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1.
Rev Med Suisse ; 16(690): 744-748, 2020 Apr 15.
Artículo en Francés | MEDLINE | ID: mdl-32301309

RESUMEN

Medical advances in the treatment of HIV over the last 35 years mean that people living with HIV (PLHIV) now have a life expectancy close to that of the general population. Further, when successfully treated, PLHIV cannot transmit the virus. Despite this, HIV-related stigma remains widespread, including within healthcare settings. Stigma is not a vague sociological notion but represents a real threat to public health, with repercussions for both PLHIV and HIV-negative individuals. Stigma has been shown to have a negative impact on HIV prevention, testing, access to health services, and on the healthcare management of PLHIV. Taking stigma into consideration is essential, both in meeting the medical and psycho-social needs of PLHIV and in order to effectively combat HIV/AIDS.


Asunto(s)
Infecciones por VIH/psicología , Salud Pública , Estigma Social , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/psicología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Seronegatividad para VIH , Seropositividad para VIH/diagnóstico , Seropositividad para VIH/psicología , Seropositividad para VIH/transmisión , Humanos
2.
Artículo en Inglés | MEDLINE | ID: mdl-32236386

RESUMEN

The aim of study was to assess the prevalence of Treponema pallidum and HIV infection in Amerindian people (Mbya Guarani) over the age of 11 in Puerto Iguazu (Argentina) and to describe the contact tracking of cases. The method was a cross-sectional study in the Mbya Guarani people living in three villages of Puerto Iguazu (community A, pop. 1,146; community B, pop. 369; and community C, pop. 149). Participants were randomly invited to participate in the survey and in blood testing. Of the 551 participants, 48 were infected by T. pallidum (8.71%; 95% confidence interval [CI] 7.38-10.04). The infection prevalence decreased with age, standing at 9.66% in the 11-19 age group, 8.42% in 20-39 age group and 4.54% in people aged 40 and older. We tracked 130 contacts for the 48 T. pallidum cases; 39/40 (97.5%) sexual contacts tested positive for syphilis. Among the 90 children born to infected mothers, 76 aged 18 months or older tested negative, while 8/14 younger children were still at risk for congenital syphilis. There were four cases of HIV infection (0.72%, 95% CI 0.31-1.13). Prevalence of T. pallidum infection and HIV infection are relevant in this indigenous community of Argentina, representing a public health concern.


Asunto(s)
Trazado de Contacto/estadística & datos numéricos , Infecciones por VIH/epidemiología , Indios Sudamericanos/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Argentina/epidemiología , Niño , Estudios Transversales , Femenino , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Infecciones por VIH/transmisión , Humanos , Lactante , Masculino , Prevalencia , Estudios Seroepidemiológicos , Sífilis/diagnóstico , Sífilis/transmisión , Adulto Joven
4.
BMC Infect Dis ; 20(1): 204, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32143643

RESUMEN

BACKGROUND: Bolivia has the highest prevalence of cervical cancer in South America and the prevalence of viral sexually transmitted infections (STIs) among people in urban cities is increasing. Little is known about the prevalence of viral STIs in rural communities, which generally have limited access to health care. In order to study the prevalence of viral STIs in rural Bolivia, we recruited women from villages and towns in the Department of La Paz in Bolivia. METHODS: Three hundred ninety-four female participants were assessed for IgG-antibodies to herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and hepatitis B virus (HBV, anti-HBc), as well as for the presence of HBV surface antigen (HBsAg) in dried blood spots. The prevalence of 12 high-risk types of human papillomavirus (HPV) was assessed by qPCR in dried cervicovaginal cell spots from 376 of these women. χ2 test was used to compare variables between the populations and binary logistic regression was used to identify risk factors associated with the positivity of the tests. RESULTS: The seroprevalence of HSV-2 was 53% and of HBV 10.3%. HBAg was detected in 15.8% of women with anti-HBV antibodies indicating chronic infection. The frequency of high-risk HPV infection was 27%, with the most prevalent high-risk HPV types being HPV 56, 39 and 31 followed by HPV 16 and 18. Finally, none of the 394 women were seropositive for HIV, and about 64% of the studied population was positive for at least one of the viral infections. CONCLUSIONS: Women in Bolivian rural communities in La Paz show a high prevalence of HBV, HPV and, in particular, HSV-2. In contrast, none of the women were HIV positive, suggesting that the HIV prevalence in this population is low. The pattern of high-risk HPV types differed from many other countries with a predominance of HPV-types not included in the Gardasil vaccine which was officially introduced in Bolivia in April 2017.


