Prevention Of Human Immunodeficiency Virus Transmission Research Articles

Characteristics of men who have casual sex with men among Chinese university students: A cross-sectional study.

The characteristics of men who have sex with men (either exclusively or with both men and women; MSM) who engaged in casual sex among Chinese male university students have not been compared with the characteristics of men who have sex with only women (MSW). This information is important for tailoring targeted behavioral interventions to prevent human immunodeficiency virus (HIV)/sexually transmitted infection (STI) transmission in this subgroup of MSM. Data were derived from a large cross-sectional electronic questionnaire survey conducted at 13 universities in Zhejiang Province, China, in 2018. Bivariate analyses were used to compare demographic, HIV-related psychosocial, and behavioral characteristics between MSM and MSW students who engaged in casual sex during the previous year. Proportion differences between the two groups and their 95% confidence intervals were analyzed. Among the 583 sexually active male students who engaged in casual sex during the previous year, 128 and 455 were MSM and MSW, respectively. Compared with MSW students, larger proportions of MSM students reported knowing that male-to-male sexual behavior was the main mode of HIV transmission among Chinese students (62.5% vs. 45.5%), consenting to commercial sex (67.2% vs. 53.4%), wanting to know the HIV serostatus of partners before casual sex (65.8% vs. 51.3%), feeling at risk of HIV infection (40.5% vs. 11.8%), high condom-decision scale scores (55.3% vs. 42.6%), engaging in sex with ≥ 5 casual sex partners (44.6% vs. 25.9%), searching for casual partners online (89.2% vs. 51.3%), consuming alcohol before casual sex (64.8% vs. 45.0%), engaging in sex with regular partners (83.1% vs. 67.0%), engaging in commercial sex (54.2% vs. 26.4%), and visiting a clinic for voluntary counselling and testing (VCT) (16.4% vs. 8.4%). However, compared with MSW students, smaller proportions of MSM students reported knowing that consistent condom use could prevent HIV transmission (80.5% vs. 95.2%) and that VCT should be actively sought after risky sexual behavior (78.9% vs. 93.8%), using condoms sometimes/often (26.4% vs. 44.3%), and consistently using condoms (28.9% vs. 40.1%) while engaging in sex with casual partners. MSM students who engaged in casual sex were at a greater risk of HIV/STI transmission, compared with MSW students. Comprehensive interventions to address the risks of unprotected male-to-male sex, searching for casual sex partners online, and non-use of HIV testing services are needed to reduce the burden of HIV/STI transmission among this subgroup of MSM.

Prevention and infection control of HIV infection and AIDS

Background: Although the global incidence of human immunodeficiency virus (HIV) has decreased significantly since modern antiretroviral therapy (ART), new HIV infections steadily occur, in the Republic of Korea. Based on the understanding of the risk factors for HIV infection, combined strategic behavioral and biomedical interventions should be implemented to reduce HIV infection. This paper reviews the strategies for the prevention of HIV infection.Current Concepts: While the consistent use of latex condoms is effective for the prevention of HIV transmission, consistent use of condoms is low among sexually active individuals. ART can be initiated, after exposure, to prevent HIV infection (post-exposure prophylaxis) after occupational or sexual exposure, injection drug use, and other nonoccupational exposures to HIV. There is a negligible risk of sexual transmission of HIV when the HIV-infected sexual partner has durably suppressed viral replication with ART. Antiretroviral agents have been shown to be highly effective when administered prophylactically to HIV-uninfected but at-risk individuals (preexposure prophylaxis). A high-risk group, such as men who have sex with men, is required to be included in health insurance care benefits for pre-exposure prophylaxis, in addition to the current partners of HIV-infected individuals, to ensure its efficacy.Discussion and Conclusion: HIV-related deaths are rapidly decreasing, but new HIV infections continue to occur. In an environment where a cure or the development of vaccines is unlikely, a multifaceted and proactive approach is required to minimize new HIV infections.

