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Women's ability to control their fertility and have the number of children they want when they want them is an internationally recognized human right. This right has been the driving force behind family planning programs in low- and middle-income countries for more than five decades. The HIV epidemic added greater urgency to those efforts once the risk of vertical transmission of the virus from mothers to their infants was recognized. In 2013, we published a systematic review of the evidence of effectiveness of family planning counseling for women living with HIV, emphasizing HIV related behaviors. In this updated review, we examined 23 studies, primarily from sub-Saharan Africa. The evidence we uncovered reflected efforts to integrate services provided to women. These showed that providing contraceptive services, including intensified counseling and support, in the HIV clinics where women living with HIV received their care increased the likelihood of subsequent use of modern contraception by as much as fourfold. These studies reflected a greater focus on women's family planning decisions and behaviors and less focus on HIV-related behaviors. Among the possible causes of this noted difference we include the widespread coverage of antiretroviral treatment for HIV. This advance has apparently changed the rationale and the approach to integrating family planning and HIV services in ways that may not have been fully appreciated. The results, however, are beneficial: greater coverage of family planning for women who wish to control their fertility and a more equal partnership between family planning services and HIV services in pursuit of the mutual goal of providing integrated services to meet women's needs. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay. [ABSTRACT FROM AUTHOR]

In their response to HIV, many countries have adopted and enacted policies to reduce transmission and increase HIV-related service use. Theoretically, policy-level interventions for HIV prevention have the potential to improve health behavior outcomes. These policy interventions vary in their scale, from relatively minor changes in clinical policy to major national legal initiatives. Assessing the effectiveness of HIV policy interventions is a challenging undertaking. While many policies exist and guide HIV programmes, relatively few have specifically been evaluated for their effects on reducing HIV risk taking or increasing HIV health-seeking behaviors. Thus, questions on the effectiveness of policy interventions to prevent HIV and change HIV-related risk behaviors remain largely unanswered. To address this current gap in the literature, we systematically reviewed the existing evidence on the effect of HIV policy interventions on changing HIV-related behaviors in low-and middle-income countries. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the effectiveness of behavioral counseling interventions in reducing sexual risk behaviors and HIV/STI prevalence in low- and middle-income countries. A systematic review of papers published between 1990 and 2011 was conducted, identifying studies that utilized either a multi-arm or pre-post design and presented post-intervention data. Standardized methods of searching and data abstraction were used, and 30 studies met inclusion criteria. Results are summarized by intervention groups: (a) people living with HIV; (b) people who use drugs and alcohol; (c) serodiscordant couples; (d) key populations for HIV prevention; and (e) people at low to moderate HIV risk. Evidence for the effectiveness of behavioral counseling was mixed, with more rigorously designed studies often showing modest or no effects. Recommendations about the use of behavioral counseling in developing countries are made based on study results and in light of the field's movement towards combination prevention programs. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effectiveness of HIV voluntary counseling and testing (VCT) in reducing HIV risk behaviors in developing countries was assessed using meta-analytic methods. A standardized protocol was used for searching, acquiring, and extracting study data and meta-analyzing the results. Seven studies met the inclusion criteria. VCT recipients were significantly less likely to engage in unprotected sex when compared to behaviors before receiving VCT, or as compared to participants who had not received VCT [OR 1.69; 95%CI 1.25–2.31]. VCT had no significant effect on the number of sex partners [OR 1.22; 95%CI 0.89–1.67]. While these findings provide only moderate evidence in support of VCT as an effective prevention strategy, neither do they negate the need to expand access to HIV testing and counseling services. Such expansion, however, must be accompanied by rigorous evaluation in order to test, refine and maximize the preventive benefits of learning one’s HIV infection status through HIV testing and counseling. [ABSTRACT FROM AUTHOR]

