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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 367-372, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31631605

RESUMO

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.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , China/epidemiologia , Feminino , Infecções por HIV/transmissão , Hospitais Gerais , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Adulto Jovem
2.
Niger J Clin Pract ; 22(10): 1341-1348, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607722

RESUMO

Background: To reduce the number of new HIV infections among children, retesting of HIV negative pregnant women in labor to identify new infections and instituting appropriate modified obstetrics practices (MOP) has a huge role to play. Aims and Objectives: This study evaluated the HIV sero-positivity in labor among pregnant women who earlier tested negative in antenatal clinic, associated risk factors and the corresponding rate of mother-to-child transmission of HIV infection. Methods: This was a prospective observational study where pregnant women in labor who had earlier tested HIV negative in the antenatal clinic at Imo State University Teaching Hospital Orlu, Imo state, Nigeria, were retested. The infants of the women who seroconverted were tested for HIV infection at 6 weeks using Deoxyribonucleic acid polymerase chain reaction (DNA PCR) by collecting Dried Blood Sample. This study was conducted from October 2015 to March 2016. Result: Out of the 163 patients studied, 6 demonstrated HIV seroconversion giving a seroconversion rate of 3.7%. Deliveries from the seroconverted patients were 5 live births and 1 intrauterine fetal death. All the 5 live babies tested HIV negative at 6 weeks of age. Predictors of seroconversion in late pregnancy include spouse's HIV status and number of other sexual partners. Conclusion: Retesting of HIV negative pregnant women in labor to identify new infections and instituting appropriate modified obstetrics practices has a huge role to play in the prevention of mother to child transmission of HIV infection.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Soropositividade para HIV/sangue , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Trabalho de Parto/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Adulto , Anticorpos Antivirais/sangue , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Soropositividade para HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Masculino , Programas de Rastreamento/métodos , Nigéria/epidemiologia , Parto , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Prospectivos , Fatores de Risco , Soroconversão
4.
Niger J Clin Pract ; 22(9): 1259-1265, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489863

RESUMO

Background: The aim of this study was to evaluate the level of knowledge about HIV, and intraoral signs that can be seen in HIV positive patients and the interpretation of attitudes toward HIV positive patients of fourth- and fifth-grade students at Marmara University Faculty of Dentistry, Istanbul, Turkey. Material and Methods: In our study, a questionnaire consisting of 23 questions was applied to 100 fourth- and 100 fifth-grade students totalling 200 dental students who are educated in Marmara University Faculty of Dentistry. Besides the knowledge level of the students, their attitudes were evaluated using the survey conducted. Chi-square (or Fisher's exact test at appropriate locations) was used to examine the relationship between categorical variables. Statistical significance level was determined as P < 0.05. Results: Of the 200 participants, 46 (23.0%) were males and 154 (77.0%) were females. One hundred people (50%) are fourth grade, 100 people (50%) are fifth grade. The rate of fifth grade agreements for the question "Treatment of HIV positive patient increases the risk of transmission of HIV infection to dentist" was statistically higher than that of fourth-grade students (Fisher's exact P < 0,05). Fifth-grade knowledge of oral symptoms of HIV/AIDS was statistically higher than fourth grades (Fisher's exact P < 0.05). Conclusion: As the grade level increases, the knowledge about HIV/AIDS raises portraying a relevant approach to patients with AIDS. Comprehensive training and motivation for improving dentistry students' awareness against HIV-positive patients will also improve knowledge and attitudes of the students that enable them to take better care of HIV-positive patients.


Assuntos
Síndrome de Imunodeficiência Adquirida/psicologia , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Odontologia/psicologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , Educação em Odontologia , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , Inquéritos e Questionários , Turquia
5.
MMWR Morb Mortal Wkly Rep ; 68(30): 653-657, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31369525

