Journal articles: 'Rural HIV'

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Wongjarupong, Nicha, Sharad Oli, Mahamoudou Sanou, et al. "Distribution and Incidence of Blood-Borne Infection among Blood Donors from Regional Transfusion Centers in Burkina Faso: A Comprehensive Study." American Journal of Tropical Medicine and Hygiene 104, no. 4 (2021): 1577–81. http://dx.doi.org/10.4269/ajtmh.20-0601.

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ABSTRACTThere is a high prevalence of blood-borne infections in West Africa. This study sought to determine the seroprevalence of blood-borne infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), HIV, and syphilis, in blood donors in Burkina Faso. Blood donors were recruited from 2009 to 2013 in four major cities in Burkina Faso of urban area (Ouagadougou) and rural area (Bobo Dioulasso, Fada N’Gourma, and Ouahigouya). Serology tests including hepatitis B surface antigen, anti-HCV, anti-HIV, and rapid plasma reagin test were used for screening and were confirmed with ELISA. Disease prevalence was calculated among first-time donors. Incidence and residual risk were calculated from repeat donors. There were 166,681 donors; 43,084 had ≥ 2 donations. The overall seroprevalence of HBV, HCV, HIV, and syphilis were 13.4%, 6.9%, 2.1%, and 2.4%, respectively. The incidence rates (IRs) of HBV, HCV, HIV, and syphilis infection were 2,433, 3,056, 1,121, and 1,287 per 100,000 person-years. There was lower seroprevalence of HBV and HCV in urban area than in rural area (12.9% versus 14.0%, P < 0.001; and 5.9% versus 8.0%, P < 0.001), and no difference in HIV (2.1% versus 2.1%, P = 0.25). The IRs of new HBV, HCV, HIV, and syphilis were 2.43, 3.06, 1.12, and 1.29 per 100,000 person-years, respectively. The residual risk was one per 268 donations for HBV, one per 181 donations for HCV, and one per 1,480 donations for HIV, respectively. In conclusion, this comprehensive study from four blood donation sites in Burkina Faso showed high HBV and HCV seroprevalence and incidence with high residual risk from blood donation.

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Rouet, François, Janin Nouhin, Du-Ping Zheng, et al. "Massive Iatrogenic Outbreak of Human Immunodeficiency Virus Type 1 in Rural Cambodia, 2014–2015." Clinical Infectious Diseases 66, no. 11 (2017): 1733–41. http://dx.doi.org/10.1093/cid/cix1071.

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Abstract Background In 2014–2015, 242 individuals aged 2–89 years were newly diagnosed with human immunodeficiency virus type 1 (HIV-1) in Roka, a rural commune in Cambodia. A case-control study attributed the outbreak to unsafe injections. We aimed to reconstruct the likely transmission history of the outbreak. Methods We assessed in 209 (86.4%) HIV-infected cases the presence of hepatitis C virus (HCV) and hepatitis B virus (HBV). We identified recent infections using antibody (Ab) avidity testing for HIV and HCV. We performed amplification, sequencing, and evolutionary phylogenetic analyses of viral strains. Geographical coordinates and parenteral exposure through medical services provided by an unlicensed healthcare practitioner were obtained from 193 cases and 1499 controls during interviews. Results Cases were coinfected with HCV (78.5%) and HBV (12.9%). We identified 79 (37.8%) recent (&lt;130 days) HIV infections. Phylogeny of 202 HIV env C2V3 sequences showed a 198-sample CRF01_AE strains cluster, with time to most recent common ancestor (tMRCA) in September 2013 (95% highest posterior density, August 2012–July 2014), and a peak of 15 infections/day in September 2014. Three geospatial HIV hotspots were discernible in Roka and correlated with high exposure to the practitioner (P = .04). Fifty-nine of 153 (38.6%) tested cases showed recent (&lt;180 days) HCV infections. Ninety HCV NS5B sequences formed 3 main clades, 1 containing 34 subtypes 1b with tMRCA in 2012, and 2 with 51 subtypes 6e and tMRCAs in 2002–2003. Conclusions Unsafe injections in Cambodia most likely led to an explosive iatrogenic spreading of HIV, associated with a long-standing and more genetically diverse HCV propagation.

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Helms, Charles M. "Rural HIV infection." Journal of General Internal Medicine 8, no. 4 (1993): 210–12. http://dx.doi.org/10.1007/bf02599269.

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Dayal, Seema, Amit Singh, Vineet Chaturvedi, Asha Pathak, Vinay Gupta, and Shweta Jaiswal. "Seroprevalence and Related Risk Factors of HBsAg, Anti–HCV and Anti–HIV Antibody Among Pregnant Women of Rural India." Annals of Clinical Chemistry and Laboratory Medicine 1, no. 2 (2015): 3–7. http://dx.doi.org/10.3126/acclm.v1i2.12956.

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BACKGROUND: Vertical transmission is also mode of transmission of HBV, HCV and HIV. Viral infections may cause abortion, ectopic pregnancies and HBV, HCV also causes hepatitis, cirrhosis. ‘Janani Sureksha Yojana’ (safe motherhood program) is a scheme in which pregnant women are benefited if they deliver in government medical facility. Antenatal screening for HBV, HCV and HIV should be done so as to provide appropriate antiviral therapy. The aim of study was to detect the frequency of HBsAg, HCV antibody, HIV antibody and their correlation with risk factors.METHODS: Present study was conducted in central laboratory of Rural Institute of Medical Science and Research Saifai, Etawah (Uttar Pradesh) on pregnant women from 1 January to 31 December 2014.RESULTS: Out of 7867 women, 2.07% were positive for HBsAg, 0.43% and 0.13% for HCV antibody and HIV antibody, respectively. The age group with maximum seropositivity was in 21-30 year (76.44%) and parity with maximum seropositivity was 3-4 children (42.30%). Seropositivity was high among low socio economic status (77.40%). Among the associated risk factors Obstetric and Gynaecology surgeries (46.15%) and blood transfusion (20%) were prominent. These associated risk factors were found more among HBsAg seropositive females (86.66%) and (84.61%) respectively.CONCLUSIONS: The prevalence of HBsAg positive (2.07%) was more. Obstetric and Gynaecology surgery, blood transfusion were major risk factors. So, screening for HBsAg, HCV antibody, HIV antibody should be mandatory for pregnant women to reduce mortality and morbidity.

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Roeder, Kevin R. "Rural HIV/AIDS Services." Journal of HIV/AIDS & Social Services 1, no. 2 (2002): 21–42. http://dx.doi.org/10.1300/j187v01n02_03.

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Tonen-Wolyec, Serge, Roland Marini Djang’eing’a, Salomon Batina-Agasa, et al. "Self-testing for HIV, HBV, and HCV using finger-stick whole-blood multiplex immunochromatographic rapid test: A pilot feasibility study in sub-Saharan Africa." PLOS ONE 16, no. 4 (2021): e0249701. http://dx.doi.org/10.1371/journal.pone.0249701.

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Background The burden of HIV, HBV, and HCV infections remains disproportionately high in sub-Saharan Africa, with high rates of co-infections. Multiplex rapid diagnostic tests for HIV, HBV and HCV serological testing with high analytical performances may improve the “cascade of screening” and quite possibly the linkage-to-care with reduced cost. Based on our previous field experience of HIV self-testing, we herein aimed at evaluating the practicability and acceptability of a prototype finger-stick whole-blood Triplex HIV/HCV/HBsAg self-test as a simultaneous serological screening tool for HIV, HBV, and HCV in the Democratic Republic of the Congo (DRC). Methods A cross-sectional multicentric study consisting of face-to-face, paper-based, and semi-structured questionnaires with a home-based and facility-based recruitment of untrained adult volunteers at risk of HIV, HBV, and HCV infections recruited from the general public was conducted in 2020 in urban and rural areas in the DRC. The practicability of the Triplex self-test was assessed by 3 substudies on the observation of self-test manipulation including the understanding of the instructions for use (IFU), on the interpretation of Triplex self-test results and on its acceptability. Results A total of 251 volunteers (mean age, 28 years; range, 18–49; 154 males) were included, from urban [160 (63.7%)] and rural [91 (36.3%)] areas. Overall, 242 (96.4%) participants performed the Triplex self-test and succeeded in obtaining a valid test result with an overall usability index of 89.2%. The correct use of the Triplex self-test was higher in urban areas than rural areas (51.2% versus 16.5%; aOR: 6.9). The use of video IFU in addition to paper-based IFU increased the correct manipulation and interpretation of the Triplex self-test. A total of 197 (78.5%) participants correctly interpreted the Triplex self-test results, whereas 54 (21.5%) misinterpreted their results, mainly the positive test results harboring low-intensity band (30/251; 12.0%), and preferentially the HBsAg band (12/44; 27.3%). The rates of acceptability of reuse, distribution of the Triplex self-test to third parties (partner, friend, or family member), linkage to the health care facility for confirmation of results and treatment, and confidence in the self-test results were very high, especially among participants from urban areas. Conclusions This pilot study shows evidence for the first time in sub-Saharan Africa on good practicability and high acceptability of a prototype Triplex HIV/HCV/HBsAg self-test for simultaneous diagnosis of three highly prevalent chronic viral infections, providing the rational basis of using self-test harboring four bands of interest, i.e. the control, HIV, HCV, and HBsAg bands. The relatively frequent misinterpretation of the Triplex self-test points however the necessity to improve the delivery of this prototype Triplex self-test probably in a supervised setting. Finally, these observations lay the foundations for the potential large-scale use of the Triplex self-test in populations living in sub-Saharan Africa at high risk for HIV, HBV, and HCV infections.

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Peteet, Bridgette, Michele Staton, Brittany Miller-Roenigk, Adam Carle, and Carrie Oser. "Rural Incarcerated Women: HIV/HCV Knowledge and Correlates of Risky Behavior." Health Education & Behavior 45, no. 6 (2018): 977–86. http://dx.doi.org/10.1177/1090198118763879.

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Rural incarcerated women have an increased risk of acquiring the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV) due to prevalent engagement in drug use and sexual behaviors. Limited research has investigated HIV and HCV knowledge in this high-risk population. Furthermore, the interplay of sociodemographic factors (i.e., education, age, income, and sexual orientation) and risky behavior is understudied in this population. The present study evaluated a sample of adult, predominately White women from rural Kentucky ( n = 387) who were recruited from local jails. The sample had high HIV and HCV knowledge but also reported extensive risk behaviors including 44% engaging in sex work and 75.5% reporting a history of drug injection. The results of multiple regression analysis for risky sexual behavior indicated that sexual minority women and those with less HIV knowledge were more likely to engage in high-risk sexual behaviors. The regression model identifying the significant correlates of risky drug behavior indicated that HIV knowledge, age, and income were negative correlates and that sexual minority women were more likely to engage in high-risk drug use. When HCV knowledge was added to the regression models already including HIV knowledge, the interaction was significant for drug risk. Interventions for rural imprisoned women should consider the varied impact of sociodemographic background and prioritize HIV education to more effectively deter risky sexual and drug behaviors.

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McLuckie, Colleen, Mai Pho, Kaitlin Ellis, et al. "Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois." International Journal of Environmental Research and Public Health 16, no. 6 (2019): 989. http://dx.doi.org/10.3390/ijerph16060989.

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Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role in the response to this syndemic. We utilized two geospatial approaches to identify areas of discordance between LHD service availability and disease burden to inform service prioritization in rural settings. Methods: We surveyed rural Illinois LHDs to assess their OUD-related services, and calculated county-level opioid overdose, HIV, and hepatitis C diagnosis rates. Bivariate choropleth maps were created to display LHD service provision relative to disease burden in rural Illinois counties. Results: Most rural LHDs provided limited OUD-related services, although many LHDs provided HIV and HCV testing. Bivariate mapping showed rural counties with limited OUD treatment and HIV services and with corresponding higher outcome/disease rates to be dispersed throughout Illinois. Additionally, rural counties with limited LHD-offered hepatitis C services and high hepatitis C diagnosis rates were geographically concentrated in southern Illinois. Conclusions: Bivariate mapping can enable geographic targeting of resources to address the opioid crisis and related infectious disease by identifying areas with low LHD services relative to high disease burden.

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Li, Chunlin, Yu Yang, Yingjian Wang, et al. "Impact of maternal HIV–HBV coinfection on pregnancy outcomes in an underdeveloped rural area of southwest China." Sexually Transmitted Infections 96, no. 7 (2020): 509–15. http://dx.doi.org/10.1136/sextrans-2019-054295.

