Factors associated with adherence to ARV treatment in people living with HIV/AIDS in a rural area (Koula-Moutou) in East Gabon

The goal of this study was to evaluate the impact of socio-clinical factors on adherence to antiretroviral treatment in people living with HIV/AIDS in Koula-Moutou (a rural area of Gabon). Two adherence assessment methods based on patient declaration and compliance with pharmacy visits were used to determine qualitative and quantitative aspects of adherence to antiretroviral therapy (ART). The quantitative (82.2%) and qualitative (79.5%) adherences to ART declared by patients were higher than those obtained through pharmacy visit assessment methods (15.8% and 45.2%, respectively). Moreover, the declarative and pharmacy visit compliance methods showed fair agreement (quantitative Kappa = 0.317; qualitative Kappa = 0.311). A better quantitative or qualitative declarative adherence was associated with a lower level of education (P = 0.05 and P = 0.025 respectively). This study reported for the first time the factors influencing adherence to ART in a rural area of East Gabon. We recommend further investigations in a large cohort to better assess the impact of socio-clinical factors on ART adherence in a vulnerable group of patients

AIDS prevention in sub-saharan Africa: as easy as abc?

Background: The failure to stem HIV in sub-Saharan Africa and the unique epidemiological modes of infection within this region have demonstrated that unique strategies for combatting the virus are required. This review article discusses why international AIDS campaigns in sub-Saharan Africa have largely been unsuccessful; and what; if any; strategies have worked. Methods: Articles were compiled using Web of Science and Google Scholar search engines. Results: Inspired by past successes in the West and in Southeast Asia; Western AIDS initiatives have attempted to replicate these results within the African continent through 'risk reduction' approaches; vying to reduce the probability of HIV transmission per coital act via physical or biochemical barriers such as condoms; male circumcision; antiretroviral therapy; post-exposure prophylactic drugs; and treatment of sexually transmitted infections. However; more than three decades of research have demonstrated that the most successful strategies were African-inspired; relied on local resources with minimal Western support; culturally relevant; and used social engineering programs that dismantled networks of sexual relationships by promoting the practice of abstinence; reducing the number of sexual partners; discouraging multiple and concurrent relationships;delaying sexual debut; and maintaining mutually monogamous relationships. Conclusion: Known through the mnemonic 'ABC' (Abstinence; Be faithful; Condoms); this strategy was first implemented in Uganda; yielding remarkable successes both in Uganda and thereafter in other African nations in stemming HIV. AIDS agencies should support and encourage programs that use this culturally sensitive; low cost; and effective strategy

Kwazulu-Natal Minibus Taxi Drivers' Perceptions on HIV and AIDS: Transmission; Prevention; Support and Effects on the Industry

In South Africa; the minibus taxi drivers are largely becoming another high-risk category in the HIV and AIDS epidemic. Although previous studies have shown that knowledge of HIV and AIDS is relatively high among the taxi drivers it is still not clear how this sub-population perceive the support rendered to them with regard to HIV and AIDS prevention strategies. This study aimed to focus on this atypical workplace and explore the KwaZulu-Natal; minibus taxi drivers' perceptions on HIV and AIDS. In this study; qualitative methods were utilized to determine the minibus taxi drivers' understanding of HIV and AIDS infection; HIV prevention strategies; existing support strategies and effects of HIV and AIDS on the taxi industry. Focus-group discussions were conducted; to collect data. The results showed that even though the taxi drivers had some understanding on HIV and AIDS there was still a dire need for interventions that were geared towards addressing HIV-related needs of the drivers in this industry

Adolescent Religiosity and Attitudes to HIV and AIDS in Ghana

This study investigated the relationships between adolescent religiosity and attitudes to HIV/AIDS based on two major techniques of analysis; factor and regression analysis towards informing preventive school education strategies. Using cross-sectional data of 448 adolescents in junior high school; the study incorporated survey in a self-administered questionnaire and sought to identify underlying factors that affect pupils' responses; delineate the pattern of relationships between variables and select models which best explain and predict relationships among variables. A seven-factor solution described the 'attitude' construct including abstinence and protection; and six for 'religiosity'. The results showed relatively high levels of religiosity and a preference for private religiosity as opposed to organisational religiosity. The regression analysis produced significant relationships between factors of attitudes to HIV/AIDS and of religiosity. Adolescent with very high private religiosity are more likely to abstain from sex but less likely to use condoms once they initiate: protection is inversely related to religiosity. The findings suggest that religious-based adolescent interventions should focus on intrinsic religiosity. Additionally; increasing HIV prevention information and incorporating culturally relevant and socially acceptable values might lend support to improved adolescent school-based HIV/AIDS prevention programmes

Epidemiology of HIV-tuberculosis co-Infection among patients on anti-retroviral therapy in Sokoto State, Nigeria

"Background: Human immunodeficiency virus/acquired immune deficiency syndrome and tuberculosis are commonly called the ""deadly duo""; because human immunodeficiency virus increases susceptibility to tuberculosis which in turn accelerates its progression to acquired immune deficiency syndrome. This study describes human immunodeficiency virus/ tuberculosis co-infection in Sokoto State; Nigeria. Methods: Data were extracted from medical records of human immunodeficiency virus infected patients on antiretroviral therapy in health facilities that offer comprehensive care for human immunodeficiency virus infected patients in Sokoto State; and analysed. Results: Majority of the 353 study subjects were females (60.6) aged 30-39 years (37.4) and living in Sokoto state (78.5). Care entry points were Medical Outpatient Department (36.8); General Outpatient Department (35.4) and voluntary counseling centre (23.5). Enrolment for human immunodeficiency virus care was highest in May (13.4) and lowest in March (5.1). The functional status of majority (75.8) of the study subjects was asymptomatic normal activity. Thirty-three (9.3) of the study subjects were human immunodeficiency virus/Tuberculosis co-infected. Human immune deficiency virus only cases and human immunodeficiency virus/Tuberculosis co-infected cases were similar with respect to age and sex but differed significantly with respect to WHO clinical stage; CD4 count and functional status. Conclusion: Human immunodeficiency virus only and human immunodeficiency virus/tuberculosis coinfection cases have similar demographic characteristics but differ with respect to the stage of acquired immune deficiency syndrome."

Evolution of HIV/AIDS Discourse among the Haya on Ten Landing Sites on the Western Shores of Lake Victoria; Tanzania: Need for a Shift from a Biomedical to a Meaningful Life Discourse

"Kagera is one of the areas considered to be an epicentre of the HIV/AIDS epidemic in Tanzania. This has been due to linking HIV/AIDS and the cross-border trade between Uganda and Tanzania; an activity that was due to lack of essential commodities after the Uganda-Tanzania War of 1978-1981. In a survey in the landing sites of Lake Victoria; where one of the elements is to know the state of HIV/AIDS; it is found out that people are giving up in their struggle against HIV/AIDS; a situation that leads to the perception of contracting HIV/AIDS being an ""occupational hazard"". As the African sexual permissiveness theory has been at the back of the bio-medical discourse and the eventual behavioural change paradigms in guiding HIV/AIDS interventions; this article proposes change of discourse by having the meaningful life discourse in HIV/AIDS interventions."

HIV Epidemiology and Trends in a Large National Manufacturing Company in South Africa; 2001-2006

This paper presents epidemiological data from ongoing HIV-prevalence surveillance in a large South African manufacturing company located in various provinces; as well as one location in Swaziland. A survey of the workforce in 12 of the manufacturer's business units (BUs) throughout these locations was carried out in 2001-2003; and each was repeated three years later; in 2004-2006. The company is typical of manufacturing in South Africa; in that it is labour-intensive; male-dominated; and has high proportions of semi-skilled and unskilled employees. The surveys were anonymous; cross-sectional and unlinked. The workforce was stratified at the level of analysis by workplace; geographical location; job status (permanent or contract); job skill level; and age group. In 2001/3 a total of 5 177 permanent employees; representing 76of those on duty at the time; plus 1 966 contract employees were surveyed. In 2004/6; 5 445 permanent employees; representing 81 of those on duty; and 2 688 contract employees were surveyed. HIV prevalence in the 2004/6 survey ranged from 0.9-30.7throughout the 12 BUs; with a mean of 15.4; showing an increase from the previous mean of 13prevalence in the 2001/3 survey of the same locations (p = 0.0001). Differences in HIV prevalence across the BUs were determined by geographical location and the profile of the workforce. Similar proportions of contract employees were found to be HIV-positive in the initial survey and repeat survey (23 and 24.5; respectively). HIV prevalence was inversely proportionate to permanent employees' job skill level. The 2004/6 data show lowest HIV prevalence in the upper-management category (3.6) and highest prevalence in the unskilled category (22.6). HIV prevalence did not increase in the upper- and middle-management categories but increased significantly in the skilled (p = 0.02); semi-skilled (p 0.001) and unskilled (p 0.001) job categories. HIV prevalence was similar among contract employees and unskilled permanent employees. Race (not considered in the study) may in part confound these findings. In both surveys; HIV prevalence was highest in the age group 30-39. Prevalence did not increase between surveys in the age group 18-29; however; significant increases occurred in the age groups 30-39 and 40-49 (p 0.001); and possibly also in the age 50+ category (p

Atteintes neuro-meningees : etudes epidemiologique; clinique et paraclinique chez 130 sideens en milieu hospitalier a Abidjan

I- Objectifs : Face au polymorphisme clinique des differentes pathologies chez malades du SIDA et au veritable probleme de sante publique que ce dernier pose nous nous sommes proposee de decrire les atteintes neuro-meningees rencontrees chez des sideens en milieu definissant les caracteristiques epidemiologiques et les particularites clinique et paracliniques. Il- Methodologie : cette etude retrospective a porte sur les atteintes neuro-meningees au cours du SIDA. Elle a permis de repertorier 130 patients ayant sejourne dans le service de Option : Medecine interne du CHU de Treichville (Abidjan-RCI); grace a la classification de la CDC-OMS de 1987. L'etude a couvert la periode allant de juillet 1995 a Aout 2000. III- Resultats : De cette etude; il ressort que : les adultes jeunes de sexe feminin et de bas niveau socio-economique sont les plus atteintes.Le zona est l'antecedent le plus frequent chez ces patients 48;6 pour cent. En plus de l'alteration de l'etat general; de la fievre au long cour et du coma qui sont les motifs de consultation les plus frequents; les cephalees constituent les signes neuropsychiatriques les plus importants (66;9 pour cent). La raideur meningee represente l'atteinte du tonus musculaire le plus important (55;4 pour cent). Quoique les paresies et les paralysies aient domine les troubles de la motricite elles ne permettent pas de presager du siege des lesions encephaliques observees a la tomodensitometrie. Par ailleurs; nous avons note des signes d'atteintes radiculaires et cerebelleuses (5;4 pour cent); l'atteinte du nerf facial a represente la moitie de toutes les atteintes des paires craniennes. Les reactions immunologiques etaient importantes malgre la presence des lesions neurologiques (serologie toxoplasmique; hyperleucocytose...). La toxoplasmose cerebrale a ete l'affection opportuniste la plus frequente avec 51;5 pour cent des cas puis a suivi la cryptococcose neuro-meningee avec 17 pour cent des cas. Les ponctions lombaires realisees ont permis de mettre en evidence des liquides cephalo-rachidiens d'aspect clair avec hyperproteinorachie et hypoglycorachie a predominance lymphocytaire. L'evolution de ces patients s'est averee le plus souvent defavorable car le sejour moyen en hospitalisation etait de 2;9 semaines et la letalite a ete de 33;8 pour cent; au vu des conditions de travail de nos praticiens. IV-Conclusion : Cette etude nous a permis d'affirmer la gravite des atteintes neuro-meningees au cours de l'infection au VIH. D'ou la necessite d'une reelle mobilisation pour la lutte contre une telle pandemie

