Rural Incarcerated Women: HIV/HCV Knowledge and Correlates of Risky Behavior

Disease burden of AIDS in last 30-year period and its predicted level in next 25-years based on the global burden disease 2019

BACKGROUND

This study examines global trends in acquired immune deficiency syndrome (AIDS) incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2019, focusing on regional disparities in AIDS incidence, mortality, and DALYs across various levels of socio-demographic index (SDI). It also investigates variations in AIDS incidence, mortality, and DALYs across different age groups, and projects specific trends for the next 25 years.

METHODS

Comprehensive data on AIDS from 1990 to 2019 in 204 countries and territories was obtained from a GBD study. This included information on AIDS incidence, mortality, DALYs, and age-standardized rates (ASRs). Projections for AIDS incidence and mortality over the next 25 years were generated using the Bayesian age-period-cohort model.

RESULTS

From 1990 to 2019, the global incidence of HIV cases increased from 1,989,282 to 2,057,710, while the age-standardized incidence rate (ASIR) decreased from 37.59 to 25.24 with an estimated annual percentage change (EAPC) of -2.38. The ASIR exhibited an upward trend in high SDI and high-middle SDI regions, a stable trend in middle SDI regions, and a downward trend in low-middle SDI and low SDI regions. In regions with higher SDI, the ASIR was higher in males than in females, while the opposite was observed in lower SDI regions. Throughout 1990 to 2019, the age-standardized death rate (ASDR) and age-standardized DALY rate remained stable, with EAPCs of 0.24 and 0.08 respectively. Countries with the highest HIV burden affecting women and children under five years of age are primarily situated in lower SDI regions, particularly in sub-Saharan Africa. Projections indicate a significant continued decline in the age-standardized incidence and mortality rates of AIDS over the next 25 years, for both overall and by gender.

CONCLUSIONS

The global ASIR decreased from 1990 to 2019. Higher incidence and death rates were observed in the lower SDI region, indicating a greater susceptibility to AIDS among women and < 15 years old. This underscores the urgent need for increased resources to combat AIDS in this region, with focused attention on protecting women and < 15 years old as priority groups. The AIDS epidemic remained severe in sub-Saharan Africa. Projections for the next 25 years indicate a substantial and ongoing decline in both age-standardized incidence and mortality rates.

The prevalence of Human Immunodeficiency Virus infection among voluntary blood donors in mainland China: A systematic review and meta-analysis

Human immunodeficiency virus (HIV) infection through transfusion has been an imperative challenge for blood safety. Despite the implementation of screening strategies, there was still the residual risk of transfusion-transmitted HIV. Considering that the prevalence of HIV infection in blood donors is significant for evaluating blood safety and potential risks to the population, meta-analysis was applied to investigate the HIV prevalence among voluntary blood donors during the past 27 years to characterize the epidemiology and related risk factors of HIV in blood donors. The literature concerning the HIV screening reactive rate and prevalence in Chinese voluntary blood donors was collected through the systematic searching of four electronic databases. After integrating data, following the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines, data manipulation and statistical analyses were conducted by Stata 12.0. The results indicated that overall HIV prevalence was 0.0178% (95% confidence interval [CI], 0.0169%-0.0187%) with a remarkable rise, which varied from 2000 (0.0034%) to 2015 (0.027%). The HIV window period infection rate was 0.0475‱ (95% CI, 0.0304‱-0.0646‱). Importantly, subgroup analysis revealed the heterogeneity in gender, occupations, education and donation frequency. With the effective control of HIV transmission through blood, HIV prevalence declined in China to some extent in recent years, and the characteristics of HIV epidemic in some provinces have drastically changed. However, remaining relatively high HIV prevalence and overall increased trend of HIV prevalence since the 21th century demonstrates the potential residual risk of blood transfusion, and the whole society is supposed to pay close attention to HIV infection.

Access to healthcare for people living with HIV: an analysis of judgments of the European Court of Human Rights from an ethical perspective

Introduction

Although HIV has been part of our reality for over 30 years, people living with HIV (PLHIV) still experience restrictions regarding their access to healthcare. This poses a significant ethical problem, especially as it endangers achieving the goal of ending the HIV epidemic worldwide. The aim of this paper is to analyze the rulings of the European Court of Human Rights (ECtHR) regarding cases where PLHIV experienced restrictions on their access to healthcare.

Methods

We conducted an analysis of the ECtHR database and were able to identify N = 28 cases dealing with restricted access to healthcare for PLHIV. A descriptive and thematic analysis was conducted to identify ways in which access to healthcare for PLHIV was restricted.

