The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.
Bias (Epidemiology) ; Delivery of Health Care ; Denial (Psychology) ; Diagnosis ; Female ; HIV ; HIV Infections ; Humans ; Male ; Nursing

PIP: By mid-1995, a total of 308 HIV cases had been reported in Papua New Guinea. The majority (74%) of these cases were diagnosed in Port Moresby. This article describes the clinical characteristics of HIV infection in 67 adults who presented to Port Moresby General Hospital in 1990-95. The median age at presentation was 27 years in men and 28 years in women, with an equal distribution of cases by sex. The major presenting symptoms were wasting and weight loss exceeding 10% of body weight (94%), chronic diarrhea (47%), prolonged fever (77%), and oropharyngeal candidiasis (66%). Pulmonary tuberculosis was diagnosed on the basis of chest X-ray and history in 37 patients (56%), but only 3 had sputum positive for acid-fast bacilli. Anemia was present in 75%. 65 patients (97%) fulfilled the World Health Organization criteria for AIDS. The inpatient mortality rate in this series was 43%, and 13 of these 29 patients died within a month of their first presentation.
Acquired Immunodeficiency Syndrome - diagnosis ; Acquired Immunodeficiency Syndrome - epidemiology ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; Humans ; Papua New Guinea - epidemiology ; Risk Factors

No abstract available.
AIDS-Related Opportunistic Infections/epidemiology* ; AIDS-Related Opportunistic Infections/diagnosis ; Acquired Immunodeficiency Syndrome/transmission ; Acquired Immunodeficiency Syndrome/epidemiology ; Acquired Immunodeficiency Syndrome/diagnosis ; Adolescence ; Adult ; Age Distribution ; Aged ; Child ; Child, Preschool ; Female ; HIV Infections/transmission* ; HIV Infections/epidemiology* ; HIV Infections/diagnosis ; Human ; Incidence ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Middle Age ; Risk Factors ; Sex Distribution ; Survival Analysis

OBJECTIVETo understand the characteristics of HIV/AIDS patients with late diagnosis and find the factors associated with late HIV detection.

METHODSHIV late diagnosed patients and early diagnosed patients, which were identified and classified by definition in advance, were selected from the case reporting database of HIV/AIDS Comprehensive Response Information Management System in eight counties of four provinces (Zhumadian, Nanyang, and Zhoukou of Hennan province; Liuzhou and Lingshan county of Guangxi autonomous region; Guangzhou and Shenzhen of Guangdong province; Dehong of Yunnan province) between January 1, 2009 and June 30, 2010. A total of 3912 eligible patients were investigated, including 2496 late diagnosis and 1416 early diagnosis. The structured questionnaires were used to obtain information on behaviors, HIV detection history and reason of late detection for all eligible HIV/AIDS patients. Late diagnosed patients were defined by CD4 T-cell counts less than 200 cells/mm(3) or diagnosis as AIDS within the reported year after the first HIV positive test. The univariate and multivariate logistic regression methods were used to analyze the characteristics of HIV/AIDS late diagnosed patients.

RESULTSOnly 14.2% (350/2469) of them have ever had the awareness of "to go for HIV testing", 68.8% (150/218)of which did not put it into practice within one month because of discrimination and stigma. Among those HIV late diagnosed patients without the awareness of "to go for HIV testing", the proportions of "never worried about HIV infection" or "never heard of AIDS" were 69.7% (1476/2116) and 18.1% (383/2116), respectively. When those HIV late diagnosed patients visited health settings because of AIDS related symptoms, only 40.0% (590/1475) of them received the HIV testing service. Furthermore, 54.5% (322/590) of those received HIV testing were not informed the results. Compared with early diagnosed patients, patients with late diagnosis were over 50 years old (OR = 4.14, 95%CI: 3.09 - 5.55), primary school education (OR = 1.29, 95%CI: 1.10 - 1.52) and illiteracy (OR = 2.15, 95%CI: 1.25 - 2.82), Routes of transmission from former illegal blood or plasma (OR = 2.91, 95%CI: 2.27 - 3.74) and transfusion of blood/blood products (OR = 2.79, 95%CI: 2.11 - 3.68). Late diagnosed patients were identified mainly from voluntary counseling and testing (45.4%, 1130/1528) and medical institutions (38.3%, 954/1469).

CONCLUSIONThe main reasons for late diagnosis of HIV infection are low initiative of HIV testing and discrimination and stigma. Furthermore, the low awareness of medical institutions to actively provide HIV testing affects the early diagnosis of HIV infections.

