Qualidade de vida de mulheres vivendo com o HIV/aids de um município do interior paulista

A terapia antirretroviral de alta potência beneficia os indivíduos com HIV/aids na sobrevida, cronicidade e qualidade de vida. Este estudo de corte transversal, com abordagem quantitativa, objetivou avaliar a qualidade de vida de mulheres com HIV/aids, utilizando o WHOQOL - HIV bref e sua associação com variáveis sociodemográficas. Foi realizado em dois ambulatórios especializados no atendimento a indivíduos com HIV/aids. De 106 mulheres participantes, 99,1% eram heterossexuais e 92,4% foram infectadas por via sexual. Dentre os domínios de qualidade de vida, espiritualidade obteve maior escore (65,7), seguido pelo físico (64,7), psicológico (60,6), relações sociais (59,5). Menores escores foram atingidos nos domínios nível de independência (58,6) e meio ambiente (54,5). Evidenciou-se que os fatores baixo nível socioeconômico e educacional tiveram associação com diferentes domínios, denotando a relação entre qualidade de vida e condições de vida. Concluiu-se que persistem os desafios no âmbito das relações sociais, afetivas, financeiras, requerendo intervenções efetivas focando o empoderamento das mulheres com HIV/aids.

HIV and STI behavioural surveillance among men who have sex with men in Europe.

This paper describes behavioural surveillance for HIV and sexually transmitted infections (STI) among men who have sex with men (MSM) in Europe, focusing on the methods and indicators used. In August 2008, questionnaires were sent to European Union Member States and European Free Trade Association countries seeking information on behavioural surveillance activities among eight population groups including MSM. Thirty-one countries were invited to take part in the survey and 27 returned a questionnaire on MSM. Of these 27 countries, 14 reported that there was a system of behavioural surveillance among MSM in their country while another four countries had conducted behavioural surveys of some kind in this subpopulation. In the absence of a sampling frame, all European countries used convenience samples for behavioural surveillance among MSM. Most European countries used the Internet for recruiting and surveying MSM for behavioural surveillance reflecting increasing use of the Internet by MSM for meeting sexual partners. While there was a general consensus about the main behavioural indicators (unprotected anal intercourse, condom use, number of partners, HIV testing), there was considerable diversity between countries in the specific indicators used. We suggest that European countries reach an agreement on a core set of indicators. In addition we recommend that the process of harmonising HIV and STI behavioural surveillance among MSM in Europe continues.

O referencial de vulnerabilidade ao HIV/AIDS aplicado às famílias: um exercício reflexivo

Objetiva-se realizar um exercício reflexivo acerca das vulnerabilidades que se apresentam no contexto das famílias que convivem com o Vírus da Imunodeficiência Humana/Síndrome da Imunodeficiência Adquirida (HIV/Aids), tendo como fundamentação a literatura pertinente. Para tanto, buscou-se tecer considerações em relação à pluralidade das famílias na contemporaneidade, bem como apresentar as compreensões e desdobramentos do referencial de vulnerabilidade à epidemia da Aids. Por fim, foram descritas aproximações e reflexões referentes às vulnerabilidades à infecção pelo HIV e/ou adoecimento por Aids a que estão expostas as famílias, em seus planos individual, social e programático. Conclui-se a enorme importância de se conhecer estas vulnerabilidades específicas vivenciadas pelas famílias, a fim de que se possa nortear e desenvolver as ações de cuidado em saúde.

State of Iowa HIV and AIDS Surveillance Report, December 2004

After taking a dip in 2003, HIV diagnoses were back up in 2004. There were 103 persons diagnosed in 2004, very close to our ten-year average of 100 cases per year. In 2003, there were 91 diagnoses. The increase in 2004 was limited to one demographic group: white, U.S.-born males. Most of these were men who have sex with men, but there were also small increases among injection-drug-using men and those without a known risk. Their median age was 41, slightly older than the overall median age of 38 years. Eighty percent were residents of the 10 most populous counties in Iowa, particularly the counties of Polk, Pottawattamie, Johnson, Linn, Scott, Story, and Woodbury.

State of Iowa HIV and AIDS Surveillance Report, December 2003

There were 33 new diagnoses of HIV infection reported in Iowa in the 4th quarter. Keeping in mind that more diagnoses will yet be reported for 2003, we have so far received reports of 79 Iowans who were newly diagnosed with HIV infection in 2003. Reports on persons diagnosed in the last quarter of the year will continue to trickle in through the end of March, but we’ll definitely be substantially below the 104 diagnoses we saw in 2002.

State of Iowa HIV and AIDS Surveillance Report, September 2005

This quarter, we received reports for 26 HIV diagnoses. So far this year, there have been 79 HIV diagnoses reported, exactly the same as this time last year. Thirty-five percent received concurrent AIDS diagnoses. There were 57 AIDS diagnoses in the first three quarters of 2005, 20% higher than what we saw at this time last year. Nearly half (47%) of these were persons who had been diagnosed with HIV for at least one year (fifteen years for two persons), and the rest received concurrent HIV and AIDS diagnoses. In surveillance news, Illinois, Maine, and Philadelphia have announced that they will begin HIV reporting by name on January 1, 2006. Currently they use code or name-to-code systems to report new diagnoses of HIV. The Centers for Disease Control and Prevention do not accept information from areas that report HIV cases by code, so no national surveillance data are available for HIV diagnoses. For this reason, Ryan White CARE Act funds cannot be appropriated according to the number of persons living with HIV. Instead, funds are distributed according to the number of AIDS cases reported to surveillance systems. These data are not representative of current trends in the epidemic and may be rewarding areas for having poorer health care systems.

State of Iowa HIV and AIDS Surveillance Report, March 2005

This quarter, we had 33 diagnoses of HIV infection (regardless of AIDS status), which is a little above our usual pace. Fifteen (45%) received concurrent diagnoses of AIDS. There were 8 persons who converted from HIV to AIDS, for a total of 23 AIDS diagnoses, also a little higher than expected. Of note is an increase in the percentage of HIV and AIDS cases diagnosed among Black, non-Hispanic persons during the 1st quarter of 2005. We also saw a bit of an increase in HIV diagnoses among foreign-born persons. It is too early to identify this as a trend; we’ll keep an eye on these numbers through the rest of the year.

State of Iowa HIV and AIDS Surveillance Report,June 2005

This quarter, we saw 17 HIV diagnoses, half the number of persons diagnosed in the first quarter of the year. For the two quarters, there were 50 diagnoses, keeping pace with last year’s number of diagnoses. Nineteen of the 50 (38%) received concurrent AIDS diagnoses. Of concern this year is the high number of persons reported without a risk. Over 40% of new cases were initially reported without a risk. Most of these cases are being investigated by disease prevention specialists. History shows us that a good proportion of these cases will be assigned to a risk category in the coming months as more is learned about their risks and the risks of their partners. Note that only 17% of cases diagnosed in 2004 remain without a known risk. There were 36 AIDS diagnoses in the first two quarters of 2005, just a bit ahead of what we saw last year. Fifteen of these were persons who had been diagnosed with HIV at least one year (fifteen years for two persons), and the rest received concurrent HIV and AIDS diagnoses.

A polymorphism in the leptin gene promoter is associated with anemia in patients with HIV disease.

To study factors associated with anemia and its effect on survival in HIV-infected persons treated with modern combined antiretroviral therapy (cART), we characterized the prevalence of anemia in the Veterans Aging Cohort Study (VACS) and used a candidate gene approach to identify proinflammatory gene single nucleotide polymorphisms (SNPs) associated with anemia in HIV disease. The study comprised 1597 HIV(+) and 865 HIV(-) VACS subjects with DNA, blood, and annotated clinical data available for analysis. Anemia was defined according to World Health Organization criteria (hemoglobin < 13 g/dL and < 12 g/dL in men and women, respectively). The prevalence of anemia in HIV(+) and HIV(-) subjects was 23.1% and 12.9%, respectively. Independent of HIV status, anemia was present in 23.4% and 8% in blacks and whites, respectively. Analysis of our candidate genes revealed that the leptin -2548 G/A SNP was associated with anemia in HIV(+), but not HIV(-), patients, with the AA and AG genotypes significantly predicting anemia (P < .003 and P < .039, respectively, logistic regression). This association was replicated in an independent cohort of HIV(+) women. Our study provides novel insight into the association between genetic variability in the leptin gene and anemia in HIV(+) individuals.

EV02: a Phase I trial to compare the safety and immunogenicity of HIV DNA-C prime-NYVAC-C boost to NYVAC-C alone.

The aim of this randomised controlled trial was to see if the addition of 4 mg/ml DNA-C priming given by the intramuscular route at weeks 0 and 4 to NYVAC-C at weeks 20 and 24, safely increased the proportion of participants with HIV-specific T-cell responses measured by the interferon (IFN)-gamma ELISpot assay at weeks 26 and/or 28 compared to NYVAC-C alone. Although 2 individuals discontinued after the first DNA-C due to adverse events (1 vaso-vagal; 1 transient, asymptomatic elevation in alanine transaminase), the vaccines were well tolerated. Three others failed to complete the regimen (1 changed her mind; 2 lost to follow-up). Of the 35 that completed the regimen 90% (18/20) in the DNA-C group had ELISpot responses compared to 33% (5/15) that received NYVAC-C alone (p=0.001). Responses were to envelope in the majority (21/23). Of the 9 individuals with responses to envelope and other peptides, 8 were in the DNA-C group. These promising results suggest that DNA-C was an effective priming agent, that merits further investigation.

Simple estimation of incident HIV infection rates in notification cohorts based on window periods of algorithms for evaluation of line-immunoassay result patterns.

BACKGROUND: Tests for recent infections (TRIs) are important for HIV surveillance. We have shown that a patient's antibody pattern in a confirmatory line immunoassay (Inno-Lia) also yields information on time since infection. We have published algorithms which, with a certain sensitivity and specificity, distinguish between incident (< = 12 months) and older infection. In order to use these algorithms like other TRIs, i.e., based on their windows, we now determined their window periods. METHODS: We classified Inno-Lia results of 527 treatment-naïve patients with HIV-1 infection < = 12 months according to incidence by 25 algorithms. The time after which all infections were ruled older, i.e. the algorithm's window, was determined by linear regression of the proportion ruled incident in dependence of time since infection. Window-based incident infection rates (IIR) were determined utilizing the relationship 'Prevalence = Incidence x Duration' in four annual cohorts of HIV-1 notifications. Results were compared to performance-based IIR also derived from Inno-Lia results, but utilizing the relationship 'incident = true incident + false incident' and also to the IIR derived from the BED incidence assay. RESULTS: Window periods varied between 45.8 and 130.1 days and correlated well with the algorithms' diagnostic sensitivity (R(2) = 0.962; P<0.0001). Among the 25 algorithms, the mean window-based IIR among the 748 notifications of 2005/06 was 0.457 compared to 0.453 obtained for performance-based IIR with a model not correcting for selection bias. Evaluation of BED results using a window of 153 days yielded an IIR of 0.669. Window-based IIR and performance-based IIR increased by 22.4% and respectively 30.6% in 2008, while 2009 and 2010 showed a return to baseline for both methods. CONCLUSIONS: IIR estimations by window- and performance-based evaluations of Inno-Lia algorithm results were similar and can be used together to assess IIR changes between annual HIV notification cohorts.

Management of the risk of HIV infection in male homosexual couples.

OBJECTIVES: To study the ways of managing HIV risk within male homosexual steady relationships (gay couples), including factors associated with consistent condom use during anal sex with the steady partner.¦METHOD: An anonymous and standardized questionnaire completed by a convenience sample of homosexuals in Switzerland in 1997 (n = 1097). Information on the couple was provided by the 74% (n = 786) of male respondents who reported having a steady partner in the past 12 months. Data were analysed by contingency tables and logistic regression.¦RESULTS: Different ways of managing HIV risk were reported: negotiated safety (both HIV negative, condoms abandoned) was chosen by one quarter of the couples, but the most frequent solution was reliance on condoms for anal sex, chosen by more than four in 10. Altogether 84% of couples exhibited safe management of HIV risk within their partnership. The 16% of couples showing inadequate management of HIV risk within the couple mostly relied on questionable assumptions about past or present risks. A total of 74% of couples had spoken about managing HIV risk with possible casual partners. Reported behaviour with the steady partner and with casual partners was highly consistent with claimed strategies chosen to manage HIV risk. Consistent condom use with the steady partner was mostly associated with variables characterizing the relationship: initial 2 years of the relationship, discordant or unknown serological HIV status, non-exclusivity.¦CONCLUSION: Gay couples manage HIV risk in a variety of ways. Most strategies provide adequate protection with casual partners, but leave gaps in protection between the steady partners themselves.

Esperança em mulheres portadoras da infecção pelo HIV

Objetivou-se avaliar a esperança na vida de mulheres infectadas pelo HIV mediante uso da Escala de Esperança de Herth (EEH). Participaram 111 mulheres portadoras de HIV atendidas em ambulatório de referência em Fortaleza-CE. De janeiro a maio de 2009, foram conduzidas entrevistas que captaram variáveis biopsicossociais e aplicou-se a EEH. Os dados analisados pelo programa SPSS-8.0 revelaram índice médio de esperança de 34,86, apontando que as mulheres possuem moderada esperança na vida diante da vigência do HIV, cujo item da escala com maior pontuação relacionou-se à fé (3,57). Isto provavelmente decorre do fato de a AIDS não ter cura, ser transmissível e produzir estigma, estando ainda relacionada à ideia de morte iminente. Conclui-se que a medida da esperança entre portadores de HIV, mediante o uso de um instrumento, possibilita avaliar e planejar intervenções, promovendo ajuda e motivação para viverem melhor e manterem a esperança na vida.

Vulnerabilidade de mulheres em união heterossexual estável à infecção pelo HIV/Aids: estudo de representações sociais

O artigo discute as representações sociais de mulheres em união heterossexual estável no que diz respeito à vulnerabilidade à infecção pelo HIV/AIDS. Os dados foram produzidos pela associação livre de palavras e constituem recorte de uma pesquisa fundamentada na Teoria das Representações Sociais desenvolvida com mulheres soronegativas para o HIV, da capital e interior da Bahia. A análise fatorial de correspondência revelou significância para as variáveis: procedência, escolaridade e tempo de união estável. A aceitação à traição emergiu como fator de vulnerabilidade para respondentes com 1-5 anos de união estável do interior. Mulheres da capital com 6-10 anos de união estável representam a monogamia como forma de prevenção. Mulheres com maior tempo de união e nível escolar básico representam-se como invulneráveis, contrárias as que têm 1-5 anos de união e escolaridade mediana. Os resultados indicam a necessidade de mais ações com o objetivo de desnaturalizar as coerções sócio-culturais que geram representações e aproximam mulheres em união estável da AIDS.