O impacto financeiro na saúde pública contra ist's em específico hiv no município de Ji-Paraná: análise de dados (2019 a 2022) / The financial impact on public health against ist's in specific hiv in the municipality of Ji-Paraná: data analysis (2019 to 2022) / Impacto financiero en la salud pública contra el vih en el municipio de Ji-Paraná: análisis de datos (2019 a 2022)

O investimento financeiro desempenha um papel fundamental no combate ao HIV, sendo essencial no financiamento de programas de prevenção, como campanhas de conscientização pública, distribuição de preservativos, testagem, tratamento e pesquisas. Sem investimento adequado, as taxas de infecção podem aumentar e as pessoas que vivem com HIV podem não ter acesso aos tratamentos e serviços de que precisam. Este estudo tem como objetivo analisar sobre o aumento de investimento na área da vigilância epidemiológica relativa ao combate a Infecções Sexualmente Transmissíveis (IST's) com um olhar para o vírus da imunodeficiência humana HIV, no município de Ji- Paraná no período de 2019 a 2022. Adotou-se como metodologia uma pesquisa elaborada de forma quantitativa, de caráter exploratório, por meio de uma análise de dados dos registros públicos epidemiológicos e também dos investimentos no fundo municipal de saúde publicados no portal de transparência do município de Ji-Paraná. O seguinte estudo possibilitou a análise dos investimentos realizados no fundo municipal de saúde para a realização de ações voltadas para o controle, diagnósticos e tratamento da Human Immuno Deficiency Virus (HIV) que teve influência direta na diminuição dos casos registrados pelo portal do Sistema de Informações de Agravos de Notificação (SINAN) no período de 2019 a 2020. Conclui-se que o investimento em saúde pública para o combate ao HIV/AIDS é fundamental e pode ser um grande desafio financeiro para os municípios, especialmente em tempos de crise econômica e escassez de recursos, a alocação de recursos adequados para programas de prevenção, tratamento, cuidados de saúde, serviços de apoio, pesquisa e monitoramento pode ajudar a reduzir a incidência de novos casos de HIV e garantir que as pessoas que vivem com HIV recebam o suporte necessário para gerenciar sua condição.

Financial investment plays a fundamental role in the fight against HIV, being essential in financing prevention programs, such as public awareness campaigns, condom distribution, testing, treatment, and research. Without adequate investment, infection rates can increase and people living with HIV may not have access to the trea- tments and services they need. This study aims to analyze the increase in investment in the area of epidemiological surveillance related to the fight against Sexually Transmitted Infections (STIs) with a focus on the Human Immunodeficiency Virus (HIV) in the mu- nicipality of Ji-Paraná from 2019 to 2022. A quantitative exploratory research methodo- logy was adopted, through an analysis of data from public epidemiological records and also investments in the municipal health fund published on the transparency portal of the municipality of Ji-Paraná. This study enabled the analysis of investments made in the municipal health fund for actions aimed at the control, diagnosis, and treatment of the Human Immuno Deficiency Virus (HIV), which had a direct influence on the decrease in cases recorded by the Notification of Aggravations Information System (SINAN) portal from 2019 to 2020. It is concluded that public health investment for the fight against HIV/AIDS is essential and can be a significant financial challenge for municipalities, especially in times of economic crisis and resource scarcity. Adequate allocation of re- sources for prevention programs, treatment, healthcare, support services, research, and monitoring can help reduce the incidence of new HIV cases and ensure that people living with HIV receive the necessary support to manage their condition. KEYWORDS: AIDS/HIV; Public Health; Financing.

La inversión financiera juega un papel fundamental en la lucha contra el VIH, siendo esencial para el financiamiento de programas de prevención, como campañas de concientización pública, distribución de preservativos, pruebas, tratamiento e investi- gaciones. Sin una inversión adecuada, las tasas de infección pueden aumentar y las per- sonas que viven con VIH pueden no tener acceso a los tratamientos y servicios que nece- sitan. Este estudio tiene como objetivo analizar el aumento de la inversión en el área de la vigilancia epidemiológica en relación a la lucha contra las Infecciones de Transmisión Sexual (ITS), con un enfoque en el virus de la inmunodeficiencia humana VIH, en el municipio de Ji-Paraná en el período de 2019 a 2022. Se adoptó como metodología una investigación elaborada de forma cuantitativa, de carácter exploratorio, a través de un análisis de datos de registros públicos epidemiológicos y también de las inversiones en el fondo municipal de salud publicadas en el portal de transparencia del municipio de Ji- Paraná. Este estudio permitió el análisis de las inversiones realizadas en el fondo munici- pal de salud para llevar a cabo acciones enfocadas en el control, diagnóstico y tratamiento del Virus de Inmunodeficiencia Humana (VIH), lo que tuvo una influencia directa en la disminución de los casos registrados por el portal del Sistema de Información de Agravios de Notificación (SINAN) en el período de 2019 a 2020. Se concluye que la inversión en salud pública para la lucha contra el VIH/SIDA es fundamental y puede ser un gran de- safío financiero para los municipios, especialmente en tiempos de crisis económica y es- casez de recursos, la asignación de recursos adecuados para programas de prevención, tratamiento, cuidado de la salud, servicios de apoyo, investigación y monitoreo puede ayudar a reducir la incidencia de nuevos casos de VIH y garantizar que las personas que viven con VIH reciban el apoyo necesario para manejar su condición.

