Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

Mengwai, Khensane; Madiba, Sphiwe; Modjadji, Perpetua

doi:10.3390/healthcare8030253

Cited by 23 publications

(23 citation statements)

References 42 publications

(65 reference statements)

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“…There is some evidence on proxy measures of secondary transmission risk individually: sexual risk or nonadherence/viral suppression. A growing body of research has documented factors associated with ART nonadherence and lack of viral suppression in this age group [11][12][13], including substance use [13,14] and complex romantic and sexual relationships [15,16]. There is mixed evidence surrounding potential predictors of sexual risk-taking among AYPLHIV, with no longitudinal data from sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

Predictors of secondary HIV transmission risk in a cohort of adolescents living with HIV in South Africa

Toska

Zhou²,

Laurenzi

et al. 2021

Aids

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Objective: Preventing secondary HIV transmission from adolescents and young people living with HIV (AYPLHIV) to their partners and children is critical to interrupting the HIV infection cycle in sub-Saharan Africa. We investigated predictors of secondary HIV transmission risk (past-year sexual risk combined with past-year viremia) among AYPLHIV in South Africa. Design: A prospective cohort of AYLPHIV in South Africa recruited n = 1046 participants in 2014–2015, 93.6% of whom were followed up in 2016–2017 (1.5% mortality). Questionnaires used validated scales where available and biomarkers were extracted from n = 67 health facilities. Methods: Multivariate logistic regressions tested baseline factors associated with secondary HIV transmission risk, controlling for covariates, with marginal effect modelling combinations. Results: About 14.2% of AYPLHIV reported high secondary HIV transmission risk. High-risk AYPLHIV were more likely to be sexually infected [adjusted odds ratio (aOR) 2.79, 95% confidence interval (95% CI) 1.66–4.68, P < 0.001], and report hunger (aOR 1.93, 95% CI 1.18–3.14, P = 0.008) and substance use (aOR 2.19, 95% CI 1.19–4.02, P = 0.012). They were more likely to be in power-inequitable relationships (aOR 1.77, 95% CI 1.08–2.92, P = 0.025) and be parents (aOR 4.30, 95% CI 2.16–8.57, P < 0.001). Adolescents reporting none of these factors had a 4% probability of secondary transmission risk, rising to 89% probability with all five identified factors. Older age and early sexual debut were also strongly associated with a higher risk of secondary HIV transmission. Conclusion: It is essential to identify and support AYPLHIV at a high risk of secondary transmission. Screening for factors such as mode of infection and parenthood during routine healthcare visits could help identify and provide resources to the most at-risk adolescents.

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Section: Introductionmentioning

confidence: 99%

Predictors of secondary HIV transmission risk in a cohort of adolescents living with HIV in South Africa

Toska

Zhou²,

Laurenzi

et al. 2021

Aids

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“…As already mentioned, multiple sex partners is one of the characteristics composing the behavioral profiles of MSM 83 , 93 , and a history of STIs is one of the consequences of this practice 94 , as suggested in the present study. Recent warnings highlight the low rates of disclosure of serological status among sex partners, which is worrisome given the persistence of viral transmissibility, especially when the majority continues to practice unprotected sex 95 . It is argued that specific social networks may be endorsing this exposure behavior 96 .…”

Section: Discussionmentioning

confidence: 99%

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Pereira

França

Costa

et al. 2021

Sci Rep

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To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.

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“…However, in South Africa, data is scarce among commercial drivers, including truckers, which focuses on their healthcare and health status [2,36], HIV and sexually transmitted diseases [39][40][41][42], with minimal research on hypertension and T2D, and associated factors [43,44]. It is worth noting that noncommunicable diseases (NCDs), inclusive of cardiovascular diseases, are prevalent [29,45] and/or co-exist with communicable (e.g., HIV) diseases among different populations in South Africa [17,46,47].…”

Section: Introductionmentioning

confidence: 99%

Obesity as a Risk Factor for Hypertension and Diabetes among Truck Drivers in a Logistics Company, South Africa

et al. 2022

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Despite the occupational nature of truckers predisposing them to cardiovascular diseases and risk factors, data is scarce on their prevalence of obesity and its association with developing hypertension (HBP) and diabetes in South Africa. Extracted from the original cross-sectional study of a sample of 312 employees in a logistics company, a census of 96 male truckers was used to determine the prevalence of obesity and its association with HBP and diabetes. WHO STEPwise approach was used to collect data, including systolic (SBP) and diastolic (DBP) blood pressure and anthropometry measurements. HBP is defined as SBP/DBP ≥ 140/90 mmHg, overweight/obesity as BMI ≥ 25 kg/m2, abdominal obesity by waist circumference as WC ≥ 90cm, waist-to-hip-ratio as WHR ≥ 0.90, and waist-to-height ratio as WHtR ≥ 0.5. Data were analysed using SPSS 22. The mean age of truckers was 46 years, 29% were smokers, and 57% alcohol users, while 26% were physically inactive. The prevalence of overweight (44%) and obesity (30%) were observed, while abdominal obesity was high; WC (59%), WHR (65%), and WHtR (80%). HBP (57%) was prevalent and diabetes was 14%. The odds of developing HBP were high for obese truckers by WC [AOR = 4.68; CI = 1.92–11.34)] and by WHtR [AOR = 5.49 CI = 1.74–17.27), while diabetes was associated with WHR (AOR = 1.19; CI = 1.19–31.21). This study showed an associative link between obesity, HBP, and diabetes among the truckers, which is informative for a relevant prevention programme tailored to their needs.

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Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

Cited by 23 publications

References 42 publications

Predictors of secondary HIV transmission risk in a cohort of adolescents living with HIV in South Africa

Predictors of secondary HIV transmission risk in a cohort of adolescents living with HIV in South Africa

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Obesity as a Risk Factor for Hypertension and Diabetes among Truck Drivers in a Logistics Company, South Africa

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