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Fernandez-Alonso V, Gil-Prieto R, Amado-Anton-Pacheco M, Hernández-Barrera V, Gil-De-Miguel Á. Hospitalization burden associated with anus and penis neoplasm in Spain (2016-2020). Hum Vaccin Immunother 2024; 20:2334001. [PMID: 38557433 PMCID: PMC10986764 DOI: 10.1080/21645515.2024.2334001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
In 2020, there were approximately 50,865 anal cancer cases and 36,068 penile cancer cases worldwide. HPV is considered the main causal agent for the development of anal cancer and one of the causal agents responsible for the development of penile cancer. The aim of this epidemiological, descriptive, retrospective study was to describe the burden of hospitalization associated with anal neoplasms in men and women and with penis neoplasms in men in Spain from 2016 to 2020. The National Hospital Data Surveillance System of the Ministry of Health, Conjunto Mínimo Básico de Datos, provided the discharge information used in this observational retrospective analysis. A total of 3,542 hospitalizations due to anal cancer and 4,270 hospitalizations due to penile cancer were found; For anal cancer, 57.4% of the hospitalizations occurred in men, and these hospitalizations were also associated with significantly younger mean age, longer hospital stays and greater costs than those in women. HIV was diagnosed in 11.19% of the patients with anal cancer and 1.74% of the patients with penile cancer. The hospitalization rate was 2.07 for men and 1.45 for women per 100,000 in anal cancer and of 4.38 per 100,000 men in penile cancer. The mortality rate was 0.21 for men and 0.12 for women per 100,000 in anal cancer and 0.31 per 100.000 men in penile cancer and the case-fatality rate was 10.07% in men and 8,26% in women for anal cancer and 7.04% in penile cancer. HIV diagnosis significantly increased the cost of hospitalization. For all the studied diagnoses, the median length of hospital stays and hospitalization cost increased with age. Our study offers relevant data on the burden of hospitalization for anal and penile cancer in Spain. This information can be useful for future assessment on the impact of preventive measures, such as screening or vaccination in Spain.
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Affiliation(s)
- Victor Fernandez-Alonso
- Department of Medical Specialties and Public Health, University Rey Juan Carlos, Alcorcón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Nursing Research Group (Nursing Department), Madrid, Spain
- Red Cross University School of Nursing, Nursing Department, Autonomous University of Madrid, Madrid, Spain
| | - Ruth Gil-Prieto
- Department of Medical Specialties and Public Health, University Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Maria Amado-Anton-Pacheco
- Department of Medical Specialties and Public Health, University Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentín Hernández-Barrera
- Department of Medical Specialties and Public Health, University Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Ángel Gil-De-Miguel
- Department of Medical Specialties and Public Health, University Rey Juan Carlos, Alcorcón, Madrid, Spain
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Huang HK, Chuang CS. Challenges in The Diagnosis of Ischemic stroke, Tuberculous Meningitis, and Co-Infection with HIV in a Socially Isolated Elderly Patient. Acta Neurol Taiwan 2024; 33(4):188-194. [PMID: 38030228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Ischemic stroke has been a common cause of death and disability in Taiwan, particularly among the elderly. Social isolation is a significant issue in an aging society, which can be associated with delayed medical care and difficulties in diagnosis. CASE A 76-year-old man presented with altered mental status, left-sided weakness, and declining cognitive function over three months. He had limited social connections and an unknown medical history. Initial brain imaging showed communicating hydrocephalus. Cerebrospinal fluid analysis revealed increased lymphocytes and high protein levels. Further imaging revealed multiple hyperintense lesions in the brain's white matter and acute ischemic stroke in specific areas. The patient was diagnosed with tuberculosis and HIV coinfection, leading to probable tuberculous meningitis, HIV encephalopathy, and pneumocystis jirovecii pneumonia. Treatment with antituberculous agents, antibiotics, and steroids improved the patient's level of consciousness. CONCLUSION Addressing social isolation and altered consciousness in elderly individuals requires a thoughtful approach. Reconsidering the differential diagnosis is crucial when it doesn't match the clinical severity. Clinicians should consider rare co-occurrences like ischemic stroke, TBM, and HIV infection in atypical TBM cases. A biopsychosocial perspective helps gather a comprehensive medical history for holistic care. Early diagnosis and timely intervention are vital for better outcomes in severe infections.
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Affiliation(s)
- Han-Ke Huang
- Department of Neurology, Changhua Christian Hospital, Taiwan
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Numfor E, Tuncer N, Martcheva M. Optimal control of a multi-scale HIV-opioid model. J Biol Dyn 2024; 18:2317245. [PMID: 38369811 DOI: 10.1080/17513758.2024.2317245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
In this study, we apply optimal control theory to an immuno-epidemiological model of HIV and opioid epidemics. For the multi-scale model, we used four controls: treating the opioid use, reducing HIV risk behaviour among opioid users, entry inhibiting antiviral therapy, and antiviral therapy which blocks the viral production. Two population-level controls are combined with two within-host-level controls. We prove the existence and uniqueness of an optimal control quadruple. Comparing the two population-level controls, we find that reducing the HIV risk of opioid users has a stronger impact on the population who is both HIV-infected and opioid-dependent than treating the opioid disorder. The within-host-level antiviral treatment has an effect not only on the co-affected population but also on the HIV-only infected population. Our findings suggest that the most effective strategy for managing the HIV and opioid epidemics is combining all controls at both within-host and between-host scales.
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Affiliation(s)
- Eric Numfor
- Department of Mathematics, Augusta University, Augusta, GA, USA
| | - Necibe Tuncer
- Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL, USA
| | - Maia Martcheva
- Department of Mathematics, University of Florida, Gainesville, FL, USA
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Dunn Navarra AM, Gormley M, Liang E, Loughran C, Vorderstrasse A, Garcia DR, Rosenberg MG, Fletcher J, Goldsamt LA. Developing and testing a web-based platform for antiretroviral therapy (ART) adherence support among adolescents and young adults (AYA) living with HIV. PEC Innov 2024; 4:100263. [PMID: 38463238 PMCID: PMC10920727 DOI: 10.1016/j.pecinn.2024.100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/12/2024]
Abstract
Objective Describe the development and testing of a web-based platform for antiretroviral treatment (ART) adherence support among HIV+ adolescents and young adults (AYA) in a randomized controlled trial (RCT). Methods A seven-member multi-disciplinary team operationalized the flat, password protected, web-based platform. Manualized protocols guided the objectives and content for each of the eight web-based sessions. Team members evaluated usability and content validity. Client satisfaction and perceived ease of use was evaluated with the first ten HIV+ AYA participants. Results The web-based platform was developed, evaluated, refined, implemented and pilot tested between September 2020 to April 2022. Usability was rated as high; the evaluation of content validity showed an excellent fit between session content and objectives. HIV+ AYA participants (mean age = 24.2 years) were satisfied with the quality, type, and amount of support/education received, and found the platform easy to use, operate, and navigate. Average time spent per session was 6.5 min. Conclusion Findings support the usability, validity, acceptability, and feasibility of this web-based platform for ART adherence support among HIV+ AYA. Innovation Our research and findings are responsive to research gaps and the need for transparency in the methodological development and testing of web-based control arms for ART adherence support among HIV+ AYA.
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Affiliation(s)
- Ann-Margaret Dunn Navarra
- StonyBrook University, School of Nursing, 101 Nicolls Road, Health Sciences Center, Level 2, StonyBrook, NY 11794, USA
| | - Maurade Gormley
- University of Connecticut, School of Nursing, 231 Glenbrook Road, Storrs, CT 06269, USA
| | - Eva Liang
- New York University, Rory Meyers College of Nursing, 380 Second Avenue, New York, NY 10010, USA
| | - Claire Loughran
- New York University, Rory Meyers College of Nursing, 380 Second Avenue, New York, NY 10010, USA
| | - Allison Vorderstrasse
- University of Massachusetts Amherst, Elaine Marieb College of Nursing, 651 N Pleasant St., Amherst, MA 01003, USA
| | - David R. Garcia
- New York University, Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA
| | - Michael G. Rosenberg
- Division of Infectious Diseases, Department of Pediatrics, Jacobi Medical Center, Bronx, NY, 10461, USA
| | - Jason Fletcher
- New York University, Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA
| | - Lloyd A. Goldsamt
- New York University, Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA
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Marcos TA, Jonas KJ, Noorman MAJ, den Daas C, de Wit JBF, Stutterheim SE. Beyond community engagement: perspectives on the meaningful involvement of people with HIV and affected communities (MIPA) in HIV cure research in The Netherlands. HIV Res Clin Pract 2024; 25:2335454. [PMID: 38577964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND Meaningful involvement of people with HIV and affected communities in HIV cure research is essential to ensuring that cure research efforts are conducted transparently, socially justly, and ethically. This study set out to investigate how people with HIV and affected communities are involved in cure research in the Netherlands and explore what can be done to optimize involvement and engagement. METHODS Eighty-five semi-structured online, telephone, and face-to-face interviews were conducted with people with HIV (N = 30), key populations (N = 35), and key informants (KI; N = 20) in the field of HIV. The interviews were analyzed using reflexive thematic analysis. RESULTS Awareness of the meaningful involvement of people with HIV (MIPA) efforts was low among people with HIV and key populations, which contrasted with KI, who exhibited greater awareness. People with HIV and KI emphasized the importance of MIPA in ensuring the representation of lived experiences in HIV cure research and fostering trust between communities and researchers. Practical implementations of MIPA were unclear, ultimately resulting in difficulties defining MIPA beyond clinical trial participation. People with HIV and key populations also doubted their skills and self-efficacy to make meaningful contributions when confronted with involvement beyond participating in research and clinical trials. CONCLUSIONS MIPA is crucial for improving the quality, transparency, and ethical conduct of HIV cure research. It emphasizes the need for increased awareness and funding, standardized guidelines to ensure meaningful involvement, and combat tokenism and misconceptions.
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Affiliation(s)
- Tamika A Marcos
- Department of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
| | - Maaike A J Noorman
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Chantal den Daas
- Institute of Applied Health Sciences, Health Psychology Group, University of Aberdeen, Aberdeen, UK
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Sarah E Stutterheim
- Department of Health Promotion and Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
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Casares-Jimenez M, Rivero-Juarez A, Lopez-Lopez P, Montes ML, Navarro-Soler R, Peraire J, Espinosa N, Alemán-Valls MR, Garcia-Garcia T, Caballero-Gomez J, Corona-Mata D, Perez-Valero I, Ulrich RG, Rivero A. Rat hepatitis E virus ( Rocahepevirus ratti) in people living with HIV. Emerg Microbes Infect 2024; 13:2295389. [PMID: 38095070 PMCID: PMC10763910 DOI: 10.1080/22221751.2023.2295389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/12/2023] [Indexed: 12/31/2023]
Abstract
Rat hepatitis E virus (ratHEV; species Rocahepevirus ratti) is considered a newly emerging cause of acute hepatitis of zoonotic origin. ratHEV infection of people living with HIV (PLWH) might portend a worse, as with hepatitis E virus (HEV; species Paslahepevirus balayani), and consequently this group may constitute a high-risk population. We aimed to evaluate the prevalence of ratHEV by measuring viral RNA and specific IgG antibodies in a large Spanish cohort of PLWH. Multicentre study conducted in Spain evaluating PLWHIV included in the Spanish AIDS Research Network (CoRIS). Patients were evaluated for ratHEV infection using PCR at baseline and anti-ratHEV IgG by dot blot analysis to evaluate exposure to ratHEV strains. Patients with detectable ratHEV RNA were followed-up to evaluate persistence of viremia and IgG seroconversion. Eight-hundred and forty-two individuals were tested. A total of 9 individuals showed specific IgG antibodies against ratHEV, supposing a prevalence of 1.1 (95% CI; 0.5%-2.1%). Of these, only one was reactive to HEV IgG antibodies by ELISA. One sample was positive for ratHEV RNA (prevalence of infection: 0.1%; 95% CI: 0.08%-0.7%). The case was a man who had sex with men exhibiting a slightly increased alanine transaminase level (49 IU/L) as only biochemical alteration. In the follow-up, the patients showed undetectable ratHEV RNA and seroconversion to specific ratHEV IgG antibodies. Our study shows that ratHEV is geographical broadly distributed in Spain, representing a potential zoonotic threat.
