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https://www.readbyqxmd.com/read/28903628/what-motivates-serodiscordant-couples-to-prevent-hiv-transmission-within-their-relationships-findings-from-a-prep-implementation-study-in-kenya
#1
Rena C Patel, Anna M Leddy, Josephine Odoyo, Keerthana Anand, Gaelen Stanford-Moore, Imeldah Wakhungu, Elizabeth A Bukusi, Jared M Baeten, Joelle M Brown
With the planned scale-up of pre-exposure prophylaxis (PrEP) for HIV prevention among serodiscordant couples in resource-limited settings, gaining an understanding of what motivates serodiscordant couples to prevent HIV is critical. We conducted 44 semi-structured, in-depth individual or couple interviews with 63 participants (33 HIV-infected and 30 HIV-uninfected participants) enrolled in a prospective implementation study of oral antiretroviral-based prevention in Kisumu, Kenya. Transcripts were iteratively analysed using inductive content analysis...
September 14, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/28899162/high-levels-of-viral-suppression-among-east-african-hiv-infected-women-and-men-in-serodiscordant-partnerships-initiating-antiretroviral-therapy-with-high-cd4-counts-and-during-pregnancy
#2
Andrew Mujugira, Jared Baeten, Lara Kidoguchi, Jessica Haberer, Connie Celum, Deborah Donnell, Kenneth Ngure, Elizabeth Bukusi, Nelly Mugo, Stephen Asiimwe, Josephine Odoyo, Edna Tindimwebwa, Nulu Bulya, Elly Katabira, Renee Heffron
BACKGROUND: People who are asymptomatic and feel healthy, including pregnant women, may be less motivated to initiate ART or achieve high adherence. We assessed whether ART initiation, and viral suppression 6, 12 and 24-months after ART initiation, were lower in HIV-infected members of serodiscordant couples who initiated during pregnancy or with higher CD4 counts. METHODS: We used data from the Partners Demonstration Project, an open-label study of the delivery of integrated PrEP and ART (at any CD4 count) for HIV prevention among high-risk HIV serodiscordant couples in Kenya and Uganda...
September 13, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28894986/fertility-intentions-pregnancy-and-use-of-prep-and-art-for-safer-conception-among-east-african-hiv-serodiscordant-couples
#3
Renee Heffron, Kerry Thomson, Connie Celum, Jessica Haberer, Kenneth Ngure, Nelly Mugo, Elizabeth Bukusi, Elly Katabira, Josephine Odoyo, Nulu Bulya, Stephen Asiimwe, Edna Tindimwebwa, Jared M Baeten
African HIV serodiscordant couples often desire pregnancy, despite sexual HIV transmission risk during pregnancy attempts. Pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) reduce HIV risk and can be leveraged for safer conception but how well these strategies are used for safer conception is not known. We conducted an open-label demonstration project of the integrated delivery of PrEP and ART among 1013 HIV serodiscordant couples from Kenya and Uganda followed quarterly for 2 years. We evaluated fertility intentions, pregnancy incidence, the use of PrEP and ART during peri-conception, and peri-conception HIV incidence...
September 11, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28880892/beyond-hiv-serodiscordance-partnership-communication-dynamics-that-affect-engagement-in-safer-conception-care
#4
Lynn T Matthews, Bridget F Burns, Francis Bajunirwe, Jerome Kabakyenga, Mwebesa Bwana, Courtney Ng, Jasmine Kastner, Annet Kembabazi, Naomi Sanyu, Adrine Kusasira, Jessica E Haberer, David R Bangsberg, Angela Kaida
INTRODUCTION: We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda. METHODS: We recruited HIV-positive men and women on antiretroviral therapy (ART) ('index') from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner ('partner'), HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP) for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision...
2017: PloS One
https://www.readbyqxmd.com/read/28872418/pregnancy-planning-preferences-among-people-and-couples-affected-by-human-immunodeficiency-virus-piloting-a-discrete-choice-experiment
#5
Mona Loutfy, V Logan Kennedy, Morvarid Sanandaji, Fatimatou Barry, Fanta Ongoiba, Marvelous Muchenje, Wangari Tharao, Dean A Regier
Decision-making related to pregnancy planning is complex and human immunodeficiency virus (HIV) may further complicate the process. With increasing rates of pregnancy among individuals affected by HIV, the need to understand decision-making is imperative. The primary objectives of this pilot study were to confirm the feasibility of using discrete choice experimentation (DCE) to elicit an understanding of this process and to determine the acceptability of the choice factors that were included in two novel DCEs, while gathering a preliminary understanding of preference...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28843576/effect-of-hsv-2-infection-on-subsequent-hiv-acquisition-an-updated-systematic-review-and-meta-analysis
#6
Katharine J Looker, Jocelyn A R Elmes, Sami L Gottlieb, Joshua T Schiffer, Peter Vickerman, Katherine M E Turner, Marie-Claude Boily
BACKGROUND: HIV and herpes simplex virus type 2 (HSV-2) infections cause a substantial global disease burden and are epidemiologically correlated. Two previous systematic reviews of the association between HSV-2 and HIV found evidence that HSV-2 infection increases the risk of HIV acquisition, but these reviews are now more than a decade old. METHODS: For this systematic review and meta-analysis, we searched PubMed, MEDLINE, and Embase (from Jan 1, 2003, to May 25, 2017) to identify studies investigating the risk of HIV acquisition after exposure to HSV-2 infection, either at baseline (prevalent HSV-2 infection) or during follow-up (incident HSV-2 infection)...
August 23, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28819988/behavior-change-following-hiv-diagnosis-findings-from-a-cohort-of-los-angeles-msm
#7
Pamina M Gorbach, Marjan Javanbakht, Robert K Bolan
The effect of an HIV diagnosis on subsequent behavior of men who have sex with men (MSM) remains unclear. From 2009 to 2012 the NIDA funded Metromates Study enrolled and followed for one year MSM seeking testing for HIV in Los Angeles, assessing those with new HIV diagnoses for acute/recent HIV infection. Behavioral data were collected via Computer-Assisted Self-Interview from 321 men of whom 125 were classified as recently HIV infected, 91 as not recently HIV infected, and 105 as HIV-negative. Differences over time between those with recent HIV infection, not recent HIV infection, and no HIV were evaluated using bivariate and multivariable analyses for repeat measures to assess associations between HIV group, behaviors and condomless receptive (CRAI), intersertive (CIAI), or any condomless anal intercourse (CAI)...
August 18, 2017: AIDS Care
https://www.readbyqxmd.com/read/28817552/effects-of-antiretroviral-therapy-to-prevent-hiv-transmission-to-women-in-couples-attempting-conception-when-the-man-has-hiv-infection-united-states-2017
#8
John T Brooks, Jennifer F Kawwass, Dawn K Smith, Dmitry M Kissin, Margaret Lampe, Lisa B Haddad, Sheree L Boulet, Denise J Jamieson
Existing U.S. guidelines recommend that men with human immunodeficiency virus (HIV) infection should achieve virologic suppression* with effective antiretroviral therapy (ART) before attempting conception (1). Clinical studies have demonstrated that effective ART profoundly reduces the risk for HIV transmission (2-4). This information might be useful for counseling couples planning a pregnancy in which the man has HIV infection and the woman does not (i.e., a mixed HIV-status couple, often referred to as a serodiscordant couple)...
August 18, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28812457/from-half-dead-to-being-free-resistance-to-hiv-stigma-self-disclosure-and-support-for-pmtct-hiv-care-among-couples-living-with-hiv-in-kenya
#9
Sydney A Spangler, Lisa L Abuogi, Eliud Akama, Elizabeth A Bukusi, Anna Helova, Pamela Musoke, Wafula Z Nalwa, Thomas A Odeny, Maricianah Onono, Iris Wanga, Janet M Turan
In sub-Saharan Africa, self-disclosure of HIV-positive status may be a pivotal action for improving access to prevention of mother-to-child transmission services. However, understanding of HIV stigma and disclosure, and their effects on demand for care remains incomplete - particularly in the current context of new antiretroviral therapy guidelines. The purpose of this study was to explore these issues among self-disclosed couples living in southwest Kenya. We conducted 38 in-depth interviews with HIV-positive pregnant or postpartum women and their male partners...
August 16, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/28777265/-i-did-not-want-to-give-birth-to-a-child-who-has-hiv-experiences-using-prep-during-pregnancy-among-hiv-uninfected-kenyan-women-in-hiv-serodiscordant-couples
#10
Jillian Pintye, Kristin M Beima-Sofie, Grace Kimemia, Kenneth Ngure, Susan Brown Trinidad, Renee Heffron, Jared Baeten, Josephine Odoyo, Nelly Mugo, Elizabeth A Bukusi, Maureen C Kelley, Grace C John-Stewart
OBJECTIVES: The perceptions, motivations, and beliefs of HIV-uninfected women about PrEP use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. DESIGN: Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. METHODS: Semi-structured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy...
July 31, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28750070/low-hiv-incidence-in-pregnant-and-postpartum-women-receiving-a-community-based-combination-hiv-prevention-intervention-in-a-high-hiv-incidence-setting-in-south-africa
#11
Geoffrey Fatti, Najma Shaikh, Debra Jackson, Ameena Goga, Jean B Nachega, Brian Eley, Ashraf Grimwood
BACKGROUND: Young Southern African women have the highest HIV incidence globally. Pregnancy doubles the risk of HIV acquisition further, and maternal HIV acquisition contributes significantly to the paediatric HIV burden. Little data on combination HIV prevention interventions during pregnancy and lactation are available. We measured HIV incidence amongst pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa...
2017: PloS One
https://www.readbyqxmd.com/read/28741331/alignment-of-adherence-and-risk-for-hiv-acquisition-in-a-demonstration-project-of-pre-exposure-prophylaxis-among-hiv-serodiscordant-couples-in-kenya-and-uganda-a-prospective-analysis-of-prevention-effective-adherence
#12
Jessica E Haberer, Lara Kidoguchi, Renee Heffron, Nelly Mugo, Elizabeth Bukusi, Elly Katabira, Stephen Asiimwe, Katherine K Thomas, Connie Celum, Jared M Baeten
INTRODUCTION: Adherence is essential for pre-exposure prophylaxis (PrEP) to protect against HIV acquisition, but PrEP use need not be life-long. PrEP is most efficient when its use is aligned with periods of risk - a concept termed prevention-effective adherence. The objective of this paper is to describe prevention-effective adherence and predictors of adherence within an open-label delivery project of integrated PrEP and antiretroviral therapy (ART) among HIV serodiscordant couples in Kenya and Uganda (the Partners Demonstration Project)...
July 25, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28737591/hiv-incidence-and-predictors-of-hiv-acquisition-from-an-outside-partner-in-serodiscordant-couples-in-lusaka-zambia
#13
Dvora L Joseph Davey, Kristin M Wall, William Kilembe, Htee Khu Naw, Ilene Brill, Bellington Vwalika, Elwyn Chomba, Joseph Mulenga, Amanda Tichacek, Marjan Javanbakt, Pamina M Gorbach, Susan A Allen
OBJECTIVE: Evaluate the incidence and predictors of HIV acquisition from outside partners in serodiscordant couples. METHODS: Demographic, behavioral, and clinical exposures were measured quarterly in a cohort of serodiscordant cohabiting couples in Zambia from 1995 to 2012 (n = 3049). Genetic analysis classified incident infections as those acquired from the study partner (linked) or acquired from an outside partner (unlinked). Factors associated with time to unlinked HIV infection were evaluated using multivariable Cox proportional hazards regression stratified by sex...
October 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28732773/efficacy-of-oral-pre-exposure-prophylaxis-prep-for-hiv-among-women-with-abnormal-vaginal-microbiota-a-post-hoc-analysis-of-the-randomised-placebo-controlled-partners-prep-study
#14
Renee Heffron, R Scott McClelland, Jennifer E Balkus, Connie Celum, Craig R Cohen, Nelly Mugo, Elizabeth Bukusi, Deborah Donnell, Jairam Lingappa, James Kiarie, Tina Fiedler, Matthew Munch, David N Fredricks, Jared M Baeten
BACKGROUND: Daily oral tenofovir-based pre-exposure prophylaxis (PrEP) is high efficacious for HIV prevention among women with high adherence. However, the effect of abnormal vaginal microbiota on PrEP efficacy is of concern. We investigated whether bacterial vaginosis modified the efficacy of oral PrEP. METHODS: We used prospectively collected data from women in the Partners PrEP Study, a placebo-controlled trial of daily oral PrEP (either tenofovir monotherapy or a combination of tenofovir and emtricitabine) in HIV serodiscordant couples aged 18 years or older in Kenya and Uganda that showed high efficacy in women...
