Pattern and determinants of HIV research productivity in sub-Saharan Africa: bibliometric analysis of 1981 to 2009 PubMed papers

<p>Abstract</p> <p>Background</p> <p>Several bibliometric studies have been published on AIDS. The findings obtained from these studies have provided a general picture of the history and growth of AIDS literature. However, factors related to variation in HIV research productivity in sub-Saharan Africa have not been examined. Therefore, this study aims to fill some of the gap in existing research to provide insights into factors associated with HIV research productivity in sub-Saharan Africa.</p> <p>Methods</p> <p>A bibliometric analysis regarding sub-Saharan Africa HIV/AIDS research was conducted in the PubMed database for the period of 1981 to 2009. The numbers of HIV research articles indexed in PubMed was used as surrogate for total HIV research productivity. Series of univariable and multivariable negative binomial regression models were used to explore factors associated with variation in HIV research productivity in sub-Saharan Africa.</p> <p>Results</p> <p>First authors from South Africa, Uganda and Kenya contributed almost half of the total number of HIV articles indexed in PubMed between 1981 and 2009. Uganda, Zimbabwe and Malawi had better records when the total production was adjusted for gross domestic product (GDP). Comoros, the Gambia and Guinea-Bissau were the most productive countries when the total products were normalized by number of people with HIV. There were strong positive and statistically significant correlation between countries number of indexed journal (Pearson correlation r = 0.77, p = .001), number of higher institutions (r = 0.60, p = .001), number of physicians (r = 0.83, p = .001) and absolute numbers of HIV articles.</p> <p>Conclusions</p> <p>HIV research productivity in Africa is highly skewed. To increase HIV research output, total expenditure on health (% of GDP), private expenditure on health, and adult literacy rate may be important factors to address.</p

UWOMJ Volume 63, Number 1, Fall 1993

Schulich School of Medicine & Dentistryhttps://ir.lib.uwo.ca/uwomj/1239/thumbnail.jp

The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development

Background: Men who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a human immunodeficiency virus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited. Objectives: To conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention. Data sources: All major electronic databases (British Education Index, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Educational Resource Index and Abstracts, Health and Medical Complete, MEDLINE, PsycARTICLES, PsycINFO, PubMed and Social Science Citation Index) were searched between January 2000 and December 2014. Review methods: A systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique (BCT) taxonomy, theory coding assessment, mode of delivery and proximity to HIV infection testing. Data were summarised in narrative review and, when appropriate, meta-analysis was carried out. Supplemental analyses for the development of the candidate intervention focused on post hoc realist review method, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of implementation and optimisation. Results: Overall, trials included in this review (n = 10) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk-related behaviours. However, there was considerable clinical and methodological heterogeneity among the trials. Exploratory meta-analysis showed a statistically significant reduction in behaviours associated with high risk of HIV transmission (risk ratio 0.75, 95% confidence interval 0.62 to 0.91). Additional stratified analyses suggested that effectiveness may be enhanced through face-to-face contact immediately after testing, and that theory-based content and BCTs drawn from ‘goals and planning’ and ‘identity’ groups are important. All evidence collated in the review was synthesised to develop a candidate intervention. Experts highlighted overall acceptability of the intervention and outlined key ways that the candidate intervention could be optimised to enhance UK implementation. Limitations: There was a limited number of primary studies. All were from outside the UK and were subject to considerable clinical, methodological and statistical heterogeneity. The findings of the meta-analysis must therefore be treated with caution. The lack of detailed intervention manuals limited the assessment of intervention content, delivery and fidelity. Conclusions: Evidence regarding the effectiveness of behaviour change interventions suggests that they are effective in changing behaviour associated with HIV transmission. Exploratory stratified meta-analyses suggested that interventions should be delivered face to face and immediately after testing. There are uncertainties around the generalisability of these findings to the UK setting. However, UK experts found the intervention acceptable and provided ways of optimising the candidate intervention. Future work: There is a need for well-designed, UK-based trials of individual behaviour change interventions that clearly articulate intervention content and demonstrate intervention fidelity

AIDS: A Legal Epidemic?

The purpose of this comment is to provide the legal community with a comprehensive consideration of some of the major legal implications of AIDS. While the knowledge about AIDS at present is limited, it is nonetheless hoped that this comment will serve as a catalyst for other legal writers to consider the myriad legal problems involved with this serious new disease. This comment will be divided into two major sections. First, the history, effects, and potential causes of AIDS will be explored in an effort to provide a framework for future analysis. Second, the legal implications of AIDS will be analyzed by looking at actual and potential cases based on either a known existence of AIDS or a feared existence of AIDS

The ADL of Sexuality: A Guide for Occupational Therapists for Elderly Clients

Purpose: The purpose of this scholarly project was to develop a guide that would address the assessments, treatment/interventions, and discharge planning process regarding sexual health/sexuality with an elderly client. Through the use of the guide and accompanying resources it is assumed that occupational therapists will have an increased level of comfort, knowledge, and competence. This is important as Couloumbis and Miller (1994) study indicated that occupational therapists that received formal education (academically or clinical practice) addressed sexuality in the elderly 27.8% more than occupational therapists who did not have any educational experience. Methodology: An in depth literature review was conducted using scholarly texts, scholarly search engines (SCOPUS, PubMed, CINAHL, Medline Plus, PsychInfo, Google), the American Occupational Therapy Association website, as well as AOTA\u27s publications such as the American Journal of Occupational Therapy, OT Practice, the Occupational Therapy Code of Ethics, Occupational Therapy Practice Framework: Domain and Process. Additional items, which were not available through the previously listed sources, were obtained through Interlibrary Loan at the Harley French Library of Health Sciences. Efforts were made to locate the original source of essential information in order to limit the use of secondary sources in this project. The project itself was guided by using the Model of Human Occupation, Malcolm Knowle\u27s Theory of Andragogy, and the BETTER model©. Results: The result of this scholarly project is the development of The ADL of Sexuality: A Guide for Occupational Therapists for Elderly Clients, which illustrates many aspects of the therapeutic process to address the ADL of sexuality with the elderly client using one source. The completed Guide will be made available at the Harley French Library of Health Sciences for educational use, including faculty and upcoming health professionals. It is also suggested this Guide be made available to practicing occupational therapists to serve as a resource regarding sexual health/sexuality in the elderly. Conclusions: The ADL of Sexuality: A Guide for Occupational Therapists for Elderly Clients provides many benefits to the occupational therapy profession. These benefits include methods to increase the comfort level and understanding of addressing sexuality as an important ADL. It provides an opportunity for occupational therapists to learn how to address sexuality in an elderly client using a holistic, client-centered approach. It is hoped that this Guide will increase the frequency of addressing sexual health/sexuality in the elderly, as well as enhancing their satisfaction with occupational therapy services

An investigation into newly diagnosed HIV infection among Africans living in London

In the UK substantial numbers of new HIV diagnoses are within migrant African communities. A continuing feature of HIV in this population is the late presentation to HIV services. This dissertation sets out to explore HIV testing among Africans in the UK, the factors associated with late presentation to HIV services, and the extent of HIV acquisition within the UK in African communities. The main focus of the thesis is the ‘study of newly diagnosed HIV among Africans in London’ (the SONHIA study), which combined qualitative and quantitative methods in a multi-centre study. The thesis begins with the work undertaken in preparation for SONHIA. It presents a literature review to provide epidemiological, cultural and historical background. Next is an analysis of the 2nd National Survey of Sexual Attitudes and Lifestyles to explore the factors associated with HIV testing among black Africans in Britain. Finally, the findings from in-depth interviews with key informants to identify the issues affecting utilisation of HIV services for Africans in Britain are presented. The SONHIA study consisted of survey of 269 Africans newly diagnosed with HIV. All respondents self-completed a questionnaire linked to clinical records, and 26 in-depth interviews with a purposively selected sub-sample were performed. The findings show that Africans are accessing services but clinicians are failing to use these opportunities for preventive and diagnostic purposes with regards to HIV infection. HIV presentation patterns appear governed by factors linked to the characteristics of, and response to, the HIV epidemic operating within people’s sociocultural networks. UK acquisition of HIV in this population appears substantially higher than acknowledged by national surveillance data, with a quarter to a third of HIV possibly acquired in the UK. The qualitative findings provide contextual understanding of the factors contributing to late presentation. They highlight the central role of HIV-related stigma and discrimination in influencing HIV testing behaviours. Failings within the health care system offer insight as how clinicians can better address HIV in the future. The key findings are summarized and contextualised with the literature and the current socio-political climate. The study’s limitations are addressed, and the thesis concludes with the public health and policy implications of the study

Evaluating Research and Impact: A Bibliometric Analysis of Research by the NIH/NIAID HIV/AIDS Clinical Trials Networks

