{"title":"HIV Late Presenters in Asia: Management and Public Health Challenges.","authors":"Chen Seong Wong, Lyu Wei, Yeon-Sook Kim","doi":"10.1155/2023/9488051","DOIUrl":"https://doi.org/10.1155/2023/9488051","url":null,"abstract":"<p><p>Many individuals are diagnosed with human immunodeficiency virus (HIV) infection at an advanced stage of illness and are considered late presenters. We define late presentation as a CD4 cell count below 350 cells/mm<sup>3</sup> at the time of HIV diagnosis, or presenting with an AIDS-defining illness regardless of CD4 count. Across Asia, an estimated 34-72% of people diagnosed with HIV are late presenters. HIV late presenters generally have a higher disease burden and higher comorbidity such as opportunistic infections than those who are diagnosed earlier. They also have a higher mortality rate and generally exhibit poorer immune recovery following combined antiretroviral therapy (cART). As such, late HIV presentation leads to increased resource burden and costs to healthcare systems. HIV late presentation also poses an increased risk of community transmission since the transmission rate from people unaware of their HIV status is approximately 3.5 times higher than that of early presenters. There are several factors which contribute to HIV late presentation. Fear of stigmatisation and discrimination are significant barriers to both testing and accessing treatment. A lack of perceived risk and a lack of knowledge by individuals also contribute to late presentation. Lack of referral for testing by healthcare providers is another identified barrier in China and may extend to other regions across Asia. Effective strategies are still needed to reduce the incidence of late presentation across Asia. Key areas of focus should be increasing community awareness of the risk of HIV, reducing stigma and discrimination in testing, and educating healthcare professionals on the need for early testing and on the most effective ways to engage with people living with HIV. Recent initiatives such as intensified patient adherence support programs and HIV self-testing also have the potential to improve access to testing and reduce late diagnosis.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2023 ","pages":"9488051"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10089683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Knowledge, Attitude, Practice, and Adherence to Antiretroviral Therapy among People Living with HIV in Nepal.","authors":"Sweta Shrestha, Subodh Chataut, Badri Kc, Khagendra Acharya, Sait Kumar Pradhan, Sunil Shrestha","doi":"10.1155/2023/7292115","DOIUrl":"https://doi.org/10.1155/2023/7292115","url":null,"abstract":"<p><strong>Introduction: </strong>Patient's knowledge and attitude towards their treatment avert stereotypical misconceptions about the disease and its treatment, as well as aid in attaining optimal adherence. This study investigated the knowledge, attitude, practice, and adherence of antiretroviral therapy (ART) clients in Nepal.</p><p><strong>Method: </strong>A cross-sectional study was conducted among 165 ART clients visiting five ART sites in the far western region and the capital city of Nepal. The convenience sampling method was employed, and the data were collected through interviews with ART clients using a validated questionnaire. Binary logistic regression was used to identify associated factors.</p><p><strong>Result: </strong>Approximately 80.7% had adequate knowledge and 55% had a positive attitude towards ART. Stigmatization was associated with ARV by only 4.2%. Half of the participants (50.3%) revealed that they had surreptitiously stored their ART medication, diverging from the recommended storage guidelines. A significant proportion of respondents (33.3%) chose to repackage the medication as a strategy to prevent unintended disclosure of their HIV status. Many (59.3%) believed that ART does not prolong life. Nevertheless, they advocated the regular use of ART rather than taking it only when the health deteriorates (81.8%). The majority (97.6%) were found to be adherent to their ART. There was a significant association of age with a level of knowledge and attitude (<i>p</i> < 0.05). A significant association was also found between knowledge and attitude towards ART (<i>p</i> < 0.05). None of the variables had a significant association with adherence (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Overall, adequate knowledge was demonstrated, whereas efforts are still needed to improve the attitude of ART clients towards ART. A need for counseling regarding the storage practices of ART is needed. A focus on ensuring the perfect translation of adequate knowledge and a positive attitude to the practice of ART clients is essential. Whether adequate ART knowledge and attitude scores will lead to near-perfect ART adherence needs further investigation.