ABSTRACT
Background: In order to advance the extent of self-disclosure of HIV sero-status in Nigeria, we evaluated the prevalence, pattern and determinants of disclosure of HIV status amongst adult patients in a hospital in the Niger Delta. Materials and Methods: In a three month cross sectional study undertaken in March 2012, the demographic and clinical data as well as HIV sero-status disclosure frequency and pattern were obtained using a pre-tested questionnaire from consenting HIV infected adults attending the Anti-Retroviral Therapy Clinic in the Niger Delta. Independent determinants of HIV disclosure to current sexual partner were determined using an unconditional logistic model. P<0.05 was considered statistically significant. Results: A total of 260 patients were studied out of which 184(71%) were females. Disclosure to current sexual partner was found to be 62.0% and students had the least disclosure rate. Majority of study participants preferred to disclose to family members (57%) than past sexual partner (2.5%) or friend (4.9%). Although HIV disclosure was significantly associated with male sex, living with sexual partner, partner being HIV positive; the only independent determinants of HIV disclosure were partner being on ART (OR-12.7,95% CI 1.2-132.7)and being currently married (OR-8.8,95% CI 2.1-36.8). Conclusion: The results of our study suggest low rate of HIV status disclosure among HIV infected patients in the Niger Delta. We found that receiving ART and being currently married promoted disclosure. There is need for clinicians and policy makers to foster disclosure of HIV sero-status in Nigeria especially among HIV infected students and unmarried sexual partners
Subject(s)
HIV Seroprevalence , Niger , Nigeria , Self DisclosureABSTRACT
Background: There is a dearth of studies on HHV8-HIV co-infections from Nigeria; even as both infections have been shown to be endemic in Africa. This study examined the seroprevalence and determinants of HHV8 infections in adult Nigerians with and without HIV-infection. Methods: In 2007; a cross sectional study undertaken in a tertiary hospital in Zaria; northern Nigeria enrolled 71 HIV-1 positive adults without Kaposi's sarcoma and 85 apparently healthy HIV-negative adult volunteers of the general population. Anti-lytic antibodies to HHV8 infection was determined by ELISA. A univariate analysis including age; sex; marital status; past sexually transmitted disease (STD); past blood transfusion; HIV/AIDS staging and CD4 count was used to determine variables associated with HHV8 seropositivity. Significant variables were adjusted in a logistic regression model expressed in odds ratio (OR) with 95confidence interval (CI). P0.05 was considered significant Results: The seroprevalence of HHV8 infection was 62in HIV-1 positive patients and 25.9in HIV negative adults (p0.001). A past history of STD [ORCI= 1.0 - 8.2] and advanced HIV/AIDS (WHO stage 3 and 4) [OR=3.5; 95CI= 1.21-10.1] were the only variables independently associated with HHV8 seropositivity in HIV-infected patients. In HIV-negative adults; none of the variables was significantly associated with HHV8 seropositivity. Conclusion: The study findings suggest an adverse interaction between HHV8 and HIV-1. The higher prevalence of HHV8 infection in HIV-infected patients and its association with STD support a predominant sexual route of HHV8 transmission among adult Nigerians
Subject(s)
Adult , Humans , Seroepidemiologic StudiesABSTRACT
Background:The introduction of the highly active antiretroviral therapy in the mid-1990s has significantly reduced morbidities and prolonged the lifespan of people living with HIV. However; the emergence of resistance to the antiretroviral drugs is becoming a major cause of treatment failure. While the problem of drug resistance is being tackled in developed countries; not much seem to be done in this regard in developing countries of Africa; Asia and Latin America. This review looked at the regional distribution of HIV groups and subtypes and how this has affected the pattern of antiretroviral resistance. Methods: The review was sourced from papers presented at international conferences on HIV/AIDS and rational drug use; relevant journals and Medline search using the keywords- Antiretroviral drugs; drug resistance; HIV subtypes and resistance testing. Results: The types; groups; subtypes; sub-subtypes and recombinant forms of HIV-1 have been identified according to their geographical distributions. The evolution of HIV viral mutations; process (es) involved in development of primary and secondary antiretroviral drug resistance; including the role of HIV genetic polymorphisms; and transmitted resistance have been discussed. Conclusion: The pitfalls in the current resistance testing based on HIV-1 subtype B have been highlighted. The design of resistance testing algorithm based on HIV-1 subtype non-B has been suggested for the developing world