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1.
MMWR Morb Mortal Wkly Rep ; 69(12): 329-334, 2020 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-32214084

RESUMEN

Tuberculosis (TB) is the leading cause of death among persons living with human immunodeficiency virus (HIV) infection. In 2018, an estimated 251,000 persons living with HIV infection died from TB, accounting for one third of all HIV-related deaths and one sixth of all TB deaths (1). TB preventive treatment (TPT) is recommended by the World Health Organization (WHO) for persons living with HIV infection without active TB disease (i.e., adults with a negative clinical symptom screen for cough, fever, night sweats, or weight loss; and children with a negative clinical screen for cough, fever, contact with a person with TB, or poor weight gain) and either without* a tuberculin skin test result or with a known positive result (2). TPT decreases morbidity and mortality among persons living with HIV infection, independent of antiretroviral therapy (ART) (3); however, in 2017, fewer than 1 million of the estimated 21.3 million ART patients started TPT worldwide. Most patients receiving TPT were treated with 6 months of daily isoniazid (1,4). This report summarizes data on TB symptom screening and TPT initiation and completion among ART patients in 16 countries supported by the U.S. President's Emergency Plan for AIDS† Relief (PEPFAR) during April 1, 2017-March 31, 2019. During this period, these 16 countries accounted for approximately 90% of PEPFAR-supported ART patients. During April 1, 2017-September 30, 2018, TB symptom screening increased from 54% to 84%. Overall, nearly 2 million ART patients initiated TPT, and 60% completed treatment during October 1, 2017-March 31, 2019. Although TPT initiations increased substantially, completion among those who initiated TPT increased only from 55% to 66%. In addition to continuing gains in initiation, improving retention after initiation and identifying barriers to TPT completion are important to increase TPT scale-up and reduce global TB mortality.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Antirretrovirales/uso terapéutico , Cooperación Internacional , Tuberculosis/prevención & control , Síndrome de Inmunodeficiencia Adquirida/epidemiología , África/epidemiología , Humanos , Tuberculosis/epidemiología , Estados Unidos
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(1): 96-102, 2020 Jan 10.
Artículo en Chino | MEDLINE | ID: mdl-32062950

RESUMEN

Objective: The prevalence of HIV/AIDS in people aged ≥50 years is increasing in China, resulting in another focus for AIDS prevention and control. A Meta-analysis was conducted to evaluate the HIV infection, its area and time distributions in people aged ≥50 years in China to provide evidence for the prevention and control of HIV/AIDS. Methods: Information on HIV infection rate in people aged ≥50 years in China were collected from Wanfang digital database, China National Knowledge Infrastructure (CNKI), PubMed and Embase. The R Studio1.1.456 software was used to calculate the pooled infection rate, and assessed the publication bias. Results: A total of 30 studies which covered 13 provinces were selected. From 2010 to 2018, the pooled HIV infection rate in people aged ≥50 years was 1.68% (95%CI:1.00%-2.79%). The HIV infection rate (2.60%) was higher in eastern China than in central and western China (0.16%, 2.13%). Conclusion: The overall HIV infection rate in people aged ≥50 years is generally high in China. It is important to control the HIV infection in this population to facilitate the AIDS prevention and control in China.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Anciano , China/epidemiología , Bases de Datos Factuales , Infecciones por VIH/epidemiología , Humanos , Persona de Mediana Edad , Prevalencia
3.
BMC Infect Dis ; 19(1): 1032, 2019 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-31801471

RESUMEN

BACKGROUND: Anemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. METHODS: MEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out. RESULTS: In Ethiopia, the overall prevalence of anemia in HIV infected children was 22.3% (95% CI: 18.5-26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2-0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias. CONCLUSION: On aggregate, anemia is a common comorbidity in pediatric HIV patients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.


