Anale intraepitheliale Neoplasien

2011 ◽  
Vol 02 (02) ◽  
pp. 55-59
Author(s):  
N. H. Brockmeyer ◽  
A. Potthoff ◽  
D. Georgas ◽  
A. Skaletz-Rorowski ◽  
U. Wieland ◽  
...  

ZusammenfassungInfektionen mit humanen Papillomviren (HPV) sind häufig bei sexuell aktiven Menschen, in der Mehrzahl der Fälle handelt es sich jedoch um transiente HPV-Infektionen. Bei Immunsuppression, zum Beispiel im Rahmen einer HIV-Infektion, kommt es regelmäßig zu persistierenden Infektionen mit HPV und konsekutiv zu einem deutlich erhöhten Risiko für die Entwicklung von analen intraepithelialen Neoplasien. Besonders davon betroffen sind HIV-positive Männer, die Sex mit Männern (MSM) haben. Hochgradige Dysplasien bei HIV-positiven MSM können innerhalb kurzer Zeit in invasive Analkarzinome übergehen. Wie beim Zervixkarzinom besteht auch beim Analkarzinom eine kausale Assoziation zu HPV-Infektionen, insbesondere mit Hochrisikotypen wie HPV16 und HPV18. Von Experten werden für das Analkarzinom Vorsorgeuntersuchungen mittels Analzytologie in Analogie zum Pap-Screening der Frau vorgeschlagen. Bei pathologischen Befunden in der Analzytologie sollte eine hochauflösenden Anoskopie, und bei klinisch vorhandenen Läsionen sollten therapeutische Maßnahmen erfolgen. Die verschiedenen Behandlungsverfahren bei AIN können in ablative (z.B. Elektrokauterisation, Lasertherapie, Infrarot-Koagulation, chirurgische Exzision) und topische (z.B. Imiquimod, Trichloressigsäure, 5-Fluorouracil) Therapien unterteilt werden, bis dato existieren jedoch nur wenige kontrollierte Studien. Analkarzinome werden in Analrandkarzinome und Analkanalkarzinome unterteilt. Diese Einteilung ist wichtig, da hieraus verschiedene Therapieansätze resultieren. Analrandkarzinome früher Stadien werden wie Plattenepithelkarzinome der Haut primär chirurgisch exzidiert, während Analkanalkarzinome mit kombinierter Radiochemotherapie behandelt werden. Aufgrund der in den vergangenen Jahren kontinuierlich zunehmenden Inzidenzen und Prävalenzen sollten im Bereich HIV/AIDS tätige Ärzte alle HIV-infizierten MSM regelmäßig auf das Vorliegen von analen Dysplasien und Analkarzinomen untersuchen.

2015 ◽  
Vol 30 (5) ◽  
pp. 423-430 ◽  
Author(s):  
Deepti Mittal ◽  
G. A. Babitha ◽  
Shobha Prakash ◽  
Naveen Kumar ◽  
G. M. Prashant

2009 ◽  
Vol 13 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Elizabeth Nafula Kuria

AbstractObjectiveTo establish the food consumption, dietary habits and nutritional status of people living with HIV/AIDS (PLWHA) and adults whose HIV status is not established.DesignCross-sectional descriptive survey.SettingThika and Bungoma Districts, Kenya.SubjectsA random sample of 439 adults; 174 adults living with HIV/AIDS and 265 adults whose HIV/AIDS status was not established in Thika and Bungoma Districts.ResultsMajority of PLWHA consume foods that are low in nutrients to build up the immune system and help maintain adequate weight, and there is little variety in the foods they consume. More adults who are HIV-positive are undernourished than those whose status is not established. Of the HIV-positive adults, those with a BMI of ≤18·5 kg/m2 were 23·6 % (Thika 20·0 % and Bungoma 25·7 %) while of the adults whose status is not established those with BMI ≤ 18·5 kg/m2 were 13·9 % (Thika 9·3 % and Bungoma 16·7 %).ConclusionsAdults who are HIV-positive are more likely to be undernourished than those whose status is not established, as there is a significant difference (P = 0·000) between the nutritional status (BMI) of PLWHA and those whose HIV/AIDS status is not established. PLWHA consume foods that are low in nutrients to promote their nutritional well-being and health.


Author(s):  
Chandrashekhara Chandrashekhara ◽  
Sandeepkumar O

Children are innocent victims of HIV infection through vertical transmission. Children who are HIV positive, either through mother-to-child transmission or following sexual abuse, are often not told what could happen to them, and they will certainly be frightened when they experience symptoms.


Author(s):  
Md Tanvir Hasan ◽  
Samir Ranjan Nath ◽  
Nabilah S Khan ◽  
Owasim Akram ◽  
Tony Michael Gomes
Keyword(s):  

2013 ◽  
Vol 22 (1) ◽  
pp. 141-148 ◽  
Author(s):  
Fabiana de Souza Orlandi ◽  
Neide de Souza Praça

This descriptive cross-sectional study had the objective to evaluate the level of hope in women aged 50 or older suffering from HIV/AIDS, utilizing the Herth Hope Scale. The study involved 200 HIV- positive women, within the age bracket of interest, enrolled in three STI/AIDS specialized healthcare services in the city of São Paulo. The rules of the 196/96 Resolution were met and the study was approved by the Research and Ethics Committee. Data were collected in 2010 using two instruments: subjects' characterization and the Herth Hope Scale. Results demonstrated an average score of 36.75 (±4.52) on the Herth Hope Scale, with an interval of 12 to 48. This score is below the score obtained with the same scale for various pathologies, indicating a reduced perception of hope by the sample. Nurses should provide interventions to improve hope for these people, establishing realistic goals and strengthening social support.


2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Riska Regia Catur Putri ◽  
Zulvayanti Zulvayanti ◽  
Panji Fortuna Hadisoemarto ◽  
Deni K. Sunjaya ◽  
Elsa Pudji Setiawati ◽  
...  

Abstract    More than 90% of cases of Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrom (AIDS) in children, occur due to transmission from mother to child. Prevention of unwanted pregnancies with contraception in HIV positive women is important strategy to reduce the rate of mother to child HIV/AIDS transmission. The practice of contraceptive use in HIV positive women is strongly influenced by individual beliefs regarding the benefits and effectiveness of contraception for the prevention of mother to child HIV/AIDS transmission. This study aims to determine the relationship of perceptions based on the construct of the Health Belief Model (HBM) wich consists of perceived susceptibility, perceived severity, perceived benefit, perceived barrier, self efficacy, and cues to action and based on pluralistic ignorance on the practice of contraceptive use among woman of childbearing age recipients of antiretroviral in Bandung. The design of this study was quantitative non-experimental with survey methods. Data were collected for one month, using questionnaire from 188 women of childbearing age  receiving  antiretroviral drughs taken by consecutive sampling (non-probability) technique. Data were analyzed by logistic regression. The results revealed perceived susceptibility is an HBM construct that affects contraceptive use (Adjusted Odds Ratio (AOR):4.5). While knowledge (AOR:7.3) and age (AOR:0.801), emerged as other factors that influence contraceptive use among WUS recipients of antiretroviral in Bandung. The HBM is used to predict contraceptive behavior in women. HIV positive women who believe themselves to be at high risk of infecting HIV/AIDS from mother to child will tend to use contraception, besides that knowledge is the basis for HIV positive women taking action to use contraception. Abstrak Lebih dari 90% kasus Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrom (AIDS) pada anak, terjadi akibat penularan dari ibu ke anak. Pencegahan kehamilan yang tidak direncanakan dengan kontrasepsi pada wanita HIV positif merupakan strategi penting untuk menurunkan angka penularan HIV/AIDS dari ibu ke anak. Praktik penggunaan kontrasepsi oleh wanita HIV positif sangat dipengaruhi oleh keyakinan individu terkait manfaat dan efektivitas kontrasepsi terhadap pencegahan penularan HIV/AIDS dari ibu ke anak. Penelitian ini bertujuan untuk mengetahui hubungan persepsi berdasarkan konstruk Health Belief Model (HBM) yang terdiri dari perceived susceptibility, perceived severity, perceived benefit, perceived barrier, self efficacy, dan cues to action serta berdasarkan ketidaktahuan majemuk terhadap praktik penggunaan kontrasepsi pada Wanita Usia Subur (WUS) penerima obat antiretroviral di Kota Bandung. Desain penelitian ini adalah kuantitatif non-experimental dengan metode survei. Data dikumpulkan selama satu bulan, menggunakan kuesioner dari 188 WUS penerima obat antiretroviral yang diambil dengan teknik consecutive sampling (non-probability). Data dianalisis dengan regresi logistik. Hasil penelitian mengungkapkan perceived susceptibility adalah konstruk HBM yang berpengaruh terhadap penggunaan kontrasepsi (Adjusted Odds Ratio (AOR):4,5). Sementara pengetahuan (AOR:7,3) dan usia (AOR:0,801) muncul sebagai faktor-faktor lain yang berpengaruh terhadap praktik penggunaan kontrasepsi pada WUS penerima obat antiretroviral di Kota Bandung. HBM digunakan untuk memprediksi perilaku kontrasepsi pada wanita. Wanita HIV positif yang meyakini dirinya berisiko tinggi dapat menularkan HIV/AIDS ke anak, akan cenderung menggunakan kontrasepsi, disamping itu pengetahuan menjadi dasar bagi wanita HIV positif dalam mengambil tindakan untuk menggunakan kontrasepsi.


2016 ◽  
Vol 28 (1) ◽  
pp. 53-68
Author(s):  
Nkosiyazi Dube ◽  
Linda Harms Smith

There is a dilemma regarding HIV/AIDS disclosure to children born and living with HIV/AIDS in residential settings. Since the advent and accessibility of Anti-Retroviral Therapy, most children born HIV positive live longer and have healthier lives. Some of these children find themselves in Need of Care due to abandonment, orphanhood and neglect or abuse, and are placed in alternative care such as a Child and Youth Care Centre (CYCC). Social Service Workers are then faced with this dilemma around disclosure of their HIV status, due to the complexities around the consequences of such a disclosure, and the absence of clear policies in this regard. The study explored the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living in a CYCC in Ekurhuleni, South Africa. The findings indicate that HIV status disclosure is a complex but essential process as it reinforces children’s ability to adhere to medication and dispels anxiety and suspicion within themselves around their status. Recommendations relate to community education and awareness programmes, policy and practice changes and makes suggestions for future research.


2020 ◽  
Vol 14 (1) ◽  
pp. 84-89
Author(s):  
A. O. Olaseni

Introduction: The spate of non-disclosure among individuals diagnosed with Human-Immunodeficiency-Virus and Acquired-Immune-Deficiency-Syndrome (HIV/AIDS) has continually been a primary global concern, especially in developing countries. Meta-analysis findings in Nigeria reported poor disclosure rates of 12.5% - 39.5%, which were far below the average disclosure benchmark of 79.0% standard stipulated for developing nations by the World Health Organization. There is no consensus regarding the roles of CD4 counts in disclosure intention. In Nigeria, there is a paucity of literature providing detailed understanding of the predictors of disclosure intention by the duration of diagnosis knowledge and CD4 counts. Methods: This study, therefore, investigated the implication of duration of diagnosis knowledge and CD4 counts in the prediction of HIV disclosure intention among people seeking HIV treatment. Longitudinal survey research designs were adopted. 390 participants were purposively selected to respond to HIV Self-Disclosure Intention Index (α=0.92), while information on CD4 counts and Duration of Diagnosis Knowledge was obtained from the selected respondents’ case files periodically. Binomial logistic regression analysis was used to analyze data at 0.05. Respondents’ mean age was 39.5±10.5 years. Results: Findings revealed that the duration of diagnosis knowledge and CD4 counts interactively predicted the outcome of disclosure intention among treatment-seeking PLHIV. (χ2 = 12.78, df = 2, p < 0.001) and further showed that the likelihood of disclosing HIV positive status increases by 13% between Time 1 (OR = -0.49, p < 0.01; 95%CI = 01.14-12.74) and Time 2 (OR = -0.36, p < 0.05; 95%CI = 01.11-10.93). Increase in CD4 counts was also found to increase the likelihood of HIV self-disclosure by 15% between Time 1 (OR = - 0.84, p < 0.01; 95%CI = 01.09-03.06) and Time 2 (OR = - 0.99, p < 0.01; 95%CI = 00.29-03.06). Conclusion: It was concluded that the duration of diagnosis knowledge and CD4 counts have significant implications in determining the intention to disclose HIV positive status. The study limitations and recommendations were further discussed.


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