Comprehensive knowledge of mother-to-child HIV/AIDS transmission, prevention, and associated factors among reproductive-age women in East Africa: insights from recent demographic and national health surveys.

BACKGROUND: More than 90% of babies acquire HIV/AIDS through vertical transmission, primarily due to low maternal comprehensive knowledge about Mother-To-Child Transmission (MTCT) of HIV/AIDS and its prevention, which is a cornerstone for eliminating MTCT of HIV/AIDS. However, there are limitations in terms of population data and literature evidence based on recent Demographic and Health Surveys (DHS) reports in East Africa. Therefore, this study aims to assess the comprehensive knowledge and PMTCT of HIV/AIDS among women, as well as the associated factors in East Africa. METHODS: Our data was obtained from the most recent DHS conducted in East African countries between 2011 and 2022. For our research, we included DHS data from ten nations, resulting in a total weighted sample of 133,724 women for our investigation. A generalized linear model (GLM) with a log link and binomial family to directly estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association between the independent variables, and the outcome variable. Finally, we reported the adjusted prevalence ratios along with their corresponding 95% CIs. Factors with p-values ≤ 0.2 for univariate logistic regression and < 0.05 were considered statistically significant factors of HIV/AIDS knowledge and prevention in the final model. RESULTS: In this study, 59.41% (95% CI: 59.15-59.67) of respondents had a comprehensive knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in East Africa. Being in the older age group, better education level, being from a rich household, employment status, having ANC follow up, institutional delivery, and modern contraception usage were associated with higher prevalence ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention. However, being single in marital status, rural women, and traditional contraception utilization were associated with lower ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention. CONCLUSION: Our findings indicate a significant deficiency in comprehensive knowledge and prevention of HIV/AIDS MTCT among women in East Africa. These results emphasize the need for significant improvements in maternal-related health services. It is crucial to effectively target high-risk populations during interventions, raise awareness about this critical public health issue, and address the catastrophic consequences associated with MTCT. By implementing these measures, we can make substantial progress in reducing the transmission of HIV/AIDS from mother to child and ensuring better health outcomes for both mothers and their children.

The Ryan White HIV/AIDS Program: Thirty Years of Addressing Health Disparities.

The Ryan White HIV/AIDS Program is a unique federal program to provide HIV care, treatment, and support services for people living with HIV in the United States. Through the distinctive structure of the program that allows for addressing both medical needs and some of the social determinants of health that can pose barriers to accessing care, the program has been instrumental in improving outcomes for people with HIV with documented improvement in HIV viral suppression and decreased disparities in that outcome over the past decade. To reach the goal of ending the HIV epidemic in the U.S., the program must expand services to people with HIV who are not regularly engaged in medical care.

Coping mechanisms used by caregivers of HIV/AIDS orphans in North West province, South Africa.

BACKGROUND:  Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a pandemic that has affected families and left many children orphaned worldwide. After the death of their parents, HIV/AIDS orphans are often taken care of by caregivers who are faced with overwhelming challenges that affect their capabilities to perform caring tasks. It has been reported that caregivers of HIV/AIDS orphans use different coping mechanisms to deal with the challenges faced during caring. Coping mechanisms play an integral role in maintaining individuals' physical and mental well-being, particularly those caring for orphans. This study explored coping mechanisms used by caregivers of HIV/AIDS orphans. METHODS:  A qualitative design was adopted, and individual semi-structured interviews were used to collect data from 13 caregivers of HIV/AIDS orphans in North West province. Non-probability purposive sampling was used to select the participants. Thematic analysis was used to analyze data. Rigor was maintained throughout the study. RESULTS:  Three main themes were identified with eight subthemes. The first theme includes support from significant others, and subthemes are family support, neighbour support, and life partner support. The second main theme emerged from this study was religious practices and two subthemes namely singing gospel songs and using prayer to cope. The third main theme identified includes the use of social support services, and subthemes were government support, support from local schools, and stokvels and social clubs. CONCLUSION:  The identified coping mechanisms in this study improved caregiving skills of caregivers to better care for children orphaned by HIV/AIDS.

