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Dissertations / Theses on the topic 'AIDS epidemiology'
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1
Labeodan, Moremi Morire OreOluwapo. "Stochastic analysis of AIDS epidemiology." Thesis, Pretoria : [s.l.], 2009. http://upetd.up.ac.za/thesis/available/etd-10172009-112824.
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2
De, Angelis Daniela. "Statistical methods in AIDS epidemiology." Thesis, University of Cambridge, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614931.
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Abati, Paulo Afonso Martins. "Análise do perfil sociodemográfico, clínico e laboratorial de pessoas com mais de 13 anos vivendo com HIV/AIDS no oeste do Pará e tendências de incidência de AIDS em Santarém." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5134/tde-27032013-103812/.
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A infecção pelo vírus da imunodeficiência humana na Amazônia tem-se mostrado como um dos mais recentes desafios para o enfrentamento da epidemia de HIV/aids no Brasil. Estudos epidemiológicos baseados em dados de incidência mostram tendência de crescimento da epidemia na região Norte do país. O Serviço de Assistência Especializada de Santarém é referência em assistência às pessoas com HIV/aids de 25 municípios das mesorregiões do baixo Amazonas e sudoeste do Pará. Os objetivos do presente trabalho consistem em descrever as características sociodemográficas, clínicas e laboratoriais de pessoas vivendo com HIV à admissão nesse serviço de referência, comparando-as entre os períodos: 1999 a 2002(P1), 2003 a 2006(P2) e 2007 a 2010(P3) e analisar as tendências de incidência de aids em Santarém entre 1999 e 2010. As informações referentes às variáveis de interesse foram obtidas em revisão de prontuários. Foram calculados os coeficientes de incidência padronizados a partir dos casos notificados de aids em Santarém, obtidos em bases de dados nacionais e locais. A análise de tendência de incidência foi realizada por modelos de regressão polinomial. A maioria dos 527 sujeitos (62,4%) foi admitida em P3, com 24,1% e 13,5% em P2 e P1, respectivamente. Observou-se aumento significativo da participação de indivíduos não procedentes de Santarém em P3 em comparação a P1. Verificou-se diferença significativa entre os sexos com relação ao motivo de realização da testagem pelo fato do conhecimento da soropositividade do parceiro ter motivado a testagem entre as mulheres em P1 e P2. Enquanto a presença de sinais e sintomas sugestivos de HIV/aids motivou o teste em homens durante todo o período avaliado. Houve redução significativa das medianas de linfócitos T CD4+ à admissão em P3, em relação a P1 e P2. Foram notificados 336 casos novos de aids em Santarém no período de 1999 a 2010. Foi encontrada tendência significativa de crescimento da epidemia em Santarém em ambos os sexos, e nas categorias de exposição ao HIV heterossexual e homo/bissexual no sexo masculino. O crescimento da demanda assistencial no serviço de Santarém, com incremento do número de pacientes procedentes de municípios menores e, admitidos em estadios tardios da infecção, associada à tendência de crescimento de incidência de aids em Santarém no período estudado, sugerem que as intervenções programáticas implementadas na região podem ter contribuído para o reconhecimento de maior número de casos de aids, porém ainda não possibilitaram o diagnóstico mais precoce. Acredita-se que estratégias de vigilância epidemiológica de segunda geração poderiam subsidiar de modo mais eficiente as intervenções programáticas voltadas ao controle da epidemia em uma região caracterizada por apresentar fatores individuais, sociais e programáticos que conferem vulnerabilidade acrescida à infecção pelo HIV.<br>Infection with human immunodeficiency virus within the Amazon region has been shown as one of the latest challenges confronting the HIV/AIDS epidemic in Brazil. Epidemiological studies based on incidence data show an increasing trend in AIDS incidence in the Brazilian North region. The specialized HIV/AIDS outpatient clinic of Santarém is the reference healthcare setting that provides care for people living with HIV/AIDS (PLHA) from 25 municipalities of the Lower Amazon and southwestern Pará regions. The aims of this study are to describe socio-demographic, clinical and laboratory features of PLHA at time of admission to this reference clinic, comparing them among the following periods: 1999 to 2002 (P1), 2003 and 2006 (P2) and 2007 and 2010 (P3), and to analyze AIDS incidence trends in Santarém between 1999 and 2010. Information about variables of interest was obtained by review of medical records. Standardized AIDS incidence rates were calculated, based on cases reported in Santarém, using data obtained from national and local databases. Incidence trend analysis was performed by polynomial regression. Out of 527 records, 62.4% of patients were admitted to the clinic in P3, 24.1% and 13.5% in P2 and P1, respectively. A significant increase was seen in the participation of individuals from cities other than Santarém in P3, as compared to P1. There was a significant gender difference in the reason to be tested for HIV, as women were more likely to have been tested due to a seropositive partner in P1 and P2, whereas existing signs and symptoms of HIV/AIDS predominated among men as the reason for testing throughout the study period. A significant reduction in median CD4+ cell counts at admission was noticed comparing P3 to P1 and P2. 336 AIDS cases were reported in Santarém from 1999 to 2010. An increasing AIDS incidence trend was found for both genders, and for both heterosexual and homo/bisexual among males. The increasing local demand for HIV/AIDS care, with larger numbers of cases coming from smaller cities and admitted in later stages of HIV infection, taken together with the increasing AIDS incidence trend in Santarém during the study period suggest that even though programmatic interventions may have succeeded in identifying more AIDS cases, they were not able to lead to an earlier diagnosis. We believe that the implementation of second generation surveillance strategies in this region could guide programmatic interventions for the control of the epidemic more efficiently, in a context characterized by individual, social and programmatic factors related to a high vulnerability to HIV infection.
4
David, Jummy Funke. "Mathematical epidemiology of HIV/AIDS and tuberculosis co-infection." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/54295.
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The project deals with the analysis of a general dynamical model for the spread of HIV/AIDS and tuberculosis Co-infection. We capture in the model the dynamics of HIV/AIDS infected individuals and investigate their impacts in the progression
of tuberculosis with and without TB treatment. It is shown that TB-only model and HIV-only model have locally asymptotically stable disease-free equilibrium when the basic reproduction number is less than unity and a unique endemic equilibrium
exists when the basic reproduction number is greater than unity. We analyze the full HIV/AIDS-TB coinfection model and incorporate treatment strategy for the exposed and active forms of TB. The stability of equilibria is derived through the
use of Van den Driessche method of generational matrix and Routh Harwitz stability criterion. Numerical simulations are provided to justify the analytical results and to investigate the effect of change of certain parameters on the co-infection.
Sensitivity analysis shows that reducing the most sensitive parameters β₁ and β₂ could help to lower the basic reproduction number and thereby reducing the rate of infection. From the study, we conclude that treating latent and active forms of TB
reduce the rate of infection, reduce the rate of progression of individuals to AIDS stage and lowers co-infection.<br>Science, Faculty of<br>Mathematics, Department of<br>Graduate
5
Wilde, Lindsey. "The Impact of Transmission Mode on HIV/AIDS Medication Adherence." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5957.
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Medication adherence amongst HIV/AIDS infected individuals can be challenging for many reasons. I examined whether there was an association between mode of HIV transmission, such as sexual intercourse, mother to child, or IV drug use, and medication adherence among HIV+ individuals 18 years and older living in New York City. The theoretical base for this study was the Social Ecological Systems Theory. Logistic regression analyses were conducted on field data obtained from the New York State Medicaid Agency from 2015. Results indicated that transmission mode, age, race, and poverty level all have statistically significant associations with the dependent variable of medication adherence. The individuals most and least likely to adhere to ART were MSM and perinatal groups, respectively. Increased age predicted increased medication adherence rates, while increased poverty level predicted decreased medication adherence rates. Caucasian and Asian/Pacific Islander races had the highest rates of medication adherence, while Hispanics had lowest rates of adherence. Alternatively, there were no statistically significant relationships between New York City borough of residence or gender on an individual's medication adherence rate. This research contributed to filling a literature gap in the HIV field since no published literature to date had examined the association between transmission mode and ART medication adherence. This study's findings can be used to lead to a positive social change by allowing those in the HIV and public health fields to identify the varying needs of populations based on transmission mode, which could help individuals achieve long lasting medication adherence, and which in turn, could result in longer lives for those with HIV/AIDS.
6
Eaton, Twilla. "Epidemiology of Mycobacterium avium complex infecting AIDS patients." Thesis, This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-03302010-020032/.
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Nyotta, Phyllis Catherine. "The Impact of Stigma on HIV/AIDS Testing Among Kenyan Diaspora women." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4469.
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Researchers have considered HIV/AIDS in Kenya as the largest HIV pandemic in the world, with about 6.3 million individuals living with the disease as of 2013. About 25% of new HIV patients are adult women, aged 15 to 24 years old. Guided by the health belief model (HBM), the purpose of this quantitative cross-sectional survey research study was to explore the influence of various dimensions of HIV/AIDS stigma (public, self, enacted, and structural) on the uptake of HIV testing among Kenyan Diaspora women in United States. Multiple linear regression analysis was used to test if there was a correlation between HIV/AIDS stigma and the uptake of HIV testing on Kenyan Diaspora women. Preliminary analyses showed the relationships were approximately linear with the residuals normally distributed, as assessed by skewness and kurtosis statistics, and there were no outliers. The results for these four research questions were not significant. The results of the study indicated that perceived levels of stigma among Kenyan Diaspora women living with HIV/AIDS did not correlate with differing levels of uptake for testing and treatment. This study promoted positive social change through encouraging HIV testing by raising awareness and understanding about HIV/AIDS, especially during the early stages of the disease. Thus, promoting positive social change in encouraging Kenyan Diaspora women to engage in HIV testing to ensure they were safe for sexual encounters or to breastfeed their children. Similar studies could carry out research to examine the influence of factors other than stigma on uptake of testing and treatment for those living with HIV/AIDS.
8
Parkhurst, Justin Oliver. "HIV prevention policy in sub-Saharan Africa : the Ugandan experience." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270134.
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Lastoria, Leticia Chamma [UNESP]. "Colonização por Staphylococcus aureus em pessoas vivendo com HIV/AIDS acompanhadas em um serviço ambulatorial de referência em Botucatu (SP): prevalência, resistência à meticilina e epidemiologia molecular." Universidade Estadual Paulista (UNESP), 2016. http://hdl.handle.net/11449/140292.
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Previous issue date: 2016-02-25<br>Staphylococcus aureus resistente à meticilina (Methicillin-resistant S. aureus, MRSA) é cada vez mais reconhecido como uma ameaça para pessoas vivendo com HIV/AIDS (PVHA). No entanto, a magnitude da colonização por MRSA varia entre diferentes países e regiões geográficas. Nós realizamos um estudo que teve por objetivo identificar a prevalência e os fatores de risco para colonização por S. aureus como um todo e MRSA em PVHA residindo em cidades de pequeno porte do interior do Estado de São Paulo. Isolados de MRSA foram caracterizados por Eletroforese em Gel de Campo Pulsado (Pulsed-Field Gel Electrophoresis, PFGE) e tiveram o Cassete Cromossômico Estafilocóccico (Staphylococcal Chromosome Cassete, SCC) mec tipado. Análise espacial foi realizada para identificar agregados geográficos e correlação com indicadores socioeconômicos. No primeiro momento, realizamos um estudo de prevalência pontual coletando swab nasal e de orofaringe de 368 PVHA atendidas em ambulatório de referência em Botucatu, SP. Sessenta e sete sujeitos residentes na cidade sede foram seguidos com coletas em dois outros momentos, e tiveram seus contactantes domiciliares também investigados para colonização. As taxas de prevalência de S. aureus e MRSA no primeiro levantamento foram 25,8% e 2,7%. A colonização por S. aureus foi negativamente associada com o uso de antibióticos beta-lactâmicos e drogas ilícitas. Por outro lado, fatores de risco para MRSA incluíam uso de crack e internação hospitalar recente. Inquéritos repetidos identificaram novos casos de colonização por MRSA, mas nenhum sujeito apresentou positividade em mais de uma ocasião. Quatro clusters foram identificados na PFGE, agrupando sujeitos em diferentes níveis – domicílio, cidade, região. Dos 19 isolados caracterizados, apenas um não carreava o SCCmec tipo IV. Análise espacial identificou hot spots par sujeitos colonizados com S. aureus, mas não conseguimos ligar esse padrão a indicadores sócio-econômicos. Em conclusão, nós idenficamos baixa – mas relevante – prevalência de MRSA em PVHA. Foram identificados tanto fatores de risco tradicionalmente associados a aquisição na comunidade quanto outros ligados a exposição a hospitais, de modo que as rotas predominantes de transmissão não puderam ser determinadas com base epidemiológica.<br>Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized as a threat for people living with HIV/AIDS (PLWHA). However, the magnitude of asymptomatic MRSA colonization in that group varies among different countries and geographic regions. We conducted a study that aimed at identifying the prevalence and risk factors for both overall S. aureus and MRSA colonization among PLWHA attending in small cities from inner São Paulo State, Brazil. MRSA isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), and submitted to typing of the Staphylococcal Chromosome Cassete (SCC)mec. Spatial analysis was performed to search for geographical clusters and correlation with socioeconomic indicators. In a first point prevalence survey, nasal and oropharyngeal swabs of 368 people were collected. Sixty-seven subjects from the main city (Botucatu) were surveyed for colonization in two other occasions, and had swabs collected from household members. The prevalence rates for S. aureus and MRSA in the first survey were 25.8% and 2.7%. The overall S. aureus colonization was negatively associated with the use of beta-lactams and of illicit drugs. On the other hand, MRSA colonized subjects were more likely to use crack and to have been admitted to a hospital during the past year. Repeated surveys found additional cases of MRSA colonization, but all subjects were positive in only one occasion. Four PFGE clusters were characterized, grouping subjects in household, city and region level. Of 19 total MRSA isolates, only one did not harbor SCCmec type IV. Spatial analysis detected hot spots of S. aureus colonized subjects from Botucatu, but that finding could not be linked to socio-economic indicators. In conclusion, we found small but relevant prevalence of MRSA among PLWHA. Community and healthcare-associated risk factors were identified, so that predominant routes of transmission could not be determined on epidemiological grounds.
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Aspin, S. C. (Stanley Clive), and n/a. "Trans-Tasman migration and Maori in the time of AIDS." University of Otago. Wellington School of Medicine & Health Sciences, 2000. http://adt.otago.ac.nz./public/adt-NZDU20070522.134607.
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At the dawn of the new millennium, migration has been identified as a crucial element in the ongoing HIV/AIDS epidemic yet few studies have been carried out into the specific ways in which migration is able to fuel the epidemic. Since the beginning of the epidemic in the 1980s we have witnessed increasing mobility of people throughout the world, with migration being a major factor in the ongoing transmission of HIV in particular regions of the world.
This study looks at the particular of migration that exists between New Zealand and Australia and examines the effects that this has had on a group of Maori gay men and transsexuals during the time of the HIV/AIDS epidemic. In particular, the study examines the effects that trans-Tasman migration has on identity and sexual practice and the implications that this has for HIV prevention among the Maori gay and transsexual communities of both countries.
In order to examine the relationship between trans-Tasman migration, identity and behaviour, in-depth interviews were conducted with two groups of Maori gay man and transsexuals. One group resided permanently in Sydney, Australia (n=13) and the other group had returned to live in New Zealand after having lived in Sydney for at least one year (n=11). During the interviews respondents were invited to talk about their cultural and sexual identity, their upbringing, their reasons for migrating to Sydney and their sexual practice in Sydney.