Asunto(s)
Anemia/inducido químicamente , Anemia/epidemiología , Terapia Antirretroviral Altamente Activa/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Antirretrovirales/efectos adversos , Antirretrovirales/uso terapéutico , Niño , Comorbilidad , Etiopía/epidemiología , Infecciones por VIH/epidemiología , Humanos , Oportunidad Relativa , Prevalencia , Calidad de Vida , Tamaño de la Muestra
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1476-1480, 2019 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-31838824

RESUMEN

Through the effort in nearly 40 years of Tanzania, the total number of reported cases, the prevalence of HIV/AIDS and the number of death have declined, while the number of patients receiving antiretroviral therapy has increased significantly in Tanzania. At the same time, however, there are new challenges that require more attention, such as the HIV spread to rural areas, middle and lower social classes, and female teenagers. Although the overall performance of the HIV/AIDS prevention and control response is great, there is still a need to survey the new trends of this disease at the micro-level in Tanzania. In addition, there is a necessity of interdisciplinary concern due to the prevalence of heterosexual anal sex in Tanzania.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Epidemias , Infecciones por VIH/epidemiología , Vigilancia de la Población/métodos , Población Rural , Síndrome de Inmunodeficiencia Adquirida/transmisión , Adolescente , Adulto , Femenino , Infecciones por VIH/transmisión , Humanos , Masculino , Persona de Mediana Edad , Conducta Sexual , Factores Socioeconómicos , Población Suburbana , Tanzanía/epidemiología
5.
Rev Soc Bras Med Trop ; 53: e20190086, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31859940

RESUMEN

INTRODUCTION: Acquired immunodeficiency syndrome (AIDS) remains a major public health issue in Brazil. This ecological study aimed to evaluate the spatiotemporal distribution of notified new AIDS cases in Brazil between 2012 and 2016. METHODS: A Bayesian spatiotemporal model based on the Poisson distribution was used to obtain smoothed incidence estimates of AIDS in each of the 133 Brazilian intermediate regions. RESULTS: Spatial distribution of new AIDS cases is highly heterogeneous. Regions with higher gross domestic product per capita tend to have higher incidence rates of AIDS. CONCLUSIONS: Strategies to prevent and control AIDS should consider regional differences.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Brasil/epidemiología , Notificación de Enfermedades , Femenino , Humanos , Incidencia , Masculino , Análisis Espacio-Temporal
6.
Rev Soc Bras Med Trop ; 53: e20190193, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31859945

RESUMEN

INTRODUCTION: Prevalence of human immunodeficiency virus among adolescents is increasing. This study aimed to analyze this current situation in Rio de Janeiro City. METHODS: This was a retrospective longitudinal study using secondary data from the National System of Notifiable Diseases database of cases in adolescents aged 13-19 years. RESULTS: There were 885 acquired immunodeficiency syndrome cases from 1978 to 2017 and 445 human immunodeficiency virus new cases from 2014 to 2017. Over time, sexually transmitted human immunodeficiency virus/acquired immunodeficiency syndrome cases increase. CONCLUSIONS: Human immunodeficiency virus/acquired immunodeficiency syndrome epidemic in adolescents requires novel prevention policies.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Epidemias , Adolescente , Brasil/epidemiología , Métodos Epidemiológicos , Femenino , Humanos , Masculino , Población Urbana , Adulto Joven
7.
BMC Infect Dis ; 19(1): 1063, 2019 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-31852545

