HIV Prevalence Research Articles

Integration of HIV pre-exposure prophylaxis (PrEP) services for pregnant and breastfeeding women in eight primary care clinics: results of an implementation science study

BackgroundAlthough HIV vertical transmission has declined significantly in sub-Saharan Africa, incident HIV infection in pregnant and postpartum women is estimated to account for over one-third of HIV vertical transmission. Oral pre-exposure prophylaxis (PrEP) for pregnant and breastfeeding women (PBFW) is included in South African PrEP guidelines since 2021; however, integration of PrEP services within ante- and postnatal care remains limited.MethodsBetween March 2022 and September 2023, we evaluated the integration of PrEP for PBFW in eight antenatal clinics in Cape Town, South Africa, following training and mentorship of providers. We applied an adapted Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate the integration of PrEP services for pregnant and breastfeeding women. Before the study, PrEP was not routinely offered. We implemented a staff didactic/practice-based training and mentorship on PrEP provision targeting PBFW. We evaluated the following: (1) Reach as the proportion of women initiating PrEP among women counselled and tested for HIV, (2) effectiveness as PrEP continuation up to 3 months by pregnant vs. breastfeeding women, (3) adoption of PrEP integration via pre- and post-training assessments and ongoing mentorship assessments, (4) implementation through clinic trends of PrEP offer over time, and (5) maintenance: continued PrEP offer 3 months following the intervention.ResultsIn 8 facilities providing ante- and postnatal care, we trained 224 healthcare providers (127 nurses and 37 counsellors). Of those, we mentored 60 nurses, midwives, and HIV counsellors working with pregnant and breastfeeding women, with 80% of nurse/midwives and 65% of counsellors scoring ≥ 80% on the final mentoring assessment. Overall, 12% of HIV-negative pregnant women started PrEP, and 41% of those continued PrEP up to 3 months. Among HIV-negative breastfeeding women, 14% initiated PrEP, and 25% continued PrEP up to 3 months. All eight facilities continued providing PrEP 3 months post intervention.ConclusionsIn these high HIV prevalence clinics, the proportion of pregnant and breastfeeding women initiating and continuing PrEP rapidly increased but was limited among breastfeeding women. Staff training, mentorship, and PrEP integration were well-adopted by nurses and counsellors, and services continued following the intervention. Barriers included limited HIV testing of breastfeeding mothers and need for additional PrEP-trained nurses.

Feasibility of Brain Ultrasound Performed by Nurses in the Evaluation of Newborns Who Are HIV Exposed in Utero and Uninfected: A Pilot Study in Botswana.

Children who are exposed to HIV in utero but are uninfected (HIV-exposed uninfected or HEU) are at higher risk of neurodevelopmental delays compared to children born to persons without HIV. Magnetic resonance imaging (MRI) studies have revealed differences in grey matter volumes, cerebral perfusion, and white matter changes in these children. However, MRI is costly and not widely available in areas with high HIV prevalence, like Botswana, where more than 15% of children are HEU. To address this, we explored the use of brain ultrasound, conducted by trained study nurses, as a safe, less costly, and accurate alternative method for assessing differences relating to HIV exposure status in the brain structures of neonates. Brain ultrasounds of newborns in the Following Longitudinal Outcomes to Understand, Report, Intervene and Sustain Health for Infants, Children, Adolescents who are HIV Exposed Uninfected (FLOURISH) observational study-comprising 35 HEU newborns and 24 HIV-unexposed (HU) newborns-were performed by study nurses and evaluated by a pediatric radiologist for quality and structural abnormalities, such as calcifications, cysts, and hemorrhages. Two radiologists measured extra-axial cerebrospinal fluid spaces, ventricles, and the corpus callosum. Ultrasound studies of 59 newborns (59% boys; median gestational age 38.4 weeks) were completed. All studies were of diagnostic quality, with 90.2% rated as being of good or excellent quality. Structural abnormalities were rare (10.2% incidence) and did not differ by HIV exposure group. Corpus callosum length was shorter in HEU infants compared to HU infants (45.7 mm vs. 47.3 mm; p = 0.03). Other ventricular and corpus callosum measurements showed no significant variations. Brain ultrasounds conducted by study nurses are feasible and reveal differences in corpus callosum length between HEU and HU infants. The benefits of easier training, lower cost, and rapid deployment make ultrasound a promising screening tool in resource-limited settings.

HIV prevalence and associated factors among adolescent boys and young men in South Africa: 2017 nationally representative household-based population survey

IntroductionThere is growing recognition that adolescent boys and young men (ABYM) have been left behind in the HIV response and are under-represented in HIV services, leading to poor outcomes across...

Climate change and sexual and reproductive health and rights research in low-income and middle-income countries: a scoping review

IntroductionThis study aimed to provide an overview of the research landscape and to identify research gaps linking climate change events and sexual and reproductive health and rights (SRHR) in low-income...

Estimation of the prevalence of HIV, syphilis and hepatitis C among prisoners in Tajikistan

Aim. To assess the prevalence of HIV, syphilis and hepatitis C in prisons in the Republic of Tajikistan.Materials and methods. The biobehavioural study included anonymous testing for 3 infections (HIV, syphilis and hepatitis C) and a survey. Participation was voluntary. Each participant was able to access the results of the study through their unique code, which was assigned prior to the start of the study. Data entry and analysis were performed using Epi-Info-3.5.2 analysis software.Results and discussion. The prevalence rates of HIV, syphilis and hepatitis C in prisons were HIV - 3.4%, syphilis - 2.8%, hepatitis C - 8.9%. According to the results, drug use by injection is prevalent in prisons. The presence of homosexual contacts in prisons is also confirmed.Conclusion. HIV prevalence among prisoners in Dushanbe has increased from 2.2 to 2.9 per cent. In Dushanbe, it increased from 2.5 per cent in 2020 to 3.5 per cent in 2023, while in Khujand it decreased (3.8 per cent and 3.3 per cent). Prisoners’ awareness of HIV/AIDS and use of preventive measures is low. In 2023, only 56 per cent of prisoners had been tested for HIV.

Chronic innate immune impairment and ZIKV persistence in the gastrointestinal tract during SIV infection in pigtail macaques.

Mosquito borne flaviviruses, including dengue (DENV) and Zika (ZIKV) viruses, have caused global epidemics in areas with high HIV prevalence due to the expanded geographic range of arthropod vectors. Despite the occurrence of large flavivirus outbreaks in countries with high HIV prevalence, there is little knowledge regarding the effects of flavivirus infection in people living with HIV (PLWH). Here, we use a pigtail macaque model of HIV/AIDS to investigate the impact of simian immunodeficiency virus (SIV)-induced immunosuppression on ZIKV replication and pathogenesis. Early acute SIV infection induced expansion of peripheral ZIKV cellular targets and increased innate immune activation and peripheral blood mononuclear cells (PBMC) from SIV infected macaques were less permissive to ZIKV infection in vitro. In SIV-ZIKV co-infected animals, we found increased persistence of ZIKV in the periphery and tissues corresponding to alterations in innate cellular (monocytes, neutrophils) recruitment to the blood and tissues, decreased anti-ZIKV immunity, and chronic peripheral inflammatory and innate immune gene expression. Collectively, these findings suggest that untreated SIV infection may impair cellular innate responses and create an environment of chronic immune activation that promotes prolonged ZIKV viremia and persistence in the gastrointestinal tract. These results suggest that PLWH or other immunocompromised individuals could be at a higher risk for chronic ZIKV replication, which in turn could increase the timeframe of ZIKV transmission. Thus, PLWH are important populations to target during the deployment of vaccine and treatment strategies against ZIKV.

The “Cycle” of HIV: Limits of Personal Responsibility in HIV Vulnerability Among Transgender Adolescents and Young Women in Lima, Peru