Spatial variation and predictors of composite index of HIV/AIDS knowledge, attitude and behaviours among Ethiopian women: A spatial and multilevel analyses of the 2016 Demographic Health Survey.

BACKGROUND: Although the dissemination of health information is one of the pillars of HIV prevention efforts in Ethiopia, a large segment of women in the country still lack adequate HIV/AIDS knowledge, attitude, and behaviours. Despite many studies being conducted in Ethiopia, they mostly focus on the level of women's knowledge about HIV/AIDS, failing to examine composite index of knowledge, attitude, and behaviour (KAB) domains comprehensively. In addition, the previous studies overlooked individual and community-level, and spatial predictors. Hence, this study aimed to estimate the prevalence, geographical variation (Hotspots), spatial predictors, and multilevel correlates of inadequate HIV/AIDS-Knowledge, Attitude, and Behaviour (HIV/AIDS-KAB) among Ethiopian women. METHODS: The study conducted using the 2016 Ethiopian Demographic and Health Survey data, included 12,672 women of reproductive age group (15-49 years). A stratified, two-stage cluster sampling technique was used; a random selection of enumeration areas (clusters) followed by selecting households per cluster. Composite index of HIV/AIDS-KAB was assessed using 11 items encompassing HIV/AIDS prevention, transmission, and misconceptions. Spatial analysis was carried out using Arc-GIS version 10.7 and SaTScan version 9.6 statistical software. Spatial autocorrelation (Moran's I) was used to determine the non-randomness of the spatial variation in inadequate knowledge about HIV/AIDS. Multilevel multivariable logistic regression was performed, with the measure of association reported using adjusted odds ratio (AOR) with its corresponding 95% CI. RESULTS: The prevalence of inadequate HIV/AIDS-KAB among Ethiopian women was 48.9% (95% CI: 48.1, 49.8), with significant spatial variations across regions (global Moran's I = 0.64, p<0.001). Ten most likely significant SaTScan clusters were identified with a high proportion of women with inadequate KAB. Somali and most parts of Afar regions were identified as hot spots for women with inadequate HIV/AIDS-KAB. Higher odds of inadequate HIV/AIDS-KAB was observed among women living in the poorest wealth quintile (AOR = 1.63; 95% CI: 1.21, 2.18), rural residents (AOR = 1.62; 95% CI: 1.18, 2.22), having no formal education (AOR = 2.66; 95% CI: 2.04, 3.48), non-autonomous (AOR = 1.71; 95% CI: (1.43, 2.28), never listen to radio (AOR = 1.56; 95% CI: (1.02, 2.39), never watched television (AOR = 1.50; 95% CI: 1.17, 1.92), not having a mobile phone (AOR = 1.45; 95% CI: 1.27, 1.88), and not visiting health facilities (AOR = 1.46; 95% CI: 1.28, 1.72). CONCLUSION: The level of inadequate HIV/AIDS-KAB in Ethiopia was high, with significant spatial variation across regions, and Somali, and Afar regions contributed much to this high prevalence. Thus, the government should work on integrating HIV/AIDS education and prevention efforts with existing reproductive health services, regular monitoring and evaluation, and collaboration and partnership to tackle this gap. Stakeholders in the health sector should strengthen their efforts to provide tailored health education, and information campaigns with an emphasis on women who lack formal education, live in rural areas, and poorest wealth quintile should be key measures to enhancing knowledge. enhanced effort is needed to increase women's autonomy to empower women to access HIV/AIDS information. The media agencies could prioritise the dissemination of culturally sensitive HIV/AIDS information to women of reproductive age. The identified hot spots with relatively poor knowledge of HIV/AIDS should be targeted during resource allocation and interventions.

Spatiotemporal Analysis of HIV/AIDS Incidence in China From 2009 to 2019 and Its Association With Socioeconomic Factors: Geospatial Study.

BACKGROUND: The Joint United Nations Program on HIV/AIDS (UNAIDS) has set the "95-95-95" targets to ensure that 95% of all people living with HIV will know their HIV status, 95% of all people living with HIV will receive sustained antiretroviral therapy (ART), and 95% of all people receiving ART will achieve viral suppression (<1000 copies/mL). However, few countries have currently achieved these targets, posing challenges to the realization of the UNAIDS goal to eliminate the global HIV/AIDS epidemic by 2030. The Chinese government has implemented corresponding policies for HIV/AIDS prevention and control; however, it still faces the challenge of a large number of HIV/AIDS cases. Existing research predominantly focuses on the study of a particular region or population in China, and there is relatively limited research on the macro-level analysis of the spatiotemporal distribution of HIV/AIDS across China and its association with socioeconomic factors. OBJECTIVE: This study seeks to identify the impact of these factors on the spatiotemporal distribution of HIV/AIDS incidence in China, aiming to provide scientific recommendations for future policy development. METHODS: This study employed ArcGIS 10.2 (Esri) for spatial analysis, encompassing measures such as the imbalance index, geographical concentration index, spatial autocorrelation analysis (Moran I), and hot spot analysis (Getis-Ord Gi*). These methods were used to unveil the spatiotemporal distribution characteristics of HIV/AIDS incidence in 31 provinces of China from 2009 to 2019. Geographical Detector was used for ecological detection, risk area detection, factor detection, and interaction detection. The analysis focused on 9 selected socioeconomic indicators to further investigate the influence of socioeconomic factors on HIV/AIDS incidence in China. RESULTS: The spatiotemporal distribution analysis of HIV/AIDS incidence in China from 2009 to 2019 revealed distinct patterns. The spatial distribution type of HIV/AIDS incidence in China was random in 2009-2010. However, from 2011 to 2019, the distribution pattern evolved toward a clustered arrangement, with the degree of clustering increasing each year. Notably, from 2012 onwards, there was a significant and rapid growth in the aggregation of cold and hot spot clusters of HIV/AIDS incidence in China, stabilizing only by the year 2016. An analysis of the impact of socioeconomic factors on HIV/AIDS incidence in China highlighted the "urbanization rate" and "urban basic medical insurance fund expenditure" as the primary factors influencing the spatial distribution of HIV/AIDS incidence. Additionally, among social factors, indicators related to medical resources exerted a crucial influence on HIV/AIDS incidence. CONCLUSIONS: From 2009 to 2019, HIV/AIDS incidence in China was influenced by various socioeconomic factors. In the future, it is imperative to optimize the combination of different socioeconomic indicators based on regional incidence patterns. This optimization will facilitate the formulation of corresponding policies to address the challenges posed by the HIV/AIDS epidemic.

Characteristics of the HIV/AIDS Epidemic among People Aged ≥ 50 Years in China during 2018-2021.

Objective: This study aimed to determine the current epidemiological status of PLWHA aged ≥ 50 years in China from 2018 to 2021. It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients. Methods: Data on newly reported cases of PLWHA, aged ≥ 50 years in China from 2018 to 2021, were collected using the CRIMS. Trend tests and spatial analyses were also conducted. Results: Between 2018 and 2021, 237,724 HIV/AIDS cases were reported among patients aged ≥ 50 years in China. The main transmission route was heterosexual transmission (91.24%). Commercial heterosexual transmission (CHC) was the primary mode of transmission among males, while non-marital non-CHC ([NMNCHC]; 60.59%) was the prevalent route in women. The proportion of patients with CHC decreased over time ( Z = 67.716, P < 0.01), while that of patients with NMNCHC increased ( Z = 153.05, P < 0.01). The sex ratio varied among the different modes of infection, and it peaked at 17.65 for CHC. The spatial analysis indicated spatial clustering, and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces. Conclusion: In China, PLWHA, aged ≥ 50 years, were predominantly infected through heterosexual transmission. The primary modes of infection were CHC and NMNCHC. There were variations in the sex ratio among different age groups, infected through various sexual behaviors. HIV/AIDS cases exhibited spatial clustering. Based on these results, the expansion of HIV testing, treatment, and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

The effects of meteorological factors and air pollutants on the incidence of tuberculosis in people living with HIV/AIDS in subtropical Guangxi, China.

BACKGROUND: Previous studies have shown the association between tuberculosis (TB) and meteorological factors/air pollutants. However, little information is available for people living with HIV/AIDS (PLWHA), who are highly susceptible to TB. METHOD: Data regarding TB cases in PLWHA from 2014 to2020 were collected from the HIV antiviral therapy cohort in Guangxi, China. Meteorological and air pollutants data for the same period were obtained from the China Meteorological Science Data Sharing Service Network and Department of Ecology and Environment of Guangxi. A distribution lag non-linear model (DLNM) was used to evaluate the effects of meteorological factors and air pollutant exposure on the risk of TB in PLWHA. RESULTS: A total of 2087 new or re-active TB cases were collected, which had a significant seasonal and periodic distribution. Compared with the median values, the maximum cumulative relative risk (RR) for TB in PLWHA was 0.663 (95% confidence interval [CI]: 0.507-0.866, lag 4 weeks) for a 5-unit increase in temperature, and 1.478 (95% CI: 1.116-1.957, lag 4 weeks) for a 2-unit increase in precipitation. However, neither wind speed nor PM10 had a significant cumulative lag effect. Extreme analysis demonstrated that the hot effect (RR = 0.638, 95%CI: 0.425-0.958, lag 4 weeks), the rainy effect (RR = 0.285, 95%CI: 0.135-0.599, lag 4 weeks), and the rainless effect (RR = 0.552, 95%CI: 0.322-0.947, lag 4 weeks) reduced the risk of TB. Furthermore, in the CD4(+) T cells < 200 cells/µL subgroup, temperature, precipitation, and PM10 had a significant hysteretic effect on TB incidence, while temperature and precipitation had a significant cumulative lag effect. However, these effects were not observed in the CD4(+) T cells ≥ 200 cells/µL subgroup. CONCLUSION: For PLWHA in subtropical Guangxi, temperature and precipitation had a significant cumulative effect on TB incidence among PLWHA, while air pollutants had little effect. Moreover, the influence of meteorological factors on the incidence of TB also depends on the immune status of PLWHA.

Trend and principal components of HIV/AIDS among adults in SSA.

This study aimed to identify the most important principal components (PCs) that contribute to the prevalence and change of HIV/AIDS in 44 SSA and data from different national and international datasets. The study estimated HIV prevalence, trend, and principal component analysis (PCA). Using the elbow method, the number of important PCs and contributions was identified. The quality of representation was checked, and more contributing variables for most important PCs were identified. Finally, the status by prevalence, the progress by trend, the more influenced component by PCA, and the more influenced variable with quality of representation by PCs were reported. The study found that HIV prevalence varied significantly, with 30 of the countries showed good progress/decline. Four PCs accounted for 51% of the total variance. Literacy, cohabitation, media exposure, and HIV status awareness are highly contributing factors. Based on these findings, a gap-based response will help reduce the burden of HIV.

Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China.

Improving access to HIV/AIDS healthcare services is of great concern to government and policymakers striving to strengthen overall public health. How to reasonably allocate HIV/AIDS healthcare resources and maximize the equality of access to healthcare services across subdistrict areas has become an urgent problem to be solved. However, there is limited research on this topic in China. It is necessary to evaluate spatial accessibility to improve the accessibility and equity of HIV/AIDS healthcare services. In this study, the improved multi-modal two-step floating catchment area (2SFCA) and inverted 2SFCA (i2SFCA) methods are used to measure the spatial accessibility of HIV/AIDS healthcare services and the crowdedness of the healthcare sites in Shandong Province, China. Then, the theoretical supply and the optimal spatial distribution of resources are calculated and visualized by minimizing the accessibility gaps between demand locations. This study showed that the spatial accessibility of HIV/AIDS service resources in Shandong Province was concentrated and unevenly distributed, and the accessibility scores in the marginal areas of prefecture-level cities were significantly lower than those in other areas. Regions with a large number of doctors had significantly higher levels of spatial accessibility. The ART accessibility scores in the southwest of Shandong Province were higher than those in other regions. As the travel friction coefficient increased, the accessibility scores formed an approximately circular cluster distribution centered on the healthcare sites in geographical distribution. More ART drugs needed to be supplied in marginal areas and more doctors were needed to work on HIV/AIDS in urban areas to address the spatial distribution imbalance of HIV/AIDS healthcare services. This study profoundly analyzed the spatial accessibility of HIV/AIDS healthcare services and provided essential references for decision-makers. In addition, it gives a significant exploration for achieving the goal of equal access to HIV/AIDS healthcare services in the future.

