AIDS Transmission Research Articles

The Real Exchange Rate, Foreign Aid and Macroeconomic Transmission Mechanisms in Tanzania and Ghana

The Real Exchange Rate, Foreign Aid and Macroeconomic Transmission Mechanisms in Tanzania and Ghana

Reproductive Health Needs of Adolescent Girls in the Age Group of 15–19 Years in an Urban Slum of Mumbai

Background : Behaviours adopted during adolescence affect the reproductive health in the long run. Objectives: 1.To study the socio-demographic characteristics of adolescent girls.2.To study knowledge, attitude and behaviour of adolescent girls with reference to reproductive health issues .3.To explore the reproductive health needs of adolescent girls. Materials and Method : A list of all adolescent girls was obtained from ICDS project catering to the study area. Total 200 adolescent girls in the age group of 15-19 years were interviewed by systematic random sampling, maintaining full privacy, with prior consent using a pretested questionnaire containing structured, pre-coded and few open ended questions. The data was analyzed by using percentages and chi-square test. Results : Only 28.14% females had a prior knowledge of menstruation. About 11.5% mentioned that females determine the sex of the child. Less than half, 49.5% were aware about any family planning method. More than 3/4th adolescent girls interviewed knew about the principle modes of transmission of AIDS. Only 38.5% females were aware of the potential benefit of condom use in preventing HIV transmission.92% expressed the need to have detail information on conception and family planning. Interpretation and conclusions : A significant number of girls were unaware about the various reproductive health issues, ranging from menstruation, conception, contraception to STI'S and HIV-AIDS. Significant association was seen between their level of education and knowledge on HIV-AIDS and Myths about HIV.

Size Estimation of Most-at-Risk Groups of HIV/AIDS Using Network Scale-up in Tabriz, Iran

Purpose: To begin to manage a serious health problem like AIDS, it is crucial that we know the size of the subpopulation related to the problem. In this study we used Network scale-up method (NSUM), an indirect method of size estimation of hard-to-reach subpopulation, to estimate most at risk population (MARPs) of Tabriz. Methods: Having adapted a purposive sampling, we interviewed 500 people of target population. To estimate the size of social network (C), we used known population method through collecting data of 29 known sub-groups. To estimate most at-risk populations, we applied frequency approach of NSUM. Adjustments were done to correct common errors of this method. Results: Among groups at risk due to sexual contact, the greatest frequency was related to clients of female sex workers (CFSWs) with 831 out of 100000 of men’s population (95% CI: 649, 1055), then female sex workers (FSWs) with 709 out of 100000 of women’s population (95% CI: 512, 930). Among groups at risk due to drug use, the biggest frequency belonged to alcoholic substance users with 1136 out of 100000 of total population (95% CI: 955, 1332). After that, it included opium users, crystal users and injecting drug users (IDUs), respectively. Conclusion: Although the estimated number of MARPs in Tabriz is less than other areas, it is necessary to perform preventive programs like harm reduction programs to reduce transmission of AIDS.

Knowledge and Attitude of Pregnant Women towards Mother to Child Transmission (MTCT) of HIV and AIDS in a Local Clinic in Mafikeng, South Africa

Knowledge and Attitude of Pregnant Women towards Mother to Child Transmission (MTCT) of HIV and AIDS in a Local Clinic in Mafikeng, South Africa

Knowledge and Attitude of Pregnant Women towards Mother to Child Transmission (MTCT) of HIV and AIDS in a Local Clinic in Mafikeng, South Africa

Lack of adequate knowledge might be a factor in MTCT of HIV/AIDS since breastfeeding has been implicated as the most common mode of transmission. The purpose of this study was to evaluate the knowl...

