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Dinagde DD, Afework HT, Wada HW, Negash MW. Level of HIV serodiscordance and associated factors among heterosexual couples in Ethiopia: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003090. [PMID: 38900765 PMCID: PMC11189220 DOI: 10.1371/journal.pgph.0003090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/03/2024] [Indexed: 06/22/2024]
Abstract
HIV-related causes accounted for approximately 770,000 deaths globally in 2018. Globally, there were 1.7 million new infections, and approximately 37.9 million people were living with HIV by the end of 2018. According to the WHO 2018 study, the African Region was the most affected, with 25.7 million people living with HIV in 2018. In Africa, married and cohabiting couples have a high prevalence of HIV discordance, ranging from 3% to 20% in the general population. Therefore, it is crucial to understand the level of HIV serodiscordance among married couples in Ethiopia and the contributing factors. Studies were systematically searched, utilizing international databases such as PubMed, Google Scholar, Cochrane Library, and Embase. The level of quality of the included articles, which employed cross-sectional and cohort study designs, was evaluated using the New Castle Ottawa scale. The systematic review employed a random-effects approach, and statistical analysis was conducted using STATA version 17 software. The presence of statistical heterogeneity within the included studies was assessed using the I-squared statistic. The random-effects meta-analysis model was used to estimate the pooled level of HIV serodiscordance. The results were reported following the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guideline. A total of ten (10) observational studies were included in this review. The pooled level of HIV serodiscordance among married heterosexual couples in Ethiopia was found to be 11.4% (95% CI = 7% -15.7%). The results from the meta-analysis indicated a significant positive association between HIV serodiscordance and the variables studied. Specifically, consistently using condoms (OR = 1.82; 95% CI: 1.08-2.56), having a CD4 count of >200 cells/mm3 (OR = 1.45; 95% CI: 1.12-1.77), and having a premarital sexual relationship (OR = 1.93; 95% CI: 1.28-2.57) were strongly linked to couples' serodiscordance. To protect a seronegative partner in a serodiscordant relationship from acquiring HIV infection, it is crucial to implement preventive measures. These measures include providing comprehensive health education on the correct and consistent use of condoms, ensuring regular monitoring and care at an antiretroviral therapy (ART) clinic, and offering voluntary counseling and testing (VCT) services to both sexual partners.
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Affiliation(s)
- Dagne Deresa Dinagde
- Departments of Midwifery, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Hana Tadesse Afework
- Departments of Midwifery, College of Health Sciences, Mizan Teppi University, Mizan Teppi, Ethiopia
| | - Habtamu Wana Wada
- Departments of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Meserat Workiye Negash
- Departments of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ntinga X, Isehunwa OO, Msimango LI, Smith PM, Matthews LT, Van Heerden A. Perceptions of Pre-exposure Prophylaxis (PrEP) for HIV prevention among men living with HIV in the context of reproductive goals in South Africa: a qualitative study. BMC Public Health 2024; 24:553. [PMID: 38389039 PMCID: PMC10882859 DOI: 10.1186/s12889-024-18118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Pre-exposure Prophylaxis (PrEP) and Treatment as Prevention (TasP) are effective strategies to prevent HIV transmission within serodifferent couples. However, limited usage of PrEP, knowledge and interest has been amongst the barriers for men, alongside testing and treatment adherence. We explored the perceptions of PreP for HIV prevention with Men living with HIV (MWH) who have reproductive goals, to understand awareness and experiences related to PrEP use in the context of HIV prevention with their partners. METHODS We undertook a qualitative study with 25 MWH aged 18 to 65 between April and September 2021 in South Africa. Potential participants were screened for eligibility and scheduled to participate in telephonic interviews. Interviews were audio recorded, transcribed, translated and thematically analysed. RESULTS Themes were organized into opportunities and barriers that men with HIV articulate as important for using PrEP to meet individual, couple, and community reproductive goals. At the individual level, some men were willing to discuss PrEP with their partners to protect their partners and babies from acquiring HIV. Lack of knowledge about PrEP among men was a potential barrier to promoting PrEP among their female partners. At the couple level, PrEP use was seen as a way to strengthen relationships between partners, signifying care, trust, and protection and was seen as a tool to help serodifferent couples meet their reproductive goals safely. At the community level, PrEP was viewed as a tool to promote HIV testing and prevention efforts, especially among men, but participants emphasized the need for more education and awareness. CONCLUSION Despite PrEP implementation in South Africa, awareness of PrEP among men with HIV in rural areas remains low. Engaging MWH to support their partners in accessing PrEP could be an innovative strategy to promote HIV prevention. Additionally, providing men with comprehensive reproductive health information can empower them to make more informed decisions, adopt safer sexual practices, and challenge societal norms and stigmas around HIV.
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Affiliation(s)
- Xolani Ntinga
- Centre for Community Based Research, Human Sciences Research Council, Old Bus Depot, Sweetwaters, Pietermaritzburg, 3201, South Africa.
| | - Oluwaseyi O Isehunwa
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindani I Msimango
- Centre for Community Based Research, Human Sciences Research Council, Old Bus Depot, Sweetwaters, Pietermaritzburg, 3201, South Africa
| | - Patricia M Smith
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alastair Van Heerden
- Centre for Community Based Research, Human Sciences Research Council, Old Bus Depot, Sweetwaters, Pietermaritzburg, 3201, South Africa
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Pediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Reis RK, Antonini M, Milanês Sousa LR, Rocha KADA, Naiff Ferreira GRO, Vettore MV, Gir E. Amplified HIV Transmission Risk Among People Living With HIV in Southeast Brazil. J Assoc Nurses AIDS Care 2023; 34:469-480. [PMID: 37565984 PMCID: PMC10470434 DOI: 10.1097/jnc.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
ABSTRACT This study investigated the factors associated with amplified HIV transmission risk among people living with HIV from a city in southeast Brazil. A cross-sectional study was conducted with 397 people living with HIV recruited in infectious diseases clinics. Data on risk of HIV transmission, sociodemographic characteristics, sexual behaviors, professional counseling, serological HIV status, HIV-related clinical data, and beliefs about risk of HIV transmission were collected through interviews and medical records. Hierarchical ordered multinomial regression analyses were performed. Amplified HIV risk transmission was associated with lower age, alcohol consumption before having sex, illicit drug use before sexual intercourse, and not receiving professional counseling about HIV transmission. The belief that HIV can be transmitted to a partner not living with HIV was associated with lower likelihood of amplified risk for HIV transmission. Our findings suggest the importance of minimizing substance use before having sex, professional counseling, and beliefs about HIV transmission on amplified HIV risk transmission.
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Affiliation(s)
- Renata Karina Reis
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Marcela Antonini
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Laelson Rochelle Milanês Sousa
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Karyanna Alves de Alencar Rocha
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Glenda Roberta Oliveira Naiff Ferreira
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Mario Vianna Vettore
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Elucir Gir
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
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