RESUMO

During 2016, 6% of persons in the United States who received a diagnosis of human immunodeficiency virus (HIV) infection had their HIV infection attributed to injection drug use (1). Injection practices and sexual behaviors among HIV-positive persons who inject drugs, such as injection equipment sharing and condomless sex, can increase HIV transmission risk; nationally representative estimates of the prevalences of these behaviors are lacking. The Medical Monitoring Project (MMP) is an annual, cross-sectional survey that reports nationally representative estimates of clinical and behavioral characteristics among U.S. adults with diagnosed HIV (2). CDC used MMP data to assess high-risk injection practices and sexual behaviors among HIV-positive persons who injected drugs during the preceding 12 months and compared their HIV transmission risk behaviors with those of HIV-positive persons who did not inject drugs. During 2015-2017, approximately 10% (weighted percentage estimate) of HIV-positive persons who injected drugs engaged in distributive injection equipment sharing (giving used equipment to another person for use); nonsterile syringe acquisition and unsafe disposal methods were common. Overall, among HIV-positive persons who injected drugs, 80% received no treatment, and 57% self-reported needing drug or alcohol treatment. Compared with HIV-positive persons who did not inject drugs, those who injected drugs were more likely to have a detectable viral load (48% versus 35%; p = 0.008) and engage in high-risk sexual behaviors (p<0.001). Focusing on interventions that reduce high-risk injection practices and sexual behaviors and increase rates of viral suppression might decrease HIV transmission risk among HIV-positive persons who inject drugs. Successful substance use treatment could also lower risk for transmission and overdose through reduced injection.


Assuntos
Infecções por HIV/diagnóstico , Assunção de Riscos , Comportamento Sexual/psicologia , Abuso de Substâncias por Via Intravenosa/psicologia , Infecções por HIV/transmissão , Humanos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Estados Unidos/epidemiologia , Carga Viral/estatística & dados numéricos
6.
BMC Public Health ; 19(1): 1165, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455290

RESUMO

BACKGROUND: Self-harm in adolescents is of growing concern internationally but limited evidence exists on the prevalence of self-harm in those living with HIV, who may be at higher risk of poor mental health outcomes. Therefore our aim was to determine the prevalence and predictors of self-harm among young people with perinatally-acquired HIV (PHIV) and HIV negative (with sibling or mother living with HIV) young people living in England. METHODS: 303 PHIV and 100 HIV negative young people (aged 12-23 years) participating in the Adolescents and Adults Living with Perinatal HIV cohort study completed an anonymous self-harm questionnaire, as well as a number of standardised mental-health assessments. Logistic regression investigated predictors of self-harm. RESULTS: The median age was 16.7 years in both groups, and 40.9% of the PHIV and 31.0% of the HIV negative groups were male. In total 13.9% (56/403) reported having ever self-harmed, with no difference by HIV status (p = 0.089). Multivariable predictors of self-harm were female sex (adjusted odds ratio (AOR) 5.3, (95% confidence interval 1.9, 14.1), p = 0.001), lower self-esteem (AOR 0.9 (0.8, 0.9) per 1 point increase, p < 0.001) and having ever used alcohol (AOR 3.8 (1.8, 7.8), p < 0.001). Self-esteem z-scores for both PHIV and HIV negative participants were 1.9 standard deviations below the mean for population norms. CONCLUSIONS: Self-harm is common among PHIV and HIV negative adolescents in England. Reassuringly however, they do not appear to be at an increased risk compared to the general adolescent population (15-19% lifetime prevalence). The low level of self-esteem (compared to available normative data) in both groups is worrying and warrants further attention.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Comportamento Autodestrutivo/epidemiologia , Adolescente , Criança , Estudos de Coortes , Estudos Transversais , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Autoimagem , Inquéritos e Questionários , Adulto Jovem
7.
BMC Public Health ; 19(1): 1172, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455306

RESUMO

BACKGROUND: Despite an increased uptake of option B+ treatment among HIV- positive pregnant and breastfeeding women, retaining these women in care is still a major challenge. Previous studies have identified factors associated with loss to follow-up (LTFU) in HIV care, however, the perspectives from HIV-positive pregnant and breastfeeding women regarding their LTFU in option B+ needs further exploration. We explored reasons for LTFU and motivation to resume treatment among HIV-positive women initiated in option B+ in an Urban setting. METHODS: A descriptive qualitative study was conducted at three public care and treatment clinics (CTC) (Buguruni health center, Sinza hospital, and Mbagala Rangitatu health center) in Dar es Salaam, Tanzania between February and May 2017. In-depth interviews were conducted with 30 HIV-positive pregnant and breastfeeding women who were lost to follow up in the option B+ regimen. Analysis of data followed content analysis that was performed using NVivo 10 computer-assisted qualitative data analysis software. RESULTS: Eleven women were lost to follow-up and did not resume Option B+, while 19 had resumed treatment. The study indicated a struggle with long term disease amongst HIV-positive pregnant and breastfeeding women initiated in option B+ treatment. The reported reasons contributing to LTFU among these women appeared in three categories. The contribution of LTFU in the first category namely health-related factors included medication side effects and lack of disease symptoms. The second category highlighted the contribution of psychological factors such as loss of hope, fear of medication side effects and HIV-related stigma. The third category underscored the influence of socio-economic statuses such as financial constraints, lack of partner support, family conflicts, non-disclosure of HIV-positive status, and religious beliefs. Motivators to resume treatment after LTFU included support from health care providers and family members, a desire to protect the unborn child from HIV-infection and a need to maintain a healthy status. CONCLUSION: The study has highlighted the reasons for LTFU and motivation to resume treatment among women initiated in Option B+. Our results provide further evidence on the need for future interventions to focus on these factors in order to improve retention in life-long treatment.


Assuntos
Infecções por HIV/tratamento farmacológico , Perda de Seguimento , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Aleitamento Materno , Feminino , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Motivação , Gravidez , Pesquisa Qualitativa , Tanzânia , Adulto Jovem
8.
BMC Infect Dis ; 19(1): 686, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382923

RESUMO

BACKGROUND: In Europe, the highest proportion of HIV diagnoses are in gay men and other men who have sex with men (MSM). Globally, HIV prevalence is particularly high among males who report selling sex, but rates among men who buy sex from other men are less clear. This study analyzed the association of transactional sex (TS) and HIV diagnosis, sexually transmitted infection (STI) diagnoses, and various drug use; and examined the variations in TS by payment direction. METHODS: We conducted a cross-sectional, non-randomized, observational study. This European MSM Internet Survey recruited MSM from 38 European countries. For descriptive purposes we stratified according to TS behavior (frequently selling sex, frequently buying sex, neither frequently selling nor buying sex in the previous 12 months), and we constructed separate multivariable logistic regression models to investigate whether engaging in TS accounted for some of the HIV- and STI diagnoses and drug use in this population. RESULTS: Of almost 161,000 sexually active MSM, 12.2% engaged in TS. The multivariable logistic regression results showed that relative to not frequently engaging in TS, frequently selling sex was independently associated with a higher odds of reporting diagnosed HIV (ever, adjusted odds ratio [aOR] 1.60, confidence interval [CI] 95% 1.39 to 1.85), bacterial STIs (past 12 months, aOR 1.75 CI 95% 1.54 to 2.00), using heroin or crack cocaine or injecting drugs (aOR 3.17, CI 95% 2.70 to 3.73), and using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41). Compared to men not engaging in frequent TS, frequently buying sex was associated with a higher odds of using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41). CONCLUSIONS: MSM who frequently sell sex suffer greater sexual- and substance use risks than other MSM, but both men who frequently sell and those who buy sex are more likely to use benzodiazepines. MSM who sell sex to other men constitute an important at-risk population who must be offered targeted health services.


Assuntos
Infecções por HIV/transmissão , Homossexualidade Masculina/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Adulto , Cocaína Crack , Estudos Transversais , Europa (Continente)/epidemiologia , Infecções por HIV/epidemiologia , Heroína , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Comportamento Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/transmissão , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
9.
AIDS Behav ; 23(Suppl 3): 304-312, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31456198

RESUMO

Client-level data from two Tennessee-based PrEP navigation demonstration projects reported to the Tennessee Department of Health from January to December 2017 were evaluated to determine the proportion of clients who accepted, were linked to, and were prescribed PrEP. Disparities by age, race, transmission risk, and geographic region as well as trends over time were examined via bivariate and multivariable modified Poisson regression models accounting for potential confounders. Among 1385 PrEP-eligible individuals, 50.5% accepted, 33.4% were linked, and 27.3% were prescribed PrEP. PrEP uptake varied by age, race, and HIV transmission risk, and most disparities persisted across Tennessee throughout evaluation period. Multivariable regression models revealed significant independent associations between age, race/ethnicity, transmission risk, and region and PrEP acceptance and linkage. While differences in PrEP acceptance by race narrowed over time, success among black MSM was limited, underscoring a significant need to improve upstream PrEP continuum outcomes for this important population.


