Colombian adolescents fail in knowledge regarding HIV and other sexually transmitted infections / Adolescentes colombianos fracasan en conocimientos sobre VIH y otras infecciones de transmisión sexual

Abstract Introduction/objective: Sexually transmitted infections (STIs) -HIV included- are a major problem in Latin America, mainly in Colombia. In 2021, 17647 cases were reported, which compared to the previous year showed an increase of 29.7%. The main aim of this study was to assess the knowledge regarding HIV and other STIs among the adolescent population in Colombia. Method: A total of 2012 Colombian adolescents between 12-19 years of age participated in this study. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI), a self-report measure, was administered. Results: The results showed moderate to low general knowledge (M = 9.90, SD = 4.64) regarding HIV and other STIs. Adolescents did not know if a tongue-kiss led to an HIV infection (75%), or whether both the vaginal ring and the IUD were effective methods for preventing HIV/AIDS (82%). Results showed better scores in knowledge regarding HIV transmission (84%), HIV testing (66%), and condom use to prevent HIV infection (71%). Conclusions: Significant differences were observed in HIV/STIs knowledge between both sexes, but the effect magnitudes were small. Thus, these differences were neglected. This study contributes to understanding the state of knowledge and strengthening prevention strategies of professionals linked to the field of quality of life, education, and sexual healthcare in Colombia.

Resumen Introducción/objetivo: Las infecciones de transmisión sexual (ITS) y el VIH son un gran desafío en América Latina, principalmente en Colombia. Para el 2021 se reportaron 17 647 casos, que comparados con el 2019 muestran un incremento del 29.7 %. El objetivo principal de este artículo fue evaluar el conocimiento sobre el VIH y otras ITS en la población adolescente de Colombia. Método: En este estudio participaron un total de 2012 adolescentes colombianos con edades entre los 12 y los 19 años. Se administró la Escala de Conocimientos sobre el VIH y otras infecciones de transmisión sexual (KSI) y una medida de autoinforme. Resultados: Los resultados mostraron un conocimiento general de moderado a bajo (M = 9.90, SD = 4.64) sobre el VIH y otras ITS. Las adolescentes no sabían si un beso con lengua conducía a una infección por el VIH (75 %) o si tanto el anillo vaginal como el DIU eran métodos efectivos para prevenir el VIH/SIDA (82 %). Los resultados mostraron mejores puntuaciones en conocimientos sobre la transmisión del VIH (84 %), pruebas de detección del VIH (66 %) y uso de preservativos para prevenir la infección por el VIH (71 %). Conclusiones: Se observaron diferencias significativas en el conocimiento del VIH/ ITS entre ambos sexos, pero los tamaños del efecto fueron pequeños. Por tanto, estas diferencias fueron despreciadas. Este estudio contribuye a comprender el estado del conocimiento y a fortalecer las estrategias de prevención que realizan los profesionales vinculados al campo de la calidad de vida, la educación y la salud sexual en Colombia.

Knowledge of final year undergraduate nursing students about HIV and AIDS in Eswatini

Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are overwhelming health issues globally. They have caused many devastating and draining health issues, which have escalated a critical need for a well-trained and sustainable healthcare workforce in order to meet the needs of people living with HIV and AIDS (PLWHA). Health science students are the future healthcare providers who will implement proper preventive measures, as well as health educational and promotional sessions to promote information and knowledge among the public regarding HIV and AIDS in Eswatini. Methods: A quantitative cross-sectional study was conducted on 140 final-year undergraduate nursing students in three nursing universities in Eswatini. A questionnaire adapted from Othman and Ali in Malaysia with closed-ended questions was modified and used to collect data. The questionnaire consisted of questions on the virus structure, transmission, prevention and management of HIV and AIDS. Statistical Package for the Social Sciences (SPSS) version 20 was utilised to analyse the data. Results: The level of knowledge about HIV and AIDS was high, as evidenced by a mean score and standard deviation of (91.02 ± 5.00). However, there were low scores on questions related to the transmission of the disease. Conclusion: Across all three universities in Eswatini, there were good nursing education programs on HIV and AIDS, evidenced by the high knowledge level about HIV and AIDS. However, there are still some knowledge gaps on HIV and AIDS transmission and management that need to be attended to contribution: This study contributed by providing knowledge of undergraduate nursing students' HIV and AIDS training and management of PLWHA.

II. The research ethics involving vulnerable groups

Abstract Vulnerability in research occurs when the participant is incapable of protecting his or her interests and therefore, has an increased probability of being intentionally or unintentionally harmed. This manuscript aims to discuss the conditions that make a group vulnerable and the tools and requirements that can be used to reduce the ethical breaches when including them in research protocols. The vulnerability can be due either to an inability to understand and give informed consent or to unequal power relationships that hinder basic rights. Excluding subjects from research for the only reason of belonging to a vulnerable group is unethical and will bias the results of the investigation. To consider a subject or group as vulnerable depends on the context, and the investigator should evaluate each case individually.

Elderly People and Reproductive Decisions of Couples Living with HIV in Southern Malawi.

Aims: To explore experiences of elderly people on reproductive decisions made by couples living with HIV in rural southern Malawi. Study Design: This was a qualitative exploratory descriptive research. Place and Duration of Study: The informants were recruited from two districts in southern Malawi, patrilineal Chikhwawa - Ngabu area and matrilineal Chiradzulu - Ndunde area between July and December, 2010. Methodology: Four focus group discussions, with thirty elderly men and women, 15 from each district, where division by gender was the criteria employed in attempts to create well-functioning and articulate groups were selected purposively. Data was analyzed concurrently with data collection using content method. The interviews, which, were transcribed verbatim were uploaded into Nvivo qualitative management software enabling a systematization and easier retrieval of data. Results: Emerging themes were generation gap, defeated/ignored, lack of information and blame situation. First there was generation gap which led to the elderly people feel that their role in the community was defeated, which they indicated by being ignored in reproductive decision making. They further indicated that they lack information about current issues related to HIV, AIDS and reproductive decisions in couples living with HIV. All these led to a blame situation where the elderly people blamed either the couples living with HIV or health workers for the current situation. Conclusion: Older people need to be recognized, supported and educated in the fight against HIV and AIDS. The different needs, roles and responsibilities of older men and women need to be acknowledged and included in programs and policies addressing this global epidemic.

An Assessment of the Level of Awareness, Attitudes, Opinions of Pharmacy Students Concerning HIV and AIDS in Malaysia.

Aims: HIV and AIDS spreading wide and causing serious threats and deaths among Malaysian residents. A nationwide cross-sectional survey was conducted to assess the awareness, attitudes and opinions about HIV and AIDS among pharmacy students. Methods: A total of 316 pharmacy students of year three and onwards took part in the survey. Students were asked to fill in questionnaires with consent forms. The results were analyzed by using SPSS version 17. Results: The data indicated that awareness about HIV and AIDS was moderate. High level of awareness was seen for major routes of HIV transmissions, but lower level of awareness was seen for other modes of transmission like circumcision, visiting barbers, and blood splashes on outer body surface. Only 19.3% and 13.3% of respondents were aware about HIV prevention by sex abstinence and by staying faithful to one partner respectively. The respondents had doubts in keeping HIV and AIDS patients in close vicinity to them and their family. Conclusion: According to the findings, the respondents had a few misconceptions about HIV transmission and prevention. Data from this survey may be useful to hold programs and campaigns designed to convey accurate information about HIV transmission and prevention. Talks and media campaigns should also be carried out to change their attitudes and opinions about HIV and AIDS.

Implementing HIV/AIDS Education: Impact of Teachers’ Training on HIV/AIDS Education in Bangladesh.

School-based HIV/AIDS education is a common and well-proven intervention strategy for providing information on HIV/AIDS to young people. However, lack of skills among teachers for imparting sensitive information to students can lead to programme failure in terms of achieving goals. A cross-sectional study was conducted among teachers to identify the factors that support or hinder their role in HIV/AIDS education. A self-administered questionnaire was used for interviewing teachers from randomly-selected schools in two adjacent districts in Bangladesh. Based on exposure to teachers’ training, the districts were divided into control and intervention areas and the teachers’ ability, skill, and their participation in HIV/AIDS education were compared between the districts. Trained teachers in the intervention schools were more likely to participate, less likely to face difficulties, and more likely to use interactive teaching methods in HIV/ AIDS classes compared to the controls who did not receive any training. Inadequate allocation of time for conducting the HIV/AIDS class was found to be barriers to HIV/AIDS education that suggest the need to provide teachers with more support in terms of training and logistics.

A qualitative study to determine factors to ART default in Zambia / 国際保健医療

<B>Objectives</B><BR>The objective of this study is to identify barriers and facilitators of anti-retroviral treatment (ART) continuation among ART patients in Zambia. It also aims to explore ART scale-up approach while reducing defaulters.<BR><B>Methods</B><BR>In October 2009, we obtained ART statistics, interviewed District Health Management Team (DHMT) in Livingstone, Zambia, and conducted Focus Group Discussion (FGD) with 27 ART defaulters who were traceable, where participants shared experience in relation to why they gave up and how they resumed treatment.<BR><B>Results</B><BR>Although ART facilities have been increased in Livingstone, half of the facilities are not equipped with CD4 count machine, which affects timely commencement of treatment. Anti-retrovirals (ARV) and consultation are basically offered free of charge to ART patients, yet patients have to pay X-ray and co-morbidity treatment. On average, 22.7% of ART patients stopped visiting ART facilities. Especially in large-scale ART centre, defaulters were not followed up. FGD revealed the process of how defaulters developed hopelessness and pill burden, which were triggered and influenced by several factors including hunger, poverty, stigma, side-effects and co-morbidities. Some stopped medication as they thought being cured after condition recovered. Others attributed discontinuation to the accessibility of service and the attitude of ART centre staff. Default was attributed by internal (inadequate knowledge, weak motivation) and also external (hunger, medical service system) factors. It is inevitable to empower patients with adherence management by strong motivation to treatment and supportive environment.<BR><B>Conclusion</B><BR>Financial empowerment of patients, free-service of co-morbidity treatment and side effect mitigation are desirable for sustainable ART scale-up. Defaulter follow-up, continuous regular adherence counseling and ART roll-out to small-scale clinics are inevitable to reduce defaulters.

Avaliação da qualidade dos dados do Sistema de Controle de Exames Laboratoriais (SISCEL) como fonte de identificação de casos de AIDS em crianças. / Assessment ofdatta quality control system for laboratory tests (siscel) as source foridentification of aids in chlddren.

O presente estudo avaliou a qualidade dos dados do SISCEL como fonte de identificação decasos de AIDS em crianças. Teve foco na avaliação dos processos com vistas à melhoria dosistema e da vigilância epidemiológica da AIDS no país. O desenho foi do tipo transversal. Paraos critérios de julgamento foram priorizados 5 dimensões: acurácia, comparabilidade, utilização,oportunidade e a validade. Para o preenchimento dos indicadores foram utilizadas seteestratégias de coleta de dados. A análise dos resultados demonstrou que o sistema tem acuráciasatisfatória, seus dados são comparáveis e estão disponíveis aos profissionais de vigilânciaepidemiológica. O VPP do sistema, para fins de VE, mostrou-se num limiar crítico para a utilizaçãodireta desses dados no cálculo de indicadores epidemiológicos (50,0%). A sua utilizaçãocomo ferramenta para diminuição da subnotificação deve considerar apenas os casos comevidência laboratorial do HIV, o que vai melhorar o VPP do sistema e consequentemente a suaqualidade para fins de vigilância epidemiológica.

This study assessed the quality of the data from SISCEL (laboratory tests control system) as asource for tracking AIDS cases in children. It focused on processes evaluation, aiming to improve the system and the epidemiological surveillance of AIDS in Brazil. A cross sectional data collection approach was used. Judgment criteria prioritized five dimensions: accuracy, comparability, use, opportunity, and validity (positive predictive value - PPV). Seven data collection strategies wereused in order to calculate the indicators. Data revealed that the system has good accuracy, and that the data are comparable and available to the epidemiological surveillance (ES) staff. The positive predictive value (PPV) of the system, for ES ends, has shown itself on the critical threshold for the direct use of such data in the calculation of epidemiological indicators (50.0%). Its use as a tool to decrease the underreporting, should consider only the laboratory-confirmed HIV infections, which will improve the PPV of the system and consequently its quality for epidemiological surveillance.

Technical Cooperation on Antiretroviral Therapy Scale Up in Zambia / 国際保健医療

 Zambia is one of the HIV high burden countries in Sub Saharan Africa. Government of Zambia has been expanding Antiretroviral Therapy (ART) service nationwide at district level. However, it is still hard to access to ART service for PLHIVs who live in rural. In terms of accessibility, the service must be expanded to rural health centre level, but there are many challenges to expand the quality services into such resource limited setting, especially in the shortage of health providers.<br> JICA's “Integrated HIV and AIDS Care Implementation Project at District Level” launched at April 2006 to improve the quality and accessibility of HIV and AIDS care services in rural Zambia. Two districts in rural area, namely Mumbwa and Chongwe, were selected as project sites. The Project introduced the “mobile ART service” at rural health centre level using the existing health system. Mobile ART services enable a rural health centre that cannot offer ART by itself to provide ART services through the human resource and technical support/assistance of the District Hospital. Mumbwa and Chongwe District Health Management Team (DHMT) started mobile ART services in the first Quarter of 2007, therefore access to ART service in districts has been improved and contributed to increase of ART clients and reduce the defaulter rate within first 6 months of treatment. The project also tried to introduce the community involvement to overcome the shortage of human resources. <br> We found that Mobile ART services involving the community are beneficial and effective, and help ART services expansion to rural health facilities where resources are limited, and as close as possible to places where clients live. The strategies we experienced were cited in “the National Mobile HIV Services Guidelines” published by the MoH and will be able to be duplicated in other resource-limited areas of not only Zambia but also other developing countries.

Terapias complementarias y alternativas en VIH/SIDA / Complementary and alternative therapies in HIV/AIDS

A pesar de ser una prioridad mundial, ONUSIDA en el 2004 reporta que sólo un 10 por ciento de las personas viviendo con VIH o SIDA en el mundo tiene acceso a los medicamentos antirretrovirales (TAR), único tratamiento que ha demostrado disminución de la mortalidad de las personas que viven con VIH y SIDA. A pesar de ello, la utilización de TAR conlleva efectos adversos inmediatos y mediatos que conducen a otras patologías crónicas. El presente estudio bibliográfico describe la literatura disponible sobre terapias complementarias y alternativas (CAM) al tratamiento convencional (TAR) utilizadas por las personas que viven con VIH/SIDA. En general, estudios sobre el uso de CAM son escasos, además, no son precisos al describir su utilización, encontrándose reportes entre un 40 y un 70 por ciento para residentes en Europa y Norteamérica. En estos también se enfatiza la falta de aceptación del CAM por los profesionales de salud que proveen de medicamentos antirretrovirales convencionales, propiciando que los pacientes omitan el uso concomitante de ambas terapias. Además, la falta de conocimiento sobre el uso de CAM en profesionales de salud que ofrecen tratamiento convencional, no favorece una atención apropiada, debido al desconocimiento de posibles interacciones entre ambas terapias, sumado a la falta de evidencia científica de buena calidad que justifique su uso. Si bien existen aún muchos déficit en evidencia, las personas viviendo con VIH y SIDA reportan un alto uso de CAM debido a sus efectos terapéuticos, principalmente en el mejoramiento de su percepción de calidad de vida y efectos colaterales del tratamiento antiretroviral. Es necesario ampliar las investigaciones locales para hacer del uso del CAM una herramienta apropiada y segura en el tratamiento de personas viviendo con VIH.

In spite of being a world-wide priority, only a 10 percent of the people living with HIV and AIDS have access to the antiretroviral treatments (ART), although is the only treatment to diminish the mortality of the affected group, its use is not free of immediate and long-term adverse effects that lead to other chronic pathologies. The present bibliographical study has the objective to analyze the literature available on complementary and alternative therapies (CAM) used by the people who live with HIV and AIDS. It is reported that 40 - 70 percent of the population living with HIV in developed countries use some type of CAM. Literature demonstrates a little development of research in the area and reports lack of acceptance of CAM in conventional medicine, originating that often users do not inform. In addition, the lack of knowledge on the use of CAM in health professionals who offer conventional treatment is detrimental for adequate care, due to ignorance of possible interactions between both therapies and lack of scientific evidence of good quality justifying its use. Although many deficits in evidence still exist, the people living with HIV report a high use of CAM due to their therapeutic effects, mainly in the improvement of their perception of quality of life and collateral effects of antiretroviral treatment. It is necessary to extend local research to the use of CAM as an appropriate and safe tool in the treatment of people living with VIH.

All Sexed Up: a resposta de mulheres lésbicas negras jovens ao sexo (mais) seguro em Johannesburg, África do Sul / All Sexed Up: young black lesbian women's responses to safe(r) sex in Johannesburg, South Africa

A saúde sexual de mulheres lésbicas não é um tema frequentemente discutido em nossas sociedades. As questões de saúde da mulher são classificadas sob uma única categoria abrangente e excluem algumas das preocupações específicas de mulheres lésbicas, que, em geral, não têm o mesmo comportamento em relação à saúde que as mulheres heterossexuais. Esta tendência se deve a uma série de razões, entre as quais: falta de conhecimento sobre saúde e risco sexuais lésbicos, medo de estigmatização pelos prestadores de serviço e o processo de "se assumir" (coming out) para esses profissionais, que além de desconhecido, é, algumas vezes, hostil. Além disso, a pouca pesquisa sobre lésbicas e saúde lésbica na África do Sul torna difícil para as mulheres que assim se autoclassificam saberem que questões de saúde sexual as afetam especificamente, bem como onde e de que forma lidar com certos problemas. Existe uma percepção equivocada e generalizada de que questões de sexo seguro não afetam mulheres lésbicas tanto quanto mulheres heterossexuais. O artigo apresenta as visões de um grupo de mulheres de 18 a 35 anos que se autoidentificam como lésbicas na África de Sul. Por meio de questionários autoaplicados e discussões, essas mulheres partilham suas experiências e pensamentos sobre sexo lésbico (seguro) e como elas têm-se relacionado e continuam a se relacionar sexualmente com outras mulheres no momento de HIV e Aids.

Lesbian women's health and sexual health is a theme not generally discussed in our societies. Women's' health issues are generally classified under one umbrella, and exclude some of the concerns specific to lesbian women. Lesbian women in general do not have the same health-seeking behaviours as heterosexual women. This is due to a number of reasons including: lack of knowledge about lesbian sexual health and sexual risk, fear of stigmatization by service providers, and the "coming out" process to unfamiliar and sometimes unsympathetic health-related service providers. Furthermore, limited research on lesbians and lesbian health in South Africa makes it difficult for lesbian women to know what sexual health issues affect them specifically, where and how to address these issues. There is a general misconception that safe sex issues do not affect lesbian women as much as they affect heterosexual women. The paper presents views of a group of young self-identified lesbian women in South Africa between the ages of 18 and 35. Through self-administered questionnaires and discussions these women share their experiences and thoughts of lesbian (safe) sex and how they have related and continue to relate sexually with other women in the time of HIV and Aids.

Survey of mental health of rural individuals with HIV/AIDS in a county of Henan Province / 第三军医大学学报

Objective To investigate the psychological condition of the rural residents with HIV/AIDS.Methods Totally 192 subjects with HIV/AIDS residing in countryside of Henan Province(China)were investigated with questionaire and Symptom Check list 90(SCL-90).Results SCL-90 total score,the number of positive items and the score of each factor for the 192 subjects with HIV/AIDS were higher than those of Chinese normal(P