Route Of HIV Transmission Research Articles

Marriage and Fertility Desire and Associated Factors Among Unmarried People Living With HIV in Jinan, China: A Cross-Sectional Study.

The desires for marriage and fertility among people living with HIV (PLWH) are increasing worldwide because of improved treatment and prognosis; yet they remain understudied in China, which has a family-oriented culture. This study aimed to investigate these desires for marriage and fertility among Chinese PLWH and explore their correlates. A cross-sectional study was conducted among 1,504 Chinese PLWH to assess their desires for marriage, fertility, and other variables through an online questionnaire. Logistic regression models were used to analyze factors associated with desires for marriage and fertility. Among the 1,504 participants, 53.9% aspired to marry at 34.76 ± 5.26 years old, whereas 62.0% desired parenthood at 36.43 ± 5.11 years old. Factors associated with these desires included age, gender, residence, education level, HIV transmission route, CD4 + T-cell count, time since HIV diagnosis, disclosure of HIV status, social support, and mental health indicators.

HIV Incidence and Transactional Sex Among Men Who Have Sex With Men in Ningbo, China: Prospective Cohort Study Using a WeChat-Based Platform.

Sexual transmission among men who have sex with men (MSM) has become the major HIV transmission route. However, limited research has been conducted to investigate the association between transactional sex (TS) and HIV incidence in China. This study aims to investigate HIV incidence and distinguish sociodemographic and sexual behavioral risk factors associated with HIV incidence among MSM who engage in TS (MSM-TS) in China. We conducted a prospective cohort study using a WeChat-based platform to evaluate HIV incidence among Chinese MSM, including MSM-TS in Ningbo, recruited from July 2019 until June 2022. At each visit, participants completed a questionnaire and scheduled an appointment for HIV counseling and testing on the WeChat-based platform before undergoing offline HIV tests. HIV incidence density was calculated as the number of HIV seroconversions divided by person-years (PYs) of follow-up, and univariate and multivariate Cox proportional hazards regression was conducted to identify factors associated with HIV incidence. A total of 932 participants contributed 630.9 PYs of follow-up, and 25 HIV seroconversions were observed during the study period, resulting in an estimated HIV incidence of 4.0 (95% CI 2.7-5.8) per 100 PYs. The HIV incidence among MSM-TS was 18.4 (95% CI 8.7-34.7) per 100 PYs, which was significantly higher than the incidence of 3.2 (95% CI 2.1-5.0) per 100 PYs among MSM who do not engage in TS. After adjusting for sociodemographic characteristics, factors associated with HIV acquisition were MSM-TS (adjusted hazard ratio [aHR] 3.93, 95% CI 1.29-11.93), having unprotected sex with men (aHR 10.35, 95% CI 2.25-47.69), and having multiple male sex partners (aHR 3.43, 95% CI 1.22-9.64) in the past 6 months. This study found a high incidence of HIV among MSM-TS in Ningbo, China. The risk factors associated with HIV incidence include TS, having unprotected sex with men, and having multiple male sex partners. These findings emphasize the need for developing targeted interventions and providing comprehensive medical care, HIV testing, and preexposure prophylaxis for MSM, particularly those who engage in TS.

Survival among people with HIV and their families in Denmark 1995–2021: a nationwide population-based cohort study

Survival among people with HIV (PWH) has vastly improved globally over the last few decades but remains lower than among the general population. We aimed to estimate time trends of survival among PWH and their families from 1995 to2021. We conducted a registry-based, nationwide, population-based, matched cohort study. We included all Danish-born PWH from 1995 to 2021 who had been on antiretroviral therapy for 90 days, did not report intravenous drug use, and were not co-infected with hepatitis C (n=4168). We matched population controls from the general population 10:1 to PWH by date of birth and sex (n=41,680). For family cohorts, we identified siblings, mothers, and fathers of PWH and population controls. From Kaplan-Meier tables with age as time scale, we estimated survival from age 25. We compared PWH with population controls and families of PWH with families of population controls to calculate mortality rate ratios adjusted for sex, age, comorbidities, and education (aMRR). The median age of death among PWH increased from 27.5 years in 1995-1997 to 73.9 years (2010-2014), but thereafter survival increased only marginally. From 2015 to 2021, mortality was increased among PWH (aMRR 1.87 (95% CI: 1.65-2.11)) and siblings (aMRR: 1.25 (95% CI: 1.07-1.47)), mothers (aMRR: 1.30 (95% CI: 1.17-1.43)), and fathers (aMRR: 1.15 (95% CI: 1.03-1.29)) of PWH compared to their respective control cohorts. Mortality among siblings of PWH who reported heterosexual route of HIV transmission (aMRR: 1.51 (95% CI: 1.16-1.96)) was higher than for siblings of PWH who reported men who have sex with men as route of HIV transmission (aMRR 1.19 (95% CI: 0.98-1.46)). Survival among PWH improved substantially until 2010, after which it increased only marginally. This may partly be due to social and behavioural factors as PWH families also had higher mortality. Preben and Anna Simonsen's Foundation and Independent Research Fund Denmark.

