Search Results for: Linee guida su HIV, epatite e malattie sessualmente trasmissibili.

Background
The involvement of male partners in the care and treatment of HIV-positive pregnant women is essential for improving health outcomes and ensuring optimal adherence to antiretroviral therapy (ART). Although ART has been shown to be effective in preventing mother-to-child transmission of HIV, maintaining adherence to the prescribed triple ART regimen remains a significant challenge. However, there has been a lack of research on the role of male partners in supporting ART adherence during pregnancy.

Objective
To assess male partner involvement in triple ART drug adherence and associated factors among HIV-positive pregnant women in government hospitals of the North Gojjam Zone, Amhara Region, Northwest Ethiopia, 2023.

Design
An institution-based cross-sectional study was conducted.

Setting
The study was carried out in hospitals located in the North Gojjam Zone of Northwest Ethiopia.

Participants
The study was conducted among 410 male partners of HIV-positive pregnant women from 1 April 2023 to 30 May 2023.

Primary and secondary outcomes
The primary outcome was to assess the involvement of male partners in triple ART adherence, while the secondary outcome was to identify factors associated with the involvement of male partners on triple ART adherence among HIV-positive pregnant women. The association between variables was assessed using bivariate and multivariable logistic regression models, and a p value

Background
In high-income countries (HICs), migrants living with HIV (MLHIV) are more likely than other HIV subpopulations to encounter problems which hamper their adherence to the care process; these include social and administrative insecurity, discrimination and psychological distress.

Objective
This systematic review aimed to determine the specific features of adherence to the HIV care process among MLHIV in HIC.

Method
Three researchers independently selected studies from a search for papers focusing on empirical studies on MLHIV’s adherence to the care process in HIC, published between 1 January 2010 and 1 November 2024 in the following databases: MEDLINE, Embase, CINAHL, PsycINFO and Google Scholar. The three dimensions evaluated for adherence to the care process were adherence to treatment, retention in care and virological response. HICs were characterised according to the World Bank’s definition.

Results
Of 601 studies screened, 69 were included (26 (38%) analysing treatment adherence 44 (64%) 44 (64%) retention in care and 34 (48%) virological response). In 49 (71%) of these studies, MLHIV from sub-Saharan Africa accounted for the majority of persons included. MLHIV were mainly categorised according to their geographical region of origin. Only one study considered the reasons for migration. Of 52 statistically significant associations, only five found that being a migrant (vs being a non-migrant) was associated with a better HIV care process. Moreover, several individual (sociodemographic, clinical and psychological), and structural (care system organisation and political) factors associated with difficulties in adhering to the HIV care process were identified.

Discussion
MLHIV living in HIC had poorer adherence to the HIV care process for all three dimensions studied (ie, treatment adherence, retention in care and virological response). Research studies categorise MLHIV according to their geographical origin. However, this type of categorisation does not adequately capture social inequalities in health. To overcome this, studies must instead categorise MLHIV according to various intersecting factors, including, among other things, their reason for migrating, the length of time living in the destination country and violence experienced during their migratory journey.

PROSPERO registration number
CRD42021253280.

Objectives
The use of antiretroviral therapy has been linked to the development of some components of metabolic syndrome (MetS), specifically glucose intolerance, weight gain and defective lipid metabolism. This study determined the relationship between dolutegravir (DTG) and MetS in a cohort of persons living with HIV (PWH) initiating DTG-based regimen in Ghana.

Design
A 2-year observational prospective study was conducted from September 2020 to August 2022.

Setting
Five HIV high-burden facilities providing antiretroviral therapy services at the district and tertiary levels of care in Ghana.

Participants
Persons with HIV who were newly enrolled onto DTG.

Primary and secondary outcome measures
Waist circumference, body mass index, blood pressure, fasting blood glucose and lipids were the primary outcomes measured at baseline, 3, 6, 12 and at 18 months follow-up to determine the incidence of MetS. MetS was defined using the Joint Consensus definition that combines the International Diabetes Federation and the National Cholesterol Education Programme Adult Treatment Panel III (ATP III) definitions. The Kaplan-Meier estimator was used to estimate the risk of developing MetS. The Cox proportional hazard model was used in estimating HRs.

Results
Of 3664 PWH screened at baseline, 31.4% (1152/3664) had MetS. Of the remaining 2512 with no MetS at baseline, there were 960 incident cases of MetS over the 1.5 years follow-up. The estimated MetS incident rate is 384.2 (95% CI: 360.6 to 409.2) per 1000 person-years with a median time to development of MetS at 6 months (IQR; 3–12 months). Being female (adjsuted HR, aHR: 1.42, 95% CI: 1.19 to 1.70), age ≥50 years (aHR: 1.30, 95% CI: 1.12 to 1.51), having a comorbidity at baseline (aHR: 1.39, 95% CI: 1.12 to 1.51) and being overweight (aHR: 1.46, 95% CI: 1.25 to 1.71) and obese (aHR: 1.62, 95% CI: 1.36 to 1.93) were associated with higher risk of MetS development.

Conclusions
The incidence of MetS was high among our patients, with elevated fasting blood sugar and elevated blood pressure being the most common developed MetS defining components. HIV programmes should institute targeted interventions at addressing central obesity to reduce the risk of MetS.

Dr. Paul Sax presents his latest Link-o-Rama in HIV and ID Observations.

Objective
To explore female sex workers’ perception, concern and acceptability of OraQuick HIV self-test (HIVST) in Woldia town, North Wollo, Ethiopia, in 2024.

Design
The study used a phenomenological design and the Integrated Behaviour Model as a theoretical framework.

Setting
Woldia town, Ethiopia, is the capital city of North Wollo Zone.

Participants
Twenty female sex workers and 18 key informants in Woldia town were involved.

Results
Most participants had a positive attitude towards testing with these devices and anticipated positive consequences, such as enhanced privacy, decreased waiting time, reduced transportation costs, increased accessibility for immobile individuals, elevated utility in index case screening and testing programmes and the provision of confidential, trustworthy and reliable test results. Most female sex workers perceived that significant people in their social environment approved and used OraQuick HIVST. The facilitators to uptake of OraQuick HIVST among female sex workers included privacy, ease of use and nonrequierement for trained healthcare providers when testing. Thus, most female sex workers were confident in their ability to test themselves and interpret their test result using OraQuick HIVST.
To optimise uptake of testing using OraQuick, female sex workers proposed supplying kits in an easily accessible manner, increasing awareness about the kit and advocating for and promoting that the kits are strategies to facilitate HIVST uptake and maximise individuals’ self-efficacy. The perceived possible concerns or barriers to the uptake of OraQuick HIVST included a shortage of kits, doubts about reliability prior to education, absence of policies or guidelines for HIVST, lack of post-test counselling and immediate treatment for positive individuals, potential psychological trauma such as suicidal ideation or attempts, lack of linkage to care for those with reactive results and inaccurate reporting of positive results or result concealment.

Conclusion
This finding suggests that OraQuick HIVST was acceptable to female sex workers in the study area, with the majority of female sex workers having a positive attitude, supportive social norms and self-efficacy. Therefore, interventions to increase awareness, advocate for the kit and address perceived concerns or barriers to HIVST are needed to maximise its uptake in the study setting.

Annals of Internal Medicine, Ahead of Print.

Objective
To assess the severity of anaemia and associated factors among drug-resistant tuberculosis (DR-TB) patients treated in DR-TB treatment-initiating centers in Addis Ababa, Ethiopia.

Design
A retrospective cross-sectional study.

Settings
This study was conducted in Alert and St. Peters specialised hospitals, Addis Ababa, from 20 September to 15 October 2022.

Methods and analysis
Data was collected from 331 patients with DR-TB. The data was entered into Epi-Data 4.1, and SPSS version 25 was used for data cleaning and analysis. A multinomial logistic regression model was fitted after the multi-collinearity assumptions, and goodness-of-fit tests were done. The OR with 95% CI was reported for each outcome variable, taking normal haemoglobin level as a reference category. Variables with a P value of 0.05 were considered statistically significant.

Results
Of the 331 patients, 51.4% had baseline anaemia, of which 5.7%, 15.7% and 29.9% had severe, moderate and mild anaemia, respectively.
Patients who were urban residents (AOR: 0.06, 95% CI: 0.012, 0.32), government employees (AOR: 0.33, 95% CI: 0.001, 0.79), private job holders (AOR: 0.02, 95% CI: 0.001, 0.27), undernourished (AOR: 15.72, 95% CI: 2.46, 100.28), patients with HIV (AOR: 7.28, 95% CI: 1.627, 32.628) and farmers and students (AOR: 0.05, 95% CI: 0.004, 0.58) were significantly associated with severe anaemia.
Patients who were male (AOR: 0.31, 95% CI: 0.11, 0.93), single (AOR: 0.19, 95% CI: 0.04, 0.85), daily labourer (AOR: 6.19, 95% CI: 1.27, 30.2), undernourished (AOR: 12.83, 95% CI: 4.88, 33.7) and patients with HIV (AOR: 12.74, 95% CI: 4.67, 34.75) were significantly associated with moderate anaemia. Patients with undernutrition (AOR: 3.92, 95% CI: 2.1, 7.35), HIV (AOR: 2.79, 95% CI: 1.22, 6.39) and primary and secondary education (AOR: 0.36, 95% CI: 0.17, 0.77) were significantly associated with mild anaemia.

Conclusion
In our study, more than 50% of patients with DR-TB had baseline anaemia, of which mild anaemia was the most common typeanaemia. Rural residents were at a higher risk of developing severe anaemia (11.5%), while the overall rate of anaemia (58.8%) was higher among urban residents.

Purpose
Pharmacovigilance (PV) systems to assess the safety of antiretroviral treatment used periconception and during pregnancy are lacking in low-resource settings with high HIV burdens, and strategies to guide their implementation are limited. We implemented the Measuring Adverse Pregnancy and Newborn Congenital Outcomes (MANGO) study in Kenya to address these gaps.

Participants
In MANGO, we ascertained delivery outcomes for pregnant women living with HIV (WLH) and not living with HIV (WNLH) enrolled in care at Moi Teaching and Referral Hospital (MTRH) through two cohorts: C1, a prospective cohort of 1:1 matched WLH and WNLH attending antenatal clinic; and C2, a cross-sectional cohort of all deliveries, including among those who did not attend antenatal clinic at MTRH.

Findings to date
24 205 deliveries were recorded from October 2020 to September 2023 (853 in C1 and 23 352 in C2). Median maternal age was 32 years, 4.5% were WLH and 2.6% of deliveries were stillbirths. Among liveborn infants, 17.2% were preterm (

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Con 1 sola iniezione bimestrale,ma in Italia uso ancora limitato

Introduction
Ensuring the effectiveness of HIV prevention and treatment methods requires high levels of adherence. Studies have recognised the significance of trust in shaping HIV risk perception.

Aim
In this qualitative analysis, our aim was to explore risk perceptions and understand how individuals assess and respond to HIV risks, as well as their uptake and adherence to oral pre-exposure prophylaxis (PrEP).

Setting
The study was based on the setting of an HIV prevention trial conducted in South Africa.

Methods
Thirty individuals, 9% of the total clinical trial participants, enrolled in the clinical trial were purposively selected and interviewed at three time points within the trial during the follow-up phase. Data analysis was conducted using the Trust, Confidence and Cooperation framework that included constructs of trust, confidence and cooperation.

Results
The findings show that the ongoing participation in the clinical trial played a significant role in influencing participants’ decision to continue PrEP as HIV prevention. This decision was grounded in their trust that PrEP would effectively reduce their vulnerability to HIV and infection.

Conclusion
Clear and consistent health-promoting initiatives enhance participants’ self-awareness of HIV risks and promote understanding (uptake) and effectiveness of HIV prevention methods.

Trial registration number
NCT04066881.

Objective
This study aimed to determine the incidence of attrition and its predictors among HIV-infected adolescents receiving antiretroviral therapy in public hospitals, South Ethiopia.

Study design
A multicentre retrospective follow-up study was conducted, and Cox proportional hazards model was used to identify predictors of the study outcome variable (attrition).

Settings
The study was conducted in eight public hospitals (two general and six primary hospitals) in South Ethiopia.

Participants
Adolescents (10–19 years) on antiretroviral therapy from 1 January 2014 to 30 December 2023 (n=409). The data were collected from patients’ charts and electronic data records.

Outcome variable
The primary outcome was time to attrition, and the secondary outcome was predictors of attrition.

Results
The overall incidence density of attrition was 3.33 (95% CI: 2.65 to 4.18) per 100 person-year of observation. Age 15–19 years (adjusted HR (AHR): 1.88; 95% CI: 1.12 to 3.18), death of both the parents (AHR: 2.19; 95% CI: 1.04 to 4.61), no formal education (AHR: 3.16; 95% CI: 1.48 to 6.77), Co-trimoxazole Prophylactic Therapy (CPT) non-utilisation (AHR: 1.73; 95% CI: 1.03 to 2.91), not changed regimen (AHR: 6.16; 95% CI: 3.56 to 10.66) and poor treatment adherence (AHR: 5.16; 95% CI: 2.35 to 11.32) were predictors of attrition.

Conclusion
Attrition was identified to be a significant public health problem in study settings. Moreover, old age, parental death, not attending formal education, not using CPT, unchanged baseline regimen and suboptimal treatment adherence predict attrition. Hence, special attention should be given to older adolescents, those with no formal education, orphaned and with poor baseline clinical characteristics. Likewise, early tracing of missed follow-up schedules, improving adherence support and increasing contacting frequency to reduce attrition are highly encouraged.