Modes of HIV transmission among adolescents and young adults aged 10–24 years in Kenya

Understanding how HIV is acquired can inform interventions to prevent infection. We constructed a risk profile of 10–24 year olds participating in the 2012 Kenya AIDS Indicator Survey and classified them as perinatally infected if their biological mother was infected with HIV or had died, or if their father was infected with HIV or had died (for those lacking mother’s data). The remaining were classified as sexually infected if they had sex, and the remaining as parenterally infected if they had a blood transfusion. Overall, 84 (1.6%) of the 5298 10–24 year olds tested HIV positive; 9 (11%) were aged 10–14 and 75 (89%) 15–24 years. Five (56%) 10–14 year olds met criteria for perinatal infection; 4 (44%) did not meet perinatal, sexual or parenteral transmission criteria and parental HIV status was not established. Of the 75 HIV-infected, 15 to 24 year olds, 5 (7%) met perinatal transmission, 63 (84%) sexual and 2 (3%) parenteral criteria; 5 (7%) were unclassified. Perinatal transmission likely accounted for 56% and sexual transmission for 84% of infections among 10–14 year olds and 15–24 year olds, respectively. Although our definitions may have introduced some uncertainty, and with the number of infected participants being small, our findings suggest that mixed modes of HIV transmission exist among adolescents and young people.

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A Phenomenological Account of HIV Disclosure Experiences of Children and Adolescents from Northern and Southern Ghana

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040595 ◽

2019 ◽

Vol 16 (4) ◽

pp. 595 ◽

Cited By ~ 2

Author(s):

Seth Appiah ◽

Inge Kroidl ◽

Michael Hoelscher ◽

Olena Ivanova ◽

Jonathan Dapaah

Keyword(s):

Children And Adolescents ◽

Social Protection ◽

Hiv Transmission ◽

Hiv And Aids ◽

Hiv Disclosure ◽

Hiv Positive ◽

Hiv Status ◽

Nations Programme ◽

United Nations Programme ◽

Southern Ghana

Disclosure of HIV status to infected children, though challenged by caregiver dilemma, remains central in achieving the United Nations Programme on HIV and AIDS (UNAIDS) global goal of 90/90/90. This study explores children’s HIV disclosure experiences across Northern and Southern Ghana. A qualitative interpretative phenomenological design facilitated the recruitment of 30 HIV positive disclosed children and adolescents aged 9–19 years in 12 antiretroviral treatment (ART) centers in Northern and Southern Ghana between January 2017 and June 2018. Data was collected via in-depth interviews. We used phenomenological analysis applying concepts and categories identification, patterns and interconnections searching, mapping, theme building and constant comparative technique to draw conclusions. Disclosure of HIV status to children occurred with little or no preparation. Caregivers intentionally or out of dilemma often prolonged or postponed disclosure to when children aged older. Illness severity and disease progression principally defined the need for disclosure. Children preference for early status disclosure averaged at age 10 was demonstrated despite the initial disclosure experience of shock and disappointment. There was improved medication adherence despite the challenge of limited knowledge about HIV transmission, financial difficulty and food insecurity. Context and culturally adapted pre- and post- disclosure guideline laced with social protection package is needed to support HIV positive children.

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Computer-assisted survey of attitudes to HIV and sexually transmissible infection partner notification in HIV-positive men who have sex with men

Sexual Health ◽

10.1071/sh09146 ◽

2010 ◽

Vol 7 (4) ◽

pp. 460 ◽

Cited By ~ 3

Author(s):

Clare L. N. Woodward ◽

Sherie Roedling ◽

Simon G. Edwards ◽

Alice Armstrong ◽

John Richens

Keyword(s):

Hiv Transmission ◽

Partner Notification ◽

Hiv Positive ◽

Computer Assisted ◽

Hiv Status ◽

Targeted Interventions ◽

Sexually Transmissible Infections ◽

Sex With Men ◽

The Uk ◽

Median Rating

Background: HIV infection continues to rise in men who have sex with men (MSM) in the UK. Of concern are the high rates of sexually transmissible infections (STI) among HIV-positive MSM, as this is associated with onward HIV transmission. Conventional partner notification (PN) may be limited in this group by the presence of multiple non-contactable partners and the fear of breach of HIV status. Methods: We explored attitudes to PN in HIV-positive MSM having an STI screen using a computer-assisted self interview. Results and Conclusion: Our study shows HIV+ MSM, rate conventional methods of PN highly (median rating 8/10) but are also supportive of new approaches to PN particularly anonymous email when linked to website information. They would also be open to targeted interventions such as peer recruitment.

