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Mokgethi NO, Christofides N, Machisa M, Akpomiemie G, Lalla-Edward S. Quality of life and associated factors among people receiving second-line anti-retroviral therapy in Johannesburg, South Africa. BMC Infect Dis 2022; 22:456. [PMID: 35550020 PMCID: PMC9103409 DOI: 10.1186/s12879-022-07429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background Studies which examine quality of life (QOL) provide important insights that are needed to understand the impacts of HIV/AIDS anti-retroviral treatment (ART), comorbid conditions and other factors on the daily activities of people living with HIV/AIDS (PLH). This study aimed to determine the inter-relationships between clinical factors, behavioural, socio-demographic variables and QOL among PLH. Methods The secondary analysis used data collected from 293 people living with HIV/AIDS (PLH) receiving second-line ART in Johannesburg in a clinical trial which evaluated the non-inferiority of ritonavir-boosted darunavir (DRV/r 400/100 mg) compared to ritonavir-boosted lopinavir (LPV/r) over a 48 week-period. Physical functioning, cognitive and mental QOL were measured using the Aids Clinical Trial Group questionnaire. Exploratory factor analyses were used to examine the structure, the relationships between and the construct validity of QOL items. Structural equation models which tested the a priori-hypothesised inter-relationships between QOL and other variables were estimated and goodness of fit of the models to the data was assessed. Results Patients on darunavir presented with lower pill burden. Older patients and women were more likely to report lower QOL scores. Pill burden mediated the effects of age, sex and treatment regimen on physical functioning QOL and adverse effects; the effects of age, sex, treatment regimen and adverse effects on cognitive QOL; and the effects of sex on mental QOL. Conclusion QOL among PLH is associated with socio-demographic and clinical factors. Therefore, QOL could be enhanced by considering PLH characteristics, clinical factors such as regimen side-effects profile, management of comorbid conditions and mitigating risks such as potential adverse drug-to-drug interactions among patients on ART. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07429-9.
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Affiliation(s)
- Nomcebo Oratile Mokgethi
- Epidemiology and Biostatistics, WHO, Bloemfontein, Free State, South Africa. .,School of Public Health, Wits University, Johannesburg, South Africa. .,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | | | - Mercilene Machisa
- School of Public Health, Wits University, Johannesburg, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Godspower Akpomiemie
- School of Public Health, Wits University, Johannesburg, South Africa.,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Lalla-Edward
- School of Public Health, Wits University, Johannesburg, South Africa.,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Syringe Sharing in Drug Injecting Dyads: A Cross-Classified Multilevel Analysis of Social Networks. AIDS Behav 2018; 22:10-18. [PMID: 29766329 DOI: 10.1007/s10461-018-2144-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We examined the association of dyadic-level factors with syringe sharing among people who inject drugs (PWID) in Kerman, Iran. In a cross-sectional study, we collected data on 329 drug-injecting dyads by individual face-to-face interviews. An injecting dyad was defined as 2 PWID who knew each other and injected drugs together during the last 6 months. If they reported at least 1 occasion of syringe sharing, the dyad was considered high-risk. Dyadic-level factors associated with syringe sharing were assessed using cross-classified multilevel logistic regression. The rate of syringe sharing was significantly higher for dyads who were more intimate (adjusted odds ratio [AOR] 4.5, CI 95%, 2.3-8.6), who had instrumental support (AOR 2.1, 95% CI 1.1-4.5), and who pooled money for drugs (AOR 4.1, 95% CI 2.0-8.3). The rate was lower in same-sex dyads (AOR 0.4, 95% CI 0.2-0.9) and in dyads who shared health information (AOR 0.5, 95% CI 0.2-0.9). Findings highlight close-peer influences on syringe-sharing behavior.
