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Creating Scientific Evidence for HIV Prevention and Elimination in COVID-19...
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Creating Scientific Evidence for HIV Prevention and Elimination in COVID-19 Era: Best Practices, Policies, and Methodological Approaches

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 15664

Special Issue Editors

Prof. Dr. Gulzar H. Shah

E-Mail Website
Guest Editor
Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
Interests: HIV/AIDS services and programs; eHealth and public health informatics; data improvement tools; practice-based public health services and systems research (PHSSR); public health finances
Special Issues, Collections and Topics in MDPI journals
Dr. Stacy W. Smallwood

E-Mail Website
Guest Editor
Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015-1, Statesboro, GA 30460, USA
Interests: HIV prevention; rural health; HIV workforce; LGBTQ+ health; sexual health; pre-exposure prophylaxis (PrEP); community engagement; social determinants of health

Special Issue Information

Dear Colleagues,

To guide HIV/AIDS prevention and treatment programs, and to assess and address issues facing persons living with HIV (PLHIV), this Special Issue aims to generate data-driven and practice-based evidence encompassing the best practices, lessons learned, and efficient strategies on all aspects of prevention and care of  PLHIV. The aim is to highlight issues facing PLHIV not simply relating to proper screening and availability of antiretroviral treatment (ART), but also covering concerns about interruptions in treatment and continued testing, such as loss to follow up and poor health outcomes emanating from broader social, economic, and cultural barriers to complete physical and behavioral health, including but not limited to housing, food security, transportation, protection against social stigma, and poor health behaviors. Issues and topics associated with COVID-19 in PLHIV may include: the use of HIV contact tracing infrastructure for  HIV/AIDS to support COVID-19 contact tracing;  interruptions in HIV care due to the burden of COVID-19 care; and intersecting stigma related to HIV, COVID-19, and mental health.

The Special Issue will showcase empirical studies, systematic reviews, and practice briefs on all aspects pertaining to health and well-being of persons with HIV/AIDS. The studies will target broad audiences as the readers and beneficiaries of the study findings, including but not limited to individuals with risk of HIV infection, PWHIV, clinical practitioners and public health programs engaged in HIV/AIDS prevention and care. Articles of high interest to the Special Issue readership will cover practice-relevant topics such as pre-exposure prophylaxis (PrEP) uptake among vulnerable populations; psychosocial determinants of PrEP use; HIV/AIDS prevention and care for youth, and Orphans and Vulnerable Children (OVC), HIV vertical transmission, and testing, treatment, and viral load suppression among children living with HIV; health outcomes, such as death, loss to follow up and WHO clinical stages of persons living with HIV/AIDS; HIV-TB and other co-infections among persons with HIV; community-level environmental impacts of HIV; and elimination of health inequities and socio-economic berries to HIV prevention and care. Research and practice reports representing multidisciplinary perspectives including public health, public policy, social and behavioral health, nursing, clinical care, and program planning and development will receive preference.

Prof. Dr. Gulzar H. Shah
Dr. Stacy W. Smallwood
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Persons with HIV/AIDS
  • HIV-associate social stigma, HIV/AIDS prevention
  • pre-exposure prophylaxis (PrEP) uptake
  • psychosocial determinants of PrEP use
  • HIV/AIDS care
  • Orphans and Vulnerable Children (OVC), HIV vertical transmission, HIV viral load suppression
  • HIV/AIHS health outcomes, loss to follow up
  • WHO clinical stages
  • HIV-TB co-infections
  • health inequities
  • HIV and COVID-19 Contact tracing
  • COVID-19-related interruptions in HIV care
  • Intersecting stigma related to HIV and COVID-19/mental health

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Published Papers (4 papers)

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Research

10 pages, 297 KiB  
Article
Sustaining an HIV Prevention and Wellness Program for Sexual Gender Minorities during the COVID-19 Pandemic
by Latrice C. Pichon, Megan L. Wilkins, Gisela Guerrero, Andrea L. Williams Stubbs, Edward D. Wiley, Justin Dodson, Carla London and Michelle Teti
Int. J. Environ. Res. Public Health 2022, 19(4), 2114; https://doi.org/10.3390/ijerph19042114 - 13 Feb 2022
Cited by 1 | Viewed by 2427
Abstract
Improving mental health, body image, and financial stability is paramount to achieving viral suppression and maintaining HIV-negative status for minoritized communities. The purpose of this paper is to describe the lessons learned from maintenance of an HIV prevention and wellness program during the [...] Read more.
Improving mental health, body image, and financial stability is paramount to achieving viral suppression and maintaining HIV-negative status for minoritized communities. The purpose of this paper is to describe the lessons learned from maintenance of an HIV prevention and wellness program during the COVID-19 pandemic. A three-session program was implemented in a hybrid format to account for county-wide restrictions and reopening processes. Lessons learned include the utility of a hybrid format, importance of CBPR partnership, innovation in virtual platform, value of social media presence and upkeep, and use of multiple methods to ascertain evaluative data. Sustaining an HIV prevention and wellness program requires strong research collaborations and ongoing engagement with priority populations and the flexibility to pivot as needed. Full article
(This article belongs to the Special Issue Creating Scientific Evidence for HIV Prevention and Elimination in COVID-19 Era: Best Practices, Policies, and Methodological Approaches)
14 pages, 387 KiB  
Article
Sexual Exposure to HIV Infection during the COVID-19 Pandemic in Men Who Have Sex with Men (MSM): A Multicentric Study
by Alvaro Francisco Lopes de Sousa, Shirley Verônica Melo Almeida Lima, João Victor Rocha, Herica Emilia Félix de Carvalho, Artur Acelino Francisco Luz Nunes Queiroz, Guilherme Schneider, Layze Braz de Oliveira, Emerson Lucas Silva Camargo, Adélia Dalva da Silva Oliveira, Isabel Amélia Costa Mendes and Inês Fronteira
Int. J. Environ. Res. Public Health 2021, 18(18), 9584; https://doi.org/10.3390/ijerph18189584 - 11 Sep 2021
Cited by 7 | Viewed by 3041
Abstract
The practice of sex with casual partners without the use of adequate prevention in the period of social distancing due to the COVID-19 pandemic among men who have sex with men (MSM) can expose them to the risk of infection by the HIV [...] Read more.
The practice of sex with casual partners without the use of adequate prevention in the period of social distancing due to the COVID-19 pandemic among men who have sex with men (MSM) can expose them to the risk of infection by the HIV virus. To assess this, we conducted an online survey in April and May 2020 in the entire national territory of Brazil and Portugal. We used the snowball technique for sampling, associated with circulation in social networks, totaling 2934 participants. Bivariate and multivariate logistic regression was used to produce the adjusted Odds Ratio (aOR). Eight-hundred-and-forty-two (28.7%) MSM presented at-risk sexual exposure in this period. In general, the types of sexual practices that most increased the chances of sexual exposure were having multiple partners (aOR:14.045); having practiced chemsex (aOR:2.246) and group sex (aOR:2.431), as well as presenting a history of at-risk sexual exposure (aOR:5.136). When we consider each country separately, the chances are increased in Brazil since the probability of the outcome was increased in those who practiced group sex (aOR:5.928), had multiple partners (aOR:19.132), and reported a sexual history of at-risk exposure (aOR:8.861). Our findings indicate that practices that are classically associated with greater chances of engaging in risky sexual exposure to HIV infection were the factors that most increased the chances of acquiring the virus in the pandemic context. Full article
(This article belongs to the Special Issue Creating Scientific Evidence for HIV Prevention and Elimination in COVID-19 Era: Best Practices, Policies, and Methodological Approaches)
11 pages, 300 KiB  
Article
Disparities in HIV Clinical Stages Progression of Patients at Outpatient Clinics in Democratic Republic of Congo
by Raimi Ewetola, Gulzar H. Shah, Lievain Maluantesa, Gina Etheredge, Kristie Waterfield, Astrid Mulenga and Apolinaire Kilundu
Int. J. Environ. Res. Public Health 2021, 18(10), 5341; https://doi.org/10.3390/ijerph18105341 - 17 May 2021
Cited by 7 | Viewed by 3454
Abstract
Context: In this era of patient-centered care, it is increasingly important for HIV/AIDS care and treatment programs to customize their services according to patients’ clinical stage progression and other risk assessments. To enable such customization of HIV care and treatment delivery, the research [...] Read more.
Context: In this era of patient-centered care, it is increasingly important for HIV/AIDS care and treatment programs to customize their services according to patients’ clinical stage progression and other risk assessments. To enable such customization of HIV care and treatment delivery, the research evidence explaining factors associated with patients’ clinical stages is needed. Objectives: The primary objective of this study was to produce such scientific evidence by analyzing the most recent data for patients at outpatient clinics in the provinces of Kinshasa and Haut-Katanga and to examine the patient characteristics associated with WHO stages of disease progression. Methods: Using a quantitative retrospective cohort study design, we analyzed data from 49,460 people living with HIV (PLHIV) on antiretroviral therapy (ART) from 241 HIV/AIDS clinics located in Haut-Katanga and Kinshasa provinces of the Democratic Republic of Congo. We performed Chi-square and multinomial logistic regression analyses. Results: A small proportion (i.e., 4.4%) of PLHIV were at WHO’s clinical progression stage 4, whereas 30.7% were at clinical stage 3, another 22.9% at stage 2, and the remaining 41.9% were at stage 1, the least severe stage. After controlling for other demographic and clinical factors included in the model, the likelihood of being at stage 1 rather than stage 3 or 4 was significantly higher (at p ≤ 0.05) for patients with no tuberculosis (TB) than those with TB co-infection (adjusted odds ratio or AOR, 5.73; confidence interval or CI, 4.98–6.59). The odds of being at stage 1 were significantly higher for female patients (AOR, 1.35; CI, 1.29–1.42), and those with the shorter duration on ART (vs. greater than 40.37 months). Patents in rural health zones (AOR, 0.32) and semi-rural health zones (AOR, 0.79) were less likely to be at stage 1, compared to patients in urban health zones. Conclusions: Our study showed that TB co-infection raised the risk for PLHIV to be at the severe stages of clinical progression of HIV. Such variation supports the thesis that customized HIV management approaches and clinical regimens may be imperative for this high-risk population. We also found significant variation in HIV clinical progression stages by geographic location and demographic characteristics. Such variation points to the need for more targeted efforts to address the disparities, as the programs attempt to improve the effectiveness of HIV care and treatment. The intersectionality of vulnerabilities from HIV, TB, and COVID-19-related hardships has elevated the need for customized care and treatment even more in the COVID-19 era. Full article
(This article belongs to the Special Issue Creating Scientific Evidence for HIV Prevention and Elimination in COVID-19 Era: Best Practices, Policies, and Methodological Approaches)
13 pages, 320 KiB  
Article
Risk Factors for TB/HIV Coinfection and Consequences for Patient Outcomes: Evidence from 241 Clinics in the Democratic Republic of Congo
by Gulzar Hussain Shah, Raimi Ewetola, Gina Etheredge, Lievain Maluantesa, Kristie Waterfield, Elodie Engetele and Apolinaire Kilundu
Int. J. Environ. Res. Public Health 2021, 18(10), 5165; https://doi.org/10.3390/ijerph18105165 - 13 May 2021
Cited by 13 | Viewed by 5465
Abstract
(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is [...] Read more.
(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from 241 HIV/AIDS clinics in Haut-Katanga and Kinshasa, two provinces in the Democratic Republic of Congo. Chi-square and logistic regression analysis were performed. (3) Results: Significantly higher proportions of patients with TB/HIV coinfection were men (4.5%; women, 3.3%), were new patients (3.7%; transferred-in, 1.6%), resided in the Kinshasa province (4.0%; Haut-Katanga, 2.7%), and were in an urban health zone (3.9%) or semi-rural health zone (3.1%; rural, 1.2%). Logistic regression analysis showed that after controlling for demographic and clinical variables, TB/HIV coinfection increased the risk of death (adjusted odds ratio (AOR), 2.26 (95% confidence interval (CI): 1.94–2.64)) and LTFU (AOR, 2.06 (95% CI: 1.82–2.34)). TB/HIV coinfection decreased the odds of viral load suppression (AOR, 0.58 (95% CI: 0.46–0.74)). (4) Conclusions: TB/HIV coinfection raises the risk of negative outcomes such as death, LTFU, and lack of viral load suppression. Our findings can help HIV clinics in Democratic Republic of Congo and other African countries to customize their interventions to improve HIV care and reduce care disparities among patients. Full article
(This article belongs to the Special Issue Creating Scientific Evidence for HIV Prevention and Elimination in COVID-19 Era: Best Practices, Policies, and Methodological Approaches)
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