Knowledge and attitudes towards AIDS among primary health care physicians in the Asir Region, Saudi Arabia

Human immunodeficiency virus in Saudi Arabia: Current and future challenges

INTRODUCTION

Understanding the pathophysiology of HIV infection has been crucial to the design of effective anti-viral strategies. HIV infection is declining worldwide due to early diagnosis and the effective long-term use of anti-retroviral therapy. New infections decreased from 3.3 million in 2002-2.3 million in 2012. However, in the Middle East and North Africa (MENA), an estimated 83,000 individuals still acquired the virus, with 37,000 morbidities reported. The first incidence of acquired immunodeficiency syndrome (AIDS) from the Kingdom of Saudi Arabia (KSA) was reported in 1984. By the end of 2013, around 1509 patients had been diagnosed with HIV infection. HIV surveillance has improved in KSA with advances in medical care, counseling, family planning, diagnostic evaluation, and anti-retroviral therapy, but challenges remain. Patients receiving anti-retroviral therapy still show significant morbidity and mortality. Further targeted treatment regimens and preventive strategies are required to control HIV infection in KSA. Progress towards meeting the 90-90-90 goals for HIV in the MENA has also not been systematically monitored.

METHOD

In this review, we examine current screening programs, therapeutic modalities, the emergence of drug resistance, and future perspectives for HIV-associated health care in KSA.

CONCLUSION

The aim is to offer insight for healthcare policymakers to comply with the UNAIDS 2020 vision program and help establish the prevailing paradigms in the HIV community for an AIDS-free generation and the 90-90-90 goals for diagnosis.

Scoping review of sexual and reproductive healthcare for men in the MENA (Middle East and North Africa) region: a handful of paradoxes?

Background

No study appraised the knowledge gaps and factors impacting men’s sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task.

Methods

We searched PubMed and Web of Science (WoS) electronic databases for original articles on men’s SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men’s experiences of and access to SRH.

Results

A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men’s SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH.

Conclusion

Men’s SRH is not sufficiently prioritized. We observed five ‘paradoxes’: strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men’s involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men’s involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These ‘mismatches’ suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men’s SRH.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14716-2.

Sexually transmitted infection knowledge and attitudes among Muslim women worldwide: a systematic review

Extramarital sexual relations are forbidden in Islam, and sexual health information is not readily available in Islamic communities, especially for women. This review aimed to explore sexually transmitted infection (STI) knowledge and attitudes among Muslim women worldwide. A systematic review was conducted on seven electronic databases. We included qualitative and quantitative studies of female Muslim participants of reproductive age, focusing on STI knowledge and attitudes. A narrative synthesis approach was used with thematic analysis methods. Eighteen studies conducted in 13 countries were included. Three main themes were identified: poor knowledge and misconceptions; sources of sexual health information and information needs; and cultural influences on STI knowledge and attitudes. Generally, Muslim women had poor knowledge regarding STI signs and symptoms, prevention, diagnosis and treatment, in addition to many misconceptions. Negative attitudes towards people infected with HIV/AIDS were common, and attitudes were highly influenced by misconceptions and insufficient knowledge. Infected women tended to be subjected to more blame and judgement compared to men. While the review summarises knowledge and attitudes of Muslim women worldwide, we excluded studies that did not clearly state that the study participants were Muslim women, hence many countries with Muslim populations are not represented in this review. Negative attitudes towards STIs make it harder for women to access sexual health information, STI prevention and treatment. This review highlights the need for culturally sensitive sexual health education for Muslim women. Future sex education interventions would benefit from considering the wider personal and external barriers.

Characterising HIV/AIDS knowledge and attitudes in the Middle East and North Africa: Systematic review and data synthesis

This article reviews HIV/AIDS knowledge and attitudes in various population groups in the Middle East and North Africa (MENA), and highlights their relevance to HIV epidemiology and the design and implementation of preventions and treatment efforts. PubMed and the MENA HIV/AIDS Epidemiology Synthesis Project database of grey/unpublished literature were searched. Levels of knowledge were categorised based on presence of basic knowledge, comprehensive knowledge, and misconceptions and misinformation. Attitudes towards people living with HIV/AIDS (PLHIV) were classified into positive or negative. Basic knowledge was overall high among key populations at higher risk of infection (KPAR), and bridging and general population groups, but still a few population pockets had low basic knowledge. Level of comprehensive knowledge was overall low, and misinformation and misconceptions were prevalent. Some KPAR, including people who inject drugs, men who have sex with men, and female sex workers, were unaware of some modes of HIV transmission. Perception of risk of infection was low even among KPAR. We found differentials in knowledge putting women, rural populations, refugees, and other marginalised minorities at a disadvantage. Attitudes towards PLHIV tended to be negative. These findings are of concern, particularly for KPAR currently experiencing emerging HIV epidemics.

Systematic review of human immunodeficiency virus (HIV) knowledge measurement instruments used on the Arabian Peninsula

Background

In 1984, the Kingdom of Saudi Arabia (KSA) began surveillance for human immunodeficiency virus (HIV) incidence and prevalence. However, no culturally-appropriate standardized questionnaire has been developed to measure HIV prevention knowledge in this population. Evidence exists that married Saudi women are especially at higher risk for infection, but lack knowledge of HIV modes of transmission and underestimate their personal risk of becoming infected. The objective of this paper is to present a critical review of existing HIV knowledge measurement tools developed for the KSA and other Arabian Peninsula populations, and to utilize this review to guide the development of a culturally- and gender-sensitive tool. Studies included were in English reporting results of a quantitative survey instrument as either an interview or self-reported questionnaire with questions about knowledge of HIV or AIDS. Surveys must have been given in English or Arabic, and must have been done in a population in the KSA or the Arabian Peninsula. The following data sources were searched for eligible studies: Google Scholar, Google Web, PubMed, PLoS, WHO publications, UN publications, news, and other peer-reviewed publication databases.

Results

Sixteen articles met criteria, and of these, 10 (63 %) were conducted in a KSA population, and a majority of the articles studied students of primary, secondary, or post-secondary schools (n = 9, 56 %). Five studies included only men, while the other 11 included both sexes.

Conclusions

The KSA’s public health goals should more specifically focus on measuring and improving knowledge in high-risk populations such as married women—an option currently limited by commonly available measurement instruments.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-015-1614-x) contains supplementary material, which is available to authorized users.

Dental practice, human immunodeficiency virus transmission and occupational risks: views from a teaching hospital in Nigeria

Background:

More than 40 oral manifestations of human immunodeficiency virus (HIV) infection have been recorded and between 70% and 90% of persons with HIV infection will have at least one oral manifestation at some time during the course of their disease. Oral health-care workers (OHCWs) are therefore, key players in the prevention and management of HIV-infection.

Aim:

The aim of this study was toassess the perceptions of the OHCWs from a Teaching Hospital in Nigeria toward HIV transmission in dental practice and occupational risk.

Subjects and Methods:

A cross-sectional study. A self-administered questionnaire was used for data collection. A total of 113 OHCWs comprising students, house officers, resident doctors, dental nurses and consultants participated. Analysis was by Statistical Package for the Social Sciences version 17 (SPSS Inc., Chicago, IL, USA). Data analysis included descriptive statistics (frequency distribution and cross tabulation).

Results:

More than half 64/113 (56%) of the respondents were in the age group 20-30 years and females 68/113 (60%). Though 88% (100/113) of the respondents demonstrated a good knowledge about HIV transmission, 82/113 respondents (72%) disagreed that the risk of HIV transmission in the dental clinic was very low. 82.4% (93/113) did not know that saliva contains anti-HIV activity while 46% (52/113) agreed that pure saliva does not contain the virus except when contaminated by blood. 86.7% (98/113) of the OHCWs disagreed that dental professionals have a lower risk of being infected with HIV compared with other health-care providers.

Conclusion:

The OHCWs studied manifested some inaccurate perception of occupational risks as regards HIV transmission in dental practice. This could lead to potential stigma and discrimination of people living with HIV/acquired immune deficiency syndrome and thus hindering efforts geared at curtailing the spread of the virus.

Delayed onset of warts over tattoo mark provoked by sunburn

Multiple warts in a 32-year-old-man are reported that developed after tattooing and remaining exclusively confined to that area. The tattooing was done 2.5 years earlier by a professional tattoo artist. It was previously a lesion-free tattoo, but when damaged by sunburn developed multiple skin warts. The ability of a latent virus to induce warts after cutaneous ultraviolet exposure was discussed.