جستجوی مقالات مرتبط با کلیدواژه « hiv » در نشریات گروه « پزشکی »

HIV-related health literacy is essential to influence people's beliefs about HIV/AIDS. It is also expected to reduce social stigma in the community. This study aimed to develop a model of HIV health literacy based on information and motivation toward social stigma in society. 

Cross-sectional designs are applied in these studies, conducted in five administrative areas of Bandung City, West Java Province, Indonesia, between March and April 2023. Sample recruitment used proportional cluster sampling in which one hundred and sixty-one community members participated in this study with criteria: aged more than 19 years old, not having HIV disease, and having the ability to read and use digital communication tools. Data analysis used a structural equation modeling approach. 

HIV information, situational factors, and motivation influenced HIV health literacy. However, individual beliefs about HIV/AIDS moderated the impact of health literacy on social stigma. The HIV Health Literacy model also has a high goodness of fit index of 0.502. 

Information and motivation factors effectively shape HIV health literacy in society. Adequate HIV health literacy can help change an individual's beliefs about HIV to prevent stigma and discrimination, thereby increasing social inclusion. The HIV Health Literacy model can be an alternative reference point in developing community HIV awareness and health literacy strategies.

Context: 

This research focuses on the impact of HIV/AIDS on transgender communities, aiming to assess their knowledge, attitudes, perceptions of risk, and practices concerning HIV/AIDS.

Evidence Acquisition: 

During this systematic review, a variety of keywords, including HIV, AIDS, knowledge, attitudes, practices, behavior, action, risk perception, perceived risk, risk susceptibility, severity perception, perceived self-efficacy, cues to action, benefit, barrier, health belief model, sexually transmitted disease, sexually transmitted infection, alcohol, drugs, amphetamine, opium, trans, transgender, transsexual, gender dysphoria were used. From Scopus, PubMed, Web of Science (ISI), and Google Scholar databases, 805 articles were initially identified and screened based on their titles, abstracts, and full texts. Exclusions were made for articles not in English and grey literature. Ultimately, 13 full-text articles met the selection criteria, adhering to COREQ and STROBE guidelines.

 The review encompassed studies involving 3,252 transgender participants. Among these, five articles evaluated knowledge levels, nearly all addressed attitudes (including perceived threats by 12 articles, perceived benefits/self-efficacy by three, and perceived barriers by seven), and 11 examined behaviors related to HIV/AIDS. The findings indicate a generally high level of knowledge about HIV/AIDS among transgender individuals, with peer health promoters playing a significant role in enhancing knowledge and facilitating access to health services. The perceived risk and severity of HIV/AIDS varied, with 52 - 82% acknowledging a perceived risk and 25 - 65% understanding the severity. The perceived benefits of HIV prevention were generally rated high, though self-efficacy in preventing HIV ranged from low to high. Barriers to HIV testing and accessing appropriate care were identified, including discrimination, distrust in health staff, lack of guidelines, and fear of test results or treatment side effects, among others. Risky sexual behaviors were common, with two-thirds engaging in such practices, 20% reporting 3 - 51 sexual partners, up to 91% having unprotected sex, around 60% using alcohol or drugs, 21 - 45% experiencing rape, and 14 - 68% being HIV-positive.

 In conclusion, the transgender community remains overlooked. Despite an adequate knowledge level and a moderate perception of HIV/AIDS risk, the prevalence of risky sexual behaviors and significant barriers to accessing health services highlight the urgent need for establishing long-term healthcare facilities and an effective surveillance system for this marginalized group.

As a vulnerable group in HIV control programs, immigrants face various obstacles to HIV testing. Despite the effectiveness of peer interventions on health promotion in HIV testing, relatively little is known about how these interventions work. This realist review aims to understand why, how, and under what conditions peer interventions can improve immigrants’ HIV testing uptake.

We followed the steps suggested by Pawson and colleagues for conducting the realist review. To test a initial program theory, we first systematically searched databases of PubMed, Web of Science, Scopus, Embase, and Cochrane, as well as the websites of UNAIDS, World Bank, Global Fund, WHO, and IOM. After data extraction and quality appraisal, data synthesis was conducted to explain the intervention pathways corresponding to context-mechanism-outcome configurations.

Seventeen studies were included in the review. Peer interventions for improving immigrants’ HIV testing uptake worked through four pathways: Following the improvement of communications (as a proximal mechanism): 1) increasing awareness, 2) reduced stigma, 3) improved support, and 4) increased access to services could lead to improved HIV testing uptake among immigrants. The identified mechanisms were influenced by three groups of individual/ interpersonal, service delivery, and structural factors.

Peer interventions with multiple strategies to be designed and implemented considering the barriers to HIV testing and also moving beyond one-size-fits-all approaches can successfully improve the immigrants’ HIV testing uptake. The refined program theory in this study can help the healthcare providers and policy-makers promote the immigrants’ HIV testing uptake and reduce the risk of disease transmission.

 Disseminated nocardiosis is a rare but life-threatening infectious disease that occurs most often in immunocompromised individuals. This report presents a human immunodeficiency virus (HIV)-infected patient with disseminated nocardiosis in the liver, lung, and brain.

 A 38-year-old woman who had recently been diagnosed with HIV infection complained of fever, abdominal pain, productive coughs, and occasional headaches from 2 months ago. Imaging findings of her abdomen and lungs displayed evidence of pyogenic liver abscess and lobar pneumonia with abscess formation, respectively. The patient underwent percutaneous liver abscess drainage and bronchoalveolar lavage (BAL). Using reverse transcription-polymerase chain reaction (RT-PCR), the genome of Nocardia farcinica was detected in the specimens obtained from both procedures. Besides, she had seizures during hospitalization. Based on cerebrospinal fluid (CSF) analysis, the specimen was positive for N. farcinica. Brain imaging also revealed evidence of multiple bacterial abscess formation. She was diagnosed with disseminated nocardiosis and treated with intravenous imipenem, trimethoprim/sulfamethoxazole, and amikacin, followed by appropriate oral agents. After a 6-month follow-up, the patient had no symptoms. Additionally, the lesions improved on brain imaging.

 Patients who are HIV-positive are particularly prone to opportunistic infections. Health care providers should consider all pathogens, even rare ones, like Nocardia spp., to establish a diagnosis if they're present. Furthermore, in cases initially diagnosed with localized nocardiosis, other body organs should also be reviewed so that the disseminated form of the disease can be diagnosed and treated immediately.

 Progressive multifocal leukoencephalopathy (PML) is a rare, severe demyelinating disease of the central nervous system predominantly found in patients with acquired human immunodeficiency syndrome (AIDS).

 This report details a case involving a male HIV-positive patient with PML who discontinued his highly active antiretroviral therapy (HAART) treatment 10 days after being diagnosed with HIV. The patient had no history of neurological symptoms either before or after his HIV diagnosis until he was administered corticosteroids. Notably, he began experiencing ataxia shortly after starting dexamethasone. Progressive multifocal leukoencephalopathy was diagnosed through polymerase chain reaction (PCR) testing for the John Cunningham virus (JCV) in the cerebrospinal fluid (CSF). The PML lesions were confined to the cerebellum.

 The occurrence of neurological symptoms (activation of JCV) after administering corticosteroids to a patient with HIV-who had not received any antiretroviral treatment for 4 years-raises a critical question: Is the use of corticosteroids, which are a primary treatment for immune reconstitution inflammatory syndrome (IRIS), a double-edged sword in CNS-IRIS?

Needle stick injury (NSI) is the most dreaded occupational health hazard affecting a healthcare worker (HCW) psychologically and physically. The risk of infection post needle stick injury ranges between 1.9% to greater than 40% for HBV infections, 2.7-10% for HCV and 0.2-0.44% for HIV infections. As per National AIDS Control Organisation (NACO) records, nursing staff is at highest risk (43%) followed by physicians (28%). The main objective of this study was to evaluate knowledge of nursing staff about needle stick injuries and to study factors leading to such incidents in their working areas, impart them knowledge regarding the same and fill gaps in knowledge.

This is a cross-sectional retrospective analysis involving nursing staff and students. p values were calculated using SPSS software.

Overall NSI prevalence among nursing staff and students was 51.6% whereas in more exposed and less exposed group was 47.45% and 10.16% respectively (p=0.2056). The most common cause of NSI incident was recapping of needle (38.5%) followed by transferring needle to sharp container (35%).

Consequences of NSI are serious and this study has tried to emphasize on the need to study the factors leading to NSI.

 Genital dermatoses can interfere with sexual functioning and self-image. Sexually transmitted infections (STIs) are among the top 10 diseases in India.

 This study aimed to document the burden, clinico-etiological, and demographic profile of patients presenting with genital lesions, determine the proportions of the pediatric and human immunodeficiency virus (HIV)-seropositive patients, and identify contributory factors.

 This was a hospital-based cross-sectional observational study conducted at a tertiary hospital in Pune, India, in the Department of Dermatology and Pediatrics over a period of 2 months (July-August 2022). Patients presenting with genital lesions were enrolled after obtaining written informed consent. Relevant information was recorded using a predesigned proforma.

 A total of 83 patients comprised 77 adults, 3 (3.6%) pediatric patients and adolescents each, and 15 (18.1%) HIV-seropositive individuals. The adult male-to-female ratio was 1.2: 1. The mean age of adults was 37.01 ± 14.57 years. The most common STI and non-STI lesions were herpes genitalis and tinea cruris, respectively, with a similar trend in the HIV-seropositive group. All three pediatric cases had non-STI lesions; however, 66.7% of adolescents had STIs (vulvovaginal candidiasis and genital warts). Overall, there was a slightly higher preponderance of non-STI lesions (53.75%), and the majority of patients had lesions of infectious nature (86.25%). The most common identifiable risk factor was lack of circumcision (51.25%), followed by unprotected intercourse (22.5%). The presence of risk factors was significantly associated with male gender (P = 0.0001).

 This study emphasizes that besides STIs, non-STIs contribute substantially to genital diseases.

Kaposi’s sarcoma (KS) and multicentric Castleman's disease (MCD) are both linked to human herpesvirus-8 (HHV-8) infection which most commonly affects people living with human immunodeficiency virus (HIV).  Herein, we describe the case of a 57-year-old patient who has been admitted for fever, night sweats, weight loss, and diffuse lymphadenopathy with abdominal pain. HIV status was confirmed by a positive Western blot test. His initial CD4 cell count was equal to 270 cells/µL. A histological study of a peripheral lymph node concluded that KS is associated with MCD. These two conditions found in the same patient highlight the malignant potential of HHV-8, particularly in the case of HIV-induced immunodeficiency.

 Antibiotic resistance is an escalating global health concern, with carbapenems, potent last-line antibiotics, facing increasing resistance and potentially dire consequences. This scoping review sought to consolidate data on carbapenem resistance in human immunodeficiency virus (HIV)-infected patient cohorts as the intricate relationship between HIV and antibiotic resistance remains inadequately understood.

 We employed a scoping review methodology and conducted a comprehensive search across Google Scholar, Scopus, Cochrane, and PubMed, utilizing specific search terms related to carbapenem resistance and HIV. We extracted and analyzed data, encompassing study design, geographic location, number of HIV-infected participants, CD4 cell counts, specimen types, cultured organisms, carbapenem susceptibility, and comparisons between HIV-infected and uninfected cohorts.

 This review encompassed 15 studies, involving 2365 HIV-infected participants, primarily employing cross-sectional designs, with nine studies conducted in African countries. The most frequently analyzed specimens included urine, stool, and sputum, with Escherichia coli emerging as the most frequently cultured organism. Commonly used carbapenem drugs included imipenem, meropenem, and ertapenem, with varying susceptibility patterns. Imipenem and meropenem exhibited sensitivities exceeding 80%, except for one study with Pseudomonas aeruginosa, which demonstrated 73% sensitivity. Ertapenem displayed fluctuating sensitivities ranging from 58% to 100% for different bacterial organisms. Only one study reported the colonization of carbapenem-resistant Enterobacterales (CRE) in HIV-infected patients, with HIV status not significantly influencing CRE carriage. When comparing HIV-infected and uninfected cohorts, four studies found no substantial impact of HIV status on carbapenem resistance.

 In the context of the HIV burden and opportunistic infections, carbapenem resistance demonstrated relatively consistent patterns across most studies comparing HIV-infected and uninfected cohorts. However, the presence of CRE among HIV-infected individuals raises concerns regarding nosocomial infections. The limited reporting of CD4 counts in the included studies necessitates further exploration of potential associations with immune status. E. coli, frequently cultured in these studies, exhibited varying resistance patterns, and the impact of HIV on these patterns remains uncertain. Carbapenem susceptibility displayed variability among different organisms, underscoring the nuanced nature of resistance. As such, this scoping review serves as a foundation for comprehending carbapenem resistance in HIV-infected populations but underscores the necessity for more comprehensive research in this field.

Since the introduction of Highly Active Anti-Retroviral Therapy (HAART), there has been a significant increase in the survival of HIV-infected patients. Consequently, there has been increased attention on the potential neoplastic pathologies, such as Kaposi’s sarcoma, associated with AIDS in these individuals. 

Case Report: 

In this case report we present, for the first time, a patient affected by Kaposi's sarcoma of the palatine tonsil with a concomitant syphilis infection. The patient underwent enlarged tonsillectomy and continued antiretroviral therapy. There were no signs of disease recurrence at a 12-month follow-up. 

Despite the rarity of tonsillar localization of Kaposi's sarcoma, it should be suspected in the presence of an HIV-infected patient. Tonsillectomy effectively controls local disease, but comprehensive patient management requires a multidisciplinary team of healthcare professionals, including infectious disease specialists, pathologists, and oncologists who work together to provide high-quality and coordinated care.

People with HIV/AIDS face numerous challenges, including the effect of the disease on their personal relationships with family, friends, colleagues, and healthcare professionals.

The purpose of this qualitative study was to investigate social interactions among patients with HIV/AIDS in Iran. Materials &

This qualitative content analysis study was conducted on 12 patients with HIV/AIDS referring to the Behavioral Disease Counseling Center of Imam Khomeini Hospital in Tehran and the Behavioral Disease Counseling Center in Rasht City in 2018. Semi-structured, face-to-face, and audio-recorded interviews were used to collect data. Purposive sampling with maximum variation was used to select participants. The duration of the interview was between 40 to 75 min. MAXQDA software, version 10 was used for data organization and management, and conventional content analysis was used for data analysis.

From the analysis of interviews with 12 individuals with HIV/AIDS (7 men and 5 women), 51 codes were extracted in three categories: Disease disclosure (disclosure to important people in life, disclosure to public and health services, and dealing with the challenges of disclosure), social support (impairment in interpersonal relationships and relationships with peers), and acceptance (social acceptance and acceptance by health care providers).

Despite significant progress in HIV/AIDS prevention, treatment, and education, the stigma caused by this disease remains high and has a negative impact on the interpersonal relationships of people living with HIV/AIDS with their families, relatives, friends, colleagues, and healthcare providers.

The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis.

This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies.

In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article.

Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat.

Female sex workers (FSWs) in most societies run a high risk of health problems, including sexually transmitted infections (STIs) such as viral infections and syphilis. The present study examines the prevalence of viral infections and syphilis among FSWs.

This cross-sectional study recruited 100 female sex workers (April 2019 to April 2020) who visited the Counseling Center for Behavioral Diseases or were selected via purposeful (snowball) sampling. A questionnaire (demographic information and STI risk factors) was completed in a face-to-face interview with the participants. Blood samples were then taken to test the markers for HBV, HCV Ab, HIV Ab, Rapid Plasma Reagin (RPR) for syphilis and a PCR was taken to test for HPV (in vaginal sex workers from the cervix and anal sex workers from the anal region). The data were analyzed in Stata 14.

Among 100 FSWs, 6 (6%) were infected with HIV, 1 (1%) with hepatitis B, and 2 (2%) were anti-HCV positive. 1 (1%) participant was suspected of having syphilis. Based on the PCR tests, 16 (16%) participants were infected with HPV. Moreover, 68 (68%) FSWs reported having unprotected sex.

Due to the prevalence of viral infections and syphilis and unprotected sex in FSWs, immediate preventive measures are critical for this vulnerable group to control the transmission of these viral infections in society.