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Human immunodeficiency virus (HIV)-infected patients are at a higher risk for co-infection with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis) than the general population. The prevalence of HBV, HCV, and syphilis has geographic differences and varies from region to region among HIV-positive individuals. A retrospective study was carried out on HIV-positive individuals between June 2011 and June 2016 in Shaanxi Province. Univariate and multivariate logistic regression analyses using stepwise regression analysis regarding risk factors for HIV-HBV, HIV-HCV, and HIV-syphilis co-infection. HBV-HCV, HCV-syphilis, HBV-syphilis, and HBV-HCV-syphilis co-infection rates were 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective hepatitis B vaccine immunization was as high as 30.2% among HIV-positive individuals. Ethnicity (OR = 31.030, 95% CI: 11.643-82.694) and HIV transmission routes (OR = 134.024, 95% CI: 14.328-1253.653) were the risk factors for HCV infection in HIV-positive individuals. Among the HIV-positive individuals with the antibodies of TP, the rate of homosexual transmission was also higher, but heterosexual transmission was lower (OR = 0.549 95% CI: 0.382-0.789) The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. The high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.

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OBJECTIVE: To assess the incidence and determinants of tuberculosis (TB) among HIV-positive individuals in selected health facilities of Addis Ababa, Ethiopia, during the period January 2013 to December 2018. METHODS: Data were collected from the records of 566 HIV-positive individuals. A retrospective cohort study design was employed. Data were entered into Epi Info 7 and analyzed using IBM SPSS Statistics version 20. TB incidence density was determined per 100 person-years. Time-to-event distributions were estimated using Kaplan-Meier estimates. Survival curves and hazards across different categories were compared using log-rank tests. Determinants were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. A p-value <0.05 in the multivariate analysis was considered statistically significant. RESULTS: A total of 566 HIV-positive individuals were followed for 2140.08 person-years, giving a TB incidence density rate of 6.82/100 person-years (146, 25.8%). The highest incidence was observed within the first year of follow-up. Independent determinants were large family size (adjusted HR (AHR) 1.783, 95% CI 1.113-2.855), lower baseline CD4 (AHR 2.568, 95% CI 1.602-4.116), and baseline body mass index <18.5 kg/m2 (AHR 1.907, 95% CI 1.530-2.690). Being enrolled in antiretroviral treatment (AHR 0.066, 95% CI 0.045-0.98) and taking isoniazid prophylaxis treatment (AHR 0.202, 95% CI 0.108-0.380) had a protective effect. CONCLUSIONS: TB is still a major cause of morbidity among HIV-positive individuals. Early HIV diagnosis, enrollment on antiretroviral treatment, and isoniazid prophylaxis treatment should be considered to decrease the TB risk.

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BACKGROUND: The risk of tuberculosis (TB) is greater for individuals with human immunodeficiency virus (HIV) who are on combined antiretroviral therapy (c-ART) than for the normal population. Therefore, the detection and treatment of latent tuberculosis infections is recommended for all HIV-positive persons with positive tuberculin skin tests (TSTs). MATERIALS AND METHODS: This retrospective cohort study included all HIV-positive individuals with CD4 lymphocyte counts greater than 200 cells/µL and negative TST results, who were taking antiretroviral drugs and had been referred to Imam Khomeini Teaching Hospital Consultation Centre for Clients with Risky Behaviors in Tehran, Iran, from 2008 to 2013. TST conversion to positivity is defined as an induration increase of at least 5 mm compared with a previously negative TST result within a 1-year period. Conversion rates are expressed in person-years of observation. RESULTS: A total of 113 patients were included in our study. At 1 year, 9 of the 113 TST-negative patients taking c-ART became TST-positive (8%; 8 males and 1 female). The TST conversion incidence rate was 10.09/100 person-years. TST conversion was only found to be associated with sex (odds ratio: 8.64; 95% confidence interval: 1.04-7.56, p = 0.032). CONCLUSION: Our results suggest that TSTs should be administered to all HIV-positive patients before beginning isoniazid preventive therapy in Iran.

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In Asian concentrated HIV epidemics, data on coinfection of sexually transmitted infections (STIs) among HIV-positive individuals are limited. The authors measured the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), and syphilis, and their correlates among 319 HIV-positive individuals in Kathmandu, Nepal. The authors tested blood samples for syphilis and urine samples for CT and NG. Overall, 17 (5.3%) participants had at least 1 STI (CT: 1.3%, NG: 2.8%, and syphilis: 1.2%). Of 226 participants who had sex in past 6 months, 51.3% did not always use condoms. Older (aged 35-60 years) participants were more likely (adjusted odds ratio [AOR] = 3.83; 95% confidence interval [CI] = 1.19-12.33; P = .024) and those who were currently married (AOR = 0.30; 95% CI = 0.09-0.97; P = .046) or on antiretroviral therapy (AOR = 0.21; 95% CI = 0.06-0.71; P = .012) were less likely to have at least 1 STI. Our results suggest the need to strengthen the efforts to screen and treat STIs and to promote safer sexual practices among Nepalese HIV-positive individuals.

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Fertility decisions among people living with HIV/AIDS (PLWHA) are complicated by disease progression, the health of their existing children and possible antiretroviral therapy (ART) use, among other factors. Using a sample of HIV-positive women (n = 353) and men (n = 299) from Nigeria and Zambia and their healthcare providers (n = 179), we examined attitudes towards childbearing and abortion by HIV-positive women. To measure childbearing and abortion attitudes, we used individual indicators and a composite measure (an index). Support for an HIV-positive woman to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already had an HIV-positive child. Such support was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than reported support from their healthcare providers. There was wider variation in support for abortion depending on the measure than there was for support for childbearing. Half of all respondents indicated no or low support for abortion on the index measure while between 2 and 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion indicate that most respondents did not see HIV as a medical condition which justifies abortion. Respondents in Nigeria and those who live in urban areas were more likely to support HIV-positive women's childbearing. About a fifth of HIV-positive respondents reported being counselled to end childbearing after their diagnosis. In summary, respondents from both Nigeria and Zambia demonstrate tempered support of (continued) childbearing among HIV-positive women while anti-abortion attitudes remain strong. Access to ART did not impart a strong effect on these attitudes. Therefore, pronatalist attitudes remain in place in the face of HIV infection.

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OBJECTIVE: As a first study, suicidal ideation and its correlates have been evaluated in Iranian HIV positive population. METHODS: One hundred and fifty HIV-positive individuals were recruited in this cross-sectional study. The Hospital Anxiety and Depression Scale (HADS), Positive and Negative Suicide Ideation (PANSI), Pittsburgh Sleep Quality Inventory (PSQI) and Somatization subscale of Symptom Checklist 90 (SCL 90) as self- reported questionnaires were used to assess the patients' anxiety and depression status, suicidal thoughts, sleep quality and physiological factors, respectively. RESULTS: Antiretroviral therapy and efavirenz intake did not show any significant effects on the patients' suicidal ideation. Anxiety (p<0.001), depression (p<0.001), poor physical activity (P<0.001) and sleep quality (p<0.001) were significantly associated with the patients' negative suicidal ideation. From the patients' demographic data, unemployment (p = 0.04), living alone (p = 0.01), and lack of family support (p = 0.01) were correlated with the patients' negative suicidal thoughts. CONCLUSION: Although hospitals are the main referral centers for providing care for HIV-positive individuals in Tehran, Iran, conducting a multi-center study with sufficient sample size from different areas of our country that include individuals with different behaviors and cultures is essential to confirm the results of this study.