艾滋病(英文)最新文献

{"title":"Outcome Evaluation of Early Implementation of Option B+ in Cameroon: A Prospective Cohort Observational Survey in the Northwest and Southwest Regions","authors":"P. Muffih, E. Tshimwanga, Andrew Abutu, Lem Edith Abongwa, J. Awa, P. N. Atanga, Felix Desembuin, E. Khan, Kuni Esther Bonje, Nshom Emmanuel, E. F. Chimoun, T. Welty, Gladys Tayong Fosah, Jennifer R. Lim, D. Duncan, Leah Petit, G. Tene, J. Mosoko, O. Bolu","doi":"10.4236/WJA.2018.83008","DOIUrl":"https://doi.org/10.4236/WJA.2018.83008","url":null,"abstract":"Background: Mother to child transmission (MTCT) of HIV constitutes a major source of new pediatric infections in Cameroon. Objective: The aim of this implementation research was to assess outcomes and effectiveness of providing life-long antiretroviral therapy (ART) for HIV-positive pregnant and breastfeeding women (Option B+). Methods: From October 2013 to July 2014, HIV-positive pregnant and breastfeeding women, not on antiretroviral (ARV) prophylaxis and ART, were recruited from 22 purposefully selected health facilities in the Northwest and Southwest regions for a prospective, observational cohort evaluation. Option B+ was offered to participants and outcome indicators were measured. Results: Out of 680 women eligible for this assessment, 669 (98%) were initiated on Option B+. Retention-in-care was 90% (95% CI, 87.85 - 92.61) and 79% (95% CI, 75.20 - 81.88), and loss to follow up (LTFU) was 7% (95% CI: 4.95 - 8.90) and 15% (95% CI: 12.06 - 17.56) at 6 and 12 months respectively. Maternal mortality at 12 months after ART initiation was 2% (13). As of March 2015, 538 HIV exposed infants (HEIs) were enrolled and received postpartum nevirapine prophylaxis within 72 hours of birth and 84% (454) were on cotrimoxazole at 6 to 8 weeks. By 8 weeks of age, 498 (93%) infants had HIV DNA PCR test with 486 (97.6%) negative and 12 (2.4%) positive. Conclusion: In Cameroon, successful implementation of Option B+ increased retention-in-care to 79% at one year for pregnant and breastfeeding women and reduced MTCT rate below 5% for HEIs at 8 weeks of age. Long term retention, maternal and infant mortality and final MTCT rate after cessation of breastfeeding require further evaluation.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"90-104"},"PeriodicalIF":0.0,"publicationDate":"2018-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48917082","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":"HIV Treatment Cascade Assessment of a Community-Based Test and Start Model for Key Populations in Lagos State Nigeria: Where Are the Gaps?","authors":"J. Njab, S. Adebajo, G. Eluwa, Elizabeth Shoyemi, P. Osakwe, Charles N. Eke, D. Offie","doi":"10.4236/WJA.2018.83009","DOIUrl":"https://doi.org/10.4236/WJA.2018.83009","url":null,"abstract":"Background: Community-based test and start (TAS) models have shown the potential to improve clinical outcomes for key populations because early access to treatment will have population level impact by reducing transmission through the promotion and provision of hassle-free quality HIV testing, on the spot ART initiation and unrestricted access to culturally competent health professionals. We assessed the effectiveness of a pioneer community-based test and start (TAS) model for key populations in Lagos along UNAIDS 90/90/90 cascade. Methods: Men who have sex with men (MSM), female sex workers (FSW), and persons who inject drugs (PWID), >14 years of age were recruited through peer-referral for HIV testing services (HTS) at a community-based KP-friendly clinic in Lagos between June 2015 and September 2016. The clinic provides comprehensive HIV services, including HIV treatment. Those who test positive are enrolled and provided with TAS services. Using routine service data, we deployed descriptive cross tabulations at p < 5% to determine the performance along the 90/90/90 cascade. Results: In total, 8812 KPs comprising MSM (51.6%), FSW (32.7%) and PWID (15.7%) were tested during this period. About one-half (46.4%) were young KP (15 - 25 years). The majority (76.1%) were male, single (86.1%), almost all (99%) had at least primary school level education, and about one-quarter (25.1%) were employed. Among MSM, 506 (11.1%) tested positive, 276 (54.5%) were initiated on ART, of whom 155 conducted viral load testing and 88 (56.7%) had achieved viral suppression (<1000 copies per milliliter). Among FSW, 88 (3.1%) tested positive, only 28 (31.8%) were initiated on ART, of whom 15 conducted viral load testing and 9 (60%) achieved viral suppression. Among PWID, of 15 (1.1%) who tested positive, only 2 (13%) were initiated on ART and none had conducted viral load testing. Client satisfaction index was 96.1%. Conclusion: The current community-based model showed excellent capacity to achieve the first 90 goal among target KP communities. However, linkage to care and treatment, adherence, and retention remain major challenges in achieving the second and third nineties at the community level.