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Affiliation(s)
- María Casares-Jimenez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
| | - Antonio Rivero-Juarez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - Pedro Lopez-Lopez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - María Luisa Montes
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
- HIV Unit, Internal Medicine Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | | | - Joaquín Peraire
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
- Infectious Diseases Unit, Joan XXIII University Hospital, IISPV, Rovira i Virgili University, Tarragona, Spain
| | - Nuria Espinosa
- Infectious Diseases and Clinical Microbiology Unit, Virgen del Rocío University Hospital, CSIC, IbIS, University of Seville, Seville, Spain
| | | | - Tránsito Garcia-Garcia
- Immunogenomic and Molecular Pathogenesis, Zoonoses and Emerging diseases Unit (ENZOEM), Genetic Department, University of Cordoba, Cordoba, Spain
| | - Javier Caballero-Gomez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
- Animal Health Unit, Zoonoses and Emerging diseases Unit (ENZOEM), University of Cordoba, Cordoba, Spain
| | - Diana Corona-Mata
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - Ignacio Perez-Valero
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - Rainer G. Ulrich
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Greifswald-Insel Riems, Germany
| | - Antonio Rivero
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
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Lyons M, Harper GW, Jadwin-Cakmak L, Beyer A, Graham SM. Listening to the Voices of Gay and Bisexual Men and Other Men Who Have Sex with Men in Kenya: Recommendations for Improved HIV Prevention Programming. Undergrad J Public Health Univ Mich 2024; 7:84-96. [PMID: 37398631 PMCID: PMC10310496 DOI: 10.3998/ujph.3949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Young gay and bisexual men and other men who have sex with men (GBMSM) are a key population at high risk for new human immunodeficiency virus (HIV) infections in Kenya; thus, increased efforts are necessary to reduce their health risks. This qualitative study describes recommendations offered by young GBMSM in Kenya regarding the development and delivery of culturally appropriate HIV prevention services. Both young GBMSM Community Members and Peer Educators recommend that future HIV prevention efforts enhance economic empowerment, provide mental health and substance use services, and incorporate arts-based health promotion strategies. In addition, participants recommended that public health professionals increase the ease of access to HIV prevention services for GBMSM and that researchers disseminate findings from HIV prevention research back to the community.
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Gorsline CA, Lotspeich SC, Belaunzarán-Zamudio PF, Mejia F, Cortes CP, Crabtree-Ramírez B, Severe DP, Rouzier V, McGowan CC, Rebeiro PF. The impact of earthquakes in Latin America on the continuity of HIV care: A retrospective observational cohort study. Public Health Pract (Oxf) 2024; 7:100479. [PMID: 38405231 PMCID: PMC10883833 DOI: 10.1016/j.puhip.2024.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024] Open
Abstract
Objectives As earthquakes occur frequently in Latin America and can cause significant disruptions in HIV care, we sought to analyze patterns of HIV care for adults at Latin American clinical sites experiencing a significant earthquake within the past two decades. Study design Retrospective clinical cohort study. Methods Adults receiving HIV care at sites experiencing at least a "moderate intensity" (Modified Mercalli scale) earthquake in the Caribbean, Central and South America network for HIV epidemiology (CCASAnet) contributed data from 2003 to 2017. Interrupted Time Series models were fit with discontinuities at site-specific earthquake dates (Sept. 16, 2015 in Chile; Apr. 18, 2014 and Sept. 19, 2017 in Mexico; and Aug. 15, 2007 in Peru) to assess clinical visit, CD4 measure, viral load lab, and ART initiation rates 3- and 6-months after versus before earthquakes. Results Comparing post-to pre-earthquake periods, there was a sharp drop in median visit (incidence rate ratio [IRR] = 0.79, 95% confidence interval [CI]: 0.68-0.91) and viral load lab (IRR = 0.78, 95% CI: 0.62-0.99) rates per week, using a 3-month window. CD4 measurement rates also decreased (IRR = 0.43; 95% CI: 0.37-0.51), though only using a 6-month window. Conclusions Given that earthquakes occur frequently in Latin America, disaster preparedness plans must be more broadly implemented to avoid disruptions in HIV care and attendant poor outcomes.
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Affiliation(s)
- Chelsea A. Gorsline
- University of Kansas Medical Center, Department of Medicine, Division of Infectious Diseases, Kansas City, KS, USA
| | - Sarah C. Lotspeich
- Wake Forest University School of Medicine, Department of Statistical Sciences, Winston-Salem, NC, USA
| | | | - Fernando Mejia
- Instituto de Medicina Tropical Alexander von Humboldt de Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudia P. Cortes
- Universidad de Chile and Fundacion Arriaran, Santiago de Chile, Chile
| | - Brenda Crabtree-Ramírez
- Departamento de Infectología, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico City, Mexico
| | | | | | - Catherine C. McGowan
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, USA
| | - Peter F. Rebeiro
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, USA
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN, USA
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Bell LM. The Epidemiology of Human Immunodeficiency Virus: Reflections and Insights. Nurs Clin North Am 2024; 59:153-164. [PMID: 38670686 DOI: 10.1016/j.cnur.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
The ongoing human immunodeficiency virus (HIV) epidemic reveals sustained health care disparities among Black and Brown people and those living in the United States South. With increased rates of HIV incidence in several geographic regions, we must identify and address the structural barriers that limit advances to end the HIV epidemic. This article will shine a reflective and insightful light on the advances that we have made with HIV treatment and prevention and propose novel ways to close the gap for vulnerable people living with or affected by HIV.
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Affiliation(s)
- Lacrecia M Bell
- School of Nursing, Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA.
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Agor D, Knettel BA, Daici K, Meanley S. The Intersection of Mental Health and Sexual and Gender Minority Identities for Older Adults Living with Human Immunodeficiency Virus: A Narrative Review. Nurs Clin North Am 2024; 59:253-271. [PMID: 38670693 DOI: 10.1016/j.cnur.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
The transition of HIV into a chronic illness has brought to the forefront the pressing need to address the complex web of social determinants of HIV outcomes. A structured literature search and narrative review of studies describing intervention strategies for mental health among sexual/gender minority (SGM) older adults living with HIV (OALWH) published in the last decade identified 2 studies for inclusion. This narrative review identifies age-sensitive and culturally adapted therapies, mindfulness and meditation-based stress reduction, group therapy, digital mental health resources, and psilocybin-assisted group therapy as emerging intervention models tailored to meet the unique needs of SGM OALWH.
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Affiliation(s)
- David Agor
- Department of Family and Community Health, University of Pennsylvania, School of Nursing, 418 Curie Boulevard, 218L E, Philadelphia, PA 19104, USA; University of Pennsylvania Eidos Center, Philadelphia, PA, USA.
| | - Brandon A Knettel
- Duke School of Nursing, 307 Trent Drive, Durham, NC 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, USA; Duke Global Mental Health Program, Duke University, Durham, NC, USA
| | - Kenneth Daici
- Brown University, 69 Brown Street, Box 9734, Providence, RI 02912, USA
| | - Steven Meanley
- University of Pennsylvania Eidos Center, Philadelphia, PA, USA; University of Pennsylvania School of Nursing, 418 Curie Boulevard, 231L, Philadelphia, PA 19104, USA
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Janek SE, Knippler ET, Saslafsky AT, Mulawa MI. A Scoping Review of Approaches to Reduce Stigma and Discrimination Against People with HIV in Health-Care Settings in the United States: Few Recent Interventions Identified. Nurs Clin North Am 2024; 59:235-252. [PMID: 38670692 PMCID: PMC11055979 DOI: 10.1016/j.cnur.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
This scoping review identified contemporary stigma-reduction studies across US health-care settings. Despite the significance of this problem, only 3 intervention studies were identified in the past 5 years. These studies highlight the value of intervening during formative training experiences and the importance of including interprofessional health-care providers in interventions. The findings relate to the novel approaches (eg, virtual patient simulations) that are used in interventions. The importance of using a participatory approach to intervention design is noted. Critical gaps in human immunodeficiency virus (HIV) stigma measurement and the lack of interventions are identified, laying a foundation for future programs and research.
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Affiliation(s)
- Sarah E Janek
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA.
| | | | - Ali T Saslafsky
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA
| | - Marta I Mulawa
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
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Luo Z, Jiang W. A protocol for anti-CD4 IgG antibody purification using plasma samples from people with HIV and antibody-mediated cytotoxicity. MethodsX 2024; 12:102698. [PMID: 38650998 PMCID: PMC11033182 DOI: 10.1016/j.mex.2024.102698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Up to 20% of people with HIV (PWH) fail to recover their CD4+ T cell counts to levels similar to healthy controls after suppressive antiretroviral therapy (ART). Immune non-responders (INRs) are PWH on suppressive ART with CD4+ T cell counts lower than 350 cells/mL, whereas their CD8+ T cell counts are higher than healthy controls. We are the first group to report that increased anti-CD4 autoantibody IgGs in INRs are responsible for blunted CD4+ T cell reconstitution in PWH with ART and viral suppression through anti-CD4 IgG-induced antibody-mediated cytotoxicity (ADCC) against CD4+ T cells in vitro. Notably, anti-CD4 IgG-mediated poor CD4+ T cell recovery from suppressive ART is the only mechanism targeting CD4+ T cells, specifically. RESULTS We provide a detailed one-by-one step protocol from antigen-specific antibody isolation using plasma samples, to ADCC assay. CONCLUSIONS To promote reproducible research, a detailed protocol for isolating anti-CD4 IgG autoantibodies from plasma samples of PWH and evaluating ADCC effects is reported here.•Antigen-specific antibody isolation using human plasma samples•Antibody-mediated cytotoxicity (ADCC).
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Affiliation(s)
- Zhenwu Luo
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
- Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Psaros C, Hill-Rorie J, Quint M, Horvitz C, Dormitzer J, Biello KB, Krakower DS, Safren SA, Mimiaga MJ, Sullivan P, Hightow-Weidman LB, Mayer KH. A qualitative exploration of how to support PrEP adherence among young men who have sex with men. AIDS Care 2024; 36:732-743. [PMID: 37748111 PMCID: PMC10961251 DOI: 10.1080/09540121.2023.2240070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/18/2023] [Indexed: 09/27/2023]
Abstract
New HIV infections disproportionately affect young men who have sex with men (YMSM). PrEP is effective in preventing HIV acquisition; however, adherence is critical and is often suboptimal among YMSM. Interventions addressing the unique PrEP adherence challenges faced by YMSM are needed. We conducted qualitative interviews with 20 HIV-negative, YMSM (ages 15-24) with a PrEP indication and 11 healthcare professionals to inform adaption of a PrEP adherence intervention (Life-Steps for PrEP) for YMSM. We explored environmental, healthcare, and individual factors influencing uptake, adherence, attitudes, and perspectives (including desired modifications) on the Life-Steps intervention. Interviews were analyzed using content analysis. Of YMSM study participants (mean age 21.6) 55% were White, 15% Hispanic, and 5% Black. Most YMSM were PrEP-experienced (70%). Healthcare professionals (6 prescribers, 1 nurse, 2 health educators, 2 other/unspecified) averaged 6.9 years of experience caring for YMSM. All described stigma as a barrier to PrEP; YMSM expressed concern around being perceived as "risky" and concern about inadvertent PrEP disclosure if family/friends found their medication, or if parental insurance was used. Difficulty with planning for potential adherence challenges were identified by both groups. YMSM highlighted benefits of a nurse-led intervention (i.e., adding "legitimacy"), but stressed need for nonjudgmental, "savvy" interventionists. YMSM expressed a desire for comprehensive YMSM-specific sexual health information. These findings informed modification and expansion of Life-Steps content. Results highlight key potential barriers, many of which center around privacy. Content that addresses PrEP stigma, disclosing PrEP use, navigating insurance, and planning ahead in a nonjudgmental environment by trusted providers emerged as important components of a YMSM-focused delivery of Life-Steps for PrEP.