Psychological profiles among people with HIV: A latent profile analysis and examination of the relationship with interpersonal personality

People living with HIV (PWH) often experience an increased vulnerability to psychiatric disorders as a result of social stigma and discrimination. This study utilized latent profile analysis on a sample of 3040 Chinese PWH to identify distinct psychological profiles. Furthermore, the study investigated the relationships between these profiles with interpersonal personalities, demographic characteristics, social variables and disease-related variables using a three-step regression (R3STEP). The findings from the latent profile analysis revealed that the psychological symptoms of PWH can be categorized into three distinct classes. Multinomial logistic regression analysis indicated that interpersonal personalities, region, sex, age, religious beliefs, marital status, occupation, monthly income, time of HIV infection diagnosis and transmission route were significant factors associated with the psychological profiles of PWH. These findings provide valuable insights for the development of individualized management strategies for PWH and contribute to a deeper understanding of the mechanisms underlying psychological symptoms of PWH.

Investigation of Presumptive HIV Transmission Associated with Receipt of Platelet-Rich Plasma Microneedling Facials at a Spa Among Former Spa Clients - New Mexico, 2018-2023.

HIV transmitted through cosmetic injection services via contaminated blood has not been previously documented. During summer 2018, the New Mexico Department of Health (NMDOH) was notified of a diagnosis of HIV infection in a woman with no known HIV risk factors who reported exposure to needles from cosmetic platelet-rich plasma microneedling facials (vampire facials) received at a spa in spring 2018. An investigation of the spa's services began in summer 2018, and NMDOH and CDC identified four former spa clients, and one sexual partner of a spa client, all of whom received HIV infection diagnoses during 2018-2023, despite low reported behavioral risks associated with HIV acquisition. Nucleotide sequence analysis revealed highly similar HIV strains among all cases. Although transmission of HIV via unsterile injection practices is a known risk, determining novel routes of HIV transmission among persons with no known HIV risk factors is important. This investigation identified an HIV cluster associated with receipt of cosmetic injection services at an unlicensed facility that did not follow recommended infection control procedures or maintain client records. Requiring adequate infection control practices and maintenance of client records at spa facilities offering cosmetic injection services can help prevent the transmission of HIV and other bloodborne pathogens and ensure adequate traceback and notification in the event of adverse clinical outcomes, respectively.

Social care institutions workers of the far eastern federal district awareness on HIV-infection and its significance in providing quality services and lowering self-perceived HIV risk

Objective of the research: to reveal level of awareness and stigmatizing factors that influence service provision, to disclose self-perceived HIV risk of social care workers and a necessity of planning events targeted at increasing their competence concerning the issues of HIV-infection. Materials and methods: by the means of a structured questionnaire, a sociological research was conducted among 386 specialists of social care institutions of 6 constituent entities of the Far Eastern Federal district. Mean age of survey participants was 41.5 years, work experience – 11.2 years. Sociological (survey) and analytical research methods were utilized in the study. Results: HIV/AIDS epidemic is one of main medical and social issues of modern days. Specialists of social care institutions will inevitably meet with people living with HIV during their practice. Their insufficient awareness about HIV transmission route, stigmatization of people living with HIV cause fear and reluctance to work with such recipients of the service. Respondents rated their knowledge on the issue of HIV-infection as satisfactory in 74.7%. All participants were well aware of main routs of HIV transmission however, mother-to-child transmission was known only by 66.1% of respondents. A certain lack of knowl­edge was revealed regarding self-perceived HIV risk as well as anxiety regarding working with HIV-infected clients and high rate of alert when working with HIV-positive colleagues. However, up to 25.7% of respondents expressed their readiness to help people living with HIV. Using condoms, disposable medical instruments and personal hygiene items as well as avoiding intravenous drug use were selected by survey participants as measures of HIV-infection prevention. Conclusion: the results of the research indicate insufficient level of awareness on the issue, because of which a con­clusion can be made that there is a certain degree of stigmatization of clients living with HIV receiving social services, as well as existence of self-perceived occupational vulnerability to HIV among social workers. This reveals a necessity of further surveillance over social workers’ knowledge to define priority topics in order to increase their professional competence on the issue of HIV-infection as well as expediency of holding training seminars for specialists of social care institutions contributing to development of their practical skills in work with HIV-positive clients.