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"105-117"},"PeriodicalIF":0.0,"publicationDate":"2018-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42327383","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":"Seroprevalence and Risk Factors of Syphilis Infection among Antiretroviral Therapy Naive HIV Patients at the Cape Coast Teaching Hospital, Ghana","authors":"Prince Asare-Bediako, K. Dankwa, Daniel E. Azumah, S. Nuvor","doi":"10.4236/WJA.2018.83007","DOIUrl":"https://doi.org/10.4236/WJA.2018.83007","url":null,"abstract":"Diagnosis of sexually transmitted infections is very important considering the spread of HIV and the extensive use of highly active antiretroviral therapy worldwide. This will assist in planning of treatment schedule in controlling these infections. The study therefore aimed at determining the prevalence of syphilis in HIV positive antiretroviral therapy naive patients in Cape Coast and the associated risk factors involved in infection. A cross-sectional study was carried out using initial HIV rapid and confirmation tests, and then Venereal Disease Research Laboratory test with the Ultra Rapid Test Kits for syphilis. Demographic data, risky sexual behaviours capable of co-transmission of both HIV and Syphilis, were also collected through the use of questionnaires. In all, 150 HIV positive antiretroviral naive subjects were studied and 15 (10%) were positive for VDRL test, with females (6.00%) and males (4.00%), who were mainly within the age group of 20 - 39 years. A significant number of males (p = 0.019) and females (p = 0.015) participants were not smoking with a fewer number of the females (p = 0.002) having multiple sexual partners. Also a smaller number of those who were infected with the bacteria (p = 0.004) did not support the control of sexually transmitted infection (p = 0.022). The result showed that co-infection of Syphilis in HIV positive antiretroviral therapy naive patients persists in the Cape Coast Metropolis, which is an indication of prominence of STIs that require further study on a larger scale to ascertain the extent of co-infection and to formulate policy for treatment to help minimize the rate of infection.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"76-89"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42110815","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":"Invasive Infections for Endemic Fungi in Pediatrics in Guatemala","authors":"Julio Werner Juárez Lorenzana, M. L. N. Gómez, A. Palma","doi":"10.4236/WJA.2018.83006","DOIUrl":"https://doi.org/10.4236/WJA.2018.83006","url":null,"abstract":"Background: Invasive fungal infections are common opportunistic diseases in patients with AIDS, other conditions related to immunodeficiency and healthy infants. Most publications on this subject are related to industrialized countries, and in adult population, with limited data in Latin America (except for Brazil, Colombia, and Argentina), and especially in pediatric population. These patients present a variety of clinical manifestations representing a diagnostic and therapeutic challenge for the health system. Objective: The objective of the study is to describe the epidemiological and laboratory characteristics of children with invasive fungal infections in Guatemala. Methods: A review of the microbiology service database was carried out at Roosevelt Hospital in Guatemala. Positive cultures were taken from children under 15 years of age, in a period of seven years, from 2007 to 2014, with its corresponding medical history. Results: Finally, 23 isolates were documented but only 15 patients were included in the study with complete information; 10 Histoplasma capsulatum cases, 4 Cryptococcus neoformans cases and 1 Coccidioidessp case. The average age was 7 years old for Histoplasma and 9 years old for Criptococo, with an age range from 6 months to 14 years. Around 60% of the patients were older than 5 years, of which, more than two-thirds were HIV positive children without antiretroviral therapy, who presented an invasive fungal infection at the time of HIV diagnosis. These infections are endemic in Guatemala, so the distribution was mostly uniform. Around 80% of the patients had some disease related to immunodeficiency and 70% were