Co-trimoxazole induced Steven Johnson syndrome in HIV infected patient: things to consider

Co-trimoxazole is a sulfonamide fixed dose combination antibiotic which is effective and widely use in treatment and prevention of opportunistic infections in people living with HIV/AIDS, but can be potentially associated with adverse drug reactions including drug hypersensitivity reactions such as Steven Johnson syndrome. PLWHA individuals have up to a 1000-fold increased risk of drug hypersensitivity reaction compared to the general population, which is associated with drug exposure, immune dysregulation, and concurrent infections. Here we present a case report of a 59-year-old man with HIV who experienced Stevens-Johnson Syndrome after taking co-trimoxazole for 18 days. Therefore, we would like to remind you to be more careful when giving cotrimoxazole to PLWHA because it can take time for a hypersensitivity reaction to occur, also in a few cases, it can occur immediately.

Qualidade do acesso percebida por usuários de serviços especializados em HIV/AIDS da Bahia, Brasil / Quality of access perceived by users of HIV/AIDS specialized services in Bahia, Brazil / Calidad de acceso percibida por los usuarios de servicios especializados en VIH/SIDA en Bahía, Brasil

Este artigo descreve o acesso e a percepção do acesso de usuários a serviços especializados no tratamento do vírus da imunodeficiência humana e da Síndrome da Imunodeficiência Humana (HIV/AIDS) em municípios baianos por meio de um recorte epidemiológico descritivo-analítico, com abordagem quantitativa de dados primários de estudo realizado em cinco serviços localizados na capital e oito no interior do estado da Bahia, Brasil. Participaram deste estudo 475 usuários, de 21 municípios baianos, predominantemente do sexo feminino, com faixa etária entre 25 e 44 anos, negros, cristãos, desempregados, com escolaridade compreendendo o ensino fundamental, renda de até três salários mínimos, heterossexual e cisgênero. O acesso à testagem para HIV e outras Infecções Sexualmente Transmissíveis (IST), profilaxias de pós-exposição e pré-exposição e outros insumos de prevenção não constituíram motivação de inserção no serviço. O tratamento específico e a assistência médica para HIV e outras IST foi motivação para que a maioria dos participantes se direcionassem ao serviço especializado. O deslocamento até o serviço de referência é realizado principalmente por transportes coletivos, e o trajeto casa-serviço tem duração de pelo menos uma hora. O horário de funcionamento da unidade atende às necessidades da maior parte dos participantes, mas parcela dos usuários mencionaram o desejo de funcionamento em horários alternativos. A marcação de consultas é realizada principalmente de forma presencial e por telefone, com possibilidade de agendamento diário, assim a maioria dos usuários avaliaram a organização do serviço para marcação de consultas como boa ou muito boa. O tempo de espera, entre marcação e consulta, mais comum é de uma semana a um mês.

This article describes user access and perception of access to specialized HIV/AIDS services in Bahia municipalities by applying a qualitative epidemiological, descriptive-analytical approach to primary data from research conducted in five services located in the capital and eight in the countryside. A total of 475 users from 21 municipalities in Bahia participated in this study. Most were female, between 25 and 44 years old, Black, Christian, unemployed, with complete primary education, income of up to 3 minimum wages, heterosexual and cisgender. Access to HIV testing and other STIs, post-exposure and pre-exposure prophylaxis and other prevention inputs did not constitute motivation for procuring the service. Specific treatment and medical care for HIV and other STIs motivated most participants to turn to specialized services. Commuting to the reference service is made mainly by public transport and the home-service journey takes at least one hour. The unit's opening hours meet the needs of most participants, but some mentioned the desire for alternative operating times. Appointments are booked mainly in person and over the phone, with the possibility of daily scheduling, so most users rated the service organization for scheduling appointments as good or very good. The most common waiting time between booking and consultation is one week to one month.

Este artículo describe el acceso y la percepción de acceso de los usuarios a servicios especializados en el tratamiento del virus de inmunodeficiencia humana y síndrome de inmunodeficiencia humana (VIH/sida) en municipios de Bahía (Brasil) mediante un enfoque epidemiológico, descriptivo-analítico, y un enfoque cuantitativo de datos primarios de un estudio realizado en cinco servicios ubicados en la capital y ocho en el interior del estado de Bahía. Participaron en este estudio 475 usuarios, de 21 municipios de Bahía, con mayor predominio femenino, con edades de entre 25 y 44 años, negros, cristianos, desempleados, con educación primaria, ingresos de hasta tres salarios mínimos, heterosexuales y cisgénero. El acceso a pruebas de VIH y otras infecciones de transmisión sexual (ITS), profilaxis posexposición y preexposición, y otros insumos de prevención no constituyeron una motivación para ingresar al servicio. El tratamiento específico y la asistencia médica para el VIH y otras ITS fueron la razón para que la mayoría de los participantes buscaran servicios especializados. El desplazamiento al servicio de referencia se realiza principalmente en transporte público, y el trayecto desde el domicilio al servicio tiene una duración mínima de una hora. El horario de atención de la unidad satisface las necesidades de la mayoría de los participantes, pero algunos usuarios mencionaron el deseo de que operase en horarios alternativos. Las citas se realizan principalmente de forma presencial y telefónica, con posibilidad de concertación diaria, por lo que la mayoría de los usuarios valoran como buena o muy buena la organización del servicio de citas. El tiempo de espera más habitual entre la reserva y la consulta es de una semana a un mes.

