Evaluating Individual and Couple-level Risk Factors Associated with HIV Acquisition in HIV Serodiscordant Couples in Zambia: Alcohol Use, Fertility Desire, and HIV Acquisition from Outside Partners in an Open Cohort in Zambia

Download Evaluating Individual and Couple-level Risk Factors Associated with HIV Acquisition in HIV Serodiscordant Couples in Zambia: Alcohol Use, Fertility Desire, and HIV Acquisition from Outside Partners in an Open Cohort in Zambia PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 93 pages
Book Rating : 4.:/5 (17 download)

DOWNLOAD NOW!


Book Synopsis Evaluating Individual and Couple-level Risk Factors Associated with HIV Acquisition in HIV Serodiscordant Couples in Zambia: Alcohol Use, Fertility Desire, and HIV Acquisition from Outside Partners in an Open Cohort in Zambia by : Dvora Leah Davey

Download or read book Evaluating Individual and Couple-level Risk Factors Associated with HIV Acquisition in HIV Serodiscordant Couples in Zambia: Alcohol Use, Fertility Desire, and HIV Acquisition from Outside Partners in an Open Cohort in Zambia written by Dvora Leah Davey and published by . This book was released on 2016 with total page 93 pages. Available in PDF, EPUB and Kindle. Book excerpt: The high prevalence of serodiscordant relationships coupled with the high risk of transmission within those relationships across sub-Saharan African countries makes these couples a target for HIV prevention efforts. The development of appropriate and effective interventions for HIV prevention in serodiscordant couples must be based on accurate assessments of sexual risk behaviors, substance use, and fertility desires. My dissertation evaluates HIV acquisition and transmission in heterosexual HIV serodiscordant couples in Lusaka, Zambia. My first study analyzed the role that alcohol use plays on sexual behavior and HIV acquisition in Zambian serodiscordant couples. Men who reported heavy drinking was associated with increased odds of having =>1 outside sexual partnership (adjusted odds ratio [aOR]=2.02; 95% CI=1.58, 2.57), and condomless sex with main partner in the past 3-months (aOR=1.61; 95% CI=1.28, 2.04). Women's heavy drinking was associated with increased odds of having =>1 outside partner (aOR=1.89, 95% CI=1.35, 2.64), and condomless sex with main partner in past 3-months (aOR=1.54; 95% CI=1.31, 1.82). Women who reported being drunk daily or almost daily was associated with increased HIV acquisition (aHR=3.71; 95% CI=0.90, 15.25). Men who reported being drunk weekly or daily/almost daily was associated with increased HIV acquisition (aHR=1.72; 95% CI= 1.01, 2.93), and transmission (aHR=1.42; 95% CI=0.97, 2.10). My second study evaluated the incidence and predictors of HIV acquisition from an outside partner in serodiscordant couples in Zambia. Forty-five unlinked HIV infections occurred among women (1.85 per 100-couple-years [CY]) and 55 unlinked HIV infections occurred among men (1.82 per 100 CY). Risk of female unlinked infection was associated with baseline female alcohol consumption (aHR=5.44; 95% CI: 1.03, 28.73), recent genital ulcers and/or genital inflammation (aHR=6.09; 95% CI: 2.72, 13.64 and aHR=11.92; 95% CI: 5.60, 25.37, respectively). Risk of male unlinked HIV infection was associated with reporting being drunk weekly or daily/almost daily at baseline (aHR=3.52; 95% CI=1.19, 10.46), recent genital inflammation (aHR=8.52; 95% CI: 3.82, 19.03), genital ulceration (aHR=4.27; 95% CI: 2.05, 8.89), self-reporting =>1 outside partner (aHR=3.36; 95% CI: 1.53, 7.37). My third study evaluated the effect of fertility desires on HIV acquisition among HIV serodiscordant couples in Zambia. Among a sub-set of 1,029 serodiscordant couples, 311 agreed that they wanted a child in the future (30.4%), and 368 agreed they did not want a child or did not know (36.0%), and 344 couples disagreed about having a child (33.6%), of which in 212 couples (61.6% of disagreeing couples) the man wanted a child but the woman did not, and in 132 couples (38.3% of disagreeing couples) the woman wanted a child but the man did not. The adjusted risk ratio for woman's HIV acquisition was 2.06 (95% CI=1.40, 3.03) among women who wanted a child, 1.75 (95% CI=1.07, 2.87) for men who wanted a child in the next 12-months, and 2.55 (95% CI=1.32, 4.93) among couples who agreed that they wanted a child compared to couples who agreed they did not want a child. In conclusion, heavy alcohol use plays an important role in linked and unlinked HIV acquisition and transmission in serodiscordant couples. The strongest predictors of unlinked infection in serodiscordant relationships were alcohol use, genital inflammation and ulceration prior to infection. Further, women were particularly vulnerable when they or their partner wanted to have a child. These findings will help improve the implementation of HIV prevention and safer conception services among heterosexual serodiscordant couples in Southern Africa and beyond.