RESUMEN

BACKGROUND: Contacting patients with tuberculosis have a substantial risk of developing the disease. Household contact screening has recently been recommended as a strategy to enhance case detection in high-burden countries. But there is no enough information in Gondar town regarding household contact screening practice among TB patients. METHODS: An institution-based cross-sectional study was conducted from March 1 to 30, 2019 on 404 tuberculosis patients attending at health facilities in Gondar Town. Epi-Info version 7 for data entry and SPSS version 20 for data analysis were used. Descriptive statistics were carried out to illustrate the means, standard deviations, and frequencies. Bivariable and multivariable logistic regression analyses were used to identify significantly associated variables with the dependent variable. RESULTS: From 412 study populations, 404 were completed the study with 98.06% response rate. The overall household contact TB screening adherence was 47.5% (95% CI: 43.1, 52.5). In the multivariable analysis, having certificate and above educational level (AOR = 2.83, 95% CI:1.40,5.67), having sufficient knowledge about TB (AOR = 8.26, 95% CI:4.34,15.71), being satisfied with health care service (AOR = 3.26, 95% CI:1.58,6.76), health education given by health care workers (AOR = 2.60, 95% CI:1.54,4.40),and having HIV/AIDS co-infection (AOR = 3.54, 95% CI:1.70,7.39), were factors associated with household contact TB screening adherence. CONCLUSION: Compared to other previous studies, the current finding was high but it was low as compared with WHO and Ethiopian Ministry of Health recommendations (all persons having TB contact should be screened). Educational status, knowledge on TB, satisfaction with delivered health care service, health education given by HCWs about TB and HIV/AIDS co-infection were factors associated with household contact TB screening practice. Thus, strengthening household TB contact screening and educational programs regarding the risk of getting TB infection from household contacts is crucial.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Infecciones por VIH/epidemiología , Cooperación del Paciente , Tuberculosis/epidemiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Coinfección , Estudios Transversales , Etiopía/epidemiología , Composición Familiar , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/virología , Educación en Salud , Instituciones de Salud , Personal de Salud/educación , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Tuberculosis/complicaciones , Tuberculosis/microbiología , Adulto Joven
8.
MMWR Morb Mortal Wkly Rep ; 68(47): 1089, 2019 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-31851652

RESUMEN

World AIDS Day, observed annually on December 1, draws attention to the status of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. Approximately 37.9 million persons worldwide are living with HIV infection, including 1.7 million persons newly infected in 2018 (1).


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Epidemias , Salud Global/estadística & datos numéricos , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Aniversarios y Eventos Especiales , Humanos
9.
Pan Afr Med J ; 33: 224, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692753

RESUMEN

Introduction: Despite increasing efforts to address the reproductive health needs of persons living with Human Immuno-Deficiency Virus (HIV), a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. Currently, Ethiopia promotes integration of family planning (FP) services in to HIV chronic care. Yet the contraceptive prevalence rate among clients remains low. The objective of the study was to assess the role of socio-cultural factors on modern family planning use among HIV+ clients attending Anti-Retroviral Therapy clinics in Addis Ababa sub-cities. Methods: The study involved a facility based cross sectional survey. The ten sub cities were initially categorized/stratified into 5 based on direction (East, West, South, North and Central) and from each category one sub city was randomly selected. The total sample size was proportionally allocated to the selected health facilities according to previous monthly average client load per health center. Participants were selected using simple random sampling technique during their routine visit at the health centers. Data were collected through a semi-structured interviewer administered questionnaire. Both descriptive and inferential statistics were generated and results considered significant at 95% confidence level using STATA version 14.0. Results: Six hundred and thirty-six clients participated in the study. Majority of them were age between 30-39 years. Though majority, 607 (95.4%) participants approved the use of modern FP method, current use rate stood at 39%. Condom was the most (14.5%) commonly used single method. The odds of FP use by participants who disclosed their HIV status were almost twice that of their counterparts (AOR= 1.84; 95% CI: 1.14, 2.95). Participants who held discussion with their spouse/partners concerning FP, irrespective of the frequency had an odd of more than four when using FP than their counterparts (AO= 4.35; 95% CI: 2.69, 7.04). Conclusion: This study revealed that 6 out of every 10 HIV+ clients are not currently using FP methods. Disclosure of HIV status as well as open discussion with spouse/partner were positively associated with family planning use. These study findings call for comprehensive and client focus FP education and counseling in line with disclosure of HIV status and dialogue with spouse/partner in order to increase uptake and utilization of FP among clients. Partners have a great influence on the use and choice of FP methods, so their views are paramount.


