Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda

2012 ◽  
Vol 24 (2) ◽  
Author(s):  
Faisal M.B. Shuaib ◽  
John E. Ehiri ◽  
Pauline Jolly ◽  
Qionghui Zhang ◽  
Donath Emusu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Violence ◽  
Partner Violence ◽  
Sexual Debut ◽  
Hiv Positive ◽  
Sexual Intimacy ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Hiv Serostatus ◽  
Hiv Negative

Abstract HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in negative concordant unions. Multivariable logistic regression was used to assess the association between participants’ serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1±11.1 years, range: 19–65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2±9.0 years, range: 18–56 years), or HIV negative women in concordant relationships (32.3±11.0 years, range: 18–62), (p=0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95% CI 1.27–4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples’ HIV serostatus was not significant related to incident sexual violence after controlling for potential confounding covariates. Nevertheless, the results were able to elucidate the sexual violence risk factor profile of participants based on couples’ HIV serostatus. Couple counseling protocols at HIV voluntary counseling and testing centers in Uganda should identify those at risk for sexual violence and develop interventions to reduce its incidence.

HPV types, cervical high-grade lesions and risk factors for oncogenic human papillomavirus infection among 3416 Tanzanian women

2020 ◽  
pp. sextrans-2019-054263 ◽  
Author(s):  
Bariki Lawrence Mchome ◽  
Susanne Krüger Kjaer ◽  
Rachel Manongi ◽  
Patricia Swai ◽  
Marianne Waldstroem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Papillomavirus ◽  
Quadrivalent Vaccine ◽  
Hiv Positive ◽  
High Grade ◽  
Factors Associated ◽  
Hpv Prevalence ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Hiv Negative

ObjectiveThe objective of the present study was to assess the prevalence and type-specific distribution of cervical high-risk (HR) human papillomavirus (HPV) among women with normal and abnormal cytology, and to describe risk factors for HR HPV among HIV-positive and HIV-negative women in Tanzania.MethodologyA cross-sectional study was conducted in existing cervical cancer screening clinics in Kilimanjaro and Dar es Salaam. Cervical specimens were obtained from women aged 25–60 years. Samples were shipped to Denmark for cytological examination, and to Germany for HR HPV testing (using Hybrid Capture 2) and genotyping (using LiPaExtra). Risk factors associated with HPV were assessed by multivariable logistic regression analysis.ResultAltogether, 4080 women were recruited with 3416 women contributing data for the present paper, including 609 HIV-positive women and 2807 HIV-negative women. The overall HR HPV prevalence was 18.9%, whereas the HR HPV prevalence in women with high-grade squamous intraepithelial lesions (HSILs) was 92.7%. Among HPV-positive women with HSIL, HPV16 (32.5%) and HPV58 (19.3%) were the the most common types followed by HPV18 (16.7%) and HPV52 (16.7%). Factors associated with HR HPV included younger age, increasing number of partners and early age at first intercourse. Similar risk factors were found among HIV-positive and HIV-negative women. In addition, among HIV-positive women, those with CD4 counts <200 cells/mm3 had an increased risk of HR HPV (OR 2.2; 95% CI 1.2 to 4.8) compared with individuals with CD4 count ≥500 cells/mm3.ConclusionGiven the HPV distribution among Tanzanian women, the current HPV vaccination in Tanzania using quadrivalent vaccine may be considered replaced by the nonavalent vaccine in the future. In addition, appropriate antiretroviral treatment management including monitoring of viremia may decrease the burden of HR HPV in HIV-positive women.

scholarly journals Should the management of high grade cervical squamous intraepithelial lesion (HSIL) be different in HIV-positive women?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Christine Gilles ◽  
Maude Velghe-lenelle ◽  
Yannick Manigart ◽  
Déborah Konopnicki ◽  
Serge Rozenberg
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Treatment Failure ◽  
Hiv Positive ◽  
High Grade ◽  
Ablative Therapy ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Risk Of Treatment ◽  
Hiv Negative

Abstract Background This study compares the management and outcome of high grade squamous intraepithelial lesions (HSIL) in HIV-positive and -negative women and identifies risk factors for treatment failure. Methods This retrospective, controlled study includes 146 HIV-positive women, matched for HSIL, age and year of diagnosis, with 146 HIV-negative women. Differences were analysed using parametric and non-parametric tests and Kaplan–Meier survival curves. A binary logistic regression was used to assess risk factors for treatment failure. Results Persistence of cervical disease was observed most frequently in HIV-positive women (42 versus 17%) (p  <  0.001) and the cone biopsy margins were more often invaded in HIV-positive-women than in HIV-negative ones. (37 versus 16%; p  <  0.05). HIV-positive women, with successful cervical treatment had better HIV disease control: with significantly longer periods of undetectable HIV viral loads (VL) (19 versus 5 months; p  <  0.001) and higher CD4 counts (491 versus 320 cells/mm3; p  <  0.001). HIV-positive women with detectable VL at the time of dysplasia had 3.5 times (95% IC: 1.5–8.3) increased risk of treatment failure. Being treated through ablative therapy was associated with a 7.4, four-fold (95% IC: 3.2–17.3) increased risk of treatment failure compared to conization Conclusion HIV-positive women have a higher risk of treatment failure of HSIL than do HIV-negative women, especially when ablative therapy is used and in women with poor control of their HIV infection. The management and the follow- up of HSIL’s guidelines in this high-risk population should be adapted consequently: for HIV-positive women with uncontrolled viral load, excisional treatment should be the preferred therapy, whereas for women with undetectable viral load, CD4  +  lymphocytes higher than 500 cells/mm3 and with a desire of pregnancy, ablative therapy may be considered.

Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

2020 ◽  
pp. 152483802090656 ◽  
Author(s):  
Eric Y. Tenkorang ◽  
Michael Asamoah-Boaheng ◽  
Adobea Y. Owusu
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Sub Saharan

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.

scholarly journals Clinical and Mental Health Correlates and Risk Factors for Intimate Partner Violence among HIV-Positive Women in an Inner-City HIV Clinic

2012 ◽  
Vol 22 (6) ◽  
pp. e563-e569 ◽  
Author(s):  
Samantha Illangasekare ◽  
Monique Tello ◽  
Heidi Hutton ◽  
Richard Moore ◽  
Jean Anderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Intimate Partner Violence ◽  
Inner City ◽  
Partner Violence ◽  
Intimate Partner ◽  
Hiv Positive ◽  
Hiv Positive Women

scholarly journals Human papillomavirus prevalence and risk factors among HIV-negative and HIV-positive women residing in rural Eastern Cape, South Africa

2020 ◽  
Vol 95 ◽  
pp. 176-182 ◽  
Author(s):  
Ongeziwe Taku ◽  
Charles B. Businge ◽  
Mana L. Mdaka ◽  
Keletso Phohlo ◽  
Wisdom Basera ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Human Papillomavirus ◽  
Hiv Positive ◽  
Eastern Cape ◽  
Hiv Positive Women ◽  
Hiv Negative

scholarly journals Cardiovascular Diseases Associated Inflammatory Biomarker Levels in a Small Cohort of HIV-1 Infected Patients Deintensificated from Abacavir/Lamivudine/ Dolutegravir to Lamivudine Plus Dolutegravir Running Head: Risk of Cardiovascular Diseases and Abacavir Use

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Be G ◽  
◽  
Lattuada E ◽  
Gibellini D ◽  
Diani E ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Hiv Infection ◽  
Hiv Positive ◽  
Biological Mechanism ◽  
Cvd Risk ◽  
Increased Risk ◽  
Small Cohort ◽  
Hiv 1 ◽  
Hiv Negative

Following the successful introduction of combined Antiretroviral Therapy (cART), a dramatic decrease in viral burden and opportunistic infections along with a consistent increase in life expectancy has been observed in Human Immunodeficiency Virus (HIV) infected patients [1]. This deep change in the HIV disease evolution has determined that HIV positive subjects were effectively monitored for several alterations of many tissue and organs due to HIV chronic disease and antiretroviral treatment for example, cardiovascular system, bone, adipose tissues, kidney and central nervous system represent the major target of these structural and functional damages during HIV infection. In particular, Cardiovascular Diseases (CVD) were considered important clinical complications in the HIV patient and represent a leading cause of death among HIV-positive patients, accounting for approximately 11% of the total deaths in this population [2]; the risk of CVD is higher in HIV positive individuals compared with HIV negative people, and particularly the reported Myocardial Infarction (MI) incidence in cohort study ranges from 3 to 11 cases per 1000 patients a year in HIV- positive individuals against 2 to 7 cases per 1000 patients-years in HIV-negative population [3,4]. Although initial studies indicated a higher prevalence of traditional CVD risk factors in HIV infected population [5,6] as a possible cause, the molecular mechanisms of increased CVD risk in HIV still remain incompletely defined and should be probably attributable to a combination of multiple factors, including both direct and indirect effects of HIV infection on metabolism. Evidence from experimental and observational studies [7,8] in recent years suggested a more important role of HIV itself in contributing to CVD. Endothelial dysfunction due to gp120, Tat and Nef proteins have been identified as a critical link between infection, inflammation, immune activation, atherosclerosis and cardiovascular system. Moreover, ART may play a role in the exacerbation of risk factors for CVD [9]; since the presentation of findings from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study in 2008 demonstrating a 90% increased risk of MI in HIV- positive individuals receiving ART regimens including Abacavir (ABC), subsequent studies, conducted by FDA [10], GlaxoSmithKline [11] and independent researchers [12], to investigate this risk have yielded conflicting results. Although more recent studies have shown an effective increased risk of CVD associated with use of ABC, many results did not reach statistical significance [13-17]. The absence of a demonstrated underlying biological mechanism for such a risk added interest and confusion about the question, as well as the higher prevalence of risk factors for CVD, such as renal impairment and substance abuse among abacavir recipients; in addition, a recent meta analysis suggests that Relative Risk (RR) for MI is increased within a 6 months exposure to ABC (RR=1.61; 95% confidence interval: 1.48–1.75) and in cART-naive population [18]. While the published evidence remains conflicting and a plausible biological mechanism for this potential association has not yet been identified, in the following study we have tried to verify whether, after introduction of ABC and its discontinuation in the contest of HAART deintensification, common metabolic markers CVD related such as glucose, LDL, HDL, total cholesterol and triglycerides and inflammatory biomarkers such as IL-6 and D-dimer could change in a small cohort of HIV-1 infected patients.

scholarly journals Homocysteine Levels in Patients with Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome in Ibadan

2020 ◽  
Vol 7 (02) ◽  
pp. 4739-4745
Author(s):  
TOLULASE OLUTOGUN ◽  
FOLUKE FASOLA ◽  
Kehinde Olufemi-Aworinde ◽  
YETUNDE AKEN'OVA
Keyword(s):  
Risk Factors ◽  
Full Blood Count ◽  
Hiv Positive ◽  
Control Group ◽  
College Hospital ◽  
Cell Counts ◽  
Increased Risk ◽  
Objective Evidence ◽  
Cd4 Cell ◽  
Hiv Negative

Introduction: Homocysteine is produced from the conversion of methionine to cysteine. Conditions resulting in hyper homocysteinemia leads to an increased risk of both arterial and venous thromboembolisms by about 2 fold. 20% of HIV infected patients with objective evidence of venous thromboembolism are found to be thrombophilic with higher homocysteine levels. We enquired into homocysteine levels prior to the development of a clinical evidence of a venous thrombus in both HAART naïve and those on HAART of HIV /AIDS population. We evaluated the association between homocysteine, CD4 lymphocyte count and ART use in order to identify possible risk factors for hyper homocysteinemia in HIV population. Method: Employing a cross sectional design; we compared mean plasma levels of homocysteine, full blood count parameters and CD4+ lymphocytes counts in HIV positive patients and HIV negative controls. One hundred and twenty patients with HIV infection attending the APIN clinic at the University College Hospital Ibadan and St Mary’s Catholic Hospital Eleta Ibadan and one hundred and twenty-six HIV negative healthy controls were compared in the study. Results:  Fifty-nine point one percent of the HIV positive patient had hyperhomocysteinemia i.e. homocysteine levels of >18µmol/l. The mean plasma homocysteine levels were significantly higher at 24.4µmol/l (SD=13.8) (CI -2 to -8; p=0.002) in the HIV positive group compared with 19.5µmol/L (SD=10.6) in the control group.  The use of Anti-retroviral drugs was not associated with higher homocysteine level in the seropositive group and neither were factors like age, gender or the use of combined oral contraceptive pills. There was no correlation between CD4 cell count and homocysteine levels (r= -0.01; p=0.9). Conclusion:  Homocysteine levels are elevated in HIV positive patients and hyperhomocysteinemia was found in a significant number of HIV positive patients. None of the patients investigated had features of thromboembolism or outright deep venous thrombosis. Neither CD4 cell counts nor traditional risk factors were associated with the higher homocysteine levels.

Risk Factors for High-Risk Human Papillomavirus Detection Among HIV-Negative and HIV-Positive Women From Tanzania

2013 ◽  
Vol 40 (9) ◽  
pp. 737-743 ◽  
Author(s):  
Myassa Dartell ◽  
Vibeke Rasch ◽  
Christian Munk ◽  
Crispin Kahesa ◽  
Julius Mwaiselage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Papillomavirus ◽  
High Risk ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Hiv Negative

scholarly journals Risk Factors and Seroprevalence of Hepatitis C among Patients Hospitalized at Mulago Hospital, Uganda

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
J. I. O'Reilly ◽  
P. Ocama ◽  
C. K. Opio ◽  
A. Alfred ◽  
E. Paintsil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Antibody Detection ◽  
Hiv Positive ◽  
Mulago Hospital ◽  
Hcv Rna ◽  
Increased Risk ◽  
Hcv Antibody ◽  
Hiv Negative

The emergence of hepatitis C virus (HCV) and its associated sequelae in Africa is a cause for significant concern. Human immunodeficiency virus (HIV) positive patients are at an increased risk of contracting HCV infection due to similar risk factors and modes of transmission. We investigated the seroprevalence of hepatitis C in hospitalized HIV-positive and HIV-negative patients in Mulago Hospital, an academic hospital in Uganda. Blood samples were first tested for HCV antibodies, and positive tests were confirmed with HCV RNA PCR. We enrolled five hundred patients, half HIV-positive and half HIV negative. Overall, 13/500 patients (2.6%) tested positive for HCV antibodies. There was no difference in HCV antibody detection among HIV-positive and HIV-negative patients. Out of all risk factors examined, only an age greater than 50 years was associated with HCV infection. Traditional risk factors for concurrent HIV and HCV transmission, such as intravenous drug use, were exceedingly rare in Uganda. Only 3 of 13 patients with detectable HCV antibodies were confirmed by HCV RNA detection. This result concurs with recent studies noting poor performance of HCV antibody testing when using African sera. These tests should be validated in the local population before implementation.

scholarly journals Multi-level risk factors associated with sex trading among women living with HIV in Kazakhstan: A neglected key population

2017 ◽  
Vol 28 (14) ◽  
pp. 1397-1404 ◽  
Author(s):  
Alissa Davis ◽  
Tina Jiwatram-Negrón ◽  
Sholpan Primbetova ◽  
Assel Terlikbayeva ◽  
Yelena Bilokon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Intimate Partner ◽  
Hiv Positive ◽  
Sex Trading ◽  
Factors Associated ◽  
The Past ◽  
Hiv Positive Women ◽  
Multi Level

Little is known about the prevalence and risk factors associated with sex trading among HIV-positive women. A total of 242 HIV-positive women were recruited in five regions in Kazakhstan. These women completed a survey containing items on socio-demographics, HIV stigma, intimate partner violence, and partner risk behaviors. Multivariate regression was used to examine associations between risk factors and sex trading after controlling for socio-demographic factors. Fifty-six (23.1%) women reported trading sex in the past 90 days. Women who reported recent sex trading were more likely than women who did not trade sex in the past 90 days to experience intimate partner violence (adjusted odds ratio [AOR]: 2.25; 95% confidence interval [CI]: 1.08–4.73), to have been homeless in the past 90 days (AOR: 4.12; 95% CI: 1.19–14.29), and to know or suspect a male partner had a sexually transmitted infection (AOR: 2.20; 95% CI: 1.07–4.53), had sex with another partner (AOR: 4.53; 95% CI: 2.25–9.14), or injected drugs in the past year (AOR: 3.31; 95% CI: 1.64–6.65). These findings underscore the need for comprehensive HIV prevention and intervention programs that address the multi-level risk factors associated with sex trading for women infected with HIV.

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