Breaking HIV News to Clients: SPIKES Strategy in Post-Test Counseling Session.

Breaking bad news is one of the most burdensome tasks physicians face in their everyday practice. It becomes even more challenging in the context of HIV+ patients because of stigma and discrimination. The aim of the current study is to evaluate the quality of giving HIV seroconversion news according to SPIKES protocol. Numbers of 154 consecutive HIV+ patients from Imam Khomeini Hospital testing and counseling center were enrolled in this study. Patients were inquired about how they were given the HIV news and whether or not they received pre- and post-test counseling sessions. Around 51% of them were men, 80% had high school education, and 56% were employed. Regarding marital status, 32% were single, and 52% were married at the time of the interview. Among them, 31% had received the HIV news in a counseling center, and only 29% had pre-test counseling. SPIKES criteria were significantly met when the HIV news was given in an HIV counseling and testing center (P.value<0.05). Low coverage of HIV counseling services was observed in the study. SPIKES criteria were significantly met when the HIV seroconversion news was given in a counseling center. The need to further train staff to deliver HIV news seems a priority in the field of HIV care and treatment.

Relationship between Health-Related Quality of Life and Social Support in HIV-Infected People in Tehran, Iran.

BACKGROUND: The present study was conducted to determine the association between social support and health-related QOL (HRQL) for a sample of 120 patients living with HIV/AIDS in Tehran. METHOD: Eighty male and 40 female living with HIV referred to Iranian AIDS Research Center at Imam Khomini Hospital in Tehran, Iran in 2011 were randomly selected for assessment. Data was collected by means of Vaux's Social Support questionnaire and Medical Outcomes Short-Form-36 (SF-36) QOL questionnaires. Pearson (P) Correlation Coefficient and Fisher z-test were used for statistical analysis. RESULTS: In general, social support was significantly associated with overall QOL in men (P = 0.001) and women (P = 0.009) living with HIV/AIDS. In men, social support was significantly associated with mental and physical domains of QOL (P = 0.001) while in women it simply associated with mental domain of QOL (P = 0.003). CONCLUSIONS: Our findings indicate that increasing social support for HIV/AIDS persons increases their QOL. This can help those physicians who are involved in care of HIV-infected persons and it maintains QOL across the spec-trum of HIV disease.

Molecular analysis and phylogenetic characterization of HIV in Iran.

The rate of human immunodeficiency virus type 1 (HIV-1) infection in Iran has increased dramatically in the last few years. While the earliest cases were found in hemophiliacs, intravenous drug users are now fueling the outbreak. In this study, both the 122 clones of HIV-1 gag p17 and the 131 clones of env V1-V5 region were obtained from 61 HIV-1 seropositives belonging to these two groups in Iran. HIV-1 subtyping and phylogenetic analysis was done by heteroduplex mobility assays (HMA) and multiple clone sequencing. The result indicated all hemophiliacs are infected with HIV-1 subtype B and all intravenous drug users are infected with HIV-1 subtype A. Since intravenous drug abuse is the major transmission route in Iran, HIV-1 subtype A is likely to be the dominant viral subtype circulating in the country. The analysis of genetic distances showed subtype B viruses in Iran to be twice as heterogeneous as the subtype A viruses. In conclusion, this first molecular study of HIV-1 genotypes in Iran suggests two parallel outbreaks in distinct high-risk populations and may offer clues to the origin and spread of infection in Iran.