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Stigma towards people living with HIV (PLWH) in healthcare settings is a barrier to optimal treatment. However, our understanding of attitudes towards PLWH from healthcare providers’ perspective in the United States is limited and out-of-date. We assessed HIV-related stigma among healthcare staff in Alabama and Mississippi, using online questionnaires. Participants included 651 health workers (60% White race; 83% female). Multivariate regression suggests that several factors independently predict stigmatizing attitudes: Protestant compared to other religions (β = 0.129, p≤0.05), White race compared to other races (β = 0.162, p ≤0.001), type of clinic (HIV/STI clinic: β = 0.112, p≤0.01), availability of post-exposure prophylaxis (yes: β = −.107, p≤0.05), and perceptions of policy enforcement (policies not enforced: β = 0.058, p = p≤0.05). These findings may assist providers wishing to improve the quality care for PLWH. Enforcement of policies prohibiting discrimination may be a useful strategy for reducing HIV-related stigma among healthcare workers.

Background The success of antiretroviral therapy (ART) has led to dramatic changes in causes of morbidity and mortality in HIV-infected individuals. As chronic diseases rates have increased in HIV+ populations, modifiable risk factors such as obesity have increased in importance. Our objective was to evaluate factors associated with weight change among patients receiving ART. Methods ART-naïve patients initiating therapy at the University of Alabama - Birmingham 1917 HIV/AIDS Clinic from 2000– 2008 were included. Body Mass Index (BMI) was categorized as: underweight (<18.5), normal weight (18.5–24.9), overweight (25–29.9) and obese (≥30). Linear regression models were used to evaluate overall change in BMI and factors associated with increased BMI category 24 months following ART initiation. Results Among 681 patients, the mean baseline BMI was 25.4 ± 6.1; 44% of patients were overweight/obese. At 24 months, 20% of patients moved from normal to overweight/obese or overweight to obese BMI categories. Greater increases in BMI were observed in patients with baseline CD4 count < 50 cells/μl (3.4 ± 4.1, P<0.01) and boosted protease inhibitor use (2.5±4.1 P=0.01), but did not account for all of the variation observed in weight change. Conclusions The findings that almost half of patients were overweight or obese at ART initiation, and 1 in 5 patients moved to a deleterious BMI category within 2 years of ART initiation are alarming. ART therapy provides only a modest contribution to weight gain in patients. Obesity represents a highly prevalent condition in patients with HIV infection and an important target for intervention.

Discordant immunologic and virologic responses at 3 to 9 months after HAART initiation play important roles in predicting long-term clinical outcomes in treatment-naive patients.

Objectives To assess the relationships between different behavioral factors and Early Childhood Caries (ECC) in African-American pre-school children. Methods Ninety-six African-American children aged 3 to 22 months old at baseline were recruited by word of mouth from Uniontown, Alabama, a non-fluoridated community. The children had dental examinations annually following World Health Organization (WHO) criteria at baseline, 1st, 2nd and 3rd follow-up. Parents provided detailed oral hygiene and dietary information every six months by completing questionnaires. Cumulative calculations using area-under-the-curve (AUC) were made for all the independent variables that were assessed at the follow-up questionnaires. Bivariate and multivariable relationships between ECC incidence and different behavioral risk factors were assessed using logistic regression for dichotomous dependent variables and negative binomial modeling for count dependent variables. Independent variables were defined at baseline, as the AUC and at 2nd follow-up. Results Ninety-nine percent of the children consumed sugar-added beverages by the time of the 2nd follow-up visit. Increased frequency of toothbrushing and increased AUC composite of daily frequency of consumption of 100% juices were associated with decreased incidence of dental caries (p-values=0.01 and 0.049, ORs=0.34 and 0.37, respectively). Greater AUC of daily frequency of consumption of sweetened foods and a history of a previous visit to a dentist by the 2nd follow-up visit were associated with increased incidence of ECC (p-values=0.002 and 0.03, ORs=9.22 and 4.57, respectively). Conclusion For those living in a non-fluoridated community, more frequent consumption of sweetened food, less frequent consumption of 100% juice, less frequent toothbrushing, and reporting a previous visit to a dentist were significantly associated with increased ECC incidence.