Increase In HIV Cases Research Articles

Importance of perceived social support for HIV/AIDS patients in Pakistan: a collectivist society

ABSTRACT Background Research related to HIV stigma is in its initial stages in Pakistan. With the recent increase in HIV cases among injection drug users, there is a growing need to study the psychosocial aspects of the disease to address and mitigate the factors associated with stigma. HIV stigma has been identified as a contributor to depression and a barrier to effective treatment. Aim This study examines the moderating role of perceived social support from three sources, i.e., family, friends, and significant others, in reducing the impact of HIV stigma on depression among individuals living with HIV in Pakistan. Methodology 150 male HIV patients were approached whose likely mode of infection was through injection drug usage. The study explored the moderating role of three sources of perceived social support. Semi-structured interviews and standardized measurements were employed to assess levels of stigma, depression, and perceived social support. Results The findings indicated that family support emerged as the most effective moderating factor in the relationship between HIV/AIDS stigma and depression. Support from significant others was observed as the second one. However, the study did not find substantial moderating effects from friends’ support on the relationship between stigma and depression. Conclusion In Pakistan, where a collectivist societal structure prevails, interventions to reduce HIV/AIDS stigma should focus on strengthening the family support system for patients. The study’s outcomes underscore the importance of tailored interventions that consider the cultural context to mitigate the adverse impact of HIV stigma on mental health of people living with HIV.

Preferred Characteristics for mHealth Interventions Among Young Sexual Minoritized Men to Support HIV Testing and PrEP Decision-Making: Focus Group Study.

Epidemiological trends in the United States have shown an increase in HIV cases among young sexual minoritized men. Using mobile health (mHealth), which refers to health services and information delivered or enhanced through the internet and related technologies, is a crucial strategy to address HIV disparities. However, despite its potential, the practical implementation of mHealth remains limited. Additionally, it is important to consider that young individuals may become accustomed to, distracted from, or lose interest in these apps, highlighting the need for regular updates and monitoring of relevant content. In this study, we sought to highlight the voices of young sexual minoritized men aged 17-24 years and explored preferred mHealth intervention characteristics and willingness to adopt these technologies among a diverse, nationwide sample of young sexual minoritized men. From April to September 2020, we recruited participants through web-based platforms such as social media and geosocial networking apps for men. These individuals were invited to participate in synchronous web-based focus group discussions centered around topics pertaining to HIV testing and prevention and their preferences for mHealth technologies. A total of 41 young sexual minoritized men, aged between 17 and 24 years, participated in 9 focus group discussions spanning April to September 2020, with 3-7 participants in each group. The findings shed light on three key insights regarding young sexual minoritized men's preferences: (1) the need for personalized and representative content, (2) a preference for mobile and web-based simulation of prevention scenarios, and (3) a preference for digital software with individually tailored content. As expected, preference for mHealth apps was high, which supports the potential and need to develop or adapt interventions that use smartphones as a platform for engaging young sexual minoritized men in HIV prevention. This study expands on previous research in multiple meaningful ways, delving into the use and perceptions of mHealth information amid the COVID-19 pandemic. This study also highlighted the importance of streamlined access to health care providers, especially in light of the barriers faced by young people during the COVID-19 pandemic. In terms of presentation and navigation, participants favored a user-friendly design that was easy to use and appropriate for their age, which was effectively addressed through the implementation of web-based simulations. Ultimately, this study provides valuable insight into the preferences of young sexual minoritized men when it comes to mHealth interventions and highlights the need for further research in order to develop effective and tailored HIV prevention tools. A future direction for researchers is to evaluate how best to address participants' desire for personalized content within mHealth apps. Additionally, as technology rapidly evolves, there is a need to re-assess the effectiveness of web-based simulations, particularly those that are used in HIV prevention.

Regression-based Model Deciphers Progression on Health Management for Two Long-standing and Unresolved Infectious Diseases in Indonesia: Integration of Outpatient Data by the National Universal Health Care (BPJS) and Fluctuation of Registered HIV and Malaria Cases

Although the COVID-19 outbreak was recently declared overcome COVID-19 is not the sole life-threatening infectious disease for which we direct our all resources. HIV and malaria are, on the other hand, two long-standing national health issues that are yet to find a proper solution. We query how these two infectious diseases load volume on National Burden as represented by the claims National Health Resilience and how far our efforts paid thus far affect the progression on optimally putting the cases in a break. We approach these mathematically as we hardly found integrated reports on this matter. Hence, we employed regression linear to model the Health Resilience of Indonesia based on the dynamics of outpatients and inpatients across facility categories (class) provided by National Universal Health Care (BPJS) in the context of HIV and malaria infection cases respectively. The estimation of the two regression parameters was done via the ordinary least square (OLS) method. We used pandas 1.3.5 for performing the data analysis, seaborn 0.11.2 and matplotlib 3.5.1 for the data visualization, and scipy 1.7.3 and statmats 0.31.2 for the statistical analysis. Our results show that the number of outpatients declines as the number of HIV and malaria cases increase. Furthermore, we obtained significant associations between the increased HIV rate and decreased number of outpatients in class 2 (P=0.030), class 3 (P=0.002), and the total outpatients (P=0.0019). These patterns are not observed for malaria cases. Meanwhile, the increase in HIV cases was found to be associated with the decreased number of registered BPJS in class 1 (P=4e-4), class 3 (P=1.5e-6), and total participants in all classes (P=3.6e-6). Less strong associations were found between the malaria cases with decreased number of participants in BPJS class 1 (P=0.010), class 3 (P=0.042), and the total registered to BPJS (P=0.045). Our data suggest that the higher the HIV incidence rate the lesser likelihood of the affected patients being treated as outpatients using facility classes 2 and 3 since this may lose the transmission control intervention. Intriguingly, in the sense of the BPJS facility category where an increased HIV rate is seen to be strongly associated with a decreased registration number for class 1 and class 3, the monthly dues and the adequateness of expected facility items may be the most abductive reasoning. Despite our understanding that these require validation cohort, taken altogether our data hint the threat of HIV is steady and demands a new approach to strategizing for the sake of limiting the transmission as well as maintaining the quality of life of the affected patients.

HIV Pre-exposure Prophylaxis at Two Urban Obstetrics/Gynecology Clinics in Buffalo: Awareness and Attitudes Among Non-Hispanic Black vs. Latinx Patients.

Non-Hispanic Black and Latinx women are disproportionately affected by HIV when compared to the general population. This study evaluated awareness of and attitude towards PrEP, self-perceived HIV infection risk, and factors constituting high-risk behavior for HIV infection at two general OB/GYN clinics in Erie County, which exhibited a 31.6% increase in HIV cases from 2019 to 2020. One thousand twenty-five self-administered surveys were analyzed. Of participants, 69.3% were non-Hispanic Black, 13.4% were Latinx, and 22.4% were White. There was no significant difference in awareness of or attitude toward PrEP between non-Hispanic Black and Latinx participants (p = 0.197, p = 0.467). Latinx participants exhibited the lowest awareness of PrEP compared with non-Hispanic Black and White participants (p = 0.002). In our high-risk group, most participants had low self-perceived risk of HIV infection and low awareness of PrEP, and most were unwilling or unsure as to whether they would take PrEP. This calls attention to a need for improved counseling regarding PrEP and what constitutes risk of HIV infection at our general OB/GYN clinics, with a potential focus on Latinx individuals.

A policy window and a network of global and local policy entrepreneurs: The introduction of opioid substitution therapy in Belarus

Abstract Why does a regime that is predominantly characterised by conservative ideology introduce opioid substitution therapy (OST), a liberal policy? This article applies the Multiple Streams Framework (MSF) to examine the introduction of OST in Belarus. Methodologically, the research draws on qualitative content analysis of drug policy documents and reports as well as on interviews. Results show how an increased HIV prevalence among injecting drug users opened a policy window in the problem stream. The increase in HIV cases could be used by a network of global and local policy entrepreneurs to frame OST as a public health policy instead of a drug policy measure. Findings suggest that, in nondemocratic regimes, global policy entrepreneurs can play a dominant role in introducing new policy ideas. However, the sustainability of the policy change remains questionable when acquiescence by key policymakers is lacking.

Improving national surveillance of new HIV diagnoses.

