Suchergebnisse

The co-infection of viral hepatitis and tuberculosis (TB) among people living with HIV/AIDS (PLWHA) makes the syndemic of HIV even worse as there is higher mortality and morbidity among PLWHA with co-infections compared to people with HIV mono-infection. In the current study, we explored predictors and sequelae among a group of Chinese PLWHA to guide future program strategies and enhance the repertoire of action for both preventative and clinical purposes. Between October 2012 and August 2013, we conducted a cross-sectional study in Guangxi Autonomous Region (Guangxi) of China. With an overall participation rate of 90%, we finally recruited 3002 patients with 2987 (99.5%) completed the survey and were included in the data analysis. We employed both predictive and explanatory modeling strategies to explore predictors and sequelae of co-infections among PLWHA. The overall prevalence of co-infection was 15.6% with 4.4% of HBV, 5.4% of HCV and 4.8% of TB, respectively. Predictors of co-infections included history of injecting drugs or drinking alcohol, sharing needles, having sex with sex workers or casual partners, higher viral loads and lower CD4 counts. Meanwhile, co-infections were associated with various physical and psychological problems among PLWHA. As an entangled phenomenon, co-infections among PLWHA produce continuous and shifting scenarios, which add complexity to clinic, epidemiological and political ways of dealing with health risks among PLWHA in China. Exploring predictors and sequelae can help to prevent and manage co-infection comorbidities among PLWHA.

AbstractPerinatally HIV‐positive (PHIV+) children face challenges arising from their complicated and highly stigmatized chronic illness throughout childhood and adolescence. Caring and support from caregivers are vital, especially from their mothers who also live with HIV. However, little is known regarding how HIV+ mothers coach their PHIV+ children to adjust to HIV. This study used dyadic‐level qualitative analyses of semi‐structured, one‐on‐one interviews among 20 mother–child dyads (n = 40; children aged 12–18 years) living with HIV in southern China. Interviews examined the perspectives of both mothers and children on the maternal caregiving in child HIV management and child adaptation outcomes. Our findings showed that based on a dual‐dimension model of the extent of maternal involvement in child HIV management and the intimacy of the mother–child relationship, four categories of maternal caring emerged among the mother–child dyads: supportiveness (n = 4, 20%), independence (n = 9, 45%), contradiction (n = 4, 20%) and alienation (n = 3, 15%). The PHIV+ children's selected HIV management indicators (including disclosure of HIV status, HIV‐related communication, antiretroviral therapy adherence, stigma coping and emotion management) also showed some variations among these four categories. The integrated model may inform the development of dyadic intervention programmes tailored for mothers and children both living with HIV.