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4.
Title: Evaluation of transmitted HIV drug resistance among recently-infected antenatal clinic attendees in four Central African countries.
Author: Aghokeng AF; Vergne L; Mpoudi-Ngole E; Mbangue M; Deoudje N; Mokondji E; Nambei WS; Peyou-Ndi MM; Moka JJ; Delaporte E; Peeters M
Source: Antiviral therapy. 2009;14(3):401-11.
Abstract: BACKGROUND: The rapid expansion of antiretroviral treatment in resource-limited settings is raising concerns regarding the emergence and transmission of HIV drug resistance (HIVDR). We evaluated the extent of transmission of drug-resistant HIV strains in four Central African countries: the Republic of Congo, Central African Republic, Chad and Cameroon. METHODS: The World Health Organization (WHO) HIVDR threshold survey was implemented in major treatment areas in each country. Pregnant women who were aged <25 years, who were at first pregnancy and who were HIV type-1-positive were enrolled at each site in 2006-2007 for genotyping. HIVDR prevalence was categorized using the WHO threshold survey binomial sequential sampling method. RESULTS: The prevalence of HIVDR in Brazzaville and Bangui sites could not be classified because the eligible sample number was not reached. HIVDR prevalence was low (<5%) in N'Djamena for all drug classes. In Yaounde, we found one individual with the D67D/N mutation and two with K103N. HIVDR prevalence was categorized as low (<5%) for protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs), and moderate (> or =5-< or =15%) for non-NRTIs (NNRTIs). HIVDR prevalence in Douala was low for PIs and NNRTIs, and moderate for NRTIs as we identified one individual with M184V plus K101E plus G190A mutations and a second with D67D/N. CONCLUSIONS: The moderate HIVDR prevalence found in Yaounde and Douala indicate that efforts should be made in Cameroon to prevent HIVDR; however, additional surveys are needed to confirm this trend. This study highlighted challenges presented by the WHO methodology, such as additional costs, workload, difficulties in acquiring even small sample numbers and the necessity for better quality assurance of HIV testing and record keeping at antenatal clinics.
Language: English
Keywords:
CAMEROON | CENTRAL AFRICAN REPUBLIC | CHAD | REPUBLIC OF THE CONGO | RESEARCH REPORT | SAMPLING STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PREVALENCE | ANTENATAL CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care
Document Number: 342346

Peer Reviewed

Title: Preventing transfusion-transmitted HIV infection in Latin America and the Caribbean: issues associated with blood donor interviews and sex between men.
Author: Alonso M; Mazin R; Md RM; Cruz JR
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S67-72.
Abstract: BACKGROUND: Blood-borne transmission is the most efficient route for acquiring HIV infection, particularly through transfusion. Availability of noninfectious blood units for hemotherapy is a necessary condition for efficient functioning of health services. They have the obligation to ensure that the blood supply is safe, which includes interviewing potential donors to ascertain whether they might be at risk of being HIV infected. The interview procedures demand that blood services staff inquire potential blood donors about sexual practices associated to HIV transmission. Assumptions and misconceptions may unnecessary exclude adequate donors. METHODS: Review of published and unpublished country reports in Latin America regarding blood safety and deferral criteria related to same sexual behavior among males. RESULTS: An analysis of criteria for deferral of potential blood donors shows inconsistencies that may impact the necessary safe blood supply. CONCLUSIONS: The blood donor deferral criteria should be revised according to relevant epidemiological evidence and social legitimacy. Personnel in blood banks and hemotherapy services should be educated to conduct appropriate interviews for accepting or deferring potential donors. Potential donors and the public should be knowledgeable for them to understand the reasons why some individuals may be deferred. Health authorities should work to reduce the stigma associated with HIV, prioritize building strong and meaningful partnerships with civil society, and engage diverse sectors in the national AIDS response.
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HIV INFECTIONS | HIV TRANSMISSION | BLOOD DONORS | SAFETY | STIGMA | HOMOSEXUALS | BLOOD TRANSFUSION | Americas | Developing Countries | Sex Behavior | Behavior | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Social Problems | Sociocultural Factors | Treatment
Document Number: 341318

Peer Reviewed

Title: Intentional condomless anal intercourse among Latino MSM who meet sexual partners on the Internet.
Author: Balan IC; Carballo-Dieguez A; Ventuneac A; Remien RH
Source: AIDS Education and Prevention. 2009 Feb;21(1):14-24.
Abstract: Data on intentional condomless anal intercourse in risky contexts, also known as "barebacking," among ethnic minority MSM, whose rates of HIV infection continue to rise, are extremely limited. In this study, 31 Latino MSM who seek barebacking partners via the Internet underwent in-depth interviews about bareback sex and its association to pleasure, substance use, HIV concerns, and cultural identity. Participants reported engaging in bareback sex owing to the physical and emotional pleasure they experience. They expressed concern about HIV infection and took steps to reduce risk of infection. Although a majority of participants reported using alcohol or drugs in the context of bareback sex, substance use did not appear to propel the behavior. Crystal methamphetamine use, prevalent only among our HIV-positive participants, was related to very high HIV risk behavior. In this sample, culture did not seem to play a large role in barebacking.
Language: English
Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | ETHNIC GROUPS | ANAL SEX | CONDOM USE | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | PARTNER COMMUNICATION | DRUG USE AND ABUSE | HIV TRANSMISSION | PERCEPTION | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Cultural Background | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Information Networks | Communication | Interpersonal Relations | HIV Infections | Viral Diseases | Diseases | Psychological Factors
Document Number: 330344

