not associated in either direction with condom use or risky sexual partnering, as measured by sex with multiple partners or female sex workers (FSW). Lower self-perceived HIV risk was associated with a greater likelihood of sex with multiple partners (aPR: 1.79, 95% CI: 1.34, 2.40) and FSW (aPR: 1.28, 95% CI: 1.04, 1.59), but was not associated with condom use. Police-enacted stigma was associated with sex with multiple partners (aPR: 1.22, 95% CI: 1.01, 1.49) and FSW (aPR: 1.32, 95% CI: 1.13, 1.54). While depression and lower levels of loneliness were associated with condomless sex (aPR: 1.14, 95% CI: 1.05, 1.24; aPR: 0.79, 95% CI: 0.68, 0.92, respectively), only depression was associated with condomless sex with FSW (aPR: 1.26, 95% CI: 1.03, 1.54).ConclusionsHIV prevention programing for male Tajik MWID must go beyond solely educating about factors associated with HIV transmission to include increased awareness of personal risk based on engaging in these behaviors. Additionally, psychological services to counter depression and police-enacted stigma are needed.

Impact of an HIV pre-exposure prophylaxis dashboard on veteran PrEP enrollment

BackgroundPre-exposure prophylaxis (PrEP) is highly effective at reducing the risk of human immunodeficiency virus (HIV) acquisition in at-risk individuals; however, it is largely underutilized. The Veterans Health Administration has created an HIV PrEP dashboard to identify at-risk veterans in attempt to increase PrEP enrollment. ObjectiveThis study aimed to determine whether the use of an HIV PrEP dashboard would prove effective at increasing PrEP enrollment at a single facility. MethodsThis was a single-center quality improvement project. Three pharmacists used the HIV PrEP dashboard and retrospective chart review to identify eligible patients for PrEP. A multimodal process of contacting patients was conducted. The primary objective was to evaluate the number of patients who enrolled in PrEP during the study period. Secondary objectives included evaluating the ability of the HIV PrEP dashboard to identify eligible patients, identify effective strategies to target PrEP enrollment, and compare those patients who accepted with those who declined PrEP to evaluate barriers to enrollment. ResultsOf the 94 patients reviewed, 26 patients (27.7%) were found eligible for PrEP. Of the eligible patients, 3 patients (11.5%) were enrolled, and 7 patients (26.9%) declined PrEP. The others were lost to follow-up (9 of 26, 34.6%), had no action taken on a chart note to provider (6 of 26, 23.1%), or did not have a primary care provider assigned at the local facility (1 of 26, 3.9%). The 3 patients who were successfully enrolled in PrEP were all contacted and prescribed PrEP through the infectious diseases (ID) clinic. There were no statistically significant differences between the cohorts of patients who accepted and declined PrEP. ConclusionsThe use of an HIV PrEP dashboard aided in identifying eligible patients for PrEP. Enrollment through the ID clinic was the most successful modality. Further research is needed to characterize barriers to PrEP uptake and to develop strategies to increase prescribing from non-ID providers.

World AIDS Day 2023: understanding the interconnected challenges of HIV and cardiovascular disease

In this article, Lis Neubeck discusses the link between human immunodeficiency virus and cardiovascular disease risk for World AIDS Day 2023.

#295 : Comparison of In Vitro Fertilization in Couples with HIV Infection with Negative Viral Load Versus Non-Infected Couples: A Case-Control Study

Background and Aims: The development of Advanced Reproductive Technology (ART) changes many aspects and perspectives towards reproductive health. Current in vitro fertilization (IVF) protocols reduce the risk of Human Immunodeficiency Virus (HIV) transmission to their partners and offspring. This study compares IVF outcome in couples in which at least one partner is HIV positive with negative viral load versus couples in which neither partner is diagnosed with HIV. Method: A total of 100 couples undergoing IVF were categorized into two groups. HIV-positive with negative viral load group in which at least one partner is infected (n = 50) and non-HIV group in which neither partner is diagnosed with HIV (n = 50) are collected from medical record in our center during the same period. The main outcomes were total oocyte retrieved, normal fertilized egg or 2 pronucleus (2PN) one day after fertilization and good quality embryos based on number of embryos that transferred and frozen for IVF procedure. Differences between groups were determined statistically using the Mann-Whitney test. Results: There is a significant difference between HIV-positive with negative viral load groups compared to non-HIV groups in terms of total oocyte retrieved (p = 0,005) and normal fertilized egg one day after fertilization (p = 0.017). There is no significant difference in the number of good quality embryos (p = 0.076) between two groups. Conclusion: The data suggested that couples with HIV-positive women have poorer total oocyte retrieved and normal fertilized egg outcome compared to non-HIV couple. HIV infection might affect success rates of IVF treatments.

Perilaku Seksual Lesbian, Gay, Biseksual,Transgender, dan Risikonya terhadap Infeksi Menular Seksual

Lesbian, gay, bisexual, transgender (LGBT) face many gaps in sexual health aspects, including an increased risk of human immunodeficiency virus (HIV infection), sexually transmitted infections (STIs), and pregnancy. LGBT often experience social stigmatization, isolation, and rejection, even from their respective parents. Risk of STIs is related to sexual orientation, sexual anatomy, and sexual behaviour. LGBTs sexual activity may vary and with multiple partners, who are vulnerable to transmission of STIs and HIV infection. Health care providers are responsible for an open discussion regarding sexual health issues; including sexual orientation, sexual behavior, and gender identity.