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2023 ","pages":"7292115"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helena Lamptey, Benjamin Newcomb, Evelyn Y Bonney, James O Aboagye, Peter Puplampu, Vincent J Ganu, Gloria Ansa, Joseph Oliver-Commey, George B Kyei
{"title":"Healthcare Provider Perspectives on HIV Cure Research in Ghana.","authors":"Helena Lamptey, Benjamin Newcomb, Evelyn Y Bonney, James O Aboagye, Peter Puplampu, Vincent J Ganu, Gloria Ansa, Joseph Oliver-Commey, George B Kyei","doi":"10.1155/2023/8158439","DOIUrl":"https://doi.org/10.1155/2023/8158439","url":null,"abstract":"<p><strong>Introduction: </strong>Antiretroviral therapy (ART) has reduced mortality and improved life expectancy among HIV patients but does not provide a cure. Patients must remain on lifelong medications and deal with drug resistance and side effects. This underscores the need for HIV cure research. However, participation in HIV cure research has risks without guaranteed benefits. We determined what HIV healthcare providers know about HIV cure research trials, the risks involved, and what kind of cure interventions they are likely to recommend for their patients.</p><p><strong>Methods: </strong>We conducted in-depth qualitative interviews with 39 HIV care providers consisting of 12 physicians, 8 counsellors, 14 nurses, 2 pharmacists, 2 laboratory scientists, and 1 community advocate from three hospitals. Interviews were transcribed verbatim and coded, and thematic analysis was performed independently by two investigators.</p><p><strong>Results: </strong>Participants were happy about the success of current treatments and hopeful that an HIV cure will be found in the near future, just as ART was discovered through research. They described cure as total eradication of the virus from the body and inability to test positive for HIV or transmit the virus. In terms of risk tolerance, respondents would recommend to their patients' studies with mild to moderate risks like what patients on antiretroviral therapy experience. Participants were reluctant to recommend treatment interruption to patients as part of a cure study and wished trials could be performed without stopping treatment. Healthcare providers categorically rejected death or permanent disability as an acceptable risk. The possibility of finding a cure that will benefit the individual or future generations was strong motivations for providers to recommend cure trials to their patients, as was transparency and adequate information on proposed trials. Overall, the participants were not actively seeking knowledge on cure research and lacked information on the various cure modalities under investigation.</p><p><strong>Conclusion: </strong>While hopeful for an HIV cure, healthcare providers in Ghana expect a cure to be definitive and pose minimal risk to their patients.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2023 ","pages":"8158439"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9608627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bartholomew Dzudzor, Samuel Essel, Latif Musah, Jennifer Adjepong Agyekum, Kwame Yeboah
{"title":"Metabolic Syndrome and Combination Antiretroviral Therapy in HIV Patients in Periurban Hospital in Ghana: A Case-Control Study.","authors":"Bartholomew Dzudzor, Samuel Essel, Latif Musah, Jennifer Adjepong Agyekum, Kwame Yeboah","doi":"10.1155/2023/1566001","DOIUrl":"https://doi.org/10.1155/2023/1566001","url":null,"abstract":"<p><strong>Background: </strong>There is an increasing prevalence of cardiovascular diseases (CVDs) and risk factors in HIV patients as the levels of AIDS-related mortality and morbidity decrease. Metabolic syndrome (MetS) is the accumulation of various CVD risk factors that predict the occurrence of CVDs. We investigated the prevalence of MetS and associated risk factors in HIV patients treated with combination antiretroviral therapy (cART), cART-naïve HIV patients, and non-HIV controls.</p><p><strong>Methods: </strong>In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients, and 156 non-HIV controls were recruited from a periurban hospital in Ghana. A structured questionnaire was used to collect data on demography, lifestyle, and medication. Anthropometric indices and blood pressure were measured. Fasting blood samples were collected to measure the plasma levels of glucose, lipid profile, and CD4+ cells. The presence of MetS was defined using the joint scientific statement criteria.</p><p><strong>Results: </strong>The prevalence of MetS was higher in cART-treated HIV patients compared with cART-naïve HIV patients and non-HIV controls (57.3% vs. 23.6% vs. 19.2% and <i>p</i> < 0.001, respectively). MetS was associated with cART-treated HIV patients (odds ratio (95% CI) = 7.24 (3.41-15.39) and <i>p</i> < 0.001), cART-naïve HIV patients (2.04 (1.01-4.15), <i>p</i>=0.048), and female gender (2.42 (1.39-4.23) and <i>p</i>=0.002). In cART-treated HIV patients, those on zidovudine (AZT)-based regimens were associated with increased likelihood (3.95 (1.49-10.43) and <i>p</i> < 0.006), while those on tenofovir (TDF)-based had decreased likelihood (0.32 (0.13-0.8) and <i>p</i>=0.015) of having MetS.</p><p><strong>Conclusion: </strong>In our study population, there was a high prevalence of MetS in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls. HIV patients on AZT-based regimens had an increased likelihood of having MetS, while those on TDF-based regimens had a reduced likelihood of having MetS.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2023 ","pages":"1566001"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level.","authors":"Leta Lencha Gemechu, Legesse Kassa Debusho","doi":"10.1155/2023/5191252","DOIUrl":"https://doi.org/10.1155/2023/5191252","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a preventable and treatable disease but it is the leading cause of death among people living with HIV (PLHIV). In addition, the emergence of the HIV pandemic has also had a major impact on TB incidence rates. There are studies in spatial patterns of TB and HIV separately in Ethiopia; there is, however, no information on spatial patterns of TB-HIV coinfection in the country at the districts level at least using yearly data. This paper, therefore, aimed at determining the spatial clustering of TB-HIV coinfection prevalence rates in the country at the districts level on an annual basis over a four-year period, 2015-2018.</p><p><strong>Methods: </strong>District-level aggregated data on the number of TB-HIV infections were obtained from the Ethiopian Federal Ministry of Health for 2015 to 2018. The univariate and bivariate global Moran's index, Getis-Ord <i>G</i> <sub><i>i</i></sub> <sup><i>∗</i></sup> local statistic, a chi-square test, and a modified <i>t</i>-test statistic for Spearman's correlation coefficient were used to evaluate the spatial clustering and spatial heterogeneity of TB among PLHIV and HIV among TB patients prevalence rates.</p><p><strong>Results: </strong>The district-level prevalence rate of HIV among TB patients was positively and significantly spatially autocorrelated with global Moran's <i>I</i> values range between 0.021 and 0.134 (<i>p</i> value <0.001); however, the prevalence of TB among PLHIV was significant only for 2015 and 2017 (<i>p</i> value <0.001). Spearman's correlation also shows there was a strong positive association between the two prevalence rates over the study period. The local indicators of spatial analysis using the Getis-Ord statistic revealed that hot-spots for TB among PLHIV and HIV among TB patients have appeared in districts of various regions and the two city administrations in the country over the study period; however, the geographical distribution of hotspots varies over the study period. Similar trends were also observed for the cold-spots except for 2017 and 2018 where there were no cold-spots for TB among PLHIV.</p><p><strong>Conclusions: </strong>The study presents detailed knowledge about the spatial clustering of TB-HIV coinfection in Ethiopia at the districts level, and the results could provide information for planning coordinated district-specific interventions to jointly control both diseases in Ethiopia.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2023 ","pages":"5191252"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10585893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omoladun O Odediran, Oluwakemi O Odukoya, Mobolanle R Balogun, Jonathan A Colasanti, Alani S Akanmu