Magnitude of intestinal parasitic infections and its determinants among HIV/AIDS patients attending at antiretroviral treatment centers in East and West Gojam Zones, Northwest, Ethiopia: institution based cross-sectional study.

BACKGROUND: Intestinal parasitic infections (IP) are a major source of morbidity in people living with Human immunodeficiency virus (HIV), particularly in resource-limited settings, mostly as a result of high viral load. Hence, this study aimed to investigate the magnitude of intestinal parasitic infections and its determinants among patients with HIV/AIDS attending public health facilities in East and West Gojam Zones in Ethiopia. METHODS: Institution-based cross-sectional study was conducted on 327 people living with HIV visiting public health facilities from December 2022 to May 2023. A simple random sampling technique was used to recruit participants. Face-to-face interviews were used to collect socio-demographics and determinants. The fresh stool was collected from each patient, transported, and tested in accordance with laboratory standard operating procedures of wet mount, formol-ether concentration technique, and modified acid-fast staining. Data were entered and analyzed in the statistical package for Social Science (SPSS) version 20. A 95% CI with p-value < 0.05 was considered statistically significant. RESULTS: The overall prevalence of IP in patients with HIV/AIDS was 19.3% (63/327). Hookworm was the most identified parasite 33.3% (21/63) followed by E.histolytica 17% (11/63) and G.lamblia 14.3% (9/63). Parasitic infections were significantly higher among viral load > 1000cps/ml (p = 0.035), WHO stage 4 (p = 0.002), CD4 < 200 cell/mm3 (p = 0.001), and bare foot walking (p = 0.001). CONCLUSION: IP infections are moderately high among patients with HIV/AIDS in the study area. The proportion of parasites was greatly affected by high viral load, WHO stage 4, CD4 < 200 cell/mm3, and being barefoot; this gives valuable insight to health professionals, health planners and community health workers. As a result, viral load monitoring, and WHO stage controlling were periodically assessed in patients with HIV/AIDS. Health education, awareness creation, routine stool examination, and environmental hygiene were regularly advocated to increase the life of patients with HIV/AIDS.

Missed Opportunities: Characteristics of People Who Received a Concurrent HIV/AIDS Diagnosis in New York State From 2016 to 2021.

BACKGROUND: Late HIV diagnosis is associated with a wide range of negative outcomes. The aim of this study was to identify the characteristics of individuals who received a concurrent diagnosis (CDX) in New York State (NYS) so that more effective interventions can be developed to encourage earlier testing among these populations. METHODS: The NYS HIV registry was used to identify people who received a CDX from 2016 to 2021. A CDX was a diagnosis that met the criteria for a stage 3 HIV infection within 30 days of the initial HIV diagnosis. Sex at birth, race/ethnicity, transmission risk group, age at diagnosis, region of residence at diagnosis, urbanicity of zip code of diagnosis, and type of diagnosing facility were used as covariates. Bivariate and multivariate risk ratios were calculated to quantify associations between CDX and covariates. RESULTS: There were 14,866 people newly diagnosed with HIV in NYS from 2016 to 2021, of which 19.0% had a CDX. Those with female sex at birth, history of injection drug use, or history of male-to-male sexual contact/history of injection drug use risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX. CONCLUSION: Populations with the highest proportions of CDX were ones that made up a small percentage of all new HIV diagnoses and may not be benefiting as much from current HIV prevention efforts. There are complex interactions between many factors including geographic and social characteristics that may lead to delayed diagnostic testing.

Evaluating social protection mitigation effects on HIV/AIDS and Tuberculosis through a mathematical modelling study.

The global economic downturn due to the COVID-19 pandemic, war in Ukraine, and worldwide inflation surge may have a profound impact on poverty-related infectious diseases, especially in low-and middle-income countries (LMICs). In this work, we developed mathematical models for HIV/AIDS and Tuberculosis (TB) in Brazil, one of the largest and most unequal LMICs, incorporating poverty rates and temporal dynamics to evaluate and forecast the impact of the increase in poverty due to the economic crisis, and estimate the mitigation effects of alternative poverty-reduction policies on the incidence and mortality from AIDS and TB up to 2030. Three main intervention scenarios were simulated-an economic crisis followed by the implementation of social protection policies with none, moderate, or strong coverage-evaluating the incidence and mortality from AIDS and TB. Without social protection policies to mitigate the impact of the economic crisis, the burden of HIV/AIDS and TB would be significantly larger over the next decade, being responsible in 2030 for an incidence 13% (95% CI 4-31%) and mortality 21% (95% CI 12-34%) higher for HIV/AIDS, and an incidence 16% (95% CI 10-25%) and mortality 22% (95% CI 15-31%) higher for TB, if compared with a scenario of moderate social protection. These differences would be significantly larger if compared with a scenario of strong social protection, resulting in more than 230,000 cases and 34,000 deaths from AIDS and TB averted over the next decade in Brazil. Using a comprehensive approach, that integrated economic forecasting with mathematical and epidemiological models, we were able to show the importance of implementing robust social protection policies to avert a significant increase in incidence and mortality from AIDS and TB during the current global economic downturn.

Sleep quality mediates the effect of medical social support on depression symptoms in patients with HIV/AIDS.

OBJECTIVES: The purpose of our study is to further understanding of the depression symptoms of HIV/AIDS patients in Guilin, Guangxi via exploring whether there is a mediating effect of sleep quality on medical-social support and depression symptoms and therefore provide a theoretical basis for application of medical-social support to alleviate depression symptoms of HIV/AIDS patients. METHODS: A convenience sampling method was used to select 200 HIV/AIDS patients for the study. Depression symptoms, sleep quality, and medical-social support of the study participants were investigated using The Center for Epidemiological Studies Depression Scale (CES-D), The Pittsburg Sleep Quality Index (PSQI), and The Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Predictors of depression symptoms were explored by multiple linear regression, and Pearson correlation was used to analyze the relationship between sleep quality, medical-social support, and depression symptoms. Mediating effect analysis was performed by nonparametric Bootstrap test. RESULTS: In this study, the incidence of depression symptoms was 54.4%. Multiple linear regression analysis showed that leanness (ß = 0.161, P = 0.008), obesity (ß = 0.186, P = 0.002), sleep quality score > 7 (ß = 0.331, P < 0.001), and medical-social support score > 56 (ß = -0.247, P < 0.001) could influence depression symptoms of HIV and Pearson's correlation analysis demonstrated that there was a two-way correlation between sleep quality, medical social support and depression symptoms (P < 0.05). In addition, Bootstrap tests showed that medical-social support might affect depression symptoms not only directly but also indirectly through the mediating effect of sleep quality with the direct and mediating effects accounting for 77.25% and 22.75% of the total effect, respectively. CONCLUSION: The prevalence of depression symptoms is high among HIV/AIDS patients in Guilin City. The depressive symptoms of PLWHs(people living with HIV) are related to their sleep quality and medical-social support, and sleep quality partially mediates the relationship between medical-social support and depression symptoms. Therefore, interventions to improve sleep quality and medical-social support have the potential to allay the depression symptoms of HIV/AIDS patients.

Prevalence trends of anemia impairment in adolescents and young adults with HIV/AIDS.

BACKGROUND: Anemia is a common complication of HIV/AIDS, particularly in adolescents and young adults across various countries and regions. However, little is known about the changing prevalence trends of anemia impairment in this population over time. METHODS: Data on anemia in adolescents and young adults with HIV/AIDS from 1990 to 2019 were collected from the Global Burden of Disease. Prevalence was calculated by gender, region, and country for individuals aged 10-24, and trends were measured using estimating annual percentage changes (EAPC). RESULTS: Globally, the prevalence of adolescents and young adults with HIV/AIDS increased from 103.95 per 100,000 population in 1990 to 203.78 in 2019. However, anemia impairment has decreased over the past three decades, with a global percentage decreasing from 70.6% in 1990 to 34.7% in 2019, mainly presenting as mild to moderate anemia and significantly higher in females than males. The largest decreases were observed in Central Sub-Saharan Africa, North America, and Eastern Sub-Saharan Africa, with EAPCs of -2.8, -2.34, and -2.17, respectively. Tajikistan (78.76%) and Madagascar (74.65%) had the highest anemia impairment percentage in 2019, while China (16.61%) and Iceland (13.73%) had the lowest. Anemia impairment was closely related to sociodemographic index (SDI) levels, with a high proportion of impairment in low SDI regions but a stable decreasing trend (EAPC = -0.37). CONCLUSION: Continued anemia monitoring and management are crucial for patients with HIV, especially in high-prevalence regions and among females. Public health policies and interventions can improve the quality of life and reduce morbidity and mortality.

Multilevel analysis of discrimination of people living with HIV/AIDS and associated factors in Ghana: demographic health survey of 2022 Ghana data.

Introduction: The negative effects of stigma and discrimination in communities and families include medication non-adherence, heightened psychological distress, verbal and physical abuse, a lack of social support, isolation, and dangerous health behaviors such as hiding prescriptions. Despite the huge burden of HIV/AIDS discriminatory attitudes, limited studies were conducted in Ghana. Therefore, this study examines the burden of discriminatory attitudes and their determinant factors on people who are living with HIV/AIDS in Ghana. Objective: This study aimed to determine the prevalence of discriminatory attitudes and associated factors among people who are living with HIV/AIDS in Ghana based on recent DHS data. Method: Secondary data analysis was used for this multilevel logistic regression analysis based on the Ghana Demographic Health Survey of 2022. Data extraction, cleaning, and analysis were conducted using Stata version 14. The community of Ghana, from the 15 to 49 age group, was used for this study, with a final sample size of 22,058 participants. Four separate models were fitted, incorporating individual and community levels. Multilevel logistic regression models were calibrated to determine the associated factors at the individual and community level with discriminatory attitudes, with a 95% CI and AOR. Results: The prevalence of discriminatory attitudes toward people living with HIV/AIDS was 60.92%, with a 95% CI (60.13, 61.70) among Ghana DHS. Lower wealth status, having no comprehensive knowledge of HIV, low educational status at the individual level, and low wealth status at the community level, poorest and poorer [AOR =2.03; 95% CI: (1.04, 3.94)] and [AOR = 2.09; 95% CI: (1.84, 8.65)], respectively, no comprehensive knowledge [AOR = 3.42; 95% CI: (1.74, 6.73)], no and primary education [AOR = 3.18; 95% CI: (2.48, 5.51)] and [AOR = 3.78; 95% CI: (2.68, 5.92)], respectively, at the individual level and low wealth status [AOR = 1.58; 95% CI: (1.00, 2.46)] community level were the associated factors. Conclusion: The prevalence of discriminatory attitudes toward people living with HIV/AIDS was high (60.92%) in Ghana's DHS. The associated factors for this study were lower wealth status, having no comprehensive knowledge of HIV, and low educational status at the individual level.

HIV infections and AIDS cases in Poland in 2021 year. / Zakazenia HIV i zachorowania na AIDS w Polsce w 2021 roku.

