Public Opinion Regarding Government Response to COVID-19: Case Study of a Large Commercial City in Nigeria

Introduction: government measures to contain the COVID-19 pandemic cannot be effective without widespread compliance by the public. A greater understanding of citizens\u27 perceptions of these measures can help government agencies adapt their strategies to boost compliance. We examined citizens\u27 perceptions of government\u27s measures to contain the COVID-19 pandemic and its implications on compliance using data from Onitsha city, Anambra State Nigeria. Methods: data was obtained through in-person interviews of 140 consenting adults in March 2020. Descriptive and inferential statistics were used to summarize the data. Results: most participants (84.7%) doubted government\u27s ability to manage the COVID-19 outbreak, raising concerns about ineffective governance (25.7%) and inadequate health facilities (20.7%). However, participants expressed a favorable perception of school closures (92.3%) and a ban on large gatherings (83.9%), driven mostly by the need to contain the COVID-19 and avoid its spread. But, they were generally indifferent about the closure of the markets and workplaces due to concerns for food insecurity and lack of government\u27s relief programs. Participants who had a positive perception of the ban on large gatherings were more likely to have high knowledge and to adopt good COVID-19 preventive practices. Conclusion: the study showed a lack of public\u27s confidence in the government\u27s ability to manage the pandemic. This provides an opportunity for the city government and the public to reflect on the existing relationships, build mutual trust, and devise collaborative engagement that will boost compliance and help contain the devastating impact of COVID-19 pandemic

Clinical and Epidemiological Analyses of Mental Illness, Substance Use and Health Outcomes of People Living with HIV in Texas

Objectives: Mental illness and substance use have been linked to poor outcomes in chronic diseases including HIV. We aimed to describe the burden of mental illness and substance use among people living with HIV in Texas, assess the impact on viral suppression and CD4 count, and develop a prediction model to predict the risk of having sub-optimal HIV clinical outcome. Methods: The 2015-2019 Texas Medical Monitoring Project (MMP) data was used. Descriptive analyses were conducted to describe patient characteristics, health behavior, and environmental factors. Multivariable logistic regression was used to assess associations between mental illness, substance use, and HIV outcomes, as well as to obtain a prediction model for assessing the risk of sub-optimal HIV outcome. The final prediction model was internally validated using 500 bootstraps. Risk score points were assigned to each risk predictors based on their respective beta coefficients. Results: We identified knowledge gaps on the impact of mental illness and substance use on HIV outcomes among people living with HIV in Texas. In aim 2, a total of 1665 respondents representing 85,354 adults living with HIV in Texas were included. Majority of the participants (78.8%) had mental illness or substance use problems. Substance use only was associated with not being virally suppressed (aOR 1.65, 95% CI 1.06-2.56, p=0.0279). In aim 3, a total of 518 respondents representative of 27,255 adults living with HIV and diagnosed mental illness or substance use disorders in Texas were included. The prediction model had an area under the receiver-operating characteristic curve (AUC) of 0.727, and contained 8 risk predictors: mental illness and substance use disorders severity, retention in care, adherence, health insurance coverage gaps, healthcare utilization, employment, poverty, and years since HIV diagnosis. Conclusion: Mental illness and substance use are highly prevalent among adults living with HIV in Texas, and are associated with poor health outcomes. The risk screening tool developed from our study can support efficient care coordination to improve health outcomes for people living with HIV and mental illness or substance use disorders in Texas. Our study findings support the need to prioritize integrated HIV/ mental illness and substance use disorders care in Texas

COVID-19 Infection among People with HIV/AIDS in Africa: Knowledge Gaps, Public Health Preparedness and Research Priorities

