scholarly journals Exploring the Factors Considered by People Living with HIV and Their Partners during Preconception

2016 ◽  
Vol 16 (3) ◽  
pp. 239-246 ◽  
Author(s):  
V. Logan Kennedy ◽  
Micaela Collins ◽  
Mark H. Yudin ◽  
Lena Serghides ◽  
Sharon Walmsley ◽  
...  
Keyword(s):  
Logit Model ◽  
Hiv Transmission ◽  
Horizontal Transmission ◽  
People Living With Hiv ◽  
Relative Importance ◽  
Hiv Status ◽  
Ordered Logit Model ◽  
Living With Hiv ◽  
Shed Light ◽  
Hiv Negative

Data are lacking on factors that may impact conception-related decision-making among individuals living with HIV. This study’s aim was to shed light on these considerations. Participants were invited to complete a survey on preconception considerations. A rank-ordered logit model was fit to estimate the relative importance of listed consideration factors; the interaction of HIV status and the factors was assessed. Fifty-nine participants living with HIV and 18 partners (11 HIV-negative participants and 7 living with HIV) were included. Risk of vertical and horizontal HIV transmission and the effect of antiretroviral therapy on the fetus were the top considerations. However, individuals living with HIV prioritized vertical transmission, whereas HIV-negative participants prioritized horizontal transmission. Other factors of importance were probability of conception, stress of trying to conceive, cost associated with fertility clinics, and stigma associated with certain conception methods. This study builds our understanding of the preconception considerations for people living with HIV.

scholarly journals Couples Living with HIV

2016 ◽  
Vol 16 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Violeta J. Rodriguez ◽  
Andrew Spence ◽  
Mallory Monda ◽  
JoNell Potter ◽  
Deborah Jones
Keyword(s):  
Perceived Risk ◽  
Hiv Transmission ◽  
Horizontal Transmission ◽  
Hiv Status ◽  
Safer Conception ◽  
Reproductive Intentions ◽  
Hiv Prevention Strategies ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Men’S Involvement

Background: Desires to have children are not lessened by a woman’s HIV status. Couples may lack information to conceive safely, and men may be especially uninformed. This study examined reproductive intentions, practices, and attitudes among men in HIV-infected couples, including attitudes regarding the perceived risk of vertical and horizontal transmission, safer conception, and preconception planning. Methods: Men ( n = 12) in HIV-infected couples were interviewed regarding reproductive intentions, attitudes, and knowledge and qualitative assessments were coded for dominant themes. Results: Themes primarily addressed concerns about the health of the baby, men’s involvement in pregnancy, safer conception, concerns about HIV transmission and antiretroviral therapy, and HIV infection. Men lacked information on safer conception and newer HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Discussion: Gaps in knowledge regarding preconception practices among men in HIV-infected couples were identified. Results highlight men’s desire for involvement in preconception planning, and opportunities for providers to facilitate this practice and to increase patient education and the use of PrEP are discussed.

scholarly journals 1281. Awareness of U=U Among Gay and Bisexual Men Who Have Sex with Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S461-S461
Author(s):  
Meredith E Clement ◽  
Rick Zimmerman ◽  
Josh Grimm ◽  
Joseph Schwartz
Keyword(s):  
Hiv Transmission ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Hiv Status ◽  
Anal Sex ◽  
And Bisexual ◽  
Sex With Men ◽  
Living With Hiv ◽  
Hiv Negative ◽  
Strong Agreement

