scholarly journals Elucidating drivers for variations in the explosive HIV epidemics among people who inject drugs in Pakistan

2021 ◽  
Author(s):  
Aaron G Lim ◽  
Adam Trickey ◽  
Laura H Thompson ◽  
Faran Emmanuel ◽  
Tahira E Reza ◽  
...  
Keyword(s):  
Risk Factors ◽  
People Who Inject Drugs ◽  
Population Attributable Fraction ◽  
Hiv Prevalence ◽  
Hiv Incidence ◽  
Regression Analyses ◽  
Opioid Substitution Therapy ◽  
Heroin Use ◽  
Hiv Model ◽  
Hiv Epidemic

Abstract Background Pakistan‘s explosive HIV epidemic among people who inject drugs (PWID) varies widely across cities. We evaluated possible drivers for these variations. Methods Multivariable regression analyses were undertaken using data from five national surveys among PWID (n=18,467; 2005-2017) to determine risk factors associated with variations in city-level HIV prevalence. A dynamic HIV model was used to estimate the population-attributable fraction (PAF; proportion of HIV infections prevented over 10-years when that risk factor is removed) of these risk factors to HIV transmission and impact on HIV incidence of reducing their prevalence. Results Regression analyses suggested city-level HIV prevalence is strongly associated with the prevalence of using professional injectors at last injection, heroin use in last month, and injecting 4+ times per day. Through calibrating a model to these associations, we estimate that the 10-year PAFs of using professional injectors, heroin use, and frequent injecting are 45.3% (95% Uncertainty Interval 4.3-79.7%), 45.9% (8.1-78.4%), and 22.2% (2.0-58.4%), respectively. Reducing to lowest city-level prevalences of using professional injectors (2.8%; median 89.9% reduction), heroin use (0.9%; median 91.2% reduction), and frequent injecting (0.1%; median 91.8% reduction) in 2020 reduces overall HIV incidence by 52.7% (6.1-82.0%), 53.0% (11.3-80.2%), and 28.1% (2.7-66.6%) over 10-years, respectively. Conclusions Interventions should focus on these risk factors to control Pakistan’s explosive HIV epidemic among PWID, including a concomitant expansion of high-coverage needle/syringe provision, opioid substitution therapy, and antiretroviral therapy.

scholarly journals HIV epidemic in fishing communities in Uganda: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249465
Author(s):  
Patou Masika Musumari ◽  
Teeranee Techasrivichien ◽  
Kriengkrai Srithanaviboonchai ◽  
Rhoda K. Wanyenze ◽  
Joseph K. B. Matovu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Hiv Prevention ◽  
Hiv Testing ◽  
Scoping Review ◽  
Hiv Prevalence ◽  
Fishing Communities ◽  
Hiv Incidence ◽  
Hiv Epidemic ◽  
Related Risk

Background Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. In Uganda, literature on HIV in fishing communities has grown extensively since the first country’s documented case of HIV in a fishing community in 1985. The current study describes the status of the HIV burden, prevention, and treatment in Ugandan fishing communities. Method This scoping review was conducted based on the York Framework outlined by Arksey and O’Malley. We searched the PubMed, Embase, and Web of Science databases to identify relevant quantitative and qualitative studies on HIV incidence, HIV prevalence, HIV-related risk factors, HIV testing, antiretroviral therapy coverage and adherence, and interventions to improve treatment outcomes and reduce HIV risk factors. Results & conclusion We identified 52 papers and 2 reports. Thirty-four were quantitative, 17 qualitative, and 3 had a mixed-methods design. Eleven studies reported on the prevalence of HIV and 8 on HIV incidence; 9 studies documented factors associated with HIV incidence or HIV positive status; 10 studies reported on HIV testing coverage and/or associated factors; 7 reported on antiretroviral therapy coverage/adherence/outcomes; and 1 study reported on the impact of combination HIV interventions in fishing communities. This scoping review revealed a significant lack of evidence in terms of what works in HIV prevention and for improving adherence to ART, in contrast to the relatively large amount of evidence from observational quantitative and qualitative studies on HIV prevalence, incidence and related risk factors in Ugandan fishing communities. Intervention studies are urgently needed to fill the current evidence gaps in HIV prevention and ART adherence.

