Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.366
Filtrar
1.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190006, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576982

RESUMO

INTRODUCTION: Knowing the factors associated with periodic HIV testing among female sex workers (FSW) is essential to expand testing coverage and to broaden programs of treatment as prevention. METHODS: We used data from 4,328 FSWs recruited by the respondent-driven sampling (RDS) method in 12 Brazilian cities in 2016. Data analysis considered the complex sampling design. The prevalence of HIV testing in the last year and periodic HIV test were estimated. Factors associated with regular HIV testing were identified through logistic regression models. RESULTS: The testing coverage in the last year was 39.3%. Only 13.5% of FSW reported having performed a periodic HIV test in the last year. Among the factors associated with the higher probability of HIV testing in the last year were a better level of education, living with a partner, working indoors, consistent use of condoms, and regular use of public and private health services stood out. DISCUSSION: Periodic HIV testing allows early diagnosis and immediate treatment of cases, reducing the chances of spreading the infection to the population. However, factors such as stigma and discrimination hinder the use of regular health services. CONCLUSION: It is necessary to expand awareness campaigns, especially among FSWs with low educational level and greater vulnerability, in order to broaden the perception of risk and the importance of periodic testing, in addition to encouraging regular health care.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Infecções por HIV/diagnóstico , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , Brasil , Preservativos/estatística & dados numéricos , Escolaridade , Feminino , Serviços de Saúde/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Análise Multivariada , Comportamento Sexual , Adulto Jovem
2.
BMC Infect Dis ; 19(1): 807, 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-31521123

RESUMO

BACKGROUND: HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. METHODS: We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. RESULTS: We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47-2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13-2.06). CONCLUSION: HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.


Assuntos
Sorodiagnóstico da AIDS/métodos , Autoavaliação Diagnóstica , Infecções por HIV/diagnóstico , HIV/imunologia , Homossexualidade Masculina/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto , China , Preservativos , Seguimentos , Infecções por HIV/prevenção & controle , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Assunção de Riscos , Sexo Seguro , Inquéritos e Questionários , Adulto Jovem
3.
BMC Infect Dis ; 19(Suppl 1): 788, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31526372

RESUMO

BACKGROUND: Since 2001 the South African guidelines to improve child health and prevent vertical HIV transmission recommended frequent infant follow-up with HIV testing at 18 months postpartum. We sought to understand non-attendance at scheduled follow-up study visits up to 18 months, and for the 18-month infant HIV test amongst a nationally representative sample of HIV exposed uninfected (HEU) infants from a high HIV-prevalence African setting. METHODS: Secondary analysis of data drawn from a nationally representative observational cohort study (conducted during October 2012 to September 2014) of HEU infants and their primary caregivers was undertaken. Participants were eligible (N = 2650) if they were 4-8 weeks old and HEU at enrolment. All enrolled infants were followed up every 3 months up to 18 months. Each follow-up visit was scheduled to coincide with each child's routine health visit, where possible. The denominator at each time point comprised HEU infants who were alive and HIV-free at the previous visit. We assessed baseline maternal and early HIV care characteristics associated with the frequency of 'Missed visits' (MV-frequency), using a negative binomial regression model adjusting for the follow-up time in the study, and associated with missed visits at 18 months (18-month MV) using a logistic regression model. RESULTS: The proportion of eligible infants with MV was lowest at 3 months (32.7%) and 18 months (31.0%) and highest at 12 months (37.6%). HIV-positive mothers not on triple antiretroviral therapy (ART) by 6-weeks postpartum had a significantly increased occurrence rate of 'MV-frequency' (adjusted incidence rate ratio, 1.2 (95% confidence interval (CI), 1.1-1.4), p < 0.0001). Compared to those mothers with ART, these mothers also increased the risk of '18-month-MV' (adjusted odds ratio, 1.3 (CI, 1.1-1.6), p = 0.006). Unknown infant nevirapine-intake status increased the rate of 'MV-frequency' (p = 0.02). Mothers > 24 years had a significantly reduced rate of 'MV-frequency' (p ≤ 0.01) and risk of '18-month-MV' (p < 0.01) compared to younger women. Shorter travel time to health facility lowered the occurrence of 'MV-frequency' (p ≤ 0.004). CONCLUSION: Late initiation of maternal ART and infant prophylaxis under the Option- A policy and extended travel time to clinics (measured at 6 weeks postpartum), contributed to higher postnatal MV rates. Mothers older than 24 years had lower MV rates. Targeted interventions may be needed during the current PMTCT Option B+ (lifelong ART to pregnant and lactating women at HIV diagnosis) to circumvent these risk factors and reduce missed visits during HIV-care.


