BACKGROUND

Human immunodeficiency virus infection and acquired immunodeficiency syndrome are significant public health concerns and social issues. Key players in efforts to stop HIV/AIDS as a public threat are healthcare personnel. Research has shown that negative attitudes of healthcare workers towards HIV can negatively influence their practices and these are associated with their level of knowledge about the disease.

OBJECTIVE

This study aims to investigate the baseline knowledge, attitudes, and practices of healthcare workers towards HIV/AIDS and to determine the association between profession and level of knowledge, attitudes and practices among healthcare workers in a tertiary pediatric government hospital.

METHODOLOGY

This study utilized an analytical cross-sectional research design. Data were collected through a written questionnaire administered to 213 healthcare personnel, who were selected via stratified random sampling from January to April 2024. Knowledge, attitude, and practice (KAP) scores were evaluated using Bloom’s cut-off points. Scores below 60% were classified as low level of knowledge, negative attitude, and poor practice. Scores from 60-79% were classified as moderate level of knowledge, neutral attitude and fair practice. Lastly, scores between 80-100% were classified as high level of knowledge, positive attitude and good practice. Descriptive and inferential statistics, specifically Fisher’s test were used whenever appropriate.

RESULTS

Among 213 study participants, 140 (65.73%) demonstrated a high level of knowledge towards HIV/AIDS among doctors, nurses, medical technologists, and radiologic technologists. There were 161 (75.59%) who exhibited positive attitude towards HIV/AIDS and worked as pharmacists, physical therapists, and dentists. About 154 (72.30%) reported having fair practices on HIV/AIDS.

CONCLUSION

The healthcare workers in our study have a high level of knowledge, positive attitude, and fair practices towards HIV/AIDS with significant differences between professions. There is a significant association between professions with the level of knowledge, attitudes, and practices towards HIV. Doctors, nurses, medical technologists, and radiologic technologists have higher level of knowledge on HIV/AIDS. Positive attitude was higher among pharmacists, physical therapists, and dentists. Lastly, good practices were highest among midwives.

Human ; Human Immunodeficiency Virus ; Hiv ; Acquired Immunodeficiency Syndrome ; Knowledge ; Attitude ; Healthcare Workers ; Health Personnel

OBJECTIVES

Patients undergoing modified radical mastectomy (MRM) often experience significant preoperative anxiety. Effective preoperative education could alleviate anxiety and improve patient outcomes. This research aimed to evaluate whether audiovisual aids during preoperative education correlated with decreased anxiety levels among female MRM patients, and it also aimed to investigate if enhanced preoperative education could lead to reduced anxiety and improved postoperative outcomes.

METHODS

A randomized controlled trial was conducted comparing anxiety levels in MRM patients receiving audiovisual aids versus verbal instructions. Purposive sampling selected female breast cancer patients scheduled for MRM. Data was collected using pre- and post-intervention questionnaires, and statistical analysis was used to test hypotheses.

RESULTS

There was no significant difference in pre-intervention anxiety levels between the control group (mean = 2.77 ± 0.32) and the experimental group (mean = 2.49 ± 0.27; t = 1.49, p = 0.176), indicating comparable baseline anxiety between groups. Following the intervention, the experimental group exhibited a significant reduction in anxiety (mean = 1.83 ± 0.20) compared to the control group (mean = 2.59 ± 0.16; t = 2.79, p = 0.046). Pearson correlation analysis revealed a moderate negative correlation between the use of audiovisual aids and preoperative anxiety levels (r = –0.643, p = 0.017), suggesting that audiovisual education was significantly associated with reduced preoperative anxiety among patients scheduled for MRM.

DISCUSSION

The study found that audiovisual aids significantly reduced anxiety levels in the experimental group but had no effect on the control group. This suggested that such interventions could be effective in reducing preoperative anxiety, particularly in females undergoing MRM. However, further research with larger and more diverse samples was needed to confirm these findings and explore influencing factors in clinical settings

CONCLUSION

The study findings suggested that incorporating audiovisual aids in preoperative education for MRM effectively reduced anxiety levels, warranting further research with larger and more diverse participant groups to validate these results

Human ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Audiovisual Aids ; Breast Neoplasms ; Control Groups ; Neoplasms ; Mastectomy, Radical ; Mastectomy, Modified Radical ; Volition ; Female ; Breast ; Acquired Immunodeficiency Syndrome