Asunto(s)
Conducta Anticonceptiva/estadística & datos numéricos , Servicios de Planificación Familiar/estadística & datos numéricos , Infecciones por VIH/epidemiología , Educación Sexual/estadística & datos numéricos , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adulto , Condones/estadística & datos numéricos , Anticoncepción/métodos , Anticoncepción/estadística & datos numéricos , Estudios Transversales , Revelación/estadística & datos numéricos , Etiopía , Servicios de Planificación Familiar/organización & administración , Femenino , Humanos , Masculino , Salud Reproductiva , Parejas Sexuales/psicología , Encuestas y Cuestionarios , Adulto Joven
10.
BMC Public Health ; 19(1): 1516, 2019 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-31718615

RESUMEN

BACKGROUND: In populations that lack vital registration systems, under-5 mortality (U5M) is commonly estimated using survey-based approaches, including indirect methods. One assumption of indirect methods is that a mother's survival and her children's survival are not correlated, but in populations affected by HIV/AIDS this assumption is violated, and thus indirect estimates are biased. Our goal was to estimate the magnitude of the bias, and to create a predictive model to correct it. METHODS: We used an individual-level, discrete time-step simulation model to measure how the bias in indirect estimates of U5M changes under various fertility rates, mortality rates, HIV/AIDS rates, and levels of antiretroviral therapy. We simulated 4480 populations in total and measured the amount of bias in U5M due to HIV/AIDS. We also developed a generalized linear model via penalized maximum likelihood to correct this bias. RESULTS: We found that indirect methods can underestimate U5M by 0-41% in populations with HIV prevalence of 0-40%. Applying our model to 2010 survey data from Malawi and Tanzania, we show that indirect methods would underestimate U5M by up to 7.7% in those countries at that time. Our best fitting model to correct bias in U5M had a root median square error of 0.0012. CONCLUSIONS: Indirect estimates of U5M can be significantly biased in populations affected by HIV/AIDS. Our predictive model allows scholars and practitioners to correct that bias using commonly measured population characteristics. Policies and programs based on indirect estimates of U5M in populations with generalized HIV epidemics may need to be reevaluated after accounting for estimation bias.


Asunto(s)
Sesgo , Mortalidad del Niño , Métodos Epidemiológicos , Infecciones por VIH/mortalidad , Mortalidad Infantil , Madres/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Adolescente , Adulto , Fármacos Anti-VIH/uso terapéutico , Tasa de Natalidad , Causas de Muerte , Preescolar , Epidemias , Femenino , VIH , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Lactante , Recién Nacido , Malaui/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Tanzanía/epidemiología , Adulto Joven
11.
BMC Infect Dis ; 19(1): 925, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666015

RESUMEN

BACKGROUND: Ruili is a border city in southwest China along the heroin trafficking route. In recent decades, the city has witnessed increased in HIV transmission. The current study aims to explore the spatiotemporal trends in HIV prevalence identify and map the spatial variation and clustering of factors associated with HIV transmission through drug use and heterosexual contact transmissions at the village level from 1989 through 2016. METHODS: Geographic information system-based spatiotemporal analyses, including global and local spatial autocorrelation analyses and space-time scanning statistics, were applied to detect the location and extent of HIV/AIDS high-risk areas. RESULTS: Drug use and heterosexual contact were identified as the major transmission routes causing infection in Ruili. Results of global spatial analysis showed significant clustering throughout the city caused by transmission via drug use in the early phase of the epidemic and transmission via heterosexual contact in the late phase of the epidemic during the study period. Hotspots of transmission from drug use were randomly distributed throughout the city. However, the hotspots of transmission by heterosexual contact were located in the central area only around the Jiegao China-Myanmar land port. Space-time scanning showed that transmission from drug use clustered in the southwest area between 1989 and 1990, while transmission by heterosexual contact clustered in the central area between 2004 and 2014. CONCLUSIONS: Heterosexual contact has become the dominant mode of transmission. Interventions should focus on highly clustered area where is around the Jiegao land port.


