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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1476-1480, 2019 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-31838824

RESUMO

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.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Epidemias , Infecções por HIV/epidemiologia , Vigilância da População/métodos , População Rural , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Fatores Socioeconômicos , População Suburbana , Tanzânia/epidemiologia
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(12): 1278-1283, 2019 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-31795586

RESUMO

Objective: Using field epidemiological investigation and molecular analysis to construct the molecular transmission network of human immunodeficiency virus/acquired immunodeficiency syndrome cases (HIV/AIDS) newly diagnosed in Huzhou in 2017, Zhejiang Province. Methods: A total of 160 participants were obtained through a web-based system from Chinese Center for Disease Control and Prevention (CCDC) with the features of diagnosed in Huzhou in 2017 who also had been collected samples for the first follow-up. The basic information of demographic characteristics and risk factors was extracted from the website. RNA was extracted from plasma samples of untreated cases, followed by RT-PCR and nest-PCR for pol gene amplification, sequencing. Phylogenetic tree was constructed by MEGA software for HIV gene subtyping. TN93 model was used for calculating the distance between two sequences. Cytoscape software was used for drawing molecular transmission network. And then an epidemiological survey was conducted to cases in the primary cluster. Results: A total of 138 sequenced individuals (86.3%) were acquired from 160 individuals. Among which, 123 (89.1%) were male. The highest proportion of subtype was CRF07_BC (60, 43.5%), followed by CRF01_AE (46, 33.3%), and with four cases of Unique Recombinant Form (URF, CRF01_AE and CRF07_BC) and one case of URF (subtype B and C). A total of 18 molecular clusters included 56 individuals (40.6%) were found in the transmission network under the optimal genetic distance threshold (1.0%). The clustering proportion of CRF07_BC (66.1%, 37 cases) was higher than that of CRF01_AE. There were 9 clusters formed among CRF07_BC, including 37 cases (accounting for 61.7%, 37/60). The primary transmission cluster contained 11 cases, among which 9 cases were transmitted by homosexual sex. The first time of the cases to have homosexual behavior is range from 2010 to 2016, whose media number (P(25), P(75)) of partners was 6 (3.5, 8.5). Most of the cases come from Anhui Province and engaged in garment industry (5 cases), between which there were 8 cases used Blued software to seek for casual partners, 1 case seeking for casual partners in garden. Conclusion: With CRF07_BC and CRF01_AE predominantly circulating, HIV genetic diversity had been noticed in this area. The primary cluster was consisted of high proportion of locally new infections, and a specific population aggregation in limited place existed.


Assuntos
Síndrome de Imunodeficiência Adquirida/transmissão , Infecções por HIV/transmissão , HIV-1/genética , Síndrome de Imunodeficiência Adquirida/diagnóstico , China , Amplificação de Genes , Genótipo , Infecções por HIV/diagnóstico , HIV-1/isolamento & purificação , Humanos , Masculino , Epidemiologia Molecular , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
3.
BMC Infect Dis ; 19(1): 925, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666015

RESUMO

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.


Assuntos
Infecções por HIV/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , China/epidemiologia , Cidades , Análise por Conglomerados , Epidemias , Feminino , Sistemas de Informação Geográfica , Infecções por HIV/transmissão , Heterossexualidade , Humanos , Masculino , Mianmar , Prevalência , Comportamento Sexual , Análise Espaço-Temporal , Transtornos Relacionados ao Uso de Substâncias/virologia
4.
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
5.
BMC Infect Dis ; 19(Suppl 1): 783, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31526371

RESUMO

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.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , HIV/imunologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Saúde Reprodutiva , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Adolescente , África ao Sul do Saara/epidemiologia , Aleitamento Materno , Criança , Pré-Escolar , Busca de Comunicante , Feminino , Soropositividade para HIV , Humanos , Lactente , Lactação , Modelos Lineares , Masculino , Programas de Rastreamento , Mães/educação , Gravidez , Cuidado Pré-Natal , Prevalência , Serviços de Saúde Reprodutiva , Organização Mundial da Saúde , Adulto Jovem
6.
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
7.
Bull Soc Pathol Exot ; 112(2): 90-95, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31478618

RESUMO

Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority.