AIDS-related Kaposi sarcoma (KS) progresses rapidly with early mucosal and systemic involvement. Early diagnosis and treatment are crucial as they significantly impact the outcome. This is a case of disseminated cutaneous and gastrointestinal KS in a 24-year-old Filipino male living with HIV, presenting with hyperpigmented violaceous subcutaneous nodules, odynophagia, progressive dysphagia, and symptomatic anemia. Capsule endoscopy demonstrated utility in diagnosing gastrointestinal KS lesions, highlighting its crucial role when conventional upper endoscopy was challenging due to oropharyngeal involvement. Diagnostic limitations, mainly the unavailability of human herpesvirus-8 (HHV-8) immunohistochemical stain, were addressed through high clinical suspicion. Multidisciplinary approach including chemotherapy with liposomal doxorubicin, radiotherapy, and supportive care eventually yielded good clinical response. This case emphasizes the importance of early diagnosis, timely intervention, and long-term surveillance in achieving favorable outcomes for patients with KS despite some diagnostic limitations.
Human ; Sarcoma, Kaposi, HIV, Acquired Immunodeficiency Syndrome, Liposomal Doxorubicin

OBJECTIVES: The prevalence of human immunodeficiency virus (HIV) associated neurocognitive disorders (HAND) in people living with HIV/acquired immunodeficiency syndrome (PLWHA) worldwide is as high as 42.6%. This study aims to investigate the neurocognitive function status and its influencing factors in PLWHA, providing evidence for early identification and intervention of neurocognitive impairment in this population. METHODS: PLWHA aged 18 and above who received outpatient or inpatient care at the First Hospital of Changsha between June and August 2019 were included. Sociodemographic and HIV-related information were collected. Neurocognitive function was assessed using the Brief Neurocognitive Screen (BNCS), which includes the Digit Symbol Test (DST) and Trail Making Test A and B (TMT-A and TMT-B). Impaired neurocognitive function was defined as abnormal scores in at least one dimension (DST score <30, TMT-A time >60 seconds, TMT-B time >90 seconds). RESULTS: A total of 375 PLWHA were included, of whom 212 (56.5%) exhibited neurocognitive impairment. Higher impairment rates were observed among females, individuals aged ≥50 years, those with primary education or below, and those who were married/cohabiting (all P<0.05). Heterosexual transmission accounted for the majority of infections (233 cases, 62.1%), with a significantly higher rate of neurocognitive impairment (69.1%) compared to homosexual transmission and unknown routes (P<0.001). Higher WHO clinical stages were associated with increased impairment rates (P<0.001). PLWHA with a nadir CD4⁺ T cell count <200 cells/mm³ or an infection duration ≥5 years had significantly higher impairment rates than those with higher CD4⁺ T cell count or shorter infection durations (both P<0.05). Logistic regression analysis showed that patients with a nadir CD4⁺ T cell count <200 cells/mm³ had a significantly higher risk of neurocognitive impairment (OR=2.461, 95% CI 1.116 to 5.427). Compared to WHO stage I, the risk increased progressively in stage II (OR=6.005, 95% CI 2.906 to 12.407), stage III (OR=6.989, 95% CI 2.502 to 19.523), and stage IV (OR=22.059, 95% CI 7.289 to 66.760; all P<0.05). CONCLUSIONS Potential risk factors for neurocognitive impairment in PLWHA include low nadir CD4⁺ T cell counts and advanced WHO clinical stages. The lower the CD4⁺ T cell count and the higher the clinical stage, the greater the risk of neurocognitive dysfunction.
Humans ; Female ; Male ; Middle Aged ; HIV Infections/psychology* ; Adult ; Acquired Immunodeficiency Syndrome/psychology* ; Neuropsychological Tests ; Cognitive Dysfunction/epidemiology* ; Neurocognitive Disorders/epidemiology* ; CD4 Lymphocyte Count ; Risk Factors ; Aged

Nodular lesions in syphilis are typical of the late benign stage of the disease. It is a rare clinical manifestation of the said disease with a generalized distribution, involving both skin and mucous membranes. Lesions are more prominent on the upper extremities with a special predilection for the palms and the soles in the early stages. We present a case of a 25-year-old Filipino male with a 5-month history of generalized purplish to violaceous nodules with excoriations and scaling. When co-infected with advanced HIV it may present similarly as malignant secondary syphilis. After administration of Benzathine Penicillin G single dose IM, it is important to frequently assess these patients clinically and serologically for possible treatment failures at 3, 6, 9, 12, and 24 months after therapy.