Assuntos
Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Profilaxia Pré-Exposição/estatística & dados numéricos , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Distribuição por Idade , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Profilaxia Pré-Exposição/métodos , Distribuição por Sexo , Tennessee
10.
AIDS Behav ; 23(9): 2522-2531, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31399793

RESUMO

The PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the "Treat All" strategy.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade/psicologia , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Lactente , Saúde Materna , Período Pós-Parto , Gravidez , Adulto Jovem
11.
Medicine (Baltimore) ; 98(29): e16375, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335685

RESUMO

A human immunodeficiency virus (HIV) risk assessment tool was previously developed for predicting HIV infection among men who have sex with men (MSM), but was not externally validated. We evaluated the tool's validity for predicting HIV infection in an independent cohort.The tool was assessed using data from a retrospective cohort study of HIV-negative adult MSM who were recruited in Beijing, China between January 2009 and December 2016.High-risk behaviors occurring within 6 months before the survey were evaluated. Area under curve (AUC) of the receiver operating character curve (ROC) was used to quantify discrimination performance; calibration curve and Hosmer-Lemeshow statistic were used for calibration performance valuation; and decision curve analysis (DCA) was used to evaluate clinical usage.One thousand four hundred forty two participants from the cohort were included in the analysis; 246 (17.1%) sero-converted during follow-up. External validation of the tool showed good calibration, the Hosmer-Lemeshow test showed no statistical difference between observed probability and tool-based predictive probability of HIV infection (X = 4.55, P = .80). The tool had modest discrimination ability (AUC = 0.63, 95% confidence interval [CI]: 0.61-0.66). The decision curve analysis indicated that implementing treatment measures based on the tool's predicative risk thresholds ranging from 10% to 30% might increase the net benefit of treatment when compared with treating all or no MSM.The HIV risk assessment tool can predict the actual risk of HIV infection well amongst MSM in China, but it has a moderate ability to discriminate those at high risk of HIV infection.


Assuntos
Infecções por HIV , Medição de Risco/métodos , Adolescente , Adulto , Área Sob a Curva , Pequim/epidemiologia , Estudos de Coortes , Técnicas de Apoio para a Decisão , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Homossexualidade Masculina , Humanos , Masculino , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Minorias Sexuais e de Gênero/estatística & dados numéricos
12.
Braz J Infect Dis ; 23(4): 218-223, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31344355

RESUMO

HIV-1 mother-to-child transmission (HIV-1 MTCT), is an important cause of children mortality worldwide. Brazil has been traditionally praised by its HIV/Aids program, which provides free-of-charge care for people living with HIV-1. Using public epidemiology and demographic databases, we aimed at modeling HIV-1 MTCT prevalence in Brazil through the years (1994-2016) and elaborate a statistical model for forecasting, contributing to HIV-1 epidemiologic surveillance and healthcare decision-making. We downloaded sets of live births and mothers' data alongside HIV-1 cases notification in children one year old or less. Through time series modeling, we estimated prevalence along the years in Brazil, and observed a remarkable decrease of HIV-1 MTCT between 1994 (10 cases per 100,000 live births) and 2016 (five cases per 100,000 live births), a reduction of 50%. Using our model, we elaborated a prognosis for each Brazilian state to help HIV-1 surveillance decision making, indicating which states are in theory in risk of experiencing a rise in HIV-1 MTCT prevalence. Ten states had good (37%), nine had mild (33%), and eight had poor prognostics (30%). Stratifying the prognostics by Brazilian region, we observed that the Northeast region had more states with poor prognosis, followed by North and Midwest, Southeast and South with one state of poor prognosis each. Brazil undoubtedly advanced in the fight against HIV-1 MTCT in the past two decades. We hope our model will help indicating where HIV-1 MTCT prevalence may rise in the future and support government decision makers regarding HIV-1 surveillance and prevention.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , HIV-1 , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Criança , Feminino , Previsões , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Fatores de Tempo , Adulto Jovem
13.
AIDS Behav ; 23(Suppl 3): 233-241, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31313094

