Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33.635
Filtrar
1.
Med. clín (Ed. impr.) ; 162(3): 95-102, Feb. 2024. tab, graf
Artículo en Español | IBECS | ID: ibc-230150

RESUMEN

Objetivo: Estimar la prevalencia de uso diario de profilaxis preexposición (PrEP) frente al VIH 6 meses después de aprobarse su financiación pública en España e identificar los factores asociados en una muestra nacional de hombres gais, bisexuales y otros hombres que tienen sexo con hombres (GBHSH). Material y métodos: Se analizaron 4.692 hombres GBHSH no diagnosticados de VIH reclutados mediante un cuestionario online difundido a nivel nacional a través de apps y webs de contacto gay entre mayo y julio de 2020. Se estimó la proporción de participantes que usaban PrEP diaria y se identificaron factores asociados mediante regresión de Poisson con variancia robusta. Resultados: El 2,8% (IC 95% 2,3-3,3) de los participantes refirió usar PrEP diariamente. El uso diario de PrEP se asoció de forma independiente con: haber sido reclutado en programas comunitarios, ser mayor de 30 años, residir en grandes ciudades, vivir abiertamente su vida sexual con hombres, haber tenido relaciones anales sin preservativo con más de 10 parejas sexuales, haber consumido drogas para sexo, especialmente drogas chemsex, y haber sido diagnosticado de alguna infección de transmisión sexual. Conclusión: Transcurridos 6 meses desde la aprobación de la PrEP en España, se observa una baja prevalencia de uso diario en una muestra nacional de hombres GBHSH. Es necesario promover el acceso, la demanda y el interés por la PrEP, especialmente entre los hombres GBHSH jóvenes, residentes en ciudades pequeñas y medianas y los que ocultan sus relaciones con otros hombres.(AU)


Objective: We aim to estimate the prevalence of daily HIV pre-exposure prophylaxis (PrEP) use 6 months after public funding approval in Spain and identify associated factors in a national sample of gay, bisexual and other men who have sex with men (GBMSM). Material and methods: We analysed 4692 HIV-undiagnosed GBMSM men recruited via an online questionnaire distributed nationally via gay contact apps and websites between May and July 2020. We estimated the proportion of participants using daily PrEP and identified associated factors using Poisson regression with robust variance. Results: Daily PrEP use was reported by 2.8% (95% CI 2.3-3.3) of all participants. Daily PrEP use was independently associated with being recruited into community programmes, being older than 30 years, living in a large city, living with men, having condomless anal intercourse with more than 10 sexual partners, using drugs for sex, especially chemsex drugs, and being diagnosed with a sexually transmitted infection. Conclusion: Six months after PrEP was approved in Spain, the prevalence of daily use is low in a national sample of GBMSM men. There is a need to promote access, demand and interest in PrEP, especially among young GBMSM men, those living in small and medium-sized cities, and those who hide their relationships with other men.(AU)


Asunto(s)
Humanos , Masculino , Femenino , VIH , Profilaxis Pre-Exposición , Prevalencia , Minorías Sexuales y de Género , Infecciones por VIH/prevención & control , Enfermedades Transmisibles , Control de Enfermedades Transmisibles , España , Encuestas y Cuestionarios , Estudios Transversales
2.
BMC Med Res Methodol ; 24(1): 44, 2024 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-38368350

RESUMEN

BACKGROUND: The residual life of a patient with human immunodeficiency virus (HIV) is of major interest to patients and their physicians. While existing analyses of HIV patient survival focus mostly on data collected at baseline, residual life analysis allows for dynamic analysis based on additional data collected over a period of time. As survival times typically exhibit a right-skewed distribution, the median provides a more useful summary of the underlying distribution than the mean. In this paper, we propose an efficient inference procedure that fits a semiparametric quantile regression model assessing the effect of longitudinal biomarkers on the residual life of HIV patients until the development of dyslipidemia, a disease becoming more prevalent among those with HIV. METHODS: For estimation of model parameters, we propose an induced smoothing method that smooths nonsmooth estimating functions based on check functions. For variance estimation, we propose an efficient resampling-based estimator. The proposed estimators are theoretically justified. Simulation studies are used to evaluate their finite sample performances, including their prediction accuracy. We analyze the Korea HIV/AIDS cohort study data to examine the effects of CD4 (cluster of differentiation 4) cell count on the residual life of HIV patients to the onset of dyslipidemia. RESULTS: The proposed estimator is shown to be consistent and normally distributed asymptotically. Under various simulation settings, our estimates are approximately unbiased. Their variances estimates are close to the empirical variances and their computational efficiency is superior to that of the nonsmooth counterparts. Two measures of prediction performance indicate that our method adequately reflects the dynamic character of longitudinal biomarkers and residual life. The analysis of the Korea HIV/AIDS cohort study data shows that CD4 cell count is positively associated with residual life to the onset of dyslipidemia but the effect is not statistically significant. CONCLUSIONS: Our method enables direct prediction of residual lifetimes with a dynamic feature that accommodates data accumulated at different times. Our estimator significantly improves computational efficiency in variance estimation compared to the existing nonsmooth estimator. Analysis of the HIV/AIDS cohort study data reveals dynamic effects of CD4 cell count on the residual life to the onset of dyslipidemia.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Dislipidemias , Infecciones por VIH , Humanos , Estudios de Cohortes , VIH , Análisis de Regresión , Simulación por Computador , Biomarcadores , República de Corea/epidemiología
3.
PLoS One ; 19(2): e0298038, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38354134

RESUMEN

Limited evidence is available on the vulnerability of Adolescent Girls and Young Women (AGYW) to sexual risk behaviour and STI/HIV. Though there are almost no statistics available on vulnerability, related literature suggests that AGYW have low awareness about sexual risk behaviour/ transmission and the prevalence of STI/HIV, making them vulnerable. We conducted a rapid review of peer-reviewed studies addressing transmission network, prevalence, incidence awareness, common determinants of sexual risk behaviour/STI/HIV, health-seeking behaviour and existing interventions addressing the situation among AGYW (age 15-24) to inform the evidence gap in this crucial area of research. We registered the study in PROSPERO (CRD42023403713). We developed detailed inclusion/exclusion criteria, searched JSTOR, PubMed, Google Scholar, Science Direct and Population Council Knowledge Commons databases and followed the guidance from Cochrane Rapid Review to develop the rapid review. We also searched the bibliography of the included studies. We included the English language peer-reviewed quantitative, qualitative, mixed method studies published from Jan 1 2000 to Mar 31 2023. Six reviewers extracted data, and the seventh reviewer independently assessed the quality. Ninety-six studies met the inclusion criteria. We used descriptive statistics and narrative synthesis methods for data analysis. We also conducted a Risk of Bias Assessment (RoB) to check the quality of the included studies. Inadequate literature was found on the transmission network. Prevalence and awareness of STI/HIV are low among AGYW. However, Female Sex Workers, sex-trafficked women or drug users in this age group suffer more. Age, education, income, relationship dynamics with spouses/partners, multiple partners, and substance use are crucial in determining STI/HIV. Traditional sources of health seeking are more popular than formal sources because of social stigma. Mass media campaigns, community mobilization programs, and life skills training programs increase awareness about HIV, condom use and self-efficacy. The inclusion of only English language studies and not conducting meta-analysis because of high heterogeneity are some of the limitations of the study.


Asunto(s)
Infecciones por VIH , Trabajadores Sexuales , Enfermedades de Transmisión Sexual , Adolescente , Adulto , Femenino , Humanos , Adulto Joven , VIH , Infecciones por VIH/epidemiología , India/epidemiología , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología
4.
Indian J Pathol Microbiol ; 67(1): 226-229, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38358229

RESUMEN

Primary effusion lymphoma and its tissue-based subtype extracavitary/solid variant was first described in human immunodeficiency virus (HIV)-seropositive patients. We report the case of a 50-year-old HIV-seronegative male patient who presented with icterus and cholestasis. Computed tomography revealed a 80 × 56 mm abdominal mass. Fine-needle aspiration biopsy was performed from the celiac lymph nodes and pancreatic head, under endoscopic ultrasonography guidance. A duodenal endoscopic biopsy was taken from the infiltration area, and a core biopsy was performed for the portal hilar mass. All biopsies showed similar cytohistopathological features. LCA-positive lymphoid neoplasia had a plasmacytoid/anaplastic morphology and null cell phenotype. HHV-8 and Epstein-Barr virus-encoded small RNAs (EBER) were diffuse positive. The patient, who did not have an effusion, was diagnosed with an extracavitary/solid variant of primary effusion lymphoma. Virus-associated lymphoproliferative disorders should be considered in the differential diagnosis of patients without a history of immunosuppression or HIV infection.


Asunto(s)
Infecciones por Virus de Epstein-Barr , Infecciones por VIH , Linfoma de Efusión Primaria , Humanos , Masculino , Persona de Mediana Edad , VIH , Infecciones por VIH/complicaciones , Linfoma de Efusión Primaria/diagnóstico , Linfoma de Efusión Primaria/patología , Herpesvirus Humano 4/genética , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/diagnóstico , Infecciones por Virus de Epstein-Barr/patología , Biopsia
5.
BMC Public Health ; 24(1): 440, 2024 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-38347483

RESUMEN

BACKGROUND: Due to the chronic nature of HIV, mental health has become a critical concern in people living with HIV (PLWHIV). However, little knowledge exists about the association between fear of progression (FoP) and medical coping modes (MCMs) in PLWHIV in China. METHODS: A cohort of 303 PLWHIV were consecutively enrolled and their demographic, clinical and psychological information was collected. The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS), Internalized HIV Stigma Scale (IHSS) and MCMs Questionnaire were utilized. RESULTS: Of the participants, 215 PLWHIV were classified into the low-level FoP group, and 88 were grouped into the high-level FoP group based on their FoP-Q-SF scores, according to the criteria for the classification of dysfunctional FoP in cancer patients. The high-level group had a higher proportion of acquired immunodeficiency syndrome (AIDS) stage (P = 0.005), lower education levels (P = 0.027) and lower income levels (P = 0.031). Additionally, the high-level group had lower scores in social support (P < 0.001) and its three dimensions, with total SSRS scores showing a negative correlation with two dimensions of FoP-Q-SF, namely physical health (r2 = 0.0409, P < 0.001) and social family (r2 = 0.0422, P < 0.001). Further, the high-level group had higher scores in four dimensions of internalized HIV stigma, and a positive relationship was found to exist between IHSS scores and FoP-Q-SF scores for physical health (r2 = 0.0960, P < 0.001) and social family (r2 = 0.0719, P < 0.001). Social support (OR = 0.929, P = 0.001), being at the AIDS stage (OR = 3.795, P = 0.001), and internalized HIV stigma (OR = 1.028, P < 0.001) were independent factors for FoP. Furthermore, intended MCMs were evaluated. FoP were positively correlated with avoidance scores (r2 = 0.0886, P < 0.001) and was validated as the only factor for the mode of confrontation (OR = 0.944, P = 0.001) and avoidance (OR = 1.059, P = 0.001) in multivariate analysis. CONCLUSION: The incidence of dysfunctional FoP in our study population was relatively high. High-level FoP was associated with poor social support, high-level internalized HIV stigma and a negative MCM among PLWHIV.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Humanos , Estudios Transversales , VIH , Progresión de la Enfermedad , Miedo/psicología , Infecciones por VIH/epidemiología , Encuestas y Cuestionarios
6.
Reprod Health ; 21(1): 21, 2024 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-38321482

RESUMEN

BACKGROUND: Adolescent girls and young woman (AGYW) comprise a significant proportion of new HIV infections and unintended pregnancies in sub-Saharan Africa yet face many barriers to accessing family planning and reproductive health (FPRH) information and services. Developed via human-centered design, the Malkia Klabu ("Queen Club") program aimed to facilitate access to HIV self-testing (HIVST) and FPRH information and products at privately-owned drug shops. We sought to understand barriers and facilitators to program implementation in a 4-month pilot in Tanzania. METHODS: Forty semi-structured interviews were conducted with participants in a cluster randomized trial of the Malkia Klabu program from November 2019 through March 2020, including 11 with AGYW, 26 with drug shopkeepers, and three with counselors at health facilities to whom AGYW were referred. Interviews were audio-recorded, transcribed, coded, and analyzed to identify key themes. The Consolidated Framework for Implementation Research (CFIR) was used to assess barriers and facilitators to program implementation at multiple levels. CFIR considers the outer setting (e.g., culture and systemic conditions), the inner setting where the intervention is implemented (e.g., incentives, relationships, and available resources), the individuals involved, the innovation as it relates to stakeholder needs, and the implementation process. RESULTS: The Malkia Klabu program reshaped and directed the role of drug shopkeepers as providers of information and resources rather than FPRH gatekeepers. Key implementation facilitators included the program's adaptability to a wide range of needs and stages of readiness among AGYW, ability to capitalize on AGYW social networks for driving membership, responsiveness to AGYW's need for privacy, and positive contributions to the income and community standing of drug shopkeepers. Components such as HIVST were highly acceptable to both AGYW and shopkeepers, and the introduction of the loyalty program and HIVST kits in shops opened doors to the provision of FPRH products and information, which was further facilitated by program tools such as videos, product displays, and symbol cards. Although some shopkeepers maintained beliefs that certain contraceptive methods were inappropriate for AGYW, most appeared to provide the products as part of the program. CONCLUSIONS: The Malkia Klabu intervention's success was due in part to its ability to address key motivations of both AGYW and drug shopkeepers, such as maintaining privacy and increasing access to FPRH products for AGYW and increasing business for shops. Better understanding these implementation barriers and facilitators can inform the program's future adaptation and scale-up. TRIAL REGISTRATION: clinicaltrials.gov #NCT04045912.


Adolescent girls and young women (AGYW) in sub-Saharan Africa have limited access to family planning and reproductive health products and information even though they are at greater risk of pregnancy and HIV infection. The Malkia Klabu intervention was designed with AGYW and shopkeepers from private drug shops to facilitate access to products and information through a loyalty program that included free products, prizes for purchases, educational videos, and a non-verbal system of requesting products through symbols. Qualitive interviews with AGYW, drug shop staff, and health system counselors suggested that the program helped provide greater privacy and confidence to AGYW while bringing new business to drug shops. These findings can help as the study team charts a pathway for scaling up the intervention.