HIV seroprevalence in three population groups

Many strategies exist for HIV antibody testing. Using a combination of an Enzyme immunoassay and Western Blotting; we found anti-HIV seroprevalence of 1.6 per cent; 1.2 per cent and 34.8 per cent in blood donors; pregnant women and patients with clinical symptoms of AIDS; respectively. Due to worldwide interest in the epidemiology of HIV disease; correct identification of infected people is important. The false labelling of people as seropositive only on ELISA screening has psychological implications. The importance of anti-HIV confirmatory testing when the test objective is diagnosis is stressed

Model stimulation of the HIV/AIDS epidemic in Uganda

The objective was to model the HIV/AIDS epidemic among the adult population (15-54 years) in Uganda; taking into account the sexual mixing and variability of infectiousness of an individual infected with HIV. The HIV/AIDS epidemic in Uganda is modeled using a computer simulation; based on a mathematical model; over a period of 30 years from the period the virus is anticipated to have been introduced in the population. The model examines transmission via sexual contact; blood transfusion; and intensive surgery. The results showed that HIV prevalence rates are found to be higher for uniform infectivity compared to variable infectivity; as well as for number of new partners based on a distribution compared to mean number of new sex partners. Blood transfusion was responsible for 0.09- 0.30of the HIV infection; while none were obtained from the projections for invasive surgery. It was concluded that use of uniform infectivity as well as use of categorical mean number of new sex partners may over estimate and underestimate the epidemic; respectively. Before blood was screened; it accounted for a small but significant portion of the epidemic

Organisation de la surveillance epidemiologique du VIH/SIDA

Pour maitriser les tendances de l'infection a VIH/SIDA; le Programme National de Lutte contre le SIDA au Togo; a mis sur pied une fiche de notification. Il ressort de cette etude que le nombre total des cas cumules de SIDA de 1987 a 1994 s'eleve a 4756. Ceci a pousse le Programme a opter depuis 1992 pour une decentralisation de ses activites. La realisation des activites de la surveillance epidemiologique est favorisee par la formation d'un reseau de laboratoires formant ensemble le Centre National de Reference pour les tests VIH (CNR/VIH)

AIDS case surveillance in Ethiopia: April 30; 1994

The major objectives of the publication are: to notify the current status of AIDS epidemic in the country; and provide information for decision making and future planning. It is also to provide feedback to health institutions and collaborating agencies in the country

AIDS case surveillance in Ethiopia: April 30; 1994

This report is published by the Epidemiology and AIDS control department of the MOH on a monthly basis. The major objectives are: to notify the current status of AIDS epidemic in the country; to provide information for decision making and future planning and to provide feedback to health institutions and colaborating agencies in the country

AIDS epidemic in Lesotho

Since the emergence of the first diagnosed case in Lesotho in 1986; the number of cases has continued to increase at a very alarming rate. Although this situation is not unique to Lesotho but follows a similar pattern in most countries of the world; especially the developing countries; it nevertheless gives cause for great concern which demands an increasing effort on the part of every individual and from all sectors of the country. As of September; 1994 a total of some 440 AIDS cases have been diagnosed and reports from sentinel surveillance sites also indicate a rising trend in the spread of the infection as measured by the number of persons infected by HIV

Aspectos epidemiologicos da SIDA. O HIV-2 na Africa Ocidental

The author presents a global overview of the AIDS pandemic from its appearance in 1981 to the present; including the discovery of the HIV virus in 1983. 851;628 cases have been notified to the World Health Organization. Reference is made to the groups initially affected and at high risk-male homosexuals and drug users-and their sexual partners. Attention is drawn to the three modes of transmission known today-sexual; parenteral; and vertical- and to their contribution to the dynamic nature of the epidemic. The increase in heterosexual transmission in industrialized countries; the rapid spread of the virus through heterosexual intercourse and the safety of blood transfusion in underdeveloped countries; and mother-child transmission are discussed. Reference is also made to the impact on health; social life; the economy; politics and religion; with emphasis on underdeveloped countries; namely in Africa. The regions in Africa with the highest prevalences of HIV-2 infection are discussed. finally; the author analyses in detail the spread of HIV-2 in Western Africa; including the higher prevalence of HIV-2 infection relative to HIV-1 infection in Guinea-Bissau. The author explores some ideas using results of prevalence and follow-up studies in infected population groups carried out by herself and her collaborators in Guinea-Bissau