Unravelling the experiences of incarcerated individuals living with HIV on ART: a qualitative study in Ghanaian prisons

PurposeThe Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.Design/methodology/approachThe study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.FindingsThree themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.Originality/valueThrough first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

Psychosocial distress patterns among key populations living with HIV in Nigeria

Abstract Background: The human immunodeficiency virus (HIV) continues to pose a substantial public health challenge in Nigeria, particularly affecting key populations due to various factors such as diminished risk perception, engaging in risky sexual and behavioral practices, stigma, discrimination, and legal barriers. Recognizing and addressing the mental health and psychosocial needs (MHPN) of HIV-positive key populations are essential for implementing tailored interventions and ensuring comprehensive care, aligning with the Joint United Nations Program on HIV and AIDS (UNAIDS) goal of ending acquired immune deficiency syndrome (AIDS) by 2030. Materials and Methods: This retrospective observational study was conducted among key populations (KPs) living with HIV who were enrolled in care at 17 one-stop shop (OSS) facilities operated by Heartland Alliance LTD/GTE across six states in Nigeria. The assessment tool used was the HALG Mental Health Screening Form III (MHSF-III). The study population consisted of diverse KPs enrolled in OSS facilities across six Nigerian states. Data analysis was performed using IBM-SPSS version 28. Results: The study revealed varying levels of MHPN among HIV-positive vital populations, with sex partners (8.9%), prisoners (7.1%), and female sex workers (6.1%) showing the highest prevalence. Among participants aged below 20, the need was most pronounced (10.7%). Female participants had increased odds (AOR = 2.072) of experiencing MHPN, as did individuals with sexual partners (AOR = 1.591), a history of drug/alcohol use (AOR = 10.458), and exposure to gender-based violence (AOR = 7.733). All respondents received brief interventions, with 69.3% being referred for further psychosocial support and 47.6% ultimately receiving specialized mental health intervention. The majority of participants preferred in-person counseling (72.7%) and a single session (74.0%), and most displayed mild confirmation outcomes (86.8%). Conclusion: The results highlight the importance of tackling the mental health obstacles encountered by these vulnerable groups to prevent HIV transmission and ensure comprehensive care. To enhance the well-being of these populations in Nigeria, policymakers and healthcare providers should prioritize integrated care and support services. Lastly, future research in this domain should concentrate on conducting long-term studies to monitor the mental health trajectories of HIV-positive key populations thoroughly.

Measures to improve participation of registered nurses in HIV and AIDS research.

Registered nurses are crucial in lowering the complications of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Nigeria. Human immunodeficiency virus infects individuals and impairs the immune system, impairing the body's capacity to fight bacteria, viruses, and other pathogens. Therefore, registered nurse-led initiatives are beneficial in promoting HIV and AIDS research development. However, these evidence-based treatments and professional expectations for registered nurse research creation do not represent contemporary research development on HIV and AIDS by registered nurses. This study aimed to explore measures to improve the participation of registered nurses in HIV and AIDS research in Nigeria. The study was conducted at a general hospital in Ijebu Ode, Ogun State, Nigeria. A qualitative approach design was employed. Participants of the study comprised 31 registered nurses in three focus groups. This study demonstrated the importance of research in effectively reducing HIV and AIDS transmission and maintaining good practices in a hospital setting in Nigeria. However, this understanding did not translate into knowledge creation through autonomous research productivity in this context. The study discovered that registered nurses were primarily involved in data collection and validation, which did not result in publications. The study found that registered nurses in Nigeria are typically worried about ways to promote nurses' engagement in research in Nigeria. These results might be utilised to improve the supply of research services and act as a baseline for future research linked to HIV and AIDS transmission prevention in Nigeria.

