Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.
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PMID:Factors associated with HIV testing among public sector clinic attendees in Johannesburg, South Africa. 1893 3

The purpose of this study was to describe prior use of detoxification and addiction-treatment programs among injection drug users (IDUs) in Kabul, Afghanistan. From 2005-2006, IDUs (n = 464) recruited into this cross-sectional study completed an interviewer-administered questionnaire and whole blood rapid testing with fingerstick samples for HIV, syphilis, and hepatitis C antibody and B surface antigen testing. Participants were predominantly male (99.8%), Afghan (98.9%), and had little formal education. Correlates of detoxification and addiction treatment were identified with logistic regression. The majority (94.0%, n = 435) felt great/urgent need for treatment, of whom 56.3% (n = 245) reported inability to access treatment. Prior detoxification was associated with new needle use with each injection (AOR = 1.91, 95% CI: 1.12-3.26) and prior incarceration (AOR = 1.81, 95% CI: 1.04-3.13). The study's limitations are noted. Rapid scale-up and subsidy of needle and syringe programs and opioid agonist treatment is urgently needed in Kabul.
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PMID:A cross-sectional assessment of utilization of addiction treatment among injection drug users in Kabul, Afghanistan. 1897 91

A brief, 8-item assessment of HIV treatment knowledge and action was developed and evaluated. Patients with HIV were interviewed in 2001 at infectious disease clinics in Shreveport, LA and Chicago, IL. Analyses on demographics, self-reported medication adherence, and responses to the Rapid Estimate of Adult Literacy in Medicine (REALM) and new, Brief Estimate of Health Knowledge and Action-HIV version (BEHKA-HIV) were performed in 2007. The BEHKA-HIV demonstrated high internal consistency, and construct validity. Lower scores on the BEHKA-HIV were independently associated with poorer rates of HIV medication adherence, scores 4-5 out of 8, AOR 2.6 (95% CI 1.9-3.6), and scores 0-3, AOR 11.4 (95% CI 8.2-15.9), as were the lowest scores on the REALM, AOR 3.3 (95% CI 1.3-8.7). The BEHKA-HIV is a psychometrically sound tool for assessing health knowledge and action regarding HIV treatment, and predicting non-adherence to HIV medications.
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PMID:Health literacy in the context of HIV treatment: introducing the Brief Estimate of Health Knowledge and Action (BEHKA)-HIV version. 1902 53

To provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal al clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery. At enrollment, 59% had disclosed to their partners and 42% to others. This rose to 67% and 59%, respectively, by follow-up. Logistic regression analysis identified being married (adjusted odds Ratio [AOR] 2.32; 95% confidence interval [CI] 1.20-4.47), prior discussion about testing (AOR 4.19; CI 2.34-7.49), having a partner with tertiary education (AOR 2.76; CI 1.29-5.88) and less experience of violence (AOR 0.48; CI 0.24-0.97) as factors associated with having disclosed to partners prior to enrollment. Better housing (AOR 1.26; CI 1.06-1.49), less financial dependence on partners (AOR 0.46; CI 0.25-0.85), and knowing someone with HIV (AOR 2.13; CI 1.20-3.76) were associated with prior disclosure to others. Increased levels of stigma at baseline decreased the likelihood of disclosure to partners postenrollment (AOR 0.91; CI 0.84-0.98) and increased levels of avoidant coping decreased subsequent disclosure to others (AOR 0.84; CI 0.72-0.97). These results provide understanding of disclosure for women diagnosed as HIV positive in pregnancy, and identify variables that could be used to screen for women who require help.
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PMID:Factors affecting disclosure in South African HIV-positive pregnant women. 1902 85

In this era of antiretroviral therapy (ART) a limited number of population-based studies have investigated the extent of voluntary counseling and testing acceptance and completion in Africa. The aim of this study was to assess the prevalence and predictors of failure to return for HIV post-test counseling (PTC) among adults in rural Kilimanjaro, Tanzania. Following a cross-sectional survey, people aged 15-44 years living in Oria village were interviewed and offered individual HIV-1 pre-test counseling. They were asked to return for PTC two weeks after blood sample collection. HIV-1 testing was accepted by 1491 (97.6%) of participants with 98.9% expressing desire to know their results. The proportion of individuals who did not return for PTC was 50.9%. These proportions did not differ by sex. Seropositive HIV result (AOR: 2.2; 95%CI: 1.3-4.3 for women and AOR: 2.1, 95%CI: 1.2-5.7 for men), low HIV/AIDS-transmission and ART availability knowledge, perceived low risk of HIV infection, not accepting to share results (men only) and inability to self-prevent HIV infection (women only) predicted failure to return for PTC. Additionally, participants were more likely not to return for PTC if they had no-formal education or reported recent sexual-risk behaviors, for both sexes. Age, prior HIV testing or AIDS-related clinical symptoms were not associated with return for PTC in this population. These findings suggest that low returns for PTC, especially for HIV-seropositive individuals, result in a substantial missed opportunity for prevention and care. Knowledge of ART accessibility is necessary but not sufficient to promote adequate return for PTC. The high attendance for pre-test counseling should be utilized to identify potential individuals who may not return for PTC and to promote risk reduction and care.
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PMID:Prevalence and predictors of failure to return for HIV-1 post-test counseling in the era of antiretroviral therapy in rural Kilimanjaro, Tanzania: challenges and opportunities. 1922 84

The purpose of this study was to assess the relative importance and interactive effects of drug use status (i.e. injection or non-injection drug user) and condom use with casual partners in predicting perceived risk of contracting HIV among drug users in Baltimore, Maryland. Baseline data was used from the longitudinal NEURO-HIV Epidemiological Study. This battery of questionnaires assessed a variety of demographic, drug use and sex risk variables. The current study examined these variables in association with perceived risk of contracting HIV. Significant covariates included having at least some college education (AOR=.42, 95%CI=.20, .89), knowing someone who is HIV-positive (AOR = 1.82, 95%CI = 1.15, 2.89), using drugs twice (AOR = 2.02, 95%CI = 1.02, 3.99) or more (AOR = 2.22, 95%CI = 1.22, 4.04) per day and having unprotected casual sex (AOR = 2.51, 95%CI = 1.42, 4.41). These covariates explained 15% of the variance in perceived HIV risk. A significant interaction between type of drug user and having unprotected casual sex revealed that the greatest likelihood of perceived HIV risk associated with unprotected casual sex occurred among non-injection drug users. The results suggest that non-injection drug users are aware of their risk for contracting HIV if they engage in unprotected casual sex. Future HIV-prevention programs should build on this awareness by targeting this subgroup of drug users for condom-use interventions with casual partners. Additional programs should target injection drug users to increase their perceived risk of contracting HIV through unprotected casual sex.
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PMID:Unprotected casual sex and perceived risk of contracting HIV among drug users in Baltimore, Maryland: evaluating the influence of non-injection versus injection drug user status. 1922 92

HIV is a chronic, life-threatening illness that necessitates regular and consistent medical care. Childhood sexual abuse (CSA) is a common experience among HIV-positive adults and may interfere with treatment utilization. This study examined rates and correlates of treatment utilization among HIV-positive adults with CSA enrolled in a coping intervention trial in New York City. The baseline assessment included measures of treatment utilization, mental health, substance abuse, and other psychosocial factors. In 2002-2004, participants (50% female, 69% African-American, M = 42.3 +/- 6.8 years old) were recruited. Nearly all (99%) received HIV medical care. However, 20% had no outpatient visits and 24% sought emergency services in the past 4 months. Among 184 participants receiving antiretroviral therapy (ART), 22% were less than 90% adherent in the past week. In a multivariable logistic regression model, no outpatient treatment was associated with African American race (AOR = 3.46 [1.42-8.40]), poor social support (AOR = 1.59 [1.03-2.45]), and abstinence from illicit drug use (AOR = 0.37 [0.16-0.85]). Emergency service utilization was associated with HIV symptoms (AOR = 2.30 [1.22-4.35]), binge drinking (AOR=2.92 (1.18-7.24)), and illicit drug use (AOR = 1.98 [1.02-3.85]). Poor medication adherence was associated with trauma symptoms (AOR = 2.64 [1.07-6.75]) and poor social support (AOR = 1.82 [1.09-2.97]). In sum, while participants had access to HIV medical care, a sizable minority did not adhere to recommended guidelines and thus may not be benefiting optimally from treatment. Interventions targeting HIV-positive adults with CSA histories may need to address trauma symptoms, substance abuse, and poor social support that interfere with medical treatment utilization and adherence.
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PMID:Utilization of medical treatments and adherence to antiretroviral therapy among HIV-positive adults with histories of childhood sexual abuse. 1926 Jul 72

