Perceptions of HIV/AIDS in One’s Community Predict HIV Testing

Using a subsample of respondents to the 2005 Los Angeles County health survey, we examined the relationship between perceptions of the seriousness of HIV/AIDS in one's community and HIV testing. We constructed a propensity score-based matched sample of three groups with differing perceptions of the seriousness of HIV in their community: high perceived seriousness, low perceived seriousness, and uncertain about seriousness. We compared HIV testing behavior in the three groups before and after using propensity score matching to control for selection on observed covariates. The unadjusted comparison showed a testing rate of 30.2?% among those perceiving high seriousness, 11.4 percentage points higher than the 18.8?% testing rate among those perceiving low seriousness. After propensity score matching, the adjusted testing difference was 7.0 percentage points (p?相似文献   

How well do trends in HIV prevalence in young people reflect HIV incidence? Results from 10 years of HIV serosurveillance in San Francisco

Trends in HIV prevalence among young populations (15-24 years) are held to approximate trends in HIV incidence. Using the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) to estimate HIV incidence, we were able to demonstrate that this assumption was true for young patients at San Francisco's public sexually transmitted infection clinic from 1989 to 1998. However, the trend in prevalence among young people did not mirror trends in incidence in the overall population.     

Is HIV out of control in the UK? An example of analysing patterns of HIV spreading using incidence-to-prevalence ratios

The incidence of diagnosed HIV in the UK is increasing. We calculated the incidence-to-prevalence ratio, IPR(t), which must exceed an 'epidemic threshold', the reciprocal of the mean infectious period, for sustained transmission to occur. For heterosexuals the IPR(t) is too low for a self-sustained UK epidemic, and incidence is driven by increasing prevalence, mostly from imported cases. For men who have sex with men the IPR(t) is around the epidemic threshold, suggesting that spread is not yet under control.     

High Frequency of Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Patients with and without Diarrhea in Lima,Perú

Diarrhea is still a prevalent health issue in HIV patients. Our objective was to characterize the different diarrheagenic E. coli (DEC) groups in stools from adult HIV patients. Cross sectional study: We enrolled HIV-positive and -negative patients with and without diarrhea from a tertiary-care center of Lima, Peru. Clinical data was recorded and a stool sample per patient was cultured. Multiplex PCR was used to detect different DECs. One hundred eighty-four participants were enrolled. The frequency of having at least one DEC was more common in HIV-positive than HIV-negative patients with diarrhea (42% versus 20%, P < 0.05). The enterotoxigenic E. coli (ETEC) was the most common DEC in patients with diarrhea, 13% in HIV patients. The diffusely adherent E. coli (DAEC) was only present in HIV positive patients with diarrhea (10.1%). Different types of DEC are frequent in stools from HIV-positive patients.Since the highly active anti-retroviral treatment (HAART) was introduced for acquired immunodeficiency syndrome (AIDS), the incidence of opportunistic infections has decreased and new pathogens, such as diarrheagenic Escherichia coli (DEC) groups,¹ are now associated with diarrhea in human immunodeficiency virus (HIV) patients. Because antibiotic therapy may be successful in cases where pathogenic bacteria are identified, studies focusing on bacterial diarrhea in AIDS patients are needed. The DECs have been classified into six groups based on specific genes that determine their virulence factors: enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), Shiga toxin producing E. coli (STEC), enteroagregative E. coli (EAEC), enteropathogen E. coli (EPEC), and diffusely adherent E. coli (DAEC).² The role of different DECs in causing diarrhea in HIV-infected people in Latin American countries has not been adequately addressed because most studies have not examined for all currently recognized groups of DECs. Our objective was to characterize the different DECs in stools from adult HIV patients in Lima, Perú.     

HIV prevalence and related behaviours of older people in Botswana — secondary analysis of the Botswana AIDS Impact Survey (BAIS) IV

The focus of HIV interventions in Botswana, a country with the second highest prevalence of HIV in the world, remains targeted at those aged 15–49 years despite a growing cohort of older people living with the disease — driven largely by the successful roll-out of antiretroviral therapy (ART). Primarily utilising the Botswana AIDS Impact Survey IV, we set out to examine HIV related characteristics and behaviours of this often ignored older cohort (50–64 years) relative to younger (25–49 years) adults. Analysis revealed that more than 80% of older people living with HIV were on ART. HIV prevalence among this older cohort was 24.6% in 2013 compared to 35.1% among the younger cohort, p < 0.0001. Prevalence in older adults was higher among older males (27.8%) than females (21.9%), p = 0.02. Furthermore, 58.9% of older adults acknowledged being sexually active, with 59.0% of these admitting to inconsistent condom use during sexual intercourse. In addition to this low condom usage, older men (6.0%) were significantly more likely to be unaware of their HIV-positive status than older women (3.0%), p = 0.002. While HIV prevalence showed a dramatic increase among older men over time (17.2% in 2004, to 23.4% in 2008, to 27.8% in 2013), the trend was flatter among older women (16.3% in 2004, to 22.4% in 2008, to 21.9% in 2013). These trends are likely attributable to a large increase in ART coverage and uptake. Going forward, more targeted interventions acknowledging the ageing epidemic are important to consider.     

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima,Perú

We conducted a prospective study in three hospitals in Lima in human immunodeficiency virus (HIV) children to determine the frequency of diarrheagenic Escherichia coli. Five E. coli colonies/patients were studied by a multiplex real-time polymerase chain reaction to identify the six currently recognized groups of diarrhea-associated E. coli. We have analyzed 70 HIV-associated diarrheal and 70 control samples from HIV-infected children without diarrhea. Among the diarrheal episodes 19% were persistent, 3% dysenteric, and 33% were associated with moderate or severe dehydration. The diarrheagenic E. coli were the most commonly isolated pathogens in diarrhea (19%) and control samples (26%) (P = 0.42), including enteroaggregative (6% versus 10%), enteropathogenic (6% versus 10%), and enterotoxigenic E. coli (4% versus 3%), respectively. The HIV-infected children with diarrhea had the worse age-related immunosuppression, higher viral loads, and were on highly active antiretroviral treatment (HAART) less often than HIV-infected children without diarrhea. Diarrheagenic E. coli were highly resistant to ampicillin (74%) and cotrimoxazole (70%).     

Correlates of Unknown HIV Status Among MSM Participating in the 2014 American Men’s Internet Survey (AMIS)

Increasing serostatus awareness is a key HIV prevention strategy. Despite expanded testing efforts, some men who have sex with men (MSM) remain unaware of their HIV status. This study explored demographic characteristics, sexual identity, sexual role, and behavioral factors associated with unknown HIV status among MSM in the United States. Data from 9170 MSM in the 2014 American Men’s Internet Survey were analyzed using logistic regression to identify correlates of unknown HIV status. Young age, race, low education, rural residence, and lack of recent healthcare visits were significantly associated with unknown HIV status. In addition, nondisclosure of one’s sexual orientation (OR = 3.70, 95% CI 2.99–4.59) and a self-identified sexual role as “bottom” (OR = 1.45, 95% CI 1.24–1.70) were predictors of unknown HIV status. Post-hoc analysis showed HIV-negative MSM not tested in the last year had fewer self-reported risk behaviors than recent testers, suggesting that repeat testing among MSM may be aligned with individual risk.     

Birth–death skyline plot reveals temporal changes of epidemic spread in HIV and hepatitis C virus (HCV)

Phylogenetic trees can be used to infer the processes that generated them. Here, we introduce a model, the Bayesian birth–death skyline plot, which explicitly estimates the rate of transmission, recovery, and sampling and thus allows inference of the effective reproductive number directly from genetic data. Our method allows these parameters to vary through time in a piecewise fashion and is implemented within the BEAST2 software framework. The method is a powerful alternative to the existing coalescent skyline plot, providing insight into the differing roles of incidence and prevalence in an epidemic. We apply this method to data from the United Kingdom HIV-1 epidemic and Egyptian hepatitis C virus (HCV) epidemic. The analysis reveals temporal changes of the effective reproductive number that highlight the effect of past public health interventions.     

Community-based survey of HCV and HIV coinfection in injection drug abusers in Sichuan Province of China

AIM: To investigate the prevalence and risk factors of HCV/HIVcoinfection in injection drug abusers (IDAs) in Lianshan YiAutonomous Prefecture of Sichuan province,China.METHODS: From November 8,2002 to November 29,2002,a community-based survey was conducted to investigatethe demographic characteristics,patterns of shared injectorsdevices and sexual behaviors in IDAs.Blood samples werealso collected to test HCV and HIV infection.A total of 379subjects were recruited in the study through communityoutreach and peer recruiting methods.RESULTS: Of the 379 IDAs,the HCV prevalence and HIVprevalence were 71.0% and 11.3%,respectively,andHCV/HIV coinfection was 11.3%.HCV infection was foundin 100% and 67.3% of HIV-positive and HIV-negative IDAs,respectively.HIV prevalence was 16.0% in HCV positiveIDAs while none of the HCV negative IDAs was positive forHIV.Ethnicity,shared needles or syringes and cotton inthe past 3 mo and syphilis infection were associated withHCV/HIV coinfection shown by univariate analysis usingchi-square test.Multivariate logistic regression analysisshowed that shared needles or syringes in the past 3 mo(Odds ratio=3.121,95% CI: 1.278-7.617,P<0.05) andsyphilis infection (Odds ratio=2.914,95% CI: 1.327-6.398,P<0.01) were significantly associated with HCV infection.No statistically significant association was found in univariateanalysis between sexual behaviors and HCV/HIV coinfection.CONCLUSION: Shared needles and syringes in the past3 mo and syphilis infection were significantly associatedwith HCV infection.Further sero-epidemiological prospectivecohort studies should be conducted to clarify the impact ofsyphilis and high risk sexual behaviors on HCV transmissionthrough unprotected sexual intercourse.     

Church representatives’ perspectives on masculinities in the context of HIV: the case of the Ecumenical HIV and AIDS Initiative in Africa

Despite a growing body of literature related to church leaders challenging dominant norms of masculinities that may enable the spread of HIV, research on masculinity issues among African church representatives who are policy makers is scarce. The objectives of this study were to explore the perspectives on masculinities held by church representatives within the Ecumenical HIV and AIDS Initiative in Africa (EHAIA) and to identify strategies they used to transform masculinities in their respective churches. Qualitative interviews were carried out with 14 church representatives belonging to the EHAIA International Reference Group. These interviews were analysed using thematic analysis and four themes were identified: “barriers to challenge masculinities” may contribute to the spread of HIV; “counterproductive conservative church leadership” fails to challenge dominant forms of masculinities; “facilitators to challenge masculinities” perceived as slowly changing men and “an evolving hope for gender equality” would be perceived in certain marital relationships. The latter two were viewed as positive approaches resulting from masculinity workshops and male priests disclosing their HIV-positive status. This research highlights strategies that may help male church-goers challenge masculinities, support gender equality and, improve the lives of men and women in the context of HIV.     

Comparison of cognitive performance in HIV or HCV mono-infected and HIV–HCV co-infected patients

Purpose

Our aim was to explore the interplay between human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections in the expression of cognitive disorders.

Methods

We performed a multi-centre cross-sectional study, enrolling three groups of asymptomatic outpatients matched for age and education: (1) HIV mono-infected; (2) HCV mono-infected; (3) HIV–HCV co-infected. All subjects were subjected to the Zung depression scale and a comprehensive neuropsychological battery.

Results

A total of 50 patients for each group were enrolled. Patients in the three groups did not significantly differ in the main common demographic and clinical characteristics, except for a lower proportion of past injecting drug use (IDU) in group 1 (4 %) in comparison to groups 2 (38 %, p < 0.001) and 3 (78 %, p < 0.001), a longer duration of HIV infection in group 3 in comparison to group 1 (p < 0.001) and a longer duration of HCV infection in group 3 in comparison to group 2 (p = 0.028). Overall, 39.3 % of patients showed minor cognitive impairment, with a higher proportion in group 3 (54 %) when compared to groups 1 (28 %, p = 0.015) or 2 (36 %, p = 0.108). Patients in group 3 [odds ratio (OR) 3.35, p = 0.038 when compared to group 1] and those with higher depression scores (OR 1.05, p = 0.017) showed an increased risk of cognitive impairment after adjusting for education and past injection drug use. In particular, group 3 showed worse performance in psychomotor speed tasks when compared to group 1 (p = 0.033).

Conclusions

A worse cognitive performance in HIV–HCV co-infected patients was observed, suggesting an additive role of the two viruses in the pathogenesis of cognitive disorders.