Analysis of the interviews showed that there were distinct differences in the two groups of respondents. While the Sydney gay community offered a haven for Maori migrants from New Zealand, this was sometimes at the expense of a compromised sense of cultural identity as well as exposure to racism, violence and prejudice from living in a predominantly white middle class society. In contrast, those who had returned to live in New Zealand had a stronger sense of their cultural identity than those who resided long-term in Sydney as well as ongoing access to a cultural context which reaffirmed and supported their sense of Maori identity. At the same time, those who lived in Sydney were more likely to report risk behaviour associated with the transmission of HIV than did those who lived in New Zealand.
This project concludes that Maori gay men and transsexuals who have a strong sense of their cultural identity may be at a lower risk of HIV infection than those who do not. These findings have significant implications for the design and implementation of HIV prevention programmes both in New Zealand and in Sydney. Such programmes need to acknowledge the cultural diversity of the gay community and must provide the means whereby community members, especially those from minority groups, may have ongoing access to cultural structures which support and reaffirm their sexual as well as their cultural identity.
11
Blumenfeld, Diana B. "Policy Making and the U.S. Response to Global HIV/AIDS." Thesis, The George Washington University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3714929.
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<p> Since it was first identified in the early 1980's, HIV/AIDS has become one of the world's most devastating epidemics, disproportionately affecting people in developing countries, particularly in Africa. A number of domestic and international efforts emerged to address the epidemic, including the creation of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) in 2003, which brought a huge surge in U.S. funding for global HIV/AIDS programs. Given the historical, political and public opposition to increasing funding for foreign assistance programs, this sudden spike in U.S. spending on global HIV/AIDS raises questions over how the policy process resulted in broad bipartisan political support for the creation of PEPFAR. While some previous literature focuses on various components of the politics surrounding the creation of PEPFAR, there has been little academic research which attempts to provide a complete picture of the policy making process that led to PEPFAR. In particular, previous research has not adequately addressed certain aspects of the policy making process, or provided a comprehensive explanation of the interests and events that shaped the policy process. In addition, previous research has not utilized existing theories of policy making or agenda setting. </p><p> This dissertation used punctuated equilibrium theory and the advocacy coalition framework as complementary lenses to explore the political processes and identify the key factors that generated and reinforced the emergence of PEPFAR. This research utilized a detailed case history, which drew on a range of primary and secondary sources, and was supplemented by analysis of quantitative data. The overarching research question, which guided this dissertation, was: how did the politics of global HIV/AIDS and the process of policy formation result in the creation of PEPFAR? Additionally, this dissertation examined the interests and events that shaped the policy process leading up to PEPFAR; issue framing as well as public and congressional attention to the global HIV/AIDS epidemic leading up to PEPFAR; and the political agreements that were negotiated to satisfy the competing interests of various stakeholders. </p><p> My findings highlight a number of key elements of the policy process which enabled PEPFAR, including the importance of: both congressional and presidential leadership on global HIV/AIDS leading up to PEPFAR; the formation of broad coalitions resulting from activism among a range of interest groups; successful use of humanitarian rationales by Congress and the President to justify the program; and the evolution in the framing of global HIV/AIDS away from prevention and sexual behavior toward treatment and innocent victims. This dissertation builds on previous literature on the influences on decision-making around U.S. foreign assistance programs and contributes to research on policy change. By better understanding the process that led to a major change in one particular area of foreign assistance, academics, policymakers, and advocates can gain greater insight into how such factors can be employed to build potential political support for future large-scale humanitarian endeavors.</p>
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Lutambi, Angelina Mageni. "Basic properties of models for the spread of HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/19641.
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Thesis (MSc)--University of Stellenbosch, 2007.<br>ENGLISH ABSTRACT: While research and population surveys in HIV/AIDS are well established in
developed countries, Sub-Saharan Africa is still experiencing scarce HIV/AIDS
information. Hence it depends on results obtained from models. Due to this
dependence, it is important to understand the strengths and limitations of
these models very well.
In this study, a simple mathematical model is formulated and then extended
to incorporate various features such as stages of HIV development, time delay
in AIDS death occurrence, and risk groups. The analysis is neither purely
mathematical nor does it concentrate on data but it is rather an exploratory
approach, in which both mathematical methods and numerical simulations
are used.
It was found that the presence of stages leads to higher prevalence levels in
a short term with an implication that the primary stage is the driver of the
disease. Furthermore, it was found that time delay changed the mortality
curves considerably, but it had less effect on the proportion of infectives. It
was also shown that the characteristic behaviour of curves valid for most
epidemics, namely that there is an initial increase, then a peak, and then a decrease occurs as a function of time, is possible in HIV only if low risk
groups are present.
It is concluded that reasonable or quality predictions from mathematical
models are expected to require the inclusion of stages, risk groups, time
delay, and other related properties with reasonable parameter values.<br>AFRIKAANSE OPSOMMING: Terwyl navorsing en bevolkingsopnames oor MIV/VIGS in ontwikkelde lande
goed gevestig is, is daar in Afrika suid van die Sahara slegs beperkte inligting
oor MIV/VIGS beskikbaar. Derhalwe moet daar van modelle gebruik
gemaak word. Dit is weens hierdie feit noodsaaklik om die moontlikhede en
beperkings van modelle goed te verstaan.
In hierdie werk word ´n eenvoudige model voorgelˆe en dit word dan uitgebrei
deur insluiting van aspekte soos stadiums van MIV outwikkeling, tydvertraging
by VIGS-sterftes en risikogroepe in bevolkings. Die analise is beklemtoon
nie die wiskundage vorme nie en ook nie die data nie. Dit is eerder ´n
verkennende studie waarin beide wiskundige metodes en numeriese simula˙sie
behandel word.
Daar is bevind dat insluiting van stadiums op korttermyn tot ho¨er voorkoms
vlakke aanleiding gee. Die gevolgtrekking is dat die primˆere stadium die
siekte dryf. Verder is gevind dat die insluiting van tydvestraging wel die
kurwe van sterfbegevalle sterk be¨ınvloed, maar dit het min invloed op die
verhouding van aangestekte persone. Daar word getoon dat die kenmerkende
gedrag van die meeste epidemi¨e, naamlik `n aanvanklike styging, `n piek en dan `n afname, in die geval van VIGS slegs voorkom as die bevolking dele
bevat met lae risiko.
Die algehele gevolgtrekking word gemaak dat vir goeie vooruitskattings met
sinvolle parameters, op grond van wiskundige modelle, die insluiting van
stadiums, risikogroepe en vertragings benodig word.
13
Fang, Yongxiang. "Modelling the epidemiology and management of HIV / AIDS in the era of HAART." Thesis, University of Salford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366019.
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Temfack, Elvis. "Epidemiology and optimal management of cryptococcal meningo-encephalitis associated with AIDS in Cameroon." Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCB049/document.
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Pas de résumé<br>Cryptococcal meningitis (CM), caused by an encapsulated yeast is a leading cause of AIDS related opportunistic infection in adults in sub-Saharan Africa and a major driver of mortality, second to tuberculosis. We aimed at optimising the management of AIDS-related cryptococcal meningitis in Cameroon through interventional studies. As such, we designed and performed three studies on the role of cryptococcal antigen (CrAg) in CM diagnosis, contributed in a major phase III non-inferiority clinical trial for inductive treatment of CM in the African setting and analysed the trial participants’ tolerability of the antifungals used in the trial. We also contributed in a review on the long-term prognosis of CM and finally in an advocacy paper for CM to be recognised as a neglected tropical disease. In Cameroon, serum CrAg detection, a major risk factor for incident CM in AIDS patient is prevalent in 7.5% of patients initiating antiretroviral therapy (ART) at less than 100 CD4 cells/μL, of whom 45% have cerebrospinal fluid (CSF) evidence of asymptomatic CM. The new Biosynex CryptoPS test for CrAg detection is comparable to the IMMY lateral flow assay test and shows promise for correctly classifying patients with high serum CrAg titre, a predictor of confirmed CM. Post CrAg screening, enhanced adherence to ART and to fluconazole-based pre-emptive therapy to CrAg positive patients who present with no CM is effective in preventing incident CM within the first year of ART. In HIV patients presenting with symptoms of central nervous system disease, compared to Indian ink staining and/or culture of CSF, serum CrAg detection is highly presumptive of CM and CSF CrAg detection is diagnostic of first episode of CM. In African patients with confirmed CM, inductive therapy based on oral fluconazole-flucytosine combination or seven-day amphotericin B-flucytosine combination are as effective and more tolerated than standard fourteen-day amphotericin B-flucytosine combination. In spite advances in HIV care, mortality due to CM remains unacceptably high warranting CM to be recognised as a neglected tropical disease for which targeted resources need to be allocated to reduce HIV-related mortality. Overall, in Cameroon, putting in place of local pragmatic algorithms based on the availability of simple but highly performant diagnostic tools and sustainable recommended treatment are indispensable to decrease AIDS-associated CM-related morbidity and mortality
15
Cardoso, Luciana Ventura. "Epidemiologia; HIV-1; AIDS; enteroparasitos; HAART; Brasil." Faculdade de Medicina de São José do Rio Preto, 2011. http://bdtd.famerp.br/handle/tede/102.
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Previous issue date: 2011-06-22<br>Was described the epidemiology of intestinal parasites in patients from an AIDS reference service in the northeastern São Paulo, Brazil Retrospective evaluation of all HIV-1/AIDS positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using version 2.4.1 statistical software R. The level of significance adopted was 5%. The most frequent protozoan was Isospora belli (4.20%), followed by Giardia lamblia (3.5%), Entamoeba coli (2.80%) and Cryptosporidium parvum (0.28%). The Ancylostoma duodenale was the most helminths frequently detected (1.40%), while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. Results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load and the characteristic of any particular parasite. Our data may serve as a starting point for further comparisons with various Brazilian regions and other developing countries. The data may provide important clues to the future understanding, prevention and control of enteric parasites around the world.<br>Foi descrita a epidemiologia de enteroparasitoses em pacientes de um serviço de referência de AIDS no noroeste paulista, Brasil. Durante o período de janeiro de 1998 a dezembro de 2008 foi realizado este estudo retrospectivo por meio da análise dos prontuários dos pacientes diagnosticados com HIV-1/AIDS atendidos no Ambulatório de Doenças Infecto-parasitárias do Hospital de Base, São José do Rio Preto, São Paulo. As análises estatísticas foram realizadas usando a versão 2.4.1 do software estatístico R. O nível de significância adotado foi de 5%. O protozoário mais frequente foi o Isospora belli (4,20%), seguido da Giardia lamblia (3,5%), Entamoeba coli (2,80%) e Criptosporidium parvum (0,28%). O Ancylostoma duodenalis foi o helminto mais detectado (1,40%), enquanto que a Taenia saginata e o Strongiloides stercoralis foram observados em 0,7% das amostras. Os resultados mostraram que a diarreia foi significativamente associada com giardíase e isosporíase. Entretanto, nenhuma associação foi observada entre as contagens de células T CD4+, carga viral e a característica de qualquer parasito em particular. Nossos dados podem servir como ponto de partida para futuras comparações em diversas regiões do Brasil e outros países em desenvolvimento. Os dados obtidos podem direcionar futuras investigações importantes para o entendimento, prevenção e controle de enteroparasitoses no paciente com AIDS em todo o mundo.
Palavras Chave: Epidemiologia, HIV-1, AIDS, enteroparasitos, HAART, Brasil.
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Bezerra, Fabricia Salvador. "Histoplasmose InfecÃÃo em Pacientes HIV/AIDS Residentes na Cidade de Fortaleza, CearÃ." Universidade Federal do CearÃ, 2009. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=4605.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior<br>A histoplasmose à uma doenÃa causada por Histoplasma capsulatum var. capsulatum, nos seres humanos e em vÃrias outras espÃcies de animais. Trata-se de um fungo encontrado na natureza, principalmente em locais ricos em fezes de aves e morcegos: galinheiros sujos e abandonados, ambiente de cavernas, construÃÃes antigas, cÃpula de prÃdios e Ãrvores ocas. A infecÃÃo em humanos ocorre atravÃs das vias aÃreas superiores. Desde o inicio da epidemia de HIV na dÃcada de 80 à notada uma detecÃÃo crescente de histoplasmose disseminada em pacientes com aids de serviÃos de referÃncia em Fortaleza, sugerindo ser o Estado do Cearà uma Ãrea com elevada endemicidade para esse fungo. Este estudo teve o intuito de identificar a prevalÃncia de histoplasmose infecÃÃo em pacientes com HIV/aids, residentes na cidade de Fortaleza, CearÃ. Trata-se de um estudo transversal, descritivo e analÃtico, com uma amostra composta por 161 pacientes, acompanhados no ambulatÃrio de HIV/aids do Centro de Especialidades MÃdicas Josà de Alencar e que ao serem abordados, aceitaram participar do estudo. Para tanto, foi preenchido um formulÃrio, realizou-se teste intradÃrmico com histoplasmina (fase miceliana, fornecido pela Fiocruz-RJ) e coleta sanguÃnea para sorologia por imunodifusÃo (antÃgenos e anticorpos comerciais de Histoplasma capsulatum e Coccidioides immitis fornecidos pelo Centro Especializado em Micologia MÃdica-CEMM). A caracterizaÃÃo geral dos pacientes revelou que a maioria tinha, em mÃdia 35,11 anos, era do sexo masculino (76,40%; n=123), solteiros (67,70%, n=109), com renda familiar de no mÃximo trÃs salÃrios mÃnimos (81,99%; n=132) e com mais de 10 anos de estudo (44,10%; n=71). O tipo de ocupaÃÃo no passado obteve distribuiÃÃo variÃvel e atualmente parte do grupo (20,5%; n=33) encontrava-se desempregada. Um nÃmero de 137 pacientes (85,10%) relatou residir em casas, sendo Messejana o bairro de moradia mais citado pelos participantes (8,7%; n=14). Prevaleceram na amostra os pacientes com diagnÃstico recente de infecÃÃo por HIV, (66,46% identificados no ano de 2008). A prevalÃncia de histoplasmose infecÃÃo em pacientes com HIV/aids em Fortaleza foi de 12,42%. PresenÃa de galinheiro na vizinhanÃa atual do paciente (p=0,031); presenÃa de mangueira na residÃncia atual (p=0,023); atividade com terra no passado (p=0,021) e visitar sÃtio no passado (p=0,009), mostraram-se significantes para a infecÃÃo por Histoplasma capsulatum; jà o uso de medicaÃÃo anti-retroviral e o fato do paciente ter ou nÃo aids, nÃo influenciaram na reatividade à histoplasmina (ambos p=1,00). Pode-se concluir que Fortaleza constitui-se Ãrea com significativa prevalÃncia de histoplasmose infecÃÃo, levando-se em conta que a populaÃÃo estudada se referia a pacientes com supressÃo da resposta imune. O valor obtido aponta para a necessidade de identificaÃÃo dessas pessoas em risco para histoplasmose doenÃa e a implementaÃÃo de medidas profilÃticas naqueles susceptÃveis Ãs formas graves desta infecÃÃo.<br>Histoplasmosis is an infection disease caused by the fungus Histoplasma capsulatum var. capsulatum that can affect humans and several other animal. This fungus can be found in nature, mainly in places rich in bat and bird droppings: dirty and abandoned chicken coops, cave environments, old constructions, building domes and hollow trees. The infection in humans occurs through the upper airways. Since the HIV outbreak in the 1980s, it is noticed an increasing detection of disseminated histoplasmosis among aids patients assisted in reference clinics of Fortaleza, suggesting the Brazilian State of Cearà as an area with high endemicity related to this fungus. The purpose of this study is to identify histoplasmosis infection prevalence among HIV/aids-infected patients, who live in the city of Fortaleza, CearÃ. It is a transverse, descriptive and analytic study, with a sample of 161 patients observed at the HIV/aids ambulatory from Josà de Alencar Center of Medical Specialties, and when invited, agreed to participate. For this, they filled in a form, took an intradermal test with histoplasmin (mycelial phase, provided by Fiocruz â RJ), and had their blood collected to serology via immunodiffusion (commercial antigens and antibodies from Histoplasma capsulatum and Coccidioides immitis were provided by Immy Immunodiagnostics laboratory). The general characterization of patients revealed that, on average, most participants were 35,11 years old, men (76,40%; n=123), single (67,70%, n=109), with a maximum family income of three minimum salaries (81,99%; n=132), and having more than 10 years of education (44,10%; n=71). Their previous employment situation had a variable distribution, although the majority of the group is currently unemployed. A number of 137 patients (85,10%) live in houses, and Messejana was the most informed quarter by the participants (8,7%; n=14). The year of 2008 had the most frequent HIV diagnoses among patients, with 66,46% (n=107). The prevalence of histoplasmosis infection among HIV/aids-infected patients, who live in the city of Fortaleza, was 12,42%. Some variables, such as the presence of chicken coops in the patientâs current neighborhood (p=0,031), the presence of mango trees in the current residence (p=0,023), dealing with soil in the past (p=0,021) and visiting small farms in the past (p=0,009) proved to be significant to the Histoplasma infection. However, the use of antiretroviral medication and having or not AIDS did not influence the reactivity to histoplasmin (both p=1,000). It can be concluded that Fortaleza constitutes an area with significant prevalence of histoplasmosis infection, considering that the analyzed population referred to people with suppression of the immune response. This result points out the necessity of identifying patients at risk for histoplasmosis, and also of implementing prophylactic measures on those susceptible to the severe forms of this disease.
