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1.
BMC Infect Dis ; 20(1): 443, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576136

RESUMO

BACKGROUND: Liangshan Yi Autonomous Prefecture is one of the areas that most severely affected by human immunodeficiency virus (HIV) in China, and virological failure on antiretroviral therapy (ART) is serious in this area. Analyses of prevalence and determinants of ART failure, the genetic diversity and drug resistance among people living with HIV (PLWH) helps improve HIV treatment efficiency and prevent HIV transmission. METHODS: A total of 5157 PLWH were recruited from 2016 to 2017. The venous blood samples were subjected to RT-PCR, followed by sequencing of the HIV-1 pol gene, targeting the protease and reverse transcriptase fragments. HIV-1 diversity was analyzed using the DNAStar software and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database. RESULTS: A total of 2156 (41.81%) PLWH showed virological failure on ART. Males (ORm = 1.25), heterosexual behaviors and drug injection (ORm = 1.44) and mother to child transmission routes (ORm = 1.58), the clinical stage of AIDS (ORm = 1.35), having used illicit drugs and shared the needles (1-4 times: ORm = 1.34; more than 5 times: ORm = 1.52), having ever replaced ART regimen (ORm = 1.48) increased the risk of virological failure among PLWH, while higher education lever (ORm = 0.77) and ≥ 12 months on ART (12 ~ 36 months: ORm = 0.72; ≥36 months: ORm = 0.66) was associated with lower likelihood of virological failure. The data revealed that CRF07_BC (1508, 95.62%) were the most common strains, and the drug-resistant rate was 32.10% among PLWH with virological failure in this area. The high frequencies of drug resistance were found in EFV and NVP of NNRTIs, ABC, FTC and 3TC of NRTIs, and TPV/r in PIs. The most common mutations in NNRTIs, NRTIs and PIs were K103N/KN (64.69%), M184V/MV/I (36.29%) and Q58E/QE (4.93%), respectively. CONCLUSION: We concluded that surveillance of virological failure, HIV-1 subtypes, and drug resistance to understand HIV-1 epidemiology and guide modification of ART guidelines, and target prevention and control strategies should be formatted to reduce the virological failure and drug resistance to promote viral suppression and prevent HIV-1 transmission.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral/genética , Variação Genética , HIV-1/genética , Grupos Minoritários , Inibidores da Transcriptase Reversa/uso terapêutico , Síndrome de Imunodeficiência Adquirida/sangue , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Fármacos Anti-HIV/efeitos adversos , China/epidemiologia , Feminino , Genes pol , Humanos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Masculino , Mutação , Prevalência , Inibidores da Transcriptase Reversa/efeitos adversos , Resultado do Tratamento , Adulto Jovem
2.
Rev Med Liege ; 75(5-6): 356-361, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32496679

RESUMO

In order to end the AIDS pandemic, new infections must be avoided. This prevention can be divided into four axes depending on the risk of exposure to the HIV virus. Over the past decade, new prevention strategies supported by various studies have emerged. These are effective when they are used in combination. Some are not without risk or even controversial according to some authors.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos
3.
BMC Infect Dis ; 20(1): 382, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32471358

