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艾滋病与临床研究杂志

体积 8, 问题 12 (2017)

评论文章

Review of HIV Interventions among Young and Adolescent Key Populations in Low to Middle Income Countries

Devika Mehra, Tina Khanna, Jagannnath Behera and Sunil Mehra

Background: Globally, Young key populations (age 10-24) (YKPs) are more at risk to HIV infection and are disproportionately infected by HIV. There is a pressing need evidence on how best to implement effective interventions for young key populations.

Objective: The overall aim was to conduct a systematic review of interventions to summarize the data on effectiveness of interventions in low and middle income countries among young key populations.

Method: We conducted a review of the evidence on interventions designed to increase adolescents and young people's access to services for reducing their HIV risk. We focused specifically on the young key populations from low to middle income countries. We searched PubMed, Medline and Cochrane databases using MesH terms to identify peer-reviewed articles. We included studies with designs such as randomized control trails (RCT), clustered randomized trails, quasi experimental, prospective observational and studies that measured outcomes pre and post an intervention. We identified a total of 10 studies that were included in the review based on certain inclusion and exclusion criteria's.

Results: Among the interventions designed for young people, community based interventions driven by peer led approach and mobile based interventions were effective in engaging with these hard to reach populations. Structural interventions focusing on stigma and psychosocial component can positively impact important HIV-related outcomes. Also, HIV screening needs to be integrated in programs and policy with intimate partner violence. The evidence on PreP is mixed and needs more systematic investigation.

Conclusion: A combination prevention packages that include behavioural, structural and biological interventions are needed for young key populations to prevent new HIV infections. These interventions with proven effectiveness should be included in all HIV prevention programming for young people.

研究文章

Knowledge, Attitude and Preventive Practices towards Sexually Transmitted Infection among Preparatory School Students of Arsi Negelle Town

Nega Degefa Megersa, Sindew Mohamud Ahmed, Befikadu Tariku Gutema, Girum Sebsebie Teshome, Zeleke Aschalew Melketsedik and Eshetu Zerihun Tariku

Background: Sexually transmitted infections (STIs) are a major global cause of acute illness, infertility, long-term disability and death with serious medical and psychological consequences of millions of men, women and infants. Due to their high prevalence, particularly in developing settings, STIs result in substantial productivity losses for individuals and communities, particularly where the majority of the population is less than 40 years of age.

Objective: To assess knowledge, attitude and preventive practices of Arsi Negelle preparatory students towards STIs.

Methodology: Institutional based cross-sectional study design and quantitative method of data collection were employed. A Proportionate Stratified random sampling technique was used and finally, a total of 303 respondents were selected by systematic random sampling method. A standardized self-administered questionnaire was used to collect information from respondents.

Results: Half of the respondents (50.8%) had good knowledge about STIs and 54.5% of respondents were identified to have positive attitude towards STIs and 38.6% of respondents had good preventive practice despite the fact that the rest 61.4% had poor preventive practice towards STIs.

Conclusion: Most of respondents had heard about STIs in one or another way however nearly half of respondent's have good knowledge regarding STIs. This study had called for continued and strengthened health education.

研究文章

Incidence and Predictors of Anti-Retroviral Treatment (ART) Failure among Adults Receiving HIV Care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Chalachew Sisay, Alemayehu Bekele, Abay Sisay, Hana Mekonen, Kumera Terfa, Daniel Melese and Boja Dufera

Background: Despite availability of antiretroviral therapy, HIV is responsible for 2.7 million new infections and 2.0 million deaths from worldwide. Anti-Retroviral treatment failure is not a commonly diagnosis in healthcare facilities in Ethiopia and there is dearth of information on the extent and predictors of treatment failure among adults receiving HIV care in the study setting. The aim of the current study is to assess the incidence and predictors of Anti-Retroviral Treatment (ART) failure among adults receiving HIV care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia.

Methods: Facility based retrospective cohort study design was employed on archived data from 2011 to 2016. Data compilation checklist was developed from intake card and ART follow-up card. The collected data were coded and entered using Epi Info 7 and analysed using Statistical Packages for Social Science (SPSS) version 20 software.

Results: The overall incidence rate of ART treatment failure were 4.91 cases per person months follow up with 2.1, 0.24 and 0.13 immunological, clinical and virological treatment failure cases per 100 person years of follow-up respectively.

Conclusion: The incidence of Anti-Retroviral Treatment failure was considerable among the study participants. The predictors for ART failure were WHO stage 3 at start, CD4 count at base line, disclosure and opportunistic infections. Comprehensive interventions have to be in place to tackle treatment failure among adults on ART through rendering optimum care focusing on adults with advanced WHO stage, lower CD4 count at baseline, opportunistic infections and people who did not disclose their HIV status.

研究文章

New HIV Diagnoses among Older Adults in the EU/EEA: Missed Opportunities and Barriers to Testing

Lara Tavoschi, Giordano Madeddu and Anastasia Pharris

The rate of HIV diagnoses among older adults in the European Union/European Economic Area (EU/EEA) is increasing. We performed a literature review to investigate factors associated with HIV infection, diagnosis and testseeking behaviour among older adults in the EU/EEA. We defined older adults as ≥ 50 years. We searched Embase and PubMed to identify studies on socio-demographic and clinical characteristics associated with new HIV diagnosis and factors influencing provision and uptake of HIV testing among older adults in EU/EEA and other high-income countries using the concepts of HIV infection and disease; older adults, and; testing and attitude towards testing. We included original papers or systematic reviews published from 2000 onwards and reporting data on the following themes: Patterns of HIV test uptake and attitudes, barriers and enablers influencing offer and uptake of HIV testing. Published evidence indicated large proportion of late diagnoses and a low likelihood of HIV testing among older adults, although results varied widely between studies. HIV test uptake was a function of several factors related to patient and provider, including perception of one’s risk. The active offer of an HIV test by the health care provider was the most significant factor positively associated with having a test. Scaling up HIV testing opportunities targeting older adults and the adult population at large is needed.

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