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DeBeck K, Cheng T, Montaner JS, Beyrer C, Elliott R, Sherman S, Wood E, Baral S. HIV and the criminalisation of drug use among people who inject drugs: a systematic review. Lancet HIV 2017; 4:e357-e374. [PMID: 28515014 PMCID: PMC6005363 DOI: 10.1016/s2352-3018(17)30073-5] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/22/2017] [Accepted: 03/09/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mounting evidence suggests that laws and policies prohibiting illegal drug use could have a central role in shaping health outcomes among people who inject drugs (PWID). To date, no systematic review has characterised the influence of laws and legal frameworks prohibiting drug use on HIV prevention and treatment. METHODS Consistent with PRISMA guidelines, we did a systematic review of peer-reviewed scientific evidence describing the association between criminalisation of drug use and HIV prevention and treatment-related outcomes among PWID. We searched MEDLINE, Embase, SCOPUS, PsycINFO, Sociological Abstracts, CINAHL, Web of Science, and other sources. To be included in our review, a study had to meet the following eligibility criteria: be published in a peer-reviewed journal or presented as a peer-reviewed abstract at a scientific conference; examine, through any study design, the association between an a-priori set of indicators related to the criminalisation of drugs and HIV prevention or treatment among PWID; provide sufficient details on the methods followed to allow critical assessment of quality; be published or presented between Jan 1, 2006, and Dec 31, 2014; and be published in the English language. FINDINGS We identified 106 eligible studies comprising 29 longitudinal, 49 cross-sectional, 22 qualitative, two mixed methods, four mathematical modelling studies, and no randomised controlled trials. 120 criminalisation indicators were identified (range 1-3 per study) and 150 HIV indicators were identified (1-5 per study). The most common criminalisation indicators were incarceration (n=38) and street-level policing (n=39), while the most frequent HIV prevention and treatment indicators were syringe sharing (n=35) and prevalence of HIV infection among PWID (n=28). Among the 106 studies included in this review, 85 (80%) suggested that drug criminalisation has a negative effect on HIV prevention and treatment, 10 (9%) suggested no association, five (5%) suggested a beneficial effect, one (1%) suggested both beneficial and negative effects, and five (5%) suggested both null and negative effects. INTERPRETATION These data confirm that criminalisation of drug use has a negative effect on HIV prevention and treatment. Our results provide an objective evidence base to support numerous international policy initiatives to reform legal and policy frameworks criminalising drug use. FUNDING Canadian Institutes of Health Research and US National Institutes of Health.
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Affiliation(s)
- Kora DeBeck
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; School of Public Policy, Simon Fraser University, Vancouver, BC, Canada
| | - Tessa Cheng
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Julio S Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris Beyrer
- Centre for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Susan Sherman
- Centre for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Stefan Baral
- Centre for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA.
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Otiashvili D, Latypov A, Kirtadze I, Ibragimov U, Zule W. Drug preparation, injection, and sharing practices in Tajikistan: a qualitative study in Kulob and Khorog. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:21. [PMID: 27251514 PMCID: PMC4890278 DOI: 10.1186/s13011-016-0065-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/26/2016] [Indexed: 11/21/2022]
Abstract
Background Sharing injection equipment remains an important rout of transmission of HIV and HCV infections in the region of Eastern Europe and Central Asia. Tajikistan is one of the most affected countries with high rates of injection drug use and related epidemics.The aim of this qualitative study was to describe drug use practices and related behaviors in two Tajik cities – Kulob and Khorog. Methods Twelve focus group discussions (6 per city) with 100 people who inject drugs recruited through needle and syringe program (NSP) outreach in May 2014. Topics covered included specific drugs injected, drug prices and purity, access to sterile equipment, safe injection practices and types of syringes and needles used. Qualitative thematic analysis was performed using NVivo 10 software. Results All participants were male and ranged in age from 20 to 78 years. Thematic analysis showed that cheap Afghan heroin, often adulterated by dealers with other admixtures, was the only drug injected. Drug injectors often added Dimedrol (Diphenhydramine) to increase the potency of “low quality” heroin. NSPs were a major source of sterile equipment. Very few participants report direct sharing of needles and syringes. Conversely, many participants reported preparing drugs jointly and sharing injection paraphernalia. Using drugs in an outdoor setting and experiencing withdrawal were major contributors to sharing equipment, using non-sterile water, not boiling and not filtering the drug solution. Conclusion Qualitative research can provide insights into risk behaviors that may be missed in quantitative studies. These finding have important implications for planning risk reduction interventions in Tajikistan. Prevention should specifically focus on indirect sharing practices.