Uptake of prevention of mother-to-child transmission of human immunodeficiency virus interventions among infected mothers attending health facilities in Mombasa County, Kenya

Background: The study was conducted in Mombasa County, Kenya, and aimed at the uptake of Prevention of Mother-to-Child Transmission interventions among HIV-infected mothers attending health facilities. A hospital-based cross-sectional study was used between May 2021 and October 2021, utilizing a self-administered structured questionnaire to collect data. The collected information was then analyzed using SPSS version 17 and STATA version 9.2. Methods: The study utilized a descriptive cross-sectional research design. Results: 84.8% of respondents exclusively breastfed their babies, and 77.3% received antiretroviral drugs (ARVs). Education level, being a housewife, and religion showed statistically significant associations with PMTCT service uptake (p<0.05). Additionally, 53.7% of participants demonstrated awareness of the importance of enrolling in PMTCT intervention services. The study highlighted high levels of knowledge among participants regarding PMTCT interventions, with 89.9% having correct knowledge of ARVs for children, 83.5% understanding the importance of counselling, 77.3% practicing modified infant feeding, and 85% acknowledging the necessity of delivering in a health facility. Knowledge of PMTCT components such as HIV counselling, ARV usage, facility-based delivery, and early diagnosis was significantly associated with the uptake of PMTCT interventions. Conclusions: Utilization of PMTCT services among postnatal HIV-positive mothers was high among postnatal HIV-positive women who embraced the PMTCT interventions. The respondents had average knowledge concerning PMTCT services. This study suggests supporting and encouraging related stakeholders to provide education about MTCT.

A enfermagem e o letramento em saúde no contexto do hiv/aids, tuberculose, hepatites virais e infecções sexualmente transmissíveis / Nursing and health literacy in the context of hiv/aids, tuberculosis, viral hepatitis and sexually transmitted infections / Enfermería y alfabetización en salud en el contexto del vih/sida, tuberculosis, hepatitis viral e infecciones de transmisión sexual

Objetivo: identificar o Letramento em Saúde (LS), relacionados ao HIV/aids, à Tuberculose, às Hepatites Virais e às Infecções Sexualmente Transmissíveis (IST), na área de conhecimento da Enfermagem. Métodos: Pesquisa exploratória, descritiva, com base em materiais documentais, acerca do HIV/aids, tuberculose, hepatites virais e IST, no campo da Enfermagem, considerando as produções de dissertações e teses, até o ano de 2023. Resultados: Elencou-se 62 produções abordando o LS na área de conhecimento em Enfermagem, sendo a primeira em 2012. Após análise, identificou-se nove estudos: três teses (33,3%) e seis dissertações (66,7%), sendo, cinco (55,6%) de HIV/ Aids, um (11,1%) de tuberculose, um (11,1%) de hepatite C e dois (22,2%) de IST. Conclusão: As produções incipientes sobre LS no contexto do HIV/aids, tuberculose, hepatites virais e IST, bem como, na área de Enfermagem, requer o desenvolvimento de novas investigações, visto a proposta de eliminar essas doenças/ infecções como problema de saúde pública até 2030. Faz-se necessário compreender o LS dos indivíduos nessas áreas, como ferramenta para potencializar a atenção prestada, principalmente, no contexto da APS, considerando a atuação da enfermagem como estratégica para o planejamento e a oferta do cuidado e para a promoção do autocuidado. (AU)

Objective: to identify Health Literacy (HL), related to HIV/AIDS, Tuberculosis, Viral Hepatitis and Sexually Transmitted Infections (STIs), around nursing knowledge. Methods: This is an exploratory, descriptive research, based on documentary materials, about HIV/AIDS, tuberculosis, viral hepatitis and STIs, in the field of nursing, considering the production of dissertations and theses, until the year 2023. Results: 62 productions were listed addressing LS around knowledge in Nursing, the first being in 2012. After analysis, nine studies were identified: three theses (33.3%) and six dissertations (66.7%), five (55.6%) of HIV/AIDS, one (11.1%) of tuberculosis, one (11.1%) of hepatitis C and two (22.2%) of STIs. Conclusion: The incipient productions on LS in the context of HIV/AIDS, tuberculosis, viral hepatitis and STIs, as well as, around nursing, requires the development of new investigations, given the proposal to eliminate these diseases/infections as a public health problem by 2030. if necessary, understand the HL of individuals in these areas, as a tool to enhance the care provided, mainly in the context of PHC, considering nursing actions as strategic for planning and offering care and promoting self-care. (AU)

Objetivo: identificar la Alfabetización en Salud (AS), relacionada con VIH/SIDA, Tuberculosis, Hepatitis Virales e Infecciones de Transmisión Sexual (ITS), en el área de conocimiento de enfermería. Métodos: Se trata de una investigación exploratoria, descriptiva, basada en material documental, sobre VIH/SIDA, tuberculosis, hepatitis virales e ITS, en el campo de la enfermería, considerando la producción de disertaciones y tesis, hasta el año 2023. Resultados: 62 producciones. fueron listados abordando LS en el área de conocimiento en Enfermería, siendo el primero en 2012. Luego del análisis, se identificaron nueve estudios: tres tesis (33,3%) y seis disertaciones (66,7%), cinco (55,6%) sobre VIH/ SIDA, uno (11,1%) de tuberculosis, uno (11,1%) de hepatitis C y dos (22,2%) de ITS. Conclusión: Las incipientes producciones sobre LS en el contexto de VIH/SIDA, tuberculosis, hepatitis virales e ITS, así como así como, en el área de enfermería, requiere el desarrollo de nuevas investigaciones, ante la propuesta de eliminar estas enfermedades/infecciones como un problema de salud pública para el año 2030. De ser necesario, entender la AS de los individuos en estas áreas, como una herramienta. potenciar los cuidados prestados, principalmente en el contexto de la APS, considerando las acciones de enfermería como estratégicas para planificar y ofrecer cuidados y promover el autocuidado. (AU)

Tecnologias relacionais e atuação psicológica em HIV/Aids: contribuições da psicologia socioconstrucionista / Relational technologies and psychological action in HIV/AIDS: contributions from socioconstructionist psychology / Tecnologías relacionales y acción psicológica en VIH/SIDA: aportes desde la psicología socioconstruccionista

OBJETIVO: Discutir como se estabelece a indicação de tecnologias relacionais off-line e on-line como recurso de cuidado a Pessoas Vivendo com HIV/Aids (PVHA) por psicólogas/os atuantes em serviços especializados. MÉTODO: Trata-se de uma pesquisa de abordagem qualitativa e exploratória. Utilizamos a perspectiva da psicologia social construcionista, além das noções de tecnologias dura, leve-dura e leve e seu encontro com a perspectiva de tecnologias (materiais e não materiais) como mediadoras inventivas. Realizamos entrevistas semiestruturadas e submetemos os dados à análise categorial temática. RESULTADOS: Foram elaboradas duas categorias: tecnologias relacionais off-line e on-line. Tratam-se dos sentidos construídos em torno de estratégias para o cuidado de PVHA, que não são típicas da clínica psicológica clássica. CONCLUSÃO: Concluímos que o uso de tecnologias relacionais off-line e on-line no acompanhamento de PVHA sugere uma ampliação do repertório profissional das/dos psicólogas/os que trabalham em serviços especializados em HIV/Aids, porém, isso não demonstrou ocorrer de forma tão articulada no campo de atuação psicológica, em comparação às práticas psicológicas clássicas.

OBJECTIVE: To discuss how offline and online relational technologies are recommended as a care resource for People Living with HIV/Aids (PLWHA) by psychologists working in specialized services. METHOD: This is research with a qualitative and exploratory approach. We use the perspective of constructionist social psychology, in addition to the notions of hard, soft-hard and soft technologies and their encounter with the perspective of technologies (material and non-material) as inventive mediators. We carried out semi-structured interviews and submitted the data to thematic categorical analysis. RESULTS: Two categories were created: offline and online relational technologies. These are the meanings constructed around strategies for caring for PLWHA, which are not typical of classical psychological clinics. CONCLUSION: We conclude that the use of offline and online relational technologies in monitoring PLWHA suggests an expansion of the professional repertoire of psychologists working in specialized HIV/AIDS services, however, this has not been demonstrated to occur in a so articulated, in the field of psychological action, in comparison to classical psychological practices.

OBJETIVO: Discutir cómo las tecnologías relacionales offline y online son recomendadas como recurso de atención a las Personas que Viven con VIH/SIDA (PVVS) por parte de psicólogos que trabajan en servicios especializados. MÉTODO: Se trata de una investigación con un enfoque cualitativo y exploratorio. Utilizamos la perspectiva de la psicología social construccionista, además de las nociones de tecnologías duras, blandas-duras y blandas y su encuentro con la perspectiva de las tecnologías (materiales y no materiales) como mediadoras inventivas. Realizamos entrevistas semiestructuradas y sometimos los datos a análisis temático categórico. RESULTADOS: Se crearon dos categorías: tecnologías relacionales en línea y fuera de línea. Estos son los significados construidos en torno a estrategias de atención a las PVVS, que no son propias de las clínicas psicológicas clásicas. CONCLUSIÓN: Concluimos que el uso de tecnologías relacionales en línea y fuera de línea en el seguimiento de las PVVS sugiere una expansión del repertorio profesional de los psicólogos que trabajan en servicios especializados en VIH/SIDA, sin embargo, no se ha demostrado que esto ocurra de manera tan articulada en el campo de acción psicológica, en comparación con las prácticas psicológicas clásicas.

Knowledge regarding HIV/AIDS and its prevention among high school students of Anantnag district, Jammu and Kashmir, India: a pre-experimental study

Background: India has become one of the most populous country in the world, and it would be a disaster if our adolescent children fell into the trap of HIV/AIDS, which not only disrupts the healthcare system of any country but also has an impact on the morals of the people. Therefore, the main aim of the study was to understand the knowledge regarding HIV/AIDS and its prevention among high school children. Methods: This was a pre-experimental study in which 60 high school students participated. The knowledge was assessed using demographic characteristics and 30-item knowledge questionnaires. SPSS V16.0 was used for the data analysis. Paired t-test, descriptive statistics, and chi-square analysis were used to check the association. Results: In the study, the majority of the participants, 46 (76.66%), had inadequate knowledge, and only 14 (23.33%) had moderate knowledge regarding HIV/AIDS. The paired “t”-test value was 54.63 at the level of p<0.0001, which was significant. We also found multiple associations between gender, qualification of the mother, occupation of the mother, qualification of the father, occupation of the father, type of family, and source of information. Conclusions: It was observed that there was relatively less knowledge among high school students regarding HIV/AIDS and its prevention. However, after the teaching program, the knowledge improved. Therefore, a multi-dimensional approach should be taken by the school authority to create awareness campaigns for the students.

Assessing accessibility of sexual reproductive health services among adolescents and young people living with HIV/AIDS in Kenya

Background: Sexual and reproductive health rights (SRHR) are fundamental human rights enshrined in national, regional, and international laws and agreements. This study aimed to determine the accessibility of SRHR services among young people living with HIV/AIDS in Kenya. Methods: The study was a cross-sectional study involving a sample of 224 adolescents and young people from Kenya. The study used both qualitative and quantitative methods of data collection and analysis. Before the study commenced, approvals were acquired from the Kenyatta University ethics and review committee, the National Commission for Science, Technology, and Innovation, County Governments, and selected county and sub-county health facilities in Kenya. Results: About 68.2% of adolescents and young people (AYP) living with HIV/AIDS accessed SRH services with a significant difference in proportion between study counties (Nairobi city and Homabay counties) in Kenya (?2=20.553; df=2; p<0.0001). Nevertheless, 33% of them reported that there were challenges that affected access to SRHR services and the unavailability of some services. Therefore, there is a need to ensure enough and constant supply of commodities and supplies for comprehensive care services. Conclusions: The study showed a statistically significant difference in the proportion of AYP living with HIV/AIDS who accessed SRH services in the study counties of Nairobi city and Homabay.

Problem and pro-social behaviour among adolescents living with HIV/AIDS and perception of healthcare workers on available medical and social support in Sokoto, northern Nigeria

Background: Adolescents living with HIV/AIDS (ALHIV) are likely to have behavioural, social, cognitive, and emotional problems. Early detection and treatment of these psychological issues in ALHIV is precarious to comprehensive HIV management. This study aimed to assess problem and pro-social behaviour among and to identify available health facility and social supports for ALHIV in Sokoto State, Nigeria. Methods: A cross sectional study with mixed methods of data collection was conducted among 236 adolescent- caregiver pairs. Key informant interviews were conducted among four health care workers. Quantitative data were analyzed using IBM SPSS version 23 while content analysis along thematic lines was done for qualitative data. Results: Mean age of adolescents was 14.6±2.2 years while mean age of caregivers was 37.9±7.2 years. Prevalence of pro-social behaviour among ALHIV was 6.4% (self- report) and 15.2% (caregiver report). Seventy-eight (33.1%) caregivers reported peer problems and 15 (6.4%) emotional problems among their ALHIV. Based on self-report, 160 (67.8%) ALHIV reported experiencing peer problems and 3 (1.8%) emotional problems. Eleven (4.7%) adolescents reported having low social support, 136 (57.6%) had moderate and 89 (37.7%) high social support. Viral suppression showed significant association with SDQ scores. Conclusions: The Sokoto State Ministry of Health and other organizations supporting HIV programs should ensure community enlightenment programs on HIV in order to reduce stigma associated with the disease.

Willingness to use HIV self-test kits in Winneba, Ghana

Over the years, many successive governments of Ghana have been making efforts to minimise the transmission of HIV in the country through its agencies such as the Ghana health service and the Ghana AIDS Commission. In an attempt to continue to bring the transmission of HIV under control, the government of Ghana in July 2023, launched the HIV self-test (HIVST) kits for use. However, like new health products such as COVID-19 vaccines, there is a tendency of hesitancy to their use in the country. Using the case study design in connection with the purposive sampling technique, the study sampled 12 participants in Winneba, Ghana and data was analysed using thematic analysis. The study found that majority of the people were aware of the HIVST kits in the country with another indicating that the HIVST kits are yet to be made available in communities. Women were found to be more willing to use the HIVST kits than other population groups. Accessing the HIVST kits on the other hand was met with scarcity and participants identified the pharmacy to be the best place to access the HIVST kits. It is recommended that the municipal health directorate and the Ghana AIDS commission should collaborate to intensify education and publicity on the availability and use of the HIVST kits. Additionally, in order to prevent unforeseen shocks, there is a need for the pharmaceutical society of Ghana to train and equip its members to offer counselling services to users of the HIVST kits.

The Investigation and Analysis of the Situation of COVID-19 Vaccination and Vaccination Willingness in HIV/AIDS Population in Yunnan Province / 昆明医科大学学报

Objective To investigate the vaccination status and vaccination willingness of novel coronavirus in HIV/AIDS population in Yunnan.Methods From October 2021 to June 2022,a questionnaire survey was conducted among 2180 HIV/AIDS patients in Kunming,Qujing,Yuxi,Zhaotong,Puer,Baoshan,Lincang,Honghe,Wenshan,Xishuangbanna,Dali,Dehong and Nujiang prefectures.The questionnaire included age,sex,education,nationality,education level,vaccination,adverse reactions within 7 days after the vaccination,safety of COVID-19 vaccine,awareness of effectiveness,vaccination willingness and so on.Results Among the subjects,2109 completed 3 injections,accounting for 96.74%,and 71 were not vaccinated,accounting for 3.26% .Within 7 days of inoculation,local adverse reactions occurred in 116 cases,accounting for 5.50%,and systemic adverse reactions occurred in 56 cases,accounting for 2.66% .Injection site pain,fatigue and muscle pain accounted for the highest proportion of adverse symptoms in different sex,age and the Han nationality,while the proportion of minority adverse reactions was very low,and there was no difference among the different sex and age(P>0.05).The main reasons for the reluctance of HIV/AIDS population to be vaccinated were(recommended by doctors)that HIV/AIDS patients could not be vaccinated(67.61%)and may have serious adverse reactions after the vaccination(19.72%).The factors affecting the vaccination were found by logistic regression analysis,whether they were worried about infecting novel coronavirus(OR = 0.121,95% CI = 0.083～0.640,P<0.001)and how much they knew about COVID-19 vaccine(OR = 28.932,95% CI = 15.469～54.115,P<0.001),safety of vaccination(OR = 13.953,95% CI = 4.819～40.404,P<0.001)and belief in the preventive effect of vaccine(OR = 14.017,95% CI = 4.752～41.348,P<0.001)were significant factors affecting vaccination.Among the 13 prefectures and cities,Dehong(20),Zhaotong(21)and Lincang(14)had the largest number of unvaccinated people.Conclusion After the mass vaccination,the rate of adverse reaction in HIV/AIDS population is low,the symptoms are mild,the correct and scientific advice and guidance from doctors and the full understanding of the harmfulness of the disease,the safety,prevention and effectiveness of the vaccine are the key to complete vaccination and put an end to vaccine hesitancy.

