Our objective was to study relations between non-disclosure of HIV to partner, socio demographics and prevention of HIV mother-to-child transmission (PMTCT), among HIV-infected pregnant women enrolled in the French Perinatal Cohort (ANRS-EPF-CO1) from 2005 to 2009 (N = 2,952). Fifteen percent of the women did not disclose their HIV status to their partner. Non-disclosure was more frequent in women diagnosed with HIV infection late in pregnancy, originating from Sub-Saharan Africa or living alone, as well as when the partner was not tested for HIV. Non-disclosure was independently associated with non optimal PMTCT: late initiation of antiretroviral therapy, detectable viral load at delivery and lack of neonatal prophylaxis. Nonetheless, the rate of transmission did not differ according to disclosure status. Factors associated with non-disclosure reflect vulnerability and its association with non optimal PMTCT is a cause for concern although the impact on transmission was limited in this context of universal free access to care.

Objectives Antiretroviral therapy has dramatically improved the survival of HIV‐infected children. Nevertheless, side effects comparable to those found in adults have been encountered, such as facial lipoatrophy, which can have a negative impact on the self‐esteem of otherwise healthy adolescents. Cosmetic surgical procedures in adolescents raise psychological issues which need to be specifically addressed and which have never been previously reported in this population. We evaluated the patient satisfaction, safety and cosmetic results of HIV‐infected adolescents who experienced autologous fat transplants for the correction of facial lipoatrophy. Methods We report the results of plastic surgery using autologous fat transplants (Coleman's Lipostructure™) in six HIV‐infected adolescents with facial lipoatrophy: three boys and three girls, aged 14–19 years. Results The quantity of reinjected fat on each side of the face varied from 5 to 12 mL within a single procedure. All the patients reported being satisfied or very satisfied with the cosmetic results and reported a positive impact on their daily life. Conclusions With well‐trained surgeons and carefully selected indications, corrective surgery of facial lipoatrophy in HIV‐infected adolescents can provide immediate and long‐lasting benefits in terms of physical appearance and psychological wellbeing, and should be considered as a component of comprehensive care.

No abstract

No abstract

No abstract

No abstract

No abstract

La découverte d'une leucémie chez un enfant entraîne un bouleversement majeur des liens intrafamiliaux. La prise en charge psychologique des effets traumatiques sur la fratrie de l'enfant malade dès l'annonce du diagnostic est nécessaire, du fait de son isolement et de sa grande souffrance. Le groupe dans ce cas semble particulièrement indiqué. Il nous a semblé évident qu'il soit ouvert à la libre expression des enfants. C'est la raison pour laquelle la présence de deux psychologues cliniciens formés à la dimension de l'écoute de l'inconscient nous a paru opportune.Les réunions ont eu lieu à un rythme mensuel entre décembre 2001 et décembre 2003 : plus de 20 rencontres ont eu lieu et plus de 30 enfants de 6 à 13 ans y ont participé. Le vécu par la fratrie des moments importants de la maladie génère des sentiments ambivalents parfois emprunts d'une grande violence. Nous avons pu noter l'expression de solitude, de ressentis abandonniques, de grands désarrois et d'angoisses. Ce groupe a eu des effets thérapeutiques significatifs tant sur le plan individuel que sur le plan familial, puisque la dynamique de ces rencontres a permis l'expression de demandes d'aides dans la famille elle-même.Abstract: Juvenile leukemia disturbs family relationships. Psychological care of the sick child's siblings is necessary as they suffer the traumatic effects of the illness and feel isolated. The group is particularly recommended here because children are able to speak freely. Moreover, two psychologists with psychoanalytic training are present. Since December 2001, children have had monthly meetings; more than 20 meetings have taken place with more than 30 children participating. During the disease, siblings showed ambivalence and were sometimes violent. They also expressed solitude, abandonment, and distress.The group has been therapeutic, for the individual and for the family group.