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Affiliation(s)
- David Otiashvili
- Addiction Research Center, Alternative Georgia, 14a Nutsubidze Str., Office 2, 0177, Tbilisi, Georgia.
| | - Alisher Latypov
- Global Health Research Center of Central Asia, Columbia University, New York, USA.,The Central Asia Program, Institute for European, Russian, and Eurasian Studies, The Eliott School of International Affairs, George Washington University, Washington, DC, USA
| | - Irma Kirtadze
- Addiction Research Center, Alternative Georgia, 14a Nutsubidze Str., Office 2, 0177, Tbilisi, Georgia.,Business School, Ilia State University, Tbilisi, Georgia
| | | | - William Zule
- RTI International, Research Triangle Park, NC, USA
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Matsumoto S, Tanuma J, Mizushima D, Nguyen NCT, Pham TTT, Do CD, Nguyen TQ, Nguyen DT, Nguyen HDT, Nguyen LT, Nguyen KV, Oka S. High Treatment Retention Rate in HIV-Infected Patients Receiving Antiretroviral Therapy at Two Large HIV Clinics in Hanoi, Vietnam. PLoS One 2015; 10:e0139594. [PMID: 26422474 PMCID: PMC4589350 DOI: 10.1371/journal.pone.0139594] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 09/14/2015] [Indexed: 11/29/2022] Open
Abstract
Background Loss to follow-up (LTFU) is viewed as a major challenge in improving retention in HIV treatment. In Vietnam, the reasons for disengagement from clinics and the effect of injection drug use (IDU) on LTFU with unknown outcome (true LTFU) are not well known. Methods Patients receiving antiretroviral therapy (ART) from two HIV clinics in Hanoi were included in this observational study between 2007 and 2012, and followed up every 6 months until the end of 2013. The reasons for disengagement from the clinic, and ART status during imprisonment were investigated in patients with a history of IDU to identify true LTFU. The retention rate at 6–54 months and true LTFU rate were calculated. Cox proportional hazards regression models were performed to identify factors associated with true LTFU. Results There were 1,431 patients, with a follow-up time of 4,371 person-years (median 2.49 years). At the end of the follow-up period, 71 (5.0%) patients died, 79 (5.5%) transferred to other clinics, 16 (1.1%) disengaged from the clinics, and the calculated true LTFU was 45 (3.1%), with 12-month ART retention rate of 95.3% for the entire study population. Imprisonment was the most frequent reason for disengagement from the clinics. True LTFU correlated significantly with low CD4 count and high plasma viral load, but not history of IDU. Conclusion Imprisonment is a major cause of disengagement from HIV care among patients with a history of IDU.
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Affiliation(s)
- Shoko Matsumoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
- * E-mail:
| | - Junko Tanuma
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daisuke Mizushima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan
| | | | | | - Cuong Duy Do
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Tuan Quang Nguyen
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | | | | | | | | | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
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Tran HV, Le LVN, Johnston LG, Nadol P, Van Do A, Tran HTT, Nguyen TA. Sampling Males Who Inject Drugs in Haiphong, Vietnam: Comparison of Time-Location and Respondent-Driven Sampling Methods. J Urban Health 2015; 92:744-57. [PMID: 26044670 PMCID: PMC4524850 DOI: 10.1007/s11524-015-9966-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Accurate measurements of HIV prevalence and associated risk factors among hidden and high-risk groups are vital for program planning and implementation. However, only two sampling methods are purported to provide representative estimates for populations without sampling frames: time-location sampling (TLS) and respondent-driven sampling (RDS). Each method is subject to potential biases and questionable reliability. In this paper, we evaluate surveys designed to estimate HIV prevalence and associated risk factors among people who inject drugs (PWID) sampled through TLS versus RDS. In 2012, males aged ≥16 years who reported injecting drugs in the previous month and living in Haiphong, Vietnam, were sampled using TLS or RDS. Data from each survey were analyzed to compare HIV prevalence, related risk factors, socio-demographic characteristics, refusal estimates, and time and expenditures for field implementation. TLS (n = 432) and RDS (n = 415) produced similarly high estimates for HIV prevalence. Significantly lower proportions of PWID sampled through RDS received methadone treatment or met an outreach worker. Refusal estimates were lower for TLS than for RDS. Total expenditures per sample collected and number of person-days of staff effort were higher for TLS than for RDS. Both survey methods were successful in recruiting a diverse sample of PWID in Haiphong. In Vietnam, surveys of PWID are conducted throughout the country; although the refusal estimate was calculated to be much higher for RDS than TLS, RDS in Haiphong appeared to sample PWID with less exposure to services and required fewer financial and staff resources compared with TLS.
