Retention in HIV Care among Patients Testing Positive for HIV and Ineligible to Start Antiretroviral Therapy

Background: The failure to monitor and link patients from HIV testing to HIV care and retain them in care until they are eligible for ART is a major barrier to early ART initiation. This study evaluated the retention in pre-ART care of HIV-positive patients who are ineligible to start ART in Nigeria. Methods: Out of 1766 ART-ineligible HIV-positive patients enrolled into pre-ART care (during 1st March to 31st December 2007), 1,098 patients were randomly selected for a five-year (ending 30th April 2012) retrospective cohort assessment using routine data in two health facilities. Retention was defined as remaining connected to pre-ART care once entered until ART initiation or transfer-out to continue care elsewhere. Probability of retention was estimated using Kaplan-Meier survival method and log-rank test. Cox proportional hazards model was used for attrition and P P P P = 0.000]. Socio-demographic characteristics, CD4 cells count and WHO clinical stage at pre-ART enrolment were not associated with attrition (P > 0.05). Conclusion: Retention in pre-ART care was somewhat poor. Uptake of CPT significantly improved retention. Majority of attrition occurred in first year of pre-ART care. Close monitoring and tracking of patients during this period is recommended.

The Evaluation of Pediatric HIV Care in Congo

Pediatric AIDS is still a public health issue. In order to improve the care of children living with HIV, a study was carried out between January and December 2014, that is in 12 months at University Center Hospital (UCH) of Brazzaville, in the two Ambulant Treatment Centers (ATCs) of Brazzaville and Pointe-Noire, In three general hospitals and seven base hospitals. Heads of centers and follow-up files of children aged 0 to 15 constituted the target population. The study variables concern the provision of care, the organization of structures and personnel, and data management. Thirteen health facilities, 13 heads of centers and 520 medical files were selected. HIV care was effective in nine out of eleven departments, only the two CTAs offered the entire package of activities. The diagnosis was made in WHO stage 3 in 433 cases (83.3%), the pre-therapeutic assessment in 246 cases (47.2%);Psychological care in 84 cases (16.1%) whose 80 (95.2%) in the ACT, nutritional management in 4 cases (0.7%). Nine out of 13 centers did not have computer tools or materials for patient information and education;No center had sufficient staff. The dispensation of Anti-retroviral drugs (ARDs) is not based on any standard and the safety conditions of the laboratory providers are not guaranteed. The importance of the observed dysfunction makes it necessary to improve the general conditions of care.

Clinician Utilization of Best Practices for HIV Care and Status Disclosure: A Cross-Sectional Study

Determining the baseline utilization of best practices among clinicians, with regard to HIV care and disclosure of status to at-risk partners, is critical to addressing HIV prevention issues and disease transmission. In this study, we examined clinicians' utilization of best practices for HIV/AIDS care and the disclosure of HIV status to sexual and needle-sharing partners (HSSNSP). We conducted a cross-sectional survey of 100 clinicians to assess knowledge, attitude, and behavior towards best practices for HIV care and disclosure of HSSNSP. Multiple logistic regression analysis was used to determine factors associated with the utilization of clinical best practices for HIV care and disclosure of HSSNSP. Forty eight percent of the participants revealed poor behaviors. Fifty six percent showed less positive attitudes towards clinical best practices for HIV care and disclosure of status. Less than half (32%) of the participants had earned at least 1 HIV/AIDS CME credit in the past two years. Our study showed strong associations between the utilization of best practices for HIV care and the disclosure of status, and clinician attitudes and knowledge levels. Further research that aims to improve knowledge and attitudes on clinical best practices for providing HIV/AIDS care and the disclosure of status is needed. This improvement may lead to increase in the utilization of best practices for HIV care and disclosure of status, and contribute to decreases in disease transmission rates.

Prevalence and Factors Associated with Hypertension among People Living with HIV Receiving Care in Three Large HIV Clinics in Nasarawa State, Nigeria

In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.

