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Sample Swot Analysis in Patient Safety - Excel

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					                                         Country of
AbsNo   New Abs No   PresType   Topic                   AbsTitle
                                         Research



                                                      Identification
                                                      and
                                                      presentation
                                                      of primary
 170    MOPEA022       PE       A18     Zimbabwe
                                                      HIV-1
                                                      infection in
                                                      Harare,
                                                      Zimbabwe




                                                      High rate of
                                                      depression
                                                      among food
                                                      insecure
                                                      individuals
2142    WEPEB192       PE        B7     Canada
                                                      receiving
                                                      highly active
                                                      antiretroviral
                                                      therapy in
                                                      Canada




                                                      Rapid HIV
                                                      testing in a
                                                      U.S.
                                                      Emergency
3034     CDB019      CDROM       B8     United States Department:
                                                      using fever
                                                      as an
                                                      indicator for
                                                      testing
                                             Community
                                             based early
                                             infant testing
                                             and
1718    CDB098    CDROM   B34   Malawi       treatment:
                                             experience
                                             from
                                             Blantyre,
                                             Malawi




                                             “Know your
                                             child's HIV
                                             status
                                             campaign” -
                                             A strategy to
                                             increase
2503   WEPEB268    PE     B34   Uganda
                                             child
                                             enrollment
                                             into care;
                                             lessons
                                             learned and
                                             challenges




                                              CHAMP+ : a
                                              family-based
                                              intervention
                                              to support
                                              the health
2702   WEPEB277    PE     B37   United States
                                              and mental
                                              health of
                                              perinatally
                                              infected
                                              youth
                                         Puppetry- a
                                         novel
                                         strategy for
                                         communicati
2998   WEPEB280    PE     B37   Zambia   ng with
                                         children and
                                         communities
                                         in Lusaka,
                                         Zambia




                                         Polyacrylami
                                         de hydrogel
                                         injection in
                                         the
                                         management
                                         of human
                                         immunodefici
977    TUAB204     OA     B38   France
                                         ency virus-
                                         related facial
                                         lipoatrophy:
                                         results of the
                                         open-label
                                         study
                                         LIPOPHILL




                                         Quality of life
                                         (QoL)
                                         improves in
                                         individuals
                                         with facial
3524    CDB114    CDROM   B38   France
                                         lipoatrophy
                                         treated with
                                         injection of
                                         poly-L-lactic
                                         acid
                                             The role of
                                             pregnancy
                                             intention in
1308   CDC034     CDROM   C5    South Africa
                                             MTCT
                                             prevention in
                                             South Africa




                                             Meeting the
                                             contraceptive
                                             needs of
                                             HIV+ women
                                             in Kenya:
                                             assessing
                                             the
                                             opportunities
2586   TUPEC057    PE     C5    Kenya        for
                                             strengthenin
                                             g
                                             contraceptive
                                             services as
                                             part of a
                                             national
                                             PMTCT
                                             strategy




                                             Traditional
                                             versus
                                             modern
                                             circumcision
1318   CDC061     CDROM   C29   Kenya        among the
                                             Tigania-
                                             Meru; trends
                                             in the era of
                                             HIV/AIDS
                                          HIV
                                          vulnerable
                                          groups
                                          research: the
                                          potential
                                Solomon   impact of an
314     CDC064    CDROM   C30
                                Islands   HIV epidemic
                                          could be
                                          devastating
                                          for the
                                          Solomon
                                          Islands




                                          Influence of
                                          gender in
                                          access to
3526    CDC073    CDROM   C31   India
                                          harm
                                          reduction
                                          services




                                          Community
                                          based risk
                                          behaviour
                                          study on
507    MOPEC014    PE     C33   Nepal
                                          HIV/AIDS
                                          targeting
                                          women in
                                          Nepal
                                        Perceptions
                                        and
                                        experiences
                                        of pregnant
                                        women
835    MOPEC017   PE   C33   Nigeria    towards HIV
                                        voluntary
                                        counselling
                                        and testing in
                                        Kano,
                                        Nigeria




                                        Intentions to
                                        provide
                                        dental
                                        treatment to
                                        the patients
                                        living with
1306   MOPEC021   PE   C33   Pakistan   HIV/AIDS
                                        (PLWHAs)
                                        among
                                        dentists of
                                        Balochistan,
                                        Pakistan,
                                        2008



                                        Predictors
                                        and
                                        outcomes of
                                        HIV-1 status
                                        disclosure
                                        among
                                        women
                                        participating
                                        in a study of
                                        transmission
2288   MOPEC026   PE   C33   Uganda
                                        rates among
                                        nevirapine
                                        (NVP)
                                        experienced
                                        compared to
                                        NVP naïve
                                        women - The
                                        NVP-Repeat
                                        Pregnancy
                                        (RP) study
                                         'Maybe my
                                         husband is
                                         on ARVs, but
                                         I cannot tell
                                         him that I am
                                         on them':
                                         gendered
2532   MOPEC029    PE     C33   Uganda   patterns of
                                         HIV
                                         disclosure
                                         and
                                         treatment
                                         experience in
                                         urban and
                                         rural Uganda




                                         Qualitative
                                         assessment
                                         of HIV risks
2841   MOPEC034    PE     C33   India
                                         among MSM
                                         in South
                                         India




                                         Voluntary
                                         HIV
                                         counseling
                                         and testing
                                         for
                                         prevention of
                                Benin,
442     CDC095    CDROM   C35            mother-to-
                                Canada
                                         child
                                         transmission
                                         (PMTCT) in
                                         Benin, what
                                         mothers
                                         consent?
                                           Community
                                           involvement
                                           in biomedical
                                           prevention -
1263   CDC100   CDROM   C36   Uganda
                                           the case of
                                           TASO
                                           Northern
                                           Uganda




                                           Home based
                                           care - an
                                           effective
                                           family
                                           response to
1284   CDC101   CDROM   C36   Uganda
                                           HIV/AIDS
                                           service
                                           delivery and
                                           treatment in
                                           Household




                                            Decoding
                                            AIDS
                                            Prevention
                                            research for
2844   CDC103   CDROM   C36   United States
                                            women and
                                            girls in the
                                            United States
                                            of America
                                          HIV stigma,
                                          disclosure,
                                          and
                                          psychosocial
75     CDC104    CDROM   C37   Thailand
                                          distress
                                          among Thai
                                          Youth living
                                          with HIV




                                          Willingness
                                          to uptake HIV
                               Burkina
                                          testing
                               Faso,
                                          among
282    CDC105    CDROM   C37   Ghana,
                                          adolescents
                               Malawi,
                                          in four
                               Uganda
                                          African
                                          countries




                                          Stigma in
                                          perinatally
512   WEPEC102    PE     C37   Thailand
                                          HIV-infected
                                          adolescents
                                         HIV status
                                         disclosure to
                                         partners of
                                         people living
                                         with
543    CDC107   CDROM   C37   Nigeria
                                         HIV/AIDS on
                                         highly active
                                         antiretroviral
                                         therapy at
                                         Ibadan




                                         Unprecedent
                                         ed levels of
                                         stigma
                                         among a
                                         cohort of
690    CDC110   CDROM   C37   Canada     individuals
                                         accessing
                                         highly active
                                         antiretroviral
                                         therapy in
                                         Canada




                                         Disclosure
                                         and stigma
                                         issues
                                         among HIV
                                         positive
1460   CDC112   CDROM   C37   Zimbabwe   women in a
                                         PMTCT
                                         program in
                                         urban
                                         Zimbabwe,
                                         2008
                                            Domestic
2875   CDC118   CDROM   C37   Zimbabwe
                                            violence




                                           Access to
                                           antiretroviral
                                           treatment by
                                           children in
                                           KwaZulu-
                                           Natal
113    CDD001   CDROM   D1    South Africa province: a
                                           qualitative
                                           exploratory
                                           study into
                                           factors
                                           influencing
                                           poor access




                                            Evaluation of
                                            a HIV/AIDS
                                            prevention
1979   CDD009   CDROM   D1    Germany       program for
                                            African
                                            migrants in
                                            Germany
                                             Assessment
                                             of pattern of
                                             antiretroviral
                                             drugs usage
                                             in the
721     CDD023    CDROM   D3   Nigeria       Ahmadu
                                             Bello
                                             University
                                             Teaching
                                             Hospital,
                                             Zaria-Nigeria




                                             Psychometric
                                             validation of
                                             PROQOL-
                                             HIV a
                                             contemporan
                                             eous and
                                             cross-cultural
2266   WEPED180    PE     D3   France
                                             health-
                                             related
                                             quality-of-life
                                             (HRQL)
                                             questionnaire
                                             specific to
                                             HIV



                                             Scaling up
                                             access to
                                             antiretroviral
                                             therapy
                                             (ART) in low-
                                             and middle-
3666   WELBD105    OA     D3   Switzerland
                                             income
                                             countries:
                                             global and
                                             regional
                                             progress in
                                             2008
                                            Home-based
                                            care for
                                            reducing
                                            morbidity and
868    WEPED187    PE     D4   South Africa
                                            mortality in
                                            people
                                            infected with
                                            HIV/AIDS




                                            Programming
                                            with injecting
                                            drug users: a
1095    CDD039    CDROM   D4   Egypt        key entry
                                            point to other
                                            most-at-risk
                                            populations




                                            Effectiveness
                                            of national
                                            scale-up of
                                            HIV stigma
                                            and
2597    CDD047    CDROM   D4   Ghana
                                            discriminatio
                                            n reduction in
                                            health
                                            facilities in
                                            Ghana
                                             Identify the
                                             challenges in
                                             implementati
                                             on and
                                             suggest ways
                                             and means
                                             of
                                             collaboration
                               Afghanistan,
                                             between
                               Bangladesh,
                                             tuberculosis
                               Maldives,
653    TUPDD102    PD     D5                 and
                               Nepal,
                                             HIV/AIDS
                               Pakistan, Sri
                                             programmes
                               Lanka
                                             in South
                                             Asian
                                             Association
                                             for Regional
                                             Cooperation
                                             (SAARC)
                                             member
                                             states




                                            Accessing
                                            entitlements
                                            enhances
1074   CDD053     CDROM   D5   India        service
                                            delivery and
                                            adherence in
                                            Karnataka




                                          A model of
                                          an
                                          occupational
                                          health
                                          service for
2273   CDD066     CDROM   D5   Mozambique health care
                                          workers in a
                                          provincial
                                          hospital,
                                          Tete,
                                          Mozambique
                                              Comprehensi
                                              ve HIV
                                              prevention
                                              services for
2402   CDD068     CDROM   D5   Pakistan       injecting drug
                                              users in four
                                              major cities
                                              of Punjab,
                                              Pakistan




                                              Improving
                                              uptake of
                                              female
                                              condoms for
                               El Salvador,   HIV
2797   TUPED110    PE     D5
                               Nicaragua      prevention
                                              among sex
                                              workers in
                                              Central
                                              America




                                              Youth
                                              Friendly
                                              Centres
                                              (YFCs): a
                                              public-private
                                              partnership
                                              model for
                                              increasing
2809   CDD070     CDROM   D5   Nigeria
                                              HIV
                                              counselling
                                              and testing
                                              (HCT)
                                              services in
                                              resource
                                              poor
                                              environments
                                           An innovative
                                           approach to
                                           mainstream
                                           HIV care into
                                           existing
                                           health
                                           services
                                           through on
                                           site whole
                                           site infection
                                           prevention
1787   CDD080     CDROM   D6   India       training
                                           (OSWST) on
                                           standard
                                           (SIP)
                                           practices and
                                           stigma and
                                           discriminatio
                                           n (S&D)
                                           reduction:
                                           experience
                                           from South
                                           India


                                           Establishing
                                           VCT services
                                           in
                                           partnership
                                           with civil
                                           society: the
                                           role of
285    TUPED139    PE     D7   Indonesia   Aceh´s
                                           positive
                                           support
                                           group in
                                           mentoring
                                           government
                                           health
                                           workers
                                             Role of
                                             positive
                                             people in
                                             irevention,
3300    CDD102    CDROM   D7   India         care, support
                                             & treatment
                                             services in
                                             New Delhi,
                                             India




                                            Integration of
                                            counselling
                                            and testing
                                            into family
                                            planning:
822     CDD105    CDROM   D8   South Africa health
                                            providers
                                            and clients'
                                            perceptions
                                            and
                                            acceptability



                                             Improvement
                                             of human
                                             rights and
                                             access to
                                             legislative
                                             services for
                                             people living
939    WEPED216    PE     D8   Serbia        with
                                             HIV/AIDS in
                                             Serbia
                                             through
                                             better
                                             understandin
                                             g of Serbian
                                             legislation
                                           Early
                                           initiation of
                                           basic
                                           HIV/AIDS
                                           care and
                                           treatment
                                           after
1145   CDD107     CDROM   D8   Uganda      diagnosis
                                           with HIV:
                                           experience
                                           from a
                                           University
                                           Hospital-
                                           based clinic
                                           in Uganda



                                          Acceptability
                                          of new child
                                          health card
                                          by health
                                          workers and
                                          users in
2311   CDD112     CDROM   D8   Mozambique Mozambique:
                                          continuum of
                                          care for HIV
                                          exposed
                                          children
                                          exposed
                                          children




                                           Promotion of
                                           HIV testing
                                           and
                                           counseling
                                           among Sub-
                                           Saharan
                                           African
1462   TUPED143    PE     D9   Belgium     migrants:
                                           assessing
                                           and
                                           addressing
                                           the barriers
                                           at community
                                           and health
                                           care level
                                                Scaling up
                                                HIV testing
                                                with
                                                community-
                                                based
                                                prevention
1609    CDD126    CDROM   D10   Haiti           and
                                                education in
                                                Haiti rural:
                                                NEC “Noyau
                                                Educatif
                                                Communauta
                                                ire”


                                Argentina,
                                Botswana,
                                Brazil,
                                Burundi,
                                Congo,
                                Congo, the      Prioritising
                                Democratic      prevention
                                Republic of     strategies for
                                the, Cote       patients in
                                D'Ivoire,       antiretroviral
1811   WEPED233    PE     D10
                                India,          treatment
                                Malawi,         programmes
                                Morocco,        in resource-
                                Nigeria,        limited
                                Rwanda,         settings
                                South Africa,
                                Thailand,
                                Uganda,
                                Zambia,
                                Zimbabwe


                                                Disclosure of
                                                HIV-positive
                                                status among
                                                HIV positive
                                                women
                                                attending the
                                                PMTCT
2511   WEPED236    PE     D10   Uganda          follow-up
                                                clinic at
                                                Mulago
                                                National
                                                Referral
                                                Hospital in
                                                Kampala,
                                                Uganda
                             Algeria,
                             Angola,
                             Argentina,
                             Armenia,
                             Azerbaijan,
                             Bahamas,
                             Bangladesh,
                             Barbados,
                             Belarus,
                             Botswana,
                             Brazil,
                             Bulgaria,
                             Burkina
                             Faso,         Protecting
                             Burundi,      HIV-
                             Cambodia,     information in
1371   TUPED152   PE   D12
                             Cameroon,     countries
                             Central       scaling up
                             African       HIV services
                             Republic,
                             China,
                             Colombia,
                             Congo,
                             Congo, the
                             Democratic
                             Republic of
                             the, Costa
                             Rica, Cote
                             D'Ivoire,
                             Dominican
                             Republic,
                             Ethiopia,



                                           Survey
                                           validity prior
                                           to HIV
                                           voluntary
                             Tanzania,     counseling
2410   TUPED156   PE   D12   United        and testing
                             Republic of   (VCT):
                                           significant
                                           pre-
                                           intervention
                                           changes
                                          HIV risk
                                          behaviors of
                                          men who
                                          have sex with
1066    CDD140    CDROM   D17   Liberia
                                          men (MSM)
                                          in post-
                                          conflict
                                          Liberia




                                          HIV care and
                                          treatment for
                                          Burmese
2092   MOPED032    PE     D17   Myanmar
                                          migrants
                                          living in
                                          Thailand




                                          Nigeria
                                          men's health
                                          network
                                          programme
                                          for the
2259   MOPED033    PE     D17   Nigeria   prevention of
                                          HIV and STIs
                                          among men
                                          who have
                                          sex with men
                                          (MSM)
                                        Sexual risk
                                        behaviours of
                                        HIV positive
                                        persons not
                                        receiving HIV
                                        treatment in
                                        Mombasa:
2638   MOPED034    PE     D17   Kenya   are
                                        prevention
                                        programs
                                        missing
                                        healthy
                                        positives in
                                        the
                                        community?




                                        Effectiveness
                                        of syndromic
                                        approach to
                                        STI
114     CDD148    CDROM   D18   Kenya   management
                                        in a high risk
                                        cohort,
                                        Nairobi,
                                        Kenya




                                        Mainstreamin
                                        g, a process
                                        towards
                                        collective
                                        strength on
1794    CDD152    CDROM   D18   India
                                        HIV/AIDS
                                        prevention in
                                        India:
                                        Jharkhand
                                        experience
                                             Implementing
                                             tuberculosis
                                             infection
                                             control
                                             measures in
2911   MOPED058    PE     D21   South Africa
                                             integrated
                                             HIV/TB
                                             services in
                                             Khayelitsha,
                                             South Africa



                                             An
                                             exploration of
                                             barriers
                                             associated
                                             with low
                                             voluntary
                                             counselling
                                             and testing
                                             uptake by
                                             adult
1360   MOPED061    PE     D22   South Africa
                                             tuberculosis
                                             patients
                                             attending
                                             primary
                                             health care
                                             clinics,
                                             Buffalo City
                                             Municipality,
                                             Eastern
                                             Cape

                                             Differences
                                             in heath-
                                             related
                                             quality of life
                                             (HRQL)
                                             measured by
2091    CDD162    CDROM   D22   France       the PROQOL-
                                             HIV, a new
                                             specific
                                             instrument
                                             developed
                                             across
                                             cultures
                                          Issues of
                                          family
                                          planning
1389    CDD168    CDROM   D23   Jamaica   among HIV
                                          positive
                                          women in
                                          Jamaica




                                          Identifying
                                          sexual health
                                          policy needs
                                          for men who
                                          have sexs
                                          with men
661     CDD175    CDROM   D26   Kenya     (MSM) in
                                          access to
                                          quality
                                          HIV/AIDS
                                          care and
                                          prevention in
                                          Kenya