A population-based probability sample of North and Central Trinidad collected information on 860 respondents' demographic characteristics, as well as the prevalence of sexual risk behaviors and precursors to sexual risk taking in the 2 months preceding interview. Precursors of sexual risk behavior included HIV transmission knowledge, condom possession, and alcohol and drug use prior to sexual intercourse. A 91% response rate was achieved. Overall, approximately 51% of respondents reported unprotected sexual intercourse with a primary sex partner (i.e., spouse or “steady” partner), and 4% reported unprotected sexual intercourse with a nonprimary partner (i.e., casual or commercial partner) during the 2 months prior to interview. Substantial variability on these risk behaviors was noted across demographic strata. Alcohol and drug use prior to intercourse was associated with reports of unprotected intercourse with primary and nonprimary partners. Those who kept condoms at home were less likely to report having unprotected sexual intercourse with both primary and nonprimary partners. The demographic indicators of marital status and respondent gender had indirect (i.e., mediated) effects, through one or more of the risk precursors, on sexual risk behaviors. Implications for the design and targeting of HIV-related interventions and services are discussed. [ABSTRACT FROM AUTHOR]

The objective of this paper is to describe the baseline characteristics, risk behavior, and HIV prevalence of individuals and couples who enrolled in the Voluntary HIV Counseling and Testing Efficacy Study at the study site in Dar es Salaam, Tanzania. Participants were recruited through flyers, radio, and outreach to schools and workplaces to participate in a randomized clinical trial testing the effectiveness of HIV voluntary counseling and testing (HIV VCT) for prevention of new HIV and STD infections. Recruitment was stratified to include men and women enrolling alone and as couples. Baseline data were collected in face-to-face interviews, then participants were randomized to receive HIV VCT or health information. A total of 1,427 participants were recruited, 708 women and 719 men; 444 participants enrolled as part of a couple. HIV seroprevalence for those who received VCT at baseline was 21% overall (12% men, 30% women). Those enrolled as couples reported less sexual risk behavior than those enrolled as individuals. Both couples and individuals reported high rates of unprotected sexual intercourse with commercial partners. Overall 45% of participants self-reported an STD symptom (54% of women and 36% of men), and men were more likely to have received treatment for their symptoms. A large number of individuals and couples responded to advertisements for VCT in Dar es Salaam, Tanzania. High rates of HIV seroprevalence and couple serodiscordance, self-reported STD symptoms, and sexual risk behavior indicate that at-risk participants were recruited. Implications for delivery of HIV VCT and related services are discussed. [ABSTRACT FROM AUTHOR]

This paper describes the recruitment and baseline characteristics of men, women, and couples who enrolled in the Voluntary Counseling and Testing Efficacy Study at the study site in Nairobi, Kenya. The purpose of this study was to test the effectiveness of Voluntary HIV Counseling and Testing (HIV VCT) to reduce sexual risk behavior. Between June 1995 and March 1996, 500 individual men, 500 individual women, and 515 couple members were recruited for a total sample of 1,515 participants. Participants were young (average age 29 years) and of low income. High levels of risk behavior and self-reported STD symptoms and a high rate of HIV seropositivity among those tested at baseline (15% of men and 27% of women) indicate that an at-risk sample was recruited. Women and participants reporting symptoms of a sexually transmitted infected were significantly more likely to be infected with HIV. Findings suggest that HIV VCT services combined with STD diagnosis and treatment and economic development services could motivate more at-risk individuals and couples to receive counseling and testing. [ABSTRACT FROM AUTHOR]

Lithium-induced nephrotic syndrome is a rare complication of lithium therapy and is even rarer in children. Most reported cases have been secondary to minimal change disease, which reverses within 1–4 weeks on discontinuation of lithium therapy. However, focal glomerulosclerosis (FSGS) has occasionally been reported and is not always reversible with discontinuation of lithium. We report an 11-year-old child with lithium-induced FSGS nephrotic syndrome who went into full remission after lithium was discontinued. [ABSTRACT FROM AUTHOR]