Mode Of HIV Transmission Research Articles

P3.311 Assessment of HIV Prevalence and Sexual Behaviours Among Men Who Have Sex with Men in Cyprus, 2011–2012

BackgroundMen who have sex with men (MSM) comprise the most vulnerable group for HIV infection.Aim of this study was the estimation (1) of HIV prevalence and (2) sexual behaviours among...

P6.022 Results of the Global Fund Programmes Implementation on STI Diagnostics and Treatment Within Most-At-Risk Populations in Ukraine

Problem: Ukraine has the fastest HIV spread pace in Europe (221 806 people as of November 2012).Sexual HIV transmission mode has been dominant in Ukraine since 2008 (51%–sexual, 28%–parenteral).HIV/STI epidemic...

P6.046 Integration of STI Diagnostics and Treatment Programmes and HIV Prevention Programmes For Vulnerable Groups

Problem: Ukraine has the fastest HIV/STI spread rate in Europe (221 806 PLWH as of November 2012).Sexual HIV transmission mode has been dominant in Ukraine since 2008 (51% - sexual...

‘BEHOLD, A VIRGIN IS WITH HIV!’ MISREPORTING SEXUAL BEHAVIOR AMONG INFECTED ADOLESCENTS

In four Southern African countries where the HIV prevalence rate is among the highest in the world, 46.4% of a sample of female adolescents infected with HIV report having never engaged in sex. This would indicate either the dominance of non-sexual modes of HIV transmission or rampant misreporting of sexual behavior in the sample. We propose a method to estimate the extent of misreporting and calculate that the true percentages of virgins among the sample of HIV-infected adolescent women is 32.1%. After accounting for misreporting, the contribution of sexual modes of HIV transmission is projected as 50.4%, compared with an estimate of 35.5% if we assume no misreporting.

Awareness among young dentists about transmission of H.I.V and preventive measures

HIV/AIDS has profoundly affected every aspect of the health sector. Most importantly doctor’s attitude of avoiding treatment of HIV patients is mainly due to their apprehensions caused by their lack of understanding of the disease and its modes of transmission. To assess the knowledge, attitudes, and perceptions of risk of occupational transmission of HIV in a group of dental students. Design-Cross sectional anonymous questionnaire survey of all occupational groups in a large inner city teaching hospital. Overall correct responses were given by most of the respondents. Others either gave wrong responses or answered ‘Not-sure’. Well known modes of HIV transmission like, blood transfusion, needle stick injuries and question about vertical transmission to newborn were answered correctly by more than 90% of the respondents. Correct responses were very low to query of possibility of spread by saliva [58.2%]. Higher percentage of correct responses by BDS graduates compared to MDS graduates was statistically significant [p>0.05]. These findings highlight the importance of teaching the dental students on various aspects of the disease. Universal Work Precautions implementation should be emphasized at an early level of their curriculum and reinforced from time to time.

HIV risk practices and access to prevention in a men's prison in Burkina Faso

The aim of this survey was to assess the HIV risk practices of male prisoners and their access to prevention. This descriptive study took place at the House of Detention and Corrections in Ouagadougou from June through August 2012. In all, 165 prisoners (median age: 28 years, range: 18-65) were interviewed. A low proportion of the prisoners (16%) had accurate knowledge of the modes of HIV transmission. Before imprisonment, their sex lives featured multiple partners, occasional sex, and low condom use. Seven (4%) prisoners reported homosexual relations while in prison. The conditions of incarceration and the denial of homosexual practices at Ouagadougou aggravate prisoners' vulnerability to HIV/AIDS.

Correlates of frequency of HIV testing among men who have sex with men in Washington, DC

In Washington, DC, the leading mode of HIV transmission is through men who have sex with men (MSM) behavior. This study explored differences between frequent HIV testers (men testing at least twice a year) and annual or less frequent testers (men testing once a year or less) in DC. Nearly, one-third of MSM reported testing for HIV at least four times in the prior two years. In the multivariable model, frequent testers had significantly higher odds of being aged 18–34 (aOR =1.94), knowing their last partner's HIV status (aOR=1.86), having 5+ partners in the last year (aOR=1.52), and having seen a health-care provider in the last year (aOR=2.28). Conversely, frequent testers had significantly lower odds of being newly HIV positive (aOR=0.27), and having a main partner at last sex (vs. casual/exchange partner; aOR=0.59). Medical providers need to be encouraged to consistently offer an HIV test to their patients, especially those who are sexually active and who have not tested recently.