Results

We were able to identify a total of four main categories, with denial of adequate therapeutic support as the main category with N = 22 cases (78.57%). Most of the judgments examined were filed against Russia (N = 12, 42.86%) and Ukraine (N = 9, 32.14%). A large proportion of PLHIV in the cases studied (N = 57, 85.07%) were detainees.

Discussion

The analysis shows a clear condemnation of limited access to healthcare for PLHIV by the ECtHR. Ethical implications of the analyzed cases are discussed in detail.

Effect of a board game on imprisoned women's knowledge about sexually transmitted infections: a quasi-experimental study

INTRODUCTION

Board games can be used as a playful educational practice in the teaching and learning process, as they constitute an educational technology that can be a source of health knowledge and an aid in decision-making. The objective of this research was to assess the effect of a board game on imprisoned women's knowledge about STIs.

METHODS

A quasi-experimental study was conducted in 2022 with 64 imprisoned women who were students at a school located in a prison unit from the city of Recife, state of Pernambuco, Brazil. A 32-item instrument was used to assess knowledge about sexually transmitted infections before, immediately after the intervention and at 15 days. The intervention consisted in applying the Previna board game in a classroom. All the analyses were performed in the Stata software, version 16.0, with a 5% significance level.

RESULTS

The knowledge mean in the pre-test was 23.62 (± 3.23) points, whereas it rose to 27.93 (± 2,28) in the immediate post-test, dropping to 27.34 (± 2.37) (p < 0.001) in post-test 2, which was performed 15 days after the intervention. There was a statistically significant difference in the means obtained between the pre-test and the immediate post-test (p < 0.001), with a difference of 4.241 points, as well as between the pre-test and post-test 2 (p < 0.001), a difference of 3.846 spots.

CONCLUSIONS

The Previna board game significantly increased its players' knowledge about STIs, and such increase in knowledge remained significant during the follow-up period.

Using theory of reasoned action to reduce high-risk sexual behaviors among patients with HPV: A randomized controlled trial

BACKGROUND

Sexually transmitted diseases are a major health problem in all countries. Human papillomavirus (HPV) infection is the most common viral sexually transmitted disease in both genders. High-risk sexual behaviors (HRSBs) are among the major risk factors for HPV infection. Lack of knowledge can contribute to HRSBs and hence, education can potentially reduce HRSB risk. This is a study using theory of reasoned action to reduce the high-risk sexual behaviors among patients with HPV.

MATERIALS AND METHODS

This study was a two-grouped, randomized, controlled trial. The educational program was developed based on the results of a survey into the most important components of the theory of reasoned action contributing to HRSBs among 100 patients recruited from Razi hospital, Tehran, Iran. Then, 110 patients from the same hospital were consecutively recruited and randomly allocated to a control (n = 55) and an intervention (n = 55) group. Then, each participant in the intervention group was provided with the developed educational program. Their counterparts in the control group solely received routine care services. Three months after the first educational session, HRSBs were reassessed in both groups. Data were analyzed via the SPSS software (v. 21.0).

RESULTS

After the intervention, the mean score of HRSBs significantly decreased in the intervention group (P < 0.001) but did not significantly change in the control group (P = 0.70). The post-test mean score of HRSBs in the intervention group was significantly less than the control group (P = 0.015).

CONCLUSION

Education based on the theory of reasoned action is effective in significantly reducing HRSBs. Nurses can develop and use educational interventions based on this theory to reduce HRSBs and HPV infection.

Translation, validation and cultural adaptation of the Arabic version of the HIV knowledge questionnaire (HIV-Kq-18)

BACKGROUND

Although the number of new HIV infections is declining in most regions of the world, the Middle East is one of the regions with a rapidly growing HIV epidemic, with Egypt having the fastest-growing epidemic, with a 76 percent increase in the number of cases. One of the major factors contributing to this trend is the general public's lack of knowledge about the disease. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) is one of the most widely used instruments for assessing HIV/AIDS knowledge and has been translated into several languages. This study examined the validity of the Arabic version of the HIV-18-KQ as well as its adaptation among Arab undergraduates.

METHODS

The HIV-18-KQ was both forward and back-translated. The translation was reviewed by an expert committee of eight experts. The final version was created and distributed to undergraduates from five Arabic countries: Egypt, Sudan, Yemen, Jordan, and Algeria. The validity of the Arabic version of the HIV-18-KQ was evaluated using internal consistency and construct validity. Internal consistency was tested using the Kuder-Richardson formula 20 (KR-20), and construct validity was evaluated using an exploratory factor analysis with a polychoric correlation matrix.

RESULTS

The majority of the translated items were easy to understand. The Arabic HIV-18-KQ was deemed culturally appropriate by the expert committee. This study included 1745 university students, including 956 (54.5%) males and 798 (45.5%) females, with 33.4% from Egypt. Based on the acceleration factor approach to interpreting the scree plot in the factor analysis, it was preferable to use only one factor, which is consistent with the original version of HIV-45-KQ. The KR-20 value was 0.73, indicating good internal reliability.

CONCLUSION

This study demonstrates that the Arabic version of the HIV-18-KQ is a valid and reliable tool for assessing HIV-related knowledge in Arabic-speaking countries.

Diagnosis, Treatment, and Prevention of HIV Infection among Detainees: A Review of the Literature

Detainees are one of the most vulnerable populations to human immunodeficiency virus (HIV). This is mostly caused by the lack of knowledge on the topic among the inmates; the lack of prophylaxis; the high percentage of risky behaviors in jail, such as sexual abuse, unprotected sexual intercourses, and injective drug use; and the generally low perception of the risk of transmission. It has also been observed that the problem does not cease to exist at the moment of release, but it also may be aggravated by the weak support system or the total absence of programs for people living with HIV/AIDS (PLWHA) to avoid discontinuation of antiretroviral drugs. Difficulty in providing housing and jobs and, therefore, a form of stability for ex-detainees, also contributes to none adherence to antiretroviral therapy. Among the detainees, there are also categories of people more susceptible to discrimination and violence and, therefore, to risky behaviors, such as black people, Hispanics, transgender people, and men who have sex with men (MSM). We reviewed the literature in order to provide a more complete picture on the situation of PLWHA in jail and to also analyze the difficulties of ex-detainees in adhering to HIV therapy.

Feasibility of using Facebook for HIV prevention: Implications for translational research among justice-involved women who use drugs in rural Appalachia

Background

Justice-involved women from rural Appalachia face significant barriers to the utilization of evidence-based HIV prevention interventions in spite of high rates of injection drug use and risky sexual practices. Adapting evidence-based practices to incorporate the cultural uniqueness of the target population is needed in order to advance translational and clinical science in this area. This study provides a descriptive overview of indicators of feasibility and acceptability of an adapted version of the National Institute on Drug Abuse Standard HIV prevention intervention for delivery using Facebook through a small randomized controlled pilot study with rural Appalachian women.

Method

Study methods include the random selection of rural Appalachian women from two local jails, screening for study eligibility, baseline data collection, random assignment to study interventions, and follow-up in the community three months post-release.

Results

Results indicate that the feasibility of the approach was supported through study enrollment of the target population who reported regular Facebook use and HIV risk behaviors including drug use and sex. Acceptability of the intervention was demonstrated through enrollment in the study intervention, engagement in the intervention through Facebook, and indicators of HIV/HCV knowledge.

Conclusions

Study findings contribute to the critical and unmet need to advance translational science on the delivery of evidence-based prevention interventions in real-world rural Appalachian settings to understudied, vulnerable individuals who are often overlooked in targeted prevention efforts.

Adaptation and validation of the HIV Knowledge Questionnaire-18 for the general population of Indonesia

Background

Despite a global decline in new HIV/AIDS cases in low-middle countries, cases are increasing in Indonesia. Low knowledge about the disease among the general population is one of the major factors responsible for this trend. Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) has been translated into several languages and is one of the most extensively used instruments for assessing HIV/AIDS knowledge. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge in the general population of Indonesia.

Methods

In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants. At the validation stage, we distributed the instrument link via Google Form to 6 major regions in Indonesia. Validity was measured using known-group validity and construct validity. The construct validity was assessed using an exploratory factor analysis (EFA) with a polychoric correlation matrix. Cronbach’s alpha was used to analyze the internal consistency.

Results

Based on the findings in the adaptation phase, additional descriptions (namely synonyms or examples) were added to 6 items to make them more understandable. In the validation phase, 1,249 participants were recruited. The a priori hypothesis in known-group validity was supported. We also found three items that did not meet the construct validity. Based on the acceleration factor approach to interpret the scree tree in the factor analysis, using only two factors was preferable. Cronbach's alpha values were 0.75 and 0.71 representing good internal reliability.

Conclusion

The HIV-KQ-18 Bahasa Indonesia is considered a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia.

Risks for acquiring hepatitis C virus among women in the United States

OBJECTIVE

To conduct a literature review about the breadth of risks for acquiring hepatitis C virus (HCV) among women who are living in the United States.

DESIGN

A mixed research synthesis of qualitative, quantitative, and mixed-methods studies guided by the Socioecological Model and Theory of Gender and Power.

SAMPLE AND ANALYTIC STRATEGY

The sample consisted of 29 studies: 10 qualitative, 18 quantitative, and one mixed-methods studies. Data were analyzed using a segregated approach and integrated into a narrative synthesis of themes by components of the Socioecological Model.

RESULTS

Individual risks themes were drug use as a coping strategy, transition to injection drug use, and lack of awareness about HCV. Interpersonal risks themes were social norms of drug use and drug use and sexual activities. Community risks themes were community re-entry, housing instability, and community HCV resources. Societal risks themes are policies affecting drug markets and social construct of "worthlessness."

CONCLUSIONS

Findings highlight the need for comprehensive gender-specific HCV prevention strategies built around harm reduction. In partnership with women with lived experience, public health nurses can apply findings to build harm reduction collaborations aimed at implementing HCV risk-reduction or risk-elimination strategies.

Prevention of alcohol consumption and transmission of human immunodeficiency virus: randomized clinical trial

Objective:

to know the effects of a nursing intervention to reduce alcohol use and risk factors for transmission of human immunodeficiency virus (HIV).

Method:

randomized single-blinded clinical trial performed by nurses with young women. The study included 66 participants in the intervention group and 66 participants in the control group. The instruments were the Alcohol Use Disorders Identification Test, the HIV Risk Behavior Knowledge and the Condom Use Self-efficacy Scale. Analysis of variance was used.

Results:

alcohol involvement decreased in the intervention group (F (1.119) = 50.28; p < 0.001; η²_p = 0.297), while HIV knowledge (F (1.130) = 34.34; p < 0.001; η²_p = 0.209) and condom use self-efficacy increased (F (1.129) = 27.20; p < 0.001; η²_p = 0.174). In addition, less participants consumed alcohol in the past week compared to the control group (χ² = 15.95; p < 0.001).

Conclusion:

the nursing intervention had positive effects, which could help young women stay away from alcohol use and the risk of sexually transmitted infections. NCT: 02405481.

Health Services Use Among Jailed Women with Alcohol Use Disorders

Correctional facilities now house unprecedented numbers of women with complex treatment needs. This investigation applied the Behavioral Model for Vulnerable Populations to study 168 jailed women with alcohol use disorders. It described the sample's predisposing (age, race, victimization), enabling (health insurance), and need (self-reported medical, substance use, and mental health problems) factors and examined associations of these factors with pre-incarceration services utilization. Most participants had clinically significant levels of depression and PTSD symptoms, most took psychiatric medications, and most had been victimized. Participants reported considerable health services utilization. Younger, Black, and uninsured women utilized fewer medical and mental health services. Drug use was associated with less use of medical services, but more use of alcohol and drug services. High rates of health services use support the need for integrated, ongoing care for substance-using women before, during, and after incarceration.

Knowledge and Awareness of Hepatitis B Virus Infection in Nigeria

Background:

The World Health Organisation recently launched a campaign to reduce Hepatitis B Viral Infections by 80% globally. Achieving this goal is partly predicated on proper awareness of persons in regions of high transmission.

Objective:

The aim of this study was to assess the Hepatitis B Virus (HBV) infection knowledge status of persons across three states in Nigeria.

Methods:

A descriptive cross-sectional study among 758 persons selected by convenience sampling was conducted from March to July 2016. Structured questionnaires were administered to consenting participants and analysed using descriptive and inferential statistical methods in SPSS V20.

Findings:

Respondents showed average knowledge with a mean knowledge score of 4.85 ± 2.69 out of a max score of 9.00. Respondents belonging to the working class had significantly better knowledge (5.59 ± 2.34 p < 0.001) than respondents in other categories. High-risk behaviour such as having multiple partners was predominant among respondents belonging to a public institution. A total of 242 (31.96%) of study respondents were aware of the existence of a vaccine for HBV, whereas only 161 (21.2%) had received at least one dose of vaccination against HBV. Previous knowledge of HBV infection, previous HBV testing, and knowing someone who had HBV infection were predictors of HBV infection knowledge as well as vaccination.

Conclusion:

This study has shown the urgent need for intervention targeted at raising awareness about HBV infection and the existence of a vaccine.