Acquired Immunodeficiency Syndrome ; diagnosis ; epidemiology ; Adult ; China ; epidemiology ; Counseling ; Delayed Diagnosis ; Female ; HIV Infections ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; Middle Aged ; Risk Factors

OBJECTIVETo understand the status of recent infected and newly reported HIV cases in Jiangsu province.

METHODSInformation including general demographic, mode of transmission and sample source of newly reported HIV infected cases was collected. Corresponding serum or plasma samples were collected and tested with BED-CEIA. Proportions of recent HIV infections among different populations were calculated, and associated factors of recent HIV infection calculated.

RESULTSAmong cases infected through different channels as homosexual, heterosexual and needles sharing, the proportions of recent infections were 29.19% , 17.40% and 21.75% , respectively. Statistically significant difference was seen between different populations(P < 0.05). Compared with female cases, male cases were more likely to be recent infected (OR = 1.569, 95%CI: 1.168-2.107). Compared with cases older than 35 years of age, the ones that younger than that age were more likely to be recently infected (OR = 1.556, 95% CI:1.289-1.879). Compared with cases who remained single, those married cases were more likely to be long-term infections(OR = 0.789, 95%CI:0.649-0.960). Compared with patients identified by hospitals, the recent HIV infections were more likely to be found through voluntary counseling programs and testing (OR = 2.278, 95%CI: 1.853-2.801), project-based surveillance programs (OR = 2.409, 95%CI:1.860- 3.120), and unpaid blood donation sites (OR = 2.911, 95%CI:2.118-4.001)(P < 0.05).

CONCLUSIONProportion of MSM ranked 1st in the newly reported HIV cases in Jiangsu province. Related HIV case-finding programs should be strengthened to reduce the secondary transmission.

Age Distribution ; China ; epidemiology ; Female ; HIV Infections ; diagnosis ; epidemiology ; HIV Seropositivity ; Heterosexuality ; Homosexuality ; Humans ; Male ; Marital Status ; statistics & numerical data ; Needle Sharing ; adverse effects ; Sex Distribution

Cytomegalovirus retinitis (CMVR) is the commonest opportunistic ocular infection in patients with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS), typically occurs when CD4+ T cell counts fall below 50/mm3. CMVR accounts for the majority of the vision loss associated with HIV-related eye diseases. However progress in the studies on CMVR, including the prevalence, clinical features, differential diagnosis and recent advances in the management of CMVR is reviewed.
Acquired Immunodeficiency Syndrome ; complications ; CD4 Lymphocyte Count ; Cytomegalovirus Retinitis ; diagnosis ; epidemiology ; therapy ; Diagnosis, Differential ; HIV Infections ; complications ; Humans

This study aims to analyze the molecular epidemiological characteristics of HIV-1 strains prevailing among men who have sex with men (MSM) in Beijing, China. The pol gene fragments from 250 newly diagnosed HIV-1-infected MSM individuals during 2006-2010 in Beijing were amplified by RT-nested PCR, sequenced, and phylogenetically analyzed. HIV-1 pol gene from 189 individuals were amplified and analyzed; 81 (42. 9%), 3 (1. 6%), 2 (1.0%), 88 (46. 6%), and 15 (7.9%) individuals were infected with HIV-1 subtypes B, B', C, CRF01_AE, and CRF07_BC, respectively. The subtypes B and CRF01_AE could both be grouped into two clusters, and CRFO7_BC strains shared high homology and were presumed to originate from a common ancestor. The HIV-1 circulating in MSM in Beijing had a lower genetic diversity than in heterosexuals. The HIV-1 epidemic (2006-2010) in MSM in Beijing was actually a rapid spread of HIV-1 CRF01 AE and B, or rather native strains of the two viruses.
Adult ; China ; epidemiology ; Epidemics ; Genetic Variation ; HIV Infections ; diagnosis ; epidemiology ; virology ; HIV-1 ; classification ; genetics ; isolation & purification ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; Molecular Sequence Data ; Phylogeny ; Young Adult

INTRODUCTIONThe delay in HIV diagnosis has been identified as a significant reason for late presentation to medical care. This research aims to elucidate the significant determinants of late-stage HIV infection in Singapore between 1996 and 2009, after the advent of highly active anti-retroviral therapies.

MATERIALS AND METHODSWe included 3735 patients infected via sexual mode of transmission from the National HIV Registry diagnosed between 1996 and 2009. Late-stage HIV infection is defined as CD4 count less than 200 mm(3) or AIDS-defining opportunistic infections at fi rst diagnosis or within one year of HIV diagnosis. We determined independent epidemiological risk factors for late-stage HIV infection at first diagnosis using multivariate logistic regression.