HIV care-seeking behaviour after HIV selftesting among men who have sex with men in Beijing,China:a cross-sectional study

Background:Men who have sex with men(MSM)has become the group with the fastest growing HIV epidemic in China.Since many Chinese MSM are conducting HIV self-testing,we aimed to determine the rate of HIV care seeking after self-testing,examine characteristics of“seekers”compared to“non-seekers,”and explore factors associated with HIV care-seeking behaviour.Methods:A cross-sectional study design was used and an online survey was conducted in Beijing,China in 2016,among users of a popular Chinese gay networking smart phone application.Chi-square test was used to compare characteristics of those who sought HIV care(“seekers”)and those who did not(“non-seekers”).Univariate and multivariate logistic regression analyses were conducted to assess factors associated with HIV care seeking.Results:Among 21,785 screened,2383 participants(10.9%)were included in the study.A total of 380 participants(15.9%)reported seeking HIV care after HIV self-testing while 2003(84.1%)did not.Lack of knowledge of the“window period”(adjusted odds ratio[AOR]=0.68,95%confidence interval[95%CI]=0.47-0.97,P=0.04)was associated with reduced odds of seeking HIV care,while lower monthly income(AOR=1.29,95%CI=1.03-1.62,P=0.03)and obtaining HIV self-testing kits from health facilities(AOR=2.40,95%CI=1.81-3.17,P<0.001),and non-governmental organizations(AOR=2.44,95%CI=1.79-3.34,P<0.001)was associated with increased odds of seeking HIV care.Among those who sought HIV care,a large majority(92.4%)had non-reactive HIV self-testing results.Only 29 out of 265 with reactive,uncertain,or unknown results sought HIV care.Conclusions:We found a very low rate of HIV care seeking among our sample of urban Chinese MSM.The observation that most with reactive,uncertain,or unknown results did not seek HIV care is a cause for concern.These people should be paid more attention and helped to enter the care cascade.Our findings highlight that interventions aimed at improving linkage to care after HIV self-testing are urgently needed.However,further study is required to inform the design and implementation of future interventions aiming to encourage HIV care-seeking behaviour.

HIV/AIDS Related Discrimination in Health Care Service:a Cross-sectional Study in Gejiu City, Yunnan Province

Objectives To investigate discrimination against people living with HIV （PLWH） and its impacts. Methods Forty people who were either HIV positive （7/40） or had high risk behavior （33/40） were interviewed. Focus group discussion was held in the interview with people who were suspected to be infected with HIV, and in-depth interview was conducted in the survey of HIV positive persons whose privacy was strictly protected to ensure the confidentiality of the collected information. Results It was identified that six forms of discrimination against people living with HIV occurred in health care service in Gejiu, including speaking to patients in an insulting manner, refusing to provide health care service, delaying treatment, treating differently, uncovering patients＇ privacy, and over-protecting themselves against patients. Discrimination against people living with HIV greatly affected their health conditions. Conclusions Discrimination against people living with HIV in health service has negative impact on their physical and mental health.

Challenges in Retention of Patients in Continuum of HIV-Care in Delhi— Experience of a Decade &Way Ahead

Retention of the patients in HIV-care is critical for success of Anti Retroviral Treatment (ART) programme to reduce HIV-related morbidity & mortality and prevent emergence of drug resistance. In last decade in Delhi (April 2004 to March 2014), overall 24% HIV-positive patients were lost-to-follow-up (LTFU) at step-1 (testing to enrolment into HIV-care), 7.8% at step-2 (enrolment to ART eligibility), 23.7% at step-3 (eligibility to initiation of ART) and 16.6% at step-4 (initiation to lifelong ART) of retention cascade. About 2/3rd losses at step-4 were within 1st year and 80% within 2 years. The retention of the patients in pre-ART care was 3 times lower than those initiated ART. Only 27.4% patients were in active pre-ART care during 2013. The intensified LTFU tracking (ILT) undertaken during November, 2013 through March, 2014 was not successful in tracking 97% pre-ART LTFU clients due to incomplete addresses/or migration since address proof of patients on enrolment into HIV-care was not mandatory prior to 2009. Amongst patients tracked, 1.5% were alive, 0.24% had disengaged from care while 1.2% had died. After ILT overall “On ART” and “Pre-ART” LTFU rate in the last decade was 15.5% and 45.2%, respectively. The retention cascade of last year from April 2013 to March 2014 showed improvement through strategies adopted in Third Phase of National AIDS Control Programme (NACP-III;2007-2013), and “On ART” and “Pre-ART” LTFU rates declined to 9.4% and 7.4%, respectively. However, desired at least 90% retention at various steps of the cascade could not be achieved. National Policy of delivering ART services through limited number of standalone ART centers in India, despite its significant success, has limitation of leaky treatment cascade and calls for policy makers to decentralize the programme by its appropriate integration with general health services and task shifting to improve continuum of care.

The HIV Infection: Clarification of Its Legal Classification of Transmission and Measures to Protect Societies from Burdening Caused by Social and Medical Care Services for the Coming Decades

This article addresses issues regarding the transmission of HIV;without the combination antiretroviral treatment (cART), HIV causes a fatal outcome of those infected in most cases. First, legal issues: For years, controversial discussions have dealt with the subject of the legal classification of HIV infection, such as “… criminalization of HIV exposure might limit access to and uptake of HIV prevention services…” Based on the rule of law of a constitutional state, we explain the legal principles that serve to protect the legal rights of its citizens. The state has to protect its citizens from harm by other people. The prosecution and conviction of a specific person for a proven HIV infection are legal. Therefore, general decriminalization of HIV infection would undermine the right of thereby harmed citizens to compensation. Second, HIV prevention strategies: Based on the Test and Treatment Strategy (TASP)1, controlled studies were undertaken to find out which framework conditions could improve their benefit. We outline concepts that can help to curb the still ongoing spread of HIV: By providing early HIV diagnosis and ongoing HIV care services as part of updated education and prevention campaigns. Also, concerted, comprehensive campaigns are required to demonstrate further impacts of HIV infection: Both on the quality of life of infected individuals due to the development of non-communicable diseases and the increasing burden to societies as a whole.

Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

2012~2023年某三甲专科医院医务人员HIV职业暴露调查分析

目的分析某三甲专科医院人类免疫缺陷病毒(HIV)职业暴露发生原因及危险因素,为预防医务人员HIV职业暴露的发生提供科学依据与建议。方法查阅2012~2023年某三甲专科口腔医院HIV职业暴露记录资料,从发生HIV职业暴露的医务人员类别、工龄、暴露类型、原因等进行统计分析。结果2012~2023年该院医务人员发生HIV职业暴露共6例;实习医生更容易发生HIV职业暴露;因锐器伤导致的职业暴露多于血液体液暴露。结论医院应结合实际情况,加强针对低年资医务人员的职业防护相关培训,规范操作流程,提高个人防护意识,降低HIV职业暴露发生风险。

Issues in the Care and Treatment of HCV/HIV Co-Infection for Key Populations in Resource-Constrained Settings

Globally, the epidemic of hepatitis virus infection is increasing in the context of common viral transmission routes with the Human Immunodeficiency Virus (HIV). Thus, co-infection with both hepatitis virus and HIV is becoming a common occurrence, particularly for key populations. Studies of key populations, people who inject drugs, sex workers, transgendered individuals and men having sex with men, report high levels of illicit drug and/or alcohol use along with limited access to health care and medical treatment. Without the medical management of co-occurring substance use disorders and hepatitis C virus (HCV) infection, a significant proportion of this population with HCV/HIV co-infection will progress to chronic liver disease then subsequently end-stage liver disease. Thus, access to comprehensive care and treatment, including HCV testing with subsequent care and treatment of acute/chronic HCV infection is essential to address the global burden of disease. Increased efforts are needed globally to address the barriers to comprehensive care and treatment for key populations with HCV/HIV co-infection.

Medical Records Documentation of HIV/AIDS Clinical Services at Primary Health Care (PHC) Facilities and Its Implications on Continuum of Care and Operational Research in South Africa

Background: Patients medical records are used to document care processes for communication amongst healthcare workers for continued patient management. Incomplete or inaccurate documentation can adversely affect the quality of patients’ care, leading to medication and treatment errors, increased morbidity, and mortality. Quality documentation in medical records is therefore an essential component of optimal healthcare and facilitates an individual’s continuity of care. This study aimed to assess the quality of documentation of clinical data through the review of the accuracy and completeness of clinical records among newly diagnosed HIV-positive persons. The study is a sub analysis of a prospective longitudinal study that followed a cohort of 12,413 persons who were newly diagnosed with HIV infection. Severe limitations in retrieving reliable information and data became an obstacle to our research and led the study team to conduct medical records documentation and data audit to verify the accuracy and completeness of the data for newly diagnosed HIV positive persons. Methods: A cross-sectional study was conducted using routine data generated from 75 randomly selected newly diagnosed HIV positive persons aged 12-years-old and above between June 1, 2014 and March 31, 2015 in 36 purposively selected primary health care (PHC) clinics in South Africa. The facilities were selected from three high HIV-burden districts of South Africa (Gert Sibande, uThukela and City of Johannesburg). Results: Significant differences in the accuracy and completeness of clinical records were observed between data generated through the self-assessment by the facility managers and data primarily collected through review of the patients’ clinical stationery and facility registers. 80% of the newly diagnosed HIV positive persons were not documented as screened for tuberculosis (TB) on the clinical chart and 69% of newly diagnosed clients were not clinically staged (WHO staging). Furthermore, 80% of newly diagnosed HIV positive persons’ follow up visit dates were not documented in the patient’s clinical chart. Completeness of the data elements on the case record forms ranged from as low as 26% to a maximum of 66%. It was noteworthy that all the clients’ information documented in HIV counselling and testing registers, continuum of care registers and clinical charts were only partially completed. Conclusion: Each of the health care facilities under study had some significant gaps in medical records documentation of clinical data on newly diagnosed HIV positive persons. Data and information accuracy and completeness were a serious challenge in most facilities during the period under investigation. Of interest was the inconsistency of data recorded in the HCT registers, continuum of care and clinical charts of individual patients. This is a major impediment to HIV/AIDS comprehensive care.

Care and Support Programmes for Orphans and Vulnerable Children: Achievements and Implications of HIV/AIDS Funded Project in Osun State, Nigeria

Orphans and Vulnerable Children (OVC) and their families face many challenges but there are opportunities to provide care and support programmes for them in their communities. This paper presents the achievements and implications of HIV Programme Development Project (HPDP) funded by World Bank on care and support services for OVC in Osun State, Nigeria. Eight Civil Society Organisations (CSOs) were engaged by Osun State Agency for the Control of AIDS (OSACA) as part of HPDP to provide care and support services for OVC between year 2013 and 2015. Using reporting tools, data collected by the CSOs were entered into District Health Information System 2 (DHIS2) platform and analysed using Microsoft Excel. In addition, Key Informant Interviews (KII) were conducted among the selected CSOs, OVC and the caregivers who were beneficiaries of HPDP in Osun State, Nigeria. A total of 12,353 OVC were reached and about half of them were female. There was an increase in the trends of number of OVC seen and the support services provided from the year 2013 to 2015. Of the 12,353 OVC that benefitted from this programme, 1905 (15.4%) received health care services, 5383 (43.6%) received nutritional services, 5317 (43.0%) received educational services and 9861 (79.8%) were provided with psychosocial support services. About 503 (4.1%) of the OVC received economic strengthening services while 270 (2.2%) of household heads were provided with economic support. However, 3 OVC were lost to follow-up, 14 OVC voluntarily withdrew from the project and 6 OVC died. The FGD and KII revealed that the project was very impactful in transforming the lives of the OVC. Programmes for children orphaned and made vulnerable by HIV/AIDS will contribute to the achievement of HIV/ AIDS prevention and control efforts. The HIV/AIDS free generation can be built by responding to the physical, social and mental needs of these children and their families in their communities. There is a need to scale-up this programme.

Service Delivery Factors That Influence Utilization of HIV Integrated Primary Health Care Programme in Embu Referral Hospital, Kenya

Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served;they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.