Evaluative bibliometrics uses advanced techniques to assess the impact of scholarly work in the context of other scientific work and usually compares the relative scientific contributions of research groups or institutions. Using publications from the National Institute of Allergy and Infectious Diseases (NIAID) HIV/AIDS extramural clinical trials networks, we assessed the presence, performance, and impact of papers published in 2006–2008. Through this approach, we sought to expand traditional bibliometric analyses beyond citation counts to include normative comparisons across journals and fields, visualization of co-authorship across the networks, and assess the inclusion of publications in reviews and syntheses. Specifically, we examined the research output of the networks in terms of the a) presence of papers in the scientific journal hierarchy ranked on the basis of journal influence measures, b) performance of publications on traditional bibliometric measures, and c) impact of publications in comparisons with similar publications worldwide, adjusted for journals and fields. We also examined collaboration and interdisciplinarity across the initiative, through network analysis and modeling of co-authorship patterns. Finally, we explored the uptake of network produced publications in research reviews and syntheses. Overall, the results suggest the networks are producing highly recognized work, engaging in extensive interdisciplinary collaborations, and having an impact across several areas of HIV-related science. The strengths and limitations of the approach for evaluation and monitoring research initiatives are discussed

HIV/AIDS Prevention: Educating Future Generations

The purpose of this study was to discover if implementing more educational interventions on HIV/AIDS would lead to lower incidents of HIV/AIDS among youth. A quantitative research design was used to determine the level of knowledge, perceptions, and attitudes of high school students in regard to HIV/AIDS. The targeted population were youth ages 14-18 years old, which are generally high school students who are at risk of contracting HIV/AIDS. Participants in this study were students from Human Resources Development Institute’s Teen Pregnancy Prevention Program at Harper High School in Chicago, Illinois. The researcher administered questionnaires to the students at Harper High School. The researcher analyzed this data using descriptive statistics to explain the research phenomena of implementing effective interventions into school curriculums as a strategy to reduce the number of incidents of HIV/AIDS cases found among youth. Based upon the student’s responses, the researcher has learned that intervention programs that are implemented in school curriculums have significant influence on the youth population’s sexual activity and risk behaviors. This study has revealed 80% of the sample population were sexual active; with approximately 60% engaging in sexual activity by the age of 15. In revealing the sample population’s sexual activity, this study also concluded that this population lacked knowledge on HIV/AIDs as it pertains to them on their sexual risk behaviors

Hepatitis C elimination among people living with HIV

Background: Hepatitis C virus (HCV) is a major cause of liver-related morbidity and mortality among people living with HIV globally. Aims: The broad aim of this research was to evaluate progress towards HCV elimination among people living with HIV in Australia. Specific aims included evaluating incidence and factors associated with HCV reinfection and patterns of drug use and sexual risk behaviours after treatment and characterizing the HCV cascade of care and factors associated with engagement in HCV care among people living with HIV in Australia. Methods: In Chapter Two, the risk of HCV reinfection following successful therapy among people living with HIV was evaluated in a global systematic review and meta-analysis, with factors associated with reinfection assessed using meta-regression. In Chapter Three, patterns of drug use and sexual risk behaviours and HCV reinfection incidence were assessed before and after direct-acting antiviral (DAA) scale-up in Australia among people with HIV/HCV coinfection enrolled in CEASE. In Chapter Four, the HCV cascade of care, including HCV testing and treatment, among people living with HIV was characterized in the pre (2010–2015) and post (2016–2018) DAA era in a population-based linkage study including all people living with HIV in New South Wales, Australia with an HCV notification. Factors associated with HCV testing and DAA treatment were assessed using logistic regression. Key Findings: Globally, HCV reinfection incidence following treatment among people living with HIV was similar following interferon-based and DAA therapy, with the highest risk among men who have sex with men and those with recent HCV infection. Following unrestricted DAA access and broad treatment uptake among people living with xviii HIV in Australia, HCV reinfection incidence was low despite stable pattens of risk behaviours before and after DAA treatment. The HCV care cascade among people living with HIV demonstrated high HCV RNA testing coverage (91%) and treatment uptake following DAA availability (7% pre DAA, 73% post DAA). Younger age, female gender, and rural region of residence were negatively associated with testing; no factors were associated with DAA treatment. Conclusion: To maintain progress towards HCV elimination, ongoing HCV screening and treatment of (re)infection among people living with HIV will be required. Enabling access to and ensuring broad coverage of HCV testing, treatment and prevention will be essential