The purpose of this study was to assess the prevalence and risk factors for syphilis infection among female sex workers (FSWs) in Liuzhou City, Guangxi Zhuang Autonomous Region, southern China. A cross-sectional study recruited FSWs using a venue-based method and subsequent snowball sampling with mapping strategies. Questionnaire-based interviews were conducted to collect demographic and behavioral information. Blood was tested for syphilis (RPR with TPPA confirmation) and HIV (EIA with Western blot confirmation) infections. Of the 362 eligible participants, 81.7% were non-local residents (60.5% from other parts of Guangxi and 21.2% were non-Guangxi residents); 58.0% belonged to non-Han minority ethnic groups; 37.5% reported inconsistent condom use with their clients and 71.2% reported inconsistent condom use with their regular sex partners during the past month. Nearly 10% reported having had sex with drug users. The prevalence rates for HIV and syphilis infections were 2.3% and 11.0%, respectively. Almost half (46.6%) of participants reported having had STD symptoms. Inconsistent condom use with clients in the past month (AOR = 5.0; 95% CI = 1.8-13.8), less education (OR = 2.6; 95% CI = 1.1-7.4), and HIV infection (AOR = 8.1; 95% CI = 1.1-68.5) were independently associated with syphilis infection.
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PMID:Prevalence of HIV infection and predictors for syphilis infection among female sex workers in southern China. 1932 11

Male circumcision can reduce the risk of HIV acquisition among heterosexual men, but its effectiveness is uncertain in men who have sex with men (MSM). Additionally, its acceptability among Chinese men is unknown given a lack of history and cultural norms endorsing neonatal and adult circumcision. This study evaluated the willingness to participate in a clinical trial of circumcision among 328 Chinese MSM. Some 11.6% respondents reported having been circumcised, most of them due to a tight foreskin. Of 284 uncircumcised MSM, 16.9% said they were absolutely willing to participate, 26.4% were probably, 28.9% were probably not, and 27.8% were absolutely not; 81% said male circumcision would help maintain genital hygiene. The major motivators for willingness to participate included contribution to AIDS scientific research and getting free medical service. Men also had concerns about ineffectiveness of circumcision in reducing HIV/sexually transmitted infection (STI) risks and side effects of the surgery. Those who did not have a Beijing resident card (adjusted odds ratio [AOR], 1.99; 95% confidence interval [CI], 1.17-3.38), did not find sexual partners through the Internet (AOR, 2.13; 95% CI, 1.21-3.75), and were not concerned about the effectiveness of circumcision (AOR, 2.37; 95% CI, 1.34-4.19) were more likely to be willing to participate in a trial. The study suggests that circumcision is uncommon among Chinese MSM. Considerable community education will be needed in circumcision advocacy among MSM in China. A clinical trial for efficacy among MSM should be considered.
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PMID:Willingness to be circumcised for preventing HIV among Chinese men who have sex with men. 1933 72

This study explored the relationship between gay identity-related factors (gay community involvement, gay bar attendance, gay identity importance, and self-homophobia) and unprotected anal sex (UA) in the past 3 months among men who have sex with men (MSM) of three different race/ethnicity groups. Four hundred eighty-three MSM (mean age 34) were recruited in the San Francisco Bay Area (33% African American, 34% Latino and 33% White). Compared with White MSM, African American and Latino MSM were less likely to identify as gay, and to attend gay bars/clubs, and more likely to report self-homophobia. Just over one third of the sample reported UA (did not vary by race). Gay community involvement was associated with receptive UA with all partners (adjusted odds ratio [AOR = 1.30, 95% Confidence Interval (CI) = 1.06-1.60). Gay bar attendance was associated with insertive UA with all partners (AOR = 1.20, 95% CI = 1.01-1.43) and with HIV-discordant partners (AOR = 1.35, 95% CI = 1.08-1.69). Implications for prevention include addressing community norms and encouraging alternatives to bars as settings in which to meet and socialize with other MSM.
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PMID:Gay identity-related factors and sexual risk among men who have sex with men in San Francisco. 1939 32


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