Social Death through HIV and AIDS Stigmatization and Discrimination in Ghana: A Case Study of the Central Regional Hospital, Cape Coast, Ghana

Stigmatization of and discrimination against People Living with the Human Immunodeficiency Virus (PLHIV) and Acquired Immunodeficiency Syndrome (AIDS) are increasingly recognized as the single greatest challenge to slowing the spread of HIV and partly the cause of the increased death rate particularly in Africa and Ghana to be specific. The purpose of the study was to identify the causes and effects of stigmatization of and discrimination against PLHIV visiting the Central Regional Hospital of Ghana for treatment and care. The research was conducted with a sample size of 120. Purposive and convenient/accidental sampling techniques were used to select respondents for the study. The study revealed that some people in Ghana stigmatize PLHIV because of the misconceptions they have about the modes of HIV transmission, the myths surrounding HIV and AIDS as well as their socio-cultural backgrounds and orientations. These stigmatizing behaviors towards PLHIV have serious health, social and psychological effects on them in particular and the society at large. Based on the results of the study, it is recommended that there should be an intensification of education on HIV and AIDS through the media. This would make the population in Ghana more knowledgeable about the disease, which may help to reduce stigmatization of and discrimination against persons living with HIV.

Curbing the Cultural Practices of Wife Inheritance and Polygamy through Information Dissemnation in Benue State

The present study investigated information dissemination as a tool for curbing the twin cultural practices of wife inheritance and polygamy in Benue state of Nigeria . A total number of 4500 participants ( 2250 men and 2250 women) were drawn in equal number from each of the three senatorial zones in the state for the study. Using a structured questionnaire and simple random sampling techniques, data were collected and analyzed. Independent t-test statistics was used to test the study hypothesis. The result revealed that, (1) there was no significant difference in the perceptions of men and women on polygamous marriages as a mode of Hiv/aids transmission in the state. (ii) There was a significant difference between men and women on the perception of wife inheritance as a mode of Hiv transmission in the state with the men being more aware of the practice of wife inheritance in this regard than the women. It was suggested that, library and information practitioners, having the responsibility of information dissemination, storage and retrieval must go beyond the walls of the library to expose to the average Benue woman the dangers behind these cultural practices, that women should be more proactive to empowering their selves than depending solely on the men. While this is done, it is expected that these cultural practices will gradually go into extinct.

Focusing the HIV response through estimating the major modes of HIV transmission: a multi-country analysis

ObjectiveAn increasing number of countries have been estimating the distribution of new adult HIV infections by modes of transmission (MOT) to help prioritise prevention efforts. We compare results from studies...

Correlates of Condom Self-Efficacy in an Incarcerated Juvenile Population

The purpose of this study was to enhance awareness of modes of HIV transmission and increase HIV/sexually transmitted diseases (STD) prevention efforts for incarcerated youth through use of an HIV/STD prevention program guided by the Making Proud Choices! curriculum. A convenience sample of 662 youth aged 13 to 18 was recruited from Alabama juvenile detention facilities. Participants took part in three 2-hour sessions. Baseline and postintervention data were collected. There was no significant difference between males and females in intent to use condoms at baseline and postintervention. Intent to use condoms was the most influential predictor of condom self-efficacy. However, there was little change in condom self-efficacy among males and females at baseline and postintervention.

