Risk Factors For HIV Infection Research Articles

Progress of research on the susceptibility of HIV infection among heterosexual partners of men who have sex with men

Affected by internal and external factors, more than 70.0% of men who have sex with men (MSM) have the intention to get married, and more than 90.0% of MSM view marriage as inevitable. Due to the marriage, there merges a group of women who are heterosexual partners of MSM and also known as'tongqi' (TQ). Because MSM is a high-risk group infected with HIV, together with the existence of other predisposing factors, the TQ population is also under increased risk of HIV infection. This article summarizes the definition, population scale, physical health problems, and risk factors of HIV infection among TQ with the purpose of providing evidence for the implementation on the follow-up prevention and control programs of sexually transmitted diseases for the TQ population.

EP26 HIV infection masquerading as connective tissue disease

Case report - IntroductionConnective tissue diseases are multisystem disorders. Diagnosis and evaluation of suspected cases is not straight forward in most of the cases. This case describes the significance of considering a broader approach when evaluating a suspected case of connective tissue disease.Case report - Case descriptionWe describe a case of 58 years old non-smoker lady, presented with acute onset livedo reticularis rash on lower limbs and background of sicca symptoms, oral ulcers, fatigue, paraesthesias in feet and arthralgias without any systemic or inflammatory joint symptoms.General examination showed livedo reticularis rash on both elbows and lower legs. There was no evidence of peripheral joint synovitis, but she had nodal osteoarthritis in her hands. Systemic examination was unremarkable.Investigations revealed anaemia, pancytopenia, ESR of 77, low C4 and urine dipstick positive for leucocytes, nitrates, protein, and blood. Schirmer’s test, ANA and ENA screen was positive with positive RNP and SMdp antibody. She also had hypergammaglobulinemia in a polyclonal pattern. Nerve Conduction and EMG studies revealed mild axonal sensory neuropathy.Case report - DiscussionThis lady appeared to have mixed connective tissue disease with mixed features of Sjögren’s syndrome and systemic lupus erythematosus. She was started on Hydroxychloroquine but stopped it shortly after developing floaters in her eye. She had poor response to Depomedrone injection. She had ongoing symptoms of fatigue, weight-loss, loose stools, and abdominal pain, investigated further and CT scan showed hyperdense liver lesions and mesenteric lymphadenopathy. Esophagogastroduodenoscopy showed oesophageal candidiasis. She was admitted with progressive symptoms. Further investigations showed a positive HIV test and liver biopsy came back positive for anaplastic lymphoma, later she was diagnosed with advanced HIV disease, rapidly deteriorated with neutropenic sepsis and multi-organ failure, and unfortunately died.Case report - Key learning pointsThis lady initially presented with symptoms of connective tissue disease and investigations in keeping with this diagnosis. Unfortunately, by the time she was tested for HIV infection, it was already too late. There could be overlap of symptoms of connective tissue disease and viral infections e.g. HIV infection. Autoantibodies may be falsely positive in infections e.g. HIV and in malignancy. Risk factors of HIV infection should be considered during assessment of multisystem diseases like connective tissue diseases particularly prior to immunosuppression. Viral screening including HIV test should be considered in all high-risk patients and particularly if the symptoms are atypical and do not quite fit well with the diagnosis.

HIV prevalence among men who have sex with men following the implementation of the HIV preventive guideline in Tanzania: respondent-driven sampling survey

ObjectivesTo estimate HIV prevalence and associated risk factors among men who have sex with men (MSM) in Dar es Salaam, Tanzania following the implementation of the national comprehensive package of...

Knowledge, attitude and stigma towards HIV patients: a survey among medical students in Tuzla, Bosnia and Herzegovina.

This survey aims to assess knowledge, attitude and stigma towards HIV patients, among medical students in Tuzla, Bosnia and Herzegovina. We also aimed to assess potential risk factors for HIV infection among fourth year medical students. Data were collected from specific questionnaire that was completed by 171 students of the Faculty of Medicine, University of Tuzla. A multivariable logistic regression was performed. Majority of students (79%) had a good knowledge of HIV, (median value of correct answers was 9 (95%) with at least 6 correct responses). Also, majority of students (73.6%) had a positive attitude towards HIV patients and the median positive value was 6 (95% CI: 6-7). More than a third of students considered that all hospitalized patients should be tested for HIV. Total of 81% of students considered that they should inform the sexual partner of HIV positive patient, although she/he disagrees. 61.4% of students had a discriminatory attitude towards HIV, with the median values of 3 (95% CI: 3-3). Multivariate regression analysis identified positive attitude towards HIV patients as an independent predictor for a non-discriminatory attitude. Moreover, an overall attitude towards HIV patients defines student`s determination to work with AIDS population. Male gender, and older age, were identified as predictors of risky behavior. Preventive measures, including better HIV education, are crucial. Knowledge can increase awareness of HIV infection, decrease the incidence and reduce stigma towards HIV patients.

Brief Report: HIV Testing and Risk Among Justice-Involved Youth.

Justice-involved youth have a number of risk factors for HIV infection, including high rates of substance use, psychiatric comorbidities, and risky sexual behaviors. Although detained youth are likely to receive health care-which may include HIV testing-court-involved, non-incarcerated (CINI) youth may be unlikely to receive HIV testing services either before or during their justice involvement. However, the relationship between risk factors and HIV testing among CINI youth is largely unknown. We explored the association between HIV testing and factors commonly associated with both HIV testing and HIV risk among 173 CINI youth with identified behaviors that put them at risk for HIV acquisition. Only 15.6% of participants reported a lifetime history of HIV testing, despite high rates of sexual and substance use risk behaviors. Age (older), gender (female), sexual orientation (non-heterosexual), recent marijuana use, lifetime use of other drugs, history of a sexually transmitted infection, pap smear in the past year and history of mental health/substance use treatment were all significantly associated with lifetime HIV testing. The extremely low testing rates in this sample emphasize that the juvenile justice system outside of detention is not adequately addressing youths' needs related to HIV testing or ensuring access to testing services for youth at risk of contracting HIV. Results suggest that additional efforts are needed to connect justice-involved youth to healthcare more broadly and HIV testing in particular.

Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador – Bahia, Brazil

BackgroundThe heterogeneity in detection rates of Human immunodeficiency virus, (HIV), Human T lymphotropic virus (HTLV) and Hepatitis B and C infections among pregnant women and the continuous exposure to risk factors limits the adoption of preventive and control actions. ObjectiveTo evaluate the HIV, HTLV, Hepatitis B and C seroprevalence rates, and associated risk factors in parturient women in Salvador, Brazil. MethodsThis was a cross-sectional study in 2099 parturient women attended in two public maternity hospitals in Salvador, Brazil. One blood sample was drawn for serological screening and socio-demographic, obstetric and clinical data were collected. ResultsHIV seroprevalence rate was 1.5% (of which 0.6% were new cases); seroprevalence rates for HTLV, HBV, and HCV were 0.4%, 0.4%, and 0.1%, respectively. Univariate analysis showed a significant association between socio-demographic and behavioral factors with retroviral infections, while viral hepatitis was mainly associated with parenteral exposure. In a multivariate analysis, multiple sexual partners (OR 3.3; 95% CI: 1.1–9.2), history of sexual/domestic violence (OR 2.8; 95% CI: 1.1–6.9), syphilis co-infection (OR 2.6; 95% CI: 1.0–6.9), use of alcohol or drugs (OR 2.5; 95% CI: 1.2–5.5), and low schooling level (OR 2.3; 95% CI: 1.1–4.9) were independent risk factors for HIV infection. History of stillbirth and low birth weight infants was significantly associated with HTLV positive status, showing a negative impact on gestation. ConclusionsThe seroprevalence rates for HIV, HCV, HBV, and HTLV were similar to that found in previous studies in other Brazilian regions. The high individual, socioeconomic, and social vulnerability detected in seropositive parturient women indicates the need to improve coverage and effectiveveness of STDs control with prevention, detection and monitoring strategies, focusing in pregnant women exposed to high biopsychosocial risk.

Attributes of HIV infection over decades (1982-2018): A systematic review and meta-analysis.

Understanding the risk factors for HIV infection is the foundation of successful preventive strategies, which must bundle sociocultural, behavioural and biomedical interventions to halt disease transmission. We aimed in this study to provide a pooled estimation of HIV risk factors and trace changes across decades in order to drive consensus and accurate assessment of disease transmission risk. We comprehensively searched PubMed, ISI Web of Knowledge, Medline, EMBASE, ScienceDirect, Ovid, EBSCO, Google Scholar and the Egyptian Universities Library Consortium from October to December 2018. Two independent reviewers extracted data from eligible studies. Funnel plots were inspected to identify publication bias. Heterogeneity across studies was checked using the Q and I2 statistics. The results were reported based on the pooled odds ratio (pOR) with 95% CI using a random-effects model. Meta-analysis of HIV risk factors revealed a superior role for risky sexual practices (unprotected vaginal/anal sex), injecting drug use (IDU), sharing needles, sexually transmitted infections (STIs), child sexual abuse and vertical transmissions. Trends across decades (1982-1999 and 2000-2018, respectively) showed rising evidence for prostitution [pOR (95% CI)= 2.3 (1.12-4.68) versus 2.69 (1.67-4.32)] and men who have sex with men (MSM) [pOR (95% CI)= 2.28 (1.64-3.17) versus 3.67 (1.88-7.17)], while transmission through IDU [pOR (95% CI)= 3.42 (2.28-5.12) versus 2.16 (1.74-2.70)], alcoholism [pOR (95% CI)= 2.35 (0.73-7.59) versus 1.71(1.08-2.72)], and sharing syringes [pOR (95% CI)= 6.10 (2.57-14.5) versus 2.70 (2.01-6.35)] showed notable decline. Harm reduction programs and condom use have been recognized as chief HIV prevention strategies, while male circumcision contributed a partial role. Collectively, sexual risk factors continue to be a key driver of the global HIV epidemic. Persistent and emerging risk factors identified in our analysis should constitute the forefront targets of HIV prevention programmes to accelerate efforts towards HIV elimination.

Prevalence of HBV/HCV Co-Infection and Associated Risk Factors in People Living with HIV

Objectives: This study was undertaken to assess the prevalence of HBV/HCV co-infection demographic characteristics of HIV/HBV and HIV/HCV co-infected patients and its risk factors in a group of HIV infected patients followed-up in an infectious diseases and clinical microbiology clinic. Methods: Treatment-naive patients attending the clinic between January 2015 and June 2018 were included. Sociodemographic characteristics of the participants, HIV infection risk factors, and laboratory findings were retrospectively evaluated using medical records. Results: Out of 717 patients, 645 were male with the mean age of 35.94 ± 11.69 years, of whom 270 (37.6%) were late presenters, and 377 (52.5%) were men who had sex with men (MSM). Of the patients, four out of 717 patients (0.5%) had HCV infection, and 32 (4.5%) had HBV co-infection. The heterosexual (HS) patients were significantly more likely to have HBV co-infection (P = 0.03). A comparison of the MSM and HS patients showed that the latter group of patients were significantly older and more likely to be late presenters (P < 0.001). Anti-HBc was positive in 216 of the patients (30.1%) who were considered to have previous exposure to HBV. A comparison of educational status in the patients showed that 70% of the MSM patients were high-school or university graduates (P = 0.008). Moreover, anti-HBs was positive in 65.7% of the MSM patients, and MSM and Heterosexual patients were not significantly different in terms of the presence of resolved HBV infection (P = 0.05). Conclusions: Our study showed that the prevalence of HBV co-infection among the HIV infected patients was similar to the prevalence of HBV infection in the general population and that patients with the heterosexual route of transmission had higher rates of seropositivity. A high occurrence of co-infections in HS patients suggests that infections are likely to follow a chronic course in those with a delayed diagnosis. MSM patients who were known in the high-risk group for HIV infection, have higher vaccination ratios and education levels. So the efforts to increase awareness must not only be limited to high-risk groups but also all individuals.

Risk factors for HIV infection among married couples in Rakai, Uganda: a cross-sectional study

BackgroundAlthough married couples can be at an elevated risk of HIV infection, few studies have explored the risk factors for HIV infection at the couple-level. We explored the risk factors for HIV infection among married couples in settings with differing HIV prevalence levels in Rakai, Uganda.MethodsThis was a cross-sectional study conducted among 664 heterosexual couples living in three HIV prevalence strata (low: 9–11.2%; medium: 11.4–20% or high HIV prevalence: 21–43%) in Rakai District, south-western Uganda, between November 2013 and February 2014. Data were collected on socio-demographic and behavioural characteristics from all consenting adults and aggregated to allow for couple-level analyses. We conducted bivariate and multivariable Logistic regression to assess the factors that were independently associated with HIV infection among married couples. Data were analysed using STATA statistical software (version 14.1).ResultsOf the 664 couples, 6.4% (n = 42) were in HIV-discordant relationships; 5.8% (n = 39) were in concordant HIV-positive relationships while 87.8% (n = 583) were in concordant HIV-negative relationships. At the bivariate analysis, we found that residing in a high HIV prevalence stratum, reporting extra-marital relations, age difference between partners and number of previous marriages were significantly associated with being part of an HIV infected couple. After adjusting for potential cofounders, living in a high HIV prevalence stratum (Adjusted OR [AOR] =2.31, 95% CI: 1.52, 3.52), being in a third or higher order relationship (AOR = 3.80, 95% CI: 2.30, 6.28), and engagement in extra-marital relations (AOR = 1.75; 95% CI: 1.19, 2.59) were associated with couple HIV infection. Individuals that had stayed together for six or more years had 28% odds of being part of an HIV infected couple (AOR = 0.28; 95%CI: 0.18, 0.43).ConclusionLiving in a high HIV prevalence stratum, engagement in extra-marital relations and having a higher number of previous marriages were significant risk factors for HIV infection among married couples. Long marital duration was associated with reduced risk of HIV infection. Interventions that increase marital stability and those that promote pre-marital couples’ HIV testing before marital formation can reduce HIV transmission risk among married couples in this setting.

Prevalence of HIV infection and associated risk behaviors among people who inject drugs in Kermanshah, Iran: 2017

ABSTRACT Background: Globally, the prevalence of HIV infection among People Who Inject Drugs (PWIDs) is higher than the general population due to high-risk behaviors. The aim of this study was to determine the prevalence of HIV infection and associated risk behaviors among male PWIDs in Kermanshah city in 2017. Methods: We surveyed 606 male PWIDs in Kermanshah city. Data on demographic characteristics and risk behaviors associated with HIV infection were gathered through structured interviews. HIV was also measured through venous blood testing. Eligible participants were recruited from two drop-in centers using snowball sampling. Simple and multiple logistic regression was used to investigate the risk behaviors of HIV infection. Results: Among 606 male PWIDs in this study, prevalence of HIV infection was 6.40% (95% CI: 1.61–4.32). Older age (Adjusted Odds Ratio; AOR = 1.08, 95% CI: 1.02–1.15) and older age at first drug injection (Adjusted Odds Ratio; AOR = 0.91, 95% CI: 0.85–0.97) were risk factors for HIV infection. Conclusion: This study implies that prevalence of HIV among male PWIDs is higher than the general population. Older age and older age at first drug injection were risk factors for HIV infection.

HIV Prevalence and Associated Risks in a Respondent-Driven Sample of Illicit Stimulant Users in a Southern United States City.

Stimulant abuse is a major contributor to HIV transmission in the United States, yet HIV prevalence among persons who use illicit stimulants remains unknown. We implemented respondent driven sampling (RDS) to estimate the prevalence of HIV infection in this high-risk population. We also examined RDS-adjusted rates of risk behaviors among HIV-positive and HIV-negative participants. Recruited from seven seeds, our sample of 387 participants was 46% female, 89% African American, and 45.94years old on average. Participants were predominantly non-injection cocaine users, had large networks of stimulant users, and reported an established relationship with their recruiter. The adjusted population proportion of HIV infection was 0.07 (0.04, 0.11). The majority of sexually active participants reported engagement in risk behaviors (73%), but rates generally did not differ by HIV status. Our results highlight that stimulant use is a risk factor for HIV infection. This study also demonstrates that RDS is a very effective strategy for reaching stimulant users in the community.

Is AIDS related to social determinants of health in Iran? A systematic review

Introduction: AIDS is a global challenge. By looking deeper into the nature of AIDS and its transmission, it can be concluded that AIDS is a social phenomenon rather than a completely biological disease and the results of studies show a significant relationship between the risk of HIV infection and some underlying factors such as demographic, social, economic and cultural factors. Today, these structural and social factors are known as social determinants of health (SDH). The current systematic study aimed to identify SDH related to AIDS in Iran, in order to adopt appropriate strategies to prevent AIDS in Iran. Methods: All studies in Persian or English focusing on the relationship between societal health and AIDS conducted in Iran were systematically reviewed from PubMed, Scopus, Embase, Web of Science and internal databases (IranMedex, SID and Magiran) by December 2018. In order to evaluate the quality of the articles, the STORBE checklist was used and, after reviewing the articles, finally, out of a total of 964 articles, 18 papers were selected to enter into the study. Results: In this systematic review, 12 articles were performed on people at risk for AIDS, while 6 articles were conducted on patients with positive HIV/AIDS. Based on the WHO model, the determinants of social well-being in this study were structural determinants of heath; (gender, educational level, occupational status, income and housing) and intermediate determinants of heath (marital status, high-risk behaviors, awareness, attitude about AIDS, social support status, access to the Internet and satellite, and history of child sexual abuse). Conclusion: The main risk factors for HIV infection in Iran (intravenous opium and unsafe sexual intercourse) were related to social, economic and behavioral factors. Therefore, it is essential to consider SDH as the key factors in the emergence and control of AIDS by health policy-makers and relevant authorities for the prevention of AIDS

Current risk factors for HIV infection among blood donors in seven Chinese regions.

In China, there is a rising concern on the increasing trends of HIV infections in high-risk groups, who make blood donations that might potentially challenge the blood safety. Analyses on current risk factors for HIV infection among Chinese blood donors are urgently needed for developing effective strategies to defer high-risk donors and to warrant the safety of the blood supply. We recruited 313 HIV-positive and 762 HIV-negative donors from seven study sites in China and evaluated donor demographic characteristics, current medical and behavioral risk factors associated with HIV infection in a case-control survey. Univariable analyses examined the relationship between HIV infection and donor and donation characteristics, medical and behavioral risks, living conditions, and lifestyles. Multivariable logistic regression analyses evaluated the association between selected individual risks and HIV infection. Regression tree analysis was used to select covariates correlated with both HIV infection and individual risks and thus need to be controlled for in logistic regression models. Being a man who has sex with men was associated with the highest odds of HIV infection. Not using a condom, having sex with HIV-infected individuals, having sex partners with sexually transmitted diseases (STDs), having more than two concurrent sex partners, or having an STD were all associated with more than five times higher odds of having HIV. Having remunerated sex was associated with a 2.4 increased odds of having HIV infection. High-risk sexual behaviors were among the major risks for HIV infection among Chinese blood donors.

Factors Affecting Married, Monogamous Women’s Risk of HIV Infection in India: Traditional Gender Roles and Husbands’ High-Risk Sexual Behaviours

International Journal of Medicine and Public Health,2019,9,4,112-117.DOI:10.5530/ijmedph.2019.4.25Published:December 2019Type:Review Article Factors Affecting Married, Monogamous Women’s Risk of HIV Infection in India: Traditional Gender Roles and Husbands’ High-Risk Sexual BehavioursKelly A A Leslie Kelly A. A. Leslie Department of Psychiatry, University of Toronto, Toronto, Ontario, CANADA. Abstract:The prevalence of HIV in India has been steadily increasing over the last three decades and India is now thought to possess the third largest number of cases out of any country in the world. India is currently experiencing a significant feminization of its HIV epidemic; a large proportion of new HIV infections are observed in women and the majority of all HIV cases in India are contracted by heterosexual transmission. While married, monogamous women were initially considered at low risk for contracting HIV in India, they are now recognized as being a high-risk group, as the prevalence of HIV among women who have ever been married is higher than the national average. Because the vast majority of these women report that unprotected intercourse with their husband is their only risk factor for HIV infection, it can be concluded that they have likely been infected by their husband. This review investigates the principal factors involved in the infection of married, monogamous Indian women with HIV by their husbands, within the context of traditional Indian gender roles and cultural expectations of behaviour. Specifically, this article examines three high-risk sexual behaviour commonly perpetrated by Indian men: extramarital sexual relations, lack of condom use during sex and intimate partner violence. Given the magnitude of the problem of HIV in India and its implications for the spread of HIV throughout the world, the topic of women’s risk of HIV infection in India is clearly of immense public health significance. Keywords:HIV, India, WomenView:PDF (228.06 KB)

Atypical presentation of classic Kaposi sarcoma in circumcised penis presenting as an ulcerative nodule with human herpesvirus 8 (HHV8) positivity and successfully treated with only local excision

IntroductionAlthough the Kaposi sarcoma (KS) is one of the AIDS defining entity and seen in almost one third of HIV infected patients with low CD4 cell counts, it is not uncommon in HIV seronegative persons, but genital KS is rare, particularly in people without risk factors for HIV infection. Isolated penile KS is an unusual manifestation, especially as solitary nodule with ulceration, in HIV seronegative patient.Case presentationWe report such a case of Kaposi sarcoma showing HHV-8 positivity in an elderly male Arabian patient with a delay in prompt diagnosis, but treated successfully with 3 3 years follow-up after limited local surgical excision.ConclusionThe general practitioners, venereologists and urologists should think of KS as a possibility in such lesion and consider early biopsy.

Prevalence and risk factors for HIV-1 infection in people who use illicit drugs in northern Brazil.

People who use illicit drugs (PWUDs) have a high risk of viral infections. To date, there is a paucity of information on HIV infection among PWUDs in remote Brazilian regions. This study determined the prevalence and factors associated with HIV-1 infection among PWUDs in northern Brazil. Sociodemographic, economic, drug use and health-related information were collected through interviews from a community-recruited, multi-site sample of 1753 PWUDs. The blood samples collected were tested for the presence of HIV-1 using chemiluminescence immunoassay and PCR or western blotting. Logistic regressions identified factors independently associated with HIV-1 infection. In total, 266 (15.2%) PWUDs were HIV-1 positive. Hepatitis B virus and/or hepatitis C virus nucleic acid was detected in 65 (3.7%) PWUDs infected by HIV-1. The factors associated with HIV-1 infection were male gender, older age, a lower educational level and a lower income, crack cocaine use, a longer drug use history and a history of drug injection and engagement in unsafe sex, sex work and a higher number of sexual partners. The current study provides unique, initial insights into HIV and co-infection status and pertinent risk factors among PWUDs in northern Brazil, with clear and diverse implications for urgently improved prevention and treatment intervention needs.

The unexposed world of the (HIV‐negative) exposed

Dear Editor, As recently discussed by Di Biagio et al. 1, the number of missed opportunities to prevent mother-to-child transmission (MTCT) is unacceptable in Italy. Only women with missed diagnoses of HIV infection that caused newborn infection were included in Di Biagio et al.'s study; the number of women who do not receive a diagnosis during pregnancy and do not transmit the infection to the newborn is even higher. In this Letter, we report the findings of a study of exposed children born to HIV-positive mothers and observed in a paediatric hospital in an Italian setting. We included mothers who came to our centre for assessment of the HIV status of the child. Eighty-eight mothers were observed between 2006 and 2017 at the Bambino Gesù Hospital, Rome, an HIV reference centre for central and southern Italy (Table 1). Fifty-four (51%) were aware of their HIV status before pregnancy and were taking antiretroviral therapy. Thirty-four mothers (39%) were diagnosed during (76%) or after (24%) after delivery. We decided to better characterize this group as they have the highest risk of MTCT. Of the mothers of these 34 HIV-exposed children (56% born to European mothers, 29% born to African mothers and 15% born to mothers from South America), 76% received highly active antiretroviral therapy (HAART) during pregnancy, 65% underwent a caesarean section and only five breastfed their children (they discovered their status after delivery). Maternal risk factors for HIV infection were risky sexual behaviour in 88% of women and injecting drug use in 12%. Regarding knowledge of the Italian language, 47% of mothers were able to communicate fully in Italian, 29% had poor or no knowledge of the language and 21% were able to comprehend basic information. Exposed children had a median birth weight of 2910 g (range 830–3980 g), the Apgar score was ≤ 7 in 8% of cases and they were born at a median of 38 weeks (range 25–42 weeks) of gestation. Of the 26 mothers who were diagnosed during pregnancy, nine (26%) were diagnosed at delivery. Three of these mothers had an earlier negative HIV test during pregnancy (two in the first trimester and one during the third trimester) and were never re-tested. Low-quality antenatal care and delays in HIV testing during pregnancy are matters of concern in Italy, where HIV testing is recommended as part of preconception and prenatal care 2. A survey carried out in 2011 in a sample of 1568 women delivering children at 36 maternity hospitals in the Lazio region found that 88.2% of pregnant women underwent the test but only 33.6% received it as part of preconception care 3. Women who missed the test tended to be younger, with a lower education level, a lower HIV knowledge score and fewer visits during pregnancy 3. Thus, despite the enormous progress made in recent years in the prevention of MTCT of HIV, we continue to observe in European countries late diagnosis in HIV-positive mothers. It is important to put in place health policies that are not limited to increasing awareness of HIV in the general population but that also aim to achieve increased awareness in health personnel (gynaecologists, obstetricians and all those who work with pregnant women) of the importance of careful diagnostic monitoring of all sexually transmitted diseases throughout pregnancy. Furthermore, it is desirable that women should have equitable access to periconceptional counselling and screening for congenital infections.

Prevalence and correlates of HIV infection among people who use drugs in Cambodia: a cross-sectional survey using respondent driven sampling method

BackgroundMost of studies on the relationship between drug use and HIV have focused largely on people who inject drugs. Non-injecting drug use is much more common than injecting drug use, and although it can also predispose people to HIV infection, it is not widely explored. We therefore conducted this study to explore the prevalence of HIV and identify risk factors for HIV infection among people who use non-injecting drugs (PWUD) in Cambodia.MethodsThis cross-sectional study was conducted in 2017. The Respondent Driven Sampling method was used to recruit the study participants who were interviewed face-to-face using a structured questionnaire. Blood samples were collected for HIV and syphilis testing. A multivariable logistic regression analysis was conducted to identify risk factors associated with HIV infection.ResultsIn total, 1367 PWUD were included in this study, whose mean age was 28.0 (SD = 7.7) years. The majority (95.1%) of the participants used methamphetamine. The prevalence of HIV was 5.7, and 35.2% of the identified HIV-positive PWUD were not aware of their status prior to the survey. After adjustment for other covariates, HIV infection remained significantly associated with being in the age group of ≥35 (AOR = 2.34, 95% CI = 1.04–6.11), having lower level of formal education of ≤ 6 years (AOR = 2.26, 95% CI = 1.04–5.15), living on the streets (AOR = 2.82, 95% CI = 1.10–7.23), perception that their HIV risk was higher as compared to that of the general population (AOR = 3.18, 95% CI = 1.27–8.62), having used injecting drugs in lifetime (AOR = 3.8, 95% CI = 1.36–4.56), and having cuts or sores around the genital area in the past 12 months (AOR = 3.42, 95% CI = 1.09–6.33).ConclusionsThe prevalence of HIV among PWUD in this study was more than 10 times higher than the prevalence in the general adult population. The findings reveal a higher vulnerability to HIV infection among specific sub-populations of PWUD, such as those who are homeless, who may benefit from tailored interventions that respond to their specific needs. To enhance HIV case finding, stratification of PWUD to facilitate HIV risk profiling based on socio-economic profiles and drug injection history is recommended.

Correlates of HIV-infection among men who have sex with men: results from a community-based, cross-sectional study in Tianjin, China

ABSTRACTChina has 747,000 confirmed HIV/AIDS cases and sexual transmission between men who have sex with men (MSM) is the most prevalent mode of transmission. Our study aims to (a) examine HIV prevalence and behavioral risk factors for HIV infection among 1900 MSM recruited from a community-based organization in Tianjin, China, and (b) describe HIV treatment outcomes for those diagnosed with HIV. We used multivariable logistic regression to identify which socio-demographics and behaviors were associated with HIV infection. The overall HIV prevalence was 3.95%. Key behavioral risk factors included: receptive sex role, older age at first sex with man, condomless anal sex, and having used 2+ drugs. Of those living with HIV, 83% were successfully enrolled in antiretroviral therapy and those enrolled were all virally suppressed after one year. These findings highlight key behavioral risk factors for HIV infection in Tianjin, China and can inform interventions to preventing further HIV transmission.

Sharing of Injection Drug Preparation Equipment Is Associated With HIV Infection: A Cross-sectional Study.

Background:Sharing needles/syringes and sexual transmission are widely appreciated as means of HIV transmission among persons who inject drugs (PWIDs). London, Canada, is experiencing an outbreak of HIV among PWIDs, despite a large needle/syringe distribution program and low rates of needle/syringe sharing.Objective:To determine whether sharing of injection drug preparation equipment (IDPE) is associated with HIV infection.Methods:Between August 2016 and June 2017, individuals with a history of injection drug use and residence in London were recruited to complete a comprehensive questionnaire and HIV testing.Results:A total of 127 participants were recruited; 8 were excluded because of failure to complete HIV testing. The remaining 35 HIV-infected (cases) and 84 HIV-uninfected (controls) participants were assessed. Regression analysis found that sharing IDPE, without sharing needles/syringes, was strongly associated with HIV infection (adjusted odds ratio: 22.1, 95% confidence interval: 4.51 to 108.6, P < 0.001).Conclusions:Sharing of IDPE is a risk factor for HIV infection among PWIDs, even in the absence of needle/syringe sharing. Harm reduction interventions to reduce HIV transmission associated with this practice are urgently needed.