Venereology, Volume 2, Issue 1 (March 2023) – 4 articles

School-age youth constitute a neglected but highly vulnerable group concerning sexual health risks in low-resource countries. Robust evidence concerning the research landscape of school-based interventions on human papillomavirus in Africa is currently lacking. Therefore, this systematic scoping review (SSR) aims to map evidence about school-based HPV interventions and identify emerging themes, gaps and lessons learned in Africa. This review was guided by Joanna Brigg’s Institute’s guidelines for SSRs and reported based on the Preferred Reporting Items for Systematic Reviews and Metanalysis for Scoping Reviews. Five databases—PubMed, CINAHL, PsycINFO, SCOPUS, and Allied and Complementary Medicine—were searched for relevant literature using appropriate search terms and Boolean operators. The retrieved literature was extracted, deduplicated and screened using the Rayyan software. Only those articles which met the eligibility criteria were included for data charting, collation, and summarization. Ten articles were included in this review. The articles demonstrate that a life-course approach is significant in health intervention. School-based health interventions help reach adolescents in a dynamic life stage, affecting their vulnerability to sexual health risks. The school-based interventions serve as an ideal platform to offer HPV peer education, improving their HPV knowledge and subsequent testing services and enhancing their acceptability for screening and vaccination. Cervical cancer education and screening can be effectively combined in HPV health services for women. While the studies are geographically diverse, such effective interventions, which help reduce bottlenecks in accessing HPV screening and vaccination, are very few in Africa. In conclusion, school-based intervention is a viable strategy that can be adopted for adolescent protection from HPV-induced diseases. However, the current evidence on the impact of these interventions, particularly HPV vaccination, is inadequate. Full article

Transgender women (TGW) in India, especially those who engage in sex work, are at high risk for HIV. Guided by the information-motivation-behavioral skills model and qualitative formative research findings, Sakhi (girlfriend), a 3-week smartphone-based pilot intervention consisting of short videos (one/week) and text messages (two/week), was implemented using a one-group pre- and post-test design to test its efficacy in promoting condom use and HIV testing among TGW (n = 50) who engage in sex work in Chennai. Changes in outcomes were assessed by conducting multivariable analyses using generalized estimating equations. Participants’ mean age was 26 years, and the mean monthly income was INR 21700 (USD 292). About one-third completed college, and 96% were HIV-negative. Significant changes in the desired direction were observed in the primary outcomes: condom use – decrease in the engagement of condomless anal sex with male partners (12% to 2%, p < 0.05) and HIV testing – increase in intentions to undergo HIV testing every 6 months (34% to 86%, p < 0.001); and in some of the secondary outcomes: decrease in alcohol use before sex, increase in intentions to use condoms consistently and increase in the well-being score. This study demonstrated the feasibility, acceptability, and preliminary efficacy of the Sakhi intervention and warrants a larger randomized trial among diverse subgroups in diverse settings. Full article

Background: Even though highly active antiretroviral therapy (HAART) for HIV (Human Immune Deficiency) patients has considerably improved viral load suppression, more people still struggle to reduce viral loads. The aim of the study was to determine the associated factors of virological failure in HIV patients on antiretroviral therapy (ART) in the Upper East Region of Ghana. Methods: A retrospective cross-sectional study involving 366 participants aged 15 years and above who were on HAART for six (6) months or longer with viral load results in 2020. Bivariate and multiple logistic regression analyses were conducted to identify the determinants of virological failure among HIV patients at 95% confidence interval (C.I.) with a significant level pegged at a p value less than 0.05. Results: The prevalence of viral load failure was 47.0% and adherence to antiretroviral therapy was 62.6% among patients on HAART. The significant predicators of virological failure were basic education (AOR (adjusted odds ratio) = 7.36, 95% C.I = 4.91–59.71), High school/Vocational /Technical education (AOR = 4.70, 95% C.I. = 1.90–9.69), monthly salary/income ˂ GHS 375.00 (AOR = 7.20, 95% C.I. = 1.73–29.95), duration on ART for ˂1 year (AOR = 0.27, 95% C.I. = 0.10–0.75), ART regimen (Tenofovir + Lamivudine + Efavirenz) (AOR = 3.26, 95% C.I. = 1.95–11.25), 3–5 times missed medication per month (AOR = 2.86, 95% C.I. = 1.34–6.08) and ≥6 missed medication per month (AOR = 23.87, 95% C.I. = 10.57–53.92). Conclusion: Educational status, salary/income, ART duration, ART combination regimen, and number of doses missed were statistically significantly associated with virological failure in patients on antiretroviral therapy. The majority of the respondents adhered to ART, which led to moderate viral load suppression but lower than the target for 2020. There is the need to strengthen the ongoing accelerated social behavior change communication among patients on ART to enhance adherence in order to attain the new UNAIDS target of 95% viral load suppression by 2030 in the Upper East Region of Ghana. Full article

Human Immunodeficiency Virus (HIV) is a chronic infectious disease, and without antiretroviral therapy (ART), it is associated with comorbidities. The prevalence of comorbidities, adherence to ART and quality of life (QoL) of HIV patients were studied. A cross-sectional study design involving 360 HIV patients from two ART clinics across the Tamale metropolis was employed. Socio-demography, adherence to therapy, and QoL data were taken with the help of a questionnaire and analyzed using SPSS version 24. The prevalence of comorbidities was 30.3% (109), with Hepatitis B infection (73, 20.3%) being the most prevalent. Adherence levels were high (192, 53.3%), moderate (108, 30.0%) and low (60, 16.7%). Overall, QoL was excellent amongst 149 (41.4%), good in 169 (46.7%), and poor in 42 (11.7%) respondents. Marital status, presence or absence of HIV symptoms, adherence level to ART and overall QoL, especially Physical, Psychological, and independence domains (p < 0.05), were factors associated with the presence of comorbidities. There is a high level of comorbidities among persons living with HIV (PLWH) in the Tamale metropolis influenced by QoL and adherence to ART. We recommend a multifaceted approach to the management of PLWH. Full article