scholarly journals Integration of a recent infection testing algorithm into HIV surveillance in Ireland: improving HIV knowledge to target prevention

2019 ◽  
Vol 147 ◽  
Author(s):  
E. Robinson ◽  
J. Moran ◽  
K. O'Donnell ◽  
J. Hassan ◽  
H. Tuite ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Epidemiological Data ◽  
Hiv Knowledge ◽  
Recent Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Surveillance ◽  
Infectious Disease Reporting ◽  
Prevention Interventions ◽  
Testing Algorithm

AbstractRecent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.

scholarly journals Sero-epidemiology and risk factors of syphilis in Makassar, Indonesia

2019 ◽  
Vol 11 (2) ◽  
pp. 43-49
Author(s):  
Maryam Kusumawaty ◽  
Khairuddin Djawad ◽  
Muh Nasrum Massi ◽  
Andi Muhammad Adam ◽  
Siswanto Wahab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Transmission ◽  
Treponema Pallidum ◽  
Public Health Problem ◽  
Sexual Relationships ◽  
Capital City ◽  
Major Public Health Problem ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk

Abstract Introduction. Syphilis is an infectious disease caused by Treponema pallidum spirochete and is mainly transmitted by sexual contact. Syphilis has the potential to cause serious complications and is closely related to human immunodeficiency virus (HIV) infection thus making syphilis still a major public health problem. In Indonesia, surveys of high-risk populations in 2007 and 2011 reported an increase in the prevalence of syphilis, especially in men who have sexual relationships with other men (MSM). Moreover, studies have described risk factors for HIV transmission including MSM, heterosexual contacts, Intravenous (IV) drug use, and infected partners. Objectives. To assess the epidemiological aspects and risk factors for syphilis in Makassar, as well as the correlation with a coinfection of other sexually transmitted infections. Material and Methods. This study is a multi-centre cross-sectional descriptive study with consecutive sampling. We evaluated cases for eligibility by confirming the diagnosis based on the serological result using rapid plasma reagin assay (RPR), Treponema pallidum haemagglutination (TPHA), and HIV screening kit. The cases were analyzed based on epidemiological features, risk factors and clinical findings, co-infection with other sexually transmitted infection (ST), and stadium of the disease. Results. A total of 79 serologically confirmed syphilis cases were collected between January 2017 and December 2018 in Makassar, the capital city of South Sulawesi province in Indonesia. Of the 63 male subjects (79.7%), 38 (48.1%) were homosexual/MSM, and in 41 cases of HIV-infected subjects, 25 (60.9%) of them were also MSM. Conclusion. Our study showed there was a significant correlation between syphilis and an increased risk of HIV transmission in MSM groups. The higher number of cases of syphilis and HIV co-infection among MSM can increase transmission of both infections and should be considered a major risk factor for syphilis in Makassar.

scholarly journals Feeling Under Pressure: Perspectives of the Meaning of Love and Sexual Relationships Amongst Young Men in KwaZulu-Natal Province, South Africa

2019 ◽  
Vol 13 (2) ◽  
pp. 155798831983663 ◽  
Author(s):  
Thabang Manyaapelo ◽  
Sibusiso Sifunda ◽  
Robert A.C. Ruiter ◽  
Anam Nyembezi ◽  
Bart van den Borne ◽  
...  
Keyword(s):  
South Africa ◽  
Sexual Behaviors ◽  
Romantic Relationship ◽  
Young Men ◽  
Sexual Relationships ◽  
Group Discussions ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Kwazulu Natal ◽  
Prevention Interventions

This study aimed to explore perspectives on the meaning of love and sexual relations amongst young men in KwaZulu-Natal province of South Africa. Gaining insights into these perspectives will help to understand the sexual behaviors of these young men better and to eventually develop more effective HIV prevention interventions. Focus group discussions were conducted in two study areas using a predetermined semistructured discussion guide. The findings indicate that the phenomenon of romantic relationship try-outs together with the idea of “feeling under pressure” to propose love to more than one woman seem to be accepted practices that often lead to multiple concurrent sexual partners and therefore potentially risky sexual behaviors. The fear of impregnating a woman is seen to be of a more significant concern than acquiring a sexually transmitted infection due to the stigma and embarrassment associated with pregnancy outside marriage. Given these findings, it is recommended that future studies investigate perspectives on sexuality and reproductive health in male populations in great detail prior to the development of behavioral change interventions because failure to do so may hamper well-intended but poorly targeted health interventions.

Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH©): Key stakeholders' perspectives

2019 ◽  
Vol 30 (14) ◽  
pp. 1397-1407
Author(s):  
David Lessard ◽  
Alexandre Aslan ◽  
Jérémy Zeggagh ◽  
Stéphane Morel ◽  
David Michels ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Epidemiological Data ◽  
Management Decision ◽  
Time Data ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Access To Data ◽  
Exposure Prophylaxis

The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.