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Affiliation(s)
- Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States
- The Fenway Institute, Fenway Health, Boston, MA, United States
| | | | - Meg Quint
- The Fenway Institute, Fenway Health, Boston, MA, United States
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Casey Horvitz
- Behavior and Technology Lab, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Katie B. Biello
- The Fenway Institute, Fenway Health, Boston, MA, United States
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, United States
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Douglas S. Krakower
- The Fenway Institute, Fenway Health, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Steven A. Safren
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Matthew J. Mimiaga
- The Fenway Institute, Fenway Health, Boston, MA, United States
- UCLA Center for LGBTQ+ Advocacy, Research & Health, Los Angeles, CA, United States
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
- Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, United States
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Lisa B. Hightow-Weidman
- Institute on Digital Health and Innovation, College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, United States
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14
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Sucharita PB, S RY, Basker MM, Verghese VP, Jeyaseelan V, Rupali P, Clarence P. Effect of Nutritional Supplementation on Illness Outcome in Adolescents with HIV on HAART: A Randomized, Double-Blind Clinical Trial. Indian J Pediatr 2024; 91:578-583. [PMID: 35771346 DOI: 10.1007/s12098-022-04195-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/22/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the effect of macronutrient and micronutrient supplementation on body mass index (BMI), hemoglobin (Hb), CD4 count, triglyceride levels, and morbidity among adolescents with human immunodeficiency virus (HIV) living in India. METHODS A prospective, randomized, double-blinded, placebo-controlled trial was conducted among 80 adolescents (10-19 y) with HIV on highly active antiretroviral therapy (HAART) for a minimum of 6 mo using simple randomization. Participants in the intervention arm received 400 kcal and 15 g protein as a powder daily and multivitamin tablets thrice weekly for 3 mo. Those in the placebo arm received a similar-appearing sachet containing 100 kcal and 2 g protein daily and a placebo tablet thrice weekly. Weight, height, BMI, Hb, CD4 count, triglycerides, and number of intercurrent illnesses were measured at 3 and 6 mo. RESULTS At 6 mo, the intervention group showed an increase in weight from 36.4 ± 10.9 kg to 39.7 ± 8.5 kg and a significant increase in BMI from 16.6 ± 2.3 kg/m2 to 17.5 ± 2.3 kg/m2. Increase in CD4 count in the placebo arm was more than that in the intervention arm, but the difference between the arms was not statistically significant. Intervention group showed a pronounced rise in Hb from 9.7 ± 2.3 g/dL to 11.4 ± 1.6 g/dL, significant reduction in triglyceride levels from 99.2 ± 92.7 mg/dL to 81.0 ± 12.8 mg/dL and reduction in intercurrent illnesses from 32.5% to none. CONCLUSIONS Nutritional supplementation of adolescents with HIV on HAART improves BMI, hemoglobin, and reduces triglyceride levels and intercurrent illnesses.
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Affiliation(s)
- P Blessy Sucharita
- Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Reshmi Y S
- Adolescent Medicine facility, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mona M Basker
- Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
- Adolescent Medicine facility, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India.
| | - Valsan Philip Verghese
- Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vishali Jeyaseelan
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
| | - Peace Clarence
- Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
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15
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Bloomfield GS, Hill CL, Chiswell K, Cooper L, Gray S, Longenecker CT, Louzao D, Marsolo K, Meissner EG, Morse CG, Muiruri C, Thomas KL, Velazquez EJ, Vicini J, Pettit AC, Sanders G, Okeke NL. Cardiology Encounters for Underrepresented Racial and Ethnic Groups with Human Immunodeficiency Virus and Borderline Cardiovascular Disease Risk. J Racial Ethn Health Disparities 2024; 11:1509-1519. [PMID: 37160576 PMCID: PMC10632543 DOI: 10.1007/s40615-023-01627-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Underrepresented racial and ethnic groups (UREGs) with HIV have a higher risk of cardiovascular disease (CVD) compared with the general population. Referral to a cardiovascular specialist improves CVD risk factor management in high-risk individuals. However, patient and provider factors impacting the likelihood of UREGs with HIV to have an encounter with a cardiologist are unknown. METHODS We evaluated a cohort of UREGs with HIV and borderline CVD risk (10-year risk ≥ 5% by the pooled cohort equations or ≥ 7.5% by Framingham risk score). Participants received HIV-related care from 2014-2020 at four academic medical centers in the United States (U.S.). Adjusted Cox proportional hazards regression was used to estimate the association of patient and provider characteristics with time to first ambulatory cardiology encounter. RESULTS A total of 2,039 people with HIV (PWH) and borderline CVD risk were identified. The median age was 45 years (IQR: 36-50); 52% were female; and 94% were Black. Of these participants, 283 (14%) had an ambulatory visit with a cardiologist (17% of women vs. 11% of men, p < .001). In fully adjusted models, older age, higher body mass index (BMI), atrial fibrillation, multimorbidity, urban residence, and no recent insurance were associated with a greater likelihood of an encounter with a cardiologist. CONCLUSION In UREGs with HIV and borderline CVD risk, the strongest determinants of a cardiology encounter were diagnosed CVD, insurance type, and urban residence. Future research is needed to determine the extent to which these encounters impact CVD care practices and outcomes in this population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04025125.
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Affiliation(s)
- Gerald S Bloomfield
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA.
| | - C Larry Hill
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA
| | - Karen Chiswell
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA
| | - Linda Cooper
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Shamea Gray
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Chris T Longenecker
- Division of Cardiology and Department of Global Health, University of Washington, Seattle, WA, USA
| | - Darcy Louzao
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA
| | - Keith Marsolo
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Eric G Meissner
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Caryn G Morse
- Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Charles Muiruri
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kevin L Thomas
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA
| | - Eric J Velazquez
- Section of Cardiovascular Medicine, Yale University, New Haven, CT, USA
| | - Joseph Vicini
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - April C Pettit
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Gretchen Sanders
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W. Morgan Street, Durham, NC, 27701, USA
| | - Nwora Lance Okeke
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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16
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Andrade-Romo Z, La Hera-Fuentes G, Ochoa-Sánchez LE, Chavira-Razo L, Aramburo-Muro T, Castro-León L, Amaya-Tapia G, Andrade-Pérez JS, Bautista-Arredondo S. Effectiveness of an intervention to improve ART adherence among men who have sex with men living with HIV: a randomized controlled trial in three public HIV clinics in Mexico. AIDS Care 2024; 36:816-831. [PMID: 38422450 DOI: 10.1080/09540121.2023.2299322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024]
Abstract
We conducted a parallel-group randomized controlled trial in three HIV clinics in Mexico to evaluate a user-centred habit-formation intervention to improve ART adherence among MSM living with HIV. We randomized 74 participants to the intervention group and 77 to the control group. We measured adherence at one, four, and ten months through medication possession ratio and self-reported adherence. Additionally, we measured viral load, CD4 cell count, major depression disorder symptoms, and alcohol and substance use disorder at baseline, fourth and tenth months. We found no statistically significant effect on adherence between groups. However, the intervention demonstrated positive results in major depression disorder symptoms (21% vs. 6%, p = 0.008) and substance use disorder (11% vs. 1%, p = 0.018) in the fourth month. The latter is relevant because, in addition to its direct benefit, it might also improve the chances of maintaining adequate adherence in the long term. This trial was retrospectively registered at ClinicalTrials.gov (trial number NCT03410680) on 8 January 2018.Trial registration: ClinicalTrials.gov identifier: NCT03410680.
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Affiliation(s)
- Zafiro Andrade-Romo
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Gina La Hera-Fuentes
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
- Newcastle Business School, The University of Newcastle, Callaghan, Australia
| | - Luz Edith Ochoa-Sánchez
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
| | - Laura Chavira-Razo
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
| | - Tania Aramburo-Muro
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
| | | | - Gerardo Amaya-Tapia
- Infectious Diseases Department, Hospital General de Occidente, Zapopan, México
| | | | - Sergio Bautista-Arredondo
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
- School of Public Health, UC Berkeley, Berkeley, USA
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17
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Perazzolo S, Shen DD, Scott AM, Ho RJY. Physiologically based Pharmacokinetic Model Validated to Enable Predictions Of Multiple Drugs in a Long-acting Drug-combination Nano-Particles (DcNP): Confirmation with 3 HIV Drugs, Lopinavir, Ritonavir, and Tenofovir in DcNP Products. J Pharm Sci 2024; 113:1653-1663. [PMID: 38382809 DOI: 10.1016/j.xphs.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024]
Abstract
Drug-Combination Nanoparticles (DcNP) are a novel drug delivery system designed for synchronized delivery of multiple drugs in a single, long-acting, and targeted dose. Unlike depot formulations, slowly releasing drug at the injection site into the blood, DcNP allows multiple-drug-in-combination to collectively distribute from the injection site into the lymphatic system. Two distinct classes of long-acting injectables products are proposed based on pharmacokinetic mechanisms. Class I involves sustained release at the injection site. Class II involves a drug-carrier complex composed of lopinavir, ritonavir, and tenofovir uptake and retention in the lymphatic system before systemic access as a part of the PBPK model validation. For clinical development, Class II long-acting drug-combination products, we leverage data from 3 nonhuman primate studies consisting of nine PK datasets: Study 1, varying fixed-dose ratios; Study 2, short multiple dosing with kinetic tails; Study 3, long multiple dosing (chronic). PBPK validation criteria were established to validate each scenario for all drugs. The models passed validation in 8 of 9 cases, specifically to predict Study 1 and 2, including PK tails, with ritonavir and tenofovir, fully passing Study 3 as well. PBPK model for lopinavir in Study 3 did not pass the validation due to an observable time-varying and delayed drug accumulation, which likely was due to ritonavir's CYP3A inhibitory effect building up during multiple dosing that triggered a mechanism-based drug-drug interaction (DDI). Subsequently, the final model enables us to account for this DDI scenario.
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Affiliation(s)
- Simone Perazzolo
- Department of Pharmaceutics, University of Washington, Seattle, WA 98195-7610, USA.
| | - Danny D Shen
- Department of Pharmaceutics, University of Washington, Seattle, WA 98195-7610, USA
| | - Ariel M Scott
- Department of Pharmaceutics, University of Washington, Seattle, WA 98195-7610, USA
| | - Rodney J Y Ho
- Department of Pharmaceutics, University of Washington, Seattle, WA 98195-7610, USA; Bioengineering, University of Washington, Seattle, WA 98195-7610, USA.
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18
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Li D, Ma S, Dang B, Shi H, Wei Y, Wang X. Effectiveness of telemedicine for the prevention of mother-to-child transmission of HIV in low-income and middle-income countries: a systematic review and meta-analysis. Int J Infect Dis 2024; 143:106981. [PMID: 38458425 DOI: 10.1016/j.ijid.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES We aimed to estimate the effectiveness of telemedicine for the prevention of mother-to-child transmission (PMTCT) program of HIV in low- and middle-income countries (LMICs). METHODS We did a systematic literature search of 15 databases for articles published from database inception to October 26, 2022, and performed meta-analyses to estimate the pooled risk ratio of intervention effect (RR) and its 95% confidence interval (CI). We used subgroup analyses and meta-regressions to explore variation in the RRs. Funnel plots and Egger regression tests were also performed to assess publication bias. RESULTS Seventeen studies were included in the systematic review, with a total sample size of 9118 participants. We found that telemedicine was beneficial for early infant diagnosis (EID) in the sixth week (RR 1.04 [95% CI 1.00-1.09]), exclusive breastfeeding (RR 1.12 [95% CI 1.01-1.24]) and PMTCT retention (RR 1.34 [95% CI 1.16-1.55]). However, we did not find a significant effect of telemedicine on infant prophylaxis, HIV transmission, and ART adherence. Besides, the heterogeneity of ART adherence was associated with enrollment time, while retention was related to ART initiation. CONCLUSIONS Our meta-analysis demonstrated the benefits of telemedicine in improving PMTCT, especially for EID, exclusive breastfeeding, and PMTCT retention.
