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2.
BMC Infect Dis ; 19(1): 1064, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856758

RESUMO

BACKGROUND: HIV, HBV and HCV remain a global public health concern especially in Africa. Prevalence of these infections is changing and identification of risk factors associated with each infection in Mali is needed to improve medical care. METHODS: We conducted a cross-sectional study of all individuals donating blood (n = 8207) in 2018 to the blood bank at university hospital in Bamako, Mali, to assess prevalence and risks factors associated with HIV, HBV, HCV and syphilis infections. RESULTS: HIV-seroprevalence was 2.16% and significantly increased with age, being married and decreasing education level. In multivariate analysis, after adjustements with age, marital status and geographical setting, only education level was associated with HIV-infection (OR, 1.54 [95% CI, 1.15-2.07], p = 0.016). HBsAg prevalence was 14.78% and significantly increased with to be male gender. In multivariate analysis, adjusting for age, marital status and type of blood donation, education level (OR, 1.17 [95%CI, 1.05-1.31], p = 0.02) and male gender (OR, 1.37 [95%CI, 1.14-1.65], p = 0.005) were associated with HBV-infection. HCV-prevalence was 2.32% and significantly increased with living outside Bamako. In multivariate analysis, adjusting for gender, age and education level, living outside Bamako was associated with HCV-infection (OR, 1.83 [95% CI, 1.41-2.35], p < 0.001). Syphilis seroprevalence was very low (0.04%) with only 3 individuals infected. Contrary to a prior study, blood donation type was not, after adjustments, an independent risk factor for each infection. CONCLUSIONS: Overall, HIV and HBV infection was higher in individuals with a lower level of education, HBV infection was higher in men, and HCV infection was higher in people living outside of Bamako. Compared to studies performed in 1999, 2002 and 2007 in the same population, we found that HIV and HCV prevalence have decreased in the last two decades whereas HBV prevalence has remained stable. Our finding will help guide infection prevention and treatment programs in Mali.


Assuntos
Doadores de Sangue , Infecções por HIV/epidemiologia , Soroprevalência de HIV/tendências , HIV/imunologia , Hepacivirus/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Sífilis/epidemiologia , Treponema pallidum/imunologia , Adolescente , Adulto , Coinfecção , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Masculino , Mali , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
3.
Rev. bioét. derecho ; (47): 93-107, nov. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184868

RESUMO

Este artículo tiene como propósito reflexionar sobre la situación de estigma y discriminación que afecta a personas con VIH/SIDA. Esto constituye una vulneración a los derechos fundamentales de estas personas y una barrera en el avance hacia la eliminación de la enfermedad. Ya que estudios realizados en diferentes países dan cuenta que las personas en esta condición se sienten discriminadas por la sociedad, y por los profesionales de la salud. Este es uno de los aspectos que ha dificultado el acceso al tratamiento, su adhesión, y educación para el cambio de conducta en los grupos de riesgo


Aquest article té com a propòsit reflexionar sobre la situació d'estigma i discriminació que afecta a persones amb VIH/SIDA. Això constitueix una vulneració dels drets fonamentals d'aquestes persones i una barrera en l'avanç cap a l'eliminació de la malaltia. Estudis realitzats en diferents països exposen que les persones en aquesta condició se senten discriminades per la societat i pels professionals de la salut. Aquest és un dels aspectes que ha dificultat l'accés al tractament, l'adhesió al mateix, i educació per al canvi de conducta en el grups de risc


This article aims to reflect on the situation of stigma and discrimination affecting people with HIV/AIDS. This constitutes a violation of the fundamental rights of these people and a barrier to progress towards the elimination of the disease. Studies carried out in different countries show that people in this condition feel discriminated against by society and by health professionals. This is one of the aspects that has hindered access to treatment, adherence, and behaviour change education in at-risk groups


Assuntos
Humanos , Ageismo/ética , Sexismo , Discriminação Social , Estigma Social , Grupos de Risco , Relações Profissional-Paciente/ética , Acesso aos Serviços de Saúde/legislação & jurisprudência , Pessoal de Saúde/ética , Síndrome de Imunodeficiência Adquirida/epidemiologia , Soroprevalência de HIV , Acesso aos Serviços de Saúde/ética , Direitos Humanos
4.
Rev Saude Publica ; 53: 71, 2019 Sep 09.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31508778

RESUMO

OBJECTIVE: To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS: This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS: The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS: HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.


