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Find video protocols related to scientific articles indexed in Pubmed.
Incidence of pregnancy after antiretroviral therapy initiation and associated factors in 8 West African countries.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 09-13-2014
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This study aimed at estimating the incidence of pregnancy after antiretroviral therapy (ART) initiation in 8 West African countries over a 10-year period.
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Acceptabilité du test VIH proposé aux nourrissons dans les services pédiatriques, en Côte d'Ivoire, Significations pour la couverture du diagnostic pédiatrique.
SAHARA J
PUBLISHED: 08-05-2014
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Résumé Problème: Le dépistage VIH chez les enfants a rarement été au centre des préoccupations des chercheurs. Quand le dépistage pédiatrique a retenu l'attention, cela a été pour éclairer seulement sur les performances diagnostiques en ignorant même que le test pédiatrique comme bien d'autres peut s'accepter ou se refuser. Cet article met au cœur de son analyse les raisons qui peuvent expliquer qu'on accepte ou qu'on refuse de faire dépister son enfant. Objectif: Etudier chez les parents, les mères, les facteurs explicatifs de l'acceptabilité du test VIH des nourrissons de moins de six mois. Méthodes: Entretien semi-directif à passages répétés avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pesée/vaccination et les consultations pédiatriques avec proposition systématique d'un test VIH pour leur nourrisson. Résultats: Nous retenons que la réalisation effective du test pédiatrique du VIH chez le nourrisson repose sur trois éléments. Primo, le personnel de santé par son discours (qui dénote de ses connaissances et perceptions même sur l'infection) orienté vers les mères influence leur acceptation ou non du test. Secundo, la mère qui par ses connaissances et perceptions même sur le VIH, dont le statut particulier, l'impression de bien-être chez elle et son enfant influence toute réalisation du test pédiatrique VIH. Tertio, l'environnement conjugal de la mère, particulièrement caractérisé par les rapports au sein du couple, sur la facilité de parler du test VIH et sa réalisation chez les deux parents ou chez la mère seulement sont autant de facteurs qui influencent la réalisation effective du dépistage du VIH chez l'enfant. Le principe préventif du VIH, et le désir de faire tester l'enfant ne suffisent pas à eux seuls pour aboutir à sa réalisation effective, selon certaines mères confrontées au refus du conjoint. A l'opposé, les autres mères refusant la réalisation du test pédiatrique disent s'y opposer ; bien entendu, même dans le cas où le conjoint l'accepterait. Discussion: Les mères sont les principales mises en cause et craignent les réprimandes et la stigmatisation. Le père, le conjoint peut être un obstacle, quand il s'oppose au test VIH du nourrisson, ou devenir le facilitateur de sa réalisation s'il est convaincu. Le positionnement du père demeure donc essentiel dans la question de l'acceptabilité du VIH pédiatrique. Les mères en ont conscience et présagent des difficultés à faire dépister ou non les enfants sans avis préalable du conjoint à la fois père, et chef de famille. Conclusion: La question du dépistage pédiatrique du VIH, au terme de notre analyse, met en face trois éléments qui exigent une gestion globale pour assurer une couverture effective. Ces trois éléments n'existeraient pas sans s'influencer, donc ils sont constamment en interaction et empêchent ou favorisent la réalisation ou non du test pédiatrique. Aussi, dans une intention d'aboutir à une couverture effective du dépistage VIH des nourrissons, faut-il tenir compte d'une gestion harmonieuse de ces trois éléments: La première, la mère seule (avec ses connaissances, ses perceptions), son environnement conjugal (de proposition du test intégrant 1- l'époux et / ou père de l'enfant avec ses perceptions et connaissances sur l'infection 2- la facilité de parler du test et sa réalisation chez les deux ou un des parents, la mère) et les connaissances, attitudes et pratiques du personnel de l'établissement sanitaire sur l'infection du VIH. Recommandations: Nos recommandations proposent une redéfinition de l'approche du VIH/sida vers des familles exposées au VIH et une intégration plus accentuée du père facilitant leur propre acceptation du test VIH et celle de leur enfant.
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Individualizing the WHO HIV and infant feeding guidelines: optimal breastfeeding duration to maximize infant HIV-free survival.
AIDS
PUBLISHED: 07-04-2014
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To determine how infant feeding recommendations can maximize HIV-free survival (HFS) among HIV-exposed, uninfected African infants, balancing risks of breast milk-associated HIV infection with setting-specific risks of illness and death associated with replacement feeding.
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Morbidity and health care resource utilization in HIV-infected children after antiretroviral therapy initiation in Côte d'Ivoire, 2004-2009.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 02-15-2014
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We describe severe morbidity and health care resource utilization (HCRU) among HIV-infected children on antiretroviral therapy (ART) in Abidjan, Côte d'Ivoire.
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Missed Opportunities for Early Access to Care of HIV-Infected Infants in Burkina Faso.
PLoS ONE
PUBLISHED: 01-01-2014
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The World Health Organization (WHO) has recommended a universal antiretroviral therapy (ART) for all HIV-infected children before the age of two since 2010, but this implies an early identification of these infants. We described the Prevention of Mother-to-Child HIV Transmission (PMTCT) cascade, the staffing and the quality of infrastructures in pediatric HIV care facilities, in Ouagadougou, Burkina Faso.
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Antiretroviral treatment response of HIV-infected children after prevention of mother-to-child transmission in West Africa.
J Int AIDS Soc
PUBLISHED: 01-01-2014
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We assessed the rate of treatment failure of HIV-infected children after 12 months on antiretroviral treatment (ART) in the Paediatric IeDEA West African Collaboration according to their perinatal exposure to antiretroviral drugs for preventing mother-to-child transmission (PMTCT).
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Intimate partner sexual and physical violence among women in Togo, West Africa: prevalence, associated factors, and the specific role of HIV infection.
Glob Health Action
PUBLISHED: 01-01-2014
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A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence.
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Reasons for hospitalization in HIV-infected children in West Africa.
J Int AIDS Soc
PUBLISHED: 01-01-2014
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Current knowledge on morbidity and mortality in HIV-infected children comes from data collected in specific research programmes, which may offer a different standard of care compared to routine care. We described hospitalization data within a large observational cohort of HIV-infected children in West Africa (IeDEA West Africa collaboration).
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Anaemia and zidovudine-containing antiretroviral therapy in paediatric antiretroviral programmes in the IeDEA Paediatric West African Database to evaluate AIDS.
J Int AIDS Soc
PUBLISHED: 08-09-2013
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There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART) containing zidovudine (ZDV) recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database.
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Evaluation of dried blood spot diagnosis using HIV1-DNA and HIV1-RNA Biocentric assays in infants in Abidjan, Côte dIvoire. The Pedi-Test DBS ANRS 12183 Study.
J. Virol. Methods
PUBLISHED: 05-13-2013
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This study evaluates HIV infant diagnosis on DBS using Biocentric HIV1-DNA and HIV1-RNA assays, in field conditions in Côte dIvoire. Paediatric screening was offered to children?3 years in clinical sites in Côte dIvoire in 2008. For each HIV-infected child, two non-infected children were included and blood samples were collected. HIV-DNA results obtained on EDTA blood samples with Biocentric assay were the reference for HIV infant diagnosis. Plasma and DBS viral loads were measured using HIV-RNA Biocentric assay. DBS samples were also tested for HIV-DNA detection using both Biocentric and Amplicor Roche assays. Sensitivity, specificity and concordance between tests were calculated. Overall samples from 138 HIV-exposed children, 46 infected, 92 non-infected were included. All tests were 100% sensitive and specific including 100% concordance with the two HIV-DNA assays. The median level of HIV-DNA on EDTA samples was 3.15 log10 copies/10(6) PBMCs; the median level of HIV RNA in plasma and DBS were respectively 5.82 and 5.17 log10 copies/ml (Pearsons correlation R2=0.92, p<0.0001). The threshold for detectable HIV-RNA on DBS was 3.3 log10. Although there are differences between viral load measured on DBS and plasma, the two Biocentric assays present very good performances for HIV infant diagnosis on DBS while cheap and feasible.
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Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children.
BMC Pediatr
PUBLISHED: 04-26-2013
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Early detection of abused children could help decrease mortality and morbidity related to this major public health problem. Several authors have proposed tools to screen for child maltreatment. The aim of this systematic review was to examine the evidence on accuracy of tools proposed to identify abused children before their death and assess if any were adapted to screening.
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Pulmonary outcome and its correlates in school-aged children born with a gestational age ? 32 weeks.
Respir Med
PUBLISHED: 04-05-2013
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There is limited data regarding factors influencing the respiratory outcome at school age of ex-preterms born since the introduction of antenatal steroids, surfactant replacement together with less aggressive ventilation.
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Outcomes of antiretroviral therapy in children in Asia and Africa: a comparative analysis of the IeDEA pediatric multiregional collaboration.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 03-09-2013
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We investigated 18-month incidence and determinants of death and loss to follow-up of children after antiretroviral therapy (ART) initiation in a multiregional collaboration in lower-income countries.
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Health care resource utilization in untreated HIV-infected children in a pediatric programme, Abidjan, Côte dIvoire, 2004-2009.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 02-27-2013
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We describe health care resource utilization among HIV-1-infected children who have not yet undergone antiretroviral treatment (ART) in Abidjan, Côte dIvoire.
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Validation and Calibration of a Computer Simulation Model of Pediatric HIV Infection.
PLoS ONE
PUBLISHED: 01-01-2013
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Computer simulation models can project long-term patient outcomes and inform health policy. We internally validated and then calibrated a model of HIV disease in children before initiation of antiretroviral therapy to provide a framework against which to compare the impact of pediatric HIV treatment strategies.
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Universal HIV screening at postnatal points of care: which public health approach for early infant diagnosis in Côte dIvoire?
PLoS ONE
PUBLISHED: 01-01-2013
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Universal HIV pediatric screening offered at postnatal points of care (PPOC) is an entry point for early infant diagnosis (EID). We assessed the parents acceptability of this approach in Abidjan, Côte dIvoire.
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Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.
Didier K Ekouevi, Eric Balestre, Patrick A Coffie, Daouda Minta, Eugène Messou, Adrien Sawadogo, Albert Minga, Papa Salif Sow, Emmanuel Bissagnéné, Serge P Eholie, Geoffrey S Gottlieb, Francois Dabis, , Djimon Marcel Zannou, Carin Ahouada, Jocelyn Akakpo, Christelle Ahomadegbé, Jules Bashi, Alice Gougounon-Houéto, Angèle Azon-Kouanou, Fabien Houngbe, Sikiratou Koumakpaï, Florence Alihonou, Marcelline d'Almeida, Irvine Hodonou, Ghislaine Hounhoui, Gracien Sagbo, Leïla Tossa-Bagnan, Herman Adjide, Joseph Drabo, René Bognounou, Arnaud Dienderé, Eliezer Traore, Lassané Zoungrana, Béatrice Zerbo, Adrien Bruno Sawadogo, Jacques Zoungrana, Arsène Hema, Ibrahim Soré, Guillaume Bado, Achille Tapsoba, Diarra Ye, Fla Koueta, Sylvie Ouedraogo, Rasmata Ouédraogo, William Hiembo, Mady Gansonré, Joachim Charles Gnokoro, Mamadou Koné, Guillaume Martial Kouakou, Clarisse Amani Bosse, Kouakou Brou, Achi Isidore Assi, Henri Chenal, Denise Hawerlander, Franck Soppi, Yao Abo, Germain Bomisso, Serge Paul Eholié, Mensah Deborah Noelly Amego, Viviane Andavi, Zelica Diallo, Frédéric Ello, Aristophane Koffi Tanon, Serge Olivier Koule, Koffi Charles Anzan, Calixte Guehi, Edmond Addi Aka, Koffi Ladji Issouf, Jean-Claude Kouakou, Marie-Sylvie N'gbeche, Pety Touré, Divine Avit-Edi, Kouadio Kouakou, Magloire Moh, Valérie Andoblé Yao, Madeleine Amorissani Folquet, Marie-Evelyne Dainguy, Cyrille Kouakou, Véronique Tanoh Méa-Assande, Gladys Oka-Berete, Nathalie Zobo, Patrick Acquah, Marie-Berthe Kokora, Tanoh François Eboua, Marguerite Timite-Konan, Lucrèce Diecket Ahoussou, Julie Kebé Assouan, Mabéa Flora Sami, Clémence Kouadio, Lorna Renner, Bamenla Goka, Jennifer Welbeck, Adziri Sackey, Seth Ntiri Owiafe, Christian Wejse, Zacarias José da Silva, Joao Paulo, Amabelia Rodrigues, David Da Silva, Candida Medina, Ines Oliviera-Souto, Lars Ostergaard, Alex Laursen, Morten Sodemann, Peter Aaby, Anders Fomsgaard, Christian Erikstrup, Jesper Eugen-Olsen, Moussa Y Maiga, Fatoumata Fofana Diakité, Abdoulaye Kalle, Drissa Katile, Hamar Alassane Traore, Tidiani Cissé, Mamadou Dembele, Mohammed Doumbia, Mahamadou Fomba, Assétou Soukho Kaya, Abdoulaye M Traoré, Hamady Traoré, Amadou Abathina Toure, Fatoumata Dicko, Mariam Sylla, Alima Berthé, Hadizatou Coulibaly Traoré, Anta Koïta, Niaboula Koné, Clémentine N'diaye, Safiatou Touré Coulibaly, Mamadou Traoré, Naïchata Traoré, Man Charurat, Samuel Ajayi, Stephen Dapiap, Otu, Festus Igbinoba, Okwara Benson, Clement Adebamowo, Jesse James, Obaseki, Philip Osakede, John Olasode, Bernard Diop, Noël Magloire Manga, Judicael Malick Tine, Haby Signate Sy, Abou Ba, Aida Diagne, Hélène Dior, Malick Faye, Ramatoulaye Diagne Gueye, Aminata Diack Mbaye, Akessiwe Patassi, Awerou Kotosso, Benjamin Goilibe Kariyare, Gafarou Gbadamassi, Agbo Komi, Kankoé Edem Mensah-Zukong, Pinuwe Pakpame, Annette Koko Lawson-Evi, Yawo Atakouma, Elom Takassi, Améyo Djeha, Ayoko Ephoévi-Gah, Sherifa El-Hadj Djibril, Elise Arrivé, Patrick Coffie, Didier Ekouévi, Antoine Jaquet, Valériane Leroy, Charlotte Lewden, Annie Sasco, Jean-Claude Azani, Gérard Allou, Franck Bohossou, Sophie Karcher, Jules Mahan Gonsan, Jérôme Le Carrou, Severin Lenaud, Célestin Nchot, Karen Malateste, Amon Roseamonde Yao, Bertine Siloué, Gwenaelle Clouet, Hugues Djetouan, Alexandra Doring, Adrienne Kouakou, Elodie Rabourdin, Jean Rivenc, Xavier Anglaret, Boubacar Ba, Jean Bosco Essanin, Andrea Ciaranello, Sébastien Datté, Sophie Desmonde, Jean-Serge Elvis Diby, Apollinaire Gninlgninrin Horo, Serge N'zoré Kangah, Denis Malvy, David Meless, Aida Mounkaila-Harouna, Camille Ndondoki, Caroline Shiboski, Rodolphe Thiébaut, Pac-Ci, Abidjan.
PLoS ONE
PUBLISHED: 01-01-2013
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HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).
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Residual HIV-1 RNA and HIV-1 DNA production in the genital tract reservoir of women treated with HAART: the prospective ANRS EP24 GYNODYN study.
Antivir. Ther. (Lond.)
PUBLISHED: 09-09-2011
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The female genital tract constitutes a reservoir for HIV providing active production of both cell-free HIV RNA and cell-associated DNA within the cervicovaginal secretions. The objective of this study was to prospectively assess residual HIV-1 RNA and HIV-1 DNA production in the genital tract reservoir of women initiating HAART over an 18-month period.
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Attitudes and practices of health care workers toward routine HIV testing of infants in Côte dIvoire: the PEDI-TEST ANRS 12165 Project.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 08-23-2011
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We assessed attitudes and practices of health care workers (HCWs) toward HIV counselling and testing (CT) routinely offered to infants in health facilities in Abidjan, Côte dIvoire.
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12-month mortality and loss-to-program in antiretroviral-treated children: The IeDEA pediatric West African Database to evaluate AIDS (pWADA), 2000-2008.
BMC Public Health
PUBLISHED: 06-30-2011
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The IeDEA West Africa Pediatric Working Group (pWADA) was established in January 2007 to study the care and treatment of HIV-infected children in this region. We describe here the characteristics at antiretroviral treatment (ART) initiation and study the 12-month mortality and loss-to-program of HIV-infected children followed in ART programs in West Africa.
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Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte dIvoire, 2004-2009.
BMC Infect. Dis.
PUBLISHED: 06-23-2011
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Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART) is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children.
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Early infant HIV-1 diagnosis programs in resource-limited settings: opportunities for improved outcomes and more cost-effective interventions.
