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2015| July-December | Volume 3 | Issue 2
July 14, 2016
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Decline in positivity rates among HIV-exposed infants with changes in prevention of mother-to-child transmission antiretroviral regimens in Nigeria: Evidence from 7 years of field implementation
Hadiza Khamofu, Edward A Oladele, Uche Ralph-Opara, Titi Badru, Oluwasanmi Adedokun, Mariya Saleh, McPaul Okoye, Olufunsho Adebayo, Kwasi Torpey
July-December 2015, 3(2):34-40
Demonstrate if the introduction of more and more efficacious antiretroviral (ARV) combinations for prevention of mother-to-child transmission (PMTCT) over time translated into a declining HIV-infection among HIV-exposed infants.
This was a retrospective review of routinely collected PMTCT service data from 2008 to 2014 in 682 secondary and tertiary health facilities across Nigeria. The ARV regimen was measured by the proportions of different ARV regimens received by HIV-positive pregnant women each year and the HIV-infection among infants was determined by the rate of HIV-positive polymerase chain reaction tests each year. The District Health Information Software (DHIS) was used to extract data from health facilities. The same DHIS was used to aggregate and analyze data.
Maternal HIV positivity rates varied from 4.1% in 2008, 2.9% in 2011, and 3.2% in 2012, then declined steadily to 1.9% in 2014. The total number of pregnant women who tested positive for HIV and received different ARV regimen for PMTCT during the period (2008-2014) was 63,774; ranging from 7506 in 2008 to 10,388 in 2014. Uptake of single dose nevirapine by the positive pregnant women was 34.4%, 41.6%, and 45.9% in 2008, 2009, and 2010, respectively. HIV positive pregnant women on triple ARVs (prophylaxis or treatment) increased from 22% in 2008 to 99% in 2014. Infant HIV positivity rates showed a steady decline over the years, from 38% in 2008 to 6% in 2014 (
We demonstrated the declining trend of HIV-infection among HIV-exposed infant in Nigeria as more and more efficacious ARV regimens were available for HIV-positive pregnant women. We conclude that if current efforts were sustained and coverage widened, an alignment of the country's PMTCT program with the best available scientific evidence could lead to the elimination of mother to child transmission.
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Integrated national guidelines for HIV prevention, treatment, and care: Chapters 5 and 6
Federal Ministry of Health (Nigeria)
July-December 2015, 3(2):47-55
These guidelines were developed taking into consideration the guiding principles of the WHO 2013 consolidated guidelines on the use of antiretrovirals (ARVs) and the President's Comprehensive Response Plan for HIV/AIDS in Nigeria. It is intended to fast-track the achievement of universal access to HIV prevention, treatment, care, and support in Nigeria. Guiding principles of these Guidelines includes the followings: (a) Public health approach - In line with the National scale-up strategy of decentralization and integration, these guidelines are based on a public health approach to scaling up the use of ARV drugs for HIV treatment and prevention. The public health approach will ensure access to high-quality services at all levels of the health-care system including the community and primary health care settings, with a focus on the best practices that are commensurate with available resources at all levels. (b) Implementation based on national context - Implementation of the recommendations in these guidelines will be informed by national context, including HIV epidemiology, availability of resources, the organization and capacity of the health system, and anticipated cost-effectiveness. While aiming to achieve attainment of the global milestones, the best practices within the country will be further refined, promoted, implemented, and scaled up nationwide. (c) Strengthening health systems through innovation and learning - Strengthening health systems recommended and described in these guidelines will be implemented with a view to strengthening the continuum of HIV care and broader health systems, especially primary care and chronic care. As more lessons are learned from ongoing integration and decentralization of HIV services at lower-level health facilities, implementation is encouraged and findings widely disseminated.
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Risky sexual behavior and associated factors among married people receiving antiretroviral therapy in a tertiary hospital in Ondo State, Nigeria
Ayodeji M Adebayo, Olayinka S Ilesanmi, Faith O Alele
July-December 2015, 3(2):29-33
Risky sexual behavior (RSB) increases the risk of human immunodeficiency virus (HIV) transmission. There are few documented studies on the pattern of RSB and associated factors among people living with HIV. This study aimed to determine the pattern and proportion of HIV-positive patients with RSB and and its associated factors at the Federal Medical Centre, Owo, Ondo State, Nigeria.
A cross-sectional study of 314 sexually active persons receiving antiretroviral therapy treatment for at least 1 month was done using a semi-structured interviewer-administered questionnaire. Study-related data were obtained and analyzed using Statistical Package for the Social Science version 21.0. Bivariate analysis to find the association between age, sex, level of education, and occupation and RSB was explored with Chi-square test.
The mean age of respondents was 38.6 8.6 years while 43.6% were male. At least one RSB was reported in 42.4% (
= 314). RSBs such as nonconsistent condom use was reported by 25.2%, multiple sexual partners by 4.8%, not knowing partner's HIV status (16.1%), and nondisclosure of status to sexual partner (12.1%). Females (47.5%) were more likely to engage in RSB compared to males (35.8%),
= 0.038. Nonconsistent condom use was reported by 32.2% of females compared to 16.1% of males,
= 0.001. Not being sure of partner's status was responsible for RSB in 21.5% of females compared to 10.2% of males,
= 0.008. Having multiple sexual partners was more in male 10.9%,
RSB occurs more in females and the risk of transmitting HIV to serodiscordant partner exists. Counseling and targeted behavioral change intervention should be instituted to reduce RSB.
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Assessment of Metabolic syndrome among adult human immunodeficiency virus/acquired immunodeficiency syndrome patients in a tertiary health facility in Southeast Nigeria
Victoria N Uwanuruochi, Favour S Michael, Kelechukwu Uwanuruochi, Christian Okafor, Esther N Ofoegbu, Basden J Onwubere, John M Oli
July-December 2015, 3(2):41-46
Metabolic syndrome (MS) on the background of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome has not been reported from Southeast Nigeria.
We sought to determine the prevalence of MS among HIV-infected Nigerians seen at the Federal Medical Centre, Umuahia, its correlation with highly active antiretroviral therapy (HAART) and other demographics. A total of 105 HAART-treated and 60 HAART-naοve patients were reviewed.
Settings and Design:
This study was cross-sectional, and the data were prospectively collected.
They were matched for sex and age. Anthropometric data including current weight and height, waist circumference, blood pressure, as well as blood lipids and fasting glucose were measured. MS was determined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria.
Statistical Analysis Used:
SPSS version 17.0 (Chicago IL, USA) was used for data collection and analysis.
There was 24.3% overall prevalence of MS in the study population, 28.8% in HAART-treated, and 25% in HAART-naïve patients (
= 0.554). The prevalence of MS components was as follows: hypertension (49.7%), impaired fasting glucose (9.62%), hypertriglyceridemia (32.0%), low high-density lipoprotein-cholesterol (44.2%), and central obesity (22.1%). Correlation of MS with female gender was highly significant (
MS was not significantly associated with the use of HAART in our patients but correlated with female gender.
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