infected with human immunodeficiency virus (HIV). The microbiological isolation was from blood, bone marrow, lymph nodes, cerebrospinal fluid and urine. The predominant laboratory findings were decrease in hematological series. The most frequent clinical syndromes were fever, adenomegaly, hepatosplenomegaly, respiratory, gastrointestinal, neurological and weight loss. Mortality rate was 53% (from them, 62% were HIV positive). From these patients, an87% did not receive antifungal treatment in time due to late diagnosis of the infection. Conclusions: These infections should be considered when treating pediatric patients from tropical regions, with nonspecific systemic symptoms and signs, lymph node involvement and hematological alterations related to the mononuclear phagocytic system, mainly if they are patients infected by HIV in an advanced stage, infants, or children with a disease that weakens the immune system. When there is a high suspicion of a fungal infection, screening for HIV is mandatory; cultures should be taken early and together with rapid diagnostic tests. An antifungal treatment should be started immediately and then modified accordingly to laboratory results.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"63-75"},"PeriodicalIF":0.0,"publicationDate":"2018-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44018164","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":"Trends of HIV Viral Load in Patients under Combined Antiretroviral Treatment in Bangui, Central African Republic","authors":"Y. T. Nyasenu, Alain Farra, S. Djorie, B. Yambiyo, A. Manirakiza, Gilles Ngaya, S. Moussa, Pulchérie Pélembi, D. Golongba, A. Béré, Rodolphe Mambely-Nzako, Marie-Joëlle Mandeng, A. Berlioz-Arthaud, P. Rubbo, J. Lombart","doi":"10.4236/wja.2018.82005","DOIUrl":"https://doi.org/10.4236/wja.2018.82005","url":null,"abstract":"Background: The success of antiretroviral therapy requires better virological monitoring. We described the virological profile of patients on combined antiretroviral therapy (cART) for HIV/AIDS in Bangui, Central African Republic (CAR). Methods: In this prospective cohort study of patients who had been on combined antiretroviral therapy treatment (cART) for at least 12 months in Bangui, only one HIV plasma viral load per patient was realized at the Institut Pasteur of Bangui, between April 4th and November 28th, 2017. Sociodemographic and biological data were collected. Blood samples were taken for viral load. The biocentric generic human immunodeficiency virus (HIV) load test was used to quantify a ribonucleic acid (RNA) HIV-1. Data were analyzed with Stata software version 14. Chi-squared test was used to analyse viral load according to sex and age. The level of significance was set at P ≤ 0.05. Results: A total of 3569 patients were recruited, with a mean age of 40 years (median, 42 years; range, 1 - 84), patients aged 40 - 49 predominating (34.2%). The sex ratio was 0.4. No virus was detectable in plasma from 49.2% of patients, while 42.4% had virological failure (viral load, ≥1000 copies/mL) according to WHO criteria. The risk for virological failure decreased with age (P = 0.001) and was higher among females than males (P = 0.001). Conclusions: The rate of virological failure among patients on cART is very high in the CAR, despite the availability of and access to monitoring of HIV plasma viral load in Bangui. Therefore, adherence to treatment should be evaluated and reinforced in Bangui, CAR.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"8 1","pages":"53-62"},"PeriodicalIF":0.0,"publicationDate":"2018-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41383110","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":"Emerging HIV Epidemic in the North-Eastern State of Assam, India: An Exploratory Study Using Mixed-Methods Approach","authors":"Chiranjeev Bhattacharjya, G. Pathak, T. Mahanta, Y. M. Singh, R. Deka, Mitali Sen, A. Deb","doi":"10.4236/WJA.2018.81003","DOIUrl":"https://doi.org/10.4236/WJA.2018.81003","url":null,"abstract":"Background: The national HIV scenario in India has improved impressively during past two decades. Contrastingly, the State-level HIV sentinel surveil-lance and routine programme data from various testing facilities indicated an increasing HIV prevalence among antenatal clinic attendees and female sex workers (FSWs) in three districts of Assam. Objectives: 1) To explore the reasons behind increasing adult HIV prevalence and 2) To understand the role of FSW and Migrants/long distance truckers as drivers of the HIV epi-demic in these districts. Methodology: Three sources of data were utilized in