High KSHV prevalence among HIV‐infected males in North India

BackgroundKaposi sarcoma is the most common cancer associated with AIDS worldwide. HIV is endemic in India but there are no studies on this co‐infection from India. Our present study examined the seroprevalence of HHV8 infections in adult Indian males infected with HIV.MethodsThe study was carried out at AIIMS, a tertiary care hospital in Delhi, India. We enrolled 93 HIV‐positive males naïve of ART. We employed whole virus enzyme‐linked immunosorbent assay [ELISA; Advanced Biotechnologies Inc, Columbia, MD, USA]. A univariate analysis including age, marital status, mode of HIV transmission and CD4 count were used to determine variables associated with HHV8 seropositivity. Significant variables were adjusted in a logistic regression model expressed in odds ratio (OR) with 95% confidence interval (CI). P<0.05 was considered significant.ResultsThe seroprevalence of KSHV infection was 33.3% in HIV‐1 infected males. HHV8 seropositivity in HIV‐infected males. Age was independently associated with the age group>25 years [OR=9.5; 95% CI=1.98–45.75.ConclusionTaken together, our findings showed high rates of KSHV antibody prevalence in the male cohort of suggesting that KSHV infection may be markedly associated with HIV‐1 infection in India especially in the heterosexual group. However, a further KSHV seroepidemiological survey; including a representative number of Indian cohorts of HIV‐1‐infected outpatients, is needed to further confirm our present findings.

Immuno‐virological discordance is associated with a higher frequency of AIDS, severe non‐AIDS, and death

Persistent immunosuppression despite viral suppression (immunovirological discordance, ID) has been associated with higher risk of AIDS and death, although the risk for AIDS seems to decrease with longer time of suppressed viral load (sVL). The impact of ID on a composite endpoint of AIDS/serious non‐AIDS/death has not been thoroughly investigated. Patients in EuroSIDA starting ≥1 new antiretroviral drugs after January 2001, when CD4 was <200 cells/mm3 and VL >500 copies/mL, and who achieved a sVL ≤50 copies/mL within 1 year were included. Person‐years of follow‐up (PYFU) accrued from the date of sVL until the first of a new AIDS or severe non‐AIDS (SNA) event or death, viral rebound >50 copies/mL (first of 2 consecutive values) or last visit. Rate ratios (RR) were calculated using Poisson regression according to whether or not patient's current CD4 count was still below 200 cells/mm3 (ID). Models were stratified according to whether or not persons were ART‐naïve at baseline. Multivariable models included age, HBV/HCV status, mode of HIV transmission, race, cohort, anemia, diabetes, hypertension or current eGFR, current cART, number of previous antiretrovirals, and time to viral suppression. 994 patients satisfied the inclusion criteria and contributed 4520 PYFU. Median age was 41 (IQR 34–47) years and 72.8% were male. 36.5% of patients were ART‐naïve and started a median of 3 (IQR 2–3) new drugs. 31 AIDS and 58 non‐AIDS events occurred, and 31 patients died (7 due to AIDS, 24 due to SNA). The rate of the combined endpoint in patients with ID (50.3 per 1000 PYFU [95% CI 35.2–69.9]) was higher than in patients recovered from ID (22.1 [17.6–27.3], adjusted RR 2.08 [1.32–3.28]; table). This was similar regardless of whether or not people were ART‐naïve before starting a new drug (interaction test p=0.47). In ID, rate was highest in the first 6 months of sVL (63.1 [33.6–107.9]) and declined thereafter (month 6–12: 60.5 [26.1–119.2],>12 months: 39.8 [22.2–65.6], adjusted RR compared to month 0–6 0.52 [0.24–1.13]). In analyses with endpoints AIDS/death due to AIDS and SNA/death due to SNA separately, the adjusted RR of ID vs. non ID was 4.11 ([1.76–9.60]; p=0.001) and 1.46 ([0.81–2.61]; p=0.207), respectively. Exposure No.events PYFU Rate (95%CI) Crude RR (95%CI) Adjusted**RR (95%CI) All patients No Discordance 84 3805 22.1 (17.6–27.3) 1 1 Discordance 36 716 50.3 (35.2–69.6) 2.28 (1.54–3.38) 2.08 (1.32–3.28) ART‐naïve* patients No Discordance 29 1324 21.9 (14.7–31.5) 1 1 Discordance 9 228 39.5 (18.1–74.9) 1.80 (0.84–3.85) 1.87 (0.81–4.33) ART‐treated* patients No Discordance 55 2481 22.2 (16.7–28.9) 1 1 Discordance 27 488 55.4 (36.5–80.6) 2.50 (1.67–3.97) 1.89 (1.08–3.32) before starting a new antiretroviral drug according to the inclusion criteria, p(test for interaction):0.47 adjusted for smoking, HBV/HCV coinfection, transmission risk, race, cohort, current cART, change of ART before viral suppression, time to viral suppression, presence of diabetes, hypertension, anemia, current eGFR <90, CD4 nadir, CD4 count and viral load at baseline. ID is a risk factor for clinical disease progression particularly related to AIDS events. In patients with ID, we found a trend for a declining incidence of events with longer periods of sVL, suggesting that sustained viral suppression might be of benefit.

