scholarly journals Impact of a structured medical staff education program on the effect of HIV testing in four multi-specialist hospitals of the mazowieckie voivodeship as a part of the „Stop late presenters” – project

2020 ◽  
pp. 133-146
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Clinical Symptoms ◽  
Medical Personnel ◽  
Late Presenters ◽  
Disease Mortality ◽  
Hospital Wards ◽  
Positive Results

In half of newly detected cases of HIV infection in Europe, the diagnosis is made late. This has significant impact on the effects of antiretroviral therapy, long-term consequences of the disease, mortality, and the risk of HIV transmission in the environment. As part of the large “STOP Late Presenters” project, the number of HIV tests was assessed in four multi-specialist hospitals in the Mazowieckie voivodeship, which generally carry out over 112,000 hospitalizations per year. First, under the structured research program, the training of medical personnel was carried out in these hospitals, and then the number of HIV tests ordered was evaluated 2 months and 4 months after the training. 459 HIV tests were performed after the training in all hospitals, which is 2.44% of hospitalizations. It is interesting to note that after 4 months, the number of performed tests fell significantly. Staff training resulted in the number of tests higher by 5.8 %, compared to the same period of previous year. Four positive results were confirmed, which is 0.87% of all tests done. This is almost twice higher than in other European countries. Tests for HIV infection are most often ordered by doctors of infectious diseases, gynecologists and the staff of dialysis departments. We found that there is little interest in HIV testing among other specialists, despite reporting patients with clinical symptoms that suggest the likelihood of this infection. The improvement in HIV testing is of great importance for public health in our country and requires modification of diagnostic algorithms in hospital wards to reduce the number of late diagnoses of HIV / AIDS.

HIV Risk Behaviour and HIV Testing of Psychiatric Patients in Melbourne

1997 ◽  
Vol 31 (4) ◽  
pp. 566-576 ◽  
Author(s):  
Sandra C. Thompson ◽  
Gill E. Checkley ◽  
Jane S. Hocking ◽  
Nick Crofts ◽  
Anne M. Mijch ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Psychiatric Patients ◽  
Population Sample ◽  
Risk Behaviour ◽  
Mental Illnesses ◽  
Hiv Education ◽  
Multiple Sexual Partners ◽  
General Community

Objectives: Patients with chronic mental illnesses constitute an important risk group for HIV infection overseas. This study aimed to determine the prevalence of risk behaviours associated with HIV transmission and factors associated with HIV testing in psychiatric patients in Melbourne. Methods: Inpatients and outpatients completed an interviewer-administered questionnaire which covered demographics, psychiatric diagnosis, risk behaviour, and HIV education and testing. Results: Of 145 participants, 60% were male and 55.2% had schizophrenia. Injecting drug use (IDU) was reported by 15.9%, a figure approximately 10 times that found in other population surveys. Most patients reported sex in the last decade and over 20% had multiple sexual partners in the last year. Of males, 12.6% reported sex with another male (9.2% anal sex); 19.0% of females reported sex with a bisexual male. Nearly half of the males reported sex with a prostitute, 2.5 times that in a population sample. Only 15.9% reported ever having someone talk to them specifically about HIV and its transmission, although one-third had been tested for HIV. In multivariate analysis, male-male sex, paying for sex, and IDU were associated with HIV testing, but those whose primary language was not English were less likely to be tested. Those who had received HIV education were more likely to have used a condom last time they had sex (OR 4.52, 95%C11.49–14.0). Conclusions: This study provides evidence that those with serious mental illness in Victoria have higher rates of participation in risk behaviour for HIV infection than those in the general community. Attention to HIV education and prevention in this group has been inappropriately scant; strategies to encourage safer behaviour are urgently needed.

scholarly journals The reasons for providing HIV testing in patients with newly-diagnosed HIV infection in Lodz region, Poland in the years 2009-2017

2019 ◽  
Vol 73 ◽  
pp. 294-302
Author(s):  
Kamila Wójcik-Cichy ◽  
Anna Piekarska ◽  
Elżbieta Jabłonowska
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Sexually Transmitted Diseases ◽  
Sexual Contact ◽  
Newly Diagnosed ◽  
Late Presenters ◽  
Sexually Transmitted ◽  
Asymptomatic Patients ◽  
Hiv Test ◽  
The Moment

Early diagnosis increases life expectancy in HIV-infected patients. Aim: The aim of this study was to determine the reasons for HIV testing in newly-diagnosed patients with HIV registered in Lodz, Poland in years 2009-2017. The study examines also whether HIV testing was performed following the recommendation of physicians or at the request of patients. Results: The study group consisted of 401 (83.72%) males and 78 (16.28%) females. The median age at the moment of diagnosis was 33 years (LQ 27-UQ 40). In total, 285 (62.91%) patients were late presenters. Clinical indications constituted the main reason for undergoing HIV testing and were reported in 228 out of 479 patients (47.59%) including AIDS-defining diseases were a reason for HIV testing in 105 patients. Thirty-four patients underwent HIV testing following diagnosis of sexually-transmitted diseases (STDs); in 91.18% of these cases the STDs was syphilis. However, high-risk sexual contact was the main reason for HIV testing in asymptomatic patients (160 of 257 cases; 62.27%). Patients in the non-AIDS group were significantly more likely to take the initiative to order an HIV test than patients in the AIDS group (p<0.0001). Conclusions: In conclusion, in the Lodz region, patients with HIV infection are most commonly diagnosed at an advanced stage of infection. This may be associated with the low number of HIV tests performed following the doctors recommendation.

scholarly journals A Novel HIV-1 RNA Testing Intervention to Detect Acute and Prevalent HIV Infection in Young Adults and Reduce HIV Transmission in Kenya: Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Susan M Graham ◽  
Clara Agutu ◽  
Elise van der Elst ◽  
Amin S Hassan ◽  
Evanson Gichuru ◽  
...  
Keyword(s):  
Young Adults ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Partner Notification ◽  
Newly Diagnosed ◽  
Intervention Period ◽  
Acute Hiv Infection ◽  
Art Initiation ◽  
Acute Hiv

BACKGROUND Detection and management of acute HIV infection (AHI) is a clinical and public health priority, and HIV infections diagnosed among young adults aged 18 to 39 years are usually recent. Young adults with recent HIV acquisition frequently seek care for symptoms and could potentially be diagnosed through the health care system. Early recognition of HIV infection provides considerable individual and public health benefits, including linkage to treatment as prevention, access to risk reduction counseling and treatment, and notification of partners in need of HIV testing. OBJECTIVE The Tambua Mapema Plus study aims to (1) test 1500 young adults (aged 18-39 years) identified by an AHI screening algorithm for acute and prevalent (ie, seropositive) HIV, linking all newly diagnosed HIV-infected patients to care and offering immediate treatment; (2) offer assisted HIV partner notification services to all patients with HIV, testing partners for acute and prevalent HIV infection and identifying local sexual networks; and (3) model the potential impact of these two interventions on the Kenyan HIV epidemic, estimating incremental costs per HIV infection averted, death averted, and disability-adjusted life year averted using data on study outcomes. METHODS A modified stepped-wedge design is evaluating the yield of this HIV testing intervention at 4 public and 2 private health facilities in coastal Kenya before and after intervention delivery. The intervention uses point-of-care HIV-1 RNA testing combined with standard rapid antibody tests to diagnose AHI and prevalent HIV among young adults presenting for care, employs HIV partner notification services to identify linked acute and prevalent infections, and follows all newly diagnosed patients and their partners for 12 months to ascertain clinical outcomes, including linkage to care, antiretroviral therapy (ART) initiation and virologic suppression in HIV-infected patients, and pre-exposure prophylaxis uptake in uninfected individuals in discordant partnerships. RESULTS Enrollment started in December 2017. As of April 2020, 1374 participants have been enrolled in the observation period and 1500 participants have been enrolled in the intervention period, with 13 new diagnoses (0.95%) in the observation period and 37 new diagnoses (2.47%), including 2 AHI diagnoses, in the intervention period. Analysis is ongoing and will include adjusted comparisons of the odds of the following outcomes in the observation and intervention periods: being tested for HIV infection, newly diagnosed with prevalent or acute HIV infection, linked to care, and starting ART by week 6 following HIV diagnosis. Participants newly diagnosed with acute or prevalent HIV infection in the intervention period are being followed for outcomes, including viral suppression by month 6 and month 12 following ART initiation and partner testing outcomes. CONCLUSIONS The Tambua Mapema Plus study will provide foundational data on the potential of this novel combination HIV prevention intervention to reduce ongoing HIV transmission in Kenya and other high-prevalence African settings. CLINICALTRIAL ClinicalTrials.gov NCT03508908; https://clinicaltrials.gov/ct2/show/NCT03508908 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16198

scholarly journals Unlinked anonymous testing indicates antenatal HIV testing in England and Scotland is being successfully implemented

2005 ◽  
Vol 10 (20) ◽  
Author(s):  
D Goldberg ◽  
L Logan
Keyword(s):  
Antiretroviral Therapy ◽  
Caesarean Section ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Transmission Rates ◽  
Anonymous Testing ◽  
Caesarean Section Delivery ◽  
Unlinked Anonymous Testing

If HIV infection is detected before or during pregnancy, interventions such as antiretroviral therapy, caesarean section delivery and avoiding breastfeeding have meant that HIV transmission rates from mother to baby can be reduced from around 25% to 1%

scholarly journals The reasons for providing HIV testing in patients with newly-diagnosed HIV infection in Lodz region, Poland in the years 2009-2017

2019 ◽  
Vol 73 ◽  
pp. 1-10
Author(s):  
Kamila Wójcik-Cichy ◽  
Anna Piekarska ◽  
Elżbieta Jabłonowska
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Sexually Transmitted Diseases ◽  
Sexual Contact ◽  
Newly Diagnosed ◽  
Late Presenters ◽  
Sexually Transmitted ◽  
Asymptomatic Patients ◽  
Hiv Test ◽  
The Moment

Early diagnosis increases life expectancy in HIV-infected patients. Aims: The aim of this study was to determine the reasons for HIV testing in newly-diagnosed patients with HIV registered in Lodz, Poland in years 2009-2017. The study examines also whether HIV testing was performed following the recommendation of physicians or at the request of patients. Results: The study group consisted of 401 (83.72%) males and 78 (16.28%) females. The median age at the moment of diagnosis was 33 years (LQ 27-UQ 40). In total, 285 (62.91%) patients were late presenters. Clinical indications constituted the main reason for undergoing HIV testing and were reported in 228 out of 479 patients (47.59%) including AIDS-defining diseases were a reason for HIV testing in 105 patients. Thirty-four patients underwent HIV testing following diagnosis of sexually-transmitted diseases (STDs); in 91.18% of these cases the STDs was syphilis. However, high-risk sexual contact was the main reason for HIV testing in asymptomatic patients (160 of 257 cases; 62.27%). Patients in the non-AIDS group were significantly more likely to take the initiative to order an HIV test than patients in the AIDS group (p<0.0001). Conclusions: In conclusion, in the Lodz region, patients with HIV infection are most commonly diagnosed at an advanced stage of infection. This may be associated with the low number of HIV tests performed following the doctors recommendation.

scholarly journals A Novel HIV-1 RNA Testing Intervention to Detect Acute and Prevalent HIV Infection in Young Adults and Reduce HIV Transmission in Kenya: Protocol for a Randomized Controlled Trial

10.2196/16198 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e16198
Author(s):  
Susan M Graham ◽  
Clara Agutu ◽  
Elise van der Elst ◽  
Amin S Hassan ◽  
Evanson Gichuru ◽  
...  
Keyword(s):  
Young Adults ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Partner Notification ◽  
Newly Diagnosed ◽  
Intervention Period ◽  
Acute Hiv Infection ◽  
Art Initiation ◽  
Acute Hiv

Background Detection and management of acute HIV infection (AHI) is a clinical and public health priority, and HIV infections diagnosed among young adults aged 18 to 39 years are usually recent. Young adults with recent HIV acquisition frequently seek care for symptoms and could potentially be diagnosed through the health care system. Early recognition of HIV infection provides considerable individual and public health benefits, including linkage to treatment as prevention, access to risk reduction counseling and treatment, and notification of partners in need of HIV testing. Objective The Tambua Mapema Plus study aims to (1) test 1500 young adults (aged 18-39 years) identified by an AHI screening algorithm for acute and prevalent (ie, seropositive) HIV, linking all newly diagnosed HIV-infected patients to care and offering immediate treatment; (2) offer assisted HIV partner notification services to all patients with HIV, testing partners for acute and prevalent HIV infection and identifying local sexual networks; and (3) model the potential impact of these two interventions on the Kenyan HIV epidemic, estimating incremental costs per HIV infection averted, death averted, and disability-adjusted life year averted using data on study outcomes. Methods A modified stepped-wedge design is evaluating the yield of this HIV testing intervention at 4 public and 2 private health facilities in coastal Kenya before and after intervention delivery. The intervention uses point-of-care HIV-1 RNA testing combined with standard rapid antibody tests to diagnose AHI and prevalent HIV among young adults presenting for care, employs HIV partner notification services to identify linked acute and prevalent infections, and follows all newly diagnosed patients and their partners for 12 months to ascertain clinical outcomes, including linkage to care, antiretroviral therapy (ART) initiation and virologic suppression in HIV-infected patients, and pre-exposure prophylaxis uptake in uninfected individuals in discordant partnerships. Results Enrollment started in December 2017. As of April 2020, 1374 participants have been enrolled in the observation period and 1500 participants have been enrolled in the intervention period, with 13 new diagnoses (0.95%) in the observation period and 37 new diagnoses (2.47%), including 2 AHI diagnoses, in the intervention period. Analysis is ongoing and will include adjusted comparisons of the odds of the following outcomes in the observation and intervention periods: being tested for HIV infection, newly diagnosed with prevalent or acute HIV infection, linked to care, and starting ART by week 6 following HIV diagnosis. Participants newly diagnosed with acute or prevalent HIV infection in the intervention period are being followed for outcomes, including viral suppression by month 6 and month 12 following ART initiation and partner testing outcomes. Conclusions The Tambua Mapema Plus study will provide foundational data on the potential of this novel combination HIV prevention intervention to reduce ongoing HIV transmission in Kenya and other high-prevalence African settings. Trial Registration ClinicalTrials.gov NCT03508908; https://clinicaltrials.gov/ct2/show/NCT03508908 International Registered Report Identifier (IRRID) DERR1-10.2196/16198

scholarly journals COURSE OF HIV INFECTION AND MECHANISMS OF PREGNANCY FAILURE DEVELOPMENT IN WOMEN LIVING IN THE SUBARCTIC REGION

2020 ◽  
pp. 57-69
Author(s):  
T.N. Sokolova ◽  
A.E. Kasparova ◽  
L.V. Kovalenko ◽  
L.A. Sus ◽  
V.S. Shelud'ko ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Antiviral Therapy ◽  
Premature Birth ◽  
Hiv Transmission ◽  
Subarctic Region ◽  
Highly Active ◽  
Literary Sources ◽  
Keywords Hiv

The aim of the paper is to present the results obtained from scientific literature on the characteristics of gestation course and the mechanisms of its failure in HIV-infected women of the Subarctic region. Materials and Methods. The authors conducted a literary search in the CyberLeninka, PubMed, Medline, Scopus, and HAC journals. They also studied statistical HIV indicators in the world, in Russia and in the Khanty-Mansi Autonomous Area – Yugra. Literary sources are no older than 10 tears. Results. Long-term residence in a Subarctic region cannot but affect the course of a chronic viral infection in pregnant women. Besides the prevention of vertical HIV transmission from a woman to her child, highly active antiviral therapy is an additional factor contributing to the development of premature birth, anemia and other gestation complications in pregnant women. Keywords: HIV infection, leukocyte indices, adaptation, antiviral therapy, premature birth. Цель – представить данные научной литературы об особенностях течения беременности и механизмах формирования ее патологии у ВИЧ-инфицированных жительниц субарктического региона. Материалы и методы. Проведен литературный поиск в базах «КиберЛенинка», PubMed, Medline, журналах Scopus, ВАК, а также изучены статистические показатели ВИЧ в мире, России и ХМАО – Югре. Глубина исследования в основном не превышала 10 лет. Результаты. Длительное проживание в условиях субарктического региона не может не отразиться на течении хронической вирусной инфекции у беременной. Высокоактивная антивирусная терапия, несмотря на профилактику вертикальной передачи ВИЧ от матери ребенку, является дополнительным фактором развития преждевременных родов, анемии беременных и других осложнений гестации. Ключевые слова: ВИЧ-инфекция, лейкоцитарные индексы, адаптация, антивирусная терапия, преждевременные роды.

scholarly journals Comparative evaluation of the Geenius™ HIV 1/2 Confirmatory Assay and the HIV-1 and HIV-2 Western blots in the Japanese population

2018 ◽  
Author(s):  
Makiko Kondo ◽  
Koji Sudo ◽  
Takako Sano ◽  
Takuya Kawahata ◽  
Ichiro Itoda ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Acute Infection ◽  
Screening Tests ◽  
Western Blots ◽  
Suitable Alternative ◽  
Confirmatory Assay ◽  
Testing Algorithm ◽  
Positive Results ◽  
Hiv 1

AbstractAccurate diagnosis of earlier HIV infection is essential for treatment and prevention. Currently, confirmation tests of HIV infection in Japan are performed using Western blot (WB), but WB has several limitations including low sensitivity and cross-reactivity between HIV-1 and HIV-2 antibodies. To address these problems, a new HIV testing algorithm and a more reliable confirmation and HIV-1/2 differentiation assay are required. The Bio-Rad Geenius™ HIV-1/2 Confirmatory Assay (Geenius) has recently been approved and recommended for use in the revised guidelines for diagnosis of HIV infection by the Center for Disease Control and Prevention (USA). We made comprehensive comparison of the performance of Geenius and the Bio-Rad NEW LAV BLOT 1 and 2 (NLB 1 and 2) which are WB kits for HIV-1 and HIV-2, respectively, to examine if Geenius is a suitable alternative to these WB assays which are now being used in HIV testing in Japan. A total of 166 HIV-1 positive samples (146 from patients with established HIV-1 infection and 20 from patients with acute infection), five HIV-1 seroconversion panels containing 21 samples and 30 HIV-2 positive samples were used. In addition, a total of 140 HIV negative samples containing 10 false-positives on screening tests were examined. The sensitivity of Geenius and NLB 1 for HIV-1 positive samples was 99.3% and 98.6%, respectively. Geenius provided more positive results in the samples from acute infections and detected positivity 0 to 32 days earlier in seroconversion panels than NLB 1. NLB 2 gave positive results in 12.3% of HIV-1 positive samples. The sensitivity of both Geenius and NLB 2 for HIV-2 positive samples was 100%. The specificity of Geenius, NLB 1 and NLB 2 was 98.5%, 81.5% and 90.0%, respectively. Geenius is an attractive alternative to WB for confirmation and differentiation of HIV-1 and HIV-2 infections. The adaptation of Geenius to the HIV testing algorithm may be advantageous for rapid diagnosis and the reduction of testing costs.

scholarly journals Educational Interventions Improved Knowledge, Attitude, and Practice to Prevent HIV Infection among HIV-Negative Heterosexual Partners of HIV-Infected Persons

2020 ◽  
Vol 19 ◽  
pp. 232595821989953
Author(s):  
Thana Khawcharoenporn ◽  
Chanika Srirach ◽  
Krongtip Chunloy
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Group Discussion ◽  
Tertiary Care ◽  
Educational Interventions ◽  
Care Hospital ◽  
Preexposure Prophylaxis ◽  
Quasi Experimental ◽  
Transmission Prevention

A 1-year quasi-experimental study was conducted among HIV-noninfected heterosexual partners of HIV-infected patients cared at a Thai tertiary care hospital. The educational interventions comprised a 1-hour educational session, a condom use teaching session, focus group discussion, and free HIV testing. Of the 88 seronegative partners enrolled, 53 and 35 underwent the educational interventions once and twice, respectively. After the educational interventions, the median score for knowledge on HIV infection and transmission prevention significantly increased (28 versus 21; P < .001). After the interventions, higher proportions of the participants would use treatment of the HIV-infected partners (77% versus 58%) and preexposure prophylaxis (59% versus 38%) as methods to prevent HIV transmission and have a regular HIV blood test every 6 months (94% versus 81%). Among the 35 participants who participated in the educational interventions twice, most of the knowledge and positive attitudes were retained. The rates of regular HIV testing every 6 months had increased significantly from baseline to 1 year later (29% to 74%, respectively). None of the participants developed HIV infection. These findings suggest that the study interventions could improve knowledge about HIV infection and transmission prevention, attitude and practices toward prevention, and increase regular HIV testing among the seronegative partners.

Myelodysplastic features in patients with long-term HIV infection and haemophilia

Haemophilia ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 47-52 ◽  
Author(s):  
O. Katsarou ◽  
E. Terpos ◽  
E. Patsouris ◽  
P. Peristeris ◽  
N. Viniou ◽  
...  
Keyword(s):  
Hiv Infection
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