Asunto(s)
Herpesvirus Humano 2/genética , Infecciones por Papillomavirus/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Adulto , Anticuerpos Antivirales/sangre , Bolivia/epidemiología , Femenino , Genotipo , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Herpesvirus Humano 2/aislamiento & purificación , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Prevalencia , Riesgo , Población Rural , Enfermedades Virales de Transmisión Sexual/epidemiología , Adulto Joven
5.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 257-260, 2020 Mar.
Artículo en Chino | MEDLINE | ID: mdl-32220197

RESUMEN

This study is aimed to explore the value of metagenomic next-generation sequencing (mNGS) in diagnosing pathogen in fever patients. It is often a challenge to identify the pathogen that caused the infection in the HIV patients with fever. How could the mNGS be helpful for pathogen diagnosis is unclear. Here we reported a case of human immunodeficiency virus (HIV) patient with 2-month period of fever. After routine clinical laboratory tests including the conventional smear, culture, serological tests and pathological examinations, the causal pathogen still remained undiagnosed. Then the lymph node biopsy tissue was subjected to broad-range polymerase chain reaction (PCR) and the peripheral blood was subjected to mNGS. At the same time, peripheral blood culture was carried out with an extension of culture time to acquire the pathogen. Results from both broad-range PCR and mNGS revealed the pathogen was Talaromyces marneffei. The isolate recovered from the peripheral blood culture was subjected to the whole-genome sequencing. Whole genome sequencing revealed that the antimicrobial resistance gene FLU1 existed in this pathogen's genome, but mNGS did not detect the FLU1 gene. Phylogenetic analysis based on whole genome sequence revealed that this isolate was far from other clones published in NCBI database. Here we reported a case of Talaromyces marneffei infection diagnosed by mNGS, showing that mNGS is helpful in etiological diagnosis for HIV patients with unexplained fever. However, application of mNGS in antimicrobial resistant genes detection and pathogen tracing need to be well-studied in the future.


Asunto(s)
Infecciones por VIH , Secuenciación de Nucleótidos de Alto Rendimiento , Metagenómica , Fiebre/etiología , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Infecciones por VIH/genética , Humanos , Filogenia , Reacción en Cadena de la Polimerasa
6.
West Afr J Med ; 37(2): 197-198, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150640

RESUMEN

Cases of West Nile Virus (WNV), co-existent with Human Immuno deficiency Virus (HIV), are rare with less than eleven cases in the literature. This clinical combination has an overall mortality of about 30%, as WNV has greater risk in patients with an immunocompromised status. Distinguishing between an acute retroviral HIV episode and a WNV infection can be a clinical dilemma. They present with similar symptoms including headaches, joint pains and fever, and a high index of suspicion and clinical acumen is required to isolate both conditions in a clinical presentation. We present a case of a 25 year old female, with dual diagnosis of new onset HIV and WNV, who required prompt diagnosis and medical intervention following presentation in ER for three weeks history of abdominal pain, headaches, joint aches, nausea, subjective fever and non-bilious, and non bloody vomiting.


Asunto(s)
Coinfección/virología , Infecciones por VIH/diagnóstico , VIH/aislamiento & purificación , Fiebre del Nilo Occidental/diagnóstico , Virus del Nilo Occidental/aislamiento & purificación , Dolor Abdominal/etiología , Adulto , Femenino , Fiebre/etiología , Cefalea/etiología , Humanos , Náusea/etiología
7.
Rev Bras Epidemiol ; 23: e200020, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32159630

RESUMEN

INTRODUCTION: Linkage is a critical step in the ongoing care of human immunodeficiency virus (HIV/aids) infection and is essential for providing access to antiretroviral therapy, as well as comprehensive care. METHODOLOGY: Cross-sectional study on people living with HIV (PLHIV), aged ≥ 18 years old, linked between January and December 2015, in a referral service for outpatient and hospital care specialized in HIV/AIDS in Belo Horizonte, Minas Gerais. Linkage time was defined as the time from diagnosis to service linkage. Timely care linkage was considered when this time was ≤ 90 days. Data were collected through clinical records. A logistic regression analysis with a confidence interval of 95% (95%CI) was performed. RESULTS: Among 208 patients, most of them were males (77.8%) with a mean age of 39 years. About 45% presented AIDS-defining conditions at the moment of linkage. Linkage time presented a mean of 138 ± 397 days. And timely linkage occurred for 76.9% of the patients. The variables associated with timely care linkage were: age ≥ 48 years (odds ratio - OR = 8.50; 95%CI 1.53 - 47.28), currently working (OR = 3.69; 95%CI 1.33 - 10.25) at the time of linkage, and present CD4+ T lymphocyte count (CD4+ T) ≤ 200 cells/mm3 at the time of HIV diagnosis (OR = 4.84; 95%CI 1.54 - 15.18). There was an important proportion of timely care linkage among PLHIV, but with late diagnosis. CONCLUSION: Interventions should be targeted at younger people with higher CD4+ T lymphocyte counts, in order to better provide continuous HIV care.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Continuidad de la Atención al Paciente/estadística & datos numéricos , Infecciones por VIH/tratamiento farmacológico , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Tiempo de Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Terapia Antirretroviral Altamente Activa , Brasil/epidemiología , Recuento de Linfocito CD4 , Estudios Transversales , Diagnóstico Tardío , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Adulto Joven
8.
MMWR Morb Mortal Wkly Rep ; 69(10): 260-264, 2020 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-32163381

RESUMEN

Since implementation of Standard Precautions* for the prevention of bloodborne pathogen transmission in 1985, health care-associated transmission of human immunodeficiency virus (HIV) in the United States has been rare (1). In October 2017, the New York City Department of Health and Mental Hygiene (NYCDOHMH) and the New York State Department of Health (NYSDOH) were notified by a clinician of a diagnosis of acute HIV infection in a young adult male (patient A) without recognized risk factors (i.e., he was monogamous, had an HIV-negative partner, and had no injection drug use) who had recently been hospitalized for a chronic medical condition. The low risk coupled with the recent hospitalization and medical procedures prompted NYSDOH, NYCDOHMH, and CDC to investigate this case as possible health care-associated transmission of HIV. Among persons with known HIV infection who had hospitalization dates overlapping those of patient A, one person (patient B) had an HIV strain highly similar to patient A's strain by nucleotide sequence analysis. The sequence relatedness, combined with other investigation findings, indicated a likely health care-associated transmission. Nucleotide sequence analysis, which is increasingly used for detecting HIV clusters (i.e., persons with closely related HIV strains) and to inform public health response (2,3), might also be used to identify possible health care-associated transmission of HIV to someone with health care exposure and no known HIV risk factors (4).


Asunto(s)
Infección Hospitalaria/diagnóstico , Infecciones por VIH/diagnóstico , Infecciones por VIH/transmisión , Análisis de Secuencia de ARN , Resultado Fatal , VIH-1/genética , VIH-2/genética , Hospitalización , Humanos , Masculino , New York , ARN Viral/genética , Insuficiencia Renal Crónica/terapia
9.
Artículo en Ruso | MEDLINE | ID: mdl-32119209

RESUMEN

Among HIV-infected patients there are individuals with masked chronic diseases that affect life quality and life-span. Their timely detection and treatment can improve life quality of HIV-infected patients. The screening examination allows to establish prevalence level, structure and features of concomitant diseases under HIV- infection to provide timely medical preventive care.