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França, Divânia Dias da Silva. "HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais." Universidade Federal de Goiás, 2016. http://repositorio.bc.ufg.br/tede/handle/tede/6564.
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Previous issue date: 2016-06-29<br>Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG<br>Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq<br>Infection by human immunodeficiency virus (HIV) is a serious global public health
problem. An estimated 78 million people have been infected. The burden of this
infection is concentrated in high vulnerability groups, such as drug users. The objective
of this study was to analyze the serological, epidemiological, and molecular profile of
HIV infection in institutionalized crack users in Goiania, a large city in Central Brazil.
This is an observational, analytical, cross-sectional study conducted among crack
users in treatment in a mental health referral facilityin Midwestern Brazil. From August
2012 to April 2013, 600 crack users were recruited. All were interviewed and tested for
HIV by enzyme-linked immunosorbent assay (ELISA). The samples that tested positive
for anti-HIV1 were subjected to detection of HIV RNA by RT-PCR and genotyped by
sequencing. Of the total enrolled participants: about half came from outside the city
(50.3%), were predominantly male (84.5%), young (median: 30 years), had low
education (8.4 years of school), were self-declared mixed race (61.5%), single (66.5%)
and religious (74.3%). Nearly three-quarters were not formally employed, and 20.3%
reported a history of life on the street in the last 180 days. Of the total, 2.8% (95% CI:
1.7 – 4.4%) were anti-HIV1 positive, ranging from 2.2% (95% CI 1.2 – 3.9) in men and
6.5% (95% CI 3.2 – 14.2) in women (p = 0.04). Logistic regression analysis revealed
that history of sexual intercourse with a carrier of HIV (adjusted OR: 12.60; p = 0.001)
and history of life on the street (adjusted OR: 4.43; p = 0.025) were predictors of HIV-
1. The variables: history of sexually transmitted infections (adjusted OR: 3.24; p =
0.057), not using a condom (adjusted OR: 2.84; p = 0.088) and consumption of more
than 10 rocks/portions of crack daily (adjusted OR: 2.81; p = 0.085) were marginally
associated with HIV infection. In 12 of 17 HIV-1 samples, subtype identification was
possible with subtype B being detected in eight samples (66.7%), F1 and C in one
sampleeach (8.3%), and recombinant BF in two samples (16.7%). These results
highlight the need for effective strategies to prevent HIV infection in crack users, with
an emphasis on health education, implementation of harm reduction measures and
control of sexually transmitted diseases.<br>A infecção pelo vírus da imunodeficiência humana (HIV) é um grave problema de
saúde pública mundial. Estima-se que 78 milhões de pessoas já se infectaram pelo
HIV. A carga dessa infecção está concentrada em grupos com elevada
vulnerabilidade, como usuários de drogas. O objetivo do presente estudo foi analisar
o perfil soroepidemiológico e molecular da infecção pelo HIV em usuários de crack
institucionalizados em Goiânia-GO. Trata-se de um estudo observacional, analítico,
de corte transversal realizado com usuários de crack em tratamento em uma
instituição de referência em saúde mental da Região Centro-Oeste do Brasil. No
período de agosto de 2012 a abril de 2013, foram recrutados 600 usuários de crack.
Todos foram entrevistados e testados para anti-HIV pelo ensaio imunoenzimático
(ELISA). As amostras que apresentaram positividade para anti-HIV foram submetidas
à detecção do RNA-HIV por RT-PCR e genotipadas por sequenciamento. Do total dos
indivíduos recrutados, 50,3% eram procedentes de outros munícipios,
predominantemente do sexo masculino (84,5%), jovens (mediana: 30 anos), de baixa
escolaridade (média: 8,4 anos de estudo), se autodeclaram de cor parda (61,5%),
solteiros (66,5%) e possuíam alguma religião (74,3%). Quase três quartos não
desenvolviam suas atividades laborais no mercado formal de trabalho, e 20,3%
relataram antecedentes de vida na rua nos últimos 180 dias. Do total, 2,8% (IC 95%:
1,7 – 4,4%) foram anti-HIV positivos, variando de 2,2% (IC 95%: 1,2 – 3,9) em homens
e 6,5% (IC 95%: 3,2 – 14,2) em mulheres (p=0,04). Análise de regressão logística
revelou que história de relação sexual com portador (a) do HIV (OR ajustado: 12,60;
p= 0,001) e antecedente de vida na rua (OR ajustado: 4,43; p= 0,025) foram preditores
da infecção pelo HIV. As variáveis: história de infecções sexualmente transmissíveis
(OR ajustado: 3,24; p= 0,057), não adesão ao uso de preservativo (OR ajustado: 2,84;
p= 0,088) e consumo de mais de 10 pedras/porções de crack diariamente (OR
ajustado: 2,81; p= 0,085) foram marginalmente associadas à infecção pelo HIV. Em
12/17 amostras anti-HIV-1 foi possível a identificação subtípica, sendo detectados os
subtipos B em oito amostras (66,7%), F1 e C em uma amostra cada (8,3%) e o
recombinante BF em duas amostras (16,7%). Os resultados evidenciam a
necessidade de estratégias efetivas de prevenção da infecção pelo HIV em usuários
de crack institucionalizados, com ênfase em educação em saúde, implementação de
medidas de redução de danos e controle de infecções de transmissão sexual.
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Webb, Douglas. "The social epidemiology of HIV and the development of AIDS prevention in southern Africa." Thesis, Royal Holloway, University of London, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321136.
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Gonçalves, Maria Jacirema Ferreira. "Incidência de tuberculose por município, Brasil 2001-2003: uma abordagem sobre o programa de controle e fatores determinantes da doença." Universidade do Estado do Rio de Janeiro, 2007. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=5024.
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Esta pesquisa avaliou a situação da tuberculose no Brasil, no período de 2001 a 2003, segundo indicadores do processo de operacionalização do Programa Nacional de Controle de Tuberculose (PNCT), e estimou os efeitos de fatores determinantes da taxa de incidência da doença. Para a avaliação utilizou-se a análise de cluster não-hierárquica, visando agrupar os municípios brasileiros de acordo com a morbidade por tuberculose (TB) e AIDS, e pelo desempenho do PNCT. Estes clusters foram mapeados, comparando-se a distribuição nos municípios, em regiões metropolitanas, municípios prioritários, e segundo o tamanho da população. O qui-quadrado de Pearson foi utilizado para testar associação nas categorias. A modelagem longitudinal multinível foi usada para identificar e estimar os efeitos dos determinantes da doença. Os agregados foram: anos, municípios e regiões metropolitanas. O modelo foi de intercepto e inclinação aleatória. Foram retidas as variáveis capazes de diminuir
a variância dos níveis, pois, desta forma, explicam a variabilidade hierárquica da doença. Incluiu-se renda, densidade populacional, proporção de cura, taxa de incidência de AIDS e as
grandes regiões brasileiras. A avaliação mostrou que a situação epidemiológica preocupante ocorreu nos municípios com Baixa TB e Alta AIDS, e Alta TB e AIDS. O cluster de Muito baixa TB e AIDS concentrou 50% dos municípios, o que pode configurar problemas de notificação. São 6 clusters de desempenho do programa. Bom e Bom com baixo DOTS predominando nos municípios pequenos, não prioritários e fora das regiões metropolitanas. No desempenho Moderado houve maior proporção de municípios prioritários. Clusters Regular e Fraco concentraram 10% dos municípios, com abandono de tratamento elevado e cura muito baixa. O cluster Muito Fraco caracterizou-se pela falta de dados nos indicadores de desempenho. O modelo multinível identificou a AIDS como fator impactante na tuberculose, anteriormente não encontrado em outros estudos; a interação entre renda e AIDS, e importante contribuição das regiões metropolitanas na distribuição da tuberculose, que se manifesta heterogeneamente nas grandes regiões do país. A análise discriminou municípios, e mostrou não haver associação entre maior morbidade e melhor desempenho do PNCT, retratando inadequação da vigilância à realidade epidemiológica do Brasil. O programa necessita ser reforçado, no sentido de considerar a AIDS ao estabelecer suas estratégias de
controle. Ademais, os aspectos de baixa renda da população e densidade populacional, já analisados em diversas pesquisas, também se manifestaram de forma importante nestes resultados.<br>This research assessed tuberculosis status in Brazil, from 2001 to 2003, in conformity with performance indicators of the National Tuberculosis Control Program (NTCP), and estimated the effects of determinant factors of the diseases incidence rate. The evaluation used the non-hierarchical cluster analysis, in order to assemble Brazilian municipalities according to tuberculosis (TB) and AIDS morbidity and to the NTCPs performance as well. These clusters were mapped, comparing the distribution among municipalities, in metropolitan areas, priority municipalities, and according to the population size. The Pearson chi-square was employed to test the association among categories. Multilevel longitudinal modeling identified and estimated the effects of the disease determinants. There were three levels, formed by years, municipalities and metropolitan areas. The model was the random intercept and slope. Variables able to reduce variance among levels were retained, thus assuming that they would explain the diseases hierarchical variability. It included income, population density, cure proportion, AIDS incidence rate and the large Brazilian regions.
Evaluation showed that epidemiological situation was worrisome in municipalities with Low TB and high AIDS and High TB and AIDS. The Very low TB and AIDS cluster concentrated 50% of municipalities, what may indicate notification problems. There are six program performance clusters. Good and Good with low DOTS predominate in small municipalities, non-priority and outside metropolitan areas. For Moderate performance, there is a larger proportion of priority municipalities. Regular and Weak clusters are concentrated in 10% of municipalities, with high treatment default and very low cure rates. The Very weak cluster was characterized by the lack of performance indicators. Multilevel analysis identified AIDS as impacting factor for tuberculosis, not previously found in other studies; interaction between income and AIDS, and an important contribution of metropolitan areas in tuberculosis distribution, which has heterogeneous expressions among large Brazilian regions. The
analysis established distinctions among municipalities and showed that there is no association between more morbidity and better performance of the program, displaying inadequacy of
surveillance in the Brazilian epidemiological situation. The program needs to be reinforced, so as to consider AIDS while setting its control strategies. Moreover, populations low income and population density, already studied in other research works, also played a very important role in these results.
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Santos, Oséias Cerqueira dos. "A invenção de uma epidemia: AIDS, Direitos Humanos e os grupos mais atingidos." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-21032016-141813/.
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Este trabalho se compõe a partir de etnografia documental e estudo social-epidemiológico voltado à compreensão dos processos sociais, jurídicos e históricos que permeiam as infecções pelo HIV entre os grupos mais atingidos, Para tanto, buscou-se a análise, intepretação e problematização de dados oficiais, tendo como principal clivagem a operacionalização de viriáveis estatísticas como forma de identificação daqueles que são mais vulneráveis à epidemia. Além disso, o trabalho tenta visibilizar os processos históricos de luta por direitos humanos e visibilidade dentro do contexto da epidemia de AIDS e suas consequências para o campo da Saúde Pública.<br>This work is composed from documentary ethnography and socialepidemiological study aimed at understanding the social, legal and historical processes that permeate HIV infections among the groups most affected. Therefore, we sought to analysis, intepretação and questioning the \"official\" data through the operation of viriáveis statistics as a way to identify those that are more \"vulnerable\" to the epidemic of viriáveis statistics as a way to identify those that are more \"vulnerable\" to the aids epidemic. In addition, the work attempts to make visible the historical processes of struggle for human rights and visibility within the context of the AIDS epidemic and its consequences for the field of Public Health.
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Korsman, Stephen Nicolaas Jacques. "Molecular epidemiology of mother-to-child transmission of HIV-1 in children at Tygerberg Hospital." Thesis, Link to the online version, 2006. http://hdl.handle.net/10019/1074.
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Kesamang, Lefhoko. "Social workers' experiences of HIV and AIDS intervention in Botswana." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/532.
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This study endeavoured to explore and describe the experiences of social workers in their intervention with HIV and AIDS clients within the Department of Clinical Services of the Ministry of Health in Botswana. The researcher undertook a qualitative research study, using an exploratory, descriptive and contextual design to explore these experiences as perceived by the social workers. The method of data collection included semi-structured face-to-face interviews, as this was deemed most appropriate to the nature of the study. Data analysis was undertaken according to the outline of Tesch (1990), as stated in Creswell (1994:155). The findings were reported as themes, sub-themes and categories emanating from the data-analysis process. In ensuring the trustworthiness of the findings, the researcher adhered to Guba’s (1981) model (in Krefting, 1991:251). The research findings were subjected to a literature control, and culminated in the compiling of the research report. The research findings centred around the following five themes: · experiences of intervention with HIV and AIDS clients; · challenges in HIV and AIDS intervention; · measures to alleviate challenges of HIV and AIDS intervention; · intervention strategies utilised by social workers; and · suggestions and advice to new social workers. The recommendations resulting from this research project proposed inter alia that social workers need to be trained in specific and specialised areas related to HIV and AIDS intervention in the health setting, and that the support structures and a holistic multidisciplinary service delivery approach need to be put in place to assist social workers to be able to meet the needs of the clients as well as their own needs. Key Words: participants, clients/patient, qualitative, HIV and AIDS, experiences, intervention, strategies.
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Barbosa, Rodrigo Nascimento. ""Leishmaniose tegumentar em AIDS: manifestações clínicas e evolução"." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5134/tde-14092006-161632/.
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De 12 casos de leishmaniose tegumentar (LT) em AIDS, em São Paulo, sete do levantamento retrospectivo (1990 a 2001) e cinco do prospectivo (2001 a 2004), com contato prévio com área endêmica para leishmanioses, 50% eram usuários de drogas injetáveis (1990-2001). Apresentavam média de linfócitos T CD4+ de 77 células/mm3, um era C2 e 11, C3 (classificação de HIV, segundo CDC) e 70% tinha sorologia positiva para leishmanioses. As manifestações de LT em mucosa e pele eram diversificadas: úlcera única ou lesões múltiplas e polimórficas ou disseminadas, incluindo comprometimento genital em 4 casos. Todos receberam tratamento específico para leishmaniose e 50%, HAART. 50% recidivaram e 50% foram a óbito no período, independentemente do uso do HAART<br>From 12 cases of tegumentary leishmaniasis (TL) in AIDS, from São Paulo, seven from retrospective (1990 a 2001) and five from prospective studies (2001 a 2004), with previous contact with endemic areas for leishmaniasis, 50% were endovenous drug users (1990-2001). Presenting mean 77 CD4+ T cells/mm3, one was C2 and 11 were C3 (HIV classification, according to CDC) and 70% had positive serology for leishmaniasis. Presentation of TL in the skin and mucosa were diversified: single or multiple ulcers and polymorphic or disseminated lesions, including lesions in genital area in 4 cases. All were treated with anti-leishmanial drugs and 50% with HAART. 50% presented relapse and 50% died during follow up period, independently of use of HAART
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Kidman, Rachel. "Child welfare in the context of HIV/AIDS epidemic: identifying vulnerable populations and shaping an effective response." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=86885.
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Background: Over 15 million children have been orphaned by AIDS. While a growing literature suggests orphans are disadvantaged, other studies have failed to find health or educational disparities. This contradictory evidence has fueled debate over whether orphans should be targeted for assistance, or whether the response should be expanded to other vulnerable children.<br>Objectives: This study sought to: 1) to estimate educational disparities for orphans relative to other AIDS-affected children; 2) to estimate health disparities for orphans relative to other AIDS-affected children; and 3) to describe the extent of community and public support available to households fostering orphans.<br>Methods: Data are drawn from the 2004-5 Malawi Integrated Household Survey, a nationally-representative survey of 52,707 individuals in 11,280 households in 564 communities. Multilevel models examine the association between orphanhood and other AIDS-related impacts and 1) education for children 6-14 years; and 2) health status for children 6-17 years. Weighted descriptives and regression models are used to examine whether orphan households receive greater private, community and public support.<br>Results: Double and maternal orphans are more likely to be out of school (OR=2.2, 2.5 respectively) and behind in attainment (grade difference = -0.3); these disparities are not explained by poverty. While there is no evidence that orphans suffer greater morbidity, children whose parents have an AIDS-related illness have higher burdens of both acute and chronic morbidity (ORs=1.5-1.9). Finally, friends and relatives provided assistance to 75% of households, and this support was more likely to be targeted to households with double orphans. Community-based organizations for the chronically ill were present in 40% of communities and many included orphan-specific programming.<br>Conclusion: There is growing international commitment to mitigate the impact of AIDS on children, but debate remains around how to best target resources. Orphans and poor children both demonstrate educational disadvantage, suggesting a simultaneous need for orphan-specific programming and general poverty alleviation. Children living with sick parents demonstrated poor health; community home-based care programs are best situated to identify these children and mitigate their risk. Finally, while many households with vulnerable children are already receiving assistance, the value and coverage is inadequate to match the need and needs to be drastically scaled-up.<br>Contexte: Plus de 15 millions d'enfants sont devenus orphelins dès suites du SIDA. D'un côté, un nombre grandissant d'études suggèrent que les orphelins sont désavantagés, tandis que de l'autre, plusieurs études n'ont pas été capables de démontrer des inégalités au niveau de la santé et de l'éducation. Cette contradiction dans la littérature suscite le débat à savoir si les orphelins devraient être ciblés de façon spécifique ou s'ils devraient être inclus dans des programmes d'aide englobant d'autres enfants vulnérables.<br>Objectifs: Cette étude a pour objectif de: 1) estimer les inégalités au niveau de l'éducation des orphelins par rapport à celle des autres enfants affectés par le SIDA; 2) estimer les inégalités au niveau de la santé des orphelins par rapport à celle des autres enfants affectés par le SIDA; et 3) décrire l'étendue du support communautaire et public destinés aux ménages hébergeant des orphelins.<br>Méthodologie: Les données proviennent du Malawi Integrated Household Survey de 2004-5, une base de données nationale et représentative de 52 707 individus répartis dans 11 280 ménages dans 564 communautés. Les modèles multiniveaux étudient l'association entre le statut d'orphelin et d'autres impacts liés au SIDA et 1) l'éducation des enfants de 6 à 14 ans; et 2) les conditions de santé des enfants de 6 à 17 ans. Des données descriptives pondérées et des modèles de régression sont utilisés pour étudier si les ménages ayant au moins un orphelin reçoivent plus de soutien des milieux privé, communautaire et public que les autres ménages.<br>Résultats: Les orphelins dont la mère ou les deux parents sont décédés sont plus susceptibles d'avoir décroché de l'école (OR=2.2, 2.5 respectivement) ou d'accuser un retard au niveau scolaire (différence de niveau = -0.3); ces inégalités ne sont pas expliquées par la pauvreté. Même si d'un côté aucun résultat ne prouve que les orphelins ont un taux de morbidité plus élevé, les enfants qui ont des parents atteints du SIDA ou d'autres maladies connexes ont un niveau plus élevé de maladies chroniques ou graves (ORs= 1.5-1.9). Finalement, les amis et la famille procurent de l'aide dans 75% des ménages, et ce soutien est plus souvent présent dans les ménages avec des orphelins ayant perdus leurs deux parents. Les organismes communautaires venant en aide aux personnes atteintes de maladies chroniques sont présents dans 40% des communautés et plusieurs incluent des programmes s'adressant spécifiquement aux orphelins.<br>Conclusion: Il y a un engagement international croissant afin de freiner l'impact du SIDA sur les enfants, mais le débat demeure à savoir comment allouer les ressources le plus efficacement. Les orphelins et les enfants pauvres dénotent tous les deux des retard en éducation ce qui suggère qu'une aide devrait être octroyée simultanément pour les programmes destinés aux orphelins et pour ceux visant l'élimination globale de la pauvreté. Il a été démontré que les enfants vivant avec des parents malades ont une mauvaise santé; les programmes communautaires de soins à domiciles sont les mieux placés pour identifier ces enfants et freiner les risques. Finalement, bien qu'il y ait plusieurs ménages qui reçoivent déjà de l'aide, la valeur et l'étendue de cette aide est inadéquate et ne répond pas au besoin; du soutien de l'extérieur devrait être ajouté.
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Lastoria, Leticia Chamma. "Colonização por Staphylococcus aureus em pessoas vivendo com HIV/AIDS acompanhadas em um serviço ambulatorial de referência em Botucatu (SP) prevalência, resistência à meticilina e epidemiologia molecular /." Botucatu, 2016. http://hdl.handle.net/11449/140292.
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Orientador: Carlos Magno Castelo Branco Fortaleza<br>Resumo: Staphylococcus aureus resistente à meticilina (Methicillin-resistant S. aureus, MRSA) é cada vez mais reconhecido como uma ameaça para pessoas vivendo com HIV/AIDS (PVHA). No entanto, a magnitude da colonização por MRSA varia entre diferentes países e regiões geográficas. Nós realizamos um estudo que teve por objetivo identificar a prevalência e os fatores de risco para colonização por S. aureus como um todo e MRSA em PVHA residindo em cidades de pequeno porte do interior do Estado de São Paulo. Isolados de MRSA foram caracterizados por Eletroforese em Gel de Campo Pulsado (Pulsed-Field Gel Electrophoresis, PFGE) e tiveram o Cassete Cromossômico Estafilocóccico (Staphylococcal Chromosome Cassete, SCC) mec tipado. Análise espacial foi realizada para identificar agregados geográficos e correlação com indicadores socioeconômicos. No primeiro momento, realizamos um estudo de prevalência pontual coletando swab nasal e de orofaringe de 368 PVHA atendidas em ambulatório de referência em Botucatu, SP. Sessenta e sete sujeitos residentes na cidade sede foram seguidos com coletas em dois outros momentos, e tiveram seus contactantes domiciliares também investigados para colonização. As taxas de prevalência de S. aureus e MRSA no primeiro levantamento foram 25,8% e 2,7%. A colonização por S. aureus foi negativamente associada com o uso de antibióticos beta-lactâmicos e drogas ilícitas. Por outro lado, fatores de risco para MRSA incluíam uso de crack e internação hospitalar recente. Inqué... (Resumo completo, clicar acesso eletrônico abaixo)<br>Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized as a threat for people living with HIV/AIDS (PLWHA). However, the magnitude of asymptomatic MRSA colonization in that group varies among different countries and geographic regions. We conducted a study that aimed at identifying the prevalence and risk factors for both overall S. aureus and MRSA colonization among PLWHA attending in small cities from inner São Paulo State, Brazil. MRSA isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), and submitted to typing of the Staphylococcal Chromosome Cassete (SCC)mec. Spatial analysis was performed to search for geographical clusters and correlation with socioeconomic indicators. In a first point prevalence survey, nasal and oropharyngeal swabs of 368 people were collected. Sixty-seven subjects from the main city (Botucatu) were surveyed for colonization in two other occasions, and had swabs collected from household members. The prevalence rates for S. aureus and MRSA in the first survey were 25.8% and 2.7%. The overall S. aureus colonization was negatively associated with the use of beta-lactams and of illicit drugs. On the other hand, MRSA colonized subjects were more likely to use crack and to have been admitted to a hospital during the past year. Repeated surveys found additional cases of MRSA colonization, but all subjects were positive in only one occasion. Four PFGE clusters were characterized, grouping subjects in household, ... (Complete abstract click electronic access below)<br>Mestre
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Khanna, Akshay. "Refracted subject : sexualness in the realms of law and epidemiology." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/4213.
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There are many ways in which gender diversity and sexualness are experienced, spoken of and transacted in India. Recent activism against marginalisation related to sexual and gender nonconformity has led to transformation of some of these idioms into objects that circulate in particular registers of governmentality. In the process, something quite else is created, and this something else portends to speak the truth of 'sexuality in India'. Based on fieldwork carried out between 2005 and 2007 in cities, towns and villages around India, this thesis tells a story of this emergence of 'sexuality' as an aspect of personhood, a political object, a basis for social mobility, a mode of connectedness between people and as a legitimate cause for a movement. The term 'Queer', used variously in India, is a shorthand in some contexts for people who identify as Lesbian, Gay, Bisexual, Transgender, and with South Asian identities such as Hijra, Kothi and Aravani. In others, it refers to a political project challenging norms of heterosexual monogamy, marking a conscious move away from identity-based politics premised on a bio-medical presumption that desire defines personhood. Evoking both these meanings, I examine queer activism as the negotiation of terms of entry of Queer bodies into epidemiological and juridical registers. In relation to the first, I examine interventions of the transnational HIV/AIDS industry that target 'men who have sex with men' – or 'MSM' – the category through which the industry apprehends sexualness between male subjects. I focus on the political-economic conditions of epidemiological knowledge, and on the transformation of idioms of gender and sexualness that its production draws upon. The industry, I argue, is involved in establishing availability of socio-economically marginalised bodies for intervention and research. These relationships of availability are possible because of their promise of social mobility and respectability for queer folk, hitherto despised in masculinist political economies. This mobility is contingent upon the creation and adoption of epidemiologically overdetermined identities which ironically find political significance in being seen as timeless and 'traditional'. The dichotomous being of the 'MSM' - simultaneously the producer and the object of this epidemiological knowledge, implies that the production of this knowledge is predicated upon the ability of queer folk to perform their place in the 'community'. The relationships in the 'field' are already written into the data, and thus the knowledge. Epidemiological knowledge, and the subjects it speaks of, I thus argue, are best understood as articulations of the conditions of their production. The second theme, of Law and the juridical register, opens with an examination of the tensions involved in the production of 'homophobia' as a political object. The disavowal of erotic dimensions in the naming of experiences as 'homophobic violence' is situated in the context of a popular imagination of a worthy juridical subject, and in broader imaginings of power. I then turn to the conditions under which the law, and in particular, Section 377 of the Indian Penal Code, a Victorian anti-sodomy law under which homosexuality is seen to be criminalised, comes to be central to the Queer movement in India. Activism has given Section 377 a 'social life', an awareness of the law in public spheres, amongst law enforcers and branches of the State. Simultaneously, the Law has been inaugurated as a space for the articulation of more diffuse tensions. It has given a tangibility and intelligibility to experiences of exclusion, marginalisation and violence. I then examine a litigation at the High Court of Delhi challenging this law on grounds that it violates Fundamental Rights, focussing on the constitution of a coherent Queer body, cast simultaneously as enumerable, drawing on epidemiological knowledge; and, as capable of instantiation through individual narratives of violation. This project, where a sexuality is ascribed to the citizen-subject, is then juxtaposed with instances where activists actively strip sexualness off of the Queer body in order to make claims to citizenship. This is a cleavage in the Queer movement, an effect of the diversity of bodies it claims to speak of, as, and for, and the conditions under which these diverse bodies seek articulation. Between these projects lies ambiguity, which, I argue, is a precious resource for Queer folk, and for the movement. I suggest a conceptual shift from 'sexuality', (as personhood), to 'sexualness' (where desire flows through subjects without constituting them), argue that the Subject found in registers of governmentality may best be understood in terms of its political economy and distinct from psychic formations, and finally, offer up thoughts for a politics of ambiguity.
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PEREIRA, Gisella Souza. "Perfil clínico e epidemiológico dos indivíduos infectados pelo vírus da imunodeficiência humana (HIV) em Goiás." Universidade Federal de Goiás, 2008. http://repositorio.bc.ufg.br/tede/handle/tde/710.
