scholarly journals Safety of the surgeon: ‘Double-gloving’ during surgical procedures

2014 ◽  
Vol 15 (4) ◽  
pp. 144-147 ◽  
Author(s):  
O. A. Arowolo ◽  
E. A. Agbakwuru ◽  
G. C. Obonna ◽  
C. U. Onyia ◽  
A. A. Akinkuolie ◽  
...  
Keyword(s):  
Operating Time ◽  
Hiv Positive ◽  
Hiv Status ◽  
Subsaharan Africa ◽  
Additional Protection ◽  
The Face ◽  
The Mean ◽  
A Prospective Study ◽  
Operating Surgeon ◽  
Hiv Negative

Background. In the face of increasing HIV/AIDS prevalence in subSaharan Africa, we evaluate the effectiveness of ‘double-gloving’ during surgery as a means of protecting the surgeon operating on patients with a known or unknown HIV status.Methods. A prospective study was conducted to determine the rate of glove puncture and intraoperative injury in categories of patients with known positive, known negative or unknown HIV status.Results. The surgeon and the first assistant double-gloved in all the 1 050 procedures performed between 2009 and 2013, and a total of 8 400 surgical gloves were used. Sixty-nine patients (6.6%) were HIV-positive, 29 patients (2.8%) were HIV-negative, and the HIV status was unknown for the remaining 952 patients (90.7%). The overall glove puncture rate in the study was 14.5%. The glove puncture rate was 0%, 31% and 15% for HIV-positive, HIV-negative and HIV status unknown, respectively, and this difference was statistically significant. The mean operating time in the group with glove punctures was 148 min (95% confidence interval (CI) 135 - 161), while mean operating time in the group without glove puncture was 88 min (95% CI 84 - 92). Conclusion. Double-gloving offers protection against intraoperative injury. Knowing the HIV status of the patient offers additional protection to the operating surgeon. While we recommend routine double-gloving for surgeons working in HIV-prevalent patient populations, we also advocate for the routine screening for HIV in all surgical patients.

scholarly journals Phenotype and Treatment of Breast Cancer in HIV-Positive and -Negative Women in Cape Town, South Africa

2016 ◽  
Vol 2 (5) ◽  
pp. 284-291 ◽  
Author(s):  
Lizanne Langenhoven ◽  
Pieter Barnardt ◽  
Alfred I. Neugut ◽  
Judith S. Jacobson
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Standard Deviation ◽  
Systemic Chemotherapy ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cd4 Cell Count ◽  
The Mean ◽  
Cd4 Cell ◽  
Hiv Negative

Purpose An estimated 5.9 million people in South Africa are infected with HIV. Because antiretroviral therapy has made infection with HIV a treatable, chronic condition, HIV-infected individuals are now surviving to middle and older age. We investigated the implications of HIV status for breast cancer in South Africa. Methods We compared clinical and demographic characteristics of women newly diagnosed with a first primary breast cancer at Tygerberg Hospital, Cape Town, South Africa, from January 2010 to December 2011 by HIV status. We then compared HIV-positive patients with HIV-negative controls, matched 2:1 on age and ethnicity, with respect to chemotherapy regimens, toxicities, completion of systemic chemotherapy, and changes in CD4 cell count. Results Of 586 women with breast cancer, 31 (5.3%) were HIV positive, 420 (71.7%) were HIV negative, and 135 (23%) were untested for HIV. Women with HIV were younger than other women (P < .001). The groups did not differ in regard to stage at presentation, histologic subtype, tumor grade, nodal involvement, or hormone receptor positivity. More than 84% of patients who initiated systemic chemotherapy, regardless of HIV status, completed it without serious toxicity. Among HIV-positive patients receiving chemotherapy, the mean baseline CD4 cell count was 477 cells/µL (standard deviation, 160 cells/µL), and the mean nadir was 333 cells/µL (standard deviation, 166 cells/µL). Conclusion HIV-infected women were younger at breast cancer diagnosis than HIV-negative women but otherwise similar in phenotype and completion of chemotherapy. Longer term follow-up is needed to evaluate the effects of HIV, antiretroviral therapy, and chemotherapy on the survival and quality of life of patients with breast cancer.

scholarly journals Prevalence and determinants of anemia amongst HIV positive pregnant women in a tertiary Hospital in Nigeria

2020 ◽  
Vol 9 (12) ◽  
pp. 4825
Author(s):  
Innocent O. Eze ◽  
Clara U. Innoeze ◽  
Malachy E. Ayogu ◽  
Stephen C. Eze
Keyword(s):  
Pregnant Women ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Positive Group ◽  
Increased Risk ◽  
The Mean ◽  
Prevalence Of Anemia ◽  
Hiv Negative

Background: In pregnancy, anemia is associated with increased risk of both maternal and fetal morbidity and mortality especially in HIV situation. To determine the prevalence and determinants of anemia in HIV positive compared to HIV negative women.Methods: This was a cross sectional study carried out from June 2016 to December 2017 amongst pregnant women who presented to the antenatal clinic. Information on socio-demographic variables and laboratory test to determine the hemoglobin levels and CD4 count (for the HIV positive women) were carried out. A total of 350 subjects with equal number of HIV positive and HIV negative pregnant women were recruited. Variables were compared between the two groups using software package for social sciences version 20. P values<0.05 at 95% confidence interval are considered statistically significant.Results: The mean age for HIV positive and negative were 31.54 ±4.1 and 29.03 respectively while, mean gestational age at booking for HIV positive and negative were 20.41±8.61 and 22.37±7.4 weeks respectively. The HIV positive group had a mean parity of 2.02±1.5, and 2.56±1.2 was that of the HIV negative group. The mean hemoglobin statuses at booking were 9.92±1.8 g/dl and 10.6±1.1 g/df HIV positive and HIV negative women respectively. The mean CD4+ at booking for HIV positive group was 478±251 per microliter. The overall prevalence of anemia irrespective of HIV status was 36.6%. The prevalence of anemia in HIV positive and negative women were 44.6% and 28.6% respectively. There was statistically significant relationship between anemia and HIV status (p=0.002).Conclusions: There was inverse relationship between CD4+ count and anemia. Low CD4+ count and non-use of HAART at booking were important determinants of anemia among the HIV.

scholarly journals Initial Experience Of Laparoscopic Incisional Hernia Repair

1970 ◽  
Vol 5 (2) ◽  
pp. 41-45
Author(s):  
SK Biswas ◽  
MM Arefin ◽  
JC Saha ◽  
T Ahmed ◽  
MM Rahman
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Laparoscopic Repair ◽  
Operating Time ◽  
Incisional Hernia Repair ◽  
Safe Alternative ◽  
Laparoscopic Incisional Hernia Repair ◽  
Open Mesh Repair ◽  
The Mean ◽  
A Prospective Study

The laparoscopic incisional hernia repair is a safe alternative to open mesh repair. The procedure has the advantages of minimal access surgery and lower recurrence rate. A prospective study of laparoscopic incisional hernia repair of our first 11 patients was performed from July 2008 to December 2009. No serious intraoperative or postoperative morbidity was encountered, only two patients developed seroma. The mean operating time was 90 minutes (60 to 180 minutes). The mean day of discharge after surgery was 3 days (2-7 days). No patient developed a recurrence during mean follow up period of 10 months. Laparoscopic repair of incisional hernia has been shown to be feasible, safe and effective. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.Key Words: Incisional hernia; Laparoscopic repair; Mesh; Polypropylene DOI: 10.3329/fmcj.v5i2.6819Faridpur Med. Coll. J. 2010;5(2):41-45

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

2010 ◽  
Vol 24 (4) ◽  
pp. 281-293 ◽  
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.

Disclosure Experiences and Challenges Among Children and Adolescents Living with HIV/AIDS in Nigeria-A Review of the Literature

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Nzube Pauline Okolo-Francis ◽  
Uyinonijesu Diamond Victor-Ogie ◽  
Abdulmumin Ibrahim ◽  
Amos Abimbola Oladunni ◽  
Goodness Ogeyi Odey ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Healthcare Workers ◽  
Negative Impact ◽  
Hiv Positive ◽  
Review Of The Literature ◽  
Hiv Status ◽  
Clinical Context ◽  
The Mean ◽  
Living With Hiv ◽  
Status Disclosure

Context: Disclosure of HIV positive infection status in children and Adolescents is multifaceted and should take into consideration their age, psychosocial maturity, cultural and clinical context. This study was conducted to examine disclosure experiences and challenges among children and ALWHA in Nigeria. Evidence Acquisition: We conducted narrative review of relevant literatures by searching PubMed, Google scholar and Medscape using predetermined keywords. Results: Findings are presented under themes of process of disclosure and age of disclosure, reasons and challenges of disclosure, reactions and responses to disclosure, consistent with various authors. This study shows that the mean age and reasons for HIV positive status disclosure are variable. Disclosure was mostly executed at home and mostly carried out by parents or caregivers of HIV-infected children. Reactions of children and ALWHA upon disclosure was mainly negative and ranged from feeling of anger to expression of shock to feeling of sadness and to crying. Barriers to HIV-positive status disclosure among caregivers were perceived sense immaturity and age of the child, fear of stigma, fear of child’s inability to cope, fear of blaming the parents and refusal to take antiretroviral (ARV) drugs. While caregivers highlighted several factors that affect disclosure of HIV status to children and adolescents, this study reveals both positive and negative impact on their emotions. Conclusions: It is of note that approach to disclosure is critical, therefore caregivers and healthcare workers should be properly trained and supported with resources required to effectively carry out disclosure. There is need for continuous research to understand and develop age and culture specific approaches to disclosure in children and adolescents in Nigeria.

scholarly journals 423. Self-Reported Screening for Rectal Sexually Transmitted Infections Among Men Who Have Sex with Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S212-S213
Author(s):  
Timothy William. Menza ◽  
Lauren Lipira ◽  
Amisha Bhattarai ◽  
Joseph Ramirez ◽  
Roberto Orellana
Keyword(s):  
Sexually Transmitted Infections ◽  
Multivariable Analysis ◽  
Prevalence Ratio ◽  
Hiv Positive ◽  
Sexually Active ◽  
Hiv Status ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

Abstract Background Rectal gonorrhea and Chlamydia are common and predict HIV acquisition among men who have sex with men (MSM); however, screening for rectal sexually transmitted infections (STIs) is not routine. Methods In 2017, we recruited sexually-active MSM in the Portland, Oregon metropolitan area through venue-based sampling. Our outcome of interest was self-reported rectal STI screening in the prior 12 months. Stratified by HIV status, we assessed the prevalence and demographic, healthcare, clinical, and behavioral predictors of screening. Results Of 448 participants, 168 (37.5%) reported rectal STI screening. One hundred twenty-seven (35.8%) of 355 HIV-negative men, 41 (58.6%) of 70 HIV-positive men, and none of 23 men who did not know their HIV status reported screening. Among HIV-negative men, having a healthcare provider who offered HIV testing (adjusted prevalence ratio [aPR]=2.09; 95% confidence interval [CI]: 1.43, 3.04), a syphilis diagnosis (aPR=1.32; 95% CI: 1.03, 1.69), use of pre-exposure prophylaxis (aPR=1.57; 95% CI 1.21, 2.04), and condomless anal sex with casual partners in the prior 12 months (aPR=1.74; 95% CI: 1.36, 2.22) independently predicted screening for rectal STI in multivariable analysis. HIV-positive men who reported having a provider who always or often initiates conversations about sex were significantly more likely to report screening compared with men who did not have such a provider (aPR=1.48; 95% CI: 1.06, 2.06). Conclusion Rectal STI screening is not universal in a venue-based sample of sexually-active MSM. Implementing innovative, acceptable, and accessible screening practices and improving provider comfort with talking about sex are paramount to increasing rectal STI screening. Disclosures All authors: No reported disclosures.

Rate of BCG Immunization in HIV-Exposed Infants in a Selected Primary Health Centre in Southern Nigeria: Implications of No Vaccine Policy for HIV-Positive Infants

2020 ◽  
Author(s):  
A M Ekanem ◽  
I P Oloyede ◽  
U E Ekrikpo ◽  
A U Idung ◽  
E Edward
Keyword(s):  
Health Centre ◽  
Primary Health Centre ◽  
Hiv Positive ◽  
Hiv Status ◽  
Hiv Dna ◽  
Primary Health ◽  
Hiv Exposed ◽  
Dna Pcr ◽  
Pcr Test ◽  
Hiv Negative

Abstract Background Maternal and infant HIV status influences the decision of BCG immunization of infants at birth. The objective of this study was to determine the HIV status of HIV-exposed infants (HEIs) by the first HIV DNA PCR test and the rate of BCG uptake among the HEIs who were confirmed HIV negative. Methods This was a retrospective descriptive cross-sectional study involving the review of results of 99 dried blood samples (DBS) for the first HIV DNA PCR test of HEIs whose mothers were diagnosed HIV positive on presentation of the infants at first immunization visit at a Primary Health Centre from January 2018 to January 2019. Results Of the 99 DBS examined, 86; 86.9% (95% CI 80.1–93.6) were HIV negative, 9; 9.1% (95% CI 3.3–14.8) were positive while the results of 4 (4.0%) infants were not in the register. Only 7; 7.1% (95% CI 1.9–12.2) of the 99 HEIs returned for BCG immunization at the centre. BCG immunization status of the HEIs after first PCR results was not significantly associated with sex of the infants or availability of phone number of the guardians (p = 0.70 and 0.12, respectively). Conclusion The majority of HEIs were HIV negative at first HIV DNA PCR test. Few of these HIV negative infants returned for BCG immunization. Hence, all HEIs should be given BCG immunization according to WHO GAVCS committee recommendation on BCG immunization for settings with poor HIV diagnostic and treatment facilities for mothers and infants.

scholarly journals Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa

2018 ◽  
Vol 3 (4) ◽  
pp. e000833 ◽  
Author(s):  
Aaron S Karat ◽  
Noriah Maraba ◽  
Mpho Tlali ◽  
Salome Charalambous ◽  
Violet N Chihota ◽  
...  
Keyword(s):  
South Africa ◽  
Verbal Autopsy ◽  
Vital Statistics ◽  
Classification Systems ◽  
Hiv Positive ◽  
Hiv Status ◽  
Civil Registration ◽  
Art Initiation ◽  
Better Than ◽  
Hiv Negative

IntroductionVerbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods.MethodsUsing the WHO 2012 instrument with added ART questions, VA was conducted for deaths among adults with known HIV status (356 HIV positive and 103 HIV negative) in South Africa. CoD were assigned using physician-certified VA (PCVA) and computer-coded VA (CCVA) methods and compared with documented HIV status.ResultsThe sensitivity of VA questions in detecting HIV status and ART initiation was 84.3% (95% CI 80 to 88) and 91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive individuals were assigned HIV-associated CoD by PCVA, 166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5, and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze V.1.1.1 and V.1.2.1. Agreement between PCVA and older CCVA methods was poor (chance-corrected concordance [CCC] <0; cause-specific mortality fraction [CSMF] accuracy ≤56%) but better between PCVA and updated methods (CCC 0.21–0.75; CSMF accuracy 65%–98%). All methods were specific (specificity 87% to 96%) in assigning HIV-associated CoD.ConclusionAll CCVA interpretation methods underestimated the HIV-associated mortality fraction compared with PCVA; InterVA-5 and SmartVA-Analyze V.1.2.1 performed better than earlier versions. Changes to VA methods and classification systems are needed to track progress towards targets for reducing HIV-associated mortality,

scholarly journals The Demand for, and Impact of, Learning HIV Status

2008 ◽  
Vol 98 (5) ◽  
pp. 1829-1863 ◽  
Author(s):  
Rebecca L Thornton
Keyword(s):  
Hiv Positive ◽  
Sexually Active ◽  
Monetary Incentives ◽  
Hiv Status ◽  
Hiv Negative

This paper evaluates an experiment in which individuals in rural Malawi were randomly assigned monetary incentives to learn their HIV results after being tested. Distance to the HIV results centers was also randomly assigned. Without any incentive, 34 percent of the participants learned their HIV results. However, even the smallest incentive doubled that share. Using the randomly assigned incentives and distance from results centers as instruments for the knowledge of HIV status, sexually active HIV-positive individuals who learned their results are three times more likely to purchase condoms two months later than sexually active HIV-positive individuals who did not learn their results; however, HIV-positive individuals who learned their results purchase only two additional condoms than those who did not. There is no significant effect of learning HIV-negative status on the purchase of condoms. (JEL I12, O15)

scholarly journals Patterns of sexualised recreational drug use and its association with risk behaviours and sexual health outcomes in men who have sex with men in London, UK: a comparison of cross-sectional studies conducted in 2013 and 2016

2019 ◽  
Vol 96 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Tyrone J Curtis ◽  
Alison J Rodger ◽  
Fiona Burns ◽  
Anthony Nardone ◽  
Andrew Copas ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Positive ◽  
Risk Behaviours ◽  
Hiv Status ◽  
Cross Sectional ◽  
The Past ◽  
Unknown Status ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

ObjectiveLondon has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM’s patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (three monthly if engaging in chemsex).MethodsCross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% CIs were calculated.ResultsComparing the 2013 and 2016 surveys, chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013–2016 data showed that compared with other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68 to 3.30; HIV-positive men: aPR 4.19, 95% CI 1.85 to 9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64 to 2.69; HIV-positive men: aPR 2.56, 95% CI 1.57 to 4.20). 68.6% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year.ConclusionsChemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including three monthly HIV/STI testing, access to pre-exposure prophylaxis/antiretroviral treatment and behavioural interventions among MSM reporting chemsex, remains vital to address sexual health inequalities in MSM.

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