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Affiliation(s)
| | - Linh-Vi N. Le
- />U.S. Centers for Disease Control and Prevention, Hanoi, Vietnam
| | - Lisa Grazina Johnston
- />FHI 360, Hanoi, Vietnam
- />64F Nieuwezijds Voorburgwal, Amsterdam, Netherlands 1012 SC
| | - Patrick Nadol
- />U.S. Centers for Disease Control and Prevention, Hanoi, Vietnam
| | - Anh Van Do
- />Partners in Health Research, Hanoi, Vietnam
| | | | - Tuan Anh Nguyen
- />National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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Ahmed T, Long TN, Huong PT, Stewart DE. Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis. BMC Public Health 2015; 15:32. [PMID: 25631330 PMCID: PMC4324409 DOI: 10.1186/s12889-015-1404-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 01/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices. METHODS Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants' understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used. RESULTS Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend's home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: the difficulty in getting new syringes, quick withdrawal management, punitive attitudes, fear of arrest/imprisonment, lack of resources, incorrect self-assessment, and risk denial. Some of the IDU participants emphasised self-care attitudes which should be encouraged to minimise HIV transmission risk. CONCLUSION The IDUs' experiences in Hai Phong identified through our data broaden our qualitative understanding about the HIV transmission risk among IDUs and emphasize the need to strengthen harm reduction services in Vietnam.
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Affiliation(s)
- Tanvir Ahmed
- School of Medicine, Griffith University, Griffith Graduate Centre, South Bank Campus, 226 Grey Street, South Brisbane, QLD 4101, Australia.
| | - Thanh Nguyen Long
- Vietnam Authority of HIV/AIDS Control, Lane 135/3 Nui Truc Street, Ba Đinh District, Hanoi, Vietnam.
| | - Phan Thi Huong
- Vietnam Authority of HIV/AIDS Control, Lane 135/3 Nui Truc Street, Ba Đinh District, Hanoi, Vietnam.
| | - Donald Edwin Stewart
- School of Medicine, Griffith University, Griffith Graduate Centre, South Bank Campus, 226 Grey Street, South Brisbane, QLD 4101, Australia.
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Hayes-Larson E, Grau LE, Khoshnood K, Barbour R, Khuat OTH, Heimer R. Drug users in Hanoi, Vietnam: factors associated with membership in community-based drug user groups. Harm Reduct J 2013; 10:33. [PMID: 24268108 PMCID: PMC4176489 DOI: 10.1186/1477-7517-10-33] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 11/05/2013] [Indexed: 11/10/2022] Open
Abstract
Background A syndemic conjoins injection drug use, incarceration, and HIV in Vietnam, where there is a need for programs that empower people who use drugs to minimize the harms thereby produced. Here we present a post-hoc evaluation of the organizing efforts of the Centre for Supporting Community Development Initiatives (SCDI) with two community-based drug user groups (CBGs) in Hanoi. Methods Members (n = 188) of the CBGs were compared to non-member peers (n = 184) on demographic, psychosocial, behavioral and knowledge variables using a face-to-face structured interview that focused on issues of quality of life and harm reduction. Bivariate analyses were conducted, and variables significantly associated with membership at p < 0.10 were included in a multivariate model. Results Variables associated with membership in the CBGs in the multivariate model included increased self-efficacy to get drug-related health care (OR 1.59, 1.24-2.04), increased quality of life in the psychological (OR 2.04, 1.07-3.93) and environmental (OR 2.54, 1.31-4.93) domains, and greater history of interactions with police about drugs (OR 3.15, 1.79-5.52). There was little difference between members and non-members on injection-related harms except in the domain of knowledge about opioid overdose. Among the 114 current injectors (30.6% of the sample), low rates of unsafe injection practices were reported, and low statistical power limited the ability to conclusively assess association with membership. Conclusions Although the CBG members displayed higher levels of well-being and access to healthcare than non-members, further longitudinal study is required to determine if these are a result of membership. The CBGs should pay more attention towards meeting challenges in responding to specific health issues of those who continue to use drugs including HIV, hepatitis, and drug overdose.