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Previous issue date: 2008-12-04<br>To investigate the clinical and epidemiologic profile of HIV/aids carriers in Goiânia, Goiás, data of 583 individuals HIV-positive seeking a referral hospital were collected from January to December of 2006. The majority were black (75.6%), men (56.6%), with 20 to 49 yers old (62.6%), with less than five years of schooling (54.1%), and residents in the metropolitan area of Goiânia. Unprotected sex (34.7%), HIV-positivity partner (19.9%), use of illicit drug (16.3%), and sex with individual of the same sex (14.8%) were the most frequent risk factors reported. Opportunistic diseases were diagnosed in 249 individuals, being esophagitis by Candida sp. and consumptive syndrome predominant. Positivity for HBsAg (n=422), anti-HBc (n=324), anti-HBs (n=247) and anti-HCV (n=349) were found in 3.6%, 23.1%, 23.5% and 6.5% individuals, respectively. The majority had LT CD4+ count less than 350 cels/mm3. Further, those with at least 50 years old (G2) had lower average of LT CD4+ when compared with those aged less than 40 years old (G1) (241.91 vs. 371.84 cels/mm3) (p<0.05). In addition, G1 had higher probability of remaining alive after 365 days when compared with G1 (84.8% vs.78.4%; log-rank=0.09). The findings of this study show the maturity of the HIV/aids epidemic in Goiás, with an increasing in women, heterosexuals, individuals with lower education level and those with at least 50 years old. The high frequency of late diagnosis of HIV infection, mainly in older individuals, and the high frequency of early death in HIV/aids carriers, suggest the necessity of intensify public strategies for early diagnosis, but also educational campaigns to prevent HIV infection including elderly people.<br>Para investigar o perfil clínico e epidemiológico dos indivíduos infectados pelo HIV/aids em Goiânia, Goiás, foram coletados dados de 583 indivíduos, sem tratamento anti-retroviral prévio, admitidos no hospital de referencia dessa cidade, de janeiro a dezembro de 2006. A maioria era homem (56,6%), com 20 a 49 anos de idade (62,6%), com menos de cinco anos de escolaridade (54,1%), de cor negra ou parda (75,6%) e residente na área metropolitana de Goiânia. Relação sexual desprotegida (34,7%), parceiro anti-HIV positivo (19,9%), uso de drogas ilícitas (16,3%) e sexo com parceiro do mesmo sexo (14,8%) foram categorias de risco mais relatadas. Doenças oportunistas foram diagnosticadas em 249 indivíduos, sendo esofagite por Candida sp. e síndrome consuptiva as mais freqüentes. Positividade para o HBsAg (n=422), anti-HBc (n=324), anti-HBs (n=247) e anti-HCV (n=349) foi encontrada em 3,6%, 23,1%, 23,5% e 6,5% dos indivíduos, respectivamente. A maioria dos indivíduos apresentou contagem de linfócitos T CD4+ (LT CD4+) inferior a 350 céls/mm3 na primeira visita clínica. Verificou-se também que a média de LT CD4+ foi menor em indivíduos com idade igual ou superior a 50 anos (G2) quando comparados aos com menos de 40 anos (G1) (241,91 vs.3 71,84 céls/mm3) (p<0,05). Mais ainda, no G1 a probabilidade de indivíduos permanecerem vivos após 365 dias foi de 84,8%, enquanto no G2 foi de 78,4% (log-rank=0,09). Os achados deste estudo mostram o amadurecimento da epidemia do HIV/aids em Goiás, com avanço de casos em mulheres, indivíduos heterossexuais, de baixa escolaridade e com idade acima de 50 anos. A freqüência elevada de diagnóstico tardio da infecção, principalmente, em indivíduos em idade mais avançada, e o elevado índice de morte prematura em portadores do HIV/aids, indicam a necessidade de intensificação de estratégias públicas para o diagnóstico precoce e campanhas educativas para prevenção da infecção pelo HIV que incluam a população idosa.
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AraÃjo, Vera LÃcia Borges de. "Pessoas de 50 anos e mais vivendo com HIV/AIDS no CearÃ, Brasil." Universidade Federal do CearÃ, 2009. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=4545.
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O crescimento dos casos de Aids em pessoas de 50 anos a mais chama a atenÃÃo, principalmente na Ãltima dÃcada. Este estudo teve como objetivo descrever as caracterÃsticas epidemiolÃgicas de pessoas com 50 anos a mais vivendo com HIV/Aids no Estado do CearÃ. MÃtodo Realizou-se um estudo transversal, em um hospital de referÃncia terciÃria localizado em Fortaleza-CE, no perÃodo de setembro a novembro de 2008. Um questionÃrio semiestruturado foi aplicado a 200 pacientes com HIV/Aids, de 50 a 83 anos de idade. Foram comparadas as diferentes proporÃÃes, separadamente para homens e mulheres com (IC 95%). Utilizou-se o teste do Qui-quadrado, de Pearson, ou Exato, de Fisher, quando apropriado. Resultados. Do total, 72,5% dos pacientes eram homens com mÃdia de idade de 63,5 anos; 53,5% tinham menos de oito anos de estudo; 69,0% residiam em Fortaleza; 51,0% pertenciam ao âEstrato econÃmico D/Eâ, revelando as precÃrias condiÃÃes de vida materiais desta populaÃÃo. O sexo feminino predominou com as cores parda (74,5%) e preta (7,3%), nÃveis de instruÃÃo mais baixos e maiores proporÃÃes de viÃvas (51,5). As mulheres foram menos sexualmente ativas (22,0%) e somente uma (0,8%) relatou mais de um parceiro nos Ãltimos 12 meses. A atividade sexual diminuiu com a idade: 60,2% entre 50-59 anos e 42,8% entre aqueles com 70 anos e mais; 48,0% dos pacientes relataram mÃdia de seis relaÃÃes sexuais ao mÃs. Homens usaram mais preservativo em relaÃÃes casuais (96,5%), entre as mulheres o menor uso foi nas relaÃÃes fixas (80,0%). O sexo vaginal predominou com 70,0%; o sexo oral e anal foi pouco frequente entre as mulheres e 33,0% dos pacientes referiu sexo comercial em algum momento na vida. No conjunto da populaÃÃo masculina, 41,0% referiram contato sexual com outro homem; 52,5% descobriram o diagnÃstico entre 30 e 49 anos; 31,0% mostraram a mÃdia de 17 anos de diagnÃstico; 59,0% nunca fizeram o teste anti-HIV antes da infecÃÃo; 76,0% referiram aquisiÃÃo da doenÃa por via sexual, homens com parceiro desconhecido (44,1%) e mulheres com parceiro conhecido (69,1%); 17,0% nÃo tÃm ideia de como se deu a infecÃÃo. O uso de Ãlcool foi prevalente e de drogas injetÃveis foi raro. ConclusÃo. A anÃlise mostrou diferenÃas entre os sexos, diagnÃstico tardio, envelhecimento com a aids, alto uso de preservativo apÃs a infecÃÃo por HIV e pouca percepÃÃo em estar em situaÃÃo de risco. Estes achados remetem à necessidade de um programa voltado especificamente para esta populaÃÃo com 50 anos ou mais.
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Carvour, Martha Lydia. "Patterns and predictors of survival following an HIV/AIDS-related neurologic diagnosis." Diss., University of Iowa, 2012. https://ir.uiowa.edu/etd/2454.
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Infection with human immunodeficiency virus (HIV) and progression to acquired immune deficiency syndrome (AIDS) often result in neurologic and neuropsychiatric changes, although the prognostic information available for patients affected by HIV/AIDS-related neurologic diagnoses has been limited. The objective of the present study was to characterize the patterns and predictors of survival, including the impacts of antiretroviral therapy (ART) use and potential factors in healthcare access and disparity, among patients with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. To accomplish this, a cohort was drawn from the Iowa HIV/AIDS reporting system, and a non-independent, university-based cohort was then used to validate the analyses conducted for the statewide sample. Patterns of ART use were identified in each cohort using logistic regression, and survival analyses were conducted using Kaplan-Meier analysis, Cox regression, and accelerated failure time modeling.
Survival was poor in both cohorts, although the university-based setting (University of Iowa Hospitals and Clinics) was associated with better overall survival. Of 230 persons in the statewide cohort, 77.0% were deceased by the end of the study period (1982-2008), and the median survival was 1.13 years (95% CI: 0.90 to 1.86 years, n=225). By contrast, 56.4% of the university-based cohort was deceased by the end of the study period (1984-2009), and the median survival in this group was 3.04 years (95% CI: 1.79 to 11.62 years, n=172). Both cohorts were predominantly male, non-Hispanic white, and residents of a small metropolitan area at the time of the AIDS diagnosis.
ART use had a strong protective effect on survival in both cohorts. Use of ART among patients diagnosed during the era of highly active antiretroviral therapies (HAART) was associated with an 80% reduction in the rate of death (HR=0.20, 95% CI: 0.08 to 0.46) compared to the non-users diagnosed during the pre-HAART era (that is, prior to 1996), after adjustment for age, race, birth sex, healthcare facility type, opportunistic infection count, HIV transmission risk category, neurologic condition, years since AIDS diagnosis, and timing of neuro-AIDS in a Cox regression model. In the UIHC cohort, the adjusted expected survival time among ART/HAART users was 37.71 (95% CI: 14.44 to 99.48) times that among non-users.
Women had significantly poorer outcomes than men in the statewide cohort (adjusted HR=2.31, 95% CI: 1.22 to 4.35), and a similar, non-significant trend was observed among university-based cases. Secondary analyses suggested that this difference persisted over the course of the epidemic and was not attributable to differential ART response among men and women. Evidence for a role of disease severity, psychosocial support, and/or psychiatric comorbidity in the differential survival of men and women was identified.
This study provides useful prognostic data for patients and providers and may guide future research efforts aimed toward improved survival for neuro-AIDS patients. The survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. Meanwhile, clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS, including potential assessment of comorbid psychiatric disorders.
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Vinhoti, Danilo Sergio. "A infecção pelo HIV em São Carlos: Um estudo do banco de dados do Programa Municipal de DST/AIDS de 1987 a 2010." Universidade Federal de São Carlos, 2012. https://repositorio.ufscar.br/handle/ufscar/5302.
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Previous issue date: 2012-02-29<br>Financiadora de Estudos e Projetos<br>The AIDS epidemic in Brazil has been characterized, in recent years, by an increase in the number of cases in small and medium sized cities. São Carlos, medium sized city in São Paulo State, has a database of people registered in the Municipal Program of STD/AIDS, since 1987. Therefore, the main goal of this research was to analyze the AIDS epidemic in the city of São Carlos, from 1987 to 2010, to identify trends in the epidemic and to prepare a user s profile of the Municipal Program of STD/AIDS participating in this research. To do so, stratified and secondary information were obtained from the database of users, registered from 1987 to 2010, where the subjects could not be identified, considering the variables: age, gender, education, exposure, marital status, year of death and "HIV x AIDS cases". The results showed that, unlike the data observed in other studies, the trend in São Carlos is the increase of incidence in men whom currently represent 65% of the users registered in this database. The most prevalent age group was 20-29 years with 40.91% of the cases. The most observed education level was the Elementary Education, with 618 users. The data concerning the form of exposure showed that heterosexuals account for 50% of the cases, besides the decrease in notifications in injecting drug users over the studied period. Regarding marital status, it was observed that singles account for 36% of cases, followed by married, 33%, while the first showed a slight increase in recent years. There were 946 reported cases of AIDS and 264 records of patients infected with HIV; however, from 2009 reports of "HIV" exceeded those of AIDS. It was also observed a decrease in the number of deaths in the historical retrospective study. Future studies are needed to reinforce our findings and highlight trends in the AIDS epidemic in the city of São Carlos.<br>A epidemia da AIDS no Brasil tem, nos últimos anos, se caracterizada pelo aumento no número de casos em cidades de pequeno e médio porte. São Carlos, cidade de médio porte do interior paulista, conta com um banco de dados de pessoas cadastradas no Programa Municipal de DST/AIDS desde o ano de 1987. Por isso, o objetivo deste trabalho foi estudar o banco de dados do Programa de DST/AIDS de São Carlos, e observar o comportamento da AIDS na cidade de São Carlos de 1987 a 2010, além de elaborar um perfil dos usuários do Programa Municipal de DST/AIDS participantes desta pesquisa. Para tanto, foram consultadas no banco de dados informações estratificadas e secundárias, de modo a não permitir a identificação dos sujeitos, considerando as variáveis: faixa etária, sexo, escolaridade, exposição, estado civil, ano de óbito e casos AIDS x HIV de usuários cadastrados a partir de 1987 até 2010. Foram incluídos os registros de pessoas adultas cadastradas no banco de dados, residentes em São Carlos. Os resultados mostraram que os homens representam 65% do total de usuários cadastrados neste banco de dados. A faixa etária mais prevalente foi de 20 a 29 anos, com 40,91% dos casos. O nível de escolaridade mais observado foi o ensino fundamental, com 618 usuários. Os dados referentes à forma de exposição mostraram que os heterossexuais respondem por 50% dos casos, além de queda nas notificações em usuários de drogas injetáveis ao longo do período estudado. Quanto ao estado civil, foi observado que os solteiros respondem por 36% dos casos, seguido pelos casados, com 33%, sendo que os primeiros apresentaram leve aumento nos últimos anos. Foram encontrados 946 registros de casos de AIDS e 264 registros de infectados pelo vírus HIV, porém, a partir do ano 2009 as notificações de HIV superaram as de AIDS. Foi observado ainda diminuição do número de óbitos na retrospectiva histórica estudada. Estudos futuros serão necessários para reforçar os achados deste estudo e evidenciar tendências da epidemia da AIDS na cidade de São Carlos.
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Nguyen, Anthony H. "HIV/STIs and Intimate Partner Violence: Results from the Togo 2013-2014 Demographic and Health Surveys." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6553.
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Background: Among clinic based studies, intimate partner violence (IPV) has been shown to contribute to HIV/AIDS among young girls and women. Results from studies among the general population have been less consistent. This study evaluated the associations between HIV infection, any sexually transmitted infections, and IPV in a population based sample of Togolese women.
Methods: Data from the Togo 2013-2014 Demographic and Health Surveys were utilized for these analyses. Women aged 15-49 who were currently married, had HIV test results and answered the Domestic Violence Module were analyzed (n = 2386). Generalized linear mixed-models adjusting for sociodemographic variables, risk behaviors, and cluster effect were used to estimate HIV and STI risks with experience of IPV.
Results: HIV prevalence was 2.8%. Prevalence of IPV was 39% among HIV positive women and 38% among HIV negative women. Significant associations between IPV and HIV infection were not detected. Adjusted models found significant associations between experience of any IPV and having had STIs (OR 2.05, 95% CI 1.25-3.35).
Conclusions: The high rates of violence in this setting warrants community-based interventions that address abuse and gender inequity. These interventions should also discuss the spectrum of STIs in relation to IPV.
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Erugo, Ebere. "Impact of the Affordable Care Act on the HIV Care Continuum." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4620.
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People living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS; PLWHA) are at increased risk of insufficient medical care due to lack of insurance. Inadequate medical care for PLWHA contributes to increases in HIV transmission rates. The U.S. Surveillance Report noted that in 2015, over 1.2 million people were living with HIV infection, and there were approximately 50,000 new infections every year. The report further stated that about 675,000 people have died from HIV-related illnesses since its discovery in 1981. The implementation of the Affordable Care Act (ACA) in 2014 was intended to provide Americans, including people at risk of or living with HIV, options for health insurance coverage and better access to health care. It was also designed to allow people with existing health conditions such as HIV to reach for optimal health, irrespective of the severity of their condition. Andersen's behavioral model and economic theory provided the theoretical framework and conceptual foundation for this study's assessment of the impact of the ACA on the HIV care continuum. This quantitative study used secondary data with a retrospective correlational design. Data from the Health Resources Service Administration and the Behavioral Risk Factor Surveillance System were analyzed. Overall, chi-square tests indicated a steady increase in the number of PLWHA who achieved viral suppression (Ï?2 (1) = 105, p < .001) between 2010 and 2015. Future research should include the general American population to assess the impact of the ACA. This study could lead to positive social change as PLWHA are made more aware of the benefits of comprehensive health care coverage and increase healthcare utilization, leading to improved health for those infected and less transmission of the virus.
