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This study explored individual- and county-level risk factors of late presentation with advanced disease (LPAD) among people with HIV (PWH) and their longer delay time from infection to diagnosis in South Carolina (SC), using SC statewide Enhanced HIV/AIDS Reporting System (eHARS). LPAD was defined as having an AIDS diagnosis within three months of initial HIV diagnosis, and delay time from HIV infection to diagnosis was estimated using CD4 depletion model. 3,733 (41.88%) out of 8,913 adult PWH diagnosed from 2005 to 2019 in SC were LPAD, and the median delay time was 13.04 years. Based on the generalized estimating equations models, PWH who were male (adjusted prevalence ratio [aPR]: 1.22, 95% CI: 1.12 ∼ 1.33), aged 55+ (aPR: 1.76, 95% CI: 1.62 ∼ 1.92), were Black (aPR: 1.09, 95% CI: 1.03 ∼ 1.15) or Hispanic (aPR: 1.42, 95% CI: 1.26 ∼ 1.61), and living in counties with a larger proportion of unemployment individuals (aPR: 1.02, 95% CI: 1.01 ∼ 1.03) were more likely to be LPAD. Among PWH who were LPAD, Hispanic (adjusted beta: 1.17, 95% CI: 0.49 ∼ 1.85) instead of Black (adjusted beta: 0.11, 95% CI: -0.30 ∼ 0.52) individuals had significant longer delay time compared to White individuals. Targeted and sustained interventions are needed for older, male, Hispanic or Black individuals and those living in counties with a higher percentage of unemployment because of their higher risk of LPAD. Additionally, specific attention should be paid to Hispanic individuals due to their longer delay time to diagnosis. [ABSTRACT FROM AUTHOR]

Despite the improvements in HIV care outcomes in the United States (US), non-US-born persons continue to be disproportionately affected by HIV. We analyzed National HIV Surveillance System (NHSS) data on HIV diagnoses, stage 3 (AIDS) at diagnosis, linkage to medical care, and viral suppression for non-US-born persons by region of birth (RoB) reported to the (NHSS) in 2020 to determine care outcomes among this population. Overall, a larger proportion of non-US-born persons received a late-stage diagnosis [stage 3 (AIDS)] classification. Among all non-US-born persons, African-born males, Asian-born females, and persons aged 55 + years had the highest proportions of late-stage diagnosis. Despite a late-stage of diagnosis, a higher proportion of non-US-born persons were linked to medical care and were virally suppressed compared to US-born persons. HIV care outcomes varied by RoB and selected characteristics. Knowing the RoB of non-US-born persons is necessary to identify culturally sensitive approaches for prevention planning and increasing testing activities to ultimately increase early diagnosis in this population. [ABSTRACT FROM AUTHOR]

This exploratory study examined sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression (SVS). The study population included 6,489 Miami-Dade Ryan White Program (RWP) clients receiving services during 2017; administrative data was analyzed. SVS was defined as having all viral load tests during 2017 below 200 copies/ml. Multilevel logistic regression models accounted for clustering by medical case management site. Models were stratified by sex. Overall, a higher proportion of females did not achieve SVS (23.5%) than males (18.1%). For females (n = 1,503), having acquired HIV perinatally and not having a partner oradult household member were associated with not achieving SVS. For males (n = 4,986), lacking access to food, Black or Haitian race/ethnicity, problematic substance use, and unknown physician were associated with not achieving SVS. For both sexes, younger age, lower household income, ever having an AIDS diagnosis, feeling depressed or anxious, and experiencing homelessness were associated with not achieving SVS. Elements of the transition from adolescent to adult HIV care that may differentially impact female clients and factors associated with disclosure should be explored further. Male clients may require additional support for food security. Improving culturally specific care for Haitian and non-Hispanic Black male clients should also be explored. [ABSTRACT FROM AUTHOR]

Introduction: In this paper, we analyzed the study of a mathematical model of non-linear differential equation on the effect of HIV/AIDS disease among unaware HIV/AIDS-infected population. Material and methods: Population was divided into four categories, including HIV-negative individuals, unaware HIV-positive cases, aware HIV-positive, and AIDS patients. The model was investigated numerically and analytically using fourth-order Runge-Kutta approach and homotopy perturbation method (HPM). Results: We have discussed the parameter variation graphically. Conclusions: Determining the dynamics of HIV prevalence and investigating the effect of each parameter on the governing equation can be simple with analytical solution. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) has a protean clinical picture, in rare instances manifesting as systemic autoimmune disorders such as vasculitides. HIV-induced autoimmune diseases often do not respond well to systemic immunosuppressive therapy. Opportunistic infections may occur in patients with either acquired immunodeficiency syndrome (AIDS) or heavy immunosuppressive treatment, and can further complicate the clinical presentation. Case presentation: A patient presenting with immunoglobulin A (IgA) vasculitis (IgAV) with treatment-refractory purpuric skin rash and suspect intestinal vasculitis was discovered to have AIDS. HIV was the trigger of IgAV, and cytomegalovirus (CMV) colitis mimicked intestinal vasculitis. Antiretroviral treatment improved both CMV colitis and the control of the autoimmune disease. Conclusions: An autoimmune disease relapsing despite adequate immunosuppressive treatment and/or the presence of recurrent severe opportunistic infections may be clues to an underlying HIV infection. [ABSTRACT FROM AUTHOR]

Introduction: Inflammation and injury within reproductive organs, including artificial vagina, can facilitate human immunodeficiency virus (HIV) transmission. However, HIV infection in a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome has been rarely described. Both MRKH and HIV diagnoses are linked to psychological distress in patients. Case description: We report on a case of a 34-year-old HIV-infected woman with MRKH syndrome. The presented report is the second described case of HIV infection in a woman with MRKH syndrome, the previous one dating back to 1992. Entry of infection were squamous cells, covering the wall of artificial vagina. Acquired immunodeficiency syndrome (AIDS) diagnosis was delayed because symptoms, such as thrombocytopenia, subfebrile illness, cachexia, malaise, and persistent diarrhea were misdiagnosed by physicians. Conclusions: HIV infection is rarely described in women with MRKH syndrome; however, the procedure of artificial vagina can favor sexually transmitted diseases (STD) transmission, including HIV. In any case, a patient with unexplained symptoms or illnesses that may have any connection with HIV infection should be tested for HIV, even in the absence of risk factors. Moreover, these two diagnoses combined can be considered as huge psychological burden for the patient. Receiving information about incurable infertility due to MRKH during young adolescence might cause severe psychological complications. Despite many sources of HIV infection, ways of transmission, and risk factors, HIV patient still can face stigma associated with the infection. Psychological circumstances of HIV infection can include depressive symptoms, feeling of guilt, fear of consequences, and escape from reality. [ABSTRACT FROM AUTHOR]