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Affiliation(s)
- Dantong Li
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China
| | - Shang Ma
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China
| | - Binfei Dang
- Peking University Health Science Center, Beijing, China
| | - Huifeng Shi
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China; National Centre for Healthcare Quality Management in Obstetrics, Beijing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China; National Centre for Healthcare Quality Management in Obstetrics, Beijing, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China.
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19
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Iriarte E, Cianelli R, De Santis JP, Villegas N, Irarrazabal L, Jankowski C, Provencio-Vasquez E. HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV. Hisp Health Care Int 2024; 22:99-108. [PMID: 37853706 DOI: 10.1177/15404153231208130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.
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Affiliation(s)
- Evelyn Iriarte
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- Millennium Institute for Care Research, MICARE (ICS2019_024), Santiago, Chile
| | - Rosina Cianelli
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Joseph P De Santis
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Natalia Villegas
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisette Irarrazabal
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Catherine Jankowski
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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20
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Martínez-Riveros H, Díaz Y, Montoro-Fernandez M, Moreno-Fornés S, González V, Muntada E, Romano-deGea P, Muñoz R, Hoyos J, Casabona J, Agustí C. An Online HIV Self-Sampling Strategy for Gay, Bisexual and Other Men Who Have Sex with Men and Trans Women in Spain. J Community Health 2024; 49:535-548. [PMID: 38141149 PMCID: PMC10981614 DOI: 10.1007/s10900-023-01311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/24/2023]
Abstract
We aimed to evaluate the feasibility of an online self-sampling pilot intervention for HIV testing addressed to gay, bisexual, and other men who have sex with men (GBMSM) and trans women (TW) users of dating apps in Spain. The website https://www.testate.org/ was designed to offer self-sampling kits for HIV testing and online consultation of the results. It was advertised on gay dating apps. Participants requested the delivery of a saliva self-sampling kit by mail and a postage-paid envelope to send the sample to the reference laboratory. An anonymous acceptability survey was conducted. The cascade of care was estimated. From November 2018 to December 2021, 4623 individual users ordered self-sampling kits, 3097 returned an oral fluid sample to the reference laboratory (67.5% return rate). 87 reactive results were detected. 76 were confirmed to be HIV-positive, we estimated an HIV prevalence of 2.45% (95% CI 1.9-3.0%). 100% of those referred to specialized care are in treatment. 45.8% of participants took more than one test. 23 incident cases were detected among repeat testers, of which 20 were confirmed. The estimated incidence was 1.00 confirmed case per 100 individual-years of follow-up. 98.01% of participants would recommend it to a friend. The most identified advantages were convenience and privacy. We demonstrated that the online offer of oral self-sampling kits for HIV detection and reporting results online among GBMSM and TW users of dating apps is feasible. The intervention counted with a high acceptability and high efficacy (in terms of reactivity, confirmation and linkage to care rates).
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Affiliation(s)
- Héctor Martínez-Riveros
- Doctorate Program in Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain.
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain.
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain.
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Edifici Muntanya, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain.
| | - Yesika Díaz
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marcos Montoro-Fernandez
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
| | - Sergio Moreno-Fornés
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Victoria González
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Service, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - Esteve Muntada
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
| | - Pol Romano-deGea
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
| | - Rafael Muñoz
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
- Early Detection of Cancer Research Group, EPIBELL Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Jordi Casabona
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
| | - Cristina Agustí
- Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), Ministry of Health of the Government of Catalonia, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Abreu Martins C, Leal Seabra I, Rocha Vila Nova PV, Barbosa Rodrigues T, Oeiras Pedroso A, Gir E, Karina Reis R, Tavares Parente A, Oliveira Naiff Ferreira GR, Botelho EP. Spatial analysis of HIV detection rates among Brazilian young men, 2007-2021. AIDS Care 2024; 36:771-780. [PMID: 38227972 DOI: 10.1080/09540121.2024.2301730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
The main goal of this study was to spatially analyze the HIV epidemic scenario in young men in Brazil, 2007-2021. We used secondary data obtained from the Brazilian Information System for Notifiable Diseases. Individuals aged 15-29 years with permanent residence in Brazil who were diagnosed with HIV during the study period were included in the analysis. Municipality HIV age-adjusted detection rates were analyzed through spatial distribution, autocorrelation, and spatiotemporal risk analyses. During the study period, 108,392 HIV cases were reported in young Brazilian men. The HIV epidemic increased territorially in the northern, northeastern, midwestern, and southeastern regions but decreased in the southern region. Although the number of clusters comprising municipalities with high HIV detection rates (hotspots) decreased, new ones appeared, expanded, or stopped changing size. Hotspots and spatio-temporal risk zones (spatial areas with increased HIV detection in a specific period) comprised economically developed municipalities with high demographic density surrounded by less developed municipalities. The period of the spatiotemporal risk zones was between 2008 and 2021. Our study showed that HIV detection rates continue to increase among young Brazilian men, and health authorities should reinforce efforts mainly in capitals and surrounded municipalities in the north, northeast, southeast, and midwest regions.
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Affiliation(s)
| | | | | | | | | | - Elucir Gir
- Nursing School of RibeirãoPreto, University of São Paulo, Ribeirão Preto, Brazil
| | - Renata Karina Reis
- Nursing School of RibeirãoPreto, University of São Paulo, Ribeirão Preto, Brazil
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Grau-Echevarría A, Labrandero-Hoyos C, Peñuelas-Leal R, Finello M, Blaya-Imbernón D, García-García JÁ, Berenguer-Romero MD, de Miquel VA, Pérez-Ferriols A, Martínez-Calabuig P, Hernández-Bel P. Anetoderma after disseminated Mpox. J Cutan Pathol 2024; 51:415-418. [PMID: 38468572 DOI: 10.1111/cup.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
Anetoderma or macular atrophy is a rare skin condition of unclear pathogenesis, often associated with autoimmune diseases and skin damage from various infections. Human immunodeficiency virus (HIV), syphilis, and poxviruses have been implicated in the development of anetoderma. A 37-year-old male patient with HIV and recent unprotected sexual encounters presented with more than 400 skin lesions, consistent with Mpox. Symptomatic treatment for Mpox resulted in acute symptom resolution. However, 8 months later he developed papular anetoderma lesions in areas previously affected by Mpox. Biopsy confirmed the loss of elastic fibers in the affected skin areas, leading to the diagnosis of Mpox-induced anetoderma. This report presents a unique case of anetoderma following Mpox in an HIV-positive patient.
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Affiliation(s)
- Andrés Grau-Echevarría
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Rodrigo Peñuelas-Leal
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Malena Finello
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Daniel Blaya-Imbernón
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - José Ángel García-García
- Pathological Anatomy Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Víctor Alegre de Miquel
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Amparo Pérez-Ferriols
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Pablo Martínez-Calabuig
- Rheumatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Pablo Hernández-Bel
- Dermatology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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23
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Bergamin G, Hudson J, Currie BJ, Mounsey KE. A systematic review of immunosuppressive risk factors and comorbidities associated with the development of crusted scabies. Int J Infect Dis 2024; 143:107036. [PMID: 38570134 DOI: 10.1016/j.ijid.2024.107036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVES Crusted scabies (CS, Norwegian scabies) is a severe form of scabies, characterized by hyper-infestation of Sarcoptes scabiei mites. CS is commonly associated with immunosuppression but is also reported in overtly immunocompetent individuals. We reviewed immunosuppressive risk factors and comorbidities associated with CS. METHODS The National Library of Medicine (PubMed) database was reviewed for patient case reports of CS from January 1998 to July 2023. Two authors screened records for eligibility, extracted data, and one critically appraised the quality of the studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023466126. RESULTS A total of 436 records were identified, of which 204 were included for systematic review. From these, 683 CS patients were included. CS impacted both genders equally. Adults (21-59 years) were more commonly affected (45.5%) compared to children (0-20 years, 21%). Corticosteroid use was the most prevalent immunosuppressive risk factor identified (27.7% of all cases). About 10.2% of reports were associated with HIV/AIDS, and 8.5% with HTLV-1 infection. 10.5% of patients were overtly immunocompetent with no known risk factors. Overall, 41 (6.0%) died, many subsequent to secondary bacteremia. CONCLUSION This study represents the first systematic review undertaken on immunosuppressive risk factors associated with CS. This provides insights into trends of immunosuppression and mechanisms of CS development.
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Affiliation(s)
- Gianni Bergamin
- School of Health, University of the Sunshine Coast, Queensland, Australia; School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia; Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Joshua Hudson
- School of Health, University of the Sunshine Coast, Queensland, Australia; School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia; Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Bart J Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Kate E Mounsey
- School of Health, University of the Sunshine Coast, Queensland, Australia; Sunshine Coast Health Institute, Birtinya, Queensland, Australia.
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24
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Zhang H, Han J, Su Y, Li Z, Zhao H. Prevalence and factors associated with fertility desires among HIV-positive MSM. AIDS Care 2024; 36:790-796. [PMID: 38387443 DOI: 10.1080/09540121.2024.2309457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/18/2024] [Indexed: 02/24/2024]
Abstract
The National surveillance data showed that homosexual transmission played a considerable role in new HIV infections in China. The emphasis on antiretroviral therapy and prevention of mother-to-child transmission provided chances for reproduction among people living with HIV/AIDS. Issues of fertility desire have a paucity of data among HIV-positive men who have sex with men (MSM). This cross-sectional study has assessed fertility attitudes and associated factors, as well as the reproductive knowledge among HIV-positive MSM. Analysis was mainly based on the multinomial regression model. The study included 129 participants, and almost all of the participants (96.1%) were between 18 and 30 years old and 82.2% of them were single. About 35.6% expressed a fertility desire. MSM without siblings tended to have fertility desire (OR = 0.236, 95%CI: 0.078∼0.712, p = 0.010). Surrogacy (36.4%) was the most desired method among the 86 respondents who had the desire or did not make a decision. While the accuracy of the reproductive knowledge was only 69.6%. In summary, we recommend that providers offer much more professional information and develop assisted reproductive technology to meet the reproductive aspirations of HIV-positive MSM.
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Affiliation(s)
- Hanxi Zhang
- WHO Collaborating Centre for Comprehensive Management of HIV Treatment and Care, Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Jing Han
- WHO Collaborating Centre for Comprehensive Management of HIV Treatment and Care, Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Ye Su
- WHO Collaborating Centre for Comprehensive Management of HIV Treatment and Care, Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Zhennan Li
- The Home of Red Ribbon, Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Hongxin Zhao
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
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Aidoo-Frimpong G, Tong G, Akyirem S, Abwoye DN, Nwanaji-Enwerem U, López DJ, Wilton L, Nelson LE. Sociodemographic correlates of late HIV diagnosis among men who have sex with men (MSM) in Ghana. AIDS Care 2024; 36:807-815. [PMID: 38460152 DOI: 10.1080/09540121.2024.2325071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/22/2024] [Indexed: 03/11/2024]
Abstract
Timely HIV diagnosis and medical engagement are crucial for effective viral load suppression and treatment as prevention. However, significant delays persist, particularly in Africa, including Ghana. This study focused on Ghanaian men whose route of exposure to HIV was through same-gender sexual contact (MSM), a group disproportionately impacted by HIV. Using structured surveys, we investigated the sociodemographic factors associated with late HIV diagnosis, a topic with limited existing research. Results indicate that older age groups were associated with an increased risk of late diagnosis compared to the 18-24 age group. Among the demographic variables studied, only age showed a consistent association with late HIV diagnosis. This study underscores the importance of targeted interventions to address HIV diagnosis disparities among MSM in Ghana, particularly for older age groups. The findings emphasize the need for tailored interventions addressing age-related disparities in timely diagnosis and engagement with medical services among this population. Such interventions can play a crucial role in reducing the burden of HIV within this community and fostering improved public health outcomes.