Does Quality of Care Differ When HIV Patients Are Treated by Non-Specialist and Specialist HIV Healthcare Providers in Developed Countries? A Systematic Narrative Review

Introduction: In developed countries, HIV care is mostly provided by trained specialist healthcare professionals. Due to the increasing demand for HIV care, pressure on healthcare providers to reduce cost and the current global economic constraints, many developed countries are searching for alternative HIV care models. This review aims to consider whether HIV treatment and care can be provided as effectively and safely by doctors and nurses with no HIV-specialist training compared to those with HIV-specialist training. Methods: Three electronic bibliographic databases MEDLINE, EMBASE and the Cochrane Library were searched for studies conducted between January 1996 and March 2015. Manual searches of reference lists of all relevant reports retrieved from the electronic databases were conducted. All comparative studies examining the quality of HIV care provided by different types of healthcare providers in developed countries were included. Results: Nine observational studies involving 27,015 patients were included in the review. Eight studies were conducted in the USA and one study in Switzerland. Healthcare providers with HIV-related expertise and or training and those without HIV-related expertise or training who collaborated with providers with HIV-related expertise and or training outperformed other healthcare providers in many virological, immunological and ART-related outcomes. Conclusion: This review found moderate quality evidence that HIV care can be provided effectively by non-HIV specialists if they have access to HIV specialists or experts for advice and support.

Syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1st ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.

Ozone Sterilizer for Treatment and Health Care

Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.

贵阳市HIV/AIDS社区支持与关怀模式研究

目的探索在城市开展艾滋病病毒感染者 (HIV) /艾滋病人 (AIDS)社区支持与关怀模式。方法对HIV感染者 /家属进行健康教育 ,给予医疗和心理关怀 ,使他们有一个宽松的环境。通过宣传倡导 ,对艾滋病的有关知识问题进行讨论 ,深入宣传发动工作 ,引起全社会的重视。结果通过对部分HIV感染者及家属的支持与关怀活动 ,了解到吸毒人群中HIV感染者迫切需要解决的是戒除毒瘾问题 ,他们与家属共同呼吁 ,能得到有关部门帮助他们戒除毒瘾 ,希望能制定有关政策 ,解决其就业、医疗及最低生活保障 ,渴望能生活在一个不受歧视、平等和宽松的生活环境。本次HIV/AIDS社区支持与关怀项目时间较短 ,由于经费与技术支持不能继续 ,其可持续性发展难以进行。结论开展HIV/AIDS社区支持与关怀 ,首先需由政府领导、多部门合作、全社会参与 ,及时制定相关配套政策 ;加强健康教育 ,让全社会了解掌握有关艾滋病传播途径及预防艾滋病的知识 ,反对歧视 ,将HIV/AIDS纳入传染病的常规管理 ;美沙酮替代治疗应尽快在吸毒人群中广泛开展 ;艾滋病防治可持续发展经费 ,除政府建立艾滋病防治专项基金并纳入每年计划外 ,应考虑募集可持续发展经费的支援。

医务人员职业感染HIV的影响因素及其防护

随着我国艾滋病疫情发展 ,医务人员因职业感染人类免疫缺陷病毒 (HIV)的风险越来越大 ,防止医务人员职业性HIV感染已成为当务之急。为此 ,本文对职业性感染HIV的影响因素、防治对策及意外事故处理措施进行了探讨 ,以增强和提高医护人员的自我防护意识和职业感染的防治水平 ,从而达到减少职业感染HIV风险的目的。影响医务人员的职业感染HIV的主要因素包括医务人员的自我防护意识 ;医务人员的职业暴露和针对职业暴露采取的措施。医务人员需要加强HIV职业感染知识的教育和防护技能的培训 ,同时应针对艾滋病 (AIDS)职业暴露的特点采取必要的防护措施 。

HIV/AIDS病人心理关怀现状分析

对HIV/AIDS病人的心理关怀和支持不仅影响着其生存/生活质量的提高,也影响着整个社会的稳定与和谐发展。但是,目前我国对HIV/AIDS心理关怀还是一个非常薄弱的环节。笔者分析当前国外在对HIV/AIDS病人实施全面关怀的具体做法和国内一些地区的尝试,结合我国国情,提出建立以提高病人的自我效能为中心、全社会参与的心理关怀模式。