Aids HIV

The Human Immunodeficiency Virus (HIV) is a neurotropic virus that is associated with cognitive, behavioral and motor deficits known as HIV Associated Neurocognitive Disorder (HAND). This was a prospective study aimed at determining the prevalence of cognitive impairment as well as comparing the performance of the HIV positive patients on a screening test, the International HIV Dementia Scale (IHDS), and subtests drawn from a neuropsychological test battery -WHO/UCLA. The screening test and neuropsychological test battery were administered to HIV positive patients while the HIV negative patients had only the test battery administered to determine the mean score of each test domain. Neurocognitive impairment was defined using the cut-off score of 10 for the International HIV Dementia scale and Z scores greater than 1 SD in at least two domains of the neuropsychological test battery. The mean performance on each domain of the test battery was determined after administration to the HIV negative individuals. Ninety-two HIV positive patients (57 females and 35 males) and ninety-two age, sex and education matched HIV negative subjects (46 females and 46 males) were enrolled into the study. The median age and interquartile range were 33(26-39) and 35(27-46) for the HIV positive and negative participants respectively. The prevalence estimates of cognitive impairment determined by the IHDS and the test battery were 42.4 and 76.1%, respectively. The IHDS in this study was found to have a sensitivity of 50% and a specificity of 81% for HAND. Neurocognitive impairment still persists in the combination anti-retroviral therapy (CART) era and is better accessed using neuropsychological testing than with screening tests although the former is cumbersome and require expertise and patience on the part of the subjects.

low CD4 cells count. In Ghana, a country where CMV infection is hyperendemic, there is no data of CMV retinitis among HIV positive persons. This work was conducted to evaluate the prevalence of CMV retinitis among HIV positive persons attending eye clinic in Korle-Bu Teaching Hospital. Eye swab and vitreous samples were collected from HIV positive patients with retinal inflammation. The samples were assayed for DNA of Herpes Simplex Virus, Varicella Zoster, Cytomegalovirus and Epstein -Barr virus by using qualitative polymerase chain reaction (PCR) (multiplex PCR) to detect the presence or absence of herpes viruses. Sixty-two patients had retinal inflammation from ophthalmoscopy out of the total 404 that came into the clinic during the study period from July, 2010 to April, 2011. Forty six of these were HIV positive. Only 3 (6.5%) HIV positive patients had their swab or vitreous humour samples yielding DNA of CMV virus. These patients had their CD4 cell counts above 25 cells/µl. This is the first study to show the prevalence of CMV retinitis among HIV patients in Korle-Bu Teaching Hospital, Ghana. It is necessary for more comprehensive longitudinal study to evaluate incidence and cumulative risk of CMV retinitis among HIV positive individual.

This paper established those information sources that mostly provided the information about HIV/AIDS to 540 adolescents in Ekwusigo Local Government Area of Anambra State, Nigeria. The study showed further, how the adolescents' personal and parental characteristics explained the use of the sources as well as the relationship between source use and adolescents' sexual behaviour. The result showed that handbills, television and friends were the most frequently used sources. Use of handbills is related to decreasing total number of sexual partners, and reduction in the chances that the respondent has ever had sex, while the use of television relates to the increased chances of ever having sex, although it increased the current number of sexual partners and the decreasing use of condom during last sex. Friends relates positively to condom use during last sex and if one has ever had sex, age at first sex, last time one had sex, and current number of sexual partners. Increased investment in the use of handbills and use of friends could not only significantly reduce government's budget for HIV/AIDS awareness among youth but could also lead to increased effectiveness in achieving the impartation of the right information.

Nepal have been obvious. However, their viral load (VL) and the effects of VL testing scale-up on the outcomes of HIV treatment have not been adequately investigated. In Nepal, VL tests were performed since 2009 at National Public Health laboratory. VL testing for monitoring scale up was introduced in 2014. The present study was undertaken to find out the virological failure (VF) and virological suppression (VS) rates in PLWH on ART in Nepal and to assess the effect of VL testing coverage on ART outcomes. A total of 8,230 blood/plasma samples were collected from among 11,922 patients on ART during 2009 to 2015. The VL testing coverage in 2009 was 2.9% which increased to 48.3% in 2015. VF was 35.9% in 2009 (mean for 2009-2013 was 27.5% and for 2014-2015 the mean VF was 10.2%). Decrease in VF to nearly one third in 2015 coincided with the rise in VL testing coverage (from 2.9 to 48.3%). Improvement in VL testing coverage for ART monitoring coincided with decline in VF, indicative of ART optimization. VL testing of ART treatment failure cases only in the first segment of the study (2009-2013), accounted for initial low VL coverage. However, 48.3% coverage in the last year of scale-up period, with a mean VF of 10.2% and nearly 90% of all those receiving ART having VS, was very encouraging.

It has been shown that Human immunodeficiency virus (HIV) positive adolescents are more vulnerable to behavioural problems than non-infected adolescents and stress compromises immune function. There is some evidence that yoga and peer support benefits mental health. This study aimed to evaluate the impact of a 10-week programme of peer support and yoga on the psychological well being of HIV positive Zambian adolescents. An exploratory randomized controlled trial design was used. Adolescents aged 11 to 16 (n = 34) were randomized to peer group with yoga, peer support only group/social support group or waitlist control. Outcomes were immune function (CD4 count), self-rated physical health (SF12), psychological well being (Strengths and Difficulties Questionnaire). Outcomes were measured pre intervention, post intervention and at 10 weeks follow-up. There were no differences between the yoga and peer support group and the peer support only group, and both were evaluated well by partici...

Adherence is engagement and accurate participation of an informed patient in a plan of care. A combination of factors:-the relationships between the patient and the provider, medication issues, psychological status, and structural issues can impede adherence efforts. The objectives were to assess barriers of adherence to antiretroviral drugs (ART) among Human immunodeficiency virus or Acquired immunodeficiency Syndrome (HIV/AIDS) infected persons in Nekemte Referral Hospital, Ethiopia. The descriptive cross-sectional study design was conducted from March 1st to March 31st 2017. Data was collected from 321 client following ART unit of this hospital using interviewer administered questionnaire. A systematic sampling technique was used. The data were checked for completeness, cleared, coded and entered into computer software Statistical Package for Social Science (SPSS) version 20 after collected. Data analysis was done and the statistical association between variable was described using logistic regression. The result of the study is summarized using tables, graphs and figures. From all, 89 (27.70%) missed taking their ART drug in the last month prior to data collection. Factors of non-adherence were age, educational status, using reminder, drinking alcohol, co-worker awareness, developing sickness and living style. Non-adherence to ART was high in the study area. Concerned bodies should work on identified barriers of adherence to improve the quality of service as well as adherence rate. Increasing awareness and belief of HIV patients towards ART is needed and health care providers should work strongly on those who miss their ART regimen.

Adherence is engagement and accurate participation of an informed patient in a plan of care. A combination of factors:-the relationships between the patient and the provider, medication issues, psychological status, and structural issues can impede adherence efforts. The objectives were to assess barriers of adherence to antiretroviral drugs (ART) among Human immunodeficiency virus or Acquired immunodeficiency Syndrome (HIV/AIDS) infected persons in Nekemte Referral Hospital, Ethiopia. The descriptive cross-sectional study design was conducted from March 1st to March 31st 2017. Data was collected from 321 client following ART unit of this hospital using interviewer administered questionnaire. A systematic sampling technique was used. The data were checked for completeness, cleared, coded and entered into computer software Statistical Package for Social Science (SPSS) version 20 after collected. Data analysis was done and the statistical association between variable was described using logistic regression. The result of the study is summarized using tables, graphs and figures. From all, 89 (27.70%) missed taking their ART drug in the last month prior to data collection. Factors of non-adherence were age, educational status, using reminder, drinking alcohol, co-worker awareness, developing sickness and living style. Non-adherence to ART was high in the study area. Concerned bodies should work on identified barriers of adherence to improve the quality of service as well as adherence rate. Increasing awareness and belief of HIV patients towards ART is needed and health care providers should work strongly on those who miss their ART regimen.

Data concerning any difference in serum lipid profiles and glucose level after patients switched from stavudine to zidovudine in Ethiopia is very limited. Seventy eight adults receiving antiretroviral therapy (ART) that included stavudine/lamivudine with either of efavirenz or nevirapine during ART initiation were enrolled. Of these patients, 53 were switched to zidovudine/lamivudine/nevirapine (NVP-group) and the rest 25 were switched to zidovudine/lamivudine/efavirenz (EFV-group). Serum lipid profiles and glucose were determined after overnight fasting. Dyslipidemia and dysglycaemia were assessed according to the United State National Cholesterol Education program-III guideline. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Of the 78 patients, 39.7% were males and 60.3% were females. At the end of the study follow-up, the prevalence of TC ≥ 200 mg/dl, LDL-c ≥ 130 mg/dl, TG ≥ 150 mg/dl, HDL-c < 40 mg/dl and glucose ≥ 110 mg/dl wer...

British colonial research put the number of ethnic groups in Nigeria at 200 in 1914-1934; Otite Onigu identified 374 ethnic groups in 1980s while M. Onwuejeogwu listed over 480 ethnic groups in 1990s. This makes Nigeria to be the most culturally diverse nation in the world. This diversity produces various shades of inter-ethnic conflicts and challenge of programmatic interventions to counter culturally specific unwholesome practices. This paper focuses on the influence of cultural and ethnic diversities in producing diverse HIV epidemic rates across the nation. Findings show a clear higher HIV prevalence rate in zones and states with significant higher levels of ethnic based violence especially in Federal Capital Territory (FCT),

akres diagnozy stanu pacjentów z chorobami układu krążenia dla potrzeb opieki pielęgniarskiej Scope of diagnosis of the state of patients with cardiovascular diseases for the needs of nursing care STRESZCZENIE Wstęp. Choroby sercowo-naczyniowe są głównym zagrożeniem zdrowia i życia dorosłych Polaków. Udział pielęgniarek w rozpoznawaniu i w rozwiązywaniu problemów opieki tej grupy pacjentów w ramach profilaktyki wtórnej jest istotnym ogniwem profesjonalnej strategii pomocy. Cel. Celem pracy było określenie stanów i problemów opiekuńczych pacjentów z chorobami układu krążenia stanowiących podstawę do postawienia diagnozy pielęgniarskiej. Materiał i metody. Badaniami objęto 120 pacjentów ze schorzeniami układu krążenia zgłaszających się do przychodni POZ. Zastosowano metodę sondażu diagnostycznego z autorsko opracowanym kwestionariuszem ankiety. Wyniki. Wśród badanych 51% stanowiły kobiety, a 49% mężczyźni. Według BMI u 47% ankietowanych wystąpiła nadwaga, a 39% osób miało otyłość. Najczęściej występującymi schorzeniami układu krążenia u badanych były: nadciśnienie tętnicze (87%), niewydolność serca (42%) oraz choroba wieńcowa (42%). Respondenci podali, że mierzą ciśnienie tętnicze kilka razy w tygodniu (36%). Prawie 3/4 pacjentów posiadało wiedzę, że czynniki ryzyka chorób sercowo-naczyniowych można zminimalizować, lecz nie podejmowało aktywnych działań w tym zakresie. Chęć zmiany swojego dotychczasowego stylu życia wyrażało 56% badanych. Wnioski. W grupie pacjentów z chorobami układu krążenia występowała nadwaga i otyłość, która istotnie częściej dotyczyła mężczyzn niż kobiet. Pacjenci deklarowali przeżywanie stresu w miejscu pracy i życiu rodzinnym głównie na poziomie średnim. Najczęstszymi problemami do postawienia diagnozy pielęgniarskiej były: nietolerancja aktywności fizycznej, duszność pochodzenia sercowego, omdlenia z utratą przytomności, bóle w klatce piersiowej.

Nigeria has high rate of pediatric HIV but there is a dearth of empirical data on the mode of HIV transmission. Association for Reproductive and Family Health (ARFH), with the support of USAID, is implementing a project to mitigate the impact of HIV on Orphans and Vulnerable Children (OVC) affected/infected with HIV/AIDS in Akwa-Ibom, Lagos, and Rivers states, Nigeria. The mode of HIV transmission among their OVC was examined. A retrospective study of enrolled OVC was done in the three states. HIV OVC whose mothers are HIV positive were classified under those who got HIV through vertical transmission, otherwise horizontal. The data was summarized using descriptive statistics. Significance of association between qualitative variables and mode of transmission was determined using Chi-square test. Among the 387 OVC HIV positives who enrolled, there was a slight preponderance of males (50.6%); and about 42% were aged 10 -17 years and 26% <5 years. Vertical mode of HIV transmission was higher (77%) in children <10 years. Horizontal transmission was highest among Akwa-ibom adolescents. In addition, age and State were significantly associated with transmission mode. A high proportion of children <10 years were infected through vertical transmission; while majority of adolescents are infected through horizontal transmission. Hence, a Swift scale-up of prevention of mother-to-child HIV transmission (PMTCT) services is recommended. Pregnant women infected with HIV need close monitoring to receive counseling as well as to get ARV prophylaxis. Also, condom demonstration should be introduced into the OVC project

Human immunodeficiency virus (HIV) related kidney disease is one of the leading causes of death and affects predominantly people of black descent. Data is unavailable on the presence of kidney disease amongst HIV positive patients in Cameroon and a high prevalence of the disease depicts a high incidence of HIV associated nephropathy. A cohort study was carried out from May to August 2010 at the Nylon District Hospital Douala to investigate the Kidney function trends amongst seropositive individuals. Kidney function tests like serum urea, serum creatinine, creatinine clearance, proteinuria and urine chemistry was measured amongst 329 participants amongst whom 100 (30.4%) were HIV negative and 229 (69.6%) were HIV positive. The age range of the study population was 18 to 60 years, with mean age of 35.122 ± 0.543. There were 94(28.6%) males and 235 (71.5%) females. The percentage of HIV seropositivity was higher in females than in males (74.3% vs. 25.7% p < 0.05). Although, Serum creatinine, creatinine clearance and proteinuria were significantly higher in the control group than in the HIV infected subjects (p < 0.0001, p = 0.046 and p = 0.001, respectively), these values were not indicative of renal pathology. Considering only HIV positive individuals the mean serum creatinine was significantly higher in the Antiretoviral treatment (ART) naïve group when compared to those who were already on ART. These findings indicate that renal function is not affected by the seropositivity status of individuals.

Human immunodeficiency virus (HIV) related kidney disease is one of the leading causes of death and affects predominantly people of black descent. Data is unavailable on the presence of kidney disease amongst HIV positive patients in Cameroon and a high prevalence of the disease depicts a high incidence of HIV associated nephropathy. A cohort study was carried out from May to August 2010 at the Nylon District Hospital Douala to investigate the Kidney function trends amongst seropositive individuals. Kidney function tests like serum urea, serum creatinine, creatinine clearance, proteinuria and urine chemistry was measured amongst 329 participants amongst whom 100 (30.4%) were HIV negative and 229 (69.6%) were HIV positive. The age range of the study population was 18 to 60 years, with mean age of 35.122 ± 0.543. There were 94(28.6%) males and 235 (71.5%) females. The percentage of HIV seropositivity was higher in females than in males (74.3% vs. 25.7% p < 0.05). Although, Serum creatinine, creatinine clearance and proteinuria were significantly higher in the control group than in the HIV infected subjects (p < 0.0001, p = 0.046 and p = 0.001, respectively), these values were not indicative of renal pathology. Considering only HIV positive individuals the mean serum creatinine was significantly higher in the Antiretoviral treatment (ART) naïve group when compared to those who were already on ART. These findings indicate that renal function is not affected by the seropositivity status of individuals.

Using estimation-projection package (EPP) and spectrum, the model was developed based on different data sources. Four scenarios were introduced, including minimum and maximum estimations, plus most realistic scenario. In the fourth scenario (R2), data of studies with adequate quality were applied. The objective of the study is to estimate and project HIV/AIDS in Iran up to 2014. Based on the main scenario R2, the estimated prevalence of HIV infection among adults was 0.16% (0.08-1.03%) in 2009. It will slightly decrease to 0.15% (0.06-1.08%) in 2012. With respect to the number of infected people with HIV, the estimated number was 89,000 and 106,000 for 2009 and 2014 respectively. There were estimated to be approximately 7,000 new cases annually. The highest trend of HIV was estimated to be a shift from IDUs to FSWs, and the estimate is that new infected cases via unsafe sex will increase in the future, while over time, the trend with respect to transmission via unsafe injection will decrease. We expect the HIV epidemic in Iran to remain almost constant at concentrate level. However we believe that the pattern of transmission will change from that of unsafe injection to unsafe sexual contact.

Background: There is a lack of research about the relationship between exercise and the psychological well-being of HIV-infected (Human Immunodeficiency Virus) patients. Objective: The objective of this study was to investigate the influence of a physical training program on life satisfaction and on the immunological function in HIV-patients. Methods: A total of 29 HIV-seropositive patients [age: 45±2 yrs; Body Mass Index (BMI): 22.8±1.0 kg/m 2 ; TCD4: 20.5±2.0%] were allocated to the control (CG, n=10) and to the experimental groups (EG, n=19). The EG participated in an exercise program combining aerobic, strength, and flexibility exercises for a period of 12 weeks [3 times/week of 30 min of aerobic exercise (workload corresponding to 150 bpm-PWC150); 50 min of strength exercises (3 sets of 12 repetitions in 5 exercises at 60-80% 12 RM); and 10 min of flexibility exercises (2 sets of 30 seconds at maximal range of motion of 8 exercises)]. The immunological function was assessed by flow citometry [absolute and relative TCD4 cells counting] and the life satisfaction was assessed by the Life Satisfaction Index (LSI). Results: The analysis of variance (ANOVA) showed no significant differences for relative and absolute CD4 T counts for both groups, however, a slight enhancement trend in the EG [16%, p=0.19] was observed. There was a significant improvement of LSI [approximately 15%; P<0.05] in EG, but not for CG. Conclusion: A physical activity program of moderate intensity improved life satisfaction perception in HIV-infected patients with no immunological function impairment. Article registered in the Australian New Zealand Clinical Trials Registry under the number ACTRN12610000683033.

Human immunodeficiency virus (HIV) is associated with increased nutrient needs and compromised body immunity. Minimal information exists on effect of food-based interventions on health status of people living with HIV (PLHIV) and not on antiretroviral therapy (ART). This study investigated the efficacy of amaranth grain (Amaranthus cruentus) consumption on CD4 count and morbidity patterns among PLHIV. A one group pre-test-post-test study design was used on a sample of 66 pre-ART adults living with HIV. The study involved collection of baseline characteristics of the respondents; this was followed by consumption of amaranth grain porridge (100 g) for six months. Post-test data was collected and paired t-test was used to compare pre-test and post-test data. Daily consumption of 100 g of amaranth grain porridge increased nutrient intake. A significant increase (P=0.004) in CD4 count from 498.2±163 SD at baseline to 608 ± 157 SD post-test was observed. There was a significant decline in the number of respondents with any form of illnesses from a total of 52 (78.8%) at baseline to 21 (31.8%) respondents at month six (P=0.031). Amaranth grain increased nutrient intake, CD4 count and consequently reduced the prevalence of illness. The study recommends that nutrition and health practitioners should educate PLHIV on importance of use of amaranth grain to complement usual dietary intake.

Cardiothoracic operations are associated with increased exposure and risk of blood and blood borne diseases. This is true in the West African Subregion where HIV/AIDS is endemic. We aimed to survey the attitude and perception of cardiothoracic surgeons in Nigeria and Ghana to patients with HIV/AIDS who presented with common cardiothoracic and vascular pathologies that would otherwise normally have low mortality rate. Data collection was by a structured questionnaire which was sent to all consultants/specialists and senior registrars practising cardiothoracic surgery in Nigeria and Ghana. Survey response rate was 64 and 70% for consultants and senior registrars respectively. The majority of surgeons were more willing to operate on emergency cases than elective cases. Patients with HIV infection and those on antiretroviral drugs were also more likely to be operated upon than AIDS patients. Eighty-seven percent (87%) of surgeons supported preoperative screening for HIV antibodies. The majority of surgeons (92.9%) also supported preoperative screening in high risk patients. Some 21.4% of surgeons wrongly believed that cardiopulmonary bypass (CPB) has an adverse effect on HIVpositive patients and 42.9% of surgeons believe there is a difference in the cardiothoracic surgical outcome between HIV-positive patients and HIV-negative patients. Some 82.1% of surgeons reported having modified their surgical practice to reduce the risk of blood-borne infection, adopting the universal precautions. The surgeons that have refused to operate on HIV/AIDS patients did so mainly for the fear of contracting the infection and the absence of an insurance policy covering the surgeon in the event of acquiring the infection from HIV-positive patients. Despite the low risk of transmission of blood-borne infection when adequate measures are taken during surgery, denial of surgical intervention in HIV-positive patients has continued. It is also disturbing to know that some surgeons still believe that there is a difference in outcome after surgical intervention in HIV-positive patients compared with HIV-negative patients and that CPB has an adverse effect on HIV-positive patients. There is need to educate these surgeons and provide adequate insurance cover for them, to enable them take the risk of operating on HIV/AIDS patients.

Sustaining virological suppression among HIV-infected adolescents is challenging. We evaluated a home-based adherence intervention and characterized self-reported adherence, virological response and drug resistance among adolescents failing atazanavir/ritonavir (ATV/r)-based 2 nd line treatment. Methods: HIV-positive adolescents (10-18 years) on ATV/r-based 2 nd line treatment with virological failure (viral load (VL) ≥1 000 copies/ml) were randomized to either standard care (SC) or SC with addition of modified directly administered antiretroviral therapy (mDAART) for 90 days. VL was measured and questionnaires were administered at study entry and at 3 months. Genotyping was done for participants with continued failure. Primary outcome was suppression to VL < 1 000 copies/ml. Results: Fifty adolescents aged 10-18 years on 2 nd line treatment for >180 days were enrolled, 23(46%) were randomized to mDAART and 27(54%) to SC. Fifty-four percent were female; mean age was 15.8 years; mean baseline VL was 4.8(log 10) copies/ml; 40% reported adherence <80% in previous 1 month at baseline; 40% suppressed (VL <1 000 copies/ml) after follow-up. mDAART resulted in significantly increased self-reported adherence (RR= 0.1; 95% CI=0.02-0.8, p=0.023); closely following dosing schedule (RR= 4.8; 95% CI=1.6-13.8, p=0.004); VL decrease (p=0.031) and modest increase in virological suppression to <1 000 copies/ml (p=0.105). Genotyping in 28/30 participants with continued virological failure demonstrated high level atazanavir resistance (I50L, N88S and I84V) in 6(21%); 3(11%) of whom also had high level resistance to lopinavir and darunavir (V32I, I50L, I54V, 147V and V82A). Discussion: The mDAART intervention modestly improved virological suppression among adolescents with ATV/rbased 2 nd line treatment failure, significantly increased self-reported adherence and decreased viral load. High level ATV/r resistance was demonstrated. Conclusion: Targeting mDAART to adolescents who are virologically failing PI-based 2 nd line treatment decreases viral load and increases self-reported adherence. Early drug-resistance testing could reduce morbidity and mortality.

Background: There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. Objective: This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. Methods: A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAARTexperienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. Results: HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] ,30%) was 57.5%, leukopenia (WBC , 2.5), 6.1%, and thrombocytopenia , 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count , 200 cells/µL in comparison with 20.4% of HAART-experienced patients (P , 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAARTexperienced patients (P , 0.001). Total lymphocyte count , 1.0 was a significant predictor of ,CD4 counts , 200 cells/µL in HAARTnaïve patients, but this relationship was not observed in HAART-experienced patients. Conclusion: HAART has the capability of reducing the incidence of anemia, other deranged hematological and immunological parameters associated with disease progression, and death in HIV-infected patients. Total lymphocyte count fails to predict CD4 count , 200 cells/µL in our cohort; thus, its use in the management and monitoring of HIV-infected patients in our settings is not reliable.

Introduction HIV/AIDS is one of the most dangerous diseases globally, impacting public health, economics, society, political issues, and communities. As of 2023, the World Health Organization estimates that 40.4 million people are living with HIV/AIDS. This study aimed to identify the determinants of survival time for HIV/AIDS patients in the pastoralist region of Borena at Yabelo General Hospital. The study design was a retrospective cohort study, with a sample size of 293 individuals living with HIV/ AIDS, based on recorded data. This research utilized survival model analysis, employing Kaplan-Meier plots, the logrank test, and Cox proportional hazard model analysis. Result Out of the total sample size, 179 (61.1%) were female and 114 (38.1%) were male. Among these males, 36 (31.6%) were deceased. The analysis using the Cox proportional hazard model revealed that the following variables were significantly associated with the survival time of HIV/AIDS patients: gender, educational status, area of residence, tuberculosis (TB), and opportunistic infections. We concluded that individuals living with HIV/AIDS in urban areas have a lower risk of death compared to those in rural areas, indicating that rural residents have a reduced survival probability. Therefore, the Borena zone administration should focus on adult patients to enhance life expectancy.

The concept of community development is founded on the premise that changes in the living conditions of people are best effected by the people themselves. The term community evokes the idea of a homogeneous social group who can recognise their common interests and work together harmoniously for their common good. The concerns of the leading development agents and donors in the past two decades have been on empowering communities to participate in their own development by taking control of decisions and initiatives that seek to improve their living conditions. The zeal to address these concerns has in the past decade been pushed with such resounding statements that people's participation in development projects has not only been seen as a basic human right, but also as an imperative condition for human survival. It has been strongly argued in the UNDP reports that the overall development strategy is to enable people to gain access to a much broader range of opportunities. From this perspective, development as a social activity seeks to ensconce economic liberalisation, freedom of association, good governance and access to free market economy as the guiding tenets of an improved life in all communities in the world. The realization of this dream posed a major challenge to many governments in the Third World and the 1980s saw the emergence of 'associational revolution' -the proliferation of small-scale non governmental organizations (NGOs) with relative autonomy from the state. The mainstream development agencies perceived the NGOs as the best instruments to instigate changes in the living conditions of the poor and the disadvantaged people. For this reason, NGOs became increasingly instrumental in implementing development objectives in the rural and iii disadvantaged communities. Development in this sense consists of processes in which various groups are stimulated to improve aspects of their lives particularly by people from outside their community. This has drawn attention to how these outsider-development agents communicate development information particularly due to the sociolinguistic situation in many rural African communities. The real concern is with is that the target majority of the people in the rural areas are not speakers of the dominant languages of the development discourse, in most cases this is the official foreign languages taught in schools. Communication is a fundamental part in community development programmes and language emerges as a key factor in effective communication and implementation of these programmes. While it is evident that social interactions are sustained by agreeable communicative principles, the role of language and the different mode of communication applied to development interventions have received very little attention from the parties concerned. This has yielded detrimental repercussions in the quality of interaction at the grassroots level. More often than not, it is assumed that once there is a common language, effective communication will take place and for this reason language use and mode of communication are never given much thought in the field of development interaction. This is a linguistic study of the social interaction in development interventions in Nyanza Province in Kenya. The study examines language use and mode of communication in disseminating development messages in the communities in the province. This thesis argues that the province has not achieved development dreams set by the many NGOs working in the area due to inattention to language use and communication modes. In order to understand the poverty situation in the province, particularly as reported in the Kenya government poverty reports in the last four years and the UNDP report 2005, this study investigated the interactive process between the change agents and the communities they target to change. Arguing from Critical Discourse Analysis (CDA) theoretical position, this thesis seeks to explain how the opaque and transparent structural relationships of dominance, iv discrimination, power and control are constituted, expressed and legitimized in the discourse practices as observed in the interactions between development agents and the target communities. The thesis also applies the tenets of Systemic Functional Linguistic (SFL) particularly the notion of metafunctions (Experiential, Interpersonal and Textual) to analyse clauses and multimodal texts used by development interactants in the study area. In this way, the thesis explores the how discourse choices, mode of communication, power and ideology impact on meaning making and dissemination of development information. To be able to investigate language use and mode of communication comprehensively, the study embarked on a thorough examination of development projects' objectives, languages used in development interaction and the modes of communication applied in disseminating development information. This study is therefore situated within the qualitative paradigm and uses qualitative methods of data collection, namely Questionnaires, Key Informant Interviews Focus Group Discussions, Document Analysis and participant Observation, to gather data that is used to advance the arguments in this thesis. While recognizing the fecundity of these tools in exhaustive data collection, the study also used them to triangulate the data gathered thus verifying the data and ensuring reliability and validity. The data is analyzed qualitatively using an analytical framework developed from two linguistic theories, Systemic Functional Linguistics and Critical Discourse Analysis. The analysis reveal that the three modes of communication (the phonic, the graphic and the multimodal) commonly used in development communication in the study area are not common to the target community. More often than not the modes are not sensitive to the cultural and situational contexts of the interaction, thus ignoring the communities' schemata, concerns and preferences. This results into disorder of discourse, which in turn hampers interactive community participation that is deemed critical to community development. Furthermore, the language preferences of the change agents construct development as an elite exercise, thereby stereotyping development as something foreign disseminated by v elites mostly through elitist language (English) and modes of communication. The results reveal that many development projects fail because they are not rooted in the socio-cultural contexts of the communities they seek to serve. The thesis also concludes that language is a powerful capital that is used to construct and construe reality hence influencing change in social structures and human relationships. This revelation dispels the notion held by many people that language is transparent and has no significant place in development. Language reflects social status and the power imbalances among participants involved in development interaction and this impact on the way development messages are disseminated and interpreted. Ultimately, the thesis concludes that the language and mode of communication used in development initiatives in the study area, do not aid effective communication and common understanding of development objectives. In some cases the language choice and mode of communication are completely inaccessible/inappropriate to the target group, thus making the projects an end in themselves and an opportunity for the powerful agents of change to manipulate and control the people in the rural communities. In this regard, development projects are not benefiting the target communities and this could explain why the province is ranked among the poorest in Kenya. Finally, based on the best practices observed from the field and the analysis of some of the communication models used, this study suggests a communication model that can be used to enhance communication in community development interactions. This model recognises the dialectical relation between texts and the socio-cultural contexts that produce them and incorporates all the modes of communication. It is my take that once participants are aware of these features of contexts and how they are manifested in texts, they will be able to select the correct modes of communication and improve their interaction in development projects.

Intestinal parasitic infestations (IPI) are not uncommon in immunocompetent individuals. However, human immunodeficiency virus (HIV)-infected individuals with depleted immunity have an abnormally high susceptibility to infections. This study therefore, examines children with intestinal parasites according to HIV status and degree of immunosuppression. Consecutively consenting patients aged 1 to 15 years attending the Paediatric Clinic of acquired immune deficiency syndrome (AIDS) Prevention Initiative, Nigeria, were recruited as cases, while age and sex matched HIV negative controls were recruited from Out Patient Department of Jos University Teaching Hospital. Stool samples were examined for parasites by direct wet mount, formol-ether and modified Ziehl-Neelsen technique. Levels of immunosuppression were assessed amongst HIV-positive subjects. Five hundred and ten children aged 1 to 15 years equally divided between the two cohorts were enrolled for the study. Seventy-nine had IPI, giving a prevalence rate of 15.5%; 44 (8.6%) HIV positive and 35 (6.9%) HIV-negative children. The most prevalent extracellular parasite was Giardia lamblia, however HIV positives had significantly higher rate of G. lamblia infestation. Among the intracellular parasites, the infection rate in HIV-positive subjects (5.9%) was three times that in HIV-negative subjects (2.0%). HIV positive children with advanced and severe immunosuppression had significantly higher intracellular parasites. HIV status did not significantly predict the overall risk of having extracellular intestinal parasites however, it was noted that G. lamblia infection was significantly higher in HIV positive children. HIV positive children had higher risk of having intracellular parasites especially if they have advanced or severe immunosuppression. Therefore, the policy of screening children for intestinal parasites should continue irrespective of their HIV status. Those that are HIV positive children should specifically be screened for intracellular parasites.

Among those with HIV, anaemia is a strong risk factor for disease progression and death independent of CD4 count. This study is aimed at evaluating the effect of ARV drugs on anaemia and immunological markers in HIV patients. A total of forty four patients placed on HAART (Niverapine + Stavudine/Zidovudine + Lamivudine) were enrolled for the study. CD4 cell count was done using Becton Dickinson (BD) FACSCount analyser, while platelets, lymphocytes%, neutrophils%, and Haemoglobin (Hb) were determined using QBC Autoread analyser. All the parameters were repeated at 12th week and 24th week after placement on drug regimen. The mean CD4 cells count was 198.26 cells/µl, 240.37 cells/µl and 360.45 cells/µl for baseline, 12th and 24th week respectively. Total WBC count was 7.62x109 /L, 7.3x109 /L and 7.39 x109 /L, while lymphocytes% count was 39.2%, 43.2% and 43.2%. The neutrophils% count was 58.8%, 39.7% and 59.7%. The platelets count was 29.5 x109 /L, 303.6 x109 /L and 286 x109 /L (Values...

Intestinal parasitic infestations (IPI) are not uncommon in immunocompetent individuals. However, human immunodeficiency virus (HIV)-infected individuals with depleted immunity have an abnormally high susceptibility to infections. This study therefore, examines children with intestinal parasites according to HIV status and degree of immunosuppression. Consecutively consenting patients aged 1 to 15 years attending the Paediatric Clinic of acquired immune deficiency syndrome (AIDS) Prevention Initiative, Nigeria, were recruited as cases, while age and sex matched HIV negative controls were recruited from Out Patient Department of Jos University Teaching Hospital. Stool samples were examined for parasites by direct wet mount, formol-ether and modified Ziehl-Neelsen technique. Levels of immunosuppression were assessed amongst HIV-positive subjects. Five hundred and ten children aged 1 to 15 years equally divided between the two cohorts were enrolled for the study. Seventy-nine had IPI, giving a prevalence rate of 15.5%; 44 (8.6%) HIV positive and 35 (6.9%) HIV-negative children. The most prevalent extracellular parasite was Giardia lamblia, however HIV positives had significantly higher rate of G. lamblia infestation. Among the intracellular parasites, the infection rate in HIV-positive subjects (5.9%) was three times that in HIV-negative subjects (2.0%). HIV positive children with advanced and severe immunosuppression had significantly higher intracellular parasites. HIV status did not significantly predict the overall risk of having extracellular intestinal parasites however, it was noted that G. lamblia infection was significantly higher in HIV positive children. HIV positive children had higher risk of having intracellular parasites especially if they have advanced or severe immunosuppression. Therefore, the policy of screening children for intestinal parasites should continue irrespective of their HIV status. Those that are HIV positive children should specifically be screened for intracellular parasites.

The direct correlation between literacy, health, economic and political power and the exercise of informed choices especially for the women is enormous. Education is a liberating force; it ensures mobility and development of one's potentials. Two research hypotheses were posed and tested in this study. The design of the study was basically survey descriptive. The population of the study comprised women from the eighteen local government areas of Cross River State, Nigeria. Twenty-four women were drawn from each of the eighteen local government areas using the simple random sampling technique. In all, a total of four hundred (400) women were used for the study. Instrument for data collection was a twenty item women human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS) Awareness, Prevention and Management Questionnaire (WLAHPAPMQ). Data were analyzed using the Pearson product moment correlation analysis. Results from this study revealed a high positive correlation between literacy and HIV/AIDS awareness, prevention and management among women. Recommendations made include the need for intensification of adult education and mass literacy programmes as well as the setting up of non-formal education for rural women. Also, agencies such as the National Orientation Agency should be made relevant to these needs.

Botswana continues to have a high level of HIV prevalence, with about 17% of the population living with HIV AIDS (BAIS IV, 2013). Female sex workers are classified among the most at risk population group in the country. However, sub-national disaggregated data on new infections are not available. Hence, there is a need to focus great attention on other proxies of infection. The present study examines predictors of HIV testing among female sex workers (FSWs) in Botswana. The FSWs were recruited into the study using the time-location cluster sampling method (TLS) to collect data on prevalence and incidence of HIV and other STIs and their risk factors for HIV. The logistic regression analysis was performed to estimate crude odds ratios and identify the factors associated with having an HIV test among the FSWs. HIV prevalence among sex workers in Botswana was found to be 3 times higher than in the general population. Analysis of the results shows that the sex workers most likely to seek HIV testing were young women with no children. The odds of testing for HIV were almost 4 times more for FSWs who had first sex older as compared to the odds of testing for those who are 17 to 19 years old. Lack of or inconsistent condom use and currently having symptoms of STIs such as lower abdominal pain and genital ulcerations were also factors associated with HIV testing. Results further show that FSW hold little discrimination and stigma related attitudes towards PLWA. FSWs have little participation in the HIV prevention, treatment and care efforts currently accessed by the general population. It is recommended is that this framework should also be extended to FSW's and their clients in order to curb HIV and STIs.

The aim of this study was to determine the magnitude of HIV/AIDS related stigmatization, discrimination and coping strategies among people living with HIV/AIDS (PLHIV) at University College Hospital Ibadan. The study adopted a descriptive cross-sectional study design carried out among 700 PLHIV selected using a systematic random sampling technique from May to June 2010.  A validated pretested questionnaire was used to collect the data which was analysed using SPSS version 16. The mean age of the respondents was 40.0 ± 9.40 years and more were females (474, 67.70%). About 212 (30.30%) have experienced stigmatization with verbal insult (138, 65.10%), subjection to ridicule (134, 63.20%) and avoidance by friends (89, 42.0%) being the most reported forms of induced stigmatization/discrimination. In addition, there was no significant relationship of experiencing stigmatization/discrimination by gender (P=0.097). However, more females experienced physical assault than male. Strategies ado...

Approximately one third of people living with human immunodeficiency virus (HIV) infection are co-infected with tuberculosis (TB), and TB accounts for up to a third of deaths from AIDS worldwide. Injectable drug use is an important factor in epidemiology of both TB and HIV. This study was carried out to assess the risk of intravenous drug use for developing TB in HIV infected patients. A cross-sectional study was conducted from January, 2009 to December, 2011. Equal numbers of HIV seropositive patients with and without history of intravenous drug use (IVDU) attending Department of Microbiology, BP Koirala Institute of Health Sciences for CD4 cells counting were enrolled to study the prevalence of pulmonary tuberculosis. Three early morning sputum specimens on consecutive days were collected from all participants and processed for microscopy (Auramine-O and Ziehl-Neelsen staining) and culture on Lowenstein-Jensen (L-J) media. Observation was noted. Of a total of 336 subjects enrolled...

Human immunodeficiency virus is grouped into the genus Lentivirus within the family of retroviridean, a subfamily of retrovirinae. Since its emergence, it has remained a global public health crisis with approximately 39.0 million (33.1-45.7 mil) people living with HIV globally in 2022, with some countries reporting increased trends in new infections and it is incurable. There has been documented success in decreasing new cases and mortality resulting from HIV/AIDS globally; however, in sub-Saharan Africa, the rate of new infections has increased disproportionately among young women. Thus, the region accounts for about 9-10 women and children living with HIV. Mother-to-child transmission (MTCT) of HIV occurs when HIV is transmitted from the mother to the child during pregnancy, childbirth, or breastfeeding, although the rate of MTCT of HIV in high-income countries has significantly reduced to less than 1% in some low-income countries, MTCT of HIV remains high at 8.9%, and about 90% of HIV infection in children occurs through MTCT of HIV. Prevention of Mother-to-child transmission (PMTCT) of HIV is recommended to curb the menace of MTCT of HIV (Falnes et al., 2010). It involves a series of events, services, or interventions, which, when fully implemented, result in a reduction in the risk of mother-to-child transmission (MTCT) of HIV (Centers for Disease Control and Prevention, 2016) that involves the use of drugs and non-drug-related services. Health care workers play an important role in the provision of services and interventions aimed at reducing HIV transmission. Therefore, this study intends to Asses Health Care Workers' Attitude Towards PMTCT of HIV At Primary Health Care Center. The study is an institutional-based cross-sectional descriptive survey study. The sample size was calculated using the formula of Yamane (1967), a multistage sampling was used to select sampling unit. A self-administered closed-ended questionnaire was used as the instrument for data collection, all responses to the completed questionnaire were coded and entered into SPSS v25.0, edited, and checked accordingly. Descriptive statistics were used to describe the frequency distribution and measures of central tendency, whereas inferential statistics were used to determine the relationship between the study variables. The study finding reveals that the general attitude score of the respondents on PMTCT of HIV was Positive (3.1) and there is a statistically significant level of association between years of work and attitude (p<0.024). In this study, it can be concluded that the level of health care workers attitude towards PMTCT of HIV was positive and there is a statistically significant level of association between years of work and attitude. This shows that health care workers with more year of working experience have a better attitude, this could be related to the fact that they have more contact time and training on PMTCT and HIV in general, it is recommended that further studies be conducted to the explore the reason behind the statistical association above.

The elimination of HIV-AIDS by 2030 is a challenging target for a country such as the D.R. Congo, since currently fewer than 50% of persons living with HIV (PLWH) are under antiretroviral treatment (ART) and have a viral suppression. There also a high rate of death of PLWH in D.R. Congo. Accessible, affordable and sustainable immunotherapy, coupled with ART, can provide a substantial support to eliminating HIV. The purpose of this paper is to describe the measured clinical and biological profiles over a 4-year period of treatment with the immunomodulator 6,6'-dithiodinicotinic acid (CPDS), of a patient who was only 10-months old at the start of treatment. The patient was part of a larger two-year clinical trial of CPDS on HIV-AIDS. This study found that despite his advanced clinical HIV stage (being born to parents with terminal HIV), the patient maintained his weight and lymphocyte counts, and did not experienced any severe HIV-AIDS-related illness during the study period. This suggests a beneficial or protective effect of CPDS treatment. The patient shifted to ARV at 5-years old and is now 17-years old, and under first-line ART. The study concludes that survival of this child could likely be attributed to CPDS. We therefore recommend exploring further the simultaneous use of ART and CPDS immunotherapy for a greater clinical and biological benefit of PLWH. We also recommend further study into the mechanism of action of the compound.

Human immunodeficiency virus (HIV) has one of the highest incidence and mortality rates of any infectious disease, with more than 33 million people infected worldwide. Specifically, HIV causes the destruction of helper T cells, ultimately resulting in the suppression of the immune system and leaving its human host susceptible to countless of other pathogenic agents. The development of an effective HIV vaccine has continued for more than 20 years. But the use of preventative vaccines using traditional vaccine technologies, which have proven successful for other diseases, has thus far failed with HIV. One vaccine, AIDSVAX, was the first HIV vaccine to reach a phase III efficacy trial, but has not yet been shown to eradicate HIV. Hope now lies in the development of therapeutic vaccines using novel technologies. One such vaccine is ALVAC-HIV, which when used in conjunction with other vaccines (AIDSVAX or Lipo-6T with IL-2 injections) has shown a great deal of promise in clinical trials suppressing viral replication and improving the immune system. Other therapeutic vaccines, such as Ad5, however, have been unsuccessful. While many believed that developing an effective HIV vaccine is impossible, efforts continue into researching its structure, transmission, immune system suppression, genetic variability, and immune system evasion. As long as research continues, hope remains that someday an effective vaccine will be developed.

Globally, Cryptosporidium infection continues to be of significant public health
importance and one major causal organism of diarrhoea in both immunocompetent and
immunocompromised individuals. This cross sectional study was carried out to survey the prevalence of Cryptosporidium infection among HIV positive and HIV negative subjects attending selected hospitals in Gboko Township. A total of 300 stool samples comprising 200 from HIV positive and 100 from HIV negative subjects were collected and analyzed using formol ether oocyst concentration technique and modified Ziehl Neelsen
technique. Other information concerning demography and risk factors were obtained with the aid of structured questionnaire. Data was analyzed using chisquare test and P≤0.05 were considered significant. Overall, 122 samples comprising 88 from HIV positive patients and 34 from HIV negative patients were positive for
Cryptosporidium oocysts with an overall
infection prevalence of 40.7%. Males
recorded the highest prevalence of 42.9%
while age group 50-59 had 50.0%. Patients
who presented with watery stool had the
highest Cryptosporidium infection rate of
81.8% while those who do not wash their
hands and others who only wash occasionally after going to the toilet revealed the highest prevalence of 43.8%. Civil servants as well as patients who normally drink water from river/streams had higher prevalence of 45.8% and 60.0% respectively (P>0.05) when compared with
their counterpart. Cryptosporidium infection was significantly associated with the consistency of the stool samples (P < 0.001). Hence, watery stool is strongly
implicated as a sign of Cryptosporidium infection among HIV positive and HIV negative subjects in Gboko. Thus, improved sanitation and good personal hygiene should be adopted to avoid infection

Adherence to highly active antiretroviral therapy (HAART) regimen, of at least 95%, is necessary for effective therapeutic response among people living with human immunodeficiency virus (PLWHIV). This study determined the factors associated with non-adherence of PLWHIV to HAART regimen among patients attending a healthcare facility in Akwa Ibom State, Nigeria. Two hundred and fifty one patients, aged 18 to 70 years, attending a healthcare facility in Akwa Ibom State, Nigeria from 8th July to 8th August 2018, were adequately informed and their consent was obtained to enroll in the study. The enrollees were defined as non-adherent (NA), if, for any reason, they missed at least one dose of their drug within the last 30 days. These NA enrollees were purposively selected. The data was obtained using interviewer-administered semi-structured questionnaire. The data obtained was checked for completeness, coded and technique analyzed using Statistical Package for Social Science (SPSS) version 22 software. The statistical association between variables was described using logistic regression. Of the 251 PLWHIV, 100 (39.84%) were NA enrollees. Three major reasons provided by enrollees for missing medication were: (1) forgetfulness 41%, (2) travelling with incomplete medication and difficulty in the accessing drug from a new clinic, 15% and (3) not willing to take HIV/AIDS drugs with other prescribed drugs, 10%. This study has shown that a majority of PLWHIV (60.16%) complied with therapy regimen. Forgetfulness was the most common factor reported for non-adherence by the enrollees. This suggests that there is an increasing need for healthcare personnel to encourage patients to use memory aids, and to increase the awareness of the consequences of non-adherence during drug administration.

A better understanding of the significance and determinants of loss of follow-up and key potential related outcome measures, such as death and missed study visit would assist program evaluation and provide basis for future interventions. Senegal has one of Africa's lowest HIV/AIDS infection rate, less than 1%. But vulnerable groups such as sex workers have higher HIV prevalence. Currently, HIV infection among legal sex workers in Dakar has risen to 27.1%, compared to 1% 20 years ago, (Fact sheet, 2004). The prostitution in Senegal has been regulated since 1969. Sex workers register at public health clinics like ours, where they receive photo identity cards and make monthly visits for medical checkups. However, many operate outside the system. We estimate that more than 80% of Senegal sex workers do not register. In a retrospective cohort analysis, loss of follow-rates and death were assessed among HIV infected female sex workers receiving antiretroviral drugs at the "Institute d'Hygiene Social" (IHS) of Dakar, Senegal. Records of 74 HIV infected female sex workers receiving antiretroviral treatment, and followed at the IHS from April 2001 to August 2008 were reviewed. Overall, 15 patients (20.3%) died and 42 (57%) were lost during an average follow-up period of 26 months (SD = 18.9). The mean age of patients was 46.6 years old (SD = 7.8) and the mean CD4 count at entry was 215 (SD = 68.6). Using Cox Regression models, we did not find a significant relationship between age, ethnicity, CD4 count at entry or HIV-1 vs. HIV-2 type and loss of follow-up. These findings indicate the need to obtain better longitudinal follow-up data for optimal assessment of the reasons for loss-of follow up among HIV infected female sex workers receiving ARV in Senegal.

Recent studies reveal that Youths living with HIV (YLHIV) enrolled in HIV treatment experience a higher rate of interruption in treatment, sub-optimal medication adherence, and greater HIV-related mortality compared with other age groups. Therefore, this study investigated the effect of text messaging on medication adherence and antiretroviral-therapy (ART) retention practices among YLHIV in Niger state, Nigeria. The study was a quasi-experimental design in two selected hospitals. One hospital was assigned to a once-weekly text message intervention (TMI) for six weeks, and the 2nd served as the control group (CG). Data were collected at baseline, immediate post-intervention, and at the sixth-week follow-up. Data were analyzed using descriptive and inferential statistics at a 0.05 level of significance. Findings showed that between baseline and immediate post-intervention, there was a significant increase (p < 0.05) in the mean score of knowledge, perception, medication-adherence, and ART retention practices (from 9.62±12.28 to 22.98±4.57; 32.21±30.01 to 79.04±4.13; 13.50±8.41 to 26.65±13.15; 6.62±3.53 to 15.15±2.42) but there was no significant (p > 0.05) difference in the CG (from 10.29±11.08 to 10.58±10.74, 34.81±25.15 to 35.81±24.80, 17.13±9.23 to 17.23±9.16, 9.00±5.59 to 9.00±5.59) respectively. Between baseline and 6th week follow-up, there was a significant difference (p < 0.05) with a large effect size for knowledge (1.6), perception (2.2), medication-adherence (2.2) and ART retention practices (3.1) but no significant difference (p > 0.05) in the CG for all measures with an effect size of 0. The text messages intervention effectively influenced knowledge and perception of YLHIV, thereby improving treatment adherence practices. In addition, findings from this study can be used to design projects or interventions for scaling up the use of mobile phone text messaging to promote the adoption of health innovations and influence mHealth policy dialogue and review.

This is a multi-phased study that addresses the issue of tertiary institution based programme for awareness creation in order to integrate HIV/AIDS issues and concerns into social relationships. The purpose of the study was to develop simple communication tool combinations and ascertain through sensitization the potency of the tools to increase HIV/AIDS pandemic awareness among students in Nigerian tertiary institutions of learning. Ten tools were administered and later categorized for same purpose on 100 and 200 level students of two Universities and two Colleges within Lagos metropolis. Each of the items in the questionnaire is biased, with such democratic principles of inclusion, equity and justice. Data were analysed and descriptive statistics used to reveal the quality of each tool as well as to predict their control potency over students' sexual behaviour and social cohabitation. Among the study findings are that the respondents have, at 25%, a limited knowledge of HIV/AIDS awareness; and 25% were indifferent to awareness programmes due to religious practices and belief, among others. It was recommended that institutions of higher learning should create a centre for HIV/AIDS sensitization and control which will adopt these sensitization tools and integrate them into general courses and relevant campaign procedures.

HIV/AIDS prevention in Africa tend to value literacy or Eurocentric communication approaches such as brochures, posters, radio, newspapers and television more than indigenous modes of communication strategies such as narration (sigendni), singing (wende) and dancing (miende). Mounting evidence indicates that these Eurocentric modes of communication have the potential of alienating and disempowering the people they are intended to inform because the communication process does not start from within their experiences and in many cases are incapable of giving full respect to their values. To make a mark in the fight against HIV/AIDS in African countries there is need to embrace culturally sensitive communication systems in the fight against HIV/AIDS. The traditional systems of communication put greater emphasis on getting the audience involved in perceiving HIV/AIDS as their problem rather than a media, government, non government organization or an international agency agenda. This paper, shares the techniques, insights and lessons learnt from Peres Wenje PhD research work that sought to investigate how the Luo ora-media have been creatively used to create awareness and empower the community to take ownership of the fight against HIV/AIDS.

Limited resources in low income countries still prevent HIV patients from accessing treatment and necessitate the rationing of anti retroviral therapy. This paper aims to describe the criteria used in actual patient selection so as to develop evidence based recommendations for improving fairness in patient selection in Uganda and similar contexts. Qualitative interviews (n = 37) from six AIDS treatment units in Uganda; review of policy and clinic documents; and group discussions (n = 47) people living with AIDS. Practitioners identified both medical criteria (need, CD4 count, WHO staging, Absence of severe co-infections, patient readiness, and ART naivety) and social criteria (economic status, social support, treatment buddy, disclosure, duration with organization, distance, alcohol consumption, relatives of clients on ART, first-in-first-out, vulnerability and activism). There was congruence around the medical criteria across institutions and the national guidelines; and variations around the social criteria. The variations around the social criteria necessitate more explicit debate. Commonly used and accepted criteria could be considered for explicit inclusion in the national guidelines. Disputed criteria should be debated to identify an acceptable set of criteria for ART rationing. These criteria should be publicized to facilitate ongoing revisions, ensure consistency, and contribute to fair patient selection.

This study investigates the possible effects of in-utero antiretroviral therapy (ART) exposure on early language development in HIV exposed uninfected infants. 27 mother-infant pairs consented to the study. Early language development was assessed using the Rossetti Infant Toddler Language Scale. Descriptive statistics were used to describe the caregiver and infant characteristics, as well as the language and communication abilities of infants exposed to in-utero ART. T-test statistics compared the early linguistic development of infants conceived while taking efavirenz and infants that were conceived on a nevirapine or protease-inhibitor (PI lopinavir/ritonavir) containing regimen. Similarly, ttests or ANOVA statistics assessed maternal and infant characteristics associated with total language development. Results obtained in the study revealed no significant differences between the overall language abilities of infants exposed to regimen containing nevirapine or a PI versus regimen that contained efavirenz. The comparison of mean total Rossetti Infant-Toddler Language scores by infant age and maternal and infant characteristics revealed no significant association between variables except for hospitalization. Results obtained suggest that overall language development may not be significantly affected by in utero ART exposure however, further research is warranted to assess whether these infants are at an increased risk of late language emergence.

This study aimed to know the social network and social support the caregiver had available to take care of children exposed to HIV in the postnatal period. It is a descriptive study with a qualitative approach that used the theoretical framework of Symbolic Interactionism. Data were collected through interviews with 36 caregivers of children born to HIV-infected mothers who were followed up in a specialized service in the Northeast of Brazil and they were analyzed by inductive content analysis. The results revealed three categories that show the family and expert service as the main social networks of the caregiver and little emotional, information, instrumental and appreciation support received both in the family and in the context of health services. Interventions are needed to strengthen the weakened social network of the caregiver and to qualify and include nursing care in the context of children exposed to HIV.

This study aimed to know the social network and social support the caregiver had available to take care of children exposed to HIV in the postnatal period. It is a descriptive study with a qualitative approach that used the theoretical framework of Symbolic Interactionism. Data were collected through interviews with 36 caregivers of children born to HIV-infected mothers who were followed up in a specialized service in the Northeast of Brazil and they were analyzed by inductive content analysis. The results revealed three categories that show the family and expert service as the main social networks of the caregiver and little emotional, information, instrumental and appreciation support received both in the family and in the context of health services. Interventions are needed to strengthen the weakened social network of the caregiver and to qualify and include nursing care in the context of children exposed to HIV.

Background: In 2018, nearly 90% of the global children living with human immunodeficiency virus (HIV) were in sub-Saharan Africa (SSA). Compared to the adult population, antiretroviral therapy (ART) coverage among children was limited. However, adherence remained a problem among children though they had limited access to ART. This study was conducted to identify the risk factors of non-adherence to ART among children aged 6 to 17 years. Methods: This case-control study was conducted in 2020 using data obtained from clinical record reviews and self-reported data from 272 caregivers of HIV-infected children aged 6–17 years. Cases and controls represented children with poor versus children with good adherence to ART, respectively. Good adherence was defined based on a past 30-day physician adherence evaluation of taking ≥ 95% of the prescribed doses. Binary logistic regression was used to identify factors associated with non-adherence to ART. All statistical tests are defined as statis...

Background: Tuberculosis and human immunodeficiency virus have been closely linked and East Africa is the hardest region hit by tuberculosis and Human immunodeficiency virus including Ethiopia. The main objective of this study was to identify the associated variables with tuberculosis status and CD4 cell count chance of patients jointly in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94. Methods: A retrospective cohort study was conducted on AIDS patients whose age greater than 19 years from 1 st January, 2018-30 th January, 2020. Generalized linear mixed model was used to identify the factors of CD4 cell count and tuberculosis status of patients separately and jointly. Results: The mean with a standard deviation of weight, and a hemoglobin level of patients were 55.48 (10.21), and 18.25 (33.028) respectively. The baseline characteristics of patients included in this study was the median CD4 count of patients was 378 cells per cubic millimeter of blood. The generalized linear mixed model was well fitted which shows, opportunistic infection, weight and hemoglobin level were significantly associated with log of CD4 cell count and tuberculosis status of patients at 5% level of significance. Conclusion: From this study, hemoglobin level, weight, and opportunistic infection of other disease were statistically significant at a 5% level of significance for the log of CD4 count and TB status of patients jointly. The result of the study shows that the log of CD4 count of patients increased when hemoglobin level and weight of patients increased. In addition, the log of CD4 count of AIDS patients who has other disease is 5.04 more likely to be co-infection than who has no other disease.

Tenofovir Disoproxil Fumarate a nucleotide reverse transcriptase inhibitor that was introduced as a preferred first line antiretroviral therapy in Ethiopia as of 2008. However, routine renal function assessment is recommended as it is known to cause renal failure and renal tubular dysfunction. To assess the practice of renal function monitoring of patients on TDF based ART regimen. The magnitude of renal dysfunction and its associated factors are also assessed. Institutional based retrospective record review was carried out to determine the magnitude of renal dysfunction and associated factors among HIV positive individuals who have been on TDF based ART regimen in Gondar university hospital. A total of 406 records were reviewed and 96.21% were found complete. From a total of 290 patients with Creatinine determination, renal dysfunction was found in 25.2%. Patients aged between 30-41years had AOR of 2.75(95%CI 1.18, 6.37), while those aged 42-53 years had AOR of 3.10 (95%CI 1.12, 8.55) as compared to those aged less than 30 years. Low body mass index (AOR 4.39(95%CI 2.24, 8.61), low CD4 (AOR 5.87(95%CI 2.73, 12.62)) were associated with increased risk of renal dysfunction. However Advanced WHO stages (stages 3 and 4), were associated with a lower incidence of renal dysfunction. About one fourth of patients who were on TDF regimen developed renal dysfunction. Twenty nine percent of participants had no renal function monitoring. Factors which influence the renal dysfunction in patients with TDF regimen in this study are age, low body mass index, low CD4 count and advanced WHO stage.

In many countries, paediatric human immune deficiency virus (HIV) has been virtually eliminated. Nigeria however still records an unacceptably high number of HIV positive births. This study aims to identify HIV exposure rates among infants and to quantify gaps in preventing mother to child transmission (PMTCT) services in a major Nigerian city. A cross-sectional design was used to assess the prevalence of HIV sero-positivity in infants and use of PMTCT services among mothers in routine immunization clinics across the city. A total of 2,125 mother-infant pairs from 53 Primary Health Care Facilities were studied. More mothers who had received Ante natal care (ANC) services from orthodox health facilities were screened for HIV; 77.5% compared to 42.5% of those who used non-orthodox care providers (p < 0.001). In all, 0.6% of mothers were people living with HIV/AIDS (PLWHA). Overall, 0.9% of infants tested positive for HIV, only one infant was confirmed by DNA polymerase chain reaction (PCR) to be HIV infected. Only one of the 18 mothers of the HIV exposed infants had been previously diagnosed as having HIV infection. Among the newly diagnosed HIV positive mothers, 58.8% had received antenatal care from an orthodox health facility and 35.3% had been screened for HIV in pregnancy. Most mothers had practiced mixed feeding of their babies. The low HIV exposure rates among infants indicate progress in limiting mother-to-child transmission of HIV infections in Nigeria. However, the achievement of National PMTCT targets will need joint action of all stakeholders to reach those women without access to orthodox health facilities.