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Safeguarding women’s and girls’ wellbeing: Exploring the role of gender-based violence on HIV transmission in Zimbabwe

10.21203/rs.3.rs-234294/v1 ◽

2021 ◽

Author(s):

Munyaradzi Mapingure ◽

Zindoga Mukandavire ◽

Innocent Chingombe ◽

Rouzeh Eghtessadi ◽

Diego F. Cuadros ◽

...

Keyword(s):

Hiv Transmission ◽

Positive Association ◽

Hiv Positive ◽

Hiv Status ◽

Gender Based Violence ◽

Women And Girls ◽

Mapping Techniques ◽

Gender Based ◽

Using Data

Abstract Background Gender-based violence (GBV) is a growing epidemic, whose role in HIV transmissions remains minimally addressed by the majority of national HIV response interventions. Methods Statistical and geo-spatial analysis was used to explore the relationship between GBV variables and HIV status using data from Zimbabwe Demographic and Health Survey, 2015-16. Results Women who were ever humiliated by their husbands or partners were 1.45 times more likely to be HIV positive than those who were never humiliated, p = 0.002. The same was true for women whose husbands or partners ever threatened to harm them or someone they love, OR (95%CI) 1.33 (1.04–1.68), p = 0.022. There was a positive association between HIV status and women who reported that their husband or partner, either pushed, shook, or threw something at them or punched them with his fist or with something that could hurt them or kicked, dragged or beat them, or tried to choke or burn them on purpose or threatened or attacked them with a knife or gun, or any other weapon. Women who experienced forced sexual violence with threats were more likely (odds 1.61, p = 0.019), to be HIV positive than those women who did not experience the same. Using geospatial mapping techniques our study has shown a substantial countrywide epidemic of GBV against women in Zimbabwe requiring urgent attention. Emotional GBV had a similar geographical distribution with HIV in the northern part of the country, where all three types of violence tend to aggregate. Conclusion There is a significant association between forms of GBV (emotional, physical, and sexual) and HIV status. The results suggest the need to strengthen interventions that empower women and girls with skills to withstand violence in order to curb HIV transmission. The engagement of men as proponents of gender equality, bringing other men to account for perpetuating GBV and actively countering violence against women and girls, is critical to the design of such interventions.

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Legal Barriers to Implementing Recommendations for Universal, Routine Prenatal HIV Testing

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2004.tb00459.x ◽

2004 ◽

Vol 32 (1) ◽

pp. 137-147 ◽

Cited By ~ 5

Author(s):

Leslie E. Wolf ◽

Bernard Lo ◽

Lawrence O. Gostin

Keyword(s):

United States ◽

Antiretroviral Therapy ◽

Pregnant Women ◽

Hiv Testing ◽

Hiv Transmission ◽

Perinatal Transmission ◽

The United States ◽

Hiv Status ◽

Mother To Child ◽

Legal Barriers

Administraation of antiretroviral therapy to women during pregnancy, labor and delivery, and to infants postnatally can dramatidy reduce mother-to- child HIV transmission (MTCT). However, pregnant women need to know that they are HIV-infected to take advantage of antiretroviral therapy, and many women do not know their HIV status. One-half of HIV-infected infants in the United States were bornto women who had not been tested for HIV or for whom the time of testing was not known. Although fewer than 400infants are infected perinatally in the United States each year, that number could be reduced even further through policies aimed at HIV testing during pregnancy.The reasons toadopt such a policy are strong: the pathophysiology of perinatal transmission is clear, prophylaxis is effective and safe, and the intended beneficiaries of the intervention - babies - cannot protect themselves.

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Preventing HIV Transmission via HIV Exposure Laws: Applying Logic and Mathematical Modeling to Compare Statutory Approaches to Penalizing Undisclosed Exposure to HIV

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2008.306.x ◽

2008 ◽

Vol 36 (3) ◽

pp. 577-584 ◽

Cited By ~ 14

Author(s):

Carol L. Galletly ◽

Steven D. Pinkerton

Keyword(s):

Hiv Transmission ◽

Sexual Contact ◽

Hiv Positive ◽

Structural Interventions ◽

Hiv Status ◽

Public Health Perspective ◽

Serostatus Disclosure ◽

Sexual Activities ◽

Hiv Serostatus ◽

Hiv Exposure

Twenty-four U.S. states have enacted HIV exposure laws that prohibit HIV-positive persons from engaging in sexual activities with partners to whom they have not disclosed their HIV-status. From a public health perspective, HIV serostatus exposure laws can be viewed as structural interventions that seek to limit the spread of HIV by acting at the policy level. A central premise of these laws is that informed partners are more likely to protect themselves by declining sex, by substituting less risky activities for higher-risk ones, or by using condoms, than are uninformed partners. However, the effectiveness of these laws at preventing HIV transmission is not known.There is little standardization among existing HIV exposure laws, which vary substantially with respect to the sexual activities that are prohibited without prior serostatus disclosure. Among the strictest laws are those in Arkansas, Michigan, New Jersey, and Ohio which mandate disclosure prior to almost any type of sexual contact.

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HIV knowledge and related sexual practices among Portuguese men who have sex with men

Cadernos de Saúde Pública ◽

10.1590/0102-311x00134813 ◽

2014 ◽

Vol 30 (11) ◽

pp. 2423-2432 ◽

Cited By ~ 1

Author(s):

Nuno Nodin ◽

Isabel Pereira Leal ◽

Alex Carballo-Diéguez

Keyword(s):

Hiv Transmission ◽

Sexual Practices ◽

Hiv Positive ◽

Sources Of Information ◽

Hiv Status ◽

Infection Rates ◽

Hiv Knowledge ◽

Relational Practice ◽

Risk Practices ◽

Sex With Men

Qualitative studies of the sexual risk practices of Portuguese men who have sex with men (MSM) are scarce, as have been campaigns to target this group despite high HIV infection rates. This study investigates the concepts and practices of safer sex of a group of 36 Portuguese self-identified gay men (age: x = 34.4, SD = 9.1) who have met sexual partners online; two identified as HIV positive. Thematic analysis of interviews showed that our participants were aware of HIV transmission risks and tended to protect themselves in most sexual practices. Oral sex and steady relationships, however, did not always include safer practices. Participants tended to rely on indirect sources of information when assessing their partners’ HIV status, such as their physical characteristics or the information available in online profiles. Contrasting HIV positive and negative men’s sexual expectations and practices indicated that communication shortcomings might be putting some at risk. Findings suggest that safe sex is a relational practice which can only be understood and addressed within the context in which it occurs.

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861. Health Disparities in HIV and Pregnancy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy209.046 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S21-S21

Author(s):

Anum Abbas ◽

Sarah Aurit ◽

Chris Destache ◽

John Horne ◽

Gary Gorby ◽

...

Keyword(s):

Race And Ethnicity ◽

Hiv Transmission ◽

Obstetric Complications ◽

Hiv Positive ◽

Hiv Status ◽

Pregnant Females ◽

Increase Rate ◽

Group B ◽

Complications And Mortality ◽

Zip Code

Abstract Background HIV infection in pregnant females confers a higher risk of morbidity and obstetric complications. Widespread use of anti-retroviral therapy (ART) has dramatically decreased vertical HIV transmission. US HIV-infected pregnant females continue to be at higher risk for obstetric complications compared with nonHIV infected females. This study will be conducted with the objective to estimate the current US morbidity and mortality in HIV-infected pregnant females as well as incidence of obstetric complications in this patient population. Methods The National Inpatient Sample (NIS) was utilized to identify hospitalizations associated with pregnancy from 2002 to 2014. The aggregation of hospitalizations was stratified into 2 groups based on HIV status to determine whether there were differences in demographic factors, complications, and mortality. All analyses accounted for the NIS sampling design. Results There were 39,404,956 pregnancy-related hospitalizations identified; of which, 51,762 were also associated with a positive HIV status. There were differences in complications for those with and without HIV, which included eclampsia (1.27% vs. 0.45%; P < 0.001), preterm labor (11.81% vs. 6.41%; P < 0.001), gestational diabetes (0.92% vs. 0.38%; P < 0.001), group B strep (0.03% vs. <0.01%; P < 0.001), and Gram-negative infection (0.07% vs. 0.03%; P = 0.013). After adjusting for mortality risk, calendar year, age, race and ethnicity, insurance, and zip-code level income, it was found that a positive HIV status was associated with a 91.1% increased odds of mortality (95% CI: 3.9%–351.5%; P = 0.037). Conclusion As ART are readily available, we expected better outcomes for our HIV-positive pregnant females. Our results are concerning that there is such an increase rate of mortality and health disparity in HIV-positive pregnant females. As this is a retrospective study, there are limitation and further studies need to be conducted. Disclosures All authors: No reported disclosures.