Avancee du front epidemique de l'infection a VIH1 en Afrique centrale

Pour limiter l'expansion de l'infection a VIH une etude socio-spaciale s'avere necessaire. En Afrique Centrale; la prevalence presente une situation contrastee; d'un cote l'expansion est rapide et lente de l'autre. Malgre une relative accalmie dans les grandes metropoles; on note une nette expansion dans les centres urbains secondaires

Update on the HIV epidemic in Cameroon

The study aimed at estimating the extent of AIDS epidemic in Cameroon upon which a guideline for activities of the National AIDS programme could be based. It comprises a total of 2377 individuals who attended the antenatal clinic (n=1091); subjects attending sexually transmitted diseases (STD) clinics (n=382) and blood donors (n=212). In Kumba a random recruited individuals attending the hospital casual consultation (n=160) was done; and compared their HIV seroprevalence results with those of frozen samples (n=391) collected from a malaria community survey in 1989; and 141 randomly selected pygmies aged between 18-45 years in the eastern province of Cameroon was screened. HIV-1/2 infection was detected with one or the other of a combined screening assay. The results obtained were as follows: in Kumba; one of the 391 was positive (0.3 percent; CL; 0-0.8) compared with one of the 160 casual consultants sera in 1992 (0.6 percent; CL; 0-1.4). In the rural areas; 13 individuals (3.5 percent; 95 percent CL; 1.7-5.3) were HIV-1 positive; one was HIV-2 positives and one of the 141 pygmies (0.7 percent; 95 percent CL; 0-2) was HIV-1 positive. The seroprevalence results in Bamenda and Bafoussam ranged from 4.2 percent and 1.2 percent. Thus rate varied from 4.3 percent in Kumba to 8.8 percent in Ngaoundere and those reported in Yaounde between 189-90 were 3.3. High HIV seroprevalence was found in blood donors in Bamenda and Limbe (3.1 to 5.7 percent). The authors concluded that since HIV will inevitably reach the remote areas in Africa; HIV control activities must be inititated in all populations in Cameroon irrespective of their location

Mortality and geographical distribution of AIDS patients in Mangochi: an indication of the impact on Mangochi Hospital

In an attempt to determine a possible impact of the AIDS epidemic on Mangochi Hospital; basic information such as drug use; admission days and date and place of death of 971 patients presenting at Mangochi Hospital between 1986-1990 was prospectively studied. The study shows that; despite the rural characteristics of the district; AIDS/HIV infection is strongly related in urban and rural settings to a high economic activity

The present and future course of the AIDS epidemic in Côte d'Ivoire

An assessment of the current and future mortality and morbidity from acquired immunodeficiency syndrome (AIDS) in Côte d'Ivoire was made using the results of the 1989 national survey of the prevalence of human immunodeficiency (HIV) infection in the country and the AIDS projection model developed by WHO. For 1989 it was estimated that about 25,000 AIDS cases in adults and children had occurred, although the total number of cases reported for 1989 (up to 1 July 1991) was about 13% (1:6.9) of this estimated total. It is projected that by 1994 in Côte d'Ivoire the cumulative number of cases of AIDS in adults will be 89,000, and that for infants and children the corresponding number will be 41,000. It was also projected that about 371,000 uninfected children will have been born to HIV-infected mothers in Côte d'Ivoire by 1994 and that many of these children will have been orphaned by the deaths of their mothers from AIDS

Profil de l'epidemie VIH/SIDA au Cameroun

Les auteurs font le point des resultats du systeme de surveillance sentinelle de l'infection a VIH et du SIDA mis en place au Cameroun depuis 1989. Au 31 decembre 1991; le total cumule des cas declares s'eleve a 763 pour un nombre de cas attendus de 300. Le taux de prevalence de l'infection a VIH1 est d'environ 1;5 pour cent dans la population generale adulte en milieu urbain. La situation en zone rurale demande a etre mieux precisee