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Bhattacharyya A, Chakraborty R, Raj T, Padhi BK, Khubchandani J, Satapathy P, Rustagi S, Chattu VK. Comprehensive Knowledge about HIV/AIDS among Women of Reproductive Age in India. EPIDEMIOLOGIA 2023; 4:492-504. [PMID: 37987313 PMCID: PMC10660847 DOI: 10.3390/epidemiologia4040041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
HIV/AIDS has been a major threat to global public health, with India ranking third when it comes to the global burden of people living with HIV, especially women. It is imperative to assess the level of knowledge women have about transmission and prevention of this infection. This study sought to delineate the determinants of the comprehensive knowledge of HIV/AIDS among women in the reproductive age groups in India. Data from the fifth round of the National Family Health Survey conducted in India were analyzed. The sample included 95,541 women aged 15-49 years. Multilevel logistic regression was fitted with individual characteristics, household characteristics, and community characteristics to identify determinants of comprehensive knowledge on HIV/AIDS. Nearly a fourth (24.8%) of the women aged 15-49 in India who had ever heard of HIV had comprehensive knowledge of HIV/AIDS. Multilevel logistic regression showed that the likelihood of comprehensive knowledge of HIV/AIDS was higher among women aged 40-44 (AOR = 1.57) and 30-34 (AOR = 1.56). The likelihood of having comprehensive knowledge increased with the increase in the level of education. Women with secondary and higher levels of education were 1.9 times and 3.38 times more likely to have comprehensive knowledge, respectively, than those with no education. Household wealth, access to mass media, and having ever tested for HIV were also significant determinants of comprehensive knowledge of HIV/AIDS among women. The odds of having comprehensive knowledge about HIV/AIDS were higher for women with higher community wealth (AOR = 1.31), higher community education (AOR = 1.09), and higher community employment (AOR = 1.12). Factors at both the individual and community levels were shown to be indicators of comprehensive knowledge of HIV/AIDS. Policymakers and public health practitioners in India should come up with plans to close the information gaps about HIV/AIDS that exist among women and their demographic subgroups.
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Affiliation(s)
- Aritro Bhattacharyya
- International Institute for Population Sciences, Mumbai 400088, India; (A.B.); (R.C.); (T.R.)
| | - Ritankar Chakraborty
- International Institute for Population Sciences, Mumbai 400088, India; (A.B.); (R.C.); (T.R.)
| | - Tapasya Raj
- International Institute for Population Sciences, Mumbai 400088, India; (A.B.); (R.C.); (T.R.)
| | - Bijaya Kumar Padhi
- Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India;
| | - Jagdish Khubchandani
- Department of Public Health Sciences, New Mexico State University, Las Cruces, NM 88003, USA
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India; (P.S.); (V.K.C.)
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Sarvesh Rustagi
- Department of Food Technology, Uttaranchal University, Dehradun 248007, India;
| | - Vijay Kumar Chattu
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India; (P.S.); (V.K.C.)
- Department of Occupation Science and Occupational Therapy-Temerty, Faculty of Medicine, University of Toronto, Toronto, ON P3C 1T6, Canada
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Okiring J, Getahun M, Gutin SA, Lebu S, Lee J, Maeri I, Eyul P, Bukusi EA, Cohen CR, Neilands TB, Ssali S, Charlebois ED, Camlin CS. Sexual partnership concurrency and age disparities associated with sexually transmitted infection and risk behavior in rural communities in Kenya and Uganda. Int J Infect Dis 2022; 120:158-167. [PMID: 35472527 PMCID: PMC9984205 DOI: 10.1016/j.ijid.2022.04.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/02/2022] [Accepted: 04/20/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES We examined sex-specific associations of partner age disparity and relationship concurrency with Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT) infection, higher-risk relationships, and condom use as proxies for HIV risk. METHODS Data were collected in 2016 from 2179 adults in 12 communities in Uganda and Kenya. Logistic regression models examined associations of age disparity and relationship concurrency with NG/CT infection, condom use, and higher-risk (commercial sex and other higher-risk) relationships in the past 6 months, controlling for covariates. RESULTS Partner age and relationship concurrency were associated with NG/CT infection in women but not men. Relative to women in age-disparate relationships, women in both age-disparate and age-homogeneous relationships had higher odds of NG/CT infection (adjusted odds ratio [aOR]=3.82, 95% confidence interval [CI]: 1.46-9.98). Among men and women, partnership concurrency was associated with higher-risk partnerships. In addition, relative to those with a single age-homogeneous partner, those with concurrent age-homogeneous partners had higher odds of condom use (men: aOR=2.85, 95% CI: 1.89-4.31; women: aOR=2.99, 95% CI: 1.52-5.89). Concurrent age-disparate partnerships were associated with condom use among men only (aOR=4.02, 95% CI: 2.54-6.37). CONCLUSION Findings underscore the importance of targeted HIV prevention efforts for couples in age-disparate and concurrent relationships.