Asunto(s)
Infecciones por VIH/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Adulto , China/epidemiología , Ciudades , Análisis por Conglomerados , Epidemias , Femenino , Sistemas de Información Geográfica , Infecciones por VIH/transmisión , Heterosexualidad , Humanos , Masculino , Mianmar , Prevalencia , Conducta Sexual , Análisis Espacio-Temporal , Trastornos Relacionados con Sustancias/virología
12.
Rev. bioét. derecho ; (47): 93-107, nov. 2019.
Artículo en Español | IBECS | ID: ibc-184868

RESUMEN

Este artículo tiene como propósito reflexionar sobre la situación de estigma y discriminación que afecta a personas con VIH/SIDA. Esto constituye una vulneración a los derechos fundamentales de estas personas y una barrera en el avance hacia la eliminación de la enfermedad. Ya que estudios realizados en diferentes países dan cuenta que las personas en esta condición se sienten discriminadas por la sociedad, y por los profesionales de la salud. Este es uno de los aspectos que ha dificultado el acceso al tratamiento, su adhesión, y educación para el cambio de conducta en los grupos de riesgo


Aquest article té com a propòsit reflexionar sobre la situació d'estigma i discriminació que afecta a persones amb VIH/SIDA. Això constitueix una vulneració dels drets fonamentals d'aquestes persones i una barrera en l'avanç cap a l'eliminació de la malaltia. Estudis realitzats en diferents països exposen que les persones en aquesta condició se senten discriminades per la societat i pels professionals de la salut. Aquest és un dels aspectes que ha dificultat l'accés al tractament, l'adhesió al mateix, i educació per al canvi de conducta en el grups de risc


This article aims to reflect on the situation of stigma and discrimination affecting people with HIV/AIDS. This constitutes a violation of the fundamental rights of these people and a barrier to progress towards the elimination of the disease. Studies carried out in different countries show that people in this condition feel discriminated against by society and by health professionals. This is one of the aspects that has hindered access to treatment, adherence, and behaviour change education in at-risk groups


Asunto(s)
Humanos , Ageísmo/ética , Sexismo , Discriminación Social , Estigma Social , Grupos de Riesgo , Relaciones Profesional-Paciente/ética , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Personal de Salud/ética , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Seroprevalencia de VIH , Accesibilidad a los Servicios de Salud/ética , Derechos Humanos
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1191-1196, 2019 Oct 10.
Artículo en Chino | MEDLINE | ID: mdl-31658515

RESUMEN

The number of people living with HIV/AIDS (PLHIV), new HIV infections, and deaths due to HIV in China were estimated. These data provided evidences for the analysis on current HIV/AIDS epidemic in China, development of AIDS prevention and control strategies and public health education. However, whether the estimation results could be fully used in practice depends on appropriate interpretation. Since the differences in estimation methods and data to produce the estimates for each year, it is not suitable to directly use the estimation results of different years to conclude the HIV/AIDS epidemic trends. The 2018 estimation results indicated that the number of PLHIV is already beyond one million by the end of 2018 and would keep growing, causing much pressure of for HIV/AIDS prevention and control. With the increased burden of case management, innovative strategies are needed to reduce secondary transmission of HIV and control the aggravating spread to general population. Less than 70%, which is significantly lower than the goal of China's 13th Five-year Action plan for AIDS prevention and control. All local governments have the necessity of analyzing percentage of PLHIV who know their status, to conduct targeted strategies and measures for the improvement of HIV case finding. New HIV infection is the core indicator for HIV epidemic evaluation. The number of estimated new HIV infections is around 80 000 in 2018. It is necessary to further improve the strategy and increase the intensity to effectively reduce the new infection of HIV.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Epidemias , Infecciones por VIH/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , China/epidemiología , Infecciones por VIH/prevención & control , Humanos
14.
Afr J AIDS Res ; 18(3): 198-204, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31575338

RESUMEN

Background: South Africa has the largest HIV/AIDS epidemic globally and the largest anti-retroviral treatment (ART) programme in the world, yet HIV incidence is still chronically high in South Africa, especially in KwaZulu-Natal province (KZN). In light of this, a study was conducted to investigate the extent of challenges making the management of HIV/AIDS difficult in people living with HIV (PLWH) in KZN, South Africa. Methods: A cross-sectional study was carried out with 297 study participants living with HIV and receiving ART from three selected clinics in the Ethekwini Metro of KZN. A self-administered questionnaire assessed the challenges experienced by PLWH, their knowledge of their condition and their management thereof. One-way frequency tables were used to descriptively assess participant responses. Associations between certain demographic characteristics and responses to HIV treatment management challenges were assessed using chi-square tests, with statistical significance set at p < 0.05. Results: One-fifth of the participants (n = 60; 20.1%) were within the 18-23 age group, with over 53% (n = 158) having secondary level education. Some of the challenges cited included: difficulty in obtaining medication, mainly due to cost; side effects resulting in non-adherence; shame for taking medication in public (younger patients were more likely to feel ashamed for taking their medication in public [χ2 = 20.3, p = 0.009]); and non-disclosure of HIV-positive status to partners. We found a significant association between education and financial status and management of their condition [χ2 = 11.2, p = 0.011]. Conclusion: These findings that challenges still exist have implications for more robust programmes on education and counselling to address such challenges.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/psicología , Terapia Antirretroviral Altamente Activa/economía , Costo de Enfermedad , Accesibilidad a los Servicios de Salud , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adolescente , Adulto , Consejo , Estudios Transversales , Epidemias , Femenino , VIH , Humanos , Masculino , Persona de Mediana Edad , Parejas Sexuales , Sudáfrica/epidemiología , Encuestas y Cuestionarios , Adulto Joven
15.
Afr J AIDS Res ; 18(3): 234-243, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31575343

RESUMEN

The numbers of people infected with HIV and living with AIDS remain high in South Africa. The youth of the Northern Cape province in South Africa are a vulnerable population in this regard. However, there seems to be a dearth of rigorous evaluations of HIV and AIDS social intervention programmes targeted at the youth. This study aimed to evaluate the relevance of the content of an HIV and AIDS social intervention programme for the youth in the Northern Cape as well as to collect attendees' recommendations with regards to programme content. The data collection method comprised a group-administered questionnaire completed by youth (N = 172) who participated in the Soul City social intervention programme (SCP) implemented for the youth in the Northern Cape, and recruited through stratified random sampling. Based on specific criteria, the results showed that the SCP programme's content was relevant to the communities it served. The youth also forwarded recommendations for the programme content. Recommendations from the study include that youth support should be beyond dialogues; women's rights should be promoted within the context of HIV prevention strategies; the SCP should intensify its condom promotion efforts because it is relevant to the South African government's macro-level plan; relevant community leaders should be visited to explain the rationale for the youth's involvement in programmes; and the programme should focus more pertinently on poverty alleviation strategies.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Promoción de la Salud/métodos , Apoyo Social , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Condones/estadística & datos numéricos , Femenino , VIH , Humanos , Masculino , Pobreza/estadística & datos numéricos , Sudáfrica , Encuestas y Cuestionarios , Poblaciones Vulnerables , Adulto Joven
17.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 367-372, 2019 May.
Artículo en Chino | MEDLINE | ID: mdl-31631605

