Prevalence of anogenital warts in Men with HIV/AIDS and associated factors

Infection with human papilloma virus (HPV) is the most common sexually transmitted disease in the world. Among the 630 million new cases of HPV that occur each year, 30 million develop anogenital warts. Although subclinical infection with HPV is the most common cause, genital warts are also associated with immunosuppression caused by HIV. In view of the high prevalence of HPV/HIV co-infection particularly among men who have sex with men, the objectives of this study were to determine the prevalence of anogenital warts in men with HIV/AIDS and to identify associated factors. A cross-sectional study was conducted on 159 men with HIV/AIDS consecutively selected at a referral service in Botucatu, São Paulo, Brazil, in which the association between sociodemographic, behavioral and clinical variables and the presence of anogenital warts was evaluated. After hierarchical analysis of the data, variables presenting a p value ≤ 0.2 were entered into an unconditional multivariate logistic regression model. Forty-nine (31%) of the HIV-positive patients had anogenital warts. The mean age was 44.6 ± 9.6 years. The main factors associated with the presence of anogenital warts were irregular antiretroviral treatment and genital herpes(HSV). The present study demonstrate that anogenital warts occur in almost one-third of the male population infected with HIV and factors associated with a higher risk of being diagnosed with anogenital warts were irregular cART use and co-infection with HSV, other variables could not be associated.

Oral health status of people living with HIV/AIDS attending a specialized service in Brazil

Verify factors that influence the oral health status of people living with HIV/AIDS (PLWHA) in Brazil. The study was cross-sectional and includes 177 HIV-positive individuals, who answered questionnaire on the sociodemographic conditions, HIV aspects, habits, and satisfaction with the service. The oral health data were collected by means of the decayed, missing, and filled teeth (DMFT) index, use and need of dentures, and the Community Periodontal Index. Average number of the DMFT was 17.64. Most HIV-positive patients presented good periodontal status, 35.0% used dentures, 41.5% needed denture in the maxilla, and 62.0% in the mandible. In the multivariate analysis, older age and dissatisfaction with health care were associated with nonuse of dentures. The abandonment of the use of antiretroviral therapy increased the risk of PLWHA presenting more than three decayed teeth. Poor oral health of the PLWHA was mainly influenced by sociodemographic factors and use and satisfaction with service.

Alterações mamográficas em mulheres que vivem com HIV-aids

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Vivendo com HIV/AIDS: estudos da ocorrência de discrimição nos serviços de saúde

Introduction: The discrimination experienced by people with HIV / AIDS, not only by society but also by health professionals is one of the major problems observed relative the epidemic. Objective: To verify and to analyze the occurrence of discriminatory attitudes in the assistance to the health of people living with HIV/AIDS. Methods: It was a quantitative research was carried out with the participation of sixty-eight HIV-positive individuals from four Brazilian cities. The participants answered auto-administrate questionnaires that contained open and closed questions including the considered subject. Results: 41.2% of the total participants, HIV + people, said they had been discriminated against by health professionals. Among the discriminatory situations experienced by HIV patients, 34.2% nursing professionals were involved, in 34.2% dentists and in 31.6% doctors were involved. Those who have suffered discrimination, 78.6% said they had been discriminated against in public health service. Conclusion: The occurrence of discrimination in the assistance to the health of HIV-positive patients was high. The majority of discrimination situations occurred in the public health service. It is necessary the institution of strategies aiming at human attendance to these patients.

Marcadores de ativação imune, inflamação crônica e estresse oxidativo em pessoas que vivem com o HIV/Aids: a busca do melhor prognóstico

Pós-graduação em Doenças Tropicais - FMB

Nebraska Adolescents' HIV/Aids Attitudes, Knowledge and Related Practices: 1989

This Prevention Center Paper (No. 22) describes the HIV/AIDS related knowledge, attitudes and practices of a random sample of 1240 Nebraska adolescents in grades 9-12. The data were gathered in 1989. Data were gathered by staff of Health Education, Inc., a Nebraska-based nonprofit research and development corporation, as part of a contract with the Nebraska Department of Education. The Nebraska Department of Education has a major HIV /AIDS cooperative agreement with the U.S. Centers for Disease Control (CDC) in Atlanta, Georgia. Schools were selected at random from each of the six classifications of Nebraska schools established by the Nebraska Department of Education. Two to three classrooms for each grade 9-12 were then randomly selected within each sampled school. All students in the classes on the day of the survey voluntarily completed CDC's HIV / AIDS adolescent survey. All responses were anonymous. Classroom teachers and school administrators 'were not involved in the data collection in any way. A data collection protocol was followed to ensure validity in this self-report survey. This report is divided into four parts: Part 1 deals with students' acceptance of HIV/AIDS instruction and of people with HIV / AIDS. Part 2 describes students' access to HIV / AIDS information: Part 3 is about students ' knowledge of HIV / AIDS, and Part 4 discusses Nebraska adolescents' practices that increase the risk of HIV/AIDS.