Impact evaluation of HIV/AIDS education in rural Henan province of China

Nowadays, there is a trend of HIV prevalence transmitting from high-risk group to average-risk group in China. Rural China is the weak link of HIV prevention, and rural areas of Henan province which is one of the most high-risk regions in China have more than 60% of the AIDS patients in the province. Thus, improving the HIV awareness and implementing health education become the top-priority of HIV/AIDS control and prevention. A multistage sampling was designed to draw 1129 people living with HIV/AIDS (PLWHAs) and 1168 non-PLWHAs in 4 prevalence counties of Henan province. A health promoting and social-psychological support model was constructed to improve the health knowledge of participants. Chi-square tests and unconditional logistic regression were performed to determine the intervention effect and influencing factors. All groups had misunderstandings towards the basic medical knowledge and the AIDS transmission mode. Before the intervention, 59.3% of the HIV/AIDS patients and 74.6% of the healthy people had negative attitudes towards the disease. There was statistically significant difference in the improvement of knowledge, attitude and action with regards to HIV prevention before and after intervention (P<0.05). PLWHAs who were males (OR=1.731) and had higher education level (OR=1.910) were found to have better HIV/AIDS health knowledge, whereas older PLWHAs (OR=0.961) were less likely to have better HIV/AIDS health knowledge. However, the intervention effect was associated with the expertise of doctors and supervisors, the content and methods of education, and participants' education level. It was concluded that health education of HIV/AIDS which positively influences the awareness and attitude of HIV prevention is popular in rural areas, therefore, a systematic and long-term program of HIV control and prevention is urgently needed in rural areas.

Risky Sexual Behaviour, Sexually Transmitted Infections, HIV/AIDS and Health Promotion among Students in the University of Douala

There are about 9,335 students in the University of Douala, 6,686 males and 3,832 females with a mean age of 20 years. Knowledge of the transmission of AIDS is high as indicated by 95% of the students, 80% were also able to identify preventive strategies. However, there is a failure to translate knowledge into protective action and behaviour. Between 1998 and 2001, there has been a nearly three-fold increase in cases of STIs from 137 to 360. Tuberculosis, which is strongly linked to HIV/AIDS in Douala, has also increased from 7 cases to 38. HIV/AIDS prevalence among students is estimated between 3%-5%. Both male and female students constitute a high-risk group because of multiple partners due to the adoption of several supposedly emotional/financial safe strategies. These include sponsors or male friends who pay rents, furnish rooms etc, in addition to campus girl friends/boy friends 'safety belts' and other short-term relationships. Condom usage is irregular. The University of Douala as part of its health promotion-prevention strategy has intensified its information, education and communication programme on HIV/AIDS with the support of governmental, non-governmental organisations and students clubs on campus and Peer educators have increased their sensitization activities. Preventive strategies include valorising positive cultural norms, empowering and encouraging students to practice sexual abstinence and fidelity. There is a need to incorporate students more in the design of appropriate and acceptable intervention strategies towards the prevention, health enhancement, treatment and management strategies of HIV/AIDS in the university arena.

APOBEC3G Polymorphism as a Selective Barrier to Cross-Species Transmission and Emergence of Pathogenic SIV and AIDS in a Primate Host

Cellular restriction factors, which render cells intrinsically resistant to viruses, potentially impose genetic barriers to cross-species transmission and emergence of viral pathogens in nature. One such factor is APOBEC3G. To overcome APOBEC3G-mediated restriction, many lentiviruses encode Vif, a protein that targets APOBEC3G for degradation. As with many restriction factor genes, primate APOBEC3G displays strong signatures of positive selection. This is interpreted as evidence that the primate APOBEC3G locus reflects a long-term evolutionary “arms-race” between retroviruses and their primate hosts. Here, we provide direct evidence that APOBEC3G has functioned as a barrier to cross-species transmission, selecting for viral resistance during emergence of the AIDS-causing pathogen SIVmac in captive colonies of Asian macaques in the 1970s. Specifically, we found that rhesus macaques have multiple, functionally distinct APOBEC3G alleles, and that emergence of SIVmac and simian AIDS required adaptation of the virus to evade APOBEC3G-mediated restriction. Our evidence includes the first comparative analysis of APOBEC3G polymorphism and function in both a reservoir and recipient host species (sooty mangabeys and rhesus macaques, respectively), and identification of adaptations unique to Vif proteins of the SIVmac lineage that specifically antagonize rhesus APOBEC3G alleles. By demonstrating that interspecies variation in a known restriction factor selected for viral counter-adaptations in the context of a documented case of cross-species transmission, our results lend strong support to the evolutionary “arms-race” hypothesis. Importantly, our study confirms that APOBEC3G divergence can be a critical determinant of interspecies transmission and emergence of primate lentiviruses, including viruses with the potential to infect and spread in human populations.

Why Do Some Women Know More? An Exploration of the Association of Community Socioeconomic Characteristics, Social Capital, and HIV/AIDS Knowledge

The objective of this study was to investigate the associations of community-level socio-economic status (SES) characteristics and social capital with women's knowledge of HIV/AIDS. We used a representative national sample of 6,771 women ages 15–49 years from the Bangladesh Demographic Health Survey of 2007. We extended the findings of prior studies by providing new evidence that both community and social capital were related to having knowledge of AIDS. The significant community characteristics associated with women's greater knowledge of AIDS were: women's higher mean age at first marriage, higher mean years of education, the higher percentage of women in the community who work, and higher mean household living standard in the community. Regardless of individual-level SES, living in a community with higher community-level SES and having greater social capital were associated with having a greater likelihood of hearing about AIDS. However, we found that once women knew about AIDS, not all of the community-SES and social capital indicators explained their advanced knowledge of AIDS prevention and transmission. Our findings underscore the importance of HIV/AIDS education campaigns in the disadvantaged communities, specifically targeting women who are not members in any non-governmental organizations, as well as greater use of media in educating women about AIDS.

Amélioration de la qualité de la prévention de la transmission du VIH de la mère à l'enfant en Côte d'Ivoire

This study analysed the impact of improvement collaborative activities on the quality of prevention of mother-to-child transmission of AIDS in 28 health services in Côte d'Ivoire. This descriptive, longitudinal, analytical study was based on the main information concerning HIV-infected pregnant women, and the integration and maintenance of HIV-infected subjects in the healthcare system. The study was conducted in 28 heathcare structures of 26 health districts in 12 health areas of Côte d'Ivoire,from January to September 2009. Monitoring of HIV-infected pregnant women and their children was analysed by quality indicators developed in the context of the demonstration phase of the collaborative. This study shows that only 16 (57.1%) out of 28 structures had the 6 PMTCT documents defined in this study. The various quality indicators gradually improved on all sites, from 34.7% to 90.3% of items collected in the PMTCT register; the testing rate of infants born to HIV-positive women increased from 30% to 62.5%. More than 95% of children screened were referred to paediatric care. Improvement collaborative approach is important for the improvement of the quality of PMTCT. However, the sustainability of the results of this approach remains the key challenge and will only be possible on the basis of a quality culture of health workers, and greater commitment of authorities.

P4.052 Low Level of Awareness Leading to Stigma Towards Persons With HIV/AIDS

AimHIV thrives among mobile populations. Truck drivers particularly the long distance truck drivers are more vulnerable to HIV infection, because they travel a lot, remain cut off from the mainstream...

1200名大学生性知识和性传播疾病调查分析

目的：了解当代大学生对性知识，性传播疾病(STDS)认知程度和性观念改变状况。方法：通过《大学生健康教育》选修课，授课时进行问卷调查归纳建档。结果：1200名大学生对性知识了解程度较高分别是第二性征98.7%和性器官75.0%。对性传播疾病了解程度很高分别是AIDS全称和传播途经(93.0%)和如何预防性传播疾病(85.0%)。性观念改变状况，男女生之间存在差别。结论：《大学生健康教育》作为高校选修课程是大学生了解性知识，性传播疾病和性观念改变一种有效的手段，同时辅以宣传栏，广播和不定期的讲座来普及有关性知识，性健康。帮助大学生培养正确的性知识，性观念，防止性传播疾病在高校中的传播。 Objective: To investigate the status of sexual knowledge, STDS and attitude towards sex change among 1200 college students. Methods: All data were collected by questionnaire survey during the elective “College Student Health Education”. Results: The remarkable cognitive rates of sexual knowledge were secondary sex characteristics (98.7%) and sexual anatomy (75.0%). Notably, the highest cognitive rates of STDs were 93.3% and 85.8% for the full name of AIDS, AIDS transmission approaches and STDS precaution. Change of attitude towards sex is discriminative between male and female. Conclusion: “College Student Health Education” as an elective is significant for college students to know the sexual knowledge and STDS, as well as to change their attitude towards sex. Other than this, methods such as educational propaganda, broadcasting and occasional lectures are also utilized to popularize knowledge about sex, sexual health and to instruct college students the correct sexual knowledge, attitude towards sex and STDs precaution.

Subtype-specific differences in human immunodeficiency virus type 1 co-receptor usage in Northern Kenya

Background HIV-1 phenotype variability plays an important role in HIV-1 transmission and pathogenesis of AIDS. The basis of heterogeneity between the phenotypes is known to be the differential use of chemokine receptors as co-receptors for viral entry. Beta Chemokine receptor-5 (CCR5) using variants are associated with acute infections, macrophage tropism, non syncytium inducing (NSI) phenotype and slow progression to AIDS. Alpha chemokine receptor-4 (CXCR4) using variants evolve later in infection in about 50 % of the patients and are associated with T cell lines tropism, syncytium induction, accelerated T cell depletion and Rapid progression to AIDS. HIV-1 co-receptor usage and phenotypes are mapped in the third variable region (V3) of the gp120 env gene. Methods One hundred and thirty five (135) whole blood samples were collected from HIV-1 infected patients in Northern Kenya. Proviral DNA was extracted using DNazol and ethanol precipitation. HIV-1 V3 region was amplified by nested PCR using C2V3 primers. Amplicons were sequenced directly using Big Dye technology in the ABI Prism Genetic Analyzer to generate gp120 V3 loop sequences. Bioinformatics tools were used to determine co-receptor usage from the sequences obtained. Results CXCR4 usage was most dominant with 94 out of 135 samples(69.6 %) using this co-receptor compared to CCR5 which was used by 29 of the 135 (21.8 %) samples and dual co-receptor usage found in 12 of the 135(8.6%) samples tested. Conclusion Most patients were inferred to be in late stages of infection and likely to be rapidly progressing to AIDS. Based on these results from co-receptor usage data, HIV-1 incidence rate was likely to be low. Co-receptor usage was observed to be associated with HIV-1 subtypes. Poor alignment of the Northern Kenya sequences with the training data for the classifier software necessitates the need for development of Bioinformatic software relevant for locally circulating HIV-1 subtypes.

Intimate relationships in young adults with perinatally acquired HIV: Partner considerations

Due to developments in anti-retroviral treatment, an increasing number of children with perinatally acquired HIV are now surviving into late adolescence and young adulthood. This cohort is facing normative challenges in terms of their intimate relationships as well as challenges that face all individuals with HIV regardless of the route of transmission (for example, concerns about disclosure). There may be additional issues specific to having grown up with HIV that affect intimate relationships, for example, the awareness of being HIV positive before the onset of intimate relationships and the way that identity is shaped by having lived with HIV from a young age. To date there has been some limited research on the experience of intimate relationships in perinatally infected adolescents but none in young adults. This exploratory study examined, in depth, experiences of intimate relationships in perinatally acquired young adults and how they perceived having grown up with HIV to have affected such relationships. Seven participants (five females, two males) aged 18–23 years, were interviewed, with the data analysed according to the principles of interpretative phenomenological analysis (IPA). Three themes emerged that related to partners' perceptions of HIV: (1) HIV being viewed by partners as being linked to AIDS and sexual transmission, (2) discrepancy between young people and their partners' views of HIV, (3) partner views of risk of HIV transmission. There were strong links between participants' personal experiences of HIV-related challenges, for example, disclosure and HIV-related stigma, and their thinking about the perceptions of partners. These findings have important implications for supporting young people in disclosing their HIV status to intimate partners in appropriate ways. Suggestions for future research are offered.

“Pinch, Leave an Inch and Roll”: Applying the Communication-for-Behavioural-Impact (COMBI) Approach to the Promotion of Proper Male Condom Use in Jamaica

IntroductionTHE PROMOTION OF CONSISTENT CONDOM has been a longstanding strategy in the response to the HIV and AIDS epidemic. The generic use a condom every time message has been featured in many health communication campaigns promulgating consistent condom use. This article recounts the experience of the Pinch, Leave an Inch and Roll campaign which focused on the specific steps of putting on a male condom properly, and targeted males aged fifteen to twenty-four years. The campaign was planned during 2008 and implemented during 2009-2010 by the National HIV/STI Programme of Jamaica as one strategic communication activity within their overall behaviour change communication which includes a mix of mediated and interpersonal communication-based interventions. Communication for Behavioural Impact (COMBI), a multifaceted approach to communication planning, is used as the framework for understanding the process of creating the Pinch, Leave an Inch and Roll campaign. It must be noted that while the COMBI approach was not purposefully used in the entire planning process of the campaign, it is applied here post-implementation as a way to conduct a structured review of what occurred during the evaluation, design, and execution stages. Of the National HIV/ STI Programme's many campaigns, Pinch, Leave an Inch and Roll was chosen as a good example of communication in action because summative evaluation indicated that it had a relatively high message recall one year after its implementation.1 The campaign also employed many of the tenets of development communication campaign planning.2Background to the National HIV/STI Programme and its condom promotion activitiesThe National HIV/STI Programme of Jamaica was established in 1986 by the Ministry of Health as an extension of the former Sexually Transmitted Disease Control Programme, which was in existence from 1930. The National HIV/STI Programme is responsible for coordinating and leading the implementation of Jamaica's response to HIV and AIDS. In order to fulfil this mandate, the National HIV/STI Programme focuses on four main components: prevention; treatment, care and support; enabling environment and human rights; and monitoring and evaluation.3Within the HIV-prevention component of the National HIV/STI Programme, behaviour-change communication interventions promoting safer sexual behaviour are created to control the transmission of HIV and AIDS among the wider population and, in particular, among the most at-risk populations which include sex workers, men who have sex with men, people living with HIV, out-of-school youth, homeless drug users, and inmates. The prevention efforts aimed at changing risky sexual activities and sustaining safer sexual practices a multisectoral approach. The HIV prevention team within the Ministry of Health collaborates closely with other agencies offering services that are useful to the various targeted populations. In order to ensure that individuals possess the self-efficacy to adopt and maintain relevant behaviours, the HIV prevention team utilises a number of strategies, including community outreach activities and special events which usually include free HIV testing, and distribution of free condoms coupled with condom demonstrations undertaken by the client and guided by the intervention officer. These are supported by national media campaigns which not only provide information but also encourage the practice of appropriate safer-sex behaviours such as consistent condom use.Other strategies of the National HIV/STI Programme's HIV prevention component include the of cultural vehicles such as television shows and party interventions. Through sponsoring of various television and party events, the programme is able to position its efforts in locations which are likely to increase the visibility of key messages and allow for the conduct of condom demonstrations. In 2009, for example, the National HIV/STI Programme sponsored Magnum Kings and Queens of the Dancehall, the popular Jamaican dancehall competition aired weekly on the television station TVJ. …

The Impact of HIV/AIDS Message in Selected Kenyan Primary School Texts: A Linguistic Perspective

In Kenya, HIV and AIDS education has been integrated into the school curriculum as an effort to curb transmission of HIV and AIDS. The current study identified the phrases with HIV and AIDS message in selected textbooks of English, Science and Social Sciences in primary schools which were classified according to Mills (1995). Standards of textuality in the phrases were then examined and their impact on the readers evaluated as per Beaugrande & Dresseler classification (1981). The target population were class seven pupils and their teachers, in five randomly selected primary schools in Nakuru Municipality Division, Kenya. Oral interviews and elicitation tests were used as data collecting tools. Evaluation of 39 phrases identified from 6 textbooks showed that none of the standard of textuality was upheld 100%. However, acceptability scored the highest (71.7%) while informativity scored the least (29.2%). Cohesion & Coherence, Intentionality, Situationality and Intertextuality had average scores ranging between 45 to 67.8%. It was concluded that the extent, to which each standard of textuality is upheld, correlates to a text’s appropriateness. Therefore, text book writers should design material that upholds all the standards of textuality to enhance effective communication. Such a move would ensure that the education system achieves its objectives.

Circoncision chez l’enfant : une simple question d’organisation des soins ou un enjeu éthique ?

ObjectivesTo review society, ethical and anaesthesiological issues related to circumcision in children. Study designReview. MethodsPubmed search and expert opinion ResultsCircumcision concerns 30 of male world population. Reasons are ritual, medical and hygienic. In Muslims, circumcision is usual performed before the age of six. Surgery is performed at best under sevoflurane general anaesthesia and a penile bloc. Level 1 and level 2 antalgics are used for 72hours, once the bloc has elapsed. In Jews, circumcision is performed soon after birth, in the community. Emla is the most convenient antalgics in this case. Except in case of emergency, circumcision under general anaesthesia should be delayed after 3 months as general anaesthesia is suspect to exert cerebral toxicity. Before the age of one year, there is a risk of increased respiratory problems following general anesthesia. Therefore, circumcision under general anaesthesia should be performed after one year of age. Circumcision may represent an adjunct to limit AIDS transmission in endemic countries. ConclusionThe ethical point associated with circumcision is to allow best analgesia, in a way matching child's age. Analgesia, is achievable by both the surgeon and the anesthesiologist.

Reactivation of latent HIV-1 by a wide variety of butyric acid-producing bacteria.

Latently infected cells harbor human immunodeficiency virus type 1 (HIV-1) proviral DNA copies integrated in heterochromatin, allowing persistence of transcriptionally silent proviruses. It is widely accepted that hypoacetylation of histone proteins by histone deacetylases (HDACs) is involved in maintaining the HIV-1 latency by repressing viral transcription. HIV-1 replication can be induced from latently infected cells by environmental factors, such as inflammation and co-infection with other microbes. It is known that a bacterial metabolite butyric acid inhibits catalytic action of HDAC and induces transcription of silenced genes including HIV-1 provirus. There are a number of such bacteria in gut, vaginal, and oral cavities that produce butyric acid during their anaerobic glycolysis. Since these organs are known to be the major site of HIV-1 transmission and its replication, we explored a possibility that explosive viral replication in these organs could be ascribable to butyric acid produced from anaerobic resident bacteria. In this study, we demonstrate that the culture supernatant of various bacteria producing butyric acid could greatly reactivate the latently-infected HIV-1. These bacteria include Fusobacterium nucleatum (commonly present in oral cavity, and gut), Clostridium cochlearium, Eubacterium multiforme (gut), and Anaerococcus tetradius (vagina). We also clarified that butyric acid in these culture supernatants could induce histone acetylation and HIV-1 replication by inhibiting HDAC. Our observations indicate that butyric acid-producing bacteria could be involved in AIDS progression by reactivating the latent HIV provirus and, subsequently, by eliminating such bacterial infection may contribute to the prevention of the AIDS development and transmission.

America's plague of incarceration

America's plague of incarceration

O conhecimento sobre Aids de homens idosos e adultos jovens: um estudo sobre a percepção desta doença

The scope was to compare awareness of elderly males and young adults about aids, taking education into consideration. By means of an epidemiological, descriptive and cross-sectional study, the information of 30 elderly males and 62 young adults about the concept, transmission, prevention, diagnosis and treatment of aids was investigated by structured interviews based on a standardized and validated questionnaire. Frequency distribution, Chi-square test or Fisher's exact test, as well as Student's t test or the Mann-Whitney test were used, with a significance level of 0.05 for contingency and variance analysis. The Mantel-Haenszel test with a significance level of 0.05 and Odds Ratio with 95% confidence intervals were used to determine scholarship influence. Individual perception of good health was greater among young adults (61.3% vs 43.3% for elderly) and major sexual activity for elderly males was detected (80% vs 62.9% of young adults). Nevertheless, the elderly males declared adequate knowledge about aids less frequently (26.7% vs 80.6% of young adults); prior HIV test (13.3% vs 24.2% of young adults) and receiving orientation about aids (36.7% vs 98.4% of young adults). Elderly males had insufficient information on HIV/aids, when compared with young adults, highlighting the need to pay closer attention to the elderly population.