Individual and Couple-level Risk Factors Associated with HIV Transmission, Family Planning, and ART Initiation in an Open Cohort of Heterosexual HIV-1 Serodiscordant Couples in Rwanda

Download Individual and Couple-level Risk Factors Associated with HIV Transmission, Family Planning, and ART Initiation in an Open Cohort of Heterosexual HIV-1 Serodiscordant Couples in Rwanda PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 108 pages
Book Rating : 4.:/5 (17 download)

DOWNLOAD NOW!


Book Synopsis Individual and Couple-level Risk Factors Associated with HIV Transmission, Family Planning, and ART Initiation in an Open Cohort of Heterosexual HIV-1 Serodiscordant Couples in Rwanda by : Megan Claire Dillavou

Download or read book Individual and Couple-level Risk Factors Associated with HIV Transmission, Family Planning, and ART Initiation in an Open Cohort of Heterosexual HIV-1 Serodiscordant Couples in Rwanda written by Megan Claire Dillavou and published by . This book was released on 2016 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: Understanding the factors of heterosexual HIV-1 serodiscordant couples that lead to risky behaviors for HIV transmission are essential in controlling the HIV epidemic in sub-Saharan Africa. Predictors of HIV transmission within stable discordant couples and trends in family planning over time, as well as predictors of ART initiation provide important information for future studies and prevention and treatment program development. This dissertation evaluates these aspects of HIV-1 serodiscordant couple transmission in an ART naive 10-year observational cohort in Kigali, Rwanda. The first study evaluated the incident HIV-1 infections and the predictors of HIV-1 transmission in ART na?ve HIV-1 heterosexual serodiscordant couples. Eighty-three partner linked incident HIV-1 infections occurred in the cohort with 37 in women (IR=2.2/100 CY; 95%CI: 1.53.299) and 46 in men (IR=2.49/100 CY; 95%CI: 1.83-3.33). In the adjusted final model of linked HIV infection in females, baseline VL (aHR 2.33; 95%CI: 1.28-4.24), female genital inflammation (cHR 4.77; 95%CI: 1.72-13.21), and having unprotected sex with study partner since last visit (cHR 3.29; 95%CI: 1.27-8.51) were significant predictors. Predictors of linked incident HIV-1 infection in males included baseline VL (aHR 2.14; 95%CI: 1.50-3.07), female genital inflammation (aHR 3.91; 95%CI: 1.71-8.94), any unprotected sex with study partner since previous visit (aHR 3.56; 95%CI: 1.48-8.56), and presence of sperm on a wet prep (aHR 3.35; 95%CI: 0.99-11.36). These findings support the need to include sexual partners in the assessment of risk and target risk reduction strategies. The second study described pregnancy and analyzed predictors of women ever using hormonal contraception (HC) by HIV status. Overall pregnancy incidence rate was 12.7/100 PY (95%CI: 11.3-14.1) while in M-F+ couples it was 13.2/100 PY (95%CI: 11.3-15.3) and 12.1/100 PY (95%CI: 10.2-14.1) in M+F- couples. 34% of HIV positive women, 26% of HIV- women who did not seroconvert, and 25% of HIV- women who seroconverted had used hormonal contraception at point during the study. In adjusted analyses, being younger (aRR 0.97; 95%CI: 0.95-0.99), ability to read Kinyarwandan easily (aRR 1.28; 95%CI: 1.06-1.55), and no STI in the past year (aRR 0.80; 95%CI: 0.67-0.95) was associated with ever HC use in HIV+ women. Among HIV negative women who did not seroconvert, HC ever use was associated with younger age (aRR 0.98; 95%CI: 0.96-1.0) and not being pregnant at baseline (aRR 0.72; 95%CI: 0.55-0.94). Across HIV groups, injectable methods were the most frequently used type of hormonal contraception at last visit and during most of study follow-up. The overall low uptake of hormonal contraception and high pregnancy rates in both HIV + and HIV- women suggest the need for more effective and widely accessible safer conception methods. The third study evaluated predictors of time to ART initiation, stratified by gender of seropositive partner. Of the 1837 couples (882 M+F- / 955 M-F+), 30% had an HIV positive partner initiate ART. Of those, 39% had a seropositive male partner (M+F-) and 61% had a seropositive female partner (M-F+). Shorter time to ART initiation in M+F- couples was predicted by baseline viral load (aHR1.54; 95%CI:1.01-2.34), while both baseline viral load (aHR1.43; 95%CI:1.02-2.02) and baseline WHO stage IV (aHR 4.85; 95%CI:1.45-16.26) predicted earlier time to ART initiation in M-F+ couples. As expected, clinical values were the main predictors of time to ART initiation. In conclusion, partner and partnership characteristics play an important in risk of HIV-1 acquisition and transmission in heterosexual serodiscordant couples. Family planning and fertility desires are particularly complex and important risk factors that may change over time for serodiscordant couples. These findings can help improve the targeted HIV prevention, safer conception and family planning services, and ART treatment programs focusing on sustained viral load suppression among heterosexual serodiscordant couples in Africa.