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ObjectivesOur objective was to determine the impact of maternal HIV–hepatitis B virus (HBV) coinfection on pregnancy outcomes.MethodsThe current study was conducted in a county of Yi Autonomous Prefecture in southwest China. Data were abstracted from hospitalisation records, including maternal and infant information. The seroprevalences of HIV and HBV infections and HIV–HBV coinfection were determined and the impact of maternal HIV–HBV coinfection on adverse pregnancy outcomes was assessed using logistic regression analysis. A treatment effects linear regression model was also applied to examine the effect of HBV, HIV or coinfection to quantify the absolute difference in birth weight from a reference of HBV–HIV negative participants.ResultsA total of 13 198 pregnant women were included in our study, and among them, 99.1% were Yi people and 90.8% lived in rural area. The seroprevalences of HIV and HBV infections and HIV–HBV coinfection were 3.6% (95% CI: 3.2% to 3.9%), 3.2% (95% CI: 2.9% to 3.5%) and 0.2% (95% CI: 0.1% to 0.2%) among the pregnant women, respectively. Maternal HIV–HBV coinfection was a risk factor for low birth weight (adjusted OR (aOR)=5.52, 95% CI: 1.97 to 15.40). Compared with the HIV mono-infection group, the risk of low birth weight was significantly higher in the HIV–HBV coinfection group (aOR=3.62, 95% CI: 1.24 to 10.56). Maternal HIV infection was associated with an increased risk of low birth weight (aOR=1.90, 95% CI: 1.38 to 2.60) and preterm delivery (aOR=2.84, 95% CI: 1.81 to 4.47). Perinatal death was more common when mothers were infected with HBV (aOR=2.85, 95% CI: 1.54 to 5.26).ConclusionsThe prevalence of HIV infection was high among pregnant women of the Yi region. Both HIV and HBV infections might have adverse effects on pregnancy outcomes. Maternal HIV–HBV coinfection might be a risk factor for low birth weight in the Yi region, which needs to be confirmed.

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Mandiwana, Azhani, and Stephane Tshitenge. "Prevalence of human immunodeficiency virus — hepatitis B virus co-infection amongst adult patients in Mahalapye, Ngami, Serowe, Botswana: a descriptive cross-sectional study." South African Family Practice 59, no. 3 (2017): 54. http://dx.doi.org/10.4102/safp.v59i3.4716.

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Background: About 37 million people are living with human-immunodeficiency-virus (HIV) worldwide, with 2.6 million co-infected with the hepatitis B virus (HBV). HBV infection causes 650 000 deaths annually worldwide. Botswana has a high prevalence of HIV and a growing population of patients on highly active antiretroviral therapy (HAART). This study aimed to determine the prevalence of HIV–HBV co-infection amongst HAART eligible adult patients in some rural settings in Botswana.  Methods: A cross-sectional study was conducted amongst HAART eligible adult patients at 15 HAART clinics in the Mahalapye, Ngami and Serowe Health Districts of Botswana, from August to October 2015. A total of 132 were recruited; of these 118 consented and were tested for HBsAg reactivity using Elisa.  Results: Six (5.1%, 6/118) patients from the three rural health districts were HIV–HBV co-infected, with three in the 20–29 age group. The association between sex and HIV–HBV co-infection status was not statistically significant; p = 1.00.   Conclusion: The finding of 5.1% HIV–HBV co-infection prevalence in some rural settings of Botswana was similar to results from one study conducted in a Botswana urban centre, while another previous similar study reported prevalence as being twice as high. This finding may call for prioritisation of pre-HAART HBV screening and early HAART initiation for all HIV-infected patients.   (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)  S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272230

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Clayton, Lucy. "HIV Education in Rural China." Promotion & Education 12, no. 1 (2005): 19–20. http://dx.doi.org/10.1177/175797590501200103.

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Nim, Ranjit Kumar, Vivek Kumar Verma, Manoj Kumar, et al. "HIV and hepatitis B co-infection - prevalence and clinical spectrum in a rural tertiary care centre of Northern India." International Journal of Research in Medical Sciences 5, no. 7 (2017): 3154. http://dx.doi.org/10.18203/2320-6012.ijrms20173005.

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Background: HBV and HIV are both endemic in India. Currently, it is not well established what proportion of HIV-positive patients harbours HBV infection in India. No study was done to know the epidemiology of HBV HIV Co infection in rural population of Northern India. So, this study was done to explore the impact of HBV in HIV patients.Methods: Prospective cohort study was conducted on HIV-HBV co infected patients who attended the ART Clinic at ART centre, Department of Medicine, UPUMS, Saifai, Etawah, after obtaining informed consent.Results: Out of these 1751 HIV patients 919 were eligible for start on ART and the remaining were treatment naïve patients. Out of these 1751 HIV positive patients 79 patients were HBS Ag positive. Thus, the prevalence of HBV-HIV co infection at our ART centre was found to be around 4.5%. 68 patients were found to be eligible for start of ART drugs. Out of these 68 patients on ART, 46 (67.6%) patients were alive, 9 (13.2%) were transferred out, 5 (7.4%) patients were lost to follow up (LFU) and 8 (11.8%) expired till the end of the study.Conclusions: HBV co infection is common in HIV serology positive and can cause significant morbidity and mortality especially in the presence of other concurrent cause of liver injury. HBV co infection might associate with severe hepatotoxicity during intake of HAART regimen. For these reasons, prevention and treatment of HBV infection is mandatory in HIV serology positive.

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Bull-Otterson, Lara, Ya-Lin A. Huang, Weiming Zhu, Hope King, Brian R. Edlin, and Karen W. Hoover. "Human Immunodeficiency Virus and Hepatitis C Virus Infection Testing Among Commercially Insured Persons Who Inject Drugs, United States, 2010–2017." Journal of Infectious Diseases 222, no. 6 (2020): 940–47. http://dx.doi.org/10.1093/infdis/jiaa017.

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Abstract Background We assessed prevalence of testing for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection among persons who inject drugs (PWID). Methods Using a nationwide health insurance database for claims paid during 2010–2017, we identified PWID by using codes from the International Classification of Diseases, Current Procedural Terminology, and National Drug Codes directory. We then estimated the percentage of PWIDs tested for HIV or HCV within 1 year of an index encounter, and we used multivariate logistic regression models to assess demographic and clinical factors associated with testing. Results Of 844 242 PWIDs, 71 938 (8.5%) were tested for HIV and 65 188 (7.7%) were tested for HCV infections. Missed opportunities were independently associated with being male (odds ratios [ORs]: HIV, 0.50 [95% confidence interval {CI}, 0.49–0.50], P &lt; .001; HCV, 0.66 [95% CI, 0.65–0.72], P &lt; .001), rural residence (ORs: HIV, 0.67 [95% CI, 0.65–0.69], P &lt; .001; HCV, 0.75 [95% CI, 0.73–0.77], P &lt; .001), and receiving services for skin infections or endocarditis (adjusted ORs: HIV, 0.91 [95% CI, 0.87–0.95], P &lt; .001; HCV, 0.90 [95% CI, 0.86–0.95], P &lt; .001). Conclusions Approximately 90% of presumed PWIDs missed opportunities for HIV or HCV testing, especially male rural residents with claims for skin infections or endocarditis, commonly associated with injection drug use.

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Sultana, Rezwana, and Akkur Chandra Das. "Knowledge and Practice Regarding HIV among Urban-Rural Men in Bangladesh: A cross sectional study." Bangladesh Journal of Infectious Diseases 2, no. 1 (2017): 3–8. http://dx.doi.org/10.3329/bjid.v2i1.31215.