Analysis of Depression and Influencing Factors in HIV/AIDS Patients Receiving Antiviral Therapy / 中山大学学报(医学科学版)

ObjectiveTo investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy. MethodsFrom July 2022 to September 2022， successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing， and they were instructed to fill out anonymous questionnaires. The questionnaire collected the basic information of patients， and depression， HIV stigma score and social support level were investigated by Patient Health Questionnaire-9 （PHQ-9）， Berger HIV stigma scale （BHSS） and Multidimensional Scale of Perceived Social Support （MSPSS）. Multivariate Logistic regression was used to analyze the influencing factors of depression. ResultsA total of 1879 valid questionnaires were collected in this study， and the detection rate of depression was 50.1%. The results of multivariate logistic analysis showed that compared with patients with middle school or below， the risk of depression was lower for those with postgraduate or above ［OR=0.534， 95%CI （0.341， 0.835）， P=0.006］. Compared with antiviral therapy duration<1 year， antiviral therapy duration for 1 to 5 years ［OR=0.729， 95%CI （0.536， 0.991）］， >5 to 10 years ［OR=0.516， 95%CI （0.379， 0.702）］， >10 years ［OR=0.603， 95%CI （0.375， 0.969）］ was associated with a lower risk of depression. High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support ［OR=0.430， 95% CI（0.349， 0.530）， P < 0.001］. There was a higher risk of depression with side effects than without side effects ［OR=2.260， 95%CI （1.833， 2.786）， P < 0.001］. The higher the score on the HIV stigma scale， the higher the possibility of depression was. ConclusionThe detection rate of depression of patients receiving antiviral therapy in Nanjing is high. After starting antiviral therapy， we should strengthen the monitoring of side effects and psychological status of patients， carry out psychological intervention， alleviate psychological problems， and improve the quality of life of patients receiving antiviral therapy.

Marriage intention among HIV-infected men who have sex with men / 预防医学

Objective@#To investigate the marriage intention and its influencing factors among HIV-infected men who have sex with men (MSM), so as to provide the reference for formulating high-risk behavior intervention strategies and reducing the risk of HIV transmission among this population.@*Methods@#Unmarried HIV-infected MSM were sampled from newly reported HIV/AIDS patients in Gongshu District of Hangzhou City from 2020 to 2022. Participants' sociodemographic information, family status and marriage intention were collected using questionnaire surveys. Factors affecting marriage intention were identified using a multivariable logistic regression model.@*Results@#A total of 430 questionnaires were allocated and 400 valid questionnaires were recovered, with an effective recovery rate of 93.02%. The respondents had a mean age of (28.90±4.67) years, and included 271 cases with registered residence outside Hangzhou City (67.75%). There were 82 cases indicating that they would probably or definitely get married, accounting for 20.50%, including 46 cases (56.10%) aged 30 years and older, 67 cases (81.71%) engaged in commercial services/freelance work/worker and 53 cases (64.63%) being the only children. Multivariable logistic regression analysis showed that unmarried HIV-infected MSM who were aged 30 years and older (OR=2.751, 95%CI: 1.230-6.154), had a monthly income of <10 000 Yuan (5 000 to <10 000 Yuan, OR=7.010, 95%CI: 2.049-23.981; <5 000 Yuan, OR=5.229, 95%CI: 1.803-15.165), had a high school education and below (OR=5.935, 95%CI: 1.775-19.844), were the only children (OR=3.407, 95%CI: 1.468-7.910), came from families with economic conditions above the average level (OR=8.906, 95%CI: 2.070-38.308), did not disclose their sexual orientation (OR=3.298, 95%CI: 1.118-9.727), held a positive attitude towards government policies (OR=70.544, 95%CI: 14.583-341.237), had no homosexual intercourse in the past six months (OR=3.583, 95%CI: 1.278-10.044), and had not informed their sexual partners of their HIV status (OR=2.910, 95%CI: 1.228-6.897) were more willing to get married.@*Conclusion@#A certain proportion of unmarried HIV-infected MSM in Gongshu District are willing to get married, and their marriage intention is affected by age, educational level, family economic conditions, the only children or not, disclosing sexual orientation or not, having homosexual intercourse in the past six months or not, informing sexual partners of HIV status or not, and the attitude towards government policies.

Changes of laboratory biochemical indicators in HIV / AIDS patients treated with different antiviral regimens / 公共卫生与预防医学

Objective To analyze the changes of liver and kidney function, blood glucose and lipid metabolism at different follow-up time points of different treatment regimens, and to provide reference for clinical optimization and adjustment of medication in HIV/AIDS patients. Methods The changes of liver and kidney function, blood glucose and lipid metabolism at seven follow-up time points were analyzed retrospectively. The baseline blood collection time of HIV /AIDS patients was set as the starting point, and the final follow-up time was set as the end point. The seven follow-up points were 0, 3, 6, 9, 12, 18 and 24 months respectively. Results There were statistically significant differences in the distribution of sex, age, education, marital status, WHO staging, infection route, and baseline CD4+T lymphocyte count among 605 enrolled patients based on different treatment regimens. Liver function: The level of T-Bil in group E was higher than that of baseline at 9M, 12M, 18M and 24M after treatment (P<0.01); In group F, the level of T-Bil was higher than that of baseline at 9M after treatment (P=0.001); The levels of ALT in group C at the six follow-up points after treatment were higher than the baseline (P<0.001); The level of AST in group C was higher than that of baseline after 3M and 6M treatment (P<0.05). Renal function: The level of UREA in group C was higher than that in baseline after 6M treatment (P=0.007); The level of UREA in group F was higher than that in the baseline after 12M treatment (P<0.001); The level of UA in group F was higher than that of baseline after 3M, 6M and 12M treatment (P<0.05). Blood lipid and blood glucose: The levels of Glu at some follow-up points after ART treatment in group A and group C were higher than that at baseline (P<0.05); The levels of TG at some follow-up points in group A, group E and group F after ART treatment were higher than those at baseline (P<0.05); The levels of TC at some follow-up points in group A, group B, group C, group E and group F after ART treatment were all higher than the baseline (P<0.05). Conclusion Regular monitoring of changes in laboratory indicators of different treatment regimens during ART is of great importance to the prognosis of patients. Different laboratory indicators should be monitored according to different treatment regimens to effectively prevent adverse reactions caused by different treatment regimens.

Knowledge, attitude, and practice (KAP) study of Egyptian physicians towards HIV infection: a multicentre study

Introduction: In Egypt, there is a paucity of new data regarding awareness of HIV/AIDS among physicians. This study aimed to assess the level of awareness, attitude, practice, and knowledge of a sample of Egyptian physicians regarding HIV regarding natural history, epidemiology, and virology, method of transmission, clinical manifestations, diagnosis, prevention, and management.Methodology: Sixty-eight Egyptian physicians were enrolled in an observational analytic multicenter cross-sectional KAP study in Egyptian tertiary health care facilities covering different localities, including New Valley University, Assiut University, South Valley University, Helwan University, Alexandria University, Aswan University, and Al-Azhar University.Results: The attitude of physicians towards the privacy of persons living with HIV, was the one with the highest percentage 85.3%. On the other hand, respondents think that only 25% of physicians do not stigmatize HIV patients. Moreover, only 25% of the study group do not stigmatize persons living with HIV. The highest proportion of favorable practice was 39.7% and the lowest was 17.6%. With regard to their knowledge about HIV, the lowest proportion of correct answers to a question was 4.4%, and the highest proportion was 92.6%. Most of the enrolled physicians were found to have a moderate knowledge score, 49/68 (72%). There was a significant difference between different specialties regarding knowledge scores.Conclusions: There are some knowledge gaps among a sample of Egyptian physicians with regard to HIV/AIDS. In addition, Egyptian physicians may have a moderate degree of undesirable attitude and practice toward HIV/AIDS

Prevalence and determinants of depression among patients attending adult HIV clinic of University of Uyo Teaching Hospital, Uyo, Southern Nigeria

Background: Mental health challenges particularly depression is common among people living with HIV/AIDS and has been largely neglected. This is of great concern because depression is associated with high morbidity among its sufferers. An assessment of depression among PLWHAand its predictors will enhance their quality of life and improve their health outcomes. Aim:To determine the prevalence and determinants of depression among patients attending the adult HIV clinic in University of Uyo Teaching Hospital, Uyo, Nigeria. Method: This was a cross-sectional descriptive study conducted at the adult HIV outpatient clinic of University of Uyo Teaching Hospital Uyo. A total of three hundred and fifty-one eligible respondents were recruited over three months. Their levels of perceived social support, depression, HIV stigma and substance abuse were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), Patient Health Questionnaire 9 (PHQ 9), Internalized AIDS-related Stigma Scale and CAGE questionnaire respectively. Results:The mean age of the respondents was 39.8 ± 10.7 years. Two hundred and sixty six (75.8%) of the respondents were females, while eighty-five (24.2%) were males. The overall prevalence of depression was 10%. Majority of respondents had disclosed their status and were experiencing HIV stigmatization representing 84.6% and 95.4% respectively. Most of the respondents (65.8%) had low 2perceived social support. Depression was found to be statistically associated with unskilled workers (χ= 2213.08, p = 0.008), unmarried respondents (χ= 8.45, p = 0.03), low perceived social support (χ= 7.76, p = 220.02), shorter duration of ART use (χ= 8.41, p = 0.04), adverse life events (χ= 4.05, p = 0.04) and 2increasing levels of HIV stigma (χ= 7.66, p = 0.02) among the study participants. Conclusion: The findings of this study showed that the prevalence of depression in PLWHA was high. Therefore, the screening and prompt treatment of depression in HIV positive persons should be inculcated into their management plan. Furthermore, policies should be made to minimize discrimination and stigmatization of PLWHA in the communities and healthcare systems. Finally, the relevant stakeholders should work in unison to improve the social welfare conditions of HIV infected persons.

Prevalence and determinants of low bone mineral density among people living with HIV on antiretroviral therapy in Lusaka, Zambia: A cross-sectional study

Background Reduced bone mineral density (BMD) is a common complication of people living with Human Immunodeficiency Virus (HIV) on antiretroviral therapy (ART). However, there is lack of information on the factors associated with reduced BMD in people living with HIV and on ART. We assessed the prevalence of reduced BMD and its associated determinants in people living with HIV and were on antiretroviral therapy. Methods A cross-sectional study on people living with HIV and on ART was conducted at the largest tertiary teaching adult hospital, in Lusaka Zambia from August 1, 2019 December 31, 2020. Included in the study were participants aged between 50 and 69 years of age. A Dual-energy X-ray Absorptiometry scan was employed to assess Bone Mineral Density. Low Bone Mineral Density was defined as both osteoporosis and osteopenia. Logistic regression analysis was employed to establish determinants associated with BMD. Results Of the 315 participants, 43.8% were females and the median age was 55.0 years (IQR 60-51). The overall prevalence of reduced bone mineral density was 82.6% and of these, 34.0% had osteopenia and 48.6% osteoporosis. After adjusting for confounders, age 55 years and older (AOR 5.87, 95% CI 3.34-10.30, p=<0.001) was independently associated with osteoporosis while CD4 count ≥ 500 cells/mm3 (AOR 0.21, 95% CI 0.08-0.55, p=<0.001) and an increase in Body Mass Index (AOR 0.94, 95% CI 0.90-0.99, p=0.008) were associated with decreased odds of osteoporosis. Conclusions Our study highlights a high prevalence of low Bone Mineral Density. Older age was positively associated with osteoporosis while a high CD4 count and high body Mass Index revealed a decreased odds for osteoporosis.

Frailty and health-related quality of life among older people living with HIV pre- and post-COVID-19 pandemic onset: A cross-sectional study

ABSTRACT Introduction: Antiretroviral therapy increased the survival and life expectancy of People living With HIV (PWH). Frailty-related syndromes among older PWH (aged 50+ years) may affect their Health-related Quality of Life (HQoL). Additionally, the COVID-19 pandemic has impacted health-related outcomes. This study aimed to estimate the prevalence of frailty and pre-frailty among older PWH, and to explore associations of HQoL with the study assessment period and frailty status. Methods: Cross-sectional study conducted pre- (23-Mar-2019 to 5-Mar-2020) and post-COVID-19 pandemic onset (23-Jun-2021 to 5-May-2022), among older PWH at INI-Fiocruz, the largest cohort of PWH in Rio de Janeiro, Brazil. We measured frailty using Fried assessment, consisting of five domains: unintentional weight loss; self-reported exhaustion, weakness, slow walking speed, low physical activity. HQoL was assessed using the ACTG SF-21, which contains 21 questions divided into 8 domains. We used Chi-Square test, Fisher's exact test, Kruskal-Wallis and ranksum test for comparisons. Results: We included 250 older PWH: 109 (43.6 %) pre- and 141 (56.4 %) post-COVID-19 pandemic onset. Median age was 60-years (IQR: 55‒64). Most self-identified as cisgender men 152 (60.8 %), Pardo/Black 146 (58.4 %), with completed secondary education or less 181 (72.7 %) and low income 132 (52.8 %). Overall, prevalence of frailty and pre-frailty were 9.2 % (95 % CI: 8.1‒10.3) and 61.6 % (95 % CI: 54.0‒69.2). Prevalence of frailty in the pre- and pos-COVID-19 pandemic periods were 7.3 % and 10.6 % (p = 0.66). HQoL scores were lower among participants with frailty compared to those with non-frailty and pre-frailty in all eight domains, and among those included in the post-COVID-19 compared to pre-COVID-19 period for four domains. Conclusions: We observed low prevalence of frailty, but high prevalence of pre-frailty among older PWH. Frailty status did not differ according to the COVID-19 assessment period. Assessment of frailty and HQoL should be incorporated in clinical practice for older PWH. Programs to reverse or prevent frailty should be implemented within the public health system.

Sangue impuro: especialistas, instituições e autoridade cultural no contexto da Aids no Brasil / Impure blood: specialists, institutions, and cultural authority in the context of AIDS in Brazil

Resumo Neste artigo examinamos o conceito de autoridade cultural no contexto da profissionalização/corporativização da medicina no final do século XX e seus contornos políticos e morais desde a epidemia de HIV/Aids em São Paulo. A partir de matérias jornalísticas recolhidas do jornal O Estado de São Paulo (1986-1989), buscamos dar relevo ao lugar do especialismo médico, examinando os discursos produzidos sobre a doença, no Brasil, em bases que evidenciam a emergência de atores sociais, disputas por credibilidade e a autoridade clínica sob contestação. Analisamos as narrativas públicas sobre a Aids, situando o lugar da autoridade. Argumentamos que tais discursos, no contexto do pânico sexual, não ocorriam fora de uma dinâmica de autoridade terapêutica/clínica e das normatizações próprias da profissão, que também tornavam imediatamente visível o papel dos médicos, especialistas e demais profissionais de saúde, em diálogo com a gramática moral da doença socialmente corrente. As conclusões ilustram a vinculação da medicina brasileira de fins do século com a história local-global da Aids, concentrando movimentos históricos e políticos que disputavam os sentidos científicos e morais da doença, fraturados pelo embate entre autoridades no campo científico, sanitário e clínico.

Abstract In this article, we examine the concept of cultural authority in the context of the professionalization/corporatization of medicine at the end of the 20th century, and its political and moral contours since the HIV/AIDS epidemic in São Paulo. Based on journalistic articles collected from the newspaper O Estado de São Paulo (1986-1989), we seek to highlight the place of medical expertise, examining the discourses produced about the disease in Brazil, in bases that show the emergence of social actors, disputes for credibility and the clinical authority under challenge. We analyze public narratives about AIDS, situating the place of authority. We argue that such discourses, in the context of sexual panic, did not occur outside a dynamic of therapeutic/clinical authority and the profession's own norms, which also immediately made visible the role of physicians, specialists and other health professionals, in dialogue with the moral grammar of the socially current illness. The conclusions illustrate the link between Brazilian medicine at the end of the century and the local-global history of AIDS, concentrating historical and political movements that disputed the scientific and moral meanings of the disease, fractured by the clash between authorities in the scientific, sanitary and clinical fields.

Fatores associados ao sexo anal sem preservativo entre adolescentes homens que fazem sexo com homens e mulheres trans em três capitais brasileiras: estudo PrEP1519 / Factors associated with condomless anal sex among adolescent men who have sex with men and transgender women in three Brazilian state capitals: a PrEP1519 study

