-
Clinics in Dermatology 2024The global burden of HIV remains a formidable challenge, affecting millions. Despite significant progress in understanding, treatment, and prevention , HIV/AIDS...
The global burden of HIV remains a formidable challenge, affecting millions. Despite significant progress in understanding, treatment, and prevention , HIV/AIDS continues to exert a substantial impact on personal and public health, particularly in sub-Saharan Africa, where the prevalence is highest. HIV not only poses a direct threat to the well-being of individuals but also contributes to social and economic disparities. Approximately 38 million people worldwide are living with HIV, with millions unaware of their status. Stigma and discrimination still hinder testing, starting and staying on treatment. Access to antiretroviral therapy has improved, yet disparities persist, with marginalized communities often facing barriers to essential health care services. Efforts to reduce new HIV infections and transmission include comprehensive prevention strategies, education, and increased access to testing and treatment. Addressing social determinants, reducing stigma, and ensuring equitable access to health care remain crucial to reach the ambitious goal of ending AIDS by 2030.
Topics: Humans; HIV Infections; Acquired Immunodeficiency Syndrome; Africa South of the Sahara; Prevalence
PubMed: 38387533
DOI: 10.1016/j.clindermatol.2024.02.001 -
AIDS (London, England) Jun 2022People with severe mental illness are 10 times more likely to have HIV/ AIDS than the general population, yet little is known about the characteristics and frequency of...
OBJECTIVES
People with severe mental illness are 10 times more likely to have HIV/ AIDS than the general population, yet little is known about the characteristics and frequency of recognition of pre-existing HIV/AIDS diagnoses among inpatients with severe mental illness. This study examines documentation rates of pre-existing HIV/ AIDS among inpatients within psychiatric hospitals in New York State.
DESIGN
Retrospective cohort study to examine recognition of pre-existing HIV/AIDS among psychiatric inpatients.
METHODS
Patient-level Medicaid claims records were linked with hospital and regional data for people admitted to psychiatric inpatient units in New York State. Presence of HIV/AIDS diagnoses prior to psychiatric hospitalization was coded for each inpatient (n = 14 602). Adjusted odds ratios of undocumented HIV/AIDS diagnoses at the time of discharge were calculated using logistic regression analyses.
RESULTS
About 5.1% (741/14 602) of unique psychiatric inpatients had pre-existing HIV/AIDS diagnoses. Of these inpatients, 58.3% (432/741) were not coded as having HIV/AIDS upon discharge. Higher rates of missed detection were associated with younger age, non-Hispanic white race/ethnicity, shorter length of stay, more distal coding of an HIV/AIDS diagnosis, and fewer HIV/AIDS-related Medicaid claims in the past year. Hospitals with higher readmission rates also had higher rates of undetected HIV/AIDS diagnoses.
CONCLUSION
Over half of inpatients previously diagnosed with HIV/AIDS did not have their HIV-positive status noted upon discharge from psychiatric hospitalization. This finding underscores how frequently clinically significant medical comorbidities fail to be incorporated into psychiatric treatment and treatment planning. Inpatient clinicians are missing important opportunities to optimize HIV/AIDS treatment and reduce morbidity and mortality.
Topics: Acquired Immunodeficiency Syndrome; HIV Infections; Hospitalization; Humans; Inpatients; Mental Disorders; Retrospective Studies
PubMed: 35142705
DOI: 10.1097/QAD.0000000000003190 -
Journal of Infection and Public Health Jul 2020HIV/AIDS prevention has been widely adopted worldwide, but little is known about HIV/AIDS knowledge and attitudes in the Arabian Peninsula. (Meta-Analysis)
Meta-Analysis
BACKGROUND
HIV/AIDS prevention has been widely adopted worldwide, but little is known about HIV/AIDS knowledge and attitudes in the Arabian Peninsula.
AIM
To summarize the level of knowledge and attitude about HIV/AIDS in seven Arabian Peninsula countries (Saudi Arabia, Oman, Kuwait, Qatar, Bahrain, Yemen, and the United Arab Emirates (UAE)).
METHODS
A systematic literature search was performed using combined keywords in four scientific databases of peer-reviewed publications from January 2010 to June 2019. Twenty-five articles were included in the systematic review, and twenty studies in the meta-analysis. The data was analyzed using a random-effect model due to the heterogeneity between the studies.
RESULTS
Seventeen studies reported on the level of knowledge and overall knowledge about HIV/AIDS in this region: 74.4% (95% confidence interval (CI): 66.8%-82.0%, p<0.001) and the attitude was 52.8% (95% CI: 36.9%-68.6%, p<0.001). A study from Oman reported higher knowledge levels (95.5%, 95% CI: 94.2%-96.8%) while less than a quarter of the Bahrain population had positive attitudes 22.5% (95% CI: 20.5%-24.5%). Medical doctors showed higher knowledge (94.1%, 95% CI: 92.9%-95.3%), but a positive attitude was only observed in 32.5% (95% CI: 28.8%-36.2%) of the dentists toward HIV/AIDS.
CONCLUSION
The overall knowledge about HIV/AIDS was found to be satisfactory (74.4%), but about half (52.8%) of those displayed negative attitudes toward HIV/AIDS. Regular training courses as well as reviewing and reinforcing HIV/AIDS prevention guidelines can be useful to update knowledge and improve attitudes in this region.
Topics: Acquired Immunodeficiency Syndrome; Attitude; Female; HIV; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Male; Middle East; Physicians; Prisoners; Students; Surveys and Questionnaires
PubMed: 32359925
DOI: 10.1016/j.jiph.2020.04.002 -
International Journal of Infectious... Jan 2020According to the United Nations AIDS reports in 2018, the Middle East and North Africa region is considered an area of increasing concern for HIV infection due to high...
According to the United Nations AIDS reports in 2018, the Middle East and North Africa region is considered an area of increasing concern for HIV infection due to high mortality associated with AIDS. The incidence of HIV/AIDS in Palestine between 1988 and 2017 as reported by the Palestinian Ministry of Health was analyzed. A total of 98 cases were reported (79 AIDS patients and 19 HIV positives). A nationwide surveillance is needed to understand the epidemiology of HIV infection in the country. Identification of the HIV risk factors and health outreach directed to the public are essentially crucial prevention measures that should be implemented by the Palestinian Ministry of Health.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Female; HIV; HIV Infections; Humans; Incidence; Male; Middle Aged; Middle East; Young Adult
PubMed: 31648004
DOI: 10.1016/j.ijid.2019.10.019 -
Bulletin of the History of Medicine 2020My essay focuses on Charles Rosenberg's provocative and enduring ideal type of epidemic drama in three acts, which he assembled from a vast knowledge of disease history...
My essay focuses on Charles Rosenberg's provocative and enduring ideal type of epidemic drama in three acts, which he assembled from a vast knowledge of disease history that stretched from the end of the seventeenth century to his then-present pandemic, HIV/AIDS of the 1980s. Reaching back to the Plague of Athens, my essay elaborates on Rosenberg's dramaturgy by questioning whether blame, division, and collective violence were so universal or even the dominant "acts" of epidemics not only before the nineteenth century but to the present. Instead, with certain pandemics such as yellow fever in the Deep South or the Great Influenza of 1918-20, unity, mass volunteerism, and self-abnegation played leading roles. Finally, not all epidemics ended "with a whimper" as attested by the long early modern history of plague. These often concluded literally with a bang: lavish planning of festivals of thanksgiving, choreographed with processions, innumerable banners, commissions of paintings, ex-voto churches, trumpets, tambourines, artillery fire, and fireworks.
Topics: Acquired Immunodeficiency Syndrome; Epidemics; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Humans; Influenza Pandemic, 1918-1919; Plague; Yellow Fever
PubMed: 33775940
DOI: 10.1353/bhm.2020.0083 -
Child: Care, Health and Development Jul 2022The Liangshan Yi Autonomous Prefecture is home to the largest population of Yi ethnic minority within mainland China. Due to the high HIV/AIDS epidemic, many Yi children...
BACKGROUND
The Liangshan Yi Autonomous Prefecture is home to the largest population of Yi ethnic minority within mainland China. Due to the high HIV/AIDS epidemic, many Yi children become AIDS orphans who lost one or both parents to AIDS-related causes. This study explored the prevalence and correlates of AIDS orphans' depressive symptom, sleep disorders and their comorbidity.
METHODS
A cross-sectional survey was conducted to collect pertinent information from 467 AIDS orphans and 856 non-orphans of Yi ethnic minority. Depressive symptoms were screened by a two-item Patient Health Questionnaire (PHQ-2). The symptoms of insomnia were assessed by the Insomnia Severity Index (ISI), which was complemented by one item from the Pittsburgh Quality Sleep Index (PSQI) to measure the frequency of nightmare.
RESULTS
The prevalence of depression (26.8% vs. 20.4%, P = 0.009) and comorbidity of depression, insomnia and nightmare (7.5% vs. 4.3%, P = 0.046) was significantly higher for AIDS orphans than for non-orphans. Risk factors such as ostracization and self-reported poor physical health had stronger effects on depressive symptoms and sleep disorders for AIDS orphans than for non-orphans. On the other hand, peer support, as an important protective factor, was significantly and negatively associated with depressive symptoms and sleep disorders for AIDS orphans.
CONCLUSIONS
AIDS orphans of Yi ethnic minority reported higher levels of depressive symptoms and comorbidity of depression and sleep disorders than their non-orphan counterparts. These symptoms were exacerbated by ostracization and self-rated poor physical health but lowered by peer support.
Topics: Acquired Immunodeficiency Syndrome; Child; Child, Orphaned; China; Cross-Sectional Studies; Depression; Ethnicity; Humans; Minority Groups; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders
PubMed: 35023201
DOI: 10.1111/cch.12964 -
Annals of Clinical Microbiology and... Jul 2023Acquired immunodeficiency syndrome (AIDS) is associated with a high rate of pulmonary infections (bacteria, fungi, and viruses). To overcome the low sensitivity and long...
BACKGROUND
Acquired immunodeficiency syndrome (AIDS) is associated with a high rate of pulmonary infections (bacteria, fungi, and viruses). To overcome the low sensitivity and long turnaround time of traditional laboratory-based diagnostic strategies, we adopted metagenomic next-generation sequencing (mNGS) technology to identify and classify pathogens.
RESULTS
This study enrolled 75 patients with AIDS and suspected pulmonary infections who were admitted to Nanning Fourth People's Hospital. Specimens were collected for traditional microbiological testing and mNGS-based diagnosis. The diagnostic yields of the two methods were compared to evaluate the diagnostic value (detection rate and turn around time) of mNGS for infections with unknown causative agent. Accordingly, 22 cases (29.3%) had a positive culture and 70 (93.3%) had positive valve mNGS results (P value < 0.0001, Chi-square test). Meanwhile, 15 patients with AIDS showed concordant results between the culture and mNGS, whereas only one 1 patient showed concordant results between Giemsa-stained smear screening and mNGS. In addition, mNGS identified multiple microbial infections (at least three pathogens) in almost 60.0% of patients with AIDS. More importantly, mNGS was able to detect a large variety of pathogens from patient tissue displaying potential infection and colonization, while culture results remained negative. There were 18 members of pathogens which were consistently detected in patients with and without AIDS.
CONCLUSIONS
In conclusion, mNGS analysis provides fast and precise pathogen detection and identification, contributing substantially to the accurate diagnosis, real-time monitoring, and treatment appropriateness of pulmonary infection in patients with AIDS.
Topics: Humans; Acquired Immunodeficiency Syndrome; High-Throughput Nucleotide Sequencing; Azure Stains; Hospitalization; Hospitals; Pneumonia
PubMed: 37430367
DOI: 10.1186/s12941-023-00608-9 -
International Journal of Molecular... Jul 2021Globally, HIV/AIDS and cancer are increasingly public health problems and continue to exist as comorbidities. The sub-Saharan African region has the largest number of... (Review)
Review
Globally, HIV/AIDS and cancer are increasingly public health problems and continue to exist as comorbidities. The sub-Saharan African region has the largest number of HIV infections. Malignancies previously associated with HIV/AIDS, also known as the AIDS-defining cancers (ADCs) have been documented to decrease, while the non-AIDS defining cancer (NADCs) are on the rise. On the other hand, cancer is a highly heterogeneous disease and precision oncology as the most effective cancer therapy is gaining attraction. Among HIV-infected individuals, the increased risk for developing cancer is due to the immune system of the patient being suppressed, frequent coinfection with oncogenic viruses and an increase in risky behavior such as poor lifestyle. The core of personalised medicine for cancer depends on the discovery and the development of biomarkers. Biomarkers are specific and highly sensitive markers that reveal information that aid in leading to the diagnosis, prognosis and therapy of the disease. This review focuses mainly on the risk assessment, diagnostic, prognostic and therapeutic role of various cancer biomarkers in HIV-positive patients. A careful selection of sensitive and specific HIV-associated cancer biomarkers is required to identify patients at most risk of tumour development, thus improving the diagnosis and prognosis of the disease.
Topics: Acquired Immunodeficiency Syndrome; Antiretroviral Therapy, Highly Active; Biomarkers, Tumor; Comorbidity; Early Detection of Cancer; Female; HIV-1; Humans; Male; Neoplasms; Oncogenic Viruses; Precision Medicine; Prevalence; Prognosis; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 34360891
DOI: 10.3390/ijms22158127 -
BMJ (Clinical Research Ed.) Aug 2023
Topics: Humans; Acquired Immunodeficiency Syndrome
PubMed: 37643770
DOI: 10.1136/bmj.p1929 -
Harvard Review of Psychiatry 2020After participating in this activity, learners should be better able to:• Assess strategies for diagnosing depressive disorders in patients with human immunodeficiency... (Review)
Review
After participating in this activity, learners should be better able to:• Assess strategies for diagnosing depressive disorders in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)• Identify factors that contribute to the development of depressive disorders in HIV/AIDS• Evaluate strategies for managing depressive disorders in HIV/AIDS ABSTRACT: Depressive disorders and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) are associated with major socioeconomic burdens. The negative impact of depressive disorders on HIV/AIDS is well known, including on treatment outcomes. Unfortunately, depressive disorders are underdiagnosed and undertreated in seropositive persons. This review summarizes clinically useful information on depressive disorders in HIV/AIDS. More specifically, we address assessment, differential diagnosis, contributing factors, management, and common challenges in the treatment of depressive disorders in seropositive individuals. Assessment and diagnosis of depression may be challenging in seropositive persons because of several biopsychosocial particularities associated with HIV/AIDS. One of the difficulties is the overlap between depression and HIV/AIDS symptoms, particularly in individuals with advanced AIDS, requiring consideration of a broad differential diagnosis. Several factors related to HIV/AIDS status contribute to the higher rates of depressive disorders, including infectious-immunological, psychosocial, and exogenous factors. The treatment of depressive disorders in HIV/AIDS involves three groups of interventions: (1) pharmacological interventions, (2) psychotherapeutic interventions, and (3) management of other contributing factors. Challenges in management include poor adherence to treatment and the risk of suicide. We provide evidence-based recommendations to improve assessment and management of depressive disorders in seropositive persons.
Topics: Acquired Immunodeficiency Syndrome; Antidepressive Agents; Depressive Disorder; Diagnosis, Differential; HIV Seropositivity; Humans; Medication Adherence; Psychotherapy; Suicide Prevention
PubMed: 32251069
DOI: 10.1097/HRP.0000000000000252