This document summarizes a study of socio-demographic characteristics associated with HIV and syphilis seroreactivity among pregnant women in Blantyre, Malawi between 2000-2004. The study found that 30% of women were HIV positive and 5% were syphilis seroreactive. In multivariate analysis, HIV infection was positively associated with higher socioeconomic status, being formerly married, and older age. Syphilis seroreactivity was positively associated with rural residence, multigravidity, and previous STI diagnosis and negatively associated with higher education levels. The study demonstrates the need for improved strategies to prevent HIV and syphilis in women in Malawi.
Prevalence of Different Types of Intimate Partner Violence among Ever-Married...AnuragSingh1049
This study examined the prevalence of intimate partner violence (IPV) among a sample of 600 ever-married women from a representative health administrative area located in the Kandy district of Sri Lanka. IPV was assessed using the world health organization (WHO) instrument developed for use in the WHO multi-country study on women’s health and domestic violence against women. Among all participants 59.5% (n=357) have experienced any type of abuse (any form of physical, psychological, sexual abuse and controlling behaviour) at least once during their lifetime. Out of the total 41.3% (n=248) have experienced abuse (any form of physical, psychological and sexual abuse) during the last 12 months. Considering the lifetime IPV experiences, 39.5% (n=237) reported physical abuse, 39% (n=234) reported psychological abuse, 12.3% (n=74) reported sexual abuse and31.3% (n=188) reported generally controlling behaviour by the partner. During the last year 14.8% (n=89) have been physically, 26.3% (n=158) have been psychologically and 7.17% (n=43) have been sexually abused. The present study reveals high lifetime and past year prevalence of IPV compared to other recent studies conducted in Sri Lanka. Furthermore, different types of IPV acts were present with chronic and severe experiences. Hence, interventions should focus on different types of IPV and various abusive behaviours. Further studies are needed to assess the association of different types of IPV and the contributory factors.
Kathleen Brady from the Philadelphia Department of Public Health presented her annual updated on the HIV Epidemic in Philadelphia at a February 2015 combined meeting of the Philadelphia Ryan White Part A Planning Council and the HIV Prevention Planning Group.
Kathleen Brady - HIV in Philadelphia (Annual Epidemiological Presentation)Office of HIV Planning
On April 27, 2016, Kathleen Brady of the Philadelphia AIDS Activities Coordinating Office (AACO) presented her annual review of the HIV Epidemic in Philadelphia and the surrounding areas.
Dr. Kathleen Brady (AACO)'s annual epidemiological update. This presentation was given to the Philadelphia EMA Ryan White Planning Council on Thursday, February 20, 2014.
Iryna Zablotska from NCHSR presents data from six Australian Gay Community Periodic Surveys (1998-2008) related to:
- Trends in sexual heath testing;
- Testing by HV serostatus and sexual practices;
- Reasons for and patterns of testing; and
- Issues in sexual health testing.
This presentation was given at AFAO's syphilis forum in May 2009.
This document summarizes a study of socio-demographic characteristics associated with HIV and syphilis seroreactivity among pregnant women in Blantyre, Malawi between 2000-2004. The study found that 30% of women were HIV positive and 5% were syphilis seroreactive. In multivariate analysis, HIV infection was positively associated with higher socioeconomic status, being formerly married, and older age. Syphilis seroreactivity was positively associated with rural residence, multigravidity, and previous STI diagnosis and negatively associated with higher education levels. The study demonstrates the need for improved strategies to prevent HIV and syphilis in women in Malawi.
Prevalence of Different Types of Intimate Partner Violence among Ever-Married...AnuragSingh1049
This study examined the prevalence of intimate partner violence (IPV) among a sample of 600 ever-married women from a representative health administrative area located in the Kandy district of Sri Lanka. IPV was assessed using the world health organization (WHO) instrument developed for use in the WHO multi-country study on women’s health and domestic violence against women. Among all participants 59.5% (n=357) have experienced any type of abuse (any form of physical, psychological, sexual abuse and controlling behaviour) at least once during their lifetime. Out of the total 41.3% (n=248) have experienced abuse (any form of physical, psychological and sexual abuse) during the last 12 months. Considering the lifetime IPV experiences, 39.5% (n=237) reported physical abuse, 39% (n=234) reported psychological abuse, 12.3% (n=74) reported sexual abuse and31.3% (n=188) reported generally controlling behaviour by the partner. During the last year 14.8% (n=89) have been physically, 26.3% (n=158) have been psychologically and 7.17% (n=43) have been sexually abused. The present study reveals high lifetime and past year prevalence of IPV compared to other recent studies conducted in Sri Lanka. Furthermore, different types of IPV acts were present with chronic and severe experiences. Hence, interventions should focus on different types of IPV and various abusive behaviours. Further studies are needed to assess the association of different types of IPV and the contributory factors.
Kathleen Brady from the Philadelphia Department of Public Health presented her annual updated on the HIV Epidemic in Philadelphia at a February 2015 combined meeting of the Philadelphia Ryan White Part A Planning Council and the HIV Prevention Planning Group.
Kathleen Brady - HIV in Philadelphia (Annual Epidemiological Presentation)Office of HIV Planning
On April 27, 2016, Kathleen Brady of the Philadelphia AIDS Activities Coordinating Office (AACO) presented her annual review of the HIV Epidemic in Philadelphia and the surrounding areas.
Dr. Kathleen Brady (AACO)'s annual epidemiological update. This presentation was given to the Philadelphia EMA Ryan White Planning Council on Thursday, February 20, 2014.
Iryna Zablotska from NCHSR presents data from six Australian Gay Community Periodic Surveys (1998-2008) related to:
- Trends in sexual heath testing;
- Testing by HV serostatus and sexual practices;
- Reasons for and patterns of testing; and
- Issues in sexual health testing.
This presentation was given at AFAO's syphilis forum in May 2009.