                                          Fears and
                                          worries of
                                          adolescents
                                          perinatally
1866   MOPED072    PE     D26   Uganda    infected with
                                          HIV in
                                          Uganda;
                                          TASO
                                          experience
                                       HIV- related
                                       stigma and
                                       discriminatio
                                       n reduction
                                       through
                                       workplace
3527   CDD183   CDROM   D26   Uganda
                                       interventions
                                       in Ugandan
                                       NGOs:
                                       evidence
                                       from applied
                                       research
                                          AbsText
Background: Screening for primary HIV infection (PHI) is uncommon in resource-limited
settings. The stigma of HIV infection precludes widespread acceptance of provider initiated
testing and counseling. Therefore, PHI is rarely recognized in clinical care settings. The aim
of this study was to access symptoms and clinical setting as determinants of PHI in an
African setting (Zimbabwe).
Methods: Screening was performed in the following settings: Genitourinary Center (GU),
Primary Care clinics (PCC) and Research site for HIV preventive studies (PS). Symptoms of
PHI and sexually transmitted infection (STI) characteristics were collected. PHI was defined
as HIV-1 RNA >12,000 copies/ml and a (1) negative or discordant rapid HIV-1 test; (2) rapid
HIV test positive, indeterminate Western blot and (3) HIV negative within 6 months of a
positive test. Statistical Analysis: Proportion of symptoms within groups were compared
using Chi-square and Fisher's exact test. Age was compared among the groups using
ANOVA. All p-values are two-sided. Results: 805 clients screened (73.2 % women, 26.8%
men) A comparison of the difference in age between the three HIV diagnosis was statistically
Background: Depression and food security are independently associated with significant
adverse clinical outcomes among HIV-infected individuals receiving highly active
antiretroviral therapy (HAART). No studies have assessed the extent to which food insecure
individuals on HAART suffer from depression, or predictors of this co-morbid condition.
Methods: The objective of this study is to assess the prevalence and independent risk
factors associated with depression among food insecure individuals receiving HAART in
Canada. Adults receiving HAART voluntarily enrolled into the Longitudinal Investigations into
Supportive and Ancillary Health Services (LISA) cohort. Food insecurity was measured using
a modified version of the Radimer/Cornell questionnaire. Bivariate analyses were performed,
applying Fisher's Exact, Chi-square, Kruskal-Wallis, or Wilcoxon rank sum tests, as
appropriate. Logistic regression was performed to determine independent predictors of
depression.
Results: Among the 363 individuals who were food insecure in this cohort, 236 (65.0%) are
also depressed. Individuals with depression were more likely to be younger (median age 44.6
versus 46.6, p=0.004), alcohol dependent (72.1% versus 48.8%, p< 0.001), use illicit drugs
(63.6% versus 50.4%, p=0.019), self-perceive HIV-related stigma (61.0% versus 29.4%), and
Background: The Centers for Disease Control and Prevention (CDC) recommends
expanding routine HIV testing to all healthcare centers including emergency departments
(ED). Early ED programs report seroprevalence rates ~1% using rapid testing. We sought to
assess approaches that may improve test acceptance and enrich detection rates in a U.S.
university hospital ED.
Methods: Based on earlier work, we hypothesized that fever may serve as an objective
marker of populations at higher risk for HIV. In December, 2008, we initiated HIV screening
using a free rapid oral swab HIV test done at the bedside in non-urgent adult ED patients
capable of providing informed consent who were not previously diagnosed with HIV. Rates of
diagnosis among febrile (>38°C) and afebrile patients will be compared. Patients declining
testing are asked to complete a questionnaire identifying reasons for refusal.
Results: Through 2/17/09, 145/224 (65%) of patients have agreed to be tested; reasons for
refusal included being 'recently tested', 'not feeling well', and perceived as not at risk.
Demographics of the tested population are representative of those seeking care in the ED:
median age 40.4 years; African-American 60%, white 35%; male 41%. Only 23 patients
(10%) have been febrile. Thus far, there has been 1 confirmed new HIV diagnosis (in a
Background An estimated 370 000 children became newly infected in 2007 despite
increasing access to PMTCT programs. The 2008 WHO guidelines recommend that infants
in high HIV prevalence countries are screened for HIV exposure and, if exposed, have a
virologic test at 4-6 weeks of age or the earliest opportunity thereafter.
Methods Free infant testing and treatment was made available at two clinics in Blantyre,
Malawi as part of a community-based neurodevelopment and HIV research study. Women
were informed on early infant testing and treatment and given educational fliers at PMTCT, 1
week and 6 week postnatal visits, and infant vaccination clinics. Six weeks testing was
performed by HIV DNA PCR assay on dried blood spots.
Results During a six month period, 166 HIV-exposed infants were tested, and 35 infants
identified as HIV-infected. Uptake of testing was lower than expected, with only 49%
(166/340) of HIV-infected women presenting for infant testing at 6 weeks. Barriers to testing
included poverty (lack of money for transport to primary health care clinic), stigma, especially
when mothers had not disclosed her status, problems with identifying exposure status due to
disconnects between mother and infant health records, and lack of awareness of infant
testing and treatment in the community. Challenges to early ART initiation included mothers
not returning for infant HIV test results, infant death prior to ART initiation, and refusal to start
treatment in asymptomatic infants. Collection of contact information, tracing of mothers by
Background: Baylor-Uganda, with support from CDC/PEPFAR, expanded pediatric
HIV/AIDS services into 32 health facilities in 29 districts throughout Uganda in 2008. To
improve identification and treatment of HIV infected children, we implemented a program in
adult ART clinics entitled “Know Your Child's HIV Status”.
Methods: Guidelines for the implementation of the campaign were developed. Each health
facility formed a KYCS committee to run the campaign. Follow up meetings and phone
discussions were held between Baylor-Uganda and each committee for proper planning and
mobilization.
The date for the campaign was then publicized in health education talks at ART clinics. PHA
networks and groups supporting home-based care services helped mobilize families to
attend the HIV testing, counseling and referral services available that day.
Results: The campaign was successfully conducted in 31 of the 32 upcountry Baylor-
Uganda sites, as well as two partner ART clinics (IDC and ISS) in Kampala. A total of 4,737
people were HIV tested; 4,363 (92.1%) were children. Among the children tested, 4,027
received their results of whom 163 (4.0%) were HIV positive. DBS results of 336 infants are
pending. Of the 374 adults tested, 39 (10.4%) were HIV positive, greater than the national
adult sero-prevalence of 6%. The success of the KYCS campaign was heavily dependent on
Background: In the US, many perinatally HIV infected (pHIV+) youth are able to envision an
adolescence and adulthood as a result of successful antiretroviral therapies (ART). However,
pHIV+ youth and their caregivers must negotiate complex health and medication related
issues over the course of development while simultaneously coping with a stigmatizing
disease. Further, clinical reports indicate that pHIV+ adolescents are presenting with serious
mental health difficulties and non-adherence to ART, ranging from 30 to 50%. Even brief
episodes of non-adherence to ART can permanently undermine treatment and lead to
reduced efficacy of and increased resistance to medications.
Methods: Eighteen participating pHIV+ youth and their families were involved in a 12-
session intervention designed to enhance youth mental health, family communication and
support for medication adherence. Further, the intervention focused on issues related to
stigma, disclosure, HIV knowledge, health and antiretroviral medication protocols in an effort
to have youth and their caregivers work more effectively together on the management of
youth health and medication. Participants completed assessments at baseline, post-
intervention and 3-month follow-up.
Results: Preliminary analyses revealed significant improvements in child emotional
symptoms (t=3.1, p < .01) and decreases in conduct problems (t=2.2, p < .05) and functional
Background: Successfully communicating public health messages to young children and
their caregivers remains a challenge. We describe the use of puppetry as a novel strategy for
raising HIV awareness, educating communities on the importance of adherence, addressing
issues of stigma and increasing knowledge surrounding good health seeking behavior in
children and their caregivers.
Methods: In collaboration with a regional puppetry training group, 7 puppeteers were trained
in script development, puppetry construction (using locally available material), song writing
and puppetry manipulation. Additionally, puppeteers were trained in basic paediatric HIV/
ART and paediatric psychosocial counseling. The script and puppets were developed in
consultation with local community leaders and utilize culturally appropriate caricatures and
age appropriate (3- 6 years) language. The show is interactive and encourages participation
whilst providing a forum for children and their caregivers to ask questions regarding HIV,
ART and other health related issues. Messages focus on stigma reduction, adherence to
medication and ART availability.
Results: To date, the puppeteers have performed over 200 shows at both public and private
clinics. The team is able to perform one performance per day. The puppetry booth utilizes
Background: Combined antiretroviral therapy is associated with facial lipoatrophy, which is
potentially stigmatizing for HIV-positive patients. Eutrophill is a 2.5% polyacrylamide hydrogel
with an official half-life of 5 years. The aim of the study was to evaluate the long-term efficacy
and safety of subcutaneous facial injections of Eutrophill in HIV-infected patients with severe
facial lipoatrophy.
Methods: Multicentric, open-label, single-arm, pilot study in HIV-infected patients with severe
facial lipoatrophy. Patients received between 2 and 6 injections every 2 to 4 weeks,
according to the aesthetic results. We evaluated the clinical efficacy using facial
ultrasonography and facial photography at screening after 6 and 12 months. In addition, we
assessed the safety of the infiltration techniques and determined changes in patient
satisfaction, and quality of life (QOL) at months 6 and 12.
Results: 111 patients were enrolled and received at least one injection of Eutrophill. Median
age was 46 years (range, 27-66 years) and median CD4 cell count was 539 cells/muL (101-
1328). The mean total cutaneous genial thickness was 9.7±1.9 mm at inclusion, 13.0±1.8
mm at month 6 (p< 0.001 vs baseline) and 14.0±1.7 mm at month 12 (p< 0.001 vs baseline).
After 12 months of follow-up, the Overall Treatment Satisfaction (score range, -7 to +7) was
Background: Lipodystrophy (LD) impacts QoL of HIV patients. Facial lipoatrophy (FL) is
particularly stigmatizing. Patient Reported Outcomes measures (PROs) are not often used as
a primary endpoint to measure interventions specific to LD. The aim of this study was to
evaluate the QoL (primary endpoint) of HIV patients treated for FL by poly-L-lactic acid
(PLLA) New-Fill®-Sculptra® injection.
Methods: 245 patients with FL were included in an open label prospective study and treated
with 1 to 5 treatment sessions at monthly intervals. Specific PROs were evaluated by the
Assessment of Body Change and Distress (ABCD), including: QoL (21 items with 4 domains,
0-100 scale), signs of LD (6 items, 0-6 point scale), and global satisfaction (1 item, 1-5 point
scale) at baseline and 2 months after the last injection. The Overall Treatment Effect (OTE)
(scale from -7 to + 7) was also assessed at this date. Photographs were evaluated, blind by
experts using James' grading (1-4, 4 being severe FL).
Results: 191 patients completed the questionnaires. Mean age was 45±8 years, 87% men,
with FL since 5±3years. The mean number of treatment sessions was 4±1.3. The QoL global
score improved significantly by +13,5 points (+24 %, p< 0,001) and each of 4 domains
improved: Satisfaction with the appearance +14,7 points; Psychosocial impact +15,4; Fear of
Background: Mother-to-child transmission represents a continuing source of new HIV
infection in South Africa. It is particularly important to understand pregnancy intention among
women and men who are HIV positive to prevent perinatal transmission. Many people
infected with HIV continue to be sexually active and, as a result, are faced with decisions
regarding reproductive intention and behavior.
Methods: We conducted six focus groups to elicit attitudes about becoming pregnant and
having children, specific social referents who are perceived to influence the pregnancy
decisions and childbearing, and control beliefs about becoming pregnant. These focus
groups were conducted among women and men in rural KwaZulu Natal Province where the
HIV prevalence rate is 39%. Focus groups were conducted among community women (3
groups), community men (1 group), female patients from an anti-retroviral therapy (ART)
clinic (1 group) and male ARV patients (1 group).
Results: The following themes were identified in the analysis of the focus group discussions.
Attitudes about having children focused on leaving a legacy. Social influences on
childbearing included the role of the Makoti system, influence of the mother-in-law, and
Background: Reducing unintended pregnancies through improved access to contraceptive
services is a critical part of prevention of mother-to-child transmission of HIV (PMTCT).
However, it remains challenging to identify ways to strengthen contraceptive services in order
to best reach HIV+ women with an unmet need for contraceptive information and services
(hereafter referred to as unmet need).
Methods: To address this issue, this study conducted survey interviews with providers and
HIV+ clients in antenatal care, postnatal care, and child health clinics in Coast Province,
Kenya. The goals of this assessment were to determine whether HIV+ women with unmet
need could be reached in each of these service delivery points, and to identify potential
strategies for improving contraceptive access. Overall, 55 service providers, 119 pregnant
HIV+ women, and 60 postpartum HIV+ women were interviewed across 10 health facilities.
Results: Our results indicate that HIV+ women with unmet need can be reached in these
health settings. Clients reported a high desire to space or limit future births but a low
frequency of contraceptive discussions with providers. Clients demonstrated minimal
knowledge of return to fertility postpartum and were unable to recognize the best time to
initiate postpartum contraceptive use. Providers demonstrated a need for contraceptive
updates, especially regarding contraception for HIV+ clients, but were highly supportive of
increasing contraceptive counseling and referral in their clinics. Our results also
Background: Modern circumcision by qualified clinicians is taking root among the Meru.
Some pockets however still practice traditional circumcision, whereby a traditional attendant,
using crude tools and charms is employed. The Kenyan government has developed a policy
to curb female circumcision, but none exists on traditional male circumcision. It is likely that
this hampers the fight against AIDS. The traditional circumciser uses no antiseptics and
employs the same instrument for all initiates. Certain beliefs and traditions have militated
against discouragement of this trend.
Methods: We looked at the method of circumcision, tools used and any safety measures
against spread of infection, beliefs and attitudes about the method of circumcision and
HIV/AIDS. Interviews were conducted to those who had undergone the rite in August 2007.
The author also observed the general trend in traditional and modern circumcision over a
span of three years.
Results: Parts of Tigania of Meru still practice traditional circumcision on a large scale.
Pastoralists in the western part of the district practice it up to 80%. Areas near the tarmac
road and major urban centers have a rate of up to 30%. Initiates believe that it is the best
form as it is done without anesthesia, and hence is the toughest passage to manhood.
Fear, misinformation about HIV, and the scarcity of HIV-testing services mean tha few
Solomon Islanders have ever been tested for the virus.Recent research revealed that the risk
of HIV infection in the Solomon Islands is high. It showed awareness about sex is low and
that females aged between 13 and 25 are. Along with other research, these reports have also
indicted high levels of unprotected sex-especially among young people resulting in a
continous increase in reported STIs and teenage pregnancies
Background: The research was conducted to assess the sexual behaviors and situations of
youth, SWs and MSM, its purpose is to strengthen the evidence base to inform HIV
interventions for these three groups. Data will give us (SCA) and other stakeholders including
the Solomon Islands National AIDS Council - a deeper insight into the situations, issues and
other needs of these groups, and enable the design of evidence -based HIV programs.
Methods: The research was qualitative study; a formative research strategy whereby
qualitative data was gathered to obtain a deeper insight and understanding of the situations
of the target groups. Qualitative data collection methods included focus group discussions
(FGD), individual in-depth interviews (IDI) with study subjects, and key informant interviews
(KIs). Observations took place at all sites. Interviews observed interaction between people
living within these communities and used this knowledge to verify stories collected from
interviews. Debriefing sessions were also held at all sites and were used to discuss the
stories and observations captured outside of formal interviews.
Results: In all of the locations among all study groups, evidence of one or several forms of
risky sexual behaviors were reported. in this report risky sexual practices refer to any activity
Background: There are substantial proportions of female injecting drug users (IDUs) in the
Northeast India who require services as much as their male counterparts and may even be
with a more pronounced needs such as reproductive health services, condom programming.
Yet, most of the harm reduction services at present are not gender friendly and smaller
proportions of female IDUs are accessing services.
Methods: The study analyzed the influence of gender in access to harm reduction services
for female IDUs in Northeast India. The study was done through literature review along with
key informants communication. The gender analysis framework was adapted to identify and
analyze the barriers to service access.
Results: The study identified that there is a low access to harm reduction services by the
female IDUs such as 7% enrollment for the opioid substitution treatment programs. Most of
the enrollments are also coming from the facilities that already have worked with female IDUs
who are also sex workers.
The challenges in female IDUs access to services includes the followings:-
-Reluctance to attend the harm reduction services as most of them are male oriented with
domination of male clients and male workers
- Inability to afford the opportunity cost of availing services.
- Double stigma for female IDUs, which makes them, want to remain hidden.
- Non-approval by the male partners to attend such services.
Background: Nepal has progressed from a HIV low prevalence country to one with a
concentrated epidemic in certain subgroups of population. There is little documented
evidence on the risk behaviours among women in Nepal. This study was conducted to
assess the pattern of risk behaviour for HIV among women in the reproductive age group.
Methods: The main component of the study comprised a community based cross- sectional
study, using a multi stage random sampling technique. Data was collected by trained field
health workers using an interviewer administered questionnaire. Eight focus group
discussions were also conducted to supplement the findings. Statistical analysis was carried
out using SPSS version 13.
Results: A significant number of un-married (13.7%) women and 2.2% of married women
indulged in high risk sexual behaviour. A significant positive association was observed
between sexual risk behaviour of married women and monthly Family income less than 5000
Nepali Rs (X2 = 5.2, P < 0.05) and young age group (15- 34) in unmarried women. (X2 =
14.96, P < 0.01). Very few women indulged in Intra venous Drug use (0.04%). Nearly 70% of
women have heard about AIDS and have satisfactory level of knowledge about HIV/AIDS.
However, significant number of respondents had misconceptions that one could contract HIV
Background: Voluntary counselling and testing (VCT) is internationally recognised as an
important strategy for both HIV prevention and care. In Nigeria, where there are an estimated
2.6 million people infected with HIV, VCT services are increasingly being established.
Previous studies on VCT in Nigeria were found not to adequately address the social aspects
of VCT, thus, the need for this study. The aim of this study was to provide a better
understanding of the perceptions and experiences of pregnant women towards HIV VCT in
Kano central, Nigeria.
Methods: A qualitative research was carried out between June and July, 2007 at Aminu
Kano Teaching Hospital, Kano. Purposive sampling was used to select twenty pregnant
women that were receiving antenatal care and have taken part in VCT in the hospital. Data
was collected through semi-structured interviews. The interviews were transcribed and
analysed thematically.
Results: Three major themes: fear of stigmatisation, information provision, and support were
identified from fourteen sub-themes relating to the perceptions and experiences of the
participants. The sub-themes, 'VCT is at first visit' and 'Poor environment and
communication' were found to be new knowledge in the VCT literature. Premarital HIV testing
Background: Pakistan, as being the world´s second most populous Muslim nation, has also
started to experience and confront the HIV/AIDS epidemic. Pakistan has been identified as a
low prevalence but high risk country for HIV/AIDS. The society in Pakistan has not yet
accepted HIV/AIDS as having anything to do with them. HIV is considered extremely
shameful, particularly in the rural setting. Awareness about HIV/AIDS in general is extremely
limited. The PLWHAs are being denied of getting dental treatment in dental hospitals &
clinics.
Methods: This study was a cross-sectional descriptive postal survey which included 115
dentists, out of which 86 responded.
A pre-test of instrument was done for validity and further improvements among dentists.
General characteristics of the dentists were summarized by using descriptive statistics.
Pearson Chi-square and Spearman's rank correlation test was used.
Results: The results revealed that only 25% of the dentists expressed their willingness to
provide dental treatment to the patients living with HIV/AIDS. On the other hand 17% of the
dentists would refuse to provide dental treatment to PLWHAs. Of those who intent to provide
treatment; 10% of the 86 dentists will treat such patients as a normal patient. Of those
Background: During one year follow up of HIV infected mothers and infants in a prospective
observational trial, women brought up issues regarding HIV status disclosure. Through
disclosure counseling and support provided by the study, mothers raised concerns related to
HIV status disclosure to significant others and the potential for stigmatization and separation.
An IRB approved sub-study was conducted to gather information on HIV status disclosure, as
well as family planning and infant feeding concerns among these women.
Methods: An exit interview was conducted with 85 HIV-1 infected mothers at their 12 month
(last) visit in the prospective arm of the NVP-RP study at MU-JHU Research Clinic.
Proportions of women who had disclosed to a significant other, as well as predictors and
outcomes of disclosure were determined.
Results: Disclosure ranged from 2.4% to employer(s) to 68% to a relative other than a
parent. 53/85 (62%) of the women had disclosed to partners. Women with an HIV infected
baby were more likely to disclose to their partner (13/15) or if staying with the partner (13/15).
Reasons for non-disclosure included fear of separation and stigmatization. Most mothers
54/85 (63%) reported getting support following disclosure while a minority (14/85) received
negative reactions (neglect or separation from their partners resulting in loss of financial
support). Only 8/85 (9.5%) of male partners underwent HIV testing based on disclosure of the
woman's status; however 33/85 (38.8%) of partners had a prior HIV test. The HIV infection
couple discordance rate was 7/33 (21.2%).
Conclusions: Almost two thirds of HIV-infected pregnant women in a Uganda clinical
research study had disclosed their HIV status to their partner or relative. Particularly high
disclosure rates were seen among mothers of HIV infected babies. The supportive one-on-
Background: As part of an ongoing NIH sponsored (R24HD056917) longitudinal study of the
social context of HIV treatment in urban and rural Uganda, we report on patterns of
disclosure in men and women receiving HIV treatment.
Methods: From September 2008 - February 2009, 258 women and 172 men receiving HIV
treatment at Joint Clinical Research Centre in Kampala City (n=248) and Mbarara hospital
(n=182) in South Western Uganda were interviewed about demographics, illness history,
treatment experience and adherence. Qualitative and quantitative analyses were performed
using content analysis and SPSS respectively. Ethical approval was granted by Case
Western Reserve University and the Uganda National Council of Science and Technology.
Results: There are differences between men and women in the perceived impact of
disclosure. Women who have recently begun treatment are less likely to report disclosing to
their partners, families, or friends, primarily in fear of social isolation. Whereas both men and
women have gone out into the community as 'expert clients' to share their experience of
living with HIV/AIDS, men overall report less fear of disclosure. Importantly, a common
reason given for having initiated treatment was hearing the personal experiences of such
“expert clients” on ARVs. This underscores the importance of patient participation in de-
stigmatizing HIV, as a means to encourage HIV infected persons to seek treatment. For
Background: Men who have sex with men (MSM) are an evolving risk group for HIV
infection in India. Earlier we described high prevalence and correlates of HIV infection among
721 MSM in Tamil Nadu (TN), India. Marriage was strongly associated with HIV, HSV-2 and
syphilis. Overall uptake of VCT and health care services were low among this population and
the prevalence of unprotected anal intercourse was high. We followed up this quantitative
survey with a series of focus groups to identify appropriate acceptable interventions for MSM
populations in South India.
Methods: Five focus groups with 12 individuals per group were conducted during the Feb
2009 across South India. These focus groups were aimed at gathering information on
reasons for poor health care, VCT access, marriage, sexual risk practices, appropriate
interventions, substance abuse patterns and mental health issues.
Results: The participants of the focus groups were both married and unmarried in these
focus groups and key findings are: stigma and discrimination were primary reasons for low
health care utilization. Social compliance and family situations force marriages on MSM Most
married MSM were not open to the option of referring their wives for a HIV test as they were
Background: Many studies about the national program about HIV/AIDS prevention of
mother-to-child transmission (PMTCT) in Benin as well as in many other sub-Saharan African
countries have shown a high level of testing of pregnant mothers (70 to 80%) of those seen
at antenatal clinics. But, what exactly are these women consenting to? This question is even
more important than the weakness concerning the follow up after the testing. Many of these
mothers often disappear from sight after this test. The question now becomes are these
ladies agreeing to do the tests in their entire mind or not.
Methods: While we were doing our research on the analysis of the program implementation
we chose to use a mixed approach by using qualitative and quantitative methods by
observation without participation, semi-directed interviews (30) undertaken with medical staff
and questionnaires given to 359 mothers in antenatal clinics.
Results: It appears from this study that low educated women (less than six years of study)
present a very low level of HIV testing refusal compared to more educated women. Many
women agree to be tested just to follow the crowd. The length and content of the individual
counseling is limited and women get the complete results of the tests only if they are tested
positive. Some do not inform their partners and others change their medical book or medical
centre to try to give birth anonymously. Medical staff think the amount of lost patient trace is
due to general context of discrimination and stigmatism.
Background: The AIDS Support Organization [TASO] realized many of her clients who came
for support services had no follow up support in the community while most of its clinics and
counseling services were over stretched and over burdened. At the same time, center was
being flooded with request for training and support for various community groups.
Aim: TASO realized that by giving people at the grass root levels, the basic skills needed for
home care, counseling and AIDS education, the community would do some thing and do it
better for themselves and they would be able to extend the HIV/AIDS services to more
people.
Methods: A based line survey was carried out and quantitative data was collected and
evaluated, and analysis made. Information of the findings was disseminated to the
communities .A plan of actions in partnership with the community programmed to fill the gaps
in knowledge attitudes and practices that were impeding the spread of HIV transmission in
the community.
Results: Communities were empowered at the local level in order to track and handle the
AIDS problems themselves. There was enough HIV/AIDS awareness through community
sensitization. The number of community members coming to seek for Voluntary Counseling
and Testing Care and Support increased compared to the ones of the previous period. There
Background: Prompt access to care and support services at the Health facilities is a big
challenge. There is an increasing number of People Living with HIV/AIDS (PHAs) who are
poor amidst the limited trained human resources and facilities. 75% of 22,462 TASO Mbale
Service centre registered PHAs are poor and live beyond 20km away from the facility (TASO
Mbale MIS, 2008)
Methods: TASO uses a Home Based Care (HBC) strategy which focuses on the PHAs and
their family members for holistic family care and treatment. The trained community nurse and
the volunteers do play a major role in providing health education, basic care and treatment of
opportunistic infections to the PHAs and make appropriate referrals to health facilities for
further investigation and management. Family members are empowered to offer home based
care services and management of simple conditions of bedridden PHAs using the local
resources. Care givers are also educated about HIV prevention, nutrition, family planning
methods, hygiene and drug adherence.
Results:
1. Involving caregivers at homes and building their capacity enhances care, adherence and
management of common infections for PHAs.
2. Home based care provision to PHAs has promoted behavior change, early HIV testing and
disclosure because of reduced stigma and effective utilization of services. 3. Home based
care service is the most efficient and cost effective strategy of service delivery for PHAs in
Background: As the number of new HIV infections persists at disproportionately high
incidence rates for Native American, Black, and Hispanic women in the United States, the
objective of this intervention is to educate women and health care providers on the benefits
of HIV/AIDS prevention research trials. Although race itself is not a risk factor for HIV
infection, a range of issues contribute to the disproportionate HIV risk for women of color,
including poverty, stigma, Sexually Transmitted Infections and drug use. Advocates and
community educators must be ongoing partners with AIDS researchers to develop effective
biomedical/ behavioral interventions to prevent the transmission of HIV.
Methods: Community Based Organizations, (CBOs) play a critical role in building
partnerships to support women's engagement in AIDS prevention research. Organizations
such as SisterLove, Inc. Women Organized to Reduce Life-threatening Diseases (WORLD)
and the Community HIV AIDS Mobilization Project,(CHAMP) have partnered with Harvard
University's Center for AIDS Research to educate women and providers about prevention
research. These community representatives raise awareness about the need for ongoing
AIDS prevention methods for uninfected women and women living with HIV. This working
group created an education and awareness training for women to become informed about
AIDS prevention research, to discuss research outcomes and to raise the level of community
Background: The purposes were to assess stigma among Thai youth living with HIV (TYLH)
and to create an abbreviated 12-item Stigma Scale based on the 40-item Berger's Stigma
Scale for TYLH.
Methods: TYLH aged 16-25 years were recruited in Bangkok. Youth answered the 40-item
Stigma Scale and the questionnaires on mental health, social support, quality of life and
alcohol/substance use.
Results: Seventy TYLH (26 men, 41 women, 3 male-to-female transgendered) were
enrolled. Sixty-two (88.6%) reported at least one person knowing their HIV status. Male youth
who had sex with men were more likely to disclose to friends (43.9% versus 6.1%, p< .01)
and less likely to disclose to immediate families (47.6% versus 91.8%, p< .01). Female youth
were more likely to disclose to immediate families (90.2% versus 62.1%, p< .01) and less
likely to disclose to friends (7.3% versus 31.0%, p< .05). Cronbach's alpha of the 40-item
Berger's Stigma Scale was 0.89, suggesting excellent reliability in TYLH. Three items with the
highest loading factor for each of the four stigma subscales were selected to create the 12-
item Thai Youth HIV Stigma Scale. The 12-item scale was reliable (Cronbach's alpha, 0.75)
and highly correlated with the 40-item Berger's scale (r=0.846, p< .01). Half of TYLH had
mental health problems. The 12-item scale score was significantly associated with mental
health (beta=0.21, p< .05). Public attitudes towards HIV were associated with poorer quality
Background: Timely uptake of HIV testing facilitates early diagnosis of HIV infection and
knowledge of one´s serotatus can lead to behavioural modification and utilization of
prophylaxis to prevent opportunistic infections. In addition a substantial proportion of HIV
infection is undiagnosed. The identification of the factors which encourage and impede the
uptake of HIV testing is necessary for the success of VCT programmes in resource limited
settings. This paper investigates the variables which influence willingness to be tested for
HIV among adolescents in Sub-Saharan Africa who are at increased risk for HIV infection.
Methods: The outcome to be examined is the willingness to be tested among adolescents
aged 12-19 years. The study uses nationally representative survey data from Protecting the
Next Generation Study carried out in Burkina Faso, Ghana, Malawi and Uganda.
Independent predictors include socio-demographic variables; exposure to sex education, HIV
related knowlegde and stigma. Bivariate and logistic regression models are estimated for
males and females separately given differential gender risk for HIV.
Results: Among males willingness to be tested ranged from 69.8% in Burkina Faso to 80%
in Malawi and among females from 62% in Burkina Faso to 72% in Ghana and Malawi. Male
adolescents with inaccurate knowledge of HIV prevention and transmission showed
Background: HIV stigma is an important barrier to HIV control and prevention, having a
major influence on adherence to medications, and influencing the use of preventative
measures. Despite the significant impact of stigma on medical outcomes, there is scant data
for children or adolescents born with HIV.
Methods: A cross- sectional study was conducted in 2008 among perinatally HIV-infected
adolescents in Chiang Mai, Thailand. A standardized questionnaire assessing HIV-related
stigma in 4 settings (home, community, school, and healthcare) was administered.
Results: A total of 79 adolescents (median age: 13 years, range: 10-18.9; 53% females)
particpated in the study. Ninety-five percent reported attending school; both parents were
alive for 21%. Forty-two percent have been treated with HAART for more than 5 years. Only
half (51%) said that an HIV-infected person had hope and 52% said that an HIV-infected
person could live in the community normally. Twenty-four percent said that they were afraid
that other people would eventually find out that they were HIV-infected. More than half (65%)
reported that they had to use their own glass at home, and one-third reported that they had
been teased with a bad name, such as ´AIDS kid´. Around one-fourth reported that
surrounding people had stopped being their friends because they were infected with HIV.
Background: Many PLWHA had been known from various studies to hide their HIV status
from their spouse or partner because of fear of stigma and the stressful effect it has on
relationship with their family. The objective is to determine factors related to partner
disclosure of HIV status of PLWHA
Method: Descriptive cross sectional study. A self-administered questionnaire on disclosure
of HIV status to their partners was distributed among PLWHA on HAART. Data was
collected, entered and analyzed using Statistical Package for Social Sciences version 11
Results: Three hundred and ten PLWHA completed the questionnaire. The mean age of the
subjects was 36.7±9.3 years with a range of 18-65years. There were 36% males and 64%
females. Thirty-three percent had tertiary education while 52% had secondary education.
Only 5.9% had no formal education. Majority (56%) were traders while 27.3% were civil
servants. Only 13.6% were unemployed. One hundred and fifty (48.4%) were currently
married, 73 (23.5%) were divorced while 86 (27.7%) were widowed. Seventy percent of those
married were monogamous while thirty percent were polygamous. Most (75%) who were
married at the time of study had never told their partner about their HIV status because of
fear of stigma. Fifteen percent of those who told their partners of their HIV status reported
Background: Research indicates that self-perceived stigma is an inhibitor to adhering to
prescribed antiretroviral therapy and contributes to nondisclosure of HIV-positive status.
Consequently, stigma affects prevention and treatment efforts as well as significantly
impacting the psychological and physical well-being of people living with HIV. We examine
the prevalence and factors associated with self-perceived HIV-related stigma among a cohort
of individuals receiving HAART in British Columbia, Canada.
Methods: Data are drawn from the Longitudinal Investigation into Supportive and Ancillary
Health Services (LISA) study. Explanatory variables were collected through a comprehensive
interviewer-administered survey. Clinical variables, which included CD4 count, viral load and
adherence, were obtained through the British Columbia HIV/AIDS Drug Treatment Program.
Categorical variables were compared using Fisher's Exact Test and continuous variables
were assessed using the Wilcoxon Rank-Sum Test. Multivariable logistic regression was