Peer Reviewed

Title: Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts ("Bareback Sex") among men who have sex with men.
Author: Bauermeister JA; Carballo-Dieguez A; Ventuneac A; Dolezal C
Source: AIDS Education and Prevention. 2009 Apr;21(2):156-68.
Abstract: Although condom use is an effective barrier against HIV transmission, some men who have sex with men (MSM) engage in bareback sex (unprotected anal sex in risky contexts) and increase their risk for HIV (re)infection. Understanding MSM's decision to bareback (vis-a-vis condom use) is essential to develop effective HIV/AIDS prevention programs for this population. An ethnically diverse sample of men who bareback (n = 120) was recruited exclusively on the Internet and stratified to include two thirds who reported both unprotected receptive anal intercourse (URAI) and being HIV uninfected. We used exploratory factor analysis to explore the domains within the Decisional Balance to Bareback (DBB) scale, and test the association between DBB and risky sexual behaviors. HIV-positive MSM (n = 31) reported higher costs/losses associated with condom use than HIV-negative men (n = 89). We found two underlying factors in the DBB scale: a Coping with Social Vulnerabilities subscale (eight items; alpha = .89) and a Pleasure and Emotional Connection subscale (five items; alpha = .92). We found a positive association between DBB (i.e. greater gains associated with bareback sex) and URAI occasions, number of partners, and having one or more sero-discordant partners in the past 3 months. We conclude that because MSM may avoid using condoms in order to cope with psychosocial vulnerabilities and create intimacy with other MSM, this population could benefit from alternatives to condoms such as pre/post exposure prophylaxis and rectal microbicides.
Language: English
Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | FACTOR ANALYSIS | ANAL SEX | CONDOM USE | HIV TRANSMISSION | DECISION MAKING | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | EMOTIONS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Data Analysis | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Information Networks | Communication | Psychological Factors
Document Number: 331286

10.

Peer Reviewed

Title: Kaposi sarcoma-associated herpesvirus (KSHV) seroprevalence in population-based samples of African children: evidence for at least 2 patterns of KSHV transmission.
Author: Butler LM; Dorsey G; Hladik W; Rosenthal PJ; Brander C; Neilands TB; Mbisa G; Whitby D; Kiepiela P; Mosam A; Mzolo S; Dollard SC; Martin JN
Source: Journal of Infectious Diseases. 2009 Aug 1;200(3):430-8.
Abstract: BACKGROUND: Kaposi sarcoma-associated herpesvirus (KSHV) infection is endemic among adult populations in Africa. A prevailing view is that childhood transmission is primarily responsible for the high seroprevalence of KSHV among adults that is observed throughout the continent. However, few studies have directly examined children, particularly in locations where KS is not commonly endemic. METHODS: Participants were children aged 1.5-8.9 years, including 427 children from a population-based sample in South Africa, 422 from a population-based sample in Uganda, and 567 from a clinic-based sample in Uganda. All serum specimens were tested by the same laboratory for KSHV antibodies with use of 2 enzyme immunoassays (against K8.1 and ORF65) and 1 immunofluorescence assay. RESULTS: KSHV seroprevalence was 7.5%-9.0% among South African children and was not associated with age. In contrast, in the Ugandan population-based sample, KSHV seroprevalence increased from 10% among 2-year-old children to 30.6% among 8-year-old children ([Formula: see text]). In the Ugandan clinic-based sample, seroprevalence increased from 9.3% among 2-year-old children to 36.4% among 8-year-old children ([Formula: see text]). CONCLUSION: Two distinct relationships between age and KSHV infection among children imply that KSHV transmission among children is not uniform throughout Africa and is therefore not always responsible for the high seroprevalence observed in adults. There are at least 2 patterns of KSHV transmission in Africa.
Language: English
Keywords:
SOUTH AFRICA | UGANDA | RESEARCH REPORT | CHILDREN | HIV TESTING | LABORATORY PROCEDURES | HIV TRANSMISSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases
Document Number: 342893

11.

Peer Reviewed

Title: AIDS and the stigma of sexual promiscuity: Thai nurses' risk perceptions ofoccupational exposure to HIV.
Author: Chan KY; Rungpueng A; Reidpath DD
Source: Culture, Health and Sexuality. 2009 May;11(4):353-368.
Abstract: This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses concerns and future research are discussed.
Language: English
Keywords:
THAILAND | RESEARCH REPORT | KAP SURVEYS | MULTIPLE PARTNERS | NURSES AND NURSING | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | STIGMA | SEX BEHAVIOR | RISK BEHAVIOR | HIV TRANSMISSION | PERCEPTION | CULTURAL BACKGROUND | OCCUPATIONAL HEALTH | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Sexual Partners | Behavior | Health Personnel | Delivery of Health Care | Health | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Psychological Factors | Population Characteristics | Demographic Factors | Population
Document Number: 341088

12.

Peer Reviewed

Title: Project AID Khmer: addressing the health impact of HIV/AIDS on Cambodia through rural capacity building.
Author: Chang M; Kong NB; Phal V; Pugatch D; Allen S
Source: Global Public Health. 2009 May 27;:1-12.
Abstract: HIV/AIDS prevention efforts in Cambodia have largely focussed on urban populations. This focus, however, has diverted attention from the impact of the disease on rural communities, where poverty and a lack of basic infrastructure forced many to migrate to urban areas. Rural communities thus play a crucial part in the understanding of HIV/AIDS transmission dynamics in Cambodia. This paper will provide an analysis of socio-economic and health-related needs of rural communities in Cambodia, giving a different context for understanding the national burden of HIV/AIDS. These concepts will be illustrated with experiences from Project AID Khmer, a Cambodian non-governmental organisation that is working to improve Cambodian health through education programmes and community capacity building in rural Takeo province.
Language: English
Keywords:
CAMBODIA | RESEARCH REPORT | EVALUATION | RURAL POPULATION | NONGOVERNMENTAL ORGANIZATIONS | CAPACITY BUILDING | HIV PREVENTION | SOCIOECONOMIC FACTORS | PROGRAM EVALUATION | POVERTY | AGRICULTURE | LAND TENURE | RURAL-URBAN MIGRATION | HIV TRANSMISSION | RISK FACTORS | Developing Countries | Asia, Southeastern | Asia | Population Characteristics | Demographic Factors | Population | Organizations | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Economic Factors | Macroeconomic Factors | Migration | Population Dynamics | Health
Document Number: 341470

13.