Confirmatory testing of 120 positive HIV antibody screening samples in Lanxi City / 预防医学

Objective@#To analyze the confirmatory test results of 120 positive HIV antibody screening samples in Lanxi City, Zhejiang Province, so as to provide insights into AIDS detection and control. Methods Western blotting confirmatory assay was performed on 120 positive HIV antibody samples from HIV screening laboratories in Lanxi City from 2020 to 2022. The confirmatory test results were determined according to the “National Technical Guidelines for AIDS Testing (2020 revision)” and “Diagnosis for HIV/AIDS” (WS 293-2019), and the positive rate of confirmatory test and band distribution were analyzed. @*Methods @#Western blotting confirmatory assay was performed on 120 positive HIV antibody samples from HIV screening laboratories in Lanxi City from 2020 to 2022. The confirmatory test results were determined according to the “National Technical Guidelines for AIDS Testing (2020 revision)” and “Diagnosis for HIV/AIDS” (WS 293-2019), and the positive rate of confirmatory test and band distribution were analyzed.@*Results@#Among 120 positive HIV antibody screening samples, there were 100 HIV-1 antibody positive samples (83.33%) as revealed by Western blotting confirmatory assay, 6 HIV antibody negative samples (5.00%), and 14 HIV-1 indeterminate tests (11.67%). There were 72 men and 28 men tested positive for HIV-1 antibody, with a male to female ratio of 2.57∶1, and there were 88 patients at ages of 20 to 59 years (88.00%), with the highest frequency of gp160, gp120 and p24 bands (100.00%). The most common Western blotting band pattern was p24 among HIV-1 indeterminate tests (78.57%). Among all HIV-1 indeterminate Western blotting tests, 6 cases were tested positive for HIV-1 antibody (gp160+p24) and 8 cases tested negative for HIV antibody during the follow-up period. @*Conclusions@# The prevalence of HIV-1 antibody was 83.33% in 120 positive HIV antibody screening samples in Lanxi City. The three most common Western blotting band patterns were gp160, gp120 and p24. The follow-up requires to be reinforced in HIV-1 indeterminate Western blotting tests for early identification and early intervention.

The quality of life and coping skills of patients with human immunodeficiency virus among different occupation

Background: Nowadays, HIV and AIDS has become an important public health issue across the world. Quality of life (QOL) is an important tool to assess general wellbeing of HIV patients. Coping skills are the psychological skills to face the difficult situations like HIV or AIDS. The workplace plays an important role in determining general wellbeing and the psychological problems in HIV patients. Therefore, it is very important to assess the quality of life and coping skills of HIV patients among different occupations.Methods: A cross-sectional study consisting of conveniently selected 200 HIV patients was conducted at ART center LLRM Medical College, Meerut. The study subjects were interviewed by using questionnaire consisting of WHOQOL HIV BREF (WHO quality of life questionnaire) and Brief-COPE scale questionnaires. Descriptive statistics and ANOVA test were used for analysis of the data.Results: 36% of HIV patients were housewives and 26.5 % of HIV patients were drivers. The quality of life score was higher in HIV patients who were in unemployed (14.98) and farmers (14.49) whereas was lowest in all others category (10.73). The housewives, farmers, government jobs or service, drivers and other had maximum adaptive coping in religion and minimum adaptive coping in humour. There was no uniform pattern of maladaptive coping skills of HIV patients among different occupations.Conclusions: Quality of life score was better in HIV patients who were unemployed and farmers as compared to HIV patients who were drivers, housewives, government jobs or service. Religion was most effective adaptive coping strategy and humour was least effective adaptive coping strategy in HIV patients.