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Affiliation(s)
- Jaffer Okiring
- Infectious Diseases Research Collaboration, Plot 2C Nakasero Hill Road, P.O. Box 7475, Kampala, Uganda
| | - Monica Getahun
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1330 Broadway, Ste. 1100, Oakland CA 94612, USA
| | - Sarah A Gutin
- Center for AIDS Prevention Studies (CAPS), Division of Prevention Science, Department of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA
| | - Sarah Lebu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1330 Broadway, Ste. 1100, Oakland CA 94612, USA
| | - Joi Lee
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1330 Broadway, Ste. 1100, Oakland CA 94612, USA
| | - Irene Maeri
- Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 54840 00200, Nairobi, Kenya
| | - Patrick Eyul
- Infectious Diseases Research Collaboration, Plot 2C Nakasero Hill Road, P.O. Box 7475, Kampala, Uganda
| | - Elizabeth A Bukusi
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1330 Broadway, Ste. 1100, Oakland CA 94612, USA; Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 54840 00200, Nairobi, Kenya
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1330 Broadway, Ste. 1100, Oakland CA 94612, USA
| | - Torsten B Neilands
- Center for AIDS Prevention Studies (CAPS), Division of Prevention Science, Department of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA
| | - Sarah Ssali
- School of Women and Gender Studies, Makerere University, Pool Road, Kampala, Uganda
| | - Edwin D Charlebois
- Center for AIDS Prevention Studies (CAPS), Division of Prevention Science, Department of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA
| | - Carol S Camlin
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1330 Broadway, Ste. 1100, Oakland CA 94612, USA; Center for AIDS Prevention Studies (CAPS), Division of Prevention Science, Department of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA.
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Andrus E, Mojola SA, Moran E, Eisenberg M, Zelner J. Has the relationship between wealth and HIV risk in Sub-Saharan Africa changed over time? A temporal, gendered and hierarchical analysis. SSM Popul Health 2021; 15:100833. [PMID: 34141854 PMCID: PMC8184650 DOI: 10.1016/j.ssmph.2021.100833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/29/2022] Open
Abstract
This study examines the relationship between wealth and HIV infection in Sub-Saharan Africa to determine whether and how this relationship has varied over time, within and across countries, by gender, and urban environment. The analysis draws on DHS and AIS data from 27 Sub-Saharan African countries, which spanned the 14 years between 2003 and 2016. We first use logistic regression analyses to assess the relationship between individual wealth, HIV infection and gender by country and year stratified on urban environment. We then use meta-regression analyses to assess the relationship between country level measures of wealth and the odds of HIV infection by gender and individual level wealth, stratified on urban environment. We find that there is a persistent and positive relationship between wealth and the odds of HIV infection across countries, but that the strength of this association has weakened over time. The rate of attenuation does not appear to differ between urban/rural strata. Likewise, we also find that these associations were most pronounced for women and that this relationship was persistent over the study period and across urban and rural strata. Overall, our findings suggest that the relationship between wealth and HIV infection is beginning to reverse and that in the coming years, the relationship between wealth and HIV infection in Sub-Saharan Africa may more clearly mirror the predominant global picture.
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Affiliation(s)
- Emily Andrus
- University of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USA
| | - Sanyu A. Mojola
- Department of Sociology, School of Public and International Affairs, Office of Population Research, Princeton University, Princeton, NJ, USA
| | - Elizabeth Moran
- University of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USA
| | - Marisa Eisenberg
- University of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USA
| | - Jon Zelner
- University of Michigan, Department of Epidemiology, School of Public Health, Ann Arbor, MI, USA
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Shamu T, Chimbetete C, Egger M, Mudzviti T. Treatment outcomes in HIV infected patients older than 50 years attending an HIV clinic in Harare, Zimbabwe: A cohort study. PLoS One 2021; 16:e0253000. [PMID: 34106989 PMCID: PMC8189507 DOI: 10.1371/journal.pone.0253000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/26/2021] [Indexed: 11/27/2022] Open
Abstract
There is a growing number of older people living with HIV (OPLHIV). While a significant proportion of this population are adults growing into old age with HIV, there are also new infections among OPLHIV. There is a lack of data describing the outcomes of OPLHIV who commenced antiretroviral therapy (ART) after the age of 50 years in sub-Saharan Africa. We conducted a cohort study of patients who enrolled in care at Newlands Clinic in Harare, Zimbabwe, at ages ≥50 years between February 2004 and March 2020. We examined demographic characteristics, attrition, viral suppression, immunological and clinical outcomes. Specifically, we described prevalent and incident HIV-related communicable and non-communicable comorbidities. We calculated frequencies, medians, interquartile ranges (IQR), and proportions; and used Cox proportional hazards models to identify risk factors associated with death. We included 420 (57% female) who commenced ART and were followed up for a median of 5.6 years (IQR 2.4–9.9). Most of the men were married (n = 152/179, 85%) whereas women were mostly widowed (n = 125/241, 51.9%). Forty per cent (n = 167) had WHO stage 3 or 4 conditions at ART baseline. Hypertension prevalence was 15% (n = 61) at baseline, and a further 27% (n = 112) had incident hypertension during follow-up. During follow-up, 300 (71%) were retained in care, 88 (21%) died, 17 (4%) were lost to follow-up, and 15 (4%) were transferred out. Of those in care, 283 (94%) had viral loads <50 copies/ml, and 10 had viral loads >1000 copies/ml. Seven patients (1.7%) were switched to second line ART during follow-up and none were switched to third-line. Higher baseline CD4 T-cell counts were protective against mortality (p = 0.001) while male sex (aHR: 2.29, 95%CI: 1.21–4.33), being unmarried (aHR: 2.06, 95%CI: 1.13–3.78), and being unemployed (aHR: 2.01, 95%CI: 1.2–3.37) were independent independent risk factors of mortality. There was high retention in care and virologic suppression in this cohort of OPLHIV. Hypertension was a common comorbidity. Being unmarried or unemployed were significant predictors of mortality highlighting the importance of sociologic factors among OPLHIV, while better immune competence at ART commencement was protective against mortality.
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Affiliation(s)
- Tinei Shamu
- Newlands Clinic, Newlands, Harare, Zimbabwe
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
- * E-mail:
| | | | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tinashe Mudzviti
- Newlands Clinic, Newlands, Harare, Zimbabwe
- School of Pharmacy, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Luo Z, Wang W, Ding Y, Xie J, Lu J, Xue W, Chen Y, Wang R, Li X, Wu L. Epidemiological Characteristics of Infectious Diseases Among Travelers Between China and Foreign Countries Before and During the Early Stage of the COVID-19 Pandemic. Front Public Health 2021; 9:739828. [PMID: 34869153 PMCID: PMC8634889 DOI: 10.3389/fpubh.2021.739828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background: International travel during the Coronavirus disease 2019 (COVID-19) pandemic carries a certain magnitude of infection risk both to travelers and their destination, which may be difficult to assess in the early stage. The characteristics of common infectious diseases of tourists may provide some clues to identify the high-risk travelers and protect susceptible population. Methods: From among 48,444 travelers screened at Shanghai Port, we analyzed 577 travelers with 590 infectious diseases for age, sex, disease type, and World Health Organization (WHO) regions. We used the Joinpoint Regression Program to identify the average percent changes (APC) in the various trends among these individuals. Results: Hepatitis B, syphilis, and HIV were the most common infectious diseases in travelers entering China, and Hepatitis B, pulmonary tuberculosis, and syphilis in Chinese nationals traveling abroad (overall detection rates, 1.43 and 0.74%, respectively; P < 0.05). Africa (2.96%), the Americas (1.68%), and the Western Pacific (1.62%) exhibited the highest detection rates. This trend did not decrease since the COVID-19 pandemic (P > 0.05) and rather showed an upward trend with increasing age [APC 95% CI = 5.46 (3.41,7.56)%, P < 0.05]. However, there were no evident trends in monthly infection rates of travelers exiting and entering China from different WHO regions (all P > 0.05). Conclusion: Travelers always carry a transmission risk of common infectious diseases. It may be reasonable to adjust strategies for airport screening and quarantine according to the age and departure area of travelers to prevent and control new infectious diseases.
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Affiliation(s)
- Zheng Luo
- Department of Neurology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Wei Wang
- Department of Infectious Disease Surveillance, Shanghai International Travel Healthcare Center, Shanghai, China
| | - Yibo Ding
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Jiaxin Xie
- Department of High Altitude Operational Medicine, Army Medical University, Chongqing, China
| | - Jinhua Lu
- Department of Infectious Disease Surveillance, Shanghai International Travel Healthcare Center, Shanghai, China
| | - Wen Xue
- Department of Infectious Disease Surveillance, Shanghai International Travel Healthcare Center, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China
- Office of Scientific Research and Information Management, Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China
| | - Ruiping Wang
- Office of Clinical Research Center, Shanghai Skin Disease Hospital, Shanghai, China
- *Correspondence: Ruiping Wang
| | - Xiaopan Li
- Office of Scientific Research and Information Management, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China
- Office of Scientific Research and Information Management, Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, China
- Xiaopan Li
| | - Lile Wu
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Lile Wu
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