Title: Timing and determinants of mother-to-child transmission of HIV in Nigeria.
Author: Charurat M; Datong P; Matawal B; Ajene A; Blattner W; Abimiku A
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 3;
Abstract: OBJECTIVE: To characterize the timing and determinants of mother-to-child transmission (MTCT) of HIV among mothers receiving single-dose nevirapine to prevent MTCT in Nigeria. METHODS: Three hundred and seventy-one HIV-infected mothers and their infants were followed from birth, at 1 week, and at 1, 3, 6, and 12 months. Risks of in utero (IU), intrapartum (IP/EPP), and postnatal (PP) transmission were quantified using conditional Cox regressions. RESULTS: Maternal viral load was the only risk factor for IU transmission after controlling for known risk factors. Low birth weight, premature birth, mixed feeding, and maternal viral load were associated with IP/EPP transmission. Increased PP transmission was associated with low birth weight and mixed feeding. At 6 months, mixed-fed infants were more likely to acquire infection than formula-fed infants (hazard ratio=5.74; 95% CI, 1.26-26.2). CONCLUSION: Risk factors for IU transmission differed from those of IP and PP transmission. Reducing mixed feeding and low birth weight delivery among HIV-infected mothers can further decrease IP and PP transmission.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | TIME FACTORS | MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | LOW BIRTH WEIGHT | RISK FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Population Dynamics | Transmission | Infections | HIV | Birth Weight | Body Weight | Physiology | Biology | Health
Document Number: 341465

14.

Peer Reviewed

Title: On the origin of South America HIV-1 C epidemic [letter]
Author: de Macedo Brigido LF
Source: AIDS. 2009 Feb 20;23(4):543-4.
Abstract: In a recent AIDS issue, two articles present sequence analysis to trace the origin of HIV-1 clade C in South America. The authors correctly point out that the density of clade C infection in south Brazil and its phylogenetic relationship to most isolates observed elsewhere in South America places south Brazil as its probable origin. When tracing the origin of the C viruses circulating in Brazil, both groups focused on phylogenic relationships of available/analyzable material. Although reported in the Epidemiology/Social sector, the authors disconnect their findings to potential social and cultural determinants of HIV dissemination, factors that may actually have played a major role in the introduction of HIV-1 clade C in Brazil. Although the precise African origin of the variant is not known, it was first observed in Ethiopia, but it is observed, along with other variants, in many countries of central and east Africa. It is conceivable that the variant migrated southwards through highland areas (including Burundi and Kenya, the putative origin, ascribed by each group, to the South America and Brazilian clade C epidemic) to dominate the epidemic in the south of the continent. Mozambique is one of the countries in the south of Africa where clade C is predominant. In 1975, Mozambique declared its independence from Portugal and Frelimo, a left-oriented liberation movement, took hold of the government. Its support to liberation movements at South Africa and Rhodesia (now Zimbabwe) resulted in an armed rebel movement supported by the white-ruled neighboring countries, causing a civil war that was associated with an exodus of most of the Portuguese community and Mozambicans of Portuguese heritage. Brazil, a former Portuguese colony, has a large community of Portuguese descendants, a fact that may have facilitate a temporary or permanent destiny for some of these emigrants. According to the official Brazilian demographic data center (IBGE), the number of conceded residency for Portuguese nationals surged five-fold in 1975, returning to 1974 levels by 1981. In some areas of the south of Brazil, as in the coast of the state of Santa Catarina, Portuguese descendents are specially noted. Coincidentally, this area includes cities with the highest proportions of clade C infection. Available molecular data may not provide sufficient support for a direct link of the two epidemics and, apart from a threonine at codon 12, most amino acid signatures listed by Bello et al. [1] are not commonly observed among Mozambique sequences available at GenBank. However, these isolates are recent (1999-2004) and may not reflect the variants circulating in late 1970s. An evolving virus in distinct ethnic groups may make the task of tracing its origins and evolution difficult, especially when based exclusively on available, most of the time fragmental, sequence information. The relationship of Mozambique to Brazil, through a 'Portuguese connection', placed the area as the most feasible origin for the Brazilian clade C epidemic. Social and cultural determinants and tangibility of potential routes of dissemination should be incorporated into these studies to allow a more precise picture of HIV epidemic dynamics. (full-text)
Language: English
Keywords:
SOUTH AMERICA | BRAZIL | AFRICA | CRITIQUE | HISTORICAL REVIEW | EPIDEMIOLOGIC METHODS | GENETIC TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | EPIDEMIOLOGY | HUMAN GEOGRAPHY | CULTURE | GENETICS | Latin America | Americas | Developing Countries | South America, Eastern | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Public Health | Geography | Social Sciences | Science | Sociocultural Factors | Biology
Document Number: 341168

