Covid-19 Escaled Ongoing Injustices: Voices of Women Living With HIV in Nepal

The first HIV case in Nepal was reported in 1988. As of July 2020, the total number of PLHIV was 29,503 PLHIV whereas the numbers for male and females were respectively 17, 587 and 11, 916 (UNAIDS, 2021.). More than 72% of People Living with HIV (PLHIV) are of age group 25 to 49 years (Ministry of Health National Centre for AIDS and STD Control, 2020). There are 80 ART (Anti-Retroviral therapy) centres providing services to PLHIV in seven Provinces and a number of community-based organizations to provide services to PLHI (Ministry of Health National Centre of AIDS and STD Control, 2020). The current knowledge on this area are maninly the reports from HIV Service Agencies that do not capture the silenced voices of PLHIV on intersectional oppression. By acknowledging the need of a evidence-based study, a Participatory Action Research (PAR) project was developed in 2019 to understand the challenges of the Women Living with HIV in Kathmandu, Nepal (Dhungel, 2020; Dhungel & Lama, 2020). This understanding was reached through a variety of means, including photovoice, individual interviews and street dramas. Four major intersectional challenges were identified including discriminations against WLHIV at workplace, violations of privacy in health sectors, excluding from parental's property and discriminations against their children at school. The same study suggested the need for a further study, focusing on intersectional oppressions and public health services and programs available for WLHIV with a focus on Mental Health Services. Therefore, this study was initiated to bridge the gaps in current knowledge with a foucs on COVID-19 policies/programs. Keywords: COVID-19, HIV community, injustice, intersectional oppression

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HIV and Sexual Dysfunction in Men

Journal of Clinical Medicine ◽

10.3390/jcm10051088 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1088

Author(s):

Sara De Vincentis ◽

Giulia Tartaro ◽

Vincenzo Rochira ◽

Daniele Santi

Keyword(s):

Sexual Dysfunction ◽

Current Knowledge ◽

Virus Transmission ◽

Sexual Problem ◽

People Living With Hiv ◽

Clinical Approach ◽

Hiv Patients ◽

Hiv Management ◽

Loss Of Libido ◽

Living With Hiv

Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) management, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.

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Prevalence and Correlates of Snuff Use, and its Association With Tuberculosis, Among Women Living With HIV in South Africa

Nicotine & Tobacco Research ◽

10.1093/ntr/nty137 ◽

2018 ◽

Vol 21 (8) ◽

pp. 1087-1092 ◽

Cited By ~ 1

Author(s):

Jessica L Elf ◽

Ebrahim Variava ◽

Sandy Chon ◽

Limakatso Lebina ◽

Katlego Motlhaoleng ◽

...

Keyword(s):

South Africa ◽

Tobacco Use ◽

Smokeless Tobacco ◽

People Living With Hiv ◽

Potential Health ◽

Adjusted Analysis ◽

Women Living With Hiv ◽

Urine Cotinine ◽

Smokeless Tobacco Use ◽

Living With Hiv

Abstract Introduction A higher proportion of people living with HIV (PLWH) smoke compared to the general population, but little information exists about the prevalence and correlates of smokeless tobacco use among PLWH. In South Africa, dry powdered tobacco is inhaled nasally as snuff. Methods A cross-sectional survey among PLWH attending three HIV clinics was conducted. Snuff use was assessed via self-report and urine cotinine. Results Given the low (3%) prevalence of snuff use among men, analysis was restricted to n = 606 nonsmoking women living with HIV. Half (n = 298, 49%) were snuff users, the majority of whom (n = 244, 84%) had a positive urine cotinine test. In adjusted analysis, snuff use was negatively associated with higher education (relative risk [RR] 0.55; 95% confidence interval [CI]: 0.39, 0.77) and mobile phone ownership (RR 0.83; 95% CI: 0.71, 0.98), and positively associated with ever having tuberculosis (TB) (RR 1.22; 95% CI: 1.03, 1.45). In adjusted analysis, with current TB as the outcome, snuff use was marginally statistically significantly associated with a twofold increase in odds of a current TB diagnosis (odds ratio [OR] 1.99; 95% CI: 0.98, 4.15). Discussion A high proportion of nonsmoking South African women living with HIV use snuff, which was a risk factor for TB. Additional research is needed to understand the relationship between snuff, TB, and other potential health risks. Implications PLWH have a higher prevalence of smoking than their seronegative peers, but there is a paucity of research on smokeless tobacco use in this population, especially in low-resource settings. TB is the leading cause of death among PLWH, and with improvements to HIV treatment and care, PLWH are at greater risk of tobacco-related diseases. We report an extremely high prevalence of snuff use among women living with HIV in South Africa. Further, in this population snuff use is positively associated with ever having a TB diagnosis, as well as currently having TB.

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Health Services Utilization Among South African Women Living with HIV and Reporting Sexual and Substance-Use Risk Behaviors

AIDS Patient Care and STDs ◽

10.1089/apc.2009.0213 ◽

2010 ◽

Vol 24 (4) ◽

pp. 257-264 ◽

Cited By ~ 14

Author(s):

Winnie K. Luseno ◽

Wendee M. Wechsberg ◽

Tracy L. Kline ◽

Rachel Middlesteadt Ellerson

Keyword(s):

Substance Use ◽

Health Services ◽

South African ◽

Risk Behaviors ◽

Health Services Utilization ◽

African Women ◽

Services Utilization ◽

Women Living With Hiv ◽

South African Women ◽

Living With Hiv

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A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV

Diagnostics ◽

10.3390/diagnostics11112047 ◽

2021 ◽

Vol 11 (11) ◽

pp. 2047

Author(s):

Davide Fiore Bavaro ◽

Paola Laghetti ◽

Mariacristina Poliseno ◽

Nicolò De Gennaro ◽

Francesco Di Gennaro ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Current Knowledge ◽

Disease Stage ◽

Oral Glucose ◽

People Living With Hiv ◽

Diagnosis And Management ◽

Increased Risk ◽

Living With Hiv

The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the “fourth 90”. To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake, according to disease stage and eventually concomitant diabetes.

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