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Burananayok S, Nachatri W, Choothanorm P, Kusolthammarat K, Jaruthamsophon K, Yodsawad C, Limsakul P, Charupanit K. COVID-19 impact on blood donor characteristics and seroprevalence of transfusion-transmitted infections in southern Thailand between 2018 and 2022. Sci Rep 2024; 14:7920. [PMID: 38575642 PMCID: PMC10995202 DOI: 10.1038/s41598-024-57584-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
Blood safety is a critical aspect of healthcare systems worldwide involving rigorous screening, testing, and processing protocols to minimize the risk of transfusion-transmitted infections (TTIs). The present study offers a comprehensive assessment of the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis among blood donors in southern Thailand. It explores the consequences of the COVID-19 pandemic on the blood transfusion service, donor characteristics, and the prevalence of TTIs. A retrospective analysis of 65,511 blood donors between 2018 and 2022 was conducted at Songklanagarind Hospital, Thailand. The socio-demographic characteristics of the donors were examined using the Chi-square test to assess the relationship between TTIs serological positivity and donor characteristics. The donors were divided into pre-COVID-19 (2018-2019) and during COVID-19 (2020-2022) groups to evaluate the impacts of COVID-19. The study found that HBV had the highest overall prevalence at 243 per hundred thousand (pht), followed by syphilis (118 pht), HCV (32 pht), and HIV (31 pht) over a five-year period of study. After COVID-19, the prevalence of HBV decreased by 21.8%; HCV decreased by 2.1%; HIV increased by 36.4%; and syphilis increased by 9.2%. The socio-demographic characteristics and TTIs prevalence were significantly altered over time. This study provides insights into blood donor characteristics and TTIs prevalence in southern Thailand, highlighting the understanding of the impact of COVID-19 on the spread of TTIs.
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Affiliation(s)
- Suparat Burananayok
- Blood Bank and Transfusion Medicine Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Wilaiwan Nachatri
- Blood Bank and Transfusion Medicine Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pimpilalai Choothanorm
- Blood Bank and Transfusion Medicine Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kantarat Kusolthammarat
- Blood Bank and Transfusion Medicine Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kanoot Jaruthamsophon
- Blood Bank and Transfusion Medicine Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Human Genetic Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chaninporn Yodsawad
- Blood Bank and Transfusion Medicine Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Praopim Limsakul
- Division of Physical Science, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
- Center of Excellence for Trace Analysis and Biosensor (TAB-CoE), Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Krit Charupanit
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
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Abukari MH, Appiah CA, Kwarteng A, Iddrisu S. Cardiovascular risk assessment of people living in prison in the Northern region of Ghana. INTERNATIONAL JOURNAL OF PRISON HEALTH 2024; 20:102-115. [PMID: 38984556 DOI: 10.1108/ijoph-09-2022-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
PURPOSE The health of people living in prisons (PLP) frequently remains marginalised in national development discourse, particularly in resource-constrained settings like Ghana. This study aims to determine the prevalence of cardiovascular disease (CVD) risk factors among PLP at a prison facility in the Northern Region of Ghana. DESIGN/METHODOLOGY/APPROACH A cross-sectional study involving 134 male persons in prison, aged 18-79 years, was conducted to assess their dietary habits, tobacco use, alcohol consumption, sleep behaviour and physical activity practices. Serum lipid profile, fasting blood glucose (FBG), blood pressure (BP) and body mass indices of participants were also measured. FINDINGS Almost half (48.1%) of the participants had abnormal lipid levels. Those with FBG in the diabetes range (= 7.0 mmol/l) constituted 3.9%, while 16.7% were in the impaired FBG range (6.1-6.9 mmol/l). Participants with BP within the pre-hypertension range were 54.5%. The majority of participants (92%) had a low daily intake of fruits and vegetables. Few participants were active smokers (5%) and alcohol users (2%). The average sleep duration at night among the participants was 5.54 ± 2.07 h. The majority (74%) of the participants were sedentary. About a quarter of the participants (24.6%) had overweight/obesity. ORIGINALITY/VALUE This study highlights the CVD risks among PLP. Findings suggest the need for targeted interventions, such as dietary and lifestyle modification strategies, regular physical activity and routine screening for diabetes, dyslipidaemia and hypertension. These interventions within the prison space could significantly improve the cardiovascular health of PLP in resource-limited settings.
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Affiliation(s)
| | - Collins Afriyie Appiah
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Kwarteng
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sherifa Iddrisu
- Department of Nutrition and Dietetics, Tamale Technical University, Tamale, Ghana
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Annor F, Nartey YA, Abbew ET, Cudjoe O, Ayisi-Addo S, Ashinyo A, Obiri-Yeboah D. Human immunodeficiency virus care and management in incarcerated populations in Sub-Saharan Africa between 2010 and 2022: A narrative review. Int J STD AIDS 2024; 35:80-95. [PMID: 37793133 DOI: 10.1177/09564624231205335] [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: 10/06/2023]
Abstract
BACKGROUND Different countries in sub-Saharan Africa (SSA) have established guidelines to reduce HIV transmission and improve its management in prisons. This narrative review aimed to examine established literature on HIV care and management among incarcerated persons in SSA to identify successful interventions that could inform improved guidelines, policies, and practices related to the clinical care of this population. METHODS We searched PubMed, Scopus, Web of Science, Embase, and TRIP Medical Databases in August 2022 for articles published between 1st January 2010 and 30th June 2022. We identified 27 eligible articles based on the Population/Concept/Context framework. RESULTS HIV screening primarily involved mass campaigns rather than formal prison programmes, with limited implementation of universal testing and treatment. Although a few studies reported on access to antiretrovirals (ARVs), prisoners in urban areas and females had disproportionate access. Barriers identified include poor living conditions, high levels of stigma, and resource constraints. Inter-prison transfers, release from prison, and lack of established programmes hindered follow-up and linkage to care. CONCLUSIONS The implementation of strategies such as universal testing and treatment, human resource strengthening, financing plans for testing, ARV care, and frequent assessment of risk could improve HIV care and management in prisons in SSA.