Asunto(s)
Infecciones por VIH , Adolescente , Femenino , Humanos , Anticoncepción , VIH , Autoevaluación , Tanzanía
7.
BMC Infect Dis ; 24(1): 160, 2024 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-38308222

RESUMEN

The pathological consequences of inflammation persist in people living with the human immunodeficiency virus (PLWH), regardless of the positive outcomes of highly active antiretroviral therapy (HAART). The current systematic review and meta-analysis aims to understand and explore the levels of high-sensitivity C-reactive protein (hs-CRP) and other cardiovascular disease (CVD)-risk factors including lipid profiles among PLWH on HAART. Major electronic databases including PubMed, Scopus, and Web of Science were searched to retrieve relevant global literature reporting on hs-CRP levels in PLWH on HAART. A total of twenty-two studies with an average participant age of 40 years were eligible for this systematic review and meta-analysis. Majority of the included studies were from Africa (n = 11), the United States (n = 6), and Europe (n = 5). Our systemic review showed that most studies reported increased levels of hs-CRP among PLWH on HAART when compared to controls (PLWH not on HAART or those without HIV), especially in studies from Africa. This was supported by a meta-analysis showing significantly elevated levels of hs-CRP in PLWH on HAART when compared to PLWH not on HAART (standardised mean difference [SMD] = 0.56; 95% CI = 0.10­1.01, z = 2.41; p = 0.02) or those without HIV (SMD = 1.19; 95% CI = 0.76­1.63, z = 5.35; p < 0.001). Where lipid profiles, as a major predictor for CVD risk, were also impaired in PLWH on HAART when compared to PLWH not on HAART and HIV-negative participants. In conclusion, elevated levels of hs-CRP and lipid levels are prevalent in PLWH on HAART, this may increase the risk of CVD complications, especially for those people living in Africa. However, more evidence in larger population studies is required to confirm these outcomes and unveil any possible clinical implications of HAART-induced modulation of hs-CRP levels in PLWH.


Asunto(s)
Enfermedades Cardiovasculares , Infecciones por VIH , Humanos , Adulto , Terapia Antirretroviral Altamente Activa , Proteína C-Reactiva , VIH , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/complicaciones , Lípidos
8.
PLoS One ; 19(2): e0291082, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38346046

RESUMEN

A retrospective facility-based costing study was undertaken to estimate the comparative cost per visit of five integrated sexual and reproductive health and HIV (human immuno-deficiency virus) services (provider perspective) within five clinic sites. These five clinics were part of four service delivery models: Non-governmental-organisation (NGO) directly managed model (Chitungwiza and New Africa House sites), NGO partner managed site (Mutare site), private-public-partnership (PPP) model (Chitungwiza Profam Clinic), and NGO directly managed outreach (operating from New Africa House site. In addition client cost exit interviews (client perspective) were conducted among 856 female clients exiting integrated services at three of the sites. Our costing approach involved first a facility bottom-up costing exercise (February to April 2015), conducted to quantify and value each resource input required to provide individual SRH and HIV services. Secondly overhead financial expenditures were allocated top-down from central office to sites and then respective integrated service based on pre-defined allocation factors derived from both the site facility observations and programme data for the prior 12 months. Costs were assessed in 2015 United States dollars (USD). Costs were assessed for HIV testing and counselling, screening and treatment of sexually transmitted infections, tuberculosis screening with smear microscopy, family planning, and cervical cancer screening and treatment employing visual inspection with acetic acid and cervicography and cryotherapy. Variability in costs per visit was evident across the models being highest for cervical cancer screening and cryotherapy (range: US$6.98-US$49.66). HIV testing and counselling showed least variability (range; US$10.96-US$16.28). In general the PPP model offered integrated services at the lowest unit costs whereas the partner managed site was highest. Significant client costs remain despite availability of integrated sexual and reproductive health and HIV services free of charge in our Zimbabwe study setting. Situating services closer to communities, incentives, transport reimbursements, reducing waiting times and co-location of sexual and reproductive health and HIV services may help minimise impact of client costs.


Asunto(s)
Infecciones por VIH , Servicios de Salud Reproductiva , Neoplasias del Cuello Uterino , Humanos , Femenino , Infecciones por VIH/diagnóstico , VIH , Salud Reproductiva , Zimbabwe , Estudios Retrospectivos , Neoplasias del Cuello Uterino/diagnóstico , Detección Precoz del Cáncer
9.
S Afr Fam Pract (2004) ; 66(1): e1-e7, 2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38299523

RESUMEN

BACKGROUND:  Human immunodeficiency virus (HIV) management guidelines have evolved from initiating therapy at CD4 counts of ≤ 200 cells/m3 to implementing universal test and treat (UTT). This study aimed to assess whether in clinical practice, patients are presenting with higher baseline CD4 counts, describe the incidence of opportunistic infections and the proportion that achieved viral suppression. METHODS:  A retrospective cohort design with convenience sampling was conducted. Cohort 1 included patients initiated on antiretroviral therapy (ART) between 01 January 2014 and 31 December 2014, when criteria were set at CD4 count ≤ 350 cells/mm3. Cohort 2 included patients initiated on ART between 01 January 2019 and 31 December 2019, during the UTT era. RESULTS:  At ART initiation, the median CD4 cell was 170 cells/mm3 (interquartile range [IQR]: 85.5-287) in Cohort 1 cells/mm3 and 243 cells/mm3 (IQR: 120-411) in Cohort 2. Tuberculosis was the predominant OI in the group with CD4 cell count ≤ 200 cells/m3 in both Cohort 1 (26.8%) and Cohort 2 (27.9%), p = 0.039. At 1 year, virological suppression was achieved in only 77.7% and 84.7% of Cohorts 1 and 2 patients. CONCLUSION:  A notable portion of patients at King Edward VIII Hospital's HIV clinic commenced ART with CD4 counts significantly below the recommended guideline thresholds.Contribution: The research revealed a delay in initiating ART. A comprehensive reevaluation is essential to pinpoint the factors contributing to this delay and to devise customised interventions.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Humanos , VIH , Fármacos Anti-VIH/uso terapéutico , Estudios Retrospectivos , Sudáfrica/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología
10.
Niger J Clin Pract ; 27(1): 82-88, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38317039

RESUMEN

BACKGROUND: Children infected with the human immunodeficiency virus (HIV) may be more prone to helminthic infestation because they have depleted immunity, which increases their susceptibility to infection and infestations, even with minimally pathogenic organisms such as helminths. AIM: The prevalence and pattern of intestinal helminthiasis among children living with HIV attending the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu. PATIENTS AND METHODS: A cross-sectional study in which 70 HIV-infected children were consecutively recruited from the Pediatric HIV clinic and matched for age and sex with 70 children recruited from the children outpatient clinic (CHOP) of UNTH Ituku-Ozalla. Stool samples of study participants were collected and analyzed using the Kato-Katz method and subsequently examined under the microscope for helminths' eggs and larvae. The worm intensity was determined using the theoretical analytic sensitivity (TAS) of 24 eggs per gram (EPG) to obtain the number of eggs per gram of feces. The CD4+ count, which describes the severity of immunosuppression in HIV-positive children was determined using the PARTEC Cyflow counter for the CD4+ lymphocyte count, whereas HIV screening was performed using the rapid diagnostic tests for HIV (Determine, Statpack and Unigold). Data were analyzed using IBM SPSS. RESULTS: The prevalence of intestinal helminthiasis among HIV-infected and non-infected children was 27.1% and 12.9%, respectively (P = 0.038). HIV-positive children were more likely to have intestinal helminthiasis than HIV-negative children (odds ratio [OR] =2.525, 95% confidence interval [CI]: 1.052-6.063). Ascaris lumbricoides was the predominant helminthic species in both HIV-infected and non-infected groups; however, there was no statistical significance between intestinal helminthic species and HIV status (P = 0.655) but the severity of intestinal helminthiasis was significantly associated with decreasing CD4+ count (P = 0.028). The risk factors for intestinal helminthic infestation examined were similar in both HIV-positive and HIV-negative children (P > 0.05). CONCLUSION: There was a significantly higher prevalence of helminthic infestation among HIV-infected children compared to their HIV-negative counterparts. The severity of intestinal helminthiasis was significantly associated with decreasing CD4+ count.


Asunto(s)
Infecciones por VIH , Seropositividad para VIH , Helmintiasis , Helmintos , Parasitosis Intestinales , Niño , Animales , Humanos , VIH , Prevalencia , Estudios Transversales , Nigeria/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Hospitales de Enseñanza , Heces/parasitología
12.
Br J Nurs ; 33(1): S6-S9, 2024 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-38194321

RESUMEN

OBJECTIVE: A documentation audit was performed to explore the multidisciplinary working of a community HIV specialist service (CHSS). The audit identified the wide range of services to which people living with HIV are referred as part of the care they receive within the CHSS. DESIGN: A retrospective documentation audit was used. SETTING: The CHSS, consisting of three teams covering a wide geographical area across West Sussex and Brighton and Hove. A total of 30 patients' notes were audited, including 10 patients from each team to ensure the results were representative of the service as a whole. RESULTS: The audit showed that, on average, each person received five onward referrals to other health care, social care, or HIV-specific services, with a range of between 1 and 12, as a result of being under the care of the CHSS. The types of referrals varied, with 46% being to HIV specialist services and the remaining 54% to non-HIV specific services, including GPs, social services and other health services. Overall, the audit showed not only the holistic care and assessments completed but also the benefit and increased access to other services and care as a result of community HIV team involvement. CONCLUSION: The audit highlights the importance of continuing to develop HIV community services to cater for this changing population, as well as identifying possible areas of development. The results also demonstrate the vital role that CHSSs have in supporting hard-to-reach patients.


Asunto(s)
Infecciones por VIH , VIH , Humanos , Estudios Retrospectivos , Servicio Social , Bienestar Social
13.
J Health Popul Nutr ; 43(1): 3, 2024 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-38167573

RESUMEN

INTRODUCTION: The biggest health problem in East Africa is the human immunodeficiency virus (HIV). Combating stigma and discrimination related to HIV/AIDS is a key goal of many international organizations in their efforts to ensure universal access to HIV/AIDS prevention, treatment, care, and support programs. However, previous studies in various regions of Africa have shown that the prevalence of discriminatory attitudes related to HIV/AIDS is particularly high. Furthermore, there is a current evidence gap in the region. Therefore, the aim of this study was to determine the prevalence of discriminatory attitude toward HIV/AIDS patients, and its associated factors among women in East African countries. METHODS: The data we utilized were gathered from the most recent Demographic and Health Surveys (DHS), which were carried out in east African nations between 2016 and 2022. We integrated DHS data from ten countries into our investigation. For our analysis, a weighted sample of 139,812 women overall was employed. The analysis used multiple logistic regressions. The adjusted odds ratio and its 95% confidence interval were then shown, and components with binary logistic regression p values of less than or equal to 0.2 and < 0.05 were regarded as significant predictors of discrimination against HIV/AIDS patients. RESULTS: In this study, 32.73% (95% CI 34.48-32.97) of respondents had a discriminatory attitude toward HIV/AIDS patients. In the multiple logistic regression analysis, being in the older age groups, having a better education level, being from a wealthy household, having employment status, having ANC follow-up, institutional delivery, mass media exposure, and having female household heads were associated with higher odds of not having a discriminatory attitude toward HIV/AIDS patients. However, being unmarried and living far from the health facilities were associated with higher odds of discriminatory attitudes toward HIV/AIDS patients. CONCLUSION: This study concluded that women in East Africa still had a very discriminatory attitude toward HIV/AIDS patients. The good news for East Africa is that prevalence has decreased when compared to earlier findings. Improving women's empowerment, maternal health services, and health facilities' accessibility are crucial.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Femenino , Humanos , Síndrome de Inmunodeficiencia Adquirida/epidemiología , África Oriental/epidemiología , VIH , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control
14.
BMC Microbiol ; 24(1): 6, 2024 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-38172680

RESUMEN

BACKGROUND: People living with HIV (PLWH) with chronic inflammation may have an increasing risk for coronavirus disease 2019 (COVID-19) severity; however, the impact of their gut microbiota on COVID-19 is not fully elucidated. Here, we analyzed the temporal changes in the gut microbiota composition of hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected PLWH (PLWH-CoV) and their correlation with COVID-19 severity. RESULT: The 16S rRNA analysis results using stool samples (along the timeline from disease onset) from 12 hospitalized PLWH-CoV, whose median CD4 + T cell count was 671 cells/µl, were compared to those of 19 healthy people and 25 PLWH. Bacterial diversity in PLWH-CoV is not significantly different from that of healthy people and SARS-CoV-2 non-infected PLWH, but a significant difference in the microbiota diversity was observed in the classification according to the disease severity. Immediately after the disease onset, remarkable changes were observed in the gut microbiota of PLWH-CoV, and the changing with a decrease in some short-chain fatty acid-producing bacteria and an increase in colitis-related pathobiont. In the second week after disease onset, relative amounts of specific bacteria distinguished between disease severity. One month after the disease onset, dysbiosis of the gut microbiota persisted, and the number of Enterobacteriaceae, mainly Escherichia-Shigella, which is potentially pathogenic, increased and were enriched in patients who developed post-acute sequelae of COVID-19 (PASC). CONCLUSION: The changes in the gut microbiota associated with SARS-CoV-2 infection observed in PLWH in this study indicated a persistent decrease in SCFA-producing bacteria and an intestinal environment with an increase in opportunistic pathogens associated with enteritis. This report demonstrates that the intestinal environment in PLWH tends to show delayed improvement even after COVID-19 recovery, and highlights the importance of the dysbiosis associated with SARS-CoV-2 infection as a potential factor in the COVID-19 severity and the PASC in PLWH.


Asunto(s)
COVID-19 , Microbioma Gastrointestinal , Infecciones por VIH , Humanos , VIH , COVID-19/complicaciones , Disbiosis , ARN Ribosómico 16S/genética , SARS-CoV-2 , Infecciones por VIH/complicaciones
15.
BMC Infect Dis ; 24(1): 52, 2024 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-38183027