this concurrent mixed methods study—1) existing programme data for past three years; 2) questionnaire-based data for a case-control study, where dur-ing past six months at designated testing facilities HIV(+) married women were “cases” and age-matched HIV(?) women from the same district were “controls”. Spouses of these women were also interviewed separately; and 3) a qualitative study, where focus group discussions were conducted among FSWs, outgoing male migrant labourers and long-distance truckers. Results: The study revealed high levels of unsafe sexual practices among the FSWs. Sometimes in poverty-struck areas, women, not identifying themselves as sex workers, sold sex on a part-time basis to earn extra money for financial sup-port and often remained invisible to the programme. The clients of the sex workers, male migrants and truckers also revealed various risk behaviours for contracting and transmitting HIV infection. Conclusion: Population and context specific programme strategies are required to halt the rising trend of HIV infection in the general population in Assam.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"21-36"},"PeriodicalIF":0.0,"publicationDate":"2018-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41947524","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":"Neurodevelopment in HIV Infected Children at Roosevelt’s Hospital Infectious Diseases Clinic, in Guatemala","authors":"A. Palma, J. Juárez","doi":"10.4236/WJA.2018.81001","DOIUrl":"https://doi.org/10.4236/WJA.2018.81001","url":null,"abstract":"Background: The infection with HIV has been related to neurological disorders that are very frequent, since this virus crosses the blood-brain barrier and enters the CNS, thus affecting its neurological development. About 50% - 90% of infected patients, with an average age of onset from 19 months to 3 years old may present some types of neurological alteration during the course of the disease. Currently in Guatemala, there are no researches that show changes in the neurodevelopment of patients infected with HIV. Objective: To identify neurodevelopment of pediatric patients infected with the HIV, taking into consideration clinical and epidemiological characteristics. Materials and Methods: Fifty-six patients, who were under 8 years and 6 months of age, that met the inclusion criteria (confirmed diagnosis of HIV), were evaluated through neurodevelopment test (Bayley Test and McCarthy’s Scale) during the months of May and June of 2016. Results: Within the neurodevelopment evaluation, it was discovered that between 36% and 54% of evaluated patients that were 3 years and 6 months to 8 years and 6 months old, presented alterations in more than one area of neurodevelopment, correlating it with studies performed in other countries with 30% - 70% of neurological affection. Conclusions-All infected patients have alterations in more than one area of neurodevelopment. The most affected areas of neurodevelopment were the verbal, numerical and cognitive areas.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2018-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43590000","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":"Biological Profile of HIV-Positive Patients in Bangui, Central African Republic, in 2017","authors":"Y. T. Nyasenu, Alain Farra, B. Yambiyo, A. Manirakiza, Fernand Didier Padou, F. Yapou, Pulchérie Pélembi, Rodolphe Mambely-Nzako, Marie-Joëlle Mandeng, A. Berlioz-Arthaud, P. Rubbo, J. Lombart","doi":"10.4236/WJA.2018.81002","DOIUrl":"https://doi.org/10.4236/WJA.2018.81002","url":null,"abstract":"Background: The biological profile of HIV-positive patients is essential for diagnosing treatment failure and the prognosis of infection. We determined the virological and immunological profiles and biological anomalies of HIV-positive people on antiretroviral therapy (ART) in Bangui, Central Afri-can Republic. Methods: We conducted an analytical, descriptive study be-tween 4 April and 30 September 2017 of all patients who had received ART for more than 12 months and who attended the Medical Analysis Laboratory of the Institut Pasteur in Bangui for a complete biological work-up, including viral load. A blood sample was taken for quantification of RNA HIV-1, CD4 lymphocytes and blood count in two tubes containing ethylenediamine te-traacetic acid, and another sample was taken in a dry tube for measurement of creatinine and transaminases. Results: The total population comprised 1748 patients, with a mean age of 38.7 years (±14.3; median, 41 years; range, 2 - 79 years); 33.3% of patients were between 40 and 49 years old. Females predo-minated (71.3%), for a sex ratio of 0.4. Immunological failure was observed in 20.2% of patients (CD4 < 200 cells/μL), and 44.5% of patients had a load of RNA HIV-1 ≥ 1000 copies/mL. The main haematological anomalies were anaemia (28.0%), leukopenia (26.7%), neutropenia (42.1%) and lymphopenia (27.2%). Blood creatinine was abnormal in 61.0% of patients, ALAT in 57.0% and ASAT in 66.9%. Conclusion: The abnormalities observed in this study concerned the haematopoietic system, the liver and the kidneys. As other or-gans and systems may be affected, periodic multidisciplinary biological and clinical follow-up is necessary for people living with HIV in order to improve their management.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"11-20"},"PeriodicalIF":0.0,"publicationDate":"2018-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49505846","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":"An Assessment of Quality Assurance in HIV and AIDS-Related Services in Chivuna Rural Health Facility of Southern Zambia","authors":"H. Ntalasha, S. Simona, F. Moyo, J. Miti, Ireen Kabembo, Eliphas Machacha, M. Libati, Emily Ng’andu, Aurick Mubita","doi":"10.4236/wja.2018.81004","DOIUrl":"https://doi.org/10.4236/wja.2018.81004","url":null,"abstract":"With many countries experiencing high prevalence rates of HIV scaling up ART, it is vital to assess quality assurance in health facilities accredited to pro-vide these HIV and AIDS-related services. Reviewed literature indicates that there are limited studies in Zambia on the capacity of accredited health care facilities to provide effective HIV/AIDS related services. Using data from a large ethnographic qualitative study in a resource poor rural setting in Zam-bia, this paper assesses quality assurance in health facilities to providing HIV/AIDS services in a remote rural setting. Findings show that although HIV and AIDS related services were available at the remote rural health facil-ity of Chivuna, the services provided did not meet the WHO minimum guide-lines/standards on the provision of such services. Therefore, there is need for such facilities to be adequately equipped in all the departments of ART deli-very so as to ensure effective delivery of these services and universal access.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"08 1","pages":"37-52"},"PeriodicalIF":0.0,"publicationDate":"2018-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48349764","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":"Receptive Anal Intercourse and HIV Infection","authors":"Gilbert R. Lavoie, J. Fisher","doi":"10.4236/WJA.2017.74023","DOIUrl":"https://doi.org/10.4236/WJA.2017.74023","url":null,"abstract":"Objective: Inform the public that receptive anal intercourse (RAI) is a key transmission route of the human immunodeficiency virus (HIV) epidemic in the United States. Method: The role of receptive anal intercourse (RAI) in this epidemic will be examined using the following approach: 1) Risk comparison of HIV transmission via RAI to the other major routes of transmission. 2) HIV transmission risks of RAI using some of the present risk reduction techniques. 3) HIV infection via anal intercourse among male youth. 4) HIV infection via anal intercourse among women. Results: Of the major transmission routes of HIV, receptive anal intercourse has the highest transmission risk for acquiring HIV infection. RAI is 2 times the risk of needle-sharing during injection drug use (IDU) and 17 times the risk of receptive vaginal intercourse. The estimated per act probability of acquiring HIV from an infected source by the exposure route of RAI is high in most circumstances: 1) Condoms alone only partially reduce the high risk of RAI. With the addition of pre-exposure prophylaxis (PrEP), the risk is further reduced. 2) When one or both partners are infected with a sexually transmitted disease (STD), even with condom use, the risks are very high. With the addition of PrEP the risks are reduced, but RAI still carries significant risks. 3) With exposure to acute HIV (high viral load) the risks of RAI are very high and remain significant even with condom use and PrEP. Anal intercourse often begins in adolescence; both genders are at risk. Conclusion: Public knowledge of the high transmission risks of receptive anal intercourse may likely result in a downward trend of new HIV infections and contribute to ending the epidemic.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"07 1","pages":"269-278"},"PeriodicalIF":0.0,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43945244","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}