Background: HIV infection is associated with increased infections. Objectives: To (1) compare patients with sepsis with and without HIV, (2) assess whether HIV is associated with mortality in sepsis, and (3) identify factors associated with mortality in patients with HIV and sepsis. Methods: Patients who met Sepsis-3 criteria were studied. HIV infection was defined as administration of highly active antiretroviral therapy, a diagnosis of AIDS encoded by the International Classification of Diseases, or a positive HIV blood test result. Propensity scores were used to match patients with HIV to similar patients without HIV, and mortality was compared with χ2 tests. Logistic regression was used to determine factors independently associated with mortality. Results: Sepsis developed in 34 673 patients without HIV and 326 patients with HIV. Of these, 323 (99%) patients with HIV were matched to similar patients without HIV. The 30-60- and 90-day mortality was 11%, 15%, and 17%, respectively, in patients with sepsis and HIV, which was similar to the 11% (P >.99), 15% (P >.99), and 16% (P =.83) in patients without HIV. Logistic regression to adjust for confounders showed that obesity (odds ratio, 0.12; 95% CI, 0.03-0.46; P =.002) and high total protein on admission (odds ratio, 0.71; 95% CI, 0.56-0.91; P =.007) were associated with lower mortality. Mechanical ventilation at sepsis onset, renal replacement therapy, positive blood culture, and platelet transfusion were associated with increased mortality. Conclusions: HIV infection was not associated with increased mortality in patients with sepsis. [ABSTRACT FROM AUTHOR]

Background The Russian invasion of Ukraine forced migration for safety, protection, and assistance. Poland is the primary sheltering country for Ukrainian refugees, providing support including medical care, which resulted in the rapid ∼15% increase in the number of followed-up people with human immunodeficiency virus (HIV) (PWH) in the country. Here, we present the national experience on HIV care provided for refugees from Ukraine. Methods Clinical, antiretroviral, immunological, and virologic data from 955 Ukrainian PWH entering care in Poland since February 2022 were analyzed. The dataset included both antiretroviral-treated (n = 851) and newly diagnosed (n = 104) patients. In 76 cases, protease/reverse transcriptase/integrase sequencing was performed to identify drug resistance and subtype. Results Most (70.05%) of the patients were female, with a predominance of heterosexual (70.3%) transmissions. Anti–hepatitis C antibody and hepatitis B antigen were present in 28.7% and 2.9% of the patients, respectively. A history of tuberculosis was reported in 10.1% of cases. Among previously treated patients, the viral suppression rate was 89.6%; 77.3% of newly HIV diagnosed cases were diagnosed late (with lymphocyte CD4 count <350 cells/μL or AIDS). The A6 variant was observed in 89.0% of sequences. Transmitted mutations in the reverse transcriptase were found in 15.4% treatment-naive cases. Two patients with treatment failure exhibited multiclass drug resistance. Conclusions Migration from Ukraine influences the characteristics of HIV epidemics in Europe, with an increase in the proportion of women and hepatitis C coinfected patients. Antiretroviral treatment efficacy among previously treated refugees was high, with new HIV cases frequently diagnosed late. The A6 subtype was the most common variant. [ABSTRACT FROM AUTHOR]

Increased HIV/AIDS testing is of paramount importance in controlling the HIV/AIDS pandemic and subsequently saving lives. Despite progress in HIV/AIDS testing programmes, most people are still reluctant to test and thus are still unaware of their status. Understanding the factors associated with uptake levels of HIV/AIDS self-testing requires knowledge of people's perceptions and attitudes, thus informing evidence-based decision making. Using the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey of 2017 (SABSSM V), this study assessed the efficacy of Generalised Linear Poisson Regression (GLPR) and Geographically Weighted Poisson Regression (GWPR) in modelling the spatial dependence and non-stationary relationships of HIV/AIDS self-testing uptake and covariates. The models were calibrated at the district level across South Africa. Results showed a slightly better performance of GWPR (pseudo R2 = 0.91 and AICc = 390) compared to GLPR (pseudo R2 = 0.88 and AICc = 2552). Estimates of local intercepts derived from GWPR exhibited differences in HIV/AIDS self-testing uptake. Overall, the output of this study displays interesting findings on the levels of spatial heterogeneity of factors associated with HIV/AIDS self-testing uptake across South Africa, which calls for district-specific policies to increase awareness of the need for HIV/AIDS self-testing. [ABSTRACT FROM AUTHOR]

This brief report calls attention to the relationship between substance use and HIV from a global perspective. The epidemiology of substance use disorders among persons living with HIV and AIDS (PLWHA) is discussed along with specific caveats in the assessment of these disorders. Important macro-interventions include needle and syringe exchange programs (NSEP) and medication assisted therapy (MAT). Yet, structural interventions such as social welfare, child protection and support services for survivors of violence and abuse are necessary to reduce HIV incidence and enhance engagement in care among those living with HIV. To this extent health systems strengthening is necessary, as is integrating services provided by health and social development departments. [ABSTRACT FROM AUTHOR]

The United Nations Joint Programme on HIV/AIDS (UNAIDS) has set ambitious treatment targets known as Project 95-95-95, aiming to achieve 95% of people living with HIV knowing their status, 95% of diagnosed individuals on antiretroviral therapy (ART), and 95% of those on ART achieving viral suppression by 2025. Through a comprehensive analysis of Ghana's HIV/AIDS response, we evaluate the feasibility of Ghana's efforts in realising these targets. The discussion explores Ghana's achievements in HIV testing and diagnosis, ART coverage, and viral suppression rates, as well as challenges related to stigma, limited access to healthcare services, funding constraints, and data quality. Strategies such as strengthening prevention efforts, expanding access to ART, addressing stigma, and enhancing health systems are discussed as the way forward to advance Ghana's progress towards the UNAIDS 95-95-95 treatment targets. While Ghana has made significant strides in its HIV/AIDS response, achieving the 95-95-95 targets is a challenging yet realistic goal. [ABSTRACT FROM AUTHOR]

Home diagnostic testing is becoming part of the modern medical landscape, but many ethical and policy questions remain unresolved. Most of them first surfaced during the long regulatory deliberations over the home HIV test, the first home test for a contagious illness sold in the United States. Between 1989 and 2012, federal regulators and their consultants debated the ideal metrics for such a test, its benefits, and its potential harms for both individuals and communities. Ultimately, two iterations of the home HIV test were marketed in the United States; neither one of them changed the course of the national HIV epidemic, as hoped. This failure has powerful implications for home testing for other contagious diseases. [ABSTRACT FROM AUTHOR]

Background: Acquired immunodeficiency syndrome (AIDS) is an acquired defect of the cellular immunity associated with the infection by the human immunodeficiency virus (HIV). The disease has reached pandemic proportion and has been considered a public health concern. This study is aimed at analyzing the trend of HIV/AIDS research in Nigeria. Method: We used the PUBMED database to a conduct bibliometric analysis of HIV/AIDS-related research in Nigeria from 1986 to 2021 employing "HIV", "AIDS", "acquired immunodeficiency syndrome", "Human immunodeficiency virus", and "Nigeria" as search description. The most common bibliometric indicators were applied for the selected publications. Result: The number of scientific research articles retrieved for HIV/AIDS-related research in Nigeria was 2796. Original research was the predominant article type. Articles authored by 4 authors consisted majority of the papers. The University of Ibadan was found to be the most productive institution. Institutions in the United States dominated external production with the University of Maryland at the top. The most utilized journal was PLoS ONE. While Iliyasu Z. was the most productive principal author, Crowel TA. was the overall most productive author with the highest collaborative strength. The keyword analysis using overlay visualization showed a gradual shift from disease characteristics to diagnosis, treatment and prevention. Trend in HIV/AIDS research in Nigeria is increasing yet evolving. Four articles were retracted while two had an expression of concern. Conclusion: The growth of scientific literature in HIV/AIDS-related research in Nigeria was found to be high and increasing. However, the hotspot analysis still shows more unexplored grey areas in future. [ABSTRACT FROM AUTHOR]

Objectives: In Canada, HIV diagnoses continue unabated, with many of these cases being identified at a late stage of infection. While current public health surveillance data does not capture timing of diagnoses, locally, we identified a number of patients concurrently diagnosed with AIDS and HIV. Design: To understand the key characteristics, presenting symptoms, and risk factors associated with an AIDS diagnosis, we undertook a prospective chart review of HIV and AIDS diagnoses in Ottawa, Canada. Sample: Sixty seven charts of persons diagnosed with HIV and AIDS between 2015 and 2021 were reviewed. Measurements: Data were analyzed using descriptive statistics. Results: Results show some inconsistencies regarding HIV risk factors identified in published literature compared to those for persons diagnosed with AIDS in this study. Namely, patients in this review were more likely to be male, Black (from HIV-endemic regions), and heterosexual, and were diagnosed at critical stage in infection (total average CD4+ count of 92.9 cells/mm³) with 44.8% of patients concurrently diagnosed with one or more AIDS-related opportunistic infections. Conclusions: The findings can be applied to strengthen HIV screening efforts in primary care settings, particularly among patients who present with persistent symptoms or illnesses related to chronic HIV infection. Additional considerations should be made for public health nurses to provide counseling and linkage to HIV testing/prevention services for patients at the time of an STI or Tuberculosis diagnosis and to increase AIDS-specific data collection. [ABSTRACT FROM AUTHOR]

Polypharmacy in people living with HIV/AIDS (PLWHA) is a rising morbidity that exacts hefty economic burden on health budgets in addition to other adverse clinical outcomes. Despite recent advances, uncertainty remains around its exact definition in PLWHA. In this systematic review and Meta-analysis, we explored relevant databases (PUBMED, EMBASE, CROI) for studies evaluating polypharmacy in PLWHA from January 2000 to August 2021 to ascertain the exact numerical threshold that defines this morbidity. Two independent reviewers extracted and reviewed relevant variables for analyses. The review included a total of 31 studies involving n = 53,347 participants with a mean age of 49.5 (SD ± 17.0) years. There was a total of 36 definitions, with 93.5% defining polypharmacy as the concomitant use of 5 or more medications. We found significant variation in the numerical definition of polypharmacy, with studies reporting it as "minor" (N = 3); "major" (N = 29); "severe" (N = 2); "excessive" (N = 1); and "higher" (N = 1). Most studies did not incorporate a duration (84%) in their definition and excluded ART medications (67.7%). A plurality of studies in PLWHA have established that polypharmacy in this cohort of patients is the intake of ≥ 5 medications (including both ART and non-ART). To standardize the approach to addressing this rising morbidity, we recommend incorporation of this definition into national and international PLWHA treatment guidelines. [ABSTRACT FROM AUTHOR]

A woman in her 30s presented with vertigo, nausea and vomiting followed by diplopia and cerebellar signs. This was on the background of a complex previous medical history of autoimmune diseases and recurrent infections. The differential diagnoses of multiple sclerosis, neuromyelitis optica, sarcoidosis and multiple vasculitides are considered. We discuss a rare condition that can present to adult neurologists with neurological involvement. This case was presented at the Association of British Neurologists Virtual Meeting 2021 as a Clinicopathological Conference. [ABSTRACT FROM AUTHOR]

Pediatric HIV remains a significant global concern, with 160,000 new infections annually. Accelerating Children's HIV/AIDS Treatment (ACT) provided a strategic response to the "treatment gap" for children. We examined whether activities under ACT increased testing and identification of youth living with HIV (YLWH). Family AIDS Care & Education Services implemented ACT across 130 health facilities in western Kenya between October 2015 and September 2016, providing: HIV-testing counselors and space; training on the Family Information Table (FIT) and chart audits; community outreach testing; and text message reminders for pregnant women. We analyzed the number of youths tested and identified with HIV over time and between intervention and control sites using interrupted time series analysis. We tested 268,312 youths (7,183 infants <18 months; 145,833 children 18 months to 9 years; and 115,296 adolescents 10–14 years). Mean monthly number tested per health facility increased from 2.8 to 7.2 (p < 0.0001) in infants, 44.8–142.0 (p < 0.0001) in children, and 30.1–123.3 (p < 0.0001) in adolescents. Mean monthly number identified with HIV per facility increased from 0.06 to 0.37 (p < 0.0001) in infants; 0.34–0.62 (p = 0.008) in children; and 0.17–0.26 (p = 0.04) in adolescents, resulting in 1,328 diagnoses. Among infants, FIT training was associated with increased HIV testing over time, incidence rate ratio (IRR) = 3.85 (95% confidence interval [CI] 2.16-6.84; p < 0.0001). Text messaging increased testing, IRR = 2.10 (95% CI 1.57-2.80; p < 0.0001) and identification of HIV in infants, IRR = 1.83 (95% CI 1.06-3.18; p = 0.0381) and older children, IRR = 2.25 (95% CI 1.62, 3.13; p < 0.0001). Chart audits increased testing over time among adolescents (IRR = 2.11; 95% CI 1.21-3.66; p = 0.0082). Outreach was associated with identification of adolescents with HIV, IRR = 1.58 (95% CI 1.22-2.06; p = 0.0005). In lower-income settings, targeted interventions effective at reaching YLWH can help optimize resource allocation to address gaps in testing and identification to further reduce HIV-related morbidity and mortality. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem 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 Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem 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 aim of this article was to evaluate the correlation between the number of voluntary human immunodeficiency virus (HIV) tests conducted and public awareness according to Internet search volumes from Google Trends. We used bivariate correlations to assess the relationship between the Internet search frequency for each term of HIV and acquired immunodeficiency syndrome (AIDS) and the number of HIV tests, by time series and prefecture. We observed positive correlations between search frequencies of the terms HIV and AIDS and the number of HIV tests in both time-series analysis (HIV: r = 0.65, P <.001; AIDS: r = 0.73, P <.001) and analysis by prefecture (HIV: r = 0.71, P <.001; AIDS: r = 0.40, P =.001). The findings of this study indicate that the current stagnant number of HIV tests conducted in Japan reflects declining public awareness regarding HIV. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to assess validity and reliability of Persian version of quality of life (QOL) questionnaire in people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (WHOQOL-HIV-BREF). Material and methods: A total of 150 HIV/AIDS patients who were referred to Fasa and Larestan Behavioral Disease Counseling Centers were recruited into the study. WHOQOL-HIV-BREF questionnaire was completed by trained interviewers. Reliability of questionnaire was measured using Cronbach's a coefficient. Construct validity was assessed by item-scale correlation method, and criterion validity was determined with discriminant validity and convergent validity. Results: Cronbach's a was computed above 0.8 for all dimensions of the questionnaire. Item-convergent validity ranged from 0.38 to 0.83. QOL score was higher in AIDS patients compared with HIV-infected individuals in all dimensions (p < 0.01). Conclusions: The findings of this study show that WHOQOL-HIV-BREF questionnaire provide acceptable validity and reliability for measuring QOL among Persian-speaking HIV/AIDS-infected patients in Iran. [ABSTRACT FROM AUTHOR]

Candida glabrata is a yeast of increasing medical relevance, particularly in critically ill patients. It is the second most isolated Candida species associated with invasive candidiasis (IC) behind C. albicans. The attributed higher incidence is primarily due to an increase in the acquired immunodeficiency syndrome (AIDS) population, cancer, and diabetic patients. The elderly population and the frequent use of indwelling medical devices are also predisposing factors. This work aimed to review various virulence factors that facilitate the survival of pathogenic C. glabrata in IC. The available published research articles related to the pathogenicity of C. glabrata were retrieved and reviewed from four credible databases, mainly Google Scholar, ScienceDirect, PubMed, and Scopus. The articles highlighted many virulence factors associated with pathogenicity in C. glabrata, including adherence to susceptible host surfaces, evading host defences, replicative ageing, and producing hydrolytic enzymes (e.g., phospholipases, proteases, and haemolysins). The factors facilitate infection initiation. Other virulent factors include iron regulation and genetic mutations. Accordingly, biofilm production, tolerance to high-stress environments, resistance to neutrophil killings, and development of resistance to antifungal drugs, notably to fluconazole and other azole derivatives, were reported. The review provided evident pathogenic mechanisms and antifungal resistance associated with C. glabrata in ensuring its sustenance and survival. [ABSTRACT FROM AUTHOR]

Thrombotic thrombocytopenic purpura (TTP) is a medical emergency that demands prompt diagnosis to allow lifesaving treatment: plasmapheresis. TTP during pregnancy is rare, with estimated prevalence of 1/200 000, and even rarer in association with acquired immunodeficiency syndrome, with only two cases reported. Differential diagnosis includes HELLP syndrome (hemolysis elevated liver enzymes and low platelets), sepsis, intravascular‐disseminated coagulation, and acquired autoimmune diseases, each one with its unique treatment and prognosis. A case of a pregnant woman at 26th week with sudden onset of left hand paresthesia and purpura is reported. PLASMIC score showed high risk for ADAMTS‐13 deficiency and diagnosis of TTP was made. Human immunodeficiency virus screening test was positive on admission. Plasmapheresis and antiretroviral therapy were initiated and the delivery of a healthy newborn at full‐term gestation was achieved, unlike other cases in literature. No obstetric complications were observed and the follow‐up shows no signs of disease recurrence. [ABSTRACT FROM AUTHOR]

Objectives: Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016–2017. Methods: Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti‐hepatitis C virus (anti‐HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. Results: Out of 1522 patients, 88.9% were male with median age of 33.6 years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09–2.08], older age (OR = 1.59, 95% CI: 1.42–1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50–2.56; IDU: OR = 3.17, 95% CI: 1.92–5.37), positive HCV results (OR = 1.90, 95% CI: 1.23–2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29–3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35–1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23–2.44; IDU: OR = 2.24, 95% CI: 1.25–4.10). Conclusions: Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care. [ABSTRACT FROM AUTHOR]

In this work, we use 2011–2013 Texas HIV surveillance data (N=2,175) and apply hierarchical linear and Cox regression modeling to characterize the association of gender and race/ethnicity with rate of immune recovery and determine whether immune recovery contributes to gender and racial/ethnic disparities in AIDS diagnosis and survival. The associations between gender and rate of immune recovery and between race/ethnicity and rate of immune recovery were not statistically significant (p > 0.05). In the multivariate survival analyses, there was no statistically significant association between gender and AIDS diagnosis (Adjusted Hazard Ratio (AHR) = 1.06, p = 0.61, 95%=0.85–1.32) and between race/ethnicity and AIDS diagnosis (Blacks vs Whites: AHR = 1.10, p = 0.24, 95% CI = 0.94–1.30; Hispanics vs Whites: AHR = 1.06, p = 0.46, 95% CI = 0.91–1.24). Similarly, there were no statistically significant associations with death (males vs females: AHR = 0.88, p = 0.73, 95% CI = 0.43–1.81; Blacks vs Whites: AHR = 0.68 p = 0.25, 95% CI = 0.36–1.30; Hispanics vs Whites: AHR = 0.96, p = 0.88, 95% CI = 0.55–1.67). However, the direction of the point estimates were in the reverse direction when compared to the rate of immune recovery or the AIDS diagnosis models. Our findings suggest that differences in rate of immune recovery may better explain disparities in AIDS diagnosis than disparities in survival. Future studies with longer follow-up may potentially generate statistically significant results. [ABSTRACT FROM AUTHOR]

The author discusses a report on the appearances of flip-flop and candle guttering neurosyphilis from a magnetic resonance imaging (MRI)of a human immunodeficiency virus (HIV) positive young with longitudinally extensive transverse myelitis (LETM). Topics covered include the MRI signs' non-sensitivity and non-specificity, and the clinical runouts that may result in blindly depending on these oxymorons. Also noted is the need to proceed with caution.

Background: The ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Côte d'Ivoire, Mali, and Senegal. During 2019-2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST. Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners. The ATLAS programme includes research support implementation to generate evidence for HIVST scale-up in West Africa. The main objective is to describe, analyse and understand the social, health, epidemiological effects and cost-effectiveness of HIVST introduction in Côte d'Ivoire, Mali and Senegal to improve the overall HIV testing strategy (accessibility, efficacy, ethics).Methods: ATLAS research is organised into five multidisciplinary workpackages (WPs): Key Populations WP: qualitative surveys (individual in-depth interviews, focus group discussions) conducted with key actors, key populations, and HIVST users. Index testing WP: ethnographic observation of three HIV care services introducing HIVST for partner testing. Coupons survey WP: an anonymous telephone survey of HIVST users. Cost study WP: incremental economic cost analysis of each delivery model using a top-down costing with programmatic data, complemented by a bottom-up costing of a representative sample of HIVST distribution sites, and a time-motion study for health professionals providing HIVST. Modelling WP: Adaptation, parameterisation and calibration of a dynamic compartmental model that considers the varied populations targeted by the ATLAS programme and the different testing modalities and strategies.Discussion: ATLAS is the first comprehensive study on HIV self-testing in West Africa. The ATLAS programme focuses particularly on the secondary distribution of HIVST. This protocol was approved by three national ethic committees and the WHO's Ethical Research Committee. [ABSTRACT FROM AUTHOR]

Copyright of Sanamed is the property of Sanamed 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.)

Adherence to ART is the primary determinant of viral suppression. Adherence of at least 95% is needed for optimal suppression. One of relationship with HAART is meaning in life. This study aimed at assessment meaning in life and adherence antiretroviral therapy before intervention about METART book. This method use descriptive statistic analysis to explain social demographic, meaning in life, and adherence antiretroviral therapy. The Result: Characteristics gender people new living with HIV/AIDS this study is 75,6% is Male with 38,5% homosexual. The age range of respondents is in the adult (65,4%). Single merital status is 74.4%. The total respondent with ARV medication is 30.8% under one year. 74.4% has meaningful life but 65,4% respondent has lack adherence ARV. Conclusion: This research get data pre intervention METART modul about demographic, meaning in life, and adherence ARV. [ABSTRACT FROM AUTHOR]

Chronically ill persons with a condition requiring self-care activities can benefit from learning from reliable internet sources. Orem's theory of self-care was used to answer the question: Does increasing technical knowledge about reliable internet sites for health information increase self-care agency of low-income persons living with HIV/AIDS (N = 100)? Self-care agency, as measured by the Self-As-Carer Inventory, increased but not significantly, after two educational interventions. We hoped to gain insight into the measurement of self-care agency in our African American and Hispanic population. The only significantly different basic conditioning factor was ethnicity in that non-Hispanic/Latinos scored higher on self-care agency than Hispanic/Latinos; the only significantly different subscale was the Judgment and Decisions Affecting Production of Self-care subscale. Self-care agency remained stable over the 1-week period, pointing to two possible conclusions: Scores accurately reflect self-care agency, and a more intensive, longer intervention may be needed to change self-care agency. [ABSTRACT FROM AUTHOR]

Midwives are expected to meet the demands of their ever-expanding roles without having a voice to contribute to the decision-making process in developing the protocols to be followed in implementing HIV/AIDS testing and counselling. The aim of the current study was to describe nurse managers' support to midwives in implementing HIV/AIDS testing and counselling within protocol at an antenatal clinic located in the Central Region of Cape Town, Western Cape, South Africa. The study followed a qualitative design to gain insight into midwives' experiences in implementing HIV/AIDS testing and counselling at an antenatal clinic and how nurse managers support midwives in this regard. In-depth individual interviews were conducted with eight (n = 8) purposively sampled professional midwives to understand the implementation of HIV/AIDS testing and counselling within protocol from the midwives' perspectives and field notes were taken. All the interviews were digitally recorded, transcribed verbatim and coded using the thematic approach. The study findings indicated that ongoing education, coaching and mentoring, and constructive feedback are all necessary support mechanisms for midwives to implement HIV/AIDS counselling for better client care outcomes. It was recommended that nurse managers should intensify their efforts in an antenatal clinic, supporting midwives with practice relevant information on HIV, to address the needs of pregnant women and the larger community. Well-informed competent midwives are needed to apply the latest protocols and trends in midwifery practices that will uplift the health status of pregnant women in the community. [ABSTRACT FROM AUTHOR]

Care of patients with human immunodeficiency virus (HIV) infection in the intensive care unit (ICU) has changed dramatically since the infection was first recognized in the United States in 1981. The purpose of this review is to describe the current important aspects of care of patients with HIV infection in the ICU, with a primary focus on the United States and developed countries. The epidemiology and initial approach to diagnosis and treatment of HIV (including the newest antiretroviral guidelines), common syndromes and their management in the ICU, and typical comorbidities and opportunistic infections of patients with HIV infection are discussed. [ABSTRACT FROM AUTHOR]

Depressive disorders and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) are associated with major socioeconomic burdens. The negative impact of depressive disorders onHIV/AIDS iswell known, including on treatment outcomes. Unfortunately, depressive disorders are underdiagnosed and undertreated in seropositive persons. This review summarizes clinically useful information on depressive disorders in HIV/AIDS. More specifically, we address assessment, differential diagnosis, contributing factors, management, and common challenges in the treatment of depressive disorders in seropositive individuals. Assessment and diagnosis of depression may be challenging in seropositive persons because of several biopsychosocial particularities associated with HIV/AIDS. One of the difficulties is the overlap between depression and HIV/AIDS symptoms, particularly in individuals with advanced AIDS, requiring consideration of a broad differential diagnosis. Several factors related to HIV/AIDS status contribute to the higher rates of depressive disorders, including infectiousimmunological, psychosocial, and exogenous factors. The treatment of depressive disorders in HIV/AIDS involves three groups of interventions: (1) pharmacological interventions, (2) psychotherapeutic interventions, and (3) management of other contributing factors. Challenges in management include poor adherence to treatment and the risk of suicide. We provide evidence-based recommendations to improve assessment and management of depressive disorders in seropositive persons. [ABSTRACT FROM AUTHOR]

HIV transmission is ongoing, primarily among men who have sex with men, injection drug users, and persons from HIV endemic regions. One prevention strategy has been prompt HIV diagnosis. Undermining these efforts is that some persons are diagnosed with HIV late in their infection because practitioners missed the diagnosis. In this article, the authors review the epidemiology and pathophysiology of HIV/AIDS, and provide a recommended clinical approach: (1) continue to screen persons who belong to the groups that are at-risk for HIV, and (2) appropriately rule out HIV infection in persons who present with HIV and AIDS-like symptoms. [ABSTRACT FROM AUTHOR]

Background: Weight gain after initiation of combination antiretroviral therapy (cART) is a possible side effect of all antiretroviral regimens, but it seems to be more evident in association with integrase strand transfer inhibitors (INSTIs). So, we aimed to evaluate weight change associated with an initial cART including one INSTI or darunavir–ritonavir (DRV/r). Methods: A retrospective, observational, cohort study of antiretroviral therapy-naive adult HIV-positive patients starting an initial cART including raltegravir (RAL), dolutegravir (DTG), elvitegravir–cobicistat (EVG), or DRV/r. We compared changes in weight and body mass index (BMI) across the four groups during a 12-month follow-up. Results: As a whole, 680 patients (470 males, mean age 42.1 years) were enrolled: 196 starting RAL, 174 DTG, 158 EVG/c, and 152 DRV/r. Baseline mean CD4 lymphocyte count was 455 cells/mm3 and 7.3% had an AIDS diagnosis. After 12 months, mean increase in body weight was 1.93 kg in the RAL group, 2.38 kg in the DTG group, 2.14 kg in the EVG group, and 1.85 in the DRV/r group. Mean increase in BMI was 0.71, 0.84, 0.77 and 0.63 kg/m2, respectively (p > 0.05 for each comparison). Therefore, no significant increases in weight and BMI were reported in each group, and no significant differences in weight and BMI changes were described across the four treatment groups. Conclusions: In our study, patients starting an initial cART including one INSTI or DRV/r after 12 months showed a small and comparable, but not significant, increase in body weight, whose long-term clinical consequences are unknown. [ABSTRACT FROM AUTHOR]

Background Existing data on the clinical features and outcomes of immunocompromised children with influenza are limited. Methods Data from the 2011–2012 through 2014–2015 influenza seasons were collected as part of the Centers for Disease Control and Prevention (CDC) Influenza Hospitalization Surveillance Network (FluSurv-NET). We compared clinical features and outcomes between immunocompromised and nonimmunocompromised children (<18 years old) hospitalized with laboratory-confirmed community-acquired influenza. Immunocompromised children were defined as those for whom ≥1 of the following applies: human immunodeficiency virus/acquired immunodeficiency syndrome, cancer, stem cell or solid organ transplantation, nonsteroidal immunosuppressive therapy, immunoglobulin deficiency, complement deficiency, asplenia, and/or another rare condition. The primary outcomes were intensive care admission, duration of hospitalization, and in-hospital death. Results Among 5262 hospitalized children, 242 (4.6%) were immunocompromised; receipt of nonsteroidal immunosuppressive therapy (60%), cancer (39%), and solid organ transplantation (14%) were most common. Immunocompromised children were older than the nonimmunocompromised children (median, 8.8 vs 2.8 years, respectively; P <.001), more likely to have another comorbidity (58% vs 49%, respectively; P =.007), and more likely to have received an influenza vaccination (58% vs 39%, respectively; P <.001) and early antiviral treatment (35% vs 27%, respectively; P =.013). In multivariable analyses, immunocompromised children were less likely to receive intensive care (adjusted odds ratio [95% confidence interval], 0.31 [0.20–0.49]) and had a slightly longer duration of hospitalization (adjusted hazard ratio of hospital discharge [95% confidence interval], 0.89 [0.80–0.99]). Death was uncommon in both groups. Conclusions Immunocompromised children hospitalized with influenza received intensive care less frequently but had a longer hospitalization duration than nonimmunocompromised children. Vaccination and early antiviral use could be improved substantially. Data are needed to determine whether immunocompromised children are more commonly admitted with milder influenza severity than are nonimmunocompromised children. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 10‑year‑old previously normal boy presented with a history of horizontal double vision on looking toward right since one month. It mentions diagnosis of Progressive multifocal leukoencephalopathy (PML), a rare demyelinating disorder of central nervous system caused by reactivation of JC polyomavirus in immune‑suppressed states.

In the article, the authors present a case of a 4-month-old boy who was rushed to a hospital due to sepsis-like episode with persistent high spiking fever and swelling of four fingers to discuss sideroblastic anaemia, immunodeficiency, periodic fevers and developmental delay (SIFD) presenting as systemic inflammation with arthritis. He was treated with etanercept and colchicine.

The analysis of urinary nucleosides is becoming a very good tool in the diagnosis of diseases like AIDS and cancer and consequently the identification of modified nucleosides using mass spectrometry is an area of utmost importance. In this context, there is a high relevance in the understanding of the mechanism of collisionally induced dissociation (CID) of these heterocyclics. The present work characterizes and differentiates the cross-linked products formed by one electron oxidation of thymine (T). Three dimers A, B and C, were analyzed, out of which the dimer A is a C5–C5' cross link of two T molecules containing a fused tetrahydrofuran ring, while B and C are N–C cross linked products. B and C showed very similar fragmentation pattern but that of A was different. The differentiation between these three were made by monitoring two characteristic peaks, the water loss peak ([M+H]+) and the protonated T fragment ([T + H]+). The probable mechanism of formation of these fragments and their CID mechanism in both positive and negative ionization modes are also explained. The neutral losses of NH 3 , H 2 O and NHCO were the prominent mechanism in the positive mode, while in the negative mode, only NHCO and CO losses were observed. Image 1 • Formation of hydrated thymine cross-links by reaction with SO 4.●- • Characterization of hydrated thymine cross-links by ESI-CID. • Characterization in positive and negative modes. • Differentiation of three isomeric cross-links. • Comparison with ESI-CID of other reported dimers. [ABSTRACT FROM AUTHOR]

Middle-aged and older adults with HIV experience double discrimination and cognitive impairment due to both their HIV status and their age. However, the relationship between perceived discrimination and self-reported cognitive ability in middle-aged and older people living with HIV (PLWH) is less clear. We measured self-reported perceived discrimination and cognitive ability using the Expanded Everyday Discrimination Scale and the subscale of the AIDS Health Assessment Questionnaire (AIDS-HAQ). The study sample included 324 middle-aged and older PLWH (over 45 years old) from five designated HIV hospitals in three regions (east coast, middle, and southwest regions) of China. The descriptive analysis showed that 45.37% of the participants reported perceiving discrimination at least once in the past twelve months, and 47.22% reported having at least one type of cognitive impairment. Multiple linear regression results showed that higher levels of perceived discrimination (β = −0.121, P = 0.036) were significantly associated with lower levels of self-reported cognitive ability after controlling for several covariates, including sociodemographic variables, mental health status, health behaviors, and social support. A longer duration of HIV was also related to a lower level of self-reported cognitive ability. Our findings indicate that perceived discrimination is related to self-reported cognitive ability and suggest that counseling services and support systems should be developed to reduce age- and disease-associated discrimination. A reduction in perceived discrimination would improve not only overall wellbeing but also cognitive ability in later life. [ABSTRACT FROM AUTHOR]

Introduction: men who have sex with other men (MSM) suffer discrimination, which leads to HIV/AIDS risky sexual behavior. Objective: To examine the evidence available on the relationship between social discrimination and risky sexual behavior of adult Latin American MSM with and without a diagnosis of HIV/AIDS. Methodology: a systematic review was carried out following the PRISMA guidelines. The inclusion criteria were complete text research articles written in English and Spanish, with no restriction on the date of publication. Search chains were constructed. The articles were analyzed with what established in the HCPRDU assessment tool for quantitative studies. Results: twelve studies published between 2000 and 2014 were included. The evidence suggests that the participants with and without a diagnosis of HIV/AIDS suffer some type of discrimination related to unprotected anal intercourse. Conclusions: the results evidence the lack of explanatory models that may improve the course of professional care practice. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to better explore the association between liver fibrosis (LF) and neurocognitive impairment (NCI) in people living with HIV (PLWH). Methods: We performed a cross-sectional cohort study by consecutively enrolling PLWH at two clinical centers. All subjects underwent a comprehensive neuropsychological battery; NCI was defined as having a pathological performance (1.5 SD below the normative mean) on at least two cognitive domains. LF was explored using FIB4 index; in a subgroup of PLWH, LF was also assessed by transient elastography. Results: A total of 386 subjects were enrolled, of whom 17 (4.4%) had FIB4 > 3.25. In the subgroup of PLWH (N = 127) performing also liver transient elastography, 14 (11%) had liver stiffness > 14 kPa. Overall, 47 subjects (12%) were diagnosed with NCI. At multivariate regression analyses, participants with FIB4 > 1.45 showed a higher risk of NCI in comparison with those with lower values (aOR 3.04, p = 0.044), after adjusting for education (aOR 0.71, p < 0.001), past AIDS-defining events (aOR 2.91, p = 0.014), CD4 cell count, past injecting drug use (IDU), HIV-RNA < 50 copies/mL, and HCV co-infection. Also a liver stiffness > 14 kPa showed an independent association with a higher risk of NCI (aOR 10.13, p = 0.041). Analyzing any single cognitive domain, a higher risk of abnormal psychomotor speed was associated with a liver stiffness > 14 kPa (aOR 223.17, p = 0.019) after adjusting for education (aOR 0.57, p = 0.018), HIV-RNA < 50 copies/mL (aOR 0.01, p = 0.007), age, past IDU, and HCV co-infection. Conclusions: In PLWH, increased LF, estimated through non-invasive methods, was associated to a higher risk of NCI independently from HCV status. [ABSTRACT FROM AUTHOR]

HIV/AIDS is associated with significant morbidity, mortality, and financial burden. For these reasons, robust clinical evidence is critical. We aim to investigate the fragility index, fragility quotient, and risk of bias of clinical trial endpoints in HIV medicine. The fragility index represents the minimum amount of trial endpoint "nonevents" changed to "events" in one trial arm required to nullify statistical significance. The fragility quotient contextualized the fragility index by dividing the index by the total trial sample size. We selected eligible trials from the Department of Health and Human Services guideline for the use of antiretroviral agents in HIV-1-infected adults and adolescents. We calculated the fragility index and fragility quotient for all included trials. The Cochrane "risk of bias" Tool 2.0 was used to evaluate the likelihood and sources of bias in the included trials. Thirty-nine RCTs were included for our analysis of fragility. Thirty-six were included for our analysis of the risk of bias. The median fragility index was 5. Three RCTs were at high risk of bias, all due to the selection of the endpoint or statistical test. Twenty had some concerns for risk of bias. The analyzed HIV medicine RCT endpoints were fragile, overall. This indicates that a median of 5 patients across all included studies would nullify the statistical significance of the endpoints. Furthermore, we found evidence that concerns for bias are present at a high rate. [ABSTRACT FROM AUTHOR]

In most HIV-positive individuals, infection time is only known to lie between the time an individual started being at risk for HIV and diagnosis time. However, a more accurate estimate of infection time is very important in certain cases. For example, one of the objectives of the Advancing Migrant Access to Health Services in Europe (aMASE) study was to determine if HIV-positive migrants, diagnosed in Europe, were infected pre- or post-migration. We propose a method to derive subject-specific estimates of unknown infection times using information from HIV biomarkers' measurements, demographic, clinical, and behavioral data. We assume that CD4 cell count (CD4) and HIV-RNA viral load trends after HIV infection follow a bivariate linear mixed model. Using post-diagnosis CD4 and viral load measurements and applying the Bayes' rule, we derived the posterior distribution of the HIV infection time, whereas the prior distribution was informed by AIDS status at diagnosis and behavioral data. Parameters of the CD4-viral load and time-to-AIDS models were estimated using data from a large study of individuals with known HIV infection times (CASCADE). Simulations showed substantial predictive ability (e.g. 84% of the infections were correctly classified as pre- or post-migration). Application to the aMASE study (n = 2009) showed that 47% of African migrants and 67% to 72% of migrants from other regions were most likely infected post-migration. Applying a Bayesian method based on bivariate modeling of CD4 and viral load, and subject-specific information, we found that the majority of HIV-positive migrants in aMASE were most likely infected after their migration to Europe. [ABSTRACT FROM AUTHOR]

Perceived social support, coping strategy, and internalized stigma have been linked with the quality of life (QOL) among people living with HIV (PLHIV). However, little is known about how these psychosocial factors interact with each other and affect QOL. This study incorporated a moderated mediation model to investigate whether coping strategy mediates the relationship between perceived social support and QOL, and to examine whether this mediating effect varies with the level of internalized stigma among PLHIV. A cross-sectional study was conducted among 599 PLHIV in Nepal. The multidimensional scale of perceived social support, World Health Organization Quality of Life-BREF, Brief COPE, and AIDS-related stigma scales were used to measure perceived social support, QOL, coping strategy, and internalized stigma, respectively. Data were analyzed using structural equation modeling, and moderated mediation analysis was conducted with multi-group approach. The relationship between perceived social support and QOL was significantly and partially mediated by problem-focused coping strategy. Internalized stigma significantly moderated the mediating effect of coping strategies on the association between perceived social support and QOL. For high internalized stigma group (total stigma score > 2), the effects of perceived social support on QOL were indirect (β = 1.48; 61.0% of total effects) through the mediating effect of coping strategy, especially problem-focused coping one. For low internalized stigma group (total stigma score ≤ 2), problem-focused coping strategy did not significantly affect the QOL, and most of the effects of perceived social support were direct (β = 1.24; 99.2% of total effects). Internalized stigma was found to moderate the mediating effect of problem-focused coping on the relationship between perceived social support and QOL. Enhancing the problem-focused coping and social support may be helpful to improve QOL among PLHIV reporting high stigma. [ABSTRACT FROM AUTHOR]

HIV infection, acquired with the conscious participation of the recipient, is a complex problem of international concern, especially among men who have sex with men. Behaviors emerge such as bareback (intentionally unprotected anal sex between men) and bugchasing (bareback sex when one participant is HIV+ and the other is not). A group of emerging risk behaviors for HIV infection was characterized. A review of the literature in the MEDLINE, Web of Science and regional SciELO databases was performed. HIV-related search terms such as unprotected sex, barebacking/bareback and bug chasing, were used. Bareback and bug chaser behaviors occur, among other factors, through social homonegativity, ART positive coverage, insufficient prevention campaigns, search for new sensations and attempts to strengthen the relationship with the HIV+ member. Unprotected sex is primarily associated with having HIV/AIDS diagnoses, physical violence due to sexual orientation, viewing homosexual sex sites, and having bought or sold sex. It is necessary to work with individual behaviors that draw individuals close to infection. [ABSTRACT FROM AUTHOR]

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We assessed the influence of supportive housing, incarceration, and health service use on markers of HIV infection for people living with HIV and serious mental illness or substance use disorder (SUD) participating in a New York City supportive housing program (NY III). Using matched administrative data from 2007 to 2014, we compared survivor time without AIDS, achievement of undetectable viral load, and maintenance of viral suppression between NY III tenants (n = 696), applicants placed in other supportive housing programs (n = 333), and applicants not placed in supportive housing (n = 268). Inverse probability of treatment weights were applied to Cox proportional hazards regression models to account for confounding of observed variables. Individuals not placed in supportive housing had a significantly greater risk of death or AIDS diagnosis than NY III tenants [adjusted hazard ratio = 1.84 (1.40, 2.44), p < 0.001]. Incarceration and outpatient SUD treatment were significantly associated with negative short-term outcomes (time to undetectable viral load) but positive long-term outcomes (time to death or AIDS diagnosis). Supportive housing, SUD treatment, and incarceration were associated with prolonged survival without AIDS among supportive housing applicants living with HIV. [ABSTRACT FROM AUTHOR]