Social Determinants of Poor Knowledge on HIV Among Nepalese Males: Findings from National Survey 2011

Since the first case detection in Nepal in 1988, the number of cases of Human Immunodeficiency Virus (HIV) are increasing. Limited studies exist concerning the knowledge on HIV among the Nepalese men. This study aimed to examine the social determinants of poor knowledge on HIV among Nepalese men aged 15–49 years based on Nepal Demographic and Health Survey (NDHS), 2011. This study is based on the secondary data of NDHS 2011. HIV knowledge was assessed by using structured qustionnaire. A Chi square test followed by logistic regression was performed to find the association of social determinants with outcome variables. Of the 3,991 participants, 1,217 (30.5 %) had comprehensive knowledge and the majority (69.5 %) had poor knowledge on HIV. More than half (54.6 %) reported that mosquito bite can transmit HIV and 26.5 % reported that sharing food can transmit HIV. Respondents who were uneducated [aOR 10.782; 95 % CI (6.673–17.421)], were manual workers [aOR 1.442; 95 % CI (1.152–1.804)], were poor [aOR 1.847; 95 % CI (1.350–2.570)]; lived in the the Eastern region [aOR 2.203(1.738–2.793)], or in the Mountain [aOR 1.542; 95 % CI (1.132–1.864)]; did not read newspaper/magazine at all [aOR 1.454; 95 % CI (1.142–1.851)] and did not listen to the radio at all [aOR 1.354; 95 % CI (1.046–1.752)] were likely to have poor knowledge of HIV. HIV prevention programs should include men incorporating appropriate educatoinal intervention to increase their knowledge.     

Voluntary counselling and testing uptake and HIV prevalence among tuberculosis patients in Jogjakarta, Indonesia

We aimed to establish HIV prevalence and uptake of unlinked anonymous testing and voluntary counselling and testing (VCT) among tuberculosis (TB) patients in Jogjakarta, Indonesia. We introduced unlinked anonymous HIV testing for TB patients attending directly observed treatment, short-course services between April and December 2006. Patients were additionally offered VCT services. Of 1269 TB patients who were offered unlinked anonymous testing, 989 (77.9%; 95% CI 75.6-80.1%) accepted. HIV prevalence was 1.9% (95% CI 1.6-2.2%). HIV infections were less frequently diagnosed among TB patients who attended a public health centre [odds ratio (OR) 0.15; 95% CI 0.03-0.70] rather than public hospital. They were more frequent in TB patients with a university education background (OR 5.16; 95% CI 1.01-26.63) or a history of HIV testing (OR 57.87; 95% CI 9.42-355.62). Of the 989 patients who accepted unlinked anonymous testing, only 133 (13.4%; 95% CI 11.5-15.7%) expressed interest in VCT. Of these, 52 (39.1%; 95% CI 31.2-47.6%) attended VCT, but interest was higher among students and those offered VCT by public health centres. The HIV prevalence in Jogjakarta is higher than expected and needs to be monitored cautiously. Unlinked anonymous HIV testing is well accepted and can be implemented with modest additional efforts.     

Factors Associated with Human Immunodeficiency Virus Screening of Women During Pregnancy,Labor and Delivery,United States, 2005–2006

The purpose of this study was to estimate prenatal human immunodeficiency virus (HIV) screening rates prior to and on admission to labor and delivery (L&D) and to examine factors associated with HIV screening, including hospital policies, with a comparison of HIV and hepatitis B prenatal screening practices and hospital policies. In March 2006, a survey of hospitals (n = 190) and review of paired maternal and infant medical records (n = 4,762) were conducted in 50 US states, DC, and Puerto Rico. Data from the survey and medical record review were analyzed using SAS software v9.2 (SAS Institute, Cary, NC). HIV testing before delivery occurred among 3,438 women (73.9 %); African American and Hispanic women were more likely to be tested than white women [aOR 2.22, 95 % CI (1.6–3.1) and aOR 1.55, 95 % CI (1.1–2.2), respectively]. Among women without previous HIV testing, 138 (16.6 %) were tested after admission to labor and delivery. Policies to test women with undocumented HIV status in at delivery were present in 65 (36.3 %) hospitals. HIV testing after admission to L&D was more likely in hospitals with policies to test women with undocumented HIV status [aOR 5.91, 95 % CI (2.0–17.8)]. Overall, policies and screening practices for HIV were consistently less prevalent than those for hepatitis B. Many women are not being routinely screened for HIV before or at delivery. Women with unknown HIV status were more likely to be tested in L&D in hospitals with testing policies.     

Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal

While early sexual debut is highly prevalent in Nepal, its link to sexually transmitted infections (STIs/HIV) risk factors has not been explored at a national level. The objective of this study was to assess potential association between early sexual debut and risk factors for STIs/HIV acquisition, including sexual risk behaviors, sexual violence, and teenage pregnancy among adults in Nepal. Data were taken from the nationally representative Nepal Demographic Health Survey (2011), which employed a two-stage complex design to collect data. A sample of 12,756 adults (ages 15–49 years) were included. Multivariate logistic models were conducted, adjusted for demographic characteristics, to assess the association between early sexual debut and STIs/HIV-related risk factors. The prevalence of early sexual debut in this sample was 39.2 %, with a mean age of coital debut at 17.9 years. After adjusting for potential confounders, individuals with early sexual debut were significantly more likely to report a history of STIs (aOR 1.19; 95 % CI 1.06–1.35) and had a significantly higher risk profile, including having multiple sex partner (aOR 2.14; 95 % CI 1.86–2.47), inconsistent condom use (aOR 0.72; 95 % CI 0.61–0.86), paid for sex (aOR 1.61; 95 % CI 1.14–2.27), a history of sexual violence (aOR 1.99; 95 % CI 1.63–2.43), and teenage pregnancy (aOR 12.87; 95 % CI 11.62–14.26). Individuals who have early sexual debut are more likely to engage in risk behaviors that place them at increased risk of STIs/HIV acquisition. STIs/HIV prevention strategies should aim at delaying sexual debut to decrease the disproportionate burden of adverse health outcomes, including STIs/HIV, among individuals in Nepal.     

广州市2019年新报告HIV/AIDS病例确诊后30天内接受抗病毒治疗分析

目的 评价广州市“发现即治疗”实施情况,分析相关影响因素,为进一步优化HIV/AIDS病例管理提供科学依据。方法 通过艾滋病防治基本信息模块,收集广州市2019年新报告的HIV/AIDS病例信息,采用单因素和多因素logistic回归,分析HIV/AIDS病例确诊后30天内开始治疗的相关影响因素。结果 2019年广州市新报告HIV/AIDS病例确诊后30天内接受抗病毒治疗1185例,占71.6%。与确诊后30天内未治疗的病例相比,确诊后30天内接受抗病毒治疗的病例女性较多［aOR(95%CI): 1.61(1.08~2.39)］（男性作为参照）,已婚有配偶的比例高［aOR(95%CI): 1.51(1.04~2.17)］（未婚作为参照）,文化程度高,初中［aOR(95%CI): 1.58(1.08~2.30)］,高中或中专［aOR(95%CI): 2.24(1.49~3.37)］,大专及以上［aOR(95%CI): 2.66(1.74~4.08)］（小学及以下作为参照）,同性传播的比例高［aOR(95%CI): 1.45(1.10~1.92)］（异性传播作为参照）,自愿检测发现的比例高［aOR(95%CI): 1.86(1.41~2.45)］（医务人员/场所主动提供检测作为参照）,确诊时已进入艾滋病期的比例高［aOR(95%CI): 1.66(1.29~2.15)］（确诊时为HIV感染者作为参照）。结论 广州市新发现HIV/AIDS病例确诊后30天内接受抗病毒治疗已达较高比例,要加强男性、单身、文化程度低、经异性传播、医务人员/场所主动提供检测发现病例的治疗转介。     

Socio-Demographic Correlates of Injection Drug Use Among Male Drug Users: A Cross Sectional Study in Nepal

Drug abuse is one of the major public health problems in Nepal. The objective of this study is to explore the factors responsible for the injecting drug use in Nepal. A cross sectional study was conducted among drug users in Pokhara sub metropolitan city in Nepal. Taking prevalence of 20 % at 95 % confidence interval and 20 % non-response rate, 448 samples were calculated for face to face interviews. Most of the study participants were >24 year’s age. Sixty-one percentage of the participants were unemployed. The largest percentage belonged to Gurung/Rai/Pun (37 %) ethnic groups, and had completed secondary level of education (47.5 %). In the logistic regression analysis occupation, motivating factors for drug use, ever been to custody, age at first drug use, age at first sex, money spent on drugs, ever been rehabilitated and age of the respondents showed a statistically significant association with injecting drug use status. The respondents having business [Adjusted Odds ratio (aOR) 4.506, 95 % CI (1.677–12.104)], service [aOR 2.698, 95 % CI (a1.146-6.355], having tragedy/turmoil [aOR 3.867, 95 % CI (1.596–9.367)], family problem [aOR 2.010, 95 % CI (2.010–53.496)], had sex at >19 years [aOR 1.683, 95 % CI (1.017–2.785)], rehabilitated >2 times [aOR 4.699, 95 % CI (1.401–15.763)], >24 years age group [aOR 1.741, 95 % CI (1.025–2.957)] had higher odds of having injecting habits. Having money spent on drugs >3,000 NRs (300 USD) [aOR 0.489, 95 %CI (0.274–0.870), not been to custody (aOR 0.330, 95 %CI (0.203–0.537)] and having curiosity for drug use [aOR 0.147, 95 % CI (0.029–0.737)] were found to be protective for injecting drug use. This study recommends the harm reduction program specifically focused on drug users of occupational groups like business, service and the youths through public health actions to stop transiting them to injecting drug use.     

Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers

Purpose

The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers.

Methods

The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039).

Results

The overall prevalence of WRSP was 5.1  % (95  % confidence interval (CI) 4.7–5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95 % CI 1.77–6.81), discrimination due to sex (aOR 2.44: 95 % CI 1.36–4.36) or age (aOR 2.22: 95 % CI 1.52–3.23), violence at work (aOR 1.98: 95 % CI 1.06–3.68), threat of violence (aOR 1.96: 95 % CI 1.05–3.66), poor work-life balance (aOR 1.78: 95 % CI 1.44–2.20), low job satisfaction (aOR 1.69: 95 % CI 1.37–2.09), high cognitive (OR 1.64: 95 % CI 1.32–2.03) and emotional (aOR 1.53: 95 % CI 1.22–1.91) demands, job insecurity (aOR 1.32: 95 % CI 1.07–1.63), and high work intensity (aOR 1.55: 95 % CI: 95 % CI 1.25–1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95 % CI 0.67–1.15).

Conclusion

The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.     

Low Compliance with Iron-Folate Supplementation Among Postpartum Mothers of Nepal: An Analysis of Nepal Demographic and Health Survey 2011

One in five maternal deaths are directly attributable to anaemia in the world. The World Health Organization recommends iron supplementation from the second trimester of pregnancy to 45 days after delivery. The aim of this study was to determine the compliance rate of iron-folate consumption and the factors associated with iron-folate consumption among post-natal mothers in Nepal. This study utilised the data of Nepal Demographic and Health Survey (NDHS) 2011. The NDHS 2011 is a cross sectional and nationally representative survey. Of the 4,148 respondents, only 20.7 % consumed iron throughout the post-natal period for 45 days. Mothers who had higher and secondary education [adjusted Odd ratio (aOR) 3.101; 95 % CI (2.268–4.240)]; had attended four or more antenatal care visits [aOR 9.406; 95 % CI (5.552–15.938)]; lived in Far-western development region [aOR 1.822; 95 % CI (1.387–2.395)]; delivered in health facility [aOR 1.335; 95 % CI (1.057–1.687)]; and attended postnatal care [aOR 2.348; 95 % CI (1.859–2.965)] were more likely to take iron for 45 days of postpartum. Intervention to increase the compliance with the postpartum iron-folate supplementation are required to avoid adverse pregnancy outcomes associated with poor iron status with especial focus on the mothers who delivered at homes and did not attend post-natal check up.     

Prevalence and Associated Factors of Intimate Partner Violence Among Pregnant Women Attending Kisumu District Hospital, Kenya

To determine prevalence and factors associated with intimate partner violence (IPV) among pregnant women seeking antenatal care. This was a cross-sectional study conducted at Kisumu District Hospital, Kenya amongst randomly selected pregnant women. A structured questionnaire was used to collect data. Participants self-reported about their own IPV experience (lifetime, 12 months prior to and during index pregnancy) and associated risk factors. Data were analyzed using Epi-info. The mean age of the 300 participants was 23.7 years. One hundred and ten (37 %) of them experienced at least one form of IPV during pregnancy. Psychological violence was the most common (29 %), followed by sexual (12 %), and then physical (10 %). Women who experienced IPV during pregnancy were more likely to have witnessed maternal abuse in childhood (aOR 2.27, 95 % CI = 1.05–4.89), been in a polygamous union (aOR 2.48, 95 % CI = 1.06–5.8), been multiparous (aOR 1.94, 95 % CI = 1.01–3.32) or had a partner who drank alcohol (aOR 2.32, 95 % CI = 1.21–4.45). Having a partner who attained tertiary education was protective against IPV (aOR 0.37, 95 % CI = 0.16–0.83). We found no association between HIV status and IPV. IPV is common among women seeking antenatal care at Kisumu District Hospital. Health care providers should be alerted to the possibility of IPV during pregnancy in women who witnessed maternal abuse in childhood, are multiparous, polygamous, have a partner who drinks alcohol or has low level education. Screening for IPV, support and referral is urgently needed to help reduce the burden experienced by pregnant women and their unborn babies.     

