Open Access Original Research Article

Non-adherence to Highly Active Antiretroviral Therapy and Occurrence of Opportunistic Infections among Adult Clients Accessing Care at a Secondary Health Facility in Imo State Nigeria

Chinomnso C. Nnebue, Chukwuma B. Duru, Donatus I. Iwuagwu, Edwin O. Akor, Blessing C. Ukasooanya, Nseabasi A. Akpan

International STD Research & Reviews, Page 1-9
DOI: 10.9734/ISRR/2017/35948

Background: Non-adherence remains an issue of concern in highly active anti-retroviral therapy (HAART). It has been reported to reduce the immunological benefit of this regimen, while increasing morbidities and mortalities associated with HIV/AIDS.

Objective: To determine the relationships between non-adherence to HAART and occurrence of opportunistic infections (OIs) among adult HIV clients accessing care in a secondary health facility in Imo state Nigeria.

Materials and Methods: This was a health facility-based descriptive cross-sectional study of 350 respondents, selected by systematic sampling technique. Data were collected by interview using semi-structured questionnaire and analysed with statistical package for social sciences version 22.0. Test of statistical significance was done using chi-square test, while statistical significance was set at p value ≤ 0.05.

Results: Majority 220 (62.9%) of respondents were females, 218 (62.3%) were currently married, 263 (75.1%) attained at most secondary level of education, while 259 (74%) were resident outside the study area. Twenty (5.7%) of them were non adherent to HAART and reasons cited include: fourteen (4%) forgetting to take medicine and 11 (3.1%) drug is out of stock. Fifty seven (16.7%) ever had OIs with oral thrush 21 (36.8%) as the commonest. There was an association between non- adherence to HAART and occurrence of OIs (p=0.000).

Conclusions: This survey found an association between non- adherence to HAART and occurrence of OIs. We recommend interventions that combine early treatment of OIs and gender cum couple targeted behavioral change communication in addressing non-adherence.


Open Access Original Research Article

90-90-90 Ambitious Targets: Achieving the Last 90 of the UNAIDS Targets in Western Nigeria

Saheed Opeyemi Usman, Oluwole Oluwaniyi, Gbemiga Peter Olubayo, Timothy Akinmurele, Ganiyu Babatunde Agboola, Funmi Abodunde, Abayomi Afe, Olatoun Adeola, Maduakolam Onyema

International STD Research & Reviews, Page 1-9
DOI: 10.9734/ISRR/2017/36534

Background: In resource-limited settings, where genotypic drug resistance testing is rarely performed and poor adherence is regarded as the most common reason for treatment failure, programmatic approaches to handling treatment failure are essential. This study is thus aimed at determining and monitoring HIV/AIDS disease progression using viral load to provide prognostic information and evaluate all patients for viral suppression using the World Health Organization (WHO) guideline strategies.

Methods: This study was an observational longitudinal prospective study of subjects living with HIV already initiated on antiretroviral (ARV) therapy for at least six months, with a minimum of two CD4 cell count test done, enrolled at PEPFAR-supported health facilities Ekiti State, Western Nigeria. All data were statistically analysed, using statistical package for the social sciences (SPSS) and statistical test of significance was performed with Chi-Square test while multiple comparisons were done using Post Hoc Bonferonni test.

Results: A total of 910 subjects eligible for the study were recruited. Most of them were in the age range of 30 – 44 years, with a mean age ± SD of 40.75 ± 10.33 years. There was a significant increase in the average cell count of the subjects while 787 (86.5%) & 490 (53.9%) of the subjects had viral suppression of <1000 RNA copies per ml and <50 RNA copies per ml respectively on all tests during the period of observation. 96% of the subjects with <50 RNA copies per ml, are currently on first line regimen.

Conclusion: HIV treatment intensive adherence counselling is key to the reduction of virologic treatment failure, thus, routine monitoring of viral load alongside CD4 cell count will ultimately reduce treatment failure tendencies thereby helping more patients stay on first line regimen and prolong their life expectancy, indicating that the UNAIDS 90-90-90 targets are achievable in resource-constrained settings.


Open Access Original Research Article

Prevalence of Intestinal Parasitic Infections among HIV/AIDS Patients in Sokoto, Nigeria

I. J. Nkwoka, M. O. Oche, K. J. Awosan, I. G. Ameh, A. O. Abiola

International STD Research & Reviews, Page 1-7
DOI: 10.9734/ISRR/2017/36701

Introduction: In the developing countries where human intestinal parasites constitute a major public health problem, HIV/AIDS patients face very high risks of intestinal infections leading to gastroenteritis. Evidence from studies has shown that infection by intestinal parasites cause immune activation and dysregulation; and these have been found to be dominant factors in the pathogenesis of AIDS in Africa. This study was conducted to assess the prevalence of intestinal parasitic infections among patients with HIV/AIDS in Sokoto, Nigeria.

Methods: A cross-sectional study was conducted among 57 consecutively diagnosed HIV/AIDS patients in two tertiary healthcare facilities in Sokoto, Nigeria. A proforma was used to collect data on study subjects’ socio-demographic characteristics. Stool samples were collected into sterile containers, labeled and examined (within 24 hours of collection) for cysts, ova or trophozoites of parasites using direct microscopy. Data were analyzed using the IBM Statistical Package for the Social Sciences (SPSS) Version 20 statistical computer software package.

Results: The mean age of the 57 participants was 34 ± 6 years, and majority of them (70.2%) were between 20 and 39 years. They were predominantly females (64.9%), and married (68.4%). Twenty two (38.6%) of the 57 participants had intestinal parasitic infections. There was no association (p > 0.05) between being infected with intestinal parasites and any of the participants’ socio-demographic variables. The most prevalent parasites among the participants were Hookworm (14.0%), and Entamoeba histolitica (12.3%). Other parasites isolated include Schistosoma mansoni (5.3%), Ascaris lumbriciodes (5.3%) and Hymenolepsis nana (1.7%).

Conclusion: This study showed high prevalence of intestinal parasitic infections among HIV/AIDS patients in Sokoto, Nigeria. Patients with HIV/AIDS should be targeted for health education on prevention of parasitic infections, in addition to periodic deworming and prophylactic treatment for other parasitic infections.


Open Access Original Research Article

Sexual Practices of Female Sex Workers in Ibadan, Nigeria

Ademola L. Adelekan, Opeyemi A. Adeosun, Fakunle G. Adekunle, Oluwatomi D. Olunuga, Funmilola I. Oyelami, Christy Ekerete-Udofia

International STD Research & Reviews, Page 1-10
DOI: 10.9734/ISRR/2017/36756

Female Sex Workers (FSWs) are highly at risk to sexually transmitted infection considering the factors associated with the nature of their work (multiple sex partners, violence, and drug use). Some of the contributing factors to HIV problem in Oyo state include promiscuity and multiple sexual partners which is related to sex worker’s working condition. This study assessed sexual practices of female sex workers in Ibadan, Nigeria.

This cross-sectional study used a three-stage sampling method to select 205 female sex workers in Ibadan. Data were collected using an interviewer-administered semi-structured questionnaire to explore respondents’ sexual practices. Data were analysed using descriptive statistics and Chi-square test.

The mean age was 27.0 ±4.52 years. A majority (44.4%) of the respondents had secondary school certificate, 70.7% were Christians while 5.9% were currently married. Few 1.5% of the respondents had never used condom, 37.6% of respondents had sometimes used condom and 42.0% reported using condom most of the time. Many (47.3%) of the respondents sometimes drink alcoholic beverages prior to or during sexual intercourse, 6.3% use cocaine or another drug prior to or during intercourse most of the times and only 15.6% always avoid sexual intercourse when they have sores or irritation in their genitals.

Consistency in condom use should be encouraged among female sex workers and interventions targeted at reducing alcohol intake should be planned and implemented.


Open Access Review Article

Use and Effectiveness of HIV Indicator Conditions in Guiding HIV Testing: A Review of the Evidence

C. F. Davies, M. Gompels, M. T. May

International STD Research & Reviews, Page 1-27
DOI: 10.9734/ISRR/2017/36373

Aims: To identify the most commonly reported HIV indicator conditions (HIV ICs) found in or associated with HIV infection and to review interventions incorporating HIV ICs to aid or guide offering of an HIV test and discuss their effectiveness in increasing HIV testing rates and diagnosing new cases of HIV-infection.

Methodology: The following electronic databases were searched; OVID Medline, Google, Web of Science and PubMed. We included studies conducted in high income countries within the adult population (>18yrs of age) that were published in the era of combination antiretroviral therapy between 1996 and 2016. We excluded studies relating to HIV testing or screening of pregnant women.

Results: We identified 42 studies investigating ICs associated with HIV infection either prior to or after diagnosis within primary, secondary and tertiary care settings. The most common ICs and symptoms associated with HIV infection were; sexually transmitted infections (syphilis, chlamydia, gonorrhoea and condyloma acuminata) and blood borne viruses (Hepatitis C and Hepatitis B), pneumonia, tuberculosis, blood dyscrasia, thrombocytopenia, oral and oesophageal candidiasis, seborrhoeic dermatitis, herpes zoster, Kaposi sarcoma, fever, weight loss, diarrhoea and lymphadenopathy. Twelve intervention studies that used HIV prediction tools and computer prompts based on HIV ICs demonstrated that these are effective in helping healthcare professionals to offer more targeted approaches to HIV testing.

Conclusion: Our review may aid policy makers and healthcare professionals in developing strategies to improve and increase HIV testing in individuals that present with defined HIV ICs. ICs have the potential to be used more effectively as triggers for earlier HIV testing and importantly for patients to receive a more timely diagnosis.