Young HIV Research Articles

Cardiovascular Risk Assessment in Young HIV Patients from Constanţa County, Romania, Using Cardiovascular Risk Scores

Abstract HIV/AIDS remains one of the greatest global health challenges, affecting millions of people worldwide. Realizing the seriousness of the situation, various strategies were designed and implemented, aiming to mitigate the impact of the disease and, finally, to eradicate it. Although these strategies have produced remarkable progress over time, a new category is emerging, the aging population with HIV. Cardiovascular pathology is increasingly common in young population with HIV infection, aged due to the presence of this virus and the antiretroviral therapy instituted for decades. Cardiovascular risk scores are useful for the general population, but for HIV patients, they need to be adapted. The aim of this study was to evaluate cardiovascular risk scores used in HIV patients from Dobrogea regional center, in the records of the Clinical Hospital of Infectious Diseases in Constanța.

Rural HIV Negative Young Women Presenting with Advanced FIGO Stages (iii and iv) of Early Onset Cancer of the Cervix Compared to their Urban Counterparts in Western Kenya – A Case Study of Jaramogi Oginga Odinga Teaching and Referral Hospital?

Background: In many Low and middle income countries, most patients present with advanced cases of cervical cancer (Figo Stages III and IV). The factors contributing to this have been studied and reported as being due to health seeking behaviours, lack of screening services and late diagnosis among others. Objective: This study aimed to explore the increase in incidences of early onset advanced cervical cancer in young HIV Negative rural women, as compared to their urban counterparts presenting at the Oncology Clinic of the hospital. Methodology: A mixed method study was undertaken of purposively recruited HIV negative patients, aged 13-35 years, presenting with Cancer of the Cervix in the 2020-2021 period of study. Findings: The study found out that, in the period 2020-2021, most patients presented to the hospital with early onset advanced cancer of the cervix, and 39 (64%) were diagnosed at FIGO Stages III and IV, while just 22 (36%) were diagnosed at Stages I and II. Conclusion: Our conclusion is that apparently due to the early routine cancer of the cervix screening of young HIV positive women, cases are being diagnosed very early, in the pre-cancer and early stages, leading to early treatment and remission, in turn leading to the increased contribution of young HIV negative women with advanced cancer of the cervix.

Rare case of pulmonary syphilis

Syphilis is a well known bacterium that has a great response to antibiotic treatment. Even though it is well known it can present with a wide array of symptoms. If left untreated, Syphilis will progress through primary, secondary, latent, and tertiary stages. In Secondary Syphilis, the bacterium can become disseminated and could potentially affect any organ. In Tertiary Syphilis, the central nervous system could be affected. These issues could be very detrimental to the patient and could be debilitating. In the past 20 years there has been a slight increase in the numbers of Syphilis seen in the U.S. which could be due to increasing number of men who have sex with men and increasing HIV numbers. The case discussed below entails a young HIV positive female who fulfilled all the guideline recommendations for Pulmonary Syphilis and responded very well to treatment. Pulmonary Syphilis is rare but due to its potential to cause widespread damage, it needs to be taken into consideration whenever an immunocompromised or high-risk patient presents with positive serology, respiratory symptoms, and imaging evidence. Due to its good response to treatment, if detected early patients can be treated appropriately and effectively in a time efficient manner

Domain-specific Embeddings for Question-Answering Systems: FAQs for Health Coaching

FAQs are widely used to respond to users’ knowledge needs within knowledge domains. While LLM might be a promising way to address user questions, they are still prone to hallucinations i.e., inaccurate or wrong responses, which, can, inter alia, lead to massive problems, including, but not limited to, ethical issues. As a part of the healthcare coach chatbot for young Nigerian HIV clients, the need to meet their information needs through FAQs is one of the main coaching requirements. In this paper, we explore if domain knowledge in HIV FAQs can be represented as text embeddings to retrieve similar questions matching user queries, thus improving the understanding of the chatbot and the satisfaction of the users. Specifically, we describe our approach to developing an FAQ chatbot for the domain of HIV. We used a predefined FAQ question-answer knowledge base in English and Pidgin co-created by HIV clients and experts from Nigeria and Switzerland. The results of the post-engagement survey show that the chatbot mostly understood the user’s questions and could identify relevant matching questions and retrieve an appropriate response.

