Geographical-level contributions of risk factors for HIV infections using generalized additive models: results from a cohort of South African women

Background: The incidence of metabolic disorders in human immunodeficiency virus (HIV) endemic settings is a prevailing burden in developing countries. Cholesterol homeostasis and fat metabolism are altered by HIV and antiretroviral therapy (ART), thereby possibly contributing to complications such as gallstone formation.Objectives: The aim of this study was to evaluate established risk factors for the formation of cholesterol gallstones in black South African women living with HIV (WLHIV).Method: A case series study was conducted of all black South African women undergoing cholecystectomy for gallstone disease over a 1-year period at King Edward VIII Hospital, Durban, South Africa. Age, body mass index (BMI), family history of gallstones, oestrogen exposure and lipograms were compared between WLHIV and uninfected women. Categorical variables were tested using either the Fisher’s exact test or Pearson’s chi-square test. Means were compared using independent t-tests. For non-normally distributed data, the Mann–Whitney U test was used. Statistical tests were two-sided, and p-values of less than 0.05 were considered statistically significant.Results: A total of 52 patients were assessed, 34 HIV-uninfected and 18 WLHIV. The median age of WLHIV versus the uninfected women was 35 and 50 years, respectively, (p = 0.015). A statistically significant number of uninfected women were in the overweight/obese category (BMI 25 kg/m2) compared to the normal weight category (BMI 25 kg/m2) (p 0.001). The number of obese WLHIV did not reach statistical significance.Conclusion: The age of occurrence of gallstone disease amongst black South African WLHIV was significantly lower and fewer women were obese compared with the uninfected women with gallstone disease. These findings differ from known gallstone risk factors in other populations and in uninfected black South African women. This could be attributed to the metabolic alterations caused by HIV infection itself and/or to the long-term use of ART. Larger cohort studies are required to elucidate the role of HIV and ART in cholestatic disease.

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Knowledge and Screening Practices of Breast and Cervical Cancer in Rural and Urban South Africa

Journal of Global Oncology ◽

10.1200/jgo.18.38000 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 46s-46s

Author(s):

A. LaVigne ◽

S. Grover ◽

S. Rayne

Keyword(s):

Risk Factors ◽

South Africa ◽

Cervical Cancer ◽

South African ◽

Rural Women ◽

Tertiary Care ◽

African Women ◽

Screening Methods ◽

Breast And Cervical Cancer ◽

South African Women

Background: The South African government has recently released cancer policies for breast and cervical cancer—the most common types and causes of cancer-related death in South African women. Increased mortality rates and advanced disease at presentation in comparison with developed countries suggests a need for greater awareness of risk factors, screening and preventative methods individualized for the population at risk. Aim: To characterize and compare the knowledge base and perceptions of women in urban and rural settings, we assessed these factors in two different cohorts in South Africa. Methods: A cross-sectional sample was taken in South Africa of women invited to participate in a survey regarding breast and cervical cancer knowledge, and awareness of risk factors, prevention and screening. Participants were approached in shopping malls and health facilities in urban Johannesburg in 2015 (“urban”) and semirural Bushbuckridge, 450 km northeast of Johannesburg (“rural”) in 2016. Results: 600 total women were surveyed, with 300 from each cohort. 83% of the urban cohort completed matriculation or higher, versus 60% of rural participants for whom high school was their highest level of education. Both groups demonstrated comparable levels of cancer awareness, and > 70% felt that cervical cancer is preventable. While the urban cohort was more knowledgeable about Pap smears (76% vs. 66%, P = 0.004), > 75% of both cohorts were willing to get one. Although both groups were largely unfamiliar with the role of HPV in cervical cancer, rural women were more aware of HIV (38% vs. 59%, P < 0.0001), smoking (43% vs. 62%, P < 0.0001) and parity (39% vs. 54%, P = 0.00019) as risk factors. Nevertheless, urban participants were more knowledgeable about breast self exams (71% vs. 59%, P = 0.001) and mammograms (62% vs. 42%, P < 0.0001), and more likely to undergo one (79% vs. 66%, P = 0.0002). Both groups identified family history and genetics as risk factors, but rural women appeared more aware of the roles of diet (30.67% vs. 39.93%, P = .011), oral contraceptives (17.33% vs. 34.77%, P < .0001), alcohol (26.67% vs. 52.15%, P < .0001) and lack of exercise (8.67% vs. 55.12%, P < .0001). Conclusion: Overall knowledge of breast and cervical cancer did not differ between both groups, despite varying levels of education and geographic setting. Women in the rural cohort demonstrated more awareness of several oncologic risk factors. Yet, the greater familiarity with and uptake of screening methods, especially for breast cancer, among women in the urban cohort may point to the benefits of proximity to health care infrastructure, such as tertiary care centers. This data supports a need for further implementation and distribution of cancer care services within cancer policies, to capitalize on increasingly sufficient levels of awareness among South African women.

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A discourse on the plight of South African women in the face of abuse and neglect

Law Democracy & Development ◽

10.17159/2077-4907/2020/ldd.v25.spe5 ◽

2021 ◽

Vol 25 (spe) ◽

pp. 1-23

Author(s):

Omololu Fagbadebo

Keyword(s):

South African ◽

Violence Against Women ◽

Secondary Data ◽

Hiv Infections ◽

African Women ◽

The Status ◽

The Face ◽

The Government ◽

South African Women ◽

Hiv Aids

An upsurge in the rate of violence against women has an adverse effect on women in South Africa. Sadly, many South African women who are the victims of violent sexual conduct, such as, rape and other forms of violent sexual abuse, have in part contributed to the prevalence of HIV/AIDS infection among women. Of the 7,7 million South African living with HIV/AIDS in 2018, 4,7 million were women, while another 69 000 were among the new infections. They are more vulnerable to HIV infections with 21,17 percent of women living with the disease. Using personal conversations, literature searches and documents for primary and secondary data, this article argues that value orientation that ascribes superiority to men has damaging consequences on the status of women. South African women are exposed to violent habitual actions of men that denigrate their womanhood. The article, therefore, submits that there is a need to reinforce civil society and strengthen the justice system for the protection and promotion of the rights and freedom of women. Aside from this, the government should increase its commitment to the enforcement of requisite legislative frameworks that safeguard the rights and freedom of women, and review punishments for any acts of violence against women.

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BODY FAT DISTRIBUTION AND CARDIO-METABOLIC RISK FACTORS IN MIXED-ANCESTRY SOUTH AFRICAN WOMEN AND MEN

Journal of Hypertension ◽

10.1097/01.hjh.0000539386.28591.a3 ◽

2018 ◽

Vol 36 (Supplement 1) ◽

pp. e145-e146

Author(s):

A.P. Kengne ◽

F.E. Davidson ◽

T.E. Matsha ◽

R.T. Erasmus ◽

J.E. Goedecke

Keyword(s):

Risk Factors ◽

South African ◽

Body Fat ◽

Fat Distribution ◽

Body Fat Distribution ◽

Metabolic Risk Factors ◽

African Women ◽

Metabolic Risk ◽

Mixed Ancestry ◽

South African Women

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The association of interleukin-18 genotype and serum levels with metabolic risk factors for cardiovascular disease

Acta Endocrinologica ◽

10.1530/eje-07-0463 ◽

2007 ◽

Vol 157 (5) ◽

pp. 633-640 ◽

Cited By ~ 32

Author(s):

Juliet Evans ◽

Malcolm Collins ◽

Courtney Jennings ◽

Lize van der Merwe ◽

Ingegerd Söderström ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

South African ◽

Normal Weight ◽

Visceral Adiposity ◽

Metabolic Risk Factors ◽

African Women ◽

Metabolic Risk ◽

Black South African ◽

South African Women

AbstractObjectiveCirculating levels of interleukin (IL)-18 are associated with the metabolic syndrome and risk for the development of cardiovascular disease (CVD). This study investigated the association between the circulating IL-18 levels and the −137 G/C polymorphism within the IL-18 gene with metabolic risk factors for CVD in normal-weight and obese black South African women.MethodsBlood pressure (BP), body composition (dual-energy X-ray absorptiometer), visceral adiposity (computerized tomography), as well as fasting glucose, insulin, lipid profile, IL-18 levels, and IL-18 genotype were measured in 104 normal-weight (body mass index (BMI) ≤25 kg/m2) and 124 obese (BMI≥30 kg/m2) black South African women.ResultsSubjects with a GC genotype (23%) had a greater mean arterial pressure (MAP, 90.6±11.1 vs 85.5±10.3 mmHg, P<0.001) than the subjects with the GG genotype. Serum IL-18 levels were not associated with IL-18 genotype (P=0.985); however, they significantly correlated with percentage of body fat (r=0.25, P<0.001), visceral adiposity (r=0.32, P<0.001), MAP (r=0.22, P=0.001), HOMA-IR (r=0.33, P<0.001), fasting insulin (r=0.25, P<0.001), triglyceride (r=0.16, P<0.05), and high-density lipoprotein-cholesterol (r=−0.14, P<0.05) levels, after adjusting for age and body fatness.ConclusionsWe show for the first time that the GC genotype of the IL-18 −137 G/C polymorphism and the circulating IL-18 levels are independently associated with raised BP. Moreover, fasting IL-18 levels are associated with the other metabolic risk factors for CVD in normal-weight and obese black South African women.

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