International STD Research & Reviews

Background: HIV/AIDS remains a public health challenge with an estimated 37.9 million persons living with HIV/AIDS (PLWHA) globally. Risky sexual behaviours/practices among PLWHA increase the likelihood of co-infection and further spread of infection. Understanding the pattern of these behaviours will aid in the modelling of campaigns to control further spread of infection.

Aim: To examine sexual behaviour and risky practices among adults living with HIV in Bayelsa State, Nigeria.

Methodology: Six hundred (600) participants were recruited for this cross-sectional study from the HIV/AIDS clinics at Federal Medical Centre (FMC), Yenagoa, and Otuasega Cottage Hospital, Ogbia in Bayelsa State, after obtaining informed consent. An interviewer-administered questionnaire was used to collect data comprising socio-demographic characteristics and the sexual activities/behaviour of the respondents in this study. The data obtained from the study were analyzed and presented as frequencies and percentages.

Results: Most of the respondents reported sexual intercourse 532(88.7%) 3 months to study. Sexual intercourse with casual partners 20(3.8%), multiple sexual partners 72(12%), and sex workers 2(0.4%) were observed among the respondents. Regular use of condoms during sex was reported by 63(11.8%), while 200(37.6%) sometimes, 96(18.0%) rarely, and 173(32.5%) never. A recent treatment of sexually transmitted infections (STIs) was reported by 115(19.2%). Alcohol use before sex was reported by 218(36.3%). Overall, 253(42.2%) of the respondents engaged in at least one form of risky sexual behaviour.

Conclusion: There is a preponderance of risky sexual behaviour/practices among PLWHA in Bayelsa State that may account for coinfection with STI as well as increase HIV/AIDS transmission.

Introduction: The aim of the study was to describe the socio-demographic characteristics of the elderly in the old people's home in the city of Kisangani, to assess the health status of these elderly people and to determine the predictors of their medical suffering.

Methodology: This was a cross-sectional study with an analytical focus. The survey method was used through interviews to collect information useful for this study, which benefited from the participation of 56 elderly people living in the hospices of the city of Kisangani.

Results: It was shown that the hospices for the elderly in Kisangani are dominated by women (51.8%), widows and divorcees are in the majority (92.9%), and the primary level predominates (37.5%). Also 41.1% of the subjects suffered since their accommodation, of which acute rheumatism occupies the first position (47.8%) and 52.2% are taken care of by the churches, but 65.2% are not satisfied with the medical treatment, among them, 41.1% do not make medical controls; 85.7% do not walk well and 82.1% do not urinate well. Similarly their suffering in hospices was associated with five factors including lack of exercise, not urinating well, insecurity in the hospice, needing a man or woman for sex and not eating well.

Conclusion: Ageing is accompanied by a decrease in the functional capacities of the body. Also, several systems of regulation of physiological parameters are less efficient in the elderly. They need to be cared for so that their end of life is also better in all respects.

HIV/AIDS has affected nearly every country on the planet. The effect of this surge has brought all major modes of HIV/AIDS transmission to the attention of public health professionals worldwide. Sexually Transmitted Infections (STIs), which are a major mode of transmission, increases the prevalence of HIV/AIDS. The study's aim was to assess knowledge and management of sexually transmitted infections by general Physicians of Lahore. A cross-sectional survey, of 203 general Physicians in Lahore, was conducted using structured questionnaires. Descriptive analysis was used to compute means and proportions. According to the findings of this study, 23 percent of UDS and 5 percent of GPs appropriately managed GUS syndromes. However, none of the GPs were found to managed VDS. The GPs were more likely to be trained in syndromic management who managed UDS appropriately (adj. OR: 8.0; 95% CI: 3.2-20.1), and UDS was appropriately managed (adj. OR: 2.7; 95% CI: 2.0-3.6). This study reveals a significant proportion of GPs in Karachi managed STIs. This provides a fantastic opportunity to treat and counsel STI patients and their partners. However, general Physicians lack the necessary skills. As a result, GPs must be trained in STI management in order to avert the impending disaster of HIV/AIDS. This study suggested that practicing doctors, particularly those who are young and female, should get prioritized training in STI care. Even though both the public and business sectors are actively working in this direction, additional efforts are still required.

Background: Advanced HIV disease (AHD) represents a stage of HIV infection characterized by severe immunosuppression and a high risk of mortality. An understanding of the burden and associated risk factors for AHD is important in order to design programs targeted at prevention and treatment with the aim of reducing HIV associated morbidity and mortality. This study set out to determine the prevalence and risk factors for AHD in a tertiary health facility in Southern Nigeria as well as to ascertain the frequency of Same day initiation of Highly Active Antiviral Therapy in AHD patients.

Methodology: This was a retrospective cross-sectional review of data from 419 adults and children diagnosed with AHD seen at the antiretroviral therapy clinic and Emergency department of the Rivers State University Teaching Hospital (RSUTH) over a 1year period. Details including personal bio-data and clinical information were obtained from the HIV registry of the hospital.

Results: Four hundred and nineteen (419) patients were diagnosed with Advanced HIV disease between January 2021- January 2022 with a mean age of 35.8 years. Regarding the co-factors, Sixty- four (29.4%) of the 218 persons tested were positive for tuberculosis while 18(9.2%) of the 196 patients tested for cryptococcus infection were positive.  One hundred and forty-eight (148) of the AHD population had CD4 cell count of <200cells comprising 144 (97%) adults and 4(3%) children. AHD, defined by a CD4 count of <200 cells was more prevalent within the age bracket of 40-49years (n=51, 34%) and among females [F:M 81 (55%) vs 67 (45%)]. Majority of the patients presented with WHO stage 3 disease (n=64, 43.2%) closely followed by stage 2 disease (n=47, 31.79%). Stage 4 disease was found in only 2.02%. The overall same day initiation (SDI) of AHD patients was 97% (n=144).

Conclusion: Advanced HIV disease is highly prevalent despite the test and treat approach to care. Interventions aimed at prevention, adherence to therapy as well as early recognition and treatment is paramount in reducing the burden of AHD.

Of late, Zambia has been experiencing a situation where a lot of adolescents have fallen pregnant and has seen a rise in sexual activities among them. This has greatly been noticed in Chipata of the Eastern Zambia. It is for this this reason Chipata was chosen as a place for conducting this research. The purpose of this study was to determine factors associated with sexual behaviour among adolescents.  The study used the quantitative research method using a cross-sectional study design.  Participants in this study included 225 adolescents comprising 113 females and 112 males aged 15 -19 years.  The study was conducted in Chipata. Participants were selected by using Convenient Sampling. A structured interview questionnaire was used to collect data from participants. The data collected was analyzed with the help of SPSS version 25. The findings showed overwhelming involvement of adolescents in sexual activity (93%).  The study found that there where 16% girls compared to 14.7% boys that said they had sex before the age of 16. The study found that initiation into sexual activity was a major factor, with 33.3% of respondents giving it as a reason. This was followed by curiosity (27.7%), a need for goods and services (5.6%), intoxication (7.1%) and accidental indulgence after experimenting with touching (4.7%). The logistic regression analysis at 95% Confidence Interval showed that age predicted a strong likelihood of having one sexual partner. And respondents who were 19 years were negatively associated with likelihood of having one partner.  It was recommended that future research with a bigger and more comprehensive participant base is recommended to assess the socio- economic and cultural factors affecting adolescents in their sexual behaviours.

Background: Blood transfusion carry the risk of transmitting blood-borne infections. HBV genetic diversity and transfusion safety are concepts that are increasingly used in public discourse. However, how the concepts are used and how they are defined remains unclear. The objective of this study is to clarify the concepts emanating from the research project titled «Genetic diversity of HBV and its effect on the transmission risks in blood transfusion in Gabon» and to propose an integrative model of HBV genetic diversity-Transmission risks based on these results.

Methods: Three databases were used in the Quantitative analysis: Pubmed, Medline and Google Scholar. The researchers delimited the search to full articles in the databases. The eligibility criteria were based on published studies in English between January 2012 and December 2020, looking at the HBV genetic diversity and the transfusion safety. The Cochrane tool was used to assess the risk of bias. A systematic review was performed on concepts and definitions. Eligible publications were reviewed using concept analysis that led to the extraction of text data for the themes “definition”, “attributes”, “antecedents”, “consequences”, and “related concepts”. The quantitative methods was used to quantify the associations between HBV Genetic diversity and transmission risk examined in the literature.

Results: A total of 2685 records were identified by primary and secondary search, of which 802 were retained after examination of titles and abstracts. A total of 144 (18%) publications were included in the review, 123 dealing with Hepatitis B Virus, 38 with Genetic diversity, 94 with Transfusion safety and 94 with Transmission risks were all coded. The final concept coding scheme contained 14 items, each with a satisfactory inter-author reliability score (r) (r ranging from 0.6 and 1), coding Hepatitis B Virus, Genetic diversity, Transfusion safety, Transmission risks, Blood donation-transmission risks, Demographic factors-transmission risks, HBsAg- transmission risks, Anti-HBc-transmission risks, Viral load-transmission risks, measurement errors- transmission risks, viral load-HBsAg, viral load-Anti-HBc, Sequencing-viral load, Genotype- transmission risks. In the resulting integrative model, the elements were mapped to different levels of care.

Conclusion: This integrated theory suggests a number of directions to improve the understanding of transfusion safety in the context of HBV genetic diversity, to speak the same language. It provides a basis for creating better measures and interventions in transfusion medicine.

Aims: To report a case of primary genital syphilis in a pregnant woman, which is atypical due to the delayed diagnosis, course of the disease and to emphasize its reasons and clinical management.

Presentation of Case: We present a pregnant primiparous woman G1P0A0 complaining of pain and growing lesion in the perineal area. She was misdiagnosed and unsuccessfully treated for the perineal abscess several times. The diagnosis of syphilis was delayed because of the negative prenatal syphilis test result in the first trimester. The negative test result misled doctors into immediately dismissing the diagnosis of syphilis. In addition to the delayed diagnosis, after the correct diagnosis regardless of an appropriate treatment with benzathine penicillin G, the pain and the chancre recurred possibly due to the reinfection during intercourse with an infected partner.

Discussion: Diagnosing syphilis may be complicated itself. In this case there were several factors that made the correct diagnosis and successful treatment even more difficult. These were: negative prenatal screening, reinfection and recurrence of the symptoms after treatment.

Conclusion: With this case we emphasize the importance to repeat the syphilis testing if the diagnosis of syphilis is suspected, regardless of previous negative first trimester syphilis screening result and importance of sexual partner’s screening and treatment if infected.