RESUMO

BACKGROUND: Disclosure of Human Immunodeficiency Virus positive status significantly reduced the transmission of HIV; yet, it remains a challenge for many HIV patients. Disclosure serves plays a crucial role to raise awareness and to reduce risky behaviors. Hence, this study aimed to determine the pooled prevalence and effect sizes of determinant factors of HIV positive status disclosure through a systematic review and meta-analysis of the results of the existing primary studies in Ethiopia. METHOD: This systematic review and meta-analysis was aimed to determine prevalence of HIV positive status disclosure and associated factors by considering and searching published primary articles from different sources. A sensitivity test was conducted to evaluate the presence of influential studies. Besides, the heterogeneity test has been conducted; and publication bias was examined through observing the funnel plot as well as objectively by interpreting the Egger's regression test. Following the Egger's regression test, P-value < 0.05 was considered as statistically significant at 95% Confidence Interval. RESULT: A total of 18 primary studies were searched from different data sources. The overall pooled prevalence of HIV positive status disclosure among adult PLWHA in Ethiopia was indicated to be 75.95% (95% CI:69.93-81.98); the highest and lowest pooled estimated HIV status disclosure was in Amhara (82.78%) and Tigray (54.31%) regions respectively. Furthermore, Knowing the HIV positive status of sexual partner, AOR = 19.66(95% CI: 10.19-37.91), having prior discussion about HIV testing with their partner, AOR = 9.18(95% CI: 5.53-15.24), got Human Immunodeficiency Virus pretest counseling service AOR = 4.29(95% CI: 2.56-7.21) and being a member of HIV/AIDS associations, AOR = 3.34(95% CI: 2.17-5.12), were significantly associated with HIV positive status disclosure among People living With HIV/AIDS in Ethiopia. CONCLUSION: The pooled national estimate of HIV/AIDS positive status disclosure is low as compared to the WHO disclosure rate of developing countries and the findings of other national and international studies. Ministry of health and other stakeholders shall design new approaches and strategies to encourage disclosure of HIV status, educate the public about the negative impact of nondisclosure within family members. Health care providers working at Human HIV test centers shall emphasis extensive counseling on disclosure of status to a partner. Moreover, different stakeholders, health workers and community members shall establish, organize, and support HIV/AIDS Associations and motivate HIV positive people to be engaged and participated.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , HIV , Autorrevelação , Parceiros Sexuais/psicologia , Revelação da Verdade , Síndrome de Imunodeficiência Adquirida/transmissão , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , Aconselhamento/métodos , Estudos Transversais , Etiópia/epidemiologia , Família , Feminino , Pessoal de Saúde , Humanos , Prevalência , Assunção de Riscos
5.
Rev Med Suisse ; 16(690): 744-748, 2020 Apr 15.
Artigo em Francês | MEDLINE | ID: mdl-32301309

RESUMO

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


Assuntos
Infecções por HIV/psicologia , Saúde Pública , Estigma Social , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/psicologia , Síndrome de Imunodeficiência Adquirida/transmissão , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Soronegatividade para HIV , Soropositividade para HIV/diagnóstico , Soropositividade para HIV/psicologia , Soropositividade para HIV/transmissão , Humanos
6.
PLoS One ; 15(4): e0231228, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32267890

RESUMO

BACKGROUND: Women of reproductive age living with HIV (WRLHIV), HIV-positive pregnant women, adolescent girls and young women (AGYW) are key populations for eliminating mother-to-child of HIV (eMTCT) in South Africa. We describe the geographical distribution of WRLHIV, their pregnant counterparts and AGYW for risk-adjusted allocation of eMTCT interventions. METHODS: For the year 2018, we triangulated data from the Thembisa Model with five routine HIV-related and demographic data sources to determine the distribution of WRLHIV (15-49 years) and AGYW (15-24 years) nationally and by province. Data analysed included total population estimates, number of live-births, live-births to HIV-positive women, age-specific HIV prevalence rates, intrauterine (IU)-transmission rates and IU-case rates/100 000 live-births. IU-transmission rates and IU-case rates were calculated from de-duplicated routine HIV test-data for neonates (aged <7days). Data de-duplication was achieved by a patient-linking algorithm that uses probabilistic matching of demographics (name, surname, date of birth), supplemented by manual matching to account for spelling errors. RESULTS: There were 58 million people in South Africa in 2018. Females (all ages) constituted 51% of the population. Women of reproductive age constituted 27% and AGYW constituted 8% of the total population. WRLHIV, AGYW living with HIV and HIV-positive pregnant women accounted for 7%, 0.8% and 0.4% of the total population respectively. Gauteng was the most populous province followed by KwaZulu-Natal, with Western Cape and Eastern Cape in third and fourth positions. The distribution of WRLHIV and AGYW followed a similar trend. However, Mpumalanga and Limpopo provinces had higher proportions of WRLHIV and AGYW living with HIV ahead of Western Cape. KwaZulu-Natal had the highest number of live-births to HIV-positive women. The national IU-transmission rate of <1% translated into 241 cases/100 000. While provincial IU-case rates were fairly similar at 179-325, districts IU-case rates varied, ranging from 87-415 cases/100 000 live-births. CONCLUSION: Findings suggest that the need for eMTCT interventions is greatest in Gauteng, KwaZulu-Natal, Western Cape and Eastern Cape. Limpopo and Mpumalanga provinces may require more HIV prevention and family planning services because of high fertility rates, high number of WRLHIV and AGYW living with HIV. eMTCT will require robust viral load monitoring among WRLHIV, pregnant and breastfeeding women. The national laboratory database can provide this service near-real time.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , HIV , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Adolescente , Adulto , Distribuição por Idade , Aleitamento Materno , Feminino , Humanos , Recém-Nascido , Nascimento Vivo , Programas de Rastreamento , Pessoa de Meia-Idade , Gravidez , Prevalência , África do Sul/epidemiologia , Carga Viral , Adulto Jovem
7.
Reprod Health ; 17(1): 20, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005263

RESUMO

BACKGROUND: Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. METHODS: This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. DISCUSSION: There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Saúde do Adolescente/normas , Prestação Integrada de Cuidados de Saúde/normas , Gravidez na Adolescência/prevenção & controle , Projetos de Pesquisa/normas , Educação Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , África ao Sul do Saara , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Gravidez , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/transmissão , Adulto Jovem
8.
Cien Saude Colet ; 25(2): 575-584, 2020 Feb.
Artigo em Português | MEDLINE | ID: mdl-32022197

RESUMO

The scope of this study was to identify and analyze the scientific production on behavior and knowledge about the sexuality of elderly people living with HIV. An integrative review of scientific articles indexed in the Lilacs, IBECS, Medline, BDENF, PubMed and Scopus (Elsevier) databases was conducted, considering publications from January 2007 to December 2016, using the following key words: knowledge, behavior, sexuality, Elderly, HIV/AIDS. Of the 1493 articles located, 11 were included because they met the inclusion criteria and were analyzed through two instruments: Critical Appraisal Skill Program (CASP) and Agency for Healthcare and Research and Quality (AHRQ). The data suggest that HIV-positive elderly people are sexually active and are involved in risk behaviors of virus transmission. It transpires that there is a limited scientific production regarding the behavior and knowledge about sexuality among elderly people living with HIV. The conclusion drawn is that the study may contribute to the improvement of public health policies that promote the approach on sexuality among elderly people, as well as the emergence of new questions regarding this issue.


Assuntos
Infecções por HIV/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Sexualidade/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Idoso , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Humanos , Assunção de Riscos
9.
Rev. enferm. UFPE on line ; 14: [1-8], 2020. ilus, tab, graf, mapas
Artigo em Português | BDENF - Enfermagem | ID: biblio-1095815

RESUMO

Objetivo: analisar o perfil epidemiológico e a distribuição espacial dos casos notificados de HIV/AIDS em crianças e gestantes. Método: trata-se de um estudo quantitativo, descritivo, retrospectivo, epidemiológico, transversal. Compôsse a amostra por todos os casos de gestantes soropositivas notificadas como infectadas com o HIV no SINAN e crianças com AIDS registradas no SIM, entre 1º de janeiro de 2008 e 31 de dezembro de 2016. Obtiveram-se os dados por meio do Sistema de Informação de Agravos de Notificação e do Sistema de Informação sobre Mortalidade, em residentes no município. Resultados: notificou-se um total de 37 casos de gestantes soropositivas, sendo estas jovens com idades entre 16 e 20 anos (32,5%), pardas (70,3%), com menos de oito anos de estudo (70,3%) e donas de casa (59,5%). Registraram-se apenas três casos de crianças com AIDS. Conclusão: conclui-se que o aumento na taxa de incidência de HIV em gestantes, bem como os casos registrados de óbitos em crianças pela AIDS, evidencia a falha na assistência prestada a esses indivíduos.(AU)


Objective: to analyze the epidemiological profile and spatial distribution of reported cases of HIV/AIDS in children and pregnant women. Method: this is a quantitative, descriptive, retrospective, epidemiological, cross-sectional study. The sample consisted of all cases of seropositive pregnant women reported as infected with HIV in SINAN and children with AIDS registered in SIM, between January 1, 2008 and December 31, 2016. Data were obtained through the System. Reporting Disease Information and Mortality Information System in residents of the municipality. Results: a total of 37 cases of seropositive pregnant women were reported, being these young women aged 16 to 20 years (32.5%), brown (70.3%), with less than eight years of study (70.3 %) and housewives (59.5%). There were only three cases of children with AIDS. Conclusion: it is concluded that the increase in the incidence rate of HIV in pregnant women, as well as the reported cases of deaths in children by AIDS, shows the failure in the care provided to these individuals.(AU)


Objetivo: analizar el perfil epidemiológico y la distribución espacial de los casos notificados de VIH/SIDA en niños y mujeres embarazadas. Método: este es un estudio cuantitativo, descriptivo, retrospectivo, epidemiológico, transversal. La muestra consistió en todos los casos de mujeres embarazadas seropositivas reportadas como infectadas con VIH en SINAN y niños con SIDA registrados en SIM, entre el 1 de enero de 2008 y el 31 de diciembre de 2016. Los datos se obtuvieron a través del Sistema de Información de Agravios de Notificación y del Sistema de Información de Mortalidad en residentes del municipio. Resultados: se informaron un total de 37 casos de mujeres embarazadas seropositivas, siendo estas mujeres jóvenes de 16 a 20 años (32.5%), marrones (70.3%), con menos de ocho años de estudio (70.3 %) y amas de casa (59.5%). Solo hubo tres casos de niños con SIDA. Conclusión: se concluye que el aumento en la tasa de incidencia de VIH en mujeres embarazadas, así como los casos reportados de muertes en niños por SIDA, muestran el fracaso en la atención brindada a estas personas.(AU)


Assuntos
Humanos , Feminino , Gravidez , Criança , Adolescente , Adulto , Perfil de Saúde , Criança , Dados Demográficos , Síndrome de Imunodeficiência Adquirida , Síndrome de Imunodeficiência Adquirida/transmissão , HIV , Transmissão Vertical de Doença Infecciosa , Gestantes , Estudos Epidemiológicos , Epidemiologia Descritiva , Estudos Transversais , Estudos Retrospectivos
10.
Rev. enferm. UFPE on line ; 14: [1-9], 2020. ilus, graf
Artigo em Português | BDENF - Enfermagem | ID: biblio-1099941

RESUMO

Objetivo: analisar a percepção de mulheres que vivem com o vírus da imunodeficiência humana sobre a perspectiva de uma futura gestação. Método: trata-se de um estudo qualitativo, descritivo, tipo explicativo, com a participação de 13 mulheres atendidas numa unidade de referência que atende pessoas que vivem com HIV. Utilizou-se para análise dos dados a técnica de Análise de Conteúdo com o auxílio do software IRAMUTEQ por meio do método de Reinert. Resultados: identificaram-se cinco categorias temáticas: << Medo do risco da transmissão vertical >>; << A descoberta do HIV: a importância do diagnóstico >>; << O desejo da mulher em gestar a partir da vontade do parceiro >>; << Terapia antirretroviral e adesão ao tratamento >> e, << Desconhecimento ou pouco conhecimento sobre a possibilidade de gestar >>. Conclusão: expressou-se o desejo de ser mãe pelas participantes, mesmo vivendo com HIV, porém, o medo da transmissão ainda é um problema enfrentado por elas. Verifica-se, assim, a necessidade de realização de práticas educativas em saúde que discutam o desejo das mulheres em gestar, sendo necessárias a realização de educação permanente e continuada para os profissionais e a produção de tecnologias educativas.(AU)


Objective: to analyze the perception of women living with the human immunodeficiency virus on the perspective of a future pregnancy. Method: it is a qualitative, descriptive, explanatory type study, with the participation of 13 women attended at a reference unit that attends people living with HIV. The Content Analysis technique was used for data analysis with the aid of the IRAMUTEQ software using Reinert's method. Results: five thematic categories were identified: << Fear of the risk of vertical transmission >>; << The discovery of HIV: the importance of diagnosis >>; << The woman's desire to gestate from the partner's will >>; << Antiretroviral therapy and treatment adherence >> and << Ignorance or little knowledge about the possibility of pregnancy >>. Conclusion: the desire to be a mother was expressed by the participants, even living with HIV, however, the fear of transmission is still a problem faced by them. Thus, there is a need to carry out educational health practices that discuss the desire of women to gestate, requiring permanent and continuous education for professionals and the production of educational technologies.(AU)