Assuntos
Sorodiagnóstico da AIDS , Saúde da Criança , Infecções por HIV/diagnóstico , HIV/imunologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Perda de Seguimento , Cuidado Pós-Natal/métodos , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade , Estudos Transversais , Feminino , Seguimentos , Infecções por HIV/tratamento farmacológico , Instalações de Saúde , Humanos , Lactente , Recém-Nascido , Lactação , Pessoa de Meia-Idade , Mães/educação , Cuidado Pós-Natal/economia , Período Pós-Parto , Gravidez , Fatores de Risco , África do Sul , Inquéritos e Questionários , Viagem , Adulto Jovem
4.
BMC Infect Dis ; 19(Suppl 1): 785, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31526381

RESUMO

BACKGROUND: In June 2015, South Africa introduced early infant HIV diagnosis (EID) at birth and ten weeks postpartum. Guidelines recommended return of birth results within a week and ten weeks postpartum results within four weeks. Task shifting was also suggested to increase service coverage. This study aimed to understand factors affecting return of EID results to caregivers. METHODS: Secondary analysis of data gathered from 571 public-sector primary health care facilities (PHCs) during a nationally representative situational assessment, was conducted. The assessment was performed one to three months prior to facility involvement in the 2010 evaluation of the South African programme to prevent mother-to-child HIV transmission (SAPMTCTE). Self-reported infrastructural and human resource EID-related data were collected from managers and designated staff using a structured questionnaire. The main outcome variable was 'EID turn-around-time (TAT) to caregiver' (caregiver TAT), measured as reported number of weeks from infant blood draw to caregiver receipt of results. This was dichotomized as either short (≤3 weeks) or delayed (> 3 weeks) caregiver TAT. Logit-based risk difference analysis was used to assess factors associated with short caregiver TAT. Analysis included TAT to facility (facility TAT), defined as reported number of weeks from infant blood draw to facility receipt of results. RESULTS: Overall, 26.3% of the 571 PHCs reported short caregiver TAT. In adjusted analyses, short caregiver TAT was less achieved when facility TAT was > 7 days (versus ≤7 days) (adjusted risk difference (aRD): - 0.2 (95% confidence interval - 0.3-(- 0.1)), p = 0.006 for 8-14 days and - 0.3 (- 0.5-(- 0.1)), p = 0.006 for > 14 days), and in facilities with staff nurses (compared to those without) (aRD: - 9.4 (- 16.6-(- 2.2), p = 0.011). CONCLUSION: Although short caregiver TAT for EID was only reported in approximately 26% of facilities, these facilities demonstrate that achieving EID TAT of ≤3 weeks is possible, making timely ART initiation within 3 weeks of diagnosis feasible within the public health sector. Our adjusted analyses underpin the need for quick return of results to facilities. They also raise questions around staff mentoring: we hypothesise that facilities with staff nurses were likely to have fewer professional nurses, and thus inadequate senior support.


Assuntos
Cuidadores , Infecções por HIV/diagnóstico , HIV/imunologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Laboratórios Hospitalares/organização & administração , Recursos Humanos/organização & administração , Sorodiagnóstico da AIDS , Estudos Transversais , Diagnóstico Precoce , Feminino , Humanos , Recém-Nascido , Programas de Rastreamento , Análise Multivariada , Enfermeiras Neonatologistas , Parto/sangue , Período Pós-Parto , Gravidez , Autorrelato , África do Sul
5.
AIDS Behav ; 23(Suppl 3): 224-232, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31473847

RESUMO

HIV prevention goals in the United States include reducing new HIV infections among people in the South Census region (commonly referred as the South). Using data reported to the National HIV Surveillance System, we examined trends in HIV diagnoses in the South, including the Deep South and Other South, during 2012-2017. Although diagnosis rates declined in all regions during the time period, declines were greater in all other regions compared to the Deep South, with the exception of the West region. Moreover, the South continues to have a diagnosis rate 50% higher (65% higher in the Deep South) than that of any other region. Diagnoses in the Deep South increased among some groups, including men who have sex with men, persons aged 25-34 years and Hispanics/Latinos. These findings highlight the need to further strengthen interventions in the South, particularly among communities of color and young adults.


