Prevention Program for HIV-Positive Youths Reduces Risks of Further HIV Transmission

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

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A Qualitative Study Exploring Harmful Cultural Practices and HIV Stigma in North Central Nigeria

Asia Proceedings of Social Sciences ◽

10.31580/apss.v6i1.1200 ◽

2020 ◽

Vol 6 (1) ◽

pp. 5-11

Author(s):

Bala Augustine Nalah ◽

Azlinda Azman ◽

Paramjit Singh Jamir Singh

Keyword(s):

Hiv Infection ◽

Hiv Transmission ◽

Cultural Practices ◽

Qualitative Interviews ◽

Well Being ◽

Cultural Practice ◽

Hiv Stigma ◽

Hiv Positive ◽

North Central ◽

Harmful Cultural Practices

Harmful cultural practices have psychosocial implications on stigmatization and vulnerability to HIV infection among HIV positive living in North Central Nigeria. To understand this, we conducted qualitative interviews with purposively selected 20 diagnosed HIV positive to explore how culture influences stigmatization and HIV transmission. Data was collected using audio-recorder, transcribed, and analyzed through thematic analysis using ATLAS.ti8 software to code and analyze interview transcripts. The coded data were presented using thematic network analysis to visualize the theme, sub-themes, and quotations in a model. The findings reveal that lack of education was a significant determinant for the continual practice of harmful cultural rites, thereby increasing the risk of HIV infection and stigmatization. Hence, six cultural facilitators have been identified to include female genital mutilation, lack of education, tribal marks and scarification, postpartum sexual abstinence during breastfeeding, sexual intercourse during menstruation, and gender inequality, polygamy, and inheritance law. We conclude that educational teachings and advocacy campaigns be organized in rural schools and public places on the implications of harmful cultural practice to health and psychological well-being. We recommend that the social workers and behavioral scientists should collaborate with other agencies to employ a behavioral-based intervention in eliminating cultural practices and HIV stigma.

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Correlates of HIV-Positive Fathers’ Involvement in Prevention of Motherto- child Transmission Programs in Northern Nigeria

Current HIV Research ◽

10.2174/1570162x18666200810133347 ◽

2020 ◽

Vol 18 (6) ◽

pp. 443-457

Author(s):

Zubairu Iliyasu ◽

Hadiza S. Galadanci ◽

Bashir Muhammad ◽

Fatima Z. Yadudu ◽

Aminatu A. Kwaku ◽

...

Keyword(s):

Condom Use ◽

Hiv Transmission ◽

Male Partner ◽

Tertiary Hospital ◽

Consistent Condom ◽

Hiv Positive ◽

Northern Nigeria ◽

Male Partners ◽

Logistic Regression Models ◽

Paternal Education

Background: The involvement of men in the prevention of mother-to-child HIV transmission (PMTCT) programs could accelerate the elimination of vertical transmission. Yet, little research has focused on HIV-positive male partners. This study determined predictors of male partners’ PMTCT knowledge and involvement in a tertiary hospital in northern Nigeria. Methods: A clinic-based sample of 401 HIV-positive male partners of women who delivered within 12 months prior were interviewed using structured questionnaires. PMTCT knowledge and involvement scores were computed. Adjusted odd ratios (AOR) for predictors were derived from multivariate logistic regression models. Results: The proportion of respondents with adequate PMTCT knowledge was 40.9%. Less than half (43.6%) of the respondents participated in PMTCT, with median involvement score of 2.00 (interquartile range, IQR = 0, 5.0). One quarter of respondents (25.7%, n =103) reported >1 sex partners, 10.5% consistently used condoms, and 20.7% had disclosed to all partners. Father’s involvement in PMTCT was predicted by paternal education (AOR = 0.30; 95% Confidence Interval (CI): 0.12-0.77, no formal vs. post-secondary), HIV-positive child (AOR = 3.85; 95%CI: 1.41-10.54, yes vs. no), treatment duration (AOR = 4.17; 95%CI: 1.67-10.41, ≤1 vs. ≥10 years), disclosure to partner(s) (AOR = 1.21; 95%CI: 1.15-3.52, ‘disclosed to all’ vs. ‘not disclosed’), condom use (AOR = 5.81; 95%CI: 3.07-11.0, always vs. never), and PMTCT knowledge (AOR = 0.62; 95%CI: 0.31-0.92, inadequate versus adequate). Conclusion: The involvement of fathers in HIV PMTCT programs was low and predicted by paternal education, HIVpositive child, duration of antiretroviral treatment, disclosure to partner, consistent condom use, and level of PMTCT knowledge. Our findings will inform the development of policies to increase male partner involvement in PMTCT in Nigeria.

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Genital abnormalities, hormonal contraception, and HIV transmission risk in Rwandan serodifferent couples

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab071 ◽

2021 ◽

Author(s):

Kristin M Wall ◽

Etienne Karita ◽

Julien Nyombayire ◽

Rosine Ingabire ◽

Jeannine Mukamuyango ◽

...

Keyword(s):

Hiv Transmission ◽

Hormonal Contraception ◽

Male Partner ◽

Female Partner ◽

Transmission Risk ◽

Hiv Positive ◽

Genital Ulceration ◽

Factors Associated ◽

Contraception Use ◽

Hiv Acquisition

Abstract Background We explored the role of genital abnormalities and hormonal contraception in HIV transmission among heterosexual serodifferent couples in Rwanda. Methods From 2002-2011, non-antiretroviral treatment using HIV serodifferent couples were followed and sociodemographic and clinical data were collected, family planning provided, and HIV-negative partners retested. Couples were assessed for genital ulcers; non-ulcerative genital sexually transmitted infection (STI) including gonorrhea, chlamydia, and trichomoniasis; and non-STI vaginal infections including bacterial vaginosis and candida. Multivariable models evaluated associations between covariates and HIV transmission genetically linked to the index partner. Results Among 877 couples where the man was HIV-positive, 37 linked transmissions occurred. Factors associated with women’s HIV acquisition included female partner genital ulceration (adjusted hazard ratio [aHR]=14.1) and male partner non-ulcerative STI (aHR=8.6). Among 955 couples where the woman was HIV-positive, 46 linked transmissions occurred. Factors associated with men’s HIV acquisition included female partner non-ulcerative STI (aHR=4.4), non-STI vaginal dysbiosis (aHR=7.1), and male partner genital ulceration (aHR=2.6). Hormonal contraception use was not associated with HIV transmission or acquisition. Conclusions Our findings underscore the need for integrating HIV services with care for genital abnormalities. Barriers (e.g., cost for training, demand creation, advocacy, client education; provider time; clinic space) to joint HIV/STI testing need to be considered and addressed.

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Limitations in knowledge of HIV transmission among HIV-positive patients accessing case management services in a resource-poor setting

AIDS Care ◽

10.1080/09540120500373844 ◽

2006 ◽

Vol 18 (7) ◽

pp. 764-771 ◽

Cited By ~ 13

Author(s):

M. C. Smith Fawzi ◽

P. Jagannathan ◽

J. Cabral ◽

R. Banares ◽

J. Salazar ◽

...

Keyword(s):

Case Management ◽

Hiv Transmission ◽

Resource Poor Setting ◽

Hiv Positive ◽

Resource Poor ◽

Management Services

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Understanding the Impact of a Community-led HIV Prevention Program in South Africa: Context, Conceptual Framework and Methodology

Australian Journal of Primary Health ◽

10.1071/py99046 ◽

1999 ◽

Vol 5 (4) ◽

pp. 9 ◽

Cited By ~ 5

Author(s):

Catherine Campbell ◽

Brian Williams

Keyword(s):

Hiv Prevention ◽

Prevention Program ◽

Hiv Transmission ◽

Evaluation Research ◽

Evaluation Study ◽

Social Contexts ◽

Outcome Evaluation ◽

Evaluation Methodology ◽

Sexually Transmitted ◽

The Impact

In this paper we provide an account of our multi-dimensional evaluation of a community led HIV-prevention program in the southern African mining community of Carletonville. The Mothusimpilo Project has three pillars: peer education and condom distribution, syndromic management of sexually transmitted diseases (STDs), and stakeholder mobilisation. Substantial efforts are being made to evaluate the impact of the intervention and in this paper we outline the theoretical rationale, research design and some preliminary results of the evaluation. The first section provides the setting for the evaluation work, viz an intervention which seeks to contextualise traditional biomedical and behavioural approaches to HIV-transmission within their broader community and social contexts. In the second section we outline the theoretical assumptions underlying the evaluation (which has both 'outcome evaluation' and 'process evaluation' components). In particular, we discuss the way in which the concepts of identity, empowerment and social capital are used to understand the processes involved in health-enhancing behaviour change. In the third section we describe our multi-disciplinary evaluation methodology and present some preliminary findings from our on-going evaluation study. One important goal of our evaluation research is to demonstrate the extent to which community level factors serve to assist or hinder the project in achieving its goals. In this way we hope to contribute to understandings of the role of community participation in influencing the outcomes of community-based health promotional projects.

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The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11967 ◽

2020 ◽

Vol 14 (11.1) ◽

pp. 122S-127S

Author(s):

Maryana Sluzhynska ◽

Olga Denisiuk ◽

Ruzanna Grigoryan ◽

Yulia Sereda ◽

Gennadiy Slabkiy ◽

...

Keyword(s):

Urban Areas ◽

Hiv Transmission ◽

Cross Sectional Study ◽

Medical Doctor ◽

Hiv Care ◽

Hiv Positive ◽

Cross Sectional ◽

Aids Epidemic ◽

Mode Of Transmission ◽

Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

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Evidence-Based Approaches to HIV-Positive Sexual Minority Men’s Sexual Health

Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities ◽

10.1093/med-psych/9780190669300.003.0015 ◽

2019 ◽

pp. 339-358

Author(s):

Audrey Harkness ◽

Steven A. Safren

Keyword(s):

Sexual Health ◽

Sexual Minority ◽

Hiv Transmission ◽

Future Research ◽

Hiv Positive ◽

Evidence Based ◽

Viral Load Suppression ◽

Sexual Minority Men ◽

Minority Men ◽

State Of Research

This chapter reviews the current state of research and theory regarding evidence-based sexual health interventions for HIV-positive sexual minority men. Among HIV-positive sexual minority men, sexual health promotion includes reducing sexual behavior that could lead to HIV transmission, increasing adherence to antiretroviral treatment (ART) medication to attain viral load suppression, and addressing psychosocial and contextual factors that impact both of these health behaviors. The chapter reviews evidence-based behavioral approaches to promote sexual minority men’s sexual health, including those focused on increasing condom use, reducing sexual risk, and improving communication about HIV status. It also discusses interventions to improve ART adherence, which promote HIV-positive sexual minority men’s personal health and serve as a secondary prevention intervention via reducing transmissibility. The chapter concludes with an illustration of an evidence-based intervention with an HIV-positive client. Overarching clinical implications and areas for future research regarding HIV-positive sexual minority men’s sexual health are also discussed.

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Modelling the epidemiologic impact of achieving UNAIDS fast-track 90-90-90 and 95-95-95 targets in South Africa

Epidemiology and Infection ◽

10.1017/s0950268818003497 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 5

Author(s):

N. N. Abuelezam ◽

A. W. McCormick ◽

E. D. Surface ◽

T. Fussell ◽

K. A. Freedberg ◽

...

Keyword(s):

South Africa ◽

Human Immunodeficiency Virus ◽

Fast Track ◽

Viral Suppression ◽

Hiv Transmission ◽

Hiv Positive ◽

Agent Based ◽

Percentage Points ◽

Immunodeficiency Virus ◽

The Continuum

AbstractUNAIDS established fast-track targets of 73% and 86% viral suppression among human immunodeficiency virus (HIV)-positive individuals by 2020 and 2030, respectively. The epidemiologic impact of achieving these goals is unknown. The HIV-Calibrated Dynamic Model, a calibrated agent-based model of HIV transmission, is used to examine scenarios of incremental improvements to the testing and antiretroviral therapy (ART) continuum in South Africa in 2015. The speed of intervention availability is explored, comparing policies for their predicted effects on incidence, prevalence and achievement of fast-track targets in 2020 and 2030. Moderate (30%) improvements in the continuum will not achieve 2020 or 2030 targets and have modest impacts on incidence and prevalence. Improving the continuum by 80% and increasing availability reduces incidence from 2.54 to 0.80 per 100 person-years (−1.73, interquartile range (IQR): −1.42, −2.13) and prevalence from 26.0 to 24.6% (−1.4 percentage points, IQR: −0.88, −1.92) from 2015 to 2030 and achieves fast track targets in 2020 and 2030. Achieving 90-90-90 in South Africa is possible with large improvements to the testing and treatment continuum. The epidemiologic impact of these improvements depends on the balance between survival and transmission benefits of ART with the potential for incidence to remain high.

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