RESUMEN

BACKGROUND: Human Immunodeficiency Virus (HIV) remains a significant global health burden, particularly affecting vulnerable populations residing in slum areas which is characterized by overcrowding, poverty, and limited access to healthcare services, create an environment conducive to the transmission and spread of HIV. Despite the recognition of this issue, there is a lack of comprehensive understanding regarding the prevalence of HIV in slums. The aim of this study was to systematically synthesize the existing global evidence on HIV prevalence in slum populations. METHODS: A rigorous systematic literature review was conducted by searching multiple electronic databases, including Medline via PubMed, Scopus, Embase, Web of Sciences, and Directory of Open Access Journals (DOAJ), covering the period from January 1, 1990, to March 31, 2023. The quality and risk of bias for each included study were assessed using the Newcastle-Ottawa Scale. The pooled prevalence with its corresponding 95% confidence interval (CI) was calculated using a random-effects model with the Freeman-Tukey double arcsine transformation. The degree of heterogeneity among the studies was evaluated using the I2 test. Publication bias was also assessed using Egger's test. Additionally, subgroup analysis was performed to explore potential factors contributing to the observed heterogeneity. RESULTS: A systematic examination of the relevant literature resulted in the inclusion of a total of 22 studies for the purpose of this meta-analysis. These studies collectively assessed a sizable cohort consisting of 52,802 participants. Utilizing a random-effects model, an estimation of the overall prevalence of HIV in the slum area was determined to be 10% (95% CI: 7-13%). Further delineation through subgroup analysis based on the gender revealed a higher prevalence of HIV among women, standing at 13% (95% CI: 8-19%, 18 studies: I2 = 98%), as opposed to men, where the prevalence was found to be 8% (95% CI: 6-12%, 16 studies: I2 = 95%). A geographical breakdown of the included studies revealed that Africa exhibited the highest prevalence, with a figure of 11% (95% CI: 9-13%, 18 studies: I2 = 98%). Subsequently, studies conducted in the American continent reported a prevalence of 9% (95% CI: 7-11%, 2 studies: I2 = 57%). The Asian continent, on the other hand, displayed the lowest prevalence of 1% (95% CI: 0-3%, 2 studies: I2 = 94%). Notably, studies employing rapid tests indicated a prevalence of 13% (95% CI: 9-17%, 6 studies: I2 = 94%), while those relying on self-reported data reported a lower prevalence of 8% (95% CI: 5-11%, 6 studies: I2 = 99%). Moreover, studies utilizing ELISA reported a prevalence of 9% (95% CI: 6-12%, 10 studies: I2 = 96%). Finally, it was determined that studies conducted in upper-middle-income countries reported a higher prevalence of 20% (95% CI: 16-24%, 5 studies: I2 = 45%), whereas studies conducted in lower- and middle-income countries reported a prevalence of 8% (95% CI: 6-10%, 12 studies: I2 = 98%). CONCLUSION: The current study elucidates the troublingly high prevalence of HIV infection within slums area. Also, this finding underscores the urgent necessity for targeted and tailored interventions specifically aimed at curtailing the spread of HIV within slums. Policymakers must take cognizance of these results and devote their efforts towards the implementation of effective strategies to mitigate gender disparities, address poverty alleviation, and empower the inhabitants of these marginalized areas.


Asunto(s)
Infecciones por VIH , VIH , Masculino , Humanos , Femenino , Áreas de Pobreza , Infecciones por VIH/epidemiología , Prevalencia , Pobreza
16.
Washington, D.C.; OPS; 2024-01-17.
en Portugués | PAHO-IRIS | ID: phr-59187

RESUMEN

Estas orientações descrevem ações estratégicas e soluções práticas para integrar o atendimento as DCNT a outros programas e sistemas de saúde mais amplos, conforme apropriado e relevante para o contexto do país. O objetivo é maximizar o atendimento em saúde dos serviços e ampliar o acesso a cuidados para as DCNT. O documento descreve experiências de implementação, barreiras e soluções pragmáticas para ambientes e contextos específicos, especialmente em locais com poucos recursos, tanto em PBMR quanto em países de alta renda. As perspectivas dos profissionais de saúde na linha de frente e dos pacientes são elementos fundamentais para a integração do atendimento em saúde das DCNT à APS. As orientações também abordam as interações entre médicos da linha de frente, enfermeiros, agentes comunitários de saúde, pacientes e comunidades. As orientações não pretendem substituir diretrizes sobre doenças clínicas específicas, o conjunto de serviços oferecidos ou a efetividade das intervenções. O público alvo são os formuladores de políticas, gerentes de programas e trabalhadores de serviços de saúde. As orientações também devem ser úteis para a OMS e para parceiros internacionais (incluindo doadores e bancos) que defendem a integração do atendimento das DCNT nos serviços de saúde e melhor gestão nos países.


Asunto(s)
VIH , Salud Reproductiva , Tuberculosis , Servicios de Salud
17.
Washington, D.C.; OPS; 2024-01-10.
en Español | PAHO-IRIS | ID: phr-59163

RESUMEN

En este documento de orientación se describen medidas estratégicas y soluciones prácticas para integrar los servicios de ENT en otros programas y sistemas de salud más amplios, según corresponda y sea pertinente para el contexto del país. El objetivo es aumentar al máximo el impacto de los servicios de salud y ampliar el acceso a la atención de las ENT. En el documento se describen experiencias de implementación, obstáculos y soluciones pragmáticas para entornos y contextos específicos, en especial entornos con recursos escasos, tanto en PIBM como en países de ingresos altos. Las perspectivas de los prestadores de servicios de primera línea y de las personas atendidas son elementos fundamentales para integrar los servicios de ENT en la APS. En esta orientación también se abordan las interacciones del personal médico, el personal de enfermería y los agentes de salud comunitarios de primera línea con las personas y las comunidades. El documento no pretende reemplazar las directrices sobre enfermedades clínicas concretas o conjuntos de servicios ni las relativas a la efectividad de las intervenciones. Las personas destinatarias son aquellas encargadas de formular políticas, dirigir programas o prestar servicios de salud. Este documento de orientación también debería ser de utilidad para la OMS y los colaboradores internacionales (incluidos los donantes y los bancos) que promueven un apoyo integrado para la prestación de servicios de ENT y una mejor gestión en los países.


Asunto(s)
VIH , Salud Reproductiva , Tuberculosis , Servicios de Salud
18.
PLoS One ; 19(1): e0296130, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38206975

RESUMEN

INTRODUCTION: Human Immunodeficiency Virus (HIV) prevalence among young gender-diverse (a wide range of gender identities for people whose gender identity is different from the sex that they were assigned at birth) individuals is high but testing coverage among this key population remains low. We aim to evaluate strategies for outreach, HIV testing, and linkage to proper management in young men-who-have-had-sex-with-men (MSM, homosexual male) and transgender women (TGW) in Bangkok, Thailand. METHODS: The "YM2M outreach program" consisted of two strategies: 1) online platforms (OP) and 2) physical outreach activities (POA). Participant questionnaires were completed on a voluntary basis during outreach activities during 2018-2021. Demographic and behavioral characteristics were assessed for association with HIV positivity. RESULTS: A total of 3,972 homosexual male and TGW participated in the YM2M program: 2,973 by OP and 999 by POA. Of 2,230 participants who reported gender identity, 603/1,392 (43.3%) of OP and 252/985 (25.6%) of POA were gender diverse. Of 631 (21.2%) participants in OP and 970 (97.1%) in POA who underwent testing, 286 (45.3%) in OP and 41 (4.2%) in POA were HIV-positive. The venue reporting highest HIV yield was the Mor-Lam (11.5%). Among those with an HIV-positive test, 175 (61.2%) from OP and 23 (51.1%) from POA were successfully linked to HIV care. The independent factors associated with HIV positive in OP were being youth (adjusted odd ratio (aOR), 0.37; 95%CI 0.16-0.81; P = 0.01) and suspected or confirmed STI (aOR 15.39; 95%CI 7.17-33.03, P<0.01); while those in in POA at Mor-Lam were being gender diverse (aOR, 8.43; 95%CI 1.94-36.62; P<0.01) and reactive syphilis test (aOR, 5.40;95%CI 2.45-11.88; P<0.01). Linkage to pre-exposure prophylaxis (PrEP) among HIV-negative participants was low, 4.9% and 2.6% in OP and POA participants, respectively. CONCLUSIONS: While uptake of HIV testing was higher in POA while OP was more effective in identifying undiagnosed people living with HIV/AIDS and linking them to care. Neither strategy was considered effective in linkage to PrEP.


Asunto(s)
Infecciones por VIH , Seropositividad para VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Personas Transgénero , Adolescente , Femenino , Humanos , Masculino , Identidad de Género , VIH , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/tratamiento farmacológico , Homosexualidad Masculina , Conducta Sexual , Tailandia/epidemiología
19.
BMC Infect Dis ; 24(1): 87, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38225550

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. METHODS: We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. RESULTS: A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. CONCLUSION: This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.


Asunto(s)
COVID-19 , Infecciones por VIH , Humanos , Masculino , Femenino , Adolescente , Adulto , VIH , COVID-19/epidemiología , Pandemias , Estudios Transversales , Vacunas contra la COVID-19/uso terapéutico , Venezuela/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología
20.
Medicine (Baltimore) ; 103(2): e36937, 2024 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-38215133

RESUMEN

This review delves into the intricate relationship between anemia, iron metabolism, and human immunodeficiency virus (HIV), aiming to unravel the interconnected pathways that contribute to the complex interplay between these 3 entities. A systematic exploration of relevant literature was conducted, encompassing studies examining the association between anemia, iron status, and HIV infection. Both clinical and preclinical investigations were analyzed to elucidate the underlying mechanisms linking these components. Chronic inflammation, a hallmark of HIV infection, disrupts iron homeostasis, impacting erythropoiesis and contributing to anemia. Direct viral effects on bone marrow function further compound red blood cell deficiencies. Antiretroviral therapy, while essential for managing HIV, introduces potential complications, including medication-induced anemia. Dysregulation of iron levels in different tissues adds complexity to the intricate network of interactions. Effective management of anemia in HIV necessitates a multifaceted approach. Optimization of antiretroviral therapy, treatment of opportunistic infections, and targeted nutritional interventions, including iron supplementation, are integral components. However, challenges persist in understanding the specific molecular mechanisms governing these interconnected pathways. Decoding the interconnected pathways of anemia, iron metabolism, and HIV is imperative for enhancing the holistic care of individuals with HIV/AIDS. A nuanced understanding of these relationships will inform the development of more precise interventions, optimizing the management of anemia in this population. Future research endeavors should focus on elucidating the intricate molecular mechanisms, paving the way for innovative therapeutic strategies in the context of HIV-associated anemia.


Asunto(s)
Anemia , Fármacos Anti-VIH , Infecciones por VIH , Humanos , Hierro , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , VIH , Anemia/tratamiento farmacológico , Fármacos Anti-VIH/uso terapéutico
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...