scholarly journals Maternal and infant health is protected by antiretroviral drug strategies that preserve breastfeeding by HIV-positive women

2012 ◽  
Vol 13 (1) ◽  
pp. 6-13
Author(s):  
Louise Kuhn
Keyword(s):  
South African ◽  
Infant Formula ◽  
Infant Health ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Infant Survival ◽  
Department Of Health ◽  
Hiv Positive Women ◽  
Antiretroviral Drug ◽  
Maternal And Infant Health

The South African Department of Health is justified in withdrawing support for free infant formula. By so doing, it recognises that any intervention that might detract from breast feeding poses a serious threat to infant survival. Since evidence is now strong that antiretroviral drugs used during lactation prevent transmission of infection from a seropositive mother, strategies that promote breastfeeding can now be recommended for enhancing the health of mothers and infants.

scholarly journals Maternal and infant health is protected by antiretroviral drug strategies that preserve breastfeeding by HIV-positive women

2012 ◽  
Vol 13 (1) ◽  
Author(s):  
Louise Kuhn
Keyword(s):  
South African ◽  
Infant Formula ◽  
Infant Health ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Infant Survival ◽  
Department Of Health ◽  
Hiv Positive Women ◽  
Antiretroviral Drug ◽  
Maternal And Infant Health

The South African Department of Health is justified in withdrawing support for free infant formula. By so doing, it recognises that any intervention that might detract from breast feeding poses a serious threat to infant survival. Since evidence is now strong that antiretroviral drugs used during lactation prevent transmission of infection from a seropositive mother, strategies that promote breastfeeding can now be recommended for enhancing the health of mothers and infants.

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
South African ◽  
Access To Health Care ◽  
Health Facilities ◽  
Hiv Positive ◽  
The South ◽  
Hiv Positive Women ◽  
Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

Age at Diagnosis of Preinvasive and Invasive Cervical Neoplasia in South Africa: HIV-Positive Versus HIV-Negative Women

2011 ◽  
Vol 21 (2) ◽  
pp. 363-366 ◽  
Author(s):  
Louis-Jacques Jean van Bogaert
Keyword(s):  
South African ◽  
Invasive Cervical Cancer ◽  
Age Distribution ◽  
Age At Diagnosis ◽  
Hiv Positive ◽  
Low Grade ◽  
Black South African ◽  
Hiv Positive Women ◽  
The Mean ◽  
Intraepithelial Lesions

Hypothesis:Human immunodeficiency virus-positive women develop invasive cervical cancer at a significantly earlier age than seronegative women. It is hypothesized that this might result from shorter preinvasive stages.Methods:Prospective observational study of histologically diagnosed 398 low-grade (LGSIL), 738 high-grade intraepithelial lesions (HGSIL), and 1048 invasive cancers (IC) in a black South African population. The study comprised of 493 (22.6%) seropositive women and 1691 (77.4%) seronegative women who served as the controls. All were subdivided into 5-years age bands.Results:The mean age at diagnosis of LGSIL and HGSIL was similar in the cases (t= 0.7;P= 0.49) and the controls (t= 1.2;P= 0.22). The mean age at diagnosis of IC was significantly younger in the HIV-seropositive women than in the HIV-seronegative women (t= 14.0;P< 0.0001). The relative age distribution curves of LGSIL, HGSIL, and IC evolved close to each other in the cases. In the seronegative women, there was an 18-year lag between the peak age distribution of HGSIL and IC.Conclusion:Our data support the hypothesis of a shorter preinvasive stage in HIV-positive women.

scholarly journals Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-15 ◽  
Author(s):  
Jennifer A. Robinson ◽  
Roxanne Jamshidi ◽  
Anne E. Burke
Keyword(s):  
Unintended Pregnancy ◽  
English Language ◽  
Full Range ◽  
Effective Means ◽  
Antiretroviral Drugs ◽  
Hormonal Contraceptives ◽  
Hiv Positive ◽  
Contraceptive Efficacy ◽  
Oral Contraceptive Pills ◽  
Hiv Positive Women

Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman’s overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy.Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations.Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking.Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs.

scholarly journals Distribution of Human Papillomavirus (HPV) Genotypes in HIV-Negative and HIV-Positive Women with Cervical Intraepithelial Lesions in the Eastern Cape Province, South Africa

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 280
Author(s):  
Ongeziwe Taku ◽  
Zizipho Z. A. Mbulawa ◽  
Keletso Phohlo ◽  
Mirta Garcia-Jardon ◽  
Charles B. Businge ◽  
...  
Keyword(s):  
South African ◽  
Hpv Infection ◽  
African Women ◽  
Hiv Positive ◽  
Eastern Cape ◽  
Hpv Prevalence ◽  
Hiv Positive Women ◽  
Hpv Types ◽  
South African Women ◽  
Hiv Negative

South African women have a high rate of cervical cancer cases, but there are limited data on human papillomavirus (HPV) genotypes in cervical intraepithelial neoplasia (CIN) in the Eastern Cape province, South Africa. A total of 193 cervical specimens with confirmed CIN from women aged 18 years or older, recruited from a referral hospital, were tested for HPV infection. The cervical specimens, smeared onto FTA cards, were screened for 36 HPV types using an HPV direct flow kit. HPV prevalence was 93.5% (43/46) in CIN2 and 96.6% (142/147) in CIN3. HIV-positive women had a significantly higher HPV prevalence than HIV-negative women (98.0% vs. 89.1%, p = 0.012). The prevalence of multiple types was significantly higher in HIV-positive than HIV-negative women (p = 0.034). The frequently detected genotypes were HPV35 (23.9%), HPV58 (23.9%), HPV45 (19.6%), and HPV16 (17.3%) in CIN2 cases, while in CIN3, HPV35 (22.5%), HPV16 (21.8%), HPV33 (15.6%), and HPV58 (14.3%) were the most common identified HPV types, independent of HIV status. The prevalence of HPV types targeted by the nonavalent HPV vaccine was 60.9% and 68.7% among women with CIN2 and CIN3, respectively, indicating that vaccination would have an impact both in HIV-negative and HIV-positive South African women, although it will not provide full protection in preventing HPV infection and cervical cancer lesions.

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