The added value of web listening understanding HIV risk, prevention and communication needs in Italy

Abstract Background Institutional communication on sexually transmitted infections (STI) and HIV requires a thorough understanding of the population's information needs and awareness on the subject. Therefore, the National Institute of Health, in collaboration with the Ministry of Health, conducted a web listening study to set up more effective communication campaigns. Methods The analysis of all conversations in Italian was conducted, from October 2021 to September 2022, through Blogmeter Suite, an integrated Social Listening platform. Data extraction was done by analyzing a database of more than 2 billion indexed documents (sources: Facebook, Twitter, Instagram, YouTube, TikTok, Twitch, forums, blogs, news sites, and app reviews such as Google Play and App Store) and containing at least one keyword among AIDS, HIV, HIV testing, STI. Results The term AIDS constitutes 48% of the total posts on STI, and conversations about it take place 62.7% on Facebook. TikTok and Instagram are the sources where there is the most interaction. Spikes in conversations about AIDS and HIV occurred in conjunction with news events and dedicated events. Younger generations have limited awareness of HIV risks and prevention. The barrier to HIV testing is cost, and it is found that not everyone is aware of self-testing. Stigma is related to the problem of anonymity, especially in the work environment, due to fear of career repercussions. Conclusions Data analysis shows that among STIs, HIV, represents the area of greatest concern. Awareness among the population is low, discussions related to seasonality and news events, and people at the time of diagnosis try to avoid their general practitioner, especially if they live in small towns and take refuge in more secretive network locations. Key messages • The analysis highlights how crucial evolution in institutional communication is. • Topics such as testing, stigma and, especially for young people, HIV risks and prevention need to be explored.

Mortality by Age, Gender, and Race and Ethnicity in People Experiencing Homelessness in Boston, Massachusetts

People experiencing homelessness (PEH) face disproportionately high mortality rates compared with the general population, but few studies have examined mortality in this population by age, gender, and race and ethnicity. To evaluate all-cause and cause-specific mortality in a large cohort of PEH by age, gender, and race and ethnicity. An observational cohort study was conducted from January 1, 2003, to December 31, 2018. All analyses were performed between March 16, 2021, and May 12, 2022. A cohort of adults (age ≥18 years) seen at the Boston Health Care for the Homeless Program (BHCHP), a large federally funded Health Care for the Homeless organization in Boston, Massachusetts, from January 1, 2003, to December 31, 2017, was linked to Massachusetts death occurrence files spanning January 1, 2003, to December 31, 2018. Age-, gender-, and race and ethnicity-stratified all-cause and cause-specific mortality rates were examined and compared with rates in the urban Northeast US population using mortality rate ratios (RRs). Among the 60 092 adults included in the cohort with a median follow-up of 8.6 (IQR, 5.1-12.5) years, 7130 deaths occurred. The mean (SD) age at death was 53.7 (13.1) years; 77.5% of decedents were men, 21.0% Black, 10.0% Hispanic/Latinx, and 61.5% White. The all-cause mortality rate was 1639.7 deaths per 100 000 person-years among men and 830 deaths per 100 000 person-years among women. The all-cause mortality rate was highest among White men aged 65 to 79 years (4245.4 deaths per 100 000 person-years). Drug overdose was a leading cause of death across age, gender, and race and ethnicity groups, while suicide uniquely affected young PEH and HIV infection and homicide uniquely affected Black and Hispanic/Latinx PEH. In this large cohort study of PEH, all-cause and cause-specific mortality varied by age, gender, and race and ethnicity. Tailored interventions focusing on those at elevated risk for certain causes of death are essential for reducing mortality disparities across homeless-experienced groups.

Image du corps et estime de soi des patients VIH au Gabon

ObjectiveThe study proposes the analysis of the relationship between body image, self-esteem and body shame (dependent variables) in HIV patients according to their age, gender, level of education, HIV status and year of their HIV screening. We also wanted to see how independent variables (gender and age) affect self-esteem, body image and body shame. MethodsParticipants included 158 HIV patients (men and women) who completed a battery of self-report measures: the Rosenberg Self-Esteem Scale (1965), the Bruchon-Schweitzer Body Image Scale (BIS) (1990), and the body shame subscale from the Shame Experience Scale (ESS) by Andrews et al. (2002). ResultsThe first hypothesis, which tests the link between self-esteem, body image and body shame and the sociodemographic variables (age, gender, level of education, HIV status and year of screening), showed a significant relationship among Gabonese HIV patients. The second hypothesis, which evaluates the influence of age and gender on all our dependent variables (self-esteem, body image and body shame), indicated that women are no more likely to express more body dissatisfaction and shame about their bodies and their level of self-esteem is no lower than that of men. Finally, an intergroup comparison demonstrated that self-esteem is lower among youth in certain age groups. ConclusionThere are significant links between self-esteem, body image and body shame with a lower level of self-esteem in young HIV patients. For clinicians involved in the management of HIV patients, knowledge of the level of self-esteem, body dissatisfaction and body shame would allow for the development of appropriate care and therapeutic intervention goals (therapeutic group, self-efficacy group).

Challenges and coping strategies among young adults living with perinatally acquired HIV infection in Botswana. A qualitative study.

Due to antiretroviral therapy, many people with perinatally acquired HIV are surviving into young adulthood which is a critical period of human development. Research conducted in various settings globally has shown that young adults living with perinatally acquired HIV (YALPH) face multiple challenges related to HIV infection while also confronting the same challenges of young adulthood faced by other HIV-negative youth. However, there is a paucity of information on YALPH in Botswana and what needs to be done to improve their health and wellbeing. Therefore, this study explores the challenges and coping strategies of YALPH in order to inform health policies and programming in Botswana. In-depth interviews were conducted with 45 YALPH (ages 18-27 years) who were enrolled on antiretroviral therapy at the Botswana-Baylor Children's Clinical Centre of Excellence (Botswana-Baylor Clinic). The Botswana-Baylor Clinic is the largest centre for pediatric, adolescent, and young adult HIV treatment and care in Botswana. The maximum variation sampling method was used to select information-rich participants. The questions focused on the challenges YALPH faced and how they coped with HIV. The data was analyzed using content analysis. The results showed that the majority of YALPH had suppressed HIV viral load and perceived themselves to be in good physical health and functioning. They did, however, face numerous challenges, including occasional or longstanding poor antiretroviral therapy adherence, disabilities and impairments, poor school performance and attainment, unemployment, financial stressors, fear of stigma, disclosure worries and concerns, and limited social support. The most vulnerable YALPH included those with disabilities and impairments, those transitioning out of residential care, young parents, the unemployed, and those with maladaptive coping strategies. The YALPH mainly used adaptive coping strategies. The most commonly used maladaptive coping strategies were self-distraction and venting. Interventions to prevent, screen for, assess, and manage the challenges identified by this study are critical to improving the health and well-being of YALPH. In addition, diverse interventions that can contribute to the development of adaptive coping mechanisms and reduce the likelihood of maladaptive coping in YALPH should be sought.

Adolescent girls and young adult women's HIV infection, male partner age, and HIV status: connecting the dots

Adolescent girls and young adult women's HIV infection, male partner age, and HIV status: connecting the dots

Cryptosporidium in human-animal-environment interphase at Adama and Asella areas of Oromia regional state, Ethiopia

BackgroundIn Ethiopia, several studies have reported the occurrence of Cryptosporidium infection in young calves, lambs, and HIV positive patients. However, research on cattle and sheep of all ages, as well as humans, has been limited.MethodsA cross-sectional study was conducted to investigate the occurrence of Cryptosporidium in dairy cattle, sheep, humans, and manure samples. Dairy cattle and sheep were stratified according to their age groups and randomly sampled. Stool samples from volunteered dairy farm workers and rural household members were collected purposefully. A semi-structured questionnaire was also used to collect information about manure handling practices and socio-demographic variables. All collected samples were processed with the sugar floatation technique and the modified Ziehl–Neelsen staining method. Logistic regression was used to analyze the association of risk factors with the occurrence of Cryptosporidium in study subjects (p < 0.05).ResultsThe overall prevalence of Cryptosporidium in dairy cattle, sheep, humans, and manure samples was 20.5%, 14%, 16%, and 13.20%, respectively. Cryptosporidium infection was significantly higher in dairy cattle aged 1–12 months and 13–36 months with odds of 3.48 and 3.07 times higher, respectively, compared to others. Similarly, its occurrence was 2.69 times higher in sheep aged 1–6 months than those above 6 months. And also, a higher average oocyst count (above 10 oocysts) per-field was observed in cattle aged 1–12 months, followed by sheep aged 1–6 months. Furthermore, the likelihood of infection was 13 times greater in farm workers compared to household members of smallholder farmers. In addition, the occurrence of oocysts was 22.8 times higher in manures from dairy cattle than that of sheep. About 16.8% of the study respondents had manure disposal pit, 98.1% of them used manure as fertilizer for crop and vegetable production without any treatment.ConclusionsThe study revealed the occurrence of Cryptosporidium infection in all age groups of dairy cattle and sheep, humans engaged in animal production. Occurrence of Cryptosporidium in manure suggests it potential contamination of environment and water sources.

Systematic Review of mHealth Interventions for Adolescent and Young Adult HIV Prevention and the Adolescent HIV Continuum of Care in Low to Middle Income Countries

Adolescents and young adults (AYA) in low to middle income countries (LMIC) have poorer outcomes along each step in the HIV continuum of prevention and care compared to younger children or older adults. The use of mHealth technology provides a potentially promising implementation strategy for interventions to remedy these disparities. We therefore conducted a systematic review of the English literature and conference proceedings from January 1, 2000 to April 1, 2021 evaluating mHealth interventions targeting AYA along each step of the HIV continuum of care in LMIC. We identified 27 mHealth interventions across the HIV continuum, with no interventions addressing transition from pediatric to adult care. The majority of studies were single arm, uncontrolled or underpowered, with few randomized trials resulting in mixed and inconclusive outcomes. mHealth interventions have potential to remedy disparities along the HIV continuum of care for AYA in LMIC but larger, powered randomized trials are needed.

Changes in brain structural volume and white matter abnormalities in young perinatally-acquired HIV infected children treated with antiretroviral therapy

Changes in brain structural volume and white matter abnormalities in young perinatally-acquired HIV infected children treated with antiretroviral therapy

Using the Positive Peers Mobile App to Improve Clinical Outcomes for Young People With HIV: Prospective Observational Cohort Comparison.

BackgroundDisparities in HIV outcomes persist among racial, gender, and sexual minorities in the United States. Younger people face a greater risk of contracting HIV, often living without knowledge of their HIV status for long periods. The Positive Peers App (PPA) is a multifunctional HIV support tool designed to improve HIV-related clinical outcomes for young people with HIV. The app was designed according to the specifications of an in-care young adult HIV community in Northeast Ohio. Data provided in this study provide preliminary evidence of the usefulness of PPA as a relevant tool for engaging this clinical patient population in care and facilitating viral suppression.ObjectiveIn this study, we aimed to describe variations in PPA use and examine the associations between use and HIV clinical outcomes between self-selected user and nonuser cohorts in the same clinical population.MethodsThe PPA was offered free of charge to persons with HIV, aged 13 to 34 years of age, diagnosed with HIV within the last 12 months, out of care for 6 months during the last 24 months, or not virally suppressed (HIV viral load >200 copies/mL) in the prior 24 months. Baseline and 6- and 12-month surveys were administered via an audio computer-assisted self-interviewing system to all participants. The app’s user activity was tracked natively by the app and stored in a secure server. Participant demographic and HIV care data were extracted from clinical records within 12 months before the start of the study and across the duration of the study period. HIV care outcomes of PPA users (n=114) were compared with those of nonusers (n=145) at the end of the study period (n=259).ResultsThe analysis showed that younger PPA users (aged 13-24 years) were more likely to obtain HIV laboratories (adjusted odds ratio 2.85, 95% CI 1.03-7.90) and achieve sustained viral suppression than nonusers (adjusted odds ratio 4.2, 95% CI 1.2-13.9).ConclusionsThe PPA appears to help younger users sustain HIV suppression. The app offers an important tool for addressing this critical population. The PPA remains in the field and is currently being adopted by other localities to facilitate their efforts to end the HIV epidemic. Although our reported observational results require additional validation and stringent ongoing surveillance, the results represent our best efforts in a pilot study to provide a measure of efficacy for the PPA. Next steps include a large-scale evaluation of the PPA acceptability and effectiveness. Given the building evidence of user reports and outcomes, the freely available PPA could be a helpful tool for achieving Ending the HIV Epidemic goals.

Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores.

BackgroundThe risk of liver fibrosis increases over time in HIV and HIV-HBV individuals even under antiretroviral treatment (ART), warranting a rigorous and periodic monitorization. Given the lower availability of transient elastography, we aimed to assess the longitudinal variation of two non-invasive liver fibrosis scores, APRI and Fib-4, in cases with HIV monoinfection, HIV-HBV co-infection and individuals with HBsAg-seroclearance.MethodsWe performed an observational retrospective study between 2013 and 2019 on 212 HIV patients including 111 individuals with HIV mono-infection, 62 individuals with HIV-HBV co-infection and positive HBsAg and 39 cases with HIV-HBV infection and HBsAg-loss. The groups were followed at 36, 48, and 60 months. Liver fibrosis was indicated by an APRI >0.5 or Fib-4≥1.45 score and advanced fibrosis by an APRI score >1.5 or Fib-4 >3.25. Logistic regression with generalized estimating equations (GEE) was used to assess the predictors for the presence of liver fibrosis over time.ResultsDuring a median follow-up of 58.5 months the prevalence of liver fibrosis in all patients increased with 0.5% reaching 11.3% using an APRI score and with 0.9% reaching 10.8% using the Fib-4 score. At the visit corresponding to 60 months the prevalence of liver fibrosis was higher in all HIV-HBV patients compared with individuals with HIV mono-infection, namely: 16.1% on APRI and 12.9% on the Fib-4 score in HIV-HBV/HBsAg-positive individuals, 12.8% on both APRI and Fib-4 scores in HIV-HBV/HBsAg-negative individuals vs. 8.1 and 9%, respectively in HIV mono-infection. The presence of liver fibrosis over the study period was independently associated with plasma HIV RNA, CD4+T cell counts, HIV-HBV co-infection (for APRI >0.5) and ART non-adherence (for Fib-4 >1.45). At the final visit, non-adherence to ART and CD4+T cell counts remained associated with liver fibrosis.ConclusionsThe study found a slow progression of APRI and Fib-4 scores over time in young PLWH with extensive ART. Liver fibrosis scores continued to increase in patients with HIV mono-infection yet remained lower than in HIV-HBV patients irrespective on the presence of HBsAg. The periodic follow-up using non-invasive scores on the long-term could help improve the surveillance in low-income settings and high scores should be followed by additional diagnostic methods.

Developing a Consensus for Adolescent and Young Adult mHealth HIV Prevention Interventions in the United States: A Delphi Method Study.

BackgroundEngaging adolescents and young adults (AYAs) who are at elevated risk for HIV acquisition or who are living with HIV in health care has posed a major challenge in HIV prevention and care efforts. Mobile health (mHealth) interventions are a popular and accessible strategy to support AYA engagement despite barriers to care present along the HIV care continuum. Even with progress in the field of mHealth research, expert recommendations for the process of designing, evaluating, and implementing HIV-related mHealth interventions are underdeveloped.ObjectiveThe aim of this study was to compile expert recommendations on the development, evaluation, and implementation of AYA-focused HIV prevention and care mHealth interventions.MethodsExperts from adolescent mHealth HIV research networks and investigators of recently funded HIV mHealth projects and programs were identified and invited to complete a series of electronic surveys related to the design, implementation, and evaluation of HIV-related mHealth interventions. A modified Delphi method was used to ask experts to score 35 survey items on a 4-point Likert scale from not important to very important and encouraged experts to leave additional comments in textboxes. Responses were reviewed by the researchers, a team of 4 HIV mHealth intervention experts. The average importance ratings from survey responses were calculated and then categorized as retained (high importance), flagged (mid-level importance), or dropped (no/low importance). Additionally, thematic analysis of expert comments helped modify survey items for the next survey round. An evaluation of the level of agreement among experts on the most important items followed each round until consensus was reached.ResultsOf the 35 invited experts, 23 completed the first survey representing a variety of roles within a research team. Following two rounds of Delphi surveys, experts scored 24 of the 28 (86%) survey items included in round two as important to very important. The final consensus items included 24 recommendations related to the mHealth intervention design process (n=15), evaluation (n=2), and implementation (n=7). The 3 survey items with the highest average scores focused on the design process, specifically, (1) the creation of a diverse team including researchers, app software developers, and youth representation; (2) the importance of AYA-focused content; and (3) the value of an iterative process. Additionally, experts highlighted the importance of establishing the best ways to collect data and the types of data for collection during the evaluation process as well as constructing a plan for participant technology disruption when implementing an mHealth intervention.ConclusionsThe modified Delphi method was a useful tool to convene experts to determine recommendations for AYA-focused HIV prevention and care mHealth interventions. These recommendations can inform future mHealth interventions. To ensure the acceptability, feasibility, and efficacy of these AYA HIV prevention interventions, the focus must be on the specific needs of AYAs by including representation of AYAs in the process, including consistent and relevant content, ensuring appropriate data is collected, and considering technology and health accessibility barriers.

Impaired Endothelial Function and Enhanced Contractility of Microarterioles from Persons Living with Human Immunodeficiency Virus (HIV+) is Mediated by Inflamed Perivascular Adipose Tissue

This research investigates the mechanisms that contribute to the enhanced cardiovascular disease (CVD) in HIV+ persons. It tests the hypothesis that perivascular adipose tissue (PVAT) mediates the microvascular dysfunction. Subcutaneous microarterioles were dissected from gluteal skin biopsies from 11 HIV+ and 10 matched control women aged &lt; 50 years who were free of CVD risk factors (except increased BMI). Arterioles were mounted on isometric myographs with or without PVAT. Nitric oxide (NO) and reactive oxygen species (ROS) were measured by fluorescence microscopy. PVAT significantly (P &lt; 0.05) enhanced endothelium‐ dependent relaxation (EDR) and NO with acetylcholine and moderated contractions with thromboxane and endothelin 1 (ET1). But these effects of PVAT were significantly (P &lt; 0.05) diminished in HIV+ vs control subjects. Although microarterioles from HIV+ had enhanced ROS with ET1. ROS was not affected by PVAT. Incubated PVAT from HIV+ persons released significantly (P &lt; 0.05) more leptin (47 +/‐ 8 vs 22 +/‐ 3 ng · mg‐1) and less adiponectin (3.0 +/‐ 0.4 vs 4.6 +/‐ 0.5 µg · mg‐1) but more 8‐isoprostane F2α (2.5 +/‐ 0.4 vs 1.3 +/‐ 0.3 µmol · mg‐1) and inflammatory cytokines such as TNFα (11 +/‐ 1 vs 5 +/‐ 1 pg · mg‐1).ConclusionPVAT from young HIV+ women has enhanced oxidative stress and inflammation and impaired ability to enhance microarteriolar NO and moderated contractility. Thus, PVAT and adipokines should be novel foci for therapy to reduce CVD in HIV+ persons.

Community-engaged mHealth intervention to increase uptake of HIV pre-exposure prophylaxis (PrEP) among gay, bisexual and other men who have sex with men in China: study protocol for a pilot randomised controlled trial

IntroductionThe large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges...

Transmission of Group B Streptococcus in late-onset neonatal disease: a narrative review of current evidence.

Group B streptococcus (GBS) late-onset disease (LOD, occurring from 7 through 89 days of life) is an important cause of sepsis and meningitis in infants. The pathogenesis and modes of transmission of LOD to neonates are yet to be elucidated. Established risk factors for the incidence of LOD include maternal GBS colonisation, young maternal age, preterm birth, HIV exposure and African ethnicity. The mucosal colonisation by GBS may be acquired perinatally or in the postpartum period from maternal or other sources. Growing evidence has demonstrated the predominant role of maternal sources in the transmission of LOD. Intrapartum antibiotic prophylaxis (IAP) to prevent early-onset disease reduces neonatal GBS colonisation during delivery; however, a significant proportion of IAP-exposed neonates born to GBS-carrier mothers acquire the pathogen at mucosal sites in the first weeks of life. GBS-infected breast milk, with or without presence of mastitis, is considered a potential vehicle for transmitting GBS. Furthermore, horizontal transmission is possible from nosocomial and other community sources. Although unfrequently reported, nosocomial transmission of GBS in the neonatal intensive care unit is probably less rare than is usually believed. GBS disease can sometime recur and is usually caused by the same GBS serotype that caused the primary infection. This review aims to discuss the dynamics of transmission of GBS in the neonatal LOD.

Facilitators and Barriers to Retention in HIV Care among HIV Infected MSM Attending Community Health Center Yaba, Lagos Nigeria

Background: The burden of HIV infection among men who have sex with men (MSM) has posed a huge public health threat to the developing country like Nigeria. Identification of effective strategies to improve their retention in HIV care especially for young HIV infected MSM is critical for overall success in scaling down the national burden of HIV/AIDS. The aim of this study was to assess the facilitators and barriers to retention in HIV care among HIV infected MSM attending community health center, Yaba Lagos Nigeria.&#x0D; Methods: A two months (May –June,2016) exploratory qualitative research study was conducted among 181 respondents enrolled into HIV care within 12 months that attend community health center, Yaba Lagos Nigeria. A pretested and semi-structured questionnaire was used to collect information on the specific facilitators and barriers to retention in HIV care among respondents. Data entries and analysis were done using SPSS package version 20. Descriptive statistics was used to summarize quantitative variables, and frequency tables were generated for the relevant variables.&#x0D; Results: The median age (in years) of the participants sampled was 24. The study identified friendly clinic service 44%, having positive relationship with clinic staff 16%, friendly and secured environment 20% as the major facilitators to retention in HIV care while implicating distance 36% and self -denial 21% as major barriers to retention in HIV care among the respondents.&#x0D; Conclusion: Majority of the respondents were retained in HIV care services due to the available friendly clinic services and conducive environment instituted at the service provision site.

Altered Lipid Profiles and Vaccine Induced-Humoral Responses in Children Living With HIV on Antiretroviral Therapy in Tanzania.

People living with HIV, even under therapy, have a high burden of age-related co-morbidities including an increased risk of dyslipidemia (which often predisposes to cardiovascular diseases) and immune-aging. In this study, lipid profiles and antibody responses to measles and pertussis toxin vaccines were compared between ART experienced HIV+ children (n=64) aged 5-10 years, and their age- and sex-matched HIV- controls (n=47). Prevalence of high-density lipoprotein cholesterol (HDL-c) and triglyceride-driven dyslipidemia was higher among treated HIV+ children than in controls (51.6% vs 27.7% respectively, p < 0.019). In a multivariate Poisson regression model adjusted for age, sex and BMI, the association between low HDL-c, hypertriglyceridemia and HIV remained significantly high (for HDL-c: ARR: 0.89, 95% CI: 0.82 – 0.96, p = 0.003; for triglycerides: ARR: 1.54, 95% CI: 1.31 – 1.81, p < 0.001). Among HIV+ children, the use of lopinavir/ritonavir, a protease-based antiretroviral therapy was also associated elevation of triglyceride levels (p = 0.032). Also, HIV+ children had a 2.8-fold reduction of anti-measles IgG titers and 17.1-fold reduction of anti-pertussis toxin IgG levels when compared to HIV- children. Our findings suggest that dyslipidemia and inadequate vaccine-induced antibody responses observed in this population of young African HIV+ children might increase their risk for premature onset of cardiovascular illnesses and acquisition of preventable diseases.