RESUMO

In the 1980s, human immunodeficiency virus (HIV) criminalization laws became widespread across the United States. Today, such laws continue to be used to prosecute people living with HIV for a variety of behaviors though there is limited evidence that doing so curbs HIV transmission. HIV criminalization remains understudied, especially in the Deep South. Therefore, the purpose of this paper was to trace the emergence, maintenance, and enforcement of HIV criminalization laws in South Carolina-a Southern state disproportionately burdened by HIV. Specifically, Nexis Uni and other criminology databases were used to identify HIV-related laws and criminal cases in South Carolina. Results indicate that the state's criminalization laws have remained nearly unchanged for over 30 years and continue to be used to prosecute individuals, a majority of whom are African-American. Findings support the need to reconsider HIV-related laws and devote more efforts to studying the impact of HIV criminalization on the Southern epidemic.


Assuntos
Crime/legislação & jurisprudência , Direito Penal/história , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Política de Saúde/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Adulto , Direito Penal/legislação & jurisprudência , Criminosos , Infecções por HIV/psicologia , História do Século XX , Humanos , Comportamento Sexual , South Carolina/epidemiologia
16.
Nat Med ; 25(8): 1205-1212, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31332393

RESUMO

Exclusive breastfeeding (EBF)-giving infants only breast-milk (and medications, oral rehydration salts and vitamins as needed) with no additional food or drink for their first six months of life-is one of the most effective strategies for preventing child mortality1-4. Despite these advantages, only 37% of infants under 6 months of age in Africa were exclusively breastfed in 20175, and the practice of EBF varies by population. Here, we present a fine-scale geospatial analysis of EBF prevalence and trends in 49 African countries from 2000-2017, providing policy-relevant administrative- and national-level estimates. Previous national-level analyses found that most countries will not meet the World Health Organization's Global Nutrition Target of 50% EBF prevalence by 20256. Our analyses show that even fewer will achieve this ambition in all subnational areas. Our estimates provide the ability to visualize subnational EBF variability and identify populations in need of additional breastfeeding support.


Assuntos
Aleitamento Materno/estatística & dados numéricos , África/epidemiologia , Feminino , Infecções por HIV/transmissão , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Prevalência , Fatores de Tempo , Organização Mundial da Saúde
18.
Pan Afr Med J ; 32: 217, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31312328

RESUMO

Introduction: this study aims to describe the knowledge, attitude and practices of hairdressers about HIV infection in Lomé. Methods: we conducted a descriptive study whose population included hair salon owners and apprentices in the Agoè-Nyivé prefecture, Lomé, between October 1 2016 and March 31 2017. The different parameters studied were data on the general knowledge about HIV, attitudes and practices about HIV/AIDS in the hair salons. Results: a total of 203 owners and apprentices were interviewed in the 68 hair salons in the Agoè-Nyivé prefecture. The study population (100%) knew about HIV/AIDS. Among the participants, 79.3% of them defined it as a sexually transmitted infection. Gloves and aprons were worn before some hairstyling gestures in 33 (51.5%) and 35 (48.5%) hair salons respectively. Moreover, in 60 (88.2%) hair salons, sharp instruments were disinfected prior to their use. However, alcohol was the disinfectant the most commonly used by the majority of the staff of hairdressing salons (89.3%). Moreover, boiling for an average of 7 minutes was performed by 79.8% of hairdressers. In the event of blood exposure accident, 69.6% of staff of hair salons cleaned the exposed site with alcohol. Conclusion: this study shows that hairdressers and their apprentices have good knowledge about HIV infection/AIDS, its modes of transmission and prevention means in hair salons. However, it highlights that the disinfection of soiled equipment and the behaviour of hairdressers and their apprentices in the case of blood exposure accident are sometimes improper.


Assuntos
Indústria da Beleza , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Exposição Ocupacional/prevenção & controle , Adulto , Desinfecção/métodos , Desinfecção/normas , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Profilaxia Pós-Exposição/métodos , Profilaxia Pós-Exposição/normas , Togo , Adulto Jovem
19.
BJOG ; 126(11): 1338-1345, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31188522

RESUMO

OBJECTIVE: Dolutegravir is recommended worldwide as a first-line antiretroviral therapy (ART) for individuals living with HIV. A recent study reported increased rates of neural tube defects in infants of dolutegravir-treated women. This study examined rates of congenital anomalies in infants born to women living with HIV (WLWH) in Canada. DESIGN: The Canadian Perinatal HIV Surveillance Programme captures surveillance data on pregnant WLWH and their babies and was analysed to examine the incidence of congenital anomalies. SETTING: Paediatric HIV clinics. POPULATION: Live-born infants born in Canada to WLWH between 2007 and 2017. METHODS: Data on mother-infant pairs, including maternal ART use at conception and during pregnancy, are collected by participating sites. MAIN OUTCOME MEASURES: Congenital anomalies. RESULTS: Of the 2423 WLWH, 85 (3.5%, 95% CI 2.85-4.36%) had non-chromosomal congenital anomalies. There was no evidence of a significant difference in rates of congenital anomalies between women who were on ART in their first trimester (3.9%, CI 1.7-7.6%) or later in the pregnancy (3.9%, 95% CI 2.6-5.6%). Four of the 80 (5.0%, 95% CI 1.4-12.3%) neonates born to WLWH on dolutegravir during the first trimester had congenital anomalies, none were neural tube defects (95% CI 0.00-3.10%). CONCLUSION: Despite recent evidence raising a safety concern, this analysis found no signal for increased congenital anomalies. TWEETABLE ABSTRACT: Five percent of the infants of Canadian women living with HIV on dolutegravir at conception had congenital anomalies; none had neural tube defects.


Assuntos
Fármacos Anti-HIV/efeitos adversos , Anormalidades Congênitas/patologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Compostos Heterocíclicos com 3 Anéis/efeitos adversos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Fármacos Anti-HIV/uso terapêutico , Canadá/epidemiologia , Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/etiologia , Feminino , Infecções por HIV/transmissão , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Humanos , Recém-Nascido , Gravidez , Efeitos Tardios da Exposição Pré-Natal/patologia , Vigilância de Evento Sentinela
20.
BMC Infect Dis ; 19(1): 562, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248372

RESUMO

BACKGROUND: The proportion of older HIV-1 infected people in China has increased rapidly in recent years. Elucidation of the transmission characteristics of this high-risk population subgroup is helpful for the development of tailored interventions. METHODS: A phylogenetic analysis was performed that uses available HIV-1 pol sequences amplified with nested RT-PCR from plasma samples of all newly diagnosed participants spanning from October 2017 to September 2018 in Fuyang, Anhui Province. Transmission clusters were identified as two or more sequences that shared a corresponding node with an aLRT-SH value ≥90 in the maximum-likelihood phylogenetic tree and had an overall mean genetic distance of ≤1.5%. A local transmission cluster was defined as a cluster that had more than 80% of its sequences from Fuyang. The role of older people in local HIV-1 transmission was determined using an integration of molecular and demographic data. RESULTS: Of 362 available sequences, 14 subtypes, and 28 local transmission clusters were identified. It was found that the proportion of older people in the local transmission cluster (69/77, 89.61%) was much higher than that of younger people (46/114, 40.35%) (χ2 test, P < 0.001). In the pretreatment drug resistance analysis, the proportion of sequences with PDRMs in the local transmission cluster was not significantly different between the older people group (57.14%, 4/7) and non-old-aged group (11.11%, 1/9) (Fisher's exact test, P > 0.05). CONCLUSION: By combining phylogenetic analyses with demographic data, more detailed information was provided about the local transmission structure in Fuyang. These findings suggested that older people play an important role in local transmission, and more tailored interventions for this population subgroup are urgently needed.


Assuntos
Infecções por HIV/diagnóstico , HIV-1/classificação , Adulto , Idoso , Antirretrovirais/uso terapêutico , China/epidemiologia , Farmacorresistência Viral/genética , Feminino , Genótipo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , HIV-1/genética , HIV-1/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Reação em Cadeia da Polimerase , RNA Viral/isolamento & purificação , RNA Viral/metabolismo
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