Risk of hiv infection among men aged 50 to 75 years using erectile dysfunctio...Alexander Decker
This study examined the risk of HIV infection among men aged 50 to 75 years who use erectile dysfunction drugs (EDDs) in Kenya. A case-control study was conducted of 137 HIV-positive men (cases) and 137 HIV-negative men (controls). The study found that a higher percentage of cases than controls reported using EDDs. However, after adjusting for other risk factors like having multiple sexual partners or a history of STDs, EDD use was not a significant independent risk factor for HIV infection. Multiple sexual partners, a history of STDs, and alcohol use were identified as independent risk factors for HIV in this population. The study suggests that while EDD use may be associated with HIV risk, other behavioral
Outcomes of Mathematical Modelling for the National Gay Men’s Syphilis Action Plan. Presentation given by David Wilson at the AFAO National Syphilis Forum, 23 October 2009.
HIV/AIDS in Special Population Groups in TexasDSHS
- The document discusses HIV trends among women in Texas based on demographic and surveillance data from 2000-2008. It finds that Hispanic women ages 25-34 in Dallas make up the largest proportion of new HIV cases. The primary risk factor for transmission differs by age and ethnicity, with intravenous drug use being most common among older non-Hispanic white women and heterosexual sex being most common among younger Hispanic women. Late testing remains a significant issue, with half of 2008 cases estimated to have been long term late testers. Further analysis is needed to understand socioeconomic barriers and cues to testing in order to reduce transmission rates.
This document summarizes a presentation on new and investigational antiretrovirals given at the UC San Diego HIV & Global Health Rounds. The presentation reviewed fostemsavir, cabotegravir/rilpivirine, leronlimab, islatravir, and lenacapavir. For each drug, the presenter discussed indications, dosing, efficacy and safety data from clinical trials, resistance profiles, and potential advantages and limitations. The goal of the HIV & Global Health Rounds is to provide clinicians and researchers with the most up-to-date information on HIV, hepatitis, tuberculosis, and other infectious diseases.
The document summarizes findings from the Saudi Health Interview Survey (SHIS) conducted in 2013. Some key findings include:
- 15.1% of Saudis ages 15 or older are hypertensive, 40.5% are borderline hypertensive
- 8.5% are hypercholesterolemic and 20% are borderline hypercholesterolemic
- 13.4% are diabetic and 16.3% are borderline diabetic
- 28.7% of Saudis are obese
Facing the Future of HIV and STD in Texas Epidemiology, Impact, and PrioritiesDSHS
This document summarizes epidemiological data on sexually transmitted diseases (STDs) and HIV in Texas. It finds that rates of STDs like chlamydia, gonorrhea, and syphilis are disproportionately high among Black populations. Nearly 25% of new HIV diagnoses in Texas are late diagnoses, defined as an AIDS diagnosis within a month of HIV diagnosis. The data shows the need for expanded testing, treatment, and prevention programs that address social and structural factors to curb the spread of STDs and HIV in communities.
The document summarizes epidemiological data on cardiovascular disease (CVD) risk factors in Saudi Arabia. It finds that CVD is the main cause of mortality, accounting for 30% of deaths. The main modifiable risk factors for CVD in Saudi Arabia are hypertension, diabetes, dyslipidemia, cigarette smoking, obesity, and lack of physical activity. The document then provides data on the prevalence of these risk factors in Saudi Arabia based on various epidemiological studies.
Review from the 24th Conference on Retroviruses and Opportunistic Infections (CROI) – 2017
Charles Hicks, M.D.
April 21st, 2017
UCSD HIV & Global Health Rounds
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
HIv risks and vulnerabilities among Gay, Bisexuals and Others MSM, Stefan BaralMSMGF
MSMGF held the Civil Society Hearings Side Event,: Unfinished Business – Taking bolder action to address HIV among gay and bisexual men and other men who have sex with men, at the United Nations in New York City in close consultation with the Global Platform to Fast Track the HIV and Human Rights Responses Among Gay, Bisexual Men and Other Men Who Have Sex with Men (The Platform), and supported by UNAIDS, UNDP, OGAC/PEPFAR, and the Global Fund.
This study assessed the knowledge and attitudes regarding care of patients with HIV/AIDS among 207 nurses working at BPKIHS, Nepal. The study found that the majority (92.3%) of nurses had moderately adequate knowledge of HIV/AIDS patient care. Over half (50.7%) of nurses reported having a favorable attitude toward caring for HIV/AIDS patients. No significant associations were found between knowledge, attitude, and socio-demographic or training variables. Knowledge was found to have a significant positive correlation with attitude. The study concluded that nurses generally have adequate knowledge and favorable attitudes, but continuous education is still needed to ensure non-stigmatizing, high-quality care of HIV/AIDS patients.
Impact of hiv naat in texas nine months and counting-myra brinson - texas h...myrabrinson
The document discusses testing for acute HIV infection in North Carolina. It details a pilot study from 2001-2002 where over 8,500 routine HIV tests were pooled and screened for HIV RNA to identify acute infections. This identified 5 cases of acute infection per 10,000 tests, compared to 44 chronic infections. Since 2002, North Carolina has screened over 240,000 HIV samples per year through its STAT program to identify acute infections using nucleic acid amplification tests on pooled samples.
This document provides an organizational chart and descriptions of the STD/HIV surveillance program in Louisiana. It shows the data management and analysis units for STD and HIV data housed in different systems. It also lists contacts for HIV surveillance data and describes how prevention and counseling data are managed. Quick definitions of epidemiological terms and examples of rates and counts are provided.
HCV and HIV Co-Infection among Adolescents and Young Adults in Massachusetts:...CDC NPIN
This document discusses HCV and HIV co-infection among adolescents and young adults in Massachusetts. It finds that reported HCV cases have increased significantly among those aged 15-25 since 2002, likely due to injection drug use. A data match found a small number of HIV/HCV co-infections in this age group, indicating potential for HIV prevention. Effective integrated prevention programs for both viruses are needed to address this emerging public health issue.
A PROSPECTIVE STUDY OF THE ONSET OF SEXUAL BEHAVIOR & RISK IN PERINATALLYHIV-...CDC NPIN
This study examined the onset of sexual behavior and risk among youth perinatally infected with HIV compared to HIV-affected youth. Using data from two longitudinal studies of over 400 youth, the study found that:
1) Perinatally HIV-infected youth showed delayed onset of sexual behaviors and unprotected sex compared to socio-demographically matched HIV-negative youth.
2) Youth with HIV-positive caregivers were less likely to report onset of unprotected sex compared to HIV-negative youth with HIV-negative caregivers.
3) Having an HIV-positive caregiver may serve a protective role by facilitating discussions around HIV prevention and access to services.
Jill Blumenthal, MD
Assistant Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
3 tue 0800 ross tue universal testing atlanta 2011CDC NPIN
This document discusses strategies for HIV testing in the United States and their effectiveness. It reports that while testing has increased under new CDC guidelines, the number of new HIV infections remains unchanged. Several studies are summarized that show current testing approaches like those in community health centers, bars, and emergency rooms are missing opportunities to test minorities and high-risk groups. Opt-out testing programs in prisons had low HIV detection rates as well. The document concludes that simply increasing testing through existing strategies is unlikely to control the HIV epidemic due to high costs and limited effectiveness in reaching key populations.
Rheumatoid arthirits (RA) is a chronic inflammatory disorder that affects many tissues and organs but mainly affects the joints,
producing a proliferative and inflammatory disease that progresses to damage the joint cartilage and ankylosis of the joints. About
1% of the world’s population is affected by RA. Women three to five times more often than men, it is more common in age group
of 40 to 70 years of age. The useful serological markers for RA are Rheumatoid factor (RF) and antibodies to citrullinated peptides.
This present study was done to find out the prevalence of serological marker in suspected arthritis case in tertiary care hospital.
This prospective study was carried out in serology section in central pathology lab in Government Medical College, Banda from
April 2015 to August 2018. Total 776 blood samples were received for RA factor analysis. Out of 776 samples, 111 samples were
positive for RA factor 14.3% prevalence. Total 88 cases were females and 23 were males. Most common age group involved was
21 - 60 years in females and 40 - 70 years in males. For evaluation of patients with suspected RA, it is recommended to perform
anti-cyclic citrullinated peptide antibody and RF analysis to increase specificity of the results.
Acute HIV infection detection and control reduces HIV infectiousness and tran...Thai Red Cross Society
Acute HIV infection detection and control reduces HIV infectiousness and transmission risk behavior among men who have sex with men in Bangkok, Thailand
Socio-demographic characteristics associated with HIV and syphilis seroreacti...Humphrey Misiri
This document summarizes a study of socio-demographic characteristics associated with HIV and syphilis seroreactivity among pregnant women in Blantyre, Malawi between 2000-2004. The study found that 30% of women were HIV positive and 5% were syphilis seroreactive. In multivariate analysis, HIV infection was positively associated with higher socioeconomic status, being formerly married, and older age. Syphilis seroreactivity was positively associated with rural residence, multigravidity, and previous STI diagnosis and negatively associated with higher education levels. The results demonstrate the need for improved strategies to prevent HIV and syphilis in women in Malawi.
This study examined the prevalence and impact of intimate partner violence (IPV) among gay and bisexual men living with HIV. The researchers found that 22.4% of men reported experiencing IPV, most commonly emotional and physical abuse. Experiencing IPV was associated with factors like being Aboriginal, childhood abuse, mental health issues, risky sexual behaviors, poorer quality of life, interruptions in HIV care, and higher rates of AIDS progression and HIV-related hospitalizations. The results suggest IPV is an important but underrecognized issue that can negatively impact the health and well-being of HIV-positive gay and bisexual men.
Risk of hiv infection among men aged 50 to 75 years using erectile dysfunctio...Alexander Decker
This study examined the risk of HIV infection among men aged 50 to 75 years who use erectile dysfunction drugs (EDDs) in Kenya. A case-control study was conducted of 137 HIV-positive men (cases) and 137 HIV-negative men (controls). The study found that a higher percentage of cases than controls reported using EDDs. However, after adjusting for other risk factors like having multiple sexual partners or a history of STDs, EDD use was not a significant independent risk factor for HIV infection. Multiple sexual partners, a history of STDs, and alcohol use were identified as independent risk factors for HIV in this population. The study suggests that while EDD use may be associated with HIV risk, other behavioral
Outcomes of Mathematical Modelling for the National Gay Men’s Syphilis Action Plan. Presentation given by David Wilson at the AFAO National Syphilis Forum, 23 October 2009.
HIV/AIDS in Special Population Groups in TexasDSHS
- The document discusses HIV trends among women in Texas based on demographic and surveillance data from 2000-2008. It finds that Hispanic women ages 25-34 in Dallas make up the largest proportion of new HIV cases. The primary risk factor for transmission differs by age and ethnicity, with intravenous drug use being most common among older non-Hispanic white women and heterosexual sex being most common among younger Hispanic women. Late testing remains a significant issue, with half of 2008 cases estimated to have been long term late testers. Further analysis is needed to understand socioeconomic barriers and cues to testing in order to reduce transmission rates.
This document summarizes a presentation on new and investigational antiretrovirals given at the UC San Diego HIV & Global Health Rounds. The presentation reviewed fostemsavir, cabotegravir/rilpivirine, leronlimab, islatravir, and lenacapavir. For each drug, the presenter discussed indications, dosing, efficacy and safety data from clinical trials, resistance profiles, and potential advantages and limitations. The goal of the HIV & Global Health Rounds is to provide clinicians and researchers with the most up-to-date information on HIV, hepatitis, tuberculosis, and other infectious diseases.
The document summarizes findings from the Saudi Health Interview Survey (SHIS) conducted in 2013. Some key findings include:
- 15.1% of Saudis ages 15 or older are hypertensive, 40.5% are borderline hypertensive
- 8.5% are hypercholesterolemic and 20% are borderline hypercholesterolemic
- 13.4% are diabetic and 16.3% are borderline diabetic
- 28.7% of Saudis are obese
Facing the Future of HIV and STD in Texas Epidemiology, Impact, and PrioritiesDSHS
This document summarizes epidemiological data on sexually transmitted diseases (STDs) and HIV in Texas. It finds that rates of STDs like chlamydia, gonorrhea, and syphilis are disproportionately high among Black populations. Nearly 25% of new HIV diagnoses in Texas are late diagnoses, defined as an AIDS diagnosis within a month of HIV diagnosis. The data shows the need for expanded testing, treatment, and prevention programs that address social and structural factors to curb the spread of STDs and HIV in communities.