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Thanh DC, Moland KM, Fylkesnes K. Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam. BMC Health Serv Res 2012; 12:428. [PMID: 23176584 PMCID: PMC3549738 DOI: 10.1186/1472-6963-12-428] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 11/22/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Seeking and utilisation of HIV prevention, treatment, care, and support services for people living with HIV is often hampered by HIV-related stigma. The study aimed to explore the perceptions and experiences regarding treatment, care, and support amongst people living with HIV in Viet Nam, where the HIV epidemic is concentrated among injecting drug users, sex workers, and men who have sex with men. METHODS In-depth interviews and focus group discussions were conducted during September 2007 in 6 districts in Hai Phong with a very high HIV prevalence among injecting drug users. The information obtained was analysed and merged within topic areas. Illustrative quotes were selected. RESULTS Stigma and discrimination against people living with HIV in the community and healthcare settings was commonly reported, and substantially hampered the seeking and the utilisation of HIV-related services. The informants related the high level of stigma to the way the national HIV preventive campaigns played on fear, by employing a "scare tactic" mainly focusing on drug users and sex workers, who were defined as "social evils" in the anti-drug and anti-prostitution policy. There was a strong exclusion effect caused by the stigma, with serious implications, such as loss of job opportunities and isolation. The support and care provided by family members was experienced as vital for the spirit and hope for the future among people living with HIV. CONCLUSIONS A comprehensive care and support programme is needed. The very high levels of stigma experienced seem largely to have been created by an HIV preventive scare tactic closely linked to the "social evil" approach in the national policy on drug and prostitution. In order to reduce the stigma and create more effective interventions, this tactic will have to be replaced with approaches that create better legal and policy environments for drug users and sex workers.
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Affiliation(s)
- Duong Cong Thanh
- National Institute of Hygiene and Epidemiology, Ha noi, Viet Nam
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Karen Marie Moland
- Centre for International Health, University of Bergen, Bergen, Norway
- Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
| | - Knut Fylkesnes
- Centre for International Health, University of Bergen, Bergen, Norway
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Tran VT, Ishizaki A, Nguyen CH, Hoang HTT, Pham HV, Bi X, Van Pham T, Ichimura H. No increase of drug-resistant HIV type 1 prevalence among drug-naive individuals in Northern Vietnam. AIDS Res Hum Retroviruses 2012; 28:1349-51. [PMID: 22264087 DOI: 10.1089/aid.2012.0006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We reported previously that the prevalence of drug-resistant HIV-1 among antiretroviral therapy (ART)-naive individuals in Northern Vietnam was 2.9% in 2007 and 6.2% in 2008. To investigate the continuing trend of prevalence, we collected plasma samples from 958 individuals in Hai Phong and Hanoi in 2009, extracted viral RNA from HIV-1 antibody-positive samples, and analyzed them genetically. HIV-1 antibody prevalence was 26.8% in injecting drug users (n=302), 13.4% in female sex workers (n=284), 0.5% in blood donors (n=206), and 0.6% in pregnant women (n=166). All HIV-1 strains were CRF01_AE. Nonnucleoside reverse-transcriptase inhibitor resistance mutations were found in two (2.0%) of the 102 successfully analyzed cases (one case with the Y181C and one with the K101E). No nucleoside reverse-transcriptase inhibitor resistance or protease inhibitor resistance mutations were detected. The prevalence of circulating ART-resistant HIV-1 in Northern Vietnam did not increase from 2007 to 2009, although the rate of ART coverage did increase.
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Affiliation(s)
- Vuong Thi Tran
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
- Hai Phong Medical University, Hai Phong, Vietnam
| | - Azumi Ishizaki
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Cuong Hung Nguyen
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
- Hai Phong Medical University, Hai Phong, Vietnam
| | | | - Hung Viet Pham
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Xiuqiong Bi
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | | | - Hiroshi Ichimura
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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11
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Chi BK, Gammeltoft T, Hanh NTT, Rasch V. Contraceptive use among HIV-positive women in Quang Ninh province, Vietnam. Trop Med Int Health 2012; 17:1227-34. [PMID: 22845648 DOI: 10.1111/j.1365-3156.2012.03046.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate contraceptive use among HIV-positive women in Ha long city and Cam Pha town of Quang Ninh, a Northern province of Vietnam. METHODS Cross-sectional questionnaire study among HIV-positive women identified through the district HIV/AIDS register. Information on socioeconomic characteristics and contraceptive use before and after HIV diagnosis was obtained through structured questionnaires. Chi-square testing was used to assess whether the included women differed from the target population in terms of age. Crude Odds ratios (ORs) were calculated to show the association between contraceptive use and the women's socioeconomic characteristics. Logistic regression analyses were applied to adjust for possible confounding. The women's contraceptive use before HIV testing and after HIV testing was described and compared by Chi-square testing, and the association between post-test counselling and the women's use of condom was assessed by ORs. RESULTS Of the 351 participants, 63% stated they had used contraception before HIV diagnosis and 89% stated they had used contraception after HIV diagnosis. Forty six per cent of the women had been using either the pill or an intrauterine device (IUD) before the diagnosis whereas the same applied for only 8% of the women after diagnosis. Thirty-nine per cent stated they had been using condom before HIV diagnosis whereas 87% stated condom use after HIV diagnosis. Condom use was more common among women who had received post-test counselling (OR 3.03, 95% CI 1.03-8.90). CONCLUSIONS A change of contraceptive methods from IUD and oral contraception before HIV diagnosis to condom use after HIV diagnosis was observed. The women's use of condoms after HIV diagnosis was associated with having received post-test counselling.
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Affiliation(s)
- Bui Kim Chi
- Health Strategy and Policy Institute, Hanoi, Vietnam, Ministry of Health, Hanoi, Vietnam Department of Anthropology, University of Copenhagen, Copenhagen, Denmark Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam Department of Obstetric and Gynaecology, Odense University Hospital, Odense, Denmark Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
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12
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Tran BX, Ohinmaa A, Nguyen LT, Oosterhoff P, Vu PX, Vu TV, Larsson M. Gender differences in quality of life outcomes of HIV/AIDS treatment in the latent feminization of HIV epidemics in Vietnam. AIDS Care 2012; 24:1187-96. [PMID: 22375681 DOI: 10.1080/09540121.2012.658752] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Understanding gender-specific predictors of Health-related Quality of Life (HRQL) outcomes of HIV/AIDS treatment is necessary in the latent feminization of HIV epidemics in Vietnam. This study assessed HRQL and its predictors among men and women with HIV/AIDS. We conducted a cross-sectional study of 155 patients (36.8% women, mean age=31.4) registering for antiretroviral treatment (ART) at Vietnam-Sweden Uong Bi General Hospital, Quang Ninh Province. The Vietnamese version of the World Health Organization Quality of Life HIV brief version (WHOQOL-HIV BREF) was developed. Factor analysis was applied to assess the construct validity of the measurement. Six major domains of the Vietnamese WHOQOL-HIV BREF were determined, namely physical; performance; morbidity; environment; psychological; and social support. Internal consistency reliability of the six domains ranged from 0.52 to 0.71. Multivariate linear regression models, constructed using step-wise forward selection, determined different predictors of HRQL domain scores in men and women with HIV/AIDS. The results showed that men reported higher scores or better in Morbidity (p=0.02), Environment (p=0.07) and Psychological dimensions (p=0.02); meanwhile, women had higher scores in Performance (p=0.09). Alcohol and injection drug use negatively predicted HRQL outcomes in both men and women. Employment was associated with better performance in men, and better physical but poorer environment status in women. Female patients who have a child experienced decrements in social support, psychological, environment, and performance. Findings of this study highlight the need to develop comprehensive interventions for HIV/AIDS patients, including HIV/AIDS treatment support and gender-specific impact mitigation interventions strategies.
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Affiliation(s)
- Bach Xuan Tran
- Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Hammett TM, Van NTH, Kling R, Binh KT, Oanh KTH. Female sexual partners of injection drug users in Vietnam: an at-risk population in urgent need of HIV prevention services. AIDS Care 2011; 22:1466-72. [PMID: 21154034 DOI: 10.1080/09540121003758580] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Vietnam's HIV epidemic has been driven by injection drug use, with HIV prevalence among injection drug users (IDUs) of ~30%. Most IDUs are sexually active and may infect their female sexual partners (SPs). Male dominance in sexual decisions is deeply embedded in Vietnamese culture. There have been few HIV prevention interventions for SPs, who represent an important potential bridging population in the epidemic. We report findings from a baseline survey of SPs conducted in 2008 in Hanoi, Vietnam, where peer-based HIV prevention interventions targeting this population are now being implemented. The survey revealed HIV prevalence of 14% among SPs in Hanoi and only 27% reported condom use with their primary male partners half the time or more. About 69% of SPs were in serodiscordant or unknown HIV status relationships but condom use was not more frequent in these relationships than in concordant partnerships. Many SPs feared angry or violent responses if they requested condom use, problems that were even more likely in serodiscordant/unknown status relationships. SPs also reported limited prior access to HIV prevention services. Many SPs in Vietnam are at high risk for HIV and in need of HIV prevention interventions. However, to date, this population has been seriously underserved. Our interventions are in progress and results will be reported subsequently.
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Herington J. Securitization of infectious diseases in Vietnam: the cases of HIV and avian influenza. Health Policy Plan 2011; 25:467-75. [PMID: 20961947 DOI: 10.1093/heapol/czq052] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The frequent and swift emergence of new and devastating infectious diseases has brought renewed attention to health as an issue of international importance. Some states and regional organizations, including in Asia, have begun to regard infectious disease as a national and international security issue. This article seeks to examine the Vietnamese government's response to the epidemics of avian influenza and Human immunodeficiency virus. Both diseases have been recognized at different times as threats to international security and both are serious infectious disease problems in Vietnam. Yet, the character of the central government's response to these two epidemics has been starkly different. How and why this disparity in policy approaches occurs depends largely on the epidemiological, economic and political context in which they occur. Although epidemiological factors are frequently explored when discussing disease as a security issue, seldom are the political, social and economic characteristics of the state invoked. These dimensions, and their interaction with the epidemiology of the disease, are central to understanding which diseases are ultimately treated by states as security issues. In particular, the role of economic security as a powerful motivator for resistance to control measures and the role that local implementation of policies can have in disrupting the effect of central government policy are explored. In exploring both the outcomes of securitization, and its facilitating conditions, I suggest some preliminary observations on the potential costs and benefits of securitizing infectious disease and its utility as a mechanism for protecting health in Asia.
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Affiliation(s)
- Jonathan Herington
- Centre for Applied Philosophy and Public Ethics, The Australian National University, Canberra, ACT 0200, Australia.
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Rafiey H, Narenjiha H, Shirinbayan P, Noori R, Javadipour M, Roshanpajouh M, Samiei M, Assari S. Needle and syringe sharing among Iranian drug injectors. Harm Reduct J 2009; 6:21. [PMID: 19643014 PMCID: PMC2731095 DOI: 10.1186/1477-7517-6-21] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 07/30/2009] [Indexed: 11/30/2022] Open
Abstract
Objective The role of needle and syringe sharing behavior of injection drug users (IDUs) in spreading of blood-borne infections – specially HIV/AIDS – is well known. However, very little is known in this regard from Iran. The aim of our study was to determine the prevalence and associates of needle and syringe sharing among Iranian IDUs. Methods In a secondary analysis of a sample of drug dependents who were sampled from medical centers, prisons and streets of the capitals of 29 provinces in the Iran in 2007, 2091 male IDUs entered. Socio-demographic data, drug use data and high risk behaviors entered to a logistic regression to determine independent predictors of lifetime needle and syringe sharing. Results 749(35.8%) reported lifetime experience of needle and syringe sharing. The likelihood of lifetime needle and syringe sharing was increased by female gender, being jobless, having illegal income, drug use by family members, pleasure/enjoyment as causes of first injection, first injection in roofless and roofed public places, usual injection at groin, usual injection at scrotum, lifetime experience of nonfatal overdose, and history of arrest in past year and was decreased by being alone at most injections. Conclusion However this data has been extracted from cross-sectional design and we can not conclude causation, some of the introduced variables with association with needle and syringe sharing may be used in HIV prevention programs which target reducing syringe sharing among IDUs.
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Affiliation(s)
- Hassan Rafiey
- Iranian Research Center for Substance Abuse and Dependence (IRCSAD), University of Social Welfare and Rehabilitation Science, Tehran, Iran.
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