Human ; Male ; Adult: 25-44 Yrs Old ; Aids ; Acquired Immunodeficiency Syndrome ; Hiv

HIV cluster detection and response (CDR) is a critical strategy to end the HIV epidemic by offering information to identify prevention and care services gaps. The risk metrics for HIV clusters can be classified into three groups: growth-based metrics, characteristic-based metrics, and phylogeny-based metrics. When identifying HIV risk clusters, the public health response can reach people in the affected networks, including people with undiagnosed HIV, people with diagnosed HIV who might not be accessing HIV care or other services, and people without HIV who would benefit from prevention services. To provide references for HIV precise prevention in China, we summarized the risk metrics and the intervention measures for CDR.
Humans ; HIV Infections/prevention & control* ; Acquired Immunodeficiency Syndrome/epidemiology* ; Public Health ; Epidemics/prevention & control* ; China/epidemiology*

Objective: To analyze the survival time of reported HIV/AIDS and influencing factors of Yunnan Province from 1989 to 2021. Methods: The data were extracted from the Chinese HIV/AIDS comprehensive response information management system. The retrospective cohort study was conducted. The life table method was applied to calculate the survival probability. Kaplan-Meier was used to draw survival curves in different situations. Furthermore, the Cox proportion hazard regression model was constructed to identify the factors related to survival time. Results: Of the 174 510 HIV/AIDS, the all-cause mortality density was 4.23 per 100 person-years, the median survival time was 20.00 (95%CI:19.52-20.48) years, and the cumulative survival rates in 1, 10, 20, and 30 years were 90.75%, 67.50%, 47.93% and 30.85%. Multivariate Cox proportional risk regression model results showed that the risk of death among 0-14 and 15-49 years old groups were 0.44 (95%CI: 0.34-0.56) times and 0.51 (95%CI:0.50-0.52) times of ≥50 years old groups. The risk for death among the first CD4⁺T lymphocytes counts (CD4) counts levels of 200-349 cells/μl, 350-500 cells/μl and ≥501 cells/μl groups were 0.52 (95%CI: 0.50-0.53) times, 0.41 (95%CI: 0.40-0.42) times and 0.35 (95%CI: 0.34-0.36) times of 0-199 cells/μl groups. The risk of death among the cases that have not received antiretroviral therapy (ART) was 11.56 (95%CI: 11.26-11.87) times. The risk for death among the cases losing to ART, stopping to ART, both losing and stopping ART was 1.66 (95%CI:1.61-1.72) times, 2.49 (95%CI:2.39-2.60) times, and 1.65 (95%CI:1.53-1.78) times of the cases on ART. Conclusions: The influencing factors for the survival time of HIV/AIDS cases were age at diagnosis in Yunnan province from 1989 to 2021. The first CD4 counts levels, antiretroviral therapy, and ART compliance. Early diagnosis, early antiretroviral therapy, and increasing ART compliance could extend the survival time of HIV/AIDS cases.
Humans ; Middle Aged ; Retrospective Studies ; China/epidemiology* ; Acquired Immunodeficiency Syndrome/epidemiology* ; Anti-Retroviral Agents/therapeutic use* ; Asian People

In recent years, HIV infection prevalence in MSM has been in increase in China. HIV testing is the only way to identify HIV-infection, effectively curb the spread of HIV and reduce AIDS-related death risks. At present, the situation of HIV testing in MSM is not satisfactory, and expanding HIV testing is the one of the key measures for AIDS prevention and control in this population. This paper summarizes the role and strategies of expanding HIV testing in MSM in order to provide a reference for the improvement of HIV testing in this population.
Male ; Humans ; HIV Infections/epidemiology* ; Homosexuality, Male ; Acquired Immunodeficiency Syndrome ; Risk-Taking ; Sexual and Gender Minorities ; HIV Testing ; China/epidemiology*