RESULTSMultivariate analysis showed that older age corresponded significantly with increasing odds of late-stage HIV infection. Compared to persons diagnosed at 15 to 24 years of age, those diagnosed at age 55 years and above were associated with 5-fold increased likelihood of late-stage infection (adjusted odds ratio (AOR): 5.17; 95% CI, 3.21 to 8.33). Chinese ethnicity, singlehood, and non-professional occupations were also significantly associated with late-stage HIV infection. Persons detected in the course of medical care had over 3.5 times the odds of late-stage infection (AOR: 3.55; 95% CI, 2.71 to 4.65). Heterosexual mode of transmission and having sex workers and social escorts as sexual partners, were the other epidemiological risk factors with significant associations.

CONCLUSIONThe findings of this study emphasises the need to increase HIV awareness and to encourage early and regular HIV testing among at-risk persons.

Adolescent ; Adult ; Age Factors ; Delayed Diagnosis ; statistics & numerical data ; Disease Notification ; Female ; HIV ; HIV Infections ; diagnosis ; epidemiology ; Humans ; Logistic Models ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Risk Factors ; Sex Workers ; statistics & numerical data ; Sexual Behavior ; statistics & numerical data ; Singapore ; epidemiology

BACKGROUNDMen who have sex with men (MSM) have been impacted by HIV and now as an important driver of the HIV/AIDS epidemic in China. This study collected HIV sentinel surveillance system data on the MSM population to describe the characteristics and trends of the HIV epidemic among MSM in China from 2003 to 2011.

METHODSData on HIV prevalence and risk behaviors from 2003 to 2011 were obtained from the national HIV sentinel surveillance database.

RESULTSMSM sentinel surveillance data for 2011 showed that proportions of MSM who consistently used condoms during anal sex in the last six months and at last anal sex encounter were 43.3% and 74.1%, respectively. Between 2005 and 2011 there were no significant changes in the proportion of consistent condom use. The proportion of MSM who had multiple male sex partners in the last six months increased. Overall HIV prevalence over the years showed a rising trend from 0.9% in 2003 to 6.3% in 2011. The syphilis antibody positive rate was 7.8% in 2011. In addition, the proportion of MSM in heterosexual marriages was rising, AIDS awareness was also increasing, and the proportion of MSM who had taken an HIV test in the last year and was aware of the results rose. The proportion who had received intervention services in the last year stabilized.

CONCLUSIONSHIV prevalence in MSM populations is rapidly and widely distributed. MSM who are in heterosexual marriages may be a bridge group transmitting HIV to their heterosexual partners. The risky sexual behavior among MSM will remain a serious and important driver of China's AIDS epidemic over the next period of time. Intervention need to be strengthened, as does the effective implementation of measures to control AIDS and prevent it from spreading further.

Adolescent ; Adult ; China ; epidemiology ; HIV Infections ; diagnosis ; epidemiology ; prevention & control ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Prevalence ; Young Adult

PURPOSE: Cryptococcal meningitis is a relatively common opportunistic infection in human immunodeficiency virus (HIV) patients and it can frequently occur in immunocompetent hosts without any apparent underlying disease. Nevertheless, little is known about cyptococcal meningitis in the Korean population. The purpose of this study was to evaluate the clinical features and initial laboratory findings of cryptococcal meningitis in patients with and without HIV at a tertiary care teaching hospital. MATERIALS AND METHODS: We performed a retrospective study at a tertiary care teaching hospital from January 2001 to December 2009. Eleven HIV positive patients and nine HIV negative patients were included. RESULTS: The most common symptoms were headache and fever in cryptococcal meningitis, and diabetic mellitus, end stage renal disease and liver cirrhosis were the main associated conditions in patients without HIV. Patients with HIV showed lower peripheral CD4+ cell counts (median: 9, range: 1-107) and a higher burden of cryptococcus than patients without HIV. There were no statistically significant differences in serum CRP level and other cerebrospinal fluid parameters between patients with HIV and without HIV. The in-hospital mortality was 10%, and recurrence of cyptococcal meningitis was observed in 3 patients with HIV and this occurred within 5 months of the first episode. CONCLUSION: Cryptococcal meningitis is fatal without treatment, therefore, rapid recognition of symptoms such as fever and headache and diagnosis is required to decrease the mortality. Recurrence of meningitis after treatment should carefully be followed up, especially in advanced HIV patients.
Adult ; Aged ; Comorbidity ; Female ; HIV Infections/*complications ; Hospitals ; Humans ; Male ; Meningitis, Cryptococcal/diagnosis/*epidemiology ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies