Suchergebnisse

Tsegaye Melaku,1,2 Desta Assefa1 1School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia; 2Jimma Medical Center, Jimma University, Jimma, EthiopiaCorrespondence: Tsegaye MelakuJimma University, P.O. Box: 378, Jimma, EthiopiaTel +251 913765609Email tsegayemlk@yahoo.comAbstract: It is a high time not to sideline human immunodeficiency virus (HIV) response during the 2019 coronavirus disease (COVID-19) crisis. COVID-19 will affect the decade's hard-earned gains from HIV care delivery and response. At the same time, it could be an important time for the COVID-19 containment response to help minimize the occurrence of a new infection. Sexual contact is the main transmission ways in HIV dynamics. However, COVID-19 prevention and control strategies such as movement restrictions, physical and social distancing will reduce exposure to such kinds of risk behaviors. Those containment strategies, including stringent infection prevention and control at health facilities, may minimize transmission of HIV infection and will reduce the incidence of new HIV infection. While recognizing the immense challenges of the COVID-19 pandemic, efforts should be made by governments and international organizations to maintain the response to HIV and to ensure that the progress made against HIV is not lost. In addition, it is very crucial to undertake further researches on the status of new HIV infection during the COVID-19.Keywords: COVID-19, human immunodeficiency virus, public health interventions, physical distancing

Although acquired immune deficiency syndrome (AIDS) was first described in the USA in 1981, there is evidence that individual cases occurred considerably earlier in Central Africa, and serological and virological data show human immunodeficiency virus (HIV) was present in the Democratic Republic of Congo (DRC) as far back as 1959. It is likely that HIV-1 infection in humans was established from cross-species transmission of simian immunodeficiency virus of chimpanzees, but the circumstances surrounding this zoonotic transfer are uncertain. This presentation will review how causality is established in epidemiology, and review the evidence (a putative ecological association) surrounding the hypothesis that early HIV-1 infections were associated with trials of oral polio vaccine (OPV) in the DRC. From an epidemiological standpoint, the OPV hypothesis is not supported by data and the ecological association proposed between OPV use and early HIV/AIDS cases is unconvincing. It is likely that Africa will continue to dominate global HIV and AIDS epidemiology in the near to medium-term future, and that the epidemic will evolve over many decades unless a preventive vaccine becomes widely available.

Over 14 million people are estimated to be infected with the human immunodeficiency viruses (HIV), with nearly three-fourths of the infected persons residing in developing countries. One factor responsible for dissemination of both HIV-1 and HIV-2 worldwide was the intense migration of individuals, from rural to urban centers with subsequent return migration and internationally due to civil wars, tourism, business purposes, and the drug trade. In sub-Saharan Africa, between 1960 and 1980, urban centers with more than 500,000 inhabitants increased from 3 to 28, and more than 75 military coups occurred in 30 countries. The result was a massive migration of rural inhabitants to urban centers concomitant with the spread of HIV-1 to large population centers. With the associated demographic, economic, and social changes, an epidemic of sexually transmitted diseases and HIV-1 was ignited. Migratory patterns were also responsible for the spread of endemic HIV-2 to neighboring West African countries and eventually to Europe, the Americans, and India. Although Southeast Asia was the last region in which HIV-1 was introduced, it has the greatest potential for rapid spread due to population density and inherent risk behaviors. Thus, the migration of poor, rural, and young sexually active individuals to urban centers coupled with large international movements of HIV-infected individuals played a prominent role in the dissemination of HIV globally. The economic recession has aggravated the transmission of HIV by directly increasing the population at risk through increased urban migration, disruption of rural families and cultural values, poverty, and prostitution and indirectly through a decrease in health care provision. Consequently, social and economic reform as well as sexual behavior education need to be intensified if HIV transmission is to be controlled.

This was a quantitative, descriptive cross-sectional study aiming to identify the sociodemographic, maternal and clinical conditions of children exposed to the Human Immunodeficiency Virus, who were treated in a reference hospital for infectious diseases in Fortaleza-Ceará. The sample consisted of 117 mothers who brought their children for consultation between July and December 2009. Data were collected through a semi-structured interview form. There was a higher percentage of mothers aged 20-29 years (53.8%), married (73.5%) and unemployed (68.3%). Most children were less than 12 months old (39.4%), did not receive governmental assistance (66.6%), and did not attend the health service on the scheduled date (77.0%). Some mothers did not use Zidovudine during pregnancy (15.4%), and eight children did not use it after birth (6.8%). Nineteen children did not use prophylaxic Trimethoprim-Sulfametaxazol in the first year of life. It was concluded that most children had socioeconomic difficulties that negatively influenced their health conditions.

The bitter, public contest for priority over the discovery of the virus that causes AIDS was officially closed in 1987 with equal credit being awarded to two parties from opposite sides of the Atlantic. One was led by Robert C. Gallo of the Laboratory of Tumor Cell Biology at the National Cancer Institute in the United States and the other was led by Luc Montagnier of the viral-oncology unit at the Pasteur Institute in France. Using citation counts from articles published by the scientific community, a process of alloca tion of credit is examined and compared with this official settlement. A novel pattern emerges. It is found that the scientific community began to redistribute priority when the dispute became highly publicized and took little notice of the official settlement. This, along with the fact that Gallo has now officially been charged with misconduct by an investigative committee, may mean that Montagnier's team may eventually receive sole creditfor the discovery of the AIDS virus. The importance of examining priority disputes from many different angles and the potential for citation analysis in such cases are highlighted.

Objective: To identify the strategies that the professionals use to assist in adherence to treatment of HIV positive pregnant women with Human Immunodeficiency Virus. Method: This was an exploratory, descriptive qualitative research study developed with ten professionals working in a Center and Counseling Center in southern Brazil. Data were collected from May 2010 through semi-structured interviews were subjected to thematic analysis. Results: The results showed as strategies welcoming actions, to include these pregnant women in the service and rapprochement with the team; conducting group activities and active pursuit of defaulting, respecting their autonomy and preserve their secrecy. Conclusion: that adherence to treatment is necessary for the staff involved in the care of interdisciplinary, humanized and qualified manner; the nurse may be the organizer of the shares was concluded.

The Human Immunodeficiency Virus (HIV) prevalence in prenatal clinic indicates that the gap in HIV prevalence between sub-regions of Africa is not reducing but widening. No evidence suggests that pregnancy accelerate the progression of HIV infection to AIDS in women, but pregnancy in HIV infected mothers are more likely to result in prematurity, intrauterine growth retardation, spontaneous abortion, and prenatal death. The aim was to determine the prevalence of HIV infection among pregnant women attending a rural primary health center for care. The study was designed as cross-sectional survey and case series using 80 pregnant women, randomly selected among those attending Antenatal care in a primary health center in Local Government Area in Rivers State, Nigeria. Descriptive method was used to represent the characteristics of the subjects and the differences in HIV infection among subjects analyzed using frequencies and percentages. The findings showed that out of 80 subjects studied; (14%) were HIV positive, (86%) were HIV negative; knowledge of risk factors identified were unprotected sex with sex partner/s (39%); existence of other sexually transmitted infection (33%); sharing of sharp instrument (17%); transfusion of unscreened blood (11%). Conclusion, the majority of the women had good knowledge of awareness on HIV infection and control using medication; which is a sound basis for the epidemiology, outcome, and effectiveness in prevention and control of HIV/AIDS in such a rural setting, considering socio-demographic factors. Awareness creation on risk factors of HIV/AIDS, lifestyle changes and adherence

<i>Background/Aim:</i> Injection drug users (IDUs) have a high risk of acquiring an infection with the human immunodeficiency virus (HIV). To improve counseling and prevention, a better understanding of risk factors and predictors for an infection must be gained. This retrospective study has the aim to determine the risk factors for acquisition of HIV infection other than sharing of needles/syringes. <i>Methods:</i> The study population consisted of all patients admitted to the detoxification unit between 1991 and 1996 who met ICD-10 criteria for opioid dependency, who reported to share needles, and who agreed to have an antibody test. Possible risk factors were assessed by interview. Cross tables based on bivariate logistic regression were constructed to estimate the relative odds. Multiple logistic regression modeling procedures were used to adjust possible confounding factors. <i>Results:</i> A total of 1,049 out of 1,656 patients admitted were included into the study. 4.8% of the patients were HIV-1 seropositive. The prevalence was higher among older patients and among patients living with a significant other substance drug user with substance dependency, after a longer duration of drug use, and after coinfection with hepatitis B virus and/or hepatitis C virus (HCV). Using multiple logistic regression analyses and including all individually significant risk factors, we found only coinfection with HCV to remain significant. 92% of the HIV-infected patients were also HCV infected. In the group younger than 23 years of age, a total of 53.5% of the IDUs were still seronegative for HIV, hepatitis A and B virus, and HCV. <i>Conclusions:</i> Despite the high rate of HCV coinfection (92%) in HIV-infected patients, we found more than 50% of IDUs younger than 23 years to be neither infected with HCV nor with HIV. Early prevention strategies against infectious diseases should especially focus on young IDUs.