Asunto(s)
Infecciones por VIH , Trastornos de la Audición , Enfermedades Pulmonares , Tamizaje Masivo , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Trastornos de la Audición/complicaciones , Trastornos de la Audición/diagnóstico , Humanos , Enfermedades Pulmonares/complicaciones , Enfermedades Pulmonares/diagnóstico , Prevalencia , Calidad de Vida , Sistema Respiratorio
10.
BMC Infect Dis ; 20(1): 235, 2020 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-32192458

RESUMEN

BACKGROUND: Loss to follow-up (LTFU) deprives HIV-exposed infants the lifesaving care required and results in exposing HIV free infants to virus requisition risk. We aimed to determine the rate of LTFU, postnatal mother-to-child HIV-transmission (MTCT) and to identify maternal factors associated with LTFU among HIV-exposed infants enrolled at Mbarara Regional Referral Hospital PMTCT clinic. METHODS: Study participants were infants born to HIV-positive mothers enrolled in the PMTCT clinic for HIV care at Mbarara Regional Referral Hospital. While access database in the Early Infant Diagnosis (EID) clinic provided data on infants, the open medical record system database at the ISS clinic provided that for mothers. Infants were classified as LTFU if they had not completed their follow-up schedule by 18 months of age. At 18 months, an infant is expected to receive a rapid diagnostic test before being discharged from the PMTCT clinic. Postnatal MTCT of HIV was calculated as a proportion of infants followed and tested from birth to 18 months of age. Logistic regression was used to determine possible associations between mothers' characteristics and LTFU. In-depth interviews of mothers of LTFU infants and health workers who attend to the HIV-exposed infants were carried out to identify factors not captured in the electronic database. RESULTS: Out of 1624 infants enrolled at the clinic, 533 (33%) were dropped for lack of mother's clinic identification number, 18 (1.1%) were either dead or transferred out. Out of 1073 infants analysed, 515 (48%) were LTFU by 18 months of age while out of the 558 who completed their follow-up schedule, 20 (3.6%) tested positive for HIV. Young age of mother, far distance to hospital and non-use of family planning were identified as outstanding factors responsible for LTFU. In addition, in-depth interviews revealed facility-level factors such as "waiting time" which would not be found in routine client databases. CONCLUSION: This study has revealed a high rate of loss to follow up among HIV-exposed infants enrolled at Mbarara Regional Referral hospital PMTCT clinic. Young maternal age, long distance to health facility and failure to use family planning were significantly associated with LTFU. Incorporating family planning services in the ART and PMTCT clinics could reduce loss to follow-up of HIV exposed infants. Young mothers should be targeted with information on the importance of completing the EID follow-up schedule and also, their clinic identification number be gotten at each visit.


Asunto(s)
Infecciones por VIH/diagnóstico , Infecciones por VIH/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Perdida de Seguimiento , Madres , Adulto , Factores de Edad , Instituciones de Atención Ambulatoria , Diagnóstico Precoz , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Embarazo , Derivación y Consulta , Estudios Retrospectivos , Factores de Riesgo , Uganda , Adulto Joven
11.
BMC Infect Dis ; 20(1): 149, 2020 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-32070297

RESUMEN

BACKGROUND: HIV testing plays a central role in the combat against HIV. We aimed to determine if the availability of HIV self-testing (HIVST) would increase the frequency of testing among men who have sex with men (MSM) attending university in China. METHODS: A stepped wedge randomized controlled trial will be conducted in 4 provinces in China: Chongqing, Guangdong, Shandong, and Tianjin. Eligibility assessment will include (1) male, aged 16 years or older, (2) university student (technical diploma and undergraduate students), (3) MSM (sexual behaviors including mutual masturbation, oral sex, and anal sex), (4) HIV negative, and (5) willing to provide informed consent. Participants will be randomly allocated to HIV self-testing intervention with free HIVST kits in every 30 days according to the intervention waiting lists with a computer-generated randomized sequence. All participants will complete a self-administrated online questionnaire onsite at baseline and 12-month follow-up and complete an online questionnaire at 4- and 8-month. The primary outcome is the effect of HIVST on HIV testing frequency. Secondary outcomes include the change in sexual behaviors and HIV incidence. DISCUSSION: No previous study had measured the effect of social media based HIVST intervention on the change in HIV testing behaviors, sexual behaviors and incident HIV infection among MSM attending university in China. Findings from this study will provide evidence for further interventional practice promotions and prevention strategies scale-up, including HIV testing, pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), and sexual partner serosorting. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1900020645. Registered 11 January 2019.