RESUMEN

Objective: To determine the clinical epidemiological characteristics of newly reported human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)in southwestern China from 2001 to 2017. Methods: Clinical data of newly diagnosed HIV/AIDS from 2001 to 2017 in the West China Hospital of Sichuan University were reviewed and analyze. Results: A total of 1 520 228 patients were screened for HIV, including 285 983 outpatient and emergency patients and 1 234 245 inpatients. About 4 037 (0.27%) patients were confirmed with HIV/AIDS. The confirmation rate increased from 2001 to 2013, followed by a slight decline from 2014 to 2017. The male to female sex ratio of confirmed HIV/AIDS was 3.49:1 from 2001 to 2017, ranging from 1.65:1 to 5.08:1. The majority of patients were identified as Han (88.23%), had low education (58.66%), and married (54.75%). Peasants/herdsman comprised 26.33% of the patients. The proportion of young (15-29 years old), and middle-aged (≥50 years old) patients and those who were unmarried and had high education (senior high school and above) increased over time. Heterosexual transmission remained stable at about 60% while homosexual transmission increased by about 15% ( χ 2=14.436, P<0.005) since 2008. Transmissions through drug abuse( χ 2=71.633, P<0.005) and blood( χ 2=16.672, P<0.005) decreased. Of the 899 female newly reported HIV/ADIS patients, 77.20% were infected through heterosexual relationship. In comparison, of the 3 138 male patients, 61.41% were infected through heterosexual and 18.10% through homosexual relationships. Homosexual transmissions decreased with age, but heterosexual transmissions increased with age. Mother-to-child transmissions were concentrated in those between 0 and 15 years old (100%). Conclusion: Newly diagnosed HIV/AIDS cases increased over the years in the West China Hospital of Sichuan University, in particular in those of young and middle-aged, highly educated and unmarried. Heterosexual transmissions remain the main route.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Infecciones por VIH/epidemiología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , China/epidemiología , Femenino , Infecciones por VIH/transmisión , Hospitales Generales , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Persona de Mediana Edad , Distribución por Sexo , Adulto Joven
18.
Int Health ; 11(5): 321-323, 2019 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-31529115

RESUMEN

The low-income developing countries require increased development assistance for health (DAH) to achieve Sustainable Development Goal 3, 'Healthy Lives for All'. DAH has a proven track record. DAH expanded during 2001-2008, with significant health gains in the LIDCs, but then stopped expanding in the wake of the 2008 financial crisis. The Global Fund to Fight AIDS, TB and Malaria requires around US$31.8 billion during 2021-2023 to maintain a trajectory to end the three epidemics by 2030, yet donors have so far signaled that they are prepared to offer less than half that sum, around US$14 billion.


Asunto(s)
Países en Desarrollo/economía , Epidemias/prevención & control , Salud Global/economía , Cooperación Internacional , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Humanos , Malaria/epidemiología , Malaria/prevención & control , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Estados Unidos
19.
BMC Infect Dis ; 19(Suppl 1): 783, 2019 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-31526371