BMC Med
PUBLISHED: 03-15-2011
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Early infant diagnosis (EID) of HIV-1 infection confers substantial benefits to HIV-infected and HIV-uninfected infants, to their families, and to programs providing prevention of mother-to-child transmission (PMTCT) services, but has been challenging to implement in resource-limited settings. In order to correctly inform parents/caregivers of infant infection status and link HIV-infected infants to care and treatment, a cascade of events must successfully occur. A frequently cited barrier to expansion of EID programs is the cost of the required laboratory assays. However, substantial implementation barriers, as well as personnel and infrastructure requirements, exist at each step in the cascade. In this update, we review challenges to uptake at each step in the EID cascade, highlighting that even with the highest reported levels of uptake, nearly half of HIV-infected infants may not complete the cascade successfully. We next synthesize the available literature about the costs and cost effectiveness of EID programs; identify areas for future research; and place these findings within the context of the benefits and challenges to EID implementation in resource-limited settings.
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[Survival, clinical and biological outcomes of HIV-infected children treated by antiretroviral therapy in Africa: systematic review, 2004-2009].
Presse Med
PUBLISHED: 02-03-2011
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With 2.1 million HIV-infected children in 2008 in the world, especially in sub-Saharan Africa, the paediatric HIV/AIDS care remains an important public health challenge and is principally based on cotrimoxazole prophylaxis and antiretroviral treatments. This paper aims to review the effectiveness of cotrimoxole prophylaxis and antiretroviral treatment in HIV-infected children in Africa, specifically mortality and treatment outcomes.
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Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa.
Int J Epidemiol
PUBLISHED: 01-18-2011
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Previously, HIV epidemic models have used a double Weibull curve to represent high initial and late mortality of HIV-infected children, without distinguishing timing of infection (peri- or post-natally). With more data on timing of infection, which may be associated with disease progression, a separate representation of children infected early and late was proposed.
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Immunological response to highly active antiretroviral therapy following treatment for prevention of mother to child transmission of HIV-1: a study in Côte dIvoire.
J Int AIDS Soc
PUBLISHED: 08-02-2010
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Information is currently limited on the long-term follow up of HIV-1 infected women who are on highly active antiretroviral therapy (HAART) that contains nevirapine and lamivudine and who were previously exposed to antiretroviral drugs for the prevention of mother to child transmission (PMTCT) of HIV.
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Universal antiretroviral therapy for pregnant and breast-feeding HIV-1-infected women: towards the elimination of mother-to-child transmission of HIV-1 in resource-limited settings.
Clin. Infect. Dis.
PUBLISHED: 11-18-2009
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Prevention of mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) remains a challenge in most resource-limited settings, particularly in Africa. Single-dose and short-course antiretroviral (ARV) regimens are only partially effective and have failed to achieve wide coverage despite their apparent simplicity. More potent ARV combinations are restricted to pregnant women who need treatment for themselves and are also infrequently used. Furthermore, postnatal transmission via breast-feeding is a serious additional threat. Modifications of infant feeding practices aim to reduce HIV-1 transmission through breast milk; replacement feeding is neither affordable nor safe for the majority of African women, and early breast-feeding cessation (eg, prior to 6 months of life) requires substantial care and nutritional counseling to be practiced safely. The recent roll out of ARV treatment has changed the paradigm of prevention of MTCT. To date, postnatal ARV interventions that have been evaluated target either maternal ARV treatment to selected breast-feeding women, with good efficacy, or single-drug postexposure prophylaxis for short periods of time to their neonates, with a partial efficacy and at the expense of acquisition of drug-related viral resistance. We hypothesize that a viable solution to eliminate pediatric AIDS lies in the universal provision of fully suppressive ARV regimens to all HIV-1-infected women through pregnancy, delivery, and the entire breast-feeding period. On the basis of available evidence, we suggest translating into practice the recently available evidence on this matter without any further delay.
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Beneficial effects of offering prenatal HIV counselling and testing on developing a HIV preventive attitude among couples. Abidjan, 2002-2005.
AIDS Behav
PUBLISHED: 09-24-2009
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Prenatal HIV counselling and testing is mainly an entry-point to the prevention of mother-to-child transmission of HIV, but it may also play an important role in triggering the development of spousal communication about HIV and sexual risks and thus the adoption of a preventive attitude. In Abidjan, Côte dIvoire, we investigated couple communication on STIs and HIV, male partner HIV-testing and condom use at sex resumption after delivery among three groups of pregnant women who were offered prenatal counselling and HIV testing: HIV-infected women, uninfected women, and women who refused HIV-testing. The proportion of women who discussed STIs with their regular partner greatly increased after prenatal HIV counselling and testing in all three groups, irrespective of the womens serostatus and even in the case of test refusal. Spousal communication was related to more frequent male partner HIV-testing and condom use. Prenatal HIV counselling and testing proposal appears to be an efficient tool to sensitize women and their partner to safer sexual practices.
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Couples, PMTCT programs and infant feeding decision-making in Ivory Coast.
Soc Sci Med
PUBLISHED: 07-06-2009
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In Sub-Saharan Africa, prevention of HIV pediatric infection due to breastfeeding requires turning to alternatives to prolonged breastfeeding: artificial feeding or exclusive breastfeeding with early weaning. Choosing a preventive option and applying it does not only depend upon the mother but also on the father and more specifically on couple interactions. To date, not enough studies have considered this question. In Abidjan, Ivory Coast, HIV-positive women and their infants were followed over two years in Ditrame Plus, a prevention of mother-to-child transmission (PMTCT) project. Using data from this project and from interviews conducted with couples and women, we analyzed the construction of decisions and practices concerning the application of preventive infant feeding options. Differences may be found between women and men in discourses regarding their attitudes, which are in part related to their conceptions of motherhood and fatherhood. We found that when men know their wife is HIV positive and are involved in the PMTCT project, they play an active role in applying the advice received. However, women do not always need the support of their spouse to undertake preventative behaviour. The project team also plays an important role in the adoption of such by women and men. The implementation of preventive options is a complex process in which three groups of actors (women, men and the project team) interact. In order to optimize PMTCT programs for couples, it is essential that this dynamic be taken into account.
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Duration, pattern of breastfeeding and postnatal transmission of HIV: pooled analysis of individual data from West and South African cohorts.
PLoS ONE
PUBLISHED: 06-26-2009
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Both breastfeeding pattern and duration are associated with postnatal HIV acquisition; their relative contribution has not been reliably quantified.
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From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple.
Soc Sci Med
PUBLISHED: 06-22-2009
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The first step in preventing mother-to-child HIV transmission (PMTCT) programmes is offering HIV counselling and testing to pregnant women. In developing countries where HIV testing remains rare, it represents a unique opportunity for many women to learn their HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks. Here we explore if these women, HIV-tested as mothers, apply the prevention recommendations they also receive as women. In the Ditrame Plus PMTCT program in Abidjan, Côte dIvoire, two cohorts of women (475 HIV-infected women and 400 HIV-negative women) were followed up two years after the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women who communicated with their regular partner on sexual risks, prior to and after prenatal HIV testing. We analysed socio-demographic factors related to this communication. We measured two potential conjugal outcomes of women HIV testing: the level of condom use at sex resumption after delivery and the risk of union break-up. Prenatal HIV testing increased conjugal communication regarding sexual risks, whatever the womans serostatus. This communication was less frequent for women in a polygamous union or not residing with their partner. Around 30% of women systematically used condoms at sex resumption. Among HIV infected ones, conjugal talk on sexual risks was related to improved condom use. After HIV testing, more HIV-infected women separated from their partners than HIV-uninfected women, despite very few negative reactions from the notified partners. In conclusion, offering prenatal HIV counselling and testing is an efficient tool for sensitizing women and their partners to HIV prevention. But sexual prevention in a conjugal context remains difficult and need to be specifically addressed.
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HIV status disclosure and retention in care in HIV-infected adolescents on antiretroviral therapy (ART) in West Africa.
PLoS ONE
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We assessed the effect of HIV status disclosure on retention in care from initiation of antiretroviral therapy (ART) among HIV-infected children aged 10 years or more in Cote dIvoire, Mali and Sénégal.
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Children who acquire HIV infection perinatally are at higher risk of early death than those acquiring infection through breastmilk: a meta-analysis.
PLoS ONE
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Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally) are thus needed.
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Altered vaginal microbiota are associated with perinatal mother-to-child transmission of HIV in African women from Burkina Faso.
J. Acquir. Immune Defic. Syndr.
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Mother-to-child transmission (MTCT) of HIV remains a significant problem in resource-limited settings, despite the advent of antiretroviral therapies. Because perturbations in vaginal microbial communities are associated with sexual transmission of HIV, we determined whether perinatal MTCT is associated with the vaginal microbiotas of HIV-infected mothers.
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