Globally, transgender women (TW) face a high burden of the HIV epidemic. In Peru, HIV prevalence among TW rises at age 25, indicating a need to understand HIV vulnerability as adolescents reach adulthood. The life course of TW is often marked by abuse, discrimination and poverty fueled by transphobic stigma. Approaches to the HIV epidemic among TW and adolescents emphasize problem behaviors such as unprotected sex and substance. However, there has been a call for HIV research and interventions to understand and leverage community strengths. This qualitative study utilized a transgender-oriented, strength-based, intersectional and feminist approach to understand the strengths and protective health behaviors among 17 transgender adolescents and young women (TAYW) age 16–24 in Lima, Peru. Most participants re-located to Lima from the Amazon due to familial rejection, and engaged in obligatory sex work. TAYW demonstrated self-knowledge, motivation for education, efforts to secure employment, strong community networks, legal advocacy, avoiding problem substance use, HIV knowledge and condom use. However, strengths were impeded by multi-level barriers such as familial physical abuse, educational discrimination, and sexual assault which led to increased HIV vulnerability. We created a conceptual model of the “cycle” of HIV to describe the limits of personal responsibility within a vulnerable community denied access to family, education, employment and human rights. We recommend researchers, clinicians and public health workers follow the lead of TAYW at the frontlines of the HIV epidemic, and support beloved communities and enabling environments which may permit protective behaviors to mitigate HIV vulnerability.

Comparative study of the prevalence of HIV using the third- and fourth-generation HIV ELISA in blood donors in South India

Comparative study of the prevalence of HIV using the third- and fourth-generation HIV ELISA in blood donors in South India

Evolving molecular HIV clusters revealed genotype-specific dynamics in Guangzhou, China (2008-2020)

ObjectivesThis study investigated the genotype-specific dynamics of molecular HIV clusters (MHCs) in Guangzhou, China, aiming to enhance HIV control. MethodsHIV pol sequences from people with HIV (PWH) in Guangzhou (2008-2020) were obtained for genotyping and molecular network creation. MHCs were identified and categorized into three types: emerging, growing, or stable. Clustering rates, proportions of cluster types, and members within each type were calculated and their trends were assessed using joinpoint regression. ResultsAmong 8395 PWH, the most prevalent HIV-1 genotypes were CRF07_BC (39.7%) and CRF01_AE (32.6%). The genotype composition has been stable since 2012 (Ps > 0.05). The overall clustering rate was 43.3%, with significant variations across genotypes (P < 0.001), indicating genotype-specific transmission fitness. Significant declines in overall and genotype-specific clustering rates toward the end of 2020 (Ps < 0.05), potentially offer support for HIV control efforts in reducing local infections. The continuously increasing proportions of stable clusters and the gradually decreasing proportions of emerging and growing clusters (either Ps < 0.05 or Ps > 0.05) suggest a trend toward stable molecular network structure. However, growing clusters exhibited CRF55_01B, CRF07_BC, and CRF59_01B dominance that indicate their priority for interventions. ConclusionThe evolving MHCs highlight the genotype-specific cluster dynamics, providing fresh insights for enhanced prevention and control strategies.

Gender and Age Trends in HIV Incidence in Turkey between 1990 and 2021: Joinpoint and Age-Period-Cohort Analyses.

Background and Objectives: Despite a global decrease in HIV incidence, recent trends in Türkiye indicate a concerning rise, particularly among younger populations and women. This study investigates the local and regional dynamics influencing these trends using advanced epidemiological methodologies. Material and Methods: Utilizing Age-period-cohort analysis and joinpoint regression, we analysed HIV incidence and prevalence data from the Global Burden of Disease study for Türkiye. These methods allowed for a detailed examination of changes over time, identifying specific age groups and periods with significant shifts in incidence rates. Results: Key findings include a 13.03% increase in annual percentage change among males aged 15-19 and an 11.37% increase among females in the same age group. Additionally, the incidence rates among females have shown a significant rise after 2008. Conclusions: The rising HIV incidence in Türkiye reflects complex socio-economic, cultural, and biological factors, with significant increases among young people and women. Addressing these challenges requires targeted interventions, comprehensive educational programs, and inclusive healthcare services to align with global efforts and commitments. The study underscores the importance of incorporating young people in decision-making processes to effectively combat HIV in Türkiye.

Identification of a Novel HIV-1 Circulating Recombinant Form (CRF150_Cpx) Among Men Who Have Sex with Men in China.

