Fertility Intentions among HIV-positive and HIV-negative mothers in Zambia: Analysis of 2013-14 and 2018 DHS data

Abstract Background: HIV infection is a strong predictor of fertility as it might influence one’s fertility desire. With advent treatment, HIV-infected mothers are now living longer and healthier just like the HIV-negative mothers. Zambia is among the developing countries in the region with high desire for more children in spite of government efforts to reduce the fertility rate. However, little is known on the influence of HIV status on the desire for children among mothers of reproductive ages in Zambia. Methods: The analyses are based on mothers with linkable information on HIV testing and fertility preferences from the 2013-14 and 2018 Zambia and Demographic Health Survey data, with national representative samples of 16,411 and 13,683 women, respectively. HIV data was merged with each woman’s individual file, which also contained household variables to create an analytical file. Of the total sample; 11,683 mothers in 2013-14 and 9,172 mothers in 2018 were eligible for the study. Cross-tabulations with statistical tests were conducted to ascertain the crude relationship and finally multiple logistic regression analysis were employed to identify the major predictors of fertility intentions among HIV positive and HIV negative mothers using Stata software version 14.0.Results: Findings indicate that fertility intentions among women either HIV-positive or HIV-negative reduced as parity increases. Generally, in both data sets, there is a significant difference between HIV-negative mothers preferring more children compared to HIV-positive mothers. Interestingly, in the 2018 survey, HIV-positive mothers residing in urban areas were 33 percent more likely to prefer more children compared to HIV-negative mothers. Conclusion: According to this study, predictors of fertility intentions among women of reproductive age are different by HIV status. Other significant variables are age, education level, marital status, and parity, which were found to be the major predictors of fertility intentions among HIV-positive. Among the HIV-negatives, age, education level, parity, marital status, employment status, wealth quintile and region explained their fertility intentions. The fact that many HIV-infected mothers expect to have more children has important implications for the prevention of vertical and horizontal transmission of HIV. There is, therefore, the need for comprehensive and continuous expansion of family planning, voluntary counseling, and prevention of mother-to-child transmission (PMTCT) and integration of HIV treatment care among HIV-positive mothers to meet diverse reproductive intentions.

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PD-L1 protein expression and copy number gains in HIV-positive locally advanced cervical cancer

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920963001 ◽

2020 ◽

Vol 12 ◽

pp. 175883592096300

Author(s):

Kongsak Loharamtaweethong ◽

Napaporn Puripat ◽

Niphon Praditphol ◽

Jidapa Thammasiri ◽

Siriwan Tangitgamol

Keyword(s):

Cervical Cancer ◽

Copy Number ◽

Locally Advanced ◽

Hiv Positive ◽

Hiv Status ◽

Free Survival ◽

Parametrial Invasion ◽

Programmed Death ◽

Significant Difference ◽

Hiv Negative

Background: The programmed death-1/programmed death-ligand-1 (PD-1/PD-L1) axis may represent a target for cervical cancer; however, it is poorly understood in human immunodeﬁciency virus (HIV)-infected patients. Methods: We evaluated HIV-positive ( n = 42) and HIV-negative ( n = 110) women with locally advanced cervical cancer regarding their PD-L1 expression, determined by combined positive score (CPS) ⩾ 1 and tumor proportion score (TPS) ⩾ 25%, and PD-L1 copy number alterations, assessed by fluorescence in situ hybridization. Results: Regardless of HIV status, 84.9% and 44.8% of cases were PD-L1-positive according to CPS ⩾ 1 and TPS ⩾ 25%. Per CPS ⩾ 1, PD-L1 positive rate was similar between HIV-positive and HIV-negative women, whereas a significant difference was seen per TPS ⩾ 25%. Tumor size and parametrial invasion were correlated with PD-L1 positivity in HIV-negative women, whereas anti-retroviral therapy (ART) was correlated with TPS < 25%. Low CD4-positive cell counts were associated with CPS < 1 in HIV-positive women. No significant difference was observed in PD-L1 copy number status between HIV-positive and HIV-negative women. PD-L1 amplification and polysomy were independently associated with TPS ⩾ 25%, whereas the presence of parametrial invasion was independently associated with CPS ⩾ 1. Cancer stage and PD-L1 amplification were identified as independent predictors of recurrence-free survival [hazard ratio (HR) = 2.40 (1.32–4.36) and HR = 5.33 (1.94–14.61)] and cancer-specific survival [HR = 13.62 (5.1–36.38) and HR = 3.53 (1.43–8.69)]. PD-L1 polysomy was an independent predictor of locoregional recurrence-free survival [HR = 3.27 (1.27–8.41)]. HIV status and PD-L1 expression (CPS ⩾ 1 or TPS ⩾ 25%) were not associated with poor patient outcomes. Conclusion: PD-L1 amplification and polysomy are the strongest drivers of PD-L1 expression in cervical cancer, and could represent prognostic biomarkers for anti-PD-1/PD-L1 therapy. Cervical cancer biology may be modulated by HIV infection, CD4-positive cells, and HIV treatments.

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Clinicopathologic Comparison of Plasmablastic Lymphoma Patients According HIV-Status: Peruvian Experience

Blood ◽

10.1182/blood-2020-142239 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 19-19

Author(s):

Jule F Vasquez ◽

Cesar Samanez-Figari ◽

Lourdes Lopez ◽

Shirley Quintana ◽

Rolig Aliaga ◽

...

Keyword(s):

Overall Survival ◽

Hiv Infection ◽

Lymphoid Cells ◽

Categorical Variables ◽

Hiv Positive ◽

Hiv Status ◽

Hiv Patients ◽

Variable Expression ◽

Significant Difference ◽

Hiv Negative

Background:Plasmablastic lymphoma (PBL) is an aggressive lymphoma associated mainly to HIV infection, although cases in immunocompetent patients are described as well. Objective:To describe the clinicopathologic features and determine the overall survival of lymphoma patients according human immunodeficiency virus (HIV) status in Peruvian patients. Methods:We reviewed the pathology databases of 2 cancer centers and a general hospital from Peru. Forty cases were documented between 2005 and 2020. Categorical variables were compared using Fisher's exact test. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Statistical analysis was based on SPSS Program version 23. All cases were reviewed by two pathologists. Results:32 patients (80%) were HIV-positive. The median age for the whole cohort was 40 years (range, 22-86). The median age for HIV-positive and HIV-negative PBL patients were 37 years (range 22-67 years) and 57 years (range 27-86 years), respectively. The proportion of patients ≥60 years was lower in HIV-positive than in HIV-negative patients (8% and 37%, respectively; p= 0.046). 80% of patients in the whole cohort were female, and 84% and 62% in the HIV-positive and HIV-negative group, respectively. Extra-oral primary sites were the most frequent primary sites in both groups (66% and 88%, respectively). There were no statistically significant differences in Ann Arbor stage, Ki-67 expression, LDH levels, IPI scores, albumin levels, and neutrophil/lymphocyte ratio between HIV-positive and HIV-negative patients. All cases showed large lymphoid cells, of plasmablastic morphology with expression of at least one plasma cell marker (CD138, CD38, MUM1), CD45 positivity, variable expression of EMA, CD79 and CD30 and absence of expression of CD20, CD3, CD68 and LMP1; the proliferative index Ki67 varied between 60 and 90%. A small proportion of patients (18%) did not receive chemotherapy because of poor performance status or a personal decision. DA-EPOCH regimen was used in 52% and 25% of HIV+ and HIV- patients, respectively and CHOP/CHOEP regimen in 48 % and 75%, respectively. The overall response rate was 68% and 57% in HIV+ and HIV- patients with complete response (CR) in 32% and 14%, respectively. In the HIV-positive group, 66% of patients were antiretroviral therapy (ART)-naïve. The median progression-free survival (PFS) was 38 months and 7 months for HIV+ and HIV- patients, and the 1-year PFS was 74% and 0%, respectively. The median overall survival (OS) was 43 months (range 0.2-86.5) in HIV-positive patients and 10 months (range 0.5-19.0 months) in HIV-negative patients and the 1-year OS were 59% y 38%, respectively (p=0.27). Conclusions: PBL is a rare lymphoma, specially, if not related to HIV infection. In this study, 60 years or older was the only variable that showed significant difference. In our cohort, HIV-positive patients had better prognosis than HIV-negative PBL patients. Disclosures No relevant conflicts of interest to declare.

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Placental Malaria histological features and the burden of congenital malaria among HIV/ malaria co-infected mothers in Benin City, Edo State

Nigerian Journal of Paediatrics ◽

10.4314/njp.v48i1.3 ◽

2021 ◽

Vol 48 (1) ◽

pp. 12-19

Author(s):

Fidelis E. Eki-udoko ◽

Ayebo Sadoh ◽

Michael O. Ibadin ◽

Augustine I. Omoigberale

Keyword(s):

Peripheral Blood ◽

Placental Malaria ◽

Blood Film ◽

Hiv Positive ◽

Hiv Status ◽

Chronic Type ◽

Hiv Positive Mothers ◽

Maternal Hiv ◽

Congenital Malaria ◽

Hiv Negative

Background: It is well documented that sub-Saharan Africa bears the highest burden of both malaria and HIV. Coinfection with both diseases is also well documented. Malaria parasites infecting the placenta lead to inflammation, intervillous fibrin deposition and infarction. This pathologic effect of malaria on the placental has led to the staging of placental malaria histology. These pathologic features may reflect different levels in the breach of the integrity of the placenta which may predispose to transmission of congenital malaria and possibly HIV. But few if any have examined the association of maternal placental malaria histology stages in HIV positive and negative mothers and the effects of these on their newborns (congenital malaria). Methods: Subjects were 162 newborns of HIV/malaria co-infected mothers and Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy. Results: The placental malaria histology in HIV positive mothers were predominantly the chronic type (51.9%) and past type (54.6%) in HIV negative mothers respectively. Congenital malaria was significantly more in chronic types of placental malaria histology irrespective of maternal HIV status (p=0.017 in subjects and p= 0.000 in controls respectively) Conclusion: Babies born to mothers are at increased risk for congenital malaria if their placental malaria histology is of the chronic type compared to the other types (active and past) irrespective of maternal HIV status. This risk (chronic type) is highest in mothers with HIV; therefore, all babies born to HIV positive mothers should be screened for congenital malaria and managed as appropriate.

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Primary and secondary supportive partnerships among HIV-positive and HIV-negative middle-aged and older gay men

PLoS ONE ◽

10.1371/journal.pone.0245863 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0245863

Author(s):

Matthew Statz ◽

Deanna Ware ◽

Nicholas Perry ◽

David Huebner ◽

Christopher Cox ◽

...

Keyword(s):

Gay Men ◽

Healthy Aging ◽

Hiv Positive ◽

Hiv Status ◽

Significant Difference ◽

Partnership Status ◽

Race Ethnicity ◽

Sex With Men ◽

Older Gay Men ◽

Hiv Negative

This study describes the primary and secondary partnerships of aging gay men participating in the Understanding Patterns of Healthy Aging Among Men Who Have Sex with Men substudy of the Multicenter AIDS Cohort Study and examines differences in the prevalence of these relationship structures by HIV status while adjusting for age, education, and race/ethnicity. Relationships were compared within the following structural categories: “only a primary partnership”, “only a secondary partnership”, “both a primary and secondary relationship”, or “neither a primary nor secondary relationship”. There were 1,054 participants (51.9% HIV negative/48.1% HIV positive) included in the study. Participants had a median age of 62.0 years (interquartile range: 56.0–67.0) and most reported being non-Hispanic white (74.6%) and college educated (88.0%). Of the 1,004 participants with available partnership status data, 384 (38.2%) reported no primary or secondary partnerships, 108 (10.8%) reported secondary-only partnership, 385 (38.3%) reported primary-only partnership, and 127 (12.6%) reported both primary and secondary partnerships. Of participants who reported primary partnerships only, the prevalence rates (PRs) were lower among those 62 years and older, HIV positive, black non-Hispanic and Hispanics. Of participants who reported only having a secondary partnership, the PRs were higher among those 62 years and older and HIV positive. Of participants who did not report having either a primary or secondary partnership, the PRs were higher among those 62 years and older, HIV positive, and black non-Hispanic compared with their respective referent groups. There was no significant difference in PRs of having both primary and secondary partnerships by age category, HIV status, race/ethnicity, and education. This study aimed to fill a knowledge gap in the literature regarding both primary and secondary supportive partnerships among aging HIV-positive and HIV-negative gay men.

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THE EPIDEMIOLOGY OF NEW CASES OF LUNG TUBERCULOSIS IN WOMEN OF THE REPRODUCTIVE AGE

Health and Ecology Issues ◽

10.51523/2708-6011.2017-14-3-17 ◽

2017 ◽

pp. 79-83

Author(s):

S. V. Goponyako ◽

I. V. Buinevich ◽

S. V. Butsko ◽

V. N. Bondarenko

Keyword(s):

Hiv Infection ◽

Causes Of Death ◽

Reproductive Age ◽

Hiv Positive ◽

Hiv Incidence ◽

Hiv Status ◽

Lung Tuberculosis ◽

Epidemiological Situation ◽

Hiv Negative

As per the WHO data, tuberculosis is often associated with HIV-infection and remains one of the prevalent causes of death among women of the reproductive age in regions with unfavorable epidemiological situation. Due to high HIV incidence in Gomel region, the epidemiology of tuberculosis in women of the reproductive age demands to be thoroughly studied. As the conducted study has showed women aged 18-45 make 1/5 of new cases of lung tuberculosis among HIV-negative women and 1/3 among HIV-positive patients. The age peak is 25-40 regardless of the HIV-status. 27.7 % women aged 18-45 who detected tuberculosis were HIV-positive. In 10 % women of this age pregnancy and parturition preceded tuberculosis which was not associated with HIV-infection.

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Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data

10.21203/rs.2.12401/v2 ◽

2020 ◽

Author(s):

Miriam Nakanwagi ◽

Lilian Bulage ◽

Benon Kwesiga ◽

Alex Riolexus Ario ◽

Doreen Agasha Birungi ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Statistical Significance ◽

Reproductive Age ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Status ◽

Significant Difference ◽

Test Result

Abstract Background: HIV testing is the cornerstone for HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). Knowledge of HIV status is associated with better reproductive health choices and outcomes for the infant’s HIV status. We analyzed trends in known current HIV status among pregnant women attending the first antenatal care (ANC) visit in Uganda, 2012-2016. Methods: We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC visit during 2012-2016. Women who brought documented HIV negative test result within the previous four weeks at the first ANC visit or an HIV positive test result and/or own HIV care card were considered as knowing their HIV status. We calculated proportions of women with known current HIV status at first ANC visit, and described linear trends both nationally and regionally. We tested statistical significance of the trend using modified Poisson regression with generalized linear models. For known HIV positive status, we only analyzed data for years 2015-2016 because this is when this data became available. Results: There was no significant difference in the number of women that attended first ANC visits over years 2012-2016. The proportion of women that came with known HIV status increased from 4.4% in 2012 to 6.9% in 2016 and this increase was statistically significant (p<0.001). Most regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at first ANC visit was slightly higher than that of women that were newly tested HIV positive at first ANC visit in 2015 and 2016. Conclusion: Although the gap in women that come at first ANC visit without knowing their HIV positive status might be reducing, a large proportion of women who were infected with HIV did not know their status before the first ANC visit indicating a major public health gap. We recommend advocacy for early ANC attendance and hence timely HIV testing and innovations to promptly identify HIV positive women of reproductive age so that timely PMTCT interventions can be made.

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Anolunula in Fingernails among Patients Infected with HIV

ISRN Dermatology ◽

10.1155/2014/271230 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Pratik Gahalaut ◽

Nitin Mishra ◽

Sandhya Chauhan ◽

Mir Mubashir Ali ◽

Madhur Kant Rastogi ◽

...

Keyword(s):

Hiv Infection ◽

Cross Sectional Study ◽

Negative Control ◽

Hiv Positive ◽

Control Group ◽

Cross Sectional ◽

Significant Difference ◽

Stage 1 ◽

And Control ◽

Hiv Negative

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.

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Pathogenicity and non-opportunistic character of Blastocystis spp.: a hospital-based survey in Central Cameroon

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10122 ◽

2018 ◽

Vol 12 (05) ◽

pp. 373-379 ◽

Cited By ~ 3

Author(s):

Stéphanie Jupsa-Mbiandou ◽

Samuel Fosso ◽

Edimo Billé ◽

Tito T Mélachio-Tanekou ◽

Gideon Ajeagah-Aghaindum ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Clinical Signs ◽

Hiv Positive ◽

Cross Sectional ◽

Significant Difference ◽

Blastocystis Spp ◽

Stool Samples ◽

Hiv Negative

Introduction: Blastocystis spp. is a protist found in humans. Although usually the most frequent protozoa found in stool samples of both symptomatic and healthy subjects, its pathogenic or rather opportunistic role is yet to be clearly elucidated. To attempt to fill this gap, a cross-sectional study was conducted to compare the frequency of Blastocystis spp. in HIV positive (HIV+) versus HIV negative (HIV-) individuals in four health facilities of the Center Region of Cameroon. Methodology: Stool samples were collected from 283 HIV positive and 245 HIV negative subjects and analyzed using direct diagnostic tests. Results: A total of 46 (8.7%) individuals were found infected with Blastocystis spp., including 6.7% HIV positive and 11.0% HIV negative. This species was more frequent in urban and semi-urban areas than in rural areas, but evenly distributed among genders and age groups as well as among all sectors of activity. The prevalence of Blastocystis spp. (11.3%) was higher in HIV+ patients with a CD4 count ≥ 500 cells / mm3, but no significant difference was found among HIV clinical stages. Likewise prevalence, the mean number of cysts per gram of stool was similar between HIV positive and HIV negative individuals. People infected with Blastocystis spp. showed diverse clinical signs, but only flatulence was significantly more prevalent. The frequencies of these clinical signs were not related to HIV status. Conclusion: No clear relationship links the infection with Blastocystis spp. to HIV, although its presence was associated with digestive disorder, suggesting that this parasite might not be opportunist.

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Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV

Infectious Disease Reports ◽

10.3390/idr14010006 ◽

2022 ◽

Vol 14 (1) ◽

pp. 43-55

Author(s):

Cristina Micali ◽

Ylenia Russotto ◽

Grazia Caci ◽

Manuela Ceccarelli ◽

Andrea Marino ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Cancer Staging ◽

Hiv Positive ◽

People Living With Hiv ◽

Liver Cancers ◽

Significant Difference ◽

Cancer Specific Mortality ◽

Living With Hiv ◽

Hiv Negative

Hepatocellular carcinoma (HCC) accounts for approximately 75–90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.

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HIV-Related Attitudes and Intentions for High-Risk, Substance-Using Men Who Have Sex With Men: Associations and Clinical Implications for HIV-Positive and HIV-Negative MSM

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.24.4.281 ◽

2010 ◽

Vol 24 (4) ◽

pp. 281-293 ◽

Cited By ~ 6

Author(s):

Gordon Mansergh ◽

David J. McKirnan ◽

Stephen A. Flores ◽

Sharon M. Hudson ◽

Beryl A. Koblin ◽

...

Keyword(s):

Substance Use ◽

Risk Behavior ◽

Self Efficacy ◽

Safer Sex ◽

Hiv Positive ◽

Hiv Status ◽

Anal Sex ◽

Sex With Men ◽

Hiv Negative ◽

Hiv Positive Men

This study compared HIV-related attitudes and intentions by respondent HIV-status in a large sample of substance-using men who have sex with men (MSM) in the United States. Attitudes and intentions included self-efficacy for safer sex; difficulty communicating with sex partners about safer sex; intent to use condoms consistently and to not use substances before sex in the next 3 months; and less concern for HIV given effective antiviral treatments. Differences were found for behavior during the most recent anal sex encounter by HIV-status, including (a) insertive and (b) receptive anal sex risk behavior, and (c) substance use before or during the encounter. Self-efficacy for safer sex was associated with less risk behavior among HIV-negative men but not among HIV-positive men, suggesting that self-efficacy for safer sex continues to be a relevant issue to address in counseling uninfected MSM. HIV-positive men who reported less concern for HIV given treatments were more likely to report receptive risk behavior, as were HIV-negative men who reported difficulty communicating about safer sex. Implications are discussed for potentially heightened client desire and therapeutic opportunity to reduce future substance use during sex for clients who report recent substance use during sex.

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