To evaluate the accessibility to a Montreal low-threshold methadone program (Relais-Méthadone). This program is aimed at a marginalized population of heroin addicts who are injection drug users (IDU).
The data (n = 141 clients) were collected during the first year of the program implementation with questionnaires administered by the programme workers.
Analysis of the characteristics of the clients revealed that the program does reach the target population. The program's clientele is characterized by long-time and frequent heroin use, unstable lifestyles, and the presence of numerous behaviours that put them at high risk for HIV transmission. The retention of clients in the program is very high (88%) within the first 30 days.
These results demonstrate the importance and value of flexible intervention programs in reaching a marginalized clientele exposed to the HIV virus, who would not have access to regular programs characterized by restrictive selection criteria and limited availability.
Increasing rates of HIV infection have been found in migrant farmworkers in the USA over the past decade. By virtue of lifestyle, language and culture, these workers are not exposed to the typical media HIV prevention messages. To determine their level of knowledge about this disease for use in prevention messages targeted specifically to this population, five gender specific focus groups were conducted among Haitian, Jamaican and African-American migrant farmworkers in upstate New York. The focus groups revealed that the health belief system of these Afro-American migrant workers primarily reflects that of their indigenous culture. This impacts their interpretation and utilization of risk aversive behaviours. The data also suggest that the culture of migrancy itself affects the extent of risky behaviours practised, but further studies are needed to examine this phenomenon.
OBJECTIVE: To describe trends and patterns in the AIDS epidemic among Scandinavian women with AIDS. SUBJECTS AND METHODS: All women with AIDS reported to national surveillance units in Denmark, Norway and Sweden in 1980-1990 were included for analyses. RESULTS: The number of heterosexually infected female AIDS cases increased over time. AIDS-defining diseases varied with transmission categories, a variation similar to that found among heterosexual Danish male AIDS cases. Heterosexually infected women were more frequently diagnosed with Pneumocystis carinii pneumonia than with oesophagus candidiasis compared with intravenous drug using women. Twenty-five out of 56 heterosexually infected women reported having a male partner who was bisexual or from a Pattern II country, while one in four did not recognize any risk in their sex partner(s). Survival time increased between 1980 and 1990 and did not differ from survival in male AIDS cases. In a proportional hazards model, age, year of diagnosis and the duration of known HIV-positivity before development of AIDS had an independent impact on survival. The number of women known to be HIV-positive for more than 1 year before diagnosis of AIDS increased over time, although the number of women tested for HIV close to the development of AIDS was especially high among heterosexually infected women. CONCLUSION: Increasing numbers of heterosexually infected women are being diagnosed with AIDS in Scandinavia.
On June 19, 1998, Alaskan governor Tony Knowles vetoed legislation that would have made it a felony to knowingly expose a person to HIV. Senate Bill 17 would have made criminal transmission of HIV a Class B felony, carrying a penalty of up to 10 years in prison and a fine up to $50,000. The legislation would have applied to those who knowingly expose others to HIV through sex or needle-sharing without informing their partners. The bill also would have made it illegal for people who know they are HIV positive to donate organs, semen, or ova.
INTRODUCTION: In Denmark assisted reproductive treatment to HIV discordant couples is offered in order to minimize risk of horizontal transmission of virus. MATERIAL AND METHODS: The outcome of 24 HIV-seropositive couples referred with a wish for parenthood to Aarhus University Hospital, Skejby, between September 1999 and December 2007 was reviewed on the basis of prospectively collected data. A total of 18 couples were offered treatment. RESULTS: In all, eight couples achieved 17 pregnancies, six by home-insemination, ten by homologous intrauterine insemination, and one spontaneously. Neither horizontal nor vertical infection occurred. CONCLUSION: Our study confirms that insemination is a good first-choice treatment in respect to chance of pregnancy and risk for virus transmission in HIV-seropositive couples in cases without indication for IVF.
*National HIV and Retrovirology Laboratories, National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, Canada; †Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Alberta, Canada; ‡Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Canada; §Division of Infectious Diseases, Department of Laboratory Medicine and Pathology, University of Alberta and Alberta Health Services, Alberta, Canada; ?Division of Infectious Diseases, Department of Medicine, University of Western Ontario, London, Canada; and ¶Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Canada.
J Acquir Immune Defic Syndr. 2013 Dec 15;64(5):443-7
To examine whether baseline clinical genotypes are equivalent to diagnostic serum genotypes for surveillance of HIV transmitted drug resistance (TDR).
Current HIV TDR surveillance in Canada is conducted through genotyping remnant diagnostic sera from new HIV diagnoses. As part of routine care, baseline genotyping is now conducted on all newly diagnosed HIV infections, with TDR data being generated a second time on the same patients.
Surveillance genotyping, on HIV diagnostic serum, was performed on newly diagnosed HIV cases from 2007 to 2010 in Alberta, Canada. All subjects with a baseline clinical genotype result on file, and no evidence of antiretroviral therapy, were studied further. The HIV sequences from diagnosis and from the first clinical genotype were compared according to elapsed time between testing and by evaluating timing of infection based on BED capture enzyme immunoassay (BED-CEIA, abbreviated as BED in this article).
Eighty-seven genotype pairs were available for analysis, most of which were subtype B. The time between genotypes ranged from 0 to 755 days, with a median of 36 days and an interquartile range of 155.25 days. Genetic distance between genotypes varied between 0 and 0.03389 substitutions per site and did not correlate with sampling times. There was a tendency for the genotypes of infections classified as recent by BED to be more similar to their clinical genotypes but this effect was lost when adjusted for elapsed time between tests. There was no difference in the identified drug resistance.
Baseline clinical genotypes from treatment-naive patients may be used for HIV TDR surveillance.