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Background: The growing number of people on antiretroviral therapy in Kenya has led to a decrease in HIV morbidity and mortality. However, virologic failure (VF) threatens to reverse these gains. In Makueni County, existing data indicate challenges in achieving viral load (VL) suppression among persons living with HIV (PLHIV). Few studies have been carried out investigating VF in the region despite its high incidence of HIV infections. Methods: An analytical cross-sectional study was conducted among PLHIV in Makueni County to investigate the determinants and estimate the prevalence of VF. The prevalence of VF and its associated 95% exact binomial confidence interval was estimated, and a mixed-effects logistic regression model used to evaluate the relationship between the predictors and VF. Results: The estimated period prevalence of VF between October 2018 and June 2019 was 13.2% (95% CI: 12.7%–13.8%). Being 15 years or older (aOR=0.53; 95% CI: 0.44 – 0.645) and having blood samples tested for reasons other than baseline VL measurement was associated with lower odds of VF: breastfeeding mothers (aOR=0.1; 95% CI: 0.01 – 0.97); clinical failure (aOR=0.08; 95% CI: 0.01 – 0.44); confirmation of VF (aOR=0.2; 95% CI: 0.07 – 0.62); no VL data (aOR=0.06; 95% CI: 0.01 – 0.31); routine VL (aOR=0.04; 95% CI: 0.01 – 0.12); drug substitution (aOR=0.03; 95% CI: 0.01 – 0.08). Taking ABC-based, AZT-based, or other non-TDF-Based regimens increased the odds of VF (aOR=1.61; 95% CI: 1.34 – 1.94), (aOR=1.75; 95% CI: 1.52 - 2.01), and (aOR=1.55; 95% CI: 0.99 - 2.44) respectively. Conclusion: This study showed that over 13% of HIV patients on ART in Makueni County had VF between October 2018 and June 2019. The significant risk factors associated with VF were found to be age lower than 15 years, taking a non-TDF-based ART regimen, and blood sampling for baseline VL measurements.

Background: India has the third largest number of people living with HIV/Acquired immunodeficiency syndrome (AIDS). It is important to understand the presentation of HIV disease in the local context and culture. Aims and Objectives: The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/ AIDS patients, opportunistic infections (OI), and the possible risk factors for acquiring HIV infection. Materials and Methods: A descriptive cross-sectional study was conducted on HIV patients from September 2021 to December 2021. The HIV-positive patients of all age groups and all categories were included in the study. However, the clinical staging was done according to the World Health Organization (WHO) classification of HIV/AIDS. Data were expressed as mean and percentage proportion with chi square test for measuring statistically significance. Results: Among 140 HIV patients 88 (62.9%) were males. More than half were 101 (72.1%) in the reproductive age group 18–40 years with mean age 35±11.5 years. The commonest mode of HIV transmission was heterosexual 114 (81.4%). Maximum belonged to social Class IV 51 (36.4%) and Class III 47 (33.6%) of socioeconomic status. Fever 92 (65.7%), weight loss 82 (58.7%), and cough 68 (48.6%) were the common presenting. Pulmonary tuberculosis and diarrhea were the most predominant secondary OI accounting for 46 (32.9%) and 35 (25.0%), respectively. More than half 82 (58.6%) of patients were in the WHO clinical Stage II of HIV disease. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of OI. Conclusion: There was a high frequency of behavioral risk factors, together with unawareness among HIV patients, socio- demographic, and clinical profile of study participants reflects an impact of early case detection and timely institution of highly active antiretroviral therapy.

Introduction: Human immunodeficiency virus (HIV)-related stigmatisation and discrimination adversely affect health outcomes in terms of timely diagnosis, treatment and care. Despite global efforts, they remain common among healthcare workers worldwide. In Malaysia, family medicine specialists are entrusted with the care of HIV patients at the primary care level. This study aimed to assess HIV-related knowledge, acts of discrimination, stigmatising attitudes and their associated factors among family medicine trainees in Malaysia. Methodology: This cross-sectional study was conducted among 397 family medicine trainees in Malaysia using a validated, self-administered questionnaire that assessed the participants’ sociodemographic information, HIV/AIDS knowledge, stigmatising attitudes (attitudes of blame, attitudes towards imposed measures, comfort in dealing with HIV patients) and acts of discrimination. Results: The most common stigmatisation was “attitudes of blame” (mean [SD] score: 3.0 (0.74); range score:1–5), and the most frequent discriminatory act was breaching patient confidentiality (54.9%). Around 82.1% had good knowledge of HIV/AIDS. Married participants and participants who had 7 years or less in service were more stigmatising in “attitudes of imposed measures” towards people living with HIV (p=0.006). Conclusion: Family medicine trainees exhibited stigmatisation and discrimination towards HIV patients despite having good HIV knowledge. Hence, appropriate and concerted health education should be given to all family medicine trainees to eliminate stigmatisation and discrimination.

Background: Since 2020 the World Health Organization (WHO) recommends Histoplasma antigen detection for the diagnosis of disseminated histoplasmosis (DH) in people living with HIV (PLHIV). Objective: Here we aimed to optimise the IMMY's Clarus® Histoplasma GM enzyme immunoassay (EIA), evaluating the best cut‐off in the semi‐quantitative (SQ‐HGM EIA), also known as 'calibrator cut‐off procedure'. Methods: The optimization was done using the quantitative standard procedure (Q‐HGM EIA), also known as 'standard curve procedure', as reference test. A retrospective study from an endemic area of DH in southern Brazil was carried out including 264 patients investigated for DH using the test. Receiver Operator Characteristic curve was plotted, and sensitivity and specificity of the SQ‐HGM EIA were calculated. Results: The study included 24 positive (values ≥ 0.20 ng/ml) and 240 negative patients by the Q‐HGM EIA. According to the manufacturer SQ‐HGM EIA protocol, the new SQ‐HGM EIA cut‐off of 0.8 EIA units was validated, resulting in sensitivity and specificity of 88% and 98.7%, respectively. Conclusion: Our study pioneers and brings important data about the optimization of the Histoplasma antigen testing for the diagnosis of DH in a population from Southern Brazil. This optimization also reduced the amount of reagents used, lowering the cost associated with testing. [ABSTRACT FROM AUTHOR]

Many people living with HIV (PLWH) experience death anxiety and depression, which may impact negatively on their health-related quality of life (HRQoL). Mindfulness is a psychological resource that protects against death anxiety and depression and promotes HRQoL. Although a direct association among these variables exist, little is known about their interactive effect. This study examined the role of PLWH mindfulness in the relationship between (a) death anxiety and HRQoL, and (b) depression and HRQoL. Participants included 311 HIV patients (199 women, 122 men, mean age = 30.52) selected from a tertiary healthcare institution in Nigeria. They completed relevant measures. Results showed that mindfulness moderated the effect of death anxiety on HRQoL. Mindfulness also buffered the effect of depression on HRQoL. Clinical efforts to improve HRQoL of PLWH should consider mindfulness-based training program due to its potentials in mitigating the effects of death anxiety and depression on health and recovery. [ABSTRACT FROM AUTHOR]