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Affiliation(s)
- Francis Annor
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
| | - Yvonne Ayerki Nartey
- Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana
- Department of Internal Medicine and Therapeutics, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Elizabeth Tabitha Abbew
- Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerpen, Belgium
| | - Obed Cudjoe
- Department of Medical Laboratory Science, University of Cape Coast, Cape Coast, Ghana
| | - Stephen Ayisi-Addo
- National AIDS/STI Control Program of the Ghana Health Service, Accra, Ghana
| | - Anthony Ashinyo
- National AIDS/STI Control Program of the Ghana Health Service, Accra, Ghana
| | - Dorcas Obiri-Yeboah
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Hussain HU, Kumar KA, Rehan ST, Khan Z, Hashmi MR, Khabir Y, Fatir CA, Tahir MJ, Ahmed A, Shrateh ON, Huda MN. Odds of HIV among incarcerated drug users: a systematic review and meta-analysis of Asian countries. Ann Med Surg (Lond) 2023; 85:5584-5592. [PMID: 37915701 PMCID: PMC10617921 DOI: 10.1097/ms9.0000000000001242] [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: 07/19/2023] [Accepted: 08/16/2023] [Indexed: 11/03/2023] Open
Abstract
Background HIV makes up a large portion of infectious diseases globally. People injecting drugs in prisons are at high risk for contracting HIV infection. Prisons house ~10.2 million people globally, making them a high-risk setting for HIV transmission. This systematic review summarizes the available data on the odds of developing HIV infection among imprisoned people who inject drugs (PWIDs) in Asian regions. Methods The authors electronically assessed published studies from January, 2000 to December, 2022, including studies that investigated the odds of HIV in imprisoned PWIDs. We extensively searched PubMed, ERIC, and Cochrane Central and Google Scholar with no constraints in language or time. All the observational studies evaluating the chances of HIV in Asian prisoners with an exposure group of PWIDs and a control group of non-injecting-drug users were included in our analysis. Results The databases search yielded 254 potential studies, 10 observational studies of which having a total of 17 333 participants were included. A low or moderate risk of bias was reported in all the studies except one case-control. The pooled analysis showed a significant association between PWIDs and the chances of contracting HIV infection (Odds ratio=6.40; 95% CI=3.89-10.52; P<0.00001; I2=53%). Conclusion This study found a vital correlation between injecting-drug usage during imprisonment and HIV transmission speed. The results of this meta-analysis support the need to prevent HIV and conducting treatment programs in high-risk settings like prisons.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ali Ahmed
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Oadi N. Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Md. Nazmul Huda
- School of Medicine
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
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Dwomoh D, Wurie I, Harding Y, Sedzro KM, Kandeh J, Tagoe H, Addo C, Arhinful DK, Sessay ARC, Kamara JL, Mansaray K, Ampofo WK. Estimating prevalence and modelling correlates of HIV test positivity among female sex workers, men who have sex with men, people who inject drugs, transgender people and prison inmates in Sierra Leone, 2021. AIDS Res Ther 2023; 20:70. [PMID: 37759241 PMCID: PMC10537076 DOI: 10.1186/s12981-023-00566-4] [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: 01/24/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Key populations (KPs) are particularly vulnerable to HIV infection and efforts to prevent HIV infections among KPs have been less successful, largely due to existing laws and legislation that classify the groups as illegal. Understanding the HIV infection pathway and the burden of HIV infection among Female Sex Workers (FSWs), Transgender people (TG), Men who have sex with Men (MSM), People who Inject Drugs (PWID), and Prison Inmates (PIs) is critical to combatting the HIV epidemic globally. This study aims to estimate HIV prevalence and model the risk factors of HIV positivity rate among the aforementioned KPs in Sierra Leone. This study used Time Location Sampling, Respondent Driven Sampling (RDS), and Conventional cluster Sampling designs to generate a representative sample of FSWs, MSM, TG, PI, and PWID. HIV prevalence and the corresponding 95% confidence intervals among each KP were estimated by adjusting for sampling weight using the logit-transformed confidence intervals. To determine correlates of HIV test positivity among KPs, a multivariable modified Poisson regression model that adjusts for RDS survey weights was used and sensitivity analysis was conducted using a multivariable logistic regression model with cluster robust standard errors. The prevalence of HIV among FSWs in the six regional headquarter towns was estimated to be 11.8% (95% CI: 7.9-17.1); MSM was 3.4% [95% CI: 1.9-5.8]; TGs was 4.2% (95% CI: 2.9-6.1); PWIDs was 4.2% (95% CI: 2.7-6.4) and PI was 3.7% (95% CI: 1.4-9.6). The correlates of HIV test positivity among KPs and PIs include HIV-related knowledge, marital status, district, income, age and sex of KP, level of education, alcohol intake, injecting drugs, and use of lubricants. HIV prevalence is relatively high among FSWs, MSMs, PWID, and TGs as compared to the previous estimate of the general population. There is a need to scale up and strengthen evidence-based HIV prevention interventions such Pre-Exposure Prophylaxis and needle and syringe exchange programmes targeting KPs, including prison inmates. Government must scale up both non-clinical and clinical routine HIV and STI testing and counseling services at the correctional center and drop-in centers for KPs screening/testing, and ensure that services are responsive to the needs of KP.
