Stereotypes About People Living with HIV: Implications for Perceptions of HIV Risk and Testing Frequency Among At-Risk Populations

Abstract Background Clinically useful predictors for fatal toxoplasmosis are lacking. We investigated the value of serological assays for antibodies to whole Toxoplasma antigens and to peptide antigens of the Toxoplasma cyst protein MAG1, for predicting incident toxoplasmic encephalitis (TE) in people living with HIV (PLWH). Methods We performed a nested case control study, conducted within the Multicenter AIDS Cohort Study (MACS), using serum samples obtained 2 years prior to diagnosis of TE from 28 cases, and 37 HIV disease-matched Toxoplasma seropositive controls at matched time-points. Sera were tested for Toxoplasma antibodies using a commercial assay and for antibodies to MAG1_4.2 and MAG1_5.2 peptides in ELISA. Results Two years prior to clinical diagnosis, 68% of TE cases were MAG1_4.2 seropositive compared with 16% of controls (OR 25.0, 95% CI 3.14-199.18). Corresponding results for MAG1_5.2 seropositivity were 36% and 14% (OR 3.6, 95% CI 0.95-13.42). Higher levels of antibody to MAG1_4.2 (OR 18.5 per doubling of the OD value, 95% CI 1.41-242) and to Toxoplasma (OR 2.91 for each OD unit increase, 95% CI 1.48-5.72) were also associated with the risk of TE. When seropositivity was defined as the presence of MAG1 antibody or relatively high levels of Toxoplasma antibody, the sensitivity was 89% and specificity was 68% for subsequent TE. Conclusions Antibodies to MAG1 showed predictive value on the occurrence of TE in PLWH, and the predictive performance was further improved by adding the levels of Toxoplasma antibody. These measures could be clinically useful for predicting subsequent diseases in multiple at-risk populations.

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High prevalence of sexually transmitted coinfections among at-risk people living with HIV

Journal of the Formosan Medical Association ◽

10.1016/j.jfma.2020.12.008 ◽

2020 ◽

Author(s):

Kuan-Yin Lin ◽

Hsin-Yun Sun ◽

Tai-Fen Lee ◽

Yu-Chung Chuang ◽

Un-In Wu ◽

...

Keyword(s):

At Risk ◽

People Living With Hiv ◽

Sexually Transmitted ◽

High Prevalence ◽

Living With Hiv

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Positive Prevention: HIV Risk Reduction for People Living with HIV/AIDS

HIV/AIDS in South Africa 25 Years On ◽

10.1007/978-1-4419-0306-8_18 ◽

2009 ◽

pp. 273-286

Author(s):

Seth C. Kalichman ◽

Leickness C. Simbayi

Keyword(s):

Risk Reduction ◽

Hiv Risk ◽

People Living With Hiv ◽

Hiv Risk Reduction ◽

Positive Prevention ◽

Living With Hiv ◽

Hiv Aids

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Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service

MDM Policy & Practice ◽

10.1177/2381468319868216 ◽

2019 ◽

Vol 4 (2) ◽

pp. 238146831986821

Author(s):

Claire E. Kendall ◽

Janessa E. Porter ◽

Esther S. Shoemaker ◽

Rachel Seoyeon Kang ◽

Michael Fitzgerald ◽

...

Keyword(s):

At Risk ◽

Primary Care Providers ◽

Question Type ◽

Hiv Care ◽

People Living With Hiv ◽

Local Health ◽

Care Providers ◽

Patients At Risk ◽

Survey Responses ◽

Living With Hiv

Background. Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV. Objective. This study aims to describe the use, value, and utility of this eConsultation service in the care of people living with HIV and to characterize the common question types and clinical topics asked by PCPs. Methods. We analyzed the data from eConsults sent to the HIV specialty group in Ontario’s Champlain Local Health Integration Network between February 2015 and December 2017. Usage data and close-out survey responses were analyzed using descriptive statistics, eConsults were classified using a predefined list of validated taxonomy, and a thematic analysis was performed on the consultation logs to identify common clinical themes. Results. Among the 46 eConsults, the most common question type related to drug treatment (58.7%, n = 27) and management (19.6%, n = 9). The main clinical themes involved the care of significant complexities in people living with HIV, such as comorbidities and drug interactions, and suggestions of coordinated patient care. As well, eConsult was used for advice regarding pre-exposure prophylaxis for HIV-negative patients at risk of HIV infection. PCPs highly valued the eConsult service (average rating 4.8/5). Conclusion. Overall, this study demonstrates that eConsult provides an efficient and valuable service to PCPs caring for patients living with or at risk for HIV by improving access to HIV specialists and facilitating the delivery of team-based comprehensive care.

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Agents of change among people living with HIV and their social networks: stepped-wedge randomised controlled trial of the NAMWEZA intervention in Dar es Salaam, Tanzania

BMJ Global Health ◽

10.1136/bmjgh-2018-000946 ◽

2019 ◽

Vol 4 (3) ◽

pp. e000946 ◽

Cited By ~ 5

Author(s):

Mary C Smith Fawzi ◽

Hellen Siril ◽

Yuanyuan Liu ◽

Keith McAdam ◽

Donald Ainebyona ◽

...

Keyword(s):

Social Networks ◽

Randomised Controlled Trial ◽

Hiv Risk ◽

Controlled Trial ◽

Risk Behaviour ◽

Dar Es Salaam ◽

People Living With Hiv ◽

Stepped Wedge ◽

Randomised Controlled ◽

Living With Hiv

IntroductionNAMWEZA is a novel intervention that focuses on preventing HIV and promoting sexual and reproductive health and rights by addressing underlying factors related to vulnerability of acquiring HIV, such as depression, intimate partner violence (IPV) and stigma. The goal of the study was to evaluate the effect of the NAMWEZA intervention on risk behaviour as well as factors potentially contributing to this vulnerability for people living with HIV and their network members.MethodsA stepped-wedge randomised controlled trial was conducted from November 2010 to January 2014 among people living with HIV and their network members in Dar es Salaam, Tanzania. 458 people living with HIV were randomised within age/sex-specific strata to participate in the NAMWEZA intervention at three points in time. In addition, 602 members of their social networks completed the baseline interview. Intention-to-treat analysis was performed, including primary outcomes of uptake of HIV services, self-efficacy, self-esteem, HIV risk behaviour and IPV.ResultsFor people living with HIV, a number of outcomes improved with the NAMWEZA intervention, including higher self-efficacy and related factors, as well as lower levels of depression and stigma. IPV reduced by 40% among women. Although reductions in HIV risk behaviour were not observed, an increase in access to HIV treatment was reported for network members (72% vs 94%, p=0.002).ConclusionThese results demonstrate the complexity of behavioural interventions in reducing the vulnerability of acquiring HIV, since it is possible to observe a broad range of different outcomes. This study indicates the importance of formally evaluating interventions so that policymakers can build on evidence-based approaches to advance the effectiveness of HIV prevention interventions.Trial registration numberNCT01693458.

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Improving communication about HIV prevention among people living with HIV and their at-risk social network members in Dar es Salaam, Tanzania

Cogent Medicine ◽

10.1080/2331205x.2019.1600230 ◽

2019 ◽

Vol 6 (1) ◽

pp. 1600230 ◽

Cited By ~ 1

Author(s):

Hellen Siril ◽

Anna Kaale ◽

Anna Minja ◽

Japheth Kilewo ◽

Ferdinand Mugusi ◽

...

Keyword(s):

At Risk ◽

Social Network ◽

Hiv Prevention ◽

Dar Es Salaam ◽

People Living With Hiv ◽

Living With Hiv

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Uptake and trends in ordering of funded hepatitis B immunisation for priority populations in Victoria, Australia, 2013–2014

Sexual Health ◽

10.1071/sh16002 ◽

2017 ◽

Vol 14 (2) ◽

pp. 188

Author(s):

Jennifer H. MacLachlan ◽

Benjamin C. Cowie

Keyword(s):

At Risk ◽

Hepatitis B ◽

Risk Groups ◽

Hepatitis B Vaccine ◽

People Living With Hiv ◽

Department Of Health ◽

Priority Populations ◽

Living With Hiv ◽

The Impact ◽

Over Time

Background The Department of Health and Human Services in Victoria provides funded hepatitis B vaccine to many priority groups at risk of acquiring infection. We aimed to determine the uptake of vaccine ordering for at-risk groups over time, to assess any trends and identify any gaps in prevention of hepatitis B for those at risk. Methods: Routinely collected administrative data regarding the indication for vaccine ordered by practitioners were analysed for the period June 2013 to December 2014. Number of doses and courses distributed was determined and compared with the estimated size of the priority populations. Results: During the 18-month period assessed, 20 498 doses of funded hepatitis B vaccine were ordered, equating to ~5700 complete courses, with the overall number of orders per quarter increasing between 2013 and 2014. The most common indication was being a household or sexual contact of people living with hepatitis B (2803 courses, 49.2% of the total), equating to approximately one course per new chronic hepatitis B notification. The remaining doses were largely distributed to people living with HIV (648 courses, 11.4%), people living with hepatitis C (621 courses, 10.9%), and people who inject drugs (594 courses, 10.4%). Conclusions: This analysis demonstrates that access to hepatitis B immunisation among priority populations appears to have increased in Victoria during 2013–14, however it could still be improved. Continued assessment of these data over time will be important to measure the impact of interventions on increasing the reach of the funded vaccine program.

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