performed to determine the independent predictors of self-perceived HIV-related stigma.
Results: Forty-six percent of participants perceive high levels of HIV-related stigma. In the
adjusted multivariate analysis, depression was associated with perceiving stigma (adjusted
odds ratio [AOR] 1.74, 95% CI 1.01, 2.98), along with three quality of life variables: health
worries, disclosure concerns and sexual dysfunction (AOR 1.41, 95% CI 1.25, 1.61; AOR
Background: Lack of disclosure of HIV-positive status to partners can result in poor
adherence to PMTCT interventions and can limit access to HIV care. The objective of this
study was to determine the rates of disclosure by HIV-positive women referred to the national
ART program in Chitungwiza.
Methods: A descriptive study was conducted at four antenatal clinics in Chitungwiza. HIV-
positive women, referred to the national ART program between January 2006 and December
2007, were interviewed. Data on disclosure and stigma were collected using a semi-
structured questionnaire.
Results: Of the 147 women that were interviewed, 115 (78%) had disclosed their HIV-
positive status to their spouses, 65 (44%) to their siblings, 44 (30%) disclosed to their parents
and 20 (14%) to their in-laws. Only 2(1%) had disclosed to the public. The reasons for
disclosure to spouse were that it would enable the woman to seek further HIV care 56 (38%),
encourage the partners to test 46 (31%), as a cultural norm that the partner should know
(27%), and for facilitating uptake of PMTCT interventions (14%). Ninety-six (65%) reported
that being a member of psychosocial support group had empowered them to disclose their
HIV status. Thirty-two (22%) women did not disclose their HIV status to their spouses
Background: The World AIDS Campaign for the years 2002 - 2003 focused on stigma,
discrimination and human rights. The main objective of the campaign was to prevent, reduce
and ultimately eliminate HIV/AIDS related stigma and discrimination. Unemployment in
Zimbabwe is over 80% one of the highest in the world, this increase vulnerability to HIV &
AIDS in several ways.The study sought to investigate the impact and discrimination on
women suffering from domestic violence, by investigating the impact of violence and HIV on
livelihoods, levels of domestic violence in the home, their experience of disclosure to others
their views on how stigma can be alleviated in the community and the benefit of counselling
in dealing with discrimination.Background information on domestic violence and on
HIV/AIDS, stigma and discrimination were researched. The literature review focused on how
stigma is a violation of human rights, and this is worsened by cultural norms that make
women themselves accept violence as in inevitable consequence in relationships.
Methods: A qualitative research design using the Case Study approach guided the
researcher in data collection and analysis. The participants comprised of 500 women. The
Internet, Questionnaire and Standardised Open Ended were used as data collection
instruments.
Background: KwaZulu-Natal province (KZN) has one of the greatest HIV burdens in the
world. The government introduced the antiretroviral treatment (ART) to eligible people in
order to reduce the morbidity and mortality. Despite widespread availability of ART in KZN,
there is poor access by children to ART compared to adults, and children continue to die
because of HIV and AIDS. This qualitative study explored psychosocial and health system
factors that influence paediatric access to ART in KZN from parents and caregivers
perspectives.
Methods: The ecological theory and the social cognitive theory was used to formulate an
interview schedule used in conducting the in-depth interviews with parents or guardians who
were bringing their children for ART-services and those attending these services themselves
at two hospitals in KZN. Purposive sampling was used to select clients for interviews and
thematic was done in accordance with the aims and objectives of the study.
Results: Low uptake of child ART was found to be influenced by several psychosocial and
economic factors such as the poor knowledge about ART, stigma and disclosure associated
with HIV, extent of support provided by parents/caregivers, parent's own ART was a
determinant for bringing children for ART, use of traditional / alternative medicines,
Background: Current results of studies show that migrants and ethnic minorities do not profit
sufficiently from public health and prevention services on HIV/AIDS prevention, treatment,
care and support. The focus of this study is the evaluation of a HIV prevention program
offered by the health services in the state of Bremen (Germany) for migrants from sub-
Saharan Africa. Aim of this evaluation study is to evaluate the quality of HIV/AIDS prevention
programs, to identify barriers and resources and to develop a cultural sensitive model that
improves the accessibility and quality of HIV preventive measures.
Methods: Related to the evaluation of a community-based approach in the prevention of
HIV/AIDS for Sub-Saharan migrants, quantitative and qualitative data were collected and
analysed, based on the idea of triangulation. A KAP-Study was conducted to study
knowledge, attitudes and practice by a multi-lingual questionnaire (German, English, French)
developed based on international experiences. Quantitative data were gathered from a first
sample of 100 participants (66,7 % male, 30 % female) and analysed by statistical methods
of multivariate data analysis. Qualitative data gained from interviews with a sample of key
persons, multipliers and community-leaders were analysed by qualitative content analysis
(Mayring, 2003).
Background: The World Health Organization has stipulated guidelines for management and
care of HIV patients. In Africa, problems of availability of drugs, stigma, adherence and cost
constitute major challenges. This study was designed to assess the drug management of HIV
patients in the Ahmadu Bello University Teaching Hospital Zaria-Nigeria.
Methods: The study was a five month random prospective data collection on clinic days.
Results: Results from the study shows that the management of HIV is in accordance with
WHO guidelines. Lamivudine and Nevirapine were used in almost all anti-retroviral drugs
(ARVs) combinations (99% and 93% respectively at joining program; 95% and 94%
respectively at time of study), with very few adverse drug reactions reported. Compliance
with therapy was over 95%. Zidovudine was used in 85% prescriptions. However, no fusion
inhibitors or protease inhibitors were used. Mean CD4+ count on enrolment was found to be
316.38±1.4. A large population of patients (41.9%) started ARVs while in WHO Stage 3 AIDS
classification. All patients were observed to have been placed on standard ARV regimens
with effective doses. The data obtained also confirms previous data showing that the
productive age class (31-50 years) constituted majority of the patients while over 47% of the
population was married. Over 65% of the clinic attendees had secondary education.
Antibiotics and multivitamin preparations formed the bulk of co-medications while all patients
Background: Instruments measuring health-related quality-of-life (HRQL) in PLWHA were
developed before HAART, and lacked relevant domains such as stigma, treatment
perception and impact of side effects particularly lipodystrophy. This study evaluated the
psychometric properties of the PROQOL-HIV, a new specific instrument to measure the
HRQL of PLWHA from different cultures and language groups.
Methods: 830 patients were included in a cross-sectional survey in 8 countries: Australia,
Brazil, Cambodia, China, France, Senegal, Thailand and the USA. Item reduction was based
on content, distribution of responses and factorial analysis. Reliability (Cronbach's alpha),
convergent validity (with the EQ-5D and MOS-HIV scores) and multi-trait scaling analysis,
and clinical validity (with biological markers and socio-demographic data) were assessed.
Test-retest reliability (Intraclass Coefficient Correlation) was evaluated.
Results: Mean age was 41±10 years, (37% women, 86% treated). CD4 mean number was
428±267 cells/µL, 75% had undetectable viral load. The PROQOL-HIV questionnaire was
reduced from 70 items to a 39-item HRQL core questionnaire and 4 individual items
(including Care Satisfaction and Financial Impact). Cronbach's alpha of the 8 scales ranged
from 0.60 to 0.89. Total score and subscale correlations (0.47-0.72) were acceptable. Factor
Background: UN member states have committed to Universal Access to HIV prevention,
treatment, care and support in 2010. WHO, UNICEF and UNAIDS support the monitoring of
national and global progress towards key interventions, including access to ART.
Methods: WHO and UNICEF developed a joint reporting tool for collecting data on progress
in the health sector response to HIV/AIDS. Data collected include the number of people on
ART at the end of 2008, disagregated by age and sex. Countries were requested to report by
31 March 2009. Country data were validated through a process involving national authorities,
key implementing partners and UN and donor agencies at national, regional and global levels
Results: At the time of abstract submission, 93 low- and middle-income countries had
reported data. At the end of 2008, between 3.8 and 4.3 million people were currently on ART,
including between 235 000 and 270 000 children less than 15 years, representing an
increase of more than 1 million since the end of 2007 and progress of about 33%. Between
2.7 and 3.1 million people were on treatment at the end of 2008 in sub-Saharan Africa,
representing about 40% progress in one year. Nevertheless, progress is unequally
distributed among regions and countries.
Conclusions: Despite continuous progress, Universal Access to ART is not likely to be
Background: Home-based care (HBC), to promote quality-of-life and limit hospital care, is
used in many countries, especially where public health services are overburdened. This
systematic review assessed the effects of HBC on morbidity and mortality in those with
HIV/AIDS.
Methods: Randomised and controlled clinical trials of HBC including all forms of treatment,
care and support offered in the home were included. A highly sensitive search strategy was
used to search CENTRAL, MEDLINE, EMBASE, AIDSearch, CINAHL, PsycINFO/LIT. Risk of
bias of all trials was assessed.
Results: Twelve completed studies (n = 31 to n = 549) conducted in USA (10), France (1)
and Uganda (1) and two ongoing studies were included. Intensive home-based nursing
significantly improved self-reported knowledge of HIV and medications, self-reported
adherence and difference in pharmacy drug refill (1 study). Another study, comparing
proportion of participants with greater than 90% adherence, found statistically significant
differences over time but no significant change in CD4 counts and viral loads. A third study
found significant differences in HIV stigma, worry and physical functioning but no differences
in depressive symptoms, mood, general health, and overall functioning. Comprehensive case
management by trans-professional teams compared to usual care by primary care nurses
Background: The 2006 Egypt Biological and Behavioral Surveillance Survey conducted by
the Ministry of Health and Population and Family Health International (FHI) revealed that
most-at-risk populations (MARPs) exhibit multiple risk behaviors. Most injecting drug users
(IDUs) engage in unprotected sex, and some female sex workers and men who have sex
with men inject drugs. In a conservative society, IDUs are less stigmatized than other
MARPs, and can be used as a safe entry point for outreach and implementation of targeted
interventions.
Methods: FHI selected Befrienders NGO, which has active linkages with IDUs, and focused
on building its institutional, programmatic, and technical capacity to provide a comprehensive
package of HIV/AIDS prevention and care services for MARPs and people living with
HIV/AIDS (PLHA). A comprehensive care center (CCC) was established and linked with
street-based outreach conducted by former IDUs. The CCC provides peer education, risk
reduction counseling, voluntary counseling and testing (VCT), basic medical care for MARPs
and PLHA, needs-based referrals, and distribution of needles/syringes and condoms.
Results: Funded by the Ford Foundation, the project began functioning in July 2008. During
the first six months, 251 clients were reached at the street level. Most (79%) visited the CCC,
of whom 80% were IDUs; 28% of male visitors were men who have sex with men; and 18%
Background: Fear of HIV-related stigma and discrimination deters people from proven
prevention technologies, HIV testing, disclosing a positive result (including to intimate
partners) and HIV treatment and support services. Stigma reduction is recognized as a key
structural approach to the HIV response. To promote universal access to HIV services,
EngenderHealth's Quality Health Partners (QHP) project scaled-up a stigma reduction
initiative at care and treatment centers across Ghana. This intervention included training
providers on stigma reduction and infection control, and use of quality improvement
processes to address stigma.
Methods: An assessment of this initiative was conducted from November-December 2008,
using quantitative and qualitative methods, including interviews of health workers and clients;
interviews with informants from affected communities (FSW, MSM and PLHIV); analysis of
problem statements within quality improvement action plans; and a review of stigma
reduction trainings results. In all, 63 respondents were interviewed, and 16 facilities´ action
plans were reviewed.
Results: Stigma reduction training among providers showed a marked increase in
knowledge and positive attitudes. Moreover, the majority of clients (85%) reported that HIV
Background: Addressing HIV associated Tuberculosis is an important component of the
new "Stop TB Strategy". SAARC is an association of eight countries. Some SAARC countries
have initiated some TB /HIV collaborative activities. However, TB/HIV collaboration is yet to
take off in a big way in SAARC member countries. Some of the reasons are barriers due to
the differences in programme implementation like fully decentralized DOTS services and
issues related to stigma and discrimination associated with both the diseases, more so with
HIV/AIDS. Hence, the study was carried out to assess strengths, opportunities, barriers and
threats to TB/HIV collaboration in SAARC Member countries and to provide pragmatic
recommendations according to national and international guidelines.
Methods: An institution based qualitative study was carried out at different levels of TB and
HIV/AIDS programme implementation units in Afghanistan, Bangladesh, Maldives, Nepal,
Pakistan, and Sri Lanka. Data was collected by trained interviewers using an interviewer
administered questionnaire. Data was analyzed making SWOT analysis.
Results: National Coordination committee, policy and strategy, focal person and guidelines
for implementing TB &HIV collaborative activities currently exist in Sri Lanka ,Bangladesh,
Afghanistan and Pakistan. Diagnosis and treatment of active TB among HIV infected is not
being carried out routinely by all study countries except in Maldives. MDR- TB is not a major
concern for all the studied SAARC countries. None of the countries implemented INH and Co-
trimoxazole prophylaxis therapy routinely. Majority stated lack of trained man power, lack of
research and weak monitoring and evaluation were the major obstacles for TB HIV
collaborative activity. Negative attitudes among health care workers towards PLHA were the
major threat for collaboration activities in the SAARC Member countries.
Background: The vertical approach puts pressure on people living with HIV who are further
stigmatised, unable to access widow pensions, child care support . A process to build their
capacities towards primary health care and development enables women and children
affected with HIV to access services for livelihoods, social networking and spiritual care.
Methods: A two week trainer programme exclusively for people living with HIV infection, is
facilitated with components from public health and development at grassroots levels. This
programme builds leadership for them to access governmental entitlements like widow
pension, ration cards, voter identity cards, katha for their houses. Follow up of these
participants was undertaken and a network of all groups facilitated linked for sharing and
learning
Results: 90 % of the women who received entitlements have stated that their adherence to
HIV care and ART has improved. Most of the young women have got their children back from
their in-laws and have begun advocating for HIV services closer to their areas.
Conclusions: A horizontal reverse-mainstreamed approach whereby people living with HIV
access governmental entitlements for their situation {Below Poverty Line/rural craftspersons
/widowsetc} enables them to develop confidence that they can advocate for HIV related
Background: The provincial hospital of Tete in Mozambique launched an occupational
health service focusing on HIV diagnosis and care in April 2008. The aim was to minimize the
negative impact of HIV/AIDS related morbidity and mortality, and other co-morbidities, on its
workforce productivity.
Methods: We describe implementation, challenges and modalities of an occupational health
service in the provincial hospital of Tete, Mozambique.
Results: Health workers were informed about the occupational health service through group
sessions, prior to starting a gradual individual invitation process for a yearly medical check-
up.
Consultations are organized twice per week and adhering to the concept of a 'one-stop
service'. A nurse-counselor and medical doctor offer active screening for HIV and other
prevalent diseases, personalized information about occupational risks, blood sample
collection (routine hematology and biochemistry analyses), initiation, clinical and
immunological HIV follow-up and delivery of HAART, Tuberculosis treatment and
opportunistic infections prophylaxis including Isoniazid. All services are free of charge. Strict
confidentiality is assured throughout the whole process. By January 2009, after 9 months of
Background: Like most Asian countries, injecting drug users (IDUs) are highly stigmatized
and marginalized in Pakistan. Since 2003-04, concentrated HIV epidemics have been
identified among IDUs. Evidence shows that in order to contain and/or reverse an IDU
related HIV epidemic at least 80% of the IDU population should regularly access HIV
prevention services. By the end of 2008, approximately 18,000 (18% of the estimated
100,000) IDUs were accessing services in Pakistan. Of this 18,000, over 14,000 were
provided regular services in Punjab province.
Methods: Through International Competitive Bidding, under World Bank supported
Enhanced HIV/AIDS Control Programme, delivery of comprehensive package of services for
IDUs through civil society organization was started in January 2005 at major cities of Lahore,
Faisalabad, Sargodha and Sialkot in most populous Punjab province of Pakistan. Client base
included injecting and oral drug users, their wives and children and homeless street children
using drugs. Periodic mapping, voluntary counseling and testing, referral for HIV treatment
and care, primary health care, needle exchange services, outreach services, detoxification,
condom distribution, access to skills training and socio-economic rehabilitation and advocacy
for creating enabling environment were some of the components of the project. Project
completed in December 2008.
Background: Female condom (FC) uptake has varied among sex workers (SWs) in different
Central American countries despite high acceptability as HIV prevention. This social
marketing study looked at women's preferences for learning to use the FC, barriers to
increasing overall protected sex acts using FCs, women's ideas of strategies to negotiate FC
use with different partners, and how FCs are currently promoted by community health
educators.
Methods: Ninety-five female SWs from four socioeconomic categories were recruited from
brothels, discotheques, and streets in Managua, Nicaragua and San Salvador and San
Miguel, El Salvador. Over eight weeks, they participated in a first focus group with anatomical
model demonstration, an individual structured interview, and a second focus group. Women
were provided 21 FCs to try during the study, with more as needed. Structured observations
were conducted with health educators in each site. Data analysis was conducted using Nvivo
and EpiInfo.
Results: Women preferred to learn to use the FC from health educators at their job sites
versus in clinics where they could be stigmatized. They reported practicing FC insertion alone
up to 10 times before using it in intercourse. They recommended trying it the first time with a
Background: The estimates of HIV/AIDS prevalence and number of People Living with
HIV/AIDS (PLWHA) in Nigeria are 4.6% and about 3 million respectively. Nigeria has the third
largest number of PLWHA in the world after India and South Africa with about 833,000
requiring ART treatment. There is a large pool of people living with HIV/ AIDS and unaware of
their status. This emphasises the need to scale up access to HCT services.In Nigeria, the
disease burden disproportionately affects the productive age group (15-29 years) with
prevalence rates higher than the National average. This age group constitutes the highest
percentage of the populations in tertiary institutions, yet most of these institutions lack regular
HIV/AIDS control programmes and where they exist, only about 1% deliver HCT services.
Furthermore, the tertiary institutions are faced with severe budgetary constraints, focused on
improving education standards and lack capacity to appropriately address issues of stigma
and discrimination.Therefore, NACA developed an innovative PPP model intervention for
tertiary institutions. Ecobank Nigeria Plc support infrastructure development, host schools
provide staff, while NACA provides technical assistance, test kits, capacity building and
monitoring & evaluation in 7 pilot institutions.
Methods: Access to HCT services through institutional medical centres (before YFCs) was
compared with access through the Youth Friendly Centres through data obtained from
questionnaires and monthly reports of YFC.
Background: Irrational fear of acquiring HIV at work contributes to S&D by Health Workers
(HW) against PLHIV and is a barrier to provide quality services. Implementing Standard
Infection Prevention (SIP) practices is perceived as expensive. Where resources are
available, the emphasis is more on getting materials rather than on system development or
building capacity. The project seeks to improve SIP practices and encourage staff to develop
positive attitudes towards PLHIV.
Methods: 16 NGO HCCs (20-200 bed) attempted to scale-up HIV care by mainstreaming
HIV into existing services Training Of Trainers (ToT) workshop to train field staff as Master
Trainers (MT)s was conducted who in turn conducted an OSWST at their HCCs which were
mentored and SIP practices were quantified prior to and at frequent intervals afterwards with
IP Quantifying Tool (IPQT). Staff attitude towards PLHIV was assessed on semi-quantitative
scale which was administered before and immediately after the training.
Results: 10 HCCs have conducted OSWST for which data is available. Staffs from all
departments (including housekeeping) participated and represented in Hospital Infection
Prevention Committees (HIPC). SIP scores on all ten parameters improved 3 months after
training- overall 100% increase (29%- to-57%). Major improvements occurred in Cleaning of
Surgical Instruments (-9%-to-50%) and in House Keeping and Waste disposal practices (-
15%-to-55%). Staff's attitude towards PLHIV increase from 3.2-to-3.5 (1-4 point scale; four is
most favorable score). Two more follow up scorings are planned (q3 months) are planned
before July'09.
Discussion: Incorporating SIP and S&D training encourages health workers to delve into
attitudes towards PLHIV and ensures acceptance of SIP and fosters a positive attitude
towards PLHIV. OSWST approach, in contrast to off-site trainings allows all cadres of
workers to work as a team, encourages decentralization and shared ownership saving
mangers' time thus allowing for sustainability.
Background: Aceh province is engaging simultaneously with post-tsunami rehabilitation and
an emerging awareness of the need to address HIV. The health system is struggling to meet
the needs of increasing numbers of people who require access to appropriate services.
Voluntary counseling and testing (VCT) and clinical management of HIV has been introduced
however the province is regarded as low prevalence, and few resources are available to
ensure high quality services are operational and accessible.
Methods: We studied structures and systems required to meet emerging HIV care, support
and treatment needs. The recently established positive support group in Aceh worked in
partnership with the provincial health office to provide on-the-job mentoring and supervision
to government counselors and clinicians involved in patient care. This has been formalized
into regular support and supervision visits, mentoring and refresher training delivered in
partnership with national and provincial government. Focus group discussions with health
workers and clients are used to assess ongoing knowledge and skills needs.
Results: The role of people living with HIV in the ongoing capacity strengthening of health
workers has resulted in a high profile for people living with HIV and consequently, the
positioning of the needs of patients at the forefront of clinical and allied service delivery,
rather than a more traditional model of clinician-led delivery. A clear referral network has
Background: Stigma & discrimination against PLHAs continue to be a major problem. There
are complaints of PLHAs being denied care, insulted and turned out of the hospital.
Methods: Delhi State AIDS Control Society (DSACS) involved PLHAs to monitor its service
delivery system as under:
1. PLHA member in State AIDS Council, Executive Committee and ART Review Committee
to address grievances at highest level.
2. Empanelled Drop in Centres run by Positive Networks , including a Women Net Work to
provide enabling environment, guide positive people, address rights, organize regular
meetings, track HIV +ve women & Baby and coordinate with DSACS for improvement.
3. Public Positive Speaking- Trained positive people are invited to present their feelings to
public to reduce stigma & discrimination.
4. Networks to monitor HIV/AIDS service delivery centres of DSACS for any deficiencies.
Results: With involvement of positive people several deficiencies were taken care of from
time to time like:
1. Ensuring adequate number of manpower, HIV test kits, OI drugs, ARV drugs at the
centres.
2. Health facilities requiring sensitization of medical & paramedical staff on HIV/AIDS
sensitized to reduce stigma & discrimination
3. Complaints of stigma & discrimination examined through local committees with PLHA
representative and report submitted to ART Review Committee.
4. A meeting of Medical Superintendents of all Delhi Govt hospitals organized under
Chairmanship of Principal Secretary (Health) to ensure provision of services to all positive
people with love & care without stigma & discrimination.
5. A Widow Pension cell was created at DSACS to help widows apply to State Govt.
Background: South Africa is a country with the highest number of people living with HIV and
AIDS (PLWHA) in the world (HIV/AIDS Policy Fact Sheet, 2005). Contraceptive use among
women in the reproductive age (15-49) is also high 65.3% (SADHS, 2003) and many women
get contraceptives in the public sector. Thus family planning services present the opportunity
to reach a large number of sexually active women. VCT provides an entry point to treatment
and care for HIV. However, the uptake remains low and many people do not know their HIV
status because they have never been offered the test, due to fear of knowing their status,
stigma and assumed lack of confidentiality. The project aimed to document client and
provider perceptions regarding the integration of information on prevention, and counselling
and testing for HIV during family planning consultations.
Methods: This presentation will focus on findings from focus group discussions with
providers and clients on feasibility, acceptability and some of the challenges and
considerations of integration of FP and HIV services.
Results: This paper will highlight provider´s opinions and perceptions on the integration of
C&T into FP services, the type of clients to be offered C&T, why clients do not test for HIV,
whether clients disclose their HIV status, and use of dual protection, how they feel about
Background: Widespread discrimination is preventing many countries from adopting
effective preventative measures against HIV/AIDS. In this battle against HIV/AIDS, the
protection of human rights is as important as the protection of public health. Only by
supporting human rights we can successfully tackle the disease. Discrimination and
stigmatization may often be the result of certain legislative solutions. UNDP CO/UN Theme
Group on HIV/AIDS in Serbia have supported review of existing legislation towards PLHIV in
Serbia. The aim was to acquaint PLHIV with their rights, possibilities and to improve access
to services. A group of experts undertook an analysis of Serbian legislation in order to find
out if there are regulations of a discriminatory and/or stigmatizing character, and to find out
what kinds of regulations are missing when it comes to the protection of PLHIV
Methods: The analysis of regulations of the Republic of Serbia regarding testing, protection
of confidential information, keeping of medical records and files, health insurance, criminal
liability for transmission of the disease, social welfare, compensation, education, work, status
of children living with HIV, were performed, and compared to the key international treaties
and other international documents pertaining to HIV/AIDS .
Results: Serbian legislation contains provisions that could be adjusted or amended in order
Background: Early initiation of HIV/AIDS care is important for successful clinical outcomes.
Understanding barriers to care-seeking following HIV diagnosis can help inform
interventions. Mulago-Mbarara Joint AIDS program (MJAP) provides HIV/AIDS care and
treatment to patients primarily referred from its Routine HIV Counselling and Testing (RCT)
programs. During RCT, clients are given a month's supply of cotrimoxazole and counselled
about the importance of prompt follow up
Methods: We retrospectively evaluated routinely collected data from clients enrolled in the
Mulago-MJAP clinic between 8/2005 and 12/2008. Data from all adult clients who had a
documented HIV positive test and a date of diagnosis were evaluated. Early initiation of
treatment was defined as enrolling in care within 30 days of HIV diagnosis.
Results: Of 10,549 patients enrolled in the clinic, 7740 (73%) reported undergoing RCT
within one month prior to the first clinic visit; 1817 (17%) enrolled in care more than 3 months
after testing. Overall, median time to seeking care was 7 days (IQR: 2-34). The median time
to starting care among patients diagnosed at the Mulago RCT was less than for those
diagnosed elsewhere (5 days [IQR: 1, 17] vs. 14 days [IQR: 3, 238]). Among clinic patients
Background: In 2007, the Ministry of Health of Mozambique reported 151431 pregnant
women with HIV identified at health facilities. 29.7% of them received antiretroviral (ARV)
prophylaxis and only 14% of HIV-exposed children were tested at 18 months. Follow up of
HIV exposed and identifying HIV-positive children as early as possible is critical to improve
access to ARV treatment. EGPAF, with other partners, assessed the acceptability of
including HIV specific information on the MOH child health card.
Methods: A cross sectional study was implemented in December 2008 in six health facilities
in three provinces, using interviews and focus group discussions. The study surveyed 63
health workers including 30 MCH nurses and 270 mothers attending MCH clinic services of
which 49 (18%) were HIV-positive. Focus groups discussions were done with 27 volunteers
and 11 community leaders. Data were entered in EPIdata and analyzed using SPSS.
Qualitative data were reviewed for key themes manually.
Results: More than 90% of health workers and 87% of mothers considered it important to
include information regarding the provision of ARV prophylaxis, cotrimoxazole prophylaxis,
HIV testing and antiretroviral treatment for children.
Only 27% of health workers and 10% of mothers responded that these additions to the health
card will not be accepted by the community, because of stigma.
All health workers, volunteers and community leaders thought that the changes would
improve the follow up of HIV-exposed children.
Background: Similar to other Western-European countries, Belgium's communities of Sub-
Saharan African migrants are affected by a concentrated HIV-epidemic, characterized by late
diagnoses and high percentages of serostatus unawareness. To develop tailored
interventions, the perceptions, needs and barriers towards opt-in and opt-out HIV-testing
were assessed among communities and physicians.
Methods: This qualitative study used purposive sampling to recruit 70 community members
and 20 physicians for 8 focus group discussions and in-depth interviews respectively.
Following grounded theory principles, data were transcribed verbatim and manually analyzed
for recurrent themes using categories and codes until saturation was achieved.
Results: Due to cultural pronunciation of health and responsibility, most community
members are in favor of HIV-testing but expect physicians to propose it. Multiple, inter-
twinned and stigma related barriers withhold African migrants from voluntary testing. Fearing
positive test-results and the related medical, personal, legal and social consequences, most
prefer ignorance about their HIV-status and consequently do not seek HIV-testing. They
expect their physician, culturally perceived as a respected authority, to propose necessary
medical interventions. Physicians, however, perform HIV-testing only when requested,
following medical indications or known risk behavior. Target group focused opt-out testing, as
Background: In rural Haiti, communication is most often by word of mouth, due in part to
lack of or sporadic power sources. In 2002 Partners In Health/Zanmi Lasante (PIH/ZL)
initiated the community-based education and prevention program: Noyau Educatif
Communautaire (NEC), including in one community (Belladeres, Haiti) where stigma against
people living with HIV was extremely high.
Methods: The program uses five young local people, with at least secondary school diploma,
in each district where PIH/ZL works. They run community-based education sessions in
schools, church and choir groups, boys and girl scout meetings, teachers groups and football
matches and have regular meetings with peasant farmers in their villages and with traditional
healers. NEC train trainers among villagers for the propagation of the work.
Results: Between 2003 and 2007 HIV testing at PIH/ZL clinics progressively increased from
23,511 tests per year to 76,326 tests per year (catchment area 550,000). The proportion of
positive cases decreased from 7.5% in 2003 to 4.8% in 2007. In Belladeres (population
65,000) a total of 50,106 HIV tests (77% of total population) were performed in the period
2003-2008. As many as 17% of the town's population were tested each year. Although some
people test more than once, this suggests a very high rate of 'knowing your status' in this
Background: The scale-up of antiretroviral treatment (ART) is a major achievement. ART
programmes could also importantly contribute to the prevention of new infections. We
examined what preventive services are available in ART programmes in resource-limited
settings.
Methods: Cross-sectional survey among ART programmes participating in ART-LINC of
IeDEA Collaboration, a network of clinics in sub-Saharan Africa, Asia and Latin America. The
questionnaire covered health education; psycho-social support; disclosure of HIV status,
counselling and testing; partner notification; prevention of mother to child transmission
(PMTCT); provision of condoms; screening for sexually transmitted infections (STIs) and
activities to reduce stigma.
Results: 27 sites were approached and 22 (81.5%) participated: 16 (72.7%) from sub-
Saharan Africa, 1 from North-Africa, 3 from Latin America and 2 from Asia. 21 sites (95.5%)
provided health education and social support, and 18 (81.8%) HIV testing and counselling. All
sites encouraged disclosure of HIV infection but only 11 (50%) had a protocol for partner
notification. 2 sites (9.1%) required disclosure to initiate ART. 21 sites (95.5%) supplied male
condoms, 7 (31.8%) female condoms and 20 (90.9%) provided prophylactic antiretrovirals for
PMTCT. 7 sites (31.8%) regularly screened for sexually transmitted infections, 12 (54.6%)
were involved in activities aimed at women or adolescents, and 10 (45.5%) in activities aimed
at HIV serodiscordant couples. Stigma and discrimination, gender roles and funding
constraints were perceived as the main obstacles to effective prevention in ART
programmes. Only one site was involved in activities to reduce stigma in the community.
Background: HIV-positive status disclosure has proven extremely challenging in PMTCT
programs when many women first become aware of their HIV status through the PMTCT
antenatal screening programmes. Non-disclosure may affect the PMTCT uptake, follow up,
adherence to drugs and infant feeding options.
Objectives:
1) determine the socio-demographic characteristics associated with disclosure of HIV-
positive women; and describe both challenges and successes of disclosure in PMTCT follow
up program.
Methods: Mulago Hospital is the National referral hospital located in Kampala Uganda.
Approximately 33,939 women attend the antenatal clinics each year and with use of routine
rapid HIV testing > 95% are tested; and 33,923 (99 %) received post-test counseling.
Women identified as HIV-positive are counseled on psychosocial issues, adherence and self-
disclosure of their HIV-positive status. They also receive PMTCT antiretroviral intervention
based on their gestational age and CD4 counts. They are then enrolled into the PMTCT
follow up clinic. These services are supported by PEPFAR funding
Results: A total of 5,280 women were given CD4 results between 5th Apr 2006 -22nd Jan
2009. 57% [95% CI 56-58%) disclosed their status. Among those disclosing 64% disclosed to
their partners. Married women were 1.3 times likely to disclose than unmarried while those
Background: Patient-level data are needed to optimize, monitor and evaluate HIV services.
Their confidentiality and security need to be safe-guarded to avoid stigmatization and
discrimination of people living with HIV. The UNAIDS/PEPFAR Interim Guidelines on
Protecting the Confidentiality and Security of HIV Information [1] can guide the development
and implementation of country guidelines.
Methods: Two questionnaires assessed the existence of country guidelines September 2007
- April 2008: one for countries, which had such guidelines (G-countries, 21) and one for
those, which did not (NG-countries, 57). Questionnaires covered 98 middle- and lower-
income countries. Questions were scored, aggregated and weighted to produce a standard
score for each of six categories: information infrastructure, country policies, data collection,
data storage, data transfer and data access. Standardised scores were analyzed using
univariate and multivariate regression analyses for associations with country HIV prevalence,
GNP per capita, OECD income, participating in the U.S. PEPFAR initiative, and being a G- or
NG country.
Results: For the 78 (80%) returned questionnaires, median scores of the categories varied
between 59.6 (IQR 41.8 to 69.7) and 80 (IQR 72.5 to 100). Based on the regression
analyses, higher scores were observed for information infrastructure comparing G- with NG-
countries. No significant differences in scores were observed between country policies or
data collection categories; for data storage and data transfer OECD lower middle-income and
G-countries had significantly lower scores, while for data access, G-countries had lower
scores.
Conclusions: G-countries provided a 'reality check' for developing and implementing these
guidelines. Most existing guidelines were substantially less comprehensive than
recommended by the Interim Guidelines [1]. Countries need to develop local guidelines,
within the context of local conditions but where possible using the published Guidelines to
guide efforts. Implementation may pose practical difficulties in resource-limited countries,
which may require assistance to develop and implement them.
1) http://www.unaids.org/en/HIV_data/Confidentiality_HIV_information/default.asp