scholarly journals Prevalence and incidence of HIV among female sex workers and their clients: modelling the potential effects of intervention in Rwanda

2020 ◽  
Vol 5 (8) ◽  
pp. e002300
Author(s):  
Sabin Nsanzimana ◽  
Edward J Mills ◽  
Ofir Harari ◽  
Placidie Mugwaneza ◽  
Etienne Karita ◽  
...  
Keyword(s):  
General Population ◽  
Condom Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Hiv Prevalence ◽  
Consistent Condom ◽  
People Living With Hiv ◽  
Hiv Incidence ◽  
Female Sex ◽  
Hiv Epidemic

BackgroundRwanda has identified several targeted HIV prevention strategies, such as promotion of condom use and provision of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) for female sex workers (FSWs). Given this country’s limited resources, understanding how the HIV epidemic will be affected by these strategies is crucial.MethodsWe developed a Markov model to estimate the effects of targeted strategies to FSWs on the HIV prevalence/incidence in Rwanda from 2017 to 2027. Our model consists of the six states: HIV-; HIV+ undiagnosed/diagnosed pre-ART; HIV+ diagnosed with/without ART; and death. We considered three populations: FSWs, sex clients and the general population. For the period 2017–2027, the HIV epidemic among each of these population was estimated using Rwanda’s demographic, sexual risk behaviour and HIV-associated morbidity and mortality data.ResultsBetween 2017 and 2027, with no changes in the current condom and ART use, the overall number of people living with HIV is expected to increase from 344,971 to 402,451. HIV incidence will also decrease from 1.36 to 1.20 100 person-years. By 2027, a 30% improvement in consistent condom use among FSWs will result in absolute reduction of HIV prevalence among FSWs, sex clients and the general population by 7.86%, 5.97% and 0.17%, respectively. While recurring HIV testing and improving the ART coverage mildly reduced the prevalence/incidence among FSWs and sex clients, worsening the two (shown by our worst-case scenario) will result in an increase in the HIV prevalence/incidence among FSWs and sex clients. Introduction of PrEP to FSWs in 2019 will reduce the HIV incidence among FSWs by 1.28%.ConclusionsContinued efforts toward improving condom and ART use will be critical for Rwanda to continue their HIV epidemic control. Implementing a targeted intervention strategy in PrEP for FSWs will reduce the HIV epidemic in this high-risk population.

Trends in HIV prevalence among people injecting drugs, men having sex with men, and female sex workers in Ukraine

2018 ◽  
Vol 29 (13) ◽  
pp. 1337-1344 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Yana Sazonova ◽  
Tetiana Salyuk ◽  
Olga Varetska
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
People Who Inject Drugs ◽  
Hiv Prevalence ◽  
New Wave ◽  
Female Sex ◽  
Hiv Epidemic ◽  
Nationally Representative ◽  
Sex With Men ◽  
Generation Surveillance

Once recognized as the most severe in Europe, the HIV epidemic in Ukraine is concentrated among people who inject drugs, men who have sex with men, and female sex workers. Integrated biobehavioral surveys, as a part of the second generation surveillance, are used to monitor HIV infection trends in key populations since 2002. The present paper is focused on the analysis of HIV prevalence trends in four nationally representative rounds of integrated biobehavioral surveys from 2008/9, 2011, 2013, and 2015 in people who inject drugs, men who have sex with men, and female sex workers. Between 2008/9 and 2015, the HIV prevalence has decreased significantly in people who inject drugs (24.2 to 22.0%) and female sex workers (13.6 to 6.3%), while the change in men who have sex with men was not significant (8.5 to 7.8%). There was a significant increase in people who inject drugs and men who have sex with men between 2013 and 2015. In subgroups younger than 25 years, prevalence increased more than twofold in men who have sex with men (1.9 to 4.3%), with no changes in people who inject drugs and female sex workers. The observed decline in prevalence, especially in young subgroups, may result from the effect of extensive prevention efforts on drug injection-related transmission. Recent increase in young men who have sex with men may be a sign of a new wave of the epidemic in this group.