Assuntos
Síndrome de Imunodeficiência Adquirida/mortalidade , Infecções por HIV/mortalidade , Síndrome de Imunodeficiência Adquirida/diagnóstico , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Escolaridade , Feminino , Infecções por HIV/diagnóstico , Soroprevalência de HIV/tendências , Serviços de Saúde do Indígena , Humanos , Índios Sul-Americanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
5.
Infez Med ; 27(3): 316-321, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545776

RESUMO

Transmission of infections through blood and blood product transfusion is a serious healthcare problem. There are insufficient up-to-date data about seroprevalence of HBsAg, anti-HCV and anti-HIV ½ among healthy blood donors in Turkey. We aimed to investigate the seroprevalence of HBsAg, anti-HCV and anti-HIV ½ in Southeastern Anatolia, Turkey. HBsAg, anti-HCV, and anti-HIV ½ analysis results among blood donors who applied to Dicle University Faculty of Medicine, Diyarbakir District Blood Centre, between January 1, 2011 and December 31, 2015 were retrospectively evaluated. HBsAg, anti-HCV, and anti-HIV 1/2 screenings were performed using a fully automated device with the microparticle enzyme immunoassay method (MEIA). The chi-square (χ2) test was applied to variables. Among the donors, 1607 (1.73%) were HBsAg-positive, 255 (0.27%) were anti-HCV-positive and two (0.0021%) were positive for anti-HIV 1/2. HBsAg positivity rates by years were 2.50% in 2011, 1.92% in 2012, 1.74% in 2013, 1.53% in 2014 and 1.27% in 2015 (p<0.001). HBsAg-positivity was 0.78% for the donors between 18-24 years of age, 1.90% for those between 25-49 years of age and 3.92% for donors over the age of 49 (p<0.001). Anti-HCV positivity rates were as follows: 0.35% in 2011, 0.34% in 2012, 0.29% in 2013, 0.23% in 2014 and 0.16% in 2015 (p<0.001). Verified anti-HIV 1/2 positivity was observed for only two donors (0.0021%) within five years. HBsAg and anti-HCV positivity were observed to decrease significantly over the years and were significantly lower among younger donors.


Assuntos
Doadores de Sangue/estatística & dados numéricos , Anticorpos Anti-HIV/sangue , HIV-1/imunologia , HIV-2/imunologia , Antígenos de Superfície da Hepatite B/sangue , Anticorpos Anti-Hepatite C/sangue , Adolescente , Adulto , Distribuição por Idade , Distribuição de Qui-Quadrado , Feminino , Soroprevalência de HIV , Nível de Saúde , Hepatite C/imunologia , Humanos , Técnicas Imunoenzimáticas/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estudos Soroepidemiológicos , Distribuição por Sexo , Fatores de Tempo , Turquia , Adulto Jovem
6.
MSMR ; 26(8): 2-9, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31442063

RESUMO

This report provides an update through June 2019 of the results of routine screening for antibodies to the human immunodeficiency virus (HIV) among civilian applicants for military service and among members of the active and reserve components of the U.S. Armed Forces. From January 2014-June 2019, full-year seroprevalences among applicants for service peaked in 2015 (0.34 per 1,000 tested) and then decreased during the subsequent 2 years (0.33 and 0.29 per 1,000 tested, respectively). Seroprevalences also peaked in 2015 for active component service members of the Army, Navy, and Air Force and among reservists of the Navy and Marine Corps. Overall (January 2014- June 2019) HIV antibody seroprevalences were highest among Army reservists, Army National Guard members, and Navy reservists. Across active and reserve components of all services, HIV antibody seroprevalences continued to be higher among men than women.


Assuntos
Infecções por HIV/epidemiologia , Soroprevalência de HIV , Militares/estatística & dados numéricos , Adulto , Feminino , Anticorpos Anti-HIV/sangue , Infecções por HIV/sangue , Infecções por HIV/diagnóstico , Humanos , Masculino , Programas de Rastreamento , Vigilância da População , Prevalência , Distribuição por Sexo , Estados Unidos/epidemiologia
7.
Ann Afr Med ; 18(2): 70-74, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31070147

RESUMO

Introduction: Human immunodeficiency virus (HIV) belongs to the Genus Lentiviruses and is made up of two main types HIV-1 and HIV-2 which are the causative agents of acquired immune deficiency syndrome (AIDS). It is well documented that HIV-1 infection is predominantly found, but HIV-2 infection has also been detected occasionally now and then. Objective: The objective of this study is to determine the seroprevalence of HIV-2 and dual infection in HIV-infected individuals along with the clinical presentation, co-infections, laboratory profile, and outcome of these patients. Materials and Methods: This descriptive cross-sectional study was carried out at a Tertiary Care Teaching Hospital for 2 years from August 2013 to July 2015, after obtaining approval from the Institutional Ethics Committee. Patients confirmed having HIV infection, as per the National AIDS Control Organization guidelines were included in the study. The sociodemographic pattern along with clinico-laboratory details and outcome were noted. Results and Discussion: In the present study, out of a total of 214 confirmed HIV-infected individuals, 2.8% (n = 6) were HIV-2 and 1.4% (n = 3) were dual infected where 40-50 years age group were most commonly affected. Males were more commonly affected than females in a ratio of 8:1. The most common presentation was fever (n = 5) followed by gastrointestinal (n = 5) symptoms. The most common opportunistic infection (OI) was tuberculosis (TB) (n = 4) followed by oral candidiasis (n = 2). Majority had anemia (n = 5) with raised erythrocyte sedimentation rate. Furthermore, majority (n = 7) showed improvement on discharge, whereas two (n = 2) left against medical advice and outcome is unknown. Conclusion: We conclude that the incidence of HIV-2 and dual infection does occur in our setup with males of older age group being more commonly affected where TB is the most common OI. Hence, clinicians should keep in mind that HIV-2 infection does occur and differentiating as HIV-1, HIV-2, or dual infection is important, to provide appropriate treatment which will result in decreased morbidity and mortality rates.