{"title":"A Qualitative Study Exploring Factors Associated with Retention in HIV Care among Women with HIV in a Large HIV Clinic in Lagos, Nigeria, after Implementing the Test and Treat Policy.","authors":"Omoladun O Odediran, Oluwakemi O Odukoya, Mobolanle R Balogun, Jonathan A Colasanti, Alani S Akanmu","doi":"10.1155/2022/9074844","DOIUrl":"10.1155/2022/9074844","url":null,"abstract":"<p><strong>Background: </strong>In Nigeria, various sociocultural and economic factors may prevent women from being retained in HIV care. This study explores the factors associated with retention in care among women with HIV in a large HIV clinic in Lagos, Nigeria, under the Test and Treat policy.</p><p><strong>Methods: </strong>Women living with HIV/AIDS (<i>n</i> = 24) enrolled in an HIV study at the AIDS Prevention Initiative in Nigeria (APIN) clinic in Lagos, Nigeria, were interviewed from April 1 to October 31, 2021, using a semistructured interview guide. Interviews were audio-taped, transcribed verbatim, and the themes were analyzed using the framework of Andersen and Newman's Behavioural Model for Healthcare Utilization.</p><p><strong>Results: </strong>The mean age of the respondents was 37.4 ± 9.27 years. The identified themes were as follows: being aware of the antiretroviral medications and their benefits, the household's awareness of the respondents' HIV status, and the presence of social support. Other themes were the presence of a dependable source of income and the ability to overcome the challenges encountered in obtaining income, ease of travel to and from the clinic (length of travel time and transportation costs), securing support from the clinic, challenges encountered in the process of accessing care at the clinic, and the ability to overcome these challenges. Also mentioned were self-perception of being HIV positive, motivation to remain in care, linkage to care, and intention to stay in care.</p><p><strong>Conclusion: </strong>Several deterring factors to retention in HIV care, such as nondisclosure of status, absence of social support, and clinic barriers, persist under the Test and Treat policy. Therefore, to achieve the \"treatment as prevention\" for HIV/AIDS, especially in sub-Saharan Africa, it is essential to employ strategies that address these barriers and leverage the facilitators for better health outcomes among women with HIV/AIDS.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2022 ","pages":"9074844"},"PeriodicalIF":1.1,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10575587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Could a Dolutegravir-Based Antiretroviral Therapy Lead to Clinical Obesity? A Retrospective Cohort Study Conducted at Hawassa University Comprehensive Specialized Hospital in Hawassa, Sidama, Ethiopia","authors":"By Aberash Eifa, Worku Ketema","doi":"10.1155/2022/2965325","DOIUrl":"https://doi.org/10.1155/2022/2965325","url":null,"abstract":"Background As of April 2019, the dolutegravir (DTG)-based regimen is replacing the efavirenz-based regimen in Ethiopia, mainly due to its superiority in viral load suppression. However, there is a growing concern about this medication-based regimen, the most serious of which is excessive weight gain. In this study, we looked at weight gain disparities among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients on antiretroviral therapy (ART) who have been shifted to tenofovir/lamivudine/dolutegravir (TLD) from a tenofovir/lamivudine/efavirenz (TLE)-based regimen versus those who are maintained on a tenofovir/lamivudine/efavirenz-based regimen. Methods A facility-based retrospective observational cohort study was conducted in pursuit of weight change disparities between tenofovir/lamivudine/dolutegravir and tenofovir/lamivudine/efavirenz-based regimens among patients who have attained optimal viral suppression at Hawassa University Comprehensive Specialized Hospital antiretroviral clinic. Chi-square and logistic regression were used as appropriate using an SPSS version 21 program to test the association of specific variables to outcome variables, and a P value <0.05 was considered statistically significant. Results This study included 422 patients, 211 of whom were switched from tenofovir/lamivudine/efavirenz to tenofovir/lamivudine/dolutegravir and the remaining were who kept on a tenofovir/lamivudine/efavirenz-based regimen. Patients on a tenofovir/lamivudine/dolutegravir-based