ЗАБОЛЕВАЕМОСТЬ ВИЧ-ИНФЕКЦИЕЙ И НАРКОМАНИЕЙ В РОССИИ И ОСОБЕННОСТИ ИХ КОРРЕЛЯЦИИ

Significance. The structure of drug use in the Russian Federation (injectable, non-injectable, psychoactive and others) is undergoing changes, which may affect the ratio of HIV transmission routes. These changes in the epidemic process require further research to form adequate measures to counter the spread of HIV infection in the Russian Federation. The purpose of the study was to identify specific features of correlation between HIV infection and drug addiction incidence in Russia and describe their role and influence on the HIV epidemic process in Russia at the present stage. Material and Methods. The study used data of the federal statistical observation forms on HIV incidence – Form No.61 “Information about HIV-infection” and on drug addiction – Form No.11 “Information about incidence of substance dependence disorders”. Data on narcotic drugs were retrieved from the website of the Unified interdepartmental information and statistical system provided by the Ministry of Internal Affairs of the Russian Federation. Population data were taken from the Rosstat website. The study used correlation analysis. Data processing was carried out using the SPSS Statistics ver. 26. Results. The correlation analysis shows a significant relationship between HIV incidence and detection of injecting drug users in the Russian Federation. Since 2017, the relationship between HIV incidence and users of all types of narcotic drugs has become significant as well, while the share of injecting drug users among all drug users dropped from 50% in 2011 to 18.7% in 2021. According to data for 2017 to 2021, the number of crimes related to illicit drug trafficking, as well as the amount of narcotic drugs withdrawn and the number of administrative offenses related to illicit drug trafficking are decreasing. Conclusion. Changes in the structure of drug use – a decrease in the share of the opioid group and an increase in the share of synthetic drug use leads to a change in the structure of infection among all drug users – the share of sexual transmission is increasing; while the share of the injection is decreasing. Presumably, non-injectable psychoactive substances play an increasing role among the factors predisposing to risky sexual behavior, and the risk group is not limited to injecting drug users only. For the purpose of a further epidemiological analysis it seems appropriate to divide the risk group of drug users into injecting drug users and non–injecting drug users.

1835. Factors impact Longevity in Persons Living with HIV

Abstract Background In contrast to high mortality including young patient in 1990’s, persons living with HIV (PLWHIV) can expect a near-normal life expectancy of 77 years. Recent mortality data suggests significant number of HIV positive patients pass before the age of 70 years. There is a current paucity of literature looking at characteristics of the elderly PLWHIV when comparing to patients who died from HIV at a younger age. The goal of this study was to compare factors between the current HIV population living longer than age 70 and the population that did not survive until age 70 at the Positive Health Clinic (PHC). PHC is an urban city Ryan White funded HIV Care Medical Home Clinic, at Pittsburgh, PA, that provides care to ∼920 PLWHIV Methods A retrospective chart review of patient records at PHC; with patients from period between 2015 -2022 was queried for HIV viral load, recent CD4 counts, and social history. Smoking, alcohol, and drug use were used as primary social measures due to their known impact in early development of prevalent chronic comorbidities. A Chi squared test was then employed to analyze for statistical significance of these factors (P < 0.05) between the cohort of patients that are living beyond the age of 70 (longevity) and the cohort of patients who died prior to age of 70 Results A total of 149 records were obtained (122M/ 27F, 95W/54B). The median age of HIV diagnosis and death was 44 and 60, respectively. There was no statistical difference between two groups in gender, race, and initial HIV transmission route, but being diagnosed with HIV after the age of 40 was associated with longevity. Unsurprisingly, patient with last viral load above 500 or CD4 below 200 were less likely to survive past age 70. HIV viral load < 200, persistently, in past 5 years and absence of smoking in last 15 years were the 2 factors most strongly associated longevity. Alcohol abuse and drug use were less likely to survive age 70. Statistical data between the two groups are listed in Table attached. Comparing factors associated with living beyond 70 versus dying before 70 Conclusion Common comorbidities such as diseases of heart, lung, kidney and cancer are impacted by substance misuse, and as a result may serve as a barrier to reaching old age in PLWHIV. Counseling against tobacco use, treatment of alcohol and drug addiction while sustaining viral control with HAART can promote the longevity of PLWHIV. Disclosures Chiu-bin hsiao, MD, Gilead: Grant/Research Support|ViiV: Advisor/Consultant|ViiV: Grant/Research Support|ViiV: Honoraria