July 18, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28719229/experiences-using-pre-exposure-prophylaxis-for-safer-conception-among-hiv-serodiscordant-heterosexual-couples-in-the-united-states
#15
Angela R Bazzi, Ashley A Leech, Dea L Biancarelli, Meg Sullivan, Mari-Lynn Drainoni
Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast...
August 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28637581/how-partnership-type-and-hiv-seroconcordance-affect-hiv-transmission-risk-in-regular-sexual-partnerships-a-cross-sectional-survey-of-australian-gay-and-bisexual-men
#16
Benjamin R Bavinton, Andrew E Grulich, Duane Duncan, Iryna B Zablotska, Garrett P Prestage
Background: Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex ('fuckbuddies') and estimated the proportion of CLAI presenting risk for HIV transmission...
June 22, 2017: Sexual Health
https://www.readbyqxmd.com/read/28634661/depression-and-art-initiation-among-hiv-serodiscordant-couples-in-kenya-and-uganda
#17
Jennifer Velloza, Connie Celum, Jessica E Haberer, Kenneth Ngure, Elizabeth Irungu, Nelly Mugo, Jared M Baeten, Renee Heffron
Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. We followed 1013 HIV-infected individuals participating in the Partners Demonstration Project, an open-label study of integrated pre-exposure prophylaxis (PrEP) and ART delivery for HIV serodiscordant couples in Kenya and Uganda. Associations between depression, measured annually with the Hopkins Symptoms Checklist-Depression (HSCL-D), and ART initiation were assessed with Cox proportional hazards regression...
August 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28591373/-vulnerability-to-hiv-infection-in-serodiscordant-couples-in-rio-de-janeiro-brazil
#18
Nilo Martinez Fernandes, Élida Azevedo Hennington, Jefferson de Souza Bernardes, Beatriz G Grinsztejn
A new era in HIV/AIDS treatment began in 1996 with the advent of highly active antiretroviral therapy (HAART). The advent of these new medicines expanded the treatment resources and improved life expectancy and quality of life for persons living with HIV and AIDS, favoring the maintenance and initiation of relationships between partners with discordant HIV serological status. The main objective of this study with serodiscordant couples was to understand the three dimensions of vulnerability - programmatic, social, and individual - in these couples...
June 1, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28567279/evolving-treatment-implementation-among-hiv-infected-pregnant-women-and-their-partners-results-from-a-national-surveillance-study-in-italy-2001-2015
#19
Marco Floridia, Valentina Frisina, Marina Ravizza, Anna Maria Marconi, Carmela Pinnetti, Irene Cetin, Matilde Sansone, Atim Molinari, Francesca Cervi, Alessandra Meloni, Kety Luzi, Giulia Masuelli, Enrica Tamburrini
BACKGROUND: The current global and national indications for antiretroviral treatment (ART, usually triple combination therapy) in adolescent and adults, including pregnant women, recommend early ART before immunologic decline, pre-exposure chemoprophylaxis (PrEP), and treatment of HIV-negative partners in serodiscordant couples. There is limited information on the implementation of these recommendations among pregnant women with HIV and their partners. METHODS: The present analysis was performed in 2016, using data from clinical records of pregnant women with HIV, followed between 2001 and 2015 at hospital or university clinics within a large, nationally representative Italian cohort study...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28562661/effects-of-patient-load-and-travel-distance-on-hiv-transmission-in-rural-china-implications-for-treatment-as-prevention
#20
M Kumi Smith, William C Miller, Huixin Liu, Chuanyi Ning, Wensheng He, Myron S Cohen, Ning Wang
BACKGROUND: Sustained viral suppression through ART reduces sexual HIV transmission risk, but may require routine access to reliable and effective medical care which may be difficult to obtain in resource constrained areas. We investigated the roles of patient load and travel distance to HIV care clinic on transmission risk in HIV serodiscordant couples in Henan Province, China. METHODS: Cox proportional hazard models were used to compare HIV transmission events across couples living near, medium, or farther distances from their assigned HIV care clinics, as well as those attending clinics where clinicians bore high versus low patient loads...
2017: PloS One
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