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Affiliation(s)
- Gloria Aidoo-Frimpong
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Guangyu Tong
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, CT, USA
| | | | | | - Daniel Jacobson López
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
- School of Social Work, Boston University, Boston, MA, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - LaRon E Nelson
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
- Yale School of Nursing, Yale University, New Haven, CT, USA
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26
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Lo Caputo S, Poliseno M, Tavelli A, Gagliardini R, Rusconi S, Lapadula G, Antinori A, Francisci D, Sarmati L, Gori A, Spagnuolo V, Ceccherini-Silberstein F, d'Arminio Monforte A, Cozzi-Lepri A. Heavily treatment-experienced persons living with HIV currently in care in Italy: characteristics, risk factors, and therapeutic options-the ICONA Foundation cohort study. Int J Infect Dis 2024; 143:106956. [PMID: 38447754 DOI: 10.1016/j.ijid.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES Heavily treatment-experienced (HTE) people living with HIV (PLWH) pose unique challenges due to limited antiretroviral treatment (ART) options. Our study aimed to investigate the prevalence and features of HTE individuals followed up in the Italian Cohort Naïve Antiretrovirals (ICONA) cohort as of December 31, 2021. METHODS HTE were defined based on meeting specific conditions concerning their current ART and their ART history up to December 31, 2021. Descriptive statistics were performed by HTE status. Regression analyses explored factors associated with becoming HTE based on pre-ART patients' characteristics. Cluster dendrogram analysis provided insights into subgroups with inadequate responses based on clusters of differentiation (CD4) counts and viral load (VL) trajectories. RESULTS Among the 8758 PLWH actively followed in our cohort, 163 individuals (1.9%), mainly female, younger, Italian, and infected through heterosexual contact, met the HTE criteria. A lower CD4 count at ART initiation (odds ratio [OR] 1.60 per 100 cells/mmc lower CD4, 95% confidence interval [CI] 1.06-2.41, P = 0.03) and hepatitis C virus antibody positivity (OR 1.90, 95% CI 1.16-3.11, P = 0.01) were associated with higher HTE risk. Thirty PLWH exhibited ongoing immune-virological failure (18% of the HTE subgroup and 0.003% of the total population). Thirty PLWH exhibited ongoing immune-virological failure (i.e., with a current CD4 count <200 cells/mmc or VL>200 copies/mL). A cluster analysis identified 13 (43%) with a current CD4 count <200 cells/mmc. Also, notably, 19/30 (63%) had major acquired resistance-associated mutations to at least one antiretroviral drug class. CONCLUSIONS HTE is rare in our cohort and tends to co-exist with major resistance mutations. A focused investigation into treatment history and immuno-virological response is warranted, particularly given the availability of new antiretroviral drugs.
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Affiliation(s)
- Sergio Lo Caputo
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, Italy
| | - Mariacristina Poliseno
- Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), A.O.U.C. Policlinic di Bari, Bari, Italy.
| | | | | | - Stefano Rusconi
- Infectious Diseases Unit, ASST Ovest Milanese Ospedaledi Legnano, and DIBIC, University Milan, Legnano, Italy
| | - Giuseppe Lapadula
- IRCCS Fondazione San Gerardo dei Tintori, University of Milano Bicocca, Milan, Italy
| | | | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Loredana Sarmati
- Department of System Medicine, Infectious Disease Clinic, Policlinic Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, Infectious Diseases Unit, Foundation IRCCS Ca' GrandaOspedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Vincenzo Spagnuolo
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | | | - Antonella d'Arminio Monforte
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, UCL London, United Kingdom
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Barabara ML, Cohen SR, Masenga G, Minja LM, Mlay PS, Stephens MJ, Olomi GA, Mlay J, Marchand V, Weglarz A, Hanson O, Mmbaga BT, Watt MH. Factors associated with respectful maternity care and influence of HIV status among women giving birth in Kilimanjaro, Tanzania. Birth 2024; 51:307-318. [PMID: 37902177 PMCID: PMC11058110 DOI: 10.1111/birt.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/25/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Respectful maternity care (RMC) is a rights-based approach to childbirth that centers the dignity, autonomy, and well-being of birthing women. This study aimed to examine factors associated with RMC among women giving birth in Tanzania and to examine whether HIV status was associated with self-reported RMC. METHODS We enrolled 229 postpartum women in six clinics in the Kilimanjaro Region; of them, 103 were living with HIV. Participants completed a survey within 48 h after birth before being discharged. RMC was measured using a 30-item scale with three subscales (dignity and respect; supportive care; communication and autonomy), each standardized from 0 to 100. Univariable and multivariable regression models examined factors associated with RMC. RESULTS The median score of the full RMC score was 74, differing slightly by subscale: 83 for dignity and respect, 76 for supportive care, and 67 for communication and autonomy. RMC did not differ by HIV status (median 67.0 vs. 67.0, p = 0.89). In multivariable linear regression, women who would not recommend the birth facility to their friends and who did not receive breastfeeding education had significantly lower RMC scores on the full RMC scale. In the dignity and respect subscale, variables associated with significantly lower RMC scores were not being able to read and write, delivering in a public facility, and delivering vaginally. CONCLUSIONS Although self-reported RMC was generally high, we identified areas for improvement. Practitioners need ongoing training on RMC principles and the delivery of equitable care.
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Affiliation(s)
- Mariam L. Barabara
- Kilimanjaro Christian Medical University College, Tanzania - PhD candidate
| | - Susanna R. Cohen
- University of Utah, Department of Obstetrics and Gynecology, Utah – Research Associate Professor
| | - Gileard Masenga
- Kilimanjaro Christian Medical Center Consultant Hospital, Tanzania – Executive Director
| | - Linda M. Minja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania – Statistician
| | - Pendo S. Mlay
- Kilimanjaro Christian Medical Center, Department of Obstetrics and Gynecology, Tanzania – Chair and Consultant Obstetric and Gynaecologist
| | - Maya J. Stephens
- University of Utah, Department of Population Health Sciences, Utah – Research Coordinator
| | - Gaudensia A. Olomi
- Kilimanjaro Regional Secretary’s Office – Health Management Department, Tanzania – Regional Nursing Officer and Regional Research Director
| | - Janeth Mlay
- Kilimanjaro Clinical Research Institute, Tanzania – Research Assistant
| | | | - Anya Weglarz
- University of Utah, Department of Population Health Sciences, Utah – Research Assistant
| | - Olivia Hanson
- University of Utah, Department of Population Health Sciences, Utah – Research Assistant
| | | | - Melissa H. Watt
- University of Utah, Department of Population Health Sciences, Utah - Research Associate Professor
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J Marwa K, Kadodo J, Iddi S, Kapesa A. Herbal medicines use among HIV/AIDS patients on antiretroviral therapy and its influence on viral suppression and CD4 count: A survey at a tertiary hospital in Tanzania. Public Health Pract (Oxf) 2024; 7:100492. [PMID: 38595639 PMCID: PMC11002646 DOI: 10.1016/j.puhip.2024.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/13/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives This study aimed to determine the magnitude of concurrent use of herbal medicines with ART, its associated factors and effect on viral load suppression and CD4 count among people living with HIV. Study design This was a cross-sectional study involving 375 HIV positive patients on ART attending at care and treatment clinic (CTC). Methods Data were obtained through face-to-face interviews using pre-structured questionnaires and patient's files through a checklist. Adherence was assessed though pill count method while CD4 count and viral load suppression were assessed using the Tanzania National guidelines for the management of HIV and AIDS. Data were analysed using STATA version 15. Independent predictors for herbal medicine use or viral suppression were assessed using univariate and multivariate logistic regression. Results Out of 375 PLHIV, 37 (35%) reported to use herbal medicines concurrently with ART. Predictors for herbal medicines use were existence of chronic disease (OR = 4.53; CI = 1.87-10.95) (p = 0.001), male gender (OR = 0.57; CI = 0.35-0.93) (p = 0.02) and HIV clinical stage (OR = 1.71; CI = 0.99-2.94) (p = 005). PLHIV who used herbal medicines along with ART did not have a significantly higher chance of achieving viral suppression than PLHIV who did not use herbal medicines (OR = 1.42; CI = 0.71-2.82). There was no statistically significant difference on CD4 count (p = 0.8943) and viral load (p = 0.8612) between herbal medicines users and non-users. Conclusion The utilization of herbal medicine among PLHIV on ART remains notably prevalent. Nonetheless, it is worth noting that despite the prevailing herbal medicine usage, there is no substantial effect on viral suppression. The primary determinants of the adoption of herbal medicines use were having chronic medical conditions and the stage of progression of the HIV infection.
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Affiliation(s)
- Karol J Marwa
- Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Josephine Kadodo
- School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Shabani Iddi
- Department of Physiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Anthony Kapesa
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Madden S, Cole J. Care of the Transgender Person Living with Human Immunodeficiency Virus. Nurs Clin North Am 2024; 59:183-188. [PMID: 38670688 DOI: 10.1016/j.cnur.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
This article explores HIV care for transgender individuals; in particular, the barriers to early diagnosis of HIV, access and engagement in care, and disease complications. The article also examines how Advanced Practice Nurse Practitioners and other health care providers are well-positioned to mitigate these obstacles to wellness.
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30
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Wu YK, Jiang TT, Su YH, Mei L, Sun TK, Li YH, Wang ZD, Ji YY. The Potential Role of Virus Infection in the Progression of Thyroid Cancer. World J Oncol 2024; 15:382-393. [PMID: 38751704 PMCID: PMC11092407 DOI: 10.14740/wjon1830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/16/2024] [Indexed: 05/18/2024] Open
Abstract
Multiple factors have engaged in the progression of thyroid cancer (TC). Recent studies have shown that viral infection can be a critical factor in the pathogenesis of TC. Viruses, such as Epstein-Barr virus (EBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may play an essential role in the occurrence, development, and even prognosis in TC. This review mainly explored the potential role of viral infection in the progress of TC. The possible mechanisms could be recognizing the host cell, binding to the receptors, affecting oncogenes levels, releasing viral products to shape a beneficial environment, interacting with immune cells to induce immune evasion, and altering the pituitary-thyroid axis. Thus, comprehensive knowledge may provide insights into finding molecular targets for diagnosing and treating virus-related TC.
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Affiliation(s)
- Yong Ke Wu
- Department of General Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- The two authors contributed equally to this work
| | - Tian Tian Jiang
- Department of General Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- The two authors contributed equally to this work
| | - Yuan Hao Su
- Department of General Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Lin Mei
- Scientific Research Center and Precision Medical Institute, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Ting Kai Sun
- Department of General Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yun Hao Li
- Department of General Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Zhi Dong Wang
- Department of General Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yuan Yuan Ji
- Scientific Research Center and Precision Medical Institute, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
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Argüello TM. Spatializing HIV: Putting Queer (men) in its place via social marketing. Dialogues Health 2024; 4:100169. [PMID: 38516214 PMCID: PMC10954028 DOI: 10.1016/j.dialog.2024.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 03/23/2024]
Abstract
The current study is concerned with how HIV is spatialized, or emplaced in everyday life, and therefore how prevention, Queer identity, and the virus itself are given meaning. Employing a transdisciplinary methodology based in Critical Discourse Studies and critical human geography, this study provides a geosemiotic analysis of an HIV prevention social marketing effort called the Little Prick campaign. Findings showed that space was constructed through multiple competing dynamics across professionals and citizens, as well as amidst contested notions of risk and branding in the epidemic. The analysis illuminates the discursive relationship amongst Queer, HIV, and prevention. Equally, this study counters the biased notion that "prevention fatigue" in high-risk populations hampers professional labor by, instead, exposing a semiotic fatigue in the HIV epidemic and prevention efforts.
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Affiliation(s)
- Tyler M. Argüello
- Director and Professor, School of Social Work, California State University, Sacramento, 6000 J Street, 4010 Mariposa, MS 6090, Sacramento, CA 95819, USA
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Zhang X, Li J, Tang G, Wang Z, Guo Q, Guo Q, Qin Q, Fan Y. The prevalence and factors of willingness to accept circumcision among MSM in Maanshan City, China. AIDS Care 2024; 36:752-761. [PMID: 38266488 DOI: 10.1080/09540121.2023.2299664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
To investigate the prevalence of male circumcision and the willingness to undergo male circumcision and influencing factors among MSM in Maanshan City, we conducted a cross-sectional study from June 2016 to December 2019. Respondent-driven sampling (RDS) was used to recruit participants. Influential factors of willingness to accept circumcision were identified by a multivariable logistic regression model. The multivariable logistic regression model revealed that five variables were independent influential factors for willingness to participate. The factors include that used condoms during last anal intercourse (OR = 1.87, 95% CI:1.03-3.41, P = 0.04), sex with female sex partners (OR = 0.499, 95% CI:0.298-0.860, P = 0.012, level of education (junior college: OR = 0.413, 95% CI:0.200-0.854, P = 0.017; bachelor's degree or higher: OR = 0.442, 95% CI:0.208-0.938, P = 0.033), condom use during oral sex in the last six months (OR = 4.20, 95% CI:1.47-12.0, P = 0.007) and level of knowledge of PrEP (OR = 5.09, 95% CI:1.39-18.7, P = 0.014). Given the willingness of MSM to accept circumcision was low in China, establishing a proper understanding of circumcision is essential if it is to be used as a strategy to prevent HIV infection among MSM. Therefore, publicity and education on the operation should be strengthened to increase the willingness to undergo male circumcision.
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Affiliation(s)
- Xinhong Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, People's Republic of China
| | - Jianwei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Gan Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, People's Republic of China
| | - Ziwei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, People's Republic of China
| | - Qian Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, People's Republic of China
| | - Qisheng Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, People's Republic of China
| | - Qirong Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Ma'anshan Center for Disease Control and Prevention, Ma'anshan, People's Republic of China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, People's Republic of China
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Jackson KJ, Chitle P, McCoy SI, White DAE. A Systematic Review of HIV Pre-exposure Prophylaxis (PrEP) Implementation in U.S. Emergency Departments: Patient Screening, Prescribing, and Linkage to Care. J Community Health 2024; 49:499-513. [PMID: 38127296 PMCID: PMC10981603 DOI: 10.1007/s10900-023-01320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
In the pursuit of ending the HIV epidemic, U.S. emergency departments (EDs) have emerged as a valuable setting to increase HIV testing and linkage to care. There is limited data available, however, describing the incorporation of HIV prevention initiatives in U.S. EDs. Over the last decade, HIV pre-exposure prophylaxis (PrEP) has significantly changed the HIV prevention landscape globally and very little is known about the provision of PrEP in U.S. EDs. To address this gap in the literature, we conducted a systematic review of peer-reviewed quantitative studies and conference abstracts spanning July 2012 - October 2022. Of 433 citations, 11 articles and 13 abstracts meet our inclusion criteria, representing 18 unique studies addressing PrEP screening, prescribing, and/or linkage to PrEP care.Most studies describe screening processes to identify PrEP-eligible patients (n = 17); most studies leveraged a patient's STI history as initial PrEP eligibility screening criteria. Fewer studies describe PrEP prescribing (n = 2) and/or linkage to PrEP care (n = 8).Findings from this systematic review highlight the potential for U.S. EDs to increase PrEP uptake among individuals at risk for HIV infection. Despite a growing number of studies exploring processes for incorporating PrEP into the ED setting, such studies are small-scale and time limited. Models providing prescribing PrEP in the ED show higher initiation rates than post-discharge engagement models. Electronic health record (EHR)-based HIV screening is valuable, but post-ED linkage rates are low. Our findings emphasize the need to establish best practices for initiating and supporting prevention effective PrEP use in the ED setting.
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Affiliation(s)
- Kristopher J Jackson
- Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th Street - 3rd Floor, San Francisco, CA, 94158, USA.
| | - Pooja Chitle
- School of Public Health, University of California, Berkeley, CA, USA
| | - Sandra I McCoy
- School of Public Health, University of California, Berkeley, CA, USA
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Leonard A, Duroseau B. Overview of the Epidemiology and Clinical Care Considerations for Adolescents and Young Adults Living with or at Risk of Human Immunodeficiency Virus. Nurs Clin North Am 2024; 59:329-344. [PMID: 38670698 PMCID: PMC11058420 DOI: 10.1016/j.cnur.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
This article provides an updated examination of human immunodeficiency virus (HIV) epidemiologic trends among adolescents and young adults (AYAs) in the United States, highlighting the significant public health challenge posed by HIV within this demographic. Despite a notable decline in HIV diagnoses among AYAs, challenges remain, particularly due to 50% of AYAs living with HIV being unaware of their status. The article aims to evaluate current clinical recommendations, identify deficiencies, and propose evidence-based improvements for HIV prevention, diagnosis, and care, with the goal of enhancing health outcomes and reducing HIV prevalence among AYAs.
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Affiliation(s)
- Adam Leonard
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins School of Nursing, Baltimore, MD, USA; Community Health Systems, University of California, San Francisco School of Nursing, San Francisco, CA, USA.
| | - Brenice Duroseau
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins School of Nursing, Baltimore, MD, USA. https://twitter.com/thenpthatcares
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Junkins A, Kempf MC, Burkholder G, Ye Y, Chu DI, Wiener HW, Szychowski JM, Shrestha S. Sexual risk characteristics, social vulnerability, and anal cancer screening uptake among men living with HIV in the deep south. AIDS Care 2024; 36:762-770. [PMID: 38268443 PMCID: PMC11035097 DOI: 10.1080/09540121.2023.2299747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
ABSTRACTWithout standard guidelines, there is a critical need to examine anal cancer screening uptake in the South which has the highest HIV incidence in the U.S. We identified factors associated with screening among men living with HIV (MLHIV) at a large academic HIV outpatient clinic in Alabama. Relationships between sociodemographic, clinical, sexual risk characteristics and screening were examined using T-tests, Fisher's exact, Chi-square, and logistic regression analyses. Unadjusted and adjusted odds ratios (AOR) were computed to estimate the odds of screening. Among 1,114 men, 52% had received annual anal cytology (pap) screening. Men who were screened were more likely to have multiple sexual partners compared to men who were not screened (22.8% vs. 14.8%, p = 0.002). Among men with one partner, the youngest were almost five times more likely to be screened compared to middle-aged men (AOR = 4.93, 95% CI: 2.34-10.39). Heterosexual men had lower odds and men who reported unprotected anal sex had higher odds of screening. Our findings suggest a racial disparity, with older black MLHIV being the least likely to be screened. In the South, MLHIV who are older, black, heterosexual, or live in high social vulnerability counties may be less likely to receive annual anal cancer screening.
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Affiliation(s)
- Anna Junkins
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mirjam-Colette Kempf
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Greer Burkholder
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yuanfan Ye
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel I. Chu
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Howard W. Wiener
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeff M. Szychowski
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sadeep Shrestha
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Guillaume D. The Impact of Human Immunodeficiency Virus on Women in the United States. Nurs Clin North Am 2024; 59:165-181. [PMID: 38670687 DOI: 10.1016/j.cnur.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Substantial improvements have been made in reducing HIV incidence rates among women in the United States. However, numerous disparities affect women's risk of HIV acquisition, in addition to affecting treatment outcomes for women living with HIV. As people with HIV continue to live longer due to antiretroviral therapy, clinicians must be cognizant of various health, financial, and social implications that can affect HIV self-management. Successfully ending the HIV epidemic will require more targeted approaches on prevention, linkage to care, and treatment while also addressing underlying factors that affect women's engagement in HIV-related services across the HIV care continuum.
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Affiliation(s)
- Dominique Guillaume
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Baltimore, MD 21205, USA.
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Raza HA, Raja MHR, Khakwani MM, Jamil B. Pakistan's HIV high-risk populations: Critical appraisal of failure to curtail spread beyond key populations. IJID Reg 2024; 11:100364. [PMID: 38660580 PMCID: PMC11039346 DOI: 10.1016/j.ijregi.2024.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
Pakistan has been a hub of several HIV outbreaks over the last 2 decades, with four major outbreaks being registered since 2018. There has been a recent rise in HIV infections, especially in high-risk populations, mainly consisting of people who inject drugs, men who have sex with men, prisoners, the transgender women community, and female sex workers. Consistently poor infection control practices, unregulated unsafe blood transfusion, questionable ethical practices by healthcare providers, and a general lack of awareness are the main drivers of recent HIV outbreaks, with these issues exacerbated by the presence of untrained health care providers. To stop the spread of HIV systemically and sustainably, aggressive measures need to be taken at all levels by all concerned stakeholders that not only deal with building up testing, tracing, and treatment capabilities but also address underlying grassroots problems that have largely been ignored to date.
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Affiliation(s)
- Hussain Ahmed Raza
- Department for Educational Development, The Aga Khan University, Karachi, Pakistan
| | | | | | - Bushra Jamil
- Section of Infectious Diseases, Department of Medicine, The Aga Khan University Hospital, National Coordinator (2021), Common Management Unit for Global Funds (AIDS, TB and Malaria Grants), Ministry of National Health Services Regulations and Coordination, Karachi, Pakistan
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McGee KS. Overview of the US National HIV Strategy and Ending the HIV Epidemic Initiative. Nurs Clin North Am 2024; 59:297-308. [PMID: 38670696 DOI: 10.1016/j.cnur.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
The US National HIV/AIDS Strategy (NHAS) is a comprehensive plan that outlines specific goals for Ending the HIV Epidemic in the United States (EHE) by 2025. The strategy also provides specific strategies to prevent new HIV infections and improve health outcomes for people with HIV. The EHE is a companion document which focuses on achieving the goals of the NHAS in specific US jurisdictions where the HIV epidemic is concentrated. This article provides an overview of the NHAS and EHE and provides examples of programs and strategies that can be used to end the HIV epidemic in the United States.
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Affiliation(s)
- Kara S McGee
- MSN Program, Division of Infectious Diseases, Duke University School of Nursing, Duke University School of Medicine, 307 Trent Drive, Box 3322, Durham, NC 27710, USA.
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Prince MA, Tan MC, Tan MX, George H, Prince EO, Nicholas RM, Shaaban H, Slim J. Exploring the impact of therapeutic advances in HIV-related mortality in the United States. IJID Reg 2024; 11:100347. [PMID: 38584850 PMCID: PMC10997884 DOI: 10.1016/j.ijregi.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 04/09/2024]
Abstract
Objectives Mortality from HIV has significantly declined with the introduction of highly active antiretroviral therapy (HAART). This study sought to examine the longitudinal trends in mortality from HIV-related diseases by race, sex, geographical region, and over time as HAART trends changed. Methods We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database and performed serial cross-sectional analyses of national death certificate data for all-cause mortality with comorbid HIV from 1999 to 2020. HIV diseases (International Classification of Diseases, Tenth Revision codes B20-B24, O98.7, R75) were listed as the contributing cause of death. We calculated the age-adjusted mortality ratio (AAMR) per 1,000,000 individuals and determined mortality trends using the Joinpoint Regression Program. Subgroup analyses were performed by sex, race, region, and organ system. The study period was further stratified into three groups when specific drug regimens were more prevalent. Results In the 22-year study period, 251,759 all-cause mortalities with comorbid HIV were identified. The leading cause of death was infectious disease (84.0%, N = 211,438). Men recorded a higher AAMR than women (4.66 vs 1.65, P < 0.01). African American individuals had the highest AAMR (13.46) compared to White, American Indian, and Asian individuals (1.70 vs 1.65 vs 0.47). The South region had the highest AAMR (4.32) and urban areas had a higher AAMR compared to rural areas (1.77 vs 0.88). Conclusions More than 80% of deaths occurred because of infectious disease over the last 2 decades with a decreasing trend over time when stratified by race, sex, and geographical region. Despite advances in HAART, mortality disparities persist which emphasizes the need for targeted interventions in these populations.