Abstract Background The “Undetectable = Untransmittable” (“U=U”) campaign is gaining traction, but prior studies from 2012–2017 have shown that the proportion of gay and bisexual men who have sex with men (GBMSM) who are aware of or have perceived accuracy of U=U is low. We report findings from a survey administered to GBMSM in 2018 to understand whether the landscape is changing with respect to U=U message dissemination. Methods GBMSM were recruited on gay dating apps to complete a 96 question survey. Survey data were collected in April-August of 2018. Collected data elements included demographic information, HIV status, ART and PrEP use, and beliefs and opinions regarding HIV transmission. Results 969 GBMSM completed the survey; of whom, 678 had analyzable data (241 had never had anal sex with a man and 54 were missing ≥1 of the variables used in the analysis). Average age was 43 years, 65% were white, 15% black, 15% white, and 15% were HIV-infected (of whom 92% were on anti-retrovirals). Of the 85% who were HIV-uninfected, 39% were on PrEP. In response to the statement that a person with an undetectable viral load cannot transmit HIV to an HIV-uninfected person, 24% strongly agreed. Among HIV-negative GBMSM, 33% of those on PrEP agreed and 12% of those not on PrEP agreed. Among those living with HIV, 42% agreed. A multivariable logistic regression was run to explain correlates of strong agreement with U=U, using the following variables: age, education, being Black, being Hispanic, relationship status, number of lifetime male sexual partners, condom use with most recent anal sex, HIV status, PrEP use, and attitudes about living with HIV. Variables associated with strong agreement with U=U were living with HIV (AOR = 1.63, P < 0.001), taking PrEP (AOR = 2.85, P < 0.001), most recent encounter’s condom use (AOR = 2.22, P = 0.003), and having positive attitudes about living with HIV (AOR= 1.93, P < 0.001). Table 1 shows percentages for each of these variables (bivariate relationships) strongly agreeing with U=U. Conclusion Now that U=U has been scientifically proven, the challenge is public awareness. U=U awareness seems to be improving among GBMSM, with HIV-negative GBMSM making the greatest strides. Education around U=U and PrEP efficacy may help reduce guilt around HIV transmission and alleviate HIV stigma. Disclosures All authors: No reported disclosures.

scholarly journals HIV Status and Contraceptive Utilization among Women in Cameroon

2019 ◽  
Vol 18 ◽  
pp. 232595821982659 ◽  
Author(s):  
Henna Budhwani ◽  
Kristine Ria Hearld ◽  
Jodie Dionne-Odom ◽  
Simon Manga ◽  
Kathleen Nulah ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Hiv Transmission ◽  
Multivariate Analyses ◽  
Hiv Status ◽  
Improve Population Health ◽  
Women Living With Hiv ◽  
Contraceptive Utilization ◽  
Living With Hiv ◽  
Mother To Child ◽  
Hiv Negative

Objective: We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers. Methods: Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.1%) and uninfected women. Multivariate analyses examined associates of contraceptive utilization and desire to become pregnant. Results: Contraceptive utilization was associated with higher education, living with HIV, monogamy, and higher parity ( P < .001). Women living with HIV had 66% higher odds of using contraceptives than their negative peers (odds ratio [OR]: 1.66, confidence interval [CI]: 1.45-1.91, P < .001). Polygamous women had 37% lower odds of using contraceptives compared to monogamous women (OR: 0.63, 95% CI: 0.52-0.75, P < .001). Conclusion: Increasing contraceptive utilization in resource-constrained settings should be a priority for clinicians and researchers. Doing so could improve population health by reducing HIV transmission between partners and from mother to child.

Sexual function and dysfunction in older HIV-positive individuals

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 502 ◽  
Author(s):  
Darren B. Russell
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Functioning ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Organ Systems ◽  
The World ◽  
Risk Of Disease ◽  
Living With Hiv ◽  
Hiv Negative

With many parts of the world seeing an aging cohort of people living with HIV (PLHIV), it is becoming clear that some organ systems in these individuals are at a greater risk of disease. There are effects on sexual functioning in aging PLHIV, with many studies finding higher levels of sexual dysfunction in HIV-positive individuals compared with those who are HIV-negative. HIV itself, along with antiretroviral agents, may cause dysfunction. Treatment involves making an assessment of the dysfunction and using the usual methods available, although treatment may be complicated by hormonal deficiencies in HIV-positive individuals, along with the effects of antiretroviral therapy, and drug interactions involving such medications. Furthermore, the issue of HIV transmission needs to be addressed in those seeking treatment for sexual dysfunction.

scholarly journals Law, criminalisation and HIV in the world: have countries that criminalise achieved more or less successful pandemic response?

2021 ◽  
Vol 6 (8) ◽  
pp. e006315
Author(s):  
Matthew M Kavanagh ◽  
Schadrac C Agbla ◽  
Marissa Joy ◽  
Kashish Aneja ◽  
Mara Pillinger ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Transmission ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Gender Based Violence ◽  
Hiv Virus ◽  
The World ◽  
Gender Based ◽  
And Gender ◽  
Living With Hiv

How do choices in criminal law and rights protections affect disease-fighting efforts? This long-standing question facing governments around the world is acute in the context of pandemics like HIV and COVID-19. The Global AIDS Strategy of the last 5 years sought to prevent mortality and HIV transmission in part through ensuring people living with HIV (PLHIV) knew their HIV status and could suppress the HIV virus through antiretroviral treatment. This article presents a cross-national ecological analysis of the relative success of national AIDS responses under this strategy, where laws were characterised by more or less criminalisation and with varying rights protections. In countries where same-sex sexual acts were criminalised, the portion of PLHIV who knew their HIV status was 11% lower and viral suppression levels 8% lower. Sex work criminalisation was associated with 10% lower knowledge of status and 6% lower viral suppression. Drug use criminalisation was associated with 14% lower levels of both. Criminalising all three of these areas was associated with approximately 18%–24% worse outcomes. Meanwhile, national laws on non-discrimination, independent human rights institutions and gender-based violence were associated with significantly higher knowledge of HIV status and higher viral suppression among PLHIV. Since most countries did not achieve 2020 HIV goals, this ecological evidence suggests that law reform may be an important tool in speeding momentum to halt the pandemic.

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

2014 ◽  
Vol 9 (2) ◽  
pp. 139-149 ◽  
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.

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

Curationis ◽  
2015 ◽  
Vol 38 (1) ◽  
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.

scholarly journals Refused and referred-persistent stigma and discrimination against people living with HIV/AIDS in Bihar: a qualitative study from India

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033790 ◽  
Author(s):  
Mohit Nair ◽  
Pragya Kumar ◽  
Sanjay Pandey ◽  
Amit Harshana ◽  
Shahwar Kazmi ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Transmission ◽  
Healthcare Providers ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Community Members ◽  
Universal Precautions ◽  
Stigma And Discrimination ◽  
Living With Hiv ◽  
Hiv Aids

ObjectivesThis study aimed to explore barriers to accessing care, if any, among people living with HIV/AIDS (PLHA) in two districts of Bihar. We also aimed to assess attitudes towards PLHA among healthcare providers and community members.DesignThis qualitative study used an exploratory study design through thematic analysis of semistructured, in-depth interviews.SettingTwo districts were purposively selected for the study, namely the capital Patna and a peripheral district located approximately 100 km from Patna, in order to glean insights from a diverse sample of respondents.ParticipantsOur team purposively selected 71 participants, including 35 PLHA, 10 community members and 26 healthcare providers.ResultsThe overarching theme that evolved from these data through thematic coding identified that enacted stigma and discrimination interfere with each step in the HIV care continuum for PLHA in Bihar, India, especially outside urban areas. The five themes that contributed to these results include: perception of HIV as a dirty illness at the community level; non-consensual disclosure of HIV status; reliance on identifying PLHA to guide procedures and resistance to universal precautions; refusal to treat identified PLHA and referrals to other health centres for treatment; and inadequate knowledge and fear among health providers with respect to HIV transmission.ConclusionsThe continued presence of discriminatory and stigmatising attitudes towards PLHA negatively impacts both disclosure of HIV status as well as access to care and treatment. We recognise a pressing need to improve the knowledge of HIV transmission, and implement universal precautions across all health facilities in the state, not just to reduce stigma and discrimination but also to ensure proper infection control. In order to improve treatment adherence and encourage optimal utilisation of services, it is imperative that the health system invest more in stigma reduction in Bihar and move beyond more ineffective, punitive approaches.

The relationship between negative responses to HIV status disclosure and psychosocial outcomes among people living with HIV

2017 ◽  
Vol 25 (4) ◽  
pp. 538-544 ◽  
Author(s):  
Elena Cama ◽  
Loren Brener ◽  
Sean Slavin ◽  
John de Wit
Keyword(s):  
People Living With Hiv ◽  
Health Providers ◽  
Hiv Status ◽  
Health Satisfaction ◽  
Related Stigma ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure ◽  
The Relationship ◽  
Shed Light

This report examines rates of HIV status disclosure and negative responses to disclosure among people living with HIV in Australia. Among 697 people living with HIV, most (>90%) had disclosed their status to friends, sexual partners and health providers. Almost a third had not disclosed to family, and half had not told any work colleagues. Negative responses to disclosure (e.g. blame, rejection) by all groups were associated with increased HIV-related stigma, psychological distress and diminished social support and health satisfaction. These results shed light on rates of disclosure among people living with HIV in Australia and the adverse health impacts of negative responses to disclosure.

scholarly journals 658. Effect of HIV Status on Tuberculosis Load as Detected by Xpert MTB/RIF in Sputum vs. Saliva Samples

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S385-S386
Author(s):  
Zoe C Burger ◽  
Si Thu Aung ◽  
Hlaing Thazin Aung ◽  
Timothy Rodwell ◽  
Marva Seifert
Keyword(s):  
Bacterial Load ◽  
Molecular Diagnostic ◽  
Clinical Samples ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sample Type ◽  
Hiv Status ◽  
Specimen Type ◽  
Living With Hiv ◽  
Hiv Negative

Abstract Background Tuberculosis (TB) is the most common co-infection among people living with HIV, but HIV positivity is associated with a lower Mycobacterium tuberculosis (MTB) bacillary load in sputum, making TB often difficult to diagnose with current diagnostic solutions. GeneXpert MTB/RIF (Cepheid, USA), a rapid, molecular diagnostic assay, has transformed the TB diagnostic landscape and can be used to diagnose TB and limited drug resistance in HIV patients from direct clinical samples in &lt; 2 hours, but results can be significantly affected by sample bacterial load, which is quantified by the GeneXpert MTB/RIF (Xpert) instrument using Ct values. Our primary objective was to assess how a patient’s HIV status affected their MTB bacterial load in sputum vs. saliva samples submitted for Xpert diagnosis of TB. Methods We completed a retrospective analysis of &gt;4,000 patient records from the Myanmar National TB Program captured as part of a nation-wide electronic reporting system developed with the assistance of FIND (Geneva). De-identified records included HIV status, Xpert testing results, and for a subset of patients, specimen type. With this diagnostic information, we compared the distribution of MTB load (quantified by Xpert Ct values) in sputum and saliva in HIV positive vs. HIV negative patients using STATA. Results Based on mean Ct value comparison independent of HIV status, saliva samples (mean Ct = 22.7) contained a significantly lower bacterial load of MTB as compared to sputum samples (mean Ct=19.2, p &lt; .001).Within saliva samples, a lower bacterial load was also detected in HIV positive patients (mean Ct = 26.9) compared to HIV negative patients (mean Ct = 22.3, p&lt; .05). Similarly, in sputum samples, a lower bacterial load was detected in HIV positive patients (mean Ct = 21.6) compared to HIV negative patients (mean Ct = 19.0, p &lt; .001) (Figure 1). Figure 1. Ct Values by HIV Status and Specimen Type Conclusion Sputum samples have a significantly higher bacterial load on average compared to saliva samples independent of HIV status. Additionally, when looking at both saliva and sputum as sample types, HIV positive patients have significantly lower bacterial load than individuals who are HIV negative. Based on these results, sputum is the optimal sample type for Xpert TB detection, especially in people living with HIV. Disclosures All Authors: No reported disclosures

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