Asunto(s)
Infecciones por VIH/diagnóstico , Homosexualidad Masculina , Autocuidado/métodos , Adolescente , Adulto , China/epidemiología , Infecciones por VIH/epidemiología , Seroclasificación por VIH , Conductas de Riesgo para la Salud , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Conducta Sexual , Parejas Sexuales , Medios de Comunicación Sociales , Encuestas y Cuestionarios , Universidades , Adulto Joven
12.
PLoS One ; 15(2): e0229424, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32109949

RESUMEN

Management of Human Immunodeficiency Virus Type 2 (HIV-2) infections present unique challenges due to low viral titers, slow disease progression, and poor response to standard antiviral therapies. The need for a nucleic acid assay to detect and quantify HIV-2 virus has led to the development of a number of molecular-based assays for detection and/or quantification of HIV-2 viral RNA in plasma in order to provide laboratory evidence of HIV-2 infection and viral loads for use in treatment decisions. As HIV-2 is less pathogenic and transmissible than HIV-1 and has resistance to several of the antiretroviral drugs, delay of treatment is common. Cross sero-reactivity between HIV-1 and HIV-2 makes it difficult to distinguish between the two viruses based upon serological tests. As such we developed a quantitative reverse transcription PCR (qRT-PCR) assay targeting the 5' long terminal repeat of HIV-2 for detection and quantification of HIV-2 viral RNA in plasma to identify HIV-2 infection and for use in viral load monitoring. Serial dilutions of cultured HIV-2 virus demonstrated a wide dynamic range (10 to 100,000 copies/ml) with excellent reproducibility (standard deviation from 0.12-0.19), linearity (R2 = 0.9994), and a lower limit of detection at 79 copies/ml (NIH-Z). The assay is highly specific for HIV-2 Groups A and B and exhibits no cross reactivity to HIV-1, HBV or HCV. Precision of the assay was demonstrated for the High (Mean = 6.41; SD = 0.12) and Medium (Mean = 4.46; SD = 0.13) HIV-2 positive controls. Replicate testing of clinical specimens showed good reproducibility above 1,000 copies/ml, with higher variability under 1,000 copies/ml. Analysis of 220 plasma samples from HIV-2 infected West African individuals demonstrated significantly lower viral loads than those observed in HIV-1 infections, consistent with results of previous studies. Slightly more than seven percent of clinical samples (7.3%) demonstrated viral loads above 100,000 copies/ml, while 37.3% of samples were undetectable. The high sensitivity, specificity, precision, and linearity of the WRAIR qRT-PCR assay makes it well suited for detection and monitoring of HIV-2 RNA levels in plasma of infected individuals.


Asunto(s)
Infecciones por VIH/diagnóstico , VIH-1/genética , VIH-2/genética , Laboratorios/normas , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Pruebas Serológicas/normas , Estudios de Casos y Controles , Infecciones por VIH/sangre , Infecciones por VIH/virología , VIH-1/aislamiento & purificación , VIH-2/aislamiento & purificación , Humanos , ARN Viral/sangre , Juego de Reactivos para Diagnóstico , Carga Viral
13.
Med Care ; 58(5): 445-452, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32040038

