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Abstract Background Informed consent is the cornerstone of research ethics. One of its goals is that participants enter research with an understanding of what their participation entails. This paper is a study on how researchers understand the informed consent process. Previous studies have looked at this topic from a research participant perspective. However, few studies focus on the perspectives of the researchers. Therefore, this is an important paper that highlights an important issue (informed consent) from the perspective of those who administer it during research. Methods In-depth interviews were conducted with 18 researchers from 3 different research centers in Malawi working in clinical trials. The data was analyzed using open code utilizing the thematic approach to qualitative data. Results This study identified that researchers have good awareness of the role of informed consent, how important it is for participants to understand the given information and ways to adjust their practice accordingly when obtaining it in order to enhance participant understanding. According to the research staff, most participants do not really understand all the concepts of the study at the initial visit, they gain more understanding during subsequent visits. It was emphasized that the best method of facilitating informed consent is reading the informed consent to the participant, thus a face-to-face conversation. Long and complex informed consent was identified as one of the barriers to participant understanding of the informed consent. Shortening the informed consent form and having additional conversation with the participants was suggested as one way of improving participant comprehension. Conclusion Most of the participants understand much of the information during subsequent visits as you keep reminding them since informed consent is an ongoing process. Existing relationship or trust between a participant and a researcher, may influence participants’ decision and misguide their understanding on the purpose of the study. Adequate time should be allocated to informed consent discussions. Shortening the informed consent forms and having additional conversations with potential participants may help improve their understanding.

Abstract Background The world is moving towards the third target of the Joint United Nations Programme on HIV/AIDS to ensure most people receiving antiretroviral therapy (ART) are virologically suppressed. Little is known about viral suppression at an undetectable level and the risk of viral rebound phenomenon in sub-Saharan Africa which covers 67% of the global HIV burden.This study aimed to investigate the proportion of viral suppression at an undetectable level and the risk of viral rebound among people living with HIV receiving ART in northern Tanzania. Methodology A hospital based-retrospective study recruited people living with HIV who were on ART for at least two years at Kibong’oto Infectious Disease Hospital and Mawenzi Regional Referral Hospital in Kilimanjaro Region, Tanzania. Participants’ two-year plasma HIV were captured at months 6, 12, and 24 of ART. Undetectable viral load was defined by plasma HIV of viral load (VL) less than 20copies/ml and viral rebound (VR) was considered to anyone having VL of more than 50 copies/ml after having history of undetectable level of the VL less than 20copies/ml. A multivariable log-binomial generalized linear model was used to determine factors for undetectable VL and viral VR. Results Among 416 PLHIV recruited, 226 (54.3%) were female. The mean (standard deviation) age was 43.7 (13.3) years. The overall proportion of undetectable VL was 68% (95% CI: 63.3–72.3) and 40.0% had viral rebound (95% CI: 34.7–45.6). Participants who had at least 3 clinic visits were 1.3 times more likely to have undetectable VL compared to those who had 1 to 2 clinic visits in a year (p = 0.029). Similarly, participants with many clinical visits ( > = 3 visits) per year were less likely to have VR compared to those with fewer visits ( = 2 visits) [adjusted relative risk (aRR) = 0.64; 95% CI: 0.44–0.93]. Conclusion Participants who had fewer clinic visits per year(ART refills) were less likely to achieve viral suppression and more likely to experience viral rebound. Enhanced health education and close follow-up of PLHIV on antiretroviral therapy are crucial to reinforce adherence and maintain an undetectable viral load.

Oropharyngeal candidiasis (OPC) and oral Candida carriage are common problem in HIV-infected populations. Early detection of oral carriage of Candida species is important for identification of patients with the tendency for rapid progression of HIV infection since oral carriage may influence the development of clinically significant candidiasis in these immunocompromised patients. This study investigated the prevalence and level of oral Candida carriage rate among HIV-infected and non-infected individuals in TikurAnbessa Teaching Hospital, Addis Ababa, Ethiopia. Oral rinse sample was collected from 71 HIV infected and 50 HIV non infected individuals. Out of the total 121 study participants 85(70.2%) were females and 36(29.8%) were males with male to female ratio of 0.4:1. It was found that 66(54.5%) of the study participants were carriers of oral Candida species from which 49(74.3%) were HIV positive. Oral Candida carriage rate among HIV infected participants was 49(69%) where as in HIV non infected participants it was 17(34%). Six Candida species were identified; C. albicanswas the predominant Candida species accounted for 53(80.3%), followed by C. parapsilosis 5(7.6%) and three samples revealed with more than one Candida species. Mean colony density of Candida in HIV positive and HIV negative study participants were 2,145.68+3395.12 CFU/ml and 684.71+1941.520 CFU/ml respectively. In conclusion, not only oral Candida carriage but also the density of Candida colony was higher in HIV infected than non infectedpopulations. C. albicans was the predominant species followed by C. parapsilosis.