The impact of HIV/AIDS stigma on HIV counseling and testing in a high HIV prevalence population in Uganda

Background

Despite its importance in HIV/AIDS prevention and treatment, HIV/AIDS Counseling and Testing (HCT) is low in sub-Saharan Africa, where the disease continues to be a serious public health problem. This has in part been attributed to HIV/AIDS related stigma.

Objective

To assess the level of HIV/AIDS related stigma and its impact on uptake of HCT in a high HIV prevalence population in Uganda.

Methods

The paper used cross-sectional data on 135 men and 185 women in reproductive ages. Data were analyzed using the Pearson''s chi-square statistic and the random intercept binary logistic regression model to identify significant predictors of uptake of HCT.

Results

The result shows that only 18.4% of the respondents, most of them men expressed highly stigmatizing attitudes against PLHA and 59%, men and women alike, received HCT. Uptake of HCT was higher among men (OR=1.89, p<0.01) and women (OR=4.48, p <0.001) who expressed least stigmatizing attitudes. Secondary/higher education, work in the informal sector and being ever married were significant predictors of uptake of HCT. Compared to men, women aged 25–34, 35+ and with one sexual partner were more likely to have received HCT.

Conclusions

The low level of stigma, older age, higher level of education, being ever married and monogamous sexual relationships are significant predictors of increased uptake of HCT.     

Religiosity for HIV prevention in Uganda: a case study among Christian youth in Wakiso district

Background

Utilization of religious institutions is one of the strategies for HIV prevention in Uganda. There is limited data on the association between religiosity and HIV infection rates.

Objective

To determine the association between religiosity and HIV prevalence rates among Christians.

Methods

An unmatched case-control study was done. Data from 106 HIV positive cases and 424 HIV negative controls between 15– 24 years were analyzed.

Results

Lower religiosity was associated with higher HIV infection rates when the following dimensions were analyzed: feeling guided by God in daily activities (odds ratio 1.90, 95%CI 1.03–3.50, p=0.035), feeling thankful for God''s blessings (odds ratio 1.76, 95%CI 1.01–3.11, p=0.042), praying privately (odds ratio 2.02, 95%CI 1.30–3.11, p=0.001), trying hard to be patient in life (odds ratio1.74, 95%CI 1.07–2.84, p=0.024) and trying hard to love God (odds ratio 1.57, 95%CI 1.01–2.42, p=0.039).Higher HIV infection rates were associated with having multiple life-time sexual partners (odds ratio 5.37, 95%CI 1.86–15.47, p<0.001), ever drinking alcohol (odds ratio 2.28, 95%CI 1.43–3.65, p<0.001) and ever using narcotics for recreation (odds ratio 2.49, 95%CI 1.14–5.44, p=0.018).

Conclusion

Lower levels of several dimensions religiosity are significantly associated with higher HIV infection rates. This data supports strengthening religiosity in HIV prevention strategies.     

Family communication about HIV/AIDS and sexual behaviour among senior secondary school students in Accra,Ghana

Background

Sexually active adolescents in Ghana are increasingly at risk of HIV and other sexually transmitted infections. As a primary agent of socialization, the family can exert a strong influence on adolescent sexual behaviour. Therefore, to aid in the design and implementation of effective prevention programmes, it is important to understand the role of the family in influencing sexual behaviour among school-going adolescents.

Objectives

To evaluate the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana.

Method

A sample of 894 students (56.9% girls, 43.1% boys; mean age = 17.4 years, SD = 1.40) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire, a self-administered instrument developed by the Centers for Disease Control and Prevention. Analytical techniques utilized included logistic regression and chisquare.

Results

Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS. Logistic regression analysis showed that student-family communication about HIV/AIDS was not associated with sexual activity. However, communication about HIV/AIDS between students and parents or other family members increased the odds of using a condom at last sexual intercourse.

Conclusions

The findings of this study suggest that prevention programmes that seek to educate Ghanaian school-going adolescents about sexual risk behaviour must strongly encourage communication about HIV/AIDS between students and family members.     

The association between dyslipidemia and anthropometric indicators in black and white adolescents residing in Tlokwe Municipality,North-West Province,South Africa: the PAHL study

Background

The dyslipidemia associated with excess weight is a risk for cardiovascular disease. Worldwide and in South Africa adolescent obesity has been reported.

Objectives

To determine the association between dyslipidemia and anthropometric indices in black and white adolescents.

Methods

The study involved 129 black and 69 white adolescents aged 12 to 16 years. Data collected included height, weight, waist circumference (WC) and skinfolds, blood pressure and blood for glucose, insulin, total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (Trig) and C - reactive protein (CRP).

Results

WC correlated negatively with HDL in both blacks (p=0.042) and whites (p=0.008) and in whites it correlated positively with LDL (p=0.006); TC/HDL (p=<0.001) and LDL/HDL ratio (p<0.0001). WC/Hgt correlated negatively with HDL (p=0.028) and positively with LDL/HDL (p=0.026 and p<0.0001) in both races. In whites positive correlations were between WC/Hgt and TC (p=0.049); LDL (p=0.003) and TC/HDL (p<0.0001). BAZ correlated positively with TC/HDL ratio (p=0.004) and LDL/HDL ratio (p=0.002). The most common abnormalities were HDL and LDL.

Conclusion

Whites exhibited more associations between dyslipidemia and anthropometric indicators as compared to Blacks, suggesting that there might be differences in the lipid metabolism or even susceptibility to risk factors in adolescents.     

Condom use amongst out of school youths in a local government area in Nigeria

Background

Reported low condom use amongst out of school requires studying the context in which condom use occurs.

Methods

A cross sectional study of 350 out-of-school youth aged 15–24 years in a local government area of Nigeria was enrolled using cluster sampling.

Results

Those who had ever had sexual intercourse were 74.9%. Of these, 56.5% used no protection while 29.0% used condoms. Up to 78.6% have had sex within the preceding 12 months with 38.9% condom use. The commonest reason for non-condom use was that it reduces sexual enjoyment. Those who believed a single unprotected sexual exposure may result in HIV infection reported more condom use than those who believed otherwise (42% vs 27.2%, P<0.05). Those who had prior discussion with their partners on HIV/AIDS reported more condom use compared to those who had not (50% vs 25%, P<0.05). Also, those who had sexual intercourse occurring as a spontaneous event reported less condom use compared to those who have previously discussed about the possibility of having sex (68.0% vs 51.8%, P<0.05).

Conclusion

Condom use is likely to occur within relationships where opportunity exists for discussion on sexual matters. Thus, further studies are needed on communication and condom use within sexual partnerships.     

Seroprevalence and determinants of human herpes virus 8 infection in adult Nigerians with and without HIV-1 infection

Background

There is a dearth of studies on HHV8-HIV co-infections from Nigeria, even as both infections have been shown to be endemic in Africa. This study examined the seroprevalence and determinants of HHV8 infections in adult Nigerians with and without HIV-infection.

Methods

In 2007, a cross sectional study undertaken in a tertiary hospital in Zaria, northern Nigeria enrolled 71 HIV-1 positive adults without Kaposi''s sarcoma and 85 apparently healthy HIV-negative adult volunteers of the general population. Anti-lytic antibodies to HHV8 infection was determined by ELISA. A univariate analysis including age, sex, marital status, past sexually transmitted disease (STD), past blood transfusion, HIV/AIDS staging and CD4 count was used to determine variables associated with HHV8 seropositivity. Significant variables were adjusted in a logistic regression model expressed in odds ratio (OR) with 95% confidence interval (CI). P<0.05 was considered significant

Results

The seroprevalence of HHV8 infection was 62% in HIV-1 positive patients and 25.9% in HIV negative adults (p<0.001). A past history of STD [OR= 2.88, 95% CI= 1.0 – 8.2] and advanced HIV/AIDS (WHO stage 3 and 4) [OR=3.5, 95% CI= 1.21–10.1] were the only variables independently associated with HHV8 seropositivity in HIV-infected patients. In HIV-negative adults, none of the variables was significantly associated with HHV8 seropositivity.

Conclusion

The study findings suggest an adverse interaction between HHV8 and HIV-1. The higher prevalence of HHV8 infection in HIV-infected patients and its association with STD support a predominant sexual route of HHV8 transmission among adult Nigerians.     

Clinical and immunological status of a newly diagnosed HIV positive population, in Marrakech, Morocco

Objective

To evaluate the clinical and the immune status of newly HIV diagnosed patients, in Marrakech city and its neighboring area, in Morocco.

Methods

We performed a retrospective study on 235 patients who have been previously confirmed for HIV infection, and underwent a CD4 T cells using flow cytometry (FacsCount, Becton Dickinson®).

Results

The mean age of patients was 34,3 ± 8,4 years (range: 14–55), with a male predominance (sex-ratio M/F=1.4). On basis of clinical data of the patients, 62% (n=146) of them were categorized as “category C”, 18.4% (n=43) as “category B”, and 19.6% (n=46) as “category A” according to CDC (Center for Disease Control) HIV classification. Among all of them, 60.4% (n=142) had less than 200 CD4T cells, 26% (n=61) had between 200 and 499 CD4T cells, and only 13.6% (n=32) showed a number of CD4T cells less or equal to 500/mm³.

Conclusion

The results of this study reflect a significant delay in the diagnosis of HIV infected patients. Therefore, this delay may compromise timely management of HIV infected individuals and enhances propagation of the epidemic in our country. These data confirm the need for intensifying prevention efforts among high-risk population. Moreover, continuing education in HIV/AIDS among healthcare providers should be reinforced.     

Parent and self-report of sleep-problems and daytime tiredness among adolescents with inflammatory bowel disease and their population-based controls

Study Objectives:

To evaluate the frequency of sleep problems and daytime tiredness among adolescents with inflammatory bowel disease (IBD) in comparison with their healthy peers.

Design:

Parent and self-reports of sleep problems and daytime tiredness.

Setting:

Questionnaire-based postal survey.

Intervention:

N/A.

Participants:

One hundred sixty Finnish adolescents with IBD; 236 adolescents matched for age, sex, and place of residence; and the parents of both groups.

Measurements and Results:

Sleep Self-Report and sleep questions of the Child Behavior Check-List, and Youth Self-Report. The parents of adolescents with IBD reported in their index child more trouble sleeping (P < 0.01), more nightmares (P < 0.01), sleeping more than most children during the day/night (P < 0.001), and overtiredness (P < 0.001) than did the parents of control subjects. In contrast, adolescents with IBD themselves did not report more problems than their peers. However, in the group of patients with self-reported severe IBD symptoms, both the parents and the adolescents reported trouble sleeping and overtiredness more often (P values < 0.01) than in the group with mild symptoms or control subjects. Adolescents with severe IBD reported more often that their symptoms affected the quality of their sleep (P < 0.001) than did adolescents with mild disease.

Conclusions:

Adolescents with severe IBD symptoms have disturbed sleep and are overtired more often than are adolescents with mild IBD symptoms or control subjects. Thus, in adolescents with severe IBD symptoms, evaluating sleep is important in characterizing the disease burden. Both parent and adolescent reports are needed for comprehensive assessment of sleep in the young.

Citation:

Pirinen T; Kolho KL; Simola P; Ashorn M; Aronen ET. Parent and self-report of sleep-problems and daytime tiredness among adolescents with inflammatory bowel disease and their population-based controls. SLEEP 2010;33(11):1487-1493.     

Mortality associated with tuberculosis/HIV co-infection among patients on TB treatment in the Limpopo province,South Africa

Background

South Africa has a high tuberculosis burden, and Limpopo Province experienced higher than national average TB mortality rates between 1997 and 2008.

Objective

To establish factors associated with TB mortality in Limpopo Province in 2008.

Design

Retrospective study using provincial data for patients who died after commencing TB treatment between 01 January 2008 and 31 December 2008.

Results

In 2008, some 18074 patients started treatment: 15995 (88.5%) had pulmonsry TB (PTB), while 2079 (11.5%) had Extra pulmonary TB (EPTB). Overall, 2242 (12.4%) patients died, mainly PTB patients (n=1906; 85%), more males (n=1159, 51.7%), mainly those aged 25 to 54 years (n=1749, 78.0%), and new cases (1914; 85.4%). TB mortality was significantly higher among smear negative than smear positive patients (17% vs 13.8%; P<0.001), among those with EPTB compared to PTB patients (P<0.001), and among re-treatment cases (P<0.001). Only 4237 (23.4%) patients had HIV status known, with higher mortality found among HIV positive than the HIV negative patients (P<0.0001); but HIV status was not known for the majority who died (n=1685, 75.2%).

Conclusion

Higher mortality was associated with age 22–55 years; smear negativity, EPTB, HIV infection, and re-treatment. The findings call for greater integration of TB control efforts and HIV services, especially among the 22–55 year age group.     

Sexual dysfunctions among people living with AIDS in Brazil

INTRODUCTION

Sexual dysfunction symptoms in patients with HIV have not been fully investigated in Brazil.

OBJECTIVES

To investigate the association between sexual dysfunction symptoms and AIDS among participants in the Brazilian Sex Life Study.

METHODS

The Brazilian Sex Life Study is a cross-sectional population study. The participants answered an anonymous self-responsive inquiry. It was applied to a population sample in 18 large Brazilian cities. Answers given by those who reported having AIDS (75) were compared with those who reported not having AIDS (control; 150). This was a case-control study nested in a cross-sectional population study.

RESULTS

In females, AIDS was associated with “sexual inactivity over the last 12 months” and “does not maintain sexual arousal until the end of the sex act” (P < 0.05) after adjusting for race and thyroid disease. Compared to the control group, men with AIDS had more difficulty becoming sexually aroused (they required more help from their partner to begin the sex act, they required longer foreplay than they wished, they reported losing sexual desire before the end of the sex act, and they required longer to ejaculate than they desired) (P < 0.05). After adjusting for sexual orientation, sex hormone deficiency, depression, and alcoholism, only “does not have sexual desire,” “have longer foreplay,” and dyspareunia were associated with AIDS.

DISCUSSION AND CONCLUSIONS

The results support the hypothesis that sexual dysfunctions are associated with AIDS. Men with AIDS need more time and stimulation to develop a sexual response, and a significant portion (37%) of women with AIDS reported sexual inactivity over the last 12 months.     

Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders

Background

For youth living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), nonadherence to antiretroviral therapy (ART) can lead to poor health outcomes and significantly decreased life expectancy.

Objective

To evaluate the feasability, acceptability, and preliminary efficacy of short message service (SMS) or text message reminders to improve adherence to ART for youth living with HIV/AIDS.

Methods

We conducted this prospective pilot study using a pre–post design from 2009 to 2010 at a community-based health center providing clinical services to youth living with HIV/AIDS. Eligibility criteria included HIV-positive serostatus, age 14–29 years, use of a personal cell phone, English-speaking, and being on ART with documented poor adherence. During the 24-week study period, participants received personalized daily SMS reminders and a follow-up message 1 hour later assessing whether they took the medication, and asking participants to respond via text message with the number 1 if they took the medication and 2 if they did not. Outcome measures were feasibility, acceptability, and adherence. Self-reported adherence was determined using the visual analog scale (VAS) and AIDS Clinical Trial Group (ACTG) questionnaire 4-day recall. Viral load and CD4 cell count were followed as biomarkers of adherence and disease progression at 0, 12, and 24 weeks.

Results

Participants (N = 25) were mean age 23 (range 14–29) years, 92% (n = 23) male, 60% (n = 15) black, and 84% (n = 21) infected through unprotected sex. Mean VAS scores significantly increased at 12 and 24 weeks in comparison with baseline (week 0: 74.7, week 12: 93.3, P < .001; week 24: 93.1, P < .001). ACTG questionnaire 4-day recall also improved (week 0: 2.33, week 12: 3.24, P = .002; week 24: 3.19, P = .005). There was no significant difference in CD4 cell count or viral load between baseline and 12- or 24-week follow-up, although there was a trend toward improvement of these biomarkers and a small to moderate standardized effect size (range of Cohen d: –0.51 to 0.22). Of 25 participants, 21 (84%) were retained, and 20 of the 21 (95%) participants who completed the study found the intervention helpful to avoid missing doses.

Conclusions

In this pilot study, personalized, interactive, daily SMS reminders were feasible and acceptable, and they significantly improved self-reported adherence. Larger controlled studies are needed to determine the impact of this intervention on ART adherence and other related health outcomes for youth living with HIV/AIDS.     

Epidemiological surveillance of the HIV/AIDS complex through the analysis of trends in the incidence of Kaposi's sarcoma in Cali,Colombia

Introduction:

The Kaposi''s sarcoma (KS) incidence has markedly changed in the general population since the onset of the AIDS epidemic in the eighties and after the introduction of the Highly Active Antiretroviral Therapy (HAART) in the nineties.

Objective:

To investigate incidence rate trends for Kaposi''s sarcoma before and during the (HIV/AIDS) epidemic in Cali, Colombia.

Methods:

Exploratory ecological study that included all Kaposi''s sarcoma cases identified by the Cali Cancer Registry from 1962-2007, and 12,887 cases of HIV/AIDS recorded in the Municipal Health Secretariat of Cali between 1986 and 2010. The joinpoint regression model was used to conduct the incidence rate analyses between the years 1962 and 2010.

Results:

A total of 349 KS cases were identified during the study period. Only 5.3% of the cases (n=20) were diagnosed in the pre-epidemic era (1963-1987), of these, 35% were women, and 90% of the tumors were located on the skin. In contrast, 94.7% of KS cases (n=329) were discovered after the emergence of HIV-AIDS. There was a significant decrease in the proportion of women (10.9%, p <0.001) and an increase in the frequency of tumors with an extra-cutaneous location (19.1%, p <0.01) compared to those cases diagnosed in the pre-epidemic era. Notification rates of HIV/AIDS have decreased since 2002 in both genders but KS incidence rates have decreased since 2004 in men only.

Conclusion:

The downward trend in the incidence of these diseases may be associated with factors that prevent the transmission of HIV infection or limit the spread of HIV in the community. Cancer registries represent a resource for timely, population-based surveil-lance of HIV-associated malignancies in Cali, Colombia.     

Pediatric HIV/AIDS in sub-Saharan Africa: emerging issues and way forward

Background

Sub-Saharan Africa has the largest burden of pediatric HIV in the world. Global target has been set for eradication of pediatric HIV by 2015 but there are still so many complex issues facing HIV infected and affected children in the sub-continent.

Objective

To review the current and emerging challenges facing pediatric HIV care in sub-Saharan Africa; and proffer solutions that could help in tackling these challenges.

Method

A Medline literature search of recent publications was performed to identify articles on “pediatric HIV”, “HIV and children”, “HIV and infants”, “HIV and adolescents” in sub-Saharan Africa.

Result

There are a number of challenges and emerging complex issues facing children infected and affected by HIV in sub-Saharan Africa. These include late presentation, limited access to pediatric HIV services, delayed diagnosis, infant feeding choices, malnutrition, limited and complex drug regimen, disclosure, treatment failure and reproductive health concerns. A holistic cost effective preventive, diagnostic and treatment strategies are required in order to eliminate pediatric HIV in SSA.

Conclusion

HIV infected children and their families in sub-Saharan Africa face myriad of complex medical and psychosocial issues. A holistic health promotional approach is being advocated as the required step for eradication of pediatric HIV in Africa.     

Respiratory symptoms and ventilatory function tests in Nigerians with HIV infection

Background

The impact of the human immunodeficiency virus (HIV) infection on the respiratory system of Africans has been little studied. This study aimed to determine the pattern of respiratory symptoms and ventilatory functions in HIV infected Nigerians.

Methods

In this cross sectional study, Respiratory symptoms frequency, Forced vital capacity (FVC), Forced expiratory volume in one second (FEV₁), FEV₁/FVC ratio, Forced expiratory flow between 25% and 75% of FVC, were determined in 100 HIV positive subjects and compared with values in 100 HIV negative controls.

Results

HIV positive patients had significantly more respiratory symptoms and lower ventilatory function tests values compared to the matched controls (p<0.05). HIV patients with at least one respiratory symptom and those with CD4 count less than 200cells/µl had lower ventilatory function values than their counterparts. 32% of the HIV patients had restrictive ventilatory functional impairment. (p<0.05). Using regression analysis, factors like HIV status, CD4 count and presence of respiratory symptoms were found to be associated with impairment in ventilatory functions.

Conclusions

HIV infected patients had more frequent respiratory symptoms and lower ventilatory function values. Further lung function studies and CT scanning in HIV positive patients especially in those with respiratory symptoms are indicated.     

The long-term effectiveness of generic adult fixed-dose combination antiretroviral therapy for HIV-infected Ugandan children

Background

Access to pediatric antiretroviral formulations is increasing in resource-limited countries, however adult FDCs are still commonly used by antiretroviral therapy (ART) programs.

Objective

To describe long-term effectiveness of using adult FDC of d4T+3TC+NVP (Triomune) in children for HIV treatment.

Methods

Clinical, immunologic, and virologic outcomes of HIV-infected ART-naïve children aged six months to 12 years, were evaluated up to 96 weeks post-ART initiation.

