Future Long-Term Care Setting Preferences and Related Factors among Japanese Middle-Aged and Older People Living with HIV

Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.

Characteristics relating to the interiorization of acquired immunodeficiency syndrome in Brazil: a cross-sectional study

Background:In recent years there has been changes in the social and geographic profile of acquired immunodeficiency syndrome(AIDS).The aim of this study was to evaluate the internalization of AIDS in the state of Rondônia,Brazil.Findings:In Rondônia,1473 AIDS cases were reported,with an average annual incidence of 15.8/100,000 persons(42.7%women).The most common mode of viral transmission was sexual(96.5%),and the majority of the individuals had not completed their primary education(64.8%).There was heterogeneity in relation to case distribution,involving almost all of the municipalities in the state.The average annual mortality rate was 2.5/100,000 persons.Conclusion:Rondônia has a higher incidence of AIDS than the national average and the northern region.Efforts to provide access to treatment and follow-up of these individuals should be implemented,prioritizing areas where the incidence is higher and decentralizing the treatment of patients with AIDS in the state.

Neglected tropical diseases in Brazilian children and adolescents:data analysis from 2009 to 2013

Background:Neglected tropical diseases(NTDs)prevail in conditions of poverty and contribute to the maintenance of social inequality.Out of the NTDs prioritized by the Brazilian Ministry of Health,four parasitic infections require mandatory notification:acute Chagas disease,leishmaniasis,malaria,and schistosomiasis.Data on the behaviour of these NTDs in the young population are currently limited.This study seeks to analyse the epidemiological aspects of these parasitic infections in children and adolescents in Brazil.Methods:A retrospective exploratory ecological study was conducted.A spatial analysis of the cases reported between 2009 and 2013 in individuals aged between 0 and 19 years that were notified through the Health Notification Aggravation Information System(SINAN)was performed.Results:In total,64,567 cases of cutaneous and visceral leishmaniasis,malaria,schistosomiasis,and acute Chagas disease were recorded in the SINAN database,representing a rate of 20.15 cases per 100,000 inhabitants.The average age of the cases was 12.2 years and 62.32%were male.Four hundred and three deaths related to these obligatorily reported parasites were recorded,indicating a case fatality rate of 0.62%.Visceral leishmaniasis and acute Chagas disease had the highest rates of lethality.A heterogeneous spatial distribution of the studied parasites was observed.Conclusions:The number of cases and the lethality rate described in this study show that these diseases still represent a serious problem for public health in Brazil.This points to the need to encourage new research and the reformulation of social,economic,and public health policies aimed at ensuring better health and living conditions for all individuals,especially those among the populations considered vulnerable,as is the case of the young.