Knowledge of specific HIV transmission modes in relation to HIV infection in Mozambique

Assessing HIV transmission knowledge and rapid test history among the general population in Iran

Considering the general population's lack of knowledge and, more importantly, the hidden proportion of people living with HIV (PLWHIV), we aimed to study people's knowledge of HIV transmission modes and investigate the history of rapid test usage in the south of Tehran, Iran. We conducted a telephone survey study on 1311 individuals aged 18 years and older. We asked the participants if they had undergone HIV testing at private or public health centers in the past year. Using five items, we assessed HIV transmission knowledge. We used multivariable logistic regression to analyze the relationship between various factors associated with HIV transmission knowledge. Overall, 40.9% of the general population demonstrated a high level of understanding about HIV transmission, with a 95% CI [37.85,44.12]. The result of multivariable logistic analysis revealed that the following factors were associated with better knowledge: higher education (OR = 7.83; [4.72,13.01] for academic and OR = 4.52; [2.78,7.35] for diploma), housekeeping (OR = 1.95; [1.47,2.59]), higher socioeconomic status (OR = 4.41; [3.01,6.15] for middle and OR = 5.46; [2.91,10.15] for middle upward), recent visits to the health center (OR = 1.29; CI [0.98,1.65]), and tobacco use (OR = 1.48; [1.07,2.06]). The knowledge of HIV transmission was negatively associated with age (OR = 0.97; [0.95,0.98]). In addition, 9.8% [7.31,12.87] of participants-4.7% in private clinics and 5.1% in public centers-had received an HIV test within the 12 months prior to the study. Our study emphasizes the importance of improving public knowledge about HIV transmission and expanding testing initiatives. Findings advocate for enhanced educational programs, increased accessibility to testing facilities, and broader public health campaigns. These measures are essential for fostering a well-informed and proactive community in efforts to address HIV/AIDS.

Machine learning approach and geospatial analysis to determine HIV infection, awareness status, and transmission knowledge among adults in Sub-Saharan Africa

BACKGROUND

HIV/AIDS remains a major public health challenge, in Sub-Saharan Africa (SSA). In 2020, 16% of people living with HIV did not know their HIV status in SSA. Understanding the geospatial distribution of HIV infection, awareness status, and transmission knowledge is crucial for designing effective prevention and control strategies to end the HIV/AIDS pandemic by 2030. However, to the best of our literature searching the evidence of geospatial analysis and a machine learning algorithm, specifically a decision tree to decide on a Sustainability Development Goal (SDG), and to establish a clear pathway of HIV awareness status and HIV infection rates in each region of SSA is limited. Therefore, this study aims to determine HIV Infection, awareness status, and transmission knowledge among Adults in SSA using a machine learning approach and geospatial analysis.

METHODS

The study used demographic and health survey data from 2009 to 2019. Machine learning algorithms and geospatial analysis techniques were employed to determine HIV infection, awareness of HIV status, and HIV transmission knowledge.

RESULTS

The overall prevalence of HIV infection among adults in SSA from 2009 to 2019 is 4.96%. The machine learning algorithm (decision tree) indicates that infected individuals are unaware of their HIV infection, about half of them do not have HIV transmission knowledge, and more of them were found in Southern SSA. The spatial hotspots show that high HIV prevalence, low levels of HIV status awareness, and adequate transmission knowledge are specifically located in the Southern and some Eastern SSA.

CONCLUSION

The machine learning algorithm (decision tree) revealed that the risk of HIV infection is high among individuals who are unaware of their HIV status and lack knowledge about HIV transmission in Southern and eastern parts of Sub-Saharan Africa. The spatial analysis revealed the high-risk areas of HIV infection with low HIV status awareness and HIV transmission knowledge were located in Southern and some Eastern SSA countries. Therefore public health strategies should focus on educating individuals about the importance of knowing their HIV status, transmission knowledge, and ensuring accessible testing options in these affected regions to address the observed spatial disparities in HIV infection, HIV status awareness, and HIV transmission knowledge to achieve the 2030 Sustainable Development Goal of ending the HIV/AIDS epidemic in Africa.

High prevalence of HIV, HBsAg and anti-HCV positivity among people who injected drugs: results of the first bio-behavioral survey using respondent-driven sampling in two urban areas in Mozambique

Background

Few countries in sub-Saharan Africa know the magnitude of their HIV epidemic among people who inject drugs (PWID). This was the first study in Mozambique to measure prevalence of HIV, HBV, and HCV, and to assess demographic characteristics and risk behaviors in this key population.

Methods

We used respondent-driven sampling (RDS) to conduct a cross-sectional behavioral surveillance survey of PWID in two cities of Mozambique lasting six months. Participants were persons who had ever injected drugs without a prescription. Participants completed a behavioral questionnaire and provided blood specimens for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) testing. We performed RDS-adjusted analysis in R 3.2 using RDSAT 7.1 weights.

Results

We enrolled 353 PWID in Maputo and 139 in Nampula/Nacala; approximately 95% of participants were men. Disease prevalence in Maputo and Nampula/Nacala, respectively, was 50.1 and 19.9% for HIV, 32.1 and 36.4% for HBsAg positivity, and 44.6 and 7.0% for anti-HCV positivity. Additionally, 8% (Maputo) and 28.6% (Nampula/Nacala) of PWID reported having a genital sore or ulcer in the 12 months preceding the survey. Among PWID who injected drugs in the last month, 50.3% (Maputo) and 49.6% (Nampula/Nacala) shared a needle at least once that month. Condomless sex in the last 12 months was reported by 52.4% of PWID in Maputo and 29.1% in Nampula/Nacala. Among PWID, 31.6% (Maputo) and 41.0% (Nampula/Nacala) had never tested for HIV. In multivariable analysis, PWID who used heroin had 4.3 (Maputo; 95% confidence interval [CI]: 1.2, 18.2) and 2.3 (Nampula/Nacala; 95% CI: 1.2, 4.9) greater odds of having HIV.

Conclusion

Unsafe sexual behaviors and injection practices are frequent among PWID in Mozambique, and likely contribute to the disproportionate burden of disease we found. Intensified efforts in prevention, care, and treatment specific for PWID have the potential to limit disease transmission.

Socio-demographic, clinical, and psychosocial factors associated with primary caregivers' decisions regarding HIV disclosure to their child aged between 6 and 12 years living with HIV in Malawi

The World Health Organisation (WHO) recommends that children living with HIV should be informed about their HIV status within the ages of 6 to 12 years using age-appropriate resources. The aim of this study was to assess the socio-demographic, clinical and psychosocial factors associated with primary caregivers’ decisions to disclose HIV to children living with HIV aged 6 to 12 years in Malawi. A cross-sectional study of 429 primary caregivers of children living with HIV were systematically recruited from all regions of the country. Information on HIV disclosure, family and child socio-demographic characteristics, child clinical characteristics, and child and family psychosocial characteristics was collected using validated instruments. Logistic regression was used to analyse data. The prevalence of non-disclosure of HIV status to children was 64 per cent. Concerns about the child’s inability to cope with the news (29%), a lack of knowledge on how to disclose HIV status (19%), and fear of stigma and discrimination (17%) were the main reasons for non-disclosure. On multivariate analysis, the odds of non-disclosure were higher among primary caregivers who were farmers (aOR 3.0; 95% CI: 1.1–8.4), in younger children (6–8 years) (aOR 4.1; 95% CI: 2.3–7.4), in children who were in WHO HIV clinical stage one (aOR 3.8; 95% CI: 1.4–10.2), and in children who were not asking why they were taking ARVs (aOR 2.9; 95% CI: 1.8–4.8). On the other hand, nondisclosure of HIV status was less likely in underweight children (aOR 0.6; 95% CI: 0.3–0.9). Many children living with HIV in Malawi are unaware of their HIV status. Non-disclosure is associated with a number of clinical and demographic characteristics. The findings highlight the need to provide guidance and support to primary caregivers to help them to effectively disclose HIV status to their children.

Developing China's Ecological Redline Policy using ecosystem services assessments for land use planning

Ecosystems services (ES) assessment is a significant scientific topic recognized for its potential to address sustainability issues. However, there is an absence of science–policy frameworks in land use planning that lead to the ES science being used in policy. China’s Ecological Redline Policy (ERP) is one of the first national policies utilizing multiple ES, but there is no standardized approach for working across the science–policy interface. We propose a transdisciplinary framework to determine ecological redline areas (ERAs) in Shanghai using: ES, biodiversity and ecologically fragile hotspots, landscape structure, and stakeholder opinions. We determine the five criteria to identify ERAs for Shanghai using multi-temporal, high resolution images (0.5 m) and biophysical models. We examine ERP effectiveness by comparing land use scenarios for 2040. Compared to alternative land uses, ES increase significantly under the ERP. The inclusion of ES in spatial planning led stakeholders to increase terrestrial habitat protection by 174% in Shanghai. Our analysis suggests that strategic planning for ES could reduce tradeoffs between environmental quality and development.

Ecosystem services, though a prominent ecological concept, have yet to be considered in major land use policy changes. Here, the authors demonstrate how the Ecological Redline Policy implemented in Shanghai utilized ecosystem services science and stakeholder engagement.

Knowledge about HIV, HBV and HCV modes of transmission among pregnant women in Nampula - Mozambique

The assessment of pregnant women's knowledge about modes of infections transmission is essential to tailor programs to their needs. This study aimed to assess knowledge about human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among pregnant women in Nampula - Mozambique, a high-risk area for sexually transmitted infections. At their first antenatal visit, women were invited to participate and data were collected by trained nurses at six public health facilities. Knowledge about HIV transmission modes was high but relevant misconceptions remained. However, knowledge regarding HBV and HCV transmission modes was very limited. There was a significant association between knowledge level and socioeconomic position, making education and women's empowerment key factors in a comprehensive strategy to prevent infections.

Does a Video Improve Knowledge of HIV/AIDS and HIV Testing among a Global Internet Audience?

The objectives of this study were to determine if a video improved HIV/AIDS and HIV testing knowledge among a global sample of Internet users, to discern if this improvement was the same for English and Spanish speakers, and to ascertain if the video was efficacious for those with lower health literacy. A worldwide sample of English- or Spanish-speaking Internet users was solicited. Participants completed a 25-item questionnaire to assess their HIV/AIDS and HIV testing knowledge before and after watching the video. Mean scores on the questionnaire improved after watching the video for both English speakers (after: 19.6 versus before: 16.4; Δ = 3.2; 95% confidence interval [CI]: 2.8-3.5) and Spanish speakers (20.7 versus 17.3; Δ = 3.4; 95% CI: 3.0-3.8). There was no difference in improvement of scores between English and Spanish speakers (Δ = -0.24; 95% CI: -0.79 to 0.31), and this video was equally efficacious for those with lower and higher health literacy skills.