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Background: Human immunodeficiency virus (HIV) is one of the very much concerning issues and nearly 30 million people have died because of HIV related causes, which are found mostly low and lower income countries of the world. Objective: The objective of this study was to evaluate knowledge and practice to reduce risk factors of getting HIV among urban and rural men in Bangladesh with the comparative analysis among them. Methodology: This is a cross sectional study among 3997 men (urban=1437 and rural=2560). Frequency and percentage on knowledge and practice to reduce risk factors of getting HIV were counted to describe and also urban-rural significance levels of knowledge and practice issues regarding HIV were tested. Result: Knowledge and practice regarding HIV among urban-rural men were comparatively different where 93.7% urban and 81.9% rural men heard about HIV; 88.3% urban and 74.8% rural men thought that HIV can get by using unsterilized needle or syringe; 90.3% urban and 75.6% rural men thought that unsafe blood transfusions resulted HIV; 78.3% urban and 62.2% rural men use condom always during sex; and these urban-rural knowledge and practice related differences are statistically significant at P<.000. Conclusion: In Bangladesh, there werent massive differences between urban and rural mens knowledge and practice reducing risk factors of getting HIV; but urban men have comparatively more knowledge and practice levels than those of rural men have because of having urban mens higher level of socio-demographic and economic status. Bangladesh J Infect Dis 2015;2(1):3-8

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Solomon, Suniti, N. Kumarasamy, A. K. Ganesh, and R. Edwin Amalraj. "Prevalence and risk factors of HIV-1 and HIV-2 infection in urban and rural areas in Tamil Nadu, India." International Journal of STD & AIDS 9, no. 2 (1998): 98–103. http://dx.doi.org/10.1258/0956462981921756.

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Summary: We aim to study the factors associated with the prevalence of HIV-1 and HIV-2 infection in the urban and rural areas of Tamil Nadu, India. The population of Tamil Nadu is approximately 60 million. Between April 94 and March 95, 992 samples from 5 representative urban centres and 1071 samples from 5 representative rural centres were collected and studied. A questionnaire was administered privately and it preceded collection of each sample. Samples were screened using ELISA and antibodies to HIV-1 and HIV-2 were confirmed using Western blot. The study was anonymous and unlinked. The prevalence of HIV infection in urban and rural areas was 7.2% (95% CI=6.1 to 8.31%); HIV-1 antibodies were found in 7.4% (95% CI=5.8 to 9.2%) of urban and 7.0% (95% CI=5.6 to 8.7%) of rural population; HIV-2 antibodies were found in 0.8% of urban and 0.3% of rural population. Heterosexual transmission, more so among those with multiple partner sex, was the main mode; higher prevalence of HIV infection among divorced/single individuals both in urban (21.1%) and rural (26.1%) was found. HIV infection among housewives stood at 4.1% (urban) and 3.8% (rural). The strength of association between STDs and HIV was observed to be greater in rural subjects (OR=8.89; 95% CI=5.11 to 15.57) than in urban subjects (OR=1.9; 95% CI=1.14 to 3.18). The prevalence of condom use was found to be less than 2% in the study subjects. HIV-2 is not as widely prevalent in Tamil Nadu as HIV-1. In our study the most common risk factors for HIV infection that emerged were (a) having multiple sexual partners, and (b) history of STDs or Venereal Disease Research Laboratory (VDRL) reactivity. Mobility of individuals between urban and rural areas has furthered the dissemination of HIV infection. Low condom usage among study subjects questions the effectiveness of the existing AIDS awareness and education programme. The study indicates the importance of placing equal emphasis on HIV prevention in rural India. HIV infection among housewives in urban and rural areas is indicative of gender inequalities and the importance of empowering women to prevent infection from spouse.

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Umoke, MaryJoy, Peter Sage, Tor Bjoernsen, et al. "Co-infection and Risk Factors Associated with STIs among Pregnant Women in Rural Health Facilities in Nigeria: A Retrospective Study." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 58 (January 2021): 004695802199291. http://dx.doi.org/10.1177/0046958021992912.

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Globally, sexually transmitted infections are recognized as a public and reproductive health challenge. The study determined the prevalence, co-infection, and risk factors associated with HBV, HCV, HIV, and Syphilis infections among pregnant women receiving antenatal care in rural health facilities in Ebonyi State, Nigeria. A retrospective study was conducted from January to December 2018 in 8 primary healthcare facilities using antenatal records of all the 4657 pregnant women who attended ANC within the period. Data were analyzed using descriptive and inferential statistics with IBM SPSS statistics version 20 and hypotheses tested at P < .05. The findings indicated a medium prevalence of HBV (4.1%), a high prevalence of HCV (4.1%) and syphilis (1.8%), and a low prevalence of HIV (0.9%). An overall co-infection rate of 0.623% that was not significant ( P > .05) was observed. Also, prevalence was more among the younger mothers (<20 years), those with secondary education. And the history of blood transfusion was significantly associated with HBV and HCV prevalence (χ2 = 7.865; P = .05*), 11.8%. conclusively, due to medium HBV prevalence and a high prevalence of HCV and syphilis observed, attention should be paid to blood screening before transfusion by health workers. Relevant stakeholders should provide intensive health education and appropriate free treatment services particularly for younger mothers and the less educated.

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Besombes, Camille, Richard Njouom, Juliette Paireau, et al. "The epidemiology of hepatitis delta virus infection in Cameroon." Gut 69, no. 7 (2020): 1294–300. http://dx.doi.org/10.1136/gutjnl-2019-320027.

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ObjectiveTo investigate the distribution and risk factors of hepatitis delta virus (HDV) infection in Cameroon.DesignWe tested for hepatitis B virus (HBV) surface antigen (HBsAg) and anti-HDV antibody 14 150 samples collected during a survey whose participants were representative of the Cameroonian adult population. The samples had already been tested for hepatitis C virus and HIV antibodies.ResultsOverall, 1621/14 150 (weighted prevalence=11.9%) participants were HBsAg positive, among whom 224/1621 (10.6%) were anti-HDV positive. In 2011, the estimated numbers of HBsAg positive and HDV seropositives were 1 160 799 and 122 910 in the 15–49 years age group, respectively. There were substantial regional variations in prevalence of chronic HBV infection, but even more so for HDV (from 1% to 54%). In multivariable analysis, HDV seropositivity was independently associated with living with an HDV-seropositive person (OR=8.80; 95% CI: 3.23 to 24.0), being HIV infected (OR=2.82; 95% CI: 1.32 to 6.02) and living in the South (latitude <4°N) while having rural/outdoor work (OR=15.2; 95% CI: 8.35 to 27.6, when compared with living on latitude ≥4°N and not having rural/outdoor work).ConclusionWe found evidence for effective intra-household transmission of HDV in Cameroon. We also identified large differences in prevalence between regions, with cases concentrated in forested areas close to the Equator, as described in other tropical areas. The reasons underlying these geographical variations in HDV prevalence deserve further investigation.

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Leung, Man-Kit. "Cultivating HIV awareness in rural China." AIDS 18, no. 7 (2004): 971–73. http://dx.doi.org/10.1097/00002030-200404300-00003.

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de Mendoza, Carmen, José M. Bautista, Susana Pérez-Benavente, et al. "Screening for retroviruses and hepatitis viruses using dried blood spots reveals a high prevalence of occult hepatitis B in Ghana." Therapeutic Advances in Infectious Disease 6 (January 2019): 204993611985146. http://dx.doi.org/10.1177/2049936119851464.

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Background: Recent advances in antiviral therapy show potential for a cure and/or control of most human infections caused by hepatitis viruses and retroviruses. However, medical success is largely dependent on the identification of the large number of people unaware of these infections, especially in developing countries. Dried blood spots (DBS) have been demonstrated to be a good tool for collecting, storing and transporting clinical specimens from rural areas and limited-resource settings to laboratory facilities, where viral infections can be more reliably diagnosed. Methods: The seroprevalence and virological characterization of hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as human retroviruses (HIV-1, HIV-2, human T-cell leukaemia virus type 1 [HTLV-1] and human T-cell leukaemia virus type 2 [HTLV-2]), were investigated in clinical specimens collected from DBS in Ghana. Results: A total of 305 consecutive DBS were collected. A high prevalence of chronic HBV (8.5%) and occult hepatitis B (14.2%) was found, whereas rates were lower for HIV-1, HTLV-1 and HCV (3.2%, 1.3% and 0.6%, respectively). HIV-2 and HTLV-2 were absent. CRF02_AG was the predominant HIV-1 subtype, whereas genotype E was the most frequent HBV variant. Conclusions: DBS are helpful in the diagnosis and virological characterization of hepatitis and retrovirus infections in resource-limited settings. The high rate of hepatitis B in Ghana, either overt or occult, is noteworthy and confirms recent findings from other sub-Saharan countries. This should encourage close clinical follow up and antiviral treatment assessment in this population, as well as universal HBV vaccine campaigns.

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O'Hara, Geraldine, Jolynne Mokaya, Jeffrey P. Hau, et al. "Liver function tests and fibrosis scores in a rural population in Africa: a cross-sectional study to estimate the burden of disease and associated risk factors." BMJ Open 10, no. 3 (2020): e032890. http://dx.doi.org/10.1136/bmjopen-2019-032890.

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ObjectivesLiver disease is a major cause of morbidity and mortality in sub-Saharan Africa, but its prevalence, distribution and aetiology have not been well characterised. We therefore set out to examine liver function tests (LFTs) and liver fibrosis scores in a rural African population.DesignWe undertook a cross-sectional survey of LFTs. We classified abnormal LFTs based on reference ranges set in America and in Africa. We derived fibrosis scores (aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), fibrosis-4, gamma-glutamyl transferase (GGT) to platelet ratio (GPR), red cell distribution width to platelet ratio and S-index). We collected information about alcohol intake, and infection with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV).SettingWe studied a population cohort in South-Western Uganda.ParticipantsData were available for 8099 adults (median age 30 years; 56% female).ResultsThe prevalence of HBV, HCV and HIV infection was 3%, 0.2% and 8%, respectively. The prevalence of abnormal LFTs was higher based on the American reference range compared with the African reference range (eg, for AST 13% vs 3%, respectively). Elevated AST/ALT ratio was significantly associated with self-reported alcohol consumption (p<0.001), and the overall prevalence of AST/ALT ratio >2 was 11% (suggesting alcoholic hepatitis). The highest prevalence of fibrosis was predicted by the GPR score, with 24% of the population falling above the threshold for fibrosis. There was an association between the presence of HIV or HBV and raised GPR (p=0.005) and S-index (p<0.001). By multivariate analysis, elevated LFTs and fibrosis scores were most consistently associated with older age, male sex, being under-weight, HIV or HBV infection and alcohol consumption.ConclusionsFurther work is required to determine normal reference ranges for LFTs in this setting, to evaluate the specificity and sensitivity of fibrosis scores and to determine the aetiology of liver disease.

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Kingori, Caroline, Zelalem T. Haile, Peter Ngatia, and Ruth Nderitu. "Factors that can influence feelings towards and interactions with people living with HIV/AIDS in rural Central Kenya." International Journal of STD & AIDS 28, no. 9 (2016): 910–19. http://dx.doi.org/10.1177/0956462416680764.

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Background In Kenya, HIV incidence and prevalence have declined. HIV rates are lower in rural areas than in urban areas. However, HIV infection is reported higher in men in rural areas (4.5%) compared to those in urban areas (3.7%). Objectives This study examined HIV knowledge, feelings, and interactions towards HIV-infected from 302 participants in rural Central Kenya. Methods Chi square tests and multivariable logistic regression analyzed variables of interest. Results Most participants exhibited positive feelings in their interaction with people living with HIV and AIDS (PLWHA). Association between HIV knowledge and socio-demographic characteristics revealed that the proportion of participants with a correct response differed by gender, age, level of education, and marital status ( p < 0.05). Compared to those with inadequate knowledge of HIV/AIDS, participants with adequate HIV/AIDS knowledge were nearly three times as likely to disagree that PLWHA should be legally separated from others to protect public health (adjusted odds ratio: aOR (95% CI) (2.76 (1.12, 6.80). Conclusions HIV stigma continues to impact HIV prevention strategies particularly in rural Central Kenya. Culturally, appropriate interventions addressing HIV knowledge among those with lower levels of education, single, older, and male are warranted. Review of HIV policies separating high-risk populations from the general population is needed to reduce stigma.

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Salem, Benissa E., Yvita Bustos, Chidyaonga Shalita, et al. "Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study." Journal of the International Association of Providers of AIDS Care (JIAPAC) 17 (January 1, 2018): 232595821877376. http://dx.doi.org/10.1177/2325958218773768.

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Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.

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Alvarez-Uria, Gerardo, Manoranjan Midde, and Praveen K. Naik. "Socio-demographic risk factors associated with HIV infection in patients seeking medical advice in a rural hospital of India." Journal of Public Health Research 1, no. 1 (2012): 14. http://dx.doi.org/10.4081/jphr.2012.e14.

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Despite the fact that two thirds of HIV infected people in India are rural residents, risk factors associated with HIV infection in rural areas are not well known. In this study we have collected socio-demographic data of 6406 patients who were tested for HIV infection in a rural hospital of India and we have investigated risk factors associated with HIV. In women the most important risk factor was being a widow and the risk was higher in younger than in older widows. Other variables found to be associated with HIV infection were age between 25 and 45 years in men, low education level (especially those who only completed primary education) and working in a field not related to agriculture in scheduled castes and men from scheduled tribes. The results of this study express the need for HIV screening of widows who live in rural areas of Indian States with high HIV prevalence.