Background: Studies of voluntary counseling and testing (VCT) have revealed disparate
results regarding its effectiveness as an education and prevention tool.
Methods: As part of a study of rural mobile VCT (MVCT) and HIV knowledge, attitudes and
risks in four villages in Northern Tanzania, 640 randomly selected community respondents
were surveyed in their homes prior to free village-based MVCT. 168 respondents were re-
surveyed at home prior to MVCT (same venue); 165 were re-surveyed during MVCT pre-test
counseling (changed venue). Agreement between responses was analyzed for 25 common
survey questions in 4 domains using kappa coefficients for nominal responses and Wilcoxon
Sign-Rank tests for mean domain scores.
Results: Mean (median) time between surveys was 22 (17) days. Across 7 internalized
stigma questions, k ranged from 0.33-0.56 for same venue and 0.25-0.46 for changed
venue. Mean internalized stigma scores (range 1-16) were 6.4 (first survey) vs. 5.5 (second
survey) in the same venue and 6.5 vs. 5.5 for changed venue (p < 0.01). Five witnessed
stigma questions yielded k of 0.12-0.46 for same venue and 0.08-0.27 for changed venue;
aggregate scores (range 1-5) were 2.1 vs. 2.2 (p=0.52) and 2.2 vs. 1.9 (p=0.02) for same
and changed venue, respectively. HIV knowledge (k 0.12-0.46 same venue, k 0.04-0.37
changed venue) aggregate scores (range 1-9) changed from 5.2 to 6.0 (p< 0.01) in same
Background: Widespread social ostracism, threat of violence, stigmatization, and structural
factors accounts for the increasing prevalence of HIV risks among men who have sex with
men (MSM) in Sub-Saharan Africa, including Liberia. Despite being a marginalized
population, MSM as a major community-based stakeholder, can play a significant role in the
mitigation of HIV/AIDS in post-conflict Liberia.
Methods: Twenty-five (25) males aged 18-40 years, who self-identified as MSM, were
interviewed by qualitative methods to ascertain their HIV risk behaviors and perceptions
regarding the development and implementation of HIV prevention programs for MSM in
Liberia. Each in-depth interview was audiotaped, transcribed and analyzed for common
themes.
Results: First, MSMs in post-conflict Liberia were identified to be at high risk for HIV/AIDS
because of the prevalence of unprotected sex, history of STIs, and limited knowledge of
HIV/STIs. Second, the lives of MSMs are characterized by cultural marginalization,
widespread discrimination and social rejection. Third, MSMs are concerned about the lack of
legislations to recognize, respect and protect their fundamental rights.
Conclusions: MSMs in post-conflict Liberia are willing to 'come out of the closet' and actively
participate in HIV prevention programming if relevant legislations are enacted to protect their
Background: Rates of HIV in Burma are suspected to be one of the highest in Asia.
However, access to accurate data is limited. Human rights violations and economic factors
cause many Burmese, especially ethnic minorities, to flee to neighbouring countries. Inside
Thailand, illegal migrants may experience oppressive conditions and access to HIV services
is limited. Our aim was to take a preliminary look at the first 150 interviews with HIV-positive
migrant workers collected from a clinic on the Thai-Burma border.
Methods: This cohort is a prospective study of HIV+ Burmese persons living in Thailand.
Participants are ≥18 years of age and recruited at the Mae Tao Clinic. Interviewer-
administered surveys collect information concerning demographics, food security, quality of
life, migration patterns, and violence among other variables. Descriptive data is presented
here.
Results: Of 150 people interviewed, 88 (59%) are women and the median age is 33 (IQR: 28-
38). Of the 144 (96%) people who receive regular care for their HIV, 108 (72%) attend a local
community based organization, and 38 (25%) attend an international NGO for care. The
median self-reported CD4 count was 204 (130-382) with 59 (39%) people receiving
antiretroviral therapy. The majority of people (95%) are illegal migrants and 141 (94%) are
Background: There remains considerable stigma and discrimination towards men who have
sex with men (MSM) in Nigeria. Though work has documented particularly high risk
behaviours, there remain limited services promoting healthy sexual behaviour amongst these
populations. Health care providers are largely unaware of the special needs of MSM and
nearly all available health education messages focus on vertical, iatrogenic and heterosexual
vaginal transmission of HIV/STI with no mention of the risks involved in either heterosexual or
homosexual unprotected anal sex. To address this gap Population Council, Nigeria designed
and implemented the Nigeria Men's Health Network (NMHN), the first comprehensive
prevention intervention programme focussing on high risk men.
Method: The NMHN employs multiple integrated approaches to create demand for and
availability of “hassle free” health and social services through the provision of a
comprehensive HIV prevention package to bring about behaviour change, change
community norms, improve access to and quality of community-Based Care and Treatment
(HCT) and Sexually Transmitted Disease (STI) services and to reduce HIV risk among men
engaged in high risk. Techniques used to achieve these goals include mapping of MSM
networks to employ social network approaches as a strategy for dissemination of health
information and to increase demand for health and prevention services among high risk men,
social franchising of health services to allow recognition of MSM-friendly health services by
Background: HIV prevention programs for persons living with HIV (PLHA) often target those
who are receiving care and treatment. There is little information on sexual behaviours of
'healthy' PLHA who are not receiving ART.
Methods: Researchers undertook a cross-sectional survey in Mombasa to examine sexual
behaviours of PLHA not receiving ART. A total of 698 PLHA (164 males; 534 females) were
recruited from the community through community health workers and post-test clubs.
Results: The mean age was 34 years, 34% were currently married and 77% had no contact
with HIV programs.
Fifty-nine percent of participants were sexually active. Males reported a higher median
number of sexual partners than females (15 vs. 4; p< 0.001) over the past 6 months.
Females reported sex with regular partners more frequently than males (80% vs. 62%; p<
0.001), while males reported sex with casual partners (11% vs. 8%) and sex workers (7% vs.
2%) more frequently than females (p< 0.001). Three-quarter of sexual partners were of
unknown HIV-status.
Unprotected sex (UPS) in the last 6-months was reported in 48% of sexual relationships.
Females reported UPS more commonly than male respondents (55% vs. 44%; p=0.01). On
multivariate analysis, non-disclosure of HIV-status to partners (AOR 2.47, 95% CI:1.53-3.99),
Background: Women in Africa continue to bear the double burden of STIS/HIV /AIDS
unabated. Despite the intensity and widespread advocacy for Behaviour Communication
Models in Kenya, women top the list of new infections each year. The purpose of this cohort
was to provide a non-stigmatizing environment where sex workers can access diagnosis and
treatment at no cost. STI diagnosis and treatment was based on Kenya National guidelines.
Methods: In a one year period, 200 female sex workers were enrolled for study. At
enrollement, all sex workers had risk assessment, pelvic examination, vaginal and blood
samples were collected at enrollement and after six months. After two weeks, clients
received laboratory results and treatment regimes revised. Syndromic diagnosis was
compared with laboratory diagnosis.
Results: 51.6% had positive tests for Bacterial Vaginosis, Candida and Trichomonas
Vaginalis. 18.2% had Pelvic Inflammatory Disease. Laboratory outcomes corresponded with
clinical diagnosis. In a six month period, 2% of the sex workers sero converted, 11 got
pregnant.
Conclusions: This study acknowledges that sex workers in this cohort are at higher risk of
STI/HIV /AIDS and unwanted pregnancies. Such an observation demonstrates the urgent
need for an intervention to stop this unprecedented crisis.
Background: Mainstreaming of HIV/AIDS is one of the most important constituents of
National AIDS Control Programme in India. Jharkhand could streamline the proccess with
successful mobilization of industries, trade unions, government departments with the
collaborative efforts of ILO and Jharkhand State AIDS Control Society.
Method: Advocacy, sensitization and capacity building are key approaches towards
generating response from various stakeholders. Policy, capacity building and linkages with
services are successful steps towards greater coverage of population on awareness building,
care and supports and restoring PLHIV rights at the workplace and community level.
Result: Good response observed on mainstreaming of HIV/AIDS in the agenda of
government departments, public and private sectors, trade unions and CBOs in Jharkhand
on priority basis. Policy has been developed by mining industries, business houses and trade
union of the state. Impact of the programme are as follows; - 17 industries of Jharkhand have
developed workplace programme with thousand of peer educators on coverage of workforce,
their family and community dewellers.·- 600 trained peer educators are implementing the
programme in different settings of government, organized and unorganized workforce and
community level.·- Pilot project initiated by trade union and government department have
Background: The risk of tuberculosis transmission is often given as a barrier to integrating
TB and HIV services at the primary care level. There are therefore few examples of
integrated services with appropriate TB infection control (IC) responses. Khayelitsha sub-
district, where HIV and TB services are provided together, has a TB case notification rate >
1500/100,000/year, with 67% of these HIV infected.
Methods: In response to high TB burden and the emerging threat of drug resistant TB, a
programme to implement TB IC measures in clinics with integrated TB and HIV services was
instituted. Given the high rate of undiagnosed TB among clinic clients, IC measures are
implemented throughout clinics, not just in TB areas. These include: initial clinic
assessments, the establishment of IC committees, health care worker training, customised
information materials, measures to maximise natural ventilation and the provision of
respirator masks for staff and paper masks for clients in waiting areas.
Results: IC committees have been established in all 9 clinics in Khayelitsha, although
implementation of IC measures has been variable. Committees have been trained and
provided with information materials and resources. Natural ventilation has been improved
through installation of wind-driven air extractors, waiting areas have been modified and
Background: Voluntary Counselling and Testing (VCT) is a central component of the South
African government's strategy to prevent the spread of HIV and to provide care and support
to those living with HIV/AIDS. In South Africa about 60% of tuberculosis (TB) patients have
HIV co-infection (WHO, 2004). VCT is critical to effective HIV prevention and TB facilities are
optimal venues for delivery of these services. The study population was drawn from TB
patients attending the primary health care facilities in Buffalo city municipality in the Eastern
Cape Province. Eight participants were purposively selected to include those who had
accepted VCT as well as those who did not.
Methods: This was a qualitative exploratory descriptive study using in-depth interviews.
Results: Barriers were grouped into three broad themes namely; the health service barriers,
patient - based barriers and community based barriers. The health service barriers are not
different to those found in the literature as challenges to implementation of VCT. These are
lack of accessibility to VCT service, poor quality service, logistical barriers, negative attitudes
experienced. Community-based barriers are misconceptions, stigma, and discrimination.
Client-based barriers include lack of knowledge about HIV and TB co-infection, fear of
positive result, fear of AIDS related stigma, and uncertainty about subsequent eligibility for
antiretroviral treatment while still receiving TB treatment were identified as other potential
barriers to the uptake of VCT.
Conclusions: This study aimed to examine the barriers to VCT uptake by the TB patients.
Three broad themes emerged from the barriers to VCT: health system based, client based
Background: The PROQOL-HIV questionnaire, a new instrument measuring the health-
related quality-of-life (HRQL) of PLWHA in different cultures, was developed to face the
challenges of the HAART era. This study presents the biopsychosocial and clinical factors
impacting on HRQL in 8 populations identified by PROQOL-HIV.
Methods: 830 individuals from Australia, Brazil, Cambodia, China, France, Senegal,
Thailand and the USA completed the cross-sectional PROQOL-HIV survey. Statistical
analyses of HRQL scores were obtained using PROQOL-HIV and correlated with socio-
demographic and clinical data, including self reported symptoms.
Results: Mean age was 41±10 years, (37% women, 86% treated). CD4 mean number was
428±268 cells/µL, 75% had undetectable viral load. Total HRQL scores (N=822) were
expressed on a 100-point scale, and were similar across most populations. However HIV
infection had a greater impact on the HRQL of Chinese and Khmer [with lower HRQL scores
(p< .001)], particularly on physical health and symptoms, health concerns, and stigma
dimensions (adjusted for multiple comparisons p< .001).Most frequently reported symptoms
were tiredness (53%), insomnia (44%), and headache (44%). HRQL scores were inversely
Background: A collaboration was established between government and academic partners
in the fields of obstetrics, gynecology, pediatrics and psychiatry to evaluate the factors
contributing to repeat pregnancies of 30-40% among 800 HIV+ women.
Methods: Following focus group discussion, a questionnaire was designed and used to
interview 92 women. Qualitative and qualitative data were analyzed using Atlas Ti and SPSS,
respectively.
Results: 70% were in visiting relationships, 60% had high school education and were
unemployed and 68% depended on the partners for financial subsistence. Despite uniform
counseling and 80% attendance at HIV clinics, 60% did not believe their HIV+ status. 67%
perceived that their child was healthy, although 40% claimed they did not know their child's
HIV status. 64% of partners had been HIV-tested and 90% perceived that the partner was in
good health. 69% had 2-3 repeat pregnancies since diagnosed with HIV sero-positivity and
23% were currently pregnant. 70% reported contraceptive use, with condoms accounting for
66%, although only 33% reported consistent condom use, with 31% reporting partner
objection was the main reason against condom use 44% wanted a tubal ligation and 16%
already had one. Tubal ligation uptake correlated with rural clients, larger family size and
Background: Research on Identifying Sexual Health Policy Needs for MSM in K For more
than a decade, many MSM have experienced discrimination, self stigmatization, rejection,
discrimination in access to HIV/AIDS care and prevention systems, quality counseling of
MSM infected by HIV/AIDS/STI's, information related to sexual health and rights, unclear
policy reflections on access to reproductive health clinics, especially MSM who suffer or have
suffered from STI's. The degree to which MSM experience negative impacts of HIV/AIDS
infections differs tremendously-that is, geographical locations, access to media, distribution
of information, number of NGO's working on MSM issues within the region.
Study Methodologies: Research on Identifying Sexual Health Policy Needs for MSM in K
The research identifying sexual health policy needs in Kenya. Was designed in five folds
which involved; social demographic characteristics of MSM, in access to quality reproductive
health care, sexual practices and pattern, including drug use, HIV/AIDS/STI, knowledge and
access to services and interpersonal communication. The projects team focused more on
quantitative and qualitative in-depth analysis of key sexual health policy issues. The process
involved review of relevant literature; assess available data at broad selection with key
Background: TASO Uganda supported by the FRONTIERS Program, Population Council
initiated a diagnostic study. It was aimed at understanding adolescent sexuality (desires,
experiences, beliefs, values and practices) and identify fears they have around growing up,.A
survey was conducted in 2007 in Uganda among 732 adolescents aged 15-19 perinatally
infected with HIV. Focus group discussions,in-depth probes and case stories were
conducted.. An intervention planning phase followed in which three manuals were developed
targeting, counselors, parents/guardians and HIV positive adolescents.
Methods: A pre-test was carried out for all three manuals. Twenty adolescents attended the
pre- test. The pre-test employed short lectures, group discussions as well as brainstorming.
Results: Although HIV+ adolescents have aspirations, dreams and careers they worry about
their poverty, failing to finish school and reach their aspirations. . 3 out of 20 have been in
and out of school and one had started dating for financial benefits. The fears brought out
were:· The majority fear that their parents will die: and they will remain alone.· Time of death,
especially if they are going to be alone;· Falling sick as this would jeopardize their dreams
and aspirations or end in death· Getting step parents and be mistreated. · Loss of hope of
living and not fulfilling their dreams and aspirations. 15 /20 adolescents worry about taking
Background: In order to meet the MDG and Universal Access goals, HIV related stigma and
discrimination need to be addressed. The applied research (AR) component of STOP AIDS
NOW! (SAN!) project - Managing HIV and AIDS in the Workplace in Ugandan NGOs,
examined HIV related stigma and discrimination effects of workplace intervention on NGOs in
Uganda. Successes and failures in development and implementation of workplace policies
(WPP) were researched to enable organizations (re)direct activities towards successful WPP
development and implementation and stigma reduction.
Methods: The AR was conducted in three phases -1) developing policies; 2) implementation
of policies; 3) implementation and effects of policies. Quantitative and qualitative data
collection methods through surveys (n=406 phase, n=236 phase 3), case studies, focus
group discussions, and in-depth interviews in 76 NGOs were used. EPI-info was used to
analyze survey data; and content analysis for qualitative data, investigating differences by
genders, age, staff-levels and organization type.
Results: All organizations studied put in place anti- stigma and discrimination guidelines in
their WPP. WPP implementation has changed attitude towards disclosure, and willingness
for staff to discuss HIV issues. Information sharing and creation of an enabling environment
                                         Country of
AbsNo   New Abs No   PresType   Topic                   AbsTitle
                                         Research




                                                      Development
                                                      of real time
                                                      PCR
                                                      targeting
3250     CDA058      CDROM      A27     Brazil        protease to
                                                      discriminate
                                                      HIV-1 from
                                                      subtypes B
                                                      and F




                                                      Methylation
                                                      reversal in
                                                      high grade B
                                                      lymphoma
                                                      cell lines
                                                      identifies
                                                      novel
                                                      epigenetic
                                                      changes
                                        United
2146    MOPEA037       PE       A44                   conserved
                                        Kingdom
                                                      between
                                                      immunocomp
                                                      etent and HIV
                                                      positive hosts
                                                      and others
                                                      specific to
                                                      HIV-
                                                      associated
                                                      lymphoma



                                                      Use of HCP5-
                                                      single
                                                      nucleotide
                                                      polymorphis
                                                      m to predict
2326     TUAB203       OA       B26     Spain         abacavir
                                                      hypersensitivi
                                                      ty reactions:
                                                      correlation
                                                      with HLA-
                                                      B*5701
                                           “Know your
                                           child's HIV
                                           status
                                           campaign” -
                                           A strategy to
2503   WEPEB268    PE     B34   Uganda     increase child
                                           enrollment
                                           into care;
                                           lessons
                                           learned and
                                           challenges




                                           HIV
                                           vulnerable
                                           groups
                                           research: the
                                           potential
                                Solomon    impact of an
314     CDC064    CDROM   C30
                                Islands    HIV epidemic
                                           could be
                                           devastating
                                           for the
                                           Solomon
                                           Islands




                                           Intentions to
                                           provide
                                           dental
                                           treatment to
                                           the patients
                                           living with
1306   MOPEC021    PE     C33   Pakistan   HIV/AIDS
                                           (PLWHAs)
                                           among
                                           dentists of
                                           Balochistan,
                                           Pakistan,
                                           2008
                                         Qualitative
                                         assessment
2841   MOPEC034    PE     C33   India    of HIV risks
                                         among MSM
                                         in South India




                                         Voluntary
                                         HIV
                                         counseling
                                         and testing
                                         for prevention
                                Benin,   of mother-to-
442     CDC095    CDROM   C35
                                Canada   child
                                         transmission
                                         (PMTCT) in
                                         Benin, what
                                         mothers
                                         consent?




                                         Community
                                         involvement
                                         in biomedical
                                         prevention -
1263    CDC100    CDROM   C36   Uganda
                                         the case of
                                         TASO
                                         Northern
                                         Uganda
                                           Problems of
                                           HIV
                              Russian
1447   CDC102   CDROM   C36                prevention
                              Federation
                                           among
                                           homosexuals




                                           HIV status
                                           disclosure to
                                           partners of
                                           people living
                                           with
543    CDC107   CDROM   C37   Nigeria
                                           HIV/AIDS on
                                           highly active
                                           antiretroviral
                                           therapy at
                                           Ibadan




                                           Domestic
2875   CDC118   CDROM   C37   Zimbabwe
                                           violence
                                               Vulnerability
                                               to sexually
                                               transmissible
                                               diseases and
3558   WEPEC115    PE     C37   Brazil         AIDS of
                                               Brazilian
                                               women who
                                               work as sex
                                               workers




                                               Access to
                                               antiretroviral
                                               treatment by
                                               children in
                                               KwaZulu-
                                               Natal
113     CDD001    CDROM   D1    South Africa   province: a
                                               qualitative
                                               exploratory
                                               study into
                                               factors
                                               influencing
                                               poor access




                                               Scaling up
                                               access to
                                               antiretroviral
                                               therapy
                                               (ART) in low-
                                               and middle-
3666   WELBD105    OA     D3    Switzerland
                                               income
                                               countries:
                                               global and
                                               regional
                                               progress in
                                               2008
                               Benin, Brazil,   HIV risk
                               Burkina          reduction and
                               Faso, China,     empowermen
                               Cote D'Ivoire,   t among sex
                               Ghana, India,    workers: a
                               Indonesia,       systematic
781    WEPED184    PE     D4
                               Kenya,           review and
                               Madagascar,      meta-
                               Malawi,          analysis of
                               Singapore,       peer
                               South Africa,    behavioral
                               Thailand         interventions




                                                Effectiveness
                                                of national
                                                scale-up of
                                                HIV stigma
                                                and
2597    CDD047    CDROM   D4   Ghana
                                                discriminatio
                                                n reduction in
                                                health
                                                facilities in
                                                Ghana




                                             Identify the
                                             challenges in
                                             implementati
                                             on and
                                             suggest ways
                                             and means of
                                             collaboration
                               Afghanistan, between
                               Bangladesh, tuberculosis
                               Maldives,     and
653    TUPDD102    PD     D5
                               Nepal,        HIV/AIDS
                               Pakistan, Sri programmes
                               Lanka         in South
                                             Asian
                                             Association
                                             for Regional
                                             Cooperation
                                             (SAARC)
                                             member
                                             states
                                       Youth
                                       Friendly
                                       Centres
                                       (YFCs): a
                                       public-private
                                       partnership
                                       model for
                                       increasing
2809   CDD070   CDROM   D5   Nigeria
                                       HIV
                                       counselling
                                       and testing
                                       (HCT)
                                       services in
                                       resource
                                       poor
                                       environments


                                       An innovative
                                       approach to
                                       mainstream
                                       HIV care into
                                       existing
                                       health
                                       services
                                       through on
                                       site whole
                                       site infection
                                       prevention
1787   CDD080   CDROM   D6   India     training
                                       (OSWST) on
                                       standard
                                       (SIP)
                                       practices and
                                       stigma and
                                       discriminatio
                                       n (S&D)
                                       reduction:
                                       experience
                                       from South
                                       India
                                           Establishing
                                           VCT services
                                           in partnership
                                           with civil
                                           society: the
                                           role of
                                           Aceh´s
285    TUPED139    PE     D7   Indonesia
                                           positive
                                           support
                                           group in
                                           mentoring
                                           government
                                           health
                                           workers




                                           Role of
                                           positive
                                           people in
                                           irevention,
3300   CDD102     CDROM   D7   India       care, support
                                           & treatment
                                           services in
                                           New Delhi,
                                           India
                                              Improvement
                                              of human
                                              rights and
                                              access to
                                              legislative
                                              services for
                                              people living
939    WEPED216   PE   D8    Serbia           with
                                              HIV/AIDS in
                                              Serbia
                                              through
                                              better
                                              understandin
                                              g of Serbian
                                              legislation


                             Argentina,
                             Botswana,
                             Brazil,
                             Burundi,
                             Congo,
                                              Prioritising
                             Congo, the
                                              prevention
                             Democratic
                                              strategies for
                             Republic of
                                              patients in
                             the, Cote
                                              antiretroviral
1811   WEPED233   PE   D10   D'Ivoire,
                                              treatment
                             India, Malawi,
                                              programmes
                             Morocco,
                                              in resource-
                             Nigeria,
                                              limited
                             Rwanda,
                                              settings
                             South Africa,
                             Thailand,
                             Uganda,
                             Zambia,
                             Zimbabwe
                                Algeria,
                                Angola,
                                Argentina,
                                Armenia,
                                Azerbaijan,
                                Bahamas,
                                Bangladesh,
                                Barbados,
                                Belarus,
                                Botswana,
                                Brazil,
                                Bulgaria,
                                Burkina
                                Faso,         Protecting
                                Burundi,      HIV-
                                Cambodia,     information in
1371   TUPED152    PE     D12
                                Cameroon,     countries
                                Central       scaling up
                                African       HIV services
                                Republic,
                                China,
                                Colombia,
                                Congo,
                                Congo, the
                                Democratic
                                Republic of
                                the, Costa
                                Rica, Cote
                                D'Ivoire,
                                Dominican
                                Republic,
                                Ethiopia,
                                Ghana,




                                              HIV risk
                                              behaviors of
                                              men who
                                              have sex with
1066   CDD140     CDROM   D17   Liberia
                                              men (MSM)
                                              in post-
                                              conflict
                                              Liberia
                                          Study of HIV
                                          positive
                                          cases
                                          attending
                                          Integrated
                                          counseling
1947    CDD144    CDROM   D17   India
                                          and testing
                                          center
                                          (ICTC),
                                          Baroda, India
                                          - a gender
                                          perspective




                                          Nigeria men's
                                          health
                                          network
                                          programme
                                          for the
2259   MOPED033    PE     D17   Nigeria   prevention of
                                          HIV and STIs
                                          among men
                                          who have sex
                                          with men
                                          (MSM)




                                          Mainstreamin
                                          g, a process
                                          towards
                                          collective
                                          strength on
1794    CDD152    CDROM   D18   India
                                          HIV/AIDS
                                          prevention in
                                          India:
                                          Jharkhand
                                          experience
                                               Barriers to
                                               HIV
                                               counseling
                                               and testing
504    MOPED060    PE     D22   Nigeria        among
                                               women of
                                               child bearing
                                               age in Abujs,
                                               Nigeria




                                               An
                                               exploration of
                                               barriers
                                               associated
                                               with low
                                               voluntary
                                               counselling
                                               and testing
                                               uptake by
1360   MOPED061    PE     D22   South Africa   adult
                                               tuberculosis
                                               patients
                                               attending
                                               primary
                                               health care
                                               clinics,
                                               Buffalo City
                                               Municipality,
                                               Eastern Cape




                                               Issues of
                                               family
                                               planning
1389    CDD168    CDROM   D23   Jamaica        among HIV
                                               positive
                                               women in
                                               Jamaica
                                               Identifying
                                               sexual health
                                               policy needs
                                               for men who
                                               have sexs
                                               with men
661     CDD175    CDROM   D26   Kenya          (MSM) in
                                               access to
                                               quality
                                               HIV/AIDS
                                               care and
                                               prevention in
                                               Kenya




                                               Fears and
                                               worries of
                                               adolescents
                                               perinatally
1866   MOPED072    PE     D26   Uganda         infected with
                                               HIV in
                                               Uganda;
                                               TASO
                                               experience




                                               ´You become
                                               afraid to tell
                                               them that you
                                               are gay´:
                                               availability
                                               and utilisation
                                               of health
                                               services by
2670   MOPED080    PE     D26   South Africa
                                               men who
                                               have sex with
                                               men (MSM)
                                               in the
                                               Johannesbur
                                               g/eThekwini
                                               Men's Study
                                               (JEMS)
                                       HIV- related
                                       stigma and
                                       discriminatio
                                       n reduction
                                       through
                                       workplace
3527   CDD183   CDROM   D26   Uganda
                                       interventions
                                       in Ugandan
                                       NGOs:
                                       evidence
                                       from applied
                                       research
                                           AbsText
Background: The discovery of 42 HIV-1 circulating recombinants forms (CRF) together with
the innumerous unique HIV recombinants forms, made clear the role of genetic recombination
for the HIV epidemic. In Brazil, clades B, F, and C co-circulate, with 5 recently described
CRFs. Brazilians CRF_28 and 29 both present protease F whereas the majority of genome
are B. Real time PCR is a rapid and reliable tool, able to detect different HIV subtypes and
recombinant profiles. The aim of this study was to develop a real time PCR system for
protease region in order to detect HIV viral strains from subtypes B and F from cell culture as
well as in clinical samples.
Methods: MT-4 cells were separately infected with the viral strains BZ167 (subtype B) and
BR020 (subtype F), and supernatant was collected in order to optimizing the real time PCR
system developed to detect the subtype profile of protease region. The designed primers
should be able to equally amplify the subtype B and F, which should be discriminated by
subtype-specific probes. For validation of this PCR system, 97 clinical samples from patients
from the city of Santos were sequenced and phylogeneticaly analyzed.
Results: The estimated efficiency for protease system, for each probe, subtypes B and F
separately, were respectively 80,97 and 85,16%. Sequencing results revealed that from 97
Background: Methylation-dependent transcriptional silencing is an important mechanism of
tumour suppressor gene inactivation in neoplasia, including lymphoma.
Methods: Pharmacological “unmasking” of transcriptionally silenced genes in B lymphoma
cell lines was achieved using 5' deazacytidine +/- the histone deaacetylase inhibitor
Trichostatin A and subsequent analysis of mRNA levels on micro-array. Candidate genes thus
identified, were further analysed by qPCR, western blotting, methylation-specific PCR (MSP)
and bisulphite sequencing in B lymphoma cell lines and by MSP and q PCR in clinical samples
from sporadic (immunocompetent) (18 cases) and HIV-infected patients (14 cases). Samples
in both patient groups were diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma
(BL).
Results: We report the identification of 13 genes, not previously described as epigenetically
regulated, which are subject to methylation-dependent transcriptional silencing in high-grade
lymphoma. novel genes encode proteins with diverse functions, include pro-apoptotic
members of the p53 pathway (Scotin), transcriptional regulators (Baz2B), regulators of
telomerase (Smrf2), prolyly hydroxylases (P3H2 and P3H3) and others of uncertain or
unknown function. The frequency of methylation varied between 20% and 75%. Further,
methylation profiling of this gene panel discriminates between atypical DLBCL and BL and
between lymphomas arising in HIV-positive and immunecompetent hosts.
Conclusions: We describe a panel of genes subject to transcriptional silencing in high-grade
B lymphomas. The similar frequency of methylation observed in immunocompetent and HIV
Background: Abacavir is a potent nucleoside analogue reverse transcriptase inhibitor used
as part of HIV therapy. About 5-8% of patients receiving abacavir develop a hypersensitivity
reaction (HRS). Current guidelines recommend the screening of HLA-B*5701 to avoid HSR
given the strong association between this allele and the risk of abacavir HSR.A single
nucleotide polymorphism within the HLA Complex P5 gene (HCP5rs2395029) has shown to
be in high linkage disequibrium with HLA-B*5701. The objective of this study was to assess
the correlation between HLA-B*5701 and HCP5rs2395029 in our population.
Methods: All HIV patients naïve for abacavir at our institution were prospectively screened for
HLA-B*5701 between September 2007-December 2008. HCP5rs2395029 genotyping was
carried out by allelic discrimination using TaqMan 5´-nuclease assays. High resolution HLA
class I typing was undertaken using Micro-SSP.
Results: Paired examination of HLA-B*5701 and HCP5 was performed in 225 patients (80%
male, 73% Caucasians, 12% Africans, 15% Hispanics; median age was 41 years [IQR:33-
48]).Overall 12 patients carried HCP5rs2395029 and 11 of them were positive for HLA-
B*5701. The sensitivity of the HCP5snp for the carriage of HLA-B*5701 was 100%, specificity
99%, negative predictive value was 100%, positive predictive value was 92%. All negative
Background: Baylor-Uganda, with support from CDC/PEPFAR, expanded pediatric HIV/AIDS
services into 32 health facilities in 29 districts throughout Uganda in 2008. To improve
identification and treatment of HIV infected children, we implemented a program in adult ART
clinics entitled “Know Your Child's HIV Status”.
Methods: Guidelines for the implementation of the campaign were developed. Each health
facility formed a KYCS committee to run the campaign. Follow up meetings and phone
discussions were held between Baylor-Uganda and each committee for proper planning and
mobilization.
The date for the campaign was then publicized in health education talks at ART clinics. PHA
networks and groups supporting home-based care services helped mobilize families to attend
the HIV testing, counseling and referral services available that day.
Results: The campaign was successfully conducted in 31 of the 32 upcountry Baylor-Uganda
sites, as well as two partner ART clinics (IDC and ISS) in Kampala. A total of 4,737 people
were HIV tested; 4,363 (92.1%) were children. Among the children tested, 4,027 received their
results of whom 163 (4.0%) were HIV positive. DBS results of 336 infants are pending. Of the
374 adults tested, 39 (10.4%) were HIV positive, greater than the national adult sero-
prevalence of 6%. The success of the KYCS campaign was heavily dependent on the
Fear, misinformation about HIV, and the scarcity of HIV-testing services mean tha few
Solomon Islanders have ever been tested for the virus.Recent research revealed that the risk
of HIV infection in the Solomon Islands is high. It showed awareness about sex is low and that
females aged between 13 and 25 are. Along with other research, these reports have also
indicted high levels of unprotected sex-especially among young people resulting in a continous
increase in reported STIs and teenage pregnancies
Background: The research was conducted to assess the sexual behaviors and situations of
youth, SWs and MSM, its purpose is to strengthen the evidence base to inform HIV
interventions for these three groups. Data will give us (SCA) and other stakeholders including
the Solomon Islands National AIDS Council - a deeper insight into the situations, issues and
other needs of these groups, and enable the design of evidence -based HIV programs.
Methods: The research was qualitative study; a formative research strategy whereby
qualitative data was gathered to obtain a deeper insight and understanding of the situations of
the target groups. Qualitative data collection methods included focus group discussions
(FGD), individual in-depth interviews (IDI) with study subjects, and key informant interviews
(KIs). Observations took place at all sites. Interviews observed interaction between people
living within these communities and used this knowledge to verify stories collected from
interviews. Debriefing sessions were also held at all sites and were used to discuss the stories
and observations captured outside of formal interviews.
Results: In all of the locations among all study groups, evidence of one or several forms of
risky sexual behaviors were reported. in this report risky sexual practices refer to any activity
Background: Pakistan, as being the world´s second most populous Muslim nation, has also
started to experience and confront the HIV/AIDS epidemic. Pakistan has been identified as a
low prevalence but high risk country for HIV/AIDS. The society in Pakistan has not yet
accepted HIV/AIDS as having anything to do with them. HIV is considered extremely
shameful, particularly in the rural setting. Awareness about HIV/AIDS in general is extremely
limited. The PLWHAs are being denied of getting dental treatment in dental hospitals & clinics.
Methods: This study was a cross-sectional descriptive postal survey which included 115
dentists, out of which 86 responded.
A pre-test of instrument was done for validity and further improvements among dentists.
General characteristics of the dentists were summarized by using descriptive statistics.
Pearson Chi-square and Spearman's rank correlation test was used.
Results: The results revealed that only 25% of the dentists expressed their willingness to
provide dental treatment to the patients living with HIV/AIDS. On the other hand 17% of the
dentists would refuse to provide dental treatment to PLWHAs. Of those who intent to provide
treatment; 10% of the 86 dentists will treat such patients as a normal patient. Of those dentists
who would prefer to refuse the PLWHAs; 7% of 86 dentists will refuse due to lack of proper
Background: Men who have sex with men (MSM) are an evolving risk group for HIV infection
in India. Earlier we described high prevalence and correlates of HIV infection among 721 MSM
in Tamil Nadu (TN), India. Marriage was strongly associated with HIV, HSV-2 and syphilis.
Overall uptake of VCT and health care services were low among this population and the
prevalence of unprotected anal intercourse was high. We followed up this quantitative survey
with a series of focus groups to identify appropriate acceptable interventions for MSM
populations in South India.
Methods: Five focus groups with 12 individuals per group were conducted during the Feb
2009 across South India. These focus groups were aimed at gathering information on reasons
for poor health care, VCT access, marriage, sexual risk practices, appropriate interventions,
substance abuse patterns and mental health issues.
Results: The participants of the focus groups were both married and unmarried in these focus
groups and key findings are: stigma and discrimination were primary reasons for low health
care utilization. Social compliance and family situations force marriages on MSM Most married
MSM were not open to the option of referring their wives for a HIV test as they were unsure of
Background: Many studies about the national program about HIV/AIDS prevention of mother-
to-child transmission (PMTCT) in Benin as well as in many other sub-Saharan African
countries have shown a high level of testing of pregnant mothers (70 to 80%) of those seen at
antenatal clinics. But, what exactly are these women consenting to? This question is even
more important than the weakness concerning the follow up after the testing. Many of these
mothers often disappear from sight after this test. The question now becomes are these ladies
agreeing to do the tests in their entire mind or not.
Methods: While we were doing our research on the analysis of the program implementation
we chose to use a mixed approach by using qualitative and quantitative methods by
observation without participation, semi-directed interviews (30) undertaken with medical staff
and questionnaires given to 359 mothers in antenatal clinics.
Results: It appears from this study that low educated women (less than six years of study)
present a very low level of HIV testing refusal compared to more educated women. Many
women agree to be tested just to follow the crowd. The length and content of the individual
counseling is limited and women get the complete results of the tests only if they are tested
positive. Some do not inform their partners and others change their medical book or medical
centre to try to give birth anonymously. Medical staff think the amount of lost patient trace is
due to general context of discrimination and stigmatism.
Background: The AIDS Support Organization [TASO] realized many of her clients who came
for support services had no follow up support in the community while most of its clinics and
counseling services were over stretched and over burdened. At the same time, center was
being flooded with request for training and support for various community groups.
Aim: TASO realized that by giving people at the grass root levels, the basic skills needed for
home care, counseling and AIDS education, the community would do some thing and do it
better for themselves and they would be able to extend the HIV/AIDS services to more people.
Methods: A based line survey was carried out and quantitative data was collected and
evaluated, and analysis made. Information of the findings was disseminated to the
communities .A plan of actions in partnership with the community programmed to fill the gaps
in knowledge attitudes and practices that were impeding the spread of HIV transmission in the
community.
Results: Communities were empowered at the local level in order to track and handle the
AIDS problems themselves. There was enough HIV/AIDS awareness through community
sensitization. The number of community members coming to seek for Voluntary Counseling
and Testing Care and Support increased compared to the ones of the previous period. There
was a reduced levels of AIDS stigma and Discrimination amongst the communities.
Background: The main hypothesis is community of gays, bisexuals and transsexuals of
Russia is “closed” for HIV prevention programmes. The abstract expounds analysis of
prevention campaign on “A Day of Victims´ Memory of Repression for Homosexuality”. Its
purpose is prevention HIV among MSM.
Methods: Association of lesbians, gays, bisexuals and transsexuals (LGBT) of RF noted the
sad event (75 years of law about criminal punishment for homosexuality) on 17th of December
in 2008. The campaign was held by members of “The homosexuals' club”. The Club works in
the Republic Fight and Prevention Center against AIDS and Infectious Diseases, MH of RT.
Its aim is prevention HIV among MSM. The members of the homosexuals' club in Kazan set
fire to 75 candles at the memorial to victims of repression.
Results: The peculiarity of this campaign is that 70 % of the members didn't come there
because of discrimination and homophobia. The law against homosexuals was recalled 16
years ago, but homosexuals conceal their non-tradition orientation. The attitude of population
towards homosexuals is important for the members of “The Club”. Some MSM are afraid of
camera because of misconceptions among general population. Association of LGBT is
“closed” for population. HIV prevention programmes for MSM are complicated and demand
peculiar way of their leading.
Conclusions: Providing HIV prevention, professionals should take into consideration that
MSM is “closed” group in Russia. It's necessary to organize and support HIV prevention
groups to give MSM the feeling of protection. New campaigns should be created to make
Background: Many PLWHA had been known from various studies to hide their HIV status
from their spouse or partner because of fear of stigma and the stressful effect it has on
relationship with their family. The objective is to determine factors related to partner disclosure
of HIV status of PLWHA
Method: Descriptive cross sectional study. A self-administered questionnaire on disclosure of
HIV status to their partners was distributed among PLWHA on HAART. Data was collected,
entered and analyzed using Statistical Package for Social Sciences version 11
Results: Three hundred and ten PLWHA completed the questionnaire. The mean age of the
subjects was 36.7±9.3 years with a range of 18-65years. There were 36% males and 64%
females. Thirty-three percent had tertiary education while 52% had secondary education. Only
5.9% had no formal education. Majority (56%) were traders while 27.3% were civil servants.
Only 13.6% were unemployed. One hundred and fifty (48.4%) were currently married, 73
(23.5%) were divorced while 86 (27.7%) were widowed. Seventy percent of those married
were monogamous while thirty percent were polygamous. Most (75%) who were married at
the time of study had never told their partner about their HIV status because of fear of stigma.
Fifteen percent of those who told their partners of their HIV status reported stressful
Background: The World AIDS Campaign for the years 2002 - 2003 focused on stigma,
discrimination and human rights. The main objective of the campaign was to prevent, reduce
and ultimately eliminate HIV/AIDS related stigma and discrimination. Unemployment in
Zimbabwe is over 80% one of the highest in the world, this increase vulnerability to HIV &
AIDS in several ways.The study sought to investigate the impact and discrimination on women
suffering from domestic violence, by investigating the impact of violence and HIV on
livelihoods, levels of domestic violence in the home, their experience of disclosure to others
their views on how stigma can be alleviated in the community and the benefit of counselling in
dealing with discrimination.Background information on domestic violence and on HIV/AIDS,
stigma and discrimination were researched. The literature review focused on how stigma is a
violation of human rights, and this is worsened by cultural norms that make women
themselves accept violence as in inevitable consequence in relationships.
Methods: A qualitative research design using the Case Study approach guided the
researcher in data collection and analysis. The participants comprised of 500 women. The
Internet, Questionnaire and Standardised Open Ended were used as data collection
instruments.
In Brazil, the activitiy engaged by prostitutes or sex professionals is considered an
independent profession and can be registered at the National Social Welfare Institute. Bill
98/2003, which is following its course for legal approval, rules on the profession and, if
passed, will expand the rights of sex professionals.
Objective: the study characterizes vulnerability to sexually transmissible diseases (STD) and
HIV/aids of women who work as sex professionals in a large Brazilian city (São Paulo).
Methods: Qualitative case-study. Interviews with four sex professionals were recorded,
transcribed and submitted to discourse analysis. The following categories and subcategories
were: a) work characteristics (time of work, workload, number of clients a day, values and
how to charge clients, violence and employment ties ); b) knowledge and experience in
STD/aids (information, history of STDs ), and c) conditions that boost or minimize vulnerability
(access to health services, utilization of protection measures, forms of aggregation ).
Results: vulnerability to STDs and HIV/aids of women who work in prostitution is presented
when: they do not use measures of protection with steady partner (boyfriend) and in the
beginning of their professional activity; there is previous history of STD (HPV and leucorrhea);
there are multiple sexual partners and a high number of sexual relations; unawareness about
HIV routes of transmission; differentiated prices for unprotected sex. Vulnerability is minimized
Background: KwaZulu-Natal province (KZN) has one of the greatest HIV burdens in the
world. The government introduced the antiretroviral treatment (ART) to eligible people in order
to reduce the morbidity and mortality. Despite widespread availability of ART in KZN, there is
poor access by children to ART compared to adults, and children continue to die because of
HIV and AIDS. This qualitative study explored psychosocial and health system factors that
influence paediatric access to ART in KZN from parents and caregivers perspectives.
Methods: The ecological theory and the social cognitive theory was used to formulate an
interview schedule used in conducting the in-depth interviews with parents or guardians who
were bringing their children for ART-services and those attending these services themselves
at two hospitals in KZN. Purposive sampling was used to select clients for interviews and
thematic was done in accordance with the aims and objectives of the study.
Results: Low uptake of child ART was found to be influenced by several psychosocial and
economic factors such as the poor knowledge about ART, stigma and disclosure associated
with HIV, extent of support provided by parents/caregivers, parent's own ART was a
determinant for bringing children for ART, use of traditional / alternative medicines,
disintegrated families, especially the issue of multiple caregivers, complexity of paediatric
Background: UN member states have committed to Universal Access to HIV prevention,
treatment, care and support in 2010. WHO, UNICEF and UNAIDS support the monitoring of
national and global progress towards key interventions, including access to ART.
Methods: WHO and UNICEF developed a joint reporting tool for collecting data on progress
in the health sector response to HIV/AIDS. Data collected include the number of people on
ART at the end of 2008, disagregated by age and sex. Countries were requested to report by
31 March 2009. Country data were validated through a process involving national authorities,
key implementing partners and UN and donor agencies at national, regional and global levels
Results: At the time of abstract submission, 93 low- and middle-income countries had
reported data. At the end of 2008, between 3.8 and 4.3 million people were currently on ART,
including between 235 000 and 270 000 children less than 15 years, representing an increase
of more than 1 million since the end of 2007 and progress of about 33%. Between 2.7 and 3.1
million people were on treatment at the end of 2008 in sub-Saharan Africa, representing about
40% progress in one year. Nevertheless, progress is unequally distributed among regions and
countries.
Conclusions: Despite continuous progress, Universal Access to ART is not likely to be
Background: Sex workers have been described as one of the most vulnerable risk groups for
HIV infection, not only due to high risk sexual behaviors but also resulting from discrimination
and marginalization within the larger society. Peer interventions may be effective in reducing
HIV risk and promoting empowerment among sex workers by providing knowledge and skills
regarding HIV risk reduction appropriate to sex worker's social contexts. The objective of this
review was to assess the effect of peer interventions in reducing HIV risk and promoting
empowerment among sex workers.
Methods: The comprehensive search strategy included searching multiple electronic
databases with no language, time or geographical restrictions to locate relevant articles,
including Medline, AIDSLine, CINAHIL, and EMBASE. Data was extracted from included
studies and study quality assessed. Meta-analyses were conducted on controlled studies
when studies utilized similar interventions and the same type of outcome.
Results: Twenty-four trials including over 10 990 participants were included. Peer
interventions in five studies were significantly associated with increased consistent condom
use (OR 3.18 [CI: 1.17, 8.66], p< .05). Peer interventions in eight trials found significant
impacts on increased occasional condom use (OR 1.71 [1.31, 2.23], p < 0.001). Peer
Background: Fear of HIV-related stigma and discrimination deters people from proven
prevention technologies, HIV testing, disclosing a positive result (including to intimate
partners) and HIV treatment and support services. Stigma reduction is recognized as a key
structural approach to the HIV response. To promote universal access to HIV services,
EngenderHealth's Quality Health Partners (QHP) project scaled-up a stigma reduction
initiative at care and treatment centers across Ghana. This intervention included training
providers on stigma reduction and infection control, and use of quality improvement processes
to address stigma.
Methods: An assessment of this initiative was conducted from November-December 2008,
using quantitative and qualitative methods, including interviews of health workers and clients;
interviews with informants from affected communities (FSW, MSM and PLHIV); analysis of
problem statements within quality improvement action plans; and a review of stigma reduction
trainings results. In all, 63 respondents were interviewed, and 16 facilities´ action plans were
reviewed.
Results: Stigma reduction training among providers showed a marked increase in knowledge
and positive attitudes. Moreover, the majority of clients (85%) reported that HIV stigma no
Background: Addressing HIV associated Tuberculosis is an important component of the new
"Stop TB Strategy". SAARC is an association of eight countries. Some SAARC countries have
initiated some TB /HIV collaborative activities. However, TB/HIV collaboration is yet to take off
in a big way in SAARC member countries. Some of the reasons are barriers due to the
differences in programme implementation like fully decentralized DOTS services and issues
related to stigma and discrimination associated with both the diseases, more so with
HIV/AIDS. Hence, the study was carried out to assess strengths, opportunities, barriers and
threats to TB/HIV collaboration in SAARC Member countries and to provide pragmatic
recommendations according to national and international guidelines.
Methods: An institution based qualitative study was carried out at different levels of TB and
HIV/AIDS programme implementation units in Afghanistan, Bangladesh, Maldives, Nepal,
Pakistan, and Sri Lanka. Data was collected by trained interviewers using an interviewer
administered questionnaire. Data was analyzed making SWOT analysis.
Results: National Coordination committee, policy and strategy, focal person and guidelines for
implementing TB &HIV collaborative activities currently exist in Sri Lanka ,Bangladesh,
Afghanistan and Pakistan. Diagnosis and treatment of active TB among HIV infected is not
being carried out routinely by all study countries except in Maldives. MDR- TB is not a major
concern for all the studied SAARC countries. None of the countries implemented INH and Co-
trimoxazole prophylaxis therapy routinely. Majority stated lack of trained man power, lack of
research and weak monitoring and evaluation were the major obstacles for TB HIV
collaborative activity. Negative attitudes among health care workers towards PLHA were the
major threat for collaboration activities in the SAARC Member countries.
Background: The estimates of HIV/AIDS prevalence and number of People Living with
HIV/AIDS (PLWHA) in Nigeria are 4.6% and about 3 million respectively. Nigeria has the third
largest number of PLWHA in the world after India and South Africa with about 833,000
requiring ART treatment. There is a large pool of people living with HIV/ AIDS and unaware of
their status. This emphasises the need to scale up access to HCT services.In Nigeria, the
disease burden disproportionately affects the productive age group (15-29 years) with
prevalence rates higher than the National average. This age group constitutes the highest
percentage of the populations in tertiary institutions, yet most of these institutions lack regular
HIV/AIDS control programmes and where they exist, only about 1% deliver HCT services.
Furthermore, the tertiary institutions are faced with severe budgetary constraints, focused on
improving education standards and lack capacity to appropriately address issues of stigma
and discrimination.Therefore, NACA developed an innovative PPP model intervention for
tertiary institutions. Ecobank Nigeria Plc support infrastructure development, host schools
provide staff, while NACA provides technical assistance, test kits, capacity building and
monitoring & evaluation in 7 pilot institutions.
Methods: Access to HCT services through institutional medical centres (before YFCs) was
compared with access through the Youth Friendly Centres through data obtained from
questionnaires and monthly reports of YFC.
Background: Irrational fear of acquiring HIV at work contributes to S&D by Health Workers
(HW) against PLHIV and is a barrier to provide quality services. Implementing Standard
Infection Prevention (SIP) practices is perceived as expensive. Where resources are
available, the emphasis is more on getting materials rather than on system development or
building capacity. The project seeks to improve SIP practices and encourage staff to develop
positive attitudes towards PLHIV.
Methods: 16 NGO HCCs (20-200 bed) attempted to scale-up HIV care by mainstreaming HIV
into existing services Training Of Trainers (ToT) workshop to train field staff as Master
Trainers (MT)s was conducted who in turn conducted an OSWST at their HCCs which were
mentored and SIP practices were quantified prior to and at frequent intervals afterwards with
IP Quantifying Tool (IPQT). Staff attitude towards PLHIV was assessed on semi-quantitative
scale which was administered before and immediately after the training.
Results: 10 HCCs have conducted OSWST for which data is available. Staffs from all
departments (including housekeeping) participated and represented in Hospital Infection
Prevention Committees (HIPC). SIP scores on all ten parameters improved 3 months after
training- overall 100% increase (29%- to-57%). Major improvements occurred in Cleaning of
Surgical Instruments (-9%-to-50%) and in House Keeping and Waste disposal practices (-
15%-to-55%). Staff's attitude towards PLHIV increase from 3.2-to-3.5 (1-4 point scale; four is
most favorable score). Two more follow up scorings are planned (q3 months) are planned
before July'09.
Discussion: Incorporating SIP and S&D training encourages health workers to delve into
attitudes towards PLHIV and ensures acceptance of SIP and fosters a positive attitude
towards PLHIV. OSWST approach, in contrast to off-site trainings allows all cadres of workers
to work as a team, encourages decentralization and shared ownership saving mangers' time
thus allowing for sustainability.
Background: Aceh province is engaging simultaneously with post-tsunami rehabilitation and
an emerging awareness of the need to address HIV. The health system is struggling to meet
the needs of increasing numbers of people who require access to appropriate services.
Voluntary counseling and testing (VCT) and clinical management of HIV has been introduced
however the province is regarded as low prevalence, and few resources are available to
ensure high quality services are operational and accessible.
Methods: We studied structures and systems required to meet emerging HIV care, support
and treatment needs. The recently established positive support group in Aceh worked in
partnership with the provincial health office to provide on-the-job mentoring and supervision to
government counselors and clinicians involved in patient care. This has been formalized into
regular support and supervision visits, mentoring and refresher training delivered in
partnership with national and provincial government. Focus group discussions with health
workers and clients are used to assess ongoing knowledge and skills needs.
Results: The role of people living with HIV in the ongoing capacity strengthening of health
workers has resulted in a high profile for people living with HIV and consequently, the
positioning of the needs of patients at the forefront of clinical and allied service delivery, rather
than a more traditional model of clinician-led delivery. A clear referral network has been
Background: Stigma & discrimination against PLHAs continue to be a major problem. There
are complaints of PLHAs being denied care, insulted and turned out of the hospital.
Methods: Delhi State AIDS Control Society (DSACS) involved PLHAs to monitor its service
delivery system as under:
1. PLHA member in State AIDS Council, Executive Committee and ART Review Committee to
address grievances at highest level.
2. Empanelled Drop in Centres run by Positive Networks , including a Women Net Work to
provide enabling environment, guide positive people, address rights, organize regular
meetings, track HIV +ve women & Baby and coordinate with DSACS for improvement.
3. Public Positive Speaking- Trained positive people are invited to present their feelings to
public to reduce stigma & discrimination.
4. Networks to monitor HIV/AIDS service delivery centres of DSACS for any deficiencies.
Results: With involvement of positive people several deficiencies were taken care of from
time to time like:
1. Ensuring adequate number of manpower, HIV test kits, OI drugs, ARV drugs at the centres.
2. Health facilities requiring sensitization of medical & paramedical staff on HIV/AIDS
sensitized to reduce stigma & discrimination
3. Complaints of stigma & discrimination examined through local committees with PLHA
representative and report submitted to ART Review Committee.
4. A meeting of Medical Superintendents of all Delhi Govt hospitals organized under
Chairmanship of Principal Secretary (Health) to ensure provision of services to all positive
people with love & care without stigma & discrimination.
5. A Widow Pension cell was created at DSACS to help widows apply to State Govt.
Conclusion: Positive people are more concerned for care of their counterparts compared to
Background: Widespread discrimination is preventing many countries from adopting effective
preventative measures against HIV/AIDS. In this battle against HIV/AIDS, the protection of
human rights is as important as the protection of public health. Only by supporting human
rights we can successfully tackle the disease. Discrimination and stigmatization may often be
the result of certain legislative solutions. UNDP CO/UN Theme Group on HIV/AIDS in Serbia
have supported review of existing legislation towards PLHIV in Serbia. The aim was to
acquaint PLHIV with their rights, possibilities and to improve access to services. A group of
experts undertook an analysis of Serbian legislation in order to find out if there are regulations
of a discriminatory and/or stigmatizing character, and to find out what kinds of regulations are
missing when it comes to the protection of PLHIV
Methods: The analysis of regulations of the Republic of Serbia regarding testing, protection of
confidential information, keeping of medical records and files, health insurance, criminal
liability for transmission of the disease, social welfare, compensation, education, work, status
of children living with HIV, were performed, and compared to the key international treaties and
other international documents pertaining to HIV/AIDS .
Results: Serbian legislation contains provisions that could be adjusted or amended in order to
Background: The scale-up of antiretroviral treatment (ART) is a major achievement. ART
programmes could also importantly contribute to the prevention of new infections. We
examined what preventive services are available in ART programmes in resource-limited
settings.
Methods: Cross-sectional survey among ART programmes participating in ART-LINC of
IeDEA Collaboration, a network of clinics in sub-Saharan Africa, Asia and Latin America. The
questionnaire covered health education; psycho-social support; disclosure of HIV status,
counselling and testing; partner notification; prevention of mother to child transmission
(PMTCT); provision of condoms; screening for sexually transmitted infections (STIs) and
activities to reduce stigma.
Results: 27 sites were approached and 22 (81.5%) participated: 16 (72.7%) from sub-
Saharan Africa, 1 from North-Africa, 3 from Latin America and 2 from Asia. 21 sites (95.5%)
provided health education and social support, and 18 (81.8%) HIV testing and counselling. All
sites encouraged disclosure of HIV infection but only 11 (50%) had a protocol for partner
notification. 2 sites (9.1%) required disclosure to initiate ART. 21 sites (95.5%) supplied male
condoms, 7 (31.8%) female condoms and 20 (90.9%) provided prophylactic antiretrovirals for
PMTCT. 7 sites (31.8%) regularly screened for sexually transmitted infections, 12 (54.6%)
were involved in activities aimed at women or adolescents, and 10 (45.5%) in activities aimed
at HIV serodiscordant couples. Stigma and discrimination, gender roles and funding
constraints were perceived as the main obstacles to effective prevention in ART programmes.
Only one site was involved in activities to reduce stigma in the community.
Background: Patient-level data are needed to optimize, monitor and evaluate HIV services.
Their confidentiality and security need to be safe-guarded to avoid stigmatization and
discrimination of people living with HIV. The UNAIDS/PEPFAR Interim Guidelines on
Protecting the Confidentiality and Security of HIV Information [1] can guide the development
and implementation of country guidelines.
Methods: Two questionnaires assessed the existence of country guidelines September 2007 -
April 2008: one for countries, which had such guidelines (G-countries, 21) and one for those,
which did not (NG-countries, 57). Questionnaires covered 98 middle- and lower-income
countries. Questions were scored, aggregated and weighted to produce a standard score for
each of six categories: information infrastructure, country policies, data collection, data
storage, data transfer and data access. Standardised scores were analyzed using univariate
and multivariate regression analyses for associations with country HIV prevalence, GNP per
capita, OECD income, participating in the U.S. PEPFAR initiative, and being a G- or NG
country.
Results: For the 78 (80%) returned questionnaires, median scores of the categories varied
between 59.6 (IQR 41.8 to 69.7) and 80 (IQR 72.5 to 100). Based on the regression analyses,
higher scores were observed for information infrastructure comparing G- with NG-countries.
No significant differences in scores were observed between country policies or data collection
categories; for data storage and data transfer OECD lower middle-income and G-countries
had significantly lower scores, while for data access, G-countries had lower scores.
Conclusions: G-countries provided a 'reality check' for developing and implementing these
guidelines. Most existing guidelines were substantially less comprehensive than
recommended by the Interim Guidelines [1]. Countries need to develop local guidelines, within
the context of local conditions but where possible using the published Guidelines to guide
efforts. Implementation may pose practical difficulties in resource-limited countries, which may
require assistance to develop and implement them.
1) http://www.unaids.org/en/HIV_data/Confidentiality_HIV_information/default.asp



Background: Widespread social ostracism, threat of violence, stigmatization, and structural
factors accounts for the increasing prevalence of HIV risks among men who have sex with
men (MSM) in Sub-Saharan Africa, including Liberia. Despite being a marginalized population,
MSM as a major community-based stakeholder, can play a significant role in the mitigation of
HIV/AIDS in post-conflict Liberia.
Methods: Twenty-five (25) males aged 18-40 years, who self-identified as MSM, were
interviewed by qualitative methods to ascertain their HIV risk behaviors and perceptions
regarding the development and implementation of HIV prevention programs for MSM in
Liberia. Each in-depth interview was audiotaped, transcribed and analyzed for common
themes.
Results: First, MSMs in post-conflict Liberia were identified to be at high risk for HIV/AIDS
because of the prevalence of unprotected sex, history of STIs, and limited knowledge of
HIV/STIs. Second, the lives of MSMs are characterized by cultural marginalization,
widespread discrimination and social rejection. Third, MSMs are concerned about the lack of
legislations to recognize, respect and protect their fundamental rights.
Conclusions: MSMs in post-conflict Liberia are willing to 'come out of the closet' and actively
participate in HIV prevention programming if relevant legislations are enacted to protect their
Background/Research Question: Are there gender-based differences in acquisition of
infection, health seeking behaviour and social support in HIV positive men and women?
Objectives: 1. To find out the pattern of high risk behavior related to acquisition of HIV/AIDS.
2. To understand the social support system and gender discrimination if any, among HIV
positive males and females. 3. To find out the health seeking behaviour and ability to access
health services among HIV positive males and females.
Methods: This was a cross sectional study of >13 yrs old HIV positive 50 male and 50 female
cases attending ICTC located at SSG Hospital, Baroda during April-July 2007. A semi-
structured and pretested proforma was used to interview these HIV positive cases.
Results: In 45 % cases, spouse was HIV positive while 31 % cases didn't know of the HIV
status of their spouse. More males presented with history of premarital sex (83 %),
extramarital sex (64 %), multiple sex partners (84 %) and continued high risk behavior even
after HIV infection. More number of females experienced careless behavior/neglect (65 %)
after HIV status disclosure to their spouse and family. 9 % cases were the victims of domestic
violence of whom majority were females (75 %). Majority of males (59 %) had contacted
private clinic/hospital initially for their health problems while females contacted government
facility.
Conclusions: More males indulged in high risk behavior related to acquisition of HIV/AIDS.
Health seeking behavior of females was affected by male dominance and their economic
Background: There remains considerable stigma and discrimination towards men who have
sex with men (MSM) in Nigeria. Though work has documented particularly high risk
behaviours, there remain limited services promoting healthy sexual behaviour amongst these
populations. Health care providers are largely unaware of the special needs of MSM and
nearly all available health education messages focus on vertical, iatrogenic and heterosexual
vaginal transmission of HIV/STI with no mention of the risks involved in either heterosexual or
homosexual unprotected anal sex. To address this gap Population Council, Nigeria designed
and implemented the Nigeria Men's Health Network (NMHN), the first comprehensive
prevention intervention programme focussing on high risk men.
Method: The NMHN employs multiple integrated approaches to create demand for and
availability of “hassle free” health and social services through the provision of a
comprehensive HIV prevention package to bring about behaviour change, change community
norms, improve access to and quality of community-Based Care and Treatment (HCT) and
Sexually Transmitted Disease (STI) services and to reduce HIV risk among men engaged in
high risk. Techniques used to achieve these goals include mapping of MSM networks to
employ social network approaches as a strategy for dissemination of health information and to
increase demand for health and prevention services among high risk men, social franchising
of health services to allow recognition of MSM-friendly health services by those in need, and
Background: Mainstreaming of HIV/AIDS is one of the most important constituents of
National AIDS Control Programme in India. Jharkhand could streamline the proccess with
successful mobilization of industries, trade unions, government departments with the
collaborative efforts of ILO and Jharkhand State AIDS Control Society.
Method: Advocacy, sensitization and capacity building are key approaches towards
generating response from various stakeholders. Policy, capacity building and linkages with
services are successful steps towards greater coverage of population on awareness building,
care and supports and restoring PLHIV rights at the workplace and community level.
Result: Good response observed on mainstreaming of HIV/AIDS in the agenda of
government departments, public and private sectors, trade unions and CBOs in Jharkhand on
priority basis. Policy has been developed by mining industries, business houses and trade
union of the state. Impact of the programme are as follows; - 17 industries of Jharkhand have
developed workplace programme with thousand of peer educators on coverage of workforce,
their family and community dewellers.·- 600 trained peer educators are implementing the
programme in different settings of government, organized and unorganized workforce and
community level.·- Pilot project initiated by trade union and government department have
Background: HCT programmes have demonstrated their ability to increase safe sexual
behavior and use of care and support services among adults. Despite the various strategies
employed by governmental and NGOs to encourage HCT, the percentage of people that know
their status is quite low. This study was conducted to identify the barriers of HCT among
women of child bearing age in Abuja, Nigeria.
Methods: A cross sectional study was carried out among women attending district health
facilities in the Abuja. Ten district facilities were randomly selected and hundred women
interviewed in each hospital. A semi structured interviewer questionnaire was adminstered.
Descriptive statistics, chi square test and logistic regression analysis were used to test for
significance of associations.
Results: 1000 women were studied with a mean age of 31.8years (SD=5.7). About 27% had
tertiary education while 20% had secondary or no formal education.. The proportion of women
who had undergone VCT was 31.5% though 92% knew a place to get an HIV test. Among
those who never tested reasons for not testing include: never asked or required (58.5%),
offered but not required (3.3%), fear of discrimination (4.1%), long waiting times (2.9%) and
Background: Voluntary Counselling and Testing (VCT) is a central component of the South
African government's strategy to prevent the spread of HIV and to provide care and support to
those living with HIV/AIDS. In South Africa about 60% of tuberculosis (TB) patients have HIV
co-infection (WHO, 2004). VCT is critical to effective HIV prevention and TB facilities are
optimal venues for delivery of these services. The study population was drawn from TB
patients attending the primary health care facilities in Buffalo city municipality in the Eastern
Cape Province. Eight participants were purposively selected to include those who had
accepted VCT as well as those who did not.
Methods: This was a qualitative exploratory descriptive study using in-depth interviews.
Results: Barriers were grouped into three broad themes namely; the health service barriers,
patient - based barriers and community based barriers. The health service barriers are not
different to those found in the literature as challenges to implementation of VCT. These are
lack of accessibility to VCT service, poor quality service, logistical barriers, negative attitudes
experienced. Community-based barriers are misconceptions, stigma, and discrimination.
Client-based barriers include lack of knowledge about HIV and TB co-infection, fear of positive
result, fear of AIDS related stigma, and uncertainty about subsequent eligibility for
antiretroviral treatment while still receiving TB treatment were identified as other potential
barriers to the uptake of VCT.
Conclusions: This study aimed to examine the barriers to VCT uptake by the TB patients.
Three broad themes emerged from the barriers to VCT: health system based, client based
Background: A collaboration was established between government and academic partners in
the fields of obstetrics, gynecology, pediatrics and psychiatry to evaluate the factors
contributing to repeat pregnancies of 30-40% among 800 HIV+ women.
Methods: Following focus group discussion, a questionnaire was designed and used to
interview 92 women. Qualitative and qualitative data were analyzed using Atlas Ti and SPSS,
respectively.
Results: 70% were in visiting relationships, 60% had high school education and were
unemployed and 68% depended on the partners for financial subsistence. Despite uniform
counseling and 80% attendance at HIV clinics, 60% did not believe their HIV+ status. 67%
perceived that their child was healthy, although 40% claimed they did not know their child's
HIV status. 64% of partners had been HIV-tested and 90% perceived that the partner was in
good health. 69% had 2-3 repeat pregnancies since diagnosed with HIV sero-positivity and
23% were currently pregnant. 70% reported contraceptive use, with condoms accounting for
66%, although only 33% reported consistent condom use, with 31% reporting partner
objection was the main reason against condom use 44% wanted a tubal ligation and 16%
already had one. Tubal ligation uptake correlated with rural clients, larger family size and
Background: Research on Identifying Sexual Health Policy Needs for MSM in K For more
than a decade, many MSM have experienced discrimination, self stigmatization, rejection,
discrimination in access to HIV/AIDS care and prevention systems, quality counseling of MSM
infected by HIV/AIDS/STI's, information related to sexual health and rights, unclear policy
reflections on access to reproductive health clinics, especially MSM who suffer or have
suffered from STI's. The degree to which MSM experience negative impacts of HIV/AIDS
infections differs tremendously-that is, geographical locations, access to media, distribution of
information, number of NGO's working on MSM issues within the region.
Study Methodologies: Research on Identifying Sexual Health Policy Needs for MSM in K
The research identifying sexual health policy needs in Kenya. Was designed in five folds
which involved; social demographic characteristics of MSM, in access to quality reproductive
health care, sexual practices and pattern, including drug use, HIV/AIDS/STI, knowledge and
access to services and interpersonal communication. The projects team focused more on
quantitative and qualitative in-depth analysis of key sexual health policy issues. The process
involved review of relevant literature; assess available data at broad selection with key
Background: TASO Uganda supported by the FRONTIERS Program, Population Council
initiated a diagnostic study. It was aimed at understanding adolescent sexuality (desires,
experiences, beliefs, values and practices) and identify fears they have around growing up,.A
survey was conducted in 2007 in Uganda among 732 adolescents aged 15-19 perinatally
infected with HIV. Focus group discussions,in-depth probes and case stories were
conducted.. An intervention planning phase followed in which three manuals were developed
targeting, counselors, parents/guardians and HIV positive adolescents.
Methods: A pre-test was carried out for all three manuals. Twenty adolescents attended the
pre- test. The pre-test employed short lectures, group discussions as well as brainstorming.
Results: Although HIV+ adolescents have aspirations, dreams and careers they worry about
their poverty, failing to finish school and reach their aspirations. . 3 out of 20 have been in and
out of school and one had started dating for financial benefits. The fears brought out were:·
The majority fear that their parents will die: and they will remain alone.· Time of death,
especially if they are going to be alone;· Falling sick as this would jeopardize their dreams and
aspirations or end in death· Getting step parents and be mistreated. · Loss of hope of living
and not fulfilling their dreams and aspirations. 15 /20 adolescents worry about taking medicine
Background: The Johannesburg/eThekwini Men's Study (JEMS) was conducted to provide
information on HIV among men who have sex with men (MSM) in two South African cities
(Johannesburg and Durban) and to assess the availability of programmes and health services
for MSM, in response to the stated commitments of the South African National Strategic Plan
on HIV & AIDS and STIs, 2007-2011 .
Methods: Perceived service access and needs were assessed using 32 key informant
interviews (KIIs) and 18 focus group discussions (FGDs) with MSM. 282 MSM were recruited
into a survey using respondent-driven sampling. Survey participants completed a
questionnaire which included a section on health service use, and provided finger-prick blood
specimens for HIV testing.
Results: The HIV prevalence among survey participants was 44% (38% adjusted). Health
services and prevention programmes targeting MSM were almost non-existent. Many FGD
participants were reluctant to use public sector health services and to disclose their sexual
orientation to health workers due to having experienced judgemental attitudes and
discrimination. Of survey participants, 57% had used a public sector health service and 45%
had used a private health service in the past year. Only 31% had health insurance coverage.
Health service use and health insurance coverage did not differ by HIV status. Preferred
providers for HIV prevention services were: a gay centre (62%); community centre (12%); or
youth centre (10%); with only 7% stating preference for a government clinic.
Conclusions: This study results confirm that there is an urgent need to allocate resources
Background: In order to meet the MDG and Universal Access goals, HIV related stigma and
discrimination need to be addressed. The applied research (AR) component of STOP AIDS
NOW! (SAN!) project - Managing HIV and AIDS in the Workplace in Ugandan NGOs,
examined HIV related stigma and discrimination effects of workplace intervention on NGOs in
Uganda. Successes and failures in development and implementation of workplace policies
(WPP) were researched to enable organizations (re)direct activities towards successful WPP
development and implementation and stigma reduction.
Methods: The AR was conducted in three phases -1) developing policies; 2) implementation
of policies; 3) implementation and effects of policies. Quantitative and qualitative data
collection methods through surveys (n=406 phase, n=236 phase 3), case studies, focus group
discussions, and in-depth interviews in 76 NGOs were used. EPI-info was used to analyze
survey data; and content analysis for qualitative data, investigating differences by genders,
age, staff-levels and organization type.
Results: All organizations studied put in place anti- stigma and discrimination guidelines in
their WPP. WPP implementation has changed attitude towards disclosure, and willingness for
staff to discuss HIV issues. Information sharing and creation of an enabling environment for
                                         Country of
AbsNo   New Abs No   PresType   Topic                   AbsTitle
                                         Research
                                                      Diverse
                                                      patterns of
                                                      non-
                                                      adherence
                                                      are
                                                      associated
                                                      with
3486     CDB128      CDROM      B41     Italy         differently
                                                      impaired
                                                      genotypic
                                                      resistance
                                                      test at
                                                      HAART
                                                      virological
                                                      failure




                                                      Vulnerability
                                                      to sexually
                                                      transmissible
                                                      diseases and
3558    WEPEC115       PE       C37     Brazil        AIDS of
                                                      Brazilian
                                                      women who
                                                      work as sex
                                                      workers
                                            ´You become
                                            afraid to tell
                                            them that you
                                            are gay´:
                                            availability
                                            and utilisation
                                            of health
                                            services by
2670   MOPED080   PE   D26   South Africa
                                            men who
                                            have sex with
                                            men (MSM)
                                            in the
                                            Johannesbur
                                            g/eThekwini
                                            Men's Study
                                            (JEMS)
                                            AbsText
Background: The association between non-adherence and virological response has been
reported to be regimen-specific. We aimed to investigate whether diverse patterns of non-
adherence are associated with differently impaired concomitant genotypic resistance test
(GRT).
Methods: All patients having a self-administered questionnaire on adherence with a
concomitant GRT were included. GRTs were reinterpreted by using the Stanford Algorithm
giving to each drug the following score: 1 for susceptibility, 0.5 for intermediate resistance, 0
for resistance. Summing the scores of individual drugs for each class (NRTI, NNRTI, PI/b) a
“future class sensitivity score” (FCSS) was obatained. Linear regression analysis was
employed to assess the association of specific non-adherence patterns with FCSS.
Results: 68 patients included: the mean number of previous virological failures was 2.0
(range 0-5). Median HIV-RNA and CD4 at failure were: 3.68 (IQR 2.56-4.46) log10/ml and 337
(189-496) cells/mmc, respectively. Current regimen included PI/b in 68%, NNRTI in 20.5%,
single PI in 7%. Prevalence of patterns of non-adherence were: < 95% of therapy
taken/prescribed in the last month=23.5%; < 100% doses taken/prescribed in the last
week=22.4%; timing deviation=48.5; drug holidays in the last month=23.9; interruption in drug
In Brazil, the activitiy engaged by prostitutes or sex professionals is considered an
independent profession and can be registered at the National Social Welfare Institute. Bill
98/2003, which is following its course for legal approval, rules on the profession and, if
passed, will expand the rights of sex professionals.
Objective: the study characterizes vulnerability to sexually transmissible diseases (STD) and
HIV/aids of women who work as sex professionals in a large Brazilian city (São Paulo).
Methods: Qualitative case-study. Interviews with four sex professionals were recorded,
transcribed and submitted to discourse analysis. The following categories and subcategories
were: a) work characteristics (time of work, workload, number of clients a day, values and
how to charge clients, violence and employment ties ); b) knowledge and experience in
STD/aids (information, history of STDs ), and c) conditions that boost or minimize vulnerability
(access to health services, utilization of protection measures, forms of aggregation ).
Results: vulnerability to STDs and HIV/aids of women who work in prostitution is presented
when: they do not use measures of protection with steady partner (boyfriend) and in the
beginning of their professional activity; there is previous history of STD (HPV and leucorrhea);
there are multiple sexual partners and a high number of sexual relations; unawareness about
HIV routes of transmission; differentiated prices for unprotected sex. Vulnerability is minimized
Background: The Johannesburg/eThekwini Men's Study (JEMS) was conducted to provide
information on HIV among men who have sex with men (MSM) in two South African cities
(Johannesburg and Durban) and to assess the availability of programmes and health services
for MSM, in response to the stated commitments of the South African National Strategic Plan
on HIV & AIDS and STIs, 2007-2011 .
Methods: Perceived service access and needs were assessed using 32 key informant
interviews (KIIs) and 18 focus group discussions (FGDs) with MSM. 282 MSM were recruited
into a survey using respondent-driven sampling. Survey participants completed a
questionnaire which included a section on health service use, and provided finger-prick blood
specimens for HIV testing.
Results: The HIV prevalence among survey participants was 44% (38% adjusted). Health
services and prevention programmes targeting MSM were almost non-existent. Many FGD
participants were reluctant to use public sector health services and to disclose their sexual
orientation to health workers due to having experienced judgemental attitudes and
discrimination. Of survey participants, 57% had used a public sector health service and 45%
had used a private health service in the past year. Only 31% had health insurance coverage.
Health service use and health insurance coverage did not differ by HIV status. Preferred
providers for HIV prevention services were: a gay centre (62%); community centre (12%); or
youth centre (10%); with only 7% stating preference for a government clinic.
Conclusions: This study results confirm that there is an urgent need to allocate resources
                                         Country of
AbsNo   New Abs No   PresType   Topic                   AbsTitle
                                         Research

                                                      Intentions to
                                                      provide
                                                      dental
                                                      treatment to
                                                      the patients
                                                      living with
1306    MOPEC021       PE       C33     Pakistan      HIV/AIDS
                                                      (PLWHAs)
                                                      among
                                                      dentists of
                                                      Balochistan,
                                                      Pakistan,
                                                      2008
                                            AbsText
Background: Pakistan, as being the world´s second most populous Muslim nation, has also
started to experience and confront the HIV/AIDS epidemic. Pakistan has been identified as a
low prevalence but high risk country for HIV/AIDS. The society in Pakistan has not yet
accepted HIV/AIDS as having anything to do with them. HIV is considered extremely
shameful, particularly in the rural setting. Awareness about HIV/AIDS in general is extremely
limited. The PLWHAs are being denied of getting dental treatment in dental hospitals & clinics.
Methods: This study was a cross-sectional descriptive postal survey which included 115
dentists, out of which 86 responded.
A pre-test of instrument was done for validity and further improvements among dentists.
General characteristics of the dentists were summarized by using descriptive statistics.
Pearson Chi-square and Spearman's rank correlation test was used.
Results: The results revealed that only 25% of the dentists expressed their willingness to
provide dental treatment to the patients living with HIV/AIDS. On the other hand 17% of the
dentists would refuse to provide dental treatment to PLWHAs. Of those who intent to provide
treatment; 10% of the 86 dentists will treat such patients as a normal patient. Of those dentists
who would prefer to refuse the PLWHAs; 7% of 86 dentists will refuse due to lack of proper

				
DOCUMENT INFO
Description: Sample Swot Analysis in Patient Safety document sample