RESUMO OBJETIVO: Analisar os fatores que aumentam a prática de sexo anal sem preservativo (SASP) entre adolescentes homens que fazem sexo com homens (aHSH) e travestis mulheres trans (aTrMT) em três capitais brasileiras. MÉTODOS: PrEP1519 é uma coorte prospectiva, multicêntrica, de demonstração da efetividade da profilaxia pré-exposição (PrEP) ao HIV entre aHSH e aTrMT, com idade entre 15 e 19 anos, em três capitais brasileiras. As análises foram realizadas com dados da linha de base da coorte, com a inclusão de 1.418 adolescentes inscritos de 2019 a 2021. O desfecho estudado foi SASP nos últimos seis meses, e os potenciais fatores associados foram sociodemográficos, comportamentais, de assistência à saúde e histórico de violência e discriminação. Foi realizada análise descritiva, bivariada e multivariada. Estimaram-se razões de prevalência ajustadas (RPa) e intervalos de confiança de 95% (IC95%). RESULTADOS: A maioria dos participantes era aHSH (91,5%), com idade de 18 a 19 anos (75,9%), pretos (40,5%), ensino médio e superior em andamento (92,7%), com relato de SASP na primeira relação sexual (54,2%), início da vida sexual antes dos 14 anos (43,4%) e história de sexo em grupo (24,6%) e de sexo transacional (14,6%). A prevalência de SASP nos últimos seis meses foi de 80,6% (IC95% 78,5%-82,6%). Adolescentes que relataram primeira relação sexual sem preservativo (RPa: 1,18; IC95% 1,10-1,25), consumo de substâncias psicoativas (RPa: 1,09; IC95% 1,03-1,16) e sexo transacional (RPa: 1,11; IC95% 1,04-1,20) tiveram maior prevalência de SASP nos últimos seis meses. Verificou-se também que aqueles com idade de 15 a 17 anos tiveram maior prevalência de SASP em comparação àqueles de 18 a 19 anos (RPa: 1,07; IC95% 0,99-1,13). CONCLUSÕES: A prevalência de SASP foi alta entre aHSH e aTrMT, bem como esteve associada a práticas que podem aumentar o risco de infecções sexualmente transmissíveis (IST). Assim, recomenda-se o fortalecimento de programas de saúde sexual para jovens que abordem o tema da sexualidade e prevenção de IST, tal como a ampliação do acesso a métodos preventivos, como preservativo e PrEP.

ABSTRACT OBJECTIVE: To analyze the factors that increase the practice of condomless anal sex (CAS) among adolescent men who have sex with men (AMSM) and adolescent travestis and transgender women (ATGW) in three Brazilian state capitals. METHODS: PrEP1519 is a prospective, multicenter cohort study demonstrating the effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among AMSM and ATGW aged from 15 to 19 years in three Brazilian state capitals. The analyses were performed with baseline cohort data, including 1,418 adolescents enrolled from 2019 to 2021. The outcome studied was CAS in the last six months, and the potentially associated factors were sociodemographic, behavioral, healthcare, and history of violence and discrimination. Descriptive, bivariate, and multivariate analyses were conducted. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (95%CI) were estimated. RESULTS: Most of the participants were AMSM (91.5%), aged 18 to 19 years (75.9%), Black (40.5%), with secondary or higher education in progress (92.7%), with CAS during the first sexual intercourse (54.2%), sexual initiation before the age of 14 (43.4%), and history of group sex (24.6%) and transactional sex (14.6%). The prevalence of CAS in the last six months was 80.6% (95%CI 78.5%-82.6%). Adolescents who reported condomless first sexual intercourse (aPR: 1.18; 95%CI 1.10-1.25), use of psychoactive substances (aPR: 1.09; 95%CI 1.03-1.16), and transactional sex (aPR: 1.11; 95%CI 1.04-1.20) had a higher prevalence of CAS in the last six months. We also found that those aged 15 to 17 years had a higher prevalence of CAS than those aged 18 to 19 (aPR: 1.07; 95%CI 0.99-1.13). CONCLUSIONS: The prevalence of CAS was high among AMSM and ATGW, being associated with practices that may increase the risk of sexually transmitted infections (STIs). Therefore, it is recommended to strengthen sexual health programs for young people that address the issue of sexuality and STI prevention, as well as to expand access to preventive methods, such as condoms and PrEP.

Contexto geográfico e HIV/SIDA: múltiplos olhares de saúde sobre as mulheres moçambicanas / Geographical context and HIV/AIDS: multiple health perspectives on Mozambican women

Resumo O objetivo deste texto é compreender a vulnerabilidade de gênero experienciada pelas mulheres que vivem com HIV/Síndrome de Imunodeficiência Adquirida (SIDA) na Cidade de Maputo, Moçambique, através dos relatos de representantes e lideranças dos serviços de saúde que atuam diretamente sobre as questões dessas condições para o público feminino. Para isso, a pesquisa se embasou em metodologias qualitativas, visto que a produção dos dados foi respaldada por um roteiro semiestruturado que considera os seguintes temas: HIV/SIDA; gênero; cultura; e serviços de saúde. As interpretações são mediadas pela Análise do Discurso (AD), que possibilita a imersão nos recursos linguísticos por meio dos sentidos e conexões. Isso permite a interpretação da complexidade do contexto geográfico das mulheres que vivem com HIV/SIDA na região, evidenciando a necessidade de se empenhar mais ações voltadas às questões das doenças, uma vez que se faz premente estabelecer uma interpretação geográfica da saúde, sobretudo, no que diz respeito à realidade vivida pelas que experienciam dificuldades, opressões, estigmas e discriminações no cotidiano.

Abstract The aim of this article is to understand the gender vulnerability experienced by women living with HIV/Acquired Immunodeficiency Syndrome (AIDS) in the city of Maputo, Mozambique, according to the reports of representatives and leaders of the health services who work directly on the issues of these conditions for the female public. To this end, the research was based on qualitative methodologies, since the production of the data was supported by a semi-structured script that considers the following themes: HIV/AIDS; gender; culture; and health services. The interpretations are mediated by Discourse Analysis (DA), which enables immersion in linguistic resources through meanings and connections. This allows us to interpret the complexity of the geographical context of women living with HIV/AIDS in the region, highlighting the need to promote actions toward the issues surrounding the disease, since it is urgent to establish a geographical interpretation of health, especially considering the reality lived by women who experience difficulties, oppression, stigma, and discrimination on a daily basis.