RESUMEN

BACKGROUND: The 2016 'Start Free, Stay Free, AIDS Free' global agenda, builds on the 2011-2015 'Global Plan'. It prioritises 22 countries where 90% of the world's HIV-positive pregnant women live and aims to eliminate vertical  transmission of HIV (EMTCT) and to keep mothers alive. By 2019, no Global Plan priority country had achieved EMTCT; however, 11 non-priority countries had. This paper synthesises the characteristics of the first four countries validated for EMTCT, and of the 21 Global Plan priority countries located in Sub-Saharan Africa (SSA). We consider what drives vertical transmission of HIV (MTCT) in the 21 SSA Global Plan priority countries. METHODS: A literature review, using PubMed, Science direct and the google search engine was conducted to obtain global and national-level information on current HIV-related context and health system characteristics of the first four EMTCT-validated countries and the 21 SSA Global Plan priority countries. Data representing only one clinic, hospital or region were excluded. Additionally, key global experts working on EMTCT were contacted to obtain clarification on published data. We applied three theories (the World Health Organisation's building blocks to strengthen health systems, van Olmen's Health System Dynamics framework and Baral's socio-ecological model for HIV risk) to understand and explain the differences between EMTCT-validated and non-validated countries. Additionally, structural equation modelling (SEM) and linear regression were used to explain associations between infant HIV exposure, access to antiretroviral therapy and two outcomes: (i) percent MTCT and (iii) number of new paediatric HIV infections per 100 000 live births (paediatric HIV case rate). RESULTS: EMTCT-validated countries have lower HIV prevalence, less breastfeeding, fewer challenges around leadership, governance within the health sector or country, infrastructure and service delivery compared with Global Plan priority countries. Although by 2016 EMTCT-validated countries and Global Plan priority countries had adopted a public health approach to HIV prevention, recommending lifelong antiretroviral therapy (ART) for all HIV-positive pregnant and lactating women, EMCT-validated countries had also included contact tracing such as assisted partner notification, and had integrated maternal and child health (MCH) and sexual and reproductive health (SRH) services, with services for HIV infection, sexually transmitted infections, and viral hepatitis. Additionally, Global Plan priority countries have limited data on key SRH indicators such as unmet need for family planning, with variable coverage of antenatal care, HIV testing and triple antiretroviral therapy (ART) and very limited contact tracing. Structural equation modelling (SEM) and linear regression analysis demonstrated that ART access protects against percent MTCT (p<0.001); in simple linear regression it is 53% protective against percent MTCT. In contrast, SEM demonstrated that the case rate was driven by the number of HIV exposed infants (HEI) i.e. maternal HIV prevalence (p<0.001). In linear regression models, ART access alone explains only 17% of the case rate while HEI alone explains 81% of the case rate. In multiple regression, HEI and ART access accounts for 83% of the case rate, with HEI making the most contribution (coef. infant HIV exposure=82.8, 95% CI: 64.6, 101.1, p<0.001 vs coef. ART access=-3.0, 95% CI: -6.2, 0.3, p=0.074). CONCLUSION: Reducing infant HIV exposure, is critical to reducing the paediatric HIV case rate; increasing ART access is critical to reduce percent MTCT. Additionally, our study of four validated countries underscores the importance of contact tracing, strengthening programme monitoring, leadership and governance, as these are potentially-modifiable factors.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/transmisión , VIH/inmunología , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Salud Reproductiva , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adolescente , África del Sur del Sahara/epidemiología , Lactancia Materna , Niño , Preescolar , Trazado de Contacto , Femenino , Seropositividad para VIH , Humanos , Lactante , Lactancia , Modelos Lineales , Masculino , Tamizaje Masivo , Madres/educación , Embarazo , Atención Prenatal , Prevalencia , Servicios de Salud Reproductiva , Organización Mundial de la Salud , Adulto Joven
20.
BMJ Support Palliat Care ; 9(4): 404-412, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31537580

RESUMEN

INTRODUCTION: The incidence of some fatal diseases, including HIV/AIDS, accompanied by depression has become a significant concern in developed, developing and underdeveloped countries. A great deal of time and money are spent on controlling and reducing the complications of this infection across the world. Accordingly, the main purpose of this study was to clarify the global prevalence rate of depression in patients living with HIV/AIDS via a systematic review and meta-analysis. METHODOLOGY: All articles in English, published between 2000 and 2018, were systematically searched from the original databases of Web of Science, PubMed, Scopus, Cochrane Library, Google Scholar and Embase. As a result, a total of 118 articles were identified. RESULTS: The total sample size in these articles was 51143 people, and the number of patients suffering from moderate and severe levels of depression was 14 942. The results of the analysis based on the random-effects (DerSimonian and Laird) model revealed that the prevalence rate of depression in patients with HIV/AIDS was 31% (95% CI 28% to 34%), with a 98% heterogeneity index which was reported significant. Meanwhile, the highest prevalence rate of depression based on continent was in South America at 44% (95% CI 35% to 53%) and the lowest rate was in Europe at 22% (95% CI 17% to 27%). CONCLUSION: In general, there was a higher prevalence rate of depression in developing and underdeveloped countries than in developed countries, which could be attributed to the advancement of science and the possibilities for early diagnosis of this syndrome. TRIAL REGISTRATION NUMBER: CRD42019119137.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Depresión/epidemiología , Depresión/etiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Síndrome de Inmunodeficiencia Adquirida/psicología , Depresión/psicología , Infecciones por VIH/psicología , Humanos , Prevalencia
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