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Title: Increasing HIV testing for at-risk children.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: The Caregiver Project is helping HIV-positive children access life-saving medical treatment and providing an outreach model that can be replicated across Africa. The project trains grandmothers (called �grannies") to serve as peer supporters for elderly caregivers. The grannies provide information about pediatric HIV testing and treatment to elderly caregivers who come to Social Security Agency sites to get grants for social services for children and the elderly. Grannies offer caregivers referral cards that list the locations of pediatric testing services and encourage them to take the children to be tested. The Caregiver Project is targeting an important gateway to accessing these children, the elderly caregivers, and motivating caregivers to seek care through age-appropriate resources. (Excerpts)
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | CARE AND SUPPORT | PROMOTION | HIV TESTING | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Marketing | Economic Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine
Document Number: 331491

Title: A strategic approach: HIV & AIDS and education.
Author: UNAIDS. Inter-Agency Task Team on Education
Source: Paris, France, UNESCO, 2009 May. 53 p. Also available: http://unesdoc.unesco.org/images/0016/001627/162723f.pdf (French) and http://unesdoc.unesco.org/images/0016/001627/162723s.pdf (Spanish).
Abstract: This publication provides a strategic vision of the role that education must play in addressing HIV and AIDS. It targets decision-makers and practitioners in the education sector, as well as colleagues who work on HIV and AIDS responses in other sectors. It can be used as an advocacy tool to build commitment to the role of education in the HIV and AIDS response and to generate multisectoral partnerships for implementation.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | PERSONS LIVING WITH HIV/AIDS | EDUCATION | AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | SCHOOLS | HIV PREVENTION | AIDS PREVENTION | TREATMENT | HIV TESTING | HEALTH EDUCATION | HEALTH SERVICES | PROGRAM ACCESSIBILITY | PROGRAM ACTIVITIES | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Medical Procedures | Medicine | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Program Evaluation | Programs | Organization and Administration
Document Number: 342035

Title: mHealth for development: The opportunity of mobile technology for healthcare in the developing world.
Author: Vital Wave Consulting
Source: Washington, D.C., United Nations Foundation, 2009. 66 p.
Abstract: Mounting interest in the field of mHealth -- the provision of health-related services via mobile communications -- can be traced to the evolution of several interrelated trends. In many parts of the world, epidemics and a shortage of healthcare workers continue to present grave challenges for governments and health providers. Yet in these same places, the explosive growth of mobile communications over the past decade offers a new hope for the promotion of quality healthcare. Among those who had previously been left behind by the 'digital divide,' billions now have access to reliable technology. There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services -- even in some of the most remote and resource-poor environments. This report examines issues at the heart of the rapidly evolving intersection of mobile phones and healthcare. It helps the reader to understand mHealth's scope and implementation across developing regions, the health needs to which mHealth can be applied, and the mHealth applications that promise the greatest impact on heath care initiatives. It also examines building blocks required to make mHealth more widely available through sustainable implementations. Finally, it calls for concerted action to help realize mHealth's full potential. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | PUBLIC HEALTH | TELECOMMUNICATIONS | INFORMATION DISTRIBUTION | EDUCATION | AWARENESS | DATA COLLECTION | PRIMARY HEALTH CARE | TRAINING ACTIVITIES | HEALTH PERSONNEL | DISEASE PREVENTION | TECHNOLOGY | TREATMENT | ADMINISTRATION AND DOSAGE | DRUGS | HIV TESTING | HIV PREVENTION | Health | Broadcast Media | Mass Media | Communication | Knowledge | Sociocultural Factors | Research Methodology | Health Services | Delivery of Health Care | Training Programs | Prevention and Control | Diseases | Economic Factors | Medical Procedures | Medicine | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | HIV Infections | Viral Diseases
Document Number: 331450

Title: Sexual and reproductive health and HIV linkages: evidence review and recommendations.
Author: World Health Organization [WHO]; United Nations Population Fund [UNFPA]; International Planned Parenthood Federation [IPPF]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; University of California, San Francisco. Global Health Sciences
Source: Geneva, Switzerland, WHO, 2009 Apr. [8] p.
Abstract: The importance of linking sexual and reproductive health (SRH) and HIV is widely recognized. The international community agrees that the Millennium Development Goals will not be achieved without ensuring universal access to SRH and HIV prevention, treatment, care and support. In order to gain a clearer understanding of the effectiveness, optimal circumstances, and best practices for strengthening SRH and HIV linkages, a systematic review of the literature was conducted. The findings corroborate the many benefits gained from linking SRH and HIV policies, systems and services. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | CLIENTS | HIV TESTING | COUNSELING | HIV PREVENTION | FAMILY PLANNING | MATERNAL HEALTH | SEXUALLY TRANSMITTED DISEASE PREVENTION | CHILD HEALTH | MANAGEMENT | KNOWLEDGE | ATTITUDES | STIGMA | BEHAVIOR | FEES | HIV/FP INTEGRATION | INTERVENTIONS | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors | Psychological Factors | Social Problems | Financial Activities | Economic Factors
Document Number: 331466

Title: Integrating gender into HIV / AIDS programmes in the health sector: Tool to improve responsiveness to women�s needs.
Author: World Health Organization [WHO]. Department of Gender, Women and Health
Source: Geneva, Switzerland, WHO, 2009. [130] p.
Abstract: This hands-on WHO tool helps programme managers and health-care providers in the public and private sectors integrate gender into HIV / AIDS programmes they wish to set up, implement and evaluate so they are more responsive to women's needs. In addition to describing basic steps in gender-responsive programming, which can be applied to all HIV / AIDS programmes, the tool suggests practical actions to address key gender issues in four service delivery areas: HIV testing and counseling; Prevention of mother-to-child transmission of HIV; HIV / AIDS treatment and care; Home-based care and support for people living with HIV. The tool also provides examples of gender-responsive interventions from the field, and resources such as: counseling role plays for risk reduction and HIV treatment adherence; examples of gender-sensitive communication messages; and protocols for addressing the risk of violence among women as a result of HIV status disclosure.
Language: English
Keywords:
GLOBAL | MANUAL | HIV PREVENTION | AIDS PREVENTION | WOMEN'S HEALTH | GENDER ISSUES | INEQUALITIES | NEEDS | PROGRAM DESIGN | PROGRAM ACCESSIBILITY | HIV TESTING | COUNSELING | ANTIRETROVIRAL THERAPY | HOME CARE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV Infections | Viral Diseases | Diseases | AIDS | Health | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration | Program Evaluation | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Clinic Activities | Program Activities | HIV | Care and Support | Disease Transmission Control | Prevention and Control
Document Number: 331798

10.

Peer Reviewed

Title: PMTCT, HAART, and childbearing in Mozambique: an institutional perspective.
Author: Agadjanian V; Hayford SR
Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S103-S112.
Abstract: Maternal and Child Health (MCH) units, where VCT/PMTCT/HAART have been integrated with traditional services, play a critical role in the connection between the massive HAART rollout and reproductive behavior. In this article, we use data from semi-structured interviews with MCH workers and ethnographic observations carried out in southern Mozambique to explore this role from the institutional perspective. We find that, along with logistical and workload problems, the de facto segregation of PMTCT/HAART clients within the �integrated� MCH system and the simplistic and uncompromising message discouraging further fertility and stressing condom-based contraception may pose serious challenges to a successful formulation and implementation of reproductive goals among seropositive clients. Although the recency of PMTCT/HAART services may partly explain these challenges, we argue that they are due largely to cultural miscommunication between providers and clients. We show how the cultural gap between the two is bridged by community activists and peer interactions among clients.
Language: English
Keywords:
MOZAMBIQUE | RESEARCH REPORT | HEALTH PERSONNEL | SUPPORT GROUPS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | MATERNAL-CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | HEALTH SERVICES ADMINISTRATION | INTERVIEWS | FERTILITY PREFERENCES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Delivery of Health Care | Health | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Diseases | HIV | HIV Infections | Viral Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Primary Health Care | Programs | Organization and Administration | Management | Data Collection | Research Methodology | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 341906

11.
Title: Attitudes of healthcare providers towards patients with HIV/AIDS in Bandar Abbas.
Author: Aghamolaei T; Tavafian SS; Hasani L; Zare S
Source: Archives of Iranian Medicine. 2009 May;12(3):298-301.
Abstract: We aimed to investigate the attitudes of healthcare providers towards patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Bandar Abbas, south of Iran. In this cross-sectional study, a random sample of 250 healthcare providers completed a 20-item questionnaire from January first through February 30th, 2007. There were five domains of attitudes towards patients with HIV. The items measured as a five-point Likert scale ranging from strongly disagree to strongly agree. The mean age of the healthcare providers was 31.3 (SD=7.3) years. Of them 24.4% were males, 42.4% had received Bachelor of Science degree, 19.2% were physicians, 63.2% were nurses, and 17.6% were laboratory technicians. The respondents had fairly positive attitudes towards patients with HIV. Men, older age, more educated participants, and laboratory technicians had more favorable attitude towards HIV (P<0.05).
Language: English
Keywords:
IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HEALTH PERSONNEL | CLIENTS | PERSONS LIVING WITH HIV/AIDS | STAFF ATTITUDE | HIV INFECTIONS | AIDS | LABORATORY PROCEDURES | Middle East | Developing Countries | Research Methodology | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services
Document Number: 342660

12.

Peer Reviewed

Title: Seroreversion in children born to HIV-positive and AIDS mothers from Central West Brazil.
Author: Alcantara KC; Pereira GA; Albuquerque M; Stefani MM
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):620-6.
Abstract: The spread of HIV-1 infection among women of childbearing age has led to increasing numbers of children at risk of vertical transmission. This study aimed to assess child outcomes among HIV-positive (n=19) and AIDS (n=22) mothers from Central West Brazil. CD4(+) T-cell counts (FACScount, BD) and viral loads (HIV-1 RT-PCR, Amplicor HIV-1 Monitor Roche) were assessed at delivery and during the first 6 months of life. Heteroduplex mobility assay identified env and gag HIV-1 subtypes. Frequencies and medians were calculated. HIV-positive and AIDS mothers did not differ with regard to age, antiretroviral prophylaxis, parity and viral load. AIDS mothers had lower CD4(+) T-cell counts. One vertical transmission and a neonatal death were observed. Gestational age, gender and oral zidovudine prophylaxis were similar regardless of maternal clinical status. Infants born to AIDS mothers had lower birthweight and shorter time to seroreversion. Eight infants were lost to follow-up, and two were breastfed due to delayed maternal diagnosis. HIV-1 B(env)/B(gag) subtype were 75.6%; discordant B(env)/F(gag) were 12.2%. Exposed uninfected infants born to AIDS mothers with lower CD4(+) T-cell counts seroreverted earlier than infants born to asymptomatic HIV-positive mothers. It is possible that maternal immunological status may impact on the time to seroreversion.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | MOTHER-TO-CHILD TRANSMISSION | BREASTFEEDING | LABORATORY PROCEDURES | AIDS | HIV INFECTIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Transmission | Infections | Infant Nutrition | Nutrition | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 342742

13.

Peer Reviewed

Title: HIV prevalence and associated risk factors among individuals aged 13-34 years in rural western Kenya.
Author: Amornkul PN; Vandenhoudt H; Nasokho P; Odhiambo F; Mwaengo D
Source: Plos One. 2009 Jul;4(7):e6470.
Abstract: From a demographic surveillance system, the authors selected a random sample of Asembo, Kenya residents ages 13�34 years, who were contacted at home and invited to a nearby mobile study site. From October 2003 to April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Of 2,606 eligible residents, 1,822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner or parental objection. Females comprised 53% of 1,762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women ages 25-29 years (36.5%) and men ages 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity.
Language: English
Keywords:
KENYA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | HIV INFECTIONS | HERPES GENITALIS | PREVALENCE | RISK FACTORS | AGE FACTORS | SEX FACTORS | MIGRATION | VOLUNTARY COUNSELING AND TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Health | Population Characteristics | Demographic Factors | Population Dynamics | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 339909

14.

Peer Reviewed

Title: Knowledge of HIV status, sexual risk behaviors and contraceptive need among people living with HIV in Kenya and Malawi.
Author: Anand A; Shiraishi RW; Bunnell RE; Jacobs K; Solehdin N; Abdul-Quader AS; Marum LH; Muttunga JN; Kamoto K; Aberle-Grasse JM; Diaz T
Source: AIDS. 2009 Jun 17;
Abstract: BACKGROUND:: Several studies support the need for effective interventions to reduce HIV transmission risk behaviors among people living with HIV/AIDS (PLWHAs). DESIGN:: Cross-sectional nationally representative demographic health survey of Kenya (2003) and Malawi (2004-2005) that included HIV testing for consenting adults. METHODS:: We analyzed demographic health survey data for awareness of HIV status and sexual behaviors of PLWHAs (Kenya: 412; Malawi: 664). The analysis was adjusted (weighted) for the design of the survey and the results are nationally representative. FINDINGS:: Eighty-four percent of PLWHAs in Kenya and 86% in Malawi had sex in the past 12 months and in each country, 10% reported using condoms at last intercourse. Among sexually active PLWHAs, 86% in Kenya and 96% in Malawi reported their spouse or cohabiting partner as their most recent partner. In multivariate logistic regression models, married or cohabiting PLWHAs were significantly more likely to be sexually active and less likely to use condoms. Over 80% of PLWHAs were unaware of their HIV status. Of HIV-infected women, nearly three-quarters did not want more children either within the next 2 years or ever, but 32% in Kenya and 20% in Malawi were using contraception. INTERPRETATION:: In 2003-2005, majority of PLWHAs in Kenya and Malawi were unaware of their HIV status and were sexually active, especially married or cohabiting PLWHAs. Of HIV-infected women not wanting more children, few used contraception. HIV testing should be expanded, prevention programs should target married or cohabiting couples and family planning services should be integrated with HIV services.
Language: English
Keywords:
KENYA | MALAWI | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | PERSONS LIVING WITH HIV/AIDS | AWARENESS | SEX BEHAVIOR | CONDOM USE | CONTRACEPTION | NEEDS | FERTILITY PREFERENCES | HIV/FP INTEGRATION | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Southern | Demographic Surveys | Population Dynamics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Knowledge | Sociocultural Factors | Behavior | Risk Reduction Behavior | Family Planning | Economic Factors | Fertility | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341748

15.

Peer Reviewed

Title: Pregnancy and optimal care of HIV-infected patients.
Author: Anderson BL; Cu-Uvin S
Source: Clinical Infectious Diseases. 2009 Feb 15;48(4):449-55.
Abstract: Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern. To prevent transmission, universal testing for HIV infection in pregnant women is ideal. In the United States and other developed countries, great strides have been made toward decreasing the risk of HIV transmission to infants to <2% with use of a combination of highly active antiretroviral therapy during the antepartum period and during labor and delivery, scheduled cesarean section when appropriate, avoidance of breast-feeding, and 6 weeks of zidovudine prophylaxis for infants. The continuation of antiretroviral therapy after delivery depends on the needs of the mother with regard to treatment of her own health. In resource-limited countries, where simplified and shortened courses of antiretroviral regimens have been used, reduction in mother-to-child transmission has also been shown, although not as effectively as that with highly active antiretroviral therapy. In these settings, exclusive breast-feeding for 6 months is recommended to reduce the risk of postnatal transmission.
Language: English
Keywords:
UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | RECOMMENDATIONS | PREGNANT WOMEN | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | RISK FACTORS | CESAREAN SECTION | BREASTFEEDING | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Disease Transmission Control | Prevention and Control | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Drugs | HIV | HIV Infections | Viral Diseases | Obstetrical Surgery | Surgery | Infant Nutrition | Nutrition
Document Number: 342644

16.

Peer Reviewed

Title: Can a clinical prediction tool guide HIV-testing decisions? Experience at a national hospital in Guatemala.
Author: Anderson MR; Samayoa B; O'Sullivan LF; Fletcher J; Arathoon E
Source: International Journal of STD and AIDS. 2009 Jan;20(1):30-4.
Abstract: The USA and international recommendations no longer emphasize using risk factors to target groups for HIV-testing. Using a Guatemalan database of HIV tests, we developed a clinical prediction rule to guide decisions on HIV-testing. Prior to HIV-testing, data were collected on demographics, risk factors and prior testing. Based on a theoretical construct incorporating demographics, known HIV risk factors and symptoms, we developed a logistic regression model to predict HIV seropositivity. Between 2000 and 2005, 16,471 tests were performed, of which 19.8% were positive. The algorithm successfully predicted 1883 of 2489 HIV-positive tests (sensitivity 76%, likelihood ratio [LR]-positive 2.45) and 6282 of 9086 HIV-negative tests (specificity 69%, LR-negative 0.35). Although the model indices are robust, applying the model in a clinical setting would have little impact on improving selective testing practices. Our findings support current recommendations for universal HIV-testing, not selective testing based on risk factors. Before these recommendations can be adopted widely in Guatemala, treatment access needs to be assured and protections put in place for people diagnosed with HIV infection.
Language: English
Keywords:
GUATEMALA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | MATHEMATICAL MODEL | STATISTICAL REGRESSION | HIV TESTING | HOSPITALS | DECISION MAKING | RISK ASSESSMENT | PROBABILITY | Central America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Theoretical Models | Data Analysis | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Behavior | Evaluation | Statistical Studies
Document Number: 330715

17.

Peer Reviewed

Title: Comparison of HIV type 1 sequences from plasma, cell-free breast milk, and cell-associated breast milk viral populations in treated and untreated women in Mozambique.
Author: Andreotti M; Galluzzo CM; Guidotti G; Germano P; Altan AD; Pirillo MF; Marazzi MC; Vella S; Palombi L; Giuliano M
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):707-11.
Abstract: We analyzed the sequences of the HIV viral populations obtained from plasma, cell-free breast milk, and breast milk cells of HAART-treated (23) and untreated (30) HIV-infected women to obtain information about the origin of the breast milk virus. Sequence analyses of viruses were performed using the TruGene HIV-1 assay. Direct sequences of the reverse transcriptase (RT) and protease (PR) genes were analyzed using the Phylip 3.68 suite of sequence analysis program and pairwise evolutionary distances were calculated with the Kimura two parameter model for estimation of distances. We found that the genetic distances between the plasma and the cell-free breast milk viruses and between the cell-free and cell-associated breast milk viruses for RT were higher in HAART-receiving women than in untreated women, suggesting viral evolution under selective drug pressure in breast milk. Our data support the hypothesis of the presence of an actively replicating viral population in the breast milk compartment, distinct from that present in plasma.
Language: English
Keywords:
MOZAMBIQUE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | HUMAN MILK | HIV | HIV TESTING | LABORATORY PROCEDURES | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342889

18.

Peer Reviewed

Title: Increasing the acceptability of HIV counseling and testing with three C's: convenience, confidentiality and credibility.
Author: Angotti N; Bula A; Gaydosh L; Kimchi EZ; Thornton RL; Yeatman SE
Source: Social Science and Medicine. 2009 Jun;68(12):2263-70.
Abstract: Agencies engaged in humanitarian efforts to prevent the further spread of HIV have emphasized the importance of voluntary counseling and testing (VCT), and most high-prevalence countries now have facilities that offer testing free of charge. The utilization of these services is disappointingly low, however, despite high numbers reporting that they would like to be tested. Explanations of this discrepancy typically rely on responses to hypothetical questions posed in terms of psychological or social barriers; often, the explanation is that people fear learning that they are infected with a disease that they understand to be fatal and stigmatizing. Yet when we offered door-to-door rapid blood testing for HIV as part of a longitudinal study in rural Malawi, the overwhelming majority agreed to be tested and to receive their results immediately. Thus, in this paper, we ask: why are more people not getting tested? Using an explanatory research design, we find that rural Malawians are responsive to door-to-door HIV testing for the following reasons: it is convenient, confidential, and the rapid blood test is credible. Our study suggests that attention to these factors in VCT strategies may mitigate the fear of HIV testing, and ultimately increase uptake in rural African settings.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | PREVALENCE | LONGITUDINAL STUDIES | RURAL POPULATION | HIV TESTING | VOLUNTARY COUNSELING AND TESTING | FEAR | Africa | Developing Countries | Measurement | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Emotions | Psychological Factors | Behavior
Document Number: 342741

19.

Title: Efficacy and acceptability of rapid, point-of-care HIV testing in two clinical settings in Ghana.
Author: Appiah LT; Havers F; Gibson J; Kay M; Sarfo F; Chadwick D
Source: AIDS Patient Care and STDs. 2009 May;23(5):365-9.
Abstract: This study assessed the efficacy and acceptability of two rapid point-of-care HIV assays used in a voluntary counseling and testing (VCT) and a tuberculosis (TB) clinic in Kumasi, Ghana. Over a 4-week period in 2007, 95 individuals attending the VCT clinic and 35 patients with newly diagnosed TB were offered a rapid HIV test. Rates of return for positive results and attendance at the HIV clinic were compared with 471 individuals (395 attending the VCT clinic and 76 patients with TB), tested during an 8-week period 6 months earlier using standard testing procedures. All patients offered a rapid test in each clinic underwent testing, compared to 93% of VCT clients and 40% of TB patients offered a test 6 months earlier. In the rapid testing period, 37%, 60%, and 3% of the VCT clients and 26%, 74% and 0% of the TB patients had positive, negative, or indeterminate serology, respectively. There were no discordant results following retesting of patients with a positive test. All patients attending either the VCT or TB clinics who tested positive for HIV with the point-of-care test returned to the HIV clinic for care, while only 64% and 95%, respectively, of the patients previously testing positive had returned for follow-up. Both clients and staff showed high levels of satisfaction with the rapid testing procedure. In conclusion, rapid point-of-care testing in both of these settings was successful in improving diagnosis of HIV infection and engaging those testing positive in a clinical care program.
Language: English
Keywords:
GHANA | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | HIV TESTING | PROGRAM ACCEPTABILITY | CLINIC ACTIVITIES | VOLUNTARY COUNSELING AND TESTING | TUBERCULOSIS | SATISFACTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Infections | Diseases | Psychological Factors | Behavior
Document Number: 342184

20.
Peer Reviewed

Title: HIV testing rates and outcomes in a South African community, 2001-2006: implications for expanded screening policies.
Author: April MD; Walensky RP; Chang Y; Pitt J; Freedberg KA; Losina E; Paltiel AD; Wood R
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51(3):310-6.
Abstract: BACKGROUND: Revised World Health Organization recommendations seek to increase HIV testing. We assessed the need for expanded testing in South Africa by examining current testing and treatment trends among a high prevalence population. METHODS: We determined the numbers of adults receiving HIV testing and antiretroviral treatment (ART) during 2001-2006 using testing registers linked to patient records from 2 health care facilities believed responsible for virtually all HIV services available to the population. We evaluated annual population testing rates using census population counts; proportions of clients testing seropositive (yield); CD4 counts and World Health Organization stage at diagnosis; and ART initiation rates. RESULTS: HIV testing rates rose from 4% in 2001 to 20% in 2006 (P < 0.001) and were highest among pregnant females receiving provider-initiated testing. Yield for first-time testers decreased from 47% in 2001 to 28% in 2006; annual incidence of seroconversion among initially HIV-negative retesters was 1.9%. Median CD4 counts and World Health Organization stage distributions for newly diagnosed clients remained stable. HIV-infected clients receiving ART within 6 months of eligibility increased from 0% in 2001 to 68% in 2006 (P < 0.001). CONCLUSIONS: Population testing and ART initiation rates rose dramatically during 2001-2006. Yet, yield remained high, and HIV-infected persons continued to receive late diagnoses. These findings highlight the continuing need for expanded testing and linkage to care.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | DATA LINKAGE | STATISTICAL STUDIES | HIV TESTING | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | SCREENING | HEALTH POLICY | CENSUS | HIV INFECTIONS | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Studies | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Population Statistics | Measurement
Document Number: 342149

21.

Peer Reviewed

Title: Rapid scale-up of antiretroviral treatment in Ethiopia: successes and system-wide effects.
Author: Assefa Y; Jerene D; Lulseged S; Ooms G; Van Damme W
Source: PLoS Medicine. 2009 Apr 28;6(4):e1000056.
Abstract: There has been substantial expansion of access to ART and HIV counseling and testing in Ethiopia, whilst maintaining the performance of other health programs such as tuberculosis and maternal and child health services. Task shifting to the health officers, nurses, and health extension workers is thought to be responsible for these successes. However, HIV prevention interventions and management of chronic care patients are lagging behind. This may be due to lack of attention to these health care areas and to physicians leaving the public sector for NGOs, including AIDS-related NGOs. Prevention of HIV infection, retention of patients in chronic care, and retention of physicians in the public sector need urgent attention for effective and sustainable HIV/AIDS and health systems responses in the long term.
Language: English
Keywords:
ETHIOPIA | EVALUATION REPORT | ANTIRETROVIRAL THERAPY | PUBLIC HEALTH | PROGRAM ACCESSIBILITY | DECENTRALIZATION | HIV TESTING | HIV PREVENTION | AIDS PREVENTION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | HIV | HIV Infections | Viral Diseases | Diseases | Health | Program Evaluation | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | AIDS
Document Number: 341678

22.

23.
Title: Circumcision's place in the vicious cycle involving herpes simplex virus type 2 and HIV [editorial]
Author: Bailey RC; Mehta SD
Source: Journal of Infectious Diseases. 2009 Apr 1;199(7):923-5.
Abstract: HSV-2 as a biological cofactor in HIV acquisition and transmission has likely contributed substantially to the HIV epidemic. Although it remains possible that HSV-2 suppressive therapy will be efficacious in reducing HIV transmission, it is not clear how and whether a twice daily regimen of acyclovir will be manageable and effective at a population level. Research is needed to develop and test a prophylactic vaccine that, even if only partially protective against HSV-2 acquisition, is likely to be effective in both concentrated epidemics and in generalized epidemics in which a large proportion of HIV transmission occurs in stable partnerships. (excerpt)
Language: English
Keywords:
AFRICA | EUROPE | SUMMARY REPORT | INCIDENCE | HERPES GENITALIS | HIV INFECTIONS | MALE CIRCUMCISION | SEX BEHAVIOR | HIV TESTING | LABORATORY PROCEDURES | Developing Countries | Developed Countries | Measurement | Research Methodology | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses
Document Number: 341208

24.
Title: Role of the calcium channel in blastocyst implantation: a novel contraceptive target.
Author: Banerjee A; Padh H; Nivsarkar M
Source: Journal of Basic and Clinical Physiology and Pharmacology. 2009;20(1):43-53.
Abstract: The proinflammatory blastocyst implantation cascade involves important mediators like prostaglandins (PG). The influx of calcium via the calcium channel acts as a trigger for the activation of the PG synthesis pathway. Hence, it was hypothesized that calcium channel blockers that are known to possess anti-inflammatory activity may interfere with normal implantation. Pregnant Swiss albino mice (Mus musculus) were treated with diltiazem (1) 4 mg/kg, po on days 1-6 of pregnancy, n=6/day) or (2) at the implantation site (25 microg/animal) via intrauterine injection in the right horn at 5:00 pm on day 4. The intact uterus was used to assay lipid peroxidation and superoxide dismutase activity as markers of membrane fluidity or to observe the day 15 fetus. Oral diltiazem treatment in therapeutic dosage before and during the implantation period did not cause any change in normal uterine milieu during the window of implantation. When injected into the uterine lumen 12-14 h before the average implantation time, however, a complete failure in implantation was observed. Thus, the site specific action of diltiazem may be blocking prostaglandin synthesis, hence causing implantation failure. Oral diltiazem treatment did not mimic this action, indicating that although orally safe in pregnancy in therapeutic dosage, calcium channel blockers may provide a new and yet unknown target in female contraceptive research.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | LABORATORY PROCEDURES | LABORATORY ANIMALS | LIPID METABOLIC EFFECTS | CONTRACEPTION RESEARCH | Asia, Southern | Asia | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Physiology | Biology | Contraception | Family Planning
Document Number: 342045

25.

Peer Reviewed

Title: Sensitivity of paediatric AIDS score vs. WHO case classification in Indian children--a retrospective study.
Author: Banerjee T; Pensi T; Banerjee D
Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):91-6.
Abstract: This study was conducted at the Department of Paediatrics, Dr Ram Manohar Lohia Hospital, to test the statistical significance of existing World Health Organization (WHO) clinical case definition (CCD) for diagnosis of AIDS in areas where diagnostic resources are limited. A total of 360 cases between 18 months and 12 years of age satisfying WHO case definitions of AIDS were included in study group. Our study detected 16.66% (60) of HIV incidence in children visiting the paediatrics outpatient clinic. Twenty percent of cases manifested three major and two minor signs, which had sensitivity of 73.33%; specificity, 90.66% and positive predictive value (PPV), 61.11%. Stepwise logistic analysis identified weight loss, chronic fever >1 month and total lymphocyte count <1500 cells mm(-3) as important predictors. Eighty-six cases (23.89%) showed two major and two minor signs with sensitivity and specificity of 86.66 and 88.66%, respectively. Thus a CCD based on 13 clinical signs/symptoms was proposed for paediatric AIDS with better sensitivity and PPV than the WHO case definition but with almost similar specificity.
Language: English
Keywords:
INDIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | HIV TESTING | AIDS | LABORATORY PROCEDURES | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | STANDARDS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 331192

26.
Title: Evaluation of commercial HIV test kits used in Nigeria.
Author: Banwat EB; Peter JY; Egah DZ
Source: Nigerian Journal of Clinical Practice. 2009 Mar;12(1):11-4.
Abstract: BACKGROUND:Accurate and reliable diagnosis of HIV plays a central role in any effective HIV intervention. We decided to evaluate 4 commercial HIV test kits to determine their reliability for use in developing countries. METHODS: Serum samples obtained from clients accessing tertiary health services at the STI clinic, Jos University Teaching Hospital were used to evaluate Sdbioline, Diaspot, Determine and DIALAB Elisa kits. A Western blot was used as the reference kit. RESULTS: DETERMINE kit gave 34 positive and 58 negative reactions and the positive sera were all confirmed by Western blot while DIASPOT kit gave 27 false negative results, which was at variance with the reference kit result. Other kits were SDBIOLINE with 5 false positive and DIALAB Elisa kit, which gave one false positive, and one false negative result. CONCLUSION: We conclude that Determine, SDbioline and DIALAB Elisa kits are reliable for HIV antibody testing in Nigeria and other developing countries.
Language: English
Keywords:
NIGERIA | EVALUATION REPORT | CLIENTS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | HIV TESTING | EQUIPMENT AND SUPPLIES | RELIABILITY | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | SCREENING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Program Activities | Programs | Organization and Administration | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement
Document Number: 342689

27.

28.

Title: Antiretroviral drug resistance surveillance among treatment-naive human immunodeficiency virus type 1-infected individuals in Angola: evidence for low level of transmitted drug resistance.
Author: Bartolo I; Rocha C; Bartolomeu J; Gama A; Fonseca M; Mendes A; Cristina F; Thamm S; Epalanga M; Silva PC; Taveira N
Source: Antimicrobial Agents and Chemotherapy. 2009 Jul;53(7):3156-8.
Abstract: The prevalence of transmitted human immunodeficiency virus type 1 drug resistance in Angola in 2001 in 196 untreated patients was investigated. All subtypes were detected, along with unclassifiable and complex recombinant strains. Numerous new polymorphisms were identified in the reverse transcriptase and protease. Two (1.6%) unrelated patients harbored nucleoside reverse transcriptase inhibitor- and nonnucleoside reverse transcriptase inhibitor-resistant viruses (mutations: M41L, D67N, M184V, L210W, T215Y or T215F, and K103N). Continued surveillance of drug resistance is required for maximization of ART efficacy in Angola.
Language: English
Keywords:
ANGOLA | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | CLIENTS | DRUG RESISTANCE | ANTIRETROVIRAL DRUGS | HIV | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses
Document Number: 342987

29.