Assuntos
Sorodiagnóstico da AIDS/tendências , Infecções por HIV/diagnóstico , Vigilância da População , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Hispano-Americanos , Homossexualidade Masculina , Humanos , Masculino , Sudeste dos Estados Unidos/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
6.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414755

RESUMO

BACKGROUND: The instructions of manufacturers of methodologies for anti-HIV-1/2 antibodies screening tests re-commend avoiding analyzing blood samples with hemolysis or lipemia, but they do not mention references about scientific studies evaluating their interference. The increased need for an opportune detection of HIV infection to avoid its spread has led to public health institutions including routine HIV screening even in internal medicine and emergency rooms. Nevertheless, these blood samples are usually associated with the presence of lipemia and/ or hemolysis, leaving doubt for probable misinterpretations. This fact highlights the need for applying verification techniques, established under the internal methodological conditions of each laboratory, in order to increase the coverage of HIV screening and to ensure the reliability of their results. METHODS: Following the ethics committee approval and patient's informed consent, a confirmed anti-HIV-1 positive human serum (undetectable viral load and p24 antigen, and stable total lymphocytes > 30%) was obtained. This work describes techniques for the semiquantitative analysis of anti-HIV antibodies of three commercial HIV-screening methodologies (immunochromatography, enzyme-immunoassay and chemiluminescence) and to deter-mine the detection limit of these screening tests, as well as evaluating the maximum concentration of total lipids and of free hemoglobin that do not interfere in the detection limits. RESULTS: The highest analyzed concentration of total lipid (870 mg/dL) did not interfere with the detection limits of anti-HIV-1 antibodies in any of the evaluated methodologies. Free hemoglobin presented interference at different concentrations depending on the methodology: immunochromatography (0.57 g/dL)), enzyme-immunoassay (8.6 g/dL), and chemiluminescence (11.5 g/dL)). CONCLUSIONS: Concentrations of lipemia above postprandial levels or hemolysis induced by experimental manipulation might not interfere with HIV-serological screening. Determining the maximum permissible limits of lipemia and hemolysis by each manufacturer or laboratory based on an internal evaluation of their serological methodology would increase the reliability of HIV-diagnosis in internal medicine and emergency rooms and in patients with dyslipidemia or physiological hemolysis.


Assuntos
Anticorpos Anti-HIV/imunologia , Infecções por HIV/diagnóstico , Soropositividade para HIV/diagnóstico , HIV-1/imunologia , Sorodiagnóstico da AIDS/métodos , Anticorpos Anti-HIV/sangue , Infecções por HIV/sangue , Infecções por HIV/virologia , Soropositividade para HIV/sangue , Soropositividade para HIV/virologia , HIV-1/fisiologia , Hemoglobinas/imunologia , Hemoglobinas/metabolismo , Hemólise/imunologia , Humanos , Hiperlipidemias/sangue , Hiperlipidemias/imunologia , Limite de Detecção , Lipídeos/sangue , Lipídeos/imunologia , Sensibilidade e Especificidade
7.
Enferm. clín. (Ed. impr.) ; 29(4): 239-244, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182918

RESUMO

Introducción: En la Comunidad de Madrid existe un 42,7% de retraso diagnóstico de VIH. La atención primaria es la puerta de entrada al sistema sanitario y se desconoce la frecuencia de serologías solicitadas por estos profesionales. Los objetivos fueron conocer la frecuencia y factores asociados a la solicitud de serologías de VIH por profesionales de medicina y de enfermería de atención primaria de la Comunidad de Madrid. Método: Mediante encuesta on-line, se preguntó por la solicitud de serologías para VIH en los últimos 12 meses, a profesionales que participaron en el estudio de evaluación de estrategias de diagnóstico precoz de VIH en consultas de atención primaria de la Comunidad de Madrid (ESTVIH). La asociación entre la solicitud de serologías y las características sociodemográficas y de práctica clínica de los profesionales se cuantificó mediante odds ratio ajustadas (ORa) según regresión logística. Resultados: Se obtuvieron 264 encuestas (59,5% medicina). El 82,2% de profesionales medicina y el 18,7% de enfermería refirieron haber solicitado alguna serología de VIH en los últimos 12 meses (mediana de 15 y 2 serologías solicitadas, respectivamente). En medicina esta petición se asoció con sexo masculino (ORa: 2,95; IC95%: 0,82-10,56) y estar entrenado para dar consejo pre-post prueba de VIH (ORa: 2,42; IC95%: 0,84-6,93); en enfermería se asoció con edad (<50años; ORa: 2,75; IC95%: 0,97-7,75) y tiempo trabajado en atención primaria (>13años; ORa: 3,02; IC95%: 1,07-8,52). Conclusión: Es necesario promover la solicitud de pruebas de VIH y el entrenamiento pre-post prueba de VIH en profesionales de medicina y enfermería de atención primaria