RESUMEN

BACKGROUND: The overlapping human immunodeficiency virus (HIV) and hepatitis C virus (HCV) epidemics disproportionately affect people with substance use disorders. However, many people who use substances remain unaware of their infection(s). OBJECTIVE: The objective of this study was to examine the efficacy of an on-site bundled rapid HIV and HCV testing strategy in increasing receipt of both HIV and HCV test results. RESEARCH DESIGN: Two-armed randomized controlled trial in substance use disorder treatment programs (SUDTP) in New York City. Participants in the treatment arm were offered bundled rapid HIV and HCV tests with immediate results on-site. Participants in the control arm were offered the standard of care, that is, referrals to on-site or off-site laboratory-based HIV and HCV testing with delayed results. PARTICIPANTS: A total of 162 clients with unknown or negative HIV and HCV status. MEASURES: The primary outcome was the percentage of participants with self-reported receipt of HIV and HCV test results at 1-month postrandomization. RESULTS: Over half of participants were Hispanic (51.2%), with 25.3% being non-Hispanic black and 17.9% non-Hispanic white. Two thirds were male, and 54.9% reported injection as method of drug use. One hundred thirty-four participants (82.7%) completed the 1-month assessment. Participants in the treatment arm were more likely to report having received both test results than those in the control arm (69% vs. 19%, P<0.001). Seven participants in the treatment arm received a preliminary new HCV diagnosis, versus 1 in the control arm (P=0.029). CONCLUSION: Offering bundled rapid HIV and HCV testing with immediate results on-site in SUDTPs may increase awareness of HIV and HCV infection among people with substance use disorders.


Asunto(s)
Infecciones por VIH/diagnóstico , Hepatitis C/diagnóstico , Tamizaje Masivo , Adulto , Femenino , Infecciones por VIH/epidemiología , Hepatitis C/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Centros de Tratamiento de Abuso de Sustancias , Trastornos Relacionados con Sustancias/epidemiología
14.
PLoS One ; 15(2): e0228783, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045460

RESUMEN

BACKGROUND: HIV counseling and testing are key to control and prevent the spread of the virus and improve the lives of people living with HIV. Although the risk of acquiring the virus is high, only 27% of young Ethiopian women age 15 to 24 years old were tested and counseled for HIV. This coverage is low to achieve the 90-90-90 goal. Identifying factors associated with low utilization of HIV testing and counseling services among young females (aged 15 to 24 years) is important to identify the barriers and improve uptake. Therefore, this analysis was done to identify factors associated with low utilization of HIV counseling and testing services among young Ethiopian women. METHODS: The study used the 2016 Ethiopian demographic and health survey data. The data was downloaded from The DHS program with permission. A total of 2661 young women (aged 15 to 24 years) were included in the final model. Data was weighted to consider disproportionate sampling and non-response. A Complex data management technique was applied to consider the complex sampling technique used in the DHS. Multivariable logistic regression was used to identify factors associated with HIV testing among young women. RESULT: Among sexually active young women, 33.5% (95%CI; 30.1, 37.1) were tested for HIV. Young women who attended primary ((AOR 2.8; (95% CI; 2.0, 3.9)), secondary (AOR 4.7; (95% CI; 3.1, 7.3)) or higher education (AOR; 5.6; 95% CI; 2.6, 12.0), those who had multiple sexual partners (AOR 5.5; 95% (CI; 1.3, 23.3)), young women who ever used alcohol (AOR 1.46; 95% (CI; 1.1, 2.0)) and young women who visited health care facilities (AOR 1.8; (95% CI; 1.4, 2.3)) had higher odds of being tested for HIV. On the other hand, young women from the rural areas had lower odds (AOR 0.5; (95% CI; 0.3, 0.7)) of being tested for HIV. CONCLUSION: HIV testing among sexually active young women in Ethiopia was low. Educational status, place of residence, alcohol intake, number of sexual partners and visiting health facility 12 months before the survey were found significant predictors of HIV testing. Therefore, the Ethiopian government should encourage girls to complete secondary education to improve HIV testing and counseling. Young women should be encouraged to visit health facilities to improve HIV testing service uptake.


Asunto(s)
Infecciones por VIH/diagnóstico , Encuestas Epidemiológicas , Tamizaje Masivo/estadística & datos numéricos , Adolescente , Consumo de Bebidas Alcohólicas , Escolaridad , Etiopía , Femenino , Infecciones por VIH/prevención & control , Instituciones de Salud , Humanos , Oportunidad Relativa , Población Rural , Parejas Sexuales , Adulto Joven
16.
BMC Infect Dis ; 20(1): 180, 2020 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-32106864

RESUMEN

BACKGROUND: Worldwide, there is limited epidemiologic evidence on the seroprevalence of undiagnosed chronic viral infections including HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among patients with severe psychiatric disorders. To our knowledge, this is the first study to explore and compare undiagnosed seroprevalence rates of HIV, HBV, and HCV infections among patients with severe psychiatric disorders. METHOD: In this study, we included a random sample of 309 patients with severe psychiatric disorders selected by systematic sampling technique. We used a structured clinical interview for DSM-IV (SCID) to confirm the diagnosis of severe psychiatric disorders among the participants. Binary and multivariable logistic regression models, adjusting for the potential confounding factors was used to explore the potential determinants of chronic viral infections. RESULT: The prevalence estimates of HIV infection among patients with severe psychiatric disorders in this study (3.24%) was roughly 3 times the estimated population prevalence of HIV infection in Ethiopia (1.1%). This study showed that the prevalence rates of HBV and HCV infections among patients with severe psychiatric disorders were 4.85 and 1.29%, respectively. Our results also showed that among patients with chronic viral infections, HIV, HBV and HCV, 76.92, 60, 80, and 75% respectively were undiagnosed. Regarding associated factors, the presence of chronic viral infection was found to be significantly associated with the age of the participants (ranging between 30 and 40 years) after adjusting for the possible confounding factors [AOR = 3.95 (95%CI.18-13.17)]. CONCLUSION: Even though the prevalence estimates of HIV (3.24%), HBV (4.85%), and HCV (1.29%) infections were high among patients with severe psychiatric disorders, the majority of them remained undiagnosed. HBV was found to be the commonly undiagnosed infection (4 out of 5) followed by HCV (3 out of 4) and HIV (6 out of 10). The present study provided evidence of a significant association between the age of the participant (between 30 and 40 years) and chronic viral infections in patients with severe psychiatric disorders. Increasing the awareness of psychiatry professionals and early screening, as well as interventions of chronic viral infections among patients with severe psychiatric disorders are imperative.


Asunto(s)
Infecciones por VIH/diagnóstico , Hepatitis B/diagnóstico , Trastornos Mentales/diagnóstico , Adulto , Estudios Transversales , Etiopía/epidemiología , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Hepatitis B/complicaciones , Hepatitis B/epidemiología , Hepatitis C/complicaciones , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/complicaciones , Trastornos Mentales/patología , Prevalencia , Índice de Severidad de la Enfermedad
17.
Medicine (Baltimore) ; 99(8): e19289, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080144

RESUMEN

Achieving the Joint United Nations Program on human immunodeficiency virus (HIV)/AIDS Fast-Track targets requires additional strategies for mobile populations. We examined trends and socio-demographics of migrants (overseas-born) and Australian-born individuals presenting with late and advanced HIV diagnoses between 2008 and 2017 to help inform public health approaches for HIV testing coverage and linkage to care and treatment.We conducted a retrospective population-level observational study of individuals diagnosed with HIV in Australia and reported to the National HIV Registry. Annual proportional trends in late (CD4+ T-cell count <350 cells/µL) and advanced (CD4+ T-cell count <200 cells/µL). HIV diagnoses were determined using Poisson regression.Of 9926 new HIV diagnoses from 2008 to 2017, 84% (n = 8340) were included in analysis. Overall, 39% (n = 3267) of diagnoses were classified as late; 52% (n = 1688) of late diagnoses were advanced. Of 3317 diagnoses among migrants, 47% were late, versus 34% of Australian-born diagnoses (P < .001).The annual proportions of late (incidence rate ratio [IRR] 1.00; 95% confidence interval [CI] 0.99-1.01) and advanced HIV diagnoses (IRR 1.01; 95% CI 0.99-1.02) remained constant. Among migrants with late HIV diagnosis, the proportion reporting male-to-male sex exposure (IRR 1.05; 95% CI 1.03-1.08), non-English speaking (IRR 1.03; 95% CI 1.01-1.05), and individuals born in countries in low HIV-prevalence (IRR 1.02; 95% CI 1.00-1.04) increased. However, declines were noted among some migrants' categories such as females, heterosexual exposure, English speaking, and those born in high HIV-prevalence countries.Late HIV diagnosis remains a significant public health concern in Australia. Small declines in late diagnosis among some migrant categories are offset by increases among male-to-male exposures. Reaching the Fast-Track targets in Australia will require targeted testing and linkage to care strategies for all migrant populations, especially men who have sex with men.


