What may encourage or deter health services utilization by people living with or at the risk of HIV/AIDS in special health centers? Qualitative evidence from a stigmatized community

BACKGROUND

Behavioral Diseases Counseling Centers (BDCCs) and Vulnerable Women's Counseling Centers (VWCCs) in Iran are the main peripheral centers that offer educational, counseling, diagnostic, preventive, curative and protective services to individuals living with or at high risk of contracting HIV/AIDS and female sex workers respectively. Due to the social stigma surrounding HIV in Iran, this study aims to identify the factors that may hinder or encourage HIV/AIDS patients and women with risky sexual behaviors from visiting these centers.

METHODS

Conducted in 2023, this qualitative study involved individuals visiting BDCCs and VWCCs in two western provinces of Iran, Ilam and Kermanshah. The study participants included 21 health staff members working in BDCCs and VWCCs and 20 HIV/AIDS patients and vulnerable women with unsafe sexual behaviors referring to these centers. Purposive, snowball and maximum variation sampling techniques were applied to interview the participants. Interviews were conducted between January 5th and May 21st, 2023, using a semi-structure guideline. Interviews were transcribed and content analysis approach was applied to analyze data using MAXQDA20 software.

RESULTS

According to the findings, the barriers and facilitators of visiting specialized centers for HIV/AIDS patients and vulnerable women were categorized into three main categories, 10 subcategories and 35 sub-subcategories including: Medical and operational processes (4 subcategories and 12 sub-subcategories), mutual interactions between the personnel and visitors (people living with and at the risk of getting HIV/AIDS) (3 subcategory and 13 sub-subcategories), and physical characteristics of the centers (3 subcategories and 10 sub-subcategories).

CONCLUSIONS

To improve the performance of BDCCs and VWCCs and encourage people living with and at the risk of contracting HIV/AIDS to visit these centers regularly, health policy makers should consider modifying clinical processes, physical features, personnel behaviors and visitors' concerns raised by the interviewees and the issues identified in this study.

Cyclopiazonic acid decreases sperm quality and in vitro fertilisation rate in mice

The presence of cyclopiazonic acid (CPA) as a mycotoxin has been reported in feed and foodstuffs. The aim of this investigation was to determine the effects of CPA on reproductive functions of male mice. In this experiment, 40 mature male mice were randomly assigned into five groups (n=8): control, control-sham, CPA (0.03 mg/kg, body weight (BW)), CPA (0.06 mg/kg, BW) and CPA (0.12 mg/kg, BW). Following 28 days exposure to CPA, sperm quality parameters, in vitro fertilisation (IVF) capacity of sperms, serum testosterone level, Leydig cells number and serum total antioxidant capacity (TAC) were analysed. The results revealed a significant (P<0.05) reduction in sperm count, sperm viability, sperm motility, chromatin quality of sperm, sperms with intact DNA, IVF rate, testosterone level, Leydig cell distribution and TAC in comparison to the control group. The most prominent detrimental effects of CPA were found at the highest given dose level. Our results suggest that CPA at higher dose levels exerts detrimental effects on the male reproductive system. Moreover, these descriptive warrant further investigations into the specific mechanisms of action and the effects of CPA on spermatogenesis.

Investigating the effect of education on health literacy and its relation to health-promoting behaviors in health center

BACKGROUND

Health literacy is a combination of reading and listening skills, data analysis, decision-making, and the ability to implement these skills during the necessary health situations. This study was conducted with the purpose of determining the effect of educational intervention on health literacy and its impact on health-promoting behaviors of the health ambassadors in the health and treatment centers of the health network in Kazeroon (Fars province, Iran).

MATERIALS AND METHODS

The present study is a quasi-experimental study using before-after test procedure on 256 health ambassadors. Random systematic sampling method was used and to assess the health literacy, Montazeri's health questionnaire was used, also the standard questionnaire (health-promoting lifestyle profile-I) was applied to determine the status of the health-promoting behaviors. Two questionnaires were filled out by the health ambassadors before and following the intervention. Data analysis was performed using SPSS software 22, through t-test, ANOVA, and Pearson correlation.

RESULTS

The mean health literacy scores of the ambassadors before educational intervention were 79.22 which increased to 95.49 after intervention. Moreover, the results of the study showed a direct significant correlation of health literacy with all the dimensions of health-promoting behavior questionnaire before and after the intervention (P < 0.001).

CONCLUSIONS

Educational interventions can be used to enhance the health literacy of health ambassadors and have a significant impact on improving health-promoting behaviors.

Pre-administration of turmeric prevents methotrexate-induced liver toxicity and oxidative stress

Background

Methotrexate (MTX) is an antimetabolite broadly used in treatment of cancer and autoimmune diseases. MTX-induced hepatotoxicity limits its application. We investigated hepatoprotective effects of turmeric in MTX-induced liver toxicity.

Methods

All experiments were performed on male Wistar albino rats that were randomly divided into six groups. Group one received saline orally for 30 days (control group), groups two and three received turmeric extract (100, 200 mg/kg respectively) orally for 30 days, group four received single dose, of MTX IP at day 30, groups five and six received turmeric extract 100 and 200 mg/kg orally respectively for 30 days and single dose of methoterxate IP (20 mg/kg) at day 30. Four days after MTX injection animals were sacrificed and evaluated. Blood ALT and AST (indicators of hepatocyte injury), ALP and bilirubin (markers of biliary function), albumin (reflect liver synthetic function) as well as the plasma TAS concentration (antioxidant defenses) were determined. The cellular antioxidant defense activities were examined in liver tissue samples using SOD, CAT, and GSH-Px for the oxidative stress, and MDA for lipid peroxidation. In addition, liver damage was evaluated histopathologically.

Results

MTX significantly induced liver damage (P < 0.05) and decreased its antioxidant capacity, while turmeric was hepatoprotective. Liver tissue microscopic evaluation showed that MTX treatment induced severe centrilobular and periportal degeneration, hyperemia of portal vein, increased artery inflammatory cells infiltration and necrosis, while all of histopathological changes were attenuated by turmeric (200 mg/kg).

Conclusion

Turmeric extract can successfully attenuate MTX-hepatotoxicity. The effect is partly mediated through extract’s antinflammatory activity.