Mechanisms of HIV Transmission

2017 ◽  
Author(s):  
Puja Nambiar ◽  
William R. Short
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
The United States ◽  
Antiretroviral Drugs ◽  
Oral Sex ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Mucous Membranes ◽  
Perinatal Treatment ◽  
Hiv Negative

HIV is a sexually transmitted infection. Most new HIV infections in the United States are the result of sex, but it is rare for HIV to be transmitted through oral sex. The risk of HIV transmission to a receptive partner remains higher than that to an insertive one; however, both are at risk. Anything that compromises the integrity of mucous membranes, such as sexually transmitted infections, may increase the risk of transmission. Although not 100% effective, keeping an infected partner’s viral load low reduces the risk of transmission to an HIV-negative partner. Maternal transmission is a larger concern in developing countries due to lack of access to perinatal treatment with antiretroviral drugs.

scholarly journals Employing Molecular Phylodynamic Methods to Identify and Forecast HIV Transmission Clusters in Public Health Settings: A Qualitative Study

Viruses ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 921
Author(s):  
Shannan N. Rich ◽  
Veronica L. Richards ◽  
Carla N. Mavian ◽  
William M. Switzer ◽  
Brittany Rife Magalis ◽  
...  
Keyword(s):  
Public Health ◽  
Hiv Transmission ◽  
Epidemiological Data ◽  
Growth Trajectories ◽  
Health Departments ◽  
Implementation Barriers ◽  
Molecular Surveillance ◽  
Hiv Surveillance ◽  
Health Strategy ◽  
Potential Strategy

Molecular HIV surveillance is a promising public health strategy for curbing the HIV epidemic. Clustering technologies used by health departments to date are limited in their ability to infer/forecast cluster growth trajectories. Resolution of the spatiotemporal dynamics of clusters, through phylodynamic and phylogeographic modelling, is one potential strategy to develop a forecasting tool; however, the projected utility of this approach needs assessment. Prior to incorporating novel phylodynamic-based molecular surveillance tools, we sought to identify possible issues related to their feasibility, acceptability, interpretation, and utility. Qualitative data were collected via focus groups among field experts (n = 17, 52.9% female) using semi-structured, open-ended questions. Data were coded using an iterative process, first through the development of provisional themes and subthemes, followed by independent line-by-line coding by two coders. Most participants routinely used molecular methods for HIV surveillance. All agreed that linking molecular sequences to epidemiological data is important for improving HIV surveillance. We found that, in addition to methodological challenges, a variety of implementation barriers are expected in relation to the uptake of phylodynamic methods for HIV surveillance. The participants identified several opportunities to enhance current methods, as well as increase the usability and utility of promising works-in-progress.

Estimating HIV incidence in eastern European country of Georgia: 2010–2012

2014 ◽  
Vol 25 (13) ◽  
pp. 913-920 ◽  
Author(s):  
Tengiz Tsertsvadze ◽  
Nikoloz Chkhartishvili ◽  
Natia Dvali ◽  
Marine Karchava ◽  
Otar Chokoshvili ◽  
...  
Keyword(s):  
European Country ◽  
Hiv Transmission ◽  
Eastern European Country ◽  
Eastern European ◽  
Hiv Incidence ◽  
Recent Infection ◽  
Undiagnosed Hiv ◽  
Country Of Georgia ◽  
Testing Algorithm ◽  
New Diagnosis

The knowledge of HIV incidence is essential to better understand patterns of HIV transmission. We estimated HIV incidence over 2010–2012 in the eastern European country of Georgia. Mathematical modeling using Spectrum software and assay-based recent infection testing algorithm were applied. The study included 1155 HIV patients newly diagnosed in 2010–2012 (84% of total diagnoses). Of them, 231 were determined to be recently infected on the recent infection testing algorithm. The proportion of recent cases did not differ between 2010, 2011 and 2012 (20.4% vs. 19.4% vs. 20.2%, p = 0.94). Both study methods derived comparable estimates ranging from 0.2 to 0.3%, which is up to twice as high as rates of new diagnosis reported in the same period. Despite the relatively stable HIV incidence over 2010–2012, the epidemic continues to grow because of the increasing gap between HIV-infected and diagnosed persons. Increased efforts are needed to reduce the number of people with undiagnosed HIV.

The role of sex worker clients in transmission of HIV in Cambodia

2005 ◽  
Vol 16 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Leng Bun Hor ◽  
Roger Detels ◽  
Sopheab Heng ◽  
Phalkun Mun
Keyword(s):  
Sex Workers ◽  
Hiv Transmission ◽  
Control Strategies ◽  
Transmitted Disease ◽  
Hiv Knowledge ◽  
Sex Worker ◽  
Sexually Transmitted ◽  
Hiv Test ◽  
History Of ◽  
High Level

The study investigated whether clients of sex workers are a bridge for transmission of HIV to the general population of Cambodia. We interviewed and collected blood from 468 clients attending 30 randomly selected brothels in three provinces of Cambodia. The levels of HIV knowledge and condom use, and prevalence of HIV (9.2%) were high. Almost 40% of those interviewed had sex with women other than sex workers (wives, girlfriends, etc.), but rarely used condoms. Sexually transmitted disease (STD) rates were high, but most sought treatment from pharmacies. HIV infection was correlated with a history of STD, having had an HIV test, not living with one's wife, a high level of HIV/AIDS knowledge, and condom slippage/breakage. Clients are a major bridge for HIV transmission from sex workers. Current condom promotion programmes need to target non-sex worker intercourse. More effective, acceptable STD-control strategies need to be implemented and evaluated.

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