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Alvarez-Uria, Gerardo, Manoranjan Midde, Raghavakalyan Pakam, and Praveen K. Naik. "Gender differences, routes of transmission, socio-demographic characteristics and prevalence of HIV related infections of adults and children in an HIV cohort from a rural district of India." Infectious Disease Reports 4, no. 1 (2012): 19. http://dx.doi.org/10.4081/idr.2012.e19.

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Despite 67% of HIV infected people in India are rural residents, the epidemiology of HIV in rural areas is not well known. This is an observational cohort study of 11,040 HIV infected people living in a rural district of India. The prevalence of hepatitis B, hepatitis C and syphilis of HIV infected patients were compared to the seroprevalence in 16,641 blood donors from the same area. The age of diagnosis in adults was below 35 years in 70% of cases and 56% were illiterate. One third of women were widows and only 3.6% of adults had a permanent job. Women were diagnosed at earlier age, had lower level of education, had poorer employment conditions and depended more on their relatives than men. In a survey performed to a subgroup of patients, 81% of women referred to have acquired HIV from their spouse, whereas 51% of men acquired HIV from commercial sex. Patients with HIV had significantly higher prevalence of hepatitis B, hepatitis C and syphilis than blood donors. Seroprevalence of HIV-2, hepatitis C and toxoplasmosis were low compared to other sites. Six percent were children (&lt;15 years) and almost half of them had lost one or both of their parents. The study shows the poor socio-economical situation and the high level of illiteracy of people living with HIV in rural India, especially women. Future health programmes of HIV in India should take into account the particularities of the HIV epidemic in rural areas.

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Firnhaber, Cynthia S., and Prue Ive. "Hepatitis B and HIV co-infection in South Africa: Just treat it!" Southern African Journal of HIV Medicine 10, no. 1 (2009): 4. http://dx.doi.org/10.4102/sajhivmed.v10i1.998.

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There are an estimated 350 million hepatitis B carriers worldwide. The prevalence of mono-infection with hepatitis B in South Africa has been estimated at approximately 10% for the rural population and 1% in urban areas. The transmission routes of hepatitis B and HIV are similar, but hepatitis B is more efficient. Co-infection with HIV and hepatitis B is therefore not unusual. Recent studies have shown that the prevalence of HIV/HBV co-infection (using HBV surface antigen (HBsAg) as a marker for HBV) in South Africa ranges from 4.8% to 17%, depending on the population studied.The guidelines for the South African HIV Comprehensive Care, Management and Treatment (CCMT) programme do not include viral hepatitis studies. Hepatitis B serology is usually done only if serum aminotransferases are evaluated in the absence of another known cause (e.g. tuberculosis and concomitant medications). The clinical sequelae of HIV/HBV co-infection are multiple and can cause an increase in morbidity and mortality. Awareness of HBV/HIV co-infection with appropriate diagnosis and management is imperative for improved care of our HIV patients.

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Zhang, Yurong, Esme Fuller-Thomson, Christine Anne Mitchell, and Xiulan Zhang. "Older Adults with HIV/AIDS in Rural China." Open AIDS Journal 7, no. 1 (2013): 51–57. http://dx.doi.org/10.2174/1874613601307010051.

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Although the number of older people living with HIV/AIDS (PLWHA) has increased substantially, few studies have focused on older PLWHA in developing countries. Based on a sample of 866 rural PLWHA in Henan, Anhui and Yunnan provinces in China, this study compares the characteristics of PLWHA aged 50 or older (n=185) with younger PLWHA (n=681). Most of the older PLWHA were female (n=112), illiterate, married and at the clinical stage of HIV. Over 90% of older people with HIV/AIDS lived in Henan and Anhui provinces. The severe epidemic in Henan and Anhui provinces was caused by commercial blood and plasma donation. Older PLWHA were less educated, received less social support and were more likely to live alone than younger PLWHA. The results underline the importance of developing programs and policy initiatives targeted at older people infected with HIV/AIDS. The policy and program recommendations include using a gender sensitive strategy, designing specific AIDS education and prevention programs suitable for low-literacy older adults and social support interventions for older PLWHA.

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HECKMAN, TIMOTHY G., MONICA SILVERTHORN, ANDREA WALTJE, MELISSA MEYERS, and WILLIAM YARBER. "HIV Transmission Risk Practices in Rural Persons Living With HIV Disease." Sexually Transmitted Diseases 30, no. 2 (2003): 134–36. http://dx.doi.org/10.1097/00007435-200302000-00008.

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Plazy, M., M.-L. Newell, J. Orne-Gliemann, K. Naidu, F. Dabis, and R. Dray-Spira. "Barriers to antiretroviral treatment initiation in rural KwaZulu-Natal, South Africa." HIV Medicine 16, no. 9 (2015): 521–32. http://dx.doi.org/10.1111/hiv.12253.

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Kshirsagar, Dr Pankaj, Dr Suresh Naik, and Dr Ajay Naik. "Surgical Presentations and Management of HIV Positive Patients in Rural Medical College." Indian Journal of Applied Research 3, no. 2 (2011): 251–53. http://dx.doi.org/10.15373/2249555x/feb2013/85.

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Leukefeld, Carl G., and Theodore Godlaski. "Perceptions of Rural Addictions and Related HIV." Substance Use & Misuse 32, no. 1 (1997): 83–88. http://dx.doi.org/10.3109/10826089709027299.

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McCoy, Clyde B., Lisa R. Metsch, H. Virginia McCoy, and Norman L. Weatherby. "HIV Seroprevalence across the Rural/ Urban Continuum." Substance Use & Misuse 34, no. 4-5 (1999): 595–615. http://dx.doi.org/10.3109/10826089909037233.

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Topping, Sharon, and Lynn C. Hartwig. "Delivering Care to Rural HIV / AIDS Patients." Journal of Rural Health 13, no. 3 (1997): 226–36. http://dx.doi.org/10.1111/j.1748-0361.1997.tb00846.x.

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Wambura, Mwita, Mark Urassa, Raphael Isingo, et al. "HIV Prevalence and Incidence in Rural Tanzania." JAIDS Journal of Acquired Immune Deficiency Syndromes 46, no. 5 (2007): 616–23. http://dx.doi.org/10.1097/qai.0b013e31815a571a.

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Lopez-Varela, Elisa, Laura Fuente-Soro, Orvalho J. Augusto, et al. "Continuum of HIV Care in Rural Mozambique." JAIDS Journal of Acquired Immune Deficiency Syndromes 78, no. 5 (2018): 527–35. http://dx.doi.org/10.1097/qai.0000000000001720.

