Factors associated with condom use among HIV-positive women living in Atlanta, Georgia

Management of HIV in the older adults: Clinical and public health challenge

As a result of significant advances in antiretroviral therapy (ART), the number of people living with human immunodeficiency virus (PLWH) who are alive well into their senior years has increased significantly in recent years. While increased life expectancy is a highly desired outcome for PLWH, it brings with it a number of challenges that are only now starting to be understood and fully appreciated. These challenges include higher rates of co-morbidities, polypharmacy, drug side effects, and cognitive deficits, as well as numerous psychosocial issues such as stigma, loneliness, and depression. Older PLWH also face challenges related to housing, health insurance, and long-term care. This review will discuss many of the challenges faced by older PLWH and present clinical and public health responses with suggested interventions that may improve outcomes for this population.

Self-reported condom use among Washington State residents prior to and during the COVID-19 pandemic: a cross-sectional analysis of BRFSS data

OBJECTIVES

COVID-19 significantly impacted healthcare access and sexual behaviour, but little is known about how COVID-19 affected condom use. This study aimed to investigate whether self-reported condom use and sex in Washington State changed during pandemic restrictions compared with prepandemic.

DESIGN

Cross-sectional survey data from the Behavioral Risk Factor Surveillance System.

SETTING

Washington State.

PARTICIPANTS

11 684 participants aged 18-65.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was changes in the prevalence of condom use by time of interview pre-COVID-19, before the Washington State lockdown (1 January 2019 to 23 March 2020, n=7708) and during COVID-19, after the first state lockdown (24 March 2020 to 31 December 2020, n=3976). The secondary outcome was changes in the prevalence of reported sex during the same periods. We assessed whether associations differed by rurality and HIV risk behaviour.

RESULTS

Condom use was similar during COVID-19 (37.3%) compared with pre-COVID-19 (37.8%) (adjusted prevalence ratio (PR): 0.98, 95% CI 0.89, 1.01). Associations did not differ by rurality or HIV risk behaviour. Compared with pre-COVID-19 (83.0%), a smaller proportion of respondents reported having sex in the last 12 months during COVID-19 (80.5%), a relative decrease of 3% (PR: 0.97, 95% CI 0.96, 0.99; p<0.001).

CONCLUSIONS

The prevalence of reported sex declined during COVID-19, but condom use remained steady in Washington. As our reproductive health system faces increased challenges, these results may inform future sexual health services.

Effectiveness of educational intervention among seropositive women about knowledge about HIV sexual transmission

OBJECTIVES

to assess the effectiveness of a group and telephone educational intervention with seropositive women about knowledge about HIV sexual transmission prevention.

METHODS

a quasi-experimental before-and-after study, carried out with 151 women living with HIV in a Specialized Care Service in a Brazilian capital. The educational intervention was carried out in three moments, with the assessment being carried out before the first and after the last moment.

RESULTS

97.4% of study participants were cisgender women aged between 18 and 58 years; 55.6% considered themselves brown; and 32.5% of interviewees had elementary school. Regarding knowledge about HIV sexual transmission, in 78.5% of items, there was an association (p<0.005) with increased participants' knowledge after receiving the intervention.

CONCLUSIONS

the educational intervention helped to increase the knowledge of women living with HIV about the sexual transmission of the infection.

Risky sexual practice and associated factors among adult people living with HIV/AIDS in public hospitals of Kembata Tambaro Zone, Southern Ethiopia: a cross-sectional study

OBJECTIVE

This study assessed the magnitude of risky sexual practices and associated factors among adult people living with HIV (PLHIV) attending antiretroviral clinics in public hospitals in Kembata Tembaro Zone, southern Ethiopia.

DESIGN

A cross-sectional study was conducted.

SETTING

A hospital-based study was conducted among adult PLHIV in the Kambata Tambaro Zone, southern Ethiopia.

PARTICIPANTS

300 men and women aged 15 years and older who had been receiving HIV/AIDS care and support in four public hospitals participated in this study.

STUDY OUTCOME

Risky sexual practice was the study outcome. It was defined based on responses to four items: multiple sexual partnerships, casual sex, consistent condom use and sex under the influence of alcohol. Risky sexual practice was defined based on a 'yes' response to any of the four items.

RESULTS

Of the adult PLHIV who were sexually active in the 6 months preceding the survey, 75.7% (95% CI: 70.5% to 80.2%) engaged in at least one risky sexual practice, with 3.3% (95% CI: 1.8% to 6.1%) engaged in three or more. A positive attitude towards condom use and being on antiretroviral therapy for over 10 years were correlated with low odds of risky sexual practices. There was a higher likelihood of risky sexual behaviour among those who kept their HIV status secret and did not bring up using a condom before sexual contact. Whereas, those with a positive attitude towards condom use had a reduced risk of engaging in risky sexual practices.