regimen had a mean weight gain of 3.88 ± 2.021 kg in one year compared to those on TLE (2.26 ± 2.39). In a bivariate analysis, being male was found to protect against unwanted weight gain at COR 0.531 (0.345, 0.816). A current CD4 count of more than 500 has been found to be strongly correlated with weight gain in multivariate analysis at an AOR of 0.315 (0.188, 0.527) at a P value ≤0.001. Conclusion According to this study, tenofovir/lamivudine/dolutegravir (TLD)-based antiretroviral medication (ART) users are more likely to gain weight, and clinicians should advise them of the risks of weight gain as well as cost-effective ways to prevent weight gain linked to poor health outcomes in these patients. Future investigations should confirm the findings of this study, and more research into the effects of weight gain in these people is required.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2022 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45045118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Coagulation Parameters in Human Immunodeficiency Virus Infected Patients: A Systematic Review and Meta-Analysis","authors":"Solomon Getawa, Tiruneh Adane","doi":"10.1155/2022/6782595","DOIUrl":"https://doi.org/10.1155/2022/6782595","url":null,"abstract":"Background Coagulation abnormalities are common complications of human immunodeficiency virus (HIV) infection. Highly active antiretroviral treatment (HAART) decreased the mortality of HIV but increased coagulopathies. HIV-related thrombocytopenia, prolonged prothrombin time (PT), activated partial thromboplastin time (APTT), and high D-dimer level commonly manifested in patients with HIV. Thus, this study is aimed to compare coagulation parameters of HAART-treated and HAART-naïve HIV-infected patients with HIV-seronegative controls. Methods A systematic literature search was conducted using the databases PubMed/MEDLINE, Embase, Web of Science, and Google Scholar of studies published until July 2021. The primary outcome of interest was determining the pooled mean difference of coagulation parameters between HIV-infected patients and seronegative controls. The Joana Briggs Institute (JBI) critical appraisal tool was used for quality appraisal. Statistical analyses were performed using Stata11.0 software. The statistical results were expressed as the effect measured by standardized mean difference (SMD) with their related 95% confidence interval (CI). Results A total of 7,498 participants (1,144 HAART-naïve patients and 2,270 HAART-treated HIV-infected patients and 3,584 HIV-seronegative controls) from 18 studies were included. HIV-infected patients (both on HAART and HAART-naive) exhibited significantly higher levels of PT than HIV-seronegative controls (SMD = 0.66; 95% CI: 0.53–0.80 and SMD = 1.13; 95% CI: 0.60–2.0, respectively). The value of APTT was significantly higher in patients with HIV on HAART than in seronegative controls. However, the values of PLT count, APTT, and fibrinogen level were significantly higher in seronegative controls. Besides, the level of fibrinogen was significantly higher in HAART-treated than treatment-naïve patients (SMD = 0.32; 95%CI: 0.08, 0.57). Moreover, the level of APTT and PT had no statistical difference between HAART and HAART-naïve HIV-infected patients. Conclusions This study identified that HIV-infected patients are more likely to develop coagulation abnormalities than HIV-seronegative controls. Therefore, coagulation parameters should be assessed regularly to prevent and monitor coagulation disorders in HIV-infected patients.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46331605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Girish Degavi, Boko Loka Safayi, Shiferaw Gelchu Adola, Biniyam Demisse, Takala Utura, Udessa Gemeda, Sarah Ezhil Kelna Edwin, F. Demissie
{"title":"A Retrospective Study of Incidence and Predictors on Mother-to-Child Transmission of HIV among HIV-Exposed Infants in West Guji Zone, Southern Ethiopia","authors":"Girish Degavi, Boko Loka Safayi, Shiferaw Gelchu Adola, Biniyam Demisse, Takala Utura, Udessa Gemeda, Sarah Ezhil Kelna Edwin, F. Demissie","doi":"10.1155/2022/2906490","DOIUrl":"https://doi.org/10.1155/2022/2906490","url":null,"abstract":"Background The transmission of HIV from mother to child among HIV-positive infants is estimated to be higher than 20%, despite the fact that antiretroviral treatment is available for antenatal mothers with HIV. In Ethiopia, the prevalence of HIV transmission from mother to child among infants aged one and a half years is estimated to be approximately 15.7 percent. Methods A retrospective cohort analysis using a simple random sampling technique was incorporated among 422 HIV-exposed babies and their mothers who were randomly chosen and screened using OPD (outpatient card) from March 2019 to March 2021 in the general hospitals of West Guji zone, Oromia, Ethiopia. The data were coded and entered into EpiData version 4.6.1 and exported to SPSS version 23 for cleaning and analysis. Result The study revealed that at the end of follow-up, 3.8% of the HIV-exposed infants were found to be HIV positive. Poor adherence of infant for CPT (AOR: 5.6; 95% CI: 1.010–27.24), father not enrolled to ART (AOR: 4.4; 95% CI: 1.187–15.724), age of infants at enrollment >6 weeks (AOR: 4.5; 95% CI: 1.102–16.1), mother's enrollment to PMTCT during labor and delivery or after (AOR: 6.84; 95% CI: 1.316–42.743), and mothers on the WHO clinical stage mild or advanced (AOR: 3.6; 95% CI: 1.146–16.842) was found to be the most important significant predictors of mother-to-child transmission of HIV. Conclusion Several factors included in the study were the main predictors of mother-to-child transmission of HIV. The study concluded that there are some lacunae in the prevention of MTCT of HIV but that the incidence of MTCT of HIV was significantly lower in this part of the world.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48936760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ibrahim Mujjuzi, Paul Mutegeki, Sarah Nabuwufu, Ashim Wosukira, Fazirah Namata, Patience Alayo, Sharon Bright Amanya, Richard Nyeko
{"title":"Care Burden and Coping Strategies among Caregivers of Paediatric HIV/AIDS in Northern Uganda: A Cross-Sectional Mixed-Method Study.","authors":"Ibrahim Mujjuzi, Paul Mutegeki, Sarah Nabuwufu, Ashim Wosukira, Fazirah Namata, Patience Alayo, Sharon Bright Amanya, Richard Nyeko","doi":"10.1155/2021/6660337","DOIUrl":"https://doi.org/10.1155/2021/6660337","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers provide the bulk of care to children living with HIV. This places an enormous demand and care burden on the caregivers who often struggle to cope in various ways, some of which may be maladaptive. This may adversely affect their quality of care. Very little literature exists in resource-limited contexts on the burden of care experienced by caregivers on whom children living with HIV/AIDS depend for their long-term care. We assessed care burden and coping strategies among the caregivers of paediatric HIV/AIDS patients in Lira district, northern Uganda.</p><p><strong>Methods: </strong>A mixed-method cross-sectional study was conducted among 113 caregivers of paediatric HIV patients attending the ART clinic at a tertiary healthcare facility in Lira district, northern Uganda. A consecutive sampling method was used to select participants for the quantitative study, while 15 respondents were purposively sampled for the qualitative data. Quantitative data were collected using standard interviewer-administered questionnaires, while in-depth interview guides were used to collect qualitative data. Data were entered, cleaned, and analysed using SPSS version 23. Qualitative data were analysed thematically.</p><p><strong>Results: </strong>The majority of the caregivers, 65.5% (74), experienced mild-to-moderate burden. The mean burden scores significantly differed by caregivers' age (<i>P</i>=0.017), marital status (<i>P</i>=0.017), average monthly income (<i>P</i>=0.035), and child's school attendance (<i>P</i>=0.039). Accepting social support, seeking spiritual support, and reframing were the three most commonly used strategies for coping. Marital status and occupation were, respectively, positively and negatively correlated with information-seeking as a coping strategy, while monthly income was positively correlated with psychosocial support as a strategy. Seeking community support was negatively correlated with the duration of the child's care.</p><p><strong>Conclusions: </strong>Our findings show that care burden is a common problem among the caregivers of children living with HIV in the study context.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2021 ","pages":"6660337"},"PeriodicalIF":1.7,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39440531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}