The document summarizes epidemiological data on cardiovascular disease (CVD) risk factors in Saudi Arabia. It finds that CVD is the main cause of mortality, accounting for 30% of deaths. The main modifiable risk factors for CVD in Saudi Arabia are hypertension, diabetes, dyslipidemia, cigarette smoking, obesity, and lack of physical activity. The document then provides data on the prevalence of these risk factors in Saudi Arabia based on various epidemiological studies.
Review from the 24th Conference on Retroviruses and Opportunistic Infections (CROI) – 2017
Charles Hicks, M.D.
April 21st, 2017
UCSD HIV & Global Health Rounds
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
HIv risks and vulnerabilities among Gay, Bisexuals and Others MSM, Stefan BaralMSMGF
MSMGF held the Civil Society Hearings Side Event,: Unfinished Business – Taking bolder action to address HIV among gay and bisexual men and other men who have sex with men, at the United Nations in New York City in close consultation with the Global Platform to Fast Track the HIV and Human Rights Responses Among Gay, Bisexual Men and Other Men Who Have Sex with Men (The Platform), and supported by UNAIDS, UNDP, OGAC/PEPFAR, and the Global Fund.
This study assessed the knowledge and attitudes regarding care of patients with HIV/AIDS among 207 nurses working at BPKIHS, Nepal. The study found that the majority (92.3%) of nurses had moderately adequate knowledge of HIV/AIDS patient care. Over half (50.7%) of nurses reported having a favorable attitude toward caring for HIV/AIDS patients. No significant associations were found between knowledge, attitude, and socio-demographic or training variables. Knowledge was found to have a significant positive correlation with attitude. The study concluded that nurses generally have adequate knowledge and favorable attitudes, but continuous education is still needed to ensure non-stigmatizing, high-quality care of HIV/AIDS patients.
Impact of hiv naat in texas nine months and counting-myra brinson - texas h...myrabrinson
The document discusses testing for acute HIV infection in North Carolina. It details a pilot study from 2001-2002 where over 8,500 routine HIV tests were pooled and screened for HIV RNA to identify acute infections. This identified 5 cases of acute infection per 10,000 tests, compared to 44 chronic infections. Since 2002, North Carolina has screened over 240,000 HIV samples per year through its STAT program to identify acute infections using nucleic acid amplification tests on pooled samples.
This document provides an organizational chart and descriptions of the STD/HIV surveillance program in Louisiana. It shows the data management and analysis units for STD and HIV data housed in different systems. It also lists contacts for HIV surveillance data and describes how prevention and counseling data are managed. Quick definitions of epidemiological terms and examples of rates and counts are provided.
HCV and HIV Co-Infection among Adolescents and Young Adults in Massachusetts:...CDC NPIN
This document discusses HCV and HIV co-infection among adolescents and young adults in Massachusetts. It finds that reported HCV cases have increased significantly among those aged 15-25 since 2002, likely due to injection drug use. A data match found a small number of HIV/HCV co-infections in this age group, indicating potential for HIV prevention. Effective integrated prevention programs for both viruses are needed to address this emerging public health issue.
A PROSPECTIVE STUDY OF THE ONSET OF SEXUAL BEHAVIOR & RISK IN PERINATALLYHIV-...CDC NPIN
This study examined the onset of sexual behavior and risk among youth perinatally infected with HIV compared to HIV-affected youth. Using data from two longitudinal studies of over 400 youth, the study found that:
1) Perinatally HIV-infected youth showed delayed onset of sexual behaviors and unprotected sex compared to socio-demographically matched HIV-negative youth.
2) Youth with HIV-positive caregivers were less likely to report onset of unprotected sex compared to HIV-negative youth with HIV-negative caregivers.
3) Having an HIV-positive caregiver may serve a protective role by facilitating discussions around HIV prevention and access to services.
Jill Blumenthal, MD
Assistant Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
3 tue 0800 ross tue universal testing atlanta 2011CDC NPIN
This document discusses strategies for HIV testing in the United States and their effectiveness. It reports that while testing has increased under new CDC guidelines, the number of new HIV infections remains unchanged. Several studies are summarized that show current testing approaches like those in community health centers, bars, and emergency rooms are missing opportunities to test minorities and high-risk groups. Opt-out testing programs in prisons had low HIV detection rates as well. The document concludes that simply increasing testing through existing strategies is unlikely to control the HIV epidemic due to high costs and limited effectiveness in reaching key populations.
Rheumatoid arthirits (RA) is a chronic inflammatory disorder that affects many tissues and organs but mainly affects the joints,
producing a proliferative and inflammatory disease that progresses to damage the joint cartilage and ankylosis of the joints. About
1% of the world’s population is affected by RA. Women three to five times more often than men, it is more common in age group
of 40 to 70 years of age. The useful serological markers for RA are Rheumatoid factor (RF) and antibodies to citrullinated peptides.
This present study was done to find out the prevalence of serological marker in suspected arthritis case in tertiary care hospital.
This prospective study was carried out in serology section in central pathology lab in Government Medical College, Banda from
April 2015 to August 2018. Total 776 blood samples were received for RA factor analysis. Out of 776 samples, 111 samples were
positive for RA factor 14.3% prevalence. Total 88 cases were females and 23 were males. Most common age group involved was
21 - 60 years in females and 40 - 70 years in males. For evaluation of patients with suspected RA, it is recommended to perform
anti-cyclic citrullinated peptide antibody and RF analysis to increase specificity of the results.
Acute HIV infection detection and control reduces HIV infectiousness and tran...Thai Red Cross Society
Acute HIV infection detection and control reduces HIV infectiousness and transmission risk behavior among men who have sex with men in Bangkok, Thailand
Socio-demographic characteristics associated with HIV and syphilis seroreacti...Humphrey Misiri
This document summarizes a study of socio-demographic characteristics associated with HIV and syphilis seroreactivity among pregnant women in Blantyre, Malawi between 2000-2004. The study found that 30% of women were HIV positive and 5% were syphilis seroreactive. In multivariate analysis, HIV infection was positively associated with higher socioeconomic status, being formerly married, and older age. Syphilis seroreactivity was positively associated with rural residence, multigravidity, and previous STI diagnosis and negatively associated with higher education levels. The results demonstrate the need for improved strategies to prevent HIV and syphilis in women in Malawi.
