An analysis of the relationship between HIV risk self-perception with sexual behaviour and HIV status in South African older adults.

Objective: To examine how older adults perceive their own risk of acquiring HIV; and how this perception correlates with their sexual behaviour and HIV status.Methods: We used cross-sectional survey data for 435 adults aged 50 years and older from South Africa. All participants completed a questionnaire on their basic socio-demographic and economic factors, self-reported health, sexual behaviour, HIV knowledge and attitudes, and self-perceived risk of HIV acquisition. In addition, anthropometrical measurements (weight, height, blood pressure, cholesterol) and HIV testing were conducted. Multinomial logistic regressions were used to determine the association between self-perceived HIV risk (categorised as "not at risk", at "low risk", at "high risk" and "didn't know") and being sexually active and testing HIV-positive, controlling for socio-demographic, behavioural and health-related factors.Results: Of the 435 respondents, 9.4% perceived themselves as at high risk of HIV infection, 18.9% as at low risk and 53.6% believed they were not at risk of HIV. Most respondent who perceived themselves as at low risk or not-at-risk at all of HIV were not sexually active. Older adults that were sexually active were more likely to consider themselves as at high risk of acquiring HIV (relative risk ratio [RRR] 2.05; 95% confidence interval (CI) 1.05-4.00; p = 0.036), as well as to test HIV positive (RRR 10.5; 95% CI 3.8-29.1; p < 0.001). Self-perceived HIV risk was significantly associated with age, sex, population group, and a greater awareness about HIV and how it is transmitted.Conclusions: Older persons who perceived themselves as at high risk of HIV were closely associated with sexual activity and testing HIV positive. Therefore, there is an urgent need for older persons, particularly those who remain sexually active, to screen and test for HIV routinely. Furthermore, there should be policy and programme interventions, such as the development of a simple risk-assessment tool for older adults to determine their risk for HIV. Older persons have been neglected in sexual health and HIV programmes. There is, therefore, a need to encourage older persons to take up appropriate HIV risk reduction and prevention behaviours.

Exploring the immunomodulatory role of depot medroxyprogesterones acetate and endogenous progesterone levels in HIV infected and uninfected women.

OBJECTIVE: The aim of this proof of concept study was to determine the effect of depot medroxyprogesterone acetate on host and viral factors in HIV infected and uninfected women. RESULTS: In this study, the gene expression levels for CCL5, CCR5 and CXCR4 was significantly higher in HIV positive women when compared to HIV negative women (p < 0.05). An upregulation of CCR5 and CXCR4 was evident in less than 20% of the HIV infected women and none of the HIV uninfected women. The mean fold change for CCL3 was much higher in HIV uninfected when compared to infected women with a borderline significance (p = 0.062). In HIV uninfected women, the mean fold change in CCL3, CCL4, and CCL5 gene expression was not statistically different between women on DMPA versus women not on hormonal contraception. The proportion of women with an upregulation of CCL4 and CCR5 was higher in HIV infected women on DMPA. There was no association between endogenous progesterone level and chemokines and the HIV-1 receptors. The gene expression levels in the chemokine receptors CCR5 and CXCR4 were significantly higher in the HIV infected women when compared to the women who remained HIV uninfected.