scholarly journals Systematic review on HIV situation in Addis Ababa, Ethiopia

2019 ◽  
Author(s):  
Melaku Adal
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Prevention And Control ◽  
Addis Ababa ◽  
Hiv Prevalence ◽  
Control Measures ◽  
Hiv Epidemic ◽  
Priority Populations ◽  
And Control ◽  
Hiv Aids

Abstract Background HIV prevalence in the Addis Ababa is still higher in key and priority populations. Therefore, this systematic review was carried out aiming in determining the prevalence of HIV, mortality rate by HIV/AIDS and predisposing risk factors, identification of hotspot areas, key and priority populations, availability and utilization of services, and challenges and gaps to be addressed for prevention and control of HIV epidemic in Addis Ababa.Methods The documents relevant to address the objectives were collected from online databases Google scholar and PubMed for published works. In addition, unpublished survey and surveillance reports, performance reports and project assessment findings, and mapping results were collected from partner organizations working on HIV/AIDS prevention and control.Results It appears that the HIV prevalence stabilizes, but varies along areas and socio-demographic groups. The most common hot spots in Addis Ababa are areas where bars, groceries, pensions, guest houses, hotels, brothels, massage houses, khat houses, shisha houses, night clubs, drinking establishments and tourist frequented settings are concentrated. The recognized key population (KP) is the female sex workers (FSWs). There is sexual mixing of key and priority populations (KPPs) with the general population. There are various behavioural, biological and socio-economic predisposing risk factors that drive HIV epidemic, and respective behavioural, biomedical and structural intervention measures are identified in the presence of gaps and challenges to address the problem.Conclusions HIV prevalence in Addis Ababa seems stabilized. However, it varies along different groups of the population. There are many behavioural, biological and socio-economic factors that predisposed to HIV/AIDS. Weak monitoring of the quality of interventions, limited linkage of positive clients, lost to follow up, financial shortage, limited man power and coordination, data quality and gaps in use of program data or research findings are some of the gaps and challenges. Therefore, prevention and control measures using behavioural, structural and biomedical interventions through filling of gaps and tackle challenges should be strengthened in order to prevent and control HIV/AIDS.

scholarly journals Alarmingly High HIV Prevalence Among Adolescent and Young Men Who have Sex with Men (MSM) in Urban Indonesia

2021 ◽  
Author(s):  
Lisa G. Johnston ◽  
Phyumar Soe ◽  
Asti Setiawati Widihastuti ◽  
Artha Camellia ◽  
Tarinanda Adzani Putri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Identity ◽  
Hiv Prevalence ◽  
Individual Risk ◽  
Structural Factors ◽  
Steady Partner ◽  
Hiv Epidemic ◽  
Young Msm ◽  
Sex With Men ◽  
Associated Risk Factors

AbstractIndonesia’s HIV epidemic is concentrated among key populations. While prevalence among men who have sex with men (MSM) is high, transmission among young MSM (15–24-years-old) remains poorly understood. We conducted a respondent driven sampling survey of 211 young MSM in urban Bandung, Indonesia in 2018–2019 to estimate HIV prevalence and associated risk factors. Thirty percent of young MSM were HIV antibody positive. This is nearly 100-fold greater than Indonesia’s population prevalence and sevenfold higher than average estimates for young MSM across Asia and the Pacific Region. Individual risk factors associated with HIV infection were being 20–24 years old, having a steady partner and preferring the receptive position during sex. Issues of stigma, discrimination and social exclusion were common. Few young MSM who were open with friends and family members about their sexual identity. Among those that were, close to half reported experiencing feelings of aversion from these groups. Wider structural factors that reduce social tolerance, restrict the rights of young MSM and compel concealment of sexual identity are likely to fuel high-risk behaviors and limit access to essential testing care and support services including pre-exposure prophylaxis which is not yet widely available. Urgent health, social, legal and political actions are required to respond to these factors and reduce the disproportionate contribution of young MSM to Indonesia’s HIV epidemic.