This study examined the prevalence and impact of intimate partner violence (IPV) among gay and bisexual men living with HIV. The researchers found that 22.4% of men reported experiencing IPV, most commonly emotional and physical abuse. Experiencing IPV was associated with factors like being Aboriginal, childhood abuse, mental health issues, risky sexual behaviors, poorer quality of life, interruptions in HIV care, and higher rates of AIDS progression and HIV-related hospitalizations. The results suggest IPV is an important but underrecognized issue that can negatively impact the health and well-being of HIV-positive gay and bisexual men.
Socio-demographic Characteristics of Clients Visiting Integrated Counseling and Testing Centre (ICTC) at SMS Medical College, Jaipur (Rajasthan) India-Human immunodeficiency virus (HIV) infection is a global pandemic and India counts for 10% of the global HIV burden and 65% of that in the South and South-East Asia. This study of clients of ICTC was carried out to know the association of HIV positivity with socio-demographic variables. Total 2412 clients have visited at ICTC of SMS Medical College, Jaipur, either voluntarily or referred by various department of this institute in ICTC in 1st quarter of 2009. They Overall HIV positivity was found 12.35% with a significant difference in voluntary and referred clients i.e. 83.59% v/s 8.36%. It was also found that HIV positivity is more in reproductive age group than extremes of ages, more in females than males, more in person who were married but presently single because of separation of spouse, divorce form spouse or death of spouse than the unmarried or married living with their spouses.
Population in 2012- 41 million
No of people living with HIV 1.5 million
Kenya ranks no 4, among countries with highest burden of HIV globally
54 % of HIV infections are just in 9 counties
Basics of HIV and STIs (English) 03292023 (1).pptxGelizaRecede
This document provides information about HIV/AIDS in the Philippines. It discusses basics of HIV including transmission methods, prevention strategies, and the Philippine HIV and AIDS Policy Act (RA 11166). Some key points include:
- As of 2022, there have been over 110,000 reported cumulative HIV cases in the Philippines since 1984.
- Risky behaviors often start in youth aged 14-18 while protective behaviors like condom use are adopted later.
- RA 11166 aims to expand HIV testing, ensure treatment access, prohibit discrimination, and provide benefits to people living with HIV.
- The document emphasizes strategies to prevent transmission like abstinence, mutual monogamy, condom use, education, and early testing
This document summarizes the position statement of the American College of Preventive Medicine (ACPM) regarding routine HIV screening. The ACPM supports routine HIV screening for all adolescents and adults ages 13-64, as well as pregnant women, based on evidence that risk-based screening is inadequate and leads to low testing rates, lack of HIV status awareness, and late diagnoses. The ACPM endorses opt-out consent procedures, use of rapid HIV tests, streamlined counseling separate from screening, and linking patients to treatment. The organization also recommends annual repeat testing for high-risk groups and repeat testing every 5 years for the general population.
HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal, South Africa according to a study of three districts. Cross-sectional surveys found HIV prevalence of 42% in Ladysmith, 46% in Edendale, and 41% in Pinetown. Follow-up cohort studies in these areas then determined HIV incidence rates of 14.8, 6.3, and 7.2 per 100 person-years, respectively. Pregnancy incidence was also high at 5.7, 3.1, and 6.3 per 100 person-years despite high reported contraceptive use. These findings suggest ongoing high risk of HIV transmission in these communities.
HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal, South Africa according to a study of three districts. Cross-sectional surveys found HIV prevalence of 42% in Ladysmith, 46% in Edendale, and 41% in Pinetown. Follow-up cohort studies in these areas measured HIV incidence rates of 14.8, 6.3, and 7.2 per 100 person-years respectively. Pregnancy incidence was also high at 5.7, 3.1, and 6.3 per 100 person-years despite high reported contraceptive use. These findings suggest ongoing high risk of HIV transmission in these communities.
Basil Donovan from NCHECR addresses the global context; Australian trends in infectious syphilis; enhanced surveillance for syphilis; and the effects of syphilis on HIV infection, at AFAO's syphilis forum in May 2009.
Achieving HIV epidemic control - the importance of HIV prevention in womenHopkinsCFAR
CAPRISA hosts research units on HIV-TB pathogenesis and treatment as well as an HIV prevention centre of excellence. The document discusses achieving epidemic control of HIV and the importance of prevention, particularly among women. It notes that treatment alone cannot end AIDS and combination prevention including behavioral interventions, condoms, medical male circumcision, early treatment and PrEP can reduce transmission at a population level.
This study analyzed data from over 18,000 pregnant women tested for HIV between 2005-2012 at a hospital in southern Odisha, India. The overall HIV prevalence was 0.66%, declining from 1.53% in 2006 to 0.34% in 2012. Most HIV-positive women were aged 25-29, married, from rural areas with low education/socioeconomic status. The declining prevalence suggests prevention campaigns promoting condom use and safe sexual behaviors are having a positive impact.
This study evaluated the suitability of populations of sexually active women in two districts of South Africa, Madibeng and Mbekweni, for participation in microbicide trials by determining HIV prevalence and incidence. The study found HIV prevalence was 24% in Madibeng and 22% in Mbekweni. HIV incidence rates based on seroconversions over 12 months were 6.0/100 person-years in Madibeng and 4.5/100 person-years in Mbekweni. Genital symptoms were very common. The populations were found to be suitable for microbicide trials if HIV incidence remains sufficiently high over time.
This study evaluated the suitability of populations of sexually active women in Madibeng, North-West Province and Mbekweni, Western Cape, South Africa for microbicide trials by determining HIV prevalence and incidence.
The study found an HIV prevalence of 24% in Madibeng and 22% in Mbekweni. HIV incidence rates based on seroconversions over 12 months in the cohort studies were 6.0/100 person-years in Madibeng and 4.5/100 person-years in Mbekweni. Incidence rates estimated by cross-sectional BED testing were similar. Pregnancy incidence rates were also determined.
Nearly all participants expressed a willingness to participate
The document summarizes HIV care continuum and engagement in care data for Philadelphia. Key points:
- In 2010, 82% of those diagnosed with HIV in Philadelphia were linked to care, 54% remained in care, 49% were on antiretroviral therapy (ART), and 38% had suppressed viral loads.
- Engagement in care varies by demographic group - males, blacks, Latinos, MSM, and younger age groups have lower rates of retention, ART use, and viral suppression compared to females, whites, heterosexuals, and older adults.
- 18% of those living with HIV/AIDS in the Philadelphia area had unmet needs for primary medical care in 2012, with higher
This study examined the influence of gender roles on adherence to antiretroviral therapy (ART) among people living with HIV in Belgrade, Serbia. A survey of 68 men and 23 women found that the most common reasons for skipping doses were fear of stigma if their HIV status or sexual practices became known. Gender roles and fear of gender-based violence appeared to negatively impact ART adherence by promoting secrecy. The researchers recommend training healthcare workers and HIV service providers on gender issues to help overcome barriers to adherence related to perceptions of gender and stigma.
Similar to Presidential address 2015: Sexual health in the era of HIV (20)
The document discusses neuroplasticity and rapid maturation in the teen brain related to independence, identity, peer approval and sex. It also discusses how slow developing brain input influences neuronal wiring and the power of pornography. Finally, it outlines the typical stages of the sexual response cycle from emotional intimacy and neutrality to arousal, desire, and satisfaction or orgasm.
This document discusses topics related to gender identity and transgender health. It provides definitions for terms like cisgender, transgender, gender non-binary, gender fluid, and gender spectrum. It examines theories of gender identity development and discusses challenges faced by the transgender community, like higher risks for HIV and other STIs. Guidelines are presented for screening and risk assessment of transgender individuals to address their specific healthcare needs. References are also provided for further reading.
1) Hepatitis B vaccination faces several challenges, including ensuring safety, demonstrating efficacy of recombinant vaccines, determining duration of protection, addressing cost and non-responders.
2) Studies showed plasma-derived and recombinant vaccines provided protection for decades, though antibody levels declined over time. Cellular immune responses persisted despite low antibody levels.
3) Global elimination of Hepatitis B is possible by 2090 through high coverage birth dose vaccination, treatment of high-risk groups, and developing a cure for chronic infection. However, this will require significant ongoing financial investment.
This document summarizes information about hepatitis B and C co-infection with HIV. It notes that co-infection leads to faster progression of liver disease and higher rates of liver cancer and mortality. Treatment for both viruses is important, with newer regimens like tenofovir alafenamide having comparable efficacy to tenofovir disoproxil fumarate but being more tolerable with less bone and kidney toxicity. Achieving a sustained virologic response reduces complications of liver disease and improves overall health outcomes.
This document summarizes immunotherapy for genital HPV infection. It discusses the life cycle of HPV and how it avoids detection by the immune system. Immunotherapeutic strategies aim to make HPV antigens accessible to antigen-presenting cells to stimulate cytotoxic T-cells. Treatment options discussed include photodynamic therapy, cryotherapy, laser ablation, surgery, imiquimod cream, and intralesional immunotherapy with killed Mycobacterium w vaccine. A randomized clinical trial found that intralesional Mycobacterium w vaccine and topical imiquimod cream were similarly effective in clearing anogenital warts, though the vaccine was associated with a self-limiting granulomatous reaction.
1) Anal cancer risk is greatly increased in people with HIV, especially gay and bisexual men with HIV who are at around 100 times higher risk compared to the general population.
2) HPV vaccination is recommended for those under 26 to prevent anal cancer and precancers, but there is no evidence of benefit in older populations.
3) If anal cancer precancers are found, there is no evidence that screening or treatment improves outcomes and treatments have very high failure rates.
4) An annual digital anal exam is recommended for MSM over 50 with HIV to aid early detection of anal cancer.
Novel Strategies to Improve STI Screening discusses strategies to improve screening for sexually transmitted infections (STIs). It notes that early diagnosis of STIs is crucial but screening remains rare in resource-limited settings. The document discusses developing point-of-care tests that meet the WHO ASSURED criteria of being affordable, sensitive, specific, user-friendly, rapid, equipment-free and deliverable. It describes developing a DNA biosensor to detect Neisseria gonorrhoeae that shows potential to diagnose STIs in clinical samples sensitively and specifically. While integration with microfluidics and further clinical studies are needed, biosensors combined with communication technologies may help improve STI screening.
Antimicrobial resistance has been an ongoing issue since the discovery of early antimicrobial treatments. Resistance first emerged in the early 1900s in Neisseria gonorrhoeae and has since developed to nearly all classes of antimicrobials used to treat it. Resistance is now widespread globally to previously effective drugs. New treatment guidelines must consider emerging resistance patterns and combine antimicrobials to preserve effectiveness. Ongoing surveillance is also needed to monitor resistance trends and ensure optimal treatment strategies.
PrEP has been successful in preventing HIV transmission but has led to increased bacterial STI rates. Research suggests PrEP using antibiotics may help control STIs by reducing transmission, though evidence is limited. Doxycycline treatment in one study reduced STI incidence in HIV+ men. However, widespread antibiotic use risks antimicrobial resistance. PrEP for STIs needs more research on effects and should be part of comprehensive prevention strategies that consider targeting, monitoring, and equity. It may contribute to global goals if risks like resistance are addressed.
Syphilis remains a major public health problem globally despite efforts to eliminate it. It is reemerging in many countries due to various factors like increased commercial sex work, migration, and lack of condom use. Prevalence is high among high-risk groups like sex workers, MSM, and drug users. While rates decreased in some areas like India and China in the 2000s, most regions have seen a rise in syphilis cases over the last decade. Enhanced screening, treatment, contact tracing and education of at-risk populations are needed to improve syphilis control and work towards elimination.
The document discusses the diagnosis of various vaginal conditions. It begins by covering vaginal physiology and changes that can occur over a woman's lifetime. It then discusses the most common physiological and pathological causes of vaginal symptoms, including infections like bacterial vaginosis, yeast, and trichomoniasis. The document provides details on evaluating patients with vaginal complaints through symptoms, clinical examination, pH, wet mount, gram stain, and other tests. It also provides examples of diagnostic approaches and classifications of common vaginal infections and conditions.
This document summarizes the National Programme for Tuberculosis Control and Chest Diseases (NPTCCD) in Sri Lanka. It provides statistics on TB case detection and treatment outcomes from 2005-2017. It identifies challenges such as insufficient case finding and inconsistent monitoring/evaluation. Opportunities include Sri Lanka's strong primary care network and availability of private hospitals. The document recommends priorities like strengthening contact tracing and screening of high-risk groups. It proposes pilot districts to improve case finding and treatment outcomes. Overall, it calls for strengthened leadership, resources and collaboration across sectors to accelerate TB control efforts and meet WHO targets to end TB in Sri Lanka.
1. Early detection of HIV-TB co-infection is challenging but important as TB is a leading cause of death among people living with HIV. New diagnostic approaches like Xpert MTB/RIF can improve detection rates.
2. TB is more difficult to diagnose, spreads faster, and is more deadly in people living with HIV. The risk of developing active TB increases with lower CD4 counts.
3. Screening and testing algorithms along with new tests like Xpert MTB/RIF, LF-LAM, and treatment of latent TB are recommended to reduce the high TB mortality among people living with HIV.
This document discusses cancers that are more common among people living with HIV/AIDS compared to the general population. It notes that HIV weakens the immune system, making people more susceptible to infections that can lead to cancer. It highlights that HIV-positive individuals are at higher risk for cancers caused by viruses like Kaposi Sarcoma herpesvirus, Epstein-Barr virus, human papillomavirus, and hepatitis B and C. The introduction of antiretroviral therapy has reduced rates of Kaposi sarcoma and non-Hodgkin's lymphoma but not cervical cancer. Regular cancer screening is important for HIV-positive people according to guidelines.
This document discusses several priorities related to perinatal, paediatric, and adolescent HIV. Priority 1 is early diagnosis of infant infection through tests like HIV DNA and RNA that can detect infection before antibodies are present. Priority 2 is ensuring appropriate paediatric HIV treatment formulations that are palatable, easy to administer, and stable for storage and transport. Priority 3 is obtaining long-term outcome data on rates of HIV transmission through breastfeeding while the mother is on combination antiretroviral therapy (cART). The document also discusses challenges in adolescent HIV including mental health issues, risk behaviors, and loss to follow up during transition from paediatric to adult care.
This document summarizes Sri Lanka's efforts to eliminate mother-to-child transmission of HIV from 2002 to the present. It outlines key milestones in Sri Lanka's prevention of mother-to-child transmission (PMTCT) program, including expanding antiretroviral treatment options for pregnant women and their babies over time. Charts show increasing HIV testing rates among pregnant women and decreasing numbers of babies born with HIV despite more women receiving PMTCT services. Sri Lanka aims to achieve elimination of mother-to-child transmission of HIV by the end of 2017.
More from Sri Lanka College of Sexual Health and HIV Medicine (20)
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
nursing management of patient with Empyema pptblessyjannu21
prepared by Prof. BLESSY THOMAS, SPN
Empyema is a disease of respiratory system It is defines as the accumulation of thick, purulent fluid within the pleural space, often with fibrin development.
Empyema is also called pyothorax or purulent pleuritis.
It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space.
Pus is a fluid that’s filled with immune cells, dead cells, and bacteria.
Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue. it is mainly caused due in infectious micro-organisms. It can be treated with medications and other measures.
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...Nursing Mastery
Title: Unlocking the Wonders of the Special Senses: Sight, Sound, Smell, Taste, and Balance
Introduction:
Welcome to our captivating SlideShare presentation on the Special Senses, where we delve into the extraordinary capabilities that allow us to perceive and interact with the world around us. Join us on a sensory journey as we explore the intricate structures and functions of sight, sound, smell, taste, and balance.
The special senses are our primary means of experiencing and interpreting the environment, each sense providing unique and vital information that shapes our perceptions and responses. These senses are facilitated by highly specialized organs and complex neural pathways, enabling us to see a vibrant sunset, hear a symphony, savor a delicious meal, detect a fragrant flower, and maintain our equilibrium.
In this presentation, we will:
Visual System (Sight): Dive into the anatomy and physiology of the eye, exploring how light is converted into electrical signals and processed by the brain to create the images we see. Understand common vision disorders and the mechanisms behind corrective measures like glasses and contact lenses.
Auditory System (Hearing): Examine the structures of the ear and the process of sound wave transduction, from the outer ear to the cochlea and auditory nerve. Learn about hearing loss, auditory processing, and the advances in hearing aid technology.
Olfactory System (Smell): Discover the olfactory receptors and pathways that enable the detection of thousands of different odors. Explore the connection between smell and memory and the impact of olfactory disorders on quality of life.
Gustatory System (Taste): Uncover the taste buds and the five basic tastes – sweet, salty, sour, bitter, and umami. Delve into the interplay between taste and smell and the factors influencing our food preferences and eating habits.
Vestibular System (Balance): Investigate the inner ear structures responsible for balance and spatial orientation. Understand how the vestibular system helps maintain posture and coordination, and explore common vestibular disorders and their effects.
Through engaging visuals, interactive diagrams, and insightful explanations, we aim to illuminate the complexities of the special senses and their profound impact on our daily lives. Whether you're a student, educator, or simply curious about how we perceive the world, this presentation will provide valuable insights into the remarkable capabilities of the human sensory system.
Join us as we unlock the wonders of the special senses and gain a deeper appreciation for the intricate mechanisms that allow us to experience the richness of our environment.
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
At Malayali Kerala Spa Ajman we providing the top quality massage services for our customers.
Our massage center prioritizes efficiency to ensure a quality massage experience for our clients at Malayali Kerala Spa Ajman. We offer a convenient appointment system and precise massage services.
Reach us at Villa No 7, Near Ammar Bin Yasir Street Al Rashidiya 2 - Ajman - United Arab Emirates.
Phone : +971 529818279
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric n...
Presidential address 2015: Sexual health in the era of HIV
1. Sexual Health in the Era of HIV
Dr Ajith Karawita MBBS, PgD Ven, MD
President, Sri Lanka College of Venereologists
2. Overview of the presentation
1. HIV epidemic in Sri Lanka
2. HIV treatment cascade in Sri Lanka
3. Challenges in closing the gaps in the cascade
4. HIV within the broader concept of Sexual health
4. History of HIV in Sri Lanka
1981
1983
HIV virus was
identified
First AIDS case
reported in Sri
Lanka (foreigner)
1986
First Sri
Lankan patient
reported with
HIV
1987
First Locally acquired
HIV infection reported
in Sri Lanka
1989 ART
started
2004
First AIDS
case Reported
11. HIV positivity rate in different settings-2014
(among non-probability samples)
12. HIV positivity rate in IBBS 2014/15
(Probability samples)
INTEGRATED BIOLOGICAL AND BEHAVIOURAL SURVEILLANCE (IBBS) SURVEY AMONG
KEY POPULATIONS AT HIGHER RISK OF HIV IN SRI LANKA
Female sex workers (All) (N=1261) 0.81 %
Female sex workers (Colombo and Galle) 1.03 % 0.3 – 1.7 (95% CI)
Men who have sex with Men (MSM) (N=1217) 0.88 %
MSM (Colombo and Galle) 1.03 % 0.2 – 1.9
PWID (N=326) 0 %
BB (N=306) 0 %
15. Condom as Prevention (CasP)
Condom use at last sex in IBBS 2014/15
(Probability samples; RDS)
INTEGRATED BIOLOGICAL AND BEHAVIOURAL SURVEILLANCE
(IBBS) SURVEY AMONG KEY POPULATIONS AT HIGHER RISK OF
HIV IN SRI LANKA
Female sex workers (All) (N=1261) 93% 91.4 – 94.5 (95% CI)
Men who have sex with Men (MSM)
(N=1217)
58% 54.1 – 61.8 (95% CI)
BB (N=306) 68% 61.8 – 73.3 (95% CI)
PWID (N=326) 24% 18.8 – 28.9 (95% CI)
18. United States treatment cascade, from HIV
diagnosis to viral suppression (n=1.1 million PLHIV)
Source: Hall et al. Continuum of HIV care: differences in care and treatment by sex and race/ethnicity in
the United States. 2012 International AIDS Conference
24. 1. More robust data need to be fed for realistic
estimations
2. Widespread testing for case detection is a must
with priority for Key populations coverage
3. Creation of enabling legal and policy
environment
4. Creation of enabling environment at healthcare
system
Addressing pre-registration gaps
EstimatesDiagnosisClinic Registratipon
50%
26. Addressing Post-registration gaps
Registration ART start VL testing VL suppression
1. Creation of enabling legal and policy environment
2. Creation of enabling social environment
3. Creating and enabling family environment for
treatment access
4. Creating an enabling personality
5. Law level of defaulter tracing and contact tracing
25%
27. Addressing Post-registration gaps
Registration ART start VL testing VL suppression
6. Lack of availability of VL testing at an accessible
distance
7. Adherence issues among patients
8. Deviations for CAMs complementary and
alternative medicines
9. Change in guidelines for start of ART
25%
29. Sexual Health
Sexual Health is not merely the absence of
disease, infirmity or dysfunction. It is the
complete physical, emotional, mental and
social wellbeing in relation to sexuality
30. Diversity of expression of Sexuality
Sexuality includes
o Biological sex (Anatomical sex),
o Gender identities and roles,
o Sexual attractions or sexual orientation,
o Sexual preference, Erotism, Pleasure, Intimacy and
o Reproduction.
These dimensions are very diverse and complex and inter-
relating. Promotion of sexual health is important than ever
to address the gaps in HIV treatment cascade.
31. Acknowledgements for the presentation
1. Dr K A M Ariyaratne, and the staff of the strategic
information management unit of the National
STD/AIDS Control Programme for generating
important information
2. Dr Sisira Liyanage, Director, National STD/AIDS
Control Programme
3. Office bearers and the Council of the college of
Venerologist
4. Dr Sriyakanthi Beneragama for HIV and IBBS data
The most important and difficult gaps exist at the Pre-registration phase that is from estimation to detection and to registration and the average gap is about 50% at each step
More robust data need to be fed for realistic estimation and projections including Surveillance data, Size estimation data, programmatic data and also Methodological issues in very low level epidemics need to be considered for the fine tuning of our estimates.
Widespread testing for case detection is a must and need to take necessary steps to mainstream HIV testing to all possible entry points in health or non-health sectors. Key populations coverage is a priority but need to make it available freely beyond KPs for case detections
Creation of enabling environment by removing or mitigating barriers for access for testing and care through legal and policy reforms and strengthening right based approaches
Creation of enabling environment at healthcare systems by reducing stigma and discrimination, ensuring confidentiality and making culturally competent workforce.
Reasons for Post registration gaps are multiple and they also need to be addressed holistically
Creation of enabling legal and policy environment by removing or mitigating barriers for access such as legal and policy barriers for treatment access, formulating laws for right to health and right to life
Creation of enabling social environment by removing or mitigating social barriers such as stigma and discrimination, marginalization, homophobia, transphobia, lack of acceptance of sexual diversity, denial attitudes of the society for sex and sexuality
Creating and enabling family environment for treatment access, such as family counselling and psychosocial support, financial assistance
Creating an enabling personality such as anxiety, non-concerned health behaviour, self stigma, fatalism, Personal attitudes of patients
Creation of enabling environment at healthcare systems with sensitive and culturally competent staff
Law level of defaulter tracing and contact tracing due to some consent, confidentiality, financial and rights based issues and conflicts of human rights
Lack of availability of VL testing at an accessible distance
Adherence issues among patients
Deviations for CAMs complementary and alternative medicines
Change in guidelines for start of ART etc