scholarly journals Antiretroviral adherence and virological outcomes in HIV-positive patients in Ugu district, KwaZulu-Natal province

2016 ◽  
Vol 15 (3) ◽  
pp. 195-201 ◽  
Author(s):  
Germain Kapiamba ◽  
Thembekile Masango ◽  
Ditaba Mphuthi
Keyword(s):  
Hiv Positive ◽  
Antiretroviral Adherence ◽  
Kwazulu Natal ◽  
Virological Outcomes

scholarly journals Impact of Next-generation Sequencing Defined Human Immunodeficiency Virus Pretreatment Drug Resistance on Virological Outcomes in the ANRS 12249 Treatment-as-Prevention Trial

2018 ◽  
Vol 69 (2) ◽  
pp. 207-214 ◽  
Author(s):  
Anne Derache ◽  
Collins C Iwuji ◽  
Kathy Baisley ◽  
Siva Danaviah ◽  
Anne-Geneviève Marcelin ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Clinical Trials ◽  
Transcriptase Inhibitor ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
Kwazulu Natal ◽  
Immunodeficiency Virus ◽  
Virological Outcomes ◽  
Reverse Transcriptase Inhibitor ◽  
Generation Sequencing

Abstract Background Previous studies in human immunodeficiency virus (HIV)-positive individuals on thymidine analogue backbone antiretroviral therapy (ART) with either nevirapine or efavirenz have suggested poorer virological outcomes in the presence of pretreatment drug resistance (PDR). We assessed the impact of PDR on virological suppression (VS; <50 copies/mL) in individuals prescribed primarily tenofovir/emtricitabine/efavirenz in rural KwaZulu-Natal within a treatment-as-prevention trial. Methods Among 1557 HIV-positive individuals who reported no prior ART at study entry and provided plasma samples, 1328 individuals with entry viral load (VL) >1000 copies/mL had next-generation sequencing (NGS) of the HIV pol gene with MiSeq technology. Results were obtained for 1148 individuals, and the presence of PDR was assessed at 5% and 20% detection thresholds. Virological outcome was assessed using Cox regression in 837 of 920 ART initiators with at least 1 follow-up VL after ART initiation. Results PDR prevalence was 9.5% (109/1148) and 12.8% (147/1148) at 20% and 5% thresholds, respectively. After a median of 1.36 years (interquartile range, 0.91–2.13), mostly on fixed-dose combination tenofovir/emtricitabine/efavirenz, presence of both nonnucleoside reverse transcriptase inhibitor (NNRTI)/nucleoside reverse transcriptase inhibitor PDR vs no PDR was associated with longer time to VS (adjusted hazard ratio [aHR], 0.32; 95% confidence interval [CI], 0.12–0.86), while there was no difference between those with only NNRTI PDR vs no PDR (aHR, 1.05; 95% CI, 0.82–1.34) at the 5% threshold. Similar differences were observed for mutations detected at the 20% threshold, although without statistical significance. Conclusions NGS uncovered a high prevalence of PDR among participants enrolled in trial clinics in rural KwaZulu-Natal. Dual-class PDR to a mainly tenofovir/emtricitabine/efavirenz regimen was associated with poorer VS. However, there was no impact of NNRTI PDR alone. Clinical Trials Tegistration NCT01509508; South African National Clinical Trials Register: DOH-27-0512-3974.

scholarly journals Social and Demographic Factors Associated with Postnatal Depression Symptoms among HIV-Positive Women in Primary Healthcare Facilities, South Africa

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 65
Author(s):  
Kebogile Elizabeth Mokwena ◽  
Nontokozo Lilian Mbatha
Keyword(s):  
South Africa ◽  
Primary Healthcare ◽  
Postnatal Depression ◽  
Hiv Positive ◽  
P Value ◽  
Depression Symptoms ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Hiv Positive Women ◽  
Kwazulu Natal

