An Estimation of HIV/AIDS’s Cost in the Voluntary Counseling and Testing Center of Imam Khomeini Hospital in 2010-2011

Introduction: Undoubtedly, HIV/AIDS is one of the most important emerging infectious disease in the late twentieth century; and its control is possible only with proper and organized program. To attain this goal, one of the most serious issues is the budget planning and distribution. The present study calculated the total costs of AIDS in Voluntary Counseling and Testing center of Imam Khomeini Hospital in 2010-2011.Methods: The total cost of AIDS at this center was divided into four categories: health care, training and educating, research and services. All costs for 2010-2011 were extracted and classified based on documents and bills which were found in the center.Results: According to the calculations, the center had a total of 6,603,479,058 IRR in 2010-2011, of which 49.5% (3,271,089,796 IRR) was allocated for health care expenditure, 20.3% (1,335,186,000 IRR) for research, 12.6% (834,000,000 IRR) for training and 17.6% (1,163,203,262 IRR) for services. The average expense for each person living with HIV was 2276 US dollars. The cost of treatment by drugs for each person eligible for treatment was 782 US dollars.Conclusion: The percentage of budget distribution in the center is equal to the same percentage in low and middle income countries; although, more percentage is allocated for research than the mentioned countries. Also, the expenditure spent for treatment by drugs is more than the average of the same found in low and middle income countries. Overall, the budget distribution in this center is almost in accordance with the international standards

Content Analysis of Teleconsultation Enquiries in Positive Health Club, Imam Khomeini Hospital, Tehran, Iran

Objective: With the availability of specialists and the overflowing information in public and social networks, individuals have easy access to information about HIV and AIDS. However, medical counselling and healthcare settings still have an essential role. The aim of the present study was to analyze phone enquiries directed to the Positive Club of Imam Khomeini Hospital in Tehran; this analysis was based on demographic features of participants.Design/Methodology/Approach: In this cross-sectional study, 5255 questions were extracted and coded from the Positive Club's counselling questionnaires; the coding procedure was based on Huber and Gilapsy's decimal classification. Data were processed by descriptive statistics and SPSS software.Findings: A majority of callers were men (59.43%), most callers were aged between 26 and 30 years, and HIV transmission and high-risk sexual behaviours were among frequently asked questions (47%).Originality/Value: Taking into account that most callers were concern about transmission via sexual contact (anal, vaginal, and oral) rather than injection and its related equipment, it seems reasonable to assume that HIV transmission flow may shift from shared injection equipment to high-risk sexual behaviors

Drugs Side Effects in Pregnant Women Infected with HIV Referred to Imam Khomeini Hospital, Voluntary Counseling and Testing Center Tehran, Iran 2009 – 2013

Objective: To have enough information about the prevalence of the ARV side effects in pregnant women infected with HIV and their infants and also evaluate drug efficacy in decreasing HIV infection in their children.Method: This descriptive study was based on information of 40 pregnant women infected with HIV files at voluntary and counseling center, Imam Khomeini Hospital, Tehran, Iran during 2009 -2013. In this study, we evaluated epidemiologic, demographic, clinical, laboratory data and drugs side effects,.Results: The most commonly used drug group was AZT/3TC/EFV; about 75.5% of patients received mother to child prevention and 27.5% received ARV Antiretroviral therapy treatment. 5% anemia, 2.5% rash and 2.5% pre rupture of membranes were reported and no preeclampsia or gestational diabetes were reported in patients files. Only one abortion (2.5%) was occurred in late first trimester. Except rash, other adverse effects were solely reported in ARV treatment group. All neonates had normal Apgar score. Fetal defects were not reported at birth.Conclusion: In this evaluation, safety of ARV in pregnancy period and at birth was observed especially in the group received prevention of mother to child transmission (PMTCT). So we advise ARV treatment or PMTCT in pregnancy period

Situational Analysis on Voluntary Counseling and Confidential Testing in HIV/AIDS Patients Referred to Behavioral Center in lmam Khomeini Hospital, Tehran, Iran