AbstractIntroduction: To assess progress towards the UNAIDS 90–90–90 initiative targets, we examined the HIV care cascade in the population‐based Rakai Community Cohort Study (RCCS) in rural Uganda and examined differences between sub‐groups.Methods: Self‐reports and clinical records were used to assess the proportion achieving each stage in the cascade. Statistical inference based on a χ2 test for categorical variables and modified Poisson regression were used to estimate prevalence risk ratios (PRRs) and 95% confidence intervals (CI) for enrolment into care and initiating antiretroviral therapy (ART).Results: From September 2013 through December 2015, 3,666 HIV‐positive participants were identified in the RCCS. As of December 2015, 98% had received HIV Counseling and Testing (HCT), 74% were enrolled in HIV care, and 63% had initiated ART of whom 92% were virally suppressed after 12 months on ART. Engagement in care was lower among men than women (enrolment in care: adjPRR 0.84, 95% CI 0.77–0.91; ART initiation: adjPRR 0.75, 95% CI 0.69–0.82), persons aged 15–24 compared to those aged 30–39 (enrolment: adjPRR 0.72, 95% CI 0.63–0.82; ART: adjPRR 0.69, 95%CI 0.60–0.80), unmarried persons (enrolment: adjPRR 0.84, 95% CI 0.71–0.99; ART adjPRR 0.80, 95% CI 0.66–0.95), and new in‐migrants (enrolment: adjPRR 0.75, 95% CI 0.67–0.83; ART: adjPRR 0.76, 95% CI 0.67–0.85). This cohort achieved 98–65–92 towards the UNAIDS "90–90–90" targets with an estimated 58% of the entire HIV‐positive RCCS population virally suppressed.Conclusions: This cohort achieved over 90% in both HCT and viral suppression among ART users, but only 65% in initiating ART, likely due to both an ART eligibility criterion of <500 CD4 cells/mL and suboptimal entry into care among men, younger individuals, and in‐migrants. Interventions are needed to promote enrolment in HIV care, particular for hard‐to‐reach sub‐populations.

Background:North Tijuana, Mexico is home to many individuals at high risk for transmitting and acquiring human immunodeficiency virus (HIV). Recently, policy shifts by local government impacted how these individuals were handled by authorities. Here we examined how this affected regional HIV transmission dynamics. Methods:HIV pol sequences and associated demographic information were collected from 8 research studies enrolling persons in Tijuana and were used to infer viral transmission patterns. To evaluate the impact of recent policy changes on HIV transmission dynamics, qualitative interviews were performed on a subset of recently infected individuals. Results:Between 2004 and 2016, 288 unique HIV pol sequences were obtained from individuals in Tijuana, including 46.4% from men who have sex with men, 42.1% from individuals reporting transactional sex, and 27.8% from persons who inject drugs (some individuals had >1 risk factor). Forty-two percent of sequences linked to at least 1 other sequence, forming 37 transmission clusters. Thirty-two individuals seroconverted during the observation period, including 8 between April and July 2016. Three of these individuals were putatively linked together. Qualitative interviews suggested changes in policing led individuals to shift locations of residence and injection drug use, leading to increased risk taking (eg, sharing needles). Conclusions:Near real-time molecular epidemiologic analyses identified a cluster of linked transmissions temporally associated with policy shifts. Interviews suggested these shifts may have led to increased risk taking among individuals at high risk for HIV acquisition. With all public policy shifts, downstream impacts need to be carefully considered, as even well-intentioned policies can have major public health consequences.

Background:North Tijuana, Mexico is home to many individuals at high risk for transmitting and acquiring human immunodeficiency virus (HIV). Recently, policy shifts by local government impacted how these individuals were handled by authorities. Here we examined how this affected regional HIV transmission dynamics. Methods:HIV pol sequences and associated demographic information were collected from 8 research studies enrolling persons in Tijuana and were used to infer viral transmission patterns. To evaluate the impact of recent policy changes on HIV transmission dynamics, qualitative interviews were performed on a subset of recently infected individuals. Results:Between 2004 and 2016, 288 unique HIV pol sequences were obtained from individuals in Tijuana, including 46.4% from men who have sex with men, 42.1% from individuals reporting transactional sex, and 27.8% from persons who inject drugs (some individuals had >1 risk factor). Forty-two percent of sequences linked to at least 1 other sequence, forming 37 transmission clusters. Thirty-two individuals seroconverted during the observation period, including 8 between April and July 2016. Three of these individuals were putatively linked together. Qualitative interviews suggested changes in policing led individuals to shift locations of residence and injection drug use, leading to increased risk taking (eg, sharing needles). Conclusions:Near real-time molecular epidemiologic analyses identified a cluster of linked transmissions temporally associated with policy shifts. Interviews suggested these shifts may have led to increased risk taking among individuals at high risk for HIV acquisition. With all public policy shifts, downstream impacts need to be carefully considered, as even well-intentioned policies can have major public health consequences.