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Disclosure of HIV Status and HIV Sexual Transmission Behaviors among HIV-Positive Black Men Who Have Sex with Men in the BROTHERS (HPTN 061) Study

Journal of Urban Health ◽

10.1007/s11524-020-00419-9 ◽

2020 ◽

Vol 97 (5) ◽

pp. 692-703 ◽

Cited By ~ 1

Author(s):

Chukwuemeka N. Okafor ◽

Michael J. Li ◽

Christopher Hucks-Ortiz ◽

Kenneth H. Mayer ◽

Steve Shoptaw

Keyword(s):

Black Men ◽

Sexual Transmission ◽

Hiv Positive ◽

Hiv Status ◽

Sex With Men

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Dating, Marriage, and Parenthood for HIV-Positive Heterosexual Puerto Rican Men

American Journal of Men s Health ◽

10.1177/1557988314532940 ◽

2014 ◽

Vol 9 (2) ◽

pp. 139-149 ◽

Cited By ~ 6

Author(s):

Francisco Sastre ◽

Diana M. Sheehan ◽

Arnaldo Gonzalez

Keyword(s):

Puerto Rican ◽

Hiv Transmission ◽

Sexual Life ◽

Hiv Positive ◽

People Living With Hiv ◽

Hiv Status ◽

Hiv Diagnosis ◽

Latino Men ◽

Hiv Positive Women ◽

Living With Hiv

HIV-positive men are living long and healthier lives while managing HIV as a chronic illness. Although research has extensively documented the experiences of illness of people living with HIV, dating, marriage, and fatherhood among heterosexual Latino men has not been examined. To address this gap, this study used a qualitative study design to examine patterns and strategies for dating, marriage, and parenthood among 24 HIV-positive heterosexual Puerto Rican men living in Boston. The findings in our study indicate that an HIV diagnosis does not necessarily deter men from having an active sexual life, marrying, or having children. In fact, for some of the men, engaging in these social and life-changing events is part of moving on and normalizing life with HIV; these men planned for, achieved, and interpreted these events in the context of establishing normalcy with HIV. Although the HIV diagnosis discouraged some men from engaging in sexual relations, getting married, or having children, others fulfilled these desires with strategies aimed to reconciling their HIV status in their personal life, including dating or marrying HIV-positive women only. Additional important themes identified in this study include the decision to disclose HIV status to new sexual partners as well as the decision to accept the risk of HIV transmission to a child or partner in order to fulfill desires of fatherhood. Understanding the personal struggles, decision-making patterns, and needs of HIV-positive heterosexual men can aid in designing interventions that support healthy living with HIV.

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Disclosure of HIV status to sexual partners by people living with HIV

Curationis ◽

10.4102/curationis.v38i1.1174 ◽

2015 ◽

Vol 38 (1) ◽

Cited By ~ 10

Author(s):

Gloria T. Tshweneagae ◽

Victoria M. Oss ◽

Tennyson Mgutshini

Keyword(s):

Hiv Transmission ◽

Sexual Partners ◽

Primary Data ◽

Hiv Positive ◽

People Living With Hiv ◽

Hiv Status ◽

Factors Associated ◽

Hiv Prevention Strategies ◽

Fear Of Rejection ◽

Living With Hiv

Background: Disclosure of one’s HIV status to a sexual partner can have significant health implications. From a health promotion point of view, disclosure is seen as a cornerstone for the prevention of HIV transmission between partners. Despite its importance as a strategy for controlling the spread of HIV, there are challenges that inhibit voluntary disclosure.Objectives: In exploring factors associated with disclosure of HIV status, the study had two complementary objectives related to: (1) investigation of participants’ views about HIV-positive status disclosure to sexual partners; and (2) a broader identification of factors that influence disclosure of HIV-positive status.Method: The study explored factors associated with disclosure of the HIV status of people living with HIV to their sexual partners. Purposive sampling was used to select 13 participants living with HIV who attended a wellness clinic. Primary data were collected via an in-depth interview with each of the participants.Results: The exploration showed that male participants were notably more reluctant to disclose to their sexual partners for fear of rejection; and secrecy was commonly reported around sexual matters. Female participants (who were in the majority) were relatively more willing to disclose their HIV status to their sexual partners. Despite the complexity of disclosure, all participants understood the importance of disclosure to their sexual partners.Conclusion: There is a need for HIV prevention strategies to focus on men in particular, so as to strengthen disclosure counselling services provided to people living with HIV and to advocate strongly for partner testing.

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