Understanding Risk Factors for HIV-1 Infectiousness and Transmission

Download Understanding Risk Factors for HIV-1 Infectiousness and Transmission PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 119 pages
Book Rating : 4.:/5 (881 download)

DOWNLOAD NOW!


Book Synopsis Understanding Risk Factors for HIV-1 Infectiousness and Transmission by : Erin M. Kahle

Download or read book Understanding Risk Factors for HIV-1 Infectiousness and Transmission written by Erin M. Kahle and published by . This book was released on 2013 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt: The studies described in this dissertation focus on clinical and biologic factors associated with increased HIV-1 infectiousness among heterosexual HIV-1 serodiscordant couples. The specific aims include 1) evaluating whether specific characteristics of HIV-1 serodiscordant couples could be used to defined a higher-risk subgroup for targeted prevention research, 2) assessing the prevalence of unreported antiretroviral therapy (ART) in HIV-1 infected participants enrolling in an HIV-1 prevention trial, 3) determining whether HIV-1 subtype C is associated with increased HIV-1 transmission, and 4) assessing whether immune activation is associated with increased HIV-1 transmission. The identification of a composite set of predictors for HIV-1 transmission is applicable to the design of efficient prevention programs targeting high-risk subpopulations to maximize limited prevention resources. We developed a risk score for identifying a high-risk subpopulation of HIV-1 serodiscordant couples which will provide greater predictive ability in identifying HIV-1 transmission risk than individual risk predictors (i.e. viral load, unprotected sex). A well-developed and validated risk scoring tool, such as ours, is a valuable addition to HIV-1 prevention intervention research in order to reduce sample size, decrease cost of study and provide more efficient recruitment. Biologic factors, including both viral and host characteristics, may be associated with increased HIV-1 infectiousness. HIV-1 subtype, specifically subtype C, has been suggested as a factor in differential HIV-1 transmission between populations, although no epidemiologic evidence supports this conclusion. We compared HIV-1 subtype C and non-C subtypes and found no significant difference in risk of HIV-1 transmission in a multinational population in sub-Saharan Africa. In an analysis of cytokines as markers for immune activation, we found elevated IL-10 and IP-10 concentrations to be associated with increased HIV-1 transmission and acquisition, suggesting a potential biologic mechanism in both HIV-1 infected and susceptible partners. HIV-1 serodiscordant couples cohorts offer unique opportunities to assess correlates of HIV-1 infectiousness, as transmissions can be directly measured within partnerships. The application of our study findings will provide more efficient methods for identifying target populations and a better understanding of the virologic and immunologic mechanisms of HIV-1 infectiousness.

The Impact of Partnership Factors on Adherence to HIV Pre-Exposure Prophylaxis and Antiretroviral Therapy

Download The Impact of Partnership Factors on Adherence to HIV Pre-Exposure Prophylaxis and Antiretroviral Therapy PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 122 pages
Book Rating : 4.:/5 (17 download)

DOWNLOAD NOW!


Book Synopsis The Impact of Partnership Factors on Adherence to HIV Pre-Exposure Prophylaxis and Antiretroviral Therapy by : Zoe Gabriele Baker