CONCLUSION

A considerable proportion of adult PLHIV engage in risky sexual practices. Efforts directed at removing barriers to disclosing HIV status to partners and promoting condom use discussion among sexual partners could reduce the burden of risky sexual practices and the onward transmission of HIV.

Prevalence and determinants of inconsistent condom use among unmarried sexually active youth. a secondary analysis of the 2016-2017 Eswatini HIV incidence measurement survey

INTRODUCTION

In sub-Saharan Africa, youth continue to have a high burden of sexually transmitted infections and unplanned pregnancies that could be reduced through improved condom use. We aimed to investigate inconsistent condom use with the three most recent sexual partners among unmarried sexually active youth in Eswatini.

METHODS

Data were analysed for 1,324 youth from the 2016-2017 Swaziland HIV incidence measurement survey (SHIMS2) using multivariable logistic regression method.

RESULTS

The prevalence of inconsistent condom use among youth was 56.8% in 2017. Higher odds of inconsistent condom use were observed among youth aged 20-24, residents in the Lubombo region, those aged less than 18 years at sexual debut and those who had two or more sexual partners in the last 12 months before the survey. Lower odds of inconsistent condom use were observed among males, and those that knew their partners reported HIV status to be negative.

CONCLUSION

Our findings highlight a notable prevalence of inconsistent condom use among youth in Eswatini. Programs that aim to reduce the incidence of HIV infections and STIs among youth in Eswatini should focus on these factors associated with inconsistent condom use.

Consistent condom use and associated factors among HIV positive women of reproductive age on anti-retroviral treatment in Ogun State, Nigeria

Introduction

consistent condom use remains an integral and essential part of comprehensive Human Immunodeficiency Virus (HIV) prevention and care programme. This study assessed consistent use of condom among HIV-positive women of reproductive age on antiretroviral treatment and its associated factors.

Methods

a cross-sectional survey of 360 women living with HIV (WLHIV) receiving treatment in four APIN Public Health Initiatives, Nigeria supported President's Emergency Plan for AIDS Relief (PEPFAR) comprehensive Antiretroviral Therapy (ART) sites in Ogun State was conducted from October 2018 to March 2019. Information were collected on consistent condom use among respondents and their associated factors using a pre-tested questionnaire. Data were analysed using SPSS IBM version, with statistical significance set at 0.05.

Results

the mean age of the women was 38.1 ± 5.8 years. About two-fifth (39.4%) of the respondents reported consistent use of condom. Of the 142 respondents who reported inconsistent use of condom, 51.6% and 37.5% mentioned sexual displeasure and partner's disagreement respectively as reasons for inconsistent use. Factors associated with consistent condom use were marital status (p < 0.001), respondent's occupation (p = 0.040), partner's occupation (p = 0.012) and partner's HIV status (p = 0.045). Respondents with HIV negative partners were 1.8 times more likely to use condom consistently compared to those with HIV positive partners (AOR = 1.826, CI = 1.018 - 3.274).

Conclusion

this study concludes that there is poor consistent condom use among WLHIV in Ogun State. The rate is worse among the sero-concordant partners than the sero-discordant partners. More needs to be done through behaviour change communication aimed at improving consistent condom use among HIV clients.

Factors Associated With HIV Preventive Behavior Among Adults in Majang Zone of Gambella Region, Southwest Ethiopia

Background

HIV-positive people can spread the virus through unprotected sex; however, HIV can be avoided if populations are educated about the risks. In underdeveloped nations, evidence suggests that the ABC method for HIV prevention is quite effective. As a result, the goal of this study was to determine the magnitude of HIV prevention behavior among adults in the Majang zone of Southwest Ethiopia, as well as the factors that influence it.

Methods

A community-based cross-sectional study was carried out from March 1st to May 31st, 2019. The data were collected through a face-to-face interview using a modified validated questionnaire among systematically selected study participants. The collected data were coded and entered using Epidata manager version 4.0.2.101 and analyzed using SPSS version 21. A logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at a p-value less than 0.05.

Results

Of the 772 adults interviewed, the proportion of adults who had good HIV preventive behavior was 51.8%, 95% CI [48.3–55.3%]. Two hundred forty (31.9%) were used abstinence as a type of HIV preventive behavior followed by being faithful (16.1%) and consistent condom use (7.3%). The study also found that respondents with the age group ≥27 years old (AOR = 1.56, 95% CI [1.3–3.12]), marital status (being married (AOR = 6.30, 95% CI [4.48–11.4]), and divorced/widowed (AOR = 5.50, 95% CI [2.60–12.4]) and having good knowledge of HIV prevention methods (AOR = 2.18, 95% CI [1.71–4.00]) were the factors associated with good HIV preventive behavior.