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Matanyaire, Sandra D. "The AIDS transition: impact of HIV/AIDS on the demographic transition of black/African South Africans by 2021." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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The first two official AIDS cases were diagnosed in South Africa in 1982. During the same period of the 1980s, the black/African population was experiencing an accelerated fertility decline, following a period of accelerated mortality decline. Demographers invoked the demographic transition theory to explain the observed mortality and fertility decline. According to the demographic transition theory, mortality and fertility rates would continue declining to low, post transitional levels with increasing modernization. The relatively higher prevalence of HIV/AIDS estimated among black/African South Africans is expected to alter their demographic transition. This research investigated the impact of HIV/AIDS on the demographic transition of black/Africans by 2021.
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Corbin, Angela Bumphus. "Adherence Barriers to Healthcare for African Americans with HIV/AIDS on Antiretroviral Medications." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3759.
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The purpose of this mixed methods research study was to examine the role of adherence barriers to healthcare and the impact that such barriers have on highly active antiretroviral therapy (HAART) compliance for African Americans living with HIV/AIDS. HAART helps reduce HIV/AIDS morbidity and mortality. Of the 49% of study participants who had been out of medical care for more than 12 months, financial concerns were listed as the most common barrier (22.8%). Not having the support from family and friends (17.5%), being tired of going to doctor appointments (15.8%), health challenges (12.3%), lack of transportation (12.3%), and incarceration (12.3%) were also barriers in medical care that had a direct influence on noncompliance. The overall model of the linear regression analysis was significant, R2 = .469, adjusted R2 = .458, F(1, 49) = 43.24, p < .001. Being in medical care on a regular basis accounted for 46.9% of the total variance in attending primary care visits. The outcome of this analysis confirms the hypotheses (HA1) that attending 2 primary care visits within 6 months of being linked to care increased the rate of compliance for African Americans on HAART living with HIV/AIDS. The overall model of the linear regression analysis was significant, R2 = .469, adjusted R2 = .458, F(1, 49) = 7.206, p < .001. Being in medical care on a regular basis accounted for 46.9% of the total variance in attending primary care visits. The outcome of this analysis empasizes the importance of HAART compliance. These findings can lead to positive social changes by improving quality of life and health, which impacts gainful employment, sustains positive relationships, improves finances, and increases self-sufficiency
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Correia, Francisco Gustavo Silveira. "AnÃlise espacial dos casos de histoplasmose disseminada associada a AIDS no municÃpio de Fortaleza." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=8454.
Full textAbstract:
A histoplasmose à considerada a micose endÃmica mais comum em seres humanos, com distribuiÃÃo cosmopolita e significativa incidÃncia no Brasil. Nas Ãltimas dÃcadas, Histoplasma capsulatum tem surgido como patÃgeno oportunista em indivÃduos com distÃrbios da imunidade celular, como aqueles em corticoterapia prolongada, transplantados, imunodeprimidos e principalmente que desenvolveram a sÃndrome da imunideficiÃncia adquirida (aids). A literatura dispÃe de poucos inquÃritos sorolÃgicos sobre a prevalÃncia dessa doenÃa no Brasil, dificultando o conhecimento sobre sua distribuiÃÃo. Nesse contexto, o Estado do Cearà tem-se destacado como Ãrea de elevada notificaÃÃo de casos de Histoplasmose Disseminada (HD) associada a aids no paÃs. A utilizaÃÃo de Sistemas de InformaÃÃes GeogrÃficas (SIG) na SaÃde PÃblica tem auxiliado na compreensÃo do processo saÃde-doenÃa em diversas situaÃÃes, como o planejamento e avaliaÃÃo de aÃÃes de saÃde, definiÃÃo de Ãreas de risco para incidÃncia de doenÃas ou anÃlise de dispersÃo espacial de epidemias. O presente estudo propÃe avaliar a distribuiÃÃo espacial dos casos de HD associada a aids no municÃpio de Fortaleza, CearÃ, ocorridos de 1999 a 2007.Dados sÃciodemogrÃficos e clÃnicos foram coletados em questionÃrio semiestruturado a partir de informaÃÃs contidas no registro do ServiÃo de Arquivo MÃdico e EstatÃstica do Hospital SÃo Josà de DoenÃas Infecciosas (SAME/HSJ), efetuando-se em seguida o georreferenciamento e anÃlise estatÃstica espacial dos casos com auxÃlio do software Terraview 4.0.0, utilizando-se os bairros e regionais (divisÃo polÃtico-administrativa da cidade) como unidades de agregaÃÃo. Foram identificados 238 casos de HD/aids, sendo excluÃdos 86 indivÃduos procedentes de outros municÃpios que nÃo Fortaleza. A razÃo entre os sexos masculino e feminino foi de 1,43, a mÃdia de idade foi de 40,3  12,8 anos, o nÃvel de escolaridade mais freqÃente ficou na faixa entre 4 e 7 anos de estudo (34,9%) e a maioria (53,02%) recebia no mÃximo trÃs salÃrios mÃnimos. Houve predomÃnio de desempregados (13,16%, p= 0.003), com a maioria (38,71%) correspondendo a mulheres. Setenta e cinco (64,7%) dos 116 bairros que compreendem o municÃpio de Fortaleza foram citados pelos pacientes como logradouro atual. A relaÃÃo da nuvem de pontos com mapas de indicadores sÃcioambientais demonstrou associaÃÃo com mÃdia e baixa cobertura de esgotamento sanitÃrio e mÃdio e baixo Ãndice de desenvolvimento humano. O Ãndice de domicÃlios particulares permanentes demonstrou que os casos se agruparam em Ãreas com alta densidade de casas. O presente trabalho à o primeiro estudo associando HD/aids e SIG no municÃpio de Fortaleza, permitindo localizar geograficamente o perfil de morbimortalidade por HD/aids na cidade, indicando Ãreas onde investigaÃÃes e intervenÃÃes sobre essas doenÃas devam acontecer.<br>Histoplasmosis is considered the most common endemic mycosis in humans, with acosmopolitan distribution and significant impact in Brazil. In recent decades, Histoplasma capsulatum has emerged as an opportunistic pathogen in individuals with impaired cellular immunity such as patients on prolonged corticosteroid therapy, transplant recipients, and immune compromised patients who developed acquire dimunideficiÃncia syndrome (AIDS). The published literature has few serological surveys on the prevalence of this disease in Brazil and little is known about its distribution; in this context, the State of Cearà has been identified as an area of high prevalence of cases of disseminated histoplasmosis (DH) associated with AIDS in this country. The use of Geographic Information Systems (GIS) in Public Health has aimed to understand the health-disease process in many situations, such as planning and evaluation of health actions, definition of risk areas for disease incidence or analysis of spatial dispersion epidemics. The goal of this study was to evaluate the spatial distribution of DH associated with AIDS cases from 1999 to 2007 in Fortaleza, CearÃ. The spatial analysis of DH / AIDS cases was based on medical records information obtained from the Medical and Statistics File System of the SÃo Josà Hospital of Infectious Diseases (SAME / HSJ) . Demographic and clinical data were collected in semi-structured questionnaires to characterize the population studied, and in sequence the geo referencing and spatial statistical analysis of cases was performed through the software Terra view 4.0.0, utilizing the districts as the aggregation units. We identified 238 cases of HD / AIDS; 86 individuals were from other municipalities and excluded. The males/females ratio was 1.43, the mean age was 40.3  12.8 years, the education level was more frequent in the range of 4 to 7 years of study (34.9% ) and most (53.02%) received up to 3 minimum wages. There was a predominance of unemployed (13.16%, p = 0.003) and the majority of them (38.71%) was women. Seventy-five (64.7%) of the 116 districts that comprise the city of Fortaleza were cited as home address by the patients. The analysis of Kernel maps with the social-environmental indicators showed an association with a medium and low sanitation coverage and medium and low Human Developing Index. The cases were clustered in areas with high density of houses. This is the first study associating DH / AIDS and GIS in Fortaleza, allowing the geographic localization of morbidity and mortality profile of DH / AIDS in this city, indicating areas where specific investigations and interventions should be carried out.
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Thompson, Clinton J. "An Analysis of Medication Adherence and Optimism-Pessimism in a Population of People Living with HIV/AIDS." Thesis, The George Washington University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3642034.
Full textAbstract:
<p>The purpose of this research was to investigate and elucidate the relationship between medication adherence and optimism-pessimism in a population of people living with HIV/AIDS. The first aim was to assess the association between optimism-pessimism and two different measures of medication adherence via two different multivariable models. The first measure of adherence was a self-report measure of the frequency with which a person missed their medications for various reasons where a higher score denoted less adherence to their current medication regimen. A robust Poisson regression model was used as the primary mechanism to analyze this measure of adherence. The second measure of adherence was an ordinal-scaled question that inquired about level of confidence to take medication as prescribed by a health care provider. An ordered logit regression (proportional odds regression) was used to analyze this measure of adherence. In both analyses, the quantification of optimism-pessimism on medication adherence began with unadjusted univariate models then progressed to fully-adjusted multivariable models. The second aim was to determine whether the hypothesized association between optimism-pessimism and medication adherence followed from the expression of optimism-pessimism as a single, bipolar metric or as two distinct, unipolar metrics. Both expressions of optimism-pessimism—the single continuum measure and the disaggregated unidimensional measures, respectively—were included in the multivariable models proposed in the first aim. The data used in this project came from a randomized controlled trial conducted between December 2005 and January 2007 by the International Nursing Network for HIV/AIDS Research. The findings from this research indicated that optimism (both dispositional and disaggregated) was positively associated with medication adherence in unadjusted and partially adjusted models but not when depression, quality of life, and self-efficacy were adjusted for. An exploratory analysis that led to the stratification of the sample by the median age, 44, returned a positive association between optimism and medication adherence across all models among subjects <44 years of age. A similar pattern was observed for the association between optimism and confidence to take medications as directed. The analysis of optimism-pessimism as a single continuum or as two independent constructs suggested that optimism and pessimism are not opposite ends of the same continuum but represent two unipolar dimensions. Medication adherence is central to benefits realized at both the individual- and population-levels and these findings help to elucidate the relationship between adequate adherence and a not-yet-fully-understood psychological factor, optimism-pessimism. </p>
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Mashingaidze, Mavis. "The Effect of Direct Contact on Public Attitudes Towards People Living with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) in Zimbabweans." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/832.
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Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the goal of identifying areas of stigma reduction. Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. This study surveyed English-speaking adult Zimbabweans from anywhere in the world. Descriptive statistics, Pearson product-moment correlation coefficients, and hierarchical stepwise multiple regression were used for analysis. Personal knowledge of someone with HIV/AIDS and the beliefs about HIV/AIDS transmission through casual contact emerged as the statistically significant predictors of stigma in the final model (r = -.172, p < .01, and r = .281, p < .001, respectively. There was an inverse correlation between personal knowledge of someone with HIV/AIDS and stigma. Potential positive social change contributions include a mobilized population with a common goal of eradicating HIV/AIDS, seeking HIV/AIDS testing services, disclosure of HIV serostatus, and seeking treatment leading to control of HIV transmission.
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Milloy, Michael-John Sheridan. "Harm production : correctional environments, injection drug users and risk of infection with blood-borne pathogens." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/3433.
Full textAbstract:
Background: Analyses of the individual-, social- and structural-level factors promoting
the transmission of HIV and other blood-borne pathogens have consistently identified
exposure to correctional environments, especially for individuals who use injection
drugs (IDU), as a risk factor for infection. The objectives of this project were: to review
the epidemiologic literature on incarceration and HIV infection among IDU, critically
examining evidence presented supporting a causal linkage between imprisonment and
infection; to investigate incarceration experiences in a cohort of active IDU; and to
assess the possible effects of incarceration on the post-release risk environment of
active IDU.
Methods: Longitudinal datasets for quantitative analyses were derived from the
Vancouver Injection Drug User Study (VIDUS) and the Scientific Evaluation of
Supervised Injection (SEOSI), both prospective cohorts of IDU in Vancouver’s
Downtown Eastside neighbourhood. In the first analysis, the prevalence and correlates
of reporting incarceration in the the previous six months were identified in SEOSI using
generalized estimating equations (GEE). In the second analysis, the possible effect of
imprisonment on the prevalence of risk factors for HIV infection was estimated in
VIDUS using linear growth curve analysis.
Results: In the first analysis, 902 individuals interviewed at least once between 1 July
2004 and 30 June 2006 were included. Overall, 423 (46.9%) reported an incarceration
event at some point during the study period. In a multivariate GEE model, recent
incarceration was independently associated with a number of high-risk factors,
including syringe sharing. In the second analysis, 1603 individuals were interviewed at
least once between 1 May 1996 and 31 December 2005 and in cluded. Of these, 147
(9.2%) matched the study criteria and were included as cases; 742 (46.3%) were included
as matched controls. In linear growth curve analyses adjusted for age, gender and
ethnicity, syringe sharing was significantly more common in the incarcerated group (p
= 0.03) after incarceration than in the control group.
Conclusions: Our findings support the existence of a role for incarceration in continued
viral transmission. In response, appropriate harm reduction measures should be
expanded within correctional environments and social, political and legal reforms
enacted to reduce the incidence of imprisonment for individuals who use illicit drugs.
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Svensson, Maria. "Kamp för överlevnad och drägligt liv hos HIV-positiva kvinnor i Bukoba." Thesis, Halmstad University, School of Social and Health Sciences (HOS), 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-1345.
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<p>The aim of this study was to examine how Tanzanian HIV-positive women experience their socioeconomic situation. Semistructured interviews were carried out and the number of interviewees was 15. Collected data was analysed according to a qualitative content analysis and resulted in an overarching theme; Struggle for survival and tolerable life. Important in the lives of the informants was the access to economic and social resources. The informants described access to economic resources as important because of the possibilty to support oneself and the possibility of a lower level of physical strain. Social resources gave the informants knowledge for a healthy lifestyle and mental support for inner strength. Further research is ought to examine how economic and social support is being comprehend and used, and with a particular weight on the social support because of lack of knowledge in this field. Research which is considering the men´s view of their situation is also important, since a change of the men´s situation could involve a change of the women´s situation.</p>
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Jacobs, Graeme Brendon. "Investigation of the molecular epidemiology of HIV-1 in Khayelitsha, Cape Town, using serotyping and genotyping techniques." Thesis, Link to the online version, 2005. http://hdl.handle.net/10019/1056.
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Silva, Zilene do Socorro Santa Brigida da. "Análise Epidemiológica, Clínica e Comportamental de Pacientes com AIDS acompanhados por um Hospital Público no Tocantins, no período de 2007 a 2013." Pontifícia Universidade Católica de Goiás, 2015. http://localhost:8080/tede/handle/tede/2994.
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Previous issue date: 2015-03-13<br>Objective: To analyze the epidemiological, clinical and behavioral characteristics of patients with AIDS
accompanied by the Hospital for Tropical Diseases in Tocantins, from 2007 to 2013. Methods: A
descriptive, retrospective and cross. Data were collected from 592 reporting forms and records of adult
AIDS cases and child, the period under study, through adapted SINAN record, according to the inclusion
and exclusion criteria. We used the chi-square test to see if there were significant differences (p <0.05)
between the observed and expected frequencies and in all analyzes, adopting a significance level of
0.05. Results: excelled males (57.4%); aged 20-59 years (93.9%); the brown skin color (82.4%); Singles
(65%); with occupancy type employees, self-employed or retired (75.8%); studied the elementary school
(44.6%); resided in Tocantins (71.05%). Except gender (p = 0.0001), the other variables showed
significant differences (p <0.0001); the cases were reported by the criteria Rio de Janeiro - Caracas:
cachexia (16.8%) and asthenia (16.5%), CDC adapted: CD4 T lymphocyte count (51.3%),
toxoplasmosis (11.7%) and pneumonia (11%) and 2.4% for criterion death; were alive until the end of
data collection (72.5%); AIDS was reported in less than 1 year of HIV diagnosis (80.7%); the year 2013
had a higher incidence of AIDS notifications; exposure to HIV through sexual contact occurred (92.9%);
were diagnosed by conventional tests (62.7%); in the notification: CD4 <350 cells - mm3 (79.9%) and
viral load> 40 viral copies (77.2%); and last record: CD4> 500 cells - mm3 (49.5%) and viral load <40
copies to undetectable (57.1%); examination performed genotyping (2.4%); visceral leishmaniasis
(35%) and pulmonary tuberculosis (21%) were the most prevalent and co-infections, toxoplasmosis
(23%) and pneumocystosis (22%) were the major opportunistic infections; in relations: regular - irregular
attendance to health services versus coinfection - IO, 56.7% of patients without regularity developed
coinfection - IO (p <0.0001); regular - irregular attendance to health services versus death, 85.9% died
without those regularly employed (p <0.0001); hospitalization versus coinfection - IO, 63.5% had
coinfection - IO but not hospitalized (p <0.0001); coinfection - IO versus death, 71.7% of patients died
with some coinfection (p <0.0001); 57.6% of patients used ART with AZT + 3TC + EFV at baseline and
at the final on 42.3% used other combinations; the behavior of patients, 41.1% of men reported using
or have used any legal or illegal drug (p = 0.0006); 85.7% of men reported not use or never used
condoms during sexual intercourse (p = 0.4574); on the type of sexual partner, 93.3% of women and
69.1% of men reported having heterosexual relationship. Conclusion: The analysis of all variables and
their results corroborate to achieve the objectives proposed in this study and to understand how it
presents the profile of the AIDS epidemic at the local level, contributing to the management in control
measures for the spread of AIDS in state and the region.<br>Objetivo: analisar as características epidemiológicas, clínicas e comportamentais dos pacientes com
AIDS acompanhados pelo Hospital de Doenças Tropicais no Tocantins, no período de 2007 a 2013.
Métodos: estudo descritivo, retrospectivo e transversal. Foram coletados dados de 592 fichas de
notificação e prontuários de casos de AIDS adultos e criança, do período em estudo, através de ficha
adaptada do SINAN, obedecendo aos critérios de inclusão e de exclusão. Foi aplicado o teste do Quiquadrado
para verificar se havia diferenças significativas (p < 0,05) entre as frequências observadas e
esperadas e em todas as análises, sendo adotado um nível de significância igual a 0,05. Resultados:
sobressaiu o gênero masculino (57,4%); faixa etária entre 20 a 59 anos (93,9%); a cor parda da pele
(82,4%); solteiros (65%); com ocupação tipo empregados, autônomos ou aposentados (75,8%);
estudaram o ensino fundamental incompleto (44,6%); residiam no Tocantins (71,05%). Com exceção
ao gênero (p = 0,0001), as demais variáveis apresentaram diferenças significativas (p < 0,0001); os
casos foram notificados pelos critérios Rio de Janeiro-Caracas: caquexia (16,8%) e astenia (16,5%),
CDC adaptado: contagem de linfócitos T CD4 (51,3%), neurotoxoplasmose (11,7%) e pneumonia (11%)
e 2,4% por critério óbito; encontravam-se vivos até o final da coleta de dados (72,5%); foi notificado
AIDS com menos de 1 ano do diagnóstico de HIV (80,7%); o ano de 2013 teve maior ocorrência de
notificações de Aids; a exposição ao HIV ocorreu por via sexual (92,9%); foram diagnosticados por
exames convencionais (62,7%); na notificação: CD4 < 350 cels-mm3 (79,9%) e carga viral > 40 cópias
virais (77,2%); e último registro: CD4 > 500 cels-mm3 (49,5%) e carga viral < 40 cópias à indetectável
(57,1%); realizaram exame de genotipagem (2,4%); a leishmaniose visceral (35%) e a tuberculose
pulmonar (21%) foram as coinfecções mais prevalentes e, a toxoplasmose (23%) e a pneumocistose
(22%) foram as principais infecções oportunistas; nas relações: comparecimento regular-irregular ao
serviço de saúde versus coinfecção-IO, 56,7% dos pacientes sem regularidade desenvolveram
coinfecção-IO (p < 0,0001); comparecimento regular-irregular ao serviço de saúde versus óbito, 85,9%
faleceram aqueles sem regularidade ao serviço (p < 0,0001); hospitalização versus coinfecção-IO,
63,5% tiveram coinfecção-IO mas não hospitalizaram (p < 0,0001); coinfecção-IO versus óbito, 71,7%
dos pacientes faleceram com alguma coinfecção (p < 0,0001); 57,6% dos pacientes utilizaram a TARV
com EFZ + AZT + 3TC no início do tratamento e, na última consulta 42,3% utilizou outras combinações;
quanto ao comportamento dos pacientes, 41,1% dos homens referiu usar ou já ter usado alguma droga
lícita ou ilícita (p = 0,0006); 85,7% dos homens referiu não usar ou nunca ter usado preservativo nas
relações sexuais (p = 0,4574); sobre o tipo de parceria sexual, 93,3% das mulheres e 69,1% dos
homens informaram ter relacionamento heterossexual. Conclusão: A análise do conjunto de variáveis
e seus resultados corroboraram para o alcance dos objetivos propostos neste estudo e para
compreender como se apresenta o perfil da epidemia de Aids em âmbito local, contribuindo com a
gestão nas medidas de controle para o avanço da Aids no estado e na região.
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Gadelha, Raimunda Rosilene MagalhÃes. "Mortalidade por tuberculose associada à infecÃÃo por HIV/AIDS na cidade de Fortaleza." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11290.
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Um dos problemas mais crÃticos relacionados à coinfecÃÃo HIV/Tuberculose (TB) à a mortalidade associada. A infecÃÃo por HIV tem contribuÃdo para o aumento do nÃmero de casos de TB e ainda tem sido responsÃvel pelo aumento da mortalidade entre os pacientes coinfectados. Fortaleza, situada no Nordeste do Brasil, à um dos centros urbanos com maior incidÃncia de TB no paÃs. O presente trabalho avaliou caracterÃsticas clÃnicas, epidemiolÃgicas e fatores de risco relacionados a mortalidade por TB em pacientes coinfectados com HIV/Aids, maiores de 12 anos, residentes na cidade de Fortaleza-CE. Realizou-se estudo retrospectivo, descritivo e de caso-controle. Foram revisados dados em 262 prontuÃrios dos pacientes com TB ativa acompanhados em quatro ambulatÃrios de referÃncia para HIV/Aids em Fortaleza entre os anos de 2004-2008. O perfil desses pacientes à caracterizado por adultos jovens, baixa escolaridade, sendo comuns os hÃbitos de etilismo (41,98%), tabagismo (33,59%) e uso de drogas ilÃcitas (26,72%). A maioria (65,65%) apresentou TB pela primeira vez. Quanto à apresentaÃÃo clÃnica, a TB pulmonar foi observada em 50% dos casos. A maioria (62,98%) foi submetida a internamento hospitalar durante o tratamento da TB. O uso de antirretrovirias foi mais frequente nos casos que evoluÃram para cura ou tÃrmino de tratamento (88,0%). A letalidade foi de 11,45% e o coeficiente de abandono de 16,03%. Na anÃlise univariada, o indivÃduo separado/viÃvo tem 3,7 vezes mais chance de Ãbito por TB, e 100% dos casos novos foram a Ãbito. Exame de raio-X alterado apresentou uma proporÃÃo de 31% de Ãbitos. O diagnÃstico de HIV devido à TB foi fator protetor ao Ãbito (OR=0,25). A mÃdia da carga viral antes da TB foi superior no grupo dos casos (p=0,04). O inicio da TARV foi outro fator protetor para o Ãbito (OR=0,11). No modelo final da regressÃo logÃstica mÃltipla, observou-se que o indivÃduo que nÃo teve resposta ao tratamento tem 9,9 (p=<0,01) vezes mais chance de evoluir para Ãbito e o indivÃduo que nÃo iniciou o antiretrovirais tem 10,1 (p=<0,01) vezes mais. Estes resultados sÃo importantes para o planejamento e desenvolvimento de aÃÃes voltadas para o controle da TB nos pacientes com infecÃÃo por HIV/Aids em Fortaleza.<br>One of the most critical problems related to HIV / tuberculosis (TB) coinfection is the associate mortality. HIV infection has contributed to the increase in the number of TB cases and has even been responsible for the increased mortality among coinfected patients. Fortaleza, located in Northeastern Brazil, is one of the urban centers with the highest incidence of TB in the country. This research evaluates clinical, epidemiological characteristics and risk factors related to mortality from TB in patients coinfected with HIV / AIDS, aged 12, residents in the city of Fortaleza. It was performed a retrospective, descriptive and case-control study. Database were reviewed in 262 charts of patients with TB active treated at four clinics reference to HIV / AIDS in Fortaleza between the years 2004-2008. The profile of these patients is characterized by young adults, low education, and common habits of alcoholism (41.98%), smoking (33.59%) and illicit drug use (26.72%). The majority (65.65%) showed the first time TB. In the clinical presentation, pulmonary TB was observed in 50% of cases. The majority (62.98%) underwent hospitalization during treatment of TB. The use of anti retrovirias was more frequent in patients who progressed to cure or end of treatment (88.0%). The mortality rate was 11.45% and the coefficient of abandonment of 16.03%. In univariate analysis, the individual separated / widowed have 3.7 times greater risk of death from TB, and 100% of new cases died. X-ray examination showed a changed ratio of 31% of deaths. The diagnosis of HIV due to TB was a protective factor against death (OR = 0.25). Mean viral load before TB was higher in the case group (p = 0.04). The start of ART was another protective factor for death (OR = 0.11). In the final model of logistic regression, we found that the individual who had no response to treatment is 9.9 (p = <0.01) times more likely to lead to death and the individual who has not started antiretroviral 10.1 (p = <0.01) more times. These results are important for planning and development of actions for the control of TB in patients with HIV infection / AIDS in Fortaleza.
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Takaidza, Isaac. "Modelling the optimal efficiency of industrial labour force in the presence of HIV/AIDs pandemic." Thesis, Cape Peninsula University of Technology, 2012. http://hdl.handle.net/20.500.11838/1305.
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Thesis (DTech (Mechanical Engineering))--Cape Peninsula University of Technology, 2012<br>In this thesis, we investigate certain key aspects of mathematical modelling to explain the epidemiology of HIV/AIDS at the workplace and to assess the potential benefits of proposed control strategies. Deterministic models to investigate the effects of the transmission dynamics of HIV/AIDS on labour force productivity are formulated. The population is divided into mutually exclusive but exhaustive compartments and a system of differential equations is derived to describe the spread of the epidemic. The qualitative features of their equilibria are analyzed and conditions under which they are stable are provided. Sensitivity analysis of the reproductive number is carried out to determine the relative importance of model parameters to initial disease transmission. Results suggest that optimal control theory in conjunction with standard numerical procedures and cost effective analysis can be used to determine the best intervention strategies to curtail the burden HIV/AIDS is imposing on the human population, in particular to the global economy through infection of the most productive individuals. We utilise Pontryagin’s Maximum Principle to derive and then analyze numerically the conditions for optimal control of the disease with effective use of condoms, enlightenment/educational programs, treatment regime and screening of infectives. We study the potential impact on productivity of combinations of these conventional control measures against HIV. Our numerical results suggest that increased access to antiretroviral therapy (ART) could decrease not only the HIV prevalence but also increase productivity of the infected especially when coupled with prevention, enlightenment and screening efforts.
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JÃnior, Alberto Novaes Ramos. "Patterns and trends of mortality and survival in brazilian children with AIDS." Universidade Federal do CearÃ, 2011. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=6750.
