Common factors in HIV/AIDS prevention success: lessons from Thailand

Stigma and discrimination against adolescents living with perinatal HIV in Thailand: caregivers' perceptions

Background

Thailand has been particularly affected by the HIV epidemic in the middle of the years 1990s. Thousands of children living with perinatal HIV have been exposed to HIV-related stigma/discrimination, but its frequency and expressions have been little studied. Our objectives were to assess, among adolescents living with perinatal HIV, the prevalence of stigma/discrimination, the factors associated with it and its expressions.

Methods

All caregivers of adolescents aged 12-19 years living with perinatal HIV and receiving antiretrovirals in 20 hospitals throughout Thailand were invited to complete a face-to-face questionnaire on their adolescent's life, and to report their adolescents' experiences of stigma/discrimination. Stigma/discrimination as perceived by the caregivers was analyzed using both quantitative and qualitative approaches.

Results

A total of 712 adolescents living with perinatal HIV and their caregivers were interviewed as part of the TEEWA study between March 2010 and November 2012. Of the 572 adolescents living in family settings, 464 had their HIV-status known in the community. Among them, the overall stigma/discrimination prevalence was 46%. The multivariable analysis showed that the risk of being stigmatized was nearly 3 times higher in the northeast region (OR: 2.93, 95%CI: 1.36-6.45) and when having a low intellectual ability (OR: 3.35, 95%CI: 1.66-7.10). It was nearly twice higher in case of conflicts with caregivers (OR: 1.81, 95%CI: 1.17-2.79) and when caregivers were members of a support group (OR: 2.28, 95%CI: 1.48-3.53), while having a BMI >18.5 was associated with a lower risk of stigma/discrimination (OR: 0.61, 95%CI: 0.37-0.98). Expressions of stigma/discrimination included bullying, social isolation, behavioral discrimination and public disclosure. Consequences of stigma/discriminations included voluntary withdrawal from school, painful awareness of HIV status, marginalization from the community, and separation of drinks and food.

Conclusion

We found that the prevalence of stigma/discrimination among adolescents living with perinatal HIV was high. Despite existing policies, stigma eradication remains necessary to normalize their life as they grow into adulthood and may face the consequences of past/current discrimination in terms of access to university studies or occupation, at work, in the community or in their romantic life.

Strategic investment and program effectiveness: a roadmap to ending AIDS in Bangladesh by 2030

The journey towards ending AIDS epidemic in Bangladesh by 2030 is ambitious yet achievable. Although Bangladesh has always had a low rate of HIV among its general population, it remains one of seven countries in Asia and the Pacific where new HIV cases are rising. This study evaluates the effectiveness of HIV programmatic strategies and investment scenarios using the AIDS Epidemic Model (AEM) from 2023 to 2030, focusing on optimizing resource allocation and interventions. The findings indicate that without improved program effectiveness, new HIV infections will increase to 1,382 by 2030, failing to meet the targets of the Global AIDS Strategy 2021-2026. If Bangladesh improves its HIV program effectiveness according to the Global AIDS Strategy 2021-2026, the NSP and Global AIDS Strategy targets could significantly lower new infections and AIDS-related deaths and increase treatment coverage to meet Ending AIDS targets. The NSP targets could reduce new HIV infections to under 275 annually and achieve treatment goals by 2030. The study reveals that NSP targets are the most cost-effective, offering the highest benefit-cost ratio, highlighting the urgent need to enhance HIV prevention program effectiveness, particularly among key populations, to achieve both public health and economic benefits.

Infectious disease research in the Association of Southeast Asian Nations region: a scientometric analysis

BACKGROUND

This study compared the research output of Association of Southeast Asian Nations (ASEAN) countries to understand research trends and clarify past, present, and future patterns using scientometric techniques.

METHODS

This scientometric study systematically mined health and social science publications from the Web of Science and Scopus databases using keywords associated with infectious disease. The analysis included only English-language articles and review articles by authors from any ASEAN country. Publication, citation, and text co-occurrence network analyses were performed. R Studio and VOSviewer enabled data management, analysis, and visualization.

RESULTS

Searches identified 12,511 articles published between 1925 and 2022, with a notable increase in research publications since 2003. The leading journals on infectious disease were associated with established publishing houses, including BMC, BMJ, and The Lancet. The most-cited articles were primarily global burden of disease studies, with 7,367 citations. Among ASEAN countries, Thailand, Malaysia, and Singapore had the most publications and collaborative efforts on the topic. Analysis of keyword co-occurrence revealed clusters related to global health, dengue, bacterial studies, non-dengue viral topics, and diagnostics. Most early studies examined diagnostics, gene and sequencing methodologies, and virology; later, the focus shifted toward herbal and alternative medicine.

CONCLUSION

Recently, the research capacity of Southeast Asia has expanded dramatically, with substantial contributions from high-income countries. Intense cooperation between member states is essential, emphasizing the role of HICs in supporting their neighbors. Increased research efforts and collaboration must be dedicated to innovative approaches to combat persistent health conditions, along with emerging issues like climate change.

Prevalence of hepatitis D virus infection among patients with chronic hepatitis B infection in a tertiary care centre in Thailand

Knowledge about the epidemiology of hepatitis D virus (HDV) is essential for effective screening and management. Our study aimed to update the prevalence of HDV infection among patients with hepatitis B virus (HBV) infection at hepatology clinics in Thailand. We enrolled HBV-infected patients from hepatology clinics at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between June 2022 and November 2023. Demographic, biochemical characteristics, and liver-related complications (LRC), including cirrhosis and hepatocellular carcinoma, were reviewed. The competitive enzyme and chemiluminescence immunoassays were used to detect anti-HDV antibodies. Real-time polymerase chain reaction (RT-PCR) was used to test for HDV RNA in anti-HDV-positive patients. The HDV genotype was identified in detectable HDV RNA samples. Of the 702 enrolled patients, four (0.6%) had positive and equivocal for both anti-HDV tests. Two (50.0%) of the four patients tested positive for HDV RNA and genotype 1 was identified; one had multiple risk factors. Anti-HDV seroprevalence was not significantly different between patients with and without LRC. In conclusion, HDV co-infection is less common in Thailand than globally. Additionally, our study identified genotype 1, the predominant HDV genotype worldwide, and observed co-infection even without LRC.