15.
Peer Reviewed

Title: Prevention of mother-to-child transmission of HIV in Haiti.
Author: Deschamps MM; Noel F; Bonhomme J; Devieux JG; Saint-Jean G; Zhu Y; Wright P; Pape JW; Malow RM
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2009 Jan;25(1):24-30.
Abstract: OBJECTIVES: To describe the effectiveness of a program designed to reduce the rate of mother-to-child transmission (MTCT) of HIV at the primary HIV testing and treatment center in Haiti between 1999 and 2004. METHODS: All pregnant, HIV-positive women who attended the major HIV testing and treatment clinic in Port-au-Prince, Haiti, between March 1999 and December 2004 were asked to participate in an MTCT prevention program. Of the 650 women who participated, 73.3% received zidovudine (AZT), 2.9% received nevirapine (NVP), and 10.1% received triple-drug therapy when it became available in 2003 and if clinical/laboratory indications were met. Approximately 13.8% received no antiretroviral medication. All participants received cotrimoxazole prophylaxis and infant formula for their children. Kaplan-Meier survival analysis and the log rank test were used to evaluate program impact on child survival. RESULTS: Complete data were available for 348 mother-infant pairs who completed the program to prevent MTCT of HIV. The rate of MTCT in the study was 9.2% (95% CI: 6.14-12.24), in contrast to the historical mother-to-child transmission rate of 27% in Haiti. HIV-positive infants were less likely to survive than HIV-negative infants at 18 months of follow-up (chi(2) = 19.06, P < .001, log rank test). Infant survival improved with early pediatric diagnosis and antiretroviral treatment. CONCLUSIONS: The MTCT prevention program described proved to be feasible and effective in reducing vertical HIV transmission in Haiti. The authors emphasize the need to expand testing, extend services to rural areas, and implement early HIV diagnosis to reduce infant mortality.
Language: English
Keywords:
HAITI | RESEARCH REPORT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTENATAL CARE | HIV TRANSMISSION | HIV INFECTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Caribbean | Americas | Disease Transmission Control | Prevention and Control | Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Viral Diseases | Program Evaluation | Programs | Organization and Administration
Document Number: 341542

16.

Title: Women's rights and women's health during HIV/AIDS epidemics: the experience of women in sub-Saharan Africa.
Author: Dugassa BF
Source: Health Care For Women International. 2009 Aug;30(8):690-706.
Abstract: Twenty-five years have passed since HIV/AIDS was recognized as a major public health problem. Although billions of dollars are spent in research and development, we still have no medical cure or vaccination. In the early days of the epidemic, public health slogans suggested that HIV/AIDS does not discriminate. Now it is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalized, women, colonized, and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS demands the need to travel extra miles. My objective in this article is to promote the need to go beyond the biomedical model of "technical fixes" and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. In this article, I argue that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders.
Language: English
Keywords:
AFRICA, SUB SAHARAN | CRITIQUE | HIV INFECTIONS | AIDS | EPIDEMICS | WOMEN'S HEALTH | WOMEN'S RIGHTS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | HIV TRANSMISSION | MALNUTRITION | SOCIOCULTURAL FACTORS | Africa | Developing Countries | Viral Diseases | Diseases | Health | Human Rights | Political Factors | Economic Factors | Nutrition Disorders
Document Number: 342818

17.

Title: Seroprevalence of human immunodeficiency virus and syphilis in blood donors of Delhi [letter]
Author: Ekadashi R; Langer S
Source: Indian Journal of Medical Microbiology. 2009 Apr-Jun;27(2):167-8.
Abstract: Transfusion of blood and blood products is a life saving measure that benefits numerous patients worldwide. At the same time it is an important mode of infection to the recipients. In up to 15% of the total patients infected with human immunodeficiency virus (HIV), blood transfusion has been the route of transmission. Syphilis positivity varies from 0.8% in voluntary donors to more than 15% in paid commercial donors. Although HIV infection has been reported in all groups of blood donors in Delhi, it is particularly high among replacement donors. Concealing the medical history by professional or replacement donors pose a great threat to safe blood supply. Problems are also due to the prevalence of asymptomatic carriers in the society, blood donations during the window period, genetic variability in the viral strains and laboratory errors. Only few reports are available regarding the trend of HIV seropositivity and syphilis serology, particularly in blood donors from northern India. In this study, we aimed to assess the prevalence and trend of HIV and syphilis over 4 years, 2004-2007, among blood donors of Central Delhi. A total of 13,672 blood units were collected from blood donors during the period from January 1 2004 to December 31 2007 at the blood bank of Delhi Heart and Lung Institute in New Delhi, India. This is a tertiary care level hospital super specializing in heart and lung ailments. Blood donors were either replacement or voluntary. Care was taken to exclude professional donors by taking appropriate history and examination. (excerpt)
Language: English
Keywords:
INDIA | CRITIQUE | BLOOD DONORS | HIV TRANSMISSION | SYPHILIS | HIV | LABORATORY PROCEDURES | SCREENING | SAFETY | PREVENTION AND CONTROL | Asia, Southern | Asia | Developing Countries | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Public Health
Document Number: 341204

18.