The purpose of national HIV surveillance is to track and summarize trends in newly diagnosed cases as an indicator of HIV transmission within Canada, and supports the development and evaluation of programs and policies for prevention, testing and delivery of care. Accurately capturing and interpreting trends in HIV diagnoses within national surveillance becomes complicated when there is movement of people within a country or when individuals are diagnosed with HIV prior to migrating to a new country. This has been identified as an issue in other countries, including Australia, New Zealand and Switzerland. The Public Health Agency of Canada (PHAC) recently assessed this in Canada after noting a rise in new HIV cases in Canada between 2014 to 2017. An environmental scan was conducted to better understand how new and previously diagnosed cases of HIV were recorded by and reported to PHAC from provincial and territorial (PT) public health authorities. It was discovered there was variation with respect to the reporting of cases who had received a new diagnosis of HIV within the province or territory, but who had previously received an HIV diagnosis from another PT or another country. Five PTs included cases previously diagnosed in another Canadian PT within the HIV surveillance data reported to PHAC and nine PTs included people who were diagnosed with HIV outside of Canada. The provincial and territorial public health authorities then reviewed HIV surveillance data from 2007 to 2017 to identify cases using a common definition of "previous HIV-positive test result". This included any case who gave a history, or had laboratory evidence, of an HIV-positive result from another PT or another country before presenting for care in the province or territory where they now resided. When these cases were subtracted from the total, a revised number of new HIV diagnoses was calculated for Canada. Re-analysis of surveillance data using this common definition for 2007 to 2017 explained more than half of the increase in HIV cases that had been documented in Canada over the last four years. In the future, national surveillance data will be calculated adopting this new common definition of a previous positive test result, in order to more accurately describe the trends in HIV transmission occurring in Canada.

DYNAMICS OF HIV INFECTION DETECTION RATES AMONG VARIOUS POPULATION GROUPS OF THE REPUBLIC OF BASHKORTOSTAN

The aim of this study was to assess the dynamics of HIV infection detection rates among various groups of the population of the Republic of Bashkortostan in 2003–2017. Materials and methods. The statistical data of the form № 4 of the Federal state statistical observation «Data on the results of blood testing for HIV antibodies» in the Republic of Bashkortostan for the period from 2003 to 2017 were analyzed. The time interval was divided into three periods of 5 years. For each of the five-year periods, the average number of HIV testing, the number of HIV-infected people identified, the level and structure of HIV detection for different groups of the population were calculated. The average number of blood tests for antibodies to HIV common to all groups of people in 2008–2012 increased from 866 307 to 938 978 compared to 2003–2007, and then decreased to 768 143 in 2013–2017. The average indicator of the number of blood tests for HIV antibodies in the Republic of Bashkortostan was 212,4 in 2003–2007, 231,1 in 2008–2012, 188,8 per 1000 population in 2013–2017. The average number of HIV testing for men who have sex with men decreased 58 times from 232 in 2003–2007 to 45 in 2008–2012, and then to 4 in 2013–2017. The largest increase in number of HIV testing (2,3 times) was registered among foreign citizens from 12 982 testing in 2003–2007 to 29 610 in 2013–2017. The average indicator of HIV-infected people common for all groups of the population increased 3,8 times from 736 cases in 2003–2007, to 1260 — in 2008–2012 and 2796 — in 2013–2017. The largest increase in HIV cases, in the studied period of time, was recorded among people examined for clinical indication — 6,2 times (from 140 to 862 cases), among foreign citizens an increase of 4,3 times was registered (from 10 to 43 cases), among the population referred to the group «other» — an increase of 4,2 times (from 111 to 469 cases). The average detection rate of HIV-infected people, common for all groups of the population increased 4,4 times, in 2003–2007 it averaged 81,8, in 2013–2017 — 356,9 per 100 000 testing. The highest increase of detection of HIV infection was registered among prisoners from 299,5 to 2644,0 per 100 000 testing (8,8 times), among the people examined for clinical indications from 68,6 to 409,1 (6,0 times), among drug addicts — from 805,9 to 4356,4 (5,4 times), among the population referred to the group «other» — from 45,4 to 244,5 (5,4 times). In the structure of HIV detection during the study period there were also changes, the average percentage of the group examined on clinical indications increased significantly from 19,69±1,49% in 2003–2007 to 32,16±0,90%, in 2013–2017, this category was in the first place in the structure among all population groups. There was an increase in the average percentage of the population referred to the group «other» from 15,61±1,36% to 17,50±0,73%, this category occupied the second place in the structure. In the structure of HIV detection, the average percentage of pregnant women decreased significantly from 11,39±1,19% to 6,60±0,48%. The study of the dynamics of indicators of detectability of HIV infection among various groups of the population allows us to determine the trends in the spread of the disease in society, which further makes it possible to apply the data in the development of preventive measures

Determinants of condom use status among men who have sex with men (MSM) group in 5 Indonesian cities in 2015

Background: Significant increase in HIV cases among men who have sex with men (hereafter MSM) group during the 2015-2016 period confirmed that sexual behavior is a major risk factor in exposure to HIV & AIDS with unprotected sexual intercourse as the dominant risk factor. This study aims to identify the determinants of condom use status among MSM group in 5 cities in Indonesia.Methods: This study used a cross sectional design, carried out in 5 cities in Indonesia: Jakarta, Bandung, Semarang, Surabaya, and Denpasar using secondary data from the Integrated Biological and Behavioural Survey (IBBS) in 2015.Results: Variables that are significantly related to the condom use status were marital status, exposure to information on HIV&AIDS, and knowledge about condoms. The marital status variable has a POR value of 1.351 (95% CI OR 0.709 í¢AS 2.576), whilst exposure to HIV&AIDS information has 1.668 (95% CI OR 1.148 í¢AS 2.422) POR value, and knowledge about condoms has POR value as much as 1.925 (95% CI OR 1.274 í¢AS 2.907).Conclusion: The number of respondents who used condoms consistently for the past one month were 76.1% and those who did not were 23.9%. Variables that are significantly related to the behaviour of not using condoms are marital status, exposure to HIV&AIDS information, and knowledge of condoms. Keywords: Determinants, Behavior, Condom, MSM, HIV&AIDS Received: 12 March 2019; Reviewed: 16 April 2019; Revised: 26 April 2019; Accepted: 30 June 2019 DOI: 10.35898/ghmj-32544

Determinants of Condom Use Status among Men Who Have Sex with Men (MSM) Group in 5 Indonesian Cities in 2015

Backgorund : Significant increase in HIV cases among men who have sex with men (hereafter MSM) group during the 2015-2016 period confirmed that sexual behavior is a major risk factor in exposure to HIV&AIDS with unprotected sexual intercourse as the dominant risk factor. Aims : This study aims to identify the determinants of condom use status among MSM group in 5 cities in Indonesia. Method : This study used a cross sectional design, carried out in 5 cities in Indonesia: Jakarta, Bandung, Semarang, Surabaya, and Denpasar using secondary data from the Integrated Biological and Behavioural Survey (IBBS) in 2015. Results : Variables that are significantly related to the condom use status were marital status, exposure to information on HIV&AIDS, and knowledge about condoms. The marital status variable has a POR value of 1.351 (95% CI OR 0.709 – 2.576), whilst exposure to HIV&AIDS information has 1.668 (95% CI OR 1.148 – 2.422) POR value, and knowledge about condoms has POR value as much as 1.925 (95% CI OR 1.274 – 2.907). Conclusion : The number of respondents who used condoms consistently for the past one month were 76.1% and those who did not were 23.9%. Variables that are significantly related to the behaviour of not using condoms are marital status, exposure to HIV&AIDS information, and knowledge of condoms.Keywords:Determinants, Behavior, Condom, MSM, HIV&AIDS

The Impact of Human Mobility on HIV Transmission in Kenya.

Disease spreads as a result of people moving and coming in contact with each other. Thus the mobility patterns of individuals are crucial in understanding disease dynamics. Here we study the impact of human mobility on HIV transmission in different parts of Kenya. We build an SIR metapopulation model that incorporates the different regions within the country. We parameterise the model using census data, HIV data and mobile phone data adopted to track human mobility. We found that movement between different regions appears to have a relatively small overall effect on the total increase in HIV cases in Kenya. However, the most important consequence of movement patterns was transmission of the disease from high infection to low prevalence areas. Mobility slightly increases HIV incidence rates in regions with initially low HIV prevalences and slightly decreases incidences in regions with initially high HIV prevalence. We discuss how regional HIV models could be used in public-health planning. This paper is a first attempt to model spread of HIV using mobile phone data, and we also discuss limitations to the approach.