Download or read book The Impact of Partnership Factors on Adherence to HIV Pre-Exposure Prophylaxis and Antiretroviral Therapy written by Zoe Gabriele Baker and published by . This book was released on 2018 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: Adherence to medications for HIV prevention and treatment is essential to reducing HIV transmission risk and improving health outcomes. Adherence to these medications remain insufficient in several key populations, however. Understanding how partnership types and dynamics may encourage or hinder HIV medication adherence is necessary to improving adherence rates among important sub-groups, including young men who have sex with men (YMSM), serodiscordant couples, and adolescent girls. My first paper identified the partnership and housing factors associated with adherence to oral PrEP among YMSM. PrEP adherence was relatively low in the study, declining from 46% at baseline to 39% at study conclusion. PrEP adherence was significantly associated with increasing age (OR=1.35; 95% CI: 1.14, 1.60), and race (African-Americans vs. other OR=0.37, 95% CI: 0.21, 0.66). Relationship type, length, and depth, number of partners, and partner's HIV status were not significantly associated with adherence. PrEP adherence was associated with housing insecurity, including ever being kicked out of the home (AOR=0.43; 95% CI: 0.18, 1.04), and the Housing Insecurity Index (AOR=0.64; 95% CI: 0.44, 0.93). PrEP adherence was also associated with privacy, including number of people living in the residence (AOR=0.82; 95% CI: 0.71, 0.95), sleeping in a private bedroom (AOR=2.10, 95% CI: 1.01, 4.40), and the Lack of Privacy Index (AOR=0.82; 95% CI: 0.71, 0.95). YMSM did not modify their PrEP-taking depending on relationship risk. Housing insecurity and lack of privacy may hinder PrEP adherence among YMSM. My second paper determined whether HIV viral suppression was associated with partnership status and partnership support among HIV-positive individuals and serodiscordant couples in Brazil. Viral suppression did not significantly differ between HIV-positive partnered (79% virally suppressed) and unpartnered (76% virally suppressed) individuals. Among individuals in partnerships, viral load suppression was significantly associated with having partners who attended monthly visits (AOR=2.99; 95% CI: 1.00, 8.93); among women in partnerships, viral load suppression was significantly associated with having a partner who actively reminded them to take ART (AOR=2.67; 95% CI: 1.04, 6.88). Practical measures of social support, including attending monthly visits and reminding a partner to take ART, may improve viral suppression among HIV-positive individuals in serodiscordant partnerships. My third paper assessed the product, relationship, and sex factors that affect acceptability of a vaginal ring (VR) for HIV prevention among adolescent girls aged 15 to 17 years. Product factors were most frequently mentioned as barriers to VR acceptability. Many participants reported concerns about the large size of the VR upon first impression, and some reported pain with VR insertion. Several participants reported concerns regarding cleanliness of the VR, particularly during menstruation. Relationship factors rarely appeared to act as barriers to VR acceptability; the majority of participants disclosed VR use to their sexual partners, and positive reactions from sexual partners regarding the VR were common. Emotional and/or physical discomfort surrounding VR use during sex was mentioned occasionally as a potentially barrier to VR acceptability. Relationship factors appear to be important in several populations for adherence to HIV-related medications. YMSM in high-risk sexual relationships may not modify PrEP-taking, leaving them at risk for HIV acquisition. Among serodiscordant couples, practical measures of partnership support may improve ART adherence and promote viral suppression. While adolescent girls most often reported that product-related factors inhibited VR acceptability, lack of partnership disclosure, negative partner reactions, and discomfort during sex may hinder VR acceptability among some girls.

The Association Between Sexual Behavior and Adherence to HIV Pre-exposure Prophylaxis Medication in HIV Serodiscordant Couples

Download The Association Between Sexual Behavior and Adherence to HIV Pre-exposure Prophylaxis Medication in HIV Serodiscordant Couples PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 22 pages
Book Rating : 4.:/5 (892 download)

DOWNLOAD NOW!


Book Synopsis The Association Between Sexual Behavior and Adherence to HIV Pre-exposure Prophylaxis Medication in HIV Serodiscordant Couples by : Alexander Kintu

Download or read book The Association Between Sexual Behavior and Adherence to HIV Pre-exposure Prophylaxis Medication in HIV Serodiscordant Couples written by Alexander Kintu and published by . This book was released on 2013 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt: High levels of adherence have been identified as a key factor for effective pre-exposure prophylaxis medication (PrEP). Because PrEP is a new concept in HIV prevention, there are limited data on predictors of adherence, though initial findings indicate that sexual behavior could be an influencing factor. This study examines different aspects of sexual behavior and their associations with monthly rates and patterns of adherence. We enrolled 1147 HIV-negative individuals living in long-term serodiscordant relationships at three sites in Uganda. Sexual behavior was assessed via monthly in-person interviews and adherence was measured through electronic monitoring of pill bottle openings. We used generalized estimation equations to adjust for risk factors of low adherence to PrEP medication. Fifty-three percent of participants were male, 51% were aged between 18 and 34 years, the median number of years they had lived with the HIV-positive partner was 8.5 years and 24.2% were in polygamous relationships. Participants who had sex with other partners and also had less than 100% use of condoms were more than twice as likely to have less than 80% adherence (OR=2.48, 95%CI=1.70-3.62). Per electronic monitoring, 54.7% of cohort participants had at least one 72-hour consecutive gap in adherence. Participants who had sex with other partners and were also had also reported less than 100% use of condoms had a 50% increase in odds of having a 72-hour gap in adherence (OR=1.50, 95%CI=1.19-31.91). Low overall adherence and extended gaps in adherence were more common in participants that abstained from sex and those that reported sex outside their primary partnership. Despite high monthly adherence rates, many study participants had long periods of non-adherence during which they engaged in risky sexual behavior with potential for HIV acquisition.