Introduction: In the Community of Madrid there is 42.7% late HIV diagnosis. Primary care is the gateway to the health system and the frequency of serological tests requested by these professionals is unknown. The objectives were to establish the frequency of requests for HIV serology by medical and nursing primary care professionals in the Community of Madrid and the factors associated with these requests. Method: An 'on-line' survey was conducted, asking professionals who participated in the evaluation study of strategies to promote early diagnosis of HIV in primary care in the Community of Madrid (ESTVIH) about the number of HIV-serology tests requested in the last 12 months. The association between HIV-serology requesting and the sociodemographic and clinical practice characteristics of the professionals was quantified using adjusted odds ratios (aOR) according to logistic regression. Results: 264 surveys (59.5% physicians). Eighty-two point two percent of medical and 18.7% of nursing professionals reported requesting at least one HIV-serology in the last 12 months (median: 15 and 2 HIV-serology request, respectively). The doctors associated the request with: being male (aOR: 2.95; 95% CI: 0.82-10.56), being trained in pre-post HIV test counselling (aOR: 2.42; 95% CI: 0.84-6.93) and the nurses with: age (<50 years; aOR: 2.75; 95% CI: 0.97-7.75), and number of years working in primary care (>13 years; aOR: 3.02; 95% CI: 1.07-8.52). Conclusion: It is necessary to promote HIV testing and training in pre-post HIV test counselling for medical and nursing professionals in primary care centres


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Sorodiagnóstico da AIDS/tendências , Atenção Primária à Saúde/normas , Pessoal de Saúde , Diagnóstico Precoce , Inquéritos e Questionários , Sistemas On-Line/estatística & dados numéricos
8.
Implement Sci ; 14(1): 62, 2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200757

RESUMO

BACKGROUND: People who inject drugs (PWID) in Kazakhstan face many barriers to HIV testing as well as to accessing HIV care, to retention in HIV care, and to initiating and adhering to anti-retroviral treatment (ART). Needle and syringe programs (NSPs) are an opportune setting for integrated interventions to link PWID to HIV care. METHODS: This Hybrid Type II study employs a stepped-wedge design to evaluate both effectiveness and implementation outcomes of Bridge, an intervention to identify, test, and link HIV-positive PWID to HIV care. The study is conducted at 24 NSPs in three different regions of Kazakhstan, to assess outcomes on the individual, organizational, and policy levels. DISCUSSION: This trial responds to an identified need for new models of HIV service delivery for PWID through harm reduction settings. TRIAL REGISTRATION: NCT02796027 on June 10, 2016.


Assuntos
Sorodiagnóstico da AIDS , Assistência à Saúde/normas , Infecções por HIV/transmissão , Melhoria de Qualidade , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Aconselhamento , Feminino , Humanos , Cazaquistão/epidemiologia , Masculino , Prevalência , Encaminhamento e Consulta , Projetos de Pesquisa , Rede Social , Abuso de Substâncias por Via Intravenosa/epidemiologia
10.
BMC Public Health ; 19(Suppl 1): 602, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31138289