Peer Reviewed

Title: AIDS among older children and adolescents in Southern Africa: projecting the time course and magnitude of the epidemic.
Author: Ferrand RA; Corbett EL; Wood R; Hargrove J; Ndhlovu CE; Cowan FM; Gouws E; Williams BG
Source: AIDS. 2009 Aug 13;23(15):2039-2046.
Abstract: The authors modeled demographic, HIV prevalence, mother-to-child transmission, and child survival data to project HIV burden among older children in two southern African countries at different stages of severe HIV epidemics. Using measured survival data for children, they estimated that 64% of HIV-infected infants are fast progressors with median survival of 0.64 years, and 36% are slow progressors with median survival of 16.0 years. They confirmed the model�s validity by comparing its predictions to available epidemiological data. The authors found that without treatment, HIV prevalence among 10-year-olds in South Africa is expected to increase from 2.1% in 2008 to 3.3% in 2020, whereas in Zimbabwe, it will decrease from 3.2% in 2008 to 1.6% in 2020. Deaths among untreated slow progressors will increase in South Africa from 7,000 per year in 2008 to 23,000 per year in 2030, and in Zimbabwe from 8,000 per year in 2008 to 9,700 per year in 2014. Drugs to prevent mother-to-child transmission could reduce the death rate in 2030 to 8,700 per year in South Africa and to 2,800 per year in Zimbabwe in 2014. The authors conclude that a substantial epidemic of HIV/AIDS in older survivors of mother-to-child transmission is emerging in southern Africa. The lack of direct observations of survival in slow progressors has resulted in failure to anticipate the magnitude of the epidemic and to adequately address the clinical needs of HIV-infected older children and adolescents. Better HIV diagnostic and care services for this age group are urgently required.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | PREVALENCE | CHILDREN | ADOLESCENTS | MOTHER-TO-CHILD TRANSMISSION | HIV TRANSMISSION | HIV INFECTIONS | HEALTH SERVICES | AGE FACTORS | NEEDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Transmission | Infections | Diseases | Viral Diseases | Delivery of Health Care | Health | Economic Factors
Document Number: 342555

19.

Peer Reviewed

Title: Rationing antiretroviral therapy in Africa--treating too few, too late.
Author: Ford N; Mills E; Calmy A
Source: New England Journal of Medicine. 2009 Apr 30;360(18):1808-10.
Abstract: The past 6 years have seen striking advances in access to antiretroviral therapy in Africa. From 2002 onward, the international drive to scale up antiretroviral treatment gained considerable momentum, most notably with the establishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the "3 by 5" Initiative of the World Health Organization (WHO), and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). The momentum has now begun to wane, with various groups arguing that the focus on AIDS has had its day and that health care funding should now be redirected to other areas, such as maternal and child health and primary care. But before the international community gives up on prioritizing care for patients with HIV infection, we believe that on-the-ground discussions must address not only whether enough has been done to scale up treatment but also whether the treatment that patients are receiving is good enough. The standard approach to HIV treatment in Africa is to wait until people are visibly sick, treat them with effective but poorly tolerated drugs, and then wait until they are sick again before switching regimens. There are several problems with this approach. The first is that too few people are receiving treatment. Second, we are waiting until people are symptomatic before they are treated. Another concern is that in most developing countries, patients are receiving drugs with major tolerability issues. Furthermore, not only should initial treatment begin earlier in developing countries, but when the first-line regimen fails, patients should also be switched earlier to another regimen. The drive to scale up antiretroviral treatment in Africa has encouraged a public health approach that promotes reaching the greatest number of patients with the simplest, most affordable regimens. We would argue that treating people when they are less sick with drugs that are less toxic and providing a simple tool for monitoring adherence and detecting treatment failure would be entirely consistent with this approach and would improve access to care by facilitating the decentralization of services from the hospital level to the clinic. (excerpt)
Language: English
Keywords:
AFRICA | DEVELOPING COUNTRIES | SUMMARY REPORT | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | TREATMENT | TIME FACTORS | SIGNS AND SYMPTOMS | DRUG RESISTANCE | ANTIRETROVIRAL DRUGS | SIDE EFFECTS | HIV TRANSMISSION | HEALTH POLICY | NEEDS ASSESSMENT | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Demographic Factors | Population | Policy | Political Factors | Sociocultural Factors | Evaluation
Document Number: 341021

20.

21.

Peer Reviewed

Title: How to contain generalized HIV epidemics? A plea for better evidence to displace speculation.
Author: Gisselquist D; Potterat JJ; St Lawrence JS; Hogan M; Arora NK; Correa M; Dinsmore WW; Mehta G; Millogo J; Muth SQ; Okinyi M; Ounga T
Source: International Journal of STD and AIDS. 2009 Jul;20(7):443-6.
Abstract: In the worst generalized HIV epidemics in East and Southern Africa, from one-quarter to three-quarters of women aged 15 years can expect to be living with HIV or to have died with AIDS by age 40 years. This disaster continues in the face of massive HIV prevention programmes based on current inexact knowledge of HIV transmission pathways and risks. To stop this disaster, both the public and public health experts need better information about the specific factors that allow HIV to propagate so extensively in countries with generalized epidemics. This knowledge could be acquired by tracing HIV infections to their source - especially tracing HIV infections in women of all ages, and tracing unexplained HIV infections in children with HIV-negative mothers.
Language: English
Keywords:
AFRICA | CRITIQUE | EPIDEMIOLOGIC METHODS | HIV INFECTIONS | AIDS | EPIDEMICS | GOALS | NEEDLE PIERCING | BLOOD TRANSFUSION | HIV TRANSMISSION | HIV PREVENTION | MALE CIRCUMCISION | Developing Countries | Research Methodology | Viral Diseases | Diseases | Planning | Organization and Administration | Risk Behavior | Behavior | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342830

22.
Peer Reviewed

Title: A framework of sexual partnerships: risks and implications for HIV prevention in Africa.
Author: Green EC; Mah TL; Ruark A; Hearst N
Source: Studies In Family Planning. 2009 Mar;40(1):63-70.
Abstract: The global diversity of HIV epidemics can be explained in part by types and patterns of sexual partnerships. We offer a typology of sexual partnerships that corresponds to varying levels of HIV-transmission risk to help guide thinking about appropriate behavioral interventions, particularly in the epidemics of sub-Saharan Africa. Declines in HIV prevalence have been associated with reductions in numbers of sex partners, whereas many other prevention strategies have not been demonstrated to reduce HIV transmission at a population level. We suggest a reorientation of current prevention efforts, based on the epidemiology of sexually transmitted HIV epidemics and trends in sexual behavior change. Concurrent sexual partnerships are likely to play a large role in transmission dynamics in the generalized epidemics of East and Southern Africa, and should be addressed through improved behavior-change interventions.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | SEXUAL PARTNERS | MULTIPLE PARTNERS | HIV TRANSMISSION | SEXUALLY TRANSMITTED DISEASES | RISK REDUCTION BEHAVIOR | BEHAVIOR CHANGE | PROGRAM EVALUATION | Developing Countries | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Programs | Organization and Administration
Document Number: 341337

23.

Peer Reviewed

Title: Sexual behavior change in countries with generalised HIV epidemics? Evidence from population-based cohort studies in sub-Saharan Africa.
Author: Gregson S; Todd J; Zaba B
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i1-i2.
Abstract: This introductory article describes the contents of the current issue which presents 10 recent analyses of sexual behaviour data from longitudinal studies in five countries-Uganda, Tanzania, Malawi, Zimbabwe and South Africa- experiencing different sizes and stages of the HIV epidemic. The results provide valuable information for use in evaluating trends in HIV epidemics and the impact of HIV prevention programmes. An underlying purpose of this is to highlight appropriate methods and to encourage better analysis and presentation of sexual behaviour data, especially as they relate to HIV and HIV prevention.
Language: English
Keywords:
AFRICA, SUB SAHARAN | LITERATURE REVIEW | KAP SURVEYS | COHORT ANALYSIS | DEMOGRAPHIC AND HEALTH SURVEYS | LONGITUDINAL STUDIES | TARGET POPULATION | HIV TRANSMISSION | EPIDEMICS | SEX BEHAVIOR | RISK BEHAVIOR | SURVIVORSHIP | RISK FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Program Design | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Length of Life | Mortality | Health
Document Number: 340100

24.

Title: Poverty, bridging between injecting drug users and the general population, and "interiorization" may explain the spread of HIV in southern Brazil.
Author: Hacker MA; Leite I; Friedman SR; Carrijo RG; Bastos FI
Source: Health and Place. 2009 Jun;15(2):514-9.
Abstract: The aim of this paper is to study how structural determinants and the role of injecting drug users (IDUs) as a bridging population to the general population affected the AIDS subepidemic in southern Brazil during 1986-2000. Data from 288 southernmost Brazilian municipalities were analyzed. Using hierarchical modeling and inputs from a Geographic Information System, a multilevel model was constructed. The dependent variable was the logged AIDS standardized incidence rate (among the heterosexual population aged 15-69-years-old); independent variables included indicators for education, water provision, sewage, and garbage collection, per capita income, Gini coefficient (on income), Human Development Index, indicators of accessibility, and AIDS rate among IDUs. Significant predictors included AIDS rate among IDUs, distance from/to highways/railways, the Human Development Index and the ratio of residents who have access to sanitary installations. Poverty (as measured by socioeconomic indicators) and bridging from IDUs contribute to the spread of HIV/AIDS in Brazilian southern municipalities.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | EPIDEMIOLOGIC METHODS | IV DRUG USERS | HIV TRANSMISSION | POVERTY | HUMAN GEOGRAPHY | PREVALENCE | SOCIOECONOMIC FACTORS | PROGRAM ACCESSIBILITY | DISTANCE | SANITATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Theoretical Models | Drug Use and Abuse | Behavior | HIV Infections | Viral Diseases | Diseases | Economic Factors | Geography | Social Sciences | Science | Sociocultural Factors | Measurement | Program Evaluation | Programs | Organization and Administration | Geographic Factors | Population | Public Health | Health
Document Number: 330964

25.
Title: Knowledge about AIDS/HIV infection among women attending obstetrics and gynaecology clinic at a university hospital.
Author: Haider G; Zohra N; Nisar N; Munir AA
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Feb;59(2):95-8.
Abstract: OBJECTIVE: To determine the level of awareness about Human Immune-deficiency Virus Infection and Auto Immune Deficiency Syndrome (HIV/AIDS) among women attending obstetrics and gynaecology clinic. METHODS: A descriptive cross-sectional study was conducted in the obstetric and gynaecology clinic at Isra University Hospital Hyderabad Pakistan from April to June 2007. A total of 189 women attending the obstetric and gynaecology clinic between ages 20 and 50 years were included. Informed consent was taken and information was collected by a pre-designed questionnaire to assess the level of awareness about HIV/AIDS. Data analysis was done by computer software, SPSS version 11. RESULTS: Out of the total, 86.8% women had heard about HIV/AIDS. A large majority of women knew that it is transmitted by close sexual relationship, through infected blood, can be transmitted from mother to baby and knew that it is transmitted by reuse of infected needles while only 40.7% knew that it can be transmitted during delivery. The respondents had the knowledge that multiple sexual partners (79.4%), prostitutes and homosexual males (49.7%), drug addicts (49.7%) were high risk groups. Regarding prevention of AIDS, 70.9% mentioned avoiding homosexuality, 58.7% knew the use of condoms and 74.7% women knew that screening of blood in laboratories before transfusion can prevent AIDS. CONCLUSION: The level of awareness regarding HIV/AIDS transmission and prevention was satisfactory among women attending the out-patient department of a gynaecology and obstetrics department. However, number of misconceptions needs to be corrected.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | MEN HAVING SEX WITH MEN | SEX WORKERS | MULTIPLE PARTNERS | KNOWLEDGE | HIV TRANSMISSION | SEX BEHAVIOR | RISK BEHAVIOR | BLOOD TRANSFUSION | MOTHER-TO-CHILD TRANSMISSION | CHILDBIRTH | NEEDLE SHARING | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Behavior | Sexual Partners | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Transmission | Infections | Pregnancy Outcomes | Pregnancy | Reproduction
Document Number: 330906

26.