Sexual abuse victimisation and perpetration in a cohort of men living with HIV/AIDS who have sex with women from Sao Paulo, Brazil

Sexual abuse leads to physical harm and devastating psychosocial consequences. It increases risk of HIV transmission and is associated with risky behaviour. Little is known about sexual abuse victimisation (SAV) and perpetration (SAP) among HIV-positive men who have sex with women (MSW). We investigated self-reported SAV and SAP among 242 Brazilian MSW selected at HIV care centres. Patients were questioned about sociodemographic data, mode of HIV acquisition, sexual practices, drug use and history of SAV or SAP. Prevalence of outcomes was estimated and risk factors for SAP investigated by logistic regression. Fifty-eight (24.1%) interviewees reported SAV. Of patients abused before 15 years of age, 64.3% reported events before the age of ten. Aggressors included relatives, friends and teachers. Among those victimised after 15 years old, 57.7% described events before 17 and 38.5% had acquainted aggressors. Fourteen (5.8%) interviewees reported SAP and most knew their victims. Sexual abuse perpetration was associated with lower schooling, marital status, illicit drug use and self-reported SAV. Sexual abuse was frequently reported by MSW from this cohort. Identifying predictors of violence and addressing SAV and SAP in comprehensive HIV care may help reduce violent behaviour, psychological distress and contribute to maximise benefits of preventive and care interventions.

Quality of life among Brazilian women living with HIV/AIDS

The purpose of the present study was to assess quality of life (QoL) in Brazilian women living with HIV/AIDS, according to the World Health Organization Quality of Life HIV-BREF (WHOQoL-HIV-BREF) domains. A quantitative-based, cross-sectional, analytical study was carried out in healthcare centers specialized in assisting people living with HIV/AIDS, located in a municipality of the state of Sao Paulo, Brazil. One hundred and six women of age 18 years or more, users of the public healthcare system, participated in the study. Socio-demographic and clinical variables were collected using a specific questionnaire. Quality of life related variables were collected by means of the WHOQoL-HIV-BREF instrument. As per the QoL domains, study results show that the Spirituality domain reached a standardized mean score of 65.7, followed by the Physical (64.7), Psychological (60.6), Social Relationships (59.5), Independence (58.6), and Environment (54.5) domains. Results of the multiple regression analysis indicate that the women's employment or retirement, income greater than the minimum wage, and higher educational level were associated with a higher standardized mean score of QoL. However, recent HIV/AIDS diagnosis and exposure to antiretroviral agents for a period shorter than two years were negatively associated with QoL. It is critical that public policies favor an all-embracing social inclusion of these women, thus promoting better social conditions. Counseling, clinical follow-up immediately after the infection diagnosis, and initiation of antiretroviral treatment are crucial moments in the lives of these individuals.

Monitoring Drug Use Among HIV/AIDS Patients in Brazil: Should we Combine Self-Report and Urinalysis?

Illicit drug use in HIV-infected patients can be linked to impairment of physical and mental health, low health-related quality of life, and suboptimal adherence to HIV treatment. This study aimed to evaluate the correlation of self-report illicit drug use, urinalysis for cocaine and cannabis metabolites, and severity of dependence among HIV-infected patients on antiretroviral therapy (ART) in a treatment center in Brazil. Four hundred and thirty-eight outpatients of an HIV referral center were interviewed and assessed for drug use (lifetime, last year and last month). Urinalysis was performed to detect the presence of cocaine and cannabis metabolites in urine samples. Overall agreement between self-report and urinalysis was almost 68% for cannabis and higher than 85% for cocaine. Positive urinalysis was significantly associated with more than once a week cannabis (p < .0001) and cocaine (p <.0001) use during the last-month. Severity of Dependence Scale (SDS) properly predicted positive cocaine urinalysis results (area under the curve [AUC] = .81, p = .0001). Frequency of cannabis and cocaine use, SDS score degree and positive urinalysis for both drugs were correlated. Our findings suggest that positive self-report is a reliable predictor of positive urine sample both for cannabis and cocaine, but since the agreement was not perfect, there is a role for urine drug screening in the care of patients with HIV-related conditions.

Spiritual support for people living with HIV/AIDS: A Brazilian explorative, descriptive study

y In this exploratory and descriptive research, we identified the meaning of religion and spirituality in the experience of patients at a public health service for treatment of HIV/AIDS in a Brazilian upcountry town. Eight participants were selected through theoretical sampling. Data were collected through semistructured interviews, and analyzed by means of qualitative content analysis. The emerging themes were religion: a path to support, and God is everything. Religion, as a path that leads patients to different sources of support, included exploration of different churches, acknowledgment of guilt, and finding strength to cope with the disease, rationalization of the disease process, meeting other churchgoers, and finding God and faith. God, an important source of support, was present in prayers, in the belief in healing through faith, and in the feeling of comfort and relief. Because spirituality and religion were seen as important sources of support, in this study we that health professionals include these aspects in care planning.

Evaluation of inadequate anti-retroviral treatment in patients with HIV/AIDS

Introduction: Since the emergence of antiretroviral therapy, the survival of patients infected with human immunodeficiency virus has increased. Non-adherence to this therapy is directly related to treatment failure, which allows the emergence of resistant viral strains. Methods: A retrospective descriptive study of the antiretroviral dispensing records of 229 patients from the Center for Health Care, University Hospital, Federal University of Juiz de Fora, Brazil, was conducted between January and December 2009. Results: The study aimed to evaluate patient compliance and determine if there was an association between non-adherence and the therapy. Among these patients, 63.8% were men with an average age of 44.0 +/- 9.9 years. The most used treatment was a combination of 2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitor (55.5%) or with 2 protease inhibitors (28.8%). It was found that patients taking lopinavir/ritonavir with zidovudine and lamivudine had a greater frequency of inadequate treatment than those taking atazanavir with zidovudine and lamivudine (85% and 83.3%, respectively). Moreover, when the combination of zidovudine/lamivudine was used, the patients were less compliant (chi(2) = 4.468, 1 degree of freedom, p = 0.035). Conclusions: The majority of patients failed to correctly adhere to their treatment; therefore, it is necessary to implement strategies that lead to improved compliance, thus ensuring therapeutic efficacy and increased patient survival.

Body changes: antiretroviral therapy and lipodystrophy syndrome in people living with HIV/aids

Objective: to identify the different types of morphological alterations from lipodystrophy syndrome (LS) in outpatients and relate them to the therapeutic regimen used. Method: a cross-sectional study which recruited 60 patients with HIV and LS and 79 without LS, who consented to interview and data collection from their medical notes. Results: the region most affected by lipoatrophy was the face; by lipohypertrophy, the abdomen, and by the mixed form, the alterations to the abdomen, face, and upper and lower limbs. Conclusion: among the therapeutic regimens, that comprised of zidovudine, lamivudine and efavirenz seemed to protect against LS. Nursing can act in the early identification of the changes, as well as providing guidance and support for patients affected by the changes in their body image.

Comensalidade e cuidado: meninas-jovens-mulheres órfãs no contexto de HIV/Aids

O "monopólio da cozinha", histórica e culturalmente, é atribuído às mulheres, mães. Para cuidar da família, elas elegem alimentos, compram, cozinham e os servem. Sustentam a comensalidade. Em contextos de HIV/Aids, onde há perda da mãe, as filhas tornam-se responsáveis por esses cuidados. O que pensam as meninas do papel de cuidadoras com o qual, prematuramente, deparam-se? O que dizem seus irmãos sobre isso? Realizamos entrevistas semidirigidas com 14 jovens órfãos. Os dados foram analisados pela proposta de Mills (2009). As jovens não demonstram insatisfação por executarem novas tarefas, mas deploram o fato de impedirem o estudo e a vida além-casa. Seus irmãos entendem a lida da cozinha como coisa de mulher e, por isso, dificilmente colaboram. Essas jovens necessitam de cuidados direcionados à situação vulnerável em que vivem. As políticas de Saúde Pública poderiam pleitear macroestruturas que atuassem sobre essa demanda.

Association between muscle strength and the cardiopulmonary status of individuals living with HIV/AIDS

OBJECTIVE: The purpose of this study was to compare aerobic function [anaerobic threshold (%_VVO2-AT), respiratory compensation point (%_VVO2-RCP) and peak oxygen uptake (_VVO2peak)] between physically active patients with HIV/AIDS and matched controls and to examine associations between disease status, poor muscle strength, depression (as estimated by the profile of mood states questionnaire) and the aerobic performance of patients. METHODS: Progressive treadmill test data for %_VVO2-AT (V-slope method), RCP and (_VVO2peak) were compared between 39 male patients with HIV/AIDS (age 40.6¡1.4 years) and 28 male controls (age 44.4¡2.1 years) drawn from the same community and matched for habitual physical activity. Within-patient data were also examined in relation to CD4+ counts (nadir and current data) and peak isokinetic knee torque. RESULTS: AT, RCP and (_VVO2peak) values were generally similar for patients and controls.Within the patient sample, binary classification suggested that AT, RCP and (_VVO2peak) values were not associated with either the nadir or current CD4+ count, but treadmill test variables were positively associated with peak isokinetic knee torque. CONCLUSION: The aerobic performance of physically active patients with HIV/AIDS is generally well conserved. Nevertheless, poor muscle strength is observed in some HIV/AIDS patients, which is associated with lower anaerobic power and (_VVO2peak), suggesting the possibility of enhancing the aerobic performance of patients with weak muscles through appropriate muscle-strengthening activities.