Assuntos
Infecções por HIV/epidemiologia , Soroprevalência de HIV , HIV-1 , HIV-2 , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/virologia , Síndrome de Imunodeficiência Adquirida , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/uso terapêutico , Coinfecção/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/sangue , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Atenção Terciária à Saúde , Tuberculose/epidemiologia , Adulto Jovem
8.
Reprod Health ; 16(1): 27, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832694

RESUMO

BACKGROUND: Sexually transmitted infections constitute a major public health problem worldwide. Syphilis and HIV infections cause various adverse pregnancy outcomes. Therefore, the aim of this study was to determine the seroprevalence of HIV and syphilis infections among pregnant women at Gondar Family Guidance Association clinic, northwest Ethiopia. METHODS: A retrospective study was conducted using sociodemographic and laboratory data obtained from registration books of Gondar Family Guidance Association clinic from January 2011 to April 2015. A binary logistic regression model was fit to identify factors associated with HIV and syphilis infections. Odds ratios with 95% confidence intervals were calculated to determine the strength of association between factors associated with HIV and syphilis infections. A p-value ≤0.05 was considered statistically significant. RESULTS: A total of 3504 pregnant women were included in the study from January 2011 to April 2015. The seroprevalence of HIV, and syphilis were 145 (4.1%) and 66(1.9%), respectively. Twenty-three (0.66%) women were co-infected. Age group 20-29 years (AOR: 3.86; 95% CI: 1.36-10.89), age group ≥30 years (AOR: 6.08; 95% CI: 2.04-18.14) compared to age < 20 year, and HIV-infection (AOR: 14.6; 95% CI: 8.49-25.18) were significantly associated with syphilis infection. There was a decline in trend seroprevalence of HIV from 5.2% in 2011 to 2.1% in 2015; and decline in syphilis seroprevalence from 2.6% in 2011 to 1.6% in 2015 but not statistically significant. CONCLUSION: The data showed that syphilis and HIV infections are still critical public health concerns among pregnant women. Screening of all pregnant women for these infections is valuable. Further community-based studies to identify risk factors are necessary.


Assuntos
Infecções por HIV/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal , Serviços Preventivos de Saúde , Sífilis/prevenção & controle , Adulto , Criança , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Soroprevalência de HIV , HIV-1/isolamento & purificação , Humanos , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Sífilis/epidemiologia , Sífilis/transmissão , Sorodiagnóstico da Sífilis , Adulto Jovem
9.
PLoS One ; 14(3): e0211921, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865633

RESUMO

BACKGROUND: Sub Saharan Africa continues to be the epicenter of HIV with 70% of people living with HIV globally. Women form nearly 60% of those living with HIV. Studies have shown disclosure of one's HIV status is important in HIV prevention, in increasing partners who are tested and getting into care early as well as in improving retention in PMTCT and ART programs. This study aimed to determine the prevalence, factors and outcomes of HIV status disclosure to partners among HIV-positive women attending HIV care-and-treatment clinics (CTCs) at Kilimanjaro region, northern Tanzania. METHODS: A cross-sectional study was conducted from January to June 2014 in 3 out of the 7 districts of Kilimanjaro region. The study population was HIV-positive women aged 15-49, who were attending for routine HIV care at 19 selected clinics. Face-to-face interviews were conducted with consenting women to collect necessary information. Multivariate logistic regression analyses were used to determine the independent predictors of HIV status disclosure to partner. RESULTS: A total of 672 HIV-positive women in Moshi municipal, Hai and Mwanga districts were enrolled. Of them, 609 HIV-positive women reported to have a regular partner. Prevalence of serostatus disclosure to partners was 66%. Of the 400 who had disclosed; 56% did so within the first month of knowing their HIV status. In a multiple logistic regression model, HIV serostatus disclosure was higher among women who: were married/cohabiting (AOR = 4.16, 95% CI: 2.39-7.25; p<0.001), currently on ART (AOR = 2.06, 95% CI: 1.11-3.82; p = 0.020), and who reported had ever communicated with partners on number of children (AOR = 1.85, 95% CI: 1.15-2.98; p = 0.010) and contraceptives use (AOR = 2.01, 95% CI: 1.27-3.20; p = 0.208). Most of the women (81%) who disclosed their HIV status to did not reported negative outcomes. CONCLUSION: In this setting still a third of the HIV-positive women (34%) fail to disclose their HIV- serostatus to partners. Interventions to impart skills in communication and negotiation between partners may help in improving disclosure of HIV. Efforts to involve men in general sexual and reproductive health including couple counseling and testing will contribute in improving disclosure and communication on HIV among partners.