Title: Highly divergent subtypes and new recombinant forms prevail in the HIV/AIDS epidemic in Angola: new insights into the origins of the AIDS pandemic.
Author: Bartolo I; Rocha C; Bartolomeu J; Gama A; Marcelino R; Fonseca M; Mendes A; Epalanga M; Silva PC; Taveira N
Source: Infection, Genetics and Evolution. 2009 Jul;9(4):672-82.
Abstract: Angola, located in South-Western Africa, has a remarkably low HIV/AIDS prevalence in the adult population (3.7%). It is bordered in the North by the Democratic Republic of Congo (DRC) and Republic of Congo that are at the origin of human HIV-1 infections. It is, therefore, likely that HIV-1 strains circulating in Angola are genetically diverse and representative of the origin of the HIV/AIDS epidemic. The aim of this work was to investigate in detail the genetic diversity and molecular epidemiology of HIV-1 in Angola. Almost 400 sequences were obtained from the gag (p17), pol (PR and RT) and/or env (C2C3) genes of 159 HIV-1 infected patients living in eight provinces of Angola (Benguela, Cabinda, Cuanza Norte, Luanda, Lunda Norte, Malange, Uige, and Zaire) and their genotype was determined by phylogenetic analyses. Gene regions representing all HIV-1 group M clades were found as well as unclassifiable sequences. In env and pol (RT), two groups of sequences forming distinct sub-clusters within the subtype A radiation were found and may define new A5 and A6 sub-subtypes. Recombinant forms were found in almost half (47.1%) of the patients of which 36.0% were second-generation recombinants. Fifty-eight different patterns of recombination were found. The A subtype, including CRF02_AG, was represented in most recombinant viruses. Epidemiological data suggests that the AIDS epidemic in Angola has probably started as early as 1961, the major cause being the independence war, and spread to Portugal soon thereafter. The extraordinary degree of HIV-1 group M genetic diversity and evolution in Angola may pose unprecedented challenges to diagnostic, treatment and prevention of HIV-1 infection.
Language: English
Keywords:
ANGOLA | RESEARCH REPORT | PREVALENCE | EPIDEMIOLOGY | HIV | LABORATORY PROCEDURES | MANAGEMENT | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Public Health | Health | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Organization and Administration
Document Number: 342757

30.
Title: Estimating HIV-1 incidence using the serologic testing algorithm for recent HIV infections at HIV counseling and testing centers in the city of Sao Paulo, Brazil.
Author: Bassichetto KC; Bergamaschi DP; Veras MA; Sucupira MC; Mesquita F; Diaz RS
Source: Brazilian Journal of Infectious Diseases. 2009 Feb;13(1):9-12.
Abstract: The network of HIV counseling and testing centers in Sao Paulo, Brazil is a major source of data used to build epidemiological profiles of the client population. We examined HIV-1 incidence from November 2000 to April 2001, comparing epidemiological and socio-behavioral data of recently-infected individuals with those with long-standing infection. A less sensitive ELISA was employed to identify recent infection. The overall incidence of HIV-1 infection was 0.53/100/year (95% CI: 0.31-0.85/100/year): 0.77/100/year for males (95% CI: 0.42-1.27/100/year) and 0.22/100/ year (95% CI: 0.05-0.59/100/year) for females. Overall HIV-1 prevalence was 3.2% (95% CI: 2.8-3.7%), being 4.0% among males (95% CI: 3.3-4.7%) and 2.1% among females (95% CI: 1.6-2.8%). Recent infections accounted for 15% of the total (95% CI: 10.2-20.8%). Recent infection correlated with being younger and male (p = 0.019). Therefore, recent infection was more common among younger males and older females.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | ESTIMATION TECHNIQUES | STATISTICAL STUDIES | CLIENTS | HIV TESTING | HIV INFECTIONS | INCIDENCE | LABORATORY PROCEDURES | EPIDEMIOLOGY | PREVALENCE | TIME FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Measurement | Public Health | Population Dynamics | Demographic Factors | Population
Document Number: 342655


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