Unprotected Sex with Casual Partners: A Neglected Source of HIV Transmission among Members of the Yi Minority in Southwestern China

The Yi are the largest and most disadvantaged ethnic minority population in southwestern China. This region contains over eight million Yi, with approximately 2.4 million living in the Liangshan Yi Autonomous Prefecture （Liangshan） in Sichuan Province. Liangshan is located along one of the main drug trafficking routes from the ＇Golden Triangle＇ to northwest and central China, making it one of the largest illicit drug production and distribution centers in China.

Knowledge, Attitudes and Perceptions of Secondary School Teenagers towards HIV Transmission and Prevention in Rural and Urban Areas of Central Uganda

HIV/AIDS has remained a challenge in Uganda among adolescent despite the ABC strategy used globally to prevent HIV infection. The study assessed the knowledge, attitudes and perceptions of secondary school teenagers towards HIV transmission and prevention in rural and urban schools of central Uganda. A cross sectional study using self-administered questionnaires and structured interviews was used to collect data from adolescents in secondary schools in Kampala and Buikwe districts. Eight schools were randomly selected with 4 schools in each district. A total of 245 students from schools were recruited in the study with 120 and 125 students from urban Kampala and rural Buikwe district schools respectively. Data were analyzed using SPSS version 11. The results were expressed as percentages in a 2 × 2 tables. The mean age of the participants was 15.9 ± 2.5 years. Results showed that 95.1% participants had knowledge on HIV/AIDS in both urban and rural schools and 27.4% knew all the modes of HIV transmission. About 83.7% knew the ABC strategy for HIV prevention and 37.6% would talk about HIV/AIDS mainly with friends. For HIV cure, 62.0% of study participants reported non-cure and 24.9% were not sure. The remaining 13.1% of the study participants in both urban and rural schools reported that HIV can be cured. And the modes of curing HIV that were mentioned by participants included spiritual healing, transmitting it to others through sexual intercourse and that antiretroviral (ARVs) drugs can cure it as well as that it can be cured abroad. About 65.7% of participants reported recognition of one with HIV/ AIDS and by having red lips, being sickly;weight loss, skin rash and being very rich were mentioned. About 39.2% of the study participants mentioned that they cannot get infected with HIV and can’t contract HIV at all and 18.4% believed that chances of getting HIV infection were high. On perception and attitude on condoms and their use, participants reported that it is a sign of mistrust, reduces sexual pleasures and they are embarrassing to buy. Majority of the participants in both urban and rural schools had some knowledge on HIV/AIDS and the ABC strategy for HIV prevention. However, there was a knowledge gap on the various modes of HIV transmission and prevention. There was misconception of the participants on HIV/AIDS cure, condom use and on the chances of contracting HIV. About the source of HIV/AIDS information, majority of the participants were getting information on HIV/AIDS from friends of which some information was misleading. This false information could be the reason for the increased HIV prevalence reported among the adolescents in the schools. Generally, participants had some knowledge on HIV/AIDS though they had knowledge gap on HIV transmission and prevention.

Evaluating the Knowledge of HIV Transmission and Prevention of Mother to Child Transmission (PMTCT) of HIV among HIV-Positive Mothers Accessing Care in Military Hospital in Lagos, Nigeria

Introduction: The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. Methods: This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. Results: Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. Conclusion: In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.

Deoxyribonucleic Acid-Polymerase Chain Reaction Status of HIV Exposed Infants in a Sub Regional Prevention of Mother-to-Child Transmission of HIV Programme during the Period 2009-2020

Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV infection status in HIVexposed infants who had their first DNA polymerase chain reaction test in our molecular Laboratory. Subjects, Materials and Methods: Dried Blood Spots for HIV DNA results from 5 states between 2009 and 2020 were analyzed in the PCR laboratory of the Federal Teaching Hospital, Gombe. Results: Nine thousand eight hundred and twenty-three Human Immunodeficiency Virus Deoxyribonucleic acid polymerase Chain Reaction results were analysed;4937 (50.2%) were males. During the study period, there was an overall declining trend in the mother-to-child transmission rate from 3.8% in 2009 to 1.0% in 2020. 6120 (62.3%) of HIV + mothers received Highly active antiretroviral therapy HAART before pregnancy. 7845 (76.2%) of the infants received Nevirapine prophylaxis. Dried blood spot samples were collected from 4077 (41.5%) at 6 - 8 weeks. 8438 (85.9%) received cotrimoxazole. 9469 (96.4%) were ever breastfed. Of the 9823 HIV DNA PCR results, 255 (2.6%) were positive while 69/4077 (1.7%) and 109/2662 (4.1%) were positive for HIV DNA at 6 - 8 weeks and > 12 weeks respectively. (p = 0.001). 86/747 (11.5%) of infants whose HIV-positive mothers received no ARVS were HIV DNA positive. (p = 0.001). 106/884 (12.0%) of infants who had no Antiretroviral prophylaxis had positive HIV DNA results;7/413 (1.7%) with Zidovudine/Nevirapine prophylaxis had positive results. (p = 0.001). 246/9469 (2.6%) of infants that were ever breastfed were positive for HIV DNA;11/354 (3.0%) that never breastfed had positive HIV DNA. Conclusion: Lack of maternal/infant ARVs and prolonged breastfeeding increased the risk of infant HIV infection.

Prevention of Maternal-to-Child Transmission of HIV: Knowledge, Attitude and Factors Influencing Active Participation among HIV-Positive Men in a Military Health Facility in Lagos, South Western Nigeria

Introduction: Traditionally, Prevention of Maternal-to-Child Transmission (PMTCT) of HIV involves women and excludes men despite their important roles. There is a need for more data on factors influencing male participation in PMTCT programs. Design: This was a cross-sectional, descriptive study of married HIV-positive men receiving care at the adult ART clinic, 68 Nigerian Army Reference Hospital Yaba. Data were collected from March 15 to April 30, 2018. Result: Out of the 366 respondents, 333 (91%) were aware that HIV can be transmitted from mother to child. However, only 43.2% correctly identified that it can be transmitted during pregnancy, while 30.2% stated during labour. Almost all of the respondents (96.4%) would also accept that their positive partners take antiretroviral treatment to protect her unborn baby, 86.9% would support non breastfeeding option after delivery, and 95.6% indicated readiness to buy formula milk for the baby. Similarly, majority believed that a pregnant woman can be tested for HIV without the permission of her partner (Mean = 1.47 ± 0.893), and that men should accompany their spouse to ANC/PMTCT clinics (Mean = 1.86 ± 0.921). Conclusion: This study revealed that despite low knowledge of PMTCT among men, there is a good level of attitude and involvement among them. We recommend further study to fully explore the impact of education on men’s participation.

Management and Outcome of Pregnant Women with HIV Acquired by Vertical Transmission

The majority of children with perinatally acquired human immunodeficiency virus (HIV) do not survive beyond childhood but this is changing due to the benefit of antiretroviral therapy for the perinatally infected cohort, so affected children are now approaching the age to be mothers. The aim of this article is to evaluate the outcomes of pregnant women with HIV acquired by vertical transmission in our centre and encourage the results obtained in “Thirty Years Later: Pregnancies in Female Perinatally Infected with Human Immunodeficiency Virus-1”, a review article published in this journal in 2012 [2]. We report 6 patients with eight pregnancies with HIV acquired by vertical transmission. They delivered a total of nine newborns between 2004 and 2013. In any case, mother-to-child transmission was reported. The management of pregnant women with HIV acquired by vertical transmission is complicated, since the patients are the most of the cases young and the compliance to the treatment may be poor. The prematurity was the more frequent complication and the cesarean section was the more frequent form of ending. In our case series, mother-to-child transmission was absent.

Prospects for the Implementation of HIV Molecular Transmission Network–Informed AIDS Prevention and Control in China

The human immunodeficiency virus(HIV)-infected population with a transmission link has a strong genetic similarity in viral gene sequences that tend to cluster.In recent years,a strategy for guiding HIV/acquired immunodeficiency syndrome(AIDS)prevention using sequence-based transmission networks has been proposed.The execution of this strategy provides an opportunity to effectively control the spread of the AIDS epidemic in China.HIV molecular transmission network research has been actively pursued by a number of Chinese research groups.Medium-and long-term strategies were created with the goal of using HIV molecular transmission networks to guide targeted prevention and control in China.Technical guidelines for HIV transmission network monitoring and intervention have been written and released.Pilot studies are continuing in the meantime.Despite the fact that this strategy has a bright future,there are still many challenges to overcome to achieve the intended AIDS prevention and control goals.

Structural sensitivity in HIV modeling: A case study of vaccination

Structural assumptions in infectious disease models,such as the choice of network or compartmental model type or the inclusion of different types of heterogeneity across individuals,might affect model predictions as much as or more than the choice of input parameters.We explore the potential implications of structural assumptions on HIV model predictions and policy conclusions.We illustrate the value of inference robustness assessment through a case study of the effects of a hypothetical HIV vaccine in multiple population subgroups over eight related transmission models,which we sequentially modify to vary over two dimensions:parameter complexity(e.g.,the inclusion of age and HCV comorbidity)and contact/simulation complexity(e.g.,aggregated compartmental vs.individual/disaggregated compartmental vs.network models).We find that estimates of HIV incidence reductions from network models and individual compartmental models vary,but those differences are overwhelmed by the differences in HIV incidence between such models and the aggregated compartmental models(which aggregate groups of individuals into compartments).Complexities such as age structure appear to buffer the effects of aggregation and increase the threshold of net vaccine effectiveness at which aggregated models begin to overestimate reductions.The differences introduced by parameter complexity in estimated incidence reduction also translate into substantial differences in cost-effectiveness estimates.Parameter complexity does not appear to play a consistent role in differentiating the projections of network models.

A mathematical modelling study of HIV infection in two heterosexual age groups in Kenya

The control of HIV demands different interventions for different age groups.In the present manuscript,we formulate and analyze a mathematical compartmental models of HIV transmission within and between two age groups in Kenya.We fitted the model to data using MCMC technique and inferred the parameters.We also estimate the reproduction numbers,namely within age group transmission and between age groups transmission basic reproduction numbers.The analysis of the data revealed that there is significant difference in mean number of new HIV infections between males and females within the two age groups.More,particularly,females are highly infected with HIV as compared to their male counterparts.Calculation of the reproduction numbers within and between age groups provides insights into control that cannot be deduced simply from observations on the prevalence of infection.More specifically,the analysis showed that the per capita rate of HIV transmission was highest when there is interaction between young adults to adults and most HIV infections occurred in adult population.Furthermore,the sensitivity analysis demonstrated that the reproduction numbers depend mainly on the probabilities of infection.This results can be used to guide HIV interventions,condom distribution and antiretroviral therapy.Precisely,the results can be used to educate the young adults on practicing safe sex with their partners in order to contain the occurrence of new infections.