Patterns and Predictors of HIV Status Disclosure in the 12 Months Following Diagnosis in Mozambique

Thu, 20 Feb 2020 00:00:00 GMT-06:00 - Taylor, Kate; Lamb, Matthew; Lahuerta, Maria; Ahoua, Laurence; Abacassamo, Fatima; Elul, Batya
Εισαγωγή: HIV disclosure benefits people living with HIV (PLWH), their partners, and HIV programs. However, data on the prevalence of disclosure and associated correlates have come largely from patients already in HIV care, potentially overestimating disclosure rates and precluding examination of the impact of disclosure on HIV care outcomes. Setting: We used data from an implementation study conducted in Maputo City and Inhambane Province, Mozambique. Adults were enrolled at HIV testing clinics following diagnosis and traced in the community 1 and 12 months later when they reported on disclosure and other outcomes.
Μέθοδοι: We examined patterns of participant disclosure to their social networks (N=1573) and sexual partners (N=1024) at both follow-up assessments, and used relative risk regression to identify correlates of non-disclosure.
Αποτελέσματα: Disclosure to one’s social network and sexual partners was reported by 77.8% and 57.7% of participants, respectively, at 1 month, and 92.9% and 72.4% of participants, respectively, at 12 months. At both time points, living in Inhambane Province, being single or not living with a partner, having high levels of anticipated stigma and not initiating HIV treatment were associated with increased risks of non-disclosure to social networks. Non-disclosure to sexual partners at both follow-up assessments was associated with being female, living in Inhambane Province and in a household without other PLWH, and reporting that post-test counselling addressed disclosure.
Συμπέρασμα: Although reported disclosure to social networks was high, disclosure to sexual partners was sub-optimal. Effective and acceptable approaches to support partner disclosure, particularly for women, are needed. Corresponding Author: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Room 528, New York, NY, 10032. Email: be2124@columbia.edu Conflicts of Interest and Funding: The authors declare no conflicts of interest. The data used for this analysis was drawn from a study funded by the United States Agency for International Development (USAID), USAID Award Number: AID-OAA-A-12- 00027. The funder had no role in this analysis, decision to publish, or preparation of the manuscript. - Β© 2020

The Impact of a Structured, Supervised Exercise Program on Daily Step Count in Sedentary Older Adults With and Without HIV

Thu, 20 Feb 2020 00:00:00 GMT-06:00 - Stabell, Alex C.; Wilson, Melissa; Jankowski, Catherine M.; MaWhinney, Samantha; Erlandson, Kristine M.
Εισαγωγή: People with HIV (PWH) may have lower daily activity levels compared to persons without HIV. We sought to determine the impact of initiating a supervised exercise program on the daily step count of sedentary PWH and uninfected controls.
Μέθοδοι: PWH and controls, aged 50-75 were enrolled in a 24-week supervised exercise program. All individuals were given a pedometer and instructed in regular use. A linear mixed model taking into account random effects was used to model daily step count.
Αποτελέσματα: Of 69 participants that began the study, 55 completed and 38 (21 PWH, 17 controls) had complete pedometer data. Baseline daily step count on non-supervised exercise day was (estimated geometric mean, 95% CI) 3543 [1306, 9099] for PWH and 4182 [1632, 10187] for controls. Both groups increased daily steps on supervised (43% [20, 69]%, p<0.001) but not unsupervised exercise days (-12% [-24, 1]%, p=0.071). Compared with controls, PWH had 26% ([-47, 4]%, p=0.08) fewer daily steps on days with supervised exercise and 35% ([-53, -10]%, p=0.011) fewer daily steps on days without supervised exercise. Higher BMI (per 1 unit) and smoking were associated with fewer daily steps (-5% [-9, -1]%; -49% [-67, -23]%; p≤0.012). Days with precipitation (-8% [-13, -3]%, p=0.002) or below freezing (-10% [-15, - 4]%, p<0.001) were associated with fewer steps.
Συμπέρασμα: Supervised exercise increased daily step counts in sedentary individuals, but at the expense of fewer steps on non-supervised exercise days. Corresponding Author: Kristine M. Erlandson, 12700 E. 17th Avenue, Aurora, CO 80045, Kristine.erlandson@cuanschutz.edu, 303-724-4941; fax 303-724-4926 Conflicts of Interest: KME has served as a consultant for Gilead Sciences and ViIV Pharmaceuticals, and has a grant pending from Gilead Sciences. Funding: This work was supported by the Gilead Sciences Research Scholars Program in HIV (to KME) the National Institute of Aging of the National Institutes of Health [K23AG050260] to KME, and NCATS Colorado CTSA Grant Number UL1TR002535. The funding sources had no role in data collection, analysis, or interpretation; trial design; or patient recruitment. No payments were made in the writing of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. - Β© 2020