Transmission Of HIV Infection Research Articles

Prevention of mother-to-child transmission of HIV infection in Nigeria: what are the barriers?

Prevention of mother-to-child transmission of HIV infection in Nigeria: what are the barriers?

Knowledge of pregnant women regarding prevention of mother-to-child transmission of HIV infection in Gert Sibande District, Mpumalanga Province, South Africa: A qualitative study.

Prevention of mother-to-child transmission (PMTCT) of HIV helps in closing the gaps for new HIV infections, thereby contributing to achieving the global targets of an AIDS-free generation. To explore knowledge regarding PMTCT among pregnant women in Gert Sibande District, Mpumalanga Province, South Africa (SA). The study was performed in two clinics in Chief Albert Luthuli Municipality, Gert Sibande District. It was a qualitative and descriptive exploratory study involving in-depth, one-on-one interviews with pregnant women regarding their PMTCT knowledge and perspectives. The study findings showed that pregnant women from the two clinics have a good knowledge of PMTCT. However, they were not aware that caesarean section can minimise mother-to-child transmission (MTCT) of HIV infection. PMTCT is important in establishing an HIV-free generation. The study revealed that women had a good understanding of MTCT; nevertheless, additional education is necessary, particularly regarding birthing procedures that minimise the risk of MTCT.

Evaluation of CD4 Count in HIV Infected Pregnant Women at Kibagabaga Level Two Teaching Hospital

CD4 count measures the degree of immunosuppression in HIV-positive patients and is used to monitor HIV infection progression in human body. HIV is a virus that attacks the body’s immune system and if not treated, can lead to AIDS The rate of CD4 cells destruction is directly proportional to progressive replication of HIV. Pregnant women infected with HIV have high risk of mother to child transmission of HIV infection and are prone to excessive immunosuppression and increased viral load if their CD4 cell count is not properly maintained. Pregnancy may influence CD4 cells count reduction or don’t, that’s why this study focused on evaluation of CD4 count in HIV infected pregnant women. The objectives of this study were to determine the association between pregnancy trimesters and CD4 count among HIV infected pregnant women at KDH. The study was a cross sectional study which included 46 patients who visited kibagabaga level two teaching hospital in 5 months. Data were obtained by collecting venous blood of patients, testing their CD4 count and use of a questionnaire to evaluate the risk factors associated with changes in CD4 count. Data collected were analysed using statistical package for social sciences (SPSS) software version 22.0 and Microsoft word, the presentation of results was done using tables. Variables with p-value less than or equal to 0.05 were considered statistically significant. The study showed that there is an association between pregnancy trimesters and CD4 count among HIV infected pregnant women where 21(45.6%) women were in third trimester and had the highest CD4 count compared to women in the 2nd trimester 14(30.4%) followed by women in 1st trimester 11(24%) with p-value of 0.04 which is statistically significant. In evaluated CD4 count changes, associated risk factors were, antiretroviral treatment intake, diet intake, education level, pregnancy trimester, and closely spaced pregnancies. Which were found to have p-values 0.00, 0.00, 0.04, 0.04 and 0.01 that were statistically significant respectively. Keywords: HIV, CD4 Count, Pregnant women

New sexually transmitted HIV infections from 2016 to 2050 in Guangdong Province, China: a study based on a dynamic compartmental model

BackgroundIn Guangdong Province, China, there is lack of information on the HIV epidemic among high-risk groups and the general population, particularly in relation to sexual transmission, which is a predominant route. The new HIV infections each year is also uncertain owing to HIV transmission from men who have sex with men (MSM) to women, as a substantial proportion of MSM also have female sexual partnerships to comply with social demands in China.MethodsA deterministic compartmental model was developed to predict new HIV infections in four risk groups, including heterosexual men and women and low- and high-risk MSM, in Guangdong Province from 2016 to 2050, considering HIV transmission from MSM to women. The new HIV infections and its 95% credible interval (CrI) were predicted. An adaptive sequential Monte Carlo method for approximate Bayesian computation (ABC-SMC) was used to estimate the unknown parameter, a mixing index. We calibrated our results based on new HIV diagnoses and proportions of late diagnoses. The Morris and Sobol methods were applied in the sensitivity analysis.ResultsNew HIV infections increased during and 2 years after the COVID-19 pandemic, then declined until 2050. New infections rose from 8,828 [95% credible interval (CrI): 6,435–10,451] in 2016 to 9,652 (95% CrI: 7,027–11,434) in 2019, peaking at 11,152 (95% CrI: 8,337–13,062) in 2024 before declining to 7,084 (95% CrI: 5,165–8,385) in 2035 and 4,849 (95% CrI: 3,524–5,747) in 2050. Women accounted for approximately 25.0% of new HIV infections, MSM accounted for 40.0% (approximately 55.0% of men), and high-risk MSM accounted for approximately 25.0% of the total. The ABC-SMC mixing index was 0.504 (95% CrI: 0.239–0.894).ConclusionsGiven that new HIV infections and the proportion of women were relatively high in our calibrated model, to some extent, the HIV epidemic in Guangdong Province remains serious, and services for HIV prevention and control are urgently needed to return to the levels before the COVID-19 epidemic, especially in promoting condom-based safe sex and increasing awareness of HIV prevention to general population.

Assessment of Stigma, Violence and Coping Mechanisms Among HIV Infected People Who Inject Drugs in Akwa-Ibom State, Nigeria

People who inject drugs (PWIDs) living with HIV face high levels of stigma, violence, and rape due to their risky lifestyles, potentially facilitating the spread of HIV. This study assessed the level and type of stigma and violence among PWIDs attending Heartland Alliance in Akwa Ibom State and their coping mechanisms. This descriptive cross-sectional study of 442 PWIDs receiving care at four one-stop shops in the state was conducted using mixed methods. Quantitative data were collected through pretested structured questionnaires and an adopted stigma scale, administered by trained research assistants using Computer Assisted Personal Interviewer (CAPI). For qualitative data, one focus group discussion (FGD) was held at each site with 8-10 purposively selected PWIDs, and transcripts were analyzed thematically. The study findings reveals that most respondents were male (78%) with a mean age of 32.7±7 years. Pentazocine use was common (52%), and 18% shared needles, with 15% sharing blood after injections among friends. More than half (58%) missed more than one dose of ARVs in the past week. Perceived stigma (59%) was more common than internal stigma (18%), with predictors being student status, non-disclosure of HIV status, and non-adherence to treatment. PWIDs Physical violence (47.5%) and verbal abuse (37.1%) were prevalent among PWIDs. Female PWIDs had a ninefold higher risk of rape. Coping mechanisms included isolation, increased substance use, battle readiness, and positive reframing. <i>Conclusion</i>: PWIDs face significant levels of stigma, violence, and non-adherence, jeopardizing treatment outcomes and perpetuating STI, HIV, and blood-borne infection transmission. Establishing harm-reduction programs is essential to address these vulnerabilities and the consequences associated with drug use.

HIV seroconversion and associated factors among seronegative pregnant women attending ANC in Ethiopia: an institution-based cross-sectional study.

In countries with limited resources, including Ethiopia, HIV is diagnosed using a rapid serological test, which does not detect the infection during the window period. Pregnant women who test negative for HIV on the first test may seroconvert throughout pregnancy. Women who are seroconverted during pregnancy may not have received interventions, as they are considered HIV-negative unless they are retested for HIV at the end of their pregnancy. Due to limited data on HIV seroconversion, this study aimed to measure the extent of HIV seroconversion and to identify associated factors among seronegative pregnant women attending ANC in Ethiopia. Institution-based cross-sectional study was conducted among HIV-negative pregnant women attending the ANC in Ethiopia between June and July 2020. Socio-demographic, clinical, and behavioral data were collected through face-to-face questionnaires and participants' records review. HIV retesting was performed to determine the current HIV status of pregnant women. The data collected were entered into Epi data version 4.4.1 and were exported and analyzed by SPSS version 25. A p-value < 0.25 in the bivariate analysis was entered into multivariable logistic regression analysis and a p-value of < 0.05 was considered statistically significant. Of the 494 pregnant women who tested negative for HIV on their first ANC test, six (1.2%) tested positive on repeat testing. Upon multivariable logistic regression, pregnant women who have had a reported history of sexually transmitted infections [AOR = 7.98; 95% CI (1.21, 52.82)], participants' partners reported travel history for work frequently [AOR = 6.00; 95% CI (1.09, 32.99)], and sexually abused pregnant women [AOR = 7.82; 95% CI (1.194, 51.24)] were significantly associated with HIV seroconversion. The seroconversion rate in this study indicates that pregnant women who are HIV-negative in early pregnancy are at an ongoing risk of seroconversion throughout their pregnancy. Thus, this study highlights the benefit of a repeat HIV testing strategy in late pregnancy, particularly when the risk of seroconversion or new infection cannot be convincingly excluded. Therefore, repeated testing of HIV-negative pregnant women in late pregnancy provides an opportunity to detect seroconverted pregnant women to enable the timely use of ART to prevent mother-to-child transmission of HIV infection.

ANALYSIS OF THE INTEGRAL EFFICIENCY OF MEDICAL AID FOR NEWBORN IN UKRAINE

Introduction. Preservation of life and quality of health of newborns is an urgent problem for formation of the future of society and mankind, defense capability, labor reserve and intellectual potential of the country. The fundamental basis for the formation and maintenance of health of newborns is the existence of eff ective health care systems. Objective information about the eff ectiveness of medical care of newborns and its dynamics is the basis for evaluation of achievement of planned results and development of necessary medical organizational technologies. The aim of the study is to analyze and evaluate the integrated eff ectiveness of medical care for newborns in Ukraine at the national and regional levels.Material and Methods. In order to carry out the research, statistical reporting materials on the activities of health care institutions providing medical care to mothers and newborns in all periods of their development for 2018, 2022 were used. The analysis of the integral eff ectiveness of medical care for newborns was carried out using a modifi ed model of the fi nal results of health care institutions. I with the calculations of coeffi cients of comprehensive assessment (CCA) and coeffi cients of achievement of normative values (CANV) of individual indicators with their gradation from high (0,8-1) to low (0,1-0,49) levels. The methods of system approach, bibliographic, statistical data processing and graphical representation are applied.Results. A comprehensive study of the integrated eff ectiveness of medical care for newborns at the national and regional levels conducted at the population level showed a suffi cient, above- average level of achievement of results CCA 0.75 in 2018 and 0.76 in 2022) without clear geological patterns in 2018 and signifi cant diff erences in 2022. – From a high level of CCA (0.82-0.94) in Volyn, Zakarpattia, Ivano- Frankivsk, Lviv, Mykolaiv, Ternopil, Kharkiv and Khmelnytsky regions to a low level of CCA (0.41 and 0.35) in Donetsk and Kherson regions. The study of the main indicative indicators of the eff ectiveness of medical care for newborns in 2022 proved a suffi cient achievement. The normative values of coverage of newborns by screening programs, BCG vaccination, survival and mortality rates of newborns, neonatal transfer index (CANV =0.96, 0.82, 0.94, 0.82 and 0.76, respectively). The most problematic indicators of medical care for newborns with low and below- average levels of the coeffi cient of achievement of results, which are signifi cantly associated with the deterioration of the health of pregnant women and the course of childbirth, are the frequency of low weight, sick newborns (CANV = 0.48, 0.51) and the frequency of transmission of HIV infection from mother to child (CANV = 0.4), which is associated with the fullapplication of an eff ective 4-component strategy for prevention of HIV transmission from mother to child.Conclusions. A toolkit for integral assessment of the eff ectiveness of medical care for newborns as a measure of viability and health quality of the off spring at all stages of ontogenesis has been developed. makes it possible to ensure on a unifi ed basis objective assessment and monitoring of it as a whole, by region and by individual indicators with the subsequent development of measures to infl uence the identifi ed problems and their implementation in the activities of maternal and child health care. The model of integral eff ectiveness of medical care of newborns is a pilot project and has dynamic properties, therefore, in the future, when the normative values of indicators of comprehensive assessment are reached, their revision is planned.

IJCM_95A: To Assess the knowledge and practice regarding reproductive tract infection among female of reproductive age group in Raipur city Chhattisgarh

Background: Reproductive tract infection (RTI) is a global health problem among women, especially in South East Asia Region (SEAR) countries. They may progress to serious complications and cause a high degree of morbidity during the sexually active period of life. More than a million women and infants die of the complications of RTI every year. RTI has become a silent epidemic that devastates women’s lives. Globally, three different types of RTI cause significant amounts of morbidity and mortality among women – sexually transmitted infections (STIs) (including gonorrhea, chlamydia, syphilis, trichomonas, and HIV infections); endogenous infections resulting from the overgrowth of organisms normally present in the reproductive tract (such as candidiasis and bacterial vaginosis); and iatrogenic infections related to medical procedures (such as menstrual regulation, abortion or IUD insertion). The presence of STI increases the risk of acquiring and transmitting HIV infection by three to five times. Objectives: 1- To Assess the knowledge of female what is reproductive tract infection how it occur and spread among residents of Raipur City, Chhattisgarh. 2- To Assess the Factors associated with Knowledge among residents of Raipur City, Chhattisgarh. Methodology: This is an observational cross-sectional study conducted in Raipur City of Chhattisgarh state during the month October 23-January 2024. A pre-designed, self-administered, semi-structured questionnaire was used for data collection. Systematic Random sampling technique was adopted to select the 350 Study participants. Results: The majority of subjects were between the age of 15-34 year. Most of the subject were of lower middle class socioeconomic status. Additionally, 37.8% of participants were graduates, 59.4% were married and 70% were unemployed. 30.3% subjects had not heard about Reproductive tract infection. 50.6% subjects don’t know about symptoms of RTI, almost half 49.4% subject don’t have knowledge about effect of RTI on health and only 84% female believed that good personal hygiene prevent RTI. 45.1% subjects did not wash their private part after urination, 10.5% female did not wash their used cloth daily after each use. 63.9% female used feminine hygiene products to maintain personal hygiene, 10% female did not change their cloth daily, 33.1% women did not change their pad/ cloth within every 4–6-hour interval during menstruation. Conclusion: Educate women through camps about genital hygiene practices to reduce the risk of RTI. For increased usage of Sanitary pads, more number of sanitary vending machine should be installed in schools, colleges, and health facilities. Implement awareness programs, promoting regular check- ups and safe sex practices to mitigate the risk of RTI.

How Would You Manage HIV Pre-exposure Prophylaxis in This Patient With Medical Comorbidities? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Despite advances in treatment, HIV infection remains an important cause of morbidity and mortality, with more than 30 000 new cases diagnosed in the United States each year. There are several interventions traditionally used to prevent HIV transmission, but these vary in effectiveness and there are challenges to their implementation. In 2014, the Centers for Disease Control and Prevention published initial guidance on the use of antiretroviral pre-exposure prophylaxis (PrEP) to prevent transmission of HIV infection in persons at risk based on multiple studies that showed it to be highly efficacious in various populations. It was updated in 2021 to reflect new drug options. The U.S. Preventive Services Task Force also recently updated its recommendations for PrEP, which strongly support its use in persons at risk. Despite its well-established effectiveness, the implementation of PrEP in clinical practice has been variable, especially among populations underserved by the medical system and marginalized by society. Fewer than one third of persons in the United States who are eligible for PrEP currently receive it. Here, 2 physicians experienced in HIV PrEP debate how best to identify patients who might benefit from PrEP, how to decide what regimen to use, and how to monitor therapy.

A systematic review and meta-analysis of HIV transmission risk behaviors, genetic variations, and antiretroviral (ARV) resistance in LGBT populations.

Currently, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) has become one of the major health problems worldwide, including Indonesia. East Java is one of the provinces in Indonesia with the highest prevalence of HIV infection. One of the causes of HIV infection transmission is lesbian, gay, bisexual, and transgender (LGBT) practice. Furthermore, the treatment using antiretroviral (ARV) drugs in HIV-1 patients can fail due to the presence of HIV drug resistance. The aim of this study is to identify the behavior at risk of HIV transmission among LGBT, patterns of genetic variation and antiretroviral (ARV) resistance. A systematic review and meta-analysis based on the PRISMA guidelines was conducted. We searched three databases including PubMed, ScienceDirect, and Google scholar for studies investigating the non-heterosexual behavior as risk factor of HIV infection and antiretroviral resistance. Only studies published in English are considered. The adjusted estimates of the risk were carried out using best-adjusted OR with 95% confidence interval (CI) and significant p value < 0.05. In the quantitative analysis of HIV infection risk factors, a total of 13 studies were included, which investigated non-heterosexual behavior as a potential factor. The studies involved a total of 37,129 participants, comprising 10,449 individuals in the non-heterosexual behavior group (LGBTQ+) and 26,680 individuals in the heterosexual group. The majority of the participants in this study were from the USA, Japan, China, and Brazil, and the main HIV subgenotypes were B and CRF. Additionally, the antiretroviral resistance of HIV patients was examined, involving a total of 3062 individuals, with 1296 individuals in the non-heterosexual behavior group and 1766 individuals in the heterosexual group. Our calculation showed that non-heterosexual behavior was significant as risk factor of HIV infection (OR = 2.17, 95% CI = 1.94-2.43, p < 0.001) and antiretroviral resistance (OR = 1.31, 95% CI = 1.00-1.71, p = 0.05). This study concludes that non heterosexual behavior is significant risk factor of HIV infection. A quite prevalent of antiretroviral resistance were found among non heterosexual behavior. The main subgenotype of HIV are B and CRF.

Perilaku Seksual Lesbian, Gay, Biseksual,Transgender, dan Risikonya terhadap Infeksi Menular Seksual

Lesbian, gay, bisexual, transgender (LGBT) face many gaps in sexual health aspects, including an increased risk of human immunodeficiency virus (HIV infection), sexually transmitted infections (STIs), and pregnancy. LGBT often experience social stigmatization, isolation, and rejection, even from their respective parents. Risk of STIs is related to sexual orientation, sexual anatomy, and sexual behaviour. LGBTs sexual activity may vary and with multiple partners, who are vulnerable to transmission of STIs and HIV infection. Health care providers are responsible for an open discussion regarding sexual health issues; including sexual orientation, sexual behavior, and gender identity.

Introducing methadone maintenance therapy into Ukrainian prisons: a qualitative study of criminal subculture, Russia's full-scale invasion, and contested methadone objects.

After pilot testing, methadone was newly being introduced into Ukrainian prisons in 2021 as part of a national scale-up strategy to treat opioid use disorder and prevent transmission of HIV and HCV infections. Opioid agonist therapy (OAT) scale-up in Eastern Europe and Central Asia prisons has been hampered by varying levels of influence of criminal subculture, an extralegal informal governance by a social hierarchy that operates in parallel to formal prison authorities. This study examined the socio-environmental factors influencing the uptake of methadone treatment in Ukrainian prisons, including changes that evolved during Russia's full-scale invasion of Ukraine and the displacement of people deprived of liberty (PDL) from conflict to non-conflict regions. In-depth qualitative interviews (N = 37) were conducted from January 2021 to October 2022 in the only two Ukrainian prisons where methadone was being introduced with PDL (N = 18). These two prisons continued to provide methadone after the full-scale invasion. Former PDL (N = 4) were also interviewed and prison staff (N = 15). Interviews were audio-recorded, transcribed, and translated into English. Four authors independently reviewed, coded, and applied a phenomenological framework for data analysis, delineating themes related to criminal subculture, drug use, methadone uptake, and evolving changes during the Russian invasion. Criminal subculture perceptions varied, with some seeing it as strongly discouraging drug use among certain groups, while others described it as a residual and weak influence from a more distant past. The influence of the subculture on methadone treatment uptake, however, was less clear. PDL and prison staff struggled to identify and articulate differences between illicit street-bought methadone, used recreationally, and medically prescribed methadone. Thus, the meaning of "methadone" varies in interpretation as it is being introduced, making it potentially conflicting for patients to opt into this evidence-based treatment. As Russia invaded Ukraine in 2022, PDL from conflict zones were transferred to non-conflict regions where methadone was being introduced. The prison environment became more enabling for PDL to start methadone as they were segregated and not subject to the existing criminal subculture's rules and lacked the social ties necessary to procure drugs illegally. It appears that the criminal subculture is variable and evolving in Ukrainian prisons and appears to be impacted differently by the invasion of Russia. As methadone scale-up in prisons expands, it will be important to distinguish the meaning of methadone perpetuated negatively by the prison subculture versus that in which it is intended as a medical treatment by the formal prison authorities. The current invasion of Ukraine by Russia provides a potential disruption to alter this course.

Health Systems Barriers to the Implementation of Preventing Mother-to-Child Transmission of Human Immunodeficiency Virus Infection in Primary Health Care Facilities in Ghana

Background. Ghana has implemented the prevention of mother-to-child transmission strategy (PMTCT) to control HIV infection transmission to babies. However, this has not yielded the desired results, as there are still many mother-to-child HIV infection cases being reported due to factors such as those related to health system barriers. This study was, therefore, conducted to identify health system barriers to the implementation of PMTCT in selected districts in the Ashanti Region of Ghana. Methods. A cross-sectional study was conducted among 118 health workers in 20 selected health facilities within the Asante-Akim Central and South Municipalities in the Ashanti Region, Ghana, to assess the health system barriers to the prevention of mother-to-child transmission of HIV/AIDS. Data was collected using a structured, self-administered questionnaire, which was later transferred to Kobo Collect software. The study participants were chosen using multistage sampling approaches. The data cleaning and analysis were done using STATA version 16.1. Multiple logistic regression models, chi-square analysis for normality testing, and descriptive analysis were all used. The results were displayed in tables, and a p-value of 0.05 was used to determine the significance level. The study was carried out from June to September 2022. Results. In all, 118 participants were involved in this study. Of this, 57.4% had a good level of knowledge of PMTCT, even though all of them were aware of PMTCT. We found being more than 40 years (Odds Ratio, OR = 2.08 95% CI: 1.05, 5.00) and being in service with Ghana Health Service for more than 15 years (OR = 2.36 95% CI: 0.51,10.84) to be significant predictors of knowledge on PMTCT among our participants. A greater proportion of our participants revealed inadequate staffing as the major challenge faced in the delivery of PMTCT in Ashanti Region. Increased education on PMTCT was the most suggested solution to improve the management of HIV infection among pregnant women and further enhance the success rates of PMTCT in Ashanti Region, Ghana. Conclusions. The majority of the health professionals had good knowledge about the prevention of mother-to-child transmission. However, the number of staff in the two districts was not adequate, which affected public education. It is therefore important to increase the number of staff to enhance educating the public and minimize the transmission rate in the districts and the country as well.

Enhancement of Tuberculosis Detection and Prevention in HIV-Infected Patients

Tuberculosis incidence and HIV infection incidence in the regions of the Russian Federation are declining, but the proportion of HIV positive people among the entire cohort of tuberculosis patients is clearly growing.The objective: to determine causes for increasing proportion of HIV infected people among tuberculosis patients and to provide additional recommendations for enhancement of tuberculosis detection in HIV infected patients. as well as prevention of its transmission.Subjects and Methods. The cohort of new tuberculosis patients with concurrent HIV infection (TB/HIV coinfection) in the Russian Federation region with a high prevalence of HIV infection was studied based personal medical records of patients for the first 6 months of 2022 (682 cases totally).Results. The cohort of patients with TB/HIV co-infection belonged to socially vulnerable population. Among them, the parenteral route of HIV infection transmission still prevails, while in the whole country, among new HIV patients, the sexual (heterosexual) route of transmission already prevails. The majority of patients with TB/HIV co-infection, who had been infected with HIV for more than 5 years by the time tuberculosis was detected, were not registered with the Center for AIDS Prevention and Control and accordingly received no antiretroviral therapy. In most cases, HIV-infected patients sought medical care in general medical services when they developed symptoms of tuberculosis, however they referred for help when the disease was advanced. When assessing effectiveness of tuberculosis treatment, the specific parameters of tuberculosis course in HIV-infected patients with compromised immunity have not been taken into account.

EFdA efficiently suppresses HIV replication in the male genital tract and prevents penile HIV acquisition.

Sexually transmitted HIV infections in heterosexual men are acquired through the penis. Low adherence to condom usage and the fact that 40% of circumcised men are not protected indicate the need for additional prevention strategies. Here, we describe a new approach to evaluate the prevention of penile HIV transmission. We demonstrated that the entire male genital tract (MGT) of bone marrow/liver/thymus (BLT) humanized mice is repopulated with human T and myeloid cells. The majority of the human T cells in the MGT express CD4 and CCR5. Direct penile exposure to HIV leads to systemic infection including all tissues of the MGT. HIV replication throughout the MGT was reduced 100-1,000-fold by treatment with 4'-ethynyl-2-fluoro-2'-deoxyadenosine (EFdA), resulting in the restoration of CD4+ T cell levels. Importantly, systemic preexposure prophylaxis with EFdA effectively protects from penile HIV acquisition. IMPORTANCE Over 84.2 million people have been infected by the human immunodeficiency virus type 1 (HIV-1) during the past 40 years, most through sexual transmission. Men comprise approximately half of the HIV-infected population worldwide. Sexually transmitted HIV infections in exclusively heterosexual men are acquired through the penis. However, direct evaluation of HIV infection throughout the human male genital tract (MGT) is not possible. Here, we developed a new in vivo model that permits, for the first time, the detail analysis of HIV infection. Using BLT humanized mice, we showed that productive HIV infection occurs throughout the entire MGT and induces a dramatic reduction in human CD4 T cells compromising immune responses in this organ. Antiretroviral treatment with novel drug EFdA suppresses HIV replication in all tissues of the MGT, restores normal levels of CD4 T cells and is highly efficient at preventing penile transmission.

Development and feasibility testing of an integrated PTSD and adherence intervention cognitive processing therapy-life steps (CPT-L) to improve HIV outcomes: Trial protocol

Despite high rates of Post-Traumatic Stress Disorder (PTSD) in persons living with HIV (PLWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PLWH does not exist. Negative reinforcement conceptual models posit that avoidant behavior (hallmark symptom of PTSD) demonstrated by PLWH with co-occurring PTSD can contribute to poor antiretroviral therapy (ART) adherence. However, research evaluating the impact of evidence-based treatment for PTSD among HIV infected populations on HIV outcomes is scarce. The Cognitive Processing Therapy (CPT) protocol is an evidence-based PTSD treatment that may address internalized stigma with targeted modifications and improve ART adherence and subsequent viral suppression through reduction of avoidant coping. This study will be the first pilot open-label randomized control trial (RCT) to test feasibility of an integrated evidence-based PTSD treatment (CPT) with an adherence intervention (Lifesteps) delivered in a Ryan White clinic to improve PTSD symptoms, adherence to ART, and retention in HIV care. Primary aims are to (1) conduct theater testing of the CPT and Lifesteps research protocol and evaluate acceptability (n = 12) and (2) deliver a modified CPT protocol (CPT-Lifesteps, or CPT-L) in 60 PLWH/PTSD exploring impact of CPT-L on PTSD symptoms and HIV outcomes compared to a Lifesteps + Standard of Care condition. This innovative research extends PTSD treatment approaches as a paradigm to reduce barriers to ART adherence. Findings of this innovative study are significant because they support the Undetectable = Untransmittable (UU) campaign and can help prevent the transmission of HIV infection through increased viral suppression.

Classification of recent and long-term infection among high-risk individuals using HIV-1 rapid recency testing

Background: HIV prevention with a significant reduction of new infections is important for epidemic control strategies. Antibody-based tests for recent infection (TRI) that can help distinguish recent from long-term HIV infection have been used since the mid-1990s to estimate population-level HIV incidence. Because the tests are done centrally, test results are not available to providers immediately. Point of care rapid testing for recent HIV infection (RTRI) was used for distinguishing recent from long-term status and estimated HIV incidence for preventing HIV infection. The usefulness of RTRI for recent HIV infection detection can be accelerated prevention of HIV infection transmission. Objectives: To demonstrate RTRI assay utility to distinguish recent from long-term HIV infection among high-risk individuals. Materials and methods: Between September and October 2022, HIV seropositive plasma samples of a high-risk group (N=90) and HIV-negative group (N=90) were collected from the outpatient department of Khon Kaen Hospital. All Specimens were tested by AsanteTM Rapid Recency Assay (ARRA) and classified as negative, recent and long-term infection based on the presence or absence of specific lines (control line [CL], Positive verification line [PVL] and Long-term line ([TL]) by visual reading. Results: Among 90 HIV seropositive plasma samples, 14.4% (13/90) were recent HIV infection and 84.4% (76/90) were long-term HIV infection. There were no significant differences between recent and long-term infections among men who have sex with men (MSM), transgender women (TG), heterosexuals and sex workers. Most of recently infected HIV patients were the MSM/TG group (53.9%, 7/13) and patients aged between 18 and 25 years old (76.9%, 10/13). CD4 count among recent cases was 396.7±278.4 cells/mm3 . ARRA performance has resulted in a sensitivity of 98.89% (95% CI: 93.96-99.97) and specificity of 100.00% (95% CI: 95.98-100.00). Conclusion: ARRA performance showed excellent agreement with high sensitivity and specificity to comparing with a standard algorithm for HIV diagnosis. Its ability to classify new infections is crucial in HIV intervention and prevention strategies.

Comparison of Immunological and Virological Recovery with Rapid, Early, and Late Start of Antiretroviral Treatment in Naive Plwh: Real-World Data.

Rapid initiation of antiretroviral therapy (ART) reduces the transmission of HIV infection in the community. This study aimed to determine whether rapid ART initiation is effective compared to standard ART treatment in our country. Patients were grouped based on time to treatment initiation. HIV RNA levels, CD+4 T cell count, CD4/CD8 ratio, and ART regimens were recorded at baseline and follow-up visits for 12 months. There were 368-ART naive adults (treatment initiated at the time of HIV diagnosis; 143 on the first day, 48 on the second-seventh day, and 177 after the seventh day). Although virological suppression rates at 12th months were higher in all groups, over 90% on average, there were no statistically significant differences in HIV-1 RNA suppression rates, CD+4 T cell count, and CD4/CD8 ratio normalization in the studied months but in multivariate logistic regression analysis; showed a significant correlation between both virological and immunological response and those with CD4+ T <350 cells/mL at 12th month in total patients. Our findings support the broader application of recommendations for rapid ART initiation in HIV patients.

Aplikasi e-ODHA sebagai Upaya Peningkatan Cakupan “Open Status” Orang dengan HIV/AIDS

Trends in the proportion of HIV incidence in the population have changed. Disclosure of HIV status to partners and families plays an important role in the health and well-being of people living with HIV/Aids (PLWHA). PLWHA who do not disclose their HIV status is the main obstacle in fighting the spread of HIV, especially for PLWHA who only open themselves to their social networks or peer groups. The purpose of this application is to reach PLWHA in disclosing their HIV status to partners and families so that they can break the chain of transmission of new HIV infections. This community service method is to build an application called E-ODHA targeting key populations such as PLWHA, male sex male, narcotics users and commercial sex workers. This application can be accessed directly by PLWHA through E-ODHA with the website "http://e-odha.digitalcreative.web.id/. To fill in information on the web, you can also access. The target of the application is people with HIV/Aids (ODHA). In addition to information about open status, through this application you can also get information about general conditions, general health and conditions. depression.

Prevalence of HIV infection in patients of a substance use treatment facility

IntroductionAccording to domestic and foreign studies, in the last decade there has been an increase in the number of HIV-infected patients suffering from alcoholic disease. Under the influence of alcohol, the risk of infection and transmission of HIV infection increases, the course of the disease worsens. There is a syndemia between alcohol abuse and HIV infection. This requires new approaches to the tactics of managing patients of a narcological hospital with HIV infection.ObjectivesTo identify the prevalence of HIV infection in patients of the substance use treatment facility suffering from alcohol disease of the second stage.MethodsThe authors analyzed 446 medical histories of patients suffering from alcoholic disease who underwent inpatient treatment in 2009-2021. For data processing, a statistical method for calculating relative indicators used.ResultsThe study showed that a significant proportion of patients with HIV infection were patients of working age 40-59 years. At the same time, since 2009, there has been an increase in HIV-infected patients from the total number of hospital patients. So, if in 2009 they were 1.2%, then in 2021 they were already 7.2%. Most HIV-infected patients of the narcological hospital are single or divorced. The study notes that abuse is common among patients with HIV infection as a means of combating depression. According to 2019 data, 39.0% of hospital patients suffer from depression. The authors show that alcohol affects the increase in risky forms of sexual relations, or risky situations with unprotected sex. In addition, with alcohol abuse, the viral load increases, and therefore the likelihood of transmitting HIV infection to a partner with unprotected sex increases.ConclusionsAlcohol abuse is a causative factor in HIV infection. Early detection of people with harmful alcohol consumption and referral to a psychiatrist will increase adherence to antiretroviral therapy, as well as reduce the rate of HIV infectionDisclosure of InterestNone Declared