HIV antibody testing in young, urban adults.

We surveyed men and women aged 21 to 34 years to determine the rates of human immunodeficiency virus (HIV) antibody testing in blacks and whites of diverse education levels in four US cities. Responses to the anonymous, mailed questionnaire were received from 90% of 777 white women, 64% of 734 black women, 79% of 677 white men, and 48% of 541 black men. The percentages reporting HIV testing for these four race-gender groups were 29%, 22%, 30%, and 38%, respectively. The percentages reporting testing that was voluntarily sought (ie, not in connection with blood donation, military service) were 16%, 14%, 18%, and 22%, respectively. In each race-gender group, roughly half of those who had not been tested said they "might have a blood test for the AIDS virus in the future". Education level was not correlated with HIV-testing frequency. Blacks were significantly less likely than whites to be aware of "a blood test that can detect the AIDS virus infection" (58% vs 77%), but blacks who knew of the test were more likely than whites to have been tested (47% vs 37%). Eleven percent of subjects reported at least one major risk factor for HIV infection. In these people, HIV testing was most common among homosexually active men (56% tested; 52% voluntarily sought), intermediate among injection drug users (40% tested; 31% voluntarily sought), and least common among the sexual partners of injection-drug users (21% tested; 11% voluntarily sought). Health education programs need to communicate the availability of, and need for, anonymous HIV testing.     

Rate of new HIV diagnoses among Latinos living in Florida: disparities by country/region of birth

HIV incidence in the USA is three times higher for Latinos than for non-Latino whites. Latinos differ in educational attainment, poverty, insurance coverage, and health-care access, factors that affect HIV knowledge, risk behaviors, and testing. The purpose of this study was to identify differences in demographics, risk factors, and rate of new HIV diagnoses by birth country/region among Latinos in Florida to guide the targeting of primary and secondary prevention programs. Using Florida HIV/AIDS surveillance data from 2007 to 2011 and the American Community Survey, we compared demographic and risk factors, and calculated annual and five-year age-adjusted rates of new HIV diagnoses for 5801 Latinos by birth country/region. Compared to US-born Latinos, those born in Cuba and South America were significantly more likely to report the HIV transmission mode of MSM; those born in the Dominican Republic (DR) heterosexual transmission; and those born in Puerto Rico injection drug use. Mexican- and Central American-born Latinos were more likely to be diagnosed with AIDS within a month of HIV diagnosis. The rate of new HIV diagnoses among Latinos declined 33% from 2007 to 2011. HIV diagnoses over time decreased significantly for Latinos born in Mexico and increased nonsignificantly for those born in the DR. Although this study was limited to Latinos living in Florida, results suggest that tailoring HIV primary prevention and testing initiatives to specific Latino groups may be warranted.     

Latinos and HIV/AIDS: Examining Factors Related to Disparity and Identifying Opportunities for Psychosocial Intervention Research

Latinos maintain an AIDS case rate more than 3 times higher than whites, a greater rate of progression to AIDS, and a higher rate of HIV/AIDS-related deaths. Three broad areas are reviewed related to these disparities: (1) relevant demographic, socioeconomic, and socio-cultural factors among Latinos; (2) drug abuse and mental health problems in Latinos relevant to HIV/AIDS outcomes; and (3) opportunities for psychosocial intervention. Latinos living with HIV are a rapidly growing group, are more severely impacted by HIV than whites, and confront unique challenges in coping with HIV/AIDS. A body of research suggests that depression, substance abuse, treatment adherence, health literacy, and access to healthcare may be fruitful targets for intervention research in this population. Though limited, the current literature suggests that psychosocial interventions that target these factors could help reduce HIV/AIDS disparities between Latinos and whites and could have important public health value.

Racial and Ethnic Disparities in Future Testing Intentions for HIV: United States, 2007–2010: Results from the National Health Interview Survey

This study examined racial/ethnic differences in rationale for intending to test for HIV. Data were analyzed from 98,971 adults from the 2007–2010 National Health Interview Survey. An estimated 38.5 % of respondents previously tested for HIV. Testing as part of a medical checkup or procedure was the most common reason for being tested among studied racial/ethnic groups. Non-Hispanic whites (80.7 %) and non-Hispanic Asians (71.2 %) had higher proportions (p < 0.001) of respondents that have not been tested for HIV due to believing they were unlikely exposed. Non-Hispanic blacks (ARR: 2.55; 95 % CI 2.39–2.72) and Hispanics (ARR: 1.81; 95 % CI 1.68–1.95) who ever tested for HIV were significantly more likely to report positive future testing intentions compared to non-Hispanic whites. Additional efforts to increase the availability of HIV tests by making HIV testing a routine part of medical care and increasing knowledge of HIV transmission, risk-perception, and treatment may reduce racial/ethnic disparities in HIV testing.     

Frequent failed early HIV detection in a high prevalence area: implications for prevention

To identify the frequency of and factors associated with early detection of HIV infection in Los Angeles County, data were evaluated from interviews of a population-based sample of adult persons with AIDS. Early detection was defined as greater than 5 years between the first reported positive HIV test and an AIDS diagnosis. The associations between early detection and sociodemographic and behavioral factors were assessed for the period January 1997 through June 2002. Over the study period, only 20% (253/1268) of persons interviewed met the criterion for early detection. Early HIV detection was less likely for women (adjusted odds ratio [AOR] = 0.6, 95% confidence interval [CI]: 0.4, 0.9), blacks (AOR = 0.5, 95% CI: 0.4, 0.8), foreign-born Latinos (AOR = 0.2, 95% CI: 0.1, 0.3), U.S.-born Latinos (AOR = 0.3, 95% CI: 0.2, 0.6, and heterosexuals (AOR = 0.5, 95% CI: 0.3, 0.7). Trends of increasing early detection with older age groups (p < 0.001) and higher educational levels (p < 0.001) were also observed. Our findings indicate an overall low level of early HIV detection and suggest that major sociodemographic and risk group disparities exist in the likelihood of early detection among HIV-infected persons in Los Angeles. These differences have important implications for reducing the level of community HIV transmission and for improving individual health outcomes among people with HIV. Aggressive efforts are needed to expand HIV testing and early detection for women, minorities, heterosexuals, younger age groups, and persons of lower education. Links to treatment and behavioral intervention programs should accompany such expanded testing efforts.     

Gender differences in university students' HIV/AIDS-related knowledge and sexual behaviours in Malawi: a pilot study

A cross-sectional study was conducted among first-year university students in Malawi to determine distributions of HIV/AIDS related knowledge, and sexual behaviours. A total of 314 (199 male and 115 female) students were eligible to participate, and of these 221 (70.4%) participated in the survey. Generally, levels of HIV/AIDS-related knowledge were similar between sexes. Overall, 68.9% of students of both sexes felt that they knew enough about HIV/AIDS. Altogether, 83.3% of students reported that they knew where to access HIV testing on campus, but only 19.0% reported that they knew their HIV status. Some 60.3% of students who had never been tested intended to have an HIV test. A history of having ever been tested was not associated with sex. Most (68.4%) students felt that they were not at risk of acquiring HIV infection. Overall, 66.8% of students knew where to get a condom on campus, and 38.7% stated that they knew exactly how to use it. About half (52.6%) of the students used a condom at last vaginal sexual intercourse. Having multiple sex partners in the last 12 months was reported by 40.4% of students.     

Care and viral suppression during the last year of life among persons with HIV who died in 2012, 18 US jurisdictions

Death due to HIV remains a leading cause of death among some US populations, yet little is known about HIV care before death. We used data from the National HIV Surveillance System to determine disease stage and care within 12 months prior to death among persons infected with HIV who died in 2012. Persons were considered to be in care within 12 months before death if they had ≥1 CD4 or viral load test results, and in continuous care if they had ≥2 CD4 or viral load test results at least 3 months apart. Viral suppression (viral load <200?copies/mL) was based on the most recent viral load test result in the 12 months before death. Among 7348 persons infected with HIV who died in 2012, 47.1% had late stage disease (AIDS) within 12 months before death. Overall, 85.7% had ≥1 test result, 64.3% had ≥2 tests at least 3 months apart, and 41.6% had a suppressed viral load. While blacks and Hispanics/Latinos had higher percentages of continuous care compared with whites, they had lower percentages of viral suppression and higher percentages with late stage disease. Viral suppression was higher among older persons. The majority had been diagnosed with HIV more than 5 years before death (86.3%). Although the majority of persons infected with HIV who died in 2012 had been diagnosed many years before death, almost half had late stage disease, and there were disparities in late stage disease and viral suppression by race/ethnicity and age.     

