Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

The Effect of Self-Care Counseling on Health Practices of 35-Year-Old or More Aged Pregnant Women Referring to Hamadan Health Care Centers, in 2018

Introduction: Maternal age of 35 years or older can be a risk factor for a significant increase in pregnancy complications. The aim of this study was to determine the effect of self-care counseling on the health practices in pregnant women aged 35 or older who referred to Hamadan comprehensive health centers. Methods: A randomized controlled clinical trial study was performed on 100 pregnant women aged 35 years and over referring to Hamedan health centers in 2018. The research instrument was a demographic questionnaire, and Health practices questionnaire that completed both groups before and after the intervention. The type of allocation of people in each clinic was done randomly using a random number table. The test group received consultation sessions. Data analysis was performed using SPSS 20 and (P<0.05) was considered significant. Results: According to the results, the mean scores of health practices in the test group before and after the intervention changed from (110.38±20.41) to (120.82±19.36) and the difference was statistically significant (P0.05). Conclusion: The present study showed the health practices of maternal aged in high risk pregnant women

Effect of Family Centered Consultation on Nausea and Vomiting in Pregnancy: A Clinical Trial Study

Introduction: Nausea and vomiting is the prevalent complications of early pregnancy; the severity of its symptoms can decrease with different protections.  This study was conducted to determine the effect of family-oriented consultation on nausea and vomiting in pregnant women. Methods: In this quasi-experimental study 90 pregnant women referring to Famenin health care centers in 2017 were selected and assigned randomly in study and control croups. The data gathering tool was demographic information, midwifery, nutrition, psychological and standard questionnaire of PUQE, which were completed at the beginning of the study and two weeks after the completion of intervention. The intervention was conducted through two weekly counseling sessions with pregnant women and their family. The content of the consultation sessions was about diet, lifestyle, and family supports. The control group received just the routine prenatal care. Finally, the data was analyzed using descriptive and analytical statistics by SPSS16. Results: Our results showed that the two groups were statistically similar in demographic and midwifery features. According to the results there was a significant reduction about the mean scores of nausea and vomiting severity in the study group after the intervention (P<0.05). However, there was a significant difference between the mean scores of nausea and vomiting severity in the study group before and after the intervention too (P<0.05). Conclusions: Family-based counseling can reduce the severity of nausea and vomiting in prenatal women. So, it is recommended as an effective, safe and accessible treatment method

Effect of Group Counseling on Sexual Knowledge, Attitude, and Function of Young Women with Sexual Dysfunction: A Randomized Controlled Clinical Trial

Background and Objective: Inadequate information and false sexual beliefs are common psychological factors in sexual disorders. This study aimed to determine the effect of counseling on the sexual knowledge, attitude, and performance of women with sexual dysfunction. Materials and Methods: This randomized controlled clinical trial was conducted on 80 women aged 18 to 30 years with sexual dysfunction. Samples were randomly assigned to two test and control groups. The required data were collected using a demographic form, the Sex Knowledge and Attitude Test, and Female Sexual Function Index. The intervention was performed in 4 counseling sessions of 45-90 minutes weekly based on the rapport building, exploring, decision making, and implementing the decision (REDI) model. Data were gathered before and 4 weeks after the intervention and analyzed using Stata-13 software. The significance level was considered less than 5%. Results: After the intervention, the mean scores of sexual knowledge, sexual attitude, and sexual knowledge and attitude, as well as the total score of sexual function in the test group were obtained at 47.13±1.74, 51.16±2.34, 98.30± 3.73, and 26.29±2.46, respectively. These resultsshowed a statistically significant increase compared to before the intervention and also compared to the control group (P<0.001). After the intervention, the mean scores of sexual desire, orgasm, and pain domains showed a significant difference between the two test and control groups (P<0.05). Conclusion: It was found that REDI model-based counseling was effective in improving the sexual knowledge, attitude, and function of young women with sexual dysfunction. Considering the simplicity and effectiveness of this method, it is recommended to use it in sexual counseling

Studying the Polypropylenimine-G2 (PPI-G2) Dendrimer Performance in Removal of Escherichia coli, Proteus mirabilis, Bacillus subtilis and Staphylococcus aureus from Aqueous Solution

Abstract Background: Dendrimers are a subset of branched structures that have certain structural order. The aim of this study was to investigate the performance of Polypropylenimine-G2 (PPI-G2) dendrimers in removal of Escherichia coli, Proteus mirabilis, Bacillus subtilis and Staphylococcus aureus from aqueous solution. Materials and Methods: In this experimental study, initially dilution of 103 CFU/ml was prepared from each strain of bacteria. Then, different concentrations of dendrimers (0.5, 5, 50 and 500 µg/ml) was added to water. In order to determine the efficiency of dendrimers in removal of bacteria, samples were taken at different times (0, 10, 20, 30, 40, 50 and 60 min) and were cultured on nutrient agar medium. Samples were incubated for 24 hours at 37 ° C and then the number of colonies was counted. Results: By the increasment of dendrimer concentration and contact time, the number of bacteria in aqueous solution decreased. In times of 40, 50 and 60 minutes, and the concentrations of 50 and 500 µg/ml, all kinds of bacteria in aqueous solution were removed. 0.5 µg/ml of dendrimer concentration had not effect in reducing the number of Escherichia coli and Proteus mirabilis. The effect of dendrimer on gram-negative bacteria was weaker than gram-positive bacteria. Conclusion: Results of this study indicated that PPI-G2 dendrimer is able to remove Escherichia coli, Proteus mirabilis, Staphylococcus aureus and Bacillus subtilis in aqueous solution. However, using dendrimers can be considered as a new approach for drinking water disinfection but it requires further wide range studies

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

10.1016/S2352-3018(21)00152-1LANCET HIV810E633-E65