Prevention Of Sexual Transmission Research Articles

Rising HIV seroconversion rates & associated risks among employees of organization 'X': A case control study, Pakistan, 2017.

Background and Objectives:In 2004 Pakistan escalated from ‘low-prevalence’ to ‘concentrated’ phase of HIV epidemic. Despite global decline in HIV incidence since 1997, rate of HIV infections in Pakistan is persistently rising since 1990. Available literature focusses on key populations or localized outbreaks limited by short study duration and regional applicability of results. We studied HIV seroconversion trends over a period of 8 years in a geographically diverse population and evaluated associated risk factors.Methods:A desk review of HIV surveillance data from 2010 to 2017 was carried out at Armed Forces Institute of Pathology. A case was defined as any adult employed in organization ‘X’, initially screened for HIV but later seroconverted on ELISA and western blot. Case-control study was conducted on cases diagnosed in 2017. Age and sex matched controls were identified from same population sub-group. Structured telephonic interviews were conducted and statistical analysis done at 5% margin of error.Results:The annual HIV diagnosis rate remained relatively stable till 2015 (< 40 /100,000/yr) after which it rose sharply to 60/100,000/yr in 2016 .Upward trend continued in 2017 to reach 125/100,000/yr (>200% increase from baseline). Acquisition of HIV was significantly associated with commercial sex activities (OR=9; 95% CI: 1.25-395).Conclusion:HIV seroconversion rates among employees of organization X have increased significantly in the past two years. Unlike HIV outbreaks previously reported from Pakistan, sexual route seems to be the predominant mode of transmission. Focus is mandated on prevention of sexual transmission of HIV at national level as well for all vulnerable populations.

Congenital Zika syndrome arising from sexual transmission of Zika virus, a case report

BackgroundSexual transmission of Zika virus is well documented and pregnant women are advised to abstain or use barrier protection if a sexual partner has risk for Zika infection. However, to date there has not been a documented case of the congenital Zika syndrome resulting from sexual transmission.Case presentationA 32 year-old woman who had not traveled to any area with local Zika transmission in years became pregnant via frozen embryo transfer. Her husband traveled to Haiti several times prior to embryo transfer and during the pregnancy. Neither partner was ever symptomatic. In her second trimester when recommendations were published by the Centers for Disease Control and Prevention (CDC) regarding prevention of sexual transmission during pregnancy she was counseled to abstain or use barrier protection with her partner. At delivery, the infant head circumference measured less than the first percentile. Placental samples were sent to the CDC and all were positive for Zika RNA by RT-PCR. Evaluation for other causes of microcephaly was negative. Consistent with the most up to date diagnostic parameters for congenital Zika, including viral infection of the placenta, the baby was diagnosed with congenital Zika syndrome.ConclusionsTransmission via sexual contact during assisted reproductive therapies (ART) and pregnancy can result in Zika fetopathy. This case supports recommendations to counsel women undergoing ART and pregnant women to use barrier protection with partners with Zika exposure regardless of their symptoms.

Knowledge of Zika virus disease among reproductive-age women attending a general outpatient clinic in Northern Nigeria

Background: Nigeria is not insulated from the global threat of Zika virus disease (ZVD) because of international travel and the presence of Zika-virus-carrying mosquitoes in the country. A paucity of studies exists concerning knowledge of ZVD among atrisk populations. Thus, the necessity for assessment of knowledge of ZVD among reproductive-age women in general outpatient setting.&#x0D; &#x0D; Materials and methods: A cross-sectional study was conducted on 377 reproductive-age women attending a Nigerian tertiary hospital’s general outpatient clinic. Their knowledge of ZVD was assessed using a structured questionnaire. A chi-square test was used to assess the relationship between participants’ sociodemographics and ZVD knowledge.&#x0D; &#x0D; Results: The participants’ median age was 27.0 ± 7.19 years. Though 68.97% of participants were aware of ZVD, only 23.85% of those had good knowledge of ZVD. Their median knowledge score was 57.14%. Participants’ age (&lt; 27 years) (p = 0.00399), tribe (Hausa) (p = 0.0174) and monogamous family type (p = 0.0108) were associated with good knowledge of ZVD. Only 5% knew that ZVD is transmitted through both mosquito bites and a sexual route. Some 80% were unaware that everybody was at risk of ZVD but 80.77% knew it could cause microcephaly. Insecticide-treated nets (80.77%), environmental sanitation (78.08%) and indoor insecticide spraying (58.85%) were preventive measures reported by most participants; a minority reported mosquito repellents (28.46%), wearing of protective clothing (36.15%), and traditional medicines (20.00%) as preventive measures. They lacked knowledge of prevention of sexual transmission.&#x0D; &#x0D; Conclusion: Participants’ knowledge of ZVD was inadequate despite the high awareness rate. Stakeholders may need to address existing knowledge gaps through effective public enlightenment.&#x0D; &#x0D; (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)&#x0D; &#x0D; S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1313484

Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016

Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016

Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016

Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016

Global HIV epidemiology: specific patterns of the epidemic in the North and South.

Thirty years after the identification of the first cases of AIDS, it was estimated that 34 million of people were living with HIV worldwide in 2011. The incidence is declining but remains high, with 2.5 million of new HIV infections per year. Africa is the region of the world most heavily affected, accounting for three-quarters of the global burden of HIV infection and the same proportion for new infections. The incidence declines in most parts of the world while heterosexual transmission remains the dominant mode of HIV acquisition followed by homosexual transmission. Intravenous drug use continues to drive the epidemic in Eastern Europe and parts of Asia. Condom use remains the cornerstone of prevention of sexual transmission. Male medical circumcision has now been proven an effective public health intervention to prevent sexual transmission. Antiretroviral treatment may reduce sexual transmission at population level while improving the conditions of life and survival of those harbouring the virus. Harm-reduction together with blood safety prevent blood transmission. The prevention of mother-to-child transmission is now moving its global objective to elimination by the end of 2015. At least 20 years will be necessary for achieving HIV control at the worldwide level with currently available interventions.

Prevention of Sexually Transmitted HIV Infections Through the President's Emergency Plan for AIDS Relief

HIV prevention in the President's Emergency Plan for AIDS Relief (PEPFAR) began when both data on HIV prevalence and the toolbox of interventions for prevention of sexual transmission were relatively limited. PEPFAR's early focus was on scaling-up information, education, and communication programs that included messaging on abstinence for youth and faithfulness primarily through nongovernmental organizations, including faith-based organizations. Additional activities included condom promotion, distribution, and social marketing. In epidemics concentrated within key populations, PEPFAR's prevention efforts focused on a minimum package of services including outreach, information, education, and communication programs, STI treatment (where appropriate), and condom promotion and distribution. As more epidemiological data became available and with experience gleaned in these early efforts, the need for tailored and flexible approaches became evident. The next iteration of prevention efforts still emphasized behavioral interventions, but incorporated a sharper focus on key epidemic drivers, especially multiple partners; a data-driven emphasis on high transmission areas and populations, including prevention with people living with HIV; and a more strategic and coordinated approach at the national level. Recently, the paradigm for prevention efforts has shifted yet again. Evidence that biomedical interventions such as male circumcision, treatment for prevention of vertical and horizontal transmission, and treatment itself could lead to declines in incidence has refocused PEPFAR's prevention portfolio. New guidance on sexually transmitted HIV focuses on combination prevention, emphasizing biomedical, behavioral and structural approaches. Landmark speeches by the President and the Secretary of State and new ambitious targets for PEPFAR point toward a new goal: an AIDS-free generation.

The evolving epidemiology of HIV/AIDS

Following its recognition in 1981, the HIV/AIDS epidemic has evolved to become the greatest challenge in global health, with some 34 million persons living with HIV worldwide. Early epidemiologic studies identified the major transmission routes of the virus before it was discovered, and enabled the implementation of prevention strategies. Although the first identified cases were in MSM in the United States and western Europe, the greatest impact of the epidemic has been in sub-Saharan Africa, where most of the transmission occurs between heterosexuals. Nine countries in southern Africa account for less than 2% of the world's population but now they represent about one third of global HIV infections. Where broadly implemented, HIV screening of donated blood and antiretroviral treatment (ART) of pregnant women have been highly effective in preventing transfusion-associated and perinatally acquired HIV, respectively. Access to sterile equipment has also been a successful intervention for injection drug users. Prevention of sexual transmission has been more difficult. Perhaps the greatest challenge in terms of prevention has been in the global community of MSM in which HIV remains endemic at high prevalence. The most promising interventions are male circumcision for prevention of female-to-male transmission and use of ART to reduce infectiousness, but the extent to which these interventions can be brought to scale will determine their population-level impact.

Understanding the association between injecting and sexual risk behaviors of injecting drug users in Manipur and Nagaland, India

BackgroundIn India, as in rest of the world, HIV prevention programs have focused on HIV transmission through unsafe injecting practices with less attention on sexual risk behaviors among injecting drug users (IDUs). This study examines the sexual risk taking behaviors of IDUs associated with their pattern of drug use in India.MethodsData were obtained from the behavioral tracking survey conducted in 2009 among 1712 IDUs in two districts each of Manipur and Nagaland states in Northeastern part of India. Sexual risk behaviors among IDUs were assessed in terms of multiple sex partners, sex with a paid female partner in the last 12 months and inconsistent condom use with any female partner.ResultsMore than one-fourth (27%) in Manipur and almost one in two (47%) IDUs reported having had sex with two or more female partners in the past 12 months. In Manipur where heroin is commonly used, the odds of having multiple sex partners were higher among non-heroin users than heroin users (42% vs. 23%, Adjusted Odds Ratio (AOR): 1.7, 95% Confidence Interval (CI): 1.1-2.6) and who shared needles/syringes in the last one month than who did not share (46% vs. 26%, AOR: 2.2, CI: 1.2-4.0). In Nagaland, where Spasmoproxyvon (SP, a synthetic opioid analgesic that contains dextropropoxyphene, dicyclomine hydrochloride and paracetamol) is most common, regular injectors as compared to occasional injectors were more likely to report multiple sex partners (67% vs. 42%, AOR: 2.7, CI: 1.8-4.1) and sex with paid partners (13% vs. 3%, AOR: 6.0, CI: 3.0-12.1). Sharing of needles/syringes was positively associated with multiple sex partners (51% vs. 44%, AOR: 1.6, CI: 1.2-2.2), and inconsistent condom use (93% vs. 80%, AOR: 3.0, CI: 1.8-5.1).ConclusionsIDUs with unsafe injecting practices also engage in risky sexual practices magnifying the risk of HIV infection. There is a need to focus on prevention of sexual transmission among high-risk IDUs, particularly in areas where Spasmoproxyvon is commonly used.

Prevention of Human Immunodeficiency Virus Type 1 Transmission by Pharmaceuticals Targeted to Host Proteins Required for Virus Infection? Consideration of Farnesyl Thiosalicylic Acid, a Ras Inhibitor

Recent success in defining the human immunodeficiency virus type 1 (HIV-1) – host cell protein interaction network has provided an opportunity for development of novel antiviral therapeutics targeted to host proteins required for virus infection. This expanded earlier successful development of antagonists for the cellular receptors (CD4) and co-receptors (CCR5 or CXCR4) involved in virus attachment. Induction of the G-alphaq signaling cascade by the HIV-1 envelope is required for virus entry, and it’s blocking prevented HIV-1-mediated membrane fusion and initiation of infection. One of the blockers, the Ras inhibitor S-trans, trans-farnesylthiosalicylic acid (FTS), was reported to interfere with HIV-1 infection. Since FTS appears to have an established safety record and is being evaluated (as Salirasib, oral) in phase II human clinical trials for treatment of lung cancer, it was of interest to evaluate the potential of FTS as a topical microbicide for prevention of sexual transmission of HIV-1. Data shown here indicated that this compound did not meet the criteria of an established screening algorithm for evaluation of topical microbicides. Nevertheless, the possibility remains to be explored that FTS (especially when used in combination with other anti-HIV drugs) might be useful in sustained pre-exposure prophylaxis to prevent HIV-1 transmission.

HIV prevention: What have we learned from community experiences in concentrated epidemics?

Drawing on lessons learned from community experiences in concentrated epidemics, this paper explores three imperatives in the effort to reduce the sexual transmission of HIV: combat prevention fatigue, diversify HIV testing and combat stigma and discrimination. The paper argues for a non-judgmental harm reduction approach to the prevention of sexual transmission of HIV that takes into account the interpretation of risk by diverse individuals and communities in the era of antiretroviral therapy. This approach requires greater attention to increasing access to opportunities to know one's serostatus, especially among key populations at greater risk. Novel approaches to diversifying HIV testing approaches at community level are needed. Finally, the paper makes a plea for bold measures to combat stigma and discrimination, which continues to represent a formidable barrier for access to services for affected populations and may contribute to HIV-related risk behaviours. A "triple therapy" approach to address stigma and discrimination is discussed, which includes greater acceptance of people living with HIV and AIDS (PLWHA), improving relevant laws and policies, and involving prevention users- working with people rather than for people-.Note: this paper corresponds to the plenary talk of Bruno Spire at the XVIIth World AIDS Conference, August 8th, Mexico city: http://www.kaisernetwork.org/health_cast/player.cfm?id=4383

Evolución de los conocimientos, actitudes y hábitos de la población general sobre la infección por el VIH

Knowledge of the social changes related to HIV infection can be helpful in the attempts to design more effecting preventive strategies for this disease. The aim of this study was assess the progress that has occurred in the knowledge, attitudes and habits of the general population in relation to HIV infection between 1997 and 2005. With this objective, a multidisciplinary team designed a questionnaire survey containing 64 items, which was validated through a pilot study performed with 100 subjects. The target population included all residents of the city of Zamora aged 18 to 70 years old. The population was stratified by district (five), sex, and age (younger or older than 40 years old) into 20 groups. The sample size was calculated and a randomly selected list of participants was obtained for each group. The questionnaire was filled out at the homes of the selected population with the help of trained personal in 1997, and was repeated in 2005. Results from the two time points were compared. In 2005, a larger number of people were interested in gaining more information about the disease and showed concern about the risk of infection. However, there were no significant changes in the related knowledge or habits, and frequent errors persisted regarding prevention of sexual transmission. Nonetheless, the attitude toward infected patients had improved. Over the 8 years of the study, knowledge about HIV infection has not changed, and errors regarding sexual prevention remain, although there is a more positive attitude toward patients with this disease. Modifying this deficit in the understanding of HIV may contribute to preventing this disease.

Analysis of HIV variants in blood and semen in serodiscordants by heteroduplex mobility assay

Purpose of the study The resistance of antiretroviral drugs is mainly attributed by the generation of HIV variants in different secretions of the same individual; distinct viral variants have been detected in different cells and body fluids of the same individual. Genotypic and phenotypic characterization of viral variants in blood and urogenital secretions may provide strategies for designing modalities in prevention of sexual transmission of HIV and to explore the mechanism of sexual transmission of human immunodeficiency virus type 1(HIV-1).

Characteristics and trends of newly diagnosed HIV-infections, 2000-2004

ObjectiveTo describe the characteristics and trends of newly diagnosed HIV-infections. MethodsWe analysed all newly diagnosed HIV-infections among residents of the Canary Islands, Ceuta, La Rioja, Navarre and the Basque Country (Spain) between 2000 and 2004. ResultsIn total, 1,807 HIV-infections –74.4 per million inhabitants, per year–were diagnosed. The heterosexual transmission category was the most frequent (48.6%), followed by that of homo/bisexual men (23.0%) and injecting drug users (IDU) (22.5%). From 2000 to 2004, the rate of new diagnoses of HIV infection decreased by 29.8% (p<0.0001). The rate of diagnoses of infections acquired by IDU diminished by 58.5% (p<0.0001), and the rate of infections associated with homo/bisexual practices in men descended by 33.9% (p=0.0318). Nevertheless, the rate of diagnoses of infections by heterosexual transmission has not undergone significant changes. In the period 2002-2004, 28.7% of cases were diagnosed in foreigners, but the rate of diagnoses in the population of non-Spanish origin diminished by 24% (p=0.0534). 39.7% of HIV diagnoses were delayed (with CD4 < 200 cells/microlitre or coinciding with the diagnosis of AIDS). This situation was less frequent in women (odds ratio = 0.5; p<0.001) and increased with age amongst people over 30. The proportion of delayed diagnoses reached a maximum in 2001 (47.5%) and then declined until 2004 (38.6%; p=0.022). ConclusionsAlthough none of the analysed indicators evolved unfavourably, it is important to insist on the prevention of sexual transmission, the early diagnosis of HIV infection, and the need to adapt preventive activities and focus them on people from other countries.

Entry inhibitors SCH-C, RANTES, and T-20 block HIV type 1 replication in multiple cell types.

The small-molecule CCR5 antagonist SCH-C (SCH 351125) was tested for its ability to inhibit HIV-1 replication in peripheral blood mononuclear cells (PBMCs), cord blood mononuclear cells, immature dendritic cells (DCs), and macrophages. Inhibition of infection of PBMCs by virus associated with mature DC in trans was also studied. For comparison, the peptide-based fusion inhibitor T-20 and the CC-chemokine RANTES were also evaluated. Although some cell type-dependent differences in potency were observed, each of the three entry inhibitors was active against the replication of three different CCR5-using primary isolates in each cell type. CCR5-dependent HIV-1 infectivity, whether DC associated or not, is thus vulnerable to inhibitors that block the virus-cell fusion process by different mechanisms. Together, these results suggest that SCH-C and other entry inhibitors should be evaluated for their clinical potential as inhibitors of HIV-1 replication in several settings, including the prevention of maternal-infant transmission and the prevention of sexual transmission by topical application as a microbicide.

HIV infection in children in developing countries

Disease progression in children acquiring HIV infection vertically from their mothers is more rapid in developing countries compared with developed countries. The probability of death by 12 months in sub-Saharan Africa ranges from 0·23 to 0·35, and by 5 years is 0·57–0·68. Data from Europe in the era before highly active anti-retroviral therapy (HAART) yielded probabilities of 0·1 and 0·2, respectively. Confirming the diagnosis can be difficult in resource-limited settings. Existing clinical case definitions are useful epidemiologically, but of low positive-predictive value in individual children. Priorities for research into management issues include nutrition (infant feeding, vitamin A and micronutrient supplementation), prophylaxis against Pneumocystis carinii pneumonia (PCP), and bacterial infections, case management of persistent diarrhoea, diagnosis/prevention/management of tuberculosis in children and prevention of sexual transmission in adolescents.

Measuring self-efficacy in the context of HIV risk reduction: Research challenges and recommendations.

Self-efficacy theory has had considerable influence in studies of health-related behaviors, including the prevention of sexual transmission of HIV. However, imprecise operationalization of self-efficacy theory in HIV prevention research is common and has important implications for the prediction of risk-reducing behavior from self-efficacy beliefs. In many instances, constructs other than self-efficacy have been assessed. In this article, the operationalization and measurement of self-efficacy in the context of HIV-risk-reduction research are reviewed and challenges inherent to such efforts are identified. Recommendations for enhancing the prediction of risk-reducing behavior from self-efficacy beliefs are also provided.

WOMEN AND HIV: A Review of Current Epidemiology, Gynecologic Manifestations, and Perinatal Transmission

HIV is increasing rapidly in women, particularly due to heterosexual transmission. The manifestations of HIV in women differ in some respects from those in men, most obviously with respect to gynecologic manifestations. Candidiasis, anogenital human papillomavirus and neoplasia, and contraception and prevention of sexual transmission are all important issues. Reduction in perinatal transmission is a key focus in women, with a growing number of effective preventative interventions.

Condom Use for Prevention of Sexual Transmission of HIV Infection

Condom Use for Prevention of Sexual Transmission of HIV Infection

Guidelines for the Development of a National AIDS Prevention and Control Programme. Volume 1. WHO AIDS Series Guidelines on Sterilization and Disinfection Methods Effective against Human Immunodeficiency Virus (HIV). Volume 2. WHO AIDS Series Guidelines for Nursing Management of People Infected with Human Immunodeficiency Virus (HIV). Volume 3. WHO AIDS Series Monitoring of National AIDS Prevention and Control Programmes. Volume

Guidelines for the Development of a National AIDS Prevention and Control Programme. Volume 1. WHO AIDS Series Guidelines on Sterilization and Disinfection Methods Effective against Human Immunodeficiency Virus (HIV). Volume 2. WHO AIDS Series Guidelines for Nursing Management of People Infected with Human Immunodeficiency Virus (HIV). Volume 3. WHO AIDS Series Monitoring of National AIDS Prevention and Control Programmes. Volume