Background and aims: Behavioral counseling centers are the main health organizations which are responsible for providing treatment and care for the patients living with HIV (PLWH). HIVpositive patients receive services through a unique counseling process called voluntary counseling and confidential testing (VCCT). Although there are reports regarding VCCT evaluation from other countries, not such an evaluation was found in Iran until this study, to the best of our knowledge. The study was performed to fulfill this necessity. Methods: Using consecutive method sampling, 314 subjects were sampled from the patients referred to Behavioral Counseling Center of Imam Khomeini hospital, Tehran, Iran. A combination of process and output evaluation of VCCT was performed in the biggest Behavioral Counseling Center of Iran at Imam Khomeini hospital, Tehran, Iran. Data were analyzed using descriptive statistics (percentages and averages). Results: Participants’ response rate was 95.54%. Two shortcomings were found in the counseling process. Cronbach alpha reliability coefficient for this scale was 0.899, which was a desirable reliability for the questionnaire. As the main finding of the study, 48.33% of patients were not using antiretroviral medications regularly. An average number of patients (2.88) had HIV related stigma and fear of disclosure. In a quantitative study before testing in the study, it has been found that HIV patients did not have adequate information about their disease. Conclusion: Defects in the consultation process for the patients with HIV infection in the hospital were concluded. The quantity of consulting services for patients was in low level; therefore it is essential to improve consulting services for health promotion of the HIV patients

Menstrual Characteristics and Patterns of Menstrual Disorders among Women Living with HIV in Tehran, Iran

Background: The relation between Human Immunodeficiency Virus (HIV) serostatus and menstrual irregularities is controversial. Toward a better understanding of menstrual abnormalities among HIV infected women and the role of HIV related variables, we conducted the present study. Materials and methods: This cross-sectional study was conducted between September 2016 and December 2017 among 111 eligible HIV infected women and in Imam Khomeini Hospital, Tehran, Iran. Participant were recruited based on convenience sampling method. We addressed the menstrual data of 102 participants (returning at least three consecutive menstrual calendars) through a self-constructed questionnaire. We also assessed HIV viral load and CD4 cells count of each participant at the time of study enrollment. Descriptive statistics as well as Kruskal-Wallis test and Bonferroni post hoc tests were used to address our objectives, so we used Statistical Package for the Social Sciences (SPSS) version 16.0 for windows (SPSS, Inc, Chicago, IL). Significance level was considered as 0.05. Results: Vaginal spotting (18%) and metrorrhagia (18%) were the most prevalent disorders among our participants. Despite of sociodemographic variables, we found significant relationship between HIV viral load and hypermenorrhea as well as CD4 cells count and polymenorrhea (Kruskal-Wallis test; P < 0.05). Conclusion: HIV related immunosuppression seems to have significant impact on some aspects of menstrual cycles among Iranian women

Efficacy of a Condom Negotiation Intervention among High Risk Iranian Women in Tehran, Iran

Background: Development of tailored interventions to promote condom use seems essential in countries with traditional gender role definitions. Learning condom influence strategies could be helpful when it is difficult for women to initiate sexual communication. These strategies have been targeted in a safer sex skills building intervention among high-risk women in Tehran, Iran. Methods: We conducted this study among 50 high-risk women who registered for counseling and HIV testing at Imam Khomeini Hospital in Tehran, Iran, 2012-2013. Participants were assigned to two groups: 1) routine 15 minute pre-test HIV counseling, or 2) routine counseling besides communication skills building monthly sessions for six months. Pre and post-tests were taken at baseline and six months. We designed an intervention based on Information-Motivation-Behavior theory. Condom influence strategies were used in the construct of the questionnaire and intervention materials. Results: After six months participants in the intervention group were able to implement influence strategies to promote partners’ condom use (P = 0.01). Risk information and relationship conceptualizing were more endorsed post-intervention (P = 0.02, P = 0.006). In addition, partner communication had significantly improved in the case group (P < 0.001). Conclusions: We found that condom influence strategies could be considered in improving current counseling sessions, as an effective intervention to minimize HIV and other Sexually Transmitted Infections (STIs) transmission among high-risk women. We recommend this skill-based intervention for condom negotiation to empower at-risk sexually active women

Assessing the Efficacy of Second-Line Antiretroviral Treatment for HIV Patients Failing First-Line Antiretroviral Therapy in Iran: A Cohort Study

There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of them had avirological response after 12 months on second-line ART. No significant associations were found between virological or immunological response and gender, age, and lopinavir/ritonavir regimens (P>0.05).With counselling and supporting in those failing first-line ART, inessential switching to more costly second-line ART can be prevented in the majority of patients. However, patients' need to second-line ART drugs has increased, for which national ART programmes and regular follow-up should be organized. The high cost of these drugs and limited access to viral load testing are main barriers to proper management of patients switched to second-line ART regimens

Full empirical path model between health anxiety, COVID-19 phobia, and social relationsaccording to T-value.

(T-value>1.96 is considered as significant). AGE: Age, PN: Partner number, CN: Child number, HA: Health anxiety, HIVY = HIV duration (year), SES: Socioeconomic status; EDU: Education, SR: Social relations; CPH: COVID-19 phobia.</p