RESUMO

BACKGROUND: Despite recent progress, there exist gaps in the prevention of vertical HIV transmission program access and uptake in Cameroon. Female sex workers (FSW), many of whom are mothers, are disproportionately affected by HIV and have specific barriers to HIV testing and treatment access. Testing for HIV-exposed infants is crucial in monitoring for incident infection and timely intervention. This study explores the level of early childhood testing and also associations between antenatal care (ANC) attendance and other factors and early childhood HIV testing among FSW in Cameroon. METHODS: FSW were recruited to participate in an integrated biobehavioral survey in Cameroon between December 2015 and October 2016. Women were included in these analyses if they were living with HIV and had at least one living child. Both univariate and multivariable logistic regression were used to look at predictors of a child being tested for HIV before age five. RESULTS: A total of 481/2255 FSW were eligible for these analyses as they were HIV seropositive and had at least one living child at the time of the study. Women included in these analyses had a median age of 35(IQR 30-41). Nearly 70% reported none of their children had been tested for HIV before age five (326/481), and 3.5%(17/481) reported one or more of their children had been diagnosed with HIV. ANC attendance (adjusted OR 2.12, 95% CI: [1.02, 4.55]), awareness of HIV status (aOR 3.70[2.30, 5.93]), pregnancy intentions (aOR 1.89[1.16, 3.08]), and higher education (aOR 2.17[1.01, 4.71]) were all independently associated with increased odds of women having a greater proportion of children tested for HIV before age five. Regional differences in early childhood testing were also observed. CONCLUSION: Vertical transmission of HIV remains a challenge in Cameroon, and HIV testing among children of FSW living with HIV was very low. ANC attendance and promotion of the mother's health were associated with increased child HIV testing. For women at high risk of HIV and for whom engagement in the health system is low, strategies to promote and ensure ANC attendance are essential for their health and the health of their children.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Filho de Pais Incapacitados/estatística & dados numéricos , Infecções por HIV/diagnóstico , Profissionais do Sexo/estatística & dados numéricos , Adulto , Camarões , Criança , Pré-Escolar , Diagnóstico Precoce , Feminino , HIV , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Modelos Logísticos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos
11.
Aust N Z J Public Health ; 43(5): 419-423, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31141274

RESUMO

OBJECTIVE: PRONTO!, a peer-led rapid HIV-testing service in Melbourne, Australia, opened to improve HIV testing among gay and bisexual men (GBM). We compared client characteristics and return testing among GBM testing at PRONTO! with GBM testing at Melbourne Sexual Health Centre (MSHC). METHODS: All GBM attending PRONTO! and MSHC for HIV testing between August 2013 and April 2016 were included. We describe the number of tests, percentage of clients who returned during follow-up, the mean number of tests and median time between tests at the two services. RESULTS: At PRONTO!, 33% of 3,102 GBM and at MSHC 50% of 9,836 GBM returned for a further HIV test at least once. The mean number of tests per client was 1.7 and 2.5 at PRONTO! and MSHC (p<0.01), respectively. A majority of clients at both services reported behaviours that would recommend up to quarterly testing, however, the median time between tests was 20.0 and 17.0 weeks at PRONTO! and MSHC (p<0.01), respectively. CONCLUSIONS: A greater proportion of clients returned and returned frequently at MSHC compared to PRONTO!, however, at both services HIV testing frequency was suboptimal. Implications for public health: Novel HIV testing services should provide convenient and comprehensive sexual health services.


Assuntos
Bissexualidade/estatística & dados numéricos , Infecções por HIV/diagnóstico , Homossexualidade Masculina/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Sorodiagnóstico da AIDS , Adulto , Austrália , Bissexualidade/psicologia , Serviços de Saúde Comunitária , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Humanos , Masculino , Programas de Rastreamento/métodos , Estudos Retrospectivos , Minorias Sexuais e de Gênero
12.
PLoS One ; 14(4): e0215353, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30986228

RESUMO

BACKGROUND: HIV-self-testing (HIVST) could be a strategy to get more people tested for HIV in resource limited settings. One of the prerequisites of a successful HIVST programme is the availability of an easy to use, valid HIV-test which is robust against field conditions and procedural errors by untrained lay users. METHODS AND FINDINGS: The primary objective of this study was to evaluate the ability of untrained persons to correctly interpret the OraQuick HIV Self-Test results with oral fluid compared with results obtained by trained users using the matched lot OraQuick Rapid HIV-1/2 Antibody Test and blinded to the results of the Self-Test. Sensitivity of the OraQuick HIV Self-Test in untrained users was 101 in 102 (99.02%; 95%CI = 93.88-99.95%)-and specificity- 1,241 in 1,241 (100.0%; 95%CI = 99.62-100.0%). Forty-eight Self-Tests were excluded in the accuracy analysis (due to a result read as invalid, not sure or ambiguous) resulting in a test system failure rate of 3.45% (95% CI 2.56%-4.55%). At least one observation of difficulty or error with one or more of the test steps were seen in 1,193 (84.6%) participants. Age, education and health literacy were independently associated with the sum score of procedural errors and difficulties. Four tests did not provide a valid result as determined by the trained user's interpretation of the Self-Test. CONCLUSIONS: The OraQuick HIV Self-Test provides reliable and repeatable results in a rural field environment in spite of procedural errors.


