Human Immune Deficiency Virus Transmission Research Articles

An assessment of the outcomes of prevention of mother-to-child transmission of HIV services in Addis Ababa, Ethiopia.

BackgroundThis article assessed maternal and neonatal outcomes amongst users of prevention of mother-to-child transmission (PMTCT) of HIV services in Addis Ababa, Ethiopia.ObjectivesThe study aimed to assess the health outcomes (antiretroviral prophylaxis versus antiretroviral treatment, CD4 counts, World Health Organization (WHO) stages of illness, other illnesses) of women who had used these services, as well as the HIV status of their babies and the infant feeding method adopted.MethodsA quantitative, cross sectional, retrospective cohort design was used. Document reviews were conducted with a sample of 384 mother-infant pairs (out of a population of 796) who had used PMTCT services.ResultsAll respondents were using prophylactic antiretrovirals or antiretroviral therapy, but some were on the wrong treatment based on their CD4 counts. The CD4 counts increased four times more for women on antiretroviral treatment than for those on prophylactic antiretrovirals. The WHO’s stages of HIV illness did not improve but deteriorated in some cases, and 52 other illnesses were recorded. Out of the 384 infants, 6.0% (n = 23) were HIV-positive. Most respondents opted for exclusive breast feeding but some used mixed feeding during the first six months of their infants’ lives, despite having received health education related to infant feeding options.ConclusionThe respondents’ improved CD4 counts were inadequate to improve their World Health Organization stages of HIV illness. Some babies received mixed feeding during the first six months of their lives and 6% of the babies were HIV-positive despite their mothers’ utilisation of PMTCT services.

Knowledge, Attitude and Practice of Condom Utilization among Axum Preparatory School Students

Background: Condoms are an integral part of sexual transmitted disease, unwanted pregnancy and human immune deficiency virus (HIV) acquiring immune deficiency syndrome (AIDS) prevention and their use has increased significantly over the past decade. Correct use of them reduces the risk of HIV transmission by almost 100 percent. Therefore condom promotion has received considerable attention in the light against the AIDS pandemic (WHO 1995). This is particularly important in sub Saharan Africa, were HIV transmission is mainly through sexual contact. Objective: To determine knowledge, attitude and practice of condom utilization in students of Axum preparatory school Methodology: the study was conducted in Axum preparatory school from April to June 2015. Total of 358 samples was taken using systematic random sampling techniques. The data was collected using self-administered questions by using structured question. The data will be interred and analyzed using SPSS software. Result: Majority of the participants 315 (90.8%) indicated that they heard and knew that about condom. The majority of the respondents 194 (55.5%) they indicated that there were no supply of male condom from their school, but 40 (11.5%) indicated that they have access. The study revealed that majority 196 (56.5%) students believed that condom use during sexual intercourse can decreases sexual pleasure (sensation), while 151 (43.5%) were disagreed. A summary of all the attitude variables revealed that 290 (83.6%) had positive attitude to majority of the questions measure the respondents attitude. The study revealed that 59 (17%) students were used male condom, and 50 (14.4%) respondents were not giving any response. Of these 17%, 31 (42.5%) students were use condom consistently, 29 (39.7%) use sometimes, 13 (17.8%) do not like to use. Conclusion: Knowledge, attitude and practices are an important tool for HIV/AIDS and STIs prevention and control. Despite the presence of adequate knowledge, positive attitude the preparatory school students had less condom use practice and the study highlighted some risky sexual practice, this might be related to low access, which needs to be addressed.

Twelve-Month Antiretroviral Therapy Suppresses Plasma and Genital Viral Loads but Fails to Alter Genital Levels of Cytokines, in a Cohort of HIV-Infected Rwandan Women.

BackgroundGenital viral load (GVL) is the main determinant of sexual transmission of human immune-deficiency virus (HIV). The effect of antiretroviral therapy (ART) on local cervico-vaginal immunological factors associated with GVL is poorly described. We aimed to identify the risk factors of detectable GVL, and the impact of ART on HIV genital shedding and its correlates in a cohort of HIV-infected women, attending HIV care in Kigali, Rwanda.Materials and MethodsAll participants were evaluated for GVL, plasma viral load (PVL), CD4 count, various sexually-transmitted infections (STIs) at baseline and at month 12. Genital concentration of 19 cytokines and mRNA expression of APOBEC3G and BST2, two host HIV restriction factors, were evaluated at baseline in all participants. Cytokine levels were re-assessed at month 12 only in participants eligible for ART at baseline. Risk factors of GVL ≥40copies/mL at baseline and month 12 were assessed using logistic regression. Effect of 12-month ART on various local and systemic immunological parameters was examined using a paired t-test and McNemar as appropriate.Results96 of the 247 women enrolled in the study were eligible for ART. After 12 months of ART, PVL and GVL decreased to undetectable level in respectively 74 and 88% of treated participants. ART did not affect cytokine levels. HIV genital shedding occurred only when PVL was detectable. At baseline, GVL was independently associated with IL-1β after controlling for PVL, age and N. gonorrhea infection (95% CI 1.32-2.15) and at month 12 with MIP-1β (95% CI 0.96-21.32) after controlling for baseline GVL, PVL and month 12 IL-8.ConclusionSuppressive ART does not necessarily reduce genital level of immune activation. Minimizing all conditions favoring genital inflammation, including active detection and treatment of STIs, might reduce the risk of HIV transmission as supplement to the provision of potent ART.

Self-reported occupational exposure to HIV and factors influencing its management practice: a study of healthcare workers in Tumbi and Dodoma Hospitals, Tanzania.

BackgroundBlood borne infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immune deficiency virus (HIV) constitute a major occupational hazard for healthcare workers (HCWs). To some degree it is inevitable that HCWs sustain injuries from sharp objects such as needles, scalpels and splintered bone during execution of their duties. However, in Tanzania, there is little or no information on factors that influence the practice of managing occupational exposure to HIV by HCWs. This study was conducted to determine the prevalence of self-reported occupational exposure to HIV among HCWs and explore factors that influence the practice of managing occupational exposure to HIV by HCWs in Tanzania.MethodsSelf-administered questionnaire was designed to gather information of healthcare workers’ occupational exposures in the past 12 months and circumstances in which these injuries occurred. Practice of managing occupational exposure was assessed by the following questions:ResultsNearly half of the HCWs had experienced at least one occupational injury in the past 12 months. Though most of the occupational exposures to HIV were experienced by female nurses, non-medical hospital staff received PEP more frequently than nurses and doctors. Doctors and nurses frequently encountered occupational injuries in surgery room and labor room respectively. HCWs with knowledge on the possibility of HIV transmission and those who knew whom to contact in event of occupational exposure to HIV were less likely to have poor practice of managing occupational exposure.ConclusionNeedle stick injuries and splashes are common among HCWs at Tumbi and Dodoma hospitals. Knowledge of the risk of HIV transmission due to occupational exposure and knowing whom to contact in event of exposure predicted practice of managing the exposure. Thus provision of health education on occupational exposure may strengthen healthcare workers’ practices to manage occupational exposure.

Folliculitis keloidalis nuchea, bleeding from haircuts, and potential HIV transmission

Infection with the human immune deficiency virus (HIV) the cause of the acquired immune deficiency syndrome (AIDS) has been reported worldwide. The overwhelming majority of people living with the disease live in lowand middle-income countries. Sub-Saharan Africa has the highest prevalence. Evidence for the contribution of social factors such as poverty, migration, and related consequences (poor education, family breakdown, substance abuse, etc.) are plausible explanations for the rapid spread of a disease that is transmitted sexually and through blood contact. However, the latter seem inadequate as explanations for the striking disproportionate burden of the epidemic in sub-Saharan Africa; an area accounting for about 10% of the world population yet where more than 60% of infected people live (Fig. 1). Variation in HIV country prevalence has been attributed to various factors that increase the likelihood of infection. There is no direct association between the burden of disease and various measures of poverty (i.e., the poorest countries do not necessarily have the highest prevalence, e.g., Southern Africa leads the continent both in wealth and disease prevalence). The correlation

Mother-to-child transmission of HIV: the pre-rapid advice experience of the university of Nigeria teaching hospital Ituku/Ozalla, Enugu, South-east Nigeria

BackgroundMother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group. A number of risk factors contribute to the rate of this transmission. Such risk factors include advance maternal HIV disease, lack of anti-viral prophylaxis in the mother and child, mixing of maternal and infant blood during delivery and breastfeeding. This study aims to determine the cumulative HIV infection rate by 18 months and the associated risk factors at the University of Nigeria Teaching Hospital, Enugu.ResultsA retrospective study, involving HIV exposed infants seen at the pediatric HIV clinic of UNTH between March 2006 and September 2008. Relevant data were retrieved from their medical records. The overall rate of mother to child transmission of HIV in this study was 3.9% (95% CI 1.1%- 6.7%). However, in children breastfed for 3 months or less, the rate of transmission was 10% (95% CI −2.5%-22.5%), compared to 3.5% (95% CI 0.5%-6.5%) in children that had exclusive replacement feeding.ConclusionsThis retrospective observational study shows a 3.9% cumulative rate of mother-to-child transmission of HIV by 18 months of age in Enugu. Holistic but cost effective preventive interventions help in reducing the rate of mother-to-child transmission of HIV even in economically-developing settings like Nigeria.

What do Malawi Polytechnic first year students know and do about HIV and AIDS?

The Polytechnic introduced a "WHY WAIT?" course to equip first year students with skills to help reduce transmission of Human Immune-deficiency Virus (HIV). Training is conducted during the first week of arrival at college. The study aimed to explore existing knowledge, beliefs and attitudes in order to tailor the training programme to students' needs. This was a cross sectional study. During first day of arrival, first year students available on campus were given a structured self-administered questionnaire which was filled and submitted before the course. Out of 320 questionnaires distributed, 295 were returned representing 92% response rate. Ten percent (30) had more than one girlfriend or boyfriend. Ninety-seven percent (286) indicated that condoms are not 100% effective towards prevention of HIV while 72% (169) reported that they had never had sexual intercourse before. Of 66 students who had had sexual intercourse before, 30% indicated that they used condoms always during sexual intercourse, 40% used it occasionally while 30% never used condoms. Thirty-two percent (94) reported having an HIV test before and 19% (56) would feel uncomfortable to share a room with an HIV infected person. The Polytechnic first year students have varying knowledge and practices about HIV and AIDS. There is need to intensify "WHY WAIT?" course to first years during first week at College to help equip them with necessary knowledge and skills to protect themselves against HIV and AIDS.

Knowledge attitude beliefs and perception of HIV-positive women towards PMTCT program services in NAUTH Nnewi Nigeria.

Background: Though transmission of Human Immune-deficiency Virus (HIV) in Nigeria occurs primarily through heterosexual contact, vertical transmission of the infection remains a major concern because of the attendant health consequences for the child. The success of a Prevention-of-Mother-to-Child-Transmission (PMTCT) programme in reducing sero-conversion among exposed-infants is determined by many factors, including anti-retroviral drugs (ARVs), infant feeding practices, use of well-baby care, counselling and support to mother-newborn pair. Little is known about the effects of PMTCT interventions in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, and this study was aimed at assessing the knowledge of PMTCT program / services and HIV risk-perception among HIV-positive women in this center. Methodology: The study design was descriptive cross-sectional. A total of 288 consenting HIV-positive mothers of recruited children was selected using the systematic sampling technique. Data were collected using a pre-tested structured interviewer-administered questionnaire and analysed by means of the SPSS software. Results: The mean age of the respondents was 30.5+4.86years. Knowledge about HIV transmission was good (97 to 99%), while risk perception about HIV was 100%. Mothers who reported their treatment in the clinic as “very good” were more likely to declare PMTCT as “good” than mothers who were less well treated in the programme (p <0.01). Conclusion: The programme has resulted in high scores in mothers’ knowledge and perception of various aspects and dimensions of HIV infection and PMTCT. Recommendations: Health education/counselling component of the PMTCT programme should be reinforced in order to strengthen it. Keywords: Effects, human immune-deficiency virus, mothers, vertical transmission.

Experiences of lay counsellors who provide VCT for PMTCT of HIV and AIDS in the Capricorn district, Limpopo Province

Human immune deficiency virus (HIV) and acquired immune-deficiency syndrome (AIDS) still carry a stigma in the community. Many people do not know their status and they are still reluctant to be tested including pregnant women despite the fact that Voluntary Counselling and Testing (VCT) is offered for free in South Africa. In South Africa VCT for HIV and AIDS is offered by lay counsellors in public hospitals and clinics. The study conducted by Mate, Bennet, Mphatswe, Barker and Rollins (2009:5483) outlined that in South Africa the prevention of mother-to-child transmission (PMTCT) of HIV guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. A qualitative, exploratory, descriptive and contextual study was conducted in 15 public clinics of the Polokwane Municipality in the Capricorn District, Limpopo Province. The purpose of the study was to determine the experiences of the lay counsellors who provide VCT for the PMTCT of HIV and AIDS in the Capricorn District, Limpopo Province. Data were collected through one-to-one interviews using a semi-structured guide (De Vos et al, 2006:296). The findings of the study reflected the following: the content of training and counselling skills received by lay counsellors were satisfactory, there was lack of counsellor support and in-service education. A program for in-service education and support for all lay counsellors who have had VCT training should be conceptualised and implemented.

HIV risk and prevention in emergency-affected populations: a review.

While basic guidelines on HIV prevention in emergencies have been available for several years, international agencies involved in the provision of health services have not placed sufficient priority on the prevention of the human immune deficiency virus (HIV) and other sexually transmitted infections (STIs) in complex emergencies. This paper reviews the factors that may increase the risk of HIV transmission in populations affected by complex emergencies and outlines recommendations for research and programmes. Research into the most appropriate methods of carrying out HIV surveillance and interventions in these settings is needed. In the post-emergency phase programmes need to be far more extensive than those offered under the Minimal Initial Services Package (MISP). While the potential for stigmatization represents an important constraint, there is a need to prioritize HIV/STI interventions in order to prevent HIV transmission in emergency-affected populations themselves, as well as to contribute to regional control of the epidemic.

Materno-Fetal Transmission of Human Immune Deficiency Virus

Mother-to-child transmission of human immune deficiency virus (HIV) is a multifactorial event highly associated with advanced maternal HIV disease and obstetric incidents taking place during parturition. Thus, various approaches to prevention may be beneficial. Although the time and the route of materno-fetal HIV transmission are still not sufficiently clear, much speaks in favor of a late HIV transmission, most probably taking place during parturition or the phase before the delivery. The fetus is remarkably protected by the placenta and the intact fetal membranes against many viral infections during gestation. These conditions change at parturition and the chance for a transition of HIV-infected carrier cells or virus into the fetal compartment increases. Proinflammatory cytokines secreted at the materno-fetal interface accumulate in amniotic fluid and may chemoattract and stimulate potentially HIV-infected immunocytes. After rupture of membranes, maternal cells of the decidua are directly exposed to the amniotic fluid. Aside from the contamination of the fetal skin at vaginal delivery as a debatable route of infection, blood-to-blood contacts and the fetal swallowing of contaminated amniotic fluid may be the major path of fetal HIV infection. For the fetal prophylaxis of an intrauterine infection, the application of zidovudine is recommended. However, cesarian section before the onset of labor leads also to a diminution of the transmission rate. As the transmission seems to have both systemic and local causes, it makes sense to combine different intervention strategies. Whether a combination of zidovudine and elective cesarean section can lower the transmission risk further has to be evaluated.