Network Characteristics of People Who Inject Drugs Within a New HIV Epidemic Following Austerity in Athens, Greece.

Greece experienced an unprecedented increase in HIV cases among drug injectors in 2011 after economic crisis. Network-level factors are increasingly understood to drive HIV transmission in emerging epidemics. We examined the relationship between networks, risk behaviors, and HIV serostatus among 1404 people who inject drugs in Athens, Greece. We generated networks using the chain-referral structure within a large HIV screening program. Network proportions, the proportion of a respondent's network with a given characteristic, were calculated. Multiple logistic regression models were used to assess the relationship between network proportions and individual HIV seroprevalence, injection frequency and unprotected sex. Of note, 1030 networks were generated. Respondent HIV seroprevalence was associated with greater proportions of network members who were HIV infected (ie, those with ≥ 50% of network members HIV positive vs. those with no network members HIV positive) (AOR: 3.11; 95% CI: 2.10 to 4.62), divided drugs (AOR: 1.60; 95% CI: 1.10 to 2.35), or injected frequently (AOR: 1.50; 95% CI: 1.02 to 2.21). Homelessness was the only sociodemographic characteristic associated with a risk outcome measure--high-frequency injecting (AOR: 1.41; 95% CI: 1.03 to 1.93). These associations were weaker for more distal second- and third-degree networks and not present when examined within random networks. Networks are an independently important contributor to the HIV outbreak in Athens, Greece. Network associations were strongest for the immediate network, with residual associations for distal networks. Homelessness was associated with high-frequency injecting. Prevention programs should consider including network-level interventions to prevent future emerging epidemics.

Needle exchange programs are a cost-effective preventative measure against HIV in Iceland

In 2007 there was a sudden increase in HIV cases among intravenous drug users (IDUs) in Iceland. In 2007 - 2011 there were 34 new HIV cases among IDUs compared to four in the previous four year period. The purpose of this study was to assess whether needle exchange programs (NEPs) were cost-effective in preventing the spread of HIV among IDUs in Iceland. Cost-utility analysis was conducted from a societal perspective. Costs are presented at the 2011 price level and values were discounted using a 3% discount rate. A ten year period, 2011 - 2020 was compared with and without NEPs. The Incremental Cost-Utility Ratio (ICUR) was calculated as societal cost per quality adjusted life year (QALY). Sensitivity analysis was performed on study assumptions. The estimated societal costs associated with HIV infections among IDUs from 2011 - 2020 was 914.369.621 ISK without NEP and 947.653.758 ISK with NEP. Excess societal cost due to NEP was 33.284.137 ISK. Societal utility from NEP was 7,39 QALYs. Additionally, NEP prevented 4-5 HIV infections. The ICUR of providing NEP was 4.506.720 ISK. According to WHO an intervention is considered cost-effective if the ICUR is less than three-fold national GDP per capita. In 2011 the GDP per capita in Iceland was 15.315.000 ISK. Sensitivity analysis on study assumptions yielded a societal cost within the WHO limit. Therefore, the results indicate that NEPs are cost-effective in preventing the spread of HIV among IDUs in Iceland.

Internet's Dirty Secret: Assessing the Impact of Technology Shocks on the Outbreaks of Sexually Transmitted Diseases

Online platforms offer access to a larger social group than is generally available through offline contacts, making the internet an emerging venue for seeking casual sex partners. The ease of seeking sex partners through classified ad sites may promote risky behaviors that increase transmission of STDs. In this paper, using a natural experiment set up, we investigate whether the entry of a major online personals ad site, Craigslist, increases the prevalence of HIV over a 10 year period from 1999 to 2008 across 33 states in the United States. After controlling for extraneous factors, our results suggest that the entry of Craigslist is related to a 15.9 percent increase in HIV cases. Our analysis suggests that the site entry produces an average of 6130 to 6455 cases of HIV infection in the U.S. each year, mapping out to $62 million to $65.3 million dollars in annual treatment costs. In addition, the analyses reveal that non-market related casual sex is the primary driver of the increase in HIV cases, in contrast to paid transactions (e.g., escort services and prostitution) solicited on the site which has a negative relationship with HIV trends. These findings are essential to the understanding of the social routes through which HIV transmission takes place and the extent to which site entry can influence HIV trends. Implications for healthcare practitioners and policy makers are discussed.

Internet's Dirty Secret: Assessing the Impact of Online Intermediaries on the Outbreak of Sexually Transmitted Diseases

We investigate how the expansion of Craigslist into different states over a 11 year period in the United States affected the incidence of HIV. Using a natural experiment setup, we identify the effects of Craigslist's entry on HIV trends by exploiting the variations across states and time. After controlling for extraneous factors, our results show that Craigslist's entry leads to a 19.8 percent increase in HIV cases, which maps out to an average of 158.7 cases for a state in a year. The analyses further suggest that non-market related casual sex serves as the underlying mechanism driving the increase in HIV cases, while paid transactions (e.g., escort services and prostitution) solicited on the site do not influence HIV trends. The increases in HIV cases as a result of Craigslist entry are estimated to impose treatment costs of over $118 million annually on the U.S. healthcare system. Study implications and limitations are discussed.

Emergence of Potential Superbug Mycobacterium Tuberculosis , Lessons from New Delhi Mutant-1 Bacterial Strains

Recent reports have shown that certain bacterial strains attain the New Delhi Metallo-beta-lactamase-1 (NDM-1) enzyme and become resistant to a broad range of antibiotics. Similarly, more dangerous "superbugs" of multi-drug resistant (MDR) and extensive drug resistant (XDR) Mycobacterium tuberculosis strains are gradually emerging through rapid genetic mutation caused by prescription non-compliance or unsupervised indiscriminate use of anti-tubercular drugs or other antibiotics. Mycobacterium tuberculosis cases have been reported in highly susceptible population groups including the aboriginal communities of US and Canada. In Canada alone, the total number of reported tuberculosis cases has decreased over the past decade. However, there is a steady increase in HIV cases in certain communities including the aboriginal communities. Reintroduction of MDR/XDR strains of tuberculosis is possible in these susceptible communities, which in turn may pose serious public health situation. MDR/XDR strains of tuberculosis are virtually untreatable using current anti-tubercular medication protocols. Thus, MDR/XDR tuberculosis presents a grave global public health threat. The unpredictable genetic mechanism involved in generating MDR/XDR resistant strains of Mycobacterium tuberculosis may pose greater challenges in developing appropriate treatment strategies. In this article, we briefly review potential genetic mechanism of emerging NDM-1 bacterial strains and draw a rationale parallel to the underlying genetic mechanism of MDR/XDR Mycobacterium tuberculosis strain development.

Tracking the Evolution of HIV/AIDS in China from 1989–2009 to Inform Future Prevention and Control Efforts

BackgroundTo determine policy implications, this analysis tracks the evolution of HIV/AIDS infection across China to understand current trends and potential risk factors.Methods and Principal FindingsA retrospective study with spatial analytical model and multilevel spatial models was conducted among 326,157 HIV/AIDS cases reported from 1989–2009. The results indicate that the distribution of HIV/AIDS was clustered at the county level with different directional distributions across China from 2003 to 2009. Compared to 2003, by 2009 there was a 122% increase in HIV cases among rural residents, 294% increase among urban residents, 211% increase among migrants, and 237% increase among permanent residents. The overall proportion of HIV by different routes of transmission showed dramatic changes with a 504% increase in sexual transmission of HIV, 90% decrease in blood/plasma transmission, and 35% decrease in injecting drug user transmission. Sexual transmission was the major transmission route among women (44%) and the elderly (59% in men, 44% in women) as well as among permanent (36%) and urban residents (33%). Among those <65 years old, women increased more than men, but among those ≥65 years, men increased more than women. Migrants contributed to the variance of HIV infection between counties but not within counties. The length of highway and urbanization combined with illiteracy were risk factors for HIV/AIDS.Conclusions/SignificanceRates of HIV/AIDS among permanent urban residents, particularly women and elderly men, have increased significantly in recent years. To prevent HIV from spreading further among the general population, additional attention should be paid to these populations as well as to migrants.