Preconception Health Promotion Among Maryland Women

Despite current guidelines that all reproductive age women receive preconception care (PCC), most US women do not, especially women with a prior birth. The objective of our study was to identify factors associated with receipt of PCC health promotion counseling among Maryland women and to assess whether prior birth outcome affects receipt of counseling. We analyzed Maryland pregnancy risk assessment monitoring system data for a stratified random sample of women with a live birth in 2009–2010; 3,043 women with PCC data were included in the analysis. The dependent variable was receipt of any PCC counseling, and the primary independent variable, prior pregnancy outcome (no prior live birth, term, preterm). 33.1 % of the weighted sample received PCC. Odds of PCC were similar for women with a history of prior prior preterm birth (aOR 1.00, 95 % CI 0.57–1.78) and no prior live birth, but decreased for women with a prior full term delivery (aOR 0.69, 95 % CI 0.51–0.94). They were decreased for women with unintended births (aOR 0.36, 95 % CI 0.26–0.51) and increased for women with a diagnosis of asthma (aOR 1.74, 95 % CI 1.05–2.89) or diabetes (aOR 2.79, 95 % CI 1.20–6.45), who used multivitamins (aOR 2.58, 95 % CI 1.92–3.47), and had dental cleanings (aOR 1.60, 95 % CI 1.16–2.18). Although selected preventive health behaviors and high-risk conditions were associated with PCC, most women did not receive PCC. Characterization of women who do not receive PCC health promotion counseling in Maryland may assist in efforts to enhance service delivery.     

Finding Sex Partners Through Social Media Among Men Who Have Sex with Men in Hanoi,Vietnam

Many men who have sex with men (MSM) in low and middle income countries search for male sexual partners via social media in part due to societal stigma and discrimination, yet little is known about the sexual risk profiles of MSM social media users. This cross-sectional study investigates the prevalence of social media use to find male sex partners in Hanoi, Vietnam and examines associations between social media use and sociodemographic and behavioral characteristics, including levels of internalized, perceived and enacted stigma, high-risk sexual behaviors, and HIV testing. 205 MSM were recruited from public venues where MSM congregate as well as through snowball sampling and completed an anonymous survey. MSM who found their male sexual partners using social media in the last year were more likely to have completed a university or higher degree (aOR 2.6; 95% CI 1.2–5.7), experience high levels of MSM-related perceived stigma (aOR 3.0; 95% CI 1.1–8.0), and have more than ten lifetime male sexual partners (aOR 3.2; 95% CI 1.3–7.6) compared to those who did not use social media. A niche for social media-based interventions integrating health and stigma-reduction strategies exists in HIV prevention programs for MSM.     

Families matter: Social relationships and adolescent HIV testing behaviors in Ndola,Zambia

A cross-sectional survey among 550 randomly selected 16–19-year-olds in Ndola, Zambia, assessed the influence of individual (e.g., HIV knowledge), relational (e.g., discussed HIV testing with family), and environmental factors (e.g., distance) on adolescents’ use of HIV counseling and testing. A multivariable logistic regression analysis comparing respondents who have taken an HIV test to respondents who have not found that at the relational level believing that one’s family would not be upset if the youth has taken an HIV test (adjusted odds ratio [AOR] = 5.08; 95% confidence interval [CI] = 1.16–22.35); and having discussed with a family member whether or not to take an HIV test (AOR = 3.51; 95% CI = 1.08–11.47) were significantly related to adolescent testing. At the individual-level, having ever had sex (AOR = 6.43; 95% CI = 2.14–19.30) and being out-of-school (AOR = 2.95; 95% CI = 1.32–6.59) were also strongly associated with HIV testing. Environmental measures were not found to be significantly related to HIV testing. These findings support the need to examine not only individual characteristics but also relational level factors, particularly the role of families, when implementing and evaluating adolescent HIV testing strategies. Programs to increase communication about HIV testing and counseling within families should be tested in a prospective design in order to assess the impact on young people’s decisions to learn their HIV status and subsequent health seeking and protective behaviors.     

Characterising the relationship between migration and stigma affecting healthcare engagement among female sex workers in Lomé, Togo

ABSTRACT

Migration in West Africa is common and complicates the sustained delivery of comprehensive HIV care programmes for those with specific vulnerabilities to HIV, including female sex workers (FSW). This study evaluated whether migration potentiates the burden of stigma affecting FSW in Lomé, Togo. Respondent driven sampling identified 354 FSW who completed HIV testing and a questionnaire. Multivariable logistic regression was used to identify factors associated with stigma among FSW. Among study participants, 76.3% (270/354) were migrants, with 30.2% (107/354) reporting stigma. Migrant FSW were less likely to report stigma (aOR 0.40; 95% CI:0.22–0.73). FSW who had an abortion (aOR 3.40; 95% CI:1.79–6.30) and were tested for a sexually transmitted infection (STI) or HIV (aOR 2.03; 95% CI:1.16–3.55) were more likely to report stigma. Among FSW, 59.8% (211/353) disclosed selling sex to a health worker. Disclosure was more common among FSW who had been tested for an STI or HIV (36.7%; 77/210), or both (55.7%; 117/210), and resulted in an attenuated but significant association between STI or HIV testing and stigma, indicating that disclosure partially mediated the relationship. These results highlight the need to mitigate healthcare-related stigma affecting FSW, while also considering decentralised HIV testing approaches, including HIV self-testing.     

Attachment to Conventional Institutions and Adolescent Rapid Repeat Pregnancy: A Longitudinal National Study Among Adolescents in the United States

Introduction There is limited research on rapid repeat pregnancies (RRP) among adolescents, especially using nationally representative samples. We examine distal factors—school, family, peers, and public/private religious ties—and their associations with RRP among adolescent mothers. Methods Guided by social development theory, we conducted multivariate logistic regression analyses, adjusted for sociodemographic characteristics, to examine associations between RRP and attachment to school, family, peers, and religion among 1158 female respondents from the National Longitudinal Study of Adolescent to Adult Health (Add Health) who reported at least one live birth before age 20. Results Attachments to conventional institutions were associated with lower likelihood of RRP. Adolescent mothers who had a stronger relationship with their parents had reduced odds of RRP (adjusted odds ratio [aOR] 0.83, 95 % CI 0.71–0.99). Increased odds of RRP were associated with anticipating fewer negative social consequences of sex (aOR 1.18, 95 % CI 1.02–1.35), never praying (versus praying daily; aOR 1.47, 95 % CI 1.10–1.96), and never participating in church-related youth activities (versus participating once a week; 1.04, 95 % CI 1.01–1.07). Discussion After an adolescent birth, social support from family, peers, and the community can benefit young mothers. Private aspects of religiosity may be especially important. Understanding the processes by which these distal factors are linked to the likelihood of RRP is needed to create multifaceted intervention programs that provide diverse methods of support customized to specific circumstances of adolescent mothers.     

Risk of Tuberculosis Among HAART Receiving HIV Patients Attending an ART Centre of West Bengal,India: A Prospective Cohort Study

This prospective study was conducted to find out the incidence density rate and to identify the attributed risk factors of Tuberculosis development among ART receivers. All patients who were registered in a nodal ART centre of India within 1st January 2008–31st December 2008 and had been initiated ART in the year of 2008 were considered as a cohort and were followed up till 31st December 2012. This study was started with 169 ART receivers and ended with 129 patients. During total 631.1 person-years observation, 39 TB cases (31 pulmonary and 8 extra pulmonary) were diagnosed. TB incidence density rate reduced from 12.08/100 to 1.12/100 person-years during the follow up periods. Cox regression model revealed that patients having past history of Tuberculosis were at 5 times higher risk (Hazard ratio = 5.205; 95 % CI 2.439–11.106; p = 0.000). Patients with WHO clinical stage 3 or 4 at the time of enrolment had 2 times more risk of development of TB (Hazard ratio = 2.081; 95 % CI 1.502–2.884; p = 0.000). This study highlighted that special attention should be paid on earliest identification of TB among the HIV patients who had past history of TB or suffering from WHO clinical stage 3 or 4 to prevent the silent transmission and multidrug resistance development of Tuberculosis in the community.     

Acceptability of Rapid HIV Testing Among Latinos in Washington Heights,New York City,New York,USA

In the United States, human immunodeficiency virus (HIV) has a disproportionately large impact on Latino Americans. This study assessed the acceptability of rapid HIV testing among a sample of Latinos from New York City. A cross-sectional study was conducted with 192 participants from The Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER) study. Participants were interviewed and offered rapid HIV testing and post-test counseling. Seventy-five percent (n?=?143) accepted rapid HIV testing when offered. More religious participants were less likely than less religious participants to undergo testing (RR?=?0.73; 95% CI 0.54–0.99). Participants tested for HIV within the past year were less likely than those who had not been tested within the past year to agree to undergo testing (RR?=?0.27; 95% CI 0.11–0.66). Community-based rapid HIV testing is feasible among Latinos in urban environments. Outreach efforts to engage religious individuals and encouraging routine testing should be reinforced.