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Affiliation(s)
- Duah Dwomoh
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
| | - Issata Wurie
- Health and Education Quality Systems Strengthening, Freetown, Sierra Leone
| | - Yvonne Harding
- Health and Education Quality Systems Strengthening, Freetown, Sierra Leone
| | - Kojo Mensah Sedzro
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joseph Kandeh
- Health and Education Quality Systems Strengthening, Freetown, Sierra Leone
| | - Henry Tagoe
- John Snow Resarch & Training Institute Inc, Accra, Ghana
| | - Christabel Addo
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Daniel Kojo Arhinful
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Abdul Rahman Cherinoh Sessay
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | | | - William Kwabena Ampofo
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Sahle ET, Amogne W, Manyazewal T, Blumenthal J, Jain S, Sun S, Young J, Ellorin E, Woldeamanuel H, Teferra L, Feleke B, Vandenberg O, Rey Z, Briggs-Hagen M, Haubrich R, McCutchan JA. Prevalence of and risk factors for Human Immunodeficiency Virus (HIV) infection in entrants and residents of an Ethiopian prison. PLoS One 2023; 18:e0271666. [PMID: 36758059 PMCID: PMC9910692 DOI: 10.1371/journal.pone.0271666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/05/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Prisoners generally have a higher prevalence of HIV infection compared to the general population from which they come. Whether this higher prevalence reflects a higher HIV prevalence in those entering prisons or intramural transmission of HIV within prisons or both is unclear. Any of these possibilities would increase the prevalence found in resident prisoners above that in the general population. Moreover, comparisons of HIV prevalence in entrants and residents and in men and women in African prisons are not well documented. The purpose of this study was to estimate and compare the prevalence and risk factors for HIV infection amongst both male as well as female and entrant and resident prisoners in a large Ethiopian Federal Prison. METHODS We studied consenting prisoners cross-sectionally from August 2014 through November 2016. Prison entrants were screened continuously for HIV infection and its associated risk factors and residents were screened in two waves one year apart. HIV was diagnosed at the prison hospital laboratory based on the Ethiopian national HIV rapid antibody testing protocol. An external, internationally-accredited reference laboratory confirmed results. Agreement of results between the laboratories were assessed. RESULTS A total of 10,778 participants were screened for HIV. Most participants were young (median age of 26 years, IQR: 21-33), male (84%), single (61%), literate (89%), and urban residents (91%) without prior incarceration (96%). Prevalence of HIV was 3.4% overall. Rates of HIV (p = 0.80) were similar in residents and entrants in wave 1 and in entrants in both waves, but were 1.9-fold higher (5.4% vs 2.8%) in residents than entrants in wave 2 (both p<0.001). At entrance to the prison women were more likely to be HIV+ than men (5.5% in women vs 2.5% in men, p< 0.001). In contrast resident women were less likely to be HIV+, but this difference was not statistically significant (3.2% in women vs 4.3% in men, p = 0.125). Other risk factors associated with HIV infection were increasing age (p<0.001), female gender (p<0.001), marital status (never vs other categories, p = 0.016), smaller number of rooms in their houses pre-imprisonment (p = 0.031), TB diagnosis ever (p<0.001), number of lifetime sex partners (especially having 2-10, p<0.001), and genital ulcer (p = 0.037). CONCLUSIONS Prevalence of HIV in the residents at this large, central Ethiopian prison was higher than that estimated for the general population and lower than in many other studies from other smaller Ethiopian prisons. A higher prevalence in residents than in entrants were found only in our second wave of screening after one year of continuous screening and treatment, possibly representing increased willingness of residents at increased risk of HIV to participate in the second wave. Thus, this findings did not clearly support intramural transmission of HIV or the effectiveness of screening to reduce prevalence. Finally, the higher HIV prevalence in women than men requires that they be similarly screened and treated for HIV infection.
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Affiliation(s)
- Eliyas Tsegaye Sahle
- ADDIS-VP Project/Ethiopian Public Health Association, Addis Ababa, Ethiopia
- Université Libre de Bruxelles/Ecole de Sante Public, Brussels, Belgium
| | - Wondwossen Amogne
- ADDIS-VP Project/Ethiopian Public Health Association, Addis Ababa, Ethiopia
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegahun Manyazewal
- ADDIS-VP Project/Ethiopian Public Health Association, Addis Ababa, Ethiopia
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jill Blumenthal
- University of California San Diego, San Diego, California, United States of America
| | - Sonia Jain
- University of California San Diego, San Diego, California, United States of America
| | - Shelly Sun
- University of California San Diego, San Diego, California, United States of America
| | - Jason Young
- University of California San Diego, San Diego, California, United States of America
| | - Eric Ellorin
- University of California San Diego, San Diego, California, United States of America
| | | | - Lemma Teferra
- Ethiopian Federal Prison Administration, Addis Ababa, Ethiopia
| | - Beniam Feleke
- Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Olivier Vandenberg
- Environmental and Occupational Health Research Centre (CRSET), School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
- Division of Infection & Immunity, University College London, London, United Kingdom
| | - Zilma Rey
- Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Melissa Briggs-Hagen
- Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Richard Haubrich
- Gilead Sciences, Foster City, California, United States of America
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Silva JKBD, Santos JMD, Moreira WC, Romero ROG, Leadebal ODCP, Nogueira JDA. Modelo multinível na identificação de fatores de risco comportamentais e estruturais ao HIV: revisão integrativa. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2021-0853pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: investigar estudos que adotaram o modelo de análise multinível na identificação de fatores de risco comportamentais e estruturais, que estão associados a infecção pelo HIV. Métodos: revisão integrativa da literatura com estudos disponíveis na íntegra, obtidos nas bases EMBASE, CINAHL, Pubmed e Scopus, cujos descritores selecionados foram os termos constantes: “HIV”, “multilevel analysis”, “behavior”. Resultados: a pesquisa resultou em 236 artigos. Destes, dez artigos compuseram a amostra. Desvantagem econômica, características de vizinhança, instabilidade habitacional, encarceramento, sexo transacional, múltiplos parceiros, abuso de substâncias e idade da primeira relação sexual foram classificados como fatores de risco estruturais e comportamentais ao HIV. Redução da desvantagem socioeconômica, fornecimento de estabilidade habitacional e uso de preservativos foram associados a fatores de proteção à exposição ao HIV. Conclusões: com a aplicabilidade do modelo multinível nos estudos de investigação de fatores de risco, foi possível identificar os elementos estruturais e comportamentais de risco ao HIV.
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da Silva JKB, dos Santos JM, Moreira WC, Romero ROG, Leadebal ODCP, Nogueira JDA. Multilevel model in the identification of behavioral and structural risk factors for HIV: integrative review. Rev Bras Enferm 2022; 76:e20210853. [PMID: 36542051 PMCID: PMC9749773 DOI: 10.1590/0034-7167-2021-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 08/21/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES to investigate studies that adopted the multilevel analysis model to identify behavioral and structural risk factors associated with HIV infection. METHODS an integrative review of the literature with studies available in full, obtained from EMBASE, CINAHL, Pubmed, and Scopus, whose selected descriptors were the indexed terms: "HIV", "multilevel analysis" and "behavior". RESULTS the search resulted in 236 studies. Out of these, ten studies comprised the sample. Economic disadvantage, neighborhood characteristics, housing instability, incarceration, transactional sex, multiple partners, substance abuse, and age at first intercourse were classified as structural and behavioral risk factors for HIV. Reduced socioeconomic disadvantage, provision of housing stability, and condom use were associated with protective factors for HIV exposure. CONCLUSIONS by applying the multilevel model in risk factor research studies, it was possible to identify the structural and behavioral elements of HIV risk.
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Tavakoli F, Parhizgari N, Shokoohi M, Khezri M, Haghdoost AA, Ghasemzadeh I, Bozicevic I, Shahesmaeili A, Nasiri N, Danesh A, Karamouzian M, Sharifi H. HIV testing among incarcerated people with a history of HIV-related high-risk behaviours in Iran: Findings from three consecutive national bio-behavioural surveys. BMC Infect Dis 2022; 22:907. [PMID: 36471282 PMCID: PMC9721074 DOI: 10.1186/s12879-022-07897-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 11/25/2022] [Indexed: 12/10/2022] Open
Abstract
BACKGROUND Incarcerated people are at a disproportionate risk of contracting HIV. We estimated the prevalence and correlates of HIV testing among incarcerated people with a history of HIV-related high-risk behaviours in Iran. METHODS Data for this analysis were obtained from three consecutive nationwide bio-behavioural surveillance surveys of a random sample of incarcerated people in 2009 (n = 5953), 2013 (n = 5490), and 2017 (n = 5785). History of testing for HIV in the last 12 months was the primary outcome variable. HIV testing was examined among those with a history of HIV-related high-risk behaviours (i.e., having multiple sex partnerships, injection drug use practices, or a history of having a tattoo). The outcome variable was divided into three categories: Never tested for HIV, ever tested for HIV inside the prison in the last 12 months, and ever tested for HIV outside the prison in the last 12 months. We used multivariable multinomial logistic regression models to examine factors associated with HIV testing. RESULTS Overall, 8,553 participants with a history of HIV-related high-risk behaviors with valid responses to the HIV testing question were included in the analysis. Although HIV testing inside prison has increased (23% [2009], 21.5% [2013], and 50.3% [2017]: P-value < 0.001), the prevalence of HIV testing outside prison has decreased (7.7% [2009], 7.5% [2013], 4.1% [2017]: P-value < 0.001) over time. Our multivariable multinomial regression model showed older age (Relative-risk ratio [RRR]: 1.24, 95% Confidence Intervals [CI]: 1.05, 1.47), history of the previous incarceration (RRR: 1.46, 95% CI: 1.24, 1.71), currently receiving methadone maintenance therapy inside prison (RRR: 2.09, 95% CI: 1.81, 2.43), having access to condoms inside prison (RRR: 1.42, 95% CI: 1.20, 1.68) and sufficient HIV knowledge (RRR: 1.74, 95% CI: 1.47, 2.05) were significantly associated with an increased probability of having an HIV test in the last 12 months inside prison. CONCLUSION HIV testing among high-risk Iranian prisoners has increased from 2009 to 2017. However, HIV testing remains considerably low, and half of the incarcerated people with a history of HIV-related high-risk behaviours had never tested for HIV inside prison. Evidence-based programs are needed to optimize HIV testing inside and outside prisons and identify those at greater risk of HIV.
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Affiliation(s)
- Fatemeh Tavakoli
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Najmeh Parhizgari
- grid.411705.60000 0001 0166 0922Medical Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Shokoohi
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Mehrdad Khezri
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Iman Ghasemzadeh
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ivana Bozicevic
- grid.4808.40000 0001 0657 4636WHO Collaborating Centre for HIV Strategic Information, School of Medicine, Zagreb, Croatia
| | - Armita Shahesmaeili
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Naser Nasiri
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Danesh
- grid.411747.00000 0004 0418 0096Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Karamouzian
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran ,grid.415502.7Centre on Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON Canada ,grid.40263.330000 0004 1936 9094Brown School of Public Health, Brown University, Providence, RI USA
| | - Hamid Sharifi
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Shahesmaeili A, Karamouzian M, Tavakoli F, Shokoohi M, Mirzazadeh A, Hosseini-Hooshyar S, Amirzadeh Googhari S, Ghalekhani N, Khajehkazemi R, Abdolahinia Z, Fahimfar N, Haghdoost A, Sharifi H. HIV prevalence and continuum of care among incarcerated people in Iran from 2010 to 2017. Harm Reduct J 2022; 19:93. [PMID: 35987692 PMCID: PMC9392948 DOI: 10.1186/s12954-022-00675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background Incarcerated people are at an increased risk of contracting HIV and transmitting it to the community post-release. In Iran, HIV epidemics inside prisons were first detected in the early 1990s. We assessed the HIV prevalence and its correlates, as well as the continuum of care among incarcerated people in Iran from 2010 to 2017.
Methods We used data collected in three national bio-behavioral surveillance surveys among incarcerated individuals in 2010 (n = 4,536), 2013 (n = 5,490), and 2017 (n = 5,785) through a multistage cluster sampling approach. HIV was tested by the ELISA method in 2010 and 2013 surveys and rapid tests in 2017. Data on demographic characteristics, risky behaviors, HIV testing, and treatment were collected via face-to-face interviews. HIV prevalence estimates along with 95% confidence intervals (CI) were reported. Using data from the 2017 round, multivariable logistic regression models were built to assess the correlates of HIV sero-positivity and conduct HIV cascade of care analysis.
Results The HIV prevalence was 2.1% (95% CI: 1.2%, 3.6%) in 2010, 1.7% (95% CI: 1.3%, 2.1%) in 2013, and 0.8% (95% CI: 0.6%, 1.1%) in 2017 (trend P value < 0.001). Among people with a history of injection drug use, HIV prevalence was 8.1% (95% CI: 4.6%, 13.8%) in 2010, 6.3% (95% CI: 4.8%, 8.3%) in 2013, and 3.9% (95% CI: 2.7%, 5.7%) in 2017. In 2017, 64% (32 out of 50) of incarcerated people living with HIV were aware of their HIV status, of whom 45% (9 out of 20) were on antiretroviral therapy, and of whom 44% (4 out of 9) were virally suppressed (< 1000 copies/ml). Conclusions While HIV prevalence has decreased among incarcerated people in Iran, their engagement in the HIV continuum of care is suboptimal. Further investments in programs to link incarcerated people to HIV care and retain them in treatment are warranted.
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Leblanc NM, Mitchell JW, Bond KT, Juarez Cuellar A, Vil NMS, McMahon J. Perspectives on a Couples-Based, e-Health HIV Prevention Toolkit Intervention: A Qualitative Dyadic Study with Black, Heterosexual Couples in New York State. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2625-2640. [PMID: 35639220 PMCID: PMC10688541 DOI: 10.1007/s10508-021-02270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 05/11/2023]
Abstract
Web-based technology provides an unparalleled opportunity to increase access and uptake of couples-based HIV prevention interventions. e-Health HIV prevention interventions for US Black heterosexual couples have largely been understudied. To address this gap, we applied the Assessment Phase of the ADAPT-ITT Framework to investigate Black heterosexual couples' perspectives on an existing e-Health, couples-based HIV prevention intervention. Applying a qualitative descriptive approach, joint dyadic interviews were conducted with 28 Black heterosexual couples from three jurisdictions in New York State. Content dyadic analysis revealed three descriptive categories: perspectives of the toolkit intervention (sub-codes: perceived relevance, reactions to core components), recommendations to enhance intervention relevancy (sub-codes: tailoring to relationship type, adding new content), and lasting intervention considerations (sub-codes: toolkit usability and language use). Overall, couples found the toolkit intervention content and usability acceptable and reflected on its potential to build sexual and relationship health. Couples recommended to enhance toolkit adaptability for varied couple's motivation and types re-consider terms like sexual agreements, and include content to facilitate communication regarding sensitive topics (e.g., childhood sexual trauma, co-parenting, family planning) and other issues that may have more relevance to the experience of US Black persons (i.e., wealth building).
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Affiliation(s)
- Natalie M Leblanc
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA.
| | - Jason W Mitchell
- Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Keosha T Bond
- City College of New York, CUNY School of Medicine, New York City, NY, USA
| | | | - Noelle M St Vil
- School of Social Work, University at Buffalo, Buffalo, NY, USA
| | - James McMahon
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA
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12
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Urrego Díaz JA, Trujillo-Trujillo J, Meza-Cárdenas M, Cruz ÓA. Caracterización de la tuberculosis multidrogorresistente y resistente a rifampicina en Colombia. Rev Salud Publica (Bogota) 2022. [DOI: 10.15446/rsap.v23n6.98937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Caracterizar la población afectada por tuberculosis multidrogorresistente y resistente a rifampicina (TB-MDR/RR) en Colombia.
Métodos Estudio transversal a partir de la información nominal de los pacientes con TB-MDR/RR tratados y reportados en Colombia desde 2009 hasta 2020, usando la totalidad de las fuentes de información oficiales. Se compararon, además, las tasas de TB-MDR/RR de diferentes grupos de riesgo con la de la población general y se evaluaron variables asociadas a la TB-MDR/RR extrapulmonar y a resistencias medicamentosas.
Resultados La TB-MDR/RR ha aumentado progresivamente durante la última década y se ha concentrado en hombres (64% vs. 36%, p<0,001), edades medias (mediana: 39,5 años; RIC: 27) y zonas de mayor densidad poblacional (59% de los casos en Antioquia, Valle del Cauca y Santiago de Cali). Además, al compararlas con las poblaciones de referencia que aplicaran, se evidenciaron tasas 2, 10 y 200 veces mayores en población indígena (9,45/1 000 000 vs. 4,31/1 000 000; p=0,02), prisioneros (169/1 000 000 vs. 16,9/1 000 000; p<0,001) y habitantes de calle (21/100000 vs. 0,1/100 000; p<0,001), respectivamente.
Conclusiones El aumento en los casos de TB-MDR/RR y sus grupos de riesgo deben tenerse en cuenta para la planeación de políticas, distribución de recursos y atención clínica.
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Burns PA, Hall CDX, Poteat T, Mena LA, Wong FY. Living While Black, Gay, and Poor: The Association of Race, Neighborhood Structural Disadvantage, and PrEP Utilization Among a Sample of Black Men Who Have Sex With Men in the Deep South. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:395-410. [PMID: 34596429 PMCID: PMC10134438 DOI: 10.1521/aeap.2021.33.5.395] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Utilizing the Andersen Healthcare Utilization Model, we examined the role of neighborhood context on pre-exposure prophylaxis (PrEP) utilization among a sample of Black men who have sex with men (MSM) residing in a medium-sized city in the Deep South. Data were derived from a sample of 142 Black MSM aged 18-64 years who were eligible for PrEP from a community-based study known as "ACCELERATE!" We used multilevel structural equation modeling to assess PrEP use. Social support, sexual risk, and health care access were predictive of PrEP use. Notably, residing in a neighborhood with concentrated poverty was associated with decreased PrEP use. Our findings reveal neighborhood structural disadvantage is associated with decreased PrEP use among Black MSM, after adjusting of individual-level sociodemographic characteristics. There is an urgent need to develop HIV prevention interventions and programs that explicitly address structural-level factors to eliminate racial/ethnic differences in HIV.
