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

Pasinelli, grazie a italiani da 3 decenni progetti d’eccellenza

Rischio triplo con la forma a grapolo

Un progetto unico al mondo per diagnosi precoce 200 disturbi

Un progetto unico al mondo per diagnosi precoce 200 disturbi

This Viewpoint identifies several barriers to ending the HIV epidemic and urges increasing expertise in HIV medicine in underserved areas like the South challenging legislation designed to keep students ignorant.

An investigation of 57 patients hospitalized with severe monkeypox found that delayed treatment of men with HIV and monkeypox, particularly Black men, may have contributed to worse outcomes.

Ematologi, ok a trapianto staminali anche se un primo fallisce

Objective
To evaluate the effect of comprehensive knowledge of HIV on extramarital sexual relationships and consistent condom use.

Design
Quasi-experimental study.

Setting
20 880 households, Uganda.

Participants
Married/cohabiting men and women, aged 15–54 years.

Methods
We applied propensity score-matched analysis and defined comprehensive knowledge of HIV as knowing that consistent use of condoms during sexual intercourse and having just one faithful partner without HIV reduces the chance of getting HIV, knowing that a healthy-looking person can have HIV and rejecting two local misconceptions (HIV can be transmitted by mosquito bites and by sharing food with a person who has HIV). The primary outcome was extramarital sexual relationship defined as involvement in a sexual relationship with a partner other than a spouse or cohabiting partner, within 12 months preceding the survey. The secondary outcome was consistent condom use, defined as using a condom at every sexual intercourse with any non-spouse/non-cohabiting partner over the past 12 months.

Results
Among 18 504 participants matched in a 1:1 ratio, comprehensive knowledge of HIV showed no effect on extramarital sexual relationships (OR 1.03, 95% CI 0.96 to 1.11) but improved consistent condom use among married/cohabiting couples in extramarital sexual relationships (OR 1.18, 95% CI 1.02 to 1.37). Among married/cohabiting men, comprehensive knowledge of HIV had no effect on extramarital sexual relationships (OR 0.95, 95% CI 0.83 to 1.08) but improved consistent use of condoms in extramarital sexual relationships (OR 1.31, 95% CI 1.04 to 1.66). However, among married/cohabiting females, there was no effect on both outcomes.

Conclusions
Comprehensive knowledge of HIV has no effect on extramarital sexual relationships but increases consistent condom use among those in extramarital sexual relationships. There is a need to consistently provide correct HIV prevention messages among sexually active married/cohabiting couples in Uganda.

Soprattutto in donne con un’infanzia con esperienze avverse

Introduction
There is a high burden of hypertension (HTN) among HIV-infected people in Uganda. However, capacity to prevent, diagnose and treat HTN is suboptimal. This study seeks to leverage the existing HIV-related infrastructure in primary care health facilities (HFs) using the integrated HIV/HTN care model to improve health outcomes of patients with HIV and HTN.

Methods and analysis
Integrated HIV/HTN study a type-1 effectiveness/implementation cluster randomised trial, will evaluate the effectiveness of a multicomponent model intervention in 13 districts randomised to the intervention arm compared with 13 districts randomised to control. Two randomly selected HFs per district and their patients will be eligible to participate. The intervention will comprise training of primary healthcare (PHC) providers followed by regular supervision, integration of HTN care into HIV clinics, improvement of the health management information system, IT-based messaging to improve communication among frontline PHCs and district-level managers. HTN care guidelines, sphygmomanometers, patient registers and a buffer stock of essential drugs will be provided to HFs in both study arms. We will perform cross-sectional surveys at baseline, 12 and 24 months, on a random sample of patients attending HFs to measure effectiveness of the integrated care model between 2021 and 2024. We will perform in-depth interviews of providers, patients and healthcare managers to assess barriers and facilitators of integrated care. We will measure the cost of the intervention through microcosting and time-and-motion studies. The outcomes will be analysed taking the clustered structure of the data set into account.

Ethics and dissemination
Ethics approval has been obtained from the Research Ethics Committees at London School of Hygiene and Tropical Medicine, and Makerere University School of Medicine. All participants will provide informed consent prior to study inclusion. Strict confidentiality will be applied throughout. Findings will be disseminated to public through meetings, and publications.

Trial registration number
NCT04624061

This Medical News article explores timely topics discussed at the annual IDWeek conference.

Introduction
Non-adherence to antiretroviral therapy (ART) is the main cause of viral non-suppression and its risk is increased by depression. In countries with high burden of HIV, there is a lack of trained professionals to deliver depression treatments. This paper describes the protocol for a 2-arm parallel group superiority 1:1 randomised controlled trial, to test the effectiveness and cost effectiveness of the TENDAI stepped care task-shifted intervention for depression, ART non-adherence and HIV viral suppression delivered by lay interventionists.

Methods and analysis
Two hundred and ninety people living with HIV aged ≥18 years with probable depression (Patient Health Questionnaire= >10) and viral non-suppression (≥ 1000 HIV copies/mL) are being recruited from HIV clinics in towns in Zimbabwe. The intervention group will receive a culturally adapted 6-session psychological treatment, Problem-Solving Therapy for Adherence and Depression (PST-AD), including problem-solving therapy, positive activity scheduling, skills to cope with stress and poor sleep and content to target barriers to non-adherence to ART. Participants whose score on the Patient Health Questionnaire-9 remains ≥10, and/or falls by less than 5 points, step up to a nurse evaluation for possible antidepressant medication. The control group receives usual care for viral non-suppression, consisting of three sessions of adherence counselling from existing clinic staff, and enhanced usual care for depression in line with the WHO Mental Health Gap intervention guide. The primary outcome is viral suppression (