Objetivo: analizar la percepción de las mujeres que viven con el virus de la inmunodeficiencia humana en la perspectiva de un futuro embarazo. Método: es un estudio cualitativo, descriptivo, explicativo, con la participación de 13 mujeres atendidas en una unidad de referencia que atiende a personas que viven con el VIH. La técnica de Análisis de Contenido se utilizó para el análisis de datos con la ayuda del software IRAMUTEQ utilizando el método de Reinert. Resultados: se plantearon cinco categorías temáticas: << Miedo al riesgo de transmisión vertical >>; << El descubrimiento del VIH: la importancia del diagnóstico >>; << El deseo de la mujer de gestarse por voluntad de la pareja >>; << Terapia antirretroviral y adherencia al tratamiento >> e << Ignorancia o poco conocimiento sobre la posibilidad de embarazo >>. Conclusión: las participantes expresaron el deseo de ser madre, incluso viviendo con VIH, sin embargo, el miedo a la transmisión sigue siendo un problema que enfrentan. Por lo tanto, existe la necesidad de llevar a cabo prácticas educativas de salud que discutan el deseo de las mujeres de gestar, lo que requiere educación permanente y continua para los profesionales y la producción de tecnologías educativas.(AU)


Assuntos
Humanos , Feminino , Percepção , Mulheres , Gravidez , Saúde da Mulher , Síndrome de Imunodeficiência Adquirida , Síndrome de Imunodeficiência Adquirida/transmissão , HIV , Transmissão Vertical de Doença Infecciosa , Direitos Sexuais e Reprodutivos , Cuidados de Enfermagem , Epidemiologia Descritiva , Pesquisa Qualitativa
11.
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
12.
BMC Public Health ; 19(1): 1630, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31801504

RESUMO

BACKGROUND: The purpose of this study was to evaluate the coverage of HIV health education among rural residents in western China by ascertaining their awareness of HIV/AIDS and its transmission routes, and to investigate how these residents receive health information. METHODS: A survey was conducted through stratified clustered sampling at 99 county hospitals in 11 provinces in western China. Information was collected on awareness of HIV/AIDS and its transmission routes, as well as residents' access to health knowledge. Chi-square analysis was used to analyse the differences in HIV/AIDS awareness (knowing of the existence of HIV/AIDS, hereinafter referred to as "HIV awareness rate") between different subgroups categorized by demographic status, regional factors, and different methods of access to health knowledge. To further analyse the effects of access to health knowledge on HIV awareness, a logistic regression model was established. The relationship between access to health knowledge and transmission routes was also examined using chi-square analysis. RESULTS: The HIV awareness rate of the total 9274 participants was 80.9%. There were statistically significant differences between subgroups classified by age (χ2 = 482.118, p<0.001), education (χ2 = 853.465, p<0.001), occupation (χ2 = 340.553, p<0.001), income (χ2 = 186.448, p<0.001), cumulative HIV cases according to province (χ2 = 59.513, p<0.001), per capita annual net income of rural households according to province (χ2 = 64.676, p<0.001), proportion of minority population according to province (χ2 = 94.898, p<0.001), direct access to health knowledge (medical staff: χ2 = 419.775, p<0.001; mass media: χ2 = 740.238, p<0.001; family members: χ2 = 12.189, p<0.001; socializing: χ2 = 48.780, p<0.001; health education activities: χ2 = 154.400, p<0.001), and indirect access to health knowledge (having a non-communicable disease with medical instructions χ2 = 78.709, p<0.001; physical examinations: χ2 = 135.679, p<0.001). The logistic regression model showed that education and mass media had the strongest impacts on HIV awareness among all methods of access. Participants had the least awareness of HIV's mother-to-child transmission route. CONCLUSION: The HIV awareness rate indicated that previous HIV health education covered 80% of the rural population in western China. Mass media should take greater responsibility in HIV health education for the general population, and special attention should be paid to the elderly, the most impoverished population, minority community as well as the mother-to-child transmission route.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , População Rural/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Conscientização , China/epidemiologia , Informação de Saúde ao Consumidor/métodos , Estudos Transversais , Feminino , Humanos , Transmissão Vertical de Doença Infecciosa , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
13.
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
14.
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
16.
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
17.
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 , Idioma , 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
18.
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
19.
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
20.
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
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