Assuntos
Sorodiagnóstico da AIDS/métodos , Anticorpos Anti-HIV/metabolismo , Infecções por HIV , HIV-1/metabolismo , HIV-2/metabolismo , Saliva/metabolismo , Autocuidado , Adolescente , Adulto , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , África do Sul
13.
Int J Infect Dis ; 83: 86-87, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30986542

RESUMO

Severe malaria is an uncommon diagnosis in the United States. However, awareness of signs, symptoms, and treatment options is imperative in order to promptly initiate optimal therapy. False positive human immunodeficiency virus (HIV) results are rare in the setting of acute malaria infection and with the introduction of newer fourth-generation immunoassays. The Centers for Disease Control algorithms assist in confirming true HIV infection (Branson et al. 2014).


Assuntos
Sorodiagnóstico da AIDS , Reações Falso-Positivas , Infecções por HIV/diagnóstico , Malária/complicações , Sorodiagnóstico da AIDS/normas , Feminino , Infecções por HIV/virologia , Humanos , Malária/diagnóstico , Pessoa de Meia-Idade
14.
BMC Res Notes ; 12(1): 238, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023349

RESUMO

OBJECTIVE: Efforts to dual eradication of mother-to-child transmission of human immune deficiency virus (HIV) and syphilis have improved in the previous decades. This has however been hindered by limited validation studies. A cross-sectional study was conducted among adult pregnant women attending antenatal care clinic at Mayuge Health Center III. Two milliliters of venous blood were collected into Ethylene di-amine tetra acetic acid vacutainers, and tested for HIV and syphilis using the SD Bioline HIV/Syphilis Duo assay, and the national HIV and syphilis testing algorithm. Sensitivity and specificity were calculated for the Duo Kit against the gold standards within 95% confidence intervals. RESULTS: Three hundred and eighty-two (382) participants were enrolled. Their mean age was 25.8 years. The prevalence of HIV was 1.8% (95% confidence interval 1.23-2.41); while that of syphilis was 2.1% (95% confidence interval 1.81-2.54), and the dual infection was 0.52% (95% confidence interval 0.37-0.92). The sensitivity and specificity of the SD Bioline HIV/Syphilis Duo assay were all 100.0% (95% confidence interval 99.5 to 100.0 and 98.6 to 100.0, respectively). The performance of the SD Bioline HIV/Syphilis Duo Kit was optimal, reassuring its aptness for use, and favorable qualities to a limited resource setting.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Kit de Reagentes para Diagnóstico/provisão & distribução , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Centros Comunitários de Saúde , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Pessoa de Meia-Idade , Gravidez , Cuidado Pré-Natal/métodos , Prevalência , Kit de Reagentes para Diagnóstico/economia , Sensibilidade e Especificidade , Sífilis/epidemiologia , Sífilis/virologia , Uganda/epidemiologia
15.
Recurso educacional aberto em Português | CVSP - Brasil | ID: cfc-379978

RESUMO

Já imaginou tomar um comprimido por dia e diminuir de maneira significativa as chances de contrair o HIV em caso de uma exposição? É basicamente assim que funciona o novo método de prevenção ao HIV oferecido pelo Ministério da Saúde. A Profilaxia Pré-Exposição, ou PrEP, como é mais conhecida, é um dos componentes da abordagem adotada pelo Ministério para combater o HIV, chamada de prevenção combinada, onde a pessoa tem a opção de usar um método de prevenção ou combinar vários que se ajustem às suas necessidades, características individuais ou momentos de vida. É dentro desse contexto que o SUS passa a oferecer a pílula que combina o medicamento tenofovir e o entricitabina. Um único medicamento por dia é tomado regularmente, mesmo que não haja suspeita de exposição, pois o objetivo é que ela funcione como uma barreira para o HIV antes da pessoa ter contato com o vírus. A apresentadora Mônica Bittencourt conversa com a Diretora do INI/Fiocruz, Valdiléa Veloso sobre a PrEP. Participante: Júlio Moreira, diretor sóciocultural do Grupo Arco-íris.


Assuntos
Sorodiagnóstico da AIDS , Sorodiagnóstico da AIDS , Antirretrovirais
16.
Cent Eur J Public Health ; 27(1): 50-53, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927397

RESUMO

OBJECTIVE: HIV testing among people who inject drugs (PWID) in Russia has been documented to be low; however, few studies have been conducted outside of the major metropolitan cities. The aim of this study was to determine how many PWID were aware of their HIV serostatus and what motivators were associated with getting tested for HIV. METHODS: Our analysis describes HIV testing behaviours among 593 PWID in Ivanovo and Novosibirsk, Russia. Participants completed a questionnaire and consented to HIV testing. We used logistic regression modelling to determine demographic and behavioural correlates of HIV testing. RESULTS: Self-reported history of HIV testing was 52% in Ivanovo and 54% in Novosibirsk. Prior knowledge of serostatus was very low among PWID who tested positive (3 of 102 in Ivanovo and 0 of 11 in Novosibirsk). The most common reason for testing was doctor referral, and the most common locations were government HIV/AIDS centres and prisons. HIV testing was rarely client initiated or led by a personal motivation for being tested. CONCLUSIONS: HIV testing in Ivanovo and Novosibirsk is suboptimal, resulting in poor knowledge of HIV serostatus. More programmes to promote HIV testing among PWID are urgently needed in both cities.


Assuntos
Sorodiagnóstico da AIDS/métodos , Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/psicologia , Cidades , Usuários de Drogas/psicologia , HIV , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Masculino , Programas de Rastreamento , Federação Russa/epidemiologia
17.
Cent Eur J Public Health ; 27(1): 54-57, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927398

RESUMO

OBJECTIVE: Men who have sex with men (MSM) are disproportionately affected by HIV in Greece. However, research on HIV incidence in this group is lacking. This study aimed at estimating HIV incidence among MSM in Athens, Greece. METHODS: The analysis included routinely collected data between January 2013-June 2015 from adult MSM who visited a community-based facility (Ath Checkpoint) at least twice and were non-reactive to the rapid INSTITM HIV-1/HIV-2 assay at baseline. HIV conversion rates were calculated by dividing the number of clients who became reactive by the person-years of observation. All statistical analyses including Poisson regression models were conducted in STATA 14. RESULTS: A total of 1,243 MSM contributed 1,102.50 person-years (py). The overall (per 100 py) conversion rate was 3.99 (95% CI: 2.97-5.36). In multivariable analyses, age less than 30 years was associated with an increased risk of HIV conversion (rate ratio: 2.01; 95% CI: 1.08-3.76). CONCLUSIONS: This analysis shows high rates of HIV conversion among MSM who repeatedly visit a community-based testing site. Ath Checkpoint could contribute to HIV surveillance and identify a high-risk group that could benefit from essential health interventions.


Assuntos
Infecções por HIV/epidemiologia , Soropositividade para HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Parceiros Sexuais/psicologia , Sorodiagnóstico da AIDS , Adulto , Centros Comunitários de Saúde , Grécia/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Humanos , Incidência , Masculino , Programas de Rastreamento
18.
Int J STD AIDS ; 30(6): 577-585, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30813861

RESUMO

Although men who have sex with men (MSM) have the highest human immunodeficiency virus (HIV) prevalence in Guatemala, prevention efforts have been focused on other vulnerable populations. Respondent-driven sampling was used to recruit 444 MSM in Guatemala City to explore factors related to HIV testing among MSM. About 56% of participants reported HIV testing in the past 12 months, which was associated with a public MSM status (adjusted odds ratio (AOR) 2.08; 95% CI 1.02-4.26), participating in peer HIV prevention intervention (AOR 3.71; 95% CI 1.86-7.43), having at least one casual male partner (AOR 2.16; 95% CI 1.11-4.20), and practicing only insertive anal sex (AOR 3.35; 95% CI 1.59-7.09). Men with comprehensive HIV knowledge (AOR 2.63; 95% CI 1.38-5.02) were also more likely to have been tested. Further interventions in Guatemala targeting the most hidden MSM are needed.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/estatística & dados numéricos , Programas de Rastreamento/métodos , Assunção de Riscos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Guatemala/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Prevalência , Fatores de Risco , Comportamento Sexual/psicologia , Parceiros Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
19.
BMC Infect Dis ; 19(1): 278, 2019 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-30909885

RESUMO

BACKGROUND: HIV pre-exposure prophylaxis (PrEP) was implemented in France in November 2015 based on individual-level risk factors for HIV infection. We evaluated the proportion of missed opportunities for PrEP among newly HIV-diagnosed people entering the Dat'AIDS cohort in 2016. METHODS: Multicenter retrospective analysis in 15 French HIV clinical centers of patients with a new diagnosis of HIV infection. Among them we differentiated patients according to the estimated date of infection: those occurring in the PrEP area (a previous negative HIV test in the last 12 months or those with an incomplete HIV-1 western blot (WB) with no HIV-1 anti-Pol-antibody at time of HIV diagnosis) and those in the pre-PrEP area (older infections). Epidemiological, biological and clinical data at HIV diagnosis were collected. Clinicians retrospectively identified potential eligibility for PrEP based on individual-level risk factors for HIV infection among those infected in the PrEP area. RESULTS: Among 966 patients with a new HIV diagnosis, 225 (23.3%) were infected in the PrEP area and 121 (53.8%) had complete data allowing evaluation of PrEP eligibility. Among them, 110 (91%) would have been eligible for PrEP, median age 31 years, with 68 (75.6%) born in France and 10 (11.1%) in Central/West Africa, with more than one previous STI in 19 (15.7%). The main eligibility criteria for PrEP were being a man who had sex with men or transgender 91 (82.7%) with at least one of the following criteria: unprotected anal sex with ≥2 partners in the last 6 months: 67 (60.9%); bacterial sexually transmitted infection in the last 12 months: 33 (30%); Use of psychoactive substances in a sexual context (chemsex): 16 (14.5%). PrEP was indicated for other HIV risk factors in 25 (22.7%). CONCLUSION: With 91% (110/121) of patients infected in the PrEP area eligible for PrEP, this study highlights the high potential of PrEP in avoiding new infection in France but also shows a persistent delay in HIV testing. Thus, an important limit on PrEP implementation in France could be insufficient screening and care access.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição , Sorodiagnóstico da AIDS , Adulto , África Ocidental , Estudos de Coortes , Diagnóstico Tardio , Feminino , França , HIV-1 , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Comportamento Sexual , Parceiros Sexuais , Pessoas Transgênero , Sexo sem Proteção
20.
Artigo em Inglês | MEDLINE | ID: mdl-30860165

RESUMO

Background: Globally, 36.7 million people are infected with Human Immunodeficiency Virus (HIV). Of these 36.7 million people, 2.1 million are in India. Integrated counseling and testing centers are the cornerstones of early access to prevention and support services. The term "serodiscordant couple" refers to a couple where one partner is HIV-positive and the other HIV-negative. Aim: To study the serodiscordance rates in a cohort of people attending integrated counseling and testing center. Materials and Methods: Aretrospective descriptive study of data from integrated counseling and testing center from January 2013 to December 2014 was done. Results: Of the 7489 persons tested, 306 persons were positive for HIV (192 males and 114 females) with a prevalence of 4 percent. Of the 126 couples tested, serodiscordance was found in 46 couples, while 80 couples were seroconcordant. The overall prevalence of HIV serodiscordance was 36.5 percent. Male positive and female negative couples (M+ F-) were 35 (76.0%) and female positive and male negative (F+ M-) were 11 (23.9%). Discordant M+ F- couples were significantly higher than discordant F+ M- couples (P < 0.001). Most participants were aged between 21 and 40 years. The average age of men was 41.91 years and that of women was 34.21 years. The average age difference between life partners was 7.7 years. Significant association was seen between age and gender, as females were found to be younger (P value = 0.001). Limitation: Information regarding years of married life, number of sex partners or sexual behavior pre- and post-detection were not collected. Thus, our data present only the magnitude of serodiscordance in a cohort but does not analyze the other predictors of serodiscordance. Conclusion: Serodiscordant relationships occur more commonly in India than is presumed. Our study highlights the profile of serodiscordant couples in this part of the country. Effective measures to prevent transmission of HIV within a serodiscordant relationship are necessary steps in halting the HIV epidemic.


Assuntos
Sorodiagnóstico da AIDS , Infecções por HIV/sangue , Infecções por HIV/diagnóstico , Parceiros Sexuais , Centros de Atenção Terciária , Sorodiagnóstico da AIDS/tendências , Adulto , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária/tendências , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA