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HIV Test (hiv + test)
Selected AbstractsInfluences on HIV testing among young African-American men who have sex with men and the moderating effect of the geographic settingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2004Andrew J. Mashburn This study examined the influence of demographic characteristics, risk behaviors, knowledge, and psychosocial variables on HIV testing among a sample (n = 551) of young African-American men who have sex with men (MSM) from three cities,Atlanta (n = 241), Birmingham (n = 174), and Chicago (n = 136). Among the entire sample of young men, age, knowledge of HIV treatments, knowledge of a comfortable place for an HIV test, and social support were related positively to rates of HIV testing. Furthermore, men who had sex with both main male partner(s) and non-main male partner(s) during the past year had significantly higher rates of HIV testing than men who had non-main male partner(s) only. Geographic setting moderated the effect on HIV testing behavior. In particular, social support, peer norms about condom use, and knowledge of HIV treatments were not associated with HIV testing in Atlanta, but were associated positively with HIV testing in either Birmingham, Chicago, or both. The strongest influence on HIV testing across all three settings was knowledge of a comfortable place for an HIV test. Implications of these findings for designing interventions to increase HIV testing are discussed. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 45,60, 2004. [source] Sudden Death from Tubercular MyocarditisJOURNAL OF FORENSIC SCIENCES, Issue 3 2006Enrico Silingardi M.D. ABSTRACT: Tuberculous myocarditis is a rare finding. We present the case of a 33-year-old woman who was in good health and who died suddenly at home. Autopsy and histopathologic examinations revealed granulamatous lesions in the myocardium, lungs, lymph nodes, liver, and spleen. No fast acid bacilli were demonstrated on histological examination. The presence of a Mycobacterium tuberculosis DNA complex was identified using a polymerase chain reaction (PCR) on formalin-fixed paraffin-embedded histological samples. An HIV test carried out on the blood obtained during the autopsy was negative according to the DNA amplification technique (PCR) and enzyme-linked immunosorbent assay serological test. We hypothesize that the mechanism of death was severe ventricular arrhythmia due to granulomatous proliferation in the structures of the interventricular septum. [source] Incidence of tuberculosis and HIV and progression of silicosis and lung function impairment among former basotho gold miners,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Harriet H. Park MPH Abstract Background Pulmonary tuberculosis and HIV incidence, mortality, and the progression of silicosis and lung function impairment are described over a 1-year period in migrant ex-gold miners from Lesotho. Methods Seven hundred seventy-nine Basotho miners were followed for 1 year starting 18 months after lay-off from a South African gold mine in 1998. At baseline and follow-up, they underwent a respiratory symptom interview, physical examination, HIV test, chest radiograph, and spirometry. Results Five hundred thirteen of 779 (65.9%) participants attended both baseline and follow-up visits. HIV incidence was 5.4/100 person-years (95% CI: 3.4,8.2). Prevalence of silicosis (ILO score ,1/1) was 26.6% at baseline and 27.0% at follow-up. Active tuberculosis diagnosed at baseline was a strong predictor of radiological progression of silicosis. Lung function as measured by FEV1 declined an average of 91,ml between visits (95% CI: 67,116,ml). Calculated minimum incidence of tuberculosis was 3,085/100,000/years (95% CI: 1,797,4,940) at follow-up. Of those seen at baseline, 18 died before their scheduled follow-up visit (mean age: 51 years). Conclusions High rates of mortality and of HIV infection and pulmonary tuberculosis were found in this cohort after leaving the South African goldmines. Continuing lung function loss was also apparent. A partnership between the South African mining industry and governments in labor-sending areas of Southern Africa is needed to provide continuity of care and access to HIV and tuberculosis treatment and prevention services. Active silicosis surveillance and an improved statutory compensation system are also needed. These findings can serve as a baseline against which the impact of such interventions can be assessed. Am. J. Ind. Med. 52:901,908, 2009. © 2009 Wiley-Liss, Inc. [source] Associations of Rural Residence With Timing of HIV Diagnosis and Stage of Disease at Diagnosis, South Carolina 2001-2005THE JOURNAL OF RURAL HEALTH, Issue 2 2010Kristina E. Weis PhD Abstract Context: Rural areas in the southern United States face many challenges, including limited access to health care services and stigma, which may lead to later HIV diagnosis among rural residents. Purpose: To investigate the associations of rural residence with timing of HIV diagnosis and stage of disease at diagnosis. Methods: Timing of HIV diagnosis was categorized as a diagnosis of acquired immune deficiency syndrome within 1 year of a first positive HIV test or HIV-only. Stage of disease was based on initial CD4+ T-cell count taken within 1 year of diagnosis. County of residence at HIV diagnosis was classified as urban if the population of the largest city was at least 25,000; it was classified as rural otherwise. Logistic regression was used to analyze timing of HIV diagnosis, and analysis of covariance was used to analyze stage of disease. Findings: From 2001 to 2005, 4,137 individuals were diagnosed with HIV infection. Of these, 1,129 (27%) were rural and 3,008 (73%) were urban residents. Among rural residents, 533 (47%) were diagnosed late, compared with 1,258 (42%) urban residents. Rural residents were significantly more likely to be diagnosed late (OR 1.19 [95% CI, 1.02-1.38]). Rural residence was associated with lower initial CD4+ T-cell count in crude analysis (P= .01) but not after adjustment (P > .05). Conclusions: Rural residence is a risk factor for late HIV diagnosis. This may lead to reduced treatment response to antiretroviral medications, increased morbidity and mortality, and greater HIV transmission risks among rural residents. New testing strategies are needed that address challenges to HIV testing and diagnosis specific to rural areas. [source] Acceptance of Rapid HIV Screening in a Southeastern Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Arin E. Freeman MPH Abstract Objectives:, The objective was to assess the acceptance of an emergency department (ED) human immunodeficiency virus (HIV) screening program based on the Centers for Disease Control and Prevention (CDC) recommendations for routine HIV screening in health care settings. Methods:, Rapid HIV screening was offered on an opt-out basis to patients aged 13 to 64 years presenting to the ED by trained HIV counselors. Patients were excluded if they had a history of HIV, were physically or mentally incapacitated, did not understand their right to opt-out, or did not speak English or Spanish. Statistical analyses, including logistic regression, were performed to assess the associations between the demographics of patients offered testing and their test acceptance or refusal. Results:, From March 2008 to January 2009, a total of 5,080 (91%) of the 5,585 patients offered the HIV test accepted, and 506 (9%) refused. White and married patients were less likely to accept testing than those who were African American and unmarried (p < 0.001). Adult patients were almost twice as likely to accept testing as pediatric patients (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.50 to 2.53). As age increased among pediatric patients, testing refusal decreased (OR = 0.71; 95% CI = 0.59 to 0.85), and as age increased among adult patients, testing refusal increased (OR = 1.17; 95% CI = 1.12 to 1.22). Two percent of persons accepting the test were considered high risk. Males were more likely to report high-risk behavior than females (OR = 1.83; 95% CI = 1.23 to 2.72). Conclusions:, The opt-out approach results in high acceptance of routine HIV screening. Widespread adoption of the CDC's recommendations, although feasible, will require significant increases in resources. [source] Determinants of adherence to a single-dose nevirapine regimen for the prevention of mother-to-child HIV transmission in Gert Sibande district in South AfricaACTA PAEDIATRICA, Issue 5 2010Karl Peltzer Abstract Aim:, To identify factors that influence adherence to antiretroviral (ARV) prophylaxis by HIV positive mothers participating in the HIV prevention of mother to child (PMTCT) programme. Methods:, Post-delivery 815 HIV-infected mothers aged 18 years and above with babies aged 3,6 months were interviewed in Gert Sibande District, Mpumalanga province, South Africa. Results:, Eighty five percent of the mothers indicated that they had been provided with nevirapine and 78.4% took it before or at the onset of labour and infant nevirapine intake was 76.9%. In multivariate analysis it was found that women with better PMTCT knowledge had a higher perceived confidentility about HIV status at the health facility. They had a term delivery and those who had told their partner about nevirapine had a higher maternal nevirapine adherence. Women who had also told their partner about nevirapine, whose partner was asked for an HIV test and those who knew the HIV status of their infant had higher infant nevirapine adherence. Conclusion:, Adherence to maternal and infant ARV prophylaxis was found to be sub-optimal. Health services delivery factors, male involvement, communication and social support contribute to adherence to ARV prophylaxis in this largely rural setting in South Africa. [source] Comparison of the performance of rapid HIV tests using samples collected for surveillance in Mozambique,JOURNAL OF MEDICAL VIROLOGY, Issue 12 2009Josefa Melo Abstract Mozambique had low HIV prevalence until the mid-1990s, but recent data indicate increasing rates. There is little information on HIV-2. Therefore, HIV seroprevalence was assessed among pregnant women and field-ready HIV diagnostic strategies were evaluated. A total of 6,930 samples collected by three health centers from 2002 to 2005 were tested on site by nurses with two simple/rapid tests, Determine HIV-1/2 (Abbott Laboratories; screening) and Uni-Gold HIV (Trinity Biotech; confirmation), which is the national HIV testing strategy. The prevalence of HIV was 14.0% (2002), 17.8% (2003), 16.5% (2004), and 20.2% (2005). A subset of 888 samples collected 2003 was sent to the Central Microbiology Laboratory, Maputo for evaluation of tests and testing strategies. The assays included for comparison were Capillus HIV-1/HIV-2 (Trinity Biotech), DoubleCheckGold HIV-1&2 (Orgenics) and Enzygnost Anti-HIV-1/2 Plus (Behringwerke, reference ELISA). Confirmation of reactive samples was done by Uni-Gold HIV and ImmunoComb II HIV-1&2 BiSpot (for HIV type differentiation). The Capillus HIV-1/ HIV-2,+,ImmunoComb II HIV-1&2 BiSpot combination was the gold standard. The sensitivity of the rapid/simple screening assays (Determine HIV-1/2, DoubleCheckGold HIV-1&2) was 100% (N,=,160) and their (initial) specificities were 99.6% and 99.7%, respectively. Repeated testing and combinations of assays increased the specificity. Four suspected cases of recent seroconversion were found. Together with the increasing prevalence rates, this may indicate that Mozambique is a high-incidence area, although further studies are needed to confirm this. Testing strategies for on-site screening and confirmation based on the combination of Determine HIV-1/2, Uni-Gold HIV and DoubleCheckGold HIV-1&2 are well suited for local field use. J. Med. Virol. 81:1991,1998, 2009. © 2009 Wiley-Liss, Inc. [source] HIV antigen,antibody combination enzyme immunoassay,the experience of a London Teaching HospitalJOURNAL OF MEDICAL VIROLOGY, Issue S1 2007Simon Goldenberg Abstract The introduction of the fourth generation HIV antigen,antibody combination enzyme immunoassay (HIV Ag,Ab EIA) has led to a reduction in the diagnostic "window period" when HIV antibody is negative during primary infection. This facilitates earlier laboratory diagnosis during sero-conversion. An HIV Ag,Ab EIA (AxSYM, Abbott Laboratories, Kent, UK) was introduced to a London Teaching Hospital since 2004 as the primary screening test. Confirmation was performed using another HIV Ag,Ab EIA (Vironostika, BioMérieux, Hampshire, UK) and an HIV Ab only assay (Bispot, Orgenics, Yavne, Israel). Retrospective analysis identified a total of 20 sero-converting patients who would have been missed if the standard antibody-only HIV tests had been used as the primary screening test. This accounted for approximately 3% of the new diagnoses made by the laboratory. The median time from onset of illness to sero-conversion was 18 days. Two patients had multiple samples analyzed between initial presentation and eventual sero-conversion. One had a prolonged sero-conversion illness lasting for over 137 days; the other sero-converted within 17 days. A plotting of the signal to cut-off ratio with time of the two HIV Ag,Ab EIAs showed a V-shaped curve and both tests were below cut-off at some time-points during sero-conversion. These two cases highlighted the difficulties in diagnosing HIV infection during sero-conversion. On the basis of these results, it is recommended that a fourth generation HIV Ag,Ab EIA could be considered for use as the standard of care, particularly in any population with a high rate of HIV infection. J. Med. Virol. 79:S23,S26, 2007. © 2007 Wiley-Liss, Inc. [source] Sero-Discordant Couples in Five African Countries: Implications for Prevention StrategiesPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2007Damien De Walque Most analyses of the determinants of HIV infection are performed at the individual level. The recent Demographic and Health Surveys, which include results from HIV tests, allow the study of HIV infection at the level of the cohabiting couple. This article exploits this feature of the data for Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania. The analysis yields two findings about the dynamics of the HIV/AIDS epidemic that have important implications for policy. First, at least two-thirds of the infected couples are sero-discordant, that is, only one of the two partners is infected. This implies scope for prevention efforts among infected couples. Second, among 30,40 percent of the infected couples only the woman is infected. This is at odds with levels of self-reported extramarital sex by women and with the common perception that unfaithful men are the main link between high-risk groups and the general population. These findings are confirmed by tests of robustness. These results indicate that extramarital sexual activity among women in union is a substantial source of vulnerability to HIV that should be, as much as male extramarital activity, targeted by prevention efforts. [source] | ||||||||||