BACKGROUND: Women comprise more than half of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) worldwide and incomplete immune recovery and metabolic abnormalities affect them deeply. Studies of HIV antiretroviral therapy (ART) have a low female representation in China. We aimed to investigate immune reconstitution and metabolic changes of female HIV-positive cohort in China longitudinally. METHODS: HIV-positive women who initiated ART from January 2005 to June 2021 and were followed up regularly at least once a year were included in this study. Immunological indicators (cluster of differentiation 4 [CD4] counts and CD8 counts), viral load (VL), and metabolic indicators were collected at follow-up. All data were collected from the China Disease Prevention and Control Information System (CDPCIS). VL was tested half a year, 1 year after receiving ART, and every other year subsequently according to local policy. CD4/CD8 ratio normalization was considered as the primary outcome and defined as a value ≥1. Incidence rate and probability of CD4/CD8 ratio normalization were estimated through per 100 person-years follow-up (PYFU) and Kaplan-Meier curve, respectively. Multivariate Cox regression was used to identify independent risk factors associated with CD4/CD8 ratio normalization. We further studied the rate of dyslipidemia, hyperuricemia, diabetes, liver injury, and renal injury after ART initiation with the chi-squared tests or Fisher's exact probability tests, and a generalized estimating equation model was used to analyze factors of dyslipidemia and hyperuricemia. RESULTS: A total of 494 female patients with HIV/AIDS started ART within 16 years from January 2005 to June 2021, out of which 301 women were enrolled with a median duration of ART for 4.1 years (interquartile range, 2.3-7.0 years). The overall incidence rate of CD4/CD8 ratio normalization was 8.9 (95% confidence interval [CI], 7.4-10.6) per 100 PYFU, and probabilities of CD4/CD8 normalization after initiating ART at 1 year, 2 years, 5 years, and 10 years follow-up were 11.7%, 23.2%, 44.0%, and 59.0%, respectively. Independent risk factors associated with CD4/CD8 normalization were baseline CD4 cell counts <200 cells/μL, CD8 counts >1000 cells/μL, and more than 6 months from the start of combined ART (cART) to first virological suppression. Longitudinally, the rate of hypercholesterolemia (total cholesterol [TC]) and high triglyceride (TG) showed an increasing trend, while the rate of low high-density lipoprotein cholesterol (HDL) showed a decreasing trend. The rate of hyperuricemia presented a downtrend at follow-up. Although liver and renal injury and diabetes persisted during ART, the rate was not statistically significant. Older age and protease inhibitors were independent risk factors for increase of TC and TG, and ART duration was an independent factor for elevation of TC and recovery of HDL-C. CONCLUSIONS This study showed that women were more likely to normalize CD4/CD8 ratio in comparison with findings reported in the literature even though immune reconstruction was incomplete.
Humans ; Female ; CD4-CD8 Ratio ; HIV ; Immune Reconstitution ; Hyperuricemia/drug therapy* ; HIV Infections/drug therapy* ; Acquired Immunodeficiency Syndrome/drug therapy* ; Anti-Retroviral Agents/therapeutic use* ; Cholesterol ; Viral Load ; CD4 Lymphocyte Count ; Anti-HIV Agents/therapeutic use*

BACKGROUND: Previous studies have examined the bulk transcriptome of peripheral blood immune cells in acquired immunodeficiency syndrome patients experiencing immunological non-responsiveness. This study aimed to investigate the characteristics of specific immune cell subtypes in acquired immunodeficiency syndrome patients who exhibit immunological non-responsiveness. METHODS: A single-cell transcriptome sequencing of peripheral blood mononuclear cells obtained from both immunological responders (IRs) (CD4 + T-cell count >500) and immunological non-responders (INRs) (CD4 + T-cell count <300) was conducted. The transcriptomic profiles were used to identify distinct cell subpopulations, marker genes, and differentially expressed genes aiming to uncover potential genetic factors associated with immunological non-responsiveness. RESULTS: Among the cellular subpopulations analyzed, the ratios of monocytes, CD16 + monocytes, and exhausted B cells demonstrated the most substantial differences between INRs and IRs, with fold changes of 39.79, 11.08, and 2.71, respectively. In contrast, the CD4 + T cell ratio was significantly decreased (0.39-fold change) in INRs compared with that in IRs. Similarly, the ratios of natural killer cells and terminal effector CD8 + T cells were also lower (0.37-fold and 0.27-fold, respectively) in the INRs group. In addition to several well-characterized immune cell-specific markers, we identified a set of 181 marker genes that were enriched in biological pathways associated with human immunodeficiency virus (HIV) replication. Notably, ISG15 , IFITM3 , PLSCR1 , HLA-DQB1 , CCL3L1 , and DDX5 , which have been demonstrated to influence HIV replication through their interaction with viral proteins, emerged as significant monocyte marker genes. Furthermore, the differentially expressed genes in natural killer cells were also enriched in biological pathways associated with HIV replication. CONCLUSIONS We generated an atlas of immune cell transcriptomes in HIV-infected IRs and INRs. Host genes associated with HIV replication were identified as markers of, and were found to be differentially expressed in, different types of immune cells.
Humans ; Acquired Immunodeficiency Syndrome ; Transcriptome/genetics* ; HIV ; HIV Infections/genetics* ; Leukocytes, Mononuclear/metabolism* ; CD4-Positive T-Lymphocytes/metabolism* ; Virus Replication ; Membrane Proteins/metabolism* ; RNA-Binding Proteins/metabolism*