HIV Incidence and Associated Risk Factors Among Female Sex Workers in a High HIV-Prevalence Area of China

Heterosexual sex is replacing injection drug use as the main mode of HIV transmission in China. The objective of this study is to determine HIV incidence and associated risk factors among female sex workers (FSWs) in China. From March 2006 to November 2009, FSWs in Kaiyuan City, Yunnan were recruited into an open cohort study. Participants were interviewed and tested for HIV and sexually transmitted infections every 6 months. A multivariate Cox proportional hazards regression model with time-dependent variables was used to measure associations between independent variables and HIV seroconversion. During 3.5 years of follow-up, 19 incident cases of HIV infection were diagnosed, yielding an overall incidence of 1.44 per 100 person-years (95% confidence interval [CI]: 0.87-2.24). In the multivariate Cox proportional hazards regression model, noninjection drug use (adjusted hazard ratio [AHR]: 6.7, 95% CI: 2.25-19.93), inconsistent condom use with clients in the previous week (AHR: 2.9, 95% CI: 1.03-8.34), and number of clients in the previous week ≥7 (AHR: 4.9, 95% CI: 1.81-13.13) were all independent risk factors for HIV seroconversion. These results underscore the urgency for preventive interventions on sexual and drug use behaviors among FSWs, including condom promotion as well as sexually transmitted infection screening and treatment.

Effects of Stigmatization on Gay Men Living with HIV/AIDS in a Central-Eastern European Context: A Qualitative Analysis from Hungary.

This qualitative study highlights the social dynamics affecting people living with HIV (PLH) in Hungary and in the Central-Eastern European region. The study focused on the special needs and concerns of men living with HIV/AIDS as well as changes in their social relationships and institutional support provision, coping strategies and patterns of social functioning, especially in the context of social stigmatization. Consistent with international qualitative research findings in the field of HIV/AIDS prevention, the present study contributes to a fuller understanding of relationship between sexual behavior, HIV/AIDS related risks and risk perceptions as well as homosexuality-and HIV/AIDS stigma-related social exclusion in a previously under-researched socio-cultural setting. The findings of our study point to several barriers to effective HIV prevention, which should be overcome to improve the present situation by lessening the adverse effects of HIV/AIDS-and homosexuality-related stigma within the gay community, the general population and especially among service providers. One of the main barriers is the lack of public health programs specifically targeting MSM in Hungary, where the predominant mode of HIV transmission remains sex between men.

Practical research designs for investigating modes of HIV transmission

Despite 30 years of epidemiologic research on HIV transmission, no published investigations in sub-Saharan Africa or Asia have involved study designs that allow HIV transmission modes to be determined with confidence. Consequently, there is much uncertainty about what is driving HIV transmission in these regions, which hampers prevention. There are four design elements in a rigorous investigation: inclusion of persons with incident HIV infection (cases) and uninfected controls, comprehensive assessment of blood and sexual exposures, tracing of contacts to such exposures for both cases and controls, and sequencing of infected persons' HIV DNA to identify persons with genetically related infections. Although all four elements are necessary to determine transmission modes with greatest confidence, investigations with the first two or three elements provide stronger evidence than exists currently and offer useful guidance on prevention strategies until more definitive investigations can be conducted. Investigations with these design elements can piggyback on existing clinical and other health services, and thus require little or no funding to implement. Scientific help is available for conducting these investigations. The most important requirement for starting this kind of project is the desire to know what is driving HIV transmission in one’s community.

