BackgroundBasic needs (e.g., food security and stable housing) are important determinants of health and well-being, yet their impact on health-related quality of life (HRQoL) in the context of HIV and aging has not been systematically investigated.MethodsMultiple linear regression models examined the relationship between unmet basic needs, and physical and mental HRQoL by age strata (20-34, 35-49 and 50+) in a cross-sectional sample of 496 people living with HIV in Ontario, Canada.ResultsAn overwhelming majority of participants (87%) reported unmet needs related to food, clothing or housing. The prevalence of unmet basic needs in the two older groups appeared to be lower than among younger participants, but the difference did not reach statistical significance. The presence of unmet basic needs predicted substantially lower mean physical health and mental health summary scores in the two oldest groups. Notably, age moderated the influence of unmet basic needs on HRQoL.ConclusionsThe availability and accessibility of food security, appropriate clothing and stable housing for people living with HIV who are aging need to become a higher priority for program planners and decision makers.
A retrospective cross-sectional survey of 299 HIV-infected inpatients and outpatients was conducted between March 1999 and June 2000 in Phnom Penh, Cambodia, to define patient demographics and risk factors for HIV-1 infection, and to compare whether symptoms and opportunistic infections (OIs) differ by gender and site of patient care. The population represented one third of HIV-infected patients regularly receiving care at the Sihanouk Hospital Center of HOPE. Over one quarter (26%) of the men were soldiers and 27% were farmers or laborers. Eighty-nine percent of the men had visited sex workers, 29% of men and women had unsafe injections in the past, and 18% of women reported a spouse who was HIV-positive. Eighty percent of patients presented with weight loss more than 10% from baseline. Seventy-two percent of patients were diagnosed with two or more concurrent OIs or conditions. Oral candidiasis (p = <0.001), abdominal lymphadenitis (p = 0.03), and two or more concurrent OIs (p = <0.001) were diagnosed more often among men than women. Multivariate logistic regression shows that patients who presented with weight loss more than 10% from baseline are more likely to have one or more OIs or conditions. The results of this survey suggest that the primary risk factor for HIV-infected men presenting to this care facility was visiting sex workers. The pattern of OIs and other HIV-associated conditions indicated that the majority of patients delayed seeking care at the hospital. HIV physicians in Cambodia should be aware of the likelihood for multiple OIs or conditions when patients present weight loss more than 10% from baseline.
Background Sexual behaviours among HIV-positive male patients in Cambodia have not been fully evaluated. Objectives The patterns of sexual behaviours and social factors were compared between married and single men. Methods A retrospective cross-sectional survey of 174 male HIV patients was undertaken during March 1999–June 2000 in Phnom Penh. Results Many participants (61%) reported that they were unaware that their sexual behaviours may have put them at risk of HIV infection. Sexual behaviours included having sex with a sex worker (90%), multiple sexual partners (41%), and both of these behaviours (37%). Two-thirds (69%) reported using a condom when having sex with a sex worker. Condom use with multiple sexual partners was low (24%). A history of condom use with a sex worker was less likely to be reported among married men than single men (P = 0.008). Always using condoms with a sex worker did not differ between married men and single men. Social factors that influenced visiting a sex worker included invitation by a friend (88%), alcohol consumption (74%), and having extra spending money (72%). Multivariate analysis suggests that alcohol consumption (P = 0.008) and having extra spending money (P = 0.02) were strongly associated with visiting a sex worker. Conclusions In Cambodia, HIV-infected men frequently reported a history of using sex workers. Having multiple sex partners or using a sex worker and multiple sexual partners were not rare. Interventions should target men in settings where alcohol is consumed and to encourage married men to use condoms.
Hyponatremia is a frequent finding in hospitalised HIV-patients. The diagnosis of extra-pulmonary tuberculosis (EPTB) is difficult in resource-limited settings, causing delays in treatment. In this cross-sectional study based on hospital chart review in a charity hospital in Cambodia we found that hyponatremia (serum sodium < 134 meq/L) was significantly associated with a diagnosis of EPTB in HIV-positive adults. Our findings suggest that hyponatremia in patients with advanced stage of HIV disease should trigger a diagnostic work-up for EPTB.
Facing a 1.2% HIV-1 seroprevalence amongst its adult female population, Cambodia recently established national guidelines for the expansion of services to prevent mother-to-child transmission. Anticipating this expansion, Sihanoukville Hospital performed an anonymous HIV-1 cord-blood serosurvey of 600 consecutive deliveries from May 2001 through June 2002. Laboratory analysis utilizing ELISA and Western blot techniques yielded a 4.2% seroprevalence; a value resembling previous reports from other Sihanoukville antenatal clinics (3.9%) but exceeding the national ANC clinic average of 2.3%. Demographic information was confidentially collected and analysed for co-variation to HIV-1 status. One hundred percent of HIV positive mothers (P =0.013) self-reported the occupation of housewife, consistent with previous documentations suggesting the shift in infection burden from high-risk groups into the general female population. A substantial proportion received no prenatal care, suggesting that interventions addressing mother-to-child transmission will need to prepare for the management of pregnant women presenting at or near the time of delivery.
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