Compliance to Viral Load Monitoring Schedules Among Women Attending Prevention of Vertical HIV Transmission Services Before and During the COVID-19 Pandemic in Ehlanzeni District, Mpumalanga, South Africa

Human immunodeficiency virus (HIV) viral load (VL) monitoring was likely interrupted during the Coronavirus disease 2019 (COVID-19) pandemic. We used routine data on repeat VL testing among 667 prevention of vertical HIV transmission (PVT) clients in Ehlanzeni district, to determine compliance to VL testing recommendations and associated factors during different time periods: pre-COVID-19, transition, and COVID-19. Descriptive and multivariable Poisson regression analyses were conducted, with and without including revised PVT-guidelines rolled out in January-2020. Among 405 women with ≥ 2 VL tests, the overall median age was 30 years (interquartile range: 26–35 years). Compliance to recommended VL testing guidelines ranged between 81.5% (172/211) and 92.3% (191/207) at different time periods. Across all three periods and when revised PVT-guidelines were used, being compliant was significantly reduced among those with earliest VL = 50–999 copies/ml (incidence rate ratio (IRR) = 0.71 [95% confidence interval (CI) 0.61–0.82], p value < 0.001) and VL ≥ 1000 copies/ml (IRR = 0.18 [95% CI 0.09–0.36], p value < 0.001). When guideline revisions were excluded, compliance was only significantly reduced among those with VL ≥ 1000 copies/ml (IRR = 0.14 [95% CI 0.06–0.32], p value < 0.001) and increased during the COVID-19 period versus pre-COVID-19 (IRR = 1.10 [95% CI 1.05–1.15], p value < 0.001). Similar significant associations between compliance and VL level were observed when the COVID-19 period was analyzed separately. Significantly increased compliance to VL testing among the 25–34 years age-group versus younger women was also observed across all periods. These results highlight the importance of strengthening strategies such as short message service reminders and educational messaging, reaching all age-groups, to fast-track implementation targets for VL monitoring.

Bayesian Spatial Modelling of HIV Prevalence in Jimma Zone, Ethiopia.

Background: Although the human immunodeficiency virus (HIV) is spatially heterogeneous in Ethiopia, current regional estimates of HIV prevalence hide the epidemic's heterogeneity. A thorough examination of the prevalence of HIV infection using district-level data could assist to develop HIV prevention strategies. The aims of this study were to examine the spatial clustering of HIV prevalence in Jimma Zone at district level and assess the effects of patient characteristics on the prevalence of HIV infection. Methods: The 8440 files of patients who underwent HIV testing in the 22 Districts of Jimma Zone between September 2018 and August 2019 were the source of data for this study. The global Moran's index, Getis-Ord Gi* local statistic, and Bayesian hierarchical spatial modelling approach were applied to address the research objectives. Results: Positive spatial autocorrelation was observed in the districts and the local indicators of spatial analysis using the Getis-Ord statistic also identified three districts, namely Agaro, Gomma and Nono Benja, as hotspots, and two districts, namely Mancho and Omo Beyam, as coldspots with 95% and 90% confidence levels, respectively, for HIV prevalence. The results also showed eight patient-related characteristics that were considered in the study were associated with HIV prevalence in the study area. Furthermore, after accounting for these characteristics in the fitted model, there was no spatial clustering of HIV prevalence suggesting the patient characteristics had explained most of the heterogeneity in HIV prevalence in Jimma Zone for the study data. Conclusions: The identification of hotspot districts and the spatial dynamic of HIV infection in Jimma Zone at district level may allow health policymakers in the zone or Oromiya region or at national level to develop geographically specific strategies to prevent HIV transmission. Because clinic register data were used in the study, it is important to use caution when interpreting the results. The results are restricted to Jimma Zone districts and may not be generalizable to Ethiopia or the Oromiya region.

Utilization of antiviral for HIV prevention

Acquired immunodeficiency disease syndrome (AIDS) and AIDS-related illnesses continue to cause a public and economic burden on any given community. Different preventive strategies have been reported, which vary in their effectiveness and safety to limit human immunodeficiency virus (HIV) transmission, the causative virus of AIDS. Antiretroviral therapy (ART) is the main agent used for HIV treatment, and it has been used as a prevention method, or prophylaxis, to prevent HIV transmission. This review was conducted to evaluate clinical trials, and updated recommendations for preventing HIV infection for individuals at risk using ART. We reviewed the literature, and six studies responded to our inclusion criteria. Most of the recent studies that used ART seemed effective in preventing HIV infection among seronegative individuals. Further studies on a larger and different population are recommended to ensure the best preventive methods against HIV.

The Influencing Factors of HIV-Preventive Behavior Based on Health Belief Model among HIV-Negative MSMs in Western China: A Structural Equation Modeling Analysis.

(1) Background: Men who have sex with other men (MSMs) are at high risk of being infected by the human immunodeficiency virus (HIV) in western China. Pre-exposure prophylaxis (PrEP) is an efficient way to prevent HIV transmission. However, adherence is the most vital determinant factor affecting PrEP effectiveness. We conducted a study based on the Health Belief Model to explore factors that predict adherence to PrEP among a cohort of 689 MSMs in western China. (2) Methods: We assessed perceived susceptibility, severity, benefits, barriers, self-efficacy, cues to action, and HIV-preventive behavior through a cross-sectional survey. (3) Results: PrEP self-efficacy was directly associated with PrEP behaviors (β = 0.221, p < 0.001), cues to action were directly associated with PrEP behaviors (β = 0.112, p < 0.001), perceived benefits were directly associated with PrEP behaviors (β = 0.101, p < 0.001), and perceived susceptibility was directly associated with PrEP behaviors (β = 0.117, p = 0.043). (4) Conclusion: Medication self-efficacy, perceived susceptibility, and cue to action structures are predictors of the MSMs’ HIV-preventive behavior in western China. These results will provide theoretical plans for promoting PrEP adherence in MSMs.

MRNA-based vaccine technology for HIV.

Human immunodeficiency virus (HIV) poses a major health problem around the globe, resulting in hundred-thousands of deaths from AIDS and over a million new infections annually. Although the standard treatment of HIV infection, antiretroviral therapy, has proven effective in preventing HIV transmission, it is unsuitable for worldwide use due to its substantial costs and frequent adverse effects. Besides promoting HIV/AIDS awareness through education, there is hardly an alternative for inhibiting the spread of the disease. One promising approach is the development of an HIV vaccine. Unfortunately, the high variability of envelope proteins from HIV subtypes, their frequency of mutation and the lack of fully understanding the mechanisms of protection against the virus constitute an obstacle for vaccine development. Efforts for developing successful anti-HIV vaccines have been underway for decades now, with little success. Lately, significant progress has been made in adopting the novel mRNA vaccine approach as an anti-HIV strategy. mRNA vaccines received a great thrust during the COVID-19 pandemic. Now, several mRNA-based HIV vaccines are undergoing clinical trials to evaluate their safety and efficacy. This review offers an overview of the pathogenesis and treatment of HIV / AIDS, previous efforts of HIV vaccine development and introduces mRNA vaccines as a promising and potential game changing platform for HIV vaccination.

Magnitude of dual contraceptive method utilization and the associated factors among women on antiretroviral treatment in Wolaita zone, Southern Ethiopia

BackgroundExpanding the contraceptive options based on desires of families and personal context is critical to address the needs of users. For instance, dual contraceptive methods were recommended for people with the human immunodeficiency virus (HIV) patients to prevent HIV transmission, other sexually transmitted infections (STIs), and unintended pregnancies. Disclosure is one of the strategies to reduce the stigma related to HIV and use of contraception clandestinely. However, there is a dearth of evidence regarding the magnitude of and the factors affecting dual contraceptive method utilization among sexually active women on antiretroviral treatment (ART).There is limited evidence regarding the association between disclosure to community and dual contraceptive utilization. Thus, the aim of this study is to assess the magnitude of dual contraceptive utilization and its associated factors among ART patients in this study area. Objectivethe primary objective of this study was to assess the prevalence of the dual contraceptive use. MethodsA facility-based cross-sectional study design was employed to collect data from a total of 556 respondents by using a semi-structured questionnaire. Data were entered in EpiData version 3.1 and exported to SPSS version 20 for analysis. Binary logistic regression was applied to determine the magnitude of dual contraceptive utilization and the factors associated with it. Variables with p-value<0.25 were considered as candidate for multivariable logistic regression. In multivariate logistic regression, variables with a p-value < 0.05 were reported to be statistically significant. ResultThe magnitude of dual contraceptive utilization was 28.6% (95%CI: 24.8, 32.4). HIV sero-status disclosure to community (AOR:7.1 (95%CI: 4.8,10.2)), disclosure to sexual partners (AOR:3.1 (95%CI:1.2,7.8)), sexual activity (AOR: 4.7 (95%CI: 2.5, 10.0)), fertility desire (AOR:4.3 (95%CI:2.4,7.5)), history of STI (AOR: 3.2 (95%CI: 1.6, 6.6)), partners’ sero-HIV status (AOR:3.7 (95%CI:1.7,8.1)), and discussion with sexual partners about dual contraceptive methods (AOR:5.8 (95%CI:2.2,8.5)) were significantly associated with dual contraceptive utilization. ConclusionThis study found that a substantial number of mothers did not use dual contraceptive methods. Disclosure to community increases the use of dual contraceptive methods. Integrating the family planning with STI and ART care, strengthening the partner involvement during posttest counseling is recommended to increase the uptake of dual contraceptive methods utilization. Moreover, encouraging PLWHIV to disclose their HIV status to the community should be advocated.

Frequently Transmission and Close Relationship Among Immigrants in the China-Myanmar Border Region Indicated by Molecular Transmission Analysis From a Cross-Sectional Data.

BackgroundAccurate identification of molecular transmission clusters (MTCs) and understanding the dynamics of human immunodeficiency virus (HIV) transmission are necessary to develop targeted interventions to prevent HIV transmission. We evaluated the characteristics of antiretroviral therapy-naïve individuals who belonged to HIV-1 MTCs in the China–Myanmar border region to inform targeted effective HIV intervention.MethodsPhylogenetic analyses were undertaken on HIV-1 pol sequences to characterize subtypes or circulating recombinant forms and identify MTCs. MTCs were defined as those with 2 or more sequences having bootstrap support > 80% and a pairwise gene distance less than or equal to 0.03. Factors correlated with MTCs were evaluated using logistic regression analysis. The chi-square test was used to compare differences between Chinese and Burmese participants belonging to MTCs.ResultsA total of 900 people had their pol gene successfully sequenced. Twenty-one MTCs were identified and included 110 individuals (12.2%). Individuals in MTCs were more likely to be Burmese [aOR = 2.24 (95% CI: 1.33, 3.79), P = 0.003], be younger [aOR = 0.34 (95% CI: 0.20, 0.58), P < 0.001 for age 26–50 vs. 25 years or younger], have a lower CD4 T cell count [aOR = 2.86 (95% CI: 1.34, 6.11), P = 0.007 for < 200 vs. 350 or greater], and have subtypes CRF07_BC or C [CRF07_BC: aOR = 7.88 (95% CI: 3.55, 17.52), P < 0.001; C: aOR = 2.38 (95% CI: 1.23, 4.62), P = 0.010 compared to CRF01_AE]. In MTCs, Burmese were younger (89.7 vs. 57.7% for age 25 years or younger), had a lower education level (41.0 vs. 8.5% for illiterate), were more likely to be infected through injection drug use (35.9 vs. 12.7%), and had a higher proportion of subtype BC (33.3 vs. 15.5%) and CRF01_AE (20.5 vs. 8.5%) compared to Chinese (P < 0.05 for all).ConclusionBurmese participants were more likely to belong to MTCs, and most MTCs had both Burmese and Chinese participants. These data highlight the bidirectional transmission of HIV-1 frequently transmission and close relationship among immigrants in the China–Myanmar border region. Local health departments should pay more attention to HIV screening and intervention to immigrants Burmese with the characteristics of younger age, having lower CD4 T cell count and infected with HIV subtypes CRF07_ BC or C.

"We just do it … we are dead already": Exploring the sexual behaviors of youth living with HIV.

This study aims to describe the sexual behaviors of youth living with human immunodeficiency virus (HIV) in Malawi. As a high-risk population, understanding the contextual factors that shape their sexual behaviors is of particular interest when designing strategies to reduce HIV transmission. Semi-structured qualitative interviews were used to collect information about sexual behaviors from 22 youth (12 females and 10 males) living with HIV aged from 15 to 24 years. All participants were recruited from a specialized HIV clinic in Malawi. Thematic analysis was applied to identify current themes. The majority of participants were sexually active. Engaging in sexual behaviors was largely related to social processes identified in three main themes: (1) Risk-taking in pursuit of confidence and maturity; (2) A lack of voice in decision making concerning practising safe sex; (3) Perceived barriers to safe sex practice such as poverty, dropping out of school, and personal perspectives about transmitting HIV to others. Our results suggest that prevention strategies targeting youth social and economic vulnerabilities to social influences are needed to enhance their personal and social skills. We suggest nurturing cultural and religious ceremonies and involving elders to equip youth with skills and knowledge for the prevention of HIV transmission.

HIV/AIDS IN ROMANIA – A SHORT HISTORY AND UPDATE, 2021

"Human immunodeficiency virus (HIV) poses a medical, social, and economic problem. In Romania since 2002, the prevention of HIV transmission and the care for HIV-positive people have been overseen by Governmental Law. HIV infection in Romania has some particularities, such as the high number of HIVinfected patients under treatment and the high percentage of long-term survivors. Romania reported its first case of AIDS to the World Health Organization in 1985, and its first case in the pediatric population in 1989. A year later, a new case definition, based on local possibilities was formulated together with the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC, Atlanta, GA). According to the latest report of the Compartment for Monitoring and Evaluation of HIV/AIDS in Romania, the cumulative number of HIV cases registered between 1985-2021 was 26,171, while the number of people living with HIV at the end of December 2021 was 17,271. Keywords: HIV, AIDS, public health surveillance"

Knowledge, attitude and behavior study on HIV awareness among continuous rotatory residential interns and postgraduates

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Human immunodeficiency virus (HIV) that leads to Acquired immunodeficiency syndrome (AIDS) is transmitted mainly by sexual contact and exposure to infected blood. Healthcare workers (HCWs) such as Continuous rotatory residential interns (CRRIs) and postgraduates are at risk of acquiring HIV infection, primarily due to exposure to infected blood. The chances of infection depend on occupation, procedures performed, and use of preventive measures. The aim of the study was to access and compare knowledge, attitude and behavior about HIV awareness among CRRIs and Postgraduates.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A cross sectional survey of 80 CRRIs and 80 postgraduates from Sree Balaji Medical College and Hospital was taken. A self-administered questionnaire was made and information regarding age, gender, knowledge about HIV, attitude and behavior towards HIV positive individual was gathered and compared between CRRIs and postgraduates. The data was compared and analyzed.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The results of the study revealed that postgraduates had better knowledge about routes of transmission of HIV compared to CRRIs. However, knowledge about preventive guidelines, vaccines and prophylaxis have to be improved by both postgraduates and CRRIs. Attitude towards HIV affected individual was positive. Behavior and practices followed to prevent HIV transmission have to be improved.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; HIV is an occupational hazard among HCWs. Appropriate knowledge about HIV is important. Attitude towards HIV infected individual plays an important role as it determines the care of the patient. Practicing standard guidelines while phlebotomy prevents the infection.&lt;/p&gt;

Changing the PrEP Narrative: A Call to Action to Increase PrEP Uptake among Women

Although the incidence of new cases of human immunodeficiency virus (HIV) has decreased in the past decade, in 2018 more than 7000 women with HIV were diagnosed in the United States (US). Globally, per recent reports, 48% of the new HIV infections were among women. There is still no vaccine to prevent HIV transmission. However, pre-exposure prophylaxis (PrEP) was approved in 2012 by the Food and Drug Administration, providing a powerful tool to block HIV infection and help prevent the subsequent development of acquired immunodeficiency syndrome (AIDS). The uptake of PrEP has been slow globally and among the most vulnerable populations in the US, even though the Centers for Disease Control (CDC) recommended its use in high-risk populations, including women. Furthermore, women represent one-quarter of people living with HIV in the US; however, PrEP is underutilized in this group. Thus, it is imperative to make women’s voices heard through conducting more research, ensuring sufficient access to PrEP, and enhancing knowledge about PrEP as a viable prevention strategy for women. This article aims to promote women’s health by changing the narrative, providing key information on empowering women, and increasing the usage of PrEP.

Trends in HIV pre-exposure prophylaxis use in eight Canadian provinces, 2014-2018.

: Canada has endorsed the Joint United National Programme on HIV and AIDS global targets to end the acquired immunodeficiency syndrome (AIDS) epidemic, including reducing new human immunodeficiency virus (HIV) infections to zero, by 2030. Given the effectiveness of pre-exposure prophylaxis (PrEP) to prevent new infections, it is important to measure and report on PrEP utilization to help inform planning for HIV prevention programs and policies. : Annual estimates of persons using PrEP in Canada were generated for 2014-2018 from IQVIA's geographical prescription monitor dataset. An algorithm was used to distinguish users of tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for PrEP versus treatment or post-exposure prophylaxis. We provide the estimated number of people using PrEP in eight Canadian provinces by sex, age group, prescriber specialty and payment type. : The estimated number of PrEP users increased dramatically over the five-year study period, showing a 21-fold increase from 460 in 2014 to 9,657 in 2018. Estimated PrEP prevalence was 416 users per million persons across the eight provinces in 2018. Almost all PrEP users were male. Use increased in both sexes, but increase was greater for males (23-fold) than females (five-fold). Use increased across all provinces, although there were jurisdictional differences in the prevalence of use, age distribution and prescriber types. : The PrEP use in Canada increased from 2014 to 2018, demonstrating increased awareness and uptake of its use for preventing HIV transmission. However, there was uneven uptake by age, sex and geography. Since new HIV infections continue to occur in Canada, it will be important to further refine the use of PrEP, as populations at higher risk of HIV infection need to be offered PrEP as part of comprehensive sexual healthcare.

Assessing the effectiveness of prevention of mother-to-child HIV transmission

Aim. To analyze the outcomes of a set of interventions to prevent vertical transmission of the human immunodeficiency virus (HIV) in the Republic of Mari El.&#x0D; Methods. A retrospective analysis of temporary registration forms Notifications of the termination of pregnancy in an HIV-infected woman and Notifications of a newborn born by an HIV-infected mother, case histories and outpatient medical records of HIV-infected women who gave birth in 20002018 was carried out. The study included all children born in the Republic of Mari El to HIV-positive women registered with the Republican Center for the Prevention and Control of AIDS and Infectious Diseases, as well as children whose HIV status is detected after birth as a result of epidemiological investigations. The assessment of the risks of transmission as an outcome of the three-step preventive interventions has been carried out. A comparative analysis of the results of perinatal prevention of HIV transmission in the Republic of Mari El and other regions of the Russian Federation was performed.&#x0D; Results. A total of 299 HIV-infected pregnant women and 368 children born to these women during the study period were registered in the region; 63 (21.7%) of these women had more than one child. Over the entire study period, 18 (4.8%) children with confirmed HIV infection were registered. The most common factor associated with infant HIV infection is late maternal HIV diagnosis: (1) several years after childbirth in the absence of antiretroviral (ARV) prophylaxis and the infants were breastfeeding (11 cases, 64.7%); (2) during or shortly after childbirth, when the patient did not receive entire three-step antiretroviral prophylaxis during pregnancy and childbirth (6 cases, 29.4%); (3) in the third trimester of pregnancy (1 case, 5.5%). An important limitation for the successful prevention of vertical transmission of HIV was the lack of routine HIV testing, which is required by women and their partners before and at various stages during pregnancy. A single case of self-infection indicates the need to introduce preventive measures from early adolescence among children.&#x0D; Conclusion. Due to the late maternal HIV diagnosis, during or after delivery, HIV transmission events occurred either with limited or no limited antiretroviral prophylaxis.

AUTOEFICACIA PARA PREVENIR EL VIH Y PRÁCTICAS SEXUALES EN ESTUDIANTES DE UN BACHILLERATO DE CHIHUAHUA, MÉXICO

El Virus de Inmunodeficiencia Humana (VIH) es un problema de salud pública que afecta principalmente a los jóvenes, en México la principal vía de transmisión es a través de las relaciones sexuales, por lo cual, es importante conocer que factores pueden influir para que los jóvenes tengan prácticas sexuales seguras y prevenir esta enfermedad. Objetivo. Determinar la influencia de la autoeficacia para prevenir el VIH en las prácticas sexuales seguras en jóvenes de Chihuahua, México. Método. Se llevó a cabo un estudio transversal y correlacional, en el cual participaron 115 jóvenes. Se utilizó un muestreo probabilístico, aleatorio simple. Para las mediciones se utilizaron dos escalas y un cuestionario para los datos sociodemográficos y de sexualidad. Resultados. La autoeficacia para prevenir el VIH influyó en las prácticas sexuales seguras, (β= .313, IC 95%= .176-.445, p= .001), a mayor autoeficacia para prevenir el VIH, mayores serán las prácticas sexuales seguras. Conclusión. Los jóvenes con niveles más altos de autoeficacia para prevenir el VIH tienen mayor posibilidad de llevar a cabo prácticas sexuales seguras. Los resultados podrían ser de utilidad en la creación de intervenciones enfocadas a mejorar la autoeficacia de los jóvenes para prevenir la transmisión del VIH.

Use of Antiretroviral Therapy for a US Medicaid Enrolled Pediatric Cohort with HIV.

Appropriate antiretroviral therapy use in children with Human Immunodeficiency Virus (HIV) is essential for optimizing clinical outcomes and preventing HIV transmission. To describe and determine correlates of HIV antiretroviral therapy (ART) persistence and implementation for children and adolescents in the United States. We studied Medicaid enrollees (ages 2-19years) with HIV in 14 states in 2011 and 2012. We defined non-persistence as a discontinuation of an ART regimen for at least 90days, and calculated implementation as the proportion of days on ART while persistent. We used Cox proportional regression and logistic regression to determine characteristics associated with ART non-persistence and poor (< 90%) implementation, respectively. Among those with ≥ 1year of observation (n = 8679), 55.7% never received ART. For ART recipients (n = 3849), 34.9% discontinued ART. Correlates of ART non-persistence included older age (e.g., 15-19 vs. 2-5years [adjusted hazard ratio (aHR) 2.9, 95% CI 2.1-4.0]; females vs. males (aHR 1.2; 1.1-1.3); mental health conditions (aHR 1.3; 1.1-1.5), drug/alcohol abuse (aHR 1.2; 1.0-1.5) and HIV-related conditions (aHR 1.2; 1.0-1.4). Those with an outpatient visit were less likely to discontinue an ART (aHR 0.32; 0.28-0.36). During persistent episodes, 42.3% had poor ART implementation. Correlates of poor implementation included females vs. males (aOR 1.2; 95% CI 1.0-1.3), Black vs. White race (aOR 1.3; 95% CI 1.1-1.7) and Hispanic/Latino vs. White (aOR 1.3; 1.0-1.8). Among Medicaid youth with HIV, there were low rates of ART exposure, and ART discontinuation was common. Correlates of persistence and implementation differed, suggesting a need for varying clinical interventions to improve connection to care and ensuring ongoing engagement with ART use.