The emergence of novel virus SARS-CoV-2 that causes COVID-19 has complicated Africa’s public health challenges, especially with the pre-existing epidemics such as HIV/AIDS. We highlight the known evidence related to COVID-19 infections among people with HIV (PWH) with specific reference to Africa. The knowledge gaps, level of public health preparedness and the potential research priorities are also outlined. Although the epidemiology and clinical course of COVID-19 in HIV patients are evolving, existing evidence indicate that the disease outcomes are comparable to that of the general population. However, PWH with low CD4 cell counts may have worse outcomes than individuals with restored immunity, whereas old age and co-morbidities such as obesity, hypertension and diabetes can further increase their overall risk. While there may be slight disruption of HIV service delivery in selected African countries, the resilience and resourcefulness of others have helped to sustain HIV service delivery and enhanced the level of public health preparedness and fight against the pandemic. The paucity of data and research studies on HIV-COVID-19 coinfection in Africa, call for concerted efforts to address these limitations. Keywords: • COVID-19 • SARS-CoV-2 • HIV • PWH • Public Health • Research • Africa   Copyright © 2021 Essien, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited

COVID-19 related knowledge, attitude and practices in a Southeastern city in Nigeria: The Baseline

Although guidelines and recommendations for the prevention of COVID-19 are in place, it is vital to assess how well people know and practice them, as well as people's attitude towards these measures to inform robust interventions. This study examined COVID-19 related knowledge, attitude, and preventive practices. We conducted a cross-sectional survey of 140 adult residents of Onitsha, Anambra state in March 2020 before the state's index case and the mandatory lockdown. Descriptive and inferential statistics were used to describe COVID-19 KAP, information gaps and needs, and associations between KAP and demographic characteristics. About 60.7% of respondents had high COVID-19 knowledge, 56.4% had a good attitude towards COVID-19 management, and 53.6% adopted good COVID-19 prevention practices. Participants with bachelor/postgraduate degrees had higher than average COVID-19 knowledge (15.42 ± 0.57, p < 0.0001), attitude (1.11 ± 0.10, p < 0.0025), and prevention practice (5.02 ± 0.32, p < 0.0005) scores. Over half of the participants correctly identified virus as the cause of COVID-19 (60%, p < 0.01). About three-quarters of the participants (75%, p < 0.0001) indicated needing more information on COVID-19. A moderate proportion of our study population (53.6–60.7%) had good COVID-19 KAP. Our study findings can inform future COVID-19 program planning to ensure a more targeted and effective intervention strategy to prevent and control the disease spread among residents of Onitsha city

HIV Non-Occupational Post Exposure Prophylaxis in Nigeria: A Review of Research Evidence and Practice.

Background: Although non-occupational Human Immunodeficiency Virus (HIV) post-exposure prophylaxis (nPEP) has been proven to be efficacious in preventing HIV, it remains an underutilized prevention strategy in Nigeria. We aimed to conduct an overview of research studies on nPEP and practice in Nigeria from 2002 to 2018 examining: sociodemographic characteristics of study sample, awareness, knowledge and prior use of nPEP, reasons for HIV nPEP, timeliness in presenting for PEP, antiretrovirals (ARVs) used for nPEP, side effects and adherence, monitoring and follow-up visits, adherence to guidelines and recommendations for nPEP by healthcare institutions and the strength of evidence of reviewed studies. Methods: An electronic search on PubMed, PubMed Central (PMC), cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Embase and Google Scholar for published studies on nPEP from January 2002 to December 2018. We conducted our search using different combinations of the keywords: “HIV,” “non-occupational,” “nonoccupational,” “post-exposure,” “postexposure,” “prophylaxis” and “Nigeria.” Results: Five articles met the inclusion criteria for this study. About 25.4% of college students were aware of PEP. PEP awareness was significantly determined by the following factors: ever tested for HIV, nude picture exchanges, sex without condom, and knowledge of partner’s HIV status. Across studies, exposed victims who presented for PEP were mostly females (64%-78%). Rape was the most frequently occurring reason for seeking nPEP (25.9%-64.1%). Although most patients presented for nPEP within 72 hours, follow up visits were generally low (0%-2%) across studies assessed, except for one study that reported a high follow up visit of 83.3%. Guidelines adherence by healthcare institutions could not be established due to lack of information on key variables. Conclusion: Our study highlights the paucity of research evidence on nPEP use in Nigeria, the societal and cultural contexts in which non-occupational exposures occur, healthcare providers’ roles and the public health and practice implications. Keywords: • HIV • Post-exposure • Prophylaxis • Non-occupational • Prevention • Nigeria   Copyright © 2019 Iloanusi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited