Transactional sex and HIV infection among commercial farm workers in South Africa

Background

High prevalence of HIV infection has been reported among commercial farm workers in South Africa, but studies of the role of transactional sex in this epidemic is limited.

Objective

This study seeks to examine the association between transactional sex and HIV infection among commercial farm workers in South Africa.

Methods

This is a cross-sectional secondary data analysis of the Integrated Biological and Behavioural Surveillance Survey by the International Organization of Migration among farm workers in Mpumalanga and Limpopo Provinces, South Africa in 2010. The study included 2,758 sexually active farm workers. The outcome variable was HIV infection while the main explanatory variable was engagement in transactional sex. Other explanatory variables were sex, age, marital status, number of sex partners, food security, recent history of sexually transmitted infection, condom use at last sex with non-regular partner, history of sexual violence and migration status. Bivariate and multivariable logistic regression analyses were done to obtain unadjusted and adjusted odds ratios of the association between transactional sex and HIV infection.

Results

Engagement in transactional sex was common (19%) but not significantly associated with HIV infection (OR 1.1; CI 0.57-2.44). Female sex (1.93; 1.60-2.32), age 25 to 44 years, recent STI (OR 1.37; CI 1.18-1.58) and sexual violence (OR 1.39; CI 1.19-1.63) were significant risk factors for HIV infection.

Conclusion

Risky sexual behaviours were common among the farmworker population. HIV prevention interventions should include behavioural change communication and improved access to healthcare for STI and HIV treatment.

Seroprevalence of human T-lymphotropic virus antibodies among patients with lymphoid malignancies at a tertiary center in Lagos, Nigeria

Background

There is a significant association of human T-lymphotropic viruses (HTLV) with lymphoid malignancies. HTLV causes a lymphoproliferative malignancy of CD4-activated cells called adult T-cell leukemia/lymphoma (ATL) and a chronic myelopathy called tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). This study aims to determine the prevalence of HTLV among patients with lymphoid malignancies at a tertiary center in Lagos.

Methods

A cross-sectional study was carried out at the hematology clinic of the Lagos State University Teaching Hospital. After obtaining consent, approximately 5 mL of venous blood was collected from each subject. The serum was separated and stored at −20°C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV-1 and -2. Western blot confirmatory testing was done on reactive samples. All patients were also screened for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) by rapid kits.

Results

A total of 39 patients with lymphoid malignancies were enrolled, consisting of 24 (61.5%) with solid malignancies, while 15 (38.5%) had leukemia. Only two patients (5.1%) with lymphoid malignancies were reactive on the ELISA test. On confirmatory testing with Western blot, two patients (5.1%) with lymphoid malignancies were also positive for HTLV. All patients were HIV negative, but four were positive to HBsAg and HCV. There was no association between history of previous blood transfusion and positivity to HTLV (P=0.544).

Conclusion

A prevalence of 5.1% of HTLV among patients with lymphoid malignancies was found in this study, and previous history of blood transfusion was not found to be a significant cause of HTLV infection.

Seroprevalence of human T lymphotropic virus antibodies among healthy blood donors at a tertiary centre in Lagos, Nigeria

Introduction

Transmission of human T-lymphotropic viruses (HTLV) occurs from mother to child, by sexual contact and blood transfusion. Presently, in most centres in Nigeria, there is no routine pre-transfusion screening for HTLV. The study aims to determine the prevalence of HTLV-1 and HTLV-2 among healthy blood donors at a tertiary centre in Lagos.

Methods

A cross-sectional study was carried out at the blood donor clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja. About 5mls of venous blood was collected from each subject into a sterile plain bottle after obtaining subject's consent. The serum separated and stored at -200C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV 1 and HTLV -2. Western blot confirmatory testing was done on reactive samples. All donors were also screened for HIV, HBsAg and HCV by rapid kits.

Results

The seroprevalence of HTLV -1 by ELISA was 1.0% and 0.5% by Western Blot among blood donors. A total of 210 healthy blood donors were enrolled. Only 2 (1.0%) blood donors were repeatedly reactive with ELISA test. On confirmatory testing with Western Blot, 1 (0.5%) blood donor was positive for HTLV. All the healthy blood donors were negative for HIV, HbsAg and HCV. None of the 210 blood donors had been previously transfused; as such no association could be established between transfusion history and HTLV positivity among the blood donors.

Conclusion

The seroprevalence of HTLV in this environment is low among healthy blood donors.

Hematologic Abnormalities in Treatment-naïve HIV Patients

Objectives

Hematologic abnormalities, indicated by a deranged full blood count, are common manifestations and important prognostic tools for human immunodeficiency virus (HIV) infection and AIDS. This study aimed to determine the prevalence of cytopenia and its relationship to the degree of immunosupression in HIV treatment-naïve patients.

Methods

This was a cross-sectional study of treatment-naïve HIV-infected clients who enrolled at the HIV clinic of Lagos State University Teaching Hospital (LASUTH) between December 2009 and June 2010. Participants had samples taken for full blood count and CD4 counts, which are free routine pre-requisite and pre-treatment evaluations done for all registered HIV patients at LASUTH. They were asked to fill the structured questionnaires to obtain demographic data, with assistance if necessary.

Results

A total of 205 cases were reviewed: 24.2% had anemia (PCV < 30%), 26.8% had leucopenia (white blood cell <4,000/L) and 16.1% had thrombocytopenia (platelet count <150,000/L) at enrollment. The degree of cytopenia was directly related to the degree of immunosupression.

Conclusion

About one-fifth of HIV treatment-naïve patients were cytopenic at enrollment and the degree of cytopenia was directly related to the degree of immunosupression. It is necessary to investigate various causes of cytopenia in these patients so as to administer a specific intervention.