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Tebit, Denis M., Jean Ganame, Kanokporn Sathiandee, Youssouf Nagabila, Boubacar Coulibaly, and Hans-Georg Krausslich. "Diversity of HIV in Rural Burkina Faso." JAIDS Journal of Acquired Immune Deficiency Syndromes 43, no. 2 (2006): 144–52. http://dx.doi.org/10.1097/01.qai.0000228148.40539.d3.

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Nyambi, Phillipe, Leopold Zekeng, Henriette Kenfack, et al. "HIV Infection in Rural Villages of Cameroon." JAIDS Journal of Acquired Immune Deficiency Syndromes 31, no. 5 (2002): 506–13. http://dx.doi.org/10.1097/00126334-200212150-00008.

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Helge, Doris. "Needs of Rural Schools regarding HIV Education." Rural Special Education Quarterly 10, no. 2 (1990): 21–29. http://dx.doi.org/10.1177/875687059001000204.

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Stephenson, Joan. "Rural HIV/AIDS in the United States." JAMA 284, no. 2 (2000): 167. http://dx.doi.org/10.1001/jama.284.2.167-jmn0712-2-1.

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Agot, Kawango E., Jeckoniah O. Ndinya-Achola, Joan K. Kreiss, and Noel S. Weiss. "Risk of HIV-1 in Rural Kenya." Epidemiology 15, no. 2 (2004): 157–63. http://dx.doi.org/10.1097/01.ede.0000112220.16977.82.

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Soni, S., and N. Ramesh. "HIV transmission within families in rural India." International Journal of STD & AIDS 20, no. 3 (2009): 214–15. http://dx.doi.org/10.1258/ijsa.2009.009004.

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Oser, Carrie B., Carl G. Leukefeld, Abby Cosentino-Boehm, and Jennifer R. Havens. "Rural HIV: Brief interventions for felony probationers." American Journal of Criminal Justice 31, no. 1 (2006): 125–43. http://dx.doi.org/10.1007/bf02885688.

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Marick, Josephine. "HIV/AIDS Peer Education: A Rural Health Project." Journal of School Nursing 18, no. 1 (2002): 41–47. http://dx.doi.org/10.1177/10598405020180010801.

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This article describes a program conducted by a group of adolescents in a rural western Nebraska high school that was designed to inform their peers about the risk of HIV/AIDS. The program was funded by state and county agencies. An AIDS Task Force composed of community health leaders developed the guidelines for the program. The Task Force met annually to plan for the coming year, implement changes, and evaluate the program. A community health nurse served as the coordinator of the program and also served as a rural school nurse. A group of students called peer helpers carried out the HIV/AIDS program. Peer helpers created an awareness of HIV/AIDS with dissemination of factual information and also served as a referral resource for their peers. A number of recommendations are provided for future implementation of programs designed to help adolescents develop a healthy lifestyle.

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Weatherby, Norman L., H. Virginia McCoy, Keith V. Bletzer, et al. "Immigration and HIV among Migrant Workers in Rural Southern Florida." Journal of Drug Issues 27, no. 1 (1997): 155–72. http://dx.doi.org/10.1177/002204269702700111.

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We studied HIV seropositivity among a targeted sample of migrant workers who used drugs, primarily crack cocaine, and their sexual partners in rural southern Florida from 1993 to 1995. We enrolled men and women who were born in the United States (n = 369) or in other countries (n = 174). Overall, 11.2% of the sample were HIV positive, including 18% of Blacks from the United States, and about 8% of non-Hispanic whites from the United States, Blacks from the Caribbean, and persons from Central or South America. No Hispanics from the United States or the Caribbean, but 3.4% of Hispanics from Mexico, were HIV positive. In logistic regression analyses, race/ethnicity, gender, and age were most highly associated with HIV seropositivity. Immigration status, current drug use, and current sexual activity were not related to HIV seropositivity. HIV prevention programs must help reduce heterosexual transmission of HIV associated with drug use both locally and where migrants travel and work.

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Lifson, Alan Raymond, Sale Workneh, Abera Hailemichael, et al. "Advanced HIV Disease among Males and Females Initiating HIV Care in Rural Ethiopia." Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821984719. http://dx.doi.org/10.1177/2325958219847199.

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Despite recommendations for rapidly initiating HIV treatment, many persons in sub-Saharan Africa present to care with advanced HIV disease. Baseline survey and clinical data were collected on 1799 adults newly enrolling at 32 district hospitals and local health HIV clinics in rural Ethiopia. Among those with complete HIV disease information, advanced HIV disease (defined as CD4 count <200 cells/mm3 or World Health Organization [WHO] HIV clinical stage III or IV disease) was present in 66% of males and 56% of females ( P < .001). Males (compared to females) had lower CD4 counts (287 cells/mm3 versus 345 cells/mm3), lower body mass index (19.3 kg/m2 versus 20.2 kg/m2), and more WHO stage III or IV disease (46% versus 37%), ( P < .001). Men reported more chronic diarrhea, fevers, cough, pain, fatigue, and weight loss ( P < .05). Most initiating care in this resource-limited setting had advanced HIV disease. Men had poorer health status, supporting the importance of earlier diagnosis, linkage to care, and initiation of antiretroviral therapy.

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pallikadavath, saseendran, laila garda, hemant apte, jane freedman, and r. william stones. "hiv/aids in rural india: context and health care needs." Journal of Biosocial Science 37, no. 5 (2004): 641–55. http://dx.doi.org/10.1017/s0021932004006893.

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primary research on hiv/aids in india has predominantly focused on known risk groups such as sex workers, sti clinic attendees and long-distance truck drivers, and has largely been undertaken in urban areas. there is evidence of hiv spreading to rural areas but very little is known about the context of the infection or about issues relating to health and social impact on people living with hiv/aids. in-depth interviews with nineteen men and women infected with hiv who live in rural areas were used to collect experiences of testing and treatment, the social impacts of living with hiv and differential impacts on women and men. eight focus group discussions with groups drawn from the general population in the four villages were used to provide an analysis of community level views about hiv/aids. while men reported contracting hiv from sex workers in the cities, women considered their husbands to be the source of their infection. correct knowledge about hiv transmission co-existed with misconceptions. men and women tested for hiv reported inadequate counselling and sought treatment from traditional healers as well as professionals. owing to the general pattern of husbands being the first to contract hiv women faced a substantial burden, with few resources remaining for their own or their children’s care after meeting the needs of sick husbands. stigma and social isolation following widowhood were common, with an enforced return to the natal home. implications for potential educational and service interventions are discussed within the context of gender and social relations.

