Sexual practices of people living with HIV in south eastern Nigeria

Couples could be in serodiscordant or seroconcordant sexual relationship. The seroconcordant could be seroconcrdant positive or negative in a heterosexual or homosexual or bisexual relationship. The various sexual practices include vaginal sex; anal sex fisting; oral sex fellatio, cunnilingus; masturbation mutual or exclusive and a host of others. These sexual practices outside safer sex guidelines will lead to HIV transmission among couples. The study is set to determine the sexual practices of people livingwithHIV(PLWHA) in SoutheastNigeria. This is an analytical epidemiological study. A total of 300 subjects were studied using interviewer administered questionnaires. Data is presented in tables and figures. Analysis was done using SPSS 11.0 statistical package. Most respondents were in heterosexual relationship (97%). The married couples in serodiscordant relationship were 25.3% while the singles in serodiscordant relationship were 20%. About 56% do not use condom for the adopted sexual practice although 65% believe that condom use would protect against HIV transmission. Couples in seroconcordant seronegative relationship have it as a challenge to remain so. This study suggests that the PLWHA are very important in the spread of HIV infection as they are still sexually active, in non-cohabiting conjugal unstable relationship, and they do not use the condomconsistently. There is an urgent need to target this population with effective behavioural change communications thatwill translate to safer sexual behaviour. The practice of safer sex should be taught in every health care center, in schools and in village gatherings by qualified health care workers. This will help curb the transmission of HIV.

COVID-19 in sub-Saharan Africa: impacts on vulnerable populations and sustaining home-grown solutions

© 2020, The Canadian Public Health Association. This commentary draws on sub-Saharan African health researchers’ accounts of their countries’ responses to control the spread of COVID-19, including social and health impacts, home-grown solutions, and gaps in knowledge. Limited human and material resources for infection control and lack of understanding or appreciation by the government of the realities of vulnerable populations have contributed to failed interventions to curb transmission, and further deepened inequalities. Some governments have adapted or limited lockdowns due to the negative impacts on livelihoods and taken specific measures to minimize the impact on the most vulnerable citizens. However, these measures may not reach the majority of the poor. Yet, African countries’ responses to COVID-19 have also included a range of innovations, including diversification of local businesses to produce personal protective equipment, disinfectants, test kits, etc., which may expand domestic manufacturing capabilities and deepen self-reliance. African and high-income governments, donors, non-governmental organizations, and businesses should work to strengthen existing health system capacity and back African-led business. Social scientific understandings of public perceptions, their interactions with COVID-19 control measures, and studies on promising clinical interventions are needed. However, a decolonizing response to COVID-19 must include explicit and meaningful commitments to sharing the power—the authority and resources—to study and endorse solutions

Survey of motivation for use of voluntary counseling and testing services for HIV in a high risk area of Shenyang, China

<p>Abstract</p> <p>Background</p> <p>HIV voluntary counseling and testing (VCT) is considered an effective prevention method of HIV infection. In order to understand the VCT environment and enhance the effective delivery of VCT services in a country, an accurate assessment of the current status of VCT services is very important.</p> <p>Methods</p> <p>From July 2006 to June 2007, we conducted a cross-sectional survey using a face to face interview among 2676 VCT clients from a high risk area in Shenyang city, China.</p> <p>Results</p> <p>The major demographic characteristics among 2,676 VCT clients were: 41.1% were in the age range 20 to 30 years; 73.1% were males; and 67.1% had attained the level of junior high school education. The primary information source for VCT services was mass media like television (TV) and newspaper in 88.9%. 34.3% were afraid of the result of infection which was the main barrier to accept VCT services among 540 participants answering the question. 75.2% were motivated by recently acquired knowledge about HIV. 47.9% had 3 or more male sex partners, 62.3% had used condoms sometimes, and 14.5% had been infected with a STD. 2.8% of the participants identified themselves as men who have sex with men (MSM). The main demographic characteristics of MSM did not differ from the total group of participants except with respect to age: 63.5% reported having one male sex partner in the preceding 12 months, 44.6% reported never using condoms in the preceding 12 months, and only 2.7% reported a history of sexually transmitted disease.</p> <p>Conclusion</p> <p>Public education offered by health workers in hospitals, private clinics and other medical institutions needs to be strengthened. Given the results from this study, we recommend: (1) making VCT a routine part of health services, especially in areas where many high-risk individuals live; (2) improving the information sources and increasing the understanding of HIV and HIV-infected individuals; (3) enhancing international collaboration in strategic planning, technical assistance, and protocols to translate policy into effective action; (4) supporting Chinese non-government organizations (NGOs) in playing a significant role in the battle against AIDS.</p

Prevalence of complications of male circumcision in Anglophone Africa: a systematic review

BACKGROUND: There is growing evidence that male circumcision (MC) prevents heterosexual acquisition of HIV by males in sub-Saharan Africa, the region of the world heavily affected by the HIV pandemic. While there is growing support for wide-spread availability and accessibility of MC in Africa, there is limited discussion about the prevalence of physical complications of male circumcision on the continent. METHODS: A systematic literature search and review of articles in indexed journals and conference abstracts was conducted to collect and analyze prevalence of complications of MC in Anglophone sub-Saharan Africa. Information extracted included: indications for MC, complications reported, age of patients and category of circumcisers. RESULTS: There were 8 articles and 2 abstracts that were suitable for the analysis. The studies were not strictly comparable as some reported on a wide range of complications while others reported just a limited list of possible complications. Prevalence of reported complications of MC ranged from 0% to 50.1%. Excluding the study with 50.1%, which was on a series of haemophilia patients, the next highest prevalence of complications was 24.1%. Most of the complications were minor. There was no firm evidence to suggest that MCs performed by physician surgeons were associated with lower prevalence of complications when compared with non-physician health professionals. CONCLUSION: The available data are inadequate to obtain a reasonable assessment of the prevalence of complications of MC in sub-Saharan Africa. Some of the available studies however report potentially significant prevalence of complications, though of minor clinical significance. This should be considered as public health policy makers consider whether to scale-up MC as an HIV preventative measure. Decision for the scale-up will depend on a careful cost-benefit assessment of which physical complications are certainly an important aspect. There is need for standardized reporting of complications of male circumcision

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Factors that influence the acceptance of HIV testing by pregnant women in Nnewi Nigeria

Context: HIV testing in pregnancy is the gateway to accessing care for the mother and the child. The interventions in Prevention of Mother-to –Child Transmission (PMTCT) of HIV can only be applied to a woman whose status is known. Therefore determining the HIV status of pregnant women is a key factor to the success of any prevention programme. Objective: To determine the various factors influencing the acceptance of HIV testing by our pregnant women. Study design, setting and subjects: The study was conducted at the antenatal clinic of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi which is the only tertiary public hospital in Anambra State. This is a cross sectional study in which questionnaires were administered to the pregnant women at the antenatal clinic on one to one bases and data collected was analysed and presented in tables and compared with simple percentages. Results: During the period of study, 200 antenatal; women responded to the questionnaires. Their age ranged from 15- 42 years with the highest age group being 25-29years (41.0%). Highest educational level and occupation of the pregnant women significantly influenced their having and HIV test (

Hiv infection prevalence among women visiting the Hiv counselling centre in Nnewi, Nigeria.

Objective: This study is aimed at determining the HIV prevalence rate among women attending the HIV counselling & testing centre at Nnewiand the effect of marital status on this.Method: This is a retrospective review of the records of women visiting the HIV counselling and testing (HCT) centre of the Nnamdi AzikiweUniversity Teaching Hospital from July 2004 to June 2005 to determine their HIV status. They include women attending antenatal clinic,premarital test, pre employment test and those referred from other centres for confirmation of their status. The data was analysed and presented in tables using comparative percentages.Results: HCT uptake during this period was 87.6% (1419/1620) while HIV sero-prevalence was 28.3% (402/1419). The breakdown of thefemale population showed a 15.3% (70/458) sero-positivity among pregnant women, 25.8% (69/268) sero-positivity among single non-pregnant girls and 38.0% (269/693) sero-positivity among married non-pregnant women. The 25 – 29 years age range had the highest sero-prevalence for HIV infection though there was no significant difference in prevalence of HIV infection for women above 20 years of age. However, the adolescents (15-19 years) had a significantly lower prevalence (

Pregnancy loss: a rare consequence of premenstrual endometrial curettage for infertility management

Two cases of pregnancy loss - a rare complication of pre-menstrual endometrial biopsy (PMEB) are reported. PMEB is an investigation performed for infertile women to assess ovulation and endometrial factors. It is usually performed during the secretory phase of the cycle. This implies that ovulation and possibly fertilization may have taken place. In the two patients presented, histology report in one suggested pregnancy while the second presented with massive vaginal bleeding few days after PMEB requiring evacuation. The histology of the latter confirmed products of conception. Though PMEB is useful, it may lead to pregnancy loss. Couples should be counseled to avoid sex during the fertile days of the cycle scheduled for PMEB investigation. Wider availability and use of ultrasonography to assess ovulatory factor may avert this painful complication. Keywords: pregnancy, abortion, infertility, curettage Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 74-7