Stigmatization and discrimination of people living with HIV in the Czech Republic: a pilot study.

OBJECTIVES: HIV positivity diagnosis is often accompanied by stigmatization and discrimination, even in developed societies. The aim of the study was to obtain current information on the quality of life of people living with HIV in the Czech Republic, to assess the level and perception of stigmatization and discrimination, and to identify existing problems of people living with HIV concerning health services, family and the public. METHODS: Data for the pilot study were collected by convenience sampling between 2021 and 2022. Respondents were recruited from residents of Czech nationality and foreigners living with HIV in the Czech Republic who participated in an ECDC online questionnaire study or attended a convalescent stay for people living with HIV. Likert scales were used to capture key opinions, attitudes and beliefs of respondents. Data were processed using descriptive analysis. RESULTS: The study involved 42 people living with HIV. A total of 77% of the respondents reported that they had learned to live with their HIV-positive status, but 21% admitted to having low self-esteem due to their status. A total of 81% of the respondents had disclosed their HIV-positive status to someone outside of the healthcare setting, however, 40% of the respondents found it difficult to do so. Assault or threats from a sexual partner were reported by 17% of the respondents. A total of 27% of the respondents admitted having been denied or suspended health care, 44% reported inappropriate comments from healthcare workers, and 32% of the respondents avoided visiting the healthcare facility. Alarmingly, 41% of the respondents had been refused dental care at some point in the past because of their HIV-positive status. CONCLUSIONS: Although the study presents only limited findings due to the small number of respondents, it is clear that stigmatization and discrimination of people living with HIV exists in the Czech society. It brings the risk of loss of motivation and involvement of people living with HIV in working together with healthcare providers on their treatment. There is a clear need for a larger study to identify the causes of stigmatization and to find ways to prevent it.

What do Czech adolescents know about HIV?

OBJECTIVE: During last years, a significant increase of HIV infection transmitted through sexual intercourse among young adults has been reported in the Czech Republic. The issue of prevention, where sexual education belongs to an important preventive tool, is much more topical than ever before. The level of knowledge and attitudes related to HIV/AIDS among adolescents has not been assessed so far. The aim of our study was to explore this field in a nationally representative sample. METHODS: Information was obtained using an anonymous questionnaire that was filled in by 1,627 adolescents 13 to 15 years old selected from a representative sample of 25 elementary and grammar schools in the Czech Republic. RESULTS: Based on the survey results, good knowledge regarding primary HIV/AIDS prevention was noted in the majority of respondents who however tended to stigmatize HIV positive people. CONCLUSION: The study has confirmed the importance of school as the main source of information (reported by 50.8% of respondents). The result of our study can serve as a starting point in assessment and comparison of the effect of various educational programmes.

Factors Influencing Suicidal Tendencies of Patients with Diagnosis of Attempted Suicide in Medical History and Potential Prevention of Relapse Prevention.

OBJECTIVE: The authors researched the incidence of suicidal thoughts and related factors in 123 patients of the psychiatric ward of the Hospital of Ceské Budejovice with diagnosed attempted suicide in their medical history for the period from January 2013 ­ June 2015. METHODS: The research was carried out in two stages. At the beginning of the hospitalization, quantitative data collection was implemented using a semi-structured questionnaire, followed by qualitative research conducted with semi-structured phone conversation, based on previous patient's written consent. The research data were statistically processed to obtain information about the character of relations among individual characteristics. To quantify them, the Bayesian Network (BN) was constructed, and to identify relations among individual characteristics, the Hill-Climbing algorithm was used. Before deriving the network, variables were discretized. The network parameters were set based on a data matrix using the maximal plausibility method. RESULTS: The results of analysed set show that the probability of suicidal thoughts is high, achieving a value of 0.750 (0.781 for women and 0.724 for men). If the patient visits a contact centre for drug-addicted persons, the probability of suicidal thoughts decreases to 0.683. If the patient visits a psychotherapist, the values of 0.736 are achieved. If a daily care centre is visited, the estimated risk rises to 0.832 and the probability of the patient repetitively attempting suicide is 0.606. If the interviewed person regularly consumes alcohol, the probable relapse amounts to 0.616. But if the person consumes alcohol from time to time, the probability rises to 0.701. In case of abstinence, the probable relapse decreases to 0.565. CONCLUSIONS: The incidence of suicidal thoughts in observed patients was high, and the amount of risk was influenced by gender, by visiting follow-up care facilities, psychotherapy, and particularly by the frequency of alcohol consumption. Intermittent alcohol consumption is the highest-risk factor in connection with relapsing suicide. In case of psychiatric patients with attempted suicide in their medical history, all verified preventive and therapeutic procedures that can contribute to prevention of relapses should be used within follow-up professional care. Specific approach of the closest social environment, medical literacy of the population and state safety measures are important.

Imaging findings after methanol intoxication (cohort of 46 patients).

OBJECTIVES: Our goal is to demonstrate the variability of imaging findings, primarily in the MRI, in 46 patients who survived acute methanol poisoning. This cohort of patients is the largest such sample group examined by MRI. METHODS: Patients were examined by means of imaging methods (42 patients by MRI and 4 by CT). All had an identical protocol of MR examination (T2WI, FLAIR, T1WI with or without application of contrast medium and T2WI/FFE, DWI in the transversal plane of the scan, and with focus on the optic nerves in the coronal plane of the scan in T2WI-SPIR). RESULTS: Imaging methods revealed a positive finding associated with methanol intoxication in 21 patients (46%). These consisted of symmetrical lesions in the putamen--13 patients (28%), haemorrhage--13 cases (28%), deposits in white matter with localization primarily subcortically--4 cases (9%), lesions in the region of the globus pallidus--7 cases (15%) (in 6 cases without combination with the lesions in the putamen), lesions in the brainstem afflicted 6 patients (13%), and lesion in the cerebellum was found in one case. A pathological finding was found only in the patients examined by MRI. CONCLUSION: Almost half of the patients who survived acute methanol poisoning had pathological findings by MRI. The most common finding concerned an affliction of the putamen, which is a predilection area. An interesting finding was the relatively frequent occurrence of selective lesion of the globus pallidus, which is more usually associated with other types of intoxication.