Asunto(s)
Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Australia/epidemiología , Recuento de Linfocito CD4 , Niño , Preescolar , Diagnóstico Tardío , Femenino , Homosexualidad Masculina , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Personas Transgénero/estadística & datos numéricos , Adulto Joven
18.
J Korean Med Sci ; 35(6): e41, 2020 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-32056401

RESUMEN

BACKGROUND: Statistical data of undiagnosed people living with human immunodeficiency virus (PLHIV) are of great importance to human immunodeficiency virus (HIV) infection control. This study estimated the total number of PLHIV using nationwide claims data. METHODS: This study used data of the incident HIV cases identified by the National Health Insurance System between 2009 and 2015. The number of patients with acquired immune deficiency syndrome (AIDS) was identified by diagnoses or prescription records. The estimated number of PLHIV and the time to diagnosis were calculated from the incident numbers of HIV and AIDS cases using the HIV Modeling Tool of the European Center for Disease Prevention and Control. RESULTS: Between 2009 and 2015, a total of 7,033 PLHIV and 2,899 AIDS patients were diagnosed. In 2009, the number of incident HIV cases was 873 (460 AIDS patients), increasing to 995 (337 AIDS patients) in 2015. Besides, the estimated number of prevalent cases was 10,753 in 2009, compared to 14,880 in 2015. Patients visiting health facilities accounted for 42.9% (4,616/10,753) in 2009 and 64.1% (9,544/14,880) in 2015. In 2009, there were 8,363 (77.8%) undiagnosed HIV cases, experiencing a decline to 6,215 (41.8%) in 2015. It took a mean of 6.96 years to diagnose after HIV infection. CONCLUSION: This study estimates the total burden of HIV infection in Korea for the first time using an internationally recognized HIV modeling tool. Claims data can be used to estimate the number of undiagnosed cases by identifying the total number of PLHIV and AIDS patients visiting health facilities.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Diagnóstico Tardío , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Prevalencia , República de Corea/epidemiología , Factores de Tiempo
20.
AIDS Educ Prev ; 32(1): 25-35, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32073307

RESUMEN

The objective of this study was to measure HIV screening rates and variables associated with screening among new enrollees in California's Low Income Health Program (LIHP). A logit model was used to estimate associations between HIV screening and enrollment, claims, and encounter data for enrollees. HIV prevalence among new LIHP enrollees was 1.2%xd. Among 42,550 new LIHP enrollees with no prior HIV diagnosis, only 27% received screening within 12 months of their first medical evaluation. A total of 350 new HIV diagnoses were identified (incidence rate of 0.8%), exceeding the 0.1% level at which the Centers for Disease Control and Prevention (CDC) recommends routine HIV screening. California reduced screening barriers by removing required written informed consent and pretest counseling; the Affordable Care Act (ACA) eliminated cost-sharing and enhanced access. Removing financial and administrative barriers to HIV screening is necessary, but may be insufficient to reach CDC's recommended screening targets.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Infecciones por VIH/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Medicaid/estadística & datos numéricos , California/epidemiología , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Promoción de la Salud , Humanos , Masculino , Tamizaje Masivo/métodos , Medicaid/economía , Patient Protection and Affordable Care Act , Pobreza , Prevalencia , Estados Unidos
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