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Affiliation(s)
- Paul A. Burns
- University of Mississippi Medical Center. John D. Bower School of Population Health | Center for HIV/AIDS Research, Education and Policy, 2500 North State Street, TR202-09, Jackson, MS 39216 USA
| | - Casey D. Xavier Hall
- Northwestern University, Department of Medical Social Sciences at Feinberg School of Medicine | Institute for Sexual and Gender Minority Health and Wellbeing, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611
| | - Tonia Poteat
- University of North Carolina-Chapel Hill, School of Medicine | Department of Social Medicine and Center for Health Equity Research 321 S. Columbia Street, Chapel Hill, NC 27599
| | - Leandro A. Mena
- University of Mississippi Medical Center. John D. Bower School of Population Health | Center for HIV/AIDS Research, Education and Policy, 2500 North State Street, TR202-09, Jackson, MS 39216 USA
- Univerisity of Mississippi Medical Center, School of Medicine, Department of Infectious Diseases, 2500 North State Street, Jackson, MS 39216 USA
| | - Frank Y. Wong
- University of Mississippi Medical Center. John D. Bower School of Population Health | Center for HIV/AIDS Research, Education and Policy, 2500 North State Street, TR202-09, Jackson, MS 39216 USA
- Florida State University, College of Nursing | Center for Population Sciences and Health Equity, 2010 Levy Avenue, Building B, Suite 3600, Tallahassee, FL 32310
- University of Hawaiì at Mānoa, Department of Psychology, Sakamaki C 400, 2530 Dole St C 400, Honolulu, HI 96822
- Fudan University, School of Public Health-Epidemiology, Shanghai, China
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Mundt AP, Rozas Serri E, Siebenförcher M, Alikaj V, Ismayilov F, Razvodovsky YE, Hasanovic M, Marinov P, Frančišković T, Cermakova P, Harro J, Sulaberidze L, Kalapos MP, Assimov M, Nurmagambetova S, Ibishi NF, Molchanova E, Taube M, Chihai J, Dedovic J, Gosek P, Tataru N, Golenkov A, Lecic-Tosevski D, Randjelovic D, Izakova L, Švab V, Vohidova M, Kerimi N, Sukhovii O, Priebe S. Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis. LANCET REGIONAL HEALTH-EUROPE 2021; 7:100137. [PMID: 34557842 PMCID: PMC8454862 DOI: 10.1016/j.lanepe.2021.100137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Numbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33•8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24•7%), residential facility beds (12•0%), and for prison populations (36•0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries. Funding Agencia Nacional de Investigación y Desarrollo in Chile, grant scheme FONDECYT Regular, grant number 1190613.
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Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile; Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Enzo Rozas Serri
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile; Medical Faculty, Universidad Diego Portales, Santiago, Chile
| | - Mathias Siebenförcher
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité Universitätsmedizin Berlin, Germany
| | - Valbona Alikaj
- Department of Neuroscience, Faculty of Medicine, Medical University, Tirana, Albania
| | | | | | - Mevludin Hasanovic
- Department of Psychiatry, University Clinical Centre Tuzla, Medical Faculty, University of Tuzla, Bosnia and Herzegovina
| | - Petar Marinov
- Association of Experts in Mental Health, Sofia, Bulgaria; Standing Committee for Professional Standards and By-Laws of the Bulgarian Psychiatric Association, Sofia, Bulgaria; Sofia University "St. Kliment Ohridski", Thrakian University St. Zagora, Bulgaria
| | | | - Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University Prague, Czech Republic; Second Faculty of Medicine, Charles University Prague, Czech Republic
| | - Jaanus Harro
- North Estonia Medical Centre, Psychiatry Clinic, Tallinn, and Chair of Neuropsychopharmacology, Institute of Chemistry, University of Tartu, Tartu, Estonia
| | | | | | - Marat Assimov
- Department of Communication Skills of the Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Nazmie F Ibishi
- Clinic of Psychiatry, University Clinical Centre of Kosovo, Pristina, Kosovo
| | | | - Māris Taube
- Department of Psychiatry, Riga Stradin's University, Riga, Latvia
| | - Jana Chihai
- Psychiatry, Narcology and Medical Psychology Department, State Medical and Pharmaceutical University Nicolae Testemitanu, Chisinau, Moldova
| | - Jovo Dedovic
- Forensic Psychiatry Unit - Special Psychiatric Hospital Kotor, Kotor, Montenegro
| | - Paweł Gosek
- Institute of Psychiatry and Neurology • Department of Forensic Psychiatry, Warsaw, Poland
| | - Nicoleta Tataru
- Senior consultant psychiatrist, Psychiatry Ambulatory Clinic, Oradea, România
| | - Andrei Golenkov
- Psychiatry and Medical Psychology, Chuvash State University, Cheboksary, Russia
| | | | | | - Lubomira Izakova
- Department of Psychiatry, Comenius University in Bratislava, Faculty of Medicine, Bratislava, Slovak Republic
| | - Vesna Švab
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Nina Kerimi
- Consultant, United Nations Office on Drugs and Crime (UNODC), Programme Office in Turkmenistan, Ashgabat, Turkmenistan
| | - Oleksii Sukhovii
- Center for Mental Health and Monitoring of Drugs and Alcohol MoH of Ukraine
| | - Stefan Priebe
- Unit of Social and Community Psychiatry, Queen Mary University of London, UK
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Grammatikopoulou MG, Lampropoulou MΑ, Milapidou M, Goulis DG. At the heart of the matter: Cardiovascular health challenges among incarcerated women. Maturitas 2021; 149:16-25. [PMID: 34134886 DOI: 10.1016/j.maturitas.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/17/2022]
Abstract
Many factors appear to contribute to an increased risk for cardiovascular disease (CVD) among incarcerated women. Imprisonment is associated with a bodyweight gain and an increased prevalence of overweight and obesity. Inadequate physical activity and unhealthy nutrition further contribute to this positive energy balance. Classical CVD risk factors are common, including hypertension, diabetes mellitus, metabolic syndrome, and smoking. Moreover, imprisonment is associated with an increased incidence of mental health issues, such as depression and anxiety, with coping mechanisms, including substance abuse, being frequently adopted. Specific attitudes in the correctional environment, including hunger strikes, bullying, abuse and solitary confinement, are effectors of cardiovascular and mental ill-health. Furthermore, the plethora of psychological stressors induces an accelerated aging process, paired with CVD risk. Communicable diseases, mainly human immunodeficiency virus, opportunistic infections and inadequate sunlight exposure increase cardiovascular dysregulation. Health care needs associated with the female sex are not always met, adding to the frustration and compromised well-being. All these factors act independently and cumulatively, increasing CVD risk among incarcerated women.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Maria Α Lampropoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Maria Milapidou
- Dr. Juris, Post Doc Researcher, Faculty of Law, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Gondwe A, Amberbir A, Singogo E, Berman J, Singano V, Theu J, Gaven S, Mwapasa V, Hosseinipour MC, Paul M, Chiwaula L, van Oosterhout JJ. Prisoners' access to HIV services in southern Malawi: a cross-sectional mixed methods study. BMC Public Health 2021; 21:813. [PMID: 33910547 PMCID: PMC8080321 DOI: 10.1186/s12889-021-10870-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The prevalence of Human Immunodeficiency Virus (HIV) among prisoners remains high in many countries, especially in Africa, despite a global decrease in HIV incidence. Programs to reach incarcerated populations with HIV services have been implemented in Malawi, but the success of these initiatives is uncertain. We explored which challenges prisoners face in receiving essential HIV services and whether HIV risk behavior is prevalent in prisons. METHODS We conducted a mixed-methods (qualitative and quantitative), cross-sectional study in 2018 in six prisons in Southern Malawi, two large central prisons with on-site, non-governmental organization (NGO) supported clinics and 4 smaller rural prisons. Four hundred twelve prisoners were randomly selected and completed a structured questionnaire. We conducted in-depth interviews with 39 prisoners living with HIV, which we recorded, transcribed and translated. We used descriptive statistics and logistic regression to analyze quantitative data and content analysis for qualitative data. RESULTS The majority of prisoners (93.2%) were male, 61.4% were married and 63.1% were incarcerated for 1-5 years. Comprehensive services were reported to be available in the two large, urban prisons. Female prisoners reported having less access to general medical services than males. HIV risk behavior was reported infrequently and was associated with incarceration in urban prisons (adjusted odds ratio [aOR] 18.43; 95% confidence interval [95%-CI] 7.59-44.74; p = < 0.001) and not being married (aOR 17.71; 95%-CI 6.95-45.13; p = < 0.001). In-depth interviews revealed that prisoners living with HIV experienced delays in referrals for more severe illnesses. Prisoners emphasized the detrimental impact of poor living conditions on their personal health and their ability to adhere to antiretroviral therapy (ART). CONCLUSIONS Malawian prisoners reported adequate knowledge about HIV services albeit with gaps in specific areas. Prisoners from smaller, rural prisons had suboptimal access to comprehensive HIV services and female prisoners reported having less access to health care than males. Prisoners have great concern about their poor living conditions affecting general health and adherence to ART. These findings provide guidance for improvement of HIV services and general health care in Malawian institutionalized populations such as prisoners.
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Affiliation(s)
- Austrida Gondwe
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi.
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
| | | | - Emmanuel Singogo
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Joshua Berman
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Victor Singano
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Joe Theu
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Steven Gaven
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Victor Mwapasa
- College of Medicine, P/Bag 360, Chichiri, Blantyre, Malawi
| | - Mina C Hosseinipour
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- University of North Carolina-Malawi Project, Tidziwe Centre, P/Bag A-104, Lilongwe, Malawi
| | - Magren Paul
- Chichiri Prison, P/Bag 30117, Blantyre 3, Blantyre, Malawi
| | | | - Joep J van Oosterhout
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
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Doat A, Navab E, Sadat Hoseini AS. Lived Experiences of Adolescent Living with human immunodeficiency virus in Ghana: A Phenomenology Study. Nurs Open 2021; 8:299-307. [PMID: 33318837 PMCID: PMC7729801 DOI: 10.1002/nop2.630] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/01/2020] [Indexed: 11/21/2022] Open
Abstract
Aim and objectives To explore the meaning of living with HIV positive in Ghanaian adolescents. Design Hermeneutic phenomenological approach developed by Van Manen methodology (1990). Method A purposive sampling of 12 adolescents living with HIV was recruited. Data were collected between September 2019-January 2020 using semi-structured interviews and analysed using thematic analysis. Results Two main themes emerged: Stigmatization and HIV disclosure and Living with a heavy burden. Seven subthemes were also found. Adolescents living with HIV in Ghana face discrimination, rejection and go through psychological distress such as suicidal thoughts, fear of death and hopelessness. Conclusion The problems faced by adolescents living with HIV are a result of the inherent beliefs of the Ghanaian society about HIV. Nurses working with ADLHIV should concentrate on identifying challenges and provide support and care, in addition to their treatment.
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Affiliation(s)
- Abdul‐Razak Doat
- Department of Pediatric NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Elham Navab
- Department of Critical Care NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Akram Sadat Sadat Hoseini
- Department of Pediatric NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
- Department of Pediatric NursingSchool of Nursing and MidwiferyResearch center of QuranHadith and MedicineTehran University of Medical sciencesTehranIran
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Ale-Ebrahim J, Janani L, SeyedAlinaghi SA, Farhoudi B, Abbasi-Ghahramanloo A, Sajadipour M, Motevalian SA. Patterns of high-risk behaviors associated with HIV among male prisoners: A latent class analysis. Med J Islam Repub Iran 2020; 34:109. [PMID: 33316009 PMCID: PMC7722948 DOI: 10.34171/mjiri.34.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Acquired Immunodeficiency Syndrome (AIDS) is one of the most important health challenges worldwide. Moreover, the prevalence of the Human Immunodeficiency Virus (HIV) infection differs among Iranian prisoners and the general population. The present study aimed to identify the patterns of HIV-related high-risk behaviors in male prisoners. Methods: In this cross-sectional study, 2832 inmates were examined for HIV-related high-risk behaviors. The required data were collected using a questionnaire on high-risk behaviors, including a history of heterosexual and homosexual intercourse, and a history of drug use disorders. A Latent Class Analysis (LCA) was performed to analyze the obtained data in WinLTA software. Results: Five latent classes were defined for the male prisoners, as follows: low-risk (20%), moderate-risk (23%), Injection Drug Use (IDU) (8%), heterosexual intercourse/methamphetamine use (38%), and high-risk (11%). The LCA results revealed that high-risk sexual behaviors, IDU, and sharing injection equipment in prisons significantly influence the classification. The obtained data suggested that a history of imprisonment was not frequent in class 2 (OR=1.0033, %95CI:0.9936-1.01) and class 4 members (OR=1.0053, %95CI:0.9929-1.0179). However, it was more prevalent in class 3 (OR=1.0164, %95CI:1.0068-1.0262), and 5 (OR=1.0211, %95CI:1.0129-1.0293). Heterosexual contact had the highest prevalence (75%) in this regard. The results showed that the lowest prevalence of high-risk behaviors was associated with morphine use (0.3%). Among illicit drugs, methamphetamine was the most prevalent drug (42%) in the studied subjects. Conclusion: The present study indicated a high prevalence of high-risk sexual behaviors and methamphetamine use in the investigated participants. We observed the co-occurrence of HIV-related high-risk behaviors in male prisoners. Thus, providing safe sex education for prisoners is highly recommended. It is also necessary to pursue care programs about IDU as a key risk factor for HIV transmission in prisons.
