Prevalence of hazardous alcohol consumption and associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia: a multicentred cross-sectional study

Background
Alcohol is a major public health problem in pregnant women due to its harmful effects on pregnancy and adverse birth outcomes. Therefore, assessing the prevalence and the factors associated with hazardous alcohol consumption among HIV-positive women is important for early identification and intervention and implementation of rehabilitation centres in healthcare settings in order to prevent maternal adverse birth outcomes.

Objective
The aim of this study was to assess the prevalence of hazardous alcohol consumption and the associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia.

Design and study setting
A facility-based, cross-sectional study was conducted among 401 HIV-positive pregnant women attending public hospitals in Northwest Ethiopia from 7 February to 7 April 2021.

Participants
From a total calculated sample size of 423, 401 HIV-positive pregnant women who had a follow-up with selected hospitals’ prevention of mother-to-child transmission (PMTCT) clinics completed the interview (17 participants refused to provide information and 5 terminated the interview in the middle of it due to serious illness).

Main outcome measures
The main outcome measure of this study was hazardous alcohol consumption assessed using the Fast Alcohol Screening Test. Bivariate and multivariable binary logistic regressions were used to identify factors associated with hazardous alcohol consumption. Statistically significant associations were set at p

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Ottobre 2024

Major financial problems, low mental well-being and reduced HIV/STI testing among sex workers in the Netherlands during the COVID-19 pandemic: a repeated cross-sectional survey

Objectives
To determine associations between the banning of sex work during the COVID-19 pandemic, and work, financial problems, mental well-being and HIV/sexually transmittable infection (STI) testing among sex workers in the Netherlands.

Design
Two cross-sectional online surveys. The first survey covered two time-periods: pre-COVID-19 (1 January 2019 to 31 December 2019) and period 1 (15 March 2020 to 1 July 2020). The second survey covered period 2 (1 January 2021 to 31 December 2021).

Setting
The Netherlands

Participants
In total, 106 (first survey) and 196 (second survey) sex workers participated. Most of the participants in the first and second survey were cisgender women (respectively, 76.4% and 66.5%), followed by cisgender men (respectively, 12.3% and 15.7%) and the combination of transgender men, transgender women, non-binary or other (respectively, 11.3% and 17.6%). Most participants were born in the Netherlands (respectively, 61.4% and 69.7%).

Primary and secondary outcome measures
We provide descriptive statistics of self-reported work during and prior to COVID-19 measures, financial problems due to COVID-19 measures and HIV/STI testing and mental well-being during the COVID-19 pandemic. We also performed logistic and linear regression analyses to identify risk factors associated with reporting financial problems due to COVID-19 measures, not testing for HIV/STIs and lower mental well-being during the COVID-19 pandemic.

Results
In periods 1 and 2, respectively, 69.6% and 62.0% reported financial problems due to the COVID-19 measures. Among those who reported to have had sex with clients, the percentage not HIV/STI testing was: 4.5% (95% CI: 0.9; 12.5) pre-COVID-19, 28.2% (95% CI: 15.0; 44.9) in period 1, and 15.2% (95% CI: 9.7; 22.3) in period 2. In the multivariate analysis, reported financial problems due to the COVID-19 pandemic was associated with not HIV/STI testing (OR: 12.1, p

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Ottobre 2024

Costs and resource distribution of direct services for HIV in Uganda

Objective
In high HIV-burden countries like Uganda, financing and resource allocation for HIV services have rapidly evolved. This study aimed to employ time-driven activity-based costing (TDABC) to examine the allocation of resources and associated costs for HIV care throughout the country.

Design
A cross-sectional study.

Setting
This study was conducted at 31 health facilities throughout Uganda: 16 level III health centres, 10 level IV health centres and 5 district hospitals.

Participants
1119 persons receiving HIV services in 2020.

Methods
We conducted TDABC to quantify costs, resource consumption and duration of service provision associated with antiretroviral therapy, prevention of mother-to-child transmission, HIV counselling and testing (HCT), voluntary medical male circumcision (VMMC) and pre-exposure prophylaxis. We also quantified disparities in resource consumption according to client-level and facility-level characteristics to examine equity. Fixed-effects multivariable regression analyses were employed to inspect factors associated with service costs and provider-client interaction time.

Results
The mean cost of services ranged from US$8.18 per visit for HCT to US$32.28 for VMMC. In terms of disparities, those in the Western region received more provider time during visits compared with other regions (35 more minutes, p

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Ottobre 2024