Seroprevalence of HBV and HCV Among HIV-Infected Adults in China According to Route of HIV Infection: High Rate of HBV and HCV Exposure

Coinfection of viral hepatitis, specifically HBV and HCV, has been increasingly observed among patients infected with HIV. However, the prevalence of coinfection is not well characterized in China. Prior studies have reported prevalence rates among individual populations that have varied significantly by mode of HIV transmission and by location. Methods: We performed a cross-sectional survey of three HIV-infected populations classified according to the route of HIV transmission, specifically, former plasma donors (FPDs), commercial sex workers and men who have sex with men, and intravenous drug users (IVDUs), and measured rates of HBV and HCV coinfection. Results: From June 2007 through December 2008, 624 FPDs, 512 IVDUs and 460 subjects infected with HIV through sexual transmission were enrolled into the study. We observed a prevalence of chronic HBV infection of 20% among IVDUs, 19% among those infected sexually and 3% among FPDs. The prevalence of an isolated positive test for hepatitis B core antibody was 27% among those infected sexually, 12% among IVDUs and 4% among FPDs. We observed the highest prevalence of HCV antibody seropositivity among IVDUs (94%), compared with 75% among FPDs and 27% among those infected sexually. Conclusion: Among three representing groups of HIV-infected patients in China, we observed a high prevalence of HBV and HCV coinfection with HIV. In order to reduce the morbidity and mortality associated with chronic coinfection, additional policies are needed for prevention and treatment.

Emerging HIV Epidemic Among Older Adults in Nanning, China

The HIV/AIDS surveillance data indicates that the proportion of people living with HIV/AIDS (PLWHAs) who were 50 years old or older increased to 42.7% in 2011 from 16.5% in 2007 in Nanning, the capital city of Guangxi Province. A greater number of newly diagnosed HIV cases compared to clinical AIDS cases were identified from older adults. The dominant HIV transmission mode among older PLWHAs was heterosexual although approximately 30% of all PLWHAs acquired HIV through heterosexual contacts.

Describing the Chinese HIV Surveillance System and the Influences of Political Structures and Social Stigma

China’s public health surveillance system for HIV was established in late 1980s and has evolved significantly during the past three decades. With the gradually changing mode of HIV transmission from sharing of intravenous injecting equipment to sexual exposure and the rapid spread of HIV infection among Chinese homosexual men in recent years, an efficient and comprehensive population-level surveillance system for describing epidemics trends and risk behaviours associated with HIV acquisition are essential for effective public health interventions for HIV. The current review describes the overall strength of the Chinese HIV surveillance system and its structural weaknesses from a political and social perspective. The HIV surveillance system in China has undergone substantial revamping leading to a comprehensive, timely and efficient reporting system. However, large data gaps and lack of quality control and sharing of information obstruct the full performance of the system. This is largely due to fragmented authoritarianism brought about by the underlying political structure. Social stigma and discrimination in health institutes are also key barriers for further improvements of HIV diagnosis and surveillance in China.

Frequent Misconceptions and Low-to-Moderate Knowledge of HIV and AIDS amongst High-School Students in Malaysia

We describe the findings from a survey of 572 high-school students aged between 15 and 19 years in the city of Seremban, Negeri Sembilan state, Malaysia. Knowledge regarding HIV and AIDS is assessed using a self-administered validated 48-item questionnaire modified from the validated HIV Knowledge Questionnaire (HIV-K-Q). Our questionnaire was divided into 4 parts assessing different areas in HIV/AIDS, namely, general knowledge of risk factors; knowledge of modes of transmission of HIV; knowledge of HIV prevention; knowledge of HIV testing. The answers were divided into “correct”, “wrong”, and “I don't know”. One mark was awarded for every “correct” answer; one mark was deducted for every “wrong” answer, while no mark was awarded for “I don't know”. The total marks for each student were converted to percentage and used for analysis. The average total score percentage was 64.7%. The highest scores were in the area of knowledge of mode of HIV transmission, while the lowest scores were in the area of knowledge of HIV testing. The level of HIV knowledge was correlated with age of the students (P<0.05) but not with gender and ethnicity. Our paper revealed frequent misconceptions and a general low-to-moderate level of knowledge amongst the high school students surveyed.