Results

From March 2004 to June 2006, 104 children were followed with a median age of 5.4 years, median CD4 cell percent and HIV-1 RNA were 11.0% (IQR 6.7–13.9) and 348,846copies/mL (IQR 160,941–681,313) respectively at baseline. Using Kaplan-Meir estimates, 75% of children had undetectable viral loads (<400copies/mL) at 96weeks of ART. Children with a baseline CD4 cell percent >15% were 3 times more likely to achieve viral load <400copies/mL than those with baseline CD4 cell percent <5% after adjusting for baseline age {aHR = 3.03 (1.10–8.32), p=0.03}; no difference was found among those with CD4 cell percent >5–14.9% and <5%.

Conclusion

Treatment with generic adult FDC for HIV-infected Ugandan children led to sustained clinical, immunologic and virologic response during 96 weeks of ART. Early initiation of ART is key to achieving virological success.     

Attitude of Lesotho health care workers towards HIV/AIDS and impact of HIV/AIDS on the population structure

Background

The impact and management of HIV/AIDS in Lesotho in the context of disaster management was investigated.

Objectives

Lesotho health care workers'' perception on HIV/AIDS progression, whether HIV/AIDS was managed as a disaster, and the impact on the demographic profile was investigated.

Methods

The empirical investigation included a literature study, and primary and secondary data analyses. Questionnaires (n=116) determined health care workers'' perception of HIV/AIDS. Interviews with officers of Lesotho Disaster Management determined how HIV/AIDS was managed as a disaster. National population censuses and data from surveys were summarised to describe the impact of HIV/AIDS on the population structure.

Results

Respondents'' modal age group was 25 to 39 years, 28.4% viewed HIV/AIDS related deaths as very high and perceived that HIV/AIDS changed the age composition, sex and dependency ratio of the population. Although HIV/AIDS was declared a disaster, the Lesotho Disaster Management Authority only aided the National AIDS Commission. There was evidence that HIV/AIDS caused the population pyramid base to shrink, and an indentation in the active population.

Conclusion

Health care workers attributed HIV/AIDS to changing the demographic profile of Lesotho, also reflected in the population pyramid. Lesotho Disaster Management Authority played a supporting role in HIV/AIDS disaster management.     

A non-specific biomarker of disease activity in HIV/AIDS patients from resource-limited environments

Background

A general non-specific marker of disease activity that could alert the clinician and prompt further investigation would be of value in patients with HIV/AIDS, especially in resource limited environments.

Objective

To investigate the potential of neopterin as non-specific biomarker in patients with advanced HIV/AIDS.

Methods

Cross-sectional study in 105 HIV positive patients (75 on highly active antiretroviral treatment (HAART). Neopterin was assessed by enzyme linked immune-absorbent assay and cytokines by flow cytometry.

Results

Neopterin levels were significantly higher (p<0.001) for the total patient than for the control group. Significant correlations between neopterin and plasma indicators of inflammation showed neopterin to be a good indicator of active inflammatory status and of the effect of HAART on the immune system. Neopterin was superior to C-reactive protein and to individual cytokines as indicator of immune deficiency. Increased neopterin levels were associated with a decline in albumin, haemoglobin and the albumin/globulin ratio, and with increases in red cell distribution width.

Conclusions

Plasma neopterin is a good non-specific biomarker of disease activity in HIV/AIDS patients. It is a good indicator of inflammatory activity, perpetuation of inflammation-associated co-morbidities, degree of immune deficiency and has predictive value for underlying disease, and for monitoring the HAART response.     

HIV/AIDS knowledge among undergraduate university students: implications for health education programs in Ghana

Background

Globally, the spread of HIV/AIDS remains on the rise especially among adolescents who are at increased risk of infection. Sexual behavioural change remains one of the most effective ways of preventing further transmission among this vulnerable group.

Objective

To evaluate HIV/AIDS knowledge among undergraduate students'' and how it can be used in HIV prevention strategies in Ghana.

Methods

A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a tertiary institution in Accra, Ghana.

Results

The mean age of the respondents was 23 years. Although the mean score of the participants'' responses to 12 HIV/AIDS knowledge questions was 7.7 of 12 points, there was an inconsistent level of AIDS knowledge with significant gender difference. While students could identify the transmission modes and preventive measure, they were less knowledgeable about the causative agent of AIDS. Majority of the students reported having received AIDS information from both print and electronic media, but few of them received such information from parents. Although over 90% of the students knew where to access VCT services, 45% of them have not had HIV test.

Conclusion

The data underscore the urgent need for HIV/AIDS-related health education and prevention efforts targeting university students as well as younger age groups in Ghana