BACKGROUND: Despite a temporary decrease in the number of newly HIV infections in Poland in 2020, a return to the growing number of new infections was observed in 2021 in the surveillance. OBJECTIVE: The aim of the study was to assess the epidemiological situation of newly HIV infections and AIDS cases and death among AIDS cases in Poland in 2021 in comparison to the changes in preceding years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases received from doctors and laboratories and the results of the annual survey of HIV testing conducted by laboratories throughout the country. A dataset on clients from Voluntary Testing and Counselling, coordinated by the National AIDS Center, which anonymously collects epidemiological and behaviour data on tested people was used. RESULTS: In 2021 there were 1 367 HIV cases newly diagnosed in Poland (diagnosis rate 3.58 per 100,000), including 236 among non-Polish citizens. The number of HIV infections increased by 43.3% compared to the previous year and was higher by 3.8% compared to the median in 2015-2019 years. Similarly, among VCT clients, number of HIV increased by 45%, from 309 in 2020 to 448 in 2021 year. The total number of AIDS cases reported to surveillance was 62 (incidence 0.16 per 100,000). The HIV infection was most often detected in the age group 30-39 year (35.8%) and among men (82.1%). Among cases with known transmission route, 68.7% concerned among MSM. The percentage of AIDS cases diagnosed at the same time with HIV increased by more than 30 percent points (from 63.5% to 95.1% of all AIDS cases). CONCLUSIONS: In 2021 the number of newly detected HIV infections increased compared to the previous year, probably due to a reduction in restrictions related to the COVID-19 pandemic and increased in HIV testing rate.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review.

BACKGROUND: Targeted interventions for key populations remain critical for realisation of epidemic control for human immunodeficiency virus (HIV) infection because of the causal relationship between HIV infection in the general population and among key population groups. AIM: To consolidate evidence on the fast-track interventions towards achieving HIV epidemic control among key populations. METHODS: A rapid scoping review was conducted using the methodological framework by Arksey and O' Malley. The Population, Intervention, Context and Outcome (PICO) framework was used to identify relevant studies using key words with Boolean operators in electronic data bases, namely CINHAL, Web of Science, Psych Info and Sabinet. Studies were extracted using a modified data extraction tool, and results were presented narratively. RESULTS: A total of 19 articles were included in this review. Most articles were primary studies (n = 17), while another involved the review of existing literature and policies (n = 2) and routinely collected data (n = 1). Most studies were conducted in the United States of America (n = 6), while another were conducted in China, Kenya, Botswana, South Africa and Mozambique. All studies revealed findings on tested interventions to achieve HIV epidemic control among key populations. CONCLUSION: Effective interventions for HIV epidemic control were stand-alone behavioural preventive interventions, stand-alone biomedical preventive strategies and combination prevention approaches. Furthermore, the findings suggest that effective activities to achieve HIV epidemic control among key populations should be centred around prevention.Contribution: The findings of this study have policy and practice implications for high HIV burden settings such as South Africa in terms of interventions to facilitate realisation of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets, thereby contributing to HIV epidemic control.

HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution.

OBJECTIVE: The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil. METHODS: An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais-Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied. RESULTS: The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval - 95%CI 1.16-3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state. CONCLUSION: The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

Multiple carcinomas in a woman with HIV infection: a case report and literature review.

Non-acquired immunodeficiency syndrome-defining cancers (NADCs) are malignancies in persons living with human immunodeficiency virus (PLWHIV) and are not primarily due to the host's immunodeficiency. There is renewed clinical interest in long-term morbidities in PLWHIV as well as malignancies that occur in this population. We herein describe a 36-year-old woman with a 2-year history of an anal wound and right breast mass. She had been diagnosed with HIV infection prior to the development of these lesions. Clinical and laboratory evaluations led to diagnoses of breast and anal cancers. Chemotherapy and antiretroviral therapy were begun, but the patient discontinued these treatments early and was lost to follow-up. NADCs will continue to be a major clinical issue as the global population ages. This presentation of two NADCs (breast and anal cancers) in a PLWHIV further highlights the burden of multiple malignancies on the depleted health of HIV-infected patients. Early identification and treatment of HIV upon patients' presentation to cancer care sites and screening for NADCs at HIV/AIDS care sites are recommended for improved outcomes.