Increasing hepatitis B vaccination coverage and decreasing hepatitis B co-infection prevalence among people with HIV-1 in Germany, 1996-2019. Results from a cohort study primarily in men who have sex with men.

Viral hepatitis co-infection among people living with HIV is known to accelerate the progression of liver disease and AIDS. An increased prevalence and incidence of hepatitis B virus (HBV) infection among people living with HIV demands continuous monitoring to adapt targeted prevention strategies to reach the global goals of eliminating viral hepatitis as a public health threat. We determined the prevalence and incidence of HBV for the years 1996-2019 from yearly blood sample testing and questionnaire reports among people living with HIV belonging to a nationwide, multicentre observational, prospective cohort study. Among this study population of 3479 participants, the majority (87%) indicated that being men who have sex with men (MSM) was their likely HIV transmission route; 51% were recruited from Berlin. HBV prevalence for acute/chronic and resolved infections decreased from 4.1% and 45% in 1996-1999 to 1.3% and 16% in 2019, respectively. Simultaneously, participants with a serological status indicating HBV vaccination increased from 25% in 1996-1999 to 69% in 2019. Among vaccinated participants with relevant information (n = 1135), 38% received their first HBV vaccination after HIV infection. The HBV incidence rate in 565 eligible participants decreased from 6.9/100 person-years in 2004-2007 to 0.45/100 person-years in 2015. Increasing vaccination coverage because of a general HBV vaccination recommendation and catch-up vaccination efforts among risk groups decreased HBV infection prevalence over time among this study population of people living with HIV, primarily MSM and from Berlin. Despite this success, the prevalence and incidence of HBV remains higher than in the general population in Germany. This emphasizes the need for continued HBV prevention by promoting HBV vaccination and HBV screening at regular intervals based on the individual risk behaviour.

Factors Influencing EMTCT Service Utilization by HIV-Positive Pregnant Women at Karoli Lwanga Hospital, Rukungiri District, Western Uganda

This study assessed the knowledge, attitude, and health-related factors affecting the utilization of Early Mother-to-Child Transmission (EMTCT) services among HIV/AIDS pregnant women at Karoli Lwangi Hospital in Rukungiri district. Data was collected from 97 pregnant mothers with HIV/AIDS through questionnaires. The findings revealed that most participants had a good understanding of HIV transmission routes, particularly from mother to child during pregnancy, labor, and breastfeeding. The majority were aware that antiretroviral therapy (ARV) could prevent mother-to-child transmission (MTCT) but disagreed that using condoms could prevent it. The study also showed a high willingness to separate from spouses if they tested positive for HIV and strong support for HIV-infected mothers delivering with skilled health workers. However, a significant barrier to the utilization of EMTCT services was the unaffordability of healthcare costs. This suggests that despite positive attitudes and knowledge, financial constraints remain a critical hindrance to EMTCT service utilization. Keywords: EMTCT, Pregnant women, HIV/AIDS, Healthcare, Health worker.

Survival times of HIV/AIDS in different AIDS Diagnostic and Treatment Guidelines from 2006 to 2020 in Liuzhou, China

BackgroundTo compare the survival rates of four timing of treatment initiation for people living with HIV/AIDS provided in China in 2006, 2011, 2015, and 2018, and to investigate the factors impacting survival time.MethodsA people living with HIV/AIDS retrospective cohort study was in Liuzhou City from April 2006 to December 2020. The information was obtained from the National Comprehensive AIDS Prevention and Control Information System. Life tables and the Kaplan–Meier method were used to calculate participant survival rates and time. The univariate and multivariate Cox regression models were used to investigate the factors related to survival.Results18,543 participants were included in this study. In four periods, the 1-year survival rates were 81%, 87%, 95%, and 95%. The 2-year survival rates were 76%, 85%, 93%, and 94%. The 3-year survival rates were 73%, 84%, 92%, and 94%. Results of multivariate Cox regression showed that sex, age of HIV diagnosis, ethnicity, household registration, occupation, marital status, the timing of treatment, education level, route of HIV transmission, whether receiving antiretroviral therapy (ART), and the count of CD4+T cells at baseline (count of CD4+T cells at HIV diagnosis) were factors that are significantly correlated with mortality caused by HIV infection.ConclusionsWith the Guidelines updated from 2006 to 2020, the 1-, 2-, and 3-year survival rates of people living with HIV/AIDS in four periods tended to increase. The timing of treatment initiation of the updated edition of the AIDS Diagnostic and Treatment Guidelines (Guidelines) significantly prolonged the survival time of people living with HIV/AIDS.

Evolution of estimated glomerular filtration rate in HIV/HCV-coinfected patients who received direct-acting antivirals: A multicenter retrospective study.

The short-term impact of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) combined with antiretroviral therapy (ART) on renal function in patients with HIV/HCV-coinfection remains controversial. This multicenter, retrospective study aimed to sequentially record the estimated glomerular filtration rate (eGFR) at baseline, end of therapy (EOT), 12 weeks off-treatment (SVR12), and at time points after SVR12 (post-SVR12) and to identify the factors associated with an eGFR decline to <60ml/min/1.73m2 in HIV/HCV-coinfected patients receiving DAAs. The evolution of mean eGFRs between different ART and DAAs combinations among patients of different HIV transmission routes were compared using a generalized linear mixed effects model. The periods between baseline and EOT, between EOT and post-SVR12, and between baseline and post-SVR12 were defined as the on-treatment, post-treatment, and all-course periods, respectively. Acute kidney disease (AKD) was defined as a decline of eGFR to <60ml/min/1.73m2. A total of 445 patients with baseline eGFRs >60ml/min/1.73m2 were included. We found that eGFRs declined during the on-treatment period in the tenofovir-containing ART and SOF-based DAA groups. There were no differences in the slope coefficient during the on-treatment and post-treatment periods among all risk groups except for people who inject drug. Increasing age and plasma HIV RNA >20 copies/ml before DAA treatment were factors independently associated with AKD during the on-treatment period while increasing age was independently associated with AKD during the all-course period. Only increasing age was an independent factor associated with AKD among HIV/HCV-coinfected patients during and after DAA treatments.

Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis

Delayed diagnosis of HIV can lead to an inappropriate response to antiretroviral therapy (ART), rapid progression of the disease, and death. It can also carry harmful effects on public health due to the increment of transmission. This study aimed to estimate the duration of delayed diagnosis (DDD) in HIV patients in Iran. This hybrid cross-sectional cohort study was conducted on the national HIV surveillance system database (HSSD). Linear mixed effect models with random intercept, random slope, and both were used to estimate the parameters required for the CD4 depletion model to determine the best-fitted model for DDD, stratified by the route of transmission, gender, and age group. The DDD was estimated in 11,373 patients including 4,762 (41.87%) injection drug users (IDUs), 512 (4.5%) men who had sexual contact with men (MSM), 3,762 (33.08%) patients with heterosexual contacts, and 2,337 (20.55%) patients who were infected through other routes of HIV transmission. The total mean DDD was 8.41 ± 5.97 years. The mean DDD was 7.24 ± 0.08 and 9.43 ± 6.83 years in male and female IDUs, respectively. In the heterosexual contact group, DDD was obtained as 8.60 ± 6.43 years in male patients and 9.49 ± 7.17 years in female patients. It was also estimated as 9.37 ± 7.30 years in the MSM group. Furthermore, patients infected through other transmission routes were found with a DDD of 7.90 ± 6.74 years for male patients and a DDD of 7.87 ± 5.87 years for female patients. A simple CD4 depletion model analysis is represented, which incorporates a pre-estimation step to determine the best-fitted linear mixed model for calculating the parameters required for the CD4 depletion model. Considering such a noticeably high HIV diagnostic delay, especially in older adults, MSM, and heterosexual contact groups, regular periodic screening is required to reduce the DDD.

Conocimientos y actitudes en adolescentes frente a enfermedades de transmisión sexual

Introduction: sexually transmitted diseases are communicable pathologies caused by microorganisms such as viruses, fungi and bacteria, which are acquired through sexual or non-sexual contact. Objective: to determine the knowledge and attitudes of adolescents towards sexually transmitted diseases. Methods: a quantitative, non-experimental, cross-sectional cohort study was carried out with a population made up of 102 leveling students of the Nursing Career. Using two validated instruments, with a Cronbach’s alpha of 0,88 and 0,66, the first consists of 24 multiple-choice questions that evaluate five components: general knowledge of HIV, knowledge of condoms as a protective method, knowledge of HIV transmission routes HIV prevention and knowledge about other sexually transmitted diseases and the second consisted of 10 questions; 8 open and 2 closed to know their attitudes. Results: the participants comprised an age between 15 to 19 years; with a predominance of the female gender in 82,4 %, there are adolescents who have not started their sexual activity with 43,1 %. In addition, this research aims to know the knowledge, so the results of the evaluation indicate that most adolescents have an average knowledge (15 points) on this topic. Conclusion: it can be concluded that adolescents have an average knowledge regarding STIs, which is why it is essential to promote health promotion and disease prevention as a fundamental nursing strategy.

Reasons for not commencing direct-acting antiviral treatment despite unrestricted access for individuals with HIV and hepatitis C virus: a multinational, prospective cohort study.

Individuals with HIV and hepatitis C virus (HCV) who remain untreated with direct-acting antivirals can contribute to HCV transmission and HCV-related mortality. We aimed to compare rates of uptake of direct-acting antivirals following unrestricted access to this treatment in high-income countries and examine factors associated with remaining untreated. This multinational, prospective cohort study used data from the International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC). We analysed data from nine observational cohorts participating in the InCHEHC, including data from six high-income countries (Australia, Canada, France, the Netherlands, Spain, and Switzerland). We included individuals aged 18 years and older, with HIV and HCV (ie, HCV-RNA positive without evidence of spontaneous clearance) during unrestricted access to interferon-free direct-acting antiviral treatment in each country. We calculated the cumulative proportion of participants who remained untreated with direct-acting antivirals, with follow-up starting after the date of unrestricted access or cohort inclusion, whichever occurred most recently. Factors associated with the commencement rate of direct-acting antiviral treatment were assessed using competing-risks regression with the Fine-Gray method. The date of unrestricted access to direct-acting antiviral treatment for people with HIV ranged from Nov 1, 2014, in France to Nov 1, 2017, in Switzerland. We included 4552 individuals with HIV-HCV, mainly men who have sex with men (MSM; n=2156 [47%]) and people who inject or have injected drugs (n=1453 [32%]). 1365 (30%) of 4552 participants remained untreated with direct-acting antivirals. For individuals treated with direct-acting antivirals, median time from start of follow-up to treatment was 5 months (IQR 2-12). For individuals who were not treated with direct-acting antivirals, median follow-up was 22 months (8-30). Being linked to care in Australia, France, or the Netherlands, on antiretroviral therapy, having undetectable HIV RNA, and shorter duration since first positive HCV test were independently associated with higher commencement rate of direct-acting antiviral treatment. Compared with MSM, male heterosexuals and females with unknown or other routes of HIV transmission (ie, neither injection drug use nor heterosexual transmission) had lower rates of commencement. Despite unrestricted access, almost a third of individuals with HIV-HCV remained untreated with direct-acting antivirals during follow-up, with variation in commencement rate of HCV treatment between countries and key populations. Increased efforts are required to reach the remaining individuals with HIV who are HCV-viraemic to achieve HIV-HCV micro-elimination. None.

Socio-demographic and psycho-social determinants of HIV late presentation in Germany – results from the FindHIV study

ABSTRACT Delayed HIV diagnosis at advanced stages of disease remains common (33%–64%). This analysis of the multi-center FindHIV study including newly diagnosed HIV-infected adults in Germany, focused on the potential role of socio-demographic and psychological factors on late diagnosis (formerly “late presentation”, AIDS diagnosis or CD4 cells <350/µL). These data were collected from patient profiles, physician-patient interviews and questionnaires. Participating centers (n = 40) represented the diverse health care settings in HIV care and geographic regions. Of 706 newly diagnosed adults (92% male, median age 39 years) between 2019 and 2020, 55% (388/706) were diagnosed late with a median CD4 cell count of 147/µL; 20% (142/706) presented with AIDS. From the physicians’ perspective, earlier diagnosis would have been possible in 45% of participants (late versus non-late presentation 58% versus 29%). The most common physician-perceived reason was an underestimated risk for HIV infection by the patient (37%). In multivariable logistic regression analysis, older age, sexual contacts with both sexes as possible route of HIV transmission, being married, and a poor level of knowledge about HIV treatment were found to be associated with a significantly elevated risk for late presentation. Education, employment status, sexual relations, migration background and personality traits were not. Trial registration: German Clinical Trials Register (DRKS00016351).

Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study.

A major shift in the routes of HIV transmission seams to be taking place in Iran. Our study aimed to investigate the 30-year trend of major HIV related behaviors in Iran. The national HIV/AIDS registry database (from September 1986 to July 2016 with data on 32,168 people newly diagnosed with HIV) was used to study the 30 years trend and demographic determinants of major HIV related behaviors. The highest rate of drug injection (DI) among people living with HIV (PLHIV) was reported during 1996 to 1999 (p-for trend < 0.001) while the highest rate of sexual activity by minorities or hard to reach groups was during 2004 to 2011 (p-for trend < 0.001). Among males, drug injection was directly associated with being single (ORsingle/married = 1.34), being unemployed (ORunemployed/employed = 1.94) and having lower level of education (OR<highschool/≥highschool = 2.21). Regarding females, drug injection was associated with being housewife (ORhousewife/employed = 1.35) and lower level of education (OR<highschool/≥highschool = 1.85). In females, condomless sexual contact was more common among those younger (OR20-29/<20 = 6.15), and married (ORmarried/single = 7.76). However, among males those being single (ORmarried/single = 0.82), being more educated (OR≥highschool/<highschool = 1.24), and being unemployed (ORunemployed/employed = 1.53) reported more sexual activity by minoritised or hard to reach groups. The pattern of major HIV related behaviors among Iranian males and females have been rapidly changing and people living with HIV (PLHIV) are being diagnosed at a younger age. Health education to younger individuals is an essential HIV controlling strategy among Iranian population. Implementation of surveys in hidden and hard-to-reach populations is also recommended.

The mother-to-child transmission of HIV-1 and profile of viral reservoirs in pediatric population: A systematic review with meta-analysis of the Cameroonian studies.

The mother-to-child transmission of HIV-1 (MTCT) remains on the major route of HIV-transmission among pediatric populations in Africa. Though a prevention of MTCT (PMTCT) high-priority country, data on the MTCT burdens in Cameroon remains fragmented. We sought to assess the pooled MTCT rate, its risk-factors, and to characterize viral reservoirs of infected-children in Cameroon. All relevant observational cohort and cross-sectional studies conducted in Cameroon were searched from PubMed, African Journals Online, Google scholar, ScienceDirect and academic medical education databases. Heterogeneity and publication bias were respectively assessed by the I2 statistic and the Egger/funnel plot test. Meta-analysis was performed using the random effects model. MTCT rate >5% was considered as "high". This review was registered in the Prospero database, CRD42021224497. We included a total of 29 studies and analyzed 46 684 children born from HIV-positive mothers. The overall rate of MTCT was 7.00% (95% CI = 6.07-8.51). According to regions, the highest burden was in Adamaoua-region (17.51% [95% CI:14.21-21.07]) with only one study found. PMTCT option-B+ resulted in about 25% reduction of MTCT (8.97% [95% CI: 8.71-9.24] without option-B+ versus 2.88% [95% CI: 5.03-9.34] with option-B+). Regarding risk-factors, MTCT was significantly associated with the absence of PMTCT-interventions both in children (OR:5.40 [95% CI: 2.58-11.27]) and mothers (OR: 3.59 [95% CI: 2.15-5.99]). Regarding viral reservoirs, a pro-viral DNA mean of 3.34±1.05 log10/mL was observed among 5/57 children and archived HIV drug resistance mutations were identified in pro-viral DNA marker among 21/79 infected-children. In spite of the dropdown in MTCT following option-B+ implementation, MTCT remains high in Cameroon, with substantial disparities across regions. Thus, in this era of option-B+, achieving MTCT elimination requires interventions in northern-Cameroon. The variation in pro-viral load in infected-children underlines the relevance of characterizing viral reservoirs for possible infection control in tropical settings.

Evaluation of YouTube Videos on HIV/AIDS: A Critical Analysis of Content Quality and Reliability

Introduction: HIV and AIDS remain as significant global health issues, with misinformation and stigma surrounding the diseases still being prevalent. Accurate and reliable information is crucial for promoting prevention, early detection, and effective management of the disease. YouTube has emerged as a popular platform for sharing and consuming health-related content, but the quality and reliability of its videos on various health topics have been questioned. Objective: This study aims to systematically review and evaluate the quality and reliability of YouTube videos on HIV/AIDS. Methods: We searched for videos on YouTube using two search terms, “HIV” and “AIDS,” and evaluated the top 100 videos for each search term. We recorded video features such as length, likes, comments, views, and upload date. Two independent evaluators assessed the videos’ quality and reliability using the Global Quality Scale and the modified DISCERN tool. We classified the videos into two groups based on the source that uploaded the video, professional and non-professional, and analyzed the data using statistical methods. Results: Of the 159 videos evaluated, the most common content categories were HIV transmission routes, basic information and definition of HIV, and HIV/AIDS activism and awareness. Non-professional videos tended to be shorter, but there were no significant differences in views, likes, and likes per day counts. Comments were significantly higher in non-professional videos. Professional videos had higher quality and reliability scores than non-professional videos. Conclusion: Accurate and reliable information on HIV/AIDS is critical for promoting prevention, early detection, and effective management of the disease. YouTube has the potential to disseminate this information, but the quality and reliability of its videos must be improved. Our study highlights the need to prioritize professional, high-quality, and reliable video content on HIV/AIDS on YouTube to improve the public health outcome.

Cutaneous Adverse Drug Reaction Among HIV-Infected Patients Starting Antituberculosis Treatment

Introduction. Treatment of tuberculosis (TB) in HIV patients is complicated due to numerous comorbidities and possible adverse effects. One of which is cutaneous adverse drug reaction (CADR). This adverse event is often difficult to manage because of multiple medications the patients get. The objective of this study was to know the prevalence and risk factors of CADR among HIV-infected patients starting anti-TB treatment. Methods. This retrospective study reviewed data from medical records of new patients at Working Group on AIDS outpatient clinic at Cipto Mangunkusumo Hospital, Indonesia in January 2008-December 2010 that had started anti-TB treatment. Risk factors of CADR among HIV patients treated with antituberculosis drugs evaluated were sex, age, route of HIV transmission, TB manifestation, and baseline CD4+ cell count. Numeric data were analyzed using independent T-test if normally distributed, otherwise Mann Whitney U test were used. Chi-square or Fisher’s exact test were used for categorical data. p-value was considered significant if below 0.05. Results. Of 454 HIV-infected patients that started anti-TB treatment, median age was 30 years. Most patients were male and intravenous drug users/IDU. Median baseline CD4+ cell count was 61 cells/ μL. There were 10.6% subjects that developed CADR. Most common manifestations were maculopapular rashes (66.7%), followed by erythema multiforme (14.6%), and Stevens Johnson Syndrome (8.3%). Anti-TB drugs were stopped and then re-challenge was conducted in 54.2% patients. Anti-TB drugs were continued and only the suspected drug was stopped in 29.2% patients. The offending drugs were cotrimoxazole (41.7%), rifampicine (41.7%), ethambutol (16.7%), pyrazinamide (14.6%), pyrimethamine (12.5%), isoniazide (10.4%), streptomycin (8.3%), efavirenz (8.3%), fixed dose combination of antituberculosis drugs (8.3%), and nevirapine (4.2%). The proportion of CADR was higher in woman than man (12% vs. 10.3%, p=0.66), non-IDU than IDU (13% vs. 9.2%, p=0.20), without extrapulmonary TB than extrapulmonary TB (11.1% vs. 9.4%, p=0.29), but the associations weren’t statistically significant. Median age was higher (31 vs. 30 years, p=0.32) and CD4 cell count (59.5 vs. 62 sel/μL, p=0.96) was lower in CADR group than non CADR group. Conclusion. The prevalence of CADR among HIV-infected patients starting anti-TB treatment was 10.6%. Sex, age, route of HIV transmission, TB manifestation, and baseline CD4+ did not have statistically significant association with CADR.