Recent studies have reported increasing complexity in human immunodeficiency virus 1 (HIV-1) genotypes among men who have sex with men (MSM) in China. In an HIV-1 molecular epidemiological study conducted among MSM in Yunnan Province, China, we discovered that four samples could potentially represent a circulating recombinant form (CRF). In this study, we conducted further analysis on their nearly full-length genome (NFLG) sequences. The NFLG sequences formed a distinct monophyletic clade in the phylogenetic tree. Recombination analysis indicated that the four sequences were constructed upon the backbone of CRF149_01B, with the insertion of three CRF07_BC fragments. Consequently, they were designated as CRF150_cpx. Evolutionary analyses suggested that CRF150_cpx emerged between approximately 2014 and 2015. The identification of new CRFs not only deepens our understanding of HIV recombination but also aids in comprehending the prevalence and transmission history of HIV among specific populations.

Prevalence and factors associated with transfusion-transmissible infections (HIV, HBV, HCV and Syphilis) among blood donors in Gabon: Systematic review and meta-analysis.

Transfusion-transmissible infections (TTIs) remain a major public health problem in countries with limited resources, particularly in Gabon. Complete information on the prevalence in Gabon of the main TTIs among blood donors is still lacking in the national context. The purpose of this systematic review and meta-analysis was to determine the prevalence and factors associated with TTIs among blood donors in Gabon. This systematic review and meta-analysis was reported in accordance with the PRISMA 2020 guidelines. It was the result of data from several comprehensive studies published between 2014 and 2022, the purpose of which focused on the prevalence and factors associated with TTIs among blood donors in Gabon. The quality of the articles was assessed using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data. The overall prevalence of TTIs among blood donors was determined using the random effects model. Heterogeneity between studies was assessed using I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. A total of 175,140 blood donors from the nine eligible studies were admitted to this study. The combined prevalence of HIV, HBV, HCV and syphilis obtained in the random effects model was 3.0%, 6.0%, 4.0% and 3.0%, respectively. Moreover, being a male blood donor and aged between 25 and 44 years was significantly associated with HBV infection and being a female blood donor and aged 35 years and over was significantly associated with HIV infection. Family or replacement blood donors had a high infection burden for all four TTIs of study. The overall prevalence of transfusion-transmissible infections remains high in the country's blood banks. Improving current prevention (selection criteria) and screening strategies may be necessary in a global approach.

The Relationship Between the Budget Allocated to Health and the Density of Health Workers and Communicable Diseases in the Context of Sustainable Development Goals

Objective: The United Nations has set 17 goals under the title of "Sustainable Development Goals (SDGs)", and aimed to end the epidemics of AIDS, tuberculosis and combat hepatitis. Health care budgets and the number of health workers play an important role in preventing and treating these diseases. We aimed to examine the relationship between the budget allocated to health services (indicator SDG 1.a) and the number of health workers per population (indicator SDG 3.c) and the prevalence of HIV, tuberculosis and hepatitis B (indicator SDG 3.3). Materials and Methods: This is a descriptive correlational study. SDG indicator data were obtained from WHO's World Health Statistics 2022 report. Data from 194 countries were included. The relationships between SDG indicators were evaluated using Spearman correlation analysis and p

Projection of HIV prevalence among individuals aged 15-49 years in Chile using Holt’s double exponential smoothing model

Projection of HIV prevalence among individuals aged 15-49 years in Chile using Holt’s double exponential smoothing model

Trends in the prevalence of HIV, HCV, and co-infection and associated factors among young people who inject drugs (PWID) in Catalonia (2008–2019)

