Correlates of HIV infection among patients with mental illness in Brazil

Guimaraes, M. S.; McKinnon, Karen; Cournos, Francine; Machado, Carla Jorge; Ap, Melo; Ln, Campos; Wainberg, Milton L.

doi:10.1080/09540121.2013.832722

Cited by 13 publications

(24 citation statements)

References 35 publications

(50 reference statements)

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“…Homeless overlapping risk groups have also shown high HIV prevalence rates, such as 3.4% in persons deprived of liberty and 19.1% in trans women in a worldwide metanalysis study, 460/1,637 (28.1%) in sex workers of sub-Saharan Africa, and 17-fold higher chance to have HIV in refugee mothers of Canada when compared to Canadian-born mothers [29][30][31]. In Brazil, 15/2,237 (0.7%) people with mental disorders, and 25/333 (7.5%) migrants from Venezuela were positive for HIV [32,33]. In addition, immunological impairment caused by HIV may aggravate co-infections, with a tendency of severe clinical manifestations in HIV-toxoplasmosis combination [14,34].…”

Section: Introductionmentioning

confidence: 98%

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Lg¹,

Pi²,

FFVd³

et al. 2020

Preprint

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Background: Homeless persons have been described as one of the most vulnerable populations worldwide, with higher morbidity and mortality of diseases associated with HIV occurrence. Seroprevalence of Toxoplasma gondii and HIV has been extensively studied in other vulnerable populations, however, no study to date have focused on their concomitant seroprevalence in homeless persons. Accordingly, the present study aimed to assess the concomitant seroprevalence of anti-T. gondii and anti-HIV antibodies and associated risk factors in homeless persons in a daytime homeless shelter of São Paulo, southeastern Brazil. Methods: Anti-T. gondii antibodies were detected by indirect fluorescent antibody test and anti-HIV levels by chemiluminescence enzyme immunoassay, with positive samples confirmed by rapid immunoblot assay. Results: Overall, IgG anti-T. gondii seropositivity was found in 43/120 (35.8%) homeless persons, with endpoint titers varying from 16 to 1,024. The only two pregnant women tested were negative for IgM by chemiluminescence enzyme immunoassay, with normal parturition and clinically healthy newborns in both cases. There were no statistical differences in the risk factors for anti-T. gondii serology (p>0.05). Anti- HIV seropositivity was found in 2/120 (1.7%) homeless persons, confirmed as HIV-1. One HIV seropositive individual was also sero-reactive to IgG anti-T. gondii, and both were negative to IgM anti-T. gondii. One HIV positive person was also diagnosed with syphilis, tuberculosis and body lice presence, while the other never returned for assistance. No evaluation of anti- HIV risk factors has been made due to the low seropositive rate. Conclusions: The anti-T. gondii prevalence herein was lower than other Brazilian populations, likely related to predominant intake of processed food such as ready-to-eat and fast-food meals, and thus, low ingestion of fresh salad and raw meat. On the other hand, the anti- HIV seropositivity was higher than the average of the general Brazilian population, with 0.4%. Despite the low prevalence of anti-T. gondii in homeless persons, clinical manifestations may be aggravated in HIV positive individuals. To the author's knowledge, this is the first study of anti-T. gondii serosurvey in homeless persons concomitantly assessed with anti-HIV seropositivity.

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Section: Introductionmentioning

confidence: 98%

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Lg¹,

Pi²,

FFVd³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Mental health disorders have been shown to contribute to barriers across the HIV care continuum from engagement in initial HIV care, to ART medication adherence and retention. A study by Krumme and colleagues shows depression as one of the strongest predictors of poor ART adherence and attrition from care among HIV-infected adults receiving antiretroviral therapy [14].…”

Section: Introductionmentioning

confidence: 99%

Telehealth Combined with Differentiated ART Delivery Improves ART Pick Up during COVID 19 at a Large HIV Treatment Facility in Trinidad and Tobago

Lyons¹,

Francis²,

Edwards³

et al. 2021

WJA

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Objective: To describe the implementation and outcomes of using telehealth in combination with a differentiated ART delivery model to improve HIV antiretroviral therapy pick up at a large treatment facility in Trinidad and Tobago during COVID-19. Design and Methods: Beginning in April 2020, a list of patients was generated daily prior to their scheduled ART appointments. Nurses, doctors and social workers conducted telephone consultations to first screen patients for COVID-19 symptoms, conducted brief medical and behavioural health screenings, and helped patients to identify barriers to ART retention. Patients were recommended for 1) fast track ART refill collection at facility, 2) community ART refills, and 3) ART pick-up through patient peers. The uptake and outcomes of telehealth and ART pick up were compared with the corresponding period in 2019. Data was analyzed using SPSS 21.0. Results: During the period April-June 2020, 1361 patients were identified for telephone consultations, 1084 (80%) were successfully contacted and 984 patients (88%) participated in phone session. The independent t test showed a significant increase in ART pick-up when compared to the corresponding period in 2019. 59% of patients collected via fast-track ART refill, 30% had community refills, and 11% pick-up medications through patient peers. Conclusion: Telehealth is an integral component of DSD as part of the COVID-19 response at the MRF. Understanding the medium and longer-term outcomes of Telehealth can provide additional insights on the scale up of telehealth as a component of DSD to improve ART outcomes for patients in the context of the developing countries of the Caribbean.

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“…These adverse life circumstances (history of homelessness, having suffered sexual violence, reporting a sexually transmitted disease, and early sexual debut) may not be unique to people living with mental illness but nonetheless the mental health care system can serve as an important point of entry for HIV prevention in this population (Guimarães et al, 2014).…”

Section: Communication About Sexuality; a Taboo In The Institutional mentioning

confidence: 99%

Factors associated with HIV transmission risk in people with a severe mental illness. A narrative review

Galarza‐Tejada

Caballero-Hoyos

Lira

2017

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Background. People with a severe mental illness (SMI) are a highly vulnerable group for the transmission risk of the human immunodeficiency virus (HIV). They have a higher seroprevalence compared with the general population and their life expectancy is shorter than those of people without the disease. This narrative review describes individual factors or those inherent to a person's characteristics and the sociocultural factors conditioning sexual behaviour and prevention norms. Objective. The purpose of this narrative review is to describe individual and sociocultural factors associated with the risk of HIV in people with a severe mental illness. Method. 82 empirical studies published between 1981 and 2015, addressing HIV transmission risk factors and sociocultural dimensions related to vulnerability were selected. Four indexes were used for this purpose: ISI Web of Knowledge, Redalyc, SciELO, and PUBMED; and four multidisciplinary electronic databases: Ebscohost Web, ProQuest, Sage Publications and ScienceDirect. Results. The analysis based on coding and systematic categorization shows that people with SMI are more vulnerable to risk than the general population, with differentials based on the severity of the disease symptomatology and economic and sociocultural characteristics associated with HIV-related risk practices. Discussion and conclusion. The need to design longitudinal studies with mixed methodology is proposed to attain a deeper understanding of the interaction of factors associated and processes conditioning risk. In this population group, structural preventive programs that take into account social and gender inequality must be implemented.

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Correlates of HIV infection among patients with mental illness in Brazil

Cited by 13 publications

References 35 publications

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Telehealth Combined with Differentiated ART Delivery Improves ART Pick Up during COVID 19 at a Large HIV Treatment Facility in Trinidad and Tobago

Factors associated with HIV transmission risk in people with a severe mental illness. A narrative review

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