Epidemiological aspects of HIV infection and AIDS among indigenous populations / Aspectos epidemiológicos da infecção pelo HIV e da aids entre povos indígenas

ABSTRACT OBJECTIVE To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

RESUMO OBJETIVO Descrever os aspectos epidemiológicos da infecção pelo HIV e da aids entre povos indígenas do Mato Grosso do Sul. MÉTODOS Estudo epidemiológico descritivo sobre ocorrência e distribuição da infecção pelo HIV e aids na população indígena assistida pelo Distrito Sanitário Especial Indígena Mato Grosso do Sul, entre 2001 e 2014, a partir de três bases de dados secundários. Calcularam-se as taxas anuais de detecção e de prevalência de HIV e aids, com distribuição dos casos segundo aldeia, Polo Base e variáveis sociodemográficas. As taxas acumuladas de detecção, mortalidade e letalidade foram calculadas por etnia e para os Polos Base com o maior número de casos. RESULTADOS A taxa de detecção de HIV flutuou entre 0,0 e 18,0/100 mil pessoas no período. Para a aids, não houve notificação antes de 2007, mas em 2012 sua taxa chegou a 16,6/100 mil. A prevalência de HIV indicou crescimento entre 2001 e 2011, e para a aids observou-se aumento contínuo a partir de 2007. As maiores taxas de detecção de HIV ocorreram entre os Guarani (167,1/100 mil) e de aids, entre os Kaiowá (79,3/100 mil); as taxas de mortalidade e letalidade foram superiores entre os Kaiowá. Para o Polo Base de Dourados, observou-se elevação da taxa de detecção de aids e diminuição das taxas de mortalidade e letalidade. CONCLUSÕES A infecção pelo HIV e a aids mostraram-se crescentes entre povos indígenas, com distribuição da doença principalmente nos Polos Base da região sul do estado, onde observa-se também maior vulnerabilidade econômica e social. O caráter endêmico do HIV e da aids pode se tornar epidêmico em alguns anos, considerando a existência de casos em outras aldeias do estado. Sua ocorrência entre os Guarani e Kaiowá sinaliza a necessidade de ampliação do diagnóstico, do acesso ao tratamento e de medidas de prevenção.

Tuberculosis gastrointestinal como causa de hemorragia digestiva masiva en un paciente con infección por VIH / Gastrointestinal tuberculosis as a cause of massive gastrointestinal bleeding in a patient with HIV infection

Resumen La tuberculosis (TBC) gastrointestinal es una complicación infrecuente y fatal en pacientes con infección por VIH. Se presenta en 3-16% de las formas extrapulmonares y su principal localización es la válvula ileocecal y colon. La hemorragia digestiva baja con presencia de una o múltiples úlceras en colon es una presentación muy inusual de TBC intestinal. El diagnóstico se confirma por biopsia y cultivo del tejido intestinal. La cirugía en caso de perforación intestinal sigue siendo el tratamiento de elección. Se presenta el caso de un paciente con infección por VIH, sin tratamiento anti-retroviral, quien desarrolló una TBC diseminada con perforación intestinal y hemorragia digestiva masiva de curso fatal.

Gastrointestinal tuberculosis is a rare and fatal complication in patients with HIV infection. It occurs in 3%-16% of extra pulmonary forms. The main location in 90% of cases is the ileocecal valve and colon. The most unusual presentation of gastrointestinal tuberculosis is massive bleeding with the presence of one or multiple ulcers in the colon. The diagnosis can be confirmed by biopsy and by culture of intestinal tissue. Surgical resection is the treatment of choice. We report a case of a HIV-infected patient, who did not receive antiretrovirals, and who developed disseminated tuberculosis with intestinal perforation, presenting a fatal massive intestinal bleeding.

Prevalence of AIDS-related sexual behaviors and HIV infection status in young men who have sex with men in China: a Meta-analysis / 中华流行病学杂志

Objective To assess the prevalence of AIDS-related sexual behaviors and HIV infection status in young men who have sex with men (YMSM) in China.Methods Literature retrieval was conducted to obtain the related literature indexed by CNKI,Wangfang and PubMed databases from January 2005 to February 2015.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and assessed the methodological quality.Meta-analysis was performed by the R software.Results Thirty seven studies involving 32 110 YMSM were included.75.5％ (95％ CI:68.8％-81.2％) YMSM sought sexual partners through Internet and 65.5％ (95％CI:60.0％-70.6％) had more than 2 sexual partners.In the last 6 months,89.1％ (95％ CI:84.2％-92.6％) YMSM had anal intercourse and 42.0％ (95％ CI:37.4％-46.6％) used condom consistently;11.4％ (95％CI:8.4％-15.4％) had vaginal intercourse and 36.9％ (95％CI:32.4％-41.6％) used condom consistently.The pooled prevalence of HIV infection was 5.0％ (95％CI:3.9％-6.5％),sub-group analysis showed that the prevalence of HIV infection in the eastern,central and western China were 4.2％ (95％CI:2.6％-6.6％),1.9％ (95％C1:0.8％-4.6％),6.3％ (95％ CI:4.7％-8.5％),respectively,and there were significant differences among different areas.Conclusion The prevalence of AIDS-related risk sexual behaviors and incidence of HIV infection in YMSM were high in China,it is necessary to conduct AIDS intervention in this population.

Prevalence of AIDS-related sexual behaviors and HIV infection status in young men who have sex with men in China: a Meta-analysis / 中华流行病学杂志

Objective To assess the prevalence of AIDS-related sexual behaviors and HIV infection status in young men who have sex with men (YMSM) in China.Methods Literature retrieval was conducted to obtain the related literature indexed by CNKI,Wangfang and PubMed databases from January 2005 to February 2015.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and assessed the methodological quality.Meta-analysis was performed by the R software.Results Thirty seven studies involving 32 110 YMSM were included.75.5％ (95％ CI:68.8％-81.2％) YMSM sought sexual partners through Internet and 65.5％ (95％CI:60.0％-70.6％) had more than 2 sexual partners.In the last 6 months,89.1％ (95％ CI:84.2％-92.6％) YMSM had anal intercourse and 42.0％ (95％ CI:37.4％-46.6％) used condom consistently;11.4％ (95％CI:8.4％-15.4％) had vaginal intercourse and 36.9％ (95％CI:32.4％-41.6％) used condom consistently.The pooled prevalence of HIV infection was 5.0％ (95％CI:3.9％-6.5％),sub-group analysis showed that the prevalence of HIV infection in the eastern,central and western China were 4.2％ (95％CI:2.6％-6.6％),1.9％ (95％C1:0.8％-4.6％),6.3％ (95％ CI:4.7％-8.5％),respectively,and there were significant differences among different areas.Conclusion The prevalence of AIDS-related risk sexual behaviors and incidence of HIV infection in YMSM were high in China,it is necessary to conduct AIDS intervention in this population.

Palliative care for an AIDS patient with small intestine cancer

<b>Introduction：</b>Patients with AIDS are considered appropriate for the admission to the inpatient palliative care unit（PCU）, but in reality, many facilities do not accept them. Furthermore, it is rare to see a patient with AIDS with complication of small intestinal adenocarcinoma. We report a case of our experience treating such patient at the PCU／hospice unit of our facility. <b>Case：</b>A 64 years old male patient, receiving a treatment with antiviral drug for AIDS diagnosis, was referred to our hospital for the admission to PCU due to the complication of small intestinal cancer. We treated his increased pain with the combination use of fentanyl patch and morphine continuous subcutaneous infusion, which successfully controled the symptom. During his final days, we had him on sedation upon his request；initiated from the intermittent sedation followed by continuous deep sedation using Phenobal. <b>Discussion：</b>Considering the aging society, the number of people with HIV／AIDS in need of palliative care would also be on the rise. Through close communication among facilities and pre-admission preparation to accommodate special needs those patients may have, palliative care units may be able to accept more people with HIV／AIDS.

Prevalence of diabetes mellitus, hypertension and lipodystrophy in HAART receiving HIV patients in Southern Ethiopia.

Aims: In Ethiopia, AIDS has become the leading cause of mortality in the 15-49 years age group, accounting for an estimated 43% of all young adult deaths. Though the introduction of highly active antiretroviral therapy (HAART), improved survival and quality of life, early data from those treated, raised concerns about a possible increase in both peripheral and coronary arterial disease through lipodystrophy, diabetes mellitus and dyslipidemia. Hence an attempt was made in this study to understand risk factors of HIV positive subjects and prevalence of lipodystrophy, type II diabetes mellitus and hypertension in subjects receiving HAART. Study Design: Institution based cross sectional and retrospective study was conducted. Place and Duration of Study and Sample: Study participants were men and women who were HIV/AIDS patients receiving HAART from Sodo government hospital, Southern Ethiopia from December 1st, 2009 - January 30th, 2010. Methodology: By using the subjects’ electronic database as sampling frame, a total of 176 subjects were recruited for the study using simple random sampling method. Data was collected on socio demographic characteristics, HAART use, CD4 count, subjects’ status at the start of treatment, measure of body fat distribution, physical activity, blood pressure and blood glucose. Results: Prevalence of Diabetes mellitus was seen in 8% of the subjects. Hypertension was seen in 15.9% of the subjects. In multivariate analysis adjusted for age and duration of HAART both lipoatrophy and lipohypertrophy were significantly associated with diabetes mellitus while only lipohypertrophy (adjusted for age) remained to be significantly associated with hypertension. Conclusion: Since lipoatrophy (adjusted for age and duration of HAART) was significantly associated with diabetes mellitus and lipohypertrophy (adjusted for age and duration of HAART) was associated with diabetes mellitus and (adjusted for age) was associated with hypertension, there is a need to investigate types of HAART regimens which do not lead to lipodystrophy and associated diabetes mellitus or hypertension in AIDS/HIV subjects.

The mediation effect of the peer attachment between the self-esteem and the school adjustment of the children affected by AIDS/HIV / 中华行为医学与脑科学杂志

Objective To explore the mediation effect of the peer attachment between the self-esteem and the school adjustment of the children affected by AIDS/HIV.Methods 250 children affected by the AIDS/HIV were investigated in the research in a district affected by AIDS/HIV in the Henan province.Self-esteem scale,peer attachment questionnaire and school adjustment questionnaire was adopted in the study.Results ①Self-esteem had a positive significant effect on the school adjustment (β=0.227,P＜0.01).(②)self-esteem had a positive significant effect on the peer attachment (β=0.236,P＜ 0.01).(③When controlled the indirect effect of peer attachment,the effect of the self-esteem on the school adjustment had still been significant (β =0.145,P＜0.05),it proved that the peer attachment played a partly mediation between the relationship of the self-esteem and the school adjustment.Conclusion Self-esteem has a positive significant effect on the school adjustment; and self-esteem can not only affect the school adjustment directly,but also affect the school adjustment through the peer attachment.

Influencia del conflicto armado en el aumento de la incidencia de VIH/sida en Colombia, durante el periodo 2002-2008 / Influence of the armed conflict in the increasing of the incidence of HIV/AIDS in Colombia 2002-2008

Introducción. Hasta el año 2000, la prevalencia de VIH/sida en Colombia era de 0,4 La intensificación del conflicto armado ha coincidido con un aumento en la incidencia del virus. El presente estudio está enfocado en determinar la existencia de un vínculo entre el aumento de las tasas de VIH/sida y el conflicto armado en el país de 2002 a 2008. Métodos. Se realizó un estudio descriptivo retrospectivo. La población de estudio fueron hombres y mujeres entre los 15 y 59 años, residentes en el territorio nacional, a los cuales se les diagnosticó infección por el virus de la inmunodeficiencia adquirida (VIH) durante el periodo 2002-2008. Las variables fueron seleccionadas del índice de riesgo de situación humanitaria. Los datos fueron analizados en tablas de análisis bivariado...

Introduction: Up until 2000 the overall estimated prevalence of HIV/AIDS in Colombia was 0.4. The intensification of the armed conflict has coincided with a rise in the prevalence of HIV/AIDS. This study was focused on determining the relationship between the rise in HIV/AIDS and the armed conflict t in Colombia (2002-2008). Methods: The present research was descriptive and retrospective. The population studied was men and women in the 15-59 age range resident in the Colombian territory, who were diagnosed as HIV (+) from January 2002 to December 2008. Variables of the study were chosen from the Humanitarian Situation Risk Index. The dates were analysed in bivariate tables...

A experiência de hospitalização vivida por pacientes com AIDS / The experience of hospitalization lived by patients with AIDS

Este artigo descreve um estudo que buscou compreender a experiência vivida por pacientes com AIDS no processo de hospitalização. Foi realizada uma pesquisa qualitativa, utilizando o método fenomenológico crítico, com sete sujeitos soropositivos na cidade de Fortaleza, que haviam vivenciado a experiência de hospitalização por causa da doença. Os resultados mostram que a experiência de hospitalização leva o paciente a deparar-se com a perspectiva da morte; a rotina hospitalar é fonte de sofrimento para alguns, mas passa a ser confortável, quando esta pessoa vive uma realidade sócio-econômica de carência; o enfrentamento do diagnóstico se dá de diferentes formas; o isolamento por conta da hospitalização é sempre vivenciado, bem como a importância do apoio dos familiares nas internações.

This article describes a study that aimed to understand the experience of hospitalization of patients with AIDS, through a qualitative research using the critical phenomenological method. Seven HIV positive subjects from Fortaleza, who had lived the experience of hospitalization due to their illness, participated in the research. The results showed that the experience of hospitalization forces the patient to face the prospect of death; the hospital routine causes suffering for some, depending on their living conditions, such as economic deprivation. Coping with diagnosis is faced different ways; the isolation due to the hospitalization is always experienced, as well as the support of the family in the hospital.

Conocimientos y actitudes sobre VIH/SIDA de estudiantes de enfermería de las Universidades de La Frontera y Austral de Chile. Temuco - Valdivia. Chile, 2004 / Knowledge and attitudes about HIV/AIDS in nursing students of two universities of southern of Chile, 2004