ABSTRACT People who inject drugs (PWID) face a significantly increased risk of blood-borne virus (BBV) infections, including HIV and hepatitis C virus (HCV), as well as co-infections. To better understand this issue, bio-behavioral surveillance studies were conducted among PWID attending harm reduction facilities in Catalonia, forming part of the comprehensive Integrated HIV/STI Surveillance System since 2008. The goal of this study was to describe the prevalence of HIV, HCV, and HIV-HCV coinfection and associated socio-demographic and behavioural factors among young PWID in Catalonia by gender and to examine trends over time, from 2008 to 2019. We first estimated the prevalence of HIV, HCV, and their co-infection and sample characteristics, and then, we calculated prevalence ratios (PR) and adjusted prevalence ratios (aPR) to identify the variables associated with HIV infection, HCV infection, and HIV-HCV co-infection. We found that the overall prevalence of HIV, HCV and HIV-HCV co-infection in 2019 was 20.1%, 66.2%, and 16.8%, respectively. In multivariable analysis, we found that being female (aPR: 1.55, 95% CI: 1.05–2.30), age (aPR: 1.09, 95% CI: 1.04–1.14), having born outside of Spain (aPR: 1.67, 95% CI: 1.19–2.34), homelessness (aPR: 1.90, 95% CI: 1.34–2.68), daily injection (aPR: 1.46, 95% CI: 1.04–2.04), sharing needles (aPR: 1.93, 95% CI: 1.32–2.82), involvement in sex work (aPR: 1.82, 95% CI: 1.09–3.03), and imprisonment (aPR: 2.54, 95% CI: 1.75–3.67) was associated with increased prevalence of HIV and HCV co-infection, while being a new injector (aPR: 0.64, 95% CI: 0.43–0.93) was associated with decreased prevalence. Overall, this research provides valuable insights into the risks and determinants of HIV and HCV co-infection among young PWID. The study’s findings contribute to the existing body of knowledge on blood-borne virus transmission in this population, informing evidence-based strategies for prevention and harm reduction.

Barriers and Facilitators That Influence HIV Pre-exposure Prophylaxis (PrEP)-Prescribing Behaviors Among Primary Care Providers in the Southern United States.

The Southern United States (US) bears the highest burden of HIV prevalence in the country, disproportionately affecting African American communities. Despite the proven efficacy of pre-exposure prophylaxis (PrEP) in reducing HIV transmission, its uptake remains suboptimal in this region. This study aimed to identify factors influencing PrEP-prescribing behaviors among primary care providers (PCPs) in the Southern USthrough the application of the transtheoretical model of behavior change. A cross-sectional survey was conducted among PCPs in 10 Southern states to assess their PrEP-prescribing practices, barriers, and facilitators. The results indicate that non-White PCPs and those practicing in urban and suburban settings are more likely to prescribe PrEP. Key barriers include lack of training, perceived stigma, and systemic issues such as health insurance coverage and time constraints. Significant facilitators are access to prescribing resources, streamlined insurance procedures, and patient motivation. Targeted educational programs and policy changes to address these barriers can enhance PrEP uptake, thereby reducing HIV transmission in high-risk populations. The findings underscore the need for tailored interventions to support PCPs in integrating PrEP into routine care, ultimately contributing to better public health outcomes in the Southern US.

Current Trends in HIV Prevalence and Incidence in Uganda: Analyzing Regional Disparities and Progress Toward Targets

HIV/AIDS remains a critical public health issue in Uganda, characterized by significant regional disparities in prevalence and incidence rates. Despite substantial progress in the fight against HIV, understanding the current trends in HIV prevalence and incidence is essential for effective intervention and resource allocation. This review article aims to analyze the latest trends in HIV prevalence and incidence across different regions of Uganda, exploring the factors contributing to regional disparities and evaluating the country’s progress towards achieving national and global health targets. By synthesizing recent data, examining trends over time, and discussing the implications of these trends for public health strategies, this review provides a comprehensive overview of the current state of HIV in Uganda and offers insights for future policy and intervention efforts. Keywords: HIV prevalence, HIV incidence, regional disparities, Uganda, public health interventions

A prospective epidemiological investigation of human leukocyte antigen-B*57:01 in HIV-1-infected Moroccan subjects

BackgroundThe occurrence of hypersensitivity reactions to abacavir, a significant adverse effect, affects approximately 5–8% of Caucasians. Multiple studies conducted in diverse populations have underscored the association between Human Leukocyte Antigen-B*57:01 and abacavir-hypersensitivity reactions. In late 2021, the Moroccan National AIDS Program issued new anti-retroviral therapy protocols for HIV management, including abacavir as an option for the first-line ART regimen. However, data regarding the HLA-B*57:01 prevalence of HIV in Morocco is scarce. This study aims to assess the prevalence of HLA-B*57:01 in both HIV-1-infected children and adults in Morocco. MethodsFrom April to December 2022, we screened 292 HIV-1 infected patients, 70 children and 222 adults, for the HLA-B*57:01 allele using sequence-specific oligonucleotide probes reverse hybridization method. The flow cytometry was used to assess the TCD4 lymphocyte count. The virological status was evaluated using quantitative real-time PCR. Sanger sequencing is under process to confirm the results obtained. ResultsOf 292 HIV-1-infected patients, 12 (4.1%) had the HLA-B*57:01 allele (95% CI, 2.1–7.1). 5 of 70 (7.2%) and 7 of 222 (3.2%) of children and adults were respectively, HLA-B*57:01 positive. There was no statistical association between clinical characteristics (TCD4 cell count and VL) and HLA-B*57:01 allele carriage. ConclusionThe prevalence of HLA-B*57:01 in Moroccan patients was 4.1%, comparable with that of other Middle Eastern populations, higher than that in South African populations but lower than that in Caucasians and Southwest Asians. Our findings indicate an urgent need for HLA-B*57:01 screening before abacavir to reduce the risk of hypersensitivity reactions.

Premium Calculations with Long Term Care Insurance using Markov Chain Method for Human Immunodeficiency Virus Inpatients

&lt;strong&gt; &lt;/strong&gt;Indonesia has a high prevalence of HIV, which is inversely proportional to its insurance product propolis. Life insurance offers economic protection by providing payment upon the death of the policyholder. Long Term Care (LTC) insurance, a type of health insurance, guarantees care and health insurance for the elderly. This study calculates LTC insurance premiums with annuities as rider benefits using a multi-status model that includes health status, HIV, and death. Using Markov Chain modeling and data from Malang city in 2022, we determine the premium based on transition probabilities. This case study involves a 20-year-old man with 5 years of LTC coverage, a benefit value of IDR100,000,000, and an interest rate of 5%. The premium varies by age and gender: at age 20, male pay Rp 2,719,241 and female Rp 2,701,893, at age 21, male pay Rp. 5,762,095 and female pay Rp.5,746,178. At age 22, male pay at Rp. 6,203,680 and females pay Rp.6,189,454 while at age 23, male pay Rp. 6,640,674 and females pay 6,628,146. And male at 24, pay Rp. 7,066,949 while females pay Rp. 7,012,138 and at age 25, male pay Rp 7,068,616 and females Rp 7,029,781. The results of this calculation show that the more age increases, the greater the net premium and also the male net premium is greater than the female net premium

Causes of pre and post-donation deferrals among blood donors, at Kwale Satellite Blood Transfusion Center, Kwale County, Kenya, 2018–2022

BackgroundBoth pre-donation and post-donation deferrals pose challenges to blood safety and availability. This study delved into the deferral rates before donations and their underlying reasons, as, transfusion transmissible infections (TTIs) leading to post-donation deferrals among potential blood donors at the Kwale Satellite Blood Transfusion Centre (KSBTC) in Kenya.MethodsWe performed a retrospective electronic record review of pre- and post-donation deferrals among blood donors at KSBTC, 2018–2022. The pre-donations deferral rate and reasons for deferral were analyzed. Accepted donations were analyzed to determine the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis. Descriptive statistics were calculated and both crude odds ratio (COR) and adjusted odds ratio (AOR), and their 95% confidence intervals (CI) were calculated. Variables with p < 0.05 were considered statistically significant.ResultsA review was conducted on 12,633 blood donation records. Among these, individuals 2,729/12,633 (21.60%) were deferred from donating with the primary reason being low hemoglobin levels, constituting 51.86% of deferrals. Around 773/9,904 (7.80%) of blood units, were discarded due to at least one TTI. Among these, HBV accounted for 4.73%, HIV for 2.01%, HCV for 1.21%, and Syphilis for 0.59% of cases. The adjusted odds ratio for male donors were, (aOR = 1.3, 95% CI 1.01–1.57), donors with none or primary education level (aOR = 1.4 95% CI 1.11–1.68), first-timer donors (aOR = 1.2, 95% CI 1.01–1.44), and static strategy for blood collection (aOR = 1.4, 95%CI 1.12–1.63) were independently potentially associated with testing positive for at least one TTI.ConclusionThe study indicates that TTIs continue to pose a risk to the safety of Kenya’s bloodstock, with a notable prevalence of HBV infections. Male donors, individuals with limited education, first-time donors, and utilizing a fixed strategy for blood collection were identified as potential risk factors independently associated with TTIs.