The role of contraception in preventing HIV-positive births: global estimates and projections

HIV/AIDS-related knowledge and attitudes toward people living with HIV among college students in Xuzhou, Jiangsu Province, China: a cross-sectional survey

Background

In the contemporary landscape, college students have emerged as a demographic increasingly vulnerable to AIDS. Recognizing that heightened awareness and progressive attitudes toward HIV are pivotal in its prevention, this study was conceived with the intent to meticulously evaluate the level of HIV understanding amongst college students, gauge their sentiments toward people living with HIV (PLHIV), and scrutinize factors influencing these perceptions.

Method

This study used an anonymous online questionnaire to collect data through a cross-sectional survey. The sample size for the survey was 4,193 students from four colleges and universities in Xuzhou City, Jiangsu Province, China, covering a variety of demographic characteristics. The survey focused on students' level of knowledge related to HIV and their attitudes toward PLHIV. The study used descriptive statistics to describe the demographic characteristics of the sample, chi-square tests to examine differences within categorical variables, and logistic regression to investigate the associations between knowledge levels and attitudes.

Results

A total of 4,193 university students were surveyed, among whom the majority (96.85%) demonstrated a high level of knowledge related to AIDS. Moreover, 55.52% of the participants reported positive attitudes toward individuals with AIDS. The multiple regression analysis revealed that female students (OR = 0.49, p < 0.001), those enrolled in medical programs (OR = 1.56, p = 0.014), students of Han Chinese ethnicity (OR = 2.46, p = 0.009), and individuals with fewer romantic involvements (OR = 1.57, p < 0.001) possess greater HIV/AIDS awareness. Moreover, lower grade levels (OR = 1.12, p < 0.001), reduced monthly living costs (OR = 1.14, p = 0.014), lack of sexual experience (OR = 0.75, p = 0.015), and a higher degree of HIV/AIDS knowledge (OR = 1.617, p = 0.007) were positively correlated with supportive attitudes toward PLHIV.

Conclusion

Overall, the awareness rate of college students in Xuzhou City about HIV/AIDS infection awareness is high. However, only about half of the university students have positive attitudes toward PLHIV. In order to ensure that a thorough understanding of HIV/AIDS is matched by positive attitudes, it is important to implement targeted educational measures aimed at bridging the gap between knowledge and attitudes toward HIV/AIDS in order to develop a more informed and empathetic student body.

Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV

BACKGROUND

Prevention of vertical (mother to child) transmission of HIV is one of the key strategies towards HIV epidemic control. Despite considerable progress over the past decade in Zambia, the country is yet to reach global and national target for elimination of vertical transmission of HIV. Avoidance of unintended pregnancy among women living with HIV is one of the cost-effective interventions in a comprehensive approach to prevent vertical transmission of HIV. Therefore, this study aimed at ascertaining trends in and predictors of unmet need for family planning among women living with HIV in Zambia.

METHODS

The study employed a repeated cross sectional (RCS) study design, using data from the three (3) most recent consecutive rounds of the Zambia Demographic and Health Survey (ZDHS) conducted in 2007, 2013/2014 and 2018. The study used data from a total of 27,153 women aged 15-49 years over the three survey periods among whom 4,113 had an HIV positive result following a rigorous HIV testing algorithm of the demographic and health surveys, and these constituted our sample size of women living with HIV. We used descriptive statistics and logistic regression analyses to respectively ascertain trends in and predictors of unmet need for family planning among women living with HIV.

RESULTS

Over the three survey points, unmet need for family planning among women living with HIV has largely remained unchanged from 20.8% in 2007 to 20.5% in 2013/14 and 21.1% in 2018 DHS. Residence, age of women, household wealth, woman's parity, employment, and age of spouse emerged as significant predictors of unmet need for family planning among women living with HIV in Zambia.

