Injecting drug use & HIV prevalence among female sex workers: Evidence from the National Integrated Biological & Behavioural Surveillance, India

Background & objectives: Female sex workers (FSWs) who inject drugs (FSW-IDs) have a higher risk of HIV infection and transmission. Understanding the socio-demographic characteristics and other risk behaviours among FSW-IDs will help in strengthening targeted interventions for HIV prevention and management. In the present study, the HIV prevalence, associated socio-demographic characteristics and risk behaviours among FSWs who injected drugs (FSW-IDs) and those who did not ID (FSW-NIDs) was determined in India. Methods: The national cross-sectional, community-based, integrated biological and behavioural surveillance was conducted in 2014-2015 at 73 randomly selected FSW domains across 28 States and Union Territories in India. The sample size was fixed at 400 for each domain, and a probability-based sampling method was followed. The data were analyzed by logistic regression methods. Results: Data from 27,007 FSWs were included in the analysis, of which 802 (3%) were FSW-IDs. HIV prevalence among FSW-IDs was significantly higher than that in FSW-NIDs (4.5 vs. 1.9%). Univariate analysis showed that factors significantly associated with higher HIV prevalence among FSW-IDs were older age, sex work as the only source of income, dissolved marriage, living with a sex worker, urban locality of sex work and consumption of alcohol or oral drugs. In multivariable analysis, factors such as older age of FSW-IDs (35 yr and above), having a dissolved marriage and sex work being the only source of income were observed to be independently and significantly associated with higher HIV prevalence. Interpretation & conclusions: Scaling up the HIV preventive interventions for FSW-IDs, such as facilitating awareness and improved access to needle and syringe exchange programme (NSEP) and opioid substitution therapy (OST), encouraging safe sex and injecting practices, educating on the harmful effects of alcohol and drugs and providing alternative vocation options to secure their financial needs are several strategies that may reduce HIV transmission among FSWs.

PMTCT Service Uptake among Pregnant Women in 3 Internally Displace Persons Camps in Borno State Northeast Nigeria

Background: Humanitarian emergencies upset and wreck existing healthcare services and systems. Pregnant women and infant are incredibly defenseless, as these infants are exposed to the risk of preventable childhood disease which includes HIV that is transmitted from their HIV positive mother. In the absence of any intervention, the risk of HIV transmission increases to about 40% among infant born to HIV positive mothers.Objectives: To examine the prevalence and uptake of HIV services among pregnant women and to assess the level of Early Infant Diagnosis (EID) by PCR uptake for children under 2 months born to HIV positive mothers.Methods: A sentinel case study approach conducted in 3 internally displaced people (IDP) camps in 3 LGAs (Banki, Dikwa and Ngala) of Borno state Nigeria, from January 2018 to May 2019. Data collected using standard tools and DHIS 2.0 used for data extraction and MS Excel used for analysis.Results: Prevalence of HIV among pregnant women (1st ANC Visits) in the 3 IDP camps were 1.22% (Ngala), 0.44% (Banki) and 0.16% (Dikwa) with an average of 0.61% compared to the 2018 National zonal average for the North East of1.1%. Uptake of HIV testing service among pregnant women in the 3 IDP camps were 90.65% (Ngala), 100% (Banki) and 100% (Dikwa), with an average uptake of 96.9%; while EID uptake for HIV exposed children within 2 months of age were: 50.0% (Dikwa), 12.5% (Banki) and 0% (Ngala).Conclusions: The study also shows that none of the 3IDP camps were able to optimize Early Infant Diagnosis at 2 months of birth. It is hereby recommended that Care-giver Focused Approach should be prioritized in preventing mother-to-child transmission (PMTCT) service delivery

Knowledge, attitudes and practices on HIV/AIDS and prevalence of HIV in the general population of Sucre, Bolivia

Background: To analyse knowledge, attitudes and sexual practices on HIV/AIDS, and estimate HIV prevalence among residents of Sucre (Bolivia).Methodology: Population-based survey of residents aged 15-49 randomly selected during 2008/2009. Blood samples were collected on Whatman-filter paper and tested with enzyme-linked immunosorbent assay. Knowledge on HIV/AIDS, sexual risk practices and discriminatory attitudes against people living with HIV/AIDS (PLWHA) were modelled with multiple logistic regression.Results: Of 1499 subjects, 59% were women. All subjects were HIV-negative. Inadequate knowledge of HIV/AIDS transmission and prevention was observed in 67% and risk factors varied by gender (interaction p-value < 0.05). Discriminatory attitudes were displayed by 85% subjects; associated factors were: rural residence, low educational level and low income. Unsafe sex was reported by 10%; risk factors varied by residence area (interaction p-value < 0.05). In urban areas, risk factors were male sex, younger age and being in common-law union.Conclusions: Prevalence of HIV infection is very low and unsafe sex is relatively uncommon. Inadequate knowledge on HIV/AIDS and discriminatory attitudes towards PLWHA are extremely high and are associated to gender, ethnic and economic inequalities.

Prevalência de HIV e sífilis em parturientes atendidas em uma maternidade de referência na cidade de Marabá-Pará. / Prevalence of HIV and syphilis in parturients attended in a reference maternity in Marabá, Pará

Objetivo: conhecer a prevalência da infecção pelo HIV e pelo Treponema pallidum em parturientes atendidas em uma maternidade de referência do SUS. Método: estudo transversal, descritivo com dados coletados do cartão pré-natal e dos prontuários de 480 parturientes envolvidas no estudo. Para o diagnóstico de sífilis e de infecção pelo HIV foi considerado a realização de 2 testes na gravidez e um no parto. Resultados: as prevalências de infecção pelo HIV e de sífilis na amostra estudada foram de 0,4% e 1,9% respectivamente; houve predomínio da faixa etária de 20 a 29 anos nas mulheres com VDRL reagente no parto. A maioria das parturientes frequentou o pré-natal; destas, 48,5% iniciou no primeiro trimestre; 67,6% com o primeiro teste de HIV e 76,3% com o primeiro VDRL e entre as que tiveram 6 ou mais consultas a cobertura do segundo teste foi 37,6% para VDRL e 12,4% para HIV. Ressalte-se que 107 (23,7%) e 146 (32,4%) parturientes respectivamente, só tiveram a oportunidade de fazer o VDRL e a sorologia para HIV no mo-mento do parto. Conclusão: a prevalência de HIV e sífilis em parturientes é elevada e está na dependência da qualidade da assistência pré-natal.

Objective: To know the prevalence of HIV and Treponema pallidum infections among parturients attended at SUS Maternity reference. Method: Cross-sectional and descriptive study. Data was collected from pre-natal cards and from medical records of 480 parturients attended in a Maternity reference, in Marabá, Pará, Brasil. Diagnosis of syphilis and HIV were based on two tests performed during pregnancy and one test performed in labor. Results: Prevalence of HIV infection and syphilis were respectively 0.4% and 1.9%. Predominance of reagent VDRL during labor was observed among 20-29 years old women. The majority attended prenatal care, 48.5% in the first trimester of pregnancy. Among those women 67.6% performed the first HIV test and 37.6% the first VDRL test. Among those who had six or more prenatal visits the coverage of second test was 37.6% for VDRL and 12.4% for HIV. It is worth to note that 23.7% (107/480) and 32.4% (146/480) of pregnant women performed VDRL and HIV serology only at delivery. Conclusion: High prevalence of HIV and syphilis were observed in pregnant attended in a reference maternity of Marabá, Pará, Brazil, and it was associated with quality of prenatal care.

HIV Prevalence and the Correlation of Different Opportunistic Infection with CD4 Cell Count.

In India, an opportunistic infection with HIV and associated complications accounts for considerable proportion of mortality. There exists definite CD4 cell count correlation with opportunistic infection in HIV patients. Objectives: To document the prevalence of HIV with correlation of different opportunistic infection with CD4 cell count. Material and Method: A total of 174 HIV positive patients either hospitalised or ART POD were studied for finding the spectrum of opportunistic infection and for HIV prevalence. Various samples were collected as per symptoms and clinical presentation. Result: Among opportunistic infection, most common were bacterial infection with 72.5%, followed by fungal infection 42.1% and parasitic infection with 25.8%. TB in 21 patients and candidacies in 5 patients were found in CD4 cell count <500 cell/μl followed by chronic diarrhoea with CD4 cell count <200 cell / μl. Conclusion: Prevalence of HIV infection in persons attending ICTC is 11.3%. TB is the most common opportunistic infection followed by candidacies and diarrhoea.

Study on HIV prevalence and factors relating to the behaviors of HIV infection among injecting drug users in various districts of Lai Chau province - 2007

Background: Lai Chau is one of northwestern provinces of Vietnam, where there was a drug vice and high prevalence of drug users. It is necessary to evaluate the situation of HIV infection in this group. Objectives: A study on HIV prevalence and factors relating to the behaviors of HIV Infection among Injecting Drug Users (IDUs) in various districts of Lai Chau province. Subjects and method: A quantitative, cross-sectional study was carried out on 330 IDUs in Lai Chau town and 3 districts of Lai Chau province from January to December 2007. Results: 40.30% of the IDUs tested positive for HIV, nearly 2 times higher than the prevalence in 2006 (23.2%). 87.27% of the IDUs never re-used their syringes and needles. However, 12.4% still sometimes re-used their syringes and needles. Of 43 IDUs (12.73%) who re-used their syringes and needles, only 27.91% always cleaned their syringes and needles, 23.26% cleaned their syringes and needles most of the time after using them and up to 27.91% only sometimes cleaned their syringes and needles. Most IDUs use heroin (97.88%). Percentage of IDUs sharing syringes and needles accounts for 12.42%. 10% of the IDUs had sexual intercourses with commercial sex workers within the last month. There is a relationship between the time of using drugs and the HIV prevalence rate. There is a double risk of HIV infection for the IDUs injecting drugs for 5 years and upwards compared to those injecting drugs less than 5 years. (p <0.05, OR = 2). Conclusion: It is required to develop communications in order to change the behaviors of HIV infection among IDUs in Lai Chau province.