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Affiliation(s)
- Jalal Ale-Ebrahim
- Department of Epidemiology, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Farhoudi
- Social Determinants of Health Research Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Seyed Abbas Motevalian
- Research Center for Addiction and High-Risk Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Carvalho IDS, Guedes TG, Bezerra SMMDS, Alves FAP, Leal LP, Linhares FMP. Educational technologies on sexually transmitted infections for incarcerated women. Rev Lat Am Enfermagem 2020; 28:e3392. [PMID: 33174996 PMCID: PMC7647417 DOI: 10.1590/1518-8345.4365.3392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/15/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE to analyze in the scientific literature the educational technologies on sexually transmitted infections used in health education for incarcerated women. METHOD an integrative review carried out by searching for articles in the following databases: Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Latin American Literature in Health Sciences, Cochrane, and the ScienceDirect electronic library. There were no language and time restrictions. A search strategy was developed in PubMed and later adapted to the other databases. RESULTS a total of 823 studies were initially identified and, after applying inclusion and exclusion criteria, eight articles were selected. Most of them were developed in the United States with a predominance of randomized clinical trials. The technologies identified were of the printed materials type, isolated or associated to simulators of genital organs, videos, and games. CONCLUSION the technologies on sexually transmitted infections used in health education for incarcerated women may contribute to adherence to the prevention of this serious public health problem in the context of deprivation of liberty.
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Najafi Z, Shekarbeigi S, Koochak HE, Farhoudi B, SeyedAlinaghi S, Mirzazadeh A. HIV and risk behaviors among visitors of inmates at the Great Tehran Prison, Iran, 2018. Open AIDS J 2020; 14:35-40. [PMID: 33654499 DOI: 10.2174/1874613602014010035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Objectives The objective of the present study was to determine the prevalence of HIV and risk behaviors among the inmates' visitors at the Great Tehran Prison in 2018.This population is more likely to be infected with HIV due to their relationship with inmates. However, they have not been prioritized to the other populations in comparison to inmates who are usually prioritized over others. Method Using a convenient sampling method, we recruited inmates' visitorsat the Great Tehran Prison in 2018. An anonymous questionnaire collected information on the participant's demographic characteristics, relationship withinmate, imprisonment history, drug-related risk behaviors, and HIV-related risk behaviors.Rapid HIV blood test detected HIV positive people. To examine the association between risk behaviors and HIV infection, we used a multivariate logistic regression model to calculate the adjusted Odds Ratio (OR)(adjusted Odds ratio of 23.140, 95% CI OD: 1.994-268.5). Results 1131 visitors were asked to participate in the study; out of which 1120 consented (99%).Out of the 1120 participants, 55.2% were female, and the majority (72.4%) aged older than 35 years. Of those who had a sexual partner, 50% did not usea condom in the last 6 months. Overall, HIV prevalence was 0.4% in the inmate visitors, but it was significantly higher among those with a history of drug injection(p=0.003). Conclusion Our findings indicated that overall the HIV prevalence is low amonginmates' visitors; Subgroups with a history of injection have high HIV prevalence which needs to beprioritized for HIV screening and treatment.
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Affiliation(s)
- Zeinab Najafi
- Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behavior, Tehran, Iran
| | - Saeede Shekarbeigi
- Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behavior, Tehran, Iran
| | - Hamid Emadi Koochak
- Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behavior, Tehran, Iran
| | - Behnam Farhoudi
- Clinical Research Development Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behavior, Tehran, Iran
| | - Ali Mirzazadeh
- University of California, University of San Francisco, San Francisco, United States
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Health service provision for disease control among prisoners: a conceptual note. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-04-2019-0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PurposeThe aim of present study was to integrate vital noncommunicable diseases (coronary artery disease, hypertension, diabetes mellitus and mental health disorders) into Prison-Based Active Health Services Provision (PAHSP).Design/methodology/approachOn Jan 1, 2018, there were 230,000 prisoners in Iran. Timely and systematic detection and diagnosis of chronic health conditions among this population are imperative. The collaboration between healthcare providers in prison and members of the multidisciplinary team of the healthcare community outside prison initiated an active health service provision approach for HIV and tuberculosis (TB). Guidelines for the control of HIV and TB in prison were piloted, and the finalized version was named “Prison-based Active Health Services Provision” (PAHSP), which has been scaled up in 16 of 260 Iranian prisons.FindingThe PAHSP approach emphasizes the importance of early identification of key symptoms and risk factors. This approach provides an opportunity for improved prevention and treatment, enabling prisoners identified at risk or those who have been diagnosed with a target disease to be followed up and receive the appropriate health care.Originality/valueInitiatives such as screening for chronic health conditions coupled with treatment will reduce the burden of chronic illness among prisoners and the broader community, thereby saving on healthcare costs and lives.
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SeyedAlinaghi S, Farhoudi B, Ataeinia B, Dadras O, Hosseini M, Jafari S, Mazaheri-Tehrani E, Alasvand R, Shahbazi M, Mohraz M. Comparison of tuberculosis indicators after implementation of the clinical protocol for tuberculosis and HIV management in Iranian prisons: a quasi-experimental study. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-04-2019-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe aim of this study was to compare the defined indicators of tuberculosis (TB) control program in the intervention and control prisons, after implementation of the national clinical protocol for TB and HIV management in Iranian prisons, suggesting active health service provision in all steps of service provision.Design/methodology/approachThis was quasi-experimental study conducted among inmates of two prisons in Iran. Great Tehran prison was purposively chosen as the intervention prison and Karaj prison was purposively chosen as control prison as well. Intervention and control prisons were compared in terms of the TB indicators within three periods (before intervention, during implementation and follow-up period) from October 2013 to June 2014.FindingsNumber of inmates with TB symptoms who underwent TB workup was four times more in intervention prison compared to control prison (9.3 vs 2.5 cases out of 1,000 inmates per month in the case prison compared to the control prison). Such difference was also significant in the intervention prison, comparing before and during the intervention period. The patient finding in case prison increased significantly after the intervention (223.6 vs 81.8 cases out of 100,000 inmates per year). The number of TB cases who received HIV testing increased from 50 to 100%.Originality/valueActive health service provision has significantly improved indicators in the intervention prison. The authors recommend implementation of this guideline in all prisons of Iran. Integration of other diseases with high burden among prisoners is also recommended in the active health services provision.
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