Risultati per: Linee guida su HIV, epatite e malattie sessualmente trasmissibili.

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Objective
To make healthcare programmes more patient-centred and efficient in light of limited resources, it is crucial to ensure patient satisfaction. There is limited information on the overall level of satisfaction with Human Immunodeficiency Virus/ Acquired Immune deficiency syndromes (HIV/AIDS) treatment and care services in Ethiopia. This meta-analysis aimed to generate a nationwide pooled estimate of the level of satisfaction with HIV/AIDS and associated factors by combining data from primary studies to provide a general overview of the effect across the country, aiming to informed policy decisions.

Design
Systematic review and meta-analysis.

Data source
PubMed, Scopus, Hinari, African journals online and Google Scholar were used to locate published studies.

Eligibility criteria
Observational studies assessing the level of satisfaction with HIV/AIDS care and treatment services and its associated factors among adult people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia were included.

Data extraction and synthesis
Two authors extracted the data using a pre-established data extraction format and exported it to Stata V.17 for analysis. The Cochran-Q and I2 test statistics were used to measure the statistical heterogeneity among included studies. A random-effects meta-analysis model with the Der Simonian-Laird method was used to estimate the pooled effect size of satisfaction with HIV/AIDS care and treatment services with its 95% CI. Small study effects were assessed using Egger’s regression test at a 5% level of significance. A meta-regression analysis and a leave-one-out sensitivity analysis were also conducted.

Results
24 studies were included. The pooled level of satisfaction with HIV/AIDS treatment and care services in Ethiopia was 69.7% (95% CI 63.8, 75.5%) with a significant level of heterogeneity (I2=98.0%; p

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I riconoscimenti del Premio Omar dalla stampa all’online, i video ed i podcast

I riconoscimenti dalla stampa all’online, ai video, ai podcast

‘Fare rete per accompagnare il cambiamento che è iniziato’

This Special Communication from the International Antiviral Society–USA provides updated 2024 recommendations for HIV treatment and clinical management and HIV prevention.

Advances in antiretroviral therapy (ART) has led to HIV being a manageable and preventable condition and provides the tools that might lead to an end of the HIV pandemic. Despite these advances, in the United States there were approximately 30 000 new infections in 2022, less than 70% of people living with HIV were virologically suppressed, and only 30% of those eligible for preexposure prophylaxis (PrEP) were receiving it. Prioritizing efforts on the significant disparities in access to care and the delivery of equitable health care are essential for future elimination goals.

Introduction
Mental health issues among women in Sub-Saharan Africa (SSA), especially those living with HIV, pose a major public health challenge. Despite the established connections between HIV status and mental health outcomes, there is a noticeable absence of targeted interventions for this group within the literature. Many studies tend to focus on broad mental health concerns without addressing the specific needs of women with HIV, or they neglect to incorporate mental health elements into current HIV-related programmes. This scoping review aims to gather and analyse the existing research on interventions designed to improve the mental health of women in SSA, both with and without HIV. It will identify barriers preventing this population from accessing mental healthcare, highlight important gaps in the current literature and suggest directions for future research.

Methods and analysis
To conduct this scoping review, the researcher will adhere to the methodological framework proposed by Arksey and O’Malley. The literature search will span several databases, including PubMed, MEDLINE, Web of Science and PsychInfo, to ensure a comprehensive collection of relevant studies. The selection process will involve two stages: two independent reviewers will initially screen titles for eligibility and a full-text review of the selected articles. A specially designed tool will be used for data extraction, focusing on minimising bias and accurately capturing study details. The final selection of studies will be analysed using a standardised tool to comprehensively assess all bibliographic information and study characteristics. The planned study dates for the review will be January to March 2025.

Ethics and dissemination
No ethical approval is required as the review will draw on publicly available publications and materials. The study’s conclusions will be subject to peer review and published in a scientific journal, with the abstract shared at local and international conferences. Key findings will be disseminated to health ministries, community-based organisations focused on women’s mental health and HIV, and policymakers to inform policy decisions regarding mental health interventions for women in SSA.

Objectives
The primary objective was to assess the acceptability of a savings intervention in which female sex workers (FSW) would save part of their earnings and call back (withdraw) when faced with a financial need that could force them into HIV risk practices. The secondary objectives were to assess its feasibility, concerns and design considerations.

Design
A cross-sectional survey. Participants were asked for views on the intervention, their earnings, saving and spending practices, and suggestions for the intervention package.

Setting
Kisumu and Siaya counties, Kenya.

Participants
FSWs aged ≥18 years, self-identifying as sex workers and living in Kisumu or Siaya county.

Outcome measures
The primary outcome was the proportion of participants who believed the Jitegemee intervention would be acceptable to FSWs in Kenya. The secondary outcomes were the proportion who: could generate money to save (assessed from income, spending and loaning practices), reported potential challenges with the intervention and suggested components to inform the intervention package.

Results
We enrolled 369 FSWs, 88% aged 18–39 years, 78% unmarried, 94% cared for ≥1 child(ren) and 78% were household heads. Over half (52.1%) had been in sex trade for ≤4 years, with 62.3% reporting

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Objective
To investigate the associations between mental health literacy (MHL), self-disclosure and psychological distress among HIV-positive young and middle-aged men who have sex with men (MSM). We hypothesised that self-disclosure would mediate the relationship between MHL and psychological distress.

Design
A cross-sectional study.

Setting
Participants were recruited from the outpatient clinic of the Department of Infection at a tertiary hospital in Nanjing, Jiangsu province, China.

Participants
A total of 209 HIV-positive young and middle-aged MSM.

Outcome measures
Using convenient sampling method, the study selected 209 HIV-positive young and middle-aged MSM from a tertiary hospital in Nanjing, China, from November 2023 to January 2024. The data were collected using a general information questionnaire, the Multicomponent Mental Health Literacy, the Kessler Psychological Distress Scale and the Distress Disclosure Index. Descriptive statistics, Pearson correlation analysis and mediation analysis were conducted in the study.

Results
The mean MHL score among HIV-positive young and middle-aged MSM was 11.90 (SD=5.09). Their mean score for self-disclosure was 31.97 (SD=6.87) and for psychological distress was 25.43 (SD=8.16). The bivariate correlation analysis showed that self-disclosure was positively correlated with MHL (r=0.264, p

Introduction
Stand-alone HIV clinics in sub-Saharan Africa (SSA) have effectively expanded antiretroviral therapy since the 2000s, transforming HIV from a deadly infection into a chronic condition. However, over the past decade, there has been a significant rise in the prevalence of non-communicable diseases (NCDs) globally and in SSA. People living with HIV are at higher risk for some NCDs, including hypertension, diabetes and different cancers. The region’s current healthcare infrastructure is not equipped to address this growing burden. Integrating health services for HIV and NCDs (ie, combining services for HIV with services for hypertension, diabetes, depression and mental health, substance use disorder or cancer) could be one strategy for responding to these challenges. In this scoping review, we aim to identify randomised controlled trials on HIV-NCD integration, assess implemented integration models and measured outcomes and highlight evidence gaps.

Methods and analysis
This scoping review will follow the Arksey and O’Malley (2005) methodological framework. Reporting will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. We will conduct a systematic search of the databases OVID Medline, Embase, Web of Science, Global, Africa Index Medicus, including terms related to HIV, NCDs and healthcare integration. Included trials must have been conducted within SSA and have been published in English or French after 1 January 2010. We will not select based on sample size or number of clusters. Both the title and abstract screening and full-text screening will be done in Covidence by at least two reviewers working independently. Data extraction will focus on key variables, including study design, geographical location, integration intervention, measured outcomes and reported findings.

Ethics and dissemination
This scoping review aims to generate new insights from publicly available research. Therefore, ethical approval is not required. Study findings will be shared through discussion with policymakers, implementation science researchers and healthcare providers. The results of this study are intended to be published in a peer-reviewed journal.

Trial registration
This protocol has been registered with Center for Open Science OSF Registry (DOI: 10.17605/OSF.IO/RGQSN). The search was conducted on 25 March 2024 and updated on 21 October 2024. The review is expected to be completed by March 2025.

Objectives
People living with HIV (PLWH) were previously shown to have a higher prevalence of non-calcified coronary plaque with discrepant results for coronary stenosis and any plaque prevalence. This systematic review and meta-analysis summarise and estimate pooled effect sizes for observational studies among PLWH using comprehensive coronary CT angiography (CTA).

Design
Preferred Reporting Items for Systematic Review and Meta-analysis reporting guidelines were used.

Data sources
PubMed, Embase, Web of Science, CINAHL, Cochrane Clinical Trials and EBM were searched from inception to 23 February 2024.

Eligibility criteria
We included studies evaluating coronary atherosclerosis in adult PLWH with controls and CTA results for plaque prevalence, extent, severity and high-degree stenosis.

Data extraction and synthesis
Two independent reviewers used standardised methods to screen for relevance by title, abstract and full-text review. Two unblinded independent reviewers manually extracted data and rated study quality using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. A sensitivity analysis was performed with a fixed effects model. Publication bias was assessed by visual inspection of funnel plots and formal testing by Egger’s and Begg’s tests. Segment scores were evaluated using the difference of medians.

Results
PLWH showed a significantly higher prevalence of non-calcified plaque (34% (95% CI: 15% to 53%)) compared with controls (22% (95% CI: 6% to 38%)) with an OR of 1.61 (1.13–2.30, p=0.009). There was no significant difference in partially calcified plaque prevalence (OR=1.20, 0.96–1.49), stenosis prevalence (OR=1.34, 0.92–1.96) and median difference in Segment Involvement Score (SIS; 0.39, –0.01 to 0.79) in PLWH compared with controls who have a non-significant difference in calcified plaque (OR=0.80, 0.61–1.04). The prevalence of any plaque (OR=1.22, 0.93–1.61) and difference in median Segment Stenosis Score (–0.12, –0.60 to 0.35) did not differ between groups.

Conclusion
This study demonstrates a greater prevalence of non-calcified plaque in PLWH than controls. Additional research is needed to assess quantitative CTA measurements. Increased power may reveal a difference in the prevalence of high-degree stenosis and median SIS score in PWLH, while controls may have a greater prevalence of calcified plaque.

Introduction
Heavy alcohol use has the potential to derail progress towards UNAIDS 95-95-95 targets for countries in sub-Saharan Africa (SSA). Within couples, alcohol use is closely linked with factors such as intimate partner violence and economic insecurity and can result in poor adherence to antiretroviral therapy (ART) and HIV clinical outcomes. We hypothesise that a combined economic and relationship intervention for couples that builds on the prior success of standalone economic and relationship-strengthening interventions will be efficacious for improving HIV clinical outcomes and reducing alcohol use. The synergy of these interventions has not been assessed in SSA—specifically among people living with HIV who drink alcohol. To test this hypothesis, we will test Mlambe, an economic and relationship-strengthening intervention, found to be feasible and acceptable in a pilot study in Malawi. We will conduct a full-scale, randomised controlled trial (RCT) to evaluate the efficacy and cost-effectiveness of Mlambe.

Methods and analysis
We will enrol 250 adult married couples having at least one partner living with HIV and reporting heavy alcohol use. There will be two arms: Mlambe or an enhanced usual care control arm. Couples in the Mlambe arm will receive incentivised matched savings accounts and monthly sessions on financial literacy, relationship skills, and alcohol reduction education and counselling. Participants will be assessed at baseline, 11 months, 15 months and 20 months to examine effects on heavy alcohol use, HIV viral suppression, ART adherence and couple relationship dynamics. Study hypotheses will be tested using multilevel regression models, considering time points and treatment arms. Programmatic costs will be ascertained throughout the study and incremental cost-effectiveness ratios will be computed for each arm.

Ethics and dissemination
The RCT has been approved by the University of California, San Francisco (UCSF) (Human Research Protection Program; Protocol Number 23-40642), and the study has been approved by the National Health Sciences Research Committee (NHSRC; Protocol Number 24/05/4431) in Malawi. Adverse events and remedial actions will be reported to authorities both in Malawi and at UCSF. Results will be disseminated to study participants, local health officials and HIV policy makers and through presentations at conferences and publications in peer-reviewed journals.

Trial registration number
ClinicalTrials.gov Protocol Registration; NCT06367348 registered on 19 April 2024; https://register.clinicaltrials.gov/. Protocol Version 1.0: 22 October 2024.