HIV counseling and testing(HCT)has become paramount in the prevention and control of HIV/AIDS worldwide.However,the uptake of HCT has been very slow globally,especially in sub-Saharan Africa.Student nurses formed the ...HIV counseling and testing(HCT)has become paramount in the prevention and control of HIV/AIDS worldwide.However,the uptake of HCT has been very slow globally,especially in sub-Saharan Africa.Student nurses formed the largest group undergoing health care training in the country compared to doctors and other health cadres.According to WHO,they are part of the most vulnerable group to HIV infection,judging by the fact that they interact more with patients/clients than other healthcare professionals.This study aimed to determine the prevalence of HCT uptake,knowledge,and attitude and evaluate influencing factors among student nurses and midwives in public nursing schools.An institutional-based cross-sectional study design was employed to collect data from 305 randomly selected nursing students and midwives using a validated and reliable self-administered questionnaire.Descriptive statistics(percentages,mean and standard deviation)and inferential statistics(chi square,logistics regression,one-way ANOVA and independent samples t-test)were used for data analysis using SPSS version 25.0.A p-value<0.05 was considered for statistical significance.Out of the 305 students recruited for the study,60.98%were females,with a mean age of 25.5 years old.About 58.4%of the participants had tested for HIV in the past.About 95.7%acknowledged the importance of HCT in the prevention and control of HIV/AIDS.HCT uptake among student nurses and midwives was influenced by factors ranging from an individual that are interpersonal challenges(such as concerns of friends),perceived susceptibility to the disease,lack of confidentiality,stigma and discrimination from health service providers.Therefore,these barriers can be addressed through an organized targeted health education intervention and advocacy programs across health training institutions in the Gambia and beyond.展开更多
Background Men who have sex with men （MSM） in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling...Background Men who have sex with men （MSM） in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China. Methods Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections （STIs） was performed. Results Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use （OR=7.9, 95% CI： 0.9-66.7, P=0.059） and bleeding during anal sex （OR=5.9, 95% Cl： 1.3-26.2, P=0.019） were risk factors for HIV infection, and group sex （OR=6.6, 95% Cl： 2.2-19.7, P=0.001） was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% （P 〈0.001）; group sex fell from 19.2% to 5.8% （P 〈0.001）; and bleeding during anal sex fell from 23.1% to 5.8% （P 〈0.001）. Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% （P 〈0.001）, and oral sex rose from 57% to 78.5% （P 〈0.001）. STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM （X^2=5.189, P=0.023）. Conclusions HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.展开更多
Background:Provider-initiated HIV testing and counseling(PITC)is offered as part of the normal standard of care to increase access to treatment for HIV-infected children.In practice,HIV diagnosis occurs in late childh...Background:Provider-initiated HIV testing and counseling(PITC)is offered as part of the normal standard of care to increase access to treatment for HIV-infected children.In practice,HIV diagnosis occurs in late childhood following recurrent and chronic infections.We investigated primary caregivers’reported reasons for seeking HIV testing for children aged 5–18 years,determined the orphan status of the children,and compared the clinical profile and disease burden of orphans and non-orphans.Methods:This was a cross-sectional survey of primary caregivers of HIV-infected children accessing antiretroviral treatment(ART)from two community hospitals and 34 primary healthcare facilities in a rural district in Mpumalanga province,South Africa.Results:The sample consisted of 406 primary caregivers:319(78.6%)brought the child to the health facility for HIV testing because of chronic and recurrent infections.Almost half(n=183,45.1%)of the children were maternal orphans,128(31.5%)were paternal orphans,and 73(39.9%)were double orphans.A univariate analysis showed that maternal orphans were significantly more likely to be older(OR=2.57,p=0.000,CI:1.71–3.84),diagnosed late(OR=2.48,p=0.009,CI:1.26–4.88),and to start ART later(OR=2.5,p=0.007,CI:1.28–4.89)than non-orphans.There was a high burden of infection among the children prior to HIV diagnosis;274(69.4%)presented with multiple infections.Multiple logistic regression showed that ART start age(aOR=1.19,p=0.000,CI:1.10–1.29)and time on ART(aOR=2.30,p=0.000,CI:1.45–3.64)were significantly associated with orphanhood status.Half(n=203,(50.2%)of the children were admitted to hospital prior to start of ART,and hospitalization was associated with multiple infections(OR=1.27,p=0.004,CI:1.07–1.51).Conclusions:The study found late presentation with undiagnosed perinatal HIV infection and high prevalence of orphanhood among the children.The health of maternal orphans was more compromised than non-orphans.Routine PICT should be strengthened to increase community awareness about undiagnosed HIV among older children and to encourage primary caregivers to accept HIV testing for children.展开更多
文摘HIV counseling and testing(HCT)has become paramount in the prevention and control of HIV/AIDS worldwide.However,the uptake of HCT has been very slow globally,especially in sub-Saharan Africa.Student nurses formed the largest group undergoing health care training in the country compared to doctors and other health cadres.According to WHO,they are part of the most vulnerable group to HIV infection,judging by the fact that they interact more with patients/clients than other healthcare professionals.This study aimed to determine the prevalence of HCT uptake,knowledge,and attitude and evaluate influencing factors among student nurses and midwives in public nursing schools.An institutional-based cross-sectional study design was employed to collect data from 305 randomly selected nursing students and midwives using a validated and reliable self-administered questionnaire.Descriptive statistics(percentages,mean and standard deviation)and inferential statistics(chi square,logistics regression,one-way ANOVA and independent samples t-test)were used for data analysis using SPSS version 25.0.A p-value<0.05 was considered for statistical significance.Out of the 305 students recruited for the study,60.98%were females,with a mean age of 25.5 years old.About 58.4%of the participants had tested for HIV in the past.About 95.7%acknowledged the importance of HCT in the prevention and control of HIV/AIDS.HCT uptake among student nurses and midwives was influenced by factors ranging from an individual that are interpersonal challenges(such as concerns of friends),perceived susceptibility to the disease,lack of confidentiality,stigma and discrimination from health service providers.Therefore,these barriers can be addressed through an organized targeted health education intervention and advocacy programs across health training institutions in the Gambia and beyond.
文摘Background Men who have sex with men （MSM） in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China. Methods Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections （STIs） was performed. Results Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use （OR=7.9, 95% CI： 0.9-66.7, P=0.059） and bleeding during anal sex （OR=5.9, 95% Cl： 1.3-26.2, P=0.019） were risk factors for HIV infection, and group sex （OR=6.6, 95% Cl： 2.2-19.7, P=0.001） was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% （P 〈0.001）; group sex fell from 19.2% to 5.8% （P 〈0.001）; and bleeding during anal sex fell from 23.1% to 5.8% （P 〈0.001）. Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% （P 〈0.001）, and oral sex rose from 57% to 78.5% （P 〈0.001）. STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM （X^2=5.189, P=0.023）. Conclusions HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.
基金This study was funded by the University of Limpopo.The authors would also like to thank the field workers and all the caregivers who participated and shared their time and experiences with us.We also acknowledge the healthcare workers who supported the data collection process.
文摘Background:Provider-initiated HIV testing and counseling(PITC)is offered as part of the normal standard of care to increase access to treatment for HIV-infected children.In practice,HIV diagnosis occurs in late childhood following recurrent and chronic infections.We investigated primary caregivers’reported reasons for seeking HIV testing for children aged 5–18 years,determined the orphan status of the children,and compared the clinical profile and disease burden of orphans and non-orphans.Methods:This was a cross-sectional survey of primary caregivers of HIV-infected children accessing antiretroviral treatment(ART)from two community hospitals and 34 primary healthcare facilities in a rural district in Mpumalanga province,South Africa.Results:The sample consisted of 406 primary caregivers:319(78.6%)brought the child to the health facility for HIV testing because of chronic and recurrent infections.Almost half(n=183,45.1%)of the children were maternal orphans,128(31.5%)were paternal orphans,and 73(39.9%)were double orphans.A univariate analysis showed that maternal orphans were significantly more likely to be older(OR=2.57,p=0.000,CI:1.71–3.84),diagnosed late(OR=2.48,p=0.009,CI:1.26–4.88),and to start ART later(OR=2.5,p=0.007,CI:1.28–4.89)than non-orphans.There was a high burden of infection among the children prior to HIV diagnosis;274(69.4%)presented with multiple infections.Multiple logistic regression showed that ART start age(aOR=1.19,p=0.000,CI:1.10–1.29)and time on ART(aOR=2.30,p=0.000,CI:1.45–3.64)were significantly associated with orphanhood status.Half(n=203,(50.2%)of the children were admitted to hospital prior to start of ART,and hospitalization was associated with multiple infections(OR=1.27,p=0.004,CI:1.07–1.51).Conclusions:The study found late presentation with undiagnosed perinatal HIV infection and high prevalence of orphanhood among the children.The health of maternal orphans was more compromised than non-orphans.Routine PICT should be strengthened to increase community awareness about undiagnosed HIV among older children and to encourage primary caregivers to accept HIV testing for children.