Peer Reviewed

Title: Understanding the HIV epidemic in the Dominican Republic: a prevention success story in the Caribbean?
Author: Halperin DT; de Moya EA; Perez-Then E; Pappas G; Garcia Calleja JM
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S52-9.
Abstract: OBJECTIVE: To analyze the general dynamics and trends of the HIV epidemic in the Dominican Republic (DR). METHODS: Thorough review of available HIV seroprevalence and sexual behavioral data from the DR. RESULTS: Multiple sources of data suggest that the DR's HIV epidemic has generally declined. Between the mid-1990s and about 2002, HIV-1 prevalence fell among pregnant women in the capital, Santo Domingo, particularly among young women. Declines in prevalence were also observed over the same period among sexually transmitted infection clinic patients, blood bank donors, US entry visa applicants, and female sex workers. National household surveys found 1.0% (confidence interval: 0.9% to 1.1%) adult prevalence in 2002 and 0.8% (0.6% to 0.9%) in 2007. Among largely Haitian immigrant residents of the impoverished former "sugarcane plantations," prevalence was much higher but declined from 5.0% to 3.2% between 2002 and 2007. The DR's heterogeneous epidemic includes an important men-having-sex-with-men (MSM) and bisexual component. The proportion of reported AIDS cases among men remained constant from 1989 to 2006, accounting for about two thirds of both total cumulative and year 2006 cases. Some survey and qualitative data also suggest a considerable occurrence of MSM-related risk behaviors. HIV prevalence remains relatively high in MSM, with no evidence of significant decrease. CONCLUSIONS: As in several other developing countries that have succeeded in slowing HIV transmission, HIV reductions in the DR seem mainly due to changes in sexual behavior, particularly increased condom use, especially for sex work, and partner reduction in men. Similarly favorable HIV declines and reported behavior change have occurred in some other Caribbean countries, including neighboring Haiti. However, of concern is that anal sex, both male-male and heterosexual, remains a taboo yet apparently common practice largely ignored by existing prevention campaigns. And although the DR epidemic has generally stabilized, there is a danger of complacency, and some recent data suggest that HIV prevalence is no longer declining (and may even be increasing) in some populations.
Language: English
Keywords:
DOMINICAN REPUBLIC | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HETEROSEXUALS | HIV PREVENTION | HIV TRANSMISSION | ANAL SEX | Developing Countries | Americas | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases
Document Number: 341320

27.

Peer Reviewed

Title: South African teachers' reflections on the impact of culture on their teaching of sexuality and HIV/AIDS.
Author: Helleve A; Flisher AJ; Onya H; Mukoma W; Klepp KI
Source: Culture, Health and Sexuality. 2009 Feb;11(2):189-204.
Abstract: The authors investigated how teachers respond to perceived cultural differences between the local community and the content of their teaching. Data were collected through interviews with teachers who taught students in grades 8 or 9 in public high schools. The teachers expressed differing viewpoints on the rationale for teaching about HIV/AIDS and sexuality. Many teachers saw teaching these topics as a response to declining moral standards, while others suggested that they were teaching issues that parents failed to address. The teachers were more concerned about young people's sexual behavior than about preventing HIV/AIDS. They perceived that cultural contradictions between what was taught and local cultural values were an issue to which they needed to respond, although they differed in terms of how to respond. Some took an adaptive approach to try to avoid conflicts, while others claimed the moral neutrality of their teaching. Teaching about sexuality was perceived to be challenging in terms of language and communication norms. Teaching about HIV/AIDS was perceived as challenging because teachers often needed to convince students about the reality of AIDS.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | TEACHERS | COMMUNITY | CULTURE | SEX EDUCATION | SEXUALITY | HIV TRANSMISSION | HIV PREVENTION | PERCEPTION | MOTIVATION | VALUE ORIENTATION | LANGUAGE | INTERPERSONAL COMMUNICATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Education | Residence Characteristics | Population Distribution | Geographic Factors | Population | Sociocultural Factors | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Diseases | Communication
Document Number: 341086

28.

