Exploring the Impact of Factors Affecting the Lifespan of HIVs/AIDS Patient’s Survival: An Investigation Using Advanced Statistical Techniques

This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.

Exploring the Impact of Factors Affecting the Lifespan of HIVs/AIDS Patient’s Survival: An Investigation Using Advanced Statistical Techniques

This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.

Immunovirological Profile of HIV1 Infection in Children and Adolescents Followed at the Bangui Pediatric University Hospital

History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.

Designing a Need Based Social Protection Intervention Package for Children and Adolescents Living with HIV and AIDS in Ghana—An Eclectic Perspective on Desired Social Protection Intervention Package/Framework

Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.

A Public Health Model and Framework to Mitigate the Impact of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon

UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million people have lost one or both parents due to the AIDS pandemic and 25 million children have been orphaned by HIV/AIDS in 2010. The HIV prevalence in Cameroon is estimated at 5.1%. As of 2010, there were 304,000 deaths due to AIDS in Cameroon. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000 were AIDS orphans. The HIV/AIDS burden impacts child survival, growth and development in the traditional African setting. With so many orphans in the population, along with many vulnerable children, strategies must be developed to respond more effectively to their critical needs. This study provides a model for OVC care and support in Cameroon. The model was developed out of extensive work using a participatory approach involving traditional, administrative and health stakeholders on OVC in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle, Ekondo Titi, and Bafaka-Balue communities in Cameroon. Consultancy services with PLAN Cameroon, the Pan African Institute for Development-West Africa coupled with facilitation of many training workshops on OVC with Save the orphans Foundation, the Ministry of Social Affairs, and the Ministry of Public Health and working with the National AIDS Control Committee. The essential components of a holistic framework for the care of OVC have been identified. A public health model for the care of OVC and a mechanism for their identification and a referral system for testing OVC for HIV are proposed. Through this model, a mechanism for the effective holistic care of OVC and collaboration is enhanced.

The Legal Protection of Children Orphaned by HIV/AIDS in Nigeria: An Appraisal

The Human Immunodeficiency Virus and the resultant disease—Acquired Immune Deficiency Syndrome are global epidemics in recent times. Although the effects of the epidemic have been curtailed somewhat in the developed world, it is not so in developing countries. As such it affects not only the infected but those directly dependent on them. Some of the affected people have been identified as children, who turn out to be unprepared for and defenceless against the imminent hardship prevalent as a consequence of the disease. The effects of the epidemic are felt more in the developing world than in developed countries and this is because the attitude of the developed world to the epidemic is positive, enhanced by awareness of the disease;whereas in the developing countries, a lot of myths are attached to it, affecting the requisite attitude needed to combat the epidemic and its effects. This paper seeks to examine the effects of this epidemic on children in Nigeria, comparing the effects on children in other African countries. The paper also looks at structures in place to cater for these children, and then seeks to proffer improved means of protecting their rights.

Impact of HIV/AIDS on mortality and nutritional recovery among hospitalized severely malnourished children before starting antiretroviral treatment

In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional recovery among severely malnourished HIV/AIDS uninfected and infected children. This was a retrospective cohort study conducted from data of 521 hospitalized severely malnourished children. We used Pearson’s Chi square test to compare proportions;and Student’s independent t-test to compare means;general linear model to analyze repeated measurements. We used mortality relative risk with confidence interval (CI 95%), Kaplan-Meir survival curves and Cox proportional hazard models to analyze the HIV impact on mortality rate. Case fatality rate differed significantly from SAM HIV uninfected (10.7%) and HIV infected children (39.7%), p < 0.001. Mortality relative risk was 3.71, 95% IC [2.51 - 5.47] for HIV infected children. Kaplan-Meir survival curves differed significantly between the two groups, (p Log Rank < 0.001). Cox regression adjusted mortality relative risk of HIV infected children was 4.27, CI: 2.55 - 7.15, p < 0.001. Mean weight gain differed significantly among infected children, p < 0.001. Anthropometric Z-scores means evolution differed significantly between HIV infected and uninfected children and within each group’s subjects for WHZ (p < 0.001) and WAZ (p < 0.001). Mortality relative risk was 3.71 times higher for HIV infected children. Multiples infections and metabolic complications have synergism on death occurrence in sever acute malnutrition;when associated to HIV infection, case fatality rate increases many times. Weight gain and anthropometrics index evolution were very slow for SAM HIV infected children, and specific diet may be needed for more nutritional recovery. Effective interventions, updated and adapting to local country context, to improve survival of severely malnourished HIV/AIDS infected children in HIV and SAM prevalent settings are urgently needed in the area of SAM’s community-based treatment approach.

总淋巴细胞计数对河南省6～18岁HIV/AIDS患者CD_4^+ T计数的预测作用

目的:探讨总淋巴细胞计数(TLC)作为CD4+T淋巴细胞(CD4+T)计数替代标志物对儿童及青少年HIV/AIDS患者细胞免疫功能的预测作用。方法:采用回顾性队列研究方法,分析266例6～18岁HIV/AIDS患者抗病毒治疗(HAART)前后TLC和CD4+T计数的相关性;通过受试者工作特征曲线判断TLC代替CD4+T<350mm-3计数的预测价值和最佳分界值。结果:HAART前、6个月和12个月时,TLC和CD4+T计数均呈正相关关系(rS分别为0.791、0.625和0.680,P<0.001)。HAART前用TLC<2600mm-3预测CD4+T<350mm-3具有较高的价值,灵敏度和特异度分别为83.56%和79.31%;HAART6个月及12个月时,用TLC预测CD4+T<350mm-3的最佳预测阈值均为2400mm-3,灵敏度分别为76.40%和71.03%,特异度分别为72.38%和82.39%。结论:TLC是CD4+T计数较好的替代标志物,可用于监测儿童及青少年HIV/AIDS患者HAART疗效。

以妇女儿童为主体 发挥妇联网络优势开展HIV/AIDS预防教育与关怀活动

以妇女儿童为主体,发挥妇联网络优势,与联合国儿基会合作通过层层培训及大众传媒,深入开展了艾滋病预防知识宣传培训的社会动员工作,包括培养骨干,将宣传材料翻译成11种少数民族文字,利用各种途径传播相关知识,开展针对辍学女童等不同人群为目标人群的HIV/AIDS预防教育培训。通过以上措施,提高了广大妇女儿童有关预防和控制HIV/AIDS知识。

四川凉山地区HIV/AIDS患儿合并支气管扩张症的临床特点分析

目的分析四川凉山地区HIV/AIDS患儿合并支气管扩张症的临床特点。方法回顾性分析2018年1月至2019年12月于凉山彝族自治州越西县第一人民医院感染科住院治疗的HIV/AIDS合并支气管扩张症患儿,共21例。收集患儿基本信息、临床资料和影像学检查资料等。结果21例患儿中,男童10例,女童11例,以7~10岁年龄段为主,HIV感染途径以母婴传播为主。主要临床表现为持续或反复咳嗽、咳痰以及发热、气促等。21例患儿中,有15例患儿的生长发育水平低于正常同龄儿。在合并机会性感染中,以细菌性肺炎的发生率最高,其次依次为结核病、肺孢子菌肺炎。双肺为支气管扩张的最常见受累部位,以混合支气管扩张为主。结论早诊断、早治疗对降低四川凉山地区HIV/AIDS患儿合并支气管扩张症的发病率和病死率具有重要意义。

Grow Together under the Sunshine——The 4th Summer Camp for AIDS Orphaned Children

The 4th summer camp for AIDS-orphaned children was held in Beijing from August 2-8, 2007. Co-sponsored by the China Youth Concern Commission and China Foundation for the Prevention and Control of STDs （sexually transmitted disease） and AIDS, the event was attended by 80 AIDS-orphaned children aged 8- 16 from 18 counties and cities of 8 provinces of Shanxi, Yunnan, Henan, Jilin, Liaoning, Guizhou, Sichuan and Anhui.

联合抗病毒阻断AIDS母婴传播影响因素分析

目的探索艾滋病母婴传播阻断抗逆转录病毒治疗联合方案应用的影响因素,为制定促进人类免疫缺陷病毒(HIV)阳性孕妇及其所生婴儿抗病毒治疗联合用药的措施提供依据。方法在云南省5个艾滋病高、中度流行县(市、区),对艾滋病母婴传播阻断中选择抗病毒治疗联合方案的影响因素进行了定量和定性调查。结果抗逆转录病毒治疗联合方案应用率为53.2%(84/158)。主要影响因素是为了子女不被感染、不让抽血的风俗习惯、交通、经济、服药怕人知道、首次咨询孕周、医生的用药倾向、知道方案数目、身体健康状况、费用承受能力、知道有副作用、阻断成功的信心。结论抗逆转录病毒治疗联台方案的应用受多种因素影响。推广联合用药方案时要针对主要影响因素开展工作。

受AIDS影响儿童的教育问题及其对策

从艾滋病的特征入题,在确定本文受AIDS影响儿童涉及范围的基础上,分析了受AIDS影响儿童的主要形势:受AIDS影响儿童的数量呈上升趋势;中国受AIDS影响儿童的数量有上百万。通过一些典型数据分析了受AIDS影响儿童受教育的不良现状。导致这种现状的原因主要是社会歧视和经济制约。因此,学校要转变对受AIDS影响儿童的歧视态度,接纳受AIDS影响儿童入学并使其享受平等的教育;国家和社会则要投入经费,提高受AIDS影响儿童的入学率;建构保障受AIDS影响儿童受教育权的法规体系;积极探索综合型的受AIDS影响儿童教育模式。

中原地区受AIDS影响的儿童心理健康水平的现况研究

目的评定中原地区受艾滋病(AIDS)影响的儿童心理健康水平,为改善他们的心理状况提供客观依据。方法选用SCL-90量表进行问卷调查,应用SAS 8.0进行统计分析。结果共调查受艾滋病影响的初中生120人,其中双孤儿童33人,单孤儿童43人,受AIDS影响的双亲儿童44人。AIDS致双孤儿童的SCL-90总分(161.36±41.17)分,明显高于AIDS致单孤儿童的(137.37±33.32)分和受AIDS影响的双亲儿童的(141.82±39.36)分。AIDS单孤儿童中女孩的总分(147.07±34.75)明显高于男孩(119.27±21.50)。结论受AIDS影响的儿童心理问题比较严重,在为其提供心理支持的过程中,应根据不同类型、不同性别的特点,进行有针对性地干预。

Parental Disclosure of Own HIV Status to Children in Two Ghanaian Regions;Examining the Determinants within a Child Vulnerability Context

Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4;95% CI: 1.08 - 10.66, P Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.

Factors Associated with Vulnerability to HIV and Sexually Transmitted Infections among Street Children in Selected Towns of Ethiopia, 2016

Background: The problem of street children is becoming a world crosscutting issue since these children exist in every part of the world and become a worldwide problem. Objective: To assess factors associated with vulnerability to STIs and HIV/AIDS among street children in selected towns of Ethiopia. Methodology: Community-based cross-sectional descriptive study design was used on the three selected towns of Ethiopia from June-September, 2016. A total of 360 street children were selected, using snow ball sampling technique. Data were collected using pre-tested interviewer-administered questionnaire. Logistic regression was used to analyze the data. Results: A total of 360 (97.8%) respondents were included in this study. Among them, 167 (46.4%) of them had practiced sexual intercourse and out of these, 137 (82%) had started having sex at the age of 16 years old. Out of these, 61 (36.53%) of them started to get daily basic needs whereas 54 (32.3%) of them were forcefully raped on the street. Only 53 (59.6%) had used condom consistently and 83 (49.7%) had conducted survival sex within the last 12 months. Children on the street or chewing khat or consumption of alcohol had more vulnerability to STIs and HIV about 2.532 (1.57 - 4.08), 2.32 (1.11 - 4.80), 4.18 (2.31 - 7.55) times respectively. But those enrolled in school were about 0.40 (0.25, 0.64) less likely vulnerable than their counterparts. Conclusion: Street children are at a higher likelihood of vulnerability to STIs and HIV. Intervention targeted multilevel approach such as re-integration with their family, life skills training, sexuality education, creating income-generating activities and information education about STIs and HIV should be considered.

HIV感染孕产妇所生儿童的死亡状况分析

目的了解我国艾滋病高流行地区艾滋病感染孕产妇所生儿童的死亡状况。方法于2008年8～11月在我国艾滋病高发4省7县／区对2004年1月-2007年12月期间艾滋病感染孕产妇所生儿童的死亡状况进行回顾性调查，分析儿童死亡原因及死亡水平。结果艾滋病感染孕产妇所生新生儿死亡率为33．71‰，婴儿死亡密度为110．78／1000人年，5岁以下儿童死亡密度为59．83／1000人年；艾滋病感染婴儿死亡率为352．94‰，艾滋病感染孕产妇所生非艾滋病感染婴儿死亡率为62．50‰；艾滋病感染孕产妇所生的5岁以下死亡儿童中，44．90％死于艾滋病，15．56％死于早产低出生体重。结论我国艾滋病高流行地区艾滋病感染孕产妇所生儿童死亡率处于较高水平，艾滋病感染孕产妇所生儿童死亡的首要原因是艾滋病，其次是早产低出生体重。

HIV感染父母对子女告知病情影响因素的质性研究

目的探讨影响HIV感染父母对子女告知病情的影响因素。方法对20例HIV感染父母进行深入访谈,以Colaizzi现象学研究方法分析资料。结果提炼出羞耻感及担心子女受歧视、担心增加子女压力、担心子女的负性反应、不知道如何告知、告知意愿5个主题。结论影响HIV感染父母对子女告知病情的主要原因为自我感知的羞耻感、担心社会歧视及不知如何告知,医护人员应关注该人群的心理社会需求,构建符合我国国情的病情告知干预指南,以减轻HIV感染者病情告知压力与困扰。

艾滋病儿童乙肝疫苗免疫效果及与CD4、CD8、HIV RNA的相关性研究

目的:探讨艾滋病儿童乙肝疫苗效果及与CD4、CD8、HIV RNA的相关性。方法:选取2018年1月-2020年1月行HARRT治疗的艾滋病儿童83例,所有患儿入院后均进行检查。对HBsAg<10 ng/mL(未感染HBV)且抗HBs水平<10 mIU/mL的患儿,按照0、1、6个方案接种乙肝疫苗;观察患儿乙肝疫苗接种效果,并分析艾滋病儿童乙肝疫苗免疫效果与CD4、CD8及HIV RNA的相关性。结果:83例患儿均全部完成0、1、6方案的乙肝疫苗接种。第3针注射完毕后,儿童抗-HBs阳性率高于第1针和第2针,差异有统计学意义(P<0.05);接种成功组第2、3针的CD4、CD8水平均高于接种失败组,差异有统计学意义(P<0.05);83例患儿乙肝疫苗注射后,接种成功76例(91.57%);相关性分析显示,艾滋病患儿乙肝疫苗免疫接种成功率与CD4、CD8水平呈正相关性。结论:艾滋病儿童乙肝疫苗免疫效果与CD4、CD8、HIV RNA水平密切相关,因此加强对CD4、CD8、HIV RNA水平的检测非常必要。