Los adolescentes constituyen la población más expuesta a contraer enfermedades de transmisión sexual, entre otros aspectos, porque muchos experimentan su primera relación sexual sin protección. El VIH/SIDA persiste como una enfermedad socialmente temida y causa de discriminación, evidenciándose déficit de conocimientos sobre formas de contagio, conduciendo a actitudes perjudiciales hacia quienes padecen este mal. El objetivo del estudio fue describir los conocimientos y actitudes de estudiantes de Enfermería de las universidades de La Frontera y Austral de Chile frente al VIH/SIDA. Se ejecutó una investigación cualitativa con enfoque antropológico cognitivo para estudiar los conocimientos y actitudes de estudiantes de tercer y cuarto año de Enfermería sobre el tema en foco. Como técnica de recolección de datos se empleó la entrevista semiestructurada, analizándose la información mediante distribución de frecuencias y análisis de discursos. Se identificaron ocho dimensiones: qué es el VIH/SIDA, formas de contagio, ¿con qué se relaciona el VIH/SIDA?, prácticas de alto riesgo, medidas de prevención, ¿quiénes están expuestos al contagio?, causas de negación al examen, y propuestas de prevención. El análisis cualitativo, evidenció déficit de formación de los estudiantes respecto del manejo de pacientes y en las medidas de prevención en población de riesgo. Enfatizan la necesidad de medidas de promoción y prevención de la enfermedad. En ambos grupos se observó una tendencia biologicista en: transmisión sexual, formas de contagio, con qué se relaciona el SIDA y prácticas de alto riesgo. En medidas de prevención, se observó limitada ponderación para educación sexual y altos valores en uso del preservativo.

Adolescents make up the most exposed population to acquiring sexually transmitted diseases, among other aspects, because many experience their first sexual relation without protection. HIV/AIDS persists as a socially feared disease and cause of discrimination, showing a lack of knowledge on the forms of infection, generating detrimental attitudes towards those who suffer from the disease. The aim of the study was to describe the knowledge and attitudes of nursing students from the Universidad de la Frontera and the Universidad Austral de Chile, in relation to HIV/AIDS. Qualitative research with anthropologic cognitive approach was executed, to study the knowledge and attitudes of nursing students of third and fourth year about the topic in focus. For data collection, the semi structured interview was used, analyzing the information by frequency distribution, and discourse analysis. Eight dimensions were identified: What is HIV/AIDS?; Ways of infection; What is related to the HIV/AIDS?; High risk practices; Prevention methods; Who are exposed to infection?; Causes of refusal of HIV/AIDS tests; and Proposal of prevention. The qualitative analysis, showed an educational deficit about the care of patients and prevention measures to the risk population. The students emphasize the need of promotion and prevention measures for the disease. In both groups, a biologicist trend was observed in: Sexual transmission, Ways of infection, What is related to the HIV/AIDS? and high risk practices. In prevention methods, a limited percentage was given to sexual education and the highest to the use of condoms.

Inmunofenotipificación basal en personas diagnosticadas con VIH-1 en una unidad regional de inmunología (URIC), Venezuela, 2004-2006 / Basal immunephenotyping in HIV-1 diagnosed persons in a regional immunology unit (URIC), Venezuela 2004-2006

En el curso de la infección por el VIH-1, la inmunofenotipificación de los individuos infectados es importante para determinar el estadio inmunológico basal así como para comenzar y monitorear la terapia. Para la inmunofenotipificación basal de individuos recién diagnosticados con infección por el VIH-1 se llevó a cabo un estudio descriptivo y retrospectivo en la URIC de Maracay, Venezuela, de enero 2004 a diciembre 2006. A 238 pacientes (70,6% hombres y 29,4% mujeres) se les determinó el recuento de linfocitos T CD4/CD8 por citometría de flujo. El rango de edad fue de 2 a 74 años y el mayor número de casos (42,0%) se observó entre los 25 y 34 años. Se registraron recuentos de CD4+ menores de 200 cels/mm³ en 39,7% de los individuos; 35,0% presentaron valores entre 200 y 499 cels/mm³ y sólo 25,2% tuvieron valores sobre 500 cels/mm³. Los recuentos de CD8+ en 52,6% de los pacientes fueron mayores de 900 cels/mm³ y en 15,8% menores 500 cels/mm³. El índice CD4/CD8 resultó menor de 1.0 en 94,9% de los individuos, evidenciándose una tendencia creciente a diagnosticar la infección por VIH en una etapa tardía, como indican los recuentos disminuidos de CD4+ encontrados, pero se observó un incremento en el diagnóstico de los casos nuevos en los pacientes menores de 35 años y en las mujeres.

During the course of HIV-1 infection immunephenotyping of infected individuals is important to determine the basal immunological status, as well for initiating and monitoring therapy, for the basal immunephenotyping of recentlyHIV-1 diagnosed individuals we carried out a descriptive and retrospective study at the regional immunology unit (URIC) in Maracay, Venezuela, between January 2004 and December 2006. In the 238 patients included (70.6% men and 29.4% women) we studied CD4/CD8 T lymphocyte numbers through flow cytometry. Age range varied between 2-74 years, and the largest number of cases corresponded to the 25-34 age group. We found CD+ counts under 200 Cells/mm³ in 39.7% individuals; 35.0% had values between 200-499 cells/mm³; and only 25.2% had values over 500 cells/mm³. CD8+ counts in 52.6% of patients were higher than 900 cells/mm³ and 15.8% had counts under 500 cells/mm³. The CD4/CD8 index was lower than 1.0 in 94.9% of the individuals, demonstrating a growing tendency to diagnose HIV infection at a late stage, as shown by the decreased CD4+ counts found. Nevertheless, an increase in the diagnosis of new cases in patients under 35 years and women was also determined.