Association between HIV/AIDS knowledge and stigma towards people living with HIV/AIDS in Botswana

In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative data from the 2013 Botswana AIDS Impact Survey (BAIS) IV to examine the relationship between HIV/AIDS knowledge and stigmatising attitudes toward people living with HIV/AIDS (PLWHA). The mean (standard error) for stigma towards PLWHA score and HIV/AIDS knowledge score were 0.99 (0.02) and 5.90 (0.03) respectively. HIV/AIDS knowledge score and stigma towards PLWHA score were strongly positively correlated r (4,4045) = 0.415, p < 0.001). After adjusting for potential confounders, HIV/AIDS knowledge score significantly predicted stigma towards PLWHA score [coefficient β (95% CI)] [?0.25 (?0.29, ?0.20), p < 0.001]. These findings imply that programmes and interventions that increase HIV/AIDS knowledge may reduce the pervasive apprehension, blame, and stigmatising attitude held towards PLWHA in Botswana.     

多部门合作人员AIDS防治相关情况调查

目的 了解多部门与艾滋病(AIDS)防治相关工作人员对《中国预防与控制艾滋病中长期规划(1998—2010年)》(简称《中长期规划》)及AIDS知识知晓情况,掌握我国AIDS防治工作存在的问题及需求,为制定AIDS防治策略及多部门人员培训计划提供建议与依据。方法 采用分层整群抽样方法。选择8个AIDS流行率及高危因素各具不同特点的省份的各1个地区(市)和1个县,随机抽样政府多部门与AIDS防治工作政策的制定或实施人员共800人,调查了解他们对《中长期规划》及AIDS知识知晓情况。结果 (1)72．35％的调查对象了解国家制定了《中长期规划》,但只有13．38％的调查对象阅读过《中长期规划》;(2)90％以上的调查对象对握手、游泳、共用办公用品不会传播艾滋病病毒(HIV)及通过性接触途径、接受输血及血制品、共用注射器和母婴途径可传播HIV的回答正确率较高;但对蚊虫叮咬、共用餐具、轻吻不传播HIV等回答的正确率不高。(3)对公开推广安全套态度不同。84．94％的调查对象认为安全套不仅可以避孕,同时也具有预防性病、AIDS的作用;有65．78％的调查对象赞成在宾馆、旅馆等公共场所放置安全套;48．23％的调查对象赞成在大学校园中公开销售安全套。(4)对防治工作的总体评价不同。84．17％的调查对象认为我国有AIDS流行;52．28％的调查对象认为当地有AIDS流行;分别有41．01％及29．53％的调查对象认为近2年来全国及当地的AIDS防治工作比较好;90％以上的调查对象认为AIDS的流行会影响当地经济和社会的发展;近70％的调查对象认为近年来当地打击卖淫嫖娼及禁毒工作取得了一定的成效,在预防与控制AIDS的工作中发挥了积极作用。(5)97．23％的调查对象认为中国需要制定有关AIDS防治的法律或法规;96．47％的调查对象认为AIDS防治有必要采取“多部门合作”的策略;67．83％的调查对象赞成“政府领导、多部门合作、全社会参与”AIDS综合防治对策;75．97％的调查对象认为健康教育是目前预防AIDS最重要和有效的措施。结论 在多部门合作领域,有针对性地开展《中长期规划》宣传和AIDS防治政策与策略的需求调研与评估工作,宣传普及AIDS防治相关知识,可以提高政府多部门间AIDS防治合作应对与决策能力,有效地达到预防和控制AIDS传播目的。     

HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town,South Africa

HIV testing benefits those who test positive, allowing them to receive treatment, but the benefits for those who test negative remain controversial. We evaluated the impact of testing on HIV knowledge and sexual risk among men in South Africa. Men were recruited from townships outside Cape Town and completed a survey that assessed testing history, knowledge, and sexual behaviours. Among the 820 participants, 516 (63%) reported being tested (82% tested negative, 6% tested positive, and 12% unknown). Compared to those who had never been tested for HIV, men who tested for HIV were more knowledgeable about HIV transmission, but did not differ on sexual risk behaviour. Knowledge moderated the effect of testing on sexual risk such that men reported fewer sexual partners (incidence rate ratio (IRR) = 0.91, 95% CI = 0.84, 0.98) and fewer unprotected anal sex events (IRR = 0.81, 95% CI = 0.66, 1.00) if they had been tested for HIV and were knowledgeable about HIV transmission. For men testing HIV-negative, knowledge predicted fewer sexual risk behaviours. Previous HIV testing is associated with enhanced knowledge, which moderates sexual risk behaviour among South African men living in Cape Town. Results suggest that HIV testing may increase knowledge and lead to reductions in sexual risk even when results are negative.     

Use of and exposure to HIV prevention programs and services by persons at high risk for HIV

Although HIV information is widely available in this country, little is known about how commonly used HIV prevention activities reach persons at highest risk for HIV. In this paper, we describe the extent to which HIV prevention strategies reach a sample of high-risk persons and whether such exposure correlates with having been tested for HIV. Data are from the 2000 HIV Testing Survey, an anonymous interview study of men who have sex with men (MSM), injection drug users (IDU), and high-risk heterosexuals (HRH), recruited from appropriate venues in seven states and New York City. We report the proportion of persons exposed to three types of interventions: information (media messages, brochures), counseling or skills-building (group counseling, role play, calling an AIDS hotline), and prevention supplies (provision of condoms, bleach kits), stratified by HIV testing status (ever, never). Exposure to information interventions was high among 2491 respondents (85%-96%) and did not differ by testing status. Use of counseling or skills-building interventions varied by testing status for IDU (8% untested versus 41% tested, p < 0.01) and HRH (14% versus 20%, p = 0.03) but not MSM (15% versus 23%, p = 0.08). Among tested IDU, those receiving bleach kits were more likely to report consistent bleach use when injecting with nonsterile needles (25% versus 9%, p = 0.003). Exposure to HIV prevention information is high but exposure to counseling or skills-building interventions is less common and more prevalent among those previously tested. Prevention initiatives should focus on counseling and testing, skills-building, and prevention supplies.     

Effectiveness of HIV counseling services on knowledge, attitude, behavior and practice (KABP) among pregnant women attending PPTCT program

Counseling services is an important component of National AIDS Control Program which aims at creating awareness and promoting changes in reducing high risk behavior against HIV/AIDS. Pregnant women attending antenatal clinics are being counseled about HIV/AIDS under prevention of parent to child transmission (PPTCT) program. The objective of this study was to assess (KABP) regarding HIV/AIDS among pregnant women attending PPTCT program before and after counseling at Lok Nayak Hospital, New Delhi. A Quasi-experimental study was conducted. Data was collected by interviewing 600 pregnant women attending ANC clinic during May 2006 to May 2007 using a pre-test and post-test interview schedule. About 69.2% of the pregnant women had heard about AIDS before the counseling. Knowledge regarding mother to child transmission of HIV was 53.5%. 38.2% knew that mother to child transmission can be reduced by drugs. The knowledge of pregnant women about AIDS was significantly different in pre-test (mean score = 15.3) and post test (mean score = 35.6) (P < 0.0001). Attitude of study participants towards people living with HIV/AIDS (PLWHA) indicated that individuals with HIV should be allowed to work (79.9%) and all commercial sex workers should compulsorily be tested for HIV (55.1%). There was significant difference between in pre-test and post-test attitude about PLWHA and HIV testing (p < 0.0001). The condom use among the study participants significantly improved after counseling (1.2% in pre-test and 58.6% after counseling) (p < 0.0001). Counseling services were effective in increasing knowledge and changes in attitude and behavior among pregnant women and the efforts needs to be sustained.     