CONCLUSION

Preventing HIV infection in a child preserves life, contributes to improving quality of life from its early stages and averts lifetime costs of HIV treatment and associated healthcare costs. There is need to consider optimization of interventions to prevent vertical transmission of HIV including shaping programming regarding preventing unintended pregnancies among women living with HIV. Among other aspects, policy and practice need to strengthen SRH/HIV integration and better target rural residents, younger women, those with high parity and consider positive male engagement to reduce unmet need for family planning among women living with HIV.

Determinants and Patterns of Contraceptive Use among Sexually Active Women Living with HIV in Ibadan, Nigeria

Background

Contraception is a strategy to meet the family planning goals of women living with human immunodeficiency virus (WLHIV) as well as to reduce the transmission of HIV. There is limited data from Nigeria, where HIV prevalent is the second-largest in the world. This study aimed to examine contraceptive use and identify factors influencing its use among sexually active WLHIV in Ibadan, Nigeria.

Methods

A facility-based cross-sectional study was conducted among 443 sexually active WLHIV across three HIV treatment centers in Ibadan, Oyo State. The inclusion criteria were WLHIV, aged 18-49 years, who asserted being fecund and sexually active. An adopted questionnaire was used to collect data, and the data was analyzedusing the Statistical Package for Social Sciences (SPSS) Windows version 25. Statistical significance was set at p < 0.05.

Results

Among sexually active WLHIV (n = 443), 73.1% used contraceptives, with 26.9% having unmet needs. The results revealed a significant association between employment status and the use of contraceptives (AOR = 2.150; 95% CI 1.279-3.612 p=0.004); accessibility to contraceptive methods and the use of contraceptives (AOR = 21.483; 95% CI 7.279-63.402 p=0.00). Also, a significant association was found between payment for service and contraceptive use (AOR = 14.343; 95% CI 2.705-76.051; p = 0.003). Previous reactions towards contraceptive use were also significantly associated with contraceptive use (AOR = 14.343; 95% CI 2.705-76.051 p = 0.003). The dual contraceptives usage rate was 30.7%.

Conclusions

Although contraceptive use among sexually active WLHIV was high, the study highlighted the need for increased adoption of dual contraceptive methods to mitigate the risk of unintended pregnancy and HIV re-infection among this population. It emphasized the importance of continuous sensitization and counseling services healthcare providers provide to promote contraceptive use among WLHIV.

Potential risk factors for cardiovascular diseases and associated sociodemographic characteristics: A cross-sectional evaluation of a large cohort of women living with HIV in north-central Nigeria

Males have a higher prevalence of cardiovascular (CVD) risk factors such as alcohol use, hypercholesterolemia, hypertension, obesity, and smoking based on limited data available from two tertiary health centers in Nigeria. Increasing age and lower educational level influence smoking among the same population in northeastern and northwestern Nigeria. Specifically in women living with HIV (WLHIV), the association between demographic characteristics and CVD risk factors has not been described. In a multi-center cross-sectional study, we documented the association of sociodemographic characteristics with potential CVD risk factors among a large cohort of WLHIV attending five treatment sites in north-central Nigeria. This was a cross-sectional study among 5430 women of reproductive age who received antiretrovirals at five selected treatment sites in Benue State, Nigeria. We performed multivariable regression of sociodemographic characteristics on potential cardiovascular risk factors, namely, smoking, alcohol consumption, and contraceptive use. We found participants' mean age was 33.2 (standard deviation: 6.1) years. Prevalence of smoking, alcohol consumption, and contraceptive use were 0.6%, 11%, and 7% respectively. Older WLHIV (≥ 40 years) had a negative association with contraceptive use (aOR: 0.58, 95%CI: 0.42-0.81). Being educated WLHIV had a positive association with contraceptive use (aOR: 1.34, 95%CI: 1.02-1.76) and a negative association with tobacco smoking (aOR: 0.37, 95%CI: 0.16-0.83). Being a farmer had a negative association with alcohol consumption (aOR: 0.43, 95%CI: 0.35-0.52) and contraceptive use (aOR: 0.61, 95%CI: 0.48-0.76). Compared to being married, being in a single relationship had positive association with alcohol consumption (aOR: 1.30, 95%CI: 1.08-1.56) while parenting was associated with 165% higher odds of contraceptive use (aOR: 2.65, 95%CI: 1.73-4.06). In conclusion, the low prevalence of smoking exists among women living with HIV on antiretroviral treatment. Older age, farming and being married are potential deterrents to lifestyle risk factors for cardiovascular diseases among this population. To improve HIV-related treatment efforts and outcomes, implementing interventions aimed at lifestyle behavioral modification among this population has the potential to reduce cardiovascular disease risks.

Factors associated with the choice of having multiple sexual partners among male college students with casual heterosexual sex in Zhejiang Province, Eastern China

BACKGROUND

Young students infected with HIV have become a significant public health issue in China, this study aimed to understand the factors influencing the choice of having multiple sexual partners among male college students who had casual heterosexual sex in Zhejiang Province and to scientifically justify developing HIV/AIDS intervention strategies among them.

METHODS

A stratified cluster sampling method was used for the survey of students from 13 colleges or universities in Zhejiang Province between October and November 2018. The questionnaire collected information on general demographic characteristics, knowledge of HIV/AIDS prevention and treatment, sexual attitudes and risk awareness, sexual behavioural characteristics, and acceptance of interventions. The univariable and multivariable analyses were conducted in this study.

RESULTS

Study participants included 362 male college students who exhibited casual heterosexual sex and were aware of the number of sexual partners they had. Among them, 222 students engaged in casual heterosexual sex with multiple sexual partners (61.33%). The results of the multivariable analysis revealed several factors associated with male students' choice to have multiple sexual partners: monthly living expenses greater than or equal to 1501 CNY (adjusted OR = 2.24, 95% CI = 1.21-4.16), sexual behavior after consuming alcohol (adjusted OR = 2.19, 95% CI = 1.32-3.63), whose casual partner types were non-student (adjusted OR = 2.51, 95% CI = 1.45-4.22), and those who discussed using condoms during sexual intercourse (adjusted OR = 0.50, 95% CI = 0.28-0.89).

CONCLUSION

The choice to engage in casual heterosexual sex with multiple partners was found to be associated with several factors among male college students, including economic status, engaging in sexual behavior after consuming alcohol, the type of the casual partner, and using condoms. These findings highlight the significance of implementing targeted interventions and comprehensive sexual health education programs within college settings in order to encourage safer sexual practices among students.

Contraception among HIV-positive women in Latvia- knowledge, experience and factors influencing the choice

OBJECTIVES

Latvia has one of the highest numbers of new HIV cases in the EU. The latest SRH national survey confirmed low effective contraceptive prevalence in the general population, no data were available about women living with HIV (WLHIV). The study aimed to assess knowledge on the use of different contraceptives, to identify factors in choosing contraception, to assess the availability of family planning health care services, and to investigate contraception habits.

METHODS

A cross-sectional study was conducted among WLHIV aged 18-49 recruited with assistance of non-governmental organisations addressing HIV issues. Interviews in Latvian and Russian languages were based on pre-tested questionnaire. Data were processed and analysed using IBM SPSS 22.0.

RESULTS

102 WLHIV were interviewed and 99 of them met the inclusion criteria. Most women were aware of at least one effective contraceptive method yet around half of them had misconceptions about hormonal methods. Most of the women were able to evaluate the effectiveness of contraceptives. Sexually active women usually used male condoms (76.3%) although around 40% did not use them permanently especially if their partner was HIV-positive. Contraception usage after HIV infection decreased. Women mainly trusted medical professionals on information provided about contraceptives. Over 50% of women experienced situations they could not afford a visit to a gynaecologist or contraceptives.

CONCLUSIONS

The survey showed a wide prevalence of misconceptions and prejudice about hormonal contraceptives. There is a need for health education including sexuality education and financial support to make effective contraception available and affordable for WLHIV.