Background: Mothers living with HIV are at risk for mental health problems, which may have a negative impact on the management of their HIV condition and care of their children. Although South Africa has a high prevalence of HIV, there is a dearth of studies on sociodemographic predictors of postnatal depression (PND) among HIV-positive women in South Africa, even in KwaZulu Natal, a province with the highest prevalence of HIV in the country. Objective: The objective of the study was to determine sociodemographic factors associated with the prevalence of postnatal depression symptoms among a sample of HIV-positive women attending health services from primary healthcare facilities in Umhlathuze District, KwaZulu Natal. Methods: A quantitative cross-sectional survey was used to collect data from 386 HIV-positive women who had infants aged between 1 and 12 weeks. The Edinburgh Postnatal Depression Scale (EPNDS), to which sociodemographic questions were added, was used to collect data. Results: The prevalence of PND symptoms among this sample of 386 HIV-positive women was 42.5%. The age of the mothers ranged from 16 to 42 years, with a mean of 29 years. The majority of the mothers were single or never married (85.5%; n = 330), living in a rural setting (81.9%; n = 316%), with a household income of less than R 2000 (estimated 125 USD) per month (64.9%; n = 120). The government child support grant was the main source of income for most of the mothers (53%; n = 183). PND symptoms were significantly associated with the participant’s partner having other sexual partners (p-value < 0.001), adverse life events (p-value = 0.001), low monthly income (p-value = 0.015), and being financially dependent on others (p-value = 0.023). Conclusion: The prevalence of PND symptoms among the sample is high, with a number of social and demographic factors found to be significantly associated with PND. This requires the consideration of sociodemographic information in the overall management of both HIV and postnatal depression. Addressing the impact of these factors can positively influence the health outcomes of both the mother and the baby.

scholarly journals Correction: The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-Natal, South Africa

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0129637 ◽  
Author(s):  
Kristin Fladseth ◽  
Mitzy Gafos ◽  
Marie Louise Newell ◽  
Nuala McGrath
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Gender Norms ◽  
Hiv Positive ◽  
Kwazulu Natal ◽  
Hiv Positive Adults ◽  
The Impact

scholarly journals Alcohol consumption among HIV-positive pregnant women in KwaZulu-Natal, South Africa: Prevalence and correlates

2012 ◽  
Vol 120 (1-3) ◽  
pp. 113-118 ◽  
Author(s):  
Katherine Desmond ◽  
Norweeta Milburn ◽  
Linda Richter ◽  
Mark Tomlinson ◽  
Erin Greco ◽  
...  
Keyword(s):  
South Africa ◽  
Alcohol Consumption ◽  
Pregnant Women ◽  
Hiv Positive ◽  
Kwazulu Natal

scholarly journals Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa

2020 ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Ingunn Marie Engebretsen ◽  
Catherine Connolly ◽  
Anna Coutsoudis ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Hiv Positive ◽  
Breastfeeding Initiation ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Breastfeeding Practices ◽  
Hiv Positive Mothers ◽  
Kwazulu Natal ◽  
Before And After

Abstract Background KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support breastfeeding initiation and sustained breastfeeding implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in feeding practices in KZN over this time period. Methods Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion of EBF was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers reporting not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), this was similar among HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.

scholarly journals Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa

2020 ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Ingunn Marie Engebretsen ◽  
Catherine Connolly ◽  
Anna Coutsoudis ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Hiv Positive ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Health Care Clinics ◽  
Breastfeeding Practices ◽  
Hiv Positive Mothers ◽  
Kwazulu Natal ◽  
Before And After

Abstract Background: KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support the initiation and sustaining of breastfeeding, implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in infant feeding practices in KZN over this time period.Methods: Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results: At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion exclusively breastfeeding was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers who reported not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), as were HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion: Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.

scholarly journals Initiation of antiretroviral therapy at rural primary health care clinics in KwaZulu Natal

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Hilda Ganesen-Moothusamy ◽  
Mergan Naidoo
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antiretroviral Therapy ◽  
Hepatitis B ◽  
Medical Care ◽  
Hiv Testing ◽  
Hiv Positive ◽  
Art Initiation ◽  
Primary Health ◽  
Kwazulu Natal

South Africa bears the greatest burden of HIV infection globally with the most infected people living in KwaZulu-Natal (KZN). Decentralised medical care for HIV positive patients and antiretroviral therapy (ART) delivery to primary health care facilities were proposed nationally to achieve adequate ART coverage for patients in need of treatment. This study described the HIV positive patients who accessed medical care and were initiated on ART at two existing government Primary Health Care (PHC) clinics with no added donor support, in Ilembe, KZN. This was an observational descriptive study of ART initiation from 01 April 2008 to 30 April 2009. Data were collected from clinical records kept on site. HIV Testing and the pre-ART programmes which consisted of medical care prior to ART initiation are briefly described. Socio-economic, demographic and clinical characteristics of patients who were initiated on ART were sampled and described. A minority (2.95%) of the study population tested for HIV of which 36.0% tested positive. Majority (60.0%) of patients who joined the pre-ART programme care did not return. The ART sample consisted of 375 patients of whom 65.0% were women, 85.9% were unmarried, 61.6% were unemployed and 50.4% had a secondary level of education. Tuberculosis (TB) prevalence and incidence at ART initiation were 22.1% and 14.7% respectively. The prevalence of Syphilis and Hepatitis B co-infections were 13.1% and 8.6 % respectively. Two thirds of female patients (66.4%) received a Pap smear result of which the majority (62.3%) were abnormal. Uptake for HIV testing followed by relevant CD4 testing was poor. High TB, Hepatitis B and Syphilis co-infection was noted amongst patients initiated on ART. Cervical cancer screening must be intensified. Although ART initiation with no added external resources was successful, record keeping was suboptimal.Suid-Afrika dra die grootste las van MIV-infeksie ter wêreld met die meeste besmette mense in KwaZulu-Natal (KZN). Gedesentraliseerde mediese sorg vir MIV-positiewe pasiënte en dienslewering van antiretrovirale terapie (ART) aan primêre gesondheidsorg- fasiliteite is nasionaal voorgestel om optimale ART-behandeling aan behoeftige te verskaf. Hierdie studie beskryf MIV-positiewe pasiënte wat ART-behandeling ontvang by twee bestaande Primêre Gesondheidsorgklinieke (PGS) in Ilembe, KZN sonder enige bykomende skenkerondersteuning. Waarnemingstegnieke is in die studie gebruik om ART-bekendstelling van 01 April 2008 tot 30 April 2009 te bestudeer. Data van kliniese rekords wat op die perseel gehou is, is ingesamel. MIV-toetsing en mediese behandelingsprogramme voor die bekendstelling van ART word kortliks beskryf. Sosio-ekonomiese, demografiese en kliniese eienskappe van pasiënte wat aan ART bekendgestel is, is versamel en beskryf. Minimum (2.95%) respondente aan die studie is vir MIV getoets, waarvan 36.0% positief getoets het. Die Meerderheid (60.0%) van pasiënte wat by die voorafgaande ART-sorgprogram aangesluit het, het nie terugkeer nie. Die ART-steekproef het bestaan ​​uit 375 pasiënte waarvan 65.0% vroue was, 85.9% was ongetroud, 61.6% was werkloos en 50.4% het ’n sekondêre vlak van onderwys gehad. Die bestaan (reeds onder behandeling) en voorkoms (diagnose tydens bekendstelling van die ART-program) van Tuberkulose (TB) tydens ART-bekendstelling was 22.1% en 14.7% onderskeidelik. Die voorkoms van sifilis- en hepatitis B-infeksies was 13.1% en 8.6% onderskeidelik. Twee derdes van die vroulike pasiënte (66.4%) het ’n Papsmeer ondergaan, waarvan die meerderheid (62.3%) se uitslae abnormaal was. Die begrip vir MIV-toetsing gevolg deur toepaslike CD4-toetsing was swak. Hoë TB-, Hepatitis B- en sifilisinfeksies was by pasiënte aangeteken wat met ART-behandeling begin het. Ondersoeke vir servikale kanker moet verhoog word. Hoewel die ART-bekendstelling met geen toegevoegde eksterne hulpbronne suksesvol was, was rekordhouding nie optimaal nie.

Influence of toilet access on antiretroviral adherence intention among pregnant and breastfeeding women who are HIV-positive and enrolled in Option B+

2020 ◽  
pp. 1-15 ◽  
Author(s):  
Jerry John Nutor ◽  
Jaime C. Slaughter-Acey ◽  
Shannon P. Marquez ◽  
Rose Ann DiMaria-Ghalili ◽  
Florence Momplaisir ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Antiretroviral Adherence
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