Study of HIV/AIDS-related knowledge among junior high-school students in Shanghai, China

The aim of this study was to assess the HIV/AIDS-related knowledge among junior high-school students in Shanghai, China, and the factors influencing this knowledge. A cross-sectional study was conducted in 20 middle schools of two districts by a cluster-stratified selection procedure in Shanghai, China. The 2432 sampled students, aged from 11.1 to 16.7 years, completed a self-administered questionnaire of HIV/AIDS prevention. The results showed that the overall correct rate of HIV/AIDS-related knowledge was 62%. Using multivariable logistic regression analysis, we found that the main factors influencing HIV/AIDS-related knowledge among junior high school students were the type of school (odds ratio [OR] = 1.641), age (OR = 1.727), whether the student was a single child in the family (OR = 1.389), whether the student had previous HIV/AIDS-related education experience (OR = 2.003) and whether the student had ever discussed HIV/AIDS with their parents (OR = 1.282). The results indicate that HIV/AIDS-related knowledge among Shanghai junior high school students is not high enough, and more attention needs to be paid to enhance HIV/AIDS-related knowledge, especially among younger students from common type schools without HIV/AIDS-related education experience. We encourage Chinese parents to get involved in their children's HIV/AIDS prevention education.     

四川省青年学生HIV检测途径及检测意愿影响因素分析

目的 分析四川省青年学生艾滋病病毒(HIV)既往检测行为特征及检测意愿,为高校HIV检测服务开展提供依据.方法 调查四川省13所高校5 311 名青年学生既往的HIV检测行为特征和未来6个月的检测意愿,并采用无序多分类Logistic 回归分析青年学生检测意愿的影响因素.结果 有效问卷5 294份,5 294人中有43...     

社区卫生服务机构艾滋病防治对象对HIV检测接受意愿调查

目的了解社区卫生服务机构艾滋病防治对象对艾滋病病毒（HIV）检测的接受意愿及影响因素。方法采用自行设计的调查问卷,在北京、上海等8个城市的社区卫生服务机构,对重点科室（妇产科、皮肤科等）的就诊人员、男男性行为人群（MSM）和娱乐场所女性工作人员进行调查。调查内容包括一般社会人口学信息、艾滋病相关知识、HIV防治服务接受意愿及利用情况等。结果共调查了755人,其中29人HIV阳性。在726名HIV阴性人员中,555人（76．4％）表示愿意接受社区卫生服务机构免费提供的HIV检测服务。多因素Logistic回归分析显示,平均月收入较高（1000～1999元、2000-2999元）、知晓艾滋病知识和以前接受过HIV检测的服务对象,更愿意接受HIV检测,其比值比（OR）和95％可信区间（CD分别为2．51（1．18～5．37）、2．35（1．28～4．32）、2．07（1．14～3．77）、1．85（1．25～2．75）。结论调查对象对社区卫生服务机构开展的HIV检测服务有较高的接受意愿,但也存在诸如担心歧视、个人隐私暴露和业务能力不高以及自身艾滋病知识欠缺等因素的影响,因此在社区卫生服务机构开展HIV检测需要加强受检者隐私保护,同时要扩大HIV防治宣传和提高社区医生的HIV咨询检测知识和技能水平。     

HIV-related knowledge, attitudes, perceived benefits, and risks of HIV testing among pregnant women in rural Southern India

The rising prevalence of HIV among pregnant women in rural India is of great concern. Prenatal voluntary counseling and HIV testing (VCT) is critical to prevent mother-to-child transmission of HIV (PMTCT). We surveyed 202 pregnant women attending a rural antenatal clinic in Southern India to investigate HIV-related knowledge, attitudes toward infant feeding practices, and perceived benefits and risks of HIV testing. Of the total of 202 women surveyed, 189 women (94%) had heard of HIV/AIDS and 60% of them had relatively good knowledge regarding risk factors for HIV transmission. However, 48% did not know that there are "means to prevent mother-to-child HIV transmission." If women were not to breastfeed her baby, negative attitudes expected from the partner would include 84% thinking that that the mother is harming the baby, 78% thinking she is not a good mother, 74% thinking she has HIV, and 66% thinking she has been unfaithful. Ninety-seven percent of women did not perceive themselves at risk for HIV and only 57% had been tested for HIV. Although, 85% of women expressed their willingness to be tested, most were concerned about confidentiality and disclosing HIV serostatus because of fear of negative reactions from their husbands, parents, and community. Many social and cultural barriers confront pregnant women when they decide to opt for HIV testing. If VCT and PMTCT interventions are to be successful, urgent attention must be focused on education, development of innovative culturally appropriate interventions that empower women to make decisions about HIV testing, involvement of men, and addressing stigma and discriminatory attitudes toward people living with HIV/AIDS.     

Sexual risk behaviors and HIV/AIDS awareness among males in a rural community in Goa

To study the heterosexual risk behaviors and to study the level of HIV/ AIDS awareness among males in a rural community in Goa. Survey was cross-sectional and community based. A sample of 300 males aged 15-49 years selected by stratified random sampling. An "UNAIDS protocol for measurement of HIV/STD prevention indicators" was used. SPSS software package was used for statistical analysis. One hundred and ninety eight (66%) males reported ever having sexual intercourse, of these 17% were single. Fifty three (17.7%) males reported intercourse with a non-regular partner in the past 12 months, of these 90.6% had intercourse with strangers, 92.5% had paid for sex and only 43.4% had used a condom for the last sexual encounter with a non-regular partner. Less educated males (<10th class), single and those employed have higher sexual indulgence with non-regular sexual partners. The level of knowledge about HIV/ AIDS was very high in all areas of causation and prevention. Although the awareness about sexual risk behavior was high, condom use was very low resulting in high risk behavior related to HIV/ AIDS and STDs among males. The study highlights the need for more effective behaviour change communication (BCC) strategies in the community as well as innovative methods like village level peer education.     

山西省某农村既往非法卖血社区影响HIV从卖血人群向一般人群传播的可能因素

目的分析农村既往非法卖血社区影响艾滋病病毒(HIV)从卖血人群向一般人群传播的可能因素。方法选择山西省某县12个村庄，随机抽取660名18～59岁村民开展以社区为基础的横断面研究。采用标准问卷收集研究对象的人口学、医疗注射情况、性行为、艾滋病(AIDS)相关的知识、态度及HIV自愿咨询检测史等信息。结果在过去5年中，约有1／4的调查对象拔过牙，2．8％的对象接受过输血，77．7％的对象有过打针和注射史。打针或注射的场所多是在个体诊所(58．1％)和村卫生室(33．0％)。仅有19．6％的对象使用过安全套；12．5％的对象有过2个以上的性伴侣。该社区婚外性行为并不少见(6．7％)，卖淫嫖娼的比例为1．O％，最近1次婚外性行为中，使用安全套的比例仅为20．O％。对HIV三种传播途径(性、血液和母要传播)的正确回答率为43．1％。该地存在广泛的AIDS相关的歧视。仅有1．7％的村民曾经接受过HIV检测。结论该地区存在广泛的影响HIV从卖血人群向一般人群传播的可能因素。有效预防HIV的二代传播成为中国农村AIDS防治的工作重点之一。关键词：艾滋病病毒；农村社区；二代传播；预防和控制     

Racial heterogeneity of HIV antigenemia in people with HIV infection

We compared the prevalence of HIV p24 antigenemia in black and white US patients with HIV infection. The prevalence of HIV antigenemia increased with severity of HIV disease (P less than 0.001). In all clinical categories, whites were more likely to be HIV-antigenemic than blacks (overall prevalence 38 versus 18%; P less than 0.01). Anti-p24 antibodies were detected in a higher proportion of blacks (84%) than whites (65%; P = 0.02). Blacks had significantly higher total serum immunoglobulin levels than whites (median 3.8 versus 3.2 mg/dl; P less than 0.00001). Racial differences in HIV antigen expression may result from differences in humoral response to HIV infection. These differences should be considered when HIV antigen is used as a surrogate marker in clinical trials.