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Affiliation(s)
- Monique A Prince
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | - Min-Choon Tan
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | | | | | | | | | - Hamid Shaaban
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | - Jihad Slim
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA
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Rozanova J, Zaviryukha I, Deac AA, Zeziulin O, Kiriazova T, Earnshaw V, Rich KM, Shenoi SV, Skipper H, Yariy V, Strang SJ. Human costs of healthcare resilience during the war in Ukraine: Lessons from addiction and HIV treatment. Addiction 2024; 119:980-983. [PMID: 38130082 DOI: 10.1111/add.16406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Julia Rozanova
- Department of Health Service and Population Research, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- AIDS Program, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Alexandra A Deac
- Department of Health Service and Population Research, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, United States
| | | | | | - Valerie Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware, USA
| | | | - Sheela V Shenoi
- Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Harry Skipper
- Kyiv Addiction Treatment Clinic "Sociotherapy", Kyiv, Ukraine
| | - Volodymyr Yariy
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Sir John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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41
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Deng Q, Guo T, Qiu Z, Chen Y. A mathematical model for HIV dynamics with multiple infections: implications for immune escape. J Math Biol 2024; 89:6. [PMID: 38762831 DOI: 10.1007/s00285-024-02104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/15/2023] [Accepted: 04/25/2024] [Indexed: 05/20/2024]
Abstract
Multiple infections enable the recombination of different strains, which may contribute to viral diversity. How multiple infections affect the competition dynamics between the two types of strains, the wild and the immune escape mutant, remains poorly understood. This study develops a novel mathematical model that includes the two strains, two modes of viral infection, and multiple infections. For the representative double-infection case, the reproductive numbers are derived and global stabilities of equilibria are obtained via the Lyapunov direct method and theory of limiting systems. Numerical simulations indicate similar viral dynamics regardless of multiplicities of infections though the competition between the two strains would be the fiercest in the case of quadruple infections. Through sensitivity analysis, we evaluate the effect of parameters on the set-point viral loads in the presence and absence of multiple infections. The model with multiple infections predict that there exists a threshold for cytotoxic T lymphocytes (CTLs) to minimize the overall viral load. Weak or strong CTLs immune response can result in high overall viral load. If the strength of CTLs maintains at an intermediate level, the fitness cost of the mutant is likely to have a significant impact on the evolutionary dynamics of mutant viruses. We further investigate how multiple infections alter the viral dynamics during the combination antiretroviral therapy (cART). The results show that viral loads may be underestimated during cART if multiple-infection is not taken into account.
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Affiliation(s)
- Qi Deng
- School of Mathematics and Statistics, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
- Department of Mathematics, Wilfrid Laurier University, Waterloo, N2L 3C5, Canada
| | - Ting Guo
- Aliyun School of Big Data, Changzhou University, Changzhou, 213164, People's Republic of China
| | - Zhipeng Qiu
- School of Mathematics and Statistics, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Yuming Chen
- Department of Mathematics, Wilfrid Laurier University, Waterloo, N2L 3C5, Canada.
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42
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Triant VA, Lyass A, Hurley LB, Borowsky LH, Ehrbar RQ, He W, Cheng D, Lo J, Klein DB, Meigs JB, Grinspoon SK, Plutzky J, Silverberg MJ, LaValley M, Massaro JM, D'Agostino RB. Cardiovascular Risk Estimation Is Suboptimal in People With HIV. J Am Heart Assoc 2024:e029228. [PMID: 38761071 DOI: 10.1161/jaha.123.029228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/16/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Established cardiovascular disease (CVD) risk prediction functions may not accurately predict CVD risk in people with HIV. We assessed the performance of 3 CVD risk prediction functions in 2 HIV cohorts. METHODS AND RESULTS CVD risk scores were calculated in the Mass General Brigham and Kaiser Permanente Northern California HIV cohorts, using the American College of Cardiology/American Heart Association atherosclerotic CVD function, the FHS (Framingham Heart Study) hard coronary heart disease function and the Framingham Heart Study hard CVD function. Outcomes were myocardial infarction or coronary death for FHS hard coronary heart disease function; and myocardial infarction, stroke, or coronary death for American College of Cardiology/American Heart Association and FHS hard CVD function. We calculated regression coefficients and assessed discrimination and calibration by sex; predicted to observed risk of outcome was also compared. In the combined cohort of 9412, 158 (1.7%) had a coronary heart disease event, and 309 (3.3%) had a CVD event. Among women, CVD risk was generally underestimated by all 3 risk functions. Among men, CVD risk was underestimated by the American College of Cardiology/American Heart Association and FHS hard CVD function, but overestimated by the FHS hard coronary heart disease function. Calibration was poor for women using the FHS hard CVD function and for men using all functions. Discrimination in all functions was good for women (c-statistics ranging from 0.78 to 0.90) and moderate for men (c-statistics ranging from 0.71 to 0.72). CONCLUSIONS Established CVD risk prediction functions generally underestimate risk in people with HIV. Differences in model performance by sex underscore the need for both HIV-specific and sex-specific functions. Development of CVD risk prediction models tailored to HIV will enhance care for aging people with HIV.
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Affiliation(s)
- Virginia A Triant
- Division of General Internal Medicine Massachusetts General Hospital Boston MA
- Division of Infectious Diseases Massachusetts General Hospital Boston MA
- Mongan Institute, Massachusetts General Hospital Boston MA
- Harvard Medical School Boston MA
| | - Asya Lyass
- Department of Mathematics and Statistics Boston University Boston MA
| | - Leo B Hurley
- Kaiser Permanente Northern California Oakland CA
| | - Leila H Borowsky
- Division of General Internal Medicine Massachusetts General Hospital Boston MA
| | - Rachel Q Ehrbar
- Department of Biostatistics Boston University School of Public Health Boston MA
| | - Wei He
- Division of General Internal Medicine Massachusetts General Hospital Boston MA
| | - David Cheng
- Biostatistics Center, Massachusetts General Hospital Boston MA
- Harvard Medical School Boston MA
| | - Janet Lo
- Metabolism Unit, Massachusetts General Hospital Boston MA
- Harvard Medical School Boston MA
| | | | - James B Meigs
- Division of General Internal Medicine Massachusetts General Hospital Boston MA
- Harvard Medical School Boston MA
| | - Steven K Grinspoon
- Metabolism Unit, Massachusetts General Hospital Boston MA
- Harvard Medical School Boston MA
| | - Jorge Plutzky
- Division of Cardiovascular Medicine Brigham and Women's Hospital Boston MA
- Harvard Medical School Boston MA
| | | | - Michael LaValley
- Department of Biostatistics Boston University School of Public Health Boston MA
| | - Joseph M Massaro
- Department of Biostatistics Boston University School of Public Health Boston MA
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Aluah CP, Robillard A, Billings D, Smallwood S. Courtesy Stigma and HIV Professionals: A Brief Review of Implications for Psychosocial and Professional Well-Being. Soc Work Public Health 2024; 39:368-378. [PMID: 38459705 DOI: 10.1080/19371918.2024.2325566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
The impact of HIV-related stigma on social workers, clinicians, counselors, and advocates working in organizations serving people living with HIV (PLWH), is rarely considered. Professionals experience "courtesy stigma" when working with or on behalf of PLWH, regardless of their personal HIV status. PubMed, Medline, and PsycInfo databases, along with a review of relevant reference lists and referrals, identified 13 studies addressing this phenomenon. Although limited, this brief review suggests that members of the HIV workforce do indeed face challenges that compromise their personal and professional well-being as a result of courtesy stigma. Addressing stigma among professionals is necessary to support the health of those working in the field, and to avoid undermining the efforts of this important workforce. More research is needed to understand the perceptions and experiences of courtesy stigma and how this stigma may adversely impact the psychological well-being, social functioning, and professional practice of HIV professionals.
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Affiliation(s)
- Christopher Peter Aluah
- Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
| | - Alyssa Robillard
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Deborah Billings
- Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
- Group Care Global, Philadelphia, PA, USA
| | - Stacy Smallwood
- Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University Statesboro, Statesboro, Georgia, USA
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Small L, Mellins C. Mental Health and Treatment Engagement among Low-Income Women of Color Living with HIV. Soc Work Public Health 2024; 39:393-404. [PMID: 38535437 DOI: 10.1080/19371918.2024.2323693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified.
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Affiliation(s)
- Latoya Small
- UCLA Luskin School of Public Affairs, Department of Social Welfare, Los Angeles, California, USA
| | - Claude Mellins
- Medical Psychology (in Sociomedical Sciences and Psychiatry), Columbia University and New York State Psychiatric Institute, New York, USA
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Psaros C, Stanton AM, Goodman GR, Blyler A, Vangel M, Labbe AK, Robbins GK, Park ER. A resiliency intervention adapted for older women with HIV: Results from a pilot randomized controlled trial in the northeastern US. J Health Psychol 2024:13591053241253050. [PMID: 38761072 DOI: 10.1177/13591053241253050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2024] Open
Abstract
Aging with HIV often results in psychosocial and health-related challenges for women; however, no resiliency interventions exist for older women with HIV (WWH). WWH aged ≥50 were randomized to 10 group sessions of an adapted resiliency intervention or time-matched supportive psychotherapy. Assessments were conducted at three timepoints. Feasibility and acceptability metrics were defined a priori; differences in resilience, stress coping, anxiety, and depression across timepoints were assessed. Overall, 44 WWH enrolled; participants were 58 years old on average, and 56.4% identified as Black/African American. Among those who attended any sessions, all feasibility metrics were met, and the intervention was acceptable. The interaction of study arm and time was associated with significant decreases in depression and a trend toward significant decreases in anxiety. The intervention was not associated with changes in resilience or stress coping. Adjusting delivery modality may further reduce barriers to attendance, improving feasibility and clinical outcomes.
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Affiliation(s)
| | | | - Georgia R Goodman
- Massachusetts General Hospital, USA
- The Fenway Institute, Fenway Health, USA
- Brigham and Women's Hospital, USA
| | - Abigail Blyler
- Massachusetts General Hospital, USA
- University of Pennsylvania, USA
| | - Mark Vangel
- Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | - Allison K Labbe
- Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | | | - Elyse R Park
- Massachusetts General Hospital, USA
- Harvard Medical School, USA
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Tabei SS, Kataria R, Hou S, Singh A, Al Hameedi H, Hasan D, Hsieh M, Raheem OA. Testosterone replacement therapy in patients with cachexia: a contemporary review of the literature. Sex Med Rev 2024:qeae031. [PMID: 38757386 DOI: 10.1093/sxmrev/qeae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Patients with long-term chronic illnesses frequently present with hypogonadism, which is primarily managed through exogenous testosterone. These same patients also experience a high degree of cachexia, a loss of skeletal muscle and adipose tissue. OBJECTIVE To perform a contemporary review of the literature to assess the effectiveness of testosterone replacement therapy (TRT) for managing chronic disease-associated cachexia. METHODS We performed a PubMed literature search using MeSH terms to identify studies from 2000 to 2022 on TRT and the following cachexia-related chronic medical diseases: cancer, COPD, HIV/AIDS, and liver cirrhosis. RESULTS From the literature, 11 primary studies and 1 meta-analysis were selected. Among these studies, 3 evaluated TRT on cancer-associated cachexia, 3 on chronic obstructive pulmonary disease, 4 on HIV and AIDS, and 2 on liver cirrhosis. TRT showed mixed results favoring clinical improvement on each disease. CONCLUSIONS Cachexia is commonly observed in chronic disease states. Its occurrence with hypogonadism, alongside the shared symptoms of these 2 conditions, points toward the management of cachexia through the administration of exogenous testosterone. Robust data in the literature support the use of testosterone in increasing lean body mass, improving energy levels, and enhancing the quality of life for patients with chronic disease. However, the data are variable, and further studies are warranted on the long-term efficacy of TRT in patients with cachexia.
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Affiliation(s)
- Seyed Sajjad Tabei
- Division of Urology, Department of Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Rhea Kataria
- Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, IL 60637, United States
| | - Sean Hou
- Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, IL 60637, United States
| | - Armaan Singh
- Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, IL 60637, United States
| | - Hasan Al Hameedi
- Section of Urology, Department of Surgery, Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, IL 60637, United States
| | - Doaa Hasan
- Section of Urology, Department of Surgery, Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, IL 60637, United States
| | - Mike Hsieh
- Department of Urology, University of California San Diego, San Diego, CA 921212, United States
| | - Omer A Raheem
- Section of Urology, Department of Surgery, Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, IL 60637, United States
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Katlama C, Bisshop F, Bogner J, Pérez Elías MJ, Di Giambenedetto S, Clarke E, Hodder S, Nwokolo N, Ait-Khaled M, Oyee J, Grove R, Wynne B, Okoli C, Jones B, Kisare M. Efficacy and safety of dolutegravir/lamivudine in virologically suppressed female participants: week 48 data from the pooled TANGO and SALSA studies. HIV Med 2024. [PMID: 38760011 DOI: 10.1111/hiv.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/24/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES Women represent >50% of people with HIV globally but have historically been underrepresented in clinical trials. We evaluated the efficacy and safety of switching to dolutegravir/lamivudine (DTG/3TC) vs continuing their current antiretroviral regimen (CAR) by sex assigned at birth (female and male) in virologically suppressed adults with HIV-1 without prior virological failure in a pooled analysis of two randomized controlled trials. METHODS This analysis included 48-week data from the phase 3 TANGO and SALSA studies. Primary and key secondary endpoints included proportions of participants with HIV-1 RNA ≥50 and <50 copies/mL at week 48, respectively. Safety was also assessed. RESULTS Of 1234 participants, 250 (DTG/3TC, n = 133; CAR, n = 117) were female at birth. Week 48 proportions of participants with Snapshot HIV-1 RNA ≥50 copies/mL were similar regardless of sex at birth (DTG/3TC vs CAR: female, <1% [1/133] vs 2% [2/117]; male, <1% [1/482] vs <1% [3/502]). Proportions with HIV-1 RNA <50 copies/mL were high across sexes and treatment groups (DTG/3TC vs CAR: female, 91% [121/133] vs 89% [104/117]; male, 94% [455/482] vs 94% [471/502]). Immunological response with DTG/3TC was slightly higher in female participants. Incidences of adverse events leading to withdrawal and serious adverse events were low and comparable between treatment groups and across sexes. Weight gain was higher with DTG/3TC than with CAR among female participants aged ≥50 years (treatment difference 2.08 kg [95% confidence interval 0.40-3.75]). CONCLUSIONS Results confirm the robustness of DTG/3TC as a switch option in virologically suppressed females with HIV-1, with outcomes similar to those in males.
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Affiliation(s)
- C Katlama
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, INSERM-Sorbonne Universités, Paris, France
| | - F Bisshop
- Holdsworth House Medical Brisbane, Fortitude Valley, Queensland, Australia
| | - J Bogner
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - S Di Giambenedetto
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Clarke
- Axess Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - S Hodder
- West Virginia Clinical and Translational Science Institute, Morgantown, West Virginia, USA
| | | | | | | | | | - B Wynne
- ViiV Healthcare, Durham, North Carolina, USA
| | - C Okoli
- ViiV Healthcare, Brentford, UK
| | - B Jones
- ViiV Healthcare, Brentford, UK
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Adegboye OA, Fujii T, Leung DHY, Siyu L. HIV estimation using population-based surveys with non-response: A partial identification approach. Stat Med 2024. [PMID: 38757791 DOI: 10.1002/sim.10108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 04/21/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
HIV estimation using data from the demographic and health surveys (DHS) is limited by the presence of non-response and test refusals. Conventional adjustments such as imputation require the data to be missing at random. Methods that use instrumental variables allow the possibility that prevalence is different between the respondents and non-respondents, but their performance depends critically on the validity of the instrument. Using Manski's partial identification approach, we form instrumental variable bounds for HIV prevalence from a pool of candidate instruments. Our method does not require all candidate instruments to be valid. We use a simulation study to evaluate and compare our method against its competitors. We illustrate the proposed method using DHS data from Zambia, Malawi and Kenya. Our simulations show that imputation leads to seriously biased results even under mild violations of non-random missingness. Using worst case identification bounds that do not make assumptions about the non-response mechanism is robust but not informative. By taking the union of instrumental variable bounds balances informativeness of the bounds and robustness to inclusion of some invalid instruments. Non-response and refusals are ubiquitous in population based HIV data such as those collected under the DHS. Partial identification bounds provide a robust solution to HIV prevalence estimation without strong assumptions. Union bounds are significantly more informative than the worst case bounds without sacrificing credibility.
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Affiliation(s)
- Oyelola A Adegboye
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Tomoki Fujii
- School of Economics, Singapore Management University, Singapore, Singapore
| | | | - Li Siyu
- School of Economics, Singapore Management University, Singapore, Singapore
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Kebede HK, Gesesew HA, Gebremedhin AT, Ward P. The impact of armed conflicts on HIV treatment outcomes in Sub-Saharan Africa: a systematic review and meta-analysis. Confl Health 2024; 18:40. [PMID: 38760792 DOI: 10.1186/s13031-024-00591-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/28/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Despite the fact that Sub-Saharan Africa bears a disproportionate burden of armed conflicts and HIV infection, there has been inadequate synthesis of the impact of armed conflict on HIV treatment outcomes. We summarized the available evidence on the impact of armed conflicts on HIV treatment outcomes in Sub-Saharan Africa from 2002 to 2022. METHODS We searched four databases; MEDLINE, PubMed, CINHAL, and Scopus. We also explored grey literature sources and reviewed the bibliographies of all articles to identify any additional relevant studies. We included quantitative studies published in English from January 1, 2002 to December 30, 2022 that reported on HIV treatment outcomes for patients receiving antiretroviral therapy (ART) in conflict and post-conflict areas, IDP centers, or refugee camps, and reported on their treatment outcomes from sub-Saharan Africa. Studies published in languages other than English, reporting on non-ART patients and reporting on current or former military populations were excluded. We used EndNote X9 and Covidence to remove duplicates, extracted data using JBI-MAStARI, assessed risk of bias using AHRQ criteria, reported results using PRISMA checklist, and determined Statistical heterogeneity using Cochran Q test and Higgins I2, R- and RevMan-5 software were used for meta-analysis. RESULTS The review included 16 studies with participant numbers ranging from 102 to 2572. Lost To Follow-Up (LTFU) percentages varied between 5.4% and 43.5%, virologic non-suppression rates ranged from 25 to 33%, adherence rates were over 88%, and mortality rates were between 4.2% and 13%. A pooled meta-analysis of virologic non-suppression rates from active conflict settings revealed a non-suppression rate of 30% (0.30 (0.26-0.33), I2 = 0.00%, p = 0.000). In contrast, a pooled meta-analysis of predictors of loss to follow-up (LTFU) from post-conflict settings identified a higher odds ratio for females compared to males (1.51 (1.05, 2.17), I2 = 0%, p = 0.03). CONCLUSION The review highlights a lack of research on the relationship between armed conflicts and HIV care outcomes in SSA. The available documents lack quality of designs and data sources, and the depth and diversity of subjects covered.
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Affiliation(s)
- Hafte Kahsay Kebede
- Tigray Health Research Institute, Mekelle, Tigray, Ethiopia.
- College of Health Sciences, Mekelle University, Mekelle, 231, Ethiopia.
- Research Centre for Public Health, Equity, and Human Flourishing, Torrens University Australia, Adelaide, 5000, Australia.
| | - Hailay Abrha Gesesew
- College of Health Sciences, Mekelle University, Mekelle, 231, Ethiopia
- Research Centre for Public Health, Equity, and Human Flourishing, Torrens University Australia, Adelaide, 5000, Australia
| | - Amanuel Tesfay Gebremedhin
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia
- School of Nursing and Midwifery, Edith Cowan University, Perth, Australia
| | - Paul Ward
- Research Centre for Public Health, Equity, and Human Flourishing, Torrens University Australia, Adelaide, 5000, Australia
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Namusisi P, Yeh PT, Ssekubugu R, Chang LW, Lutalo T, Zimmerman L, Grabowski MK. The intersection between migration, HIV, and contraceptive use in Uganda: a cross-sectional population-based study. Reprod Health 2024; 21:65. [PMID: 38760855 DOI: 10.1186/s12978-024-01796-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/20/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Low use of modern methods of contraception has been linked to HIV seropositivity and to migration, but few studies have evaluated the intersection of both risk factors with contraceptive use. METHODS We analyzed cross-sectional data from sexually active female participants aged 15 to 49 years in the Rakai Community Cohort Study (RCCS) between 2011 and 2013. The RCCS is an open population-based census and individual survey in south-central Uganda. Recent in-migrants (arrival within approximately 1.5 years) into RCCS communities were identified at time of household census. The primary outcome was unsatisfied demand for a modern contraceptive method (injectable, oral pill, implant, or condom), which was defined as non-use of a modern contraceptive method among female participants who did not want to become pregnant in the next 12 months. Poisson regression models with robust variance estimators were used to identify associations and interactions between recent migration and HIV serostatus on unsatisfied contraceptive demand. RESULTS There were 3,417 sexually active participants with no intention of becoming pregnant in the next year. The mean age was 30 (± 8) years, and 17.3% (n = 591) were living with HIV. Overall, 43.9% (n = 1,500) were not using any modern contraceptive method. Recent in-migrants were somewhat more likely to have unsatisfied contraceptive demand as compared to long-term residents (adjusted prevalence risk ratio [adjPRR] = 1.14; 95% confidence interval [95%CI]: 1.02-1.27), whereas participants living with HIV were less likely to have unsatisfied contraceptive demand relative to HIV-seronegative participants (adjPRR = 0.80; 95%CI = 0.70-0.90). When stratifying on migration and HIV serostatus, we observed the highest levels of unsatisfied contraceptive demand among in-migrants living with HIV (48.7%); however, in regression analyses, interaction terms between migration and HIV serostatus were not statistically significant. CONCLUSIONS Unsatisfied contraceptive demand was high in this rural Ugandan setting. Being an in-migrant, particularly among those living with HIV, was associated with higher unsatisfied contraceptive demand.
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Grants
- D43TW010557 National Institutes of Health Fogarty International Center
- D43TW010557 National Institutes of Health Fogarty International Center
- D43TW010557 National Institutes of Health Fogarty International Center
- R01AI087409, U01AI075115, U01AI100031 National Institute of Allergy and Infectious Diseases
- R01AI087409, U01AI075115, U01AI100031 National Institute of Allergy and Infectious Diseases
- R01AI087409, U01AI075115, U01AI100031 National Institute of Allergy and Infectious Diseases
- R01AI087409, U01AI075115, U01AI100031 National Institute of Allergy and Infectious Diseases
- R01HD050180, R01HD070769 National Institute of Child Health and Human Development
- R01HD050180, R01HD070769 National Institute of Child Health and Human Development
- R01HD050180, R01HD070769 National Institute of Child Health and Human Development
- R01HD050180, R01HD070769 National Institute of Child Health and Human Development
- F31MH095649, R01MH099733 NIMH NIH HHS
- F31MH095649, R01MH099733 NIMH NIH HHS
- F31MH095649, R01MH099733 NIMH NIH HHS
- F31MH095649, R01MH099733 NIMH NIH HHS
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Affiliation(s)
- Prossy Namusisi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Kawempe National Referral Hospital, Kampala, Uganda.
| | - Ping Teresa Yeh
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Larry William Chang
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Tom Lutalo
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - Linnea Zimmerman
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mary Kathryn Grabowski
- Rakai Health Sciences Program, Kalisizo, Uganda
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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