Peer Reviewed

Title: High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies.
Author: Hesseling AC; Cotton MF; Jennings T; Whitelaw A; Johnson LF; Eley B; Roux P; Godfrey-Faussett P; Schaaf HS
Source: Clinical Infectious Diseases. 2009 Jan 1;48(1):108-14.
Abstract: BACKGROUND: There are limited population-based estimates of tuberculosis incidence among human immunodeficiency virus (HIV)-infected and HIV-uninfected infants aged < or =12 months. We aimed to estimate the population-based incidence of culture-confirmed tuberculosis among HIV-infected and HIV-uninfected infants in the Western Cape Province, South Africa. METHODS: The incidences of pulmonary, extrapulmonary, and disseminated tuberculosis were estimated over a 3-year period (2004-2006) with use of prospective representative hospital surveillance data of the annual number of culture-confirmed tuberculosis cases among infants. The total number of HIV-infected and HIV-uninfected infants was calculated using population-based estimates of the total number of live infants and the annual maternal HIV prevalence and vertical HIV transmission rates. RESULTS: There were 245 infants with culture-confirmed tuberculosis. The overall incidences of tuberculosis were 1596 cases per 100,000 population among HIV-infected infants (95% confidence interval [CI], 1151-2132 cases per 100,000 population) and 65.9 cases per 100,000 population among HIV-uninfected infants (95% CI, 56-75 cases per 100,000 population). The relative risk of culture-confirmed tuberculosis among HIV-infected infants was 24.2 (95% CI, 17-34). The incidences of disseminated tuberculosis were 240.9 cases per 100,000 population (95% CI, 89-433 cases per 100,000 population) among HIV-infected infants and 14.1 cases per 100,000 population (95% CI, 10-18 cases per 100,000 population) among HIV-uninfected infants (relative risk, 17.1; 95% CI, 6-34). CONCLUSIONS: This study indicates the magnitude of the tuberculosis disease burden among HIV-infected infants and provides population-based comparative incidence rates of tuberculosis among HIV-infected infants. This high risk of tuberculosis among HIV-infected infants is of great concern and may be attributable to an increased risk of tuberculosis exposure, increased immune-mediated tuberculosis susceptibility, and/or possible limited protective effect of bacille Calmette-Guerin vaccination. Improved tuberculosis control strategies, including maternal tuberculosis screening, contact tracing of tuberculosis-exposed infants coupled with preventive chemotherapy, and effective vaccine strategies, are needed for infants in settings where HIV infection and tuberculosis are highly endemic.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | INCIDENCE | INFANT | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | HIV TRANSMISSION | SCREENING | EXPOSURE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Factors | Biology
Document Number: 329778

29.

Title: Heterosexual transmission of human immunodeficiency virus type 1 subtype C: Macrophage tropism, alternative coreceptor use, and the molecular anatomy of CCR5 utilization.
Author: Isaacman-Beck J; Hermann EA; Yi Y; Ratcliffe SJ; Mulenga J; Allen S; Hunter E; Derdeyn CA; Collman RG
Source: Journal of Virology. 2009 Aug;83(16):8208-20.
Abstract: Human immunodeficiency virus type 1 transmission selects for virus variants with genetic characteristics distinct from those of donor quasispecies, but the biological factors favoring their transmission or establishment in new hosts are poorly understood. We compared primary target cell tropisms and entry coreceptor utilizations of donor and recipient subtype C Envs obtained near the time of acute infection from Zambian heterosexual transmission pairs. Both donor and recipient Envs demonstrated only modest macrophage tropism, and there was no overall difference between groups in macrophage or CD4 T-cell infection efficiency. Several individual pairs showed donor/recipient differences in primary cell infection, but these were not consistent between pairs. Envs had surprisingly broad uses of GPR15, CXCR6, and APJ, but little or no use of CCR2b, CCR3, CCR8, GPR1, and CXCR4. Donors overall used GPR15 better than did recipients. However, while several individual pairs showed donor/recipient differences for GPR15 and/or other coreceptors, the direction of the differences was inconsistent, and several pairs had unique alternative coreceptor patterns that were conserved across the transmission barrier. CCR5/CCR2b chimeras revealed that recipients as a group were more sensitive than were donors to replacement of the CCR5 extracellular loops with corresponding regions of CCR2b, but significant differences in this direction were not consistent within pairs. These data show that sexual transmission does not select for enhanced macrophage tropism, nor for preferential use of any alternative coreceptor. Recipient Envs are somewhat more constrained than are donors in flexibility of CCR5 use, but this pattern is not universal for all pairs, indicating that it is not an absolute requirement.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | HIV TRANSMISSION | HETEROSEXUALS | GENETICS | HIV | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Sex Behavior | Behavior | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342733

30.
Title: A randomised controlled trial of peer-adult-led intervention on improvement of knowledge, attitudes and behaviour of university students regarding HIV/AIDS in Malaysia.
Author: Jahanfar S; Lye MS; Rampal L
Source: Singapore Medical Journal. 2009 Feb;50(2):173-80.
Abstract: INTRODUCTION: The aim of this study was to investigate the knowledge, attitudes and behaviour of university students regarding acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV). METHODS: A randomised controlled trial of 530 university students was done using peer-adult facilitators. Participants completed a questionnaire before and after the intervention, which was a four-hour group session. A prevention programme was developed by local experts, health educators and peer facilitators. The peer-adult-led programme was designed to provide a conceptual model of HIV risk reduction through information, motivational and behavioural skills, a harm reduction module and health promotion theme. RESULTS: The main outcome measured was the level of knowledge, attitudes and behaviour scores. The results suggest that relative to the control group, participants in the intervention group had higher levels of knowledge (30.37 vs. 25.40; p-value is 0.001) and a better attitude (12.27 vs. 10.84; p-value is 0.001). However, there was no difference in the behavioural score (9.47 vs. 9.41; p-value is 0.530). The correlation between the level of knowledge and age and the level of education was found in the intervention group, but not in the control group (p-value is 0.01). Attitude and gender were found to be correlated in the intervention group only (p-value is 0.01). CONCLUSION: Our programme was successful in increasing knowledge and improving attitudes towards AIDS and HIV. However, it did not improve risk-taking behaviour. Peer-adult-led educational programmes for youth using various interactional activities, such as small group discussions, poster activity and empathy exercises, can be successful in changing the prevailing youth perceptions of AIDS and HIV.
Language: English
Keywords:
MALAYSIA | RESEARCH REPORT | STUDENTS | UNIVERSITIES | KNOWLEDGE | ATTITUDES | BEHAVIOR | HIV TRANSMISSION | SEXUALLY TRANSMITTED DISEASES | AIDS | HEALTH EDUCATION | EDUCATIONAL ACTIVITIES | Asia, Southeastern | Asia | Developing Countries | Education | Schools | Sociocultural Factors | Psychological Factors | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections
Document Number: 342091


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