Oral cavity lymphoma as secondary AIDS-defining neoplasm in a patient on HAART with immune reconstitution

Lymphomas of the oral cavity are a rare complication of advanced HIV/AIDS disease. The clinical appearance of these neoplasms includes masses or ulcerative lesions that involve the oral soft tissue and the jaw as the predominant manifestation. We report the case of a patient with AIDS who developed diffuse large B-cell non-Hodgkin’s lymphoma of the oral cavity during highly active antiretroviral therapy, with undetectable plasma viral load and immune reconstitution.

Os linfomas da cavidade oral são uma complicação rara da AIDS/HIV avançada. A aparência clínica dessas neoplasias inclui massas ou lesões ulcerativas que envolvem o tecido mole oral e da mandíbula como manifestação predominante. Relatamos um caso de um paciente com AIDS que desenvolveu um linfoma não Hodgkin de células B difuso e extenso da cavidade oral durante a terapia antiretroviral altamente ativa com carga viral plasmática indetectável e reconstituição imune.

Comportamento sexual em adultos maiores de 50 anos infectados pelo HIV / Sexual behavior in HIV infected adults more than 50 years old

Introdução: o número de casos de aids na faixa etária acima de 50 qnos é crescente, sendo o risco de contaminação dos idosos pelo HIV ignorado por parte da população e dos profissionais de saúde. Objetivo: identificar quais fatores podem ter propiciado a infecção pelo HIV em adultos com idade superior a 50 anos e verificar o comportamento sexual antes e após o conhecimento da infecção. Métodos: estudo descritivo transversal, realizado em janeiro de 2007. A amostra foi composta por adultos maiores de 50 anos soropositivos residentes em Capivari de Baixo (n=9) e Imbituba (n=13). A coleta de dados foi realizada pelo autopreenchimento de um questionário constituído de perguntas fechadas e semifechadas referentes a dados sociais, econômicos e culturais, comportamento sexual e conhecimentos sobre DST e HIV. Resultados: neste estudo, 95,5% dos entrevistados têm vida sexualmente ativa. Metade dos participantes não usa preservativo regularmente, independente da soropositividade do parceiro. Observou-se que a maioria é heterossexual e possui baixo grau de escolaridade. A principal forma de contaminação foi por meio de relação sexual (72,7%), seguida do uso de drogas injetáveis (27,3%). Conclusão: o conhecimento da infecção pelo HIV alterou o comportamento sexual em metade dos casos, havendo ainda bastante resistência quanto ao uso do preservativo. Salientamos a necessidade de campanhas educativas exclusivas direcionadas a adultos mais velhos e idosos.

Health Insurance Status and Access to Antiretroviral Treatment Among HIV/AIDS Patients in Northeast Thailand: a Patient-based Analysis / 国際保健医療

The objective of this study is to assess the differences in access to antiretroviral treatment among health insurance recipients, using a patient-based analysis.<br><b>METHODS:</b> The subjects were 324 outpatients with the human immunodeficiency virus who were treated at a regional hospital for infectious diseases in Khon Kaen Province. We collected data every visit of the patients during the study period between April1 and September 30 in 2002. We defined access to antiretroviral treatment as having a prescription for antiretroviral drugs on at least one visit during the study period. We examined the relationship between access to antiretroviral treatment and age, sex, stage of acquired immune deficiency syndrome (AIDS), and health insurance. We also compared the results of the patient-based analysis and the record-based analysis that was used in our previous study.<br><b>RESULTS:</b> Multiple logistic regression analysis shows that patients insured by the Civil Servant Medical Benefit Scheme have better access to antiretroviral treatment than the others (vs. Universal Coverage; odds ratio=11.38, 95% confidence interval=4.09, 31.65). We have also shown that patients with AIDS-related complex have better access to antiretroviral treatment compared to asymptomatic AIDS patients (odds ratio=3.38, 95% confidence interval=1.31-8.76). Values of these odds ratios were lower in the record-based analysis than in the patient-based analysis.<br><b>CONCLUSIONS:</b> Patients insured by the Civil Servant Medical Benefit Scheme had better access to antiretroviral drugs. We reconfirm the differences in access to antiretroviral treatment among health insurance recipients, using the patient-based analysis.

Evaluación familiar y del desarrollo de dos niñas, hijas de padres con VIH/SIDA

Objetivos: Describir las pautas de interacción de dos familias con VIH/SIDA con la infección ubicada en los padres y evaluar a dos niñas de estas familias en su organización conductual alrededor de los cuarenta días de vida y el desarrollo mental y motor a los seis y doce meses de edad. Material y métodos: A través del genograma se evaluaron los sistemas familiares de dos niñas, hijas de padres infectados por VIH/SIDA; las pequeñas, a su vez, fueron evaluadas con la Escala de Conductas Neonatales de Brazelton (NBAS) entre los 39 y 44 días después del nacimiento y a través de las Escalas de Desarrollo de Nancy Bayley (BSID-II) a los seis y doce meses de edad. Resultados: En los dos casos la organización familiar corresponde a una pareja de adultos-jóvenes con VIH positivo en etapa de bebés y con hijos no enfermos; en el primer caso la madre se define como la transmisora; en el segundo el padre. Hay un debilitamiento en el subsistema de los padres. Las relaciones de parejas de los padres presentan ambivalencias. A medida que la VIH/SIDA avanza, las alianzas dividen a las familias y excluyen de la colaboración contra la enfermedad a varios miembros, lo que sobrecarga a las abuelas maternas. Las jerarquías y los límites son difusos, lo cual impide una contención estable y firme a los hijos. Las dos familias se encuentran estancadas en la etapa de estrés situacional. En el NBAS las dos lactantes obtuvieron una ejecución de buena a excelente (puntajes 7, 8 y 9) en los diferentes conglomerados; en el BSID-II, se advirtió que en ambos casos, en los primeros seis meses el desarrollo mental y motor cursó dentro de los límites normales; mientras que a los 12 meses el primer caso continuó con un desarrollo normal y en el segundo no fue posible evaluar con precisión el desarrollo, debido a una conducta de oposicionismo. Conclusiones: Ambos sistemas familiares presentan una organización con enfermo crónico y en particular con VIH-SIDA. Este estudio nos muestra que la evaluación en el desarrollo motor y mental de las dos niñas cursa conforme a lo esperado y que en la organización actual existe la estructura familiar con un proceso de parentalización (inversión de roles) y desamparo para las niñas.

Objective: To describe the family patterns of interaction of two girls born to parents infected with AIDS/HIV, and their behavioral organization around forty days, also the mental and motor development at six and twelve months. Methodology: The two family systems of the two girls with both parent infected by AIDS/HIV, were evaluated using a genogram; they were also appraised with the Brazelton Neonatal Behavioral Assesment Scale (NBAS), between days 39 and 44; and with the Bayley Scale of Infant Development (BSID-II) at six and twelve months of age. Results: In the two cases, the family organization belongs to a young adult couple with HIV positive and two healthy sons; in the first case, the mother is identified as the transmitter; in the second, the father is the spreading agent. There is a weakening effect in the parental subsystem. The couples relations are ambivalent. As the HIV/AIDS advances, the alliances divide the family, excluding several members from the collaboration effort against the illness; this overloads the maternal grandmothers. Hierarchies and limits become diffused, resulting in a lack of a firm and stable emotional contention for the children. The two families are stalled in a situational stress period. In respect to the NBAS the two infants obtained performance from good to excelent (scores 7,8,9) across the clusters; in the BSID-II both cases had a normal score in the first six months of their mental and motor development, while at twelve months of age, the first case continued with a normal development, but the second case was not precisely evaluated due to oppositional behavior. Conclusions: Both family systems are identified with an organization affected by the HIV presence, their structure is promoting a parentalization (role reversal) process and neglect for the children; though the motor and mental development of the two girls were found according to the expected norm for their age.

The Evaluation and Revelation of AIDS/HIV Health Education——An Effect Evaluation of Optimistic Bias of Female AIDS/HIV Carriers before and after the Health Education in Penitentiary and Relevant Ethical Countermeasure / 中国医学伦理学

Objectives: This study aimed to evaluate the effect of optimistic bias of female AIDS/HIV carriers before and after the health education in penitentiary.Methods: Two questionnaires including AIDS Events Questionnaires and AIDS Knowledge Scale are conducted among 57 female AIDS/HIV carriers after receiving health education in penitentiary.Results: Female AIDS/HIV carriers from the penitentiary had both type I and typeⅡoptimistic bias of AIDS/HIV;Female AIDS/HIV carriers from the penitentiary acquired significantly more knowledge after receiving health education,the health education of AIDS/HIV had significantly reduced the optimistic bias to AIDS/HIV.Conclusion: Health education of AIDS/HIV had notably changed the cognitive ability and reduced optimistic bias to AIDS/HIV of female AIDS/HIV carriers from the penitentiary,therefore effectively corrected their irrational ideas of AIDS/HIV.