Conclusion and Recommendation

In the study area, overall HIV prevention behavior was average. The characteristics linked with successful HIV prevention behavior among adults in the Majang community included increasing age, being married or divorced/widowed, and having a solid understanding of HIV prevention approaches. As a result, policy-level and multi-sectorial intervention approaches from all stakeholders are necessary to develop short- and long-term strategies to address the problem and improve the community’s quality of life.

Condom use consistency among South African HIV serodiscordant couples following an HIV risk-reduction intervention

Background: Although there are several ways to transmit HIV, condomless sex remains the primary mode in sub-Saharan Africa, including South Africa, with KwaZulu-Natal Province being one of the epicentres of HIV infection. This study explored the use of condoms in serodiscordant couples who were exposed to an HIV-risk reduction intervention that aimed to improve condom use and reduce the spread of HIV.Methods: A Total of 30 couples completed a paper-based questionnaire on their demographics and general health at baseline and 3 months, plus a semi-structured questionnaire with four domains. An analysis of HIV knowledge, condom use, condom use attitudes and protection perceptions about how other serodiscordant couples behave was conducted following a 12-week HIV risk reduction intervention. Participants were randomised 2:1 into intervention and control groups.Results: Condom use increased from 55% at baseline to 73.7% (p = .0047) at 3 months for the intervention group and condom use in the last 7 days increased from 53% to 86% (p = .0117). For the control group, condom use remained low at the 3 months follow up period (p = .625). HIV knowledge improved significantly from baseline to 3 months for the intervention group (p < .0001), as well as the control group (p = .0005). Negative HIV condom use attitude scores in both groups decreased significantly from baseline to 3 months; intervention group (p = .0059) and control group (p = .0007).Conclusion: HIV knowledge and condom use improved significantly, while negative condom use attitudes and HIV protection perceptions decreased significantly following exposure to a risk-reduction intervention, suggesting that HIV preventive interventions should focus on partnership interventions.

Reproductive decision-making of Black women living with HIV: A systematic review

BACKGROUND

Black women living with HIV account for a higher proportion of new HIV diagnoses than other groups. These women experience restricted access to reproductive services and inadequate support from healthcare providers because their position in society is based on their sexual health and social identity in the context of this stigmatizing chronic disease. By recognizing the analytical relevance of intersectionality, the reproductive decision-making of Black women can be explored as a social phenomenon of society with varied positionality.

OBJECTIVE

The purpose of this review was to synthesize the evidence about the reproductive decision-making of Black women living with HIV in high-income countries from the beginning of the HIV epidemic to the present.

METHODS

This systematic review was guided by the JBI evidence synthesis recommendations. Searches were completed in seven databases from 1985 to 2021, and the review protocol was registered with PROSPERO (CRD420180919).

RESULTS

Of 3503 records, 22 studies were chosen for synthesis, including 19 observational and three qualitative designs. Nearly, all studies originated from the United States; the earliest was reported in 1995. Few studies provided detailed sociodemographic data or subgroup analysis focused on race or ethnicity. Influencing factors for reproductive decision-making were organized into the following seven categories: ethnicity, race, and pregnancy; religion and spirituality; attitudes and beliefs about antiretroviral therapy; supportive people; motherhood and fulfillment; reproductive planning; and health and wellness.

CONCLUSION

No major differences were identified in the reproductive decision-making of Black women living with HIV. Even though Black women were the largest group of women living with HIV, no studies reported a subgroup analysis, and few studies detailed sociodemographic information specific to Black women. In the future, institutional review boards should require a subgroup analysis for Black women when they are included as participants in larger studies of women living with HIV.

Adolescents and young adults with early acquired HIV infection in the united states: unique challenges in treatment and secondary prevention

INTRODUCTION

Worldwide, children who acquired human immunodeficiency virus (HIV) at an early age, either perinatally or through blood transfusion, are reaching adolescence and adulthood due to successful antiretroviral treatment (ART). While many are thriving, a significant proportion face unprecedented multilevel challenges that can affect their long-term outcomes. Specifically, longstanding and poorly controlled HIV resulting from inadequate early regimens and nonadherence, along with the toxicities of some ART agents, can predispose them to sequelae including HIV-associated complications and other comorbidities.

AREAS COVERED

This paper reviews and summarizes the unique issues facing adolescents and young adults with early acquired HIV (AYA-EAHIV), including ART challenges, emerging comorbidities, and complications, including mental health comorbidities, secondary prevention, and transition from pediatric/adolescent to adult care.

EXPERT OPINION

AYA-EAHIV are a special population that have lived their entire lives with the physical and psychological toll of HIV mandating targeted and purposeful approaches to optimize their management and outcomes. Multifaceted inclusive and context-specific approaches focusing on heightened research, risk reduction interventions, and 'outside the box' thinking will be required to optimize treatment and reduce morbidity and mortality.