HIV Treatment and Prevention in KwaZulu-Natal, South Africa: Individual, Couple, and Household Effects of Antiretroviral Therapy

Download HIV Treatment and Prevention in KwaZulu-Natal, South Africa: Individual, Couple, and Household Effects of Antiretroviral Therapy PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (951 download)

DOWNLOAD NOW!


Book Synopsis HIV Treatment and Prevention in KwaZulu-Natal, South Africa: Individual, Couple, and Household Effects of Antiretroviral Therapy by : Catherine E. Oldenburg

Download or read book HIV Treatment and Prevention in KwaZulu-Natal, South Africa: Individual, Couple, and Household Effects of Antiretroviral Therapy written by Catherine E. Oldenburg and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Using the Africa Centre for Population Health's demographic and HIV surveillance program, a population-based open cohort that has been conducting annual surveillance since 2000, this dissertation evaluates the effectiveness of ART in a real-world setting at multiple levels, including for individuals, within couples, and in households. First, this dissertation analyzes the effect of ART uptake in serodiscordant couples in the risk of HIV acquisition by the uninfected partner. Second, the effectiveness of immediate eligibility for ART on household-level HIV acquisition is assessed. Finally, the effect of immediate ART eligibility and uptake on survival in HIV-infected individuals is examined using two causal modeling approaches.

The Role of Individual Or Neighborhood Factors

Download The Role of Individual Or Neighborhood Factors PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 122 pages
Book Rating : 4.:/5 (785 download)

DOWNLOAD NOW!


Book Synopsis The Role of Individual Or Neighborhood Factors by : Henry Fisher Raymond

Download or read book The Role of Individual Or Neighborhood Factors written by Henry Fisher Raymond and published by . This book was released on 2011 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: The majority of new HIV infections occur among high-risk groups such as men who have sex with men (MSM) and transfemales. Segments of these populations are also more likely to be economically disadvantaged. Economic disadvantage or low socioeconomic status has been linked to disease acquisition, morbidities and mortality. Interventions have been proposed to address these health issues through the reduction of poverty. However, this approach to intervention does not address underlying structural factors such as high HIV prevalence in impoverished neighborhoods and thus in social and sexual networks. The present analysis examines low individual socioeconomic status and /or social and sexual network factors and their relationship to HIV acquisition risk among three populations at high-risk for HIV infection. Geographic analysis examined residential patterns and neighborhood patterns of HIV prevalence in San Francisco. Data collected in San Francisco from White MSM, Black MSM and transfemales were analyzed using Poisson regression to determine the factors associated with engaging in more episodes of potentially serodiscordant unprotected receptive anal intercourse. As expected, transfemales and Black MSM were more likely to live in areas of higher HIV prevalence and lower income compared to White MSM. Interestingly the areas of higher HIV prevalence and lower income were also the areas with greater numbers of HIV prevention and care services. Black MSM and transfemales had lower socioeconomic status (SES) scores compared to White MSM. Black MSM were more likely to report serodiscordant partnerships and higher numbers of potentially serodiscordant unprotected sex acts. Decreasing SES and increasing neighborhood HIV/AIDS case density did not predict serodiscordant partnerships in any group. Increasing neighborhood HIV prevalence predicted an increase in the number of potentially serodiscordant unprotected sex acts among transfemales and Black MSM but only significantly so for transfemales. HIV prevention interventions must also consider neighborhood factors such as neighborhood HIV prevalence in addition to considering individual level behavior change.

Evaluating Risk Factors and Synergistic Effects of Two Common HIV-1 Coinfections

Download Evaluating Risk Factors and Synergistic Effects of Two Common HIV-1 Coinfections PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 85 pages
Book Rating : 4.:/5 (19 download)

DOWNLOAD NOW!


Book Synopsis Evaluating Risk Factors and Synergistic Effects of Two Common HIV-1 Coinfections by : Aaron F. Bochner

Download or read book Evaluating Risk Factors and Synergistic Effects of Two Common HIV-1 Coinfections written by Aaron F. Bochner and published by . This book was released on 2018 with total page 85 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: HIV-1 coinfections have long been suspected of catalyzing the HIV-1 epidemic by increasing HIV-1 transmission or acquisition risk. The geographical distribution of coinfections may explain why some regions have been more heavily impacted by HIV-1. The primary objective of this dissertation was to expand our understanding of two common HIV-1 coinfections that have been hypothesized to increase the risk of HIV-1 transmission and acquisition: schistosomiasis and trichomoniasis. The specific aims of this dissertation were 1) Identify correlates of T. vaginalis infection within a population of HIV-1 serodiscordant heterosexual couples, 2) Estimate the association between schistosomiasis and HIV-1 acquisition, 3) Evaluate the impact of schistosome coinfection on HIV-1 set-point genital viral load levels, and 4) Evaluate the association between schistosome coinfection and HIV-1 set-point plasma viral load levels. Methods: To conduct these analyses, we used data from four cohort studies: the Partners in Prevention HSV/HIV Transmission Study, the Couples Observational Study, the Partners PrEP Study, and the Mombasa Cohort. All analyses utilized data from multiple cohorts. For all cohorts, a large amount of individual-level information was collected, including characteristics associated with HIV-1 acquisition risk and the prevalence of coinfections, permitting thorough adjustment for possible confounding factors. Results and Conclusions: Correlates of T. vaginalis infection: In a cross-sectional analysis of 8,155 HIV-1 serodiscordant couples, the strongest predictor of a prevalent T. vaginalis infection was having an infected sexual partner. Thus, concurrent treatment of sexual partners is critical to prevent reinfection. Among women, having a circumcised male partner was associated with reduced T. vaginalis risk while bacterial vaginosis (detected via Nugent Score) was associated with an increased risk, so expanding male circumcision programs and bacterial vaginosis treatment has the potential to reduce the prevalence of trichomoniasis. Schistosomiasis and HIV-1 acquisition risk: In nested case-control analyses including 575 HIV-1 seroconverters and 1,675 controls, S. mansoni infection was not associated with an increased the risk of HIV-1 acquisition. In addition, S. haematobium infection was not associated with a statistically significant increase in HIV-1 acquisition risk, though our result suggested that women with S. haematobium could face a moderate increased risk of HIV-1 acquisition. Schistosomiasis and set point HIV-1 RNA viral loads: Schistosomiasis was not associated with increased plasma HIV-1 viral loads. Our results do not support the hypothesis that schistosome coinfection increases the rate of HIV-1 disease progression. Schistosomiasis and genital HIV-1 RNA viral loads: Schistosomiasis was not associated with increased genital HIV-1 viral loads. Our results do not support the hypothesis that schistosome coinfection increases HIV-1 transmission risk.

Substance Use, Sexual Networks, and HIV Risk Among Men who Have Sex with Men and Transgender Women in Peru

Download Substance Use, Sexual Networks, and HIV Risk Among Men who Have Sex with Men and Transgender Women in Peru PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 58 pages
Book Rating : 4.:/5 (99 download)

DOWNLOAD NOW!


Book Synopsis Substance Use, Sexual Networks, and HIV Risk Among Men who Have Sex with Men and Transgender Women in Peru by : Angela K. Ulrich

Download or read book Substance Use, Sexual Networks, and HIV Risk Among Men who Have Sex with Men and Transgender Women in Peru written by Angela K. Ulrich and published by . This book was released on 2017 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: In Peru, the HIV epidemic is concentrated among men who have sex with men (MSM) and transgender women (TGW) in whom HIV incidence rates are as high as 4.2 per 100 person-years with HIV prevalence reported to be as high as 22% in MSM and up to 30% in TGW. This dissertation seeks to add to the knowledge of the structure of sexual networks, namely the level and predictors of sexual concurrency among MSM and TGW in Peru (Aim 1), and the understanding of risk factors for HIV acquisition in MSM and TGW with high levels of substance use in Lima (Aim 2). Methods: Data are from the 2011 Peruvian Biobehavioral Surveillance survey (Aim 1) and the Sabes cohort study conducted in Lima from 2013-2016 (Aim 2). Data were collected with the computer assisted self-interview (CASI) (Aim 1 & 2); HIV testing was performed with Determine 1/2 rapid antibody tests (Aim 1 & 2), pooled nucleic acid amplification test (NAAT), and Western Blot to determine Fiebig Stage at HIV diagnosis. Statistical methods used include Poisson regression and generalized estimating equations (GEE) (Aim 1), and Pearson's Chi-square, Poisson regression estimated with GEE, and stratified Cox proportional hazards survival analysis with time-varying covariates (Aim 2). Results: Concurrency is a common practice among MSM and TGW in Peru with a 3-month cumulative prevalence of over 23%. There was evidence of negotiated safety--those with a stable partner were less likely to have condomless anal intercourse (CLAI) with a concurrent non-stable partner. In the Sabes cohort, HIV incidence was 11.7 per 100 person-years of follow-up. Those with alcohol use disorders (AUD) were significantly more likely to attend a venue that served alcohol, binge drink, and use marijuana or amyl nitrites. AUD modified the association between the time-varying behavioral factors and HIV; behavioral risk factors (binge drinking, marijuana use, sex with a casual partner, client, or one-time partner) were most strongly associated with HIV acquisition amongst those with dependent drinking patterns. Conclusion: This study suggests that AUD is linked to HIV risk in two important ways: first, through CLAI with non-stable partners and second, through amplifying the impact of other HIV risk behaviors. These studies suggest that harm reduction approaches, such as negotiated safety with concurrent partners, and treatment of AUDs to decrease alcohol intake could decrease the HIV risk associated with these behaviors.

Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples

Download Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 78 pages
Book Rating : 4.:/5 (957 download)

DOWNLOAD NOW!


Book Synopsis Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples by : Andrew Mujugira

Download or read book Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples written by Andrew Mujugira and published by . This book was released on 2016 with total page 78 pages. Available in PDF, EPUB and Kindle. Book excerpt: The studies described in this dissertation examine the relationship between use of antiretroviral therapy (ART) and biologic and behavioral factors related to HIV-1 transmission risk in stable heterosexual HIV-1 serodiscordant African couples. ART is recommended for all HIV-1 infected persons, regardless of CD4 count, to reduce HIV-1 related morbidity, mortality and risk of transmission to uninfected partners. ART is a cornerstone of combination HIV-1 prevention, and optimizing use of ART, both for treatment and prevention, is an urgent public health priority. The complementary prospective studies presented in this dissertation were secondary analyses of data from the Partners PrEP Study, a randomized clinical trial of daily oral pre-exposure prophylaxis (PrEP) to decrease HIV-1 acquisition among HIV-1 uninfected members of serodiscordant couples in Kenya and Uganda. This work includes prospective studies of: 1) correlates of failure to achieve plasma viral suppression and virologic rebound after initial suppression, 2) frequency, magnitude and correlates of seminal HIV-1 RNA shedding in men initiating ART, 3) residual HIV-1 transmission risk during the first 6 months of ART, and 4) sexual risk behavior before and after ART. Younger age was associated with delayed ART initiation, failure to achieve viral suppression, and increased risk of virologic rebound after initial suppression. Seminal HIV-1 RNA shedding was infrequent and present at low levels in HIV-1 infected African men with suppressed blood HIV-1 RNA. There were no HIV-1 transmission events on suppressive ART. We observed residual HIV-1 transmission risk during the first 6-months of ART, prior to complete viral suppression in blood and genital secretions. Importantly, substantial risk compensation did not occur following ART initiation among HIV-1 infected persons with known uninfected partners. Results from this dissertation contribute further evidence of the effectiveness of ART for HIV-1 prevention, and provide reassurance that HIV-1 transmission risk declines after starting ART. As treatment guidelines evolve from wait-and-treat to test-and-treat, scaling up access to HIV-1 testing, improving linkage and retention in care, and achieving high ART coverage and complete viral suppression at individual and population levels are essential to achieving zero new HIV-1 infections and zero AIDS-related deaths.

Alcohol Use and HIV Risk in the IPrEx Study

Download Alcohol Use and HIV Risk in the IPrEx Study PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : 25 pages
Book Rating : 4.:/5 (935 download)

DOWNLOAD NOW!


Book Synopsis Alcohol Use and HIV Risk in the IPrEx Study by : Vanessa Margaret McMahan

Download or read book Alcohol Use and HIV Risk in the IPrEx Study written by Vanessa Margaret McMahan and published by . This book was released on 2015 with total page 25 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: HIV acquisition continues to be a critical global health concern even with existing effective prevention strategies. Men who have sex with men (MSM) are disproportionately affected by the epidemic. Unhealthy alcohol consumption is prevalent in certain MSM populations and has been shown to be a risk factor for HIV infection. The objective of this study is to describe the association between unhealthy alcohol use over time and HIV acquisition in the iPrEx (Pre-exposure Prophylaxis Initiative) study, which was an HIV pre-exposure prophylaxis (PrEP) trial in MSM enrolled in 6 countries. Methods: Data for this study were obtained from the iPrEx study, which was a phase III, randomized placebo-controlled trial that evaluated the safety and efficacy of daily, oral FTC/TDF for HIV PrEP in initially HIV-uninfected MSM. Alcohol use and sex behavior data were collected quarterly throughout follow-up and HIV laboratory assays were performed monthly. Cox proportional hazards models were used to assess the association between time-varying average volume of alcohol consumed and HIV acquisition. The Cox models were sequentially adjusted in order to ensure adequate control for measured confounders. Results: The analytical sample included 2,361 participants of whom 139 became HIV infected during the study. The mean age of the sample was 27 years old, and the range of follow-up time was between 3 months and 3.3 years (median = 1.8). At baseline, the majority of the cohort reported drinking (87%), and over half reported typically drinking 1-4 drinks or 5 or more drinks (52%). There was a positive, but not statistically significant association between HIV acquisition and reporting an average of 1-4 drinks or 5 or more drinks, relative to no drinking, in all of the models. There was a significant association between sharing large bottles/pitchers of beer and HIV acquisition compared to not drinking alcohol in the model adjusting for site and treatment assignment, (adjusted hazard ratio [AHR] 2.01, 95% CI: 1.03, 3.90); however, this finding was no longer significant after further adjustment for demographic characteristics and sex behavior (AHR 1.83, 95% CI: 0.94, 3.56). Conclusions: In this diverse but select cohort of MSM, we did not observe a statistically significant association between average volume of drinking and HIV acquisition. In the model only adjusted for site and treatment assignment we did find a significant association between reporting sharing of bottles/pitchers of beer. While this association was attenuated after adjustment for additional demographic and behavioral characteristics, findings related to shared bottles/pitchers are hypothesis-generating and may warrant further investigation.

A Guide to the Clinical Care of Women with HIV

Download A Guide to the Clinical Care of Women with HIV PDF Online Free

Author :
Publisher : DIANE Publishing Inc.
ISBN 13 : 9780160726118
Total Pages : 636 pages
Book Rating : 4.7/5 (261 download)

DOWNLOAD NOW!


Book Synopsis A Guide to the Clinical Care of Women with HIV by : Jean R. Anderson

Download or read book A Guide to the Clinical Care of Women with HIV written by Jean R. Anderson and published by DIANE Publishing Inc.. This book was released on 2005 with total page 636 pages. Available in PDF, EPUB and Kindle. Book excerpt: NOTE: NO FURTHER DISCOUNT FOR THIS PRODUCT ITEM -OVERSRTOCK SALE-- Significantly reduced price. Edited by Jean R. Anderson. This guide addresses the health care needs unique to women with HIV. It targets clinicians who provide primary care to women as well as those seeking an understanding of how to take care of women with HIV/AIDS. This guide includes tables, figures, color plates, resources, references, and indices. This 2005 edition includes new chapters on international issues and nutrition. Edge indexed."

Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV

Download Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV PDF Online Free

Author :
Publisher : World Health Organization
ISBN 13 : 9241549998
Total Pages : 144 pages
Book Rating : 4.2/5 (415 download)

DOWNLOAD NOW!


Book Synopsis Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV by : World Health Organization

Download or read book Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV written by World Health Organization and published by World Health Organization. This book was released on 2017-02-20 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.

Sexually Transmitted Infections

Download Sexually Transmitted Infections PDF Online Free

Author :
Publisher :
ISBN 13 : 9780309683951
Total Pages : 750 pages
Book Rating : 4.6/5 (839 download)

DOWNLOAD NOW!


Book Synopsis Sexually Transmitted Infections by : National Academies of Sciences, Engineering, and Medicine

Download or read book Sexually Transmitted Infections written by National Academies of Sciences, Engineering, and Medicine and published by . This book was released on 2021-12-24 with total page 750 pages. Available in PDF, EPUB and Kindle. Book excerpt: One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection

Download Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection PDF Online Free

Author :
Publisher :
ISBN 13 : 9789241549684
Total Pages : 429 pages
Book Rating : 4.5/5 (496 download)

DOWNLOAD NOW!


Book Synopsis Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection by : World Health Organization

Download or read book Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection written by World Health Organization and published by . This book was released on 2016 with total page 429 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.

Preventing and Mitigating AIDS in Sub-Saharan Africa

Download Preventing and Mitigating AIDS in Sub-Saharan Africa PDF Online Free

Author :
Publisher : National Academies
ISBN 13 :
Total Pages : 36 pages
Book Rating : 4.1/5 (375 download)

DOWNLOAD NOW!


Book Synopsis Preventing and Mitigating AIDS in Sub-Saharan Africa by : National Research Council (U.S.). Panel on Data and Research Priorities for Arresting AIDS in Sub-Saharan Africa

Download or read book Preventing and Mitigating AIDS in Sub-Saharan Africa written by National Research Council (U.S.). Panel on Data and Research Priorities for Arresting AIDS in Sub-Saharan Africa and published by National Academies. This book was released on 1996-01-01 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.

An Aging World

Download An Aging World PDF Online Free

Author :
Publisher : Bureau of Census
ISBN 13 :
Total Pages : 194 pages
Book Rating : 4.:/5 (319 download)

DOWNLOAD NOW!


Book Synopsis An Aging World by : Kevin G. Kinsella

Download or read book An Aging World written by Kevin G. Kinsella and published by Bureau of Census. This book was released on 2001 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides statistical information on the worldwide population of people 65 years old or older.