scholarly journals Cross-sectional study on risk factors of HIV among female commercial sex workers in Cambodia

2000 ◽  
Vol 124 (1) ◽  
pp. 143-152 ◽  
Author(s):  
K. OHSHIGE ◽  
S. MORIO ◽  
S. MIZUSHIMA ◽  
K. KITAMURA ◽  
K. TAJIMA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Chlamydia Trachomatis ◽  
Sex Workers ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
Regression Analyses ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Commercial Sex Workers

To describe epidemiological features on HIV prevalence among female commercial sex workers (CSWs), a cross-sectional study on sexual behaviour and serological prevalence was carried out in Cambodia. The CSWs were interviewed on their demographic characters and behaviour and their blood samples were taken for testing on sexually transmitted diseases, including HIV, Chlamydia trachomatis, syphilis, and hepatitis B. Associations between risk factors and HIV seropositivity were analysed. High seroprevalence of HIV and Chlamydia trachomatis IgG antibody (CT-IgG-Ab) was shown among the CSWs (54 and 81·7%, respectively). Univariate logistic regression analyses showed an association between HIV seropositivity and age, duration of prostitution, the number of clients per day and CT-IgG-Ab. Especially, high-titre chlamydial seropositivity showed a strong significant association with HIV prevalence. In multiple logistic regression analyses, CT-IgG-Ab with higher titre was significantly independently related to HIV infection. These suggest that existence of Chlamydia trachomatis is highly related to HIV prevalence.

scholarly journals HIV epidemic trend and antiretroviral treatment need in Karonga District, Malawi

2007 ◽  
Vol 135 (6) ◽  
pp. 922-932 ◽  
Author(s):  
R. G. WHITE ◽  
E. VYNNYCKY ◽  
J. R. GLYNN ◽  
A. C. CRAMPIN ◽  
A. JAHN ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Antiretroviral Treatment ◽  
Hiv Prevalence ◽  
Hiv Incidence ◽  
Simple Mathematical Model ◽  
Population Surveys ◽  
Treatment Need ◽  
Hiv Epidemic ◽  
Using Data

SUMMARYWe describe the development of the HIV epidemic in Karonga District, Malawi over 22 years using data from population surveys and community samples. These data are used to estimate the trend in HIV prevalence, incidence and need for antiretroviral treatment (ART) using a simple mathematical model. HIV prevalence rose quickly in the late 1980s and early 1990s, stabilizing at around 12% in the mid-1990s. Estimated annual HIV incidence rose quickly, peaking in the early 1990s at 2·2% among males and 3·1% among females, and then levelled off at 1·3% among males and 1·1% among females by the late 1990s. Assuming a 2-year eligibility period, both our model and the UNAIDS models predicted 2·1% of adults were in need of ART in 2005. This prediction was sensitive to the assumed eligibility period, ranging from 1·6% to 2·6% if the eligibility period was instead assumed to be 1·5 or 2·5 years, respectively.

scholarly journals Modelling the Impact of Prevention and Treatment Interventions on HIV and Hepatitis C Virus Transmission Among People Who Inject Drugs in Kenya

2021 ◽  
Author(s):  
Jack Stone ◽  
Hannah Fraser ◽  
Josephine G Walker ◽  
Nyashadzaishe Mafirakureva ◽  
Bernard Mundia ◽  
...  
Keyword(s):  
Sexual Risk ◽  
People Who Inject Drugs ◽  
Scale Up ◽  
Coastal Region ◽  
Hiv Infections ◽  
Hiv Incidence ◽  
Hcv Treatment ◽  
Opioid Substitution Therapy ◽  
Substantial Impact ◽  
The Impact

AbstractBackgroundPeople who inject drugs (PWID) in Kenya have a high prevalence of HIV (14-26%) and HCV (11-36%). Needle and syringe programmes (NSP) and antiretroviral therapy (ART) have high coverage among PWID, while HCV treatment and opioid substitution therapy (OST) access is low.MethodsA dynamic model of HIV (sexual and injecting-related) and HCV (injecting-related) transmission among PWID was calibrated using Bayesian methods to data from Nairobi and the Coastal region. We projected the impact of existing coverage levels of interventions (ART: 64-66%; OST: 4-7%; NSP: 54-56%) in each setting, and the impact over 2020-2030 of increasing the coverage of OST (50%) and NSP (75%; ‘full HR’), ART (UNAIDS 90-90-90 target), HCV treatment (1000 over 5 years), and reducing HIV sexual risk by 75%. We estimated HCV treatment levels needed to reduce HCV incidence by 90% with or without full HR.FindingsSince 2013, HR has averted 15.1-20.6% (range in medians across settings) of HIV infections and 29.0-31.6% of HCV infections across Nairobi and the Coastal region, with most impact being due to NSP. Conversely, ART has only averted <5% of HIV infections since 2004 because of sub-optimal viral suppression (28-48%). Going forward, Full HR and ART could reduce HIV incidence by 58.2-62.0% and HCV incidence by 62.6-81.6% by 2030 across these settings. If sexual risk is also reduced, HIV incidence would reduce by 77.1-81.4%. Alongside full HR, treating 896 PWID over 2020-2025 could reduce HCV incidence by 90% by 2030.InterpretationExisting interventions have had moderate impact on HIV and HCV transmission in Kenya, but may have substantial impact if scaled-up. However, to achieve HIV and HCV elimination, reductions in sexual risk are needed and a scale-up in HCV treatment.FundingGlobal Fund, MDM

scholarly journals Systematic review on HIV situation, gaps and challenges in Addis Ababa, Ethiopia

2019 ◽  
Author(s):  
Melaku Adal
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Prevention And Control ◽  
Addis Ababa ◽  
Hiv Prevalence ◽  
Control Measures ◽  
Hiv Epidemic ◽  
Priority Populations ◽  
And Control ◽  
Hiv Aids

Abstract Background HIV prevalence in the Addis Ababa is still higher in key and priority populations. Therefore, this systematic review was carried out aiming in determining the prevalence of HIV, mortality rate by HIV/AIDS and predisposing risk factors, identification of hotspot areas, key and priority populations, availability and utilization of services, and challenges and gaps to be addressed for prevention and control of HIV epidemic in Addis Ababa.Methods The documents relevant to address the objectives were collected from online databases Google scholar and PubMed for published works. In addition, unpublished survey and surveillance reports, performance reports and project assessment findings, and mapping results were collected from partner organizations working on HIV/AIDS prevention and control.Results It appears that the HIV prevalence stabilizes, but varies along areas and socio-demographic groups. The most common hot spots in Addis Ababa are areas where bars, groceries, pensions, guest houses, hotels, brothels, massage houses, khat houses, shisha houses, night clubs, drinking establishments and tourist frequented settings are concentrated. The recognized key population (KP) is the female sex workers (FSWs). There is sexual mixing of key and priority populations (KPPs) with the general population. There are various behavioural, biological and socio-economic predisposing risk factors that drive HIV epidemic, and respective behavioural, biomedical and structural intervention measures are identified in the presence of gaps and challenges to address the problem.Conclusions HIV prevalence in Addis Ababa seems stabilized. However, it varies along different groups of the population. There are many behavioural, biological and socio-economic factors that predisposed to HIV/AIDS. Weak monitoring of the quality of interventions, limited linkage of positive clients, lost to follow up, financial shortage, limited man power and coordination, data quality and gaps in use of program data or research findings are some of the gaps and challenges. Therefore, prevention and control measures using behavioural, structural and biomedical interventions through filling of gaps and tackle challenges should be strengthened in order to prevent and control HIV/AIDS.

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