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nÃo hÃ<br>A infecÃÃo pelo HIV/aids em crianÃas vem sendo eliminada como problema de saÃde pÃblica em paÃses desenvolvidos, mas mantÃm elevada carga de morbimortalidade naqueles em desenvolvimento. O Brasil se destaca pela polÃtica consistente de controle, especialmente pela adoÃÃo universal/gratuita da HAART em 1996. Esta tese visa caracterizar padrÃes e tendÃncias de morbimortalidade e sobrevida em crianÃas com aids no paÃs. Foram estruturados dois blocos analÃticos: 1) estudos nacionais de morbimortalidade por aids em crianÃas, 2) estudos nacionais de sobrevida em crianÃas com aids. No primeiro bloco realizou-se estudo ecolÃgico do tipo sÃrie temporal (1984-2008) de casos (14.314) e Ãbitos (5.041) por aids no Brasil, regiÃes e grupos etÃrios (0-12 e 0-4 anos), baseado na anÃlise dos respectivos coeficientes por modelos de regressÃo polinomial, diferenÃa percentual e razÃes nas eras prÃ-HAART e HAART. Adicionalmente, realizou-se anÃlise de tendÃncia temporal (1999-2007) da mortalidade por causas mÃltiplas relacionadas à infecÃÃo pelo HIV/aids em crianÃas infectadas no Brasil (2.191/680.736) pela estimativa da razÃo de chances de mortalidade (MOR). No segundo bloco, realizou-se estudo de coorte retrospectiva, multicÃntrico-nacional, de sobrevida em crianÃas com aids (920 crianÃas, 1999-2002, atà 2007) e fatores associados, com anÃlise integrada ao primeiro estudo nacional (914 crianÃas, 1983-1998, atà 2002) para verificaÃÃo de tendÃncias de sobrevida e padrÃes de ocorrÃncia de diagnÃstico tardio e doenÃas definidoras de aids. Os resultados demonstram que o Brasil apresenta reduÃÃo da tendÃncia temporal da morbimortalidade da aids apÃs a adoÃÃo da HAART, mas com grandes desigualdades regionais. As regiÃes mais pobres do paÃs (Norte/Nordeste) apresentaram o pior cenÃrio para mortalidade (p<0,001), apesar da concentraÃÃo de casos e Ãbitos nas regiÃes mais desenvolvidas (Sul/Sudeste). Para a incidÃncia, o Nordeste evoluiu com estabilizaÃÃo (p<0,001); o Sul apresenta tendÃncia crescente para crianÃas 0-4 anos (p<0,001) e os maiores coeficientes do paÃs em ambos grupos etÃrios. O coeficiente de mortalidade por causas nÃo relacionadas ao HIV/aids entre 1999-2007 era estÃvel (0,08/100.000 habitantes). A MOR indica tendÃncia de crescimento destas causas entre 2000-2007 (1,18 versus 1,85), embora nÃo significativa (p=0,413); nÃo foi verificada tendÃncia de causas especÃficas neste grupo. A probabilidade de sobrevida em 60 meses foi de 0,88 (IC 95%: 0,86-0,91), com menor sobrevida para crianÃas com <1 ano (p=0,013), categoria C (p<0,001), doenÃas oportunistas (p<0,001) e sem TARV (p<0,001). Nos estudos nacionais, houve, respectivamente, 420 (46%) e 109 (11,8%) Ãbitos, com tendÃncia de ampliaÃÃo da sobrevida (p<0,001), variando de 0,20 (<1988) a 0,90 (2001-2002), e tambÃm pÃs-HAART (0,41 versus 0,84, p<0,001). Houve reduÃÃo do diagnÃstico tardio e de doenÃas definidoras em crianÃas nascidas (p=0,009 e p<0,001) e diagnosticadas pÃs-HAART (p=0,004 e p<0,001), com proporÃÃes ainda elevadas na segunda coorte (47,7% versus 36,1% e 80,7% versus 50,8%); doenÃas bacterianas e pneumocistose mantiveram importÃncia, com menor grau. Conclui-se que a morbimortalidade da aids em crianÃas no paÃs vem sendo reduzida, sobretudo pÃs-HAART. A sobrevida ampliou-se significativamente, tornando a aids uma condiÃÃo crÃnica, com desafios inerentes. Mas desigualdades regionais indicam implementaÃÃo diferenciada das aÃÃes, com pior cenÃrio nas regiÃes mais pobres, com aspectos ainda da era prÃ-HAART. Adicionalmente, o estudo revela questÃes importantes relacionadas à cobertura/qualidade da atenÃÃo à saÃde da mulher (em especial prÃ-natal e planejamento familiar) e Ãs crianÃas expostas/infectadas pelo HIV bem como à complexidade da dinÃmica de transmissÃo do HIV-1 no paÃs.<br>HIV/AIDS infection among children is in the process of being eliminated as a public health problem in high-income countries, but still maintains an elevated level of morbidity-mortality in developing nations. Brazil stands out for its consistent HIV/AIDS control policy, particularly its adoption of free and universal distribution of HAART in 1996. This thesis describes the patterns and trends of morbidity-mortality and survival in children with AIDS in Brazil. Two analytical groupings were formed: 1) national studies of AIDS morbidity-mortality in children, 2) national survival studies in children with AIDS. In the first group, an ecological time-series study was undertaken (1984-2008) on cases (14,314) and deaths (5,041) from AIDS in Brazil by region and age group (0-12 and 0-4 years), based on an analysis of the respective rates using polynomial regression, percentage differences and ratios in the pre-HAART and HAART eras. In addition, a temporal trend analysis was done (1999-2007) on mortality from the various causes related to HIV/AIDS infection in children in Brazil (2,191/680,736) using Mortality Odds Ratio (MOR). Among the second group, a multi-centric, national retrospective cohort study of survival of children with AIDS (920 children, 1999-2002, until 2007) and associated factors was conducted with integrated analysis of the first national study (914 children, 1983-1998, until 2002) for verification of survival trends and occurrence patterns of late diagnosis and AIDS-defining diseases. The results point to the fact that Brazil shows a reduction of AIDS morbidity and mortality after the implementation of HAART, but with large regional disparities. The poorest regions of the country (North/Northeast) showed the worst trend for mortality (p<0.001), despite the concentration of cases and deaths in the most developed regions (South/Southeast). In terms of incidence, evolution in the Northeast stabilized (p<0.001), whereas the South showed increasing trends for children aged 0-4 (p<0.001), with the highest national rates for both age groups. The mortality rate from causes not related to HIV/AIDS between 1999 and 2007 was stable (0.08/100,000 population). The MOR indicates an increasing trend of these causes from 2000-2007 (1.18 versus 1.85), although not statistically significant (p=0.413). A trend of specific causes was not identified in this group. The probability of survival at 60 months was 0.88 (CI 95%: 0.86-0.91), with the lowest survival rates among children <1 year of age (p=0.013), category C (p<0.001), opportunistic diseases (p<0.001) and without ART (p<0.001). In the national studies there were, respectively, 420 (46%) and 109 (11.8%) deaths, with a trend for increased survival (p<0.001), varying from 0.20 (<1988) to 0.90 (2001-2002) post-HAART (0.41 versus 0.84, p<0.001). There was a reduction in late diagnosis and AIDS-defining diseases in children born (p=0.009 and p<0.001) and diagnosed post-HAART (p=0.004 and p<0.001), though with elevated frequencies still seen in the second cohort (47.7% versus 36.1% and 80.7% versus 50.8%). Bacterial diseases and pneumocystosis remained important, but to a lesser degree. It is concluded that morbidity-mortality due to AIDS among Brazilian children has been declining, principally after the adoption of HAART. Survival increased significantly to the point of making AIDS a chronic condition with inherent challenges. However, there were regional inequalities with differences in the implementation of control activities, and worse conditions in the poorest regions, still showing characteristics of the pre-HAART era. In addition, the study reveals important issues related to coverage/quality of health care for women (particularly pre-natal care and family planning) and for children exposed to or infected with HIV, as well as to the dynamics of HIV-1 transmission in Brazil.
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Reed, Joel Christian. "Hiv/aids workplace interventions in south africa and the united states." [Tampa, Fla.] : University of South Florida, 2005. http://purl.fcla.edu/fcla/etd/SFE0001117.
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Petoumenos, Kathy Public Health & Community Medicine Faculty of Medicine UNSW. "Treatment experience and HIV disease progression: findings from the Australian HIV observational database." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/24937.
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The Australian HIV Observational Database (AHOD) is a collaboration of hospitals, sexual health clinics and specialist general practices throughout Australia, established in April 1999. Core data variables collected include demographic data, immunological and virological markers, AIDS diagnosis, antiretroviral and prophylactic treatment and cause of death. The first electronic data transfer occurred in September 1999 followed by six monthly data transfers thereafter. All analyses included in this thesis are based on patients recruited to AHOD by March 2004. By March 2004, 2329 patients had been recruited to AHOD from 27 sites throughout Australia. Of these, 352 (15%) patients were recruited from non-metropolitan clinics. The majority of patients were male (94%), and infected with HIV through male homosexual contact (73%). Almost 90% of AHOD patients are antiretroviral treatment experience, and the majority of patients are receiving triple therapy as mandated by standard of care guidelines in Australia. Antiretroviral treatment use has changed in Australia reflecting changes in the availability of new treatment strategies and agents. The crude mortality rate was 1.58 per 100 person years, and of the 105 deaths, more than half died from HIV-unrelated deaths. The prevalence of HBV and HCV in AHOD was 4.8% and 10.9%, respectively. HIV disease progression in the era of highly active antiretroviral treatment (HAART) among AHOD patients is consistent with what has been reported in developed countries. Common factors associated with HIV disease progression were low CD4 cell count, high viral load and prior treatment with mono or double therapy at the time of commencing HAART. This was demonstrated in AHOD in terms of long-term CD4 cell response, the rate of changing combination antiretroviral therapy and factors predicting death. HBV and HCV coinfection is also relatively common in AHOD, similar to other developed country cohorts. Coinfection does not appear to be serious impediments to the treatment of HIV infected patients. However, HIV disease outcome following HAART does appear to be adversely affected by HIV/HCV coinfection but not in terms of HIV/HBV coinfection. Patients attending non-metropolitan sites were found to be similar to those attending metropolitan sites in terms of both immunological response and survival.
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Grant, April C. "The Effects of Massage Therapy on Immune Functioning of Inner-City Adults Living with HIV/AIDS." Master's thesis, Temple University Libraries, 2011. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/148681.
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Epidemiology<br>M.S.<br>Background/Objective: Massage therapy has moderate empirical support for enhancing immunological functioning. This study examined the effects of massage on 144 inner-city HIV/AIDS-positive men/women. It was hypothesized that adults electing massage would have greater improvement in immune functioning compared to adults declining massage. This study has Temple IRB approval. Methods: 48 HIV/AIDS-positive adults who elected to receive one or more massage sessions from the licensed massage therapist at Congreso were compared to 96 sex-matched HIV/AIDS-positive adults who declined massage over one year. Pre/Post massage CD4+ counts were measured as proxies for immune functioning. Mean immune functioning change was compared between the massage and control group to identify differences Pre/Post the massage/control window and within the massage group to test for dose-dependent effects. Results: No significant differences in age, education, race/ethnicity, language, income, mental health or substance-abuse history were found between the massage and control group. The massage group had lower immune functioning at baseline (394.5±279.7) compared to control group (467.3±283.8); however, this 16.9% difference in baseline mean CD4+ counts between the two groups was non-significant (p=0.23). ANOVA analyses found no difference in CD4+ change (Post-Pre) between the groups (p=0.70). Further ANCOVA analyses found the effects of massage on mean CD4+ counts non-significant after adjusting for baseline differences (p=0.75). However, the trends were in the hypothesized direction with an increase of 36.9 (±148.6) in CD4+ counts for the massage group compared to an increase of 22.5 (±183.4) in the control group. The presence of a dose-dependent effect within the massage group was also non-significant (p=0.95). Pre/Post differences among subjects who received only one massage were found significant (p=0.04), but not for subjects receiving more than one massage (p=0.51). Conclusion: These trends highlight that massage therapy effects may be an important non-pharmacological modality to complement standard-of-care to improve or sustain immune functioning.<br>Temple University--Theses
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Ferreira, Bianca da Silva. "Histoplasmose disseminada em pacientes com AIDS: características clínico-epidemiológicas e análise espacial em hospital de referência de uma metrópole do centro- oeste brasileiro." Universidade Federal de Goiás, 2015. http://repositorio.bc.ufg.br/tede/handle/tede/7701.
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Previous issue date: 2015-05-21<br>The histoplasmosis is an important endemic mycosis caused by Histoplasma
capsulatum. It’s is an AIDS-defining illness. It causes in patients with AIDS,
especially when LT-CD4 + <100 cells./mm³ the disseminated form and has high
letality rates. Although In the metropolitan area of Goiânia a high rate of
disseminated histoplasmosis is observed in patients with AIDS, the real incidence
and risk factors are unknown. Objectives: Describe the clinical-epidemiological
characteristics and the spatial distribution of cases of histoplasmosis in patients
with AIDS in the city of Goiânia and Aparecida de Goiânia. Methods: A descriptive
ecological study conducted in patients from Tropical Diseases Hospital Dr. Anuar
Auad, from January 2003 to July 2014. A standardized survey was applied to
medical records of patients with AIDS and disseminated histoplasmosis with
laboratory confirmation from Goiânia and Aparecida de Goiânia. A statistical
analysis and description of the epidemiological clinical data was performed with
georeferencing, production of maps and spatial analysis. Results: The
disseminated histoplasmosis in AIDS patients has a high incidence in the
metropolitan area of Goiânia and Aparecida de Goiânia, with a total of 166 cases.
Most of the patients were young men with low income and low education level.
Histoplasmosis was AIDS-defining illnesses in 68 patients, and the average LTCD4+
was 70 cels./mm³ to histoplasmosis diagnosis. The main symptoms were:
respiratory, gastrointestinal and cutaneous. The spatial location of the cases were
predominantly aleatory in both cities studied, however two important regions were
detected: one in the east and another in western of Goiania, both close to water
sources. Conclusions: Histoplasmosis is an urban disease with very high
incidence in Goiânia and Aparecida de Goiânia. All cases presented a serious
clinical features and high mortality rates. The treatment is applied in an irregular
manner and does not follow the guidelines recommendations. The cases found are
related to areas of environmental degradation and uncontrolled urbanization. They
were also related to green areas and waterways.<br>Introdução: A histoplasmose é causada pelo fungo Histoplasma capsulatum, é
uma importante micose endêmica, e é uma doença definidora de AIDS. Causa no
paciente com AIDS, principalmente quando há LT-CD4+ <100 céls./mm³ a forma
disseminada e tem elevada taxa de letalidade. Na região metropolitana de Goiânia
é observado elevada taxa de histoplasmose disseminada em pacientes com AIDS,
entretanto a real incidência e fatores de risco não são conhecidos. Objetivos:
Descrever as características clínico-epidemiológicas e a distribuição espacial dos
casos de histoplasmose em pacientes com AIDS, no município de Goiânia e
Aparecida de Goiânia. Métodos: Estudo ecológico descritivo, realizado em
pacientes do Hospital de Doenças tropicais Dr Anuar Auad, no período de janeiro
de 2003 a julho de 2014. Através de questionário padronizado aplicado a
prontuários de pacientes com AIDS e Histoplasmose disseminada confirmados
laboratorialmente, residentes nos municípios de Goiânia e Aparecida de Goiânia.
Foi realizado descrição e análise estatística dos dados clínico epidemiológicos,
com georreferenciamento dos casos, produção de mapas e análise espacial.
Resultados: A Histoplasmose disseminada em pacientes com AIDS tem uma
prevalência elevada na região metropolitana de Goiânia e Aparecida de Goiânia,
com total de 166 casos. A maioria dos pacientes eram homens jovens, com baixa
renda e nível de escolaridade. Histoplasmose foi doença definidora de AIDS em
68 pacientes, e a média de LT-CD4+ foi de 70 céls./mm³ ao diagnóstico de
histoplasmose. Os principais sintomas apresentados foram respiratórios,
gastroinstestinais e cutâneos. A localização espacial dos casos ocorreu
predominantemente de forma aleatória nos dois municípios estudados, entretanto
houve identificação de dois importantes focos próximo a mananciais de água, um
na região leste outro na região oeste de Goiânia Conclusões: A histoplasmose é
uma doença urbana, com prevalência muito elevada em Goiânia e Aparecida de
Goiânia, os casos apresentam grave quadro clínico laboratorial e de letalidade
elevada. O tratamento é feito de maneira irregular e não segue as recomendações
dos guidelines. Os casos encontrados estão relacionados a áreas de degradação
ambiental e urbanização desordenada, e áreas próximas a cursos d’água e áreas
verdes.
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Wagbara, Maureen A. "Gender Inequality in Women's Knowledge and Awareness of HIV/AIDS in Port Harcourt." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3732.
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In Nigeria, gender inequality significantly impacts women's knowledge and awareness of the transmission of the human immunodeficiency virus (HIV) and the proliferation of acquired immunodeficiency syndrome (AIDS). Early marriage, traditional beliefs, religion, and polygamy all contribute to gender inequality. This study explored the role of these and other sociocultural practices in the gender inequalities that increase vulnerability of contracting HIV/AIDS among women in Port Harcourt, Rivers State, Nigeria. The study employed a phenomenological design, collected data through a semistructured interview approach, which was managed using NVivo software. The purposive sample comprised 20 female students from a college in Port Harcourt. This study's key findings correlated with other studies highlighting the interconnectedness of sociocultural practices responsible for increasing HIV/AIDS among Port Harcourt women. Other underlying findings included women's lack of economic power to achieve personal needs, such as access to HIV treatment, and the lack of skills to negotiate safe sex, which contributed to increased HIV/AIDS among women. Recommendations for further research include programs for reduction of gender inequality related to this HIV/AIDS outbreak. The implications for social change included adequate government funding to help provide available and accessible health services to women, promote safe sex conduct and education among the most vulnerable (women), and reduce HIV transmission from mother to child.
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Correll, Patricia Kay. "Completion of Preventive Health Care Actions by Older Women with HIV/AIDS." ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1494.
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The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the completion of these screening tests. The electronic medical records of 142 HIV seropositive women were reviewed. Univariate analysis, bivariate analysis, and logistic regression were conducted to create a model associated with the completion of preventive health care screening tests. For breast cancer, cervical cancer, and colorectal cancer, 69%, 71.8%, and 69.7% failed to complete screening, respectively. Number of years living with HIV infection and HIV stage were associated with breast cancer screening; distance between residence and health care facility, and HIV stage were associated with cervical cancer screening; and age and marital status were associated with colorectal cancer screening. Addressing issues related to the completion of cancer screening tests over the lifespans of HIV seropositive women can result in positive social change by preventing disease and disability, which can negatively impact these women, their families, and their communities.