Sexually transmitted infection as a risk factor for HIV : describing treatment seeking behaviours and sexual risk practices of clinic attendees at the Cyril Zulu Communicable Diseases Centre : a potential application of the information-motivation-behaviour skills model for HIV prevention interventions.

Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.Co-infection with a sexually transmitted infection (STI) is both an indicator of behavioural risk, as well as an indicator of increased risk for infection with HIV. This is a cross-sectional, descriptive study. The overall aim of the study is to profile the demographic data, health seeking behaviour, sexual risk behaviour and HIV awareness and willingness to test in a sample of STI clinic attendees in order to inform intervention programmes aimed at reducing the burden of disease in this group, thereby reducing HIV risk. It is hypothesised that those individuals who are poorly informed about key prevention information (particularly regarding the biological susceptibility to HIV infection when co-infected with an STI), who are poorly motivated due to poor attitudes towards or lack of social norms in favour of prevention behaviour, and who lack some key behaviour skills (like skills for identifying STIs early, or negotiating safer sexual practises) will be less likely to be able to initiate and maintain specific prevention behaviours. Data are collected using a structured questionnaire and analysed in relation to the Information-Motivation Behavioural Skills (IMB) model of HIV prevention behaviour. This model was specifically developed to provide a conceptual framework for the design, implementation and assessment of targeted and empirically focussed interventions to change sexual risk behaviour in HIV. Components of the IMB model that are identified as important in contributing to risk of infection in this group are identified. Finally, recommendations regarding the form and content of an intervention in this group are made. The study concludes that STI clinics may be excellent environments within which to implement HIV risk reduction pehavioural interventions which currently may be missed opportunities

Relationship between levels of inflammatory cytokines in the genital tract and CD4+ cell counts in women with acute HIV-1 infection.

Inflammatory responses at mucosal surfaces after human immunodeficiency virus type 1 (HIV-1) transmission may influence disease outcome. We evaluated levels of interleukin (IL)-1beta, IL-6, tumor necrosis factor-alpha, IL-8, IL-10, and IL-12 in genital tract and plasma specimens from 44 women with acute HIV infection and 29 HIV-negative control women (13 of whom were women in the acute HIV infection cohort who had preinfection samples available for analysis). Women with acute HIV infection had significantly elevated levels of IL-6, IL-10, and IL-12 in genital tract specimens and elevated levels of IL-1beta, IL-8, and IL-10 in plasma specimens, compared with HIV-negative control women. Levels of IL-1beta, IL-6, and IL-8 in cervicovaginal specimens from women with acute HIV infection showed a significant inverse correlation with systemic CD4(+) cell counts, suggesting that mucosal inflammation is associated with low CD4(+) cell counts during acute HIV infection

A research methodology study to map the process of initiating and operating a randomised controlled trial of podoconiosis treatment in Northern Ethiopia

No description supplie

HIV prevention in high-risk women in South Africa: condom use and the need for change.

Introduction: Young women are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviors and factors associated with ability to negotiate safe sex and condom use is likely to be key in curbing the spread of HIV. Traditionally prevention efforts have focused on creating behavioral changes by increasing knowledge about HIV/AIDS. Methods: This was a cross-sectional analysis from a prospective observational cohort study of 245 women at a high-risk of HIV infection in KwaZulu-Natal, South Africa. Results: Participants demonstrated a high level of HIV/AIDS knowledge. Overall, 60.3% of participants reported condom use. Reported condom use at last sexual encounter varied slightly by partner type (57.0% with steady versus 64.4% with casual partners), and self-perceived ability to choose to use a condom was significantly lower with steady partners compared to casual partners (p<0.01). In multivariate analysis, women who had high school education were more likely to use condoms at their last sex encounter compared to those with only primary school education (RR of 1.36 (95% Confidence Interval (CI) 1.06–1.75) and 1.46 (95% CI 1.13–1.88) for grades 8–10 and 11–12, respectively). Those who used condoms as a contraceptive method were twice as likely to use condoms compared to women who did not report using them as a contraceptive method. Greater perceived ability to choose to use condoms was associated with higher self-reported condom use at last encounter, irrespective of partner type (RR = 2.65 (95% CI 2.15–32.5). Discussion: Self-perceived ability to use condoms, level of formal education and condom use as a contraceptive were all significantly associated with self-reported condom use at last sexual encounter. These findings suggest that that gender inequality and access to formal education, as opposed to lack of HIV/AIDS knowledge, prevent safer sexual practices in South Africa

Anaemia in Acute HIV-1 Subtype C Infection

BACKGROUND: The high prevalence of anaemia and the increased morbidity and mortality associated with anaemia during AIDS has been well described yet there has been little information about anaemia and changes in haemoglobin levels during acute and early HIV-1 infection. METHODS: HIV-negative women (n = 245) were enrolled into an observational cohort as part of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) Acute Infection Study. Acute infection was diagnosed following a positive HIV RNA PCR in the absence of antibodies, or detection of HIV-1 antibodies within 3 months of a previously negative antibody test. Haemotologic parameters were assessed before infection and at regular intervals in the first twelve months of HIV infection. RESULTS: Fifty-seven participants with acute HIV infection were identified at a median of 14.5 days post-infection (range 10-81) and were enrolled in the CAPRISA Acute Infection cohort at a median of 41 days post-infection (range 15-104). Mean haemoglobin prior to HIV-1 infection was 12.7 g/dL, with a mean decline of 0.46 g/dL following infection. The prevalence of anaemia increased from 25.0% prior to HIV-1 infection to 52.6% at 3 months post-infection, 61.1% at 6 months post-infection, and 51.4% at 12 months post-infection. CONCLUSIONS: Haematologic derangements and anaemia with a trend towards iron deficiency are common with acute HIV-1 subtype C infection in this small cohort. The negative impact of anaemia concurrent with established HIV infection upon morbidity and mortality has been well documented but the prognostic potential and long-term effects of anaemia during acute HIV-1 infection remain unknown

One-year recovery rates for young people with depression and/or anxiety not receiving treatment: a systematic review and meta-analysis

Objectives: To systematically review 1-year recovery rates for young people experiencing depression and/or anxiety who are not receiving any specific mental health treatment. Design: Systematic review and meta-analysis. Data sources: MEDLINE, Embase, PsycINFO, Web of Science and Global Health were searched for articles published from 1980 through to August 2022. Eligibility criteria: Articles were peer-reviewed, published in English and had baseline and 1-year follow-up depression and/or anxiety outcomes for young people aged 10–24 years without specific treatment. Data extraction and synthesis: Three reviewers extracted relevant data. Meta-analysis was conducted to calculate the proportion of individuals classified as recovered after 1 year. The quality of evidence was assessed by the Newcastle-Ottawa Scale. Results: Of the 17 250 references screened for inclusion, five articles with 1011 participants in total were included. Studies reported a 1-year recovery rate of between 47% and 64%. In the meta-analysis, the overall pooled proportion of recovered young people is 0.54 (0.45 to 0.63). Conclusions: The findings suggest that after 1 year about 54% of young people with symptoms of anxiety and/or depression recover without any specific mental health treatment. Future research should identify individual characteristics predicting recovery and explore resources and activities which may help young people recover from depression and/or anxiety

Risk factors for HIV acquisition in high risk women in a generalised epidemic setting.

CAPRISA, 2015.Abstract available in pdf

A qualitative study of patient motivation to adhere to combination antiretroviral therapy in South Africa.

CAPRISA, 2015.Abstract available in pdf