scholarly journals Experiences, Emotions, and Adjustments of HIV-Infected Men in HIV-Concordant Marital Relationship in Cambodia

2018 ◽  
Vol 12 (5) ◽  
pp. 1215-1225
Author(s):  
Roshna Thapa ◽  
Youngran Yang

Although it has been well documented that the HIV infection experience can be problematic for those affected, the experiences and perceptions of living with HIV among married males in Cambodia have not yet been examined until now. This study’s purpose was to describe the revelations, emotions, reactions, and adjustments to HIV diagnosis among infected Cambodian males in seroconcordant heterosexual relationship. Fifteen qualitative in-depth interviews were conducted with 15 HIV-positive males using unstructured, open-ended questions and in the local Khmer language. Conventional content analysis method was employed for analyzing data. After analysis, four main categories were developed: knowledge of HIV-positive status; realization of self-deeds; discouraging news for both partners; and comparative improvement of life. Participants reported the appearance of physical symptoms as the only reason for pursuing HIV testing. Feelings ranged from sadness and guilt to acceptance of HIV infection in their lives. The participants’ wives expressed anger and worry about being infected by their husbands. However, sufficient inspiration from medical personnel and peer groups, as well as a shared concern for their children, helped couples adjust to their dyadic relationship. The study results highlight the link between individual and couple experiences and emotions post-infection, with implications for designing and implementing coping interventions for this population. The findings of this study have public health implications in the design of couple-based intervention and counseling programs for HIV prevention and treatment with the input of the HIV-positive individuals’ voices.

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.


2021 ◽  
Author(s):  
Valentina Delle Donne ◽  
Nicoletta Ciccarelli ◽  
Valentina Massaroni ◽  
Francesca Lombardi ◽  
Silvia Lamonica ◽  
...  

Abstract Our aim was to explore the psychological impact of the initial 2019 Coronavirus (COVID-19) pandemic in a cohort of people living with HIV (PLWH), a population at increased risk of psychological distress. PLWH, treated at our unit, responded an online survey. Data on demographics, clinical and physical symptoms, contact history, as well as knowledge, concerns, precautionary measures and additional information required with respect to COVID-19 during the first phase of the pandemic in Italy were collected. Additionally, the Impact of Event Scale-Revised (IES-R) (identifying COVID-19 pandemic as specific traumatic life event) and the Depression, Anxiety and Stress Scale (DASS-21) were also administered. Out of 98 participants, 44 (45%) revealed from mild to severe psychological impact distress from COVID-19 according to IES-R. According to DASS-21, a lower percentage of significant levels of depression (14%), anxiety (11%) or stress (6%) were reported. Higher education, unemployment, number of perceived physical COVID-19 symptoms, concerns contracting COVID-19 and the situation regarding the pandemic in Italy, and the need of additional information to prevent COVID-19 infection were positively associated to psychological distress. Moreover, female gender, older age, recent HIV diagnosis and unawareness of own viremia were associated to a higher psychological distress. Almost half of our cohort experienced significant levels of distress related to the COVID-19 pandemic. Women, elderly patients and those with recent HIV diagnosis resulted to be the more psychological fragile subgroup. Our findings could help to identify patients in need of psychological interventions to improve wellbeing of PLWH.


Author(s):  
Marcin Rzeszutek ◽  
Ewa Gruszczyńska

AbstractThe aim of this study was to examine the heterogeneity of change of posttraumatic growth (PTG) among people living with HIV (PLWH) in a 1-year prospective study. The goal was also to identify sociodemographic and clinical covariates and differences in baseline coping strategies. Particularly, time since diagnosis and positive reframing coping were of special interest. The sample consisted of 115 people with medically confirmed diagnosis of HIV infection. The participants filled out paper-and-pencil questionnaires three times with an interval of 6 months, including also sociodemographic and clinical data. Four trajectories of PTG were identified: curvilinear, low stable, high stable, and rapid change. Participants’ gender, education level, CD4 count and time since HIV diagnosis occurred to be significant covariates of class membership. Positive reframing and self-distraction differentiated only between the high stable and the rapid change trajectory, with lower values in the latter. The study results call for attention to the complexity of PTG patterns in a face of struggling with HIV infection. Specifically, interventions in clinical practice should take into account the fact that there is no single pattern of PTG that fits all PLWH and that these differences may be related to the sociodemographic and clinical characteristics as well as to coping strategies representing meaning-making mechanism.


2019 ◽  
Author(s):  
Gadiel Rafael Alvarado ◽  
Courtney Usry ◽  
Rosco Gore ◽  
James Watts ◽  
Jason Okulicz

Abstract Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. The pathogenicity of HIV induced cardiotoxicity has been described however the time to development of echocardiographic abnormalities after HIV acquisition remains unclear. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection. Results Patients (n=50) were predominantly male (96%), mostly black (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/uL; 2 patients were diagnosed with AIDS. All were found to have normal systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and cardiac remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p >0.05 for all). This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.


Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 195 ◽  
Author(s):  
Rebecca Guy ◽  
Megan S. C. Lim ◽  
Yung-Hsuan J. Wang ◽  
Nicholas Medland ◽  
Jonathan Anderson ◽  
...  

Objectives: To establish a new mechanism for monitoring patterns of HIV infection, in the context of a sustained increase in HIV diagnosis among men who have sex with men (MSM) in Victoria. Methods: Between April 2004 and August 2005, a linked voluntary HIV sentinel surveillance system was implemented at five medical clinics with a high case load of MSM. Using a questionnaire, doctors collected HIV testing history, demographic and sexual risk behaviour information from all clients undergoing voluntary HIV testing. Questionnaires were linked with HIV test results. Logistic regression analysis was conducted to determine factors associated with HIV infection. Results: Of 3435 MSM tested for HIV at participating sites, 1.7%, (95% CI = 1.2–2.2) were newly diagnosed with HIV; between 2004 and 2005 the proportion increased from 1.3% (95% CI = 1.2–1.5) to 2.0% (95% CI = 1.8–2.2), P = 0.107. There was no significant change in the number of HIV tests conducted per month or in demographic characteristics, testing history and sexual behaviour characteristics between time periods. In multivariate analysis, reporting unprotected anal intercourse (UAI) with any partner, UAI with a HIV-positive partner/s and being aged 30–39 years or 40 years or greater were significantly associated with HIV infection. Conclusion: This new surveillance mechanism, based on linked testing at participating clinics, indicates that the increase in HIV notifications in 2005 was unrelated to changes in testing and data from a Melbourne sexual behavioural survey suggests the increase was more likely to be attributed to increases in transmission within the past few years. The sentinel system highlighted UAI, especially with HIV positive partner/s are important transmission factors.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
N. Bhaskaran ◽  
E. Schneider ◽  
F. Faddoul ◽  
A. Paes da Silva ◽  
R. Asaad ◽  
...  

AbstractResidual systemic inflammation and mucosal immune dysfunction persist in people living with HIV, despite treatment with combined anti-retroviral therapy, but the underlying immune mechanisms are poorly understood. Here we report that the altered immune landscape of the oral mucosa of HIV-positive patients on therapy involves increased TLR and inflammasome signaling, localized CD4+ T cell hyperactivation, and, counterintuitively, enrichment of FOXP3+ T cells. HIV infection of oral tonsil cultures in vitro causes an increase in FOXP3+ T cells expressing PD-1, IFN-γ, Amphiregulin and IL-10. These cells persist even in the presence of anti-retroviral drugs, and further expand when stimulated by TLR2 ligands and IL-1β. Mechanistically, IL-1β upregulates PD-1 expression via AKT signaling, and PD-1 stabilizes FOXP3 and Amphiregulin through a mechanism involving asparaginyl endopeptidase, resulting in FOXP3+ cells that are incapable of suppressing CD4+ T cells in vitro. The FOXP3+ T cells that are abundant in HIV-positive patients are phenotypically similar to the in vitro cultured, HIV-responsive FOXP3+ T cells, and their presence strongly correlates with CD4+ T cell hyper-activation. This suggests that FOXP3+ T cell dysregulation might play a role in the mucosal immune dysfunction of HIV patients on therapy.


2021 ◽  
Vol 20 (5) ◽  
pp. 79-88
Author(s):  
E. A. Bazykina ◽  
V. B. Turkutukov ◽  
O. E. Trotsenko ◽  
V. O. Kotova ◽  
L. A. Balakhontseva

Relevance. Monitoring the genotypic diversity of the hepatitis C virus as well as its prevalence in the population, including in certain population groups, is an important public health task.Aim. To analyze main epidemiological indices (incidence and prevalence) among people living with HIV and evaluate abundance of chronic hepatitis C among them, reveal molecular-genetic distribution of hepatitis C virus (HCV) isolated from HIV-positive people living in the Far Eastern Federal district (FEFD) of the Russian Federation.Materials and methods: a retrospective epidemiological analysis including estimation of HIV-infection incidence and prevalence as well as percent of HIV-positive people suffering from chronic viral hepatitis C was conducted for nine constituent entities of the FEFD. Molecular genetic analysis included evaluation of 120 samples of serum positive for HCV RNA that was obtained from people diagnosed with HIV-infection. A type-specific commercial PCR test-kit as well as partial sequencing by Sanger of HCV NS5B gene (241 bp and 350 bp) were utilized in order to specify HCV genotypes.Results and discussion: in total 26.26% of people living with HIV were registered for regular medical examination due to chronic hepatitis C in the FEFD in year 2019. Their percentage has grown over a 5-year period. Dominant HCV subtype among surveyed HIV-positive people was subtype 3a followed by HCV subtype 1b. HCV genotype 2 and subtype 1a were detected less frequently and were identified as minor genotypes. Genotype distribution among people aged under 35 years was more significant in comparison with older citizens. Some regional particularities were discovered. For example, HCV genotype 2 was registered more frequently in the Khabarovsk krai compared to mean estimated value of the sampling collection. Subtype 1b was dominant in Republic Sakha (Yakutia).Conclusion: an increase in percent of HIVinfected people suffering from chronic hepatitis C has been noted during a 5-year period. Should be noted that the value varies in different constituent entities ofthe FEFD. Molecular-genetic analysis showed general prevalence of HCV 3a subtype while 1b HCV subtype is dominant in the Russian Federation in patients suffering from HCV-monoinfection as well as in those infected with HIV and HCV.


2015 ◽  
Vol 20 (46) ◽  
Author(s):  
Annabel Desgrées-du-Loû ◽  
Julie Pannetier ◽  
Andrainolo Ravalihasy ◽  
Anne Gosselin ◽  
Virginie Supervie ◽  
...  

We estimated the proportion of migrants from sub-Saharan Africa who acquired human immunodeficiency virus (HIV) while living in France. Life-event and clinical information was collected in 2012 and 2013 from a random sample of HIV-infected outpatients born in sub-Saharan Africa and living in the Paris region. We assumed HIV infection in France if at least one of the following was fulfilled: (i) HIV diagnosis at least 11 years after arrival in France, (ii) at least one negative HIV test in France, (iii) sexual debut after arrival in France. Otherwise, time of HIV infection was based on statistical modelling of first CD4+ T-cell count; infection in France was assumed if more than 50% (median scenario) or more than 95% (conservative scenario) of modelled infection times occurred after migration. We estimated that 49% of 898 HIV-infected adults born in sub-Saharan Africa (95% confidence interval (CI): 45–53) in the median and 35% (95% CI: 31–39) in the conservative scenario acquired HIV while living in France. This proportion was higher in men than women (44% (95% CI: 37–51) vs 30% (95% CI: 25–35); conservative scenario) and increased with length of stay in France. These high proportions highlight the need for improved HIV policies targeting migrants.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259708
Author(s):  
Gallican N. Rwibasira ◽  
Samuel S. Malamba ◽  
Gentille Musengimana ◽  
Richard C. M. Nkunda ◽  
Jared Omolo ◽  
...  

Background Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency testing is primarily for surveillance, monitoring, and evaluation but it’s not for diagnostic purposes. However, it’s important to know what proportion of the newly diagnosed are recent infections so that HIV prevention can be tailored to the profile of people who are recently infected. We therefore used available national data to characterize individuals with recent HIV infection in Rwanda to inform the epidemic response. Methods We included all national-level data for recency testing reported from October 2018 to June 2020. Eligible participants were adults (aged ≥15 years) who had a new HIV diagnosis, who self-reported being antiretroviral therapy (ART) naïve, and who had consented to recency testing. Numbers and proportions of recent HIV infections were estimated, and precision around these estimates was calculated with 95% confidence intervals (CI). Logistic regression was used to assess factors associated with being recently (within 12 months) infected with HIV. Results Of 7,785 eligible individuals with a new HIV-positive diagnosis, 475 (6.1%) met the criteria for RITA recent infection. The proportion of RITA recent infections among individuals with newly identified HIV was high among those aged 15–24 years (9.6%) and in men aged ≥65 years (10.3%) compared to other age groups; and were higher among women (6.7%) than men (5.1%). Of all recent cases, 68.8% were women, and 72.2% were aged 15–34 years. The Northern province had the fewest individuals with newly diagnosed HIV but had the highest proportion of recent infections (10.0%) compared to other provinces. Recent infections decreased by 19.6% per unit change in time (measured in months). Patients aged ≥25 years were less likely to have recent infection than those aged 15–24 years with those aged 35–49 years being the least likely to have recent infection compared to those aged 15–24 years (adjusted odds ratio [aOR], 0.415 [95% CI: 0.316–0.544]). Conclusion Public health surveillance targeting the areas and the identified groups with high risk of recent infection could help improve outcomes.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
Yinan Zheng ◽  
Jonah Musa ◽  
Brian Thomas Joyce ◽  
Jun Wang ◽  
Demirkan Gursel ◽  
...  

e17513 Background: Nigeria faces a high health burden of cervical cancer (CC), which is worsened by high prevalence of human immunodeficiency virus (HIV) infection. Repetitive elements (RE) are DNA sequences that occur in multiple copies throughout the human genome. HIV infection can lead to RE hypomethylation that causes genome instability, an event often seen in the early phase of tumorigenesis. We aim to examine global RE hypomethylation as a novel epigenetic biomarker for CC among HIV-positive women in Nigeria. Methods: This study involved three groups of women: a) HIV-positive with CC (n=39); b) HIV-positive and cancer-free (n=52); and c) HIV-negative with CC (n=23). We estimated three types of global RE methylation in cervical tissue using genome-wide methylation data: long interspersed nuclear elements (LINE-1), Alu, and human endogenous retrovirus (HERV). We used multiple linear regression adjusting for age, education, parity, employment, cancer stage, body mass index, and sample batch to compare the biomarkers across the HIV/ICC groups and paired t-test to compare 26 pairs of tumor vs. surrounding normal tissues, stratified by HIV status. Receiver operating characteristic curve (ROC) and area under the ROC (AUC) were used to examine the diagnostic value. Results: Among HIV-positive women, all 3 global RE methylation biomarkers were hypomethylated in CC compared to cancer-free (LINE-1: mean difference [MD]=-0.049, p-value=2.9e-8; Alu: MD=-0.011, p-value=2.0e-4; HERV: MD=-0.013, p-value=1.7e-6). Paired analyses showed a larger, more significant MD in HIV-positive stratum than HIV-negative, especially LINE-1 (MD=-0.048 vs. -0.020, p-value=0.004 vs. 0.254). LINE-1 achieved the highest AUC (0.85, 95% CI: 0.76-0.95) in distinguishing tumor tissue from normal tissue among HIV-positive women, followed by HERV (0.82, 95% CI: 0.73-0.92) and Alu (0.60, 95% CI: 0.47-0.72). Conclusions: Global LINE-1 hypomethylation may serve as a novel biomarker for CC screening and early detection for women living with HIV in low- and middle-income countries.


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