Assuntos
Infecções por HIV/prevenção & controle , Autorrevelação , Parceiros Sexuais , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Soroprevalência de HIV , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Inquéritos e Questionários , Tanzânia/epidemiologia , Adulto Jovem
10.
PLoS One ; 14(1): e0210935, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30677068

RESUMO

BACKGROUND: Fertility desires of female and male partners in current relationships are often correlated. We examined the influence of HIV seropositive status of female and male partners on short-term fertility desires in Rakai, Uganda, a setting with high fertility and HIV infection rates. METHODS: Participants were couples (15-49 years old) enrolled in the Rakai Community Cohort Study, from 2011 to 2013 (n = 2,291). Cohen's kappa coefficient was used to measure the correlation of female and male partners' short-term fertility desires (measured as 'wanting a child in the next 12 months'), in both total sample and stratified serostatus groups. HIV serostatus and additional characteristics of female and male partners were included in Poisson regression models to estimate the rate ratios (RR) for each partner's short-term fertility desires. Individual and partner characteristics included HIV status, partner HIV status, age in years, partner age in years, educational attainment, number of living children, community of residence, and socioeconomic status (SES). RESULTS: Short-term fertility desires among female and male partners were moderately associated (Kappa = 0.37, p-value<0.001). The association was weakest among female sero-positive and male sero-negative couples (Kappa = 0.29, p-value<0.001). When adjusting for parity and other covariates in the model, women's short-term fertility desires were significantly associated with their positive sero-status regardless of male partners' sero-status (adjRR = 1.58, p<0.001 for F+M-; adjRR = 1.33, p = 0.001 for F+M+; in comparison with F-M-). Men's short-term fertility desires were significantly associated with their positive sero-status, in addition to their female partners' positive sero-status (adjRR = 1.23 with p-value = 0.022 for F-M+; adjRR = 1.42 with p-value<0.001 for F+M-; adjRR = 1.26 with p-value<0.001 for F+M+; in comparison with F-M-). When the differential effect of parity was included in the model, similar associations remained for both female and male partners when the number of living children was small, but largely reduced when the number of living children was large (3 or more). CONCLUSION: Female and male partners in couple dyads demonstrated moderate agreements about short-term fertility desires. The HIV seropositive status of female partners was most strongly associated with short-term fertility desires of both genders, and this association was even stronger for women who had few or no living children.


Assuntos
Fertilidade , Infecções por HIV/epidemiologia , Infecções por HIV/fisiopatologia , Adolescente , Adulto , Estudos de Coortes , Serviços de Planejamento Familiar , Feminino , Infecções por HIV/complicações , Soronegatividade para HIV , Soropositividade para HIV/epidemiologia , Soropositividade para HIV/fisiopatologia , Soroprevalência de HIV , Humanos , Masculino , Pessoa de Meia-Idade , Paridade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/fisiopatologia , Parceiros Sexuais , Classe Social , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
11.
Infect Genet Evol ; 69: 146-152, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30682549

RESUMO

Identifying individuals recently infected with HIV has been of great significance for close monitoring of HIV epidemic dynamics. Low HIV sequence ambiguity (SA) has been described as a promising marker of recent infection in previous studies. This study explores the utility of SA defined as a proportion of ambiguous nucleotides detected in baseline pol sequences as a tool for routine real-time surveillance of HIV incidence trends at a national level. A total of 353 partial HIV-1 pol sequences obtained from persons diagnosed with HIV infection in Slovenia from 2000 to 2012 were studied, and SA was reported as a percentage of ambiguous base calls. Patients were characterized as recently infected by examining anti-HIV serological patterns and/or using commercial HIV-1 incidence assays (BED and/or LAg-Avidity assay). A mean SA of 0.29%, 0.14%, and 0.19% was observed for infections classified as recent by BED, LAg, or anti-HIV serological results, respectively. Welch's t-test showed a significant difference in the SA of recent versus long-standing infections (p < 0.001). CD4+ T-cell counts ≤250 cells/mm3 significantly correlated with higher SA (p < 0.001), whereas the homo/bisexual transmission route significantly correlated with lower SA (p = 0.005). When the LAg-assay was used as an indicator of recent infection, a receiver operating characteristic curve with the largest area under the curve (0.896) was observed for SA (sensitivity and specificity of 79%), indicating the best correlation of the data. A reliable estimation of the trends of HIV incident infection could be inferred from measuring SA irrespective of the cutoff used; however, in Slovenia it seems that lower cutoffs are more appropriate. Our data suggest that SA could be used as a real-time surveillance tool for close monitoring of HIV incidence trends, especially in countries where baseline HIV resistance genotyping is performed routinely, rendering this approach cost-effective.