Assuntos
Comunicação , Infecções por HIV , Serviços de Saúde Escolar , Livros de Texto como Assunto , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Atitude Frente a Saúde , Costa do Marfim/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , HIV-1/fisiologia , HIV-2/fisiologia , Promoção da Saúde/métodos , Promoção da Saúde/normas , Humanos , Conhecimento , Linguagem , Programas de Rastreamento/psicologia , Serviços de Saúde Escolar/normas , Serviços de Saúde Escolar/estatística & dados numéricos , Educação Sexual/normas , Educação Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Doenças Sexualmente Transmissíveis/transmissão , Livros de Texto como Assunto/normas
8.
Przegl Epidemiol ; 73(2): 179-192, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385676

RESUMO

AIM: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases and death among AIDS cases in Poland in 2017 in comparison to the changes in preceding years. MATERIALS AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. RESULTS: In 2017 there were 1,419 HIV cases newly diagnosed in Poland (diagnosis rate: 3.69 per 100,000), including 51 among non-Polish citizens. The frequency of newly detected HIV infections increased by nearly 8% compared to the previous year and by almost 28% compared to the median in 2011-2015 years. The total number of AIDS cases was 108 (incidence 0.28 per 100,000), and 20 people died from AIDS disease (0.05 per 100,000). New HIV diagnoses were reported mainly among people in age 20 to 39 years (69.5%) and among men (88.5%). Among cases with known transmission route, 69.5% concerned among men who had sexual contact with men (MSM). The percentage of MSM cases, similarly to heterosexual cases decrease in comparison to previous year, relatively by 5.7% and 6.4%. The percentage of AIDS cases diagnosed at the same time with HIV diagnosis increased by 6% percentage points in comparison with 2016 year (from 68% to 74% AIDS cases). CONCLUSION: The most HIV cases are diagnosed among MSM, so prophylactic activities are still needed in this key population. It is also need to increase the number of new cases linkage-to-care and to improve the low frequency in HIV testing rate in all population.


Assuntos
Infecções por HIV/epidemiologia , Sistema de Registros , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , Distribuição por Idade , Comorbidade , Feminino , Infecções por HIV/transmissão , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Distribuição por Sexo , Adulto Jovem
9.
BMC Infect Dis ; 19(1): 517, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185927

RESUMO

BACKGROUND: Although Option B+ may be more costly than Options B, it may provide additional health benefits that are currently unclear in Yunnan province. We created deterministic models to estimate the cost-effectiveness of Option B+. METHODS: Data were used in two deterministic models simulating a cohort of 2000 HIV+ pregnant women. A decision tree model simulated the number of averted infants infections and QALY acquired for infants in the PMTCT period for Options B and B+. The minimum cost was calculated. A Markov decision model simulated the number of maternal life year gained and serodiscordant partner infections averted in the ten years after PMTCT for Option B or B+. ICER per life year gained was calculated. Deterministic sensitivity analyses were conducted. RESULTS: If fully implemented, Option B and Option B+ averted 1016.85 infections and acquired 588,01.02 QALYs.The cost of Option B was US$1,229,338.47, the cost of Option B+ was 1,176,128.63. However, when Options B and B+ were compared over ten years, Option B+ not only improved mothers'ten-year survival from 69.7 to 89.2%, saving more than 3890 life-years, but also averted 3068 HIV infections between serodiscordant partners. Option B+ yielded a favourable ICER of $32.99per QALY acquired in infants and $5149per life year gained in mothers. A 1% MTCT rate, a 90% coverage rate and a 20-year horizon could decrease the ICER per QALY acquired in children and LY gained in mothers. CONCLUSIONS: Option B+ is a cost-effective treatment for comprehensive HIV prevention for infants and serodiscordant partners and life-long treatment for mothers in Yunnan province, China. Option B+ could be implemented in Yunnan province, especially as the goals of elimination mother-to-child transmission of HIV and "90-90-90" achieved, Option B+ would be more attractive.


Assuntos
Controle de Doenças Transmissíveis , Infecções por HIV , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/economia , Complicações Infecciosas na Gravidez/terapia , Planos Governamentais de Saúde , Síndrome de Imunodeficiência Adquirida/economia , Síndrome de Imunodeficiência Adquirida/terapia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , China/epidemiologia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Análise Custo-Benefício , Árvores de Decisões , Feminino , HIV , Infecções por HIV/economia , Infecções por HIV/terapia , Infecções por HIV/transmissão , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/economia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Masculino , Modelos Econométricos , Mães/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Planos Governamentais de Saúde/economia , Planos Governamentais de Saúde/organização & administração , Planos Governamentais de Saúde/normas , Resultado do Tratamento , Adulto Jovem
10.
Rev Soc Bras Med Trop ; 52: e20180355, 2019 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-31141049

RESUMO

INTRODUCTION: This study evaluated knowledge about HIV/AIDS in elders using the services of Family Health Strategy. METHODS: Cross-sectional, descriptive, and analytical study involving 238 participants. Mini-Mental State Examination and QHIV3I were applied. RESULTS: About 30% of participants had active sexual lives and 5.5% used condoms consistently. The question with the highest score of right answers was about transmission through needles (95%) and the lowest (52.5%) was about whether individuals infected with the virus always displayed symptoms. CONCLUSIONS: It is necessary to train health professionals to develop actions that encourage elders to take preventive measures.


Assuntos
Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/psicologia , Síndrome de Imunodeficiência Adquirida/transmissão , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana
11.
Afr J AIDS Res ; 18(1): 81-88, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30880583

RESUMO

The role played by the transport sector in the regional spread of HIV in sub-Saharan Africa is well known, yet attention has remained confined to entertainment hotspots and stopping places along long-distance highways and cross-border transport corridors. This paper draws attention to informal modes of transit prevalent in sub-Saharan African cities, by linking the rise of two-wheeled, manually operated bicycles, known as "Sacramento", to the potential spread of HIV and AIDS in Malawi. The findings of a qualitative study from Mzuzu city show that Sacramento operators are prone to demanding or accepting sexual favours from female commuters as payment for a ride. We draw on complementary theories of the political ecology of health (PEH) and feminist political ecology to show how a popular belief that Sacramento is an inferior mode of urban transit underpins risky sexual behaviour among men hired to operate this informal mode transport. The findings further show that operators' responses to this perceived inferiority are themselves also driven by gender discourses that seek to validate their identities as powerful go-getters. These scripts also create an environment that fosters multiple sexual partners and venerates unprotected sex. Because Sacramento is both a source of livelihood and an HIV risk milieu, it epitomises the contraction inherent in HIV and AIDS vulnerability in sub-Saharan Africa.


Assuntos
Síndrome de Imunodeficiência Adquirida/transmissão , Comportamento Sexual/psicologia , Transportes/métodos , Sexo sem Proteção/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adulto , Feminino , HIV/isolamento & purificação , Humanos , Malaui/epidemiologia , Masculino , Prevalência , Assunção de Riscos , Parceiros Sexuais
13.
Cien Saude Colet ; 24(3): 715-728, 2019 Mar.
Artigo em Português | MEDLINE | ID: mdl-30892494

RESUMO

The scope of this article is to conduct a critical identification and analysis, based on the analytical framework of the concept of vulnerability of truck drivers to HIV. The criteria for inclusion were to address the issue of truck drivers' susceptibility to HIV/AIDS and to adopt the qualitative approach. A total of 445 abstracts were located, of which 17 articles were included in the analysis and categorized as "sociocultural studies", "evaluative studies" and "risk behavior studies." The analysis was based on reflections surrounding the concept of vulnerability in health. The study criticizes the predominance of qualitative studies of a behaviorist nature, with an emphasis on the identification of risk behaviors, concepts and representations about HIV/AIDS. Furthermore, it points to studies of a sociocultural and evaluative nature that transcend the barrier of individual behaviors, expanding the scope of analysis, analysis of structural phenomena and interactions of subjects faced with the epidemic, duly approaching the concept of vulnerability. The review reveals the need for studies that take into account the concept of vulnerability, contextualizing the behaviors to the socio-structural dimensions involved in the AIDS epidemic.


Assuntos
Síndrome de Imunodeficiência Adquirida/transmissão , Condução de Veículo , Infecções por HIV/transmissão , Síndrome de Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Veículos Automotores , Pesquisa Qualitativa , Assunção de Riscos
14.
Eur J Dent Educ ; 23(2): 212-219, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30681237

RESUMO

PURPOSE: The aim was to evaluate the knowledge of the students of dental students regarding patients care towards HIV positive individuals. METHODS: Two hundred and eighty-three dental students (pre-clinical, n = 45; clinical, n = 238) answered an electronic questionnaire, approaching biosafety procedures, oral manifestations of AIDS and knowledge of HIV infection. Data were present as an average from findings from students of nine different semesters, grouping them by pre-clinical (1-4) and clinical (5-9) semesters, from two different university campuses. Furthermore, data were analysed using the t test and chi-square test. RESULTS: Students' mean age was 24 years. Amongst 14 oral manifestations questioned, Kaposi sarcoma, oral candidiasis, necrotizing ulcerative gingivitis and herpes simplex were more associated with HIV. Over 90% of the respondents would be concerned about becoming infected with HIV after a needle stick injury and were willing to be tested for HIV; know that HIV/AIDS patients can contaminate dental care professionals, that needle perforation can transmit HIV, and that medical professionals are more prone to cross-contamination. Regarding the use of physical barrier, almost all participants use disposable mask, goggles, cap and procedure gloves with all patients; the use of disposable lab coat and two pairs of gloves were the least used with all patients. CONCLUSIONS: Participating students have good knowledge on biosafety in the management of HIV/AIDS patients, as well as on the most commonly associated oral manifestations. However, there is a need for improvement on some topics related to HIV/AIDS, especially regarding less known oral lesions, and HIV diagnostic tests.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Conhecimento , Assistência ao Paciente , Estudantes de Odontologia/psicologia , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , Contenção de Riscos Biológicos/métodos , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Masculino , Roupa de Proteção , Inquéritos e Questionários , Adulto Jovem
15.
PLoS One ; 14(1): e0211099, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30657797

RESUMO

INTRODUCTION: Men who have sex with men (MSM) are disproportionately impacted by HIV/AIDS resulting from risky sexual behaviors. Social and contextual factors are known to mediate risk behaviors, but there is limited information about the prevalence of risky sexual practices of Rwandan MSM and the concomitant socio-contextual determinants making it difficult to assess implications for preventing HIV/STI transmission in this key population. METHODS: Using exploratory qualitative design, we obtained socio-contextual information regarding prevalence of risky sexual behavior and assessed implications for HIV/ STIs transmission and preventive measures taken by MSM to improve sexual health and wellbeing. Thirty MSM were recruited to participate in in-depth interviews using respondent-driven sampling from LGBT associations in Kigali. Data were analyzed using standard qualitative data analysis procedures. RESULTS: Respondents' were between 18-40 years old; all completed primary education and are mostly low-socioeconomic status. Risky sexual practices were common, but differed by peculiar individual and contextual factors. Older MSM often reported occasional sexual relations with women to avoid suspicion and social stigma. Younger MSM's risky sexual practices are mostly transactional and mediated by the need for social acceptance and support. Knowledge of STIs was poor, but prevalence, especially of HPV was high. The options for improving sexual wellbeing are limited and mostly clandestine. CONCLUSION: Risky sexual behavior of Rwandan MSM has major implications for HIV/STI transmission. An environment of intense social stigma and social isolation makes it difficult to obtain information or services to improve sexual health. Effective interventions that address individual and contextual determinants of risk and access to health services are urgently needed to limit the consequence of MSM as a bridge for HIV transmission to the general population.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , HIV-1 , Comportamentos de Risco à Saúde , Homossexualidade Masculina , Minorias Sexuais e de Gênero , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Humanos , Masculino , Prevalência , Ruanda , Fatores Socioeconômicos
16.
Cell Host Microbe ; 25(1): 27-38, 2019 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-30629915

RESUMO

HIV, the causative agent of AIDS, has a complex evolutionary history involving several cross-species transmissions and recombination events as well as changes in the repertoire and function of its accessory genes. Understanding these events and the adaptations to new host species provides key insights into innate defense mechanisms, viral dependencies on cellular factors, and prerequisites for the emergence of the AIDS pandemic. In addition, understanding the factors and adaptations required for the spread of HIV in the human population helps to better assess the risk of future lentiviral zoonoses and provides clues to how improved control of viral replication can be achieved. Here, we summarize our current knowledge on viral features and adaptations preceding the AIDS pandemic. We aim at providing a viral point of view, focusing on known key hurdles of each cross-species transmission and the mechanisms that HIV and its simian precursors evolved to overcome them.


Assuntos
Síndrome de Imunodeficiência Adquirida/transmissão , Síndrome de Imunodeficiência Adquirida/veterinária , Síndrome de Imunodeficiência Adquirida/virologia , Adaptação Fisiológica/genética , HIV-1/genética , HIV-1/patogenicidade , Pandemias , Síndrome de Imunodeficiência Adquirida/imunologia , Adaptação Fisiológica/imunologia , Animais , Animais Selvagens/virologia , Gorilla gorilla/virologia , HIV-1/imunologia , HIV-2/genética , HIV-2/imunologia , HIV-2/patogenicidade , Haplorrinos/virologia , Especificidade de Hospedeiro , Humanos , Imunidade Inata , Pan troglodytes/virologia , Pandemias/veterinária , Doenças dos Primatas/virologia , Recombinação Genética , Síndrome de Imunodeficiência Adquirida dos Símios/imunologia , Síndrome de Imunodeficiência Adquirida dos Símios/transmissão , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus da Imunodeficiência Símia/genética , Vírus da Imunodeficiência Símia/imunologia , Vírus da Imunodeficiência Símia/patogenicidade , Especificidade da Espécie , Replicação Viral , Zoonoses/imunologia , Zoonoses/transmissão , Zoonoses/virologia
17.
Rev. enferm. UFPE on line ; 13(1): 15-22, jan. 2019.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1005927

RESUMO

Objetivo: conhecer as repercussões do diagnóstico de crianças com o vírus da imunodeficiência humana para a família. Método: trata-se de um estudo qualitativo e descritivo realizado com dez familiares, em um Hospital Dia. Coletaram-se os dados por entrevistas semiestruturadas submetendo-os à técnica de Análise de Conteúdo. Resultados: verificou-se que algumas mães não sabiam que eram portadoras do vírus HIV e só descobriram a contaminação durante a realização de exames no pré-natal e pré-parto. Gerou-se culpa diante do recebimento do diagnóstico da criança e essa revelação foi difícil para as mães. Convive-se com o medo da morte por doenças oportunistas priorizando-se a alimentação como forma de manutenção da saúde. Relatouse preocupação das mães por apenas as pessoas da família nuclear se dedicarem ao cuidado da criança com o objetivo de que seu diagnóstico não seja revelado. Conclusão: fornecem-se informações, diante das principais dificuldades referidas pelas mães ao receberem o diagnóstico, para que a equipe de saúde promova ações a serem implementadas o mais precocemente possível como forma de instrumentalização da família para o cuidado e de incentivo ao viver saudável da criança.(AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Família , Cuidado da Criança , Saúde da Criança , Síndrome de Imunodeficiência Adquirida , Síndrome de Imunodeficiência Adquirida/transmissão , HIV , Soropositividade para HIV , Cuidadores , Transmissão Vertical de Doença Infecciosa , Impacto Psicossocial , Enfermagem Pediátrica , Epidemiologia Descritiva , Infecções Oportunistas Relacionadas com a AIDS , Pesquisa Qualitativa
18.
AIDS Behav ; 23(7): 1824-1832, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30327997

RESUMO

In 2013, Tanzania adopted the World Health Organization's Option B+ guidelines for prevention of mother-to-child transmission of HIV (PMTCT), whereby all HIV-infected pregnant women initiate lifelong antiretroviral therapy. This study examined retention in PMTCT across critical junctures in the care continuum. This was a retrospective study of patient-level data for a cohort of women enrolled in PMTCT during the first year of Option B+ in Tanzania. Retention in care was described across three periods: (1) the first month of antenatal care (ANC), (2) pregnancy, and (3) the postpartum period. Logistic regression was used to identify factors associated with loss to follow up (LTFU) during the first month of ANC. Survival analyses were used to identify factors associated with LTFU during pregnancy and the postpartum periods. 650 participants were included in the cohort; 262 (40.3%) were newly diagnosed with HIV. Two years after delivery, 383/650 (58.7%) were LTFU. Of the 383 LTFU, 73 (19.1%) were lost during the first month of ANC, 44 (11.5%) during pregnancy, and 266 (69.5%) after delivery. Being newly diagnosed with HIV predicted higher LTFU during the first month of ANC (aOR 1.76; 95% CI 1.06-2.94) and faster time to LTFU during the postpartum period (adjusted relative time, 0.68; 95% CI 0.51-0.89). High LTFU occurred across the PMTCT continuum, including immediately after enrollment into ANC and the postpartum period. Ongoing research is needed to encourage treatment uptake and sustained engagement after delivery.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Perda de Seguimento , Período Pós-Parto , Complicações Infecciosas na Gravidez/prevenção & controle , Adulto , Estudos de Coortes , Continuidade da Assistência ao Paciente , Feminino , Humanos , Gravidez , Gestantes , Cuidado Pré-Natal , Estudos Retrospectivos , Tanzânia/epidemiologia , Organização Mundial da Saúde , Adulto Jovem
19.
Afr J AIDS Res ; 17(4): 341-351, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30560730

RESUMO

HIV and AIDS continue to pose a global health and development challenge, particularly in sub-Saharan Africa. South Africa has the largest number of people living with HIV (PLHIV) in the world. In spite of the accelerated efforts to combat the HIV and AIDS epidemic, there still remains an unabated challenge, i.e. continuing new infections, particularly among young African adults. HIV is largely transmitted through unprotected vaginal and anal sexual intercourse. This study sought to unpack the meaning of ukujola (casual or informal sexual relationships) as socially constructed by Zulu people, and to identify underlying socio-economic factors for ukujola. This study uses a generic qualitative study approach in which 32 qualitative interviews (4 focus groups, 20 in-depth interviews and 8 key-informant interviews) were conducted with isiZulu-speaking participants (aged 21-34) from Umgungundlovu district, KwaZulu-Natal province. The study found that ukujola relationships are a relatively new phenomenon in Zulu society. Ukujola relationships encompass all "illegitimate" relationships, i.e. in which there has never been involvement of the families. The involvement of families in negotiating ilobolo (bride wealth) is a pre-requisite for legitimate relationships, particularly marriage. Multiple concurrent sexual partnerships typically exist in ukujola relationships, and unprotected sex is common. There is a need for a national dialogue on ilobolo in the context of HIV and AIDS.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Sexo sem Proteção/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/psicologia , Confidencialidade , Feminino , Grupos Focais , HIV , Humanos , Masculino , Casamento , Negociação , Pesquisa Qualitativa , África do Sul/epidemiologia , Adulto Jovem
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