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Rohr, Julia K., Jennifer Manne-Goehler, Francesc Xavier Gómez-Olivé, et al. "HIV treatment cascade for older adults in rural South Africa." Sexually Transmitted Infections 96, no. 4 (2019): 271–76. http://dx.doi.org/10.1136/sextrans-2018-053925.

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ObjectivesThe HIV treatment cascade is a powerful framework for understanding progress from initial diagnosis to successful treatment. Data sources for cascades vary and often are based on clinical cohorts, population cohorts linked to clinics, or self-reported information. We use both biomarkers and self-reported data from a large population-based cohort of older South Africans to establish the first HIV cascade for this growing segment of the HIV-positive population and compare results using the different data sources.MethodsData came from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) 2015 baseline survey of 5059 adults aged 40+ years. Dried blood spots (DBS) were screened for HIV, antiretroviral drugs and viral load. In-home surveys asked about HIV testing, diagnosis and antiretroviral therapy (ART) use. We calculated proportions and CIs for each stage of the cascade, conditional on attainment of the previous stage, using (1) biomarkers, (2) self-report and (3) both biomarkers and self-report, and compared with UNAIDS 90-90-90 targets.Results4560 participants had DBS results, among whom 1048 (23%) screened HIV-positive and comprised the denominator for each cascade. The biomarker cascade showed 63% (95% CI 60 to 66) on ART and 72% (95% CI 69 to 76) of those on ART with viral suppression. Self-reports underestimated testing, diagnosis and ART, with only 47% (95% CI 44 to 50) of HIV-positive individuals reporting ART use. The combined cascade indicated high HIV testing (89% (95% CI 87 to 91)), but lower knowledge of HIV-positive status (71% (95% CI 68 to 74)).ConclusionsOlder South Africans need repeated HIV testing and sustained ART to reach 90-90-90 targets. HIV cascades relying on self-reports are likely to underestimate true cascade attainment, and biomarkers provide substantial improvements to cascade estimates.

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Kane, Stephanie, and C. Jason Dotson. "HIV Risk and Injecting Drug Use: Implications for Rural Jails." Crime & Delinquency 43, no. 2 (1997): 169–85. http://dx.doi.org/10.1177/0011128797043002003.

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The Department of Justice estimates that 25% of all state prisoners have injected illegal drugs and that needle use is a major factor in human immunodeficiency virus (HIV) transmission among state prison inmates. But little is known regarding the problem in rural jails. Data presented here, based on interviews and questionnaires administered to inmates and staff in Indiana rural county jails, indicate that system management procedures may increase HIV risk to inmates and staff. Formulating policies on HIV risk for rural jails may prove crucial to epidemic management within particular institutions and may be a critical dimension of nationwide transmission patterns.

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Lifson, Alan R., Sale Workneh, Abera Hailemichael, Workneh Demisse, Lucy Slater, and Tibebe Shenie. "Implementation of a Peer HIV Community Support Worker Program in Rural Ethiopia to Promote Retention in Care." Journal of the International Association of Providers of AIDS Care (JIAPAC) 16, no. 1 (2016): 75–80. http://dx.doi.org/10.1177/2325957415614648.

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Retention in care is a major challenge for HIV treatment programs, including in rural and in resource-limited settings. To help reduce loss to follow-up (LTFU) for HIV-infected patients new to care in rural Ethiopia, 142 patients were assigned 1 of 13 trained community health support workers (CHSWs) who were HIV positive and from the same neighborhood/village. The CHSWs provided HIV and health education, counseling/social support, and facilitated communication with the HIV clinics. With 7 deaths and 3 transfers, the 12-month retention rate was 94% (95% CI = 89%-97%), and no client was LTFU in the project. Between enrollment and 12 months, clients had significant ( P ≤ .001) improvements in HIV knowledge (17% increase), physical and mental quality of life (81% and 21% increase), internalized stigma (97% decrease), and perceived social support (24% increase). In rural and resource-limited settings, community-based CHSW programs can complement facility-based care in reducing LTFU and improving positive outcomes for HIV-infected people who enter care.

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Granade, Timothy C., Bharat S. Parekh, Pius M. Tih, et al. "Evaluation of Rapid Prenatal Human Immunodeficiency Virus Testing in Rural Cameroon." Clinical Diagnostic Laboratory Immunology 12, no. 7 (2005): 855–60. http://dx.doi.org/10.1128/cdli.12.7.855-860.2005.

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ABSTRACT Pregnant women (n = 859) in rural Cameroonian prenatal clinics were screened by two rapid human immunodeficiency virus (HIV) antibody tests (rapid tests [RT]) (Determine and Hema-Strip) using either whole blood or plasma. One additional RT (Capillus, HIV-CHEK, or Sero-Card) was used to resolve discordant results. RT results were compared with HIV-1 enzyme immunoassay (EIA) and Western blot (WB) results of matched dried blood spots (DBS) to assess the accuracy of HIV RTs. DBS EIA/WB identified 83 HIV antibody-reactive, 763 HIV antibody-nonreactive, and 13 indeterminate specimens. RT results were evaluated in serial (two consecutive tests) or parallel (two simultaneous tests) testing algorithms. A serial algorithm using Determine and Hema-Strip yielded sensitivity and specificity results of 97.6% and 99.7%, respectively, whereas a parallel RT algorithm using Determine plus a second RT produced a sensitivity and specificity of 100% and 99.7%, respectively. HIV RTs provide excellent alternatives for identifying HIV infection, and their field performance could be monitored using DBS testing strategies.

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Cossa, H. A., S. Gloyd, R. G. Vaz, et al. "Syphilis and HIV Infection among Displaced Pregnant Women in Rural Mozambique." International Journal of STD & AIDS 5, no. 2 (1994): 117–23. http://dx.doi.org/10.1177/095646249400500208.

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A cross-sectional study was conducted among displaced pregnant women in Mozambique to determine the prevalence and correlates of HIV infection and syphilis. Between September 1992 and February 1993, 1728 consecutive antenatal attendees of 14 rural clinics in Zambézia were interviewed, examined, and tested for HIV and syphilis antibodies. The seroprevalence of syphilis and HIV were 12.2% and 2.9%, respectively. Reported sexual abuse was frequent (8.4%) but sex for money was uncommon. A positive MHA-TP result was significantly associated with unmarried status, history of past STD, HIV infection, and current genital ulcers, vaginal discharge, or genital warts. Significant correlates of HIV seropositivity included anal intercourse, history of past STD, and syphilis. In summary, displaced pregnant women had a high prevalence of syphilis but a relatively low HIV seroprevalence suggesting recent introduction of HIV infection in this area or slow spread of the epidemic. A syphilils screening and treatment programme is warranted to prevent perinatal transmission and to reduce the incidence of chancres as a cofactor for HIV transmission.

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Journal articles on the topic 'Rural HIV'

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