Assuntos
Variação Genética , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , HIV-1/genética , Produtos do Gene pol do Vírus da Imunodeficiência Humana/genética , Feminino , Infecções por HIV/transmissão , Soropositividade para HIV , Soroprevalência de HIV , HIV-1/classificação , Humanos , Incidência , Masculino , Vigilância em Saúde Pública , Curva ROC , Análise de Sequência de DNA , Eslovênia/epidemiologia
12.
Emerg Infect Dis ; 25(2): 325-327, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30666940

RESUMO

Using reported case data from ArboNET and previous seroprevalence data stratified by age and sex, we conservatively estimate that ≈7 million persons in the United States have been infected with West Nile virus since its introduction in 1999. Our data support the need for public health interventions and improved surveillance.


Assuntos
Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Soroprevalência de HIV , História do Século XX , História do Século XXI , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância em Saúde Pública , Estados Unidos/epidemiologia , Febre do Nilo Ocidental/história , Adulto Jovem
13.
Sex Transm Infect ; 95(1): 71-74, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29680827

RESUMO

OBJECTIVES: In many populations, men who have sex with men (MSM) are at a high risk of HIV infection. This study aimed to estimate the burden of HIV, other STIs and risk behaviours among Rwandan MSM. METHODS: In this cross-sectional study, we recruited through peer referral men aged between 18 and 60 years, who reported sex with men at least once in the 12 months prior to the survey. Representativeness was increased using 'seeds' from a variety of sources. Signed informed consent was obtained from all participants. Data on demographics, risk behaviours and self-reported STIs were collected through an interviewer-administered questionnaire. We screened all eligible participants for HIV using the Rwanda-approved protocol for rapid HIV detection. RESULTS: 504 MSM were recruited from five major cities in Rwanda. Participants were mostly young (median age 23 years, range 18-55 years) and unmarried (484/504, 96.0%). Thirteen per cent (65/504) of the participants reported past gonorrhoea and/or syphilis infection. Of 504 MSM, 53 (10.5%) reported they were diagnosed and treated for gonorrhoea in the past 12 months and 24 (4.8%) tested positive for HIV. A high proportion (232/504, 46%) reported receiving payment for sex by a man, with almost half of these reporting on more than three occasions (107/232, 46%). Many reported having had an HIV test within the past 12 months (385/504, 76.4%). In multivariate logistic regression models controlling for age, being paid for sex was associated with higher odds of past STI (OR 3.36 (1.82-6.43]; P<0.001) and testing HIV positive (OR 3.13, P<0.05). CONCLUSION: Further research is needed to understand the high rate of payment for sex in this population, which appears to be a major risk factor for STI including HIV.


Assuntos
Infecções por HIV/epidemiologia , Soroprevalência de HIV , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Estudos Transversais , Gonorreia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Assunção de Riscos , Ruanda/epidemiologia , Autorrelato , Sífilis/epidemiologia , Adulto Jovem
14.
J Cosmet Dermatol ; 18(1): 258-262, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29781249

RESUMO

BACKGROUND/OBJECTIVES: Injection drug use is one of the major public health problems in Iran. Injection drug use is associated with numerous negative health outcomes, such as blood-borne infections (HIV, HCV) and injection site skin infections (abscesses, cellulitis). The aim of this study was to determine prevalence of injection site skin infections and its associated risk factors among people who inject drugs (PWID) in Tehran, Iran. METHODS: The cross-sectional study was conducted from March to August 2016 in Tehran province. A total of 500 PWID were recruited by convenience and snowball sampling from Drop-in Centers (DIC) in the South of Tehran. Our primary outcomes were self-report of ever having injection sites skin infections and receiving treatment for them. We first examined associations between individual variables and lifetime history of having injection site infections in bivariate analysis using the chi-square or Fisher's exact tests, as appropriate. Variables with P-value <.2 were included in a multiple logistic regression model. RESULTS: Overall, 40% (CI95%: 30.3%, 52.2%) of participants reported ever having an injection site infection. In the multivariable model, those with low socioeconomic status (AOR = 2.4, P = .03), self-reported as HIV positive (AOR =1.6, P = .01), reporting more than 3 injections per day (AOR = 4.1, P = .03) and reuse of their own syringes (AOR = 8.5, P = .03) were more likely to have injection sites skin infections. PWID who used needle and syringe program (NSP) services were less likely to report injection site infections (AOR = 0.5, P = .04). CONCLUSION: We have identified several risk factors for injection sites infections among PWID, including frequency of injection per day, reuse of their own syringes, not using NSP services, HIV status, socioeconomic status with skin infections in PWID. Prevention strategies to reduce skin infections should focus on high-risk injection behaviors and improving access to NSP services.


Assuntos
Soroprevalência de HIV , Reação no Local da Injeção/epidemiologia , Dermatopatias Infecciosas/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Estudos Transversais , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Programas de Troca de Agulhas , Prevalência , Fatores de Proteção , Fatores de Risco , Autorrelato , Dermatopatias Infecciosas/prevenção & controle , Classe Social , Seringas , Adulto Jovem
15.
Rev. enferm. UFPE on line ; 13: [1-8], 2019. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1048163

RESUMO

Objetivo: avaliar o perfil sociodemográfico e a evolução clínica dos pacientes com síndrome da imunodeficiência humana. Método: trata-se de pesquisa quantitativa, retrospectiva e descritiva realizada em um serviço de saúde especializado. Coletaram-se os dados no serviço de arquivamento médico e estatístico, em prontuários. Aplicou-se um formulário contendo variáveis de caracterização do perfil clínico e sociodemográfico dos pacientes. Utilizou-se amostra probabilística que totalizou 172 prontuários. Analisaram-se os dados pelo software Statistical Package for the Social Sciences. Resultados: verificou-se o predomínio de homens adultos, solteiros, na cor parda e com média de idade de 40 anos e baixo nível socioeconômico, com prevalência das coinfecções causadas por protozoários, seguidas pelas infecções bacterianas. Conclusão: percebe-se que há uma mudança do perfil das pessoas que vivem com o vírus da imunodeficiência humana com o aumento de casos entre mulheres e interiorização dessa patologia. Infere-se que tais achados podem contribuir para a adoção de ações de saúde direcionadas e adaptadas ao perfil evidenciado.(AU)


Objective: to evaluate the sociodemographic profile and clinical evolution of patients with human immunodeficiency syndrome. Method: it is a quantitative, retrospective and descriptive research carried out in a specialized health service. The data was collected in the medical and statistical archival service, in medical records. A form containing variables characterizing the clinical and sociodemographic profile of the patients was applied. A probabilistic sample was used, which totaled 172 medical records. Data was analyzed by the software Statistical Package for the Social Sciences. Results: the prevalence of adult males, single, in the brown color and with a mean age of 40 years and low socioeconomic level, with prevalence of co-infections due to protozoa, followed by bacterial infections were observed. Conclusion: it is noticed that there is a change in the profile of people living with the human immunodeficiency virus with the increase of cases among women and the internalization of this pathology. It is inferred that such findings can contribute to the adoption of health actions directed and adapted to the profile evidenced.(AU)


Objetivo: evaluar el perfil sociodemográfico y la evolución clínica de los pacientes con síndrome de inmunodeficiencia humana. Método: se trata de investigación cuantitativa, retrospectiva, descriptiva, realizada en un servicio de salud especializado. Se recogió los datos en el servicio de archivo médico y estadístico, en prontuarios, se aplicó un formulario conteniendo variables de caracterización del perfil clínico y sociodemográfico de los pacientes. Se utilizó muestra probabilística que totalizó 172 prontuarios. Se analizaron los datos por el software Statistical Package for the Social Sciences. Resultados: se verificó el predominio de hombres adultos, solteros, de color pardo y con promedio de edad de 40 años y bajo nivel socioeconómico, con prevalencia de las coinfecciones causadas por protozoarios, seguida por las infecciones bacterianas. Conclusión: se percibe que hay un cambio del perfil de las personas que viven con el virus de la inmunodeficiencia humana con aumento de casos entre mujeres e interiorización de esa patología. Se infiere que tales hallazgos pueden contribuir a la adopción de acciones de salud dirigidas y adaptadas al perfil evidenciado.(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Pacientes , Condições Sociais , Perfil de Saúde , Infecções por HIV , Soroprevalência de HIV , Evolução Clínica , Síndrome de Imunodeficiência Adquirida , HIV , Registros Médicos , Epidemiologia Descritiva , Estudos Retrospectivos
16.
Rev. enferm. UFPE on line ; 13: [1-11], 2019. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1046435

RESUMO

Objetivo: identificar a soroprevalência de sífilis, HIV e hepatites B e C nos atendimentos de pacientes no CTA Itinerante do Ambulatório Escola. Método: trata-se de um estudo quantitativo, descritivo, retrospectivo. Escolheu-se o método de pesquisa documental. Obteve-se o registro de 1125 usuários do serviço de CTA Itinerante no ano de 2017. Apresentaram-se os resultados em forma de tabelas. Resultados: identificou-se a soroprevalência de 79 (7,02%) casos confirmados de todas as patologias testadas (HIV, sífilis, hepatite B e C), incluindo 5 (0,44%) testes positivos para HIV; 4 (0,36%), para hepatite B; 7 (0,62%), para hepatite C e 63 (5,60%), para sífilis. Conclusão: reportou-se a alta prevalência de sorologias positivas, principalmente, para sífilis, que apresentou um número bem mais elevado. Conclui-se, portanto, que as infecções sexualmente transmissíveis estão presentes na população em geral e que o CTA Itinerante pode contribuir para identificar novos casos e, consequentemente, para que sejam encaminhados para o tratamento o mais precocemente possível, levando a um prognóstico favorável.(AU)


Objective: to identify the seroprevalence of syphilis, HIV and hepatitis B and C in the care of patients in the Itinerant TCC of the Ambulatory Clinical Teaching Unit. Method: this is a quantitative, descriptive, retrospective study. The documentary research method was chosen. The registration of 1125 users of the Itinerant TCC service was obtained in 2017. The results were presented in the form of tables. Results: seroprevalence of 79 (7.02%) confirmed cases of all pathologies tested (HIV, syphilis, hepatitis B and C), including five (0.44%) positive HIV tests; four (0.36%) for hepatitis B; seven (0.62%) for hepatitis C and 63 (5.60%) for syphilis. Conclusion: a high prevalence of positive serologies was reported, mainly for syphilis, which presented a much higher number. It is concluded, therefore, that sexually transmitted infections are present in the population in general and that the Itinerant TCC can contribute to identify new cases and, consequently, to be referred to the treatment as early as possible, leading to a favorable prognosis.(AU)


Objetivo: identificar la seroprevalencia de sífilis, VIH y hepatitis B y C en las atenciones de pacientes en el CTA Itinerante del Ambulatorio Escuela. Método: se trata de un estudio cuantitativo, descriptivo, retrospectivo. Se eligió el método de investigación documental. Se obtuvo el registro de 1125 usuarios del servicio de CTA Itinerante en el año 2017. Se presentaron los resultados en forma de tablas. Resultados: se identificó la seroprevalencia de 79 (7,02%) casos confirmados de todas las patologías probadas (VIH, sífilis, hepatitis B y C), incluyendo 5 (0,44%) pruebas positivas para el VIH; 4 (0,36%), para la hepatitis B; 7 (0,62%), para hepatitis C y 63 (5,60%), para sífilis. Conclusión: se reportó la alta prevalencia de serologías positivas, principalmente, para sífilis, que presentó un número mucho más elevado. Se concluye, por lo tanto, que las infecciones sexualmente transmisibles están presentes en la población en general y que el CTA Itinerante puede contribuir a identificar nuevos casos y, consecuentemente, para que sean encaminados al tratamiento lo más precozmente posible, llevando a un pronóstico favorable.(AU)


Assuntos
Humanos , Masculino , Feminino , Sífilis , Doenças Sexualmente Transmissíveis , Soroprevalência de HIV , Estudos Soroepidemiológicos , HIV , Hepatite C , Hepatite B , Unidades Móveis de Saúde , Epidemiologia Descritiva , Estudos Retrospectivos
17.
BMC Pregnancy Childbirth ; 18(1): 504, 2018 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-30577760

RESUMO

BACKGROUND: HBV, HCV, HDV and HIV are blood borne and can be transmitted from mother-to-child. Reports of HBV infection rates show up to 11.9% in Cameroon while for HCV, the rate is less than 2%. More so, as pregnant women get enrolled in the HIV PMTCT Programme and stay in the care continuum, selection of HIV-1 drug resistant strains is evident. We sought to determine the seroprevalence of HBV, HCV, HDV and HIV among pregnant women, assess their knowledge, attitudes and practices on transmission and prevention of HBV infection, and determine HIV drug resistance profile of breastfeeding women. METHODS: A serosurvey of HBV, HCV, HDV and HIV was carried out among 1005 pregnant women in Yaounde, Cameroon. In 40 HIV-infected breastfeeding women enrolled in the PMTCT Programme, HIV-1 genotypes and HIV-1 resistance to NRTIs, NNRTIs and PIs, were determined by phylogeny and the Stanford University HIV Drug Resistance interpretation tool, respectively. RESULTS: Among the pregnant women, the rates of HIV-1, HBV, HCV and HDV infections were 8.5, 6.4, 0.8 and 4.0%, respectively. About 5.9% of the women knew their HBV status before pregnancy unlike 63.7% who knew their HIV status. Although 83.3% reported that vaccination against HBV infection is a method of prevention, and 47.1% knew that HBV could be transmitted from mother-to-child, only 2.5% had received the Hepatitis B vaccine. Of the 40 women on antiretroviral therapy (ART), 9 had at least one major resistance-associated mutation (RAM, 22.5%) to NRTI, NNRTI or PI. Of these M184 V (12.5%), K70R (10.0%), K103 N (12.5%), Y181C (10.0%), M46 L (2.5%) and L90 M (2.5%) were most frequently identified, suggesting resistance to lamivudine, nevirapine, efavirenz and zidovudine. Eighty four percent were infected with HIV-1 recombinant strains with CRF02_AG predominating (50%). CONCLUSIONS: The rates of HBV and HIV-1 infections point to the need for early diagnosis of these viruses during pregnancy and referral to care services in order to minimize the risk of MTCT. Furthermore, our results would be useful for evaluating the HIV PMTCT Programme and Treatment Guidelines for Cameroon.


Assuntos
Farmacorresistência Viral/genética , Soroprevalência de HIV , HIV-1/genética , Hepatite B/epidemiologia , Hepatite B/transmissão , Hepatite C/epidemiologia , Hepatite D/epidemiologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Aleitamento Materno , Camarões/epidemiologia , Coinfecção/epidemiologia , Feminino , HIV-1/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/imunologia , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B , Hepatite C/imunologia , Anticorpos Anti-Hepatite C/sangue , Hepatite D/imunologia , Humanos , Lamivudina/uso terapêutico , Mutação , Nevirapina/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem , Zidovudina/uso terapêutico
18.
BMC Res Notes ; 11(1): 908, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30567589

RESUMO

OBJECTIVE: This systematic review and meta-analysis aimed to determine the pooled prevalence of HIV among pregnant women in Ethiopia. RESULT: PubMed, EMBASE, Science Direct and Google scholar databases were searched to retrieve 15 relevant articles based on the inclusion criteria. A total of 13,746 participants were included in the original studies and considered in this analysis. Among subjects, 717 were infected with HIV only, and 12 were HIV-HBV co-infected pregnant women. In this meta-analysis, the pooled prevalence of HIV among pregnant women in Ethiopia was 5.74% (95% CI 3.96-7.53%). Regional analysis showed that 9.50% (95% CI 7.76-11.23%) in Amhara, 4.80% (95% CI 3.12-6.49%) in Addis Ababa, 2.14% (95% CI - 0.54 to 4.82%) in SNNP and 4.48% (95% CI 2.56-6.41%) in Oromia region. Besides, six studies reported HIV-HBV co-infection and the pooled prevalence was 0.68% (95% CI 0.27-1.08%) among pregnant women in Ethiopia.


Assuntos
Infecções por HIV/epidemiologia , Soroprevalência de HIV , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Etiópia/epidemiologia , Feminino , Humanos , Gravidez , Adulto Jovem
20.
Afr J AIDS Res ; 17(3): 265-271, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30319023

RESUMO

BACKGROUND: Evidence from previous research has shown that antiretroviral (ARV) drug initiation to seropositive pregnant women could significantly contribute to eliminating new paediatric infections even when started during labour and delivery. This study therefore seeks to assess missed opportunities for ARV initiation during this critical period of pregnancy to improve outcomes of the prevention of mother-to-child transmission (PMTCT) programmes in Cameroon. METHODS: A retrospective study was conducted on the 2014 PMTCT data for labour and delivery among pregnant women of unknown HIV status within health facilities in six regions of Cameroon (428 eligible facilities). Outcomes were summarised using (relative) frequencies. ARV initiations for eligible facilities were stratified per region and per facility type (public and private facilities). Initiation to ARV was reported using odds ratios and 95% confidence intervals. RESULTS: An average of 14.6% of the 9 170 pregnant women presenting with unknown HIV status at labour and delivery, were diagnosed HIV-positive. A cumulative average from the six regions revealed that only half (51.4%) of these seropositive women received an ARV regimen. The findings from the North-West region depict 100% initiation to ARV among the study population. The odds of ARV initiation in the study population was more likely in the public health facilities than the private facilities for five regions, excluding the North-West (odds ratio of 1.35 [1.07, 170]). CONCLUSION: A significant portion of women do not receive the care required, especially in private health facilities. Evidence from the results in the North West region suggest that processes to address health system barriers to improve PMTCT uptake are feasible in Cameroon.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/prevenção & controle , Soroprevalência de HIV , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Antirretrovirais/administração & dosagem , Camarões , Assistência à Saúde/métodos , Feminino , HIV , Humanos , Gravidez , Estudos Retrospectivos
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