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

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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Hormonal Contraception Use and Risk of Female-to-Male HIV Transmission Risk in a Zambian Cohort

AIDS Research and Human Retroviruses ◽

10.1089/aid.2014.5097.abstract ◽

2014 ◽

Vol 30 (S1) ◽

pp. A55-A55

Author(s):

Kristin M. Wall ◽

William Kilembe ◽

Htee Khu Naw ◽

Ilene Brill ◽

Bellington Vwalika ◽

...

Keyword(s):

Hiv Transmission ◽

Hormonal Contraception ◽

Transmission Risk ◽

Contraception Use ◽

Hiv Transmission Risk

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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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Hormonal contraception and HIV acquisition among women: an updated systematic review

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2019-200509 ◽

2020 ◽

Vol 46 (1) ◽

pp. 8-16 ◽

Cited By ~ 6

Author(s):

Kathryn M Curtis ◽

Philip C Hannaford ◽

Maria Isabel Rodriguez ◽

Tsungai Chipato ◽

Petrus S Steyn ◽

...

Keyword(s):

Systematic Review ◽

Observational Study ◽

Oral Contraceptives ◽

Hiv Risk ◽

Contraceptive Method ◽

Hormonal Contraception ◽

Hormonal Contraceptive ◽

Contraception Use ◽

Hiv Acquisition ◽

Risk Of Hiv Acquisition

ObjectiveTo update a 2016 systematic review on hormonal contraception use and HIV acquisition.MethodsWe searched Pubmed and Embase between 15 January 2016 and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using a hormonal contraceptive method and either non-users or users of another specific hormonal contraceptive method. We extracted information from newly identified studies, assessed study quality, and updated forest plots and meta-analyses.ResultsIn addition to 31 previously included studies, five more were identified; three provided higher quality evidence. A randomised clinical trial (RCT) found no statistically significant differences in HIV risk among users of intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG implant) or the copper intrauterine device (Cu-IUD). An observational study found no statistically significant differences in HIV risk among women using DMPA, norethisterone enanthate (NET-EN), implants (type not specified) or Cu-IUD. Updated results from a previously included observational study continued to find a statistically significant increased HIV risk with oral contraceptives and DMPA compared with no contraceptive use, and found no association between LNG implant and HIV risk.ConclusionsHigh-quality RCT data comparing use of DMPA, LNG implant and Cu-IUD does not support previous concerns from observational studies that DMPA-IM use increases the risk of HIV acquisition. Use of other hormonal contraceptive methods (oral contraceptives, NET-EN and implants) is not associated with an increased risk of HIV acquisition.

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HIV transmission risk behaviours among HIV-positive persons in serodiscordant relationships

International Journal of STD & AIDS ◽

10.1258/095646202760326426 ◽

2002 ◽

Vol 13 (10) ◽

pp. 677-682 ◽

Cited By ~ 69

Author(s):

Seth C Kalichman ◽

David Rompa ◽

Webster Luke ◽

James Austin

Keyword(s):

Hiv Transmission ◽

Anal Intercourse ◽

Transmission Risk ◽

Hiv Positive ◽

Sexually Active ◽

Risk Behaviours ◽

Unprotected Sexual Intercourse ◽

Persons Living With Hiv ◽

Hiv Transmission Risk ◽

Hiv Positive Men

As many as one in three persons living with HIV-AIDS continue to practise unprotected sexual intercourse and these practices often occur with HIV-negative or unknown HIV serostatus (serodiscordant) partners. The current study examined the rates of HIV transmission risk behaviours in non-regular (e.g. casual) and regular (e.g. steady) serodiscordant relationships. HIV positive men ( n = 269) and women ( n = 114) responded to measures of demographic characteristics, health and mental health status, and sexual behaviours assessed in partner-by-partner interviews. 257 (67%) participants were sexually active in the preceding three months and 182 (71%) of the sexually active persons had engaged in vaginal or anal intercourse with serodiscordant partners. Comparisons of persons with non-regular ( n = 97) and regular ( n = 85) serodiscordant partners showed that overall rates of unprotected and protected intercourse were greater with regular partners than non-regular partners. Disclosure of HIV status to regular and non-regular serodiscordant partners did not appear to influence the pattern of results. Mathematical modelling showed that HIV transmission estimates over a one-year horizon were significantly greater for male regular partners of HIV-positive men than non-regular partners and there was a trend toward greater HIV transmission rates from HIV-positive men to their regular serodiscordant female partners compared to non-regular partners. Results suggest an urgent need for HIV transmission risk reduction interventions for HIV serodiscordant couples, particularly for couples in established, regular relationships.

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Factors associated with HIV and syphilis infection among female sex workers in three cities in Papua New Guinea: findings from Kauntim mi tu, a biobehavioral survey

Sexual Health ◽

10.1071/sh19218 ◽

2020 ◽

Vol 17 (4) ◽

pp. 311 ◽

Cited By ~ 2

Author(s):

Angela Kelly-Hanku ◽

Damian Weikum ◽

Steven G. Badman ◽

Barne Willie ◽

Ruthy Boli-Neo ◽

...

Keyword(s):

Papua New Guinea ◽

Sex Workers ◽

Physical Violence ◽

Male Partner ◽

New Guinea ◽

Syphilis Infection ◽

Factors Associated ◽

Modern Contraception ◽

Contraception Use ◽

Port Moresby

Background In this paper, factors associated with HIV and syphilis infection in three cities in Papua New Guinea are explored. Methods: Respondent-driven sampling surveys among FSW in Port Moresby, Lae, and Mt. Hagen (2016–17) were conducted. FSW who were aged ≥12 years, who were born female, who spoke English or Tok Pisin and who had sold or exchanged vaginal sex in the past 6 months were eligible to participate. Participants were interviewed face-to-face and offered rapid HIV and syphilis testing. Survey logistic procedures were used to identify factors associated with HIV and syphilis infection, including modern contraception use, physical violence and having a casual male partner. Weighted data analysis was conducted. Results: Overall, 2901 FSW (Port Moresby, 673; Lae, 709; and Mt. Hagen, 709) were enrolled in the study. HIV prevalence was 15.2% in Port Moresby, 11.9% in Lae and 19.6% in Mt. Hagen. Factors associated with HIV varied by city; for example, use of modern contraception in Port Moresby, experiences of physical violence in Lae and ever having tested for HIV in Mt. Hagen. No one variable was associated with HIV in all cities. Prevalence of syphilis infection was 7.1%, 7.0%, and 3.0% in Port Moresby, Lae, and Mt. Hagen, respectively. Factors associated with syphilis infection also varied by city and were only significant in Lae. Conclusion: The different factors associated with HIV and syphilis infection in each city highlight the complex HIV and syphilis epidemics among FSW and the importance of conducting surveys in multiple locations and developing local interventions.

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Factors associated with HIV transmission risk in people with a severe mental illness. A narrative review

Salud Mental ◽

10.17711/sm.0185-3325.2017.005 ◽

2017 ◽

Vol 40 (1) ◽

pp. 29-42 ◽

Cited By ~ 3

Author(s):

Dulce Galarza-Tejada ◽

◽

Ramiro Caballero-Hoyos ◽

Luciana Ramos-Lira ◽

◽

...

Keyword(s):

Mental Illness ◽

General Population ◽

Severe Mental Illness ◽

Hiv Transmission ◽

Population Group ◽

Narrative Review ◽

Transmission Risk ◽

Sociocultural Factors ◽

Factors Associated ◽

Hiv Transmission Risk

Background. People with a severe mental illness (SMI) are a highly vulnerable group for the transmission risk of the human immunodeficiency virus (HIV). They have a higher seroprevalence compared with the general population and their life expectancy is shorter than those of people without the disease. This narrative review describes individual factors or those inherent to a person’s characteristics and the sociocultural factors conditioning sexual behaviour and prevention norms. Objective. The purpose of this narrative review is to describe individual and sociocultural factors associated with the risk of HIV in people with a severe mental illness. Method. 82 empirical studies published between 1981 and 2015, addressing HIV transmission risk factors and sociocultural dimensions related to vulnerability were selected. Four indexes were used for this purpose: ISI Web of Knowledge, Redalyc, SciELO, and PUBMED; and four multidisciplinary electronic databases: Ebscohost Web, ProQuest, Sage Publications and ScienceDirect. Results. The analysis based on coding and systematic categorization shows that people with SMI are more vulnerable to risk than the general population, with differentials based on the severity of the disease symptomatology and economic and sociocultural characteristics associated with HIV-related risk practices. Discussion and conclusion. The need to design longitudinal studies with mixed methodology is proposed to attain a deeper understanding of the interaction of factors associated and processes conditioning risk. In this population group, structural preventive programs that take into account social and gender inequality must be implemented.

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